Obsessive-compulsive disorder (OCD) is characterized by recurrent episodes of intrusive thinking and/or behavior, persistent and variable symptoms, and chronic recurrence. It is clearly recommended in the OCD treatment guidelines that psychotherapy can effectively improve clinical symptoms and play an important role in maintaining long-term efficacy. However, previous research and clinical practice paid little attention to the application of psychological interventions in OCD.Currently, there is insufficient understanding of psychotherapy for OCD, especially the proven first-line exposure and response prevention therapy (ERP), cognitive-behavioral therapy, and Morita therapy.Due to limited resources, they have not received effective intervention. Therefore, this article reviews the relevant research on psychological therapy intervention for OCD in recent years, summarizes the intervention effects of different psychological therapy methods on OCD and further elaborates on possible therapeutic mechanisms.Based on this, combined with the existing research, this article clarifies the effect of various behavioral psychological interventions and their combined treatment, and explores group and online forms of psychological intervention in order to increase the accessibility of psychotherapy for OCD patients.

Obsessive-compulsive disorder (OCD) is characterized by recurrent episodes of intrusive thinking and/or behavior, persistent and variable symptoms, and chronic recurrence. It is clearly recommended in the OCD treatment guidelines that psychotherapy can effectively improve clinical symptoms and play an important role in maintaining long-term efficacy. However, previous research and clinical practice paid little attention to the application of psychological interventions in OCD.Currently, there is insufficient understanding of psychotherapy for OCD, especially the proven first-line exposure and response prevention therapy (ERP), cognitive-behavioral therapy, and Morita therapy.Due to limited resources, they have not received effective intervention. Therefore, this article reviews the relevant research on psychological therapy intervention for OCD in recent years, summarizes the intervention effects of different psychological therapy methods on OCD and further elaborates on possible therapeutic mechanisms.Based on this, combined with the existing research, this article clarifies the effect of various behavioral psychological interventions and their combined treatment, and explores group and online forms of psychological intervention in order to increase the accessibility of psychotherapy for OCD patients.

Objective To conduct data mining of asthma-inducing medications in underage populations based on the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)database,so as to provide reference for the clinical application of related medications.Methods Adverse drug event(ADE)reports from the first quarter of 2013 to the fourth quarter of 2022 in the FAERS database were collected and screened for reports of asthma adverse events in the this population(under 18 years old),which were categorized into infants,toddlers,children,and adolescents according to different age groups,and were subjected to medication signal mining by using the reporting odds ratio method,the composite standardized method,and the information component method.Results A total of 1 915 reports were obtained after screening,involving 1 042(54.41％)males and 831(43.39％)females;the highest percentage of the reporting population was between 12 and under 18 years old,with a total of 762(39.79％);60.78％of the reports were reported by health professionals;and the results of the clinical referrals showed that serious adverse events occurred in 85.90％of the cases.306 suspected drugs were screened,52 drugs were determined to be valid signals,and 1 044 adverse events were reported,of which 16 drug inserts did not mention the risk of asthma,in order of elosulfatase alpha,canakinumab,tobramycin,vancomycin,ceftriaxone,cetirizine,phenylephrine,imiglucerase,cefuroxime,betamethasone,atropine,tadalafil,riscovastatin,cyclophosphamide,octreotide,and omeprazole.Conclusion The FAERS database was mined for adverse drug event signals and evaluated using the proportional disequilibrium method to identify 16 medicines that may trigger pharmacogenetic asthma and are not documented in the specification,which can be used to provide a good early warning for the clinic.At the same time,focusing on special populations,strengthening the assessment of lung function before medication and monitoring during and after medication,timely interventions were taken to reduce the harm of drug-derived adverse reactions and ensure the safe use of medication.

Objective Based on the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)database,data mining was conducted on hematological adverse events related to antibody drug conjugates(ADC),providing reference for the safe use of ADC drugs in clinical practice.Methods The report data from the third quarter of 2011 to the fourth quarter of 2022 were retrieved from the FAERS database.After data cleaning such as deduplication and name standardization,extract hematological adverse events related to ADC,and use report odds ratio method and the information component method for signal detection.Results A total of 101 610 adverse event reports were extracted,with 8 ADC drugs as the primary suspected drugs,and 5 768 ADC related hematological adverse event reports.Among them,3 423 cases of agranulocytosis were involved,and the signal intensity from strong to weak were sacituzumab govitecan(SG),gemtuzumab ozogamicin(GO),brentuximab vedotin(BV),polatuzumab vedotin(PV),enfortumab vedotin(EV),trastuzumab deruxtecan(TD),inotuzumab ozogamicin(IO)and ado-trastuzumab emtansine(TDM-1).There were 2 327 cases hematopoietic cell deficiency,with signals ranging from strong to weak were IO,SG,BV,EV,PV,TD,TDM-1,and GO.Report with clinical outcome of death of ADC drug related hematological adverse events included BV 179(16.84％),TDM-1 102(13.01％),TD 88(27.08％),GO 12(16.90％),IO 8(11.59％),EV 54(24.32％),PV 22(27.16％),and SG 84(21.05％).Adverse event time analysis showed that the number of events on the first day of TD,IO,and SG medication accounts for ≥ 40％of the total number of cases.The median time of hematological adverse events in TD,GO,IO,EV,PV,and SG was within one treatment course(21 days).Conclusion Attention should be paid to the risk of ADC drug-related hematological adverse event,during the clinical medication process,blood cell count changes should be closely monitored,and any abnormalities should be promptly diagnosed and treated.

Objective:The principal components (PC) of venous-to-arterial carbon dioxide content diference [C(v-a)CO 2] were extraceted in septic shock patients, in orter to compare the contribution of the principal components to C(v-a)CO 2. Methods:Septic shock patients monitored by Swan Ganz floating catheter in the Medical Intensive Care Unit of Peking Union Medical College Hospital were included in the retrospective study. All pairs of arterial and mixed-venous blood gases within 1 h before and after a flood challenge were included in the analyses. The principal component method was used to extract the components of C(v-a)CO 2. Spearman correlation analysis was used to evaluate the correlation between the components and C(v-a)CO 2, and the correlation between the components and cardiac output. The differences of the components beween the 28-day survival group and 28-day death group were analyzed by univariate analysis. Results:A total of 504 pairs of blood gases in 104 septic shock patients were included in the analyses. The median age of patients was 62 years ( IQR, 48 to 71), and 59.6% (62/104) were men. Four principal components were extracted and the components account for 77.7% of variance. PC1 included PaO 2, PvO 2, SaO 2 and SvO 2. PC2 included pHa and pHv. PC3 included Hb and Hct. PC4 included PaCO 2 and PvCO 2. There was a significant difference in PC4 between the two group. PC4 could weakly predict the 28-day death (AUROC 0.634, 95% CI 0.527-0.741, P=0.015). Conclusions:In patients with infectious shock, arteriovenous [C(v-a)CO 2] consists of principal components of four dimensions: oxygenation, pH, Hb, and CO 2 partial pressure difference.Arterial CO 2 partial pressure difference [P(v-a)CO2] weakly predicts 28-d morbidity and mortality.

Acquired cerebral amyloid angiopathy,as a cerebrovascular disease discovered in recent years,mainly spreads through iatrogenic factors.This paper focuses on acquired cerebral amyloid angiopathy and delves into the new applications and profound implications of the"toxins damaging brain collaterals"theory proposed by academician WANG Yongyan in stroke research.Starting from the perspective of"toxins damaging brain collaterals",it comprehensively analyzes the causes and pathological mechanisms of acquired cerebral amyloid angiopathy,emphasizing the importance of external toxins,latent toxins,and turbid toxins in understanding the pathogenesis of the disease.It reveals that"toxins damaging brain collaterals"is the core mechanism of acquired cerebral amyloid angiopathy.On this basis,it proposes a new connotation of"toxins damaging brain collaterals":first,"toxin"includes both internal and external toxins;second,the organic integration of"external wind theory"and"toxins damaging brain collaterals"guides the improvement of theoretical research,clinical treatment,and prevention strategies for stroke,and promotes a deeper understanding of the disease.This approach to understanding acquired cerebral amyloid angiopathy from the perspective of"toxins damaging brain collaterals"not only demonstrates the effective integration of traditional Chinese medicine theory and modern biomedical science,but also provides insights and references for the clinical diagnosis and treatment of the disease.

Epilepsy is a disease of the central nervous system caused by excessive neuronal discharges in the brain,characterized by sudden,recurrent and self-limited onset. The brain's qi collateral and the brain neural network are highly correlated and internally consistent in terms of structure and function. The theory of "brain's qi collateral-abnormal collateral",which is centered on the structural disorder and dysfunction of brain's qi collateral leading to the poor circulation of brain's qi collateral,can comprehensively explain the related pathogenesis of epilepsy and the law of disease evolution,so it has important clinical value. Taking the pathogenic characteristics as an entry point and based on the theory of "brain's qi collateral-abnormal collateral",this paper argues that phlegm and qi stagnation,wind in the brain's qi collateral,and phlegm and blood stagnation damaging the brain's collaterals,as well as the structural and functional characteristics of brain's qi collateral that circulate bi-directionally are the key factors for epilepsy to present sudden,recurrent,and self-limited characteristics. According to the therapeutic principle of "Collaterals need to be unobstructed to function normally",it is proposed that the method of regulating the qi and collaterals should be used as the basic treatment principle throughout the treatment. In addition,the method of resolving phlegm and eliminating blood stasis is supplemented for different pathological changes,while combining the syndrome differentiation of zang-fu viscera and attaching importance to the accompanying symptoms of epileptic seizures,to regulate the brain's qi collateral to achieve the effects of wind quenching and epileptic arrest. This is to provide reference for the treatment of epilepsy in traditional Chinese medicine.

Objective To investigate clinicians'practice and opinions on sedation therapy in end-stage patients at Peking Union Medical College Hospital.Methods From August,2022 to April,2023,an online questionnaire survey was conducted among clinicians involved in end-stage patient management.Results A total of 205 questionnaires were distributed,with an effective response rate of 56.1% .Among the clinicians,55.7% of them had experience of applying sedation therapy in end-stage patients;85.2% of clinicians believed that se-dation could relieve the suffering of terminal patients from physical refractory symptoms;75.7% of clinicians considered that sedation therapy could be used to relieve agony from psycho-existential distress.Most clinicians had concerns about sedation therapy due to the lack of legal support(86.1% )and the lack of understanding of patients or families(59.1% ).The majority(90.4% )of clinicians were willing to receive training on palliative sedation.Conclusions A majority of clinicians agree that sedation therapy could relieve the physical distress and psycho-existential distress in end-stage patients.However,most clinicians have concerns about the application of sedation therapy due to the lack of legal support.It is necessary to enhance the training on palliative sedation.

Objective:To mine the risk signals of adverse events of limaprost and provide reference for safe use of the drug.Methods:US FDA Public Data Open Project (OpenFDA) platform was searched, and the adverse event (AE) reports on limaprost from January 1, 2004 to October 1, 2023 were collected. AEs were classified and standardized according to the system organ class (SOC) and preferred terms (PT) of Medical Dictionary for Regulatory Activities version 25.1. The reporting odds ratio (ROR) method was used to mine the risk signal of limaprost. An AE with reports ≥3, ROR ≥2 and the lower limit of the 95% confidence interval ( CI)>1 was defined as a risk signal, which was analyzed descriptively. Results:A total of 1 618 AE reports with limaprost as the primary suspect drug were collected, 69 risk signals were identified, involving 17 SOCs. Of the 69 PTs, 10 were recorded in the drug instructions including hepatic function abnormal, red blood cell count decreased, drug eruption, blood pressure decreased, liver disorder, platelet count decreased, anaemia, haemoglobin decreased, pyrexia, and decreased appetite. The other 59 risk signals were not recorded in the drug instructions. The top 10 PTs in signal intensity were scleroderma, tumour haemorrhage, brain natriuretic peptide increased, inappropriate antidiuretic hormone secretion, colitis microscopic, large intestine perforation, cardiac failure acute, depressive symptom, cardiac failure chronic, pulmonary alveolar haemorrhage. The risk signals with more than 10 reports were inappropriate antidiuretic hormone secretion, interstitial lung disease, renal impairment, cardiac failure, pneumonia, fall, etc.Conclusion:In addition to the AEs recorded in the instructions, limaprost may also cause serious adverse reactions such as tumour haemorrhage, brain natriuretic peptide increased, and inappropriate antidiuretic hormone secretion, which are not recorded in the instructions and have a poor prognosis.

Objective:To mine the risk signals of adverse events of limaprost and provide reference for safe use of the drug.Methods:US FDA Public Data Open Project (OpenFDA) platform was searched, and the adverse event (AE) reports on limaprost from January 1, 2004 to October 1, 2023 were collected. AEs were classified and standardized according to the system organ class (SOC) and preferred terms (PT) of Medical Dictionary for Regulatory Activities version 25.1. The reporting odds ratio (ROR) method was used to mine the risk signal of limaprost. An AE with reports ≥3, ROR ≥2 and the lower limit of the 95% confidence interval ( CI)>1 was defined as a risk signal, which was analyzed descriptively. Results:A total of 1 618 AE reports with limaprost as the primary suspect drug were collected, 69 risk signals were identified, involving 17 SOCs. Of the 69 PTs, 10 were recorded in the drug instructions including hepatic function abnormal, red blood cell count decreased, drug eruption, blood pressure decreased, liver disorder, platelet count decreased, anaemia, haemoglobin decreased, pyrexia, and decreased appetite. The other 59 risk signals were not recorded in the drug instructions. The top 10 PTs in signal intensity were scleroderma, tumour haemorrhage, brain natriuretic peptide increased, inappropriate antidiuretic hormone secretion, colitis microscopic, large intestine perforation, cardiac failure acute, depressive symptom, cardiac failure chronic, pulmonary alveolar haemorrhage. The risk signals with more than 10 reports were inappropriate antidiuretic hormone secretion, interstitial lung disease, renal impairment, cardiac failure, pneumonia, fall, etc.Conclusion:In addition to the AEs recorded in the instructions, limaprost may also cause serious adverse reactions such as tumour haemorrhage, brain natriuretic peptide increased, and inappropriate antidiuretic hormone secretion, which are not recorded in the instructions and have a poor prognosis.