2011年1月14日星期五

Osteoporosis

What is osteoporosis (referred to as osteoporosis)

means porous bones covered, the reason for the gradual loss of calcium in bones, making the internal bone becomes thin, resulting in many pores, rendering hollow the phenomenon of loose, (example: Hai Shawu structure) and have loose bones, no longer able to withstand the daily lives of the load caused by the body, a long time to become an inevitable consequence of fracture.

common osteoporosis:

postmenopausal osteoporosis.

senile osteoporosis: more common in people over the age of 70.

the causes of osteoporosis

osteoporosis Glance

osteoporosis caused by the crisis:

by the National Health Insurance information, the Republic of China 95 years, men over the age of 65 hip fractures per year to 5,000 cases, about 10,000 cases of women, an annual increase of 5% of the cases.

at least 160 million people worldwide each year hip fracture, 2050 will reach 6.26 million passengers.

50-year-old woman with hip fracture caused by the probability of death was 2.8%, the mortality rate of endometrial cancer 4 times, and the probability of breast cancer death as high.

hip fracture mortality rate after the first year of 20-24%; 40% of the person who could not walk with hip fracture, 60% of the daily life in need of help.

vertebral fractures lead to an increase in bed days, lung function decreased, thus reducing the self-confidence and even lead to depression.

Global Status:

at least 160 million people worldwide each year hip fractures in 2050 will reach 6.26 million passengers.

one lifetime fracture due to osteoporosis lead to opportunities for women have 30-50%, men 15-30%.

women over 45 years of age due to osteoporosis in hospital days, more than any other disease.

(above information taken from the International Osteoporosis Foundation, more full text see:)

Oriental women susceptible to osteoporosis:

people intake of dairy products is only about half of the West, so the Chinese women's bone density is lower on average than Western women, it likely to develop osteoporosis.

some is due to chronic disease or osteoporosis caused by medication, for example, dialysis patients, commonly known as the United States elixir of long-term use of steroids, long-term use of antacids (such as stomach milk) ... and so can easily lead to bone loss. There are many herbs are mixed in among the steroids, if unwitting, under large doses, can also cause bone loss.

China the status of several domestic medical centers according to the research, more than six-year-old woman with osteoporosis accounts for more than sixteen percent, the health of elderly women, a potential threat. fractures of elderly women is not just medical care issue, seven-year-old women over forty percent because some fractures of the femur caused mobility, require long-term care beds and others, including mortality rates as high as 22% of men, women up to 15%.

How to treat osteoporosis

If after investigation, found the phenomenon of osteoporosis should be how to do it? most important calcium supplement for women closer to menopause, the use of women hormone, vitamin D and other important food intake, milk is the best provider of calcium, others such as pork, dried fish and so on. vegetarians tofu in calcium also contain quite a lot. taking calcium supplement calcium quality, must have a certain concentration and intensity, it is best prescribed by a physician, the so-called natural calcium, and nothing special. eat too much calcium is 2 grams per day or more, may produce kidney stones and so on, unless there is a physical or kidney stones in the physician to use the normal amount of calcium recommended, should be Buzhi Yu produce stones. What kind of people need more calcium; general, postmenopausal women need more calcium absorption due to the elderly less capable and therefore need to increase the calcium content, pregnant women need calcium every day to 2 times the average person.

common treatment for osteoporosis vs. the latest drug developments

bone density increased by 2 ~ 3% lower fracture rate of 40 to 50% local osteoporosis patients should continue to be effective drugs to increase bone mass

common treatment

drug class drug use frequency of drug use means the role of

daily oral calcium preparations essential calcium supplement the body

daily oral vitamin D to promote intestinal calcium absorption

female daily oral hormone inhibition of osteoclasts, reduce bone loss

daily nasal spray calcitonin inhibited osteoclasts, reduce bone loss

daily bisphosphonate / weekly oral inhibiting osteoclasts, and increase bone density

daily injections of parathyroid hormone stimulation of osteoblasts, a significant increase in bone density

new drug development

of frequency of administration of drug class effects medication way / Notes

monthly oral bisphosphonate inhibition of osteoclasts and increase bone density has been listed on the United States and Europe

Prevention of postmenopausal osteoporosis

Prevent and treat osteoporosis in postmenopausal 2009-04-13 11:15 main clinical manifestations of this disease are: waist, back, limb pain, weakness, severe activity limitation or bedridden; easy because of minor trauma induced fractures, can be found in diffuse bone tenderness; hump or significantly reduced figure or the occurrence of compression fractures.

biochemical indicators of serum osteocalcin (bgp) that osteocalcin synthesis by the osteoblasts, as an important indicator of bone formation; serum alkaline phosphatase (akp), the bone cells or the liver, the activity of two different cases in the normal liver function can be used as indicators of bone formation; and urinary calcium / creatinine (vca / cr) ratio, as indicators of bone resorption.

above target levels higher than normal, below normal or in the normal range, reflecting the bone remodeling cycle were shortened, extended or close to normal. postmenopausal bone osteoporosis is bone resorption exceeds bone formation disease.

nutritional factors of osteoporosis in postmenopausal women have an additional role in the occurrence of senile osteoporosis occurs to a certain extent.

calcium deficiency due to:

(1) absorption, the outdoor activities and receive less sunlight, vitamin d deficiency, 1,25 a (oh) 2vds decreased production in the kidney, affecting intestinal the absorption of calcium channel. In addition, the elderly less active, so that bone cells decreased, while the relative activity of osteoclasts increased bone resorption increased, becoming one of the factors of primary osteoporosis. (2) Long-term intake of calcium. domestic and foreign nutrition survey material shows that dietary calcium is generally lower than in the standard volume. older persons and reduce food intake, more a lack of calcium.

control of the main measures are:

(1) hormone replacement therapy.

the best selection of natural, short-acting, oral estrogen preparations. such as estradiol valerate, micronized estradiol 1-2 mg / day, estrogen o.625 mg / g, when the calcium intake amounted to 1,500 mg / g, can halve the amount of hormone. synthetic hormones commonly used in China nylestriol for estriol derivatives, oral administration of 2 mg / 2 weeks, ethinyl estradiol 0.005 mg / day medroxyprogesterone acetate 2 mg / day, alternating every other day to take. (2) a sufficient amount of calcium intake is the most basic method of prevention and treatment of osteoporosis.

In order to prevent bone loss in postmenopausal women, need calcium to 1,500 mg / day, women over the age of 65 should be increased to 2500 mg / day. In order to prevent bone loss in case of night fasting, should drink at every night before bed serving of milk or calcium.

summary, attention to nutrition, calcium supplement and strengthen the training, prevention and treatment of postmenopausal osteoporosis, the basic means of laser pro-replacement therapy also has the effect of holding special shall be carried out under the guidance of doctors.

Treatment of osteoporosis

As mentioned earlier, osteoporosis before fracture in the event of multiple asymptomatic, so the risk factors in patients with pre-determined and take appropriate preventive measures, such as changes in diet and lifestyle is very important. At the same time, drugs can only thickening of trabecular bone thinning, perforation can be repaired, but not enough to have re-connected trabecular bone fracture, bone damage that has been micro-structure can not be fully restored, showing that prevention of this disease is more realistic and important than the treatment . prevention, including the best peak bone mass, osteoporosis intervention in risk factors, reduce bone loss. peak bone mass depends on genetic factors and environmental factors in two ways. genetic factors are the main, about 75%, but so far There is no effective interventions, and environmental factors can be adjusted to control. So the preventive measures of environmental factors should be started from the children and adolescents, including adequate calcium intake, appropriate exercise, especially weight-bearing exercise can increase bone peak. eliminating risk factors for osteoporosis prevention is an effective means, such as quit smoking and avoid alcohol, excessive caffeine, low weight, long-term braking and excessive exercise are due to be avoided. glucocorticoid intake for the need and the other increased risk factors for osteoporosis patients should take certain precautions, use the lowest effective dose possible, if possible, use of hormones by inhalation, or the next day, use of hormone therapy, as well as muscle strengthening exercises. effective prevention measures are the following. 1. Movement of children and adolescents have the rules if the movement, the bone mass than those without regular exercise is higher, a variety of sports is better to weight-bearing exercise can increase BMD, although its exact The mechanism is unclear. In adulthood, many types of exercise helps maintain bone mass. To insist on postmenopausal women 3h per week increase in the movement of the overall calcium, exercise in moderation. But the sports were over-induced amenorrhea, bone loss but faster. exercise can also improve the sensitivity and balance, reduce the risk of elderly falls. to encourage patients with osteoporosis as much as possible activities. 2. Nutrition Good nutrition for the prevention of osteoporosis is important, including adequate amount of calcium, vitamin D, vitamin C and protein. From childhood onwards, the daily diet should have adequate calcium intake, calcium affect the acquisition of peak bone mass. European and American scholars have advocated daily intake of calcium during youth (elemental calcium) is 1,000 ~ 1,200 mg, for adults 800 ~ 1,000 mg, daily in postmenopausal women 1,000 ~ 1,500 mg, 65 men after the age and other risk factors with osteoporosis in patients with recommended calcium intake of 1500mg / d. small size and low protein into the crowd, calcium intake may be lower than the content. calcium carbonate, calcium chloride, calcium lactate and calcium gluconate elements were 40%, 27%, 13% and 9%. If the calcium after taking the meal, while taking 200ml of liquid, can promote calcium absorption, and sub-times taking more than 1 time to take effect. achlorhydria may take calcium citrate, in order to facilitate absorption. Vitamin D, intake of 400 ~ 800U / d. 3. Prevention of wrestling should be to minimize the risk of osteoporosis patients falls, hip fractures and Corus to reduce the fracture. old wrestling occurrence probability increased exponentially with age increase. Shiliang exercise improves the sensitivity and balance, for the prevention of elderly Shuaidao some help. For easy Yinqi wrestling diseases or injuries should be promptly be effective treatment. Avoid using drugs affect the body balance. 4. Drug therapy effective in drug therapy can prevent and treat osteoporosis, including estrogen replacement therapy, calcitonin, selective estrogen receptor modulators, and bisphosphonates, these drugs can prevent the formation of bone resorption, but very small role. Experience slow-release sodium fluoride treatment and found that low doses of PTH can increase bone formation, can prevent estrogen deficiency bone loss in women. The former can also reduce the incidence of vertebral fractures. study confirmed these drugs can improve BMI, for gonadal function male osteoporosis, hypothyroidism testosterone therapy given to maintain bone mass. given calcium and vitamin D are important preventive measures. for the treatment and prevent the development of osteoporosis drugs are divided into two categories, the first category as inhibit bone absorption of drugs, including calcium, vitamin D, active vitamin D, calcitonin, bisphosphonates, estrogen, and isoflavones; second category is the promotion of bone medicine, including fluoride, anabolic steroids, parathyroid hormone, and different flavonoids. So far, all drugs are experiments conducted in women, in addition to estrogen and selective estrogen receptor modulator, the assumption that all of the drugs on the treatment of men is the same. (1) Hormone Replacement therapy (hormone replacementtherapy, HRT): Hormone replacement therapy is considered the treatment of osteoporosis in postmenopausal women the best and most effective methods of treatment problem is hormone replacement therapy may bring adverse effects to other systems. Hormone replacement therapy be avoided in patients with breast disease, and those who can not tolerate the side effects. For these patients, the choice of other drugs. Hormone Replacement Therapy drugs in the estrogen, estrone can be pregnant horses (conjugated estrogen) , 0.3 ~ 0.625mg / d, for the removal of the uterus is not, it is recommended that estrogen cycle, 1 time a day, once every 3 weeks, and then disabled for 1 week. reported that estrogen therapy can reduce cardiovascular disease in postmenopausal women increased risk, which may be due to drugs improve plasma lipid levels (high density lipoprotein increased, lowering cholesterol and low density lipoprotein), and the direct effect of drugs on the arterial. If you disable estrogen, then the l 2 years, recurrence of rapid bone loss, the loss of estrogen at the same time bring the cardiovascular protective effect. of the drug allergies, breast cancer, diagnosis is not clear vaginal or uterine bleeding, active thrombophlebitis, thrombosis, diseases and Past use of this hormone cause similar symptoms were banned. Estrogen can reduce the effect of anticoagulant drugs, and barbiturates, rifampicin, and other hepatic microsomal enzymes induced by the drug combination can reduce serum levels of estrogen. Estrogen also can reduce the hepatic P450 enzyme activity, associated with glucocorticoid use may therefore affect the role of glucocorticoid and toxicity. some patients taking estrogen can stimulate the emergence of symptoms of estrogen excess, such as abnormal uterine bleeding or large, Breast pain can also occur in some patients fluid retention. long-term use of estrogen therapy increased the risk of endometrial hyperplasia, progesterone was added to offset the side effects, the uterus has been removed by the addition of progestin is not required. taking estrogen hormones, including gynecological patients should receive regular comprehensive physical examination, including examination and breast examination and photography. jaundice, and beyond the control of high blood pressure should be discontinued. should be discontinued 2 weeks before surgery, to avoid blood clots. Although hormone replacement therapy osteoporosis is effective, but in July 2002 a U.S. study showed that estrogen plus progestin hormone replacement therapy to prevent cardiovascular disease more harm than good, for the U.S. National Institutes of Health (NIH) proposal to scrap the purpose of prevention estrogen replacement therapy. the United States under the NIH National Heart, Lung and Blood Institute conducted a named women's health initiative estrogen plus progestin used to prevent the purpose of hormone replacement therapy study, the study is a randomized, controlled a prevention research, since 1993, the original plans to continue to 8.5 years, is expected to end in March 2002. For security reasons, the average follow-up of 5.2 years, the study on May 31, 2005 termination. WHI were included the 16,608 persons aged 50 to 79-year-old postmenopausal women with an intact uterus, in which 8,506 women were randomly assigned to receive estrogen and progesterone combination therapy, 8,102 women were randomized to receive placebo. Research in the United States conducted 40 clinical centers. The test uses combined estrogen plus progestin therapy (pregnancy horse estrone 0.625mg / d, medroxyprogesterone acetate 2.5mg / d), day 1. So far the WHI showed that compared with placebo, estrogen and progesterone The prognosis for the combination therapy: stroke increased 4l%; heart disease increased by 29%; vein thrombosis rate of doubling; total cardiovascular disease increased by 22%, 26% of breast cancer, colon cancer by 37%, hip fractures reduced by 1 / 3, the total fractures decreased by 24%, no difference in overall mortality between the two groups. The results of the risk / benefit ratio does not meet the need for primary prevention of chronic disease interventions. WHI results suggest that the method of cardiovascular disease and breast cancer may exceed the actual disadvantages of the benefits of prevention of osteoporosis. In view of this, the choice of estrogen plus progestin treatment of osteoporosis should be careful, the situation must be weighed against the combination of patients. estradiol (estradio1): can reduce bone increased absorption of bone cell activity, a number of studies have shown that estrogen can prevent spine and hip bone loss, it is recommended to start taking after menopause, in the case of tolerance to take life. Adult 0.1mg / d, cycle taking that use 3 weeks, disabling for 1 week. can be used through the skin film, the amount of daily release of estradiol is not less than 0.05mg, if necessary, adjust the dose to control menopausal symptoms. allergies, breast cancer, thrombophlebitis and the diagnosis of obscure bleeding disabled. while ethinyl estradiol (ethinylestradio1) and norethisterone (norethindrone) is progesterone, used to treat moderate to severe menopause-related and vasomotor symptoms, 1 tablet / d. androgen: Research shows that the sex hormones caused a serious lack of male patients with osteoporosis, given testosterone replacement therapy can increase spine BMD, but the hip appears to be invalid, it can be seen as an anti-androgen drug resorption. Testosterone (testosterone): intramuscular injection every 200mg, every 2 to 4 weeks 1, for the treatment of hypogonadism in patients with decreased BMD. elderly patients with impaired renal function, and testosterone with caution, to avoid increasing the risk of benign prostatic hyperplasia; testosterone can subclinical increase in the growth of prostate cancer, so the medication should be monitored prostate-specific antigen (PSA); need to monitor liver function, blood and cholesterol; such as edema and jaundice should be discontinued. medication should ensure that during the supply of calcium and vitamin D . Another topical testosterone available. (2) selective estrogen receptor modulators (selective estrogen receptor modulators, SERMs): these drugs in certain organs with weak estrogen-like effect, while in other organs can be antagonism from estrogen. SERMs can prevent osteoporosis, but also to reduce cardiovascular disease, breast and endometrial cancer incidence. these drugs raloxifene (raloxifene, trade name Evista), a non- steroids benzo thiophene (nonsteroidal benzothiophene), is the estrogen agonist, can inhibit bone resorption, increased spine and hip BMD, fracture risk can cone dropped 40% to 50%, but the effects of estrogen than poor. do not want to take the drug for illness can not take estrogen or estrogen with a moderate risk of osteoporosis for women, particularly those with vasomotor menopausal syndrome (such as hot flashes, flushing) of women and with cardiovascular disease and breast cancer risk in women. premenopausal women, disabled and is not recommended and estrogen replacement therapy, Evista dose of 60mg / d. The drug has antagonistic effect of warfarin, prohibition and anion exchange resin ( such as the test to enamine) while taking, and diazepam (stability), diazoxide, lidocaine and other high protein binding of drugs combined with caution. long-term braking and disabled 3 days before surgery in order to avoid thrombosis. (3) two phosphate (Bisphosphonates): two phosphate hydroxyapatite in bone with a combination of synthetic analogues of pyrophosphate, can specifically inhibit osteoclast-mediated bone resorption and increase bone density, the specific mechanisms are not yet entirely clear, consider regulating osteoclast function and activity. banned from pregnant women and women planning pregnancy. first named sodium hydroxyethyl phosphonate (etidronate disodium) called for by Sodium phosphate, therapeutic doses to inhibit bone mineralization of adverse reactions, so stand intermittent, periodic administration, the beginning of a row to take a week hydroxyethyl phosphonate sodium for 2 weeks 400mg daily for 10 weeks and then disable each for a period of 12 weeks. hydroxyethyl phosphonate sodium to be taken while taking calcium, such as to adhere to use 3 years, will enable patients with vertebral osteoporosis, estimate an increase of 5.7% increase in femoral neck bone mass is relatively smaller. Bone biopsy results showed that this cycle of therapy did not affect bone mineralization. in recent years a new generation of phosphate used clinically, such as the amino-bisphosphonates (alendronate, alendronate Qu ester), risedronate acid (risedronate sodium phosphate) (risedronate sodium, commodity Actonel), Lin acid chloride (Cl A diphosphate) (coldronate, commodity bonefos, bone phosphate) and sodium pamidronate (pamidronate, trade name Aredia, Aredia), etc. exceptionally strong inhibition of bone resorption, therapeutic doses do not affect bone mineralization. alendronate (alendronate, brand name fosamax, Fosamax) can reduce bone resorption confirmed lower spine, hip and wrist fracture rates 50% in pre-menopausal hormone use can prevent glucocorticoid-related osteoporosis. prevention dose 5mg / d, healing 10mg / d or 70mg / week. taking the drug need to stand or remain sitting after 30min, blood calcium disease, esophageal dysfunction, drugs that affect the emptying of the esophagus. and calcium and other multivalent cations drugs when taken together, it is recommended to take apart, separated by at least 30min. while taking aspirin and NSAIDs may increase gastrointestinal reactions. There upper gastrointestinal disease, renal insufficiency (creatinine clearance 35ml/min) when used with caution; medication to ensure adequate calcium and vitamin D intake. as a serious gastrointestinal reactions, such as difficulty swallowing, swallowing pain, chest increased pain and burning sensation in the stomach should be discontinued. bisphosphonates are the current domestic solid state, taking the approach with simvastatin alendronate. risedronate acid can prevent bone resorption, increase bone density in the spine and 5% of the femoral neck and 1.6% respectively. postmenopausal women taking risedronate acid 3 consecutive years, vertebral fractures and vertebral fractures outside the decreased incidence of 41% and 39%. risedronate dose of acid 5mg / d, newly listed 35mg dosage form, taking 1 for the week, efficacy and 5mg / d very. phosphine major role in bone tissue in the bone, and its mechanism is to prevent the dissolution of hydroxyapatite crystals and direct inhibition of osteoclast activity, thus inhibiting bone absorption. osteoclastic bone phosphorus can lead to morphological changes of cells containing objects such as cell loss (such as lysosomes), and wrinkle-like margin contraction. there is evidence that phosphine can inhibit bone of different mediators, such as the inhibition of acid fluid production, prostaglandin synthesis and release of lysosomal indirectly reduce the activity of osteoclasts. physicochemical properties of bone and hydroxyethyl phosphonic acid disodium (EHDP) is similar, but the potential inhibition of osteoclast active function is 10 times higher than EHDP, Er absorbed without impact on bone mineral. Kuangwu Zhi bone phosphate of calcium and has a strong adsorption, the main role in the bones. Bone phosphine are capsules, tablets and injection liquid available. pamidronate is dissolved bone osteoclast inhibitor, can firmly adsorbed on the surface of trabecular bone, forming a protective film to prevent absorption of osteoclast precursor cells in the bone, and the subsequent transformation into mature osteoclasts process. pamidronate for intravenous use. These drugs, alendronate is most commonly used to treat and prevent osteoporosis. (4), calcitonin (Calcitonin): Calcitonin is a peptide hormones, you can quickly inhibit osteoclast activity, the slow effect can reduce the number of osteoclasts, with pain, increase mobility and improve the calcium balance function, pain relief for patients with fractures of the role of bisphosphonates and estrogen for hormone contraindications or intolerant patients. agents are commonly used in China calcitonin (Miacalcin, salmon calcitonin) and by calcitonin (calcium benefits Ning). calcitonin with parenteral and intranasal administration to drug 2 ways, the role of parenteral drug delivery time of up to 20 months sustainable. calcitonin (Miacalcic) every day to use spray 200U, alternate use of two nostrils, or intramuscular injection or subcutaneous injection of 100U or intravenous administration can be. acceptable in patients treated with calcitonin nasal administration of the nasal cavity should be regularly inspected and, if severe nasal ulcer drug should be discontinued; long-term intravenous administration in patients with hypocalcemia should be prevented due to the foot convulsions and urinary sediment should be checked regularly. (5) of vitamin D and calcium: vitamin D and its metabolites can promote intestinal calcium absorption and bone mineralization, active vitamin D (such as Rocaltrol, alfacalcidol) can promote bone formation, increased osteocalcin production and alkaline phosphatase activity. taking active vitamin D than simply taking calcium can reduce osteoporosis in patients with vertebral and vertebral fracture rate outside. Another vitamin D and The joint preparation of calcium available, treatment is more reliable. (6) Fluoride: Fluoride is an effective stimulant of bone formation, can increase vertebral and hip bone mineral density and reduce the incidence of vertebral fractures. Every day 15 small dose of 20 mg of fluoride, which can be effective in stimulating bone formation and side effects. single fluoride phosphate (Monoflurophospate, MFP) the role of hydrolytic enzymes by slow release in the small intestine, sustainable 12h. special music set (Tridin) of the active ingredient single-glutamine and glucose phosphate calcium fluoride, fluoride per tablet 5mg, elemental calcium 150mg, 3 times / d, with meals Juefu. the drug development stages of children and the disabled. for treatment of osteopenia, and bone quality of osteoporosis patients, recommended every 1 to 2 years BMD a review. If the update detection indicators of bone is high, drugs should be reductions. for long-term prevention of bone loss, it is recommended in postmenopausal women estrogen replacement therapy after the beginning, at least for 5 years, preferably 10 to 15 years. If patients are diagnosed illnesses known to cause osteoporosis, or use of specific drugs can cause osteoporosis, recommend simultaneous administration of calcium, vitamin D and bisphosphonate therapy. 5. only in the surgical treatment of fractures due to osteoporosis only after the required surgical treatment, with the aim of treatment of fractures, early resumption of normal function. (b) prognosis is the main factor affecting the prognosis after fracture-related complications each year in the United States about 37,500 patients died of complications of osteoporosis-related fractures. Although osteoporosis can not be completely prevented, but given a certain preventive measures, such as adequate intake of calcium, vitamin D, exercise, etc., to a large extent reduce the bone osteoporosis, to prevent serious complications. In addition, a risk factor for osteoporosis, people with high-risk situations lead to osteoporosis, a disease and the use of drugs can cause osteoporosis patients, timely removal of risk factors, given appropriate prevention and treatment of drug is particularly important. can lead to osteoporosis disease risk factors, including age, gender and race; family history of bone fractures in osteoporosis; reproductive factors, particularly premature menopause; and decreased bone density-related lifestyles of smoking, alcohol abuse, and lack of exercise, resulting in amenorrhea high intensity exercise (eg marathon runners); dietary factors, especially the influence of calcium and vitamin D intake (to increase both the lack of osteoporosis risk), and eating disorders, such as anorexia nervosa; other diseases and medication, especially glucocorticoids; in order to reduce the incidence of fractures, elderly patients should be alert to easily fall risk factors, including impaired balance, postural low blood pressure, lower extremity muscle strength decreased, unresponsive, medication (such as sedatives), visual impairment and cognitive impairment.

2011年1月13日星期四

Clinical Practice Guidelines Series Full 45

Series of clinical diagnosis and treatment guidelines of the whole 45 books: Chinese Medical Association Publishing House: People's Medical Publishing House the number of copies have been published specifications: All 45 16 Folio Price: ¥ 1555 yuan price: ¥ 1480 yuan Tel :010 -82,565,616 82565615 Mobile: 13661353796 Fax :010-82565616 QQ: 276836936 QQ: 843910613 more books audio books visit check the website of the three Educational Books Clinical Practice Guidelines Clinical Practice Guidelines Clinical Practice Guidelines Introduction Books Books supported by the Ministry of Finance, Ministry of Health Leadership Chinese Medical Association organized the compilation, to guide and regulate the conduct of clinical diagnosis and treatment of medical personnel. Bentaocongshu comprehensive and systematic introduction to the latest progress of medical science, both scientific and reliable clinical diagnostic criteria, but also optimize the clinical treatment of advanced program, fully embodies the scientific, advanced, authoritative organic unity, so that medical personnel at all levels of medical institutions in the rules to follow in daily medical practice, evidence-based, will help improve the overall quality of the majority of medical workers and the quality of medical work, and promote scientific and medical and health work in China, standardization and legal process. Detailed List of the following books for 2005 -2009 have been published on September 1, clinical treatment guidelines - Cardiovascular Surgery Volume Price: 22 yuan 2 Clinical Practice Guidelines - Pathology Volume Price: 118 yuan 3, clinical treatment guidelines - radiologic technology Volume Price: 32 yuan 4, clinical practice guidelines - Head and Neck Surgery Volume Price: 70 yuan 5, clinical practice guidelines - Critical Care Medicine, Volume Price: 36 yuan 6, clinical treatment guidelines - Cardiovascular Volume Price: 24 yuan 7, clinical treatment guidelines - Respiratory Diseases Volume Price: 28 yuan 8, clinical treatment guidelines - Thoracic Surgery Volume Price: 24 yuan 9, clinical diagnosis and treatment guidelines - Aesthetic Medicine Volume Price: 40 yuan 10, clinical treatment guidelines - Orthopaedics Volume Price: 35 yuan 11, clinical treatment guidelines - Nursing Volume Price: 54 yuan 12, clinical treatment guidelines - Immunology Volume Price: 25 yuan 13, clinical Clinic Guide - Burn Surgery Volume Price: 31 yuan 14, clinical treatment guidelines - Volume Parenteral Enteral Nutrition price: 23 yuan 15, clinical treatment guidelines - epilepsy Volume Price: 20 yuan 16, clinical treatment guidelines - Nuclear Medicine Price: 53 yuan 17, clinical treatment guidelines - Hematology Volume Price: 19 yuan 18, clinical treatment guidelines - Obstet Price: 35 yuan 19, clinical treatment guidelines - Infectious Diseases Volume Price: 27 yuan 20, clinical treatment guidelines - Traumatology Volume Price: 85 yuan 21, clinical treatment guidelines - Surgery Volume Price: 39 yuan 22, clinical treatment guidelines - Ophthalmology Volume Price: 40 yuan 23, clinical treatment guidelines - Neurology Volume Price: 28 yuan 24, clinical treatment Guide - Pain Science Volume Price: 45 yuan 25, clinical treatment guidelines - osteoporosis and bone mineral DISEASE Price: 10 yuan, 26, clinical treatment guidelines - Neurosurgery Volume Price: 26 yuan 27, clinical treatment guidelines - Hand Surgery Volume Price: 19 yuan, 28, clinical treatment guidelines - Skin and Venereal Disease Volume Price: 30 yuan 29, clinical treatment guidelines - Urology Volume Price: 23 yuan 30, clinical treatment guidelines - Radiation Oncology Price: 16 yuan 31, Clinical Practice Guidelines - Psychiatry Volume Price: 17 yuan 32, clinical treatment guidelines - Anesthesia Volume Price: 14 yuan 33, clinical treatment guidelines - Physical Medicine and Rehabilitation Volume Price: 38 yuan 34, clinical treatment guidelines - Tumor Volume Price: 77 yuan 35, clinical treatment guidelines - Pediatric Internal Medicine Volume Price: 52 yuan, 36, clinical treatment guidelines - Digestive Diseases Volume Price: 19 yuan 37, clinical treatment guidelines - Pediatric Surgery Volume Price: 24 yuan, 38, clinical treatment guidelines - Rheumatology Volume Price: 19 yuan 39, clinical treatment guidelines - STOMATOLOGY Price: 45 yuan 40, clinical treatment guidelines - Tuberculosis Volume Price: 17 yuan 41, clinical treatment guidelines - FAMILY PLANNING Price: 14 yuan 42, clinical treatment guidelines - Endocrinology and Metabolic Diseases Volume Price: 15 yuan 43, clinical treatment guidelines - Plastic Surgery Volume Price: 32 yuan 44, clinical treatment guidelines - Assisted Reproductive Technology and the sperm bank Volume Price: 28 yuan 45, clinical treatment guidelines - Emergency Medicine Volume Pricing: 67 per

Anemia in pregnant women how to do

Many women during pregnancy, there will be varying degrees of anemia. Usually iron deficiency anemia. Our recommended daily iron supply of pregnant women is 28 mg, in order to achieve this standard, pregnant women should eat iron-rich food. in early pregnancy, a daily intake should be at least 15 to 20 mg iron; late pregnancy, daily intake of 20 to 30 mg of iron. Here, I will introduce, reproductive age woman during pregnancy can take to improve anemia drugs, hoping to help a friend in need. Strong oral indications of bone and blood: for the lack of blood, liver and kidney deficiency, pale complexion, bones and muscles atrophy; iron deficiency anemia, rickets in children, pregnant women, calcium, bone Dosage and osteoporosis: a 10 ml, 3 times a day

effervescent tablets of ferrous lactate indications: children and pregnant women may need additional iron and vitamin C. Dosage :7 - 11 years old , day 1, every one; 11 years old daily 1 - 2 times, each time one; pregnant women (more than the second trimester) and lactating mothers, 2 times a day, each one, with each piece about 180 - 200ml warm (cold) dissolved in drinking water.

vitamin B12 tablets Indications: for megaloblastic anemia. Dosage: Oral. day 25-100μg (1-4 tablets) or every other day for 50-200μg (2-8 pieces), divided doses or as directed.

folic acid tablets Indications: 1. to prevent congenital neural tube defects. 2. pregnancy, lactation Women prophylaxis. Dosage: Prevention of congenital neural tube defects: oral, pregnant women of childbearing age from the plan until three months after the end of pregnancy, a 0.4mg, day 1; pregnancy, breast-feeding women to prevent drug use: a 0.4mg, day 1.

more information, please contact: Hunan days of King Pharmaceutical Co., Ltd.

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[Reprinted] reversal of osteoporosis the magic food

Original Address: reversal of the magic food of osteoporosis: reversal of osteoporosis, Lau Buddhist magic food

all the way from Florida State University Dr.Bahram Arjmandi (he is the school of Food and Nutrition and Head, Department of Multilateral Bay for carrying W) is the world-renowned research of bone (bone study) expert

, has been committed to seeking to prevent / alleviate osteoporosis (osteoporosis) and osteoarthritis (osteoarthritis) natural food. the day he reported his meeting with "black date dry", also known as "California plum") (prune) do experiments, people gasped in amazement.

I never thought that I often used the original oatmeal and added to the black date hi Riel dry, not only high in fiber and high antioxidant power of food, it still can help prevent and reverse osteoporosis magic food (miraclefood)!

Dr.Arjmandi menopausal women to do clinical trials have shown:

1. 8-10 pieces of black date dry day

Biheermeng therapy and other drugs can be more effective to reduce bone loss

(provided that the daily adequate intake of calcium and vitamin D),

and more effective for the "reconstruction" (restore) had osteoporosis bone health.

(but not processed and dried and fresh black date is invalid)

2. 8-10 pieces of black date daily dry

the subjects In the 90-day trial period by several pounds.

(but eating black date with water when dry, so black date absorbent fibers within the dry,

expansion in the stomach, satiety, suppress appetite)

Dr.Arjmandi experimental results have been published in authoritative journals in the world,

so amazing physiological effects of dry black date there is solid scientific evidence,

not out of thin air in vain for . Dr.Arjmandi found that black date dry

the mechanism of resistance to bone loss and its high antioxidant activity related to,

Although the detailed description of the meeting the day he biochemical mechanisms,

but I do not write out here, so we too boring.

because the fiber content is high, dry and black date black date juice, are U.S. doctors

recommended that constipation will eat of the holy items. Taiwan's supermarkets

(top well, RT-Mart, Carrefour, Geant.) Diospyros lotus can buy dry,

almost all and raisins, dried cranberries these foods on the same rack.

tried several brands, my personal favorite is "The Sun card" (SUNSWEET)

seeded Diospyros lotus stem (California plum).

black date cheap dry (only 500 grams of canned 125),

also has to help bowel movement, anti-oxidation, weight loss, reduce bone loss in multiple effects,

each boys and girls ages 8-10 should be the stars of the black date dry

included in every day to eat food

(Oh, but not more than 10 , otherwise you will over-intestinal motility).

reminded everyone that this stars the black date 8-10 and unnecessary a dry finish,

-3 times in the day finished.

method to increase bone density fourteen-year-old Zhao-Ji Li, bone density and the thirties, young men. The old man said that his dictionary, no elderly osteoporosis and obesity these terms.

his health, even the Cathay General Hospital, all seems unbelievable.

sponsored National Road Taipei International Marathon, Lin Yuan, chairman of Cathay Building Foundation Zhao-Ji Li, in front of Road Running Association Honorary Chairman "leap of antelope" Chi Cheng said before, while getting under way, while drinking coffee can burn fat, keep fit.

cross step when walking to heel, can stimulate bone cells within the bud the growth of bone, can prevent osteoporosis in the elderly, is the best proof of his own.

Li Zhaoji seven or eight years ago, state-run television station NHK reported that Japan, the inter-stride walking

, if the heel first landing, and stimulate the bones can be vibrating the growth of bone bud cells and inhibit osteoclast destruction.

Zhao-Ji Li psychological hold it a try, the result ran down a few months, to the Cathay General Hospital for tests, was surprised to find his bone density and the same young man in his thirties, would then bid farewell to old age people often suffer from osteoporosis.

Zhao-Ji Li reports on the health of NHK increasingly confident that when he saw the NHK a relevant cross-stride, can accelerate the burning of body fat, he accepted to try to do, the results of one month ran down, the effect of weight loss is obvious.

the home of his departure from the Jen-ai Road, went to Ta-an Forest Park, started about an hour and fifty minutes of walking around the park across step, Mr. Lee in choosing to go for a few months before the examination for bone mass density test

, nurses will be informed of the findings, he thought that the test equipment is not correct, demand a repeat test. and re-test. and re-test, made a total of five times, the results are the same, very strange value, +4.6

, last year, -1.2, the nurses do another test is negative, confirmed that the instrument is not bad, just think of this method may indeed work, so I hope you try to share .

Current treatment of osteoporosis

Current treatment of osteoporosis is caused by various reasons 2010-12-24 20:17 bone metabolism disorders, mainly for the reduction of bone mass per unit volume, the organic component of bone matrix and calcium were reduced calm , but the basic structure can remain the same. clinical manifestations were bone pain and fractures, X-ray performances are cortical thinning and reduced trabecular bone characteristics.

1) cause of treatment: ① Vitamin D and calcium deficiency, calcium and the right type of vitamin D; ② renal acidosis, sodium bicarbonate, sodium citrate correct acidosis; ③ primary hyperparathyroidism, parathyroid lesions removed; ④ multiple myeloma, the appropriate chemotherapy.

2) symptomatic treatment: in postmenopausal and senile, treatment is mainly symptomatic. hormone treatment: on older women, estrogen replacement therapy methods can control; calcium Supplementary: normal daily needs of calcium 10 mg / kg body weight, 17 mg of calcium per day to be / kg body weight, in order to maintain calcium balance, may be supplemented from the diet, such as chicken soup, volleyball slip soup, milk, shrimp, tofu , vegetables and other foods are rich in calcium, calcium can also be used nightly before bedtime calcium 1; Vitamin D: on a simple invalid, if accompanied by osteomalacia, may increase with vitamin D, both with the calcium , sex hormone combination; inorganic phosphate: it can improve after fracture; calcitonin: It inhibits osteoclast activity, slow decomposition of bone metabolism, reduce blood calcium, to stimulate new bone formation; pain treatment: Pain drugs, calcitonin, etc..

3) inhibition of elevated bone turnover treatment: used estrogen, calcitonin, three kinds of amino-bisphosphonate drugs inhibit bone resorption. postmenopausal estrogen for After the disease; calcitonin for patients, including those of bone turnover rate; amino-bisphosphonates for postmenopausal patients, older men, long-term glucocorticoids are medicinal.

4) inhibition secondary hyperparathyroidism treatment: mainly supply the appropriate amount of calcium and vitamin D to correct hypocalcemia. add at least 800 milligrams per day of elemental calcium, vitamin D 400 units a day for adults, the elderly 600 per day units, persons with poor kidney function of alpha hydroxylation D. 0.25 to 0.5 micrograms per day.

5) physical therapy: physical therapy, many different types, such as FM, infrared, medicine and other ions through the people, to promote muscle fascia and other soft tissue absorption of aseptic inflammation, ease muscle tension, eliminating the pain. physiotherapy for low back syndrome or other bit of pain occurs in patients.

6) Integrated treatment: no current disease an effect of treatment, must adhere to the comprehensive treatment, it may be effective in improving bone metabolism, decrease bone loss or increase bone mass, alleviate and reduce the clinical symptoms. modern medical treatment of symptomatic common method of synthesis of 6 kinds: drug therapy, exercise therapy, physical therapy, nutritional therapy, surgical therapy, the hook live surgery therapy.

7) in elderly patients with kidney and bone health can be traditional Chinese medicine; such as XLGB, strong capsule and so on.

[Turn] Yoga and Osteoporosis

Osteoporosis is a common disease of modern women, and has become a major threat to women's health issues. What is osteoporosis it? As people age, bone mass will naturally reduce the age of the women growth process, bone loss problem more obvious, especially in the shoulder, waist, back and thighs and other parts of the bone density will be significantly reduced. As density decreased, the effect of gravity, many women's height will be declined.

osteoporosis culprit:

what caused the loss of bone mass in women? Is fertility it? This can not blame the kids, and they have no relationship. is the lack of calcium it? do, but it is what causes calcium deficiency? Is not oxygen? or the lack of light? If that'd be good if solved. calcium absorption is controlled by the hormone, the body of women in today's society there is a limited thing the absorption of calcium, but also limits the secretion of female hormones, it is the pressure. There are two ways yoga can reduce stress, increase bone density, reversal of osteoporosis: that is, breathing and movement.

Yoga for strong bones:

breathing is the only one to help us both to reduce pressure on the body and mind approach. any decompression, the interest rate adjustment of relaxation methods are useful exercises. use of experts in yoga therapy found that very severe osteoporosis after women practice yoga, not only reversed the situation, but also increased the height of about 2 cm. research conducted in nursing homes showed that the bones through exercise, older women and improve their muscle bone mass, bone mass has made remarkable improvement. the right exercise can improve bone health, increasing bone density. and consistent with the idea that people are different, the researchers found, so that older people gently, carefully and reduced activity but will accelerate the degradation of the body. In fact, ease of movement would be able to improve bone health, especially weight-bearing postures exercises. weight-bearing exercise can increase bone mineral density in the Form, and promote bone in calcium absorption and utilization. through the active bone near the blood circulation, more calcium is absorbed to the bone.

calcium load style:

hands, feet touch the ground, knees apart, and hip width. palm landed just below the shoulders, fingers spread significantly, that the root forced to push the ground, this way, refers not only to be actively mobilized the root, the pressure of the shoulder was pouring an empty. especially for every day computer working people, eyes fixed on the two thumbs to the middle of the back of the neck parallel to the ground, conscious breathing. Each time after this simple weight-bearing postures, the quiet one minute, and fully understand the feelings of all parts of the body. The style, an increase of the density of our bones, although very simple, just do the standard can achieve the desired effect. If we can continue to do the exercises to be completed soon on the photo below style - bones character type.

Chinese medicine treatment of osteoporosis

Chinese medicine to treat osteoporosis

osteoporosis in the elderly is no longer the patent, according to several surveys, more and more young people to bone health has been lit red. Now, let us look at how Chinese medicine treatment of osteoporosis, the osteoporosis medicine in the prevention and treatment has advantages do?

Chinese belong to osteoporosis "bone atrophy , marrow, bone Bi ", the view that the pathogenesis of kidney and spleen, we focused on the use of Bushenzhuanggu pathogenesis, treatment of spleen qi rules.

one Bushenzhuanggu method

under "Kidneys bone" theory of Chinese medicine, kidney is the key to osteoporosis, so treatment should Bushenzhuanggu, if the kidney essence is sufficient, then the bones hard and strong. with Young, etc. Select degradation of the 11 patients with osteoporosis, according to the clinical manifestations into kidney and kidney yang, respectively the left and right normalized Pill Pill treatment, even serving 2 months, the results of 9 patients with low back pain symptoms significantly reduced or disappeared, X-ray showed significantly higher bone mineral density in 6 cases. Wang and other benefits with the kidney and bone paste (Rehmannia, Epimedium, Placenta, Alisma, keel, etc.) treatment of osteoporosis in menopausal women , 3 months after medication, the patient flex, ulna bone mineral content increased compared with before treatment. Liang added, etc. to break, Loranthaceae, cornus, Drynaria, cultivated land and other treatment in 58 cases, kidney symptoms improved and the average bone mineral density rose slightly, with forearm bone mineral content increased significantly compared with before treatment, while the control group showed a progressive decrease. The above cases show that the clinical treatment of osteoporosis from kidney disease to kidney deficiency symptoms only improved, and the bone mineral content, bone mineral density testing and other indicators can also be improved, confirming the kidney herbs on osteoporosis treatment excellent effect.

Second, Qi and spleen, promoting blood circulation of Liver

Spleen Kidney essence deficiency, bone dystrophy, fragile bones and weak, resulting in osteoporosis. Therefore, treatment should be qi and blood circulation, tone the liver spleen. Japan Jinjing Cheng-line Treatment of the spleen with a bone Modified osteoporosis disease, showed significant increases in bone salt, can improve the anemia and menopause index. Salvia Zhang, etc. that can fracture the formation of collagen fibers increased calcium deposits rich Salvia can be proved from the adjacent bone fracture the mobilization of calcium, to meet the new bone formation on the need for calcium, indicating that SM has a direct role in regulating calcium metabolism.

above information shows that Chinese medicine in prevention and treatment of osteoporosis has the potential and advantages.

[Turn] strontium ranelate treatment of osteoporosis

Strontium ranelate is the original study by the French pharmaceutical company Servier original new class of anti-osteoporosis drugs, is the only drug with a dual mechanism of action, creating a new era in the treatment of osteoporosis. The one hand, , Optek the United States through the calcium sensing receptor pathway promotes bone cell replication before the differentiation of osteoblasts increased the number of new bone formation, improve bone microstructure. On the other hand, Optek United States increased the secretion of OPG and reduce RANKL expression, thereby inhibiting osteoclast differentiation before, so that the number of osteoclasts decreased production and activity decreased, thereby reducing bone resorption, bone turnover restore the dynamic balance of fundamentally the treatment of osteoporosis. a controlled study of bone micro-CT imaging revealed Optek United States to promote new bone formation, and fundamentally improve osteoporosis cortical and trabecular bone microstructure. new and better bone bone, bone strength improved significantly. international multi-center clinical registration SOTI study showed that: Optek U.S. treatment for 3 years reduced the incidence of vertebral fractures 41%, spine BMD was significantly improved, and easy to take and well tolerated. TROPOS study shows that: Optek hip fracture and the United States can reduce the risk of peripheral fractures. Optek the United States has 8 years of extensive anti-fracture efficacy of evidence based medicine, is the only effective in preventing the young age of 50 to 65 and 80 osteoporosis patients over the age of fractures in osteoporosis drugs. its innovative mechanism of action, Optek the United States has been in Europe, Asia and other guidelines recommend as first-line drugs, and China, written prior to listing Jibei official "guide to diagnosis and treatment of osteoporotic fracture", published in the October 2008 "Chinese Orthopaedics "on. Optek United States also won the Frost & Sullivan Award and the 2004 Award for the best economic efficacy. Optek the United States in 2005 to obtain Prix Galien Award (prize known as the Nobel Prize in the field of pharmaceutical R & D), the participating experts Optek the advent of the United States agreed that, not only for the treatment of osteoporosis has brought new breakthroughs, but also brought new hope to patients. Manual:

【Drug name】 generic name: strontium ranelate dry suspension English name: Strontium Ranelate for Suspension (OSSEOR ?) Pinyin Name: Leinaisuansi Ganhunxuanji Trade Name: Optek the U.S. The main components major components of the chemical name: strontium ranelate, 5 - [bis (carboxymethyl ) amino] -2-- carboxyl -4-- cyano -3-- thiophene acetic acid two strontium salts. 【Molecular Formula】 C12H6N2O8S, Sr2 【Molecular Weight】 513.5 【Structural formula】 【Properties】 This product is yellow powder. pharmacological effects】 【Pharmacology and Toxicology In vitro study found that strontium ranelate increased bone tissue culture of bone formation, bone cell culture in osteoblast precursors to improve replication and collagen synthesis; by reducing osteoclast differentiation and activity to reduce the absorption of bone resorption . thus restoring the balance of bone turnover, is conducive to new bone formation. in the rat model, strontium ranelate increases trabecular bone quality, quantity and thickness; to improve bone strength. in the treatment of an animal or human bone tissue, the strontium adsorption on crystal surface, the carbon in the newly formed bone substitute lime little calcium crystals. strontium ranelate does not change the characteristics of bone crystals. In Ⅲ clinical studies, daily strontium ranelate 2 overcome by up to 60 months after iliac crest bone biopsies obtained data of strontium ranelate is not observed in bone mass and mineralization of harmful effects. the distribution of strontium in bone tissue and its (compared with calcium) to X-ray combined effect of increased absorption of lead dual-energy X-ray absorption absorptiometry (DXA) measured bone mineral density (BMD) to enlarge. The existing data suggest that the FDA 2 g / day treatment for 3 years, about 50% of the BMD measurements change is caused by these factors. Therefore, in using this treatment in the interpretation of BMD change to take into account these factors. Based on the results of clinical studies in stage Ⅲ in the treatment of this product has proven efficacy against fractures of the case before treatment after treatment compared to the determination of this product in lumbar spine BMD annual average increase of 4%, femoral neck increased by 2%; treatment for 3 years increased by 13% to 15% and 5% to 6%. In Ⅲ clinical studies, compared with placebo, after 3 months from treatment start to 3 years after treatment, biochemical markers of bone formation (bone - specific alkaline phosphatase and type Ⅰ procollagen C terminal peptide) was increased. The biochemical markers of bone resorption (serum type Ⅰ collagen cross-linked C telopeptide (CTX) or urinary crosslinked N telopeptide (NTX)) decreased. as strontium ranelate secondary pharmacological effects, found that calcium and parathyroid hormone (PTH) plasma concentrations decreased slightly, phosphorus and total alkaline phosphatase activity increased, but did not observe any clinical consequences. toxicology preclinical safety pharmacology, genotoxicity, carcinogenic potential study did not found that the goods are at special risk to humans. rodent long-term use of high dose of strontium ranelate leading to bone and teeth abnormalities, including spontaneous fractures and delayed mineralization. These effects occur, the action level of strontium in bone than When the clinical long-term medication in patients with 2 to 3 times higher, and can be reversed after treatment is stopped. in rats and rabbits, developmental toxicology studies, strontium ranelate led to progeny animal bone and teeth abnormalities (such as bending of long bones and wavy ribs). In rats, 8 weeks after discontinuation of these effects are reversed. 【Pharmacokinetics of strontium ranelate is composed of two stable strontium ranelate atom and a molecule composed of an integral part of making the molecular weight, pharmacokinetics, and drug tolerance to achieve the best compromise. strontium ranelate and pharmacokinetics in healthy young men and healthy postmenopausal women were measured, and in postmenopausal osteoporosis in women, including elderly women in long-term treatment during the process were determined. As high ranelate polarity, the absorption, distribution and plasma protein binding rate is lower. in animals and humans, no accumulation of ranelate, also found no evidence of its metabolism. ranelate absorbed quickly by the kidneys to prototype discharge. Kelei Nai strontium absorption after oral administration of 2, the absolute bioavailability of strontium is about 25% (range 19 ~ 27%). After a single oral dose of 3 to 5 hours to reach maximum plasma concentration. After 2 weeks of treatment to reach steady state. and 3 hours after meals taking strontium ranelate, compared with calcium or food while taking strontium strontium ranelate reduced the biological utilization of about 60 to 70%. because the relatively slow uptake of strontium, strontium before and after taking food and calcium should be avoided. oral vitamin D supplements had no effect on the absorption of strontium. Distribution of volume of distribution of strontium is about 1 liter / kg. strontium binding to human plasma proteins is low (25%), and with a higher affinity for bone tissue. strontium ranelate 2 g / day treatment for patients up to 60 months to determine the anterior superior iliac crest bone biopsy the concentration of strontium in bone tissue, the results show about 3 years in the treatment of bone strontium concentrations may reach a plateau. There is no data to show that after stopping treatment strontium bone removed from the dynamics. biotransformation as a divalent cation, strontium is not is metabolized. strontium ranelate does not inhibit cytochrome P450 enzymes. clear the removal of strontium has nothing to do with the time and dose, the effective half-life of approximately 60 hours, cleared by the kidneys and gastrointestinal tract, plasma clearance rate is about 12 hours (CV 22 %), renal clearance is about 7ml/min (CV 28%). In the case of special clinical pharmacokinetics of the elderly population pharmacokinetic data, in the target population in the age and apparent clearance rate of strontium and unrelated. renal dysfunction in patients with mild - moderate patients with impaired renal function (creatinine clearance rate of 30 ~ 70ml/min), with the rate of decline in creatinine clearance, thus resulting in reduced clearance of strontium (creatinine clearance rate in the range of 30 ~ 70ml/min, about 30% decrease), resulting in increased plasma concentrations of strontium. In Ⅲ clinical study, 85% of selected patients when creatinine clearance ranging between 30 ~ 70ml/min, 6% of the patients Diyu 30ml/min, and the average creatinine clearance rate is about 50ml/min. Yinci mild - moderate renal impairment Bingren not need to adjust Jiliang. no severe renal impairment Bingren TO PHARMACOKINETIC such information (creatinine clearance below 30ml/min). liver injury in patients without liver dysfunction in patients with pharmacokinetic information. Because the pharmacokinetic characteristics of strontium is expected to no effect. 【Storage】 Sealed kept below 30 ℃ . 【Indications】 treatment of postmenopausal osteoporosis to reduce vertebral and hip fracture risk. 【Packing】 paper - polyethylene - aluminum - polyethylene bags, 7,14,28 bags / box 【Validity】 36 months Zhunzi】 【[imported drugs registration No] H 20080315 (7 bags, 14 bags / box), H 20080320 (28 bags / box)

Older people how to prevent osteoporosis,

The elderly on how to prevent osteoporosis prevention 2010-03-09 10:09 elderly, should be" five-five should not ":

should not be cutting kidney kidney

experiments show of herbs can inhibit the bone resorption activity of osteoclasts, increased bone formation while cells and promote bone formation. of herbs to some extent, but also stability and improve people's sex hormone levels. Therefore, middle-aged people to be biased according to constitution of yin and yang, kidney dressed in uniforms of the goods. If deficiency, the "form is insufficient, the temperature of the air," kidney pills to take right go balls; such as kidney, the "fine is insufficient, fill them with taste," to take Liu Wei Di Huang Wan, Dabuyin balls.

should not damage the spleen spleen

in the process of bone metabolism need the right amount of calcium, phosphorus and vitamin D. some of the gastrointestinal tract disease caused by poor digestion and absorption, then the impact of the absorption of calcium and vitamin D, resulting in osteoporosis. There are elderly intestinal absorption of calcium reduced also is the list of spleen. Clinical Spleen Spleen tune and improve the treatment of gastrointestinal disorders of digestion and absorption older, proven, available ginseng Guipi, SHENLINGBAISHU balls.

sooner rather than later

modern medicine, the loss of bone mass in women age 35 years, male 40 years of age, osteoporosis prevention and treatment are also special emphasis on age, should the sooner the better. 70 older, "the five internal organs are feeble bones relentless fall into this", this time in order to slow through the treatment of bone loss, on the more difficult. Therefore, the middle age, bone mineral density should be inspected once a year to understand their peak bone mass and take preventive measures.

appropriate action should not be static

long-term progressive movement, not only can slow bone loss, but also significantly improved bone salt content. exercise can to promote bone cell activity. There are reports that people over the age of 60 long-distance running every day, can the young bone age of 20 years.

Poxue consumption should not be nourishing and activating blood circulation of blood

senile osteoporosis is a prominent symptom of low back pain, or with limbs radiating pain, shingles pain, numbness, weakness, or with muscle pain, lower limb gastrocnemius muscle spasms. General does not hurt, with blood stagnation will pass laws, but should nourishing blood to pass it, can angelica, Chuanxiong, white peony root, Achyranthes, Millettia so.

Orthopedic Hospital of Zhengzhou Chihuahua will maintain the "heritage to create a model of minimally invasive orthopedic medicine orthopedic the essence of "the concept of running the hospitals," the essence of traditional Chinese medicine and minimally invasive orthopedic Orthopedics perfect combination of technology, "featuring the" care of human bone health "for the purpose of bone disease in patients around the world provide comprehensive, humane, noble of the medical service experience. We are based in China, of a first-class international professional Orthopaedic Hospital.

Hospital Address: Zhengzhou City, Hong Chuan Road 106 (Red professionals Road and west all the way through the intersection 50 meters)

Hospital-mail: zzjhgk@163.com

National Unity Advisory Hotline :0371 - 96995

Stand up and cry for your bones

2009 World Osteoporosis Day theme is: stand up for your bones (Stand tall for your bones!) Continuation of the themes of the 2008" stand up and cry for your bones! "Theme marked "stand up" theme into the new year. of the health system, health organizations, the public has been concerned about bone health, but the mandatory spondylitis, shares arthritis, bone disease, femoral head necrosis has been difficult to cured, troubled people's lives. Osteopathic involve all parts of the body, from the cervical, shoulder, down to the knee, ankle, or even related to the mandatory body spondylitis, and its important location, described as " indeed affect the whole body. "bone disease have a high popularity in China has 3.8% -10%, which is about one billion people suffer from bone disease. Journal of Pain Medicine Medical Director, Ozone treatment of pain Experts Wang Zhangxia President pointed out that the level of the previous restrictions on domestic health care, the current public perception of pain was significantly less than that in the treatment of pain are also common errors. Most of Orthopaedic acute disease risk area because of its complex structure, there are many important organizations such as the carotid artery, jugular vein, thyroid, trachea, recurrent laryngeal nerve, esophagus, etc., which oppresses the nervous system of patients, the treatment of high-risk areas, have occurred in surgical cases of paraplegia, the treatment is not difficult being understood. At present, lumbar, cervical traction treatment for most of treatment, surgical treatment and the Western anti-inflammatory pain, as the disc is an independent cartilage, blood vessel barrier, the treatment of lumbar, can only solve the short-cervical pain, effect is temporary. traction therapy, the medical profession long-term clinical trials, traction therapy for most patients, pain relief can do; surgical treatment, the indication is required strict clinical populations suitable for surgery is less than 5%, plus the high cost of trauma, long recovery period, and so easy to relapse, so there is nothing to address the need of most patients; pain medication, only pain can not be treating pain, long-term use is easy to produce dependence and side effects, not only useless but also stimulate the stomach liver and kidney damage. coupled with not enough public awareness of pain, mild pain and more with external plaster, acupuncture, medicine and other adjuvant therapy deposited, temporarily reached the blood circulation, dredge the meridians, anti-inflammatory analgesic effect, but was not timely cured, the disease tends to aggravate the disease in turn lead to other complications. Today, the troubled years of the chronic illness, patient finally had a revolutionary therapy. of pain therapy experts, the domestic "ozone first person" under the title of president PATHOLOGY clinical trials for many years, developed a painless, quick, do not rebound, and low cost of new treatments - ozone target micro- invasive intervention, effective treatment of cervical disc herniation, frozen shoulder, shares arthritis, tennis elbow, rheumatism, rheumatoid, femoral head necrosis, ankylosing spondylitis, gout, soft tissue of the neck and all Yaotui Teng, various types of aseptic inflammation, synovitis, treatment effect, low cost, no recurrence. and not the same as the traditional closed approach, minimally invasive treatment of target ozone concentration of ozone of high disc herniated disc injection into the medullary nuclear organization, a fundamental solution to the system causes pain. instantaneous oxidation of proteoglycan within the nucleus pulposus and the destruction of nucleus pulposus cells, loss of function of protein polysaccharides, cells to produce protein decreased the osmotic pressure within the nucleus pulposus can not be maintained, resulting in water loss and atrophy, thereby reducing the intradiscal pressure, so that symptoms can be removed for therapeutic purposes. This therapy can be within 1-3 months after injection returned to normal, and the other with the disc nerve root injection of the rapid elimination of the inflammation and edema , both to make the symptoms disappear immediately, and can completely restore the herniated disk, so especially good long-term effect, not who rebound, the cure rate of up to 97%. Three oxygen therapy targets a wide range of application and low risk of disease. by Ozone dedicated needle, diameter 0.3 mm, when both the disc puncture, the joint cavity, local injection of the surrounding tissue will not harm. According to different patients with different concentrations of ozone injection and injection volume, the use of overlapping therapy, relapse rate 3%. with original liquid knife, in the treatment to rid itself of the hormones, anesthetics, painkillers, bondage, so far in the treatment of patients with pain, treatment side effects from drugs. healthy bones is a healthy body support, minimally invasive treatment of ozone targets help you to shake off the bone disease, and freely.

Do a good job of osteoporosis treatment and prevention

Century Church gelatin /

incidence of osteoporosis is a gradual process, primary osteoporosis increased with age occurred; idiopathic osteoporosis Some people will be the inclusion of patients with primary osteoporosis range of areas. In fact there are specific factors (such as heredity, pregnancy, lactation, etc.); secondary osteoporosis is a disease or some of the reasons some cause, no matter what type of osteoporosis, its treatment, the precautionary principle should be in common.

1, symptomatic treatment of osteoporosis in clinical manifestations of pain, kyphosis, fractures. Based on the clinical symptoms and signs for processing. such as pain and minor fractures because of bone resorption or osteoporosis due to soft tissue pull. We will use drugs, physical, surgery, such as different treatment, prevention and rehabilitation measures.

2, slow bone loss or increase bone mass in osteoporosis treatment and prevention special emphasis on age, women 35 years ago as a long-term increase in volume of bone, gradually lost thereafter, 50 years of age were rapid loss of bone mass growth in our age of peak bone mass as possible to increase, and to maintain peak bone a long time, bone loss in age (before menopause), should slow down the bone loss in postmenopausal women quickly loss should be used for appropriate treatment and preventive measures (such as estrogen replacement therapy.) age bone loss, women 35 years of age, male 40 years old, should try every means to slow down the bone loss, special attention is 70-year-old After treatment of the elderly in order to slow through the bone loss is not easy.

3, prevention of fractures in osteoporosis fracture is the most serious consequences, is to prevent the occurrence of bone fracture osteoporosis treatment and prevention of the most important measures we have taken is to reach a maximum peak bone mass, slow bone loss, which is to prevent the occurrence of fractures of the most effective steps. In the fall of the opportunities that vision is very important, emphasizes the protection of eyesight, to reduce the chance of falling. China and some regions in the world, due to environmental factors, opportunities fall, fracture rate was also high. it should take the appropriate treatment, prevention measures to reduce the fracture (such as increased light therapy, ultraviolet light therapy, to prevent slipping, etc.).

4, the right amount of strengthening calcium supplement. a huge loss of calcium leading to osteoporosis is an important reason, so we osteoporosis prevention issues, the calcium is a very important part.

for calcium supplement to achieve the following main aspects: one to "closure" to reduce the loss of calcium, slow rate of bone calcium loss; Second, we must strengthen the exercise. outdoor exercise can promote the formation of vitamin D to promote calcium absorption; exercise can also increase the load on the muscles, enhance muscle on bone, joint protection, the so-called gluten bone health; third, "open source", eat some calcium-rich foods, promote absorption of calcium, like we usually eat dairy, soy products, pork and so contains a lot of calcium material. In addition, it can amount Some Ejiao tonic. because "donkey-hide gelatin" also contains a lot of calcium, it can increase serum calcium levels, improve the balance of the body of calcium, so that hypocalcemia to normal. and gelatin is also rich in collagen, can promote calcium absorption and storage, effectively improve the result of calcium loss caused by calcium deficiency, calcium outflow, osteoporosis and bone fractures and various types of hyperplasia. Meanwhile Ejiao of calcium, zinc, iron, manganese and cartilage collagen factors and other nutrients can promote bone growth, so donkey-hide gelatin and calcium to combat osteoporosis, one of the effective drugs.

course, if we prevent osteoporosis through the consumption of gelatin to be sure to choose authentic authentic gelatin, because only good medicine will cure disease. The donkey-hide gelatin as a product of the land of East Azerbaijan, its water quality and eastern Afghanistan and is closely related to the local culture. Only a "sexual tendency, the clear and heavy" the nature of the East County Groundwater proudly plastic, is a nourishing health effects authentic gelatin. So we must choose to use gelatin production of authentic East A donkey-hide gelatin, and one hundred authentic Church gelatin as a donkey-hide gelatin East Azerbaijan example, spend a good result has been a unique leather and the local water, boil eight-day eastern Afghanistan, during which also add sugar to taste fishy wine plus soybean oil anti-sticking and other special skills ... the production of gelatin due to "black as a shade If the grease paint condensate, run through, such as jade, amber, not wet through the summer and winter is not soft, Chen still good old glue effect "feature, which has been loved and sought after by a wide audience.

Search Browse Medicines treasures, knowing the source of origin, end of the story, we review the town's folk Ejiao

2011年1月9日星期日

【Reference】 Chinese medicine treatment of osteoporosis

To share this post, my view is:

Original Address: 【Reference】 text of Chinese medicine treatment of osteoporosis: Xinyu Ming

like to share filed, in my opinion:

Original Address: Chinese text of the treatment of osteoporosis: health division

◆ Epimedium ◆

Weixin, sweet, and warm, the liver, kidney. modern pharmacological experiments showed that water extract of Epimedium total effective area and its application to the Castration-dimensional A acid, adrenal cortex hormones and hydroxyurea in rats caused by OP model are have some role in prevention and treatment, its mechanisms and improve bone metabolism, regulate the levels of enzymes and hormones promote protein synthesis, nucleic acid metabolism and enhance the hypothalamus - pituitary - gonadal axis and adrenal axis, thymus axis related to the function such as secretion system . 5 mg ml -1 aqueous extract of Epimedium can promote the proliferation of osteoblasts, but the differentiation of osteoblasts had no effect. icariin Monomers which can promote osteoblast differentiation and mineral features, and can promote bone marrow stromal cells into osteoblasts, the level of the gene for BMP2-mRNA expression. Epimedium times glycosides Ⅰ, Epimedium times glycosides Ⅱ, Epimedium set B, set Epimedium C also has to promote in vitro osteoblast proliferation and mineralization. In addition, Epimedium also dose dependently inhibited the formation of bone marrow cells differentiated osteoclast-like cells and inhibit bone resorption. in recent years has been suggested by inhibition of adipogenic differentiation of bone marrow stromal cells and promote their osteogenic differentiation to achieve prevention and treatment of OP's point of view. Recently, the Chinese Academy of Medical Sciences Peking Union Medical College Institute of Medicinal Plant Research Institute, Shenzhen City University of Hong Kong studied 95% Epimedium Extraction of ethanol extract of various parts (including petroleum ether, chloroform, ethyl acetate, butanol) and 50% ethanol extract, water extract some bone on bone marrow stromal cells differentiation, and found some with ethyl acetate promote osteogenic differentiation of.

◆ Drynaria ◆

and warm, bitter, kidney, liver. There kidney, blood, bleeding, continued injury The effectiveness of commonly used drugs for the bone-setting. the whole animal study found that Drynaria prevention and treatment can significantly OP. Drynaria water extract and alcohol extract could promote mouse osteoblastic cell line MC3T3-E1 proliferation, differentiation and mineralization. Overseas research has shown that isolated from Drynaria monomer (such as flavan -3-- alcohol) can promote human breast cancer cells MCF-7 and the proliferation of osteoblast-like cells in the role of ROS17/2.8 , the proliferation of even more than the estradiol and genistein, suggesting that there Gusuibu the role of estrogen-like compounds, and thus have therapeutic effects in postmenopausal OP. In addition, Drynaria extract can inhibit osteoclastic bone bone resorption, specifically in the number and area of bone resorption showed a dose-dependent reduced. The role of osteoclasts may be through inhibition of intracellular mature cathepsin K, the sky, the inhibitory effect and concentration-dependent relationship.

◆ Cnidium ◆

warm non-toxic, taste hard, in the final kidney. with kidney impotence, dampness, expelling wind, the role of pesticides. snake Chuangzai contain coumarins were considered to have weak estrogen-like biological effects. Series results show that the total coumarins can use Cnidium glucocorticoids and OP caused by ovariectomy model has obvious therapeutic effect This may be related to the promotion of osteoblast proliferation and secretion of alkaline phosphatase, inhibiting the secretion of osteoblasts NO, interleukin (IL) -1 and IL-6 related. Another study shows that the total coumarins through Cnidium inhibition of osteoclast differentiation and bone resorption and thus play a protective role. molecular level, studies have shown that osthole can increase osteoblast OPG (OPG) expression, while a slight inhibition of RANKL (also said ODF, osteoclast differentiation factor) expression.

◆ Dipsacus ◆

of bitter lukewarm, sweet Sim, the liver, kidney. with liver and kidney, strengthening the bones and blood, continued off injury, only uterine bleeding, miscarriage and other effects. Modern research shows that, Chuan-off can be reversed due to bone loss in ovariectomized rats. 95% ethanol and 50% ethanol extract can dose both to promote the proliferation of osteoblasts, and the effect of promoting proliferation of the former is stronger than the latter.

◆ psoralen ◆

of Greater Vancouver, bitter, acrid, spleen, kidney by. with kidney impotence, urinary solid minified, Wenpi antidiarrheal effect. pharmacological experiments showed that psoralen acetone extract can increase the non-polar bone strength, increase blood levels of inorganic phosphate. In vitro experiments showed that ethanol extracts psoralen, ethyl acetate monomer in the extraction of parts of its flavonoids psoralen and psoralen A Su Ning could promote osteoblast-like cells UMR106 proliferation and differentiation. psoralen also can inhibit osteoclastic bone resorption pit formation and expansion, and the inhibitory effect of psoralen concentration.

Often heard that regular Coke cause osteoporosis, prone to d

Often heard ordinary coke will lead to osteoporosis, prone to diabetes, is there science

2010-09-12 issue: often heard that Coke will often lead to osteoporosis, easy diabetes, is there a scientific basis? I like to drink, has been a long time, please help me look at you! Thank ~~!

best answer: Yes, because the Coca-Cola is carbonated beverage , often a large number of young people drinking carbonated drinks the risk of fracture is 3 times the other young people. carbonated drinks on long-term harm to human health. It not only affects the bone development in childhood, and easily endanger the elderly, particularly when women in the menopausal osteoporosis. carbonated drinks can also affect dental health, dental encounter PH55 acidity will dissolve the following, and many carbonated drinks, fruit juice, vitamin C, etc. and even tooth form of the potential danger, when you find teeth become sensitive, sore, it means that your teeth are eroded.

carbonated drinks, most containing more sugar, saccharin, electrolyte and synthetic pigments. excrete these substances as fast like drinking water, thus stimulate gastric adverse affect appetite digestion. to increase the burden on the kidneys filter and affect kidney function.

other answer 2: carbonated drinks - affect your calcium and iron

carbonate beverages including various types of soft drinks, flavored soft drinks, cola, flavored cola, and all kinds of carbonated beverage.

not likely to drink carbonated beverages for four reasons:

carbonated drinks contain gas, that carbon dioxide

carbon dioxide will stimulate gastric secretion, gastric acid too easy to feel abdominal distention, decreased appetite, and reduce diet intake. diet if the intake of nutrients will affect the normal growth and development, learning, sports performance, performance and health.

carbonated drinks containing sugar

jar of 355 cc of cola contains about 35 grams of sugar, equivalent to 140 calories, equivalent to half-bowl too heat . However, only the numbers of calories, nutrients are rather different, because sugar contains only calories and other nutrients that are not, is apart from the empty calories of food or junk food, empty card, often drinking, will add up to weight gain, also easy to develop bad eating habits addicted to sweet, just like drinking a sweet water, and drink water; addition of sugar on dental health is also adversely affected.

another ingredient phosphoric acid soda

calcium phosphate will reduce the absorption of the body, affecting bone growth and normal development of height. positive growth and development of children and adolescents, the need for adequate calcium, so that normal bone growth and development, maintain good bone metabolism, bone density and to achieve the best conditions, so it can not drink carbonated beverages. In addition, phosphate also hinder iron absorption, iron is to create one of the main material of blood, once the iron is not enough, can cause iron deficiency anemia. are the children of rapid growth and development, also is in need of blood quickly enough iron. particularly adolescent girls, a higher iron requirements, because the monthly menstruation, the loss will be fixed a lot of iron. so love soda girl, more prone to iron deficiency anemia.

all kinds of cola contains caffeine

caffeine stimulates the heart muscle contraction, heart rate and breathing; Council stimulate gastric acid secretion, gastrointestinal injury; a diuretic effect, the elderly prone to the risk of dehydration; long-term consumption is addictive, once the drink to feel so wrong, lethargy or headache. If the long-term excessive drinking caffeine a day more than 200 mg, there will be indigestion, headaches, insomnia, nervousness, tremors, irritability, rapid heart beat and other chronic poisoning. caffeine found in cola, tea and coffee in a can of Coke contains 355 cc of 65 mg of caffeine, a oolong tea containing 80 cans of 350 cc to 120 milligrams, a cup of instant coffee contains 85 to 200 mg; Therefore, if they drink three cans a day or more cola, or drink a can of Coke, plus a can of tea and a cup of coffee to caffeine more than 200 milligrams, a long time down it is easy to chronic poisoning.

dental erosion (protective layer thinning, teeth become vulnerable), is the role of acid caused by tooth decay is caused by eating polysaccharide . Dr. Locke observed: foam beverage drank 28 grams of 12-year-old youth, was significantly affected by dental erosion; foam beverage drank 4 cups, 12-year-olds up to 25.2% of damaged teeth, 14-year-old young Junior is as high as 51.3%.

an experiment you can go home if the toilet to wash clean, put a bottle of Coke to wash down does not go in, wait for a few hours to paint, to ensure clean, and porcelain on the toilet luminous layer was eroded enamel, porcelain surface will become dull ~ ~

can see how hard it is corrosive!

really the best drink less

other answer 3: carbonated soft drinks three components of health

excess of carbon dioxide affect the digestive

[To] take a look at yourself if you have osteoporosis, the

Occasionally checks out today, suffering from osteoporosis, I have a little fameng, although that will be calcium deficiency, but did not realize would be so serious, the doctor said, wanted to restore is not possible, quickly and effective calcium control the conduct of the continued development of osteoporosis, a serious consultation with the doctor, the Internet and then at the back, choose a suitable way to make it, how to do?

By the way here I come friends, go to the hospital quickly do a bone density check, a very simple check, do not tell me, and appeared too late to fix. I have been off the past few years re-calcium, did not think there will still be so serious osteoporosis, we can see how necessary checks regularly. menopausal women in particular and frequently prone to smoking, drinking, men's.

Here is my online search to the post, turn Come share it with friends.

osteoporosis drink porridge

sheep bones porridge: sheep bones of about 100 grams, 100 grams of rice, a little thin salt, light blue 2, ginger, 3. Take fresh sheep bones, washed and broken hammer, water decoction, and then take soup on behalf of the water, with the rice porridge, congee will become, adding thin salt, ginger, scallion stalk. a little boiling can.

Drug Effect: You can play a role in kidney and bone health.

porridge Dodder: Dodder 60 grams (100 grams of fresh available), 100 grams of rice, sugar amount. Dodder cleaned first broken, add water to cook the juice, to the slag into the rice porridge. porridge will become when you add sugar, Shaozhu can.

Drug Efficacy: waist and knee pain, weak legs, weak virtual failure patients, adhere to the taking it quite effective.

wolfberry Yang Shen porridge: 250 grams medlar leaves, Yang Shen 1, 100 grams of meat, very light blue 2, a little fine salt, 100 grams of rice, wash the Yang Shen profile to cut thin membrane, and then washed mutton chopped, with juice, wolfberry leaf to the residue before, with the Yang Shen, lamb, light blue, rice porridge, congee into, add thin salt, Shaozhu can.

Drug Efficacy: Yang Shen of kidney disorders, Yao Ji Leng Tong, knee and foot atrophy rather weak embolism efficacious.

select key calcium products are three strategies

We all know that calcium needs to fight a "protracted war" and therefore "health benefits" and "price" has become the two Key indicators. But how to do both make up a good calcium supplement, but also save money heart? the face of dozens of calcium products, is to listen friend? or to vote for he knows, the price moderate brand? The former is a subjective description, which is affected by advertising, dazzling. teach you the following three strategies, so that you easily calcium.

an operator:

"elemental calcium" content, see the key value of calcium

common calcium carbonate, calcium gluconate, amino acid calcium, calcium lactate and calcium hydrogen phosphate, calcium compounds are in fact, commonly known as calcium. People taking any kind of truly absorbed only one of the "elemental calcium." difference of calcium, "elemental calcium" content also different. containing elements such as calcium gluconate is only 9%, dicalcium phosphate containing 23% elemental calcium, while calcium carbonate is relatively high calcium content elements of the same to take a calcium tablet, even the intake of elemental calcium have 2-4 times the difference.

Tip: in the choice of calcium, the calcium content of not focusing on the element calcium is the key, see this section is to enhance the efficiency of calcium hurdle.

b ratio:

dimension D with a good source of calcium, a good calcium absorption

common elements of various calcium salts not only different Xishou rate is also a difference: confirmed, 27% calcium gluconate, calcium lactate 32%, 29% calcium acetate, calcium citrate 21%, DCP 15% ... compared calcium content in the elements, the performance of good calcium carbonate, the absorption rate of 39%, is currently the most widely used, and the higher cost of calcium, highly respected doctors and consumers.

calcium source is selected on the importance of effective calcium step further effect of vitamin D3 can make. scientific evidence, the blood concentration of vitamin D needed to maintain a certain order to ensure optimal calcium absorption. D3 tablets of calcium carbonate as calcium carbonate, calcium carbonate used not only the source, which also contains vitamin D3125IU, increased calcium absorption and utilization.

Tip: Select the source of calcium is an important step in effective calcium, vitamin D, containing also very important, both with calcium in order to better absorption.

Third, look at:

single calcium content, recognize the real cost

considered cost-effective, single or more than just a single bottle price is not right depends on the calcium content of each piece and to meet the day was taking the required number of pieces. some readers have said that many calcium products have said one day, as long as a dollar. But this one is to meet the daily needs?

New NOF Osteoporosis Clinic Guide

Risk assessment

all postmenopausal women and older men should be in the clinical assessment of osteoporosis risk, needs to be done to determine whether bone mineral density (BMD) examination. Generally speaking, The more risk factors, the greater the risk of fracture. Osteoporosis is preventable and treatable, but because there is no early warning signs prior to fracture, so many people can not accept the disease early diagnosis and prompt effective treatment. Many factors can increase bone the risk of osteoporosis-related fractures.

Since the majority of osteoporosis-related fractures are caused by falls, so the assessment of risk factors for falls are also important. In addition to muscle weakness, gait, balance and visual defects, The most important seems to be falling personal history.

in the WHO's 10-year fracture risk model, risk factors, the present age, gender, history of fracture, femoral neck BMD, low BMI and whether use of oral glucocorticoids, but also whether the secondary osteoporosis, parents hip fracture history, smoking, drinking large. WHO pointed out that this group of risk factors combined with BMD measurements to assess the patient's fracture risk.

addition to osteoporosis, the metabolic bone diseases (such as a gland next to Kang or osteomalacia) can lower the BMD. Many of these patients have very special effects of the treatment, diagnosis of osteoporosis based solely on BMD history of osteoporosis should be completed before the collection and examination.

If there can be considered the treatment of patients with secondary causes of osteoporosis, should be done before starting treatment, the corresponding blood and urine tests (such as serum calcium, urinary calcium, serum thyrotropin, protein electrophoresis, cortisol, or gluten sensitive enteropathy on antibodies). of recent fractures in elderly patients, secondary causes should be assessed, considering the osteomalacia or vitamin D deficiency should be Serum 25 (OH) D levels. In general, patients diagnosed with osteoporosis should be considered before beginning therapy biochemical tests done (such as serum calcium and creatinine).

diagnostic criteria

osteoporosis diagnosis based on BMD measurements. fractures in a low-invasive high-risk patients can often make a preliminary diagnosis of osteoporosis or clinical diagnosis.

bone mineral density measurement and classification

axial DXA hip and spine are now using dual energy X ray absorptiometry (DXA) to determine or confirm the diagnosis of osteoporosis, predict future fracture risk, and through a series of measurements to monitor patients.

diagnosis according to WHO classification, BMD diagnosis were divided into normal: BMD in the "normal young" adult BMD 1 standard deviation (SD) or less (T min ≥ -1.0); low bone (" osteopenia "): BMD than the" normal young "adults with low BMD 1.0 ~ 2.5 SD (T min -1.0 ~ -2.5); osteoporosis: BMD more than" normal young "adults with low BMD ≥ 2.5 SD (T sub ≤ -2.5); severe osteoporosis or certain: had 1 or more fractures in this group of patients.

in postmenopausal women and ≥ 50-year-old man, WHO for T sub-standard diagnosis (normal, low bone mass and osteoporosis) for axial DXA (lumbar spine, total hip and femoral neck) of the BMD measurements. If you can not measure the hip or spine BMD, a 1 / 3 radius site The DXA BMD measurements to diagnose osteoporosis. in premenopausal women or 50-year-old men and children, do not use the BMD WHO diagnostic classification criteria. In this group of population, not only according to the density measurement standard diagnosis of osteoporosis . International Society of Clinical Densitometry (ISCD) recommendations, not T divided, it should be corrected with a racial or ethnic sub-Z, Z min ≤ -2.0 is defined as the "chronological age than low bone mineral density" or "than the expected age Range Low "; Z points -2.0 is defined as" expected in this age range ".

BMD Check indications

1. age ≥ 65 years for women and ≥ 70 years men, with or without clinical risk factors.

2. have risk factors for younger postmenopausal women and 50 to 70 year-old man.

3. menopausal transition women, if increased risk of a fracture of special risk factors such as low birth weight, a low invasive fracture history or in the use of high-risk drugs.

4.50 after the age of fractures in adults.

5. There lead to low bone mass or bone loss disease (eg rheumatoid arthritis) or lead to low bone mass or bone loss drugs (eg glucocorticoids ≥ 5 mg / d ≥ 3 months) in adults.

6. consider the use of osteoporosis drugs of any person.

7. is the treatment of osteoporosis with any person, to monitor treatment effect.

8. There are no treatment, but there is evidence of bone loss, the treatment of people.

9. deactivate estrogen in postmenopausal women should consider doing BMD examination.

prevention

1. recommended that all patients adequate intake of calcium and vitamin D.

2. Recommended for women over 50 years of age to at least 1200 mg elemental calcium intake. 1200 ~ 1500 mg intake / d may be limited benefits and may increase the incidence of kidney stones or cardiovascular disease risk. NOF recommended daily intake for adults 50 years old 800 ~ 1000 international units (IU) of vitamin D3. This will make adults mean serum 25 ( OH) D concentration rose to the desired level ≥ 30 ng / ml (75 nmol / L).

The researchers claim that beer can prevent osteoporosis,

UC Davis researchers recently published a study stating that beer may help prevent osteoporosis. That given in the" Journal of Food and Agricultural Sciences, "the study found that some of the beer is rich The consumption of silicon, can maintain strong bones and prevent bone disease osteoporosis.

study's lead author, Charles Voss stressed classes, each of the silicon content of beer is different. "silicon the most abundant is rich in malt and hops in beer. "he said. Studied 100 species on the market after the sale of beer, class Voss and his team found that the beer made from wheat and corn, was the lowest consumption of silicon.

"silicon content than wheat, barley, barley, less because of the shell is rich in this ingredient already." He stressed, and added that the hull together with the brewing of beer to the silicon extracted.

According to the authors, the silicon in beer has a high bioavailability, meaning that the body can easily absorb. Many companies have sales of nutritional supplements, natural silicon [or known as silicon dioxide], can improve hair, nail and bone health.

National Osteoporosis Society to further stress to help prevent bone problems in addition to this component, there are other more effective ingredients. Clay child package Linbo Shi said the study also confirmed earlier about the benefits of moderate alcohol consumption, but also stressed that excessive alcohol consumption but will cause the opposite effect.

"Despite the small amount of alcohol may be beneficial to increase bone density, excessive intake would decrease bone strength. And more than 2 units of alcohol a day will increase the risk of fracture."

package Lynn that silicon is not important for bone health. Because the recommended amount of daily intake of silicon is not standardized, it is difficult to know whether the lack of such a body composition. The water and some anti-caking agent in the silicon content is not fixed, it is difficult to determine the daily intake of each person and their content down for the long-term bone health.

many experts currently recommend that the calcium and proven ingredients such as vitamin D to maintain bone health and prevention of bone diseases. If you still want to intake of silicon, the best natural sources or instead of alcohol.

2011年1月7日星期五

Nursing intervention on senile osteoporosis treatment of pat

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Abstract Objective To study the nursing intervention on senile bone osteoporosis treatment of patients. Methods 126 patients with senile osteoporosis were treated with comprehensive care and intervention, including health guidance, psychological intervention, functional exercise, medication and anti-fall care, extended care. Results after six months the intervention group the total effective rate was 93.93%, 3% fall rate, compared with the control group significantly (P 0.05). Conclusion integrated care intervention can improve cognition in patients with bad attitudes and behavior of life, reduce pain, reduce falls, improve patient quality of life .

Key words osteoporosis in older nursing intervention

osteoporosis (Osteoprosis, OP) is the older of the common disease, is a result of bone low amount of bone micro-structural damage, leading to bone fragility, high incidence of systemic bone disease characterized by fractures. The main symptoms are pain, osteoporosis, easy to fracture, height loss and kyphosis. in our country over the age of 60 about osteoporosis 1.3 million people, it has been seriously affected and threatened the health and quality of life of older persons. from June 2008 to June 2009 Division I with nursing intervention with drug treatment of primary osteoporosis treatment in 126 cases, results were satisfactory , are reported as follows.

1. Materials and methods

1.1 Material Selection June 2008 to June 2009, hospitalized in our department were 126 cases of osteoporosis, male 32, female 91 cases, age (60 to 85) years, mean age (71.4 ± 8.5) years, 12 cases complicated with vertebral compression fractures, femoral neck fractures in 5 cases, 2 cases of radial fractures, all patients were treated with the United States LUNAR Corporation PIXI dual energy X ray absorptiometry of distal radius BMD test, t = -2.0 SD radius diagnosis of osteoporosis. the patients at hospitalization 66 patients were randomly divided into intervention group and control group 60 cases, two group sex, age, educational level, t value of the main clinical manifestations and compared, no significant difference, comparable.

1.2 method of treatment, all patients were using intramuscular injection of salmon calcitonin, oral calcium carbonate D3 tablets, 600mg / d, oral alendronate (Fosamax) 10mg / d or 70mg / w, for 6 months observation period. In addition to the treatment intervention group, but also the comprehensive nursing intervention.

1.2.1 Health education intervention after admission assessment by the nurse in charge of osteoporosis in patients with existing risk factors, if no fracture history, weight, smoking drinking, oral steroid treatment for 3 months or more, visually impaired, Alzheimer's disease, ill health, long-term without adequate intake of calcium, exercise less and so on. understand the patient and family awareness of the disease, determine the objectives of health education, targeted health guidance. set up a "House of osteoporosis", prior to discharge to the were issued membership cards, a healthy file. 2 from the one month, deputy director of physician and charge nurse to the patients and their families to explain the teaching methods of osteoporosis-related knowledge, including causes, prevention, treatment and functional exercise, fall prevention method, and compiled the content of health education manual distributed to patients at A prize competition, so that patients and their families have a correct understanding of the disease, understanding the long-term therapy and functional exercise adhere to the meaning, change unhealthy behavior.

1.2.2 repeated unhealed psychological intervention because of disease, with some patients due to pain, fractures, restricted activity, life can not take care of themselves, it is prone to anxiety, worries, disease treatment and rehabilitation at a disadvantage. guide self-assessment of their condition properly and give specific psychological counseling, symptomatic treatment to improve the psychological state of patients, reduce the burden of thinking, try to eliminate the family and the adverse social stimulus to the patient.

1.2.3 medication guide the non-steroidal anti-inflammatory drugs should be taken at 0.5 ~ 1h after the meal, to avoid stimulation of the gastrointestinal tract; use chewable calcium and alfacalcidol same time taking, can promote calcium absorption, postprandial 1 hours before bedtime is good. calcium required to achieve effective long-term use, take the time to increase the water intake of calcium to prevent urinary calculi; taking vitamin D, can not eat green leafy vegetables, and so reduce the absorption of calcium; taking alendronate to be fasting, but drinking 300ml of water to swallow, at least half an hour can not eat or drink, can not be supine, to reduce the stimulation of the esophagus. taking bisphosphonates without calcium and vitamin during the D.