Treatment-resistant depression (TRD) remains a major challenge in psychiatric clinical practice. However, there is still substantial controversy in the academic community regarding how to define and assess it, and treat and manage these patients effectively. This paper reviews the evolution of the concept of "treatment resistance"in depression with a particular focus on comparing the conventional concept of TRD with the recently proposed concept of "Difficult-to-Treat Depression (DTD)". It explores the underlying rationale and logic behind this conceptual shift, and discusses the practical challenges associated with implementing the "DTD" framework in clinical practice. Finally, the paper provides targeted recommendations to address these challenges, aiming to serve as a reference for psychiatric clinicians and researchers in China.

Anticipatory anxiety is a negative emotion that arises when individuals encounter potential threats or uncertainties in the future. It is the core symptom of a variety of anxiety disorders, and is closely associated with the occurrence, severity, treatment outcome, and prognosis of anxiety disorders, which has garnered a growing amount of focus in clinical practice. Nevertheless, scientific research on anticipatory anxiety continues to face obstacles such as unclear pathological mechanisms, the absence of simple and consistent self-assessment tools, and effective interventions. To improve understanding of the role of anticipatory anxiety in the diagnosis and treatment of anxiety disorders, this study reviews pertinent domestic and international literature, and briefly introduces the concept, assessment and measurement, activation paradigm, pathological mechanisms, and interventions of anticipatory anxiety.

Toll-like receptor 5(TLR5)is a pattern recognition receptor,the main extracellular receptor for recognizing flagel-lin,and a bridge between innate and adaptive immunity.It can activate innate immunity and induce the release of a series of down-stream cytokines,as well as play an important role in protecting the host from flagellated pathogens and establishing immune tolerance.These functions are related to the pathogenesis of obesity hypertension in various aspects.This article aims to review the relationship between TLR5 and obese hypertension,as well as the new progress on the interaction between TLR5 and flagellin structure and func-tion,and discuss the future research directions and challenges.

Toll-like receptor 5(TLR5)is a pattern recognition receptor,the main extracellular receptor for recognizing flagel-lin,and a bridge between innate and adaptive immunity.It can activate innate immunity and induce the release of a series of down-stream cytokines,as well as play an important role in protecting the host from flagellated pathogens and establishing immune tolerance.These functions are related to the pathogenesis of obesity hypertension in various aspects.This article aims to review the relationship between TLR5 and obese hypertension,as well as the new progress on the interaction between TLR5 and flagellin structure and func-tion,and discuss the future research directions and challenges.

Treatment-resistant depression (TRD) remains a major challenge in psychiatric clinical practice. However, there is still substantial controversy in the academic community regarding how to define and assess it, and treat and manage these patients effectively. This paper reviews the evolution of the concept of "treatment resistance"in depression with a particular focus on comparing the conventional concept of TRD with the recently proposed concept of "Difficult-to-Treat Depression (DTD)". It explores the underlying rationale and logic behind this conceptual shift, and discusses the practical challenges associated with implementing the "DTD" framework in clinical practice. Finally, the paper provides targeted recommendations to address these challenges, aiming to serve as a reference for psychiatric clinicians and researchers in China.

Anticipatory anxiety is a negative emotion that arises when individuals encounter potential threats or uncertainties in the future. It is the core symptom of a variety of anxiety disorders, and is closely associated with the occurrence, severity, treatment outcome, and prognosis of anxiety disorders, which has garnered a growing amount of focus in clinical practice. Nevertheless, scientific research on anticipatory anxiety continues to face obstacles such as unclear pathological mechanisms, the absence of simple and consistent self-assessment tools, and effective interventions. To improve understanding of the role of anticipatory anxiety in the diagnosis and treatment of anxiety disorders, this study reviews pertinent domestic and international literature, and briefly introduces the concept, assessment and measurement, activation paradigm, pathological mechanisms, and interventions of anticipatory anxiety.

OBJECTIVE To summarize the current status of position training for clinical pharmacists in China and provide references for the continuous optimization of such training programs.METHODS SinoMed,CNKI,VIP and Wanfang Data were electronically searched to collect position training of clinical pharmacists studies from the inception until November 5th 2024.After data extraction and quality evaluation,descriptive analysis was performed on the results of the included studies.RESULTS&CONCLUSIONS A total of 68 pieces of relevant literature were included in the study.Among them,50 studies reported on training content,49 involved the allocation of teaching resources in the bases,48 addressed training methods,and 39 focused on training evaluation;only 2 studies mentioned faculty development.There were notable variations in the clinical pharmacist training programs across different bases,particularly in the allocation of teaching resources,such as the composition of the teaching team and the utilization of auxiliary teaching tools.Additionally,differences existed in training approaches,such as those employing a single method versus a blended approach.Conversely,the core training content of each base generally revolved around clinical pharmacy practice,demonstrating a degree of consistency.Moreover,the overall emphasis on teacher training and assessment tended to be obviously insufficient.Each base can focus on enhancing the competence of clinical pharmacists by allocating teaching resources,selecting training methods,improving training content,and using evaluation tools,to further enhance the quality of clinical pharmacist training.

Rumination is a pathological habitual thinking pattern commonly observed in various mental disorders. It is closely associated with the severity of symptoms, treatment outcomes, and social functioning outcomes in conditions such as depression, anxiety, post-traumatic stress disorder, and obsessive-compulsive disorder. In recent years, rumination has become a focal point in the clinical diagnosis and treatment of mental disorders. However, research on rumination still faces challenges, including conceptual ambiguity, lack of consistent assessment tools, unclear pathological mechanisms, and a shortage of effective intervention methods. This paper conducts a comprehensive review by examining relevant domestic and international literature to enhance our understanding of rumination across different mental disorders. The review encompasses the concepts, assessments, pathological mechanisms, and intervention methods of rumination, aiming to provide insights and references for the clinical diagnosis and treatment of rumination.

Rumination is a pathological habitual thinking pattern commonly observed in various mental disorders. It is closely associated with the severity of symptoms, treatment outcomes, and social functioning outcomes in conditions such as depression, anxiety, post-traumatic stress disorder, and obsessive-compulsive disorder. In recent years, rumination has become a focal point in the clinical diagnosis and treatment of mental disorders. However, research on rumination still faces challenges, including conceptual ambiguity, lack of consistent assessment tools, unclear pathological mechanisms, and a shortage of effective intervention methods. This paper conducts a comprehensive review by examining relevant domestic and international literature to enhance our understanding of rumination across different mental disorders. The review encompasses the concepts, assessments, pathological mechanisms, and intervention methods of rumination, aiming to provide insights and references for the clinical diagnosis and treatment of rumination.

Objective: To understand the current status of diagnosis and treatment of chronic lymphocytic leukemia (CLL) /small lymphocytic lymphoma (SLL) among hematologists, oncologists, and lymphoma physicians from hospitals of different levels in China. Methods: This multicenter questionnaire survey was conducted from March 2021 to July 2021 and included 1,000 eligible physicians. A combination of face-to-face interviews and online questionnaire surveys was used. A standardized questionnaire regarding the composition of patients treated for CLL/SLL, disease diagnosis and prognosis evaluation, concomitant diseases, organ function evaluation, treatment selection, and Bruton tyrosine kinase (BTK) inhibitor was used. Results: ①The interviewed physicians stated that the proportion of male patients treated for CLL/SLL is higher than that of females, and the age is mainly concentrated in 61-70 years old. ②Most of the interviewed physicians conducted tests, such as bone marrow biopsies and immunohistochemistry, for patient diagnosis, in addition to the blood test. ③Only 13.7% of the interviewed physicians fully grasped the initial treatment indications recommended by the existing guidelines. ④In terms of cognition of high-risk prognostic factors, physicians' knowledge of unmutated immunoglobulin heavy-chain variable and 11q- is far inferior to that of TP53 mutation and complex karyotype, which are two high-risk prognostic factors, and only 17.1% of the interviewed physicians fully mastered CLL International Prognostic Index scoring system. ⑤Among the first-line treatment strategy, BTK inhibitors are used for different types of patients, and physicians have formed a certain understanding that BTK inhibitors should be preferentially used in patients with high-risk factors and elderly patients, but the actual use of BTK inhibitors in different types of patients is not high (31.6%-46.0%). ⑥BTK inhibitors at a reduced dose in actual clinical treatment were used by 69.0% of the physicians, and 66.8% of the physicians had interrupted the BTK inhibitor for >12 days in actual clinical treatment. The use of BTK inhibitors is reduced or interrupted mainly because of adverse reactions, such as atrial fibrillation, severe bone marrow suppression, hemorrhage, and pulmonary infection, as well as patients' payment capacity and effective disease progression control. ⑦Some differences were found in the perceptions and behaviors of hematologists and oncologists regarding the prognostic assessment of CLL/SLL, the choice of treatment options, the clinical use of BTK inhibitors, etc. Conclusion: At present, a gap remains between the diagnosis and treatment of CLL/SLL among Chinese physicians compared with the recommendations in the guidelines regarding the diagnostic criteria, treatment indications, prognosis assessment, accompanying disease assessment, treatment strategy selection, and rational BTK inhibitor use, especially the proportion of dose reduction or BTK inhibitor discontinuation due to high adverse events.
Female ; Humans ; Male ; Aged ; Middle Aged ; Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy* ; Prognosis ; Lymphoma, B-Cell ; Immunohistochemistry ; Immunoglobulin Heavy Chains/therapeutic use*