Coagulation factors ,which are involved in the intrinsic and extrinsic coagulation process of organism ,perform mutual coordination with the anticoagulation system .The dynamic balance between them inorder to maintain the normal blood physiological state .The molecular structure , physicochemical properties , physiological function involved in the trau-matic bleeding hemostasis were detailed in this paper .Meanwhile , the importance of coagulation factors for trauma hemo-stasis and coagulation ,the coagulation factor products , and their use were reviewed here to provide reference for the devel-opment of coagulation factors as drugs .

Objective To promote the progress in varicella-zoster virus (VZV) immunoglobulin preparation,a rapid microneutralization test ( RMNt) was set up for screening plasmapheresis donations with high titers of special neutralizing antibodies to VZV.Methods With reference to the VZV immunoglobulin (VZIG) preparation standard of FDA and VZIG international unit ( IU) , a screening standard was formulated; the amount of virus was analyzed to determine the optimal conditions for RMNt;screening technology was established and the IU was introduced as quality control ;twenty samples of apheresis plasma and fifteen samples of pooled plasma were diluted at 1∶2 to 1∶256 and tested by RMNt respectively;and the sensitivity of RMNt was also analyzed by the commercial ELISA kit .Results Plasma samples that were diluted at 1∶16 and had a titer more than 0.4 U/ml could be used in the production of VZIG .1500 PFU/ml titers of virus in RMNt pro-duced readable results in plasma screening .Eight apheresis plasma samples tested met the screening standard , but none of the pooled samples tested positive .RMNt had a good linear relationship with ELISA (r=0.895 24,P<0.0001).Conclu-sion The sensitivity, throughput and operability of the established RMNt can be used in the screening of plasma donations as key techniques for the production of VZIG .

Objective To evaluate the curative effect,adverse reactions and complications of transcatheter uterine arterial embolization (TUAE) therapy for leiomyoma of uterus with three different embolization agents: silk particles, pingyangmycin-lipiodol emulsion (PLE), polyvinyl alcohol (PVA).Methods One hundred and twenty-six patients of uterus leiomyoma were included, who undergoing TUAE treatment with silk particles(54 cases, silk particles group) ,PLE(40 cases,PLE group) and PVA(32 cases, PVA group) respectively.Adverse reactions and complications were recorded until 6-60 months after TUAE treatment.Measured the volume of the leiomyoma by ultrasonic inspection or enhanced computed tomography (CT).Results All clinical symptoms of three groups were relieved, and the volumes of uterus leiomyoma after TUAE treatment of 6,12,24 months in PVA group [(50.84 ± 30.77), (39.92 ± 25.72), (31.24 ± 30.60) cm~3]were less than those in PLE group[(76.24 ± 31.16), (58.21 ± 32.05), (52.48 ± 31.41 ) cm~3]and silk particles group[(69.22 ± 36.22), (68.31 ± 32.42), (68.01 ± 30.12) cm~3].The inferior belly and perineal region pain were most slight in silk particles group, but no significant difference in complications was observed in three groups.The symptom recurrence was 3 cases, 2 cases in silk particles group and 1 case in PIE group.Conclusions Clinical outcome of TUAE treatment with all the three embolization agents is acceptable.Adverse reactions and complications are associated with volume of the leiomyoma and the area being embolized.PVA is superior in prevention of complications and relapse of uterus leiomyoma after TUAE treatment.

Objective To explore the acquired deficiencies of vitamin K-dependent coagulation factors in etiology, clinical characteristics and treatment. Methods Retrospective analysis was performed on the data of etiology, clinical manifestations of 45 patients with acquired deficiencies of vitamin K-dependent coagulation factor. All patients were treated with Vitamin K1 10 -40 mg/d, i. v. , for three months. Some patients with severe blooding were additionally treated with fresh freezing plasma or prothromibin complex. Prothrombin time(PT) and activated partial thromboplastic time(APTT) were measured using Stago automatic blood coagulation analyzer before and after treatment. Ⅱ , Ⅶ, Ⅸ and Ⅹ were measured in some patients. Results Among the 45 cases, no certain cause was found in 19 cases (42.2%), anticoagulant rodenticides poison was a common cause ( 11 cases,42.3% ). The main presentations was hemorrhage, the most common bleeding sites were mucosa (77.8%) (35/45)and hematuria (46.7%) ( 21/45 ). After vitamin K1 treatment, PT and APTT had shortened remarkably from ( 110.35 ± 35.36 ) s,(98.91 ±48.98)s to (13.48 ±2. 17)s,(33.25 ±6.95)s,respectively(t=19.10 and 6.19,Ps ＜0.01)and the activities of factor Ⅱ、Ⅶ、Ⅸ、Ⅹ had rapidly increased from ( 17.48 ± 10.93 ) %, ( 10.23 ± 5.68 )%, ( 11.98 ±4.69)%,(12.93±7.48)% to (70. 12 ±21.31)%,(92.76 ±29. 15)%,(88.64 ±40. 21)%,(63.97 ±20.11)%(t=12.13,14.43,13.27and9. 74,respectively,Ps＜0. 01).Conclusions The histories of patients with acquired deficiencies of vitamin K-dependent coagulation factors are usually hiding, therefore it is easily misdiagnosed. It is worth of detecting PT and APTT in diagnosis and monitoring. Using vitamin K1 10 -40 mg/d is effective and safety.

Objective To elucidate the clinical and pathological features, diagnosis, treatment and prognosis of nodal marginal zone B-cell lymphoma (NMZL). Methods 2 patients, with NMZL who has extremely elevated monoclonal IgM were analyzed and review were included. Results The common pathological diagnosis caused by the association of monoclonal gammopathy with indolent B-cell non-Hodgkin lymphomas was marginal zone lymphoma or B small cell lymphocytic lymphoma/B-cell chronic lymphocytic leukemia. According to our cases and literatures, the main distribution of involved sites in NMZL were lymph nodes, spleen and bone marrow. Sixty percent of the NMZL patients presented with advanced stage with, high risk of IPI. The diagnosis of NMZL was based on pathology of the lymph node. The proliferation and distribution of the differentiation monocytoid cell had a specified significance. Prognosis of early stage ( I or Ⅱ) NMZL were much better than that of advanced stage NMZL even the patients had received chemotherapy.Conclusion NMZL mainly involved lymph nodes, bone marrow and spleen, sporadically associated with the elevated monoclonal IgM. Most of the NMZL patients presented with advanced stage.The prognoses were poor.

Objective:To compare two digital methods of quantitatively accessing the degree of facial asymmetry by three-dimensional data.Methods: The three-dimensional data of 20 subjects were got by the FaceScan, and then were input to the reverse engineering software Imageware 13.0 and Geomagic 12 .Their mirror data were acquired and superimposed with the original data by the methods of interactive closest points ( ICP) and Procrustes analysis ( PA) .The mid-sagittal planes of the two methods were ex-tracted respectively, the degree of facial asymmetry and the distance of 21 automatic landmarks to mid-sagittal plane were calculated and compared.Results:The paired t test was taken and t=1.346, P=0.193.Conclusion:We can safely come to the conclusions that for the subjects with no evident facial asymmetry, there are no significant difference between the PA and the ICP methods for extracting the mid-sagittal plane from three-dimensional data.

Objective To study the clinical effect of fetoscopic laser occlusion of chorioangiopagous vessels (FLOC) in treating twin to twin transfusion syndrome.Methods The clinical data of 44 consecutive cases of twin to twin transfusion syndrome (TTTS) who had FLOC in the Department of Obstetrics and Gynaecology of Peking University Third Hospital were reviewed and analyzed for perioperative complications,perinatal outcomes and fetal survival rate.Results (1) Patient characteristics:the mean maternal age was (29±4) years,the median gestational age at TTFS being primarily diagnosed was 20.4 weeks,the median gestational age at FLOC was 21.2 weeks.According to the Quintero staging system,there were 9 cases had stages progressed before the operation.(2) FLOC parameter and intraoperative complications:44 cases all could tolerate the operation; there was 1 case of placenta vascular rupture in the operation,no fetal body injury by laser or placental abruption.3 cases underwent cervical cerclage following FLOC.The average operation time of 41 cases alone with FLOC was (60.1± 15.1) minutes.(3) Postoperative complications:the rate of intrauterine fetal death was 15％ (13/88),the rate of intrauterine growth restriction after FLOC was 5％ (4/88),the rate of membranes rupture less than 28 weeks was 16％ (7/44),the rate of TAPS after FLOC was 5％ (2/44),the rate of membrane sepration after FLOC was 5％ (2/44).(4) Perinatal outcome and survival rate:there were 25 patients after FLOC had delivered in the perinatal period.The average gestational age of delivery was (33.5±2.7) weeks.The donor fetuses survival rate was 88％ (22/25),the recipient fetuses survival rate was 100％ (25/25).The birth weight of donor fetuses was significantly less than that of recipient fetuses (1 631g vs 2 071 g,P=0.016).From Quintero staging Ⅰ to Ⅳ,the rate that 44 cases of TTTS had entered the perinatal period was 4/7,11/14,7/19,3/4; both twins survival rates were 4/7,10/14,5/19,3/4; all the fetal survival rate was 8/14,75％ (21/28),32％ (12/38),6/8,respectively.(5) Compared the early stage (Ⅰ + Ⅱ) with the advanced stage (Ⅲ + Ⅳ),the rates that 44 cases of TTTS had entered the perinatal period (71％ vs 44％) and that both twins survived (67％ vs 35％) had no statistically significance.The rate that all the fetus survived in the early stage was significantly (69％ vs 39％) more than that in the advanced stage.(6) All the cases of neoborn were followed up till 1 month postpartum,the donor fetuses and the recipient fetuses had 12 and 5 cases of cardiac abnormalities respectively,each had 1 case of neonatal death and 2 cases of neonatal white matter damage.Conclusions FLOC for TTTS is associated with a better survival rate.Quintero staging probably does not effectively predict the fetal diagnosis of TTTS after FLOC.When TTTS diagnosed,the sooner FLOC given,the better fetal prognosis had.

Objective To analyze the motion, elastic and derived parameters of normal common carotid artery (CCA) wall in short-axis orientation with velocity vector imaging (VVI) technique. Methods Two-dimensional dynamic images of CCA in 40 healthy volunteers people were obtained in short-axis view with Siemens Acuson Sequoia 512 color Doppler ultrasound. The motion, elastic and derived parameters were analyzed in right CCA including 6 segments: Anterior wall, posterior wall, anterolateral wall, anterior internal wall, posterolateral wall and posterointernal wall. Relationship between these parameters and the influencing factors were analyzed as well. Results There was no statistical difference of the elastic parameters among 6 walls (P>0.05). Some of the motion parameters of the lateral wall and anterior wall were higher than those of the posterior wall and internal wall (P<0.05). Age and intima-media thickness were negatively correlated with some elastic parameters and some motion parameters (P<0.05). Heart rate were positively correlated with some elastic parameters and some motion parameters (P<0.05). Elastic parameters were positively correlated with motion parameters (P<0.05) and positive correlation was found between time to peak of elastic and motion parameters (P<0.05). Conclusion VVI is an effective technique for observing CCA mechanical characteristics of the movement in normal human, and has potential for studying some of related factors of the characteristics.

It is difficult for medical students to understand electrocardiogram theory. The sec-ond clinical medical college of Wuhan University has explored clinical pathophysiology and therapy (CPPT) pattern in electrocardiogram education. Basic medical knowledge and clinic medical knowl-edge are combined with electrocardiogram theory to reinforce students ' comprehension and attract theit interest in order to obtain better teaching effect. Drawing themselves, analyzing electrocardiogram sys-tematically and memorizing theory with figure is aimed at solving forgetful problems. In addition, the problems such as lack of conformable teaching material, professional teaching teams and objective mode of examination are raised, and the solutions are explored under CPPT pattern.

Objective To investigate the clinical characteristics, therapeutic outcomes and prognostic factors of primary nodal peripheral T-cell lymphoma(PTCL). Methods Clinical records, therapy responses as well as prognostic factors of 19 PTCL patients were analyzed. Results The median age of the 19 patients was Ⅲ-Ⅳ, 84.2 % (16/19) with B symptoms, 84.2 % (16/19) with extranodal involvement, 57.9 % (11/19) with bone marrow involvement. After treatment, the complete remission (CR) rate was 36.8 % (7/19). The 2-year overall survival (OS) rate of all patients was 47.2 % and the 2-year progression free survival (PFS) rate was 25 %. The number of sites of extranodal involvement (EN)≥2, ECOG≥2, IPI＞2 and elevated β2-MG were poor prognostic factors. Conclusion Primary nodal PTCL is a heterogeneous group of aggressive T-cell lymphoma with poor chemotherapy results. Multifactors indicate negative prognosis.