摘要：目的克罗恩病因其无法治愈及肠道症状特点,不可避免地影响了患者生活,并可能导致病耻感。本研究旨在调查克罗恩病患者病耻感的现状及影响因素。方法采用便利抽样的方法,于2020年10月至2021年3月对广州市某三级甲等医院消化内科病房的146例克罗恩病患者进行问卷调查。采用自行设计的一般资料问卷、社会影响量表(Social Impact Scale,SIS)、炎症性肠病自我效能量表(Inflammatory Bowel Disease-Self-Eficacy Scale,IBD-SES)及社会支持评定量表(Social Support Rating Scale,SSRS)分别对克罗恩病患者的一般资料、病耻感现状、自我效能和社会支持水平进行调查。采用多重线性回归分析对克罗恩病患者病耻感的影响因素进行分析。结果克罗恩病患者病耻感得分为(58.14±10.74)分,处于中等水平。85.6%(125/146)的克罗恩病患者存在中重度的病耻感。多重线性回归分析结果显示,患者感知到的社会公众对疾病的了解情况、家庭人均月收入、年龄、自我效能为克罗恩病患者病耻感的影响因素,可解释病耻感总变异的52%。结论绝大部分克罗恩病患者存在中重度的病耻感。感知到的社会公众对疾病的了解少、家庭人均月收入低、年龄≥40岁、自我效能低的克罗恩病患者表现出更高程度的病耻感。

摘要：Background:Total mesorectum excision(TME)is considered the standard surgical procedure for rectal-cancer *** TME(taTME)is a new procedure to treat low rectal *** published studies have proven that taTME can provide a better-quality resected specimen in low-rectal-cancer patients in comparison to the transabdominal procedure,yet long-term outcomes must be *** designed this non-inferiority trial(TaLaR trial)to compare short-term and long-term outcomes between taTME and laparoscopic TME(lapTME)for rectal ***:The TaLaR trial is a phase III open-labeled multicenter randomized-controlled *** who are diagnosed with rectal cancer with no more than T3N2 stage,and with the tumor location below the peritoneal reflection by magnetic resonance imaging scan,digital rectal examination,or colonoscopy,qualify for this *** calculating,a total of 1,114 patients(557 per group)will be randomly allocated to either the taTME or the lapTME *** endpoints are the 3-year disease-free survival(DFS)rate and the 5-year overall survival(OS)*** endpoints include specimen quality,perioperative results,pelvic and anal function,and quality of ***:The TaLaR trial is expected to clarify whether taTME can achieve comparable oncological outcomes,as well as improve specimen quality and recovery conditions in rectal-cancer patients compared with lapTME.