Apathy is a common neuropsychiatric complication after stroke,the identification of apathy after stroke and its related factors and providing an effective intervention on it may contribute to the rehabilitation in patients with stroke.This article reviews the incidence of apathy after stroke,pathophysiological mechanisms,diagnostic evaluation and treatment.

Objective To study the gastroscopic and pathohistologic mucosal changes in children′s chronic gastritis and to improve the diagnosis of the chronic gastritis in children.Methods Two thousand four hundred and forty children with upper-abdominal symptoms who were examined by gastroscopic observation were collected,and samples of gastric mucosa were examined by the same pathohistologist.And then the pathohistologic changes were analysed.Results All the 2440 children had different mucosal inflammation confirmed by gastroscope,and the pathologic results show that there were 2132 cases of chronic superficial gastritis(90.03%) and 76 cases of chronic atrophic gastritis(3.21%).Among 2440 cases,80 cases with intestinal metaplasia(3.37%),972 cases with lymphoid follicles(41.05%),409 cases with active inflammation(17.28%),902 cases with helicobacter pylori(Hp) infection(38.09%).Moderate and severe inflammatory were more predominant in patients with Hp infection,especially with lymphoid follicles or active gastritis,and the percentage of them were 50.79%,68.73%,73.53%,respectively.Conclusions Major chornic gastritis in children are chronic superficial gastritis,and the pathohistological changes are different from the adults.It also shows that there is a close relationship between gastric mucosal inflammation and Hp.

Objective To study the relationship between the expression level of human telomerase reverse transcriptase (hTERT) protein and telomerase activity as well as its clinical significance in hepatocellular carcinoma (HCC). Methods Immunohistochemical SP method was employed to detect hTERT protein expression in 52 cases of HCC and paired adjacent tumor tissues, and telomerase activity was examined in these samples with telomeric repeat amplification-ELISA. Results The positive rates of hTERT protein expression and telomerase activity in HCC were 86.5%(45/52) and 80.8%(42/52), respectively, which were significantly higher compared with the adjacent tumor tissues(P

Background and purpose:Aberrant expressions of microRNAs (miRNA, miR)are reported in various cancers and may associate with cancer occurrence, development, invasion and metastasis, thereby functioning as either tumor suppressors or oncogenes. This study attempted to observe the expression of miR-214 in pancreatic cancer and to explore its clinical signiifcance.Methods:Real-time PCR was used to detect the miR-214 expressions between pancreatic cancer tissues and matched adjacent tissues. The correlations of miR-214 expression with clinic-pathological features and clinical prognosis were analyzed.Results:MiR-214 expression was up-regulated in 69.4%(25/36) of tumor tissue specimens. The relative expression level of miR-214 was signiifcantly higher in tumor tissues than in matched adjacent tissues (3.45vs 1.52,P<0.01). Higher miR-214 level was strongly associated with T3-T4 stage (P=0.018). The Kaplan-Meier analysis revealed that patients with higher expression of miR-214 had a shorter survival time (P=0.032).Conclusion:The expression of miR-214 is associated with clinic-pathological features and patient’s clinical prognosis, so it may be used as a potential diagnostic biomarker and a prognostic predictor in patients with pancreatic cancer.

Objective To investigate the effect of intracoronary application of tirofiban on coronary slow flow patients with acute myocardial infarction during primary percutaneous coronary intervention (PPC1).Method It was a retrospective analysis of 187 patients with acute myocardial infarction treated with PPCI in the emergency department of Beijing Anzhen Hospital enrolled in this study from January,2008 through January,2011.The patients divided into 2 groups in terms of intra-coronary administration of tirofiban (tirofiban group) and intra-coronary use of nitroglycerol (control group).Data were statistically analyzed by using SPSS 13.0 software.Categorical variables were analyzed using x2 test and continuous variables were compared by t test.Results Between two groups,there were no differences in preoperative systolic pressure (P =0.245),the rate of TIMI flow 3 (P =0.568) after PPCI and ST segment resolution (P =0.824),LVEF (P =0.275) and in-hospital mortality (P =0.502).Compared with tirofiban group,the systolic pressure was lower and the rate of using intra-aortic counter-pulsation was higher in control group.Although the incidence of slight bleeding in the control group was lower than that in the tirofiban group,no severe bleeding was observed in both groups.Conclusions The effect of intracoronary use of tirofiban was similar to that of nitroglycerol in terms of improving slow flow of coronary artery.It could safely and effectively reduce the incidence of the coronary slow flow in the patients after PPCI,but it produced a little impact on systolic pressure.It may be a better method of choice for AMI patient with low blood pressure.

Chloasma is a common pigmentation on facial skin among middle-aged or young women. The characteris-tic of chloasma is acquired brown spots on exposed facial regions. Modern traditional Chinese medicine (TCM) clini-cal treatment mostly follows syndrome differentiation and treatment as well as prescriptions of TCM doctors from pre-vious dynasties. On the basis of different facial location of chloasma, the author explored the correlation between the facial lesion location and five zang-organ under the guidance of TCM holism concept. The creativeness of combining division differentiation and channel pattern differentiation, and the application of channel tropism medicine, provide new ideas for chloasma treatment.

Objective Discuss the treatment effect of sodium ferulate,deproteinized calf serum and high pressure oxygen on acute carbon monoxide poisoning.Methods Seventy-five cases with coma acute carbon monoxide poisoning were randomly divided into two groups:the treated group (37 cases) and the control group (38 cases).The two groups were treated with high pressure oxygen,high flow oxygen uptake and support treatment,The treated group were treated with sodium ferulate and deproteinized calf serum.The control group were treated with citicoline act medicaments.Result The occurrence and injury degree of myocardial damage and delayed encephalopathy were markedly attenuated (P ＜ 0.05),the time of coma was obviously decreased (P ＜0.01),the death rate was obviously difference (P ＜0.05) in the treated group compared with the control group.Conclusion Sodium ferulate,deproteinized calf serum injection possess obviously effect on acute carbon monoxide poisoning.

Traditional Chinese medicine (TCM) diagnostic methods contain inspection, auscultation-olfaction, inter-rogation and palpation. The clinical doctor collects information through the four diagnostic methods. Various symp-toms of the disease are especially used as the main evidence to determine different diseases and to identify the syndrome. Therefore, the TCM four diagnostic methods are the basic means of disease understanding in TCM. This article collected and analyzed clinical data in order to summarize the unique features and focused aspects of TCM four diagnostic methods application on TCM surgery and dermatology. This article was aimed to provide new ideas for TCM four diagnostic methods in the clinical diagnosis of dermatological diseases.

Objective To explore the relationship of serum parathyriod hormone ( PTH) level with renal ane-mia in patients with chronic kidney disease (CKD).Methods Serum levels of PTH,Hb,Hct,BUN,Cr were observed in 126 patients with CKD at stages 3-5,the changes of 42 patients in maintenance hemodialysis(MHD) with recombi-nant human erythropoietin (rhEPO) and calcitriol-1.25(OH)2D3 treatment for three months were determined. Results The serum PTH level was significantly increased in CKD patients at stage 3 and more in CKD patients at stage 4 and 5.There were positive relationship between blood PTH and BUN ,Cr(P<0.01),but a negative relation-ship between PTH and Ccr,Hb(P <0.01).42 patients of MHD treated with rhEPO,1.25(OH)2D3 after three months,according to the changes of HCT ,the effective rate was 73.8% and the ineffective rate was 26.2%.The PTH,Hb,HCT of the effective group had statistically significant differences compared with the ineffective group ( all P<0.01).Hb and Hct significantly increased and PTH significantly decreased in the effective group .Conclusion CKD patients had decreased renal function ,elevated blood PTH .High serum PTH might aggravate renal anemia and fail to respond to rhEPO.The high serum PTH corrected by using 1.25(OH)2D3 might improve renal anemia,with high plasma PTH correcting .

Ischemic stroke is a catastrophic event in young adults. It may cause death,disability, incapacity and decline in the quality of life. When the neurologists are facing the suspected ischemic stroke in young adults, the greatest challenge of diagnosis is to identify the causes. This article reviews the risk factors, etiological diagnosis as well as its associated disorders and dysfunction in young adults.