Objective To explore the mediating role of mindful attention and awareness in depressive symptoms and insomnia severity among patients with comorbid depression and insomnia.Methods A cross-sectional study was conducted,enrolling 267 patients with comorbid depression and insomnia who were treated in the outpatient Department of Medical Psychology of Second Affiliated Hospital of Army Medical University,from March to May 2024.Basic demographic and clinical data were collected using a general information questionnaire.Depressive symptom severity was measured via the Patient Health Questionnaire-9(PHQ-9),insomnia severity via the Insomnia Severity Index(ISI),perceived stress via the Perceived Stress Scale-10(PSS-10),and mindful attention and awareness via the Mindful Attention Awareness Scale(MAAS).Pearson correlation analysis was used to examine the correlations between depressive severity,insomnia severity,perceived stress,and mindful attention and awareness.Mediation analysis was performed using Process 4.1.Results The PHQ-9 score was(13.80±5.98)and the ISI score was(17.10±5.56)in the 267 patients.Pearson correlation analysis showed that depressive severity and insomnia severity were positively correlated with perceived stress(r=0.531,0.351,P<0.001)and negatively correlated with mindful attention and awareness(r=-0.373,-0.350,P<0.001).Mediation analysis using Process 4.1 indicated that the combined mediating effect of mindful attention and awareness and insomnia between perceived stress level and depressive level was 0.157,with a 95%confidence interval(CI)of 0.102～0.217,and the total mediating effect was significant(P<0.001).Conclusion Perceived stress directly positively affects depression and indirectly exacerbates depression through insomnia as a mediator,and mindful attention and awareness can weaken the promoting effect of perceived stress on insomnia.

Objective To investigate whether the amount of blood transfusion affects the lengths of stay (LOS),costs,and outcomes of hospital patients or not,and to prepare for the execution of patient blood management.Methods The data of hospital patients,who had been administrated with blood in our hospital during 2016,were collected.And the influence of blood transfusion volume on LOS,costs and outcomes of patients was analyzed retrospectively.Results LOS,costs and outcomes of patients vary significantly with the amount of blood transfusion (P＜0.01).There were positive correlations between the total amount of blood transfusion and LOS,costs,and outcomes of patients.The Spearman correlation coefficient was 0.317,0.497,0.290,respectively (P＜0.01).Plasma preparation transfusion volume has a great influence on LOS,costs,and outcomes than red blood cell (P＜0.05).The transfusion volume of death patients was significantly higher than that of the survival (P＜0.01).In particular,the amount of transfused plasma and precipitation was distinctly higher than that in death patients(P＜0.01).Conclusion Blood transfusion volume affects LOS,costs and outcomes of hospital patients.The administration of plasma preparations should deserve more attention.

Objective To compared and analyze the therapeutic effect of conservative treatment on distal radius fracture as compared with surgical treatment,so as to provide evidence for the diagnosis and treatment of distal radius fracture.Methods A retro-spective analysis was made on the clinical data of 162 patients with distal radius fracture treated in our hospital from January 2005 to De-cember 2011.In accordance with the different treatment methods,the patients were divided into 2 groups:the conservative treatment group and the surgical treatment group.The patients in the conservative treatment group consisted of 95 patients,including 58 males and 37 females,with an age range between 21 and 64,averaging 52.8 years old.There were 47 cases of extra-articular fracture (type A fracture),28 cases of partial intra-articular fracture (type B fracture)and 20 cases of complicated intra-articular fracture (type C fracture).They were fresh closed fractures and were sent to hospital within 8 hours after fracture.After manual reposition,they had plaster splint for 4 to 7 weeks.The surgical treatment group contained 40 male and 27 female patients,with an age range between 22 and 65,averaging 53.1 years old.The control group included 31 type A fractures,22 type B fractures and 14 type C fractures.T-form steel plates were used for fixation of fractures after surgical reposition.Medical follow-ups were performed 12 to 41 months after surgery (averaging 14.5 months),and therapeutic effects were observed by using reposition scores and function test scores.Results Of the
162 patients,139 patients fulfilled the 12 to 41-month (averaging 14.5 months)medical follow-ups,including 80 cases in the conser-vative treatment group and 59 cases in the surgery group.With regard to function test scores,35 cases were of excellent rate,20 cases were of good rate and 4 cases were of moderate rate for the surgical treatment group.As for the conservative treatment group,45 cases were of excellent rate,25 cases were of good rate,8 cases were of moderate rate and 2 cases were of poor rate.Excellent rates for type A,B and C fractures accounted for 89.47% (17 /19),94.12% (16 /17)and 92.31% (12 /13)respectively,all with satisfactory therapeutic results.As for conservative treatment group,excellent rates for type A,B and C fractures accounted for 94.59% (35 /37), 91.67% (22 /24)and 68.42% (13 /19)respectively.There was no statistical significance in the reposition scores of type A and B fractures and function test scores,when comparisons were made between the surgical and conservative treatment groups(P >0.05). However,the reposition scores of type C fracture and function test scores for the surgical treatment group were obviously superior to those of the conservative treatment group,with statistical significance (P <0.01).Conclusion As for type A and B fractures,manual reposition plus external splint fixation and surgical reposition plus internal fixation could all achieve relatively good therapeutic results, whereas surgical reposition plus internal fixation for type C fracture could achieve better results.