Objective:To explore the influencing factors of olfactory impairment in patients with obstructive sleep apnea（OSA） and establish a nomogram prediction model. Methods:A total of 100 OSA patients were enrolled. Snap&Sniff olfactory test was used to evaluate the olfactory identification function and olfactory threshold of the patients. According to the scoring criteria, either olfactory identification scores below 14 points or olfactory threshold scores below 3 points was defined as olfactory impairment. Multivariate logistic regression analysis was used to explore the influencing factors of olfactory impairment in OSA. The nomogram model was constructed by using the R 4.4.2 software package. ROC curve, calibration curve and decision curve were used to evaluate the predictive efficacy, consistency and clinical utility of the model. Results:A total of 55 of 100 OSA patients had olfactory impairment. The results of multivariate logistic regression analysis showed that age, ESS score, MoCA score, and apnea-hypopnea index（AHI） were the influencing factors of olfactory impairment in OSA. Based on the above parameters, a nomogram model was established. The ROC curve analysis showed that the AUC was 0.897（95%CI 0.834-0.961）, indicating that the model had good predictive ability. The calibration curve showed that the predicted probability of the model fits the actual probability well. Decision curve analysis showed that when the threshold probability was in the range of 0-0.9, the model had a high clinical net benefit rate. Conclusion:Age, ESS score, MoCA score and AHI are the influencing factors of olfactory impairment in patients with OSA. The nomogram model constructed based on the above factors has good predictive value, which is conducive to the clinical multi-angle understanding of OSA and the formulation of scientific prevention and treatment measures.
Humans ; Sleep Apnea, Obstructive/physiopathology* ; Nomograms ; Olfaction Disorders/etiology* ; Logistic Models ; Middle Aged ; Male ; Female ; ROC Curve ; Adult ; Aged

ObjectiveTo systematically evaluate the distribution of traditional Chinese medicine（TCM） syndromes of primary osteoporosis（POP） in China by using evidence-based medicine methods， and to understand the distribution law of the syndromes. MethodChina National Knowledge Infrastructure（CNKI）， VIP Chinese Science and Technology Journal Database（VIP）， WanFang Data Knowledge Service Platform（WanFang） and China Biology Medicine（CBM） were searched to obtain representative literature， and each database was searched from the 1994 World Health Organization defined diagnostic criteria for osteoporosis until May 1， 2023. Two researchers independently screened literature according to the criteria， extracted data， and cross-checked them. Meta analysis was conducted using R4.1.3， and subgroup analysis was performed. ResultA total of 56 Chinese papers were included， involving 14 415 patients. After standardized classification of syndromes， 11 articles were excluded， and Meta analysis results of the ultimately included 45 Chinese articles showed that the distribution frequencies of liver-kidney Yin deficiency syndrome， spleen-kidney Yang deficiency syndrome and kidney deficiency and blood stasis syndrome in 12 723 patients were 27%［95% confidence interval（CI） 0.24-0.31］， 32%（95% CI 0.29-0.36）， 36%（95% CI 0.30-0.42）. Subgroup analysis showed that there was a statistically significant difference in the distribution of the three TCM syndromes in the north and south（P<0.05）. In addition， the incidence of TCM syndrome fractures in different types of POP was 15%（95% CI 0.09-0.24） for liver-kidney Yin deficiency syndrome， 20%（95% CI 0.12-0.30） for spleen-kidney Yang deficiency syndrome， and 31%（95% CI 0.25-0.39） for kidney deficiency and blood stasis syndrome. ConclusionThe distribution of syndromes in POP patients is mainly kidney deficiency， accompanied by liver and spleen dysfunction. Liver-kidney Yin deficiency syndrome， spleen-kidney Yang deficiency syndrome and kidney deficiency and blood stasis syndrome are all the main syndromes of POP and osteoporotic fractures， and kidney deficiency and blood stasis syndrome is most closely related to the development of osteoporotic fractures. The reference standards for syndrome determination among the included studies are inconsistent， and in the future， it is necessary to focus on their determination standards to obtain consensus research results， at the same time， conduct large-scale syndrome research to obtain representative research results， providing a basis for clinical practice and research.

BACKGROUND:Suitable stress signals such as extracorporeal shock wave (ESW) and parathyroid hormone can be involved in regulation of bone formation and metabolism.
OBJECTIVE:To investigate the effects of low-density ESW and low-dose intermittent recombinant human parathyroid hormone 1-34 (rhPTH1-34) on the proliferation and differentiation of osteoblasts from rats cultured in vitro.
METHODS:Osteoblasts from the skul of neonatal rats were cultured using col agenase digestion method. After 60-150 times of stimulations of 0.18 mJ/mm2 ESW, different patterns of rhPTH1-34 at 10-12-10-10 mol/L and ESW+intermittent rhPTH1-34 (10-11 mol/L), osteoblasts were col ected to observe cel proliferation by cel counting, MTT and flow cytometry analysis and to observe cel differentiation by measuring alkaline phosphatase and type I col agen expression.
RESULTS AND CONCLUSION:0.18 mJ/mm 2 ESW (60-150 times), intermittent rhPTH1-34 (10-11 and 10-10 mol/L) and ESW+intermittent rhPTH1-34 (10-11 mol/L) stimulations could al improve proliferation and differentiation of rat osteoblasts cultured in vitro (P<0.05). ESW (60-150 times)+intermittent rhPTH1-34 stimulation showed better effects than ESW and intermittent rhPTH1-34 alone (P<0.05). These findings indicate that the combination of suitable ESW stimulation and low-dose intermittent rhPTH1-34 stimulation can improve the proliferation and differentiation of rat osteoblasts significantly.

Objective To investigate the effects of total hip replacement (THR) and dynamic hip screw (DHS) to intertrochanteric fracture in the geriatric with serious osteoporosis. Methods The clinical data of 51 senile cases (age over 60 years) with serious osteoporosis (Singh index less than grade Ⅲ ) cured from January 2003 to March 2008 were retrospectively reviewed. Two different groups were randomly selected from all cases treated with THR and DHS. Nineteen cases of THR were selected in THR group, modified Gibson approach was taken to complete hip joint replacement Thirty-two cases of DHS were selected in DHS group,lateral hip approach was employed to complete DHS fixation. Mobilization by CPM from the 2nd day and weight burdening from 3rd to 7th day according to general physical condition after surgery were carried out in THR group, mobilization and weight bearing start according to different conditions from the 2nd to 10th week in DHS group. Results Among 51 cases, 47 cases had got follow-up for 5.0 -40.5 (28.1 ± 11.9) months. Nineteen cases in THR group had got follow-up, Harris hip score of 18 cases (94.7% ) were good or excellent, and the other 1 case was bad. Twenty-eight cases in DHS group had got follow-up. Harris hip score of 23 cases (82.1% ) were good or excellent, and the other 5 cases were bad. There was statistical significance between the two groups (P < 0.05 ) . The average periods to start partly weight bearing of THR group and DHS group were( 8.3 ±4.2) days and (43.6 ± 15.3) days respectively, there was statistical significance between the two groups (P< 0.05). Conclusion To the geriatric intertrochanteric fracture with serious osteoporosis, THR is a better choice than DHS, because THR has shorter recovery period before full weight bearing, higher hip functional outcome evaluated by Harris hip score, earlier recovery of mobilization and less complications related with long term bed-bound .

Objective To investigate the reveral effect of Tanshitone(Tan) Microemulsion on multidrug resistance(MDR) of sensitive K562 cell line(KS) and ADM resistant K562 cell line(KA) and the mechanism.Methods The reversal effect of Tan Microemulsion(Tan and Microemulsion as controls) on MDR of KA cells was observed.The inhibitory effect of cell growth was investigated by MTT.The apoptosis of KS and KA cell lines was observed by flow cytometry.The intracellular drug concentration was measured by detecting fluorescent density.Results The result showed that Tan Microemulsion,Microemulsion and Tan reduced the expression levels of P-gp and Bcl-2 in KA cells and Tan Microemulsion had the most significant effect.The MDR reversal folds of Tan Microemulsion of KA was highest among all 3 groups(P