0 05) between the two procedures in incidence of anastomotic leakage (25 0% vs 10 7%), pulmonary infection rate (31 3% vs 32 1%), incide nce of thoracic cavity infection (0 vs 3 6%), proportion of re-thoracotomy (0 vs 3 6%), incidence of d elayed gastric emptying (3 1% vs 21 4%), postoperative SICU stay (4d?2 3d vs 5d ?3 6d), and peri-operative mortality (3 1% vs 7 1%). The incidence of recurr ent laryngeal nerve injuries (28 1% vs 7 1%, ? 2=4 391,P =0 036) and arr hythmia (43 8 % vs 17 9%, ? 2 =4 627, P =0 031) in the THE Group were significantly higher than those in the TTE Group, while the intra-operative blood loss in the THE Group was signif icantly less than that in the TTE Group ( t = -3 100, P =0 003).ConclusionsVideo- assisted THE is a safe procedure. With the increase of the experience, the incid ence of post- operative complications is subject to further decrease.

Purpose　To investigate whether thoracotomy can induce lung injury in the operative side and the protection by ambroxol in this procedure.　Methods　24 patients with esophageal carcinoma who were performed esophagectomy with anastomosis over the arcus aortae were randomized into 2 groups:an ambroxol group (ambroxol 1 g iv gtt qd×3,preoperatively) and a controlled group without any respiratory medication.General anesthesia by tracheo-cannula combined with continuous epidual anesthesia were used in all the patients.Bilateral broncho-alveolar lavage(BAL) was carried out after intubation preoperatively and before removal of the cannula postoperatively.Total Phospholipid(TPL),Saturated Phosphaytidylcholine(SatPC) and Total protein(TP) in the BALF were measured.The ratio of SatPC/TPL and SatPC/TP represented the activity of PS.　Results　In the controlled group,SatPC/TPL and SatPC/TP of the left lung(operation side) showed significant difference(P<0.05),compared with the right side(non-operation side).In the ambroxol group,no significant difference of such ratio was showed.　Conclusions　Thoracotomy can induce lung injury and bring out the decrease of PS and increase of protein exudation in the operative side.Large dose of ambroxol can promote in synthesize and secretion of PS and protect those changes.

Objective To investigate the difference of clinical characteristics and outcomes between different isoforms of BCR/ABL in adults with Philadelphia-positive acute lymphoblastic leukemia (ALL).Methods The data of 106 adults with Ph+ALL diagnosed in our hospital from January 1, 1996 to December 31, 2007 were reviewed. The difference of clinical characteristics between different subgroups of BCR/ABL was compared and their relation with outcomes was studied. Results The median age of the 106 patients was 34 years and the median white blood cell count at baseline was 28. 5 × 109/L. Comparative analysis demonstrated that patients in p210 group had an older age, higher blood platelet count (BPC) and more frequent occurrence of splenomegaly. Referring to the outcomes, the complete remission (CR) rate of the two groups were 92. 2% and 93.9%, respectively. The median overall survival (OS) and relapse free survival (RFS) in p190 group were 13 months and 10 months, the 1,3-year estimated OS were (54. 7±6. 7)% and (5.5±5.2)%, and the 1,3-year estimated RFS were (40. 2±6. 8)% and (7. 8±6. 7)%,while in p210 group, the median OS and RFS were 15 months and 10 months, respectively, the 1,3-year estimated OS were (65.8±8. 9)% and (14. 5±7.4)%, and the 1,3-year estimated RFS were (48. 3±9. 4)% and (12. 9±7. 7)%. All of the above data had no statistic significance between the two groups.Conclusion Majority of the adults with Ph+ALL is p190 positive and patients with p210 have older age, higher BPC and more frequent occurrence of splenomegaly, while there is no significant difference between p190 group and p210 group in CR rate, RFS and OS.

Objective To identify the clinical and pathological features of blastic plasmacytoid dendritic cell neoplasm (BPDC). Methods The characteristics of BPDC hematodermic neoplasm were discussed with a report of two new cases and review the literatures. Results Both patients presented with skin nodules and the tumors were CD+4 and CD+56. Lineage specific markers for B- and T-cell were negative and the tumors did not express myeloperoxidase. Systemic chemotherapy resulted in complete remission, but the disease relapsed quickly and were unresponsive to further chemotherapy. The patients died 26 months and 11 months respectively after diagnosis. Conclasion BPDC hematodermic neoplasm is a rare subtype of lymphoma with distinct clinicopathologic and immunophenotypic features. The disease often has a fulminant course with a poor prognosis. More recent studies suggest that there is a derivation from a plasmacytoid dendritic cell precursor.

Objective To evaluate the effect of comprehensive control for schistosomiasis with emphasis on environmental modification in the Bianmin River water system of Nanjing City.so as to provide scientific evidence for making up further control measures in this water system.Methods Schistosome infections of Oncomelania snails in the waterway.sentinel mice in water and neighbouring human were investigated longitudinally from 1998 to 2007,and the changes of huaman infection rates in differentyears,the infection rates of sentinel mice and snails in different settings were analyzed and compared.Results A total of 77 395 snails collected from the Bianmin River water system were dissected from 1998 to 2007,and among them,27 snails were infected with Schistosoma japonicum,with a total snail infection rate of 0.03%.A total of 61 039 snails collected from the neighbouring marshland which connected to the Yangtze River wore dissected,and among them,257 were infected with S.japonicum,with a total snail infection rate of 0.42%,and there was a significant difference compared with that in the water system(χ~2=248.55,P<0.01).After the protection works in the waterway,the infection rates of sentinel mice in the water system decreased from 69.68% in 1998 to 17.50% in 2001.with a reduction rate of 74.89%.Two years afterthe clearance ofmarshlandinthewaterway,no infected sentinel mouse was found.The infection rates of residents from 1998 to 2007 were 1.96%,1.37%,1.34%,1.60%,0.30%, 0.26%,0.16%,0.10%,0.04% and 0,respectively,andthe rates declined year by year afterthecomprehensive control.Conclusions The control measures based on the elimination of snail habitats in the waterway that is connected to the Yangtze River have achieved obvious effect.However,the clearance of the re-emerging snail habitats should be carried out termly to consolidate the control effect.

Objective:To compare the durability of resin-based root-surface coating material and all-in-one self-etching adhesive on root surface in vitro.Methods:Human extracted premolars or molars with intact roots were selected.The cementum was removed using a periodontal scaler to expose root dentin. The root surface was coated with an acid-resistant nail varnish,leaving a window of 3 mm ×3 mm on the exposed dentin.The window was covered with either PRG Barrier Coat (PRG)or Clearfil S3 Bond (CS3).After water aging for 14 d,specimens were immersed in acid buffer at pH 4.5 for 4 d and the demineralization buffer was changed every 24 h.Then the specimen was split longitudinally through the center of the ‘window’and the cross-sectional surface was observed with scanning electron microscope (SEM).After fixed and dehydrated,the prepared samples were coated with platinum.The coating mate-rial,root dentin and the interface was observed by scanning electron microscope (SEM).The thickness of the coating material was measured on the SEMimages.Regarding toothbrush wear test,coronal dentin-disks were prepared and covered with PRG and CS3,respectively.After storage in water for 24 h,the specimen was subjected to the toothbrush wear tester for 100,200,300,500,700,1 500 brushing cy-cles.A slurry of fluoride toothpaste (1 ∶2 ratio of toothpaste and deionized water by weight)was used and the brushing load was 300 N.The surface microstructure of remaining coating material was analyzed using SEM.The wear depths were determined by a profilometer.Statistical analysis was performed with SPSS 20.0 by one-way ANOVA.The level of significance was at 0.05.Results:Application of PRG Barrier Coat produced a coating layer of (47.1 ±27.3)μm,while CS3 presented a thin film of (5.7 ± 2.1)μm in thickness.The exposed dentin was hermetically sealed and no obvious gap was observed at the interface in both PRG and CS3 groups.There was no dentin demineralization observed in both groups after water aging.The wear depths of PRG and CS3 increased along with the numbers of brushing cycles. PRG wore at a significant lower pace than CS3 did (P <0.05).Conclusion:PRG coating resin had similar performances as CS3 on protecting root dentin from demineralization after water aging.What’s more,PRG demonstrated a higher toothbrush wear resistance than CS3.We concluded that PRG Barrier Coat contained S-PRG filler may be an effective coating material for protecting exposed root from both chemical and mechanical challenges.Further studies should be carried out to evaluate the long-term reli-ability of the rootsurface coating materials under the clinical setting.

Objective To improve the recognition of precursor T- lymphoblastic lymphoma (T-LBL)of the breast. Methods One case of breast T- LBL was reported, the development of breast non-Hodgkin lymphoma and T-LBL presenting as breast masses was reviewed. Results One case of breast T-LBL was diagnosed, the patient with a high leukocyte count, breast mass and peripheral lymph nodes was treated with Hyper-CVAD regimen after active therapy and achieved complete remission (CR). Followed by maintenance therapy with Hyper-CVAD regimen for three times, disease free survival had been obtained five month.Conclusion Lymphoma of the brest is a rare malignancy. T-LBL is a highly aggressive disease with adverse prognosis, it is very uncommon for presenting as lymphoma of breast. Initiation of intensive muhiagent chemotherapy can improve the free survival and the prognosis.

Objective To identify the clinical and pathological features of aggressive natural killercell leukemia (ANKL). Methods 9 cases of ANKL fulfilling the criteria defined by the World Health Organization classification were retrospectively analyzed with literature review, Results Systemic symptoms, hepatomegaly, splenomegaly, lymphadenopathy were frequently observed. Liver dysfunction, neutropenia, anemia and thrombocytopenia were often seen during the course of the disease. Most of the bone marrow shows focal or subtle infiltration by the neoplastic cells. The immunophenotype of cells was characteristic for CD+56, sCD-36, and variable expression of CD2, CD7, CD8 and CD11b. T-cell receptor (TCR) genes rearrangement were in germline configuration. Median survival time was 9 weeks. Conclusion ANKL is an entity of mature cytotoxic NK-cell neoplasms with distinct phenotype and disease presentations. The disease often has a fulminant course with a poor response to chemotherapy and a short survival time. Patients achieving CR showed significantly longer survival time, but the remission did not translate into cure of the disease.

Objective To summarize the common complications of chronic lymphocytic leukemia (CLL). Methods 203 cases of CLL patients from the Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, were retrospectively reviewed and followed up.The common complications of CLL were also summarized. Survival analysis was used to analyze the prognostic value of these common complications. Results 40 (19.7 %) patients sustained infectious complications,and the respiratory tract infections were the most common type (75.6 %). 15 (7.4 %) patients complicated with autoimmune diseases (AID), and the autoimmune hemolytic anemia(AIHA) were the most common type(31.3%). 8(3.94 %) patients suffered from secondary cancers, including lung cancer, etc.3(1.48 %) patients developed other high-grade lymphomas, 2 of them transformed to prolymphocytic leukemia (PLL), 1 of them transformed to diffuse large B cell lymphoma (DLBCL) which was called Richter syndrome. Complicating infections and secondary cancers or transformations were associated with poor prognosis.Complicating AIDs was not an adverse prognostic factor. Conclusion Infections, AIDs and secondary cancers or transformations are common complications of CLL patients.Lung is the most common infectious site, and AIHA is the most common AID type,none secondary cancer s incidence rate is specifically higher than the others. Infections and secondary cancers or transformations indicate poor prognosis.

Objective To review the efficacy of bisphosphonates in reducing skeletal events in patients with multiple myeloma. Methods Two hundred and five patients with newly diagnosed MM were enrolled in this retrospective study,with bisphosphonates or not.Skeletal-related events,therapeutic reaction of myeloma bone disease and patient survival were analyzed. Results The occurrence of skeletal-related events (SRE) per patient year (P＜0.01) and the time to first SRE (P＜0.05)were significantly lower in the reatment group than in the untreated group. After 6 cycles of treatment, a significant higher percentage of effective and marked effect patients were observed through X ray in the treatment group (80.0 ％) compared to the untreated group (48.7 ％), P＜0.001. There was no overall significant difference in the level of serum calcium between the two groups (P=0.278). After 6 cycles of treatment, the patients who received bisphosphonates had significant decreases in bone pain and lower ECOG score (ECOG≤2) compared to the untreated group (P＜0.05). Bisphosphonates were tolerated well, and the common adverse reaction including gastrointestinal reaction (3 cases,3.3 ％),fever (lcase,1.1％) and skin rash (2 cases,2.2 ％).There was no significant difference in overall survival between the two treatment groups,(P=0.580).Conclusion Infusions of Bisphosphonates could reduce the occurrence of skeletal- related events (SRE), prolong the time to first SRE and improve the quality of life of patients with multiple myeloma. Bisphosphonates could not prolong survival time of myeloma patients.