大豆异黄酮对模拟失重雌性大鼠骨丢失的影响

目的 研究大豆异黄酮对模拟失重雌性大鼠骨丢失的影响.方法 24只雌性SD大鼠随机分为3组（每组8只）,FC组：自由活动对照组（饲普通饲料）;SC组：模拟失重对照组（饲普通饲料）;SS组：模拟失重大豆异黄酮组（饲普通饲料＋大豆异黄酮）,实验期为21 d.结果 1）SC组大鼠股骨的骨密度（BMD）与生物力学参数最大载荷、弹性载荷、弹性能量吸收、最大应力及弹性应力的水平均显著低于FC组大鼠（P〈0.05）;而SS组大鼠股骨的BMD与生物力学参数最大载荷、弹性载荷、弹性能量吸收、最大应力及弹性应力的水平均显著高于SC组大鼠（P〈0.05）.2）SC组大鼠血清中的碱性磷酸酶（AKP）、骨钙素（BGP）、雌二醇（E2）的水平均显著低于FC组,而血钙水平显著高于FC组（P〈0.05）;SS组大鼠血清中的AKP、BGP、E2的水平均显著高于SC组,而血钙显著低于SC组（P〈0.05）.结论 大豆异黄酮可以促进模拟失重雌性大鼠的骨形成,减少骨丢失,改善骨质量,这可能是大豆异黄酮的类雌激素作用所致.     

阿仑膦酸钠对绝经后骨质疏松症患者骨密度及血清碱性磷酸酶、骨钙素的影响

目的:探讨阿仑膦酸钠对绝经后骨质疏松症患者骨密度(BMD)及血清碱性磷酸酶(ALP)、骨钙素(BGP)的影响。方法:62例绝经后骨质疏松症患者随机分为2组,治疗组32例,对照组30例。治疗组口服阿仑膦酸钠、阿法迪三;对照组口服阿法迪三。分别于治疗前、治疗6个月、治疗12个月双能X线骨密度仪测定患者正位腰椎(L 2～4)、髋部股骨颈(Neck)、大转子(Troch)和Ward’s三角区BMD,全自动生物分析仪测定血清ALP和BGP含量。结果:治疗组治疗6个月、12个月血清ALP和BGP含量与对照组比较有明显差异(P<0.01)。治疗组,治疗12个月后L1-4和髋部(Neck,Troch,Ward’s)BMD值与治疗前比较显著增加(P<0.01)。治疗组与对照组比较L1-4和全髋部BMD值明显差异(P<0.01)。结论:阿仑膦酸钠能有效阻止绝经后骨矿丢失,降低血清ALP含量和提高血清BGP含量。     

绝经后妇女雌激素缺乏与糖代谢关系的研究

目的：探讨绝经后妇女性激素变化与糖代谢的关系。方法：测定15例绝经前健康育龄行经妇女（A组）及23例绝经后健康妇女（B组）的雌二醇（E2），促卵泡刺激素（FSH），促黄体生成素（LH），睾酮（T）及血糖（G），胰岛素（INS）并计算胰岛素敏感指数（ISI），结果。绝经后妇女E2，ISI较绝经前妇女明显降低，而G及INS水平明显升高，线性相关分析显示，绝经后妇女E2与ISI呈显正相关，而与G，INS呈显负相关。结论：绝经后妇女存在胰岛素抵抗和糖耐量减退，而雌激素水平降低是导致其产生的原因之一。     

绝经对人单核细胞趋化因子受体CXCR2的影响

为探讨绝经对雌激素对外周血单核细胞趋化因子受体CXCR2水平的影响,选择21例绝经后妇女,20例绝经前妇女,抽空腹静脉血,以放免法测定雌激素、明胶法分离外周血单核细胞、流式细胞仪测定单核细胞趋化因子受体CXCR2的蛋白表达和半定量PCR测定其mRNA水平。结果发现,绝经后妇女雌激素水平下降,而CXCR2蛋白表达及mRNA水平均升高,雌激素水平与CXCR2表达呈负相关。提示雌激素下降所致绝经后的冠心病危险增加可能部分是由于CXCR2的影响。     

老年绝经后妇女血脂和雌激素与冠心病关系

目的:探讨老年绝经后妇女雌激素、血脂在冠心病发病中的作用。方法:对老年绝经后妇女49例冠心 病组与59例正常组雌激素水平和血脂水平进行测定。结果:老年绝经后妇女冠心病组较正常组雌激素水平 明显降低(P<0．01),TC、TG、LDL-C明显升高,HDL-C降低均呈显著性差异(P<0．01)。结论:老年绝经 后妇女雌激素水平下降,血脂代谢异常,增加了冠心病的发病率。     

HMG-COA还原酶抑制剂对2型糖尿病患者骨密度的影响

目的探讨HMG-COA还原酶抑制剂对2型糖尿病（diabetes mellitus,DM）患者骨密度（bone mineral density,BMD）的影响。方法 2型DM患者156例,治疗组87例为高胆固醇血症且服用他汀类降脂药物患者。对照组69例为血浆胆固醇水平正常的2型DM患者。两组年龄、性别、体重、绝经情况和空腹血糖水平相匹配。14月后用超声骨密度测定仪测定跟骨骨密度,比较两组患者BMD随访前后变化。结果 14月后与对照组比较,治疗组的BMD明显升高（P〈0.05）。结论 HMG-COA还原酶抑制剂可增加2型糖尿病患者的骨密度。     

中西医结合治疗高原地区卵巢早衰67例疗效观察

目的：观察中草药二仙汤加味联合雌激素替代治疗高原地区妇女卵巢早衰（POF）的疗效。方法：选择符合诊断标准的POF患者67例,分治疗组和对照组,治疗组给予二仙汤加味联合激素替代治疗,对照组单纯给与激素替代治疗,疗程为3个月。两组治疗前后均观察症状改善情况和药物副反应,同时测定血清生殖激素（FSH、LH、E2）水平。结果：治疗组症状改善明显优于对照组（P〈0.01）;两组血清FSH、LH治疗后明显低于治疗前,E治疗后明显高于治疗前;两组治疗后3种血清生殖激素水平均无显著性差异,两组治疗中均未发现明显的不良反应。结论：二仙汤加味对高原POF患者的甚至激素水平影响不大,但中西医结合治疗可达到西药补充性激素,中药进行有效全身调节的目的,副反应小,患者依从性好,效果理想。     

芳香化酶抑制剂对绝经后乳腺癌患者的骨量影响

目的探讨芳香化酶抑制剂治疗对绝经后乳腺癌患者骨密度的影响。方法采用法国CHALLENGER公司双能X线骨密度仪,测定47例应用芳香化酶抑制剂治疗和47例同年龄段非芳香化酶抑制剂治疗乳腺癌患者的腰椎（L2～4）及左髋部骨密度值。结果治疗组腰椎骨密度（BMD）较对照组明显降低,具有极显著性差异（P〈0．01）;左侧整体髋BMD也较对照组降低,两组有显著差异（P〈0．05）。两组患者骨量减少的发生率均占绝大多数,其次为骨质疏松的发生率。治疗组患者骨量减少和骨质疏松的发生率均高于对照组．但差异无显著性意义（P〉0．05）。结论绝经后乳腺癌患者不同程度存在骨量减少和骨质疏松,芳香化酶抑制剂治疗可使乳腺癌患者BMD明显下降,对接受芳香化酶抑制剂治疗的乳腺癌患者,定期监测BMD和适当采用预防性骨质疏松治疗是非常必要的。     

绝经后妇女骨关节炎、骨质疏松的性激素与细胞因子的变化

目的：探讨绝经后妇女骨关节炎（OA）、骨质疏松（OP）患者性激素与细胞因子血浆水平的变化;讨论绝经后妇女OA、OP的相关细胞因子,寻找这两种疾病重要的生物学指标。方法：设立病例对照组,病例组：OA组（32例绝经后OA患者）,OP组（30例绝经后OP患者）;对照组（30例绝经后健康体检者）,检测92例受检者的雌二醇（E2）、睾酮（T）、促卵泡刺激素（FSH）、黄体生成素（LH）、白介素-6（IL-6）、白介素-10（IL-10）、金属蛋白酶（MMF）等的血浆水平,并进行相关性分析。结果：性激素E2、T、FSH和LH与绝经后妇女OA、OP呈负相关性;OA组患者血浆IL-10水平降低,血浆MMP水平增高,较对照组、OP组有显著性差异（P〈0.05）;而OP组的血浆IL-6水平较对照组、0A组增高,有显著性差异（P〈0.05）。结论：提示性激素不平衡是绝经后OA、OP的发病共同因素之一;血浆IL-10、MMP可能是绝经后OA发病过程中较重要的生物学指标,IL-6可能是绝经后OP发病过程中较重要的生物学指标。     

甲亢^131I治疗前后骨密度及相关指标变化分析

目的探讨^131I治疗甲状腺功能亢进（简称甲亢）对骨代谢的影响。方法58例甲亢患者治疗前、治疗后3及6个月分别检测其血清TT3、TT4、sTSH、骨钙素（BGP）、甲状旁腺素（PTH）和降钙素（CT）浓度，用全自动生化仪测定血清碱性磷酸酶（ALP）、血清钙（Ca）和无机磷（P）的含量，治疗前后均采用双能X线检测其前臂、腰椎（L2-L4）及股骨上段的骨密度（BMD）值。结果①甲亢^131I治疗后6个月（除无效组外）与治疗前及治疗后各组与无效组的各部位平均BMD值比较差异有显著性（P〈0.05）；②甲亢^131I治疗后6个月BGP、CT、CT／PTH比值、ALP和Ca与治疗前及治疗后各组与无效组比较差异有显著性（P〈0.01或P〈0.05）；③治疗前血清TT3，水平与血清BGP呈正相关（r=0．4113，t=2.9896，P〈0.005）；血清Ca与TT3水平及CT／PTH比值呈正相关（r值分别为0.3613和0．3915，t值分别为2.6836和2.9639，P〈0.01和〈0.005）。结论^131I治疗甲亢患者能使其骨代谢指标在短时间里有较好恢复。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.