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BackgroundChronic obstructive pulmonary disease （COPD） is a common chronic respiratory disease， and patients with COPD often experience substantially emotional difficulties， such as anxiety and depression， all of which may cause serious detriment to the prognosis of patients. As a non-pharmacological intervention in clinical practice， group mindfulness-based stress reduction therapy （MBSR） is beginning to emerge， while has rarely been studied in COPD patients with concurrent emotional difficulties. ObjectiveTo evaluate the effects of group MBSR on depression， state of mindfulness and pulmonary function in stable COPD patients， so as to provide references for the application of group MBSR in patients with COPD. MethodsA total of 97 patients with stable COPD who were followed up in the Department of Respiratory and Critical Care Medicine of Mianyang Third People's Hospital from January to October 2019 were selected as the study objects， and they were assigned into study group （n=50） and control group （n=47） by random number table method. All individuals received routine medication therapy and an 8-week health education， based on this， participants in study group partook an 8-week intervention comprising group MBSR. At the baseline， 4 weeks and 8 weeks of intervention， participants were assessed with Self-rating Depression Scale （SDS）， Five Facet Mindfulness Questionnaire （FFMQ） and COPD Assessment Test （CAT）， as well as the pulmonary function testing. ResultsThere were 41 patients in study group and 42 cases in control group completed the study. The group * time interaction was interpreted as significant between two groups for SDS， FFMQ and CAT scores （F=54.858， 86.161， 69.862， P<0.01）. Baseline SDS， FFMQ and CAT scores of the two groups yielded no statistical difference between two groups （F=0.240， 0.052， 0.019， P>0.05）， while study group scored lower on SDS and CAT （F=12.900， 38.511， 7.797， 28.824， P<0.01） and higher on FFMQ （F=27.324， 82.412， P<0.01） than those of the control group after 4 and 8 weeks of intervention. With the prolongation of intervention time in study group， participants demonstrated an overall reduction in SDS and CAT scores （F=109.753， 124.144， P<0.01）， and an increase in FFMQ scores （F=228.194， P<0.01）. There were no between-group differences in forced expiratory volume in one second as percentage of predicted volume （FEV1%pred） after 4 and 8 weeks of intervention （F=0.104， P=0.748） ， and the within-group changes in FEV1%pred value over the intervention period in study group was not statistical （F=0.561， P=0.458）. ConclusionGroup MBSR may help relieve depressive symptoms， enhance mindfulness level， and alleviate clinical symptoms in stable COPD patients， but has no effect on pulmonary function. ［Funded by Mianyang Health and Health Commission Scientific Research Project （number， 201916）］
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Objective To determine the diagnosis value of urinary albumin(mAlb)/creatinine(Ucre) ratio in random urine from patients with early diabetic nephropathy.Methods From March 2015 to December 2016,98 case with simple diabetes and early diabetic nephropathy in Ankang Hospital of Traditional Chinese Medicine were selected,including 47 cases with simple diabetes and 51 cases with early diabetic nephropathy.And 60 healthy people were selected as control group.The mAlb and mAlb/Ucre ratios in morning urine,postprandial urine and random urine were detected for three times in three days,and the resluts were calculated and analyzed.Results In early diabetic nephropathy group,the mAlb concentration varied during different time periods,mAlb in morning urine [(60.5 ± 27.1)mg/L] and postprandial urine [(60.7 ± 26.7)mg/L] were significantly increased compared with that in random urine [(40.9 ± 25.1) mg/L] (F =9.551,P =0.000).The MAlb/Ucre ratios were stable in morning urine,postprandial urine and random urine of each period (P ＞ 0.05).The positive rate of mAlb/Ucre ratio was sharply higher than mAlb alone in random urine (90.2％ vs.62.7％).No statistically significant difference showed in positive rates of mAlb/Ucre ratio in subjects from different groups(the positive rate of morning urine specimen was 92.2％;postprandial urine 88.2％;random urine 90.2％,P ＞ 0.05).Conclusion Positive rate of mAlb/Ucre ratio changed slightly during different test periods,and is superior to mAlb alone in clinic application.Additionally,the positive rate of mAlb/Ucre ratio in random urine could serve as an indicator in early screening of early diabetic nephropathy.