PurposeHypertension is considered a major public health issue worldwide because of its high frequency and concomitant risk of cardiovascular disease (CVD). Chronic-disease self-management has been proven to be cost-effective, but influencing factors and pathways remain complex and unclear. The purpose of this study was to integrate factors associated with hypertension self-management to provide a theoretical reference for community hypertension management.MethodsA total of 268 community-dwelling hypertensive patients were enrolled in a cross-sectional study conducted from July to September in 2017. A questionnaire on demographic–disease characteristics, disease knowledge, social support, self-efficacy, and self-management was completed by patients. Structural equation modeling was performed to verify multiple factors in self-management based on the self-efficacy theory.ResultsThe final model showed a good fit to sample data, ie, younger patients with lower CVD risk, shorter disease course, and less disease knowledge and social support predicted less self-efficacy, less hypertension self-management, and less controlled hypertension. Furthermore, social support was negatively correlated with age, CVD risk, and disease course and positively with disease knowledge.ConclusionMedication adherence is the lowest dimension in self-management, and self-efficacy is vital to consider in the development of self-management interventions. Self-management education and mutual-help groups may be potential solutions with the power of technology. Younger patients with lower CVD risk and shorter disease course are vulnerable and need more attention.

Background: We launched a screening program for colorectal cancer (CRC) in Yuexiu District, Guangzhou, China, in 2014. Here we aimed to report the early results of the program and evaluate the benefits of a screening questionnaire.Methods: Residents aged between 50 and 74 were eligible for the screening. A questionnaire and two consecutive fecal immunological tests (FITs) were used as primary screening methods. Subjects who were positive for any of the two tests were referred for further examination with colonoscopy. Neoplasms were removed either colonoscopically or by colectomy. Atypical adenoma and CRC were defined as advanced neoplasms.Results: A total of 6,971 residents in Dadong Street, Yuexiu District were screened with a questionnaire, and among them, 5,343 underwent at least one FIT. Four thousand and two hundred eleven (60.4%) were female, and 2,760 (39.6%) were male, with a median age of 62.0 years. Questionnaire and FITs identified 1,219 candidates for further examination with colonoscopy, among whom only 647 (53.1%) comply. As of this writing, 623 colonoscopy results were obtained, among which 270 (43.3%) had positive findings. The adenoma detection rate (ADR) was 43.3% (270/623). The ADR was 43.3% (270/623). Of the 270 patients, 10 (3.07%) had CRC, 81 (30.0%) had advanced adenoma, 178 had low-grade adenoma or other benign polyps, one had carcinoid. Except for three advanced CRC, all neoplasms detected were benign or in an early stage.Conclusions: Our screening program help identified patients with colonic neoplasms at an early stage, precluding them from developing into the malignant disease. The addition of the questionnaire significantly increased the sensitivity of primary screening, while also decreasing the specificity. Long-term results should evaluate the social and economic benefits of this program.

In recent years, the lower limb exoskeleton has been more and more widely used in military, medical and other fields. In this paper, the muscle–bone model of the lower limb during the human walking process is analyzed, and a lower limb exoskeleton with the purpose of loadbearing is designed. The exoskeleton is driven by four hydraulic cylinders to the hip and knee joints whose design load is 50 kg. The kinematic and dynamic model of the exoskeleton designed in this paper is established and analyzed, and it is simulated. Finally, the experiments were carried out on the exoskeleton test platform to verify that the stability, bearing capacity, tracking effect and durability of the exoskeleton can meet the requirements.

Aiming at the difficulty of debugging the exoskeleton control system driven by a hydraulic cylinder, a research method of a nonlinear control strategy for the hydraulic exoskeleton system with 1 degree of freedom (DOF) joint is proposed. Based on a hardware-in-the-loop (HIL) simulation, this method establishes the dynamic model of the 1-DOF joint system of the hydraulic driven exoskeleton, constructs the HIL simulation test platform based on the Linux real-time kernel patch, and studies the nonlinear control strategy of the 1-DOF joint system on this platform system. The control effects of the PID control algorithm and the backstepping method on nonlinear control are compared, and the controller parameters are tested on the HIL simulation platform. From the experimental results of the HIL simulation, the research method has the advantages of low cost, high efficiency of system development, safety, and reliability. It has important reference value for the development and debugging of a hydraulic exoskeleton control system.

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