Objective:To evaluate the effect of unilateral pediatric kidney donation for adult kidney transplantation.Methods:Retrospective analysis was conducted on the cases of children who donated unilateral donor kidney for adult kidney transplantation recipients in our hospital, and those who were followed up for more than three years were included in this study. The body weight of the recipients in group A was ≤50 kg, and the body weight of the recipients in group B was ≤70 kg.The recipients were divided into 0-5 year old donor group (group A) and 6-17 year old donor group (B group). Clinical data, recipient/kidney survival, graft function and growth, and complications of the recipient were analyzed.Results:A total of 45 adult recipients were enrolled, including 12 in group A and 33 in group B. The renal survival rate at 3 years after operation was (100%, 96.9%)/(91.6%, 93.9%). One week after the operation, the early postoperative recovery of renal function in group B was better than that in group A, and the difference of serum creatinine was statistically significant ( P<0.05), while the difference of serum creatinine in other postoperative follow-up time points was not statistically significant ( P>0.05). Within a year, both groups of grafts continued to grow, reaching adult levels in one year. There was no statistical significance in the incidence of complications between the two groups ( P>0.05). The incidence of protein in the two groups was 33.3% and 6.1%, respectively, 1 case in each group still had proteinuria at 1 year after surgery, and only 1 case in the infant donor kidney recipient in group A had proteinuria at 3 years after surgery. Conclusions:Unilateral donor kidney transplantation from children can provide good results for adult patients with uremia by selecting suitable donors according to the weight of the recipient.

Objective To compare the therapeutic efficacy of plasmapheresis (PP ) and intravenous immunoglobulin (IVIG) plus Rituximab for antibody-mediated rejection (AMR) after kidney transplantation .Methods From May 2015 to November 2018 ,a single-center retrospective cohort study was conducted for 540 recipients with high-resolution HLA undergoing kidney transplantation .According to the criteria of diagnosing AMR and patient selection ,20 patients were selected for PP+IVIG (group A ,n=12) ,PP+ IVIG+ Rituximab (group B ,n=8) .The efficacies and outcomes of two groups were compared .Results During a follow-up period of (12 .0 ± 5 .8 ) months ,no significant inter-group differences existed in basic profiles (P> 0 .05) .After AMR treatment ,serum creatinine levels decreased significantly from 283 .4 to 226 .4 μmol/L in group A (P=0 .001) and from 289 .4 to 166 .6 μmol/L in group B (P=0 .049) .And the magnitude of decline was more marked in group B (P=0 .023) .Meanwhile ,antibody MFI (log10) decreased from 3 .73 to 3 .62 in group A (P=0 .012) and from 3 .57 to 3 .02 in group B (P=0 .043) .At months 3 and 6 , serum creatinine level was lower in group B than that in group A (125 .0 vs .166 .1 μmol/L , P=0 .03 ;127 .0 vs .169 .0μmol/L ,P=0 .048) .The serum creatinine levels of AMR patients were 249 .8 and 233 .8 μmol/L respectively ( P= 0 .182 ) .Serum creatinine levels were 176 .1 and 120 .3 μmol/L ( P=0 .045) and 180 .2 and 114 .8 μmol/L at months 3 and 6 (P=0 .044) respectively .Serum creatinine levels were 202 .8 and 122 .5μmol/L (P=0 .049) in group A and 142 .7 and 107 .0μmol/L (P=0 .046) in group B respectively .Four recipients developed allograft failure .At month 6 post-operation ,AMR occurred in group A (n=3 ,25％ ) and group B (n=1 ,12 .5％ ) .And the incidence of leucopenia was 37 .5％ and 0 (P=0 .049) in groups A and B respectively .Conclusions PP and IVIG plus rituximab is more efficacious for AMR .The earlier occurring time ,the better prognosis .

OBJECTIVEThe research regarding the central mechanism of acupuncture (arrival of ) based on functional magnetic resonance imaging (fMRI) in recent 10 years was analyzed to summarize existing research achievements and experience.

METHODSThe literature regarding fMRI-based research published from January of 2007 through December of 2016 in CNKI and PubMed databases was collected. The research content and methods, including research design, inclusion criteria, acupoint selection and evaluation, were analyzed.

RESULTSTotally 18 articles regarding the central mechanism of acupuncture based on fMRI was included. According to research content, the literature was divided into two categories: research and sensation research. In research, the differences of and not on brain functional activity were compared to summarize the central response pattern of ; in sensation research, the differences of different sensations and intensities of on central response were compared to explore the effects of different sensations and intensities of on brain functional activity. In recent 10 years, the number of research gradually increased, and the type of design was various, mainly RCT and paired design. The majority of participants was healthy people, and single acupoint was the focus of researches, including Zusanli (ST 36), Waiguan (TE 5), Hegu (LI 4), etc. The evaluation of was based on visual analogue scale (VAS). The research contents were mainly the effects of and not and different sensations on brain function activities. The present studies confirmed that and not as well as different sensations had different impacts on brain functional effects, and different acupoints had specific activated brain areas. There was a positive correlation between the degree of and the intensity of the activation of brain regions. Furthermore, tingling sensation was not included to sensations.

CONCLUSIONThe number and quality of fMRI-based research need to be improved; the research content is simple, and research method is in exploratory stage. The results obtained in the literature are the phenomena of in the central level, and it is imperative to summarize the essential link between and the central effect through these phenomena to reveal the mechanism of . The specific impact of for brain function needs more clinical exploration.

OBJECTIVETo evaluate the effects of needling depth on clinical efficacy of lumbar disc herniation (LDH).

METHODSTen electronic databases, including China National Knowledge Infrastructure (CNKI), VIP Database, Chinese Biomedical Literature Database (CBM), Wanfang Database, MEDLINE, CENTRAL, CINAHL PLUS, AMED, Embase, PsycINFO, and 6 registry platforms of clinical trials were searched. All randomized controlled trials (RCTs) that compared the effect of needling depth on clinical efficacy of LDH were collected; in addition, the reference lists of the studies included were hand searched. Data were extracted independently by two reviewers. RevMan 5.3 was applied to carry out statistical analysis.

RESULTSTotally 8 716 articles were retrieved, and 10 RCTs were included after screening, involving 1 116 patients. The results showed the effects of deep acupuncture onrelievingpain, reducing the Oswestry disability index (ODI), improving total effective rate and Japanese Orthopaedic Association (JOA) were superior to those of shallow acupuncture in patients with LDH.

CONCLUSIONIt is preliminarily indicated that deep acupuncture is helpful to improve the therapeutic effect of LDH; however, due to the low research quality and small sample size, the evidence is insufficient, and more high-quality researches are needed to further confirm the results.

The effects of(arrival of) on acupoint effects in patients with primary dysmenorrhea (PD) were evaluated.Ten literature databases,including China National Knowledge Infrastructure (CNKI),VIP Database,Wanfang Database,Chinese Biomedical Literature Database (CBM),Cochrane Library CENTRAL,MEDLINE,Embase,AMED, CINAHL Plus,PsycINFO were selected.In addition,5 registers of ongoing trials,the reference lists of included articles and grey literature website OpenGrey were added.The search time was from date of database establishment to August 2016;no restrictions were made on language or status of publication.All randomized controlled trials (RCTs) and quasi-randomized controlled trials (q-RCTs) which compared the effects ofand non-on PD or compared the effects of differentelements on PD were included.The research quality was assessed according to Cochrane bias risk evaluation tool 5.1.0.The RevMan 5.3.5 was applied for quantitative analysis if insignificant clinical heterogenicity with≤ 75%,otherwise the results was summarized by qualitative analysis.As a result,6 RCTs involving 645 patients were included.Because of considerable clinical heterogeneity,only qualitative analysis was performed,which indicated ① acupuncture could reduce pain and anxiety regardless of,and the effects ofon pain relief were superior or equivalent to that of none-,and the effects ofon anxiety relief were similar to that of none-;② the more intensity ofand higher number of acupoints selected,the better effects on pain alleviation,symptom relief and pain duration;③ the higher rate ofhad a better acupoint effect on alleviating anxiety,but was not on pain relief;④appeared early and propagated to affected area could lead to faster onset on pain relief;⑤ the effects on relieving pain and symptoms was better when warm sensation inorreaching affected area.Due to the few number,low quality and potential bias of included studies,it was not sufficient to draw clear conclusion regarding the effects ofon PD patients.This study protocol was registered in PROSPERO (CRD42016038518).

The paper is a systematic review on the efficacy of acupuncture manipulation on primary dysmenorrhea. Ten medical literatures database at home and abroad were retrieved, including CNKI, VIP, CBM, WANFANG, MEDLINE, Cochrane, CENTRAL, CINAHL PLUS, EMBASE, AMED and PsycINFO, as well as 6 clinical trial registration platforms. All of randomized controlled trials (RCTs) on primary dysmenorrhea treated with different acupuncture manipulations were collected. The data were extracted by two persons. Finally, RevMa 5.3 software was used for statistical analysis. Totally, 5 148 pieces of literature were retrieved and 8 pieces on RCTs were screened with 644 cases included. According to the results of statistical analysis on the total effective rate and other indicators of pain degree, it was showed that the effects of the manipulation with filiform needle, deep puncture with strong stimulation, and specific reinforcing and reducing needling technique were better than those without manipulation applied or with shallow puncture and weak stimulation and even needling technique in the treatment of primary dysmenorrhea. It is believed initially that acupuncture manipulation contributes to the improvement of the therapeutic effects of primary dysmenorrheal, but much higher quality studies are required for the further confirmation. Protocol registration number:PROSPERO:CRD42016038515.

Objective To explore the morphological changes of renal grafts in implantation protocal biopsy,and early stage effect of lesions from donation after cardiac death (DCD) donors.Methods Preimplantation kidney biopsy from 48 cases of DCD donors from August 2016 to March 2017 was retrospectively reviewed.Protocal biopsy was performed on dual kidneys and evaluated according to Banff 2016 donor criteria before transplantation.The Banff score of kidneys was calculated and its effects on renal function were evaluated.Results There were 48 donors and 95 kidneys (there was one kidney with congenital renal indevelopment).In.one case,diffused thrombus in arteriae arcuata occurred on the left side (normal on the right side),and the left kidney was discarded.In one case,diffused arteriolar hyaline (ah3) occurred on the left side (normal on the right side),and the left kidney was discarded.Severe interstitial fibrosis (＞70％) was seen in one pair of kidneys,and the kidneys were discarded.The proportion of glomerulosclerosis (GS) was ＞30％ in one pair of kidneys,and the kidneys were discarded.There was no statistically significant difference in morphometric changes between left kidney group and right kidney group (P＞0.05).Besides GS,the morbidity of interstitial fibrosis (ci) was 17％,that of tubular atrophy (ct) was 16％,that of interstitial inflammation (i) was 13％,that of fibrous intimal thickening (cv) was 19％,that of arteriolar hyaline changes (ah) was 28％,that of glomerolar thrombi (gt) was 0％,and that of acute kidney injury (AKI) was 81 ％.Glomerular filtration rate (eGFR) estimated was compared between ah ＞2 group and ah≤2 group.eGFR in ah＞2 group was significantly higher in 16 days,one month and three months,but not in 7 days.Terminal blood serum creatinine (t-Scr) in ah＞2 group in three months was significantly higher than that in ah≤2 group (152.5 ± 47.38 vs.122.08 ± 36.57 μmol/L,P＜0.05).The eGFR was compared between Banff score ＞3 group and Banff score ≤3 group.The eGFR in ah＞2 group was significantly higher in one month and three months,but not in 7 days and 16 days.t-Scr in Banff score ＞3 group was higher significantly than in Banff score ≤3 group (146.18-± 44.55 vs.115.27 ± 30.67 μmol/L,P＜0.05).Seven patients were diagnosed as having delayed graft function (DGF),there were 2 patients with ah＞2 and Banff score＞3,and 1 patient with primary non-function (PNF).Conclusion Vasculopathy and acute renal tubular injury were most common lesions in donor renal pathology.Kidneys with diffused arteriolar hyaline change (ah＞2) or Banff score ＞3 have poor graft function at 3rd month.

Objective To evaluate the effect of conversion from mycophenolic acid (MPA) to mizoribine (MZR) in renal transplant recipients with gastrointestinal tract (GI) symptoms.Methods A total of 355 renal transplant recipients with GI symptoms caused by MPA administration were enrolled from April 2015 to March 2017 in 25 different renal transplant centers in China.The symptomatic improvement of GI before (baseline) and after conversion to MZR (1,2,4 weeks) was assessed by each item of GI symptoms indication.In addition,the efficacy and safety of the conversion therapy during 12 months were determined.Results Patients showed improvement in GI symptoms including diarrhea,abdominal pain,abdominal distention and stomachache after conversion to MZR 1,2,4 weeks (P＜0.05).In patients with different severity of diarrhea,conversion to MZR therapy significantly improved diarrhea (P＜0.05).During 12 months,no patient experienced clinical immune rejection.We did not observe any infections,leucopenia and other serious side effects.Conclusion MZR could markedly improve GI symptoms caused by MPA administration in renal transplant recipients.

Qi arrival is the meridian qi response to acupuncture stimulation. Through analyzing the relevant concepts of qi arrival and summarizing the general understanding of it in clinic and on the basis of the collection of the relevant literature at home and abroad on the determination of qi arrival and its strength, the characteristics are analyzed on the present method and the method for the determination of qi arrival and its strength is discussed in terms of the results in the needling sensation scale. It is believed that the needling sensation and its strength can be used to determine whether the qi is arrived or not and its strength. The components of different types of needling sensation are much better applicable for the analysis on the characteristics and rules on the influence on qi arrival. This method is in compliance not only with the theoretic connotation of qi arrival, but also with the clinical general understanding, which lays the foundation for the analysis on the scale results.
Acupuncture Therapy ; instrumentation ; methods ; Humans ; Meridians ; Qi ; Sensation

Objective By using infrared thermal imager (Flir-SC620), to observe the effect of needling Sanyinjiao (SP6) on the skin temperature at Guanyuan (CV4) and Sanyinjiao in patients with primary dysmenorrhea (PD) of cold and dampness stagnation pattern, and to explore the probability of using infrared thermal imaging for diagnosis and as an objective index for evaluating the action and needling qi of acupuncture. Method Thirty-six subjects were recruited and divided into four group, a health control group (group A), a control group of PD of cold and dampness stagnation pattern (group B), a needling-qi-expected group (group C) and a needling-qi-unexpected group (group D). Group A and B were not given acupuncture treatment, while group C and D were treated with acupuncture at bilateral Sanyinjiao with needles retained for 30 min, and the needling sensations were recorded. The infrared thermal imager was used to detect the skin temperature at Guanyuan and bilateral Sanyinjiao for 40 min for each group, and the temperature was recorded every 10 min. The temperature during different periods of time, 0-10 min, 20-20 min, 20-30 min, 30-40 min, 0-30 min, and 0-40 min were then calculated. In group C, those obtained the needling qi sensation were further grouped into C-1 and those didn’t obtain the sensation were into C-2; in group D, those obtained needling qi sensation were further grouped into D-1 and those didn’t obtain the sensation were into D-2. SPSS 17.0 was adopted for data processing, and the data were analyzed by using MANOVA of repeated measuring. Result Compared to group A (6 cases), the temperature at Guanyuan in group B (6 cases) was significantly decreased during 0-30 min and 0-40 min (P<0.05), the temperature at the left Sanyinjiao during 0-40 min in group B was significantly decreased (P<0.05), and the temperatures at bilateral Sanyinjiao during 30-40 min in group B significantly dropped (P<0.05). Compared to group B, the temperatures at Guanyuan during 0-30 min and 0-40 min in group C1 (12 cases) and group D1 (11 cases) were significantly increased (P<0.05), the temperature at left Sanyinjiao during 0-40 min in group D1 was significantly increased (P<0.05), and the temperatures at bilateral Sanyinjiao during 30-40 min in group D1 were significantly increased (P<0.05). There was no case in group C2 and only 1 case in group D2, hence, the data were not enough for analysis. Conclusion Decrease of the infrared temperature at Guanyuan and Sanyinjiao can be taken as one of the diagnostic criteria for dysmenorrhea of cold stagnation pattern. Increase of the infrared temperature at Guanyuan can be regarded as one of the objective evidences for the along-meridian transmission characteristic in needling Sanyinjiao.