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Objective To observe the effect of raloxifene, a selective estrogen receptor modulator, on osteoporosis in the osteoprotegerin (OPG) gene knock-out female and male mice. Methods Two groups of OPG gene deficient (OPG-/-) female and male mice, 20 mice in each group, were assigned to raloxifene-treated (3 mg The effect of raloxifene was evaluated by comparing the values of bone mineral density (BMD) , bone strength,histomorphometric measurement and osteoclast number between the raloxifene treated group and placebo group.Results As compared with placebo group osteoporotic manifestations were improved in OPG-/- female mice treated with raloxifene orally. BMD was increased both in lumbar vertebrae (P<0.05) and femurs (P<0.01).Bone strength was measured in femurs by three-point bending test and vertebrae by stress test. Results showed that ultimate load, ultimate stress and Young's modulus were increased both at lumbar and femur bone, suggesting decreased risk of fracture. Tartrate-resistant acid phosphatase, a marker enzyme of osteoclasts, was detected, and the number of osteoclasts declined significantly after the treatment of raloxifene. At the same time, results of histomorphometric measurements indicated that bone trabecular volume was increased and bone formation rate decreased from(8.05±4.02)mm3·mm-2·year-1 to (5.48±1.89)mm3·mm-2· year-1(P＜0.05).These findings were found in the group of OPG-/- female mice treated with reloxifene but not in male mice. Conclusions Raloxifene is effective in treating osteoporosis in female OPG-/- mice, indicating that its action is at least in part independent of OPG gene. But it is ineffective in male OPG-/- mice.
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Objective To observe the bone density, serum osteoprotegerin (OPG) level,relevant parameters of bone metabolism and sex hormones in elderly men with osteoporosis before and after treatment with oral Fosamax for 3 years. Methods The serum OPG level was compared between 72 randomly selected elderly male patients with osteoporosis and age-matched healthy controls. The bone density, serum OPG level, sex hormones, serum calcium and phosphorus,parathyroid hormone (PTH), osteoealein and urine type Ⅰ collegen crosslinked N-telopeptides (NTX),urine calcium and cretinine were tested in all elderly male patients with osteoporosis before and after 3 years of oral Fosamax treatment. The role of OPG in anti-osteoporotic therapy was studied by comparison of the parameters tested during the course of treatment. Results The serum levels of OPG osteoealcin, PTH and urine NTX were obviously higher in elderly men with osteoporosis than in healthy controls [(10.56±2.56) pmol/L vs. (8.91±2.20) pmol/L, (9.544±4.40) g/L vs. (6.774±2.87)rig/L, (70.39±35.58) ng/L vs. (47.11±21.80) ng/L, (72.06±9.78) nmol/L vs. (63.36±14.61)nmol/L, all P<0.05]. After treatment with oral Fosamax , the bone density was significantly increased. However, serum levels of OPG[(8.23±2.96)pmol/L], osteocalcinE(6.18±2.27)μg/L],PTH[(40.46±14.43) ng/L] and urine NTX[(64.83±11.40) nmol/L] were significantly decreased after treatment (all P<0.05). Spearman analysis showed that the improvement of bone density after treatment was closely associated with serum OPG level. Conclusions Serum OPG level in elderly patients with osteoporosis is much higher than that in control group. The improvement in bone density after treatment is associated with the decrease in OPG level. Bone density and relevant parameters of bone metabolism can be improved in elderly male patients with osteoporosis by using oral Fosamax.
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Objective To analyze the pregnancy outcomes and measures to prevention and cure for pregnancy women with pulmonary hypertension.Methods Clinical data of 40 women with pulmonary hypertension were analyzed and they were divided into three groups on the basis of Doppler transthoracic echocardiography detections.Results(1)The proportions of rheumatic heart disease and congenital heart disease were 22.64% and 45.38%;8 cases appeared with the perinatal heart disease and 5 cases' hearts structure were normal.(2)49 cases applied cesarean section and 2 delivery naturally.2 women were induction of labour in second trimester.In midrange and severity groups,prematurity and small gestational age were significently higher than those of gentle group.(3)3 women died of congestive heart failure and pulmonary embolism.6 women were treated by SICU and physician because of serious illness.Conclusion Women with midrange and severely pulmonary hypertension should avoid pregnancy.Pregnant women with pulmonary hypertension needed monitor closely and being treated with pulmonary vasodilator added decoagulant would improve outcomes of mather and infant.
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Objective To explore the curative effect and indication in coverage of the thumb soft tissue defect by five kinds of minute flaps. Methods From January 1998 to March 2003, 52 cases with skin and soft tissue defect of the thumb were treated by five different kinds of flaps: 5 underwent the wrapping flap with nail from the big toe, 15 with the reversible thumb dorso-ulnar artery island flap, 10 with the thenar flap, 8 with the lateral digital island flap, 14 with the index finger dorsal island flap. There were 40 males and 12 females, aged from 17 to 35 years (average, 25 years). The maximum area of the repair flap was 5.0 cm?2.5 cm, and the minimum area was 2.0 cm?1.5 cm. Results All flaps survived. After 6 to 36 months postoperative follow-up, with an average of 20 months. The blood supply and texture of the flaps were excellent, their outer aspect and function were satisfactory. Among 46 cases of flaps with their proper or connecting nerves, the average distance of the two-point discrimination was 5.8 mm in the wrapping flap with nail from the big toe, 8.5 mm in the reversible thumb dorso-ulnar artery island flap, 7.0 mm in the thenar flap, 6.2 mm in the lateral digital island flap, 8.8 mm in the index finger dorsal island flap. Of the 6 cases that the nerves were not connected, the healed flaps had only the pain and touch sensation, the two-point discrimination was poorly recovered. Conclusion The five kinds of flaps are safe and reliable for repairing thumb soft tissue defect, among which the wrapping flap with nail from the big toe and the lateral digital island flap have the advantage of the best sensation recovery, the reversible thumb dorso-ulnar artery island flap and the thenar flap are easy to perform with minimum damage. Better curative effect can be obtained by choosing different flaps according to the site of tissue defect.
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Purpose:To study the changes of t-PA ?u-PA expression and fibrinolysis molecular mark ers in patients with gastric or intestinal cancer in order to elucidate their cl inical significance. Methods:The plasma levels of t-PA ?u-PA ?u-PAR and PAP were measured by ELISA . Gen e transcription of t-PA?u-PA mRNA were detected by Real-time RT-PCR. Results:The plasma levels of u-PA?u-PAR and PAP were elevated in gastric or intestina l cancer patients ,while u-PA was markedly elevated in patients with local infi ltration?lymph node involvement or distal metastasis. u-PA mRNA was higher and t-PA was lower in gastric or intestinal cancer compared to normal tissue. Conclusions:Hyperfibrinolysis was an important factor related with m etastasis potential of gastric or intestinal cancer. t-PA may be a character of well differentiated tissue.