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 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.

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.

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 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.

Objective To establish reliable proteomics analysis models for Yersinia pestis and obtain the basic proteomics data of this pathogen. Methods The human-avirulent Y. pestis strain 91001 was cultured as an experimental strain, and the proteins of which were extracted and divided into three parts fractionally according to their solubility. Then three different methods (Shotgun-LC-MS-MS, 1D-LC-MS-MS and 2D-MS) were used to analyze the extracted proteins. The obtained data were compared with the theoretical protein database of strain 91001 so as to identify the expressed protein of Y.pestis strain 91001 in this study. Results 971 proteins were identified by shotgun-LC-MS-MS method, accounting for 23.4% of the predicted proteins of strain 91001 (971/4 143). 915 proteins were identified by 1D-LC-MS-MS method, accounting for 22.1% of the predicted proteins of strain 91001 (915/4 143). However, with 2D-MS only 5.62% of the predicted proteins (233/4 143) were identified. Altogether 1 193 proteins were identified when the results of the 3 methods added together, accounting for 28.7% of all the predicted CDS in 91001. Conclusion The kind and quantity of proteins identified by various proteomics methods differ from each other dramatically, therefore it is necessary to utilize multiple methods to get more reliable protein profiles of Y. pestis.

Objective To study genetic variations of pgm locus and its flanking regions in Yersinia pestis isolated from Chinese natural focus so as to understand differences in virulence between different strains and to improve the prevention of plague. Methods We analysed the sequence variations of pgm locus and its flanking regions by using PCR-sequencing and allele-specific PCR among 260 strains of Y. pestis isolated from different foci and 7 strains of Yersinia pseudotuberculosis. Results For YP1666, only the strains of Xilin Gol grassland type and Microtus fuscus type had intact transmembrane helix, and the T-deletion at base 1406 was unique in strains of Orientalis. Same as Y. pseudotuberculosis, there was no IS100-insertion at the 3′ end of pgm locus of strains from Eastern section of North Tianshan Mountain type, Western section of North Tianshan Mountain type A and B, Xilin Gol grassland type and M. fuscus type. Only the strains of Xilin Gol grassland type and M. fuscus type had IS285-insertion in pigmentation segment and IS100-insertion at its downstream flanking region. pgm locus was deleted entirely from 36 strains, most of which came from Ordos plateau type, Song-liao plain type B , Kunlun Mountain type A and B. Conclusion Strains of Eastern section of North Tianshan Mountain type, Western section of North Tianshan Mountain type A and B, Xilin Gol grassland type and M. fuscus type are the oldest lineage of Chinese isolates. The pgm locus of the strains of these three types is very stable because there is no IS100-insertion at its 3′ terminal. We suggest that the strains of Xilin Gol grassland type and M. fuscus type should be grouped into a fourth biovar: Microtus. pgm locus is highly conserved among strains of different ecotypes, and its variations are well correlated with biovar, focus and ecotype, which indicates that pgm locus has played a role in strains′ adaptation to their environment.

6 months (n=12), control group, without AF (n=8). Atrial muscle samples of the left and right atrial appendage were cut off during heart valve replacement. Expressions of Cx40 and Cx43 were detected by immunoblotting and immunohistologic analyses. Results ①No obvious change of Cx43 and Cx40 in the left and right atrium of each patient in each group was measured. ②Compared with that in the control group, the level of Cx40 was decreased signficantly in GroupⅠ (P

6 months; Control group (n=8) without AF. Atrial muscle samples of the left and right atrial appendage were cut off during heart valve replacement. Morphological changes were observed by light microscopy and electron microscopy. Results ① The incidence rates of Aschoff body were 37.5% (3/8), 46% (5/11) , and 50% (6/12) in Group Ⅰ, Group Ⅱ, and the control group. There was no difference in Aschoff body between the left and right atrial myocytes. ② There was no difference in myocytic degeneration, interstitial hyperplasia, and lymphocytes infiltration between the left and right atrial myocytes in each group. ③ Myolysis, accumulation of glycogen, and fibrosis were detected by electron microscopy in the 3 groups. Changes of myolysis and fibrosis were more obvious in patients with AF than patients without AF. Conclusion There are similar pathological changes in the left and right atria in rheumatic heart disease patients with or without AF. Fibrosis of atrial myocytes may be involved in the occurrence and maintenance of AF.