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 To investigate the clinicopathologic features of cerebral hemisphere ulegyria in children with refractory epilepsy.Methods The clinical and pathologic findings were reviewed in 26 children who underwent resection of lesion and epileptogenic lobectomy operation in the Neurosurgery Department of Haidian Hospital,Haidian District of Peking University Third Hospital,from January 2011 to August 2015,and pathological diagnosis was cerebral hemisphere ulegyria.Results All children including 19 male and 7 female had medically intractable seizures.The mean ages of seizure onset and disease duration were 3.93 years old (from 10 days to 12 years old) and 5.42 years (from 1 month to 13 years),respectively.Eight cases had seizures because of perinatal period injury,and 12 cases developed seizures owing to infancy injury and others had no cause of disease.The mean operation age was 9.35 years old (5-14 years old).Fourteen cases underwent multilobar resection and the whole corpus callosum incision,and 12 cases were given modified anatomical cerebral hemisphere resection.The pathological diagnoses of brain tissues were cerebral hemisphere ulegyria with focal cortical dysplasia(FCD) Ⅲ d and dual pathology.Seizure outcome after the operation revealed that 19 cases (73.08％) had an Engel grade Ⅰ,3 cases (11.54％)had an Engel grade Ⅱ,2 cases (7.69％) had an Engel grade Ⅲ,and 2 cases (7.69％) missed the follow-up.Conclusions Acquired brain injury during the period of infant can cause ulegyria and cortical dysplasia,resulting in intractable epilepsy.The treatment of improved anatomical cerebral hemisphere resection and multilobar resection is significantly effective.

Objective To evaluate the effect and safety of the argon plas ma coagulation (APC)a non－ touched technique via endoscopy. Methods Various po wer setting (40 W,60 W,80 W) at increasing exposure time (1 sec,3 sec,5 sec) wer e used during application of APC to different mucosa (gastric body and autrum) o f fresh stomaches gotten from 5 pigs.Histologic appearance and measurement of de pth and diameter of tissue necrosis area were examined through light microscope. Results Under the same power,the depth and the diameter were increased with th e exposure time increasing(P

Objective:To isolate genes related to benflumetol resistance in the rodent malaria P.berghei K173 strain.Methods:The mRNA differential display technique was used to identify differentially expressed genes between drug-sensitive P.berghei K173 strain and benflumetol-resistant strain selected under benflumetol pressure.Northern blot was performed in order to determine the genes actually derived from maternal strains.Results:PCR reactions were prepared respectively with twenty-four pairs of primers in each of the strains.Thirty-three differentially displayed genes fragments were cloned and eight of them were sequenced. The eight sequences were novel ESTs and were submitted to GenBank. Homology searching revealed that clone CB52 was slightly homologous to P.falciparum cyclophilin gene. Hybridization confirmed that the gene fragment CB52 was upregulated in the benflumetol-resistant parasite strain, while downregulated in the chloroquine-resistant strain.Conclusions:CB52 fragment was involved in the benflumetol resistance in P.berghei and the genetic mechanisms of drug-resistance to benflumetol and chloroquine were different.

Objective To investigate the techniques of laparoscopic retroperitoneal lymph node dissection(LRPLND)through extraperitoneal approach. Methods Seven non-seminomatous germ cell testicular tumor(NSGCT)patients of clinical stage Ⅰ underwent LRPLND through extraperitoneal approach.The average age was 31(27-39 years old),the average weight was 62 kg(weight 58-72 kg).Pathological examination revealed 2 testis mixed carcinoma(major of embryonal carclnoma and seminoma),2 yolk sac tumor,1 ehoriocarcinoma,2 teratoma with seminoma.Two of them were in right side,and 5 in left.All the chest X-ray,abdominal CT and bone scanning of them were normal before operation.All patients were general anesthetized.Three or 4 trocars were placed,from 2 of them two gasbags were used to expand the retroperitoneal space at volume of 800-900 ml.The retroperitoneal fat was cleared off from the surface of Gerota's fascia to iliac fossa and the plane spance betwwwn anterior rena fascia and posterior peritoneum was separated In the same way the Plane between dorsal renal and the surface of psoas major and quadratus lumborum unto iliae lossa was exposed.Abdominal aorta or vena cava was exposed,then divided and dissected free from surfaee of psoas maior.The conflux of renal vein and testicular vein at the deep face of renal artere(left)was exposed,then testicular vein was ligated and divided it at its end.Fat and lymph tissue between ureter and vessels was dissected to the crotch of abdominal aorta or inferior vena cava.The primary inguinal incision of testectomy was then excided.Normal antegrade ejaculation recovered in 1 month postoperatively. Results The initial 2 operations were converted to open way as the peritoneum were penetrated largely.The other 5 operations were successful.The average operating time was 285 min(245-350 min),intraoperative blood loss was 100-250 ml.Four patients'pathologic results accorded with clinical staging,and 2 positive lymph nodes were found in the other one.The average number of lymph node resected was 25.6 counts(22-31).Follow-up for 3-20 months,chest X-ray and abdominal CT revealed no evidence of recurrence or distant metastasis,and serum tumor markers were in normal range.Normal antegrade ejaculation recovered in 1 month postoperatively. Conclusions The technique through extraperitoneal approach could be applied for LRPLND.It might be an approach for diagnosis and treatment of stage Ⅰ NSGCT.

Objective To investigate the values of urine neutrophil gelatinase associated lipocalin (NGAL), kidney injury molecular-1 (KIM-1) and interleukin-18 (IL-18) in the diagnosis of acute kidney injury (AKI) in children after cardiopulmonary by-pass (CPB). Methods Sixty-seven patients who had undergone CPB were recruited from March to June 2013 and assigned to acute kidney injury group (AKI group) or non-acute kidney injury group (non-AKI group) according to the pediatric RIFLE (pRIFLE) cri-teria. Serum and urine samples were collected from each patient at 30 min, 2 h, 4 h, 24 h, 48 h and 72 h after CPB for serum and urine creatinine, urine NGAL, KIM-1 and IL-18. All the data were evaluated by receiver operator characteristic curve (ROC) analysis and area under curve (AUC) analysis. Results Twenty-three cases (34.3%) had AKI in 67 children after CPB. Among them 15 cases were risk-stage AKI, 4 cases injury-stage AKI, 3 cases failure-stage AKI and 1 cases loss-stage AKI. The levels of urine NGAL/Ucr were higher in AKI group than those in non-AKI group at 4h, 48h and 72h after CPB (P<0.05). The cut-off value of NGAL/Ucr was 1.200 at 4 h after CPB, the sensitivity and specificity for prediction of AKI were 0.864 and 0.561, and the AUC was 0.671 (95%CI:0.537-0.804). The levels of urine KIM-1/Ucr were higher in AKI group than those in non-AKI group at 48h and 72 h after CPB (P<0.05). The cut-off value of KIM-1/Ucr was 1.162 at 24h after CPB, the sensitivity and specificity for prediction of AKI were 0.773 and 0.512, and the AUC was 0.698 (95%CI:0.563-0.834). The levels of IL-18/Ucr were higher in AKI group than those in non-AKI group at 4 h after CPB (P<0.05). The cut-off value of IL-18/Ucr was 0.04 at 4 h after CPB, the sensitivity and specificity for predici-ton of AKI were 0.773 and 0.561, and the AUC was 0.655 (95%CI:0.510-0.800). Conclusions It is indicated that urine NGAL, KIM-1 and IL-18 may have important clinical values for early prediction of AKI.

Objective Sylvian Veins morphology analysis contributes to cortex veins protection for clear surgical fields, a better choice for operation plan evaluation. Methods 33 cases diagnosed as epilepsy, male∶female=19∶14, mean ages 18.7y (9-52). Results 4 types of Sylvian Veins spreading were observed from the procession of functional surgery: long stem pattern 49%(16/33), short stem pattern 15%(5/33), long truncks pattern 33%(11/33), and absent stem pattern 3%(1/33). Conclusion Sylvian Veins morphology analysis shows that there exist 4 main patterns, which may contribute to functional surgery about frontal operculum, temporal operculum and insular lobe or intracranial electrode placement.

Objective To screen gastric infiltrating carcinoma from gastric high grade intraepithelial neoplasia (HGIEN) checked again by regular gastroscopy and confocal laser endomicroscopy(CLE).Methods From January 2005 to December 2010,82 patients with endoscopic biopsy and the tissue pathological diagnosed HGIEN were collected at Department of Gastroenterology,Ruijin Hospital,Jiaotong University.61 male patients and 21 female patients were collected,of which 38 patients underwent common gastroendoscopy and the other 44 patients were underwent CLE besides common gastroendoscopy.The pathological diagnosis of endoscopic biopsy tissues were compared,and patients with indications were referred to surgery and pathological examination again.Results A total of 82 patients were confirmed by repeated examination,and there were 8 cases of inflammation or benign ulcers (24.4％),12 cases of low grade intraepithelial neoplasia (14.6％),10 cases of HGIEN (12.2％),52 cases of infiltrating carcinoma (63.4％).36 cases of differentiated carcinoma and 16 cases of undifferentiated carcinoma.Of the 21 infiltrating carcinoma cases diagnosed by CLE,17 cases (81.0％) were consistent with the pathological diagnosis.The consistent parameter value of κ between CLE diagnosis and pathological diagnosis was 0.7250.Conclusion It is necessary to make differential diagnosis of infiltrating cancer in patients with endoscopic biopsy and the tissue pathological diagnosed HGIEN.

Objective To explore the changes of nitric oxide (NO) and superoxide dismutase(SOD) in the serum and intestine mucosal and the treatment of ulcerative colitis(UC) with Tanshinone.Methods Seventy-nine patients with UC were randomly divided into the treatment group(group A,n=40) and the routine treatment group(group B,n=39).Patients in the group A were given Tanshionon and routine treatment.Patients in group B were given routine treatment.The levels of NO and SOD were measured in all patients before and after the treatment.The clinical symptom,enteroscopy,and hospital day were compared in the patients of the two groups.Twenty normal healthy controls(group C) were involved in the study.Results The NO level in the serum and intestine mucosal was significantly increased and the SOD level was significantly decreased in the patients with UC compared with those of the controls(all P