Objective: To clarify the prognostic value of the neutrophil to lymphocyte ratio (NLR) in oral squamous cell carcinoma (OSCC) patients. Methods: literature on the correlation between NLR and the prognosis and clinicopathological features of OSCC was searched in PubMed, Web of Science, Cochrane and Embase. The outcome indicators, including overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), tumor size, cervical lymph node metastasis, tumor stage, extracapsular lymph node invasion and peripheral nerve invasion, were analyzed by RevMan5.3 software Results : In total, 6 180 patients were included in 23 studies. The analysis showed that NLR was significantly negatively correlated with OS [HR=1.62, 95%CI(1.38, 1.91), P < 0.001], DFS [HR=1.48, 95%CI(1.24, 1.77), P < 0.001] and DSS [HR=1.87, 95%CI(1.60, 2.20), P < 0.001]. In addition, higher NLR values were positively correlated with tumor size [OR=2.68, 95%CI (1.84, 3.90), P < 0.001], cervical lymph node metastasis [OR=1.59, 95%CI (1.35, 1.88), P < 0.001], tumor stage [OR=2.85, 95%CI (2.35, 3.47), P < 0.001], extralymphatic invasion [OR=1.72, 95%CI (1.23, 2.40), P=0.001], and peripheral nerve invasion [OR=1.70, 95%CI (1.29, 2.24), P < 0.001]. However, there was no significant correlation with age [OR=0.96, 95%CI (0.71, 1.29), P=0.77], sex [OR=1.08, 95%CI (0.88, 1.33), P=0.55], or degree of differentiation [OR=1.15, 95%CI (0.92, 1.43), P=0.22] Conclusion Elevated NLR was significantly associated with the prognosis and clinicopathological features of OSCC and might be an independent prognostic factor.

Objective: : This study aims to investigate the relationship between aneurysm wall enhancement and clinical rupture risks based on the magnetic resonance vessel wall imaging (MR-VWI) quantitative methods. Methods: : One hundred and eight patients with 127 unruptured aneurysms were prospectively enrolled from Feburary 2016 to October 2017. Aneurysms were divided into high risk (≥10) and intermediate-low risk group (<10) according to the PHASES (Population, Hypertension, Age, Size of aneurysm, Earlier SAH history from another aneurysm, Site of aneurysm) scores. Clinical risk factors, aneurysm morphology, and wall enhancement index (WEI) calculated using 3D MR-VWI were analyzed and compared. Results: : In comparison of high-risk and intermediated-low risk groups, univariate analysis showed that neck width (4.5±3.3 mm vs. 3.4±1.7 mm, p=0.002), the presence of wall enhancement (100.0% vs. 62.9%, p<0.001), and WEI (1.6±0.6 vs. 0.8±0.8, p<0.001) were significantly associated with high rupture risk. Multivariate regression analysis revealed that WEI was the most important factor in predicting high rupture risk (odds ratio, 2.6; 95% confidence interval, 1.4–4.9; p=0.002). The receiver operating characteristic (ROC) curve analysis can efficiently differentiate higher risk aneurysms (area under the curve, 0.780; p<0.001) which have a reliable WEI cutoff value (1.04; sensitivity, 0.833; specificity, 0.67) predictive of high rupture risk. Conclusion : Aneurysms with higher rupture risk based on PHASES score demonstrate increased neck width, wall enhancement, and the enhancement intensity. Higher WEI in unruptured aneurysms has a predictive value for increased rupture risk.

Objective To assess the efficacy and safety of intensity-modulated radiation therapy (IMRT) for nasopharyngeal neoplasm.Methods PubMed,EMBASE,Cochrane Library,CBM,CNKI,VIP and WanFang Data were fully searched up from creating database to June 15,2012.Randomized controlled trials (RCTs) of IMRT versus conventional radiotherapy (CRT) for nasopharyngeal neoplasm were included.The quality of included studies was evaluated by two individual researchers and data were analyzed by using RevMan 5.1 software.Results Fifteen RCTs were included.Meta-analyses suggested that patients treated by IMRT had a higher fractional stimulated parotid salivary flow rate and a higher stimulated whole salivary flow rate than CRT.IMRT can significantly reduce the acute xerostomia (RR =0.46,P ＜ 0.000 1),reaction of mucosa(RR =0.g6,P =0.04),reaction of skin (RR =0.33,P ＜ O.000 1),long-dated xerostomia (RR ＝0.28,P =0.01) and limitation of mouth opening (RR =0.42,P =0.008).And IMRT trended to improve short-term efficacy (RR =1.22,P =0.02) and long-term survival (RR =1.25,P =0.04).Moreover,IMRT trended to shorten the treatment time while increasing the costs.Conclusion Compared with CRT,IMRT trends to be superior for nasopharyngeal neoplasm.However,because of small sample size,the results need to be proved by more clinical trials.

Among 172 patients with coronary artery disease (CAD),94 received community and hospital joint management (joint group) after percutaneous coronary intervention (PCI) for Ⅰ year and 78 received community-based health education only (control group) after PCI.The compliance of medication,readmission rate,times of hospitalization,medical costs,major adverse cardiac events (MACE),and general quality of life inventory (CQOLI-74),self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores were compared between two groups.The rate of readmission,times of hospitalization,medical costs,the sores of SAS and SDS in joint group were lower than those in control group(P ＜ 0.01 or 0.05).The compliance of medication,body health dimension,psychological health dimension and social function dimension in joint group were better than those in control group,but there were no differences in material life dimension and the MACE rate between two groups(P ＞ 0.05).Community and hospital joint management can reduce the readmission rate and medical burden,and improve quality of life for elderly CAD patients after PCI.

ObjectiveTo evaluate the clinical efficacy and safety of gefitinib versus docetaxel in previously treated non-small cell lung cancer.Methods Literatures were searched on database like PubMed,EMBASE,Cochrane Library,Chinese Biomedical Literature Database,China Journal Full Text Database,and Chinese Scientific Journals Full Text Database and Wanfang Database.All the relevant randomized controlled trials that gefitinib versus docetaxel in non-small cell lung cancer patients who have previously received chemotherapy were collected,and the quality of the included trials was assessed by Cochrane Systematic Review Handbook 5.0.2. Meta-analyses were conducted by RevMan 5.0 software. Results Four studies were involved and 2 257 patients were included.Meta-analysis showed that gefitinib can improve objective response rate and quality of life in local advanced non-small cell lung cancer patients who have previously received chemotherapy compared with docetaxel ( P ＜ 0.05) ； and it's low in the 3-4 level adverse reaction rate (P ＜ 0.05 ).But there was no significant difference in overall survival rate,symptoms improving rate and progression-free survival rate (P ＞ 0.05).ConclusionsGefitinib is superior to docetaxel in the objective response rate with local advanced or metastatic non-small cell lung cancer patients who have previously received chemotherapy.The quality of life of the patients is improved significantly.Because of it has high drug tolerance and high safety,gefitinib can be actively promoted application as a kind of current effective second-line drugs at present,but the survival aspect needs to be studied further.

Objective To assess the influence of community and hospital comprehensive Health management on quality of life in aged patients with coronary artery disease (CAD) after PCI.Methods 147 patients with CAD after PCI were divided into experimental group(72 cases) and control group (75 cases) accordance with their residential community.In control group,community health education was introduced.While in experimental group,hospital and community comprehensive healthy education lasted for one year.Before and after invention,major adverse cardiac events (MACE) was recorded and generic quality of life inventory (CQOLI-74),self-rating anxiety scale (SAS),and self-rating depression scale (SDS) were carried out on the basis of giving unite guiding words.Results The observation items of the SAS(34±6 vs41 ±7,t =2.714,P ＜0.01)and SDS(35 ±7 vs 41 ±8,t =2.572,P ＜0.05)scores in experimental group were lower than those in control group.Meanwhile the body health dimension(63 ± 12 vs 59 ±11,t =5.935,P ＜0.01 ),psychological health dimension(64 ± 14 vs 58 ± 13,t =6.116,P ＜0.01 ),social function dimension(64 ± 11 vs 58 ± 10,t =6.157,P ＜0.01 ) were higher than those in control group,but the difference of the material life dimension and the MACE rate were not statistically significant( P ＞0.05).Conclusions Community and Hospital comprehensive health management is a practical and valuable strategy for palliating the depression and anxiety and improving quality of life after PCI in aged patients.

Objective To explore the feasibility of 256-slice whole-brain CT perfusion (CTP) in evaluate graft reperfusion after surgical revascularization and hemodynamic alterations before and after surgery in Moyamoya disease. Methods Twenty-five cases with Moyamoya disease were scanned on a 256-slice CT.CTP was performed pre- and post- surgical revascularization. The wolumetric CT angiographic ( CTA ) images were generated from volumetric data acquired at the arterial phase of CTP. CBF, CBV, TTP and MTT were measured in functional maps at the operated side within middle cerebral artery perfusion areas and contralateral mirroring areas. Relative CBF( rCBF), relative CBV (rCBV), relative TTP (rTTP), relative MTT (rMTT) were also obtained. Differences in perfusion CT values pre- and post operation were assessed with the paired t test or matched-pairs signed-ranks test. Data with normal distribution was present as : (x-)± s,while those with the non-normal distribution were present as M ( P25-P75 ). Results All the direct graft patencies were displayed on volumetric CTA. No significant differences were found between volumetric CTA and conventional CTA. Postoperative CBF, rCBF and rCBV values of the operated side [ 72. 86 (55.54-112. 19) ml · 100 g-1 · min-1 , 1. 31 ( 1.05-1.73), 1.45 ±0. 62] were significantly higher than those before operation [46.72(28.57-57.67) ml · 100 g-1 · min-1, 0.53(0.33-0.82), 1.01 ±0.36](Z=- 2.72, - 2. 98, t = - 2. 85, P ＜ 0. 05 ). Postoperative MTT, TTP and rTTP values of the operated side [ (3.98 ± 2. 36 ) s, ( 17.56 ± 4. 38 ) s, 1.01 ± 0. 09 ] were significantly lower than those before operation [(5.43±2.07) s,(19.40±3.87) s,1.14±0.28] (t=2.41,2.17,2.17, respectively, P＜0.05).However, no significant differences were detected for changes of CBV and rMTT after revascularization ( P ＞0. 05). Conclusion 256-slice CT has the potential value for the non-invasive assessment of both the graft patency and cerebral hemodynamics changes in moyamoya disease after surgery with administration of one contrast medium bolus in a single examination.

Background and purpose: Primary intracranial epithelioid haemangioendothelioma (EH) was rare. This study was to discuss the clinical pathological features, radiographic findings, treatment and prognosis of primary intracranial EH combined with literature review. Methods: We reviewed a case of EH reported from our hospital, and comprehensively analyzed the related literature. Results: Based on our report and review of the literature, EH is rare and with borderline or uncertain behavior. The original tumors demonstrated specific image features. The tumor usually appeared as a small nest or cords composed of eosinophilic epithlioid or spindled cells.Immunohistochemical assay were positive for endothelial markers CD31, CD34 and FⅧ. EH may be treated with complete surgical resection whenever possible and is sensitive to radiation. The EH has a favorable prognosis. Conclusion: EH has variable malignant potential, and should be differentiated from meningioma. Total resection and close follow-up is recommended. Additional radiotherapy is advised for residual tumors.

Objective To explore a simple and safe method for preservation of the sputum aspirator nozzle. Methods Using self-controlled method, the traditional method was to place the nozzle in the glass bottle of disinfectant liquid, the modified method was to fix a sputum tube to a suitable location of the sputum aspirator or bedside with the joint free, after sputum aspiration,the nozzle was connected to the joint. One patient used the same sputum aspirator. The two methods of preservation were alternated every 24 hours. The slippage times of the nozzle were compared, and samples from glass nozzle and joints of disinfectant liquid bottles/spu-tuna tube joints were underwent bacterial culture. Results Significant difference existed in slippage times of the nozzle, the positive rate of bacteria colony in the.glass nozzle and disinfectant liquid bottles/sputum tube joints between the two methods. Conclusions Using sputum aspiration tubes to fix the nozzle of aputum aspi-rator is better than the traditional method of putting the nozzle into the glass bottle of disinfectant liquid,this method proves to be easy, safe,portable and economical and is worthy of clinical application.

OBJECTIVETo calculate the volume embolization ratio of densely packing experimental aneurysms by three dimensional digital subtraction angiography (3D-DSA).

METHODSSix experimental crotch aneurysms were created microsurgically in the common carotid artery of white rabbits. Two weeks later, each aneurysm's volume was measured with 3D-DSA surface shaded display(SSD) and the correction of lacteprene balloon calibration method. In the same time, the aneurysms were densely packed with electric detachable coils. The volume of coils that were used in each aneurysm was calculated separately. The ratio of coils volume and aneurysm volume was the volume embolization ratio (VER).

RESULTSThe aneurysms volumes measured by 3D DSA SSD ranged from 0.037 to 0.087 ml. The VER ranged from 23.5% to 32.5% (average 27.4%).

CONCLUSIONThe minimum VER of densely packing experimental crotch aneurysms with electronic detachable coils was 23.5%.