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.

Background: and Purpose We performed a two-sample Mendelian randomization (MR) analysis to evaluate the causal effect of genetically proxied AMP-activated protein kinase (AMPK) activation, which is the target of metformin, on functional outcome following ischemic stroke onset. Methods: A total of 44 AMPK-related variants associated with HbA1c (%) were used as instruments for AMPK activation. The primary outcome was the modified Rankin Scale (mRS) score at 3 months following the onset of ischemic stroke, evaluated as a dichotomous variable (3–6 vs. 0–2) and subsequently as an ordinal variable. Summary-level data for the 3-month mRS were obtained from the Genetics of Ischemic Stroke Functional Outcome network, including 6,165 patients with ischemic stroke. The inverse-variance weighted method was used to obtain causal estimates. The alternative MR methods were used for sensitivity analysis. Results: Genetically predicted AMPK activation was significantly associated with lower odds of poor functional outcome (mRS 3–6 vs. 0–2, odds ratio [OR]: 0.06, 95% confidence interval [CI]: 0.01–0.49, P=0.009). This association was maintained when 3-month mRS was analyzed as an ordinal variable. Similar results were observed in the sensitivity analyses, and there was no evidence of pleiotropy. Conclusion This MR study provided evidence that AMPK activation by metformin may exert beneficial effects on functional outcome following ischemic stroke.

Objective:To report the design,field investigation and main findings of mental health survey in Ningxia Hui Autonomous Region,and to provide valid data for mental disorder prevention.Methods:According to the design of China Mental Health Survey,a cross-sectional study was conducted in 5 390 eligible participants se-lected by multi-stage sampling.The Composite International Diagnostic Interview was used to complete computer assisted personal interview.According to the diagnostic criterion of the Diagnostic and Statistical Manual of Mental Disorder,Fourth Edition(DSM-Ⅳ),the 12-month prevalence and lifetime prevalence were calculated using post-stratification weighting.Results:In 4 085 respondents interviewed in the survey,the 12-month prevalence rate of any mental disorder was 9.4％,and the lifetime prevalence was rate 15.1％.The prevalence rate in rural areas was higher than that in urban areas(10.9％vs 7.9％,P＜0.01).The prevalence rates of anxiety disorder and mood disorder in the female were higher than those in the male(5.3％vs.2.9％,4.9％vs.3.3％,Ps＜0.05),while the prevalence rates of substanceuse disorder and impulse-control disorder were higher in the male than those in the fe-male(2.5％vs.0.2％,2.3％vs.1.5％,Ps＜0.05).The 12-month prevalence rate of any mental disorder showed a decreasing trend with age growth.Among those who met any mental disorder's criteria,93.4％never sought help,and 57.5％of the help seekers didn't receive any effective help.Conclusion:Mental disorders have become an important public health problem in Ningxia,prevention and control measures should be taken accordingly.

Objective:To investigate the prevalence of anxiety disorder and its distribution,and related factors in adults in Ningxia community.Methods:Using the method of China Mental Health Survey,anxiety disorder was investigated with the Composite International Diagnostic Interview,and related factors were analyzed.Twelve-month prevalence and life-time prevalence and their distributions were calculated according to DSM-Ⅳ criteria.Results:A total of 4 085 respondents were interviewed in the survey.The 12-month prevalence rate of any anxiety disorder was 4.2％,and the lifetime prevalence rate was 5.6％.The 12-month prevalence rates of social phobia,special phobia and generalized anxiety disorder were higher in women than in men(P＜0.05).The prevalence of special phobia and any anxiety disorder in rural area was higher than that in urban area.Logistic regression model revealed that fe-male(OR=1.86,95％CI:1.32-2.64)had higher prevalence risk of anxiety disorder,and individuals with somat-ic pain had higher risk of anxiety disorder than those without(P＜0.05).Conclusion:Anxiety disorder is prevalent in Ningxia.It suggests that strengthening somatic pain community mental health service is necessary to develop tar-geted intervention programs among the high-risk population.

Objective:To explore the prevalence of mood disorders and utilization of health services inadults in the Ningxia Hui Autonomous Region,thus providing the scientific basis for disease prevention and control.Methods:Using Composite International Diagnostic Interview with the criteria of the Diagnostic and Statis-tical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ),the first survey on mood disorders was carried out by multiple stage sampling.The Rao-Scott x2 test was used to compare the prevalence rate of mood disorders in popula-tions with different characteristics.Results:The 12-month prevalence rate of mood disorder was 4.0％,while life-time prevalence rate of mood disorder was 7.4％.The 12-month prevalence rate was higher in female than male(4.9 vs.3.3％),and the 12-month prevalence rate in rural area was higher than that in urban area(5.0％vs.3.0％)(Ps＜0.05).The 12-month prevalence rate of bipolar Ⅰ disorder decreased with age growth(P＜0.001),and the 12-month prevalence rate of any mood disorder and major depressive disorder decreased with the increase of education level(Ps＜0.05).Among those who met any mood disorder's criteria,92.6％never sought help,45.8％of the help secekers didn't receive any effective help.Conclusion:The prevalence of mood disorder in Ningxia adults is relatively high,but the utilization of mental health services is very low.Females,rural residents,and persons with low education level are the key groups for the prevention of mood disorder.