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

AIM:To investigate the transcriptional regulating function of the catalytic subunit(GCLC)gene of ?-glutamylcysteine synthase(?-GCS),the rate-limiting enzyme of glutathione(GSH)synthetic enzymes.METHODS:The regulating region of the human GCLC gene was cloned by PCR method to construct the wild type plasmid,which expressed luciferase reporting gene.Many mutated plasmids expressing luciferase reporting gene were also constructed by the method of exonuclease Ⅲ with S1 nuclease.The transcription regulation of GCLC gene was investigated by transient transfection of the wild type and the mutated plasmids through the observation of relative activities of luciferase.RESULTS:We found that the-2 515～-2 236 bp,-864～-838 bp,-769～-538 bp,-421～-341 bp regions upside from the transcriptional start site up-regulated the gene transcription are the new positive transcription-regulating regions and the-810～-769 bp(especial the-782～-769 bp)region is the negative transcription-regulating region,which is more precise than ever.CONCLUSION:The results of this experiment provide one good foundation to study the transcription management of the GCLC gene and GSH synthesis.

Objective The clinical efficacy of pancreatic stent in treating chronic pancreatitis was summarized. Methods The stents were applied in 14 patients with chronic pancreatitis and ductal stricture manifested clinically and roentgenographically. Postoperative abdominal pain, changes in appetite, body weight and fat in stools were observed in follow－ ups. Results The stents, 5～ 10F in caliber, were successfully placed in all patients with first attempt. They were followed up for 210 days ( ranging 28～ 520 days ). The early (3 months ) results showed that the pain remitted in 13/14 (92.9％ ) and 11/13 (84.6％ ) of cases respectively. While abdominal pain persisted in 2 cases inspite of the stents. Along with pain remission the appetite and presence of fat in stools improved associated with increase in body weight. The stents drainage maintained for a median to 256 days (ranging 90～ 520 days) Transient hyperamylasemia occurred in 3 cases. Translocation and occlusion of the stent was found in 1 occasion each on the 98 and 520 day respectively. No other serious complication was detected. Conclusion It is assumed that pancreatic stent is effective to treat chronic pancreatitis with ductal stricture.

Objective To evaluate the usefulness of cytologic examinations of pancreatic duct brushing obstained during ERCP in diagnosis of pancreatic neoplasms. Methods In 27 patients with suspected manlignancy, cytologic examinations of pancreatic duct brushing during ERCP were performed. Results The positive rate of brush cytology was 55.6%.The results were affected by the location of lesion, correct cytodiagnoses of cancer were 69.2% in cancer at the head of the pancreas and 60% in cancer of the body. The accuracy rate of ERCP was 77.8%.However, by combining these 2 methods, the accuracy rate rose to 100%. Conclusion Our results confirm the significance,safety,and usefulness of the cytologic specimens obtained at the time of ERCP for the diagnosis of pancreatic neoplasms.

Objective To study the technique of double stent drainage on biliary and pancreatic ducts obstruction,and to assess its clinical effectiveness.Methods Firstly,ERCP was done on all patients to investigate the locus and extent of the stricture or obstruction,in order to choice the stent with suitable diameter and length.Then the stents placed into biliary and pancreatic ducts though the guidewires those was inserted into the ducts already.After the operation,the level of serum amylase and clinical symptoms such as jaundice,abdominal pain and diarrhea were observed to assess the therapeutic effect.Results 14 patients diagnosed as biliary and pancreatic ducts stricture or obstruction were treated successfully with this method(5 patients suffered from ampulla cancer,4 carcinoma of head of pancreas,3 carcinoma of duodenum papilla,2 chronic inflammation of head of pancreas).Thirteen patients were placed with 14 plastic biliary stents in their biliary ducts(each was placed with one stent except one with 2 stents),and one patient was placed with metal stent.At the same time,14 pancreatic stents were placed into pancreatic ducts of these patients.The rate of jaundice extinction in 2 weeks,1 month and 3 months after the operation was 50 percent,71 percent and 93 percent respectively.The rate of abdominal pain remission in 2 weeks after operation was 75 percent.Among 7 diarrhea patients ,the clinical symptoms disappeared in 5 patients and were significantly improved in 2 patients one month after the operation.The obstruction and displacement of stents had not been observed in all patients within 3 months after the operation.The complications related to operation had not been observed in all patients within 3 months after the operation.Conclusions The therapy with double stent drainage in biliary and pancreatic duct stricture is safe and effective.It can relieve jaundice and abdominal pain,decrease biliary pressure and improve the exocrine dysfunction of pancreas.

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.