Training mode of robotic surgical system in thoracic surgery: A single-center study at Ruijin Hospital / 中国胸心血管外科临床杂志

@#Objective    To explore the training mode of robotic surgical system for thoracic surgeons. Methods    Thirteen surgeons enrolled in the Department of Thoracic Surgery, Ruijin Hospital from May 2015 to December 2019 were targeted for training. Training methods included learning basic knowledge of Da-Vinci robotic system, simulation platform training, physical simulation training, training on animal models, practice of thoracic surgery and video analysis. Results    The robotic operation skills of the surgeons were improved. Currently 4 surgeons were qualified for using robotic system to do thoracic surgery, and 9 surgeons had assistant qualification. Conclusion    Multiple modes of training can help surgeons learn and master the techniques of robotic surgery, and will provide the basis for robotic training standard.

The effects of repetitive high-frequency magnetic stimulation in treating post-stroke depression and their evaluation using event-related potentials / 中华物理医学与康复杂志

Objective:To investigate the value of event-related brain potentials (ERPs) for evaluating the effect of repeated high-frequency transcranial magnetic stimulation (rTMS) in treating post-stroke depression.Methods:Sixty-four depressed stroke survivors were divided at random into an observation group and a control group, each of 32. Thirty-five healthy volunteers constituted a healthy control group. All of the patients were treated with 150mg/d of venlafaxine for 6 weeks. The observation group was additionally given rTMS five times a week for 6 weeks. Before and after the treatment, both patient groups were evaluated using the Hamilton depression scale (HAMD-17) as well as the visual P300.Results:After the treatment the average HAMD-17 scores of the two patient groups had decreased significantly, but with significantly greater improvement in the observation group. The total effective rate of the observation group after treatment (87.5%) was significantly higher than the control group′s rate (62.5%). Before the treatment the latency and amplitude of Cz and Fz in both patient groups was significantly delayed and lower than in the healthy group. After the treatment the average Fz amplitude in the observation group had risen and the latency had moved forward significantly compared with the other two groups. No significant differences were observed among the control group before and after the treatment. Before the treatment the average P2 and P3 latencies of the two patient groups were significantly longer than in the healthy group, while the amplitudes were significantly lower. After the treatment the average latency of P2 and the average P3 latency and amplitude of the observation group were significantly better than before the treatment. No significant differences were observed in the healthy control group.Conclusions:High-frequency rTMS can affect post-stroke depression. The MMN and visual P300 instruments can be used for rehabilitation evaluation.

Repeated transcranial magnetic stimulation for treating the negative symptoms of schizophrenia / 中华物理医学与康复杂志

Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the negative symptoms of chronic schizophrenia and on the P300 component of schizophrenics' event-related potentials (ERPs).Methods Ninety convalescing schizophrenia patients were randomly divided into a 5 Hz group,a 10 Hz group and a 15 Hz group,each of 30.The three groups were treated with the corresponding 5 Hz,10 Hz or 15 Hz rTMS once a day,five times a week for five consecutive weeks.The P300 ERPs of all three groups were tested before and after the treatment.Any curative effect was evaluated using the scale for the assessment of negative symptoms (SANS).Results After the treatment,the average SANS score of the 10 Hz group was significantly different from that before the treatment and also from those of the other two groups after the treatment.After the treatment,significant improvement was also observed in the amplitude of P300 in the 10 Hz group.The treatment's effectiveness was negatively correlated with age and longer course of the disease.Conelusion rTMS at 10 Hz is the most effective of the protocols tested for improving the negative symptoms of schizophrenia and improving cognitive functioning.

Application of event-related brain potential in intelligence impairment assessment after craniocerebral trauma / 中华行为医学与脑科学杂志

Objective To investigate the changes of event-related potentials (ERPs) in patients with intelligence impairments after craniocerebral trauma.Methods 60 patients with intelligence impairments after craniocerebral trauma were enrolled as case group,and 60 healthy subjects were enrolled as control group.EEG instrument was used to record P300 and P50 of the two groups and the differences in P300 and P50 components were compared.Results There are significant differences between case group and control group in latency of P300 ((440.430 ± 77.367) ms vs (342.928 ± 36.175) ms,P＜ 0.01),and case group showed decreased amplitude ((12.692±8.152) μV vs (18.138±6.590) μV,P＜0.01).The S2-P50 amplitude of case group was significantly higher than that of control group ((3.75± 1.59) μV vs (2.42±1.43) μV,P＜0.01).In addition,the S2-P50 amplitude/S1-P50 amplitude ratio of case group was higher than that of the control group,and the difference was statistically significant (0.78±0.54 vs 0.46±0.18,P＜0.01).The latency and amplitude of P300 were significantly correlated with the total score of WAIS-RC (r=-0.31,P＜0.01;r=0.17,P＜0.01);The amplitude of S2-P50 and the ratio of S2-P50 amplitude to S1-P50 amplitude were significantly negatively correlated with the total score of WAIS-RC (r=-0.33,P＜0.01;r=-0.45,P＜0.01).Conclusion P300 and P50 components of ERP can provide references for judicial expertise to evaluate intelligence impairments after craniocerebral trauma.

Procedures and research status of Da Vinci robot-assisted minimally invasive esophagectomy / 中华消化外科杂志

Esophageal cancer is one kind of the common gastrointestinal cancers, which is a serious threat to health and life of human beings.Esophagectomy with systematic lymphadenectomy is still the most effective treatment method for early and resectable esophageal cancer.However, due to the complex paraesophageal anatomy, there are some great difficulties need to be overcome in traditional open surgery and minimally invasive esophagectomy(MIE), such as the exposure and separation of esophagus together with tumor, lymph node dissection, etc.Da Vinci Surgical System (Intuitive Surgical, USA) with the advantages like 3-dimensional view, accuracy and stability, has been used to perform robot-assisted minimally invasive esophagectomy (RAMIE) in many countries including China.Frequently-used procedures of RAMIE include McKeown procedure, Ivor-Lewis procedure and transhiatal esophagectomy (THE).This review makes an introduction to the methods and applications of these 3 procedures, and the research status of RAMIE.

Differences in P50 and prepulse inhibition of the startle reflex between male smokers and non-smokers with first episode schizophrenia without medical treatment / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Nicotine may improve schizophrenia patient's cognitive deficit symptoms. This study was to explore the chronic effects of smoking on prepulse inhibition of the startle reflex (PPI) and P50 in the patients with first-episode schizophrenia (FES).</p><p><b>METHODS</b>The event-related potentials (ERP) recording and analysis instrument made by Brain Products, Germany, was used to detect PPI and P50 in 49 male FES patients (FES group, n = 21 for smokers and n = 28 for non-smokers) and 43 normal male controls (control group, n = 19 for smokers and n = 24 for non-smokers).</p><p><b>RESULTS</b>Compared with normal controls, the FES group had prolonged PPI latency when elicited by single stronger stimulus (P < 0.05); the FES group had prolonged PPI latency and increased PPI amplitude (P < 0.05, 0.01) when elicited by weak and strong stimuli. The FES group had lower PPI inhibition rate than normal controls (P < 0.05). Compared with normal controls, the FES group had increased P50-S2 amplitude and increased amplitude ratio S2/S1 (both P <0.05). In the control group, the smokers had a tendency of increase in P50-S2 amplitude (P > 0.05) and shorter P50-S2 latency (P < 0.05) than the non-smokers. The smokers had higher PPI amplitude than the non-smokers (P < 0.05). In the FES group, the smokers had higher P50-S1 amplitude, shorter P50-S2 latency, and higher amplitude ratio S2/S1 than the non-smokers (P < 0.05, 0.01). The smokers had higher PPI amplitude than the non-smokers (P < 0.05).</p><p><b>CONCLUSIONS</b>There is obvious PPI and P50 deficits in schizophrenic patients. However, these deficits are relatively preserved in the smokers compared with the non-smokers, which suggests that long-term smoking might partially improve the sensory gating in schizophrenic patients. Whether this conclusion can be deduced to female patients requires further follow-ups.</p>

Effects of sleep deprivation on polysomnography and executive function in patients with depression / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Sleep deprivation (SD) has been used in treatment of depression disorder, and could effectively improve the patients' depressive symptoms.The aim of the study was to explore the effects of SD on electroencephalographic (EEG) and executive function changes in patients with depression.</p><p><b>METHODS</b>Eighteen depression patients (DPs) and 21 healthy controls (HCs) were enrolled in the present study. The whole night polysomnography (PSG) was recorded by Neurofax-1518K (Nihon Kohden, Japan) system before and after 36 hours of SD. The level of subjects' depression state was assessed by Visual Analogue Scale (VAS), and the executive function was assessed by Wisconsin Card Sorting Test (WCST).</p><p><b>RESULTS</b>Significantly decreased sleep latency (SL; before SD: (31.8 ± 11.1) minutes, after SD: (8.8 ± 5.2) minutes, P < 0.01) and REM sleep latency (RL; before SD: (79.8 ± 13.5) minutes, after SD: (62.9 ± 10.2) minutes, P < 0.01) were found after SD PSG in depression patients. Decreased Stage 1 (S1; before SD: (11.7 ± 2.9)%, after SD: (7.3 ± 1.1)%, P < 0.01) and Stage 2 (S2, before SD: (53.8 ± 15.5)%, after SD: (42.3 ± 14.7)%, P < 0.05) of non-rapid eye movement (NREM) sleep, and increased Stage 3 (S3, before SD: (11.8 ± 5.5)%, after SD: (23.6 ± 5.8)%, P < 0.01) and Stage 4 (S4, before SD: (8.8 ± 3.3)%, after SD: (27.4 ± 4.8)%, P < 0.01) NREM sleep were also found. After SD, the depression level in patients decreased from 6.7 ± 2.1 to 2.9 ± 0.7 (P < 0.01). In WCST, the patients showed significantly decreased Response errors (Re, before SD: 22.3 ± 2.4, after SD: 18.3 ± 2.7, P < 0.01) and Response preservative errors (Rpe, before SD: 11.6 ± 3.6, after SD: 9.3 ± 2.9, P < 0.05). Depression patients' RE (t = 2.17, P < 0.05) and Rpe (t = 2.96, P < 0.01) also decreased significantly compared to healthy controls.</p><p><b>CONCLUSION</b>SD can improve depression symptom and executive function in depression patients.</p>

Study on event related potentials P300 of children with attention deficit/hyperactive disorder / 中国基层医药

Objective To explore the characteristics of P300 of subjects with attention deficit/hyperactive disorder(ADHD).Methods 34 children with ADHD were selected as ADHD group and 32 healthy subjects were selected as the health control group.They were matched in age,gender,degree of education.The auditory Oddball paradigm was applied,the event-related long latency components (N2 and P3) from Cz and Pz were measured in each test.Results Compared with the health control group,at the Cz electrode,children with ADHD showed a significandy prolonged latency of target N2 [(277.2 ± 20.3) ms vs (259.0 ± 14.9) ms,t =3.70,P ＜ 0.01] and decreased amplitude of target P3[(4.1 ± 1.6) μμV vs (5.7 ±2.0) μμV,t =3.57,P＜ 0.01].At the Pz electrode,the patient showed a significantly prolonged latency [(342.4 ± 26.3) ms vs (324.6 ± 15.5) ms,t =3.33,P ＜ 0.01] and decreased amplitude of target P3 [(4.1 ± 1.9) μV vs (7.4 ± 2.2) μV,t =6.54,P ＜ 0.01],decreased amplitude of non-target P2 [(3.0±1.l)μμV vs (3.7 ±1.3) μV,t =2.30,P＜0.05].Conclusion This study provides direct evidence that ADHD subjects have abnormal indices of endogenous P300,which is suggested that P300 might be potentially objective indicator applied in evaluation of cognitive dysfunction in ADHD children.

Using event-related potentials to explore language processing / 中华物理医学与康复杂志

Objective To investigate the use of component N400 of the event-related potentials (ERPs) elicited by Chinese idioms ending with matching and nonmatching words to explore the cognitive patterns and processing mechanisms elicited by Chinese characters. Methods Sixty-two right-handed healthy adults (age 19-50 years) , were presented with Chinese idioms ending with words with the same pronunciation but different form and meaning, words with similar forms but different pronunciation and meaning, words with same meaning but different pronunciation and form, and words with different pronunciation, form and meaning. A Guangzhou Runjie WJ-1 instrument was used to record component N400 of the potentials evoked. Results N400 showed a midline distribution , and could be detected under electrodes Fz, Cz and Pz. Significant differences were found in N400 latencies and amplitudes between matching and nonmatching ending-words. Compared with idioms with matching ending-words, N400 latencies were prolonged and amplitudes increased in nonmatching cases. The observed changes in N400 latencies and amplitudes were related to stimulus types, and the longest latency and largest amplitude were e-licited by ending-words with different pronunciation, form and meaning. No gender difference in N400 latency or amplitude was observed. Conclusions Compared with Western phonetic words, Chinese ideographic words are more flexible stimuli for N400 research, offering 3 dimensions for change: pronunciation, form and meaning. The N400 features elicited by matching and nonmatching ending words in Chinese idioms are mainly determined by the meaning of the word.

Study on neural generators of N400 in first episode schizophrenia / 上海交通大学学报（医学版）

Objective To explore the features and neural generators of the events related potentials ( ERP) component N400, elicited by congruent and incongruent ending sentences, in first episode schizophrenia patients. Methods N400 was elicited by 76 congruent (31) or incongruent (45) ending Chinese sentences paradigm, and recorded by WJ-1 ERP instruments in 56 first episode schizophrenia. The neural generators of N400 different wave in 105 -615 ms time windows were analyzed by Brain Electrical Activity Mapping software. Results① The N400 latencies were significantly longer and amplitudes significantly higher in incongruent conditions than in congruent conditions in first episode schizophrenia (P < 0.05 or P <0.01).② N400 elicited by Chinese sentences distributed on frontal, parietal, occipital and temporal regions, and had a clear waveform. ③ The main brain areas activated by N400 were frontal areas in 345 -405 ms time windows, and central areas in 420 - 570 ms time windows. Conclusion N400 elicited by Chinese sentences are multi-generated in first episode schizophrenia, especially in frontal area.

Variations of event-related potentials in senile depression and their dynamic changes after treatment / 中华物理医学与康复杂志

Objective To investigate the features of event-related potentials (ERP) P300, auditory evoked potential(AEP) and brainstem auditory evoked potential(BAEP) in senile depression patients and the dynamic chan-ges before and after treatment of sertruline. Methods P300, AEP and BAEP were recorded in 31 senile depression patients using Chinese WOND 2000C Instrument, and a comparison between the patients and 33 normal controls in terms of these evoked potentials were made. Some of the depression patients treated with oral intake of sertraline were followed electophysiologically after 12 months of treatment. Results Compared with normal controls, senile depres-sion patients showed delay of latency of P300-P3 and BAEP-Ⅲ, decreased amplitude of P300-P3, AEP-P2 and BA-EP-Ⅲ(P <0.05 or 0.01). The 12-month follow-up measures of ERP showed significant improvement in terms of la-tency and amplitude of P3/P300,AEP-P2 and BAEP-Ⅲ after treatment of sertraline. Conclusion Senile depres-sion patients showed abnormality on several ERP indexes (such as P3/P300, AEP-P2 and BAEP-Ⅲ), and these in-dexes might provide important evidences to monitor the effect of medicine.

Experiment of brain evoked potentials in "Qigong state" and "hypnosis" of normal adults / 中国组织工程研究

BACKGROUND: Since the diagnostic unit is established in "mental disorder due to Qigong", it has been lack of comparative analysis of experimental observation on whether Qigong exercise affects physiological state in central nerve system, on what the difference are between Qigong and hypnotic induction in the effects on central system.OBJECTIVE: To observe the changes in brain evoked potentials in "normal state", "Qigong meditation" and "hypnosis" so as to analyze the difference between Qigong release and hypnotic induction in cerebral physiological effects in normal adults.DESIGN: Brain evoked potential experiment was designed, in which, normal adults were employed.SETTING: Shanghai Mental Health Center.PARTICIPANTS: They were staffs, interns and volunteers in Shanghai Mental Health Center, of either gender, at any age and with any educational background, totally 52 people.METHODS:① American Nicolet Spirit evoked brain electrophysiological meter was used. The electrodes were attached according to 10/20 system on Cz, C3, C4, Pz and Fz of scalp. Verbal or fixation inductive hypnosis was applied. Hypnosis lasted 20 to 30 minutes, in which, the induction lasted 10to 15 minutes. The experimental observation were performed when the receptors were determined to be in hypnosis.② The Qigong meditation was co-performed by the Qigong masters from Shanghai Qigong Institute or Qigong folk masters. They released "external qi" to the receptors. The degree of "Qigong meditction" was based on folk standards. The observation was carried on when the receptors were identified to be in theQigong state.The entire process lasted 20 to 30 minutes.③ To observe successively the latency and amplitude of the event related potentials [contingent negative variation (CNV), P300 ] and sensory evoked potentials [visual evoked potentials (VEP), auditory evoked potentials (AEP), auditory brainstem reaction (ABR)] of receptors in "normal state", "Qigong meditation" and "hypnotic state". The observed values were performed multiple analysis of variance of single-factor quantitative linear model in 2 × 2 factorial design.MAIN OUTCOMES MEASURES:① Observation of event related potentials. ② Observation of sensory evoked potentials RESULTS: Due to limited result of hypnotic induction and incomplete record of brain-evoked potentials, 3 cases were lost. Terminally, 49 cases entered statistical analysis. ①Observation of event related potentials: under hypnotic state, the amplitude of P300 (target stimuli-P3) was decreased compared with normal state [(4.18±2.23), (6.07±3.23) μV, P ＜ 0.01]. The amplitude of AEP (P2) in hypnotic state and normal state was decreased compared with Qigong meditation [(2.01±1.28), (2.71±1.83), (2.73±1.34)μV, P＜0.05].The amplitude of CNV(M2) was decreased comparedwith normal state and Qigong meditation[(5.93±3.36),(7.83±4.59),(7.76±4.42) μ,V,P ＜ 0.05].②Observation of sensory evoked potentials: The amplitude of VEP (P2, P3) in hypnotic state was reduced compared with normal state and Qigong meditation [(3.47±2.69), (4.76±2.78), (4.30±2.64) μV; (1.18 ±1.08), (1.68±0.95),(2.01±1.48) μV, P ＜ 0.05].CONCLUSION: In hypnotic state, sensory evoked potentials presented low amplitude and such alternation did not appeared in Qigong meditation and normal state. It is explained that there are differences between hypnotic induction and Qigong release in the influence on cerebral physiological process. The extensively recognized hypothesis in Qigong field that "Qigong state" is "hypnosis" cannot be verified by above-mentioned experiment.

The study of event related potential P_(300) in patients with anxiety disorder / 中华物理医学与康复杂志

Objective To investigate the characteristics of event related potential(ERP) P 300 in patients with anxiety disorder. Methods Thirty patients with anxiety disorder (AD group), diagnosed with CCMD 2R, and 30 normal people (NC group) were recruited. The odd ball auditory evoked model was used to test ERP P 300. Results All waveforms of P 300 were clear. (1)Target stimuli: At Fz、Cz electrodes position, compared with those in NC group[respectively (263.3?18.9)ms and(259.5?13.8)ms], latencies of target N2 in AD group were significantly longer [respectively (282.7?34.6)ms and(277.9?22.6)ms](P0.05). (2)Non-target stimuli: At Fz electrodes position, the amplitudes of non-target P2 in AD group[(2.3?1.3)?V] were lower than that in NC group[(3.4?1.0)?V] (P

Sensory evoked potentials in patients with affective disorders accompanying suicidal behavior / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the variations of sensory evoked potentials (SEPs) in patients with affective disorders accompanying suicidal behavior.</p><p><b>METHODS</b>39 depressive patients, 22 manic patients and 33 normal controls were included in the study. Visual, auditory and somatosensory evoked potentials (VEP, AEP & SSEP) were recorded from every subject using a Nicolet Spirit Instrument.</p><p><b>RESULTS</b>Both the depressive and manic groups presented prolonged latencies and decreased amplitudes of major components of SEPs as compared to that of normal controls. Depressive patients with suicidal behavior had decreased P(3) amplitude of VEP (P < 0.05), while maniacs with suicidal behavior had decreased P(2) amplitudes of VEP & AEP (P < 0.05 or 0.01). Compared with patients without suicidal behavior, patients with suicidal behavior had significantly decreased P(3) amplitudes of VEP & SSEP.</p><p><b>CONCLUSIONS</b>The variations of SEPs in patients with affective disorders is closely associated with a history of suicidal behavior. Their clinical significance and biological correlates with suicidal behavior need further study.</p>

Vascular Dementia and Contingent Negative Variation / 复旦学报（医学版）

PurposeTo study the characteristics of contingent negative variation (CNV) in vascular dementia.MethodsCNV was tested and compared in 24 vascular dementia (VD) patients and 22 normal aged persons. Results The data showed that in compare with normal controls the latencies of early component and late component of CNV in VD were greatly prolonged and closely correlated to the extent of dementia. The amplitude of early component was greatly reduced. The reactive time (RT) was prolonged prominently and also correlated with the extent of dementia. The occurrence of postimperative negative variation (PINV) increased. Conclusions The value of CNV can be used to reflect the extent of dementia. Test the CNV in series may help to evaluate the cognitive impairment in VD.