Objective To investigate the effects of circadian rhythm on interictal epileptiform discharges in patients with localization-related epilepsy.Methods Patients diagnosed with epilepsy in Sanbo Brain Hospital from January 2011 to January 2012 participated in this study.All patients were subjected to comprehensive evaluation,which included prolonged video-electroencephalogram (EEG),magnetic resonance imaging.Intracranial electrodes,PET,SPECT were also adopted if necessary.Circadian rhythm was divided into four stages:REM,NREM Ⅰ-Ⅱ,NREM Ⅲ-Ⅳ,and waking.The amount and distribution of ⅡD were compared by ANOVA.Results Significant differences in the amount and distribution of ⅡD were found among NREM Ⅰ-Ⅱ,NREM Ⅲ-Ⅳ,REM,and waking.However,no differences in the amount and distribution of ⅡD were noted between NREM Ⅰ-Ⅱ and NREM Ⅲ-Ⅳ as well as between REM and waking.Conclusion The amount of ⅡD is higher in NREM than in REM and waking;thus,NREM is more sensitive to diagnose epilepsy.The distribution of ⅡD in REM and waking is more restricted than that in NREM.

Objective To investigate the prevalence of mcr-1 gene,a plasmid-mediated polymyxin resistance gene,in Escherichia coli(E.coli) strains isolated in Dongyang of Zhejiang Province and to under-stand the epidemiological characteristics of E.coli strains carrying mcr-1 gene in order to provide local clini-cians with a theoretical basis for prevention and control of the spread of mcr-1-bearing E.coli strains. Meth-ods A total of 315 E.coli strains were collected in the People′s Hospital of Dongyang, Zhejiang Province from January to December 2016. All strains were isolated from specimens of blood,urine,respiratory tract, etc. PCR was performed to detect the genes confering resistance to polymyxin (mcr-1 gene), β-lactamase and carbapenem. Minimal inhibitory concentrations (MIC) of antibiotics against mcr-1-positive strains were determined by micro-broth dilution method. Conjugation test was performed to confirm whether the mcr-1 gene was located on the transferable plasmid. Multilocus sequence typing (MLST) was used for molecular typing of mcr-1-positive strains. Results Five mcr-1-positive strains were identified from 315 E.coli strains with a positive rate of 1.6%. Two out of the five mcr-1-positive E.coli strains contained β-lactamase resist-ance genes,blaTEM-1and blaCTX-M-14. Both of them were resistant to the first, second and third generation of cephalosporins and one was also resistant to cefepime. All of the five mcr-1-positive E.coli strains were sen-sitive to ciprofloxacin and levofloxacin,but resistant to ticarcillin/clavulanic acid. No carbapenem resistance genes were detected. One transconjugant was successfully obtained by transconjugation assay. MLST analysis showed that a total of four sequence types were identified, including ST131 (two strains), ST43 (one strain),ST69 (one strain) and ST349(one strain). Conclusion Only 1.6% of all E.coli strains isolated in Dongyang area of Zhejiang Province carry mcr-1 gene,indicating that there is no epidemic of mcr-1 gene-positive E.coli infection. The coexistence of mcr-1 gene and β-lactamase resistance genes in E.coli strains isolated in Dongyang suggests that local clinicians should avoid antibiotic abuse to prevent the spread of drug-resistant E.coli.