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Background: Returning to work (RTW) has always been regarded as one of the important indicators to evaluate the therapeutic effect of patients with schizophrenia. The existing studies on RTW in patients with schizophrenia are mostly focused on intervention measures, and the qualitative research on RTW is very limited. The purpose of this study was to evaluate the experience of the RTW after treatment in patients with schizophrenia. Method: A longitudinal qualitative study was conducted involving 24 patients with schizophrenia in China. The interviews were held at three time-points during their RTW process, (1) when patients had improved and were close to discharge, (2) within 1 month post-discharge, and (3) 6 months post-discharge. The interview recordings were transcribed by the research team, and transcripts were independently analyzed by two independent coders using reflexive thematic analysis. Results: A total of 24 patients with schizophrenia participated in 72 personal interviews. The thematic framework based on the experience of patients with schizophrenia reveals a three-phases of the process of RTW: improved, being at a loss, and job crisis. The study identified one theme of the first phase: the expectation and optimism. Two themes in the second phase: (1) psychological distress of upcoming work; (2) expectation of assistance pre-work. And four themes in the third phase: (1) tremendous pressure of RTW; (2) lack of medical and social support; (3) social status and interpersonal relationships change; and (4) high level of financial pressure. Conclusion: The experience of RTW is a dynamic process with great challenges in each phase, patients with schizophrenia have been deeply affected by what they have experienced. There is an urgent need to ensure that existing community and social support is integrated into daily care to support patients with schizophrenia to RTW successful. The findings of this study also suggest relevant departments and employers should be aware of the barriers to RTW for patients with schizophrenia, and take certain measures to change the current situation.

Silkworms have been reported to promote the growth and production of the stromata of C. militaris (L.) Link as a parasite insect medium and may improve its metabolites. The effects of Tussah silkmoth pupae (TG group) and rice (RG group) on the metabolic profile of C. militaris (L.) Link were compared by metabolomics. Meanwhile, the profile of natural C. sinensis (NG group) was also analyzed. The functions of these metabolites from different groups and cordycepin were tested using breast cancer cells and an animal model. 292 metabolites were detected, including 51, 31 and 23 unique metabolites from the TG, RG and NG groups, respectively. The level of 3-deoxyadenosine (cordycepin with anti-tumor activity) was highest in the TG group. Tussah silkmoth pupae induced the biosynthesis of cordycepin and unsaturated fatty acids, which may be beneficial in the prevention of breast cancer. The TG group and cordycepin had significant inhibitory activities on breast cancer cells and in animal models when compared with the two other groups. Tussah silkmoth pupae improved the metabolic profile of C. militaris (L.) Link, which has more pharmaceutical metabolites than C. sinensis.