I. Osteoporosis risk factors The major risk factors for osteoporosis include: age, race, bone mass, fragility fracture after age 50, long-term corticosteroid treatment. Secondary factors include: low body mass index or weight loss, smoking, family history, premature menopause, and propensity to fall. Other risk factors are long-term application of certain drugs (e.g., heparin) and having certain diseases. Second, bone mass and anti-bone resorption therapy Anti-bone resorption drugs include bisphosphonates, estrogens and SERMs, which can intervene in bone metabolism by reducing the bone conversion rate, thus treating osteoporosis, but the improvement of bone mass varies. 2001 when the National Health Association defined osteoporosis, it emphasized that bone strength affects bone quality as much as bone density. Bone quality is determined by five factors: bone turnover rate, degree of mineralization, increased accumulation, bone matrix protein, and bone structure. A high bone conversion rate will result in a negative balance of bone metabolism, while a low bone conversion rate will produce an excessive accumulation of mineralization and microdamage, while bone conversion directly affects bone structure. New breakthroughs in osteoporosis treatment 1. Selective estrogen receptor modulator raloxifene: SERM refers to substances that can act like estrogen on the estrogen receptors of bones to produce effects, while in other tissues, especially breast and uterus, they can produce the opposite effect of estrogen. Renoxifene is the main representative of SERM. It not only regulates bone turnover and improves bone density in the treatment of osteoporosis, but also has good effects in the following areas: (1) Bone: significantly increases bone mass, effectively regulates the excessive bone turnover rate and significantly reduces the incidence of osteoporotic fractures. (2) Breast: After 4 years of SERM treatment, the incidence of breast cancer in the treatment group decreased significantly compared to the control group, with a decrease rate of 62%-84%. (3) Cardiovascular disease prevention: The onset of osteoporosis in postmenopausal women may be accompanied by an increased risk of coronary vascular disease. A comparative study found that the risk of cardiovascular disease decreased significantly in patients treated with SERM for 4 years compared to the control group, suggesting that SERM has a positive effect on the prevention of cardiovascular disease. (4) Gynecological aspects: Treatment with SERM does not result in sudden uterine bleeding, no endometrial thickening, and no breast distension. (2) Parathyroid hormone 1-34 fragment: At present, the treatment of osteoporosis mainly focuses on using anti-bone resorption drugs. rhPTH(1-34) is a new osteoporosis osteogenic treatment drug, which can effectively promote bone formation and increase bone mass (including vertebrae and hips), especially it can significantly reduce osteoporotic fractures with a total decrease rate of 36%-40%, while for osteoporotic vertebral fragility fractures, its decline rate is as high as 53%, is currently the most promising drug for osteoporosis osteogenesis treatment. 3, osteoporosis imaging: the diagnosis of osteoporosis mainly relies on imaging methods, which can be divided into qualitative, semi-quantitative and quantitative 3 categories, with standard X-ray performance as the diagnosis is inappropriate. Bone mass loss has reached 30-40% before the appearance of x-ray manifestations in osteoporosis, so qualitative and semi-quantitative measurement methods cannot make early diagnosis, nor can they be used as sensitive indicators of dynamic changes in bone mineral content, and are no longer used as a routine means of osteoporosis measurement. Currently, popular measurement methods such as single-photon measurement, two-photon measurement, dual-energy X-ray absorptiometry and quantitative CT as well as the recently developed ultrasound measurement and MR measurement are available.