Osteoporosis is a common disease in the elderly. As studies on its causation and pathogenic mechanism deepened in recent years,there appeared many anti-osteoporotics and many of them had been widely used in clinic. However,none of them was found to be able to completely replace other drugs to achieve satisfactory effect in clinical applications. They all have certain defects. In this paper,three types of drugs including bone resorption inhibitors,bone mineralizers and bone formation accelerators,were analyzed in terms of their mechanisms of action,advances in clinical application as well as their side effects,so as to guide the clinical choice and combination of drugs targeted to avoid serious side effects and to seek for the direction of further study.

Objective To know the impact of nursing intervention mode of parent-child interactive on the adaption of postpartum family roles.Methods One hundred families (maternal,husbands,baby at birth) were divided into the intervention group and the control group.The intervention group was cared by the responsibility nurses who were trained to master the parent-child interactive nursing intervention.The control group was cared by conventional nursing methods.The role adaptation of the fathers and the mothers of the two groups,and self-confidence of the parents to take care of newborns were observed.Results In the intervention group,the role adaptation of the fathers and the mothers was better than the control group; self-confidence of taking care of the newborn was better than the control group.The sleep time of the newborns was prolonged and the crying times were less than the control group.Conclusions The parent-child interactive nursing intervention model can help the family to adapt to the father and the mother role as soon as possible; teach the parents to comprehensively understand newborns,give stimulation of touch,sight,hearing,smell,so as to achieve positive response of newborns and increase the confidence of rearing newborns of the parents.

Objective: To investigate the mechanism of butyrate,which is the by-products of diet fiber fermented in colon and induce the apoptosis of human colon cancer cell. Methods: The subculture of human colon cancer cell line SW1116 was cultured in medium with different concentration of butyrate(0、2 、3 、4、7 and 10 mmol/L).The mRNA and proteins of bcl-2 or bax in cell lines were detected respectively by RT-PCR and Western Blotting while the concentration of p53 protein and the activity of caspase-3 was detected by flow cytometer and fluorescent quantitative assay respectively after 6、24、48 and 72h cultivation.Results: There was no expression of bcl-2 mRNA and its protein in SW1116 cell during the study periods but the expression of bax mRNA and its protein,the p53 protein concentration and the caspase-3 activity increased gradually when the butyrate concentration was increased and the cultivation time was prolonged. Conclusion: By up-regulating the expression of bax mRNA and its protein,butyrate induce the apoptosis of colon cancer cell on a p53 dependent way.

Objective To describe practice experience of the male nurses in obstetrics and gynecology department.Methods Phenomenological methodology was adopted in this study.In-depth interview was conducted on 12 male nurses who practiced in obstetrics and gynecology department from March 2012 to May 2013.Data were analyzed by Colaizzi's analysis method.Results The main experience included:lack of patient understanding and support,a sense of loss,decline in the enthusiasm to learn,inconvenience of live and study,dissatisfied with specialist operations.Conclusions Male nurses in obstetrics and gynecology has many adverse experiences,clinical teachers should take measures to help them successfully complete the practice and prevent occurrence of adverse experience.

There are great differences in the education and working system of certain professionals between Chinese mainland and Taiwan region due to the differeuces in the political system.In this essay,we try to compare the differences in the education level,objective and course offering of the medical imaging technique major and the differences in the professional qualification examination system and the working system between Chinese Mainland and Taiwan Region.We also probe into the possible fields for both sides to learn from each other and to provide references for cooperative school - running,professionals' interchange and working system of medical imaging technique majors of both sides.

Objective To observe the effects and traits of applying locking anatomic plates to the proximal femur for the old-aged aroundtrochanteric fractures. Methods From January 2006 to August 2010, 56 cases with old-aged aroundtrochanteric fractures were selected as samples. Clinical and radiographic data were retrospectively reviewed at the 1st, 3rd, 6th, 12th month after operations. In the meantime, analysis of comparison between them and ones with the DHS treatment was conducted. Results All of the operations were successful. Altogether 56 patients were followed up, average 9.4 months. All of their fractures were healed in a mean time of 5.3 months without delayed union, nonunion, hip equinovarus, failure of screws and plates or death. Comparison of the excellent and goodrate of two groups, the dif-ferences was significant (P<0.05). Conclusion Applying locking anatomic plates to the proximal femur can provide sta-ble fixation with a good functional outcome, which is an effective method for the old-ageed aroundtrochanteric fractures and reducing death rate.

Objective: To understand the impact of left behind experience on the mental health of secondary vocational school students, so as to provide theoretical basis for the psychological health education of secondary vocational school students. Methods: From September to December in 2019, a total of 3 401 students from Duyun, Guiding and Pingtang County were selected by multi stage cluster random sampling method. Self designed questionnaire and Symptom Check List-90(SCL-90) were used to investigate mental health status. A total of 1 415 left behind students and 1 415 non left behind students were matched by using propensity score matching (PSM). Wilcoxon test and Logistic regression analysis were conducted. Results: Before the matching of propensity score, there were statistically significant differences in the distribution of family structure, mother s educational level, family residence,family harmony and children s past health among the students with or without left behind experience ( χ 2=28.17, 52.40, 96.31, 29.75 , 19.10, P <0.05). After the matching, there were no statistically significant differences in the distribution of the above variables among the students with or without left behind experience ( χ 2=0.02-4.32, P >0.05). Before the matching of propensity scores, there were significant differences in the scores of 10 dimensions of SCL-90, including somatization (1.67,1.58), interpersonal sensitivity (2.00,1.89), anxiety (1.90,1.70), obsessive compulsive symptoms (2.20, 2.10), depression (2.00, 1.85), hostility (1.83, 1.67), terror (1.85, 1.71), paranoia (1.83, 1.67), psychotic (1.70, 1.60) and other (1.85, 1.71) dimensions among secondary vocational school students with or without left behind experience ( Z=-5.15 to -2.84, P <0.05). After propensity score matching, there were significant differences in scores remained only in three factors for interpersonal sensitivity [(2.00(1.56,2.67)，2.00(1.44,2.56)], paranoia [1.83(1.33,2.50)，1.83(1.33,2.33)] and psychoticism [1.70(1.30,2.30)，1.70(1.20,2.20)] in SCL- 90 among secondary vocational students with or without left behind experience ( Z=-2.45, -2.12, -2.23, P <0.05). Conclusion The impact of left behind experience on the mental health of vocational school students is mainly reflected in interpersonal sensitivity, paranoia, and psychoticism, which should be identified as key areas of psychological education for secondary vocational school students.

Objective:To evaluate the prognostic value of arterial lactate (Lac) combined with central venous-to-arterial carbon dioxide difference to arterial-to-central venous oxygen content difference ratio (Pcv-aCO 2/Ca-cvO 2) in patients with septic shock following early fluid resuscitation. Methods:A total of 97 patients with septic shock admitted to intensive care unit (ICU) of Lanzhou University Second Hospital from January 2017 to December 2019 were enrolled. The Pcv-aCO 2/Ca-cvO 2 ratio was calculated from blood gas analysis of radial artery and superior vena cava which was performed before resuscitation and at 6 hours of resuscitation at the same time. The patients were divided into death group and survival group according to the 28-day prognosis. The baseline data, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure score (SOFA), clinical therapy, lactate clearance rate (LCR) at 6 hours, the length of ICU stay, hemodynamics and oxygen metabolism parameters before and after resuscitation were compared between the two groups. Risk factors were analyzed by multivariate Cox regression for 28-day mortality of patients with septic shock. The receiver operating characteristic (ROC) curve was plotted to assess the prognostic values of these factors for 28-day mortality. Results:① Compared with the survival group, the patients in the death group showed significantly higher levels of APACHEⅡ score (23.96±4.31 vs. 17.70±3.92) and SOFA score (12.74±2.80 vs. 9.23±2.43, both P < 0.01), significantly higher proportions of mechanical ventilation [85.2% (23/27) vs. 50.0% (35/70)] and continuous renal replacement therapy [CRRT; 51.9% (14/27) vs. 25.7% (18/70), both P < 0.05], a significantly more fluid replacement at 6 hours (L: 2.92±0.24 vs. 2.63±0.25, P < 0.01), a significantly lower level of LCR at 6 hours [(11.61±7.76)% vs. (27.67±13.71)%, P < 0.01], and a shorter length of ICU stay (days: 6.37±2.70 vs. 7.67±2.31, P < 0.05). ② Compared with the survival group, the patients before resuscitation in the death group showed a significantly lower level of mean arterial pressure [MAP (mmHg, 1 mmHg = 0.133 kPa): 52.63±4.35 vs. 55.74±3.01, P < 0.01], significantly higher levels of Lac and Pcv-aCO 2/Ca-cvO 2 ratio [Lac (mmol/L): 7.13±1.75 vs. 5.22±1.36, Pcv-aCO 2/Ca-cvO 2 ratio: 1.67±0.29 vs. 1.48±0.22, both P < 0.01]; and the patients at 6 hours of resuscitation in the death group showed a significantly lower level of MAP (mmHg: 62.59±4.80 vs. 66.71±3.91, P < 0.01), significantly higher levels of central venous pressure (CVP), Lac, Pcv-aCO 2 and Pcv-aCO 2/Ca-cvO 2 ratio [CVP (mmHg): 10.74±1.40 vs. 8.80±0.75, Lac (mmol/L): 6.36±1.86 vs. 3.90±1.95, Pcv-aCO 2 (mmHg): 7.59±2.02 vs. 4.34±1.37, Pcv-aCO 2/Ca-cvO 2 ratio: 1.87±0.51 vs. 1.03±0.27, all P < 0.01]. ③ Multivariate Cox regression analysis showed that the independent risk factors for 28-day mortality in patients with septic shock were Lac and Pcv-aCO 2/Ca-cvO 2 ratio whether before or at 6 hours of resuscitation [Lac before resuscitation: relative risk ( RR) = 1.434, 95% confidence interval (95% CI) was 1.070-1.922, P = 0.016; Lac at 6 hours of resuscitation: RR = 1.564, 95% CI was 1.202-2.035, P = 0.001; Pcv-aCO 2/Ca-cvO 2 ratio before resuscitation: RR = 2.828, 95% CI was 1.108-4.207, P = 0.038; Pcv-aCO 2/Ca-cvO 2 ratio at 6 hours of resuscitation: RR = 4.386, 95% CI was 2.842-5.730, P = 0.000]. ④ ROC curve analysis showed that Lac and Pcv-aCO 2/Ca-cvO 2 ratio at 6 hours of resuscitation had predictive value for the prognosis of patients with septic shock, the area under ROC curve (AUC) was 0.849 (95% CI was 0.762-0.914) and 0.905 (95% CI was 0.828-0.955), respectively. However, the predictive value of Lac combined with Pcv-aCO 2/Ca-cvO 2 ratio in patients with septic shock was significantly higher than Lac [AUC (95% CI): 0.976 (0.923-0.996) vs. 0.849 (0.762-0.914), Z = 3.354, P = 0.001], the sensitivity was 97.14%, and the specificity was 88.89%. Conclusions:Lac and Pcv-aCO 2/Ca-cvO 2 ratio are independent risk factors for predicting 28-day mortality in patients with septic shock. Lac combined with Pcv-aCO 2/Ca-cvO 2 ratio can assess the prognosis of patients with septic shock more accurately.

Objective To determine the correlation between intravoxel incoherent motion (IVIM) parameters and both histologic inflammatory and fibrotic grades of Crohn disease (CD) in adults. Methods Prospectively, 17 patients (77 lesions) with a clinical and pathological diagnosis of CD in the first affiliated hospital of sun yat-sen university from July 2015 to June 2016 underwent MRE 15 days before surgery. All patients underwent T2WI, IVIM and enhanced MRI and calculated IVIM parameters include diffusion-related coefficient (D), perfusion-related coefficient (D*) and perfusion-related fraction (f). Histological intestinal inflammation and fibrosis was scored using the surgical histopathology as reference standard and further divided into mild-moderate (score 1 to 2) and severe (score 3 to 4) groups. Intestinal microvessel density (MVD) were also analyzed. Differences in IVIM parameters among different histological inflammation and fibrosis grades were assessed with the Kruskal-Wallis test. The Wilcoxon test was used for assessing differences in f between mild-moderate and severe fibrosis. The bivariate correlations between IVIM parameters and histological inflammation and fibrosis grades were analyzed using partial correlation . The bivariate correlations between IVIM parameters and MVD were analyzed using Spearman rank correlation. The areas under the receiver operating characteristics curves (AUROC) were analyzed to evaluate the efficacy for distinguishing severe from mild-moderate fibrosis. Results Of 77 surgical specimens, there were 41 mild-moderate and 36 severe inflammatory bowel segments, along with 22 mild-moderate and 55 severe fibrotic bowel segments. Positive correlation was shown between histologic inflammatory and fibrotic scores (r=0.592, P<0.01). MVD (42.7 ± 39.9)/HP presented weak positive correlation with histologic inflammatory scores (r=0.332, P=0.003) while no correlation with histologic fibrotic scores (r=0.129, P=0.262) was presented. Neither the D nor the D* values significantly correlated with histologic inflammation or fibrosis (P>0.05) while the f value significantly correlated with both histologic inflammation and fibrosis (P<0.05). Significant correlation was present between the f value and histologic inflammatory and fibrotic scores, respectively (r=-0.280, -0.520;P<0.05). There was significant difference in the f value between mild-moderate and severe fibrosis(Z=-5.255,P<0.01). The AUROC for the f value to distinguish between patients with mild-moderate fibrosis and severe fibrosis were 0.885. Using a threshold fractional perfusion of 0.33, the sensitivity and specificity values were 95.5％ and 81.8％, respectively. No correlation between f, D and D*value with histologic fibrotic scores (r=0.129, P=0.262) was presented. Conclusion The f value derived from IVIM could help to evaluate the severity of intestinal inflammation and fibrosis CD in adults.

Objective To explore the effect of continuous nursing intervention on limb function and nursing quality after proximal femoral nail antirotation (PFNA) internal fixation for femoral intertrochanteric fracture in the elderly. Methods From February, 2017 to November, 2018, 100 elderly patients with femoral intertrochanteric fracture who underwent PFNA internal fixation in our hospital were randomly divided into control group (n = 50) and observation group (n = 50), who accepted routine nursing and continuous nursing respectively for three months. They were assessed with Harris score and visual analogue scale for pain (VAS) before and after the intervention. The postoperative nursing effect was compared. Results The Harris score increased in both groups after the intervention (t > 45.98, P < 0.001), and increased more in the observation group than in the control group (t = 15.03, P < 0.001). The VAS score decreased in both groups after the intervention (t > 16.33, P < 0.001), and decreased more in the observation group than in the control group (t = 9.749, P < 0.001). The effect of nursing was better in the observation group than in the control group (Z = -2.272, P = 0.023). Conclusion Continuous nursing intervention can significantly improve the limb function and nursing satisfaction of elderly patients with femoral intertrochanteric fracture after PFNA.