Objective To compare the clinical effect of PMMA bone cement augmented screw passageway and bone cement-injectable cannulated pedicle screw in treatment of degenerative lumbar disease with osteoporosis. Methods Forty-eight patients with lumbar degenerative disease accompanied with osteoporosis from June 2012 to March 2014 were selected, including 21 males and 27 females with an average age of 64.5 years ( ranged 54 -78 years).There were 17 cases of lumbar degenerative stenosis,18 cases of lumbar intervertebral disc herniation, 8 cases of lumbar degenerative spondylolisthesis,and 5 cases of lumbar degenerative scoliosis.According to the opera-tion method,the patients were divided into two groups.23 cases in group A were treated with bone cement injectable cannulated pedicle screw and 25 cases in group B were treated with PMMA bone cement augmented screw passageway by used conventional screw.Operation time, amount of bleeding and hospitalization time were used to evaluate the clinical characteristics.Visual analogue scale( VAS) score and Oswestry disability index( ODI) were used to evaluate function recovery of post-operative pain and function.The height of intervertebral space,failure rate of internal fixa-tion and bone fusion rate were analyzed by X-ray films postoperative1,3,6,12 months and per year.Results All 48 cases were followed up for 1 -3.5 years.Operation time,amount of bleeding and the time of hospitalization of group A were significantly lower than those in group B(all P<0.05).The fusion rates of group A and group B were 94.6%and 90.2%,respectively.There was no significant difference between the two groups(P>0.05).One case of group A had screw fracture,but group B did not appear this kind of situation(P<0.05).Three cases of group B had screw loosening or pullout,but that did not happen in group A.The loss of intervertebral height was (2.7 ±1.7) mm in group A,which in group B was (3.7 ±2.1) mm,there was significant difference between the two groups( P<0.05).According to VAS score and ODI,pain and function in both two groups were improved,but the effect of group A was better than group B(all P<0.05).Conclusion Bone cement-augmentation bone cementinje-ctable cannu-lated pedicle screw may be a safe and effective method in treatment of degenerative lumbar disease with osteoporosis.

Objective To investigate the correlation between vitamin D receptor gene and bone mass and obesity phenotypes in patients with type 2 diabetes mellitus.Methods 318 patients with type 2 diabetes were chosen as diabetes group,and 50 healthy people were selected as healthy control group.Vitamin D receptor gene Apa Ⅰ type was detected in the two groups.Height,weight and body mass index(BMI)biochemical index,fat content(FM),lean tissue content(LM)and bone mineral density were detected in patients with type 2 diabetes mellitus.The relationship between vitamin D receptor gene(Apa Ⅰ)polymorphism and BMD and obesity phenotypes in type 2 diabetes was analyzed.Results The VDR gene distribution between the diabetes group and healthy control group showed no signif-icant difference(Z =0.561,P >0.05).The vitamin D receptor genotype in the diabetes group included AA 31 cases (9.7%),Aa type 108 cases(34.0%),aa type 179 cases(56.3%),while the vitamin D receptor genotype in the healthy control group comprised AA 7 cases(9.3%),Aa type 29 cases(38.7%),aa type 39 cases(52.0%).The percentage of AA in both groups was significantly less than that of Aa and aa(χ2 diabetic group =4.127,3.976,all P <0.05;χ2 healthy control group =5.129,4.213,all P <0.05).Proportion of normal bone mass and average bone density in AA,Aa,aa type decreased(χ2 =15.552,P <0.05;F =5.127,P <0.05),the genotype AA was not detec-ted in osteoporosis group.BMI and FM were the highest in AA,which were significantly higher than those of Aa,aa (F =4.319,4.263,all P <0.05).Conclusion Vitamin D receptor gene Apa Ⅰ type polymorphism is related with BMD and obesity in type 2 diabetes mellitus,and it has predictive value on bone mass changes.The increase of BMI and FMmay be beneficial to bone mineral density.