基于"经筋理论"针刀治疗对早中期膝骨关节炎患者骨代谢指标和血清TIMP-1、MMP-3、MMP-13的影响

摘要 目的：探讨基于"经筋理论"针刀治疗对早中期膝骨关节炎（KOA）患者骨代谢指标和血清金属蛋白酶抑制物-1（TIMP-1）、基质金属蛋白酶（MMP）-3、MMP-13的影响。方法：根据随机数字表法,将2021年1月至2023年1月期间就诊于新疆医科大学附属第一医院的120例早中期KOA患者分为对照组（n=60,常规治疗）和研究组（n=60,对照组的基础上接受"经筋理论"针刀治疗）。对比两组疗效、量表评分[疼痛视觉模拟评分（VAS）、西安大略和麦克马斯特大学骨关节炎调查表（WOMAC）]、骨代谢指标[抗酒石酸盐酸性磷酸酶异构体（TRACP-5b）、骨特异性碱性磷酸酶（BALP）、骨钙素（BGP）]和血清TIMP-1、MMP-3、MMP-13。结果：与对照组相比,研究组的临床总有效率更高（P<0.05）。与对照组相比,研究组治疗后WOMAC、VAS评分和血清MMP-3、MMP-13、TRACP-5b水平更低,TIMP-1、BALP、BGP水平更高（P<0.05）。结论：基于"经筋理论"针刀治疗早中期KOA患者,可有效减轻疼痛症状,提高临床治疗效果,可能与改善骨代谢指标和血清TIMP-1、MMP-3、MMP-13水平有关。     

血清Irisin、SOST、H2S与膝骨关节炎合并骨质疏松症患者骨密度、骨代谢标志物的相关性及其预测价值

摘要 目的：探讨血清鸢尾素（Irisin）、骨硬化蛋白（SOST）、硫化氢（H₂S）与膝骨关节炎（KOA）合并骨质疏松症（OP）患者骨密度、骨代谢标志物的相关性,分析Irisin、SOST、H₂S预测KOA合并OP的价值。方法：选取2020年4月至2023年4月我院收治的179例KOA患者,根据是否合并OP将其分为OP组（68例）和非OP组（111例）。检测血清Irisin、SOST、H₂S和骨代谢标志物骨钙素（OC）、骨碱性磷酸酶（BALP）、Ⅰ型原胶原N-端前肽（PINP）、抗酒石酸酸性磷酸酶异体（TRACP5b）水平,股骨颈、腰椎L1～4骨密度。Pearson分析血清Irisin、SOST、H₂S与股骨颈、腰椎L1～4骨密度和血清骨代谢标志物的相关性,受试者工作特征（ROC）曲线分析血清Irisin、SOST、H₂S对KOA合并OP的预测价值。结果：OP组血清Irisin、H₂S、OC、BALP、PINP水平,股骨颈、腰椎L1～4骨密度低于非OP组（P＜0.05）,TRACP、SOST水平高于非OP组（P＜0.05）。OP组血清Irisin、H₂S水平与股骨颈、腰椎L1～4骨密度,血清OC、BALP、PINP水平呈正相关（P＜0.05）,与血清TRACP水平呈负相关（P＜0.05）;SOST水平与股骨颈、腰椎L1～4骨密度,血清OC、BALP、PINP水平呈负相关（P＜0.05）,与血清TRACP水平呈正相关（P＜0.05）。Irisin、SOST、H₂S预测KOA合并OP的曲线下面积为0.784、0.773、0.755,联合预测KOA合并OP的曲线下面积为0.908,高于单独预测。结论：KOA合并OP患者血清Irisin、H₂S水平降低、SOST水平增高,低水平Irisin、H₂S和高水平SOST与骨密度降低、骨代谢异常有关,可用于预测KOA合并OP患者骨代谢异常状态和骨质流失风险。     

Wnt通路中蓬松蛋白DNA甲基化对骨质疏松患者骨髓间充质干细胞成骨分化影响

摘要 目的：探讨蓬松蛋白（DVL）DNA甲基化对骨质疏松（OP）患者骨髓间充质干细胞（BMSCs）成骨分化及Wnt通路的影响。方法：分离、培养OP患者的BMSCs,成骨诱导培养BMSCs 0、7、14、21天,观察BMSCs细胞形态变化,检测碱性磷酸酶（ALP）染色及活性,检测茜素红染色及钙结节形成,荧光定量聚合酶链式反应（RT-PCR）及免疫印迹检测远端缺失同源盒5（Dlx5）、核心结合蛋白因子2（Runx2）、成骨细胞特异性转录因子（OSX）、Ⅰ型胶原蛋白（Colla Ⅰ）表达。检测DVL1、Wnt、糖原合成酶激酶3（GSK3）、β连环蛋白（β-catenin）表达及DVL DNA甲基化水平。在成骨诱导培养基中加入甲基转移酶抑制剂5-Aza,将BMSCs分为对照组（Control组）、甲基转移酶抑制剂组（5-Aza组）、甲基转移酶抑制剂+si-NC组（5-Aza+si-NC组）、甲基转移酶抑制剂+si-Wnt组（5-Aza+si-Wnt组）,依次进行ALP活性测定,茜素红染色及钙结节形成测定。RT-PCR检测Dlx5、Runx2、OSX、Colla 1水平,免疫印迹检测Dlx5、Runx2、OSX、Colla Ⅰ、DVL1、Wnt、GSK3、β-catenin的蛋白表达量,并检测DVL DNA甲基化水平。结果：成骨诱导后BMSCs具有强的ALP活性和矿化结节生成能力,且随着培养时间的增长,BMSCs细胞ALP活性和矿化结节生成能力增强,Dlx5、Runx2、OSX、Colla Ⅰ mRNA水平和Wnt、GSK3、β-catenin、DVL1表达升高,DVL DNA甲基化水平降低（P＜0.05）。5-Aza组较Control组ALP染色加深,活性增强,钙结节形成增多（P＜0.05）,Dlx5、Runx2、OSX、Colla Ⅰ mRNA及蛋白表达、Wnt、GSK3、β-catenin、DVL1表达升高,DVL DNA甲基化水平降低（P＜0.05）。5-Aza+si-Wnt组较5-Aza+si-NC组ALP染色变浅,活性降低,钙结节形成减少（P＜0.05）,Dlx5、Runx2、OSX、Colla Ⅰ mRNA及蛋白表达、Wnt、GSK3、β-catenin、DVL1表达降低,DVL DNA甲基化水平升高（P＜0.05）。结论：DVL DNA甲基化可以通过抑制Wnt/β-catenin信号通路抑制OP患者BMSCs成骨分化。     

2型糖尿病合并骨质疏松症患者外周血炎性因子表达与骨代谢、骨密度丢失的关系

摘要 目的：探讨2型糖尿病合并骨质疏松症患者外周血中炎性因子NLR、IL-1β、TNF-α与骨代谢指标骨密度、活性维生素D、PTH、ALP及生化指标FPG、2hPG、HbA1c、空腹C肽、BMI、血脂、血尿酸之间的关系,为该类患者的诊断和治疗提供参考。方法：选取2020年9月至2021年9月在本院内分泌科就诊的2型糖尿病合并骨质疏松症患者80例作为观察组,同时选取同期健康体检者80例作为对照组。比较两组患者的一般资料,采用ELISA法检测两组患者外周血中NLR、IL-1β、TNF-α的水平,采用双能X线吸收法（DEXA）检测两组患者的骨密度,采用放射免疫法检测两组患者外周血中活性维生素D、PTH的水平,采用生化分析仪检测两组患者外周血中ALP、FPG、2hPG、HbA1c、空腹C肽、BMI、血脂、血尿酸的水平。结果：观察组患者外周血中NLR、IL-1β、TNF-α的水平均高于对照组（P<0.05）,观察组患者骨密度低于对照组（P<0.05）,观察组患者外周血中活性维生素D水平低于对照组（P<0.05）,观察组患者外周血中PTH水平高于对照组（P<0.05）,观察组患者外周血中ALP水平高于对照组（P<0.05）,观察组患者外周血中FPG、2hPG、HbA1c水平高于对照组（P<0.05）,观察组患者空腹C肽水平低于对照组（P<0.05）,观察组患者BMI高于对照组（P<0.05）,观察组患者血脂异常率高于对照组（P<0.05）,观察组患者血尿酸水平高于对照组（P<0.05）。观察组患者外周血中NLR、IL-1β、TNF-α与骨密度呈负相关（P<0.05）,与活性维生素D呈负相关（P<0.05）,与PTH、ALP呈正相关（P<0.05）,与FPG、2hPG、HbA1c、空腹C肽、BMI、血脂、血尿酸无显著相关性（P>0.05）。结论：2型糖尿病合并骨质疏松症患者外周血中炎性因子NLR、IL-1β、TNF-α水平升高,可能与骨代谢紊乱和骨密度丢失有关,提示该类患者存在慢性低度炎症状态,应加强对其骨代谢和骨密度的监测和干预,以降低骨折风险和改善生活质量。     

A factor synthesized by rabbit periosteal fibroblasts stimulates bone resorption and collagenase production by connective tissue cells in vitro

Unstimulated monolayer cultures of confluent rabbit periosteal fibroblasts synthesize a factor that stimulates bone resorption in vitro. Furthermore it stimulates rabbit chondrocytes and mouse osteoblasts to synthesize collagenase. The factor has no effect on dead bone in culture, and its activity on live bone is mediated principally by osteoclasts, since it is 75% inhibited by salmon calcitonin. Characterization of the factor by gel filtration and isoelectric focusing indicates an M_r in the range 15 000–25 000 and a pI corresponding to approx. pH 4.7. These biological and physicochemical properties are similar to those reported for a factor released by peripheral blood monocytes. However, whereas human monocyte factor in both the crude and partially-purified state exhibits interleukin-1 activity, crude and fractionated periosteal fibroblast-conditioned medium does not. This is the first report of a conditioned medium containing a molecule like the monocyte-factor which appears to have no interleukin 1 activity. The factor may be synthesized by a wide range of cell types, and could have an important role in mediating connective tissue degradation during both physiological and pathological resorption.     

The synergistic role of Pu.1 and Fms in zebrafish osteoclast-reducing osteopetrosis and possible therapeutic strategies

Osteoclasts are bone resorption cells of myeloid origin. Osteoclast defects can lead to osteopetrosis, a genetic disorder characterized by bone sclerosis for which there is no effective drug treatment. It is known that Pu.1 and Fms are key regulators in myelopoiesis, and their defects in mice can lead to reduced osteoclast numbers and consequent osteopetrosis. Yet how Pu.1 and Fms genetically interact in the development of osteoclasts and the pathogenesis of osteopetrosis is still unclear. Here, we characterized pu.1^G242D;fms^j4e1 double-deficient zebrafish, which exhibited a greater deficiency of functional osteoclasts and displayed more severe osteopetrotic symptoms than the pu.1^G242D or fms^j4e1 single mutants, suggesting a synergistic function of Pu.1 and Fms in the regulation of osteoclast development. We further demonstrated that Pu.1 plays a dominant role in osteoclastogenesis, whereas Fms plays a dominant role in osteoclast maturation. Importantly, treatment with the drug retinoic acid significantly relieved the different degrees of osteopetrosis symptoms in these models by increasing the number of functional osteoclasts. Thus, we report the development of valuable animal models of osteopetrosis, and our results shed light on drug development for antiosteopetrosis therapy.     

Long‐term research avoids spurious and misleading trends in sustainability attributes of no‐till

Agricultural management recommendations based on short‐term studies can produce findings inconsistent with long‐term reality. Here, we test the long‐term environmental sustainability and profitability of continuous no‐till agriculture on yield, soil water availability, and N₂O fluxes. Using a moving window approach, we investigate the development and stability of several attributes of continuous no‐till as compared to conventional till agriculture over a 29‐year period at a site in the upper Midwest, US. Over a decade is needed to detect the consistent effects of no‐till. Both crop yield and soil water availability required 15 years or longer to generate patterns consistent with 29‐year trends. Only marginal trends for N₂O fluxes appeared in this period. Relative profitability analysis suggests that after initial implementation, 86% of periods between 10 and 29 years recuperated the initial expense of no‐till implementation, with the probability of higher relative profit increasing with longevity. Importantly, statistically significant but misleading short‐term trends appeared in more than 20% of the periods examined. Results underscore the importance of decadal and longer studies for revealing consistent dynamics and emergent outcomes of no‐till agriculture, shown to be beneficial in the long term.     

Effects of manganese-supplemented diets on growth performance,blood biochemistry,nitrogen metabolism and skeletal development of rex rabbits

(Background) Manganese (Mn) is an essential mineral, although its effects on rabbits is not clear. (Research Purpose) This study was conducted to investigate the effects of the level of supplementation of dietary manganese on growth performance, blood biochemistry, nitrogen metabolism and skeletal development of growing Rex rabbits. (Methods) Two hundred 3-month-old healthy Rex rabbits with similar body weights were randomly divided into 5 groups (A, B, C, D, E), with 40 replicates in each group. The rabbits in the 5 groups were fed a basal diet containing 0, 5, 10, 20 and 40 mg/kg manganese (in the form of manganese sulfate), respectively. The trial included 7 days for adaptation and 29 days of testing. Seven days before the end of feeding, eight rabbits from each group were transferred into a metabolic cage for metabolic testing. (Results) The results showed that supplemental dietary manganese levels did not significantly influence final body weight (FBW) or average daily feed intake (ADFI) (P＞0.05). Average daily gains (ADG) were significantly higher in the 20 mg/kg manganese group than in the other groups, and the ratio of feed to body weight gain (F/G) was significantly affected by manganese level (P < 0.05). No significant differences were found in the digestion coefficients among the groups (P > 0.05). Regarding carcass traits, the thymus index and total fat were significantly different (P < 0.05) among the groups, but there were no other significant differences (P > 0.05). The addition of manganese had no significant effect on the intake of nitrogen (IN), fecal nitrogen (FN), digestible nitrogen (DN) or the apparent digestibility of nitrogen (NAD). Compared to the other groups, urinary nitrogen (UN) was lower in the 20 mg/kg group, although nitrogen deposition (RN), nitrogen utilization (NUR) and the biological potency of nitrogen (NBV) were higher in this group (P < 0.05). As the amount of manganese added to the diet increased, serum triglycerides decreased (P < 0.05). Serum Mn-SOD was significantly lower in the 5 mg/kg manganese group than in the other groups (P < 0.05). The results of this study demonstrate that a diet with supplemented manganese can improve Rex rabbit growth performance and increase RN, NUR and NBV. There were no significant effects of different dietary levels of Mn on the ratio of bone to meat (P > 0.05) or bone strength (P < 0.05). (Conclusion) In conclusion, we determined that the optimal level of manganese supplementation in the diet of growing Rex rabbits was 20 mg/kg, which was also found to reduce nitrogen emissions into the environment.