Purpose: The current meta-analysis combining mid and low rectal cancer with no meta-analysis only for low rectal cancer was seen. This meta-analysis was to compare the short- and mid-term outcomes of the transanal total mesorectal excision (TaTME) vs. laparoscopic total mesorectal excision (LaTME) for low rectal cancer. Methods: A systematic literature search was conducted using the web-based databases; China National Knowledge Infrastructure, Chinese BioMedical Database, PubMed, Embase, Cochrane Central Register of Controlled Trials, and Wanfang Database. Randomized controlled trials (RCTs) were evaluated using the Jadad scale and non-RCTs (NRCs) were evaluated using the Newcastle-Ottawa Scale. Results: Ten studies (2 RCTs and 8 NRCs) involving 772 patients were included. Among them, 378 patients underwent TaTME and 394 patients underwent LaTME. Compared with the LaTME group, the conversion rate was low (risk ratio [RR], 0.25; 95% confidence interval [CI], 0.11–0.54; P < 0.001), the circumferential resection margin (CRM) involvement was low (RR, 0.48; 95% CI, 0.27–0.86; P = 0.010), and the hospital stay was short (mean difference, –1.72; 95% CI, –2.89 to –0.55; P = 0.004) in the TaTME group. No significant differences were seen in the mesorectal resection quality, CRM distance, distal resection margin (DRM) involvement, DRM distance, local R1 resection, intraoperative complications, morbidity, anastomotic leakage, severe morbidity, mortality, operative time, intraoperative blood loss, harvested lymph nodes, and local recurrence rate (P > 0.05). Conclusion The TaTME is a promising surgical technique and is fully a safe and efficacious option in managing low rectal cancer.

Objective To know the current situation of core competency of midwives in Guangzhou, and analyze the influencing factors.Methods A cross sectional survey was conducted among 256 midwives from 13 hospitals in Guangzhou to investigate their core competency.Results The total average score of core competency of midwives was (4.09±0.49). The scores of intrapartum care and antenatal care were higher,while the scores of progestational care and public health care were lower. Multivariate regression analysis showed that the core competency of midwives was influenced by several aspects,and they were work experience,work experience in midwifery,age,title,job and marital status (β′=0.771, 0.549,0.409,0.390,0.250,0.137;P<0.05).Conclusions The overall level of midwifery competency of midwives in Guangzhou is good,but their professional scope and role function need to be deepen and expanded,so as to satisfy the growing health care demand from pregnant women and their families. Managers should develop individualized and specific training and management strategies to improve midwives′ competency based on the condition of hospitals.