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 clinical pharmacodynamics and efficacy for endotracheal intubation of rocuronium and succinylcholine at different dosage. Method: Sixty adult patients under general anesthesia according to the different drugs and dosage, were randomly divided into four groups. In groupⅠorⅡ,2 or 3?ED_(95) rocuronium were administrated,and in group Ⅲ and Ⅳ, 2 or 3?ED_(95) succinylcholine were given respectively. The course of depression and recovery of twitch response of the adductor pollicis muscle were recorded, and intubating condition were assessed. Result:The intubation condition was excellent in all patients of group Ⅱ,but only in 20％ of group Ⅲ.The degree of twitch at maximal depression was similar between all groups. The lag time and the time of twitch reaching maximal depression were not significantly different between group Ⅱ,Ⅲ and Ⅳ, which were shorter than those of groupⅠ.The times of twitch recovery to 25％ and 95％ of baseline in groupⅠor Ⅳ were significantly longer than in groupⅠor Ⅲ, respectively. Conclusion: 3?ED_(95) rocuronium has similar onset time to 2 or 3?ED_(95) succinylcholine with the excellent intubation condition,but the clinical effective duration is more longer than that of 2?ED_(95) rocuronium.

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.

The research and quality control of traditional Chinese medicine has meaningful importance, because it has influence not only in the health and treatment of patients, but also in the solid growth and development of phar-maceuticals companies. In some cases, for the complex of TCM, the common QC method on single or multi-target compounds can't really and truly disclose the quality of the Chinese materia medica. Therefore, a lot of researchers do plenty of works to make clear the effectiveness basis, to improve the quality and realize the modernization of TCM. All of these works close together with modern analysis and separation technology. In this article, a novel analy-sis technology-UltraPerformance Convergence Chromatography (UPC2) based its characters and applications should be introduced. It should be a helpful technology for the TCM researchers to facilitate the study and QC works.

Early diagnosis and early intervention for cognitive impairment after ischemic stroke can delay disease progression and prevent the occurrence of dementia.This article reviews the advances in research on ischemic stroke caused each risk factor for cognitive impairment.

Objective To explore how to prevent biliary duct injury during laparoscopic cholecystectomy.Methods The clinical data of 484 cases of laparoscopic cholecystectomy from December 2002 to December 2007 were retrospectively analyzed,and the experiences of preventing biliary duct injury were summarized.Results No biliary duct injury case was found but 26 cases were converted to laparotomy during operation and 20 cases were placed drainage tube.Conclusion Familiar with the anatomy of bile duct,careful handling of the Calot's triangle are the keys to prevent biliary duct injury in LC.

Objective To explore the clinical effect of treatment for cholecystolithiasis and calculus of com-mon bile with duodenoscope and laparoscope. Methods 48 cases of patients with cholecystolithiasis and calculus of common bile duct were analysed, of whom 30 cases were treated by traditional operation, and 18 cases were treated by duodenoscope and laparoscope. The operation time, stay-in-hospital time after operation, the gastrointestinal function recovery time after operation, the degree of pain were compared. Results The cost of duodenoscope and laparoscope was higher than that of traditional operation group, but the other parameters were better ( P < 0.05 ). Conclusion Treating cholecystolithiasis and calculus of common bile duct with duodenoscope and laparoscope is safe, less traumatic and the patients may recover faster than routine treatment.

Background and purpose:Ethanol has been reported to stimulate progression of breast cancer, yet the underlying mechanism is not fully understood. This study aimed to investigate effects of ethyl alcohol (EtOH) on the calcium-activated neutral protease (CANP)-cyclin E/focal adhesion kinase (FAK) signaling and cell migration in breast cancer cells, as well as the role of epidermal growth factor receptor (EGFR) in the EtOH-stimulated effects, in order to assess the signaling mechanism(s) underlying how EtOH enhances cancer progression.Methods:Human breast cancer cell line MCF-7 was employed as a model system, with MCF-10A mammary epithelial cells as control. In vitro wound healing assay was carried out to evaluate EtOH-induced cell migration. The effects of EtOH or epidermal growth factor on the proteolysis of cyclin E/FAK were detected by Western blot. EGFR inhibitor (EGFR-I) and a speciifc inhibitor for CANP, Calpeptin, were applied to pretreat cultured cells to explore their inlfuences on the cell migration and cyclin E/FAK proteolysis triggered by EtOH.Results:Treatment of model cells with EtOH (0.3%) stimulated significant proteolysis of cyclin E/FAK in a dose-/time-dependent manner and increased migration (+47.30%,P<0.05) in MCF-7 breast cancer cells, but had no signiifcant effect on migration in MCF-10A cells. Pretreatment with Calpeptin (10 μmol/L) signiifcantly reduced EtOH (0.3%)- or EGFR (10 ng/mL)-induced cyclin E/FAK truncation. EGFR-I (3 μmol/L) pro-foundly reduced EtOH-indcued CANP dependent proteolysis of CANP1 and cyclin E/FAK as well as cell migration (-53.00%,P<0.01).Conclusion:EtOH signiifcantly stimulates activation of CANP via EGFR pathway, resulting in proteolysis of cyclin E/FAK and migration in MCF-7 breast cancer cells, suggesting EGFR-CANP signaling to be a potential target for suppression of metastasis in breast cancer.

Aim To study the effect of estrogen on the migration of breast cancer cells and the possible underlying mechanisms.Methods Human breast cancer cell lines MCF-7(estrogen receptor, ER+) and MDA-MB-468(ER-) were employed as a model system.Cells were treated with E2 and pretreated with CANP inhibitor(calpeptin)where needed.Wound-healing assay was applied to evaluate cell migration, Western blot assay was performed to observe protein level, and fibronectin expression was silenced by specific siRNA transfection.Results ① Treatmentof MCF-7 and MDA-MB-468 cellswith E2(50 nmol·L-1) increased cell migration by(51.55±5.50) ％(P<0.01)and (40.78±4.78)％(P<0.05), respectively;② E2 significantly up-regulated the expression of FN protein in MCF-7 and MDA-MB-468 breast cancer cells, which was 2.11 times(P<0.05)and 1.86 times(P<0.01), respectively;③ Pretreatment with calpeptin(10 μmol·L-1) decreased E2-induced cell migration by (49.55±6.44)％(P<0.05) in MCF-7 and(36.85±4.40)％ (P<0.01)in MDA-MB-468 cells;④ Calpeptin pretreatment inhibited E2-induced fibronectin up-regulation by(80.12±4.55)％ and(78.84±5.70) ％(P<0.01), respectively;⑤ Knockdown of FN with siRNA suppressed cell E2-induced migration by(40.65±5.80)％(P<0.01)in MCF-7 and(40.88±6.02)％(P<0.05)in MDA-MB-468 cells.Conclusion E2 stimulates the migration of breast cancer cells with or without ER expression and a calpain-FN signaling pathway may be involved in the E2 action.

Objective:To test the validity and reliability of the Perceived Stress Scale-14 items (PSS-14) applied in cancer survivors.Methods:Totally 652 cancer survivors (patients who had finished active treatments and were in convalescence) were selected and a field questionnaire survey was conducted among them.Exploratory factor analysis and confirmatory factor analysis were performed to test the construct validity of PSS-14.Correlation between the two dimensions (discriminant validity) and correlation between stress and quality of life were analyzed to further test its validity.The intemal consistency reliability,split-half reliability,retest reliability and sensitivity analysis were adopted to test the reliability of PSS-14.Results:Two common factors were extracted in the exploratory factor analysis.The cumulative percentage of variance explained was 60.8％.The index of confirmatory factor analysis were:TLI =0.92,CFI =0.93,SRMR =0.07,RMSEA =0.08.The correlation coefficient between the two dimensions of PSS-14 was-0.16 (P ＜0.001).The correlation coefficients between the score of PSS-14 and each dimension of EORTC QLQ-C30 were 0.24-0.55 (P ＜ 0.001).The Cronbach α coefficients of the whole scale and the two dimensions named "perceived coping ability" and "perceived distress" were 0.78,0.91 and 0.88 respectively.After the scale was split into two parts,the Cronbach α coefficients of each part were 0.66 and 0.60.The Spearman-Brown coefficient was 0.79.The Guttman split-half coefficient was 0.79.After one item was removed from the scale each time,the Cronbach a coefficients of the remaining items varied from 0.75 to 0.77.The retest reliability of the whole scale and the two dimensions were 0.89,0.86 and 0.85 respectively.Conclusion:PSS-14 shows favorable validity and reliability,suggesting the utility to assess stress of cancer survivors as a self-administered inventory.