As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.

As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.

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.

Transcranial direct current stimulation (tDCS) is a well-tolerated, safe and noninvasive physical brain stimulation method, which has been widely used in the treatment of some common mental disorders and neurological diseases and has achieved certain clinical effects. It is necessary to develop expert consensus on clinical treatment to improve the use norms in related fields. According to the clinical research published before August 2021 and the method of evidence-based medicine, we published an expert consensus on tDCS in the treatment of depressive disorders, schizophrenia, substance use-related disorders, obsessive-compulsive disorder, attention deficit hyperactivity disorder, autism, anxiety disorders, post-traumatic stress disorder, sleep disorders, pain, Parkinson′s disease, stroke, and epilepsy. The consensus also introduced the safety and efficacy of the clinical use of tDCS, and standardized the treatment process and operation technology, aiming to provide guidance for the clinical application of tDCS and promote the standardized development of this treatment technology in the future.

Transcranial direct current stimulation (tDCS) is a well-tolerated, safe and noninvasive physical brain stimulation method, which has been widely used in the treatment of some common mental disorders and neurological diseases and has achieved certain clinical effects. It is necessary to develop expert consensus on clinical treatment to improve the use norms in related fields. According to the clinical research published before August 2021 and the method of evidence-based medicine, we published an expert consensus on tDCS in the treatment of depressive disorders, schizophrenia, substance use-related disorders, obsessive-compulsive disorder, attention deficit hyperactivity disorder, autism, anxiety disorders, post-traumatic stress disorder, sleep disorders, pain, Parkinson′s disease, stroke, and epilepsy. The consensus also introduced the safety and efficacy of the clinical use of tDCS, and standardized the treatment process and operation technology, aiming to provide guidance for the clinical application of tDCS and promote the standardized development of this treatment technology in the future.

OBJECTIVE: To explore the status and its influencing factors of anxiety symptoms in patients with occupational noise-induced deafness(ONID). METHODS: A total of 220 ONID patients were selected as the ONID group,and 200 healthy participants without noise exposure were selected as the control group by judge sampling method.The two groups were investigated by the Self-Rating Anxiety Scale, Self-Rating Depression Scale and Pittsburgh Sleep Quality Index. The Tinnitus Handicap Inventory was used to evaluate the disability levels of tinnitus, and pure-tone audiometry was used to assess the degree of tinnitus and hearing impairment in the ONID group. RESULTS: The incidence of anxiety, depression, and sleep disorder were higher in the ONID group than that in the control group(52.7% vs 9.0%, 55.0% vs 15.0%, 52.3% vs 7.0%, P<0.05). In ONID with anxiety subgroup, the duration of disease was longer(1.0 vs 2.0 years, P<0.01), incidences of tinnitus, depression and sleep disorder were higher than those in ONID without anxiety subgroup(92.3% vs 100.0%, 18.3% vs 87.9%, 19.2% vs 81.9%, P<0.01). The result of multivariate logistic regression analysis showed that the longer the duration of disease and the more severe of the tinnitus, the higher the risk of anxiety symptoms in patients with ONID [the odds ratio(OR) and its 95% confidence interval(CI) were 1.35(1.10-1.65) and 2.94(1.56-5.54) respectively, P<0.01]. The risk of anxiety in patients with sleep disorders was higher than those without sleep disorders [OR(95%CI) was 12.78(5.90-27.64), P<0.01]. CONCLUSION: The ONID patients are more likely to have anxiety. The duration of disease, severity of tinnitus and sleep disorders are the risk factors causing anxiety in ONID patients.

Objective To explore the therapeutic effects of sub-hypothermia and hyperbaric oxygen (HBO) combined with drugs in the treatment of patients with severe traumatic brain injury in the high plateau region and possible mechanism involved.Methods With the knowledge and consent of the patients and following the approval of the ethics committee,118 patients with severe traumatic brain injury were randomly divided into the comprehensive treatment group (58 cases),the sub-hypothermia group (30 cases) and the HBO group (30 cases).Fifty-eight patients in the comprehensive treatment group had sub-hypothermia and HBO treatment,in addition to routine drug therapy; the patients in the sub-hypothermia group were treated with sub-hypothermia in addition to routine drug therapy; and the patients in the HBO groups received HBO therapy in addition to routine drug therapy.Glasgow coma scale (GCS) scores,Glasgow outcome scale (GOS) scores and therapeutic effects were closely observed and compared both before and after treatment between the 3 groups.Results Analyses indicated that total efficacy for the comprehensive treatment group was 93.16％,which was higher that of the sub-hypothermia group (66.7％) and the HBO group (76.7％),with statistical significance(P ＜ 0.05),when comparisons were made between the 3 groups.Before therapy,there were significant differences in the GCS scores for the 3 groups (P ＞ 0.05).Following treatment with respective protocols,GCS scores for the 3 groups all increased to some extent,and differences could be uoted in statistical significance,when comparisons were made between pre-therapy and post-therapy (P ＜ 0.05).Following treatment,GCS and GOS scores for the comprehensive treatment group were obviously higher than those of the sub-hypothermia group and the HBO group,and there were statistical differences when comparisons were made between the 3 groups (P ＜ 0.05).Conclusions Early application of sub-hypothermia and timely treatment with HBO could significantly improve the therapeutic effects on patients with severe traumatic brain injury,decrease mortality,reduce incidence of neural function disorder after severe traumatic brain injury and the incidence of sequelae,and at the same time could improve the life quality ofthe patients.

Objective To explore the therapeutic effects of sub-hypothermia and hyperbaric oxygen (HBO) combined with drugs in the treatment of patients with severe traumatic brain injury in the high plateau region and possible mechanism involved.Methods With the knowledge and consent of the patients and following the approval of the ethics committee,118 patients with severe traumatic brain injury were randomly divided into the comprehensive treatment group (58 cases),the sub-hypothermia group (30 cases) and the HBO group (30 cases).Fifty-eight patients in the comprehensive treatment group had sub-hypothermia and HBO treatment,in addition to routine drug therapy; the patients in the sub-hypothermia group were treated with sub-hypothermia in addition to routine drug therapy; and the patients in the HBO groups received HBO therapy in addition to routine drug therapy.Glasgow coma scale (GCS) scores,Glasgow outcome scale (GOS) scores and therapeutic effects were closely observed and compared both before and after treatment between the 3 groups.Results Analyses indicated that total efficacy for the comprehensive treatment group was 93.16％,which was higher that of the sub-hypothermia group (66.7％) and the HBO group (76.7％),with statistical significance(P ＜ 0.05),when comparisons were made between the 3 groups.Before therapy,there were significant differences in the GCS scores for the 3 groups (P ＞ 0.05).Following treatment with respective protocols,GCS scores for the 3 groups all increased to some extent,and differences could be uoted in statistical significance,when comparisons were made between pre-therapy and post-therapy (P ＜ 0.05).Following treatment,GCS and GOS scores for the comprehensive treatment group were obviously higher than those of the sub-hypothermia group and the HBO group,and there were statistical differences when comparisons were made between the 3 groups (P ＜ 0.05).Conclusions Early application of sub-hypothermia and timely treatment with HBO could significantly improve the therapeutic effects on patients with severe traumatic brain injury,decrease mortality,reduce incidence of neural function disorder after severe traumatic brain injury and the incidence of sequelae,and at the same time could improve the life quality ofthe patients.

BACKGROUND: Recently, some people believed that the mechanisms of primary hepatic carcinoma might be caused by poor differentiation or disdifferentiation of hepatic stem cells. Studies on hepatic stem cells are in the early stage at present, and the theory of "stem cell origins" of human primary hepatic carcinoma deserves further verification. OBJECTIVE: To investigate the activation, distribution, origin and immunological expression characteristics of hepatic stem cells in different histopathologic types of primary hepatic carcinoma. DESIGN: Observational comparative study. SETTING: Tumor Center, Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA. PARTICIPANTS: Experiments were performed at the Laboratory of Tumor Center, Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA from September 2003 to July 2004. We took 94 cases of hepatic cellular cancer, 12 cases of intrahepatic cholangiocellular carcinoma and 10 cases of mixed hepatocarcinoma paraffin-embedded tissue blocks as research objects, with 5 cases of liver cirrhosis and 4 cases of normal liver as experimental control. These materials were collected from the archive of the Department of Pathology of Daping Hospital. Primary hepatic carcinoma tissues and corresponding adjacent liver tissues were obtained from patients who had undergone surgery for the removal of their tumors. All the patients were not treated by chemotherapy or radiotherapy before the operation. They had signed the informed consent. Main Antibodies were bought from Santa Cruz Company.METHODS: The histological and immunohistochemical characteristics were examined by haematoxylin and eosin staining and immunohistochemistry (SP method), including mouse antihuman cytokeratin 19 monoclonal antibody, mouse antihuman cytokeratin 7 monoclonal antibody, mouse antihuman cytokeratin 8&&18 monoclonal antibody, mouse antihuman c-kit monoclonal antibody, mouse antihuman Thy-1 monoclonal antibody, mouse antihuman alpha fetoprotein monoclonal antibody. MAIN OUTCOME MEASURES: Expression of immunological markers of hepatic stem cells in different histopathologic types. RESULTS: Immunological markers of hepatic stem cells expressed variously in different histopathologic types of primary hepatic carcinoma. Hepatic stem cells differentiated into hepatoma carcinoma cells in all the types. The highest expression rate of hepatic stem cell immunophenotype was found in the mixed hepatocarcinoma (P < 0.05). Immunophenotypes of hepatic stem cells were negative in normal group and cirrhosis group. CONCLUSION: Hepatic stem cells of varied differentiations and origins existed in different histopathologic types of primary hepatic carcinoma.