This article reports a case of a male patient with anti-N-methyl-D-aspartate receptor （NMDAR） encephalitis comorbid with early-onset Alzheimer's disease （AD）. The patient presented with depression， hallucinations and delusions syndrome， and cognitive impairment， and was admitted to a psychiatric hospital. Through multidisciplinary consultation， the diagnosis was confirmed based on positive biological and pathological biomarkers. The patient's symptoms improved after receiving a therapeutic regimen comprising high-dose glucocorticoid therapy and psychiatric-related treatments. Based on relevant current research findings domestically and internationally， this article reviews the pathogenesis and clinical manifestations of early-onset AD and anti-NMDAR encephalitis， in order to enhance the discrimination ability of psychiatric specialists for such patients and improve the diagnosis and treatment level. ［Funded by Medical Research Project of Chengdu City （number， 2024403）］

Objective To explore the application value of MRI diaphragmatic navigation technology combined with three dimensional liver acquisition with volume acceleration-flexible(3D LAVA-FLEX)sequence in abdominal enhanced imaging of infants and young children.Methods A retrospective analysis was conducted on imaging data of 84 infants and young children who underwent abdominal enhanced MRI examination in our hospital between January 2021 and December 2023.All 84 infants and young children initially underwent conventional dynamic contrast-enhanced 3D LAVA-FLEX sequence scanning;the delayed phase images obtained were included in the dynamic enhancement group.Subsequently,diaphragmatic navigation combined with 3D LAVA-FLEX sequence examination was implemented,and the obtained images were included in the diaphragm navigation group.Subjective scoring was performed for images in both groups,while the signal to noise ratio(SNR),contrast to noise ratio(CNR),and artifact quantification(AQ)were measured and compared between the two groups.Results The respiratory motion artifacts,the clarity of liver parenchyma enhancement,the clarity of liver vascular enhancement,the clarity of spleen parenchyma enhancement and the overall image quality score in the diaphragm navigation group were higher than those in the dynamic enhancement group,and the differences were statistically significant(P<0.05).There were statistically significant differences in SNR and AQ between the two groups of images(P<0.000 1),while there was no statistically significant difference in CNR between the two groups of images(P>0.05).Conclusion Diaphragmatic navigation technology combined with 3D LAVA-FLEX sequence imaging can improve the image quality of abdominal MRI enhanced imaging in infants and young children,and provide a reference for clinical diagnosis and treatment.

Depression and anxiety are the two most common mental disorders, which have severe negative impacts on individuals and society. Early and accurate identification of these disorders is crucial for symptom control and positive prognosis. Traditional identification approaches such as scale screening and interviews rely on patients' self-reporting and the comprehensive judgment of psychiatrists. These methods inherently have limitations such as subjectivity and dependence on the availability and convenience of medical resources. Therefore, seeking objective means to assist in the identification of depression and anxiety disorders has become a research focus in recent years. Electroencephalogram (EEG), which describes changes in potential difference on the scalp surface, offers advantages such as objectivity, quantification and high temporal resolution. EEG has become one of the potential objective indicators for identifying depression and anxiety disorders.Machine learning algorithms are key technologies for extracting EEG signal features and improving identification accuracy. The combination of EEG collection and machine learning algorithms is expected to become a new method for identifying depression and anxiety disorders. In addition, portable EEG collection provides the possibility for rapid identification of mental disorders and large-scale screening activities. This article reviews the application of EEG for depression and anxiety disorders identification, providing a reference for scholars in related fields, with the aim of promoting the development of mental disorder identification towards objectivity and visualization in China.

Nursing practice is an important component of the healthcare service system and plays a crucial role in achieving the strategic goal of"Healthy China Initiative".Facing the growing health needs and increasingly complex health issues,the concept of Population Medicine,which aims to maximize the overall and long-term health benefits of the population,is expected to provide new theoretical foundations for the nursing practice in China.Integrating the concept of Population Medicine into nursing practice can give full play to the professional value of nursing workers,improve nursing quality,and promote the construction of Healthy China.This review summarized the development of the concept of Population Medicine,its specific connotation and its application in the field of nursing practice,and relevant suggestions are put forward,providing references for scholars to deepen the integration and application of Population Medicine in nursing practice and promote the development of nursing in China.

Objective To explore the application value of MRI diaphragmatic navigation technology combined with three dimensional liver acquisition with volume acceleration-flexible(3D LAVA-FLEX)sequence in abdominal enhanced imaging of infants and young children.Methods A retrospective analysis was conducted on imaging data of 84 infants and young children who underwent abdominal enhanced MRI examination in our hospital between January 2021 and December 2023.All 84 infants and young children initially underwent conventional dynamic contrast-enhanced 3D LAVA-FLEX sequence scanning;the delayed phase images obtained were included in the dynamic enhancement group.Subsequently,diaphragmatic navigation combined with 3D LAVA-FLEX sequence examination was implemented,and the obtained images were included in the diaphragm navigation group.Subjective scoring was performed for images in both groups,while the signal to noise ratio(SNR),contrast to noise ratio(CNR),and artifact quantification(AQ)were measured and compared between the two groups.Results The respiratory motion artifacts,the clarity of liver parenchyma enhancement,the clarity of liver vascular enhancement,the clarity of spleen parenchyma enhancement and the overall image quality score in the diaphragm navigation group were higher than those in the dynamic enhancement group,and the differences were statistically significant(P<0.05).There were statistically significant differences in SNR and AQ between the two groups of images(P<0.000 1),while there was no statistically significant difference in CNR between the two groups of images(P>0.05).Conclusion Diaphragmatic navigation technology combined with 3D LAVA-FLEX sequence imaging can improve the image quality of abdominal MRI enhanced imaging in infants and young children,and provide a reference for clinical diagnosis and treatment.

Objective:To construct an early warning model of postpartum urinary retention risk after painless delivery of primipara by using machine learning algorithm,and to find the best effective early warning model,so as to provide scientific basis for early and accurate identification of high-risk groups in clinical practice.Methods:This study was a single-center retrospective study,80 primipara who delivered painlessly in Tingzhou Hospital of Fujian Province from July 2021 to June 2024 were included,they were divided into urinary retention group(18 cases)and non urinary retention group(62 cases)according to whether there was urinary retention after delivery.General data between two groups were compared,Univariate and Multivariate logistic regression were used to screen for influencing factors,three machine learning algorithms:Random Forest,Support Vector Machine,and Logistic Regression were used to construct an early warning model,the area under the receiver operating characteristic curve(ROC-AUC),accuracy,sensitivity,and specificity were used as performance evaluation indicators to evaluate the predictive performance of the model.Results:Univariate analysis showed that age,body mass index(BMI),gestational week,length of the second stage of labor,anesthetic dose,lateral episiotomy were associated with postpartum urinary retention(P＜0.05);Multivariate logistic regression identified BMI ≥ 28 kg/m2(OR=3.210,95％CI:1.450-7.090),length of the second stage of labor ≥ 2 hours(OR=2.890,95％CI:1.230-6.810),anesthetic dose≥ 15 mL(OR=3.560,95％CI:1.670-7.620),and lateral episiotomy(OR=2.540,95％CI:1.120-5.780)as independent risk factors.After comprehensive evaluation of various indicators,the random forest model has the best predictive performance.Conclusion:The risk warning model constructed based on machine learning has good predictive performance,and the random forest model performs the best,which can provide effective support for early clinical intervention.

Depression and anxiety are the two most common mental disorders, which have severe negative impacts on individuals and society. Early and accurate identification of these disorders is crucial for symptom control and positive prognosis. Traditional identification approaches such as scale screening and interviews rely on patients' self-reporting and the comprehensive judgment of psychiatrists. These methods inherently have limitations such as subjectivity and dependence on the availability and convenience of medical resources. Therefore, seeking objective means to assist in the identification of depression and anxiety disorders has become a research focus in recent years. Electroencephalogram (EEG), which describes changes in potential difference on the scalp surface, offers advantages such as objectivity, quantification and high temporal resolution. EEG has become one of the potential objective indicators for identifying depression and anxiety disorders.Machine learning algorithms are key technologies for extracting EEG signal features and improving identification accuracy. The combination of EEG collection and machine learning algorithms is expected to become a new method for identifying depression and anxiety disorders. In addition, portable EEG collection provides the possibility for rapid identification of mental disorders and large-scale screening activities. This article reviews the application of EEG for depression and anxiety disorders identification, providing a reference for scholars in related fields, with the aim of promoting the development of mental disorder identification towards objectivity and visualization in China.

Objective:To investigate the alterations in brain functional activity before and after chemotherapy in breast cancer patients with chemotherapy-related cognitive impairment (CRCI) using resting-state functional magnetic resonance imaging (rs-fMRI) and their relations with cognitive impairment.Methods:A prospective observational study was performed; female breast cancer patients with CRCI admitted to Department of Oncology, Affiliated Hospital 6 of Nantong University were recruited, and age- and education level-matched female healthy controls were chosen. Before and one month after chemotherapy, statuses of cognitive function, depression and anxiety in breast cancer patients with CRCI were evaluated by Montreal cognitive assessment (MoCA), functional assessment of cancer therapy-cognitive function (FACT-cog), self-rating depression scale (SDS), and self-rating anxiety scale (SAS); subsequently, conventional MRI and resting-state functional magnetic resonance imaging (rs-fMRI) were conducted. The healthy controls accepted MoCA, SDS, and SAS, followed by conventional MRI and rs-fMRI. Differences in clinical data and amplitude of low-frequency fluctuation (ALFF, rs-fMRI brain spontaneous neural activity index) were compared between breast cancer patients with CRCI before chemotherapy and healthy controls, and in the breast cancer patients with CRCI between before and after chemotherapy. Taking the brain regions with significant differences in ALFF before and after chemotherapy in breast cancer patients with CRCI as seed points, the difference in whole-brain functional connectivity (FC) before and after chemotherapy was compared in breast cancer patients with CRCI. Pearson or Spearman correlation tests were used to analyze the correlations of ALFF and FC in brain regions with significant differences in ALFF with cognitive function scores in breast cancer patients with CRCI.Results:(1) A total of 22 breast cancer patients with CRCI and 22 healthy controls were enrolled. Compared with the healthy controls, the breast cancer patients with CRCI before chemotherapy had significantly higher SDS and SAS scores ( P<0.05). Compared with breast cancer patients with CRCI before chemotherapy, the breast cancer patients with CRCI after chemotherapy had significantly lower MoCA, FACT-cog-perceived cognitive impairment, FACT-cog-comment from others on cognitive function, and FACT-cog-perceived cognitive ability ( P<0.05). (2) Compared with those before chemotherapy, breast cancer patients with CRCI after chemotherapy exhibited significantly increased ALFF in the right precuneus, right middle occipital gyrus, and left superior frontal gyrus, while statistically decreased FC in the right middle occipital gyrus-left middle temporal gyrus, right precentral gyrus-right middle temporal gyrus, and left superior frontal gyrus-left fusiform gyrus ( P<0.05). (3) ALFF in the right precentral gyrus in breast cancer patients with CRCI after chemotherapy was negatively correlated with difference value of FACT-cog before and after chemotherapy ( r=-0.497, P=0.018) and difference value of PCA before and after chemotherapy ( r s=-0.436, P=0.042); FC in the left superior frontal gyrus-left fusiform gyrus was positively correlated with score of FACT-cog-perceived cognitive impairment ( r=0.621, P=0.002). Conclusion:Chemotherapy induces compensatory enhancement of spontaneous neural activity in multiple brain regions in breast cancer patients with CRCI, accompanied by FC disruption at specific brain areas, which are associated with cognitive impairment.

Objective To investigate the effect of individual pretreatment of preoperative medical multi-dimensional carbohydrates on intraoperative body temperature in elderly patients with hip replacement under general anesthesia. Methods A total of 81 elderly patients who underwent unilateral hip replacement in Yancheng Third People's Hospital from January 2022 to June 2024 were selected as the study subjects,and they were randomly divided into the conventional group and the pretreatment group. Both groups of patients were given routine fasting and drinking restriction before operation,and patients in the pretreatment group were given individual pretreatment of 5 mL/kg medical multi-dimensional carbohydrates 2 hours before anesthesia. The perioperative related indicators,body temperature,intraoperative hypothermia,adverse reactions during the recovery period,and pre-anesthesia gastric antral ultrasound examination results of patients in the two groups were compared. Results There was no statistically significant difference in the surgical time or intraoperative intravenous fluid infusion between the two groups (P>0.05). The anesthesia recovery time,tracheal extubation time and intraoperative bleeding volume of patients in the pretreatment group were significantly shorter/less than those in the conventional group (P<0.05). At 30 minutes,60 minutes and the end of the surgery,the body temperature of patients in the pretreatment group was significantly higher than that in the conventional group (P<0.05),and the incidences of intraoperative hypothermia and shivering in the pretreatment group were significantly lower than those in the conventional group (P<0.05). There was no statistically significant difference in the cross-sectional area (CSA) of gastric antrum,gastric volume (GV) or ratio of gastric volume/weight (GV/W) between the two groups of patients (P>0.05). Conclusion The individual pretreatment of 5 mL/kg medical multi-dimensional carbohydrates before surgery can significantly reduce the incidence of intraoperative hypothermia in elderly patients with hip replacement under general anesthesia,promote anesthesia recovery,reduce intraoperative bleeding volume and adverse reactions,and not increase the risk of reflux aspiration.

AIM To investigate the protective effects and mechanisms of aqueous extract of Cimicifugae Rhizoma on intestinal mucosa in a mouse model of ulcerative colitis(UC).METHODS The UC mouse models established by sodium dextran sulfate were allocated into different groups and administered with sulfasalazine(200 mg/kg)or aqueous extract of Cimicifugae Rhizoma(3.9,7.8 g/kg)by gavage,respectively.The mice had their changes of body weight,defecation patterns,disease activity index(DAI)and colon length recorded;their colon tissue pathological alterations and goblet cell quantification analyzed through HE and AB-PAS staining;their ROS levels in colon tissue measured via ELISA;their mRNA expressions of inflammatory cytokines,Nrf2/HO-1 signaling pathway components and NLRP3/Caspase-1/GSDMD pathway regulators in colon tissue assessed by RT-qPCR;their protein expressions of Nrf2/HO-1 and NLRP3/Caspase-1/GSDMD pathway verified by immunohistochemistry;and their ZO1 and Occludin tight junction proteins in colon tissues quantified by Western blot analysis.RESULTS Compared to the model group,the high-dose Cimicifugae Rhizoma aqueous extract group demonstrated significantly increased body weight,colon length and DAI scores(P＜0.01);mitigated intestinal mucosal barrier damage;reduced ROS levels in colon tissue(P＜0.01);suppressed mRNA levels of pro-inflammatory factors IL-1β,IL-6 and TNF-α in colon(P＜0.01);elevated expressions of tight junction protein ZO1 and Occludin in colon tissue(P＜0.05);upregulated mRNA and protein expressions of Nrf2,NQO1 and HO-1 in colon tissue(P＜0.05,P＜0.01);downregulated mRNA and protein expressions of Keap1(P＜0.05);and reduced expressions of NLRP3 inflammasome components(ASC,Caspase-1,GSDMD)in mRNA and protein(P＜0.05,P＜0.01).CONCLUSION The aqueous extract of Cimicifugae Rhizoma exerts protective effects against UC through dual mechanisms involving redox regulation and pyroptosis inhibition by reducing ROS level via Nrf2/HO-1 pathway activation and attenuating NLRP3-mediated pyroptosis via Caspase-1/GSDMD pathway inhibition,and thereby synergistically preserves the structural and functional integrity of intestinal mucosal barrier and mitigates UC progression.