Objective To establish an osteoporosis screening tool for Chinese40-years-old or above women. Methods The T-score was calculated based on the mean bone mineral density(BMD) of 20-39 years women. Considering the result of dualenergy X-ray absorptiometry(DXA) as the golden criteria, the Bayes discriminant analysis was employed to explore the function. Results The formula of the screening tool for Chinese 40-years-old or above women as following:osteoporosis screenig tool for Chinese(OSTC):Weight-2×age+50. OSTC≤0was classified into high risk, OSTCgt;0 was low risk. The hit rate of OSTC was 75.78%.The sensitivity is 76.8%. The specificity is 75.1%, Kappa value was 0.51(P=0.000).That means the consistency of diagnosis result between OSTC and DXA was relatively good. Conclusion OSTC is a simple tool. Just based on age and weight, it can evaluate the osteoporosis risk of Chinese 40-years-old or above women. But the effect of OSTC has not been proved by other datasetand should be tested further.
In order to meet the requirements of ultrasound bone density measurement, we proposed a software solution to improve the accuracy and speed of measurement of bone mineral density of the ultrasound bone densitometer. We used a high-speed USB interface chip FT232H, along with a high-speed AD converter chip to calculate speed of sound (SOS), broadband ultrasound attenuation (BUA ) and other bone density parameters in the PC software. This solution improved the accuracy of the measurement data, reduced the measurement time and increased the quality of the displayed image. It is well concluded that the new software can greatly improve the accuracy and transmission speed of bone density measurement data through a high-speed USB interface and a software data processing technology.
Objective To summarize the advances in MRI-based bone quality scoring systems and their clinical applications. Methods A comprehensive literature review was conducted on recent studies related to the MRI-based bone quality scoring system, focusing on measurement methods, influencing factors, and clinical significance. Results Osteoporosis has a high incidence in China, significantly impacting patients’ quality of life and the postoperative outcomes of related orthopedic surgeries. Early identification of osteoporosis holds important clinical significance. In recent years, both domestic and international research has enriched the MRI-based bone quality scoring systems, which includes vertebral bone quality scoring, endplate bone quality scoring, and pedicle bone quality scoring. Compared to the “gold standard” of bone density measurement, dual-energy X-ray absorptiometry, the bone quality scoring systems demonstrate good efficacy in identifying abnormal bone mass and predicting postoperative complications, while being less influenced by degenerative changes in the lumbar spine, indicating its important clinical application value. ConclusionThe MRI-based bone quality scoring systems have good value in clinical applications. However, current studies are mostly retrospective cohort and case-control studies, which carry a risk of bias. The clinical application value needs further clarification through meta-analysis and large-scale prospective studies.
Objective To determine whether statins has some effects on the treatment of cardio-cerebral vascular diseases or hyperlipdemia increases bone mineral density （BMD）. Methods One hundred and sixty-two patients aged over 60 were identified in the outpatient-department of Geriatrics of West China Hospital from Jan. 1998 to Aug. 2003. Seventy cases were exposed to statins with follow-up for 5 years. BMD of the spine, femoral neck, femoral wards triangle and femoral trochanter was measured by dual-energy X-ray absorptiometry. The multiple regression analysis was used to exclude potential confounders, e.g. age, BMI, comorbidity,etc. Results Those elderly patients with a history of taking statins had higher BMD, such as femoral neck with t =-2. 466 （P =0. 015）, femoral wards triangle with t =-2. 483 （P = 0. 014 ）and femoral trochanter with t =-2. 743 （P =0. 007 ）than the control elderly at the end of follow-up. Conclusions It has been found that HMG-CoA reductase inhibitors （statins ） may prevent bone loss in elderly patients by increasing BMD. Further prospective studies of statins are needed to confirm these observatioris.
ObjectiveTo observe the treatment effects of zoledronic acid on postmenopausal osteoporosis. MethodsSeventy-two postmenopausal osteoporosis patients from July 2007 to December 2010 were randomly divided into observation group and control group, with 36 patients in each. Traditional drug treatment was used in the control group, while traditional drug treatment and zoledronic acid were used for patients in the observation group. The Indicator of bone mineral density (BMD) and ostocalcin were used to comapre the treatment effects between the two groups after one-year treatment. ResultsThere was a significant difference in BMD and osteocalcin in both the observation group and the control group before and after treatment (P<0.05). The treatment effect is superior in the observation group (P<0.05). ConclusionZoledronic acid is an effective treatment for postmenopausal osteoporosis; it can increase BMD and osteocalcin more effectively.
ObjectiveTo evaluate the incidence of osteoporosis and relevant factors in the elderly male patients with chronic obstructive pulmonary disease(COPD).Methods Forty elderly male patients with COPD were enrolled and thirty age-matched healthy subjectss were enrolled.The BMD of lumbar vertebrae and proximal end of the femur were measured by dual energy X-ray absorptiometry.Serum levels of osteocalcin （BGP）and lung function were measured while blood-gas analysis of arterial blood was conducted.Results The BMD of lumbar vertebrae and proximal end of the femur(including lumbar 1 to 4，femoral neck，wards triangle，trochanter and shaft) in the COPD group were significantly lower than those in the control subjects(all Plt;0.01).Serum BGP level in the COPD group was higher than that in the control group[(5.67±1.59)ng/mL vs (4.37±1.47)ng/mL，Plt;0.01).The prevalence of osteoporosis among the COPD patients was significantly higher than that among the control subjects（65% vs 40%，50% vs 20%，both Plt;0.05）.BMD in the COPD patients who had a history of smoking was significantly lower than those who did not smoke cigarettes（Plt;0.01 or Plt;0.05）.BMD in the COPD patients treated with glucocorticoid were significantly lower than those who were not receiving glucocorticoid therapy(Plt;0.01 or Plt;0.05).BMD was positively correlated with PaO2，BMI，FEV1%pred and FEV1/FVC(Plt;0.01 or Plt;0.05).Conclusions Compared with age-matched normal controls，BMD in elderly male COPD patients are significantly lower with increased osteoporosis risk.Osteoporosis induced by COPD is high change-over pattern. BMD in patients with COPD may be correlated with hypoxia，lung function，smoking，low body mass index and glucocorticoids therapy.
Objective To explore the significance and the relationshi p between osteoporosis and the mRNA expressions of vascular endothel ial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2) in nontraumatic avascular necrosis of the femoral head (NONFH), so as to provide a theoretical basis for the pathogenesis and the cl inical treatment of NONFH. Methods Sixty-nine specimens of femoral head were collected from voluntary donators undergoing total hi p arthroplasty, including 37 cases of NONFH (NONFH group) and 32 cases of fresh femoral neck fracture (control group). In NONFH group, there were 26 males and 11 females with an average age of 57.3 years (range, 43-75 years), including 19 cases of steroid-induced avascular necrosis of the femoral head (ANFH), 16 cases of alcohol ic ANFH, and 2 cases of idiopathicANFH; according to Ficat staging system, there were 23 cases at stage III and 14 cases at stage IV. In control group, there were 23 males and 9 females with an average age of 58.6 years (range, 46-79 years). The NO level of serum, the Q value of femur, and the bone mineral density (BMD) of weight-bearing area were measured firstly. The bone tissues were harvested from weightbearing necrosis area and healthy area. The pathological change was observed by HE staining, the percentage of empty bone lacuna and the percentage of trabecular bone area were calculated. The mRNA expressions of VEGF and BMP-2 in femoral head were detected through in situ hybridization technique. Results There were significant differences (P lt; 0.05) in the NO level of serum, the Q value of femur, and the BMD between NONFH group and control group. In NONFH group, the femoral head showed irregular shape, the articular cartilage exfol iated and collapsed. In weight-bearing necrosis area, the bone trabeculae were sparse and non-intact with a great number of empty lacuna; necrotic bone trabeculae were decomposed and absorbed; no obvious bone regeneration and repair were observed. In weight-bearing healthy area, the fat cells in bone marrow showed prol iferation and hypertrophy. In control group, the femoral head had normal appearance, intact articular cartilage, and intact bone trabeculae with a regular arrange, and osteocytes were clearly seen. There were significant differences in the percentage of empty bone lacuna and the percentage of trabecular bone area between NONFH group and control group (P lt; 0.05). The mRNA expressions of VEGF and BMP-2 were positive in 2 groups. The positive area ratio, the absorbance value, and integral absorbancevalue of VEGF mRNA and BMP-2 mRNA in NONFH group were significantly lower than those in control group (P lt; 0.05);the grey scales of VEGF mRNA and BMP-2 mRNA in NONFH group were significantly higher than that in control group (P lt;0.05). Conclusion The pathological stage of osteoporosis may play an important role in the mechanism of the NONFH. The decrease of mRNA expressions of VEGF and BMP-2 in femoral head of NONFH is important reason that affect its bone mass, osteoporosis, rehabil itation, and reconstruction. It may be benefit to the reparative process of the necrosis femoral head to increase the mRNA expressions of VEGF and BMP-2 in the femoral head.
In order to meet the requirements of ultrasound bone density measurement, we designed a software based on Visual Studio C++ 2008. The software includes interface design, acquisition and control, data processing and parameter extraction, data storage and printing. Excellent human-computer interface (HCI) will give users a convenient experience. Auto gain control (AGC) and digital filter can improve the precision effectively. In addition, we can observe waveform clearly in real time. By using USB communication, we can send control commands to the acquisition and get data effectively, which can shorten the measuring time. Then we calculated the speed of sound (SOS) and broadband ultrasound attenuation (BUA). Patients' information can be accessed by using XML document. Finally, the software offers printing function.
To observe the effect of pulsed electromagnetic fields (PEMFs) of different treatment time on bone mineral density of femur in ovariectomized rats, so as to find out the treatment time for the best therapeutic efficacy. Methods Fifty female SD rats were randomly divided into 5 groups: sham-ovariectomized (SHAM) group (no PEMFs treatment), ovariectomy (OVX) control group (no PEMFs treatment), OVX I, II and III groups (PEMFs treatment at 8 Hz frequency with 3. 8 ×10-10A/m intensity 20, 40, and 60 minutes daily for 30 days, respectively). All rats were given bilateral ovariectomy except those in the SHAM control group. Bone mineral density (BMD) of femur was assessed at 30 days after PEMFs treatment. Results In OVX control group, hypotrichosis, hypoactivity and l istlessness were observed after operation; and in SHAM group, OVX I group, OVX II group and OVX III group, pilus, psyche and activity were normal. The BMD values were (0.226 ± 0.011), (0.210 ± 0.011), (0.231 ± 0.013), (0.231 ± 0.017) and (0.229 ± 0.013) g/cm2 in SHAM group, OVX control group, OVX I group, OVX II group and OVX III group respectively, showing significant differences between OVX control group and other groups (P lt; 0.05), but showing no significant differences between other 4 groups (P gt; 0.05). Conclusion P EMFs of the three different treatment times can maintain the BMD in ovariectomized rats. It shows that PEMFs have the same effect of maintaining BMD with increasing of treatment time at the range of 20-60 minutes in ovariectomized rats.
ObjectiveTo systematically review the efficacy of zoledronic acid (ZOL) on postoperative osteoporosis vertebral fracture (OVFs) of patients undergoing percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP).MethodsWe searched databases including PubMed, EMbase, CBM, CNKI, VIP and WanFang Data to collect randomized controlled trials (RCTs) about ZOL on postoperative OVFs of patients undergoing PVP or PKP from inception to June 30th, 2016. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies. Then, RevMan 5.3 software was used for meta-analysis.ResultsA total of 11 RCTs involving 950 cases of OVFs were included. The results of meta-analysis showed that: the bone mineral densities of the ZOL group at 6 months (SMD=0.62, 95%CI 0.06 to 1.18, P=0.03) and 12 months (SMD=1.32, 95%CI 0.62 to 2.02, P=0.000 2) after the operation were higher than those of the control group. The re-fracture risk of the ZOL group was lower than that of the control group (RR=0.27, 95%CI 0.16 to 0.47, P<0.000 01). The visual analogue scales of the ZOL group were lower than those of the control group at 3 weeks (SMD=–1.03, 95%CI –1.42 to –0.63, P<0.000 01), 1 month (SMD=–1.57, 95%CI –2.30 to –0.83, P<0.000 01), 3 months (SMD=–1.53, 95%CI –2.20 to –0.86, P<0.000 01), 6 months (SMD=–2.59, 95%CI –3.42 to –1.76, P<0.000 01), and 12 months (SMD=–2.69, 95%CI –4.21 to –1.18, P=0.000 5) after the operation. In addition, Oswestry disability index (ODI) score of the ZOL group was better than that of the control group at 1 year after the operation (SMD=–1.61, 95% CI–2.42 to –0.81, P<0.000 1).ConclusionsThe current evidence shows that the usage of ZOL after PVP/PKP has better effects, it relieves the pain further, increases the quantity of bone significantly, ameliorates the BMD, reduces the incidence of re-fracture and improves the quality of life. Due to the limited quantity and quality of included studies, more high-quality studies are needed to verify the above conclusion.