In recent years, the diagnosis of idiopathic membranous nephropathy (IMN) has been more and more important with the rapid growth rate on incidence in China.Previous diagnosis of IMN depends on renal biopsy, a gold standard, but a high risk of traumatic examination.The detection of serum PLA2R antibody and THSD7A antibody to assist in the diagnosis of is not only fast, sensitive, simple and noninvasive, but also can reflect the immune status in real time.Compared with the traditional proteinuria severity based therapeutic efficacy evaluation, that is more effective and agile to monitor the disease condition, reflect the treatment effects and predict the prognosis better.Therefore, it should be vigorously promoted.

This article,in view of the research status and development tendency of hospital core competence,introduced the index selection process and constructed the evaluation index system of core competence.This system comprises 3 level-1 indexes (social reputation,hospital health resources and development potential)and 9 level-2 indexes,with recommendations on improvements of the existing system.

In this paper,based on theoretical analysis,the concept of hospital core competence is redefined,combined with the needs of hospital's development in medical service market,the connotation is also clearly definition,and the characteri stics is summarized.Meanwhile,on the basis of all above,this paper has carried on a thorough discussion about the construction of Chinese hospital core competence.

OBJECTIVEThis study aims to determine the effect of fluoride concentration on the corrosion behavior of cobalt-chromium alloy fabricated by two different technology processes in a simulated oral environment.

METHODSA total of 15 specimens were employed with selective laser melting (SLM) and another 15 for traditional casting (Cast) in cobalt-chromium alloy powders and blocks with the same material composition. The corrosion behavior of the specimens was studied by potentiodynamic polarization test under different oral environments with varying solubilities of fluorine (0, 0.05%, and 0.20% for each) in acid artificial saliva (pH = 5.0). The specimens were soaked in fluorine for 24 h, and the surface microstructure was observed under a field emission scanning electron microscope after immersing the specimens in the test solution at constant temperature.

RESULTSThe corrosion potential (Ecorr) value of the cobalt-chromium alloy cast decreased with increasing fluoride concentration in acidic artificial saliva. The Ecorr, Icorr, and Rp values of the cobalt-chromium alloy fabricated by two different technology processes changed significantly when the fluoride concentration was 0.20% (P < 0.05). The Ecorr, Icorr, and Rp values of the cobalt-chromium alloy fabricated by two different technology processes exhibited a statistically significant difference. The Icorr value of the cobalt-chromium alloy cast was higher than that in the SLM group cobalt-chromium alloy when the fluoride concentration was 0.20% (P < 0.05). The Ecorr, tRp alues of the cobalt-chromium alloy cast were lower htan those of the SLM group cobalt-chromium alloy when the fluoride concentration was 0.20% (P< 0 .05).

CONCLUSIONFluoride ions adversely affected the corrosion resistance of the cobalt-chromium alloy fabricated by two different technology processes. The corrosion resistance of the cobalt-chromium alloy cast was worse than that of the SLM group cobalt-chromium alloy when the fluoride concentration was 0.20%.

Diabetic nephropathy (DN) is one of the most common microvascular complications in diabetes mellitus patients and is characterized by thickened glomerular basement membrane,increased extracellular matrix formation,and podocyte loss.These phenomena lead to proteinuria and altered glomerular filtration rate,that is,the rate initially increases but progressively decreases.DN has become the leading cause of end-stage renal disease.Its prevalence shows a rapid growth trend and causes heavy social and economic burden in many countries.However,this disease is multifactorial,and its mechanism is poorly understood due to the complex pathogenesis of DN.In this review,we highlight the new molecular insights about the pathogenesis of DN from the aspects of immune inflammation response,epithelial-mesenchymal transition,apoptosis and mitochondrial damage,epigenetics,and podocyte-endothelial communication.This work offers groundwork for understanding the initiation and progression of DN,as well as provides ideas for developing new prevention and treatment measures.

As an important part of the hierarchical medical system in China ,urban secondary hospitals play as a pivot between tertiary hospitals and community healthcare centers.By describing the overall development status of such hospitals in China ,the paper discussed the problems existing in the development of urban secondary hospitals and put forward strategies in the hope of providing reference for the transformation of these hospitals .

This paper introduced the measures to construct the hierarchical medical system in Yichang city. The authors identified problems found and proposed the city to take the following countermeasures. Such steps included service capacity building at primary level, motivating primary medical workers, attracting patients to primary care, and improving policies of hierarchical medical system.

Hierarchical medical system empowers the current healthcare reform on the medical supply side in China, a key to resolving the contradictions in the healthcare sector. This study analyzed the necessity and obstacles for such a system with synergy between hospitals, insurance and pharmacy, putting forward suggestions for building a scientific and rational hierarchical system.

Objective To investigate the undergraduates′cognition ,attitude and behavior about low‐carbon life and then to provide a relatively scientifically strategy .and provide scientific basis to formulate countermeasures about undergraduates′low‐car‐bon lifestyle .Methods By multistage sampling ,382 students′knowledge ,attitude and practice about low‐carbon life in Wuhan Uni‐versity of science and technology were analyzed .Results The students′cognition about low‐carbon life was good ,the awareness rate of girl was higher than that of boy ;Their attitude was positive ,grade and knowledge awareness were the two influence factors ;the behavior situation was unsatisfactory ,the origin of students and attitude enthusiasm were the elements affect rationality of be‐havior .Conclusion Undergraduates should strengthen the cognition of low‐carbon life ,improve attitude enthusiasm ,and form a good behavioral habit of low‐carbon life .

Aim To study the cardiotoxicity of celastrol to zebrafish embryo.Method 48 h post-fertilization zebrafish embryos were used as model for analysis of heart toxicity and were treated with various concentrations of celastrol.6,12,24 h after treatment morphological and functional changes of embryos hearts were observed.Results Cardiotoxicity was not found in embryos during 24 h treatment with 1 ?mol?L-1 concentration of celastrol.Toxic symptoms of embryos were caused by 2,3,4 ?mol?L-1 concentrations of celastrol with appearance of heart linearization,heart membrane hemorrhage and hemocytes accumulation in cardiac region.Moreover,heart rate decreased significantly with increase of concentration and prolongation of treatment.The EC50(24 h)of decrease of heart rate was about 1.78 ?mol?L-1.Conclusion Celastrol is cardiotoxic to zebrafish embryo.