Idiopathic membranous nephropathy(IMN) is one of the main pathology of nephrotic syndrome,and has a rising trend year by year.In recent years that IMN is organ specific autoimmune disease.Phospholipase A2 receptor(PLA2R) and thrombospondin type-1 domain containing 7A(THSD7A) are the two main antigens of IMN,which could be used to distinguish the IMN and secondary membranous nephropathy.The anti-PLA2R antibody and anti-THSD7A antibody are associated with diagnosis,severity and activity of the disease.The antibody titer and its change could be used to help deciding the beginning of therapy and the therapitive courses.

Objective To investigate the structural and ultrastructural changes of the skin induced by micro-plasma radio-frequency technology,and to preliminarily discuss this novel technology mechanism.Methods Thirty guinea pigs were enrolled and randomly divided into three groups.They were radiated by different dose parameters 40 W,10 kJ; 60 W,10 kJ and 80 W,10 kJ.Every guinea pig's back was divided into two parts which was removed after immediately,one week and one month,and dermatopathology and transmission electron microscopy (TEM) were performed.Results The different dose setting could make different skin change of immediately effect.When dose setting was 40 W,10 kJ,skin showed that epidermal cells were integrity and the superficial layer of dermis collagen tissue was light homogenization.When dose setting was 60 W,10 kJ,epidermal tissue showed focal emergence of fractional shape change and obvious homogenization.When dose setting was 80 W,10 kJ,epidermal showed complete vaporization loss or degeneration necrosis,and dermal superficial and middle layer of collagen tissue showed a large area of homogenization.Skin superficial collagen tissue's structure gradually showed dense and arranged in an orderly manner after one week and markedly thickened and arranged in compact manner after one month.TEM showed that epidermal cells were relatively complete,intercellular structure was normal,but the dermal collagen lost originally normal structure and cell structure disappeared and obviously showed massive apoptosis.A small amount of apoptosis was showed but collagen structure gradually restored after one month.Conclusions The novel micro-plasma radio-frequency has obvious dose effect to skin,and its main target tissues are dermal collagen tissue.It can stimulate skin collagen hyperplasia in certain degree.

In recent years, more and more reports have been reported on the treatment of refractory primary membranous nephropathy with rituximab in bed, and its effect has been confirmed.A case of refractory primary membranous nephropathy was treated in the Department of Nephrology, Peking university Third Hospital.After the treatment of hormone combined with cyclophosphamide, cyclosporine and tacrolimus was ineffective, the patients were treated with low-dose rituximab for 2 years according to their condition, and the condition of the patients was finally relieved.

Objective To analyze the spatial and temporal distribution of smear positive pulmonary tuberculosis (PTB) in Liangshan Yi autonomous prefecture in Sichuan province from 2011 to 2016. Methods The registration data of PTB in 618 townships of Liangshan from 2011 to 2016 were collected from"Tuberculosis Management Information System of National Disease Prevention and Control Information System". Software ArcGIS 10.2 was used to establish the geographic information database and realize the visualization of the analysis results. Software OpenGeoda 1.2.0 was used to conduct the analyses on global indication of spatial autocorrelation (GISA) and local indication of spatial autocorrelation (LISA). Software SaTScan 9.4.1 was used for spatio-temporal scanning analysis. Results From 2011 to 2016, the registration rate of smear positive PTB in Liangshan declined from 56.97/100000 (2666 cases) to 21.11/100000 (1038 cases). The global spatial autocorrelation coefficient Moran's I ranged from 0.25 to 0.45 and the difference was significant (all P=0.000). Local autocorrelation analysis showed that"high-high"area covered 43, 34, 37, 34, 42 and 61 townships from 2011 to 2016, respectively, mainly in Leibo county. Spatial temporal clustering analysis found one class Ⅰ clustering in the area around Bagu township of Meigu county and two class Ⅱ clustering in the areas around Liumin and Hekou township of Huili county, respectively (all P=0.000). Conclusion Obvious spatial temporal clustering of smear positive PTB distribution was found in Liangshan from 2011-2016. Hot spot areas with serious smear positive PTB epidemic and high spread risk were mainly found in northeastern Liangshan, including townships in Leibo and Meigu counties. Targeted TB prevention and control should be conducted in these areas.