Objective:To explore the construction of abdominal aortocaval fistula (ACF) model in adenine-induced renal failure rats, and to provide a suitable animal model for subsequent mechanism and intervention researches.Methods:Adult female Sprague-Dawley rats (250-300 g) were fed with 0.75% adenine diet (renal failure group, n=60) and the same diet without adenine (control group, n=10) for 4 weeks, and the rats were randomly grouped by block randomization method with a ratio of 6∶1. Thirty rats in the renal failure group were randomly selected by block randomization method at a ratio of 1∶1 to undergo laparotomies to establish ACF models (renal failure+ACF group). The serum creatinine, blood urea nitrogen detection and Masson staining were used to evaluate the establishment of renal failure model. Small animal ultrasound imaging system was applied to verify the successful construction of the ACF model. After 6 weeks of ACF observation, blood samples were collected from the heart of rats, and ACF-vascular tissues were collected for pathological study (HE staining). Results:At 4 weeks of feeding, compared with the control group, serum creatinine [(63.8±23.5) μmol/L vs. (33.0±3.8) μmol/L, Z=3.651, P<0.001] and blood urea nitrogen [(13.1±6.9) mmol/L vs. (5.3±0.6) mmol/L, Z=3.254, P=0.001] in the renal failure group were both higher. Masson staining showed renal tubulointerstitial inflammatory cell infiltration, renal tubular epithelial cell atrophy, interstitial fibrosis and vascular injury. Five rats sacrificed after ACF surgeries, and the survival rate was 83.3%. Doppler ultrasound showed turbulent blood flow of arterial to venous shunt at the anastomosis of open ACF (23/25) in the renal failure+ACF group. HE staining showed typical eccentric neointimal hyperplasia in the outflow tract of ACF vein in the renal failure+ACF group. Conclusions:The adenine-induced ACF rat model is successfully constructed, and ACF shows typical eccentric neointimal hyperplasia. The ACF construction would provide a reliable animal model to study the mechanism and intervention of neointimal hyperplasia for autologous arteriovenous fistula.

Objective:To explore the association between thyroid function and chronic kidney disease (CKD) in adults.Methods:A cross-sectional study was conducted in adults who received health checkup in the First Affiliated Hospital of Shandong First Medical University from January to December in 2021. Clinical data were collected, including age, gender, height, weight, blood pressure, etc. And blood glucose, blood lipid, blood creatinine, blood uric acid, routine urine function, thyroid function (free triiodine, free thyroxine, thyroid stimulating hormone) were measured. Multivariate logistic regression model was used to investigate the correlation between thyroid function indicators and the onset of CKD; and receiver operator characteristic (ROC) curve was used to explore the ability of thyroid function indicators in evaluating CKD.Results:In the study, 46 342 adults with an average age of (47.6±14.3) years were enrolled, of which 56.2% were males. The prevalence of DeGFR (eGFR<60 ml·min -1·(1.73 m 2) -1), proteinuria and CKD was 1.15%, 0.53% and 1.58%, respectively. The TSH subgroup analysis showed that the prevalence of DeGFR, albuminuria and CKD in the hypothyroidism group was significantly increased to 1.07%, 2.36% and 3.20%, respectively (all P<0.05). After adjusting for confounding factors, multivariate logistic regression analysis showed that FT3 was negatively associated with CKD ( OR=0.63, 95% CI: 0.54-0.74), however FT4 ( OR=1.05, 95% CI: 1.03-1.07) and TSH ( OR=1.03, 95% CI: 1.01-1.04) were positively correlated with CKD. Similar results were obtained in the subgroup without hypertension and diabetes ( P<0.05). The ROC analysis indicated that FT3 had a better capability for evaluating CKD than FT4 and TSH, with an area under the curve of 0.63, a cut-off value of 4.18 pmol/L, and a sensitivity and specificity of 57.5% and 62.6%, respectively. Conclusions:Thyroid function status is closely associated with the onset of CKD in the adult population receiving health check-up. FT3 is a risk factor for the onset of CKD.

Objective:To analyze the effect of hyperbaric oxygen therapy on peritoneal dialysis（PD）patients with cognitive impairment and its impact on quality of life.Methods:A total of 120 maintenance PD patients with cognitive impairment admitted to Linyi Central Hospital from December 2019 to December 2020 were divided into observation group and control group according to the random number table method，with 60 cases in each group. Patients in both groups received conventional treatments including PD for end-stage renal disease. The control group received cognitive training，and the observation group received hyperbaric oxygen therapy on the basis of the training of the control group. The changes of cognitive function and quality of life of the patients in the two groups were compared.Results:There was no significant difference in the levels of BUN，Scr，PaO 2，PaCO 2，and pH between the two groups before and after treatment（ P>0.05）. After treatment，Hb levels in the two groups were significantly higher than those before treatment，with statistically significant differences（ P<0.05），while there was no statistically significant difference between the two groups（ P>0.05）. After treatment，the Addenbrooke’s Cognitive Examination-Revised（ACE-R）total score and sub-scale scores of patients in both groups were significantly increased than those before treatment，with statistically significant differences（ P<0.05），and those scores in the observation group were significantly higher than those in the control group，with statistically significant differences（ P<0.05）. The serum BNDF level of the observation group was significantly higher than that before treatment. The serum Hcy and CRP levels of the two groups were significantly lower than those before treatment，with statistically significant differences（ P<0.05），and those two levels of the observation group were significantly lower than those of the control group，with statistically significant differences（ P<0.05）. The indicators of quality of life in the two groups were significantly improved than those before treatment，with statistically significant differences（ P<0.05），and the indicators of the observation group were better than those of the control group，with statistically significant differences（ P<0.05）. There was no statistically significant difference in the incidence of adverse events between the two groups during treatment（ P>0.05）. Conclusion:Hyperbaric oxygen therapy can significantly improve the cognitive function and quality of life of PD patients，and it is safe and reliable，which is worthy of clinical promotion.

Objective:To analyze the effect of hyperbaric oxygen therapy on peritoneal dialysis（PD）patients with cognitive impairment and its impact on quality of life.Methods:A total of 120 maintenance PD patients with cognitive impairment admitted to Linyi Central Hospital from December 2019 to December 2020 were divided into observation group and control group according to the random number table method，with 60 cases in each group. Patients in both groups received conventional treatments including PD for end-stage renal disease. The control group received cognitive training，and the observation group received hyperbaric oxygen therapy on the basis of the training of the control group. The changes of cognitive function and quality of life of the patients in the two groups were compared.Results:There was no significant difference in the levels of BUN，Scr，PaO 2，PaCO 2，and pH between the two groups before and after treatment（ P>0.05）. After treatment，Hb levels in the two groups were significantly higher than those before treatment，with statistically significant differences（ P<0.05），while there was no statistically significant difference between the two groups（ P>0.05）. After treatment，the Addenbrooke’s Cognitive Examination-Revised（ACE-R）total score and sub-scale scores of patients in both groups were significantly increased than those before treatment，with statistically significant differences（ P<0.05），and those scores in the observation group were significantly higher than those in the control group，with statistically significant differences（ P<0.05）. The serum BNDF level of the observation group was significantly higher than that before treatment. The serum Hcy and CRP levels of the two groups were significantly lower than those before treatment，with statistically significant differences（ P<0.05），and those two levels of the observation group were significantly lower than those of the control group，with statistically significant differences（ P<0.05）. The indicators of quality of life in the two groups were significantly improved than those before treatment，with statistically significant differences（ P<0.05），and the indicators of the observation group were better than those of the control group，with statistically significant differences（ P<0.05）. There was no statistically significant difference in the incidence of adverse events between the two groups during treatment（ P>0.05）. Conclusion:Hyperbaric oxygen therapy can significantly improve the cognitive function and quality of life of PD patients，and it is safe and reliable，which is worthy of clinical promotion.

Objective To investigate the clinical and histopathologic characteristics, diagnosis, differential diagnosis and prognostic features of anastomosing hemangioma.Methods Five cases of anastomosing hemangioma of the kidney and adrenal gland were collected, the clinical and radiologic features, histomorphology, immunophenotype and prognosis were analyzed with review of literature.Results Three patients were male and two were female with ages ranging from 47 to 77 years; three were located in adrenal gland and 2 originated from the kidney.Clinically, 4 tumors were incidentally identified, 1 presented as edema of lower extremity.By radiography, all presented as a well-demarcated, oval, solid and low-density mass.Grossly, the tumors ranged in maximum diameter from 1.6 to 2.5 cm ( mean 2.1 cm) .Microscopically, the tumors consisted of anastomosing sinusoidal capillary-sized vessels lined by a single layer of flattened, cubical to hobnail endothelial cells, setting in an pauci-cellular stroma of edematous and hyaline changes.Other commonly seen features included vaguely lobular growth pattern ( 3/5 ) , hemorrhage and thrombosis ( 5/5 ) , intravascular growth pattern ( 5/5 ) , eosinophilic intracytoplasmic hyaline globules ( 1/5 ) and extramedullary hematopoiesis ( 3/5 ).The tumor cells were typically bland-appearing and mitoses were scarce, with 1 case demonstrating cellular foci of tumor with slight pleomorphism and increased mitoses ( 2/50 HPF ).Immunohistochemical studies showed the tumor cells expressed endothelial cells markers.Follow-up information was available for all 5 patients and showed no evidence of tumor recurrence or metastasis within 6 to 52 months ( mean 30 months).Conclusions Anastomosing hemangioma is a rare, benign subtype of capillary hemangioma that predominantly affects the urologic organs and adrenal glands;it is needed to distinguish it histologically from a series of benign or malignant tumors that feature a richly vascular stroma.Careful attentions to its characteristic morphology with the judicious use of immunohistochemistry can help distinguish this tumor from its many mimickers.

Objective To summarize the imaging features of esophageal hamartoma.Methods The clinical data of 1 patient with esophageal hamartoma who was admitted to the First Hospital of Jilin University in October 2010 were retrospectively analyzed.The patient received the X-ray barium meal examination,plain and enhanced multi-slice computed tomography (MSCT),esophagoscopy and endoscopic ultrasonography (EUS),and then the imaging features of those were analyzed.The patient underwent endoscopic resection of esophageal hamartoma and postoperative X-ray barium meal reexamination.Results X-ray barium meal examination demonstrated a lobular filling defect and smooth surfaces in the upper third of the esophagus,intact esophageal mucosa with good creeping.MSCT in esophagus showed a lobular soft-tissue density with the uneven inner density and liparod middle density with the size of 4.2 cm × 1.6 cm × 1.5 cm.There was no significant enhancement by enhanced CT scan.The irregular mass of white tumor at insicors 16-23 cm was observed by esophagoscopy,its proximal end was pedunculated and its nodular distally was rough,soft without bleeding and with a luminal stenosis of the local lesions.EUS revealed that there were a heterogeneous and hypoechoic lesion and the rough edge of adventitious coat of esophagus.The patient underwent endoscopic resection of tumor and was confirmed as with esophageal hamartoma by postoperative pathological diagnosis.The patient was followed up for 12 months with a good condition and without tumor recurrence by X-ray barium meal examination.Conclusions Esophageal hamartoma is a rare benign tumor,and its main clinical presentation is chocked fealing when patients take solid food.Enhanced CT scan and EUS are of great significance for the diagnosis of this disease.