女性原发性骨质疏松患病率及易患因素的初步研究

随着人口老龄化的加快，骨质疏松症发病率日益增加。原发性骨质疏松症已越来越引起人们的重视，尤以中老年妇女为突出。我科对西安市24～86岁妇女482例进行双能X线骨密度测量，通过对年龄、身高、体重、绝经时限、症状、职业与原发性骨质疏松（POP）患病率的关系进行分析，同时探讨POP的易患因素。报告如下。     

仙灵骨葆对原发性骨质疏松症骨矿密度的影响

随着国内人口日趋老龄化,老年原发性骨质疏松症(P O P),发病率呈逐年上升趋势。目前,治疗方法甚多,疗效不一。认为钙质与维生素D缺乏是导致POP骨矿密度降低的主要因素,骨矿含量是评价POP的重要标志。自2001年4月～2003年1月,我们应用仙灵骨葆治疗POP100例,对其治疗前后BMD、血清Ca、P及AKP进行了检测,获得良好效果,现总结如下。1资料与方法1.1临床资料依据刘忠厚教授制定的国人原发性骨质疏松症诊断标准,明确诊断并排除其他疾病所致骨量减少和骨质疏松症的患者200例,根据就诊时间,随机分为治疗组100例,其中男40例,女60例;65～81岁,…     

原发性老年人骨质疏松症骨折发病特点及治疗策略

原发性老年人骨质疏松症概述 原发性骨质疏松症是老年人,．尤其是绝经后妇女的常见骨骼系统疾病,以骨量减少和正常骨微结构破坏为特征,骨脆性增加,易导致骨折。随着全球人口的老龄化,骨质疏松症的发病率逐渐增加。由于我国人口基数大,以及老龄化社会的到来,骨质疏松症的危害正目趋显著。     

女性原发性骨质疏松症的病因和检查方法

骨质疏松症是以骨量减少、骨的微观结构退化及骨脆性增加的一种全身性骨骼疾病。原发性骨质疏松症分Ⅰ型绝经后骨质疏松症和Ⅱ型老年性骨质疏松症,其症状不典型,早期无症状,尚未有特效治疗,对已发生严重骨质疏松的骨不能完全恢复正常,因此对高危人群应早期预防及诊断,减少骨质疏松的发病率及降低骨质疏松性骨折发生率。     

骨质疏松症药物治疗的研究进展

骨质疏松症(osteopomsis，OP)是以骨量减少及骨组织微结构退变为特征的一种全身性骨骼疾病。伴有骨脆性增加，易于发生骨折。骨质疏松症可分为原发性、继发性和特发性三大类。其中，原发性骨质疏松症约占骨质疏松症的90％，它又可分为两型：Ⅰ型为绝经后骨质疏松症，Ⅱ型为老年性骨质疏松症。目前，随着人口老龄化日趋明显，骨质疏松症的发病率已位居全球常见病的第7位，由骨质疏松所致的骨痛和骨折可直接影响中老年人的生存质量。近年来，随着对其病因、发病机制及分子生物学的深入研究，骨质疏松症治疗的药物研究有了很大进展，主要可分为骨吸收抑制剂和骨形成促进剂两大类。     

骨灵丸对抗维甲酸致骨质疏松作用的实验研究

目的用中药骨灵丸进行防治原发性骨质疏松症（POP）的动物实验研究,以观察骨灵丸防治POP疗效并探讨其主要作用机理。方法以维甲酸制作POP大鼠模型,观测骨密度、血生化指标、骨生物力学、骨组织形态计量学指标。结果大鼠灌服维甲酸后出现高转换型骨质疏松,而骨灵丸能够有效对抗模型大鼠出现的骨丢失,维护骨强度,保持骨生物力学性能。结论骨灵丸可防止POP模型鼠骨丢失,有效地维持其骨密度,其作用可能通过影响垂体一下丘脑一性腺轴和域影响成骨细胞（OB）活性、抑制破骨细胞（OC）活性等途径实现,其防治机制,值得深入研究。     

原发性骨质疏松症中医证型分布及其相关研究概述

原发性骨质疏松症（POP）多见于中老年人群体，临床常见中医证型有肝肾阴虚证、脾肾阳虚证、气滞血瘀证及肾虚兼血瘀证等。梳理近年来POP中医证型与相关指征研究发现，其证型分布与中医体质、骨密度、骨代谢等相关生化指标、细胞、基因、脆性骨折、性别及年龄、握力等不同指征皆具有相关性，此为进一步临床辨证治疗该病提供了理论参考。参考文献35篇。     

原发性骨质疏松症的预防和治疗

骨质疏松症是以骨量降低、骨微结构破坏、骨脆性增加、骨强度下降、骨折风险性增大为特征的全身性、代谢性骨骼系统疾病,可分为原发性骨质疏松症和继发性骨质疏松症。原发性骨质疏松症分为绝经后骨质疏松症（I型）和老年性骨质疏松症（Ⅱ型）。     

中西医对原发性骨质疏松症的认识与防治进展

原发性骨质疏松症是以骨量减少、骨的微观结构退化为特征,骨脆性增加以及易于发生骨折的一种常见的全身性、代谢性疾病。随着人口结构老龄化,骨质疏松患病率日益上升。现将近年来中西医对原发性骨质疏松症的认识与防治研究综述如下。     

补肾中药组方对去卵巢大鼠骨质疏松症的防治效果及机制

目的 建立原发性骨质疏松症(POP)动物模型，研究不同剂量补肾中药组方对去卵巢大鼠(OVX)骨质疏松的防治效果及其影响机制，为防治骨质疏松症(OP)提供安全、有效且经济的药物。方法 (1)经过药物筛选和专家咨询制定补肾中药组方；(2)通过卵巢摘除建立POP，并通过病理检查和骨密度测定来判定模型建立；(3)研究补肾中药不同剂量对去卵巢大鼠OP的防治效果(测定其对骨密度、骨微结构     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.