Therapeutic effects of single versus bilateral approaches for percutaneous kyphoplasty in osteoporotic compression fractures.

the clinical effectiveness of unilateral/bilateral percutaneous vertebral augmentation (PVA) for the treatment of osteoporotic vertebral compression fractures (OVCF) was assessed to provide guidance for clinical treatment.Through retrospective analysis of data from 107 patients, including preoperative and postoperative visual analogue scale scores, bone cement leakage, adjacent vertebral fractures, vertebral height, and infection.There was no significant difference in preoperative and postoperative scores, Cobb angle, anterior height, and bone cement leakage rate, but the vertebral body height in the bilateral percutaneous vertebral fusion surgery group was significantly higher than that in the unilateral group(P < 0.05).Grade I compression fractures, a unilateral PVA approach was recommended, while for Grade II and III compression fractures, a bilateral PVA approach was preferable.

Effects of obesity with reduced 25(OH)D levels on bone health in elderly Chinese people: a nationwide cross-sectional study.

Background: Obesity is often accompanied by lower 25(OH)D levels, whereas these two parameters exhibit opposite effects on bone health. It is uncertain what are the effects of lower 25(OH)D levels in obesity on bone health in elderly Chinese people. Methods: A nationally representative cross-sectional analysis of China Community-based Cohort of Osteoporosis (CCCO) was performed from 2016 to 2021, which consisted of 22,081 participants. Demographic data, disease history, Body mass index (BMI), bone mineral density (BMD), the levels of the biomarkers of vitamin D status and those of bone metabolism markers were measured for all participants (N = 22,081). The genes (rs12785878, rs10741657, rs4588, rs7041, rs2282679 and rs6013897) related to 25(OH)D transportation and metabolism were performed in a selected subgroup (N = 6008). Results: Obese subjects exhibited lower 25(OH)D levels (p < 0.05) and higher BMD (p < 0.001) compared with those of normal subjects following adjustment. The genotypes and allele frequency of rs12785878, rs10741657, rs6013897, rs2282679, rs4588 and rs7041 indicated no significant differences among three BMI groups following correction by the Bonferroni's method (p > 0.05). The levels of total 25(OH)D (ToVD) were significantly different among the GC1F, GC1S and GC2 haplotype groups (p < 0.05). Correlation analysis indicated that ToVD levels were significantly correlated with parathyroid hormone levels, BMD, risk of osteoporosis (OP) and the concentration levels of other bone metabolism markers (p < 0.05). Generalized varying coefficient models demonstrated that the increasing BMI, ToVD levels and their interactions were positively associated with BMD outcomes (p < 0.001), whereas the reduced levels of ToVD and BMI increased the risk of OP, which was noted notably for the subjects with reduced ToVD levels (less than 20.69 ng/ml) combined with decreased BMI (less than 24.05 kg/m2). Conclusion: There was a non-linear interaction of BMI and 25(OH)D. And higher BMI accompanied by decreased 25(OH)D levels is associated with increased BMD and decreased incidence of OP, optimal ranges exist for BMI and 25(OH)D levels. The cutoff value of BMI at approximately 24.05 kg/m2 combined with an approximate value of 25(OH)D at 20.69 ng/ml are beneficial for Chinese elderly subjects.

Mechanism of NLRP3 inflammasome intervention for synovitis in knee osteoarthritis: A review of TCM intervention.

Objective: This paper briefly reviews the structure and function of NLRP3 inflammasomes, signaling pathway, relationship with synovitis in KOA, and intervention of traditional Chinese medicine (TCM) in NLRP3 inflammasomes as a means to improve its therapeutic potential and clinical application. Method: Literatures about NLRP3 inflammasomes and synovitis in KOA were reviewed to analyze and discuss. Result: NLRP3 inflammasome can activate NF-κB mediated signal transduction, which in turn causes the expression of proinflammatory cytokines, initiates the innate immune response, and triggers synovitis in KOA. The TCM monomer/active ingredient, decoction, external ointment, and acupuncture regulating NLRP3 inflammasomes are helpful to alleviate synovitis in KOA. Conclusion: The NLRP3 inflammasome plays a significant role in the pathogenesis of synovitis in KOA, TCM intervention targeting the NLRP3 inflammasome can be a novel approach and therapeutic direction for the treatment of synovitis in KOA.

The prevalence of osteoporosis in China, a community based cohort study of osteoporosis.

Background: Osteoporosis has already been a growing health concern worldwide. The influence of living area, lifestyle, socioeconomic, and medical conditions on the occurrence of osteoporosis in the middle-aged and elderly people in China has not been fully addressed. Methods: The study was a multicenter cross-sectional study on the middle-aged and elderly permanent residents, which gathered information of 22,081 residents from June 2015 to August 2021 in seven representative regions of China. The bone mineral density of lumbar vertebrae and hip were determined using the dual-energy X-ray absorptiometry densitometer instruments. Serum levels of bone metabolism markers were also measured. Information about education, smoking, and chronic diseases were also collected through face-to-face interviews. Age-standardized prevalence and 95% confidence intervals (CIs) of osteopenia and osteoporosis by various criteria were estimated by subgroups and overall based on the data of China 2010 census. The relationships between the osteoporosis or osteopenia and sociodemographic variables or other factors were examined using univariate linear models and multivariable multinomial logit analyses. Results: After screening, 19,848 participants (90%) were enrolled for the final analysis. The age-standardized prevalence of osteoporosis was estimated to be 33.49%(95%CI, 32.80-34.18%) in the middle-aged and elderly Chinese permanent residents, for men and women was 20.73% (95% CI, 19.58-21.87%) and 38.05% (95% CI, 37.22-38.89%), respectively. The serum concentrations of bone metabolic markers, and calcium and phosphorus metabolism were influenced by age, body mass index (BMI), gender, education level, regions, and bone mass status. Women, aged 60 or above, BMI lower than 18.5 kg/m2, low education level including middle school, primary school and no formal education as well as current regular smoking, a history of fracture were all significantly associated with a higher risk of osteoporosis and osteopenia in the middle-aged and elderly people. Conclusions: This study revealed dramatic regional differences in osteoporosis prevalence in China, and female, aged 60 or older, low BMI, low education level, current regular smoking, and a history of fracture were associated with a high risk of osteoporosis. More prevention and treatment resources should be invested into particular population exposed to these risk factors.

MAPK /ERK signaling pathway: A potential target for the treatment of intervertebral disc degeneration.

Intervertebral disc degeneration (IDD) is a chronic skeletal muscle degenerative disease, which is considered the main cause of low back pain. It seriously affects the quality of life of patients and consequently brings a heavy economic burden to their families and the society. Although IDD is considered a natural process in degenerative lesions, it is mainly caused by aging, trauma, genetic susceptibility and other factors. It is closely related to changes in the tissue structure and function, including the progressive destruction of extracellular matrix, cell aging, cell death of the intervertebral disc (IVD), inflammation, and impairment of tissue biomechanical function. Currently, the treatment of IDD is aimed at alleviating symptoms rather than at targeting pathological changes in the IVD. Furthermore, the mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK) signaling pathway is closely related to various pathological processes in IDD, and the activation of the MAPK/ERK pathway promotes the degradation of the IVD extracellular matrix, cell aging, apoptosis, and inflammatory responses. It also induces autophagy and oxidative stress that accelerate the IVD process. In our current review, we summarize the latest developments in the negative regulation of IDD after activation of the MAPK/ERK signaling pathway and emphasize on its influence on IDD. Targeting this pathway may become an attractive treatment strategy for IDD in the near future.

Menarche age exceed 17 years and menopausal age smaller than 48 years may affect prevalence of osteoporosis for Chinese women.

In this work, we used a cross-sectional study to evaluate influence of menarche age, menstrual cycle, menstrual period, menopausal age, and menopause years for osteoporosis in women from China. We found that different menarche age, menstrual cycle, menopausal years, and menopausal age are related with the prevalence of osteoporosis. However, menarche age exceeds 17 years and menopausal age smaller than 48 years are risk factors for osteoporosis in women. STUDY DESIGN: A cross-sectional, population-based study. PURPOSE: The purpose of this study was to explore relationship between prevalence of osteoporosis and menarche age, menstrual cycle, menstrual period, menopausal age, and menopause years for women. METHODS: From March to October 2016, the cluster sampling method was used to conduct an osteoporosis-related questionnaire survey on women aged 40-80 in two communities in Lanzhou City, Gansu, China, and bone mineral density(BMD)was carried out using the DTX-200 dual-energy X-ray absorptiometer produced by the US OSTEOMETER company. The relationship between prevalence of osteoporosis and menarche age, menstrual cycle, menstrual period, menopausal age, and menopause years were analyzed using logistic regression analysis. RESULTS: There were 2224 female participates enrolled in this study and average age was 61.60 ± 8.05 years and total rate of prevalence was 32.73%; among them, different menarche age, menstrual cycle, menopausal years, and menopausal age have statistical differences with the prevalence of osteoporosis, but there is no statistical difference between different menstruation and the prevalence of osteoporosis. Single logistic regression analysis found that older menarche age, earlier menopausal age, and longer menopausal years were related factors for the prevalence of osteoporosis, while menarche age exceed 17 years and menopausal age smaller than 48 years are risk factors for osteoporosis for women in multivariate regression analysis. CONCLUSIONS: In China, ages at menarche and menopause are associated with prevalence of osteoporosis. Later, menarche and earlier menopause are associated with higher osteoporosis risk. Menarche and menopause history may help identify women with increased risk of developing osteoporosis.

A randomized controlled study for Yuanhu Zhitong dropping pills in the treatment of knee osteoarthritis.

BACKGROUND: Knee osteoarthritis (KOA) is a common chronic disorder of knee and the leading cause of pain in the elderly with an overall prevalence of 50% in people over 60 years of age. This disease is an important factor affecting the quality of life of middle-aged and elderly people, and its main symptom is knee joint pain. Due to the pain, the knee joint activity function is limited, bringing great pain to patients, affecting their quality of life, effective prevention, and treatment of KOA is a modern medical problem. METHODS: The 60 patients who met the inclusion criteria were randomly divided into the treatment group and the control group. In this study, single center, randomized control and equivalent clinical trial were used for treatment. The treatment group received Yuanhu Zhitong dropping pills within 4 weeks, and the control group received diclofenac sodium sustained-release capsule treatment within 4 weeks. The main measures were visual analogue scale (VAS), WOMAC osteoarthritis index score and gastrointestinal symptoms rating scale (GSRS).Secondary measures included biochemical markers and adverse reactions during treatment. RESULT: The results of this trial will be published on the website of China Clinical Trial Registration Center (http://www.chictr.org.cn/searchprojen.aspx) and in peer-reviewed journals or academic conferences. CONCLUSIONS: This study is to assess the efficacy and safety of Yuanhu Zhitong dropping pills for knee osteoarthritis (KOA). REGISTRATION: PROSPERO (registration number ChiCTR1900024712).

Association between hepatitis B virus infection and risk of osteoporosis: a systematic review and meta-analysis: A protocol for systematic review.

BACKGROUND: The potential association between hepatitis B virus (HBV) infection and development of osteoporosis has drawn significant attention from clinicians and researchers in recent years due to the increasing prevalence of HBV infection. This study aims to perform a systematic review and meta-analysis of the literature to show whether HBV infection is associated with an increased risk of osteoporosis. METHODS: Case-control, cohort, and cross-sectional studies that report the incidence of osteoporosis, osteoporotic fracture, osteopenia, and bone mineral density level in populations with HBV infection will be selected. Four databases from their inception to October 2019 will be searched. All data were assessed and extracted by 2 authors independently. The Newcastle-Ottawa scale and (Agency for Healthcare Research and Quality) Agency for Healthcare Research and Quality checklist will be used to assess the quality of the selected studies. Stata 15.1 (Stata Corp, College Station, TX) will be used to conduct meta-analysis. RESULT: The results of this systemic review and meta-analysis will be submitted to a recognized journal for publication. CONCLUSION: This systemic review and meta-analysis will determine whether HBV infection is associated with an increased risk of osteoporosis. We hope this review can provide a reliable evidence. REGISTRATION: PROSPERO (registration number CRD42020140522).

Acupoint injection treatment for primary osteoporosis: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Acupoint injection has currently received increasing attention as a treatment for primary osteoporosis (POP), This study aimed to evaluate the efficacy and safety of acupoint injection as a clinical treatment for POP. METHODS: Randomized controlled trials (RCTs) of acupoint injection compared with conventional non-acupoint injection for POP were identified in searches of seven databases from their inception to March 2019. All data were assessed and extracted by two authors independently. The risk of bias assessment recommended by the Cochrane Collaboration was used to assess the quality of the selected studies. RevMan 5.3 was used to conduct meta-analysis for the efficacy and safety of acupoint injection. RESULTS: Five trials with 337 patients (aged 45-86 years) with bone mineral density (BMD) ≤2 SD were included in our meta-analysis. The results showed that, compared with conventional intramuscular injection, acupoint injection significantly increased the BMD [mean difference (MD) =0.02; 95% CI, 0.01 to 0.03, P<0.00001]. Subgroup analysis indicated that acupoint injection significantly improved lumbar BMD (MD =0.02; 95% CI, 0.01 to 0.03, P<0.00001) but did not reduce the pain score (SMD =-2.29, 95% CI, -6.81 to 2.23, P>0.05). Individuals results showed that acupoint injection improved biochemical indicators, such as NBAP, IGF-I and reduced CTX and leptin levels. While the risk of bias was high in all five trials. CONCLUSIONS: This meta-analysis and systematic review suggests that acupoint injection improves BMD and some biochemical indicators in POP patients compared with the effects of conventional intramuscular injection. However, due to the high risk of bias in all the trials reviewed, the evidence remains inconclusive and future research will be required with improved methodological quality.

Polymorphisms of genes related to vitamin D metabolism and transportation and its relationship with the risk of osteoporosis: protocol for a multicentre prospective cohort study in China.

INTRODUCTION: Osteoporotic fracture is one of the most common causes of disability and a major contributor to medical care costs in many regions of the world. The polymorphisms of genes related to vitamin D metabolism and transportation are associated with variation in bone mineral density and the risk of osteoporosis. METHODS AND ANALYSIS: The China Community-based Cohort of Osteoporosis study is an observational, longitudinal, multicentre, prospective cohort study for middle-aged and older permanent residents of China, which has been ongoing in six cities since 2016. Female residents aged 45-80 years old and male residents aged 50-80 years old are identified through permanent resident lists. All the enrolled participants will complete questionnaires on their personal characteristics and histories. The bone mineral density of their lumbar vertebrae and left hip will be measured and serum bone metabolism parameters assessed. Polymorphisms of genes related to vitamin D metabolism and transportation will be detected, and their relationship with the risk of osteoporosis, and osteoporotic fracture, will be analysed. About 18 000 residents will be involved in the study. ETHICS AND DISSEMINATION: The study was approved by Institutional Ethics Board of Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine (2016LCSY065). Results will be published in peer-reviewed journals. The results of this study are expected to improve the understanding of the association between polymorphisms of genes related to vitamin D metabolism and transportation and the risk of osteoporosis and osteoporotic fracture among middle-aged and older residents of China. TRIAL REGISTRATION NUMBER: NCT02958020.

Acupoint injection treatment for primary osteoporosis: A systematic review and meta-analysis of randomized controlled trials protocol.

BACKGROUND: Acupoint injection has currently received increasing attention as a treatment for primary osteoporosis (POP). A number of randomized controlled trials (RCTs) have reported that acupoint injection have some advantages in treatment of POP. However, no article has summarized the existing evidence. This study will evaluate the efficacy and safety of acupoint injection as a clinical treatment for POP, so as to provide an important reference for clinical decision-making. METHODS: RCTs of acupoint injection compared with conventional non-acupoint injection for POP were identified in searches of 7 databases from their inception to March 2019. All data were assessed and extracted by 2 authors independently. The risk of bias assessment recommended by the Cochrane Collaboration was used to assess the quality of the selected studies. Review Manager 5.3 (Cochrane Collaboration) was used to conduct meta-analysis for the efficacy and safety of acupoint injection. RESULT: The results of this systemic review and meta-analysis will be submitted to a recognized journal for publication. CONCLUSION: This systemic review and meta-analysis will evaluate the efficacy and safety of acupoint injection as a clinical treatment for POP. We hope this study can make a definitive conclusion for acupoint injection in the treatment of POP. REGISTRATION: PROSPERO (registration number CRD42019130890).

[Design and clinical application of an adjustable spine prone frame].

The design principle and application of an adjustable spine prone frame are introduced. Adjustable spine prone frame is used in posterior lumbar surgery, during operation, X-ray can shoot fast and internal fixation implants can fix accurately, the vacant abdominal ensure normal respiratory and circulatory function, and the lumbar curvature can adjust conveniently. It meets the surgical position and care requirements, can prevent the complications effectively.