Objective To provide scientific basis for developing mental interventions for the wounded in major disasters by assessing the mental health status and the mental intervention effect among the Wenchuan earthquake survivors transferred to Chongqing.Methods A total of 389 transferred wounded survivors were examined by using questionnaires including general information questionnaire,Psychological Health Self-rating Questionnaire (PHSQ),Symptom Checklist 90 (SCL-90),Perceived Social Support Scale (PSSS) and Coping Styles Questionnaire (CSQ).According to PHSQ,the wounded were divided into control group and stress group.Then,the stress group was given mental intervention and taken the second mental evaluation one month later.Results Acute stress disorder (ASD) rate (30.08％) was remarkably observed in these transferred wounded,who were subsequently administered a set of mental intervention.The wounded whose PHSQ mark ≥8 were defined as the stress group (Group A) and the others as the control group ( Group B).Compared with Group B,Group A had higher scores in depression ( P ＜ 0.01 ),anxiety ( P ＜ 0.01 ) and consternation ( P ＜ 0.01 ),and lower scores in PSSS (P ＜0.01 ).Group A inclined to negative coping styles mainly including shrink back (P ＜ 0.01 ) and fantasy (P ＜0.01 ),while Group B inclined to coping styles mainly including rationalization and help.The PSSS score in Group A was significant lower than that in Group B (P ＜ 0.01 ).The scores in PHSQ,SCL-90 (anxiety and consternation),CSQ and PSSS were significantly improved after the mental intervention in Group A.Conclusions The incidence of ASD is high in the transferred wounded survivors and is mainly related with mental stress,such as emotional symptoms,negative coping styles and low perception of social support.Early mental interventions will help improve the psychological status of the transferred wounded.

Objective:To investigate the relationship between vulnerability of mouse coronary artery plaque and downstream myocardial perfusion and myocardial strain.Methods:Thirteen ApoE knockout mice with stable coronary plaques (stable plaque group)and 13 ApoE knockout mice with vulnerable coronary plaques(vulnerable plaque group) were selected as the experimental group, and 15 sex- and age-matched C57BL/6 mice with the same genetic background as ApoE mice were chosed as the control group. Myocardial contrast echocardiography (MCE) was carried out to quantify regional myocardial perfusion at rest and during adenosine stress using a Vevo 2100 system (Visual sonics). Replenishment curves of myocardial contrast were obtained, and rates of signal rise (β) and plateau intensity (A) were recorded. MBF was estimated by the product of A and β. Speckle tracking imaging combined with adenosine stress test was used to evaluate the longitudinal strain of left ventricular myocardium in mice. The vulnerability of the plaque was assessed by histopathology in serial tissue sections of proximal and middle left coronary artery according to the previously reported method.Results:There were no significant differences in body weight, heart rate, left ventricular end diastolic volume, left ventricular end systolic volume, left ventricular mass and ejection fraction among the three groups( P>0.05). The levels of serum triglyceride, total cholesterol, high density lipoprotein and low density lipoprotein in stable plaque group and vulnerable plaque group were significantly increased when compared with those in control group (all P<0.05). The pathological results showed that the coronary luminal stenosis rates in the stable plaque group and the vulnerable plaque group were (74.3±4.9)% and (75.5±7.1)% respectively, with no significant difference between the two groups( P>0.05). MBF of the middle anterior septum and left ventricular posterior wall in the experimental groups were significantly decreased when compared with that in the control group both in the resting status and during adenosine stress(all P<0.05). There were no significant differences in the MCE parameters between the stable plaque group and the vulnerable plaque group at rest( P>0.05). However, during adenosine stress, MBF of the vulnerable plaque group was decreased more significantly than that of the stable plaque group ( P<0.05). Compared with the control group, the values of longitudinal strain of the left ventricle in both experimental groups were decreased during resting status, without statistical significance (all P>0.05), but decreased significantly during adenosine stress and with more decrease in the vulnerable plaque group (all P<0.05). Conclusions:For the same degree of coronary artery stenosis in mice, the coronary artery vulnerable plaque group has less downstream myocardial perfusion and myocardial strain than the stable plaque group during adenosine stress. That is, the plaque vulnerability can affect the downstream myocardial perfusion and myocardial strain in the mouse model.

Objective To assess the reproducibility of contrast-enhanced echocardiography and conventional echocardiography for measurements of left ventricular ejection fraction(LVEF) and left ventricular volume in patients undergoing cancer chemotherapy. Methods One hundred and two patients undergoing cancer chemotherapy were divided into satisfactory image group(36 subjects) and unsatisfactory image group(66 subjects) according to the quality of the recorded images.High frame rate two-dimensional and three-dimensional images were recorded from apical long-axis view,four-chamber view and two-chamber view of left ventricle. Contrast-enhanced echocardiography was performed in the unsatisfactory image group.Two equally experienced examiners measured the LVEF and left ventricular volume in all patients by EchoPac software. Results The reproducibilities of Simpson′s biplane method and 3D full-volume echocardiography were low for measurements of LVEF in unsatisfactory image group ( P < 0.01).But they were improved significantly with contrast-enhanced echocardiography ( P > 0.05 ). The reproducibilities of Simpson′s biplane method and 3D full-volume echocardiography for measurements of left ventricular end-diastolic volume in unsatisfactory image group were also improved by performing contrast-enhanced echocardiography ( P > 0.05). The reproducibilities for measurements of left ventricular end-systolic volume were well in both group.Conclusions The reproducibilities for measurements of LVEF and left ventricular volume are improved in patients undergoing cancer chemotherapy with unsatisfactory images by using contrast-enhanced echocardiography.

Objective:To explore the clinical characteristics of adult-onset non-radiographic axial spondyloarthritis (nr-axSpA) in different genders.Methods:A total of 662 patients with adult-onset nr-axSpA (age at disease onset ≥16 years) who visited the Rheumatology Department of the First Affiliated Hospital of Shantou University Medical College from 1999 to 2020 were included in the study. Comparisons of baseline demographic and clinical characteristics between different genders were performed.Results:Overall, the male-to-female ratio was 1.17∶1, and the prevalence of human leukocyte antigen-B27 (HLA-B27) positivity was 71.8%(475/662). The median baseline disease duration and age at diagnosis was 1.6 (0.5, 4.0) years and 25.0 (21.0, 33.0) years respectively. The males had a significantly earlier age at disease onset and diagnosis [21.0 (18.0, 28.0) vs 25.0 (21.0, 30.0), Z=5.63, P<0.001; 24.0 (19.0, 32.0) vs 27.0 (23.0, 34.5), Z=4.90, P<0.001, respectively] than females. HLA-B27 positivity was more frequent in males than in females [78.4% (280/357) vs 63.9%(195/305), χ2=17.06, P<0.001]. The prevalence of inflammatory back pain (IBP), morning stiffness, nocturnal pain, enthesitis, hip and groin pain were higher in males, whereas females showed a higher prevalence of small joint involvement of the hands. At baseline, males had higher median ankylosing spondylitis disease activity score (ASDAS)-C-reaction protein (CRP) [3.0(2.3, 3.8) vs 2.4(2.0, 3.0), Z=5.59, P<0.001] and a greater prevalence of high disease activity ASDAS-CRP>2.1 [81.9%(185/227) vs 67.9%(133/195), χ2=11.08, P=0.001] than females. The proportions of male patients with elevated CRP levels and erythrocyte sedimentation rate (ESR) were also higher than those of female patients [49.0%(175/357) vs 27.9%(85/305), χ2=30.85, P<0.001; 49.3%(176/357) vs 33.4%(102/305), χ2=16.98, P<0.001, respectively]. Conclusion:The adult-onset nr-axSpA in China is characterized by a comparable sex ratio. Males have an earlier age at disease onset and are higher HLA-B27 positivity with higher prevalence of IBP, enthesitis, hip and groin pain, as well as high disease activity.

Systemic lupus erythematosus (SLE) complicated with acquired hemophilia A (AHA) is a rare condition with frequently delayed diagnosis and a high mortality rate, so it is necessary to strengthen the understanding of this disease. In this study, the characteristics and treatment in 1 case of SLE complicated by AHA is reported and analyzed, and a literature review is conducted. The patient was a 29-year-old young female with a 10-year history of SLE, the main clinical manifestation was severe abdominal bleeding. Laboratory tests revealed that the activated partial thromboplastin time (APTT) was notably prolonged (118.20 s), and the coagulation factor VIII activity (FVIII꞉C) was extremely decreased (0.20%) with high-titer of factor VIII (FVIII) inhibitor (31.2 BU/mL). After treating with high-dose glucocorticoid, immunoglobulin, cyclophosphamide, rituximab, blood transfusion, and intravenous infusion of human coagulation FVIII, the coagulation function and coagulation FVIII꞉C were improved, and FVIII inhibitor was negative without serious adverse reactions. During the next 5-year follow-up, the patient's condition was stable and no bleeding occurred. In the case of coagulation dysfunction in SLE, especially with isolated APTT prolongation, AHA should be screened. When the therapeutic effects of glucocorticoid combined with immunosuppressants are not desirable, rituximab could be introduced.
Female ; Humans ; Adult ; Hemophilia A/therapy* ; Rituximab ; Glucocorticoids ; Factor VIII ; Lupus Erythematosus, Systemic/complications* ; Hemorrhage/complications*