Besides performing medical moral rules, aneasthetist should be of special morals and deal with the relation to patients and surgeon.

There is rapid growth of pediatric surgery service in China in the recent years. A survey by the China Association �A gainst �Epi�lepsy underta�ken in �June ����� 2006���� on the ma�jor cities in different parts of the country showed a dramatic increase particularly in years 2004 and 2006. Surgery for temporal lobe epilepsy accounts for half of the operation. Surgery has an important role in the treatment of drug resistant pediatric epilepsy. With large population and vast geographical spread, it is important to further develop pediatric epilepsy surgery service in China

The earliest activities related to epilepsy surgery in China ma�� � y be tra�ce��d to the 19���50s an�� �� d 60s��. A�ter a lull during the cultural revolution, there was resurgence of epilepsy surgery from the 1980s, and rapid development from 2000. It is estimated that app�roximately 150- ���200 p hysi�cians �currentl�� � y pra�cti�ce epilepsy surgery in the country.�� In year 2��� 005, there were a total of 2,��500 �cases of e�pile�ps��y o�perate��d in whole of �China, close to half in Beijing, Tian�jin, �Shanghai, �Chongqing an��d Guang�zhou, an�� a �uarter in Beijing. There are three Chinese epilepsy surgery journals, 5 monographs on epilepsy surgery, and “��Epilepsy surgery” edite�� ��� ��� �� ��� ��� d by HO Luders has also �been translate��d into �Chinese��.

Objective Helicobacter pylori (H. pylori )contains more than 30 genes and many of them in cag pathogenicity island (cag PAI) composed of cag Ⅰ and cag Ⅱ are involved in eliciting the transcription of interleikin 8 (IL 8) and the induction of IL 8 protein secretion in gastric epithelial cells, although some genes are not involved. This study was designed to observe the effect of ORF10 of H. pylori cag Ⅱ on the transcription of IL 8 in gastric epithelial cells and to test the possibility that certain genes in the cag PAI also downregulate (modulate) the transcription and expression of IL 8 in gastric epithelial cells. Methods Three strains of H. pylori mutants with deletion of ORF10 gene (ORF10, namely 28 1, 28 2, 28 3) and L5F11 cells containing IL 8 reporter gene were constructed. The constructed L5F11 cells were co cultured with the above strains and the luciferase activity (IL 8 transcription) was measured in a scintillation counter and the concentration of IL 8 protein was assayed by enzyme linked immunosorbent assay (ELISA). Results The activities of luciferase induced by 3 strains of H. pylori mutants with deletion of ORF10 gene were much higher than that of the mother strain 26695 [ 28 1:(1.49 ? 0.27)?10 6 cpm vs. (0.67 ? 0.08 )? 10 6 cpm, P

Following an analysis of the problems and challenges of public hospitals in Shanghai,the paper presented the approach of Shanghai Shenkang Hospital Development Center in its problem-based reform of such hospitals.The measures include promotion of capital construction,enhanced discipline human resources,and accelerated informationization,as well as overall budget management and hospital director performance appraisal,which enhanced their service capacity and operational efficiency.

Objective To study the relationship between the cardiac markers in ST-segment elevation myocardial infarction (STEMI) and quality of life (QOL) six months later.Methods N-terminal pro-B-type natriuretic peptide (NT-proBNP),cardiac troponin I (cTnI),creatine kinase isoenzyme-MB (CK-MB)and myoglobin(Myo) was tested in 76 patients with STEMI on admission(0 h) and 24 h after admission.QOL six months later was evaluated by using the SF-36 health survey questionnaire.The relationship between the cardiac markers and QOL was analyzed by multivariate linear regression analysis.Results The total SF-36 scores and the scores of physical function,body pain and general health showed negative linear correlation with NT-proBNP on admission (0 h) and 24 h after admission (P ＜ 0.05).The total SF-36 scores and the scores of physical function and body pain showed negative linear correlation with cTnI on admission (0 h)and 24 h after admission (P ＜ 0.05).The total SF-36 scores and the scores of body pain showed negative linear correlation with CK-MB on 24 h after admission (P ＜ 0.05).The scores of vitality showed negative linear correlation with Myo on admission (0 h) (P ＜ 0.05).Conclusion The higher levels of NT-proBNP,cTnl and CK-MB indicate the lower QOL six months later.

Objective To study the expression of a new drug resistance-related gene cDNA fragment from human lung adenocarcinoma cell line in several types of lung cancer and their adjacent normal tissues. Methods The in situ hybridization histochemistry (ISHH) and Northern blot were employed to study the location and expression of the cDNA fragment in lung cancer cells. Results The results of ISHH and Northern blot showed that the expression of the fragment was discovered in 6 cases of 12 patients with lung adenocarcinoma, but not observed in the lung cancer tissues of other types and normal tissues(P

Objective To investigate the resistant status and to type the phenotype and plasmid profiles of prevalent gonococcal strains. Methods A total of 98 gonococcal strains isolated from 1998 to 1999 in Zhanjiang was identified systemically. The susceptibilities of 98 strains of gonococci to penicillin,tetracycline and ciprofloxacin were detected by agar dilution method. The β － lactamase production was tested by iodometric method. The plasmids were extracted by alkaline lysis technique. Results The prevalence of gonococcal strains resistant to penicillin, tetracycline and ciprofloxacin were 22.44％ ,45.94％ and 55.12％ ,respectively. There were 6 positive strains for β － lactamase, accounting for 6.12％ (6/98). The most common phenotypes were susceptiblePT、 CMRNGT、 CMRNGPT and TRNG, accounting for 43.86％ ,23.46％ ,10.20％ and 10.20％ ,respectively. The detection rate of plasmids were 91.84％ .Among them, the percentages of 42.5 kb,39.5 kb,7.4 kb and 4.2 kb plasmids accounted for 11.22％ ,41.82％ ,59.16％ and 67.32％ ,respectively.There were 12 types of plasmid profiles(PP), the predominant types were 7.4kb＋ 4.2kb and 39.5kb＋ 7.4kb＋ 4.2kb, accounting for 21.42％ and 17.34％ ,respectively. Conclusion The gonococcal strains resistant to ciprofloxacin are very high in Zhanjiang. The phenotype and plasmid profiles of the strains have characteristic distribution.

Objective To investigate the occurrence of early complications of diagnostic and therapeutic ERCP and its treatment .Methods Occurrence,kind,treatment and outcome of early complications of diagnostic and therapeutic ERCP were respectively reviewed in 8 579 cases in our hospital between January 1977 and December 1999.Results 112 cases had early complications(1.31%).In diagnostic ERCP morbidity of early complications was 1.30%(95/7290) and it was 1.32%(17/1289)in therapeutic ERCP.Of them,acute pancreatitis occurred in 38 cases(0.44%),billiary infection 30 cases(0.35%),bleeding of digestive tract 26 cases(0.30%),drug reaction 8 cases(0.09%),stone and basket incarceration 5 cases(0.06)%,intestinal perforation 1 cases (0.01%) and retroperitoneal pneumatosis 1 cases(0.01%).Of them,106 patients were cured by conservative therapy.Operations were performed in 5 patients.1 patient died.Conclusion In diagnostic ERCP acute pancreatitis is the most common complication,which may be related to difficulty of cannulation,repeated developing and inappropriately injecting contrast medium. In therapeutic ERPC bleeding of digestive tract is the most common complication ,which is related to the procedure ,jaundice and diabetes.Most of complications can be cured by conservative therapy,but a minority needs operation.

Objective To study the changes of collagen content in the esophageal tissue after stenting. Methods To select healthy adult dogs as experimental subjects.Esophageal stent was installed by the method of “autogenous fascia lata femoris transplantation and fixation",the dogs were killed at the end of 1,2,4 and 8 weeks,and the esophageal tissues with stent were taken out and studied by gross observation,light microscopy and electromicroscopy. The bulk density and distribution of collagen fiber were studied by special staining and computer technology.The content of P I CP and PⅢNP in restenosis tissue were measured by radio immunoassay(RIA).The contents of hydroxyproline and total amino acid(AA) in restenosis tissue were measured by amino acid analyser. Results At week 1 and 2 the inflammatory reaction occurred evidently in stenting esophagus with granulation and fibrosis,in some sites the esophageal tissue began to proliferate towards the lumen where the fibroblasts were in the state of active proliferation and secretion .The contents of hydroxyproline and total amino acid were significantly higher in the esophageal tissue within 1 and 2 weeks of stenting than those in normal esophagus.At week 4 and 8 esophageal lumen narrowed conspicuously,with a lot of fibrotic tissue and a little of inflammatory cells.The staining density of collagen elevated gradually within 4 weeks,there after the content of collagen was stabilized.The change of P I CP and PⅢNP accorded with that of collagen staining.The content of AA at week 4 increased significantly compared with that at week 2,its level was similar to that between 4 and 8 weeks. Conclusions Re-stenosis mainly expressed as fibrosis. At week 4,8 the fibrosis stabilized gradually with the lessening of inflammatory reaction. The content of collagen in re-stenosis tissue elevated within 4 weeks,and stablilized after week 4,it was in accordance with the pathological changes of re-stenosis.