Objective Provided the basis on psychological treatment for the earthquake wounded, through investigated the psychological healthy condition of them in Yushu, Qinghai Province. Method To investigated the 102 cases earthquake wounded from 15 - 18 April 2010 who transported from Yushu, Qinghai to West China hospital of Sichuan University; Accept standard: The wounded (96 cases) who could cooperated this investigative; Adopted the Hamiton anxiety scale( HAMA) to had a review investigation for the wounded in the from of talk, and used the SPSS statistics software to have the Wilcoxon Mann-Whitney test and correlation analysis for the investigation data. Results There were 55 of the 96 cases have been confirmed anxiety, HAMA > 14 points; 16 cases had serious anxiety (HAMA > 29 points); The average score in all of them equal to (17.3 ±10.8) points. And there was a remarkable difference between male and female. The age is possible have related degree with the wounded anxious. What the main in their characteristics of them was Psychic anxiety. Conclusions There was apparent anxiety of them whom came from Yushu, Qinghai, and they needed proactive psychological treatment, female、 middle-aged and elderly need more.

Objective According to radiation therapy (6WV-X line) on experimental gerbils which were successfully infected by echinococcus granulosus,the outcomes of bone hydatid disease after radiation therapy were studied.Methods Totally 240 gerbil models that were infected bone hydatid disease,were randomly divided into three groups (each group was further divided into three-month and six-month groups,40 gerbils per group),one group as a control group,the 40 Gy/5 times and 50 Gy/5 times groups were given 6WV-X line radiation therapy.After 5 consecutive radiation therapies,stopped for two days and then repeated for five times.At the end of three and six months after radiotherapy,the rate of death and the ulceration or infection of the lesions was compared.Fifteen gerbils from each group were randomly selected to observe the deaths of scolex,protein and calcium concentration changes,the maximum diameter changes of the lesions,the changes of hydatid cyst wet weight and the rate of suppressing capsule,the bone destruction,and rebuilding situation of lesions under a microscope.Results At the end of three and six months after radiation therapy,with increasing dosage,the deaths decreased significantly (x2 =10.4,17.4,all P ＜ 0.05);the ulceration or infection of the lesions decreased significantly (x2 =6.0,10.1,all P ＜ 0.05);the mortality rate of scolex increased [3 month:(22.4 ± 3.1),(95.0 ± 5.2),(136.0 ± 5.4);6 month:(23.2 ± 2.2),(98.2 ± 4.6),(169.3 ± 7.0);F =2 252.5,3 220.3,all P ＜ 0.05];the concentration of protein and the calcium ion were changed significantly [3 month:(1.059 ± 0.056),(0.733 ± 0.051),(0.571 ± 0.043)g/L and (2.802 ± 0.157),(3.056 ± 0.060),(3.546 ± 0.135)mmol/L;6 month:(1.088 ± 0.043),(0.753 ± 0.034),(0.340 ± 0.032)g/L and (2.804 ± 0.019),(3.068 ± 0.052),(3.886 ± 0.046)mmol/L;F =366.0,138.9 and 1 550.5,2 727.3,all P ＜ 0.05];the maximum diameters of the lesions reduced significantly [3 month:(2.38 ± 0.14),(1.69 ± 0.05),(1.40 ± 0.09)cm;6 month:(2.65 ± 0.05),(1.69 ± 0.03),(1.03 ± 0.06)cm;F =372.5,3 846.1,all P ＜ 0.05];the hydatid cyst wet weight decreased significantly [3 month:(3.47 ± 0.11),(2.54 ± 0.12),(1.46 ± 0.07)g;6 month:(3.75 ± 0.31),(2.55 ± 0.08),(1.02 ± 0.20)g;F =1 475.6,608.0,all P ＜ 0.05].In the same group with time went on,in the control and 40 Gy/5 times group,the deaths gradually increased (x2 =4.3,4.6,all P ＜ 0.05),but in the 50 Gy/5 times group,the deaths was not significantly increased (x2 =1.1,P ＞ 0.05);in the control and 40 Gy/5 times group,the ulceration or infection of the lesions gradually increased (x2 =5.5,4.3,all P ＜ 0.05),but in the 50 Gy/5 times group,the ulceration or infection of the lesions did not change significantly (x2 =0.3,P ＞ 0.05);in the 50 Gy/5 times group,the mortality rate of scolex was significantly increased (F =212.6,P ＜ 0.05);in 50 Gy/5 times group,the protein (calcium) concentration decreased (increased) significantly (F =271.8,84.7,all P ＜ 0.05);the maximum diameters of the lesions increased gradually in the control group (F =47.1,P ＜ 0.05),in 50 Gy/5 times group,the maximum diameters of the lesions decreased gradually (F =188.3,P ＜ 0.05);in the control group,hydatid cyst wet weight increased significantly (F =10.7,P ＜ 0.05),in the 50 Gy/5 times group,hydatid cyst wet weight was significantly reduced (F =68.5,P ＜ 0.05);with increasing dosage,the damage of the bone matrix and the cells in lacunae of the lesions gradually increased,in the same group with time went on,in the control group,a few amount of bone cells in lacuna died,and in 40 Gy/5 times and 50 Gy/5 times groups,the bone matrix and bone cells were partially repaired.Conclusion The long-term effects of appropriate dosage (50 Gy/5 times) radiation on experiments hydatid diseased gerbils are affirmed,but it is still need a clinical validation.

Objective To analyze the imaging characteristics of lung cancer detected by LDCT ( low-dose CT )lung cancer screening. Methods Between July 1st, 2007 and June 30th, 2013, 7 141 asymptomatic enrolled participants aged 40-88 years old (male 4 710, female 2 431, median age 47), and 1 071 volunteer participants aged ≤39 underwent chest LDCT. The imaging characteristics were analyzed retrospectively in lung cancer pathologically proved. Three types were classified according to the imaging findings: solid lesion, part-solid lesion and non-solid lesion. Results A total of 31 participants (32 lesions) were diagnosed as lung cancer, including 30 adenocarcinomas, 1 carcinoid and 1 small cell lung cancer. The detecting rate of the lung cancer was 0.4%(31/8 212). The solid lesion was further classified as classical solid nodule, irregular solid lesion and atypical solid nodule, and the part-solid lesion was further classified as part-solid nodule, irregular part-solid lesion and cystic part-solid nodule. Lung cancer or probably lung cancer was diagnosed in 24 cases (77.4%), and uncertainty diagnosis was made in 3 cases (9.7%). Benign or probably benign was diagnosed in 3 cases, and another 1 cases were missed at baseline screening. The false positive rate and the false negative rate was 9.7%and 3.1%, respectively. Conclusion The imaging characteristics of lung cancer detected by LDCT are varied, which provide preliminary experience in lung cancer screening.

Objective To get well-informed of the current status of emergency training in primary hospitals in Sichuan Province and to find weaknesses in the system in order to provide scientific basis for emergency knowledge and skills training.Methods A stratified random cluster sampling method as adopted and an anonymous questionnaire survey method was conducted to investigate the basic circumstances of the current training and the training needs of 1 000 emergency medical staff in 9 regions throughout Sichuan Province.Results The scope of the survey covered emergency doctors,nurses and technicians in hospitals of Grade Ⅱ,Grade Ⅲ and below.A total of 1 000 surveys were sent out and 983 were recovered.The questionnaire completion rate was 98.3％.The respondents mainly worked for more than 10 years,most of which with Bachelor degree,junior and intermediate titles.Results of the survey showed,63.1％ Most respondents have only one or two training opportunities per year.The training methods are mainly continuing education (59.0％,580 trips),training organized within the unit (58.5％,575 trips),and training organized by health administrative units (39.3％,386 trips).The main contents of the training are:basic professional skills learning (66.7％,655 trips),basic professional theoretical study (59.2％,582 trips),and new emergency technology (42.5％,418 trips),only 32.0％ of the respondents believe that these methods meet the practical needs.The main factors that influence participation in the training were:not be arranged by employer (36.2％,356 trips);the training was different from actual work (31.6％,311 trips);no replacement for work so they couldn't join training (29.8％,293 trips).The survey showed that the most desirable way of training is:practical application (60.1％,591 trips) and the most desirable training content is:emergency first aid knowledge (73.7％,724 trips).There were significant differences in case discussion,technical observation,academic lectures,special study trainingand learning methods in hospitals of different levels (P＜0.05),but there was no significant difference in the choice of professional practice methods (P＞0.05),and the selection of training contents was in emergency first aid knowledge,general medical knowledge and prevention and treatment of chronic diseases.There was no statistical difference in the selection of training contents of knowledge,infectious disease knowledge and department management knowledge (P＞0.05).There were significant differences in the choice of nursing knowledge training (P＜0.05).Conclusion The current situation showed a lack of first-aid knowledge and skills training for emergency personnel in Sichuan Province.The present situation of skill training can't satisfy the need of their desire to participate in training.It is urgent to develop a standardized,systematic and scientific training mode to improve the emergency first aid ability of primary medical and emergency personnel.

Objective To summarize the methods and experiences of one-stage repair of aortic coarctation.Methods During January 2009 and September 2016,31 patients underwent surgery for coarctation of aorta (COA) in our department.Of them,fifteen patients were accompanied by patent ductus arteriosus (PDA),five associated with ventricular septal defect (VSD),five with VSD and PDA,and six patients were single COA.All patients accepted one-stage repair and follow-up.The surgical strategies and follow-up results were retrospectively reviewed.Results Excision of coarctation and anastomoses was performed in 24 patients,a bypass with artificial graft was performed in 3 patients,longitudinally section transverse suture was performed in 2 patients,and aortoplasty with patch graft was used in 2 patients.Accompanied intracardiac malformations were repaired simutaneously.One patient died of low cardiac output syndrome 1 d after operation.Other patients recovered smoothly.Thirty patients were followed up from 6 months to 7 years.The anastomotic systolic pressure difference disappeared in 21 patients.Eight patients still suffered from systolic pressure difference (5-20 mmHg),but had no need of reoperation.One patient suffered from anastomotic recoarctation 2 years and 3 months after operation and the pressure difference was 48 mmHg.After exerting balloon dilatation,the pressure difference reduced to 17 mmHg.Conclusions Surgery is an effective method of COA treatment.The surgical strategies should be selected according to the characters of coarctation lesions,intracardiac malformations,and the age of patient.

Objective:To investigate the efficacy and safety of protein A immunoadsorption (PAIA) combined with rituximab (RTX) in highly sensitized patients who underwent haplo-hematopoietic stem cell transplantation (haplo-HSCT) .Methods:The clinical data of 56 highly sensitized patients treated with PAIA and RTX before haplo-HSCT at the First Affiliated Hospital of Soochow University and Soochow Hopes Hematonosis Hospital between March 2021 and June 2023 were retrospectively analyzed. The number of human leukocyte antigen (HLA) antibody types and the mean fluorescence intensity (MFI), humoral immunity, adverse reactions during adsorption, and survival within 100 days before and after adsorption were measured.Results:After receiving the PAIA treatment, the median MFI of patients containing only HLA Ⅰ antibodies decreased from 7 859 (3 209-12 444) to 3 719 (0-8 275) ( P<0.001), and the median MFI of HLA Ⅰ+Ⅱ antibodies decreased from 5 476 (1 977-12 382) to 3 714 (0-11 074) ( P=0.035). The median MFI of patients with positive anti-donor-specific antibodies decreased from 8 779 (2 697-18 659) to 4 524 (0–15 989) ( P<0.001). The number of HLA-A, B, C, DR, and DQ antibodies in all patients decreased after the PAIA treatment, and the differences were statistically significant (A, B, C, DR: P<0.001, DQ: P<0.01). The humoral immune monitoring before and after the PAIA treatment showed a significant decrease in the number of IgG and complement C3 ( P<0.001 and P=0.002, respectively). Forty-four patients underwent HLA antibody monitoring after transplantation, and the overall MFI and number of antibody types decreased. However, five patients developed new antibodies with low MFI, and nine patients continued to have high MFI. The overall survival, disease-free survival, non-recurrent mortality, and cumulative recurrence rates at 100 days post-transplantation were 83.8%, 80.2%, 16.1%, and 4.5%, respectively. Conclusions:The combination of PAIA and RTX has a certain therapeutic effect and good safety in the desensitization treatment of highly sensitive patients before haplo-HSCT.