PURPOSE: The current study aimed to examine the short-term outcomes and multidimensional factors associated with preoperative sedentary behavior among Chinese older adults with gastric cancer. METHOD: An observational study was conducted among older adults with gastric cancer in a tertiary hospital in Jiangsu, China. A total of 393 participants were enrolled by convenience sampling. Sedentary behavior was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Logistic regression was applied to explore the relationship between preoperative sedentary behavior and short-term outcomes. Univariate and multivariate analyses were used to determine the factors associated with participants'sedentary behavior. RESULTS: Preoperative sedentary behavior was related to multiple outcomes, including total complications, prolonged length of stay, and increased hospitalization costs. Two or more comorbidities and depression were risk factors for sedentary behavior. High-density lipoprotein; female sex; and high school, middle school, and primary school and below educational levels were protective factors for sedentary behavior. CONCLUSION: Health care professionals need to simultaneously concentrate on multidimensional aspects linked to sedentary behavior to successfully administer behavioral interventions for enhancing older adults' overall prognosis. [Journal of Gerontological Nursing, 51(1), 32-41.]

INTRODUCTION:This study aimed to explore the associations of low hand grip strength (HGS), HGS asymmetry, their combinations, and frailty on hospital readmissions, total complications, and prolonged length of stay (PLOS) among older adults with gastric cancer. MATERIALS AND METHODS:This study included 342 patients with gastric cancer aged ≥60 years who were scheduled to undergo radical surgery. The Tilburg Frailty Indicator (TFI) was used to collect information on frailty. HGS was measured twice for each hand using an electronic handgrip dynamometer. The highest HGS readings on each hand were used for calculating the HGS asymmetry ratio: non-dominant HGS (kg)/dominant HGS (kg). The Fine and Gray proportional subdistribution hazard model and the logistic regression model were used for the analyses, with covariates adjusted. RESULTS:Low HGS (subdistribution hazard ratios [SHR] = 2.10, 95% confidence interval [CI] = 1.05-3.93, P = 0.036) and low HGS with HGS asymmetry (SHR = 3.95, 95% CI = 1.50-10.36, P = 0.005) were significantly associated with hospital readmissions. Frailty was associated with total complications (odds ratio [OR] = 2.87, 95% CI = 1.61-5.13, P < 0.001) and PLOS (OR = 1.98, 95% CI = 1.19-3.29, P < 0.001). Low HGS, HGS asymmetry, and their combinations were not significantly associated with total complications and PLOS. DISCUSSION:Preoperative low HGS and low HGS with HGS asymmetry were associated with hospital readmissions, while frailty was associated with total complications and PLOS among older adults with gastric cancer. In the future, more rigorously designed studies are needed to verify our results further to improve preoperative clinical assessment and frailty evaluation among older adults with gastric cancer.

目的:采用Meta分析探究气道压力释放通气(APRV)对急性呼吸窘迫综合征(ARDS)患者的有效性,并与传统的机械通气模式进行对比.方法:通过检索PubMed、Cochrane、Embase和中国知网等数据库,收集从建库至2022年6月公开发表的关于APRV对ARDS患者疗效的随机对照试验(RCT)研究,研究的APRV组采用APRV,对照组采用传统机械通气模式,结局指标包括住院死亡率、ICU住院时间及氧合指数;排除观察性研究、病例报告、动物研究等文献类型.结果:纳入12篇文献,共706例患者,其中APRV组356例、对照组350例.结果 显示APRV能够显著降低ARDS患者住院死亡率(RR=0.66,95％CI0.52～0.84,P=0.001),缩短ARDS患者 ICU 住院时间(MD=0.72,95％CI-1.49～0.05,P=0.048),改善 ARDS 患者氧合指数(MD=1.69,95％CI 0.89～2.49,P=0.001).结论:APRV较传统机械通气模式能够降低ARDS患者住院死亡率、缩短ARDS患者ICU住院时间、改善ARDS患者氧合指数,APRV对ARDS患者来说是一种更为安全有效的通气模式.

BACKGROUND:Frailty is commom among gastric cancer survivors and increases the burden of care. AIMS:Our aims were to identify the frailty trajectories and investigate their associations with health outcomes in older gastric cancer survivors. METHODS:We finally recruited 381 patients aged ≧60 who underwent radical gastrectomy and recorded frailty at discharge from the hospital, 1, 3, 6, and 12 months after surgery. Growth mixture modeling was used to investigate the frailty trajectories and linear regression models were used to examine their associations with health outcomes. RESULTS:Three classes of frailty trajectories were identified: the "improving frailty", "maintaining frailty" and "deteriorating frailty". Compared with class 1, patients who followed class 2 and class 3 frailty trajectories were more likely to have more severe disability (β = -14.22, 95 % CI: -17.92, -10.61, P < 0.001; β = -48.34, 95 % CI: -52.25, -44.42, P < 0.001), worse quality of life (β = 10.89, 95 % CI: 7.71,14.08, P < 0.001; β = 34.82, 95 % CI: 31.46, 38.19, P < 0.001), and more frequency readmission within 1 year (β = 1.02, 95 % CI: 0.98, 1.06, P < 0.001; β = 2.10, 95 % CI: 2.01, 2.14, P < 0.001) after controlling potential confounders. However, class 2 and class 3 have no significant difference from class 1 in the total hospitalization costs (β = 1672.12, 95 % CI: -7145.95, 10496.19, P = 0.709; β = 7651.60, 95 % CI: -1670.28, 16793.47, P = 0.107). CONCLUSIONS:Our study suggested the significant prognostic heterogeneity in frailty trajectories, and what we need to do is to identify patients with heterogeneous trajectory and intervene in them to reduce adverse outcomes, promote rational use of resources, and reduce the burden of care.

Frailty is defined as a state of decreased physiologic reserves arising from cumulative deficits in multiple homeostatic systems, which is important in the field of clinical oncology. We aimed to explore the relationship between preoperative frailty and adverse outcomes, and systematically analyze the factors influencing frailty based on the health ecology model among elderly gastric cancer patients. A observational study was conducted to select 406 elderly patients who would undergo gastric cancer surgery at a tertiary hospital. The logistic regression model was used to examine the relationship between preoperative frailty and adverse outcomes, including total complications, prolonged length of stay (PLOS), and 90-day hospital readmission. Based on the health ecology model, the factors which may influence frailty were collected from four levels. Univariate and multivariate analysis were utilized to determine the factors influencing preoperative frailty. Preoperative frailty was associated with total complications (odds ratio [OR] 2.776, 95

AIM:Nutritional status and frailty are significant indicators reflecting physiological reserve. We sought to establish and validate a web-based calculator containing the Geriatric Nutritional Risk Index (GNRI) and the Tilburg Frailty Indicator (TFI) together with general clinical information to predict total complications among elderly patients with gastric cancer. METHODS:This was a prospective cohort study of 582 elderly patients with gastric cancer in a tertiary hospital in China. Nutritional status and frailty were assessed by the GNRI and the TFI, respectively. The nomogram was built and further converted into a web-based calculator. The receiver operating characteristic analysis was performed to evaluate the discrimination of the nomogram. Calibration was assessed using the calibration curve and Hosmer-Lemeshow test via the bootstrap resampling procedure. The decision curve analyses (DCAs) were employed to quantify the net benefits of a certain threshold probability for assessing the clinical values. RESULTS:The GNRI (odds ratio [OR], 0.921; 95% confidence interval [CI], 0.895-0.949; P < 0.001), the TFI (OR, 1.243; 95% CI, 1.113-1.386; P < 0.001), surgical approach (OR, 1.913; 95% CI, 1.073-3.408; P = 0.028) and comorbidity (OR = 1.599, 95%CI = 1.028-2.486, P = 0.037) were independently associated with total complications. The nomogram demonstrated good discrimination (area under the receiver operating characteristic curve: training cohort, 0.735; validation cohort, 0.777) and calibration (P = 0.135). The DCA curves of the nomogram also showed good positive net benefits. CONCLUSIONS:The web-based calculator incorporating the GNRI, the TFI, surgical approach, and comorbidity could successfully predict total complications among elderly patients with gastric cancer with good accuracy in a convenient manner. Geriatr Gerontol Int 2023; 23: 205-212.

This study aimed to determine the association of absolute and relative HGS indicators with postoperative short-term outcomes in older patients with gastric cancer. Associations between different low HGS indicators and worse postoperative outcomes was observed. HGS indicators could be the ideal predictors for clinical outcomes in older patients with gastric cancer. This study aimed to determine the association of absolute and relative HGS indicators with postoperative short-term outcomes in older patients with gastric cancer. The prospective, single-center, observational study involved 230 patients (age ≥ 60 years) who underwent radical gastrectomy. Absolute HGS was directly obtained from results measured by a hand dynamometer, while relative HGS was calculated as the value of absolute HGS divided by body mass index (BMI), appendicular skeletal muscle mass index (ASMI) and age, respectively. Low absolute HGS was defined according to the criterion in AWGS 2019 consensus and the first gender-specific quartile. Low relative handgrip strength was defined if it was below the first gender-specific quartile of the distribution. Postoperative outcomes included total complications, malnutrition and length of hospital stay. Univariate and multivariate regression models were performed to investigate and compare the predictive values of different HGS indicators. For the five HGS indicators, multivariate analyses showed that low absolute HGS (AWGS consensus), low HGS/BMI and HGS/age were independent risk factors for both postoperative total complications (absolute HGS(AWGS consensus): OR 2.03, 95

Objectives:This study aimed to assess the feasibility of the home-based kyphosis-specific exercises among Chinese older adults with different exercise habits and explore its potential effects on reducing the kyphosis angle and improving physical performance. Methods:A single-group, pre-and post-test design was conducted according to CONSORT 2010 statement: extension for pilot and feasibility trials. A total of 20 participants aged ≥60 with thoracic hyperkyphosis and rehabilitation potential were recruited from four local communities in Wuhan, China. Participants underwent a six-week home-based kyphosis-specific exercises intervention that included warm-up, muscle strengthens, spinal alignment, spinal mobility and flexibility, and cool down five sections (22 exercises). The intervention involved seven 1-h group classes and 35 times daily home practice with identical content. At pre- and post-intervention, the participants' kyphosis angle in two standing postures, static balance, dynamic balance, cardiopulmonary function, dynamic gait assessment, pain, and self-image were assessed and compared. Feasibility was assessed by group class attendance, home practice adherence, and participant evaluations. Results:All participants completed group classes and >75% home practice. Post-intervention, the participant's kyphosis angle in relaxed and best-standing postures was changed by -12.0° (-15.5°, -4.0°) (Z = - 3.98, P < 0.001）and -10.0° (-14.0°, -5.3°) (Z = -3.79, P < 0.001), respectively. In addition, participants had significantly less pain (P < 0.001), better self-image (P < 0.001), and improved performance in five physical assessments (P < 0.01). Different pre-intervention hyperkyphosis angle and daily physical activity did not affect intervention effects. Most participants considered the interventional exercise as moderate intensity and satisfactory. Conclusions:Home-based kyphosis-specific exercises showed the possibility of being a feasible intervention. And it was advantageous to reducing the kyphosis angle and improving physical performance.

Objectives: The aim of this study was to compare the performance of five sarcopenia screening tools in preoperative patients with gastric cancer, including strength, assistance with walking, rise from a chair, climb stairs, and falls; strength, assistance with walking, rise from a chair, climb stairs, falls, and calf circumference (SARC-CalF); Ishii score chart; short version of the mini sarcopenia risk assessment; and full version of the mini sarcopenia risk assessment.Methods: We conducted a cross-sectional study of consecutive patients undergoing a gastrectomy between May 2020 and October 2020. Sarcopenia was diagnosed per the diagnostic criteria proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Data on the five sarcopenia screening tools, patient characteristics, nutrition risk screening 2002, and diagnostic indicators of sarcopenia were collected preoperatively, and pathological characteristics of the tumor were collected postoperatively. Based on the EWGSOP2 criteria, the clinical validity of the sarcopenia tools was measured using sensitivity, specificity, and predictive value. A receiver operator characteristic curve and area under curve were applied to compare the overall screening accuracy, and a Youden index was calculated to determine the optimal cutoff value of each tool.Results: We included 260 participants age 62.38 11.21 y. Based on the EWGSOP2 criteria, the prevalence of sarcopenia and severe sarcopenia were 8.46% and 4.62%, respectively. Moreover, the prevalence of sarcopenia risk ranged from 3.46% to 73.85% based on the five screening tools. Of these tools, SARC-CalF had the largest area under the curve (0.896) with moderate-to-high sensitivity (86.36%) and high specificity (92.86%). For SARC-CalF, the cutoff value of 10 reached the highest Youden index, and the corresponding sensitivity and specificity were 81.82% and 93.44%, respectively. Conclusion: Among the above five screening tools, SARC-CalF appeared to be the optimal choice to screen sarcopenia in preoperative patients with gastric cancer.(c) 2021 Elsevier Inc. All rights reserved.

Purpose: To classify the frailty subgroups by employing the Tilburg Frailty Indicator (TFI), as well as exploring the differences in postoperative total complications, length of stay (LOS), disability, and quality of life (QOL) between each subgroup among preoperative elderly gastric cancer patients. Methods: Overall 290 patients were enrolled in this follow-up study. The TFI was used to collect the information of physical, psychological, and social frailty. The data of total complications and LOS were provided from the electronic medical records, while the data of disability and QOL were obtained from the telephone at 30 days after discharge. Results : The TFI divided the preoperative elderly gastric cancer patients into eight frailty subgroups: exclusive physical frailty (18.3%), exclusive psychological frailty (20%), exclusive social frailty (3.4%), physical and psychological frailty (14.5%), physical and social frailty (3.4%), psychological and social frailty (3.4%), multidimensional frailty (4.8%) and full robust subgroup (32%). The multidimensional frailty subgroup had worse outcomes in total complications (P=0.001) and LOS (P＜0.001) while the subgroup of physical and social frailty had poorer QOL (P=0.015) at 30 days after discharge. Conclusion : The multidimensional frailty subgroup and the physical and social frailty subgroup should be of particularly concerned in the hospital and outside hospital according to our study. It also indicates that prehabilitation strategies can be developed precisely based on reported items to improve functional status of elderly gastric cancer patients. Further studies are needed to conduct in a longer-term period to capture significant change of other outcome indicators.

This systematic review and meta-analysis aimed to explore the predictive value of preoperative handgrip strength on postoperative outcomes in patients with gastrointestinal tumors. Databases including Cochrane Library, Pubmed, Embase, Web of Science, and CINAHL Complete were searched for articles published from the establishment of database until August 7, 2021. Two researchers independently screened the literature, extracted the data, and evaluated the quality. Eight studies were included, involving five prospective and three retrospective cohort studies with 2291 participants. The prevalence of preoperative low handgrip strength ranged from 11.8 to 62.7%. Preoperative low handgrip strength was associated with an increased risk of total complications (OR = 2.23, 95%CI = 1.43–3.50), pneumonia (OR = 5.16, 95%CI = 3.17–8.38), ileus (OR = 2.48, 95%CI = 1.09–5.65), and short-term mortality (OR = 7.28, 95%CI = 1.90–27.92). This systematic review and meta-analysis indicated that preoperative HGS had important value to predict certain adverse postoperative outcomes among patients with GI tumors. Low handgrip strength criteria, definition of total complications, and country are the potential sources of heterogeneity, and more research are required to test and update these results.

To evaluate the association between metabolic syndrome and the presence of frailty. Metabolic syndrome was significantly associated with the presence of frailly, as well as weakness, slow gait speed, decreased physical activity and weight loss. People with metabolic syndrome are more likely to suffer from frailty, while this association could be modified by age and specific disease. Frailty represents a progressive deterioration in multi-system of the body and could increase vulnerability to stressors. Recently, several studies found that metabolic syndrome was significantly associated with frailty and emphasized its role in assessing and preventing frailty. However, these conclusions are controversial. We conducted this systematic review and meta-analysis to evaluate the association between metabolic syndrome and frailty. Databases including Pubmed, Embase, Web of Science, CINAHL Complete, China National Knowledge Infrastructure (CNKI) and Wanfang Data Knowledge Service Platform were searched for studies on the association between metabolic syndrome and frailty, from inception to 17th June 2022. Two researchers independently screened the literature, extracted the data and evaluated the quality. Stata/SE 15.0 software was used to perform the statistical analysis. Eleven studies were included in this review and eight studies were included in the meta-analysis, involving one prospective cohort studies and ten cross-sectional studies with 12,640 participants. The pooled results indicated that metabolic syndrome was significantly associated with frailty (OR = 1.82, 95% CI = 1.46–2.27) with a low heterogeneity (I2 = 32.1%), and there were significant associations between MetS and weakness (OR = 1.35, 95% CI = 1.15–1.58, I2 = 0.0%), slow gait speed (OR = 1.80, 95% CI = 1.51–2.14, I2 = 93.4%), weight loss (OR = 1.77, 95% CI = 1.36–2.29, I2 = 0.0%) and decreased physical activity (OR = 1.87, 95% CI = 1.49–2.35, I2 = 39.7%). The findings of this systematic review and meta-analysis suggested that metabolic syndrome could be significantly associated with the presence of frailly. Future studies need to further consider the effects of measurement tools, age and specific disease status in this association. Furthermore, the casual relationship between them is to be determined.

综述移动医疗在消化道肿瘤病人延续护理中的应用研究现状、现存的问题,以期为移动医疗在消化道肿瘤延续护理中的广泛应用提供参考.

目的 比较5种不同肌肉减少症筛查工具在胃癌患者术前营养评定中的应用效果.方法 便利选取2020年5月—10月江苏省某三级甲等医院收治的拟行胃癌手术的患者270例,分别应用肌肉减少症五条目问卷、改良版肌肉减少症五条目(Strength,Assis tance with walking,Rise from a Chair,Climb Stairs,Falls and Calf Circumference,SARC-CalF)问卷、Ishii评分、迷你肌肉减少症风险评估-7条目问卷和迷你肌肉减少症风险评估-5条目问卷对其进行评估,并基于2019年亚洲肌肉减少症工作组(Asian Working Group for Sarcopenia,AWGS 2019)提出的诊断标准,采用SPSS 20.0和MedCalc 19.0.4软件计算灵敏度、特异度和预测值,绘制受试者操作特征曲线,计算曲线下面积,并通过计算Youden指数,确定各筛查工具的最佳截断值.结果 依据AWGS 2019提出的诊断标准,胃癌患者术前肌肉减少症的发生率为8.76％,使用5种评估工具得出存在肌肉减少症风险的发生率为3.42％～73.76％.上述5种筛查工具在胃癌患者术前肌肉减少症筛查中的灵敏度为26.09％～95.65％,特异度为28.33％～98.75％,受试者操作特征曲线下面积为0.696～0.901.其中,SARC-CalF问卷的受试者操作特征曲线下面积相对更高(0.901),且其灵敏度(82.61％)和特异度(92.08％)也较好,此时对应的最佳截断值为10分.结论 5种肌肉减少症筛查工具均具有一定的临床实用性和准确性,使用SARC-CalF问卷对胃癌患者术前进行肌肉减少症筛查更具灵敏度、特异度和准确性.

Background: Frailty is common in patients who undergo digestive system tumor surgery. This review aimed to explore the effects of preoperative frailty on multiple outcomes following surgery among patients with digestive system tumors. Methods: PubMed (Medline), Embase, Web of Science, and other databases were searched from the inception of each database to April 2021. Meta-analysis or qualitative synthesis was performed to examine the relationship between preoperative frailty and adverse postoperative outcomes. Results: A total of 29 studies encompassing 122,548 patients were included. Through meta-analysis, frailty was associated with an increased risk of total complications (risk ratio [RR] 1.44; 95 % confidence interval [CI] 1.39 to 1.50), major complications (RR 1.72; 95 % CI 1.51 to 1.95), 30-d mortality (RR 2.40; 95 % CI 2.14 to 2.70), and 5-year mortality (RR 1.74; 95 % CI 1.35 to 2.24). Through qualitative synthesis, compared with non-frail patients, two studies found that frail patients had a worse quality of life, and three studies reported that frail patients experienced greater rates of non-home discharge. However, two studies demonstrated inconsistent conclusions regarding the relationship between frailty and functional status. Conclusions: Preoperative frailty was an important risk factor for multiple adverse postoperative outcomes of patients with digestive system tumors, including objective clinical outcomes and patient-centered outcomes. Future studies focusing on the effects of frailty on patient-centered outcomes such as quality of life and functional status are needed. (C) 2021 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

The disease treatment of patients with gastrointestinal cancer is accompanied by impaired bodily functions. Frailty is very common in patients with gastrointestinal cancer, and is closely related to its various adverse health outcomes, which seriously affects their prognosis. This article reviews the risk factors, correlation with adverse health outcomes and intervention methods of frailty in gastrointestinal cancer patients. It is pointed out that medical and nursing staff should identify the frailty state of patients with gastrointestinal cancer as soon as possible and make early interventions to improve the prognosis of patients.

目的 对患者参与的主观全面评定(Patient-generated Subjective Global Assessment,PG-SGA)量表进行改良,检验改良版PG-SGA的信效度及条目质量.方法 基于项目反应理论筛选出PG-SGA中质量不佳的条目,修订后形成改良版PG-SGA.2019年9月-2020年2月纳入江苏省某三级甲等医院收治的281例胃癌围手术期患者,利用因子分析法确定改良版PG-SGA的条目权重并赋予相应分值.以主观全面评定(Subjective Global Assessment,SGA)为参照,根据受试者操作特征曲线划分改良版PG-SGA营养评定的截断值.最后评价信效度及条目质量.结果 经统计测试,确定了11个条目,总分为0～33分.营养评定的截断值如下:评分≥11分表示营养不良,评分<11分表示营养良好.信效度分析示,改良版PG-SGA用于营养评定的准确性高于PG-SGA,约登指数为0.844;总量表的内容效度指数为0.910;探索性因子分析提取4个公因子,累计方差贡献率为83.494％;Cronbach's a系数为0.707.项目反应理论分析显示,修订后的条目质量显者改善.结论 形成的改良版PG-SGA信效度良好,条目质量佳,临床可用该量表进行营养评定.

Background: Postoperative pain is a prevalent problem leading to many adverse outcomes in surgical patients. Virtual reality (VR) is an emerging non-pharmacological method of postoperative pain relief, but the effects of it are not clear. This review aimed to explore the effects of VR on relieving postoperative pain. Methods: Studies published up to November 2019 were identified by searching the PubMed (Medline), Embase, Web of Science, and other databases. Meta-analyses were conducted to compare VR and usual care for relieving postoperative pain. Subgroup analyses and sensitivity analyses were performed to explain the heterogeneity. Results: Overall, 8 randomized control trials (RCTs) enrolling 723 participants were included. Our results demonstrated that the patients receiving the VR intervention had lower postoperative pain scores than those receiving the usual care (mean difference [MD] -0.64; 95% CI -1.05 to -0.22; P = 0.002). One subgroup analysis revealed that VR could relieve postoperative pain both in minor surgery (MD -1.48; 95% CI -2.02 to -0.95; P < 0.0001) and major surgery (MD -0.32; 95% CI -0.53 to -0.11; P < 0.03). Another subgroup analysis demon-strated a significant reduction in postoperative pain among patients receiving VR during the intraoperative (MD -1.51; 95% CI -2.04 to -0.97; P < 0.00001) and the postoperative periods (MD -0.50; 95% CI -0.76 to -0.24; P 0.002). However, there was no significant postoperative pain relief when receiving VR during the preoperative period. Additionally, significant improvements in postoperative satisfaction were reported in two studies. However, another two studies included found that VR could not affect physiological parameters related to pain. Conclusions: Applying VR can relieve postoperative pain effectively. The type of surgery and timing of using VR are the main sources of heterogeneity. More rigorous studies about the relationship between VR and post-operative pain relief will be needed.

Vitamin deficiency, bacterial overgrowth, and gastrointestinal symptoms can be detected in obese patients after bariatric surgery that influences their quality of life (QoL) and weight. It is unclear if microecological preparations benefit obese patients following bariatric surgery. The aim of this study is to investigate the effects of microecological preparations on QoL, excess weight loss (EWL), and levels of vitamin B12 and inflammatory markers. We searched seven databases to identify reports published till December 1, 2019, and included randomized controlled trials investigating the effects of microecological preparations in obese adults undergoing bariatric surgery. The primary outcomes included QoL and EWL, while secondary outcomes comprised serum levels of vitamin B12, interleukin 6, TNF-α, and C-reactive protein (CRP). Study bias was analyzed using the Cochrane risk-of-bias tool. Statistical analyses were performed using Review Manager. The mean difference in outcomes was calculated using standardized mean difference (SMD) with a confidence interval (CI) of 95%. A majority of the studies showed a low or moderate risk of bias. Meta-analysis showed significantly higher levels of vitamin B12 in postoperative patients administered with microecological preparations (SMD = 0.52; 95% CI = 0.08–0.95; P=0.02). There were no significant differences in QoL (SMD = −0.14; 95% CI = −0.45–0.17; P=0.38), EWL (SMD = 0.45; 95% CI = −0.16–1.05; P=0.15), and levels of TNF-α (SMD = −0.29; 95% CI = −0.64–0.05; P=0.09), interleukin 6 (SMD = −0.1; 95% CI = −0.81–0.61; P=0.78]), and CRP (SMD = 0.02; 95% CI = −0.32–0.36; P=0.93). The trials examined indicated that microecological preparations had limited efficacy in improving QoL, EWL, and inflammatory response, but they stimulated the synthesis of vitamin B12. This may help in designing efficient microecological preparations to supplement bariatric surgery in obese individuals.

目的 调查目前医学教育模式下,医学院校大学二年级本科生的跨专业合作学习准备状态和跨专业团队合作态度的现状,并分析二者间的相关关系,为国内开展跨专业教育提供依据.方法 2018年9月-11月采取便利抽样法,运用中文版跨专业合作学习准备量表和跨专业教育认知量表在南京某医学院校的2017级大学二年级本科生中开展一次横断面调查.结果 共调查341名大二本科生,其跨专业学习准备状态得分中位数为69.00分,四分位数间距为11.00分;跨专业团队合作态度得分中位数为86.00分,四分位数间距为14.00分.且二者间存在正相关关系(r,=0.282,P<0.001).结论 医学专业大二本科生跨专业学习准备状态和跨专业团队合作态度总体均较为积极,且两者间呈正相关关系.提示在医学专业大二本科生教育中设置跨专业教育实践活动是值得考虑的.