目的 探究显微镜外科手术在窦旁脑膜瘤患者中的应用价值.方法 选择收治的窦旁脑膜瘤患者42例,将患者进行随机分组,对照组给予常规手术治疗,研究组给予显微外科手术治疗,比较两组患者的手术时间、术中出血量、住院时间、治疗有效率和肿瘤全切率.结果 治疗有效率高于对照组,肿瘤全切率高于对照组.结论 显微外科手术用于窦旁脑膜瘤患者中能够缩短手术时间,减少术中出血,增加治疗有效率,提升肿瘤全切率,促进患者术后恢复,推荐临床应用.

Objective To investigate the effect of microvascular decompression on treating primary typical and atypical tri‐geminal neuralgia .Methods 40 cases with primary typical and 40 cases with atypical trigeminal neuralgia were chosen ,all of which were completed microvascular decompression under general anesthesia and endotracheal intubation .The origin of com‐pressed blood vessels ,the degree and position of compression were compared in two groups .Results Compressed blood ves‐sels originated from simple artery in typical group accounted for 85 .0% ,which was significantly higher than 57 .5% of atypical group(P<0 .05);and originated from mixed arteriovenous accounted for 15 .0% ,which was significantly lower than 42 .5% of the atypical group(P<0 .05) .The number of nerve and vessel rather closing together and compression in vascular proximity of typical group were significantly higher than that of atypical group in operation (P<0 .05) ,and the number of atrophy of tri‐geminal nerve and compression in vascular distance of typical group were significantly less than that of atypical trigeminal neu‐ralgia(P<0 .05) .Conclusion Trigeminal neuralgia treated with microvascular decompression and characteristics identified be‐fore operation can predict vascular compression type ,position and its relationship with nerves .

A 71-year-old woman had presented to our clinic with the history of trigeminal neuralgia involving the second and third divisions on the right side. The magnetic resonance tomography angiography examination before operation revealed that the root of the right trigeminal nerve was compressed by the superior cerebellar artery (SCA) artery. During the operation, a fusiform aneurysm was visualized at the distal portion of the SCA. The symptoms of pain disappeared after the surgery of microvascular decompression and the wrapping of the SCA aneurysm. Trigeminal neuralgia coexisting with the aneurysm of the ipsilateral SCA is extremely rare, and it has not been reported before.

Previously, we developed an orthotopic xenograft model of human glioblastoma multiforme (GBM) with high EGFR expression and invasiveness in Balb/c nu/nu nude mice. Now we also developed the same orthotopic xenograft model in transgenic nude mice with green fluorescent protein (GFP) expression. The present orthotopic xenografts labeled by phycoerythrin fluorescing red showed high EGFR expression profile, and invasive behavior under a bright green-red dual-color fluorescence background. A striking advantage in the present human GBM model is that the change of tumor growth can be observed visually instead of sacrificing animals in our further antitumor therapy studies.

Objective To discuss the feasibility of treating multilocular brain abscess under neuroendoscopic stereotaxy.Methods Retrospective analysis of 14 patients with multilocular brain abscess were treated under neuroendoscopic stereotaxy.Results All samples were punctured once successfully and the cavities disappeared.Follow up 8 months to 3 years,13 samples are cured and 1 relapsed.Conclusion Neuroendoscopic stereotaxy assisted to treat multilocular brain abscess is an effective and feasible way,it is located exactly,safe and less inasie.

Objective To study the differential proteins of well-differentiated astrocytoma and identify tumor-associated protein markers for diagnosis and prognosis.Methods The specimen of normal brain tissue(29 cases) and well-differentiated astrocytoma(36 cases,Kernohan II) identified by pathological method were electrophoresed and dyed,and then were analyzed by PDQUEST and two-dimentional electrophoresis(2-DE) softwares.The proteins were identified by MALDI-TOF mass spectrometry or MALDI-TOF/TOF tandem mass spectrometry.Results We obtained 2-DE gel atlas of normal brain and well-differentiated astrocytoma by 2-DE and 24 prominent different proteins spots by mass spectrometry.Compared with normal brain tissue,9 down-regulated and 15 up-regulated proteins were found in astrocytoma.Conclusion We have got different proteins from normal brain and well-differentiated astrocytoma by proteomics.Some proteins are useful for discovering the molecular mechanisms of genesis development and helpful to find the markers of tumor and treatment target.

Objective To explore the value of monitoring brain stem evoked potential and electromyograms to the surgery for acoustic neurinomas.Method The clinical data of 11 patients with acoustic neurinomas,who underwent surgery for the acoustic neurinomas under monitory brain stem evoked potential and electromygrams from March,2010 to June,2011,were analyzed retrospectively.Results Of 11 patients with acoustic neurinomas,9 underwent the total removal of the tumors and 2 greatly part.All the patients were follow up for 3～6 months.The facial palsy in all the patients mended in different degree and 1 patient still felt numbness on his face during the following up period.The significant manifestations of the posterior cranial nerves and brain stem injuries were not found in all the patients.Conclusion The rate of total resection of the acoustic neurinomas may be increased and the postoperative complications may be decreased by intraoperative monitoring the brain stem evoked potential and the electromyograsms.

目的探讨早期显微手术夹闭对颅内动脉瘤破裂预后的影响。方法回顾性分析36例颅内动脉瘤破裂出血病人的临床资料,所有病人于发病早期(72 h)行手术夹闭,术后3个月行改良Rankin量表(mRS)评分。结果术后复查DSA 35例,动脉瘤颈完全夹闭34例,瘤颈部分残留1例,行二次手术完全夹闭。术后应用mRS评分:0～1分27例,2分2例,3分3例,4分2例,5分和6分各1例。结论早期手术夹闭破裂动脉瘤仍是治疗动脉瘤最基本的方法,且娴熟的显微外科技术是手术成功的重要保证。

Differential protein expression between various pathological grades of glioma has been shown in studies of glioma proteomics. However, very little data is available regarding normal brain tissues and glioma differential protein expression, because normal human brain tissues are difficult to harvest. The present study selected samples from low-grade astrocytomas and peritumoral brain tissues to analyze differential protein expression by two-dimensional (2D) electrophoresis and mass spectrometry techniques. Results revealing 36 protein spots by 2D electrophoresis, including 23 spots revealing increased expression and 13 spots revealing decreased expression. However, 25 differential proteins were identified by mass spectrometry, including 16 proteins with increased expression and 9 with decreased expression. Western blot analysis confirmed the mass spectrometry results, i.e., heat shock protein 70 (HSP70) and human transthyretin (TTR) expressions were increased, but glial fibrillary acidic protein (GFAP) was decreased, in astrocytomas. The present study constructed a 2D electrophoresis pattern between low-grade astrocytomas in the human brain and peritumoral tissues. Results demonstrated that a majority of differential proteins, such as HSP70, TTR, and GFAP, participate in malignant progression of gliomas.

[目的]用双向电泳分析高分化星形细胞瘤和正常脑组织的差异蛋白质表达.[方法]取经病理证实的正常脑组织及高分化星形细胞瘤(KernohanⅡ级)进行双向电泳分离,重复6次后,经PDQuest 2D软件比较分析蛋白质表达差异并获得差异蛋白质的相对分子质量、等电点等信息.[结果]通过双向电泳得到了正常脑组织和高分化星形细胞瘤标本的双向凝胶电泳图谱,经分析在差异图谱上发现了15个有显著差异的蛋白质点.[结论]高分化星形细胞瘤与止常脑组织蛋白质表达存在明显差异,可能与肿瘤发病机制有关,差异蛋白质的发现有利于肿瘤标志物及治疗靶点的发现.

胶质瘤是最常见的颅内肿瘤,在脑组织中呈浸润性生长,在诊断中肿瘤分级比较模糊。全文综述近年来用蛋白质组学的方法对胶质瘤的研究。

局灶性皮质发育不良是难治性癫痫的重要病因,近年来,随着影像学和脑电生理学的发展,分子生物学和病理生理学在癫痫发病机制研究中的应用,人们对局灶性皮质发育不良的遗传和病理生理学特点的认识产生了浓厚的兴趣。本文对大脑皮质的发育过程、局灶性皮质发育不良的发病及致痫机制分类及影像学的特征、手术治疗进行综述。

Objective To explore the surgical treatment for children with catastrophic epilepsy.Methods The clinical data of 10 children who underwent surgical treatment for their catastrophic epilepsy were retrospectively analyzed,in order to compare the preoperative and postoperative seizures and intelligence of these children.Results Except for one case withdrawn,the other cases were all followed up for more than 12 months;all cases had no postoperative aggravation of nerve function impairment complicated with intelligence disturbances.Evaluation on therapeutic effects showed that therapeutic satisfaction was realized in 4 cases,significant improvement in 2 cases,good improvement in another 2 cases and mild improvement in 1 case.Postoperative deteriorations in behavioral abnormalities and language disorders were evident,but there was no significant difference between preoperative and postoperative IQ.Conclusion Active surgical treatment for children with catastrophic epilepsy can not only control seizures effectively,but also partially alleviate intelligence disturbances.

目的 观察胶质瘤中缺氧诱导因子-1α(HIF-1α)蛋白及HIF-1α mRNA的表达情况,探讨HIF-1α在胶质瘤中的表达特点,与胶质瘤分级的关系及意义.方法用SABC免疫组化法和原位杂交检测41例胶质瘤和8例正常脑组织标本中HIF-1α蛋白和HIF-1α mRNA的表达,并将胶质瘤分级,比较各级之间阳性表达率的差异.结果 41例胶质瘤标本中HIF-1α蛋白阳性表达率为56.1%(23/41例),而8例正常脑组织中HIF-1α蛋白阳性表达率为0,二者相比有显著性差异(P＜0.05).HIF-1α蛋白在胶质瘤各病理分级中的阳性表达率分别为Ⅰ+Ⅱ级42.3%(11/26例),Ⅲ+Ⅳ级80.0%(12/15例),二者之间有显著性差异(P＜0.05).HIF-1αmRNA在胶质瘤中与正常脑组织表达无显著性差异(P＞0.05),在胶质瘤各病理分级中的表达亦无显著性差异(P＞0.05).结论 HIF-1α在胶质瘤中的表达上调,且与胶质瘤病理分级相关,它有助于肿瘤细胞在缺氧状态下的存活,协助肿瘤的生长和侵袭.HIF-1α在胶质瘤中表达的调节是在转录后水平。