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 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: 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 clinical efficacy of heat-sensitive moxibustion in treating post-stroke urinary incontinence. Method Ninety patients with post-stroke urinary incontinence were randomized into a treatment group and a control group, 45 cases in each group. The treatment group was intervened by heat-sensitive moxibustion at Qihai (CV 6), Guanyuan (CV 4), and Sanyinjiao (SP 6), while the control group was by moxa-box moxibustion. After 4-week treatment, the two groups were compared with each in the incontinence grading and Activities of Daily Living (ADL).Result After treatment, the incontinence grading and ADL scores were significantly changed in both groups (P<0.05). The incontinence grading and ADL scores of the treatment group were significantly different from that of the control group after treatment (P<0.05).Conclusion Heat-sensitive moxibustion can improve the post-stroke urinary incontinence and ADL.

Objective To investigate the clinical features of kidney transplantation of small pediatric donors to pediatric recipients.Method A retrospective analysis of 48 kidney transplants from small pediatric donors into pediatric recipients was performed.Result Based on the transplantation types,the patients were divided into two groups:the single kidney transplantation (SKT) group and the en bloc kidney transplantation (EBKT) group.SKT was performed on 36 patients and EBKT on 12 patients.In the SKT group,postoperative complications included vascular thrombosis in 1 case (2.8％),primary disease recurrence in 1 case (2.8％),ureteral stenosis in 1 case (2.8％),delayed graft function in 17 cases (47.3 ％) and acute rejection in 4 cases (11.1 ％).In the EBKT group,postoperative complications included vascular thrombosis in 4 cases (33.3％),urine leak in 2 cases (16.7％),delayed graft function in 2 cases (16.7％) and acute rejection in 2 cases (16.7％).At last follow-up,patient survivals were 100％ in both groups,whereas graft survival was 94.4％ (34/36) in the SKT group and 75％ (9/12) in the EBKT group.The mean serum creatinine in the SKT and EBKT group was (68.4 ± 22.1) and (55.8 ± 16.7) μmol/L,respectively.Conclusion Favorable outcomes can be obtained from transplantation from small pediatric donors.The use of this donor population for pediatric recipients should be encouraged.

Objective By using primary cultured mouse renal tubular epithelial cells (TECs) to develop an in vitro model of simulated ischemia-reperfusion (IR) injury.Methods The outer medulla of C57BL/6J mouse kidney was flushed and primary cultured after digestion in type Ⅰ collagenase,and then immunocytochemical staining was used to verify TECs.Primary cultured TECs were immersed in mineral oil to simulate the ischemic process,and 60 min later the whole culture medium was added to simulate reperfusion process.The cells were collected and RAN was extracted at indicated time points after medium replacement.The expression of TNF-α,IL-1β and IL-6 was detected by using real-time fluorescence quantitative RT-PCR. The culture supernatants were collected at 24 h after medium replacement for detection of the expression of cytokine protein by using ELISA.Results Primary cultured TECs were identified by cobblestone-shaped morphology and then verified by cytokeratin 18 (CK18) staining.In TECs of IR group after medium replacement the mRNA expression of TNF-α,IL-1β and IL-6 was higher than in control group.The expression of TNF-α after medium replacement was increased to a peak level at 0.5 h,about (24.45 ±6.51) times (P＜0.01 ) higher than the control group,and gradually declined thereafter.The mRNA expression of IL-1β after medium replacement kept an increasing tendency,about ( 15.27 ± 4.29) times (P＜0.05) higher than the control group at 6 h,and that of IL-6 after medium replacement was increased to a peak level at 3 h,about ( 11.19 ±4.55) times (P＜0.01) higher than the control group. In the IR group at 24 h after medium replacement,the protein expression of NF-α,IL-1β and IL-6 in the supernatants was significantly higher than in the control group.Conclusion High purity of primary cultured TECs was achieved from the outer medulla of mouse kidney by separation and digestion.The in vitro model of simulated IR in primary cultured mouse renal TECs was successfully created using paraffin oil.