Objective To analyze clinical efficacy of operation approach in lateral fissure for patients with hypertensive intracerebral hemorrhage (HICH) in basal ganglia region.Methods Retrospectively analyzed 120 cases of patients with HICH in basal ganglia region in the department of neurosurgery in our hospital from 2012 to 2015.Among them,64 cases of patients were treated by surgery via lateral fissure-insular approach (lateral fissure group),the other 56 cases of patients were treated by surgery via the traditional trans-temporal cortex approach (temporal lobe group).The perioperative indicators and clinical efficacy were compared between the two groups.Results Compared with the temporal lobe group,the operative time in the lateral fissure group was decreased,and the hematoma clearance rate was increased,there were statistically significant differences(P＜0.05).No statistically significant difference was found in postoperative re-bleeding rate and rate of complications between the two groups(P＞0.05).The activity of daily living (ADL) Barthel index scores,1 month,3 months and 6 months after operation,in the lateral fissure group were significantly higher than those in the temporal lobe group(P＜0.05).In the lateral fissure group one patient died and in the temporal lobe group 2 patients died.The proportion of patients with good prognosis in the lateral fissure group (70.31％) was higher than that in the the temporal lobe group(51.78％,P＜0.05).Conclusion Patients with HICH in basal ganglia region treated by operation via lateral fissure-insular approach undergo a shorter operation time,hematoma is evacuated more thoroughly,and have better postoperative prognosis,compared with those patients treated by operation via traditional trans-temporal cortex approach.

Objective To compare the results of three phase bone scans between benign and malignant lesions, and explore its clinical value. Methods Patients with pain symptom underwent three phase bone scan. Their corresponding clinical data was collected and input into SPSS software package for further evaluation. Results Forty-nine patients had 73 positive foci in the acquiring field of vascular and blood pool phase bone scans. Excluding 10 foci that suspected of bone metastasis, 37 of 63 were malignant,26 were benign lesion. On vascular, blood pool and delayed images, benign and malignant foci did not exist any significant difference (χ2 =3.341, 1.685 and 2.923, P ＞0.05). In these lesions, 33.3 % (5/15) foci had positive vascular and blood pool results in thoracic, 72.2 % (13/18) in extremity and 75.0 % (18/24) in pelvic.There were no significant difference among subgroup of chest, abdomen, limb and pelvic diseases. In addition,4 foci outside bone system were occasionally found in three phase bone scans. Conclusion Acquiring position could significantly affect the results of three phase bone scan, for example more sensitive rate can be found for limb and pelvis lesions. This method could not significantly differentiate malignant from benign lesions, but could detect soft tissue foci or the change of blood flow, and provide more information for differential diagnosis.

Objective Systematically reviewed the standard treatment of primary brain glioma patients high levels,and discussed effective new therapies. Surgery,radiotherapy and chemotherapy are the main methods of treatment of high?grade gliomas, molecular markers supplement clinical prognostic factors under certain circumstances be able to guide treatment decisions. The rapid development of technology using molecular data can improve our understanding of the disease pathogenesis and proliferation. Effectively validate prognostic biomarkers and identification of tumor may improve the outcome.

ObjectiveTo explore the relationship between rotary strength of trunks and stability of the low back in patients with nonspecific low back pain. MethodsBefore sling exercise therapy (SET), 22 patients with chronic nonspecific low back pain were measured the rotary strength of core muscles of trunks with Proxomed Tergumed functional spinal evaluation and training system and the core stability of the low back with SET system. Their correlation was analyzed. ResultsThe core rotary strength was positively correlated with the local stability in patients with chronic nonspecific low back pain (r=0.876, P<0.001). ConclusionIncreasing the rotary strength of trunks is important to improve local stability in patients with chronic nonspecific low back pain.

Objective To study setup errors in precise radiotherapy by Varian ix accelerator OBI system and provide reference data for clinic.Methods 15 patients with pelvic cancer patients were studied in intensity modulated radiation therapy, measurement in patients with left and right (X), head and feet (Y),before and after the (Z) 3 directions respectivelY,the linear error and X,Y,Z axis to form the corresponding U, V, W rotation errors, online error correction anyway, and record the error values. The error data was analyzed before and after corrections using the two-parameter method to calculate the clinical target volume (CTV) to planning target volume (PTV) of putting boundaries (MPTV).Results 15 patients were preformed total 146 times of the first place after a and after treatment of conical CT scan,in the X,Y,Z direction system error ((x)) ± random error (s) were (1.23±0.134) mm,(2.02±7.96) mm and (1.87±3.13) mm,after treatment for respectively (0.49±1.14) mm,(0.98±2.28) mm and (1.87±3.13) mm.There was no significant difference on X direction of the tapered bed CT scan in the first place,before and after calibration,in Y and Z direction there were significant differences, corrected position error in Y and Z direction is lower compared with that of primary (P ＜ 0.05); the setup error were (0.72±1.23)°,(0.06±1.12)°,(0.12±0.97)° on U,V and W direction respectively. rotate error in general was not more than 3°. Since online correction only worked to the translation error correction, There was no difference in U,V and W before and after correction.The MPTV was 2.55,9.61 and 5.93 mm on X,Y,Z direction before correcting. Conclusions Online or offline using the OBI system to guide positioning error correction can improve the positioning accuracy and reduce the positioning uncertainty,while maintaining or increasing local control rate at the same time,reducing exposure to surrounding normal tissue,so as to improve treatment accuracy purposes.

Objective:To assess the accuracy of the portable blood glucose meters. Methods:The study design was equivalent clinical trial. The participants were selected according to the inclusion and exclusion criteria from inpatients, outpatients and outpatient volunteers of the department of endocrinology. The fingertip blood glucose was measured by five portable blood glucose meters and compared with vein blood glucose measured by biochemistry. The measurement error was assessed by the mean difference with biochemical results. The correlation coefficient was calculated to test the correlation between fingertip and vein blood glucose. Results:there were 230 cases in total including 86 males and 144females. The average age was (50.6±13.5) years old. There were 73 fasting blood glucose and 157 postprandial blood glucose. The range of biochemical blood glucose value was from 2.19 to 19.95 mmol/L and the averaged biochemical blood glucose concentration was (6.77±2.65) mmol/L. The minimum measurement error was 0.08mmol/L measured by blood glucose meter C. However, there was one meter E whose 95%confidence interval of measurement error exceeds the equivalent interval (-0.83, 0.83) mmol/L range and the difference does not meet the clinical equivalence. The measurement bias was all lower than 95%. Conclusion:The blood glucose meters can be used as the day-to-day monitoring of blood glucose in patients. The accuracy needs to be improved and continuously monitored.

T cell immune deficiency results in inefficient anti-tumor immune response in most patients with hematological malignancies,thereby tumor cells escaping the attack of host immune system,that is the immune escape of tumor cells.Recently,new insights regard to the CD8+ T cell exhaustion which is one of the most important mechanisms of tumor immune suppression.The CD8 + T cell exhaustion is mediated by abnormal expression of T-cell immunosuppressive receptors such as PD-1 and CTLA-4.Blocking these molecules may restore the partial or all functions of T cells.This article reviewed the advances on the role of the PD-1 and CTLA-4 in hematological malignancies,including their functions on mediating T cell-immune tolerance and the progression of targeted immunotherapy,to provide the new strategy for hematological malignancies.

Objective To develop Z-score reference ranges for tricuspid annular plane systolic excursion(TAPSE) in normal fetuses from the measurements of gestational age(GA),biparietal diameter (BPD) or femur length(FL) using fetal echocardiography.Methods A retrospective cross sectional study of 1012 singleton normal fetuses were performed.The gestation age ranged from 20 to 41 weeks.Non-cardiac fetal biometric parameters included GA and BPD and FL were measured and calculated GA based on menstrual age.TAPSE was measured in a standard apical four-chamber view by free angle M-mode echocardiography.Normal Z-score ranges were developed for TAPSE using GA,BPD and FL as independent variables.These were accomplished by using first standard regression analysis and then weighted regression of absolute residual values for each parameter in order to adjust for inconstant variance.Results Linear regression model was the best description of the data in each case and correlations between TASPE and independent variables (GA,BPD,FL) were excellent.Heteroscedasticity of standard deviation (SD) with increasing independent variables also could be modeled with a simple linear regression.According to these equations,TAPSE Z-score =(the actual measurement of TAPSE-predicted TAPSE)/prediction SD.Conclusions Normal reference ranges and Z-scores for TAPSE have been provided.These normative data may be useful tools for assessment of fetal TAPSE,to evaluate fetal right ventricular function more accurately and effectively.

Objective To establish z-score model for fetal tricuspid annular plane systolic excursion(FAM-TAPSE) and mitral annular plane systolic excursion(FAM-MAPSE) based on gestational age(GA),then to evaluate the ventricle systolic function of fetus with heart failure.Methods One thousand and twelve normal fetuses and 24 fetuses with heart failure were involved. FAM-TAPSE and FAM-MAPSE were measured by free angle M-mode echocardiography,and FAM-TAPSE and FAM-MAPSE z-score models of normal fetuses were constructed by using first standard regression analysis with GA as independent variable.The fetuses with heart failure were divided into left heart failure (LHF) group and right heart failure (RHF) group by Tei index.Subsequently,the two parameters between normal and fetuses with heart failure were compared. Results The models used to calculate z-score for FAM-TAPSE and FAM-MAPSE were constructed,and GA had close correlation with them. Compared with normal fetuses,the mean z-scores of FAM-TAPSE and FAM-MAPSE were statistically different in fetuses with heart failure(P<0.001). The FAM-MAPSE z-scores of LHF and the FAM-TAPSE z-scores of RHF were all less than-2 z-scores.Conclusions The FAM-TAPSE and FAM-MAPSE z-scores decline in fetuses with heart failure and they can provide quantitative evidence in evaluation of heart systolic function,FAM-TAPSE and FAM-MAPSE z-score would be markers for assessing heart systolic function in fetuses with heart failure.

Objective To obtain the annular plane systolic excursion difference (APSED)of fetuses in second and late trimester by free angle M-mode (FAM)and tissue motion of annular displacement (TMAD)in order to assess the fetal ventricular function.Methods The mitral annular plane systolic excursion(MAPSE)and tricuspid annular plane systolic excursion(TAPSE)of four hundred and fifty five normal fetuses from 20 to 41 weeks were measured by FAM echocardiography,and the difference between them were calculated.Early diastolic velocities (Em)of the mitral annular and early diastolic velocities (Em')of the tricuspid annular were estimated by pulsed-wave tissue Doppler imaging (TDI),meanwhile systolic velocities (Sm)of the mitral annular and systolic velocities (Sm')of the tricuspid annular were also estimated by TDI.Fifty normal fetuses in the second and late trimester were choosed randomly,two-dimension imaging was obtained at the apical four-chamber view,then mitral annular plane and tricuspid annular plane displacement curve were acquired at the same time by using off-line QLab 8.1 software,and the differences in the peak time between them were compared.The trace of annular displacement were recorded by color tissue tracking technology.Results There was a significant difference between FAM-TAPSE and FAM-MAPSE in different gestational weeks (P <0.05),FAM-TAPSE was growing with the increase of gestational weeks,FAM-APSED showed significant positive correlations with gestational week, Em,Sm,Em' and Sm'.Annular plane displacement curve showed that TMAD-TAPSE was higher than TMAD-MAPSE in the entire cardiac cycle,and there was no statistically significant difference in time to peak of the annular plane displacement curve between them(P >0.05).Conclusions The APSED existed in the second and late trimester continually.It was considering associated with fetal ventricular torsion.As the growth of gestational weeks,the increase of APSED reflected the enhanced reserve capacity of the fetal ventricular torsion.APSED can reflect the longitudinal motion and torsion movement of fetal ventricle quantitatively,and can be used as a new index to assess the fetal cardiac function.