Objective To evaluate early bone loss by radionuclide 99mTc-MDP bone imaging and to intervene in early stage.Methods Early bone loss and osteoporosis models were produce in rabbits by intramuscular injection of dexamethasone sodium phosphate (DX) and then a treatment was used on the model rabbits.The treatment drug 99Tc-MDP was injected once a week,up to 14 weeks.The ratio between region of interest (ROI) site of radionuclide bone imaging and the fixed radioactive standard source (RSF),bone histopathology,bone histomorphometry,bone mineral density,bone biomechanics,serum bone alkaline phosphatase (BALP),osteocalcin (BGP),and X ray and CT radiography of the lumbar vertebrae were determined,and the differences between the groups of were compared.Results After injection of different doses of DX on experimental rabbits,bone tissue pathological section,indexes of Bone morphological metrology,bone density,bone biomechanics,and BALP and BGP were used to confirm that the animal model was established successfully.After treatment for 14 weeks,early bone loss group showed that trabecular bone of the femoral head was arranged regularly and the trabecular bone was thickening comparing with those in the model group.However,the osteoporosis treatment group showed that trabecular bone was slightly sparse,and trabecular thickness was not uniform,but no fracture was found.The uptake of 99m Tc MDP bone scintigraphy agent in early bone loss model and osteoporosis bone tissue was significantly higher than that in control group (P ＜ 0.05),but the uptake of imaging agent in the treatment group was significantly decreased than the corresponding model group (P ＜ 0.05).Bone mineral density and bone histomorphometry were not significantly different between early bone loss treatment group and the control group (P ＞ 0.05).But the uptake of imaging agent in the early bone loss treatment group was significantly higher than that in the normal control group (P ＜ 0.05).Bone mineral density,bone biomechanics,and BALP and BGP were significantly different between bone osteoporosis therapy group and normal control group,and the greatest improvement was found in osteoporosis treatment group (P ＜ 0.05).Conclusion Radionuclide " 99m Tc-MDP" bone imaging can detect early bone loss in different individuals,and the effect of intervention on early bone loss stage is significantly better than that of severe osteoporosis.

目的:观察骨康灵联合锝-99亚甲基二磷酸钠(99Tc-MDP)干预兔股骨头无菌性坏死(ANFH)的疗效,探讨其作用机制及指导临床实践.方法:将兔子随机分成两组:正常组、ANFH组;采用肌肉注射地塞米松磷酸钠方法制作ANFH模型,8周后进行ANFH模型鉴定,将造模成功的兔子随机分成ANFH组、99Tc-MDP组、骨康灵组和99Tc-MDP联合骨康灵组,16周治疗后评价各效应指标.结果:HE染色提示,ANFH组兔骨小梁排列稀缺和断裂现象,呈骨组织明显破坏形态;99Tc-MDP组骨小梁形态较ANFH组明显的致密、增粗;骨康灵组骨小梁密度较ANFH组有所增加,骨小梁断裂现象消失;99Tc-MDP联合骨康灵组股骨头的骨组织形态排列较规则、均匀,无明显组织破坏.与ANFH组比较,99Tc-MDP组和99Tc-MDP联合骨康灵组骨密度、骨生物力学、骨形态计量、99mTc-MDP骨骼显像ROI比值、血清碱性磷酸酶(ALP)、血清骨钙素(BGP)等检测结果有差异(P＜0.05).结论:骨康灵对ANFH模型有一定的抑制骨吸收作用,与99Tc-MDP联合治疗后效应更明显,可能存在增效协同作用.

Objective To study the therapeutic value of99 Tc-MDP for bone repairing in aseptic necrosis of the femoral head ( ANFH) .Methods The animal experiment included 2 stages:the establishment of animal model and the treatment observation. ANFH animal model was made by dexamethasone intramuscular injection.Intramuscular injection of dexamethasone was used to establish the ANFH model.In the first stage of 8 weeks, normal group ( Group A) and ANFH model group ( Group B) were set up.The successful animal model was proved by cell pathology, bone morphology, BMD, tetracycline double labeling, bone scintigraphy ROI value, X-ray, and CT.In the second stage of 16 weeks, normal control group ( Group C) , ANFH model control Group ( Group D) ,99 Tc-MDP therapy Group ( Group E) , and alendronate sodium therapy group ( Group F) were set up.The same tests were applied like in stage 1 and the efficacy in Group E and Group F was valued.SPSS13 was used for statistical analysis. Results At the end of stage 1, the pathology showed that no bone tissue was destroyed in Group A, but in Group B the surface soft tissue of the femoral head was destroyed, and bone trabecular breaking and bone lacuna increased. BMD, bone histomorphology, tetracycline double labeling decreased and bone scintigraphy ROI, serum BALP and BGP increased in Group B. ANFH could be seen by X ray and CT in Group B.After 16-week therapy in Group E and Group F, all the test results showed a nearly same results between Group A, C and Group B, D.Improved result showed in Group E and Group F, especially in Group E for bone repairing, bone trabecular increasing, and bone lacuna disappearing.All the results were comparable between Group E and Group C.Conclusion Animal study shows an apparent result of99 Tc-MDP treatment for ANFH.99 Tc-MDP not only has the same function like alendronate sodium showing increased bone trabeculae in tetracycline double labeling test, but also reveals the potential function in promoting osteoblast function and bone tissue repairing indicated by bone lacuna disappearing.

目的探讨不同双磷酸盐药物联合"骨康灵"治疗兔股骨头无菌性坏死（ANFH）模型的疗效分析。方法采用肌肉注射地塞米松磷酸钠方法制作ANFH动物模型;制作动物模型成功后,将实验兔设为A组（正常对照组）、B组（ANFH对照组）、C组（"99Tc-MDP"治疗组）、D组（"阿仑膦酸钠"治疗组）、E组（"骨康灵"治疗组）、F组（"99Tc-MDP"联合"骨康灵"治疗组）和G组（"阿仑膦酸钠"联合"骨康灵"治疗组）,疗程为16周,后比较各组之间骨密度、影像学及生化指标变化并评价疗效。采用SPSS17.0软件进行统计学处理。结果 ANFH模型组与正常组比较显示:骨组织病理学、99mTc-MDP骨显像,骨密度、骨生物力学、骨形态计量、ALP、BGP均有明显差异（P＜0.01）。经过不同药物联合治疗后,C、D、E、F、G组经治疗后与B组相比,骨组织病理学、99mTc-MDP骨显像,骨密度、骨生物力学、骨形态计量、ALP、BGP均比B组有有明显统计学意义;疗效评判结果显示:F组为显效基本接近A组,C组、G组和D组均为有效,但E组疗效相对不明显。结论药物"99Tc-MDP"联合联合"骨康灵"治疗骨质疏松效果优于其他药物治疗;因此,中草药联合"99Tc-MDP"可能成为治疗骨质疏松的有效治疗方法。

Objective To investigate the value of 99 Tc-MDP therapy in aseptic necrosis femur head ( ANFH) .Methods The animal experiment was divided into 2 stages: animal model establishment and clinical observation.In the first stage, Group A ( normal group) and Group B ( ANFH group) were set up.The animal ANFH model was established by intravenous injection of dexamethasone sodium phosphate for 8 weeks.Bone pathology, histomorphology, bone mineral density, tetracycline double labeling experiment, radionuclide bone scintigraphy ROI ratio value, X-ray, and CT were examined.The second stage of the experiment started until the ANFH model had been proved.During the second stage, these groups were set up for the further 16 week-therapy based on the ANFH animal model: Group C (normal control), Group D (ANFH control), Group E (99Tc-MDP therapy) , and Group F ( alendronate therapy) .After the treatment, the efficacy in Group E and Group F was valued.A SPPSS 13.0 software was used for statistical analysis.Results After 2 stages of ANFH model establishment and clinical observation, the results, including bone pathology, histomorphology, bone mineral density, tetracycline double labeling experiment, and ROI ratio of radionuclide bone scintigraphy, showed apparent difference between Group A and B (p<0.01), indicating the success of animal modeling.After the treatment, the bone pathology in Group E showed that trabecular bone in the femoral head lined regularly with a little scatter.But the repair was apparent comparing with that in Group D.In Group F trabecular bone in the femoral head showed scattered and irregular lining and little broken.Comparing with that in Group D, the situation improved in Group F.The results of bone mineral density, tetracycline double labeling experiment, and ROI ratio of radionuclide bone scintigraphy also supported the&nbsp;improvement ( p<0.05 ) .Conclusion On the bases of ANFH animal model,99 Tc-MDP and Alendronate have got different therapy value and 99 Tc-MDP showed an apparent remoulding result.99 Tc-MDP can reach the ANFH target tissue.Besides controlling bone absorption, it also can maintain the activity of superoxide dismutase( SOD) , protect the bone tissue absorption from free radius and prevent from its further damaging.From the tetracycline double labeling experiment we can conclude that the increased deposition rate maybe relate to the bone cell proliferation.

Objective To investigate the correlation among early changes in bone metabolism and99Tcm-MDP bone nuclear image,serum BGP,and BALP,and to focus on the importance of the value.Methods Rabbit osteoporosis model was established using intramuscular injection of dexamethasone sodium phosphate( DX).Three groups were set up including Group A( normal control group),Group B( osteoporosis group induced with DX injection,2 mg/kg,b.i.w),and Group C( bone mass loss group induced with DX injection,1 mg/kg,q.w).The time for the model establishment lasted for 8 weeks.99Tcm-MDP bone nuclear image was taken,and histopathological examination was performed.Bone mineral density,serum BALP and BGP were detected.Semi-quantitative detection of ROI in nuclear image was calculated by the ratio of L3/S4,the femur head/S4,the knee/S4,and the femoral diaphysis/S4.T test and variance analysis were conducted among the groups using a SPSS 13.0 software.Results At the 7th week,obvious wear and tear on the surface cartilage of the femoral head and bone destruction such as trabecular sparse and broken were observed in Group B.Bone mineral density decreased significantly,while serum BALP and BGP increased,and the ROI ratio of99Tcm-MDP nuclear image also elevated( P < 0.05).In Group C,the histopathological sections demonstrated slightly sparse trabecular only without signs of bone destruction.The serum BGP and the ROI ratio of99Tcm-MDP nuclear image increased( P < 0.05),but no significant changes of bone mineral density and serum BALP were observed( P > 0.05),which proved the establishment of animal model was successful.When comparing the results of Group B and Group C,all ROI ratios and BGP remained in same range except the ratio of the femoral diaphysis/S 4 increased in Group B,and significant difference of bone mineral density and serum BALP level was observed( P <0.05).Conclusion According to the results of the animal experiment,when the ratios of L 3/S 4,the femur head/S 4,the knee/S 4 in 99Tcm-MDP nuclear image increase while the ratio of the femoral diaphysis/S 4 remains unchanged,it may indicate the stage of bone mass loss,which is more valuable than serum BGP.This may provide reference for clinical prevention and intervention of the early stage of osteoporosis.

Objective To investigate the correlation among early changes in bone metabolism and 99 Tcm-MDP bone nuclear image , serum BGP, and BALP, and to focus on the importance of the value .Methods Rabbit osteoporosis model was established using intramuscular injection of dexamethasone sodium phosphate ( DX ) .Three groups were set up including Group A ( normal control group) , Group B ( osteoporosis group induced with DX injection , 2 mg/kg, b.i.w) , and Group C ( bone mass loss group induced with DX injection, 1 mg/kg, q.w).The time for the model establishment lasted for 8 weeks.99Tcm-MDP bone nuclear image was taken, and histopathological examination was performed .Bone mineral density , serum BALP and BGP were detected .Semi-quantitative detection of ROI in nuclear image was calculated by the ratio of L 3/S4 , the femur head/S4 , the knee/S4 , and the femoral diaphysis/S4 .T test and variance analysis were conducted among the groups using a SPSS 13.0 software.Results At the 7th week, obvious wear and tear on the surface cartilage of the femoral head and bone destruction such as trabecular sparse and broken were observed in Group B.Bone mineral density decreased significantly , while serum BALP and BGP increased , and the ROI ratio of 99 Tcm-MDP nuclear image also elevated ( P<0.05) .In Group C, the histopathological sections demonstrated slightly sparse trabecular only without signs of bone destruction .The serum BGP and the ROI ratio of 99 Tcm-MDP nuclear image increased ( P<0.05 ) , but no significant changes of bone mineral density and serum BALP were observed ( P>0.05 ) , which proved the establishment of animal model was successful .When comparing the results of Group B and Group C , all ROI ratios and BGP remained in same range except the ratio of the femoral diaphysis/S4 increased in Group B , and significant difference of bone mineral density and serum BALP level was observed (P<0.05).Conclusion According to the results of the animal experiment , when the ratios of L3/S4, the femur head/S4, the knee/S4 in 99Tcm-MDP nuclear image increase while the ratio of the femoral diaphysis /S4 remains unchanged , it may indicate the stage of bone mass loss , which is more valuable than serum BGP .This may provide reference for clinical prevention and intervention of the early stage of osteoporosis .