Clinical characteristics and outcomes of idiopathic membranous nephropathy with glomerular IgM deposits.

Glomerular IgM deposition is commonly shown in idiopathic membranous nephropathy, but the clinicopathological features and outcomes of IMN with IgM deposition are unclear. This single-center prospective cohort study enrolled 210 patients with biopsy-proven IMN from January 2016 to December 2018. Clinicopathological features, treatment responses, and kidney outcomes were compared between patients with and without IgM deposition. In total, 76 (36.2%) patients show glomerular IgM deposition. Patients with IgM deposition were younger (45 ± 13.30 vs. 50.59 ± 13.65 years, P = 0.006), had a higher estimated glomerular filtration rate (eGFR) (100.03 [81.31-111.37] vs. 92.67 [74.71-106.63] mL/min/1.73 m2, P = 0.041), and had a lower proportion of nephrotic syndrome (60.5% vs. 75.4%, P = 0.024) at the time of kidney biopsy. Patients with IgM deposition had a significantly higher proportion of focal segmental glomerular sclerosis (FSGS) lesions (27.6% vs. 13.4%, P = 0.011) and C1q deposition (72.4% vs. 57.5%, P = 0.032). Although the treatments and initial treatment responses were comparable, patients with glomerular IgM deposition had a significantly greater proportion of eGFR decline of ≥ 5 mL/min/1.73 m2 per year (log-rank test, P < 0.001) and eGFR decrease of ≥ 10% from baseline (log-rank test, P = 0.003). Cox regression analysis showed that IgM deposition was an independent risk factor of eGFR decline of ≥ 5 mL/min/1.73 m2 per year (HR, 2.442; 95% CI, 1.550-3.848, P < 0.001) and eGFR decline by ≥ 10% from baseline (HR, 2.629; 95% CI, 1.578-4.385, P < 0.001) during follow-up. IgM deposition in the glomeruli is an independent risk factor for decreased renal function in patients with IMN.

[Management strategy and technology of medical assistance to advanced schistosomiasis patients in Hunan Province].

The medical assistance to advanced schistosomiasis patients established by the Chinese government is a major public facility for patients with advanced schistosomiasis. Since the medical assistance to advance schistosomiasis patients in Hunan Province started ten years ago, a set of mature and operable programs with whole program management and related technologies has been developed. The author investigated the data on medical assistance to advanced schistosomiasis patients in Hunan Province during the last 10 years (from 2006 to 2015) retrospectively, and found that the program had high therapeutic effect and high satisfaction degree of both patients and the society. In order to improve the management of the medical assistance to advanced schistosomiasis patients and share our experiences of the whole program management and related technologies with the colleagues of other provinces, this paper mainly illustrates the experiences of the program, as well as the existing problems and related strategies.

[Diagnosis and treatment of imported African schistosomiasis].

This paper summarizes the clinical diagnosis and treatment of imported African schistosomiasis, in order to make the therapeutic standards. Imported African schistosomiasis includes mainly schistosomiasis haematobia and schistosomiasis mansoni in China. In order to set up the operational standards, enhance diagnostic and cure rates, and reduce the complications, we review the related literature combined with our experience over years, and summarize, in this paper, the pathogenic mechanism, and key points of clinical diagnosis and treatment of schistosomiasis haematobia and schistosomiasis mansoni, so as to provide the reference for clinical doctors.

Design optimization of beam-like ferroelectrics-silicon microphone and microspeaker.

Design optimization of beam-like ferroelectrics-silicon integrated microphone and microspeaker is studied. The Pt/Pb(Zr,Ti)O3/Pt/SiO2/Si3N4 cantilever structure is designed theoretically using multimorph model. The sensitivity and the sound pressure level (SPL) of the integrated microphone and microspeaker are calculated. It is found that the sensitivity of the microphone and the SPL of the microspeaker are very high. This integrated microphone and microspeaker will be valuable for high quality micro-acoustic devices.