补肾健脾活血方配合阿仑膦酸钠片治疗骨质疏松症疗效研究

目的:研究补肾健脾活血方配合阿仑膦酸钠片治疗骨质疏松症的疗效。方法:选取骨质疏松症患者76例,按随机数表法分为观察组与对照组各38例。对照组在常规治疗基础上给予阿仑膦酸钠片,观察组在对照组基础上加用补肾健脾活血方,均持续6个月。比较两组血液流变学,检测患者骨代谢与骨密度指标,评估临床疗效,统计不良反应发生率。结果:观察组治疗6个月后全血低切黏度、全血高切黏度、血浆黏度、红细胞聚集指数显著低于对照组(P<0.05)。观察组治疗6个月后血清骨钙素(OC)、骨碱性磷酸酶(BALP)显著高于对照组(P<0.05),β-Ⅰ型胶原羧基端肽(β-CTX)显著低于对照组(P<0.05)。观察组治疗6个月后L2-4腰椎、股骨颈、Ward’s三角区、大粗隆的骨密度显著高于对照组(P<0.05)。观察组治疗总有效率显著高于对照组(P<0.05)。两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论:补肾健脾活血方具有改善微循环、调节骨代谢等作用,配合阿仑膦酸钠片可以提高骨质疏松症患者骨密度,改善其临床症状。

Association Between Geranylgeranyl Pyrophosphate Synthase Gene Polymorphisms and Bone Phenotypes and Response to Alendronate Treatment in Chinese Osteoporotic Women

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.

Breaking the vicious cycle between tumor cell proliferation and bone resorption by chloroquine-loaded and bone-targeted polydopamine nanoparticles

The vicious cycle between tumor cell proliferation and bone resorption remarkably elevates the progression and metastasis of bone tumors.Here,we fabricated polyethylene glycol-conjugated alendronate-functionalized and chloroquine(CQ)-loaded polydopamine nanoparticles(PPA/CQ)for efficient treatment of bone tumors via breaking the vicious cycle.The nanoparticles were efficiently accumulated to the bone tissues,especially the osteolytic lesions around tumors.CQ released from PPA/CQ inhibited osteoclastogenesis via preventing the degradation of tumor necrosis factor(TNF)receptor-associated receptor 3 to attenuate the osteolysis in bone tumors.On the other hand,CQ blocked the autophagy in cancer cells,resulting in improved photothermal killing of cancer cells.Finally,the in vivo experiment revealed that PPA/CQ-associated treatment efficiently inhibited both tumor growth and osteolysis.This work suggests that autophagy inhibition-associated photothermal therapy could be a promising strategy for treating malignant bone tumors.