Primary brain calcification(PBC) is a hereditary neurodegenerative disorder with symmetrical calcification in the bilateral basal ganglia and other brain regions as its core imaging feature, and presents diverse heterogeneous clinical manifestations such as movement disorders, cognitive impairment, and psychiatric disturbances. The identification of multiple causative genes has not only facilitated the exploration of PBC pathogenesis but also continuously expanded its phenotypic spectrum. The diagnosis, evaluation, and management of this disease are experiencing pivotal shifts, accompanied by new challenges. In 2025, the first international expert consensus on PBC was published, laying a foundation for the standardized diagnosis and treatment of PBC worldwide. Based on China′s clinical practice and research status, and referring to the international consensus, domestic experts in related fields conducted multiple rounds of discussions, supplemented and revised the contents covering clinical manifestations, auxiliary examinations, diagnostic criteria, differential diagnosis, molecular classification and characteristics, genetic testing and counseling, disease management and treatment of PBC, and finally developed this consensus. This consensus aims to provide guidance for the standardized diagnosis, treatment, and research of PBC in China, help improve the quality of diagnosis and treatment, and drive the steady advancement of relevant research in this field.

A 35-year-old female patient with advanced lung cancer was treated with paclitaxel(albumin-bound)and carboplatin chemotherapy,combined with tislelizumab immunotherapy for one cycle.After 6 days of treatment,the patient developed sagging of the right eyelid compared to the leftside,mild morning and heavy evening,systemic muscle soreness,abnormal transaminases and myocardial enzymes,and abnormal electrocardiogram.It is suspected that there may be a correlation between tislelizumab and myasthenia gravis or related myositis.After admission,patients were treated with methylprednisolone,intravenous immunoglobulin,plasma exchange,mycophenolate mofetil,temporary pacemaker installation,and tracheal intubation.After more than a month of treatment,the patient's indicators decreased,but the patient became unconscious,the patient's family requested discharge.The association between the multisystem adverse reactions and tislelizumab was evaluated using the Naranjo's Assessment Scale,the correlation score was 7 and evaluated as probably relevant.It is suggested that when using tislelizumab in clinical practice,risk factor assessment and medication monitoring should be strengthened to ensure drug safety.

A 55-year-old male patient received immunotherapy combined with chemotherapy regimen(intravenous infusions of tislelizumab 200 mg on day 1, paclitaxel protein-bound 470 mg, and carboplatin 500 mg on day 1) after surgery for left upper lung squamous cell carcinoma, with 21 days as a treatment cycle. After more than half a month of medication in the 1st cycle, the patient developed multiple symmetrical purple red bruises on both lower limbs, which did not fade when pressed. The purple red bruising disappeared the next day after treatment with anti-allergic drugs. After 3 days of medication in the 3rd cycle, the patient developed a large number of scattered red papules on both lower limbs, protruding from the surface of the skin and accompanied by itching, a small number of red papules were scattered on both upper limbs and the face; after 15 days, the patient felt poor appetite; after 16 days, the patient experienced abdominal pain accompanied by vomiting and loose yellow stool. Laboratory tests showed a blood creatinine level of 204 μmol/L and occult blood in urine (+++). Pathological examination of skin tissue at the lesion site of the patient suggested IgA vasculitis (IgAV). After excluding other factors such as primary disease and infection, it was considered that the IgAV was probably related to tislelizumab. Tislelizumab was discontinued, anti-allergic and anti-inflammatory drugs, and glucocorticoid were given. After 2 weeks of treatments, the skin purpura gradually disappeared, and the abdominal pain and renal function indicators were improved. After fully aware of the risks, the patient was restarted tislelizumab immunotherapy combined with chemotherapy, and anti-allergic drugs were add at the same time. IgVA did not recur.

Objective To investigate the current status of sleep quality,depression,anxiety and stress of special service convalescents and their correlation.Methods A questionnaire survey was conducted on 311 special service convalescents by the Pittsburgh sleep quality index(PSQI)and the depression-anxiety-stress self-rating scale-21(DASS-21)from May to July 2022.Results The mean total PSQI score of 311 special service convalescents was 4.93±3.14,and 63 of them(20.26%)had sleep quality problems(total score of PSQI>7).The proportions of respondents with the scores≥2 in sleep time,daytime dysfunction,subjective sleep quality,and fall-asleep time were 30.87%,26.05%,21.22%,and 20.26%,respectively.The proportions of respondents with mild depression,anxiety and stress were 6.11%,4.50%and 2.57%,respectively,which were higher than the other three grades(moderate,severe and very serious).The incidence of sleep quality problems,depression,anxiety,and stress in respondents aged 40 years and above was higher than those in the other age groups,and there was a tendency to increase with age.The total score of PSQI and all factors(except hypnotic drugs)were positively correlated with depression,anxiety,and stress in special service convalescents(all P<0.01).Regression analysis showed that depression and stress were the direct influencing factors of sleep quality.Conclusion The special service convalescents have varying degrees of sleep quality problems and negative emotions such as depression,anxiety,and stress,especially those aged 40 years and above.Sleep quality is closely related to depression,anxiety,and stress.

Objective To explore the efficacy and safety of standard pulsed radiofrequency for treating rare-site glomus tumors.Methods A prospective self before-and-after control study was conducted and 6 pa-tients diagnosed as glomus tumors in the pain department of Yongkang Municipal First People's Hospital from June 2022 to January 2023 served as the study subjects.Among them,1 case was located in the outer beam of deltoid muscle in the upper arm,and 5 cases were located under the nail beds of the hands/feet.All subjects underwent the standard pulsed radiofrequency treatment under ultrasound guidance and were fol-lowed up for at least 12 months.The changes in the preoperative and postoperative Numerical Rating Scale(NRS)scores were observed,and the changes in the"typical triad",healing degree of the nail growth matrix and recurrence of pain were recorded.Results The postoperative follow-up results showed that all patients had significant decreases in NRS scores,indicating that the pain degree obtained the effective control.Among them,4 patients did not experience the pain recurrence after adopting the standard pulsed radiofrequency;1 pa-tient had pain recurrence in postoperative 6 months and the tumor body was ultimately removed by surgery.Apart from the patient 2 developing transient subungual congestion,no significant adverse events were observed.Conclusion The standard pulsed radiofrequency treatment is a safe and effective therapeutic method for pain caused by rare-site glomus tumors.

Objective To explore the changes in ability to cope with ethical conflicts in palliative care in neonatal intensive care units(NI CU)before and after ethical sensitivity theory training.Methods A descriptive phenomenological research method was employed.Using purposive sampling,we recruited 16 NICU nurses from a tertiary general comprehensive hospital in the city.After ethical sensitivity theory training between January and March 2025,the nurses participated in a semi-structured interview.Data were analyzed using Colaizzi's seven-step analysis method.Results All participants completed the interview.The data were abstracted to three main themes encompassing eight sub-themes:experiences of ethical conflict dilemmas before ethical sensitivity theory training(conflicts between treatment decision-making and family expectations,trust crises triggered by family cognitive biases),the changes of strategy to cope with ethical conflicts after ethical sensitivity theory training(individualized coping strategies,teamwork and communication,introduction and support of external resources),and the role of ethical sensitivity theory training in enhancing coping ability(improving the ability to identify ethical issues,optimizing the decision-making process,and promoting effective communication).Conclusion Palliative care nurses in the NICU face various ethical conflicts,and ethical sensitivity training can enhance their ability to manage these conflicts.

A 35-year-old female patient with advanced lung cancer was treated with paclitaxel(albumin-bound)and carboplatin chemotherapy,combined with tislelizumab immunotherapy for one cycle.After 6 days of treatment,the patient developed sagging of the right eyelid compared to the leftside,mild morning and heavy evening,systemic muscle soreness,abnormal transaminases and myocardial enzymes,and abnormal electrocardiogram.It is suspected that there may be a correlation between tislelizumab and myasthenia gravis or related myositis.After admission,patients were treated with methylprednisolone,intravenous immunoglobulin,plasma exchange,mycophenolate mofetil,temporary pacemaker installation,and tracheal intubation.After more than a month of treatment,the patient's indicators decreased,but the patient became unconscious,the patient's family requested discharge.The association between the multisystem adverse reactions and tislelizumab was evaluated using the Naranjo's Assessment Scale,the correlation score was 7 and evaluated as probably relevant.It is suggested that when using tislelizumab in clinical practice,risk factor assessment and medication monitoring should be strengthened to ensure drug safety.

Objective To explore the changes in ability to cope with ethical conflicts in palliative care in neonatal intensive care units(NI CU)before and after ethical sensitivity theory training.Methods A descriptive phenomenological research method was employed.Using purposive sampling,we recruited 16 NICU nurses from a tertiary general comprehensive hospital in the city.After ethical sensitivity theory training between January and March 2025,the nurses participated in a semi-structured interview.Data were analyzed using Colaizzi's seven-step analysis method.Results All participants completed the interview.The data were abstracted to three main themes encompassing eight sub-themes:experiences of ethical conflict dilemmas before ethical sensitivity theory training(conflicts between treatment decision-making and family expectations,trust crises triggered by family cognitive biases),the changes of strategy to cope with ethical conflicts after ethical sensitivity theory training(individualized coping strategies,teamwork and communication,introduction and support of external resources),and the role of ethical sensitivity theory training in enhancing coping ability(improving the ability to identify ethical issues,optimizing the decision-making process,and promoting effective communication).Conclusion Palliative care nurses in the NICU face various ethical conflicts,and ethical sensitivity training can enhance their ability to manage these conflicts.

A 55-year-old male patient received immunotherapy combined with chemotherapy regimen(intravenous infusions of tislelizumab 200 mg on day 1, paclitaxel protein-bound 470 mg, and carboplatin 500 mg on day 1) after surgery for left upper lung squamous cell carcinoma, with 21 days as a treatment cycle. After more than half a month of medication in the 1st cycle, the patient developed multiple symmetrical purple red bruises on both lower limbs, which did not fade when pressed. The purple red bruising disappeared the next day after treatment with anti-allergic drugs. After 3 days of medication in the 3rd cycle, the patient developed a large number of scattered red papules on both lower limbs, protruding from the surface of the skin and accompanied by itching, a small number of red papules were scattered on both upper limbs and the face; after 15 days, the patient felt poor appetite; after 16 days, the patient experienced abdominal pain accompanied by vomiting and loose yellow stool. Laboratory tests showed a blood creatinine level of 204 μmol/L and occult blood in urine (+++). Pathological examination of skin tissue at the lesion site of the patient suggested IgA vasculitis (IgAV). After excluding other factors such as primary disease and infection, it was considered that the IgAV was probably related to tislelizumab. Tislelizumab was discontinued, anti-allergic and anti-inflammatory drugs, and glucocorticoid were given. After 2 weeks of treatments, the skin purpura gradually disappeared, and the abdominal pain and renal function indicators were improved. After fully aware of the risks, the patient was restarted tislelizumab immunotherapy combined with chemotherapy, and anti-allergic drugs were add at the same time. IgVA did not recur.

Objective To investigate the influencing factors of malnutrition in hospitalized elderly patients with comorbidities of chronic diseases, and to construct a predictive model. Methods A convenience sampling method was used to select 426 elderly patients with comorbidities of chronic diseases admitted to the Department of Geriatrics of Suzhou Ninth People's Hospital Affiliated to Soochow University from January 2023 to February 2024. Based on a Mini-nutritional Assessment-Short Form (MNA-SF) score < 8 and either an albumin level < 34.0 g/L or a prealbumin level < 200 mg/L as reference of malnutrition, patients were classified into malnutrition group and non-malnutrition group. General characteristics, oral status[assessed using the Oral Health Assessment Tool (OHAT)], dietary inflammatory index (DII, evaluated through a food frequency questionnaire), and activities of daily living[assessed using the Barthel Index (BI)]were compared between the two groups. Multivariable Logistic regression analysis was employed to explore the influencing factors of malnutrition in elderly patients with comorbidities of chronic diseases and to construct a model formula. A gradient boosting machine (GBM) algorithm was implemented using R software to build a GBM predictive model. Receiver Operating Characteristic (ROC) curves were utilized to analyze the predictive performance of both models, and the Delong test was applied to compare the difference of the area under the curve (AUC). Results Ninety-two patients were diagnosed with malnutrition (malnutrition group), while 334 patients had no malnutrition (non-malnutrition group). Statistically significant differences were observed between the malnutrition and non-malnutrition groups in terms of age, the number of chronic comorbidities, the number of medication taken, OHAT scores, DII, and BI scores (P < 0.05). Advanced age, a higher number of chronic comorbidities, a greater number of medication taken, higher OHAT scores, higher DII, and lower BI scores were all influencing factors of malnutrition in elderly patients with comorbidities of chronic diseases (P < 0.05). The ROC curve analysis revealed an AUC of GBM model was 0.901 and 0.874 for the Logistic regression model. The Delong test indicated that the predictive performance of the GBM model was superior to that of the Logistic regression model (P < 0.05). Conclusion Malnutrition in hospitalized elderly patients with chronic multimorbidity is associated with age, the number of chronic comorbidities, the number of medications taken, OHAT scores, DII, and BI scores. The constructed GBM model can effectively assess the risk of malnutrition in these patients.