白豆蔻、草豆蔻、高莨姜挥发油成份研究

以气相—质谱法分离、鉴定了白豆蔻、草豆蔻、高莨姜挥发油的组成以及各自在油中的相对含量。同时以不同极性的填充柱,相同的程序升温方式,分离挥发油,以得到的色谱图比较三种挥发油之间的同异。挥发油所含成份与原药材所属性味以及归经之间的内在联系尚需作进一步的探讨。     

建立中风病血瘀证宏观辨证量化标准的方法探讨

试采用非条件和ｋｌｉ：ｋ２ｉ 配对的条件ｌｏｇｉｓｔｉｃ 回归的分析方法, 对２２１ 例中风病人的临床中医证候特征进行比较分析, 建立急性期中风病血瘀证的证候预测模型, 并采用临床调查的结果对模型进行验证, 以探讨建立中风病血瘀证宏观辨证量化标准的方法。结果： 非条件与条件ｌｏｇｉｓｔｉｃ 回归均提示口唇紫暗或面色晦暗、舌有瘀点或舌有瘀斑、舌背脉络瘀张青紫、舌紫暗是鉴别血瘀证与非血瘀证的重要指标, 且４ 项指标与急性期中风病血瘀证发生概率均呈正相关。将另外的一组与本研究无关、但研究对象的选择相似的临床数据作为检验样本代入模型得到的诊断准确率达９９ ．０６％ （１０５／１０６）。结论： 模型对急性期中风病血瘀证具有较好的预测作用。条件和非条件ｌｏｇｉｓｔｉｃ 统计模型以及ｋ１ｉ：ｋ２ｉ 的配对方法用于急性期中风病血瘀证的研究有助于宏观辨证量化标准的建立, 并且这些方法可以推广应用到非急性期中风病以及其他系统疾病的血瘀证或其他证候的量化研究中     

Early Discrimination Between Tumor-Induced Rickets/Osteomalacia and X-Linked Hypophosphatemia in Chinese Children and Adolescents: A Retrospective Case–Control Study

In children and adolescents, distinguishing tumor-induced rickets/osteomalacia (TIR/O) from hereditary hypophosphatemic rickets/osteomalacia (HR/O) is a medical challenge. We retrospectively studied 10 Chinese children and adolescents with TIR/O who underwent surgery at a mean age of 17.4 ± 2.1 years and compared their characteristics to 24 age- and sex-matched patients with X-linked hypophosphatemia (XLH). Positive family history of HR/O and dental problems, such as enamel hypoplasia and dental abscess, were reported in 8 (33.3%) and 5 (20.8%) patients with XLX, respectively, but not in patients with TIR/O. In addition, in comparison with XLH patients, TIR/O patients had an older disease onset age (150 versus 24 months, p < 0.001), a higher height standard deviation score (SDS; −1.2 ± 1.8 versus −4.0 ± 1.4, p < 0.001), a lower Z-score of bone mineral density (BMD) at lumbar spine (LS) (−3.9 [6.0] versus +1.8 [7.0], p < 0.001), and a higher serum intact fibroblast growth factor 23 (FGF23) level (500.27 ± 87.20 versus 121.71 ± 70.94 pg/mL, p < 0.001), corresponding to a lower serum phosphate level (0.52 ± 0.07 versus 0.64 ± 0.11 mmol/L, p = 0.005) and a higher serum alkaline phosphatase (ALP) level (557 [631] versus 305 [249] U/L, p = 0.005). We generated receiver operating characteristic (ROC) curves and calculated the area under the ROC curve (AUC). The AUCs of onset age, FGF23, and LS Z-score were equal to 1, suggesting that these are excellent indices for the differential diagnosis between TIR/O and XLH. In summary, our study furthers our understanding of the spectrum of clinical, biochemical, and pathologic findings associated with TIR/O. For children and adolescent patients with HR/O, a comprehensive and careful clinical and laboratory evaluation is of great importance, and we recommend enquiry of the family history, onset age, and dental problems, as well as measurement of serum FGF23 and BMD. © 2021 American Society for Bone and Mineral Research (ASBMR).     

中风病中医证候与相关因素的分析

对连续收治的221例中风病急性期的病人,进行了中风病中医证候相关因素研究结果：男性病人疾证的均值和比例均显著高于女性病人（P＜0．001,P＝0．003）;60～69岁年龄组血瘀证的比例显著高于其他年龄组（P＜0．05）;体力劳动者风证的均值、比例显著高于其他劳动形式（P＝0．003,P＜0．001）,同时在火热证、痰证、血瘀证的比例也显著高于其他劳动形式（P＜0．001）,而脑力劳动者阴虚阳亢的均值显著高于其他劳动形式（P＝0．045）。为辨证预防。诊治中风提供了科学依据。     

Relationship Between Low Bone Mineral Density and Fractures With Incident Cardiovascular Disease: A Systematic Review and Meta‐Analysis

An increasing evidence base suggests that low bone mineral density (BMD) and fractures are associated with cardiovascular disease (CVD). We conducted a systematic review and meta‐analysis summarizing the evidence of low BMD and fractures as risk factors for future CVD. Two independent authors searched major databases from inception to August 1, 2016, for longitudinal studies reporting data on CVD incidence (overall and specific CVD) and BMD status and fractures. The association between low BMD, fractures, and CVD across longitudinal studies was explored by calculating pooled adjusted hazard ratios (HRs) ±95% confidence intervals (CIs) with a random‐effects meta‐analysis. Twenty‐eight studies (18 regarding BMD and 10 fractures) followed a total of 1,107,885 participants for a median of 5 years. Taking those with higher BMD as the reference, people with low BMD were at increased risk of developing CVD during follow‐up (11 studies; HR = 1.33; 95%CI, 1.27 to 1.38; I² = 53%), after adjusting for a median of eight confounders. This finding was confirmed using a decrease in one standard deviation of baseline BMD (9 studies; HR = 1.16; 95% CI, 1.09 to 1.24; I² = 69%). The presence of fractures at baseline was associated with an increased risk of developing CVD (HR = 1.20; 95% CI, 1.06 to 1.37; I² = 91%). Regarding specific CVDs, low BMD was associated with an increased risk of developing coronary artery disease, cerebrovascular conditions, and CVD‐associated death. Fractures at baseline was associated with an increased risk of cerebrovascular conditions and death due to CVD. In conclusion, low BMD and fractures are associated with a small, but significant increased risk of CVD risk and possibly death. © 2017 American Society for Bone and Mineral Research.     

Longitudinal Adaptations of Bone Mass,Geometry, and Metabolism in Adolescent Male Athletes: The PRO‐BONE Study

Adolescence is a crucial period for bone development, and exercise can enhance bone acquisition during this period of life. However, it is not known how the different loading sports practiced can affect bone acquisition in adolescent male athletes. Therefore, the purpose of the present study was to determine the 1‐year longitudinal bone acquisition among adolescent males involved in osteogenic (football) and non‐osteogenic (swimming and cycling) sports and to compare with active controls. A total of 116 adolescent males aged 12 to 14 years at baseline were followed for 1 year: 37 swimmers, 37 footballers, 28 cyclists, and 14 active controls. Bone mineral content (BMC) was assessed using dual‐energy X‐ray absorptiometry (DXA); cross‐sectional area (CSA), cross‐sectional moment of inertia (CSMI), and section modulus (Z) at the femoral neck was assessed using hip structural analysis (HSA); and bone texture of the lumbar spine was assessed using trabecular bone score (TBS). Serum N‐terminal propeptide of procollagen type I (PINP), isomer of the Carboxi‐terminal telopeptide of type 1 collagen (CTX‐I), total serum calcium, and 25 hydroxyvitamin D [25(OH)D] were analyzed. Footballers had significantly higher adjusted BMC at the lumbar spine (7.0%) and femoral neck (5.0%) compared with cyclists, and significantly greater BMC at the lumbar spine (6.9%) compared with swimmers. Footballers presented significantly greater TBS (4.3%) compared with swimmers, and greater CSMI (10.2%), CSA (7.1%), Z (8.9%) and TBS (4.2%) compared with cyclists. No differences were noted between cyclists and swimmers, both groups had similar bone acquisition compared with controls. PINP was significantly higher in footballers and controls compared with cyclists and swimmers (3.3% to 6.0%), and 25(OH)D was significantly higher in footballers and cyclists compared with swimmers and controls (9.9% to 13.1%). These findings suggest that bone acquisition is higher in adolescent male footballers compared with swimmers and cyclists at the femoral neck and lumbar spine sites of the skeleton. © 2017 American Society for Bone and Mineral Research.     

Mechanical Competence and Bone Quality Develop During Skeletal Growth

Bone fracture risk is influenced by bone quality, which encompasses bone's composition as well as its multiscale organization and architecture. Aging and disease deteriorate bone quality, leading to reduced mechanical properties and higher fracture incidence. Largely unexplored is how bone quality and mechanical competence progress during longitudinal bone growth. Human femoral cortical bone was acquired from fetal (n = 1), infantile (n = 3), and 2- to 14-year-old cases (n = 4) at the mid-diaphysis. Bone quality was assessed in terms of bone structure, osteocyte characteristics, mineralization, and collagen orientation. The mechanical properties were investigated by measuring tensile deformation at multiple length scales via synchrotron X-ray diffraction. We find dramatic differences in mechanical resistance with age. Specifically, cortical bone in 2- to 14-year-old cases exhibits a 160% greater stiffness and 83% higher strength than fetal/infantile cases. The higher mechanical resistance of the 2- to 14-year-old cases is associated with advantageous bone quality, specifically higher bone volume fraction, better micronscale organization (woven versus lamellar), and higher mean mineralization compared with fetal/infantile cases. Our study reveals that bone quality is superior after remodeling/modeling processes convert the primary woven bone structure to lamellar bone. In this cohort of female children, the microstructural differences at the femoral diaphysis were apparent between the 1- to 2-year-old cases. Indeed, the lamellar bone in 2- to 14-year-old cases had a superior structural organization (collagen and osteocyte characteristics) and composition for resisting deformation and fracture than fetal/infantile bone. Mechanistically, the changes in bone quality during longitudinal bone growth lead to higher fracture resistance because collagen fibrils are better aligned to resist tensile forces, while elevated mean mineralization reinforces the collagen scaffold. Thus, our results reveal inherent weaknesses of the fetal/infantile skeleton signifying its inferior bone quality. These results have implications for pediatric fracture risk, as bone produced at ossification centers during children's longitudinal bone growth could display similarly weak points. © 2019 American Society for Bone and Mineral Research.     

Sex-Specific Associations Between Cardiac Workload,Peripheral Vascular Calcification,and Bone Mineral Density: The Gambian Bone and Muscle Aging Study

Noncommunicable diseases (NCD) are rapidly rising in Africa, with multimorbidity increasing the burden on health and social care. Osteoporosis and cardiovascular disease (CVD) share common risk factors; both often remain undiagnosed until a major life-threatening event occurs. We investigated the associations between cardiac workload, peripheral vascular calcification (PVC), and bone parameters in Gambian adults. The Gambian Bone and Muscle Aging Study (GamBAS) recruited 249 women and 239 men aged 40 to 75+ years. Body composition and areal bone mineral density (aBMD) were measured using dual-energy X-ray absorptiometry; peripheral quantitative computed tomography (pQCT) scans were performed at the radius and tibia. Supine blood pressure and heart rate were measured and used to calculate rate pressure product and pulse pressure. Presence of PVC was determined from tibia pQCT scans. Sex interactions were tested (denoted as p-int); adjustments were made for residuals of appendicular lean mass (ALM) and fat mass (FM). There were negative associations between rate pressure product and aBMD in women only, all p-int < .05; after adjustment for ALM residuals, for every 10% increase in rate pressure product, aBMD was lower at the whole body (−0.6% [−1.2, −0.1]), femoral neck (−0.9% [−1.8, −0.05]), L₁ to L₄ (−0.6% [−1.7, 0.5]), and radius (−1.9% [−2.8, −0.9]); there were similar associations when adjusted for FM residuals. Similar negative associations were found between pulse pressure and aBMD in women only. PVC were found in 26.6% men and 22.5% women; women but not men with calcification had poorer cardiac health and negative associations with aBMD (all sites p-int < .001). There were consistent associations with cardiac parameters and pQCT outcomes at the radius and tibia in women only. Multiple markers of cardiac health are associated with poorer bone health in Gambian women. In the context of epidemiological transition and changing NCD burden, there is a need to identify preventative strategies to slow/prevent the rising burden in CVD and osteoporosis in Sub-Saharan Africa. © 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).     

Bone Fracture Toughness and Strength Correlate With Collagen Cross‐Link Maturity in a Dose‐Controlled Lathyrism Mouse Model

Collagen cross‐linking is altered in many diseases of bone, and enzymatic collagen cross‐links are important to bone quality, as evidenced by losses of strength after lysyl oxidase inhibition (lathyrism). We hypothesized that cross‐links also contribute directly to bone fracture toughness. A mouse model of lathyrism using subcutaneous injection of up to 500 mg/kg β‐aminopropionitrile (BAPN) was developed and characterized (60 animals across 4 dosage groups). Three weeks of 150 or 350 mg/kg BAPN treatment in young, growing mice significantly reduced cortical bone fracture toughness, strength, and pyridinoline cross‐link content. Ratios reflecting relative cross‐link maturity were positive regressors of fracture toughness (HP/[DHLNL + HLNL] r² = 0.208, p < 0.05; [HP + LP]/[DHNL + HLNL] r² = 0.196, p < 0.1), whereas quantities of mature pyridinoline cross‐links were significant positive regressors of tissue strength (lysyl pyridinoline r² = 0.159, p = 0.014; hydroxylysyl pyridinoline r² = 0.112, p < 0.05). Immature and pyrrole cross‐links, which were not significantly reduced by BAPN, did not correlate with mechanical properties. The effect of BAPN treatment on mechanical properties was dose specific, with the greatest impact found at the intermediate (350 mg/kg) dose. Calcein labeling was used to define locations of new bone formation, allowing for the identification of regions of normally cross‐linked (preexisting) and BAPN‐treated (newly formed, cross‐link‐deficient) bone. Raman spectroscopy revealed spatial differences attributable to relative tissue age and effects of cross‐link inhibition. Newly deposited tissues had lower mineral/matrix, carbonate/phosphate, and Amide I cross‐link (matrix maturity) ratios compared with preexisting tissues. BAPN treatment did not affect mineral measures but significantly increased the cross‐link (matrix maturity) ratio compared with newly formed control tissue. Our study reveals that spatially localized effects of short‐term BAPN cross‐link inhibition can alter the whole‐bone collagen cross‐link profile to a measureable degree, and this cross‐link profile correlates with bone fracture toughness and strength. Thus, cross‐link profile perturbations associated with bone disease may provide insight into bone mechanical quality and fracture risk. © 2014 American Society for Bone and Mineral Research.     

A Bone Anabolic Effect of RANKL in a Murine Model of Osteoporosis Mediated Through FoxP3+ CD8 T Cells

TNF‐α and IL‐17 secreted by proinflammatory T cells (T_EFF) promote bone erosion by activating osteoclasts. We previously demonstrated that in addition to bone resorption, osteoclasts act as antigen‐presenting cells to induce FoxP3 in CD8 T cells (Tc_REG). The osteoclast‐induced regulatory CD8 T cells limit bone resorption in ovariectomized mice (a murine model of postmenopausal osteoporosis). Here we show that although low‐dose receptor activator of NF‐κB ligand (RANKL) maximally induces Tc_REG via Notch signaling pathway to limit bone resorption, high‐dose RANKL promotes bone resorption. In vitro, both TNF‐α and IL‐17, cytokines that are abundant in ovariectomized animals, suppress Tc_REG induction by osteoclasts by repressing Notch ligand expression in osteoclasts, but this effect can be counteracted by addition of RANKL. Ovariectomized mice treated with low‐dose RANKL induced Tc_REG that suppressed bone resorption, decreased T_EFF levels, and increased bone formation. High‐dose RANKL had the expected osteolytic effect. Low‐dose RANKL administration in ovariectomized mice lacking CD8 T cells was also osteolytic, confirming that Tc_REG mediate this bone anabolic effect. Our results show that although RANKL directly stimulates osteoclasts to resorb bone, it also controls the osteoclasts' ability to induce regulatory T cells, engaging an important negative feedback loop. In addition to the conceivable clinical relevance to treatment of osteoporosis, these observations have potential relevance to induction of tolerance and autoimmune diseases. © 2015 American Society for Bone and Mineral Research.