北京地区老年髋部脆性骨折患者术后抗骨质疏松症药物治疗现状及影响因素分析

目的 评估北京地区老年髋部脆性骨折患者术后抗骨质疏松症药物（AOM）治疗现状并探讨其影响因素。方法 横断面研究。纳入2018年11月—2019年11月北京积水潭医院、北京医院、北京安贞医院、北京市昌平区医院、北京市顺义区医院、北京市房山区良乡医院收治的髋部脆性骨折患者1 963例,总结其人口学特征,并收集患者入院后30、120、365 d的临床资料,AOM治疗及健康基本补充剂使用情况。通过单因素和多因素logistic回归分析AOM治疗的影响因素。结果 1 963例老年髋部脆性骨折患者,住院时年龄65~102（79.3±7.2）岁,≥80岁患者占56.7%（1 113/1 963）;男性患者占30.8%（604/1 963）,女性患者占69.2%（1 359/1 963）;股骨颈骨折846例,股骨粗隆间骨折1 077例,股骨粗隆下骨折40例。综合3个时间点,在髋部骨折后1年内,33.0%（648/1 963）的患者接受过AOM治疗,71.0%（1 394/1 963）的患者使用过健康基本补充剂。入院后30、120、365 d患者AOM治疗率分别为23.0%（451/1 963）、17.9%（353/1 963）、21.0%（412/1 963）,健康基本补充剂使用率分别为59.0%（1 158/1 963）、45.0%（883/1 963）、38.0%（746/1 963）。单因素分析结果显示,年龄≥80岁[粗比值比（OR）=0.645,95%可信区间（CI） 0.495~0.840]、男性（粗OR=0.760,95% CI 0.581~0.996）、共管模式（粗OR=3.025,95% CI 0.973~9.405）、居住地农村（粗OR=0.523,95% CI 0.388~0.704）、AOM服用史（粗OR=7.612,95% CI 2.227~26.020）、既往骨质疏松症史（粗OR=5.065,95% CI 3.149~8.147）、骨质疏松评估（粗OR=1.379,95% CI 1.105~2.451）是AOM治疗的影响因素。多因素分析结果显示,年龄≥80岁（调整后OR=0.618,95% CI 0.488~0.781）、男性（调整后OR=0.716,95% CI 0.565~0.908）、居住地农村（调整后OR=0.492,95% CI 0.375~0.645）是AOM治疗的危险因素;共管模式（调整后OR=2.632,95% CI 1.004~6.897）、AOM服用史（调整后OR=4.870,95% CI 2.080~11.402）、既往骨质疏松症史（调整后OR=4.804,95% CI 3.253~7.096）、骨质疏松评估（调整后OR=1.393,95% CI 1.041~1.862）是AOM治疗的保护因素。结论 北京地区老年髋部脆性骨折患者的AOM治疗率偏低。年龄≥80岁、男性、在农村居住的髋部脆性骨折患者治疗率较低,可采取共管模式,术前进行骨质疏松诊断与评估,提高骨质疏松治疗率。     

Carbon Nanomaterials for Enhancing the Thermal,Physical and Rheological Properties of Asphalt Binders

Effective thermal conduction modification in asphalt binders is beneficial to reducing pavement surface temperature and relieving the urban heat island (UHI) effect in the utilization of solar harvesting and snow melting pavements. This study investigated the performance of two nanometer-sized modifiers, graphene (Gr) and carbon nanotubes (CNTs), on enhancing the thermal, physical and rheological properties of asphalt binders. Measurements depending on a transient plant source method proved that both Gr and CNTs linearly increased the thermal conductivity and thermal diffusivity of asphalt binders, and while 5% Gr by volume of matrix asphalt contributed to 300% increments, 5% CNTs increased the two parameters of asphalt binders by nearly 72% at 20 °C. Meanwhile, a series of empirical and rheological properties experiments were conducted. The results demonstrated the temperature susceptibility reduction and high-temperature properties promotion of asphalt binders by adding Gr or CNTs. The variation trends in the anti-cracking properties of asphalt binders modified by Gr and CNTs with the modifier content differed at low temperatures, which may be due to the unique nature of Gr. In conclusion, Gr, whose optimal content is 3% by volume of matrix asphalt, provides superior application potential for solar harvesting and snow melting pavements in comparison to CNTs due to its comprehensive contributions to thermal properties, construction feasibility, high-temperature performance and low-temperature performance of asphalt binders.     

What modulates the impacts of acid rain on the allelopathy of the two Asteraceae invasives?

Most of the allelopathic studies have focused on the independent allelopathy of one invasive plant, but have ignored the co-allelopathy of the two invasives. The variations in the type of acid rain can modulate the invasiveness of invasives via the changes in the allelopathy. Thus, it is vital to elucidate the allelopathy of invasives, particularly the co-allelopathy of the two invasives, under acid rain with different types, to illuminate the mechanisms driving the co-invasion of two invasives under diversified acid rain. However, little progress has been finished in this aspect presently. This study aimed to evaluate the co-allelopathy of two Asteraceae invasives Solidago canadensis L. and Erigeron annuus L. treated with acid rain with different nitrogen-to-sulfur ratios on seed germination and seedling growth of the horticultural Asteraceae species Lactuca sativa L. via a hydroponic experiment. Aqueous extracts of the two Asteraceae invasives generated obvious allelopathy on L. sativa. S. canadensis aqueous extracts caused stronger allelopathy. There may be an antagonistic effect for the co-allelopathy of the two Asteraceae invasives. Nitric acid at pH 5.6 weakened the allelopathy of the two Asteraceae invasives, but the other types of acid rain strengthened the allelopathy of the two Asteraceae invasives. The allelopathy of the two Asteraceae invasives increases with the increasing acidity of acid rain, but the allelopathy of the two Asteraceae invasives decreases with the increasing nitrogen-to-sulfur ratio of acid rain. Accordingly, the species number of invasives, and the acidity and type of acid rain modulated the impacts of acid rain on the allelopathy of the two Asteraceae invasives.

     

Osthole induced apoptosis in human normal liver cells by regulating cell proliferation and endoplasmic reticulum stress

Osthole (Ost) is often used in treatment for cancer, inflammation and rheumatism in clinic. However, Ost‐induced liver injury has been reported. In this study, we aim to investigate the possible mechanism of Ost‐induced hepatotoxicity in human normal liver cells (L02). When cells were exposed to Ost, the cell viability was decreased and apoptosis rate increased, the intracellular markers of oxidative stress were changed. Simultaneously, Ost altered apoptotic related proteins levels, including Bcl‐2, Bax, Cleaved‐Caspase‐9/‐8/‐3, and Pro‐Caspase‐3/‐8. In addition, Ost enhanced the levels of endoplasmic reticulum (ER) stress proteins (GRP78/Bip, CHOP, Caspase‐4, IRE1α, PERK, JNK, P‐JNK, and ATF4), decreased the cell proliferation and cycle‐associated protein (Phospho‐Histone H3, P‐Cdc25C, Cdc25C, P‐Cdc2, Cdc2, and Cyclin B1) level. The results show that Ost has toxic effects on L02 cells. Furthermore, it induces apoptosis by inhibiting cell proliferation, arresting cell cycle at the G2/M phase and activating ER stress.     

合并脑卒中史的老年髋部骨折患者的临床特征及治疗效果分析

目的 探讨合并脑卒中病史的老年髋部骨折患者的临床特征,以及在老年髋部骨折共管模式下的治疗效果。方法 回顾性队列分析。纳入2018年11月—2019年11月在北京积水潭医院手术治疗的1 092例老年髋部骨折患者的临床资料,其中男306例,女786例,年龄65~95岁（平均79.6岁）。根据既往是否有脑卒中病史分为脑卒中组155例和非脑卒中组937例。脑卒中组患者发生脑卒中至髋部骨折手术时间均大于30 d。观察指标：（1）分析脑卒中组患者的临床特征（脑卒中类型、发病史、后遗症发生率、遗留肢体不利情况,以及肢体不利侧与肢体利侧发生骨折的占比）。（2）比较2组患者的年龄、性别、骨折类型、骨折侧别、伤前能否户外活动、伤前行走是否需要辅具等临床特征的差异。（3）比较2组患者的入院48 h内手术率、术前等待时间、住院时间,比较不同观察时间的死亡率、再手术率,以及并发症发生率、活动恢复情况、健康相关生活质量等结果的差异。结果 （1）脑卒中组155例患者的临床特征：其中,脑梗死141例（91.0%）,脑出血14例（9.0%）;1次脑卒中发病史148例（95.4%）,≥2次发病史7例（4.5%）;有脑卒中后遗症60例（38.7%）;遗留肢体不利的患者43例（27.7%）,其中81.4%（35/43）骨折发生在肢体不利侧,18.6%（8/43）发生在利侧。（2）2组患者的性别、骨折侧别比较差异均无统计学差异（P值均>0.05）;脑卒中组患者较非脑卒中组患者的中位年龄小（79岁与81岁）,脑卒中组患者股骨颈骨折发生率（58.7%,91/155）、辅具帮助行走的比例（43.9%,68/155）及无法户外活动的比例（11.6%,18/155）均较非脑卒中患者高（49.6%,465/937;23.5%,276/937;5.7%,53/937）,差异均有统计学意义（P值均<0.05）。（2）2组患者的入院48 h内手术率、术前等待时间、住院时间、再手术率及并发症发生率比较差异均无统计学意义（P值均>0.05）;院内死亡率及入院后30 d、120 d、1年死亡率差异均无统计学意义（P值均>0.05）;入院后30 d、120 d、1年骨折术后并发症发生率与再手术率差异均无统计学意义（P值均>0.05）;患者恢复伤前活动能力的比较,入院后30、120 d差异均无统计学意义（P值均>0.05）,入院后1年随访脑卒中组（48.9%,68/139）低于非脑卒中组（59.8%,468/782）,差异有统计学意义（χ²=5.79,P<0.001）。脑卒中组入院后30 d、120 d、1年健康相关生活质量评分为0.62（0.46,0.74）、0.78（0.57,0.90）和0.83（0.57,0.94）分均低于非脑卒中组的0.69（0.51,0.78）、0.83（0.73,0.94）和0.93（0.75,1.00）分,差异均有统计学意义（Z=-3.12、-2.97、-4.83,P值均<0.05）。结论 合并脑卒中史的老年髋部骨折患者,骨折总体发病年龄稍早于无脑卒中史者,既往多有1次脑梗死病史发作,少部分人遗留有后遗症,伤前活动能力较差,髋部骨折多发生在脑卒中后遗留肢体活动不利侧。共管模式下对于脑卒中病史超过30 d的老年髋部骨折患者尽早实施手术是安全有效的。