Search

The pollution of sediments around Lu Ban Island is a serious environmental issue that is threatening human health. The concentration of As, Cd, Cu, Cr, Hg, Ni, Pb, and Zn at 73 layer points were investigated, vertical distribution characteristics, correlation among potential toxic elements and potential ecological risks of sediments at different depth were analyzed. The following results were obtained, (1) the hypothesis that there was a linear relationship between concentration of potential toxic elements and the reciprocal of deep was reasonable. Based on hypothesis, the ultimate value of concentration by making depth go to infinity was regarded as the background concentration. The background concentration of As, Cd, Cu, Cr, Hg, Ni, Pb, and Zn are respectively 4.94 mg/kg, 0.20 mg/kg, 15.48 mg/kg, 58.41 mg/kg, 0.062 mg/kg, 26.96 mg/kg, 20.29 mg/kg, and 53.31 mg/kg. (2) But correlation between Ni and As was relatively weak, high degree of correlation among other potential toxic elements were found. Based on their correlation, eight potential toxic elements were classified into three groups. First group included Ni and Cr, mainly releasing by coal burning; Cu, Pb, Zn, Hg, and Cd were grouped together, possibly due to their shared source of fish cage culture; Arsenic with relatively weak correlation with other potential toxic elements was classified as a separate class, which was usually one important mineral resource associated with phosphate. (3) Potential ecological risk index (PERI) of sediment above − 0.40 m belonged to moderate risk, the PERI of sediment in − 0.10 m, − 0.20 m, and − 0.40 m were 289.06, 254.33, and 201.44, respectively. Sediment below − 0.40 m belonged to low risk with average PERI value 112.82, with no significant changes in PERI values. The order of contribution to PERI was Hg > Cd > As > Cu > Pb > Ni > Cr > Zn. (4) According to result of cluster analysis and potential ecological risk, the potential ecological risk of sediment above − 0.40 m mainly contributed by potential toxic elements of Cu, Cd, Hg, Pb, and Zn sharing source of fish cage culture.

Abstract Few studies have investigated factors associated with acute postsurgical pain (APSP) trajectories, and whether the APSP trajectory can predict chronic postsurgical pain (CPSP) remains unclear. We aimed to identify the predictors of APSP trajectories in patients undergoing gastrointestinal surgery. Moreover, we hypothesised that APSP trajectories were independently associated with CPSP. We conducted a prospective cohort study of 282 patients undergoing gastrointestinal surgery to describe APSP trajectories. Psychological questionnaires were administered 1 day before surgery. Meanwhile, demographic characteristics and perioperative data were collected. Average pain intensity during the first 7 days after surgery was assessed by a numeric rating scale (NRS). Persistent pain intensity was evaluated at 3 and 6 months postoperatively by phone call interview. CPSP was defined as pain at the incision site or surrounding areas of surgery with a pain NRS score ≥ 1 at rest. The intercept and slope were calculated by linear regression using the least squares method. The predictors for the APSP trajectory and CPSP were determined using multiple linear regression and multivariate logistic regression, respectively. Body mass index, morphine milligram equivalent (MME) consumption, preoperative chronic pain and anxiety were predictors of the APSP trajectory intercept. Moreover, MME consumption and preoperative anxiety could independently predict the APSP trajectory slope. The incidence of CPSP at 3 and 6 months was 30.58% and 16.42% respectively. APSP trajectory and age were predictors of CPSP 3 months postoperatively, while female sex and preoperative anxiety were predictive factors of CPSP 6 months postoperatively. Preoperative anxiety and postoperative analgesic consumption can predict APSP trajectory. In addition, pain trajectory was associated with CPSP. Clinicians need to stay alert for these predictors and pay close attention to pain resolution.

Abstract In recent years, circular RNA (circRNA) has been found to be involved in a variety of cancer processes. More and more attention has been paid to the research of circRNA in lung cancer. This study aims to investigate whether circ_0000517 affected the physiology of non‐small cell lung cancer (NSCLC) and the underlying mechanism. The results demonstrated that circ_0000517 was highly expressed in lung cancer tissues and cells, and overexpression of circ_0000517 was negatively correlated with the prognosis of NSCLC patients. Silencing of circ_0000517 significantly inhibited the proliferation, glycolysis, and glutamine decomposition of NSCLC cells in vitro and repressed the growth of xenografted tumors in vivo. Moreover, knockdown of circ_0000517 attenuated the expression of PCNA, HK2, LDHA, ASCT2, and GLS1. Further study found that circ_0000517 targeted miR‐330‐5p and miR‐330‐5p targeted YY1. In addition, miR‐330‐5p inhibitor reversed inhibition of cancer cell proliferation, glycolysis, and glutamine decomposition induced by si‐circ_0000517. In conclusion, our study revealed that silencing of circ_0000517 improved the progression of NSCLC through regulating miR‐330‐5p/YY1 axis.

ObjectiveWe performed this systemic review to investigate the therapeutic potential and safety of adjunctive accelerated repetitive transcranial magnetic stimulation (aTMS) for older patients with depression.MethodsWe included published randomized clinical trials (RCTs) and observational studies targeting adjunctive aTMS for older patients with depression.ResultsTwo open-label self-controlled studies (n = 29) fulfilled the criteria for inclusion. The included studies reported significant improvements in depressive symptoms from baseline to post-aTMS (all Ps < 0.05). One study reported a dropout rate of 10.5% (2/19). Mild headache was the most common adverse reaction.ConclusionThe currently available evidence from two open-label self-controlled studies indicates that adjunctive aTMS is a safe and effective therapy for older patients with depression.

Background: The diagnosis of hypertension should be based on the mean of two or more properly measured BP readings on each of two visits for clinical practice, but a one-visit strategy was applied in most epidemiological surveys. The impact of hypertension definition based on two visits on estimates of hypertension burden is unknown. This study aims to assess the impact of hypertension diagnosis based on a two-visit strategy for estimating hypertension burden in China. Methods: The one-visit and two-visit strategies were applied to investigate the incidence of hypertension in a cohort study based on the China Health and Nutrition Survey (CHNS) 1989–2011. Additionally the prevalence of hypertension was investigated in a cross-sectional study based on the CHNS 2006–2009/2011 and the hypertension burden in China was estimated with data from the 2012–2015 China hypertension survey. Results: Overall, the age-adjusted incidence of hypertension based on the two-visit strategy (1.82%; 95% confidence interval [CI], 1.74–1.90%) was 62.1% lower than estimation based on the one-visit strategy (4.80%; 95% CI, 4.68–4.93%). Similar results were found in the prevalence of hypertension (one-visit: 18.13% [95% CI, 17.34–18.92%]; two-visit: 9.47% [95% CI, 8.87–10.07%]). When the two-visit strategy was applied to the 2012–2015 China hypertension survey, the hypertension burden was predicted to be overestimated by 25.5–47.8% (based on JNC 7) and 23.5–48.2% (based on the 2017 ACC/AHA). Conclusion: The hypertension burden would decrease from 244.5 million persons to 127.5–182.3 million persons in China if the two-visit strategy was applied.

It is important to predict the capacity related parameters of reservoir such as brittleness, total organic carbon (TOC), in-situ stress, maturity of organic carbon (Ro), and buried depth in shale gas exploration and exploitation. Among these parameters, brittleness and TOC are especially important for shale gas exploitation. The complex resistivity measurement and analysis show that the rich organic shale in southern China features low resistivity and high chargeability. These characteristics are a geophysical prerequisite for predicting the sweet spot characteristic parameters of shale, such as TOC and brittleness, with rapid developing of high resolution controlled source electromagnetic (CSEM) method prospecting which can give resistivity and chargeability distribution of underground. Based on the rich organic shale composition analysis and complex resistivity measurements in southern China, this paper analysed the presence of pyrite as an associated mineral in organic-rich shale, and examined its relationship to resistivity, chargeability, TOC content and brittleness, and the quantitative relationship between the models has been established. Therefore, this study provides a firm experimental foundation for predicting parameters of shale sweet spots with CSEM prospecting.

Objective: The efficacy and safety of adjunctive magnetic seizure therapy (MST) for patients with schizophrenia are unclear. This systematic review was conducted to examine the efficacy and safety of adjunctive MST for schizophrenia.Methods: Chinese (WanFang and Chinese Journal Net) and English (PubMed, EMBASE, PsycINFO, and the Cochrane Library) databases were systematically searched.Results: Two open-label self-controlled studies (n = 16) were included and analyzed in this review. In these studies, the Positive and Negative Syndrome Scale (PANSS) total scores and Brief Psychiatric Rating Scale (BPRS) total scores significantly decreased from baseline to post-MST (all Ps < 0.05), without serious adverse neurocognitive effects. Mixed findings on the neurocognitive effects of adjunctive MST for schizophrenia were reported in the two studies. A discontinuation rate of treatment of up to 50% (4/8) was reported in both studies. The rate of adverse drug reactions (ADRs) was evaluated in only one study, where the most common ADRs were found to be dizziness (25%, 2/8) and subjective memory loss (12.5%, 1/8).Conclusion: There is inconsistent evidence for MST-related adverse neurocognitive effects and preliminary evidence for the alleviation of psychotic symptoms in schizophrenia.

Background. Quadratus lumborum block (QLB) has been used to reduce postoperative acute pain and opioid consumption. However, the efficacy of QLB on the quality of recovery (QoR) after gastrointestinal surgery has not been established. The aim of this study was to evaluate the ability of QLB to enhance the postoperative QoR in patients undergoing open gastrointestinal surgery. Methods. Eighty-four patients undergoing open gastrointestinal surgery were randomized to receive ultrasound-guided QLB with either 20 ml of 0.375% ropivacaine or saline. The primary outcome was the QoR-15 score at 24 h after surgery. The secondary outcomes were the postoperative pain intensity, opioid consumption, the incidence of nausea, vomiting, and chronic pain. Results. The global QoR-15 score at 24 h postoperatively was significantly higher in the QLB group than in the control group (mean difference: 16.9; 95% CI: 11.9–21.9). Additionally, the QoR-15 scores for five dimensions were significantly higher in the QLB group than in the control group. The cumulative oxycodone consumption was significantly lower in the QLB group during 0–6, 6–24, 0–24, 24–48, and 0–48 h postoperatively than in the control group. At rest or during coughing, the pain verbal rating scale scores were significantly lower at 1, 3, 6, 12, and 24 h after surgery in the QLB group than in the control group. The incidence of postoperative nausea was significantly different between the groups, but postoperative vomiting was not. Conclusion. Single-injection posteromedial QLB with ropivacaine enhanced the QoR at 48 h after surgery and improved analgesia during the early postoperative period in patients undergoing gastrointestinal surgery.

Background: The prevalence of overweight is increasing dramatically worldwide. The aim of our study was to investigate the association of plain water intake (PWI) with the risk of new-onset overweight risk among Chinese adults. Methods: A total of 3,200 adults aged 18–65 who were free of overweight at baseline were enrolled from China Health and Nutrition Survey (CHNS) cohort study in 2006–2011. The risk of new-onset overweight with different amounts of PWI per day was analyzed in this 5-year cohort. A multiple logistic regression model was used to assess the association of PWI and the risk of new-onset overweight and adjust for potential confounders. Moreover, dose-response models were developed to estimate the linear relationship. Results: During 5 years of follow-up, 1,018 incident cases were identified. Our analysis indicated an inverse association of more than 4 cups of PWI per day and the risk of new-onset overweight among normal weight individuals. Compared with participants who drank 2 to 3 cups PWI, the adjusted odds ratios (OR) of overweight were 0.741 (95% confidence interval [CI], 0.599–0.916) in participants who drank 4 to 5 cups PWI, and 0.547 (95% CI, 0.435–0.687) in participants who drank more than 6 cups PWI. The dose-response analysis showed that every cup of PWI was associated with a 6.5% and 8.4% decrease in the risk of new-onset overweight among men and women, respectively. The interactions of PWI and covariates on the risk of overweight were not found. Conclusion: Drinking more than 4 cups (≈1 liter) per day of plain water is associated with decrease in the risk of new-onset overweight among normal-weight individuals.

Background. Several predictors have been shown to be independently associated with chronic postsurgical pain for gastrointestinal surgery, but few studies have investigated the factors associated with acute postsurgical pain (APSP). The aim of this study was to identify the predictors of APSP intensity and severity through investigating demographic, psychological, and clinical variables. Methods. We performed a prospective cohort study of 282 patients undergoing gastrointestinal surgery to analyze the predictors of APSP. Psychological questionnaires were assessed 1 day before surgery. Meanwhile, demographic characteristics and perioperative data were collected. The primary outcomes are APSP intensity assessed by numeric rating scale (NRS) and APSP severity defined as a clinically meaningful pain when NRS ≥4. The predictors for APSP intensity and severity were determined using multiple linear regression and multivariate logistic regression, respectively. Results. 112 patients (39.7%) reported a clinically meaningful pain during the first 24 hours postoperatively. Oral morphine milligram equivalent (MME) consumption (β 0.05, 95% CI 0.03–0.07, p

Sterculia monosperma fruit is the dried and mature seed of Sterculia monosperma, which belongs to genus Sterculia. In China, this plant is a widely distributed arbor with a long planting history in Lingnan area. It is mainly cultivated in Guangdong, Guangxi, Fujian, Yunnan and Taiwan of China; it is also distributed in India, Vietnam and Indonesia, mostly cultivated artificially. S. monosperma fruit has many functions like warming the stomach and killing pests, but its name and characteristics are easily confused with other plants of genus Sterculia. However, the relevant research foundation is relatively weak. Pharmacognostical study can provide reference for its resource development and quality standard formulation. This study identifies the morphological and microscopic characteristics of S. monosperma fruit, as well as the microscopic identification of seed cross-section and powder. The DNA barcode sequences ITS2, psbA-trnH, matK and rbcL of S. monosperma were obtained through bidirectional sequencing, Kimura 2-Parameter (K2P) genetic distance was calculated, and the neighbor joining tree was established for clustering analysis. The results were as follows: (1) The morphological characteristics of S. monosperma fruit included dark red fruit shell and reddish brown or dark chestnut surface. It was hard in texture, with two thick yellowish endosperms inside. (2) The micro-morphological characteristics was that the exotesta was reddish brown, extremely thin, and brittle in texture; the mesotesta was black brown, thick, and hard in texture; the endotesta coat was light yellow and soft in texture. (3) The microscopic characteristics included the structure and arrangement of the exotesta stone cell, the grid cell structure of the mesotesta, the bead thickening of the cell wall of the endotesta cells, and the calcium oxalate cluster crystals. (4) Based on the ITS2 sequence, S. monosperma fruit could be effectively distinguished from other plants in genus Sterculia, while the matK sequence could effectively distinguish S. lanceolata from other plants in genus Sterculia. This study obtained the data on the morphological characteristics, micro-morphological characteristics and microscopic characteristics of S. monosperma fruit. Combined with the ITS2 barcode sequence, S. monosperma fruit can be effectively identified, which provides a scientific reference for the development of its germplasm resources and the formulation of relevant quality standards.

DNA barcoding based on a fragment of the cytochrome c oxidase subunit I (COI) gene in the mitochondrial genome is widely applied in species identification and biodiversity studies. The aim of this study was to establish a comprehensive barcoding reference database of fishes in the Taiwan Strait and evaluate the applicability of using the COI gene for the identification of fish at the species level. A total of 284 mitochondrial COI barcode sequences were obtained from 85 genera, 38 families and 12 orders of fishes. The mean length of the sequences was 655 base pairs. The average Kimura two parameter (K2P) distances within species, genera, families, orders and classes were 0.21%, 6.50%, 23.70% and 25.60%, respectively. The mean interspecific distance was 31-fold higher than the mean intraspecific distance. The K2P neighbor-joining trees based on the sequence generally clustered species in accordance with their taxonomic classifications. High efficiency of species identification was demonstrated in the present study by DNA barcoding, and we conclude that COI sequencing can be used to identify fish species.

BackgroundThe efficacy and safety of deep transcranial magnetic stimulation (dTMS) as an intervention for schizophrenia remain unclear. This systematic review examined the efficacy and safety of dTMS for schizophrenia.MethodsA systematic search of Chinese (WanFang and Chinese Journal Net) and English databases (PubMed, EMBASE, PsycINFO, and Cochrane Library) were conducted.ResultsThree randomized clinical trials (RCTs) comprising 80 patients were included in the analyses. Active dTMS was comparable to the sham treatment in improving total psychopathology, positive symptoms, negative symptoms, and auditory hallucinations measured by the Positive and Negative Syndrome Scale (PANSS), the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), and the Auditory Hallucinations Rating Scale (AHRS), respectively. Only one RCT reported the effects on neurocognitive function measured by the Cambridge Neuropsychological Test Automated Battery (CANTAB), suggesting that dTMS may only improve one Stockings of Cambridge measure (i.e., subsequent times for five move problems). All three studies reported overall discontinuation rates, which ranged from 16.7% to 44.4%. Adverse events were reported in only one RCT, the most common being tingling/twitching (30.0%, 3/10), head/facial discomfort (30.0%, 3/10), and back pain (20.0%, 2/10).ConclusionThis systematic review suggests that dTMS does not reduce psychotic symptoms in schizophrenia, but it shows potential for improving executive functions. Future RCTs with larger sample sizes focusing on the effects of dTMS on psychotic symptoms and neurocognitive function in schizophrenia are warranted to further explore these findings.

BackgroundIn randomized clinical trials (RCTs) investigating the application of transcranial alternating current stimulation (tACS) in schizophrenia, inconsistent results have been reported. The purpose of this exploratory systematic review of RCTs was to evaluate tACS as an adjunct treatment for patients with schizophrenia based on its therapeutic effects, tolerability, and safety.MethodsOur analysis included RCTs that evaluated adjunctive tACS’ effectiveness, tolerability, and safety in schizophrenia patients. Three independent authors extracted data and synthesized it using RevMan 5.3 software.ResultsThree RCTs involving 76 patients with schizophrenia were encompassed in the analysis, with 40 participants receiving active tACS and 36 receiving sham tACS. Our study revealed a significant superiority of active tACS over sham tACS in improving total psychopathology (standardized mean difference [SMD] = −0.61, 95% confidence interval [CI]: −1.12, −0.10; I2 = 16%, p = 0.02) and negative psychopathology (SMD = −0.65, 95% CI: −1.11, −0.18; I2 = 0%, p = 0.007) in schizophrenia. The two groups, however, showed no significant differences in positive psychopathology, general psychopathology, or auditory hallucinations (all p > 0.05). Two RCTs examined the neurocognitive effects of tACS, yielding varied findings. Both groups demonstrated similar rates of discontinuation due to any reason and adverse events (all p > 0.05).ConclusionAdjunctive tACS is promising as a viable approach for mitigating total and negative psychopathology in individuals diagnosed with schizophrenia. However, to gain a more comprehensive understanding of tACS’s therapeutic effects in schizophrenia, it is imperative to conduct extensive, meticulously planned, and well-documented RCTs.

ObjectiveThis meta-analysis of randomized clinical trials (RCTs) was conducted to explore the therapeutic effects, tolerability and safety of repetitive transcranial magnetic stimulation (rTMS) as an adjunct treatment in adolescents with first-episode major depressive disorder (FE-MDD).MethodsRCTs examining the efficacy, tolerability and safety of adjunctive rTMS for adolescents with FE-MDD were included. Data were extracted by three independent authors and synthesized using RevMan 5.3 software with a random effects model.ResultsA total of six RCTs involving 562 adolescents with FE-MDD were included. Adjunctive rTMS was superior in improving depressive symptoms over the control group [standardized mean difference (SMD) = −1.50, 95% confidence interval (CI): −2.16, −0.84; I2 = 89%, p

ObjectiveIntermittent theta-burst stimulation (iTBS), which is a form of repetitive transcranial magnetic stimulation (rTMS), can produce 600 pulses to the left dorsolateral prefrontal cortex (DLPFC) in a stimulation time of just over 3 min. The objective of this systematic review was to compare the safety and efficacy of iTBS and high-frequency (≥ 5 Hz) rTMS (HF-rTMS) for patients with treatment-resistant depression (TRD).MethodsRandomized controlled trials (RCTs) comparing the efficacy and safety of iTBS and HF-rTMS were identified by searching English and Chinese databases. The primary outcomes were study-defined response and remission.ResultsTwo RCTs (n = 474) investigating the efficacy and safety of adjunctive iTBS (n = 239) versus HF-rTMS (n = 235) for adult patients with TRD met the inclusion criteria. Among the two included studies (Jadad score = 5), all were classified as high quality. No group differences were found regarding the overall rates of response (iTBS group: 48.0% versus HF-rTMS group: 45.5%) and remission (iTBS group: 30.0% versus HF-rTMS group: 25.2%; all Ps > 0.05). The rates of discontinuation and adverse events such as headache were similar between the two groups (all Ps > 0.05).ConclusionThe antidepressant effects and safety of iTBS and HF-rTMS appeared to be similar for patients with TRD, although additional RCTs with rigorous methodology are needed.

ObjectiveWe performed a meta-analysis of randomized, double-blind, controlled trials (RCTs) to systematically investigate the therapeutic effects and tolerability of transcranial alternating current stimulation (tACS) for the treatment of patients with major depressive disorder (MDD).MethodsElectronic search of PubMed, PsycINFO, EMBASE, Chinese National Knowledge Infrastructure, Wanfang database, and the Cochrane Library up to 1 April 2022. Double-blind RCTs examining the efficacy and safety of tACS for patients with MDD were included. The primary outcome was the improvement of depressive symptoms following a course of tACS treatment. Data were analyzed using Review Manager Version 5.3 (Cochrane IMS, Oxford, UK). Study quality was assessed using the Cochrane risk of bias and Jadad scale. Publication bias was assessed using a funnel plot and the Egger test.ResultsWe identified 883 articles, of which 4 RCTs with 5 active treatment arms covering 224 participants with MDD on active tACS (n = 117) and sham tACS (n = 107) were eligible for inclusion. Meta-analysis of depressive symptoms at post-tACS found an advantage of active tACS over sham tACS (n = 212, standard mean difference (SMD) = −1.14, 95% confidence interval (CI): −2.23, −0.06; I2 = 90%, P = 0.04). The significant superiority of active tACS over sham tACS in improving depressive symptoms remained in a sensitivity analysis. Active tACS was significantly superior to sham tACS regarding depressive symptoms at the 4 week follow-up (SMD = −1.07, 95% CI: −2.05, −0.08; I2 = 88%, P = 0.03) and study-defined remission [risk ratio (RR) = 2.07, 95% CI: 1.36, 3.14, I2 = 9%, P = 0.0006]. The discontinuation rate due to any reason was similar between the two groups (P > 0.05). All included studies were rated as high quality (Jadad score ≥ 3), with funnel plots of primary outcome not suggestive of publication bias.ConclusiontACS appeared to be modestly effective and safe for improving depressive symptoms in patients with MDD, although further studies are warranted.

BackgroundElectroconvulsive therapy (ECT) is a safe and effective therapy for individuals suffering from major psychiatric disorders, but attitudes towards ECT among patients and caregivers have not been well studied. This study was conducted to elucidate patient and caregiver knowledge and attitudes concerning ECT in South China.MethodsThe sample comprised 92 patients diagnosed with major psychiatric disorders and their caregivers (n = 92). Participants completed questionnaire measures of knowledge and attitudes related to ECT.ResultsInformation before ECT was inadequately provided to both caregivers and patients (55.4% versus 37.0%, p 0.05), while more than half of them believed that ECT was beneficial (53.3% versus 71.7%, p 0.05). A total of 32.6% of patients and 55.4% of caregivers (p

Pituitary adenomas (PAs) are the second most common primary central nervous system tumors. Although most PAs can be cured by surgical operation, medicine treatment or radiotherapy, some PAs may recur, invade adjacent structures or even metastasize to other organs after traditional treatments, so decreaseing patient overall survival and deteriorate their life quality. In recent years, studies on the immune microenvironment of brain tumors emerged, especially in the field of glioma, providing potential effective treatment targets for immunotherapy and setting the foundation for improving patient survival. However, previous studies have only conducted preliminary analyses on immune cells, immune molecules, and cytokines in the microenvironment of PAs. The research on immunotherapy of PAs with animal model and humans is only at an early phase.

Objectives: As a new physical therapeutic technique, magnetic seizure therapy (MST) has established efficacy in the treatment of depression with few cognitive side effects, and thus appears to be a potential alternative to electroconvulsive therapy (ECT). The findings of randomized controlled trials (RCTs) examining the efficacy and safety of MST versus ECT for depression are inconsistent. This systematic review of RCTs was designed with the aim of assessing the safety and efficacy of MST versus ECT for patients with depression. Methods: The WanFang, Chinese Journal Net (CNKI), EMBASE, PubMed, Cochrane Library, and PsycINFO databases were systematically searched by three independent investigators, from their inceptions to July 24, 2021. Results: In total, four RCTs (n = 86) were included and analyzed. Meta-analyses of study-defined response (risk ratio (RR) = 1.36; 95% CI = 0.78 to 2.36; p = 0.28; I2 = 0%), study-defined remission (RR = 1.17; 95% CI = 0.61 to 2.23; p = 0.64; I2 = 0%), and the improvement in depressive symptoms (standardized mean difference (SMD) = 0.21; 95% CI = −0.29 to 0.71; p = 0.42; I2 = 0%) did not present significant differences between MST and ECT. Three RCTs evaluated the cognitive effects of MST compared with ECT using different cognitive measuring tools, but with mixed findings. Only two RCTs reported adverse drug reactions (ADRs), but these lacked specific data. Only one RCT reported discontinuation due to any reason. Conclusions: This preliminary study suggests that MST appears to have a similar antidepressant effect as ECT for depression, but mixed findings on adverse cognitive effects were reported.

Objective To evaluate the emergence agitation and recovery quality of patients with 3 endocrine types of pituitary tumor after transnasal transsphenoidal hypophysectomy. Methods Patients who received pituitary adenoma resection under general anesthesia were enrolled and categorized into three groups: growth hormone group (GH), adrenocorticotropic hormone group (ACTH) and non-functional group (control). Riker Sedation-Agitation Scale (RSAS), the severity of the emergence coughing, headache (by VAS), medical staff satisfaction were recorded in the post-anesthesia care unit. QoR-40 score, headache(by VAS), nausea score (by VRS) and vomiting score, and patient satisfaction were recorded at 24 h postoperatively. Results 163 cases were enrolled in the analysis, including 51 in GH group, 44 in ACTH group and 68 in control group. No significant difference was found regarding the emergence agitation among 3 groups. The ACTH group showed significantly higher nausea VRS score at 24 h after surgery than control group (P＜0.01). The headache VAS score of ACTH group was significantly higher than that in control group (P＜0.001). The incidence of postoperative sore throat in ACTH group was significantly higher than that in control group (P＜0.05). The postoperative QoR-40 score of ACTH group was significantly lower than that of control group (P＜0.01). Conclusions The incidences of postoperative nausea, headache and sore throat are significantly increased and the score of QoR-40 is significantly reduced in patients with ACTH pituitary adenoma.

Acromegaly is associated with systemic complications due to excess serum growth hormone, including cardiovascular diseases, endocrine and metabolic diseases, bone diseases and respiratory diseases. In addition, abnormalities of haemostatic function in patients with acromegaly have been described by several studies recently, including the alterations in coagulation, anticoagulation, fibrinolytic system and platelet function, presenting a potential of hyper-coagulation. Significantly elevated fibrinogen levels, reduced levels of protein C and protein S, and enhanced platelet activity were observed in patients with acromegaly. Some of these abnormalities are reversible after treatment like surgery or medication.

Immunotherapy induced hypophysitis (IH) has been demonstrated an autoimmune adverse effect of immune checkpoint inhibitors treatment of malignant tumors. The incidence of IH depends on types of immunotherapeutic agents. Patients with IH often present non-specific symptoms, ACTH, TSH and gonadotrophin deficiencies, and radiographic pituitary enlargement. Hormone replacement is recommended to be applied on IH patients. High-dose glucocorticoids but not supported by recent studies. This study systematically reviewed the prevalence, epidemiological characteristics, clinical characteristics, treatment and prognosis of IH.