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 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.

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.

Chest wall tuberculosis is a common extra-pulmonary tuberculosis, which often occurs in lung or pleura tuberculosis, or coexists with tuberculosis in other parts. The final manifestation of the disease is cold abscess on the chest wall, chronic sinuses with repeated exudation after the abscess is broken. At present, There were a series of problems in the diagnosis, treatment, and extremely prognosis of tuberculosis of the chest wall. Therefore, we reviewed the diagnosis of chest wall tuberculosis, including B-ultrasound, chest CT and positron emission tomography/computed tomography (PET/CT), tuberculous infectin of T cells spot test (T-SPOT TB), pathological examination. The related treatments including medical treatment, surgical treatment and other local treatment in order to better understand the chest wall tuberculosis.

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.

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.

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.

BACKGROUNDSleep 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.

METHODSEighteen 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).

RESULTSSignificantly 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.

CONCLUSIONSD can improve depression symptom and executive function in depression patients.

Adult ; Depression ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Polysomnography ; methods ; Sleep Deprivation ; physiopathology

BACKGROUNDNicotine 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).

METHODSThe 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).

RESULTSCompared 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).

CONCLUSIONSThere 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.

Adult ; Case-Control Studies ; Evoked Potentials ; drug effects ; physiology ; Humans ; Male ; Reflex, Startle ; physiology ; Schizophrenia ; physiopathology ; Smoking ; adverse effects ; Young Adult

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.