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.

This paper reviews the current situation of massive open online course (MOOC) construction both domestically and internationally, highlighting the similarities, differences, and limitations of MOOC construction across nations. Based on the full-cycle MOOC construction of the "clinical epidemiology" course at Southern Medical University, including course design, resource integration, online deployment, and teaching evaluation, this study explored the significance, implementation path, and challenges of MOOC construction. This paper also reflects on the activation of teaching content, teacher-student interaction, and teaching mode, aiming to provide a reference for the construction and continuous enhancement of MOOC in China.

Mixed reality technology combines the benefits of virtual reality and augmented reality to provide a new experience of virtual and real-world interaction, demonstrating great potential in nursing education. This paper reviews the application progress of mixed reality in basic nursing teaching, clinical skills training, personalized learning pathways, and teamwork, and looks ahead to future developments, innovations, and challenges of mixed reality technology to advance nursing education.

OBJECTIVE To analyze the reliability of Xpert MTB/RIF(referred to as Xpert)in detecting rifampicin resistance under varying bacterial loads of Mycobacterium tuberculosis(MTB)so as to reference for clinical diag-nosis and treatment.METHODS A total of 3 050 mycobacterial culture-positive test results from Jan.2016 to Dec.2023 at the First Affiliated Hospital of Xiamen University were selected.After excluding 220 non-tubercu-lous mycobacteria cases,2 830 culture-positive specimens underwent Xpert testing,with 2 412 positive and 418 negative cases.Based on MTB bacterial load,specimens were divided into four treatment groups-high,medi-um,low and very low-with 552,916,656 and 288 cases,respectively.Solid phenotypic drug susceptibility testing(DST)was performed on 1 801 MTB strains that were both culture-positive and Xpert-positive.RESULTS The positive rates of rifampicin in the high,medium,low and very-low treatment groups were 10.33％(57/552),11.14％(102/916),8.54％(56/656)and 8.68％(25/288),respectively.Using the solid phenotypic drug sus-ceptibility testing results as the reference standard,the specificity and negative predictive value of Xpert for detec-ting rifampicin resistance in all four bacterial load groups exceeded 96％,with no statistically significant differ-ences observed.No significant difference in sensitivity was noted among the groups(P=0.053),though the high bacterial load group exhibited relatively lower sensitivity at 84.62％(44/52),while the very-low bacterial load group showed the lowest sensitivity at 76.00％(19/25),which was lower than the medium bacterial load group's 94.05％(79/84).The positive predictive values(PPV)across all groups were generally low but without statisti-cally significant differences(P=0.239),with the high and very-low bacterial load groups registering PPVs of 77.19％(44/57)and 76.00％(19/25),respectively.The concordance rates of Xpert and solid phenotypic drug susceptibility testing were consistently high among all four bacterial load groups,including 94.95％(395/416),97.51％(666/683),96.75％(477/493)and 94.26％(197/209),respectively,with no significant difference(P=0.052).The Kappa values from high to very-low bacterial load groups were 0.778,0.889,0.831 and 0.727,re-spectively.Among the strains with discordant results between Xpert and phenotypic drug susceptibility testing,the rifampicin result consistency rates between Xpert and gene chip were 81.82％(9/11),100.00％(9/9),100.00％(2/2)and 25.00％(1/4),respectively for the high to very-low bacterial load groups.CONCLUSIONS When the bacterial load of MTB is very low,the Xpert assay demonstrates a higher probability of both false-posi-tive and false-negative results for rifampicin resistance,followed by high bacterial loads.The most reliable detec-tion of rifampicin resistance occurs with medium bacterial loads.

OBJECTIVE To analyze the reliability of Xpert MTB/RIF(referred to as Xpert)in detecting rifampicin resistance under varying bacterial loads of Mycobacterium tuberculosis(MTB)so as to reference for clinical diag-nosis and treatment.METHODS A total of 3 050 mycobacterial culture-positive test results from Jan.2016 to Dec.2023 at the First Affiliated Hospital of Xiamen University were selected.After excluding 220 non-tubercu-lous mycobacteria cases,2 830 culture-positive specimens underwent Xpert testing,with 2 412 positive and 418 negative cases.Based on MTB bacterial load,specimens were divided into four treatment groups-high,medi-um,low and very low-with 552,916,656 and 288 cases,respectively.Solid phenotypic drug susceptibility testing(DST)was performed on 1 801 MTB strains that were both culture-positive and Xpert-positive.RESULTS The positive rates of rifampicin in the high,medium,low and very-low treatment groups were 10.33％(57/552),11.14％(102/916),8.54％(56/656)and 8.68％(25/288),respectively.Using the solid phenotypic drug sus-ceptibility testing results as the reference standard,the specificity and negative predictive value of Xpert for detec-ting rifampicin resistance in all four bacterial load groups exceeded 96％,with no statistically significant differ-ences observed.No significant difference in sensitivity was noted among the groups(P=0.053),though the high bacterial load group exhibited relatively lower sensitivity at 84.62％(44/52),while the very-low bacterial load group showed the lowest sensitivity at 76.00％(19/25),which was lower than the medium bacterial load group's 94.05％(79/84).The positive predictive values(PPV)across all groups were generally low but without statisti-cally significant differences(P=0.239),with the high and very-low bacterial load groups registering PPVs of 77.19％(44/57)and 76.00％(19/25),respectively.The concordance rates of Xpert and solid phenotypic drug susceptibility testing were consistently high among all four bacterial load groups,including 94.95％(395/416),97.51％(666/683),96.75％(477/493)and 94.26％(197/209),respectively,with no significant difference(P=0.052).The Kappa values from high to very-low bacterial load groups were 0.778,0.889,0.831 and 0.727,re-spectively.Among the strains with discordant results between Xpert and phenotypic drug susceptibility testing,the rifampicin result consistency rates between Xpert and gene chip were 81.82％(9/11),100.00％(9/9),100.00％(2/2)and 25.00％(1/4),respectively for the high to very-low bacterial load groups.CONCLUSIONS When the bacterial load of MTB is very low,the Xpert assay demonstrates a higher probability of both false-posi-tive and false-negative results for rifampicin resistance,followed by high bacterial loads.The most reliable detec-tion of rifampicin resistance occurs with medium bacterial loads.

This paper reviews the current situation of massive open online course (MOOC) construction both domestically and internationally, highlighting the similarities, differences, and limitations of MOOC construction across nations. Based on the full-cycle MOOC construction of the "clinical epidemiology" course at Southern Medical University, including course design, resource integration, online deployment, and teaching evaluation, this study explored the significance, implementation path, and challenges of MOOC construction. This paper also reflects on the activation of teaching content, teacher-student interaction, and teaching mode, aiming to provide a reference for the construction and continuous enhancement of MOOC in China.

Mixed reality technology combines the benefits of virtual reality and augmented reality to provide a new experience of virtual and real-world interaction, demonstrating great potential in nursing education. This paper reviews the application progress of mixed reality in basic nursing teaching, clinical skills training, personalized learning pathways, and teamwork, and looks ahead to future developments, innovations, and challenges of mixed reality technology to advance nursing education.

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 study the epidemiological characteristics of brucellosis (hereinafter referred to as brucellosis) among non-occupational population in Jinan City, and to provide a basis for formulating further prevention and control measures.Methods:From "the Infectious Disease Monitoring System of the China Center for Disease Control and Prevention", Center for Disease Control and Prevention of Jinan City and its subordinate counties, the epidemiological data and case investigation data of brucellosis in Jinan from 2012 to 2021 were collected and statistically analyzed using descriptive epidemiological methods.Results:From 2012 to 2021, a total of 453 cases of brucellosis were reported in the non-occupational population of Jinan City, accounting for 20.21% (453/2 241) of the total number of cases. The proportion of brucellosis cases in the non-occupational population showed an increasing trend year by year (χ 2tend = 25.50, P < 0.001). Among the non-occupational population, there were 317 males and 136 females, with a gender ratio of 2.33∶1.00; the age was (46.34 ± 17.72) years old, with a minimum age of 1 year and a maximum age of 86 years. The majority of the affected population were farmers, accounting for 71.74% (325/453). The peak onset time was April and May. The main routes of infection were through the digestive tract and respiratory tract, accounting for 36.87% (167/453) and 33.77% (153/453), respectively. The clinical symptoms were mainly fever, muscle soreness, fatigue, and hyperhidrosis. The diagnosis time was 20.0 (7.5, 37.5) d, and the sensitivity of city and district general hospitals to detect and diagnose brucellosis was relatively low. Conclusions:The incidence rate of brucellosis among non-occupational population in Jinan is increasing year by year. The high incidence season is spring, and the high incidence population is male young and middle-aged farmers. Digestive and respiratory transmission are the main transmission routes, with atypical clinical symptoms and a long diagnosis time. The next step is to strengthen the promotion of brucellosis prevention and control knowledge and the training of medical personnel in brucellosis diagnosis.

Objective:The Self-Compassion Scale(SCS)is used to evaluate self-compassion in general popu-lation.The study was designed to evaluate the validity and reliability of the Chinese version of SCS in patients with eating disorders.Methods:Ten experts in the related disciplines completed the content validity evaluation.A total of 136 patients who met the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)eating dis-order diagnostic criteria were surveyed with SCS to evaluate structural validity.Using the Rosenberg Self-Esteem Scale(SES),Satisfaction with Life Scale(SWLS),and Eating Disorder Examination Questionnaire 6.0(EDE-Q 6.0)as gold criterion,the criterion validity of SCS was measured.Twenty patients were selected for retesting to e-valuate test-retest reliability.Results:The item-level content validity index(I-CVI)of each item was between 0.70 and 1.00,and the average scale-level content validity index(S-CVI/Ave)was 0.96,indicating good content validi-ty.Factor analysis indicated a good fit for the six-factor model with reasonable factor loadings:x2/df=1.70,RM-SEA=0.07,CFI=0.92,TLI=0.91.The Chinese version of the SCS had an ICC of 0.31 with both SES and SWLS,and a negative correlation with EDE-Q 6.0 scores(r=-0.32).The test-retest reliability of the scale was 0.80.Conclusion:The Chinese version of the SCS has moderate validity and high reliability in patients with eating disorders,and can provide a clinical measure tool for psychological assessment in the Chinese population with eating disorders.