Objective:To investigate the efficacy of rituximab in the treatment of idiopathic membranous nephropathy with varying levels of serum phospholipase A2 receptor antibodies.Methods:A total of 137 patients with idiopathi...Objective:To investigate the efficacy of rituximab in the treatment of idiopathic membranous nephropathy with varying levels of serum phospholipase A2 receptor antibodies.Methods:A total of 137 patients with idiopathic membranous nephropathy admitted to Beijing Sixth Hospital were selected.Based on their blood PLA2R antibody levels before rituximab treatment,patients were categorized into the PLA2R antibody positive group(n=94)and the PLA2R antibody negative group(n=43).They were followed up for at least 1 year,during which the efficacy,measured through 24-hour urine protein quantification and serum albumin levels,were compared between the two groups before and after treatment.Results:After 3 months of treatment,there was no significant difference in the quantitative levels of 24-hour urine protein between the two groups(P>0.05).However,after 6 and 12 months of treatment,there was a significant difference in the levels of 24-hour urine protein between the two groups(P<0.05).Additionally,after 3 months of treatment,there was a notable difference in the serum albumin levels between the two groups(P<0.05).However,after 6 and 12 months of treatment,there was no significant difference in serum albumin levels between the two groups(P>0.05).Analysis of complications in the two groups revealed that in the positive group,9 individuals experienced thrombosis,5 had infections,and 11 developed acute kidney injury(AKI).In contrast,in the negative group,5 individuals had thrombosis,2 had infections,and 3 developed AKI.There was no statistically significant difference in complications between the two groups(P>0.05).Conclusion:Serum anti-PLA2R antibody levels provide valuable insights into the clinical observation of rituximab treatment for idiopathic membranous nephropathy.They aid in understanding the disease’s pathogenesis,evaluating treatment efficacy,and predicting disease prognosis.展开更多
Premature Rupture of Membranes (PROM) with the resulting prematurity remains a major public health issue in the Democratic Republic of Congo (DRC). This study aimed to assess expectant management of PPROM before 34 we...Premature Rupture of Membranes (PROM) with the resulting prematurity remains a major public health issue in the Democratic Republic of Congo (DRC). This study aimed to assess expectant management of PPROM before 34 weeks at the university hospital of Kinshasa. We conducted a retrospective analysis of expectantly managed PROM before 34 weeks between January 2008 and December 2018. Maternal and fetal outcomes were collected, and all data were analyzed using the SPSS 23.0 software. Of the 113 patients included in the study, 2.6% were diagnosed with PROM before 34 weeks. We observed prolongation of the pregnancy duration;the median latency period was eight days, and the average gestational age at delivery of 32.85 ± 2.5 weeks. Chorioamnionitis (23%), severe oligoamnios (7%), and acute fetal distress (4%) were complications observed during the latency period. In the postpartum period, endometritis (6.2%), neonatal jaundice (39.8%), anemia (25.7%), ulcerative necrotizing enterocolitis (6.2%), cerebromeningeal hemorrhage (5.3%), and acute respiratory distress syndrome (4.4%) were complications observed. The risk of infection during the latency period was significantly associated with irregular (P = 0.045) or lack (P = 0.006) antenatal care (ANC) attendances and C-Reactive Protein (CRP) results 6 (P = 0.013). The risk of neonatal death was significantly associated to infection during the latency period (P = 0.011), irregular (P = 0.009) or lack of ANC (P = 0.000) attendances, Birth weight g (P = 0.039) as well as Gestational age at birth between 28 to 30 Weeks (S) (P = 0.021). These findings report first-time pregnancy outcomes related to the management of PPROM before 34 weeks in our setting. We found that the conservative attitude adopted allowed the prolongation of pregnancies, reducing the risks associated with prematurity. Nevertheless, attendance in good quality ANC could reduce the frequency of PROM and related adverse outcomes.展开更多
BACKGROUND The co-occurrence of Anti-phospholipase A2 receptor-associated membranous nephropathy(anti-PLA2R-MN)and human immunodeficiency virus(HIV)infection is a rare clinical scenario,presenting significant challeng...BACKGROUND The co-occurrence of Anti-phospholipase A2 receptor-associated membranous nephropathy(anti-PLA2R-MN)and human immunodeficiency virus(HIV)infection is a rare clinical scenario,presenting significant challenges in terms of management and treatment.CASE SUMMARY A 32-year-old Chinese male diagnosed with HIV infection presented with a clinical history of proteinuria persisting for over two years.A kidney biopsy demonstrated subepithelial immune complex deposition and a thickened glomerular basement membrane,indicative of stage I-II membranous nephro-pathy.Immunofluorescence staining revealed granular deposition of PLA2R(3+)along the glomerular capillary loops,corroborated by a strongly positive anti-PLA2R antibody test(1:320).Initial treatment involving losartan potassium,rivaroxaban,tacrolimus,and rituximab was discontinued due to either poor effec-tiveness or the occurrence of adverse events.Following a regimen of weekly subcutaneous injections of telitacicept(160 mg),a marked decline in the 24 h urine protein was observed within a three-month period,accompanied by a rise in serum albumin level.No significant reductions in peripheral blood CD3+CD4+T and CD3+CD8+T cell counts were detected.The patient's physical and psychological conditions showed significant improvements,with no adverse events reported during the treatment course.CONCLUSION Telitacicept might offer a potential therapeutic avenue for patients diagnosed with anti-PLA2R-MN concomitant with HIV infection.展开更多
Objective:To further evaluate the efficacy and safety of low-dose glucocorticoids combined with tacrolimus in the treatment of adult idiopathic membranous nephropathy(IMN)in a clinical setting.Methods:We carried out a...Objective:To further evaluate the efficacy and safety of low-dose glucocorticoids combined with tacrolimus in the treatment of adult idiopathic membranous nephropathy(IMN)in a clinical setting.Methods:We carried out a single-center prospective study of 88 patients with IMN who were admitted into the Affiliated Hospital of Hebei University from January 2019 to December 2021,and the participants were divided into two groups based on their serum anti-PLA2R antibody levels:the negative group and the positive group.46 patients were positive for anti-PLA2R antibodies and 42 were negative.Results:After 6 months of treatment,the serum albumin,cholesterol,and 24h urine protein quantification in the anti-PLA2R negative group improved more significantly compared to the positive group(P<0.05);after 6 months of treatment,the remission rate of the positive group was significantly lower than that of the negative group,and(P<0.05);Conclusion:After treatment with tacrolimus combined with low-dose glucocorticoids,patients with idiopathic membranous nephropathy who were tested positive for anti-PLA2R antibodies had a higher overall remission rate compared those who were tested negative for serum anti-PLA2R antibodies.展开更多
Membrane thickness has significant effect on permeability of membrane.In this work the membrane thickness gradient of isoflux ceramic membrane was calculated with the Navier-Stokes and Darcy equations,which governed t...Membrane thickness has significant effect on permeability of membrane.In this work the membrane thickness gradient of isoflux ceramic membrane was calculated with the Navier-Stokes and Darcy equations,which governed the bulk flow and the flow through the membrane,respectively.The specific resistance of porous medium was calculated by Konzey-Carmen equation.The results showed that the membrane thickness was approximately linear to the distance in axial direction.The cross-flow velocity had a significant influence on the membrane thickness gradient along the axial direction,so it is necessary to choose different membrane thickness gradient along the axial direction to obtain uniform trans-membrane pressure at different cross-flow velocity.The effects of pressure and temperature were relatively insignificant.The result of this study may provide guidance on membrane preparation and application.展开更多
目的分离体外培养的结核分枝杆菌分泌的膜囊泡，检测其形态和粒径分布，初步探索结核分枝杆菌膜囊泡对巨噬细胞中细胞因子释放的作用。方法采用结核分枝杆菌实验室标准菌株H37Rv，通过7H9培养基复苏、扩大培养标准株H37Rv至对数生长期...目的分离体外培养的结核分枝杆菌分泌的膜囊泡，检测其形态和粒径分布，初步探索结核分枝杆菌膜囊泡对巨噬细胞中细胞因子释放的作用。方法采用结核分枝杆菌实验室标准菌株H37Rv，通过7H9培养基复苏、扩大培养标准株H37Rv至对数生长期，菌体全部接种于苏通培养基中继续培养3周，离心取上清，超滤浓缩结合超速离心分离提取结核分枝杆菌H37Rv膜囊泡，通过透射电镜观察膜囊泡的大小、形态，采用纳米颗粒跟踪仪分析膜囊泡的粒径及分布。同时，设置不处理对照组、H37Rv感染组[按照感染复数（multiplicity of infection，MOI）=20：1]和H37Rv膜囊泡处理组（按照膜囊泡：细胞=100：1）处理佛波酯（50ng／ml）诱导贴壁的单核巨噬细胞（THP-1）4h，更换新鲜培养基后0h、4h、8h、24h收集细胞培养上清，采用Milliplex多细胞因子检测试剂盒检测细胞因子的释放情况，通过曼-惠特尼U（Mann-WhitneyU）检验对各时间点H37Rv膜囊泡处理组和不处理对照组之间肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）、白细胞介素1β（IL-1β）、白细胞介素10（IL-10）释放量进行比较，以P〈0．05为差异有统计学意义。结果按照调整后的提取方法得到的提取物中可检测到H37Rv分泌的膜囊泡，平均粒径为137nm，主要分布在30～510nm之间，〈250nm的膜囊泡数量占总量的96．88％。4h、8h和24h的TNF-α、ID6和IL-1β释放量与不处理对照组[分别为348．19（333．99，360．47）pg／ml、412．38（406．67，418．79）pg／ml、324．44（316．11，331．14）pg／ml；3．01（2．81，3．02）pg／ml、5．40（5．26，5．83）pg／ml、13．22（11．80，13．77）pg／ml；118．92（113．97，122．47）pg／ml、132．33（125．87，137．62）pg／ml、169．31（167．75，172．49）pg／ml]相比，H37Rv膜囊泡处理组[分别为507．33（501．80，513．84）pg／ml、4483．00（4130．75，4522．50）pg／ml、8170．00（8058．25，8206．75）pg／ml；12．88（12．04，13．84）pg／ml、68．51（66．88，69．77）pg／ml、335．44（331．02，340．64）pg／ml；800．57（791．18，809．60）pg／ml、1559．00（1546．00，1566．00）pg／ml、4316．50（4094．75，4389．75）pg／ml]均明显增加，差异均有统计学意义（u值均〈0．001，P值均〈0．01）；但4h、8h和24h的ID-10释放量[不处理对照组分别为1．23（1．21，1．31）pg／ml、1.56（1．31，1．82）pg／ml、5．41（4．99，5．89）pg／ml；H37Rv膜囊泡处理组分别为4．56（4．49，4．82）pg／ml、1．43（1．28，1．89）pg／ml、1．56（1．48，1．68）pg／ml]差异均无统计学意义（U值分别为6．00、17.00、7．00，P值分别为0．065、0．898和0．087）。结论本研究建立了结核分枝杆菌膜囊泡分离提取的技术流程，可以得到纯度较好、形态完整、粒径正常的膜囊泡。同时，结核分枝杆菌膜囊泡可以诱发巨噬细胞中细胞因子TNF-α、IL-6和IL-1β的释放。展开更多
文摘Objective:To investigate the efficacy of rituximab in the treatment of idiopathic membranous nephropathy with varying levels of serum phospholipase A2 receptor antibodies.Methods:A total of 137 patients with idiopathic membranous nephropathy admitted to Beijing Sixth Hospital were selected.Based on their blood PLA2R antibody levels before rituximab treatment,patients were categorized into the PLA2R antibody positive group(n=94)and the PLA2R antibody negative group(n=43).They were followed up for at least 1 year,during which the efficacy,measured through 24-hour urine protein quantification and serum albumin levels,were compared between the two groups before and after treatment.Results:After 3 months of treatment,there was no significant difference in the quantitative levels of 24-hour urine protein between the two groups(P>0.05).However,after 6 and 12 months of treatment,there was a significant difference in the levels of 24-hour urine protein between the two groups(P<0.05).Additionally,after 3 months of treatment,there was a notable difference in the serum albumin levels between the two groups(P<0.05).However,after 6 and 12 months of treatment,there was no significant difference in serum albumin levels between the two groups(P>0.05).Analysis of complications in the two groups revealed that in the positive group,9 individuals experienced thrombosis,5 had infections,and 11 developed acute kidney injury(AKI).In contrast,in the negative group,5 individuals had thrombosis,2 had infections,and 3 developed AKI.There was no statistically significant difference in complications between the two groups(P>0.05).Conclusion:Serum anti-PLA2R antibody levels provide valuable insights into the clinical observation of rituximab treatment for idiopathic membranous nephropathy.They aid in understanding the disease’s pathogenesis,evaluating treatment efficacy,and predicting disease prognosis.
文摘Premature Rupture of Membranes (PROM) with the resulting prematurity remains a major public health issue in the Democratic Republic of Congo (DRC). This study aimed to assess expectant management of PPROM before 34 weeks at the university hospital of Kinshasa. We conducted a retrospective analysis of expectantly managed PROM before 34 weeks between January 2008 and December 2018. Maternal and fetal outcomes were collected, and all data were analyzed using the SPSS 23.0 software. Of the 113 patients included in the study, 2.6% were diagnosed with PROM before 34 weeks. We observed prolongation of the pregnancy duration;the median latency period was eight days, and the average gestational age at delivery of 32.85 ± 2.5 weeks. Chorioamnionitis (23%), severe oligoamnios (7%), and acute fetal distress (4%) were complications observed during the latency period. In the postpartum period, endometritis (6.2%), neonatal jaundice (39.8%), anemia (25.7%), ulcerative necrotizing enterocolitis (6.2%), cerebromeningeal hemorrhage (5.3%), and acute respiratory distress syndrome (4.4%) were complications observed. The risk of infection during the latency period was significantly associated with irregular (P = 0.045) or lack (P = 0.006) antenatal care (ANC) attendances and C-Reactive Protein (CRP) results 6 (P = 0.013). The risk of neonatal death was significantly associated to infection during the latency period (P = 0.011), irregular (P = 0.009) or lack of ANC (P = 0.000) attendances, Birth weight g (P = 0.039) as well as Gestational age at birth between 28 to 30 Weeks (S) (P = 0.021). These findings report first-time pregnancy outcomes related to the management of PPROM before 34 weeks in our setting. We found that the conservative attitude adopted allowed the prolongation of pregnancies, reducing the risks associated with prematurity. Nevertheless, attendance in good quality ANC could reduce the frequency of PROM and related adverse outcomes.
文摘BACKGROUND The co-occurrence of Anti-phospholipase A2 receptor-associated membranous nephropathy(anti-PLA2R-MN)and human immunodeficiency virus(HIV)infection is a rare clinical scenario,presenting significant challenges in terms of management and treatment.CASE SUMMARY A 32-year-old Chinese male diagnosed with HIV infection presented with a clinical history of proteinuria persisting for over two years.A kidney biopsy demonstrated subepithelial immune complex deposition and a thickened glomerular basement membrane,indicative of stage I-II membranous nephro-pathy.Immunofluorescence staining revealed granular deposition of PLA2R(3+)along the glomerular capillary loops,corroborated by a strongly positive anti-PLA2R antibody test(1:320).Initial treatment involving losartan potassium,rivaroxaban,tacrolimus,and rituximab was discontinued due to either poor effec-tiveness or the occurrence of adverse events.Following a regimen of weekly subcutaneous injections of telitacicept(160 mg),a marked decline in the 24 h urine protein was observed within a three-month period,accompanied by a rise in serum albumin level.No significant reductions in peripheral blood CD3+CD4+T and CD3+CD8+T cell counts were detected.The patient's physical and psychological conditions showed significant improvements,with no adverse events reported during the treatment course.CONCLUSION Telitacicept might offer a potential therapeutic avenue for patients diagnosed with anti-PLA2R-MN concomitant with HIV infection.
文摘Objective:To further evaluate the efficacy and safety of low-dose glucocorticoids combined with tacrolimus in the treatment of adult idiopathic membranous nephropathy(IMN)in a clinical setting.Methods:We carried out a single-center prospective study of 88 patients with IMN who were admitted into the Affiliated Hospital of Hebei University from January 2019 to December 2021,and the participants were divided into two groups based on their serum anti-PLA2R antibody levels:the negative group and the positive group.46 patients were positive for anti-PLA2R antibodies and 42 were negative.Results:After 6 months of treatment,the serum albumin,cholesterol,and 24h urine protein quantification in the anti-PLA2R negative group improved more significantly compared to the positive group(P<0.05);after 6 months of treatment,the remission rate of the positive group was significantly lower than that of the negative group,and(P<0.05);Conclusion:After treatment with tacrolimus combined with low-dose glucocorticoids,patients with idiopathic membranous nephropathy who were tested positive for anti-PLA2R antibodies had a higher overall remission rate compared those who were tested negative for serum anti-PLA2R antibodies.
文摘Membrane thickness has significant effect on permeability of membrane.In this work the membrane thickness gradient of isoflux ceramic membrane was calculated with the Navier-Stokes and Darcy equations,which governed the bulk flow and the flow through the membrane,respectively.The specific resistance of porous medium was calculated by Konzey-Carmen equation.The results showed that the membrane thickness was approximately linear to the distance in axial direction.The cross-flow velocity had a significant influence on the membrane thickness gradient along the axial direction,so it is necessary to choose different membrane thickness gradient along the axial direction to obtain uniform trans-membrane pressure at different cross-flow velocity.The effects of pressure and temperature were relatively insignificant.The result of this study may provide guidance on membrane preparation and application.
文摘目的分离体外培养的结核分枝杆菌分泌的膜囊泡，检测其形态和粒径分布，初步探索结核分枝杆菌膜囊泡对巨噬细胞中细胞因子释放的作用。方法采用结核分枝杆菌实验室标准菌株H37Rv，通过7H9培养基复苏、扩大培养标准株H37Rv至对数生长期，菌体全部接种于苏通培养基中继续培养3周，离心取上清，超滤浓缩结合超速离心分离提取结核分枝杆菌H37Rv膜囊泡，通过透射电镜观察膜囊泡的大小、形态，采用纳米颗粒跟踪仪分析膜囊泡的粒径及分布。同时，设置不处理对照组、H37Rv感染组[按照感染复数（multiplicity of infection，MOI）=20：1]和H37Rv膜囊泡处理组（按照膜囊泡：细胞=100：1）处理佛波酯（50ng／ml）诱导贴壁的单核巨噬细胞（THP-1）4h，更换新鲜培养基后0h、4h、8h、24h收集细胞培养上清，采用Milliplex多细胞因子检测试剂盒检测细胞因子的释放情况，通过曼-惠特尼U（Mann-WhitneyU）检验对各时间点H37Rv膜囊泡处理组和不处理对照组之间肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）、白细胞介素1β（IL-1β）、白细胞介素10（IL-10）释放量进行比较，以P〈0．05为差异有统计学意义。结果按照调整后的提取方法得到的提取物中可检测到H37Rv分泌的膜囊泡，平均粒径为137nm，主要分布在30～510nm之间，〈250nm的膜囊泡数量占总量的96．88％。4h、8h和24h的TNF-α、ID6和IL-1β释放量与不处理对照组[分别为348．19（333．99，360．47）pg／ml、412．38（406．67，418．79）pg／ml、324．44（316．11，331．14）pg／ml；3．01（2．81，3．02）pg／ml、5．40（5．26，5．83）pg／ml、13．22（11．80，13．77）pg／ml；118．92（113．97，122．47）pg／ml、132．33（125．87，137．62）pg／ml、169．31（167．75，172．49）pg／ml]相比，H37Rv膜囊泡处理组[分别为507．33（501．80，513．84）pg／ml、4483．00（4130．75，4522．50）pg／ml、8170．00（8058．25，8206．75）pg／ml；12．88（12．04，13．84）pg／ml、68．51（66．88，69．77）pg／ml、335．44（331．02，340．64）pg／ml；800．57（791．18，809．60）pg／ml、1559．00（1546．00，1566．00）pg／ml、4316．50（4094．75，4389．75）pg／ml]均明显增加，差异均有统计学意义（u值均〈0．001，P值均〈0．01）；但4h、8h和24h的ID-10释放量[不处理对照组分别为1．23（1．21，1．31）pg／ml、1.56（1．31，1．82）pg／ml、5．41（4．99，5．89）pg／ml；H37Rv膜囊泡处理组分别为4．56（4．49，4．82）pg／ml、1．43（1．28，1．89）pg／ml、1．56（1．48，1．68）pg／ml]差异均无统计学意义（U值分别为6．00、17.00、7．00，P值分别为0．065、0．898和0．087）。结论本研究建立了结核分枝杆菌膜囊泡分离提取的技术流程，可以得到纯度较好、形态完整、粒径正常的膜囊泡。同时，结核分枝杆菌膜囊泡可以诱发巨噬细胞中细胞因子TNF-α、IL-6和IL-1β的释放。
