ABSTRACT
Objective:To observe the effects of music therapy combined with scalp acupuncture on post-stroke depression (PSD) using resting-state functional magnetic resonance imaging (rs-fMRI). Methods:From December, 2018 to November, 2019, 40 patients with PSD from Rehabilitation Department of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into control group (n = 20) and observation group (n = 20). Both groups received routine rehabilitation and scalp acupuncture, while the observation group received music therapy as acupuncture, for four weeks. They were assessed with Hamilton Depression Scale (HAMD-17), Pittsburgh Sleep Quality Index (PSQI) and modified Barthel Index (MBI) before and after treatment, and scanned with rs-fMRI to obtain amplitude of low-frequency fluctuation (ALFF). The patients with definite improvement were followed up with HAMD-17 through telephone four weeks after treatment. Results:There were three cases dropped down in each group. The scores of HAMD-17, PSQI and MBI improved in both groups (|t| > 11.446,P < 0.001), and improved more in the observation group than in the control group (|t| > 2.314, P < 0.05). ALFF of bilateral wedge lobe, bilateral lingual gyrus, right orbitofrontal cortex, right anterior cingulate gyrus and right middle temporal gyrus increased in the observation group, and it increased in the right lingual gyrus, right angular gyrus and lateral groove of right occipital lobe in the control group. A total of 29 patients were followed up successfully, and the HAMD-17 scores were still less than that before treatment (t > 13.558, P < 0.001). Conclusion:Music therapy can further alleviate depression under scalp acupuncture in patients with PSD for a long time after treatment, and improve sleep and activities of daily living, which may relate with the activation of the emotional circuit, such as orbitofrontal cortex and the middle temporal gyrus, and the primary visual cortex.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the epidemiology, diagnosis, and treatment status of neuroendocrine tumors (NETs) in our hospital.</p><p><b>METHODS</b>Medical records of 252 patients with neuroendocrine tumors diagnosed and treated in our hospital from January 1, 2004 to December 31, 2009 were collected and retrospectively reviewed in this study. The clinicopathological data including age of onset, initial symptoms, primary site, pathological conditions (Sny, CgA, Ki-67), disease stage at diagnosis, treatment, and follow up were analyzed.</p><p><b>RESULTS</b>The gender ratio M/F of the 252 cases was 1.9:1, with mean age of 55.2 years, and the high incidence was in age of 60-69 years. The tumors were located in the gastrointestinal tract (117 cases, 46.4%), broncho-pulmonary system (74 cases, 29.4%), other sites (61 cases, 24.2%) and unknown primary site (2 cases, 0.8%). Their first clinical symptoms vary, depending on the primary site. The common symptoms of primary rectal NETs were changes in bowel habits (29.3%) and diarrhea or constipation (17.5%), and most gastric NETs presented epigastric discomfort (86.4%). Most patients (71.4%) were diagnosed with stage I, II, III disease. Among the 252 cases, there were 110 carcinoids (43.7%), 108 neuroendocrine carcinomas (42.9%), 23 atypical carcinoids (9.1%), five neuroendocrine tumors (2.0%), four Merkel cell tumors (1.6%), and two composite carcinoids (0.8%). 206 patients (81.7%) received surgery, 39 (15.5%) received chemotherapy, and 31 cases (12.3%) were treated by palliative radiotherapy.</p><p><b>CONCLUSIONS</b>This single-center retrospective analysis of data demonstrated that males have a higher incidence rate than females. The most common primary sites of NETs are the digestive tract and lungs. The initial symptoms of NETs are different depending on their primary sites. Good prognosis can be achieved in the majority of patients after surgery, chemotherapy and palliative radiotherapy.</p>