This report describes the clinical course， diagnosi and treatment of a patient with neuromyelitis optica spectrum disorder （NMOSD） who presented initially with depression and delusion. The patient was a 38-year-old woman who initially presented with low mood， accompanied by nausea and vomiting. Mental examination revealed delusions of jealousy and psychomotor retardation. Subsequently， she developed fever and decreased muscle strength. Magnetic resonance imaging (MRI） revealed lesions involving pons and upper cervical spinal cord. Cerebrospinal fluid testing was positive for aquaporin 4 （AQP4） antibodies， and metagenomic sequencing of cerebrospinal fluid detected DNA fragments of Escherichia coli and Klebsiella pneumoniae. Following treatment with glucocorticoid pulse therapy combined with anti-infective therapy， the patient's mood， psychiatric symtoms， and neurological symptoms improved. This case suggests that psychiatric symptoms including depression and delusion may be the presenting features of NMOSD， and that infectious factors might play a role in triggering autoimmune responses. These observations offer valuable clinical clues for the early identification of NMOSD.

Objective Neurological disorders,constitute the majority of acupuncture-treated ailments.By critically examining a comprehensive selection of high-quality clinical randomized controlled trials(RCTs)from both domestic and international sources,we aimed to uncover the prevailing hot research topic and potential future directions in acupuncture therapy for these conditions.Methods Four databases,including PubMed,Web of science,Cochrane Library and EMBASE were searched.The search period is set from the establishment of each database to November 30,2023.And the search content was RCTs of acupuncture for neurological diseases classified as Ⅰ and Ⅱ by the Chinese Academy of Sciences were extracted.Key aspects extracted included annual publication volume,journals,disease types,outcomes,conclusions,acupuncture methods and control groups.Results A total of 81 high-quality RCTs were identified,revealing a consistent annual publication trend of acupuncture for neurological disorders.Key journals contributing to this research were Cephalalgia,Clinical Rehabilitation and Clinical Journal Of Pain,etc.The studies predominantly focused on migraine and sequela of apoplexy with migraine days/frequency and Ashworth scale and its modifications as commonly used primary outcome indicators,respectively.Overall,there were 73 RCTs that concluded that acupuncture for neurologic disorders were effective,8 were ineffective.The acupuncture methods were diverse,encompassing acupuncture,individualized acupuncture and transcutaneous electrical nerve stimulation,etc.The control measures were also varied,featuring sham acupuncture,sham-acupoint and micro-needle,etc.Conclusion With the development of acupuncture RCTs,their international influence has expanded.Research has shifted from validation of effectiveness to exploration of mechanisms,and despite the expansion of the disease spectrum of acupuncture,acupuncture trials have yet to be regulated and standardized,and the assessment of acupuncture efficacy remains controversial and challenging for the discipline.It is recommended to promote multi-center cooperation and strengthen the training of trialists etc.to provide more high-quality clinical evidence.

Objective Neurological disorders,constitute the majority of acupuncture-treated ailments.By critically examining a comprehensive selection of high-quality clinical randomized controlled trials(RCTs)from both domestic and international sources,we aimed to uncover the prevailing hot research topic and potential future directions in acupuncture therapy for these conditions.Methods Four databases,including PubMed,Web of science,Cochrane Library and EMBASE were searched.The search period is set from the establishment of each database to November 30,2023.And the search content was RCTs of acupuncture for neurological diseases classified as Ⅰ and Ⅱ by the Chinese Academy of Sciences were extracted.Key aspects extracted included annual publication volume,journals,disease types,outcomes,conclusions,acupuncture methods and control groups.Results A total of 81 high-quality RCTs were identified,revealing a consistent annual publication trend of acupuncture for neurological disorders.Key journals contributing to this research were Cephalalgia,Clinical Rehabilitation and Clinical Journal Of Pain,etc.The studies predominantly focused on migraine and sequela of apoplexy with migraine days/frequency and Ashworth scale and its modifications as commonly used primary outcome indicators,respectively.Overall,there were 73 RCTs that concluded that acupuncture for neurologic disorders were effective,8 were ineffective.The acupuncture methods were diverse,encompassing acupuncture,individualized acupuncture and transcutaneous electrical nerve stimulation,etc.The control measures were also varied,featuring sham acupuncture,sham-acupoint and micro-needle,etc.Conclusion With the development of acupuncture RCTs,their international influence has expanded.Research has shifted from validation of effectiveness to exploration of mechanisms,and despite the expansion of the disease spectrum of acupuncture,acupuncture trials have yet to be regulated and standardized,and the assessment of acupuncture efficacy remains controversial and challenging for the discipline.It is recommended to promote multi-center cooperation and strengthen the training of trialists etc.to provide more high-quality clinical evidence.

BACKGROUND: With the rapid development of modern society, psychological problems in college students have been paid high attention by educatienal organizations of psychological health in China. OBJECTIVE: To probe into the influencing factors of psychological problems in college students. DESIGH: Cluster sampling 1∶2 paired observation, case-control study. SETTING: Medical College of Wuhan Polytechnic University. PARTICTPANTS: 1 200 sophomores with the age ranged 19-20 years were selected from Wuhan Polytecnic University by cluster sampling at June 2001, and 145 students with the scores of more than 3 factors greater than 3 points were screened by Symptom Checklist 90 (SCL-90) (including 9 factors of somatization, compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoid and schizophrenia. The higher the grade was, the severer the symptom was) to be the psychological problem group. Subjects were selected to be the normal controls at the ratio of 1∶2 with those in the psychological problem group, whose classes, specialties and ages (the difference was less than 2 years) were similar to those of the enrolled patients. 290 students normal in the indexes of SCL-90 were taken as the matched group. Of all subjects in both experiment groups, there were 173 males and 262 females with an average age of 19.2 years. METHODS: ① The subjects in the two experiment groups were investigated of the psychological health by SCL-90 as well as the personality characteristics and Eysenck Personality Questionnaire (EPQ) (For Adult). The EPQ statistic software designed by the Institute for Juvenile and Children, Tongji Medical College of Huazhong University of Science and Technology was adopted to acquire the E score (introversion, extroversion), N score (nervousness), P score (psychoticism), L score (conceal) and quantity form quadrant of E-N coordinate picture, so as to define the tendencies of characters. ② The psychological problem was considered to be the dependent variable, while all relevant factors (The influencing factors of psychological problem included the understanding from parents, relationship with family members, desire for learning, personality characteristics, over-high P score, over-high/low E score, over-high/low N score) were taken as the independent variable. Single-factor Logistic regression analysis was conducted at 1:2. ③ Based on 1:2 single-factor Logistic regression analysis, the variances were selected from factors of P ＜ 0.01 together with the Logistic regression models of multifactor at 1:2 by stepwise regression method.MAIN OUTCOME MEASURES: ① Comparison in the SCL-90 score between the psychological problem group and the normai control group. ② Single-factor and multivariate analysis of the relevant factors of psychological problems. RESULTS: A total of 435 enrolled students were involved in the analysis of results. ① The average score of somatization, compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoid and schizophrenia in students of the psychological problem group was higher than that in the normal control group (t=-13.39, 29.64, 27.09, 26.04, 19.52, 18.13, 14.15, 18.61, 22.41, P＜ 0.01). ② Nine factors were selected in the single factor analysis after the Logistic regression analysis, including 6 protective factors of understanding from parents, relationship with family members, desire for learning, personality characteristics, E ＞ 61.5, N ＜ 38.5, while he other 3 factors (P ＞ 61.5, E ＜ 38.5, N ＞ 61.5) were risk factors. The multivariate analysis showed that factors of relationship with family members, desire for learning as well as personality characteristics were protective factors, while it was a risk factor when N ＞ 61.5.CONCLUSION: The psychological problems in college students relate to the relationship with family members,understanding from the parents, desire for learning as well as the character trait and personality characteristics.