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.

BACKGROUND:Free vascularized fibular grafting is an effective hip preservation treatment for femoral head osteonecrosis,but its influencing factors are still controversial. OBJECTIVE:To explore the clinical efficacy of free vascularized fibular grafting for femoral head osteonecrosis,and the influence of the etiology and severity of femoral head osteonecrosis on its efficacy. METHODS:Clinical data and clinical efficacy scores of preoperative and postoperative hip joints in 63 patients with femoral head osteonecrosis(73 cases of hip)were enrolled.The subjects were divided into three groups by the etiological classification criteria of femoral head osteonecrosis,including glucocorticoid-associated,alcohol-associated,and idiopathic groups,and also were divided into three groups by the Ficat classification system,including Ficat Ⅱ,Ficat Ⅲ and Ficat Ⅳ groups.The effects of etiological classification and lesion degree on the clinical efficacy of free vascularized fibular grafting for femoral head osteonecrosis were analyzed. RESULTS AND CONCLUSION:(1)The visual analog scale scores in all periods after free vascularized fibular grafting for femoral head osteonecrosis were significantly decreased compared with preoperative data(P<0.001),and Harris scores were significantly increased compared with preoperative data(P<0.001).(2)In the glucocorticoid-associated,alcohol-associated,and idiopathic groups,except the glucocorticoid-associated group,postoperative Harris scores were significantly increased 2 and 3 years after surgery in other groups compared with preoperative data(P<0.05).(3)In the three groups of Ficat Ⅱ,Ficat Ⅲ,and Ficat Ⅳ,the postoperative Harris scores of Ficat Ⅱ and Ficat Ⅲ groups were significantly increased compared with preoperative data(P<0.05),while the difference was not significant in the Ficat Ⅳ group between the preoperative and postoperative data(P>0.05).(4)These results indicate that the clinical effect of free vascularized fibular grafting for the femoral head osteonecrosis is significant,which can reduce hip pain and improve hip joint function.It may not be affected by the etiology,but by the severity of the femoral head osteonecrosis.

Objective To investigate the clinical efficacy of Zhuangjin Yangxue decoction on Hepple stage Ⅰ and Ⅱ of osteochondral lesion of the talus(OLT).Methods From February 2021 to December 2022,a total of 62 cases of OLT were seleted from the Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine.According to random number table method,the patients were divided into observation group and control group,with 31 cases in each group.The control group was treated with Western medicine,and the observation group received an additional treatment of Zhuangjin Yangxue decoction alongside with Western medicine.Serum matrix metalloproteinase 13(MMP-13),tumor necrosis factor-α(TNF-α),ankle visual analogue scale(VAS)score,American Orthopedic Foot and Ankle Society(AOFAS)ankle-hind foot function score,TCM syndrome score and magnetic resonance observation of cartilage repair tissue(MOCART)score before and after treatment were compared between two groups.Results After 5 weeks and 3 months of treatment,MMP-13,TNF-α,VAS score and TCM syndrome score in two groups were significantly lower than before treatment,and AOFAS ankle-hind foot function score and MOCART score were significantly higher than before treatment(P<0.05).MMP-13,TNF-α and TCM syndrome scores in observation group were significantly lower than those in control group,and MOCART score was significantly higher than that in control group(P<0.05).After 5 weeks of treatment,VAS score of observation group was significantly lower than that of control group,and AOFAS ankle-hind foot function score was significantly higher than that of control group(P<0.05).Conclusion Zhuangjin Yangxue decoction shows a good short-term efficacy in treating Hepple stage Ⅰ and Ⅱ of OLT,with anti-inflammatory and analgesic effects,improved joint function,and promotion of cartilage repair.

Objective To evaluate left ventricular wall motion changes after successful pereutaneous coronary artery intervention (PCI) in patients with acute myocardial infarction (MI) by velocity vector imaging (VVI). Methods Twenty patients with acute MI, 16 anterior MI and 4 inferior MI,were studied by VVI within 3 days before PCI, 1 week and 3 months after PCI. The VVI parameters included peak systolic myocardial velocity (Vsys), peak systolic strain (εsys), maximal strain (εmax), peak systolic strain rate ( SRsys), isovolumic relaxation strain rate(SRivr),segmental ejection fraction (sEF), time to peak of velocity (TPKvel),and time to peak of strain (TPKε). Results Compared with that before PCI,εsys, SRsys, sEF, PSI, SRivr/SRsys, and TPKε were improved one week after PCI,and were further significantly improved at 3 months follow-up. Conclusions The VVI parameters can be used to evaluate the effectiveness of PCI shortly after the procedure and during long-term follow-up.

Objective:To study the relationship between the recurrence of benign meningiomas and cell proliferation, and to find some parameters that can predict the recurrence of benign meningiomas. Methods:49 samples from 15 recurrent benign meningiomas and 22 non recurrent benign meningimas were immunohistochemically stained with PCNA antibody and Ki 67 antibody.The ratios of positive tumor cells were calculated,then PCNA LI and Ki 67 LI of different groups were compared. Results:PCNA LI or Ki 67 LI in recurrent benign meningiomas was significantly higher than non recurent benign meningiomas individually( P 0.05). Conclusion:The proliferative potential of recurrent benign meningiomas was higher than that of non recurrent benign meningiomas.When the PCNA LI was greater than 2.0%,the recurrent risk was high.The proliferative potential did not increase when benign meningiomas recurred.

The apparatus introduced in this paper can be used to measure and record the realtime environmental parameters and such physical information of individual protection equipment as the temperature,thermal current and thermal insulating value.The apparatus has several advantages including high accuracy,practicability,reliability and easy to operate.