PurposeIt has been reported that women have higher incidence of Modic changes than men and it may be related to the change of female hormone levels during menopause which leads to osteoporosis and other factors. This paper investigated the relationship between vertebral bone mineral density (BMD) of menopausal female suffering from chronic low pain and lumbar vertebral Modic changes on MRI, to explore the effect of vertebral bone mineral density upon Modic changes.Materials and Methods A total of 205 menopausal women with chronic low back pain were enrolled and underwent vertebral bone mineral density measurement and lumbar MRI examination. The bone mass of vertebral body and bone imaging data were observed. All patients were divided into three groups according to their level of bone mass: group of normal bone mass: 128 cases; osteopenia group: 58 cases; osteoporosis group: 19 cases. The incidence rate of Modic changes was compared among the three groups and the relationship between bone mineral density and vertebral Modic changes was further analyzed.Results Among 205 patients, 128 were with normal bone mass, 44 had Modic changes (type I: 19 cases; type II: 22 cases; type III: 3 cases) and the incidence rate was 34.4%; osteopenia occurred in 58 patients, among whom 34 had Modic changes (type I: 15 cases; type II: 17 cases; type III: 2 cases), which showed that the rate was 58.6%; 19 patients presented osteoporosis, 15 of whom appeared Modic changes (type I: 6 cases, type II: 7 cases;type III: 2 cases), with the rate of 78.9%. There was statistically signiifcant difference in incidence rate of Modic changes among the three groups (χ2=18.995,P<0.05). Pearson column connection numberC=0.29<0.40. The osteopenia group and osteoporosis group both had higher incidence rates than the group of normal bone mass (χ2=9.636 and 13.680,P<0.01), and the incidence rate showed no difference between the osteopenia group and osteoporosis group (χ2=2.555,P>0.05).Conclusion Lumbar vertebral bone mineral density is correlated to the incidence of vertebral Modic changes in menopausal women with chronic low back pain. With the loss of vertebral bone mass, the incidence of vertebral Modic changes gradually rise. However, the correlation is rather weak; Modic change is a dynamic process, which is also influenced by other factors except vertebral bone mineral density.

OBJECTIVE： To investigate the mechanism of Drynariae rhizoma in the treatment of osteoporosis （OP）. METHODS： The active compounds and targets of D. rhizoma were obtained by using Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine （BATMAN-TCM database）. The targets of relevant compounds were also obtained by GeneCards database， and targets of D. rhizoma were obtained by the combination of the two. The disease targets corresponding to OP were obtained by using TTD， DrugBank， OMIM， GAD， PharmGKB and CTD database. The D. rhizoma-OP disease intersection targets were obtained after intersecting with the target of D. rhizoma. PPI network was constructed by STRING online database， analyzed by using Cytoscape 3.6.1 software to obtain key targets and showed by network visualization. Gene ontology（GO） analysis of drug-disease intersection target were conducted by DAVID online tools. KEGG pathway enrichment analysis was conducted by KOBAS online tools to screen the significant enrichment pathway （P＜0.05）. The key genes were screened by MCC algorithm. RESULTS： There were 7 active compounds of D. rhizoma 136 intersection targets of D. rhizoma-OP disease. GO analysis results showed that the biological function of intersection target mainly included chemical reaction， steroid metabolic process as well as cellular response to chemical stimulus and so on； cell composition mainly included extracellular space， extracellular area and cytoplasm；molecular functions included heme binding， tetrapyrrole binding and monooxygenase activity， etc. KEGG pathway enrichment showed that above targets were mainly related to bone metabolism， endocrinology， inflammation， tumor， apoptosis， etc. Thirty key genes （such as ALB， AKT1， JUN， etc.， P≤1.96×10－9） were screened by MCC algorithm. CONCLUSIONS： The mechanism of action of D. rhizoma in the treatment of OP is in multi-target and multi-system manner. In addition to influencing the related pathways of bone metabolism， it can also affect various metabolic pathways in vivo.