ABSTRACT
Objective:To analyze the long-term efficacy of percutaneous kyphoplasty (PKP) assisted with vitamin D in the treatment of elderly thoracolumbar single vertebral osteoporotic vertebral compression fractures (OVCF) and its effect on transfected bone morphogenetic protein-Effects of 7 (BMP-7) /25-hydroxyvitamin D3 [ (25- (OH) -D3] levels.Methods:106 elderly patients with fresh OVCF of thoracic and lumbar vertebrae who were treated with PKP in Li Huili Hospital of Ningbo Medical Center from Jun. 2017 to Jun. 2021 were selected as the research object, and they were divided into two groups according to the random number table method (53 cases in each group) . Both groups were treated with PKP and received conventional anti-osteoporosis treatment and rehabilitation training. On this basis, patients in the treatment group were given vitamin D therapy. Before treatment and 1, 3, 6, and 12 months after treatment, the degree of pain improvement, Cobb angle improvement, bone mineral density, vertebral body compression rate, vertebral body function recovery and serum BMP-7, 25- (OH) -D3 level, and the cement leakage rate of all subjects within 1 year of follow-up was recorded.Results:Two patients in the observation group and 3 patients in the control group lost to follow-up. Comparing the results of before treatment and 12 months after treatment: the control group’s BMD increased from 0.585±0.042 to 0.755±0.0641; BMP-7 increased from 80.02±6.24 to 129.87±10.52;25- (OH) -D3 increased from 9.15±2.16 to 13.52±2.64;and the treatment group’s BMD increased from 0.576±0.039 to 0.868±0.079; BMP-7 increased from 78.36±6.20 to 153.41±12.70; 25- (OH) -D3 increased from 9.01±2.12 to 16.24±2.81; the treatment group had higher increase ( P<0.05) . Meanwhile the control group’s Cobb angle decreased from 13.54±1.81 to 8.05±1.05; vertebral body compression rate decreased from 28.41±3.47 to 19.86±2.29; ODI score decreased from 74.42±7.37 to 24.08±2.41; VAS score decreased from7.54±0.81 to 2.65±0.25,and the treatment group’s Cobb angle decreased from 13.70±1.89 to 7.42±0.97;vertebral body compression rate decreased from 28.97±3.62 to 18.86±2.02; ODI score decreased from75.78±7.43 to 21.39±2.08; VAS score decreased from7.70±0.891 to 2.32±0.20,while the treatment group decreased more ( P<0.05) . In addition, the vertebral refracture rate in the control group was 22.00% (11/50) , while the vertebral refracture rate in the treatment group was 5.88% (3/51) , and there was a significant difference between the groups ( χ 2=5.125, P=0.024) . Conclusion:PKP combined with vitamin D in the treatment of elderly thoracolumbar OVCF can significantly improve the levels of BMP-7 and 25- (OH) -D3, better restore bone mineral density, vertebral body function and correct kyphosis, with a more ideal long-term efficacy.
ABSTRACT
Objective To analyze the epidemiological characteristics of patients with sea lice injury in coastal baths in Qinhuangdao City, and provide scientific evidence for the importance of prevention of sea lice injury and the early warning of sea lice outbreak. Methods The data of 2 659 patients with sea lice injury, including gender, age composition, severity of bruises and other epidemiological data reported by the coastal bathing stations in Qinhuangdao City from 2016 to 2018 (mainly from July to August) were retrospectively analyzed, and the correlation between the temperature at the surface of sea water and the number of patients with sea lice injury was also analyzed. Results Among the 7 bathing beaches along the coast of Qinhuangdao City, Dongshan Bathing Spot (1 101 cases) and Repulse Bay Bathing Beach (1 365 cases) had the largest numbers of bruises, while the Gold Coast Bath had the least (only 5 cases), and the differences in number of bruises in different baths were statistically significant in 2016, 2017, 2018 years (277, 1 890, 492 cases respectively, χ2= 490.611, P < 0.05). Among 2 659 patients, 1 124 were children (≤14 years old), 1 535 were adult, 1 570 male and 1 089 female patients. The severity type of patients' sea lice injury in each bath was mainly mild to moderate type; among the total injury cases, there were 2 589 cases with mild type injury accounting for 97.37%, 61 cases with moderate type (2.29%) and 9 cases with severe type (0.34%). A linear trend between sea surface temperature and the patients' number of bruises was seen, and there was a positive correlation between the sea surface temperature and the patients' number (r = 0.433, P < 0.05). Conclusion The sea lice injuries in Qinhuangdao City are mainly distributed in the Dongshan and Repulse Bay Baths, the main type of injury is light one, and in the mean time the injury is influenced by factors such as popularization of science, medical care, environmental factors, and collective sea lice drift, etc.