Relationship between clinical phenotype and autoantibodies in systemic sclerosis / 西安交通大学学报(医学版)

【Objective】 To detect autoantibodies in Chinese systemic sclerosis (SSc) patients and analyze the relationship between clinical phenotype and autoantibodies in SSc. 【Methods】 We sequentially included 93 SSc patients. Their general information and clinical data were gathered. The differences in clinical characteristics among autoantibody negative and positive groups were analyzed statistically. 【Results】 Anti-nuclear antibodies were detected in 82 (88.2%) SSc patients. The positive rate of autoantibodies was detected in 26 cases (28.0%) of anti-Scl-70 antibody, 24 cases (25.8%) of anti-SSA/Ro-52 antibody, 19 cases (20.4%) of anti-U1-snRNP antibody, and 16 cases (17.2%) in anti-CENP-B antibody, respectively. The patients with positive anti-SSA/Ro-52 antibody had a significantly higher morbidity rate of pulmonary arterial hypertension (P=0.016). Patients with anti-Scl-70 antibody showed a higher incidence rate of digital tip ulcers or gangrene (P=0.004) and cardiac damage (P=0.014). The patients with anti-U1-snRNP antibody had a higher prevalence of pulmonary arterial hypertension (P=0.047) and Raynaud’s phenomenon (P=0.019), and showed an increased trend in the occurrence of interstitial lung disease (P=0.058). Those with anti-CENP-B antibody had a lower IgG level (P=0.049) and higher ALP (P=0.010) and γ-GT (P=0.003). The incidence of autoimmune liver disease was increased in anti-CENP-B positive patients (P=0.001). 【Conclusion】 Different autoantibodies in SSc are associated with clinical phenotype, and may contribute to the diagnosis, evaluation, and prognostic judgment of the disease.

Investigation of the effect of occupational stress on mental health of anesthesia nurses in Shanghai / 中国实用护理杂志

Objective:To investigate the effect of occupational stress on mental health of anesthesia nurses in Shanghai tertiary and first-class hospitals. These results provide theoretical basis for managers to adjust the allocation of human resources, reduce the professional pressure of anesthesia nurses and promote the development of anesthesia nursing.Methods:A questionnaire survey was conducted among 229 anesthetic nurses in 11 tertiary and first-class hospitals in Shanghai using Chinese Nurses Work Stressors Scale and Symptom Checklist 90 (SCL-90). Each dimension and item of the stress source scale and symptom Checklist-90 for anesthesia nurses were scored, and the effects of occupational stress on mental health were analyzed.Results:The mental health status of anesthesia nurses was positively correlated with occupational stress. The occupational stressors with the highest correlation coefficient with mental health factors was"management and interpersonal relationship"dimension( P<0.01). The five dimensions of occupational stress were the highest correlation coefficient of "obsessive compulsive symptoms" in mental health factors( P<0.01).In terms of nursing specialty and work: correlation coefficient r = 0.566; workload and time distribution: correlation coefficient was 0.477; work environment and resources: correlation coefficient was 0.477; patient care: correlation coefficient was 0.588; management and interpersonal relationship: correlation coefficient was 0.604.The results of multiple regression analysis showed that the independent variable"the management and interpersonal relationship" dimension of occupational stressors had influence on the dependent variable ten factors of mental health( P<0.01). And "independent variable nursing profession and work" had an impact on dependent variable "obsessive-compulsive symptoms" and "sleep-eating" factors( P<0.05); independent "variable workload and time allocation" had an impact on dependent variable "phobic" factors( P<0.05). Conclusions:The occupational stress of anesthetic nurses in Shanghai has an impact on mental health. "Management and interpersonal relationship" has the greatest impact on mental health in occupational stressors.

Social support and management strategies for chronic disease in patients with systemic lupus erythematosus / 中南大学学报(医学版)

To investigate the social support level and its influencial factors in patients with systemic lupus erythematosus (SLE), and to develop the management strategies for chronic disease.
 Methods: Patients with SLE were investigated by Social Support Rating Scale (SSRS), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), 36-Item Short-Form Health Survey (SF-36) and Visual Analogue Scale (VAS) of fatigue. The demographic and clinical data of SLE patients were recorded. SLE disease activity and damage severity were assessed by SLE Disease Activity Index (SLEDAI) and SLE Damage Index (SDI), respectively. Influencial factors for social support were analyzed.
 Results: A total of 246 patients were included. Social support scores for these patients were 40.76±7.93 and the scores showed no significant difference with the national norm (P>0.05). Patients who were younger than 18, single, unemployed or damaged by disease showed lower level of social support (P<0.05). Compared with the high social support group, patients in the low social support group experienced more severe depression or anxiety, and scored lower on mental component summary scale (vitality, social functioning, emotional role and mental health perception) and physical role of SF-36 (P<0.05).
 Conclusion: Social support levels for patients with SLE are closely related to the quality of life, and influenced by age, marital status, professional condition, and disease damage. Health education for patients and their families should be strengthened in chronic disease management to enhance social support and finally, improve their quality of life.

Associated factors on sleep disorders in systemic lupus erythematosus patients / 中华风湿病学杂志

Objective To investigate the prevalence of sleep disorders and the relevant determinants in a cohort of systemic lupus erythematosus (SLE) patients.Methods One hundred patients with SLE were included in the study.Sleep quality was assessed using the Pittsburgh sleep quality index (PSQI).Depression,anxiety,quality of life,and fatigue were evaluated by patient health questionnaire (PHQ)-9,generalized anxiety disorder (GAD)-7,short form 36 health survey (SF-36),and visual analogue scale (VAS) respectively.The demographic and clinical data were also recorded.SLE disease activity and damage severity were assessed by systemic lupus erythematosus disease activity index (SLEDAI) and systemic lupus erythematosus damage index (SDI) respectively.Mann-Whitnry U test,t test,Logistic regression were used for statistically analysis.Results The prevalence of sleep disorders in SLE patients was 42％.Compared with patients without sleep disorders,the ratio of males and married patients,age,the score of SDI,PHQ-9,GAD-7,and fatigue were higher in SLE patients with sleep disorders,while the score of SF-36 was lower (r＜0.05).Age,SLEDAI,SDI,PHQ-9,GAD-7,and fatigue correlated positively with sleep disorders (The values of r were 0.215,0.230,0.311,0.529,0.455,0.541,P＜0.05).C3 and the score of SF-36 correlated negatively with sleep disorders (The values of r were-0.204,-0.342,-0.490,-0.464,-0.497,-0.590,-0.428,-0.478,-0.398,-0.412,-0.659respectively,P＜0.05).In multi-ple logistic regression analyses,gender (OR=22.22),anxiety (OR =2.895),body pain (OR =0.964),and energy (OR =0.947) were the independent determinants of sleep disorders (R2=0.494,P＜0.01).Conclusion Poor sleep quality is common in SLE patients.Gender,age,disease activity and severity,anxiety,depressed mood,and quality of life contribute significantly to sleep disorders in SLE.