黄精多糖干预骨质疏松性骨折大鼠白细胞介素1和白细胞介素6的表达

背景：骨质疏松性骨折主要是由于雌激素减少引发的高转换型骨质疏松并发症,给予雌激素能够得到有效地纠正。 目的：观察黄精多糖对骨质疏松性骨折大鼠细的胞因子的影响。 方法：6月龄雌性SD大鼠行卵巢切除建立骨质疏松症大鼠模型90 d后,锯断胫骨建立骨质疏松性骨折模型。骨折1周后,分别以400,200,100 mg/kg黄精多糖灌胃和0.066 mg/kg雌二醇肌肉注射给药治疗。 结果与结论：相比于一般性骨折大鼠,骨质疏松性骨折大鼠血清白细胞介素1,6的表达升高;400 mg/kg黄精多糖或雌激素干预治疗后,大鼠血清的白细胞介素1,6的表达明显降低(P < 0.05),但200和100 mg/kg黄精多糖对大鼠血清的白细胞介素1,6的表达没有影响(P > 0.05),提示黄精多糖干预治疗骨质疏松性骨折需要较高浓度     

咪达普利对实验性骨质疏松大鼠的骨代谢和生物力学的影响

目的:探讨咪达普利对维甲酸所致的实验性骨质疏松的大鼠骨代谢和生物力学的影响.方法:将60只SD雌性大鼠随机分为3组:对照组(Ⅰ组)、维甲酸诱导骨质疏松模型组(Ⅱ组)、咪达普利组(Ⅲ组),每组20只.对Ⅱ组和Ⅲ组的大鼠用维甲酸80mg/(kg.d)连续灌胃21d建立实验性骨质疏松模型.造模后,Ⅲ组给予按大鼠体重10 mg/(kg.d)咪达普利灌胃,Ⅰ组和Ⅱ组采用生理盐水对照,持续7d后处死大鼠,分别检测各组大鼠的体重、股骨骨密度和干湿重、骨代谢指标和骨生物力学指标.结果:与Ⅰ组相比,Ⅱ组在大鼠体重、股骨骨密度、股骨干湿重、骨代谢指标上差异均有统计学意义(P＜0.05).咪达普利干预后,与Ⅱ组相比,Ⅲ组大鼠的体重增加,股骨干湿重增加,差异有统计学意义(p＜0.05);股骨中钙和磷的含量明显增加,差异有统计学意义(p＜0.05),血清中骨钙素(bone gamma-carboxyglutamic-acid-containing proteins,BGP)浓度降低,差异有统计学意义(P＜0.05);抗酒石酸酸性磷酸酶(tartrate resistant acid phosphatase,TRAP)浓度下降,差异有统计学意义(P＜0.05);肱骨生物力学最大载荷(Pmax)、最大挠度(Lmax)、最大弯矩(Mmax)、骨应力(σ)和骨应变增加,差异有统计学意义(P＜0.05).结论:咪达普利能增加维甲酸所致的实验性骨质疏松大鼠骨密度,增加股骨干湿重,减少骨质流失,促进骨形成和矿物质的沉积,增加骨的生物力学强度,减少骨折的发生,对骨质疏松具有保护作用.     

培哚普利对维甲酸所致骨质疏松模型大鼠骨代谢的影响

BACKGROUND: Renin-angiotensin-aldosterone system existed in bone tissue. Recent studies on antihypertensive drugs found that angiotensin converting enzyme inhibitor type antihypertensive drug was possibly effective for osteoporosis. Perindopril is one of the commonly used antihypertensive drugs. Whether perindopril affected bone metabolism or could be used in anti-osteoporosis has not been reported.     

骨生化指标联检在骨质疏松诊疗中的临床意义

目的:探讨25-羟基维生素D(25-OH-VD)与抗酒石酸酸性磷酸酶(TRACP-5b)联检在骨质疏松诊疗中的意义。方法:使用英国IDS公司的试剂盒,采用酶联免疫法(ELISA),对328例中老年患者血清做25-OHVD与TRACP-5b的检测及分析。结果:25-OH-VD指标均偏低,男性(16.18±6.77)ng/ml,女性(15.16±7.87)ng/ml,男女间差异无统计学意义(P>0.05);TRACP-5b水平女性高于男性,女性(5.71±2.46)u/L,男性(4.98±1.61)u/L,差异具有统计学意义(P<0.05)。25-OH-VD与TRACP-5b两项指标比较,相关系数(r)=-0.121,两指标呈负相关,有统计学意义(P<0.05)。结论:25-OH-VD与TRACP-5b联检对骨质疏松诊疗具有重要的参考价值。     

流体剪应力对大鼠破骨细胞骨吸收活性的影响

探讨流体剪应力对大鼠破骨细胞骨吸收活性的影响。我们采用低温离心法获取6月龄健康雌性SD大鼠椎骨骨髓细胞,以1.6×106细胞密度种植于血盖片上,采用1,25-(OH)2维生素D3体外诱导获取破骨细胞。于破骨细胞诱导的第7d取出细胞爬片,置于流体剪应力装置中,分别加载5.97、11.36、16.08、20.54dyne/cm2大小的流体剪应力,持续30min,以未加载流体剪应力的破骨细胞为对照组。实验结束时,以2.5%戊二醛固定细胞爬片,置于0.25mol/L氢氧化铵液超声处理10min,清除细胞爬片上的破骨细胞,经1%硪酸固定,梯度酒精脱水,醋酸异戊酯置换酒精,CO2临界点干燥,喷金后扫描电镜观察骨吸收陷窝并计数,图像分析法测定骨吸收陷窝的面积;同时分别收集每次灌流液10ml,冻干,用1ml复溶后,紫外分光光度仪检测抗酒石酸酸性磷酸酶(Tartrate-resistant acid phosphatase,TRAP)活性的变化。结果显示:在本实验中所选用的流体剪应力可增强破骨细胞TRAP活性,而骨吸收陷窝的数量和面积也增加,尤其是剪应力在16.08dyne/cm2时,破骨细胞TRAP活性增强以及骨吸收陷窝的数量和面积增高最为明显。结果表明,一定范围内的流体剪应力可以增强破骨细胞的骨吸收活性。     

续断对大鼠骨质疏松性骨折愈合影响的生物力学实验研究

目的:观察续断对大鼠去卵巢骨质疏松性骨折模型骨折愈合中生物力学性能的影响。材料与方法:选取30只4月龄大鼠,分为假手术骨折对照组、去卵巢骨折对照组、去卵巢骨折中药处理组。后两组去卵巢3月造成绝经后骨质疏松模型,之后三组均造成桡骨远端骨折,灌药1月后检测桡骨骨痂生物力学强度。结果:中药处理组最大剪切力17.76±1.25N,剪切应力1.12±0.13N/mm2,生物力学性能与基础骨折对照组相接近,明显优于去卵巢骨折对照组(P<0.01)。结论:续断能改善骨质疏松性骨折愈合骨痂的生物力学性能,具有一定的促进骨折愈合的作用。     

植物雌激素对去卵巢大鼠骨质疏松性骨折愈合的影响

目的观察植物雌激素对卵巢去势大鼠骨折愈合过程中骨痂骨密度的影响。方法复制卵巢去势大鼠骨质疏松模型并制造股骨中段闭合性骨折,然后进行克氏针髓腔内固定,观察大鼠骨折内固定后骨痂与近骨痂段股骨骨密度的变化。结果异黄酮组、雌二醇组和假手术组骨痂的骨密度高于无用药组,差异具有统计学意义(P<0.05);而异黄酮组、雌二醇组和假手术组之间没有显著差别。结论植物雌激素能够显著提高骨质疏松大鼠骨痂及近骨痂段骨组织的骨密度、促进骨折愈合,与雌二醇组作用相近。     

仙灵骨葆对大鼠骨质疏松性骨折愈合的影响

背景：骨质疏松可延迟骨折愈合,仙灵骨葆对骨质疏松性骨折愈合的影响及其机制尚有待研究。 目的：观察骨质疏松对大鼠股骨干骨折愈合的影响以及仙灵骨葆的干预效果及其作用机制。 方法：50只3月龄雌性SD大鼠随机分成5组：正常对照组、骨质疏松组、正常骨折组、骨质疏松性骨折组、治疗组,前2组每组6只,后3组每组12只。去除大鼠双侧卵巢制备骨质疏松模型,8周后制备右侧股骨干中段横行骨折模型。治疗组给予仙灵骨葆灌胃250 mg/(kg•d),正常骨折组、骨质疏松性骨折组灌胃等量生理盐水,灌胃6周。 结果与结论：去卵巢后8周骨质疏松组的骨密度显著低于正常对照组(P < 0.05),说明骨质疏松模型制作成功;灌胃6周,骨质疏松性骨折组骨密度、X射线摄片评分、最大载荷均显著低于正常骨折组和治疗组(P < 0.05),但给予仙灵骨葆的治疗组仍显著低于正常骨折组(P < 0.05)。以上结果提示骨质疏松大鼠骨折愈合过程延迟,仙灵骨葆对骨质疏松大鼠骨折愈合具有积极促进作用。     

抗酒石酸酸性磷酸酶与骨吸收

抗酒石酸酸性磷酸酶（ＴＲＡＣＰ）是酸性磷酸酶的第５型同工酶，由破骨细胞分泌，受甲状旁腺激素和降钙素调节。它能水解各种磷酸酯，可被钼酸盐抑制和巯基化合物激活。用化学比色法和免疫分析法测定血清ＴＲＡＣＰ可了解骨骼正在发生的骨吸收状况。     

卵巢切除股骨骨折大鼠骨愈合中降钙素的作用

背景：降钙素可活化腺苷酸环化酶蛋白激酶A通路及磷脂酶C通路,抑制破骨细胞的活性,可能治疗骨质疏松性骨折。 目的：观察降钙素对去卵巢大鼠股骨骨折愈合的作用。 方法：构建双侧卵巢切除骨质疏松右股骨骨折SD大鼠模型,然后分别皮下注射生理盐水和降钙素(16 IU/kg),隔日1次,于骨折后3周和6周测量右股骨行骨密度,苏木精-伊红及抗酒石酸酸性磷酸酶染色,骨形态发生蛋白2及血管内皮生长因子免疫组化染色。 结果与结论：骨折后给予降钙素治疗的大鼠抗酒石酸酸性磷酸酶染色阳性细胞积分吸光度值较生理盐水治疗的大鼠显著减少(P < 0.05)。骨折后3周,两组骨折线均较清晰,骨痂体积无明显差别,骨折愈合以软骨内化骨过程为主,骨密度无显著性差异(P > 0.05)。骨折后6周,两组骨折线较模糊,骨痂体积无差别,骨小梁排列较有序,用药组股骨骨密度较对照组升高(P < 0.05)。两组在骨折后3周和6周的骨形态发生蛋白2及血管内皮生长因子差异无显著性意义(P > 0.05)。证实降钙素可以抑制去卵巢大鼠骨折部位破骨细胞活性,但无明显促进大鼠股骨骨折愈合的作用。     

去势大鼠骨质疏松性骨小梁的压缩断裂仿真

文题释义： 原发性骨质疏松症：是一种以骨量降低、骨微结构破坏、骨脆性增加、骨折风险性增大为特征的全身性骨骼系统疾病,其多发于老年人,尤以绝经后妇女多见。 断裂：材料或构件力学性能的基本表征。根据断裂前发生的塑性变形的大小,可把材料的断裂分为脆性断裂和延性断裂两大类。随材料和条件的不同,循环载荷作用下的疲劳断裂、高温下的蠕变断裂以及环境作用下的应力腐蚀断裂,均可表现为脆性断裂和延性断裂。 背景：目前已有相关有限元模型仿真模拟了股骨骨折,并探讨了载荷速率、载荷角度及松质骨在髋部骨折中的影响,但骨小梁的断裂仿真仍缺乏相关研究。 目的：仿真模拟去势大鼠骨质疏松性骨小梁压缩断裂的生物力学过程。 方法：取去势大鼠右侧股骨于Micro-CT扫描股骨远端,获得大鼠股骨感兴趣区域骨微结构参数及三维模型,在Geomagic Studio几何优化后在Hypermesh 14.0前处理,包括体网格划分、设置材料属性参数、边界条件,设置载荷1 200 N,作用时间2 ms,在LS-DYNA软件中进行运算。 结果与结论：①感兴趣区域骨小梁显示空间分布不均;②骨小梁体积小、数量少的部位最先开始出现变形断裂,板状及较大体积的骨小梁最后发生断裂塌陷;③Von-mises应力变化趋势与骨小梁断裂塌陷趋势大致相同;④感兴趣区域骨小梁断裂塌陷过程包括了垂直塌陷和水平扭转,其中水平扭转程度及速率低于垂直塌陷,使得横断面扭转成角大小及成角速率小于冠状面成角;⑤破坏单元的剪切应力增幅及峰值较Von-mises应力小;⑥提示骨小梁断裂塌陷是个复杂的过程,包含了不同平面的变形、成角。 ORCID: 0000-0002-5792-3012(吴宇航) 中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

中药补肾活骨方对去势骨质疏松大鼠骨代谢的影响

背景：中药补肾活骨方可有效防治骨质疏松症,但其具体的药理学机制仍不是很清楚。25-羟基维生素D3和1,25-二羟基维生素D3是调节骨吸收与骨形成的重要的偶联因子。 目的：观察补肾中药对去势骨质疏松大鼠骨密度、骨生物力学、血清及肝肾组织中25-羟基维生素D3和1,25-二羟基维生素D3水平的影响。 方法：健康雌性SD大鼠108只随机等分为假手术组、模型组和治疗组。后2组摘除双侧卵巢,导致雌激素缺失,从而诱导骨质疏松症模型。治疗组大鼠造模后以中药补肾活骨方2 mL灌胃,2次/d。 结果与结论：与模型组相比,治疗组股骨头骨密度明显提高(P < 0.05),最大应力和最大负荷指数明显增强(P < 0.05),血液、肝脏和肾脏组织中25-羟基维生素D3和1,25 二羟基维生素D3水平明显提高(P < 0.05);且接近于假手术组(P < 0.05)。提示补肾中药在雌激素缺失早期即可在分子水平上调节25-羟基维生素D3和1,25-二羟基维生素D3的表达水平,激活骨代谢提高骨密度增强骨质量达到预防骨质疏松的作用。关键词：补肾活骨方;1,25-二羟基维生素D3;骨密度;骨生物力学;骨质疏松症;骨代谢 doi:10.3969/j.issn.1673-8225.2012.15.006 中图分类号: R318  文献标识码: A       

Effect of intramuscular clodronate on bone mass and metabolism in osteoporotic women

Bisphosphonates have significantly improved the treatment of postmenopausal osteoporosis. However, when administered orally, gastric intolerance is their main adverse effect. This makes patients reluctant to undergo treatment. As an alternative, intramuscular (i.m.) administration may be more acceptable to patients undergoing long-term treatment. Since clodronate has been easily available in Italy for many years, we carried out this study to evaluate its effect on bone mineral density (BMD) in 36 osteoporotic postmenopausal women who were intolerant to oral administration of bisphosphonates. Patients received 100 mg of clodronate i.m. every 10 days together with 500 mg/day of calcium orally for 2 years. A control group of 32 women received only oral calcium at the same dose and for the same length of time. In the control group a progressive but not statistically significant decrease in BMD was observed in the spine and femoral neck over the 2-year follow-up. In contrast, patients treated with clodronate had a statistically significant increase in BMD in the spine at the first yearly check-up (+2.63%) and a further but not statistically significant increase during the second year of treatment (+0.59%). The increase in BMD at the femoral neck was not statistically significant during the first and second years of treatment, being 1.21% and 0.37% respectively. In the women treated with clodronate, hydroxyproline was significantly suppressed. All the patients reported local pain at the injection site. This led 11.11% of the subjects to withdraw from treatment.     

Effect of androgen on bone metabolism in hyperuricemic rats

IntroductionThis study aimed to investigate the effect of androgen on bone metabolism in hyperuricemic rats.Material and methodsForty male Wistar rats were randomly divided into four groups: sham operation group, simple hyperuricemic group, hyperuricemic castration group, and simple castration group. A rat model of chronic hyperuricemia was established using potassium oxonate and ethambutol. Blood was sampled from the vena angularis at week 0, 4, 6, 8 and 12 after surgery to detect for uric acid, calcium, phosphorus and alkaline phosphatase, and investigate the effect of androgen on bone metabolism in hyperuricemic rats.ResultsFrom the 4^th week, compared with the sham operation group, the differences in uric acid levels between the simple hyperuricemic group and hyperuricemia castration group were statistically significant (p < 0.05), suggesting the successful establishment of the model of hyperuricemia. At the 6^th week, uric acid levels decreased in the two hyperuricemic groups, and the difference from the sham operation group decreased (p = 0.05), showing that the modeling method had deteriorated. At the 8^th week, the differences in uric acid levels between the two castration groups and sham operation group were statistically significant (p < 0.05). At the 12^th week, the differences in serum levels of phosphorus between the simple hyperuricemic group and hyperuricemic castration group were statistically significant (p < 0.05).ConclusionsAndrogen can induce bone metabolism changes in rats with hyperuricemia.     

Bone metabolism and bone status in osteoporotic patients

We have studied bone turnover and bone status in 29 patients with hip fractures and compared them with normal subjects and patients with arthritis of the hip. Markers for bone formation, bone Gla protein, alkaline phosphatase and whole body retention of 99mTc-diphosphonate, and fasting urinary hydroxyproline, a marker for bone resorption, were all significantly higher in the hip fracture group than in the control group. The serum concentrations of 1,25-dihydroxyvitamin D were similar in the three groups, whereas the serum 25-hydroxyvitamin D concentration in the control group was higher than in the patient groups. The bone mineral content (BMC) measured in the distal forearm and the spine was lower than normal in the hip fracture group. We conclude that patients with hip fractures have an increased bone turnover with no signs of bimodality and low BMC values at all locations.     

Effect of immune cytokines on bone

The effect of the bone resorptive cytokines IL-1 alpha, IL-1 beta, and TNF on bone formation was studied in an in vitro system. All three cytokines were profoundly inhibitory, with the rank order of potency IL-1 beta greater than IL-1 alpha greater than TNF. Inhibition was mediated by a depression of differentiated osteoblast functions, including alkaline phosphatase expression and matrix synthesis. Osteoblast proliferation was not affected. Bone formation inhibition was independent of PGE2 production, indicating a direct effect of cytokines on osteoblasts. High concentrations of IL-1 beta (10 U/ml) abrogated IGF-1-stimulated bone formation, providing evidence for the hypothesis that cytokines act as 'uncoupling factors'. Conversely, high concentrations of IGF-1 circumvented inhibition by IL-1 beta (0.1-1.0 U/ml). The interaction of cytokines and bone growth factors with osteoblasts are likely to be of critical importance in the regulation of bone mass at local inflammatory sites.     

辛伐他汀局部注射对大鼠骨质疏松性骨折愈合的影响

目的： 研究辛伐他汀局部注射对去势大鼠骨折愈合的影响。方法: 2月龄雌性SD大鼠采用去势方法模拟人绝经后骨质疏松症,模型成立后进一步建立胫骨骨折髓内钉内固定模型,实验组于骨折端皮下注射辛伐他汀(10 mg·kg^-1·d^-1,5 d),另一组仅注射无辛伐他汀的溶剂作为空白对照组。骨折后1、2、4周取标本,通过X片、生物力学、组织病理学以及组织形态计量学等方法评价两组骨折愈合质量。结果: 与空白对照组相比,实验组骨痂横截面积在骨折后1周、2周分别增加21.3% (P<0.05) 和21.5% (P<0.05);骨痂最大载荷在骨折后2周、4周分别增加57.5% (P<0.05) 和31.4% (P<0.05);组织学显示实验组新生编织骨较对照组多且排列致密;组织形态计量学测量结果表明辛伐他汀可明显增加矿化宽度(MLW)、矿化容积(MLV) 以及矿化率(MAR)。结论: 局部应用辛伐他汀可促进去势大鼠骨折愈合。     

经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折

目的初步探讨应用球囊扩张椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床疗效。方法应用球囊扩张椎体后凸成形术治疗骨质疏松性椎体压缩骨折患者24例28个椎体，并随访4～11个月，平均8个月。结果所有患者手术均获成功，无脊髓神经损伤，病椎疼痛缓解，后凸畸形平均矫正20°，随访期间，疗效满意，无病椎高度丢失。结论应用经皮椎体成形术治疗骨质疏松性椎体压缩骨折能明显改善患者疼痛症状，恢复椎体高度，矫正后凸畸形，是一种安全的微创方法。