Objective To study the histopathological characteristics and the correlations between the cortical tissues from ictal discharge (ID) area and interictal epileptiform discharge (IED) area in epilepsy patients due to focal cortical dysplasia (FCD), in order to further discuss the mechanism of epileptogenicity. Methods Twenty-two subjects who underwent epilepsy surgeries consecutively in our institute since April 2005 to August 2006. All patients underwent intracranial electrode implantations and long-term video-EEG monitoring before the resective surgeries and the postoperative pathologies proved to be FCD. According the long-term EEG monitoring results, the cortex with intense IED and the cortex with ID onset were resected separatively in the operation for further histopathologic studies. Twenty cases were collected. Based on the Palimini' s pathologic subtype classification for FCD as well as quantificational scoring for immunocytochemistry for the calcium-binding protein parvalbumin (PV) which we designed by ourself, the specimens of IED and ID were studied and compared. Results The resected specimens from 20 cases were examed. ID specimens showed more severe abnormalities in the laminar cortical architecture, alterations in the morphology of neurons and in the appearance of abnormal balloon cells. With the PV quantificational scoring, we found significant difference between IED (6.4±2.1) and ID (4.4±1.8) from FCD Ⅱ specimens (P=0.042). No difference was found between ID subtypes (F=2.734, P=0.093 ). Conclusions ID cortical area showed more severe abnormalities in histopathologic changes than lED area. Our results suggested that the ID area of FCD had more severe damage in inhibitory synaptic circuits and neural networks, which meant it was more epileptogenic than IED. No difference was identified between each ID subtype in term of epileptogenicity, which meant all of them should be resected during the surgery.

Objective An epidemiological study was conducted to investigate the prevalence of female breast disease and risk factors in Tongzhou District of Beijing,providing objective data to prophylaxis of the disease in this area.Methods A questionnaire survey was done in 1 575 females aged 18-60 years in Tongzhou district of Beijing by a cluster random sampling method.Clinical breast examination,near- infrared scanning,colour ultrasound,X-ray and other adjunctive examinations were performed in these subjects for diagnosis of the disease.The subjects were divided into breast disease group and normal control group.And then a case-control study was conducted for risk factor analysis of female breast disease.Results Breast disease was found in 303 of 1 575 females,most in 30-50 years,the incidence being 19.2％.Breast hyperplasia was found in 270 females,breast fibroma in 5,other benign breast disease in 25,and breast cancer in 3,Breast disease was found related to education level,menopause time,history of breast hyperplasia and annoyance.Conclusions Female breast disease is related to age,education and menopause.History of breast hyperplasia and negative emotion are risk factora of the disease.Attention should be paid to breast health care and healthy life style,decreasing incidence of the disease.

Objective To explore the clinicopathological features and imaging characteristics of non-Langerhans cell histiocytosis in central nerve system,thus to facilitate the diagnosis and differential diagnosis.Methods A total of ten cases were enrolled in the study,with seven cases of Rosai-Dorfman disease(RDD) and three cases of xanthoma disseminatum (XD).Data on the clinicopathological features,imaging,immunophenotype and prognosis were collected and analyzed.Results Seven patients with RDD,5 males and 2 females with the mean age of 46.7 years old,all presented as dural-based or intraparenchymal hypo-to isointense lesions on T1 and T2 with post-contrast enhancement.The polymorphous admixture of histiocytes,lymphocytes and plasma cells was observed in a fibrous stroma,with emperipolesis of some histiocytes.The immunohistostaining of CD11c,CD68,MAC387 and S-100 was positive in the histiocytes,while the staining of CD1α was negative.Five patients recovered after the operation,while one patient died of the disease.All the 3 XD patients were female,with the median age of 20.7 years old.All XD patients presented as multiple intraparenchymal hypointense lesions on T1 and hyperintense lesions on T2 with post-contrast enhancement.The infiltration of foam-like histiocytes,a few Touton giant cells,lymphocytes and eosnophils was observed in all XD patients.The immunohistostaining of CD68 and CD11c was positive in the histiocytes and that of MAC387 partly positive,while the staining of S-100 and CD1α was negative.One XD patient survived well,while another one died of the disease.Conclusions The diagnosis of RDD and XD should be based on their typical morphology and immunophenotype and should be differentiated from Langerhans cell histiocytosis and other non-Langerhans cell histiocytosis.Non-Langerhans cell histiocytosis in central nerve system often presents untypical clinical presentation and imaging features,thus the communication and cooperation between clinician and pathologist is needed.

at model is an ideal MS model for clinical MRI study.

Objective To investigate the clinicopathologic features of the brain tissue from multilobar resection or hemispherectomy for refractory epilepsy. Methods The clinical and pathologic findings of 46 cases seen at Xuanwu hospital from 2005 to 2009 were reviewed retrospectively. Results The mean age of seizure onset and disease duration were 3.9 years and 10.2 years, respectively. There were 33 cases of hemispherectomy and 13 cases of multilobar resection. Temporal lobe abnormality was seen in all cases. The pathologic subgroups were as follows: ulegyria (31/46), malformation of cortical development (MCD, 7/46 ) and infection (8/46). Microscopic examination of ulegyria showed cortical architectural disturbances, neuronal loss, reactive gliosis and appearance of corpora amylacea. We also noted deposition of hemosiderin (13 cases), calcification (9 cases) and island-like neurons (5 cases). All ulegyria cases were accompanied by varying degree of cortical dysplasia, and hippocampus sclerosis were identified in 7 cases. MCD comprised of 5 cases of focal cortical dysplasia ( FCD), including 3 cases of FCDⅠB, 1 case of FCDⅡA and 1 case of FCDⅠA, 1 case of polymicrogyria and 1 case of porencephaly. Among 8 infection eases, there were 5 cases of Rasmussen encephalitis ( RE), l case of cysticercosis, 1 case of tuberculous meningitis and l case of Cytomegalovirus encephalitis. Conclusions The most common pathological category of specimens from hemispherectomy or multilobar resection is ulegyria with obvious temporal lobe abnormality. This is followed by MCD ( with FCDⅠB as the main type) and central nervous system infection (RE as the most frequent abnormality).

Previous studies have demonstrated that the Chinese medicine paeoniflorin, derived from the Ranunculaceae plant peony, peony, purple peony root, was able to have anti-inflammatory, anti-ulcer, anti-hypersusceptibility and anti-oxidation activity. In order to elucidate the pesticide effect and the mechanisms by which paeoniflorin exerts its effect of anti-inflammation and immunoregulation on oxazolone-induced colitic mice, disease activity index (DAI) and histological grading of colitis (HGC) were evaluated in animal model. Moreover, the expressions of HBD-2, IL-6 and IL-10 of mice with experimental colitis were observed with immunohistochemistry and RT-PCR in this study. Results showed that DAI and HGC of oxazolone control group was significantly higher than that of normal control group, and that paeoniflorin groups and 5-ASA group, compared with oxazolone control group, could alleviate the symptoms and histological damages of colitic mice (P < 0.05, P < 0.01). The expression of HBD-2 and IL-6 cytokine on the colon of colitic mice was higher than that of normal control, paeoniflorin and 5-ASA groups (P < 0.05, P < 0.01), but the expression of IL-10 is lower than that of normal control, paeoniflorin and 5-ASA groups (P < 0.05, P < 0.01). The positive correlations were demonstrated between the expression of (HBD-2 and IL-6) and DAI (Pearson r = 0.728, Pearson r = 0.758, P < 0.01, respectively), (HBD-2 and IL-6) and HGC (Pearson r = 0.819, Pearson r = 0.825, P < 0.01, respectively), whereas, the negative correlations were demonstrated between the expression of IL-10 and DAI (Pearson r = -0.789, P < 0.01), IL-10 and HGC (Pearson r = -0.725, P < 0.01). It can be concluded that to some extent paeoniflorin effectively alleviate the symptoms of oxazolone-induced colitis through regulating the expression of HBD-2, IL-6 and IL-10.

Objective To study the locations of P-glycoprotein(P-gp),multi-drug resistanceassociated protein (MRP) and lung resistance.related protein(LRP)in brain tissue of focal cortical dysplasia (FCD) and to compare the quantity of these proteins in different brain tissues in an effort to study the mechanism of refractory epilepsy and to provide theoretical basis for medical treatment in patients with epilepsy.Methods The brain tissues of 16 cases with refractory epilepsy were collected during surgery,including 8 cases of focal cortical dysplasia type Ⅰ(FCD Ⅰ)and 8 cases of focal cortical dysplasia type Ⅱ (FCD Ⅱ) Five cases of glioma without history of epilepsy were included as the control group.Envision method was used to observe the location and intensity of expression of these three proteins.Western-Blot was used to analyze these proteins quantitatively.Results In brain tissue,the locations of P-glycoprotein,multi-drug resistance-associated protein and lung resistance-related protein were difierent.P-gp located mainly in capillary endothelial cells;MRP in neurons components;the location of LRP included capillary endothelial cells,balloon cells and the matrix of lesions.The expressions of three proteins in brain tissue of FCD were significantly higher than in control group(P-gp:0.520 ±0.121,MRP:0.132±0.018,LRP:0.092.±0.018,U=0.000,P<0.01).The expressions of P-gp and LRP in lesions of FCD Ⅱ(3.809 ±0.842 and 0.655±0.303,respectively)were higher than that in surrounding regions(2.636 ±0.622 and 0.290±0.096,U value were 6.000 and 4.500,both P<0.01).Conclusions P-gp,MRP and LRP expressed at different position of focal cortical dysplasia,suggesting that their roles were distinctive.

Objective To investigate the elinieopathologie features of refractory epilepsy. Methods The clinical and pathologic features of refractory epilepsy of 273 cases undergoing surgical treatment in Xuanwu Hospital from January 2005 to December 2007 were reviewed retrospectively. Results The mean age of seizure onset and disease duration were 11.0 years and 11.2 years respectively. The following pathologic subgroups were identified: malformation of cortical development (MCD, 158/273) including focal cortical dysplasia (FCD) type Ⅰ (104, the mean age of seizure onset and disease duration were 11.1 years and 11.2 years respectively), FCD type Ⅱ (30, the mean age of seizure onset and disease duration were 7. 9 years and 12. 7 years respectively) , mild MCD (6) , tuberous sclerosis complex (6) and other types (9) , brain turnouts (26/273, the mean age of seizure onset and disease duration were 14. 5 years and 6. 3 years respectively), ulegyria (63/273), brain infections (13/273), vascular malformation (3/273), cyst (3/273), cholesteatoma (1/273) and other unknown types (6/273). Dual pathology was identified in 31 of 158 MCD cases. Eighty-six of 134 (64. 2%) FCD cases were type Ⅰ B predominantly seen in temporal lobe. Twenty of 26 (76. 9%) brain tumours were mixed neuronal-glial tumours predominantly located in temporal lobe. Cortical dysplasia was often seen in these cases. Conclusions The 3 most common causes of refractory epilepsy are MCD, ulegyria and brain tumours. The predominant subtype of FCD is type Ⅰ B often located in temporal lobe, in which associated hippoeampal sclerosis is often seen. Brain tumors in patients with refractory epilepsy are almost benign neoplasms located in temporal lobe, in which the most frequent type is mixed neuronal-glial tumour.

Objective To observe the effect of electroacupuncture on urodynamic alteration in rats after complete T10 spinal cord transection.Methods Thirty-one female Sprague-Dawley rats were divided randomly into a sham operation group (n=10),a model group (n=11) and an electroacupuncture (EA) group (n=10).The spinal cords of the rats in the latter two groups were completely transected at the T10 level.Pressure was applied to the rats'lower abdomens every day while in the EA group electroacupuncture with continuous wave electricity was applied to the guanyuan (RN4) and sanyinjiao (SP6) acupoints for 15 min.The treatment was carried out daily for consecutive 7 days.Urodynamic examinations were carried out after the treatment course had finished.Results At the 9th day after the operation,average residual urine volume and bladder capacity in the EA group were both significantly lower than in the model group.Residual urine volume and bladder capacity were lowest in the sham operation group.Average voided volume and voiding rate in the EA group were significantly higher than in the model group.The average voiding rate was highest in the sham operation group.The average vesical pressure of the urine leak point and bladder compliance of the EA group rats were significantly lower than those of the model group The average vesical pressure of the urine leak point and bladder compliance of the sham operation group were lowest of all.All of these differences were statistically significant at the 1％ level of confidence.Conclusion EA can improve the lower bladder's detrusor reflex state and urinary tract function soon after complete T10 spinal cord transaction,at least in rats.

Objective To compare the expression and distribution of drug resistance proteins Pglycoprotein (P-gp) and lung resistance protein (LRP) in brain tissues of patients with refractory epilepsy and to investigate the relationship between expression of drug resistance proteins and concentration of antiepileptic drug carbamazepine (CBZ).Methods We included the brain tissues of 26 cases with refractory epilepsy who had in the experiment.They had following pathologic diagnosis: focal cortical dysplasia (FCD) Ⅰb (n =10),FCD Ⅱ a (n =4),FCD Ⅱb (n =2) and brain tumorsincluding ganglioglioma (n =6) and dysembryoplastic neuroepithelial tumor(n =4).Immunohistochemistry staining using EnVision system was used to reveal the expression location of P-gp and LRP,and Western blot in SDS-polyacrylamide gel was used to quantitatively analyze the expression of P-gp and LRP.Fluorescence polarization immunoassay was used to determine concentration of CBZ.Results Both P-gp and LRP performed(μg/ml) prominent overexpression in brain tissues of patients with refractory epilepsy,especially in the lesions of both FCD type Ⅱ (P-gp: 2.593 ±0.829 vs 1.711 ±0.292,t =-2.201,P=0.028;LRP:1.352 ±0.445 vs 1.179 ±0.593, t =-2.516,P =0.028, respectively)and tumor(P-gp:1.567 ±0.092 vs 0.775 ± 0.101, t =2.698, P =0.024; LRP: 1.091 ± 0.239 vs 0.825 ± 0.297, t =3.997, P =0.003respectively).The concentration of CBZ in lesions of brain tumors were lower than which in surrounding regions(0.848 ±0.726 vs 0.948 ±0.785, t =-3.056,P =0.014), while P-gp and LRP were higher than which in surrounding regions in 80％ cases.There was no relationship between expression of drug resistance proteins and concentration of CBZ.Conclusions In processing of drug resistance, P-gp and LRP play important roles.However, there is no correlation between expression of drug resistance proteins and concentration of CBZ, suggesting epilepsy drug resistance to be a complicated mechanism.