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）］

Imaging examinations play a crucial role in oral diagnosis.Conventional X-ray and cone beam computed tomography(CBCT)techniques are widely used in clinical practice but are associated with certain radiation risks and imaging limitations.In recent years,magnetic resonance imaging(MRI)has gained attention for its radiation-free nature and superior soft tissue imaging capabilities.This review explores the fundamental principles of MRI and its specific applications in endodontic diseases,maxillofacial surgery disea-ses,periodontitis,and implant restoration.Additionally,it further analyzes the technical challenges and difficulties of MRI in hard tis-sue imaging,aiming to provide reference and guidance for the future development of oral medical imaging.

As ultrasound medicine is a clinical specialty characterized by high technological dependency and inter-disciplinary integration,the cultivation of research abilities in the standardized residency training for ultrasound medicine specialists is crucial for disciplinary innovation and physicians'career development.This article systematically analyzes the current status and challenges of research ability training in ultrasound residency programs and proposes core strategies including a hierarchical training model,systematic research thinking training,and mentor system optimization.Addition-ally,the innovative approaches such as multidisciplinary integration and digital tools are explored.Future efforts should fo-cus on establishing a nationally unified standardized training system,strengthening mental health support,and promoting career sustainability,ultimately achieving a"clinical-research-humanistic"integrated talent cultivation framework and pro-viding compound ultrasound medicine talents for the Healthy China strategy.

Imaging examinations play a crucial role in oral diagnosis.Conventional X-ray and cone beam computed tomography(CBCT)techniques are widely used in clinical practice but are associated with certain radiation risks and imaging limitations.In recent years,magnetic resonance imaging(MRI)has gained attention for its radiation-free nature and superior soft tissue imaging capabilities.This review explores the fundamental principles of MRI and its specific applications in endodontic diseases,maxillofacial surgery disea-ses,periodontitis,and implant restoration.Additionally,it further analyzes the technical challenges and difficulties of MRI in hard tis-sue imaging,aiming to provide reference and guidance for the future development of oral medical imaging.

Objective:To extract, evaluate, and summarize evidence related to family participation in delirium management of ICU patients and provid a reference for clinical practice.Methods:A systematic search was conducted in databases such as UpToDate, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, Medlive, Cochrane Library, PubMed, Embase, CINAHL, China National Knowledge Infrastructure, and China Biology Medicine disc. The search covered clinical decisions, guidelines, expert consensus, evidence summaries, systematic reviews, and randomized controlled trials related to family participation in ICU delirium management, with a timeframe up to March 20, 2024. Two researchers independently screened literature, assessed quality, extracted evidence, and graded it.Results:A total of 28 articles were included, comprising seven evidence summaries, five guidelines, three expert consensuses, six systematic reviews, and seven randomized controlled trials. The findings were synthesized into five themes: visitation, assessment, non-pharmacological management, psychological and physical care, and health education, with a total of 26 best evidence points.Conclusions:The best evidence summarized in this study provides an evidence-based foundation for ICU healthcare providers to guide and encourage family participation in delirium management, which aida in the prevention of delirium in ICU patients.

Objective:To perform a Meta-synthesis of qualitative studies on the positive psychological experiences of cardiac surgery patients post-operation, and to analyze and evaluate these experiences.Methods:A systematic search was conducted in PubMed, Web of Science, CINAHL, Embase, ProQuest, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc, with the search period from the establishment of the database to March 10, 2024. The quality of the included literature was assessed using the Australia Joanna Briggs Institute for Evidence-Based Healthcare Centre Database Quality Assessment Criteria for Qualitative Research (2016). Results were integrated using the Meta synthesis method.Results:A total of 13 studies were included, of which one study was rated as Grade A and 12 as Grade B. 46 research outcomes were identified, which were summarized into 10 new categories and integrated into three main results: awakening of self-awareness, changes in health behaviors, and perceived social support.Conclusions:Cardiac surgery patients post-operation exhibit positive psychology. Medical staff should be able to identify and understand the supporting factors for these psychological states, correctly guide and maintain the positive psychological state of patients, and help facilitate active recovery.

Objective:To summary the best evidence of integrated traditional Chinese and Western medicine exercise rehabilitation for phase I cardiac rehabilitation after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) and to provide an evidence-based basis for clinical practice.Methods:The literature on integrated Chinese and Western medicine exercise rehabilitation among AMI patients in phase I after PCI was systematically searched in UpToDate, National Guideline Clearinghouse, Guidelines International Network, Scottish Intercollegiate Guidelines Network, Canadian Medical Association Clinical Practice Guideline, Chinese Medical Association, China National Knowledge Infrastructure, Medlive, VIP, China Biology Medicine disc, Wanfang Data, Scops, Cochrane Library, PubMed, and Web of Science, etc. The search period was from database establishment to May 20, 2024. Literature quality assessment and data extraction were performed independently by two researchers.Results:A total of 19 papers were included, including four guidelines, eight expert consensus, six systematic reviews, and one randomized controlled trial. Thirty-two pieces of best evidence were summarized from eight areas containing pre-rehabilitation assessment, timing of exercise, type of exercise, exercise program, exercise monitoring, frequency of exercise, criteria for termination of exercise, and health education and follow-up.Conclusions:The summary of the best evidence of integrated Chinese and Western medicine exercise rehabilitation among AMI patients in phase I after PCI provides an evidence-based basis for standardizing the process and practice standards of exercise rehabilitation among AMI patients in phase I after PCI.

As ultrasound medicine is a clinical specialty characterized by high technological dependency and inter-disciplinary integration,the cultivation of research abilities in the standardized residency training for ultrasound medicine specialists is crucial for disciplinary innovation and physicians'career development.This article systematically analyzes the current status and challenges of research ability training in ultrasound residency programs and proposes core strategies including a hierarchical training model,systematic research thinking training,and mentor system optimization.Addition-ally,the innovative approaches such as multidisciplinary integration and digital tools are explored.Future efforts should fo-cus on establishing a nationally unified standardized training system,strengthening mental health support,and promoting career sustainability,ultimately achieving a"clinical-research-humanistic"integrated talent cultivation framework and pro-viding compound ultrasound medicine talents for the Healthy China strategy.

Objective:To extract, evaluate, and summarize evidence related to family participation in delirium management of ICU patients and provid a reference for clinical practice.Methods:A systematic search was conducted in databases such as UpToDate, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, Medlive, Cochrane Library, PubMed, Embase, CINAHL, China National Knowledge Infrastructure, and China Biology Medicine disc. The search covered clinical decisions, guidelines, expert consensus, evidence summaries, systematic reviews, and randomized controlled trials related to family participation in ICU delirium management, with a timeframe up to March 20, 2024. Two researchers independently screened literature, assessed quality, extracted evidence, and graded it.Results:A total of 28 articles were included, comprising seven evidence summaries, five guidelines, three expert consensuses, six systematic reviews, and seven randomized controlled trials. The findings were synthesized into five themes: visitation, assessment, non-pharmacological management, psychological and physical care, and health education, with a total of 26 best evidence points.Conclusions:The best evidence summarized in this study provides an evidence-based foundation for ICU healthcare providers to guide and encourage family participation in delirium management, which aida in the prevention of delirium in ICU patients.

Objective:To perform a Meta-synthesis of qualitative studies on the positive psychological experiences of cardiac surgery patients post-operation, and to analyze and evaluate these experiences.Methods:A systematic search was conducted in PubMed, Web of Science, CINAHL, Embase, ProQuest, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc, with the search period from the establishment of the database to March 10, 2024. The quality of the included literature was assessed using the Australia Joanna Briggs Institute for Evidence-Based Healthcare Centre Database Quality Assessment Criteria for Qualitative Research (2016). Results were integrated using the Meta synthesis method.Results:A total of 13 studies were included, of which one study was rated as Grade A and 12 as Grade B. 46 research outcomes were identified, which were summarized into 10 new categories and integrated into three main results: awakening of self-awareness, changes in health behaviors, and perceived social support.Conclusions:Cardiac surgery patients post-operation exhibit positive psychology. Medical staff should be able to identify and understand the supporting factors for these psychological states, correctly guide and maintain the positive psychological state of patients, and help facilitate active recovery.