TBI大鼠海马糖皮质激素受体表达变化对认知功能的影响

目的 研究创伤性脑损伤(traumatic brain injury,TBI)后大鼠海马区糖皮质激素受体(ghcocorticoid receptor,GR)表达的变化对认知功能的影响.方法 建立大鼠脑损伤模型,应用免疫组化、Western blot和Morris水迷宫检测伤后大鼠海马区GR表达与学习记忆功能的关系.结果伤后4～10 d大鼠海马区GR持续低表达;Morris水迷宫检测伤后大鼠出现认知功能障碍.结论 TBI大鼠海马区GR表达变化与认知功能的障碍改变具有相关性.

Abstract：

Objective To explore the effect of glucocorticoid receptor(GR)expression in rat hippocampus on cognitive function after traumatic brain injury(TBI). Methods The TBI model wag established in rats.Then,immunohistochemistry and Western blot were used to detect the GR expression and evaluate its relation with cognitire dysfunction by Morris water maze. Results Expression of hippocampal GR was down-regulated 4-10 days after TBI.Morris water maze test showed significant impairment of the cognitive function in rats. Conclusion There is correlation between expression change of hippocampal GR and cognitive dysfunction.     

次声对脑组织血栓素A_2、前列环素代谢的影响

目的　探讨次声作用后脑皮层组织血栓素A2 (TXA2 )、前列环素 (PGI2 )代谢改变及及代谢性谷氨酸受体拮抗剂MCPG的作用。方法　 40只SD大鼠随机分为正常对照、次声作用 1次、7次、14次及代谢性谷氨酸受体拮抗剂MCPG治疗 5组。采用第四军医大学研制的次声压力仓。用 8Hz、12 0dB的次声按规定次数 ,每次作用 2h。采用蛋白定量和放免法行脑TXA2 、PGI2 稳定代谢产物血栓素B2 (TXB2 )及 6 酮 PGF1α( 6 酮 )含量测定。结果　 7次与 14次组 ,TXB2 含量有显著意义升高 (P <0 .0 1) ,6 酮含量明显降低 (P <0 .0 1)。TXA2 /PGI2 值呈递增趋势 ;治疗组 ,TXB2 及 6 酮含量与TXA2 /PGI2 值恢复致正常水平。结论　次声可以通过引起脑TXA2 、PGI2 代谢改变造成脑损害 ,是次声导致脑损害的关键因素之一。MCPG可能通过影响脑TXA2 、PGI2 代谢改变而起脑保护作用。     

Content change of neurofilament protein subunits in experimental brain diffuse axonal injury by lateral head rotation

Objective:To explore the content change of neurofilament (NF) protein subunits in the experimental brain diffuse axonal injury(DAI) by lateral head rotation.Methods:Twenty-four Sprague Dawley (SD) rats were equally divided into three injury groups (2h,12h,and 24h post injury) and one control group.The models of DAI were made in the injury groups by lateral head rotation.western blotting technique was used to measure the contene of NF68(a kind of NF protein subunit) in the brainstem tissues among all the injured and control rats.The NF68 immunohistochemical staining was used in another six SD rats in order to observe the morphological changes in DAI.Results:The NF68 content in the brainstem tended to decrease at 2h post injury,decreased significantly at 12h and continued its decrease at 24h.NF56 and NF52,as the breakdown products of NF68,had a tendency to increase at 2-12h after the injury,and amounted to a significantly higher level at 24h.Microscopically,there were a lot of swelling neuronal axons in the ventral part of the medullar oblongate at 2h after the injury.some axons were disconnected,and axonal retraction balls formed on their proximal end.Conclusions:There is and occurrence of phosphorolysis within the brainstem in DAI by lateral head rotation.These reactions cause the breakdown of NF68,which results in the decrease of NF68 in content.It suggests that the breakdown of neurofilament protein subunits is an important reason for structural destroy of neurofilaments in DAI.     

Emergency treatment of craniocerebral firearm wounds

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经蝶入路显微外科切除颅咽管瘤

目的　为探求一种颅咽管瘤切除的手术径路可能性。　方法　回顾总结１８ 例颅咽管瘤的诊断方式,手术技巧和治疗结果,均经 Ｃ Ｔ 或 Ｍ Ｒ Ｉ扫描确诊。手术采取经唇下蝶窦入路或经鼻前庭鼻中隔蝶窦入路两种方式行肿瘤切除术。　结果　９ 例肿瘤获全切除,４ 例次全切除,余５ 例为部分切除,术后无死亡。１５ 例获长期随访（ 平均３１ 年） ,有１２ 例恢复良好。　结论　对位于鞍内的颅咽管瘤或肿瘤系囊性并向鞍上扩展者,采用经蝶入路显微手术切除是一种安全、有效的方法     

颅内海绵状血管瘤的诊断与治疗

目的 探讨颅内海绵状血管瘤的诊断和手术治疗方法。方法 回顾我院经手术证实的１６例病人的临床资料,对其临床特征、诊断和治疗经验进行总结。结果 按发生部位将肿瘤分为三种类型：大脑半球型,颅中窝型,小脑型。大脑半球型９型,主要表现癫痫发作;颅中窝型５例,主要表现为视力视野损害和眼球活动障碍;小脑型２例,表现为头痛和呕吐。肿瘤ＣＴ表现为圆形或类圆形的血供丰富的占位病变,但血管造影很少发现其血供。ＭＲ检查有     

大黄提取物治疗犬肢体枪弹伤后脑神经元c-fos基因表达变化

目的　探讨中药大黄治疗犬肢体高能量枪弹伤后脑神经元c fos基因表达的变化。方法　 18只杂种犬 ,以M 193、5 .5 6mm制式弹射击犬双后肢肌肉丰满处 ,随机分为对照组、大黄治疗组。对照组伤后应用无菌注射用水鼻饲 ,大黄治疗组应用中药大黄的乙醇及水提液鼻饲。采用免疫组化 ,对两组伤后 2、6、10小时远隔部位脑组织脑神经元中c fos基因的表达分别进行检测。结果　大黄治疗组脑神经元中c fos基因表达较对照组显著减少 (P <0 .0 1)。结论　中药大黄能够抑制犬肢体枪弹伤后脑神经元c fos基因的表达。     

恶性脑胶质瘤中EphA2、EphrinA1表达与预后的关系

目的 检测受体酪氨酸激酶EphA2和其配体EphrinA1在恶性脑胶质瘤中的表达,并探讨其与患者预后的关系.方法 选取68例原发性恶性脑胶质瘤(Ⅲ或Ⅳ级)入组,患者在手术全切除肿瘤的基础上接受规范的放化疗,并行长期随访.免疫组化SABC法检测肿瘤标本中EphA2、EphrinA1的表达水平,并结合患者的随访资料进行统计学分析.结果 68例标本中,52例EphA2表达阳性,28例EphrinA1表达阳性;EphA2和EphrinA1的表达水平与肿瘤病理分级相关,Ⅲ级肿瘤的EphA2表达水平低于Ⅳ级肿瘤,而Ⅲ级肿瘤的EphrinA1表达水平高于Ⅳ级肿瘤.肿瘤标本呈EphA2阴性、弱阳性表达的患者预后显著优于EphA2中度阳性、强阳性表达的患者,EphrinA1表达水平不同的患者预后差异无统计学意义,EphA2阳性/EphrinA1阴性表达的患者预后显著差于EphA2阳性/EphrinA1阳性,EphA2阴性/EphrinA1阳性和EphA2阴性/EphrinA1阴性表达的患者.结论 EphA2是恶性脑胶质瘤的预后相关因子,同时检测EphA2和EphrinA1的表达对于评估恶性胶质瘤患者的预后具有重要意义.

Abstract：

Objective Malignant gliomas display over- expression of the receptor tyrosine kinase EphA2.However,expression levels of the EphA2 ligand,EphrinA1,have not been fully elucidated.This study aims to determine the expression of EphA2/EphrinA1 in detail,and further detect the predictive roles of EphA2 /EphrinA1 for prognosis of malignant glioma patients.Method Sixty- eight patients with primary gliomas (grade Ⅲ or Ⅳ) were included in this study.The expression of EphA2 and EphrinA1 in tumors was assessed by immunohistochemistry and was statistically analyzed in combination with the follow- up data of patients.Methods of 68 cases,52 cases were EphA2- positive and 28 were EphrinA1- positive.The increased EphA2 expression was associated with higher grade histology and poor patient prognosis.On contrary to this,the increased EphrinA1 expression was associated with lower grade histology,but not associated with poor patient prognosis.Moreover,patients with tumors positive for EphA2 and negative for EphrinA1 had significantly shorter overall survival than patients with tumors positive for both EphA2 and EphrinA1,negative for both EphA2 and EphrinA1,or negative for EphA2 and positive for EphrinA1.Conclusion These data indicate that altered expression of EphA2 and EphrinA1 may correlate with prognosis of malignant glioma patients.     

超声实时导航下射频消融治疗巨大脑膜瘤

目的探讨超声实时导航下射频消融治疗在巨大脑膜瘤手术中的作用。方法回顾性分析2010年11月至2011年4月经开颅手术治疗的巨大脑膜瘤29例,术中行超声实时导航、造影,其中15例患者在肿瘤切除前应用射频消融治疗。观察指标包括临床症状变化以及并发症情况。结果超声实时导航可以从多种角度、各种切面清楚地观察到肿瘤的位置、形状、大小、边界及毗邻关系,可随时显示内部及周边大血管分布、走行情况。射频消融术后,肿瘤出现凝固性坏死,切除时瘤体出血明显减少。肿瘤全切25例(86.2%),大部分切除4例(13.8%)。大多数患者临床症状明显改善。术后病理诊断为脑膜瘤WHO I级27例,WHO II级2例。结论超声实时导航以及射频消融治疗对于提高巨大脑膜瘤的切除率,减少术中出血及术后并发症具有重要作用。     

中颅窝蛛网膜囊肿的临床特点及外科治疗

目的 探讨中颅窝蛛网膜囊肿的临床特点及不同术式对其治疗的临床疗效.方法 回顾性分析第四军医大学西京医院神经外科自2001年5月至2008年5月收治的352例中颅窝蛛网膜囊肿患者(占同期收住的颅内占位性病变患者的2.58%)的临床资料、手术方式及预后情况,其中男性发病率明显高于女性(男:女为4.1∶1),以左侧居多(左∶右为3.6∶1),324例行囊肿切除术,28例巨大囊肿行囊肿-腹腔分流术.结果 术后平均随访3个月～3年.头痛就诊患者中75例(58.59%)术后头痛完全消失,41例(32.03%)明显缓解.癫痫发作患者中8例术后发作频率明显减少或程度减轻.行为异常、注意力不集中或学习困难患者中11例术后改善明显.头围增大和颞部局限性隆起就诊者术后头围及局部隆起无明显变化.影像学复查显示囊肿完全消失者46例(13.07%),囊肿部分消失者257例(73.01%),囊肿无明显变化者49例(13.92%).结论 中颅窝蛛网膜囊肿的临床特点为男性、左侧多发,年龄愈小手术效果越好,手术仅部分切除壁层即可;囊肿巨大时行分流手术效果好,分流管以中低压为佳.

Abstract：

Objective o investigate the clinical characteristics of middle cranial fossa arachnoid cyst (MCFAC) and its therapeutic effects with different surgical methods. Methods Three hundred and fifty-two patients with MCFAC (about 2.58% of patients with intracranial space occupying lesion),admitted to our hospital from May 2001 to May 2008, were chosen in out study; their clinical data,surgical approach and prognosis were analyzed retrospectively. The gender ratio of patient with MCFAC adopted resection of arachnoid cyst and arachnoid cyst-peritoneal shunt was performed in 28 patients.Results Follow-up was performed for 3 months to 3 years. The headache completely disappeared in 75 patients (58.59%) and partial remission in 41 (32.03%) after the operation. The frequency and degree of seizures obviously decreased in 8 of the patients with MCFIAC. Eleven patients with dystropy,attention-deficit disorder or difficulty of learning got improvement. The head circumference and local skull eminentia was stable. The cyst disappeared completely in 46 patients (13.07%), partially in 257 (73.01%) and no changes in 49 (13.92%). Conclusion The clinical features of MCFAC is that it mainly occur in the left side of male. The younger the patient with MCFAC is, the better the treatment effect in the surgical intervention is. good outcome can be achieved by resection of the parietal layer of arachnoid cysts. The indication of shunt with meso-low pressure shunt system is for larger arachnoid cyst.