目的 探讨颞肌下与颞肌外钛网颅骨修补对创伤性颅脑损伤去骨瓣减压术后患者预后的影响.方法 选取2017年1月～2020年10月昆明市第一人民医院神经外科收治的60例外伤性颅内脑损伤去骨瓣减压术患者为研究对象,随机分成颞肌外组(n=28)和颞肌下组(n=32).颞肌外组采用颞肌外颅骨修补术,颞肌下组采用颞肌下颅骨修补术.比较两组患者格拉斯哥预后评分(GOS)、简明精神状态量表(MMSE)评分、术后并发症发生率、住院时间、术中失血量.结果 术后3个月两组GOS及MMSE评分均高于术前,差异有统计学意义(P<0.05),术后两组GOS及MMSE评分比较,差异无统计学意义(P>0.05);两组术中失血量、住院天数比较,差异无统计学意义(P>0.05);两组硬膜外血肿、积液及癫痫等并发症发生率比较,差异无统计学意义(P>0.05).结论 虽然颞肌下颅骨修补对患者术后并发症发生率及预后与颞肌外颅骨修补无区别,但颞肌下颅骨修补符合生理解剖复位,可避免咀嚼受限,卡压痛和外观异常,故颞肌下颅骨修补可能是一种可行的、更优的选择.

目的 探讨不同时期行颅骨修补的安全性和可行性.方法 回顾性分析昆明市第一人民医院神经外科2014年1月～2020年8月收治的233例行颅骨修补的患者的临床资料,根据颅骨修补的时机将其分为早期组(术后≤3个月,78例)与晚期组(术后>3个月,155例);比较两组术后感染、脑出血、癫痫、脑积水发生率及术后住院天数、术中失血量及手术时间.结果 两组术后感染、脑出血、癫痫、脑积水发生率及并发症总发生率比较,差异均无统计学意义(P>0.05);两组术后住院天数、术中失血量及手术时间比较,差异均无统计学意义(P>0.05).结论 早期颅骨修补较晚期颅骨修补并未增加患者并发症的发生率,且也未增加住院时间、术中出血量及手术时间,故建议临床应用早期行颅骨修补术.

目的 探讨早期颅骨修补对创伤性颅脑损伤去骨瓣减压术后患者日常生活能力和神经功能的影响.方法 选取昆明市第一人民医院神经外科2016-01—2019-10收治的121例创伤性颅脑损伤去骨瓣减压术后患者为研究对象,根据颅骨修补的时机,将其分成早期组(术后≤3个月,50例)与晚期组(术后>3个月,71例).比较2组患者术前、术后6个月功能独立性评定量表(FIM)评分、简明精神状态量表(MMSE)评分,同时比较术后并发症发生率、住院时间、术中失血量.结果 早期组术后FIM评分、MMSE评分[120.0(115.0,124.2)分和27.0(24.5,29.0)分]较术前[114.0(90.0,116.5)分和23.0(15.8,25.3)分]均有所提高,同时晚期组术后FIM评分、MMSE评分[117.0(110.0,120.0)分和26.0(18.0,27.0)分]较术前[115.0(105.0,119.0)分和24.0(16.0,26.0)分]均有提高,差异具有统计学意义(均P<0.05).术后早期组FIM评分、MMSE评分[120.0(115.0,124.2)分和27.0(24.5,29.0)分]较晚期组[117.0(110.0,120.0)分和26.0(18.0,27.0)分]提高更明显,差异具有统计学意义(均P<0.05);本组无死亡和感染病例,早期组和晚期组硬膜外血肿和积液发生率[8％(4/50)和9.9％(7/71)],癫痫发生率[10％(5/50)和19.7％(14/71)],脑积水的发病率[4％(2/50),2.8％(2/71)],术后住院时间[(8(7,9)d和8(7,9)d]和术中失血量[300(300,400)mL和300(250,350)mL]差异均无统计学意义(均P>0.05).结论 早期颅骨修补(≤3个月)并未增加术后并发症的发生率和住院时间及术中失血量,且更有助于日常生活能力的改善和神经功能的恢复.

Objective To investigate the expression of angiotensin converting enzyme (ACE)and clinical significance in evaluating the prognosis in patients with different grades of brain glioma.Methods The expression levels of ACE mRNA and protein in 48 patients with different grades of brain glioma and 22 cases of human normal brain tissues were detected by real-time fluorescence quantitative PCR and western blot.According to the criteria of the World Health Organization,all 48 patients with different grades of brain glioma,including 8 cases (grade Ⅰ),18 cases (grade Ⅱ),16 cases (grade Ⅲ)and 6 cases (grade Ⅳ),were observed.Results The expression levels of ACE mRNA and protein in brain glioma tissues were significantly higher than those of normal brain tissues (P <0.05). The expression levels of ACE mRNA in the brain glioma tissues were significantly higher in patients with grade Ⅲ-Ⅳthan in patients with grade Ⅰ-Ⅱ (P <0.05).Conclusion ACE is highly expressed in the tumor tissues of patients with brain glioma,which is closely related to tumors grade.These findings suggest that the high expression of ACE in glioma may provide clinical reference value in evaluating the prognosis of the patients with brain glioma.

目的 从神经行为学、组织病理和生化方面对3种不同脑区单侧定点注射6-羟基多巴胺(6-hydroxydopamine,6-OHDA)损伤大鼠帕金森病(Parkinson disease,PD)模型进行比较研究.方法 健康雄性SD大鼠随机分为3组(n=10):纹状体组、黑质组、黑质+中脑腹侧被盖区组.根据脑立体定位图谱,将微量6-OHDA单点定位注入大鼠中脑黑质区、纹状体区和双点定位注入黑质区与中脑腹侧被盖区.观察阿朴吗啡诱发大鼠旋转行为,免疫组织化学检测大鼠黑质区酪氨酸(tyrosinehydroxy-lase,TH+)阳性神经元数目,电化学高效液相色谱法检测纹状体中多巴胺(dopamine,DA)及其代谢产物3,4-二羟苯乙酸(dihydroxy-phenyl acetic acid,DOPAC)和高香草酸(homovanillic acid,HVA)含量.结果 纹状体组3周后模型稳定,黑质组与黑质+中脑腹侧被盖区组大鼠2周后稳定,3组30 min内向健侧转圈数均呈升高趋势,黑质+中脑腹侧被盖区组高于纹状体组和黑质组,组间·时点间交互作用差异有统计学意义(P＜0.05).纹状体组和黑质+中脑腹侧被盖区组造模成功率高于黑质组(P＜0.05).3组大鼠注射6-OHDA损伤侧纹状体中DA、DOPAC、HVA含量和TH+神经元数目均明显低于非损伤侧(P＜0.05).结论 纹状体单点注射6-OHDA损伤建立PD模型成功率高,可作为研究PD的一种稳定可靠的动物模型.

BACKGROUND:There are several routes for stem cel transplantation;however, it is stil unable to determine which one is the best. As for the different individuals with brain injury, the type of transplanted cel s, transplantation route and time wil affect the therapeutic effects. <br> OBJECTIVE:To investigate the effect of bone marrow mononuclear cel s transplanted via different approaches on neurological function of rats with traumatic brain injury. <br> METHODS:Bone marrow mononuclear cel s of rats were administered gradient centrifugation with Ficol lymphocyte separation medium, and were labeled with CFDA-SE in vitro as standby. Rat models of traumatic&nbsp;brain injury were established by the method of freefal . After successful establishment of rat models, bone marrow mononuclear cel s labeled with CFDA-SE were immediately transplanted into rats via injured area, lateral ventricle and internal carotid artery. One control group was designated for each transplantation route (bone marrow mononuclear cel s were replaced with the same volume of DMEM). The degree of neurological deficits was evaluated using mNSS scores at different time points after treatment. The brain tissue was harvested after the last neurobehavioral evaluation. The survival and migration of bone marrow mononuclear cel s in the injured area were observed under an inverted fluorescent microscope. <br> RESULTS AND CONCLUSION:At 7, 10, and 14 days after treatment, the mNSS scores of rats in al groups were al lower than those at 1 and 3 days (P<0.05). At 7 and 10 days, the mNSS scores of rats in the internal carotid artery transplantation group were significantly lower than those in the control group (P<0.05). At 14 days after treatment, the number of fluorescence-labeled cel s of rats in the internal carotid artery transplantation group was greater than that in the other groups (P<0.05) and these labeled cel s were widely distributed. The results demonstrate that the neurological function of rats can be improved by transplanting bone marrow mononuclear cel s via the internal carotid artery, and a large number of transplanted cel s can survive and migrate in the injured area.

Objective To investigate the association between angiotensin I-converting enzyme(AC) Einsertion(I) and deletion(D) polymorphism and risk of glioma.Methods The ACE I/D polymorphism was genotyped in 152 patients with glioma and 199 healthy controls using polymerase chain reaction(PCR) strategy.Results The ID genotype was associated with an increased risk of glioma compared with deletion and deletion(DD) genotype(P=0.038).When stratified according to sex and clinical stages,no significant association between the ACE I/D polymorphism and sex and maligancy was observed.Conclusion ACE I/D polymorphism may be a risk factor for the development of glioma.