Objective To explore expression of HMGB1 and TLR4 in epileptogenic focus brain tissue of temporal lobe intractable epilepsy patients, and analyze its significance in epileptic seizures. Methods 85 tempo-ral lobe intractable epilepsy patients were included in the research. Patients underwent resection of epileptogenic focus in Neurosurgery Department of The Fifth Affiliated Hospital of Zhengzhou University during January 2011 to January 2012. Epileptogenic focus brain tissue during operation were studied. 20 patients underwent intracranial decompression were selected as control group. Normal brain tissue during operation were studied. Immunohisto-chemical method was applied to detect HMGB1 and TLR4 expression level in epileptogenic focus brain tissue of ex-perimental group patients and normal brain tissue of control group patients. Correlation of HMGB1 and TLR4 expres-sion level and epileptic seizures was analyzed. Results Positive expression rate of HMGB1 (χ2= 74.375, P =0.000) and TLR4(χ2= 57.495, P = 0.000) in epileptogenic focus brain tissue of experimental group patients are both higher than that in normal brain tissue of control group patients. Expression of HMGB1 and TLR4 in epilepto-genic focus brain tissue is correlated with course of epilepsy (χ2= 25.798, P = 0.000), (χ2= 10.548, P = 0.001) preoperative epileptic seizure duration(χ2=8.403, P=0.004),(χ2=10.564, P= 0.001) and preoperative epilep-tic seizure frequency (χ2=4.912, P=0.027), (χ2=5.567, P=0.018). Conclusions HMGB1-TLR4 passageway may become new direction to study pathogenesis, diagnosis, and treatment of intractable epilepsy.

Objective To investigate the correlations of the expression of high mobility group box 1 protein(HMGB1)and toll-like receptor 4(TLR4)with the clinical characteristics of patients with refractory epilepsy,as well as their predictive value.Methods A retrospective analysis was conducted on the clinical data of 84 patients with refractory epilepsy,and they were included in ob-servation group.During the same period,35 patients with intracranial hypertension undergoing crani-ectomy for decompression were selected as control group.Immunohistochemistry was used to detect the expressions of HMGB1 and TLR4,while Nissl staining was applied to observe tissue morphology.The relevant experimental results were analyzed simultaneously.Results The expression levels of HMGB1 and TLR4 in the observation group were significantly higher than those in the control group(P＜0.05).The optical density values of HMGB1 and TLR4 protein bands as well as internal refer-ence β-actin bands in the observation group were significantly higher than those of the control group(P＜0.05).The intensity of TLR4 expression was correlated with seizure frequency,seizure dura-tion,disease duration,and seizure type,while the intensity of HMGB1 expression was correlated with seizure frequency,seizure duration,and disease duration.In the lesion tissues,the expression of TLR4 was positively correlated with the expression of HMGB1,suggesting a synergistic effect between them.Receiver Operating Characteristic(ROC)curve analysis revealed that the areas under the curve(AUCs)for TLR4 and HMGB1 proteins in predicting refractory epilepsy were 0.888 and 0.923,respectively.Conclusion HMGB1 and TLR4 are highly expressed in the lesions of patients with refractory epilepsy,and their expression intensities are positively correlated.They can predict the occurrence and development of the disease to a certain extent,providing new biomarkers for the di-agnosis and treatment of refractory epilepsy.

Objective To investigate the correlations of the expression of high mobility group box 1 protein(HMGB1)and toll-like receptor 4(TLR4)with the clinical characteristics of patients with refractory epilepsy,as well as their predictive value.Methods A retrospective analysis was conducted on the clinical data of 84 patients with refractory epilepsy,and they were included in ob-servation group.During the same period,35 patients with intracranial hypertension undergoing crani-ectomy for decompression were selected as control group.Immunohistochemistry was used to detect the expressions of HMGB1 and TLR4,while Nissl staining was applied to observe tissue morphology.The relevant experimental results were analyzed simultaneously.Results The expression levels of HMGB1 and TLR4 in the observation group were significantly higher than those in the control group(P＜0.05).The optical density values of HMGB1 and TLR4 protein bands as well as internal refer-ence β-actin bands in the observation group were significantly higher than those of the control group(P＜0.05).The intensity of TLR4 expression was correlated with seizure frequency,seizure dura-tion,disease duration,and seizure type,while the intensity of HMGB1 expression was correlated with seizure frequency,seizure duration,and disease duration.In the lesion tissues,the expression of TLR4 was positively correlated with the expression of HMGB1,suggesting a synergistic effect between them.Receiver Operating Characteristic(ROC)curve analysis revealed that the areas under the curve(AUCs)for TLR4 and HMGB1 proteins in predicting refractory epilepsy were 0.888 and 0.923,respectively.Conclusion HMGB1 and TLR4 are highly expressed in the lesions of patients with refractory epilepsy,and their expression intensities are positively correlated.They can predict the occurrence and development of the disease to a certain extent,providing new biomarkers for the di-agnosis and treatment of refractory epilepsy.