Objective:To standardize the management of auditory hallucination symptoms in inpatients with mental illness and develop an expert consensus on the management of auditory hallucinations in hospitalized psychiatric patients.Methods:From March 2023 to July 2023, the Mental Health Committee of the Chinese Nursing Association focused on the key issues in the management of auditory hallucinations symptoms in inpatients with mental illness, based on clinical practice, using literature analysis combined with the work experience of mental health experts, and formed the first draft of the expert consensus on the management of auditory hallucinations in inpatients with mental illness (hereinafter referred to as the consensus). Through 3 rounds of expert consultation and 3 rounds of expert demonstration meeting, the draft was adjusted, revised, and improved.Results:37 experts were included in the Delphi expert consultation, 1 male and 36 females with 39-67(51.48 ± 6.61) years old. The positive coefficients of experts in 3 rounds of Delphi expert consultations were all 100%, and the degrees of expert authority were 0.924, 0.938 and 0.949, respectively. The average importance value of each item was higher than 4.00, the variation coefficient of each item was less than 0.25. The Kendall harmony coefficient of the experts were 0.179, 0.195 and 0.198, respectively (all P<0.05). There were 15, 12, 12 experts in the first, seeond, third rounds of expert demonstration meeting. Finally, a consensus was reached on the recommendation of 4 parts, included auditory hallucination assessment, management format, symptom management implementation, and precautions. Conclusions:The consensus covers all parts of the management of auditory hallucination symptoms in hospitalized patients with mental disorders, which is practical and scientific. It is helpful to guide mental health professionals to standardize the management of auditory hallucination symptoms, improve the quality of nursing and ensure the safety of patients.

Multiple myeloma (MM) is a malignant plasma cell disease that currently cannot be cured. Several new drugs have continuously been introduced in the recent years. New drugs targeting B-cell maturation antigen (BCMA) have greatly improved the efficacy and prognosis of MM compared with traditional treatments. This article reports the case of an IgD type relapsed and refractory MM patient with poor efficacy of BCMA×CD3 bispecific antibody. The patient achieved deep remission after receiving BCMA-targeted CAR-T cell therapy after initial seven lines of treatment. Literature review was also conducted to improve the clinical physicians’ understanding of BCMA target therapy for relapsed and refractory MM patients.

Most drugs taste bitter and irritating, resulting in poor compliance of patients, and the bad odor affects the therapeutic effect. The successful research and development of a drug should not only conform to the five quality characteristics of effectiveness, stability, safety, uniformity and economy, but also the compliance of patients to drugs with bad odor. The development of taste masking techniques is critical for bitter drugs.This review describes the principles, advantages and drawbacks of traditional taste masking techniques, and introduces the mechanism and application of novel taste masking techniques, such as melt granulation, hot melt extrusion, 3D printing, drug complex preparation, and bitter taste inhibitors. The in vitro evaluation methods of drug taste masking effect, such as functional magnetic resonance imaging, in vitro dissolution, and electronic tongue technology, are described. And introduce in vivo evaluation methods, such as animal and human taste, in the field of taste masking effect. A new strategy of BP neural network prediction model for drug taste evaluation is proposed, with a view to providing theoretical reference for the future research on drug taste masking.

Primary liver cancer(PLC)is one of the most common malignant tumors of digestive system in clinic.TCM plays an important role in the treatment of PLC.After sorting out the medical records and literatures related to the syndrome types of primary liver cancer in recent years,it was found that the syndrome type of qi stagnation and blood stasis was one of the important syndrome types of primary liver cancer.This article discusses and supplements the syndrome type of qi stagnation and blood stasis from the aspects of etiology and pathogenesis,proportion of syndrome types,staging of liver cancer,objective indicators of liver cancer,etc.It provides a new understanding for the treatment of primary liver cancer based on syndrome differentiation,so as to improve the clinical cure rate of liver cancer,alleviate the clinical symptoms of patients,improve the quality of life,and prolong the survival period.

Objective:To explore the association of different obesity measurement indexes on serum C-reactive protein (CRP) in Chinese adult women.Methods:The data were obtained from baseline and follow-up surveys of the urban Breast Cancer Screening Program in Shuangliu District, Chengdu. A total of 441 adult women were included in the study. A questionnaire survey, physical examination, and laboratory testing were conducted on the subjects. Multivariate logistic regression model, two-level mixed effects logistic regression model, and restricted cubic spline method were used to investigate the linear and nonlinear correlation between different obesity measurement indexes and serum CRP in adult women.Results:For every 1 unit increase in BMI, waist circumference (WC), and adiposity, the risk of elevated serum CRP or exacerbation of chronic low-grade inflammation in adult women increased by 16.5%, 5.0%, and 11.1% ( P<0.05), respectively. Both BMI and adiposity were nonlinear correlated with serum CRP. Using BMI=24.0 kg/m 2 as the reference point, serum CRP level increased with the increase of BMI when BMI >24.0 kg/m 2. Using adiposity=30% as the reference point, serum CRP level increased with the increase of adiposity when adiposity >30%. Conclusions:Overall, obesity reflected by BMI had the strongest association with serum CRP in adult women, followed by body fat content reflected by adiposity, and central obesity reflected by WC had the weakest association with CRP. Adult women with BMI >24.0 kg/m 2 or adiposity >30% are at high risk for obesity-related inflammatory manifestations.

Objective:To investigate the treatment options for multiple myeloma patients with central nervous system involvement (CNS-MM) , as well as their clinical characteristics and prognostic factors.Methods:Between January 2011 and January 2022 our center diagnosed 18 people with CNS-MM. A retrospective analysis was done on the clinical information from the initial diagnosis and central nervous system involvement, and it was compared to 1∶3 matched newly diagnosed MM from the same period. Analysis was done on the clinical characteristics and survival rates of the two groups.Results:In patients with CNS-MM, the median time of onset was 14.2 (0.9-79.6) months and the median overall survival (OS) was 30.5 months from initial diagnosis and only 3.8 months in patients after CNS involvement. The CNS-MM patients showed more IgD type ( P=0.010) , severer anemia ( P=0.014) , a higher proportion of bone marrow plasma cells ( P=0.013) , more extramedullary lesions ( P=0.001) , and increased lactic dehydrogenase (LDH) ( P=0.009) when compared to the control group. Lenalidomide or pomalidomide-based combinations had higher rates of hematology and CNS remission than bortezomib or daratumumab-based regimens (75.0% vs 16.7% , P=0.019) . Patients who received IMiD-based regimens and had 2 high-risk factors at initial diagnosis (high LDH and extramedullary lesions) had a significantly lower incidence of CNS-MM ( P=0.026) . At the initial diagnosis, LDH ( P=0.008, HR=7.319, 95% CI 1.663-32.219) and extramedullary lesions ( P=0.006, HR=8.054, 95% CI 1.828-35.486) were independent risk factors for the occurrence of CNS-MM. Conclusion:Patients with CNS-MM had a poor prognosis. Patients with high LDH or extramedullary lesions at the time of the initial diagnosis are more likely to have CNS-MM. The prognosis of this patient may be improved by immunoregulator-based therapy.

Objective:To understand the attitude of clinical nurses in a ClassⅢ Grade A hospital in Shanghai towards the implementation of the advance fixed scheduling model and to explore the influencing factors of whether nurses are willing to try the advance fixed scheduling model, so as to lay the foundation for later development in clinical practice.Methods:Mixed design was used to study. In the quantitative study, a cross-sectional survey of 1 326 nurses in a comprehensive Class Ⅲ Grade A hospital in Shanghai was conducted with a self-made questionnaire from September to October 2018 with cluster sampling method. And multivariate Logistic regression was used to analyze the influencing factors of the willingness of nurses to try the advance fixed scheduling model. A total of 1 326 questionnaires were distributed and 1 326 were effectively collected, with an effective recovery rate of 100.0%. In the qualitative study, 12 nurses from a comprehensive Class Ⅲ Grade A hospital in Shanghai from September to December 2018 were selected for semi-structured in-depth interviews with the purposive sampling method, so as to deeply understand the attitude and reasons of clinical nurses towards the implementation of the advance fixed scheduling model. And Colaizzi phenomenological analysis method was used to collate and analyze the interview data.Results:A total of 49.2% (653/1 326) of the nurses heard of the advance fixed scheduling model and 67.5% (896/1 326) of the nurses expressed their willingness to try the advance fixed scheduling model. The results of multivariate Logistic regression analysis showed that non-emergency department, whether they had children, whether they heard of the advance scheduling model and whether they believed that shifts had a great effect on life were influencing factors of the willingness of nurses to try the advance fixed scheduling model ( P<0.05) . The results of qualitative interviews showed that some nurses supported the advance fixed scheduling model and looked forward to a more reasonable arrangement of their study and life under the new work model, while some nurses feared change, and worried about their competence, fairness issues and non-support from their family members. Conclusions:Clinical nurses have a general attitude towards the advanced fixed scheduling model. In clinical practice in the future, some nurses who are willing to try can be recruited to implement the advance fixed scheduling model and their working status, satisfaction and quality of work can be dynamically monitored to provide an empirical basis for the new nursing manpower management model.

Objective: To investigate the effects of sinomenine on brain edema and the expression of aquaporin 4 (AQP-4) and aquaporin 5 (AQP-5) in rats with acute brain injury. Methods: According to random number table method, rats were divided into sham operation group, model group, low-dose sinomenine group, high-dose sinomenine group, 20 in each group. In addition to the sham operation group, the rat brain injury model was established by Feeney free falling impact method. Rats in low and high dose of sinomenine group were given sinomenine 30, 60 mg/kg by intraperitoneal injection, and the sham operation group and model group were injected intraperitoneally with the same volume of normal saline, once per day for 7 days. Histopathological changes in each group were observed by HE staining and electron microscope. Western blot and RT-PCR were used to detect AQP-4 and AQP-5 protein and gene expression in brain tissue. Results: The pathological results showed that the nerve cells in the model group were loosely arranged, disordered in hierarchy, some cells appear to have degenerated. The degeneration and necrosis of nerve cells in the low and high dose sinomenine group were less than those in the model group. Compared to the model group, the expression of AQP-4 (0.74 ± 0.13, 0.49 ± 0.11 vs. 1.30 ± 0.21), AQP-5 (0.98 ± 0.07, 0.45 ± 0.10 vs. 1.47 ± 0.18) in the low dose and high dose sinomenine group significantly decreased (P<0.05). The expression of AQP-4 (1.48 ± 0.18, 1.26 ± 0.12 vs. 2.04 ± 0.14), AQP-5 (1.31 ± 0.17, 1.20 ± 0.11 vs. 1.87 ± 0.15) mRNA in the low dose and high dose sinomenine group significantly decreased (P<0.05). Conclusions Sinomenine could alleviate cerebral injury by lowering the expression of AQP-4 and AQP-5.

Objective:To explore the knowledge and attitude of cardiopulmonary resuscitation (CPR) in community residents in Shanghai and analyze the influencing factors.Methods:The residents in 16 communities in Shanghai were selected by convenient sampling and investigated from November 2018 to June 2019, and a total of 714 valid questionnaires were recovered. The residents' CPR knowledge and attitude were analyzed descriptively, and multiple linear regression was used to analyze the influencing factors.Results:The total score of CPR knowledge among the 714 community residents in Shanghai was (24.58±7.80) , with a passing rate of 36.13% (258/714) , and the passing rate of "artificial respiration knowledge" was the lowest, which was 38.66% (276/714) . The total score of the residents' CPR attitude was (40.95±5.18) , and the average scores of "attitude to learning CPR" and "attitude to implementing CPR" were (3.60±0.45) and (3.22±0.50) , respectively. Analysis of the influencing factors showed that gender, age, education level, conscious health status, whether they have heard of CPR, whether they have received CPR training, and whether they have encountered emergency rescue communities were the influencing factors to the community residents' CPR knowledge and attitude ( P < 0.05) . Conclusions:The overall CPR knowledge level of the community residents in Shanghai is relatively low, and the residents prefer to learn CPR and implement CPR for their relatives and friends, rather than strangers. Younger, better conscious health status, and having heard of CPR can help the residents improve their CPR knowledge and attitude, while women, higher education level, and residents who have encountered emergency rescue communities have better CPR knowledge. The CPR training has a positive effect on the residents' attitude to learning and implementing CPR. Future CPR training needs to increase the training intensity and duration, and help the residents to improve the level of CPR knowledge and attitude.

To evaluate the differential expression profiles of the lncRNAs, miRNAs, mRNAs and ceRNAs, and their implication in the prognosis in clear cell renal cell carcinoma (CCRCC), the large sample genomics analysis technologies were used in this study. The RNA and miRNA sequencing data of CCRCC were obtained from The Cancer Genome Atlas (TCGA) database, and R software was used for gene expression analysis and survival analysis. Cytoscape software was used to construct the ceRNA network. The results showed that a total of 1 570 lncRNAs, 54 miRNAs, and 17 mRNAs were differentially expressed in CCRCC, and most of their expression levels were up-regulated (false discovery rate < 0.01 and absolute log fold change > 2). The ceRNA regulatory network showed the interaction between 89 differentially expressed lncRNAs and 9 differentially expressed miRNAs. Further survival analysis revealed that 38 lncRNAs (including COL18A1-AS1, TCL6, LINC00475, UCA1, WT1-AS, HOTTIP, PVT1, etc.) and 2 miRNAs (including miR-21 and miR-155) were correlated with the overall survival time of CCRCC ( < 0.05). Together, this study provided us several new evidences for the targeted therapy and prognosis assessment of CCRCC.
Carcinoma, Renal Cell ; genetics ; Humans ; Kidney Neoplasms ; genetics ; MicroRNAs ; genetics ; RNA, Long Noncoding ; genetics ; Transcriptome