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.

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.

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.

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

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.

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.

Objective:To observe the effects of electroacupuncture(EA)on sleep electroencephalogram(EEG)and event-related potential(ERP)in patients with somatoform disorders(SFD). Methods:Seventy-five SFD patients were recruited as an EA group to receive EA at Shenting(GV24)and Baihui(GV20)once daily,30 min each time,with 6 straight days as a treatment course,and 4 courses were conducted at 1-day intervals.Before treatment,patients underwent a survey using a physical symptom checklist on their primary symptoms.Before and after treatment,their sleep EEG was monitored using Quisi,and the ERP mismatch negativity(MMN)and P300 were detected.The Quisi sleep EEG and ERP were also examined among 40 normal volunteers as the normal group data. Results:During the trial,13 cases were removed from the EA group due to incomplete data,and 62 cases were finally included for statistical analyses.Of the 62 SFD patients,the main disturbing symptoms were cognitive impairments,sleep disorders,respiratory symptoms,digestive symptoms,five-sense organ problems,and cardiovascular symptoms in order.Before treatment,the EA group had increased MMN and P300 latencies and decreased amplitudes compared with the normal control group(P<0.01 or P<0.05);according to Quisi,the EA group also had reduced total sleep time(TST),shorter rapid eye movement sleep(REM)latency(RL)and REM time(RT),smaller number of REM period(NRP),extended sleep latency(SL),longer awaking time(AT),lower sleep efficiency(SE),larger percent of non-rapid eye movement sleep(NREM)stage 1(S1)and smaller percent of NREM stage 2(S2),and the percent of slow wave sleep(SWS),i.e.NREM stage 3(S3)plus stage 4(S4),also went down,all presenting significant differences between groups(P<0.01 or P<0.05).After 4 courses of treatment,the MMN and P300 latencies were reduced,and their amplitudes became larger in the EA group compared with the baseline(P<0.05);they had insignificant differences compared with the normal control group(P>0.05).Quisi showed that the TST and RL increased,and the SL and AT decreased in the EA group,and the predominant change in sleep architecture was reduced S1 percent,increased S2,and improved SE,all showing significant intra-group differences(P<0.01 or P<0.05);however,the intra-group difference in the NRP was statistically insignificant(P>0.05).Except the TST,RT,S1 percent,and SWS,there was no statistical significance in comparing the other Quisi parameters(including RL,NRP,SL,AT,SE,and S2 percent)between the two groups(P>0.05). Conclusion:SFD patients have a variety of clinical symptoms,and most of them show abnormal sleep EEG and ERP;EA can correct abnormal sleep EEG parameters and the MMN and P300 of ERP in SFD patients.

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.

OBJECTIVETo investigate the variations of sensory evoked potentials (SEPs) in patients with affective disorders accompanying suicidal behavior.

METHODS39 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.

RESULTSBoth 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.

CONCLUSIONSThe 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.

Adult ; Bipolar Disorder ; physiopathology ; Depressive Disorder ; physiopathology ; Evoked Potentials, Auditory ; Evoked Potentials, Somatosensory ; Evoked Potentials, Visual ; Female ; Humans ; Male ; Middle Aged ; Suicide, Attempted

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.