ABSTRACT
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.
ABSTRACT
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 .