Search

To investigate whether there is an influence on the results of lumbar spine bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) under three different hip flexion angles (90°, 45°, 0° of hip flexion). We collected a total of 60 outpatients, including 44 females (56.4 ± 5.7 years) and 16 males (50.2 ± 13.7 years). The DXA results of the lumbar spine were scanned and analyzed in three different positions with hip flexion of 90°, 45°, and 0°. We found that there was no significant difference in the area of interest, bone mineral content, BMD, and vertebral body height of the lumbar vertebral body measured by DXA in three hip flexion positions of 90°, 45°, and 0°; Pearson’s correlation analysis showed that lumbar BMD in hip flexion 90° was correlated with it in hip flexion 45° (r = 0.998, P＜0.01) and in hip flexion 0° (r = 0.996, P＜0.01) respectively. There was no statistically significant difference in the diagnosis of BMD between 90° and 45° hip flexion (P = 0.903), which was the same as 90° and 0° hip flexion (P = 0.822). Therefore, we conclude that different hip flexion angles can be used in lumbar BMD detection by DXA, which is beneficial to patients who have difficulty in hip flexion, especially for elderly patients with osteoporosis.

In this retrospective study, we studied the impact of educational osteoporosis program on the rates of bone mineral density (BMD) assessment and bone turnover markers (BTM) and drug medications in the patients with hip fracture.

Glial scar formation is a major obstacle to nerve regeneration following spinal cord injury (SCI). Pin1 and the PI3K/AKT/CDK2 signaling pathway play crucial roles in neuronal regulation, but research on their involvement in glial scarring remains limited. In this study, we have for the first time observed that Pin1, PI3K, AKT, and CDK2 are upregulated and interact with each other following SCI. Further experiments revealed that Pin1 contributes to the development of glial scars by promoting astrocyte proliferation, inhibiting apoptosis, and activating the PI3K/AKT/CDK2 pathway. Additionally, all‐trans retinoic acid (ATRA), a specific chemical inhibitor of Pin1, effectively suppresses Pin1 expression. However, its clinical application is limited by its short half‐life and susceptibility to inactivation. To address these issues, we have developed a thermosensitive sodium beta‐glycerophosphate (β‐GP)/chitosan (CS) hydrogel loaded with ATRA (β‐GP/CS@ATRA). This hydrogel exhibits favorable morphology and biocompatibility. Compared to free ATRA, the β‐GP/CS@ATRA hydrogel significantly enhances functional motor recovery after SCI and protects spinal cord tissue, thereby inhibiting glial scar formation. Mechanistically, ATRA administration blocks the development of glial scars and the activation of the PI3K/AKT/CDK2 pathway by inhibiting Pin1 expression. This study suggests that combining ATRA with a hydrogel to target Pin1 expression may be a promising strategy for treating glial scar formation following SCI. [ABSTRACT FROM AUTHOR]

Background: Fragility fracture significantly increases risk of future fracture. The fragility fracture cycle should be disrupted. The secondary fracture prevention is important for the patients with fragility hip fracture. The pharmacotherapy for osteoporosis is important for prevention of new fracture. However, many patients with hip fracture do not receive osteoporosis treatment. This retrospective study investigates the influence of bone mineral density (BMD) assessment on the initiation of anti-osteoporosis medications in the hospitalized patients with fragility hip fracture. Methods: This retrospective research enrolled 1211 patients with fragility hip fracture 50 years of age and older. Among 1211 patients aged from 50 to 103 years with the average age of 77.83 ± 9.95 years, there were 807 females and 404 males. There were 634 fractures of femoral neck and 577 intertrochanteric fractures of femur. We examined whether patients had received bone mineral density assessment and received anti-osteoporosis therapy during the period of hospitalization. The patients were divided into BMD assessment group and no BMD assessment group. Measurement data were expressed as mean ± standard deviation and compared with t test. All parameters of groups were compared with Chi-square test. Results: Of 1211 patients, 331 (27.33%) had received BMD assessment and 925 (76.38%) had received anti-osteoporosis drugs during the period of hospitalization. The rate of bisphosphonate use was lower and only 11.31% in the total patients. The anti-osteoporosis treatment rate was 93.66% in the patients receiving BMD assessment and 69.89% in the patients without BMD assessment (p < 0.01). The zoledronate use significantly increased from 6.7% in the patients without BMD assessment to 23.56% in the patients receiving BMD assessment (p < 0.01). Conclusions: BMD assessment is a good basis for communication between patients and orthopedic surgeons. BMD assessment significantly increases the initiation of osteoporosis treatment and bisphosphonate use in the patients with hip fracture during the period of hospitalization. [ABSTRACT FROM AUTHOR]

Background: This study assessed the differences in femoral geometry and bone mineral density between femoral neck fragility fractures and trochanteric fractures.Methods: One hundred and seventeen patients were divided into femoral neck and trochanteric fracture groups. There were 69 patients with femoral neck fractures, 20 men and 49 women with an average age of 75.1 ± 9.6 years and an average body mass index (BMI) value of 21.6 ± 4.1 kg/m2. The trochanteric group consisted of 48 patients, 16 men and 32 women with an average age of 78.1 ± 9.1 years and an average BMI value of 21.5 ± 4.3 kg/m2. All patients underwent dual-energy X-ray absorptiometry (DXA) of the contralateral hip; hip structural analysis (HSA) software was used to analyze the femoral geometry parameters, including hip axis length (HAL), neck-shaft angle (NSA), cross-sectional area (CSA), the cross-sectional moment of inertia (CSMI), the buckling ratio (BR), and cortical thickness.Results: The cortical thickness in the intertrochanteric region was reduced in the trochanteric fractures group compared to the femoral neck fracture group (P < 0.05). There were no statistically significant differences (P > 0.05) in gender, age, height, weight, or BMI between the two groups. In addition, no statistically significant differences (P > 0.05) were found in the CSA, CSMI, or BR of the femoral neck or the intertrochanteric region between the two groups. There were no statistically significant differences (P > 0.05) in femoral neck cortical thickness between the two groups.Conclusions: Cortical thickness thinning in the intertrochanteric region may be one of the relevant factors causing different types of hip fractures, especially in elderly patients. [ABSTRACT FROM AUTHOR]

Objective To study the change of bone mineral density and hip structural strength in the females with osteoporotic hip fractures. Methods The bone mineral density and hip structure analysis was performed with DXA for 95 female patients with osteoporotic hip fractures. The age and BMI of the patients were 76. 60 ± 9. 36 years and 20. 88 ± 3. 72 kg/m². Sixty-three females ( ≥50 years old) with normal BMD were included in the control group. The age and BMI were 57.24 ± 5.65 years and 26.56 ± 4.82 kg/m² in the control group. Bone mineral density and structural strength variables including cross surface area, cortical thickness, and buckling ratio were compared between the females with osteoporotic hip fractures and the females with normal BMD. Results The females with osteoporotic hip fractures had significantly lower femoral neck BMD, cross surface area, and cortical thickness, and higher buckling ratio than the females with normal BMD. The buckling ratio at femoral neck and intertrochanter was > 10 in 87. 4% of the females with hip fractures. It was ≤ 10 in 84. 1% of the females with normal BMD. Conclusion The significant change of BMD at femoral neck and hip structural strength is present in the females with osteoporotic hip fractures, suggesting the decrease of bone strength. The HSA including structural strength variables is helpful to predict the risk of the hip fracture. [ABSTRACT FROM AUTHOR]

Objective In order to improve the diagnosis of vertebral fracture, VFA was performed during the BMD measurement. Methods VFA were consecutively performed during the BMD measurement of proximal femur in 217 postmenopausal women whose ages were over 50 years. Vertebral fracture evaluation software was used to find vertebral body fractures. According to T scores, the patients were divided into the group with BMD T > -2.5 and the group with BMD T ≤ -2.5. According to the age, the patients were divided into 50-59 yrs group, 60-69 yrs group, and ≥70 yrs group. According to the duration of menopause, the patients were divided into 0-9 yrs group, 10 - 19 yrs group, and ≥20 yrs group. The effect of BMD, age, and duration of menopause on the vertebral fracture was analyzed. In order to understand the agreement of the vertebral fracture assessment with VFA, the patients' images were performed repeatedly to assess the accordance of the evaluation by the same researcher in 2 months. The reproducibility was estimated using Kappa method. Results The vertebral fracture rate was 21. 6% in the patients with BMD T > -2. 5 and 34. 8% in the patients with BMD T ≤ -2.5. The vertebral fracture rates were 12. 5%, 25. 6%, and 44. 8% in the age groups of 50 - 59 yrs, 60-69 yrs, and ≥70 yrs, respectively. The vertebral fracture rate was significantly higher in the patients with long duration of menopause. The reproducibility indicated almost perfect agreement. Conclusion BMD measurement together with VFA for postmenopausal women at same time improves the diagnosis of vertebral fracture and osteoporosis. [ABSTRACT FROM AUTHOR]

Objective To monitor the early response to bisphosphonates treatment with bone turnover markers. Methods Serum (β-CTX P1NP were monitored for 60 postmenopausal women before and 16 weeks after the bisphosphonates treatment, in order to evaluate the efficacy of the treatment. Results β-CTX was 0.390 ±0.230 ng/ml and P1NP was 51.445 ± 25.955 ng/ml before the bisphosphonates treatment. Bone turnover was high in 24 patients and normal in 36 before the treatment. β-CTX was 0.133 ± 0.120 ng/ml and P1NP was 18.853 ± 10.225 ng/ml after the bisphosphonates treatment. The significant reduction in β-CTX and P1NP was present. The efficacy of the treatment was 95%. Conclusion The measurement of (β-CTX and P1NP are effective method for monitoring the bisphosphonates treatment. [ABSTRACT FROM AUTHOR]