Objective:To evaluate the clinical efficacy and impact on quality of life of the biofeedback (BF) therapy combined with the Wenyang Yiqi Prescription and self-efficacy interventions in patients with functional defecation disorders (FDD).Methods:A prospective, randomized controlled trial design was employed. A total of 128 FDD patients were selected from the Pelvic Floor Center of the Department of Proctology, Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, between January 2021 and April 2023. These patients were randomly divided into two groups, with 64 cases in each group. Additionally, 41 historical control patients, who had received conventional BF training between June 2015 and January 2018 at the same center, were included for comparison. The historical control group received conventional BF therapy, the intervention group 1 combined BF therapy with self-efficacy interventions, and the intervention group 2 added the Wenyang Yiqi Prescription based on intervention group 1's treatment. All three groups underwent two treatment courses. Constipation symptom scores before and after treatment were performed; self-efficacy was assessed via the Self-Rated Abilities for Health Practices scale (SRAHP); health behaviors were evaluated using the Health-Promoting Lifestyle Profile (HPLP); anxiety and depression were evaluated through Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS); quality of life was measured through SF-36. Clinical efficacy was evaluated based on constipation symptom scores.Results:During the treatment period, seven patients dropped out due to personal reasons, leaving 61 patients in intervention group 1 and 60 patients in intervention group 2 for efficacy analysis.　The total effective rates were 80.32% (49/61) in intervention group 1, 83.33% (50/60) in intervention group 2, and 56.10% (23/41) in the historical control group. The total effective rates of both intervention groups were significantly higher than those in the historical control group ( χ2=7.06, 9.15; P=0.029, 0.010, respectively). After treatment, intervention group 2 showed significantly lower constipation-related straining scores [1 (1, 2) vs. 2 (1, 2), Z=-4.51] compared to intervention group 1 ( P<0.05). Additionally, intervention group 2 had lower scores for straining [1 (1, 2) vs. 2 (1, 2), Z=-3.15] and defecation time [1 (0, 1) vs. 1 (1, 2), Z=-3.13] compared to the historical control group ( P<0.05). Psychological comfort efficacy (19.13 ± 2.51 vs. 16.98 ± 1.86, t=5.36), health responsibility efficacy (23.63 ± 4.69 vs. 22.59 ± 3.05, t=2.06), and overall SRAHP scores (75.98 ± 4.44 vs. 72.33 ± 5.16, t=4.17) were higher in intervention group 2 compared to intervention group 1 ( P<0.05). The HPLP scores (79.33 ± 11.13 vs. 72.80 ± 9.20, t=3.10) of intervention group 2 were higher than those of the historical control group ( P<0.05). Emotional functioning scores (75.98 ± 18.45 vs. 68.92 ± 20.58 and 68.55 ± 18.21, F=20.91) in intervention group 2 were higher than in both intervention group 1 and the historical control group ( P<0.05). Conclusion:The combination of the Wenyang Yiqi Prescription with BF therapy and self-efficacy interventions effectively improves the clinical symptoms and quality of life in FDD patients.

Objective To modify the dosage form of Guoganglong Sugar-Coated Tablets,and to investigate the chemical equivalence and pharmacodynamic equivalence between the new and old dosage forms of Guoganglong Tablets.Methods The preparation technology was screened by single-factor exploration with the indexes of hardness and dispersion uniformity,the quality standard was established by thin layer chromatography identification,high performance liquid chromatography(HPLC)content determination and charactertistics chromatograms,the constituents absorbed into blood were analyzed by ultra-high performance liquid chromatography quadrupole time of flight mass spectrometry(UHPLC-Q-TOF-MS),and the pharmacodynamics was evaluated by anti-inflammatory experiment and analgesic experiment in mice model with inflammatory pain.Results The molding process of Guoganglong Dispersible Tablets was determined.A thin layer chromatographic identification method was established.A method for detecting the content of Guoganglong Tablets and the charactertistic chromatograms was established by HPLC,and a total of 15 common peaks were identified,with the similarity of the new-old dosage forms being greater than 0.9.A total of 12 constituents absorbed into blood were identified.Guoganglong Tablets could alleviate swelling degree of toes in mice with inflammatory pain,reduce the levels of interleukin 6(IL-6)in serum,improve spleen index,and increase the thermal pain threshold and acetic acid twisting frequency in mice.Conclusion The prescription process of Guoganglong Dispersible Tablets is stable,the quality standard is feasible,the chemical composition and pharmacological actions between the new and old dosage forms are basically the same,and in terms of certain indexes,Dispersible Tablets of Guoganglongare superior to Sugar-Coated Tablets.

Under the"Four Specials"conditions(special environments,special tasks,special equipment,and special personnel),complex tightly-coupled human-machine systems exhibit distinct characteristics such as human-in-the-loop,frequent human-machine interactions,and significant mutual influence between humans and machines.These features lead to prominent and typical human related safety issues.Through aggregating knowledge from literature review,accident case studies,and engineering practice,this paper elaborates on the characteristics of complex tightly-coupled human-machine systems,clarifies the definition of human related safety(including its research subjects,topics,and methods),and provides a systematic analysis framework on the causes of human related safety from a whole life-cycle perspective of system development.Furthermore,theoretical hypotheses are proposed for human related safety,along with its fundamental scientific research questions and methods.

Objective:To describe functional disability rate of anxiety disorders in Chinese community adults and explore related risk factors of functional disability.Methods:To conduct in-depth data analysis on China Mental Health Survey(CMHS).The diagnostic tool for anxiety disorders was the Composite International Diagnostic Inter-view-3.0,according to the Diagnostic and Statistical Manual for Mental Disorders,Fourth Edition(DSM-Ⅳ).The World Health Organization Disability Assessment Schedule,2nd edition,was the functional disability assessment standard for anxiety disorders.Weighted 12-month functional disability rate of DSM-Ⅳ anxiety disorder with co-morbidities and only anxiety disorder in population and those in patients,as well as days of partial disability were calculated.The effects of anxiety disorders comorbid other mental disorders and physical diseases and demographic factors on the severity and occurrence of functional disability were analyzed by multiple linear regression and logis-tic regression.Results:The functional disability rate of anxiety disorder with comorbidities in population was 1.7％,and 42.2％in patients,in which constituent rate of grade-four disability was the highest as 84.1％.The functional disability rate of only anxiety disorder in population was 0.3％,and 17.8％in patients.The medians of days of partial disability days in the past 30 days were from 0 to 14.42.Multiple linear regression showed a positive association between comorbid anxiety disorder with other mental disorders and physical diseases(β=0.24),comor-bid other mental disorders and physical diseases(β=0.21),physical diseases(β=0.18),comorbid anxiety disor-der and physical diseases(β=0.15),comorbid anxiety disorder with other mental disorders(β=0.08),other men-tal disorders(β=0.07),only anxiety disorder(β=0.06),lower education level(β=0.12),lower economic status(β=0.08),older age(β=0.06),non-marital status(β=0.06),male(β=0.02)and the severity of functional dis-ability.Logistic regression showed that comorbid anxiety with other mental disorders and physical diseases(OR=64.07),comorbid anxiety disorders with other mental disorders(OR=36.75),comorbid other mental disorders with physical diseases(OR=20.60),comorbid anxiety with physical diseases(OR=18.88),anxiety disorder(OR=9.20),other mental disorders(OR=6.65),physical diseases(OR=4.00),65 years old and over(OR=4.40),50 to 64 years old(OR=2.33),low economic status(OR=2.10),illiterate and below primary school educational level(OR=1.89),middle economic status(OR=1.70),elementary school educational level(OR=1.59),non-marital status(OR=1.47),male(OR=1.16)were the risk factors of the occurrence of functional disability.Conclusion:Comorbidity of anxiety disorders and other mental disorders,and physical diseases increases severity and occurrence of functional disability.Comorbidity,male,gender,older age,lower economic and educa-tional level and non-marital are risk factors of anxiety disorder functional disability.

Objective:To describe disability rates of dementia in community residents aged 65 years and over in China,and explore related risk factors of disability.Methods:This study conducted an in-depth data analysis of the China Mental Health Survey.World Health Organization Disability Assessment Schedule 2.0(WHODAS 2.0)was used to assess dementia disability,Community Screening Interview for Dementia(CSID)and Geriatric Mental Status Examination(GMS)were used for dementia screening and diagnosing.Univariate analysis was used to calcu-late the weighted disability rates of dementia in population and in patients,and their population distribution.Multiple linear regression and logistic regression were used to analyze the risk factors of the occurrence of dementia disability and its severity.Results:The weighted disability rate of dementia was 2.1％in population,and 38.6％in pa-tients.The disability rates of comorbid dementia in population and in patients were higher than those of patients with only dementia.Female,older age,lower education level,lower economic status,and lower cognitive test scores in CSID had higher disability rates of dementia in population.Female and urban resident had higher disability rates of dementia in patients.Multiple linear regression showed economic status(β=0.11),gender(β=0.11),age(β=0.10),and treatment in the last 12 months(β=-0.20)were statistically associated with WHODAS 2.0 scores.Multiple logistic regression showed female(OR=2.81)and treatment in the last 12 months(OR=2.38)were statistically associated with disability.Conclusions:Persons with low economic status,female and elderly peo-ple are the high-risk groups for dementia disability.It should be paid attention to prevent dementia and its conse-quential disabilities.

Objective:To design a programmed evaluation process,and to explore its application effect in the management of medical equipment in emergency department.Methods:The information management platform was constructed based on IntelliJ IDEA and Java language with browser and server(B/S)architecture,a programmed evaluation process was designed to manage medical equipment in the emergency department.From 2021 to 2022,27 medical devices in use in the emergency department of Beijing Friendship Hospital,Capital Medical University were selected,the programmed evaluation process and the post-evaluation process were adopted respectively for management according to the different equipment management methods.A total of 800 equipment operation logs sampled were analyzed under the two management methods.The timeliness of equipment management,management effect and satisfaction scores of related management personnel were compared between the two management methods.Results:The average time consumption of equipment warning timeliness,timeliness of maintenance personnel's arrival and timeliness of proposed treatment methods in the programmed evaluation process management were(0.92±0.21)min,(5.43±1.08)min and(15.63±2.27)min,respectively,which were lower than those in post-evaluation process management method,the difference was statistically significant(t=13.810,16.893,16.554,P＜0.05).The failure rate of 400 logs sampled by the programmed evaluation process management method was 2.75%(11/400),which was lower than that of the post-evaluation process management method,the regular maintenance completion rate was 99.75%(399/400),which was higher than that of the post-evaluation process management method,the difference was statistically significant(x2=18.841,10.778,P＜0.05).The equipment maintenance time and equipment maintenance cost of the programmed evaluation process management were(9.32±1.18)days and CNY(201,600±50,500),respectively,which were lower than those of the post-evaluation process management method,and the difference was statistically significant(t=12.663,37.213,P＜0.05).The satisfaction scores of maintenance engineers,medical staff and patients in equipment use management for the programmed evaluation process management were(97.25±2.44),(98.63±4.57)and(97.16±3.09),respectively,which were higher than the post-evaluation process management method,and the differences were statistically significant(t=21.284,8.206,5.933,P＜0.05).Conclusion:The application of programmed evaluation process to the equipment management of emergency department of the hospital can effectively improve and make up for the loopholes and deficiencies in the conventional equipment management,improve the effect of equipment management,reduce the frequency of equipment failure,and ensure the safe and stable operation of equipment.

Objective:To construct the operation quality management model of ECG monitor based on fuzzy cluster evaluation technology,and to explore its application effect in ECG monitor operating health management.Methods:The quality management of ECG monitor was carried out from two aspects of fault diagnosis and operation health evaluation,and the evaluation index system of hardware structure and system performance was established.The fuzzy clustering algorithm was used to grade the operation health status,and the equipment classification management and early warning maintenance were carried out according to the evaluation results.The ECG monitor equipment in clinical use in the Emergency Department of Beijing Friendship Hospital Capital Medical University from January to December 2022 was selected,12 devices in clinical use from January to June were managed by conventional ECG monitor monitoring and management method(referred to as conventional management),and 13 devices in clinical use from July to December were managed by constructing a health management model for ECG monitors based on fuzzy clustering evaluation technology(referred to as health management).During the study,a total of 440 alarm parameter data were collected by the conventional management method and 480 alarm parameter data by the health management method,the accuracy of the ECG monitor alarm parameters,the satisfaction score of equipment users and the monthly failure rates of the two groups were compared.Results:The accuracy rate of ECG monitor alarm parameter setting using the health management method was 90.21%(433/480),which was higher than that of the conventional management,he difference was statistically significant(x2=8.265,P<0.05).The scores of equipment users on the system quality,service quality,information quality,net benefit,user satisfaction and total satisfaction of ECG monitors using health management methods were(19.47±3.25),(19.55±4.14),(18.92±2.08),(19.34±2.39),(19.82±3.37)and(97.10±3.39),respectively,which were higher than those using conventional management methods,the differences were statistically significant(t=7.358,4.481,2.859,5.304,2.297,29.001,P<0.05).The ECG monitor using the health management method failed 15 times in 6 months,and the failure incidence rate was 3.97%,which was lower than that of the conventional management method(12.71%),the difference was statistically significant(x2=4.672,P<0.05).Conclusion:The application of ECG monitor operation health management model based on fuzzy clustering evaluation technology to the ECG monitor management in the emergency department can effectively improve the correct alarm rate of the ECG monitor,reduce the failure rate of the ECG monitor,and improve the satisfaction of equipment users.

OBJECTIVES: Atrial fibrillation (AF) contributes to stroke development and progression. We aimed to quantify the mediating role of AF in the causal associations between a wide range of risk factors and stroke via a Mendelian randomization (MR) framework. METHODS: We assessed the associations of 108 traits with stroke and its subtypes in a 2-sample univariable MR approach, then conducted a bidirectional MR analysis between these 108 traits and AF to evaluate the presence and direction of their causal associations. Finally, to further investigate the extent to which AF mediated the effects of eligible traits on stroke, we applied multivariable and 2-step MR techniques in a mediation analysis where outcomes were restricted to stroke types causally affected by AF (any stroke [AS], any ischemic stroke [AIS], and cardioembolic stroke [CES]). RESULTS: Among 108 traits, 42 were putatively causal for at least 1 stroke type; of these 42 traits, 20 that had no bidirectional relationship with AF were retained. Finally, 33 associations of 15 eligible traits were examined in the mediation analysis. The mediation analyses for AS, AIS, and CES each included 11 eligible traits. After AF adjustment, the direct effects of all traits on CES were attenuated to null (all p>0.05), while the associations with AS and AIS persisted for most traits (AF-mediated proportion: from 6.6% [95% confidence interval, 2.7 to 0.6] to 52.0% [95% confidence interval, 39.8 to 64.3]). CONCLUSIONS The causal associations between all eligible traits and CES were largely mediated through AF, while most traits affected AS and AIS independently of AF.

Objective:To explore the association between mild cognitive impairment(MCI)and the risk of all-cause death among community middle-aged and older adults, and to provide evidence for early identification of high-risk populations.Methods:From September to November 2011, the residents aged 55 years and middle-aged and older in five urban communities were selected as the research objects by typical sampling method.The baseline survey of general information questionnaire, Mini-Mental State Examination(MMSE), activity of daily Living Scale(ADL), Geriatric Depression Scale(SDS)was carried out and the physical examination was performed.Mild cognitive impairment at the time of enrollment was the exposure factor.In 2017, 2019 and 2021, Deaths were followed up through home visits and search for death surveillance information systems.COX regression model was used to analyze the influencing factors for death.Results:A total of 1046 participants completed the follow-up and were included in the study.The baseline age was(66.4±6.6)years, and 199(19.0%)of them met the criteria for MCI.The average follow-up time was 112±16 months.During the follow-up period, 106 deaths were observed.The mortality rate was higher in participants with MCI(40 deaths, 21.1%)than those without MCI [(66 deaths, 10.1%), χ2=26.80, P<0.001)]. Participants with MCI had a shorter median survival time than those without MCI[(108.0±1.5) vs.(113.0±0.5)months, χlog-rank2=28.02, P<0.001]using the Kaplan-Meier method.Controlling for gender, age, and ethnicity, the Cox regression model revealed that MCI is associated with an increased risk of all-cause death( HR=1.98, 95% CI: 1.30-3.02, P=0.023). Conclusions:Mild cognitive impairment is an independent risk factor for all-cause death among community older adults.Early identification and intervention of MCI may have potential value in preventing premature death and prolonging life in middle-aged and older adults.