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BACKGROUND:With the aging of the global population,the incidence rate of osteoporosis is also increasing.It is very important to further understand its pathogenesis and propose new therapeutic targets.Recent studies have shown that ferroptosis is closely related to the pathogenesis of some bone diseases,such as inflammatory arthritis,osteoporosis and osteoarthritis. OBJECTIVE:To summarize the previous studies on the mechanism of ferroptosis in osteoporosis,so as to provide new therapeutic ideas and potential therapeutic targets for osteoporosis. METHODS:The first author used the computer to search the documents published from 2000 to 2022 in CNKI,WanFang,VIP,PubMed and Web of Science with the key words of"ferroptosis,osteoporosis,osteoblasts,osteoclasts,iron chelators,reactive oxygen species,nuclear factor erythroid 2-related factor 2,heme oxygenase-1,glutathione peroxidase 4,review"in Chinese and English.A total of 70 articles were finally included according to the inclusion criteria. RESULTS AND CONCLUSION:Ferroptosis is significantly different from necrosis,apoptosis and autophagy.In terms of cell morphology and function,it does not have the morphological characteristics of typical necrosis,nor does it have the characteristics of traditional apoptosis,such as cell contraction,chromatin condensation,the formation of apoptotic bodies and the disintegration of cytoskeleton.Contrary to autophagy,ferroptosis does not form a classical closed bilayer membrane structure(autophagic vacuole).Morphologically,ferroptosis is mainly manifested by obvious contraction of mitochondria,increased membrane density,and reduction or disappearance of mitochondrial cristae,which are different from other cell death modes.Iron overload can destroy bone homeostasis by significantly inhibiting osteogenic differentiation and stimulating osteoclast formation,leading to osteoporosis.Iron overload interferes with the differentiation of stem cells to osteoblasts,leading to a weakened osteoblast function and further imbalance of bone metabolism in the body,which eventually leads to osteoporosis.Stimulated by iron overload,osteoclast bone resorption is enhanced and bone loss exceeds new bone formation.Iron chelators have been proved to have osteoprotective effects by inhibiting osteoclast activity and stimulating osteogenic differentiation of osteoblasts.Its potential mechanism is related to inhibiting osteoclast differentiation and promoting osteoblast differentiation.Antioxidants can prevent reactive oxygen species production and inhibit bone absorption,thus improving bone metabolism and effectively preventing osteoporosis.
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Objective:To investigate internalized and externalized behavioral problems in children with leukemia and to analyze the influencing factors.Methods:A total of 121 children match the inclusion and exclusion criteria with leukemia hospitalized in Hematology and Oncology Department of 3 hospitals in Zhengzhou city from November 2021 to March 2022 were recruited through a cluster sampling method.The general information questionnaire, Strengths and Difficulties Questionnaire (parent version), Psychological Adaptation Scale, Perceived Social Support Questionnaire and Zarit Burden Interview were used for investigation.Multiple linear regression was used to analyze the influencing factors of internalized and externalized behavioral problems in children with leukemia.Results:Among 121 children with leukemia, there were 72 males and 49 females, with the age of (7.16 ± 3.18) years.The total score of interna-lized and externalized behavioral problems in 121 children with leukemia was (6.12±3.13) points and (5.49±2.92) points, respectively.Multiple linear regression analysis showed that burden of care ( β=0.412, P<0.001), family support ( β=-0.242, P=0.003) and monthly household income per capita ( β=-0.167, P=0.036) were the influencing factors of internalized behavioral problems in children with leukemia.Burden of care ( β=0.360, P<0.001), social integration ( β=-0.223, P=0.008) and caregiver age ( β=-0.176, P=0.035) were the influencing factors of externalized behavioral problems in children with leukemia. Conclusions:Children with leukemia suffer severe internalized and externalized behavioral problems.Burden of care of the caregiver, family support and social integration are predictors of adverse emotional and behavioral problems in children.
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Objective:To explore the current situation of emotional and behavioral problems in children with hematological tumors, and the relationship with caregivers′ coping styles and family cohesion.Methods:Using cross-sectional study design and cluster sampling method, caregivers of children with hematological tumors hospitalized in hematology department of five third-class hospitals in Zhengzhou from November 2020 to January 2021 were selected as the respondents. The strengths and difficulties questionnaire (parent version), simple coping style questionnaire, family cohesion scale and self-made general information questionnaire were used for questionnaire survey. Statistical analysis was performed by SPSS 24.0 software using Spearman correlation analysis and multivariate Logistic regression analysis.Results:A total of 237 questionnaires were distributed and 214 valid questionnaires were collected. The abnormal detection rates of total difficulty score, emotional symptoms, conduct problems, hyperactivity, peer interaction problems and prosocial behavior were 17.8%, 22.9%, 10.7%, 8.4%, 39.7% and 13.6% respectively. The results of correlation analysis showed that caregivers′ positive coping was negatively correlated with the total score of difficulties, hyperactivity and peer interaction problems ( r=-0.186, -0.153, -0.174, all P<0.05), and positively correlated with the score of prosocial behavior ( r=0.214, P<0.05). Caregivers′ negative coping was positively correlated with the total score of difficulties, emotional symptoms and hyperactivity ( r=0.203, 0.204, 0.170, all P<0.05). Family cohesion was negatively correlated with the total score of difficulties, emotional symptoms, conduct problems, hyperactivity and peer interaction problems ( r=-0.254, -0.225, -0.183, -0.137, -0.195, all P<0.05), and positively correlated with prosocial behavior ( r=0.235, P<0.01). Multivariate Logistic regression analysis showed that positive coping of caregivers was a protective factor of peer interaction in children ( β=-0.050, OR=0.951, 95% CI=0.907-0.996), while family intimacy was also a protective factor for children with prosocial behavior ( β=-0.045, OR=0.956, 95% CI=0.923-0.991). Conclusion:The emotional and behavior problems of children with hematological tumors are serious, and the positive coping of caregivers and family cohesion have certain predictive value for the occurrence of negative emotional behavior problems in children, so medical staff should take corresponding measures to reduce the occurrence of emotional and behavior problems in children.