The purpose of this systematic review was to quantify the effects of psychological interventions on psychological health, physical health and disease activity in patients with systemic lupus erythematosus (SLE). Studies were identified through a systematic search of six electronic databases and were included if they used a randomized controlled trial designed to explore the effects of psychological interventions in patients with SLE. Two authors independently assessed the methodological quality of included studies using a quality-scoring instrument developed by Jadad et al. and extracted relevant information according to a pre-designed extraction form. Data was analysed using the Cochrane Collaboration's Revman5.1. Finally, six studies involving 537 patients were included. Meta-analysis showed that psychological interventions could reduce the levels of anxiety (standard mean difference (SMD) -0.95, 95% confidence interval (CI) -1.57,-0.34, p-value 0.00), depression (SMD -1.14, 95% CI -1.84,-0.44, p-value 0.00), stress (SMD -0.63, 95% CI -1.02,-0.23, p-value 0.00), and disease activity (SMD -0.34, 95% CI -0.57,-0.11, p-value 0.00). Although the effects on mental health, fatigue and physical function were in the expected direction, they were not statistically significant (p > 0.05). The present data indicate that psychological interventions are promising treatments for patients with SLE. The findings were based on only six randomized controlled trials (RCTs), some of which were relatively small, so more methodologically rigorous large-scale randomized controlled trials are required to confirm these preliminary estimates of effectiveness.
Objective: To investigate the efficacy of combined interventional methods in treatment of tubal pregnancy. Materials and Methods: One hundred sixty-two patients with tubal pregnancy were enrolled in this study. In all patients, the feeding uterine artery at affected side was perfused with methotrexate (MTX), followed by occlusion using gelatin sponge. Nineteen patients were also treated by perfusion of MTX in ovarian artery at affected side which partially participated in blood supply. Seven patients received direct puncture perfusion of MTX under B ultrasound guidance. Four cases received perfusion of MTX through fallopian tube. After surgery, the serum beta-human chorionic gonadotropin (β-HCG) level was regularly detected, and B ultrasound was used to monitor the pelvic mass change. For 33 patients with fertility requirement, hysterosalpingography (HSG) was conducted after menstruation restoration. Results: Tubal pregnancy was terminated in 160 patients (98.76%), with inefficacy in two patients (1.23%) who were treated by surgery. HSG showed tubal patency in 27 patients. Tubal obstruction was found in the other six patients. After recanalization, three cases were unobstructed, with obstruction in other three cases. Fifteen patients achieved intrauterine pregnancy after six to 17 months from surgery. Conclusions: Comprehensive interventional treatment can prevent internal bleeding caused by failure of many conservative treatments, improve the indication and success rate of treatment, and preserve the complete fallopian tube.
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