Objective:To assess type C behavior in patients with oral lichen planus (OLP) in order to provide basis for clinical prevention,treatment and psychological intervention of OLP.Methods:Type C behavior scale was used on 85 OLP patients and 85 control patients,who were in accordance with the inclusion criteria,in order to investigate their type C behavior.The scale included 9 items:anxiety,depression,anger,anger toward inside (anger-in),anger toward outside (anger-out),reasoning,domination,optimism,and social support.Scores of the 9 items between OLP patients and control group were calculated under the instruction of the scale and were statistically analyzed,and OLP group was further stratified statistically by sex,reticulate-erosive-ulcerative (REU) pathological type and course of diseases,and the scores of each group were analyzed and compared.Results:Among the 85 OLP patients,there were more females,more non-erosive lesion type,and the most common site for OLP was the buccal mucosa.The scores of the type-C behavior questionnaire for anxiety,depression,anger and optimism were respectively 43.01 ± 7.47,44.02 ± 7.61,21.56 ± 5.26,22.15 ± 4.00 among the OLP patients and were 37.94 ±8.70,39.58 ±7.35,18.12 ±5.39,24.05 ±3.23 among control group,with significant differences (P ＜ 0.05 for all) between the two groups.The female OLP patients had higher anxiety,depression,anger scores (43.21 ± 6.97,44.29 ± 7.54,21.64 ± 5.09) and lower reasoning,domination,optimism scores (39.12 ±5.66,16.29 ±3.95,22.05 ±4.12) with significant differences (P ＜0.05 for all) compared with those of the female controls.The scores between male patients and male controls showed no significant difference.The patients with erosive lesions had higher anger score (22.94 ± 5.26) than that of the patients without erosive lesions (20.60 ± 5.03),with a significant difference (P ＜ 0.05).With the development of the disease,the tendency of anxiety and depression of the patients were more obvious,while optimism scores remained declining.The patients suffering more than 3 years of OLP had higher anger-toward-outside scores (17.36 ± 3.35) than the patients suffering less than 3 years of OLP (15.19±3.99),with a significant difference (P ＜0.05).Conclusion:OLP patients showed an obvious type C behavior characteristic,especially in anxiety,depression,anger and low optimism.This research provides the C behavior characteristic of OLP for further psychological consultation or intervention during OLP treatment.

Objective To investigate the efficiency of intraoperative neurophysiological monitoring in cervical spinal tumor surgery.Methods Retrospective case-control study comparing 23 cervical spinal tumor patients received surgery under neurophysiological monitoring (case) and 23 cases without neurophysiological monitoring (control).Results All of 46 cases,there were no significant differences of age,gender and preoperative neurological function.Duration of operation and estimated blood loss in the IONM cohort was less than the control group with significant difference.The preoperative JOA score of IONM group and control group were 12.0±2.4 and 12.7±2.1,with no significant difference.The postoperative JOA score of each group were 15.0±1.5 and 15.2±1.7,with no significant difference.The rate of cervical cord neurological improvement of IONM group was higher than control group,but there was no significant difference.In the IONM cohort,abnormal signal appeared in 8 cases,with 1 case developed new postoperative deficit,and the sensitivity and specificity of SEP were 100％ and 77.3％,the sensitivity and specificity of MEP were 100％ and 86.4％.Compared with preoperative SEP,4 cases showed major improvement (baseline increase ＞ 40％),2 cases showed moderate improvement (baseline increase:15％-40％).The coincidence rate of the SEP improvement and the AISA grade was 66.7％.Conclusion IONM could reduce the duration of operation and intraoperative blood loss.Changes of IONM were correlated with postoperative neurological function improvement.

Objective The type 1 autoimmune pancreatitis is gradually being recognized, but the type 2 AIP is still very rare in Asia.This paper summarizes the clinical characters of type-2 AIP patients in Peking Union Medical College Hospital.Methods From January 2001 to December 2016,all type 2 AIP hospitalized patients who met the ICDC were included in the study.The clinical data, laboratory results and imaging features of all patients were recorded, verified and follow-up.Results Six patients with type 2 AIP were included in the study.The ratio of men and women was 2/1, with an average age of 38.4 years.67.7% (4/6) patients have UC.37.7% (2/6) of patients were asymptomatic.Three patients were diagnosed by pathology.50% (3/6) of patients showed mass of pancreas, and 50% (3/6) of patients showed pancreatic enlargement.Conclusions The clinical manifestations of the type 2 AIP patients in Peking Union Medical College Hospital are the same as those in foreign countries.

Objective To investigate the predictors of deep remission in patients with Crohn′s disease (CD)treated with infliximab.Methods From February 2008 to February 2015 ,the clinical, laboratory and follow up data of 44 CD patients who received infliximab treatment and maintained clinical remission over six months were retrospectively analyzed.Mucosal healing was defined as no ulcer under endoscopy.Deep remission was defined as clinical remission with mucosal healing.According to results of endoscopy examination,the enrolled patients were divided into deep remission group and non-deep remission group.T test or Wilcoxon rank sum test was used for comparison of measurement data between groups,and chi square test was performed for the rate comparison.Multivariate analysis was made with Logistic regression.Results Median age of 44 patients was 19.5 yeares,39 males (88.6%),five females (11 .4%),and the median disease duration was 35 .0 months (18.5 to 73.5 months).Deep remission was achieved in 20 CD patients with long-time follow-up (median follow-up time 19 months,12 to 29 months). The mean duration of achieving deep remission was (28.9 ± 14.3 )weeks.There was no statistically significant difference between 20 patients with deep remission and 24 patients without deep remission in age of onset,disease duration,smoking status,Montreal phenotype,concurrent medications (mesalazine, steroids and azathioprine ), as well as body mass index (BMI ) and laboratory tests (erythrocyte sedimentation rate (ESR),high-sensitivity C-reactive protein (hsCRP),hemoglobin (Hb)and platelet (PLT)count)before administrating.The results of Logistic regression demonstrated that extraintestinal manifestations (arthralgia)(odds ratio (OR)=29.9,95 % confidence interval (CI )1 .26 -714.20,P =0.036),normalization of hs CRP at 14 th week after induced remission (OR=0.88,95 %CI 0.78-0.99, P =0.045)and thrombocytopenia (OR = 0.98,95 %CI 0.96 - 0.99,P = 0.016 )were independent predictive factors of deep remission.Conclusions Infliximab could effectively maintain long term deep remission in treatment of CD.Arthralgia,normalization of hsCRP and PLT counts at 14 th week after induced remission are predictive factor of deep remission.

Objective To analyze the discrepancy and similarities of clinical characteristics in elderly patients with ulcerative colitis (UC) and ischemic colitis (IC).Methods A total of 43 elderly patients (age≥60 yrs) with UC and 36 elderly patients with IC were enrolled from 2004 to 2015 at Peking Union Medical College Hospital.The clinical characteristics were retrospectively analyzed and compared between the two groups.Results Compared with IC group,the disease course was longer with lower incidence of cardiovascular comorbidities in UC patients (P ＜ 0.05).In UC group,more patients presented with diarrhea,mucopurulent bloody stool [39 (90.7％) vs 16 (44.4％) and 34 (79.1％) vs 2 (5.6％)respectively,both P ＜ 0.01].Yet bloody stool as the only symptom was seen in more IC patients than UC patients [61.1％ (22/36) vs 7.0％ (3/43),P ＜ 0.01].The ratio of extra-intestinal manifestations was higher [18.6％ (8/43) vs 0 (0/36)] in UC patients,while complications were lower [11.6％ (5/43) vs 30.6％ (11/36),P ＜ 0.05].As to the laboratory parameters,median platelet count [(294.38 ± 104.83) × 109/L vs (235.47±94.82) × 109/L,P ＜0.05] was higher in UC group.In addition,more patients with UC had positive perinuclear antineutrophil cytoplasmic antibody (p-ANCA) [50.0％ (15/30) vs 10.0％ (2/20),P ＜ 0.05].The most commonly involved regions of IC were descending colon and sigmoid colon,in which the lesions were clearly demarcated with the normal mucosa.Lesions in patients with UC mainly originated from rectum and might spread to the whole colon.Vascular occlusion and micro thrombosis were characteristic pathological findings of IC.The crypt abscesses were frequently seen in the UC group.Conclusion Even though UC and IC have some similar manifestations in the elderly patients,clinical and pathological discrepancy is still helpful to differentiate each other.

Objective To observe the electronic physiological mechanism of Low Resistance Thought Induction Psychotherapy (TIP) on depression.Methods 48 patients with depression were randomly divided into TIP group and Citalopram group.The observation period was 6 months.The Hamilton Rating Scale for Depression(HAMD) was used to evaluate the efficacy,and Polysomnogram(PSG)was used to evaluate the electronic physiological mechanism.Results TIP had efficacy on reducing numbers of wake [before treatment (3.92±3.24),after treatment (2.38± 1.21),P＜0.05]、REM time [before treatment (86.75 ±28.29),after treatment (63.19±28.11),P＜0.01]、REM％ [before treatment (23.89±6.84),after treatment (16.16±6.36),P＜0.01].Citalopram had efficacy on increasing Sleep time [before treatment (350.52±50.71),after treatment (388.58±43.89),P＜0.01]、number of REM [before treatment (3.71±2.87),after treatment (5.17±5.58),P＜0.05]、S3+4 [before treatment (35.79±32.76),after treatment (56.77±34.21),P ＜0.05]、S3 +4％ [before treatment (10.13 ± 9.20),after treatment (14.53 ± 8.66),P＜0.05]、REM time [before treatment (66.39±29.22),after treatment(78.61 ±30.19),P＜0.05].TIP had superior to Citaloprarn on regulating numbers of wake and REM time.Conclusions Electronic physiological mechanism of TIP treating depression is to regulat numbers of wake,REM time,REM％.

Objective To investigate the value of color Doppler flow imaging(CDFI) in diagnosing lower limb artery in-stent restenosis (ISR), and to provide the evidences for clinical application. Methods Patients with lower limb artery percutaneous transluminal stent insertion in 12 months were enrolled in this study and divided into two groups, CT angiography (CTA) or digital subtraction angiography (DSA) was applied to diagnose ISR, 31 patients with 47 stenting which were diagnosed ISR was named as restenosis group, 63 patients with 89 stenting which were diagnosed no ISR was named as no stenosis group, and 30 normal person was enrolled and named as normal control group. Ultrasonic characteristics and peak systolic blood flow velocity (PSV), systolic blood flow acceleration time (AT) of proximal part, inner stents, distal part were recorded in restenosis group and no stenosis group, then compared with data in normal control group. Regression and receiver operator (ROC) curve were applied to analyse the correlation between PSV and AT. Results PSV of no stenosis group in common femoral artery, femoral artery, superifcial, popliteal artery stent respectively were (146.71±35.59) cm/s, (120.11±25.67) cm/s, (96.44±32.87) cm/s. PSV of normal control group in common femoral artery, femoral artery, superifcial, popliteal artery respective were (119.67±15.34) cm/s, (91.17±15.09) cm/s, (71.13±21.23) cm/s. There was statistically signiifcant difference between the two groups (t=2.457, 2.459, 2.321, all P<0.05). AT of no stenosis group in common femoral artery, femoral artery, superficial, popliteal artery stent respectively were (84.98±13.77) ms, (87.33±16.36) ms, (90.77±12.05) ms. AT of normal control group in common femoral artery, femoral artery, superficial, popliteal artery respective were (78.23±21.24) ms, (82.31±18.24) ms, (84.29±23.01) ms. There was no statistically signiifcant difference between the two groups (t=1.696, 1.904, 1.835, all P>0.05). PSV of restenosis group in proximal part, restenosis part, distal part respectively were (87.67±23.34) cm/s, (218.17±72.09) cm/s, (54.13±21.23) cm/s. PSV of no stenosis group in proximal part, inner stents, distal part respectively were (91.71±25.59) cm/s, (131.11±45.67) cm/s, (96.44±32.87) cm/s. There was statistically significant difference between restenosis part/inner stents, distal part (t=3.412, 3.511, both P<0.05). There was no statistically signiifcant difference between the two groups in proximal part (t=1.901, P>0.05). AT of restenosis group in proximal part, restenosis part, distal part respectively were (98.31±14.09) ms, (109.54±21.03) ms, (158.23±45.21) ms. AT of no stenosis group in proximal part, inner stents, distal part respectively were (84.98±13.77) ms, (86.34±19.36) ms, (83.77±17.05) ms. There was statistically signiifcant difference between restenosis part/inner stents, distal part (t=2.319, 3.610, both P<0.05). There was no statistically signiifcant difference between the two groups in proximal part (t=1.833, P>0.05). ROC curve showed that in ISR lower limb artery, PSV>168 cm/s had a sensitivity of 89.4%, speciifcity of 92.1%, the area under the ROC curve was 0.949;AT>127 ms, had a sensitivity of 86.8%, speciifcity of 98.0%, the area under the ROC curve was 0.867. Conclusions CDFI can detect the changes of PSV and AT, ISR can be detected and diagnosed earlier in lower limb artery. By combining PSV>168 cm/s with AT>127 ms, the value of ISR diagnosis can be increased.

Objective To clarify the efficacy and safety of cyclosporine A CsA) as salvage therapy in patients with severe active ulcerative colitis (UC) and refractory to steroids.Methods A total of 24 severe active UC patients refractory to steroids and hospitalized from 2006 to 2012,were retrospectively enrolled.Data including demographic features,clinical manifestations,laboratory tests and medications were collected.Results CsA was effective in 15 (62.5％) patients,who did not receive colectomy during 12-week administration.This regimen was tolerable in most patients.Twelve (50.0％) patients reported 16 adverse events,but only one patient withdrew CsA due to intolerance.The rates of adverse events in initial intravenous CsA including 4 mg · kg-1 · d-1,3 mg · kg-1 · d-1 and 2 mg· kg-1 · d-1 were 2/2,9/17 and 1/5 respectively.Responders had higher white blood cell count compared with non-responders (P =0.045).Conclusions CsA could be an effective alternative regimen to colectomy in severe active UC patients who are refractory to steroids.

Carotid Artery, Internal ; physiology ; Carotid Body Tumor ; blood supply ; complications ; surgery ; Carotid Sinus ; physiopathology ; Female ; Humans ; Middle Aged ; Syncope ; etiology ; Syndrome

Cardiac Catheterization ; Ductus Arteriosus, Patent ; therapy ; Heart Septal Defects, Atrial ; therapy ; Humans ; Printing, Three-Dimensional ; Vena Cava, Inferior