Objective To investigate the related high-risk factors of the occurrence of progressive hemorrhagic injury (PHI) after acute traumatic brain injury ,and to provide the basis for early clinical diagnosis and treatment .Methods Retrospective analysis the clinical data of 398 cases of traumatic brain injury patients .According to whether PHI occurred ,the patients were divided into the progress group and non-progress group .Relevant factors with progressive hemorrhagic injury were assessed .Results The univari-ate analysis showed that ,the age ,gender ratio ,injury to first CT time ,GCS score when admitted in hospital ,mean arterial pressure , combined with skull fracture ,combined with epidural hematoma ,combined with cerebral contusion ,bilateral injury ,subarachnoid hemorrhage ,disturbance of consciousness ,mydriasis ,volume of intracranial hematoma more than 10 mL and volume of hematoma at the first CT scanning ,Platelets ,plasma fibrin concentration and D-dimer influenced the development of progressive hemorrhagic in-jury(P<0 .05) .Logistic regression showed that ,injury to first CT time ,GSC score less than 12 ,disturbance of consciousness ,my-driasis ,volume of hematoma more than 10 mL at the first CT scanning ,combined with cerebral contusion ,combined with subarach-noid hemorrhage ,platelet and D-dimer were the independent risk factors for PHI (P<0 .05) .Conclusion Patients with acute brain injury should be promptly head CT .Patients with GCS score less than 12 ,disturbance of consciousness ,mydriasis ,volume of in-tracranial hematoma more than 10 mL at the first CT scanning ,combined with cerebral contusion ,subarachnoid hemorrhage ,platelet and D-dimer were the independent risk factors of the progressive hemorrhagic injury after traumatic brain injury ,Should closely ob-serve the illness progress ,regularly review the head CT as soon as possible .

Objective To study the value and effectiveness of surgical management and mapping in supratentorial tumoral complicated with epilepsy and to study the correlations between tumor and the epileptogenic focus.Methods The clinical data of 121 patients with supratentorial cerebral tumor but epilepsy as initial symptom were retrospectively analyzed for the incidence of pre-and postoperative epileptic seizures,including grade Ⅰ glioma in 1 5 cases and grade Ⅱ glioma in 35 cases,grade Ⅲ-Ⅳglioma in 12 cases,menigoma in 32 cases,metastases in 10 cases,cavernous angiomas in 15 cases,and ependymomas in 2 cases.Results Surgery based on CT/MRI,seizure type and EEG changes was conducted.There was no death in operation.The highest incidence was in frontal lobe and the lowest in occipital lobe.Correlations between localization of tumor and the epileptogenic focus:there were 50 cases in the same location,near or beside tumors in 28 cases,far separate apart(＞2 cm)from tumors in 25 cases,no relationship was found in 18 cases.103 patients were followed up for one to nine years.31 patients had a few seizures in the early postoperative period.Epileptic seizures were cured without anti-epilepsy drugs in 83 cases.Conclusion There are some differences between tumors'location and epileptogenic focus in supratentorial tumoral epilepsy.The location and size of epileptogenic zone should be detected before and during operation.The resection of the tumor combined with the resection of the epileptogenic zone"epilepsy surgery"can provide good results.

Objective To investigate the expressions ofnucleostemin (NS) and p53 up-regulated apoptotic factor (PUMA) proteins in human gliomas and its clinical significance.Methods Sixty-two human gliomas,collected in our hospital from January 2011 to February 2013 and confirmed by pathology,were used in our study; according to the WHO grading,grade Ⅰ included 8 patients in the study group,grade Ⅱ 21 patients,grade Ⅲ 19 patients and grade Ⅳ 14 patients.Other 10 patients accepted decompressions in our hospital at the same time period were used as control group.The expressions of NS and PUMA proteins in the brain tissues were detected by immunohistochemical S-P method.Results The NS protein expression was significantly higher and PUMA protein expression was statistically lower in study group than those in the control group (P＜0.05).As compared with gliomas of grade Ⅰ and Ⅱ,gliomas of grade Ⅲ and Ⅳ had significantly higher NS protein expression and lower PUMA protein expression (P＜0.05).Conclusions The expression changes of NS and PUMA are closely associated with gliomas malignant degrees,and the two play important roles in the progression and proliferation of glioma cells.

Objective To investigate the expression of high mobility group protein b 1 (HMGPB1) and toll-like receptors 4 (TLR4) in human glioma tissues of patients with epilepsy and explore the mechanism of glioma-associated epilepsy.Methods Ninety-five glioma specimens,collected during the resection surgery in our hospital firom June 2011 to June 2014,were used in our experiment;among them,55 were low-grade gliomas and 40 were high-grade gliomas.Immunohistochemistry and real time-PCR were used to assay the protein and mRNA expressions of HMGB1 and TLR4 in glioma tissues and peritumoral tissues,and the relation between HMGB1/TLR4 and glioma-associated epilepsy was analyzed.Results The incidence of glioma-associated epilepsy was 35.79％ (34/95),and the incidence of glioma-associated epilepsy in low-grade gliomas (49.09％) was significantly higher than that in high-grade gliomas (17.50％)(x2=10.057,P=0.002).Immunohistochemisty and RT-PCR showed that the protein and mRNA expressions of HMGB1/TLR4 in the peritumoral tissues with glioma-associated epilepsy were significantly higher than those in the peritumoral tissues without glioma-associated epilepsy (P＜0.05),while no significant difference was noted between glioma tissues with and without epilepsy (P＞0.05).Conclusion Over-expression of HMGB1 and TLR4 in peritumoral tissues of glioma patients may be related with the development of glioma-associated epilepsy,which may be a new target in glioma therapy.

Objective To investigate the expressions of intercellular adhesion molecule (ICAM)-1 and matrix metalloproteinase (MMP)-2 in human gliomas and their correlation.Methods Sixty glioma samples,resected in our hospital from March 20,2010 to May 10,2014,were chosen in our study,and corroding to the WHO central nervous system tumor histological grading,they were divided into low-grade glioma group (grade Ⅰ-Ⅱ,n=26) and high-grade glioma group (grade Ⅲ-Ⅳ,n=34);other 10 normal brain tissues were used as controls.Reverse transcription-PCR and SP immumohistochemical staining were used to detect the ICAM-Ⅰ and MMP-2 mRNA and protein expressions.Results (1) The ICAM-1 and MMP-2 mRNA expressions in normal brain tissues,low-grade glioma group and high grade glioma group were increased in sequence,with significant difference (P＜0.05);the positive rate of ICAM-1 protein expression in normal brain tissues,low-grade glioma group and high grade glioma group was 20％,46.1％ and 88.2％,with significant differences (P＜0.05),and that in MMP-2 protein expression was 10％,50％ and 91.1％,with significant differences (P＜0.05).The mRNA expressions ofICAM-1 and MMP-2 in gliomas were positively correlated (r=0.702,P=0.001).Conclusions The expressions of ICAM-1 and MMP-2 are positively related to the malignant degrees of gliomas;the two may be useful reference factors to evaluate prognosis of human gliomas and potential targets for therapy.