Objective This study aims to build a differential diagnosis model for unipolar and bipolar depression based on clinical features and blood indicators.Methods According to inclusion and exclusion criteria,participants with unipolar and bipolar depression were included,and clinical data and blood test indicators of the participants were extracted.The data were randomly divided into a training set and a testing set.Classification models were trained on the training set using extreme gradient boosting based on different feature combinations,and the performance of the models was validated on the testing set.Receiver operating characteristic(ROC),area under curve(AUC),sensitivity,specificity and accuracy were used to evaluate model performance.The SHapley additive explanations(SHAP)method was used to calculate the importance of selected features for the differential diagnosis of unipolar and bipolar depression.Results In the unipolar and bipolar depression classification model,the XGBoost model performs the best,with an AUC of 0.889,sensitivity of 0.831,specificity of 0.839,and accuracy of 0.863.The main features in this model include duration of illness,age of onset,albumin,low-density lipoprotein,blood potassium concentration,white blood cell count,platelet/lymphocyte ratio,and monocytes.Conclusion Duration of illness and hematological biomarkers,which are easily obtainable in clinical settings,can provide important support for the differential diagnosis of unipolar and bipolar depression.

Objective This research aims to investigate the impact of Orff music therapy on long-term schizophrenic patients in hospitals.Methods The study was a randomized,single-blind controlled trial conducted from April,2023 to September,2023.From April to September 2023,sixty-eight individuals diagnosed with persistent schizophrenia were enrolled and evenly distributed into a pair of cohorts:a treatment group of thirty-four people receiving the intervention,and an equal number forming the control group for comparative purposes.Individuals enrolled in the experimental arm of the study were administered Orff-music therapy alongside routine rehabilitation treatment across a span of two months.For a period of 8 weeks,the control group was given only standard rehabilitation treatment,whereas the research group underwent Orff-music therapy in addition to the standard rehabilitation treatment.Results Before treatment,there were no significant differences in the positive and negative symptoms scale(PANSS),the inpatient psychosis rehabilitation observe scale(IPROS)and the personal and social performance scale(psp)between two groups.After intervention,the PANSS showed that the changes were better in the study group than in the control group in 3 indicators:negative symptoms(-3.20±4.13 vs.-0.17±2.43,P<0.001),general symptoms(-2.79±3.83 vs.-0.17±2.99,P=0.003)and the total scores(-5.88±6.36 vs.0.00±4.08,P<0.001),but not in positive symptoms(P>0.05).The IPROS showed that the performances of patients in the study group were better than the control group in terms of participation in work therapy(-0.82±2.08 vs.0.23±2.10,P=0.041),socialization(-0.59±1.94 vs.0.53±1.69,P=0.014)and ability to live(-0.94±2.50 vs.0.15±1.48,P=0.033),the changes in scores before and after the intervention were significantly different when compared to the control group.The PSP showed that the changes in scores before and after the treatment of the study group was better than the control group in terms of social activity[0(-1,0)vs.0(0,0),P=0.011],and self-care[0(-1,0)vs.0(-0.25,0),P=0.012]were better than the control group.Conclusion For long-term hospitalized patients with chronic schizophrenia.Orff-music therapy can be a powerful tool for alleviating mental issues,fostering social functioning,and enhancing rehabilitation results.

Objective To investigate the electrophysiological characteristics of hamster primary cortical neurons by using the whole-cell patch-clamp recordings in a Mg2+-free cell model of epilepsy.Methods The cerebral cortex were isolated for primary neuron culture from neonatal Syrian hamsters 1-2 days after birth.After 12 days,primary neurons were exposed to normal external(Mg2+group)or Mg2+-free external(Mg2+-free group)respectively for 3 hours,followed by a 24-hour incubation in normal culture medium.Excitatory postsynaptic currents(EPSC)and excitatory postsynaptic potentials(EPSP)were recorded in voltage clamp mode and current clamp mode using whole-cell patch-clamp recordings,respectively.Results Compared to Mg2+group,the frequency of EPSC[(124.38±75.15)Hz vs.(33.93±22.32)Hz,P<0.001](P<0.001)and EPSP[(37.05±38.37)Hz vs.(5.63±9.52)Hz,P<0.01]in primary cortical neurons from the Mg2+-free group increased significantly.Meanwhile,there were no statistically significant differences in the amplitude,area under the curve and half-width of EPSC and EPSP between the two groups(P>0.05).Conclusion The present study demonstrates an increase in excitability of primary hamsters cortical neurons after Mg2+depletion,suggesting that these neurons can be utilized to use to create cell models of epilepsy.

Objective We analyzed clinical characteristics of dipeptidyl-peptidase-like protein 6(DPPX)antibody-associated encephalitis and evaluated the effect of immunotherapy on anti-DPPX encephalitis.Methods A total of 9 patients with anti-DPPX encephalitis were retrospectively analyzed,including clinical manifestations,laboratory examinations,imaging features,treatment and prognosis.Results Nine patients were identified(medium age 45 years old,5 were men).Neurologic disorders were multifocal:cognitive dysfunction(3 cases),psychosis(anxiety,irritability,auditory hallucination,abnormal behavior)(3 cases),CNS hyperexcitability(6 cases),brainstem(5 cases),cerebellar dysfunction(4 cases),sleep disorders(3 cases),dysautonomia(1 case),allodynia(1 case).In additional,there were 4 patients complicated with weight loss and/or gastrointestinal symptoms.CSF data showed that white cell counts were elevated in 2 patients and protein levels were elevated in 4 patients.EEG revealed epileptiform discharges in 3 patients and delta wave in 1 patient.Abnormalities were found in the brain MRIs of 4 patients including T2/FLAIR lesions in the hippocampus,insula.Seven patients received corticosteroids and six patients received plasma exchange.Seven patients subsequently treated with Mycophenolate Mofetil.Among 7 patients with adequate follow-up data,all patients had recovered to some degree and 3 of them completely remitted after 4 months to 2 years of follow-up.Conclusion The clinical symptoms of anti-DPPX encephalitis were diverse,the classic triad of clinical symptoms were weight loss and/or gastrointestinal disorders,CNS hyperexcitability and cognitive disorders.Long-term oral Mycophenolate Mofetil may be helpful in improving prognosis and reducing recurrence.

Propriospinal myoclonus(PSM)is a rare painless movement disorder characterized by recurrent axial myoclonus during the wake and sleep transition periods.The recurrent muscle twitches during the hypnotic period severely affect the patient's sleep.In this paper,we reported a case of typical PSM.The patient was treated for involuntary limb shaking before sleep for more than 1 year,and no significant positive signs were found after physical examination in hospital.After perfecting video polysomnography and polymyography,he was diagnosed as having idiopathic PSM,and he responded well to 1/3 of clonazepam tablets,suggesting the necessity of video polysomnography and polymyography in the diagnosis of PSM.

This article reports one case of adult COVID-19-associated acute necrotizing encephalopathy(ANEC).The patient developed disturbance of consciousness and seizure on the 12th day after SARS-CoV-2 infection.Imaging showed significant swelling and signal changes in the bilateral thalamus,brainstem,cerebral hemisphere and cerebellar hemisphere,which were consistent with the characteristic images of Acute necrotizing encephalitis(ANE).Although methylprednisolone shock therapy and high-dose human immunoglobulin therapy were given early,the patient died.ANEC often starts quickly and progresses rapidly,unconsciousness and seizure are the main manifestations.Imaging features of thalamic and subtentorial symmetry and multifocal lesions are specific for diagnosis,but the treatment and prognosis still face challenges and need further study.

A case of paraneoplastic cerebellar ataxia syndrome caused by immune checkpoint inhibitors(ICI)was treated with ofatumumab(OFA).The patient is a 57-year-old male.He used"Camrelizumab"immunotherapy for his previous history of small cell lung cancer.The main reason was"walking unsteadily for more than one year and shaking his head involuntarily for more than one month".After admission,the head MRI,chest CT,electroencephalogram,lumbar puncture and other related examinations were improved.The antibody spectrum of paraneoplastic neurological syndrome was anti-GAD65 antibody IgG(+),and the case was then diagnosed as the immune checkpoint inhibitor-related paraneoplastic neurological syndromes(PNS)of nervous system.After OFA treatment(20 mg/time),the symptoms were obviously improved.This paper analyzes the clinical features and diagnosis and treatment approaches of this case,in order to improve clinicians'understanding of the disease and provide reference for clinical diagnosis and treatment of similar cases.

A retrospective analysis was performed on one case of adult-onset type Ⅱcitrullinemia(CTLN2)caused by homozygous mutations of SLC25A13 genes.The patient,a 28-year-old male,had repeated limb convulsions for more than 4 years and worsened for 2 months.He usually liked to eat peanuts and meat.The brain MRI examination showed no abnormality,and anti-epileptic treatment was not effective.Further examination of blood aminotransferase,blood ammonia and citrulline were elevated,genetic testing showed that the SLC25A13 gene c.851_854del homozygous pathogenic mutation,the diagnosis was CTLN2,and the treatment was treated with a high-protein,high-fat,low-sugar diet and arginine,and there were no seizures followed up for half a year.Patients with recurrent seizures with special dietary preferences should be paid attention to the possibility of CTLN2,and genetic testing plays an important role in the diagnosis of CTLN2 and provides a basis for clinical diagnosis and treatment.

A 41-year-old male was presented with rapidly progression memory impairment for 2 months and episodic limb shaking for 2 weeks as the main manifestations.Physical examination showed verbal disadvantage with decreased memory,attention,comprehension,and orientation.Serum vitamin B12 levels decreased,serum anti gastric parietal cell antibodies and anti-intrinsic factor antibodies were positive.Blood analysis showed macrocytic anemia,neuropsychological scale showed functional impairment in multiple cognitive domains,electrophysiological examination showed peripheral nerve damage,cerebrospinal fluid and imaging examination showed no abnormalities.The patient was diagnosed as having vitamin B12 deficiency dementia,vitamin B12 deficiency related involuntary movement and pernicious anemia.Supplementing with B vitamins and folic acid significantly improved cognitive impairment and eliminated symptoms of limb shaking.The purpose of this case report is to enhance the understanding of clinical doctors about dementia and involunting movement caused by vitamin B12 deficiency,in order to diagnose and treat it early.

Sensory and perceptual abnormalities are one of the symptoms of children with autism spectrum disorder(ASD),which have a profound impact on children's social interaction,learning and overall function.The clinical features of sensory abnormalities in ASD include sensory hypersensitivity and hyposensitivity,involving sensory systems such as hearing perception,visual perception,olfactory perception,taste perception,touch perception,and vestibular function.The mechanism of sensory abnormalities in ASD is discussed from the aspects of executive function,genomics,excitation-inhibition disequilibrium,and arousal theory.In order to promote the improvement of sensory perception function and quality of life in children with ASD,this article provides a basis for early clinical identification of sensory perception abnormalities in children with ASD.