Objective To explore the mediating role of mindful attention and awareness in depressive symptoms and insomnia severity among patients with comorbid depression and insomnia.Methods A cross-sectional study was conducted,enrolling 267 patients with comorbid depression and insomnia who were treated in the outpatient Department of Medical Psychology of Second Affiliated Hospital of Army Medical University,from March to May 2024.Basic demographic and clinical data were collected using a general information questionnaire.Depressive symptom severity was measured via the Patient Health Questionnaire-9(PHQ-9),insomnia severity via the Insomnia Severity Index(ISI),perceived stress via the Perceived Stress Scale-10(PSS-10),and mindful attention and awareness via the Mindful Attention Awareness Scale(MAAS).Pearson correlation analysis was used to examine the correlations between depressive severity,insomnia severity,perceived stress,and mindful attention and awareness.Mediation analysis was performed using Process 4.1.Results The PHQ-9 score was(13.80±5.98)and the ISI score was(17.10±5.56)in the 267 patients.Pearson correlation analysis showed that depressive severity and insomnia severity were positively correlated with perceived stress(r=0.531,0.351,P<0.001)and negatively correlated with mindful attention and awareness(r=-0.373,-0.350,P<0.001).Mediation analysis using Process 4.1 indicated that the combined mediating effect of mindful attention and awareness and insomnia between perceived stress level and depressive level was 0.157,with a 95%confidence interval(CI)of 0.102～0.217,and the total mediating effect was significant(P<0.001).Conclusion Perceived stress directly positively affects depression and indirectly exacerbates depression through insomnia as a mediator,and mindful attention and awareness can weaken the promoting effect of perceived stress on insomnia.

Objective:To investigate gut microbiota differences between individuals with and without colorectal adenoma(CRA)and to identify gut microbes associated with CRA.Methods:This cross-sectional study analyzed the gut microbiota of 100 patients with CRA and 68 individuals without CRA(aged 40-75 years)who underwent colonoscopies between March 2021 and March 2022 at Tianjin Nankai Hospital.Fecal samples were sequenced for the V3-V4 region of the bacterial 16S rRNA gene using the Illumina NovaSeq platform.Results:Compared to the non-CRA group,the CRA group exhibited reduced relative abundances of identified and unidentified Lachnospiraceae,with increased Faecalibacterium and Streptococcus.In the non-CRA group,the relative abundances of Coprococcus,unidentified Clostridiaceae,and Clostridium were higher.LEfSe analysis revealed significant enrichment of Gammaproteobacteria,Proteobacteria,Enterobacteriales,and Faecalibacterium in the CRA group,while the non-CRA group was enriched for Moraxellaceae,Acinetobacter,and Anaerostipes.Conclusions:These findings suggest a discernible disparity in the gut microbiota structure between CRA patients and individuals without adenoma.The enrichment of potential pathogenic taxa,such as Faecalibacterium and Streptococcus,in the CRA group suggests a possible association with adenoma development.

Objective To explore the clinical characteristics as well as infection prevention and control strategies of patients with Candida auris(C.auris)infection/colonization.Methods Clinical characteristics as well as preven-tion and control measures of patients detected with C.auris in a general hospital from September 2023 to March 2024 were analyzed,prevention and control measures were evaluated.Results A total of 9 patients were detected C.auris,and the specimen sources were urine from 5 cases(55.56％),sputum from 3 cases(33.33％),and ab-dominal drainage fluid from 1 case(11.11％).There were 5 cases of community-associated infection(55.56％),3 cases of community colonization(33.33％),and 1 case of hospital colonization(11.11％).There were 5 cases of deaths(55.56％),3 cases of discharges(33.33％),and 1 case of transfer(11.11％).Through measures such as training,early warning,single-room isolation,personal protection,hand hygiene,environmental cleaning and disin-fection and strengthening supervision on sampling process,supervising sampling detection and screening,terminal disinfection,and ensuring a qualified detection result of specimens before admitting new patients,no C.auris was detected from patient's surrounding environment sampling,and no cross-transmission occurred in the hospital.Conclusion Paying attention to the implementation of prevention and control measures for C.auris infection can effectively control the occurrence and cross transmission of healthcare-associated infection.

Objective:To investigate and analyze the safety of empirical or experimental medication (EEM) for adult-onset Still disease (AOSD) before diagnosis.Methods:The AOSD inpatients admitted to the Second Hospital of Jilin University from January 1, 2019 to December 31, 2023 were collected through hospital information system, and those who were misdiagnosed on admission were screened out. The main clinical characteristics, laboratory tests, misdiagnosis situation, the use of EEM and their adverse drug reactions (ADR), and the potential drug-drug interactions in the misdiagnosed patients were analyzed by descriptive statistics.Results:During the set time period, a total of 49 patients with AOSD were admitted to the hospital, of which 16 (32.7%) were misdiagnosed with other diseases on admission. Among the 16 patients, 10 were male and 6 were female, with a median age of 53 years. The main clinical manifestations were fever (in 15 patients), arthralgia/arthritis (in 10 patients), lymphadenopathy (in 10 patients), rash (in 9 patients), pleural or pericardial effusion (in 6 patients), pneumonia (in 5 patients), splenomegaly (in 4 patients) and sore throat (in 4 patients). Abnormalities in laboratory tests included white blood cell count elevation (in 13 patients), platelets count elevation (in 8 patients), serum ferritin elevation (>500 μg/L, in 12 patients), and abnormal liver function (in 9 patients). The median time of treatment before admission was 5.5 months (11 days to 27.0 months), and the median time from admission to diagnosis of AOSD was 12 days. Before the diagnosis of AOSD, all patients received a long time of EEM, including antibiotics, traditional Chinese medicine preparations, liver-protection drugs, anti-allergic drugs and antiviral drugs in 15, 12, 11, 3 and 2 patients, respectively. Four patients experienced ADRs related to EEM, all of which were caused by antibiotics. There were potential interactions in the therapeutic drugs in 4 patients.Conclusion:The misdiagnosis rate of AOSD was high. Patients might had accepted multiple EEMs before the definite diagnosis, which posed risks of ADRs and drug interactions.

Objective:To investigate gut microbiota differences between individuals with and without colorectal adenoma(CRA)and to identify gut microbes associated with CRA.Methods:This cross-sectional study analyzed the gut microbiota of 100 patients with CRA and 68 individuals without CRA(aged 40-75 years)who underwent colonoscopies between March 2021 and March 2022 at Tianjin Nankai Hospital.Fecal samples were sequenced for the V3-V4 region of the bacterial 16S rRNA gene using the Illumina NovaSeq platform.Results:Compared to the non-CRA group,the CRA group exhibited reduced relative abundances of identified and unidentified Lachnospiraceae,with increased Faecalibacterium and Streptococcus.In the non-CRA group,the relative abundances of Coprococcus,unidentified Clostridiaceae,and Clostridium were higher.LEfSe analysis revealed significant enrichment of Gammaproteobacteria,Proteobacteria,Enterobacteriales,and Faecalibacterium in the CRA group,while the non-CRA group was enriched for Moraxellaceae,Acinetobacter,and Anaerostipes.Conclusions:These findings suggest a discernible disparity in the gut microbiota structure between CRA patients and individuals without adenoma.The enrichment of potential pathogenic taxa,such as Faecalibacterium and Streptococcus,in the CRA group suggests a possible association with adenoma development.

Objective To explore the clinical characteristics as well as infection prevention and control strategies of patients with Candida auris(C.auris)infection/colonization.Methods Clinical characteristics as well as preven-tion and control measures of patients detected with C.auris in a general hospital from September 2023 to March 2024 were analyzed,prevention and control measures were evaluated.Results A total of 9 patients were detected C.auris,and the specimen sources were urine from 5 cases(55.56％),sputum from 3 cases(33.33％),and ab-dominal drainage fluid from 1 case(11.11％).There were 5 cases of community-associated infection(55.56％),3 cases of community colonization(33.33％),and 1 case of hospital colonization(11.11％).There were 5 cases of deaths(55.56％),3 cases of discharges(33.33％),and 1 case of transfer(11.11％).Through measures such as training,early warning,single-room isolation,personal protection,hand hygiene,environmental cleaning and disin-fection and strengthening supervision on sampling process,supervising sampling detection and screening,terminal disinfection,and ensuring a qualified detection result of specimens before admitting new patients,no C.auris was detected from patient's surrounding environment sampling,and no cross-transmission occurred in the hospital.Conclusion Paying attention to the implementation of prevention and control measures for C.auris infection can effectively control the occurrence and cross transmission of healthcare-associated infection.

Objective:To investigate and analyze the safety of empirical or experimental medication (EEM) for adult-onset Still disease (AOSD) before diagnosis.Methods:The AOSD inpatients admitted to the Second Hospital of Jilin University from January 1, 2019 to December 31, 2023 were collected through hospital information system, and those who were misdiagnosed on admission were screened out. The main clinical characteristics, laboratory tests, misdiagnosis situation, the use of EEM and their adverse drug reactions (ADR), and the potential drug-drug interactions in the misdiagnosed patients were analyzed by descriptive statistics.Results:During the set time period, a total of 49 patients with AOSD were admitted to the hospital, of which 16 (32.7%) were misdiagnosed with other diseases on admission. Among the 16 patients, 10 were male and 6 were female, with a median age of 53 years. The main clinical manifestations were fever (in 15 patients), arthralgia/arthritis (in 10 patients), lymphadenopathy (in 10 patients), rash (in 9 patients), pleural or pericardial effusion (in 6 patients), pneumonia (in 5 patients), splenomegaly (in 4 patients) and sore throat (in 4 patients). Abnormalities in laboratory tests included white blood cell count elevation (in 13 patients), platelets count elevation (in 8 patients), serum ferritin elevation (>500 μg/L, in 12 patients), and abnormal liver function (in 9 patients). The median time of treatment before admission was 5.5 months (11 days to 27.0 months), and the median time from admission to diagnosis of AOSD was 12 days. Before the diagnosis of AOSD, all patients received a long time of EEM, including antibiotics, traditional Chinese medicine preparations, liver-protection drugs, anti-allergic drugs and antiviral drugs in 15, 12, 11, 3 and 2 patients, respectively. Four patients experienced ADRs related to EEM, all of which were caused by antibiotics. There were potential interactions in the therapeutic drugs in 4 patients.Conclusion:The misdiagnosis rate of AOSD was high. Patients might had accepted multiple EEMs before the definite diagnosis, which posed risks of ADRs and drug interactions.

Objective:To evaluate the clinical effect of YM-W type gastrointestinal motility treatment device on the quality of bowel preparation of elderly patients with constipation. Methods:A convenient sampling method was used to select 70 elderly patients with constipation who underwent colonoscopy examination at the Sixth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine from July 2022 to May 2023. The patients were randomly divided into a control group and an intervention group by using random number method,with 35 cases in each group. The control group received routine intestinal preparation,while the intervention group underwent a gastrointestinal motility treatment with 30 minutes on the basis of control group. The scores of Boston bowel preparation scale,first defecating time,usage time from defecating to no-slag,and the amount of laxatives used from defecating to no-slag of two groups were compared after intervention. Results:For the scores of Boston bowel preparation scale,the left colon (2.9±0.55),transverse colon (2.2±0.69),right colon (2.2±0.58) and total score (7.69±1.69) in the intervention group were all higher than those (2.6±0.60,2.6±0.65,1.8±0.76,6.66±1.83) in the control group,with statistically significant differences between the two groups (Z=-0.304,-2.84,-2.488,-3.141,P<0.05),respectively. Both of the first defecating time and usage time from defecating to no-slag in the intervention group were significantly shorter than those in the intervention group (Z=-3.64,-2.52,P<0.05). The amount of laxatives used from defecating to no-slag in the intervention group was less than that in the control group (Z=-1.18,P<0.05). The adverse reaction rate of patients in the intervention group was significantly lower than that in the control group (F=31.8,P<0.05),and the difference between the two groups was statistically significant. Conclusion:The gastrointestinal motility treatment device can enhance the cleanliness quality of bowel before elderly patients with constipation undergo colonoscopy examination,which is worth to be applied in clinical practice.

Objective:To evaluate the clinical effect of YM-W type gastrointestinal motility treatment device on the quality of bowel preparation of elderly patients with constipation. Methods:A convenient sampling method was used to select 70 elderly patients with constipation who underwent colonoscopy examination at the Sixth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine from July 2022 to May 2023. The patients were randomly divided into a control group and an intervention group by using random number method,with 35 cases in each group. The control group received routine intestinal preparation,while the intervention group underwent a gastrointestinal motility treatment with 30 minutes on the basis of control group. The scores of Boston bowel preparation scale,first defecating time,usage time from defecating to no-slag,and the amount of laxatives used from defecating to no-slag of two groups were compared after intervention. Results:For the scores of Boston bowel preparation scale,the left colon (2.9±0.55),transverse colon (2.2±0.69),right colon (2.2±0.58) and total score (7.69±1.69) in the intervention group were all higher than those (2.6±0.60,2.6±0.65,1.8±0.76,6.66±1.83) in the control group,with statistically significant differences between the two groups (Z=-0.304,-2.84,-2.488,-3.141,P<0.05),respectively. Both of the first defecating time and usage time from defecating to no-slag in the intervention group were significantly shorter than those in the intervention group (Z=-3.64,-2.52,P<0.05). The amount of laxatives used from defecating to no-slag in the intervention group was less than that in the control group (Z=-1.18,P<0.05). The adverse reaction rate of patients in the intervention group was significantly lower than that in the control group (F=31.8,P<0.05),and the difference between the two groups was statistically significant. Conclusion:The gastrointestinal motility treatment device can enhance the cleanliness quality of bowel before elderly patients with constipation undergo colonoscopy examination,which is worth to be applied in clinical practice.

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