计算机灰度法对牙槽骨密度变化的初步评价

本论文使用灰度法在数字化曲面体层片上比较牙周炎治疗前与基础治疗后2个月牙槽骨密度的变化情况,初步评价了计算机灰度法对牙槽骨密度变化检测的敏感性。研究结果表明,灰度法提示基础治疗后2个月牙槽骨密度显著增加（P=0．003）,揭示了计算机灰度法对评价牙槽骨密度改变具有较高的灵敏度。     

WHBE兔脾虚型肠易激综合征模型舌象病理组织形态学观察

目的观察脾虚型肠易激综合征模型WHBE兔活体舌象和舌组织病理形态学的变化。方法采用湿热应激复合番泻叶致脾虚型肠易激综合征兔模型,观察造模及自然恢复后WHBE兔和日本大耳白兔活体舌象和舌组织病理形态学的变化。结果与正常对照组比较,脾虚型肠易激综合征模型兔舌色淡红,舌质嫩;背隆起前后固有层乳头密度明显降低（P〈0．01）,基底层核分裂相频数减少（P〈0．01）,舌下角质层和上皮层厚度均明显增厚（P〈0．01）,且角质层／上皮层比值明显增加（P〈0．01）,且WHBE兔菌状乳头密度显著降低（P〈0．05）;自然恢复10d后,自然恢复组实验兔背隆起前后固有层乳头密度仍显著低于正常对照组（P〈0．01）,舌下角质层厚度明显大于正常对照组（P〈0．05）,且WHBE兔的上皮层厚度显著高于正常对照组（P〈O．05）,日本大耳白兔角质层,上皮层比值显著高于正常对照组（P〈0．05）。结论脾虚型肠易激综合征可能与机体营养、代谢相关。     

补骨脂抑制人工关节假体周围骨溶解的研究

目的：探讨中药补骨脂对人工关节置换术后假体周围骨溶解,假体无菌性松动的核因子KB受体活化因子配体-核因子KB受体活化因子受体-骨保护素（RANKL-RANK-OPG）信号通路的作用。方法：取24只200＋5g雌性SD大鼠。随机分为A、B、C组,均注射钛颗粒溶液建立骨溶解模型,术后A组采用中药补骨脂水溶液腹腔注射,B组采用外源性OPG腹腔注射作为阳性对照,C组采用生理盐水腹腔注射作为阴性对照。给药4周后,通过免疫组化及反转录聚合酶链反应（RT-PCR）检测各组动物体内RANKL／RANK的表达水平变化。结果：用药4周后,3组12只大鼠背部气囊均为厚壁囊腔,骨溶解模型成功建立,免疫组化及RT-PCR检测RANKIJRANK均呈阳性表达。免疫组化RANKL平均光密度（AOD）值A组（0．168±0．017）、B组（0．147±0．009）明显低于C组（0．314±0．011）,差异有统计学意义（P〈0．05）;A组、B组之间比较无明显差异。RANKAOD值测定A组（0．172±0．015）、B组（0．193±0．045）明显低于C组（0．342±0．007）,差异有统计学意义（P〈0．05）;A组、B组之间比较无明显差异。RT-PCR检测RANKL相对量A组（0．575±0．143）、B组（0．543±0．174）明显低于C组（0．951±0．362）,差异有统计学意义（P〈0．05）;A组、B组之间比较无明显差异。RANK相对量A组（0．433±0．025）、B组（0．611±0．209）明显低于C组（0．871±0．211）,差异有统计学意义（P〈0．05）;A组、B组之间比较无明显差异。结论：中药补骨脂对人工关节置换术后假体周围骨溶解,假体无菌性松动具有抑制作用。     

日粮添加海藻粉和抗菌肽对海兰褐蛋鸡产蛋性能的影响

采用4×2（海藻粉×抗菌肽）完全随机试验设计,研究日粮添加不同水平的海藻粉（0．0％、1．0％、3．0％、5．0％）和抗菌肽（300 mg/kg、600 mg/kg）对蛋鸡不同产蛋期（24～27周龄和28～31周龄）产蛋性能的影响。结果表明：（1）日粮海藻粉的添加水平显著提高了产蛋率和料蛋比（P＜0．05）。（2）抗菌肽添加水平在28～31周龄显著提高了产蛋率（P＜0．05）。（3）海藻粉和抗菌肽互作效应显著提高了产蛋率和料蛋比（P＜0．05）。结果提示,海藻粉和抗菌肽对蛋鸡产蛋性能的影响存在互作效应,以海藻粉5％、抗菌肽300 mg/kg水平组合最为理想。     

PEMF对废用性骨质疏松大鼠骨形态及骨代谢作用的观察

目的：观察脉冲电磁场（pulsedelectromagneticfields,PEMF）对于废用性骨质疏松（disuseosteoporosis,DOP）大鼠骨形态学及血清学指标的影响,探讨PEMF治疗废用性骨质疏松的作用及其可能的机制。方法：选择雌性SD大鼠,体重250-280g,随机分为4组,即正常对照组（INT组）、废用模型组（DOP组）、药物治疗组（ALN组）、脉冲电磁场组（PEMF组）,每组20只,除正常对照组外,其余大鼠通过改良胫骨．尾部固定法制动建立模型废用性骨质疏松模型,ALN组大鼠灌胃予以阿仑膦酸钠（1mg·kg^-1·d^-1）治疗,PEMF组大鼠予以PEMF照射40min·d^-1治疗,治疗后2、4、8、12周时检测各组大鼠的血清学指标并观察其骨组织形态学。结果：治疗2周后,与INT组比较,其余各组血清钙无明显差异,血磷明显降低（P〈0．05或P〈0．01）,骨钙素（BGP）、碱性磷酸酶（ALT）、抗酒石酸磷酸酶（TRAP）则显著升高（P〈0．01）。治疗4周后,与ALN组比较,PEMF组BGP、ALT显著升高（P〈0．01）;ALN组骨小梁排列比较DOP组紧密,整齐,骨小梁间隔较大。网状结构断裂程度较轻。治疗8周后,与DOP组比较,余组ALP、TRAP降低（P〈0．01）．与ALN组相较,PEMF组BGP、ALT显著升高（P〈0．01）。治疗12周后,与DOP组比较,余组BGP、ALP、TRAP降低（P〈0．05或P〈0．oD,与药物治疗组相较,PEMF组BGP、ALT、TRAP显著升高（P〈0．05或P〈0．01）。PEMF组比较ALN组,骨小梁排列整齐有序,骨小梁数目增多,网状结构完整,骨小梁体积增大,厚度增厚。结论：PEMF通过增强成骨细胞功能促进骨形成,同时降低破骨细胞抑制骨吸收,可达到治疗废用性骨质疏松疾病的作用。     

Neuritin在大鼠脑外伤合并骨折过程中的作用研究

目的：研究脑外伤合并股骨骨折的骨痂中Neuritin的表达及血清中变化,探讨中枢神经系统损伤加速对骨折愈合的作用,为临床难治性骨创伤提供新的理论依据。方法：取96只雄性SD大鼠随机分成：A组正常组8只、B组单纯骨折组40只、C组单纯脑外伤组8只及D组骨折合并脑外伤组40只,做股骨骨折和采用脑损伤液压装置建脑损伤模型,术后3、7、14、21、28天取血离心,ELISA法测血清中的Neuritin值。分时间处死B组和D组,取骨痂做切片,行免疫组织化学染色,观测各时间点骨痂中Neuritin的变化和骨折愈合情况。结果：①免疫组织化学染色：骨折愈合过程中血管内皮细胞、软骨细胞及成骨细胞的胞浆中有阳性表达,并显色强。D组1w至3w时的Neuritin阳性细胞百分数均高于B组有显著性统计意义（P〈0．05）,但4周时（P〉0．05）。②血清浓度值：A组值（81．37±1．37）,B组、C组、D组3天（94．94±3．77107．28±3．46118．35±1．43）逐渐升高,2周达到高峰（110．18±1．48131．89±3．26161．48±1．46）,然后下降,3d至3w时各组有显著性统计意义（P〈0．05）,4周下降为略高于正常（P〉0．05）。结论：血清和骨痂中Neuritin的表达显著升高,提示Neuritin可能是大鼠股骨骨折合并脑损伤时促进骨折修复的重要因素一。     

猫上丘浅层GABA能神经元的年龄相关性变化

目的比较青年猫和老年猫上丘浅层（superricial Superior Colliculus,sSC）GABA能神经元及其表达的年龄相关性变化,探讨老年个体视觉功能衰退的相关神经机理。方法Nissl染色显示上丘浅层结构及神经元、免疫组织化学ABC法标记GABA免疫阳性神经元。光镜下观察,采集图像,并利用图像分析软件对带状层、浅灰质层和视层神经元及GABA免疫阳性神经元及其灰度值进行分析统计。结果GABA免疫阳性神经元、阳性纤维及其终末在青年猫及老年猫上丘浅层均有分布。与青年猫相比,老年猫上丘浅灰质层、视层神经元和GABA免疫阳性神经元密度及其GABA免疫阳性反应强度均显著下降（P〈0．01）（免疫反应强度与平均灰度值成反比）;带状层神经元密度也显著下降（P〈0．01）,但其GABA免疫阳性神经元密度无显著变化（P〉0．05）。结论衰老过程中猫上丘浅层GABA能神经元的丢失和GABA表达的下降,可能是在上丘水平上导致老年个体视觉功能衰退的重要因素之一。     

肝郁脾虚证模型大鼠下丘脑- 垂体- 肾上腺皮质的变化

目的：探讨复合造模法复制肝郁脾虚证大鼠模型的HPA轴变化及特点。方法：大鼠采用慢性束缚＋过度疲劳＋饮食失节法,连续三周,自然恢复一周。观察造模期间各不同时间点大鼠肾上腺重量及指数、下丘脑促肾上腺皮质激素释放激素（CRH）、血浆促肾上腺皮质激素（ACTH）及皮质酮（CORT）的变化。结果：与正常组比较,模型大鼠肾上腺重量第一周显著增加（P〈0．001）,第三、四周显著减低（P〈0．001和P〈0．01）,其肾上腺指数在实验各周均显著高于正常组（P〈0．05和P〈0．01）;下丘脑CRH第三周显著低于正常组（P〈0．05）,第四周回升并显著高于正常组（P〈0．05）;血浆ACTH在第一、三、四周均显著降低（P〈0．05）;血浆CORT第一周显著降低（P〈0．05）,第二周有所回复,第三、四周仍显著降低（P〈0．05和P〈0．001）。结论：该肝郁脾虚证大鼠模型存在HPA轴的功能减低,垂体对上位激素调节的反应能力减低可能是该模型的一个重要的生物学特征。     

氨氯地平联合依那普利治疗原发性高血压的临床疗效及对患者左心室肥厚的影响

摘要目的：探讨氨氯地平联合依那普利治疗原发性高血压的临床效果,观察联合用药对左心室肥厚的影响。方法：选择本院收治的原发性高血压患者92例,随机分为观察组和对照组,各46例,对照组给予苯磺酸左旋氨氯地平5mg,1次／d,口服;观察组在对照组基础上加用马来酸依那普利10mg,2次／d,口服,疗程均为24周。观察两组治疗前后血压变化,应用超声心动图测量两组左心室厚度变化。结果：治疗后,观察组总有效率为91_3％;对照组总有效率为73．9％,观察组总有效率高于对照组（P〈0．05）。治疗前两组心率、血压比较无统计学差异（P〉0．05）,治疗后两组血压均明显降低,观察组收缩压、舒张压明显低于对照组（P〈O．05）;观察组心率明显低于对照组（P〈0．01）。治疗前两组左心室舒张末期室间隔厚度（Leaventricularend—diastolicventricularseptalthickness,IVST）、左心室后壁厚度（1eftventricularposteriorwallthickness,U,PwT）和左室射血分数（Leftventricularejectionfxaction,LVEF）比较无统计学差异（P〉0．05）;治疗后观察组IVST、L、,PwT明显低于对照组,LVEF明显高于对照组（P〈0．05）。结论：氨氯地平联合依那普利治疗原发性高血压能有效扭转左心室肥厚,降压效果较单独应用氨氯地平更佳。     

滋肾骨康丸治疗骨质疏松症的临床研究

目的：观察滋肾骨康丸治疗骨质疏松症的临床疗效,并对该药的作用机理进行探讨。方法：将60例病人随机分为治疗组（滋肾骨康丸组）及对照组（西药组）,根据2组骨密度、骨痛、中医证候结果及临床总体疗效为指标进行比较。结果：治疗组治疗后总有效率为95．8％,对照组治疗后总有效率为75．3％,差异有统计学意义（P〈0．01）;2组治疗前后骨密度无显著性差异（P〉0．05）;治疗组治疗后骨痛有效率为92．5％。优于对照组的7313％（P〈0．05）;治疗后治疗组中医证候有效率为100％,明显优于对照组的53.3％（P〈0．01）。结论：滋肾骨康丸能显著改善骨痛、肾虚证候,总体改善临床症状,具有较好的治疗作用,值得进一步推广。     

How plate positioning impacts the biomechanics of the open wedge tibial osteotomy; A finite element analysis

A numerical model of the medial open wedge tibial osteotomy based on the finite element method was developed. Two plate positions were tested numerically. In a configuration, (a), the plate was fixed in a medial position and (b) in an anteromedial position. The simulation took into account soft tissues preload, muscular tonus and maximal gait load.

The maximal stresses observed in the four structural elements (bone, plate, wedge, screws) of an osteotomy with plate in medial position were substantially higher (1.13–2.8 times more) than those observed in osteotomy with an anteromedial plate configuration. An important increase (1.71 times more) of the relative micromotions between the wedge and the bone was also observed. In order to avoid formation of fibrous tissue at the bone wedge interface, the osteotomy should be loaded under 18.8% (～50 kg) of the normal gait load until the osteotomy interfaces union is achieved.     

熊果酸对酒精性骨质疏松大鼠骨形成、骨矿化的影响

目的：探讨熊果酸对酒精所致骨质疏松大鼠骨形成、骨矿化的影响。方法：雄性Wistar大鼠60只,按体重随机分为空白对照 组、熊果酸对照组、模型组、熊果酸低、中、高剂量组,同时分别给予生理盐水、150 mg/kg 熊果酸、50%酒精,50 mg/kg 熊果酸,100 mg/kg 熊果酸,150 mg/kg 熊果酸灌胃。熊果酸对照组生理盐水剂量同空白组,熊果酸低、中、高剂量组酒精剂量同模型组。灌胃共 持续8 周。磷钼酸法检测血清磷(P)含量,比色法检测血清钙(Ca)含量,酶联免疫吸附（ELISA）法检测血清骨钙素(BGP)、骨形成蛋 白-2(BMP-2)浓度;HE 染色法观察股骨结构的病理学变化。结果：与空白对照组相比较,模型组血清BGP、BMP-2 和Ca、P 均明显 降低,且有统计学差异(P < 0.05),但熊果酸对照与空白对照组各项指标结果相近。熊果酸中、高剂量组大鼠血清BGP、Ca 和P 水 平均较模型组有显著升高,差异具有统计学意义(P < 0.05),但仅熊果酸高剂量组血清BMP-2 显著升高(P < 0.05)。股骨组织HE 染色结果显示,空白对照组骨小梁致密、规则且较粗,粗细均匀;模型组骨小梁稀松、不规则、粗细不均匀,甚至可见骨小梁断裂; 熊果酸中、高剂量组骨小梁致密、规则、较厚、粗细均匀,未见骨小梁断裂。结论：熊果酸能够促进酒精性骨质疏松大鼠的骨形成, 抑制骨矿物质的流失,在改善酒精致骨质疏松方面有一定的保护作用。     

The effects of tensile-compressive loading mode and microarchitecture on microdamage in human vertebral cancellous bone

The amount of microdamage in bone tissue impairs mechanical performance and may act as a stimulus for bone remodeling. Here we determine how loading mode (tension vs. compression) and microstructure (trabecular microarchitecture, local trabecular thickness, and presence of resorption cavities) influence the number and volume of microdamage sites generated in cancellous bone following a single overload. Twenty paired cylindrical specimens of human vertebral cancellous bone from 10 donors (47–78 years) were mechanically loaded to apparent yield in either compression or tension, and imaged in three dimensions for microarchitecture and microdamage (voxel size 0.7×0.7×5.0 μm³). We found that the overall proportion of damaged tissue was greater (p=0.01) for apparent tension loading (3.9±2.4%, mean±SD) than for apparent compression loading (1.9±1.3%). Individual microdamage sites generated in tension were larger in volume (p<0.001) but not more numerous (p=0.64) than sites in compression. For both loading modes, the proportion of damaged tissue varied more across donors than with bone volume fraction, traditional measures of microarchitecture (trabecular thickness, trabecular separation, etc.), apparent Young?s modulus, or strength. Microdamage tended to occur in regions of greater trabecular thickness but not near observable resorption cavities. Taken together, these findings indicate that, regardless of loading mode, accumulation of microdamage in cancellous bone after monotonic loading to yield is influenced by donor characteristics other than traditional measures of microarchitecture, suggesting a possible role for tissue material properties.     

Assessment of vertebral wedge strength using cancellous textural properties derived from digital tomosynthesis and density properties from dual energy X-ray absorptiometry and high resolution computed tomography

The purpose of this study was to examine the potential of digital tomosynthesis (DTS) derived cancellous bone textural measures to predict vertebral strength under conditions simulating a wedge fracture. 40 vertebral bodies (T6, T8, T11, and L3 levels) from 5 male and 5 female cadaveric donors were utilized. The specimens were scanned using dual energy X-ray absorptiometry (DXA) and high resolution computed tomography (HRCT) to obtain measures of bone mineral density (BMD) and content (BMC), and DTS to obtain measures of bone texture. Using a custom loading apparatus designed to deliver a nonuniform displacement resulting in a wedge deformity similar to those observed clinically, the specimens were loaded to fracture and their fracture strength was recorded. Mixed model regressions were used to determine the associations between wedge strength and DTS derived textural variables, alone and in the presence of BMD or BMC information. DTS derived fractal, lacunarity and mean intercept length variables correlated with wedge strength, and individually explained up to 53% variability. DTS derived textural variables, notably fractal dimension and lacunarity, contributed to multiple regression models of wedge strength independently from BMC and BMD. The model from a scan orientation transverse to the spine axis and in the anterior-posterior view resulted in highest explanatory capability (R²_adj = 0.91), with a scan orientation parallel to the spine axis and in the lateral view offering an alternative (R²_adj = 0.88). In conclusion, DTS can be used to examine cancellous texture relevant to vertebral wedge strength, and potentially complement BMD in assessment of vertebral fracture risk.     

Knockout of Nuclear High Molecular Weight FGF2 Isoforms in Mice Modulates Bone and Phosphate Homeostasis

We previously reported that targeted overexpression of the fibroblast growth factor 2 (FGF2) high molecular weight (HMW) isoforms in osteoblastic lineage cells in mice resulted in phenotypic changes, including dwarfism, rickets, osteomalacia, hypophosphatemia, increased serum parathyroid hormone, and increased levels of the phosphatonin FGF23 in serum and bone. This study examined the effects of genetically knocking out the FGF2HMW isoforms (HMWKO) on bone and phosphate homeostasis. HMWKO mice were not dwarfed and had significantly increased bone mineral density and bone mineral content in femurs and lumbar vertebrae when compared with the wild-type (WT) littermates. Micro-computed tomography analysis of femurs revealed increased trabecular bone volume, thickness, number, and connective tissue density with decreased trabecular spacing compared with WT. In addition, there was significantly decreased cortical porosity and increased cortical thickness and sub-periosteal area in femurs of HMWKO. Histomorphometric analysis demonstrated increased osteoblast activity and diminished osteoclast activity in the HMWKO. In vitro bone marrow stromal cell cultures showed there was a significant increase in alkaline phosphatase-positive colony number at 1 week in HMWKO. At 3 weeks of culture, the mineralized area was also significantly increased. There was increased expression of osteoblast differentiation marker genes and reduced expression of genes associated with impaired mineralization, including a significant reduction in Fgf23 and Sost mRNA. Normal serum phosphate and parathyroid hormone were observed in HMWKO mice. This study demonstrates a significant negative impact of HMWFGF2 on biological functions in bone and phosphate homeostasis in mice.     

2型糖尿病模型GK大鼠骨形态学和生物力学特点观察

目的观察2型糖尿病模型GK大鼠的骨代谢特点以及骨密度和骨生物力学特性的变化。方法采用雄性6月龄GK大鼠10只,以月龄、性别匹配的健康Wistar大鼠作为正常对照。颈静脉取血检测与骨代谢有关的生化指标。DXA法测定股骨和腰椎骨密度,并行股骨三点弯曲实验和腰椎压缩实验。甲基丙烯酸甲酯包埋胫骨干骺端以制备不脱钙骨切片。应用多媒体病理图像分析软件进行骨组织形态计量学分析。结果GK大鼠体重明显低于健康对照Wistar大鼠（P〈0.01）。与对照组相比,GK大鼠血清骨钙素水平明显降低[（4.97±0.49,6.75±0.71）μg/mL,P〈0.01],而抗酒石酸酸性磷酸酶活性明显升高[（17.92±5.23,8.31±2.69）U/L,P〈0.01],但血钙和血磷无明显变化（P〉0.05）;股骨和腰椎骨密度显著降低[（0.16±0.01,0.22±0.02;0.12±0.01,0.16±0.02）g/cm2,P〈0.01];骨强度和腰椎的弹性模量明显降低（P〈0.01）。骨形态学分析显示GK大鼠股骨长度和第五腰椎高度分别降低10.3%和9.5%（P〈0.01）,股骨和腰椎横截面积无明显变化（P〉0.05）。骨组织形态计量学分析显示,GK大鼠骨小梁体积、骨小梁厚度、类骨质表面和厚度明显降低[（15.72±1.18,19.13±1.13）%,（61.91±4.54,74.43±3.63）μm,（18.18±1.25,19.63±1.07）%,（3.68±0.48,4.34±0.35）μm,P〈0.01或0.05],动态参数如矿化表面、矿化沉积率和骨形成率也明显降低[（17.77±1.54,19.56±2.07）%,（1.07±0.22,1.35±0.16;0.20±0.03,0.26±0.04）μm/day,P〈0.05或0.01],而矿化延迟时间显著延长（2.66±0.56,2.12±0.35,P〈0.05）。结论非肥胖的GK大鼠表现有骨量减少和骨折危险性增加;2型糖尿病本身可干扰成骨细胞功能和活性而导致骨重建失衡。     

Spatial distribution of trabeculae in iliac bone from 145 osteoporotic females

145 women showing clinical and radiological signs of involutional osteoporosis of the spine were biopsed at the ilium for histomorphometric analysis of bone mass including trabecular bone volume and parameters reflecting the spatial distribution of bony elements (mean trabecular plate thickness, density and separation). Results were compared with an age-matched population of 22 healthy females. Postmenopausal osteoporotics (i.e. younger than 75 years) were characterized by a significant reduction in trabecular bone volume, plate density and thickness, while senile osteoporotics (i.e. older than 75 years) did not exhibit any difference with controls. 51% of the osteoporotic patients had a trabecular bone volume higher than the spontaneous vertebral crush threshold defined by Meunier. Osteoporotic patients with trabecular bone volume under the vertebral crush threshold had a significant decrease in all trabecular parameters. On the opposite, patients with trabecular bone volume above the vertebral crush threshold had only a significant decrease in the number of trabeculae. A negative correlation was found between age and plate density in both osteoporotic patients and controls. A linear correlation was found between trabecular bone volume and plate density, but thickness and density of trabecular plates were not correlated. This study confirms that involutional osteoporosis is not only a decreased bone mass disorder. A modified spatial distribution of trabeculae or a mechanically less resistant bone matrix could be additional factors.     

Moderate/subclinical calcium deficiency attenuates trabecular mass,microarchitecture and bone growth in growing rats

Adequate dietary calcium (Ca) intake is essential for bone accretion, peak bone mass (PBM) attainment, bone quality and strength during the mammalian growth period. Severe Ca deficiency during growing age results in secondary hyperparathyroidism (SHPT) and poor bone quality and strength. However, the impact of moderate Ca deficiency during rats early growth period on bone health and the reversibility with supplementing calcium later in adult life remains unclear. Female Sprague-Dawley (SD) rats (postnatal 28th day, P28) were initiated either with a moderate calcium-deficient diet (MCD, 0.25% w/w Ca) or a control diet (0.8% w/w Ca, control group) till P70. Thereafter, MCD rats were continued either with MCD diet or supplemented with calcium diet (0.8% w/w Ca, calcium supplemented group, CaS) till P150. Another group (control rats) were fed 0.8% w/w Ca containing diet from P28 till P150.MCD group, as compared to the control group, had significantly reduced serum ionized Ca and procollagen type 1 N-terminal propeptide (P1NP) at P70 while no significant change was observed in serum corrected Ca, inorganic phosphate (P), alkaline phosphatase (ALP), 25-hydroxy vitamin D [25(OH)D], intact parathyroid hormone (iPTH), and urinary C-terminal telopeptide of collagen 1 (CTX-1), Ca, and P. Femoral and tibial metaphysis in MCD rats had significantly reduced linear growth, cortical and trabecular volumetric BMD (vBMD), trabecular microarchitecture (BV/TV%, trabecular thickness, separation and number, structural model index and connectivity density), cortical thickness, and bone stiffness despite the absence of secondary hyperparathyroidism (SHPT). Continued MCD at P70–P150 results in persistence of compromised bone strength while calcium supplementation (CaS group) improved all the parameters related to bone strength and microarchitecture. Our results indicate that uncorrected moderate/subclinical calcium deficiency in growing rats can result in poor bone quality and strength despite the absence of SHPT. This finding could have relevance in children with poor calcium intake in childhood and adolescence.     

椎间植骨粒体积对腰椎滑脱融合内固定术融合效果的影响

目的:探讨在腰椎后路植骨融合手术中,椎间植骨粒的体积对手术效果的影响。方法:回顾性分析我院2012年5月-2013年9月采用腰椎后路植骨融合术的75例患者的临床资料,根据患者手术中椎间植骨粒体积不同分为A组(小体积组,5粒/cm3)、B组(中体积组,11粒/cm3)以及C组(大体积组,23粒/cm3)。分析三组患者的植骨粒体积、植骨融合率以及手术效果。结果:三组患者植骨粒体积比较,差异具有统计学意义(P0.05);椎间植骨总体积比较,差异无统计学意义(P0.05)。与术前比较,三组术后ODI指数及VAS评分明显下降,差异具有统计学意义(P0.05);但三组间比较,差异无统计学意义(P0.05)。B组植骨融合率高于A组及C组,而A组高于C组,组间比较,差异均具有统计学意义(P0.05)。手术后各组椎体滑脱程度与术前相比得到明显改善(P0.05)。结论:腰椎滑脱内固定术中应用中等体积植骨粒可明显提高椎体间融合率。     

PEMF对废用性骨质疏松大鼠骨形态及骨代谢作用的观察

目的:观察脉冲电磁场(pulsed electromagnetic fields,PEMF)对于废用性骨质疏松(disuse osteoporosis,DOP)大鼠骨形态学及血清学指标的影响,探讨PEMF治疗废用性骨质疏松的作用及其可能的机制。方法:选择雌性SD大鼠,体重250~280 g,随机分为4组,即正常对照组(INT组)、废用模型组(DOP组)、药物治疗组(ALN组)、脉冲电磁场组(PEMF组),每组20只,除正常对照组外,其余大鼠通过改良胫骨-尾部固定法制动建立模型废用性骨质疏松模型,ALN组大鼠灌胃予以阿仑膦酸钠(1 mg·kg-1·d-1)治疗,PEMF组大鼠予以PEMF照射40 min·d-1治疗,治疗后2、4、8、12周时检测各组大鼠的血清学指标并观察其骨组织形态学。结果:治疗2周后,与INT组比较,其余各组血清钙无明显差异,血磷明显降低(P0.05或P0.01),骨钙素(BGP)、碱性磷酸酶(ALT)、抗酒石酸磷酸酶(TRAP)则显著升高(P0.01)。治疗4周后,与ALN组比较,PEMF组BGP、ALT显著升高(P0.01);ALN组骨小梁排列比较DOP组紧密,整齐,骨小梁间隔较大,网状结构断裂程度较轻。治疗8周后,与DOP组比较,余组ALP、TRAP降低(P0.01),与ALN组相较,PEMF组BGP、ALT显著升高(P0.01)。治疗12周后,与DOP组比较,余组BGP、ALP、TRAP降低(P0.05或P0.01),与药物治疗组相较,PEMF组BGP、ALT、TRAP显著升高(P0.05或P0.01)。PEMF组比较ALN组,骨小梁排列整齐有序,骨小梁数目增多,网状结构完整,骨小梁体积增大,厚度增厚。结论:PEMF通过增强成骨细胞功能促进骨形成,同时降低破骨细胞抑制骨吸收,可达到治疗废用性骨质疏松疾病的作用。