The single brain metastases of lung cancer is defined as limited brain metastases .Mechanism of brain metastasis from lung cancer remains to be further studied .Based on surgery ,radiotherapy ,and chemother-apy,the comprehensive treatment on limited brain metastasis of non -small cell lung cancer gets a better result , however ,the indications for combination therapy must be strictly controlled .Increasing radiation doses of local tumor area,followed by whole-brain radiotherapy,can improve tumor local control rate and prolong overall sur-vival.Prophylactic irradiation of whole brain showed no evidence on prolonging the overall survival .For patients with poor general state,targeted drugs combined with whole brain radiotherapy can be tolerated well ,as well as prolonged the overall survival to ertain extent .

Objective To investigate the efficacy of heart value replacement on elderly patients and summarize the experience of surgical treatment.Methods The clinical data and follow-up status of 76 elderly patients were analyzed retrospectively in our hospital from January 2008 to December 2011.The operative method,general effect,postoperative death,postoperative complications,survival rate and life quality followed-up were analyzed.Results No intraoperative death appeared and there were 4 early operative deaths with a mortality rate of 5.3％.There were 31 cases occurred postoperative complication with a complication rate of 40.8％ which including respiratory insufficiency,lung infection,arrhythmia,incision infection,pleural effusion,low cardiac output syndrome and renal insufficiency.The follow-up time was 18-52 months and the mean follow-up time was (24.7± 3.6)months.There were 5 cases lost of follow up and the follow-up rate was 93.4％.There were 6 patients died after a month postoperative with a mortality rate of 7.9％.The heart function of the survivors achieved differed degree improvements and the result at the end of follow-up were grade Ⅰ-Ⅱ 47 cases,grade Ⅲ 13 cases and grade Ⅳ 6 cases.Conclusions To correctly determine the surgery indications,do all the preoperative preparation,intraoperative rigorous operating with a good myocardial protection and to strengthen the postoperative care will be help to reduce the mortality and complications of the elderly patients with heart value replacement.

Objective Promote the use of medical record information, the depth of excavation,provide strong support for clinical research and hospital management.Methods Medical Record Information lower utilization reasons put forward need to build the whole structure of the paperless electronic medical records, electronic medical records for research concluded that the key to building elements to provide support.Results Pointed out that the construction of paperless electronic medical records from the storage structure of the building medical record systems, and data warehouse technology combined start, outpatient and inpatient medical records while achieving interoperability, building regional health care, improve follow-up system, and finally pointed out the key technical implementation.Conclusions It is to promote the utilization of medical records, medical records for research to improve support efforts to promote development and progress of medicine and enhance the hospital's soft power has great significance.

Objective Improve the level of education of medical information to promote faster and better development of medical information.Methods According to the disciplinary development lag,weak teachers' drawbacks of medical education and medical information technology status quo,research talent development solutions.Results Departure from the practice of medical information is proposed to establish and improve the incentive mechanism,curriculum system and teaching content changes,the establishment of hospital information system simulation laboratory recommendations.Conclusion For the development and maturation of the education of medical information,to promote the cultivation of medical information,certain referential significance.

Objective To analyze the effectiveness evaluation of cardiovascular drugs which have been developed on the CYP2C9 target protein by multi-layer fuzzy evaluation technology .Methods The multi-layer fuzzy evaluation method was used to evaluate the effectiveness of cardiovascular drugs interacting with the CYP 2C9 protein and to construct the index system that affects drug efficacy .Results and Conclusion The index system was used to study such cardiovascular drugs as valsartan and to score the drug effectiveness of individual samples .The results were consistent with actual drug treatment and were well confirmed .The results contribute to evaluation of personalized medication .

Objective To evaluate the relationship between echocardiographic epicardial adipose tissue thickness(EAT) and the presence and severity of coronary artery disease(CAD). Methods One hundredand forty-seven patients (101 patients with CAD and 46 patients with normal coronary arteries by diagnostic coronary angiography) were enrolled. EAT thickness was measured using 2-D echocardiographic parasternal long-and short-axis views. EAT thickness measurements were compared with angiographic findings. Results EAT was significantly higher in CAD group comparison to control group [(7.41 ± 1.63)mm vs (4.41±1.60) mm, P ＜0.01 ]. Furthermore, EAT increased with the severity of CAD [(8.53 ± 1.00)mm vs (6.36 ±1.73)mm, P ＜0.01]. Gensini's score significantly correlated with EAT (r = 0.71, P ＜0.01 ). EAT thickness ≥5.35 mm had 87.13% sensitivity and 80.42% specificity (ROC area 0. 89, P = 0.01,95% CI [0.84 - 0.9;]) for predicting CAD. Conclusions EAT thickness, which is easily and non-invasively evaluated by transthoracic echocardiography, can be an adjunctive marker to classical risk factors for the prediction of CAD, it was significantly correlated with the severity of coronary artery disease.

Objective To compare the imaging quality of articular cartilage of the knee with 3D-sampling perfection with applica-tion optimized contrast using different flip angle evolutions (3D-SPACE),3D-true fast imaging with steady-state precession (3D-True FISP)and 2D-fast-spin-echo-proto-density(2D-FSE-PD)sequences.Methods 40 healthy volunteers and 20 patients of knee joints were examined with 3D-SPACE,3D-True FISP and 2D-FSE-PD sequences at 1.5T MRI.Signal-noise ratio (SNR),contrast-to-noise ratio (CNR)and lesion visualization of articular cartilage were compared.Results 3D-SPACE showed the highest SNR of cartilage and CNR of fluid/cartilage among the three sequences (P <0.05).3D-SPACE had the better capability for showing the lev-el I 、level Ⅱcartilage injury comparing with 3D-True FISP,but no significant difference between the cartilage injury at level Ⅲ and level Ⅳ.For all levels of cartilage injury,3D sequence was better than the 2D sequence.Conclusion Compared with the 3D-True FISP sequence and 2D-FSE-PD sequence,3D-SPACE sequence can show the structure of knee and knee cartilage injury better.

Objective To investigate the correlation between epicardial fat thickness and non dipper hypertension.Methods A total of 150 subjects was included in the study,of which 50 were in the non dipper hypertension group,the same in the non dipper hypertension group and the healthy control group.History collection and routine laboratory tests,ultrasonic measurement of epicardial fat thickness,and 24 hour ambulatory blood pressure monitoring were carried on all subjects.Epicardial fat thickness between groups was compared to primarily analyze the correlation of epicardial fat thickness and non dipper type hypertension.The optimal screening positive value in epicardial fat thickness of non dipper type primary hypertension was obtained by receiver operating characteristic (ROC) curve and maximum Youden index.Results When non dipper hypertension group and non-dipper hypertension group were compared,epicardial fat thickness was significantly increased [(6.30 ± 0.94) mm vs (5.92 ± 0.75) mm,P ＜ 0.05],as compared dipper hypertension group to healthy group,the epicardial fat thickness was significantly increased [(5.92 ±0.75)mm vs (5.50 ±0.13)mm,P ＜0.05].Epicardial fat thickness and non dipper type primary hypertension were linearly related (r =0.43,P ＜ 0.05),and epicardial fat thickness in diagnosis of non dippers primary hypertension optimal screening positive value was 6.01 mm.Conclusions There is a close relationship of epicardial fat thickness and non dipper hypertension.

Objective:To evaluate the application values of small FOV surface coil and BLADE sequence in MR imaging on assessment of talar cartilage injury of ankle joint under traction.Methods:The clinical and imaging data of 53 patients with ankle cartilage injury in the Affiliated Suzhou Hospital of Nanjing Medical University from December 2018 to July 2020 were prospectively analyzed. All patients underwent the following MR sequences: sequence Ⅰ was fast spin echo proton density weighted (FSE-PD) BLADE sequence with surface coil small FOV, and sequence Ⅱ was FSE-PD-BLADE imaging of small FOV under horizontal load traction of ankle joint. Paired sample Wilcoxon rank sum test was used to compare the thickness of talus dome cartilage, cartilage space and subjective assessment score of image quality (including the outline of the upper surface of the cartilage at the injury, the thickness of the cartilage layer at the injury, the rupture of the cartilage at the injury, the relationship between cartilage and subchondral bone, subchondral bone collapse or trabecular fracture line) between sequence I and sequence Ⅱ.Results:There was significant difference in the thickness of central cartilage of talus between sequence Ⅰ and sequence Ⅱ [0.70 (0.60, 0.90) mm and 0.80 (0.70, 0.90) mm, Z=-2.900, P=0.004, respectively]. There was no significant difference in the thickness of medial and lateral talus cartilage between sequence Ⅰ and sequence Ⅱ (P>0.05). There were significant differences between sequence Ⅰ and sequence Ⅱ in the center [0.10 (0, 0.15), 0.89(0.63, 1.00) mm], medial [0.10(0, 0.31), 1.20(0.70, 1.25) mm] and lateral cartilage space [0.18(0.08, 0.23), 0.90(0.76, 0.94)mm] (all P<0.001). As for the subjective assessment score of talus cartilage injury, except for score in subchondral bone collapse or bone trabecular fracture line between sequence Ⅱ and sequence Ⅰ ( Z=-1.480, P=0.139), significant differences were found in all other scores ( P<0.05). Conclusion:MRI of the ankle under traction is safe and feasible. Under the condition of horizontal traction, small FOV surface coil combined with BLADE sequence can better display talus cartilage injury.

Objective To evaluate the efficacy and safety of super-selective renal artery embolization in treatment of iatrogenie renal pseudoaneurysm and arteriovenous fistula.Methods Twenty-nine patients with iatrogenic renal pseudoaneurysm and arteriovenous fistula underwent renal angiography after ineffective conservative treatment.After identifying the location and characteristic of lesions by DSA,super-selective renal artery embolization was performed.Symptoms and signs,renal function changes before and after embolization and complications were recorded to evaluate the therapeutic effect.Results The technical success rate of super-selective renal artery embolization was 100％ (29/29),and clinical success rate was 96.55 ％ (28/29).The serum creatinine level before and after embolotherapy was (93.26 ± 28.79) mmol/L and (91.51 ± 27.68) mmol/L respectively,and there were no significant differences (t=1.28,P=0.22).No serious complications such as nephrapostasis or renal failure occurred in the study.Conclusion Super-selective renal artery embolization has technically and clinically high success rate with limited effect on renal function.It is a safe and effective therapy method in patients with iatrogenic renal pseudoaneurysm and arteriovenous fistula.