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.

Langerhans cell sarcoma(LCS)is a rare malignant tumor derived from Langerhans cell histiocytes with unique clinicopathological,immunophenotypic,ultrastructural and molecular genetic features.Most studies on LCS are case reports,and the immunohistochemical features,biological mechanisms and molecular basis of the tumor remain to be further elucidated.A large body of literature suggests that LCS is extremely aggressive and presents many difficulties in clinical diagnosis,so it is important to accurately diagnose LCS.In this paper,we will review the clinical,patholog-ical and molecular features of LCS to provide more ideas for the definitive diagnosis of LCS and providing a basis for the selection of treatment regimens for LCS.

Infertility is an important cause of reproductive health. With the increasing development of assisted reproductive technology, millions of people choose to use assisted reproductive technology to assist pregnancy every year. However, there are still many patients in the clinic who may have fertilization disorders during the assisted pregnancy. The causes of fertilization disorders are complex and varied. Although research on fertilization disorders has progressed in recent years, the question of how to improve the fertilization rate and oocyte utilization in patients remains a focal issue. The aim of this review is to summarize the latest research progress on the possible etiology and treatment of fertilization disorders in the process of conception, so as to provide a more comprehensive theoretical reference for the clinical diagnosis and management of people with fertilization disorders.

Objective Analyze the causes of coding issues in the inpatient medical record homepage of a hospital and propose targeted improvement measures,providing a reference basis for enhancing coding quality.Methods A total of 3 000 in-patient medical records from April 1,2021,to March 31,2022(pre-intervention group)and 2 900 records from April 1,2022,to March 31,2023(post-intervention group)were selected for analysis.Quality control statistics were performed on key indica-tors,including the overall coding accuracy rate,primary diagnosis coding,secondary diagnosis coding,primary surgical proce-dure coding,and other surgical procedure coding.Results After the implementation of intervention measures,the overall accu-racy rate of the first page coding of medical records increased from 80.77％to 86.72％(P＜0.001).While,the accuracy rate for primary diagnosis coding improved from 96.90％to 98.07％(P＜0.05).The secondary diagnosis coding accuracy showed significant enhancement from 87.48％to 92.26％(P＜0.001),and primary surgical procedure coding accuracy rose from 96.50％to 98.34％(P＜0.001).Although other surgical procedure coding demonstrated improvement,the difference was not statistically significant(P＞0.05).Conclusion Through a series of measures—including standardized training for coders,es-tablishing a robust quality control system,and adopting advanced information technology—both the professionalism of coders and coding efficiency were enhanced.These interventions effectively reduced coding defects and improved the quality of medical re-cord homepage coding.

Infertility is an important cause of reproductive health. With the increasing development of assisted reproductive technology, millions of people choose to use assisted reproductive technology to assist pregnancy every year. However, there are still many patients in the clinic who may have fertilization disorders during the assisted pregnancy. The causes of fertilization disorders are complex and varied. Although research on fertilization disorders has progressed in recent years, the question of how to improve the fertilization rate and oocyte utilization in patients remains a focal issue. The aim of this review is to summarize the latest research progress on the possible etiology and treatment of fertilization disorders in the process of conception, so as to provide a more comprehensive theoretical reference for the clinical diagnosis and management of people with fertilization disorders.

Objective Analyze the causes of coding issues in the inpatient medical record homepage of a hospital and propose targeted improvement measures,providing a reference basis for enhancing coding quality.Methods A total of 3 000 in-patient medical records from April 1,2021,to March 31,2022(pre-intervention group)and 2 900 records from April 1,2022,to March 31,2023(post-intervention group)were selected for analysis.Quality control statistics were performed on key indica-tors,including the overall coding accuracy rate,primary diagnosis coding,secondary diagnosis coding,primary surgical proce-dure coding,and other surgical procedure coding.Results After the implementation of intervention measures,the overall accu-racy rate of the first page coding of medical records increased from 80.77％to 86.72％(P＜0.001).While,the accuracy rate for primary diagnosis coding improved from 96.90％to 98.07％(P＜0.05).The secondary diagnosis coding accuracy showed significant enhancement from 87.48％to 92.26％(P＜0.001),and primary surgical procedure coding accuracy rose from 96.50％to 98.34％(P＜0.001).Although other surgical procedure coding demonstrated improvement,the difference was not statistically significant(P＞0.05).Conclusion Through a series of measures—including standardized training for coders,es-tablishing a robust quality control system,and adopting advanced information technology—both the professionalism of coders and coding efficiency were enhanced.These interventions effectively reduced coding defects and improved the quality of medical re-cord homepage coding.

Langerhans cell sarcoma(LCS)is a rare malignant tumor derived from Langerhans cell histiocytes with unique clinicopathological,immunophenotypic,ultrastructural and molecular genetic features.Most studies on LCS are case reports,and the immunohistochemical features,biological mechanisms and molecular basis of the tumor remain to be further elucidated.A large body of literature suggests that LCS is extremely aggressive and presents many difficulties in clinical diagnosis,so it is important to accurately diagnose LCS.In this paper,we will review the clinical,patholog-ical and molecular features of LCS to provide more ideas for the definitive diagnosis of LCS and providing a basis for the selection of treatment regimens for LCS.

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 analyze the short-term clinical efficacy and safety of arsenic trioxide (ATO) combined with a modified N7 induction regimen in the treatment of children with high-risk neuroblastoma (NB).Methods:This study was a prospective, single-arm, multicenter phase Ⅱ clinical study. Sixty-seven high-risk NB children from eight units of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Wuhan Children′s Hospital of Tongji Medical College of Huazhong University of Science and Technology, First Affiliated Hospital of Guangxi Medical University, Hainan General Hospital, Affiliated Hospital of Guangdong Medical University, Kunming Children′s Hospital, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, and Guangdong Provincial Agricultural Reclamation Center Hospital were enrolled from January 2019 to August 2023 and were treated with ATO combined with a modified N7 induction regimen. The efficacy and adverse effects at the end of induction chemotherapy were assessed and analyzed, and the differences in the clinical characteristics were further compared between the treatment-responsive and treatment-unresponsive groups by using the Fisher′s exact test.Results:Among 67 high-risk NB children, there were 40 males (60%) and 27 females (40%), with the age of disease onset of 3.5 (2.6, 4.8) years. Primary NB sites were mostly in retroperitoneum (including adrenal gland) (56/67, 84%) and the common metastases sites at initial diagnosis were distant lymph node in 25 cases (37%),bone in 48 cases (72%),bone marrow in 56 cases (84%) and intracalvarium in 3 cases (4%). MYCN gene amplification were detected in 28 cases (42%). At the end of induction, 33 cases (49%) achieved complete remission, 29 cases (43%) achieved partial remission, 1 case (1%) with stable disease, and 4 cases (6%) were assessed as progressive disease (PD). The objective remission rate was 93% (62/67) and the disease control rate was 94% (63/67). The percentage of central system metastases at the initial diagnosis was higher in the treatment-unresponsive group than in the treatment-responsive group (2/5 vs. 2% (1/62), P=0.013), whereas the difference in MYCN gene amplification was not statistically significant between two groups (3/5 vs.40% (25/62), P=0.786). Grade Ⅲ or higher adverse reactions during the induction chemotherapy period were myelosuppression occurred in 60 cases (90%), gastrointestinal symptoms occurred in 33 cases (49%), infections occurred in 20 cases (30%), hepatotoxicity occurred in 4 cases (6%), and cardiovascular toxicity occurred in 1 case (2%). There were no chemotherapy-related deaths. Conclusion:ATO combined with N7-modified induction regimen had a superiority in efficacy and safety, which deserved further promotion in clinical practice.

The genomic island(GI)characteristics and virulence factor differences of clinical isolates of Burkholderia pseudomallei in Hainan Province,China were analyzed to provide a scientific basis for diagnosis and treatment of melioidosis.In total,52 B.pseudomallei isolates were collected for detection of virulence-related GIs by PCR.The whole genome sequence annotation format file was submitted on Islandviwer 4 platform,and the genomes of the same species and close relatives were added for comparison.Two algorithms,SIGI-HMM and IslandPath-DIMOB,were integrated to predict GIs and sequence a-lignments were conducted to identify specific GIs and differences in virulence factors.The genomes of 52 clinical strains could be divided into three branches based on evolutionary distance,with 82.69％(43/52)of strains concentrated in branch 1.In to-tal,828 GIs were identified among the 52 B.pseudomallei genomes,which formed 157 GI clusters based on sequence similari-ty.GIs accounted for 2.05％-6.38％of the genome content.While GI clusters 1 and 2 were present in all strains,a total of 84(53.50％)GI clusters only clustered within a single genome isolate.Of 10 GI likely specific clusters,five were from the same genus,two from another genus,and three with uncertain origins.Moreover,25 GI clusters were associated with virulence,which included eight shared by B.pseudomallei BP76 and BP169,which had the highest number of virulence-associated GIs among all isolates.O the 52 B.pseudomallei isolates,variations were identified in the virulence genes fhaB1,fhaB2,BPSL1661,cheY1,wzM,tssH-5/clpV,tssA-5,boaA,and boaB.Comparisons of these findings with clinical isolates from Thailand and Australia showed that B.pseudomallei isolates from Hainan had significant differences in the sequences of boaA,boaB,cheY1,and chbp.Additionally,fhaB1,fhaB3,and bimA displayed significant variations specifically within the Australian isolates.B.pseudomallei GI was conserved and specific to Hainan.The identification of specific GI and virulence factors was useful to clarify the source of horizontal gene transfer and differences in virulence at the molecular level.