Objective To observe the value of MRI texture features combined with apparent diffusion coefficient(ADC)for differentiating uterine sarcoma(US)and cellular uterine leiomyoma(CUL).Methods Pelvic MRI data of 27 US patients(US group)and 34 CUL patients(CUL group)were retrospectively analyzed.The texture features of lesions were extracted from T2WI and diffusion weighted imaging(DWI),the ADC value were measured,and the average ADC value(ADCmean),the minimum ADC value(ADCmin)and standard ADC value(ADCst)were recorded.Then logistic regression(LR)models were constructed based on ADC value,optimal texture features alone and their combination,respectively,including LRADC,LRtexture and LRADC+texture models.Receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy of each model for differentiating US and CUL.Results The ADCmean,ADCmin and ADCst in US group were all lower than those in CUL group(all P＜0.05).A total of 3 750 texture features were extracted from pelvic T2WI and DWI,5 optimal features were finally obtained,and the constructed LRADC+texture model and LRtexture model had similar efficacy of differentiating US and CUL(AUC=0.921,0.887;P＞0.05),which were both higher than that of LRADC model(AUC=0.696;both P＜0.05).The calibration curve of LRADC+texture model was basically consistent with the ideal curve,which had better clinical benefits than LRADC and LRtexture models.Conclusion MRI texture features combined with ADC value could improve efficacy for differentiating US and CUL.

Objective To explore the intervention effect of nursing program based on contact-introduce-communicate-ask-respond-exit(CICARE)communication model on breast cancer patients undergoing chemotherapy.Methods Sixty patients with breast cancer who received routine intervention in Huai an First People's Hospital from January 2019 to June 2020 were selected as routine intervention group.Sixty patients with breast cancer who underwent chemotherapy nursing program based on CICARE communication model on the basis of routine intervention in Huai'an First People's Hospital from July 2020 to December 2021 were selected as CICARE intervention group.The intervention was carried out until discharge in both groups.The psychological state,self-management ability,level of hope and quality of life were compared between the two groups at admission and discharge.Results Compared with those at admission,the scores of Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)at discharge decreased in both groups,and the scores in the CICARE intervention group were lower than those in the routine intervention group at discharge(P<0.05).The scores of resilience rating,exercise,and cognitive symptom management implementation,communication with the physician ratings,reality and future of attitude,positive action of attitude,keeping intimate relationships with others and quality of life at discharge increased in both groups,and these scores in the CICARE intervention group were significantly higher than those in the routine intervention group(P<0.05).Conclusion The nursing program based on CICARE communication model can improve psychological state,self-management ability,hope level and quality of life in breast cancer patients undergoing chemotherapy by enhancing the communication between nurses and patients with good intervention effect.

Objective:To explore the status and influencing factors of stigma in patients with pituitary adenoma.Methods:From January 2020 to May 2021, a total of 106 patients with pituitary adenoma in the Affiliated Huai'an No.1 People 's Hospital of Nanjing Medical University were selected using the convenience sampling method. Internalized Stigma of Mental Illness, Medical Coping Style Questionnaire and Connor-Davidson Resilience Scale were used to investigate them. Binary Logistic regression analysis was used to evaluate the influencing factors of stigma in patients with pituitary adenoma. Results:Among 106 patients with pituitary adenoma, 87 (82.08%) had stigma. The stigma score of patients with pituitary adenoma was (2.58±0.61) . Binary Logistic regression analysis results showed that family monthly income, coping style and mental elasticity were the influencing factors of stigma in patients with pituitary adenoma ( P<0.05) . Conclusions:Stigma is common in patients with pituitary adenoma. Medical staff should take targeted intervention measures according to the influencing factors of stigma in patients with pituitary adenoma, so as to help patients reduce stigma.