2018 China guideline for diagnosis and treatment of senile osteoporosis / 中国实用内科杂志

According to the procedures for the development of evidence-based medicine guidelines, a multi-disciplinary guideline development working group was established, after three rounds of discussions by the consensus expert group, a new evidencebased guideline for diagnosis and treatment of senile osteoporosis in China(2018) was developed. The grading of recommendations assessment, development and evaluation(GRADE) system was used to rate the quality of evidence and the strength of recommendations. Recommendations were derived from evidence body, and at the same time considered the balance of benefits and harms as well as values and preferences of Chinese patients. The guideline development working group developed 15 recommendations for the diagnosis and treatment of senile osteoporosis. The guideline covered the screening for senile osteoporosis, risk assessment, diagnosis, basic treatment, multiple anti-osteoporosis drugs, therapeutic effect monitoring and evaluation of senile osteoporosis. This guideline aims to serve as a tool for clinicians and patients for best decisions-making in China.

Basal or bolus dose, which is the key factor in CSII? / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To observe the value of HbA(1)c level evaluating the total daily basal insulin dose by continuous subcutaneous insulin infusion (CSII) in 268 patients with type 2 diabetes mellitus.</p><p><b>METHODS</b>5-point capillary blood glucose was monitored in pre- and post-CSII and the insulin dose which could stabilize blood glucose was defined as the total daily dose of insulin, including basal and bolus total dose. Correlation between HbA(1)c level and total daily dose of insulin in patients with type 2 diabetes mellitus was analyzed. Correlation between HbA(1)c level and 5-point capillary blood glucose was also analyzed.</p><p><b>RESULTS</b>Obvious correlation was observed between HbA(1)c level and the basal total daily dose of insulin if HbA(1)c was more than 9.3% (r=0.635, P<0.05). The average of 5-point capillary blood glucose was best correlated with HbA(1)c and fasting blood glucose next best.</p><p><b>CONCLUSION</b>HbA(1)c level can forecast basal total daily dose of insulin in CSII.</p>

Establishment of bone mineral density reference databases of multiple skeletal regions in adult women in Qingdao and its prediction for fracture risk / 中华内分泌代谢杂志

Objective To establish the reference databases for bone mineral density(BMD)in multiple skeletal regions,which would be useful for diagnosis of osteoporosis(OP)and prediction of fracture risk in adult women in Qingdao.Methods BMD was measured by dual-energy X-ray absorptiometry at skeletal regions of lumbar spine,left hip(femoral neck,Ward's triangle and greater trochanter)in 868 healthy adult women aged 25- 83 years and 191 women with fractures.BMD of skeletal regions with age-related change was found to fit in 8 kinds of regression models.Best model equations of fitting were found and the reference database was established.BMD of women with fractures was compared with the reference databases to predict the risk of fracture.Results BMD in 6 skeletal regions changed with aging and a cubic regression model was better fitted with aged-related change as compared with other regression models.The coefficients of determination(R~2)of fitting curve were 0.21?0.09 (P＜0.01).The BMD reference databases of women in Qingdao were established by cubic regression equation, the peak BMD of lumbar spine and hip appeared at 25-29,and 40-44 years old groups respectively.Finally,the BMD in fracture group was significantly decreased by 1.6-2.5 s as compared with the peak BMD of health women. Conclusion The bone quantity is lost rapidly after 45 years old in women.If the BMD in women after 50 years old is decreased by 1.6-2.5 s compared with the peak BMD in the same area,the risk of fracture is increased.