Osteoporosis is a common disease in the elderly. As studies on its causation and pathogenic mechanism deepened in recent years,there appeared many anti-osteoporotics and many of them had been widely used in clinic. However,none of them was found to be able to completely replace other drugs to achieve satisfactory effect in clinical applications. They all have certain defects. In this paper,three types of drugs including bone resorption inhibitors,bone mineralizers and bone formation accelerators,were analyzed in terms of their mechanisms of action,advances in clinical application as well as their side effects,so as to guide the clinical choice and combination of drugs targeted to avoid serious side effects and to seek for the direction of further study.

BACKGROUND:Mason II type and III type radial head fractures with massive bone are mainly treated by open reduction and metal fixation, but metal implants have to be removed in the second operation, which increased patients’ travail and financial burden. Absorbable screw/rod also can be used to treat radial head fractures, and has its special advantages due to the low price and no second operation. OBJECTIVE:To compare the clinical therapeutic effects of absorbable rod and Herbert screw for the treatment of Mason II or III type radial head fractures. METHODS:A total of 80 patients with Mason II and III type radial head fractures were equal y assigned to experimental and control groups. They received open reduction and internal fixation. The experimental group was treated with absorbable rod and the control group received Herbert screw. RESULTS AND CONCLUSION:A total of 79 patients were fol owed up for averagely 34 months. No significant difference in average operative time, fracture healing time, Broberg and Morrey elbow scores and incidence of complications was detected between the experimental and control groups (P>0.05). However, treatment costs were lower in the experimental group than in the control group (P<0.05). Results indicated that the therapeutic effects between absorbable rod and Herbert screw for Mason II or III type radial head fractures were similar. However, absorbable rod for radial head fractures can avoid the second operation for removal of the implant. Therefore, we recommend absorbable rod in the choice of internal fixation materials.

BACKGROUND:At present, the methods of treating unstable comminuted radial head fractures contain open reduction and internal fixation and metal prosthesis replacement. There were success cases treated by the two methods, but some shortcomings simultaneously existed.
OBJECTIVE:To compare the clinical therapeutic effects of replacement of the radial head with metal prosthesis with open reduction and internal fixation for the treatment of unstable comminuted radial head fractures.
METHODS:A prospective randomized control ed analysis was performed in 45 cases of unstable comminuted radial head fractures. These cases received open reduction and internal fixation and metal prosthesis replacement. This study compared the Broberg and Morrey elbow joint function score and the incidence of complications after fixation, and performed statistical analysis.
RESULTS AND CONCLUSION:The subjects were fol owed up for 1-5 years, averagely 2.8 years. According to Broberg and Morrey scores, the average score was 90.1 and the incidence of complications was 13.6%in the prosthesis replacement group. The average score was 76.8 and the incidence of complications was 47.9%in the open reduction. Significant differences were visible between the two groups (P<0.01). Compared with the open reduction group, prosthesis replacement for unstable comminuted radial head fractures obtained better joint function and lower incidence of complications.

BACKGROUND:Diabetes mel itus can give rise to bone metabolic disorders that may involve long-term hyperglycemia, hypoglycemic agents, diet control, estrogen, insulin-like growth factor, leptin, body mass, sex and age.
OBJECTIVE:To establish type 2 diabetic rat models, and to explore the influence of type 2 diabetes on bone metabolism.
METHODS:High-fat and high-glucose diets combining with 35 mg/kg streptozotocin were used to induce type 2 diabetic model in seven male Sprague-Dawley rats (diabetic group). Thirteen rats in control group were given intraperitoneal injection of the same amount of citric acid and sodium citrate buffer. At 4 weeks after modeling, the bone density of rats was serum detected by dual-energy X-ray, levels of fasting blood-glucose, cholesterol, triacylglycerol, serum calcium, phosphate, alkaline phosphatase, fasting insulin, osteocalcin and C-terminal telopeptide-I were measured, and morphology of bone was observed.
RESULTS AND CONCLUSION:Compared with control group, (1) the rat body mass and fasting blood-glucose kept on an overt rise in the diabetic group (P<0.05);(2) levels of cholesterol, triacylglycerol, fasting insulin and alkaline phosphatase, as wel as insulin resistance index were significantly increased, but insulin sensitivity index was significantly decreased in the diabetic group (P<0.05). (3) There were no significant differences in the levels of serum calcium, phosphate, alkaline phosphatase, osteocalcin and C-terminal telopeptide-I between two groups (P>0.05). (4) In the diabetic group, thinner and sparse bone trabeculae were split presenting more free broken ends;(5) the bone density in lumbar spine, double femoral, pelvic and thoracolumbar spine were al significantly decreased (P<0.05). (6) In conclusion, the type 2 diabetic rat model can be successful y induced by 5-week feeding high-fat and high-glucose diets combining with intraperitoneal injection of 35 mg/kg streptozotocin;these mode rats hold some characters, such as hyperglycemia, dyslipidemia, insulin resistance, diminished bone density, and accelerated bone resorption.

OBJECTIVE： To compare the quality of ceftazidime for injection among the domestic and imported products METHODS： The ceftazidime was observed and determined with respect to the property， color and clarity of the solution， insoluble particle， content of pyridine， polymer of ceftazidime and marked content of ceftazidime RESULTS： There were some differences in above－ mentioned parameters among products of different factories， however， the parameters were within the range of standard CONCLUSION： The quality of domestic products is reliable and comparable to that of imported ones

Objective To investigate and analysis the actuality and demands of scientific researchers in state clinical research facility of TCM, in order to provide evidences for policy making. Methods All the trainees taken part in the meeting for the training of clinical research method were assigned to answer the self-designed questionnaire. Results Of all these people, 47.58 percent people had senior professional title, 84.14 percent people had doctorate or master degree, 57.24 percent people had participated in project research at provincial or ministerial level as key personnel, 35.17 percent people had participated in a key disease research as directors, 65.52 percent people had taken methodology training of clinical research,30.34% of who trained by evidence-based medicine. The majority of these people had clear understanding in methodology of clinical research, who believed that evidence-based medicine and system evaluation are the most difficult subjects to understand and practice, hoping to learn more about the knowledge on statistics. Conclusion Clinical researchers of state clinical research facility of TCM had sound basis for scientific research, but relatively lacking of key disease research and systematic knowledge of scientific methodology, which needed to be enhanced.

From the point of view of ethics review work situation of our country, the existing capacity of our review of ethical problems in development are analyzed, a preliminary summary of the Chinese medicine ethics review ca-pacity development, systematically analyzes the Assessment Human Research Protection System of TCM and Chinese medicine clinical research ethics review platform evaluation work, and to improve the ethical review system to perfect supervision system, improve the medical ethics review standards and guidelines, carrying out the innovation and con-struction of ethical review professional knowledge training, to promote Chinese medicine ethics review certification and accreditation system construction work and Chinese medical ethics review of the clinical research objective, the practice of ethical review management of Chinese medicine are discussed.

Objective:To investigate the expression of fibroblast growth factor 7 (FGF7) and related inflammatory factors in the serum of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods:A case control study was conducted. The patients with AECOPD admitted to the First Affiliated Hospital of Xinjiang Medical University from November 2016 to January 2020 were enrolled. The patients were divided into mild group [forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ratio (FEV1/FVC) < 0.70, FEV1 percentage in predicted value (FEV1%) ≥ 80%], moderate group (FEV1/FVC < 0.70, 50% ≤ FEV1% < 80%), and severe group (FEV1/FVC < 0.70, 30% ≤ FEV1% < 50%) based on their lung function test results, with 20 patients in each group, and 20 patients with normal pulmonary function who underwent elective non-thoracic surgery such as gastrointestinal surgery and orthopedics surgery in the same period were selected as controls. The demographic data, FEV1/FVC, FEV1%, FVC, maximum mid-expiratory flow percentage in predicted value (MMEF%), 6-minute walking test (6MWT), and St George Respiratory Questionnaire (SGRQ) score were recorded respectively. Serum levels of FGF7, interleukins (IL-6, IL-1β) and tumor necrosis factor-α (TNF-α) were determined by enzyme linked immunosorbent assay (ELISA). Pearson correlation was used to analyze the correlation between TNF-α and lung function.Results:Compared with the normal pulmonary function group, the levels of FEV1/FVC, FEV1%, MMEF% and 6MWT in the mild, moderate and severe groups were significantly decreased, and the SGRQ scores were increased, the indicators continued to deteriorate with the aggravation of the disease, the statistical differences were found between severe group and normal pulmonary function group [FEV1/FVC: 0.39±0.09 vs. 0.81±0.04, FEV1%: (38.80±6.28)% vs. (109.58±13.80)%, MMEF%: (0.34±0.14)% vs. (2.69±0.99)%, 6MWT (m): 279.00±41.61 vs. 402.85±53.97, SGRQ scores: 34.95±6.71 vs. 2.60±2.06, all P < 0.05]. Compared with the normal pulmonary function group, the levels of FGF7 in the mild, moderate and severe groups were significantly lowered (ng/L: 6.31±2.65, 6.10±1.39, 6.64±1.77 vs. 8.29±3.51, all P < 0.05), but no significant difference was found among the mild, moderate and severe groups (all P > 0.05). Compared with the normal pulmonary function group, IL-6 and TNF-α levels were significantly increased in the mild, moderate and severe groups, and TNF-α increased with the aggravation of the disease, the statistical difference was found between severe group and normal pulmonary function group (ng/L: 7.42±2.28 vs. 3.83±0.92, P < 0.05). There was no significant difference in IL-1β level between the normal pulmonary function group and the mild, moderate, severe groups. Correlation analysis showed that TNF-α was negatively correlated with FEV1/FVC and FEV1% ( r values were -0.350 and -0.527, respectively, both P < 0.01). Conclusion:In AECOPD patients, serum FGF7 was decreased, while IL-6 and TNF-α were increased; however, with the aggravation of the disease, there was no significant change in the level of FGF7 in the peripheral blood, but the TNF-α level might be increased, accompanied by severe damage of small airway function.

BACKGROUND:The therapeutic regimen of intraarticular calcaneal comminuted fractures commonly selects plate and screw fixation. However, for case of posterosuperior calcaneal fracture, the weakness of achil es tendon stretch and plate screw fixation results in difficulty or maintenance of reduction. OBJECTIVE:To investigate the therapeutic effects of open reduction and internal fixation with steel screw and Steinmann pins for comminuted calcaneal intra-articular and posterosuperior fractures. METHODS:From December 2009 to December 2013, forty patients with fractures of comminuted calcaneal posterosuperior fractures were randomly divided into two groups. In the control group, patients were treated by open reduction and internal fixation by plate screw only. In the experimental group, patients were treated by open reduction and internal fixation by combination of plate screw and Steinmann pin. The Gissane and Bohler angles of the calcaneus were measured from lateral radiograph before and 4 weeks after surgery, and the MARYLAND score was assessed at the last fol ow-up. Gissane and Bohler angle and MARYLAND score were compared in each group and among different groups. RESULTS AND CONCLUSION:Al patients were fol owed up for 9-23 months. BOHLER and GISSANE angles were significantly bigger at 4 weeks after surgery compared with pre-treatment in both groups (P<0.05). BOHLER and GISSANE angles were significantly bigger in the experimental group than in the control group at 4 weeks after surgery (P<0.05). During final fol ow-up, the average score by MARYLAND Foot Score was 78 in the experimental group and 67 in control group, with their excellent and good rate of 80%and 73%. The excellent and good rate was significantly higher in the experimental group than in the control group (P<0.05). These data indicated that open reduction and internal fixation with combination of plate screw and Steinmann pin has better efficacy in treatment of the comminuted calcaneal intra-articular and posterosuperior fractures compared with plate and screw fixation alone. Their fixation is firm. Functional exercise can be performed earlier. Postoperative recovery of function of the affected limbs is better than plate and screw fixation alone.

OBJECTIVE: To investigate the effects of serum from the obesity patients and obesity patients with Diabetic mellitus on toll-like receptor 4/Nuclear factor -κB p65 (TLR/NF-κB) pathway in human THP-1 monocytes and to explore the inflammatory immune response in obesity. METHODS: Peripheral serum was isolated from healthy volunteers (the control group), the obesity patients (Ob group) and the obesity patients with diabetic mellitus (the Ob with DM group), respectively, 20 in each group. THP-1 monocytes were incubated with the serum for 48 h. The monocytes and culture supernatant were collected. The phosphorylation level of NF-κB p65 protein in THP-1 monocytes was evaluated by Western blot as well as immunofluorescence assay. The TLR4 mRNA expression was evaluated by RT-PCR. ELISA was used to measure the monocyte chemotactic protein-1 (MCP-1) levels in the culture supernatant. RESULTS: In the presence of serum, the obesity group and the obesity with diabetic mellitus group showed the up-regulated phosphorylation level of NF-κB p65 protein and TLR4 mRNA expression in THP-1 monocytes compared with the healthy control group (both P<0.05), and the MCP-1 levels in the obesity patients were up-regulated significantly compared with the healthy control group [healthy control group (26.4 ± 3.9) pg/mL, Ob group (45.8 ± 10.0) pg/mL, Ob with DM group (58.0 ± 15.3) pg/mL; P<0.05]. These parameters were further up-regulated in the obesity patients with diabetic mellitus patients. CONCLUSION The serum from the obesity patients or the obesity patients with diabetes can induce monocyte dysfunction, which might be related to the activation of TLR4/NF-κB signaling pathway.
Cell Line ; Chemokine CCL2 ; Diabetes Mellitus ; blood ; Humans ; Monocytes ; cytology ; metabolism ; Obesity ; blood ; Phosphorylation ; Serum ; Signal Transduction ; Toll-Like Receptor 4 ; metabolism ; Transcription Factor RelA ; metabolism ; Up-Regulation