Objective To study the results of percutaneous kyphoplasty(PKP) in treating subtle fracture of osteoporotic vertebral body,and to explore the clinical value of PKP in patients with subtle fracture of osteoporotic vertebral body.Methods 52 thoracical vertebral bodies of 35 patients with subtle fracture of osteoporotic vertebral body.Nineteen patients with 30 vertebrae were assigned to group 1 treated by PKP,and sixteen patients with 22 vertebrae were assigned to group 2 treated by conservative therapy.The patients were examined after surgery to ascertain the alleviation of the pain and evaluate the patients' life quality,measuring the heights of vertebrae on the lateral plain films during follow-up.Results Surgery was successful in all cases,no serious complications occurred with PVP.Pain relief was obtained in all of group 1,pain still remained in all 16 patients of group 2 at 1 week after conservative treatment.Improvement was significantly greater in the group 1 than in group 2 at1 week,1 month,3 months,6 months,but no difference at 12 months after treatment (P ＞ 0.05 ).According to ADL,the patients' life quality scores,improvement was significantly greater in the group 1 than in group 2 at1 week,1 month,3 months,6 months,but no difference at 12 months after treatment(P ＞ 0.05 ).The height of the veterbral body showed significant difference at 12 months of follow( P ＜ 0.05).Conclusion PKP was an effective and safe procedure for treating subtle fracture of osteoporotic vertebral body.PKP has satisfactory analgesic effect on subtle fracture of osteoporotic vertebral body and improve quality of patients' life.PKP could effectively prevent collapse of veterbral body.

Objective:To investigate the risk factors of proteinuria in patients with hypertension in Qinghai-Tibet Plateau.Methods:From March 2019 to June 2020, prospective design was used to collect data of Qinghai-Tibet Plateau hypertension patients who were eligible for continuous enrollment in the Department of Cardiovascular Medicine in Hospital of Chengdu Office of People's Government of Tibet Autonomous Region. Questionnaire survey, physical examination and blood pressure measurement were performed on the selected patients. Fasting venous blood samples were collected for liver function test, blood lipid test, blood glucose test, and hemoglobin test, etc. Three times of morning urine samples were taken on different days, and urine protein creatinine ratio (UACR) was measured, UACR < 30 mg/g was negative for urinary protein, and UACR≥30 mg/g was positive for urinary protein. At the same time, the selected patients were examined by carotid artery color ultrasound and heart color ultrasound. The risk factors of proteinuria were analyzed.Results:A total of 588 patients with hypertension met the inclusion criteria, including 472 patients (80.3%) who received antihypertensive drug therapy, 239 patients (40.6%) had antihypertensive treatment compliance, and 252 patients (42.9%) reached the standard blood pressure after theropy. Hypertension was associated with diabetes mellitus in 150 patients (25.5%), and urinary protein was positive in 126 patients (21.4%). In univariate analysis, ethnic composition, systolic blood pressure [(138.19 ± 19.65) vs (133.16 ± 18.45) mmHg, 1 mmHg = 0.133 kPa], diastolic blood pressure [(85.80 ± 13.51) vs (83.17 ± 12.19) mmHg], uric acid [(411.79 ± 101.54) vs (379.96 ± 102.18) μmol/L], hemoglobin [(152.86 ± 30.70) vs (143.49 ± 21.15) g/L], pulmonary artery trunk width [(21.76 ± 3.94) vs (20.98 ± 3.34) mm], and ventricular septal thickness [(9.90 ± 1.70) vs (9.47 ± 1.60) mm] in the positive group ( n = 126) were significantly higher than those in the negative group ( n = 462, P < 0.01 or < 0.05). In multivariate logistic regression analysis, increased systolic blood pressure [odds ratio ( OR) = 1.015, 95% confidence interval (95% CI): 1.005 - 1.026], uric acid ( OR = 1.003, 95% CI: 1.001 - 1.005), and pulmonary artery trunk width ( OR = 1.058, 95% CI: 1.001 - 1.118) were risk factors for proteinuria; Tibetans had a decreased risk of proteinuria compared with Han ( OR = 0.505, 95% CI: 0.317 - 0.805), but increased hemoglobin had an increased risk of proteinuria compared with normal hemoglobin ( OR = 1.890, 95% CI: 1.231 - 2.903). Conclusion:In patients with hypertension at high altitude, increased hemoglobin, systolic blood pressure, uric acid, pulmonary artery trunk width, and Han nationality are risk factors for proteinuria.