Objective To investigate the risk factors for delayed graft function (DGF) under-(going) cadaver renal transplantation.Methods Twenty-four relative variables were analyzed by SPSS11.0 statistical software. Using chi-square analysis method, the influence of these variables on DGF was retrospectively studied. Logistic regression analysis was done to assess and rank the relative risk of potential variables.Results The overall incidence of DGF was 5.01 %. Chi-square analysis (revealed) that the risk factors for DGF were identified as: cold ischaemia time, warm ischaemia time, recipient hypovolaemia, number of previous transplants, allosensitisation of the recipient, ATN, (accelerated) rejection, cyclosporine nephrotoxicity, ureteral leakage obstruction. Logistic multivariate analysis showed that there were 8 risk factors contributing to DGF.Conclusion DGF is a common (allograft) complication in the immediate posttransplant. There are many risk factors contributing to this condition. The basic change is ischemia-reperfusion injury. It is very important to comprehend the risk (factors) thoroughly in order to prevent them effectively.

Objective To observe the effect of electroacupuncture at the Balance Area on ambulation and quality of life in patients with cerebral stroke.Method A hundred patients with cerebral stroke were randomized into a treatment group and a control group, 50 cases in each group. The treatment group was intervened by electroacupuncture at the Balance Area plus rehabilitation, while the control group was by conventional acupuncture plus rehabilitation. The Berg Balance Scale (BBS), Holden ambulation grading score, and modified Barthel Index (BI) were adopted to evaluate the walk ability and quality of life.Result The BBS score, Holden grading score, and modified BI score respectively after 1 treatment course and 2 treatment courses were significantly different from that before intervention in both groups (P<0.01). After 1 treatment course, the BBS score, Holden grading score, and BI score of the treatment group were significantly different from that of the control group (P<0.05).Conclusion Electroacupuncture at the Balance Area can effectively enhance the balance function of cerebral stroke patients, and it can promote the ambulation ability and quality of life.

OBJECTIVE: Some studies have documented that living donor kidney transplantation has a better clinical results than cadaveric donors, however, it is poorly understood whether different living-related donors has different effects on kidney transplantation. The aim of this study is to discuss the clinical results of different living-related donors on kidney transplantation, in addition, to analyze the related problems including the donor selection, and relation of type matching with transplantation results. METHODS: Donors comprise 36 males and 58 females, aged (42.6±8.8) years. There were 72 males and 22 females received kidney transplantation, aged (33.9±8.7) years. Except for 6 cases being donated by spouse, 35 cases were donated by parents and 53 cases were donated by brothers and sisters. As to human leucocyte antigen (HLA) matching, 18 cases were full matched, 2 cases shared one-haplotype mismatched, 5 cases with 2-haplotype mismatched, 2 cases with 3-haplotype mismatched, 2 cases with 4-haplotype mismatched, and 1 case with 5-haplotype mismatched, 10 cases with full mismatched. Totally 85 cases had identical blood type, 9 cases had blood type compatibility. All recipients were negative for panel reaction antibody with smaller than 10% of lymphocytotoxicity tests prior to transplantation. RESULTS: All donors recovered well. Acute rejection episodes occurred in 8 patients, 4 cases donated by parents, 3 cases donated by siblings and 1 case donated by spouse. One recipient donated by spouse suffered accelerated rejection and delayed graft function recovery occurred. The renal function recovered in 5 weeks post-operation. All cases were reversed successfully by high intravenous dose of methyl-prednisolone or polyclonal anti-T-cell antibodies. A 6 month to 10 years follow-up showed all the donors kept normal kidney function without impairment of life quality, and 92 recipients with 92 grafts survived yet. Two recipients were dead: one due to serious pulmonary infection, and the other due to heart failure. 2 recipients underwent chronic allograft nephropathy. CONCLUSION: Living-related donor kidney transplantation has optimal HLA matches, low incidence of acute rejection and long-term surviving ratio and blood relative, which is better for renal transplantation.

OBJECTIVETo verify the clinical efficacy of acupuncture for mild cognitive impairment of stroke at subacute stage.

METHODSOne hundred patients at subacute stage of cerebral infarction or cerebral hemorrhage with scores of Montreal cognitive assessment (MoCA) less than 26 were randomly divided into an observation group and a control group,50 cases in each one. Based on the regulation of blood pressure and blood sugar and anticoagulation,cognitive rehabilitation training was adopted in the control group. On the basis of treatment in the control group,acupuncture was applied in the observation group. The acupoints were Baihui(GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Yintang(GV 29), Hegu (LI 4) and Taichong(LR 3). Sishencong(EX-HN 1), Shenting (GV 24) and Yintang (GV 29) were connected to electroacupuncture apparatus. The treatment was given once a day,5 times a week, and 8-week treatment was acquired in the two groups. In the 4th week and the 8th week,limbs motor function, daily life ability and cognitive function were evaluated by Fugl-Meyer assessment (FMA) scale,Bathel index and MoCA scale.

RESULTSIn 4 weeks and 8 weeks, the scores of FMA, Bathel index and MoCA in the two groups were improved compared with those before treatment (all P < 0.05). After 8-week treatment, the scores of Bathel index and MoCA in the observation group were better than those in the control group (both P < 0.05).

CONCLUSIONBased on the cognitive rehabilitation training and the conventional treatment, acupuncture can improve the cognitive function and daily life ability of stroke patients at subacute stage with mild cognitive impairment.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Cognition ; Cognitive Dysfunction ; psychology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; psychology ; therapy

Objective To observe the clinical efficacy of long-time needle retaining at scalp acupoints plus body acupuncture in treating motor dysfunction in the sub-acute stage of cerebral stroke.Method A hundred patients in sub-acute stage of cerebral infarction or hemorrhage scored 4-24 by the National Institute of Health Stroke Scale (NIHSS) were randomized into a treatment group and a control group, 50 cases in each group. The control group was intervened by dry rehabilitation training, while the treatment group was additionally intervened by long-time needle retaining at scalp acupoints (6-8 h) plus body acupuncture. The neural functional deficit, motor function, and activities of daily life were estimated and compared respectively by using NIHSS, Fugl-Meyer Assessment Scale (FMA), and Barthel Index (BI).Result The NIHSS score was significantly changed in the treatment group after 1 treatment course (P<0.05). After 2 treatment courses, the NIHSS scores were significantly changed in both groups compared to that before treatment (P<0.05). The FMA and BI scores were remarkably changed in both groups respectively after 1 and 2 treatment courses compared to that before treatment (P<0.05). After 2 treatment courses, there were significant differences in comparing the NIHSS score and BI score between the two groups.Conclusion Long-time needle retaining at Scalp acupoints plus body acupuncture can improve the neural function deficit, motor function, and activities of daily life in sub-acute stage of cerebral stroke.

Objective To investigate the role of integrin CD11b in liver ischemia/reperfusion (I/R) injury and its possible mechanism.Method CD11b-/-and WT (C57BL/6) mice were used to establish a 70％ liver warm I/R by clamping the left and median liver lobes for 60 min with vascular micro clamp at 37℃,then the clamp was removed and the abdominal incision was sutured.The blood plasma and liver samples were obtained at different time points (1,3,6,12,24 and 48 h) postreperfusion to assess liver function and cellular injury.Serum ALT and AST levels were determined,and HE staining and TUNEL assay were performed to estimate the severity of liver damage.Tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) were assayed by Reverse transcription polymerase chain reaction (RT-PCR).Kupffer cells were isolated from the live,and the reduced form of nicotinamide-adenine dinucleotide phosphate (NADPH) oxidase activity and active oxygen species (ROS) production were assayed.Result CD11b-/-mice displayed a significantly preserved liver function as represented by lower alanine aminotransferase (ALT) and aspartic transaminase (AST) levels,less histological damage and apoptosis compared to WT mice.Furthermore,TNF-α was decreased and IL-10 mRNA expression was increased in CD11b-/-mice compared to WT mice.Finally,CD11b-/-mice showed decreased activity of NADPH oxidase and less ROS production.Conclusion Integrin CD11 b may regulate the levels of inflammatory (TNF-α) and anti-inflammatory (IL-10) cytokines,enhance the activity of NADPH oxidase in Kupffer cells and enrich the production of ROS,which aggravate liver I/R injury.

Objective To observe the effect of acupuncture on walk ability and motor function of lower limbs in subacute stage of cerebral stroke.Method A hundred patients in subacute stage of cerebral infarction or hemorrhage and scored 4-24 according to the National Institute of Health Stroke Scale (NIHSS) were randomized into a treatment group and a control group, 50 cases in each group. The control group was intervened by rehabilitation training, while the treatment group was additionally intervened by acupuncture. The neural deficit degree (NIHSS score), motor function of lower limbs [Fugl-Meyer Assessment (FMA)], activities of daily life [Barthel Index(BI)], and ambulation ability [Functional Ambulation Category (FAC)] were evaluated before and after intervention.Result After 1 treatment course, the NIHSS score was significantly changed in the treatment group compared to that before intervention (P<0.05). The NIHSS scores after 2 treatment courses were significantly different from that before intervention and that after 1 treatment course in both groups (P<0.05). In both groups, the FMA score, BI, and FAC score after 1 treatment course and 2 treatment courses were significantly different from that before intervention (P<0.05). The FMA and FAC scores after 2 treatment courses were significantly different from that after 1 treatment course in both groups (P<0.05). After 2 treatment courses, there were significant differences in comparing the NIHSS score, FMA, BI, and FAC scores between the two groups (P<0.05). Conclusion Acupuncture can improve the ambulation ability, neural deficit, motor function of lower limbs, and activities of daily life of hemiplegia patients in subacute stage of cerebral stroke.

Objective To investigate whether the pretreatment of SS31 could alleviate hypoxia/reoxygenation (H/R)-induced injury by inhibiting p66Shc.Method The cultured rat renal proximal tubular cell line NRK52E cells were exposed to 24-h hypoxia (5％ CO2,1％ O2,and 94％ N2) followed by 6-h reoxygenation (5％ CO2,21％ O2,and 74％ N2).SS31 was added to the culture medium 4 h prior to the treatment.Then the cell viability,apoptosis,ROS and MTP were determined.In addition,Western blotting was used to detect the expression of p66Shc and p-p66Shc.Result H/R induced apoptotic cell death,accompanied with activation of total and p-p66Shc in NRK52E cells.Total p66Shc and p-p66Shc were detected at low levels in control NRK52E cells,and their levels were dramatically increased in cells after H/R treatment.Pretreatment with 100 μmol/L SS31 significantly prevented cell death and attenuated total p66Shc and p-p66Shc levels after H/R.Conclusion This study revealed that SS31 pretreatment serves a protective role against H/R-induced apoptosis of human renal tubular epithelial cells by suppressing p66Shc.

Objective To investigate the therapeutic principle of en-bloc kidney and single kidney transplantation from pediatric donors to pediatric recipients.Method A retrospective analysis of 11 pediatric kidney transplants into pediatric recipients was performed.The age of donors and recipients was 33 days to 48 months,and (9.1 ± 3.4) years (4.6 14.3 years) respectively.Result During the follow-up period of 1 to 22 months,the patient survival rate was 100％.Complications included delayed graft function in 1 case (managed by peritoneal dialysis),urine leak in 2 cases (treated by reoperation),hydronephrosis in 2 cases (treated by extracting ureteral catheter) and vascular thrombosis in 1 case.Due to thrombosis,one graft was lost.Of the remaining 10 recipients,all had excellent long-term function.At the last follow-up,their serum creatinine levels were 65.5 ±13.6 μmol/L (49-83μmol/L),and transplanted renal ultrasound examination showed no abnormality.Conclusion Kidney grafts from pediatric donors can be successfully transplanted to pediatric recipients,but the therapeutic principle is different from that in adult kidney transplantation.

Objective To investigate correlation between microRNA (miR-494) and TH 17 cell differentiation in murine cervical heterotopic cardiac transplant model.Method The heterotopic cardiac transplant models of Balb/c→C57BL/6 mice were established as experimental group,and those of C57BL/6→C57BL/6 mice as control group.Real time-polymerase chain reaction(PCR) was used to detect miR-494 and interleukin(IL)-17A mRNA expression in the grafts.CD4+ T cells,CD8+ T cells and CD45+ myeloid cells were isolated from the grafts,and miR-494 and IL-17 mRNA expression was detected.In vitro,lymphocytes in the spleen from C57BL/6 mice were harvested,and CD4+ T cells were isolated with MACS and then stimulated to TH 1,TH 2,TH 17,Treg subset cells.The expression of IL-17A mRNA and miR-494 in different T subsets was examined by Reverse transcription-polymerase chain reaction(RT-PCR).Result Two grafts from each study group were harvested on the 7th day post-transplantation.In experimental group,the IL-17A mRNA expression was increased,while the expression of miR-494 was decreased as compared with control group with the difference being significant between two groups.The expression of IL-17A rnRNA in CD4+ T cells of the grafts was significantly increased,while that expression of miR-494 was decreased.In vitro,the expression of miR-494 in TH 17 cells was significantly lower than that in TH 1,TH 2 and Treg cells.Conclusion miR-494 is related closely to TH 17 cells differentiation in the transplant rejection,which may play a role in transplant rejection through regulating TH 17 cells.