Objective:This study aimed to explore the clinical value of myostatin(MST) and follistatin(FST) as biological biomarkers in evaluating sarcopenia in elderly women.Methods:This was a retrospective cross-sectional study that enrolled 350 females aged 20-89 years who underwent physical examinations in Shanghai Huadong Hospital in 2021. Demographic characteristics, muscle mass, fat mass, bone mineral density, hand grip strength, gait speed, and serum indices of MST and FST were collected.Results:The serum levels of MST did not change significantly with age. However, the serum levels of FST increased with age. In women aged≥60 years, MST was positively correlated with total lean mass and appendicular skeletal muscle index(ASMI; r=0.236, P=0.041; r=0.289, P=0.014), while FST was negatively correlated with ASMI( r=-0.265, P=0.030). In multivariate stepwise regression analysis, after adjusting for age, body mass index, hip bone mineral density, and total fat mass, only FST was independently correlated with ASMI( β=-0.238, P=0.006), while MST was not correlated with ASMI. The receiver operating characteristic curve was plotted using muscle mass reduction as the state variable and serum FST level as the test variable. The area under the curve was 0.753. And when the FST cutoff value was 17.49 ng/mL, the maximum Jordan index was 0.46, with a sensitivity of 77.3% and a specificity of 68.7%. Women aged ≥60 years were divided into three groups based on serum FST levels. Compared to the upper third of the serum FST level group, the low third of the FST level group had a significantly reduced risk of suffering from sarcopenia( OR=0.098, P =0.036). Conclusions:Serum FST lever has a better correlation with muscle mass among elderly women, making it a promising biomarker for evaluating muscle mass.

Humans ; Aged ; Processing Speed ; Cross-Sectional Studies ; Cognition ; Hearing Loss/psychology* ; Cohort Studies ; Cognitive Dysfunction

BACKGROUND: Kyphoplasty with bone cement injection for the treatment of osteoporotic vertebral compression fractures has a good clinical effect, but it is unclear whether there is a difference in the efficacy on the fractures in different parts of the spine. OBJECTIVE: To compare the outcomes of kyphoplasty with bone cement injection in the treatment of osteoporotic vertebral compression fractures in different parts of the spine. METHODS: We retrospectively analyzed the clinical data of 247 cases of single-segmental osteoporotic vertebral compression fractures undergoing kyphoplasty with bone cement injection at the Department of Orthopaedic Surgery, the First Affiliated Hospital of Soochow University in China from January 2011 to August 2014. There were 24 cases of upper and middle thoracic (T1-T10) fractures, 187 cases of thoracolumbar (T11-L2) fractures and 36 cases of lower lumbar (L3-L5) fractures. The surgical time, X-ray exposure time, bone cement volume and leakage, the Visual Analog Scale score, the Oswestry Disability Index score, anterior vertebral height ratio and Cobb angle were assessed preoperatively, at 1 day posteroperatively and at the final visit. RESULTS AND CONCLUSION: (1) All patients underwent the surgery successfully, and were followed up for 12-44 months, with an average of (25.44±7.85) months. (2) There were 18 cases of bone cement leakage in the three groups, including 3 (12.5％) cases of upper and middle thoracic fractures, 13 (6.4％) cases of thoracolumbar fractures and 2 (5.6％) cases of lower lumbar fractures. (3) The surgical time and X-ray exposure time were significantly higher in the patients with upper and middle thoracic fractures than those with thoracolumbar fractures or lower lumbar fractures (P < 0.05) , while the volume of bone cement was significantly lower than that in the other two groups (P < 0.05) . Additionally, there were no significant differences in the surgical time, X-ray exposure time, and amount of bone cement between the patients with thoracolumbar fractures and with lower lumbar fractures (P> 0.05) . (4) There were no significant differences in the Visual Analog Scale score, Oswestry Disability Index score, anterior vertebral height ratio and Cobb angle among the three groups preoperatively, at 1 day postoperatively and at the final visit (all P> 0.05) . However, compared with baseline, these indicators were significantly improved in each group at 1 day postoperatively and at the final visit (P < 0.05) . (5) To conclude, kyphoplasty with bone cement injection has achieved satisfactory outcomes in the treatment of osteoporotic vertebral compression fractures in different parts of the spine.

Objective To evaluate the clinical outcomes of internal fixation with extra-articular distal humerus locking compression plate (LCP) for the treatment of mid-distal humerus diaphyseal fracture.Methods From December 2012 to December 2016,a cohort of 22 patients with mid-distal humerus shaft fracture were treated by open reduction and internal fixation using extra-articular distal humerus LCP.They were 14 males and 8 females with an average age of 42.7 years (range,from 18 to 86 years).According to AO classification,there were 13 cases of type 12-A,7 cases of type 12-B,and 2 cases of type 12-C.The surgical time,intra-operative blood loss and hospital stay were recorded.The clinical outcomes were evaluated by the Mayo elbow performance score (MEPS) at the last follow-ups.Results Surgical time ranged from 46 to 95 minutes with an average of 57 minutes.The average blood loss was 220 mL (range,from 150 to 400 mL).The average hospital stay was 10.5 days (range,from 9 to 13 days).The mean follow-up was 23.8 months (range,from 6 to 48 months).Bone union was achieved in 21 cases after an average of 4.6 months (range,from 3 to 9 months),and one patient experienced bone non-union which was uneventfully healed after secondary auto platelet rich plasma (PRP) graft management.The average MEPS elbow performance score was 88.2,resulting in 16 excellent,4 fine and 2 fair cases (excellent and fine rate:90.9％).Conclusions Since extra-articular distal humerus LCP can provide stable internal fixation,facilitating early postoperative rehabilitation,it may be considered an effective alternative osteosynthesis for mid-distal comminuted humeral diaphyseal fractures.

Objective To investigate the effect of metformin on the osteogenic differentiation of human mesenchymal stem cells exposed to PMMA particles. Methods Human placental mesenchymal stem cells were iso-lated and cultured in vitro. The effect of metformin with different concentrations on cell viability was determined by CCK8 assay. The effect of metformin on the mRNA expression of osteogenic genes was detected by using real-time RT-PCR. Calcified nodules were stained by alizarin S. The effect of metformin on the expression of eNOS was also detected by using real-time RT-PCR. Results PMMA particles could inhibit the viability of mesenchymal stem cells. Metformin(0.05 mmol/L)could promote the viability of mesenchymal stem cells exposed to PMMA particles. Metformin(0.05 mmol/L)could increase the expression of osteogenic genes,including OCN,RNUX2,and ALP, in human mesenchymal stem cells exposed to PMMA particles. The calcium deposit was also increased after metfor-min treatment. Results of real-time RT-PCR showed that metformin could increase the expression of eNOS in human mesenchymal stem cells exposed to PMMA particles. Conclusions Metformin can increase the osteogenic differentiation of human mesenchymal stem cells exposed to PMMA particles,partially by inducing eNOS expression.

BACKGROUND:Posterior cervical open-door expansive laminoplasty is one of the simple and effective methods to treat cervical spinal diseases, has satisfactory results but low complications. However, the imbalance of sagittal plan, loss of lordosis or axial pain is often reported recently. OBJECTVE:To analyze the correlation between cervical sagittal alignment and clinical outcomes after laminoplasty. METHODS:Between January 2011 and June 2015, 122 cases of cervical spinal disease, who were treated with open-door expansive laminoplasty with mini-titanium plate, were retrospectively analyzed. Clinical outcomes were evaluated by Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale. Radiographic results were assessed by C2-7 Cobb angle, C2-7 sagittal vertical axis and C7 slope. The correlation between sagittal alignment and clinical outcomes were analyzed. RESULTS AND CONCLUSION:(1) Al patients were fol owed up for 7-32 months. (2) Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale scores were improved in the final fol ow-up (al P<0.001). No significant difference in upper limb Visual Analogue Scale scores was determined (P=0.142). In the final fol ow-up, C2-7 sagittal vertical axis increased (P=0.036), but neither the C2-7 Cobb angle nor the C7 slope significantly changed (P=0.092, P=0.184). (3) There were no correlations between sagittal alignment parameters (C2-7 Cobb angle, C2-7 sagittal vertical axis and C7 slope) and clinical outcomes (Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale) (al P>0.05). (4) These findings indicated that posterior cervical open-door expansive laminoplasty with mini-titanium plate can significantly improve the neurological function of patients. However, there is no correlation between cervical sagittal alignment and clinical outcomes.

Objective To investigate the anti-inflammatory mechanism by which curcumin affects TNF-αand IL-8 production in Propionibactierium acnes-induced THP-1 cells. Methods THP-1 cell viability was determined by CCK8 assay. The productions of TNF-α and IL-8 were detected by ELISA assay. Total RNA and proteins were collected for real-time PCR and Western blot analysis, respectively. Results Curcumin didn′t significantly affect the cell viability at 12 h. It decreased Propionibactierium acnes-induced productions of TNF-αand IL-8 in THP-1 cells. Moreover, it decreased TLR2, NF-κB p65, and P-NF-κB p65 expressions in THP-1 cells. Conclusions Curcumin may reduce TNF-α and IL-8 expressions in Propionibactierium acnes-induced THP-1 cells by inhibiting TLR2/NF-κB signaling pathway.

Objective To study the feasibility of using silk fibroin/calcium phosphate cement (SF/CPC) as an injectable bone augmentation filling material for defected vertebrae in a sheep model.Methods Bone defects were created on L3,L4 and L5 in 24 adult sheep through the lateral retroperitoneum approach.CPC,SF/CPC,and polymethylmethacrylate (PMMA) were injected into the defects of 3 vertebrae randomly.Twelve sheep were sacrificed at 1 and 6 months postoperation,respectively.Un-decalcified sections were made from the specimens from any 4 sheep and stained with Van-Gieson method.The microcosmic changes of bone-material interface were observed,and the amounts of new bone formation and cement residue were evaluated by histomorphometric analysis.Biomechanical testing was performed on the specimens from the other 8 sheep,in which the strength and stiffness were determined on the vertebrae with L6 as a control.Results Histologically,CPC and SF/CPC contacted the bone directly but the absorption and bone formation were superficial at one month postoperation.At 6 months postoperation,the absorption and bone formation were limited on the surface of CPC while the absorption and bone ingrowth were accelerated in SF/CPC group.In PMMA group where no significant changes were observed between 1 and 6 months,the material contacted the bone loosely,with membrane structure at partial interface but no new bone formation on the material.Histological quantitative analysis showed that new bone formation was significantly more and cement residue significantly less in SF/CPC group than in CPC group at 6 months (P ＜0.05).Biomechanical testing showed that the compressive strength and stiffness were significantly enhanced at 6 months compared with one month in CPC and SF/CPC groups but significantly decreased in PMMA group (P ＜ 0.05).At the 2 time points,SF/CPC,PMMA and intact groups showed equivalent compressive strength and stiffness(P ＞ 0.05).Conclusions The SF/CPC composite has advantages of satisfactory bioactivity and osteoconduction,and relatively faster cement degradation and bone formation during which biomechanical function of vertebrae can be maintained.Therefore it may become a new kind of vertebral augmentation filling material to replace PMMA.

OBJECTIVETo determine whether smoking increases the risk for developing metabolic syndrome (MetS) in Chinese men.

METHODSA total of 693 men with no MetS at baseline were followed for 2.9-5.5 years. Subjects were divided into nonsmokers, ex-smokers, and current smokers according to baseline smoking status.

RESULTSAfter adjusting for age, education level, alcohol intake, fasting plasma insulin, HOMA-IR index, and BMI at baseline and weight change, current smokers were dose-dependently associated with increased risk for developing new MetS compared with nonsmokers. The odds ratio (OR) was 2.131 (95% CI, 1.264, 3.592; P<0.01) for the NCEPIII definition or 3.083 (95% CI, 1.807, 5.295; P<0.01) for the JCDCG definition of MetS. Ex-smokers who had quit for ≥13 years significantly decreased the risk for developing new MetS defined by the JCDCG definition. Compared with nonsmokers, current smokers were significantly associated with increased incidence of hypertriglyceridemia and low HDL-C.

CONCLUSIONSmoking is a risk factor for developing MetS in Chinese men after adjusting for age, education level, alcohol intake, fasting plasma insulin, HOMA-IR, BMI, and weight change. This could be due to an increased incidence of dyslipidemia. Smoking cessation for >13 years decreased the risk for developing MetS defined by the JCDCG definition.

Adult ; Aged ; Aged, 80 and over ; Blood Glucose ; metabolism ; Body Mass Index ; China ; epidemiology ; Cholesterol, HDL ; blood ; Diabetes Mellitus ; blood ; epidemiology ; Follow-Up Studies ; Humans ; Hypertriglyceridemia ; blood ; epidemiology ; Male ; Metabolic Syndrome ; blood ; epidemiology ; etiology ; Middle Aged ; Odds Ratio ; Risk Factors ; Smoking ; adverse effects ; blood ; epidemiology ; Waist Circumference

Objective To evaluate the osteogenic characteristics of an injectable silk fibroin (SF) enhanced calcium phosphate cement (CPC) composite loaded with recombinant human bone morphogenetic protein-2 (rhBMP-2) on lumbar interbody fusion in sheep. Methods Twenty-four mature sheep were randomly divided into two groups. Each sheep underwent L1.2, L3.4 and L5.6 lumber interbody fusion, and the three disc spaces were randomly implanted with three of the following materials: SF/CPC, CPC/rhBMP-2, SF/CPC/rhBMP2 and autogenous iliac crest bone. One group was killed at 6 months and the other at 12 months. The fusion segments were observed and analyzed by manual palpation, CT scan, undestructive biomechanical testing, undecalcified histology, and histomorphology. Results The fusion rates of SF/CPC, CPC/rhBMP-2, SF/CPC/rhBMP-2 and autogenous bone assessed by manual palpation were 0, 33.33%, 55.56% and 77.78% respectively at 6 months. At 12 months, the fusion rates improved to 11.11%, 44.44%, 77.78% and 77.78%, respectively.The biomechanical results showed that fusion stiffness was significantly greater in autograft compared with SF/CPC/rhBMP-2, CPC/rhBMP-2, and SF/CPC in 4 degrees of freedom (flexion, extension, right bending, and left bending) at 6 months. The SF/CPC/rhBMP-2 composite showed similar stiffness as autograft, which was significantly greater than CPC/rhBMP-2 and SF/CPC at 12 nonths. Both CPC/rhBMP-2 and SF/CPC/rhBMP-2 showed significantly greater stiffness at 12 months compared with that of at 6 months. The results showed that bone volume was significantly greater in autograft compared with SF/CPC/rhBMP-2, CPC/rhBMP-2, and SF/CPC at 6 months. There was significant difference among ceramic residue among SF/CPC, CPC/rhBMP-2 and SF/CPC/rhBMP-2, with SF/CPC the greatest and SF/CPC/thBMP-2 the least. At 12 months, the bone volume of SF/CPC/rhBMP-2 composite was comparable with autograft, and greater than that of CPC/rhBMP-2 and SF/CPC. The bone volume of SF/CPC, CPC/rhBMP-2 and SF/CPC/rhBMP-2 was significantly greater at 12 months than that of at 6 months. The ceramic residue of SF/CPC, CPC/rhBMP-2 and SF/CPC/rhBMP-2 were significantly decreased. Conclusion The SF/CPC/rhBMP-2 composite had excellent osteoconduction and osteoinduction, and balanced degradation and osteogenesis, which may be a kind of ideal bone grafts in spinal fusion.