文本框: THE EFFECT AND MECHANISM OF CHINESE HERBAL MEDICINE ON SKELETAL DEVELOPMENT IN CHILDREN WITH PRECOCIOUS PUBERTY Cai Depei1, Ji Zhiying1, Zhang Wei2 1Pediatric Hospital Fu Dan University, Shanghai 2Shanghai PASIC Bio-engineering Institute, Shanghai, China Objective: To observe the effect of Chinese herbal medicine (CHM) on skeletal development in children with precocious puberty and to elucidate the mechanism of action of CHM. Methods: (1) Clinical part: 82 girls with idiopathic precocious puberty were treated by CHM. The formula consisted of Radix rehmanniae, Carapax et Plastrum testudinis, Cortex phellodendri, Rhizoma anemarrhenae, etc. All medicines were extracted and concentrated (1ml mixture contained approximately 2.5g crude extract). The dosage was 60ml/ day. The therapeutic course was an average of 1 year. Linear growth rate and bone age (BA) were measured, and bone mineral content (BMC) and serum Osteocalcin (OST) were determined. Final heights were predicted before therapy and after clinical remission. (2) Experimental part: 20 pubertal female rats were divided into two groups. The experimental group was fed the above mentioned formula of CHM, the control group was fed normal saline. The dosage was 5ml/day. The therapeutic course was two months. Femoral metaphyses was sampling. The level of the mRNA expression of OST was measured with the method of quantitative RT-PCR. All data were expressed as means±SD. Results: (1) Clinical part: After an average of 1 year of therapy, the growth rate of the girls decelerated, with the change in BA per change in chronological age decreased from 1.35±0.18 to 0.65±0.15 ( P<0.001 ). BMC decreased from 0.585±0.098 to 0.519±0.07 g/cm ( P< 0.001 ), serum OST decreased from 17.24±3.48 to 10.55±3.57μg/L ( P<0.001 ), and predicted final height increased from 153.3±3.5 to 158.5±4.2 cm ( P<0.001 ).(2) Experimental part: The optical density value of cDNA amplicative product of OST in experimental group was less than that in control group ( 0.406±0.026 and 0.433±0.017,respectively. P<0.05 ). Conclusion: Therapy with CHM could decelerate skeletal growth and delay skeletal maturity in the girls, thereby preventing premature epiphyseal fusion and increasing final height. One possible mechanism of CHM on ameliorating skeletal development in the girls could be to inhibit excessive functional activity of osteoblast through down regulating the gene expression of OST in the osteoblast. 0910