Objective To investigate the correlation between glycemic variability metrics and the risk of diabetic foot(DF)in patients with type 2 diabetes mellitus(T2DM)utilizing flash glucose monitoring(FGM)tech-nology.Methods A retrospective analysis was conducted on 233 hospitalized patients with T2DM,with or without DF,who were treated in the Department of Endocrinology at Lianyungang First People's Hospital from January 2021 to May 2022 and monitored using FGM.Patients were categorized into a non-DF group(n=147)and a DF group(n=86)based on the presence of DF.The study compared general clinical characteristics,biochemical parameters,and glycemic variability metrics between the two groups and performed subgroup analyses.Binary logistic regression was employed to identify factors associated with the risk of DF,while receiver operating characteristic(ROC)curves were utilized to assess the predictive value of glycemic variability metrics for DF.Results Compared with the non-DF group,patients in the DF group exhibited significantly longer disease duration,higher body mass index(BMI),glycated hemoglobin(HbA1c),urinary albumin-to-creatinine ratio(UACR),alanine aminotransferase(ALT),serum uric acid(SUA),mean amplitude of glycemic excursions(MAGE),coefficient of variation(CV),mean of daily differences(MODD),and mean blood glucose(MBG),but lower fasting C-peptide(FCP),fasting insulin(FINS),high-density lipoprotein cholesterol(HDL-C),and time in range(TIR),with statistically signifi-cant differences(P<0.05).Subgroup analysis revealed that TIR was associated with the incidence of DF and diabetic retinopathy(DR).Binary logistic regression analysis identified HbA1c,MAGE,MODD,and MBG as risk factors for DF,while TIR was a protective factor(P<0.05).ROC curve analysis demonstrated that the area under the curve(AUC)for predicting DF using HbA1c,TIR,MAGE,MODD,MBG,and their combination were 0.646,0.850,0.868,0.764,0.619,and 0.967,respectively,indicating superior performance of the combined prediction model.Conclusions HbA1c,TIR,MAGE,MODD,and MBG are critical factors associated with the development of DF in patients with T2DM.Targeted early interventions aimed at optimizing these glycemic variability indicators may effectively reduce the incidence of DF.

Objective To investigate the correlation between glycemic variability metrics and the risk of diabetic foot(DF)in patients with type 2 diabetes mellitus(T2DM)utilizing flash glucose monitoring(FGM)tech-nology.Methods A retrospective analysis was conducted on 233 hospitalized patients with T2DM,with or without DF,who were treated in the Department of Endocrinology at Lianyungang First People's Hospital from January 2021 to May 2022 and monitored using FGM.Patients were categorized into a non-DF group(n=147)and a DF group(n=86)based on the presence of DF.The study compared general clinical characteristics,biochemical parameters,and glycemic variability metrics between the two groups and performed subgroup analyses.Binary logistic regression was employed to identify factors associated with the risk of DF,while receiver operating characteristic(ROC)curves were utilized to assess the predictive value of glycemic variability metrics for DF.Results Compared with the non-DF group,patients in the DF group exhibited significantly longer disease duration,higher body mass index(BMI),glycated hemoglobin(HbA1c),urinary albumin-to-creatinine ratio(UACR),alanine aminotransferase(ALT),serum uric acid(SUA),mean amplitude of glycemic excursions(MAGE),coefficient of variation(CV),mean of daily differences(MODD),and mean blood glucose(MBG),but lower fasting C-peptide(FCP),fasting insulin(FINS),high-density lipoprotein cholesterol(HDL-C),and time in range(TIR),with statistically signifi-cant differences(P<0.05).Subgroup analysis revealed that TIR was associated with the incidence of DF and diabetic retinopathy(DR).Binary logistic regression analysis identified HbA1c,MAGE,MODD,and MBG as risk factors for DF,while TIR was a protective factor(P<0.05).ROC curve analysis demonstrated that the area under the curve(AUC)for predicting DF using HbA1c,TIR,MAGE,MODD,MBG,and their combination were 0.646,0.850,0.868,0.764,0.619,and 0.967,respectively,indicating superior performance of the combined prediction model.Conclusions HbA1c,TIR,MAGE,MODD,and MBG are critical factors associated with the development of DF in patients with T2DM.Targeted early interventions aimed at optimizing these glycemic variability indicators may effectively reduce the incidence of DF.

Objective Based on DRG evaluation indicators,research an evaluation method that can comprehensive-ly evaluate the medical service capacity and efficiency of clinical departments in hospitals.Methods Using the front page of inpatient medical records from a tertiary hospital in Xuzhou in 2022 as a sample,obtaining DRG related indi-cators through the China Healthcare Security Diagnosis Related Groups 1.1 grouping system.Based on the number of DRG,CMI,TEI,and CEI indicators,use TOPSIS method to comprehensively evaluate the quality of medical ser-vices in clinical departments.Results The widest coverage of medical services is in General Surgery,with a DRG group of 325;The most difficult medical service is in the Emergency Department,with a CMI value of 1.45;The best time efficiency is in Ophthalmology,with a TEI of 0.56,The Dermatology has the best cost efficiency,with a CEI of 0.36;TOPSIS comprehensive evaluation shows that the top five are Pediatrics,General Medicine,Emergen-cy Department,General Surgery,and Gastroenterology,and the bottom five are Dentistry,Burn Unit,Orthope-dics,Neurosurgery,and CCU.Conclusion The TOPSIS method based on DRG integrates two dimensions of medical service capability and medical service efficiency,and horizontally compares clinical departments.The evaluation re-sults are more objective,reasonable,and accurate,which can provide a methodological basis for hospital refined management.

Objective Based on DRG evaluation indicators,research an evaluation method that can comprehensive-ly evaluate the medical service capacity and efficiency of clinical departments in hospitals.Methods Using the front page of inpatient medical records from a tertiary hospital in Xuzhou in 2022 as a sample,obtaining DRG related indi-cators through the China Healthcare Security Diagnosis Related Groups 1.1 grouping system.Based on the number of DRG,CMI,TEI,and CEI indicators,use TOPSIS method to comprehensively evaluate the quality of medical ser-vices in clinical departments.Results The widest coverage of medical services is in General Surgery,with a DRG group of 325;The most difficult medical service is in the Emergency Department,with a CMI value of 1.45;The best time efficiency is in Ophthalmology,with a TEI of 0.56,The Dermatology has the best cost efficiency,with a CEI of 0.36;TOPSIS comprehensive evaluation shows that the top five are Pediatrics,General Medicine,Emergen-cy Department,General Surgery,and Gastroenterology,and the bottom five are Dentistry,Burn Unit,Orthope-dics,Neurosurgery,and CCU.Conclusion The TOPSIS method based on DRG integrates two dimensions of medical service capability and medical service efficiency,and horizontally compares clinical departments.The evaluation re-sults are more objective,reasonable,and accurate,which can provide a methodological basis for hospital refined management.

Objective Based on DRG evaluation indicators,research an evaluation method that can comprehensive-ly evaluate the medical service capacity and efficiency of clinical departments in hospitals.Methods Using the front page of inpatient medical records from a tertiary hospital in Xuzhou in 2022 as a sample,obtaining DRG related indi-cators through the China Healthcare Security Diagnosis Related Groups 1.1 grouping system.Based on the number of DRG,CMI,TEI,and CEI indicators,use TOPSIS method to comprehensively evaluate the quality of medical ser-vices in clinical departments.Results The widest coverage of medical services is in General Surgery,with a DRG group of 325;The most difficult medical service is in the Emergency Department,with a CMI value of 1.45;The best time efficiency is in Ophthalmology,with a TEI of 0.56,The Dermatology has the best cost efficiency,with a CEI of 0.36;TOPSIS comprehensive evaluation shows that the top five are Pediatrics,General Medicine,Emergen-cy Department,General Surgery,and Gastroenterology,and the bottom five are Dentistry,Burn Unit,Orthope-dics,Neurosurgery,and CCU.Conclusion The TOPSIS method based on DRG integrates two dimensions of medical service capability and medical service efficiency,and horizontally compares clinical departments.The evaluation re-sults are more objective,reasonable,and accurate,which can provide a methodological basis for hospital refined management.

Objective Based on DRG evaluation indicators,research an evaluation method that can comprehensive-ly evaluate the medical service capacity and efficiency of clinical departments in hospitals.Methods Using the front page of inpatient medical records from a tertiary hospital in Xuzhou in 2022 as a sample,obtaining DRG related indi-cators through the China Healthcare Security Diagnosis Related Groups 1.1 grouping system.Based on the number of DRG,CMI,TEI,and CEI indicators,use TOPSIS method to comprehensively evaluate the quality of medical ser-vices in clinical departments.Results The widest coverage of medical services is in General Surgery,with a DRG group of 325;The most difficult medical service is in the Emergency Department,with a CMI value of 1.45;The best time efficiency is in Ophthalmology,with a TEI of 0.56,The Dermatology has the best cost efficiency,with a CEI of 0.36;TOPSIS comprehensive evaluation shows that the top five are Pediatrics,General Medicine,Emergen-cy Department,General Surgery,and Gastroenterology,and the bottom five are Dentistry,Burn Unit,Orthope-dics,Neurosurgery,and CCU.Conclusion The TOPSIS method based on DRG integrates two dimensions of medical service capability and medical service efficiency,and horizontally compares clinical departments.The evaluation re-sults are more objective,reasonable,and accurate,which can provide a methodological basis for hospital refined management.

Objective Based on DRG evaluation indicators,research an evaluation method that can comprehensive-ly evaluate the medical service capacity and efficiency of clinical departments in hospitals.Methods Using the front page of inpatient medical records from a tertiary hospital in Xuzhou in 2022 as a sample,obtaining DRG related indi-cators through the China Healthcare Security Diagnosis Related Groups 1.1 grouping system.Based on the number of DRG,CMI,TEI,and CEI indicators,use TOPSIS method to comprehensively evaluate the quality of medical ser-vices in clinical departments.Results The widest coverage of medical services is in General Surgery,with a DRG group of 325;The most difficult medical service is in the Emergency Department,with a CMI value of 1.45;The best time efficiency is in Ophthalmology,with a TEI of 0.56,The Dermatology has the best cost efficiency,with a CEI of 0.36;TOPSIS comprehensive evaluation shows that the top five are Pediatrics,General Medicine,Emergen-cy Department,General Surgery,and Gastroenterology,and the bottom five are Dentistry,Burn Unit,Orthope-dics,Neurosurgery,and CCU.Conclusion The TOPSIS method based on DRG integrates two dimensions of medical service capability and medical service efficiency,and horizontally compares clinical departments.The evaluation re-sults are more objective,reasonable,and accurate,which can provide a methodological basis for hospital refined management.

Objective Based on DRG evaluation indicators,research an evaluation method that can comprehensive-ly evaluate the medical service capacity and efficiency of clinical departments in hospitals.Methods Using the front page of inpatient medical records from a tertiary hospital in Xuzhou in 2022 as a sample,obtaining DRG related indi-cators through the China Healthcare Security Diagnosis Related Groups 1.1 grouping system.Based on the number of DRG,CMI,TEI,and CEI indicators,use TOPSIS method to comprehensively evaluate the quality of medical ser-vices in clinical departments.Results The widest coverage of medical services is in General Surgery,with a DRG group of 325;The most difficult medical service is in the Emergency Department,with a CMI value of 1.45;The best time efficiency is in Ophthalmology,with a TEI of 0.56,The Dermatology has the best cost efficiency,with a CEI of 0.36;TOPSIS comprehensive evaluation shows that the top five are Pediatrics,General Medicine,Emergen-cy Department,General Surgery,and Gastroenterology,and the bottom five are Dentistry,Burn Unit,Orthope-dics,Neurosurgery,and CCU.Conclusion The TOPSIS method based on DRG integrates two dimensions of medical service capability and medical service efficiency,and horizontally compares clinical departments.The evaluation re-sults are more objective,reasonable,and accurate,which can provide a methodological basis for hospital refined management.

Objective Based on DRG evaluation indicators,research an evaluation method that can comprehensive-ly evaluate the medical service capacity and efficiency of clinical departments in hospitals.Methods Using the front page of inpatient medical records from a tertiary hospital in Xuzhou in 2022 as a sample,obtaining DRG related indi-cators through the China Healthcare Security Diagnosis Related Groups 1.1 grouping system.Based on the number of DRG,CMI,TEI,and CEI indicators,use TOPSIS method to comprehensively evaluate the quality of medical ser-vices in clinical departments.Results The widest coverage of medical services is in General Surgery,with a DRG group of 325;The most difficult medical service is in the Emergency Department,with a CMI value of 1.45;The best time efficiency is in Ophthalmology,with a TEI of 0.56,The Dermatology has the best cost efficiency,with a CEI of 0.36;TOPSIS comprehensive evaluation shows that the top five are Pediatrics,General Medicine,Emergen-cy Department,General Surgery,and Gastroenterology,and the bottom five are Dentistry,Burn Unit,Orthope-dics,Neurosurgery,and CCU.Conclusion The TOPSIS method based on DRG integrates two dimensions of medical service capability and medical service efficiency,and horizontally compares clinical departments.The evaluation re-sults are more objective,reasonable,and accurate,which can provide a methodological basis for hospital refined management.

Objective:To investigate the safety and efficacy of four-hook needle combined with holographic image in robot-assisted partial nephrectomy for completely intrarenal tumors.Methods:The clinical data of 8 patients with completely intrarenal tumors treated by robot-assisted partial nephrectomy with four-hook needle combined with holographic image admitted to General Hospital of Central Theater Command from October 2023 to December 2023 were retrospectively analyzed. There were 6 males and 2 females, with average age of (44.5±12.0) years old. Tumors of 6 cases were in the left side and 2 cases in the right side. The maximum diameter of the tumor was (23.2±8.1) mm. The R. E.N.A.L. score was (9.0±1.4). The preoperative serum creatinine (Scr) was (73.1±14.7) μmol/L. CT-guided four-hook needle was used to locate the edge of completely intrarenal tumor before surgery. During the operation, the tumor was precisely resected under the guidance of hologram and four-hook needle. Perioperative data of patients were collected and analyzed.Results:All the tumor were successfully resected under the guidance of four-hook needle and hologram without conversion to radical nephrectomy or open surgery. The mean operative time was (117.0±14.5) min, the mean hot ischemia time was (20.2±5.1) min, the mean intraoperative blood loss was (75.0±17.3) ml, and the average hospitalization time was (9.5±1.3) days.The one week postoperative Scr was (73.2±14.8) μmol/L, which had no significant difference with that of before operation ( P=0.952). None of them received blood transfusion. The pathology results of 8 patients were clear cell renal cell carcinoma, and the surgical margins were negative. Conclusions:For completely intrarenal tumors, the four-hook needle combined with the hologram can guide the surgeon to quickly locate the tumor, accurately resect the tumor, reduce perioperative complications, and is safe and effective.