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.

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.

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.

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.

Objective To investigate the clinical effect of nicorandil for treatment of patients with acute respiratory distress syndrome (ARDS).Methods A prospective randomized controlled trial was conducted. A total of 40 cases of patients with ARDS admitted to Department of Critical Care Medicine of Guizhou Provincial People's Hospital from October 2012 to October 2014 were enrolled, and they were randomly divided into two groups, 20 cases in each group. The two groups were treated with routine western medicine after admission. On this basis, the observation group was given nicorandil 10 mg, while the control group was given warm boiled water 10 mL, through gastric tubes 3 times a day, the therapeutic course being consecutive 5 days in both groups. The length of stay in intensive care unit (ICU), duration of mechanical ventilation after treatment, oxygenation index (OI), alveolo-arterial oxygen partial pressure difference (PA-aO2), positive end-expiratory pressure (PEEP), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, Glasgow coma score (GCS) before and after treatment, the predicted death rate (PDR) and 28-day mortality were compared between the two groups. The predicitive factors for 28-day mortality were screened by binary logistic analysis.Results The length of stay in ICU and duration of mechanical ventilation of control group were longer than those of observation group, but the difference was not statistically significant [ICU length of stay (day): 14.55±12.71 vs. 9.15±6.00, duration of mechanical ventilation (day): 13.25±12.27 vs. 7.75±5.32, bothP > 0.05]. After treatment, the GCS was higher than that before treatment in control group and observation group (11.95±3.98 vs. 10.75±4.89, 12.95±3.67 vs. 12.20±4.56), while APACHE Ⅱ score, PDR and PEEP were all lower than those before treatment [APACHE Ⅱ: 21.05±8.58 vs. 24.90±5.63, 18.70±11.21 vs. 26.65±7.67; PDR: (47.71±29.49)% vs. (61.00±23.29)%, (36.79±18.49)% vs. (56.12±18.16)%; PEEP (cmH2O, 1 cmH2O = 0.098 kPa): 4.40±3.14 vs. 5.75±2.59, 3.80±2.55 vs. 7.55±3.32], but there were no statistically significant differences between the two groups before and after treatment (allP > 0.05). After treatment, the OI was significantly higher and the PA-aO2 was significantly lower than those before treatment in the two groups, and the degrees of improvement of the observation group were more remarkable than those of the control group [OI (mmHg, 1 mmHg = 0.133 kPa): 224.72±85.12 vs. 141.37±45.82, PA-aO2 (mmHg): 132.60±46.64 vs. 204.30±121.2, bothP < 0.05]. The 28-day mortality of observation group was lower than that of control group, but no statistically significant difference was seen [15% (3/20) vs. 25% (5/20),χ2 = 0.156,P > 0.05). Binary logistic regression analyses showed that the PA-aO2 [odds ratio (OR) = 0.958,P = 0.013, 95% confidence interval (95%CI) = 0.927 - 0.991], APACHE Ⅱ score (OR = 0.882,P = 0.010, 95CI = 0.803 - 0.970), GCS (OR = 1.399, P = 0.004, 95%CI = 1.111 - 1.761) and PDR (OR = 0.907,P = 0.002, 95%CI = 0.853 - 0.965) after treatment were the independent predictors of 28-day mortality.Conclusion Nicorandil can significantly improve oxygenation, but cannot reduce 28-day mortality in patients with ARDS.

Objective Study of Shuxuening combined with sodium phosphocreatine on acute severe carbon monoxide poisoning with ischemia modified albumin level and its curative effect in patients. Methods 66 cases of ASCOP patients were randomly divided into routine group and treatment group, all patients were detected for myocardial enzymes, cTnI, IMA before treatment, after treatment 6 h and 3 d. Results IMA was significantly decreased before treatment, while no significant changes occurred in myocardial enzymes and cTnIn levels. After treatment for 6 h, IMA in treatment group was higher than conventional group (P < 0.05). Myocardial enzymes and cTnI gradually increased, the two groups had no difference (P>0.05). After treatment for 3d, cTnI level of normal group increased obviously compare with the treatment group (P>0.05). Myocardial enzymes, IMA restored to the normal level (P>0.05). The level of cTnI after treatment for 3 d improved compare with 6 h. Conclusion Treatment of early ASCOP patients by Shuxuening combined with sodium phosphocreatine significantly improve the recovery of myocardial injury poisoning. The level of IMA can be used as evaluation index of myocardial ischemia and drug treatment.

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