Tuberous sclerosis complex (TSC) is a rare autosomal dominant neurocutaneous disease.Epilepsy is the most common manifestation.Studies show that even with a variety of antiepileptic drugs, more than 50％ of TSC related epilepsy are drug-resistant.Since cortical tubers are the main epileptogenic foci, resection surgery become an important treatment of intractable epilepsy in TSC.In recent years, with the development of electrophysiology and imaging technology, surgical treatment of epilepsy in TSC shows a great efficacy of controlling seizures and improving intelligence.Up to date, there are no standard procedures of surgical treatment for refractory epilepsy in TSC.This paper aimed to provide some instructions.

At present, there are still problems in medical postgraduate education in our country such as backward concept, disconnected basic research and clinical transformation, as well as imper-fect cultivation system and evaluation system. Translational medicine conception has been generally accepted and practiced, and provides a new thinking for medical postgraduate education. As a result, medical postgraduate education should reform education model to resolve the disconnection between basic research and clinical application, build a multidisciplinary intersection translational medicine research guidance team, create a strong translational medicine research atmosphere, and the quantita-tive evaluation system and peer evaluation system of scientific research achievements, thus strengthen-ing medical graduate students' concept of translational medicine and their scientific research ability, to provide the necessary talent base to solve the major problems in medical science.

Objective To investigate the distribution of acquired carbapenemases in carbapenemresistant strains of Klebsiella pneumoniae, and explore its role in epidemiology of nosocomial infection. Methods From November 2008 to March 2009, twenty clinical isolates of carbapenem-resistant Klebsiella pneumoniae were collected from children hospitalized in Wuhan children's hospital. MICs of antibiotics were tested by DNA of Klebsiella pneumoniae. Modified Hodge test was used to screen strains producing carbapenemases,combined imipenem(IPM)-EDTA , meropenem(MEM)- EDTA and ceftazidime(CAZ) - EDTA double-disk synergy test (DDST) were used to detect metallo-β-lactamase-producing. PCR amplification of the carbapenemase and integrase genes, and sequencing were performed. Plasmid conjugation transfer experiments and Southern hybridization were applied to study the mode of drug resistance transmission. Results Four types of Klebsiella pneumoniae were detected by PFGE, type A consisted of 5 strains, including 3 strains of type Al and 2 strains of type A2), type B (2 strains), type C (12strains) and type D (1 strain). Type A and C were the main drug resistant clones. Eight strains of Klebsiella pneumoniae carried both KPC-2 and IMP-4 genes, 10 strains carried IMP-4 gene, 2 strains carried KPC-2 gene. None of NDM-1 ,GIM, SPM, SIM, OXA-23, and VIM carbapenemase genes was detected in 20 isolates. All of 20 isolates carried lntl which were found to be located on bacterial chromosome by Southern blot. Conclusions KPC-2and IMP-4 genes are the major carbapenemase genes in Klebsiella pneumoniae isolated in Wuhan.Transmission of drug resistance is mainly through vertical transmission of type C resistant clone and horizontal transmission of Intl on bacteria chromosome.

Objective To verify the best treatment strategy in reducing prostate specific antigen (PSA) progression and death rate in patients with locally advanced prostate cancer by a meta-analysis. Methods The literature search strategy was followed according to the Collaborative Review Group search strategy. Published data of randomized clinical trials comparing radical prostatectomy (RP) plus adjuvant therapy to either RP alone or other treatment were analyzed. Both fixed effect model and randomized effect model were applied and odds ratio (OR) with its 95% confidence interval (95% CI) was also used as the effect size 'estimate. Results Eight clinical trials were chosen with total in-volved cases of 3826. There were 5 trials compared post radical prostatectomy plus adjuvant hormonal therapy with radical prostatectomy alone. PSA progression was used as the indicator of progression and the combined OR was 0.86 (95%CI 0.48-1.56). There were 3 trails compared the combination of radical prostateetomy with hormonal therapy and radical prostatectomy alone. Disease specific death rate was used as the evaluating criteria and the OR was 0.72(95%CI,0.51-1.02). Conclusion RP plus adjuvant hormonal therapy can reduce PSA progression of patients with locally advanced pros-tate cancer, but it has no significant effect on disease specific death rate.

Objective To study the pathologic changes of hippocampus during the model development and explore the mechanism of epileptogenesis by observing the morphologic changes of hippocampal formation in rat of kainate-induced chronic temporal lobe epilepsy (TLE). Methods Thirty Wistar rats were injected of Kainic acid at dose of 2 ?g/20 ?l into the lateral cerebral ventricle under the guidence of stereotactic technique to make a epileptic focus, and subgrouped under acute phase, silent period and chronic phase. Another 10 rats received normal saline as controls. The rats were killed at 1 day, 15 day and 6 months after epileptic model establishment, and the hippocampus was taken out for HE staining, TUNEL staining, Timm’s staining, NSE staining. Results By cell counting, the neuron loss mainly occurred in acute phase, worst in CA3 and CA4, moderate in CA1 and CA2, and no loss in the dentate gyrus. The cell apoptosis in hippocampal structure was detected by TUNEL staining. Timm’s staining showed that mossy fiber began sprouting in silent period and increased continuously. Conclusion The morphologic changes of hippocampal formation in rat of kainate-induced TLE is mainly the neuron loss and the glia hyperplasy.

Objective To investigate the molecular epidemiology of CRAB isolated from children in wuhan. Methods Forty non-repetitive strains of CRAB were collected from hospitalized children of emergency department, neonatal medicine, cardiothoracic surgery, bone surgery, respiratory medicine and renal medicine in Wuhan children's hospital during December 2008 and May 2009. MIC values were PFGE; KPC, IMP, GIM, SPM, SIM, OXA-23, VIM genes and integrase gene were amplified by PCR and then sequenced to confirm the genotypes.; Plasmid conjugation experiment was used to study the transfer method of bacterial resistance and southern blot hybridization was used to target the resistance genes. Results Susceptible rates of 40 strains to gentamicin, tobramycin, amikacin, ciprofloxacin, levofloxacin, trimoxazole were 20%, 5%, 93%, 93%, 95%, and 23% respectively. Eleven types of clone were detected by PFGE,including 29 strains of type A clone, 2 strains of type B clone, and 1 strain for each type of C to K clone. Eleven isolates produced both IMP-4 and OXA-23 carbapemase. Twenty-six isolates only possessed OXA-23 carbapemase. Thirty-six strains carried class Ⅰ integron. The results of southern blot hybridization showed that Intl, IMP-4 and OXA-23 type were located on chromosome. Conclusions Type A clone of CRAB is the most common. OXA-23 and IMP-4 type are the major acquired carbapemases, especially the OXA-23 is the most common type. The horizontal transmission of OXA-23 and IMP-4 gene mediated by Int1 and the spread of type A resistant clone is the major way of the spread of carbapenem-resistant Acinetobacter baumannii in the region.

Objective To improve the quality standard of Anti- virus Oral Liquid. Methods Rhizoma Anemarrhenae and Rhizoma Acori tatrinowii in Anti- virus Oral Liquid were identified by TLC. Forsythin in Fructus Forsythiae was determined by HPLC. Results Rhizoma Anemarrhenae and Rhizoma Acori tatrinowii can be identified by TCL. The linearity of forsythin in the range of 0.1～ 0.6 ? g/? L was good, r=0.9998. The average recovery is 99.87 % , RSD=1.93 % . Conclusion The methods is accurate, reliable and specific and can be used for the quality control of Anti- virus Oral Liquid. 

Objective The fingerprint of volatile components from three breeds of Radix Curcumae was compared to supply evidence for the standard of quality control of Radix Curcumae.Methods Gas chromatography was used to establish fingerprint of Radix Curcumae and GC-MS chromatography was applied to identify its characteristic peaks. The similarity of fingerprint was evaluated by computing method.Results The fingerprint had its similarity and characteristics in different breeds of Radix Curcumae. The fingerprint detection is a good method for identifying Radix Curcumae,RSD 2.53 %.Conclusion This method is simple and effective for identifying different breeds of Radix Curcumae and can be used to control the quality of medicinal material of Radix Curcumae.

Objective To investigate the roles of endoscopic biopsy and third ventriculostomy in the diagnosis and treatment of pineal region tumors in children. Methods Endoscopic biopsy and third ventriculostomy were performed in 9 pediatric patients with pineal region tumors. Results Successful third ventriculostomy, confirmed by MRI, was performed in 9 cases of children with obstructive hydrocephalus. No complications were found in all patients. Conclusion Endoscopic biopsy and third ventriculostomy are effective neuroendoscopic procedures in minimally invasive preferential management of pineal region tumors.

Objective To investigate the effect of midazolam on human sperm motility in vitro.Methods Sperm samples were obtained from normal adults and prepared with discontinuous percoll gradient centrifugation technique.The samples were randomly divided into 3 groups (n =10 each):control group and 2 midazolam groups.The samples were incubated with normal saline in control group and with midazolam with the final concentrations of 5 or 1 μg/ml in 2 midazolam groups.The samples were incubated for 60 min in an airtight container at 37 ℃.Then human sperm motility was examined in vitro at 37 ℃ and analyzed by the computer-assisted sperm analysis at 10,30 and 60 min exposure to midazolam,including sperm motility (a + b)％,curvilinear velocity,straight line velocity,average path velocity,amplitude of lateral head displacement,beat-cross frequency,linearity,wobble,straightness,and mean angular displacement.Results There was no significant difference in the parameters of human sperm motility within each group and between groups (P ＞ 0.05).Conclusion Midazolam has no significant effect on human sperm motility in vitro.