Summary： Serum sclerostin is positively associated with serum 25 hydroxyvitamin D concentration. Our preliminary studies confirmed that Qing＇e formula （QEF） could effectively increase serum 25 hy- droxyvitamin D concentration in patients with postmenopausal osteoporosis （PMOP）, but the effect of supplementation with QEF on serum sclerostin is unknown. This study investigated the effects of sup- plementation of QEF on serum sclerostin levels in patients with PMOP. Totally 120 outpatients and in- patients with PMOP treated in our hospital between January and October 2012 were randomly divided into QEF＋calcium group, alfacalcidol＋calcium group, and placebo＋calcium group （n=40 each）, with a follow-up period of 2 years. The serum levels of sclerostin, 25 hydroxyvitamin D, and bone turnover markers （β-CTX, N-MID and T-PINP） at baseline and at the 6th month, 1st year, 1.5th year, and 2nd year after treatment were measured. The results showed that the levels of circulating sclerostin were in- creased significantly at the 6th month after treatment in QEF＋calcium group and alfacalcidol＋calcium group as compared with placebo＋calcium group （P〈0.05）, but there was no significant difference be- tween the former two groups （P〉0.05）. The levels of β-CTX, N-MID and T-PINP in serum were de- creased in both QEF＋calcium group and alfacalcidol＋calcium group at the 6th month after treatment, without significant difference between the two groups （P〉0.05）. BUt the levels were significantly lower than that in placebo＋calcium group （P〈0.05）. These results suggest that the mechanism by which QEF modulates bone metabolism in patients with PMOP might be related with the effect of QEF in increas- ing sclerostin expression. Our findings provide a scientific rationale for using QEF as an effective drug to prevent bone loss in PMOP.
In colorectal surgery, eradicating the fistula and maintaining continence are still complex challenges for a colorectal surgeon. A minimally invasive method using a novel device was performed to consecutively treat 14 patients with anal fistula from August 2008 to November 2009. After a follow-up period of 36 months, 13 patients achieved successful closure of their fistula tracts, and recurrence occurred only in one patient. Recurrence was due to the delay of dressing change. No patient had interference with continence, and no major intra- and post- operative complications were identified. Using the novel device with invasive methods can be a promising alternative for managing anal fistulas.
Background Sclerostin, expressed exclusively by osteocytes, is a negative regulator of bone formation. To gain insights into the action of sclerostin in postmenopausal osteoporosis, we evaluated serum sclerostin levels in postmenopausal women and investigated its possible associations with bone turnover markers in patients with postmenopausal osteoporosis. Methods We detected serum sclerostin, and measured lumbar spine bone mineral density in 650 Chinese postmenopausal women. We also assessed serum levels of 13-isomerized C-terminal crosslinking of type I collagen, intact N-terminal propeptide of type I collagen, N-mid fragment of osteocalcin, 25-hydroxyvitamin D, and estradiol. Results Serum sclerostin levels were lower in postmenopausal osteoporotic women compared with non-osteoporotic postmenopausal women （（38.79＋7.43） vs. （52.86＋6.69） pmol/L, P 〈0.001）. Serum sclerostin was positively correlated with lumbar spine bone mineral density （r=0.391, P 〈0.001） and weakly negatively correlated with [3-isomerized C-terminal crosslinking of type I collagen, intact N-terminal propeptide of type I collagen, N-mid fragment of osteocalcin （t= -0.225, P 〈0.001; r= -0.091, P=0.046; r= -0.108, P=0.018; respectively） in postmenopausal osteoporosis. There was no significant association of serum sclerostin with age, body mass index, 25-hydroxyvitamin D, and estradiol （r= -0.004, P=0.926; r=0.067, P=0.143; r=0.063, P=0.165; r= -0.045, P=0.324; respectively）.Conclusion Sclerostin may be involved in the pathogenesis of postmenopausal osteoporosis and may play a role in bone turnover.
XU Xiao-juan SHEN Lin YANG Yan-ping LU Fu-rong ZHU Rui SHUAI Bo LI Cheng-gang WU Man-xiang
