Risk factors for newly developed osteoporotic vertebral compression fractures following treatment for osteoporotic vertebral compression fractures

Background context

It has been reported that newly developed osteoporotic vertebral compression fractures (OVCFs) occur at a relatively high frequency after treatment. While there are many reports on possible risk factors, these have not yet been clearly established.

Effect of leukocyte and platelet rich fibrin (L-PRF) on stability of dental implants. A systematic review and meta-analysis

The aim of this study was to assess the impact, if any, of L-PRF application in an implant bed prior to implant placement, focusing on stability by means of implant stability quotient (ISQ) values. The literature was searched in a systematic way by means of the main databases and hand searching of the most relevant journals. The inclusion and exclusion criteria were used to determine the eligible studies included in this review. Only randomised controlled trials (RCT) and controlled clinical trials (CCT) were included. A total of four RCTs were included for data extraction. The risk of bias was deemed moderate to unclear. Meta-analysis was performed to assess the effect of L-PRF, on implant stability, immediately post-insertion in three studies, after one week from the implant placement in three studies and after four weeks for all the included studies. The fixed effects model has shown Hedges g statistic for the one week varying from 0.380 to 1.401 with a pooled figure of 0.764 (95% CI 0.443 to 1.085) and for four weeks varying between 0.74 and 1.1 with a combined effect of 0.888 (95% CI 0.598 to 1.177). The results for both intervals were in favour of the use of L-PRF while the statistical difference immediately post-insertion was not statistically significant. The present systematic review, though acknowledging its limitations, suggests that L-PRF has a positive effect on secondary implant stability and that needs to be correlated to the clinical practice to measure the actual clinical effect by means of reducing treatment times.     

Fixation of subcondylar fractures of the mandible: a randomized clinical trial comparing one trapezoidal plate with two miniplates

Subcondylar fracture of the mandible accounts for 25–35% of all mandibular fractures. In the past, most subcondylar fractures were managed non-surgically. The traditional method of fixation for subcondylar fractures uses two miniplates; however some bench studies have reported that trapezoidal plates are superior. The aim of this study was to compare the outcomes of subcondylar fractures fixed either with two non-parallel straight miniplates or with one trapezoidal plate. A randomized clinical trial was designed and implemented. Fifty-two consecutive patients with subcondylar fractures were recruited. All patients underwent surgery via a retromandibular approach. The time taken for fixation of the plate after fracture reduction and postoperative outcomes and complications were compared between the groups. The trapezoidal plates were superior in terms of ease of adaptation and time taken for fixation (P =  0.0001). Plate fracture was observed only in the two miniplates group, in four (16%) patients. Outcomes were similar in the two groups in terms of occlusion, mouth opening, protrusion, and lateral excursion. In conclusion, both systems – two miniplates and the trapezoidal plate – provide functionally stable fixation. The outcome was significantly better for the trapezoidal plate than for two miniplates regarding the time taken for insertion and ease of adaptation, but not for other parameters.     

维生素K2结合钙剂在甲状腺功能亢进症继发骨质疏松症中的临床应用

目的探讨维生素K_2对甲状腺功能亢进性骨质疏松症患者骨密度、骨代谢指标及细胞因子水平变化的影响。方法选取2014年7月至2015年7月来我院治疗的57例甲状腺功能亢进性骨质疏松症患者作为研究对象,随机分为治疗组(n=29)和对照组(n=28)。对照组给予钙剂治疗,治疗组给予维生素K2联合钙剂治疗,为期12个月。检测所有对象治疗前后髋部及腰椎的骨密度(bone mineral density,BMD)、骨代谢指标[骨钙素(osteocalcin,BGP)和总I型前胶原氨基端延长肽(total Nterminal propeptide of type I procollagen,PINP)]以及细胞因子[胰岛素样生长因子-1(insulin-like growth factor,IGF-1)、白细胞介素(interleukin,IL)-2、6(IL-2、IL-6)],并进行比较。结果治疗前,两组患者的BMD、BGP、PINP及IL-2、IL-6和IGF-1比较差异无统计学意义(P0.05);治疗12个月后,治疗组髋部及腰椎的BMD水平显著高于对照组(P0.05);治疗组BGP、PINP水平显著低于对照组(P0.05);治疗组IL-2水平显著高于对照组(P0.05);治疗组IL-6和IGF-1水平显著低于对照组(P0.05)。结论维生素K2可以明显提高甲状腺功能亢进性骨质疏松患者的骨密度、降低骨转换,提高IL-2表达且降低IL-6和IGF-1水平,对骨质疏松有保护作用。     

Disuse osteopenia following leg fracture in postmenopausal women: Implications for HIP fracture risk and fracture liaison services

IntroductionDisuse osteopenia is a known consequence of reduced weight-bearing and has been demonstrated at the hip following leg injury but has not been specifically studied in postmenopausal women.MethodBilateral DXA (GE Lunar Prodigy) bone mineral density (BMD) measurements were taken at the neck of femur (NOF), total hip region (TH) and lumbar spine in postmenopausal female groups comprising controls (N = 43), new leg fractures (#<3wks) (N = 9), and participants who had sustained a leg fracture more than one year previously (#>1yr) (N = 24). #>1yr were assessed at a single visit and the remaining groups at intervals over twelve months. Weight-bearing, function, 3-day pedometer readings, and pain levels were also recorded.ResultsThe #<3wks demonstrated significant (p < 0.05) losses in ipsilateral TH BMD at 6 weeks from baseline 0.927 ± 0.137 g/cm², to 0.916 ± 0.151 g/cm² improving to 0.946 ± 0.135 g/cm² (n.s) at 12 months following gradual return to normal function and weight-bearing activity. The #>1yr scored significantly below controls in almost all key physical and functional outcomes demonstrating a long-term deficit in hip bone density on the ipsilateral side.ConclusionThe clinical significance of post-fracture reduction in hip BMD is a potential increased risk of hip fracture for a variable period that may be mitigated after return to normal function and weight-bearing. Improvement at 12 months in #<3wks is not consistent with #>1yr results indicating that long-term impairment in function and bone health may persist for some leg fracture patients. Unilateral bone loss could have implications for Fracture Liaison Services when assessing the requirement for medication post fracture.     

Potential advantages of a combination of Chinese Medicine and bone marrow mesenchymal stem cell transplantation for removing blood stasis and stimulating neogenesis during ischemic stroke treatment

Combined treatment of ischemic stroke with Chinese medicine and exogenous bone marrow mesenchymal stem cell (BMSC) transplantation may improve the removal of blood stasis and stimulation of neogenesis.Chinese medicines that remove blood stasis not only promote blood circulation but also calm the endopathic wind,remove heat,resolve phlegm,remove toxic substances and strengthen body resistance.The medicinal targeting effect of Chinese medicine can promote the homing of BMSCs,and the synergistic therapeutic effects of drugs can contribute to BMSC differentiation.As such,exogenous BMSC transplantation has potential advantages for neogenesis.Chinese medicines and exogenous BMSCs provide complementary functions for the removal of blood stasis and stimulation of neogenesis.Therefore,a combination of Chinese medicine and transplantation of exogenous BMSCs may be particularly suited to ischemic stroke treatment.     

Comparison of manual and digital microvascular density counting of RECK expression in glioma

A microvascular density (MVD) counting method for reversion‐inducing cysteine‐rich protein with Kazal motifs (RECK) expression, using a digital image analysis tool, has advantages over manual counting by microscope. Thirty glioma cases with RECK staining were photographed at a magnification of 200× high power field and the photographs in RGB images were analyzed, and stained vessels were captured and were counted automatically. MVD with RECK expression using a digital image analysis tool showed comparable results to those of the manual method. RECK intensity expression could show linear correlation with grades of glioma by the digital method, which was superior compared to the manual method. The present method is recommended to researchers undertaking MVD study for glioma.