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ABSTRACTA pretreatment experiment of preparing starch syrup with α-amylase and twin-screw extrusion together with broken rice of resistant starch rice was studied. Results showed that the content of reducing sugar in the extrudate was 23.52% when the moisture content of the material was 25%, the screw speed was 210 r/min, the barrel temperature was 85°C, and the addition amount of α-amylase was 90 U/g. The influence of various factors was ranked as follows: material ratio > screw speed > α-amylase addition > barrel temperature. After the extrusion, the contents of starch and resistant starch were not significantly changed, fat content was reduced, and protein and ash contents increased. Starch in the rice was degraded, and the particle structure was destroyed, while the crystal structure changed from type A to type V. Thermodynamic properties and solubility both changed. Rice syrup has a high transparency, good rheology, and a more delicate and soft taste.

Background and aims: Idiopathic membranous nephropathy (IMN), which is considered one of the most common causes of nephrotic syndrome in adult patients, is frequently managed with immunosuppressive agents. Both tacrolimus (TAC) and cyclophosphamide (CTX) are recommended as immunosuppressive agents in the management of IMN. However, profound effects and moderate evidence on the two drugs remains poorly defined at this period. The meta-analysis aims to summarize current best evidence on the efficacy as well as safety of TAC and CTX among IMN patients. Methods: We searched the publications on comparison of the safety and efficacy of TAC versus CTX for IMN up to April 2018. After rigorous reviewing on the quality, the data was extracted from eligible trials. All trials analyzed the summary hazard ratios (HRs) of the endpoints of interest. Results: Moderate-strong evidence indicated that tacrolimus and cyclophosphamide had comparable effects on remission rate (either CR or PR) (p > 0.05). No significant differences were found in the following parameters: the rates of diarrhea, glucose intolerance (or diabetes mellitus), gastrointestinal syndrome, as well as hypertension because of adverse effects (p > 0.05). However, patients with TAC therapy had a higher chance to develop urinary tract infection (p = 0.010) and tremor (p = 0.006). Additionally, remarkably higher risk existed in leukopenia among the CTX group as compared with the TAC group (p = 0.03). Conclusion: This meta-analysis presents a comprehensive assessment of current available evidence for the therapy of IMN, indicating a comparable remission rate with both TAC and CTX, while the long-term effects are needed for further verification. Nevertheless, different adverse effect profiles of two groups need careful consideration. Remarkably higher rates of urinary tract infection and tremor were observed among TAC group, while higher risk of leukopenia was found among CTX group. Further research into the treatment efficacy of both drugs is warranted to confirm the present conclusions. Resumen: Antecedentes y objetivos: La nefropatía membranosa idiopática (NMI), que se considera una de las causas más comunes del síndrome nefrótico en pacientes adultos, se trata con frecuencia con inmunodepresores. Tanto el tacrolimus (TAC) como la ciclofosfamida (CTX) se recomiendan como inmunosupresores en el tratamiento de la NMI. Sin embargo, los efectos profundos y la evidencia moderada de los 2 fármacos continúan estando mal definidas en este período. El metaanálisis pretende resumir la mejor evidencia actual sobre la eficacia y la seguridad del TAC y la CTX entre los pacientes con NMI. Métodos: Se realizaron búsquedas de publicaciones sobre comparación de seguridad y eficacia del TAC frente a la CTX para la NMI hasta abril de 2018. Después de una revisión rigurosa de la calidad, los datos se extrajeron de los ensayos idóneos. Todos los ensayos analizaron los cocientes de riesgo instantáneos resumidos de los criterios de valoración de interés. Resultados: La evidencia moderada-sólida indicó que el TAC y la CTX tuvieron efectos comparables en la tasa de remisión (remisión completa o remisión parcial) (p > 0,05). No se encontraron diferencias importantes en los siguientes parámetros: tasas de diarrea, intolerancia a la glucosa (o diabetes mellitus), síndrome gastrointestinal, así como hipertensión por efectos adversos (p > 0,05). Sin embargo, los pacientes con TAC como tratamiento tuvieron mayor probabilidad de desarrollar infección urinaria (p = 0,010) y temblor (p = 0,006). Además, existía un riesgo notablemente mayor de leucopenia entre el grupo que tomaba CTX que en el grupo que tomaba TAC (p = 0,03). Conclusión: Este metaanálisis presenta una evaluación exhaustiva de la evidencia disponible actualmente sobre el tratamiento de la NMI, que indica una tasa de remisión comparable con TAC y CTX, mientras que los efectos a largo plazo son necesarios para una comprobación adicional. Sin embargo, el perfil de diferentes efectos adversos de 2 grupos debe considerarse cuidadosamente. Se observaron tasas notablemente más altas de infección urinaria y temblor entre el grupo que tomaba TAC, mientras que se encontró mayor riesgo de leucopenia entre el grupo que tomaba CTX. Es necesaria investigación adicional sobre la eficacia del tratamiento de ambos fármacos para confirmar las conclusiones actuales. Keywords: Tacrolimus, Cyclophosphamide, Idiopathic membranous nephropathy, Meta-analysis, Palabras clave: Tacrolimus, Ciclofosfamida, Nefropatía membranosa idiopática, Metaanálisis