Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

Objective To study the protective effect of shenfu injection on cerebral ischemia reperfusion injury in rats.Methods 120 male Sprague Dawley (SD) rats(320-350 g) were randomly divided into sham operation group,model control group,Nimodipine injection group,low,medium and high dose group of shenfu injection according to gender weight.20 males in each group were given medicine once a day for 7 days before operation.The cerebral ischemia model was established by thread embolization after 5 days of administration.In the sham operation group,the other operations were the same as those in the model group except for carotid artery ligation and thread insertion.After 24 hours of perfusion,the neurological score,abdominal aorta blood flow,malondialdehyde (MDA),superoxide dismutase (SOD) and glutathione (GHS) levels in brain tissues were measured.Triphenyltetrazolium chloride (TTC) staining was used to calculate the area of cerebral infarction and pathological examination of brain tissues.Results Compared with the model control group,the middle and high dosage of shenfu injection could obviously improve the nerve function and increase the percentage of cerebral infarction area (P ＜ 0.05);the high dosage group of shenfu injection could obviously decrease the whole blood viscosity (P ＜ 0.01);the middle and high dosage of shenfu injection could obviously reduce the level of MDA in rat brain tissue (P ＜ 0.01) while increasing the levels of SOD and GSH (P ＜0.01),finally could significantly improve the pathological changes of brain tissues such as mild swelling of nerve fibers,mild neuronal degeneration,inflammatory interstitial edema and inflammation.Conclusions Shenfu injection has obvious protective effect on cerebral ischemia reperfusion model in rats.

Objective To evaluate the efficacy and safety of single bolus high dose (SD group) ATG-Fresenius induction therapy in kidney transplantation vs.multiple low dose (MD group) administration.Methods A multiple center,prospective,randomized and controlled clinical study was performed on 280 de novo renal transplant recipients from 19 centers.Patients were randomized into 2 groups as follows:SD group,a single high dose (7-9 mg/kg) of ATG-F infused as an induction agent before the vessel anastomoses;MD group,2 mg/kg of ATG-F daily administrated in postoperative 4 days.All the patients accepted maintenance immunosuppressive protocol including tacrolimus,mycophenolate and prednisone.Patients were assessed and data were collected at regular schedule clinic visits on the day 1,3,7,14,30,90,180,270 and 365.The primary end point of efficacy was therapeutic failure rate [the number of death,grafts loss and acute rejection (AR)].The event first occurred should be used in the classification of patients.The non-inferiority evaluation of the two treatment regimens was done based on treatment failure rate.The secondary end points of efficacy were the incidence of AR,delayed graft function (DGF),1-year survival rate of patients and grafts,and serum creatinine at each visiting point.The indicators for safety evaluation included hemotologic variation and incidence of adverse events.Results The therapeutic failure rate in SD group was non-inferior to the MD group (17.24％ vs.23.08％).AR was the major cause of therapeutic failure and there was similar incidence of AR between SD gronp and MD group (12.07％ vs.21.37％).There was no significant difference in the incidence of DGF between SD group and MD group (12.07％ vs.6.84％,P =0.1721).The 1-year patient's survival rate and 1-year graft survival rate in SD group and MD group showed no significant difference (96.55％ vs.98.29％,P =0.6714;94.83％ vs 98.29％,P =0.2750).The serum creatinine level showed no significant differences between two groups at each visit point.There was also no significant difference in total incidence of adverse events between the two groups.In addition,there was also no statistically significant difference in the incidence of concerned and drug-related adverse events between the two groups,including infection,hemotologic abnormality,liver or renal dysfunction,gastrointestinal disorder,etc.After ATG--F administration,peripheral blood lymphocytes in the SD and the MD group immediately decreased but nearly restored to the normal level on the postoperative day 30 and 90 respectively.No severe granulocytopenia,erythropenia or thrombocytopenia occurred in both two groups.Conclusion The efficacy and safety of single high dose of ATG-F induction are non-inferior to multiple low dose ATG-F induction,moreover,single high dose of ATG-F induction is administered more conveniently and economically.

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.

Objective To investigate the correlation between posterior neck pain and lumbar epidural pressure (LEP)during percutaneous endoscopic lumbar discectomy (PELD).Methods A prospective study was performed on 86 patients undergoing PELD,46 males,40 females,aged 1 9-71 years,with ASA physical status of Ⅰ or Ⅱ.Each patient received lumbar epidural anesthesia.Lum-bar epidural pressure (LEP)was monitored continuously through a lumbar epidural catheter which was connected to a pressure transducer.LEP before the operation (LEPbase ),LEP at the time of pos-terior neck pain (LEPpain )and maximal LEP (LEPmax )were recorded.Results Thirty patients (34.9%)complained of posterior neck pain during the procedure.The lowest LEPmax was 31.0 mm Hg,and the highest LEPmax was 77.0 mm Hg.The LEPmax in patients with neck pain [(60.6± 8.8)mm Hg]was significantly higher than LEPmax in patients without neck pain [(50.7 ± 9.5 ) mm Hg](P <0.01 ).Patients with higher LEPmax had higher probabilities of having posterior neck pain (P <0.01).Conclusion Patients with higher LEPmax had higher probabilities of having posterior neck pain.

BACKGROUNDKidney transplantation (KTx) is the primary therapy for children with renal failure. Unlike KTx in adult patients, it is commonly agreed that pediatric KTx in China is far behind that of America. There has been no systematic analysis of Chinese pediatric KTx reported. This study aimed to demonstrate the current status of pediatric KTx in China.

METHODSRegistry data of pediatric KTx (1983-2012) from Chinese Scientific Registry of Kidney Transplantation (CSRKT) were retrospectively analyzed.

RESULTSThere were 851 pediatric KTx from 102 transplant units. The recipients were (15.4±2.5) years of age, 93.9% of who were over 10 years old. Chronic glomerulonephritis and pyelonephritis accounted for 75.6% of recognized primary diseases. Allografts were from deceased donors (72.2%) or living donation (27.7%). The patient survival for 1, 3, 5, and 10 years was 96.9%, 94.2%, 92.3%, and 92.3% and the graft survival was 94.6%, 91.4%, 86.3%, and 79.2%, respectively. The majority of post-transplant complications were acute rejection and infections. Annual transplant reached the peak in 2008 (n = 114), and decreased sharply in 2006 (n = 41) and 2010 (n = 57). The percentage of pediatric KTx in total KTx was highest in 2007 (1.95%) and decreased to trough level in 2010 (1.0%). Living donation increased by 32.5-folds from 2004 to 2008 and then decreased by 86.6% till 2010. The percentage of living donation in pediatric or total KTx dynamically changed in a similar manner, while living donation ratio in pediatric KTx was much higher.

CONCLUSIONSKidney transplant can provide long-term benefits to pediatric recipients. Rejection and infections are worthy of concern during follow-up. Pediatric kidney transplant in China is very much lagging behind that in developed countries. Living donation played an important role in its development in the past decades. New strategies for implementation are encouraged to increase the priority of uremic children in organ allocation so as to promote its progress in China.

Objective To investigate the effect of hydrochloric acid dyclonine mucilage combined with painless catheter on reducing the reaction of urethral catheterization in patients recovering from general anesthesia. Methods Sixty male adults, scheduled for surgery under general anesthesia, were randomly divided into 2 groups (the research group and the control group)with 30 patients in each group. All patients received urethral catheterization with painless catheter after anesthetic induction,and were injected with hydrochloric acid dyclonine mucilage 10 mL(research group) or normal saline 10 mL (control group). The reaction of urethral catheterization was recorded. Results The incidence of CRBD was significantly lower in research group(13.33%) than in control group(66.67%)(P<0.05),and the incidence of pain was also significantly lower in research group(10%) than in control group (56.67%)(P<0.05). Conclusion The application of hydrochloric acid dyclonine mucilage combined with painless catheter can effectively alleviate the reac-tion of urethral catheterization in patients recovering from general anesthesia.

Objective To investigate the effects of a corrective tr ea tment on open bite malformations, such as gnash their teeth, nail-biting, tongu e thrusting, impacted tooth, cross bite with improper correction, open bite defo rmity resulted from premature shedding of deciduous tooth and molar cysts. Methods We used dental resin technology: acid etching the teeth, adh ering metal clasps to the teeth by means of composite resin, and applying elasti c bands for intermaxillary traction to correct the cross bite. Results We had treated 22 patients, age ranged from 7-30, with the malformatio ns resulted from different kinds of reasons, and obtained significant results. Conclusion With cooperation of the patients, simple corrections for open bite with sticky clasp and occlusion with elastic band are easy to car ry on, with short period of treatment time, and every patient gets prominent out come. It is effective, prior to commonly-used corrective therapy and deserves t o be widely used.

0.05),respectively.The fractured adheisive dentin surface was mainly a mixed failue mode.Conclusions:There is no significant difference in the bond strengths of each of the three bonding agents to ND and CAD.

0.05), the FADRHPC could save a great amount of time and worked automatically. Conclusion: The FADRHPC can simplify manipulation processes and make satisfied dentures.