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Zhu TY, Liu K. [Research progress on the relationship between myopia and glaucoma]. Zhonghua Yan Ke Za Zhi 2023; 59:757-763. [PMID: 37670661 DOI: 10.3760/cma.j.cn112142-20221129-00607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
Myopia and glaucoma are two common ocular diseases that pose significant health and economic burdens to patients, their families, and society. In recent years, the relationship between these two conditions has become a prominent research focus. This article provides a systematic review of the current research progress on the association between myopia and glaucoma, with a primary emphasis on discussing the two major viewpoints: myopia as a risk factor for glaucoma development and the multifaceted impact of myopia on glaucoma progression. Possible mechanisms and potential clinical biomarkers are outlined, and the academic community's complementary insights and doubts regarding these viewpoints are summarized. Additionally, unresolved issues in existing studies are identified to pave the way for future scientific explorations, aiming to further elucidate the relationship between myopia and glaucoma and optimize the clinical diagnosis and management of glaucoma.
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Affiliation(s)
- T Y Zhu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai 200080, China
| | - K Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai 200080, China
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Tong JL, Zhu GH, Sun DW, Lu D, Cheng YF, Chen H, Pei LJ, Yin X, Zhou WD, Zhang W, Ling D, Xie X, Tan X, Zhu YJ, Wu XM, Hu CY, Li H, Wang Y, Fan JY, Jia XM, Zhu TY, Chen LM, Guo HY, Zhao SJ, Wang S, Feng SW, He XY, Chi YG, Sun XL, Lang JH, Sui L, Zhu L. [Consensus of Chinese experts on hysteroscopy day surgery center set-up and management process]. Zhonghua Fu Chan Ke Za Zhi 2022; 57:891-899. [PMID: 36562222 DOI: 10.3760/cma.j.cn112141-20220925-00594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Fan JP, Zhu TY, Sun MQ, Shi J, Liu AL, Qin L, Song L, Liu YP, Tian XL, Liu JH. [Tuberculosis presenting as gastrointestinal perforation and large confluent pulmonary cavities: a case report]. Zhonghua Jie He He Hu Xi Za Zhi 2022; 45:904-909. [PMID: 36097928 DOI: 10.3760/cma.j.cn112147-20220209-00102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
We report an unusual case presented as acute gastrointestinal perforation and large confluent pulmonary cavities. A 23-year-old male was admitted to the emergency department with complaints of abdominal pain for 1 month, which exacerbated for 1 day. He also reported a 3-month history of diarrhea and productive cough. Computed tomography (CT) scan showed multiple large confluent cavities in the lung, along with massive free gas in the abdomen suggesting gastrointestinal perforation. Exploratory laparotomy was performed and affected bowel segment was resected. His sputum examination was positive for both acid-fast staining and Mycobacterium tuberculosis complex gene (Xpert) testing. Pathology of small intestine revealed micro-abscess formation and was positive for acid-fast bacilli. A final diagnosis of pulmonary tuberculosis and intestinal tuberculosis was made.
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Affiliation(s)
- J P Fan
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - T Y Zhu
- Department of Medical Intensive Care Unit, Peking Union Medical College Hospital, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - M Q Sun
- Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - J Shi
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - A L Liu
- Department of Emergency Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - L Qin
- Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - L Song
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Y P Liu
- Department of Medical Genetics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - X L Tian
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - J H Liu
- Department of Emergency Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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Li X, Wang HL, Zhou TY, Chen SQ, Nie CH, Zhang YL, Yu ZN, Zhou GH, Zhu TY, Sun JH. [Analysis of influencing factors of shunt dysfunction after transjugular intrahepatic portosystemic shunt in liver cirrhosis accompanied with portal vein thrombosis]. Zhonghua Gan Zang Bing Za Zhi 2020; 28:742-746. [PMID: 33053973 DOI: 10.3760/cma.j.cn501113-20200301-00079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the efficacy of shunt after transjugular intrahepatic portosystemic shunt (TIPS) in liver cirrhosis accompanied with portal vein thrombosis (PVT). Methods: Forty-four cases with liver cirrhosis accompanied with PVT who underwent TIPS treatment from January 2015 to May 2018 were retrospectively analyzed. Clinical baseline data of the patients were collected. Portal vein pressure gradient (PVPG) before and after the surgery was recorded. Shunt patency was observed at 3, 6, 12, 18 and 24 months after the surgery. The influencing factors were determined by univariate and multivariate analysis. Results: Transjugular intrahepatic portosystemic shunt was successfully established in all 44 cases. The postoperative PVPG was lower than preoperative (P < 0.01). The shunt patency rate after TIPS in PVT was 18.2% (n = 8). The cumulative shunt patency rates at 3, 6, 12, 18, and 24 months after surgery were 95.5%, 90.7%, 90.7%, 86.8% and 74.4%, respectively. Univariate analysis showed that diabetes history, platelet level and prothrombin time-international normalized ratio were associated with postoperative shunt dysfunction. Multivariate analysis showed that diabetes history (P = 0.007, OR = 28.606) was an independent risk factor for postoperative shunt dysfunction. Conclusion: TIPS is a safe and feasible procedure, which can effectively reduce the portal pressure in liver cirrhosis accompanied with PVT. Diabetic patients have a higher risk of postoperative shunt dysfunction. Therefore, clinical intervention should be strengthened for high-risk patients.
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Affiliation(s)
- X Li
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China; Department of Radiology, the Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - H L Wang
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China; Zhejiang Clinical Research Center of Hepatobiliary and Pancreatic Diseases, Hangzhou 310003, China
| | - T Y Zhou
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China; Zhejiang Provincial Research Center for Diagnosis and Treatment of Heapatobiliary Diseases, Hangzhou 310003, China
| | - S Q Chen
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China; Zhejiang Provincial Research Center for Diagnosis and Treatment of Heapatobiliary Diseases, Hangzhou 310003, China
| | - C H Nie
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China; Zhejiang Clinical Research Center of Hepatobiliary and Pancreatic Diseases, Hangzhou 310003, China
| | - Y L Zhang
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China; Zhejiang Clinical Research Center of Hepatobiliary and Pancreatic Diseases, Hangzhou 310003, China
| | - Z N Yu
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China; Zhejiang Clinical Research Center of Hepatobiliary and Pancreatic Diseases, Hangzhou 310003, China
| | - G H Zhou
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China; Zhejiang Clinical Research Center of Hepatobiliary and Pancreatic Diseases, Hangzhou 310003, China
| | - T Y Zhu
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China; Zhejiang Clinical Research Center of Hepatobiliary and Pancreatic Diseases, Hangzhou 310003, China
| | - J H Sun
- Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China; Zhejiang Clinical Research Center of Hepatobiliary and Pancreatic Diseases, Hangzhou 310003, China; Zhejiang Provincial Research Center for Diagnosis and Treatment of Heapatobiliary Diseases, Hangzhou 310003, China
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Hu XP, Tian Y, Zhu TY, Chen JH, Wang CX, Li XT, Xue WJ, Lin T, Peng LK, Tan JM, Feng GW, Chen ZS, Han WK, Dong J, Fan Y, Zhang XD. [Risk factors for acute rejection in living-donor kidney transplant recipients in China: a subgroup analysis of a multi-center, registry study]. Zhonghua Yi Xue Za Zhi 2017; 97:85-91. [PMID: 28088950 DOI: 10.3760/cma.j.issn.0376-2491.2017.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate pre-and early post-transplantation risk factors for acute rejection(AR) in kidney recipients. Methods: This subgroup analysis of a multi-center registry study was conducted on living-donor kidney transplant recipients in China with 10 years of follow-up. This study analyzed 1 255 recipients including 921 males(73.4%) and with a mean age of (33±10)years. Data from patients were first analyzed with univariate analysis and then multivariate analysis was used for finding out the potential risk factors of AR. Results: A total of 106(8.4%) patients were suspected with AR after kidney transplantation, while 1 149 patients were considered as non-AR. Multivariable analysis demonstrated a significant influence of recipient age and cold ischemia time(CIT) on the occurrence of AR(OR: 0.956, 95% CI: 0.923-0.990; OR: 1.006, 95% CI: 1.002-1.011, respectively). The frequency of severe infection was significantly higher in the AR group than non-AR group(38.7% vs 10.8%; P<0.000 1). The occurrence of new-onset diabetes mellitus and tumors was similar in the two groups. Conclusions: Recipient age and CIT are risk factors for AR after living-donor kidney transplantation. Reducing CIT and intensive management of younger recipient could benefit kidney transplant patients.
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Affiliation(s)
- X P Hu
- Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Cheung TF, Cheuk KY, Yu FWP, Hung VWY, Ho CS, Zhu TY, Ng BKW, Lee KM, Qin L, Ho SSY, Wong GWK, Cheng JCY, Lam TP. Prevalence of vitamin D insufficiency among adolescents and its correlation with bone parameters using high-resolution peripheral quantitative computed tomography. Osteoporos Int 2016; 27:2477-88. [PMID: 27010646 DOI: 10.1007/s00198-016-3552-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 02/23/2016] [Indexed: 12/25/2022]
Abstract
UNLABELLED Vitamin D deficiency and insufficiency are highly prevalent among adolescents in Hong Kong, which is a sub-tropical city with ample sunshine. Vitamin D level is significantly correlated with key bone density and bone quality parameters. Further interventional studies are warranted to define the role of vitamin D supplementation for improvement of bone health among adolescents. INTRODUCTION The relationship between bone quality parameters and vitamin D (Vit-D) status remains undefined among adolescents. The aims of this study were to evaluate Vit-D status and its association with both bone density and bone quality parameters among adolescents. METHODS Three hundred thirty-three girls and 230 boys (12-16 years old) with normal health were recruited in summer and winter separately from local schools. Serum 25(OH) Vit-D level, bone density and quality parameters by Dual Energy X-ray Absorptiometry (DXA) and High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT), dietary calcium intake, and physical activity level were assessed. RESULTS Sixty-four point seven percent and 11.4 % of subjects were insufficient [25 ≤ 25(OH)Vit-D ≤ 50 nmol/L] and deficient [25(OH)Vit-D < 25 nmol/L] in Vit-D, respectively. The mean level of serum 25(OH)Vit-D in summer was significantly higher than that in winter (44.7 ± 13.6 and 35.9 ± 12.6 nmol/L, respectively) without obvious gender difference. In girls, areal bone mineral density (aBMD) and bone mineral content (BMC) of bilateral femoral necks, cortical area, cortical thickness, total volumetric bone mineral density (vBMD), and trabecular thickness were significantly correlated with 25(OH)Vit-D levels. In boys, aBMD of bilateral femoral necks, BMC of the dominant femoral neck, cortical area, cortical thickness, total vBMD, trabecular vBMD, BV/TV, and trabecular separation were significantly correlated with 25(OH)Vit-D levels. CONCLUSION Vit-D insufficiency was highly prevalent among adolescents in Hong Kong with significant correlation between Vit-D levels and key bone density and bone quality parameters being detected in this study. Given that this is a cross-sectional study and causality relationship cannot be inferred, further interventional studies investigating the role of Vit-D supplementation on improving bone health among adolescents are warranted.
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Affiliation(s)
- T F Cheung
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, General Office, 5/F LCW Clinical Sciences Building, Sha Tin, NT, Hong Kong, China
| | - K Y Cheuk
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, General Office, 5/F LCW Clinical Sciences Building, Sha Tin, NT, Hong Kong, China
| | - F W P Yu
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, General Office, 5/F LCW Clinical Sciences Building, Sha Tin, NT, Hong Kong, China
| | - V W Y Hung
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, General Office, 5/F LCW Clinical Sciences Building, Sha Tin, NT, Hong Kong, China
| | - C S Ho
- Department of Chemical Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | - T Y Zhu
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, General Office, 5/F LCW Clinical Sciences Building, Sha Tin, NT, Hong Kong, China
| | - B K W Ng
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, General Office, 5/F LCW Clinical Sciences Building, Sha Tin, NT, Hong Kong, China
| | - K M Lee
- Lee Hysan Clinical Research Laboratory, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | - L Qin
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, General Office, 5/F LCW Clinical Sciences Building, Sha Tin, NT, Hong Kong, China
| | - S S Y Ho
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | - G W K Wong
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | - J C Y Cheng
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, General Office, 5/F LCW Clinical Sciences Building, Sha Tin, NT, Hong Kong, China
- SH Ho Scoliosis Research Laboratory, Sha Tin, Hong Kong, China
| | - T P Lam
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, General Office, 5/F LCW Clinical Sciences Building, Sha Tin, NT, Hong Kong, China.
- SH Ho Scoliosis Research Laboratory, Sha Tin, Hong Kong, China.
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Cheuk KY, Zhu TY, Yu FWP, Hung VWY, Lee KM, Qin L, Cheng JCY, Lam TP. Abnormal Bone Mechanical and Structural Properties in Adolescent Idiopathic Scoliosis: A Study with Finite Element Analysis and Structural Model Index. Calcif Tissue Int 2015; 97:343-52. [PMID: 26100651 DOI: 10.1007/s00223-015-0025-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 06/15/2015] [Indexed: 11/29/2022]
Abstract
Previous studies found adolescent idiopathic scoliosis (AIS) is associated with low bone mineral density (BMD) and abnormal bone quality, whilst the association between AIS and their bone strength is unknown. From high-resolution peripheral quantitative computed tomography-generated images, bone mechanical properties can be evaluated with finite element analysis (FEA), and trabecular rod-plate configuration related to trabecular bone strength can be quantified by structure model index (SMI). This study aimed to compare trabecular configuration and bone mechanical properties between AIS and the controls. 95 AIS girls aged 12-14 years and 97 age- and gender-matched normal controls were recruited. Bilateral femoral necks and non-dominant distal radius were scanned by dual-energy X-ray absorptiometry for areal BMD and HR-pQCT for SMI and FEA, respectively. Subjects were further classified into osteopenic and non-osteopenic group based on their areal BMD. Bone mechanical properties (stiffness, failure load and apparent modulus) were calculated using FEA. Linear regression model was used for controlling age, physical activity and calcium intake. AIS was associated with lower failure load and apparent modulus after adjusting for age, whereas AIS was associated with lower apparent modulus after adjusting for all confounders. Osteopenic AIS was associated with more rod-like trabeculae when compared with non-osteopenic AIS, whereas no difference was detected between osteopenic and non-osteopenic controls. This might be the result of abnormal regulation and modulation of bone metabolism and bone modelling and remodelling in AIS which will warrant future studies with a longitudinal design to determine the significance of micro-architectural abnormalities in AIS.
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Affiliation(s)
- K Y Cheuk
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong and Nanjing, China
| | - T Y Zhu
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Department of Orthopaedics and Traumatology, Bone Quality and Health Centre, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - F W P Yu
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong and Nanjing, China
- Department of Orthopaedics and Traumatology, Bone Quality and Health Centre, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - V W Y Hung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Department of Orthopaedics and Traumatology, Bone Quality and Health Centre, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - K M Lee
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong and Nanjing, China
- Lee Hysan Clinical Research Laboratories, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - L Qin
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Department of Orthopaedics and Traumatology, Bone Quality and Health Centre, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - J C Y Cheng
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong and Nanjing, China
- Department of Orthopaedics and Traumatology, Bone Quality and Health Centre, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - T P Lam
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
- Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong and Nanjing, China.
- Department of Orthopaedics and Traumatology, Bone Quality and Health Centre, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
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Hung VWY, Zhu TY, Cheung WH, Fong TN, Yu FWP, Hung LK, Leung KS, Cheng JCY, Lam TP, Qin L. Age-related differences in volumetric bone mineral density, microarchitecture, and bone strength of distal radius and tibia in Chinese women: a high-resolution pQCT reference database study. Osteoporos Int 2015; 26:1691-703. [PMID: 25627115 DOI: 10.1007/s00198-015-3045-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 01/18/2015] [Indexed: 01/23/2023]
Abstract
UNLABELLED In a cohort of 393 Chinese women, by using high-resolution peripheral quantitative computed tomography (HR-pQCT), we found that significant cortical bone loss occurred after midlife. Prominent increase in cortical porosity began at the fifth decade but reached a plateau before the sixth decade. Trabecular bone loss was already evident in young adulthood and continued throughout life. INTRODUCTION This study aimed to investigate age-related differences in volumetric bone mineral density (vBMD), microarchitecture, and estimated bone strength at peripheral skeleton in Chinese female population. METHODS In a cross-sectional cohort of 393 Chinese women aged 20-90 years, we obtained vBMD, microarchtecture, and micro-finite element-derived bone strength at distal radius and tibia using HR-pQCT. RESULTS The largest predictive age-related difference was found for cortical porosity (Ct.Po) which showed over four-fold and two-fold differences at distal radius and tibia, respectively, over the adulthood. At both sites, cortical bone area, vBMD, and thickness showed significant quadratic association with age with significant decrease beginning after midlife. Change of Ct.Po became more prominent between age of 50 and 57 (0.26 %/year at distal radius, 0.54 %/year at distal tibia, both p ≤ 0.001) but thereafter, reached a plateau (0.015 and 0.028 %/year, both p > 0.05). In contrast, trabecular vBMD and microarchitecture showed linear association with age with significant deterioration observed throughout adulthood. Estimated age of peak was around age of 20 for trabecular vBMD and microarchitecture and Ct.Po and age of 40 for cortical vBMD and microarchitecture. Estimated stiffness and failure load peaked at mid-30s at the distal radius and at age 20 at distal tibia. CONCLUSIONS Age-related differences in vBMD and microarchitecture in Chinese women differed by bone compartments. Significant cortical bone loss occurred after midlife. Prominent increase in Ct.Po began at the fifth decade but appeared to be arrested before the sixth decade. Loss of trabecular bone was already evident in young adulthood and continued throughout life.
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Affiliation(s)
- V W Y Hung
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - T Y Zhu
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - W-H Cheung
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Joint ACC-CUHK Space Medicine Center on Health Maintenance of Musculoskeletal System (Shenzhen Base of ACC-CUHK State Key Lab of Basic and Applied Space Medicine), The Chinese University Shenzhen Research Institute, Shenzhen, China
| | - T-N Fong
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - F W P Yu
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - L-K Hung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - K-S Leung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Joint ACC-CUHK Space Medicine Center on Health Maintenance of Musculoskeletal System (Shenzhen Base of ACC-CUHK State Key Lab of Basic and Applied Space Medicine), The Chinese University Shenzhen Research Institute, Shenzhen, China
| | - J C Y Cheng
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Joint ACC-CUHK Space Medicine Center on Health Maintenance of Musculoskeletal System (Shenzhen Base of ACC-CUHK State Key Lab of Basic and Applied Space Medicine), The Chinese University Shenzhen Research Institute, Shenzhen, China
| | - T-P Lam
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China.
| | - L Qin
- Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, SAR, China.
- Translational Medicine Research and Development Center, Institute of Biomedical and Health Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
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Zhu TY, Griffith JF, Qin L, Hung VWY, Fong TN, Au SK, Tang XL, Kun EW, Kwok AW, Leung PC, Li EK, Tam LS. Cortical thinning and progressive cortical porosity in female patients with systemic lupus erythematosus on long-term glucocorticoids: a 2-year case-control study. Osteoporos Int 2015; 26:1759-71. [PMID: 25736166 DOI: 10.1007/s00198-015-3077-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 02/11/2015] [Indexed: 10/23/2022]
Abstract
UNLABELLED In this study, we characterized longitudinal changes of volumetric bone mineral density and cortical and trabecular microstructure at the distal radius using HR-pQCT in female systemic lupus erythematosus (SLE) patients on long-term glucocorticoids. Cortical thinning and increased cortical porosity are the major features of longitudinal microstructural deterioration in SLE patients. INTRODUCTION The study aims to characterize longitudinal changes of volumetric bone mineral density (vBMD) and bone microstructure at distal radius in female systemic lupus erythematosus (SLE) patients on long-term glucocorticoids. METHODS This 2-year case-control study consisted of 166 premenopausal subjects (75 SLE patients and 91 controls) and 79 postmenopausal subjects (44 SLE patients and 35 controls). We obtained areal BMD (aBMD) by dual-energy X-ray absorptiometry at multiple skeletal sites and indices of vBMD and microstructure at distal radius by high-resolution peripheral quantitative computed tomography (HR-pQCT) at baseline, 12 and 24 months. RESULTS In either premenopausal or postmenopausal subjects, changes in aBMD did not differ between patients and controls except that decrease in aBMD at total hip at 24 months in premenopausal patients was significantly higher. In premenopausal subjects, decrease in cortical area (-0.51 vs. -0.06 %, p = 0.039) and thickness (-0.63 vs. 0.02 %, p = 0.031) and increase in cortical porosity (21.7 vs. 7.16 %, p = 0.030) over study period were significantly larger in patients after adjustment of age and body mass index. Decreased in trabecular vBMD was significantly less (-0.63 vs. -2.32 %, p = 0.001) with trabecular microstructure better maintained in patients. In postmenopausal subjects, decrease in cortical vBMD (-2.66 vs. -1.56 %, p = 0.039) and increase in cortical porosity (41.6 vs. 16.3 %, p = 0.021) were significantly higher in patients, and there was no group-wise difference in change of trabecular microstructure. CONCLUSION Longitudinal microstructural deterioration in SLE is characterized by cortical thinning and increased cortical porosity. Cortical bone is an important source of bone loss in SLE patients on glucocorticoids.
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Affiliation(s)
- T Y Zhu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Bone Quality and Health Center, Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - J F Griffith
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - L Qin
- Bone Quality and Health Center, Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - V W Y Hung
- Bone Quality and Health Center, Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - T-N Fong
- Bone Quality and Health Center, Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - S-K Au
- The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - X-L Tang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - E W Kun
- Department of Medicine and Geriatrics, Tai Po Hospital, Tai Po, Hong Kong SAR, China
| | - A W Kwok
- The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - P-C Leung
- The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - E K Li
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - L-S Tam
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
- Department of Medicine & Therapeutics, The Prince of Wales Hospital, 9/F Clinical Sciences Building, 30-32 Ngan Shing Street, Shatin, N.T, Hong Kong SAR, China.
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Zhu TY, Griffith JF, Qin L, Hung VWY, Fong TN, Au SK, Kwok AW, Leung PC, Li EK, Tam LS. Density, structure, and strength of the distal radius in patients with psoriatic arthritis: the role of inflammation and cardiovascular risk factors. Osteoporos Int 2015; 26:261-72. [PMID: 25160570 DOI: 10.1007/s00198-014-2858-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 08/13/2014] [Indexed: 01/21/2023]
Abstract
UNLABELLED We investigated the densitometric and microstructural features of the distal radius in psoriatic arthritis (PsA) patients using high-resolution peripheral quantitative computed tomography. PsA patients have unique bone microstructural deficits, manifested as lower cortical bone density and higher cortical porosity, which are associated with a propensity to bone fragility. INTRODUCTION The aim of this study was to investigate the densitometric, geometric, microstructural, and biomechanical features of the distal radius in psoriatic arthritis (PsA) patients. METHODS This study cohort consisted of 53 PsA patients (24 males and 29 females), with an average age of 53.1 years and 53 gender- and age-matched controls. Areal bone mineral density (aBMD) of the hip, lumbar spine, and ultradistal radius was measured by dual-energy X-ray absorptiometry. High-resolution peripheral quantitative computed tomography (HR-pQCT) was performed at the distal radius to obtain measures of volumetric BMD (vBMD), microstructure, and derived biomechanical indices. RESULTS There were no significant between-group differences in aBMD at the femoral neck, total hip, and ultradistal radius, while aBMD at the lumbar spine was significantly higher in patients. The only indices indicating compromised bone quality in PsA patients were related to cortical bone quality. Cortical vBMD were -3.8% significantly lower, while cortical pore volume, porosity index, and pore diameter were 108, 79.5, and 8.6%, respectively, significantly higher in patients. Cortical stress was marginally lower (-1.3%, p = 0.077) in patients with stress significantly more unevenly distributed (4.9%, p = 0.035). Endocortical perimeter and cortical pore volume were significantly higher in patients with vertebral fracture. Deficits in cortical bone quality were associated with indices of disease activity/severity and were more prominent in patients with type 2 diabetes mellitus or hypertension. CONCLUSIONS There is an intertwined relationship between chronic inflammation, cardiovascular risk factors, and bone loss in PsA. PsA patients seem to have unique bone microstructural deficits which are associated with a propensity to bone fragility.
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Affiliation(s)
- T Y Zhu
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, 9/F Clinical Sciences Building, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, N.T., Hong Kong, SAR, China
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Zhu TY, Griffith JF, Au SK, Tang XL, Kwok AW, Leung PC, Li EK, Tam LS. Incidence of and risk factors for non-vertebral and vertebral fracture in female Chinese patients with systemic lupus erythematosus: a five-year cohort study. Lupus 2014; 23:854-61. [DOI: 10.1177/0961203314528555] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 02/26/2014] [Indexed: 11/15/2022]
Abstract
Objective The objective of this paper is to investigate the incidence of both non-vertebral and vertebral fracture in female patients with systemic lupus erythematosus (SLE) and to identify risk factors for incident fracture. Methods In a five-year prospective study of 127 female Chinese SLE patients with an average age of 46.9 years (SD: 10.1 years), information on potential risk factors, including demographics, clinical data and bone mineral density (BMD) at lumbar spine and hip by dual-energy X-ray absorptiometry was collected at baseline. At follow-up, participants reported incident non-vertebral fracture during the study period. Semi-quantitative analysis was used to determine incident vertebral fracture on lateral thoracic and lumbar radiographs, defined as any vertebral body graded normal at baseline and at least mildly deformed (20%–25% reduction or more in any vertebral height) at follow-up. Results Nine incident non-vertebral fractures occurred in eight patients during the study period. Six patients had one or more incident vertebral fractures. The incidence of non-vertebral and vertebral fracture was 1.26 and 0.94 per 100 patient-years, respectively. In multivariate logistic analyses, independent variables associated with incident non-vertebral fracture were duration of glucocorticoid use and prevalent lumbar spine osteoporosis, while risk factors associated with incident vertebral fracture were higher organ damage and prevalent lumbar spine osteoporosis. Conclusions The incidence of fracture in SLE patients is lower than the prevalence reported in cross-sectional studies. Lumbar spine BMD appears to have a stronger relationship with incident fracture than hip BMD. This warrants further investigation regarding the optimal site of BMD measurement when predicting fracture risk in SLE patients.
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Affiliation(s)
- TY Zhu
- Department of Medicine and Therapeutics
| | - JF Griffith
- Department of Imaging and Interventional Radiology
| | - S-K Au
- The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - X-L Tang
- Department of Medicine and Therapeutics
| | - AW Kwok
- The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - P-C Leung
- The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - EK Li
- Department of Medicine and Therapeutics
| | - L-S Tam
- Department of Medicine and Therapeutics
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Tam LS, Shang Q, Kun EW, Lee KL, Yip ML, Li M, Li TK, Zhu TY, Pui MO, Li EK, Yu CM. The effects of golimumab on subclinical atherosclerosis and arterial stiffness in ankylosing spondylitis--a randomized, placebo-controlled pilot trial. Rheumatology (Oxford) 2014; 53:1065-74. [DOI: 10.1093/rheumatology/ket469] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Tang XL, Griffith JF, Qin L, Hung VW, Kwok AW, Zhu TY, Kun EW, Leung PC, Li EK, Tam LS. SLE disease per se contributes to deterioration in bone mineral density, microstructure and bone strength. Lupus 2013; 22:1162-8. [PMID: 23884986 DOI: 10.1177/0961203313498802] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The objective of this report is to assess the effect of systemic lupus erythematosus (SLE) disease itself on deterioration of bone mineral density (BMD), microstructure and bone strength. METHOD Thirty age-matched SLE patients on long-term glucocorticoids (GC) (SLE/GC), 30 SLE patients without GC (SLE/non-GC) and 60 healthy controls were examined. Areal BMD (aBMD) was measured by dual-energy X-ray absorptiometry. Bone geometry, volumetric BMD (vBMD), and architectural parameters at the nondominant distal radius were assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT). Bone strength was estimated by HR-pQCT-based micro-finite element analysis. RESULTS Adjusted for menopausal status and adjusted calcium level, when compared with controls, SLE/non-GC patients had significantly lower aBMD at femoral neck and total hip, and diminished radial total vBMD, cortical area, vBMD and thickness, respectively, by 8.3%, 8%, 2.7% and 9.2%, as well as significant compromised bone strength (stiffness, failure load and apparent modulus) by 8.3%, 9.1% and 9.5%, respectively. Similar alterations were also found in SLE/GC patients when compared to controls. In the premenopausal subgroup analysis, when compared with controls, total hip aBMD and radial cortical area were significantly lower in SLE/non-GC patients, and cortical area and thickness were significantly deficit in SLE/GC patients. However, no significant difference in any bone variables was present between SLE/GC and SLE/non-GC patients in the entire cohort or in the premenopausal subgroup. CONCLUSION SLE disease per se contributes to the deterioration in bone density, cortical microstructure and bone strength. This might help to explain the considerably higher fracture risk seen in SLE patients.
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Affiliation(s)
- X L Tang
- 1Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong; Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong; Department of Orthopedics & Traumatology, The Chinese University of Hong Kong, Hong Kong; Jockey Club Centre of Osteoporosis Care and Control; The Chinese University of Hong Kong, Hong Kong; and Department of Medicine & Geriatrics, Tai Po Hospital, Hong Kong
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Tam LS, Shang Q, Kun EW, Lee VK, Yip ML, Li M, Li TK, Zhu TY, Pui MO, Choi KW, Li EK, Yu CM. FRI0412 The effects of golimumab on the progression of subclinical atherosclerosis and arterial stiffness in patients with ankylosing spondylitis – a randomized, placebo- controlled trial. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Tang XL, Qin L, Kwok AW, Zhu TY, Kun EW, Hung VW, Griffith JF, Leung PC, Li EK, Tam LS. Alterations of bone geometry, density, microarchitecture, and biomechanical properties in systemic lupus erythematosus on long-term glucocorticoid: a case-control study using HR-pQCT. Osteoporos Int 2013; 24:1817-26. [PMID: 23104200 DOI: 10.1007/s00198-012-2177-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 09/19/2012] [Indexed: 11/25/2022]
Abstract
UNLABELLED Compared to controls, HR-pQCT at distal radius of SLE patients on chronic glucocorticoid (SLE/GC) revealed reduced bone area, vBMD, deteriorated microarchitecture, and unevenly distributed stresses limited to cortical bone. Despite similar trabecular quality, whole bone strength decreased in patients. These alterations may partly explain high fracture rates in SLE/GC. INTRODUCTION To assess bone geometric, densitometric, microarchitectural, and biomechanical properties in patients with systemic lupus erythematosus (SLE) on long-term glucocorticoid (GC) (SLE/GC) as compared with healthy controls. METHODS A total of 180 female SLE patients and 180 healthy controls were in this cross-sectional study to assess areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry. High-resolution peripheral quantitative computed tomography (HR-pQCT) and microfinite element analysis (μFEA) was performed at distal radius. RESULTS In addition to significantly lower aBMD at femoral neck, total hip and lumbar spine, cortical area, average volumetric BMD (vBMD) and cortical vBMD also significantly reduced by 5.3, 5.7, to 1.9 % in SLE patients, respectively. Deteriorations of cortical microarchitecture were pronounced in patients, with 6.3 % reduction in cortical thickness and 13.6 % higher in cortical porosity. Local stresses were more unevenly distributed through cortical bone in patients. SLE/GC patients had decreased whole bone stiffness, estimated failure load, and apparent modulus. Parameters related to trabecular bone density and microarchitecture were comparable between patients and controls. CONCLUSION In SLE/GC patients, despite a reduction in bone area, vBMD and deteriorated microarchitecture and unevenly distributed stresses limited to the cortical compartment, whole bone strength decreased. HR-pQCT and μFEA were promising in elucidating the potential underlying pathophysiology of bone loss and propensity to fracture in SLE/GC and provide us additional information about alterations of bone quality which might better predict fracture risk beyond aBMD in SLE/GC.
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Affiliation(s)
- X L Tang
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, 9/F, Clinical Science Building, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, N.T., Hong Kong
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Tang XL, Griffith JF, Qin L, Wong CK, Hung VW, Zhu TY, Leung PC, Li EK, Tam LS. FRI0324 Dkk-1 and rankl/opg predict changes in bone mineral density and bone microstructure in sle on long-term glucocorticoid: a prospective study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Disease activity 6 months before pregnancy of patients with systemic lupus erythematosus (SLE) associated with adverse maternal and fetal outcomes is not well studied. The aim of the study was to identify predictors of adverse maternal and fetal outcomes in pregnant SLE patients, based on patients’ background characteristics, clinical and laboratory data 6 months before pregnancy. Of 103 pregnancies, 55 pregnancies in 39 SLE patients were investigated. Clinical and laboratory data were recorded at regular intervals from 6 months before conception to 1 year after delivery. Primary outcomes included the predictors of combined adverse maternal and fetal outcomes. Potential explanatory variables included demographic, clinical and laboratory data 6 months before conception. Using logistic regression, history of nephritis ( p = 0.001, odds ratio [OR] 13.3, 95% confidence interval [CI] 2.7–65.1) and a high SLE Disease Activity Index (SLEDAI) score 6 months before pregnancy ( p = 0.015, OR 1.7, 95% CI 1.1–2.7) were associated with combined adverse maternal outcome, whereas flare during pregnancy ( p = 0.003, OR 29.3, 95% CI 3.1–273.1) predicted combined adverse fetal outcome. The area under the curve for SLEDAI score of combined maternal outcome was 0.73 (95% CI 0.58–0.87). The optimal cut-off point according to the receiver operating characteristic curve was 4, with a sensitivity of 64% and a specificity of 75%. In conclusion, a history of nephritis or a SLEDAI score of 4 or more in SLE patients 6 months before conception predicts adverse maternal outcomes, while disease flare during pregnancy predicts adverse fetal outcomes. Pregnancies should be delayed until the disease has been in remission for 6 months.
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Affiliation(s)
- L-W Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - L-S Tam
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - TY Zhu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - Y-Y Leung
- Department of Medicine and Geriatrics, North District Hospital, Hong Kong
| | - EK Li
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
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Zhu TY, Tam LS, Li EK. Societal costs of rheumatoid arthritis in Hong Kong: a prevalence-based cost-of-illness study. Rheumatology (Oxford) 2011; 50:1293-301. [DOI: 10.1093/rheumatology/ker014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Wang HY, Cui TG, Hou FF, Ni ZH, Chen XM, Lu FM, Xu FF, Yu XQ, Zhang FS, Zhao XZ, Zhao MH, Wang GB, Qian JQ, Cai GY, Zhu TY, Wang YH, Jiang ZP, Li YN, Mei CL, Zou WZ. Induction treatment of proliferative lupus nephritis with leflunomide combined with prednisone: a prospective multi-centre observational study. Lupus 2008; 17:638-44. [PMID: 18625636 DOI: 10.1177/0961203308089408] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To evaluate the efficacy and safety of leflunomide in the treatment of proliferative lupus nephritis, a prospective multi-centre observational study was conducted. Patients with biopsy proven proliferative lupus nephritis were assigned to receive either leflunomide or cyclophosphamide with concomitant prednisone. Leflunomide was given orally with a loading dose of 1 mg/kg/day for 3 days followed by 30 mg/day. Intravenous cyclophosphamide was administered monthly at a dose of 0.5 g/m2 of body-surface area. A total of 110 patients were enrolled, 70 in the leflunomide group and 40 in the cyclophosphamide group. The complete remission rate in the leflunomide group was 21% and partial remission rate 52%, as compared with 18% and 55%, respectively, in the cyclophosphamide group. Renal parameters and systemic lupus erythematosus disease activity index improved significantly and similarly in both groups. Serum creatinine decreased or stabilized in both treatment groups. No significant difference was noted with respect to clinical outcome between groups. Repeat biopsy also showed a significant reduction of active lesions in kidney pathology after 6 months of leflunomide treatment. Major adverse events, similar in both treatment groups, included infection, alopecia and hypertension. Leflunomide, compared with cyclophosphamide, in combination with prednisone was effective in the induction therapy of proliferative lupus nephritis and was generally well-tolerated.
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Affiliation(s)
- H Y Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.
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Zhu TY, Tam LS, Lee VWY, Hwang WW, Li TK, Lee KK, Li EK. Costs and quality of life of patients with ankylosing spondylitis in Hong Kong. Rheumatology (Oxford) 2008; 47:1422-5. [DOI: 10.1093/rheumatology/ken287] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Zhu TY, Shi YY, Zhang G. [Experimental study of reinforcing effect of bushen yijing capsule on bone quality of cancellous bone in ovariectomy caused rats osteoporosis model]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2001; 21:688-91. [PMID: 12575559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
OBJECTIVE To explore the influence of Bushen Yijing Capsule (BSYJC) on bone quality of cancellous bone in ovariectomize induced osteoporosis rats model. METHODS Forty Wistar female rats, 10 months old, were randomly divided into 4 groups, the normal group, the model control group, the premarin treated and the BSYJC treated group, 10 in each group. The normal group was only sham operated and the other three were ovariectomy performed and treated starting at day 91 postoperationally for consecutively 90 days. Rats were sacrificed at the end of experiment, the second lumbar vertebra was taken out to determine bone density and contents of calcium, phosphorus and organic substances, and the third lumbar vertebra taken out to measure the bone density and biomechanics properties. Bone quality was evaluated with the above indices. RESULTS BSYJC could significantly raise the bone density, increase the contents of calcium, phosphorus and organic substances, and improve the biomechanical properties of the lumbovertebral bone in osteoporosis rats. CONCLUSION BSYJC could improve the bone quality of the cancellous bone in ovariectomized rats.
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Affiliation(s)
- T Y Zhu
- Luoyang Institute of Traditinonal Chinese Orthopedics and Traumatology of Henan Province, Henan 471002
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Zhu TY, Chen HL, Gu JX, Zhang YF, Zhang YK, Zhang RA. Changes in N-acetylglucosaminyltransferase III, IV and V in renal cell carcinoma. J Cancer Res Clin Oncol 1997; 123:296-9. [PMID: 9201254 DOI: 10.1007/bf01208642] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The activities of N-acetylglucosaminyltransferase (GnT) III, IV and V were determined in 10 cases of renal cell carcinoma (RCC) and compared with the normal kidney cortex (NKC) regions of the same kidney resected from RCC patients. It was found that the GnT III and GnT IV activities decreased consistently in all samples of RCC, while GnT V activity increased, decreased or did not change in different samples. The mean levels of GnT III and GnT IV activities in RCC were found to be very significantly lower than those of NKC on statistical analysis, but the mean value of GnT V activity was almost identical in RCC and NKC. The decrease in GnT activities in RCC were compatible with the decrease in bisecting N-acetylglucosamine (GlcNAc) and antennary number of complex-type N-glycans in gamma-glutamyltranspeptidase (gamma-GT) partially purified from RCCs as studied with concanavalin A (ConA) affinity column chromatography, which showed a decrease of unbound fraction and increase of bound fractions.
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Affiliation(s)
- T Y Zhu
- Key Laboratory of Glycoconjugate Research, Shanghai Medical University, China
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Ma KC, Zhu TY, Wang FX. Stimulative effects of gusuibu (Drynaria baronii) injection on chick embryo bone primordium calcification in vitro. Am J Chin Med 1996; 24:77-82. [PMID: 8739184 DOI: 10.1142/s0192415x96000104] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Through tissue culture and isotope tracing, it was found that Gusuibu (Drynaria baronii) injection (GI) significantly promoted calcification of the cultivated chick embryo bone primordium (CEBP), increased ALP activity in the cultivated tissue, and accelerated synthesis of proteoglycan. It was also confirmed that the promotion of proteoglycan synthesis was an important factor in the promotion of calcification.
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Affiliation(s)
- K C Ma
- Laboratory of Nuclear Medicine, Luoyang Orthopedic-Traumatological Institute, Henan Province, China
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Zhu TY. [Effects of selenium on experimental ischemic myocardial injuries of heart in organ culture]. Zhonghua Yi Xue Za Zhi 1993; 73:649-51, 699-700. [PMID: 8124611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The effects of selenium on experimental ischemia, anoxia and ischemia plus anoxia myocardial injuries of hearts in organ culture in vitro were studied. The survival and spontaneous beating of cultured hearts with experimental ischemia, anoxia and ischemia plus anoxia were prolonged by selenium. The lanthanum probe technique and ACPase technique demonstrated that the permeability function of cell membrane, mitochondria membrane, lysosome membrane and Golgi membrane could be protected by selenium. The transition electron microscopy showed that selenium may to some extent maintain membrane system integrity of cultured hearts with experimental ischemia, anoxia and ischemia plus anoxia and postpone the occurrence of irreversible injuries. The obvious difference in amount of intracellular ribosome, polyribosome and short rough surfaced endoplasmic reticulum indicated that selenium may play an important role in synthesis of protein and promoting cell repair.
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Affiliation(s)
- T Y Zhu
- Department of Pathology, Institute of Basic medical Sciences, Liaoning
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Zhu TY. [Protective effects of selenium on ultrastructural changes in heart muscles with experimental free-glucose and anoxia in organ culture]. Kokyu To Junkan 1991; 39:1115-20. [PMID: 1775741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Fetal hearts taken from the 16th to 18th day of pregnant mice were cultured in MEM + 0.5 microgram/ml of sodium selenite [Na2SeO3] (MEMS), and in MEM alone with oxygen for 24 hours, and then the two groups of hearts were exposed to 10, 15, 20, 30, 40, 60 min and a long term of anoxia in glucose-free MEMS and glucose-free MEM respectively. Results showed that the survival and beating of the cultured fetal mouse hearts with experimental free-glucose and anoxia were prolonged by selenium. The application of lanthanum as a marker demonstrated that the permeability function of myocardial cell membrane and mitochondrial membrane of early experimental anoxia were protected by selenium. By using electron microscopy when structural damages occurred, it was shown that the time of occurrence of irreversible injuries could be postponed by selenium. From the fact that ribosomes increased in the cell of selenium-treated hearts, we concluded selenium may play a promotive role in the synthesis of protein in experimental free-glucose and anoxic conditions.
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Affiliation(s)
- T Y Zhu
- Department of Pathology, Institute of the Basic Science of Medicine, Liaoning Province, China
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Zhu TY. [Effect of selenium on myocardial function and structure in mice within ischemic and hypoxic environment]. Zhonghua Bing Li Xue Za Zhi 1991; 20:131-3. [PMID: 1914021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The experiment was designed to study the protective effect of selenium on myocardial function and ultrastructure changes of fetal mouse heart model under ischemic and hypoxic circumstances. The results showed that selenium can prolong the period of heart surviving and beating. Results via lanthanum probe technique indicated that selenium is able to maintain the functional integrity of the myocardial cell membrane as well as the mitochondria membrane. Ultrastructure changes under REM suggested that selenium may play a role in delaying the development of irreversible myocardial injury and to promote protein synthesis and the repairment of the injured cells.
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Affiliation(s)
- T Y Zhu
- Department of Pathology, Institute of Basic Science of Medicine, Shenyang
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Zhu TY, Schlegel KF. [An early follow-up of the mecring cup in total hip arthroplasty]. Zhonghua Wai Ke Za Zhi 1990; 28:672-5, 703. [PMID: 2086074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
41 non-cement total hip arthroplasties with the Mecring cup are reported in this paper. The follow-up results in an average of 14 months showed that this operation relieved the hip pain and improved the functional capacity and the motion of the hip. 80.5% of the reported hips gained excellent or good results. Because the cup was firm on the acetabulum with the thread, the defect of bone was smaller and the cup revision was easier than others, it is applicable not only for the elderly but also for younger patients. The relationship between the hip function and cup position was observed and it suggested that the correct abduction angle of the cup should be 40-50 degrees and the anteversion angle 5-20 degrees. The postoperative complications were dislocation and ectopic ossification.
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Affiliation(s)
- T Y Zhu
- First Teaching Hospital, Beijing Medical University
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Zhu TY, Li GZ, Ren HZ. [Protection from anoxic myocardial injury in fetal mouse heart culture by selenium]. Zhonghua Xin Xue Guan Bing Za Zhi 1989; 17:238-9, 254. [PMID: 2627882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Fetal hearts taken from the 17 day pregnant mice were cultured in minimum essential medium (MEM) + 0.5 ug ml of Na2SeO, and in MEM alone with oxygen for 24 h, and then the hearts in groups were exposed to 15, 20, 30, 40 min, 1 h, 3h and long term of anoxia respectively. The results showed that the survival and beating of the cultured fetal mouse hearts with anoxia were prolonged by selenium. Using lanthanum as a marker, we found that after 20 min of anoxia, this electroopaque marker remained extracellular in the selenium-treated hearts, however, intracellular lanthanum could be found in the control hearts, entering selectively into the swelling mitochondria. During the same period of anoxia, ACPase reaction products could be only found in the lysosomes and in the Golgi complex in the selenium-treated hearts, but a lot of reaction products deposited in cytoplasm in the control hearts. By electron microscopy, at 40 min of anoxia, there were swelling of mitochondria, with cristae partially lost and plasma-membrane changed and so on. Generally normal ultrastructure was observed in the selenium-treated hearts at 40 min of anoxia. The cytoplasm was rich in ribosomes and the sarcoplasmic reticulum with a rough face. There events showed that cellular membrane and membrane-bound organelles appeared to be well protected target by the selenium. Therefore, selenium may play an important role in the synthesis of protein.
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Zhu TY, Zhang JW, Chen BN. [Study of the isolated fetal mouse heart in organ culture]. Zhonghua Xin Xue Guan Bing Za Zhi 1984; 12:302-4, 317. [PMID: 6544220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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