Impact of closed management on gastrointestinal function and mental health of Chinese university students during COVID-19.

BACKGROUND: The innovative closed management of universities may have influenced the physical and mental health of students during the fourth stage of the COVID-19 pandemic in China. The study aimed to assess the gastrointestinal and mental health status of students in this stage and to explore the possible risk factors and mechanisms to provide a reference for future school responses to similar stressful events. METHOD: A multicenter, cross-sectional survey was administered to 598 college students from 10 Chinese universities. The study used the 7-item Generalized Anxiety Disorder Scale (GAD-7), 9-item Patient Health Questionnaire (PHQ-9), Fear of COVID-19 Scale (FCV-19 S), and the Diagnostic Tendency of Functional Bowel Disease Scale (DT-FBD) to evaluate anxiety, depression, fear of COVID-19 and likelihood of being diagnose diagnosed with functional bowel disease (FBD), respectively. RESULTS: A total of 516 college students completed the questionnaire. The proportions of students with more severe anxiety, more severe depression, greater fear of COVID-19, and a greater likelihood of being diagnosed with FBD were 49.8%, 57.0%, 49%, and 49%, respectively. These symptoms were significantly and positively correlated with the frequency of irregular sleep and eating (p < 0.05). Students in high-risk areas were more likely to experience anxiety and depression than students in areas with low/medium risk (odds ratio [OR] = 1.90, 95% confidence interval [CI]: 1.12-3.24, p = 0.017; OR = 2.14, 95% CI: 1.11-4.11, p = 0.022). A high likelihood of being diagnosed with FBD was positively associated with the severity of anxiety and depression symptoms and fear of COVID-19 (all p < 0.001). Moreover, mediation analysis revealed the following pathway in college students: fear of COVID-19 → depression and anxiety → poor diet → likelihood of being diagnosed with FBD. CONCLUSION: College students generally exhibited higher more severe anxiety and depression symptoms and psychological symptoms with a greater higher propensity likelihood of being to be diagnosed with FBD. Good lifestyle habits, especially adequate sleep and a regular diet, can alleviate these problems. In addition, appropriate psychological intervention is very important.

A nomogram based on the log odds of positive lymph nodes for predicting the prognosis of T1 stage rectal cancer.

Early detection and timely treatment is the key to improving the prognosis of rectal cancer. Lymph node metastasis is one of the reasons for the poor prognosis of rectal cancer, especially early-stage rectal cancer. In this study, we developed a nomogram based on log odds of positive lymph nodes (LODDS) to predict cancer-specific survival (CSS) in patients with T1 rectal cancer. We included 1934 patients from the Surveillance, Epidemiology, and End Results (SEER) database and divided them into a training cohort and an in-validation cohort. 140 patients from our hospital formed the ex-validation cohort. Multivariate Cox regression analysis indicated that age, sex, grade, and M stage were independent prognostic factors for CSS. LODDS showed better predictive ability than the N stage and PLNs (positive lymph nodes) and was further selected as an independent prognostic factor for the construction of the nomogram. The C-index of the nomogram was 0.743, 0.756, and 0.876 in the training, in-validation, and ex-validation cohorts, respectively. The AUC values of the three cohorts were 0.750, 0.703, and 0.958 at 3 years and 0.731, 0.678, and 0.783 at 5 years. The calibration curves and DCA demonstrated the nomogram's excellent performance. In conclusion, we developed and validated a new nomogram based on LODDS that can effectively predict CSS at 3 and 5 years for patients with T1 rectal cancer.

Analysis of the timing of endoscopic treatment for esophagogastric variceal bleeding in cirrhosis.

Background: Existing guidelines recommend endoscopic treatment within 12 h or 12-24 h for patients with esophagogastric variceal bleeding (EGVB) in cirrhosis. In addition, research findings on the optimal time for endoscopy are inconsistent. Aim: The aim of this study was to investigate the relationship between the timing of endoscopy and clinical outcomes in cirrhotic patients with EGVB and to analyze the risk factors for the composite outcomes after endoscopic treatment. Methods: From January 2019 to June 2020, 456 patients with cirrhotic EGVB who underwent endoscopy were matched by a 1:1 propensity score. Finally, 266 patients were divided into two groups, including 133 patients within 12 h (urgent endoscopy group) of admission and after 12 h (non-urgent endoscopy group). Baseline data and clinical outcomes were compared. Logistic regression model analysis was used to determine risk factors for 30 days rebleeding and mortality. Results: In 266 patients, the overall 30 days rebleeding rate and mortality were 10.9% (n = 29) and 3.4% (n = 9), respectively. Patients who underwent endoscopic treatment within 12 h had significantly higher 30 days rebleeding outcomes than those who underwent treatment beyond 12 h (15 vs. 6.8%, p = 0.003). However, 30 days mortality did not differ significantly between the two groups (3 vs. 3.8%, p = 0.736). Logistic regression analysis showed that age and shock on admission were independent risk factors for the composite outcome of 30 days rebleeding and mortality in patients with EGVB. Conclusion: The 30 days rebleeding rate in patients with cirrhotic EGVB treated with urgent endoscopy was significantly higher than that in patients treated with non-urgent endoscopy, but there was no significant difference in 30 days mortality.