Objective To discuss the correlation between glutamate receptor 5 (GLUR5) and the pathogenesis of intractable temporal lobe epilepsy (ITLE), through detecting the GLUR5 expression in human with ITLE and Coriaria lactone-induced rhesus monkey temporal lobe epilepsy model. Methods Fifty-four patients with ITLE treated in West China Hospital between January 2007 and December 2015 were regarded as clinical case group in this study. The other 43 patients who underwent temporal lobe removal decompression surgery in the same time period due to trauma, tumor or large area cerebral hemorrhage complicated with cerebral hernia were designated as the clinical control group. Quantitive polymerase chain reaction (PCR) and Western blot methods were used to detect mRNA and protein levels of GLUR5. Western blot was also used to detect the GLUR5 protein level in the hippocampus and temporal lobe tissues of Coriaria lactone-induced rhesus monkey epilepsy model, and the result was compared with that of animal controls. Results Quantitive PCR results showed that the expression ratio (R value) of GLUR5 in the temporal lobe of the clinical case group to the clinical control group was 0.262, without significant difference (P>0.05), while theR value in the hippocampus was 4.896, with a significant difference (P<0.05). The amplification curve showed that the GLUR5 level in the hippocampus of the clinical case group was higher than that of the clinical control group, but the GLUR5 mRNA level in the temporal lobe tissue was not significantly changed. GLUR5 PCR amplified product electrophoresis showed that the amplified fragment was 161 bp. Western blot analysis showed that the GLUR5/actin value of the temporal lobe tissue in the clinical case group was 2.172±0.063, while the value in the clinical control group was 2.142±0.060, and the difference was not statistically significant (P>0.05). The GLUR5/actin value of the hippocampus in the clinial case group was 2.548±0.509, while it was 1.584±0.415 in the clinial control group, and the difference was statistically significant (P<0.05). The GLUR5/actin value of the hippocampus of the rhesus monkey model of epilepsy was 1.007±0.034, and it was 1.001±0.032 in the animal control group, and the difference was not statistically significant (P>0.05). The GLUR5/actin value of the temporal lobe tissue in the animal experimental group of rhesus model of epilepsy was 0.763±0.026, and it was 0.742±0.034 in the animal control group, and the difference was not statistically significant (P>0.05). The target protein bands showed that GLUR5 protein expression in the temporal lobe tissue and hippocampus of the rhesus model of epilepsy and animal controls was not significantly different (P>0.05). Conclusions GLUR5 participates in the pathogenesis of human ITLE by acting on the hippocampus. The expression of GLUR5 in human ITLE is abnormal, but the expression of GLUR5 is not changed in the rhesus model of epilepsy. The abnormal expression of GLUR5 may play a role in the pathogenesis of ITLE.
目的 探讨颅脑损伤急性期血小板（PLT）参数与外伤性脑梗死（TCI）的关系。 方法 选取2010年9月－2012年1月符合纳入除标准的颅脑损伤患者191例。将伤后14 d内发生脑梗死的患者划入观察组，余为对照组。分别于伤后第24、48小时，第3、7、14天，采集肘静脉血对PLT计数、PLT平均体积（MPV）、PLT体积分布宽度（PDW）；伤后24 h行格拉斯哥昏迷评分（GCS），伤后6个月随访行格拉斯哥结果评分（GOS）。分别分析脑梗死与上述PLT参数的关系、PLT参数与颅脑损伤病情轻重的关系以及与预后的关系。 结果 观察组PLT计数降低、MPV升高、PDW升高；观察组患者GCS/GOS与PLT计数呈正相关，与MPV、PDW呈负相关。 结论 PLT计数、MPV、PDW均与TCI有关，三者中PLT最具临床意义。PLT计数越低、MPV和PDW越高，脑梗死可能性越大，颅脑损伤可能越严重，预后可能越差。
【摘要】 目的 探讨中型和重型颅脑损伤后患者血小板（platelet，Plt）参数的变化特点及临床意义。 方法 选取2009年3月-2010年3月脑外伤后24 h内入院的颅脑损伤患者75例作为观察组，于伤后1、3、7、14 d采血测定Plt数量、血小板平均体积（mean platelet volume，MPV）、血小板体积分布宽度（platelet distribution width，PDW），并同时进行格拉斯哥昏迷评分（Glasgow coma scale，GCS）。同时选取60例健康体检者，测定Plt、MPV和PDW作为对照组。 结果 观察组伤后1、3、7 d Plt计数分别为（106.21±36.31）、（102.76±35.23）、（108.37±31.32）×109/L，较对照组[（210.41±68.56）×109/L]明显降低（Plt;0.05）；观察组伤后1、3、7 d MPV分别为（12.34±1.34）、（11.21±1.52）、（10.78±1.36） fL，PDW分别为（15.78±1.26）、（17.67±1.16）、（16.72±1.21） fL，均较对照组[MPV：（8.24±1.76） fL，PDW：（12.86±1.42） fL]明显升高（Plt;0.05）；伤后14 d Plt、MPV和PDW均较对照组差异无统计学意义（Pgt;0.05）。GCS≤8分组伤后1 d Plt计数为（96.85±36.52）×109/L，明显低于GCSgt;8分组[（123.85±35.78）×109/L]，而GCS≤8分组MPV为（12.14±1.32） fL，PDW为（18.63±1.21） fL，均明显高于GCSgt;8分组[MPV：（9.78±1.34） fL，PDW：（16.72±1.34） fL]，差异均有统计学意义（Plt;0.05）。伤后第1天Plt与随访6个月GOS评分呈正相关（r=0.625，Plt;0.05）。 结论 中型和重型颅脑损伤后Plt计数明显降低，MPV和PDW值明显升高，且与伤情及预后有关。Plt及其参数的检测有助于对伤情、预后的判断。【Abstract】 Objective To investigate the platelet parameters changes and its clinical significance in medium and severe head injury patients. Methods From March 2009 to March 2010, 75 brain injury patients hospitalized within 24 h after injury were included in this study. The platelet number (Plt), mean platelet volume (MPV), platelet volume distribution width (PDW) and Glasgow coma scale were measured on the first, third, seventh and fourteenth day after injury respectively. We also measured the Plt, MPV and PDW of 60 healthy volunteers to make comparisons. Results The Plt counts were (106.21±36.31), (102.76±35.23), and (108.37±31.32)×109/L in the head injury patients on the first, third, and 7th day respectively, which were significantly lower than those in the control group [(210.41±68.56)×109/L] (Plt;0.05); the MPV and PDW values measured on the first day [MPV: (12.34±1.34) fL, PDW: (15.78±1.26) fL] and the third day [MPV: (11.21±1.52) fL, PDW: (17.67±1.16)fL] were both significantly lower than those of the control group (Plt;0.05); There was no evidence of a difference in Plt, MPV and PDW between the two groups fourteen day after injury (P＞0.05); The Plt count was (96.85±36.52)×109/L in GCS≤8 group on the first day, which was significantly lower than that of GCSgt;8 group [(123.85±35.78) fL, Plt;0.05]; However, the MPV and PDW values in GCS≤8 group [(MPV: (12.14±1.32) fL, PDW: (18.63±1.21) fL] were both significantly higher than those of GCSgt;8 group [MPV: (9.78±1.34) fL, PDW: (16.72±1.34) fL, Plt;0.05]; The Plt count was correlated with GOS score positively (r=0.625,Plt;0.05). Conclusions Medium and severe head injury patients are significantly associated with a lower Plt count and increased MPV and PDW values. The Plt parameters changes are correlated with the prognosis of patients. Therefore, the measurement of Plt parameters may contribute to the valuation of severity and prognosis, and provide new ideas for treatment of head injury patients.
【摘要】 目的 探讨颅内原发生殖细胞瘤的临床特征。方法 收集华西医院脑外科2000年1月—2009年3月119例颅内原发生殖细胞瘤的临床资料进行回顾性分析。结果 发病率约占同期颅内肿瘤的 1.1%。男〖DK〗∶女=1.64〖DK〗∶1,平均发病年龄15.4岁。临床表现主要为颅内高压症状及视力视野改变,分别为61、56例；肿瘤主要来源于松果体区及鞍区；64例患者行放疗或放疗加化疗,随访45例。55例患者行手术治疗(其中术后行单纯放疗19例,放疗加化疗5例),随访36例。随访时间3~94个月,平均29.7个月。行放疗和放化疗的患者3、5年生存率明显高于单纯行手术治疗的患者。结论 颅内原发生殖细胞瘤多见于儿童及青少年,男性多见,肿瘤大多位于松果体区及鞍区。临床表现位于松果体区者主要为颅内高压症状等,位于鞍区者主要为视力视野改变、尿崩等。放疗联合化疗是主要治疗手段。