A lot of evidence shows that autophagy is involved in the occurrence and development of cerebral ischemia - reperfusion. Autophagy and its related signal transduction pathways may be an effective therapeutic target for ischemic brain injury. This article reviews related signal transduction pathways of autophagy regulation after cerebral ischemia.

Objective To explore the clinical efficacy of intranasal endoscopic turbinate fracture relocation press in treatment of chronic hypertrophic rhinitis.Methods According to digital table,66 patients with chronic hypertrophic rhinitis were randomly divided into two groups.33 cases in the observation group were treated with endoscopic sinus lateral fracture crush,33 patients in the control group received inferior turbinate submucosal injection of sclerosing treatment.The clinical effect was compared between the two groups.Results The total effective rate of the observation group was 93.9％,which was significantly higher than 72.7％ of the control group (x2 =6.23,P ＜0.05).The average nasal recovery time was (35 ± 12)d in the observation group,which was significantly shorter than (64 ± 21) d in the control group (t =1.74,P ＜ 0.05).The SCT test results had statistically significant differences between the two groups before treatment and 3 months after treatment (t =3.21,2.85,all P ＜0.05).After treatment,the difference was statistically significant between the two groups (t =2.13,P ＜ 0.05).Conclusion Endoscopic turbinate fracture relocation squeezing surgery in the treatment of chronic hypertrophic rhinitis was satisfied.

Objective To realize the incidence of healthcare-associated infection (HAI),the rate of invasive procedure and related infection rate,use of antimicrobial agents and distribution of pathogens in gereral intensive care units (GICUs) of hospitals in China.Methods HAI cross-sectional investigation data of GICUs reported to China HAI Surveillance Net-work were summarized and analyzed.Results Of 1 313 hospitals,621(47.30%)had GICUs;a total of 5 887 patients were surveyed,1 634 patients developed 1 962 times of infection,HAI prevalence rate and case rate was 27.76% and 33.33%respectively.The main infection sites were lower respiratory tract(70.39%),urinary tract (12.79%)and blood(2.86%). The application rate of urinary catheter,arteriovenous catheter and ventilator was 53.52%(n=3 151),37.05%(n=2 181) and 35.62%(n=2 097)respectively,and related prevalence of urinary tract infection,pneumonia and blood stream infection was 4.67%,20.41%,and 0.60%,respectively,which accounting for 58.57%,30.99%,and 23.21 % of urinary tract infection,pneumonia and blood stream infection respectively,the overall prevalence of above invasive procedure-re-lated infection accounted for 29.97%(588/1 962)of the overall HAI prevalence.A total of 1 795 isolated pathogens causing HAI were detected,the top three were Pseudomonas aeruginosa (20.78%),Acinetobacter baumannii(17.99%)and Klebsiella pneumoniae (11 .64%).The usage rate of antimicrobial agents was 71 .58%(n=4 214), rate of specimens delivered for detection was up to 75.27%(2 553/3 392).Conclusion Prevalence and antimicrobial use in patients in GICUs are all high,all kinds of invasive procedure are frequent,30% of HAI are related to inva-sive procedure;infection caused by non-fermentative bacteria is serious,pathogen detection is well performed.

Objective To explore application of pulse indicator continuous cardiac output(PICCO)in the treatment of septic shock during continuous renal replacement therapy (CRRT).Methods 34 patients with septic shock who underwent CRRT were randomly divided into the control group and the experimental group.Heart rate(HR),mean arterial pressure(MAP)and central venous pressure (CVP) were monitored in the control group.The experimental group were monitored by PICCO technology in addition to conventional monitoring,the hemodynamics parameters were collected such as end-diastolic volume index (GEDI),extravascular lung water index(EVLWI),and systemic vascular resistance index(SVRI),etc.Dehydration volume and supplementary volume were controlled by means of two group's hemodynamics parameters.The change of Acute Physiology And Chronic Health Evaluation-Ⅱ (APACHE Ⅱ),lactate (Lac),saturation of central venous oxygen(SevO2) and oxygenation index (PaO2/FiO2) were observed.Results After treatment of 72h,the decrease of APACHE Ⅱ and lactate in the experimental group was higher than those in the control group,the increase of ScvO2 in the experimental group was higher than those in the control group,the increase of PaO2/FiO2 in the experimental group was evidently higher than those in the control group.Conclusions During PICCO monitoring technique to guide CRRT therapy in patients with septic shock,the volume status of patients can be accurately controlled,organizational cycle can be improved,oxygenation of lung can be obviously improved,which contributes to treatment of septic shock.

Objective To investigate the expressions of protein kinase B (PKB/Akt) and glycogen synthase kinasc-3β in the hippocampus in mice with vascular dementia (VaD) induced by repetitive bilateral common carotid artery occlusion.Methods Forty-eight healthy adult male C57B1/6 mice were randomly allocated into 3 group:normal group,sham operation group,and model group (n =16 in each group).A mouse VaD model was induced by intermittent blocking the bilateral common carotid artery for 3 times in the model group.The sham group only separated the bilateral common carotid artery,but did not block it.The normal group did not receive any treatment.The behavioral changes of the mice were observed using the water maze and step-down tests at 4 weeks after procedure.HE staining was used to observe the histopathological changes of hippocampal tissue.The Western blotting was used to detect the expressions of Akt,p-Akt (Ser473),GSK3β and p-GSK3β (Ser9) proteins.Results In the water maze test,the time of swimming the entire distance was prolonged at the learning stage and memory stage (learning stage:F =19.389,P ＜0.05; memory stage:F =27.929,P ＜ 0.05),the number of errors increased (learning stage:F =7.228,P ＜ 0.05; memory stage:F =21.189,P＜0.05) in the model group.In the step-down test,the response time was prolonged (F=19.162,P ＜0.05) at learning stage and the number of errors increased (F =6.562,P ＜ 0.05),the latency time was shortened (F=10.634,P＜0.05) and the number of errors increased (F=12.890,P＜0.05) in the model group.At the same time,HE staining showed the reduction of neurons and the proliferation of glial cells in the hippocampal CA1 region in the model group; p-Akt (Ser473) (F=37.849,P＜0.05) and p-GSK3β (Ser9)(F =67.725,P ＜0.05) protein expressions were up-regulated significantly (F =37.849,P ＜0.05; F =67.725,P＜0.05) at 4 weeks after procedure compared to those in the sham operation group,while there were no significant differences in Akt (F =1.004,P ＞0.05) and GSK3β(F =0.329,P ＞0.05) total protein expressions among all groups.Conclusions The repetitive bilateral common carotid artery occlusion may result in learning and memory impairment and severe damage in the hippocampus in mice.The Akt and GSK3β expressions may be involved in the mechanism of VaD.

This study aimed to examine whether ophiopogonin D (OP-D) is capable of protecting cardiomyocytes against DOX-induced injury and the mechanisms involved. H9c2 cells were cultured. MTT assay was used to evaluate cell viability and toxicity. Mito-tracker as fluorescence probe was used to measure ROS content raised from mitochondria. The mRNA and protein expression of ATF6alpha, GRP78 and CHOP were analyzed using real-time PCR and Western blotting, respectively. The results showed that a significant endoplasmic reticulum stress (ERS) was induced upon exposure of H9c2 cells to DOX as indicated by the increase in the expression of ERS related proteins, which was paralleled with the accumulation of reactive oxygen species (ROS) and decrease in the viability of H9c2 cells. Whereas, DOX-induced ROS accumulation and up-regulation of ERS related proteins were partially abolished by pretreatment with OP-D. Consequently, a DOX-induced ERS was mitigated by application of OP-D. Similarly, DOX-induced decrease in cell viability was partially attenuated by either inhibiting CHOP or pretreatment with N-acetylcysteine (NAC), an antioxidant. Moreover, cardiac ultrastructural abnormalities seen in mouse receiving DOX injections were obviously ameliorated by pretreatment of OP-D. Taken together, the present study proved that OP-D protects cardiomyocytes against DOX-induced injury, at least in part, through reducing ROS accumulation and alleviating ERS.

Aim To observe the effect of methotrexate (MTX) on proliferation, migration and apoptosis of cultured vascular smooth muscle cells (VSMC). Methods Rabbit thoracaortic VSMC were cultured in vitro.VSMC proliferation was evaluated by cell counting and cell cycle analysis. Monolayer cell scrape was used to observe VSMC migration. Apoptosis was observed with flow cytometry, DNA gel electrophoresis and TUNEL stain. Results MTX (25～100 nmol?L -1) inhibited VSMC proliferation in a dose-dependent manner.25 nmol?L -1 and 50 nmol?L -1 MTX increased the percentage of the S phase cells and decreased the percentage of the G 2/M phase cells (P

Objective:To investigate the distribution and drug resistance of anaerobic bacteria in the patients with oral and maxillofacial infection.Methods:Aerobic and anaerobic bacteria cultures from 61 specimens of pus from the patients with oral and maxillofacial infection in the Department of Oral and Maxillofacial Surgery,Peking University School of Stomatology were identified.The culture type was evaluated by API 20A kit and drug resistance test was performed by Etest method.The clinical data and antibacterial agents for the treatment of the 61 cases were collected,and the final outcomes were recor-ded.Results:The bacteria cultures were isolated from all the specimens,with aerobic bacteria only in 6 cases (9 .8%),anaerobic bacteria only in 7 cases (1 1 .5%),and both aerobic and anaerobic bacteria in 48 cases (78.7%).There were 55 infected cases (90.2%)with anaerobic bacteria,and 81 anaero-bic bacteria stains were isolated.The highest bacteria isolation rate of Gram positive anaerobic bacteria could be found in Peptostreptococcus,Bifidobacterium and Pemphigus propionibacterium.No cefoxitin, amoxicillin/carat acid resistant strain was detected in the above three Gram positive anaerobic bacteria. The highest bacteria isolation rate of Gram negative anaerobic bacteria could be detected in Porphy-romonas and Prevotella.No metronidazole,cefoxitin,amoxicillin/carat acid resistant strain was found in the two Gram negative anaerobic bacteria.In the study,48 patients with oral and maxillofacial infection were treated according to the results of drug resistance testing,and the clinical cure rate was 81 .3%. Conclusion:Mixed aerobic and anaerobic bacteria cultures are very common in most oral and maxillofa-cial infection patients.Anaerobic bacteria culture and drug resistance testing play an important role in clinical treatment.

Objective:To explore a rapid and cost-effective method for identification of Candida gla-brata through the comparison of two different methods , using molecular methods of sequencing as gold standard.Methods:From our clinic, 200 strains of suspected Candida glabrata were collected during the last 3 years and selected after incubation in CHROMagar Candida medium for 48 h.By comparing the results of the CHROMagar Candida medium, the identification of the rapid trehalose test for different kinds of strains were analyzed under incubation in the tubes for 3 h, 6 h, and 24 h at 37 ℃and 42 ℃, respectively .All the strains were identified to species level by methods of sequencing .The optimal time and temperature of the trehalose test for the identification of Candida glabrata were assessed .Two different methods, CHROMagar Candida medium and the rapid trehalose test , in identification of Candi-da glabrata were compared.Results:In all the 200 strains, Candida glabrata ferment trehalose with 3 h incubation under 42 ℃ were the optimal time and temperature for fermenting trehalose .The accuracy , sensitivity, and specificity of the rapid trehalose test were 99.00% (198/200), 98.66% (147/149) and 100.00%(51/51).The accuracy rate of CHROMagar Candida medium was 79.50%(159/200), the sensitivity and specificity were only 89.93%(134/149) and 49.02%(25/51), however, compared with the domestic current popular methods , the rapid trehalose test had better time efficiency ratio .Con-clusion:The evaluation results suggest that the rapid trehalose test has advantages in terms of operational convenience and low cost , and the results can be obtained in 3 h.Therefore, it has application value in clinical laboratory .

Objective To explore the influence of smoking on clopidogrel resistance in patients with coro-nary artery disease. Methods A total of 216 patients with coronary artery disease who accept selective percutane-ous coronary intervention in our hospital from May 2015 to December 2015 were selected as study subjects;their average age was 63 years old ,146 were male and 70 were female. All the patients were divided into clopidogrel resistance group (CR group) and normal clopidogrel response group (NCR group) according to the results of platelet aggregation test. History of smoking ,alcohol drinking and diabetes mellitus ,baseline medication uses , level of platelet counts,platelet distribution width,mean platelet volume,HbA1c,and results of echocardiogram and coronary angiography were compared between the two groups. Results The rate of smoking was significantly higher in CR group than in NCR group (P < 0.05). The changed value of PDW before and after treatment with clopidogrel was smaller in CR group than in NCR group ,the difference was statistically significant (P < 0.05). Conclusions Smoking may be a protective factor for clopidogrel resistance. The changed value of PDW before and after treatment with clopidogrel can reflect the level of clopidogrel resistance.