Hello, Sina netizens!

Host: Famous doctors gather to talk about people's health. Good afternoon, Sina netizens! Welcome to the famous doctor hall broadcast live by Sina Health and Medical Forum. I'm Cui Yinmo. While broadcasting the program, you can communicate with experts through our interactive platform. With the increase of the elderly population in China, the problem of osteoporosis has also increased year by year. In recent years, we have found that many young people also have osteoporosis, and the patients with osteoporosis are also getting younger and younger. Many patients will feel backache at ordinary times. With the increase of sitting time, the pain will also worsen, further disturbing our life. In order to better understand osteoporosis, we specially invite Professor Li Ling, the director of the Department of Rehabilitation Medicine and Physiotherapy and the director of the Orthopedic Rehabilitation Center of the First Affiliated Hospital of the PLA General Hospital.

Li Ling: Hello.

Host: Professor Li, you can see that we have a case of a 77 year old retired cadre of an enterprise, Wang Lao, who has suffered from osteoporosis. Recently, his illness has worsened. He went to the orthopaedic hospital for X-ray examination and was diagnosed with serious osteoporosis. He used to play basketball in the park every day, but now he can't exercise because of his symptoms. What's more, he can't take care of himself because of the pain every day. He was wounded on the Korean battlefield before and was a hero. The bullet hit his leg without tears, but now because of osteoporosis, his tears of pain go straight every day. Through this case, we know that osteoporosis is very painful. Let Professor Li explain to us in popular terms what osteoporosis is? Where does it usually happen?

Li Ling: Ordinary people think that osteoporosis, even some medical staff think that it is inevitable when they get old, and that it is not a disease. In fact, what is osteoporosis pathology? One is the reduction of bone mass, the thinning of bone trabeculae, and the destruction of microstructure. At the same time, it will also lead to brittle fracture, which is a systemic disease of our lumbar vertebrae. It is not only an orthopedic disease, but also a systemic disease.

The predilection sites, such as thoracic vertebrae, lumbar vertebrae, wrists, and femoral head and neck at the root of thigh, are all the predilection sites for fracture.

Host: Osteoporosis may affect every part of the body.

Li Ling: Yes. It affects bones throughout the body.

Host: As you said just now, it used to be considered as a senile disease, which can't be avoided when people get old. In fact, we shouldn't know this way. Young people can also get it, and old people can also avoid it.

Li Ling: Especially now, with the continuous extension of our average life span, this disease has become a particularly prominent one, bringing a very high disability rate and mortality rate of the quality of life to the elderly.

Host: Now I heard that the medical profession has compared the prevention and treatment of osteoporosis and fractures caused by osteoporosis with the prevention and treatment of hypertension and myocardial infarction. It can be seen that the prevention and treatment of osteoporosis is very important. What harm will osteoporosis cause to the body when it rises to fragile bones?

Li Ling: Bone is a very important structure to support the human body. After osteoporosis, the most serious harm is pain. Pain is a very painful feeling for people. Then there is disability. We are disabled by hunchback, and we have difficulty walking, and then there is death. It was just said that some brittle fractures will occur, which will lead to death. The most obvious is hip fracture. The mortality rate in the first year is 15% - 20%. Even if it survives, 50% will be disabled for life.

There is also a family where we have a fracture. The whole quality of life has declined. A fracture needs to lie in bed, need someone to help him take care of him, and need to spend money to go to the hospital. In addition, it is a burden on the family and society, not only on individuals, but also on the whole family and society.

Host: You said that we understand disability better. How can fracture kill? What is the reason?

Li Ling. It is also counted that 80% of those who can not walk independently, can not complete at least one daily life, and 40% can not walk independently.

Compere: When it comes to osteoporosis, people think it is not particularly serious. I heard from you today that it has such a serious impact on our life. How can we know if we have osteoporosis? Do you think my back is sore and I have to pay attention every day? Is it possible that I have osteoporosis?

Li Ling: Osteoporosis usually has no obvious clinical symptoms in its early stage. It is a silent disease. So it starts with pain. People often go to the hospital without saying that I have low back pain or back pain. Some people can bear it or have activities. It's especially painful to stand up and walk, move or roll over.

What will happen over time? The spine is deformed, hunchbacked, and the hunchback is becoming more and more curved. You can see the elderly on the street. It's better now. In the past, there were many elderly people with hunchbacks. Then my body became shorter. Some patients said that when I was young, I was 1.78 meters, but now how can I measure 1.74 meters? My body became shorter.

As I said just now, a slight carelessness is a fracture, such as the spine, hip and wrist. Some extend the wall, and some lift a watermelon, which is painful. When we go to the hospital, three sections of the bone are compressed, one sneeze bone is broken, and some patients break the bone as soon as they roll over. This squat spine is broken, this hand is a wrist fracture, and this is a fall hip fracture, This is the hip, this is the wrist, this is the spine.

Host: In our life, we found that more women seem to be prone to osteoporosis, especially elderly women. We found that she would say that I am old and short, especially those women who had a very straight waist when they were young. Does osteoporosis especially favor women?

Li Ling: Because female estrogen plays a very important role in bone absorption and reconstruction. We usually begin to decline in ovarian function after the age of 45. In fact, many of us begin to decline in ovarian function at the age of 40 due to high occupational pressure. After estrogen drops, it first affects the activity of our vitamin D and its quantity. This is because vitamin D3 promotes the absorption of calcium, which cannot be absorbed into the human body.

On the other hand, it also affects our human osteoblasts, which are the cells that make bones grow, and their activity is reduced. It also affects osteoclasts. Osteogenesis and osteoclast have been with us all our lives. When we are young, osteogenesis is greater than osteoclast. As we grow older, osteoclast is greater than osteoclast. Osteoporosis occurs earlier in women than in men, and also in men.

Compere: In terms of diet, for example, drinking soy milk can increase estrogen. Can we pay attention to osteoporosis in our daily life?

Li Ling: The process of ovarian aging can only be delayed but can't be stopped. We can delay the decline of bone through other lifestyles, drug supplements, exercise and diet.

Host: In addition to the gender factor just mentioned, who else is more likely to have osteoporosis?

Li Ling: Race. For example, white and yellow people are more likely to have osteoporosis than black people. Another is the elderly, who are also prone. Then there is the maternal family history, that is, if the mother has osteoporosis, her daughter is more likely to have some. This is something we can't change. What kind of race are you? That is to say, the four things we just mentioned are something we can't change. There are also some factors that can be changed, and some non intrinsic factors, such as the skinny people are easy to get. They all like being thin. The thinner people are more likely to suffer from osteoporosis.

When the patient came, I saw that he was petite, and I expected that he might have osteoporosis.

Compere: I always thought that people with large weight were easy to get.

Li Ling: There are also some drugs, which are easier for patients who use hormone drugs. Another disease such as hyperthyroidism, smoking, excessive drinking, strong coffee and strong tea will also affect bone absorption. Then we talked about the lack of physical activity of modern people just now because transportation is more convenient. I remember when I was a child, my mother went to work every day and had to walk 40 minutes with me because there was no such good traffic at that time.

Then there is the lack of calcium in the diet. Because the Chinese have no habit of drinking milk, our next generation will drink more milk. Then there is the lack of vitamin D in the diet. So that's what we said just now. Let's judge from the age, weight and family as a whole. If you have these, you should check them out. Maybe you need to do some bone density tests.

Moderator: This table is very important for everyone.

Li Ling: Yes. Some people have no intention of making films. I don't know why my bones have been crushed.

Compere: There are many factors. Now I have passed the self test in the hospital. I think I may have osteoporosis. What tests should I carry out in the hospital to make a diagnosis?

Li Ling: We usually diagnose osteoporosis because we just mentioned that it is related to the strength of its bones. Bone strength is also related to bone density and bone quality. So far, we do not have a device to directly measure bone strength. But we usually measure bone density, because bone density can reflect the strength of this bone by 70%.

There is still some bone mass, but 70% of it can be measured, so we now take bone density as the net standard. However, bone density has dual energy absorption. FRAX is a standard. It also measures the limbs. Usually, the hands and feet are measured in the periphery, and CT is also used. However, CT costs too much and the amount of radiation is also a little large.

Host: What is the best choice for us in general?

Li Ling: It is to measure bone density.

Host: As ordinary people, we are especially afraid of reading various reports that we can't understand. You can help us explain the bone density report. What should we focus on?

Li Ling: We have a bone density report behind this one. This is usually a report of bone density examination that our patients will get after finishing. The left one is the lumbar spine, and the right one is the area around the thigh root and femoral neck that we usually talk about. This is a report because we import equipment, and many people can't understand these words. Just now, we talked about osteoporosis and gender, race, age, height, weight Menopause age is related. At the beginning, he would like to input these things. You can see that the masthead just now has been enlarged. Gender, birthday age, race, subspecies, black race, white race, age, and women are related to rejection. Is it right to input all the influencing factors just now into the system. Then we will see a number L1 and L2, which refer to waist 1 and waist 2. In particular, there are T values and Z values. Usually, the patient's T value is - 3.3. We will diagnose osteoporosis, and later we will see the standard.

This is a data of the hip joint, this is the part we measured, the lumbar part, this is the root of the thigh, the femoral neck, the femoral head, it is often said that the femoral head necrosis, femoral neck fracture is this area, because the cultural quality of patients is different, green is normal, red is osteoporosis. What are the three lines? The middle line is the average value, the upper line is the high value, and the lower line is the low limit value. The patient is in the small circle. He is in the red area. We diagnosed him as osteoporosis. Compared with his peers, his average value is here, and he must be lower than the average value of his peers.

Moderator: The patient was over 53 years old just now. In fact, at this age, if it is kept well, it is OK.

Li Ling: He is much lower than his peers. Bone mineral density examination can have a risk that you will have a fracture in the next ten years. Because he just input it, FRAX risk estimation in the next ten years is related to these 11 factors, and we input them into the system. Just now we have all input. The final forecast tells you whether there will be important osteoporosis fractures within ten years and whether there will be hip fractures within ten years. We will tell the patient that it will attract his attention and he will care. For one patient, the important risk of osteoporosis fracture is 6.3%, and the risk of hip fracture is 2.1%. The patient will pay attention to it.

Host: He knows which part of himself should pay attention to.

Li Ling: Finally, give the patient a diagnosis. Usually, T-value greater than - 1 is normal in the green area. The yellow area just now between - 1 and - 2.5 is low in bone mass. If T-value is less than - 2.5, it is the green area just now diagnosing osteoporosis. This is a risk for you in the next ten years. This is a report of our osteoporosis.

Moderator: After finishing this report, you will know what your situation is now, and what it may be ten years later.

Li Ling: Yes. We will give a guide for different values.

Moderator: We know that osteoporosis is very serious, but at the same age group, you can maintain a particularly good state, or you may already have osteoporosis. When we have no problems, can we take good exercise, for example, as you said now, we are often reluctant to walk because of taking cars or driving too much. Do we have a certain exercise method to prevent osteoporosis?

Li Ling: Because as long as we have stress on the bone, we can enhance its bone density. Sports, whole body sports and local sports are combined, because it hopes to resist resistance and have great explosive force. Different sports are different, such as going up stairs and running. Just now, it is better for bone density of lower limbs. If lifting weights, it is also necessary to support upper limbs and lower limbs. Gymnastics is good for the whole body. The greater the strength, the better, but the elderly should be moderate, too strong, jump rope strength is too strong, and fracture.

Host: How do we know the intensity?

Li Ling: For the elderly, we let him do walking and take some exercise to get in touch with the sun. If he has severe osteoporosis, he can't exercise intensely, but he can't stop exercising. I also do some exercises that are less resistant to resistance. Muscle stress is also good for it. If you take five liang, five jin and five ton, the bigger the better, but not more than the bone stress.

Host: It is suggested that the elderly should choose their own suitable sports. Osteoporosis has already existed, and I don't know how to choose the medicine, how to choose the medicine? Is there any way?

Li Ling: Generally speaking, the treatment of osteoporosis is a combination of basic treatment plus drug treatment and rehabilitation treatment. As for basic treatment, I just talked about changing the lifestyle, such as exercising more, not drinking too much, smoking too much, drinking strong coffee, drinking strong tea, etc., and basking in the sun. Chinese people are especially afraid of the sun. In fact, the sun is very good, and basking in the sun changes the diet structure.

Host: I always said that "one white covers one hundred ugly". I was always afraid of tanning, but I didn't expect that the skeleton would change because of fear of tanning.

Li Ling: Yes. Originally, we have less and less outdoor homework now than in the past. Sit in the office. And our basic calcium supplement is that we take calcium and vitamin D. Many patients asked me how long I had been taking caltrate D, and he was already severe. I said that if you take it for a long time, you need 1000 mg of calcium every day, and 800 mg for normal people. The average diet is only 400 mg. We need to supplement it to 500-600 mg. We now generally use about 500-600 mg of calcium.

Host: For example, I don't have osteoporosis. Can I start calcium supplementation now to prevent osteoporosis?

Li Ling: There were several periods in our human life. Before we were 30 years old, our bone formation was greater than bone destruction, so our bone density was increasing. You didn't exceed 35, did you. From the age of 35 to the age of 45, we are at a plateau stage. Our osteogenesis and osteoclasis are almost at a plateau stage. After the age of 45, bone destruction is greater than bone formation. Every stage of life, we should emphasize the supplement of the changed diet. Before the age of 35, if you have a good lifestyle, drink more milk and eat more calcium containing foods, your peak will be very high, and a peak bone density will go down.

At the age of 35 to 45, we will keep the plateau longer. Why do we take calcium supplements after the age of 45? Let it slow down and let the bone loss slow down.

At any age, remember that this is the rule I just mentioned.

Host: We should pay attention to calcium supplementation from birth.

Li Ling: When we were young, our generation could not drink milk. There were many children at home. Now children drink yogurt and milk like water on their mouths.

Moderator: All children have formula milk powder.

Li Ling: Yes. This is a few periods. We change naturally. Just now, when you looked at bone density, even normal people go down. This is our childhood. Bone formation is greater than bone absorption. The length of bone density increase is longer, and so is adolescence. Therefore, bones are particularly strong and reach the peak.

Compere: Is it long?

Li Ling: At the same time, the bones become thicker and heavier. At this stage, the plateau of bone formation, after the age of 45 for women and 50 for men, is a regular pattern. When will it be made up? At any time, we can't ignore that we should pay attention to calcium supplementation in diet at any age.

Host: After hearing your advice, I decided to start calcium supplementation tonight.

Li Ling: Not necessarily taking medicine.

Compere: Drink milk and bask in the sun every day.

Li Ling: Exercise more.

Compere: They are all calcium supplements.

Li Ling: Yes.

Host: It suddenly occurred to me that we had a physical examination after graduation from college. When the doctor said bone calcification, he didn't understand what it meant at that time. At that time, he understood that bone calcification would not grow after it. I took the opportunity to ask you what it meant?

Li Ling: Bone calcification is a problem at the end of bone dirt in the growing period. The bone has a cartilage area, and the long bone has a growth at the end of the bone.

Compere: Does calcification mean no longer growing?

Li Ling: It has nothing to do with calcium supplementation.

Moderator: Today you put our thoughts out of order. We should take calcium supplements in various ways for our health. Now we have some questions from netizens.

Netizen: How should women in their 40s take calcium supplements every day to prevent osteoporosis?

Li Ling: Because I just said that we need 800 mg of calcium for normal adults and 1000 mg for postmenopausal women or elderly people. She doesn't know if she has amenorrhea.

Compere: It is estimated that she has not. Can I take calcium tablets during the plateau period?

Li Ling: Yes. If she doesn't have amenorrhea, simply take calcium supplements. If she enters menopause, even if she has taken calcium, it is difficult to absorb it, because she has just said that after estrogen drops, it is better to combine it with vitamin D3.

Compere: I remember that I once heard that calcium can't be absorbed if I eat something without sun exposure. Don't you know whether this statement is reasonable?

Li Ling: Because ultraviolet ray is the formation of vitamin D, because there are enzymes in the skin, which play a very important role in the formation. Lack of sunlight is most obvious for our children. Lack of sunlight is very easy to get rickets. In the past, like coal miners, those who have not been exposed to the sun for a long time are also prone to calcium deficiency and osteoporosis.

Compere: It is really to bask in the sun so that calcium can be absorbed better. Some elderly people like to sit on closed balconies and bask in the sun. They also feel warm. In fact, the second sunshine after glass isolation will also promote calcium absorption?

Li Ling: Ultraviolet ray cannot penetrate through any glass except quartz glass. It receives red light, and there is no ultraviolet light inside. Our human body is inseparable from light, which has not improved osteoporosis, but it is still good for human health.

Netizen: There is always a noise at the ankle when going up and down the stairs. Why?

Li Ling: There is a noise at the ankle. It may be the cartilage of the ankle joint or some ligaments in it. Some injuries may be caused by disharmony, which has little to do with osteoporosis.

Compere: It doesn't matter. It's not symptomatic to take calcium supplements, is it.

Li Ling: We should check with the hospital.

Netizen: At the age of 50, there is hyperplasia of cervical vertebra and lumbar vertebra, and the elbow is painful like needle pricking from time to time. What is the reason and how to treat it?

Li Ling: At the age of 50, amenorrhea occurs, and some ovarian functions are nearing the end. Another disease is osteoarthritis after the estrogen drops. Now we talk about osteochondral degeneration, also called degenerative disease osteoarthritis, which can also cause pain in all joints of the body. This is caused by osteoporosis, and it may also be osteoporosis. We need to measure the bone density and take some films to identify it. Maybe both diseases exist in one person.

Compere: He should make a diagnosis and pass the test.

Li Ling: Osteoporosis is a degenerative disease of bone, and osteoarthritis is a common degenerative disease of bone joints and osteochondral.

Netizen: Female, she often sleeps at night and tightens her left calf. When she was 40 years old, the doctor said that her bone age was over 55 years old. How should we prevent and treat this situation?

Li Ling: She's tight, usually because her blood calcium is low. I don't know what the concept of her bone age is. One is that her bone is very sparse, and the other is very hyperplastic. I suggest that she go to the hospital to have a bone density test to see her bone density content. Just now, the bone density can reflect the strength of 70% of the bone. If it is diagnosed as osteoporosis, we will treat it according to the regular osteoporosis plan.

Netizen: 46 years old, female, bone density is - 1.2, there is no leg tightening, and the location of pain in the hip joint is unclear. Is this the reason for calcium deficiency? How to solve it?

Li Ling: 42 years old. - 1.2 is osteopenia. Just now we talked about the yellow area, but it has not yet reached osteoporosis. For the 42 year old, I didn't see her bone density chart. She may be lower than the average of her peers. But - 1.2 is not enough to cause hip joint pain. She should check again to see if there are other reasons for hip joint pain. For her osteopenia, she should take some calcium and vitamin D supplements properly.

Host: The problem of bone density is not the most serious.

Li Ling: We have to eliminate it. Because there are many diseases that cause pain, we should exclude other diseases. Even the elderly should rule out other diseases.

Compere: Simply say - 1.2 should start calcium supplementation. Many netizens think that there may be many misunderstandings in the treatment of osteoporosis. Just now, many questions have been raised, and people may not have a clear understanding of themselves. At present, what are our cognitive misunderstandings about the treatment of osteoporosis?

Li Ling: Now, many of our patients will pass through the media for osteoporosis treatment. In addition, we have some doctors in various departments who have some uneven understanding of diseases. In addition, our drugstore will also go to the doctor to make some of my medicines. There will be a misunderstanding that a certain kind of medicine can solve the problem. For example, we can't say that we have patients who say that calcium is good and I will take this, but they just take calcium supplements. Some of our patients think that this has introduced me to vitamin D3, which is very good. I can take this to treat them.

What's more, some of the calcitonin recommended by doctors are bisphosphonates and estrogens. From what perspective, most of them are single. In fact, osteoporosis is not a single treatment, it is a comprehensive scheme. First, we must solve the source of calcium, that is, we must supplement calcium.

Second, for our elderly, our calcium absorption capacity declines, and the decline of estrogen and androgen will lead to the decline of calcium absorption capacity. We need to supplement the corresponding vitamin D3. That is the basic treatment just mentioned. The other is our drug treatment. Drug treatment includes two aspects. One is to inhibit bone absorption, the so-called bone absorption is bone destruction, and the second is to promote bone formation. Drugs that inhibit bone absorption, such as some bisphosphonates and calcitonin. PDH to promote bone formation has not yet been marketed, and women can use estrogen regulators and estrogen therapy. But we must supplement calcium and promote bone formation.

We also have continuous therapy. One segment of bisphosphonate may be used to replace calcitonin, but calcium runs through the whole process.

Host: Patients should always follow the guidance of doctors.

Li Ling: There are a lot of health education now. It's better to go to hospitals. The osteoporosis treatment department of each hospital is different. Some hospitals are in the endocrine department, some hospitals are in the orthopaedics department, and some hospitals are in the rehabilitation medicine department.

Host: How do we usually choose? This is also a problem for patients. I don't know which department to visit when I go to the hospital today.

Li Ling: You can go to the hospital for consultation. Some patients do not know that they may go to a department and have incomplete treatment plans. It cannot be said that mistakes are incomplete treatment.

Moderator: Maybe several subjects need to be considered.

Netizen: 63 years old, male, once fell down carelessly, and his knee hurt very much. He tried many ways to relieve the pain, but some friends recommended liquid calcium. After taking it for a while, it worked very well. What is the principle? Is this really effective?

Li Ling: First, I fell down. I don't know what the diagnosis is. Is it a ligament injury or a fracture?

Host: At that time, there was no diagnosis. I felt that my knee hurt. After a period of time, it would be better, but not better. Many friends recommended him to use various methods, including drinking medicinal wine and hot compress. Finally, I felt that the way of liquid calcium was the most effective one.

Li Ling: Calcium supplementation will not directly relieve pain. Calcium supplementation itself is a slow process, not a direct pain relief. Long term calcium supplementation and increasing bone density may improve symptoms.

Compere: He may be just in time for this period, and psychologically so.

Li Ling: There is no clear diagnosis of knee pain, ligament injury or soft tissue injury.

Compere: Long term calcium supplementation is good for your health. At present, it is very common for senile vertebral compression fractures caused by osteoporosis. When we talk about treatment, we would like to ask if there is any minimally invasive treatment?

Li Ling: There is bone marrow mud.

Compere: This is difficult for us to understand. Could you be specific?

Li Ling: Did you see the compression fracture in the first chapter? Now we need to clarify the concept of beating the bone marrow mud to support it. This patient is not suitable for playing. The cement is used here. The bone is thin, the cement is harder than the bone, and may leak if it is not propped up. A little bit of compression fracture is used to open the bone. The solution is not osteoporosis, but compression fracture. Because compression fracture compresses the nerve root, the deformity caused by compression fracture, the first solution is not hunchback, not hunchback, not pressure heart and lung. Relieve some symptoms caused by compression fracture.

A compressed nerve root is compressed, and the nerve hole is propped up to recover to the original, which solves the compression symptom of the nerve hole. But it is not a cure for the root cause, not for osteoporosis, to alleviate the symptoms caused by compression fractures. Some people say that the treatment of osteoporosis with Lone Pine Mud is not effective. We must adhere to the osteoporosis drug treatment program, and pay attention to diet and exercise therapy.

Moderator: This is the solution, but not the eradication.

Li Ling: It solves a series of symptoms caused by compression fracture.

Compere: Is this method used by many people at present? How about the effect?

Li Ling: The effect is very good. The patient felt that the nerve pressure was very painful, and the nerve pain disappeared immediately after holding it up.

Moderator: Immediate results.

Li Ling: If osteoporosis treatment is not carried out, the nearby ones will shrink. They can't shrink one by one. When the bone is too loose, the cement will be put into it, which will damage the bone. The beating should be based on the conditions. Many patients mobilized to prevent osteoporosis. He said there was nothing to be afraid of at discount. Now there are many advanced technologies, and the nails are advanced. We said that when the nails are loosened to the end, they will not set. They often fall off after being nailed with cement. If it is too loose to hang, it is very important to treat osteoporosis and prevent osteoporosis fundamentally.

Netizen: At the age of 60, I want to know whether there is room for osteoporosis to ease. At this age, osteoporosis has begun. Is there any way to reduce pain?

Li Ling: What pain?

Netizen: Do you want to know whether there is room for moderation? Is it reversible? Is there any way to reduce the pain caused by osteoporosis?

Li Ling: The comprehensive drug treatment plan is to solve the problem. First, we can relieve his symptoms, relieve his pain, and increase bone density. Second, let him slow down his aging. Some patients said that the last time I tested, how could my treatment be lower for one year next time? If there was no treatment, we would slow it down faster. Of course, it is better to be flat, but increase is the best. Look at the age. If we are in our 70s and 80s, even if we give him a very reasonable plan, we may not be able to increase it, but one thing can slow down the decline. The end goal of all osteoporosis treatment is to prevent fractures.

Host: As long as the fracture does not occur.

Li Ling: The final goal is to prevent fractures and relieve pain. The effectiveness of drugs takes reducing the incidence of fractures as a very important indicator.

Compere: Fragile fracture. As you said just now, trabecula fractures continuously, but no compression fracture occurs. Can you choose bone marrow mud?

Li Ling: It's unnecessary. The operation itself has certain risks. There is a certain mortality rate.

Netizen: Male, 33 years old. The recent physical examination found that the bone density was slightly lower than - 2.5. The physical examination doctor said it was osteoporosis. Last year, the physical examination was normal. The bone density dropped to osteoporosis within a year, and the waist felt weak and painful occasionally. When you get up after sitting for a long time and stand for a long time, it is very painful. Because you are not good at exercise, is this situation specially treated for osteoporosis? How should we treat it? What should we pay attention to?

Li Ling: First of all, he is 33 years old. The first thing to find out is that he is relatively young. Whether he has other diseases, drugs, other factors, and lack of exercise are also included. First, we should analyze and check the blood sampling. If all of them are excluded, we will confirm to him that he is primary osteoporosis only because of lack of exercise. We should first exclude him.

Whether it is primary or secondary, and the bone density is lower than - 2.5, osteoporosis treatment must be carried out. Osteoporosis treatment must be adhered to.

Compere: At 33, you should pay attention to this problem anyway.

Li Ling: The diagnosis is lower than - 2.5. Osteoporosis treatment must be carried out. Because we are young, we need to find out the reason. If there are other reasons, we need to treat other diseases, change drugs to other drugs, or contact with life habits.

Host: Some elderly people, as you said, may like smoking and drinking strong tea. This phenomenon is particularly popular. If they have osteoporosis, is it because of senile osteoporosis that they should stop the habit of many years ago?

Li Ling: We will dissuade him from gradually changing. Smoking is not only bad for bones, but also bad for cancer and lungs. He said why not when he was young. When he was young, the whole body was in good condition. Many diseases did not show up, and the function of organs was declining in old age. We will advise them to reduce the amount slowly until they quit.

Compere: Including tea?

Li Ling: Tea itself is not too bad for the human body. The concentration should be reduced. The amount of coffee should not exceed a certain amount a day. The amount of agricultural tea should not exceed a certain amount. It is not an absolute abstinence.

Compere: Control it.

Netizen: 72 years old, female, osteoporosis has had bone marrow mud surgery. What should I do if bone marrow mud infiltrates and compresses nerves?

Li Ling: Did she leak bone marrow mud?

Moderator: Yes. What should we do because bone marrow mud leaks out and compresses the nerves?

Li Ling: Find an orthopedic doctor for clinical treatment.

Host: Is it possible to recover from standing and walking? Is it possible to recover from further surgery?

Li Ling: If the bone marrow mud compresses the nerves, it may still be necessary to contact the oppression, or go to the hospital, especially the orthopaedics department to help her solve the problem of oppression. First, solve the compression, and then recover if the nerve is damaged.

Netizen: 60 years old, female, fracture due to osteoporosis, also lying in bed after bone marrow mud surgery. Between the two strands of the bone marrow mud surgery position, there are two erythema about the size of a thumb, sitting up with pain, not sleeping, with hot water will not return. What should I do?

Li Ling: It has nothing to do with bone marrow mud. The skin changes. Bone marrow mud will not affect the redness of the skin.

Compere: If you lie down for a long time, you will have some doubts psychologically.

Netizen: 14 years old, male, what should I do if the tibial fracture plate is taken out for one month and the fracture occurs again, causing costly osteoporosis?

Li Ling: We call it secondary, because fracture immobilization. With the recovery of exercise, calcium and vitamin D can be properly supplemented to bask in the sun.

Moderator: Through age growth.

Li Ling: This is the best solution to the temporary cost shrinkage.

Host: Now many patients find that pain has always been the most common symptom. For pain, as you said, in addition to the primary secondary treatment according to the etiology, is there any symptomatic auxiliary treatment?

Li Ling: In the treatment plan, the bone density is increased, and the pain is very serious. In addition to calcium plus D, the comprehensive plan has effects on osteoporosis, bone pain, and bone tumors. With the help of physical therapy, local ultraviolet radiation and laser irradiation can alleviate the pain.

Compere: Is it only helpful for pain relief or treatment?

Li Ling: Ultraviolet not only relieves pain, but also plays an auxiliary role in treating bone density.

Compere: I see a lot of baking lamps.

Li Ling: The baking lamp is infrared. The ultraviolet radiation dose is calculated by seconds, which is usually not available at home.

Host: There are also mothers who are breast-feeding or expectant mothers who are pregnant. Osteoporosis is also a disease that is particularly easy to find. What should be paid attention to in treatment?

Li Ling: Breastfeeding needs a lot during lactation. The most important treatment is to strengthen calcium supplementation. Other drugs are not necessarily, mainly calcium supplements. Estrogen is very high at this age. D3 is not necessarily, mainly strengthening calcium supplements.

Compere: calcium supplements, more exercise in the sun, may be enough. Now, we have always heard that there is a new concept of calcium supplementation, that is, active vitamin D should be supplemented at the same time. In particular, we don't understand the difference between active vitamin D and ordinary vitamin D? Who is more suitable for active vitamin D?

Li Ling: Because of vitamin D, we are exposed to ultraviolet light, which is a process from inactive to active. That is to say, if you eat inactive vitamin D, it needs to be metabolized by the liver and kidney. If you use E25 cavity vitamin D, active vitamin D can be directly absorbed and utilized in the intestine without being metabolized by the liver and kidney.

There is also a kind of alpha calciferol, which is metabolized by the liver rather than the kidney. The young people's liver and kidney are very good at advocating the use of inactive alcohol. Active D is recommended for the elderly in terms of intestinal absorption capacity.  

Netizen: I often feel the shoulder is cool. Is this related to osteoporosis?

Li Ling: Many people suffer from osteoarthritis. Many elderly people have bone joints that are particularly cold. It can't be said that osteoporosis is the symptom.

Compere: Should we go to diagnose this problem?

Netizen: How should mild hyperosteogeny be treated?

Li Ling: We usually don't deal with mild hyperosteogeny without symptoms. When the hyperosteogeny compresses the nerves or causes pain, we may need to give some to him. If it is mild, we may use medicine to treat some physical therapy. If it is very serious, we may need surgery. If it is serious, it will hinder the joint function, so we need surgery.

Moderator: Is there any relationship between osteoporosis and osteoporosis?

Li Ling: Both of them coexist. One is joint disease and the other is bone disease, both of which are degenerative diseases.

Netizen: 61 years old, female, suffered from low back and leg pain. Last year, the hospital diagnosed severe osteoporosis, and took 70 mg 20 boxes of alendronate tablets and calcium carbonate D3 tablets. It was effective to relieve low back and leg pain. I want to ask, how long is a course of treatment after taking alendronate? Should I stop taking it for a period of time between two courses of treatment? Thirdly, can I take it for a long time?

Li Ling: The scheme she uses includes calcium D, bisphosphate, which can inhibit the activity of osteoclasts. Usually, bisphosphate can be taken for about a year and a half, which can be stabilized for a period of time. You can stop taking it for half a year, and then take it again. You can also use the traditional method, use drugs that promote bone formation and inhibit bone absorption, or change the dressing.

Compere: Are you worried about drug resistance?

Li Ling: Any medicine has side effects. In some patients, about one and a half years, 70 mg can be maintained for a period of time in the first half of the year. When stopping the drug, bone density is usually measured. After three months and half of the year, it is measured again to see if it continues. If it can be maintained, it can be stopped for a period of time.

Moderator: Just now you have introduced a lot of life styles for osteoporosis prevention. Here is a little time. Could you tell us more about what we should pay more attention to in terms of lifestyle?

Li Ling: The first thing in life is diet. We should eat food with more calcium, milk and seafood. Second, try to avoid smoking, drinking, strong tea, strong coffee, and try to eat less. Then we should move. We should exercise more and bask in the sun more.

Host: bask in the sun and exercise.

Li Ling: Eat the good, and reduce the bad.

Host: Thank you very much, Professor Li, for coming to our studio. We know that osteoporosis is such a serious problem, how to prevent it, and how to treat it if we get it. Thank you very much. Thank you very much for your attention to our program. Due to time constraints, our program is coming to an end and famous doctors are gathering, Talk about people's health. See you on the next program.