Objective:To investigate the correlation between plasma concentration and effective dose of tacrolimus in the treatment of membranous nephropathy. Methods: Totally 41 patients with membranous nephropathy were given tacrolimus combined with hor-mone at low dose. The valley plasma concentration of tacrolimus was detected using a homogeneous enzyme multiplied immunoassay method. According to the changes of 24-hour urine protein,serum albumin and kidney function, the clinical efficacy was evaluated. The correlation between curative effect and plasma concentration and dosage of tacrolimus in the treatment of membranous nephropathy was analyzed. Results:The plasma concentration of tacrolimus was (7. 47 ± 2. 74) ng·ml-1 and the dosage of administration was (0.047 ±0.007)mg·kg-1·d-1 in complete remission group, that in partial remission group respectively was (5.72 ±1.19)ng· ml-1 and(0.049 ±0.008)mg·kg-1·d-1, and that in non-remission group was respectively (3.30 ±1.08 )ng·ml-1 and (0.052 ± 0. 01)mg·kg-1·d-1. Conclusion: The clinical efficacy of tacrolimus in the treatment of membranous nephropathy has close rela-tionship with the plasma concentration,and that is promising when the plasma concentration within the range of (5. 10-9. 32) ng· ml-1 . The plasma concentration of tacrolimus isn't increased with the dosage increase in some patients.

ObjectiveTo compare the efficacies between conventional acupuncture plus acupoint application and conventional acupuncture plus TDP in treating dysmenorrhea due to blood stagnation led by cold.MethodSixty patients were randomized into two groups, 31 cases in the treatment group and 29 cases in the control group. The treatment group was intervened by conventional acupuncture plus acupoint application, while the control group was by conventional acupuncture plus TDP. Before and after the intervention, McGill Pain Questionnaire was adopted to compare the Pain Rating Index (PRI) score, Visual Analogue Scale (VAS) score, and Present Pain Index (PPI) score, and the therapeutic efficacy was also compared.ResultThe recovery rate was 58.1% in the treatment group, significantly higher than 24.1% in the control group (P<0.01); the total effective rate was 90.3% in the treatment group, significantly higher than 62.1% in the control group (P<0.01), indicating that the therapeutic efficacy of the treatment group was more significant than that of the control group. Before the intervention, there were no significant differences in comparing the PRI, VAS, and PPI scores between the two groups (P>0.05), suggesting the comparability. After the intervention, there were significant differences in comparing the PRI, VAS, and PPI scores between the two groups (P<0.05), and the PRI, VAS, and PPI scores were markedly decreased in the treatment group.ConclusionConventional acupuncture plus acupoint application can improve dysmenorrhea symptoms and reduce patient’s pain, and can produce a more significant efficacy compared with conventional acupuncture plus TDP.

Medical service system integration follows the logic of system innovation and development.Case studies of the UK,the USA and Australia found that medical delivery system integration is the product of a series of mixed factors.Health care financing and payment mechanism reform,physician team building,stair-cased movement to grassroots of healthcare service,shared clinical norms utilization as well as its gradual development constitute the general logic of such an integration.In the evolution process,the check and balance between the government and market,equity and efficiency have been affecting the integration process all the way.In light of these logics,China should speed up its transform of the integration concept,improve the integration elements,and strengthen the guidance of integration principles during its integration of the medical service integration.

Objective:To investigate the effect of pelvic motion in late pregnancy on the outcome of first trimester delivery.Methods:A total of 127 first-borns admitted to the midwifical clinic of Nanjing Maternal and Child Health Hospital from November 1, 2019 to March 10, 2020 were selected as the research objects, and they were divided into the walking group and the pelvic motion group according to the random number table method. In the end, 62 cases were included in the walking group and 65 cases in the pelvic motion group. The walking group did brisk walking in the third trimester. In the pelvic motion group, the motion in the third trimester consisted of the combined pelvic motion involving the two planes of the upright spine and the horizontal spine, and multiple peripelvic joints. The changes of fertility, birth canal and fetus before and after exercise were observed, and the outcomes of childbirth were compared between the two groups.Results:Indicators reflecting productivity: persistence time of "air bike" on the day before delivery was (27.12±7.73) seconds in the pelvic motion group and (20.56±6.60) seconds in the walking group, the difference was statistically significant ( t value was 5.12, P<0.01). The time of contractions after exercise before delivery was (269.38±123.70) seconds in the pelvic motion group and (591.29±201.82) seconds in the walking group, the difference was statistically significant ( t value was 10.89, P<0.01). The indicators reflecting the situation of the maternal birth canal were as follows: "sitting forward flexion level", pelvic motion group was (33.64±5.91) cm, walking group was (29.50±5.28) cm, the difference was statistically significant ( t value was 4.15, P<0.01). The cervical score during regular contractions was 8.01±1.69 in the pelvic motion group and 7.30±1.40 in the walking group, the difference was statistically significant( t value was 2.56, P<0.05). At the beginning of regular contractions, the proportion of fetal "occipital position" was 93.85% (61/65) in the pelvic motion group and 72.58%(45/62) in the walking group, the difference was statistically significant ( χ2 value was 10.41, P<0.01). The "no pain rate after exercise the day before delivery" was 72.31% (47/65) in the pelvic motion group and 29.03% (18/62) in the walking group, the difference was statistically significant ( χ2 value was 25.30, P<0.01). Time of the first labor was (395.84±165.24) min in the pelvic motion group and (574.35±152.23) min in the walking group, the difference was statistically significant ( t value was 6.32, P<0.01). The second stage of labor was (25.98±9.88) min in the pelvic motion group and (33.62±13.94) min in the walking group, the difference was statistically significant ( t value was 3.57, P<0.01). Conclusions:Pelvic motion in middle and late pregnancy can affect labor force, birth canal, fetus and other delivery factors, reduce movement pain and shorten the time of labor.

Midkine (MK),a newly discovered heparin-binding growth factor,promotes growth,survival,and migration in various cells. Meanwhile,MK stimulates statistically significant forms in new arterioles and capillaries,causes vascular remodeling,prevents ischemia myocardial cells from injury via inhibiting apoptosis. MK also regulates the level of blood-fat. In general,MK plays key roles in cardiovascular diseases.

Midkine (MK) , a newly discovered heparin - binding growth factor, promotes growth, survival, and migration in various cells. Meanwhile, MK stimulates statistically significant forms in new arterioles and capillaries, causes vascular remodeling, prevents ischemia myocardial cells from injury via inhibiting apoptosis. MK also regulates the level of blood - fat.In general, MK plays key roles in cardiovascular diseases.

There were 3 000 Zhuangs,1 102 Miaos, and 1 283 Yaos in Baise City of Guangxi,who were enrolled in this population sampling stratfying survey. Height, weight, blood pressure, fasting blood glucose, and lipids were determined, and compared with those of 2 000 Hans of the same town. The prevalence of hypertension and metablic syndrome in Zhuang inhabitants was high, so were the disorders of glycemia and lipidemia, while in Miao and Yao minorities, the prevalences were comparatively lower. The awareness, treatment, and control of hypertension in these minorities were insufficient.

To establish a gene regulation system compatible with biopharmaceutical industry and gene therapy, we constructed a fusion protein of biotin ligase from Bacillus subtilis (BS-BirA) and the trans-activation domain, and used its expression vector as the regulatory vector. Meanwhile, BS-BirA-specific operators were ligated upstream of attenuated CMV promoter to obtain the response vector. In this way, a novel eukaryotic gene regulation system responsive to biotin was established and named BS-Biotin-On system. BS-Biotin-On system was further investigated with the enhancing green fluorescent protein (EGFP) as the reporter gene. The results showed that our system was superior to the current similar regulation system in its higher induction ratio, and that the expression of interest gene could be tuned in a rapid and efficient manner by changing the biotin concentrations in the cultures, Our results show that the established system may provide a new alternative for the exogenous gene modulation.
Bacillus subtilis ; Biotin ; chemistry ; Eukaryotic Cells ; metabolism ; Gene Expression Regulation ; Genetic Vectors ; Promoter Regions, Genetic ; Trans-Activators

Although Germany is an important cradle of Western medicine, traditional Chinese acupuncture and moxibustion are widely accepted and have been developed hardly in Germany for several centuries. This paper reviews the development courses of acupuncture and moxibustion in Germany, and gives an introduction to the level of acupuncture and moxibustion science, acupuncture in medical insurance, acupuncture research, acupuncture clinics, acupuncture organizations, acupuncture journals and trend of acupuncture development in Germany.
Acupuncture ; education ; Acupuncture Therapy ; history ; Germany ; Medicine, Chinese Traditional ; history ; Moxibustion ; history ; Science

OBJECTIVETo compare the difference in the efficacy on thoracic facet joint disorder between the combined therapy of electroacupuncture and manual reduction and the simple manual reduction.

METHODSOne hundred and sixty patients were randomized into an electroacupuncture and manual manipulation group (group A) and a simple manual manipulation group (group B), 80 cases in each one. In the group A, Ashi points and three pairs of Jiaji (EX-B 2) bilateral to the painful sites were selected. The perpendicular puncture was used at Ashi points, the oblique puncture was used at Jiaji (EX-B 2) and connected with electric stimulation for 20 min, additionally, the corresponding manual reduction was adopted at the sites of facet joint disorder. In the group B, the simple manual reduction was applied to the affected sites. Acupuncture was given once every day, the manual reduction was applied once every 10 days. The treatment of 10 days made one session. The efficacy was analyzed statistically at the end of two sessions of treatment. Before and after treatment, McGill pain scale was adopted for the value statistical analysis. PRI score, VAS score and PPI score of patients were calculated before and after treatment and compared in the two groups. The efficacy was compared between the two groups.

RESULTSThe curative rate was 56.3% (45/80) in the group A, which was better than 18.8% (15/80) in the group B (P< 0.01). The total effective rate was 95.0% (76/80) in the group A, which was better than 76.3% (61/80) in the group B (P<0.01). The scores of PRI, VAS and PPI after treatment were all improved significantly in the two groups (all P<0.05), in which, the results in the group A were better than those in the group B (PRI: 4.00 +/- 0.97 vs 5.44 +/- 1.16, VAS: 3.29 +/- 0.72 vs 3.87 +/- 0.81, PPI: 1.07 +/- 0.74 vs 1.64 +/- 0.90, all P<0.05).

CONCLUSIONThe combined therapy of electroacupuncture and manual manipulation achieves the superior efficacy on thoracic facet joint disorder as compared with the simple manual manipulation. The combined therapy relieves the symptoms of thoracic facet joint disorder and reduces the severity of disorder.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Thoracic Diseases ; therapy