骨碎补对大白鼠骨质疏松模型的影响

实验选10月龄雄性大白鼠30只,随机分为空白组、对照组和实验组。空白组不进行任何处理,对照组和实验组每天皮下注射醋酸可的松,试验组同时每天给骨碎补制剂。21天杀死,测定各组骨密度、单位体积骨中脱钙骨其质、钙、磷、羟脯氨酸的含量。结果表明:对照各项指标均明显低于空白组。松质骨的差别尤为明显。而实验组各项指标高于对照组,但仍低于空白组。提示:骨碎补制剂有部分抑制糖皮质激素引起的骨丢失的作用,但不能完全阻止其发展。     

人结肠癌裸鼠原位种植癌及转移模型的建立

目的 建立人结肠癌裸鼠原位种植瘤模型，为研究结肠癌的转移机制和抗转移治疗提供动物模型。方法 采用人结肠腺癌细胞株SWlll6接种于裸鼠皮下，形成稳定传代的皮下种植瘤。再取该肿瘤组织块原位种植于裸鼠结肠壁，建立类似于临床的结肠癌模型。观察原位种植肿瘤的成瘤率，生长情况，转移率和腹水出现率。结果 原位种植成瘤率为l00％(24／24)，区域淋巴结转移率l00％(24／24)，腹膜转移率为9l.7％(22／24)，肝转移率为75．0％(19／24)，腹水出现率为25．0％(6／24)。荷瘤裸鼠晚期出现消瘦和全身衰竭，中位生存期为l0周。结论 该实验的裸鼠原位种植转移模型的生物学行为与临床病程非常相似，为研究结肠癌转移机制和抗转移治疗提供理想的动物模型。     

Establishing a psychiatry clerkship in a clinical teaching unit

Difficulties arising during the establishment of a clinical unit students' clerkship programme are presented. These are reviewed to establish general principles important for the successful introduction of such clerkships. Particular emphasis is laid on continual evaluation, and the results of one such evaluation are discussed.     

创伤骨折病人血液流变学变化的临床观察

观察了不同类型新鲜创伤骨折病人不同时期血液流变学的变化，发现骨折病人血液流变学的特点为：红细胞压积降低，纤维蛋白原升高，血浆粘度升高，血沉加快，全血粘度在早期（创伤后３天）降低，以后逐渐升高直到出现高粘态，这些血流变的变化，因创伤的程度和部位不同可有大差别，这种变化一般来说可持续４０天左右。     

Student evaluation: its worth for course tutors

As part of their evaluation of the 9-week 'Medicine in the Community' course, final-year medical students completed a terminal evaluation questionnaire. Items and subject groupings were scored using a scale of 1–5 for 'value', 'interest', and 'presentation', and mean evaluations were calculated for each group of students. The results, summarized in tabular form, were posted to the seventy-three course tutors together with the mean evaluations of the course as a whole. It was hoped that this feedback on the course would help tutors to improve the standard of their contributions.
After 2 years of this evaluation, a questionnaire was sent to the course tutors to examine whether student opinion is useful to them in the planning of teaching. Findings indicate that student opinion is actively sought and the results are useful, but only if tutors can identify their individual contributions from the tabulated summary.     

Inflammatory Markers and the Risk of Hip and Vertebral Fractures in Men: the Osteoporotic Fractures in Men (MrOS)

Cytokines play major roles in regulating bone remodeling, but their relationship to incident fractures in older men is uncertain. We tested the hypothesis that men with higher concentrations of pro‐inflammatory markers have a higher risk of fracture. We used a case‐cohort design and measured inflammatory markers in a random sample of 961 men and in men with incident fractures including 120 clinical vertebral, 117 hip, and 577 non‐spine fractures; average follow‐up 6.13 years (7.88 years for vertebral fractures). We measured interleukin (IL)‐6, C‐reactive protein (CRP), tumor necrosis factor alpha (TNFα), soluble receptors (SR) of IL‐6 (IL‐6SR) and TNF (TNFαSR1 and TNFαSR2), and IL‐10. The risk of non‐spine, hip, and clinical vertebral fracture was compared across quartiles (Q) of inflammatory markers using Cox proportional hazard models with tests for linear trend. In multivariable‐adjusted models, men with the highest (Q4) TNFa cytokine concentrations and their receptors had a 2.0–4.2‐fold higher risk of hip and clinical vertebral fracture than men with the lowest (Q1). Results were similar for all non‐spine fractures, but associations were smaller. There was no association between CRP and IL‐6SR and fracture. Men in the highest Q of IL‐10 had a 49% lower risk of vertebral fracture compared with men in Q1. Among men with ≥3 inflammatory markers in the highest Q, the hazard ratio (HR) for hip fractures was 2.03 (95% confidence interval [CI] 1.11–3.71) and for vertebral fracture 3.06 (1.66–5.63). The HRs for hip fracture were attenuated by 27%, 27%, and 15%, respectively, after adjusting for appendicular lean mass (ALM), disability, and bone density, suggesting mediating roles. ALM also attenuated the HR for vertebral fractures by 10%. There was no association between inflammation and rate of hip BMD loss. We conclude that inflammation may play an important role in the etiology of fractures in older men. © 2016 American Society for Bone and Mineral Research.     

Persistent Effect of Vitamin D Supplementation on Musculoskeletal Parameters in Adolescents One Year After Trial Completion

We showed a beneficial effect of vitamin D supplementation on musculoskeletal parameters in adolescent girls in a 1‐year, randomized, double‐blinded placebo‐controlled trial (RCT). Our objective for this study was to investigate the residual effect of vitamin D supplementation on bone mineral content (BMC), bone mineral density (BMD), at the lumbar spine and hip, lean mass, and height, 1 year after trial completion. We performed post hoc analyses in 167 adolescents, 86 girls and 81 boys, age 13.9 ± 2 years, who received vitamin D or placebo during the trial, and continued into the follow‐up trial. Musculoskeletal parameters were measured at baseline, 12 months (intervention), and 24 months (follow‐up). ANOVA and t tests were used to compare results between the placebo group and the merged vitamin D arms (200 or 2000 IU/day), by gender. Baseline characteristics were comparable between treatment groups at entry into the extension. Girls who had received vitamin D during the trial, had significantly larger hip BMC increments compared to those assigned to placebo, at 24 months compared to study entry, but not 24 compared to 12 months, which persisted in adjusted analyses. There were no significant differences in bone mass changes between treatment groups in boys, at 24 months compared to 12 months or to baseline. The beneficial effect of vitamin D supplementation on hip bone mass, achieved in girls during the trial, persisted 1 year after trial completion. These net cumulative increments, 1 year after discontinuation of supplementation, may have important implications on optimizing peak bone mass accretion in adolescent girls. © 2016 American Society for Bone and Mineral Research.     

The Road to Reproducibility in Animal Research

Reproducibility of research findings is the hallmark of scientific advance. However, the recently noted lack of reproducibility and transparency of published research using animal models of human biology and disease has alarmed funders, scientists, and the public. Improved reporting of methodology and better use of statistical tools are needed to enhance the quality and utility of published research. Reporting guidelines like Animal Research: Reporting In Vivo Experiments (ARRIVE) have been devised to achieve these goals, but most biomedical research journals, including the JBMR, have not been able to obtain high compliance. Cooperative efforts among authors, reviewers and editors—empowered by increased awareness of their responsibilities, and enabled by user‐friendly guidelines—are needed to solve this problem. © 2016 American Society for Bone and Mineral Research.     

Enhancement of Lumbar Fusion and Alleviation of Adjacent Segment Disc Degeneration by Intermittent PTH(1‐34) in Ovariectomized Rats

Osteoporosis, which is prevalent in postmenopausal or aged populations, is thought to be a contributing factor to adjacent segment disc degeneration (ASDD), and the incidence and extent of ASDD may be augmented by osteopenia. Parathyroid hormone (PTH) (1‐34) has already been shown to be beneficial in osteoporosis, lumbar fusion and matrix homeostasis of intervertebral discs. However, whether PTH(1‐34) has a reversing or retarding effect on ASDD in osteopenia has not been confirmed. In the present study, we evaluated the effects of intermittent PTH(1‐34) on ASDD in an ovariectomized (OVX) rat model. One hundred 3‐month‐old female Sprague‐Dawley rats underwent L₄–L₅ posterolateral lumbar fusion (PLF) with spinous‐process wire fixation 4 weeks after OVX surgery. Control groups were established accordingly. PTH(1‐34) was intermittently administered immediately after PLF surgery and lasted for 8 weeks using the following groups (n = 20) (V = vehicle): Sham+V, OVX+V, Sham+PLF+V, OVX+PLF+V, OVX+PLF+PTH. The fused segments showed clear evidence of eliminated motion on the fusion‐segment based on manual palpation. Greater new bone formation in histology was observed in PTH‐treated animals compared to the control group. The extent of ASDD was significantly increased by ovariotomy. Intermittent PTH(1‐34) significantly alleviated ASDD by preserving disc height, microvessel density, relative area of vascular buds, endplate thickness and the relative area of endplate calcification. Moreover, protein expression results showed that PTH(1‐34) not only inhibited matrix degradation by decreasing MMP‐13, ADAMTS‐4 and Col‐I, but also promote matrix synthesis by increasing Col‐II and Aggrecan. In conclusion, PTH(1‐34), which effectively improves lumbar fusion and alleviates ASDD in ovariectomized rats, may be a potential candidate to ameliorate the prognosis of lumbar fusion in osteopenia. © 2015 American Society for Bone and Mineral Research.     

The Effects of Age,Adiposity, and Physical Activity on the Risk of Seven Site‐Specific Fractures in Postmenopausal Women

Risk factors for fracture of the neck of the femur are relatively well established, but those for fracture at other sites are little studied. In this large population study we explore the role of age, body mass index (BMI), and physical activity on the risk of fracture at seven sites in postmenopausal women. As part of the Million Women Study, 1,154,821 postmenopausal UK women with a mean age of 56.0 (SD 4.8) years provided health and lifestyle data at recruitment in 1996 to 2001. All participants were linked to National Health Service (NHS) hospital records for day‐case or overnight admissions with a mean follow‐up of 11 years per woman. Adjusted absolute and relative risks for seven site‐specific incident fractures were calculated using Cox regression models. During follow‐up, 4931 women had a fracture of the humerus; 2926 of the forearm; 15,883 of the wrist; 9887 of the neck of the femur; 1166 of the femur (not neck); 3199 a lower leg fracture; and 10,092 an ankle fracture. Age‐specific incidence rates increased gradually with age for fractures of forearm, lower leg, ankle, and femur (not neck), and steeply with age for fractures of neck of femur, wrist, and humerus. When compared to women with desirable BMI (20.0 to 24.9 kg/m²), higher BMI was associated with a reduced risk of fracture of the neck of femur, forearm, and wrist, but an increased risk of humerus, femur (not neck), lower leg, and ankle fractures (p < 0.001 for all). Strenuous activity was significantly associated with a decreased risk of fracture of the humerus and femur (both neck and remainder of femur) (p < 0.001), but was not significantly associated with lower leg, ankle, wrist, and forearm fractures. Postmenopausal women are at a high lifetime risk of fracture. BMI and physical activity are modifiable risk factors for fracture, but their associations with fracture risk differ substantially across fracture sites. © 2016 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR)