1.A meta-analysis of mindfulness-based stress reduction for improving symptoms of post-traumatic stress disorder
Tingting DONG ; Chengshuai ZHANG ; Zhiqiang ZHANG ; Yingying DONG ; Feng LI
Chinese Mental Health Journal 2018;32(1):7-14
Objective:To systematically examine the efficacy of mindfulness-based stress reduction (MBSR) for post-traumatic stress disorder (PTSD).Methods:A systematic literature search was performed in multiple databases,including Cochrane Library,Pubmed,MEDLINE,Embase,Web of Science,CBM,CNKI,WanFang Database.Paper inclusion criteria were confined to intervention trials of MBSR conducted in patients with PTSD.Revman5.3 and Stata12.0 was used to get pooled results.Results:A total of 8 studies were included,4 randomized controlled trials (including 255 patients with PTSD) and 4 self-controlled studies (including 152 patients with PTSD).Comparing to control groups,MBSR groups resulted in statistically significant improvements on symp toms of PTSD [SMD =-0.53,95 % CI(-0.87--0.19),P < 0.05].The symptoms of PTSD after the intervention was improved [SMD =-1.95,95% CI(-2.84--1.07),P <0.01].There was no statistically significant difference between the data of follow-up and post-intervention [SMD =-0.26,95% CI(-0.77-0.26),P >0.05].Contusion:It suggests that the mindfulness-based stress reduction (MBSR) may be effective in reducing symptoms of post-traumatic stress disorder and have stable short-term effects.
2.Analysis of Curative Effect of Posterior Cervical Pedicle Screw Fixation Operation for Cervical Spondylotic Myelopathy
Chengshuai SUN ; Lei LI ; Weining MENG
Journal of Shenyang Medical College 2016;18(4):245-247,250
Objective:To evaluate the clinical effect of posterior cervical pedicle screw fixation operation for cervical spondylotic myelopathy.Methods: From Mar 2014 to Sep 2015, 55 patients with cervical spondylotic myelopathy treated with posterior cervical pedicle screw fixation operation were involved. Cervical curvature in the cervical three dimensional CT by the Harrison’ s cervical curvature measuring method was measured, and JOA scores, NDI scores and VAS scores before and after operation and the last follow-up were evaluated. Results:A total of 55 patients with cervical spondylotic myelopathy obtained good operation effect and the cervical curvature and neural function were improved.The cervical curvature, JOA score, NDI scores, and VAS scores were significantly better than that before operation (P < 0.05) . Last follow-up results showed that there was statistical significance on JOA score, NDI score, and VAS score compared with that after operation (P<0.05), but not on cervical curvature (P>0.05) . Conclusion:The neurological function and cervical curvature of the cervical spondylotic myelopathy can be improved through posterior cervical pedicle screw fixation operation.
3.Establishment of a nomogram prediction model for early mortality risk in extremely preterm infants
Jing XU ; Rui ZHANG ; Huabin WANG ; Ru YANG ; Chengshuai LI ; Jingjing HAN ; Xiaohui KONG ; Xueyun REN
Chinese Journal of Perinatal Medicine 2024;27(5):394-401
Objective:To identify the risk factors and to construct a predictive model for early postnatal mortality (with the first 7 days of life) in extremely preterm infants.Methods:This retrospective study involved 244 extremely preterm infants with a gestational age of 22 to 27 weeks and 6 days, born at the Affiliated Hospital of Jining Medical College from January 2017 to December 2022. They were divided into an early survival group ( n=140) and an early mortality group ( n=84), based on survival for ≥7 days after birth. LASSO and logistic regression were used to select risk factors for early mortality. A nomogram predictive model was constructed using the R software program. The goodness-of-fit tests, area under the curve (AUC), calibration curves, and decision curves were used to evaluate its performance and clinical usefulness. Results:LASSO regression and multivariate logistic regression analyses showed that breech delivery ( OR=3.055, 95% CI: 1.125-8.296), intubation in the delivery room ( OR=4.320, 95% CI: 1.328-14.053), diagnosis of grade Ⅲ-Ⅳ neonatal respiratory distress syndrome within 6 h after birth ( OR=11.552, 95% CI: 3.056-43.677), and use of adrenaline in the delivery room ( OR=10.706, 95% CI: 1.454-78.816) were risk factors for early mortality in extremely preterm infants. Conversely, large gestation age ( OR=0.234, 95% CI: 0.125-0.436), antenatal administration of corticosteroids to promote fetal lung maturity ( OR=0.046, 95% CI: 0.014-0.145), and the use of pulmonary surfactant within 6 h after birth ( OR=0.021, 95% CI: 0.004-0.122) were protective factors against mortality. The goodness of fit test of the early death risk nomogram prediction model for extremely preterm infants indicates a good fit ( P=0.702). The AUC of the model was 0.963 (95% CI: 0.943-0.983), with a sensitivity of 0.904 (95% CI: 0.806-0.949), specificity of 0.892 (95% CI: 0.829-0.938), and accuracy of 0.880. Decision curve analysis indicated that a threshold probability>2% would yield a net benefit. Conclusions:Breech delivery, intubation in the delivery room, use of adrenaline in the delivery room, and the diagnosis of grade Ⅲ-Ⅳ neonatal respiratory distress syndrome within 6 h post-birth are independent risk factors for early mortality in extremely preterm infants. Large gestational age, antenatal administration of corticosteroids to promote fetal lung maturity and use of pulmonary surfactant within 6 h after birth are protective factors. The constructed prediction model based on the aforementioned factors can quantitatively, conveniently, and intuitively assess the risk of early mortality in extremely preterm infants.