Embolic stroke of undetermined source ( ESUS ) refers to non-lacunar brain infarcts without definite proximal arterialstenosis or major cardioembolic sources.Paroxysmal atrial fibrillation may be the most important cause of ESUS, thus anticoagulation may be more effective than antiplatelet therapy for secondary stroke prevention to this group of patients.This paper reviews the latest progress on the definition, epidemiology, diagnostic approach, relation to atrial fibrillation and management of ESUS.

OBJECTIVE:To investigate the correlation of serum resistin and adiponectJn Ievels with bone mineral density(BMD)in 232 healthy male volunteers in Changsha area.METHODS:A totaI of 232 healthy Chinese men of Han population were selected randomly from Changsha area.All subjects gave their informed consent to participate in this study.Subjects were excluded from the study if they had conditions or received treatment that affecting bone metabolism.Serum adiponectin and resistin levels were determined by ELISA.BMD was measured by dual energy X-ray absorptiometry in total body,lumbar spine,and total hip.Body fat mass and lean body mass were measured by the whole body scanning.The correlation of serum adiponectin and resistin levels with fat mass and BMD at various sites were analyzed;the predictors of BMD at various sites was assayed using multiple linear stepwise regression analysis.RESULTS:Adiponectin was negatively correlated with fat mass(r=-0.216.P＜0.05),while resistin had no correlation with fat mass.The correlation disappeared after adjustment for age and fat mass(r=-0.006,P＞0.05).The significant negative correlations between adiponectin and BMD were found,and remained significant after adjustment for age and fat mass.There was no correlation between resistin and BMD at various sites.In the multiple linear stepwise regression analysis.adiponectin was an independent predictor of BMD in men.CONCLUSION:Resistin js not correlated with fat mass and BMD at various sites.Adiponectin is correlated with fat mass,and has a negative correlation with BMD at various sites,it is an independent predictor of BMD in Chinese men.

AIM: To compare the effect of trabeculectomy and combined surgery of glaucoma and cataract treating primary angle-closure glaucoma ( PACG) with cataract. METHODS: It was retrospectively reviewed that 80 patients (90 eyes) with PACG and cataract were treated in our hospital from January 2012 to October 2013. They were divided into observation group ( combined surgery of glaucoma and cataract group, 45 eyes ) and control group ( trabeculectomy group, 45 eyes) . Postoperatively, all the patients were followed up for 6mo. Intraocular pressure ( IOP ) , visual acuity and complications were observed.
RESULTS: Compared to preoperative IOP, postoperative IOP was significantly reduced in both observation group and control group, while IOP was reduced more greatly in observation group (P=0. 003). Visual acuity was significantly improved in observation group, while it was not improved significantly in control group ( P = 0. 036 ). Compared to control group, complications such as shallow anterior chamber with hypotony, macular edema and anterior chamber inflammation were less observed in observation group, with significant statistical difference ( P=0. 002, P=0. 003, P=0. 001).
CONCLUSION: For patients with PACG and cataract, combined surgery of glaucoma and cataract is an effective surgery that can improve visual acuity and reduce IOP with fewer complications.

Objective To investigate the clinical effect of three kinds of dose of pulmonary surfactant (PS) in neonatal respiratory distress syndrome (NRDS), and to determine the optimal dose. Methods One hundred and seventy-four cases of NRDS were divided into A group (59 cases), B group (57 cases) and C group (58 cases) according random digits table. Based on the conventional treatment, children in A group were given large dose of poractant alfa injection 250 mg/kg, children in B group were given 200 mg/kg, and children in C group were given 100 mg/kg. After treatment for 1, 6, 12 and 24 h, the arterial oxygen saturation (SaO2), inspired oxygen concentration (FiO2), arterial oxygen tension (PaO2), oxygenation index (OI), arterial/alveolar oxygen tension ratio (a/APO 2), ventilator using and oxygen using time and the incidence of complication were compared. Results After treatment for 12,and 24 h, the levels of SaO 2 in A group and B group were significantly higher than those in C group: 0.936 ± 0.018, 0.935 ±0.019 vs. 0.857 ±0.027;0.941 ±0.017, 0.946 ±0.015 vs. 0.847 ±0.053, and there were significant differences (P<0.01). After treatment for 12 and 24 h, the levels of SaO 2 in A group and B group had no significant differences ( P>0.05). After treatment for 1, 6, 12, and 24 h, the levels of FiO 2 and OI in A group and B group were significantly lower than those in C group, and the levels of PaO 2 and a/APO2 in A group and B group were significantly higher than those in C group. There were significant differences (P<0.01). The levels of FiO2, OI, PaO2 and a/APO2 in A group and B group had no significant differences ( P>0.05). The ventilator using time in A, B and C group were (108.6±23.5) , (119.6±32.8), (156.3±27.3) h, and there were significant differences (P<0.05 or<0.01). The oxygen using time in A and B group had no significant difference ( P>0.05). The oxygen using time in C group was significantly longer than that in A and B group: (186.5 ± 52.8) h vs. (148.7 ±24.4), (154.6±28.2), P<0.01. The incidence of complication in A and B group had no significant difference ( P>0.05).The incidence of complication in C group was significantly higher than that in A and B group:29.31%(17/58) vs. 13.56%(8/59), 12.28%(7/57), P<0.05. Conclusions Poractant alfa injection 200 mg/kg is optimal dosage for poractant alfa injection in the treatment of NRDS, and it can effectively improve oxygenation and ventilation function, reduce the incidence of complication, shorten the course of disease and improve the prognosis and increase the cure rate. Excessive dose is waste, and little dose can not get effective treatment.

Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Humans ; Kidney Diseases ; therapy ; Nephrotic Syndrome ; therapy ; Rituximab

Drug metabolism will change significantly during inflammation, including the reduction of expression and activity of many drug metabolizing enzymes and transporters. Body would release a series of inflammatory cytokines which can regulate drug metabolizing enzymes. Recent studies have revealed that drug transporters are also regulated by the cytokines with obvious species difference. Mechanism studies show that several transcription factors play important roles during the signal pathways of regulation. This review focuses on the progress in the regulation of drug transporters during inflammation.

Regulation of the activity of CYP450 has always been research focus of drug metabolism. The effect of compounds on the mRNA and protein expression level of CYP450 is the main purpose of most of the existing reports. In recent years, the protein modification in the posttranslation level has been found to participate in maintaining the proper function of CYP450, thus effect of posttranslational modification on the enzyme activity has been paid more and more attention. Posttranslational modifications including phosphorylation, nitration, and ubiquitination have been described to regulate the activity of CYP450. In this paper, recent developments in the effects of posttranslational modifications on the activity of CYP450 have been reviewed.

Nuclear receptors pregnane X receptor (PXR) and constitutive androstane receptor (CAR) are originally characterized as transcription factors regulating many target genes. Recent works have revealed that these nuclear receptors play critical roles in regulating genes that encode drug metabolism enzymes and modulating hepatic energy metabolism, such as down-regulating gluconeogenesis, fatty acid oxidation, and ketogenesis, as well as up-regulating lipogenesis. Studies on PXR and CAR have important implication on drug-drug interaction (DDI) and potential disease treatment targets.

Liver perfusion technique has been used in drug study for many decades. Liver perfusion has outstanding advantages over other techniques, such as isolated hepatocytes, hepatic cell lines, and hepatocyte membrane vesicles.It is an ideal experimental model used in drug metabolism, drug-drug interactions, and pharmacokinetic studies. Liver perfusion technique, its advantages or disadvantages, and its extensive applications have been reviewed.

Abstract: Objective　To monitor and analyze the avian influenza virus contamination in the environment outside the poultry-related places in Guangxi, and to assess the risk of human infection with avian influenza viruses, so as to provide a scientific basis for the prevention and control of avian influenza in Guangxi. Methods　From 2021 to 2022, environmental samples from 5 kinds of poultry-related sites were collected monthly in 14 cities of Guangxi. The real-time fluorescent quantitative RT-PCR method was used to detect the nucleic acids of generic influenza A viruses, and H5, H7, and H9 subtypes of avian influenza virus. The detection results of avian influenza virus in the environment of the poultry-related sites in Guangxi were collected for retrospective analysis. SPSS 22.0 was used for data analysis, and the chi-square test was used to compare the rates. Results　From 2021 to 2022, a total of 5 960 environmental samples were collected in 14 cities, of which 3 918 were positive for influenza A virus nucleic acid, with a positive rate of 65.74%; Among the positive samples, 281 were positive for H5 subtype (7.17%), 2 508 were positive for H9 subtype (64.01%), 552 were positive for H5+H9 subtype (14.09%), 577 were positive for type A but not H5/H7/H9 (14.73%), and no subtype H7 was detected. The positive rate of influenza A in poultry-related environment samples was higher throughout the year in Guangxi; except for Wuzhou, which had a similar number of H5, H9, and A non-H5/H7/H9 subtypes, the H9 subtype was predominantly detected in other cities. There was significant variability in positive rates among different regions, with the highest being in Hezhou City (90.32%, 653/723) and the lowest in Yulin City (28.96%, 75/259). The positive rate of different specimen types ranged from 50.32% to 74.94%. There were statistically significant differences in the positive rates of samples from different types of samples (χ2=163.08, P<0.001), different months (χ2=172.69, P<0.001), different regions (χ2=498.86, P<0.001), different monitoring sites (χ2=370.01, P<0.001). Conclusions　There is severe contamination of avian influenza virus in the poultry-related environment in Guangxi, predominantly with the H9 and H5 subtypes. Therefore, the relevant authorities in Guangxi should strengthen the monitoring, management, and disinfection of poultry-related premises.