Kidney transplantation is a high-cost and high-risk surgery,thus genuine informed consent from the patients and their family members is indispensable both for protecting rights of patients and ensuring medical safety.Guided by related regulations and ethical guidelines,this paper proposes necessary information which should be provided for patients,one example of Informed Consent Form(ICF) composing of information sheet,and consent signature form offered for reference.The proposed ICF applies three accepted requirements for informed consent,i.e.,completely being informed,fully understood and free to make choice.

OBJECTIVETo explore the relationship between the needling sensation of catgut embedding therapy and the depth of embedded catgut so as to improve the safety of the needle insertion and catgut implantation of the therapy.

METHODSTwenty healthy adults were selected. Under the ultrasound, the structure of the cervical Jiaji (EX-B 2) was observed. In the ultrasound guidance, the catgut was embedded. The two-dimensional imaging method was adopted to observe the anatomic structure and the procedure of needle insertion at the cervical Jiaji (EX-B 2). The high-frequency ultrasound was used to collect the images at Jiaji (EX-B 2) of C5 and determine the depths from the skin surface to the different layers of the point. Additionally, the visual analogue scale (VAS) was adopted to score the needling sensations when the needle inserted at different layers. The persistent sensation duration in the local area was followed continuously.

RESULTSUnder the ultrasound, the anatomic structure and tissue layers of cervical Jiaji (EX-B 2) were displayed clearly. The difference was significant in the average depth from the skin surface to the subcutaneous tissue, trapezius, splenius capitis, semispinalis capitis, semipinalis cervicis, multifidus and vertebral arch between the males and females (all P<0. 01). During the needle insertion, the sensations were apparently different when the implantation went to different layers. The qi arrival presented when the catgut was embedded to the trapezius, splenius capitis, semispinalis capitis, semipinalis cervicis and multifidus. But the distending pain was the most significant when in the myofascial. Commonly, the embedded catgut 2. 5 cm in length may be implanted deeply to the multifidus and the local needling sensation lasted averagely for (72. 0 ± 10. 2) h. Conclusion Under the ultrasound guidance, the depth of embedded catgut is clearly displayed at cervical Jiaji (EX-B 2). The needle insertion and the implanted material are visible, and the relationship between qi arrival and the layer of needle insertion is determined. The accuracy and safety of minimally invasive catgut embedding therapy is improved in the treatment of cervical spondylosis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Catgut ; utilization ; Female ; Humans ; Male ; Middle Aged ; Neck Muscles ; anatomy & histology ; diagnostic imaging ; Qi ; Sensation ; Spondylosis ; diagnostic imaging ; therapy ; Ultrasonography

OBJECTIVETo explore the relationship between the therapeutic effect of minimally invasive embedding therapy and the implanted depth for cervical spondylosis.

METHODSNinety patients of cervical spondylosis of nerve root type were randomized into a shallow-layer embedding group (subcutaneous layer), a middle-layer embedding group (semispinalis capitis muscle layer) and a deep-layer embedding group (multifidus muscle layer), 30 cases in each one. Jiaji (EX-B 2) of C5 and C6 on the affected side and Dazhui (GV 14) were selected. Under the guide of ultrasound, the catgut was implanted to the corresponding tissue layers. The treatment was given once a week, continuously for 3 weeks in the three groups. The symptoms and physical signs were observed before and after treatment. The pain rating index (PRI), visual analogue scale (VAS) and present pain index (PPI) were assessed. The neck disability index (NDI) was compared.

RESULTSThe score of symptoms and function after treatment was increased apparently in the deep-layer embedding group (P < 0.05), which was increased more apparently as compared with those in the shallow-layer embedding group and the middle-layer embedding group (both P < 0.05). PRI, VAS and PPI after treatment were all reduced apparently as compared with those before treatment in the deep-layer embedding group and the middle-layer embedding group (all P < 0.05), which were reduced more remarkably than the shallow-layer embedding group (all P < 0.05). After treatment, the scores of NDI in the deep-layer embedding group and the middle-layer embedding group, were reduced apparently as compared with those before treatment (both P < 0.05), and that in the deep-layer embedding group was reduced more remarkably as compared with the shallow-layer embedding group and the middle-layer embedding group after treatment (both P < 0.05).

CONCLUSIONIn the acupoint embedding treatment of cervical spondylosis of nerve root type, the efficacy is different apparently in terms of the implantation depth. The deep-layer implantation, meaning to the multifidus muscle layer is more conductive to the treatment of cervical spondylosis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Catgut ; Female ; Humans ; Male ; Middle Aged ; Pain Measurement ; Spondylosis ; diagnostic imaging ; therapy ; Treatment Outcome ; Ultrasonography