OBJECTIVE To investigate the reference range of steady-state trough concentrations in depression patients taking paroxetine. METHODS Therapeutic drug monitoring data of 890 depression inpatients treated with paroxetine in our hospital from January 1， 2023 to December 31， 2024 were retrospectively collected. Univariate analysis and multiple linear regression analysis were employed to explore the influencing factors of the steady-state trough concentration of paroxetine， as well as the correlation between concentration and efficacy and adverse reactions. The reference range of steady-state trough concentration was obtained by receiver operating characteristic（ROC） curve method. RESULTS Patients with a greater degree of improvement in therapeutic efficacy exhibited higher steady-state trough concentrations of paroxetine （P＜0.000 1）. The steady-state trough concentrations of paroxetine and the ratio of paroxetine steady-state trough concentration to dose （C/D ratio） were significantly lower in male patients and those weighing 60-80 kg compared to female patients and those weighing＜60 kg， respectively （P＜0.05 or P＜0.000 1）. The steady-state trough concentration， C/D ratio， dosage， and concomitant medication all showed a positive correlation with therapeutic efficacy （P＜0.05 or P＜0.000 1）. Both the steady-state trough concentration and C/D ratio were correlated with liver function impairment， and the C/D ratio was also correlated with urinary retention （P＜0.05 or P＜0.000 1）. The critical threshold for the effective concentration of paroxetine was 56.31 ng/mL in the overall population， 56.42 ng/mL in males， 44.91 ng/mL in females， and 198.90 ng/mL in patients experiencing adverse reactions. CONCLUSIONS The reference range for the steady-state trough concentration of paroxetine in the overall population is 56.31-198.90 ng/mL； for male patients， it is 56.42-198.90 ng/mL， and for female patients， it is 44.91-198.90 ng/mL. Dosage of paroxetine should be reduced as appropriate for female patients and patients with low body weight or abnormal liver function.

Objective:To exploring the application effect of doctors-nurses-patients theory of goal attainment combined with StMarys cluster intervention mode in patients with tracheotomy after stroke.Methods:Using convenient sampling method, a total of 130 stroke patients with tracheostomy who were admitted to Shangqiu First People's Hospital from August 2020 to February 2022 were selected as the research objects. The patients were divided into the control group and the observation group using the random number table method, with 65 cases in each group. The control group received routine nursing care, while the observation group applied doctors-nurses-patients theory of goal attainment combined with StMarys cluster nursing intervention mode on the basis of the control group. After intervention, scores of Self Rating Anxiety Scale (SAS) and Self Rating Depression Scale (SDS) and patient nursing satisfaction were compared between the two groups.Results:After intervention, the SAS and SDS scores of the observation group were lower than those of the control group, and the nursing satisfaction was higher than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The doctors-nurses-patients theory of goal attainment combined with StMarys cluster intervention mode can help improve the psychological state of patients and increase nursing satisfaction.

Objective: Schizophrenia is a common mental disorder, and mitochondrial function represents a potential therapeutic target for psychiatric diseases. The role of mitochondrial metabolism-related genes (MRGs) in the diagnosis of schizophrenia remains unknown. This study aimed to identify candidate genes that may influence the diagnosis and treatment of schizophrenia based on MRGs. Methods: Three schizophrenia datasets were obtained from the Gene Expression Omnibus database. MRGs were collected from relevant literature. The differentially expressed genes between normal samples and schizophrenia samples were screened using the limma package. Venn analysis was performed to identify differentially expressed MRGs (DEMRGs) in schizophrenia. Based on the STRING database, hub genes in DEMRGs were identified using the MCODE algorithm in Cytoscape. A diagnostic model containing hub genes was constructed using LASSO regression and logistic regression analysis. The relationship between hub genes and drug sensitivity was explored using the DSigDB database. An interaction network between miRNA-transcription factor (TF)-hub genes was created using the Network-Analyst website. Results: A total of 1,234 MRGs, 172 DEMRGs, and 6 hub genes with good diagnostic performance were identified. Ten potential candidate drugs (rifampicin, fulvestrant, pentadecafluorooctanoic acid, etc.) were selected. Thirty-four miRNAs targeting genes in the diagnostic model (ANGPTL4, CPT2, GLUD1, MED1, and MED20), as well as 137 TFs, were identified. Conclusion Six potential candidate genes showed promising diagnostic significance. rifampicin, fulvestrant, and pentadecafluorooctanoic acid were potential drugs for future research in the treatment of schizophrenia. These findings provided valuable evidence for the understanding of schizophrenia pathogenesis, diagnosis, and drug treatment.

Objective:To explore the effect of Taijicao training on activities of daily living (ADL) and quality of life (QOL) in patients with coronary heart disease after percutaneous coronary intervention (PCI) .Methods:From June 2020 to May 2021, 160 patients with coronary heart disease who underwent PCI in the Department of Cardiology of First People's Hospital of Shangqiu were selected by convenience sampling as the research object. The patients were divided into the control group of 80 cases and the intervention group of 80 cases by random number table method. The control group was given routine nursing and exercise instruction, and the intervention group was given 6-month Taijicao training on the basis of routine nursing. The ADL of the patients was evaluated by the Instrumental Activities of Daily Living Scale and the QOL of the patients was evaluated by the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) .Results:After the intervention, the ADL score of the intervention group was lower than that of the control group, and the scores of each dimension of SF-36 were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Taijicao training can improve the ADL and QOL of patients with coronary heart disease after PCI, and it is worthy of promotion in hospitals and communities.

Objective To evaluate the clinical efficacy of Yangxue-Pinggan decoction on intractable headache. Methods A total of 66 patients with intractable headache who met the inclusion criteria were randomly divided into two groups by random number table method, 33 in each group. The control group was given flunarizine hydrochloride capsule orally, while the treatment group was given professor Guan Youbo's Yangxue-Pinggan decoction. Both groups were treated for 4 weeks. The improvement rates of headache were observed. The headache attacks, the degree of headache, the duration of headache and the accompanying symptoms were scored, and the clinical efficacy was evaluated. Results The total effective rate was 97.0％ (32/33) in the treatment group and 63.6％ (21/33) in the control group, which there was significant difference between the two groups (χ2=11.591, P=0.001). After treatment, the scores of the headache attacks, the degree of headache, the duration of headache and the accompanying symptoms in the treatment group were significantly lower than those in the control group (t=17.689, 12.523, 26.907, 25.569, P<0.001). Conclusions The Yangxue-Pinggan decoction can obviously improve the clinical symptoms of intractable headache, relieve the pain degree and reduce the number of attacks, and its clinical efficacy is better than oral flunarizine hydrochloride capsule.

Objective? To explore the effect of WeChat-based information support in patients with bronchial asthma. Methods? Using convenient sampling method, 100 cases of bronchial asthma patients admitted to Shangqiu First People's Hospital from June 2014 to December 2016 were selected as the research objects. The selected patients were divided into observation group and control group by random number table method, 50 cases in each group. The control group was given routine out-of-hospital guidance when discharged, on the basis of that, the observation group was given transitional nursing based on WeChat information support. The control of asthma at discharge and 6 months after intervention [assessed by Asthma Control Test Table (ACT)], quality of life (assessed by Asthma Quality of Life Questionnaire (AQLQ)], total compliance rate of medication during 6 months of intervention, recurrence rate, number of acute episode and number of hospitalizations were compared between the two groups. Results? There was no significant difference in ACT score and AQLQ score between the two groups at discharge (P＞0.05). After intervention for 6 months, the ACT and AQLQ scores of the two groups increased compared with those at discharge,the differences were statistical (P＜ 0.05). The scores of ACT and AQLQ in the observation group were (22.98±3.11) and (133.14±12.35) respectively, higher than those in the control group, which were (20.50±3.05) and (116.24±11.87), respectively, and the differences were statistical (P＜0.01). The total compliance rate of the observation group was 86% during the 6-month intervention period, which was higher than 68% of the control group with statistical difference (P＜ 0.05). The recurrence rate, the number of acute episodes and the number of hospitalizations in the observation group [10%, (0.45±0.20) and (0.30±0.14)times ]were lower than those in the control group [26.00%, (1.04±0.38) times and (0.89±0.33) times], and the differences between the two groups were statistical (P＜0.05). Conclusions? Information support based on WeChat can provide comprehensive guidance for the work and life of patients with tracheal asthma after discharge, effectively control their condition, improve their quality of life and medication compliance, and reduce the recurrence rate.

Objective? To explore the application value of trajectory nursing of chronic diseases in patients with chronic obstructive pulmonary disease (COPD). Methods? By convenience sampling, a total of 69 COPD patients at the stable stage after treatment in Shangqiu First People's Hospital from January 2016 to January 2018 were selected as research objects, and a total of 66 patients completed the research. According to the communities they belonged to, they were divided into the observation group(n=31) and control group (n=35). BODE index(B: body mass index; O: airway obstruction; D: dyspnea; E: exercise endurance) was counted in both groups. The patients' COPD disease trajectory in the observation group were evaluated by their scores in BODE and were divided into different stages: 1-2 points were stage I, 3-4 points were stage Ⅱ, 5-7 points were stage Ⅲ, 8-10 points were stage Ⅳ and for those at different stages were given different nursing care with different focus and the control group was given conventional continuous nursing care. The intervention lasted for 3 months, the two groups were compared in their score change status in COPD Assessment Tes(t CAT), BODE index, Zarit Burden Interview(ZBI). Results? Before intervention, there was no statistical difference in the two groups' CAT scores, BODE index, and ZBI scores (P＞0.05). After intervention, the CAT score and BODE index, ZBI score in the observation group were lower than the control group with statistical significance (P＜ 0.05). Conclusions? Chronic disease trajectory model is conducive to reducing COPD patients' clinical symptoms and the main caregivers' burden.

Objective To explore the effects of individualized psychological support on sleep condition, psychological status and quality of life in patients with chronic obstructive pulmonary disease (COPD) in Respiratory Department and ICU. Methods A total of 68 patients with COPD administrated in the respiratory department and ICU of Shangqiu First People's Hospital from July 2014 to October 2016 were selected by convenience sampling method and divided into control group and observation group by random number table method, with 34 cases in each group. The patients in the control group were given routine nursing care, while the patients in the observation group were given individualized psychological nursing support on the basis of routine care till discharged or transferred. Pittsburgh Sleep Quality Index (PSQI) was applied to evaluate patients' sleep condition; Self-Perceived Burden Scale (SPBS) and Memorial University of Newfoundland Scale of Happiness (MUNSH) were used to assess patients' psychological status; and the Quality of Life Scale for Adult Patient with Chronic Obstructive Pulmonary Disease (COPD-QOL) was applied to compare the patients' quality of life between the two groups before and after the intervention. The sleep condition, psychological status and quality of life were compared between the two groups. Results Before the intervention, there were no statistical differences in sleep condition, self-perceived burden, subjective happiness and quality of life between the two groups (P>0.05). After the intervention, the scores of sleep quality and sleep condition of the observation group was significantly lower than those of the control group; the total score and the score of each dimension in the self-perceived burden scale of the observation group were all lower than those of the control group; the positive score of subjective happiness and its total score of the observation group were higher than those of the control group, while the negative score was lower than that of the control group; in addition, the total scores of patients' living ability, psychological status and quality of life of the observation group were all higher than those of the control group;the differences were all statistically significant (P<0.05). Conclusions Individualized psychological support can significantly improve the sleep quality of patients with COPD in respiratory department and ICU,relieve their self-perceived burden, encourage patients to adopt healthy and positive coping style, so as to improve the quality of life.

Objective To explore the application effects of psychological support therapy in the treatment of patients with COPD combined with emotional disorders. Methods A total of 100 COPD patients with emotional disorders treated in the First People's Hospital of Shangqiu from March 2015 to March 2017 were selected for the study using convenient sampling. The participants were divided into the control group (n=50) and the observation group (n=50). Patients in the control group were given routine therapy and nursing. Based on the routine therapy and nursing care, the observation group was given additional psychological support therapy. The percentage of FEV1 in predicted value (FEV1%), the ratio of FEV1 in the forced vital capacity (FEV1/FVC), scores of Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), COPD Assessment Test (CAT), Modified Medical Research Council (mMRC) Score, the satisfaction degree and happiness degree were compared between two groups. Results There were no significant differences in FEV1% and FEV1/FVC between two groups after the treatment (P>0.05). The observation group had significantly lower scores of HAMA, HAMD, CAT, and mMRC compared with the control group (P< 0.05). The nursing satisfaction level and happiness degree were significantly higher in the observation group compared with the scores in the control group (P<0.05). Conclusions The psychological support therapy can effectively alleviate unhealthy emotions and improve the dyspnea symptoms in COPD patients combined with emotional disorders. It can also improve their quality of life and satisfaction and happiness level.

Objective To strengthen the voluntary blood donation publicity through the analysis of the voluntary blood donation.Methods The ratio of voluntary blood donation was statistically analyzed between staffs in some Medical institutions in Hangzhou and Ordinary people.Results The ratio of voluntary blood donation in ordinary people is 1.82％,which is higher than the national data (1.05％).The ratio of medical institutions in Hangzhou is 9.54％,which is far higher than ordinary people.The data of provincial,civic and private medical institutions are 10.20％,6.11％ and 15.42％,respectively.Conclusion The ratio of voluntary blood donation is different between different level hospitals,and the staffs in medical institutions are more willing to donate blood than ordinary people.