Age is an important risk factor for osteoporosis.With its high rates of osteoporosis prevalence and fracture incidence,bone fracture results in increment of mortality rate,reduction of function,rising long—term care requirements,drop of life quality and increased medical resource consumption,especially in the advanced elderly.The current article introduces the prevalence and key points of prevention and treatment of osteoporosis and bone fracture in the elderly.

Objective To investigate the association of osteoporosis and coronary artery calcification in elderly patients with type 2 diabetes mellitus (T2DM).Methods A total of 82 elderly T2DM patients underwent dual-energy x-ray absorptiometry scanning (DXA) of lumbar spine and femur neck for getting bone mineral density (BMD),and dual-source computed tomography (DSCT) of coronary artery for calculating calcification score and total calcification score (TCS).All subjects were divided into two groups:osteoporosis group and non-osteoporosis group.The levels of serum calcium (Ca),parathyrin (PTH),phosphorus (P),alkaline phosphatase (AKP),triglyceride (TG),total cholesterol (TC),high density lipoprotein-cholesterol (HDL-C),low density lipoproteincholesterol (LDL-C) and glycosylated hemoglobin (HbA1c) were detected.Results Compared with non-osteoporosis group,the levels of serum Ca,PTH and TCS were higher [(2.32± 0.15)mmol/L vs.(2.04±0.20) mmol/L;(5.64±1.97) pmol/L vs.(5.01±1.93) pmol/L;(374.4±433.5) scores vs.(242.5±224.8) scores,t=5.790,5.331 and 2.248,all P<0.05] in osteoporosis group.Correlation analysis showed TCS was negatively associated with BMD of L2-4 and femur neck,while was positively associated with serum Ca and PTH (r=0.310,0.246,0.290,0.284 and 0.324,0.575 all P<0.05).Conclusions Osteoporosis is associated with coronary atherosclerosis.TCS could be considered as an index for judging the relationship between osteoporosis and coronary atherosclerosis.

Objective To study the changes of heart rate variability (HRV) and the effects of treatment with nasal continuous positive airway pressure (nCPAP) in elderly patients with sleep apnea/ hypopnea syndrome (SAHS). Methods SAHS patients and controls were examined by polysomnography(PSG) and dynamic cardiograph(DCG). Mean RR interval(Mean RRi), standard deviation of RR interval (SDRRi), low frequency(LF), high frequency(HF) and their ratio(LF/HF) were calculated. Results When compared with controls(847.9?113.8)ms vs (45.7?16.2) ms, there was significantly decrease in the Mean RRi and SDRRi in moderate, severe elderly patients and non-elderly SAHS patients(764.3?131.0)ms, (709.4?101.8)ms, (759.5?80.0)ms and (37.5?12.2)ms, (31.5?9.6)ms, (41.4?10.6)ms. There was statistical differences in LF, HF, and LF/HF between elderly and non-elderly severe SAHS (P

Objective To evaluate the predictive value of fracture risk assessment tool (FRAX) for determining fracture probabilities in middle-aged and elderly patients with type 2 diabetes.Methods Retrospective analysis was carried out on 153 type 2 diabetic patients aged over 50 years undergoing dual energy X-ray absorptiometry measurements.Fracture risk factors including age,gender,height,weight,body mass index,history of previous fragility fractures,parental history of hip fracture,history of smoking,excessive drinking,long-term use of steroid hormone,history of rheumatoid arthritis,the history of secondary osteoporosis diseases,and femoral neck T-score of bone mineral density (BMD) were recorded.FRAX scores with BMD (FRAX/BMD) and without BMD (FRAX/-) were calculated.Therapeutic interventions were recommended if the 10-year risk of fractures was more than 3％ for hip osteoporotic fractures and more than 20％ for other major fractures.Subjects were separated into the identical treatment recommendation group and the different treatment recommendation.Fracture risk factors were compared between groups.Results 133 (6.9 ％) patients had identical fracture risk predictions in the FRAX calculation,regardless of whether BMD join in or not.Age,gender and femoral neck T scores had significant differences between the two groups (all P＜0.001),while other risk factors had no statistical differences between the two groups (all P＞0.05).Conclusions In most middle-aged and elderly patients with type 2 diabetes,the FRAX/-provides the same prediction as FRAX/BMD value for predicting fracture risk,which shows that fracture risks can be predicted without bone density examination.The FRAX/-has higher predictive values on fracture for people who are younger,male,and has higher BMD.

OBJECTIVETo determine the percentage of hypercholesterolemic patients who had met the criteria as total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), defined by the Chinese National Recommendations for Prevention and Treatment of Dyslipidemia.

METHODSAdult patients with hypercholesterolemia, who had been receiving the same lipid-lowering therapy for at least 2 months, were enrolled. Lipid levels were determined at the time of enrollment, to assess whether the patients' lipid levels had reached the criteria for treatment. Patients' cardiovascular risk factors and lipid-lowering treatments were also collected.

RESULTSOne hundred and eighty patients with mean age of 65.8 were studied. Of these, 6.7% had no risk factors and no definite disease of atherosclerosis (low-risk group), 65.5% had risk factors but no documented atherosclerosis (high-risk group), and 27.8% had established atherosclerosis diseases or diabetes mellitus. Overall, only 44% of patients achieved both TC and LDL-C target levels. The success rates were higher among low and high-risk groups than that among patients with atherosclerosis or diabetes mellitus. The relationship between four different lipid-lowering drug therapies and successful patient outcome was also investigated. The success rates were 51.8% for simvastatin, 42.9% for pravastatin, 31.6% for fluvastatin, 12.5% for other drugs respectively.

CONCLUSIONMore than half of the hypercholesterolemic patients receiving lipid-lowering therapy had not achieved TC and LDL-C target levels. Data from this study indicated that a significant gap still existed between dyslipidemia prevention principles and clinical practices, suggesting that more aggressive treatment of dyslipidemia is needed.

Aged ; Anticholesteremic Agents ; therapeutic use ; Cholesterol ; blood ; Cholesterol, LDL ; blood ; Female ; Humans ; Hypercholesterolemia ; blood ; drug therapy ; Male ; Middle Aged

Objective To compare the clinical efficacy and safety between recombinant human parathyroid hormone ( rhPTH) ( 1 -34) and elcatonin in the treatment of postmenopausal women with osteoporosis in China.Methods This 6 month, multicenter, randomized and controlled study enrolled 205 postmenopausal women with osteoporosis.They were randomized to receive either rhPTH (1 -34) 20 μg (200 U) daily or elcatonin 20 U weekly.Lumbar spine (L1-4 ) and femoral neck bone mineral density (BMD) and biochemical markers of bone turnover were measured. In the meantime adverse events were recorded. Results The results showed that both rhPTH ( 1 -34) and elcatonin increased L1-4 BMD significantly at the endpoint of the study, but femoral neck BMD did not change significantly.From baseline to endpoint, BMD of L1-4 and femoral neck in the rhPTH( 1-34) group increased by 5.51% (P <0.01) and 0.65% (P >0.05), but BMD of L1-4 and femoral neck in elcatonin group increased by 1.55% (P <0.05) and 0.11% (P>0.05).Moreover, the rhPTH(1-34) group had better improvement in L1-4 BMD than the elcatonin group at 3, 6 months, but there was no difference of BMD in these two groups with regard to femoral neck.There were greater mean increases of the bone markers in the rhPTH( 1-34) group than those in the elcatonin group at 3, 6 months [serum bone-specific alkaline phosphatase ( BSAP) 36.79% vs 0.31% ; 92.42% vs -0.17% ; the ratio of urine N-telopeptide of type I collagen and creatinine (NTX/Cr) 48.91% vs -5.32% ; 68.82% vs - 10.86%].Both kinds of treatment were well tolerated and there were no differences between the two groups in the rates of adverse events and serious adverse events.Conclusion It is concluded that rhPTH (1 -34) has more positive effects on bone formation than elcatonin as shown by the greater increments of L1-4 BMD and bone formation markers and the less occurrence of adverse events as well as no significant change in hepatic, renal or hemopoietic function.

Objective To investigate the clinical application value of predicting the severity of acute pancreatitis(AP)based on MRI-T2WI radiomics nomogram.Methods A total of 375 patients with AP were analyzed retrospectively,who were divided into 281 cases in the training group and 94 cases in the validation group according to the ratio of 3∶1.Based on MRI-T2WI image,man-ual segmentation was performed for the pancreatic parenchyma.The radiomics feature were selected by feature extraction and dimen-sionality reduction,the support vector machine(SVM)classifier were used to construct the radiomics model.Logistic regression analysis was used to screen out independent risk factors,and an radiomics nomogram model was constructed in combined with the Radiomics score(Radscore),and the predictive performances of the models were evaluated.Results Receiver operating characteristic(ROC)curve analysis showed that the predictive efficacy of radiomics nomogram model[training group,area under the curve(AUC)=0.893;val-idation group,AUC=0.889]was higher than that of clinical model(training group,AUC=0.799;validation group,AUC=0.809)and radiomics model(training group,AUC=0.814;validation group,AUC=0.823).Conclusion The radiomics nomogram based on MRI-T2WI radiomics features and independent risk factors has high clinical application value for the prediction of AP severity.