Objective To explore the role of the brief visuospatial memory test-revised(BVMT-R)in predicting the clinical conversion to psychosis in subjects with clinical high-risk for psychosis(CHR-P).Methods A total of 217 CHR subjects were recruited and assessed using BVMT-R at baseline.Participants were followed up for three years to determine whether they converted to psychosis.The relationship between BVMT-R total score and CHR-P conversion probability was analyzed using generalized additive model,and the cutoff values of BVMT-R total score for predicting CHR-P conversion were calculated by maximally selected rank statistics.Then,the total BVMT-R score was stratified into different intervals based on the cutoff values obtained as previously described.Finally,the positive likelihood ratios and the conversion rates at different time points were calculated for each interval.Results A total of 168 subjects with CHR-P completed the 3-year follow-up assessment.According to the results of the generalized additive model,the relationship between the BVMT-R total score and CHR-P conversion probability exhibited the characteristics of a piecewise function model.The cutoff values identified using the maximally selected rank statistics method were 18 and 29,which divided the BVMT-R total scores into three intervals:0-18,19-29,and 30-36.The positive likelihood ratios of the three intervals for predicting CHR-P psychosis conversion were significantly different(all P<0.01).All three intervals had significantly different rates of psychosis conversion at different follow-up time points(all P<0.01).Conclusion The total BVMT-R score can be divided into three intervals,each associated with a distinct positive likelihood ratio for predicting psychosis conversion in CHR-P individuals.Accordingly,the BVMT-R total score may serve as a preliminary indicator for estimating the probability of psychosis conversion in the CHR-P population.

As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.

Objective To explore the role of the brief visuospatial memory test-revised(BVMT-R)in predicting the clinical conversion to psychosis in subjects with clinical high-risk for psychosis(CHR-P).Methods A total of 217 CHR subjects were recruited and assessed using BVMT-R at baseline.Participants were followed up for three years to determine whether they converted to psychosis.The relationship between BVMT-R total score and CHR-P conversion probability was analyzed using generalized additive model,and the cutoff values of BVMT-R total score for predicting CHR-P conversion were calculated by maximally selected rank statistics.Then,the total BVMT-R score was stratified into different intervals based on the cutoff values obtained as previously described.Finally,the positive likelihood ratios and the conversion rates at different time points were calculated for each interval.Results A total of 168 subjects with CHR-P completed the 3-year follow-up assessment.According to the results of the generalized additive model,the relationship between the BVMT-R total score and CHR-P conversion probability exhibited the characteristics of a piecewise function model.The cutoff values identified using the maximally selected rank statistics method were 18 and 29,which divided the BVMT-R total scores into three intervals:0-18,19-29,and 30-36.The positive likelihood ratios of the three intervals for predicting CHR-P psychosis conversion were significantly different(all P<0.01).All three intervals had significantly different rates of psychosis conversion at different follow-up time points(all P<0.01).Conclusion The total BVMT-R score can be divided into three intervals,each associated with a distinct positive likelihood ratio for predicting psychosis conversion in CHR-P individuals.Accordingly,the BVMT-R total score may serve as a preliminary indicator for estimating the probability of psychosis conversion in the CHR-P population.

As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.

Given the intimate connection between the visual system and the central nervous system, the study of eyes holds paramount importance in the investigation of psychiatric disorders. Some eye movement features, such as restricted visual scanning, declines in responsive search score (RSS), elevated error rates in antisaccades, spatial-temporal anomalies in microsaccades and an integrated eye movement score are considered as potential biomarkers of schizophrenia. Meanwhile, alterations in retinal vascular morphology, thinning of the retinal nerve fiber layer, abnormal electroretinography (ERG), and morphological variations in the cornea and iris also hold indicative significance for the detection of schizophrenia. This review discussed several methods of visual system assessment in clinical practice, aiming to provide insights into visual systems as biomarkers for mental illnesses.

Given the intimate connection between the visual system and the central nervous system, the study of eyes holds paramount importance in the investigation of psychiatric disorders. Some eye movement features, such as restricted visual scanning, declines in responsive search score (RSS), elevated error rates in antisaccades, spatial-temporal anomalies in microsaccades and an integrated eye movement score are considered as potential biomarkers of schizophrenia. Meanwhile, alterations in retinal vascular morphology, thinning of the retinal nerve fiber layer, abnormal electroretinography (ERG), and morphological variations in the cornea and iris also hold indicative significance for the detection of schizophrenia. This review discussed several methods of visual system assessment in clinical practice, aiming to provide insights into visual systems as biomarkers for mental illnesses.

Objective:To investigate the treatment of autologous fat grafting (AFG) for breast reconstruction of soft tissue defects in pediatric Poland syndrome (PS) with computer-assisted calculation.Methods:Patients with PS were recruited in Children’s Hospital of Nanjing Medical University from January 2016 to January 2021. The children were divided into two groups: CT-assisted group and control group. CT-assisted group were examined by CT scan before operation. The imaging data were imported to 3D Slicer Software. Three -dimensional (3D) reconstruction of thoracis soft tissue in defected side were created in the software with the healthy side served as controls. The obtained 3D image was divided into six sections and the volume of each section was calculated. The interest 3D model was fabricated by using a 3D resin printer. The autologous fat grafting was made in PS patients under the 3D printing model guidance. Patients in control group for AFG that the volume of fat determined by surgeon experience without CT scan. The following outcomes were studied: postoperative breast contour, local complications and major systemic complications. Patients were reviewed at six months postoperatively. The satisfaction scores were made by physicians and patient’s guardians, respectively. The scores were analyzed by the independent samples t-test. P< 0.05 was considered statistically significant. Results:18 patients is in CT-assisted group, 8 males, 12 females, the age range from 3-12 years, mean age: 8.3 years. 10 cases underwent once injection, 6 cases underwent twice injections and 3 times in 2 cases, the average is 1.5 times. 18 patients are in control group, 4 males, 14 females, the age range from 4-14 years, mean age: 8.1 years. 8 cases underwent once injection, twice in 5 cases, and 3 times in 5 cases, the average is 1.8 times. The follow-up ranged from 1 to 2 years. The chests were essentially symmetrical and upper limb and thoracic functions were unaffected, no serious local and systematic complications were observed in the CT-assisted group. Thoracic deformities were improved to various degrees in control group. There was chest induration in two cases at 6-month follow-up, which disappeared at 1-year follow-up without any treatment. The physician satisfaction score grades in the control group and CT-assisted group: very satisfied 7 and l2 cases, satisfied 8 and 6 cases, general 3, respectively. The patient’s satisfaction score grades in the control group and CT-assisted group: very satisfied 7 and l2 cases, satisfied 10 and 6cases, general 1 , respectively. The physician satisfaction scores in the CT-assisted group and control group were 83.56±7.90, 75.67±13.63, respectively, which showing statistically significant differences ( t=2.13, P=0.041). Furthermore, the patient’s guardian satisfaction scores in the CT-assisted group and control group are 84.39±7.77, 78.28±9.82, respectively, which showing statistically significant differences ( t=2.07, P=0.046). Conclusions:AFG under computer guidance is an individualized surgical method based on children’s own characteristics in improving chest deformity of PS patients, following with high postoperative satisfaction.

Objective:To investigate the treatment of autologous fat grafting (AFG) for breast reconstruction of soft tissue defects in pediatric Poland syndrome (PS) with computer-assisted calculation.Methods:Patients with PS were recruited in Children’s Hospital of Nanjing Medical University from January 2016 to January 2021. The children were divided into two groups: CT-assisted group and control group. CT-assisted group were examined by CT scan before operation. The imaging data were imported to 3D Slicer Software. Three -dimensional (3D) reconstruction of thoracis soft tissue in defected side were created in the software with the healthy side served as controls. The obtained 3D image was divided into six sections and the volume of each section was calculated. The interest 3D model was fabricated by using a 3D resin printer. The autologous fat grafting was made in PS patients under the 3D printing model guidance. Patients in control group for AFG that the volume of fat determined by surgeon experience without CT scan. The following outcomes were studied: postoperative breast contour, local complications and major systemic complications. Patients were reviewed at six months postoperatively. The satisfaction scores were made by physicians and patient’s guardians, respectively. The scores were analyzed by the independent samples t-test. P< 0.05 was considered statistically significant. Results:18 patients is in CT-assisted group, 8 males, 12 females, the age range from 3-12 years, mean age: 8.3 years. 10 cases underwent once injection, 6 cases underwent twice injections and 3 times in 2 cases, the average is 1.5 times. 18 patients are in control group, 4 males, 14 females, the age range from 4-14 years, mean age: 8.1 years. 8 cases underwent once injection, twice in 5 cases, and 3 times in 5 cases, the average is 1.8 times. The follow-up ranged from 1 to 2 years. The chests were essentially symmetrical and upper limb and thoracic functions were unaffected, no serious local and systematic complications were observed in the CT-assisted group. Thoracic deformities were improved to various degrees in control group. There was chest induration in two cases at 6-month follow-up, which disappeared at 1-year follow-up without any treatment. The physician satisfaction score grades in the control group and CT-assisted group: very satisfied 7 and l2 cases, satisfied 8 and 6 cases, general 3, respectively. The patient’s satisfaction score grades in the control group and CT-assisted group: very satisfied 7 and l2 cases, satisfied 10 and 6cases, general 1 , respectively. The physician satisfaction scores in the CT-assisted group and control group were 83.56±7.90, 75.67±13.63, respectively, which showing statistically significant differences ( t=2.13, P=0.041). Furthermore, the patient’s guardian satisfaction scores in the CT-assisted group and control group are 84.39±7.77, 78.28±9.82, respectively, which showing statistically significant differences ( t=2.07, P=0.046). Conclusions:AFG under computer guidance is an individualized surgical method based on children’s own characteristics in improving chest deformity of PS patients, following with high postoperative satisfaction.

Objective:To investigate the effects of different sperm retrieval methods on clinical pregnancy and perinatal outcomes in patients undergoing intracytoplasmic sperm injection (ICSI) for pregnancy.Methods:A retrospective cohort study was conducted to analyze the clinical data of patients who underwent ICSI for male factors in Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from October 2015 to October 2020. A total of 3096 cycles were included. Patients with oligozoospermia had sperm retrieval by ejaculation, which was recorded as ejaculation group ( n=2558); patients with azoospermia had sperm retrieval by surgical method (PESA/TESA/mirco-TESE), which was recorded as surgical sperm retrieval group ( n=538). The ovulation promotion and embryo culture of the two groups were compared and analyzed, and the clinical pregnancy outcome and perinatal outcome indexes of fresh embryo transfer patients in the two groups were observed. Results:Data from both groups were adjusted for confounding factors by linear/logistic regression, which revealed that the number of high-quality embryos [ MD(95% CI)=0.412(0.153-0.670), P=0.002] and blastocyst formation [ MD(95% CI)=0.265(0.035-0.494), P=0.024] were significantly higher in surgical sperm retrieval group relative to ejaculation group, and the number of two pronuclei (2PN) and the number of available embryos were not statistically different (all P>0.05). The embryo implantation rate [a OR(95% CI)=1.311(1.010-1.701), P=0.042] and the clinical pregnancy rate [a OR(95% CI)=1.307(1.007-1.697), P=0.044] were significantly higher in patients after fresh embryo transfer. The differences in live birth rate, multiple birth rate, miscarriage rate, singleton preterm birth rate, singleton full-term neonatal weight and sex ratio between the two groups were not statistically significant (all P>0.05). Conclusion:Patients with azoospermia can still obtain a live birth rate comparable to that of conventional ICSI through surgical sperm retrieval and do not increase the risk of miscarriage, fetal malformation, singleton preterm birth, or full-term low birth weight babies.

Objective:To investigate the effects of different sperm retrieval methods on clinical pregnancy and perinatal outcomes in patients undergoing intracytoplasmic sperm injection (ICSI) for pregnancy.Methods:A retrospective cohort study was conducted to analyze the clinical data of patients who underwent ICSI for male factors in Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from October 2015 to October 2020. A total of 3096 cycles were included. Patients with oligozoospermia had sperm retrieval by ejaculation, which was recorded as ejaculation group ( n=2558); patients with azoospermia had sperm retrieval by surgical method (PESA/TESA/mirco-TESE), which was recorded as surgical sperm retrieval group ( n=538). The ovulation promotion and embryo culture of the two groups were compared and analyzed, and the clinical pregnancy outcome and perinatal outcome indexes of fresh embryo transfer patients in the two groups were observed. Results:Data from both groups were adjusted for confounding factors by linear/logistic regression, which revealed that the number of high-quality embryos [ MD(95% CI)=0.412(0.153-0.670), P=0.002] and blastocyst formation [ MD(95% CI)=0.265(0.035-0.494), P=0.024] were significantly higher in surgical sperm retrieval group relative to ejaculation group, and the number of two pronuclei (2PN) and the number of available embryos were not statistically different (all P>0.05). The embryo implantation rate [a OR(95% CI)=1.311(1.010-1.701), P=0.042] and the clinical pregnancy rate [a OR(95% CI)=1.307(1.007-1.697), P=0.044] were significantly higher in patients after fresh embryo transfer. The differences in live birth rate, multiple birth rate, miscarriage rate, singleton preterm birth rate, singleton full-term neonatal weight and sex ratio between the two groups were not statistically significant (all P>0.05). Conclusion:Patients with azoospermia can still obtain a live birth rate comparable to that of conventional ICSI through surgical sperm retrieval and do not increase the risk of miscarriage, fetal malformation, singleton preterm birth, or full-term low birth weight babies.