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.

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.

OBJECTIVEDiscrete potentials (DPs) have been recorded and targeted as the site of ablation of the outflow tract arrhythmias. The aim of the present study was to investigate the significance of DPs with respect to mapping and ablation for idiopathic outflow tract premature ventricular contractions (PVCs) or ventricular tachycardias (VTs).

METHODSSeventeen out of 24 consecutive patients with idiopathic right or left ventricular outflow tract PVCs/VTs who underwent radiofrequency catheter ablation between September 2012 and December 2013 in our department were included. Intracardiac electrograms during the mapping and ablation were analyzed.

RESULTSDuring sinus rhythm, sharp high-frequency DPs that displayed double or multiple components were recorded following or buried in the local ventricular electrograms in all of the 17 patients, peak amplitude was (0.51 ± 0.21) mV. The same potential was recorded prior to the local ventricular potential of the PVCs/VTs. Spontaneous reversal of the relationship of the DPs to the local ventricular electrogram was noted during the arrhythmias. The DPs were related to a region of low voltage showed by intracardiac high-density contact mapping. At the sites with DPs, unipolar and bipolar ventricular voltage of sinus beats were lower compared with the adjacent regions without DPs (unipolar: (6.1 ± 1.8) mV vs. (8.3 ± 2.3) mV, P < 0.05; bipolar: (0.62 ± 0.45) mV vs. (1.03 ± 0.60) mV, P < 0.05). The targeted DPs were still present in 12 patients after successful elimination of the ectopies. Discrete potentials were not present in seven controls.

CONCLUSIONSDiscrete potentials and related low-voltage regions were common in idiopathic outflow tract ventricular arrhythmias. Discrete potential- and substrate-guided ablation strategy could help to reduce the recurrence of idiopathic outflow tract arrhythmias.

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.

With the application of monoclonal antibody technology more and more widely, its production technology is becoming more and more perfect. Small molecule monoclonal antibody technology is becoming a hot research topic for people. The application of traditional Chinese medicine small molecule monoclonal antibody technology has been more and more widely, the technology for effective Chinese medicine component knockout provide strong technical support. The preparation of monoclonal antibodies and small molecule knockout technology are reviewed in this paper. The preparation of several steps, such as: in the process of preparation of antigen, hapten carrier coupling, coupling ratio determination and identification of artificial antigen and establishment of animal immunization and hybridoma cell lines of monoclonal antibody, the large-scale preparation; small molecule monoclonal antibody on Immune in affinity chromatography column method is discussed in detail. The author believes that this technology will make the traditional Chinese medicine research on a higher level, and improve the level of internationalization of Chinese medicine research.
Animals ; Antibodies, Monoclonal ; chemistry ; genetics ; immunology ; Humans ; Hybridomas ; metabolism ; Immunologic Techniques ; methods ; trends

Antigens, CD ; metabolism ; Antigens, CD20 ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Axilla ; Histiocytic Sarcoma ; drug therapy ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Leukemia, Lymphocytic, Chronic, B-Cell ; drug therapy ; metabolism ; pathology ; Male ; Middle Aged ; Receptors, IgE ; metabolism