替格瑞洛对行PCI术后患者心肌酶影响及一年随访事件相关性分析

摘要 目的：研究替格瑞洛对行PCI术后患者心肌酶影响及一年随访事件相关性分析。方法：选取2019年5月至2019年12月的133例急性心肌梗死患者。按照随机数表法分为观察组（n=68）和对照组（n=65）,两组均采用PCI术治疗,术后对照组采用氯吡格雷治疗,观察组采用替格瑞洛治疗。对比两组治疗效果,心肌血流灌注指标,心肌酶变化,不良反应发生率。结果：治疗后,观察组总有效率显著高于对照组[95.58%（65/68）vs75.38％（49/65）]（P＜0.05）;TIMI3级、TMPG3级及无复流/满血流均显著低于对照组[17.64%（12/68）vs40.00%（26/65）,26.47%（18/68）vs46.15%（30/65）,7.35%（5/68）vs27.69%（18/65）]（P<0.05）; LDH、CK、CK-MB均显著低于对照组[（207.38±21.90）U/L vs（253.75±26.37）U/L,（166.38±19.32）U/L vs（389.75±52.03）U/L,（121.58±15.86）U/L vs（162.60±18.75）U/L]（P<0.05）;一年随访事件发生率显著低于对照组［11.76％（8/68）vs36.92％（24/65）］（P<0.05）。结论：替格瑞洛对可有效改善行PCI术后患者血流灌注,保护心肌细胞,改善心肌功能,提高治疗疗效。     

静注人免疫球蛋白联合万古霉素治疗小儿败血症的疗效及外周血NLR、PCT变化观察

摘要 目的：观察静注人免疫球蛋白联合万古霉素治疗小儿败血症的疗效及外周血中性粒细胞/淋巴细胞比值（NLR）、降钙素原(PCT)变化。方法：选取2011年1月~2020年1月我院收治的败血症患儿80例为研究对象,按数字随机表法分为对照组和观察组各40例,对照组给予万古霉素治疗,观察组在对照组基础上给予静注人免疫球蛋白治疗,比较两组临床疗效、症状改善时间和住院时间、NLR、PCT、超敏C反应蛋白(hs-CRP)、白细胞计数（WBC）、免疫功能及不良反应发生率。结果：观察组治疗有效率高于对照组（87.50%vs65.00%）（P<0.05）。观察组神经系统症状改善时间、体温改善时间、拒奶改善时间和住院时间为（6.22±1.05）d、（3.88±0.25）d、（5.10±0.86）d、（8.71±2.05）d,均短于对照组的（8.76±1.53）d、（6.22±0.64）d、（7.53±1.46）d和（11.24±3.36）d,比较差异有统计学意义（P<0.05）。治疗后观察组外周血NLR、PCT、hs-CRP、WBC水平为（1.35±0.20）、（0.80±0.34）mg/mL、（3.56±0.62）g/L、（9.12±1.80）×10⁹/L,均显著低于对照组的（1.83±0.32）、（2.19±0.73）mg/mL、（9.78±2.64）g/L和（12.26±2.59）×10⁹/L,比较差异有统计学意义（P<0.05）。治疗后观察组CD4⁺、CD3⁺、CD4/CD8为（42.77±11.36）％、（41.27±11.26）％、（1.70±0.33）,均显著高于对照组的（35.80±9.32）％、（35.66±9.40）％和（1.29±0.25）,比较差异有统计学意义（P<0.05）。两组不良反应发生率比较无差异（10.00%vs7.50%）（P>0.05）。结论：静注人免疫球蛋白联合万古霉素治疗小儿败血症的疗效显著,可降低炎症因子,提高免疫功能,且安全性较高。     

限制性液体复苏对多发性骨折合并创伤失血性休克患者凝血功能、心肌损害指标及预后的影响

摘要 目的：研究限制性液体复苏对多发性骨折合并创伤失血性休克患者凝血功能、心肌损害指标及预后的影响。方法：选择2020年6月至2022年5月的90例多发性骨折合并创伤失血性休克患者进行本次研究，按照随机数表法分为研究组（n=47）和对照组（n=43），对照组采用常规液体复苏治疗，研究组采用限制性液体复苏治疗。对比两组输液量、失血量、输血量，复苏前及复苏后1 h凝血功能指标（PT、APTT、TT）水平，心肌损害指标（CK、CK-MB、CTnT）水平，并发症发生率。结果：研究组输液量、失血量、输血量均显著低于对照组[（2106.87±135.62）mL vs（2950.39±139.57）mL，（1049.31±160.07）mL vs（1390.18±135.89）mL，（1465.02±191.78）mL vs（1860.23±198.59）mL]（P＜0.05）；研究组PT、 APTT、 TT水平均显著高于对照组[（19.06±1.80）s vs（15.82±1.26）s，（42.03±3.85）s vs（37.02±3.19）s，（21.03±3.86）s vs（15.80±3.27）s]（P＜0.05）；研究组CK、CK-MB、CTnT水平均显著低于对照组[（20.85±2.72）U/L vs（32.97±3.69）U/L，（23.06±3.28）U/L vs（35.97±3.70）U/L，（2.07±0.36）ng/mL vs（2.90±0.38）ng/mL]（P＜0.05）；研究组并发症发生率显著低于对照组[10.64%（5/47）vs27.91％（12/43）]（P＜0.05）。结论：多发性骨折合并创伤失血性休克患者采用限制性液体复苏可有效改善的其凝血功能，保护心肌细胞，提高患者预后。     

普适泰治疗慢性IIIA型前列腺炎患者的疗效及对前列腺液IFN-γ、TGF-β1的影响

摘要 目的：探讨普适泰治疗慢性IIIA型前列腺炎患者的疗效及对前列腺液干扰素-γ（IFN-γ）、转化生长因子-β₁（TGF-β₁）的影响。方法：选择2018年1月至2019年6月我院接诊的120例慢性IIIA型前列腺炎患者,通过随机数表法分为观察组和对照组,每组60例。在常规处理基础上,对照组给予左氧氟沙星、坦索罗辛缓释胶囊治疗,观察组在对照组基础上,联合普适泰片治疗,均连续治疗连续用药12周。比较两组临床疗效、美国国立卫生研究院慢性前列腺炎症状指数（NIH-CPSI）、前列腺液白细胞计数（WBC）、卵磷脂小体（HP）、IFN-γ、TGF-β₁的变化及不良反应。结果：治疗后,观察组临床疗效总有效率为93.33%,明显高于对照组的78.33%,差异有统计学意义（P＜0.05）;观察组NIH-CPSI评分中疼痛和不适、排尿症状、症状严重程度及总分均明显低于对照组[（5.05±0.69）vs（6.33±0.74）分,（1.56±0.43）vs（2.70±0.55）分,（6.31±1.50）vs（7.92±1.64）分,（12.92±2.44）vs（16.95±2.87）分],差异有统计学意义（P＜0.05）;观察组前列腺液WBC、IFN-γ、TGF-β₁明显低于对照组[（8.52±1.70）vs（10.04±1.58）个/HP,（8.06±1.32）vs（9.72±1.61）ng/L,（27.34±3.06）vs（42.57±3.89）ng/L],HP明显比对照组高[（81.06±5.75）vs（70.22±6.31）%],差异有统计学意义（P＜0.05）;两组治疗期间恶心呕吐、乏力、心悸的总发生率比较差异无统计学意义（P＞0.05）。结论：在常规治疗基础上,联合普适泰治疗治疗慢性IIIA型前列腺炎患者疗效显著,可有效促进症状恢复,降低前列腺液IFN-γ、TGF-β₁的表达,且不增加不良反应,值得应用推广。     

痹祺胶囊联合依那西普对强直性脊柱炎患者急性时相反应物指标、血清疼痛介质和骨代谢指标的影响

摘要 目的：探讨痹祺胶囊联合依那西普对强直性脊柱炎（AS）患者急性时相反应物指标、血清疼痛介质和骨代谢指标的影响。方法：纳入西安市第五医院2020年4月~2022年3月期间收治的96例AS患者。按照随机数字表法分为对照组（n=48）和研究组（n=48）,对照组接受依那西普治疗,研究组接受痹祺胶囊联合依那西普治疗。对比两组疗效、临床症状指标[Bath强直性脊柱炎活动指数（BASDAI）、Bath强直性脊柱炎功能指数（BASFI）、Bath强直性脊柱炎计量学指数（BASMI）、视觉疼痛模拟（VAS）评分]、急性时相反应物指标[红细胞沉降率（ESR）、C反应蛋白（CRP）]、血清疼痛介质指标[前列腺素E₂ (PGE₂) 、P物质( SP)、多巴胺（DA）,五羟色胺（5-HT）]和骨代谢指标[骨形态发生蛋白-2（BMP-2）、骨钙素（BGP）],观察两组不良反应发生情况。结果：研究组（95.83%）的临床总有效率高于对照组（79.17%）,差异有统计学意义（P<0.05）。两组治疗后PGE₂、SP、DA、5-HT下降,且研究组的下降程度更大（P<0.05）。两组治疗后CRP、ESR下降,且研究组的下降程度更大（P<0.05）。两组治疗后BMP-2、BGP升高,且研究组的升高程度更大（P<0.05）。两组治疗后BASDAI、BASFI、BASMI、VAS评分下降,且研究组的下降程度更大（P<0.05）。两组不良反应发生率对比无差异（P>0.05）。结论：痹祺胶囊联合依那西普治疗AS患者,疗效较好,可改善临床症状,调节急性时相反应物指标、血清疼痛介质和骨代谢指标水平,安全性较高。     

针灸、推拿及中药外敷对腰椎间盘突出的临床疗效及血清TXB2、IL-1β、IL-10水平对比

摘要 目的：研究针灸、推拿及中药外敷对腰椎间盘突出的临床疗效及血清血栓素（thromboxane,TXA2）、白细胞介素-1β （Interleukin-1β）、白细胞介素-10 （Interleukin-10 IL-10）水平对比。方法：选取2019年1月至2020年12月的80例腰椎间盘突出患者。按照随机数表法分为观察组（n=41）和对照组（n=39）,对照组采用中药外敷治疗,观察组采用针灸、推拿及中药外敷联合治疗。对比两组治疗效果,治疗前后日本骨科协会评估治疗分数（Japanese Orthopaedic Association Scores JOA）、视觉模拟评分法（visual analogue scale VAS）评分情况变化,血清TXB2、IL-1β、IL-10水平变化,腰椎功能及腰部关节活动度,不良反应发生率。结果：治疗后,观察组总有效率显著高于对照组[95.12%（39/41）vs71.79％（28/39）]（P＜0.05）;JOA显著高于对照组[（23.19±3.21）分vs（17.62±2.65）分]（P<0.05）,VAS评分显著低于对照组[（2.07±0.38）分vs（3.58±0.61）分]（P<0.05）;血清TXB2、IL-1β水平均显著低于对照组[（24.37±3.26）μg/L vs（34.08±4.72）μg/L,（0.12±0.03）ng/L vs（0.27±0.05）ng/L]（P<0.05）;血清IL-10水平显著低于对照组[（85.82±7.03）pg/mL vs（57.28±6.31）pg/mL]（P<0.05）;功能障碍指数（Oswestry disability index）显著低于对照组[（37.81±6.23）％ vs（68.02±8.91）％]（P<0.05）;腰部关节活动度显著高于对照组[（80.36±0.82）° vs（71.27±0.6）°]（P<0.05）;两组不良反应对比无显著差异（P>0.05）。结论：针灸、推拿及中药外敷对腰椎间盘突出的临床疗效显著,可有效改善患者的临床症状,缓解疼痛,抑制炎症因子TXB2、IL-1β表达,促进抗炎因子IL-10水平升高,安全有效。     

痛敏穴刺血加艾灸疗法治疗类风湿关节炎临床疗效研究

摘要 目的：观察痛敏穴刺血加艾灸疗法治疗类风湿关节炎（RA）患者的临床疗效。方法：选取2019年1月~2022年1月44例类风湿关节炎患者随机分为2组,每组22例。对照组予以来氟米特片和塞来昔布胶囊治疗,观察组在对照组基础上采用痛敏穴刺血加艾灸疗法。两组患者治疗前后采用视觉模拟评分法（VAS）和疾病活动评分（DAS-28）进行评估,并检测类风湿因子(RF)、超敏C反应蛋白（hs-CRP）、血沉(ESR)、类风湿因子（RF）、纤维蛋白原（FIB）、D二聚体水平。结果：两组治疗后VAS评分降低（P<0.05）,而研究组较对照组低（P<0.05）。两组治疗后DAS-28评分降低（P<0.05）,而研究组较对照组低（P<0.05）。两组治疗后RF、hs-CRP、FIB、D二聚体水平均明显下降（P<0.05）,而研究组均明显低于对照组（P<0.05）。观察组总有效率（100.00 %）明显高于对照组（72.73 %）（P<0.05）。结论：痛敏穴刺血加艾灸能够提高RA患者的临床疗效,且能够提高机体的抗炎效应。     

六味能消胶囊联合复方消化酶对功能性消化不良患者临床症状及脑-肠轴相关因子水平的影响

摘要 目的：探讨六味能消胶囊联合复方消化酶对功能性消化不良（FD）患者临床症状及脑-肠轴相关因子水平的影响。方法：选取2018年7月~2019年12月期间攀枝花市中心医院收治的80例FD患者,以随机数字表法分为研究组（n=40）和对照组（n=40）。对照组给予复方消化酶治疗,研究组给予复方消化酶联合六味能消胶囊治疗,对比两组的脑-肠轴相关因子水平,疗效,症状改善时间及不良反应。结果：治疗4周后研究组的临床总有效率为92.50%（37/40）,高于对照组的72.50%（29/40）（P<0.05）。研究组食量恢复时间（4.62±0.74）d、食欲恢复时间（3.61±0.57）d、恶心呕吐消失时间（1.59±0.36）d分别较对照组的（7.68±1.71）d、（5.71±0.86）d、（3.87±0.52）d缩短（P<0.05）。研究组治疗4周后胃泌素（149.77±13.89）ng/L、胃动素（159.18±12.86）ng/L、神经肽S 受体 1（NPSR1）（164.10±15.88）pg/mL均高于对照组的（93.34±8.92）ng/L、（123.23±10.97）ng/L、（130.23±12.64）pg/mL（P<0.05）,研究组治疗4周后降钙素基因相关肽（CGRP）（49.52±6.49）pg/mL、血管活性肠钛（VIP）（22.69±3.61）ng/L、生长抑素（SS）（32.13±3.36）pg/mL低于对照组的（63.19±8.38）pg/mL、（27.83±3.73）ng/L、（41.85±4.38）pg/mL（P<0.05）。两组不良反应发生率对比无明显差异（P>0.05）。结论：复方消化酶联合六味能消胶囊治疗FD患者疗效显著,可有效缓解临床症状,改善脑-肠轴相关因子水平,且不增加不良反应发生率。     

白细胞、C反应蛋白与凝血指标在哮喘发作期患儿的临床意义

摘要 目的：探讨白细胞（WBC）、C反应蛋白（CRP）与常见凝血指标凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、凝血酶时间（TT）、抗凝血酶Ⅲ（ATⅢ）、D二聚体（D-D）在哮喘发作期儿童的临床意义。方法：选取发作期哮喘儿童,根据发作严重程度分为轻度、中度、重度3组。比较指标的组间差异,Pearson相关计算WBC、CRP与凝血指标的相关性,Logistic评估中度或重度哮喘发作期的影响因素。结果：全血WBC在中度组（12.02 ×10⁹ /L ± 4.61 ×10⁹ /L）显著高于轻度组（9.56 ×10⁹ /L ± 3.21 ×10⁹ /L,P < 0.05）,重度组（12.91×10⁹ /L ± 3.14 ×10⁹ /L）显著高于轻度组（9.56 ×10⁹ /L ± 3.21 ×10⁹ /L,P < 0.05）;重度组抗凝血酶ATⅢ（109% ± 13%）高于轻度组（99% ± 13%,P < 0.05）。WBC与FIB正相关（r = 0.297, P = 0.018）,CRP与TT（r = -0.330, P = 0.008）、ATⅢ（r = -0.375, P = 0.002）负相关,与FIB（r = 0.496, P = 0.001）、D-D（r = 0.326, P = 0.009）正相关。Logistic回归显示校正性别年龄的WBC影响重度组的比值比（OR）为1.602。结论：WBC和儿童哮喘发作严重程度有关,哮喘发作期儿童体内炎症状态与凝血指标存在一定关联。     

齐墩果酸对APP/PS-1双转基因AD小鼠的神经保护作用研究

摘要 目的：研究齐墩果酸（Oleanolic Acid，OA）对APP/PS-1双转基因阿尔茨海默病（Alzheimer''s disease，AD）小鼠模型神经保护作用及机制。方法：选取6月龄APP/PS-1雄性小鼠21只，随机分为模型组（0.5% CMC-Na）、阳性组（多奈哌齐组，0.7 mg?kg^-1）、齐墩果酸组（10 mg?kg^-1）每组7只，6月龄同背景SPF级C57BL/6小鼠7只为对照组。灌胃8周之后通过Morris水迷宫实验观察小鼠学习记忆能力的改变，HE染色观察神经元细胞形态，ELISA检测血清中Aβ1-42含量；免疫组化检测Aβ_1-42、APP、Iba1蛋白表达情况；Western blot检测APP、Iba1蛋白表达水平。结果：（1）对照组，模型组，阳性组及齐墩果酸组进入有效区域次数分别为7.00±2.09，1.00±0.89，3.67±1.97，4.33±2.50，与模型组相比，对照组，阳性组，齐墩果酸组均有统计学意义（P<0.05）；（2）血清Aβ_1-42含量按上述顺序依次为4.98±0.25，2.50±0.66，4.63±0.73，4.36±0.97，与模型组相比，对照组，阳性组，齐墩果酸组均有统计学意义（P<0.05）；（3）免疫组化结果显示与模型组相比，对照组，阳性组，齐墩果酸组Aβ_1-42、APP、Iba1蛋白阳性细胞数减少；（4）WB结果：对照组，模型组，阳性组，齐墩果酸组APP蛋白相对表达量分别为0.52±0.17，1.38±0.35，0.89±0.25，0.93±0.27；这四组的IBA1蛋白相对表达量分别为0.98±0.34，1.79±0.74，1.06±0.61，0.88±0.49，与模型组相比，野生对照组，阳性组，齐墩果酸组APP、IBA1蛋白相对含量有统计学意义（P<0.05）。结论：齐墩果酸组可以改善APP/PS-1模型小鼠记忆力及认知功能，降低海马神经元的损伤，并通过下调Aβ_1-42、APP、Iba1蛋白的表达水平来发挥保护神经作用。     

Straining of the intact and fractured proximal humerus under physiological-like loading

Surgical treatment of proximal humeral fractures remains challenging in elderly patients, primarily due to insufficient implant fixation. Both bone quality and physiological-like loading conditions are commonly overlooked during pre-clinical in vitro evaluation. However, this knowledge is necessary in order to improve surgical treatment of the proximal humerus and the mechanical behavior of implants, particularly in patients with complex fractures and weak bone stock. We hypothesize that the bone quality has a high influence on the bone straining, independent of the arm position. The goal of this study was to determine the straining of the intact and fractured proximal humerus under physiological-like loading conditions. Furthermore, the impact of augmentation on tissue straining was evaluated.

Two representative humeri were selected for this study, one osteoporotic and one reference quality, and scanned using both QCT and DEXA (average DEXA VALUE=0.26 and 0.49 g/cm² respectively). Subcaptial defects were generated, then stabilized with a plate prior to mechanical stiffness testing. From the QCT data, finite element models were generated and the in vitro stiffness tests analytically simulated. Under physiological-like loading conditions, the straining of the bone and implant were analyzed for 0°, 90° forward flexion, and 90° abduction.

Maximal strain values were found for the intact and fractured bone at 90° abduction. This study demonstrates that the straining in a fractured bone of poor quality leads to considerably higher bone strains (up to +30%) than in a more healthy bone. Augmentation of a central void under physiological-like loading with commercial cement led to mechanical failure at the bone–cement interface.

New concepts for the surgical treatment of complex fractures of the proximal humerus should take bone distribution into account and thereby allow effective treatment of fractures in osteoporotic patients. The ultimate salvage procedure of augmentation has mechanical limitations as long as current cement materials are used in osteoporotic patients.     

Circadian rhythms in serum bone markers and their relation to the effect of etidronate in rats

Circadian rhythmicity is an essential feature of bone metabolism. The present study was undertaken to (Aoshima et al., [1998]) determine the changes in bone resorption and formation in rats over 24h, (Black et al., [1999]) evaluate the effect of the consecutive administration of etidronate on circadian rhythms of serum bone markers, and (Blumsohn et al., [1994]) determine whether the effect of etidronate on bone metabolism is circadian time-dependent. One hundred twenty male Wistar rats, which had been adapted to a 12/12h light/dark cycle, were injected subcutaneously once daily with either 0.5 mgP/kg etidronate or 0.9% NaCl (control group) at 0090, 1300, 1700, 2100, 0100, or 0500h for 10d. Serum was collected and tibiae were dissected 24h after the last injection. Serum pyridinoline (Pyd), tartrate-resistant acid phosphatase (TRAP), osteocalcin (OC), alkaline phosphatase (ALP), calcium (Ca), phosphorus (Pi), calcitonin (CT), and parathyroid hormone (PTH) were determined. Bone mineral density (BMD) in the proximal tibia, and the rate of formation of longitudinal trabecular bone over the past 48h were also determined using a chronological labeling method with NTA-Pb. The results showed characteristic circadian rhythms in serum bone markers in rats, with peaks in both bone resorption and bone formation during the animals' rest span. The administration of etidronate at the different times of the day decreased the level of bone-resorption markers (Pyd and TRAP) without affecting the circadian patterns of markers of bone formation (OC and ALP). However, the magnitude of the decrease due to etidronate was not uniform throughout the day, and was greatest during the daytime. Etidronate increased the BMD in the tibial metaphysis in all of the time-treatment groups, but the magnitude of the increase did not vary with the time of etidronate administration. The present data provide a physiological basis for future studies on bone metabolism and may be important in the design of future experiments and in the interpretation of experimental data.     

钙、磷摄入对骨代谢及骨组织形态影响的研究进展

骨代谢始终贯穿于动物的生命过程之中,而机体摄入的钙、磷水平和钙、磷比例又是骨代谢的重要影响因素。钙、磷摄入水平和比例的改变会使甲状旁腺激素（PTH）、降钙素（CT）和1α,25-双羟维生素D3[1,25-（OH）2D3]的水平产生变化,影响RANK／RANKL／OPG系统对骨细胞功能的调控,进而对骨代谢及骨组织形态产生影响。骨唾液酸蛋白（Bone Sialoprotein,BSP）是目前评价成骨细胞分化和骨骼矿化情况的新指标,研究BSP表达水平的变化规律,可以从分子水平解释钙、磷摄入水平和比例对骨组织形态影响的机理。而骨组织形态计量学（Bone Histomorphometry）则是研究钙、磷摄入水平和比例对骨组织形态影响的重要方法。     

Relationship between the shape and density distribution of the femur and its natural frequencies of vibration

It has been recently suggested that mechanical loads applied at frequencies close to the natural frequencies of bone could enhance bone apposition due to the resonance phenomenon. Other applications of bone modal analysis are also suggested. For the above-mentioned applications, it is important to understand how patient-specific bone shape and density distribution influence the natural frequencies of bones. We used finite element models to study the effects of bone shape and density distribution on the natural frequencies of the femur in free boundary conditions. A statistical shape and appearance model that describes shape and density distribution independently was created, based on a training set of 27 femora. The natural frequencies were then calculated for different shape modes varied around the mean shape while keeping the mean density distribution, for different appearance modes around the mean density distribution while keeping the mean bone shape, and for the 27 training femora. Single shape or appearance modes could cause up to 15% variations in the natural frequencies with certain modes having the greatest impact. For the actual femora, shape and density distribution changed the natural frequencies by up to 38%. First appearance mode that describes the general cortical bone thickness and trabecular bone density had one of the strongest impacts. The first appearance mode could therefore provide a sensitive measure of general bone health and disease progression. Since shape and density could cause large variations in the calculated natural frequencies, patient-specific FE models are needed for accurate estimation of bone natural frequencies.     

Death of osteocytes turns off the inhibition of osteoclasts and triggers local bone resorption

Osteocytes have been suggested to play a role in the regulation of bone resorption, although their effect on bone turnover has remained controversial. In order to study this open question, we developed an organ culture system based on isolated rat calvaria, where the osteocyte viability and its effect on osteoclastic bone resorption can be monitored. Our results suggest that osteocytes are constitutively negative regulators of osteoclastic activity. Osteoclasts, which were cultured on calvarial slices with living osteocytes inside, failed to form actin rings which are the hallmarks of resorbing cells. A similar inhibitory effect was also achieved by the conditioned medium obtained from calvarial organ culture, suggesting that living osteocytes produce yet unrecognized osteoclast inhibitors. On the contrary, when osteocyte apoptosis was induced, this inhibitory effect disappeared and strong osteoclastic bone resorption activity was observed. Thus, local apoptosis of osteocytes may play a major role in triggering local bone remodeling.     

抗癫痫药物左乙拉西坦对大鼠骨骼的物理及生化指标的影响

本研究的目的是以性腺完整的动物为模型调查左乙拉西坦(LEV)是否对于骨矿物质密度、骨结构和骨代谢生化指标产生影响,探究抗癫痫药物左乙拉西坦(LEV)是否对骨骼健康存在显著风险。本研究将实验大鼠分为对照组和试验组,每组10只。对照大鼠接受标准实验室饮食(SLD),而试验组中的大鼠喂食富含LEV的实验室饮食12周,并以双能X-线吸收仪测量全身、股骨和腰椎的骨密度。在骨组织中检查骨标记的浓度,股骨和胫骨均用于生物力学测试。研究结果表明:在LEV组中,脂肪组织的绝对值和相对值显著降低,全身骨密度增高,骨碱性磷酸酶(BALP)、Ⅰ型胶原C末端肽(CTX-1)和Ⅰ型前胶原氨基端前肽(PINP)浓度显著增加。本研究初步得出结论:在性腺完整的大鼠模型中长期施用LEV对骨质不具有负面影响。骨矿物质密度(BMD)的显著增加可能表明LEV对骨质可能有正面影响。     

不同强度的体育运动对糖尿病大鼠骨密度及骨代谢的影响

目的:探讨运动强度对糖尿病大鼠骨密度及骨代谢的影响,为糖尿病骨质疏松的预防和治疗提供实验依据。方法:采用一次性腹腔注射链服佐菌素建立糖尿病大鼠模型,随机分为糖尿病对照组、小强度运动组(10 m/min)、中强度运动组(20 m/min)和高强度运动组(30 m/min)。分别于运动前后测定各组大鼠的血糖、骨密度、血清骨钙素(BGP)、碱性磷酸化酶(AKP)、血钙(S-Ca)及血磷(S-P)含量。结果:运动组大鼠血糖均低于训练前和对照组(P0.05)。小强度运动组和高强度运动组大鼠骨密度低于对照组,中强度运动组大鼠骨密度显著高于对照组、小强度运动组和高强度运动组(P0.05);小强度运动组与高强度运动组大鼠骨密度无显著性差异(P0.05)。运动组大鼠BGP和S-P显著升高,AKP下降,差异具有统计学意义(P0.05)。小强度运动组和高强度运动组大鼠S-Ca无显著变化(P0.05);中强度运动组大鼠S-Ca显著升高,且高于小强度运动组和高强度运动组(P0.05)。结论:运动强度对骨密度和骨代谢有一定影响,采取适当的体育运动可提高血清骨钙素含量,改善骨代谢状况,有利于糖尿病骨质疏松症的预防。     

网袋强化椎体成形术与经皮后凸椎体成形术在胸腰段骨质疏松压缩骨折中的短期疗效比较

摘要 目的：研究和比较使用网袋强化椎体成形术与经皮后凸椎体成形术在胸腰段骨质疏松压缩骨折中的短期疗效和安全性。方法：对2018年1月至2021年1月3年内,诊断为脊柱骨质疏松性骨折且行手术治疗的共计95例患者进行回顾性分析。根据实施手术方式的不同,将纳入的95例患者分为网袋组和PKP组。其中行网袋强化椎体成形术41例（网袋组）,行经皮后凸椎体成形术54例（PKP组）。统计和比较两组患者在术后的3天,3月的VAS评分及ODI评分。并对患者的影像学指标进行详细比较,包括患椎的前后缘及中线高度,cobb角,及骨水泥的分布以及骨水泥渗漏率。结果：在术后3天及3月时,两组患者的VAS评分和ODI评分较前均有显著改善(P<0.05),但两组间并无显著差异(P>0.05)。在术后3天及3月时,两组患者的患椎前后缘、中线高度及cobb角较前均有显著改善(P<0.05),但两组间并无显著差异(P>0.05)。网袋组在术后的骨水泥单侧分布率、渗漏率均优于对照组(P<0.05)。两组均未出现严重并发症(P>0.05)。结论：在胸腰椎骨质疏松性压缩骨折的治疗中,与常规的经皮椎体后凸成形术相比,网袋强化椎体成形术在手术疗效及撑开效果中无明显差异,但骨水泥渗漏率显著降低,能够有效的提高手术的安全性,在临床中可以进一步推广。     

On the track of the bog people

The amount of radiographically detectable cortical bone, as determined by measurements of the second metacarpal, was evaluated in 42 male and 45 female Guamanian Chamorros and compared with the degree of bony demineralization in U.S. Caucasians participating in the Baltimore Longitudinal Study on Aging of the Gerontology Research Center. All Chamorros were individually matched to the Caucasian participants for age, sex, and menopause status. Chamorros of both sexes showed bilateral asymmetry in bone measurements and in the amount of cortical bone. Both Chamorro and Caucasian males had longer second metacarpals and more cortical bone than females. Caucasian males, however, had longer and larger second metacarpals than Chamorro males. Despite differences in the length and total width, Chamorro and Caucasian participants generally showed no significant differences in the amount of cortical bone or percent cortical area in the second metacarpal, suggesting that larger bones may not always indicate greater cortical mass. Although cross-sectional data suggested apparent age differences in the onset and rate of bone loss between Chamorros and Caucasians, the numbers of participants were too small to allow meaningful age-by-age statistical comparisons.     

An assessment of impact strength of the mandible

In this study, an animal biomechanical study was performed to investigate the absorbed energy and impact strength of the mandible in relation to specimen position. Four regions of mandibles were loaded as complete pieces and gripped by the jaw of an Izod impact tester. All tests were carried out wet using the Izod impact test under two different impact loading directions, lateral and ventral.Absorbed energy and impact strength in kilojoules per square meter of specimen area were determined for each specimen. Under lateral impact loading, the absorbed energy was lowest for the anterior section due to the mental foramen's notch effect. The premolar region demonstrated more absorbed energy per unit area, or impact strength, than any other region. However, due to its small cross-sectional area, the premolar region also absorbs less impact energy.Under ventral impact loading conditions, anterior region absorbed twice as much impact energy than under lateral loading conditions. Premolar region absorbed the same impact energy under both lateral and ventral loading. Interestingly, mandibular angle under ventral loading absorbed five times more impact energy than under lateral loading. This behaviour is considered to be a mechanical adaptation to the actual loading of the mandible in vivo.