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Objective:To investigate the diagnosis of dual-energy X-ray absorptiometry(DXA)for osteoporosis(OP)of postmenopausal patients with rheumatoid arthritis(RA)in Qinghai region and the risk factors of them.Methods:A total of 200 postmenopausal female RA patients who admitted to Qinghai Hospital of Traditional Chinese Medicine from May 2022 to April 2023 were selected.All patients were tested for bone mineral density(BMD)after admission,and lumbar spines L1-L4,whole lumbar,large trochanter,Ward's triangle area,whole body and whole forearm were measured by DXA.According to the results of BMD test,patients whose BMD T values of all body parts-2.5 SD were less or equal to-2.5 were included in the OP group(121 cases),and patients whose BMD T value of all body parts were larger than-2.5 SD were included in the non-OP group(79 cases).The BMD T value of different body parts between two groups of RA patients were compared and analyzed.The area under curve(AUC)of receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of BMD T value for OP.The logistic regression method was adopted to analyze the risk factors that postmenopausal RA patients of Qinghai region occurred OP.Results:The BMD T values of L1,L2,L3,L4,whole lumbar,large trochanter,Ward's triangular area,whole body and whole forearm of OP group were obviously lower than those of the non-OP group.In analysis of ROC curve,the sensitivities of BMD T values of L1,L2,L3,L4,whole lumbar,large trochanter,Ward's triangle area,whole body and forearm were respectively 96.20%,95.22%,90.16%,96.03%,92.01%,89.36%,99.26%,90.02% and 96.03% in diagnosing OP,and the specificities of them were respectively 81.00%,82.19%,85.22%,83.06%,83.06%,90.22%,80.06%,86.23%,83.09%,and the AUC values of them were respectively 0.908,0.905,0.896,0.906,0.903,0.879,0.918,0.901 and 0.906.The results of the logistic-regression analysis showed that advanced age,long disease course,rheumatic activity scores of 28 joints,erythrocyte sedimentation rate and Calcium supplementation were the risk factors of occurring OP in postmenopausal RA patients in Qinghai region.Conclusion:The DXA method that detects BMD of RA patients who occur OP can be used as gold standard to assess OP,and there are many risk factors that affect the occurrence of OP in postmenopausal RA patients of Qinghai region.The clinical work should combine with relative factors to formulate reasonable measure so as to reduce the incidence of OP.
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Objective:To assess the value of Xiaozeng Qianggu tablet combined with Zhengshishuhuo tincture in treating knee osteoarthritis(KOA)combined with osteoporosis(OP)on the basis of quantitative magnetic resonance imaging(MRI)and quantitative CT(QCT).Methods:A total of 80 patients with KOA combined with OP admitted to the hospital were selected,and they were divided into an observation group and a control group according to the random number table method,with 40 cases in each group.The observation group was treated with Xiaozeng Qianggu Tablets combined with Zhengshishuhuo tincture that coordinated local massage,while the control group was treated with Zhengshishuhuo tincture alone coordinated local massage.The visual analogue scale(VAS),Westerm Ontario and Mcmaster Universities Osteoarthritis Index(WOMAC)and short form-36(SF-36)scores before and after treatment of the two groups of patients were compared,as well as the changes of serum IL-1β,IL-6 and TNF-α levels of patients.Quantitative MRI and QCT were used to measure the imaging changes of the patients'knee joints before and after treatment,and whole organ magnetic resonance imaging score(WOMRIS)and bone mineral density(BMD)values of knee joint before and after treatment between two groups were further compared.Results:After treatment,the VAS and WOMAC scores of the patients in the observation group were significantly lower than those of the control group,and the SF-36 scores of that was significantly lower than that of the control group,the differences were statistically significant(t=2.518,t=2.017,t=2.262,P<0.05),respectively.The serum TNF-α,IL-1β,and IL-6 levels of the observation group were significantly lower than those in the control group,and the differences were statistically significant(t=2.429,t=2.641,t=4.065,P<0.05).The scores of subchondral bone marrow edema,meniscal injury and degeneration and joint effusion of observation group were significantly lower than those of the control group,and the differences were statistically significant(t=2.641,t=2.216,t=2.262,P<0.05).The BMD values of the four parts included the femoral medial condyle,lateral condyle,tibial lateral platform and tibial medical platform of the observation group were respectively higher than those of control group,and the differences were statistically significant(t=2.864,t=3.985,t=4.276,t=2.714,P<0.05).Conclusion:Xiaozeng Qianggu Tablets combined with Zhengshishuhuo tincture that coordinated local massage can effectively relieve pain of patients with KOA combined with OP,and improve joint function,and delay osteoporosis of knee joint.
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Osteoporosis （OP） is one of the most common diseases in the aged population worldwide. Due to the rapid change in world population structure， the effective prevention and treatment of OP is increasingly becoming the health problem of global concern and also the hot spot of clinical research. OP can be affected by many factors such as heredity， endocrine dyscrasia， nutritional deficiency， and bad living habits. The breakdown of coupling of osteoclast-mediated bone resorption to osteoblast-mediated bone formation leads to stronger bone resorption than bone formation， which is currently recognized as the main pathogenesis of OP. The exploration of OP in modern medicine based on molecular immunology has revealed that related cytokines play an important role in the pathogenesis of OP，and regulating the osteoclast-mediated bone resorption and osteoblast-mediated bone formation is essential for controlling the occurrence and development of OP. Tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6） are able to stimulate bone formation and inhibit osteoblast function， thus playing a key role in bone destruction. By contrast， such cytokines as vascular endothelial growth factor （VEGF）， transforming growth factor-β （TGF-β）， bone morphogenetic protein （BMP）， and osteoprotegerin （OPG） strengthen osteoblast differentiation and promote bone formation. At present， western medicine like calcitonin， estrogen， and bisphosphonate are mostly used for clinical treatment of OP， but a long-term use of these drugs will result in poor compliance and obvious gastrointestinal adverse reactions. Traditional Chinese medicine （TCM） occupies an important position in the treatment of OP due to its advantages of overall regulation， low price， and few side effects. In addition， with the deepening of research on network pharmacology and molecular biology， it has been found that TCM exerts the therapeutic effect against OP by interfering with the expression of various cytokines and adjusting bone homeostasis. This paper has elaborated the role of related cytokines in the pathogenesis of OP and reviewed the research results concerning the regulation of related cytokines by TCM， in order to provide reference for the prevention and treatment of OP with TCM.
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Osteoporosis (OP)-related vertebral fractures often occur in the transitional thoracolumbar region,which are the earliest signs of OP deterioration in elderly patients.Such fractures can be regarded as a physical incident that occurs when the vertebral stress load exceeds the mechanical structural strength.To OP patients,preventing the occurrence of OP fracture is the primary goal for preventative measures,treatment and research of OP.This paper reviews the biomechanical research progress of osteoporotic vertebra compressive fracture (OVCF),and advocates early prevention of OVCF in OP patients,who should avoid activities that might exceed the security scope of the vertebral body load in daily life,so as to prevent subsequent fractures of the vertebral fracture cascade.
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Osteoporosis (OP)-related vertebral fractures often occur in the transitional thoracolumbar region, which are the earliest signs of OP deterioration in elderly patients. Such fractures can be regarded as a physical incident that occurs when the vertebral stress load exceeds the mechanical structural strength. To OP patients, preventing the occurrence of OP fracture is the primary goal for preventative measures, treatment and research of OP. This paper reviews the biomechanical research progress of osteoporotic vertebra compressive fracture (OVCF), and advocates early prevention of OVCF in OP patients, who should avoid activities that might exceed the security scope of the vertebral body load in daily life, so as to prevent subsequent fractures of the vertebral fracture cascade.
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Osteoporosis (OP)-related vertebral fractures often occur in the transitional thoracolumbar region,which are the earliest signs of OP deterioration in elderly patients.Such fractures can be regarded as a physical incident that occurs when the vertebral stress load exceeds the mechanical structural strength.To OP patients,preventing the occurrence of OP fracture is the primary goal for preventative measures,treatment and research of OP.This paper reviews the biomechanical research progress of osteoporotic vertebra compressive fracture (OVCF),and advocates early prevention of OVCF in OP patients,who should avoid activities that might exceed the security scope of the vertebral body load in daily life,so as to prevent subsequent fractures of the vertebral fracture cascade.
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Osteoporosis (OP)-related vertebral fractures often occur in the transitional thoracolumbar region,which are the earliest signs of OP deterioration in elderly patients.Such fractures can be regarded as a physical incident that occurs when the vertebral stress load exceeds the mechanical structural strength.To OP patients,preventing the occurrence of OP fracture is the primary goal for preventative measures,treatment and research of OP.This paper reviews the biomechanical research progress of osteoporotic vertebra compressive fracture (OVCF),and advocates early prevention of OVCF in OP patients,who should avoid activities that might exceed the security scope of the vertebral body load in daily life,so as to prevent subsequent fractures of the vertebral fracture cascade.
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Objective To investigate the effect of 1,25-(OH)2-vitamin D3 (VD3) or mechanical strain alone and their combined treatment on proliferation and differentiation of pre-osteoblast MC3T3-E1 cells in vitro, as well as gene and protein expression of osteoprotegerin (OPG) and receptor activator of nuclear factor-кB ligand (RANKL) in those cells. Methods MC3T3-E1 cells were treated with 10 nmol/L VD3, intermitted mechanical strain or with a combination of these two factors. Cell proliferation was assessed with flow cytometry, and alkaline phosphatase (ALP) activity was measured using a fluorometric detection kit. The mRNA expression of ALP, runt-related transcriptional factor 2 (Runx2), OPG, and RANKL genes was determined by real-time PCR. The proteins expression of Runx2, OPG, and RANKL was determined by Western blotting. ResultsVD3 inhibited the proliferation of MC3T3-E1 cells, but the mechanical strain had no effect on cell proliferation. Mechanical strain, VD3, and the combined treatment enhanced the ALP activity of MC3T3-E1 cells as well as the protein expression of Runx2. The effect of combined treatment was less pronounced than the effect of VD3 or mechanical strain alone. Mechanical strain promoted the gene and protein expression of osteoprotegerin (OPG) and increased the ratio of OPG/RANKL. However, the combination of VD3 and mechanical strain led to a decrease in ratio of OPG/RANKL. Conclusions Mechanical strain might be effective in inducing osteogenic differentiation and increasing bone formation. A joint stimulation with VD3 and strain can decrease proliferation and osteogenic differentiation and increase RANKL expression, which might affect bone remodeling. This study supplies some new data, which might be important in theoretical and clinical research of osteoporosis (OP) and other related bone diseases.