An easy way to determine bone mineral density and predict pelvic insufficiency fractures in patients treated with radiotherapy for cervical cancer.

PURPOSE: The aim of this study was to investigate whether bone mineral density (BMD) as measured in planning computed tomographies (CTs) by a new method is a risk factor for pelvic insufficiency fractures (PIF) after radio(chemo)therapy (R(C)T) for cervical cancer. METHODS: 62 patients with cervical cancer who received definitive or adjuvant radio(chemo)therapy between 2013 and 2017 were reviewed. The PIF were detected on follow-up magntic resonance imaging (MRI). The MRI of the PIF patients was registered to the planning CT and the PIF contoured. On the contralateral side of the fracture, a mirrored structure of the fracture was generated (mPIF). For the whole sacral bone, three lumbar vertebrae, the first and second sacral vertebrae, and the PIF, we analyzed the BMD (mg/cm3), V50Gy, Dmean, and Dmax. RESULTS: Out of 62 patients, 6 (9.7%) had a fracture. Two out of the 6 patients had a bilateral fracture with only one of them being symptomatic. PIF patients showed a significantly lower BMD in the sacral and the lumbar vertebrae (p < 0.05). The BMD of the contoured PIF, however, when comparing to the mPIF, did not reach significance (p < 0.49). The difference of the V50Gy of the sacrum in the PIF group compared to the other (OTH) patients, i.e. those without PIF, did not reach significance. CONCLUSION: The dose does not seem to have a relevant impact on the incidence of PIF in our patients. One of the predisposing factors for developing PIF after radiotherapy seems to be the low BMD. We presented an easy method to assess the BMD in planning CTs.

The Effects of Soy Milk Enriched with Lactobacillus casei and Omega-3 on the Tibia and L5 Vertebra in Diabetic Rats: a Stereological Study.

Bone fragility, despite relatively high BMD values, is an important complication related to insulin resistance and oxidative stress in diabetes mellitus type 1. The present study aimed to compare the effects of soy milk (SM), soy milk containing Lactobacillus casei (PSM), and soy milk enriched with Lactobacillus casei and omega-3 (OPSM) on the stereology of the tibia and vertebra, and antioxidant activity in type 1 diabetic rats. Sixty-five male Sprague Dawley rats were randomly assigned into 5 groups of 13 animals each. Diabetes was induced by a single injection of STZ (60 mg/kg); two control groups (non-diabetic: CN and diabetic: CD) were selected and then fed with 1 mL of distilled water. Three treatment groups were fed 1 ml of SM, PSM, and OPSM via intragastric gavage for 60 days. Treatment with SM, PSM, and OPSM significantly decreased (P < 0.05) the number of the osteoclasts in both tibia and L5 vertebra, and plasma alkaline phosphatase level. Also, the osteoblast number, calcium level, catalase activity, and total antioxidant capacity were increased in the SM, PSM, and OPSM groups compared to the STZ group. OPSM had the greatest effects on the stereological and biochemical parameters compared to the SM and PSM groups. Soy milk combination with Lactobacillus casei and omega-3 can ameliorate the stereological changes in the tibia and vertebra. In addition, this combination increased the antioxidant activity and improved the redox homeostasis in diabetic rats. These results suggest the potential role of soy milk containing Lactobacillus casei enriched with omega-3 in preventing and delaying osteoporosis in diabetic patients.

[Bone-length measurement at low back and its application].

By reviewing some acupuncture literature regarding the settings of bone-length measurement at low back, it was found out that ancient and modern descriptions were not consistent. In China current acupuncture textbook, it was mostly described as "the horizontal distance between inner borders of two scapulas was 6 cun". However, after analysis, it was believed that this setting was not reasonable in the clinical application of acupuncture, and it was agreed with the opinion that "midpoint of inner borders of two scapulas when scapulas are in abduction position" should be taken as bone-length measurement of low back. Besides, a self-made bone-length scale was applied to locate acupoint at low back, which could provide references for its standardized application manipulation.

High-Dose α-Tocopherol Supplementation Does Not Induce Bone Loss in Normal Rats.

Oxidative stress affects bone turnover. Preventative effects of antioxidants such as vitamin E on reduced bone mineral density and fractures associated with aging, osteoporosis, and smoking have been examined in animals and humans. The effects of vitamin E (α-tocopherol; αT) on bone health have yielded conflicting and inconclusive results from animal studies. In this study, to determine the bone effects of αT, we investigated the in vivo effects of αT on the bone mineral density, bone mass, bone microstructure, bone resorption, and osteogenesis through peripheral quantitative computed tomography (pQCT) measurements, micro-computed tomography (micro-CT) analyses, and bone histomorphometry of lumbar vertebrae and femurs in normal female Wistar rats fed diets containing αT in different quantities (0, 30, 120, or 600 mg/kg diet) for 8 weeks. To validate our hypotheses regarding bone changes, we examined ovariectomized rats as an osteoporosis model and control sham-operated rats in parallel. As expected, ovariectomized rats had reduced bone mineral density in lumbar vertebrae and the distal metaphyses of their femurs, reduced bone mass and deteriorated microstructure of cancellous bones in the vertebral body and distal femur metaphyses, and reduced bone mass due to resorption-dominant enhanced bone turnover in secondary cancellous bones in these sites. In comparison, αT administered to normal rats, even at the highest dose, did not induce reduced bone mineral density of lumbar vertebrae and femurs or a reduced bone mass or fragile microstructure of cancellous bones of the vertebral body and distal femur metaphyses. Instead, αT-fed rats showed a tendency for an osteogenesis-dominant bone mass increase in secondary cancellous bones in the vertebral body, in which active bone remodeling occurs. Thus, αT consumption may have beneficial effects on bone health.

[Colorectal nociceptive signal input facilitates impact of acupoint stimulation of "Zusanli" (ST 36) on electrical activities of wide dynamic range neurons in lumbar spinal cord in rats].

OBJECTIVE: To observe changes of electrical activities of wide dynamic neurons (WDR) in the lumbar spinal cord after electroacupuncture (EA) stimulation of "Zusanli" (ST 36) during colorectal distension in rats, so as to analyze alternations of acupoint's functions under pathological conditions. METHODS: Experiments were performed in male Sprague-Dawley rats. Visceral nociceptive information input was generated by colorectal distension (CRD). Extracellular discharges of WDR neu- rons in the dorsal horns of L(1-3) spinal cord were recorded using glass micropipettes and a microelectrode amplifier. EA stimulation (15 Hz, 1, 4, 7, 10 mA) was applied to ipsilateral "Zusanli" (ST 36) area. RESULTS: A total of 40 neurons were recorded in the present study. Under no CRD conditions, the firing rates of WDR neurons were significantly increased by (18.12 +/- 13.56)% (1 mA), (152.38 +/- 36.19)% (4 mA), (231.21 +/- 49.74)% (7 mA) and (331.54 +/- 61.89)% (10 mA) respectively after EA sti- mulation of ST 36. Under CRD conditions, the firing rates of these WDR neurons were increased by (226.78 +/- 39.59)% (1 mA), (282.80 +/- 47.54)% (4 mA), (343.06 +/- 58.35)% (7 mA), and (338.62 +/- 80.04)% (10 mA) respectively after EA stimulation. It showed a considerablely increased sensitivity of electrical activities of WDR neurons to EA stimulation during CRD nociceptive stimulation. CONCLUSION: colorectal distension (visceral nociceptive stimulation) can strengthen the sensitivity of acupoint-EA stimulation-induced increase of firing rates of WDR neurons in the dorsal horns of the lumbar spinal cord in rats, suggesting a potentiation of the acupoint action under visceral nociceptive signal inputs.

[Association between bone turnover markers, bone mineral density and vitamin D in Moroccan postmenopausal women]. / Association entre les marqueurs du remodelage osseux, la densité minérale osseuse et le statut vitaminique D chez des femmes ménopausées d'origine marocaine.

UNLABELLED: The aim of the study is to find the correlation between bone turnover markers and bone mineral density in a cohort of Moroccan postmenopausal women. PATIENTS AND METHODS: A cross-sectional study, conducted over a period of 12 months from October 2008 to November 2009. Five hundred Moroccan postmenopausal women volunteers participated in this study and we included only 185. RESULTS: In this cohort of 185 women, average age 60 years, the percentage of osteoporotic women was 35.7%, they were older 62.09 (9.13) years and they had an average of the body mass index (BMI), the lowest 29.58 (4.45). The values of the bone mineral density (BMD) measured at the lumbar spine correlated positively and significantly with BMI (P<0.001), serum calcium (P=0.026), negatively with age (P<0.001) and osteocalcin (OC) (P=0.0033). As for the results of BMD measured at the femoral neck, they show a negative and highly significant correlation with age (P<0.001) and osteocalcin. Looking for an association between the biochemical markers of bone remodeling, a weak positive correlation was found between the calcium (Ca) and alkaline phosphatase (PAL) on the one hand and Ca and intact parathyroid hormone (PTHi) in the other hand. And a significant positive correlation was found between PTHi and PAL, and between PTHi and OC. Finally, a significant positive correlation was found between the cross-laps (ß-CTX) and Ca and between PAL and OC. CONCLUSION: Our results are in agree to some international studies and disagree to others.

The Canadian Home Total Parenteral Nutrition (HTPN) Registry: vitamin K supplementation and bone mineral density.

BACKGROUND: Vitamin K supplementation improves bone health, and its absence might be associated with low bone mineral density (BMD). The authors aim to assess vitamin K supplementation practices in Canadian home parenteral nutrition (HPN) programs and their relationship with BMD. METHODS: This is a cross-sectional study of 189 patients from the Canadian HPN registry. RESULTS: All 189 patients studied received M.V.I.-12, which does not contain vitamin K. Of those, 41.3% were supplemented with 10 mg of intravenous vitamin K (VK+) weekly, whereas the others did not receive vitamin K except via lipid emulsion (VK-). Short bowel syndrome accounted for 69% of VK+ and 46% of VK- patients. On univariate analysis, VK+ patients had substantially lower body mass index (BMI) and received lower bisphosphonate infusion than did VK-patients. There were no statistically significant differences in HPN calcium or lipid content, liver function test results, age, sex, or reason for HPN between the 2 groups. Patients who were VK+ had higher lumbar spine T scores and hip T scores than did VK-patients. General linear modeling analysis, adjusted for BMI, age, PN magnesium, PN phosphate, PN calcium, and bisphosphonate as possible predictors of BMD, showed a trend toward better hip T scores (P = .063) for VK+ patients compared with VK- patients. CONCLUSION: In HPN patients supplemented with vitamin K, the trend toward a better hip BMD compared with no supplementation suggests a role for vitamin K in preserving BMD. This requires further study.

Effect of tetracalcium dimagnesium phytate on bone characteristics in ovariectomized rats.

The aim was to evaluate the influence of dietary Ca-Mg-phytate consumption on the bone characteristics of ovariectomized rats, an animal model for postmenopausal osteoporosis. Twenty ovariectomized female Wistar rats were randomly assigned to two groups fed, respectively, with a non-phytate diet (AIN-76A) or the same diet enriched with 1% phytate (as the calcium magnesium salt, phytin). After 12 weeks of feeding the rats were sacrificed, and both femoral bones and L4 vertebra were removed from each rat. Bone mass, length, width, volume, and mineral density were measured, and the phosphorus, calcium, magnesium, and zinc contents of bones were determined. Deoxypyridinoline (a bone resorption marker) was measured in urine, and osteocalcin (a bone formation marker) was measured in serum. The calcium and phosphorus contents and bone mineral density were significantly higher in both femoral bones and L4 vertebra for phytate-treated rats in comparison to rats in the non-phytate group. Deoxypyridinoline was significantly increased in rats in the non-phytate treatment group. Ca-Mg-phytate consumption reduces bone mineral density loss due to estrogen deficiency. Thus, phytate exhibits effects similar to those of bisphosphonates on bone resorption and may be of use in the primary prevention of osteoporosis if larger studies in humans confirm these findings.

A food supplement of hydrolyzed collagen improves compositional and biodynamic characteristics of vertebrae in ovariectomized rats.

Collagen hydrolysates (CHs) are mixtures of peptides obtained by partial hydrolysis of gelatins that are receiving scientific attention as potential oral supplements for the recovery of osteoarticular tissues. The effect of supplementing the diets with a CH was assessed in 48 ovariectomized rats by analyzing the compositional and biomechanical characteristics of the bone. Six groups of rats (three ovariectomized, one sham-operated, and two intact) were fed a standard diet, supplemented with either CH or gelatin (Control), at two levels: a dose equivalent to five times the amount suggested for humans (10 g/day) or another 10 times greater. After 8 weeks, the femora and vertebrae were excised, the blood was collected, and serum alkaline phosphatase and osteocalcin were determined. Bone weight, total protein, and biomechanical strength were also determined. The vertebrae of the ovariectomized group that received the higher dosage of CH withstood a load four times greater and exhibited higher levels of protein and osteocalcin content than those receiving either gelatin or no supplement. CH supplementation at the higher level in the ovariectomized rat had an unequivocal contribution in the conservation or preservation of vertebral mass, protein content, and mechanical strength not seen when gelatin was used as a supplement. Similar treatment of the intact rat with the CH, however, appeared to have the opposite effect.

Effect of soy isoflavone extract supplements on bone mineral density in menopausal women: meta-analysis of randomized controlled trials.

This study was conducted to clarify the effect of ingesting soy isoflavone extracts (not soy protein or foods containing isoflavones) on bone mineral density (BMD) in menopausal women. PubMed, CENTRAL, ICHUSHI, CNKI, Wanfang Data, CQVIP, and NSTL were searched for randomized controlled trials published in English, Japanese, or Chinese reporting the effects of soy isoflavone extracts on lumbar spine or hip BMD in menopausal women. Trials were identified and reviewed for inclusion and exclusion eligibility. Data on study design, participants, interventions, and outcomes were extracted. Eleven, seven, five, and five trials were finally selected for estimation of the effects on spine, femoral neck, hip total, and trochanter BMD, respectively. Meta-analysis including data from1240 menopausal women revealed that daily ingestion of an average of 82 (47-150) mg soy isoflavones (aglycone equivalent) for 6-12 months significantly increased spine BMD by 22.25 mg/cm2 (95% CI: 7.62, 32.89; p=0.002), or by 2.38% (95% CI: 0.93, 3.83; p=0.001) compared with controls (random-effects model). Subgroup analyses indicated that the varying effects of isoflavones on spine BMD across trials might be associated with study characteristics of intervention duration (6 vs. 12 months), region of participant (Asian vs. Western), and basal BMD (normal bone mass vs. osteopenia or osteoporosis). No significant effects on femoral neck, hip total, and trochanter BMD were found. Soy isoflavone extract supplements increased lumbar spine BMD in menopausal women. Further studies are needed to address factors affecting the magnitudes of effect on spine and to verify the effect on hip.

Infusion of ibandronate once every 3 months effectively decreases bone resorption markers and increases bone mineral density in Chinese postmenopausal osteoporotic women: a 1-year study.

The efficacy and safety of intravenous ibandronate were evaluated in postmenopausal osteoporosis women in China. In this multicenter, positive drug-controlled study, 158 postmenopausal osteoporotic women were randomized to receive 2 mg ibandronate given intravenously once every 3 months or 70 mg alendronate given orally once per week. All women also received supplemental calcium (500 mg) and vitamin D (200 IU) daily. One hundred fifty-one patients completed the 1-year study. Ibandronate produced mean increases in bone mineral density (BMD) by 4.27% at the lumbar spine, 3.48% at the femoral neck, and 2.03% at the trochanter. Mean increases in BMD by 4.24% at the lumbar spine, 2.72% at the femoral neck, and 2.99% at the trochanter were observed in the alendronate group. No significant difference was found between the two groups in BMD in all sites measured. Significant decreases in serum c-telopeptide of type I collagen (CTX) and alkaline phosphatase (ALP) were found in the two groups after 1 and 3 months of treatment, respectively; these serum CTX and ALP levels were then maintained at the decreased levels throughout the study period (12 months). No changes of stature were found in the patients of the two groups. Adverse events were similar in the two groups, except more mild muscle pain was observed in the first month after infusion of ibandronate than with oral alendronate (P < 0.001). The results observed in Chinese patients may support the observation that intravenous ibandronate significantly reduced bone resorption and increased BMD with good tolerance in Chinese postmenopausal osteoporotic women. Use of intravenous ibandronate possibly could potentially improve compliance as compared with other oral bisphosphonates because it may avoid the peptic side effects of oral bisphosphonate.

Effects of 3,3',4,4',5-pentachlorobiphenyl (PCB126) on vertebral bone mineralization and on thyroxin and vitamin D levels in Sprague-Dawley rats.

The aim of the present study is to use Fourier transform infrared spectrometry (FTIR), and transmission electron microscopy (TEM) techniques, to make a more detailed description of toxic effects of 3,3',4,4',5-pentachlorobiphenyl (PCB126) on bone tissue at the microstructural and at the molecular level as a result of an altered bone metabolism. We have analysed potential changes on vitamin D and thyroxin serum levels since these hormones represent endocrine endpoints that are critical for bone growth and development. For this purpose Sprague-Dawley rats were exposed (n=10) to PCB126 (i.p.) for 3 months (total dose, 384microg/kg bodyweight), while control rats (n=10) were injected with corn oil (vehicle). Results from FTIR showed that vertebrae from the exposed rats had an overall lower degree of mineralization (-8.5%; p<0.05) compared with the controls. In addition, results from peripheral quantitative computed tomography (pQCT) analyses showed significant increases in the trabecular bone mineral density (+12%; p<0.05) in the exposed group compared with the controls. The TEM analyses also showed an alteration in the crystallinity properties of vertebral bone mineral with a significant decrease in the size and crystallinity of apatite crystal forming the bone tissue in the exposed vs. non-exposed rats. Serum analysis revealed lower levels of thyroid hormones, FT4 (-42%; p<0.005), TT4 (-26%; p<0.005), and vitamin D (-21%; p<0.005) in exposed group compared to control animals. The complementary techniques (TEM and FTIR) used in this study have revealed insights into possible bone mineralization alteration due to PCB126 exposure. The lowering of both the thyroxin and vitamin D serum levels might be an underlying explanation for the observed effects on bone mineralization.

Standard multivitamin supplementation does not improve vitamin D insufficiency after burns.

Children suffering severe burns develop progressive vitamin D deficiency because of inability of burned skin to produce normal quantities of vitamin D(3) and lack of vitamin D supplementation on discharge. Our study was designed to determine whether a daily supplement of a standard multivitamin tablet containing vitamin D(2) 400 IU (10 microg) for 6 months would raise serum levels of 25-hydroxyvitamin D [25(OH)D] to normal. We recruited eight burned children, ages 5-18, whose families were deemed reliable by the research staff. These children were given a daily multivitamin tablet in the hospital for 3 months in the presence of a member of the research staff and then given the remainder at home. At 6 months, the subjects returned for measurements of serum levels of 25(OH)D,1,25-dihydroxyvitamin D [1,25(OH)(2)D], intact parathyroid hormone (iPTH), Ca, P, albumin, and total protein as well as bone mass by dual energy X-ray absorptiometry. Serum 25(OH)D levels were compared to a group of seven age-matched burned children studied at an earlier date without the vitamin supplement but with the same method of determination of 25(OH)D at 6 months post-burn. In addition, the chewable vitamins were analyzed for vitamin D(2) content by high performance liquid chromatography. Serum concentration of 25(OH)D was 21 +/- 11(SD) ng/ml (sufficient range 30-100) with only one of the eight children having a value in the sufficient range. In comparison, the unsupplemented burn patients had mean serum 25(OH)D level of 16 +/- 7, P = 0.33 versus supplemented. Serum levels of 1,25(OH)(2)D, iPTH, Ca, P, albumin, and total protein were all normal in the supplemented group. Vitamin D(2) content of the chewable tablets after being saponified and extracted was 460 +/- 20 IU. Bone mineral content of the total body and lumbar spine, as well as lumbar spine bone density, failed to increase as expected in the supplemented group. No correlations were found between serum 25(OH)D levels and age, length of stay, percent body surface area burn or third-degree burn. Supplementation of burned children with a standard multivitamin tablet stated to contain 400 IU of vitamin D(2) failed to correct the vitamin D insufficiency.

Flaxseed combined with low-dose estrogen therapy preserves bone tissue in ovariectomized rats.

OBJECTIVE: Flaxseed is rich in lignans and alpha-linolenic acid, compounds that may promote healthy skeletons. Many postmenopausal women consume complementary health products such as flaxseed or its components in addition to pharmacological agents such as low-dose estrogen therapy for additional support for menopausal symptoms and related conditions. However, their combined effect on bone health is unknown. The aim of this study was to determine the effects of 10% dietary flaxseed, low-dose estrogen therapy, or their combination on bone mineral density, biomechanical strength, and skeletal fatty acid composition in an ovariectomized rat model of postmenopausal osteoporosis. METHODS: Ovariectomized rats received (1) basal diet (negative control), (2) 10% flaxseed, (3) low-dose estrogen implant (13 microg, 90 day release), or (4) flaxseed + low-dose estrogen implant for 12 weeks. A sham-operated group was included as a positive control. Bone mineral density, biomechanical strength, and fatty acid composition were measured at multiple skeletal sites. RESULTS: Flaxseed + low-dose estrogen therapy resulted in the highest bone mineral density and peak load at the lumbar vertebrae, with no effect on bone mineral density or strength in the tibia and femur. Flaxseed and flaxseed + low-dose estrogen therapy resulted in significantly higher relative levels of alpha-linolenic acid and eicosapentaenoic acid and lower levels of linoleic acid, arachidonic acid, and n-6/n-3 ratio in the lumbar vertebrae and tibia compared with all other groups. CONCLUSION: Flaxseed + low-dose estrogen therapy provides the greatest protection against ovariectomy-induced bone loss at the lumbar vertebrae. Moreover, this study is the first to demonstrate that flaxseed, rich in alpha-linolenic acid, alters fatty acid composition in the ovariectomized rat skeleton.

Sickle cell bone disease: response to vitamin D and calcium.

Bone disease with osteoporosis and osteomalacia are common in sickle cell disease (SCD). Some patients have vitamin D deficiency and low bone mineral density (BMD). The role of vitamin D and calcium supplementation to restore bone health in SCD has not been well studied. In 14 adults with SCD, we measured 25(OH)D (25-hydroxyvitamin D) and BMD at the femoral neck, lumbar spine, and distal third of the ulna plus radius, along with markers of bone resorption (CTx; C-terminal component of pro-collagen type I) and bone formation (osteocalcin) before and after 12 months of vitamin D(2) and calcium carbonate treatment. Pretreatment, all patients were vitamin D deficient with a mean 25(OH)D level of 11.6 [corrected] +/- 4 [corrected] ng/ml, had low BMD at the lumbar spine (L-spine), 0.87 +/- 0.11 g/cm(2) (mean Z-score of -2.6 3 +/- 0.71 SD and T score of -2.31 +/- 0.75 SD), femoral neck, 0.8 +/- 0.18 g/cm(2) (mean Z-score -1.36 +/- 0.84, T-score -1.14 +/- 0.75), and the distal radius and ulna, 0.6 +/- 0.17 g/cm(2) (mean Z-score -1.18 +/- 0.79, T-score -1.01 +/- 0.74) and had elevated CTx (0.87 +/- 0.5 ng/ml) and osteocalcin levels (12.3 +/- 3.7 ng/mul). After treatment, all patients corrected their 25(OH)D level (34.6 [corrected] +/- 11 [corrected] ng/ml) (P < 0.001) with a 3.6% +/- 3.9% increase in BMD at the L-spine (P = 0.009), 4.6% +/- 8.5% increase at the femoral neck (P = 0.05) and 6.5% +/- 12.6% increase at the distal radius plus ulna (P = 0.09). CTx, osteocalcin, and PTH(i) levels were unchanged. Treatment of adult SCD with vitamin D and calcium can restore 25(OH)D levels to normal and improve BMD, but, markers of bone resorption remained unchanged. Screening for vitamin D deficiency and BMD in SCD patients seems warranted.

[Effects of pricking bleeding at "Weizhong" (BL40) on sciatic nerve conduction velocity and interleukin-1alpha content in the lumbar vertebral nucleus pulposus in experimental lumbar intervertebral disc protrusion rabbits].

OBJECTIVE: To observe the effect of "Weizhong" (BL40) bleeding on sciatic nerve conduction velocity (SNCV) and interleukin-1alpha (IL-1alpha) content of the lumbar vertebral nucleus pulposus tissue in experimental lumbar intervertebral disc protrusion (LIDP) rabbits so as to explore the underlying mechanism of blood letting in the treatment of LIDP. METHODS: Forty healthy New Zealand rabbits were randomly assigned to control, model, BL40 and non-point (1 cm medial to BL40) groups, with 10 cases in each group. LIDP model was established by pushing the intervertebral disc tissue rightward to protrude the posterior longitudinal ligament with a self-made instrument after exposing the L6-7 vertebrae and intervertebral space. Blood-letting was performed at "Weizhong" (BL40) and non-point by using a triangle-edged needle to prick the local tissue, once daily and continuously for 7 days. SNCV was detected by using BL-410 physiological signal recording system, and the content of IL-1alpha in L6-7 intervertebral disc tissue determined with enzyme linked immunsorbent assay (ELISA). RESULTS: In comparison with control group and pre-modeling, SNCV decreased significantly in model, BL40 and non-acupoint groups after LIDP; while compared with model group, values of SNCV in BL40 group increased considerably (P<0.05), no significant changes were found between non-acupoint group and model group (P>0.05). Compared with control group, the contents of IL-1alpha in the nucleus pulposus in model and non-acupoint groups increased remarkably (P<0.05, 0.01), but no significant difference was found between control and BL40 groups in IL-1alpha level (P>0.05). CONCLUSION: Blood-letting at "Weizhong" (BL40) can relieve LIDP-induced nerve injury and mechanical oppression to improve SNCV, which may be closely related to its effect in decreasing inflammatory factor IL-1alpha level.

Effects of vitamin E supplementation on bone metabolism in nicotine-treated rats.

INTRODUCTION: Nicotine has been shown to exert negative effects on bone. This study determined whether vitamin E supplementation is able to repair the nicotine-induced adverse effects in bone. METHODS: 24 male rats were divided into three groups. The fi rst group was the baseline control and killed untreated at the beginning of the study. Groups 2 and 3 received nicotine at 7 mg per kg for three months but during the second and third months, group 2 was supplemented with alpha-tocopherol (N+ATF) while group 3 was given palm tocotrienol mixture (N+TT). Serum interleukin-1 (IL-1), serum interleukin-6 (IL-6), serum osteocalcin, urine deoxypyridinoline (DPD) and bone calcium content were measured. RESULTS: Palm tocotrienol mixture was able to prevent the increment of IL-1 and IL- 6 due to nicotine treatment. No changes were seen in the osteocalcin levels, but the N+ATF group had lower urine DPD levels after treatment. However, bone-remodelling index revealed no significant changes. No significant differences were seen in the femoral bone calcium content results, although the fourth lumbar bone calcium content was reduced in both groups with 66.5 percent reduction in the N+ATF group and 59.6 percent reduction in the N+TT group. CONCLUSION: Palm tocotrienol mixture was better than alpha-tocopherol in reversing the effects of nicotine on IL-1 and IL-6. Both forms of vitamin E were not able to restore the nicotine-induced bone calcium loss, but the N+ATF group suffered a greater loss. Tocotrienol seemed to be superior to alpha-tocopherol in combating against the adverse effect of nicotine.

A follow-up study on the effects of a milk supplement on bone mineral density of postmenopausal Chinese women in Malaysia.

BACKGROUND: A previous study on a randomized controlled trial in 173 postmenopausal Chinese women in Kuala Lumpur showed that milk supplementation was effective to reduce bone loss at the total body, lumbar spine, femoral neck and total hip compared to the control group on a usual diet (Chee et al. 2003). OBJECTIVE: The objective was to determine whether the results were sustained after the conclusion of the study. DESIGN: A follow-up study, 18 months after a randomized controlled trial of milk supplementation was concluded. A total of 139 participants were followed up 21 months after the study ended. Bone mineral density (BMD) was measured at the total body, lumbar spine, femoral neck and total hip by dual energy X-ray absorptiometry, and anthropometric measurements as well as changes in dietary habits were measured. RESULTS: At the follow-up, the milk supplement group did not show significant bone loss from baseline at most sites (mean differences +/- SE) (total body 0.42 +/- 0.25%, femoral neck 0.44 +/- 0.58%, total hip -0.06 +/- 0.46%), unlike the control group (total body -1.07 +/- 0.28% p < 0.005, femoral neck -1.49 +/- 0.56% p < 0.05, total hip -0.89 +/- 0.57% p < 0.05). However, both the milk and control groups showed bone loss from baseline at the lumbar spine (milk -2.01%, control -3.29%, p superior 0.05). The calcium intake of the milk group remained significantly higher than the control group (milk 710 mg/day, control 466 mg/day, p < 0.005) despite discontinuation of the milk supplement. CONCLUSIONS: The results showed that some of the beneficial effects of a milk supplement were still evident at follow-up and it was possible to motivate subjects to adopt a positive change in dietary calcium intake after intervention.

Effect of 17beta-oestradiol and ginsenoside on osteoporosis in ovariectomised rats.

To study the anti-osteoporosis effects and mechanism of action of oestradiol (E2) and ginsenoside (tR), we measured the bone mineral densities (BMD) of lumbar vertebra and tibia and analysed the tibia histological morphological data, as well observed the activity and the number of osteoblasts and the activity of alkaline phosphatase (ALP) and the concentration of cAMP. Results showed that E2 (400 microg kg- 1 week- 1) and tR (10, 20, 30 mg kg- 1 day- 1) were able to countervail the decreasing in BMDs of lumbar vertebra and tibia induced by OVX in rats (P<0.05); E2 (0.1 micromol l- 1) and ginsenoside Rg1 (1 micromol l- 1 and 10 micromol l- 1) were able to increase the number of osteoblasts, the activity of ALP and the concentration of intercellular cAMP in cultured osteoblast cells. The present findings suggest that E2 and tR have an anti-osteoporosis effect in ovariectomised rats.

Effect of chronic glucocorticoid therapy and the gender difference on bone mineral density in liver transplant patients.

BACKGROUND: Chronic glucocorticoid therapy (CGT) has been shown to result in bone density loss causing osteoporosis. Patients undergoing liver transplantation (LT) are on CGT and are at increased risk for bone disease. To further study the relationship between CGT and bone loss, we analyzed the bone mineral density (BMD) in relation to the cumulative dose of CGT in patients who had undergone LT. MATERIALS AND METHODS: We retrospectively collected information on 57 patients who underwent LT more than 1 year ago, which included demographics, cumulative CGT dose, BMD and t-scores of the femur/lumbar vertebra as measured by dual-energy X-ray absorptiometry (DEXA) for 1 and 2 years post-transplant. Patients receiving CGT >3500 mg/1st year were compared with CGT <3500 mg the first year. The group consisted of 75% males and 25% females. RESULTS: Data showed that all patients on CGT had a moderately increased risk of fracture one year post-transplant. In the high dose group, females had significantly worse femur BMD and t-scores that persisted through the second year. This difference was not seen in the low dose group. CONCLUSION: We found that all liver transplant patients on CGT have an increased risk of bone disease and that female patients receiving CGT >3500 mg the first year have a much higher risk of bone disease than males and that this risk persists during the second year. Because most of the steroids are given during the 1st month post-transplant, the amount of steroids given in this time period dictates the patients' risk for the subsequent 2 years.