Low bone mineral density and the increased risk of fracture in gastrointestinal diseases have a multifactorial pathogenesis. Inflammatory bowel disease （IBD） has been associated with an increased risk of osteoporosi...Low bone mineral density and the increased risk of fracture in gastrointestinal diseases have a multifactorial pathogenesis. Inflammatory bowel disease （IBD） has been associated with an increased risk of osteoporosis and osteopenia and epidemiologic studies have reported an increased prevalence of low bone mass in patients with IBD. Certainly, genetics play an important role, along with other factors such as systemic inflammation, malnutrition, hypogonadism, glucocorticoid therapy in IBD and other lifestyle factors. At a molecular level the proinflammatory cytokines that contribute to the intestinal immune response in IBD are known to enhance bone resorption. There are genes influencing osteoblast function and it is likely that LRP5 may be involved in the skeletal development. Also the identification of vitamin D receptors （VDRs） and some of its polymorphisms have led to consider the possible relationships between them and some autoimmune diseases and may be involved in the pathogenesis through the exertion of its immunomodulatory effects during inflammation. Trying to explain the physiopathology we have found that there is increasing evidence for the integration between systemic inflammation and bone loss likely mediated via receptor for activated nuclear factor kappa-B （RANK）, RANK-ligand, and osteoprotegerin, proteins that can affect both osteoclastogenesis and T-cell activation. Although glucocorticoids can reduce mucosal and systemic inflammation, they have intrinsic qualities that negatively impact on bone mass. It is still controversial if all IBD patients should be screened, especially in patients with preexisting risk factors for bone disease. Available methods to measure BMD include single energy x-ray absorptiometry, DXA, quantitative computed tomography （QCT）, radiographic absorptiometry, and ultrasound.DXA is the establish method to determine BMD, and routinely is measured in the hip and the lumbar spine. There are several treatments options that have proven their effectiveness, while new emergent therapies such as calcitonin and teriparatide among others remain to be assessed.展开更多
Objective To investigate the relationship between geranylgeranyl pyrophosphate synthase （GGPPS） gene polymorphisms and bone response to alendronate in Chinese osteoporotic women. Methods A total of 639 postmenopaus...Objective To investigate the relationship between geranylgeranyl pyrophosphate synthase （GGPPS） gene polymorphisms 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 of GGPPS gene were 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 of GGPPS gene was correlated to serumβ-CTX levels at baseline, and patients with TT genotype had significantly higher serum β-CTX level than those with TC or CC genotype （all P〈0.05）. No correlation was found between polymorphisms of GGPPS 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 （all P〉0.05）. However, GGPPS gene polymorphisms were uncorrelated to percentage changes of BMD, serum total ALP, and β-CTX levels （all P〉0.05）. Conclusion GGPPS gene polymorphisms are correlated to osteoclasts activity, but all tag single nucleotide polymorphisms of GGPPS gene have no influence on the skeletal response to alendronate treatment.展开更多
Objective: To observe the influence of different intervals of acupuncture treatment on bone intensity in primary osteoporosis subjects. Methods: A total of 45 cases of primary osteoporosis female patients were randoml...Objective: To observe the influence of different intervals of acupuncture treatment on bone intensity in primary osteoporosis subjects. Methods: A total of 45 cases of primary osteoporosis female patients were randomly divided into 1 treatment/week (1-T/W), 2 treatments/week (2-T/W) and 3 treatments/week (3-T/W) groups, with 15 cases being in each group. Guanyuan (CV 4), Zusanli (ST 36), Sanyinjiao (SP 6), Shenshu (BL 23), Taixi (KI 3) and Pishu (BL 20) were used and stimulated with reinforcing needling manipulation. For patients with deficiency syndrome of kidney-yang, thermal acupuncture was applied to Shenshu (BL 23), and for patients with spleen-deficiency syndrome, thermal acupuncture applied to Zusanli (ST 36). Results: After 6 months’ treatment, in 1-T/W group, no apparent change of bone intensity was observed, while in 2-T/W and 3-T/W groups, the bone intensity was increased significantly (P<0.05, 0.01). Conclusion: Acupuncture plus moxibustion treatment twice or 3 times every week can obviously improve the bone intensity.展开更多
Osteoporosis,a prevalent systemic degenerative disease,poses significant challenges to China’s national health,particularly due to complications such as fractures.Therapeutic interventions for osteoporosis primarily ...Osteoporosis,a prevalent systemic degenerative disease,poses significant challenges to China’s national health,particularly due to complications such as fractures.Therapeutic interventions for osteoporosis primarily involve bone resorption inhibitors(antiresorptive)and bone formation promoters(anabolic).Numerous studies underscore the importance of sequential and combination treatments using diverse drug types.Such approaches have shown considerable efficacy in increasing bone mineral density,reducing fracture risk,and preventing the progression of osteoporosis.This article aimed to consolidate various sequential treatment schemes,offering valuable insights for clinicians in their practice.展开更多
Objective： To observe the clinical result and assess clinical value of cemented bipolar hemiarthroplasty with a novel cerclage cable technique for treatment of unstable intertrochanteric hip fractures in senile patie...Objective： To observe the clinical result and assess clinical value of cemented bipolar hemiarthroplasty with a novel cerclage cable technique for treatment of unstable intertrochanteric hip fractures in senile patients. Methods： Forty-eight consecutive patients with unstable intertrochanteric fractures were treated in our hospital from March 2001 to March 2006 （ Evans type Ⅲ in 11 cases, Evans type Ⅳ in 25 cases and Evans type Ⅴ in 22 cases）. All the cases were evaluated by Zuckerman functional recovery score （ FRS ） and operative risk assessment software 1 （ORAS1）, which were based on the patients ＇ physical and laboratory examinations preoperatively. Seventeen cases （19 hips） were treated with cemented bipolar hemiarthroplasty. There were 5 male cases （5 hips） and 12 female cases （14 hips, including 2 patients who suffered from additional slight injuries and resulted in contralateral hip fracture and were treated with the same procedure 3 months after the first operation ）. The average age was 85 years （78-95 years ）. All the operations were carried out under general anesthesia, through Southern incision and lateral approach by the same orthopaedic surgeon. All prostheses consisted of Link SPH femoral stem and bipolar femoral head. All patients were followed up for more than 30 days. Results ： The operative risks of all the 17 cases （ 19 hips） were calculated by ORAS1 preoperatively. The average preoperative FRS was 81.7 （ 80. 7- 82.7 ）. The average predictive value of operative morbidity was 10% （7 %-15 % ）. The average predictive value of mortality was 2.97 % （ 2. 1%-3.2 % ）. The average operation time was 1.5 hours. The average blood transfusion was 400 nd. There were no operative or anesthetic complications and no deaths within 30 days after operation. Sitting up was permitted 3 to 4 days after operation, and partial weight bearing was permitted 5 to 7 days after operation. Patients were allowed to walk with a walker 10 days after operation. The average FRS was 78.7 at 30 days postoperatively. No patient died during at least one year follow-up. Conclusions Although the value of the technique of cemented bipolar hemiarthroplasty in the treatment of unstable intertrochanteric hip fracture is not widely recognized, we have consistently achieved satisfactory results with strict preoperative risk assessment, strict indication selection and systematic postoperative rehabilitation.展开更多
Objective：To discuss the curative effect of the dynamic hip system blade （DHS-blade） on the treatment of femoral neck fractures in elderly patients with osteoporosis.Methods：A retrospective study was conducted to ...Objective：To discuss the curative effect of the dynamic hip system blade （DHS-blade） on the treatment of femoral neck fractures in elderly patients with osteoporosis.Methods：A retrospective study was conducted to analyse the clinical data of 60 elderly patients with osteoporosis who had been treated for femoral neck fractures with DHS-blade in our department between September 2012 and February 2014.There were 22 males and 38 females with a mean age of （66.8±3.2） years.According to the Singh Index Classification,all the patients＇ Singh index was below level 3.The Harris criterion and function recovery after operation were analysed.Results：All patients were followed up for 12-17 months （mean 14 months）.No femoral head necrosis,femoral neck shortening,internal fixation loosening or backing out of the nails occurred.Bone nonunion was found in one case and he had a good recovery after total hip arthroplasty.The time for fracture healing ranged from 3-6 months （average 3.5 months）.According to Harris criterion,35 cases were rated as excellent,22 good,2 fair and 1 poor.The Harris scale was significantly improved from 28.46±2.35 preoperatively to 91.98±3.26 at 6 months postoperatively （P＜0.05）.Conclusion：DHS-blade,being minimally invasive,allowing earlier postoperative exercise and avoiding the complications elicited by traditional internal fixation,is advisable for treatment of femoral neck fractured patients with osteoporosis.展开更多
Objective: To evaluate the effect of osteoporosis on fracture healing through observing the histomorphological changes, bone mineral density of callus and expression and distribution of transforming growth factor beta...Objective: To evaluate the effect of osteoporosis on fracture healing through observing the histomorphological changes, bone mineral density of callus and expression and distribution of transforming growth factor beta 1 (TGF β1),basic fibroblast growth factor (bFGF) and bone morphogenetic protein 2 (BMP 2) in ovariectomized rats. Methods: Sixty female Sprague Dawley rats (aged 12 weeks and weighing 235 g on average) were randomly divided into an ovariectomized (OVX) group (n=30) and a sham operated (SO) group (n=30). Ovariectomy was performed in the OVX rats and same incision was made in the SO rats. Three months later, fracture of femoral shaft was made on all the rats. Then they were killed at different time points. Callus formation was observed with histological and immunohistochemical methods. Results: A reduction in callus and bone mineral density in the healing femur and a decrease of osteoblasts expressing TGF β1 near the bone trabecula were observed in the OVX rats 3 4 weeks after fracture. Histomorphological analysis revealed a higher content of soft callus in the OVX rats than that in the SO rats. Immunohistochemistry results showed that no remarkable difference in expression and distribution of BMP 2 and bFGF between the OVX and SO groups was found. Conclusions: Osteoporosis influences the quantity and quality of callus during the early period of fracture healing. The effect of osteoporosis on fracture healing has no relationship with the expression of BMP 2 or bFGF. The decreased expression of TGF β1 in osteoblasts may cause a decrease in quality of facture healing after osteoporosis.展开更多
OBJECTIVE:To evaluate the efficacy and long-term effects of the three therapies for regulating and reinforcing lung and kidney(reinforcing lung and invigorating spleen,reinforcing lung and replenishing kidney,and supp...OBJECTIVE:To evaluate the efficacy and long-term effects of the three therapies for regulating and reinforcing lung and kidney(reinforcing lung and invigorating spleen,reinforcing lung and replenishing kidney,and supplementing Qi and nourishing kidney) in Traditional Chinese Medicine(TCM) on osteoporosis in rats with chronic obstructive pulmonary disease.METHODS:Totally 120 rats were randomly divided into control,model,Bufeijianpi,Bufeiyishen,Yiqizishen,aminophyline groups.Repeated smoke inhalations and bacterial infections were used to duplicate the stable Chronic obstructive pulmonary disease rat model.Normal saline was given to the air control and model groups,while Bufeijianpi granule,Bufeiyishen granule,and Yiqizishen granule,and aminophylline were administrated to rats in the Bufeijianpi,Bufeiyishen,Yiqizishen,and aminophylline groups respectively from weeks 9 through 20.Another 12 weeks without medicines to observe the long-term effect.Rats were sacrificed at week 20 and week 32.Bone mass density(BMD),bone mineral content(BMC),morphology of the femoral head,lung function,and levels of serum interleukin(IL)-1β,IL-6,and tumor necrosis factor-a were detected.RESULTS:At weeks 20 and 32,tidal volume,peak expiratory flow and expiratory flow at 50% tidal volume in the three TCM-treated groups were higher than those in the model group(P < 0.05).Femur weight,BMD,and BMC were significantly higher in the three TCM-treated groups and the aminophylline-treated group compared with the model group(P < 0.01),except for BMC in the Yiqizishen-treated group at week 20.CONCLUSION:Bufeijianpi,Bufeiyishen,and Yiqizishen granules show good effects in the prevention and treatment of osteoporosis,which can alleviate airflow limitations and inflammation,improve BMD and BMC of the femur,and have favorable long-term effects.展开更多
文摘Low bone mineral density and the increased risk of fracture in gastrointestinal diseases have a multifactorial pathogenesis. Inflammatory bowel disease （IBD） has been associated with an increased risk of osteoporosis and osteopenia and epidemiologic studies have reported an increased prevalence of low bone mass in patients with IBD. Certainly, genetics play an important role, along with other factors such as systemic inflammation, malnutrition, hypogonadism, glucocorticoid therapy in IBD and other lifestyle factors. At a molecular level the proinflammatory cytokines that contribute to the intestinal immune response in IBD are known to enhance bone resorption. There are genes influencing osteoblast function and it is likely that LRP5 may be involved in the skeletal development. Also the identification of vitamin D receptors （VDRs） and some of its polymorphisms have led to consider the possible relationships between them and some autoimmune diseases and may be involved in the pathogenesis through the exertion of its immunomodulatory effects during inflammation. Trying to explain the physiopathology we have found that there is increasing evidence for the integration between systemic inflammation and bone loss likely mediated via receptor for activated nuclear factor kappa-B （RANK）, RANK-ligand, and osteoprotegerin, proteins that can affect both osteoclastogenesis and T-cell activation. Although glucocorticoids can reduce mucosal and systemic inflammation, they have intrinsic qualities that negatively impact on bone mass. It is still controversial if all IBD patients should be screened, especially in patients with preexisting risk factors for bone disease. Available methods to measure BMD include single energy x-ray absorptiometry, DXA, quantitative computed tomography （QCT）, radiographic absorptiometry, and ultrasound.DXA is the establish method to determine BMD, and routinely is measured in the hip and the lumbar spine. There are several treatments options that have proven their effectiveness, while new emergent therapies such as calcitonin and teriparatide among others remain to be assessed.
基金Supported by National Natural Science Foundation of China(81570802)National Key Program of Clinical Science(WBYZ2011-873)
文摘Objective To investigate the relationship between geranylgeranyl pyrophosphate synthase （GGPPS） gene polymorphisms 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 of GGPPS gene were 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 of GGPPS gene was correlated to serumβ-CTX levels at baseline, and patients with TT genotype had significantly higher serum β-CTX level than those with TC or CC genotype （all P〈0.05）. No correlation was found between polymorphisms of GGPPS 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 （all P〉0.05）. However, GGPPS gene polymorphisms were uncorrelated to percentage changes of BMD, serum total ALP, and β-CTX levels （all P〉0.05）. Conclusion GGPPS gene polymorphisms are correlated to osteoclasts activity, but all tag single nucleotide polymorphisms of GGPPS gene have no influence on the skeletal response to alendronate treatment.
文摘Objective: To observe the influence of different intervals of acupuncture treatment on bone intensity in primary osteoporosis subjects. Methods: A total of 45 cases of primary osteoporosis female patients were randomly divided into 1 treatment/week (1-T/W), 2 treatments/week (2-T/W) and 3 treatments/week (3-T/W) groups, with 15 cases being in each group. Guanyuan (CV 4), Zusanli (ST 36), Sanyinjiao (SP 6), Shenshu (BL 23), Taixi (KI 3) and Pishu (BL 20) were used and stimulated with reinforcing needling manipulation. For patients with deficiency syndrome of kidney-yang, thermal acupuncture was applied to Shenshu (BL 23), and for patients with spleen-deficiency syndrome, thermal acupuncture applied to Zusanli (ST 36). Results: After 6 months’ treatment, in 1-T/W group, no apparent change of bone intensity was observed, while in 2-T/W and 3-T/W groups, the bone intensity was increased significantly (P<0.05, 0.01). Conclusion: Acupuncture plus moxibustion treatment twice or 3 times every week can obviously improve the bone intensity.
基金The Undergraduate Research Innovation Program of Capital Medical University(Grant No.XSKY2021387).
文摘Osteoporosis,a prevalent systemic degenerative disease,poses significant challenges to China’s national health,particularly due to complications such as fractures.Therapeutic interventions for osteoporosis primarily involve bone resorption inhibitors(antiresorptive)and bone formation promoters(anabolic).Numerous studies underscore the importance of sequential and combination treatments using diverse drug types.Such approaches have shown considerable efficacy in increasing bone mineral density,reducing fracture risk,and preventing the progression of osteoporosis.This article aimed to consolidate various sequential treatment schemes,offering valuable insights for clinicians in their practice.
文摘Objective： To observe the clinical result and assess clinical value of cemented bipolar hemiarthroplasty with a novel cerclage cable technique for treatment of unstable intertrochanteric hip fractures in senile patients. Methods： Forty-eight consecutive patients with unstable intertrochanteric fractures were treated in our hospital from March 2001 to March 2006 （ Evans type Ⅲ in 11 cases, Evans type Ⅳ in 25 cases and Evans type Ⅴ in 22 cases）. All the cases were evaluated by Zuckerman functional recovery score （ FRS ） and operative risk assessment software 1 （ORAS1）, which were based on the patients ＇ physical and laboratory examinations preoperatively. Seventeen cases （19 hips） were treated with cemented bipolar hemiarthroplasty. There were 5 male cases （5 hips） and 12 female cases （14 hips, including 2 patients who suffered from additional slight injuries and resulted in contralateral hip fracture and were treated with the same procedure 3 months after the first operation ）. The average age was 85 years （78-95 years ）. All the operations were carried out under general anesthesia, through Southern incision and lateral approach by the same orthopaedic surgeon. All prostheses consisted of Link SPH femoral stem and bipolar femoral head. All patients were followed up for more than 30 days. Results ： The operative risks of all the 17 cases （ 19 hips） were calculated by ORAS1 preoperatively. The average preoperative FRS was 81.7 （ 80. 7- 82.7 ）. The average predictive value of operative morbidity was 10% （7 %-15 % ）. The average predictive value of mortality was 2.97 % （ 2. 1%-3.2 % ）. The average operation time was 1.5 hours. The average blood transfusion was 400 nd. There were no operative or anesthetic complications and no deaths within 30 days after operation. Sitting up was permitted 3 to 4 days after operation, and partial weight bearing was permitted 5 to 7 days after operation. Patients were allowed to walk with a walker 10 days after operation. The average FRS was 78.7 at 30 days postoperatively. No patient died during at least one year follow-up. Conclusions Although the value of the technique of cemented bipolar hemiarthroplasty in the treatment of unstable intertrochanteric hip fracture is not widely recognized, we have consistently achieved satisfactory results with strict preoperative risk assessment, strict indication selection and systematic postoperative rehabilitation.
文摘Objective：To discuss the curative effect of the dynamic hip system blade （DHS-blade） on the treatment of femoral neck fractures in elderly patients with osteoporosis.Methods：A retrospective study was conducted to analyse the clinical data of 60 elderly patients with osteoporosis who had been treated for femoral neck fractures with DHS-blade in our department between September 2012 and February 2014.There were 22 males and 38 females with a mean age of （66.8±3.2） years.According to the Singh Index Classification,all the patients＇ Singh index was below level 3.The Harris criterion and function recovery after operation were analysed.Results：All patients were followed up for 12-17 months （mean 14 months）.No femoral head necrosis,femoral neck shortening,internal fixation loosening or backing out of the nails occurred.Bone nonunion was found in one case and he had a good recovery after total hip arthroplasty.The time for fracture healing ranged from 3-6 months （average 3.5 months）.According to Harris criterion,35 cases were rated as excellent,22 good,2 fair and 1 poor.The Harris scale was significantly improved from 28.46±2.35 preoperatively to 91.98±3.26 at 6 months postoperatively （P＜0.05）.Conclusion：DHS-blade,being minimally invasive,allowing earlier postoperative exercise and avoiding the complications elicited by traditional internal fixation,is advisable for treatment of femoral neck fractured patients with osteoporosis.
文摘Objective: To evaluate the effect of osteoporosis on fracture healing through observing the histomorphological changes, bone mineral density of callus and expression and distribution of transforming growth factor beta 1 (TGF β1),basic fibroblast growth factor (bFGF) and bone morphogenetic protein 2 (BMP 2) in ovariectomized rats. Methods: Sixty female Sprague Dawley rats (aged 12 weeks and weighing 235 g on average) were randomly divided into an ovariectomized (OVX) group (n=30) and a sham operated (SO) group (n=30). Ovariectomy was performed in the OVX rats and same incision was made in the SO rats. Three months later, fracture of femoral shaft was made on all the rats. Then they were killed at different time points. Callus formation was observed with histological and immunohistochemical methods. Results: A reduction in callus and bone mineral density in the healing femur and a decrease of osteoblasts expressing TGF β1 near the bone trabecula were observed in the OVX rats 3 4 weeks after fracture. Histomorphological analysis revealed a higher content of soft callus in the OVX rats than that in the SO rats. Immunohistochemistry results showed that no remarkable difference in expression and distribution of BMP 2 and bFGF between the OVX and SO groups was found. Conclusions: Osteoporosis influences the quantity and quality of callus during the early period of fracture healing. The effect of osteoporosis on fracture healing has no relationship with the expression of BMP 2 or bFGF. The decreased expression of TGF β1 in osteoblasts may cause a decrease in quality of facture healing after osteoporosis.
基金Supported by National Natural Science Fund of China(Influence and Long-Term Effects of Three Tiao-Bu Fei-Shen Therapies in Rats with Chronic Obstructive Pulmonary Disease on Regulation of Multidimensional Molecular Network,No.81130062)
文摘OBJECTIVE:To evaluate the efficacy and long-term effects of the three therapies for regulating and reinforcing lung and kidney(reinforcing lung and invigorating spleen,reinforcing lung and replenishing kidney,and supplementing Qi and nourishing kidney) in Traditional Chinese Medicine(TCM) on osteoporosis in rats with chronic obstructive pulmonary disease.METHODS:Totally 120 rats were randomly divided into control,model,Bufeijianpi,Bufeiyishen,Yiqizishen,aminophyline groups.Repeated smoke inhalations and bacterial infections were used to duplicate the stable Chronic obstructive pulmonary disease rat model.Normal saline was given to the air control and model groups,while Bufeijianpi granule,Bufeiyishen granule,and Yiqizishen granule,and aminophylline were administrated to rats in the Bufeijianpi,Bufeiyishen,Yiqizishen,and aminophylline groups respectively from weeks 9 through 20.Another 12 weeks without medicines to observe the long-term effect.Rats were sacrificed at week 20 and week 32.Bone mass density(BMD),bone mineral content(BMC),morphology of the femoral head,lung function,and levels of serum interleukin(IL)-1β,IL-6,and tumor necrosis factor-a were detected.RESULTS:At weeks 20 and 32,tidal volume,peak expiratory flow and expiratory flow at 50% tidal volume in the three TCM-treated groups were higher than those in the model group(P < 0.05).Femur weight,BMD,and BMC were significantly higher in the three TCM-treated groups and the aminophylline-treated group compared with the model group(P < 0.01),except for BMC in the Yiqizishen-treated group at week 20.CONCLUSION:Bufeijianpi,Bufeiyishen,and Yiqizishen granules show good effects in the prevention and treatment of osteoporosis,which can alleviate airflow limitations and inflammation,improve BMD and BMC of the femur,and have favorable long-term effects.
