目的:探讨经肛门内镜微创手术治疗结直肠肿瘤的临床价值和安全性.方法:选择笔者所在医院2011年12月-2013年12月收治的90例结直肠肿瘤患者为本次研究对象,按照随机数字表法分为研究组和对照组,对照组采用传统经肛门局切术治疗,研究组采用经肛门内镜微创手术治疗.观察比较两组患者手术相关指标,并对患者进行术后随访,记录两组患者复发率及并发症发生状况.结果:对照组手术时间为(68.17±1.78)min,研究组手术时间为(30.56±1.88)min,两组比较差异有统计学意义(P<0.05);两组术中出血量和术后住院时间比较,差异均有统计学意义(P<0.05).研究组复发率为6.7%,显著低于对照组的24.4%(P<0.05);研究组并发症发生率为2.2%,显著低于对照组的13.3%(P<0.05).结论:应用经肛门内镜微创手术治疗结直肠肿瘤,安全系数较高,术后复发率较低,远期疗效较为理想,值得在临床上推广应用.

With the rapid industrialization, especially the arsenic containing gold ore mining, arsenic contamination has become a universal concerned eco-environmental problem. How to make better use of a rapid and green approach in biology to disposal of arsenic wastewater could be of great value in relieving arsenic contamination brought by industrial development, improving residents' quality of life and improving human settlements. In the present study, three samples were used as the research objects, which were collected from the water of tailings pond (SY), mine drainage from the mine tunnel 400 m below the surface (XY) and the sediment of tailings pond (NY) in the Shimen Realgar Mine, respectively. Three kinds of As(Ⅲ)-oxidizing microfloras were obtained from these three samples by enrichment culture with arsenic containing medium and subculture after several generation. The As(Ⅲ) tolerance ability was determined in the medium with l~5 g·L-1 of arsenic. Results showed that the cell density of these microfloras reached 109 cells·mL-1 within 2~3 d under 5 g·L-1 of arsenic. Results also showed that the solution containing 1 g·L-1 of sodium arsenite could be completely oxidized by SY, XY and NY within 25 h, 20 h and 35 h respectively, with the decrease of total arsenic mass concentration by 66.7%. 11 As(Ⅲ)-oxidizing bacteria were obtained from those microfloras by repeated plate streaking and qualitative AgNO3 screening method. The 16S rDNA of these strains were examined by sequence alignment of the BLASTN in NCBI. Results showed strains SMY24, SMY33, SMY22, SMY32, SMY21 and SMY31 are Pseudomonas, SMY104 is Acinetobacter. of all known sequences, the maximum rate of sequence similarity of SMY17, SMY25, SMY9 and SMY1 is only 91%, while the minimum is 76%, indicating they are pure culture bacteria that never been reported. By measuring the As(Ⅲ)-oxidizing ability of each strain, results showed SMY104 and SMY21 could completely remove As(Ⅲ) within 20 h. Preliminary tests for the As(Ⅲ) oxidase gene showed that most of these strains had the arsenic oxidase gene (AoxB).

[目的]探讨结肠癌行右半结肠切除时十二指肠壁损伤的处理方法.[方法]比较造瘘与直接修补两组病人康复情况及并发症发生率的差异.[结果]造瘘组的并发症少于直接修补组,康复情况优于直接修补方法.[结论]十二指肠造瘘是右半结肠切除时十二指肠缺损的处理安全有效的方法之一.

[目的]研究甲胎蛋白(AFP)阴性肝细胞癌(HCC)的临床特点及其预后.[方法]比较2005-2007年期间30例AFP阴性HCC和101例AFP阳性HCC患者的临床资料以及术后生存情况.[结果]AFP阴性肝癌患者消瘦乏力、腹痛、腹部肿块的症状少于AFP阳性肝癌患者;合并乙型肝炎较AFP阳性肝癌少;Child-Pugh分级中A级显著多于AFP阳性肝癌;AFP阴性肝癌肿瘤多较小,少有卫星灶及脉管瘤栓,行根治性切除者较多.AFP阴性肝癌术后1、3、5年生存率显著高于AFP阳性肝癌患者.[结论]AFP阴性肝癌患者临床表现较轻且缺乏特异性,其预后较AFP阳性肝癌为好.