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S pontaneous intracerebral hemorrhage (ICH) accounts for 10% to 15% of all strokes and is one of the leading causes of stroke-related mortality and morbidity worldwide. Patients with ICH are generally at risk of developing stroke-associated pneumonia (SAP) during acute hospitalization. Evidence has shown that SAP not only increases the length of hospital stay (LOS) and medical cost 1,2 but also is an important risk factor of mortality and morbidity after acute stroke. 3,4 Several risk factors for SAP have been identified, such as older age, 4-12 male sex, 5,6,10,11,13 current smoking, 12 diabetes mellitus, 6 hypertension, 14 atrial fibrillation, 7,10,12 congestive heart failure, 7,12,13,15 chronic obstructive pulmonary disease, 8,[12][13][14] preexisting dependency, 8,12,13,16 stroke severity, 5,6,8,12,17,18 dysphagia, [8][9][10][11][12]14,[18][19][20] and blood glucose. 12 Meanwhile, based on these risk factors, a few risk models have been developed for SAP after acute ischemic stroke. [8][9][10][11][12] Currently, no valid scoring system is available for predicting SAP after ICH in routine clinical practice or clinical trial. We hypothesized that there might be some common grounds for the development of pneumonia after acute ischemic stroke and ICH, and those predictors for SAP after acute ischemic stroke might also be useful for predicting SAP after ICH. For clinical practice, an effective risk-stratification and prognostic model for SAP after ICH would be helpful to identify vulnerable patients, allocate relevant medical resources, and implement tailored preventive strategies. In addition, for clinical trial, it could be used in nonrandomized studies to control for case-mix variation and in controlled studies as a selection criterion.Background and Purpose-We aimed to develop a risk score (intracerebral hemorrhage-associated pneumonia score, ICH-APS) for predicting hospital-acquired stroke-associated pneumonia (SAP) after ICH. Methods-The ICH-APS was developed based on the China National Stroke Registry (CNSR), in which eligible patients were randomly divided into derivation (60%) and validation (40%) cohorts. Variables routinely collected at presentation were used for predicting SAP after ICH. For testing the added value of hematoma volume measure, we separately developed 2 models with (ICH-APS-B) and without (ICH-APS-A) hematoma volume included. Multivariable logistic regression was performed to identify independent predictors. The area under the receiver operating characteristic curve (AUROC), Hosmer-Lemeshow goodness-of-fit test, and integrated discrimination index were used to assess model discrimination, calibration, and reclassification, respectively. Results-The SAP was 16.4% and 17.7% in the overall derivation (n=2998) and validation (n=2000) cohorts, respectively.A 23-point ICH-APS-A was developed based on a set of predictors and showed good discrimination in the overall derivation (AUROC, 0.75; 95% confidence interval, 0. Ji et al Risk Score to Predict SAP After ICH 2621In the study, we aimed to ...

The threat of antibiotic resistant bacteria has called for alternative antimicrobial strategies that would mitigate the increase of classical resistance mechanism. Many bacteria employ quorum sensing (QS) to govern the production of virulence factors and formation of drug-resistant biofilms. Targeting the mechanism of QS has proven to be a functional alternative to conventional antibiotic control of infections. However, the presence of multiple QS systems in individual bacterial species poses a challenge to this approach. Quorum sensing inhibitors (QSI) and quorum quenching enzymes (QQE) have been both investigated for their QS interfering capabilities. Here, we first simulated the combination effect of QQE and QSI in blocking bacterial QS. The effect was next validated by experiments using AiiA as QQE and G1 as QSI on Pseudomonas aeruginosa LasR/I and RhlR/I QS circuits. Combination of QQE and QSI almost completely blocked the P. aeruginosa las and rhl QS systems. Our findings provide a potential chemical biology application strategy for bacterial QS disruption.The emerging threat of antibiotic resistant bacterial pathogens has called for alternative strategies that could replace the usage of current antibiotics and minimize the development of resistance mechanism. One such strategy is to interfere with the bacterial signaling pathways governing the social behaviors involved in pathogenesis and drug-resistant biofilm formation 1 . Microbial organisms exhibit social behaviors and communicate with each other through quorum sensing (QS) [2][3][4] . By synthesizing small signal molecules, they respond collectively to regulate expression of virulence factors, biofilm development, secondary metabolite production, interactions with host and other microbes in a population-density dependent manner 5 . Targeting QS mechanisms has been put forward as an attractive approach to conventional infection control 1 .Acylhomoserine lactone (AHL)-based QS signals are found in more than 70 bacterial species, in which many of them are pathogens 3,6 . In most cases, the structures of the AHLs are conserved with a homoserine lactone (HSL) ring connected to an acyl group with different chain length (n = 4-16) 5,7 . Multiple AHL-based QS systems often co-exist in individual bacterial species. There are two AHL-mediated QS systems in the opportunistic

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Microglia are the representative myeloid cells in the brain, and their over-activation plays an important role in the pathogenesis of Parkinson's disease (PD). Microglia activation is believed to be regulated by the CD200-CD200R signaling. As the peripheral counterpart of microglia, monocyte-derived macrophages (MDMs) share the same progenitor and antigen markers, and they have similar biological behaviors and mirror microglial function in the brain. Here, we studied CD200R expression and its regulation in MDMs from 32 PD cases, 27 age-matched old controls, and 28 young controls. We found that the basal CD200R expression is similar in MDMs from young control, old control and PD patients. However, the induction of CD200R expression in MDMs under various conditions is impaired in the old groups, especially in PD patients. There was a selective decrease in CD200R expression induced by co-culture with dying PC12 cells in MDMs from PD cases, as compared with MDMs from the age-matched controls. We also found that the inducible CD200R expression correlated inversely with the onset age of PD and to tumor necrosis factor-alpha (TNF-alpha) released from MDMs. These results suggest an intrinsic abnormality in the CD200-CD200R signaling in MDMs during aging and, especially, in PD. We speculate that in the PD brain,microglia might undergo abnormalities similar to MDMs.