Osteoporosis is a systemic disease characterized by decreased bone mass and deterioration of bone microstructure, significantly increasing the risk of fragility fractures. With aging global populations, osteoporotic fractures impose a substantial healthcare burden. Strategy of risk-based tiered treatment optimizes cost-effectiveness. Current mainstream tools for fracture risk assessment integrate multiple risk parameters to estimate fracture probability over 5 to 10 years. However, these tools exhibit such limitations as long prediction intervals, insensitivity to temporal dynamics in fracture risk, and difficulties in accurate assessment of short-term (12 to 24 months) fracture risk and treatment response. Imminent fracture risk models address these shortcomings by incorporating time-sensitive indicators such as fractures, fall events, bone mineral density, and imaging findings. They identify the high-risk window for an imminent fracture, enhance precision in recognizing high-risk individuals, and facilitate personalized intervention strategies, thereby offering greater clinical utility. This article reviews the current researches in imminent fracture risk assessment models for osteoporosis and discusses their future developments in association with the recent research findings by our team.

Objective:To analyze the clinical efficacy and learning curve for robot-assisted cortical bone trajectory (CBT) screw fixation performed by surgeons with different seniority in the treatment of lumbar degenerative disease.Methods:The clinical data of 91 lumbar degenerative disease patients underwent robot-assisted CBT screw fixation from August 2020 to December 2022 in Beijing Shijitan Hospital, Capital Medical University were retrospectively analyzed. Among them, 48 patients underwent surgery performed by the same senior surgeon (senior group), with a total of 234 CBT screws were placed; while 43 patients underwent surgery performed by the same junior surgeon (junior group), with a total of 206 CBT screws were placed. The surgical related indexes, functional improvement score, lower back pain and lower limb radiation pain scores, acceptable nail insertion rate, non invasion rate of facet joints and incidence of postoperative complications were compared between two groups. The functional improvement score was evaluated using the Japanese Orthopaedic Association (JOA) score, the pain score was evaluated using visual analog score (VAS). The cumulative sum (CUSUM) method was used to depict the learning curve with "single screw placement time" as the observation index.Results:There were no statistical difference in incision length, operation time, intraoperative blood loss and postoperative hospital stay between two groups ( P>0.05). The least squares means of JOA scores 1, 3 and 6 months after surgery in both groups increased significantly compared to baseline, while the least squares means of lower back pain VAS and lower limb radiation pain VAS decreased significantly compared to baseline; there were no statistical differences between two groups ( P>0.05). There were no statistical difference in acceptable nail insertion rate, non invasion rate of facet joints and incidence of postoperative complications between two group ( P>0.05). The CUSUM learning curves were fitting well and the inflection point for senior surgeon corresponded to 18 cases, while it was reached after performing surgery on 21 cases for junior surgeon. Conclusions:Robot-assisted CBT screw fixation performed by surgeons with different seniority could achieve similar clinical outcomes for treating lumbar degenerative disease. The senior surgeons are able to complete the initial learning stage faster than the junior surgeons, but there is not much difference in the number of surgeries performed the learning curve.

Objective:To compare the effectiveness and safety between robot-assisted percutaneous kyphoplasty (PKP) and traditional fluoroscopy-assisted PKP in the treatment of dual-segment recurrent osteoporotic vertebral compression fracture (OVCF) including in situ vertebral fracture.Methods:The clinical data of 33 patients with dual-segment recurrent OVCF including in situ vertebral fracture from January 2016 to January 2023 in Beijing Shijitan Hospital Affiliated to Capital Medical University were retrospectively analyzed. All the patients were treated with PKP. Among them, 14 patients were treated with robot-assisted surgery (robot-assisted group), and 19 patients were treated with fluoroscopy-assisted surgery (fluoroscopy-assisted group). The total surgical time, preparation time and number of fluoroscopy were recorded. The in situ and other fracture vertebral operation time, number of punctures, amount of bone cement injection, bone cement filling effect, bone cement leakage, pedicle wall breakthrough and other special intraoperative situations were separately recorded. The visual analogue score (VAS) before surgery and 1 d, 3 months after surgery was recorded.Results:The preparation time in robot-assisted group was significantly longer than that in fluoroscopy-assisted group: (30.8 ± 6.9) min vs. (19.1 ± 4.5) min, the number of fluoroscopy was significantly lower than that in fluoroscopy-assisted group: (17.1 ± 4.1) times vs. (41.0 ± 6.3) times, and there were statistical differences ( P<0.01 and <0.05); there were no statistical differences in total surgical time and VAS at any time point between the two groups ( P>0.05). For the in situ fracture segment, the operation time and number of punctures in robot-assisted group were significantly lower than those in fluoroscopy-assisted group: (15.4 ± 2.8) min vs. (22.0 ± 5.5) min and (1.1 ± 0.4) times vs. (2.4 ± 1.2) times, the amount of bone cement injection was significantly higher than those in fluoroscopy-assisted group: (2.36 ± 0.75) ml vs. (1.79 ± 0.69) ml, the filling effect of bone cement was significantly better than that in fluoroscopy-assisted group, and there were statistical differences ( P<0.01 and <0.05); there were no statistical difference in bone cement leakage and pedicle wall breakthrough between the two groups ( P>0.05). For the other fracture segment, the operation time in robot-assisted group was significantly shorter than that in fluoroscopy-assisted group: (13.8 ± 3.8) min vs. (19.2 ± 6.4) min, and there was statistical difference ( P<0.01); there were no statistical difference in number of punctures, amount of bone cement injection, filling effect of bone cement, bone cement leakage and pedicle wall breakthrough between the two groups ( P>0.05). Conclusions:Robot-assisted PKP in the treatment of dual-segment OVCF including in situ vertebral fracture, could reduce operation time, minimize punctures and fluoroscopy numbers, and provide superior bone cement filling results.

Objective:To analyze the clinical efficacy and learning curve for robot-assisted cortical bone trajectory (CBT) screw fixation performed by surgeons with different seniority in the treatment of lumbar degenerative disease.Methods:The clinical data of 91 lumbar degenerative disease patients underwent robot-assisted CBT screw fixation from August 2020 to December 2022 in Beijing Shijitan Hospital, Capital Medical University were retrospectively analyzed. Among them, 48 patients underwent surgery performed by the same senior surgeon (senior group), with a total of 234 CBT screws were placed; while 43 patients underwent surgery performed by the same junior surgeon (junior group), with a total of 206 CBT screws were placed. The surgical related indexes, functional improvement score, lower back pain and lower limb radiation pain scores, acceptable nail insertion rate, non invasion rate of facet joints and incidence of postoperative complications were compared between two groups. The functional improvement score was evaluated using the Japanese Orthopaedic Association (JOA) score, the pain score was evaluated using visual analog score (VAS). The cumulative sum (CUSUM) method was used to depict the learning curve with "single screw placement time" as the observation index.Results:There were no statistical difference in incision length, operation time, intraoperative blood loss and postoperative hospital stay between two groups ( P>0.05). The least squares means of JOA scores 1, 3 and 6 months after surgery in both groups increased significantly compared to baseline, while the least squares means of lower back pain VAS and lower limb radiation pain VAS decreased significantly compared to baseline; there were no statistical differences between two groups ( P>0.05). There were no statistical difference in acceptable nail insertion rate, non invasion rate of facet joints and incidence of postoperative complications between two group ( P>0.05). The CUSUM learning curves were fitting well and the inflection point for senior surgeon corresponded to 18 cases, while it was reached after performing surgery on 21 cases for junior surgeon. Conclusions:Robot-assisted CBT screw fixation performed by surgeons with different seniority could achieve similar clinical outcomes for treating lumbar degenerative disease. The senior surgeons are able to complete the initial learning stage faster than the junior surgeons, but there is not much difference in the number of surgeries performed the learning curve.

Objective:To compare the effectiveness and safety between robot-assisted percutaneous kyphoplasty (PKP) and traditional fluoroscopy-assisted PKP in the treatment of dual-segment recurrent osteoporotic vertebral compression fracture (OVCF) including in situ vertebral fracture.Methods:The clinical data of 33 patients with dual-segment recurrent OVCF including in situ vertebral fracture from January 2016 to January 2023 in Beijing Shijitan Hospital Affiliated to Capital Medical University were retrospectively analyzed. All the patients were treated with PKP. Among them, 14 patients were treated with robot-assisted surgery (robot-assisted group), and 19 patients were treated with fluoroscopy-assisted surgery (fluoroscopy-assisted group). The total surgical time, preparation time and number of fluoroscopy were recorded. The in situ and other fracture vertebral operation time, number of punctures, amount of bone cement injection, bone cement filling effect, bone cement leakage, pedicle wall breakthrough and other special intraoperative situations were separately recorded. The visual analogue score (VAS) before surgery and 1 d, 3 months after surgery was recorded.Results:The preparation time in robot-assisted group was significantly longer than that in fluoroscopy-assisted group: (30.8 ± 6.9) min vs. (19.1 ± 4.5) min, the number of fluoroscopy was significantly lower than that in fluoroscopy-assisted group: (17.1 ± 4.1) times vs. (41.0 ± 6.3) times, and there were statistical differences ( P<0.01 and <0.05); there were no statistical differences in total surgical time and VAS at any time point between the two groups ( P>0.05). For the in situ fracture segment, the operation time and number of punctures in robot-assisted group were significantly lower than those in fluoroscopy-assisted group: (15.4 ± 2.8) min vs. (22.0 ± 5.5) min and (1.1 ± 0.4) times vs. (2.4 ± 1.2) times, the amount of bone cement injection was significantly higher than those in fluoroscopy-assisted group: (2.36 ± 0.75) ml vs. (1.79 ± 0.69) ml, the filling effect of bone cement was significantly better than that in fluoroscopy-assisted group, and there were statistical differences ( P<0.01 and <0.05); there were no statistical difference in bone cement leakage and pedicle wall breakthrough between the two groups ( P>0.05). For the other fracture segment, the operation time in robot-assisted group was significantly shorter than that in fluoroscopy-assisted group: (13.8 ± 3.8) min vs. (19.2 ± 6.4) min, and there was statistical difference ( P<0.01); there were no statistical difference in number of punctures, amount of bone cement injection, filling effect of bone cement, bone cement leakage and pedicle wall breakthrough between the two groups ( P>0.05). Conclusions:Robot-assisted PKP in the treatment of dual-segment OVCF including in situ vertebral fracture, could reduce operation time, minimize punctures and fluoroscopy numbers, and provide superior bone cement filling results.

Osteoporosis is a systemic disease characterized by decreased bone mass and deterioration of bone microstructure, significantly increasing the risk of fragility fractures. With aging global populations, osteoporotic fractures impose a substantial healthcare burden. Strategy of risk-based tiered treatment optimizes cost-effectiveness. Current mainstream tools for fracture risk assessment integrate multiple risk parameters to estimate fracture probability over 5 to 10 years. However, these tools exhibit such limitations as long prediction intervals, insensitivity to temporal dynamics in fracture risk, and difficulties in accurate assessment of short-term (12 to 24 months) fracture risk and treatment response. Imminent fracture risk models address these shortcomings by incorporating time-sensitive indicators such as fractures, fall events, bone mineral density, and imaging findings. They identify the high-risk window for an imminent fracture, enhance precision in recognizing high-risk individuals, and facilitate personalized intervention strategies, thereby offering greater clinical utility. This article reviews the current researches in imminent fracture risk assessment models for osteoporosis and discusses their future developments in association with the recent research findings by our team.

【Objective】 To obtain the quality information of von Willebrand factor (vWF) in coagulation factor Ⅷ (FⅧ) concentrates in China. 【Methods】 FⅧ concentrates produced by 7 domestic blood product manufactures and 1 foreign manufacture were collected, then FⅧ and vWF contained in FⅧ concentrates were evaluated. 【Results】 The activity loss of vWF was more than 25% in 2 of the 7 domestic FⅧ concentrates. The ratio of vWF activity to FⅧ activity in FⅧ concentrates from different domestic manufactures was significantly different (P<0.05). The ratio in FⅧ concentrates prepared by C, D, F manufacturer was greater than 1, which was similar to that in willate^@ approved abroad for the treatment of vWD. The ratio in FⅧ concentrates prepared by E manufacturer was greater than 0.7 and less than 1, and by A, B, G manufacturers was less than 0.5. In addition, the specific activities of FⅧ and vWF were significantly different among different FⅧ concentrates in China (P<0.05), and the specific activities of FⅧ and vWF were much lower than that of willate^@. 【Conclusion】 The variation of vWF quality between domestic FⅧ concentrates and willate^@ is mainly due to the different in vWF content. After the comprehensive consideration of various indicators, the FⅧ concentrates made by C and D manufacturers may be used in the treatment of vWD.

OBJECTIVE: The pathogenesis of depression is not fully understood yet, but studies have suggested higher circulating C reactive protein (CRP) level might relate to depression occurrence. However, due to high variability of patients’ individual condition, the results to date are inconsistent. Considering CRP single-nucleotide polymorphisms (SNPs) could also regulate plasma CRP levels, in the present study, we hypothesized that inherited CRP allelic variations may co-vary with depressive symptomatology. METHODS: We recruited 60 depression patients with family depression history and 60 healthy control volunteers into this project. We detected circulation CRP level as well as genome CRP SNPs from participants of this project. RESULTS: We have found a significantly higher circulating CRP level in patients with a positive family history. Furthermore, we also identified some certain inherited CRP SNPs (A allele in rs1417938 and C allele in rs1205) could up regulate serum CRP level and distributed more in depression patients with family history. CONCLUSION: Our finding may raise new evidence that genetically increased serum CRP level through SNPs variation is likely to induce family inherited depression.
Alleles ; C-Reactive Protein* ; Depression* ; Genome ; Humans ; Plasma ; Polymorphism, Single Nucleotide ; Volunteers

Objective to provide the evidence for inducing the SAP model in rats with proper concentration of sodium taurocholate.Methods 60 SD rats were divided into sham operated group, group of 1.5% in concentration, group of 3.5% in concentration and group of 5% in concentration randomly, while the SAP model was induced by the sodium taurocholate concentration of 1.5%,3.5% and 5% with the method of retrograde injection into the biliopancreatic duct.To calculate the mortality of different groups, measure the serum amylase, tumor necrosis factor -α(TNF -α) and interleukin -6 (IL -6),and to observe the pancreatic pathological scores of HE staining in rats.Results The mortality in group of 5% in concentration has a significant ascending compared with group of 1.5% in concentration, while the serum amylase, tumor necrosis factor -α(TNF -α) , interleukin -6( IL -6), pathological score of hemorrhage and acinar necrosis in group of 5% in concentration have a significant ascending compared with group of 1.5% in concentration and group of 3.5% in concentration.Conclusions A better SAP model may be induced by sodium taurocholate with the concentration of 5% by the method of retrograde injection into the biliopancreatic duct, which may accord with the physiological and pathological manifestation of SAP.

Objective To explore the microsurgical techniques for total removal of the suprasellar cranio pharyngiomas via the pterional approach.Methods The clinical data of 28 patients with suprasellar craniopharyngio mas resected by the microsurgery was analyzed retrospectively.Results The tumors were total removed in 24 cases (86%)and subtotal resected in 4 cases(14%).The frequent postoperative complications are diabetes insipidus,hy perthermy,imbalance of water and electrolyte and lower level of hormone.Conclusion It is the key to get fine operation effect that removal sclerotin of base of skull as far as possible and releasing cerebrospinal fluid sufficiently,paying attention to protect the perforating branch and nourishing artery in each operative spaces.