[Laparoscopic with extralevator abdominoperineal excision for low rectal carcinoma].

OBJECTIVE: To explore the feasibility of laparoscopic with extralevator abdominoperineal excision (LELAPE group) for low rectal cancer. METHODS: From June 2011 to January 2013, 35 patients with low rectal cancer undergoing laparoscopic abdominoperineal excision at the Department of Gastroenterological Surgery, Beijing Hospital were analyzed retrospectively. Among them, 20 received laparoscopic abdominoperineal excision (LAPE group). There were 12 males and 8 females with an average age of (63 ± 6) years old. Another 15 patients underwent laparoscopic extralevator abdominoperineal excision (LELAPE group). There were 10 males and 5 females with an average age of (61 ± 7) years old. Operative duration, blood loss volume, time of postoperative out-of-bed activity, recovery of gastrointestinal function, removal time of drainage tube, edge of perineal position take out stitches time, postoperative hospital stay and complication rates were relative analyzed. RESULTS: There was no significant difference in operative time, time of postoperative out-of-bed activity, recovery of gastrointestinal function, removal time of perineal stitches, postoperative hospital stay and complication rates between 2 groups ((259 ± 52) vs (246 ± 55) min, (35 ± 13) vs (33 ± 9) d,(61 ± 25) vs (63 ± 20) h, (15.7 ± 2.5 ) vs (16.8 ± 2.9) d, (12 ± 3) vs (15 ± 4) d, 2/15 vs 3/20, all P > 0.05). Blood loss volume of perineal position in LELAPE group was less than those in LAPE group ((76 ± 31) vs (148 ± 36) ml, P < 0.05). Removal of perineal drainage tube in LELAPE group was earlier than that in LAPE group ((6.2 ± 1.6) vs (10.3 ± 1.8) d, P < 0.05). CONCLUSION: LELAPE is a safe and feasible surgical approach for low rectal cancer.

[Mercury in tree rings: Advances, problems and prospects]. / æ ‘æœ¨å¹´è½®æ±žè®°å½•: 进展、问题和展望.

As a highly biotoxic element, mercury (Hg) can be enriched by the food chain and has negative effect on ecosystems. Changes of Hg flux and reserves in forest have important effects on its biogeochemical cycle in forest ecosystem. Due to limitation of temporal and spatial monitoring, there is not comprehensive understanding on Hg distribution. Widely distributed trees can be used as effective bio-monitors and Hg records in tree rings can be used to study Hg temporal and spatial distribution. Hg accumulated by root, leaf, bark, and other tissues can be detained in bole and record environmental Hg variations. Therefore, historical Hg trends can be restructured by analyzing Hg concentration in tree rings and the biogeochemical characteristics can be understood with Hg isotope ratio. We reviewed the method of measurement of Hg concentration and isotope ratio and application of reconstruction using Hg concentration in tree ring. We suggested the great application potential of Hg isotope ratio in atmospheric Hg construction and biogeochemistry cycle and raised concerns in further studies.

The quality of total mesorectal excision specimen: A review of its macroscopic assessment and prognostic significance.

As a surgical procedure which could significantly lower the recurrence rate of cancers, total mesorectal excision (TME) has been the gold standard for middle and lower rectal cancer treatment. However, previous studies have shown that the procedure did not achieve the ideal theoretical local recurrence rates of rectal cancers. Some researchers pointed out it was very likely that not all so-called TME treatments completely removed the mesorectum, implying that some of these TME surgical treatments failed to meet oncological quality standards. Therefore, a suitable assessment tool for the surgical quality of TME is necessary. The notion of "macroscopic assessment of mesorectal excision (MAME)" was put forward by some researchers as a better assessment tool for the surgical quality of TME and has been confirmed by a series of studies. Besides providing rapid and accurate surgical quality feedbacks for surgeons, MAME also effectively assesses the prognosis of patients with rectal cancer. However, as a new assessment tool used for TME surgical quality, MAME has an only limited influence on the current guidelines and is yet to be widely applied in most countries. The aims of this review are to provide a detailed introduction to MAME for clinical practice and to summarize the current prognostic significance of MAME.