2019年 · 第99卷第45期

osteoporosis (OP) is an age-related bone disease that seriously affects the quality of life of patients^[1]。 According to the first OP epidemiological survey in China released by the National Health Commission in 2018, the prevalence rate of OP among people over 65 years old in my country reached 32.0%, including 10.7% men, 51.6% women, 25.6% urban areas, and 35.3% rural areas. The most serious consequence of OP is OP fracture, which is one of the leading causes of disability and death in elderly patients. It is estimated that medical expenditure for common OP fractures (vertebral body, hip and wrist) in China will reach 174.5 billion yuan by 2050^[2]。 Traditional Chinese and Western medicine have their own advantages in the diagnosis and treatment of OP. In order to clarify the role of integrated Chinese and Western medicine in the diagnosis and treatment of OP and improve the diagnosis and treatment level of integrated Chinese and Western medicine, the Professional Committee of Orthopaedics and Traumatology of Chinese Society of Integrated Chinese and Western Medicine organized experts to formulate this guide after many discussions according to the latest progress in the diagnosis and treatment of OP in recent years, with reference to domestic and foreign guidelines and the latest evidence-based medical evidence, combined with clinical experience. This guideline is an academic opinion only, and should be implemented in conjunction with patient and medical specific circumstances.

Portal hypertension can cause a series of serious clinical symptoms, such as esophageal and gastric varicose bleeding, refractory pleural and ascites effusion, etc. Liver cirrhosis is the most common and main cause of portal hypertension. transjugular intrahepatic portosystemic shunt (TIPS) is one of the key measures to reduce portal pressure in patients with liver cirrhosis by establishing a shunt in the hepatic parenchyma between the hepatic vein and the portal vein to significantly reduce portal vein resistance in a minimally invasive manner. At present, TIPS has been widely used in the treatment of esophageal and gastric variceal bleeding caused by portal hypertension in liver cirrhosis, refractory pleural and ascites effusion, Budd-Chiari syndrome (BCS) and hepatic sinus obstruction syndrome. After nearly 30 years of continuous exploration and development, especially with the clinical application of special covered stents, we have a new understanding of the indications, contraindications, technical operating standards, shunt stent selection and postoperative complications of TIPS^[1,2,3]。 However, at present, there are problems in China, such as understandardized TIPS operation process and perioperative management, poor technical quality control management, and lack of standardized collection and input management of relevant clinical data, which restricts the further improvement and development of domestic TIPS technology.

Radiofrequency therapy technology is to accurately output ultra-high frequency radio waves through special equipment and puncture needles to act on local tissues, and play the role of thermal coagulation, cutting or neuromodulation, thus treating pain diseases. This minimally invasive treatment method is classified into a standard radiofrequency (thermocoagulation) mode and a pulsed radiofrequency mode. Since the 19th century, animal experiments with electrical currents to damage the nervous system have been carried out, and by the middle of the 20th century, the first commercial radio frequency generator was created^[1]So that radiofrequency therapy technology can be put into clinical application. In 1997, Dutch physician Sluijter and engineer Rittman first proposed pulsed radio frequency (PRF) technology^[2]Because it does not damage nerves, does not appear hypoesthesia, soreness, burning pain and dyskinesia caused by nerve thermal disconnection, and has remarkable curative effect, it has great potential and application value in the treatment of pain diseases, and is a further development and supplement to traditional radiofrequency therapy technology. After years of continuous improvement and development, the clinical application range of radiofrequency therapy technology has been continuously expanded, and now it has become an effective means to treat many kinds of intractable pain.