Current status and dilemmas of osteoporosis screening tools: A narrative review.

OBJECTIVE: This review aims to explore the strengths and dilemmas of existing osteoporosis screening tools and suggest possible ways of optimization, in addition to exploring the potential of AI-integrated X-ray imaging in osteoporosis screening, especially its ability to improve accuracy and applicability to different populations. To break through the dilemma of low accessibility, poor clinical translation, complexity of use, and apparent limitations of screening results of existing osteoporosis screening tools. DATA SOURCES: A comprehensive literature search was performed using PubMed, Web of Science, and CNKI databases. The search included articles published between 2000 and 2023, focusing on studies evaluating osteoporosis screening tools, Artificial intelligence applications in medical imaging, and implementing AI technologies in clinical settings. STUDY SELECTION: The Osteoporosis Risk Assessment Tool for Asians (OSTA), the Simple Calculated Osteoporosis Risk Estimator (SCORE), age, body size, one or no estrogen ever (ABONE), and the Osteoporosis Risk Index (OSIRIS) are the six commonly used screening tools for osteoporosis that are discussed in this review. In addition, the performance of AI-integrated imaging systems is explored in light of relevant research advances in Artificial intelligence in osteoporosis screening. Studies of the use of these tools in different populations and their advantages and disadvantages were included in the selection criteria. RESULTS: The results highlight that AI-integrated X-ray imaging technologies offer significant improvements over traditional osteoporosis screening tools. Artificial intelligence systems demonstrated higher accuracy by incorporating complex clinical data and providing personalized assessments for diverse populations. The studies showed that AI-driven imaging could enhance sensitivity and specificity, particularly in detecting early-stage bone density loss in patients with complex clinical profiles. The findings also suggest that Artificial intelligence technologies have the potential to be effectively applied in resource-limited settings through the use of mobile devices and remote diagnostics. CONCLUSIONS: AI-integrated X-ray imaging technology significantly advances osteoporosis screening, offering more accurate and adaptable solutions than traditional tools. Its ability to incorporate complex clinical data and apply it across various demographic groups makes it particularly promising in diverse and resource-limited environments. Further research is needed to explore the full potential of AI in enhancing screening accessibility and effectiveness, particularly in underserved populations.

Research Progress on the Role of Cartilage Endplate in Intervertebral Disc Degeneration.

Low back pain significantly impacts individuals' quality of life, with intervertebral disc degeneration (IDD) being a primary contributor to this condition. Currently, IDD treatment primarily focuses on symptom management and does not achieve a definitive cure. The cartilage endplate (CEP), a crucial nutrient-supplying tissue of the intervertebral disc, plays a pivotal role in disc degeneration. This review examines the mechanisms underlying CEP degeneration, summarizing recent advancements in understanding the structure and function of CEP, the involvement of various signaling pathways, and the roles of cartilage endplate stem cells (CESCs) and exosomes (Exos) in this process. The aim of this review is to provide a comprehensive reference for future research on CEP. Despite progress in understanding the role of CEP in IDD, the mechanisms underlying CEP degeneration remain incompletely elucidated. Future research poses significant challenges, necessitating further investigations to elucidate the complexities of CEP.

Effectiveness and Safety of High-Dose Tranexamic Acid in Adolescent Idiopathic Scoliosis Surgery: A Meta-Analysis and Systematic Review.

OBJECTIVE: This systematic review and meta-analysis of randomized controlled trials and retrospective controlled studies aims to evaluate the efficacy and safety of high-dose tranexamic acid (TXA) in spinal correction surgery for adolescent idiopathic scoliosis patients. METHODS: In March 2024, a comprehensive search was conducted in PubMed, Web of Science, Embase, and Cochrane databases to identify randomized controlled trials and retrospective controlled studies comparing the effects of high-dose TXA on blood loss and transfusion requirements during spinal correction surgery. RESULTS: This meta-analysis included 10 studies encompassing a total of 741 patients. The pooled results indicated that the use of high-dose TXA significantly reduced intraoperative blood loss [weighted mean difference (WMD) = -519.83, 95% CI (-724.74, -314.92), P < 0.00001], transfusion rate [RR = 0.28, 95% CI (0.17, 0.45), P < 0.00001], total blood loss [WMD = -891.09, 95% CI (-1623.92, -158.26), P = 0.02], and postoperative blood loss [WMD = -105.91, 95% CI (-141.29, -70.52), P < 0.00001]. There was no significant difference in operative time [WMD = -18.96, 95% CI (-40.20, 2.28), P = 0.08] and blood loss per segment [WMD = -50.51, 95% CI (-102.19, 1.17), P = 0.06]. Both groups had a comparable incidence of thromboembolic events. CONCLUSIONS: Our meta-analysis suggests that the use of high-dose TXA reduces intraoperative blood loss, transfusion rate, total blood loss, and postoperative blood loss in spinal correction surgery for adolescent idiopathic scoliosis patients. However, there were no significant differences in operative time and blood loss per segment.

Research progress on long non­coding RNAs in non­infectious spinal diseases (Review).

Spinal diseases, including intervertebral disc degeneration (IDD), ankylosing spondylitis, spinal cord injury and other non­infectious spinal diseases, severely affect the quality of life of patients. Current treatments for IDD and other spinal diseases can only relieve symptoms and do not completely cure the disease. Therefore, there is an urgent need to explore the causes of these diseases and develop new treatment approaches. Long non­coding RNA (lncRNA), a form of non­coding RNA, is abundant in diverse sources, has numerous functions, and plays an important role in the occurrence and development of spinal diseases such as IDD. However, the mechanism of action of lncRNAs has not been fully elucidated, and significant challenges remain in the use of lncRNAs as new therapeutic targets. The present article reviews the sources, classification and functions of lncRNAs, and introduces the role of lncRNAs in spinal diseases, such as IDD, and their therapeutic potential.

Research Progress of Long Non-coding RNA-ZFAS1 in Malignant Tumors.

Long non-coding RNAs (lncRNAs), although incapable of encoding proteins, play crucial roles in multiple layers of gene expression regulation, epigenetic modifications, and post-transcriptional regulation. Zinc finger antisense 1 (ZFAS1), a lncRNA located in the 20q13 region of the human genome, exhibits dual functions as an oncogene or tumor suppressor in various human malignancies. ZFAS1 plays a crucial role in cancer progression, metastasis, invasion, apoptosis, cell cycle regulation, and drug resistance through complex molecular mechanisms. Additionally, ZFAS1 has a long half-life of over 16 h, demonstrating exceptional stability, and making it a potential biomarker. This review integrates recent studies on the role and molecular mechanisms of ZFAS1 in malignancies and summarizes its clinical significance. By summarizing the role of ZFAS1 in cancer, we aim to highlight its potential as an anti-cancer biomarker and therapeutic target.

[Identification and characterization of a bacterial strain C3 capable of aerobic denitrification].

A bacterial strain C3 screened from the activated sludge was found capable of aerobic denitrification and the denitrifying capability of the strain was studied in batch culture under aerobic condition. The results showed that the nitrate in the culture could be efficiently removed by strain C3 and the nitrogen removal rate was up to above 90%. According to the morphological observation, physiological biochemical test and sequence analysis of the 16S rDNA, strain C3 was identified as Pseudomonas sp.. And the phylogentic position of the strain was performed based on the phylogenetic tree. The factors affecting aerobic denitrificatrion by strain C3 were also discussed. The results indicated that the most suitable temperature and pH value for aerobic denitrification were 30 degrees C and 7.0, respectively. The denitrification performance of strain C3 was almost not affected by the presence of oxygen and the strain C3 had a higher tolerance of dissolved oxygen concentration than other aerobic denitrifiers reported previously. The optimal C/N ratio was 5.5 - 6.0 and nearly complete denitrification can be obtained at the range of C/N ratio.

[Aerobic denitrification of nitrate wastewater and changes of microbial community structure in a bio-ceramic reactor].

Biological treatment of nitrate wastewater with aerobic denitrifiers in a bio-ceramic reactor was investigated. And denaturing gradient gel electrophoresis (DGGE) method was used for analyzing the stability of microbial community structure. At the condition of the influent with hydraulic loading 0.75 m/h, gas/water ratio 5:1-10:1, temperature 15-23 degrees C, COD loading rate 1.92-5.98 kg/(m3 x d) and NO3- -N loading rate 0.60-1.34 kg/(m3 x d), high nitrate nitrogen removal of almost 100% and the maximum total nitrogen removal of up to 95.73% were achieved during stable operation stage. In addition, the nitrite concentration of effluent was lower. The PCR-DGGE profiles showed that shift of microbial diversity corresponded to the effect of nitrate removal and the preponderant populations for aerobic denitrification were steady during the test period.