Background: Serum levels of C-reactive protein (CRP) were measured in patients with deficit schizophrenia (DS) to confirm the association between CRP level and cognitive performance and to determine whether CRP was a new biological indicator with the potential clinical applications in DS patients. Methods: Three independent samples [41 DS and 50 non-deficit schizophrenia (NDS) and 30 sex- and age-matched healthy controls (HCs)] were recruited in our study. Serum CRP levels were measured by immunofluorescence. The Positive and Negative Syndrome Scale (PANSS) and alternative forms of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were also assessed. And the relationships between serum CRP levels and both PANSS and RBANS scores were finally analyzed. Results: The results of serum CRP level were showed significantly different among the three groups and increased from the HCs to NDS patients to DS patients. There were also significant differences in the cognitive subdomain analyses among the three groups. Serum CRP levels were found positively correlated with total and negative PANSS scores, and showed negatively correlated with overall cognitive test scores in the DS samples. Conclusion: Serum C-reactive protein levels and their association with cognitive performance were different between deficit schizophrenia and non-deficit schizophrenia samples, and higher serum CRP level was associated with worse cognitive performance in the DS patients. The results indicated that CRP could be a potential biomarker, and DS could be a distinct subset of schizophrenia.

Bcl-2 family proteins play key roles in the intrinsic apoptosis pathway in platelets, with both pro- and antiapoptotic protein expressions regulating survival during ex vivo storage. We detected a significant decrease in antiapoptotic Bcl-x_L and increase in proapoptotic Bak expression on the third day of storage and as a result the ratio of Bak:Bcl-x_L also decreased. Moreover, we identified an interaction between Bcl-x_L and Bak. These shifts corresponded with activation of the apoptotic pathway, suggesting these proteins might play an important role in platelet survival. We then performed bioinformatic analysis to gain insight into protein expression regulation during storage. This identified a potential binding site of the microRNA (miRNA) let-7b in the 3ʹ-UTR of the Bcl-x_L gene, which we confirmed by a dual-luciferase reporter assay. We also determined that let-7b was upregulated during platelet storage, and let-7b transfection influenced Bcl-x_L and Bak protein, but not mRNA, expression. Together, these data suggest that only posttranscriptional mechanisms are available for regulating gene expression in anucleate platelets.

To clarify the functional orientation of community health nurses in the continuous care of patients with chronic diseases and to encourage community nurses to play their expected roles in extended nursing work. In this study, conducted from May to July 2020, the staff of Shanghai Community Health Service Center were sampled, and representative medical staff were selected for in-depth interviews and focus group discussions. Eighteen community medical staff members participated. The functions of community nurses in the continuous care of patients with chronic diseases are mainly as follows: ① undertaking individualized projects for patients’ continuous treatment, nursing and rehabilitation; ② creating “peer education” conditions for patients; ③ providing supportive care to family caregivers; and ④ participating in the whole process of family doctor team health management. The results provide a reminder for nurse managers that under the new mission, community nurses need “one specialty and multiple abilities,” appropriate nursing technology and good health management skills. The training of community nurses should better meet the practical needs of patients with chronic diseases.

To explore the application of plan-do-check-action (PDCA) cycle management model in the management outpatient appointment, and improve the efficiency of outpatient appointment services. The data of outpatients from January 2019 to December 2020 were collected from a tertiary class B general hospital affiliated to a university in Shanghai. Through the investigation and analysis of the current situation, the reasons were found for the low rate of outpatient appointment. PDCA management was carried out, and measures were formulated for continuous improvement and the effective measures were standardized. The appointment rate, recognition rate and the utilization rate of self-service appointment (handheld hospital and self-service machine) were analysed after the intervention of PDCA. Through PDCA cycle management model, the appointment rate of outpatients increased from 9.93% before improvement to 82.50% after improvement, and the recognition rate of patients increased from 51.39% to 92.76%. The utilization rate of self-service appointment increased from 1.03% to 56.38%. Through the construction of multi-channel, wide coverage and convenient operation of the appointment service system, the PDCA cycle management model effectively improves the efficiency of the outpatient appointment services.

Objective: Schizophrenia is a highly polygenic psychiatric disorder; however, the complex genetic architecture underlying the pathogenesis remains elusive. Brain-derived neurotrophic factor (BDNF), a neurotrophin, and matrix metalloproteinase 9 (MMP-9), a gelatinase B, are the promising candidate genes for schizophrenia. To shed new light on the relationship between the single-nucleotide polymorphisms (SNPs) of BDNF and MMP-9 and the clinical variability of schizophrenia phenotype, this study aims to evaluate the relationship, and provide more definitive evidence for the relationship with various clinical features of schizophrenia.Methods: A case-control association study was performed, and one hundred and five subjects of Chinese Han population were enrolled, including 55 schizophrenia patients (SP) and 50 healthy controls (HC). The BDNF rs6265 196 G > A and MMP-9 rs3918242 −1562C > T SNPs were genotyped using PCR-RFLP assay. The Positive and Negative Syndrome Scale (PANSS) was used to assess the clinical symptoms of patients with schizophrenia.Results: Compared with HC, the frequency of SP carrying BDNF rs6265 GG/GA genotype was significantly higher than HC, and the frequency of SP carrying BDNF rs6265 AA genotype was significantly lower than HC (p < 0.01). With regards to MMP-9 rs3918242 −1562C > T SNP, no significant difference was observed between the control and SP. BDNF GG genotype showed significantly higher PANSS and positive symptoms score than GA and AA genotypes (P < 0.01). MMP-9 CC genotype showed significantly higher PANSS and general score than CT and TT genotypes (P < 0.05).Conclusion: BDNF rs6265 196 G > A and MMP-9 rs3918242–1562C > T SNPs are related to the clinical features of schizophrenia and could be a useful biomarker for the changes, remission or deterioration of clinical status of schizophrenia.