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Primary membranous nephropathy （PMN） is a kidney-specific autoimmune disease mediated by autoantibodies. Although rituximab （RTX） has been widely applied as a first-line treatment for PMN, 20%-40% patients are non-responsive to RTX. High disease activity, severe renal lesions and low RTX bioavailability may be correlated with poor therapeutic response to RTX. Residual B cells in tissues, preservation of CD20 negative B cells, epitopic spreading, disorders of T cells and cytokines are potential mechanisms of RTX-refractory PMN. Elucidation of these factors and potential mechanisms shall help to boost the efficacy of RTX for PMN.

Background & Problems: Hypothermia is the cause of multiple problems such as delayed awaking from anesthesia, feelings of discomfort, increased oxygen consumption, and increased risks of surgical wound infection and complications. A review of the record of post-operative patients receiving general anesthesia (GA) revealed that only 74% of the patients in our post-anesthesia room (PAR) had restored their body temperature to 36°C after 60 minutes. Through situation analysis, several causes were identified, including insufficient warming facilities, lack of standard procedures and an audit system, lack of knowledge regarding hyperthermia among nurses, and the incompleteness of perioperative warming interventions performed by the healthcare team. Purpose: The aim of the present project was to apply team resource management (TRM) to raise the rate of body temperature restoration to 36°C after 60 minutes in our post-anesthesia room (PAR) from 74% to 100%. Resolution: Several strategies were implemented to accelerate the post-operative rewarming for patients receiving GA, including: establishment of standard operating procedures for warming, conducting routine audits, purchasing warming facilities, conducting in-service education, applying TRM, and cooperating with nurses in operating rooms on executing the warming plan. Result: After implementing these strategies, our PAR achieved a 100% success rate in raising the body temperature of postoperative patients to 36°C after 60 minutes. Conclusions: The result demonstrates that hypothermia may be effectively avoided and that the quality of postoperative care may be effectively improved through transdisciplinary teamwork. [ABSTRACT FROM AUTHOR]

Objective To explore the teaching effects of paper presentation in physiology. Methods 179 undergraduate students were selected from Jining Medical College as the research object and divided into the experiment group using the teaching method of paper presentation,and control group using the traditional lecture based learning teaching methods. At the end of the curriculum, an examination and a questionnaire were used to evaluate the teaching effects of students in the two groups. Results The performance of the students in the experiment group was statistically better than the control group (P＜0.05,P＜0.01)in terms of learning capacity and reasoning logic and capacity to solve problems. Conclusions In the physiology teaching, the paper presentation method is superior to the traditional method.