Delirium is a common cause and complication of hospitalization in the elderly and is associated with higher risk of future dementia and progression of existing dementia, of which 70% is Alzheimer's disease (AD). AD and delirium, which are known to be aggravated by one another, represent significant societal challenges, especially in light of the absence of effective treatments. The intricate biological mechanisms have led to numerous clinical trial setbacks and likely contribute to the limited efficacy of existing therapeutics. Artificial intelligence (AI) presents a promising avenue for overcoming these hurdles by deploying algorithms to uncover hidden patterns across diverse data types. This review explores the pivotal role of AI in revolutionizing drug discovery for AD and delirium from target identification to the development of small molecule and protein-based therapies. Recent advances in deep learning, particularly in accurate protein structure prediction, are facilitating novel approaches to drug design and expediting the discovery pipeline for biological and small molecule therapeutics. This review concludes with an appraisal of current achievements and limitations, and touches on prospects for the use of AI in advancing drug discovery in AD and delirium, emphasizing its transformative potential in addressing these two and possibly other neurodegenerative conditions.

Objective:To explore the application effects of the goal-oriented teaching method based on mind mapping in the teaching of stomatology practical courses.Methods:From September 2022 to September 2023, 52 fourth-year students of clinical stomatology at Harbin Medical University were divided into test group and control group for practical teaching, with 26 cases in each group. The test group received goal-oriented teaching based on mind mapping, while the control group received traditional teaching, for 20 class hours in both groups. The two groups were compared in terms of general data, theoretical and practical assessment scores, the score of the self-rating scale of self-directed learning (SRSSDL) and the score of critical thinking disposition inventory-Chinese version (CTDI-CV) before and after training, and student satisfaction with teaching activities. SPSS 25.0 software was used to perform the t-test or χ2 test. Results:After completing the practical training courses, the test group showed significantly higher scores than the control group in multiple-choice questions [(16.85±1.39) vs. (15.33±2.21)], fill-in-the-blank questions [(17.21±1.98) vs. (16.01±2.02)], short answer questions [(17.47±2.27) vs. (15.23±2.45)], case analysis [(34.36±2.79) vs. (32.57±3.02)], and practical assessment [(84.69±4.73) vs. (80.57±4.21)] (all P<0.05). The SRSSDL score and CTDI-CV score were improved in both groups, and were significantly higher in the test group [(215.29±10.42) and (357.49±17.80)] than in the control group [(200.23±11.42) and (342.23±17.26)] (both P<0.05). The students of the test group were significantly more satisfied with teaching activities than those of the control group ( P<0.05). Conclusions:Compared with the traditional teaching method, the goal-oriented teaching method based on mind mapping is more effective in stomatology practical teaching, which can improve students' self-directed learning ability and critical thinking ability, promote their mastery of theoretical knowledge, enhance their clinical practice ability, and increase their satisfaction with teaching activities.

Objective To investigate the clinical manifestations,molecular genetics and gonadal pathol-ogy characteristics of patients with disorders of sex development(DSD),and to summarize the clinical experi-ence of identifying rare diseases from common symptoms.Methods The clinical data of 416 patients with DSD diagnosed and treated in the multidisciplinary center of DSD of Guangzhou Women and Children's Medical Cen-ter from May 2018 to August 2023 were retrospectively analyzed,summarized and discussed.Results Accord-ing to chromosome karyotype,416 cases of DSD were classified into three types:92 cases(22.1％)of abnormal sex chromosome karyotype,285 cases(68.5％)of 46,XY karyotype and 39 cases(9.4％)of 46,XX karyotype.Among the 92 patients with abnormal sex chromosome karyotype,59 cases were raised as males,18 cases(30.5％)complained of short penis with hypospadias and cryptorchidism.The most common karyotype was 45,X/46,XY(58 cases,63.0％).Among the 285 patients with 46,XY karyotype,238 cases were raised as males,and 63 cases(26.5％)complained of short penis and hypospadias;47 cases were raised as females,and 13 ca-ses(27.7％)complained of inguinal mass.A total of 216 patients with 46,XY karyotype were subjected to whole exome gene detection,and 155 cases(71.8％)were found to have molecular pathogenesis with the clinical phe-notype.Among the 39 patients with 46,XX karyotype,19 cases were raised as males,and 8 cases(42.1％)com-plained of short penis and hypospadias.In the 18 cases of gonad biopsy,17 cases showed testicular tissue in go-nads.Whole exome sequencing was performed in 14 cases.NR5A1 gene heterozygous mutation,SRY gene muta-tion and SOX3 gene mutation were found in 2 cases,respectively(14.3％).Twenty cases were raised as females,and 14 cases(70.0％)complained of clitoral hypertrophy.Gonad biopsy was performed in 8 cases,with 7 cases of ovotestis(87.5％)and 1 case of NR5A1 gene heterozygous mutation(14.3％).Conclusions The etiologies of DSD are complex and diverse,and the clinical manifestations are various,which can be manifested as hypospa-dias,micropenis,cryptorchidism and other common symptoms of the urinary system.Different etiologies have dif-ferent treatment options.Therefore,chromosome karyotype,molecular genetic testing and gonadal pathology can be used to clarify the cause of disease,especially for rare diseases,improve the detection rate,reduce the rate of missed diagnosis,and ensure reasonable treatment,especially sex selection.

ObjectiveTo observe the intervention effect of Chaihu and Longgu Mulitang （CLMT） on rat depression model prepared by chronic unpredictable mild stress （CUMS） based on cyclic adenosine monophosphate （cAMP）/protein kinase A （PKA）/cAMP-response element-binding protein （CREB）-brain-derived neurotrophic factor （BDNF） signaling pathway. MethodSixty SD rats were divided into normal group， model group， and CLMT low-， medium- and high-dose groups and fluoxetine group （positive control） according to random number table. They， except the normal group， were treated with CUMS for 49 days to prepare the rat depression model. The CLMT low-， medium- and high-dose groups were given 2.89， 5.78 11.56 g·kg^-1 of CHMD granules， respectively， and the fluoxetine group was given 2.06 mg·kg^-1 of fluoxetine hydrochloride on the 29^th day. The normal group and the model group received equal volume of normal saline for 21 days. The behavioral performance of rats were observed by open field test and forced swim test. The levels of 5-hydroxytryptamine （5-HT）， norepinephrine （NE） and cAMP in rat hippocampus were measured by enzyme-linked immunosorbent assay （ELISA）. The mRNA expressions of PKA， CREB， and BDNF in rat hippocampus were detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， and the protein expressions of PKA and BDNF were detected by Western blot. Immunohistochemistry was used to determine the expression of CREB， and hematoxylin and eosin （HE） staining and Nissl staining were used to observe the morphological changes of hippocampus. ResultCompared with the conditions in the normal group， the immobility time of the model group in the forced swim test was increased （P<0.01） and the total movement distance， residence time in central area， number of entries in central area and movement distance in central area were decreased （P<0.01）. Additionally， the contents of 5-HT， NE and cAMP in hippocampus of the model group as well as the protein expressions of PKA， BDNF and CRE，the mRNA expressions of BDNF and CREB were lower than those in the normal group （P<0.01）. Compared with the model group， the CLMT groups had reduced immobility time （P<0.01）， elevated total movement distance， residence time in central area， number of entries in central area and movement distance in central area （P<0.05， P<0.01）， up-regulated contents of 5-HT， NE and cAMP in hippocampus （P<0.05， P<0.01）， and up-regulated protein expressions of PKA， BDNF and CREB and mRNA expressions of BDNF and CREB （P<0.01）. HE staining and Nissl staining showed that CLMT significantly improved the neuronal structure in rat hippocampus. ConclusionCLMT alleviates the anxiety and depression of rats. These effects may be mediated by regulating monoamine neurotransmitters 5-HT and NE in hippocampus of depressed rats， activating cAMP/PKA/CREB/BDNF signaling pathway， up-regulating the expression of BDNF and protecting hippocampal structure and function .

Objective:To investigate the characteristics of 18F-DCFPyL PET/CT imaging in castration-resistant prostate cancer (CRPC) patients with different PSA levels. Methods:The imaging and clinical data of 50 patients with CRPC who underwent 18F-DCFPyL PET/CT examination in Chinese PLA General Hospital from January 2018 to December 2020 were analyzed retrospectively. The average age was 72 (54-95) years old. Serum total PSA was 92.28(0.36-2000.00) ng/ml. According to the total PSA level, the patients were divided into low PSA group(total PSA ≤ 1 ng/ml, n=9), medium PSA group (1 ng/ml10ng/ml, n=23). According to the standardized evaluation standard of molecular imaging, the suspicious tumor lesions on 18F-DCFPyL PET/CT imaging were scored by molecular imaging PSMA(miPSMA), and the miPSMA score ≥2 was defined as positive lesions. According to the number of lesions displayed by 18F-DCFPyL PET/CT, patients were divided into oligofocal group (the number of lesions ≤3) and multiple lesions group (the number of lesions >3). The imaging characteristics of patients in different groups were summarized. Results:The 18F-DCFPyL PET/CT imaging results of 50 cases in this study were all positive, including oligofocal group (n=27) and multiple lesions group (n=23). Of the 30 patients with unresected prostate, 18 had local recurrence of the prostate, while the other 12 patients with unresected prostate and 20 patients with resected prostate had no signs of local recurrence. The oligofocal group showed local recurrence, regional lymph node metastasis or bone metastasis. Patients with multiple lesions showed multiple lymph nodes and/or bone metastasis with or without local recurrence. There were 9, 18 and 4 patients with oligofoci in low, middle and high PSA groups, respectively.There were 27 patients in the oligonucleogenous group, and 21 of the 22 patients receiving local treatment were effective. All 3 patients treated with systemic treatments were effective. PSA progressed in 2 untreated patients. In the multi-foci group of 23 patients, 6 of 9 patients treated with abiraterone were effective. Two patients treated with enzalumide were ineffective. One of the 4 patients with chemotherapy was effective. One of the two patients treated with 177 Lu-PSMA nuclide was effective. One case did not respond to treatment with 89SrCl 2. Radiotherapy failed in 2 cases. PSA progressed in 3 untreated patients. Conclusions:18F-DCFPyLPET/CT imaging has a high detection rate of lesions in patients with CRPC and has potential guiding significance for follow-up treatment. The number of lesions in CRPC patients with different PSA levels was different, and the patients with low PSA levels were mainly oligofoci.

Literature review is an essential link in nursing research. A systematic and rigorous literature review can transform the existing primary research into evidence that effectively guides nursing practice, thereby promoting the development of nursing specialization. This article introduces common review types such as the systematic review, Meta-analysis, overview of systematic reviews, Meta-synthesis, scoping review, and integrative review, and distinguishes the similarities and differences of different types of reviews, and analyzes their advantages and limitations, in order to improve the scientific and professional level of nursing practice, and promote the development of evidence-based and nursing disciplines.

Objective:To explore the effect of positive group psychological counselling on self-efficacy and stigma of patients with ulcerative colitis so as to provide a basis for clinical intervention.Methods:By the convenient sampling method, a total of 100 patients with ulcerative colitis who were hospitalized in the First Affiliated Hospital of Xinxiang Medical University from July 2018 to June 2019 were selected as research subjects. According to the random number table method, they were divided into the control group ( n=50) and the observation group ( n=50) . The control group was given routine nursing while the observation group was given positive group psychological counselling. Inflammatory Bowel Disease Self-Efficacy Scale (IBD-SES) and Social Impact Scale (SIS) were used to evaluate the effect of the intervention. Results:After intervention, scores of stress and emotion management, medical care management, disease management and maintenance management during remission period in the IBD-SES between the two groups had statistically significant differences ( P<0.05) . There was statistically significant difference in the score of social isolation dimension in SIS between the two groups after intervention ( P<0.05) . There were no statistically significant differences in the scores of social exclusion, economic discrimination and intrinsic shame ( P>0.05) . Conclusions:Positive group psychological counselling can improve the self-efficacy of patients with ulcerative colitis, but the effect on the stigma needs further large samples and long-term research.

Objective To investigate the efficacy of acupuncture combined with doctor-nurse cooperation mode on stroke-associated pneumonia in patients with acute stroke. Methods 67 patients of acute stroke within 1 week in our hospital from March, 2013 to January, 2015 were randomly divided into control group (n=35) and treatment group (n=32). Both groups received neurological routine treatment and systematic rehabilitation training by professional physiotherapists under general nursing mode. The treatment group received acupuncture treatment under doctor-nurse cooperation mode additionally. Incidence of stroke-associated pneumonia, swallow function and aspiration rate were recorded. Results Compared with the control group, the incidence of stroke-associated pneumonia significantly decreased in the treat-ment group after treatment (χ2=4.615, P=0.032). The retention volume of epiglottic vallecula and pyriform sinus (tdilute barium=21.01, tthick barium=19.85), the duration of pharynx period (tdilute barium=17.03, tthick barium=13.68), and the start time of pharynx period (tdilute barium=19.63, tthick barium=17.86) were less in the treatment group than in the control group (P<0.05). In the test of dilute barium, the aspiration rate was lower in the treatment group than in the control group (χ2=4.03, P=0.044), however, there was no significant difference between 2 groups in the test of thick bari-um and solid food (P>0.05). Conclusion Acupuncture combined doctor-nurse cooperation mode may decrease the rates of aspiration and stroke-associated pneumonia in acute stroke patients through improving their swallow function.

Objective To observe the effect of acupuncture combined with moxibustion on heart rate variability (HRV) in patients with post-stroke depression. Methods 120 patients were divided into control group (n=60) and treatment group (n=60). Both groups took fluoxetine and accepted acupuncture therapy, and the treatment group accepted moxibustion additionally. Hamilton Depression Rating Scale-17 (HAMD-17) and the change of HRV were compared before and after treatment. Results The score of HAMD was lower, and the reductive ratio was higher in the treatment group than in the control group (P<0.05). The standard deviation of the mean of qualified normal sinus interval (SDNN) and standard deviation of sequential five-minute R-R interval means (SDANN) increased in both groups after treatment (P< 0.05), and were higher in the treatment group than in the control group (P<0.05). The root mean square differences of successive R-R intervals (RMSSD) and percentage of differences between adjacent normal sinus intervals greater than 50 ms (PNN50) decreased in both groups after treatment (P<0.05), and were lower in the treatment group than in the control group (P<0.05). The low frequency (LF), high frequency (HF) and LF/HF were higher in both groups after treatment (P<0.05), and were higher in the treatment group than in the control group (P< 0.05). Conclusion Acupuncture combined with moxibustion therapy can better adjust the function of autonomic nerve and reduce depression in patients with post-stroke depression.

Objective To observe the effect of needle warming moxibustion on cognitive dysfunction after stroke. Methods 76 stroke patients with cognitive dysfunction were randomly divided into treatment group (n=38) and control group (n=38). The treatment group received needle warming moxibustion and routine rehabilitation for 4 weeks, while the control group only received routine rehabilitation. They were assessed with Montreal Cognitive Assessment (MoCA) and activities of daily living (ADL) scale before and after treatment. Results The score of MoCA and ADL improved in both groups (P<0.05), and improved more in the treatment group than in the control group (P<0.05) after treatment. Conclusion Needle warming moxibustion could improve cognitive function in patients after stroke and activities of daily living.