RESUMEN
Objective: This study aims to evaluate and compare the therapeutic outcomes and prognoses of osteoporotic fracture (OSF) patients undergoing percutaneous kyphoplasty (PKP), emphasizing the role of bone mineral density T-values (BMD-T) as a guiding factor in the surgical intervention for OSF. Methods: An observational cohort study was conducted, and 162 OSF patients admitted to our hospital from March 2021 to December 2021 were selected. Patients were categorized based on BMD-T into mild (-2.5 ≤ BMD-T ≤ -4, n=40), moderate (-4 < BMD-T ≤ -5, n = 78), and severe groups (BMD-T < -5, n = 44). All patients underwent PKP treatment, and vertebral body (VB) lavage fluid was analyzed for calcium (Ca), magnesium (Mg), and zinc (Zn) levels. X-ray assessments were performed before and after surgery to examine changes in wedge and kyphosis angles and VB height. Additionally, the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), and Barthel Index (BI) scores were recorded. Results: The mild group exhibited the highest Ca, Mg, and Zn contents in VB lavage fluid, while the severe group had the lowest (P < .05). A positive correlation was observed between patients' Ca, Mg, and Zn levels and BMD-T (P < .05). The severe group, characterized by lower BMD-T, required a higher amount of bone cement injection, resulting in more significant differences in wedge angle, kyphosis angle, and VB height before and after surgery (P < .05). Moreover, the severe group demonstrated a higher incidence of postoperative adverse reactions (P < .05). Age, bone cement leakage, BMD-T, Ca, Mg, and Zn were identified as independent factors influencing post-PKP re-fracture in OSF patients (P < .05). Conclusion: In PKP for OSF, lower BMD-T correlates with improved correction but is also associated with a higher likelihood of cement leakage.
RESUMEN
Rivers play essential roles in human civilization, while anthropogenic activities have deteriorated their resilience and functionalities. Combating contamination is one of the priorities for building the river's resilience and providing safe water and habitats for livelihoods, wildlife preservation, and food production. We collected 174 water and sediment samples from the upstream to the estuary of the Pearl River (PR), characterized the heavy metal and antibiotics contamination levels, and analyzed the spatiotemporal distribution by compiling historical datasets extracted from published research papers and governmental documents. We also assessed the feasibility of removing PR water heavy metals and antibiotics using biochars derived from two invasive plants, Bidens pilosa L. and Lantana camara. According to our findings, heavy metals and antibiotics in water and sediment increased towards the downstream region of the Pearl River Delta (PRD). The water and sediment samples obtained from the Dongguan and Shenzhen regions exhibited the most elevated levels of heavy metals, whereas the samples from the Huizhou region demonstrated the highest levels of antibiotics. Compared with previously published PRD sediment heavy metals (1976-2011) and antibiotics contamination data (2006-2017), we found that some heavy metals and all measured antibiotics contents in sediment substantially reduced (80-100%). Cu, Zn, Cr, and As significantly polluted the sediment in PRD. Shenzhen had the highest Index of geo-accumulation (Igeo) for Cu, Zn, and Cr, while Zhaoqing had the highest Igeo for As. The dominant antibiotics were Ciprofloxacin, Doxycycline, Norfloxacin, Ofloxacin, Oxytetracycline, and Tetracycline. Invasive plant-derived biochars showed high antibiotic removal capacity but failed to reduce most PR water heavy metals since these invasive plants are potential heavy metal hyperaccumulators. The spatial distribution of heavy metal and antibiotics concentration/content in water and sediment samples is primarily affected by anthropogenic activities such as industrialization, aquaculture, pharmaceutical, and agricultural practice. Our study provides insights into the extensive freshwater watersheds' decontamination and green policymaking.
