With the widely development of psychiatric clinical researches,the ethical issue has been concerned gradually.Although the ethical review has strict rules on informed consent,there are many problems and challenges on informed consent implementation because of the special mental illness population.According to the relevant laws and regulations,combined with the characteristics of clinical psychiatric researches,this paper discussed the protection of subjects' fights and interests during the implementation of informed consent in psychiatric clinical researches,from the following aspects:providing a quiet,comfortable,and relatively independent environment for the participants to ensure informed consent,guaranteeing full informed consent time,choosing qualified researchers for informed consent,ensuring the effective process of informed consent,and guiding the subjects to correctly sign their names and the date.

To isolate corynoline from Corydalis bungeana Turcz.and study its anti-inflammatory mechanism via TLRs/NF-κB signal pathway.Corynoline was extracted by 80％ ethanol and purified by silicagel column chromatography.The structure and purity of corynoline was determined by UPLC,MS,1H NMR and 13C NMR.In the course of experiment,the cytotoxicity of corynoline was evaluated by MTT assay.And the inflammation model was established by RAW264.7 macrophages induced by lipopolysaccharide(LPS),which was intervened by coryno line.The expression levels of TLR4,TLR2 and nuclear transcription factor-κB(NF-κB) signaling pathways related proteinsin RAW264.7 macrophages were detected by Western blot.Furthermore,the expressionof NF-κB p65 mRNA and nuclear p65 were determined by the real-time fluorescence quantitative PCR(RT-qPCR) and Western blot.Results showed that 5-40 μmol/L corynoline reduced the expression level of TLR4 and TLR2,and inhibited the phosphorylation level of IκBα and the phosphorylation and nuclear translocation of p65 at gene and protein levelin a dose-dependent manner in LPS-induced RAW264.7 cells.This study indicated the protective effect of corynoline on LPS-induced RAW264.7 macrophages may be related with the inhibition of TLRs/NF-κB inflammatory signaling pathway.

Objective To study the distribution and properly of the transparent globules within Hensen cells (HC) of guinea -pig Corti organ .Methods The cochlear epithelial cells were isolated from 10 guinea pigs .The cells of cochlea were marked by Bodipy493/503 ,sudan III ,oil red O ,and osmium tetroxide .Results The transpar‐ent globules within the HCs of the guinea -pigs were green staining by Bodipy493/503 ,jacinth staining by Sudan III ,ruby red by oil red O .And they were black globules stripe as post -fixed in 1% osmium tetroxide .Conclusion The results indicate that the transparent globules within guinea -pigs HCs'lipid droplets by four methods .

In this paper, water extract of Nauclea officinalis was absorbed by AB-8 macroporous resin and subsequently gradient-eluted with alcoholic solution of different proportion to prepare pumiloside monomer of high purity. The metabolites in urine, feces and bile of rats with gavage administration were analyzed by UPLC-QTOF/MS. Accurate MS/MS data of all components were collected with full scan mode, and analyzed by MetaboLynx software. Results showed that the monomer of high-purity pumiloside was prepared and four metabolites in rats were identified.

To establish the experts consensus on the management of delirium in critically ill patients.A special committee was set up by 15 experts from the Chinese Critical Hypothermia-Sedation Therapy Study Group.Each statement was assessed based on the GRADE (Grading of Recommendations Assessment,Development,and Evaluation) principle.Then the Delphi method was adopted by 36 experts to reassess all the statements.(1) Delirium is not only a mental change,but also a clinical syndrome with multiple pathophysiological changes.(2) Delirium is a form of disturbance of consciousness and a manifestation of abnormal brain function.(3) Pain is a common cause of delirium in critically ill patients.Analgesia can reduce the occurrence and development of delirium.(4) Anxiety or depression are important factors for delirium in critically ill patients.(5) The correlation between sedative and analgesic drugs and delirium is uncertain.(6) Pay attention to the relationship between delirium and withdrawal reactions.(7) Pay attention to the relationship between delirium and drug dependence/ withdrawal reactions.(8) Sleep disruption can induce delirium.(9) We should be vigilant against potential risk factors for persistent or recurrent delirium.(10) Critically illness related delirium can affect the diagnosis and treatment of primary diseases,and can also be alleviated with the improvement of primary diseases.(11) Acute change of consciousness and attention deficit are necessary for delirium diagnosis.(12) The combined assessment of confusion assessment method for the intensive care unit and intensive care delirium screening checklist can improve the sensitivity of delirium,especially subclinical delirium.(13) Early identification and intervention of subclinical delirium can reduce its risk of clinical delirium.(14) Daily assessment is helpful for early detection of delirium.(15) Hopoactive delirium and mixed delirium are common and should be emphasized.(16) Delirium may be accompanied by changes in electroencephalogram.Bedside electroencephalogram monitoring should be used in the ICU if conditions warrant.(17) Pay attention to differential diagnosis of delirium and dementia/depression.(18) Pay attention to the role of rapid delirium screening method in delirium management.(19) Assessment of the severity of delirium is an essential part of the diagnosis of delirium.(20) The key to the management of delirium is etiological treatment.(21) Improving environmental factors and making patient comfort can help reduce delirium.(22) Early exercise can reduce the incidence of delirium and shorten the duration of delirium.(23) Communication with patients should be emphasized and strengthened.Family members participation can help reduce the incidence of delirium and promote the recovery of delirium.(24) Pay attention to the role of sleep management in the prevention and treatment of delirium.(25) Dexmedetomidine can shorten the duration of hyperactive delirium or prevent delirium.(26) When using antipsychotics to treat delirium,we should be alert to its effect on the heart rhythm.(27) Delirium management should pay attention to brain functional exercise.(28) Compared with non-critically illness related delirium,the relief of critically illness related delirium will not accomplished at one stroke.(29) Multiple management strategies such as ABCDEF,eCASH and ESCAPE are helpful to prevent and treat delirium and improve the prognosis of critically ill patients.(30) Shortening the duration of delirium can reduce the occurrence of long-term cognitive impairment.(31) Multidisciplinary cooperation and continuous quality improvement can improve delirium management.Consensus can promote delirium management in critically ill patients,optimize analgesia and sedation therapy,and even affect prognosis.