Objective To investigate the the effect of motherwort on metalloproteinases in decidual tissue in the treatment of abnormal uterine bleeding induced by drug abortion in patients.Methods 76 patients with abnormal uterine bleeding by drug abortion in this study form Cangnan County Maternity & Child Healthcare Hospital were selected and divided into 2 group, 38 cases of each group.The control group received mifepristone, misoprostol and progynova treatment,the experimental group received more with motherwort.The serum hormones change and matrix metalloproteinases in decidual tissue by S-P method were determine,while adverse reaction were compared after the treatment.Results Compared with before treatment,levels of serum estradiol increased,progesterone decreased,content of the matrix metalloproteinase(MMP-3)and MMP-9 in decidual tissue increased,tissue inhibitor of metalloproteinase(TIMP-1)in decidual tissue decreased,the differences were statistically significant(P<0.05),compared with the control group,levels of serum estradiol in the experimental group were higher,progesterone were lower,contents of MMP-9 and MMP-3 in the tissues were higher, levels of TMP-1 were lower, and bleeding duration was shorter, vaginal bleeding was less ( P <0.05 ) .Conclusion Motherwort in the treatment of abnormal uterine bleeding by drug abortion in patients has good curative effect,it could increase the levels of MMP-3 and MMP-9,reduce levels of TIMP-1 in decidual tissue,and reduce the bleeding time and bleeding volume.

Objective To evaluate the therapeutic effect of extendable intramedullary nail on children with femoral deformity due to osteogenesis imperfecta.Methods From June 2009 to June 2012,21 patients with femoral deformity due to osteogenesis imperfecta were treated with extendable intramedullary nail.There were 13 males and 8 females,aged from 9 years and 6 months to 15 years and 7 months (average,12 years and 3 months).All children had been performed osteotomy on the shaft of femur and implanted with non-extendable nail before 2-4 years (average,3 years).All children had suffered refracture and deformity,including 9 children with femoral bending deformity and 12 with refracture.The deformity angle ranged from 10°to 30°,with an average of 15°.According to revised Sillence classifications,there were 6 cases with type Ⅲ and 14 with type Ⅳ and 1 case with type Ⅴ.Twenty-one patients were operated with extendable nail for fixing fracture and correcting deformity and incisions were 2-3 cm long and located on the great trochanter and distal osteotomy point.Results All of 21 children were followed up for 6-30 months (average,18 months).The bone healing time was 7-12 weeks (average,8.5 weeks).Patients started to walk after X-ray showing bone union.Parents of 21 children were satisfied with surgical operation effect and deformity correction.The Barthel index score improved from 72.85 (range,50-90 points) preoperatively to 91.42 (range,80-100 points) postoperatively at the latest follow-up of patients.WeeFIM index score increased from preoperative average of 55.42 points (range,40-70points) to postoperative average 79.00 points (range,70-86 points).Ten of all children with stick aid preoperative could walk independently after small incision repairing,and 6 of all children in sickbed preoperative,4 of 6 children could walk independently,2 of 6 children could walk with stick aid.Conclusion Small incision repair with extended intramedullary nail operation therapy is advantaged.It gets less bloody,less damages,less pain,less healing time and walking after removing plaster.

Objective To validate the four chronic kidney disease epidemiology collaboration (CKD-EPI) predictive equations based on serum creatinine (SCr) and cystatin C (Cys C) in Chinese CKD patients,and try to develop the GFR predictive equations for Chinese CKD patients.Methods254 CKD patients were randomly selected from four Grade ⅢA hospitals in different regions in China from September 2007 to December 2010.Clearance of dual plasma sampling 99mTc-DTPA was used to measure glomerular filtration rate (rGFR) in 254 CKD patients.The serum concentration of Cr and Cys C were measured.CKD-EPI SCr equation,Cys C equation,Cys C equation adjusted for age,sex and race,SCr/Cys C combinated equation adjusted for age,sex and race were used to estimate GRF ( labeled as eGFR1,eGFR2,eGFR3 and eGFR4,respectively).The correlation,bias and precision of eGFRs were compared with rGFR by Wilcoxon signed rank test,intraclass correlation coefficient (ICC) and Spearman correlation analysis.The deviation degree between rGFR and different eGFRs was compared via Bland-Altman graph.The accuracy within 15％,25％,30％ ( P15,P25,P30) and the staging correctness of eGFR against CKD at different stages was calculated.ResultsThe rGFR in 254 CKD participants was [ 48.07 (26.19 -92.97 )] ml · min -1·(1.73 m2) -1.The Spearman correlatiou coefficients (CC) of eGFR and rGFR varied within the range of 0.873 - 0.896 ( P =0.000 ).The intra-class CC ( ICC ) varied within the range of 0.920 - 0.942.The correlation of eGFR4 was the best.The absolute deviations of 4 eGFRs and deviation precision were eGFR4 ＜eGFR3 ＜ eGFR2 ＜ eGFR1.The 95％ confidence intervals for the regression line of 4 eGFRs shown by Bland-Altman graphs were 92.5,87.3,83.0 and 76.1 ml · min-1 · ( 1.73 m2 ) -1,respectively,with the best result of eGFR4.For P30,the correctness of 4 eGFRs were eGFR4 ＞ eGFR3 ＞ eGFR2 ＞ eGFR1,but no significant difference was found by Chi square test (x2 =6.448,P =0.092).The overall correctness rate in 4 eGFRs against CKD stages were 48.4％ -57.5％,with the highest consistency of eGFR4,but their staging correctnessratewerenotideal(Kappa values were 0.405,0.348,0.366 and 0.463,respectively).Conclusions Compared with CKD-EPI SCr equation,no advantage was found in CKD-EPI Cys C equation.The Cys C equation adjusted by age and sex shows a little advantages over CKD-EPI Cys C equation in bias,precision,correlation and accuracy.The CKD-EPI SCr/Cys C combinated equation adjusted by age,sex and race has advantage over other three equations not only in bias,precision,correlation and accuracy,but also in staging correctness.However,the validation of this equation is still not fairly ideal for Chinese CKD patients.Based on these findings,it is essential for the Chinese CKD patients to develop SCr/Cys C combined predictive equation which adjusted by age,sex or other factors.(Chin J Lab Med,2012,35:798-804)

ObjectiveBased on the TCM theory of "Yang transforms materials to Qi while Yin constitutes material form"， this paper explored the effects of Zuogui Wan and Yougui Wan on the molecular mechanism of mitochondrial biogenesis during the adipogenic differentiation process of rat bone marrow mesenchymal stem cells （BMSCs） by mediating peroxisome proliferator-activated receptor γ coactivator-1α （PGC-1α） and peroxisome proliferators-activated receptor γ （PPARγ）， providing theoretical support for the prevention and treatment of postmenopausal osteoporosis （PMOP） using Zuogui Wan and Yougui Wan. MethodsBMSCs were divided into a blank group， Zuogui Wan （ZGW） group， Yougui Wan （YGW） group， and Progynova group. Cell identification was performed using flow cytometry. The growth curves of BMSCs were plotted using the methylthiazolyldiphenyl-tetrazolium bromide （MTT） method， and the effects of Zuogui Wan and Yougui Wan on the proliferation of BMSCs were detected. The Oil red O staining method was used to detect lipid droplet formation. The Western blot method was used to detect the expression of adipogenesis-related factors PPARγ， CCAAT/enharcer-binding protein （C/EBP）α， C/EBPβ， lipoprotein lipase （LPL） protein， brown adipose tissue-related （BAT） proteins PGC-1α， uncoupcing protein 1 （UCP1）， PR domdin-containing protein 16 （PRDM16）， mitochondrial biogenesis-related PGC-1α， nuclear respiratory factor 1 （Nrf1）， nuclear factor E₂-related factor 2 （Nrf2）， and mitochondrial transcription factor A （TFAM）. The expression of adipogenesis-related factors PPARγ， C/EBPα， C/EBPβ， LPL genes， and the copy number of cytochrome B （CytoB mtDNA） gene was detected using real-time polymerase chain reaction （Real-time PCR）. Mitochondrial ultrastructure was detected using transmission electron microscopy. ResultsCompared with that in the blank group， the proliferation ability of BMSCs in each treatment group increased continuously as the intervention progressed， and lipid droplets significantly decreased after the drug intervention. The mRNA and protein expression levels of adipogenesis-related factors PPARγ， C/EBPα， C/EBPβ， and LPL were significantly downregulated （P<0.01）， while those of the BAT-related factors PGC-1α， UCP1， PRDM16 were significantly upregulated （P<0.01）. The number of mitochondria increased， accompanied by reduced swelling. The double membrane and cristae structure were clear， and the internal cristae rupture was reduced. The copy number of CytoB mtDNA in each treatment group was significantly increased （P<0.01）. The protein expression levels of mitochondrial biogenesis-related PGC-1α， Nrf1， Nrf2， and TFAM in each treatment group were significantly increased （P<0.01）. ConclusionBoth Zuogui Wan and Yougui Wan can prevent and treat PMOP by intervening in mitochondrial biogenesis in BMSCs through PGC-1α/PPARγ.