1.Effect of blood glucose management mode based on hospital-community linkage network on the elderly patients with type 2 diabetes
Xiaoyan GU ; Chunlan ZHOU ; Cuihua XIE
Chinese Journal of Practical Nursing 2023;39(26):2007-2013
Objective:To explore the application advantages of hospital-community linkage network blood glucose management model for elderly type 2 diabetes patients in community in order to supply reference for improve patients′ qualitye of life.Methods:This study was a randomized controlled study. A total of 84 elderly patients in Huangpu Community Hospital of Guangzhou from February to September 2022 were selected and divided into control group and intervention group by a table of random numbers. The control group adopted the hospital community linkage management model, and the intervention group followed the network management mode on the basis of the routine management. After 6 months of intervention, we compared the level of fasting blood glucose, blood glucose two hours after meal and glycosylated hemoglobin, and the scores of the Summary of Diabetes Self-Care Activities (SDSCA), Diabetes Specificity Quality of Life Scale(DSQL) between the two groups to illustrate the application advantages.Results:There were no significant differences in blood glucose two hours after meal, fasting blood glucose and glycosylated hemoglobin between the intervention and control groups (all P>0.05). After 6 months of intervention, the blood glucose two hours after meal, fasting blood glucose and glycosylated hemoglobin of the intervention group were (9.25 ± 2.87) mmol/L, (6.07 ± 0.69) mmol/L and (7.04 ± 1.59) %, respectively, which were lower than those of the control group (11.04 ± 3.75) mmol/L, (6.57 ± 0.95) mmol/L and (8.02 ± 2.25)%. The differences were statistically significant ( t = 2.45, 2.76, 2.30, all P<0.05). After 6 months of intervention, the scores of SDSCA scale and DSQL scale were (34.21 ± 10.43) and (135.64 ± 10.71) points, which were higher than (29.12 ± 7.36) and (145.85 ± 10.33) points in the control group, and the differences were statistically significant ( t = 2.58, 4.44, both P<0.05). Conclusions:The hospital-community linkage network management model can improve the blood glucose level of elderly patients with type 2 diabetes mellitus in the community and has a positive effect on improving self-management behavior ability and improving quality of life.
2.Application of MRI-based radiomics model in predicting the tumor response in patients with advanced hepatocellular carcinoma after transcatheter arterial chemoembolization
Cuihua GU ; Shiwen PAN ; Jue QIU ; Jinjin WANG
Journal of Interventional Radiology 2024;33(1):63-68
Objective To develop a nomogram model based on the clinical features and the radiomics texture analysis of multimodal magnetic resonance imaging(MRI),so as to predict the tumor response in patients with advanced hepatocellular carcinoma(HCC)3 months after receiving transcatheter arterial chemoembolization(TACE).Methods A total of 105 patients with advanced HCC,whose diagnosis was pathologically-confirmed at the Suzhou Municipal Ninth People's Hospital between January 2017 and December 2021,were enrolled in this study.The patients were randomly divided into training group(n=63)and verification group(n=42).Before chemotherapy,T1WI,T2WI,dynamic contrast-enhanced(DCE)scan,and diffusion-weighted imaging(DWI)were performed by using a 3.0T MRI scanner.A.K.software was used to extract the texture.Three months after chemotherapy,according to the modified Response Evaluation Criteria in Solid Tumors(mRECIST)the patients were divided into response group(n=63)and non-response group(n=42).Results Compared with the response group,in the non-response group the percentage of Child-Pugh grade B and BCLC stage C was obviously higher and the serum alpha fetoprotein(AFP)level was remarkably elevated(P<0.05).A.K.software extracted 396 MRI texture features,and LASSO regression analysis screened out 6 optimal predictors.The radiation score(Rad-score)was calculated by ROC.The AUC of Rad-score for predicting tumor non-response after TACE by ROC in the training group and verification group were 0.842 and 0.803 respectively.Multivariate logistic regression model analysis showed that AFP≥50 ng/mL(OR=1.568,95%CI=1.234-1.902,P=0.003),Child-Pugh grade B(OR=1.754,95%CI=1.326-2.021,P=0.001),BCLC stage C(OR=1.847,95%CI=1.412-2.232,P=0.001)and Rad-score(OR=2.023,95%CI=1.569-2.457,P<0.001)were the independent risk factors for tumor non-response.Clinico-radiomics combination had the highest AUC value for predicting tumor non-response.The correction curve showed that the nomogram model had a good agreement.Conclusion The quantitative score of radiomics texture analysis of multimodal MRI has a certain value in predicting tumor non-response in advanced HCC patients 3 months after TACE,and the nomogram model,which is constructed if combined with clinical factors,carries good practical potential.(J Intervent Radiol,2024,32:63-68)