不同运动项目对老年人骨密度的影响

不同运动项目对老年人骨密度的影响Ｅｆｅｃｔｓｏｆｄｉｆｅｒｅｎｔｓｐｏｒｔｓｃｏｕｒｓｅｓｏｎｂｏｎｅｍｉｎｅｒａｌｄｅｎｓｉｔｙｉｎｔｈｅａｇｅｄ孙银平杨现新卢宏王云汉骨质疏松（ｏｓｔｅｏｐｏｒｓｉｓ，ＯＰ）是一种常见的老年性疾病，严重地威胁老年人...

肾虚证与骨密度的关系研究

为根据肾主骨理论探索肾虚证与骨密度的关系,并为这种关系确立量化标准,我们采用1986年6月全国中医、中西医结合第3次老年医学研究协会在长春通过的中医虚证辨证参考标准,选择肾虚和无肾虚以及肺虚、脾虚病人进行骨密度测量比较。因此标准把腰膝酸软作为诊断肾虚各证型不可缺少的主症,不失“肾主骨”的意义,且舌脉俱备。

Artificial intelligence models based on non-contrast chest CT for measuring bone mineral density

Objective To observe the value of artificial intelligence(AI)models based on non-contrast chest CT for measuring bone mineral density(BMD).Methods Totally 380 subjects who underwent both non-contrast chest CT and quantitative CT(QCT)BMD examination were retrospectively enrolled and divided into training set(n=304)and test set(n=76)at a ratio of 8∶2.The mean BMD of L1—L3 vertebrae were measured based on QCT.Spongy bones of T5—T10 vertebrae were segmented as ROI,radiomics(Rad)features were extracted,and machine learning(ML),Rad and deep learning(DL)models were constructed for classification of osteoporosis(OP)and evaluating BMD,respectively.Receiver operating characteristic curves were drawn,and area under the curves(AUC)were calculated to evaluate the efficacy of each model for classification of OP.Bland-Altman analysis and Pearson correlation analysis were performed to explore the consistency and correlation of each model with QCT for measuring BMD.Results Among ML and Rad models,ML Bagging-OP and Rad Bagging-OP had the best performances for classification of OP.In test set,AUC of ML Bagging-OP,Rad Bagging-OP and DL OP for classification of OP was 0.943,0.944 and 0.947,respectively,with no significant difference(all P>0.05).BMD obtained with all the above models had good consistency with those measured with QCT(most of the differences were within the range of Ax-G±1.96 s),which were highly positively correlated(r=0.910—0.974,all P<0.001).Conclusion AI models based on non-contrast chest CT had high efficacy for classification of OP,and good consistency of BMD measurements were found between AI models and QCT.

森田疗法地慢性精神分裂症的应用

应用森田疗法治疗30例慢性精神分裂症，其目的是改善患者的生活懒散、行为退缩、社会适应不良、生活不能自理和社会功能低下等症状。治疗前后测定BPRS、SDSS、ADL和骨矿物质含量。经过300天的森田疗法康复训练，包括卧床期；轻作业期；重作业期和社会回归期。结果表明，精神症状、社会功能和个人生活能力的改善明显优于对照组，骨矿物质含量也显著高于对照组。提示森田疗法对慢性精神分裂症的身心健康是有益的，可大大减少或延缓精神衰退和残疾程度。

Competitive trampolining influence trabecular bone structure,bone size,and bone strength

Background：Trampolining is a form of gymnastics that has increased in popularity over the last decade and due to its concurrence with the formative years of bone development,it may have an important impact on bone health.However,bone density,microarchitecture,and bone strength of competitive trampolinists have not been explored.Therefore,the purpose of this cross-sectional study was to investigate the relationship between trampolining participation and（1） bone density,area,and microarchitecture;and（2） estimated bone strength and the role of muscle and impact loading in young female adults.Methods：We recruited 29 female participants aged 16–29 years for this study（n=14 trampolinists;n=15 controls）.Skeletal parameters were assessed using dual X-ray absorptiometry,high-resolution peripheral quantitative computed tomography（HR-pQCT）,and finit element analysis（FEA）.Muscle strength was measured using dynamometers.Results：Trampolinists had higher bone density at the hip and spine,greater trabecular density and thicker trabeculae at the tibia,as well as larger bones at both the tibia and radius than controls（p〈0.05）.Trampolinists also had higher muscle strength than controls at the lower body with no difference between groups in the upper body.Estimates of bone strength using FEA were greater for trampolinists than controls at both the radius and tibia.Conclusion：This is the firs study to investigate bone density,area,and microarchitecture in female trampolinists using HR-p QCT.Trampolinists had greater bone density,area,microarchitecture,and estimated bone strength than controls.

COMPARISON OF BONE MASS IN FOREARM,LUMBAR VERTEBRA AND HIP BY SINGLE AND/OR DUAL ENERGY X-RAY ABSORPTIOMETRY

OBJECTIVE: Bone mineral density (BMD) was measured in normal Chinese women with single X-ray absorptiometry (SXA) and dual energy X-ray absorptiometry (DEXA). These two methods were compared to evaluate the sensitivity in reflecting bone loss. METHODS: Measurements were performed in 300 women aged 20 to approximately 79 (5 for each age). The 8mm distal, 1/4 distal, ultra distal site of the nondominant forearm were measured with SXA; the AP spine (L2-4), right femoral neck (Neck), Ward's triangle (Ward) and trochantor (Troch) were measured with DEXA. Ten women had 5 repeated measurements to evaluate the reproducibility of the equipments. RESULTS: The BMD peak for Neck and Ward was found between age 20 to approximately 29, for ultra distal and L2-4 at age 30 to approximately 39, for 8mm distal, 1/4 distal and Troch at age 40 to approximately 49. After reaching the peak values, BMD at all sites decreased with increasing age. The highest rate of yearly loss of BMD was at 8mm distal. Results of measurement showed significant correlation between SXA and DEXA. Comparing with premenopausal women, the bone loss rate in postmenopausal women was faster and highest up to 11 to approximately 15 years and the highest rate was at the Ward. CONCLUSION: The present study gives the normal values of BMD at seven sites for normal Chinese women. The ages of BMD peak were different at seven sites. The yearly loss of BMD was highest at 8mm distal, it seemed to be the sensitive region for bone loss with age. The postmenopausal women had highly significantly loss bone mass than the premenopausal women. Comparing with premenopause, postmenopause BMD for Ward's triangle with DEXA seemed to be most sensitive to the effect of menopause.

BONE MINERAL ANALYSIS OF WHOLE BODY IN 292 NORMAL SUBJECTS ASSESSED BY DUAL X-RAY ABSORPTIOMETRY

Objective. To study the whole body bone mineral changes in normal subjects.Methods. Bone mineral was measured by dual X-ray absorptiometry(DXA) in 292 normal subjectsaged 10～79 years, including 152 females and 140 males. They were divided into age-groups by decade.Results. In males, the ages with peak value of total bone mineral content (TBMC), total bone min-eral density (TBMD), anteroposterior spine BMD(L2-4 BMD) were in the 30～39,20～39, 20～29 age-groups respectively. In females, they were all in the 30～39 age-group. Peak values of TBMC, TBMD,L2-4 BMD were higher in males than those in females. Loss of bone mineral for females was more pro-nounced than that for males. Loss of L2-4 BMD was more pronounced than TBMD.Conclusion. This study provides the normal bone mineral data of whole body for males and females,and the characteristic of changes.

Analysis on the risk factors of second fracture in osteoporosis-related fractures

Objective： To explore the clinical characteristics and risk factors of refracture in patients suffering from osteoporosis-related fractures as well as effective interventions. Methods： From January 2006 to January 2008, both out-patients and in-patients in our hospital who were over 50 years old and suffered from osteoporosis-related fractures were selected for this research. They were divided into fracture group and refracture group. The refracture rate was followed up for 2 years, during which 11 patients developed refracture, thus were included in the refracture group. Therefore, 273 patients, 225 first-fracture cases, aged （67.7± 8.5） years, and 48 refracture cases, aged （72.7±9.5） years, were included in this study. General data including age and sex, fracture types, femoral neck bone mineral density （BMD） T-scores tested by dual-energy X-rays absorptiometry （DEXA）, Charlson index, time-frame between two fractures as well as mobility skill assessment were collected and analyzed by single-factor and multivariate statistical methods. Results： Females accounted for 70.2% of the fracture group and 77.1% of the refracture group. The most common refracture type was vertebral fracture for the first time and femoral neck fracture for the second time during the followup. The second fracture happened 3.7 years after the first one on average. The refracture rate was 2.12% within one year, and 4.66% within two years. Risk factors for a second fracture in osteoporotic fracture patients included age （〉75 years, HR=1.23, 95%CI 1.18-1.29; 〉85 years, HR=1.68, 95% CI 1.60-1.76）, female sex （HR=1.36, 95%CI 1.32-1.40）, prior vertebral fractures （HR= 1.62, 95%CI 1.01-2.07）, prior hip fractures （HR=1.27, 95%CI 0.89-2.42）, BMD T-score〈-3.5 （HR-1.38, 95%CI 1.17-1.72） and weakened motor skills （HR=1.27, 95%CI 1.09-1.40）. Conclusions： The risks of second fracture among patients with initial brittle fracture are substantial. There is adequate time between the first and second fractures for interventions to reduce the risks of refracture, especially for the old women with a vertebral or hip fracture. Medication, motor functional rehabilitation and fall-down prevention training are helpful.