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.
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 investigate the femoral bone remodeling and long-term effectiveness of total hip arthroplasty (THA) with anatomic medullary locking (AML) prosthesis.MethodsThe clinical data of 24 cases (26 hips) who were treated with THA with AML prosthesis between November 1997 and January 2003 were retrospectively analyzed. There were 12 males and 12 females with an age of 32-69 years (mean, 53.7 years). There were 5 cases (5 hips) of avascular necrosis of the femoral head, 6 cases (7 hips) of secondary osteoarthritis of the hip dysplasia, 6 cases (6 hips) of femoral neck fracture, 2 cases (2 hips) of primary osteoarthritis, 3 cases (3 hips) of revision surgery, 1 case (2 hips) of ankylosing spondylitis, 1 case (1 hip) of femoral head fracture. The patients were followed up at immediate, 6 weeks, 3 months, 6 months, 1 year, and then every year after operation for imaging evaluation (X-ray film was taken immediately after operation to evaluate the femoral isthmus compression, Engh standard was used to evaluate the biological fixation of the femoral shaft prosthesis, and Brooker method was used to evaluate the occurrence of heterotopic ossification); bone reconstruction evaluation [reconstruction of prosthesis and bone interface (type of bone reaction, Gruen zone, incidence, and occurrence time were recorded), reconstruction of bone around prosthesis (proximal femur stress shielding bone absorption was evaluated according to Engh and Bobyn methods, and bone mineral density change rate was measured)]; clinical efficacy evaluation [Harris score for efficacy, visual analogue scale (VAS) score for thigh pain].ResultsAll patients were followed up 15 years and 2 months to 20 years and 4 months, with a median of 16 years and 6 months. At immediate after operation, 24 hips (92.3%) had good femoral isthums compression, 24 hips (92.3%) had good bone ingrowth. Heterotopic ossification occurred in 2 patients with degree 1, 2 patients with degree 2, and 1 patient with degree 3 at 3-6 months after operation. Hyperplastic bone reactions were more common in Gruen 2, 3, 4, 5, 6, 10, 11, and 12 zones, mainly occurring at 6-20 months after operation, with the incidence of 3.8%-69.2%, with the highest incidence of spot welding. All absorptive bone reactions were osteolysis, which was common in Gruen 1 and 7 zones, and mainly occurred at 8 years after operation, with an incidence of 42.3%. No clear line (area) or enlarged sign of medullary cavity was observed. Twenty-one hips (80.8%) had 1 degree stress shieding, and 5 hips (19.2%) had 2 degree stress shieding. It mainly occurred at 10-24 months after operation in Gruen 1 and 7 zones. Dual energy X-ray absorptiometry showed that bone mineral density mainly decreased in Gruen 1, 2, 6, and 7 zones, mainly increased in Gruen 3, 4, and 5 zones. Bone mineral density loss progressed slowly after 2 years of operation, and it was stable in 5-8 years, but decreased rapidly in 8-9 years, and stabilized after 10 years. The Harris score increased from 51.1±6.2 before operation to 88.3±5.1 at last follow-up (t=–21.774, P=0.000). Mild thigh pain occurred in only 2 cases (7.7%) with the VAS score of 2. No aseptic loosening or revision of femoral prosthesis occurred during the follow-up.ConclusionThe application of AML prosthesis in THA has a good bone remodeling and a good long-term effectiveness.
The present research is to investigate the time effect of sinusoidal electromagnetic fields (SEMFs) at different exposure time on the biomechanical properties in rats, and to find a best time for improving biomechanical properties. Forty female SD rats were randomly divided into five groups, i.e. control group, 45 min SEMFs group, 90 min SEMFs group, 180 min SEMFs group, and 270 min SEMFs group. In addition to the control group, other groups were exposed to 50 Hz and 0.1 mT magnetic field every day for the corresponding time periods. After eight weeks, bone mineral density (BMD), bone biomechanics, bone tissue morphology, micro-CT and pathological examination were performed. The results showed that there was no abnormal pathological finding in the experimental groups. In the 90 min SEMFs group, BMD, femur maximum load, elastic modulus, yield strength, trabecular number (Tb.N), trabecular thickness (Tb.Th) and trabecular area (Tb.Ar) percentage were all significantly higher than those in the control group (P＜0.01), and trabecular separation (Tb.Sp) was significantly lower than that of the control group (P＜0.01). However, for other experimental groups, some indices showed statistical significance compared to the control group (P＜0.05), but some did not (P>0.05). This study showed that under 50 Hz and 0.1 mT SEMFs, 90 min is the best time that can effectively increase bone mineral density, improve the bone tissue microstructure organization and the biomechanical properties.
【摘要】 目的 观察重组人甲状旁腺激素（1-34）[rhPTH（1-34）]治疗骨质疏松症患者骨密度的疗效和安全性。 方法 采用自身前后对照临床研究，纳入2008年3-5月就诊的原发性骨质疏松症患者共39例，予rhPTH（1-34） 20 μg 1次/d皮下注射，疗程18个月。治疗期间均同时口服钙制剂600 mg/d及维生素D3 125 U/d作为基础治疗。患者治疗前采用双能X线检测腰2~4椎体（L2~4）和股骨颈骨密度（BMD）、肝肾功能、血钙、血磷，治疗后6、12、18个月复查BMD和上述生化指标改变，记录患者不良事件，对患者治疗前后L2~4、股骨颈BMD变化进行对比分析。 结果 35例患者完成全疗程治疗，其中男2例，女33例；平均年龄65岁，平均病程6.5年；治疗6、12、18个月时L2~4 BMD均较治疗前明显提高（Plt;0.01），而股骨颈BMD在治疗6、12个月时改善不明显（Pgt;0.05），18个月时表现出较治疗前明显增加（Plt;0.01）；腰椎平均BMD增长率为12.27%，股骨颈BMD增长率为4.11%；治疗期间不良反应少，均不需特殊处理而自行好转。 结论 rhPTH（1-34）治疗原发性骨质疏松症安全有效，对改善椎体BMD疗效迅速明显，对改善股骨颈BMD起效慢；适用于绝经后骨质疏松和老年性骨质疏松症患者。【Abstract】 Objective To observe the therapeutic effect of recombinant human parathyroid hormone (1-34) [rhPTH(1-34)] on the improvement of bone mineral density (BMD) in patients with primary osteoporosis. Methods A before and after self control study was performed on 39 patients with primary osteoporosis from March to May 2008. The patients underwent the subcutaneous injection with rhPTH (1-34) 20 μg/d for 18 months. All patients were given oral calcium (Ca 600 mg+Vit D3 125 U per day) as primary drug treatment. BMD of lumbar spine (L2-L4) and femur neck, serum calcium, and serum phosphate were measured before and 6, 12, and 18 months after the treatment. All of the adverse reactions were recorded. Results A total of 35 patients finished the trial,including two males and 33 females with the average age of 65 years and the course of disease of (6.54±4.30) years. BMD of lumbar spine (L2-L4) significantly increased 6, 12, and 18 months after treatment (Plt;0.01). There was no significant difference of femur neck BMD 6 and 12 months after treatment (Pgt;0.05), whereas by the end of the treatment, it improved significantly (Plt;0.01). The average increase rate was 12.27% in lumbar spine (L2-L4) and was 4.11% in femur neck BMD. There were a few adverse reactions during the therapeutic process, most of which were tolerable and self-restored. Conclusion rhPTH(1-34) is an effective and safe drug in treating primary osteoporosis. It can increase lumbar spine BMD rapidly and raise femur neck BMD gradually. It is applicable for postmenopausal osteoporosis and senile osteoporosis.
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 ananlyze the relationship between bone mineral density and sex hormone in male patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods The study recruited 88 male patients with OSAHS aged 45-60 years in our hospital from October 2014 to October 2016 as an OSAHS group, and 30 healthy subjects without OSAHS as a control group. The general information and PSG parameters were recorded, the bone metabolic markers and bone mineral density of lumbar spine 1-4 (L1-4) and femoral neck (Neck) were measured, and the expressions of serum sex hormone (E2, P, T, FSH, LH and PRL) were determined by chemical luminescence immunity analyzer. The differences in above indexes between two groups and their correlation with bone mineral density were analyzed. Results Smoking rate, drinking rate, neck circumference and body mass index (BMI) of the OSAHS group were significantly higher than those of the control group. Compared with the control group, beta crosslaps (β-CTX, a bone metabolic marker) was significantly higher [(0.53±0.14) ng/ml vs. (0.47±0.15) ng/ml], the bone mineral density of L1-4 and Neck was significantly lower [(0.92±0.12) g/cm2 vs. (1.08±0.08) g/cm2, (0.91±0.11) g/cm2 vs. (1.06±0.13) g/cm2], and the serum testosterone was significantly lower in the OSAHS group [(267.32±89.56) ng/dlvs. (315.68±78.49) ng/dl] (all P<0.05). The result of Pearson correlation analysis showed that apnea hypopnea index (AHI) was negatively correlated with bone mineral density of L1-4 and Neck (bothP<0.001), lowest oxygen saturation (LSaO2) and testosterone were positively correlated with bone mineral density of L1-4 and Neck (all P<0.01). Conclusions The risk of suffering from osteoporosis is higher in male OSAHS patients and it is closely related to the degree of hypoxia. The decrease of testosterone may be one of the mechanisms.
Objective To estimate the population attributable disease burden (PAD) of low bone mineral density (LBMD) related fractures among Chinese people over 50 years old from 1990 to 2023, using data from the Global Burden of Disease Study 2023 (GBD 2023), and to provide evidence for prevention strategies and health resource allocation. Methods Based on the GBD 2023, the LBMD summary exposure values (SEV), fracture incidence, years lived with disability (YLDs), and LBMD-related falls YLDs of Chinese people over 50 years old from 1990 to 2023 were extracted. PAD was calculated with population attributable fraction (PAF), and an entropy-weight method was applied to evaluate the contribution of individual fracture sites. Temporal trends and sex differences were examined with Joinpoint regression. Results From 1990 to 2023, the age-standardized SEV of LBMD in people over 50 years old showed an overall decline [average annual percent change (AAPC)=−0.564%]. Age-standardized fracture incidence, fracture YLDs rate, and LBMD-related falls YLDs rate all exhibited W-shaped upward trends (AAPC=1.045%, 0.296%, and 0.724%, respectively). PAF-based estimates indicated that LBMD-attributable fracture incidence likewise increased in a “W-shaped” manner (AAPC=0.558%), whereas the corresponding YLDs rate showed an overall W-shaped decline (AAPC=−0.193%). In international comparison, China and the global average displayed broadly concordant directions of change, with greater volatility in China and a progressive narrowing of the gap after 2015. Regarding sex differences, fracture YLDs rates were consistently higher in the males, whereas the other burden indicators were higher in the females; the temporal patterns were similar in both sexes. Entropy weight method identified hip fractures as contributing most to incidence (weight 0.133), and pelvic fractures as the largest contributor to YLDs rate (weight 0.115). ConclusionSince 1990, the LBMD attributable fracture burden in China’s older population has risen, with female and hip or pelvic fractures bearing the heaviest load. Strengthened osteoporosis screening, improved insurance coverage, and targeted health education are urgently needed to curb further increases in disease burden.
Alveolar bone reconstruction simulation is an effective means for quantifying orthodontics, but currently, it is not possible to directly obtain human alveolar bone material models for simulation. This study introduces a prediction method for the equivalent shear modulus of three-dimensional random porous materials, integrating the first-order Ogden hyperelastic model to construct a computed tomography (CT) based porous hyperelastic Ogden model (CT-PHO) for human alveolar bone. Model parameters are derived by combining results from micro-CT, nanoindentation experiments, and uniaxial compression tests. Compared to previous predictive models, the CT-PHO model shows a lower root mean square error (RMSE) under all bone density conditions. Simulation results using the CT-PHO model parameters in uniaxial compression experiments demonstrate more accurate prediction of the mechanical behavior of alveolar bone under compression. Further prediction and validation with different individual human alveolar bone samples yield accurate results, confirming the generality of the CT-PHO model. The study suggests that the CT-PHO model proposed in this paper can estimate the material properties of human alveolar bone and may eventually be used for bone reconstruction simulations to guide clinical treatment.