Objective To analyze the changes of drug resistance of Acinetobacter baumannii in our hospital during 2010-2012 to provide reference for clinical rational drug use and the effective control of Acinetobacter baumannii infection .Methods The drug resistance of Acinetobacter baumannii clinically isolated from 2010 to 2012 and its infection situation were retrospectively performed the statistical analysis .Results The clinical isolation rate of Acinetobacter baumannii in our hospital was increased from 218 cases (12 .19% ) to 741 cases (18 .48% ) in 2012 .The resistance rates of 18 kinds of antibiotics were almost more than 70% ,and pan-drug-resistant Acinetobacter baumannii appeared in some clinical departments ,such as ICU and neurology .The selective pressure of antibiotic was one of the main motive causes of drug resistance change ,and age ,underlying diseases ,duration of hospitalization and invasive procedures were the high risk factors in patients infection .Conclusion Hospital should enhance a series of measures including reinforcing the disinfection of the medical environment ,medical equipments and medical staffs ,strengthening the monito-ring of hospital infection and using antibiotics rationally to reduce and control the prevalence of Acinetobacter baumannii .

Objective To investigate the pathological features, distinguishment and diagnosis and prognosis of multiple cystic renal cell carcinoma. Methods Six patients with multilocular cystic renal cell carcinoma in our hospital from 2007 to 2010 were chosen and reviewed for analysis. All patients who were found to have mass after physical examina-tion, came to our hospital, and image examination was conducted, and pathological detection and immunohistochemical detection were conducted after surgical resection. All the results were recorded. After hospitalization, all patients were followed up for a period of five years, and prognosis was recorded. Results Among 6 cases of multilocular cystic renal cell carcinoma patients, there were three cases of male patients and three cases of female patients. Pathological exami-nation revealed the apparent limits of diseased region and normal part, the surface coating, no vascular invasion, and no metastasis. The average tumor diameter was (3.52士0.48) cm, and different cysts of varying sizes were visible in section, with visible bloody or serous liquid in cavities. Microscopic examination showed clear cell of monolayers lining in cysts, partially with papillary structures, and there were inflammatory cells in interval composed of fibrous tissue. Tumor cells included translucent pulp and stained chromatin. According to fuhrman nuclear grade, 5 patients were grade Ⅰ, and 1 patients was gradeⅡ. Immunohistochemical detections such as Vim and EMA were strongly positive, and CD68 and CD10 were negative. Six patients had no recurrence within 5 years, and 5-year survival rate was 100%, with good prog-nosis. It should be noted that multi-cystic renal cell carcinoma and other renal cystic diseases should be identified. Conclusion Pathological features of multi-cystic renal cell carcinoma are unique, and we should pay attention to iden-tification of multi-cystic renal cell carcinoma and other renal cystic diseases. The prognosis of multi-cystic renal cell carcinoma is good.

Objective:To investigate the immunological features of 135 patients with corona virus disease 2019 (COVID-19), and to provide reference for the pathogenesis of the disease.Methods:The clinical and laboratory data of 135 confirmed COVID-19 patients in Guangzhou Eighth People′s Hospital from January 23 to February 29, 2020 were collected. The features of lymphocytes (CD4 + and CD8 + T lymphocytes, B lymphocytes, natural killer cells and natural killer T cells), and cytokines (interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor (TNF)-α and interferon (IFN)-γ) of patients at a median of 19 (14, 27) days of admission were analyzed. Kruskal-Wallis test, Mann-Whitney U test, chi-square test and Spearman rank correlation were used for statistical analysis. Results:Patients were divided into three groups according to the relevant diagnostic criteria, including mild group (14 cases), ordinary group (92 cases) and severe group (29 cases). Decreased CD4 + T lymphocytes were found in 44.4% (60/135) patients, while decreased CD8 + T lymphocytes were found in 42.2%(57/135) patients. Compared to mild group and ordinary group, level of CD4 + T lymphocytes in severe group was significant lower ( Z=4.379 and 3.799, respectively, both P<0.01), and level of CD8 + T lymphocytes was also significant lower ( Z=2.684 and 3.306, respectively, P=0.022 and 0.003, respectively). Decreased B lymphocytes were found in 25.3% (24/95) patients and significant different among the three groups, with the lowest levels ((88(56, 189)/μL; Z=6.199, P=0.045) and most frequency of decreased levels ((52.2%(12/23); χ2=11.723, P=0.003) in the severe group. Compared to the mild group and the ordinary group, IL-6 level in severe group was significant higher ( Z=-4.022 and -4.108, respectively, both P<0.01) and IL-10 level was also significant higher ( Z=-3.261 and -4.006, respectively, both P<0.01). Similar levels of IL-2, IL-4, TNF-α and IFN-γ were found among three groups (all P>0.05). The IL-6 level was positively correlated with the persistence of viral shedding ( r=0.301, P=0.007). Conclusion:The immune-mediated inflammation may be the important cause of disease deterioration of COVID-19, which might be the key target of the treatment of severe cases.

Objective To investigate the association of serum ghrelin level with cognition, hippocampal volume, and proton magnetic resonance spectrum ( [ 1 H ]-MRS ) in patients with type 2 diabetes mellitus ( T2DM) . Methods The T2DM patients cared at the Wuhan Fourth Hospital were recruited. Data on demographic characteristics and clinical parameters were collected. Ghrelin was measured by ELISA assay. Cognitive performance was assessed by the Montreal Cognitive Assessment ( MoCA ) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The changes of metabolites in hippocampus were detected by [1 H]-MRS, including N-acetyl asparate ( NAA) , choline ( Cho) , myo-inositol ( MI) , creatine ( Cr) . All patients were divided into 2 groups[cognitive impairment (CI) and non-cognitive impairment (NCI) groups] by MoCA. Results (1) Compared with patients in NCI group, the serum ghrelin level, bilateral hippocampal volume, and NAA/Cr ratio of [1H]-MRS metabolites in CI group were decreased, but MI/Cr and Cho/Cr ratios were increased(all P<0.05). (2) Serum ghrelin was positively correlated with a variety of RBANS scores ( including immediate memory, attention, delayed memory, and total scores) , bilateral hippocampal volume, and NAA/Cr ratio of [ 1 H]-MRS metabolites in T2DM patients, but it was negatively correlated with MI/Cr ratio and Cho/Cr ratio ( all P<0. 05 ) . ( 3 ) Logistic regression analysis showed that ghrelin was a protective factor of cognition in T2DM patients. Conclusions T2DM patients with cognitive impairment had lower levels of ghrelin, and serum ghrelin was postively correlated with their cognitive performance, hippocampal volume, and [1 H]-MRS metabolites, suggesting that serum ghrelin may be involved in the occurrence and development of cognitive dysfunction in patients with T2DM.