Regional Variations in the Apparent and Tissue-Level Mechanical Parameters of Vertebral Trabecular Bone with Aging Using Micro-Finite Element Analysis

The aim of this study was to obtain the apparent and tissue-level mechanical parameters of vertebral cancellous bones using micro-finite element analysis, and to identify the regional variations and their relative differences with respect to aging. Ninety trabecular specimens were obtained from six normal L4 vertebral bodies of six male cadavers in two age groups, three aged 62 years and three aged 69 years, and then were scanned using a high-resolution micro-Computed Tomography (micro-CT) system. The obtained micro-CT reconstruction models were then converted to micro-finite element models. Micro-finite element analyses were done to determine the apparent Young’s moduli and tissue-level Von Mises stress distribution for each trabecular specimen on the longitudinal direction, and medial–lateral and anterior–posterior directions (transverse directions), respectively. Regional variations about the mechanical parameters at both apparent and tissue levels in different transverse layers and vertical columns within and between the two age groups were then analyzed. The results showed significant decreases in the apparent Young’s moduli in each direction with aging, and those in the two transverse directions decreased more with aging compared with the longitudinal direction. Furthermore, there were no statistically significant differences between the mechanical parameters in the two transverse directions in both age groups. This study offered an insight into the distributions and variations of mechanical properties within a vertebral body. The mechanical parameters calculated from this study may help in a better understanding of regional fracture risks and the vertebral fracture mechanism in the prevention of osteoporotic fracture in elder individuals.     

椎基静脉孔及椎体静脉解剖在椎体成形术中的意义

目的　为胸腰椎（T8～L5）椎体成形术减少骨水泥渗漏等并发症提供解剖学依据。 方法　对40例健康成人胸腰椎螺旋CT薄层扫描和重建,观察每节段正中矢状位和横断位图像上椎基静脉孔（basivertebral foramen, BF）和椎体静脉孔道(vertebral vein, VV)出现的频率;测量椎体正中矢状径（VD）和BF宽（BFW）、深（BFD）高（BFH）;测量BF距椎体左右缘距离（VW1和VW2）和距上下终板的距离（VH1和VH2）,应用Stata7.0统计学软件包对上述数据进行统计学分析。 结果 BF及VV出现的频率从T8到L5逐渐增大,BF和VV观察到的频率在性别间差异无统计学意义（P＞0.05）。BFW、BFH、BFD从T8至L5随椎体增大相应增大。在不同椎体上BFD约为VD的1/3。VW1和VW2之间差异无统计学意义（P＞0.05）;VH1和VH2之间差异有统计学差异(P＜0.05)。BF更接近椎体上终板。 结论 熟悉BF和VV在椎体内的分布有助于减少椎体成形术中骨水泥渗漏等并发症的发生。     

Possible antiosteoporotic mechanism of Cicer arietinum extract in ovariectomized rats

Objective: The present study aimed to throw the light on the anti-osteoprotic mechanism of Cicer arietinum extract (CAE) seeds against ovariectomized (OVX) rats. Methods: Seventy female rats were divided into two groups. The first group (14 rats/group) represented normal rats (Sham operated) while the second group (56 rats/group) underwent bilateral ovariectomy (OVX). After one week of recovery from ovariectomy surgery, the second group was randomly subdivided into 4 subgroups (14 rats/ each subgroup). The rats administered orally; distilled water (vehicle) (1^st subgroup), Cicer arietinum extract (CAE) (500 or 1000 mg/kg body weight/day) (2^nd and 3^rd subgroups), alendronate (6.5 mg/kg mg/kg body weight) as a positive control one time/week (4^rh subgroup), daily for 10 weeks. Results: The present study demonstrated that ovariectomy caused significant decrease in bone mineral; density (BMD) and content (BMC), Bone-specific alkaline phosphatase (BALP), calcium (Ca), phosphorus (P), parathyroid hormone (PTH) and calcitonin levels. Furthermore, ovariectomy induced significant elevation of tartrate-resistant acid phosphatase 5b (TRAP 5b) and receptor activator of nuclear factor (NF-kappa β) ligand (RANKL) concentration. Conversely, osteoprotegerin (OPG) and OPG/RANKL ratio were decreased following ovariectomy. The present work suggests that CAE has antiosteoporotic action against ovariectomy effects and its activity may results from its phytochemical and/or phytoestrogen contents. Conclusion: The ongoing study speculates that the CAE exerts its action through regulation of RANK/RANKL/OPG system. As, CAE not only promotes osteoblast differentiation, but also up-regulates OPG and downregulates RANKL secretion in osteoblasts, subsequently prevents bone loss and osteoporosis.     

彩色多普勒超声在椎动脉粥样硬化诊断中的研究进展

后循环缺血（PCI）是一种临床常见病和多发病,系指椎基底动脉系统短暂性脑缺血发作和脑梗死。椎动脉粥样硬化是PCI常见的病因之一。 PCI的影像学检查包括经颅多普勒超声（TCD）、数字减影血管造影术（DSA）、计算机控制体层摄影造影术（CTA）、磁共振血管造影术（MRA）及彩色多普勒超声（CDU）等。TCD可作为PCI的初步筛查工具,DSA是目前椎动脉疾病诊断的“金标准”;CTA和DSA同属有创检查,且都需要造影剂,不易被患者接受;MRA属于无创检查,但其可能夸大血管狭窄程度;CDU可较准确测量椎动脉内径及评价血流动力学参数,可作为PCI无创伤性的检查手段,具有直接、准确、方便及可重复性等优点,为PCI的明确诊断和疗效评价提供客观依据。就CDU在椎动脉粥样硬化患者诊断中的研究进展作一综述。     

绝经激素治疗与骨质疏松症

绝经激素治疗（MHT）是治疗绝经相关的血管舒缩症状和外阴阴道萎缩症状最有效的方法。此外,MHT对绝经后骨质疏松症的预防和治疗均有显著疗效。国际绝经学会及中国绝经学组制定的相关指南已将预防或治疗绝经后骨质疏松症纳入为MHT适应证之一。但雌激素的生理作用广泛,使用时获益和风险并存,故使用MHT预防或治疗绝经后骨质疏松症需注意掌握好适应证及禁忌证。     

内窥镜后路下腰椎间盘切除术解剖与临床研究

目的：为显微内窥镜下腰椎间盘切除术提供解剖学基础,提高手术效果.方法：20具成人L3～S1段尸体标本,去除腰椎畸形凸出标本,正中矢状锯开,观测椎板、黄韧带、神经根与椎间盘之间关系.临床应用椎间盘镜（MED）治疗腰椎间盘突出56例.结果：L3～4椎间盘被L3椎板遮挡最多,L4～5椎间盘次之,而L5～S1椎间盘没有或仅有少许被L5椎板遮挡 L3～4椎间盘下缘均在L4神经根肩部上方,L4～5椎间盘下缘多在L5神经根肩部、腋部之间,而L5～S1椎间盘多在S1神经根腋部下方 临床随访5～8个月,根据NaKai分级,优46例,良9例,可1例.优良率98.2% .结论：严格把握适应证、熟练掌握腰椎各节段解剖特点,是提高MED手术成功率和减少并发症的关键.     

胰岛素联合唑来膦酸治疗糖尿病骨质疏松症对患者血清指标的影响

目的 分析胰岛素联合唑来膦酸治疗对糖尿病骨质疏松（DOP）患者血糖血脂以及骨代谢指标的影响。方法 选择2016年12月~2019年4月于我院诊治的DOP患者共136例进行研究,采用随机数字表法分为对照组和实验组,每组68例,对照组采用二甲双胍联合唑来膦酸治疗,实验组采用胰岛素联合唑来膦酸治疗,比较两组干预后血脂水平（TG、TC、LCL-C、HDL-C）、血糖指标（空腹、餐后2h、糖化血红蛋白）以及骨代谢相关指标（BAP、TRAP-5b、BGP以及s-CTX）。结果 治疗后实验组空腹、餐后2h血糖及HbA1c均低于对照组（P＜0.05）;实验组治疗后TG、TC、LCL-C、HDL-C水平均低于对照组（P＜0.05）;实验组BAP、BGP水平均高于对照组（P＜0.05）;实验组TRAP-5b水平均低于对照组（P＜0.05）;两组s-CTX指标比较,差异无统计学意义（P＞0.05）。结论 对DOP患者使用胰岛素与唑来膦酸联合治疗方案,有助于改善患者的血脂以及血糖水平,同时利于患者骨骼骨质的沉积,值得临床应用。     

自然衰老大鼠不同部位骨组织形态、骨密度及骨代谢指标的变化

背景:大鼠是四足啮齿动物,其骨骼负重方面与直立行走的人类并不相同,且大鼠最大寿限内出现骨稳态破坏的时程变化与人也是不一致的.目的:分析不同大鼠自然衰老过程中骨代谢的变化.方法:将SD大鼠分为雌性组与雄性组,各40只.其中雌性组随机分为雌性7,10,15,20月龄组,各10只;雄性组随机分为雄性7,10,15,20月龄组...     

Relationship between bone mass density and tensile strength of the skin in women

BACKGROUND: Skin and bone may be affected similarly during the climacteric and during long-term corticotherapy. Little is known about the correlation between the respective alterations in bone mass density (BMD) and tensile strength of the skin. MATERIALS AND METHODS: A total of 100 women aged 19-88 years, receiving, or not, hormone replenishment therapy or systemic corticosteroids, were enrolled in the study. Tensile strength of the inner forearm skin was measured using the suction method operated in both the steep and progressive-force application modes. BMD was measured by dual X-ray absorptiometry at the hip, femoral neck and lumbar spine. RESULTS: Being heterogeneous, the population of volunteers yielded a wide range of BMD and cutaneous tensile strength values. However, significant correlations were found between BMD and tensile skin parameters. In particular, a positive correlation was yielded between the biological elasticity of skin and the BMD of the hip and femoral neck. CONCLUSION: An overall correlation is shown between skin elasticity on a relatively sun-protected area and cortico-trabecular BMD.