Repetitive transcranial magnetic stimulation (rTMS) has become an essential method in psychiatric disorders. However, many problems occurred in clinical application. This article interpreted the Association Standard T/CMEAS 011-2023'Operating Specifications for Repetitive Transcranial Magnetic Stimulation in Clinical Applications on Psychiatric Disorders′ released by the Chinese Medicine Education Association. The main content included a range of applications, normative references, terms and definitions, site specifications, equipment specifications, ability specifications of rTMS operators and rTMS process specifications.This article provided suggestions for clinical applications of rTMS on psychiatric disorders.

Repetitive transcranial magnetic stimulation (rTMS) has become an essential method in psychiatric disorders. However, many problems occurred in clinical application. This article interpreted the Association Standard T/CMEAS 011-2023'Operating Specifications for Repetitive Transcranial Magnetic Stimulation in Clinical Applications on Psychiatric Disorders′ released by the Chinese Medicine Education Association. The main content included a range of applications, normative references, terms and definitions, site specifications, equipment specifications, ability specifications of rTMS operators and rTMS process specifications.This article provided suggestions for clinical applications of rTMS on psychiatric disorders.

The COVID-19 epidemic has caused serious and long-lasting health and social harm. Vaccination is considered as the most effective way to prevent the COVID-19 epidemic. Patients with mental disorders are at high risk of COVID-19 infection who are in urgent need to get protection. However, due to the particularity of their conditions, whether these patients should be vaccinated has become a tough issue that obsesses doctors, patients with mental disorders, and their families. In light of this issue, this article provides expert advice on the safety, legal and ethical issues of vaccination for patients with mental disorders to regulate the vaccination of these vulnerable populations against COVID-19.

The COVID-19 epidemic has caused serious and long-lasting health and social harm. Vaccination is considered as the most effective way to prevent the COVID-19 epidemic. Patients with mental disorders are at high risk of COVID-19 infection who are in urgent need to get protection. However, due to the particularity of their conditions, whether these patients should be vaccinated has become a tough issue that obsesses doctors, patients with mental disorders, and their families. In light of this issue, this article provides expert advice on the safety, legal and ethical issues of vaccination for patients with mental disorders to regulate the vaccination of these vulnerable populations against COVID-19.

Objective:To investigate the associations of brain white matter integrity deficits, and to explore the association of fractional anisotropy (FA) abnormality with clinical symptoms and cognitive impairments, as well as the prediction effect of the FA alterations on symptoms and cognitive function outcomes in the acute stage of schizophrenia from the whole brain level based on magnetic resonance diffusion tensor imaging (DTI).Methods:From November 2019 to December 2020, thirty-eight patients with first-episode schizophrenia and 38 healthy controls were recruited in this study. Wisconsin card classification test (WCST), digit span test (DST forward/backward), verbal fluency test, Stroop (A/B/C), trail making test (TMT-A/B), as well as positive and negative syndrome scale (PANSS) were utilized to evaluate patients' cognitive function and clinical symptoms both before and after 8 weeks of risperidone monotherapy. T1-weighted images and DTI data of all the subjects were collected . FSL and SPM8 were used to preprocess MRI data and compare the between-group differences of FA. Support vector machine (SVM) analysis was used to evaluate the accuracy of abnormal FA values in differentiating schizophrenic patients from healthy controls. Finally, stepwise multiple regression analysis or generalized linear models were used to explore the associations between white matter integrity and symptoms or cognition.Results:Before treatment, patients' FA values of right medial temporal lobe (mTL), cuneus, anterior cingulate gyrus (ACG) and inferior parietal lobe (IPL) were significantly lower than those in healthy controls ( P<0.01, GRF corrected), and patients' FA values of bilateral middle cingulate gyrus (mCG) were significantly higher than those in the control group ( P<0.01, GRF corrected). SVM analysis showed that four combinations could distinguish the patients from the control with the most accurate rate of 89.47%. Patients' baseline decreased FA values in the right IPL were positively associated with their increased total response time in WCST ( β=0.489, P=0.003, FDR corrected), correct response time in WCST ( β=0.450, P=0.008, FDR corrected), error response time in WCST ( β=0.435, P=0.008, FDR corrected), TMT-B ( β=0.296, P=0.042, FDR corrected), Stroop-C ( β=0.345, P=0.035, FDR corrected), and PANSS-P ( β=0.321, P=0.042, FDR corrected). Reduced FA values in the right mTL in patient group were significantly negatively related to the total time spent on the TMT-A ( β=-0.425, P=0.009, FDR corrected) and TMT-B ( β=-0.325, P=0.026 with FDR correction). Increased FA values in right mCG in patient group demonstrated positive associations with total response time in the WCST ( β=0.585, P=0.002, FDR corrected), correct response time in WCST ( β=0.524, P=0.003, FDR corrected), error response time in WCST ( β=0.536, P=0.003, FDR corrected) and total time consuming in TMT-B ( β=0.484, P=0.004, FDR corrected), as well as negative associations with DST-forward ( β=-0.319, P=0.042, FDR corrected). After treatment, patients' percentage changes in total response time of WCST ( β=0.715, P<0.001, FDR corrected), correct response time of WCST ( β=0.752, P<0.001, FDR corrected), as well as total time-consuming of TMT-A ( β=1.333, P=0.001, FDR corrected) showed positive correlations with baseline increased FA values in the left mCG. Percentage alteration of Stroop-B was negatively correlated with baseline FA values in the right cuneus ( β=-0.745, P=0.015, FDR corrected). Conclusions:The combination of abnormal FA values in multiple brain regions may be potential biomarkers to distinguish schizophrenic patients from healthy volunteers. There was regional dependence in the associations of the impairment of white matter integrity with the cognitive impairment, the severity of psychopathological symptoms as well as the prognosis of patients in the acute stage.

Objective: To explore the effect of therapeutic application of pneumatic ballistic lithotripsy under percutaneous nephroscope ultrasound and holmium laser lithotripsy for complex kidney stone. Methods: 124 patients with complex renal calculus were selected and divided into observation group (62 cases) and control group (62 cases) as randomly number table. The patients of observation group were cured by pneumatic ballistic lithotripsy under percutaneous nephroscope ultrasound while patients of control group were cured by holmium laser lithotripsy. A series of correlative indicators, such as some correlative indexes in during and post operation, complication situation of post operation and kidney function, were compared. Results:The differences about bleeding volume during operation and postoperative hospital stay between the two groups were significant (t=12.475, t=7.659, P<0.05). For clearance rate of calculus and incidence of complication, the differences between the two groups were significant (x2=6.048, x2=7.159, P<0.05). And the differences of separation index of renal pelvis collective system, creatinine and urea nitrogen post treatment between the two groups also were significant (t=8.529, t=7.058, t=10.596, P<0.05). Conclusion: Comparing with the traditional holmium laser lithotripsy, the clinical better effect of pneumatic ballistic lithotripsy under percutaneous nephroscope ultrasound for complex renal calculi is significant. Its series of advantages, such as shorter operation time, faster recovery, safer and reliable for patients and lower incidence of postoperative complication and so on, can effectively relieve the renal function for patients.

To observe the effect of electro-acupuncture on the relapse to heroin-seeking induced by heroin-related cues after withdrawal from heroin self-administration in rats.Methods:Sixty male Wistar rats were randomized into physiological saline group,withdrawal group A,withdrawal group B,electro-acupuncture(EA)treatment group A and EA treatment group B,with 12 rats in each group.The rats were trained by nose-poke response to self administer heroin (50 μg/kg/per infusion) or saline with one daily 4-h session for 14 consecutive days,the session ended after 25 infusions were eamed or 4 hours had passed,the reinforcement schedule was a progressive ratio.Then rats in withdrawal group A and withdrawal group B were withdrawn from heroin for 1 week and 2 weeks respectively,and then they were reintroduced to their training chambers for 4-h relapse testing which was induced by heroin-related environmental cues;And rats in EA treatment group A and EA treatment group B were also withdrawn from heroin for 1 week and 2 weeks respectively,during which they were given EA treatment for 20 min daily,then they received relapse testing;In the meantime,rats in saline group were trained with saline instead of heroin for 14 days as control.after 7 days of withdrawal from saline,they received relapse testing.Results:Following 7-8 days of drug training,the rats began to establish the stable intravenous heroin self-administration behavior;For the stable heroin self-administrating rats that received EA treatment,when they were reintroduced to their training chambers,their heroin-seeking behaviors were obviously inhibited,and this inhibitory effect related to the cumulativeness of EA stimulation.Conclusion:The results suggested that EA could prevent relapse to heroin-seeking to a certain extent.

Objective: This present study is to investigate the biochemical adaptations in the related brain regions of the mesolimbic dopamine system, such as the ventral tegrnental area (VTA), nucleus accumbens (Nac), amygdale (Amy), prefrontal cortex (PFC) , substantia nigra (SN) and caudateputamen (Cpu) in response to heroin self-administration in rats and observe the effect of electroacupuncture on them. Methods: 2hirty rats were trained by nose-poking response to establish stable intravenous heroin self-administration within 14 days, and then divided randomly into model group (group B) including 6 rats, withdrawal group which were withdrawn from heroin for 1 week (group C, n = 6) and for 2 weeks (group D, n= 6), during which time they only lived in their individual home cages,and electro-acupuncture group which were also withdrawn from heroin for 1 week (group E, n= 6) and for 2 weeks (group F, n= 6), during which time they were given electro-acupuncture treatment for 20 min daily and then returned to their individual home cages; in the meantime, another 6 rats were trained by nose-poking response with saline for 14 days as control (group A); Then the levels of tyrosine hydroxylase (TH) and glial fibrillary acidic protein (GFAP) in VTA, Nac, Amy, PFC, SN, Cpu were detected with immunohistochemistry method. Results: The leveks of TH and GFAP in VTA of the heroin self-administrating rats were obviously increased, and the levels of TH and GFAP in Nac were also decreased, and these changes were not found in SN, Cpu, Amy and PFC; Electro-acupuncture could promote the up-regulation of TH and GFAP in VTA and down-regulation of TH and GFAP in Nac to return to the normal level. Conclusions: The chronic heroin self-administration produced some biochemical adaptations in the rdated brain regions of the mesolimbic dopamine system and electroacupuncture could promote the repair of the injured DA neurons in VTA of heroin addicted rats and their functional recovery.

Objective: This present study is to establish a rat model of intravenous heroin self-administration and observe the effect of electro-acupuncture on the heroin-seeking behavior of the heroin self-administrating rat. Methods: Six Male Wistar rats were surgically implanted with an intra-jugular intravenous catheters under sodium pentobarbital anesthesia,following a minimum recovery of 7 days, the rats were trained by nose-poke response with one daily 4-hour session for 14 consecutive days to self administer heroin (50 μg /kg / per injection), the session ended after 25 infusions were earned or 4 hours had passed, whichever came first, the reinforcement schedule was fixed ratio 1 (FR1) that the rat received a heroin injection for each nose poke response. And then the rats were given electro-acupuncture treatment daily 30min prior to each session and then were trained with one daily 4-h session for 7 consecutive days. Results: Stable intravenous heroin self-administration behavior of rats was established after 7-8 days' drug training, electro-acupuncture given to the stable heroin self-administrating rat 30 min prior to each session could reduce the drug self-administration behavior, namely the total heroin intake in each session was reduced, especially the 1st hour heroin intake, the initiation of first nose-poke response in each session was relayed, and the haste heroin-seeking behavior also became slower. Conclusions: The above results suggested that the electro-acupuncture had better detoxification effect.