Objective To estimate the impact of sonographically identified multiple or large (≥5cm in diameter)fibroids on perinatal outcomes.Methods Retrospective cohort study of 219 women with uterine fibroids was conducted.Results Compared to women with no fibroids,women with multiple fibroids (n =34)had a signifi-cantly higher rate of preterm birth (29.4% vs.5.0%,χ2 =23.0,P <0.001),cesarean section (73.5% vs.37.0%,χ2 =16.0,P <0.001)and breech presentation (11.8% vs.2.7%,χ2 =6.3,P =0.04).Women with large fibroids (n =48)had a higher rate of preterm birth (16.7% vs.5.0%,χ2 =8.1,P =0.01 )and pPROM (10.4% vs. 0.5%,χ2 =17.8,P <0.001).Conclusion Women with uterine fibroids are at increased risk of obstetric complica-tions.Multiple fibroids are associated with a significantly increased risk of preterm birth and cesarean delivery,while large fibroids are associated with a higher risk of pPROM.No correlation with IUGR,placenta previa or placental abruption was found.

Objective To investigate the therapeutic effects and the possible mechanisms of Tongluo recipe(TLR) on podocyte injury in streptozotocin-induced diabetic rats. Methods Diabetes was induced by a single intraperitoneal injection of streptozotocin(60 mg/kg) dissolved in citrate buffer. The diabetic model rats were randomly divided into two groups(n=12): diabetic mellitus(DM) group and DM+TLR group. Rats in the DM+TLR group received 0. 4 g/(kg • d) TLR throughout the experiment. Rats in the DM group and CON group (n = 8) were given celiac perfusion of distilled water once at the same time and dose. After 12-week treatment, 24 h urinary protein of rats was determined; the cellular ultrastructures of podocytes were observed by transmission electronic microscope; the number and the density of podocytes in glomerulis were measured by stereo logical dissector/fractionatormethods; the expression of nephrin in renal cortical tissuewas detected by Western blotting analysis; the activity of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and the content of malondialdehyde (MDA) were measured in the plasma and renal cortical tissue. Results Compared with CON group, DM group and DM+TLR group had significantly increased ratio of kidney mass to body mass, blood glucose, and 24-h proteinuria(all P<0. 01); at the 12th week, the glomerular basement membrane in DM group became conspicuously thick, foot process fusion and microvilii of podocytes were observed, and nephrin expression, podocyte number and podocyte density in the glomerulis were all significantly decreased(P < 0. 01). The morphology of the foot process was almost normal in DM+TLR group, with the basement membrane thickened, but was slighter than that in the DM group; and nephrin expression, podocyte number and podocyte density in DM+TLR group were significantly higher than those in the DM group(P<0. 01). Compared with CON group, DM group and DM+TLR group had significantly increased MDA content, and significantly decreased SOD and GSH-Px activities in the plasma and renal cortical tissue (P<0. 01, P<0. 05). Compared with DM group, DM+TLR group hadsignificantly increased SOD and GSH-Px activities and significantly decreased MDA content in plasma and renal cortical tissue(P<0. 01, P< 0.05). Conclusion TLR can ameliorate podocyte injury probably through depleting free radical production and increasing activities of antioxidatant.

Objective To investigate the therapeutic effects and the possible mechanisms of Tongluo reiipe (TLR) on podocyte injury in streptozotocin-induced diabetic rats. Methods Diabetes was induced by a ingle intraperitoneal injection of streptozotocin (60 mg/kg) dissolved in citrate buffer. The diabetic model rats were randomly divided into two groups (n=12): diabetic mellitus (DM) group and DM+TLR group. Rats in the DM+TLR group received 0. 4 g/(kg · d) TLR throughout the experiment. Rats in the DM group and CON group (n=8) were given celiac perfusion of distilled water once at the same time and dose. After 12-week treatment, 24 h urinary protein of rats was determined; the cellular ultrastructures of podocytes were observed by transmission electronic microscope; the number and the density of podocytes in glomerulis were measured by stereological dissector/fractionator methods; the expression of nephrin in renal cortical tissue was detected by Western blotting analysis; the activity of superoxíde dismutase (SOD), glutathione peroxidase (GSH-Px) and the content of malondialdehyde (MDA) were measured in the plasma and renal cortical tissue. Resulls Compared with CON group, DM group and DM+TLR group had significantly increased ratio of kidney mass to body mass, blood glucose, and 24-h proteinuria (all P<0.01); at the 12th week, the glomerular basement membrane in DM group became conspicuously thick, foot process fusion and microvilli of podocytes were observed, and nephrin expression, podocyte number and podocyte density in the glomerulis were all significantly decreased (P<0.01). The morphology of the foot process was almost normal in DM+TLR group, with the basement membrane thickened, but was slighter than that in the DM group; and nephrin expression, podocyte number and podocyte density in DM+TLR group were significantly higher than those in the DM group (P<0.01). Compared with CON group, DM group and DM+TLR group had significantly increased MDA content, and significantly decreased SOD and GSH-Px activities in the plasma and renal cortical tissue (P<0.01, P<0.05). Compared with DM group, DM+TLR group had significantly increased SOD and GSH-Px activities and significantly decreased MDA content in plasma and renal cortical lissue(P<0.01, P< 0.05). Conclusion TLR can ameliorate podocyte injury probably through depleting free radical production and increasing activities of anfioxidatant.

Bronchial asthma is one of the most common children health problems, with still increasing prevalence.Bronchial hyperresponsiveness is a characteristic feature of asthma,and its measurement may provide a useful adjunct in the diagnosis of asthma. Many children with asthma go into long-term clinical remission at adolescence, but bronchial hyperresponsiveness persists in approximately one half of these subjects, so implement the bronchial provocative tests in children with asthma remission may appears very important.

The purpose of applying antibiotics prophylaxis in perioperative orthopedic surgery is to prevent or decrease the risk of infection.The opportune administration is the key point for prevention of infection.The application principle,classification and current situation are reviewed in this paper,its perspective and prospects are also investigated.

This paper reports the diagnosis and treatment of one rare case of thyroid dysfunction caused by Strongyloides ster-coralis infection.

Osteoporosis is a kind of systemic metabolic bone diseases ,characterized by bone loss , bone subtle structural dam-age.Leptin is a peptide hormone which secreted by fat cells , that has both positive and negative effects to the bone , and plays a role of regulating on bone metabolism .In vitro, Leptin can regulate proliferation of osteoblast and inhibit reabsorption of osteoblasts depend on osteoclast.In vivo, Leptin can inhibit the synthesis of serotonin in the brain stem and increase the sympathetic nerve signals output by the hypothalamus to the bone , it mainly has a negative effect .But clinical trials about the correlation between Leptin and senile oste-oporosis, the role of Leptin in the central nervous system and peripheral tissue problems are still unclear .In this paper, we will make a comprehensive overview about the latest research progress in the correlation between leptin and senile osteoporosis .

Heterotopic ossification is a pathologic bone formation,and can lead to joint dysfunction.There are several related factors for heterotopic ossification,such as surgery and wound,cytokine,genetic factor and perioperative drugs,while the definite pathogenesis is still unclear.Mature heterotopic ossified bone shows similar images as normal bones,and dynamic histomorphologic measurements suggest contrast to normal bone,heterotopic ossified bone exhibits higher metabolic activity.Risk factors for heterotopic ossification include severe central nerve injury,long-term coma,limb spasticity,limb braking and increase of serum alkaline phosphatase.Related factors for heterotopic ossification at molecular level are important in future studies to provide support for the prevention and therapy in heterotopic ossification following trauma or surgery.

Oxidative stress is one of the important pathogenesis of diabetic nephropathy.In recent years,the role of oxidized low-density lipoprotein(Ox-LDL) in the occurrence and progress of diabetic nephropathy has been more and more concerned about,and becomes a hot spot once again.This paper makes a review of the formation and metabolic mechanism of Ox-LDL,the changes of Ox-LDL in the progress of diabetic nephropathy and its clinical significance,and a number of new treatments for Ox-LDL in recent years to further understand the role of Ox-LDL in the occurrence and progress of diabetic nephropathy,then to provide new ideas for effective clinical treatment of diabetic nephropathy. Abstract:Summ ary:Oxidative stress is one of the important pathogenesis of d iabetic nephropathy.In recent years,the role of oxi-d ized low-density lipoprote in(Ox-LDL) in the occurrence and progress of d iabetic nephropathy has been more and more concerned about,and becom es a hot spot once again.Th is paperm akes a review of the form ation and m etabolic m echan ism of Ox-LDL,the changes of Ox-LDL in the progress of d iabetic nephropathy and its c lin ical sign ificance,and a number of new treatm ents forOx-LDL in recent years to further understand the role ofOx-LDL in the occurrence and progress of d ia-betic nephropathy,then to provide new ideas for effective c lin ical treatm ent of d iabetic nephropathy.