Objective： To investigate the causal relationship between inflammatory bowel disease and osteoporotic fracture by using the two-sample Mendelian randomization (MR) method. Methods: The pooled data from GenomeWide Association Studies (GWAS) were analyzed. Samples from Crohn′s disease and ulcerative colitis were selected for further analysis, where GWAS summary data for Crohn′s disease and ulcerative colitis were obtained from the European IEU database, 20 883 for Crohn′s disease, 47 745 for ulcerative colitis, and GWAS summary data for osteoporotic fractures from the FinnGen database, 173 619. Single nucleotide polymorphisms (SNPs), which are closely associated with Crohn′s disease and ulcerative colitis, were used as instrumental variables (IVs), and the inverse variance weighting method (IVW), the MR-Egger regression method, the Weighted Median method (WME), Simple Mode method and the Weighted Mode method were used to evaluate the causal relationship by means of odds ratio (OR). The Cochran Q heterogeneity test was performed by IVW and MR-Egger method, horizontal pleiotropy analysis by MR_pleiotropy_test function and MR PRESSO pleiotropy test, sensitivity analysis by MR_leaveoneout_plot function, and F values were calculated to evaluate the presence of weak IVs bias. Results: A total of 52 SNPs closely related to Crohn′s disease were obtained as IVs, IVW result ［OR(95%CI): 1.12(1.03-1.22), P=0.006］, WME result ［OR(95%CI) 1.15(1.01-1.32), P=0.02］, MREgger results ［OR(95%CI) 1.16(0.94-1.44), P=0.15］. Simple Mode results ［OR(95%CI): 1.15(0.88-1.50), P=0.28］ and Weighted Mode results ［OR(95%CI): 1.16(0.97-1.39), P=0.10］ suggested a positive causal relationship between Crohn′s disease and osteoporotic fracture. In total, 88 SNPs closely associated with ulcerative colitis were obtained as IVs, IVW result ［OR(95%CI) 1.15(1.03-1.28), P=0.009］, MREgger result ［OR(95%CI): 1.35(1.03-1.75), P=0.02］, WME result ［OR(95%CI): 1.18(1.01-1.37), P=0.02］, Simple Mode result ［OR(95%CI): 1.15(0.86-1.55), P=0.32］ and Weighted Mode results ［OR(95%CI): 1.19(0.96-1.47), P=0.10］ suggested a positive causal relationship between ulcerative colitis and osteoporotic fracture. The results of the heterogeneity test in Crohn′s disease-osteoporotic fractures were P=0.55 and P=0.52, respectively, suggesting the absence of heterogeneity. The MR_pleiotropy_test function result was P=0.69, and the MR PRESSO method result was P=0.55, indicating the absence of pleiotropy, and the sensitivity analysis showed stable results. The heterogeneity tests of ulcerative colitis-osteoporotic fractures were P=0.23 and P=0.25, respectively, suggesting the absence of heterogeneity. The MR_pleiotropy_test function result was P=0.20, and the MR PRESSO method result was P=0.24, indicating the absence of pleiotropy, and the sensitivity analysis showed stable results. All F values were greater than 10, suggesting that there was no weak IVs bias. Conclusion: Inflammatory bowel disease may increase the risk of osteoporotic fractures.

Objective： To investigate the relationship between serum glucagon-like peptide-1 (GLP-1) level and bone mineral density, bone turnover markers and osteoporotic fracture in postmenopausal women. Methods： From January 2020 to December 2021, a total of 206 postmenopausal women who received physical examination were enrolled. According to the results of dual-energy X-ray absorptiometry in patients with lumbar spine and left hip bone density, they were divided into osteoporosis group (90 cases) and non-osteoporosis group (116 cases).The serum GLP-1, type Ⅰ procollagen N-terminal propeptide (PINP), osteocalcin (OC), β-type Ⅰ collagen C-terminal peptide (β-CTX), specific bone alkaline phosphatase (BALP) and tartrate-resistant acid phosphatase (TRACP) levels were determined. The probability of osteoporotic fracture was assessed by the Osteoporotic Fracture Risk Prediction Simple Tool (FRAX). The general information between the two groups (age, menopausal age, menopausal years, height, weight, BMI, waist circumference, hip circumference, waist/hip and bone mineral density of each part), differences in serum GLP-1 and bone turnover markers were compared and the correlation between serum GLP-1 level and bone turnover markers, the probability of osteoporotic fracture in postmenopausal women was analyzed. Binary logistic regression analysis was performed on the influencing factors of osteoporosis in postmenopausal women. Results： Compared with the non-osteoporosis group, the number of menopausal years of the patients in the osteoporosis group increased significantly, and the weight, waist circumference, hip circumference, BMI and bone mineral density of all parts decreased significantly. There was no statistical difference between the two groups in age, menopausal age, height, waist/hip.The serum GLP-1 level in osteoporosis group was significantly lower than that in non-osteoporosis group, the levels of PINP and OC were significantly higher, TRACP, BALP, β-CTX has no statistical difference between the two groups.GLP-1 level was not correlated with bone turnover markers, but positively correlated with bone mineral density of L1-4 sum, femoral neck and left hip sum. GLP-1 level was negatively correlated with major osteoporotic fracture probability (MOFP) and hip osteoporotic fracture probability (HOFP). BMI and GLP-1 levels can be considered as independent protective factors for postmenopausal osteoporosis, and years of menopause and OC levels can be considered as independent risk factors for osteoporosis. Conclusion： Serum GLP-1 levels were significantly decreased in postmenopausal women with osteoporosis. GLP-1 levels can be considered as an independent protective factor for postmenopausal osteoporosis. GLP-1 levels are associated with the risk of osteoporotic fractures in the postmenopausal women.
［Key words］glucagon-like peptide 1; postmenopausal osteoporosis; bone turnover marker; bone mineral density; osteoporotic fracture

Objective:The L1000 micro-interference data set was used to screen compounds for the treatment of osteoporosis, and the evaluation and cytological activity verification by multiple biological information methods were conducted, aiming to discover new osteoporosis treatment drugs.Methods:The data related to osteoporosis（OP）were retrieved in the GEO（Gene Expression Omnibus）database, and the difference in gene expression levels on the datasets was analyzed using limma package in R language. Pathway enrichment analysis of differential genes was performed using MetaScape data platform. The resulting differential OP gene expression profiles were analyzed to match potential OP therapeutic compounds in the L1000 dataset of the Connectivity Map database. The molecular docking study of the matching compounds and bone metabolism targets was conducted by Autodock_Vina software, and the ADMET（absorption, distribution, metabolism, excretion, and toxicity）characteristics of the matching compounds were calculated and analyzed by using pkCSM database. The activity of the candidate compound was studied by a cell proliferative activity experiment.Results:After analyzing the dataset of osteoporosis expression profile, 195 differential genes related to osteoporosis were obtained, including 127 genes with significantly up-regulated expression and 68 genes with significantly downregulated expression. There were 146 GO Biological Processes with differential gene enrichment;There were nine enriched KEGG signaling pathways and nine enriched Reactome Gene Sets. A total of 10 potential therapeutic compounds were matched in the L1000 dataset: diethylstilbestrol, PLX-4720, mezlocillin, KU-C103428N, rhapontin, maravir, quinine, MST-312, risperidone, and CO-102862. Through molecular docking studies, we found that the matching compounds have multi-target characteristics, and the main docking activities with the compounds are CAⅡ, PGR, ERβ, BMP2 and other OP targets. The ADMET properties of potential therapeutic compounds were calculated using the ADMET calculation module of the pkCSM database, which showed that mezlocillin had good ADME performance and low toxicity, with good comprehensive evaluation. Cell proliferation experiment showed that mezlocillin at 20 μg/mL had the most significant effect on the proliferation of osteoblasts.Conclusion:The candidate OP therapeutic compound, mezlocillin, was screened from the L1000 data set with good ADMET characteristics and bone cell proliferation promoting activity.

Objective:To evaluate the clinical efficacy of the sequential infusion of bone cement when percutaneous kyphoplasty(PKP) was conducted for the treatment of osteoporotic vertebral compression fracture(OVCF) with posterior wall bone defects. Methods: Patients with posterior wall bone defects OVCF treated in our department from May 2016 to July 2020 were retrospectively analyzed. A total of 32 patients meeting the inclusion and exclusion criteria were treated by the sequential infusion of bone cement when PKP was applied. The visual analog score(VAS), Oswestry disability index(ODI), Cobb angle and height of injured vertebra were recorded and compared before surgery and 1 and 3 months after surgery. Postoperative bone cement leakage and complications were also recorded. Results:The postoperative VAS,ODI and Cobb angle of injured vertebra were significantly lower than those before surgery(P＜0.05).The postoperative height of the injured vertebra was significantly higher than that before surgery(P＜0.05). However, there was no significant differences between followup results at 1 and 3 months postoperatively(P＞0.05). There were 3 cases (9.38%) of bone cement leakage, without any cases of spinal canal leakage. No surgical complications such as nerve injury and pulmonary embolism were observed. Conclusion:Sequential infusion of bone cement during PKP is a safe and effective surgery for the OVCF with posterior wall bone defects, which could effectively reduce the bone cement leakage.

目的: 探讨应用自体大块髂骨结构性植骨结合锁定钢板治疗老年骨质疏松性肱骨近端Neer三、四部分骨折的临床效果。方法: 回顾性分析2016年1月至2020年9月成都市第一人民医院收治的58例老年骨质疏松性肱骨近端Neer三、四部分骨折患者的临床资料。根据手术方式的不同分为单纯锁定钢板治疗组（A组,33例）和应用自体大块髂骨结构性植骨结合锁定钢板治疗组（B组,25例）。记录并比较两组患者手术时间、术中出血量、术中透视次数、手术切口并发症；术后通过X线片评估骨折及内固定稳定情况、骨折愈合情况；根据Neer肩关节功能评分比较两组患者肩关节功能。结果: A组手术时间和术中出血量均优于B组(P均<0.05）。两组患者均获随访,随访时间12～24个月,平均14.3个月。A组并发症发生率（12%）明显高于B组（4%）,差异有统计学意义(χ2=1.191,P<0.05）。末次随访B组Neer肩关节功能评分明显高于A组(P<0.05）,骨折愈合时间明显短于A组(P<0.05）。结论: 对于老年骨质疏松性肱骨近端Neer三、四部分骨折,应用自体大块髂骨结构性植骨结合锁定钢板植骨固定牢靠,可减少术后出现内翻畸形,与单纯锁定钢板固定比较,肩关节功能恢复更好。

骨质疏松症是以骨的微观结构破坏为特征,易于导致骨折发生的代谢性骨病。近年来随着对骨质疏松研究的进展,诸多研究者发现淫羊藿及其衍生物治疗骨质疏松的潜力巨大,且临床使用疗效良好。本文综述了淫羊藿苷刺激成骨细胞的生成和骨合成、抑制破骨细胞的生成和骨吸收以及临床应用的研究进展,旨在为临床使用淫羊藿治疗骨质疏松提供相关思路。

Objective:To explore the potential mechanism of Astragalus membranaceus and Atractylodes macrocephala in the treatment of osteoporotic fracture (OPF) based on network pharmacology.  Methods:  The active components and action targets of Astragalus membranaceus and Atractylodes macrocephala were screened by pharmacologic database and Analysis Platform (TCMSP) . GeneCards, OMIM and TTD databases related to disease targets were retrieved to screen the action targets of OPF, and then the intersection core targets of Astragalus membranaceus, Atractylodes macrocephala membranaceus and OPF were screened.  Cytoscape 3.7.1 software was used to construct a compoundtargetdisease network, and DAVID database was used to analyze the enrichment of GO function and KEGG pathway.  Results: Based on TCMSP database, 19 active components and 115 intersection targets of Astragalus membranaceusAtractylodes for OPF were screened. A total of 568 items were obtained by GO functional enrichment analysis, including 433 biological process items, 43 cell composition items and 92 molecular function items.  KEGG pathway enrichment analysis revealed 111 items, including AGE-RAGE, IL-17, TNF, prostate cancer, Toll-like receptor, HIF-1, NF-κB signaling pathway, etc.  Conclusion: Astragalus membranaceus and Atelectylodes atelectylodes may regulate inflammatory response and internal balance of osteoclasts by regulating TNF, NF-κB and HIF-1 signaling pathways, and thus exert therapeutic actions on OPF.