ObjectiveTo investigate the effects of caleitriol,training on balance and lower extremity muscle strength on fall risk of postmenopausal women with osleoporosis or osteopenia.Methods A total of 200 postmenopausal women with osteoporosis or osteopenia,whose balance test confirmed higher fall risk,were randondy assigned to group A or B.Those of group A received the following intervention:( 1 ) 0.25 μg calcitriol,QD; (2) general information on fall and osteoporosis; (3) balance training; (4) lower extremity muscle strength exercises.Those of group B were only treated with 0.25 μg calcitriol.All the participants were supplemented with 600 mg/d calcium and 125 IU/d vitamin D.Fall index,bone mineral density,serum levels of calcium and phosphorus,and adverse reactions were record.Results After 3 months' intervention,the fall index of both groups was significantly decreased ( group A:t =2.16,P＜0.05 ; group B:t =2.08,P＜0.05 ).After 6 months' intervention,the fall index of both groups went on decreasing,and significant difference of fall index between 6 month and baseline of group A and between group A and group B at 6 months was found.After 1-year intervention,the fall index of group A was further decreased in comparison with group B ( t =2.66,P＜0.05 ).No hypercalcemia occurred during the study period.Conclusion The fall risk of the patients with postmenopausal osteoporosis or osteopenia was reduced after 3 months' intervention.Twelve months' active vitamin D intervention could either reduce the risk of fall or improve bone mineral density.Patient education,balance training and muscle exercise may be effective intervention to reduce fall risk.

Objeetive To investigate the changes of kidney cortex hemoperfusion before and after extracorporeal shock wave lithotripsy (ESWL) with contrast-enhanced ultrasonography (CEUS) and time-intensity curve.Methods Thirty patients of renal calculi were treated with ESWL and examined with CEUS before and after ESWL.Renal cortex blood perfusion parameters of the lithotriptic areas,including the contrast agent arrival time (AT) ,time to peak (TTP) .peak intensity (PI) and velocity parameters (β) were quantitatively measured with ACQ software.Results The value of AT,TTP and β were not significantly different before and after ESWL (P＞0.05) .PI value after ESWL was lower than that before ESWL (P＜0.05) . Conclusion CEUS can quantitatively evaluate the changes of kidney cortex hemoperfusion after ESWL,and reflect the minor renal damage resulted from ESWL.CEUS can be used as a new method of observing and evaluating the renal damage caused by ESWL.

Objective To explore the real user experiences of patients with PICC catheter for PICC maintenance network in Shandong province.Methods Descriptive phenomenological methodology was adopted in this study.A semi-structured interview was conducted with 18 patients of PICC-line maintained in different hospitals from PICC maintenance network in Shandong province.We analysed the data by Colaizzi's phenomenological research method.Results The experiences of patients with PICC catheter for PICC maintenance network in Shandong province contain positive and negative aspects.The positive aspects were convenient medical treatment,cooperation in various level hospitals,progress of basic hospitals,and enthusiastic services;the negative aspects were personnel shortage,different levels of nurses and imperfect supporting system.Conclusions Patients with PICC maintenance network possessed positive experience,but the accessibility of PICC maintenance network should be further enhanced,specialized development should be promoted.Meanwhile,for the questions proposed by patients,some measures should be taken to improve the overall PICC maintenance service from various level hospitals in Shandong province and make the experience of patients better.These measures include strengthening the standardized training and quality control of PICC,improving the supporting system,and promoting the implementation of continuous nursing mode in the primary hospitals.

Objective:To investigate the clinical effect of high diffusion sensitivity coefficient(high b value)diffusion-weighted imaging(DWI),dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with tumor carbohydrate antigen 125(CA125)in judging the nature of ovarian lesions.Methods:A total of 100 patients with ovarian lesions who were treated in Nantong Haimen People's Hospital from April 2020 to April 2022 were selected for retrospective study.All of them underwent CA125,DWI,DCE-MRI and pathologically qualitative examination.According to the pathological results,58 patients with malignant lesions of ovarian were divided into malignant group and patients with benign lesions of ovarian were divided into benign group.The CA125 levels of the two groups were analyzed and compared,and the results of the receiver operating characteristics(ROC)of different detection methods(DWI with high b value+CA125,DCE-MRI+CA125,DWI with high b value+DCE-MRI+CA125)also were analyzed and compared.Results:The CA125 index of the malignant group was significantly higher than that of the benign group,with a statistically significant difference(t=29.357,P＜0.05),and the CA125 positive rate of the malignant group was significantly better than that of the benign group,with a statistically significant difference(x2=34.456,P＜0.05).The apparent diffusion coefficient(ADC)value[(0.91±0.18)×103mm2/s]of the malignant group was significantly less than that[(33±0.21)×103mm2/s]of the benign group,while the contrast agent volume conversion constant(Ktrans),rate constant(Kep)and the extracellular space volume ratio outside of blood vessels(Ve)of the malignant group were significantly higher than those of the benign group,with significant differences(t=16.863,9.686,10.205,P＜0.05),respectively.The diagnostic accuracy,sensitivity,negative predictive value and positive predictive value of DWI with high b-value+DCE-MRI+CA125 examination method were higher than those of DWI with high b-value + CA125 or DCE-MRI+CA125 examination method in diagnosing malignant ovarian tumors.There were not significant differences in various indicators between DCE-MRI+CA125 examination method and DWI with high b-value +CA125 examination method(P＞0.05).ROC curve analysis showed that the area under curve(AUC)of the DWI with high b-value +DCE-MRI+CA125 examination method was the best(AUC=0.920).Conclusion:The combined examination method of DWI with high b-value + DCE-MRI + CA125 has better overall diagnostic efficiency,which can improve the screening ability of clinical diagnosis for malignant ovarian tumors.It has a certain clinical application value.

ObjectiveThis study aims to investigate the effects of Linggui Zhugantang （LGZGT） on ventricular remodeling （VR） in mice with myocardial infarction （MI） and its impact on the Ras homologgene A （RhoA）/Rho-associated coiled-coil forming protein kinase （ROCK） signaling pathway. MethodsThe MI model of mice was established by ligating the left anterior descending coronary artery （LAD）. They were divided into the sham-operated group， the model group， the low-dose， medium-dose， and high-dose groups of LGZGT （2.34， 4.68， 9.36 g·kg^-1）， and the captopril group （3.25 mg·kg^-1）， with 10 mice in each group. After four weeks of continuous drug administration by gavage， the level of cardiac function in each group of mice was examined using small animal Doppler ultrasound. Hematoxylin-eosin （HE） staining and Masson staining was used to assess the morphological changes of myocardial tissue and calculate the rate of collagen fiber deposition in mouse myocardial tissue. Wheat germ agglutinin （WGA） staining was employed to compare the cross-sectional area of cardiomyocytes in each group of mice. The expression levels of α-smooth muscle actin （α-SMA）， matrix metalloproteinase-2 （MMP-2）， type Ⅰcollagen （Col Ⅰ）， Col Ⅲ， tissue inhibitor of metalloproteinase 1（TIMP1）， B-cell lymphoma-2 （Bcl-2）-associated X protein （Bax）， Bcl-2， Caspase-3， and cleaved Caspase-3 were detected by Western blot. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to evaluate the mRNA levels of the pathway-related genes RhoA， ROCK1， and ROCK2. The protein expression levels of RhoA， ROCK1， and ROCK2 were tested by Western blot. ResultsThe level of cardiac function was markedly declined in the model group compared to the sham-operated group（P<0.01）. Myocardial tissue morphology changed significantly. The cross-sectional area of cardiomyocytes was significantly enlarged. The expression of α-SMA， MMP-2， Col Ⅰ， and Col Ⅲ was significantly upregulated（P<0.01）， and TIMP1 protein expression was significantly reduced（P<0.01）. The expressions of apoptosis-related proteins Bax were significantly up-regulated（P<0.01）， while the expression of Bcl-2 protein was significantly decreased（P<0.01）. The mRNA expression of RhoA， ROCK1， and ROCK2 were significantly upregulated （P<0.01）. Compared to the model group， the low-dose， medium-dose， and high-dose groups of LGZGT and the captopril group significantly reversed the experimental results of the model group in a dose-dependent manner （P<0.05， P<0.01）. ConclusionLGZGT significantly attenuated myocardial fibrosis， myocardial hypertrophy， and cardiomyocyte apoptosis after MI in mice and effectively reversed VR， the mechanism of which may be related to the modulation of the RhoA/ROCK signaling pathway.

ObjectiveThis study aims to investigate the effects of Linggui Zhugantang （LGZGT） on ventricular remodeling （VR） in mice with myocardial infarction （MI） and its impact on the Ras homologgene A （RhoA）/Rho-associated coiled-coil forming protein kinase （ROCK） signaling pathway. MethodsThe MI model of mice was established by ligating the left anterior descending coronary artery （LAD）. They were divided into the sham-operated group， the model group， the low-dose， medium-dose， and high-dose groups of LGZGT （2.34， 4.68， 9.36 g·kg^-1）， and the captopril group （3.25 mg·kg^-1）， with 10 mice in each group. After four weeks of continuous drug administration by gavage， the level of cardiac function in each group of mice was examined using small animal Doppler ultrasound. Hematoxylin-eosin （HE） staining and Masson staining was used to assess the morphological changes of myocardial tissue and calculate the rate of collagen fiber deposition in mouse myocardial tissue. Wheat germ agglutinin （WGA） staining was employed to compare the cross-sectional area of cardiomyocytes in each group of mice. The expression levels of α-smooth muscle actin （α-SMA）， matrix metalloproteinase-2 （MMP-2）， type Ⅰcollagen （Col Ⅰ）， Col Ⅲ， tissue inhibitor of metalloproteinase 1（TIMP1）， B-cell lymphoma-2 （Bcl-2）-associated X protein （Bax）， Bcl-2， Caspase-3， and cleaved Caspase-3 were detected by Western blot. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to evaluate the mRNA levels of the pathway-related genes RhoA， ROCK1， and ROCK2. The protein expression levels of RhoA， ROCK1， and ROCK2 were tested by Western blot. ResultsThe level of cardiac function was markedly declined in the model group compared to the sham-operated group（P<0.01）. Myocardial tissue morphology changed significantly. The cross-sectional area of cardiomyocytes was significantly enlarged. The expression of α-SMA， MMP-2， Col Ⅰ， and Col Ⅲ was significantly upregulated（P<0.01）， and TIMP1 protein expression was significantly reduced（P<0.01）. The expressions of apoptosis-related proteins Bax were significantly up-regulated（P<0.01）， while the expression of Bcl-2 protein was significantly decreased（P<0.01）. The mRNA expression of RhoA， ROCK1， and ROCK2 were significantly upregulated （P<0.01）. Compared to the model group， the low-dose， medium-dose， and high-dose groups of LGZGT and the captopril group significantly reversed the experimental results of the model group in a dose-dependent manner （P<0.05， P<0.01）. ConclusionLGZGT significantly attenuated myocardial fibrosis， myocardial hypertrophy， and cardiomyocyte apoptosis after MI in mice and effectively reversed VR， the mechanism of which may be related to the modulation of the RhoA/ROCK signaling pathway.