Objective: To investigate the changes of blood coagulation and fibrinolysis in patients with acute craniocerebral injuries (ACI) and to assess their relationship with patients' diagnoses and prognoses. Methods: A prospective study was performed using 528 ACI patients and 257 healthy controls taking a physical examination. The prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg), thrombin time (TT), platelet (PLT), and D-dimer (D-D) were observed within 6 h after injury. Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) were also employed and the statistical analysis was performed. Results: The incidence of abnormal blood coagulation and fibrinolysis in our group was 80.49% (425/528), with the abnormal indicators from high incidence to low were: D-D> PT> Fg> APTT > PLT>TT. (2) The levels of PT and D-D in ACI patients were significantly different from those of the control group (P<0.05); their levels increased with the aggravation of the severity of the injuries. Fg levels in the severe and moderate ACI patients were significantly different from that in the control group (P<0.05); there were no significant differences between the moderate inury group and the slight injuy group or between the slight injury group and the control group. The levels of APTT and TT were significantly different between the severe injury group and other groups(P<0.05). PLT levels were similar in all the groups. (3) Patients of GOS 1 and 2-3 had significantly increased PT, D-D levels and decreased Fg level compared with patients of GOS 4-5. Conclusion: ACI patients have abnormal coaculation and fibrinolysis function early after injury. PT,D-D and Fg are sensitive indices and may be helpful for early prediction of the injuries and prognoses.

Objective To investigate the effect of attention training on cortical activation area and lateralization index in interference effect of dual-task paradigm as the poststroke nonfluent aphasiacs processing the Chinese character tasks. Methods 20 cases with nonfluent aphasia after stroke were divided into the training group and the control group, who accepted attention training and cognitive training respectively, 30 min a time, 5 times a week, for 4 weeks. They were investigated the cortical activation area and lateralization index caused by interference effect of dual-task paradigm under block design. Results The right inferior frontal gyrus, bilateral parietal and cerebellar cortex were activated before training in both groups, and more activated after attention training, but no change after cognitive training. Lateralization index suggested that the right brain was more activated before training, while the left side was activated after attention training, but no change after cognitive training. Conclusion The right inferior frontal gyrus, bilateral parietal and cerebellar cortex are very important in solving the dual task interference in the attention stage, and they are activated after attention training. It indicates that attention training makes a significant functional reorganization on Chinese character processing in poststroke nonfluent aphasiacs.

Objective To explore the influence of attention training on Chinese character processing capability in poststroke nonfluent aphasiacs. Methods 60 stroke patients with nonfluent aphasia and cognition dysfunction were divided into control group (n=30) and experimental group (n=30). The trainings (attention training and cognition training) were respectively 30 minutes each time, 5 times each week for 4 weeks. The change of reaction time and error rate were compared before and after they were performing the orthographic, semantic and phonological tasks. Results In the dual-task paradigm the change of reaction time and error rate in orthographic and semantic tasks of the experimental group were all higher than the control group (P<0.001). But there was no difference between the two groups in the phonological task (P>0.05). In the single task paradigm there was no difference between the two groups (P>0.05). Conclusion 1. Attention training can improve the processing capacity significantly in orthographic and semantic tasks in the dual-task paradigm because the volume and distributive ability of attention improve significantly. 2. Attention training can't improve the processing capacity in phonological tasks in the dual- task paradigm because reading aloud and judging are required to process the vowel simultaneously. So that the competion intensifies and it is more difficult to finish the task. 3. In the single task paradigm, there is no significant difference between the influence of the two trainings in poststroke nonfluent aphasiac because the single task needs little attention and the change in the control group is enough.

Objective To investigate the Chinese characters processing in healthy subjects with functional magnetic resonance imaging (fMRI). Methods 10 healthy subjects were asked to finish the dual-task paradigm Keying/Reading and single-task paradign Keying or Reading.The active area and partial lateralization index in brains of them were investigated with fMRI with block design. Results and onclusion The tasks activated the right inferior frontal gyrus, bilateral parietal and cerebellar cortex. The laterality index showed that the left brains were more active in the tasks.

Objective:To observe the clinical curative effect of long-time needle retaining at Baihui(GV20)combined with multidirectional point-toward-point needle insertion with needle shaking at Fengchi(GB20)for the treatment of cervical vertigo(CV)and its influence on the blood flow velocity of vertebrobasilar arteries. Methods:Seventy patients with CV were randomly divided into a treatment group(35 cases,1 dropout)and a control group(35 cases,2 dropouts)according to the random number table method.Those in the treatment group were treated with long-time needle retaining at Baihui(GV20)combined with multidirectional point-toward-point needle insertion with needle shaking at Fengchi(GB20),and those in the control group were treated with conventional acupuncture.The treatment was performed every other day,7 sessions as a treatment course,for a total of 2 courses.The clinical efficacy was compared between the two groups by observing changes in the evaluation scale for symptoms and functions of cervical vertigo(ESCV)and the mean blood flow velocity(Vm)of vertebrobasilar arteries. Results:The total effective rate and the cured plus markedly effective rate were 91.2%and 79.4%,respectively,in the treatment group,versus 78.8%and 54.5%in the control group,respectively,with a statistically significant difference in the cured plus markedly effective rate between the two groups(P<0.05).The ESCV score and the Vm of vertebrobasilar arteries in the two groups improved significantly after treatment.The Vm of the left vertebral artery(LVA),right vertebral artery(RVA),and basilar artery(BA)increased in patients with low and normal flow velocities(P<0.05),and the Vm of the LVA,RVA,and BA decreased in patients with a high flow velocity(P<0.05);the results in the treatment group were significantly better than those in the control group(P<0.05). Conclusion:Long-time needle retaining at Baihui(GV20)combined with multidirectional point-toward-point needle insertion with needle shaking at Fengchi(GB20)can significantly reduce the clinical symptoms of CV and regulate the blood flow rate of vertebrobasilar arteries bidirectionally,and thus is an effective therapy for CV.

Objective To observe the effect of nursing intervention on type 2 diabetes in communities. Methods During Jul. 2007 to Jul. 2008, 256 cases with type 2 diabetes were chosen and intervened with non-medication treatment, direction for rational application of medication and management of the follow-up by community nurses. Results The awareness rates about blood presure, blood glucose, blood lipids and diabetes prevention & treatment among the patients were 47% , 43.8% , 60.7% and 91.5% . The compliance rates for medication, the treatment of non-medication and the attainment rate of self monitoring were 89%, 77.6% and 68%, respectively, and all of these results were significantly increased. Conclusion Nursing intervention on patients with Type 2 Diabetes in communities promotes the comprehensive treatment of diabetes.

To analyze the outcome of allogeneic peripheral blood stem cell transplantation(allo PBSCT) for hematological malignancies and prevention of complications, forty one patients with hematological malignancies were treated with allo PBSCT. One regimen of prophylaxis for acute graft versus host disease(GVHD) was the combination of cyclosporine(CsA)and methotrexate(MTX),another mycophenolate mofetil(MMF) with cyclosporine and methotrexate .The results showed that all patients were successfully engrafted .The incidence of over grade Ⅱ acute GVHD after HLA matched transplantation was 21 05%(8/38). Chronic GVHD occurred in 19/25(76%) patients. Three of thirty four patients with acute leukemia(CR 1 ) and CML(CP) after HLA matched transplantation relapsed(8 82%). The disease free survival was 71 43%(10/14) after follow up for more than 2 years. The results suggest that the incidence of acute GVHD in allo PBSCT appears to be similar to allo BMT, but the incidence of chronic GVHD in allo PBSCT is higher than that in allo BMT. Infection and interstitial pneumonitis are the main cause of death.

Objective To investigate the role of TGF-? 1 and -? 2 in the pathogenesis of scleroderma(SD) and the relationship between this kind of cytokines and the clinical types of SD. Methods The TGF-? 1 and -? 2 mRNA and protein expressions in lesions of 17 patients with SD and 10 normal controls were detected using in situ RT-PCR technique and immunohistochemistry SP assay respectively. Results ①The positive rate and the expression strength of TGF-? 1 mRNA expression in the SD group were much higher than those in control group. There was no difference in TGF-? 1 mRNA expression between the localized SD and SSc patients. ②The positive rate and expression strength of TGF-? 1 and -? 2 proteins in SD group were much higher than those in control group. There was no difference in TGF-? 1 and -? 2 protein expressions between localized SD and SSc cases. Conclusion ①The positive rate and expression strength of TGF-? 1 mRNA in SD patients increased, which implied that TGF-? 1 mRNA may play an important role in fibrosis of SD. ②The positive rate and expression strength of TGF-? 1 and -? 2 proteins were more elevated in SD,which suggested that TGF-? 1 and -? 2 proteins were associated with skin fibrosis of SD. ③There was no relationship between the expression of TGF-? 1 and TGF-? 2 mRNA or proteins and the clinical types of SD, which indicated that there may be a similar pathogenesis for localized SD and SSc.

Objective To study the genetic basis for biovar conversion of Y. pestis. Methods In silico comparative genomic analysis was conducted and some critical genetic variations of Yersinia pestis were comparatively analyzed by means of PCR and DNA sequencing. Results A 93bp in-frame deletion in glpD gene results in the glycerol negative characteristic of Orientalis strains. A point mutation in the napA gene may cause the negative characteristic of nitrate reduction in Mediaevalis and Microus strains. A 122-bp frameshift deletion in the araC gene may lead to the arabinose negative phenotype of Microus strains. Conclusion In this study, Microtus strains with their unique pathogenic, biochemical and molecular features, were proposed as a novel biovar Microtus. In the light of its differential ability to ferment glycerol and arabinose and to reduce nitrate, Y. pestis can be classified into four biovars-Antiqua(glycerol positive, arabinose positive and nitrate positive), Mediaevalis(glycerol positive, arabinose positive and nitrate negative), Orientalis(glycerol negative, arabinose positive and nitrate positive), and Microtus(glycerol positive, arabinose negative and nitrate negative).

Objective To better understand the pathogenicity and evolution of Yersinia pestis, we carried out the whole genome sequencing of human-avirulent Yersinia pestis strain 91001, which was isolated from a species of rodent-Microtus brandti. Methods We utilized “whole genome shotgun” approach to get the genome sequence of 91001. Based on the finished and annotated genome sequence of 91001, as well as the previously published genome sequences of CO92 and KIM, we performed detailed comparative genomics analysis on their chromosomes and plasmids. Results The genome of 91001 consisted of one chromosome and four plasmids (pPCP1, pCD1, pMT1 and pCRY). The pPCP1 plasmid of 9 609bp was almost identical with its counterparts from reference strains, which possessed 10 CDS. Plasmid pCD1 was found to be a plasmid of the type III secretory apparatus, and its length was 70 159bp. Although its CDS are quite similar to those of the reference plasmids, there were obvious rearrangements which produced certain differences in structure among them. Another plasmid was pMT1, a 106 642bp plasmid, which showed slightly different architecture compared with the reference ones. There was no mutation in virulent-related genes of pMT1 and pMT1 of 91001, which seemed to have retained more fragments of an ancestor plasmid. pCRY was a novel plasmid discovered in this work. It was 21 742bp long and harbored a group of gene encoding type IV secretory system. pCRY seemed to be able to replicate. The length of chromosome of 91001 was 4 595 065bp, and among its 4 037 predicted CDS (coding sequences), 141 were possibly pseudogenes. There were many IS in the chromosome. Due to the rearrangments mediated by IS, the structure of 91001 chromosome showed significant differences compared with CO92 and KIM. According to the results of comparative genomics analysis, we deduced the genetic mechanisms of nitrate reduction, glycerol fermentation, arabinose and milibiose utilization in 91001. Conclusion According to the analysis of plasmids structure, pseudogenes distribution, nitrate reduction negative mechanism, gene comparison and chromosome architecture, we conclude that 91001 and other strains isolated from Microtus brandti and Microtus fuscus evolved from ancestor Y. pestis and then developed into a different lineage. The deletion of large genome fragments from 91001 chromosome and pseuogenes might contribute to its unqiue pathogenicity and host-specificity.