Objective : To explore the mediating effect of self-efficacy on family health and health literacy among middle-aged and elderly chronic diseases patients in rural areas, so as to provide a basis for developing targeted health literacy improvement strategies. Methods: Based on the publicly available 2021 "Survey of Chinese Residents' Psychology and Behavior" database, rural chronic diseases patients aged >45 years were selected as the study subjects. Data on demographic information, family type, and chronic diseases comorbidities were collected. The Chinese simplified Family Health Scale, General Self-Efficacy Scale, and Health Literacy Scale were used to assess family health, self-efficacy, and health literacy, respectively. Correlation analysis was employed to explore the relationships between variables, and the 4.1 Process program was used to analyze the mediating effect of self-efficacy on family health and health literacy. The Bootstrap method was applied to test the significance of the mediating effect. Results: A total of 449 participants were included, of whom 241 were male (53.67%) and 208 were female (46.33%). The majority (205 cases, 45.66%) were aged 60-<76 years. There were 168 cases (37.42%) with chronic disease comorbidities. The total score for family health was (37.96±6.25) points. The self-efficacy score was (27.28±5.40) points, the health literacy index was (27.72±8.08) points, and the health literacy proficiency rate was only 14.90% (67 patierts). Mediating effect analysis showed that family health could directly and positively influence health literacy, with a direct effect value of 0.090 (95%CI: 0.001-0.179). It could also indirectly and positively influence health literacy through self-efficacy, with a mediating effect value of 0.164 (95%CI: 0.099-0.234). The mediating effect accounted for 64.31% of the total effect. Conclusion Self-efficacy plays a positive mediating role between family health and health literacy among middle-aged and elderly chronic diseases patients in rural areas.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Robot-assisted surgery with its advantages such as three-dimensional high-definition vision, dexterous robotic arms, and tremor filtration, is increasingly being applied to complex radical gastrectomy. However, the role of the surgical assistant remains crucial during the procedure. The assistant is responsible for tasks outside the console, including adjusting robotic arms, changing instruments, exposing the surgical field, and addressing unexpected situations. The technical proficiency of the assistant and their collaboration efficiency with the primary surgeon directly impact the smoothness of surgery and patients' outcomes. With the expansion of robot-assisted surgical indications, the establishment of a standardized training system and the optimization of team collaboration models have become urgent challenges to address. This article draws on the author's practical experience as an assistant in robot-assisted gastric cancer surgeries, conducting an in-depth analysis of the responsibilities and operational skills of surgical assistants in robot-assisted procedures. The aim is to develop a relatively comprehensive set of operational guidelines for surgical assistants in robot-assisted radical gastrectomy, providing valuable references for enhancing the overall efficiency of surgical teams and improving surgical outcomes.

Objective To evaluate the efficacy,safety and patient compliance of a quadruple therapy containing minocycline compared with the traditional quadruple therapy in the treatment of Helicobacter(H.)pylori.Methods This study included 200 H.pylori positive patients,with 100 assigned to the minocycline-containing bismuth quadruple therapy group(LBMC group)and the other 100 to the amoxicillin-containing bismuth quadruple therapy group(LBAC group).After matching the two groups of patients using the propensity score matching(PSM)method,there were 86 cases in each group.Telephone follow-up was conducted on the 14th day after the start of treatment to record patient medication compliance and adverse drug reactions.A 13C urea breath test was performed for re-examination at least one month after completing the treatment plan and discontinuing medication.The intention-to-treat(ITT)and per-protocol(PP)analyses were used to compare the H.pylori eradication rates between the two groups,and Chi-square test and t-test were used for intergroup comparison.Results In the ITT analysis,the eradication rates of the LBMC group and the LBAC group were 89.5%(77/86,95%CI:82.9%～96.1%)and 82.6%(71/86,95%CI:74.4%～90.7%),respectively.In the PP analysis,the eradication rates were 92.6%(75/81,95%CI:86.8%～98.4%)and 88.8%(71/80,95%CI:81.7%～95.8%),respectively.The adverse reaction rate of the LBMC group was 27.9%(24/86),and that of the LBAC group 31.4%(27/86),showing no statistically significant difference(P>0.05).In terms of compliance,the LBMC group was 94.2%(81/86),and the LBAC group 93.0%(80/86),revealing no statistically significant difference(P>0.05).Conclusion As a first-line treatment for eradicating H.pylori,regimens containing minocycline demonstrate equivalent eradication rates to those containing amoxicillin,with similar safety and compliance.They can be used as an alternative treatment for patients allergic to penicillin.

Over the past two decades, the surgical treatment of gastric cancer has witnessed remarkable transformations. It has evolved from traditional open - surgery to laparoscopic minimally - invasive surgery, and subsequently to robot - assisted surgery. The robotic surgical system, owing to its distinctive advantages, has been gradually applied and popularized in gastric cancer surgeries. Nevertheless, it inevitably gives rise to specific technical blind spots and operational challenges.This paper systematically reviews the classification of intraoperative errors in robotic gastric cancer surgery and their clinical implications. It proposes a grading standard for bleeding, explores the identification and prevention strategies of hazard zones, and underscores the core values of meticulous preoperative planning, the standardized operation, and teamwork. Simultaneously, in light of the impact of tissue edema and fibrosis following neoadjuvant therapy on surgery, corresponding grading standards are established. The objective is to offer a valuable reference for clinical practice and facilitate the standardized and precise development of robotic gastric cancer surgery.

Polymyxins,a class of cyclic peptide antibiotics,have become the last line of defense against gram-negative bacterial infections as the number of multidrug-resistant bacteria continues to rise.Het-eroresistance refers to the presence of subpopulations within the same strain with varying sensitivities to antibi-otics,which cannot be detected by standard clinical tests and may result in treatment failure.In several com-mon gram-negative bacteria,mutations in the PhoPQ and PmrAB two-component systems are key contributors to polymyxin heteroresistance.This review aims to summarize recent research on the mechanisms of polymyxin heteroresistance in gram-negative bacteria,so as to provide insights for developing rapid detection methods and improving clinical treatment strategies.

To investigate the application value of disposable subscope-assisted intestinal metal stent placement in the treatment for acute malignant colorectal obstruction, a retrospective analysis was conducted on the patients who underwent intestinal metal stent placement assisted by disposable subscope for acute malignant colorectal obstruction at the Digestive Endoscopy Center, Affiliated Hospital of Yangzhou University from June 2023 to July 2024. The technical success rate, clinical success rate, operation time, postoperative complications and first-stage surgical resection anastomosis rate of intestinal metal stent placement assisted by subscope were analyzed. Among the 16 included patients, there were 10 males and 6 females, with the age of 72.19±9.40 years. Obstruction occurred at the descending colon in 8 cases (50.00%), at the sigmoid colon in 6 cases (37.50%), at the rectosigmoid junction in 1 case (6.25%), and at the splenic flexure of the transverse colon in 1 case (6.25%). All 16 patients successfully underwent stent placement, with a technical success rate of 100.00% (16/16). Obstruction symptoms did not relieve in one patient (6.25%) after stent placement, resulting in a clinical success rate of 93.75% (15/16). The endoscopic operation time for the 16 patients was 37.8±13.9 minutes. No bleeding, perforation, stent displacement, or detachment occurred after the operation. Fourteen patients underwent subsequent surgical treatment, the first-stage surgical resection anastomosis rate was 71.43% (10/14). This preliminary study suggests that the disposable subscope-assisted intestinal metal stent placement for the treatment of acute malignant colorectal obstruction is safe and effective, with no radiation exposure.

Hereditary angioedema(HAE)is a rare autosomal dominant disorder characterized by recur-rent,unpredictable episodes of skin and mucosal edema,which may affect the face,extremities,respiratory tract,gastrointestinal tract,and genitals,with a global prevalence of approximately 1 in 50 000.This case re-port presents a young female patient with a history of recurrent abdominal pain and multisite edema.During an acute episode,laboratory tests revealed decreased complement C4 levels along with reduced concentration and function of C1 esterase inhibitor.Computed tomography(CT)demonstrated bowel wall edema and pelvic effu-sion.Previously undiagnosed,the patient was admitted for this acute attack and was ultimately diagnosed with HAE following a multidisciplinary treatment(MDT)team discussion at our hospital.The rapid diagnosis and treatment of this case highlight the critical role of MDT in the management of complex and rare diseases.

Objective:To explore the factors influencing the success rate of culturing patient-derived gastric and colorectal cancer organoids.Methods:From Feb 2022 to Oct 2023, 398 tumor tissue specimens from patients who underwent gastric cancer and colorectal cancer resection at the Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, were used for organoid culture. The clinicopathological factors affecting the success rate of organoid culture were analyzed.Results:The overall success rate of organoid culture in this group was 75.1% (299/398), with the success rate of gastric cancer organoid culture being 79.8%(154/193) and that of colorectal cancer being 70.7% (145/205). Different clinicopathological T stage ( χ2=4.765, P<0.05),histological type ( χ2=11.248, P<0.05), and tumor regression grade (TRG) grade after neoadjuvant chemotherapy ( χ2=7.797, P<0.05) were related to the success rate of organoid culture . Multivariate analysis showed that the TRG grade was an independent influencing factor( P=0.040). For colorectal cancer, different pathological T stage ( χ2=5.108, P<0.05), histological type ( χ2=11.270, P<0.05), and TRG grade after neoadjuvant chemotherapy ( χ2=6.797, P<0.05) were related to the success rate of organoidculture . Different from gastric cancer, the results of multivariate analysis of colorectal cancer showed that the histological type was an independent influencing factor ( P=0.018). Conclusions:The pathologic T stage, histological type of tumors, and TRG of cancer patients all have a significant impact on the success rate of establishing tumor organoids. Among them, the TRG grade is an independent influencing factor for the culture of gastric cancer organoids, and the histological type is an independent influencing factor for colorectal cancer organoids.