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.

Hearing loss is the most prevalent disabling disease. Cochlear implantation（CI） serves as the primary intervention for severe to profound hearing loss. This consensus systematically explores the value of genetic diagnosis in the pre-operative assessment and efficacy prognosis for CI. Drawing upon domestic and international research and clinical experience, it proposes an evidence-based medicine three-tiered prognostic classification system（Favorable, Marginal, Poor）. The consensus focuses on common hereditary non-syndromic hearing loss（such as that caused by mutations in genes like GJB2, SLC26A4, OTOF, LOXHD1） and syndromic hereditary hearing loss（such as Jervell & Lange-Nielsen syndrome and Waardenburg syndrome）, which are closely associated with congenital hearing loss, analyzing the impact of their pathological mechanisms on CI outcomes. The consensus provides recommendations based on multiple round of expert discussion and voting. It emphasizes that genetic diagnosis can optimize patient selection, predict prognosis, guide post-operative rehabilitation, offer stratified management strategies for patients with different genotypes, and advance the application of precision medicine in the field of CI.
Humans ; Cochlear Implantation ; Prognosis ; Hearing Loss/surgery* ; Consensus ; Connexin 26 ; Mutation ; Sulfate Transporters ; Connexins/genetics*

Objective:To explore the efficacy of indocyanine green angiography (ICGA) in preventing flap perfusion disorders after liposuction combined with abdominoplasty.Methods:A retrospective analysis was conducted on the clinical data of patients who underwent liposuction combined with abdominoplasty and used ICGA to evaluate flap perfusion in the Department of Plastic Surgery, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from March 2022 to March 2024. After the incision was sutured, 2 ml of indocyanine green solution (2.5 mg/ml) was intravenously injected, and a fluorescence angiography imaging system was used to observe perfusion in the distal flap and the suture site. Lack of fluorescence within 3 minutes after injection indicated local hypoperfusion. Flap perfusion was observed on the 1st, 2nd, and 3rd days after surgery, and compared with intraoperative ICGA results.Results:A total of 52 female patients were included, aged 29-55 years, with an average age of 33.8 years. The size of the flap excised during surgery ranged from 12 cm×29 cm to 19 cm×42 cm, and the liposuction volume was 300-1 400 ml. Among the 52 patients, 3 cases showed blood supply disorders in the central area of the distal flap during intraoperative ICGA examination. Timely release was performed, but there was still obvious tension in the distal flap. All 3 cases developed distal flap hypoperfusion after surgery, with sizes ranging from 3 cm×3 cm to 7 cm×5 cm. The range was basically consistent with the area shown by ICGA. After dressing changes, the flaps healed well. During a 12-month follow-up, the three patients reported no wound discomfort or dissatisfaction with the appearance. The ICGA images of the remaining 49 patients were good during the operation, and the blood supply of the flaps was good after the operation. After a 12-month follow-up, the abdominal appearance of 52 patients was satisfactory.Conclusion:ICGA for evaluating flap blood supply in liposuction combined with abdominoplasty has the advantages of simple operation, fast imaging speed, and high diagnostic accuracy. It has application prospects in preventing flap necrosis after liposuction combined with abdominoplasty.

Objective:To explore the efficacy of indocyanine green angiography (ICGA) in preventing flap perfusion disorders after liposuction combined with abdominoplasty.Methods:A retrospective analysis was conducted on the clinical data of patients who underwent liposuction combined with abdominoplasty and used ICGA to evaluate flap perfusion in the Department of Plastic Surgery, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from March 2022 to March 2024. After the incision was sutured, 2 ml of indocyanine green solution (2.5 mg/ml) was intravenously injected, and a fluorescence angiography imaging system was used to observe perfusion in the distal flap and the suture site. Lack of fluorescence within 3 minutes after injection indicated local hypoperfusion. Flap perfusion was observed on the 1st, 2nd, and 3rd days after surgery, and compared with intraoperative ICGA results.Results:A total of 52 female patients were included, aged 29-55 years, with an average age of 33.8 years. The size of the flap excised during surgery ranged from 12 cm×29 cm to 19 cm×42 cm, and the liposuction volume was 300-1 400 ml. Among the 52 patients, 3 cases showed blood supply disorders in the central area of the distal flap during intraoperative ICGA examination. Timely release was performed, but there was still obvious tension in the distal flap. All 3 cases developed distal flap hypoperfusion after surgery, with sizes ranging from 3 cm×3 cm to 7 cm×5 cm. The range was basically consistent with the area shown by ICGA. After dressing changes, the flaps healed well. During a 12-month follow-up, the three patients reported no wound discomfort or dissatisfaction with the appearance. The ICGA images of the remaining 49 patients were good during the operation, and the blood supply of the flaps was good after the operation. After a 12-month follow-up, the abdominal appearance of 52 patients was satisfactory.Conclusion:ICGA for evaluating flap blood supply in liposuction combined with abdominoplasty has the advantages of simple operation, fast imaging speed, and high diagnostic accuracy. It has application prospects in preventing flap necrosis after liposuction combined with abdominoplasty.

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.

Objective To investigate the clinical characteristics,treatment methods,and prognosis of a-cute leukemia patients with extramedullary infiltration.Methods The clinical characteristics and treatment methods of 47 acute leukemia patients with extramedullary infiltration admitted to the Affiliated Hospital of Guizhou Medical University from April 2014 to April 2023 were retrospectively analyzed.Subgroup analysis was performed according to whether there was extramedullary infiltration before transplantation,and whether there was isolated extramedullary recurrence after transplantation.Based on this analysis,the patients were di-vided into the pre-transplantation radiotherapy group and pre-transplantation non-radiotherapy group,the post-transplantation radiotherapy group and post-transplantation non-radiotherapy group.According to the treatment methods of central nervous system leukemia(CNSL),the patients were divided into the intrathecal injection group(n=12)and combination of intrathecal injection and radiotherapy group(n=13).The local remission situation,survival duration,and toxic and side effects of radiotherapy and chemotherapy were com-pared.Results For acute leukemia patients with extramedullary infiltration,the overall survival time(OS)in the radiotherapy group was better than that in the non-radiotherapy group(median OS:706 d vs.151 d,P=0.015).Subgroup analysis showed that the OS of the pre-transplantation radiotherapy group was better than that of the pre-transplantation non-radiotherapy group(median OS:592 d vs.386 d,P=0.035).For CNSL,the combination of intrathecal injection and radiotherapy group had a better OS than the intrathecal injection group(median OS:547 d vs.388 d,P=0.045).The event-free survival time(EFS)of the radiotherapy group was better than that of the non-radiotherapy group(median EFS:175 d vs.50 d,P=0.005).The COX pro-portional-hazards model showed that treatment with or without radiotherapy had a significant impact on the OS of acute leukemia patients with extramedullary infiltration.The risk of death in the pre-transplantation non-radiotherapy group was 2.231 times higher than that in the pre-transplantation radiotherapy group(HR=3.231,95％CI:1.021-10.227,P=0.046).Compared with the non-radiotherapy group,the radiother-apy group had a higher local remission and a lower risk of haematological toxicity,infection,and haemorrhage.Conclusion Radiotherapy can rapidly alleviate the local symptoms of acute leukemia complicated with extr-amedullary infiltration,prolong the survival time of these patients,and reduce the risk of hematologic toxicity,infection,and haemorrhage.

Objective:To investigate the abdominal function and aesthetics outcomes of patients with abdominally based breast reconstruction.Methods:In this research, we retrospectively analyzed the cases of breast reconstruction in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from July 2013 to June 2018. In accordance with the inclusion and exclusion criteria, patients undergoing breast reconstruction by deep inferior epigastric perforator flap (DIEP) or muscle-sparing transverse rectus abdominis myocutaneous flap (TRAM) were included in the study. A questionnaire was designed to evaluate the patient’s abdominal strength, and the BREAST-Q breast reconstruction abdominal health module was used to assess the patient’s satisfaction degree with the abdomen. SPSS 21.0 statistical software was used to analyze the data. The independent-samples t test is used for comparison between the two groups; the matched-samples t test is used for the preoperative and postoperative comparison of a single group. P<0.05 indicates that the difference is statistically significant. Results:A total of 32 patients were enrolled, including 17 cases of DIEP breast reconstruction, aged 43.6±9.2 years old, and 15 cases of TRAM breast reconstruction, aged 41.0±10.1 years old. The postoperative follow-up period ranged from 12 to 73 months, with an average of 41.5 months. Preoperative abdominal wall strength scores in the DIEP group and the TRAM group were 4.71±0.47 and 4.60±0.50 , respectively, and there were on significant difference between two groups. Three months after operation, the abdominal wall strength of the DIEP group scored 2.65±0.86, which was higher than the score in the TRAM group(1.93±0.70) ( P<0.05). The scores of the two groups were significantly different from those before operation ( P<0.01). One year after the operation, the abdominal wall strength of DIEP group scored 4.65±0.49, which was significantly higher than the score in TRAM group (4.07±0.88)( P<0.05). There was no significant difference between the scores of DIEP group and those before operation ( P>0.05), however, the scores of TRAM group were significantly different from those before surgery ( P<0.05). One year after operation, the appearance of the abdomen was not significantly different between the preoperative and postoperative score in both two groups ( P>0.05). Preoperative abdominal satisfaction scores of the DIEP group and the TRAM group were 86.53±5.68 and 85.87±7.31, respectively, and there was no significant difference between two groups ( P>0.05). Three months after the operation, the abdominal satisfaction score of the DIEP group was 76.41±7.74, which was higher than the score in the TRAM group(68.00±9.08) ( P<0.01). The scores of the two groups were compared with those before surgery, and the differences were statistically significant ( P<0.01). One year after the operation, the abdominal satisfaction score was 85.00±5.32 in the DIEP group and 82.93±6.12 in the TRAM group, showing no statistical significance between two groups ( P>0.05). There was no significant difference between the scores of DIEP group and those before operation ( P>0.05), however, the scores of TRAM group were significantly different from those before surgery ( P<0.05). Conclusions:The study demonstrates that both two kinds of abdominal flaps can obtain a better abdominal appearance. The long-term abdominal function and abdominal satisfaction of patients undergoing breast reconstruction with DIEP flaps can return to the baseline levels, however, that of TRAM flaps can not return to the baseline levels. Further research is needed for the longer term results.

Objective:To investigate the influences of different amounts of negative pressure on postoperative drainage volume for patients undergoing axillary endoscopic augmentation mammoplasty.Methods:According to the random number table, patients who were admitted to the Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology for augmentation mammoplasty between January 1st, 2018 and May 31st, 2019 were randomly grouped into high negative pressure group and low negative pressure group respectively. In the high negative pressure group, -90 kPa negative pressure was applied through a 600 ml negative pressure drainage bottle. In the low negative pressure group, -10 to -16 kPa negative pressure was applied through a 200 ml negative pressure drainage ball. Total drainage volume, drainage volume per day, drainage placement time, incidence and types of complications were recorded. Independent sample t-test or the rank-sum test for two independent samples was applied for comparison between groups. Results:A total of 56 patients who met the inclusion criteria were divided into high negative pressure group(age 28.2±4.1 years) and low negative pressure group(age 27.0±3.3 years). Patients’ BMI was (19.2±1.4) kg/m 2 in the high negative pressure group and (19.1±1.2) kg/m 2 in the low negative pressure group. Implant volume was (249.2±24.9) ml in the high negative pressure group and (257.5±23.8) ml in the low negative pressure group. There was no significant difference in baseline data between 2 groups ( P>0.05). There were significant differences in the daily drainage volume per breast (except for the third day), total drainage volume per breast and the duration of drainage placement between the two groups. The duration of drainage placement was 5.9±0.9 days in the high negative pressure group and 4.8±1.1 days in the low negative pressure group. Total drainage volume per breast was (336.4±86.7) ml in the high negative pressure group and (233.5±43.8) ml in the low negative pressure group. Patients were followed up for 12 months. No hematoma, seroma, inflammation or capsular contracture occurred in either group. One patient(3.6%) suffered breast implant displacement in the high negative pressure group and had revisional surgery. Conclusions:Lower negative pressure (-10 to -16 kPa) was associated with less drainage volume and shorter drainage placement time compared to higher negative pressure (-90 kPa) in patients undergoing axillary endoscopic augmentation mammoplasty.

Objective:To investigate the abdominal function and aesthetics outcomes of patients with abdominally based breast reconstruction.Methods:In this research, we retrospectively analyzed the cases of breast reconstruction in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from July 2013 to June 2018. In accordance with the inclusion and exclusion criteria, patients undergoing breast reconstruction by deep inferior epigastric perforator flap (DIEP) or muscle-sparing transverse rectus abdominis myocutaneous flap (TRAM) were included in the study. A questionnaire was designed to evaluate the patient’s abdominal strength, and the BREAST-Q breast reconstruction abdominal health module was used to assess the patient’s satisfaction degree with the abdomen. SPSS 21.0 statistical software was used to analyze the data. The independent-samples t test is used for comparison between the two groups; the matched-samples t test is used for the preoperative and postoperative comparison of a single group. P<0.05 indicates that the difference is statistically significant. Results:A total of 32 patients were enrolled, including 17 cases of DIEP breast reconstruction, aged 43.6±9.2 years old, and 15 cases of TRAM breast reconstruction, aged 41.0±10.1 years old. The postoperative follow-up period ranged from 12 to 73 months, with an average of 41.5 months. Preoperative abdominal wall strength scores in the DIEP group and the TRAM group were 4.71±0.47 and 4.60±0.50 , respectively, and there were on significant difference between two groups. Three months after operation, the abdominal wall strength of the DIEP group scored 2.65±0.86, which was higher than the score in the TRAM group(1.93±0.70) ( P<0.05). The scores of the two groups were significantly different from those before operation ( P<0.01). One year after the operation, the abdominal wall strength of DIEP group scored 4.65±0.49, which was significantly higher than the score in TRAM group (4.07±0.88)( P<0.05). There was no significant difference between the scores of DIEP group and those before operation ( P>0.05), however, the scores of TRAM group were significantly different from those before surgery ( P<0.05). One year after operation, the appearance of the abdomen was not significantly different between the preoperative and postoperative score in both two groups ( P>0.05). Preoperative abdominal satisfaction scores of the DIEP group and the TRAM group were 86.53±5.68 and 85.87±7.31, respectively, and there was no significant difference between two groups ( P>0.05). Three months after the operation, the abdominal satisfaction score of the DIEP group was 76.41±7.74, which was higher than the score in the TRAM group(68.00±9.08) ( P<0.01). The scores of the two groups were compared with those before surgery, and the differences were statistically significant ( P<0.01). One year after the operation, the abdominal satisfaction score was 85.00±5.32 in the DIEP group and 82.93±6.12 in the TRAM group, showing no statistical significance between two groups ( P>0.05). There was no significant difference between the scores of DIEP group and those before operation ( P>0.05), however, the scores of TRAM group were significantly different from those before surgery ( P<0.05). Conclusions:The study demonstrates that both two kinds of abdominal flaps can obtain a better abdominal appearance. The long-term abdominal function and abdominal satisfaction of patients undergoing breast reconstruction with DIEP flaps can return to the baseline levels, however, that of TRAM flaps can not return to the baseline levels. Further research is needed for the longer term results.

Objective:To investigate the influences of different amounts of negative pressure on postoperative drainage volume for patients undergoing axillary endoscopic augmentation mammoplasty.Methods:According to the random number table, patients who were admitted to the Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology for augmentation mammoplasty between January 1st, 2018 and May 31st, 2019 were randomly grouped into high negative pressure group and low negative pressure group respectively. In the high negative pressure group, -90 kPa negative pressure was applied through a 600 ml negative pressure drainage bottle. In the low negative pressure group, -10 to -16 kPa negative pressure was applied through a 200 ml negative pressure drainage ball. Total drainage volume, drainage volume per day, drainage placement time, incidence and types of complications were recorded. Independent sample t-test or the rank-sum test for two independent samples was applied for comparison between groups. Results:A total of 56 patients who met the inclusion criteria were divided into high negative pressure group(age 28.2±4.1 years) and low negative pressure group(age 27.0±3.3 years). Patients’ BMI was (19.2±1.4) kg/m 2 in the high negative pressure group and (19.1±1.2) kg/m 2 in the low negative pressure group. Implant volume was (249.2±24.9) ml in the high negative pressure group and (257.5±23.8) ml in the low negative pressure group. There was no significant difference in baseline data between 2 groups ( P>0.05). There were significant differences in the daily drainage volume per breast (except for the third day), total drainage volume per breast and the duration of drainage placement between the two groups. The duration of drainage placement was 5.9±0.9 days in the high negative pressure group and 4.8±1.1 days in the low negative pressure group. Total drainage volume per breast was (336.4±86.7) ml in the high negative pressure group and (233.5±43.8) ml in the low negative pressure group. Patients were followed up for 12 months. No hematoma, seroma, inflammation or capsular contracture occurred in either group. One patient(3.6%) suffered breast implant displacement in the high negative pressure group and had revisional surgery. Conclusions:Lower negative pressure (-10 to -16 kPa) was associated with less drainage volume and shorter drainage placement time compared to higher negative pressure (-90 kPa) in patients undergoing axillary endoscopic augmentation mammoplasty.