Single-cell RNA sequencing (scRNA-seq) can analyze the transcriptome of various tissues and organs at single cell level, identifying cellular subpopulation and intercellular heterogeneity to construct gene expression profile. Currently, scRNA-seq has been widely applied in central nervous system diseases, offering insights into disease pathogenesis, uncovering disease-related biomarkers, and identifying novel diagnostic and therapeutic targets. This review summarizes the recent advance in application of scRNA-seq in central nervous system diseases, aiming to provide new perspective for disease diagnosis and personalized treatment.

The rapid development of artificial intelligence (AI), especially generative AI (GenAI), has already brought, and will continue to bring, revolutionary changes to our daily production and life, as well as create new opportunities and challenges for diagnostic and therapeutic practices in the medical field. Haihe Hospital of Tianjin University collaborates with the National Supercomputer Center in Tianjin, Tianjin University, and other institutions to carry out research in areas such as smart healthcare, smart services, and smart management. We have conducted research and development of a full-process disease diagnosis and treatment assistance system based on GenAI in the field of smart healthcare. The development of this project is of great significance. The first goal is to upgrade and transform the hospital's information center, organically integrate it with existing information systems, and provide the necessary computing power storage support for intelligent services within the hospital. We have implemented the localized deployment of three models: Tianhe "Tianyuan", WiNGPT, and DeepSeek. The second is to create a digital avatar of the chief physician/chief physician's voice and image by integrating multimodal intelligent interaction technology. With generative intelligence as the core, this solution provides patients with a visual medical interaction solution. The third is to achieve deep adaptation between generative intelligence and the entire process of patient medical treatment. In this project, we have developed assistant tools such as intelligent inquiry, intelligent diagnosis and recognition, intelligent treatment plan generation, and intelligent assisted medical record generation to improve the safety, quality, and efficiency of the diagnosis and treatment process. This study introduces the content of a full-process disease diagnosis and treatment assistance system, aiming to provide references and insights for the digital transformation of the healthcare industry.
Artificial Intelligence ; Humans ; Delivery of Health Care ; Generative Artificial Intelligence

Amino acids are essential nutrients for the survival of all cells in the body,and their metabolic processes are closely associ-ated with tumor development and progression.The metabolic changes of the essential amino acid tryptophan have a significance impact on tumor microenvironment.Tryptophan is mainly metabolized to kynurenine(KYN)by indoleamine 2,3-dioxygenase and tryptophan 2,3-dioxygenase,and the accumulation of KYN and the deficiency of tryptophan cause alterations in the immune status in tumor micro-environment,which in turn affects tumor development and progression.Based on the current studies on tryptophan,this article system-atically discusses the influence of abnormal tryptophan metabolism on tumors and the interventions targeting this pathway,in order to provide a reference for subsequent tumor therapy.

Tumor microenvironment(TME)is the cellular environment for tumor development,growth,and metastasis.Adenosine(ADO)is an immunosuppressive metabolic product that is continuously upregulated in TME,with various types and wide distribution of receptors.The complex and dynamic interactions between ADO and tumor cells constantly influence tumor progression.ADO can di-rectly or indirectly promote tumor development and progression by promoting tumor generation and metastasis,mediating the immune escape of tumor,and modulating tumor-infiltrating immune cells.Based on the characteristics of ADOs in TME,this article reviews the latest advances in the dynamic alterations of ADO in TME,in order to provide insights into tumor treatment targeting the ADO pathway.

Cholesterol,as an important component of cell membranes,plays a multifaceted role in mediating tumor immunomodulation and drug intervention.In case of cholesterol metabolic imbalance,the accumulation of cholesterol metabolic intermediates,the changes in concentrations,and the regulation of related signaling pathways can affect tumor immunity by promoting inflammation and inhibiting immune cell function.Preclinical and clinical studies have shown that controlling cholesterol metabolism can inhibit tumor growth,re-shape body immune regulation,and enhance antitumor immunity.A deep understanding of the association between immune cells and cholesterol metabolic pathways in the tumor microenvironment can help to develop novel drugs targeting cholesterol metabolism.This article reviews the multifaceted role of cholesterol and its derived metabolites in the tumor microenvironment by regulating various types of immune cells such as myeloid-derived suppressor cells,tumor-associated macrophages,dendritic cells,and T-lymphocytes,as well as the characteristics of tumor immunomodulation mediated by cholesterol metabolism and the advances in pharmaceutical re-search on improving the immune function of the body by intervening against cholesterol,in order to further provide new ideas and a thera-peutic basis for cholesterol modulation and intervention in tumor im-munotherapy.

Objective To develop a scientific and reliable sensitive index system of nursing quality in enteral nutrition for neurocritical patients to ensure the effective implementation of enteral nutrition.Methods Literature on enteral nutrition for neurocritical patients were systematically retrieved from databases,such as BMJ Best Practice,UpToDate,Joanna Briggs Institute(JBI)Evidence-Based Healthcare Database,American Society for Parenteral and Enteral Nutrition(ASPEN),European Society for Clinical Nutrition and Metabolism(ESPEN),National Guideline Clearinghouse(NGC),Guidelines International Network(GIN),Medlive,the Cochrane Library,PubMed,Cumulative Index to Nursing and Allied Health Literature(CINAHL),SinoMed,and China National Knowledge Infrastructure(CNKI)and Wanfang Data.The initial questionnaire was formulated by using the quality evaluation model of"structure-process-outcome".The index system was established by using the Delphi method,and the index weight was determined by the analytic hierarchy process.Results A total of 11 papers were included,of which 5 were graded in A and 6 in B.The effective recovery rates of the two rounds of correspondence questionnaires were 100%(19/19),the expert authority coefficients was 0.864,and the Kendall harmony coefficients were 0.328 and 0.392(P<0.01),respectively.Consequently,a sensitive index system of nursing quality in enteral nutrition for neurocritical patients was established,which encompassed 3 primary indexes,10 secondary indexes and 28 tertiary indexes.Conclusion The index system developed in this study is scientific,reliable and clinically applicable.It conforms to the characteristics of clinical management and nursing,thereby it provides a reference for assessment of the nursing quality in enteral nutrition for neurocritical patients.

Objective To develop a scientific and reliable sensitive index system of nursing quality in enteral nutrition for neurocritical patients to ensure the effective implementation of enteral nutrition.Methods Literature on enteral nutrition for neurocritical patients were systematically retrieved from databases,such as BMJ Best Practice,UpToDate,Joanna Briggs Institute(JBI)Evidence-Based Healthcare Database,American Society for Parenteral and Enteral Nutrition(ASPEN),European Society for Clinical Nutrition and Metabolism(ESPEN),National Guideline Clearinghouse(NGC),Guidelines International Network(GIN),Medlive,the Cochrane Library,PubMed,Cumulative Index to Nursing and Allied Health Literature(CINAHL),SinoMed,and China National Knowledge Infrastructure(CNKI)and Wanfang Data.The initial questionnaire was formulated by using the quality evaluation model of"structure-process-outcome".The index system was established by using the Delphi method,and the index weight was determined by the analytic hierarchy process.Results A total of 11 papers were included,of which 5 were graded in A and 6 in B.The effective recovery rates of the two rounds of correspondence questionnaires were 100%(19/19),the expert authority coefficients was 0.864,and the Kendall harmony coefficients were 0.328 and 0.392(P<0.01),respectively.Consequently,a sensitive index system of nursing quality in enteral nutrition for neurocritical patients was established,which encompassed 3 primary indexes,10 secondary indexes and 28 tertiary indexes.Conclusion The index system developed in this study is scientific,reliable and clinically applicable.It conforms to the characteristics of clinical management and nursing,thereby it provides a reference for assessment of the nursing quality in enteral nutrition for neurocritical patients.

Single-cell RNA sequencing (scRNA-seq) can analyze the transcriptome of various tissues and organs at single cell level, identifying cellular subpopulation and intercellular heterogeneity to construct gene expression profile. Currently, scRNA-seq has been widely applied in central nervous system diseases, offering insights into disease pathogenesis, uncovering disease-related biomarkers, and identifying novel diagnostic and therapeutic targets. This review summarizes the recent advance in application of scRNA-seq in central nervous system diseases, aiming to provide new perspective for disease diagnosis and personalized treatment.

Objective To analyze the content and psychometric properties of measurement tools for children's gross motor function and activity. Methods Six measurement tools for children's gross motor function and activity were selected,including Gross Motor Function Measure(GMFM),Bruininks-Oseretsky Test of Motor Proficiency-Second Edition(BOT-2),Peabody Developmental Motor Scales-Second Edition(PDMS-2),Movement Assessment Battery for Children-Second Edition(MABC-2),Test of Gross Motor Development-Third Edition(TGMD-3)and Functional Movement Screen(FMS).International Classification of Functioning,Disability,and Health(ICF)linking rules,categories and coding were used to analyze the content of measurement dimensions and items of these six tools,and their psychometric properties were explored. Results For the body function,the content of these six tools primarily addressed neuromusculoskeletal and movement-re-lated functions(b7),such as mobility of joint functions(b710),stability of joint functions(b715),muscle power functions(b730),motor reflexes functions(b750),control of voluntary movement functions(b760),supportive functions of arm or leg(b7603)and gait patterns functions(b770).For the activities and participation,the content primarily addressed mobility(d4),such as changing and maintaining body positions(d410,d415),transferring oneself(d420),walking(d450),running(d4552),and jumping(d4553).GMFM was good in inter-rater and test-retest reliability;BOT-2 was good in inter-rater reliability,test-retest reliability and internal consistency;PDMS-2 was good in inter-rater and test-retest reliability;MABC-2 was good in test-retest reliability and internal consis-tency with an excellent model fit;TGMD-3 was good in internal consistency and test-retest reliability;and FMS was good in internal consistency and test-retest reliability. Conclusion The six tools for motor and activity function measurement primarily concern neuro-musculoskeletal and movement-related functions(b7)for ICF body function,and mobility(d4)for activities and participation.PDMS-2 is suggested for a comprehensive evaluation of children's motor functions and activities;TGMD-3 and GMFM for gross motor functions;and BOT-2,MABC-2 and FMS for motor development,coordination and functional movement patterns.BOT-2,PDMS-2,MABC-2 and TGMD-3 are norm-referenced measures,whereas GMFM and FMS are criterion-referenced.Norm-referenced tools,due to their established norms tailored for various ob-jectives,boast superior psychometric properties and wider applications.All the six tools exhibit good to excellent reliability,and internal consistency coefficients ranging from moderate to excellent.Their validity also spans from moderate to excellent.

Objective To analyze the potential categories of foot care knowledge-attitude-practice(KAP)of diabetic high-risk foot patients,and analyze the influencing factors of different potential categories classification prediction,so as to provide references for clinical nursing.Methods By convenience sampling,a questionnaire survey was conducted from July to December 2023,employing a general information questionnaire and a diabetes foot care KAP evaluation scale on patients at high risk of diabetic foot in a tertiary hospital in Guangzhou.Latent profile analysis was used to identify the potential classifications of foot care KAP status among these patients.The iterative dichotomiser 3 algorithm of decision tree in machine learning was used to make classification prediction of foot nursing KAP status of patients,using multivariate logistic regression to analyse its influencing factors.Results There are 3 potential profiles of foot care KAP in high-risk diabetic foot patients,including"high knowledge-medium attitude-medium behavior"type(29.00％),"low knowledge-low attitude-low behavior"type(56.00％)and"medium knowledge-high attitude-high practice"type(15.00％).Decision tree model showed that residence,education level,receiving education about diabetic foot and stage of diabetic high-risk foot were decision-making factors for different potential categories of foot care KAP.The results of the Logistic analysis showed that literacy level,per capita monthly household income,and whether received diabetes-related follow-up were influential factors in different potential profiles of foot care KAP.Conclusion The level of foot care KAP of patients at high risk of diabetic foot needs to be improved,and shows population heterogeneity.Medical staff should intervene and support diabetic foot patients at high risk according to different potential profile and influencing factors to improve their KAP level.