Objective To investigate the emergency treatment measures of spontaneous frontotemporal intracerebral hematoma.Methods Retrospectively analyzed the rescue process and surgical experiences of 27 patients with spontaneous frontotemporal intracerebral hematoma combined with subarachnoid hemorrhage or ventricular hemorrhage.Twenty-three cases underwent surgery;4 cases with cerebral hernia under general anesthesia underwent craniotomy hematoma clearance,aneurysm clip and decompressive craniectomy;7 cases with previous history of hypertension,considered with hypertensive intracerebral hemorrhage,was performed with craniotomy hematoma clearance and decompressive craniectomy in the emergency under general anesthesia; 12 cases of middle cerebral artery aneurysms bleeding,chosen craniotomy hematoma clearance and aneurysm clip;4 cases found nothing by digital subtraction angiography (DSA) or CT angiography (CTA),were given conservative treatment,one of them was found arteriovenous malformations after 1 month,which was treated by γ-ray.Results After the surgery,2 cases died due to severe cerebral infarction,25 cases were followed up for 6 months,according to the Glasgow outcome scale(GOS) classification:17 cases with good prognosis,7 cases with poor prognosis,1 case with vegetative state.Conclusions Cerebral hernia formation in patients with spontaneous frontotemporal intracerebral hematoma should relieve cerebral hernia and mass effect as soon as possible,early surgery to save lives.Which of them without brain hernia,after diagnosis by CTA or DSA,choice suitable treatment.Sufficient preoperative evaluation,suitable surgical timing and good microsurgical techniques can improve the prognosis.

Objective To investigate the relationship between the levels of programmed death ligand 1 (PD-L1) on circulating B cells and disease severity as well as renal injury of patients with systemic lupus erythematosus (SLE) .Methods 50patients with SLE were enrolled from May 2015to May 2017, and 20healthy individuals were enrolled as the control group.All patients were scored for their disease severity and renal injury.The expression of PD-L1on circulating B cells were evaluated by flow cytometery.Results In the group of patients with active SLE, the percentage of CD19+in B cells was (11.35±3.65) ％and the percentage of in CD19+B cells was (2.47±0.89) ％, both of which were significantly higher than that in the group of patients with non-active SLE and control group (P<0.05) .In addition, patients with SLE were divided into lower group and higher group according to the median percentage of CD19+and CD19+/PD-L1Bcells.The incidence of kidney lesion was robustly increased in the high group, and CD19+/PD-L1Bcells, LNⅣwere independent risk factors of renal insufficiency in lupus nephritis.Conclusion The level of peripheral CD19+/PD-L1in SLE patients increased significantly and was closely related to the activity degree and renal injury of the disease, which was an independent risk factor for renal insufficiency in patients.