1.Serum 25-hydroxyvitamin D levels in elderly patients with hip and vertebral compression fracture
Shaohui SHI ; Wei PAN ; Guoping WU ; Dongjian LU ; Maoting LI ; Sanli CAO ; Yuqing ZHEN
Chinese Journal of General Practitioners 2020;19(3):233-237
Objective:To investigate the serum 25-hydroxyvitamin D [25(OH) D] levels in elderly patients with hip and vertebral compression fractures (VCF).Method:Ninety patients (58 males and 32 females) aged over 60 years with hip fracture and 120 patients (88 males and 32 females) aged over 60 years with VCF admitted in the Aviation General Hospital from January 2017 to June 2019 were enrolled. Serum 25(OH)D levels were measured.Results:Serum level of 25 (OH) D in hip fracture patients was (9.0±6.8) μg/L, the 25 (OH) D level was lower than the normal value(<19.0 μg/L)in 79 patients and<3 μg/L in 24 patients. The level of 25(OH)D in VCF patients was (16.7±10.6) μg/L, the 25 (OH) D level was<19.0 μg/L in 78 patients (65.0%) and <3 μg/L in 10 patients (8.3%). The low level of 25(OH)D was negatively correlated with age in two groups ( r=-0.367, P=0.01; r=-0.313, P=0.04). The mean level of 25 (OH) D in the hip fracture group was lower than that in the VCF group ( t=5.960, P<0.01), and the low 25(OH)D rate in the former group was significantly higher than that in the latter group (χ 2=14.14, P<0.01; χ 2=12.74, P<0.01). The 25(OH)D value of female VCF patients was (14.5±8.8) μg/L, which was significantly lower than that of male patients (22.5±12.9) μg/L ( t=3.882, P<0.01).Among hip fracture patients, the 25(OH)D level in patients with fracture history was (8.3±6.9) μg/L, which was significantly lower than that of patients without fracture history (10.8±6.9) μg/L, and the difference was statistically significamt ( t=2.123, P=0.04). The serum osteocalcin level was (20.5±19.8) μg/L in patients with fracture history, which was significantly higher than that in patients without fracture history [(10.6±5.4) μg/L, t=3.245, P<0.01]. Conclusion:Elderly patients with new hip fractures have more severely low vitamin D level than patients with new VCF, and patients with previous fracture history have lower vitamin D levels than patients without fracture history.
2.The Influence of Sex in Stroke Thrombolysis: A Systematic Review and Meta-Analysis.
Mingsu LIU ; Guangqin LI ; Jie TANG ; Yan LIAO ; Lin LI ; Yang ZHENG ; Tongli GUO ; Xin KANG ; Maoting YUAN
Journal of Clinical Neurology 2018;14(2):141-152
BACKGROUND AND PURPOSE: There is increasing recognition of the importance of stroke in females to both clinical and public health. The natural course of stroke is worse in females than in males, but the evidence regarding sex disparities in the responses to thrombolysis in stroke patents is still controversial. We compared outcomes after thrombolysis treatment between females and males. METHODS: Clinical trials reported in the Embase, PubMed, and Cochrane Library electronic databases up to March 13, 2017 were included in this analysis. Two reviewers independently extracted the data and conducted quality assessments. Statistical tests were performed to check for heterogeneity and publication bias. Sensitivity analysis was also performed to evaluate the stability of the conclusions. RESULTS: Sixteen reports involving 60,159 patients were available for analysis. The female patients were a 0.89-fold [95% confidence interval (CI)=0.87–0.90, p < 0.001], 0.89-fold (95% CI=0.87–0.91, p < 0.001), and 1.24-fold (95% CI=1.11–1.36, p < 0.001) more likely to obtain good, excellent, and poor functional outcomes, respectively, with no significant difference in the complications of symptomatic intracranial hemorrhage among the sexes [risk ratios (RR)=0.99, 95% CI=0.92–1.07, p=0.81] after thrombolysis treatment. In addition, the prevalence of a good functional outcome did not differ significantly between females and males in the intra-arterial thrombolysis (IAT) group (RR=1.05, 95% CI=0.85–1.29, p=0.67) in a subgroup analysis. CONCLUSIONS: This study has demonstrated that females often exhibit a worse outcome than males after intravenous thrombolysis (IVT), whereas no relevant sex differences were found in outcome or recanalization after IAT, with safety regarding hemorrhage complications from thrombolysis being the same for the sexes. However, IVT should not be withheld from female stroke patients solely based on their sex before the findings are confirmed in further large-scale research.
Female
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Hemorrhage
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Humans
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Intracranial Hemorrhages
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Male
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Population Characteristics
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Prevalence
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Public Health
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Publication Bias
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Sex Characteristics
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Stroke*