Objective To evaluate the feasibility of laparoscopic rectal resection (LR) in elderly and younger patients with rectal cancer. Methods From January 2008 to March 2009, 76 patients with rectal cancer undergoing elective rectal resection were included in this study. Older than 70 years named elderly group, in which LR was given to 16 cases, and open resection (OR) to 18 cases. Younger than 70 years named younger group, in which LR was performed in 23 cases, and OR in 19 cases. The results after LR and OR in rectal cancer between 2 groups of patients were compared. Results No surgery-assisted death occurred in either group. In 2 groups, ventilation time, intake food time and hospitalization after operation in LR were shorter than those of OR (P＜0.05， P＜0.01); intraoperative blood loss and the proportion of postoperative analgesia in LR were less than those of OR in 2 groups (P＜0.01); there were no significant differences between LR and OR (Pgt;0.05) in mean operation time or number of lymph node resected. In addition to the incision infection rate, the other complications rates and the postoperative life self-care rate between LR and OR were no significantly different in younger group (Pgt;0.05). In the elderly group, every complication rates of LR were lower than those of OR (P＜0.05), oppositely, the postoperative life self-care rate was higher (P＜0.01). Conclusions LR of rectal cancer can be applied to both elderly and younger patients. It is suggested that advanced age should not be the contraindication for LR, and by contrary elderly patients may be particularly indicated for lower postoperative complications rate compared to open surgeries.
ObjectiveTo investigate the effect of Metformin (MET) on the anxiety behavior of mice with Pentylenetetrazol (PTZ)-induced epilepsy and the mechanisms. MethodsSixty male 8-week-old C57BL/6 mice were randomly divided into normal control group (Normal), Temporal lobe epilepsy (TLE) model control group (TLE-con), TLE + MET treatment group (TLE-MET), and normal mice + MET intervention group (MET-con) (n=15/group). In the TLE-con group and the TLE-MET group, mice were injected intraperitoneally with PTZ every other day to establish the TLE model, while mice in the Normal group and the MET group were given the same dose of normal saline. During PTZ administration, mice in the TLE-MET treatment group and the MET-con group were intraperitoneally injected with MET at 200 mg/(kg·d) every other day, for 14 times in a total of 28 days. The mice in the Normal group and the TLE-con group were intraperitoneally injected with the same amount of normal saline. Open field test (OFT) and elevated cross maze (EPM) were used to evaluate the anxiety behavior of mice in each group, and the Western blotting analysis was performed to detect expression of Toll like receptor 4 (TLR4), Nuclear factor-kappa B (NF-κB) p65 in brain tissues. ResultsCompared with the Normal group, the TLE-con group showed decreased times in the open arm in the EPM test (P<0.01) and in the center of open field in the OFT test (P<0.01), while MET intervention could increase the times of epileptic mice in the central area and the open arm (P<0.05). Compared with the Normal group, the expression of TLR4 and NF-κB in the cerebral cortex in the TLE-con group was increased significantly (P<0.05), while MET intervention could partially decrease the expression of TLR4 and NF-κB in the cerebral cortex of epileptic mice (P<0.05). ConclusionMET may improve the anxiety behavior of epileptic mice by reducing the inflammatory TLR4–NF-κB pathway.
ObjectiveTo explore the trajectories of health-related quality of life (HRQoL) among adolescents after metabolic bariatric surgery and to identify influencing factors. MethodsThis retrospective cohort study included 208 adolescents who underwent metabolic bariatric surgery at the First Affiliated Hospital of Nanjing Medical University from June 2023 to December 2024. Data on quality of life were collected at baseline, 3 months, and 6 months postoperatively, along with related scale assessments at 6 months. Latent class growth modeling was applied to identify trajectory categories of quality of life. Demographic characteristics and scale points were compared across groups, and unordered multinomial logistic regression was used to analyze influencing factors. ResultsThree distinct HRQoL trajectories were identified by latent class growth model: low-level improvement group (102 cases, 49.0%), moderate-level stable group (74 cases, 35.6%), and high-level decline group (32 cases, 15.4%). Significant differences were observed among groups in BMI, percentage of excess weight loss (EWL%), points of body image, self-esteem, objective support, support utilization and appearance anxiety index at 6 months after operation (P<0.05). At 6 months postoperatively, patients in the low-level improvement group had the lowest BMI and the highest EWL%, along with higher body image and support utilization points. Patients in the moderate-level stable group experienced less weight reduction than those in the low-level improvement group, with only limited improvement in quality of life. Although patients in the high-level decline group initially had better preoperative quality of life, they showed the least postoperative weight loss, the lowest body image and support utilization points, and higher appearance anxiety points, with a progressive decline in quality of life. Results of unordered multinomial logistic regression analysis indicated that postoperative BMI, EWL%, points of body image, and support utilization were influencing factors associated with HRQoL trajectories (P<0.05). ConclusionsMetabolic bariatric surgery improves quality of life in most adolescents, yet a subgroup experiences unfavorable trajectories. Postoperative weight loss, body image, and social support are critical determinants. Early identification and targeted interventions are needed to optimize long-term outcomes.
ObjectiveTo explore the effects of mindful eating intervention on the dietary adherence and surgical outcomes for patients after bariatric and metabolic surgery. MethodsA total of 124 obese patients who underwent bariatric and metabolic surgery in the First Affiliated Hospital of Nanjing Medical University from May 2023 to May 2024 were recruited by convenience sampling method. The patients were randomly equally divided into the observation group and the control group respectively. Mindful eating intervention and routine follow-up management were given in the two groups respectively. The dietary aderence and the effects of bariatric and metabolic surgery were compared between the two groups. ResultsA total of 124 patients were included based on sample size calculation, with 62 patients in each group. The baseline characteristics, including gender, age, body mass index (BMI), surgical approach, and comorbidities, showed no statistically significant differences between the two groups (P>0.05). The points of dietary compliance, dietary control, and fluid intake in the observation group were all better than those in the control group (P＜0.05), while there was no significant difference in the points of nutrient intake and eating habits between the two groups (P＞0.05). Over time, the differences in the points of dietary compliance, dietary control, and fluid intake between the observation group and the control group gradually increased (P＜0.05), while there were no significant differences in the points of nutrient intake and eating habits between the two groups (P＞0.05). The BMI, percentage of excess weight loss, and remission of comorbidities in the observation group were significantly better than those in the control group at 6 months after surgery (P<0.05), there was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). ConclusionThe preliminary results of this study suggest that mindful eating intervention after bariatric and metabolic surgery can effectively improve patients’ dietary adherence and promote surgical results.
Objective By investigating the employment situation and intentions of medical students, to provide scientific evidence for guiding students’ employment by relevant departments, and to give references for formulating reasonable medical personnel training and distribution policy by health administrations. Methods The medical students of Grade 2005 in Lanzhou University were investigated by using a self-designed questionnaire. Results Among 397 questionnaires distributed, 337 were returned (84.8%). The analyses showed, when hunting a job, 45% of the respondents thought the “opportunities for personal development” was the most important factor, 61% thought the influence of parents’ or family’s desires was “greater” or “extremely greater”, 85% thought the job matching their majors was “important” or “very important”, 57% thought it is “easier” to get a content job by their majors, 51% held that the “fewer opportunities” were the most unfavorable conditions for working in township hospitals, 68% wouldn’t directly choose township hospitals after graduation, and 67% still gave up the choice even if an official position was provided. Conclusion The medical students attach great importance to the opportunities for their personal development, but they lack self-consciousness in choosing the occupation. They are optimistic about the employment but lack passion for primary hospitals. Meanwhile, they aren’t familiar with national policy guidance; their employment fields are narrow.