Objective To investigate the diversity of gut microbiota in osteoporosis(OP)patients with various traditional Chinese medicine(TCM)syndrome types in the Lingnan region.Methods The analysis was carried out in 13 OP patients with blood stasis and qi stagnation syndrome(Group 1)and 13 OP patients with liver-kidney deficiency syndrome(Group 2)who were treated at Guangzhou Hospital of Chinese Medicine,the Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2023 to December 2023.Fecal samples of both groups were collected,and baseline comparisons between the two groups were performed before testing.After DNA extraction,valid sequencing data were processed by operational taxonomic unit(OTU)clustering,species annotation,and microbial community composition analysis.Alpha and Beta diversity indices were employed to assess species diversity,and LEfSe was used to identify key microbial taxa.Results No significant differences in baseline characteristics such as gender and age were presented between the two groups(P＞0.05).Microbial community composition analysis revealed no significant differences in the top 15 abundant taxa at various taxonomic levels between the two groups,but structural variations were noted.Alpha diversity analysis showed that the Simpson index in Group 1 differed from that in Group 2(P＜0.05),while chao 1,ACE,richness,and coverage indices exhibited no significant differences between the two groups(P＞0.05).In Beta diversity analysis,multi-response permutation analysis(MRPP)indicated no significant intergroup differences in community structure(P＞0.05),whereas principal coordinate analysis(PCoA)suggested distinct differences in the distribution of species composition.LEfSe identified 14 taxa(e.g.,Lachnospiraceae and Lachnospirales)with significantly higher abundance and 5 taxa(e.g.,Anaeromassilibacillus and Desulfovibrio)with significantly lower abundance in Group 1.Conclusion OP patients with various TCM syndrome types in the Lingnan region exhibit distinct gut microbiota diversity and dominant microbial taxa,which will provide an objective basis for TCM syndrome differentiation of OP.

BACKGROUND:Osteoporosis is often accompanied by sarcopenia and an increased risk of fractures from falls.Recent studies have indicated a close relationship between lipid metabolism and sarcopenia.Abnormal lipid metabolism may directly impact muscle physiological function and metabolism. OBJECTIVE:To investigate the relationship between lipid metabolism and sarcopenia and evaluate their causal relationship using Mendelian randomization. METHODS:Mendelian randomization was used to explore the causal relationship between low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,triglycerides,and muscle mass.Research data from genome-wide association studies were used and a sensitivity analysis was conducted to verify the reliability of the results.Approximate indicators of muscle mass,including trunk lean mass and appendicular lean mass,were used as outcome measures. RESULTS AND CONCLUSION:The study found a negative correlation of low-density lipoprotein cholesterol and triglycerides with muscle mass,while no correlation was observed between high-density lipoprotein cholesterol and muscle mass.The results of the sensitivity analysis indicated a robust causal relationship.Using Mendelian randomization,this study provides evidence of a causal relationship between low-density lipoprotein cholesterol and triglycerides and muscle mass.This finding deepens our understanding of the effects of lipids on sarcopenia and has important clinical implications for the prevention and treatment of sarcopenia and osteoporosis.

Objective To explore the effect of improved surgical method of intramedullary fibular allograft together with cannulated screw fixation combined with blood-activating and stasis-resolving Chinese medicine on the quality of life (QOL) of young and middle-aged fresh femoral neck fractures at intermediate stage. Methods A retrospective analysis was carried out in the articular orthopedics department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine. The study involved 80 cases of young and middle-aged fresh femoral neck fractures receiving intramedullary fibular allograft together with cannulated screw fixation, and 50 qualified cases receiving cannulated screw fixation alone ( control group) . After the operation, all of the patients were given oral use of blood-activating and stasis-resolving Chinese medicine. After the last follow-up, Harris hip scoring, SF-36 scoring and radiographic evaluation were performed for the evaluation of clinical efficacy. Results The clinical application of intramedullary fibular allograft together with cannulated screw fixation combined with Chinese medicine was fulfilled in 80 hips of 80 cases. The follow-up period ranged from 48 to 84 months, averaging 62.68 ± 12.43 months. The improved surgical method group had an excellent and good rate of 93.75%, presented excellent-grade Harris scores and SF-36 scores, and had higher QOL scores than the control group (P<0.05) . After treatment, the two groups had statistically significant differences in the scores of SF-36 items of physical function ( PF) , bodily pain ( BP) , mental health ( MH) , vitality ( VT) , and general health ( GH) ( P<0.05 or P<0.01) , and also had significant differences in Harris scoring of pain, function and daily activities as well as the joint range-of-motion ( P<0.05 or P<0.01) . Conclusion The improved surgical method of intramedullary fibular allograft together with cannulated screw fixation combined with blood-activating and stasis-resolving Chinese medicine shows satisfactory therapeutic effect for young and middle-aged fresh femoral neck fractures at intermediate stages, which has the advantages of lower collapse rate after femoral head necrosis, less joint replacement, higher scores of the quality of life and Harris scoring, and better radiographic indicators than cannulated screw fixation alone.