妇科肿瘤患者化疗后骨髓Ⅳ级抑制的护理

通过１４例妇科肿瘤患者化疗后骨髓Ⅳ级抑制的护理,探讨在无隔离层流室的条件下医疗护理的信度和效度,经过护理人员的精心护理和医疗干预,除２例病情好转后放弃继续治疗外,１２例均痊愈出院,说明只要及早发现并对高危因素进行评估,采取积极的措施,化疗后骨髓Ⅳ级抑制是能得到控制和康复的。     

Influence of different sports on bone mass in growing girls

The aim of this study was to analyse whether there are differences in bone mass in girls playing different sports. Two hundred girls (10.6 ± 1.5 years old, Tanner stages I–III) participated in the study and were divided into groups of 40 (swimmers, soccer players, basketball players, handball players and controls). Bone mineral content and bone mineral density (BMD) (whole body and hip) were measured using dual-energy X-ray absorptiometry. The degree of sexual development was determined using Tanner test, and physical activity habits were recorded through a questionnaire designed ad hoc for this research. Girls were divided by pubertal stage and the type of sport. In the prepubertal group, intertrochanteric BMD was significantly higher in both handball and soccer players compared with the control group (P < 0.05). Furthermore, in the pubertal group, total BMD, mean arms BMD, pelvis BMD, femoral neck BMD, intertrochanteric BMD and Ward’s triangle BMD were significantly higher in soccer and handball players compared with the control group (P < 0.05), and the swimmers showed significantly higher values in the mean arms BMD compared with the control group (P < 0.01). Our data suggest that sport practice during puberty, especially in activities that support the body weight, may be an important factor in achieving a high peak bone mass and improving bone health in girls.     

上、下坡跑台运动对去卵巢小鼠骨密度及骨组织形态计量学指标的影响

目的:以去卵巢手术小鼠模拟妇女绝经后骨质疏松症状,对比研究上、下坡跑台运动对于去卵巢小鼠骨密度和骨组织结构的影响。方法:32只8周龄C57 BL/6雌性小鼠随机分为4组:假手术安静组(SHAM)、去卵巢安静组(OVX)、去卵巢上坡跑组(OVX+UP)和去卵巢下坡跑组(OVX+DOWN)。SHAM组小鼠行去卵巢假手术,其余3组小鼠均摘除卵巢。训练方案:OVX+UP组进行上坡跑训练而OVX+DOWN组进行下坡跑训练,每次40min,每周训练5次,共训练8周。8周后取左侧股骨和胫骨检测其干骺端骨密度,取右侧胫骨和第3腰椎做硬组织切片,检测其组织形态计量学指标。结果:与SHAM组相比,OVX组小鼠股骨和胫骨干骺端骨密度显著下降,胫骨和第3腰椎组织形态计量学指标也出现骨质疏松性变化;两运动组小鼠股骨和胫骨干骺端骨密度比OVX组小鼠明显提高,胫骨和第3腰椎组织形态计量学指标也比OVX组明显改善,且OVX+DOWN组比OVX+UP组的效果更明显。结论:跑台运动可有效预防小鼠去卵巢后骨质疏松症的发生,且下坡跑运动比上坡跑运动更有效。     

湖北地区正常成年人群桡骨远端定量超声测量的临床应用研究

采用以色列Sunlight Omnissense8000s超声骨密度仪,对湖北省1186名年龄在20-80岁之间的正常成年人,进行超声骨密度测定。按不同性别、年龄组进行统计学分析。结果显示男、女桡骨远端SOS峰值（Peak bone mass,PBM）出现的年龄段均为40-49岁,此后都随年龄的增长而下降。各年龄段男女...     

长期进行10000m跑对男大学生骨骼代谢的影响

目的:探讨长期进行10 000m跑对我国男大学生骨骼代谢带来的影响。研究对象:男性大学生15人。方法:男性大学生长期进行10 000m跑(6个月,每周1次),监测并对比实验前后与骨骼代谢相关的生理生化指标变化。结果:在身体特征中,训练前后的体重、体脂率、体脂量、腹部脂率、肌肉量上有着显著性差异;骨骼代谢标记变化中,降血钙素、甲状旁腺激素、碱性磷酸酶比训练前有细微的变化但没有显著性差异,而骨钙素显著性减少,脱氧吡啶啉显著性增加;磷在血液和尿液中显著性减少,但是钙没有减少,也没有显著性差异。结论:长期进行适宜运动强度的10 000m跑对我国男大学生骨骼代谢有着积极的锻炼意义。     

长期递增负荷跑台对大鼠骨髓Pro B细胞、Pre B细胞发育的影响

目的:探讨运动性免疫失衡对骨髓B细胞分化、发育的影响。方法:SPF级雄性SD大鼠128只,随机分成绝对安静组(Absolute control,C)组,运动前安静组(Control,A)、运动后即刻组(ImmediateI,)、运动后3h组(3 Hours,3H),进行6周递增负荷跑台运动,分别在第0、2、46、周用流式细胞术检测其骨髓中Pro B、Pre B细胞数量及凋亡率。结果:六周递增负荷运动过程中,在第0周pro B、pre B细胞数量及凋亡率均没有显著性变化。第2周J组,pro B数量呈显著性下降(P<0.05),pre B呈非常显著性下降(P<0.01),3H组基本恢复到A组(P>0.05)。4周J组6、周J组pro B、pre B呈显著性下降(P<0.05),3H组基本恢复到A组,而同一时相的凋亡率变化则呈相反趋势。结论:提示六周递增运动过程中,机体根据运动需要,通过改变凋亡率,进而改变早期发育中B细胞的数量百分比,以求尽可能维持免疫稳态;并发现pre B细胞对运动负荷更敏感,易受运动的刺激而发生凋亡,细胞数量百分比显著性下降。     

Determinants of bone mineral density in patients on haemodialysis or peritoneal dialysis – a cross-sectional,longitudinal study

Introduction:

The aim of the study was to identify biomarkers of alteration in bone mineral density (BMD) in patients on haemodialysis (HD) and peritoneal dialysis (PD).

Materials and methods:

In a cross-sectional, longitudinal study dual-energy X-ray absorptiometry scans were performed in 146 HD-patients and 28 PD-patients. Follow-up after 14 months (mean) was conducted in 73 patients. As potential biomarkers we investigated parathyroid hormone (PTH), 25-hydroxy vitamin-D, ionised calcium, albumin, phosphate, and total alkaline phosphatases (t-ALP).

Results:

Both groups of dialysis patients had lower BMD in the femoral neck (BMD_neck) (P < 0.001) and forearm (BMD_forearm) (P < 0.001) compared to healthy controls, but comparable BMD in the lumbar spine (BMD_spine). BMD did not differ between dialysis types, but patients ever-treated with glucocorticoids had significantly lower BMD, while patients with polycystic kidney disease had higher BMD. BMD correlated with body weight, actual age, age at initiation of dialysis, duration of dialysis and levels of PTH and t-ALP. However, t-ALP only remained associated with low BMD_spine after adjusting for other factors (P = 0.001). In the follow-up study all patients had decreased BMD in all three locations, but only for the lumbar spine there was a significant association between BMD and the bone markers t-ALP (P = 0.009) and PTH (P = 0.013).

Conclusions:

Both HD and PD patients have low BMD, and increased concentrations of t-ALP is associated BMD_spine after adjustment, while PTH and t-ALP is associated with decrease in BMD_spine over time. This substantiates the use of these biomarkers in both types of dialysis patients.     

New insights in professional horse racing; “in-race” heart rate data,elevated fracture risk,hydration, nutritional and lifestyle analysis of elite professional jockeys

Weight-making practices have been shown to impair musculoskeletal and physiological function of jockeys. This study investigated the “in-race” heart rate (HR) responses and hydration status during competitive racing, as well as selected physiological and lifestyle parameters of professional jockeys based in Hong Kong. “In-race” HR responses and early morning hydration status of 20 male jockeys were examined in hot and moderate climactic occasions. Additionally, bone mineral density (BMD), dietary intake and lifestyle choices were assessed. Osteopenia was observed in the calcanei of jockeys (left: 0.51 ± 0.06; right: 0.46 ± 0.12 g · cm^?2). Energy and protein intake were significantly lower on a race day compared to a non-race day (P < 0.05). “In-race” HR_max values were similar to those from VO_2max laboratory tests (186 ± 14 vs. 185 ± 8 bpm). Hypohydration was observed on both racing days. (USG: 1.0247 ± 0.006 and 1.0256 ± 0.0258 mg · L^?1 for hot and moderate conditions, respectively). Sauna usage (25.5%) and food restriction (20.4%) were the most common weight-making practices. Current lifestyle choices of jockeys result in suboptimal bone health, hydration status and nutritional intake, which can significantly enhance the fracture risk. Further research should develop exercise and nutrition guidelines for optimising their skeletal health.     

2~6年室内游泳训练对儿童骨量影响的研究*

目的 青春期是骨质疏松初级预防的重要时期;游泳作为一种非负重运动方式,对改善青少年骨量方面的作用有待证实.研究通过对2~6年室内游泳训练儿童骨量的研究,探讨长期室内游泳训练对骨量的影响.方法 研究运用定量超声骨强度仪对招募的20名长期系统室内游泳训练(平均训练年限4.3±1.7年)的儿童(游泳组)和20名无训练史的普通儿童(普通组),进行骨强度测试.结果 游泳组身高高于普通组(145.5±11.3,142.3±15.1;P>0.05)、体重低于普通组(36.1±9.1,39.25±17.0;P>0.05)、BMI低于普通组(16.8±2.3,18.8±4.7;P>0.05).游泳组SOS值(3738±92m/s)显著低于普通组(3824±52 m/s),经T检验两组间存在显著性差异P<0.05.游泳组骨量百分位数(游泳组61.55%±25.07%、普通组84.25%±12.30%;P<0.05)和Z-值(游泳组0.33±0.80、普通组1.14±0.54;P<0.05)均显著低于普通组.对Z-值的具体分析发现,游泳组有6人(33.3%)骨量低于平均基线水平,普通组骨量均高于平均基线水平.相关分析显示,游泳组SOS值与身高(r=0.628,P<0.05)和体重(r=0.551,P<0.05)存在中度相关,与其它指标无显著相关;普通组SOS值与其它指标无显著相关(P>0.05).结论 长期的系统游泳训练可有助于青少年获得更理想的身体质量.长期室内游泳训练将引起青少年骨量减少;长期室内游泳训练产生的骨量减少,会对身高和体重的发展产生影响.     

基于选择性激光烧结的骨组织仿生支架

This paper introduces a technical method by which bone tissue bionic scaffolds are fabricated on a selective laser sintering machine. It also analyses determinative factors in fabricating porous structure using this method, and proposes a new technique to fabricate porous structure by rapid prototyping method.