Chronic kidney disease (CKD) has become a serious impact on global human public health, one major problem with high morbidity,low awareness, high cost of treatment, as well as the high mortality rate. In recent years, both at domestic and foreign have been carried out large-scale epidemiological study of CKD screening and in the incidence of CKD, detection methods and risk factors, etc. With a better understanding. In this paper the definition of CKD and staging, morbidity, detection methods, risk factors and causes of such areas as research progress v. Comprehensive guidance and services in clinical work.

Objective To evaluate how to select operation procedures for different CT manifestation of splenic artery aneurysm ( SAA) with posthepatitic cirrhosis. Methods In 61 cases with SAA,the CT manifestation ( location,number,size,portal vein,varicose vein,proxi-mal splenorenal shunt and spleen changes) of SAA,clinical features of cases,and operation approach were were retrospectively analyzed. Re-sults 4 patients who have the primary tumors located in the distal splenic artery with diameter 1. 0~2. 0 cm,spleen kidney shunt and mega-losplenia were given aortic aneurysm exclusion and branch aneurysms embolism by stages. Amiong the 15 cases of tumors resection,splenecto-my and devascularization,there were 4 cases of the primary tumors located in the middle of splenic artery and 11 cases in the distal splenic artery. There were 15 cases whose diameter of the primary tumor were lager than 2. 0 cm and 13 cases whose diameter of the primary tumor were 1. 0~2. 0 cm. There were 4 cases of cavernous transformation of portal vein,5 cases of splenic and gastric varices,15 cases of esophage-al and gastric varices,4 cases of splenic and gastric venous shunt,15 cases of megalosplenia and 4 cases of splenic infarction. Tumors resec-tion and branch aneurysms embolism by stages were conducted in 7 cases. The primary tumors located in the proximal splenic artery occured in 7cases,and the diameter of the primary tumor were 1. 0~2. 0 cm occured in 7 cases. Esophageal and gastric varices occured in 2 cases and splenomegaly occured in 7 cases. And there were 4 cases whose diameter of the tumor were 1. 0~2. 0 cm were given tumor resection and re-construction of splenic artery and continuity, including 1 case of proximal splenic artery,2 cases of medial splenic artery and 1 case of distal splenic artery. Conclusion Operation procedures were confirmed by CT findings such as location,number,size,portal vein,varicose vein, proximal splenorenal shunt and spleen changes of SAA combined with age,gender,body mass index and history.

ObjectiveTo investigate oral collagen type Ⅱ peptide-cholera toxin B subunit-liposome complex induce tolerance to collagen-induced arthritis (CIA).MethodsDBA/1 mice were divided into four groups,group Ⅰ:normal control,group Ⅱ:CIA control,group Ⅲ:oral collagen type Ⅱ peptidecholera toxin B subunit-liposome complex,and group Ⅳ:for testing IgG2a (on day 14 after primary immunization).Arthritis scores and histopathologic assessment were analyzed.The levels of serum IgG2a were examined by ELISA.ResultsThere was no arthritis development in group Ⅰ.The incidence of arthritis in group Ⅱ was higher than that in group Ⅲ ( 100％ vs 28.6％,P＜0.05).The arthritis score in group Ⅱ was higher than that in group Ⅲ (5.40 vs 0.4,3,P＜0.01).Histopathologic score was higher in group Ⅱ than that in group Ⅲ (16.00 vs 2.85,p＜0.05).Level of serum IgG2a of group Ⅰ was very 1ow(38 ng/ml).Mice of group Ⅱ produced significantly higher level of IgG2a than mice of group Ⅲ (3922 ng/ml vs 3219ng/ml,P＜0.05).IgG2a of group Ⅳ was 98 ng/ml which was significantly higher than that of group Ⅰ (P＜0.01 ).ConclusionOral collagen type Ⅱ peptide-cholera toxin B subunit-liposome complex could inhibit CIA progression through immune tolerance.

Objective To explore the CT manifestations of splenic artery aneurysm (SAA)in patients with liver cirrhosis,and its relationship with degree of cirrhosis.Methods SAA in 61 patients were confirmed from total 2 024 patients with liver cirrhosis but without hepatoma,and the clinic and CT data were retrospectively analyzed.Results SAA incidence rate of 3.0% (13.6% of women,1.5% of men,9.3% of portal hypertension and 10.2% of hypersplenotrophy)was observed in patients with liver cirrhosis. Multiple SAAs usually were showed with large round lesions (>1.0 cm)in the middle and distal segment of splenic artery and small fusiform ones (≤1.0 cm)in the branches of splenic artery (P =0.000).With the gradual deterioration of cirrhosis produce,the number and size of large aneurysms in proximal segment of splenic artery and number of small ones were increased with more inci-dence rates of calcification of aneurysm wall,haematoma of peri-aneurysm,mural thrombosis in SAA,megalosplenia/infarction of spleen and phlebeurysma (P =0.000).Conclusion Higher incidence rate of SAA in female patients with liver cirrhosis,portal hy-pertension and hypersplenotrophy is observed.CT can show well the location,number,size,shape and other features of SAA and portal hypertension,CT findings are correlated with the degree of cirrhosis,which may help for the treatment.

Objective To compare the CT features and clinic data of patients with congenital coarctation of the aorta ( CoA) and com-plex CoA. Methods CT findings and clinical characteristics of 29 patients with CoA were retrospectively analyzed and compared. Results There were difference in clinical characteristics between isolated COA and complex COA(P<0. 05). Local COA, aortic isthmus COA, associated with patent ductus arteriosus, bicuspid aortic valve were more than those of complex COA(all P<0. 05). Grade of vascular steno-sis in patients with isolated COA was higher than ones with complex COA. Isolated COA associated with vascular variations and aorta malfor-mation were less than those of Complex COA(P<0. 001). More cardiacvascular malformation were common in patients with complex COA, collateral circulation were in in all patients with isolated COA. Conclusion There were differences of CT findings in patients with different COAs. CT findings would be helpful for early diagnosis, treatment in early stage, and choice of treatment.

Small bowel wall thickening is one of the presentations of small bowel diseases.Conventional diagnostic methods,such as enteroscopy, barium-contrast radiography,X-ray,capsule endoscopy,and ultrasonograhy have disadvantages of low positive rate and high misdiagnosis rate.From December 2009 to December 2011,2672 patients with small bowel wall thickening were admitted to the Southwest Hospital.The location,range,degree,attenuation,enhancement feature and associated perienteric abnormalities of thickened bowel wall were studied. Differential diagnosis of tumorous and non-tumorous small bowel wall thickening,malignant and benign tumorous small bowel wall thickening,and different diseases caused nontumorous small bowel wall thickening were carried out in the study.Etiopathogenesis of small bowel wall thickening can be inferred by computed tomography,and multi-slice computed tomography plays an important role in the differential diagnosis.

A new system of blood flow block for control of bleeding in abdominal operation is composed of an abdominal magnetic blocking unit, an abdominal external electromagnet unit and other non-magnetic operation instrument. The abdominal external electromagnetic unit is placed in advance in the operation bed. The abdominal magnetic blocking unit can be placed directly on the ventral of the large vessels when need to blocking the abdominal large vessels during the operation. According to the non-contact suction characteristics of magnetic materials, the two magnetic units will attract each other and compression the vessels. Using this system for vascular occlusion does not need clear exposure and without separating vessel. There is the advantage of rapid, accurate and reliable for the system.
Abdomen ; blood supply ; Blood Loss, Surgical ; prevention & control ; Electromagnetic Phenomena ; Equipment Design ; Surgical Equipment

Objective:To investigate the clinical value of abdominal adipose volume in predicting early tumor recurrence after resection of hepatocellular carcinoma (HCC).Methods:The retrospective case-control study was conducted. The clinicopathological data of 132 HCC patients with tumor diameter ≤5 cm who were admitted to The First Affiliated Hospital of Army Medical University from December 2017 to October 2019 were collected. There were 110 males and 22 females, aged (51±4)years. All patients underwent resection of HCC. Preoperative computer tomography scanning was performed and the visceral and subcutaneous fats of patients were quantified using the Mimics Research 21.0 software. Based on time to postoperative tumor recurrence patients were divided to two categories: early recurrence and non-early recurrence. Observation indicators: (1) consistency analy-sis; (2) analysis of factors influencing early tumor recurrence after resection of HCC and construction of prediction model. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribu-tion were represented as M( Q1,Q3) or M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were expressed as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Consistency analysis was conducted using the intragroup correlation coefficient (ICC) test. Multivariate analysis was performed using the binary Logistic regression model forward method. Independent risk factors influencing early tumor recurrence after resection of HCC were screened. The area under curve (AUC) of receiver operating characteristic (ROC) curve was applied to select the optimal cut-off value to classify high and low risks of recurrence. The Kaplan-Meier method was used to draw survival curve and calculate survival time. The Log-Rank test was used for survival analysis. Results:(1) Consistency analysis. The consistency ICC of abdominal fat parameters of visceral fat volume (VFV), subcutaneous fat volume, visceral fat area, and subcutaneous fat area measured by 2 radiologists were 0.84, 1.00, 0.86, and 0.94, respectively. (2) Analysis of factors influencing early tumor recurr-ence after resection of HCC and construction of prediction model. All 132 patients were followed up after surgery for 662(range, 292-1 111)days. During the follow-up, there were 52 patients with non-early recurrence and 80 patients with early recurrence. Results of multivariate analysis showed that VFV was an independent factor influencing early tumor recurrence after resection of HCC ( odds ratio=4.07, 95% confidence interval as 2.27-7.27, P<0.05). The AUC of ROC curve based on VFV was 0.78 (95% confidence interval as 0.70-0.85), and the sensitivity and specificity were 72.2 % and 77.4 %, respectively. The optimal cut-off value of VFV was 1.255 dm 3, and all 132 patients were divided into the high-risk early postoperative recurrence group of 69 cases with VFV >1.255 dm 3, and the low-risk early postoperative recurrence group of 63 cases with VFV ≤1.255 dm 3. The disease-free survival time of the high-risk early postoperative recurrence group and the low-risk early post-operative recurrence group were 414(193,702)days and 1 047(620,1 219)days, showing a significant difference between them ( χ2=31.17, P<0.05). Conclusions:VFV is an independent factor influen-cing early tumor recurrence of HCC after resection. As a quantitative indicator of abdominal fat, it can predict the prognosis of HCC patients.