Can digital economy foster synergistic increases in green innovation and corporate value? Evidence from China.

The rapid evolution of the digital economy has significantly accelerated progress towards achieving green and sustainable processes, particularly in the field of green production. While existing research has delved into the effects of the digital economy on Green Innovation (GI) and the consequences of digital transformation on Corporate Value (CV), there remains a notable gap in the literature regarding the potential for synergistic enhancements in firms' GI&CV through the ongoing digital revolution. This study utilizes an evolutionary game model and employs system dynamics methods to simulate the dynamic evolution trajectory of the influence of the digital economy on the synergy between GI&CV. Subsequently, it empirically assesses the interconnected synergies between GI&CV using a dataset comprising information from Chinese listed firms spanning from 2011 to 2020, examining the impact of the digital economy on these synergies. Moreover, the study delves into the analysis of the transmission mechanism and conducts an extended investigation to further explore this phenomenon. The findings of this paper including: (1) The digital economy acts as a driving force behind the synergistic enhancement of firm GI&CV. Moreover, this effect is further augmented by governmental environmental regulation and green subsidy policies. (2) Drawing upon the information asymmetry theory and the resource-based theory, the regional marketization level and firms' digital transformation play intermediary roles. (3) The heterogeneity test indicate that firms situated in eastern regions and those classified as non-heavily polluted benefitted to a greater extent. This study sheds light on the incentive implications of digital economy for the synergistic upgrading of GI&CV, thereby extending the breadth of study on the consequences of digital economy. Moreover, it offers actionable suggestions for enterprises to leverage digital economy development towards achieving a synergistic improvement of GI&CV.

Green finance and the synergy of ESGGI performance of Chinese companies: Does green concern matter?

This study aims to investigate green finance's impact on the synergy between ESG and green innovation (ESGGI) performance and examine the potential influence played by stakeholders' green concerns on this impact. Hence, we calculated the synergy of ESGGI performance based on the entropy method and the coupled coordination degree model and conducted regression analyses on the data of 1143 Chinese companies from 2012 to 2020. The results reveal a remarkable inverted U-shaped relationship between green finance and the synergy of ESGGI performance. Additionally, the green concerns of the government and the media can efficiently moderate green finance's impact on the synergy of ESGGI performance. Further tests show that green finance's impact on the synergy of ESGGI performance of SOEs, HPEs, and HTEs is more significant. This paper demonstrates an association between green finance and the synergy of ESGGI performance, which yields new insights for companies to implement green transformation and sustainable development.

MicroRNA-302a inhibits osteosarcoma cell migration and invasion by directly targeting IGF-1R.

[This retracts the article DOI: 10.3892/ol.2018.8049.].

Digital Transformation on Enterprise Green Innovation: Effect and Transmission Mechanism.

With the development of blockchain, big data, cloud computing and other new technologies, how to achieve innovative development and green sustainable development in digital transformation has become one of the key issues for enterprises to obtain and maintain core competitiveness. However, little of the literature has paid attention to the impact of digital transformation on enterprise green innovation. Using the data of Chinese A-share listed companies from 2010 to 2020, this paper empirically analyzes the impact of enterprise digital transformation on green innovation and its transmission mechanism, by constructing double fixed-effect models. The results show that digital transformation has remarkably promoted the green innovation of enterprises. R&D investment, government subsidies, and income tax burden have played a conductive role between digital transformation and enterprise green innovation. Furthermore, digital transformation can significantly promote the high-quality green innovation of enterprises and also plays a more significant role in promoting the green innovation of high-tech enterprises and state-owned enterprises. A robustness test is carried out by using the lag data and changing the measurement methods of the dependent variable and independent variables, and the research conclusions are still valid. Based on resource-based theory and dynamic capability theory, this paper reveals the impact path of digital transformation on enterprise green innovation, further expanding the research field of digital transformation and enriching the research on the influencing factors of enterprise green innovation. This paper provides policy suggestions for the government to improve the enterprise green innovation level by increasing government subsidies and providing tax incentives and also provides reference for digital transformation enterprises to accelerate green innovation by increasing R&D investment, obtaining government subsidies, and acquiring tax policy support.

Sleep quality and the associated factors among in-hospital nursing assistants in general hospital: A cross-sectional study.

Background: Sleep quality and the associated factors in professional nurses have been extensively investigated. However, as an important part of the workforce in hospitals, sleep quality and influencing factors among in-hospital nursing assistants is rarely investigated. Aim: This study aimed to assess the sleep quality and the associated factors of in-hospital nursing assistants in general hospital. Methods: A cross-sectional survey study was conducted in a tertiary general hospital. Data were collected from 187 in-hospital nursing assistants using convenience sampling from June to July 2018. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate participants' sleep quality. A multiple linear regression was performed to identify associated factors with sleep quality. Results: This study revealed a mean PSQI score of 5.96 ± 3.64 among all participants, of which 62.3% (114/187) participants suffered from impaired sleep quality. In-hospital nursing assistants with significant medical condition, low monthly income, irregular diet and high family burden reported more worse sleep quality. Conclusion: The study showed that poor sleep quality is a highly prevalent issue among Chinese in-hospital nursing assistants in general hospital. Measures to enhance nursing assistants' wellbeing status (health and burden) and improve their salary (monthly income) are recommended.

Facile Fabrication of Flexible, Robust, and Superhydrophobic Hybrid Aerogel.

Silica aerogels, which are constructed with silica nanoparticles and numerous nanoscale pores, have many outstanding attributes, but they are usually brittle and hydrophilic. For the construction of a robust aerogel, the novel polyhedral oligomeric silsesquioxane (POSS) was introduced to prepare a series of aerogels possessing particles covered with elastic cushion to improve the mechanical property. The multialkoxy POSS, which possessed stiff Si-O-Si nanocages and flexible alkyl chains, was synthesized via thiol-ene click chemistry. After a facile and efficient approach, a partially ordered structure of SiO2 nanoparticles and organic elastic cushion would form spontaneously within the aerogels. With the POSS as the only precursor, several outstanding attributes were achieved in a single aerogel such as high specific surface area (SSA), high compression strength, high compression modulus, and noticeable compression flexibility. Meanwhile, the aerogel was superhydrophobic of which the contact angle (CA) was higher than 153°. Moreover, the potential application of oil-water separation is also presented.

MicroRNA-302a inhibits osteosarcoma cell migration and invasion by directly targeting IGF-1R.

Osteosarcoma is one of the most frequent types of primary malignant bone neoplasm in children and adolescents. Despite advancements developed in therapeutic modalities, the 5-year overall survival rates for patients with metastatic osteosarcoma disease remain poor. The present study aimed to investigate the expression level of microRNA-302a (miR-302a) in osteosarcoma tissues and cell lines, and the biological roles of miR-302a in osteosarcoma cells. In addition, the molecular mechanism underlying its tumor suppressive roles was evaluated. miR-302a expression in osteosarcoma tissues and cell lines was detected using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Following transfection of miR-302a mimics or IGF-1R siRNA, transwell migration and invasion, luciferase reporter assay RT-qPCR and western blot assays were conducted in osteosarcoma cells. In the present study, the data demonstrated that miR-302a was frequently reduced in osteosarcoma tissue and cell lines. In addition, the expression of miR-302a was correlated with metastatic features of patients with osteosarcoma. Restoration of miR-302a expression significantly inhibited the migration and invasion capacity of osteosarcoma cells. Mechanistic studies indicated that insulin-like growth factor 1 receptor (IGF-1R) was a direct target gene of miR-302a. Overexpression of miR-302a resulted in decreased expression of IGF-1R at the mRNA and protein levels. Furthermore, the knockdown IGF-1R mimicked the functions of miR-302a overexpression on osteosarcoma cell migration and invasion. Collectively, the results of the current study indicate that miR-302a acts as a metastasis suppressing miRNA and could be investigated as a therapeutic target for the treatment of patients with osteosarcoma to prevent metastasis.

Systematic review with network meta-analysis: comparative efficacy of different enteral immunonutrition formulas in patients underwent gastrectomy.

OBJECTIVES: Optimal enteral immunonutrition (EIN) regime for gastric cancer (GC) patients underwent gastrectomy remains uncertainty. To assess comparative efficacy of different EIN formulas in GC patients underwent gastrectomy, we performed network meta-analysis. RESULTS: We included 11 RCTs enrolling 840 patients. Pairwise meta-analysis indicated that EIN (RR 0.56, 95% CI 0.36-0.86; MD -0.42, 95% CI -0.74-0.10), Arg+RNA+ω-3-FAs (RR 0.37, 95% CI 0.22-0.63; MD -0.42, 95% CI -0.75-0.07), Arg+Gln+ω-3-FAs (RR 0.22, 95% CI 0.05-0.94; MD -0.69, 95% CI -1.22-1.07) reduced ICs and LOS. Network meta-analysis confirmed the potential of Arg+RNA+ω-3-FAs for ICs (OR 0.27, 95% Crl 0.12-0.49) and Arg+Gln+ω-3-FAs for CIs (OR 0.22, 95% Crl 0.02-0.84) and LOS (SMD -0.63, 95% Crl -1.07-0.13), and indicated that Arg+RNA+ω-3-FAs was superior to Arg+RNA and Arg+Gln for ICs as well. MATERIALS AND METHODS: We performed direct and network meta-analyses for randomized controlled trials comparing EIN formulas with each other or standard enteral nutrition (SEN) in reducing infectious complications (ICs), noninfectious complications (NICs) and length of hospital stay (LOS), through January 2016. The surface under the cumulative ranking curve (SCURA) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) were used to rank regimes and rate qualities of evidences respectively. CONCLUSIONS: As for GC patients underwent gastrectomy, Arg+RNA+ω-3-FAs and Arg+Gln+ω-3-FAs are the optimal regimes of reducing ICs and LOS.

Concurrent chemo-radiotherapy with S-1 as an alternative therapy for elderly Chinese patients with non-metastatic esophageal squamous cancer: evidence based on a systematic review and meta-analysis.

OBJECTIVE: This systematic review and meta-analysis aims to systematically assess the effects of concurrent chemo-radiotherapy (CRT) compared with radiotherapy (RT) alone for elderly Chinese patients with non-metastatic esophageal squamous cancer. METHODS: We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), China Biomedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) databases. We retrieved randomized controlled trials on concurrent CRT with Gimeraciland Oteracil Porassium (S-1) compared with RT alone for aged Chinese patients with non-metastatic esophageal squamous cancer performed until August 2016. RESULTS: Eight eligible studies involving 536 patients were subjected to meta-analysis. As a response rate measure, a relative risk (RR) of 1.37 [95% confidence intervals (CIs): 1.24, 1.53; P = 0.00], which reached statistical significance, was estimated when concurrent CRT with S-1 was performed compared with RT alone. Sensitivity analysis on response rate confirmed the robustness of the pooled result. The RR values of 1.44 (95% CIs: 1.22, 1.70; P = 0.00) and 1.77 (95% CIs: 1.26, 2.48; P = 0.00) estimated for 1- and 2-year survival rate indices, respectively, were also statistically significant. The incidence of adverse events was similar in both groups. CONCLUSION: This review concluded that concurrent CRT with S-1 can improve the efficacy and prolong the survival period of elderly Chinese patients with non-metastatic esophageal squamous cancer and does not significantly increase the acute adverse effects of RT alone.

The design and analysis of channel transmission communication system of XCTD profiler.

In this paper, a channel transmission communication system of expendable conductivity-temperature-depth is established in accordance to the operation characteristics of the transmission line to more accurately assess the characteristics of deep-sea abandoned profiler channel. The wrapping inductance is eliminated to maximum extent through the wrapping pattern of the underwater spool and the overwater spool and the calculation of the wrapping diameter. The feasibility of the proposed channel transmission communication system is verified through theoretical analysis and practical measurement of the transmission signal error rate in the amplitude shift keying (ASK) modulation. The proposed design provides a new research method for the channel assessment of complex abandoned measuring instrument and an important experiment evidence for the rapid development of the deep-sea abandoned measuring instrument.

Meta-analysis comparing chewing gum versus standard postoperative care after colorectal resection.

BACKGROUND: Previous incomplete studies investigating the potential of chewing gum (CG) in patients undergoing colorectal resection did not obtain definitive conclusions. This updated meta-analysis was therefore conducted to evaluate the effect and safety of CG versus standard postoperative care protocols (SPCPs) after colorectal surgery. RESULTS: Total 26 RCTs enrolling 2214 patients were included in this study. The CG can be well-tolerated by all patients. Compared with SPCPs, CG was associated with shorter time to first flatus (weighted mean difference (WMD) -12.14 (95 per cent c.i. -15.71 to -8.56) hours; P < 0.001), bowl movement (WMD -17.32 (-23.41 to -11.22) hours; P < 0.001), bowel sounds (WMD -6.02 (-7.42 to -4.63) hours; P < 0.001), and length of hospital stay (WMD -0.95 (-1.55 to -0.35) days; P < 0.001), a lower risk of postoperative ileus (risk ratio (RR) 0.61 (0.44 to 0.83); P = 0.002), net beneficial and quality of life. There were no significant differences between the two groups in overall complications, nausea, vomiting, bloating, wound infection, bleeding, dehiscence, readmission, reoperation, mortality. MATERIALS AND METHODS: The potentially eligible randomized controlled trials (RCTs) that compared CG with SPCPs for colorectal resection were searched in PubMed, Embase, Cochrane library, China National Knowledge Infrastructure (CNKI), and Chinese Wanfang databases through May 2016. The trial sequential analysis was adopted to examine whether a firm conclusion for specific outcome can be drawn. CONCLUSIONS: CG is benefit for enhancing return of gastrointestinal function after colorectal resection, and may be associated with lower risk of postoperative ileus.

Laparoscopic cholecystectomy for acute cholecystitis: early or delayed?: Evidence from a systematic review of discordant meta-analyses.

The laparoscopic cholecystectomy (LC) is an important approach of treating acute cholecystitis and the timing of performing this given treatment is associated with clinical outcomes. Although several meta-analyses have been done to investigate the optimal timing of implementing this treatment, the conflicting findings from these meta-analyses still confuse decision-making. And thus, we performed this systematic review to assess discordant meta-analyses and generate conclusive findings to facilitate informed decision-making in clinical context eventually. We electronically searched the PubMed, Cochrane Library, and EMBASE to include meta-analysis comparing early (within 7 days of the onset of symptoms) with delayed LC (at least 1 week after initial conservative treatment) for acute cholecystitis through August 2015. Two independent investigators completed all tasks including scanning and appraising eligibility, abstracting essential information using prespecified extraction form, assessing methodological quality using Oxford Levels of Evidence and Assessment of Multiple Systematic Reviews (AMSTAR) tool, and assessing the reporting quality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), as well as implementing Jadad algorithm in each step for the whole process. A heterogeneity degree of ≤50% is accepted. Seven eligible meta-analyses were included eventually. Only one was Level I of evidence and remaining studies were Level II of evidence. The AMSTAR scores varied from 8 to 11 with a median of 9. The PRISMA scores varied from 19 to 26. The most heterogeneity level fell into the desired criteria. After implementing Jadad algorithm, 2 meta-analyses with more eligible RCTs were selected based on search strategies and implication of selection. The best available evidence indicated a nonsignificant difference in mortality, bile duct injury, bile leakage, overall complications, and conversion to open surgery, but a significant reduction in wound infection, hospitalization, and operation duration and improvement of the quality of life when compared early LC with delayed LC. However, number of work days lost, hospital costs, and patient satisfaction are warranted to be assessed further. With the best available evidence, we recommend early LC to be as the standard treatment option in treating acute cholecystitis.

Moxibustion is an Alternative in Treating Knee Osteoarthritis: The Evidence From Systematic Review and Meta-Analysis.

Knee osteoarthritis (KOA) is a common disorder in elderly. There is no known cure for KOA, and thus therapeutic strategies of alleviating symptoms are increasingly emphasized. Moxibustion has been widely used to treat KOA; however, results are inconclusive. The aim of our study is to critically reassess the effects of moxibustion on KOA.We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Chinese Biomedical Literature database (CBM) through 25 November 2015. Two independent reviewers selected studies and abstracted information, as well as assessed the risk of bias using Cochrane risk of bias tool. The random-effects meta-analyses were performed based on abstracted data.We initially captured 163 citations and added 4 records through checking review. After critical appraisal, 13 RCTs were included. Meta-analyses indicated that moxibustion is not statistically different from oral drug in improving the response rate (MD = 1.09; 95% CI = 1.00, 1.20; P = 0.05), alleviating pain and improving physical function. Our meta-analysis also found that moxibustion is superior to usual care and sham moxibustion in reducing WOMAC score (MD = 7.56; 95% CI = 4.11, 11.00; P = 0.00), pain and function, as well as increasing QoL. Moreover, most AEs caused by moxibustion can heal without medical care.We concluded that moxibustion treatment is equal to the oral drugs and intra-articular injections and may be an alternative in treating patients with KOA.

Regime for Bowel Preparation in Patients Scheduled to Colonoscopy: Low-Residue Diet or Clear Liquid Diet? Evidence From Systematic Review With Power Analysis.

Clear liquid diet (CLD) is used to perform bowel preparation before colonoscopy traditionally, but several clinical studies indicated that low-residue diet (LRD) generates equal effects to CLD and a conclusive conclusion has not yet been yielded. The systematic review was performed to address this conflict and facilitate informed decision-making eventually. To capture randomized controlled trials (RCTs) comparing LRD with CLD in terms of bowel preparation, a search was performed in PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Science Direct, recent conference abstracts, Google Scholar, and Clinicaltrials.gov through May 2015. We performed all meta-analyses based on fixed- or random-effects model, which is generated from clinical characteristics and methodology. Moreover, the G*Power software was adopted to achieve statistical power for each outcome. In total, we captured 109 potential citations at initial search stage and 2 topic-related articles were included through other sources. After critical appraisal, 7 RCTs were eligible for our inclusion criteria. Meta-analyses generated similar effects in bowel preparation quality, efficacy of colon cleansing, and compliance with recommended dietary regime when LRD versus CLD regime, but patients who were prescribed to receive LRD have slightly better tolerance (RR, 1.06; 95% CI, 1.02-1.11) and tended to repeat the same preparation regime in future (RR, 1.17; 95% CI, 1.09-1.26) relative to patients in CLD. Importantly, both regimes resulted in similar adverse events (AEs). With the best available evidence, LRD could be recommended to be as standard regime for bowel preparation prior to colonoscopy.

Oral Motor Intervention Improved the Oral Feeding in Preterm Infants: Evidence Based on a Meta-Analysis With Trial Sequential Analysis.

Oral feeding for preterm infants has been a thorny problem worldwide. To improve the efficacy of oral feeding in preterm infants, oral motor intervention (OMI), which consists of nonnutritive sucking, oral stimulation, and oral support, was developed. Published studies demonstrated that OMI may be as an alternative treatment to solve this problem; however, these results remain controversial. We conducted a meta-analysis with trial sequential analysis (TSA) to objectively evaluate the potential of OMI for improving the current status of oral feeding in preterm infants.A search of PubMed, EMBASE, Web of Science, the Cochrane Library, and China National Knowledge Infrastructure was performed to capture relevant citations until at the end of October, 2014. Lists of references of eligible studies and reviews were also hand-checked to include any latent studies. Two independent investigators screened literature, extracted data, and assessed the methodology, and then a meta-analysis and TSA was performed by using Reviewer Manager (RevMan) 5.3 and TSA 0.9 beta, respectively.A total of 11 randomized controlled trials (RCTs), which included 855 participants, were incorporated into our meta-analysis. The meta-analyses suggested that OMI is associated with the reduced transition time (ie, the time needed from tube feeding to totally oral feeding) (mean difference [MD], -4.03; 95% confidence interval [CI], -5.22 to -2.84), shorten hospital stays (MD, -3.64; 95% CI, -5.57 to -1.71), increased feeding efficiency (MD, 0.08; 95% CI, 0.36-1.27), and intake of milk (MD, 0.14; 95% CI, 0.06-0.21) rather than weight gain. Results of TSA for each outcomes of interest confirmed these pooled results.With present evidences, OMI can be as an alternative to improve the condition of transition time, length of hospital stays, feeding efficiency, and intake of milk in preterm infants. However, the pooled results may be impaired due to low quality included, and thus, well-designed and large RCTs were needed to further established effects.

Role of Enteral Immunonutrition in Patients Undergoing Surgery for Gastric Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Gastric cancer (GC) is one of the most common upper gastrointestinal malignancies. Surgical resection remains the mainstay of curative treatment for GC. Enteral immunonutrition (EIN) has been increasingly used to enhance host immunity and relieve inflammatory response of patients undergoing surgery for GC; however, conclusions across studies still remain unclear. We aimed to evaluate the effects of EIN for such patients.We searched some electronic databases including PubMed, EBSCO-Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE to identify any latent studies which investigated the effects of EIN compared with standard EN on GC patients who undergoing surgery until the end of December 30, 2014. Relative risk (RR), mean difference (MD), or standard mean difference (SMD) with 95% confidence interval (CI) were calculated and we also assessed heterogeneity by using Cochrane Q and I statistic combined with corresponding P-value.We included 9 eligible studies which included 785 patients eventually. The meta-analysis results shown that EIN increased level of IgA (MD, 0.31; 95% CI, 0.12-0.51), IgG (MD, 1.5; 95% CI, 0.73-2.28), IgM (MD, 0.22; 95% CI, 0.06-0.39), CD4 (SMD, 0.81; 95% CI, 0.53-1.09), CD3 (SMD, 0.68; 95% CI, 0.21-1.15), CD4/CD8 ratio (MD, 0.56; 95% CI, 0.12-1.01), and NK cell (MD, 2.35; 95% CI, 0.66-4.05); decreased IL-6 (MD, -98.22; 95% CI, -156.16 to -40.28) and TNF-α (MD, -118.29; 95% CI, -162.00 to -74.58), but not improve remained outcomes of interest involving postoperative complications, length of hospitalization, serum total protein, and CD8. Descriptive analysis suggested that EIN also increased the concentration of IL-2 but not CRP. Impact on lymphocytes remains inconsistent.EIN is effective for enhancing host immunity and relieving the inflammatory response in GC patients undergoing gastrectomy, but clinical outcomes cannot be benefit from it. Heterogeneity caused by different compositions and timing of administration of EIN regimes and not enough sample size and number of eligible studies in most of sensitive analyses with subgroup analysis may impaired the power of our study, and thus some large-scale and well-designed studies are warranted to further establish effects.

Treatment of Adults With Treatment-Resistant Depression: Electroconvulsive Therapy Plus Antidepressant or Electroconvulsive Therapy Alone? Evidence From an Indirect Comparison Meta-Analysis.

Electroconvulsive therapy (ECT) and antidepressant are the effective treatment alternatives for patients with treatment-resistant depression (TRD); however, the effects and safety of the ECT plus antidepressant relative to ECT alone remain controversial. We decide to assess the potential of ECT plus antidepressant compared with ECT alone by undertaking an indirect comparison meta-analysis.Databases from PubMed, ISI Web of Science, CENTRAL, Clinicaltrials.gov, EMBASE, CBM (China Biomediccal Literatures Database), and CNKI (China National Knowledge Infrastructure) were searched for relevant studies through November 21, 2014. Literature was screened, data were extracted and methodological quality of the eligible trial was assessed by 2 independent reviewers accordingly. Then, head-to-head and indirect comparison meta-analyses were carried out.A total of 17 studies which including 13 studies regarding ECT plus antidepressant versus antidepressant alone and 4 studies concerning ECT versus antidepressant alone containing a total of 1098 patients were incorporated into this meta-analysis. The head-to-head comparison suggested that response rate can be improved in the ECT plus antidepressant (RR, 1.82; 95% CI, 1.55-2.14) and ECT alone group (RR, 2.24, 95% CI, 1.51-3.33) compared with antidepressant alone, respectively; adverse complications including memory deterioration and somatization were not significantly increased except incidence of memory deterioration in ECT plus antidepressant in the 4th weeks after treatment (RR, 0.09, 95% CI, 0.02-0.49). Indirect comparison meta-analysis showed that no significant differences were detected in response rate and memory deterioration between ECT plus antidepressant and ECT alone. However, ECT plus antidepressant increased the incidence of memory deterioration relative to ECT alone.With present evidence, the regime of ECT plus antidepressant should not be preferentially recommended to treat the patients with TRD relative to ECT alone.