目的 分析绝经后女性血清生长激素(growth hormone,GH)、胰岛素样生长因子-1(insulin-like growth factors-1,IGF-1)水平与骨密度(bone mineral density,BMD)、骨代谢的相关性.方法 将符合研究标准的绝经后女性按BMD检查参数分为骨质疏松组(n=63)、骨量低下组(n=108)及骨量正常组(n=67),对比3组间以下指标的差异:①临床一般资料;②BMD;③骨质疏松生化指标:甲状旁腺激素(parathyroid hormone,PTH)、总Ⅰ型胶原氨基端前肽(total N-terminal propeptide of type Ⅰ collagen,PINP)、β-胶原降解产物(β-crosslaps,β-CTX)、N 端骨钙素(osteocalcin,OC)、1-25羟基维生素 D3(1,25-dihydroxy vitamin D,1-25-OH-D3);④ GH、IGF-1.并对 GH 及 IGF-1 与各部位 BMD 及骨质疏松生化指标的相关性进行分析.结果 ①骨质疏松组患者的年龄高于骨量低下组与骨量正常组,体质量、体质量指数(body mass index,BMI)、各部位BMD水平低于骨量低下组与骨量正常组,组间比较差异有统计学意义(P均＜0.05);②骨质疏松组PINP、β-CTX水平高于骨量低下组及骨量正常组,OC显著高于骨量正常组,组间比较差异有统计学意义(P均＜0.05);③骨质疏松组GH水平低于骨量低下组与骨量正常组,IGF-1水平低于骨量正常组,组间比较差异有统计学意义(P均＜0.05).GH与腰椎、左股骨颈、左股骨上端BMD均呈正相关(r分别为0.372、0.249、0.276,P均＜0.05),IGF-1 与腰椎 BMD 呈正相关(r=0.200,P＜0.05);GH 与 PTH 呈负相关(r=-0.112,P＜0.05),IGF-1 与PTH、β-CTX均呈负相关(r分别为-0.155、-0.240,P均＜0.05).结论 GH、IGF-1与绝经后女性BMD呈正相关,与绝经后女性高骨转换率状态呈负相关,GH及IGF-1水平对维持机体BMD有重要作用,对调节绝经后女性高骨转换率状态具有重要意义.

目的 探讨血脂与老年女性骨质疏松患者骨折风险的相关性.方法 2018年1月至2019年1月,随机将来我院就诊的老年女性骨质疏松患者50例设为观察组,另选取同期骨密度正常的同年龄段女性40例为对照组.记录所有研究对象的骨碱性磷酸酶(BAP)及血脂水平,随访18个月观察其骨折发生情况;分析骨代谢指标与血脂的相关性.结果 观察组BAP、HDL-C水平低于对照组,TG、TC、LDL-C均高于对照组(P<0.05);观察组骨折总发生率明显高于对照组(P<0.05).进一步相关分析显示,观察组患者骨代谢指标BAP与HDL-C呈正相关(r=0.669,P<0.05),与TG、TC、LDL-C均呈负相关(r=-0.665,-0.745,-0.845,P<0.05).结论 老年女性骨质疏松患者血脂存在明显异常,且与患者骨折发生有一定的相关性,应加强对此类患者血脂水平的监测.

Objective To establish the GIOP model and extract BMSCs from the rat model.We aim to in-vesitigatethe effect ofrhPTH(1-34)for inhibiting β-catenin ubiquitination when combining with Micro-CT and bio-logical technology.We also investigate the influence of rhPTH(1-34)on the GIOP.Methods Female SPF emale rats wererandomly divided into normal control group,methylprednisolone group(model group),methylpredniso-lone+saline group(blankcontrol group)and methylprednisolone+rhPTH(1-34)group(test group). The proximal femoral cancellous bone was examined by Micro-CTand histopathological Staining. The expression of Wnt10b and β-catenin protein were detected. By comparing with inducedBMP-2,BMSCs were treated withrhPTH(1-34)and stained with ALP and alizarin red.Results(1)In Micro-CT,BV/TV,Tb.Th and Tb/N decreased,whereas Tb/sp increased in the test group comparedwith model group(P<0.05).ROI three-dimensional reconstruction of trabecu-lar bone in test group showed local bone repair;(2)Wnt10b and β-cateninexpression increased in the test group compared with the model model(P<0.05),indicating that rhPTH(1-34)can enhance the transcriptional activity of β-catenin(P<0.05)and promote the expression of Wnt10b andβ-catenin(P<0.05).Conclusion The inter-vention with rhPTH(1-34)can prevent GIOP by regulating the Wnt/β-catenin signaling pathway and inhibiting GIOP progress,which can improve the microstructure of bone.

Objective To investigate the effect of FTZ on the bone absorption ability of osteoclasts in vitro. Methods Osteoclasts were separated from C57 B6/ J of 4-6w mice and cultured. They were randomly divided into five groups, control, Alendronate, FTZ-H, FTZ-M and FTZ-L groups. After 8 days of cultivation, the number of osteoclast and bone absorptive lacunae were counted by electron microscope. Trap, MMP-9 and NFATc1 mRNA were assessed by RT-PCR. Results Compared with the control group, the number of osteoclasts and the area of bone absorptive lacunae were significantly reduced Alendronate, FTZ-H and FTZ-M groups (P ＜ 0. 01, P ＜ 0. 05). Compared with FTZ-L group, significant reduction in the number of osteoclasts was observed in FTZ-H group. There is no significant difference between FTZ-L and FTZ-H in the area of bone absorptive lacunae (P ＞ 0. 05). The gene expressions of Trap, MMP-9 and NFATc1 were significantly lower in Alendronate and FTZ-H groups than that in control group (P ＜ 0. 01). Conclusion FTZ-H and FTZ-M inhibit osteoblast differentiation and bone absorbing activity, but there is no significant difference between FTZ-H and FTZ-M.

目的 探讨仙灵骨葆胶囊对去势大鼠股骨形态计量学和成骨相关基因骨钙素(OCN)、核心结合因子(Cbfα1)mRNA的影响.方法 50只6月龄雌性SD大鼠,随机分为A组(作为空白对照)、B组(作为模型)、C组(给予高剂量仙灵骨葆胶囊)、D组(给予低剂量仙灵骨葆胶囊)、E组[给予阿仑膦酸钠维D3片(福美加)],每组10只.药物干预3个月后,采用X线显微断层显像仪检测左侧离体股骨骨密度(BMD)和骨小梁数量(TbN),逆转录-聚合酶链式反应(RT-PCR)检测右侧股骨组织OCN、Cbfα1 mRNA表达,比较各组检测结果.结果 干预3个月后,B组左侧股骨BMD、TbN明显低于A组,差异具有统计学意义(P<0.05);与B组比较,C、E组左侧股骨BMD明显增高,E组左侧股骨TbN明显增高,差异具有统计学意义(P<0.05);与E组比较,C、D组左侧股骨BMD、TbN明显降低,差异具有统计学意义(P<0.05);五组左侧股骨BMD、TbN比较差异具有统计学意义(F=86.400、28.027,P<0.05).干预3个月后,与A组比较,B组右侧股骨Cbfα1、OCN mRNA表达量明显降低,差异具有统计学意义(P<0.05);与B组比较,C、D、E组右侧股骨Cbfα1 mRNA表达量明显增高(P<0.05),C、E组右侧股骨OCN mRNA表达量明显增高,差异具有统计学意义(P<0.05);与E组比较,C组右侧股骨Cbfα1和OCN mRNA表达量明显增高(P<0.05),D组右侧股骨Cbfα1 mRNA表达量明显降低,差异具有统计学意义(P<0.05);五组大鼠右侧股骨Cbfα1、OCN mRNA比较差异具有统计学意义(F=13.233、48.338,P<0.05).结论 仙灵骨葆胶囊提高去势大鼠股骨BMD可能是通过提高OCN、Cbfα1 mRNA表达量发挥作用,TbN和BMD及成骨基因OCN、Cbfα1之间的关系尚需要进一步研究.

骨质疏松症在老年人中发病率较高,严重影响着老年人群的生活质量.随着全球人口老龄化加剧,骨质疏松的防治已成为世界医药关注的热点.本文分析近5年广东省学者发表的文章995篇,并与5年前文献对比,发现近年的研究在流行病学方面有了新的认识,说明骨质疏松症已引起广大临床医生的重视.骨质疏松症的动物实验和病理机制研究已比较成熟,近年研究有所下降.双能X线骨密度检查已广泛应用于临床骨质疏松的诊断.骨折是骨质疏松最严重的并发症,尤其是股骨粗隆间骨折是老年人常见骨折,并发症概率高,死亡率高.骨质疏松性骨折的治疗不仅要考虑局部骨折的处理,且要把骨质疏松症的治疗结合在一起,才能提高其整体疗效,改善患者生活质量.钙剂、维生素D、阿伦膦酸钠、鲑鱼降钙素已规范应用于临床.新的治疗措施,如复合振动治疗已在临床应用.总之,骨质疏松症已引起广东省医学界广泛的重视,诊断、治疗也逐渐规范.若能提高患者的自我保健意识和水平,积极用科学的方法干预,骨质疏松症是可以延缓和预防的,这将对病人及社会均有重要的意义.

BACKGROUND & OBJECTIVES:Vitamin D insufficiency is prevalent in postmenopausal women and has been related to low bone mineral density (BMD). However, controversial results have been reported for the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and BMD. This study was done to investigate whether serum 25(OH)D levels were associated with BMD in postmenopausal women living in Guangzhou in southern China.METHODS:This cross-sectional study involved 119 asymptomatic postmenopausal women, aged 48-85 yr, who were consecutively selected from Guangzhou city. BMD was measured at the lumbar spine and femoral neck. The correlation between serum 25(OH)D levels and BMD wes investigated.RESULTS:With increasing serum 25(OH)D levels categorized as <20, 20-30, and ≥ 30ng/ml, the PTH levels decreased gradually ( P=0.031). Bivariate correlation analyses showed an inverse relationship between serum 25(OH)D and PTH levels after controlling for age and BMI (r=-0.209, P=0.023). Although subjects with vitamin D<30 ng/ml had significantly lower BMD, age- and BMI-adjusted serum 25(OH)D was weakly correlated with BMD at femoral neck (r=0.185, P0.045), and not at lumbar spine (r=0.172, p =0 0.063). In multiple regression analyses, serum 25(OH)D was a predictor for BMD at femoral neck (R 2= 0.424). However, serum β-CTX was a determinant for BMD at lumbar spine (R 2= 0.361).INTERPRETATION & CONCLUSIONS:Serum 25(OH)D levels showed a positive correlation with BMD at femoral neck and serum β-CTX levels were inversely correlated with BMD at lumbar spine in postmenopausal women. Further studies are needed to elucidate the clinical impact of these findings.

Objective To study the relationship between osteopontin ( OPN) and bone mineral density ( BMD) and bone turnover markers in postmenopausal women, and to explore the clinical value of OPN in postmenopausal osteoporosis.Methods One hundred and twenty-five postmenopausal women were selected in the study.BMD of the lumbar spine 1-4 and the left femoral neck was measured using dual-energy X-ray absorptiometry.Levels of serum procollagen type I N-terminal propeptide ( PINP ) , β-crosslaps (β-CTX), 25-hydroxyvitamin D (25OHD), parathyroid hormone (PTH), OPN, osteocalcin (OC), calcium (Ca), and phosphorus(P) were measured.Results ①Osteopontin level in osteoporosis group was significantly higher than that in osteopenic and normal group (F=0.118, P=0.000).②BMD and Ca were negatively correlated, while age, β-CTX, and OC were positively with OPN ( all P <0.05 ) .③Multiple regression analysis showed that BMD of left femoral neck and Ca were independent predictors of the serum OPN level.Conclusion High level of OPN is associated with low BMD, increased level ofβ-CTX, and the lack of Ca, which enriches the existing clinical evidence and provide a new idea for controlling postmenopausal osteoporosis.

Objective(s): Studies have reported that whole body vibration (WBV) played a vital role in bone remodeling. Circulating serotonin is also involved in negative regulating bone mass in rodents and humans. However, both WBV and inhibition of serotonin biosynthesis may suppress receptor activator of nuclear factor-kappaB ligand (RANKL)-induced osteoclastogenesis in vitro. The purpose of the current study was to investigate the effect of WBV therapy on the levels of serum serotonin in ovariectomized rats. Materials and Methods: Thirty-six-month-old female Sprague Dawley rats weighing 276.15±37.75 g were ovariectomized to induce osteoporosis, and another ten rats underwent sham operation to establish sham control (SHAM) group. After 3 months, ovariectomized rats were divided into three subgroups and then separately treated with WBV, Alendronate (ALN) and normal saline (OVX), SHAM group was given normal saline. After 6 weeks of treatment, rats were sacrificed. Serum serotonin, RANKL, bone turnover markers, and bone mineral density (BMD), bone strength were evaluated. Results: The serum serotonin level was significantly lower in WBV group than OVX and ALN groups (P<0.05 and P<0.001). RANKL levels significantly decreased in WBV and ALN groups compared to OVX group (P<0.001 for both). BMD and biomechanical parameters of femur significantly increased (P<0.05 for both) and bone turnover levels decreased (P<0.001 for both) in WBV group compared to OVX group. Conclusion: These data indicated that WBV enhanced the bone strength and BMD in ovariectomized rats most likely by reducing the levels of circulating serotonin.

Objective To investigate the effects of kidney- tonifying,spleen- strengthening,and blood stasis removing herbal on femoral region bone mineral content and density in an ovariectomized rat model. Methods Thirty female non- pregnant SD rats( 7 months) were randomly divided into 5 groups: control group,ovariectomized group,low-dose herb group,high- dose herb group and Fumeijia group. Ovariectomized rat models were set up in all the other groups except for control group. Low- dose( 0. 83 mg /kg) or high- dose( 2. 5 mg /kg) Bushenzhuanggu Granule ig qd. was given to low- dose herb group or high- dose herb group,respectively; while fumeijia( 5mg /kg) was given to Fumeijia group weekly. Rat weights were recorded during treatment. After the 8- week treatment,the bone mineral density( BMD) and bone mineral content( BMC) were measured by small animals specially dual energy X- ray absorptiometry. Results There was no significant difference on pre- /post- treatment weight changes among five groups. Compared with control group,the BMC and BMD in ovariectomized group were significantly reduced( P 0. 05). Compared with ovariectomized group and low- dose herb group,the BMD of high- dose herb group and Fumeijia group were significantly increased( P 0. 05); while no significant difference was observed among control,high- dose herb and Fumeijia groups. There was no significant difference on BMC or BMD of femoral medial condyle among the five groups. Compared with ovariectomized group and low- dose herb group,significant increase in the BMC and BMD of femoral head and shaft,the BMD of greater trochanter in control,high- dose herb and Fumeijia groups( P 0. 05). Compared with ovariectomized, low- dose herb and high- dose herb groups,significant increase in the BMC of greater trochanter were obserrved in control and Fumeijia group( P 0. 05). Compared with ovariectomized,low- dose herb and Fumeijia groups,significant increase in the BMC and BMD of femoral lateral condyle was observed in high- dose herb group( P 0. 05). Conclusion The BMC and BMD are abnormal in ovariectomized rats,which could be reversed by the herbal,especially in femoral lateral condyle.

Objective To investigate the effect of general mechanical vibration on hemorheology in ovariectomized osteoporotic rats.Methods Twenty-four 7-month female SD rats were randomly divided into 4 groups:control group, ovariectomized group, general mechanical vibration group, and Fumeijia group.After 8-week treatment, the bone mineral density ( BMD) and the bone mineral content ( BMC) of the left femur was detected.Hemorheology detection was also performed.Results BMC and BMD in ovariectomized group were significantly lower than those in control group (P<0.05).BMD in control group and Fumeijia group was significantly higher than that in ovariectomized group and general mechanical vibration group ( P<0.05 ) .BMD in general mechanical vibration group was higher than that in ovariectomized group ( P<0.05 ) .Compared with that in control group, the levels of 200/S, 30/S, 3/S, TK, IR, and EPT in ovariectomized group increased significantly (P<0.05).The level of 30/s in general mechanical vibration group was lower than that in ovariectomized group (P<0.05).Compared with that in control group, no significant difference was observed.Conclusion The hemorheology in ovariectomized rats is abnormal.The general mechanical vibration can improve the abnormal viscosity of 30/s in whole blood, and increase BMD and BMC in variectomized rats.

Objective To explore the effect of kidney-tonifying, spleen-strengthening, and blood stasis removing recipe on the expression of ERRαand PGC-1αmRNA in the bone marrow of the rat femurs in an ovariectomized rat model.Methods Forty 7-month-old female SD rats were randomly divided into sham-operated group, ovariectomized ( OVX) group, herb group ( kidney-tonifying, spleen-strengthening, and blood stasis removing recipe) , and alendronate ( ALEN) group, with 10 rats per group.After a 12-week treatment, the bone mineral density ( BMD) of the left femur was measured using small animal special dual energy X-ray absorptiometry.Bone morphology of the proximal tibia was observed using HE staining.The expression of ERRαand PGC-1αmRNA of bone marrow was detected using quantitative PCR.Results Compared with that in sham-operated group, BMD in OVX group was obviously decreased ( P<0.05 ) .Compared with that in OVX group, BMD in herb group and in ALEN group was obviously increased ( P<0.05 ) .There was no statistically significant among sham-operated, herb and ALEN groups.Compared with sham-operated group, the expression of ERRαmRNA in OVX group was obviously increased (P<0.05) and the expression of PGC-1αmRNA was obviously decreased (P<0.05).After the drug intervention, the expression of ERRαmRNA in herb group was obviously decreased ( P<0.05 ) and the expression of PGC-1αmRNA was obviously increased compared with that in OVX group (P<0.05).The expression of ERRαmRNA in ALEN group was obviously decreased (P<0.01), but PGC-1αmRNA expression increased with no statistical difference (P>0.05).Conclusion The kidney-tonifying, spleen-strengthening, and blood stasis removing recipe enhances rat BMD by increasing the expression of PGC-1αmRNA and decreasing the expression of ERRαmRNA.

Objective:To explore the effects of Kidney-tonifying Spleen-strengthening and Removing Blood Stasis Formula on hemorheology in an ovariectomized rat model of osteoporosis.Methods:30 female non-pregnant SD rats(7 months) were randomly divided into 5 groups:control group,ovariectomized group,low-dose herb group,high-dose herb group and fumeijia group.After treatment for 8 weeks,the bone mineral density(BMD) and bone mineral content(BMC) were measured by small animals specially dual energy X-ray absorptiometry.And whole blood were detected with the automatical analysis machine of hemorheology.Results:Compared with control group,the BMC and BMD of ovariectomized group were obviously decreased(P0.05).Compared with the ovariectomized group and low-dose herb group,the BMD of high-dose herb group and fumeijia group were obviously increased(P0.05).There was no statistically significant different among control,high-dose herb and fumeijia group.Compared with control group,the level of 200/s,30/s,3/s,TK,IR,EPT of ovariectomized group were obviously increased(P0.05,P0.01).Compared with other groups,the level of 200/s,30/s,3/s,TK,IR,EPT of high-dose herb group were obviously decreased(P0.05).There was a negative linear relationship between BMD and TK,IR,EPT.Conclusion:Hemorheology is abnormal in ovariectomized rat,and some of index is related to BMD.The formula can improve the abnormal status of blood flow,and increase BMD and BMC.

目的 探讨补肾壮骨颗粒对去势骨质疏松大鼠血脂代谢指标的影响.方法 30只7月龄SD雌性大鼠随机分成对照组、模型组、中药低剂量组、中药高剂量组、福善美组.治疗8周后,分别收集左侧股骨和血清的骨矿含量、骨密度和血脂代谢指标检测.结果 模型组的骨矿含量和骨密度低于对照组(P＜0.05);对照组、中药高剂量组与福善美组骨密度高于模型组和中药低剂量组(P＜0.05),而对照组、中药高剂量组与福善美组之间比较差异无统计学意义.模型组甘油三酯(TG)、胆固醇(CH)高于对照组(P＜0.05),高密度脂蛋白(HDL)低于对照组(P＜0.05).中药高剂量组甘油三酯低于模型组(P＜0.05),而模型组、中药低剂量组与福善美组之间比较差异无统计学意义.中药高剂量组高密度脂蛋白高于模型组、中药低剂量组与福善美组(P＜0.05).结论 去势大鼠存在血脂代谢异常,补肾壮骨颗粒可改善血脂代谢异常状态,有一定的预防作用,提高骨矿含量和骨密度.

目的 调查广州地区青年男性维生素D、PTH状态及其与区域骨密度之间的关系.方法 随机选取2011年5月-2012年8月在广州军区广州总医院门诊部体检的60名广州青年男性志愿受试者,年龄18～44岁.评估血清25(OH)D、PTH水平,并分析血清25(OH)D、PTH与骨转换指标和区域骨密度(BMD)的相关性.结果 46.7％的青年男性血清25(OH)D水平＞30 ng/mL,53.3％低于30 ng/mL,5％低于20 ng/mL.血清25(OH)D水平与年龄分布无统计学差异(P＞0.05).双变量分析显示血清25(OH)D水平与PTH负相关(r=-0.264,P=0.042),与β-Crosslaps负相关(r=-0.257,P=0.047).血清25(OH)D水平、PTH与L1-4以及单个腰椎L1、L2、L3、L4的BMD无相关性.股骨大转子BMD与血清25(OH)D正相关(r=0.271,P=0.040),校正年龄、BMI和骨生化指标后,正相关性更加明显(r =0.319,P=0.020).多元线性回归分析显示BMI、ALP与全腰、L1、L3、L4椎BMD相关,BMI、PINP与L2椎BMD相关,BMI、25(OH)D与全髋、大转子BMD相关.结论 青年男性广泛存在血清25(OH)D不足状态,血清25(OH)D水平与股骨大转子BMD明显正相关,适当补充维生素D和钙剂,对维持大转子区域的骨量至关重要.

Objective To explore the effect of alendronate vitamin D3 on lipid metabolism in ovariectomized rats with osteoporosis.Methods Eighteen female non-pregnant SD rats(7 months old)were randomly divided into control group,ovariectomized group and alendronate vitamin D3 group.After eight weeks of treatment,the left femur and serum were collected to test the bone mineral content(BMC),bone mineral density(BMD)and lipid metabolism indexes.Results Compared with control and alendronate vitamin D3 group,the BMC and BMD of ovariectomized group were significantly decreased(P0.05).There was no significant difference between the control group and alendronate vitamin D3 group.Compared with control and alendronate vitamin D3 group,the level of triglyceride(TG),cholesterol(CH)of ovariectomized group were significantly increased,and high density lipoprotein(HDL)level was significantly decreased(P0.05).There was no significant difference between the control group and alendronate vitamin D3 group.Conclusion Lipid metabolism is abnormal in ovariectomized rat.Alendronate vitamin D3 can improve abnormal lipid metabolism status,and increase BMC and BMD.

Objective:To evaluate the effect of Danhong Injection in treatment of patients with knee osteoarthritis.Meth-ods:72 knee osteoarthritis patients were collected and were equally randomized into treatment group and control group.The treatment group was given Danhong Injection,and the control group was treated with glucosamine hydrochloride for five weeks.Visual analog scale(VAS) was used to assess the degree of joint pain,KSS score was applied to assess the knee function,and SF-36 scale was used to evaluate the quality of life.Results:All of patients were followed up.After treatment for two weeks,knee pain was relieved and joint function was improved in both of the treatment group and control group,and the differences of VAS score and KSS score were significant between the two groups(P0.05).After treatment for 5 weeks,the differences of VAS score and KSS score were insignificant between the two groups(P 0.05).The score of each items of SF-36 in the two groups after treatment for 5 weeks differed from that before treatment(P 0.05).Conclusion: Danhong Injection exerts satisfactory and quick effect in treatment of knee osteoarthritis patients by relieving knee pain,im-proving knee function and the quality of life.