Osteoporosis affects more than 200 million women worldwide, with postmenopausal women being particularly susceptible to this condition and its severe sequelae disproportionately, such as osteoporotic fractures. To date, the current focus has been more on symptomatic treatment, rather than preventive measures. To address this, we performed a meta-analysis aiming to identify potential predictors of osteoporotic fractures in postmenopausal women, with the ultimate goal of identifying high-risk patients and exploring potential therapeutic approaches. We searched Embase, MEDLINE and Cochrane with search terms (postmenopausal AND fracture) AND (“risk factor” OR “predictive factor”) in May 2022 for cohort and case–control studies on the predictors of osteoporotic fracture in postmenopausal women. Ten studies with 1,287,021 postmenopausal women were found eligible for analyses, in which the sample size ranged from 311 to 1,272,115. The surveyed date spanned from 1993 to 2021. Our results suggested that age, BMI, senior high school and above, parity ≥ 3, history of hypertension, history of diabetes mellitus, history of alcohol intake, age at menarche ≥ 15, age at menopause < 40, age at menopause > 50, estrogen use and vitamin D supplements were significantly associated with osteoporotic fracture in postmenopausal women. Our findings facilitate the early prediction of osteoporotic fracture in postmenopausal women and may contribute to potential therapeutic approaches. By focusing on preventive strategies and identifying high-risk individuals, we can work toward reducing the burden of osteoporosis-related fractures in this vulnerable population.

Spinal cord injury (SCI) imposes a remarkable burden on affected cases and their families, while current treatment options remain insufficient. This study aimed to identify and validate the molecular targets, signaling pathways, and mechanisms by which Betulinic acid (BA) exerts its therapeutic effects on SCI, providing new directions for clinical intervention. In vivo, Kunming mice underwent behavioral tests, Nissl staining, and Hematoxylin-eosin staining to evaluate motor function recovery and determine the expression levels of relevant biomarkers. Bioinformatics analyses were employed to investigate the genes involved in the SCI-BA interaction, elucidating key signaling pathways, followed by molecular docking of potential target genes. In vitro, lipopolysaccharide was used to induce a secondary SCI condition in cultured astrocytes, enabling the evaluation of BA’s effects on inflammatory and apoptotic responses. The results demonstrated that BA could significantly promote motor function recovery and reduce the expression levels of inflammation-related cytokines, including IL-1β, IL-6, and TNF-α, in SCI mice. Through bioinformatics analysis, Myc was identified as a key target of BA in SCI, and NF-κB and apoptosis pathways could be implicated in its mechanism of action. Both in vitro and in vivo experiments confirmed that BA could target Myc to modulate the inflammatory response in astrocytes, reducing the activation of RELA and MAPK14. In conclusion, these findings indicate that BA attenuates neuroinflammation and apoptosis via Myc and the NF-κB signaling pathway, thereby promoting functional recovery following SCI.

Polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes (POEMS) syndrome is frequently mistaken for chronic inflammatory demyelinating polyneuropathy, as its clinical profile is highly variable and neurological symptoms often dominate the initial course. In the present case, the disorder initially presented as cardiovascular dysfunction, which delayed decision-making related to the original diagnosis. As the condition advanced, the patient developed progressive limb weakness, splenomegaly, and abnormalities in lipid metabolism. Whole-body bone scintigraphy revealed osteolytic lesions in association with a plasmacytoma, whereas the serum vascular endothelial growth factor levels were markedly elevated. Based on the cumulative findings, POEMS syndrome was diagnosed. Treatment with interventional chemotherapy combined with adjunctive symptomatic care resulted in a marked reduction in symptoms and promoted functional recovery. This case provides detailed clinical evidence highlighting the critical importance of early recognition and accurate diagnostic evaluation in POEMS syndrome. By aligning our observations with the existing literature, we emphasize strategies that promote timely diagnosis, minimize diagnostic error, and improve therapeutic outcomes.