胸腰椎骨质疏松性骨折治疗后BMD、BGP变化的Meta分析

目的 系统评价胸腰椎骨质疏松性骨折在接受复方骨肽注射液治疗后骨密度(bone mineral density,BMD)、骨钙素(bone gla protein,BGP)的变化.方法 制定检索策略并检索目前国内外公开发表的中、英文数据库,应用Review Manager 5.3对纳入文献中所提取的数据资料进行分析.结果...     

新钙灵对兔血清中若干骨形成因素相关性的分析

用于儿童的钙剂直接移用于年老者补钙效果并不佳。试图探讨血清中Ca、BGP、CT、AKPP、BUN六个有关骨形成因素的相关性。本文结果如下：（1）报告兔血清中以上六个因素的正常平均值；（2）BGP与Ca、CT、AKP均有程度不等的相关性；BGP与兔体重有密切相关，体重大于2.5kg，多数BGP形成减少；根据BGP形成多少，血清中GBP：Ca、BGP：P等比值也有差异。认为BGP是血清中骨形成因素的主要因素：（3）给予家兔小剂量新钙灵后，血清BGP与有关因子的比值，和BGP形成低下的兔血清中BGP的相关性相符。活性钙能使BGP：CT王相关，此因素分别又与其他因素呈现负相关，不利BGP、CT存留，达不到理想效果。     

补肾活血液对去势雌鼠骨质疏松的影响

目的：研究补肾活血液对模型大鼠骨质疏松的影响及其机制，为临床中医药治疗骨质疏松提供实验依据。方法：ＳＤ雌性大鼠５０只，随机分为５组：正常组，模型加生理盐水组，雌激素组，中药高，低剂量组。采用切除卵巢诱导的骨质疏松模型，用灌胃法给服补肾活血液，并以尼尔雌醇及生理盐水作为对照。     

左归丸联合阿仑膦酸钠治疗绝经后骨质疏松症的临床研究

目的观察左归丸联合阿仑膦酸钠治疗绝经后骨质疏松症的临床疗效。方法选取2014年2月—2016年2月在武汉市中医医院确诊的绝经后骨质疏松症患者152例,随机分为对照组和治疗组,每组各76例。对照组患者于早餐前30 min凉开水口服阿仑膦酸钠肠溶片,1片/次,1次/d;治疗组患者在对照组的基础上口服左归丸,9 g/次,2次/d。两组患者均连续治疗3个月。比较两组患者治疗前后临床疗效、骨密度变化,以及血清碱性磷酸酶(ALP)、骨钙素(BGP)和1,25-(OH)2D3水平。结果治疗后,对照组和治疗组的总有效率分别为76.32%和92.11%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者腰L2~L4、双髋、右侧股骨颈的骨密度均较治疗前显著升高,同组比较差异具有统计学意义(P0.05);且治疗组患者骨密度指标显著高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者ALP、1,25-(OH)2D3均显著升高,BGP显著降低,同组比较差异具有统计学意义(P0.05);且治疗组ALP、1,25-(OH)2D3和BGP水平显著优于对照组,两组比较差异具有统计学意义(P0.05。结论左归丸联合阿仑膦酸钠治疗绝经后骨质疏松患者比单用阿仑膦酸钠治疗的临床效果优势明显,且不良反应较轻,具有一定的临床推广应用价值。     

骨钙素基因Hind Ⅲ多态性与体质量指数变异的相关联性：南昌地区绝经前女性390例调查

背景： 体质量指数(BMI)是研究肥胖的常用表型,它是由多基因决定的复杂性状。 目的：验证骨钙素基因Hind Ⅲ多态性是否与体质量指数的变异相关联。 方法：征集南昌当地绝经前女性390例,并测量身高和体质量。用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)法对所有个体的骨钙素基因Hind Ⅲ位点进行基因分型。 结果与结论：骨钙素HH,Hh和hh基因型频率分别为0.077,0.408和0.515。骨钙素基因型分布符合哈的温格尔平衡(P > 0.05)。骨钙素基因Hind Ⅲ与体质量指数存在显著的关联(P=0.002),它可以解释大约5.47%体质量指数的变异。HH基因型个体的体质量指数最高[(22.81±0.73)kg/m2],Hh基因型个体的体质量指数居中[(21.50±0.53) kg/m2],而hh基因型个体的体质量指数最低[(20.23± 0.63) kg/m2]。因此,HH和Hh基因型个体的体质量指数比hh基因型个体的体质量指数分别高大约12.75%和6.28%。文章首次在健康绝经前女性中报道骨钙素基因HindⅢ多态性与体质量指数的变异相关联。     

Serum Level of Biliary Glycoprotein I,a Determinant of Cholestasis,of Similar Use as γ-Glutamyltranspeptidase

Biliary glycoprotein I (BGP I), a constituent of normal bile and serum, is a glycoprotein (mol. wt. ~ 90,000) containing about 40% carbohydrate. Serum BGP I (S-BGP I) was determined by means of a double-antibody radioimmunoassay in patients with liver and gastrointestinal disease and in healthy individuals. The serum levels of five liver enzymes (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase (S-ALP), γ-glutamyltranspeptidase (S-GT), and lactic dehydrogenase), bilirubin (total and conjugated), and bile acids (cholic and chenodeoxycholic acid) were determined in parallel. Healthy individuals had 0.5 ± 0.3 mg/l of S-BGP I (mean ± 2 S.D.; range, 0.2-0.9 mg/l). Most patients with liver disease (chronic hepatitis, alcoholic cirrhosis, primary biliary cirrhosis) had elevated levels, up to 5-10 times the upper reference limit, whereas most patients with gastrointestinal disease (ulcerative colitis, Crohn's disease, other GI diseases) had normal values. In patients with liver disease S-BGP I was positively correlated (p < 0.0005) to S-GT. In primary biliary cirrhosis a positive correlation (p < 0.005) between S-BGP I and S-ALP was also obtained. All other comparisons between S-BGP I and the other liver function tests showed non-significant correlations. It is concluded that S-BGP I is a determinant of cholestasis of similar use as S-GT.     

新疆乌鲁木齐地区汉族与维吾尔族绝经后女性骨质疏松患者发病特点的研究

目的 探讨新疆乌鲁木齐地区汉族与维吾尔族绝经后女性骨质疏松患者发病特点.方法 将确诊为绝经后女性骨质疏松症患者汉族(118例),维吾尔族(39例)进行分组,分析对比两组患者骨密度测定值,骨特异性碱性磷酸酶(BAP)、骨钙素(BGP)、抗酒石酸酸性磷酸酶5b(TRACP-5b)、1-(OH)维生素D_3以及血清Ca、P、Mg水平.结果 维吾尔族女性原发性骨质疏松症患者发病年龄小于汉族患者,维吾尔族女性原发性骨质疏松症患者的绝经年龄早.维吾尔族1-(OH)维生素D_3水平明显低于汉族组(P<0.01),骨钙素(BGP)检测值维吾尔族原发性骨质疏松症患者高于汉族(P<0.05).结论 维吾尔族原发性骨质疏松症患者,可能与汉族有着不同的骨质疏松症发病机制.维吾尔族原发性骨质疏松症患者更应补充足量的活性维生素D.     

雌激素和维生素K抗去势成年雌性大鼠骨质疏松的实验研究

目的寻找一种或一组简便有效,价格低廉的防治骨质疏松（osteoporosis,OP）的方法,以期为防治骨质疏松药物的开发提供实验依据。方法以去卵巢雌性SD大鼠作为绝经早期骨质疏松模型。将50只SD雌性大鼠随机分为5组：卵巢去势（ovariectomized,OVX）组（OVX组,n=10）、卵巢去势＋雌激素组（OVX＋E组,n=10）、卵巢去势＋维生素K组（OVX＋vit K组,n=10）和卵巢去势＋雌激素＋维生素K组（OVX＋E＋vitK组,n=10）、假手术组（sham组,n=10）。卵巢去势1个月后,分组给药,8周后集中统一处死,取左侧股骨检测骨密度（bone mineral density,BMD）,右侧股骨病理学切片进行骨小梁形态计量观察,取右心室血清检测白介素（interleukin,IL）-6、骨钙素（bone gla protein,BGP）和胰岛索样生长因子（insulin-like growth factor,IGF）-1含量。结果①OVX组与sham组比较,骨密度显著下降,血清白介素-6和骨钙素测量值明显升高,而胰岛素生长因子-1显著下降,表明造模成功。②OVX组骨组织病理学切片40倍光镜下骨小梁形态计量观察结果与sham组、OVX＋vitK组、OVX＋E组和OVX＋E＋vit K组比较,差异有显著意义。其中,OVX＋E＋vit K组与sham组最相似。③OVX＋E组与OVX组比较,股骨干骺端（松质骨）骨密度显著升高,而股骨中段（皮质骨为主）骨密度升高,差异无显著意义。OVX＋vitK组与OVX组比较,股骨中段（皮质骨）骨密度显著升高,股骨干骺端（松质骨为主）骨密度升高,但差异无显著意义。OVX＋E＋vitK组股骨干骺端和股骨中段骨密度均显著性升高,与sham组最接近。④OVX＋E组与OVX组比较,血清白介素-6含量和骨密度低,胰岛素生长因子-1含量升高,差异有显著意义;OVX＋vitK组与OVX组比较,血清白介素-6测量值低,骨钙素和胰岛素生长因子-1测量值升高,差异有显著意义;OVX＋E＋vitK组血清白介素-6,骨钙素和胰岛素生长因子-1含量与sham组比较,最为接近。结论①去卵巢大鼠骨密度及骨形成指标胰岛素生长因子-1下降,骨吸收指标白介素-6、骨吸收和骨形成指标骨钙素升高,表明绝经早期骨代谢处于骨吸收大于骨形成的高转换状态,导致骨质疏松。②雌二醇（estrogen,E2）水平下降是骨质疏松的一个重要致病因素。病理形态学观察和骨密度及血清白介素-6、骨钙素、胰岛素生长因子-1含量检测表明,维生素K和雌激素防治骨质疏松均有效,二者联合用药的作用明显优于单一用药。     

Metabonomic study on the anti-osteoporosis effect of Rhizoma Drynariae and its action mechanism using ultra-performance liquid chromatography-tandem mass spectrometry

Ethnopharmacological relevance

Rhizoma Drynariae (RD) is an effectively traditional Chinese medicine which is usually used in treating osteoporosis, bone fracture, streptomycin ototoxicity and hyperlipemia. Up to now, studies on pharmacological mechanism of RD mostly focus on cell and gene level, little is known about its metabonomics study. The aim of this study is to establish the rats plasma metabonomic profiles of control, model and treatment group, then to investigate the anti-osteoporosis effect of RD and its action mechanism.

Method

A total of 21 Wistar rats was divided into three groups: control group, model group and treatment group. The model and treatment rats were injected prednisolone for 12 weeks, at the same time the treatment rats were orally administered RD extract at a therapeutic dose (10 g/kg, expressed as the weight of raw material) once daily throughout the experimental period, control group and model group were orally gavaged approximately volume normal saline solution. After 12 weeks, all plasma samples of three groups were collected and their metabolic profiling changes were analyzed by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The resulting dataset was analyzed by principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA). The identification of all potential biomarkers was performed using reference standard by comparing their mass spectra, MS/MS fragmentation and retention time. Furthermore, clinical biochemistry and biomechanics study were also carried out to ensure the success of the osteoporosis model and to investigate the anti-osteoporosis effect of RD.

Results

Obvious separation trend between control and model group was found in PCA score plot, the anti-osteoporosis effect of RD can be indicated in PLS-DA score plot among these three groups. Six potential metabolite biomarkers, Lysophosphatidylcholines (C16:0 LPC, C18:0 LPC, C18:1 LPC and C18:2 LPC), tryptophane and phenylalanine, which were proved to be related with osteoporosis, were identified in the rats plasma. Compared with control group, level of all biomarkers increased significantly in model group, while that was much closer to normal in treatment group.

Conclusion

The anti-osteoporosis effect of RD has been reliably confirmed by the metabonomics method. The osteoporosis might be prevented by RD via intervening antioxidant-oxidation balance, tryptophane metabolism and phenylalanine metabolism in vivo in rats.