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1.
Food Chem ; 367: 130663, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34343810

RESUMO

Effects of high internal phase emulsion (HIPE) stabilized by egg yolk-modified starch complex on the gelling properties of chicken gels with or without sodium chloride (NaCl)/sodium tripolyphosphate (TP) were studied. The addition of 30 % HIPE increased the hardness from 376 g to 590 g. The NaCl addition further improved textural and viscoelastic properties compared with the gels without NaCl. 30 % HIPE-filled gels with salts (NaCl and TP) has the highest hardness (3562 g) and the lowest cooking loss (3.41 %). Fourier transform infrared spectra (FTIR) revealed that salts, especially TP, could promote the transition of α-helices to ß-sheets structure. Moreover, the chicken gels with TP had higher acyl chain disorder. In summary, the co-addition of HIPE and salt (NaCl/TP) has a positive effect on the formation of chicken gel, thereby providing potential applications in comminuted meat products.


Assuntos
Galinhas , Produtos da Carne , Animais , Emulsões , Géis , Produtos da Carne/análise , Sais
2.
Ecotoxicol Environ Saf ; 226: 112842, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34624530

RESUMO

Dissolved organic matter (DOM) assists in the phytoremediation of heavy-metal-contaminated soils, but the effect of synergistic remediation of DOM on plants is unclear. This study investigated the effect of two DOM sources (cotton straw (CM) DOM and farmyard manure (FM) DOM) on cadmium (Cd) accumulation in Cd-contaminated soil by cotton and evaluated the phytoremediation effect of DOM. The results showed that adding DOM reduced the available nitrogen and increased organic matter, available phosphorus and available potassium. Applying DOM increased the proportions of Cd acid soluble fractions and reduced the proportions of Cd residual fractions by 1-7%. DOM application increased root length, root surface area and root volume compared to the control and had a promoting or inhibiting effect on cotton biomass, depending on the soil Cd concentration. Furthermore, applying DOM improved the Cd content and bioconcentration factor of cotton. The lower the molecular weight, hydrophilic components and aromaticity of DOM, the more conducive to Cd accumulation is in cotton. The correlation and random forest analyses also showed that CM showed high remediation potential. According to our study, DOM can improve the phytoremediation efficiency of cotton, especially in low-concentration contaminated soils. This study provides a basis for applying DOM in the phytoremediation of Cd-contaminated soils.

3.
Artigo em Inglês | MEDLINE | ID: mdl-34665490

RESUMO

Modulation of A-site defects is crucial to the redox reactions on ABO3 perovskites for both clean air application and electrochemical energy storage. Herein we report a scalable one-pot strategy for in situ regulation of La vacancies (V La) in LaMnO3.15 by simply introducing urea in the traditional citrate process, and further reveal the fundamental relationship between V La creation and surface lattice oxygen (Olatt ) activation. The underlying mechanism is shortened Mn-O bonds, decreased orbital ordering, promoted MnO6 bending vibration and weakened Jahn-Teller distortion, ultimately realizing enhanced Mn-3d and O-2p orbital hybridization. The LaMnO3.15 with optimized V La exhibits order of magnitude increase in toluene oxidation and ~0.05 V versus RHE (reversible hydrogen electrode) increase of half-wave potential in oxygen reduction reaction (ORR). The reported simple but effective strategy for in situ modulation of La-site defects and the corresponding influence on the electronic structure of MnO6 can benefit the development of novel defect-meditated perovskites in both heterocatalysis and electrocatalysis.

4.
Sci Total Environ ; 807(Pt 2): 150810, 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34626642

RESUMO

The issue of how to achieve removal of recently accumulated sediment is one of the largest unresolved puzzles in China's lower Yellow River. In this work, the feasibility and sustainability of achieving full-stream erosion in the lower Yellow River based on a water-sediment regulation scheme (WSRS) have been comprehensively investigated. The results indicate that the erosion-deposition state of the lower Yellow River is controlled by the incoming flow discharge level and the corresponding sediment concentration. The year 1987 is identified as an abrupt change point for streamflow in Xiaolangdi station. The relationships between channel erosion or deposition and the sediment concentration of the incoming discharge are constructed for the periods 1960-1987 and 1988-2017. Based on a constrained optimization approach, a sediment concentration lower than 19.96 kg/m3 in the discharge from Xiaolangdi Reservoir is determined to be the critical controlling condition for achieving full-stream erosion in the lower Yellow River under the average discharge level observed during 1960-1987; however, it is challenging to achieve full-stream erosion under the average discharge level of 1988-2017. Although this erosion status could potentially be achieved through continued implementation of the WSRS, its sustainability is restricted by the declining storage capacity of Xiaolangdi Reservoir, decreasing water discharge levels and riverbed coarsening in the Yellow River. It is necessary to design cross-basin collaboration measures for the upper, middle and lower Yellow River to achieve sustainable sediment reduction and healthy development of the Yellow River basin as a whole.

5.
Environ Pollut ; : 118392, 2021 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-34678392

RESUMO

The short-term effects of ambient temperature on mortality have been widely investigated. However, the epidemiological evidence on the long-term effects of temperature on mortality is rare. In present study, we conducted a nationwide quasi-experimental design, which based on a variant of difference-in-differences (DID) approach, to examine the association between long-term exposure to ambient temperature and mortality risk in China, and to analyze the effect modification of population characteristics and socioeconomic status. Data on mortality were collected from 364 communities across China during 2006-2017, and environmental data were obtained for the same period. We estimated a 2.93 % (95 % CI: 2.68 %, 3.18 %) increase in mortality risk per 1 °C decreases in annual temperature, the greater effects were observed on respiratory diseases (5.16 %, 95 % CI: 4.53 %, 5.79 %) than cardiovascular diseases (3.43 %, 95 % CI: 3.06 %, 3.80 %), and on younger people (4.21 %, 95 % CI: 3.73 %, 4.68 %) than the elderly (2.36 %, 95 % CI: 2.06 %, 2.65 %). In seasonal analysis, per 1 °C decreases in average temperature was associated with 1.55 % (95 % CI: 1.23 %, 1.87 %), -0.53 % (95 % CI: -0.89 %, -0.16 %), 2.88 % (95 % CI: 2.45 %, 3.31 %) and 4.21 % (95 % CI: 3.98 %, 4.43 %) mortality change in spring, summer, autumn and winter, respectively. The effects of long-term temperature on total mortality were more pronounced among the communities with low urbanization, low education attainment, and low GDP per capita. In total, the decrease of average temperature in summer decreased mortality risk, while increased mortality risk in other seasons, and the associations were modified by demographic characteristics and socioeconomic status. Our findings suggest that populations with disadvantaged characteristics and socioeconomic status are vulnerable to long-term exposure of temperature, and targeted policies should be formulated to strengthen the response to the health threats of temperature exposure.

6.
Am J Transl Res ; 13(8): 9421-9428, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34540061

RESUMO

OBJECTIVE: The study was designed to analyze the efficacy and safety of domestic and imported rapamycin drug-eluting stents (DES) and paclitaxel drug-coated balloons (DCB) in the treatment of coronary bifurcation lesions. METHODS: A total of 98 patients with coronary bifurcation lesions treated in our hospital from January 2019 to December 2019 were recruited as the study cohort and divided into four groups according to the different treatment method each patient underwent, including group A (n=25, treated with domestic rapamycin DES), group B (n=21, treated with imported rapamycin DES), group C (n=29, treated with domestic paclitaxel DCB), and group D (n=23, treated with imported paclitaxel DCB). The minimum lumen diameters (MLD), the diameter stenosis rates, the late lumen losses (LLLs), and the incidence of adverse events in each group were compared. RESULTS: The MLD in the four groups were increased immediately after the surgeries and at nine months after the surgeries (P<0.05), and the diameter stenosis rates were decreased (P<0.05). However, there were no significant differences in the MLD or the diameter stenosis rates among the four groups before the surgeries, immediately after the surgeries, or at nine months after the surgeries (P>0.05). The LLLs of groups A and B were significantly higher than the LLLs of groups C and D (P<0.05). Compared with the incidences of major adverse cardiovascular events (16.00% vs. 14.29% vs. 13.79% vs. 17.39%) and the incidences of restenosis (8.00% vs. 4.76% vs. 6.90% vs. 4.35%) in groups A, B, C, and D, there were no significant differences (P>0.05). CONCLUSION: Domestic and imported rapamycin DES and paclitaxel DCB can effectively improve MLD, reduce the diameter stenosis rate, and have fewer adverse events in the treatment of coronary bifurcation lesions, and domestic and imported paclitaxel DCB have lower LLLs.

7.
J Hazard Mater ; 416: 125939, 2021 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-34492867

RESUMO

An increasing number of industries remove toluene from flue gas by the existing NH3-selective catalytic reduction (NH3-SCR) units. A thorough probe into the impact of NOx and NH3 addition on toluene oxidation is imperative but still lacks a unified understanding. In this work, NH3-SCR reactants are found to inhibit the toluene oxidation process over the MnOx-CeO2 catalyst below 200 °C. The competitive adsorption between NH3-SCR reactants and toluene, the NO2 adsorption state, and carbon deposition are emphasized to play important roles in this deactivation. Within the NO2 adsorption states, only the adsorbed NO2 can enhance the toluene oxidation. The formed nitrate species (NO3-) on the surface is inactive. NO2 adsorption is the weakest among the reactants with the smallest adsorption energy of -0.42 eV, restricting its promotion on toluene oxidation. NO and N2O are both demonstrated to be inefficient to oxidize toluene. Meanwhile, MnOx-CeO2 catalyst suffers from serious acetonitrile and benzonitrile poisoning. The amount of nitrile species accounts for ~95% of total carbon deposition, while no simple substance carbon (C) can be generated from CO disproportionation. Special care should be considered towards the formation of environmentally hazardous benzamide in the off-gas from the simultaneous NOx and toluene removal process.

8.
Innovation (N Y) ; 2(1): 100072, 2021 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-34557729

RESUMO

Although numerous studies have investigated premature deaths attributable to temperature, effects of temperature on years of life lost (YLL) remain unclear. We estimated the relationship between temperatures and YLL, and quantified the YLL per death caused by temperature in China. We collected daily meteorological and mortality data, and calculated the daily YLL values for 364 locations (2013-2017 in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces, and 2006-2011 in other locations) in China. A time-series design with a distributed lag nonlinear model was first employed to estimate the location-specific associations between temperature and YLL rates (YLL/100,000 population), and a multivariate meta-analysis model was used to pool location-specific associations. Then, YLL per death caused by temperatures was calculated. The temperature and YLL rates consistently showed U-shaped associations. A mean of 1.02 (95% confidence interval: 0.67, 1.37) YLL per death was attributable to temperature. Cold temperature caused 0.98 YLL per death with most from moderate cold (0.84). The mean YLL per death was higher in those with cardiovascular diseases (1.14), males (1.15), younger age categories (1.31 in people aged 65-74 years), and in central China (1.34) than in those with respiratory diseases (0.47), females (0.87), older people (0.85 in people ≥75 years old), and northern China (0.64) or southern China (1.19). The mortality burden was modified by annual temperature and temperature variability, relative humidity, latitude, longitude, altitude, education attainment, and central heating use. Temperatures caused substantial YLL per death in China, which was modified by demographic and regional characteristics.

9.
Genomics ; 113(6): 3895-3906, 2021 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-34555497

RESUMO

Persistent infections of high-risk human papillomaviruses (HPVs) are the leading cause of cervical cancers. We collected cervical exfoliated cell samples from females in Changsha city, Hunan Province and obtained 338 viral genomes of four major HPV types, including HPV 16 (n = 82), 18 (n = 35), 52 (n = 121) and 58 (n = 100). The lineage/sublineage distribution of the four HPVs confirmed previous epidemiological reports, with the predominant prevailing sublineage as A4 (50%), A1 (37%) and A3 (13%) for HPV16, A1 (83%) for HPV18, B2 (86%) for HPV52 and A1 (65%), A3 (19%) and A2 (12%) for HPV58. We also identified two potentially novel HPV18 sublineages, i.e. A6 and A7. Virus mutation analysis further revealed the presence of HPV16 and HPV58 sublineages associated with potentially high oncogenicity. These findings expanded our knowledge of the HPV genetic diversity in China, providing valuable evidence to facilitate HPV DNA screening, vaccine effectiveness evaluation and control strategy development.

10.
Pediatr Investig ; : e12282, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34540320

RESUMO

Importance: The Coronavirus disease 2019 (COVID-19) global pandemic poses a considerable challenge for pediatricians. Objective: This study aimed to identify the epidemiological characteristics and clinical features of pediatric patients with COVID-19 in China. Methods: This multicenter retrospective study included pediatric patients from 46 hospitals in China, covering 12 provinces and two municipalities. Epidemiological, demographic, clinical, laboratory, treatment, and outcome data were analyzed. Results: In total, 211 pediatric patients with COVID-19 were included in this study. The median age was 7.0 years (range: 22 days to 18 years). Approximately 16.3% of the patients exhibited asymptomatic infections, 23.0% had upper respiratory tract infections, and 60.7% had pneumonia, including two with severe pneumonia and one with critical illness. Approximately 78.7% of the pediatric patients occurred in familial clusters. The most three common symptoms or signs at onset in children with COVID-19 were fever (54.5%), cough (49.3%), and pharyngeal congestion (20.8%). Only 17.6% of the patients presented with decreased lymphocyte count, whereas 13.6% had increased lymphocyte count. Among the patients with pneumonia who exhibited abnormal chest computed tomography findings, 18.2% (23/127) of the patients had no other symptoms. Generally, the chest radiographs showed abnormalities that affected both lungs (49.6%); ground-glass opacity (47.2%) was the most common manifestation. The cure and improvement rates were 86.7% (183/211) and 13.3% (28/211), respectively. Only one patient with an underlying condition received invasive mechanical ventilation; none of the patients died. Interpretation: Similar to adults, children of all age groups are susceptible to COVID-19. Fortunately, most pediatric patients have mild symptoms or remain asymptomatic, despite the high incidence of pneumonia. Decreased proportions of white blood cells and lymphocytes are less frequent in children than in adults.

11.
J Food Sci Technol ; 58(10): 3798-3806, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34471303

RESUMO

This study, three different procedures were used for preparation of egg white protein (E) and egg white protein fibrous microparticle (EM) complex emulsions, to modify the interfacial and aqueous composition. According to the adding order of EM and E during emulsification, the emulsions were named as type I (EM and E mixed firstly, followed by emulsification), type II (emulsified with EM firstly, followed by the addition of E) and type III (emulsified with EM firstly, followed by the addition of E). The particle size, creaming stability at various salt concentration, elastic module (G'), and lipid oxidation degree were investigated. The results showed that, EM at interface is beneficial for improving salt resistance of the complex emulsions, while E was more effective in terms of preventing oxidation of oil, attributed to the possibility to form continuous elastic interface film. The type III complex emulsion at EM:E ratio of 2:1 showed both improved creaming and oxidation stability, behaving the potential to be used as carrier of lipo-nutrients.

13.
Environ Pollut ; 289: 117970, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34426192

RESUMO

Chromophoric dissolved organic matter (CDOM) in rivers is mainly affected by natural conditions and human activities and can reflect the watershed pollution status to a certain extent. The Yellow River is one of the largest contributors to the global riverine sediment flux from the land to ocean, and there is a paucity of information on how the optical properties of CDOM have the potential to serve as an indicator of water quality for the sediment-laden Yellow River. In this study, a three-dimensional fluorescence parallel factor (PARAFAC) analysis method was applied to investigate the seasonal and spatial variations in CDOM fluorescence components and spectral characteristics from the source region to the estuary in the mainstream of Yellow River. The relationships of CDOM with water quality indicators and trophic state were also analyzed. Six PARAFAC components (C1-C6) were identified and grouped into two categories: humic-like components (C1-C4), which accounted for 85.8 %, and protein-like components (C5 and C6), which accounted for only 14.2 %. The CDOM components, spectral parameters, and their clear correlations with the main ions (Na+ and Cl-) all indicated that the humic-like components may be primarily derived from nonpoint source erosion, and the protein-like components were mainly derived from point source discharges in the watershed. The combination of the CDOM absorption coefficient at 254 nm (a(254)), spectral slope ratio (SR), specific UV absorbance SUVA254, and fluorescence index (FI) had a good predictive ability for the key water quality indicators (total nitrogen (TN), dissolved total nitrogen (DTN), total phosphorus (TP), dissolved total phosphorus (DTP), and chlorophyll a (Chl a)) and trophic state index (TSI). Therefore, some fluorophores and UV spectral parameters of CDOM in the Yellow River can be used for rapid water quality monitoring and pollution source indication, especially pollutants related to nitrogen and phosphorus nutrients in the basin.


Assuntos
Rios , Qualidade da Água , China , Clorofila A , Monitoramento Ambiental , Humanos , Espectrometria de Fluorescência
14.
Trends Parasitol ; 37(11): 943-946, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34334318

RESUMO

Echinococcosis is a major public health problem and an emerging/re-emerging disease. It was proposed that Echinococcus cell-free DNA (cfDNA) could be used in diagnosing human echinococcosis, though earlier attempts failed. Here, we update the research on detecting Echinococcus cfDNA in echinococcosis patients' samples and highlight future research directions.

16.
Environ Sci Technol ; 55(18): 12630-12639, 2021 09 21.
Artigo em Inglês | MEDLINE | ID: mdl-34448390

RESUMO

Catalytic combustion is an advanced technology to eliminate industrial volatile organic compounds such as toluene. In order to replace the expensive noble metal catalysts and avoid the aggregation phenomenon occurring in traditional heterogeneous interfaces, designing homogeneous interfaces can become an emerging methodology to enhance the catalytic combustion performance of metal oxide catalysts. A mesocrystalline CeO2 catalyst with abundant Ce-Ce homogeneous interfaces is synthesized via a self-flaming method which exhibits boosted catalytic performance for toluene combustion compared with traditional CeO2, leading to a ∼40 °C lower T90. The abundant Ce-Ce homogeneous interfaces formed by both highly ordered stacking and small grain size endow the CeO2 mesocrystal with superior redox property and oxygen storage capacity via forming various oxygen vacancies. Surface and bulk oxygen vacancies generate and activate crucial oxygen species, while interfacial oxygen vacancies further promote the reaction behavior of oxygen species (i.e., activation, regeneration, and migration), causing the splitting of redox property toward lower temperature. These properties facilitate aromatic ring decomposition, the important rate-determining step, thus contributing to toluene catalytic degradation to CO2. This work may shed insights into the catalytic effects of homogeneous interfaces in pollutant removal and provide a strategy of interfacial defect engineering for catalyst development.


Assuntos
Cério , Tolueno , Catálise , Oxirredução , Óxidos
17.
J Food Sci Technol ; 58(9): 3473-3481, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34366464

RESUMO

In this study, the stability of 5-methyltetrahydrofolate (5-MTHF) in the model system and folate-enriched egg yolk and strategies for 5-MTHF stabilization were investigated. The oxygen, temperature and light affect the stability of 5-MTHF in the model system, among which oxygen is the main factor. In thermal pasteurization and spray-drying with normal air media, 5-MTHF is sensitive to oxidation, with the retention rate of blank group only reaching 74.96% ± 1.28%. The addition of vitamin C or vitamin E can protect 5-MTHF in egg yolk from degradation and the latter has a better protective effect. By adding 0.2% (w/v) vitamin E to egg yolk liquid, the retention rate of 5-MTHF during thermal pasteurization and spray-drying with normal air media were 94.16% ± 0.48% and 84.80% ± 0.82% respectively. Additionally, the spray-drying technique with inert gas media (N2) was also an effective method to improve the stability of the 5-MTHF in egg yolk. Our study explored the factors affecting the stability of 5-MTHF in both model systems and egg yolk liquid and provided effective strategies for the protection of 5-MTHF during the processing of egg.

18.
Front Plant Sci ; 12: 593001, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34367193

RESUMO

Aminoacylase-1 is a zinc-binding enzyme that is important in urea cycling, ammonia scavenging, and oxidative stress responses in animals. Aminoacylase-1 (ACY-1) has been reported to play a role in resistance to pathogen infection in the model plant Nicotiana benthamiana. However, little is known about its function in plant growth and abiotic stress responses. In this study, we cloned and analyzed expression patterns of ZmACY-1 in Zea mays under different conditions. We also functionally characterized ZmACY-1 in N. benthamiana. We found that ZmACY-1 is expressed specifically in mature shoots compared with other tissues. ZmACY-1 is repressed by salt, drought, jasmonic acid, and salicylic acid, but is induced by abscisic acid and ethylene, indicating a potential role in stress responses and plant growth. The overexpression of ZmACY-1 in N. benthamiana promoted growth rate by promoting growth-related genes, such as NbEXPA1 and NbEIN2. At the same time, the overexpression of ZmACY-1 in N. benthamiana reduced tolerance to drought and salt stress. With drought and salt stress, the activity of protective enzymes, such as peroxidase (POD), superoxide dismutase (SOD), and catalase (CAT) from micrococcus lysodeikticus was lower; while the content of malondialdehyde (MDA) and relative electrolytic leakage was higher in ZmACY-1 overexpression lines than that in wild-type lines. The results indicate that ZmACY-1 plays an important role in the balance of plant growth and defense and can be used to assist plant breeding under abiotic stress conditions.

19.
Infect Drug Resist ; 14: 3175-3181, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34429617

RESUMO

Objective: The number of children presenting with coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 infection is increasing, and we aimed to assess the clinical characteristics of pediatric patients with a definite epidemiological history during the early COVID-19 epidemic. Methods: Retrospective analysis was performed on the clinical data of children admitted to the fever ward of Xiangyang Central Hospital in Hubei province between January 1, 2020 and March 17, 2020. According to definite epidemiological history, patients with SARS-CoV-2 nucleic acid test (NAT) positive detection were grouped as confirmed cases, and patients with two consecutive negative NATs were grouped as suspected cases. We compared the clinical characteristics of the two groups. Results: A total of 47 (47/127, 37%) cases had a definite epidemiological history, of which 32 (68.1%) were suspected, with a median age of 5.5 years (interquartile range [IQR]: 0.7-10.3), and 15 (31.9%) were confirmed, with a median age of 9 years (IQR: 4-14). Statistically significant differences in age, family cluster of infection, and numbers of patients with clinical symptoms and fever (P<0.05) were found between the two groups, but no statistically significant differences in leucocyte and lymphocyte counts were observed (P>0.05). Significant differences were found in the computed tomography (CT) manifestation of ground glass opacity (GGO) between the two groups (P<0.05). Conclusion: Children of older age and from family clusters of infection were more easily diagnosed as having COVID-19. GGO changes on chest CT was more likely in confirmed cases. Although obvious clinical manifestations increase our awareness of COVID-19, children without manifestations of fever or cough should not be ignored as they may be asymptomatic carriers.

20.
Am J Transl Res ; 13(7): 7622-7631, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34377239

RESUMO

INTRODUCTION: Some patients with idiopathic membranous nephropathy (iMN) do not respond to cyclophosphamide plus steroids treatment, and we define them as non-responsive iMN. The combined regimen of rituximab (RTX) and tacrolimus (TAC) has an excellent effect on this kind of non-responsive iMN patients; however, the optimal dose is still unclear. In this retrospective study, we comapred the efficacy and safety of ultra-low dose RTX plus low-dose TAC therapy versus standard TAC monotherapy in patients with non-responsive iMN. MATERIALS AND METHODS: Sixty-seven Chinese non-responsive iMN patients were included. There were 41 patients received standard tacrolimus monotherapy (TAC) and 26 patients received ultra-low dose rituximab plus low dose tacrolimus (RTX/TAC) combination therapy. All patients were observed for 12 months. RESULTS: 18 patients (18/26, 69.2%) in the RTX/TAC group and 17 patients (17/41, 41.5%) in the TAC group achieved clinical response after 12-month follow-up (P=0.044). The median time for achieving response in the two groups was 3.0 months. As indicated by Kaplan-Meier curve, the response rate in the RTX/TAC group was higher than that in the TAC group (P=0.015). 24-hour proteinuria, serum albumin, estimated glomerular filtration rate (eGFR) and serum creatinine in the two groups were comparable at baseline; howerver, after 12-month follow up, they were significantly improved in the RTX/TAC group compared with the TAC group (P<0.05). B-cell depletion was achieved in all patients in the RTX/TAC group during the whole follow-up period. Pneumonia, urinary tract infections and glucose intolerance were the major side effects observed in this study. All adverse events were mild, and the cumulative incidence was lower in the RTX/TAC group compared with that in the TAC group (9 (34.6%) vs 27 (65.9%), P=0.023). CONCLUSION: The combination of ultra-low dose rituximab and low dose tacrolimus is more effective in inducing proteinuria response, improving eGFR and serum albumin in non-responsive iMN patients than standard tacrolimus monotherapy. The combined treatment also has higher safty.

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