Effects of vibration therapy on bone mineral density in postmenopausal women with osteoporosis

Background Jaw osteonecrosis possibly associated with the administration of bisphosphonates is expected to be treated with a non-pharmacologic approach. This study aimed to determine whether noninvasive, mechanically mediated vibration would inhibit the decline in bone mineral density （BMD） that follows menopause, enhance the BMD of the lumbar and femoral neck, and reduce chronic back pain in postmenopausal women with osteoporosis.
Methods A total of 116 postmenopausal women with osteoporosis participated in this study, and they were divided into groups A （66 patients） and B （50）. Group A received vibration treatment （Subjects vertically stand on the vibration platform, with a vibration frequency of 30 Hz, amplitude of 5 mm; they received the treatment five times per week, ten minutes each time and totally for six months）, whereas women of group B served as controls without any treatment. L2-4 BMD, bilateral femoral neck BMD, and body mass index （BMI） were recorded before the treatment or at the third and sixth months of the treatment respectively. After the ending of the treatment, the change of BMD in each group was compared and analyzed. Chronic back pain was evaluated by visual analogue scale （VAS） at baseline and the third and sixth months of the treatment.
Results Of the 116 women, 94 including 51 women from group A （（61.23±8.20） years） and 43 women from group B （（63.73±5.45） years）, completed the study. There were no significant differences in baseline characteristics including age, BMI, menopausal years, lumbar BMD, femoral neck BMD, and VAS between the two groups. The lumbar BMD of the 51 women in group A increased by 1.3% （P=0.034） after vibration treatment for 3 months and by 4.3% at the sixth month （P=0.000）. The lumbar BMD in group B was decreased at the third month, but there was not statistical significance （P〉0.05） At the sixth month, it was decreased by 1.9% （P 〈0.05）. The femoral neck BMD of the 51 women in group A was slightly in     

Association of farnesyl diphosphate synthase polymorphisms and response to alendronate treatment in Chinese postmenopausal women with osteoporosis

Background Genetic factors are important in the pathogenesis of osteoporosis,but less is known about the genetic determinants of osteoporosis treatment.We aimed to explore the association between the gene polymorphisms of key enzyme farnesyl diphosphate synthase （FDPS） in mevalonate signaling pathway of osteoclast and response to alendronate therapy in osteoporotic postmenopausal women in China.Methods The study group comprised 639 postmenopausal women aged （62.2＆#177;7.0） years with osteoporosis or osteopenia who had been randomly assigned to low dose group （70 mg/2w） or standard dose group （70 mg/w） of alendronate in this 1-year study.We identified allelic variant of the FDPS gene using the polymerase chain reaction and restriction enzyme Faul.Before and after treatment,serum levels of calcium,phosphate,alkaline phosphatase （ALP）,cross linked C-telopeptide of type Ⅰ collagen （β-CTX） were detected.Bone mineral density （BMD） at lumbar spine and proximal femur was measured.The association was analyzed between the polymorphisms of FDPS gene and the changes of BMD,bone turnover biomarkers after the treatment.Results The FDPS rs2297480 polymorphisms were associated with baseline BMD at femoral neck,and patients with CC genotype had significantly higher baseline femoral neck BMD （（733.6＆#177;84.1） mg/cm2） than those with AC genotypes （（703.0＆#177;86.9） mg/cm2） and AA genotypes （（649.8＆#177;62.4） mg/cm2） （P 〈0.01）.No significant difference in BMD at lumbar spine was observed among different genotypes of FDPS.The percentage change of serum ALP level was significantly lower in patients with CC genotype （-22.9%） than that in those with AC genotype （-24.1%） and AA genotype （-29.8%） of FDPS after 12 months of alendronate treatment （P 〈0.05）.Neither percentage change of BMD nor β-CTX level after alendronate treatment had association with FDPS genotype.Conclusions FDPS gene was probably a candidate gene to predict femoral neck BMD at baseline.FDPS gene alleles could predict change percentage of ALP after treatment of alendronate,but possibly had no significant relationship with the responsiveness of BMD to alendronate therapy.     

Changes in bone mineral density among women aged 19-24 years using injectable contraceptive depot medroxyprogesterone acetate

Objective To compare bone mineral density(BMD) between users of intramuscular depot medroxyprogesterone acetate(DMPA) and nonhormonal control subjects.Methods The study included 87 women aged between 19 and 24 years using DMPA(DMPA group) for 24 months and 83 same-age women using nonhormonal contraception as control group. BMD of the lumbar spine and femoral neck were measured using dual-energy X-ray absorptiometry, comparing mean BMD changes in DMPA group with the control.Results After 24 months of DMPA treatment, as compared with baseline, the mean BMD in lumbar spine and femoral neck were decreased by 2.67% and 2.71%, respectively.The mean lumbar spine and femoral neck BMD in DMPA group at 24 months were not significantly different compared with baseline(P=0.080 and P=0.076, respectively). In comparison, in control group, there was a trend toward increasing BMD. After 24 months of observation, the mean percentage changes from baseline in lumbar spine and femoral neck BMD were increased by 1.24% and 1.30%, respectively. There was no significantly difference compared with baseline(P=0.436 and P=0.373, respectively).Mean BMD at the spine and femoral neck did not differ significantly between DMPA users and nonusers over 12 months(P=0.153 and P=0.140, respectively), but the BMD at both anatomical sites was significantly lower in DMPA group than in the controlafter 24 months of treatment(P=0.012 and P=0.008, respectively).Conclusion The use of DMPA for short-term(≤12-month) had no significant effects on BMD at spine and femoral neck, but long-term exposure to DMPA had significant loss in BMD in women aged between 19 and 24 years.     

Salmon calcitonin in prevention of osteoporosis in maintenance dialysis patients

Background Renal osteodystrophy is one of the commonest complications of chronic renal failure. It may have a severe impact on the quality of life of patients on maintenance dialysis therapy. Besides post-menopausal women and elderly people, the dialysis patients are another high risk group. But at present, there is no research on how to prevent osteoporosis in maintenance dialysis patients. This study was conducted to observe the bone density of maintenance dialysis patients and to evaluate the clinical outcomes and safety of different administration dosage of salmon calcitonin to prevent osteoporosis in maintenance dialysis patients.
Methods One hundred and forty-eight patients on maintenance dialysis were involved in the 12-month, randomized, controlled trial. Fifty patients （experiment I group） received subcutaneous injection of salmon calcitonin （50 U） three times a week for 12 months. Fifty patients （experiment II group） received subcutaneous injection of salmon calcitonin （100 U） three times a week for 12 months. At the same time, both of them received oral calcium carbonate 1500 mg tid and rocaltrol 0.25 pg qn for 12 months. The control group only received oral calcium carbonate 1500 mg tid and rocaltrol 0.25 μg qn for 12 months. The levels of bone mass density （BMD） of the lumbar spine and femoral neck, serum intact parathyroid hormone （iPTH）, osteocalcin （OC）, calcium, phosphorus, alkaline phosphatase （ALP） were assessed at baseline and then again after 3, 6 and 12 months of treatment.
Results The values of BMD at the lumbar spine and femoral neck before the treatment were not significantly different from those 3, 6, and 12 months after the treatment in trial groups I and II （all P 〉0.05） and there were no significant differences in the BMD values at different time points between trial groups I and II. In the control group, the BMD values at the lumbar spine and femoral neck 3, 6, and 12 months after the beginning of trial were significantly lower than those be     

Association Between Geranylgeranyl Pyrophosphate Synthase Gene Polymorphisms and Bone Phenotypes and Response to Alendronate Treatment in Chinese Osteoporotic Women△

Objective To investigate the relationship between geranylgeranyl pyrophosphate synthase (GGPPS) genepolymorphisms and bone response to alendronate in Chinese osteoporotic women.
Methods A total of 639 postmenopausal women with osteoporosis or osteopenia were included and randomly received treatment of low dose (70 mg per two weeks) or standard dose (70 mg weekly) of alendronate for one year. The six tag single nucleotide polymorphisms ofGGPPSgenewere identified. Bone mineral density (BMD), serum cross-linked C-telopeptide of type I collagen (β-CTX), and total alkaline phosphatase (ALP) were measured before and after treatment.GGPPS gene polymorphisms and the changes of BMD and bone turnover markers after treatment were analyzed.
Results rs10925503 polymorphism ofGGPPS gene was correlated to serumβ-CTX levels at baseline, and patients with TT genotype had significantly higher serumβ-CTX level than those with TC or CC genotype (allP<0.05). No correlation was found between polymorphisms ofGGPPS gene and serum total ALP levels, as well as BMD at baseline. After 12 months of treatment, lumbar spine and hip BMD increased and serum bone turnover markers decreased significantly (P<0.01), and without obvious differences between the low dose and standard dose groups (allP>0.05). However,GGPPSgene polymorphisms were uncorrelated to percentage changes of BMD, serum total ALP, andβ-CTX levels (allP>0.05).
ConclusionGGPPS gene polymorphisms are correlated to osteoclasts activity, but all tag single nucleotide polymorphisms ofGGPPS gene have no influence on the skeletal response to alendronate treatment.     

EFFECTS OF ALENDRONATE ON STRUCTURAL PROPERTIES OF TRABECULAR BONE IN DOGS

To evaluate the effects of alendronate on the structural properties of trabecular bone.Methods. Alendronate was administered at a daily p. o. dose of 0. 5 mg/kg over a 12-week period in hound dogs (n = 8 for both the control and treated group), and the structural indices of the lumbar vertebral (LI and L2) trabecular bone were assessed directly from 3-D images.Results. Treatment with alendronate increased bone volume fraction by 9. 5% and 7. 7% in LI and L2 respectively. Trabecular thickness significantly increased after alendronate treatment, whereas trabecular separation remained constant. The degree of anisotropy for the alendronate - treated group was decreased compared with that of the control group. Bone surface to volume ratio declined significantly in the alendronate-reated group, whereas alendronate induced a higher bone surface density.Conclusion. Alendronate increased the structural properties of canine trabecular bone after short-term treatment at a dose of 0. 5 mg · kg-1·day-1.     

COMPARISON OF BONE MASS IN FOREARM, LUMBAR VERTEBRA AND HIP BY SINGLE AND/OR DUAL ENERGY X-RAY ABSORPTIOMETRY

Objective. Bone mineral density(BMD) was measured in normal Chinese women with single X-ray sbsorptiometry (SXA) and dtml energy X-ray absorptiometry (DEXA). These two methods were compared to evaluate the sensitivity in reflecting bone loss. Methods. Measurements were performed in 300 women aged 20～79(5 for each age). The 8mm distal,1/4 distal, ultra distal site ot the nondominant torearrn were measured with SXA; the AP spine(L2-4), right femoral neck(Neck), Ward‘s triangle(Ward)and trochantor (Troch) were measured with DEXA. Ten wcanen had 5 repeated measurements to evaluate the reproducibility ot the equipments. Rgsults. The BMD peak for Neck and Ward was found between age 20～29, for ultra distal and L2-4 at age 30～39, for 8mm distal, 1/4 distal and Troth at age 40～49. After reaching the peak values, BMD at all sites decreased with increasing age. The highest rate of yearly loss of BMD was at 8ram distal. Resuits of measurement showed siguifieant correlation between SXA and DEXA. Comparing with premenopausal women, the bone loss rate in postnaenopausal women was faster and highest up to 11～15 years and the highest rate was at the Ward. Conclusion. The present study gives the normal values of BMD at seven sites for nccmal Chinese wonaen. The ages of BMD peak were different at seven sites. The yearly loss of BMD was highest at 8ram distal, it seemed to be the sensitive region for bone loss with age. The postmenopansal women had highly signiflcantly loss bone mass than the premenopausal women, Comparing with premenopause, postmenopsuse BMD for Ward‘s triangle with DEXA seemed to be most sensitive to the effect of menopause.     

Effect of Combined Oral Contraceptive Use on Bone Mineral Density in Adolescent Females

Objective To compare adolescents’bone mineral density (BMD) between users of combined oral contraceptive (Marvelon, desogestrel/ethinylestradiol) and nonhormonal control subjects. Methods The study included 127 women who aged between 16 and 18 years using Marvelon for 24 months and 115 women who aged between 16 and 18 years using nonhormonal contraception as control subjects. BMD of the lumbar spine and femoral neck were obtained using dual energy X-ray absorptiometry. Results After 24 months of Marvelon use, as compared with baseline, the mean BMD in lumbar spine and femoral neck were decreased by 0.30% and 0.61%, respectively. While in the nonusers group, the mean BMD were increased by 1.88% and 1.10%, respectively. Lumbar spine and femoral neck BMD in women who used Marvelon were not significantly different compared with the subjects who used nonhormonal contraception (P>0.05). Conclusion Two years of Marvelon use had no significant effect on BMD, but it remains unknown whether longer than 2 years of use has a significant adverse effect on the attainment of peak bone mass.     

Effect of Two Kinds of Different Combined Oral Contraceptives Used on Bone Mineral Density in Women of Reproductive Age

Objective To compare bone mineral density (BMD) among users of ethinylestradiol/desogestrel, ethinylestradiol/cyproterone acetate and nonhormonal control subjects. Methods The study included 154 women aged 25-40 years. Forty-six women were using ethinylestradiol/desogestrel (group A) and 55 women using ethinylestradiol/cyproterone acetate (group B) for 24 months and 53 women using nonhormonal contraception as control subjects (group C). BMD of the lumbar spine and femoral neck were obtained using dual energy X-ray absorptiometry, comparing mean BMD changes in combined oral contraceptives (COCs) users with nonusers. Results For 24 months of treatment, lumbar spine and femoral neck BMD values in women who used ethinylestradiol/desogestrel and ethinylestradiol/cyproterone acetate were not significantly different compared with the baseline and the values of subjects in nonuser (P>0.05). Conclusion There was no statistical difference in BMD between the users of ethinylestradiol/desogestrel or ethinylestradiol/cyproterone acetate and nonusers.     

Evaluation of the Potential Inhibitory Activity of A Combination of L. Acidophilus, L. Rhamnosus and L. Sporogenes on Helicobacter Pylori: A Randomized Double-Blind Placebo-Controlled Clinical Trial

Objective: To investigate whether three strains of probiotics, L. acidophilus, L. rhamnosus, and L. sporogenes, had significant inhibitive effects on Helicobacter pylori(H. pylori). Methods: This is a 4-week, randomly assigned, parallel-group, doubled-blind, and placebo-controlled study. Fifty patients with a positive H. pylori infection urea breath test(△UBT) result 10% and without ulcer symptoms were randomized into a treatment group and a placebo group by a computer generated allocation sheet with 1:1. These subjects took one capsule of probiotics or placebo twice daily. The primary measurement was the change in △UBT values. Results: The △UBT values during the 4-week treatment period and the 2-week follow-up period were not significantly different between the treatment group and the placebo group, indicating that the inhibitive effects on H. pylori were comparable between both groups. The monocyte count(%) was 5.77±1.11 in the treatment group versus 5.09±1.12 in the placebo group(P=0.044), and the basophile count was 0.55±0.32 in the treatment group versus 0.36±0.23 in the placebo group(P=0.024) at week 2 of the treatment period, both of which reached statistical significance. The monocyte count was 5.75±1.26 in the treatment group and 4.72±0.99 in the placebo group at the end of the follow-up period(P=0.003). Conclusions: There was no significant inhibitive effects of the three probiotic strains(L. acidophilus, L. rhamnosus, and L. sporogenes) on H. pylori. Probiotics can not play the same role as antibiotics in the eradication of H. pylori, the role of probiotics is likely to be important as adjuvant to the triple or quadruple therapy for H. pylori, especially in resistance cases.     

Alendronate treatment does not inhibit bone formation within biphasic calcium phosphate ceramics in posterolateral spinal fusion: an experimental study in porcine model

Background Biphasic calcium phosphate （BCP） ceramics has a potential advantage as an osteoconductive matrix and has an optimal resorption rate for bone formation. Using BCP ceramics as a bone graft during spinal fusion requires osteogenesis within the material and subsequent bridging between adjacent vertebraes to provide long-term support. Bisphosphonates have been reported to prolong the process of bone healing. The influence of bisphosphonate treatment on bone formation within BCP ceramics in spinal fusion remains unknown. The aim of this study was to evaluate the influence of alendronate on BCP osteoaenesis in Dosterolateral spinal fusion.
Methods Posterolateral spinal fusion with pedicle screw fixation was performed at the lumbar spine in twenty-two pigs. BCP ceramics were applied as a bone graft to obtain bone fusion between adjacent transverse processes. Eleven pigs in the treatment group received oral alendronate 10 mg/d for three months postoperatively. Eleven pigs in the control group did not receive treatment with alendronate. All animals underwent posterolateral spinal fusion with BCP ceramics. The fusion rate was evaluated three months after the operation.
Results The fusion rates evaluated by X-ray were 27.3% in the treatment group and 20% in the control group. The fusion rates using histological evaluation were 18.2% in the treatment group and 20% in the control group. The mean volumes of fusion mass were （3.64±0.86） cm^3 in the treatment group and （4.26±0.63） cm^3 in the control group. No significant differences were found in either trabecular bone volume or residual BCP volume between treatment and control groups using histological evaluation. The new bone formation within BCP ceramics was greater in the area adjacent to transverse process （P 〈0.01）.
Conclusion Oral alendronate with a dose of 10 mg daily do not inhibit bone formation within BCP ceramics or affect the fusion rate in posterolateral spinal fusion from porcine models.     

Percutaneous estrogen in prevention of early postmenopausal bone loss in Chinese women

Objective To identify the optimal dosage of 17β-estradiol gel+oral progestin for preventing bone loss in postmenopausal Chinese women.Methods A 3-year open label, randomized, prospective clinical trial was conducted.Sixty healthy women who had been postmenopausal for 1 to 5 years were recruited and divided into following 4 groups: group 1, percutaneous gel 17β-estradiol (E(2)) 1.5 mg/d plus micronized progesterone (MP) 100 mg/d; group 2, percutaneous gel 17β-estradiol (E(2)) 1.5 mg/d plus medroxyprogesterone acetate (MPA) 2 mg/d; group 3, percutaneous gel 17β-estradiol (E(2)) 0.75 mg/d plus micronized progesterone (MP) 100 mg/d; and group 4, percutaneous gel 17β-estradiol (E(2)) 0.75 mg/d plus medroxyprogesterone acetate (MPA) 2 mg/d. Estrogen and progestin were given continuously for 25 days per month.Bone mineral density (BMD) was measured using quantitative computed tomography (QCT) for trabecular bone of L2-5 and dual energy X-ray absorptiometry (DEXA) for L2-4 and hip 5 times during the trial at baseline and at the 6-, 12-, 18-, 24- and 36-month visits.Results Fifty-nine patients (98.3%, 59/60) stayed in the study for 1 year, 56 patients (93.3%, 56/60) for 2 years, and 51 (85%, 51/50) for 3 years.On average, menopausal symptoms were relieved by 80% after 6 months of treatment.By the 24th month, the mean increase in BMD ranged from 4.3% to 7.5% in trabecular bone; and by the 36th month, it ranged from 4.2% to 6.2% in L2-4 and 1.61% to 3.77% in the neck.There were significant difference after treatment (P&lt;0.05).Among the four groups, no significant difference (P&gt;0.05) was found in improvement of symptoms, levels of bone markers or BMD.Conclusion A daily dose of estradiol gel, either 0.75 mg or 1.5 mg, is effective in preventing early postmenopausal bone loss and relieving menopausal symptoms.After 3-year treatment, spinal BMD could increase steadily, so does hip BMD, especially in the first 2 years.     

The clinical value of BALP on diagnosis and treatment of osteoporosis in postmenopausal women

Objective： To investigate the changes of bone-specific alkaline phosphatase （BALP） in postmenopausal women, analyze the relationship between BALP and bone mineral density, and study the effects of treatment with risedronate on BALP. Methods ： In this study, 243 women who were all at least 1 year past natural menopause were divided into two groups according to WHO standards. Group Ⅰ was 100 osteopenic patients aged from 43 to 85 （mean age, 61.2 years）. Group Ⅱ was 143 osteoporotic patients aged from 45 to 80（mean age, 62.6 yearsi. Bone mineral density（BMD） was measured by dual-energy X-ray absorptiometry （DEXA） and bone-specific alkaline phosphatase（BALP） was tested among all the patients. All the osteoporotic patients received 1-year Risedronate treatment. BALP was tested again after 3 months treatment of Risedronate for osteoporotic patients and BMD was measured after 1-year treatment. All data were processed by the application of statistical package SAS for windows V.6.12. Results： BALP was greater in the osteoporotic patients as compared with the osteopenic patients （P 〈 0.05）. There was also a significant difference of BALP in the patients before and after treatment of risedronate （P 〈 0.05）. BALP was greater in the patients who were less than 5 years past a natural menopause as compared with those who were more than 5 years past a natural menopause （P 〈 0.05）. There was no significant difference of BALP in the patients who were more than 10 years past a natural menopause. Risedronate decreased serum BALP significantly. Logistic regression analyses showed that 3-month percentage decrease in BALP was profoundly associated with the 1-year percentage increase in BMD（r = 0.696, P 〈 0.01 ）. Conclusion： BALP can predict the response in bone mass during Risedronate treatment in postmenopausal women and identify those noncompliant patients. 3-month percentage change in serum BALP was significantly correlated with the increase of BMD. Serum BALP can play a role in the monitoring of risedronate-treated postmenopausal women with osteoporosis, but it is poor to predict the treatment effects on an individual level.     

Decreased bone mineral density in female patients with systemic lupus erythematosus after long-term administration of Tripterygium Wilfordii Hook .F

Objective To investigate the possible bone changes in female patients with systemic lupus erythematosus (SLE) induced by long-term administration of Tripterygium Wilfordii Hook.F (TW). Methods 70 female SLE patients were divided into 4 groups accordiog to their drug history: SLE disease control group, corticosteroids treatment group, TW treatment group, and both corticosteroids and TW treatment group.Bone mineral density (BMD) of the lumbar spine 2-4 and biochemical markers of bone turnover were studied. Results Long-term administration of TW could significantly decrease BMD levels in female SLE patients (P&lt;0.05).The patients receiving TW for more than 5 years had significantly lower BMD levels compared with those for less than 5 years.The degree of decreased BMD induced by TW was less severe compared with that of prednisone.No significant differences were observed in the biochemical markers of bone turnover among four groups (P&gt;0.05). Conclusion Long-term administration of TW could decrease BMD levels in women.Osteoporosis may be an important problem for SLE patients treated with TW.     

A randomized double-blinded sham-controlled trial of α electroencephalogram-guided transcranial magnetic stimulation for obsessive-compulsive disorder

Background Obsessive-compulsive disorder （OCD） is a highly prevalent and devastating psychiatric condition.Repetitive transcranial magnetic stimulation （rTMS） is a potential and non-invasive treatment for OCD.Diverse efficacies of rTMS have been reported in different locations or frequencies of the stimulation.The main objective of this study was to assess the treatment effect for OCD with alpha electroencephalogram （αEEG）-guided TMS over dorsal Iateral prefrontal cortex bilaterally.Methods There were 25 OCD patients in the αTMS treatment group and 21 OCD patients in the sham control group.Each subject received 10 daily treatment sessions （5 days a week）.The αTMS group had significant reduction in scores of Yale-Brown Obsessive Compulsive Scale and Hamilton Rating Scale for Anxiety （HAMA） compared with the control group at the end of 2-week treatment and 1-week follow-up.Analysis of variance with repeated measures was used to test the effects between the two groups.Results Significant difference in scores of obsession and HAMA were found between the two groups after treatment.No significant difference in scores of Hamilton Rating Scale for Depression was found between the two groups after the treatment,but statistical significance was shown at the end of 1-week follow-up.Conclusions αEEG-guided TMS may be an effective treatment for OCD and related anxiety.Delayed response to αTMS in depression suggests that it might be secondary to the improvement of primary response in OCD and anxiety.     

Protective effect of periplaneta americana extract on intestinal mucosal barrier function in patients with sepsis

OBJECTIVE: To investigate the effect of the periplaneta americana extract on the intestinal mucosal barrier and prognostic implications in patients with sepsis. METHODS: Sixty and six patients with sepsis were assigned randomly to treatment group (32 cases) and control group (32 cases). The extractfrom periplaneta americana plus conventional medication for sepsis was administered to the treatment group, while the control group only received conventional treatment. The gastrointestinal function scores and acute physiology and chronic health evaluation II (APACHEⅡ) scores of all subjects were documented at baseline, at days 1, 3 and 7 after treatment respectively and their blood endotoxin was tested at the same time points as well.The incidence of death was recorded for both groups throughout the trial. RESULTS: At days 3 and 7 after treatment, gastroin-testinal function score, APACHE II, and endotoxin level in treatment group wasbetter than that in control group and the difference between them was significant (both P<0.05). Although the incidence of death in treatment group was less than that in control group, the difference between the two groups was not significant (P> 0.05). CONCLUSION: The extract of periplaneta americana had protective effect on intestinal mucosal barrier and could improve the condition and prognosis in patients with sepsis.     

针灸对血管性痴呆中医证候的改善作用

Objective： To study the effects of acupuncture on Chinese medicine syndromes of vascular dementia （VaD）. Methods： Sixty-three VaD patients were divided into three groups. Those willing to be randomized were randomly assigned to receive either acupuncture （random acupuncture group, 24 cases） or rehabilitation training （guided rehabilitation group, 24 cases） for 6 weeks. Those unwilling to be randomized also received acupuncture for 6 weeks （non-random acupuncture group, 19 cases）. Patient syndromes and their severity were evaluated before treatment （baseline）, at the end of treatment, and at 4-week follow-up after the completion of treatment using a CM scoring system （scale of differentiation of syndromes of vascular dementia, SDSVD）. The SDSVD scores of the random and non-random acupuncture groups, and of all patients who received acupuncture （combined acupuncture group, 43 cases）, were compared with those in the guided rehabilitation group. Results： In the random, non-random, and combined acupuncture groups, SDSVD scores were significantly reduced at the end of treatment and at follow- up than at baseline. In the guided rehabilitation group, SDSVD scores were similar to baseline scores at the end of treatment and at follow-up. However, there were no significant differences in SDSVD scores among the three groups or between the combined acupuncture group and the guided rehabilitation group at any time points. In the non-random and combined acupuncture groups, SDSVD scores were significantly reduced at the end of treatment than at baseline in patients with hyperactivity of Liver （Gan）-yang or phlegm obstruction of the orifices. Conclusions： Acupuncture reduced the severity of VaD. The improvement was the greatest in patients undergoing their treatment of choice. Treatments in this study were more effective for excess syndromes, such as Liver-yang hyperactivity or phlegm obstruction of the orifices than deficiency syndromes, such as Kidney （Shen）-essence deficiency.     

Study of Coping-competence among Unmarried Pregnant Young Women in Three Big Cites in China

Objective To identify the coping-competence among unmarried pregnant young women. Methods A cross-sectional study was conducted in the setting of clinics-based. A total of 1 391 unmarried young women were recruited as the sample in Youth Clinics of 3 maternal care hospitals in Beijing, Jinan, and Guangzhou respectively in China. ＂Behavioral Attributes of Psychosocial Competence Scale-Condensed Form＂ was administered to identify the coping-competence of these women. All these women were aged 10-24 years old and were divided into three groups based on whether or not they had sex and pregnancy. The three groups were named as follows： pregnancy group with young women having had both sex and pregnancy, sex group with young women having had only sex but not pregnancy, and non-sex group with young women having no sex experience. Results Among the adolescents aged 10-19 years old, the coping-competence was different among the three groups （P=O.050）. Compared with the pregnancy group, the non-sex group were more inclined to active coping （P=0.026）. Among all the pregnant women aged 10-24 years old, the coping-competence was various by region （P〈0.001）： the women in Jinan were more inclined to active coping than the women in another two cites （P=0.009, P〈0.001）, and there was no difference between the women from Beijing and Guangzhou （P=0.324）. Conclusion This is the first study of coping among unmarried pregnant young women in China. The results supported the point of view that the pregnant adolescents were more inclined to passive coping, and the coping had regional differences.     

Effect of traditional Chinese herbs combined with low dose human menopausal gonadotropin applied in frozen thawed embryo transfer

Objective： To assess embryo implantation rate （IR） and pregnancy rate （PR） in women who received Bushen Wengong Decoction （补肾温宫汤, BSWGD）, a Chinese herbal formula, combined with low dose of human menopausal gonadotropin （hMG） prior to frozen-thawed embryo transfer （FET）. Methods： A total of 262 subjects （674 transferred embryos） who received FET were analyzed retrospectively. In them, 122 women were under 30 years old, 106 between 30-35 years and 32 over 35 years. The 85 subjects with normal ovulation were assigned to Group A, the natural menstruation cycling group, on whom no pre-transfer treatment was applied. The other 177 subjects with abnormal ovulation were assigned to Group B, and subdivided, according to the pre-transfer treatment they received, into three groups, Group B1 （50 cases） received BSWGD, Group B2 （58 cases） received hMG and Group B3 （69 cases） received both BSWGD and low dose hMG. The IR and PR of FET in the four groups were compared time on PR of FET were compared also. Besides, the influencing factors and the effect of the embryo cryoto FET were analyzed. Results： IR and PR were significantly higher in all age sects of Group B3 than those in Group A, showing significant difference （ P〈0.05）. IR and PR in subjects in age sects of 〈30 years and 〉 35 years in group B3 were significantly higher than those in Group B1 （ P〈0.05）, but no significant difference was shown in the two parameters between Group B 2 and Group B3 （P〉0.05）. PR in the subjects who received embryos with cryo-time of 〉 200 days was significantly lower than that in those with cryo-time of ~ 100 days （P〈0.05）. Embryo cryo-time, endometrial thickness, use of BSWGD and use of hMG were of significance in FET （ P〈 0.05）. Conclusion： A programmed cycle of BSWGD combined with low dose of hMG could improve the embryo IR and PR of FET. Embryo cryo-time, endometrial thickness, and the use of BSWGD and hMG are of significance for FET.     

Relationship of Helicobacter pylori eradication with gastric cancer and gastric mucosal histological changes: a 10-year follow-up study

Background Helicobacter pylori （Hp） is a common and potentially curable cause of gastric mucosa lesion. This study investigated the relationship of Hp infection with histological changes in gastric mucosa and gastric cancer in Hp-positive patients compared with Hp-eradication patients followed up for ten years. Methods From an initial group of 1 006 adults, 552 Hp-positive subjects were randomly assigned to a treatment group （T; n=276） or a placebo group （P; n=276）. In the randomized, double-blind, placebo-controlled, parallel trial, T group subjects received oral doses of omeprazole, amoxicillin and clarithromycin for 1 week; those in the P group received a placebo. One month after treatment ended, a 13C urea breath test was performed, and Hp was undetectable in 88.89% of the T group. All subjects were followed at 1, 5, 8, and 10 years after treatment, with endoscopy and biopsies for histological examination. Results Gastric mucosa inflammation was significantly milder in the T group than that in the P group one year after Hp eradication and this persisted for 10 years. Glandular atrophy and intestinal metaplasia （IM） had deteriorated in both groups during ten years. However, the increased score of glandular atrophy at both the gastric antrum and corpus, and IM only at the gastric antrum, in the P group was more obvious than that in the T group. During the 10 years, 9 patients were diagnosed with gastric cancer （2 in the T group; 7 in the P group; P=0.176）. When mucosal atrophy was absent at the gastric antrum and corpus when entering the study, the incidence of gastric cancer in the P group （n=6） was much higher than that in the T group （n=0, P=0.013）. Conclusions Hp eradication may significantly diminish and delay the development of IM and atrophy gastritis. Hp especially in the early stage of Hp infection. and help halt progression of gastric mucosal inflammation eradication is helpful for reducing the risk for gastric cancer,