Recent studies suggest that changes of cervical vestibular-evoked myogenic potential (cVEMP) could be observed postoperatively, which reflects the degree of damage to saccule caused by cochlear implant (CI). The waveform of cVEMP can display the influences of surgical methods, ear disease condition, machine status and other factors on saccule, therefore it shows important clinical value in diagnosis and treatment. Two possible changes of cVEMP may be observed after CI. One is negative response and the other is impairment, which reflects surgical injury to saccule with varing degree. However, a uniform quantitative conclusion in cVEMP parameters is still expected. By reviewing the studies in cVEMP of CI reciepients, a typical changing pattern was discovered and a more comprehensive understanding about vestibular changes after cochlear implant was achieved.
Cochlear Implantation ; Humans ; Vestibular Evoked Myogenic Potentials

OBJECTIVE: To observe the ocular vestibular evoked myogenic potential (oVEMP) and the cervical vestibular evoked myogenic potential (cVEMP) in patients with vestibular diseases. METHOD: From March, 2011 to March, 2012, 13 patients (14 ears) with peripheral vestibular diseases were recruited. Each patient underwent conventional oVEMP and cVEMP examinations elicited by intensive air conducted sound (short tone burst, 500 Hz) in bilateral ears. RESULT: Thirteen cases (14 ears) were included in this study. They were 3 cases (3 ears) with Ramsay Hunt syndrome, 3 cases (4 ears) with acoustic neuroma, 1 case (1 ear) with VII and VIII cranial nerve trauma after head injury, 2 cases (2 ears) with vestibular neuritis, 3 cases (3 ears) with Meniere's disease, and Icase (1 ear) with unilateral hypoplasia of the internal auditory canal. Altogether, oVEMP could be elicited in only 2 ears (14. 3%) and cVEMP were found abnormal in 11 ears (78. 6%). CONCLUSION The otolithic vestibular end organs and their input pathways could be examined by cVEMP and oVEMP examinations in patients with peripheral vestibular disorders.
Acoustic Stimulation ; Eye ; Humans ; Meniere Disease ; Neuroma, Acoustic ; Otolithic Membrane ; Vestibular Diseases ; physiopathology ; Vestibular Evoked Myogenic Potentials ; Vestibular Neuronitis ; Vestibule, Labyrinth

Cochlear implantation has become a crucial approach for the treatment for patients with severe and profound sensorineural hearing loss. However, some patients would be embarrassed by the exterior components, which limited the patient′s social activities. The idea of totally implantable cochlear implant (TICI) was put forward to alleviate these inconveniences. The implantable acoustical-electrical transducer would be a breakthrough in the study of TICI. In this paper, a summary of all kinds of designs ideas was made.

Objective:To establish a nomogram model for predicting positive resection margins after prostate cancer surgery, and to perform the corresponding verification, in order to predict the risk of positive resection margins after surgery.Methods:A total of 2 215 prostate cancer patients from The First Affiliated Hospital of Naval Medical University, Hospital, Peking University First Hospital, Peking University Third Hospital, Peking University, and First Affiliated Hospital of Xi′an Jiaotong University were included in the PC-follow database from 2015 to 2018, and a simple random sampling method was used. They were divided into 1 770 patients in the modeling group and 445 patients in the verification group. In the modeling group, the age (<60 years, 60 to 70 years, >70 years), PSA (<4 ng/ml, 4-10 ng/ml, 11-20 ng/ml, >20 ng/ml), pelvic MRI (negative, suspicious, positive), clinical stage of the tumor (T 1-T 2, ≥T 3), percentage of positive needles (≤33%, 34%-66%, >66%), Gleason score of biopsy pathology (≤6 points, 7 points, ≥8 points). Univariate and multivariate logistic analysis were performed to screen meaningful indicators to construct a nomogram model. The model was used for validation in the validation group. Results:The results of multivariate analysis showed that preoperative PSA level ( OR=2.046, 95% CI 1.022 to 4.251, P=0.009), percentage of puncture positive needles ( OR=1.502, 95% CI 1.136 to 1.978, P=0.002), Gleason score of puncture pathology ( OR=1.568, 95% CI 1.063 to 2.313, P=0.028), pelvic MRI were correlated ( OR=1.525, 95% CI 1.160 to 2.005, P=0.033). Establish a nomogram model for independent predictors of positive margin of prostate cancer. The area under the receiver operating characteristic (ROC) curve of the validation group is 0.776. The area under the ROC curve of the preoperative PSA level, percentage of puncture positive needles, puncture pathology Gleason score, pelvic MRI, postoperative pathology Gleason score were 0.554, 0.615, 0.556, 0.522, and 0.560, respectively. The difference between the nomogram model and other indicators was statistically significant ( P<0.05). Conclusions:The constructed nomogram model has higher diagnostic value than the preoperative PSA level, percentage of puncture positive needles, Gleason score of puncturing pathology, pelvic MRI, and postoperative pathological Gleason score in predicting positive margin.

Objective:To investigate the risk factors for Gleason score upgrading after radical prostatectomy in clinical low-risk prostate cancer patients aged≥65 years.Methods:A total of 485 clinical low-risk prostate cancer patients aged≥65 years at five centers of the national multi-center PC-follow database from January 2015 to March 2019 were retrospectively analyzed.Data including age at diagnosis, prostate-specific antigen(PSA), MRI prostate imaging, puncture Gleason score, operation method, puncture method, positive incision margin and capsule penetration were collected.Differences in Gleason scores before and after operation were compared, and the risk factors for Gleason score upgrading after radical resection were evaluated by univariate and multivariate Logistic regression analysis.Results:Of 485 patients with a puncture Gleason score of 3+ 3=6, 261(53.8%)cases had postoperative pathological upgrading, in whom 228(87.4%)cases had Gleason score upgrading of 7, 22(8.4%)had Gleason score upgrading of 8, and 11(4.2%)had Gleason score upgrading of 9 or more.The rate of Gleason score upgrading was elevated with increased preoperative PSA levels, positive pelvic MRI, and higher positive rates of puncture biopsy.The incidences of postoperative capsule penetration(27.2% vs.12.5%, P<0.001)and positive incision margin(25.2% vs.17.4%, P=0.036)had statistically significant differences between the pathologically upgraded group and the pathologically non-upgraded group.Multivariate analysis showed that preoperative PSA level, percentage of positive puncture biopsies, biopsy Gleason score and pelvic MRI were independent predictors of prostate cancer. Conclusions:For clinical low-risk prostate cancer patients aged≥65 years with high risk factors for Gleason score upgrading, repeated biopsies should be carried out when necessary and the treatment plan should be adjusted accordingly.

OBJECTIVETo identify the aging effects on air-conducted sound (ACS) elicited ocular vestibular-evoked myogenic potential (oVEMP) and cervical vestibular-evoked myogenic potential (cVEMP) in normal Chinese population.

METHODSNighty-seven normal subjects (194 ears) were recruited for conventional ACS-oVEMP and ACS-cVEMP examinations. The candidates'age were 4-83 years old (Ave. ± SD, 45.7 ± 19.3), 41 male and 56 female, divided into 5 groups according to age. 500 Hz short tone burst was employed for examinations. Thresholds were identified and the parameters of the responses to 100dB nHL were calculated and compared among groups. SPSS 13.0 software was used to analyze the date.

RESULTSAs the age growing, the response rate for oVEMP decreased. It was recorded 100% in both ≤ 10-year-old and 11-30-year-old groups, 84.00% in the 31-50-year-old group, 48.15% in the 51-70-year-old group and 15.00% in the > 70-year-old group; while that for cVEMP were 100% in both ≤ 10-year-old group and 11-30-year-old group, 82.00% in the 31-50-year-old group, 77.78% in the 51-70-year-old group and 45.00% in the > 70-year-old group. The thresholds elevated and the amplitudes decreased in both examinations with the age growing. However, latencies and latency-intervals of both oVEMP and cVEMP examinations displayed minor difference among groups except that nI latency of oVEMP prolonged with age growing.

CONCLUSIONSWith the age growing, the otolithic end organ input pathways degenerate in normal subjects, as shown that ACS elicited oVEMP and cVEMP responsed less with higher threshold and smaller amplitude. The extremely low response rates of both VEMPs in the > 70-year-old group in this study indicates that VEMPs can only provide limited diagnostic information among very old people in clinical practice.

Aging ; Evoked Potentials ; Eye ; Female ; Head ; Humans ; Male ; Neck ; Otolithic Membrane ; Sound ; Vestibular Evoked Myogenic Potentials ; Vestibule, Labyrinth