Clinical correlations between chronic hepatitis C infection and decreasing bone mass density after treatment with interferon-alpha

Objective: To compare the bone mass density in chronic hepatitis patients before and after interferon-a treatment.Methods: A total of 70 patients with chronic hepatitis C were treated with interferon-a and were evaluated. The treatment dosage was three million IU three times a week for one year. All the patients underwent bone mass density detection at lumbar spine and femoral neck before and after the interferon-a treatment. All the necessary information such as age,sex, and laboratory test, history of occurrence of fractures, lifestyle, and menopause status was collected by interviewers face-to-face from participants at the research visit. Smoking was categorized by whether participants were nonsmokers or smokers. Menopause was designated if there had been complete cessation of menses for more than 12 months. All statistical analyses were performed by SPSS version 14(SPSS, Inc., Chicago, IL, USA).Results: Among 70 patients, 52% were male, 48% were female and the mean age was(57.0 ± 9.6) years(range: 24–79). Twenty-nine percent of the patients had a history of smoking. The mean body mass index was(24.4 ± 3.6) kg/m^2(range: 18.4–35.3). Of the70 cases, 21 had high fibrosis-4. The prevalence of overall fracture history was 2.9%(two patients).Conclusions: Chronic hepatitis C virus infection did increase the risk of development of metabolic bone disease in this cohort. Indeed, greater reduction of bone mass density occurs in advanced liver fibrosis. The bone loss in earlier stages of chronic hepatitis C infection is likely to result from increased bone reduction rather than decreased bone formation. Overall, these observations suggest an important role for chronic hepatitis C virus infection in increased bone turnover in osteodystrophy pathogenesis.

Androgen and bone mass in men

<abstract>Androgens have multiple actions on the skeleton throughout life. Androgens promote skeletal growth and accumulation of minerals during puberty and adolescence and stimulate osteoblast but suppress osteoclast function, activity and lifespan through complex mechanisms. Also androgens increase periosteal bone apposition, resulting in larger bone size and thicker cortical bone in men. There is convincing evidence to show that aromatization to estrogens was an important pathway for mediating the action of testosterone on bone physiology. Estrogen is probably the dominant sex steroid regulating bone resorption in men, but both testosterone and estrogen are important in maintaining bone formation.

CHIP regulates bone mass by targeting multiple TRAF family members in bone marrow stromal cells

Carboxyl terminus of Hsp70-interacting protein（CHIP or STUB1） is an E3 ligase and regulates the stability of several proteins which are involved in different cellular functions. Our previous studies demonstrated that Chip deficient mice display bone loss phenotype due to increased osteoclast formation through enhancing TRAF6 activity in osteoclasts. In this study we provide novel evidence about the function of CHIP. We found that osteoblast differentiation and bone formation were also decreased in Chip KO mice. In bone marrow stromal（BMS） cells derived from Chip^-/- mice, expression of a panel of osteoblast marker genes was significantly decreased. ALP activity and mineralized bone matrix formation were also reduced in Chip-deficient BMS cells. We also found that in addition to the regulation of TRAF6, CHIP also inhibits TNFα-induced NF-κB signaling through promoting TRAF2 and TRAF5 degradation. Specific deletion of Chip in BMS cells downregulated expression of osteoblast marker genes which could be reversed by the addition of NF-κB inhibitor. These results demonstrate that the osteopenic phenotype observed in Chip^-/- mice was due to the combination of increased osteoclast formation and decreased osteoblast differentiation. Taken together, our findings indicate a significant role of CHIP in bone remodeling.

Effect of chronic sleep deprivation on peak bone mass in rats: An experimental study

Objective:To investigate the effects of chronic sleep deprivation(CSD)on bone microstructure and peak bone mass(PBM)in SD rats.Methods:Twenty-four SD rats were randomly divided into CSD group and control group.In the CSD group,a CSD model was established using a new sleep deprivation instrument for rats and mice,and intervened for 5 weeks.Bone turnover markers including P1NP and CTX-1 before and after the experiment were observed.After the experiment,the left femur were scanned by Micro-CT,and the cortical bone and bone trabecula were three-dimensionally reconstructed,respectively.The bone mineral density(BMD)and relevant parameters were detected.Results:CT images of the femur(proximal ends)showed significant trabecular loss in CSD rats.Trabecular parameters including bone volume fraction(BV/TV),trabecular number(Tb.N)and trabecular separation(Tb.Sp)in the CSD group were all lower than those in the control group.The bone cortex of the middle segment of the femur and tibia in CSD rats was also lower than that in the control group.The parameters of bone cortex including total tissue area(Tt.Ar),cortical bone area(Ct.Ar)and cortical bone thickness(Ct.Th)in the CSD group were significantly lower than those in the control group(P<0.01).After chronic CSD,BMD of both bone trabecula and bone cortex of the femur was lower,while the corresponding P1NP and CTX-1 were significantly higher than those in the control group.Conclusion:Sleep plays an important role in PBM formation.CSD accelerates bone turnover and thus significantly reducing PBM in SD rats.

Profile of Bone Mass and Its Determining Factors in Type 2 Diabetes: Case-Control Study

Background: Type 2 diabetes mellitus, beyond its well-known cardiovascular and neurological complications, is now increasingly recognized as having deleterious effects on bone tissue. It’s thus presented as an independent risk factor for bone fragility with a considerable fracture risk relating to many more or less intricate parameters. The general objective of our study is to assess bone mass during type 2 diabetes in Senegalese women. Methodology: We had carried out a cross-sectional and descriptive study. Socio-demographic characteristics were collected on the basis of a questionnaire. Then each of the subjects had undergone a complete clinical examination followed by a blood sample for a biological assessment of certain cardiovascular risk factors. Bone mass was measured using a bio-impedancemeter. Results: We recruited 88 women with type 2 diabetes and 83 healthy control women. The mean age of diabetic subjects was 52.7 years ± 6.8 (with extremes of 39 and 74 years). In control, the mean age was 51.0 ± 8.5 years (with extremes of 35 and 72 years). Among the diabetic subjects, 22 subjects or 25% practiced a regular walk against 27 (32.5%) in the control. Forty-three among the diabetic subjects (48.8%) were known hypertensive and followed. According to the body mass index, 71 patients (80.7%) were overweight compared to 59 (71.1%) controls. According to the waist size, 80 (90.9%) diabetic subjects had an elevated waist size compared to 69 control women (83.1%). Among diabetic subjects, 41 patients (46.5%) were hyperglycemic imbalance according to fasting blood glucose and 59 patients (67%) according to glycated hemoglobin level. Thirty-seven diabetics (42%), had both high fasting blood glucose and elevated glycated hemoglobin. The mean duration of diabetes was 8.68 ± 7.18 years. We found significantly higher bone mass in type 2 diabetic subjects (p = 0.03). Among diabetics, 27.3% had low bone mass compared to 36.1% of control. It’s noted that the subjects of the “low bone mass” group among the control subjects also have a significant drop in other anthropometric parameters (weight, body mass index, waist size, muscle mass). It should also be noted that the fat mass is significantly higher in diabetic subjects with normal or even high bone mass. In control subjects, bone mass was positively correlated with weight (r = 0.36;p = 0.001), muscle mass (r = 0.93;p < 0.0001) and fasting blood glucose (r = 0.26;p = 0.02);and negatively correlate with age (r = 0.22;p = 0.04). On the other hand, in type 2 diabetic subjects, bone mass is positively correlated with age (r = 0.22;p = 0.04), muscle mass (r = 0.89;p < 0.0001) and the diabetes duration (r = 0.44;p = 0.001). Conclusion: Bone mass is higher in type 2 diabetics compared to healthy controls. Chronic hyperglycemia and the diabetes duration are believed to be responsible for the increase in bone mass. In addition, an increase in muscle mass would lead to an increase in bone mass.

Spectrum-effect relationship between HPLC fingerprints and bioactive components of Radix Hedysari on increasing the peak bone mass of rat

The traditional Chinese medicine of Radix Hedysari plays an important role in invigorating gas for ascending, benefiting blood for promoting production of fluid, and promoting circulation for removing obstruction in collaterals, which is consistent with the principle of treatment for osteoporosis. This study is designed to investigate the bioactive components on increasing peak bone mass (PBM) by exploring the spectrum-effect relationship between chromatography fingerprints and effect. Multiple indicators are selected to evaluate the pharmacological activity. In fingerprints, 21 common peaks are obtained, five of which are identified. Furthermore, gray relational analysis (GRA) is a quantitative method of gray system theory and is used to describe the correlation degree of common peaks and pharmacological activities with relational value. 21 components are then divided into three different regions, of which ononin and calycosin play an extremely significant role in increasing PBM. In addition, factor analysis and hierarchical cluster analysis (HCA) are used to screen the optimal producing area for Radix Hedysari. This provides a comprehensive and efficient method to improve the quality evaluation of Radix Hedysari, confirming the bioactive components for PBM-enhancement and further develop its medicinal value.

Factors influencing peak bone mass gain

Bone mass is a key determinant of osteoporosis and fragility fractures.Epidemiologic studies have shown that a 10%increase in peak bone mass(PBM)at the population level reduces the risk of fracture later in life by 50%.Low PBM is possibly due to the bone loss caused by various conditions or processes that occur during adolescence and young adulthood.Race,gender,and family history(genetics)are responsible for the majority of PBM,but other factors,such as physical activity,calcium and vitamin D intake,weight,smoking and alcohol consumption,socioeconomic status,age at menarche,and other secondary causes(diseases and medications),play important roles in PBM gain during childhood and adolescence.Hence,the optimization of lifestyle factors that affect PBM and bone strength is an important strategy to maximize PBM among adolescents and young people,and thus to reduce the low bone mass or osteoporosis risk in later life.This review aims to summarize the available evidence for the common but important factors that influence bone mass gain during growth and development and discuss the advances of developing high PBM.

Research progress on the role of cold-sensitive channel TRPM8 in controlling low temperature-induced bone metabolic imbalance

With increasing aging population,osteoporosis has emerged as a public health problem worldwide.Epidemiological data reveal that the prevalence of osteoporosis in cold regions is high,and low temperatures may crucially affect bone mass.Recent studies have found that the transient receptor potential melastatin-8(TRPM8)channel,a cold-sensitive ion channel,can sense cold environment,and can be activated in cold environment.It may play an antagonistic role in low temperature-induced bone mass reduction.Mechanistically,this function may be ascribed to the activation of TRPM8 channel proteins in human bone marrow mesenchymal stem cells(hBM-MSCs),which causes osteoblast differentiation and mineralization in the bone.TRPM8 channel on the surface of brown adipocytes participates in the thermogenesis in brown adipose tissue(BAT)and the regulation of whole-body energy balance to maintain bone homeostasis.TRPM8 may be involved in bone remodeling throughout life.This paper reviews recent research on the possible antagonistic mechanism of TRPM8 in signaling pathways related to low temperature-induced bone mass loss and assesses the possibility of TRPM8 as a molecular target for the prevention and treatment of low temperature-induced osteoporosis in cold regions.

Administration of soluble activin receptor 2B increases bone and muscle mass in a mouse model of osteogenesis imperfecta

Osteogenesis imperfecta（OI） comprises a group of heritable connective tissue disorders generally defined by recurrent fractures, low bone mass, short stature and skeletal fragility. Beyond the skeletal complications of OI,many patients also report intolerance to physical activity, fatigue and muscle weakness. Indeed, recent studies have demonstrated that skeletal muscle is also negatively affected by OI, both directly and indirectly. Given the well-established interdependence of bone and skeletal muscle in both physiology and pathophysiology and the observations of skeletal muscle pathology in patients with OI, we investigated the therapeutic potential of simultaneous anabolic targeting of both bone and skeletal muscle using a soluble activin receptor 2B（ACVR2B） in a mouse model of type Ⅲ OI（oim）. Treatment of 12-week-old oim mice with ACVR2 B for 4 weeks resulted in significant increases in both bone and muscle that were similar to those observed in healthy,wild-type littermates. This proof of concept study provides encouraging evidence for a holistic approach to treating the deleterious consequences of OI in the musculoskeletal system.

Bone and soft tissue tumors presenting as sciatic notch dumbbell masses: A critical differential diagnosis of sciatica

AIM To study the clinical findings and characteristic features in sciatic notch dumbbell tumors(SNDTs).METHODS We retrospectively reviewed the clinical outcomes and characteristic features of consecutive cases of SNDTs(n = 8). RESULTS Buttock masses occurred in three patients with SNDT(37.5%). Severe buttock tenderness and pain at rest were observed in seven patients with SNDTs(87.5%). Remarkably, none of the patients with SNDTs experienced back pain. Mean tumor size was 8.4 ± 2.0 cm(range, 3.9 to 10.6 cm) and part of the tumor mass was detected in 2 patients in the sagittal view of lumbar magnetic resonance imaging(MRI).CONCLUSION The clinical information regarding to SNDTs is scarce. The authors consider that above mentioned characteristic findings may facilitate the suspicion of pelvic pathology and a search for SNDT by MRI or computed tomography should be considered in patients presenting with sciatica without evidence of spinal diseases.

Bone mineral density in Iranian patients: Effects of age, sex, and body mass index

Introduction: Osteoporosis is a multifactorial skeletal disease that is characterized by reduced bone mineral density (BMD). BMD values depend on several factors such as age, sex and age at menopause. The purpose of this study was to determine the prevalence and changes in bone mineral density in Iranian patients. Methods: Three hundred patients were selected through random sampling technique in 2009. BMD was assessed by Norland (Excell) technique at the lumbar and femoral neck. Weight and height were measured through standard methods. A thorough history was taken from each patient. The data was analyzed using SPSS software version 13.0. P-values less than 0.05 were considered statistically significant. Results: From among the 300 studied patients, 86.6% were female. their mean age was 52.7 years. Their average body mass index (BMI) was 28.14 kg/m2. Mean T-Score at lumbar spine and femoral neck was -1.07 ±1.19 and -1.75 ± 1.33 respectively. Mean BMD value at lumbar spine and femoral neck was 0.92 ± 0.19 and 0.77 ± 0.16 respectively. The prevalence of osteoporosis at lumbar spine and femoral neck was 33.7% and 16.7, respectively. There was a significant correlation between age, BMI and BMD values (P-Value Conclusion: This study shows that ageing and low BMI are risk factors associated with bone loss. it is recommended to measure BMD and implement prevention programs for high-risk people.

不同慢性病中老年女性骨折风险及低骨量切点预测分析

背景:中老年女性是骨质疏松的高发人群,慢性病增加骨质疏松罹患风险。低骨量是骨质疏松发病前的危险阶段,目前缺少常见慢性病人群的骨折风险差异及诊断指标切点值的相关报道。目的:通过对不同慢性病中老年女性骨折风险的分析,探讨肥胖、高血压、高血脂、糖尿病、动脉硬化与骨密度的相关性,找到可预测低骨量指标的切点值,为防治骨质疏松提供参考。方法:将45-70岁203名女性受试者分为正常组和慢性病组,采用超声骨密度测量仪进行跟骨骨密度测试,采用动脉硬化仪测试肱-踝脉搏波传导速度,采用全自动生化分析仪测试血糖、血脂,采用身体成分分析仪测试体质量指数、脂肪质量及肌肉质量。结果与结论:①61-70岁女性骨密度和骨折风险系数及51-60岁、61-70岁骨强度与<50岁比较,差异有显著性意义(P<0.05);②糖尿病组骨折风险明显高于其余各组,动脉硬化组则高于正常组和肥胖组(P<0.05);③骨密度与年龄、左侧血管弹性程度、右侧血管弹性程度、三酰甘油呈负相关,与体质量指数呈正相关(P<0.05);上述指标与骨密度受试者工作特征(ROC)曲线下面积介于0.5-0.7之间,低骨量对应切点分别为55.5岁(年龄)、756.0 cm/s(左侧血管弹性)、789.0 cm/s(右侧血管弹性)、1.115 mmol/L(三酰甘油)、22.35 kg/m^(2)(体质量指数);④结论:糖尿病和动脉硬化增加中老年女性骨折风险,测定体质量指数、血管弹性和三酰甘油对女性低骨量预测具有一定早期诊断价值。

探讨定量CT及生物电阻抗测定内脏脂肪面积和骨密度的关系

目的:探讨采用定量CT(Quantitative computer tomography,QCT)及生物电阻抗(Bioelectrical impedance analysis,BIA)测定内脏脂肪面积(Visceral fat area,VFA)与骨密度(Bone density,BMD)的关系。方法:回顾性选取郑州大学第一附属医院健康管理中心1131例体检者行QCT和BIA测定的VFA及BMD,采用Pearson相关系数、多因素线性回归、单因素和多因素Logistic回归分析二者的相关性;并采用Bland-Altman评估两者测定VFA的一致性。结果:Pearson相关分析显示QCT和BIA测定的VFA与BMD呈负相关(r=-0.197和r=-0.288)。多因素Logistic回归分析显示VFA(BIA)是骨量下降的危险因素(OR=1.010,95%CI:1.005~1.015);VFA(QCT)是骨量下降的危险因素(OR=1.003,95%CI:1.001~1.005);Bland-Altman分析显示,QCT和BIA测量VFA具有较高的一致性。结论:VFA是骨量下降的危险因素,测定VFA的QCT和BIA两者具有较高的一致性,可以采用BIA测定的VFA评估骨量下降。

龟板提取物抑制细胞衰老缓解SOP小鼠骨量丢失及海马退变

目的探讨龟板提取物(Plastrum testudinis extract,后简称PTE)通过抑制细胞衰老缓解SOP小鼠的骨量丢失及海马退变的作用。方法动物实验:应用传统半乳糖皮下注射+去势法建立老年性骨质疏松症(senile osteoporosis,SOP)模型,将C57/BL6小鼠分为雌性或雄性的CON组、SOP组、SOP+PTE组;SOP+PTE组在造模过程中用PTE 0.5 g/mL灌胃干预4周,取材前1周进行行为学实验,后取大脑、L4椎体,检测骨和海马组织形态学;细胞实验:利用过氧叔丁醇(TBHP)诱导MC3T3/HT22细胞衰老,分别观察诱导后HT22半乳糖苷酶染色、衰老标志物和MC3T3成骨、衰老标志物的变化及PTE相应的治疗效果。结果MicroCT提示雌雄小鼠中,与CON组相比,SOP组骨量丢失,SOP+PTE组骨量则得到了恢复;骨HE切片结果与MicroCT结果相符;海马组织切片提示,与CON组相比,SOP组海马出现退变,而SOP+PTE组退变则得到缓解。在新物体识别实验和时序实验中,与CON、SOP组相比,雄性SOP+PTE组记忆能力明显恢复;但雌雄小鼠旷场实验均无明显变化。②TBHP可诱导MC3T3衰老,降低成骨能力及增加衰老蛋白表达,而当加入PTE后,均能逆转TBHP导致的成骨能力降低与蛋白下降;TBHP亦可增加HT22半乳糖苷酶染色区域,增加衰老蛋白表达,而加入PTE后,上述变化均得到逆转。结论PTE通过抑制前成骨细胞与海马神经元细胞的衰老,缓解SOP小鼠的骨量丢失和海马衰老退变。

定量CT测定锁骨远端骨密度分区指导肩锁关节脱位重建的价值

背景:肩锁关节脱位喙锁韧带重建在锁骨侧骨隧道的最佳位置尚未达成共识,且术后会发生锁骨侧骨隧道扩大、骨溶解、锁骨骨折、内固定失效等并发症。骨密度在内植物固定强度及稳定性上起重要作用,锁骨远端骨密度的区域差异在肩锁关节脱位修复重建中不应被忽视,目前临床上尚无人体有关锁骨远端骨密度的定量研究。目的:通过定量CT测量锁骨远端不同区域骨密度的大小,为外科医生修复重建喙锁韧带提供参考。方法:对2022年10-12月在安徽医科大学附属阜阳人民医院(阜阳市人民医院)行定量CT检查的101例患者1616份亚分区进行锁骨远端骨密度测量。对于每个定量CT样本,首先由内侧向外侧划分锁骨远端为以下4个区域,即锥状结节区(A区)、结节间区(B区)、斜方嵴区(C区)以及锁骨远端区(D区),再将每个区域分为前半部分和后半部分确定8个亚分区,在亚分区中设置半自动感兴趣区(ROIA1、A2、B1、B2、C1、C2、D1、D2),将每个定量CT扫描图像传输至QCTpro分析工作站,对锁骨远端感兴趣区松质骨骨密度进行测量,测量时注意避开锁骨骨皮质。结果与结论:①不同侧肩部骨密度比较,差异无显著性意义(P>0.05);②锁骨远端A1、A2、B1、B2、C1、C2、D1、D2亚分区骨密度分析,差异有显著性意义(P<0.05),可以认为锁骨远端不同区域骨密度有差别,经过两两比较,除A1与A2,D1与D2,A2与B1之间的骨密度差异无显著性意义(P>0.05),其余亚分区骨密度两两比较差异均有显著性意义(P<0.05);③锥状韧带解剖止点A2区骨密度高于B区,差异有显著性意义(P<0.05);A1区骨密度高于A2区,但差异无显著性意义(P>0.05);斜方韧带解剖止点C1区骨密度高于C2区、D1区及D2区,B区骨密度高于C区及D区,差异有显著性意义(P<0.05);④结果表明,锁骨远端不同区域骨密度存在差异,肩锁关节脱位修复重建时锁骨远端骨密度的区域差异不容忽视,除考虑生物力学因素外,还应考虑将内植物或骨隧道置于骨密度较高的区域,以提高内植物固定强度及稳定性,减少骨隧道扩大、骨溶解、骨折及内植物失效等并发症发生的风险。

绝经后2型糖尿病LRP5基因多态性与骨量异常的研究

目的分析低密度脂蛋白受体相关蛋白5(low density lipoprotein receptor related protein 5,LRP5)rs556442、rs312778位点基因多态性及突变在绝经后女性2型糖尿病(type 2 diabetes mellitus,T2DM)患者中骨量异常的意义。方法收集2021年5月至2023年5月新疆石河子地区的142例绝经后女性资料进行回顾性分析,分为正常对照组(A组,n=29)、T2DM组(B组,n=30)、骨量降低组(C组,n=28)、骨量降低+T2DM组(D组,n=55)。收集记录相关基线资料,运用全自动生化测定仪测定受试者血糖、血脂及骨代谢指标。通过双能X线骨密度仪测定骨密度(bone mineral density BMD),LRP5基因位点多态性采用飞行时间质谱法(MALDI-TOF-MS)测定,采用SNPscan技术对上述SNP位点进行基因分型。结果①四组基线资料比较,绝经年限、年龄及腰臀比(waist hip ratio,WHR)比较差异具有统计学意义(P<0.05);②与A组相比,B组的空腹血糖(FPG)、糖化血红蛋白(HbA1c)升高(P<0.05);D组的FPG、HbA1c的血清学水平升高,甘油三酯(TG)血清学水平降低(P<0.05);③rs556442位点:与A组相比,D组基因型分布(AA/AG/GG基因型)有统计学意义(P<0.05);rs312778位点组间基因型(CC/CT/TT基因型)及等位基因分布频率均无统计学意义(P>0.05);④rs556442位点:与AA基因型相比,B、C组AG/GG基因型的股骨颈BMD水平降低;D组AG/GG型的HDL血清学水平降低(P<0.05)。rs312778位点:与CC基因型相比,A组HbA1C、FPG血清学水平较CT/TT基因型低(P<0.05);D组CT/TT基因型的低密度脂蛋白(LDL)血清学水平升高(P<0.05);⑤多元线性回归分析:rs556442位点,TG增加是腰L_(1~4)BMD降低的危险因素(P<0.05);rs312778位点,体质量指数(body mass index,BMI)降低是腰L_(1~4)及股骨颈BMD降低的危险因素,TG增加是腰L_(1~4)BMD降低的危险因素(P<0.05);⑥在rs556442、rs312778位点骨量异常与基因型分布均无统计学意义(P>0.05)。结论新疆石河子地区绝经后T2DM女性患者LRP5基因rs556442、rs312778基因位点的突变可能与骨量降低有关。

督灸对肾阳亏虚型绝经后低骨量患者腰背疼痛的疗效

目的探究督灸对肾阳亏虚型绝经后低骨量患者腰背疼痛的作用效果。方法将2022年1月到2023年6月在医院接受系统治疗的86例肾阳亏虚型绝经后低骨量患者按照随机数字表法进行分组,对照组接受常规治疗,观察组在常规治疗的基础上接受督灸干预,比较两组在腰椎正位骨密度、视觉模拟评分(VAS)、血清骨钙素(OCN)及血清Ca^(2+)、临床疗效和不良反应方面的差异。结果治疗后观察组腰椎骨密度大于对照组,VAS评分低于对照组(P<0.05);治疗后观察组血清Ca^(2+)比对照组高,血清OCN比对照组低(P<0.05);观察组治疗有效率高于对照组(P<0.05)。两组不良反应的发生率差异无统计学意义(P>0.05)。结论督灸能改善肾阳亏虚型绝经后低骨量患者的腰背疼痛情况,提升患者生活质量,有较好的临床疗效,值得进一步推广使用。

成年正畸患者颧牙槽嵴区微种植钉植入的位点选择

目的 对成年男性及女性正畸患者颧牙槽嵴区的骨皮质密度、骨皮质厚度及颊侧可利用的有效骨量进行分析,为微种植钉植入时的位点选择提供参考。方法 采集200例年龄20~30岁患者(男女比例为1∶1)的锥形束CT扫描数据,从近中至远中依次将矢状面上右侧上颌后牙区分为6个层面,每个层面在垂直距离为颊侧骨皮质距离釉牙骨质界8、10、12 mm处分别设置3个测量位点,共计18个测量位点,测量其骨皮质密度、厚度及有效骨量,并进行统计分析。结果 成年男性与女性正畸患者的骨皮质密度、厚度及有效骨量的最高值均位于平分第二前磨牙与第一磨牙根间区,其中骨皮质密度、厚度随着垂直高度增加而增大,而有效骨量随着垂直高度增加而减少。成年男性与女性患者之间的骨皮质密度、骨皮质厚度和颊侧有效骨量存在一定的差异。结论成年男性与女性正畸患者颧牙槽嵴区微种植钉的最佳植入位点均位于第二前磨牙与第一磨牙根间区,其中男性最佳植入位点的垂直高度可以适当高于女性。

运动对骨量减少老年人影响效果的Meta分析

目的:通过评价分析运动干预对骨量减少老年人的影响效果,为骨量减少老年人的运动实践干预提供证据支持,并探讨最佳运动干预方案。方法:通过检索PubMed、Web of Science、Cochrane Library、Em⁃base、中国知网、万方等6个数据库,收集相关研究的国内外文献,并通过使用RevMan5.4.1软件进行Meta分析。结果:共纳入14篇文献,Meta分析结果显示:运动对骨密度T值[MD=0.25,95%CI(0.13,0.37),P<0.0001]、骨密度[SMD=0.30,95%CI(0.05,0.54),P=0.02]、生活质量[MD=-6.33,95%CI(-8.43,-4.24),P<0.00001](QUALEFFO评分)[MD=2.18,95%CI(0.92,3.43),P=0.0007](SF-36量表)等的影响具有显著差异。结论:运动干预可以改善骨量减少老年人的身体功能、预防骨量减少、延缓骨质流失;预达到有效运动干预。建议骨量减少老年人可以进行运动周期为24周(或>12周)、运动频率≥3次/周、时间60min或者30-60min的有氧运动、阻力运动或敏捷运动。

肌少症病人超声参数与体质指数、骨密度及骨骼肌质量指数的关系

目的:探究肌少症病人超声参数与体质指数、骨密度及骨骼肌质量指数的关系。方法:选取山西医科大学第二医院2023年1月1日—2024年1月1日收治的60例肌少症病人为研究组,选取同期来院体检的50名性别、年龄匹配的健康志愿者为对照组。两组均接受超声检查,记录腓肠肌肌肉厚度、肌肉最大横截面积、肌肉硬度(收缩及舒张时杨氏模量值)及双能X线吸收法检查,记录骨密度、四肢肌肉量并计算骨骼肌质量指数及体质指数。对比两组上述指标差异,使用Logistic回归分析筛选肌少症影响因素,使用受试者工作特征(ROC)曲线分析超声参数对肌少症诊断效能,使用Pearson相关系数分析研究组超声参数与体质指数、骨密度及骨骼肌质量指数的相关性。结果:Logistic回归分析结果显示:腓肠肌肌肉厚度、肌肉最大横截面积、收缩及舒张时杨氏模量值、体质指数、骨密度及骨骼肌质量指数是肌少症的独立影响因素(P<0.05);腓肠肌肌肉厚度、肌肉最大横截面积、收缩、舒张时杨氏模量值诊断肌少症ROC曲线下面积分别为0.908,0.958,0.909,0.932;Pearson相关分析结果显示,肌少症病人腓肠肌肌肉厚度、肌肉最大横截面积、收缩及舒张时杨氏模量值与体质指数、骨密度及骨骼肌质量指数均呈正相关(P<0.05)。结论:超声参数有助于筛查诊断肌少症,超声参数、腓肠肌肌肉厚度、肌肉最大横截面积、肌肉硬度与体质指数、骨密度及骨骼肌质量指数存在明显关联。