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Purpose: Tacrolimus is recommended by KDIGO Clinical Practice Guidelines as an initial therapy for the treatment of membranous nephropathy (MN). However, little is known about the factors that influence response and recurrence of the disease after tacrolimus therapy, and there are limited data regarding the duration of tacrolimus treatment. Here, we present a real-world retrospective cohort study of 182 MN patients treated with tacrolimus, aiming to assess the efficacy and safety of tacrolimus in the treatment of MN. Patients and Methods: The clinical data of 182 patients with MN treated with tacrolimus and followed up for at least one year were analyzed retrospectively for the efficacy and safety of tacrolimus. Results: The mean follow-up period was 27.3 (19.3-41.6) months. A total of 154 patients (84.6%) achieved complete or partial remission, and 28 patients (15.4%) did not. Multivariate Cox regression analysis showed that male and higher baseline BMI were independently associated with lower, while higher serum albumin was associated with higher probability of remission. Among the responders, 56 patients (36.4%) relapsed. After adjustments for age and sex, Cox regression analysis revealed that the longer period of full-dose tacrolimus was administered, the lower the incidence of relapse. However, high levels of serum creatinine and proteinuria at the onset of tacrolimus discontinuation were risk factors for relapse. During the treatment of tacrolimus, a decline in renal function (≥50% increase in serum creatinine after the onset of tacrolimus treatment) was the most common adverse reaction, observed in 20 (11.0%) patients, followed by elevated blood glucose and infection, but the latter two occurred mostly during treatment with tacrolimus plus corticosteroids. Conclusion: Tacrolimus is effective in the treatment of MN, but the relapse rate is high. Clinical studies with larger sample sizes are needed to further explore the use of tacrolimus in the treatment of membranous nephropathy.

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ABSTRACT Introduction: Cardiopulmonary function is directly related to the body's ability to perform metabolism under aerobic conditions. It is a key characteristic for the training of professional swimmers. It is believed that adding interval training to traditional workouts may contribute to the aerobic endurance of these athletes. Objective: Evaluate the interval training effects on the cardiorespiratory capacity of swimmers. Methods: Twenty volunteer swimmers were randomly divided into two groups for seven weeks. There were 4 hours of class per week, totaling 28 hours of training. In the formal training stage, the experimental group performed intermediate-intensity training, while the control group continued to perform traditional swim team training. The experimental indicators pertinent to the evaluated athletes were collected, tested, and analyzed before and after the experiment. Results: The VO2 of the athletes in the experimental group increased from 3.90±0.67L/min before the experiment to 4.06±0.73L/min after the experiment; VE increased from 156.08±35.76L before the experiment to 180.08±39.42L after the experiment; underwater endurance time increased from 46.80±8.43s before the experiment to 55.49±7.60s after the experiment. Conclusion: Intermittent training improves athletes' physical fitness and sports capacity, being an effective method to improve cardiopulmonary function. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A função cardiopulmonar está diretamente relacionada à capacidade do organismo de executar a metabolização sob condições aeróbicas. É uma característica chave para os treinamentos de nadadores profissionais e acredita-se que a adição do treinamento intervalado nos treinos tradicionais possa contribuir à resistência aeróbica desses atletas. Objetivo: Avaliar o efeito do treinamento intervalado sobre a capacidade cardiorrespiratória dos nadadores. Métodos: Vinte nadadores voluntários foram divididos aleatoriamente em dois grupos durante 7 semanas. Foram 4 horas de aula por semana, totalizando 28 horas de treino. Na etapa de treinamento formal, o grupo experimental realizou essencialmente o treinamento de intensidade intermediária, enquanto o grupo de controle permaneceu executando o treinamento tradicional da equipe de natação. Os indicadores experimentais pertinentes aos atletas avaliados foram coletados, testados e analisados antes e depois do experimento. Resultados: O VO2 dos atletas do grupo experimental aumentou de 3,90±0,67L/min antes do experimento para 4,06±0,73L/min após o experimento; o VE aumentou de 156,08±35,76L antes do experimento para 180,08±39,42L após o experimento; o tempo de resistência subaquática aumentou de 46,80±8,43s antes do experimento para 55,49±7,60s após o experimento. Conclusão: O treinamento intermitente contribui para melhorar a aptidão física e a capacidade esportiva dos atletas, sendo um método eficaz no aprimoramento da função cardiopulmonar. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La función cardiopulmonar está directamente relacionada con la capacidad del organismo para realizar el metabolismo en condiciones aeróbicas. Es una característica clave para los entrenamientos de los nadadores profesionales y se cree que la adición del entrenamiento interválico en los entrenamientos tradicionales puede contribuir a la resistencia aeróbica de estos atletas. Objetivo: Evaluar el efecto del entrenamiento por intervalos sobre la capacidad cardiorrespiratoria de los nadadores. Métodos: Veinte nadadores voluntarios fueron divididos aleatoriamente en dos grupos durante 7 semanas. Se impartieron 4 horas de clase a la semana, totalizando 28 horas de entrenamiento. En la etapa de entrenamiento formal, el grupo experimental realizó esencialmente un entrenamiento de intensidad intermedia, mientras que el grupo control permaneció realizando el entrenamiento tradicional del equipo de natación. Los indicadores experimentales pertinentes a los atletas evaluados fueron recogidos, testados y analizados antes y después del experimento. Resultados: El VO2 de los atletas del grupo experimental aumentó de 3,90±0,67L/min antes del experimento a 4,06±0,73L/min después del experimento; el VE aumentó de 156,08±35,76L antes del experimento a 180,08±39,42L después del experimento; el tiempo de resistencia subacuática aumentó de 46,80±8,43s antes del experimento a 55,49±7,60s después del experimento. Conclusión: El entrenamiento por intervalos contribuye a mejorar la forma física y la capacidad deportiva de los atletas, siendo un método eficaz para mejorar la función cardiopulmonar. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.