ObjectiveTo investigate the effects of raloxifene on osteoprotegerin (OPG)/receptor activator nuclear factor kappa B ligand (RANKL) expression in mouse osteoblasts.MethodsSterile calvaria of mouse was taken from 30 newborn mice, and the osteoblasts were separated by enzyme digestion methods. Raloxifene in different concentrations (0,10<'-12>, 10<'-10>, 10<'-9>mol/L) were administrated into culture medium. The OPG/RANKL mRNA expression and OPG protein secretion were examined by RT-PCR and ELISA methods respectively.ResultsOPG mRNA expression in osteoblasts after raloxifene treatment was significantly higher than that in control group(P<0.05), and compared to 10<'-9> mol/L and 10<'-12> mol/L groups, it was significantly increased in 10<'-10> mol/L group.RANKL mRNA expression in osteoblasts after raloxifene treatment was significantly lower than that in control group(P<0.01), and the effect showed a dose- dependent manner. Compared to the control group, OPG protein secretion of osteoblasts was promoted by raloxifene treatment (10<'-9> mol/L:3.017±0.459;10<'-10> mol/L: 3. 981±0.762;10<'-12> mol/L : 2.864±0.416; control: 2.106±0.316, P<0.05).ConclusionsRaloxifene can increase OPG mRNA expression, promote OPG protein secretion and inhibit RANKL mRNA expression in osteoblasts.

Objective To study the effects of vaginal estrogen application on blood flow of the lower urinary tract in post-menopausal women. Methods Arterial blood flow frequency spectrum, peak systolic blood flow, end-diastolic blood flow velocity and resistance index of the peri-urethra and neck of the urinary bladder, as well as changes in their genitourinary system, were measured with color Doppler ultrasound imaging in post-menopausal women before and three months after their use of premarin ointment containing natural estrogen per vagina. Results Three months after treatment with estrogen-premarin ointment per vagina in post-menopausal women, their peak systolic blood flow velocity of the peri-urethra arteries increased to 13.23 cm/s from 11.94 cm/s before treatment, end-diastolic blood flow velocity increased to 3.92 cm/s from 1.91 cm/s and resistance index decreased to 2. 79 from 3. 84 (P <0. 01 ). And, their peak systolic blood flow velocity of the arteries of the neck of the urinary bladder increased to 17.09 cm/s from 12. 77 cm/s before treatment, end-diastolic blood flow velocity increased to 2. 83 cm/s from 1.31 cm/s and resistant index decreased to 2. 78 from 3.78 (P<0.01). It indicated that local vasodilatation and decrease dresistance of the lower urinary tract made blood flow of the arteries of the peri-urethra and neck of the urinary bladder increase, urinary frequency and nocturia occurrence decrease, and sexual satisfaction improve.Conclusions Blood flow, symptoms of the lower urinary tract and their quality of life can be improved in post-menopausal women after treatment with natural estrogen-premarin ointment per vagina.

Objective To analyze the epidemiological characteristics of the severe cases of hand , foot and mouth disease ( HFMD) in Danzhou and to provide a scientific evidence for the prevention of severe HFMD.Methods Descriptive epidemiological analysis was used to analyze the characteristics of severe ca -ses of HFMD occurred from 2010 to 2014 .Results A total of 18 960 cases of HFMD were reported in Danzhou City from 2010 to 2014.The death rate (annual deaths/1000 persons) was 0.13%.One hundred and eighty-eight cases (0.99%) were diagnosed as severe HFMD with a male to female ratio of 2.4 :1 and 96.28%of them were scattered inhabiting children .Six cases were died from severe HFMD and all of them were under 2 years of age.In total 87.77%of the severe cases were occurred in children under 2 years of age.The severe cases were mainly occurred in June and July .Children form the countryside showed higher rates of severe HFMD than those from cities and towns .No significant differences in the time between the in-itial diagnosis and treatment for children with HFMD in countryside and urban areas were found .However , the differences in the duration from initial diagnosis to severe HFMD between children in countryside and ur -ban areas were statistically significant (M-W test, P<0.05).Among the 188 severe cases, 82.44% were initially diagnosed as common HFMD cases by the county-level medical institutions and 90.96%were diag-nosed as severe cases by the municipal and above medical institutions .The cases positive for EV71 strains accounted for 44.15%.Conclusion Most of the severe HFMD were developed in scattered inhabiting chil-dren under 2 years of age in the countryside of Danzhou during 2010 to 2014.In order to decrease the mor-bidity and mortality of severe HFMD in children , it is necessary to implement health education for residents , to improve the professional skills of medical staffs in the early diagnosis of HFMD , and to strengthen etiologi-cal surveillances and warning system for HFMD .

Objective To investigate the feasibility of low-c oncentration iso_osmolar contrast agent together with low tube voltage and iterative reconstruction algorithm in rabbit liver computed tonography (CT) perfusion imaging.Methods A total of 15 bealthy New Zealand rabbits were scanned twice of liver CT perfusion scans each with 24 hours interval.The first scan (routine group) was acquired at 100 kV and 100 mAs with ultravist (370 mg/ml),while the second (double low group) was acquired at 80 kV and 100 mAs with iodixanol (270 mg/ml) at 24 hours after the first scan.The obtained images were reconstructed with filtered back projection (FBP) and adaptive iterative dose reduction (AIDR-3D)algorithms in the controlled and experimental groups,respectively.The perfusion parameters including hepatic artery perfusion(HAP),portal vein perfasion(PVP),hepatic perfusion index(HPI),and total liver perfusion(TLP) and image quality as image quality score,average CT value of abdomen aorta,signalto-noise ratio(SNR),carrier-to-noise ratio(CNR),and figure of merit(FOM) were compared used pair ttest or Mann-Whitney U-test between the two groups wherever appropriate.The effective radiation dose and iodine intake were also recorded and compared.Results The image quality and perfusion parameters had no significantly different between the two groups except for FOM.The effective radiation dose and iodine intake were 38.79％ and 27.03％ lower in the double low group.Conclusions Low concentration iso _osmolar contrast agent (iodixanol,270 mg/ml) together with low tube voltage (80 kV) helps to reduce radiation dose and iodine intake without compromising perfusion parameters and image quality in liver CT perfusion imaging.

Objective:To investigate the effectiveness of stroke standardized patient (SP) combined with the subjective-objective-assessment-plan (SOAP) problem-based medical recording method in the practice teaching of Physiotherapy. Methods:A randomized controlled study was conducted, and 116 students from the undergraduate class of rehabilitation therapy were selected as research subjects. The students in the control group received traditional teaching, and those in the experimental group received the teaching model of stroke SP combined with the SOAP assessment recording method. The effectiveness of teaching was compared between the two groups at the end of the course. SPSS 24.0 was used for statistical analysis; the chi-square test was used for categorical data, and the paired samples t-test was used for comparison between groups. Results:Compared with the control group, the experimental group had significantly higher scores of practical skills (85.97±3.19 vs. 78.14±3.86, P<0.05), basic theoretical knowledge (86.00±3.74 vs. 84.07±5.24, P<0.05), and writing of rehabilitation treatment records (85.74±4.76 vs. 66.86±4.16, P<0.05). Compared with the control group, the experimental group had significantly higher scores of the dimensions of knowledge confidence (12.55±1.30 vs. 8.79±1.59, P<0.01), skill confidence (10.86±1.51 vs. 7.45±1.27, P<0.01), and communication confidence (11.69±1.71 vs. 7.83±1.44, P<0.01). Conclusion:In the practice teaching of Physiotherapy, stroke SP combined with the SOAP assessment recording method can effectively improve the professional quality and clinical thinking ability of students, enhance their professional confidence, make up for the shortcomings of traditional teaching methods, and promote the teaching reform of rehabilitation medicine.

Objective:To compare the therapeutic effects of modified plantar skin grafting and thigh skin grafting on the deep burn wounds of the back and buttocks.Methods:A retrospective cohort study was conducted to analyze the clinical data of 30 patients with deep burn wounds on their back and buttocks who were admitted to the 910th Hospital of Joint Logistic Support Force of PLA from January 2021 to April 2023, including 26 males and 4 females, aged 21-72 years [(49.9±14.0)years]. The total burn size was 50%-97% of the total body surface area (TBSA), with the third-degree burn on the back and buttocks 6%-16% TBSA. The burn wounds on the back and buttocks were repaired using plantar skin grafts alone, thigh skin grafts alone or plantar skin grafts combined with the grafts from other body parts. The patients were grouped according to the skin graft donor sites and the times of harvesting skin grafts: there were 20 patients undergone plantar skin grafting including 10 patient with plantar skin graft harvested once (group of plantar skin graft harvested once) and 10 patients with plantar skin graft harvested twice or three times (group of plantar skin graft harvested more than once), and 10 patients undergone thigh skin grafting harvested once (group of thigh skin graft harvested once). The areas of plantar skin grafts harvested at the last time and the wound areas on the back and butts that could be repaired each time were calculated. After the last harvest, the thickness of the stratum corneum, 7-day survival rate of the skin grafts, proportion of 3-month residual wound area in the skin graft area, healing time of the donor sites, and 6-month Vancouver Scar Scale (VSS) scores of the donor sites in the group of plantar skin graft harvested once were compared with those in the group of thigh skin graft harvested once and the group of plantar skin graft harvested more than once. The appearance and texture of the skin graft, patients′ walking patterns and complications were observed at 6 months after the last skin harvest.Results:All the patients were followed up for 6-18 months [(7.8±1.6)months]. In the 20 patients with plantar skin grafts harvested, the areas of skin grafts harvested at the last time were 2.5%-4.5% TBSA [(3.4±0.6)% TBSA] and the wound areas that could be repaired each time were 3%-8% TBSA [(5.5±1.5)% TBSA]. After the last harvest, the thickness of the stratum corneum in the group of plantar skin graft harvested once was (190.4±8.9)μm, which was significantly thicker than that in the group of thigh skin graft harvested once [(50.0±6.6)μm] and that in the group of plantar skin graft harvested more than once [(166.8±21.9)μm] ( P<0.01); the 7-day survival rate of the skin grafts, proportion of 3-month residual wound area in the skin graft area, healing time of the donor sites, and 6-month VSS scores of the donor sites were (93.6±2.3)%, 2.0 (0.1, 3.5)%, (9.9±1.8)days and (1.7±0.7)points in the group of plantar skin graft harvested once, (78.0±6.6)%, 5.3 (4.0, 5.8)%, (14.0±1.4)days and (4.9±2.3)points in the group of thigh skin graft harvested once, and (93.4±2.6) %, 2.0 (0.1, 3.8)%, (10.0±1.2)days and (1.8±0.8)points in the group of plantar skin graft harvested more than once. The group of plantar skin graft harvested once showed a significant increase in the 7-day survival rate and a significant decrease in the proportion of 3-month residual wound area in the skin graft area, healing time of the donor sites, and 6-month VSS scores of the donor sites in comparison with the group of thigh skin graft harvested once ( P<0.05 or 0.01), while there were no significant differences in above mentioned indices between the group of plantar skin graft harvested once and the group of plantar skin graft harvested more than once ( P>0.05). At 6 months after the last skin harvest, the skin graft areas on the back and buttocks were flat, hard and firm and all the patients in the three groups could walk normally, with no complications such as severe itching, pain or folliculitis in the skin graft area. Conclusions:In the treatment of burn wounds on the back and buttocks, compared with thigh skin grafting, modified plantar skin grafting has advantages of thicker stratum corneum, better wear resistance and pressure resistance in the skin graft areas, a higher survival rate of skin grafts, rapid healing, mild scar, and undisturbed walking pattern after surgery and no common complications. Moreover, skin grafts can be harvested repeatedly from the donor sites, with no impact on the therapeutic effects.