Objective To systematically review the effectiveness of repetitive transcranial magnetic stimulation (rTMS) versus modified electroconvulsive therapy (ECT) on efficacy of treating depression.Methods Pubmed,Embase,Web of science,Cochrane library,CNKI,WanFang Data and CBM were searched since the database establishment till March in 2017 for randomized controlled trials(RCTs) that compared the efficacy of rTMS and ECT on depression mainly by assessment of response rate,and the mean Hamilton Depression Rating Scale (HDRS) score and remission rate. The dropout rate was also analyzed. The meta-analysis was performed by using RevMan 5.3 software. Results Fourteen RCTs involving 671 patients were finally included. The results showed that there was no significant difference between two therapies on the response rate (OR=0.71,95% CI: 0.46-1.10, P=0.120), remission rate(OR=0.67,95%CI:0.39-1.15,P=0.140)and dropout rate(OR=0.48,95%CI:0.23-1.01,P=0.050).Subgroup analysis showed ECT was more effective on psychotic depression(OR=0.27,95% CI:0.12-0.60,P=0.001).Moreover, mean HDRS score after the ECT was significantly lower than rTMS treatment(MD=2.04,95%CI:0.58-3.50, P=0.006).Conclusion rTMS has the same efficacy and acceptability as ECT for depression treatment,and ECT seems to be advantageous on psychotic depression.

Objective To systematically review the effectiveness of repetitive transcranial magnetic stimulation (rTMS) versus modified electroconvulsive therapy (ECT) on efficacy of treating depression.Methods Pubmed,Embase,Web of science,Cochrane library,CNKI,WanFang Data and CBM were searched since the database establishment till March in 2017 for randomized controlled trials(RCTs) that compared the efficacy of rTMS and ECT on depression mainly by assessment of response rate,and the mean Hamilton Depression Rating Scale (HDRS) score and remission rate. The dropout rate was also analyzed. The meta-analysis was performed by using RevMan 5.3 software. Results Fourteen RCTs involving 671 patients were finally included. The results showed that there was no significant difference between two therapies on the response rate (OR=0.71,95% CI: 0.46-1.10, P=0.120), remission rate(OR=0.67,95%CI:0.39-1.15,P=0.140)and dropout rate(OR=0.48,95%CI:0.23-1.01,P=0.050).Subgroup analysis showed ECT was more effective on psychotic depression(OR=0.27,95% CI:0.12-0.60,P=0.001).Moreover, mean HDRS score after the ECT was significantly lower than rTMS treatment(MD=2.04,95%CI:0.58-3.50, P=0.006).Conclusion rTMS has the same efficacy and acceptability as ECT for depression treatment,and ECT seems to be advantageous on psychotic depression.

Objective: To explore the electrocardiographic characteristics of patients with idiopathic ventricular arrhythmias (VAs) originating from different portions of distal great cardiac veins (DGCV). Methods: The study included 49 patients underwent successful RFCA of premature ventricular complex(PVCs)/ventricular tachycardia(VT) from different portions of the DGCV in our department from July 2009 to March 2016. The surface 12-lead electrocardiogram (ECG) and intraventricular ablation mapping features were analyzed. Patients were divided into four groups according to the mapping and ablation results: DGCV1(10 patients), DGCV2 (13 patients), proximalanterior interventricular vein (PAIV, 17 patients)and extend distal great cardiac vein (EDGCV, 9 patients). We analyzed the similarities and differences between surface 12-lead ECG of patients with PVCs/VT from different portions of DGCV, and compared with random chosen 290 patients with PVCs/VT from ventricular outflow tract and adjacent structure. Results: A positive R wave in inferior leads, a negative QS morphology in lead aVL and aVR were found among all groups. The different characteristics of surface 12-lead ECG of VAs originating from DGCV were as follows: (1)EDGCV patients demonstrated a positive R or r wave on lead Ⅰ(6/9) while a negative rS or qr wave was evidenced in other three groups (39/40). (2)A positive R pattern on lead V₁, V₅-V₆ (11/13) was presented in patients of DGCV2 group; R (without S or s) wave on V₁ (9/10), RS or Rs wave on V₅-V₆ were found in DGCV1 group; RS or rS wave was seen on lead V₁, R(without S)wave in lead V₅-V₆ (25/26) were found in EDGCV and PAIV group and the amplification of R wave in EDGCV was higher than V₁ of PAIV group.(3)Precordial lead transition zone was in front of V₁ for DGCV1 and DGCV2 groups (23/23), within V₁-V₃ for EDGCV group, but on V₂ or within V₂-V₃ for PAIV group.(4)Patients of DGCV1 and DGCV2 demonstrated a longer Pseudo delta wave time(PdW), intrinsicoid deflection time (IDT), significantly larger maximum deflection index (MDI) than those in PAIV and EDGCV groups (P<0.001). (5)The different characteristics of surface 12-lead ECG between VAs originating from DGCV and those from ventricular outflow tract and adjacent structure were as follows: ① The ECG features were similar between PVIA and LCC group, both demonstrated a rs wave on the lead Ⅰ, rS wave on V₁-V₂ and R wave on V₅-V₆; ②The ECG features were similar betweenEDGCV and RCC group, both presented with R or r wave on the lead Ⅰ, the QRS wave of precordial leads was similar as PAIV and LCC groups; ③A R wave on the lead V₁, V₅-V₆ was found in group DGCV2, and ILCC; ④Similar to the group Endo-MAA, patients in DGCV1 group also demonstrated a R wave on the lead V₁ and a Rs wave on V₅-V₆. Conclusion A positive R wave in inferior leads, a negative QS morphology in lead aVL and aVR are seen in all patients, but different electrocardiographic characteristics of PVC/VT originating from the different portions of the DGCV are presented on lead Ⅰ and V₁-V₆.

Objective To investigate the effects of ketamine and propofol on cardiovascular system and cognitive function in the patients with depression during the modified electroconvulsive therapy (MECT). Methods A total of 60 patients with depression treated by MECT were randomly divided into 2 groups. Induced anesthesia with ketamine and propofol were performed respectively during MECT. The course of treatment was 8 times. The mean arterial pressure(MAP)was recorded before therapy and at 5 min after MECT.Depression and the cognitive function were evaluated by using the Hamilton Depression Scale(HAMD)and the Wisconsin Card Sorting Test(WCST)before treatment and 1 day after treatment. Results There was no significant difference in MAP between the two groups after MECT(P > 0.05). The HAMD scores of the two groups were lower than those before treatment(P<0.05). In the total number of errors and the number of random errors,there was no significant difference between two groups (P > 0.05). But in completing classification of WCST ,the ketamine group was better than the propofol group(P<0.05). Conclusion Propofol has no obvious influence on the cognition function and little influence on MAP,so it could be the first choice of anaesthetic for the induction of MECT.