Objective To investigate the distribution of blaOXA-51-like genes and the clonal relation-ship among Acinetobacter baumannii strains isolated from three teaching hospitals in Guangzhou , China. Methods Fifty-two Acinetobacter baumannii isolates were genotyped by multilocus sequence typing (MLST).eBURST algorithm was performed to define clonal complexes (CCs).blaOXA-51-like genes were am-plified by using polymerase chain reaction ( PCR) and sequenced .Results MLST grouped the A.bauman-nii isolates into 5 existing sequence types (STs) and 7 new STs.STn4 carried allele G1 with a T→C muta-tion at the 3rd nucleotide site (nt3) on the gpi111 locus.STn5 carried allele A1, possessing A→C muta-tions at nt156 and nt159 on the gltA1 locus.ST195 and ST208 accounted for 69.2%of all isolates.Clonal relationship analysis showed that ST 195 and ST208 belonged to CC92.Fifty-one A.baumannii isolates car-ried OXA-66 and the rest one carried OXA-199.Conclusion A.baumannii strains that belonged to CC92 and carried OXA-66 were the predominant genotype circulating in Guangzhou , China.

Objective Accumulating reports have suggested that hepatic stellate cells (HSCs) exhibit immunosuppressive ability and may be responsible for the occurrence and development of hepatocellular carcinoma (HCC).The mechanisms through which HSCs affect T-cell-induced adaptive immune responses and the relationship with the regulatory T cells (Treg cells) were studied.Methods We isolated HSCs from wildtype mice to demonstrate the influence of HSCs on T-cell proliferation and explored their effect on Treg cells through mixed leukocyte reactions (MLRs) in vitro.Results We found that activated HSCs could induce T-cell hyporesponsiveness in adaptive immune response by inhibiting the proliferation of T cells andincreasing the quantity of Treg cells.Conclusion Activated HSCs may lead to hypoergia of T cells in adaptive immune reaction and up-regulate the expression of Treg cells,thus facilitating immunotolarance.

Objective To investigate the efficacy of treatment of intracranial venous sinus thrombosis using systemic anticoagulation combined with endovascular intervention.Methods From May 2014 to January 2017,the clinical data of 52 patients with cerebral venous sinus thrombosis diagnosed with DSA and treated with micro catheter thrombolysis at the Department of Neurology,the Second Hospital of Hebei Medical University were analyzed retrospective.The microcatheters were indwelled for 3-14 d.The dosage of urokinase ranged from 10-20 thousand U/h,13 patients were also treated with balloon dilatation,and 1 was also treated with stent-assisted treatment.The results of imaging data and 6-month telephone follow-up were analyzed.The prognosis was evaluated with the modified Rankin scale (mRS) and National Institutes of Health Stroke Scale (NIHSS).Results In 52 patients admitted to hospital,the whole brain DSA showed sagittal sinus thrombosis in 34 cases,transverse-sigmoid sinus transitional zone thrombosis in 31 cases,inferior sagittal sinus thrombosis in 2 cases,straight sinus thrombosis in 3 cases,and cortical vein thrombosis in 14 cases.Angiography before discharge showed complete patency of the venous sinus in 9 cases,most patency in 42 cases,partial patency in 1 cases,the symptoms were relieved,and neurological function scores were improved at discharge in 48 cases.There were no obvious changes in 3 cases,and 1 case aggravated.The mRS and NIHSS scores before and after treatment were compared.The difference was statistically significant (Z =5.45 and 3.03 respectively,all P ＜ 0.05).Forty-eight patients were followed up for 6 months by telephone,no symptoms related to venous sinus thrombosis were found.Three patients died,and 1 died of traumatic intracranial hemorrhage.Conclusions Endovascular intervention is an effective and safe treatment for intracranial venous sinus thrombosis.It can be used as an alternative treatment scheme of internal medicine for patients of ineffective anticoagulation.

Objective To investigate the related factors of early neurological deterioration in eld-erly patients with thrombolysis for acute occlusive stroke of large intracranial vessels.Methods Clin-ical materials of 480 elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels were retrospectively analyzed.The National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the neurological function of patients within 72 hours after thrombectomy,and the pa-tients were divided into deterioration group and non-deterioration group.The baseline materials were compared between the two groups,the factors of early neurological deterioration were analyzed,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of risk.Results Among 480 elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels,92 cases(19.17％)had early neurological deterioration;the blood glucose level,white blood cell count,incidence of dysphagia,and incidence of coma in the deterioration group were sig-nificantly higher than those in the non-deterioration group(P＜0.05);the Logistic regression analy-sis showed that high level of blood glucose(95％CI,1.203 to 1.478),high level of white blood cell count(95％CI,1.159 to 1.408),dysphagia(95％CI,7.049 to 31.475),and coma(95％CI,8.375 to 43.195)were risk factors for early neurological deterioration in elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels(OR＞1,P＜0.05).ROC curve results showed that blood glucose,white blood cell count,dysphagia,and coma had certain predictive val-ue for early neurological deterioration in elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels[the area under the curve(AUC)was 0.733,0.708,0.707 and 0.701];the ROC curve showed AUC was 0.934,indicating that the model was reliable and stable.Conclusion Early neurological deterioration in elderly patients with thrombolysis for acute occlu-sive stroke of large intracranial vessels may be related to factors such as blood glucose,white blood cell count,dysphagia,and coma.Early risk assessment and relevant intervention measures can be taken clinically to improve prognosis.

Objective To investigate the related factors of early neurological deterioration in eld-erly patients with thrombolysis for acute occlusive stroke of large intracranial vessels.Methods Clin-ical materials of 480 elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels were retrospectively analyzed.The National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the neurological function of patients within 72 hours after thrombectomy,and the pa-tients were divided into deterioration group and non-deterioration group.The baseline materials were compared between the two groups,the factors of early neurological deterioration were analyzed,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of risk.Results Among 480 elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels,92 cases(19.17％)had early neurological deterioration;the blood glucose level,white blood cell count,incidence of dysphagia,and incidence of coma in the deterioration group were sig-nificantly higher than those in the non-deterioration group(P＜0.05);the Logistic regression analy-sis showed that high level of blood glucose(95％CI,1.203 to 1.478),high level of white blood cell count(95％CI,1.159 to 1.408),dysphagia(95％CI,7.049 to 31.475),and coma(95％CI,8.375 to 43.195)were risk factors for early neurological deterioration in elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels(OR＞1,P＜0.05).ROC curve results showed that blood glucose,white blood cell count,dysphagia,and coma had certain predictive val-ue for early neurological deterioration in elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels[the area under the curve(AUC)was 0.733,0.708,0.707 and 0.701];the ROC curve showed AUC was 0.934,indicating that the model was reliable and stable.Conclusion Early neurological deterioration in elderly patients with thrombolysis for acute occlu-sive stroke of large intracranial vessels may be related to factors such as blood glucose,white blood cell count,dysphagia,and coma.Early risk assessment and relevant intervention measures can be taken clinically to improve prognosis.