It was believed that there were only two patterns of cell death named after necrosis and apoptosis in the past.With the progress of research,scholars have found that there also existed other cell death patterns.However,the mechanisms and relationships between cell death patterns are still unclear,especially in the neuronal cell death.This review focuses on the cell death patterns and their relationships during ischemic stroke,in order to provide the theoretical basis and new ideas for the further study of neuronal cell death,and for the treatment of ischemic stroke.

OBJECTIVE To investigate the genotypes of meticillin-resistant Staphylococcus aureus(MRSA)and its resistance.METHODS A total of 73 MRSA clinical isolates were collected in Anhui Province,MIC of sixteen different antibacterial agents against the isolates were determined by agar dilution method.PCR amplified the mec associated hypervariable region(HVR)of MRSA,and the genotypes were classified based on the fragments of amplified products.The correlation of genotypes and antimicrobial resistance was analyzed.RESULTS Seventy three strains of MRSA from Anhui Province were grouped into A,B and C genotypes based on HVR polymorphism,and respectively 17.8%,23.3%,and 58.8%.All strains were sensitive to vancomycin.CONCLUSIONS MRSA is multi-drug resistant and can be divided into 3 genotypes based on the HVR PCR amplified products.HVR PCR method is a rapid and convenient method for molecular epidemiology study of MRSA infections.

Objective To investigate the distribution and antibiotic resistance of the pathogens isolated from blood culture . Methods Identification and antimicrobial susceptibility testing were performed with MicroScan WalkAway 96 PLUS or VITEK 2 compact .WHONET 5 .6 software was used for analysis of the susceptibility data according to CLSI 2013 breakpoints .IBM SPSS 20 .0 was employed to compare the resistance rates between groups . Results Gram-positive bacteria , gram-negative bacteria and fungi accounted for 57 .8% ,36 .0% and 6 .2% of the 503 nonduplicate isolates ,respectively .The most common isolates included coagulase-negative Staphylococcus , Escherichia coli , Enterococcus spp ., Staphylococcus aureus and K lebsiella pneumoniae . The prevalence of methicillin-resistant S . aureus (MRSA ) and coagulase-negative Staphylococcus (MRSCN) was 32 .3% and 71 .7% respectively .The coagulase-negative Staphylococcus isolates from ICU patients showed higher resistance rates to many antibiotics than those non-ICU strains (P<0 .05) .E .coli and K .pneumoniae strains showed high percentage of resistance to cephalosporins , but relatively low resistance to piperacillin-tazobactam , imipenem and amikacin .A .baumannii isolates were highly resistant to most antimicrobial agents . Candida species were less resistant to antifungal agents .Conclusions The pathogens isolated from blood culture are diverse .The resistance profile is quite different among various pathogens .The distribution and antibiotic resistance should be actively monitored for the pathogens isolated from blood culture in order to facilitate the rational use of antimicrobial agents .

Objective To determine the risk factors of nosocomial infections caused by Enterococcus,and to develop effective protective measures.Methods A retrospective study was conducted among 193 patients who had been infected by Enterococcus from Jan.2011 to Dec.2011 in the First Affiliated Hospital of Anhui Medical University.Clinical data were collected and related risk factors for enterococcal infection were screened.Results The risk factors for enterococcal infection included biliary tract surgery (OR=1.264,95％CI:1.141-1.401,P =0.000),drainage tube intubation (OR=1.619,95％CI:0.301-4.190,P=0.010),urinary tract intubation (OR=2.001,95％CI:1.739-3.803,P 0.000),uses of third generation cephalosporin (OR=2.085,95％CI:1.181-3.682,P=0.011) andcarbapenems (OR=1.473,95％CI:1.060-2.023,P =0.024).Furthermore,biliary tract surgery (OR=4.861,95％CI:3.029-7.802,P=0.000) and urinary tract intubation (OR=2.737,95％CI:1.764-4.246,P=0.002) were risk factors for both Enterococcus faecalis and Enterococcus faecium infection,while drainage tube intubation (CR =1.861,95％CI:1.702 1.911,P=0.038),uses of the third generation cephalosporin (OR=1.122,95％CI:1.022-1.224,P=0.016) and carbapenems (OR=3.051,95％CI:1.185-7.855,P=0.021) were independent risk factors for Enterococcus faecium infection.Conclusions Surveillance

Objective To report clinical features,diagnosis and treatment in a case of adult onset Still's disease (AOSD) accompanied by demyelinating encephalopathy.Methods We reported a case of Stills disease with signs of encephalopathy.We also reviewed and discussed the literature on the neurological manifestations in AOSD.Results The 35-year-old patient had recurrent fever and arthralgias for 3 years,headache for 1 month and transient loss of consciousness.Laboratory tests showed non-specific immunological activity.MRI showed tumor-like lesions at left parietal and occipital lobes surrounded by sleeve-like edema.The lesion had significant occupation effect.Biopsy proved the presence of demyelinating changes.The patient recovered favorably after administration of corticosteroids and immunoglobulin.The lesions had almost disappeared on follow-up MRI 4 months later.Conclusions Demyelinating encephalopathy may develop in patient with AOSD.MRI may show tumor-like damage,which is rarely reported in the literature.Diagnosis depends on history,clinical manifestation and neuroimaging.Biopsy provides important information in making diagnosis.Treatment with corticosteroids and intravenous immunoglobulin was found to achieve good recovery.

BACKGROUND: We can investigate mechanism of endogenous neuroprotection in rat cerebral hypoxic tolerance trial. OBJECTIVE: To observe the characteristics of cerebral hypoxic tolerance in rat models with cerebral hypoxic preconditioning. DESIGN: Randomized controlled observation. SETTING: Department of Neurology, China-Japanese Friendship Hospital, Jilin University. MATERIALS: The experiment was performed in the Basic Animal Experimental Center, China-Japan Friendship Hospital, Jilin University from April 2003 to April 2004. Inbred line healthy Wistar rats, of either sex, with the body mass of 200-300 g, were randomly assigned into normal control group (n=6), sham operation group (n=6), ischemic control group (n=20), hypoxic preconditioning (3 hours, 8% O2 and 92% N2) plus ischemic group (n=60) (according to different hypoxic phases, there were 5 time phases: 30 minutes, 1, 3, 5 and 6 hours with 12 rats in each time phase), hypoxic preconditioning group (n=18) [according to different hypoxic phases, there were 3 time phases: 1, 3 and 5 hours with 6 rats in each time phase, 3 rats received TTC staining and 3 rats received hematoxylin and eosin (HE) staining]. METHODS: ①Hypoxic preconditioning: Firstly, natrica calx was put into closed glass container to absorb CO2 and O2, secondly, mixed gas of 8% O2 and 92% N2 was input, and then animals were put into the container, 3 rats each time. Temperature and humidity were kept steadily. ②Permanent ischemic middle cerebral artery rat models were established. ③The models were determined with a series in procedures: neurological score, infarcted volume evaluation, pathological sample preparation, immunohistochemical staining, imaging analysis and so on. ④The data were compared in groups with variance analysis.MAIN OUTCOME MEASURES: Changes in cerebral infarcted volume, neurological score and pathological morphology in rats of experimental group and control group. RESULTS: Neurological score in the hypoxic preconditioning (8% O2, at hours 1, 3 and 5) plus ischemic group was lower than in the ischemic control group(P＜0.01). Neurological score at minute 30 and hour 6 after hypoxia (8% O2) had insignificant difference in the ischemic control group. Mean cerebral infarcted volume ratio in the hypoxic preconditioning (8% O2, at hours 1, 3 and 5) plus ischemic group was lower than in the ischemic control group(P＜0.01). Mean cerebral infarcted volume ratio after hypoxia (8% O2, at minute 30 and hour 6) had insignificant difference with ischemic control group (P＞0.05). CONCLUSION: Hypoxic preconditioning in rats can effectively release nerve injury induced by focal cerebral ischemia, suggesting that it has protective effect on brain. The procedure of establishing cerebral ischemic tolerance models with hypoxic preconditioning, which is simple and stable, with little injury on experimental animals, is a useful tool for studying cerebral ischemic tolerance.

Objective To investigate the distribution and drug resistance of pathogens isolated from urinary tract infections.Methods A total of 6 262 midstream urine samples were collected from patients in the First Alfiliated Hospital of Anhui Medical University during April 2012 and March 2013.MicroScan WalkAway 96 Plus or Vitek 2 Compact system was applied in bacteria identification and drug sensitivity test.WHONET 5.6 was adopted to analyze drug resistance,and IBM SPSS 20.0 was applied to compare resistance rates between isolates from outpatients and hospitalized patients.Results A total of 1 426 strains were isolated,in which 370 strains were gram-positive coccus (25.9％),942 strains were gram-negative bacilli (66.1％) and 114 strains were fungi (8.0％).Escherichia coli and Klebsiella pneumoniae,Enterococcus faecium and Enterococcus faecalis were the top two among gram-negative bacilli and grampositive coccus,respectively.The prevalence of extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis were 60.5％,51.0％ and 30.3％,respectively; About 73.3％ of Staphylococcus aureus strains and 86.7％ of coagulase-negative Staphylococcus strains were methicillin-resistant.Candida albicans and Candida glabrata were the two most prevalent fungi in urinary tract infections,and they were sensitive to most antifungal agents.Conclusion Gram-negative bacilli,especially Escherichia coli are the most prevalent pathogen in urinary tract infections,and strains are highly resistant to most antibacterial agents,suggesting that antimicrobial resistance monitoring system is needed.

OBJECTIVE To investigate the distribution and the resistance rate of Shigella in Anhui Province to guide the choice of antibacterials. METHODS Ninety one strains of Shigella were cultured in Sep 2005.The groups were identified by biochemical and serologic tests.Susceptibility of 91 strains of Shigella in Anhui to various antibiotics was tested using standardized custom dilution MIC panels according to CLSI(2005) guidelines. RESULTS There were 57 strains of Shigella flexneri,31 strains of S.sonnei and 2 strains ofS.boydii among 91 strains of Shigella.The resistance rates of Shigella to cefoperazone/sulbactam and piperacillin/tazobactam were remarkably lower than to other third generation cephalosporins.The susceptible rates to carbopenems were 100%.The resistance rates to ciprofloxacin lactate and pazufloxacin mesilate were 27.47% and 32.97%,respectively. CONCLUSIONS There is a certain resistance rate of the Shigella to fluoroquinolones and the third generation cephalosporins.More attention should be paid to the surveillance and control of such resistance.

Objective To investigate the distribution and the antibiotic resistance profile of clinical isolates in the First Affiliate Hospital of Anhui Medical University during 2015.Methods Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method and automated systems.Results A total of 5 524 nonduplicate clinical isolates were collected during 2015,including gram-negative bacteria (3 882,70.3 ％),gram-positive bacteria (1 642,29.7 ％).The prevalence of methicillin-resistant isolates in Staphylococcus aureus (MRSA) and coagulase-negative Staphylococcus (MRCNS) was 57.6％ and 83.0 ％,respectively.All staphylococcal isolates were susceptible to vancomycin and linezolid.E.faecalis and E.faecium accounted for 46.1％ and 46.8 ％ of enterococcal isolates.Some E.faecalis and E.faecium strains were nonsusceptible to vancomycin or linezolid.The prevalence of extended-spectrum lactamases (ESBLs) positive strains was 62.0 ％ in E.coli,32.2 ％ in Klebsiella and 18.8 ％ in Proteus mirabilis.Enterobacteriaceae strains were still highly susceptible to carbapenem antibiotics,evidenced by lower resistance rate of Enterobacteriaceae strains to ertapenem,imipenetn and meropenem (a11＜22 ％).Conclusions It seems that antibiotic resistance still poses a serious threat to clinical antimicrobial therapy.More attention should be paid to resistance surveillance and rational use of antibiotics.

Objective:To investigate the expression of MKK 4 protein in the nasopharyngeal carcinoma and its clinical significance.Methods:Immunohistochemical methods were employed to analyze MKK 4 positive expression intensity and positive cells in freshly collected nasopharyngeal carcinoma of both 90nasopharyngeal carcinoma cases and 20 chronic nasopharyngitis control.The clinical pathological characteristic were analyzed.Results:The data obtained by MKK4 immunohistochemistry showed that the MKK 4 positive rate was higher in control group than in the NPC group (95.5%vs 75.6%,P<0.05).The expression of MKK4 was related to tumor differentiation and lymph node metastasis ( P<0.05 ) , but not to gender , age, tumor volum and TNM stage ( P>0.05 ) . Conclusion:Positive rate of MKK4 protein in nasopharyngeal carcinoma tissues is lower than in chronic nasopharyngitis.MKK4 protein expressions in nasopharyngeal carcinoma tissues negatively correlated with lymph node metastasis ,clincal stage ,invasive depth ,and TTP (Time to progression),but not with age,gender,location and tumor volume.