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71.
Fengxiu Ouyang Binyan Wang Lester M. Arguelles Xiping Xu Jianhua Yang Zhiping Li Liuliu Wang Xue Liu Genfu Tang Houxun Xing Craig Langman Xiaobin Wang 《Archives of osteoporosis》2007,2(1-2):29-43
Summary We prospectively examined bone growth patterns in 894 children aged 6–17 years at the baseline visit, with a 6-year follow-up.
Results show bone “tracking” over a six-year interval and sexual dimorphism of bone attained levels and timing of peak bone
growth. Our findings underscore childhood and adolescence as critical periods for building bone and developing gender differences.
Introduction Bone growth patterns were prospectively examined in 894 Chinese children (496 males), aged 6–17 yrs, from a population-based
twin cohort. Whole-body bone area (BA), bone mineral content (BMC), and bone mineral density (BMD) were measured by DEXA at
baseline and a 6-yr follow-up.
Methods Graphic smoothing plots and generalized estimating equations were used to model bone attained levels, growth, and “tracking”.
Results Attained levels of BMC and BA increased curvilinearly with age. Male attained levels were higher than females after age ∼15 yr,
but BMD was lower between 13–17 yrs (Tanner stage I to IV). In both genders, peak BMC and BMD growth lagged ∼2 yrs behind
peak BA growth, which lagged 2 yrs behind peak height growth. Peak bone growth occurred 1–3 yrs later in males. Over the 6-yr
follow-up, all bone measurements “tracked”, but “shifting” across ranks also occurred, and baseline tertile ranking influenced
bone growth. Females with early menarche had higher attained levels than females with late menarche at age 12–13 yrs.
Conclusion Our findings confirm and expand previous studies on peak bone growth conducted in Caucasian cohorts, particularly sexually
dimorphic and maturational effects. The significant “tracking” of bone measurements in this 6-yr follow-up study underscores
the importance that osteoporosis prevention should begin in childhood and adolescence.
Fengxiu Ouyang and Binyan Wang contributed equally to this article.
Source(s) of support: This study is supported in part by grant R01 HD049059, R01 HL0864619 and R01 AR045651 from the National
Institute of Health and by the Food Allergy Project. 相似文献
72.
Philip F. Giampietro MD PhD Margaret G. E. Peterson PhD Robert Schneider MD Jessica G. Davis MD Stephen W. Burke MD Oheneba Boachie-Adjei MD Charles M. Mueller PhD RD Cathleen L. Raggio MD 《HSS journal》2007,3(1):89-92
Reduced bone mineral density (BMD) was sporadically reported in patients with Marfan syndrome. This may or may not place the
Marfan patient at increased risk for bone fracture. In comparing the BMDs of our patients with those reported in the literature,
it seemed that agreement between values, and hence the degree of osteoporosis or osteopenia reported, was dependent on the
instrumentation used. The objective of this study was to statistically assess this impression. Bone mineral density measurements
from our previously published study of 30 adults with Marfan syndrome performed on a Lunar DPXL machine were compared with
studies published between 1993–2000 measured using either Lunar or Hologic bone densitometry instruments. The differences
of our measurements compared with those made on other Lunar machines were not statistically significant, but did differ significantly
with published results from Hologic machines (P < 0.001). Before progress can be made in the assessment of BMD and fracture risk in Marfan patients and in the evidence-based
orthopedic management of these patients, standardization of instrumental bone density determinations will be required along
with considerations of height, obesity, age, and sex. 相似文献
73.
同种异体骨支撑架微创治疗股骨头坏死的临床研究 总被引:1,自引:0,他引:1
目的应用改良髓芯减压术结合同种异体骨支撑架加自体骨和脱钙骨基质(decalcified bone matrix,DBM)治疗早期股骨头坏死,探索早期股骨头坏死的微创治疗方法。方法2004年1月~2005年4月,23例24个髋关节采用经大转子下通过股骨颈钻隧道至股骨头骨坏死区,将装有自体松质骨和DBM的同种异体骨支撑架经隧道拧入骨坏死区直至软骨下骨约5mm处,隧道远端用自体髂骨填塞。观察手术前后Harris评分变化、x线影像学表现及是否需进一步治疗。结果本组所有患者均获得随访,平均随访19(12—27)个月,以最后一次随访资料作为最终评价依据。Harris评分,术前优良率为43.5%(10/23)。术后优良率为91.3%(21/23)。22侧髋关节影像学表现保持稳定,无明显并发症发生。结论同种异体骨支撑架植入结合自体松质骨和DBM治疗成人股骨头坏死,增加了股骨头负重区软骨下骨的机械支撑,成骨作用强,有利于股骨头坏死的修复与重建,同时,不破坏患者股骨头本身的血液供应,创伤小,操作简单,值得临床推广使用。 相似文献
74.
目的应用重组人骨形态发生蛋白4基因腺相关病毒载体(AAV-hBMP4)转染兔骨髓基质干细胞(BMSCs),观察其对BMSCs生物学行为的影响,从而为骨组织工程寻找理想的病毒载体及种子细胞。方法全骨髓法培养兔BMSCs,按感染复数(MOI)值不同设定为四组,分别转染兔BMSCs,观察病毒量对细胞形态的影响。选取影响最小的MOI值,进行后续实验。转染兔BMSCs,MTT法描记细胞生长曲线,观察AAV对细胞增殖活性的影响。以重组增强型绿色荧光蛋白基因的腺相关病毒载体(AAV-EGFP)为参照,行流式细胞仪检测,计算转染效率。AAV-hBMP4与对照病毒AAV-EGFP分别转染细胞,观察细胞形态,行碱性磷酸酶(ALP)染色、Von Kossa染色及ALP含量测定,观察成骨活性。兔肌袋实验观察异位成骨情况。结果MOI值为5×10~4 vg/cell时,AAV对细胞形态影响最小,以此值进行后续实验。AAV转染后,细胞增殖活性良好,转染效率为55%~65%。AAV-hBMP4转染后,细胞形态呈现典型的成骨改变,ALP染色及Von Kossa染色均出现成骨的特征性改变,而AAV-EGFP组无上述改变。细胞上清ALP含量测定显示,实验组ALP含量显著增高,与对照组比较差异有统计学意义(t=218.65,P<0.01)。兔肌袋实验术后4周组织学检测可见大量钙盐沉积,矿化结节形成。结论AAV-hBMP4转染效率高,对BMSCs的增殖活性影响小,AAV-hBMP4转染的BMSCs可望成为组织工程化骨的理想种子细胞。 相似文献
75.
G. Burastero N. Sessarego G. Grappiolo C. Castellazzo S. Castello A. Pitto G. Cittadini M. Podesta G. Bovio M. Peresi E. Fulcheri F. Frassoni L. Spotorno 《Journal of orthopaedics and traumatology》2007,8(1):49-54
Mesenchymal stem cells (MSC), easily culture-expanded from bone marrow, can significantly enhance bone defect healing. Several
proteins, such as the bone morphogenetic proteins (BMPs) and in particular BMP-7, are involved in bone formation in vitro
and in vivo. In this preclinical study, we evaluated if the association of human MSC (hMSC) with BMP-7 had synergic action
on bone healing. Rat femoral defects (n=12) were treated with: autoclaved bone and mononucleated cells (MNC) as control group
G1; bone and hMSC, group G2; bone with BMP-7, group G3; bone and hMSC plus BMP-7, group G4. Defect regeneration was evaluated
with plain radiographs after 2, 4, 8 and 12 weeks and with histological analysis. We observed organized trabeculae bridging
between the osteotomic ends of the host bone in rats treated with the association of hMSC and rhBMP-7. These trabeculae, formed
by a core of devitalized tissue surrounded by osteoblasts, osteocytes and osteoclasts, were continuous with a cortical-like
structure of bony tissue. Such new bone formation of the group treated with the association of hMSC and rhBMP-7 (G4) was clearly
superior compared to rats treated with rhBMP-7 (G2) or hMSC (G3) alone, as shown by radiographic analysis and histological
study. The present study suggests that the association of hMSC and BMP-7 is more effective than hMSC or BMP-7 alone in the
healing of femoral defects in rats. Further studies with larger samples are required to confirm these results and to evaluate
the best dosage. 相似文献
76.
Saskia L.M.A. Beeres MD Katja Zeppenfeld MD Jeroen J. Bax MD Petra Dibbets-Schneider Marcel P.M. Stokkel MD Willem E. Fibbe MD Ernst E. van der Wall MD Douwe E. Atsma MD Martin J. Schalij MD 《Heart rhythm》2007,4(3):257-265
BACKGROUND: Bone marrow cell injection has been introduced to treat patients with ischemic heart disease. However, focal application of bone marrow cells may generate an arrhythmogenic substrate. OBJECTIVES: To assess the electrophysiological and arrhythmogenic effects of intramyocardial bone marrow cell injection in patients with chronic myocardial ischemia. METHODS: Bone marrow was aspirated in 20 patients (65+/-11 years, 19 male) with drug-refractory angina and myocardial ischemia. Electroanatomical mapping (NOGA, Biosense-Webster, Waterloo, Belgium) was performed during mononuclear cell isolation. Areas for cell injection were selected based on the localization of ischemia on SPECT. These areas were mapped in detail to evaluate local bipolar electrogram duration, amplitude and fragmentation. Mononuclear cells were injected in the ischemic area with the NOGA system. SPECT and electroanatomical mapping were repeated at 3 months. Holter monitoring was repeated at 3 and 6 months. RESULTS: SPECT revealed a decrease in the number of segments with ischemia (3.5+/-2.5 vs. 1.1+/-1.0 at 3 months; P<0.01) and an increased left ventricular ejection fraction (44+/-13% vs. 49+/-17% at 3 months; P=0.02). The number of ventricular premature beats remained unchanged (10+/-24x10(2)/24h vs. 8+/-23x10(2)/24h at 3 months (P=NS) and 12+/-30x10(2)/24h at 6 months (P=NS)). At 3 months follow-up, bone marrow cell injection did not prolong electrogram duration (15.9+/-4.6 ms vs. 15.6+/-4.0 ms; P=NS), decrease electrogram amplitude (3.8+/-1.5 mV vs. 3.8+/-1.5 mV; P=NS), or increase fragmentation (2.0+/-0.5 vs. 1.9+/-0.4; P=NS). CONCLUSION: Intramyocardial bone marrow cell injection does not increase the incidence of ventricular arrhythmias and does not alter the electrophysiological properties of the injected myocardium. 相似文献
77.
目的探讨骨胶原含量在绝经后骨质疏松症的发生、发展及在骨质疏松性骨折中的作用。方法取7个月龄未交配雌性SD大鼠60只,随机分为四组,A组:对照组(sham组);B组:切除卵巢组;C组:切除卵巢+雌激素治疗组;D组:切除卵巢+降钙素治疗组。除A组外,其他三组通过切除双侧卵巢法12周后制成骨质疏松模型,24周后分别行k的力学特性、右侧股骨三点弯曲试验、羟脯氨酸含量、k骨密度(BMD)测定,Masson三色染色法显示骨胶原形态。结果A、C、D组与B组在k羟脯氨酸含量、BMD、k压缩力学参数值、右侧股骨生物力学参数值、骨胶原染色含量及形态方面差异均有统计学意义(P〈0.05),而A、C、D组之间差异无统计学意义(P〉0.05)。统计学分析显示羟脯氨酸含量与BMD及骨生物力学参数值呈直线相关性。结论骨质疏松的发生与骨胶原含量下降有关。骨胶原含量的下降与BMD降低及骨生物力学改变呈相关性。应用雌激素和降钙素治疗去势后骨质疏松大鼠,不仅可以提高其BMD含量和骨生物力学性能,而且还可以提高骨胶原的含量。 相似文献
78.
目的 探讨靶心图上心肌灌注缺损区定量分析方法的可靠性、重复性及应用价值。方法 16例急性心肌梗死(AMI)行自体骨髓单个核细胞移植治疗的住院患者,于治疗前、治疗后45和90d行^99Tc^m-MIBI静息心肌灌注显像。在靶心图上勾画缺损区(在左心室靶心图中放射性计数低于40%的区域),并进行定量分析。结果 (1)不同操作者所得ROI结果之间的差异无统计学意义(t=0.52,P〉0.05)。(2)治疗后45d心肌灌注缺损区面积较治疗前缩小34.32%,差异有统计学意义(t=2.83,P〈0.05);治疗后90d心肌灌注缺损区面积较治疗后45d缩小14.77%,差异有统计学意义(t=2.51,P〈0.05)。示自体骨髓单个核细胞移植对缺血心肌的恢复有一定疗效,能够缩小梗死面积,且自体骨髓单个核细胞冠状动脉内移植治疗AMI的疗效在移植后早期(45d内)即有体现。(3)面积百分比是观察心肌灌注变化的重要定量指标。结论 该方法对心肌病变范围及严重程度能准确定量;对评价AMI骨髓于细胞移植术疗效有一定的价值。 相似文献
79.
自固化磷酸钙人工骨修复骨缺损的临床应用 总被引:5,自引:1,他引:4
目的:探讨自固化磷酸钙人工骨(CPC)填充修复骨缺损的临床效果。方法:骨缺损94例,男59例,女35例;年龄11~72岁,平均39.4岁。骨缺损部位:胸腰椎38例,跟骨25例,胫骨15例,股骨7例,肱骨近端3例,桡骨远端5例,近节指骨1例。骨缺损原因:骨折塌陷复位后骨缺损63例,骨髓炎20例,骨囊肿6例,骨纤维异常增殖症4例,内生软骨瘤1例。骨缺损范围为1cm×1cm~4cm×20cm,用CPC填充修复,CPC充填量为3~42g,其中单纯CPC填充修复74例(胸腰椎骨折行椎体成形38例,骨折复位后空腔充填25例,良性骨肿瘤病灶刮除后充填11例),载药CPC填充修复骨髓炎20例。结果:所有患者均获随访,随访时间14~48个月,平均29.6个月。全部患者术后未见过敏或毒性反应,无皮疹或高热,血钙、磷、碱性磷酸酶均正常,切口无瘙痒感。随访时X线片显示,植入CPC与宿主骨接触紧密,界面处未见间隙存在,骨缺损处的解剖形状完全或大部分恢复,未见脱落现象,随访时部分患者CPC部分降解成骨。9例发生术后伤口渗出,为淡黄色清亮稀薄分泌物,细菌培养阴性,经换药后伤口愈合良好。结论:CPC填充修复骨缺损安全有效,并发症少,是理想的骨替代品,载药CPC是治疗骨髓炎的理想方法。 相似文献
80.
F.-P. Tillmann M. Jäger D. Blondin D. Schooldermann A. Voiculescu C. Sucker B. Grabensee R. Krauspe G. R. Hetzel 《American journal of transplantation》2007,7(3):667-671
The purpose of this study was to investigate the application of intravenous iloprost as a novel therapy for the treatment of post-transplant distal limb syndrome (PTDLS). PTDLS is a benign but disabling complication in the first year after renal transplantation. It is characterized by bilateral, often incapacitating pain in the feet and or knees on motion and a significant rise in alkaline phosphatase levels on laboratory evaluation. On MRI, bone marrow edema of the affected bone regions can be demonstrated. PTDLS differs from steroid induced osteonecrosis of the hip in terms of localization, an average cumulative steroid dosage within expected limits, and a benign outcome, as PTDLS does not progress to overt cell necrosis. From August 2003 to April 2005 we treated 10 patients with MRI-proven diagnosis of PTDLS following a standardized regimen of intravenous iloprost over 5 days. Iloprost led to prompt pain relief measured on a visual analogous scale (VAS) ranging from 1 to 10 (5.6 +/- 1.5 before vs. 2.1 +/- 1.3 after treatment, p = 0.0004). PTDLS represents a benign but disabling complication following renal transplantation. Intravenous iloprost might be a promising therapeutic concept leading to a quick relief of symptoms without relevant side effects. 相似文献