肠道菌群与骨量变化的研究进展

肠道菌群的丰度与多样性的改变与机体的骨量变化关系密切。肠道菌群主要通过其代谢产物与自身的微生物相关分子模式参与宿主生理调节,通过免疫反应、内分泌作用与营养物质吸收等途径对骨骼生长代谢进行调节。补充益生菌或菌群移植等治疗方法能够调节骨转换因子表达与机体钙吸收水平从而改善骨代谢。该文就肠道菌群与骨量变化的研究进展进行综述。     

双膦酸盐在骨科相关疾病治疗中的地位及再认识

 双膦酸盐是目前临床上治疗骨质疏松症的首选药物, 它能够靶向性地沉积在骨骼中,紧密吸附在骨的羟基磷灰石表面,与之结合并选择性聚积在破骨细胞周围;同时能够有效抑制破骨细胞活性及对骨质的吸收,通过预防骨丢失、提高骨质量以降低骨折风险。迄今为止,双膦酸盐类药物已经研究发展到第三代。第一代双膦酸盐为不含氮的双膦酸盐, 代表药物为羟乙膦酸钠,其分子结构中侧链是直链烃,药物活性和结合力相对较弱,有抑制骨钙化,干扰骨形成,导致骨 软化或诱发骨折的可能,且胃肠道不良反应大。第二代双膦 酸盐药物结构中的侧链引入了氨基称为氨基双膦酸盐,代表药物为帕米膦酸钠和阿仑膦酸钠,其药物活性和结合力比羟乙膦酸钠增加10～100倍,对骨的钙化作用干扰小,选择性强。而第三代双膦酸盐为具有杂环结构的含氮双膦酸盐,如利塞膦酸钠、唑来膦酸等,鉴于其强效、低剂量、使用方便等特点,被认为是具有更强的临床疗效且适应证更加广泛的抗骨吸收药物。目前,双膦酸盐已经广泛用于原发性骨质疏松症、继发性骨质疏松症(如糖皮质激素引起的骨质疏松)以及骨质疏松性骨折的预防及治疗。随着临床应用的深入推广, 越来越多的临床医生和研究人员发现,双膦酸盐除适用于上述疾病外,在关节置换术、脊柱融合术、骨坏死、骨关节炎、软骨损伤的治疗,以及乳腺癌、食管癌、结肠及直肠癌等重大疾病的预防中,扮演着十分重要的角色。为此,本文就双膦酸 盐在骨科相关疾病治疗中的重要作用及新进展做一阐述。     

纤维多孔钛微球复合纳米锶磷灰石修复骨缺损的实验研究

Objective To evaluate the effect of titanium fiber mesh microballoons combined with nano-Sr-HAP on repair of bone defects in vivo. Methods The experimental model was set up by creating drill defects in the bilateral femoral condyle of 24 SD rats [6 months, with the mean weight of (545±22 g)]. The left femoral defects were filled with titanium fiber mesh microballoons combined with nano-Sr-HAP, and the right with pure metal scaffolds. At the 1st, 2nd, 4th, and 8th week after surgery, the specimens were killed and taken the X-ray, histology, and histomorphology observation. The results were contrasted and ana-lyzed. Results X-ray observation showed that the bone defects in both sides were repaired. Histological re-sults showed that the titanium fiber mesh microballoons allowed the new bones growing inside, and more new bones in the left implants compared with those in the right sides. The results of histomorphometrical analysis confirmed that neo-bones in the left sides gradually increased as time passed. There were statistic differences in neo-bones at the 2nd, 4th, and 8th week, and the differences between the two sides were statistically sig-nificant at the 4th and 8th week. Conclusion As titanium fiber mesh microballoons used in this experiment have good biocompatibility and osteoconduction ability, they can be used as scaffold for bone defect repair; and Nano-Sr-HAP can enhance the repair ability of titanium fiber mesh.     

纤维多孔钛微球复合纳米锶磷灰石修复骨缺损的实验研究

Objective To evaluate the effect of titanium fiber mesh microballoons combined with nano-Sr-HAP on repair of bone defects in vivo. Methods The experimental model was set up by creating drill defects in the bilateral femoral condyle of 24 SD rats [6 months, with the mean weight of (545±22 g)]. The left femoral defects were filled with titanium fiber mesh microballoons combined with nano-Sr-HAP, and the right with pure metal scaffolds. At the 1st, 2nd, 4th, and 8th week after surgery, the specimens were killed and taken the X-ray, histology, and histomorphology observation. The results were contrasted and ana-lyzed. Results X-ray observation showed that the bone defects in both sides were repaired. Histological re-sults showed that the titanium fiber mesh microballoons allowed the new bones growing inside, and more new bones in the left implants compared with those in the right sides. The results of histomorphometrical analysis confirmed that neo-bones in the left sides gradually increased as time passed. There were statistic differences in neo-bones at the 2nd, 4th, and 8th week, and the differences between the two sides were statistically sig-nificant at the 4th and 8th week. Conclusion As titanium fiber mesh microballoons used in this experiment have good biocompatibility and osteoconduction ability, they can be used as scaffold for bone defect repair; and Nano-Sr-HAP can enhance the repair ability of titanium fiber mesh.     

双膦酸盐治疗不良反应的研究进展

双膦酸盐类药物具有强大的抗骨吸收作用,可有效减低骨质疏松性骨折的发生率,是用于骨质疏松治疗的首选药物[1]。其临床适应证也包括Paget’s骨病、高钙血症以及由恶性肿瘤骨转移所带来的骨痛、病理性骨折等症状[1]。患者对长期服用该类药物的依从性较好,许多患者甚至服用该类药物达5—10年之久[2]。过去,关于双膦酸盐类长期服用后的安全性的临床研究较少,不良反应报道多来自药物售后监察。这些因素导致人们缺乏对该类药物使用安全问题应有重视。近年来,随着双膦酸盐类药物使用数量的增多,以及大量药效更强、服用方便的新剂型不断开发和推出,也出现了越来越多的不良反应报道。     

大鼠局部肌肉萎缩实验模型的设计与建立

背景:目前研究肌肉与骨骼关系的常用动物模型均存在不足.已经有研究表明A型肉毒素可以使局部肌肉萎缩,而不影响周围其他的肌肉.目的:尝试是否可以用局部肌肉注射A型肉毒素的方法建立一种较为理想的肌肉萎缩的动物实验模型.方法:4月龄雄性Wistar大鼠25只,采用氯胺酮(0.2 mL/kg)和速眠新(0.2 mL/kg)肌注麻醉,在股骨背侧中部做-0.5 cm切口,暴露股四头肌,右侧股四头肌肌注2 U(0.2 mL)注射用A型肉毒毒素,左侧股四头肌注射等量生理盐水作为对照.分别于模型建立后的1,2,4,6和8周各取5只做肌肉大体、组织学观察.结果与结论:肌肉大体观察发现:与生理盐水侧对照组相比,注射A型肉毒素侧股四头肌体积明显缩小、质量明显降低(P＜0.01);肌肉组织学观察发现:注射A型肉毒素侧股四头肌较生理盐水侧明显萎缩、肌纤维变细、肌纤维细胞核聚集、肌纤维与肌纤维之间间距变小.肉毒素侧1周和2周出现肌肉质量突降,4,6,8周之间肌肉质量增加缓慢,而各时间点生理盐水侧肌肉质量呈显著增加的趋势.通过对局部肌肉注射A型肉毒素可以理想地建立单个目的肌肉萎缩的实验模型,此模型操作性强、重复性好、特异性高,可应用于肌肉与骨骼关系的相关研究.     

脑中风偏瘫患者股骨颈骨折治疗方法探讨

目的 探讨中风偏瘫患股骨颈骨折治疗方法。方法 回顾分析25例患治疗方法及结果。结果 23例股骨颈骨折发生在偏瘫同侧，24例接受人工股骨头置换手术，10例双动股骨头，其余患为单极股骨头；23例接受随访，时间为4周至1年，Harris评分均在80分以上。结论 人工股骨头置换是中风偏瘫患股骨颈骨折治疗的有效方法。     

骨科钛合金内植物表面氧化钛纳米管改性的研究进展*

1引言在创伤外科领域,内固定手术成功与否的关键之一在于植入材料与周围骨的结合情况,两者结合稳定性越高,则植入后松动的可能性就越小。骨整合即特指内植物与并置骨界面形成     

动静力平衡失调与颈椎病——颈椎病动物模型的实验研究

为探讨颈椎生物力学失衡与颈椎病发生的关系,通过切除大鼠颈部肌群、切断兔颈棘上和棘间韧带及风寒湿刺激低头位兔颈部肌肉,采用组织形态学、生物化学及血液流变学等观察方法,分别建立颈椎动力性平衡失调,静力性平衡失调以及风寒湿痹证型颈椎生理弯曲消失甚至反曲,椎间孔变小,椎间隙变窄,椎体骨赘形成;光镜、电镜也充分证实颈椎间盘的进行性退变过程与对照组相比有明显差异。动物颈椎间盘中HE、5-HT、PGE2和6-酮-PGF1a含量变化经组间比较有显性差异（P<0.01);正常组与风寒湿复合模型组LPO、SOD含量均有统计学差异（P<0.05)。结果证实,颈椎生物力学失衡是颈椎退变的主要机制,提出“动力失衡为先,静力失衡为主”的颈椎病病机学说,并认识到,风寒湿雅可加速、加重颈椎生物力学失衡过程。