Objective To investigate the clinical application value of hand-assistant laparoscopy and total laparoscopy in radical right colectomy.Methods Five hundred and twenty-four patients were selected as our subjects who performed by hand-assistant laparoscopic radical right colectomy (213 cases) or total laparoscopic radical right colectomy (293 cases) in colon cancer therapy.The operation durations,bleeding volumes,postoperative pain scores,postoperative draining volumes,recovery time of gastrointestinal function,hospitalization times,hospitalization expenses,postoperative complications and cosmetic satisfactory scores were recorded and compared.Results The operation durations,bleeding volumes,postoperative draining volumes in hand-assistant laparoscopic group were (112.4±52.9) min,(105.6 ± 49.5) ml,(28.6± 15.7) ml,lower than those in total laparoscopic group((148.5±61.7) min,(171.5±72.4) ml,(28.6±15.7) ml;P=0.032,0.041,0.039).The recovery time of gastrointestinal function of hand-assistant laparoscopic group were (69.4±21.8) h,longer than total laparoscopic group ((53.4 ± 21.7) h;P =0.008).The hospitalization times,hospitalization expenses,postoperative complications of hand-assistant laparoscopic group were as same as total laparoscopic group(P＞0.05).Hand-assisted laparoscopic group mild pain in 35 cases,121 cases of moderate and severe 75 cases;Total 96 cases of mild pain in laparoscopic group,146 cases of moderate and severe in 51 cases,the difference was statistically significant(P=0.027).Beauty score incision of laparoscopic group was higher than in the whole hand-assisted laparoscopic group,the difference was statistically significant ((4.3 ± 0.9) score vs.(2.4±0.6) score;P=0.002).Conclusion Hand-assistant laparoscopic radical right colectomy is convenient and more quickly for operation.Total laparoscopic radical right colectomy has advantage in terms of less injury and the patients are more satisfactory.For practiced operators,total laparoscopic radical right colectomy is recommended cosmetic satisfactory score.

Nocardia is a genus of gram-positive,weakly acid-fast,filamentous aerobic actinomycetes,which mainly causes infection in immunocompromised persons. We reported a successfully treated fatal case of severe pneumonia caused by Nocardia farcinica in a hospital,then reviewed 25 domestic and abroad case reports about nocardiosis combined with severe pneumonia occurred since 2006,so as to improve health care workers'cognition on clinical manifestations,image features,pathogenic characteristics,and diagnostic and treatment schemes of se-vere pneumonia caused by Nocardia farcinica.

Objective:To investigate the expression of intestinal alkaline phosphatase (IAP) in intestinal mucosa with bile deficiency and the effect of bile on the expression of IAP in intestinal epithelial Caco-2 cell model.Methods:Thirty healthy male SD rats were randomly divided into control group (Ctrl, n=10), external drainage group (ED, n=10) and obstructive jaundice group (OJ, n=10). Ileum specimens were collected on the 7th day after modeling. Western blot and immunohistochemical staining were used to determine the expression of IAP in rat intestinal mucosa. Different concentrations of human bile were used to treat on Caco-2 cells, and Western blot was used to detect the changes in IAP expression in Caco-2 cells. Results:Rat models were successfully established. The expression level of IAP in the intestinal mucosa of ED group [(9.19±1.67)%] was significantly lower than that of the Ctrl group [(15.09±0.61)%, P<0.05]; the expression of IAP in the intestinal mucosa of OJ group [(6.86±1.07)%] was significantly lower than that of the Ctrl group ( P<0.05). Through in vitro cell experiments, expression of IAP in Caco-2 cells was increased in a time and dose-dependent manner when treated with human bile. Conclusions:Bile deficiency in the intestine can cause inhibition of IAP in the intestinal mucosa. Bile can promote the expression of IAP in intestinal mucosal epithelial cells.