Objective:To explore the impact of treatment duration with human urinary kallidinogenase (HUK) on the efficacy and safety of acute ischemic stroke (AIS).Methods:In this subgroup analysis of RESK study, a total of 990 AIS patients recruited from 65 centers in China between August 2015 and June 2020 were included and divided into short medication group (HUK for 8 days, n=185) or long medication group (HUK for 15 days or 21 days, n=805). The proportions of patients with modified Rankin Scale (mRS) score of 0, 0-1, 0-2 at 90 days, National Institutes of Health Stroke Scale (NIHSS) score change from baseline to 22 days, the proportions of patients with Barthel index (BI)≥95 at 90 days, and the incidences of adverse events were analyzed. Comparisons between groups were conducted using chi-square test, single factor and multivariate Logistic regression analysis, etc. Results:Multivariate regression analysis showed that the proportions of patients with 90-day mRS score of 0-2 [74.1% (137/185) vs 75.0% (604/805); OR=1.047, 95% CI 0.676-1.620, P=0.838] and 22-day NIHSS score change from baseline (4.60±2.00 vs 4.26±2.80; OR=-0.390, 95% CI -1.125-0.344, P=0.297) showed no statistically significant difference between the short medication and long medication groups; the proportions of patients with 90-day mRS score of 0-1 [48.1% (89/185) vs 59.1% (476/805); OR=0.674, 95%CI 0.463-0.983, P=0.041] and 90-day BI≥95 [43.6% (79/181) vs 55.1% (442/802); OR=0.614, 95%CI 0.420-0.897, P=0.012] were significantly lower in the short medication group than in the long medication group. There was no statistically significant difference in the incidences of adverse events between these 2 groups. Conclusions:In AIS patients, consecutive 8-day dosing of HUK improved immediate (22-day NIHSS score) and long-term outcome (90-day mRS score 0-2) and was safely tolerated. When applicable, extended duration of HUK could improve long-term disability-free rate (90-day mRS score 0-1) and quality of life (90-day BI) without increasing the risk of adverse events.

In 2023, the National Health Commission and the National Administration of Traditional Chinese Medicine jointly issued the " Notice on carrying out the theme activity to improve medical experience and enhance patient experience", China has entered a new stage of development in the field of medical service improvement. This study, through literature research, sorted out the evolution of China′s patient medical experience-related policies and the shift in concept from satisfaction to medical experience. It divided the historical evolution of patient medical experience policies into four periods: the exploration period, the development period, the policy improvement period, and the new policy implementation period, based on the implementation of reform and opening up, the introduction of new medical reforms, and the proposal of the " theme activity" in 2023. From May to August 2023, interviews were conducted with 20 experts in the field of health management, 20 clinical doctors, and 20 inpatients to discuss China′s experience, deficiencies, and suggestions for improving patient medical experience. Based on the interview materials, this study summarized China′s experience and deficiencies in enhancing patient medical experience from aspects such as resources, systems, concepts, and human resources. It suggested adjusting the structure and layout of medical resources to enhance the balance of high-quality medical resource allocation; establishing a comprehensive evaluation system for patient medical experience; increasing the attention and conceptual understanding of health administrative departments and medical institutions at all levels to optimize patient medical experience, and improving the formulation and connection of supporting policies; caring for medical staff and fully mobilizing their initiative to enhance patient experience, in order to continuously improve patient medical experience.

Objective:To analyze the factors influencing patients′ medical experience, to provide reference for medical institutions to improve patients′ medical experience.Methods:A stratified sampling method was employed nationwide to select 32 patients and 20 medical staff. From May to August 2023, semi-structured interviews were conducted with them regarding the factors influencing patients′ medical experience. The data from the interviews were analyzed using programmed grounded theory, which led to the identification of factors affecting patients′ medical experience.Results:After three-level coding, four main categories of demographic characteristics, self health characteristics, medical outcome experience, and medical process experience, two core categories of patient related influencing factors and hospital related influencing factors were obtained. Additionally were also obtained.Conclusions:The factors influencing patients′ medical experience are multifaceted and jointly dominated by multiple stakeholders. Medical institutions should adopt a variety of measures to continuously improve patients′ medical experience. When assessing patients′ medical experience, the impact of individual differences among patients on the assessment results should be fully considered.

In 2023, the National Health Commission and the National Administration of Traditional Chinese Medicine jointly issued the " Notice on carrying out the theme activity to improve medical experience and enhance patient experience", China has entered a new stage of development in the field of medical service improvement. This study, through literature research, sorted out the evolution of China′s patient medical experience-related policies and the shift in concept from satisfaction to medical experience. It divided the historical evolution of patient medical experience policies into four periods: the exploration period, the development period, the policy improvement period, and the new policy implementation period, based on the implementation of reform and opening up, the introduction of new medical reforms, and the proposal of the " theme activity" in 2023. From May to August 2023, interviews were conducted with 20 experts in the field of health management, 20 clinical doctors, and 20 inpatients to discuss China′s experience, deficiencies, and suggestions for improving patient medical experience. Based on the interview materials, this study summarized China′s experience and deficiencies in enhancing patient medical experience from aspects such as resources, systems, concepts, and human resources. It suggested adjusting the structure and layout of medical resources to enhance the balance of high-quality medical resource allocation; establishing a comprehensive evaluation system for patient medical experience; increasing the attention and conceptual understanding of health administrative departments and medical institutions at all levels to optimize patient medical experience, and improving the formulation and connection of supporting policies; caring for medical staff and fully mobilizing their initiative to enhance patient experience, in order to continuously improve patient medical experience.

Objective:To analyze the factors influencing patients′ medical experience, to provide reference for medical institutions to improve patients′ medical experience.Methods:A stratified sampling method was employed nationwide to select 32 patients and 20 medical staff. From May to August 2023, semi-structured interviews were conducted with them regarding the factors influencing patients′ medical experience. The data from the interviews were analyzed using programmed grounded theory, which led to the identification of factors affecting patients′ medical experience.Results:After three-level coding, four main categories of demographic characteristics, self health characteristics, medical outcome experience, and medical process experience, two core categories of patient related influencing factors and hospital related influencing factors were obtained. Additionally were also obtained.Conclusions:The factors influencing patients′ medical experience are multifaceted and jointly dominated by multiple stakeholders. Medical institutions should adopt a variety of measures to continuously improve patients′ medical experience. When assessing patients′ medical experience, the impact of individual differences among patients on the assessment results should be fully considered.

Suffering is prevalent in the palliative care population and is an important factor affecting the quality of life of palliative care patients and their family caregivers. In this paper, we review the assessment content, measurement methods, current application status and advantages and disadvantages of suffering assessment tools for palliative care patients, analyze the problems of current suffering assessment tools for palliative care patients and make suggestions, aiming to provide reference for palliative suffering treatment in China.

Objective: To evaluate the efficacy and safety of Oryz-Aspergillus enzyme and pancreatin tablets (Combizym^®) in the treatment of postprandial distress syndrome (PDS) in the elderly, compared with gastrointestinal motility drugs. Methods: A prospective randomized controlled trial was designed and registered in the China Clinical Trials Registry (ChiCTR-IPR-16008185). The elderly patients with PDS were randomly divided into three groups, including Mosapride group with Mosapride citrate tablets 5 mg 3 times per day for 2 weeks; Combizym^® group with Combizym tablets 244 mg 3 times per day for 2 weeks; combined treatment group with both drugs and same doses for 2 weeks. The modified Nepean dyspepsia index (NDSI) score, discomfort intensity score and PDS score were calculated on patients before treatment, at the end of first and second week of treatment, as well as 4 weeks after treatment finished, respectively. Adverse effects were evaluated. Results: A total of 323 patients from 16 tertiary hospitals in China were enrolled in this study. Among them, 105 patients were in Mosapride group, 109 in Combizym^® group and 109 in combined treatment group. There were 148 males (45.8%) and 175 females (54.2%) with median age 71.4±9.0 years (60-100 years). Baseline characteristics of three groups were comparable. After treatment, the NDSI scores in three groups all decreased significantly (P<0.001), while they were similar between groups (P>0.05). The discomfort intensity score and PDS score in three groups showed a significant reduction after treatment (P<0.001), especially in the combined treatment group. Compared with Mosapride group, the scores in Combizym^® group decreased significantly after one or two weeks [discomfort intensity score: after one week, 4.0(2.5, 8.0) vs. 6.0(3.0, 10.0); after two weeks, 3.0(0.0, 5.0) vs. 4.0(2.0, 6.0); all P<0.05. PDS score: after one week, 6.0(3.0, 9.0) vs. 7.0(3.5, 10.5); after two weeks, 3.0(0.0, 5.0) vs. 4.0(2.0, 7.0); all P<0.05]. The efficacy rate in all patients after first week of treatment was over 15.0%. The efficacy rates after two weeks were 55.2%, 68.8% and 73.4% in Mosapride group, Combizym^® group and combined treatment group, respectively. After two week treatment, the efficacy rates in Combizym^® group (P=0.041) and combined group (P=0.006) were higher than that of Mosapride group. The recurrence rate of Mosapride group was 9.5%, which was significantly higher than that of Combizym^® group (1.8%, P<0.05) and combined treatment group (1.8%, P<0.05). There were no serious adverse effects in the three groups. Conclusions The efficacy of Oryz-Aspergillus enzyme and pancreatin tablets is comparable with that of Mosapride in elderly PDS patients, with fewer adverse effects and low recurrence rate. Combination regimen indicates better efficacy than that of Oryz-Aspergillus enzyme and pancreatin tablets or Mosapride alone.

OBJECTIVE: To investigate the prevalence and influencing factors of work-related musculoskeletal disorders(WMSDs) among workers in a cement plant. METHODS: A total of 196 workers in a cement plant were selected as study subjects using a judgment sampling method. A revised Musculoskeletal Injury Questionnaire was used to investigate the occurrence of WMSDs in workers in the past year. RESULTS: The detection rate of WMSDs in different parts of the body of workers in the cement plant was 18.4%-32.1%. The detection rates of WMSDs in all parts of the body from high to low was as follows: shoulder(32.1%), neck(30.6%), upper back(24.0%), ankle/foot(24.0%), lower back(23.5%), hip/thigh(22.4%), wrist/hand(21.4%), elbow(18.4%), and knee(18.4%). Multivariate logistic regression analysis results showed that keeping the neck in the same posture for a long time was a risk factor for neck WMSDs [odds ratio(OR)=2.29, P<0.05). Frequent turning around was a risk factor for WMSDs on the neck and lower back(waist)(OR were 3.06 and 3.32, P<0.05). Maintaining the same posture for a long time on the back was a risk factor for shoulder and upper back WMSDs(OR were 3.22 and 2.34, P<0.05). Hard work was a risk factor for shoulder and upper back WMSDs(OR were 2.60 and 2.58, P<0.05). Driving a vehicle was a risk factor for lower back(waist) and ankle/foot WMSDs(OR were 2.54 and 3.17, P<0.05). Carrying objects heavier than 20 kilograms and frequent overtime working were risk factors for ankle/foot WMSDs(OR were 3.03 and 2.54, P<0.05). CONCLUSION: The most frequent parts of the body having WMSDs in the cement production workers are shoulders and necks. Occupational factors(turning around or keeping the same posture of neck and back) are risk factors of WMSDs on shoulder and neck.

Objective To investigate the clinical manifestations and risk factors related to ulcer in patients with ischemic colitis(IC).Methods Clinical data of sixty-three IC patients with definite diagnosis from June 2002 to June 2012 in the PLA General Hospital were retrospectively analyzed.All patients were classified into ulcer group (23 cases) and non-ulcer group (40 cases) according to the presence of ulcer or not.Clinical manifestations and risk factors related to ulcer lesions were compared in the two groups.Logistic regression model was used for statistical analysis.Results There were 50 men and 13 women enrolled,with an average age of 70 years old.The main clinical manifestations included abdominal pain [85.7％ (54/63)],diarrhea [54.0％ (34/63)],hematochezia [41.3％ (26/63)].In comparison with non-ulcer group,the ulcer group showed higher incidences of chronic constipation[34.8％ (8/23)vs 12.5％ (5/40),P =0.03],enteric-coated aspirin intake [52.2％ (12/23) vs 25.0％ (10/40),P =0.03] and abdomen tenderness[82.6％ (19/23) vs 52.5％ (21/40),P =0.02].Chronic constipation and entericcoated aspirin intake were independent risk factors related to ulcer lesions (OR =3.38,P =0.04 ; OR =5.91,P =0.03).Patients with abdomen tenderness had higher incidence of ulcer lesion(OR =3.12,P =0.04).The most common location of IC was left colon[69.8％ (44/63)].No difference of site distribution was found in ulcer and non-ulcer group(P =0.066).Splanchnic atherosclerosis in the ulcer group was more common than in non-ulcer group [88.2％ (15/17) vs 58.3％ (14/24),P =0.038].The duration of hospitalization was significantly longer in ulcer group [(14.3 ± 7.1) d vs (6.2 ± 4.1) d,P ＜ 0.01].Higher white blood cell (WBC) count and lower hemoglobin (Hb) were seen in ulcer group than those in non-ulcer group [(10.17 ±3.32) × 109/L vs (7.25 ±3.15) × 109/L,P =0.018; (98 ±27)g/L vs (126 ±35)g/L,P=0.041].Conclusions Chronic constipation,enteric-coated aspirin intake and splanchnic atherosclerosis are risk factors related to ulcer in IC patients.Abdomen tenderness,high WBC and low Hb strongly indicate possible IC with ulcer.