Volume 95  ·  Issue 11  ·  2015

In recent years, cardiac CT imaging technology has become more and more mature, and its examination methods include not only coronary CT angiography, but also new technologies such as myocardial CT perfusion and CT blood flow reserve fraction. As a non-invasive examination method, the application value of cardiac CT in coronary atherosclerotic heart disease is no longer simply to evaluate the presence of plaque and the degree of luminal stenosis in coronary arteries, but more emphasized on predicting the risk of sudden cardiovascular events and guiding the clinical selection of appropriate revascularization opportunity.

Ischemic cerebrovascular disease causes a high rate of disability, death and recurrence of stroke, which causes a great economic burden to families and society^[1,2,3]。 More and more clinical studies have shown that endovascular interventional therapy can significantly reduce the disability, mortality and recurrence rate of stroke in ischemic cerebrovascular disease. Therefore, as an important treatment for ischemic cerebrovascular disease, endovascular therapy has attracted much attention.

To compare the image qualities of different contrast medium injection protocols for 128-slice dual-source computed tomography (DSCT) in children with Tetralogy of Fallot (TOF).

A total of 60 patients with TOF were randomly divided into groups A, B and C (n=20 each). And 128-slice DSCT angiography was performed with sequential mode according to the contrast injection protocols: the volume of contrast medium was 1.2, 1.2 and 1.5 ml/kg and the injection time 10, 12 and 15 s respectively.Contrast medium was followed by a saline bolus for 10 s. Enhancement and noise of ascending aorta, main pulmonary artery, descending aorta and left ventricle were quantified.Signal-to-noise ratio (SNR), dose-length product (DLP) and effective dose (ED) were calculated.The absolute difference of left and right ventricular attenuations was calculated to represent the image uniformity.Subjective image quality was assessed by two radiologists in consensus.

No significant difference existed in attenuation or SNR between three groups in the same evaluated anatomic regions.No significant difference existed in image quality of heart chamber and great vessels.The image uniformity(81±65) and subjective image quality of artifacts of superior vena cava were significantly better in group B than those in groups A and C (179±178, 106±66, P<0.05).

The contrast medium injection protocol of 1.2 ml/kg volume contrast medium injected within 12 s may enhance the image quality of 128-slice dual-source CT in children with TOF.

To explore the distribution and magnetic resonance imaging or computed tomography (MRI/CT) of lymphoma in orbit.

Retrospective analyses were conducted for 73 cases with ocular complaints at Beijing Tong′ren Hospital from June 2006 to September 2012.They were confirmed pathologically as lymphoma with complete MRI/CT records.

Ocular adnexal lymphoma occurred predominantly in adults.There were 47 males and 26 females with a median age of (60±12.0) years.The lesions were bilateral (n=24), right side (n=23) and left side (n=26) respectively.The pathological types included mucosa-associated lymphoid tissue (MALT) lymphoma (n=59), diffuse large B-cell lymphoma (DLBCL, n=7), mantle cell lymphoma (MCL, n=3), lymphoplasmacytic lymphoma (LPL, n=2) and follicular lymphoma and natural killer/T-cell lymphoma (FL and NKT, n=1) respectively.They had well-defined margins in 64 sides, less well-defined margins in 17 sides and ill-defined margins in 16 sides.And 29 sides of lesions presented as a regional mass within conjunctiva in 16/97 sides (16.5%), lacrimal gland in 5/97 sides (5.2%), eyelids in 3/97 sides (3.1%), ocular muscle in 2/97 sides (2.1%) and lacrimal sac in 3/97 sides (3.1%). Moreover, 68 sides of lesion were diffusely distributed.The invaded sites included preseptal region in 38/97 sides (39.2%), extraconal compartment in 69/97 sides (71.1%), intraconal compartment in 54/97 sides (55.7%), eyeball region in 45/97 sides (46.4%), subperiosteum in 14/97 sides (14.4%), cone compartment in 73/97 sides (75.3%), lacrimal gland in 38/97 sides (39.2%) and sheath of optic nerve in 33/97 sides (34.0%). And, on MRI scan, 70 cases (94 sides) had isointensity in 88/94 sides, hypointensity in 6/94 sides on T₁WI and isointensity in 52/94 sides, mild hypointensity in 40/94 sides or mixed signal in 2/94 sides on T₂WI. In addition, the signals were homogeneous in 67/94 sides and heterogeneous in 27/94 sides.After contrasting, these lesions showed mild contrast-enhancement (CE) in 27/94 sides, moderate CE in 67/94 sides with homogeneous CE in 52/94 sides and heterogeneous CE in 42/94 sides.On CT scan, 21 cases (24 sides) had isodensity in 18/24 sides and mild hyperdensity in 6/24 sides with homogeneous in 7/24 sides and heterogeneous in 17/24 sides.Moreover, most adjacent bone show no change (16/24 sides). Only 16/24 sides and 2/24 sides showed reformation or destruction respectively.At the same time, the lesions also involved other para-orbit structures, such as orbital apex (27/97 sides, 27.8%), fissure orbitalis inferior (14/97 sides, 14.4%), fossa pterygopalatina (10/97 sides, 10.3%), supraorbital nerve (8/97 sides, 8.2%), cavernous sinus (8/97 sides, 8.2%) and facial soft tissue (6/97 sides, 6.2%), et al.

Ocular adnexal lymphoma occurs predominantly in male adults.And multiple strictures and sites are often involved.There is iso-/mild hyperintensity with mild-to-moderate homo-/heterogeneous CE and little change of adjacent bone on T₁WI and T₂WI.

To assess the image quality of gastrointestinal tract malignant tumors arteries using low tube voltage, low contrast medium concentration and 50% adaptive statistical iterative reconstruction (ASiR) algorithm.

A total of 58 patients with pathologically confirmed gastrointestinal tract malignant tumors and body mass index (BMI) under 22 kg/m² undergoing computed tomography (CT) scanning during March-December 2013.They were randomly divided into group A (270 mgI/ml of contrast medium, 80 kVp tube voltage scanning and 50% ASiR; 21 males and 11 females with an age range of 40-90 years) and group B (350 mgI/ml of contrast medium, 120 kVp routine tube voltage; 22 males and 4 females with an age range of 40-76 years). The inter-group differences of age and gender ratio were compared with Mann-Whitney U and Fisher exact tests respectively.Two independent radiologists reviewed reconstructions and separated the reconstructed image into 5 points according to image quality.The CT value of tumor blood supplying artery (CT₁ value) and fat in anterior abdominal wall (SD value) were measured and image noise, contrast-to-noise ratio (CNR) and figure of merit (FOM) calculated.The interobserver variation was estimated by weighted kappa statistics and intra-class correlation coefficients (ICC) test.The point of image quality of two groups was compared by Mann-Whitney U test.The paired Student t test was used to compare the inter-group differences in CT_1, SD, CNR, FOM and CT dose index (CTDIvol).

No inter-group difference existed in patient age or gender ratio.The consistency of two radiologists was excellent (kappa value >0.80; ICC value >0.75). The subjective image quality scores of tumor blood supplying arteries showed no inter-group difference ( P=0.09). The tumor blood supply arteries CT value, CNR and FOM of group A (459±69 HU, 20.2±3.3 and 85±37) were significantly higher than those of group B (250±42 HU, 9.3±1.9 and 9±4) (both P<0.01). The SD value of group A (20.0±1.7) was obviously lower than that of group B (22.4±3.2) (P<0.01). And the CTDIvol of group A (5.2±1.2 mGy) was obviously lower than that of group B (13.5±4.7 mGy) (P<0.01).

For patients of BMI ≤22 kg/m^2, low tube voltage and low contrast medium concentration scan condition with 50% ASiR algorithm is feasible for acquiring better quality image and ensuring significant reduction in effective dose.

To evaluate the characteristics of sensory gating inhibition and variation of schizophrenia with both prepulse inhibition (PPI) and P50.

The PPI of startle reflex and P50 were tested by an event-related potential (ERP) recorder in 82 first episode schizophrenics (FES) recruited from September 2007 to February 2014 at Shanghai Mental Health Hospital and 78 healthy controls (NC) from hospital staffs and local residents for the same period.All patients fulfilled the evaluation of PPI with strong stimulus alone and strong + weak stimulus paradigm, P50 with conditioning (S1)-testing (S2) paradigm.The psychotic symptoms were assessed with Positive and Negative Syndrome Scale (PANSS).

(1)Compared with control group, schizophrenia group had increased P_L (NC: (89±14) ms, FES: (97±17) ms, P<0.05) and PP_L, decreased amplitude (NC: (92±21) ms, (24±14) μV, FSZ: (96±20) ms, (41±29) μV, P<0.05, 0.01), lower PPI inhibition ratio (NC: (67±32)%, FSZ: (41±37)%,P<0.05). (2)Compared with NC group, there were increased S2 amplitude[NC: (3±2) μV vs FES: (5±3) μV,P<0.05] and ratio of S2/S1 amplitude[(43±22) % vs (82±41)%,P<0.05] in schizophrenia group.And P50 inhibition decreased significantly.

Schizophrenics have both PPI and P50 impairments.And a combination of PPI inhibition ratio and S2/S1(P50) may be a better electrocerebrophysiological index for schizophrenia.

Modern shoulder prosthesis has evolved through four generations.And the fourth generation technology has a core three-dimensional design of restoring 3D reconstruction of proximal humeral anatomy.Thus a new shoulder prosthesis is developed on the basis of the technology of 3D prosthesis.Assessment of whether shoulder prosthesis can restore individualized reconstruction of proximal humeral anatomy is based on the adaptability of proximal humeral anatomy.To evaluate the adaptability of proximal humeral anatomy through measuring the parameters of proximal humeral anatomy after shoulder replacement with individualized shoulder prosthesis and compare with normal data.

The parameters of proximal humeral anatomy were analyzed and evaluated for a total of 12 cases undergoing shoulder replacement with individualized shoulder prosthesis.The relevant anatomical parameters included neck-shaft angle (NSA), retroversion angle (RA), humeral head height (HH) and humeral head diameter (HD). And the anatomical parameters were compared with the data from normal side.

All underwent shoulder replacement with individualized shoulder prosthesis.The postoperative parameters of proximal humeral anatomy were compared with those of normal side.And the difference of NSA was < 3°, RA < 3°, HH < 3 mm and HD < 2 mm.And paired-sample t test was used to study the parameters of proximal humeral anatomy between postoperative and normal side.The normal and postoperative NSA was (140.2±6.8) ° and (139.5±6.6)° respectively, RA (34.4±3.3)° and (33.8-3.1)°, HH (15.3±2.1) mm and (14.6+ 0.9) mm, HW (42.2±2.82) mm and (41.8±2.33) mm respectively. No significant difference existed between two groups (P>0.05).

Individualized shoulder prosthesis has excellent adaptability to shoulder.All core parameters are freely adjustable and specification models may be optimized.With matching tools, individualized shoulder prosthesis improves the accuracy and reliability in shoulder replacement.

To explore the risk factors for mortality in nonagenarians with femoral neck fractures and clarity the relationships between risk factors and postoperative mortality.

For this retrospective study, a total of 197 patients with consecutive isolated nonpathologic hip fractures undergoing hemiarthroplasty were recruited.There were 64 males and 133 females with an age range of 70 years or above.They were divided into three age groups: A, 70-79 years; B, 80-89 years; and C, ≥90 years.A retrospective chart review was conducted to compare these groups in terms of age, gender, nutritional status, blood albumin, total lymphocyte count, hemoglobin levels at admission, comorbidities, American Society of Anesthesiologists (ASA) rating of operative risk and time period between injury and surgery.

Among them, 14 patients died within 1 year. There was one in-hospital death and 13 patients died during follow-ups.The mortality rates of groups A, B and C were (n=3, 3.9%), (n=5, 7.2%) and (n=6, 24.0%). The ASA scores were Ⅲ (n=9) and Ⅳ (n=4). And 13 patients had a preoperative blood albumin level <35 g/L while 11 patients showed a preoperative lymphocyte count level<1 500 cells/ml.The mortality rates were similar in groups A and B but were significantly lower than that of group C.

The nonagenarians have a significantly higher mortality.And lower lymphocyte count, nonagenarian, >2 comorbidities, high ASA score, low blood albumin level and low hemoglobin levels at admission are significant factors for assessing 1-year mortality in elders with femoral neck fractures.

To explore the predictive values of ambulatory blood pressure-related parameters for moderate renal impairment in resistant hypertension (RH).

The clinical data were retrospectively analyzed for 401 hospitalized patients with hypertension at our hospital from October 2010 to October 2013.They were divided into RH (n=263) and non-RH (n=138). The modified estimating equation of glomerular filtration rate (GFR) for Chinese patients was used to assess renal functions.The standardization of moderate renal impairment was when GFR below 60 ml·min^-1·1.73 m^-2.The ambulatory blood pressure-related parameters were obtained by 24 h ambulatory blood pressure monitoring.The important prediction of these parameters for moderate renal impairment was accessed by receiver operating characteristic (ROC) curve.And the related risk factors for renal function impairment were tested by multiple stepwise Logistic regression analysis.

Ambulatory arterial stiffness index (AASI), 24 h mean pulse pressure (24 hPP), sleeptime relative systolic blood pressure (SBP) decline and 24 h systolic blood pressure (24 hSBP) had important predictive values for moderate renal impairment in RH.GFR was significantly lower in those with AASI ≥0.485, 24 hPP ≥47.5 mmHg, sleeptime relative SBP decline ≤-1.75% and 24 hSBP ≥130.5 mmHg (P<0.05). Area under curve of ROC curve of AASI, 24 hPP, sleeptime relative SBP decline and 24 hSBP were 0.804, 0.644, 0.602 and 0.623 respectively.Multiple Logistic regression analysis showed that AASI (OR 1 268.5, P=0.000), low density lipoprotein (OR 0.7, P=0.01) and sleeptime relative SBP decline (OR 1.3, P=0.01) were independent risk factors for GFR<60 ml·min^-1·1.73 m^-2 in RH.

AASI, 24 hPP, sleeptime relative SBP decline and 24 hSBP are the most significant ambulatory blood pressure-related parameters in predicting renal impairment in resistant hypertension.

To explore the clinical features, surgical approaches and postoperative outcomes of craniopharyngiomas.

A series of 169 consecutive cases of craniopharyngiomas undergoing microsurgical resection via various approaches at our hospital were retrospectively analyzed.There were 102 males and 67 females with a mean age of 34.1 (3-74) years. The operations were performed via unilateral subfrontal (n=11), frontopterional (n=69), anterior interhemispheric (n=57), transcallosal (n=9), transsphenoidal (n=14), transcortical (n=2), transventricular-foramen with neuroendoscope (n=5) and combined (n=2). Postoperative measures included the managements of blood sodium disorder and diabetes insipidus.During follow-ups, they were monitored for residual or recurrent tumor by postoperative contrast magnetic resonance imaging (MRI) every 1-3 months.

The removals of lesions were total (n=124, 73.4%), subtotal (n=32, 18.9%)and partial (n=13, 7.7%). And 104 cases had an intact preservation of pituitary stalk and stalk was partially preserved in 21 patients. Visual improvement (n=49) and deterioration (n=21) were achieved.The major postoperative complications included diabetes insipidus (n=101) and electrolyte disorder (n=89). And 26 patients had recurrence during a follow-up period of 26.1 (3-66) months.

Selection of appropriate approaches according to morphological characteristics is essential for successful microsurgery of craniopharyngiomas.

To explore the efficacies of endoscopic third ventriculostomy (ETV) and tumor biopsy in surgical treatment of obstructive hydrocephalus induced by pineal region tumors.

For 65 patients of obstructive hydrocephalus induced by pineal region tumors, endoscopic third ventriculostomy (ETV) and tumor biopsy were performed from 2012 to 2014.Tumor specimens were harvested and analyzed histopathologically.According to pathological diagnosis, appropriate treatment strategies were followed.

Sixty-five patients underwent successfully ETV and pineal region tumor biopsy.And the histological diagnosis yield rate was 98.5% (64/65). PEB chemotherapy (cisplatin+ etoposide+ bleomycin) and radiotherapy were offered for germ cell tumors (n=37) and pineal blastomas (n=6). The therapy effective rate of germ cell tumors was 91.7% (33/36). A total of 56.9% (37/65) patients benefited without traditional craniotomy or shunt.

For pineal region tumor induced non-communicating hydrocephalus, ETV and endoscopic tumor biopsy can relieve hydrocephalus while obtaining pathological diagnosis at a relative low risk.Most patients of germ cell tumors and pineoblastomas may avoid craniotomy and shunt.It will become a routine treatment for pineal region tumors with non-communicating hydrocephalus.

To evaluate the application of non-invasive prenatal testing (NIPT) in high-risk pregnancies before invasive prenatal diagnosis.

This prospective study involved all pregnancies participating in the clinical trial of NIPT validation.The indication, age and gestational week were recorded.And the results of karyotype and NIPT risk were compared.

A total of 2 439 high-risk pregnancies were enrolled from 18 prenatal diagnosis clinics in China.After excluding 48 cases (36 missing clinical information, 9 karyotype failures and 3 NIPT failures), 2 391 cases were analyzed.Their gestational ages were 10 to 31 weeks.And 56.3% (1 345/2 691) were at a high risk for mid-trimester screening, following by advanced maternal age (26.0%, 621/2 391). Forty-six aneuploidies (trisomy 21, n=38; trisomy 18, n=7; trisomy 13, n=1) were diagnosed by karyotyping.And it was consistent with the NIPT results of high-risk distribution.

NIPT may be used to reduce unnecessary invasive prenatal diagnosis by improving the efficacy of current mid-trimester screening strategy, particularly for trisomy 21.

To investigate the safety and efficacy of trans-T tube duodenal papilla balloon dilatation for the removal of residual common bile duct stone after choledocholithotomy and T tube drainage.

Thirteen cases with residual common bile duct stone treated with trans-T tube duodenal papilla balloon dilatation in our department from June 2010 to April 2012 were analyzed retrospectively. Record CA19-9, bilirubin and albumin before the procedure, 1 week and 1 month later. Check if immediate complications occurs, including hemorrhage, perforation, pancreatitis and cholangitis. During the following up for 2 years, stone recurrence, reflux cholangitis and other long-term complications were observed. Analyze the changes of indicators between preoperative and postoperative and the correlation.

All of the 13 patients were treated successfully. 11 patients underwent one procedure, and 2 patients received twice or more times of procedures. CA19-9 decreased significantly 1 week later and 1 month later compared with those before the procedure, while ALB was opposite. Incidences of biliary tract infection and hemorrhage were 1 and 1 respectively. No severe complications occurred, including perforation of gastrointestinal or biliary tract. Incidences of recurrent stone and reflux cholangeitis were 2 and 1 in two years after the procedure.

Trans-T tube duodenal papilla balloon dilatation is a safe and effective procedure for patients with recurrent common bile duct stone after choledocholithotomy and T-tube drainage. For the cases which could not be handled with endoscopic procedures, it provides a new therapeutic approach.

To explore the human papilloma virus (HPV) infection and genotypes distribution in female patients with cervical intraepithelial neoplasia so as to provide rationales for preventing and treating HPV and developing HPV vaccine.

Polymerase chain reaction (PCR) amplification, flow-through hybridization and gene chip were used to identify 23 HPV genotypes in cervical cells collected from 823 female patients with cervical intraepithelial neoplasia at Third Municipal People′s Hospital and Central Municipal Hospital during January 2011 and December 2013.

Among them, HPV infections were detected in 47.51%(391/823). From 2011 to 2013, there was a trend of increase year by year and the difference was statistically significant (P<0.05). With the greater degree of cervical intraepithelial neoplasia, LR-HPV and HR-HPV infection rate increased.And there were statistically significant differences (P<0.05). And single or double genotype infection dominated (86.19%). Multiple genotype infection accounted for 0.51%.And 76.21% of HPV infections were high-risk genotypes and most of them belonged to HPV16.Otherwise, most low-risk genotypes were HPV6.Besides, HPV39 and HPV82 were not detected.

HPV infections, particularly high-risk ones, are widespread among female patients with condyloma acuminatum or cervical erosion in Qingdao.Thus active clinical therapy should be provided.

To explore the role of renal sympathetic denervation (RSD) on ventricular substrate remodeling in dogs with pacing-induced heart failure (HF).

A total of 19 dogs were randomized into 3 groups of sham-operated control (n=7), right ventricular pacing induction of HF (n=6) and RSD (n=6). After 8-week pacing induction of HF.Hemodynamic variables were monitored at baseline and after HF.Masson′s trichrome staining, enzyme-linked immunosorbent assay (ELISA) and Western blot were used to measure ventricular interstitial fibrosis, brain natriuretic peptide (BNP), angiotensin Ⅱ (Ang Ⅱ), aldosterone and transforming growth factor-beta (TGF-β).

All dogs in HF and HF+ RSD groups showed increased left and right ventricular diastolic dimensions[left ventricle: (27.0±2.4) vs (37.0±2.8) mm, P<0.01 and (30.0±2.5) vs (36.0±2.8) mm,P<0.05; right ventricle: (11.0±1.5) vs (14.0±1.7) mm,P=0.03 and (12.0±1.1) vs (14.0±1.2) mm, P<0.05]. Compared with HF+ RSD dogs, HF dogs had higher left ventricular end-diastolic pressure (LVEDP)[(25.0±3.7) vs (3.3±1.6) mmHg,P<0.01] and more fibrous tissue (left ventricle: 24.1%±4.8% vs 8.5%±1.9%,P<0.01; right ventricle: 17.2%±5.2% vs 11.8%±3.9%,P<0.01). The levels of BNP, Ang Ⅱ, aldosterone and TGF-β in ventricular tissue increased in HF dogs compared to sham-operated and HF+ RSD dogs.

RSD could suppress ventricular substrate remodeling induced by long-term rapid ventricular pacing.

To explore the efficacy of a novel tissue engineered bone in repairing bone defects using poly-lactic acid-polycaprolactone (PLA-PCL) scaffolding seeded with PEG-bone morphogenetic protein-2 (BMP-2) transfected rBMSCs (rabbit bone marrow stromal cells).

rBMSCs were harvested, transfected with PEG/BMP-2 or liposome/BMP-2 and then implanted into PLA-PCL tissue engineered bone. The protein level of BMP-2 was assessed by Western blot and immunohistochemistry. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the amount of BMP-2 in culture media.The mRNA levels of BMP-2 and osteocalcin were assayed quantitatively by real-time polymerase chain reaction (PCR). The middle portion of bilateral radius in New Zealand rabbits was excised and implanted with tissue engineered bone.And the modified areas were monitored by radiology, hematoxylin-eosin staining and immunohistochemical staining of BMP-2.

PEG-BMP-2 nanoparticles (NPs) and BMP-2 loaded PEG-PLA-PCL tissue engineered bones were successfully constructed.The novel PEG-PLA-PCL NPs/DNA complex was superior for transfecting BMP-2 in rBMSCs compared to traditional liposomes.Moreover, the mRNA level of osteocalcin and alkaline phosphatase activity also increased after a transfection of BMP-2 encapsulated NPs.

PEG-PLA-PCL NPs/BMP-2 complex facilitates bone repair so that it provides theoretic rationales for potential clinical treatments.

perforator flap (perforator flap) has been developed continuously^[1,2,3]It has created a new era of miniaturization, refinement, thinning and minimally invasive skin flaps, and has gradually become the main skin flap in microscopic repair and reconstruction surgery, which is more and more widely used in clinical practice. At present, there are very detailed research data on the anatomical location, tube diameter, pedicle length, nutritional range of perforator flap, and the connection mode between perforators^[4]The "Gent consensus" on the naming of perforator flaps was reached at a special meeting held in Ghent, Belgium, in 2001^[5]Perforator Flaps: Anatomy, Technique, and Clinical Applications and Saint-Cyr et al.^[6]The proposed concept of "perforasome" has greatly standardized and promoted the development of perforator flap, which also indicates that the development of perforator flap has gradually matured and entered a new development period.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors, and its mortality rate is second only to gastric cancer and lung cancer^[1,2,3]。 Hepatic arterial chemoembolization (TACE) is the preferred palliative treatment for intermediate and advanced HCC^[1,2]。 The embolic material has been a hot spot in clinical research. In recent years, various microsphere embolization agents have been developed rapidly and achieved good curative effect^[4,5,6]。 Microspheres are defined as tiny spheroids, spheres, or spheroids formed of polymer materials, generally between 1 and 900 μ m in diameter, wherein the diameter<500 nm called nanomicrospheres^[7]。 According to the properties and functions of microspheres, they can be divided into two categories: simple microspheres and carrier microspheres. Faced with numerous embolization microspheres, how to individually select embolization materials has become a new problem. Therefore, this article reviews the characteristics, clinical efficacy and adverse reactions of microspheres commonly used in clinic.

Glioblastoma multiforme (GBM) is the most common primary craniocerebral tumor in adults, accounting for approximately half of primary craniocerebral tumors^[1]。 Despite the combined treatment of surgery, radiotherapy and chemotherapy, the prognosis of glioblastoma patients is still not ideal. The median survival time is only 14.6 months, and the 5-year survival rate is less than 10%^[2,3]。 In recent years, tumor immunotherapy has developed rapidly, and related clinical trials have achieved exciting results. In 2010, sipuleucel-T, a vaccine targeting prostate acid phosphatase, and ipilimumab, a human monoclonal antibody to the immunosuppressive target CTLA-4, were respectively approved for the treatment of prostate cancer and advanced melanoma^[4,5]。 Similarly, immunotherapy has shown good efficacy in clinical and preclinical studies of glioma, and is expected to become a new treatment in addition to surgery, radiotherapy, chemotherapy and other treatments.