BackgroundModified electroconvulsive therapy （MECT） is a common front-line strategy widely used in psychiatric practice， and the optimal first stimulus dosage in MECT is usually estimated clinically based on the factors influencing the patient's initial seizure threshold （IST）. However， previous studies on the influencing factors of IST have mostly suffered from limitations such as small sample sizes and single-dimensional research perspectives. ObjectiveTo explore the factors influencing IST in MECT for patients with mental disorders， so as to provide references for stimulus dosing strategies in MECT for the patients. MethodsA retrospective study was used to include 1 446 inpatients fulfilling the diagnostic criteria for any specific mental disorder listed in the ICD-10 and receiving MECT at Shandong Daizhuang Hospital from January 1， 2021 to August 1， 2023. Their general and clinical data were collected， including IST， psychiatric diagnostic categories， gender， ethnicity， age， body weight， body mass index （BMI）， course of disease， family history of psychiatric disorders， first episode status， use of antiepileptic drugs the day before treatment， use of benzodiazepines the day before treatment， and previous MECT treatment history. Pearson correlation analysis was utilized to test the correlation of IST with age， height， body weight， BMI， and course of disease， and stepwise multivariate linear regression analysis was performed to identify the factors affecting IST. ResultsIST yielded statistical difference among patients in terms of gender， first episode status， use of antiepileptic drugs the day before treatment， and use of benzodiazepines the day before treatment （t=2.256， -3.059， -2.136， -3.006， P<0.05 or 0.01）. IST in patients of different ages and psychiatric diagnostic categories also demonstrated statistical difference （F=913.120， 6.212， P<0.01）. Within young population， IST varied significantly based on the psychiatric diagnostic categories （F=2.986， P<0.05）. Correlation analysis indicated that IST was positively correlated with age， body weight， BMI and course of disease （r=0.886， 0.055， 0.184， 0.456， P<0.05 or 0.01）， and negatively correlated with height （r=-0.183， P<0.01）. Stepwise multivariate linear regression analysis revealed that age， gender， and body weight were influencing factors of IST （β=0.888， -0.049， -0.035， P<0.01）. ConclusionsAge， gender and body weight may be factors influencing IST in MECT for patients with mental disorders. ［Funded by Key R&D Plan Projects of Jining City in 2024 (number, 2024YXNS202）］

BackgroundMajor depressive disorder is one of the most disabling mental diseases. Currently， medication in combination with physiotherapy and psychotherapy remains the most commonly used treatment modality for the disease， whereas only a few randomized controlled studies have been conducted on physiotherapy， and even fewer studies have focused on medication combined with physiotherapy. ObjectiveTo explore the efficacy and safety profile of repetitive transcranial magnetic stimulation （rTMS） versus modified electroconvulsive therapy （MECT） in combination with antidepressants in the treatment of major depressive disorder， so as to provide an optimized treatment plan for patients with major depressive disorder. MethodsPatients with major depressive disorder （n=335） hospitalized in Shandong Daizhuang Hospital from January 1， 2019 to April 30， 2023 were included， all of whom met the diagnostic criteria of the International Classification of Diseases， tenth edition （ICD-10）. Depending on their disease condition， patients were subjected to either MECT in combination with drugs （n=141） or rTMS in combination with drugs （n=194） after admission. Depressive symptoms were assessed using Hamilton Depression Scale-24 item （HAMD-24） at the baseline and the end of the 1^st， 2^nd， 3^rd and 4^th week of treatment， and the adverse reactions were documented in patient's medical records. ResultsAnalysis of variance on HAMD-24 revealed a significant effect of time （F=3.081， P=0.042）， but no effect of group （F=1.023， P=0.313）， and the interaction effect between the time and the groups was not statistically significant （F=1.642， P=0.191）. No statistical difference was reported between two groups in response rate and full remission rate （P>0.05）. Throughout the course of treatment， 58 cases （41.13%） of recent memory impairment and 74 cases （52.48%） of headache or neck muscle pain occurred in MECT combined with drugs group， and 27 cases （13.92%） in rTMS combined with drugs group experienced headache or head skin discomfort. ConclusionAntidepressants in combination with rTMS or MECT show equivalent efficacy in the treatment of major depressive disorder， while rTMS combined with antidepressants demonstrates a superior safety profile compared to MECT.

To construct and validate a deep learning-based bone age prediction model for children living in both plain and highland regions.

To construct and validate a deep learning-based bone age prediction model for children living in both plain and highland regions.

Objective:To develop a post-stroke insomnia (PSI) evidence-based nursing practice protocol to provide reference for the implementation of insomnia nursing in stroke patients.Methods:In January 2022, a research team was formed. Based on evidence-based principles, systematically searched and summarized high-quality evidence of Western medicine care and Chinese medicine care related to PSI to develop the first draft of the evidence-based nursing practice protocol for PSI, invited medical experts and nursing experts in the field of stroke care, medical treatment, research and teaching, and the protocol was revised through 2 rounds of Delphi expert consultation to form the final draft of the protocol.Results:A total of 15 experts were invited, 3 males and 12 females; 2 between 31 and 40 years of age, 6 between 41 and 50 years of age, and 7 between 51 and 60 years of age.The positive coefficient for both rounds of expert consultation was 100% and the expert authority coefficient was 0.89; the Kendall coordination coefficients for the importance and feasibility scores of the entries in the 2 rounds expert consultation were 0.188 and 0.146, 0.224 and 0.188 (all P<0.01). The PSI evidence-based nursing practice protocol included 27 entries in 6 dimensions: assessment of sleep quality, diagnosis of PSI, development of an individualized plan, non-pharmacological interventions, Chinese medicine nursing interventions, preparation for discharge and follow-up. Conclusions:The PSI evidence-based nursing practice protocol is scientific, reliable and applicable, and can provide a reference for the nursing practice of PSI patients.

The emergence of high virulent mutant strains of infectious bursal disease virus(IBDV)becomes a serious threat to the poultry industry.However,the live attenuated IBDV vaccine can potentially revert to a virulent strain.Therefore,it is a necessary to develop safe and effective IB-DV-associated vaccines.The construction of a recombinant Marek's disease(MD)vaccine strain,CVI988,expressing the IBDV VP2 protein,can protect against disease induced by both IBDV and Marek's disease virus(MDV).Here,the IBDV-VP2 gene was integrated into the UL55 locus of CVI988 by bacterial artificial chromosome(BAC)technique,resulting in the recombinant virus CVI988 BAC-VP2.The recombinant virus was characterized by PCR,IFA and subsequently the bi-ological properties of the recombinant virus were investigated.The results showed that the recom-binant virus CVI988 BAC-VP2 was successfully rescued.The VP2 protein stably expressed in chick-en embryo fibroblasts(CEF).The growth kinetics and plague size assays showed that there was comparable replication ability between recombinant virus and parental virus.This study provides the basis for the development of a low-cost vaccine against both IBDV and MDV infections.

[Objective]To summarize the research status and hotspots of tripterygium glycosides(TG),to provide reference basis for future in-depth research and clinical promotion of TG.[Methods]Computer retrieval of literature related to TG from January 2000 to June 2023 was conducted using the China National Knowledge Internet(CNKI),Wanfang Data,China Science and Technology Journal Database(VIP),China Biology Medicine disc(CBM).Use NoteExpress software to merge,duplicate check,and clean data,and use Excel software to construct an annual publication volume line chart.Visualize and analyze the author,organization,and keywords using VOSviewer 1.6.13 and CiteSpace 6.2 R2 software,and draw relevant graphs.[Results]A total of 1 752 articles were included.Since 2008,the number of publications has shown a decreasing trend in recent years after a gradual increase.A total of 4 186 authors were involved,including 75 core authors,forming a collaborative team represented by DING Ying,LI Zhenbin,LIN Na,CUI Ruiqin,CHEN Weidong and others.The main publishing institutions were the First Affiliated Hospital of He'nan University of Chinese Medicine and He'nan University of Chinese Medicine,followed by Dongzhimen Hospital of Beijing University of Chinese Medicine.The research institutions were relatively independent and scattered,mostly through cooperation between traditional Chinese medicine universities and their affiliated hospitals,with less cross regional cooperation.A total of six clusters of key words had been formed in the network diagram.The research focuses were mainly summarized as the clinical research on the application of TG combination drugs in kidney diseases such as diabetes nephropathy,purpura nephritis and nephrotic syndrome,rheumatic immune diseases such as rheumatoid arthritis,skin and mucosal diseases,and the experimental research on the toxicity and side effects of TG.In recent years,keywords that had emerged included dermatitis,eczema,mizolastin,inflammatory factors,immune function,tacrolimus,and so on.[Conclusion]The clinical efficacy and safety research of TG in kidney diseases,rheumatic immune diseases and other fields are hot topics.Dermatitis,eczema,and other skin and mucosal diseases,as well as the mechanism of TG action and inflammatory factors,may be the future research trends.There is still a need to strengthen cooperation among teams,strengthen basic research on the mechanism of TG action,and explore effective compatibility and detoxification methods,providing reference basis for the clinical application of TG in the future.

ObjectiveTo build an evaluation index system for traditional Chinese medicine （TCM） medicated diet， promoting the scientific and standardized development of medicated diet in TCM. MethodsThe framework of the evaluation index system was constructed through literature review and Delphi expert consultation method. The analytic hierarchy process was used to construct a hierarchical structure model. Pairwise comparisons between the indicators were conducted using the Saaty 1-9 scale method， and the weight of each indicator was calculated using Yaahp 10.3. ResultsThe response rates for the two rounds of expert consultation were 93.33% and 100%， respectively. The Kendall's W coefficients for the first-level and second-level indicators in the second round were 0.270 and 0.281， respectively （both P＜0.001）. Finally， an evaluation index system for TCM medicated diet therapy was constructed， consisting of 6 primary indicators and 27 secondary indicators. The weightings of the primary indicators were as follows： sensory appearance （0.1843）， health value （0.3569）， ingredient compatibility （0.1271）， packaging （0.0370）， production and preparation （0.1005）， and reliability （0.1940）. ConclusionA comprehensive and universally applicable evaluation index system for TCM medicated diet has been developed， taking into conside-rations of color， taste， appearance， efficacy， preparation， quality and others. This system can provide valuable reference for the evaluation of the value of medicated diet as well as its development.

The development of medical technology has prolonged the life of patients, but in the face of incurable but imminent death, hospice care is needed to help patients die comfortably, peacefully and with dignity. As important recipients of hospice care, minors need special attention because of their particularity in physiology, psychology and social roles. Suggestions on the Standard of Hospice Care Procedure for Minors makes up for the deficiency that the existing standards do not target minors as a special group, standardizes the process of hospice care, and plays a role in protecting the rights and interests of minors.

Chronic wounds are with characteristics of long last time and cannot heal in time, which is a problem in clinic. Wound pH value plays an important role in the process of healing of chronic wounds. In this paper, we review the relative researches on wound pH value and wound microenvironment, summarize the potential relationship between wound pH value and healing of chronic wounds, as well as the method to change pH value of chronic wounds, thereby to provide theoretical basis for the treatment of chronic wounds in clinic.