A meta-analysis of the risk of osteoporotic fractures in inflammatory bowel disease.

BACKGROUND: There are a variety of perspectives on the risk of osteoporotic fractures in inflammatory bowel disease (IBD), and few thorough assessments that are pertinent. OBJECTIVES: We conducted a meta-analysis to assess the risk of osteoporotic fractures in IBD. MATERIAL AND METHODS: A systematic literature search up to September 2022 was performed, and 1,158,982 subjects participated in the baseline trials of the selected studies. A total of 261,829 patients had IBD, while 897,153 were controls. Odds ratio (OR) and mean difference (MD) with 95% confidence intervals (95% CIs) were calculated to measure the risk of osteoporotic fractures in IBD patients using contentious and dichotomous approaches with a random or fixed influence model. RESULTS: The presence of IBD resulted in significantly higher frequency of osteoporotic fractures (OR: 1.42, 95% CI: 1.21-1.66, p < 0.001) compared to controls. Nevertheless, no significant differences in terms of osteoporotic fractures were found between ulcerative colitis (OR: 2.79, 95% CI: 0.88-8.87, p = 0.08) and Crohn's disease (OR: 1.84, 95% CI: 0.81-4.18, p = 0.14) compared to controls. CONCLUSION: This study found a strong correlation between the risk of osteoporotic fractures and inflammatory bowel disease. The small number of studies in certain comparisons requires care when analyzing the results.

Uncovering the mechanism of Radix Paeoniae Alba in the treatment of restless legs syndrome based on network pharmacology and molecular docking.

Restless legs syndrome (RLS) is a neurological motor disorder with a high prevalence. The treatment efficacy of RLS is unsatisfactory. Radix Paeoniae Alba (RPA) can effectively treat RLS symptoms such as the discomfort of the legs. RPA has great potential for the development of new medications for RLS. Hence, we explored the mechanism of RPA in the treatment of RLS using network pharmacology and molecular docking. The active components and targets of RPA were obtained from the Traditional Chinese Medicine System Pharmacology database and analysis platform and PharmMapper platform. The RLS-related targets were found in GeneCards, OMIM, DrugBank, and DisGeNET databases. The overlapping targets of RPA and RLS were then collected. The "active components-overlapping targets" network was built, and network topology analysis was performed. Furthermore, Cytoscape 3.9.1 software was used to screen the key components of RPA in the treatment of RLS. Protein-protein interaction was performed using the Search Tool for the Retrieval of Interacting Genes. The gene ontology functions and Kyoto Encyclopedia of Genes and Genomes signaling pathways were analyzed using ClusterProfiler, PathView, and other R packages to reveal the main mechanism of RPA in treating RLS. Component and protein structures were downloaded from the Traditional Chinese Medicine System Pharmacology and Protein Data Bank databases, respectively. The AutoDock 4.2.6 software was used for molecular docking. A total of 12 active components and 109 targets of RPA, as well as 2387 RLS-related targets, were collected. Following that, 47 overlapping targets were obtained. Furthermore, 5 key components and 12 core targets were screened. The results of gene ontology functions were as follows: 2368 biological processes, 264 molecular functions, and 164 cellular components. A total of 207 Kyoto Encyclopedia of Genes and Genomes signaling pathways were obtained, including the lipid and atherosclerosis pathway, the endocrine resistance pathway, the prolactin signaling pathway, and the IL-17 signaling pathway. The components and the core targets completed molecular docking stably. RPA has multi-component, multi-target, and multi-pathway characteristics in treating RLS, which could provide a basis for future research and improve clinical efficacy.

[3D mirror printing combined with minimally invasive percutaneous plate osteosynthesis in the treatment of adult median clavicle fracture].

OBJECTIVE: To retrospectively analyze clinical effect of 3D mirror printing combining with minimally invasive percutaneous plate osteosynthesis(MIPPO) technology in the treatment of adult clavicle fracture. METHODS: The clinical data of 32 adult patients with collarbone AllmanⅠdisplacement of fracture who had undergone the combination of 3D mirror printing with MIPPO technology treatment were collected from October 2019 to October 2020. There were 19 males and 13 females, aged from 19 to 55 years old with an average of(34.12±16.42) years old. According to Allman classification, there were 14 cases of AllmanⅠb and 18 cases of AllmanⅠc. Fracture occurred on the left in 17 cases and on the right in 15 cases. Postoperative complications, operation time, incision length, intraoperative blood loss, the number of fluoroscopies, fracture healing time of all patients were retrospectively analyzed, and the curative effect was evaluated by Constant-Murley shoulder joint score before operation, 1 and 6 months after operation. RESULTS: All the 32 patients were followed up for 6 to 8 months, with an average of (6.67±2.13) months. All the patients did not have postoperative complications such as incision infection and skin numbness in the operating area. The operation time was (35.37±4.28) min. The incision length was (3.78±0.45) cm. Intraoperative blood loss was(37.23±4.76) ml. The number of fluoroscopies was(3.12±0.47) times. Fracture healing time was (8.18±2.58) weeks. Constant-Murley shoulder joint score of the affected side at 1 and 6 months after operation was 81.08±3.92 and 98.03±1.05 respectively, which had a significant difference compared with 54.62±5.25 before operation(P<0.05). According to Constant-Murley shoulder function score at 6 months after operation, 30 cases were excellent and 2 cases were good. CONCLUSION: 3D mirror printing can effectively assist MIPPO technique in the treatment of adult clavicle AllmanⅠdisplaced fracture. It not only has the advantages of less trauma and fewer complications of the MIPPO technique, but also can further shorten the operation time and improve the operation maneuverability. It is a better method in the treatment of adult clavicle AllmanⅠdisplaced fracture.

CircHIPK3 alleviates inflammatory response and neuronal apoptosis via regulating miR-382-5p/DUSP1 axis in spinal cord injury.

BACKGROUND: Spinal cord injury (SCI) is one of the serious neurological diseases with high morbidity which may be treated with hematopoietic stem cell (HSC) transplants. Circular RNAs (circRNAs) play vital roles in SCI. The study aimed to reveal the function and mechanism of circRNA homeodomain interacting protein kinase 3 (HIPK3) in SCI. METHODS: SCI model in vitro was established by treating neuronal cells AGE1.HN with oxygen-glucose deprivation (OGD) and CoCl2. The levels of circHIPK3, miR-382-5p and dual specificity phosphatase 1 (DUSP1) were examined using quantitative real-time PCR (qRT-PCR) or western blot assay. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of inflammatory factors (IL-6 and TNF-α). Cell proliferation and apoptosis were evaluated by 5'-ethynyl-2'-deoxyuridine (EdU) assay and flow cytometry. Caspase-3 Colorimetric Assay Kit was used to detect aaspase-3 activity. The interactions among circHIPK3, miR-382-5p and DUSP1 were confirmed by dual-luciferase reporter and RNA immunoprecipitation assays. RESULTS: CircHIPK3 and DUSP1 were down-regulated, while miR-382-5p was up-regulated in OGD-induced AGE1.HN cells. Overexpression of circHIPK3 suppressed inflammatory response and cell apoptosis and promoted proliferation in OGD-induced AGE1.HN cells by sponging miR-382-5p. CircHIPK3 regulated DUSP1 expression by targeting miR-382-5p. MiR-382-5p inhibition hindered inflammatory response of IL-6 and TNF-α and neuronal apoptosis and promoted apoptosis via targeting DUSP1. CONCLUSION: CircHIPK3 overexpression alleviated OGD-induced AGE1.HN cell inflammatory response and neuronal apoptosis via regulating miR-382-5p/DUSP1 axis, indicating that circHIPK3 might be a promising therapeutic target for SCI.

Mechanical Analysis of Posterior Pedicle Screw System Placement and Internal Fixation in the Treatment of Lumbar Fractures.

Objective: Image segmentation technology is applied to separate a single vertebra from the three-dimensional model of the spine, so as to separate a single vertebra image with smaller error, higher degree of automation, and better results. The objectives are to study the biomechanical characteristics of posterior short-segment pedicle screw fixation by three-dimensional finite element method, analyze the mechanical characteristics of posterior pedicle screw rod fixation system under different factors, and demonstrate the feasibility of its application in the treatment of lumbar fracture. Methods: The authors searched the database for articles about the treatment of lumbar spine fracture, screw rod internal fixation system, and its mechanical parameters. The threshold segmentation method based on region segmentation method was used to segment the image, and the three-dimensional finite element model was used to analyze the biomechanical characteristics of different posterior internal fixation for lumbar spine fracture. Results: The posterior pedicle internal fixation system for the treatment of multilevel spinal fractures is a mature surgical technique and has fewer postoperative complications. Transpedicle fixation is effective and reliable. It can effectively restore the coronal and sagittal curvature of the vertebral body and restore the stability of the spine better. But the choice of internal fixation method should be individualized based on fracture type, identification of critical and secondary injury sites, and stability assessment. Only after mastering the biomechanical characteristics of the posterior screw rod system for the treatment of lumbar fracture, selecting the appropriate method, and fixing the appropriate movement unit can the best fixation be achieved. Conclusion: Threshold method is the most direct and simple image segmentation method. The core technology of thresholding is the selection of threshold, which will affect the final segmentation effect. The most common segmentation method is to calculate the segmentation threshold by histogram. The threshold method has less computation and good segmentation effect for the image with large contrast between background and target. Posterior pedicle screw rod system internal fixation has the advantages of less trauma, good reduction, reliable fixation, and less complications. The design, placement angle and depth of various internal fixation systems, and the number of fixed segments all show different mechanical characteristics. As long as we master the above characteristics, choose the appropriate method and fix the appropriate motor unit, and we can get the best fixation; it can be used as an effective treatment for lumbar fracture.

Application of Medical Imaging Based on Deep Learning in the Treatment of Lumbar Degenerative Diseases and Osteoporosis with Bone Cement Screws.

OBJECTIVE: To explore the application value of magnetic resonance spectroscopy (MRS) and GSI-energy spectrum electronic computed tomography (CT) medical imaging based on the deep convolutional neural network (CNN) in the treatment of lumbar degenerative disease and osteoporosis. METHODS: There were 56 cases of suspected lumbar degenerative disease and osteoporosis. A group of 56 subjects were examined using 1.5 TMR spectrum (MRS) and dual-energy X-ray absorptiometry (DXA) to collect the lumbar L3 vertebral body fat ratio (FF) and L1~4 vertebral bone mineral density (BMD) value. We divided the subjects into 2 groups with T value -2.5 as the critical point. Set T value > -2.5 as the negative group and T value ≤ -2.5 as the positive group. Pearson's method is used for FF-MRS and BMD correlation analyses. A group of all patients underwent GSI-energy spectrum CT scan, and X-ray bone mineral density (DXA) test results (bone density per unit area) were used as the gold standard to analyze the diagnosis of osteoporosis by the GSI-energy spectrum CT scan method value. RESULTS: The differences in FF and BMD between the negative group and the positive group were statistically significant (P < 0.01), and there was a highly negative correlation between the average value of FF and BMD. 30 cases were diagnosed as osteoporosis by DXA. The accuracy of GSI-energy spectrum CT medical imaging in diagnosing osteoporosis is 89.30%. The GSI-energy spectrum CT diagnosis of osteoporosis and DXA examination results have good consistency. CONCLUSION: Based on the deep convolutional neural network (CNN) MRS technology, GSI-energy spectrum CT medical imaging is used in the clinical diagnosis and treatment of lumbar degenerative lesions and osteoporosis. It has a good advantage in assessing bone quality and has good consistency with DXA examination and has better application value high.

[Finite element analysis of InterTan for the treatment of femoral intertrochanteric fractures].

OBJECTIVE: To study the biomechanical characteristics of InterTan for the treatment of femoral intertrochanteric fracture of Evans-Jensen IV. METHODS: Scanning the femur and internal plant of volunteers with spiral CT to obtain DICOM format data. Three-dimensional models of left femur and InterTan were reconstructed by Mimics software. On this basis, a three-dimensional finite element model of internal fixation for Evans-Jensen IV intertrochanteric fracture of femur was established. The stress and microstrain distribution of Von Mses in different models were studied. The biomechanical stability after internal fixation of the Evans Jensen IV femoral intertrochanteric fracture was analyzed. RESULTS: The stress pattern of the femur of InterTan model was the same as that of the normal femur, which was mainly located on the medial side of the proximal femur and the lower third of the femur. However, the stress of femur in InterTan model was lower than that in the same part of normal femur. The peak stress of the femur in the model was 13.92 MPa, located at the end of the inner plant in contact with the femur. The stress peak of the plant in the model was 146.5 MPa at the lower contact point between the tension nail and the main nail. CONCLUSIONS: InterTan fixation has obvious biomechanical advantages and is not easy to cause stress fractures in the middle femur in patients with osteopenic Evans-Jensen IV intertrochanteric fractures. In particular, for patients with greater activity in the intertrochanteric fracture of the Evans-Jensen IV femur, InterTan fixation has better stability and provides a theoretical basis for the choice of internal fixation.