ObjectiveTo review the effects and mechanisms of various myokines secreted by skeletal muscle on various bone tissue cells.MethodsLiterature related to myokines and their regulation of bone tissue cells was reviewed and analyzed comprehensively in recent years.ResultsBone and skeletal muscle are important members of the motor system, and they are closely related in anatomy, genetics, and physiopathology. In recent years, it has been found that skeletal muscle can secrete a variety of myokines to regulate bone marrow mesenchymal stem cells, osteoblasts, osteoclasts, and bone cells; these factors mutual crosstalk between myoskeletal unit, contact each other and influence each other, forming a complex myoskeletal micro-environment, and to some extent, it has a positive impact on bone repair and reconstruction.ConclusionMyokines are potential targets for the dynamic balance of bone tissue cells. In-depth study of its mechanism is helpful to the prevention and treatment of myoskeletal diseases.
Objective To establish a rapid, simple, and economic method to prepare osteoporosis (OP) in vitro model. Methods Eighty pairs of fresh goat femur were collected from 18-month-old female goats and were randomly divided into 4 groups (20 pairs in each group). The femur was immersed decalcifying solution (18% EDTA) for 1-5 days (group B), 6-10 days (group C), and 11-15 days (group D), while group A had no treatment as control. Four pairs of femur were taken out every day. Quantitative computed tomography was used to scan the medial and lateral femoral condyles, and the bone mineral density (BMD) was calculated. Electronic universal testing machine was used to do three-point bending test and compress and tensile ultimate strenght test, and the mechanical parameters for femur were calculated. Results With demineralized time passing, BMD of the medial and lateral femoral condyles were downtrend in groups A, B, C, and D, showing significant differences among 4 groups (P lt; 0.05); BMD of the lateral femoral condyle was significantly higher than that of the medial femoral condyle in each group (P lt; 0.05). The three-point bending test showed that broken load, ultimate strength, and elastic modulus of groups A and B were significantly higher than those of groups C and D (P lt; 0.05); but no significant difference was found between groups A and B, and between groups C and D (P gt; 0.05). Compress and tensile ultimate strength test showed that the compress and tensile ultimate strengths were significantly higher in group A than in groups C and D (P lt; 0.05), and in group B than in group D (P lt; 0.05), but no significant difference was found between groups A and B, between groups B and C, and between groups C and D (P gt; 0.05). Conclusion The 18% EDTA immersing for 6-15 days is a fast, simple, economical method to prepare an OP in vitro model of goat femur.
Methods of evidence-based medicine were used to discuss the drug treatment of postmenopausal osteoporosis. After clinical problems were put forward, we searched for and assessed the evidence. A rational treatment plan for osteoporosis patients with fractures was developed according to the results of systematic reviews and Meta-analysis.
Objective To systematically review the prevalence of osteoporosis (OP) in Chinese postmenopausal females. Methods The CNKI, VIP, CBM, WanFang Data, PubMed, EMbase and The Cochrane Library databases were electronically searched to collect studies on the prevalence of OP in Chinese postmenopausal females from inception to March 17th, 2022. Two reviewers independently screened the literature, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was then performed using Stata 14.0 software. Results A total of 54 studies involving 96 391 cases and 41 651 confirmed OP patients were included. The meta-analysis results showed that the prevalence of OP in Chinese postmenopausal females was 38.8% (95%CI 34.1% to 43.5%). Subgroup analysis showed that the prevalence of OP was 31.7% (95%CI 16.6% to 48.6%) in females who had been menopausal for less than 5 years, 47.4% (95%CI 32.2% to 62.5%) for 5-9 years, 52.7% (95%CI 37.1% to 68.3%) for 10-14 years, 77.5% (95%CI 69.5% to 85.4%) for 15-19 years, and 78.3% (95%CI 56.3% to 100.0%) for more than 20 years. The rate was 16.2% (95%CI 28.8% to 37.2%) in under 50 years age group, 28.8% (95%CI 34.4% to 47.9%) for 50- years group, 41.1% (95%CI 34.4% to 47.9%) for 60- years group, 55.3% (95%CI 45.8% to 64.8%) for 70- years group, 82.0% (95%CI 76.1% to 87.9%) for 80- years group. The prevalence in different regions was between 31.0% and 43.5%, which was lowest in the northeast (31.0%, 95%CI 26.3% to 51.4%) and highest in the northwest (43.5%, 95%CI 22.3% to 64.7%). According to the year of publication, the rate was 43.9% (95%CI 15.7% to 72.0%) from 1997 to 2009 and 38.2% (95%CI 33.8% to 42.5%) from 2010 to 2021. The prevalence of OP was 24.9% (95%CI 20.5% to 29.3%) in postmenopausal females with no birth or 1 birth, and 45.0% (95%CI 37.0% to 53.0%) in females with 2 or more births. Conclusion The prevalence of OP in Chinese postmenopausal females is relatively high. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
【摘要】 目的 评价亚洲骨质疏松自我评价工具（OSTA）和我国妇女骨质疏松筛选工具（OSTC）与四川地区围绝经期和绝经后汉族妇女骨密度的关系，比较两种工具对骨质疏松症的筛检能力，探讨其临床应用价值。 方法 2010年7—10月筛选获得356名45岁以上妇女的双能X线骨密度仪腰椎、股骨颈和全髋骨密度数据，利用体重和年龄分别计算OSTA指数与OSTC指数，并进行比较。 结果 OSTA指数与OSTC指数和各部位骨密度值均呈正相关（r=0.458~0.593和r=0.440~0.599，Plt;0.001），两种筛选指数之间呈正相关（r=0.956，Plt;0.001）。按两级危险程度分类界值进行判定，OSTA和OSTC的灵敏度分别为78.2%、93.5%，特异度为67.2%、43.0%，受试者工作特征曲线下面积为0.792、0.798，Kappa系数为0.452、0.357。 结论 OSTA与OSTC应用于四川地区围绝经期和绝经后妇女骨质疏松症的筛查效果均不理想，临床应用价值受限。【Abstract】 Objective To evaluate the relationship between osteoporosis self-assessment tool for asians (OSTA), osteoporosis self-assessment tool for Asians (OSTC) and bone mineral density in Sichuan perimenopausal and postmenopausal women of Han nationality, and discuss the value of their clinical application through comparison of the screening ability of the two tools in predicting osteoporosis and low bone mass. Methods With the data of bone mineral density at lumbar spine, femoral neck and total proximal femur measured by DXA of 356 women aged 45 years old and above, OSTA and OSTC risk indexes of each subject were calculated based on their weight and age, and were then compared. Results The bone mineral density of above-mentioned locations were positively correlated with OSTA and OSTC indexes (r=0.458-0.593 and r=0.440-0.599,Plt;0.001), and these two indexes were also correlated positively (r=0.956, Plt;0.001). According to the two risk levels by these cutoffs, OSTA and OSTC indexes could diagnose osteoporosis with the sensitivity of 78.2% and 93.5%, the specificity of 67.2% and 43%, the area under ROC curve of 0.792 and 0.798, and the Kappa value of 0.452 and 0.357, respectively. Conclusion Both OSTA and OSTC were not ideal tools for screening osteoporosis in perimenopausal and postmenopausal women in Sichuan province.
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.
To evaluate the effects of XiangLingGuBao (XLGB) on femoral fracture heal ing in ovariectomized (OVX) rats. Methods Forty 12-week-old female SD rats weighing (258 ± 14) g were divided randomly into 4 groups (n=10 per group): group A, sham operation by opening the abdominal cavity; group B, bilateral ovariectomy; group C, bilateral ovariectomy, transverse midshaft fracture of the right femur with intramedullary nail fixation, and normal sal ine by gavage; group D, bilateral ovariectomy, transverse midshaft fracture of the right femur with intramedullary nail fixation, and 250 mg/(kg•d) XLGB by gavage. The weight of rabbits in groups A and B was measured 0, 1, 2, 3, 4 and 5 weeks after operation. The right femur of each rat was obtained 5 weeks after operation. Total femur bone mineral density (tBMD), distal femur bone mineral density (dBMD) and middle femur bone mineral density (mBMD) were measured by double energy X-ray absorptiometry CR filming, HE staining and immunohistochemistry staining of groups C and D were performed. Results The weight of rats in group B was obviously higher than that of group A at 3, 4 and 5 weeks after operation (P lt; 0.05), indicating the animal model of postmenopausal osteoporosis was establ ished successfully. CR films showed more callus and obscure fracture l ine in group D, while less callus and distinct fracture l ine in group C. The tBMD and the dBMD of group B were far less than that of group A, the mBMD of group D was significantly higher than that of group C(P lt; 0.05), the tBMD and the dBMD of group D were higher than that of group C, but no significant difference was evidentbetween two groups (P gt; 0.05). Histology observation showed, when compared with group C, most fracture ends in groupD reached bone union, and the introduction of capillaries was evident in the marrow cavity. Immunohistochemistry staining demonstrated that the BMP-2 integrated absorbance (IA) value in groups C and D was 2.236 6 ± 0.181 8 and 3.727 3 ± 0.874 2, respectively, the VEGF IA value in groups C and D was 2.835 5 ± 0.537 0 and 3.839 6 ± 0.223 0, respectively, indicating there were significant differences between two groups (P lt; 0.05). Conclusion XLGB can obviously promote the femoral fracture heal ing in OVX rats, and speed the transformation of woven bone into lamellar bone, which may rely on its role of enhancing expression of BMP-2 and VEGF.
【Abstract】 Objective To study the effectiveness of computer assisted pedicle screw insertion in osteoporotic spinalposterior fixation. Methods Between December 2009 and March 2011, 51 patients underwent pedicle screw fixation using the computer assisted navigation (navigation group), while 41 patients underwent the conventional technique (traditional group). All patients had osteoporosis under the dual-energy X-rays absorptiometry. There was no significant difference in age, gender, bone mineral density, involved segment, preoperative complications, and other general status between 2 groups (P gt; 0.05). The amount of blood loss, the operation time, the rate of the pedicle screw re-insertion, and the postoperative complication were observed. The state of the pedicle screw location was assessed by CT postoperatively with the Richter’s classification and the fusion state of the bone graft was observed using three-dimensional (3-D) CT scans during follow-up. Results A total of 250 screws were inserted in navigation group, and 239 were inserted successfully at first time while the other 11 screws (4.4%) were re-inserted. A total of 213 screws were inserted in traditional group, and 190 were successful at first time while 23 screws (10.8%) were re-inserted. There was significant difference in the rate of screws re-insertion between 2 groups (χ2=6.919, P=0.009). Both the amount of blood loss and the operation time in navigation group were significantly less than those in traditional group (P lt; 0.05). According to Richter’s classification for screw location, the results were excellent in 240 screws, good in 10 screws innavigation group; the results were excellent in 191 screws, good in 21 screws, and poor in 1 screw in traditional group. Significant difference was noticed in the screw position between 2 groups (χ2=7.566, P=0.023). The patients were followed up (7.8 ± 1.5) months in navigation group and (8.7 ± 1.5) months in traditional group. No loosening, extraction, and breakage of the pedicle screw occurred in navigation group, and all these patients had successful fusion within 6 months postoperatively. While in traditional group, successful fusion was shown in the other patients by 3-D CT, except the absorption of bone graft was found in only 1 patient at 6 months after operation. And then, after braking by adequate brace and enhancing the anti-osteoporotic therapy, the bone graft fused at 9 months postoperatively. Conclusion The computer assisted navigating pedicle screw insertion could effective reduce the deviation or re-insertion of the screws, insuring the maximum stabil ity of each screw, mean while it can reduce the exposure time and blood loss, avoiding complication. The computer assisted navigation would be a useful technique which made the pedicle screw fixation more safe and stable in patients with osteoporosis.