Objective To improve the awareness of the treatment and mechanisms of the gastric mucosa-associated lymphoid tissue lymphoma with secondary thrombocytosis. Methods One case of gastric MALT lymphoma with secondary thrombocytosis was reported and reviewed the literatures. Results The patient received anti-Hp therapy,with remission of gastric MALT lymphoma, platelet count also will return to normal levels. Conclusion It is shown that anti-Hp therapy of gastric MALT lymphoma with secondary thrombocytosis is an effective treatment.

Objective To detect serum CA125 and VEGF in patients of non-Hodgkin lymophoma (NHL) involved in bone marrow and analyse prognostic criteria for NHL. Methods The clinical data of 97 patient were chosen as research objects. They were all first-visit patients. Bone marrow infiltrated with lymphoma cell leukemia of 50 patients were identified by bone marrow aspiration or bone marrow biopsy 46 cases of normal bone marrow were used as controls. The serum CA125 and VEGF were detected by ELISA before treatment. Results Among 97 cases of non-Hodgkin disease, there were 50 cases of bone marrow infiltrated lymphoma cells with a incidence rate of 51.5 %. CA125 and VEGF level in the patients whose bone marrow or lymphoma cell leukemia existed NHL cells was much higher than that of NHL with negative bone marrow infutration (P <0.05). Conclusion CA125 and VEGF can be concluded clinical markers which decide bone marrow or lymphoma cell leukem of the NHL patients whether existed NHL cells or not.

Esophageal cancer is a unique malignant disease in China. A fundamental difference exists between the Chinese population and the western population on esophageal cancer in terms of epidemiology, histogenesis, and carcinogenic risk factors. Therefore, ap-plying the western academic achievements to Chinese is difficult. Thus, Chinese scientists have the responsibility to conquer esopha-geal cancer in China. This article reviews the progress of esophageal cancer focused on the molecular mechanism for interactions of ge-netic and environmental risk factors and human esophageal multistage carcinogenesis.

Objective: To compare the peri-implant tissue stability between immediate implant and delayed implant in maxillary anterior region after loading 2 years.Methods: In the study, 38 patients with single anterior tooth loss in the Second Clinical Division of Peking University School and Hospital of Stomatology from October 2010 to December 2011 were enrolled , and 43 implants were inserted .The gin-gival contour was induced using implant-supported temporary crowns prior to restoration till permanent prostheses delivered .The gingival papilla height , labial gingival margin level and peri-implant bone level were measured immediately after the permanent restoration and 2 years later .Results: In the study , 16 patients were treated by immediate implant for 17 implants;22 patients were treated by delayed im-plant for 26 implants .The implant stability quotient ( ISQ ) value of the 2 groups showed no significant difference before permanent restoration (P>0.05).In all the cases after loading 2 years, the average mesial gingival papilla height in the implant area of the immediate group and delayed group increased by (0.15 ±0.42) mm and (0.06 ±0.65) mm, respectively;the distal gingival papilla height increased by (0.06 ±0.50) mm and (0.02 ±0.57) mm respectively;while the labial gingival margin level shrinka-ges were (0.15 ±0.23) mm and (0.15 ±0.46) mm, respectively.The peri-implant bone losses in the mesial side were (0.67 ±0.35) mm and (0.69 ±0.49) mm, respectively, while in the distal side were (0.73 ±0.31) mm and (0.75 ±0.48) mm, respectively.All these indicators showed no significant difference between the 2 groups ( P>0 .05 ) .Conclusion:Both the cases obtained optimizer results after loading 2 years, and the soft and hard tissues around the implant were very stable , which means that both the protocols can achieve reliable therapeutic effects .If we can handle the indications , immediate implant for anterior teeth shows similar efficacy with delayed implant in the short term .But immediate implant in terms of shortening the course of treatment is clearly superior to delayed implant .

Objective:To evaluate the treatment effects of the half-columnar shaped mandibular block bone onlay grafting technique for augmentation of the resorbed maxillary anterior alveolar ridge after single tooth missing.Methods: A total of 15 sites of 14 patients received ridge augmentation surgeries.The recipient sites were prepared with trephines,the half-columnar shaped bone blocks were harvested from the ramus and external oblique ridges with trephines according to diameters of the recipient sites.The bone blocks were placed as lateral onlay grafts on recipient beds and secured by means of titanium screws.Particulate bone was added and absorbable membranes were used to stabilize and protect the grafts.After a mean interval of 4.5 months of healing the flaps were re-opened,the screws were removed and non-submerged implants were placed.The width and height of the alveolar ridges were recorded.After 3 months,implant-supported crowns were provided to the patients.One year later,the peri-impant condition and the marginal bone resorption on the proximal sites were observed.Results: Mean lateral augmentation obtained at the time of bone grafting was(3.8?0.8) mm(x?s),5 out of 15 sites exhibited a mean of 3 mm of vertical augmentation.The mean healing time was 4.5 months,the mean percentage of horizontal and vertical bone resorption in the mean time were 8% and 7% respectively.No major complications were recorded at donor sites.No implant was lost during the study period.Clinical parameters and probing depth(≤4 mm) demonstrated the presence of a healthy peri-implant mucosa after 1 year of prosthetic reconstruction.The clinical and radiographic bone observations showed no more than 1.2 mm of resorption after bone graft and implant placement.Conclusion: The half-columnar shaped mandibular bone graft(from the ramus and external oblique ridge) is a promising technique for bone augmentation in localized alveolar ridge defects after single tooth missing.This procedure offers easy access,good bone quantity for localized repair,low morbidity,decreased complaints of postoperative sensory disturbances or discomfort,minimal graft resorption,and a shorter healing time as compared with other methods for bone repair.

Objective To investigate the pathogen distribution and drug resistance of biliary tract infection in patients with cholelithiasis, and to summarize the clinical experience.Methods160 patients with cholelithiasis were analyzed.The proportion of patients with biliary tract infection was counted.The bile and venous blood were collected and the distribution of pathogens was detected.The patients were also analyzed for the drug resistance.ResultsThe incidence of biliary tract infection was 62.5%, the positive rate of bile culture was 62.5%, and the positive rate of blood test was 37.5% for 160 patients with cholelithiasis.Gram-positive bacteria include Escherichia coli, Enterococcus faecium, Staphylococcus, Gram-negative bacteria, including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, etc.;Gram-positive bacteria for the large Methicillin and erythromycin resistance is higher, Gram-negative bacteria for ampicillin and levofloxacin higher resistance.ConclusionThe pathogen distribution and drug resistance of biliary tract infection in patients with cholelithiasis are analyzed.The clinical pathogens are widely distributed.At the same time, the pathogens have different resistance to different antimicrobial agents.Therefore, clinical use should be reasonable choice when using antimicrobial agents, With a view to give full play to drug effects.

Objective To evaluate the result of multiple segmentectomy under selective occlusion of hepatic inflow for complicated intrahepatic cholangiolithiasis. Methods In this study 12 cases of complicated intrahepatic cholangiolithiasis receiving multiple segmentectomy under selective occlusion of hepatic inflow during 2004. 1 - 2010. 10 were reviewed retrospectively. The short-term and long-term outcomes of the patients were analyzed. Results There was no surgical mortality in this group. The segmentectomy performed were Ⅱ + Ⅲ + Ⅴ in 1 case; Ⅱ + Ⅲ + Ⅵ in 2 cases; Ⅱ + Ⅲ + Ⅴ + Ⅵ in 1 case;Ⅱ +Ⅲ+Ⅵ +Ⅶ in4 cases; Ⅱ +Ⅲ +Ⅳ +Ⅵ in 3 cases and Ⅱ + Ⅲ +Ⅳ +Ⅵ +Ⅶ in 1 case. The average intraoperative blood loss was 560 ± 291 ml. Postoperative complications were wound infection in 2 cases, bile leakage in 1 case, abdominal infection in 1 case. There were no liver failure, intrabdominal hemorrhage or hemobilia; stone clearance rate at 10 days after operation was 83% (10/12) and 92%(11/12) at 6 weeks after operation following postoperative choledochoscopic lithotripsy. 92% (11/12) cases were followed-up with the median follow-up period of 31 months. The result was excellent or good in 92% (11/12) cases. Conclusions Multiple segmentectomy was the choice for complicated intrahepatic cholangiolithasis, and the procedure could be safely performed under selective occlusion of the hepatic inflow.

Objective To evaluate right hepatic veins exclusion in the prevention of massive bleeding and air embolism during the resection of huge hepatic cavernous hemangioma near the second hepatic portal. Method This is a retrospective study on the clinical data of 12 hepatic hemangioma patients at the Live Surgery Department of Zhejiang Provincial People's Hospital from 2004. 1 to 2010.3. In all patients the huge hepatic cavernous hemangioma was adjoining the second hepatic portal. Block webbing or vascular clamp were used to exclude the right hepatic veins. Among the 11 patients without hepatic cirrhosis Pringle maneuvre was applied in 5 cases and selective hepatic inflow occlusion in 6 cases. Patients with hepatic cirrhosis used hemi-hepatic blood inflow occlusion. Results During the surgery no rupture of right hepatic vein happened. Nine patients used vascular block webbing and 3 patients used vascular clamp.Six patients without cirrhosis used the complete hepatic inflow occlusion and other patients without cirrhosis used hemi-hepatic blood inflow occlusion. Cirrhotic patients used hemi-hepatic blood inflow occlusion. All the operations were successful. Intraoperative blood loss ranged from 200 - 5800 ml, averaging 680 ml. Three patients needed not blood transfusion. There was no right hepatic vein rupture or air embolism. Conclusion Right hepatic veins exclusion is a useful technique to prevent massive bleeding and air embolism caused by the rupture of right hepatic vein during the resection of huge hepatic cavernous hemangioma.

Objective To evaluate hepatic vein exclusion (HVE) outside the liver in the resection of giant hepatic hemangioma near the second hepatic hilum. Methods From January 2003 to December 2009, giant hepatic hemangiomas near the second hepatic hilum were resected in 19 cases. Preoperatively 19 cases were divided into two groups: HVE group (9 cases) and IVE group ( 10 cases). Data regarding the intra-operative and postoperative courses of the patients were analyzed. Results There was no difference between the 2 groups regarding the age, sex and tumor size. No damage of hepatic vein was happened in HVE group. Resection of the hemangioma was applied in all cases of HVE group, and 1 case in IVE group had right hemi-hepatectomy. Hepatic veins rupture occurred in 4 cases in IVE group and 2 cases of them had massive bleeding, while in HVE group hepatic veins rupture occurred in 5 cases but no massive bleeding occurred. Intra-operative blood loss was significantly less in HVE group than IVE group. The serum ALT value in postoperative day 1 and total bilirubin in postoperative day 3 in HVE group was significantly lower than that of the IVE group. The mean drainage volume in HVE group was significantly less than that of the IVE group on postoperative day 1 and day 2. The total cost of patient in HVE group were significant less than in IVE group. Conclusions The use of hepatic vein exclusion reduces the risk in the resection of giant hepatic hemangioma near the second hepatic hilum.

BACKGROUND:Whether long time exposure to the lead concentration which is withinthe state allowed range will cause any bad effects on people's health?OBJECTIVE: To investigate the nerve conducting velocity (NCV) and other biological indices of workers who are exposed to low concentration lead.DESIGN: It was an investigation and the subjects were workers exposed to low concentration lead.SETTING: Occupational Disease Department and Electrophysiological Department of Xinhua Affiliated Hospital of the Shanghai Second Medical University.PARTICIPANTS: In lead contact group were 66 heat treatment workers who were exposed to lead and received physical examination from September 2000 to October 2002. In control group were 40 office workers that worked at the same factory but were not exposed to lead.METHODS: Questionnaire and laboratory examination were adopted for measurement of NCV and other biological indices like blood lead, blood zinc protoaetioporphyrin (ZPP), blood free protoporphyrin (FPP) and hemoglobin content in the two groups. And the relative risk analysis was conducted.biological indices in both groups.RESULTS: All the 106 subjects entered analysis stage. In lead contact group there were 34 workers of more than 10 working years and the other ulnar nerve in those of over 10 working years were faster than those in control group [(50.11 ±4.76) m/s, (63.11±2.58) m/s vs (47.59±4.86)m/s,those of over 10 working years was higher than those of less than 10years [(0.568±0.28), (0.425±0.31) μmol/ L, P ＜ 0.05]. So was the FPP level [(2.24±0.32), (2.09±0.27) μmol/L, P ＜ 0.05] and urine lead level [(0.087±0.008), (0.083±0.007) μmg/L, P ＜ 0.05]. The ZPP level of those of over 10 working years was also higher than those less than 10 years [(1.42±0.33) μmol/L vs (1.25±0.35) μmol/L, P ＜ 0.05] and control [(1.42±0.33) μmol/L vs (1.22±0.44) μmol/L, P＜ 0.05]. The hemoglobin of those of over 10 working years was lower than those of less than 10 years [(12.26±4.5) g/L vs (14.55±4.81) μmol/L, P ＜ 0.05] and control [(12.26±4.5) g/L years presented abnormality in conducting sensory signals and the abnormality rate was 3% (1/32). Whereas four cases in those with more than 10working years did so and the abnormality rate was 12% (4/34). As for biological indices, one case in those less than 10 working years was beyond normal values (abnormality rate 3%) and five did so in those of over 10working years (abnormality rate 15%). It could be seen that changes in both NCV and biological indices of those of over 10 working years were more serious than those les than 10 years exposure with the relative risks of 4.1 and 5.3 respectively.CONCLUSION: Persistent exposure to lead not only alters biological indices but also damages nervous system in different degrees. Sensory verve of lower extremities and motor nerves of upper extremities are usually damaged first. Peripheral nerve injury is common in workers of over 10 working years. Because the regeneration of nervous system is poor, so the nerve injury is usually irreversible. Therefore the neuroelectrophysiological changes always predict early nerve injury and so neuroelectrophysiological monitoring can be adopted for prevention of nerve injury.