Objective To concentrate coagulation Factor Ⅺ(FⅪ)from human plasma.Methods FⅪwas isolated and purified from human plasma via two-step chromatography,including CM-Sepharose fast flow ion exchange and Heparin CL-6B affinity chromatography.Results The recovery rate of FⅪ was(21.02?5.04)%,the specific clotting activity of purified FⅪ was(17.59?1.96) U/mg,and the purification factor was(1162.29?129.64) fold(n=7).Conclusion The two-step chromatography is effective in concentrating FⅨ.

Objective To investigate the clinical significance of expression of P53,Ki67 in proliferation,invasion and metastasis of cancer cells of patients with esophageal carcinoma.Methods Eighty-six patients with esophageal carcinoma were selected as tumor group from January 2006 to May 2008.And another 86 patients without tumor were as control group.ABC-immunohistochemistry was used to detect the expression of P53 and Ki67 in 172 cases of patients with esophageal carcinoma.Results The expression of P53 in patients with esophageal carcinoma was different from that in control subjects (x2 =4.045,P ＜ 0.05),and the P53 expression rate in two group were 66.3％ (57/86) and 51.1％ (44/86) respectively.The rate of P53 expression reaching to + + in two groups was also significant (x2 =8.592,P ＜ 0.01).Ki67 expression in patients with esophageal carcinoma was higher than that of control patients (76.7％ (66/86) vs.60.5％ (82/86),x2 =5.291,P ＜ 0.05).Additionally,there was significant difference regarding of Ki6 expression reaching to + + positive(x2 =13.661,P ＜ 0.01).Moreover,the expression of P53 and Ki67 were found to be a positively correlation(r =0.400,P =0.00).The expression of P53 and Ki67 were related with invasion and differentiation of cancer cells (x2 =3.945,5.794 respectively,all P ＜ 0.05) and lymph node metastasis (x2 =5.570,4.354 respectively,all P ＜ 0.05).Conclusion Over-expression of P53 and Ki67 were involved in the process of proliferation,invasion and metastasis of cancer cells in esophageal carcinoma,which coherently impacted the occurrence and development of esophageal cancer.The combined detection of P53 and Ki67 seems to help the early diagnosis of esophageal cancer and evaluation of the degree of malignancy,invasion,metastasis and prognosis.Over-expression of P53,Ki67 might be served as a reference marker in screening for chemotherapy for esophageal cancer.

OBJECTIVEThe aim of this retrospective study is to present the long-term effects of open healing of keratocystic odontogenic tumors (KCOTs) in the mandible.

METHODSA retrospective case series study was conducted on 41 patients with large KCOTs (the maximum diameter of the tumors exceeded 5 cm) treated at our institution between September 2003 and April 2011. A conservative surgical treatment was applied. The treatment involved enucleation of the primary lesion through narrow unroofing and open packing of the residual osseous defect with iodoform gauze for secondary healing. Bone regenera- tion and surgical complications were observed. The long-term effects of the treatment were followed up.

RESULTSThe inferior alveolar nerve was exposed in the KCOT bone cavity in all cases, and some nerves adhered to the tumor tightly. The post- operative follow-up time was 81.5 months on the average (36 to 127 months). The packing gauze was changed every two weeks after enucleation, and the total duration time for packing was 8.9 months on the average (3 to 15 months). Notable bone regeneration and satisfactory secondary healing were observed clinically and radiographically. The KCOT-affected teeth were reserved, and their chewing functions were restored. Two cases presented recurrences after the initial treatment. The recurrence rate was 4.9% (2/41). No serious complications were observed.

CONCLUSIONEnucleation associated with subsequent open packing is a reliable treatment for patients with large KCOTs in the mandible.

Adult ; Bone Regeneration ; Female ; Humans ; Male ; Mandible ; Mastication ; Neoplasm Recurrence, Local ; Odontogenic Tumors ; Retrospective Studies

Objective:To study the efficacy and safety of natural calcined bone repair material(NCBM)in repairing bone defect af-ter tooth extraction.Methods:A randemized,double-blinded,parallel,positive control(Bio-Oss)and multi-center clinical trial was employed.Imaging examination was used as the main efficacy evaluation index,surgical wound healing,rejection reaction,bone me-tabolic changes,bone infection signs were the subordinate efficacy evaluation indexes,the incidence of adverse reactions was observed for safety evaluation.Results:280 cases were included,269 cases completed the trial.In NCBMand Bio-Oss group the effective rate of imaging examination was 93.08% and 93.70%(P >0.05)respectively.The wound healing time of the 2 groups was less than 7 days,no rejection reaction,bone metabolic change and bone infection sign were observed.The incidence of adverse events in NCBM and the Bio-Oss group was 0.72% and 2.14%(P >0.05)respectively.Conclusion:The efficacy and safety between natural cal-cined bone repair material is not inferior to Bio-Oss in repairing bone defect after tooth extraction.

Objective To explore clinical effect of repairing soft tissue defect in forearm, hand and foot with free super-thin anterolateral thigh perforator flaps. Methods At first the site of perforator vessels were determined by Doppler, then the flaps were designed and harvested with the site as center; the fascia lata and subcutaneous fat were removed by sandhill-likely only the 4.0 cm × 3.0 cm - 3.0 cm×2.5 cm disc-like fascia lata and dermis layer were reserved. 15 traumatic soft tissue defects including forearm, hand and foot were repaired with the ree super-thin antemlateral thigh perforator flaps. Results No vascular crisis happened and all skin grafts survived in donor sites. 2.0 cm×1.2 cm of the distal of flap was necrosis in 1 case and it was healed by dress changing. 15 cases were followed up 3 months-2 years and the average is 6 months. The contour and texture of all flaps were good and two point discrimination (2-PD) was about 8-10 mm of. Conclusions The contour and texture of free super-thin anterolateral thigh perforator flap are good, the feeling of recipient site recovered well, it's less injury for donor site and there is no reshaping for flap. It is a fineness donor site for repairing soft tissue defects in hand and foot.

Objective:To compare the outcomes of guide bone regeneration by calcined bovine bone and Bio-Oss graft material in alveolar ridge preservation after tooth extraction.Methods:280 patients were divided into two groups randomly.Each patient had single tooth extracted.The sockets were filled with calcined bovine bone in 140 patients and Bio-Oss graft in another 140 patients. After shaping,all the sockets were covered with Bio-Gide membrane.Buccal mucoperiosteal flap was released and sutured to close the alveolar sockets.The patients were regularly examined at the 1st,12th and 24th week after surgery.Physical examination and X-ray evaluation were applied to compare the outcomes of the two materials in alveolar ridge preservation.Results:No infection and re-jection occurred.The radiographic results showed the width and height of the alveolar bone were preserved well at the 12th and 24th weeks.No statistically difference was found in the two groups at the 1st and 24th weeks(P>0.05).Conclusion:The two graft ma-terials can effectively preserve alveolar bone after tooth extraction.

Objective To summarize clinical experience of application of muliplefoliated flap combined with tendon graft from dorsal foot for repairing soft tissue defects of multi-fingers. Methods Based on the results of microdissection researches, muliplefoliated flap including medial foot flap, the first metatarsal dorsal flap, lateral foot flap, extensor pollicis brevis of toe and extensor proprius of the fifth toe pedicled by anterior tibial vessels and dorsal pedis vessels as trunk, anterior medial malleolus vessels, the first metatarsal vessels and anterior lateral malleolus vessels as branches respective was designed for repairing soft tissue and tendon defects of multi-fingers. Results In all 12 cases, total survival of flap was 11 cases , 1 case had partial necrosis of distal flap and it was healed by dress changing. Conclusion Transplantation of muliplefoliated flap combined with tendon graft from dorsal foot is a good method to repair soft tissue and tendon defects of multi-fingers.

Objective:To investigate the correlations between perfused lung volumes, visual scores (using perfusion SPECT/CT) and right-heart catheter (RHC) hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods:A total of 51 consecutive CTEPH patients (17 males, 34 females, age (59±12) years) in the First Affiliated Hospital of Guangzhou Medical University between March 2015 and July 2019 were retrospectively analyzed. All patients underwent lung perfusion SPECT/CT imaging and RHC examinations. Perfused lung volumes were determined using threshold-based (15%-85%) segmentation. Visual semiquantitative scoring in each lung segment was performed using Begic method. RHC hemodynamic parameters including pulmonary artery systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP), mean pulmonary artery pressure (mPAP), pulmonary arteriolar wedge pressure (PAWP), pulmonary vessel resistance (PVR), cardiac output (CO), cardiac index (CI) were recorded. Spearman correlation analysis was used to evaluate the correlations between perfused lung volumes, visual scores and hemodynamic parameters.Results:There were significant correlations between perfused lung volumes (30%-70% threshold) and mPAP ( rs values: from -0.414 to -0.302, all P<0.05). Among them, perfused lung volumes under the threshold of 40% and 45% were moderately correlated with mPAP ( rs values: -0.414, -0.412, both P<0.05). Perfused lung volume (40% threshold) was moderately negatively correlated with PASP, PADP ( rs values: -0.402, -0.440, both P<0.05), and slightly negatively correlated with PVR ( rs=-0.352, P<0.05). Visual scores were slightly positively correlated with the PADP ( rs=0.311, P<0.05), while there was no correlation between visual scores and other RHC hemodynamic parameters ( rs values: from -0.201 to 0.275, all P>0.05). Conclusion:Perfused lung volumes based on threshold-based segmentation in lung perfusion SPECT/CT imaging can accurately reflect hemodynamic status and may provide useful information for severity assessment of CTEPH.

Objective:To establish training system for postoperative delirium (POD) assessment and evaluate the efficacy of training for anesthesia nurses.Methods:Sixteen nurse anesthetists of both sexes in our hospital were selected and received the systemic training for POD assessment.The training system included questionnaire survey, theoretical teaching, simulated visit, clinical observation, independent evaluation, centralized question-answering, evaluation of efficacy and random inspection.The level of POD knowledge tests were performed before the training and at the end of the fourth week of independent evaluation, respectively.At week 1 and 4 of independent evaluation, the diagnostic rate of POD and sensitivity and specificity of the assessment were calculated, and Kappa consistency analysis was used to assess the consistency between anesthesia nurses and training group in diagnosis of POD.In the first week of the third month after the end of training, the evaluation results were randomly inspected, the POD diagnosis rate was calculated between the anesthesia nurses and the training group, and the consistency analysis was conducted.Results:Compared with the scores of POD knowledge questionnaire and sensitivity of the assessment of the anesthesia nurses in the first week of training, the scores were significantly increased ( P<0.05), and no significant change was found in the POD diagnosis rate in the fourth week of training ( P>0.05). Compared with the training group, the diagnosis rate of POD of anesthesia nurses was significantly decreased in the first week of training ( P<0.05), and no significant change was found at the fourth week of training ( P>0.05). In the first and fourth weeks of training, the Kappa value of anesthesia nurses and the training group was 0.676 and 0.954 ( P<0.001), respectively.In the first week of the third month after the end of training, the Kappa value between anesthesia nurses and the training group in diagnosis of POD was 0.862 ( P<0.05). Conclusion:The training system of POD assessment has been successfully established, and the standardized anesthesia nurses training of POD has been achieved with good results.

Objective:To investigate the predictive value of trigeminal nerve vascular compression grading evaluated by preoperative magnetic resonance imaging (MRI) in patients with trigeminal neuralgia (TN) after microvascular decompression (MVD).Methods:Two hundred and seventy patients with TN accepted MVD in our hospital from January 2015 to December 2017 were chosen in our study; their clinical and MRI data were retrospectively analyzed. By referring to Sindou's method and Jannetta standard, these patients were divided into patients with mild vascular compression ( n=71) and patients with severe vascular compression ( n=199) according to preoperative MRI data; these patients were divided into typical TN patients ( n=219) and atypical TN patients ( n=51) according to their symptomatic characteristics; the differences in prognoses after one year of follow-up were compared among patients from different categories. Results:The degree of intraoperative vascular compression was basically consistent with the preoperative imaging evaluation results, and the intraoperative vascular compression in 256 patients was consistent with preoperative imaging evaluation grading, with a coincidence rate of 94.8% (256/270). The difference in prognosis between patients with mild vascular compression and patients with severe vascular compression was statistically significant ( Z=-3.420, P=0.001), and the mean rank indicated that the prognosis of patients with severe vascular compression was better than that of patients with mild vascular compression (142.01 vs. 117.25). The prognosis difference between typical TN patients and atypical TN patients was statistically significant ( Z=-5.810, P=0.000), and the mean rank indicated that the prognosis of typical TN patients was better than that of atypical TN patients (144.45 vs. 97.08). Conclusions:Preoperative MR imaging evaluation is a reliable method to assess the degree of vascular compression. Patients with severe vascular compression and typical TN have high postoperative pain relief rate after MVD.