Schizophrenia is a chronic and debilitating mental disorder.Around 20%to 40%of patients do not respond well to normal antipsychotic medication,and are ultimately diagnosed with treatment-resistant schizophrenia(TRS),representing the most severe and challenging form of schizophrenia.Currently,clozapine is the standard treatment for TRS.Early identification and standardized treatment can be beneficial to patients with TRS by controlling acute-phase symptoms as soon as possible,reducing suicidal rate and improving their quality of life.Under the guidance of the Steering Committee,this consensus was formed after multiple discussions by 30 psychiatric experts and anonymous Delphi surveys including 17 consensus opinions on treatment-resistant schizophrenia,which cover risk factors and prevention,diagnosis and evaluation,standardized clozapine treatment and management of adverse reactions,treatment regimens for clozapine resistance and intolerance,and psychosocial intervention,etc.The consensus-making process also incorporated evidence-based medicine to help standardize and guide diagnosis and treatment for adults with TRS in China.

Semaglutide is a long-acting glucagon-like peptide-1 receptor agonist (GLP-1RA), which is commonly used in the treatment of type 2 diabetes mellitus and weight loss. Its weight loss effect was exerted mainly by suppressing appetite, delaying gastric emptying, promoting energy metabolism, and accelerating lipolysis. However, delayed gastric emptying can lead to residual gastric content, increasing the risk of pulmonary aspiration during anesthesia. This article reviews the effects and mechanisms of semaglutide on gastric emptying, and proposes preventive measures for perioperative pulmonary aspiration in patients treated with semaglutide by reviewing case reports and clinical studies on semaglutide-related delayed gastric emptying. This provides a reference for the safety of semaglutide treatment during the perio- perative period.

Schizophrenia is a chronic and debilitating mental disorder.Around 20%to 40%of patients do not respond well to normal antipsychotic medication,and are ultimately diagnosed with treatment-resistant schizophrenia(TRS),representing the most severe and challenging form of schizophrenia.Currently,clozapine is the standard treatment for TRS.Early identification and standardized treatment can be beneficial to patients with TRS by controlling acute-phase symptoms as soon as possible,reducing suicidal rate and improving their quality of life.Under the guidance of the Steering Committee,this consensus was formed after multiple discussions by 30 psychiatric experts and anonymous Delphi surveys including 17 consensus opinions on treatment-resistant schizophrenia,which cover risk factors and prevention,diagnosis and evaluation,standardized clozapine treatment and management of adverse reactions,treatment regimens for clozapine resistance and intolerance,and psychosocial intervention,etc.The consensus-making process also incorporated evidence-based medicine to help standardize and guide diagnosis and treatment for adults with TRS in China.

Semaglutide is a long-acting glucagon-like peptide-1 receptor agonist (GLP-1RA), which is commonly used in the treatment of type 2 diabetes mellitus and weight loss. Its weight loss effect was exerted mainly by suppressing appetite, delaying gastric emptying, promoting energy metabolism, and accelerating lipolysis. However, delayed gastric emptying can lead to residual gastric content, increasing the risk of pulmonary aspiration during anesthesia. This article reviews the effects and mechanisms of semaglutide on gastric emptying, and proposes preventive measures for perioperative pulmonary aspiration in patients treated with semaglutide by reviewing case reports and clinical studies on semaglutide-related delayed gastric emptying. This provides a reference for the safety of semaglutide treatment during the perio- perative period.

Objective To observe the effect of reversed circadian rhythms on wound healing of mouse corneal epithelium.Methods Ninety male C57BL/6 mice were divided into LD group (12 hours light/12 hours dark) and DL group (12 hours dark/12 hours light) by random number table,and then were placed in circadian rhythm box for 12 days.The circular area was scarped and marked as 2 mm diameter area in the center of the mouse's cornea with a golf-like knife.The dynamics of epithelial healing in the wound area were observed under microscope by fluorescein staining and hematoxylin-eosin staining.Besides,being marked antibodies of anti-Ly6G-FITC,anti-γδT-PE and DAPl,dynamic changes of the dividing cells,neutrophils and γδT cells were also investigated for every 6 hours until 42 hours.All mice were treated in accordance with the Association for Research in Vision and Ophthalmology's Statement for the Use of Animals in Ophthalmology and Vision Research and the guidelines of the Animal Experimental Committee at Jinan University (JN-A-2002-01).Results In LD group,percentage of corneal epithelial defective area were (100.000 ± 0.000) ％,(37.677 ± 5.243) ％,(14.959 ± 1.739) ％ and (0.000 ± 0.000) ％ after wounding 0 hour,6,12,18 and 24 hours.In DL group,percentage of the corneal epithelial defective area were (100.000±0.000) ％,(10.967 ± 1.065 ％) ％,(1.985 ±0.106) ％ and (0.000±0.000) ％ after wounding 0 hour,6,12,18 and 24 hours.The healing rate in DL group was higher than that in LD group,with a significant difference between them (P＜0.05).As with the uninjured corneal,thickness of corneal epithelium was (33.983 ± 1.074)μm in DL group and (33.993±0.904)μm LD group,with no statistically significant difference between them (P＞0.05).After 24 hours,thickness of corneal epithelium in DL group was (19.473 ±0.856) μm,and was more than that in LD group [(17.485±0.718)μm],with a significant difference between them (P＜0.05).Paraffin section of wounded corneal epithelium after 24 hours by hematoxylin and eosin staining showed that corneal epithelium cells arranged loosely and disorderly and were in irregular shape in both groups.The epithelium were mainly basal cells in LD group,while epithelium included basal cell and a few pinacocytes in DL group.After corneal epithelium wounded,the number of cell division,neutrophils and corneal limbus γδT cells in two groups were statistically significant difference,respectively(P＜0.05).Conclusions Reversed circadian rhythms can significantly regulate the wound healing of corneal epithelium.