Osteoporotic spinal fractures is a serious orthopedic chronic disease in the healthy elder people .Because of the complexity of its pathogenesis , there has no standard treatment scheme .In order to solve this problem , we review the mechanism of the disease etiology, imaging, treatment, prevention of osteoporotic spinal fractures to provide references for the further prevention and con -trol of this disease .

Objective · To investigate the clinical effects of photo-activated disinfection (PAD)-assisted non-surgical therapy on the treatment of chronic periodontitis. Methods · Eleven patients with chronic periodontitis (totally 118 selected sites) were randomly enrolled. A split-mouth self-control method was adopted. Selected sites with the probing depth (PD) of bilateral homonymous teeth ≥ 5 mm were randomly assigned to the group A (receiving scaling and root planning, SRP) and the group B (receiving SRP+ PAD). Periodontal clinical indexes, inflammation indexes, and periodontal pathogens at selected sites were examined at baseline and 6 and 12 weeks after treatment. Results · Both SRP alone and SRP+PAD improved the periodontal inflammation significantly. The positive rate of bleeding on probing (BOP) 12 weeks after treatment was remarkably lower in the group B than in the group A (37.3% vs 57.6%, P=0.042). Both SRP and SRP+PAD effectively decreased matrix metalloproteinase-8 (MMP-8) and interleukin-1β (IL-1β) levels in gingival crevicular fluid. The IL-1β levels 6 and 12 weeks after treatment were significantly lower in the group B than in the group A [(17.99±14.26) pg/mL vs (32.64±30.69) pg/mL, P=0.007; (11.37±10.25) pg/mL vs (23.85±15.55) pg/mL, P=0.000]. Both treatments decreased the ratio of P. gingivalis and F.nucleatum in total bacteria. Conclusion · PAD can serve as a potential adjunctive therapy to conventional SRP in the treatment of chronic periodontitis with better improvement of bleeding gums and control of periodontal inflammation.

Objective · To observe short and medium term survival of implants in patients with chronic periodontitis after implantation. Methods · 54 patients with chronic periodontitis (133 implants) were enrolled from August 2011 to August 2013. The survival of implants was observed and the periimplant diseases were compared and analyzed between patients with different degrees of chronic periodontitis. Results · The 3-year survival rate of implants was 97.74%. The differences between patients with different degrees of chronic periodontitis were not statistically significant (P=0.452). Periodontal pocket depth (PPD) and modified plaque index (mPLI) were significantly higher in patients with severe chronic periodontitis than in patients with mild and moderate chronic periodontitis. For patients not receiving supportive periodontal therapy (SPT), the peri-implantitis rate in patients with severe chronic periodontitis was significantly higher than that in patients with mild and moderate chronic periodontitis (P=0.009). For smokers, the periimplantitis rate in patients with severe chronic periodontitis was significantly higher than that in patients with mild and moderate chronic periodontitis (P=0.016). Conclusion · For patients with chronic periodontitis, the theraputic effect of implant treatment is good. Plaque control, SPT, and smoking cessation can reduce the incidence of peri-implantitis.

[Objective] To observe the effect of extract of Carapax et Plastrum Testudinis (ECPT) on nuclear receptor in the proliferation of rat mesenchymal stem cell (MSC) in vitro. [Methods] The rat MSC dissociated from bone marrow by density gradient method were cultured and identified by marking of bromodeoxyuridine (Brdu) and staining of CD44. Then different doses of ECPT (3333, 333.3 and 33.33 ?g/mL) were respectively added into in-vitro cultured MSC for 12, 24, 72 and 120 hours. The expression of retinoic acid receptor-?(RAR?), vitamin D receptor (VDR), estrogen receptor (ER), glucocorticoid receptor (GR), thyroid hormone receptor-?(TR?) and peroxisome proliferator-activated receptor ?(PPAR?) in MSC was detected by immunohistochemistry and immunofluorescence methods. [Results] The number of RAR?-and VDR-positive cells in ECPT groups was higher than that in the control group (P

Objective To observe the clinical effects of Huoxue Dingxuan Capsules on treatment of vertebral artery type of cervical spondylosis, and evaluate its efficacy and safety. Methods Totally 130 cases of vertebral artery type of cervical spondylosis were randomly assigned to treatment group and control group, and treated with Huoxue Dingxuan Capsules and Sibelium capsules respectively. Integration method was used to compare the differences of main symptoms and signs, the overall efficacy and safety were evaluated, and relapse after six months was followed up. Results Both groups had a significant effect on the improvement of signs and symptoms in vertebral artery type of cervical spondylosis, the total efficiency was 94.03%(63/67) in treatment group and 82.54% (52/63) in control group. The treatment group had a better effect on the overall efficacy and relieving symptoms and signs compared with the control group (P<0.01). The mean blood flow velocity had a significant change after treatment (P<0.05), and the treatment group was better than the control group (P<0.01). Within six months, the treatment group had 4 cases (6.34%) with mild recurrence of symptoms and signs, and the control group had 18 cases (34.61%), the difference between the two groups was statistically significant (P<0.05), and no severe recurrence was found. The two groups showed no side effects. Conclusion Huoxue Dingxuan Capsules is safe and effective for treating vertebral artery type of cervical spondylosis, and the long-term efficacy and subjects’ compliance are better than oral Sibelium capsules.

Objective To investigate the effects of age and gender on anti-oxidative,antiinflammatory and anti-apoptosis functions of high-density lipoprotein (HDL).Methods Totally 120 healthy subjects aged from 20 to 60 years were randomly divided into young and middle-aged male (n=60) group and female (n =60) group,and the 120 healthy elderly aged from 60 to 78 years divided into elderly male (n =60) and elderly female (n =60) groups.Serum levels of high-and low-density lipoprotein cholesterol (HDL-C,LDL-C),total cholesterol (TC),and triacylglycerol (TG) were detected.Content of malonaldehyde (MDA) was detected to determine anti-oxidative function of HDL.Adhesion assay of endothelial cells and monocytes (THP1) was adopted to test the protective effects of HDL on endothelial cells.The expressions of endothelial cell adhesion molecules,VCAM-1 and ICAM-1,were analyzed by Western blot.MTT and flow cytometry assays were used to detect the viability and apoptosis of the cells to test anti-apoptosis function of HDL.Results The levels of low-density lipoprotein,triglycerides and total cholesterol were higher in elder female group than in other three groups (all P＜0.05).The level of HDL-C was higher in young and middle-aged females than in other three groups(all P＜0.05).The level of MDA was higher in elder female group than in other three groups(all P＜0.05).The level of MDA was higher in elder male group than in the young and middle-aged male and female groups(all P＜0.05).After protection of HDL,the number of monocytes adhesion and expression levels of VCAM-1 and ICAM-1 were higher in elder groups than in young and middle-aged male and female groups(all P＜ 0.05).Relative survival and viability rates of endothelial cells were higher in young and middle-aged groups than in elder groups (all P＜0.05).Conclusions Ageing in both male and female induces impairments of anti-oxidative,anti-inflammatory and anti-apoptosis functions of HDL,with more evident decrease in anti-oxidative function in females.

Objective To evaluate the effect of continuous passive motion (CPM) as an adjunct to active physiotherapy on pain and range of motion (ROM) after knee arthroplasty. Methods 20 female osteoarthritis patients (40 knees) undergoing bilateral knee arthroplasty were assigned into two groups. The experimental group received CPM and active physiotherapy twice a day while the control group received active physiotherapy only. They were assessed with visual analogue scale (VAS) and goniometer on pain and ROM of knee before and after operation. Results There were no statistical difference between these two groups for any outcome measures either 2 weeks or 3 months after operation (P>0.05), and they all improved in pain and ROM 3 months after operation compared with before (P<0.01). Conclusion CPM as an adjunctive therapy is not found to have an additional effect on pain or ROM 3 months after operation while active physiotherapy was used.

[ABSTRACT]AIM:Toinvestigatetheinteractionandthemechanismofsphingosine-1-phosphate(S1P)and phospholipid transfer protein (PLTP) in lipoprotein.METHODS:The S1P content in the plasma and lipoprotein from 10-week-old PLTP transgenic (PLTP-Tg) mice and wild-type (WT) mice (n=8 each) was assayed.The transport of S1P by PLTP was determined by S1P transfer assay.The content of specific S1P carrier, apolipoprotein M, was detected by West-ern blotting.RESULTS:Plasma S1P contents were decreased by 21.1%in PLTP-Tg mice compared with WT mice.S1P content in high-density lipoprotein ( HDL) fraction ( HDL-S1P) from PLTP-Tg mice was decreased by 35.1% compared with WT mice, whereas the S1P in low-density lipoprotein (LDL) fraction (LDL-S1P) was increased by 127.4%.The re-sults of S1P transfer assay indicated that PLTP facilitated S 1P transport from erythrocyte to recombinant liposome at 37℃in D-Hanks buffer solution .The plasma content of apolipoprotein M was not changed in PLTP-Tg mice compared with WT mice.CONCLUSION:PLTP is a key factor to maintain plasma HDL-S1P under physical condition .Overexpression of PLTP decreases the HDL-S1P but increases LDL-S1P.The mechanism might be related to the capability of PLTP on trans-ferring S1P from erythrocyte to lipoprotein.

Objective:To assess the value of amide proton transfer weighted (APTw) imaging in the evaluation of pH changes in infarct core (IC) and ischemic penumbra (IP) in subacute cerebral infarction.Methods:The data of twenty-three subacute cerebral infarction patients with unilateral steno-occlusive disease of the middle cerebral artery (subacute infarction group) from April to November 2019 in the First Affiliated Hospital of Dalian Medical University were prospectively analyzed. Fifteen healthy volunteers were enrolled in this study as the control group. All subjects underwent conventional MRI, DWI, 3D-pseudo continuous arterial spin labeling (3D-pCASL) and APTw sequences. Based on DWI images, relative cerebral blood flow (rCBF) and APTw images to determine the region of IC, blood flow penumbra [cerebral blood flow(CBF)-DWI mismatch area, IP CBF] and metabolic penumbra (APTw-DWI mismatched area, IP APT). 3D ROIs were used to semi-automatically measure the APTw signals and the volume of IC and IP CBF of the patients in subacute infarction group. The comparison of APTw signals between the infarct side and the contralateral side in the subacute infarction group, the comparison of bilateral APTw signals in the control group, and the comparison of APTw signals in the IC and IP CBF regions were performed by paired-sample t test or Wilcoxon signed-rank test. The paired-sample t test or Mann-Whitney U test was used to compare the APTw signals between the two groups. The Friedman test was applied to compare the difference of volumes among IP CBF1.5, IP CBF2.5 and IP APT . Results:There was no significant difference of the APTw signals among the IC, the contralateral side in the subacute infarction group and the control group ( P>0.05). The APTw signals of IP CBF and IC of the infarction group were statistically different ( P<0.05). Compared with the contralateral side of IP CBF1.5 (3.7±1.7, -1.84±1.48, 5.57±2.75), the APTwmax (3.07±1.41, t=-3.012, P=0.006), APTw min [-1.30 (-1.74, -0.57), Z=-2.099, P=0.036], and APTwmax-min(4.51±2.58, t=-3.273, P=0.003) signals in the IP CBF1.5 were decreased ( P<0.05). Compared with the contralateral side of IP CBF2.5 [-1.53 (-2.80, -0.91), 5.31±2.61], the APTw min [-1.08 (-1.60, -0.49), Z=-2.616, P=0.009] and APTwmax-min (4.41±2.72, t=-3.228, P=0.004) signals in the IP CBF2.5 were decreased. The volumes of IP CBF1.5 [107.51(50.08, 138.61)mm 3], IP APT [99.00 (53.27, 121.335) mm 3] and IP CBF2.5 [89.91 (51.53, 139.87) mm 3] were successively reduced (χ2=7.913, P=0.019), and the volume of IP CBF2.5 was significantly smaller than that of IP CBF1.5 ( P=0.037). Conclusion:The acid-base metabolism in the IC of subacute cerebral infarction is not obvious, but the blood flow penumbra has local acid-base metabolism imbalance, and the range of metabolic penumbra coincides with the blood flow penumbra.

Objective To observe the value of nomogram model based on clinical and ultrasonic characteristics for diagnosing lymphoma.Methods Data of 176 patients with suspected lymphoma due to enlarged superficial lymph nodes were retrospective analyzed.The patients were divided into lymphoma group(n=90,invasive subgroup[n=40]and non-invasive subgroup[n=50])or non-lymphoma group(n=86)based on pathological results.Clinical and ultrasonic data were compared between groups and subgroups.Multivariate logistic regression was used to screen the independent risk factors of lymphoma,and then a nomogram was constructed.Receiver operating characteristic curves were drawn to evaluate the efficacy of conventional ultrasound,conventional contrast-enhanced ultrasound(C-CEUS),high-frame-rate contrast-enhanced ultrasound(H-CEUS)and nomogram for diagnosing lymphoma.Results Multivariate logistic regression analysis revealed that age＞59 years,cortical stripe/reticular hyperecho of lymph nodes and"centrifugal firework"enhancement pattern showed with H-CEUS were all independent risk factors of lymphoma(all P＜0.05).Taken 59 years as the best cut-off value of patients'age,the sensitivity,specificity,accuracy and the area under the curve(AUC)for diagnosing lymphoma was 67.78%,58.10%,63.06%and 0.630,respectively.The sensitivity,specificity,accuracy and AUC of cortical stripe/reticular hyperecho of lymph nodes for diagnosing lymphoma was 73.33%,58.10%,65.91%and 0.657,respectively,while of"centrifugal firework"pattern enhancement in H-CEUS was 77.78%,69.80%,73.86%and 0.738,respectively.AUC of conventional ultrasound,C-CEUS,H-CEUS and nomogram for diagnosing lymphoma was 0.657,0.540,0.738 and 0.844,respectively.Conclusion Nomogram model based on clinical and ultrasonic characteristics had good diagnostic efficacy for lymphoma,and"centrifugal firework"pattern enhancement in H-CEUS could be regarded as the specific characteristic of lymphoma.