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Experience of humanistic nursing in hemodialysis nursing for patients with diabetic kidney disease 糖尿病肾病患者血液透析护理中的人文护理体会
Pub Date : 2024-02-15 DOI: 10.4239/wjd.v15.i2.186
Xiaoying Chai, Xiao-Yan Bao, Ying Dai, Xing-Xing Dai, Yu Zhang, Yu-Ling Yang
BACKGROUND Diabetic kidney disease (DKD) is a prevalent complication of diabetes that often requires hemodialysis for treatment. In the field of nursing, there is a growing recognition of the importance of humanistic care, which focuses on the holistic needs of patients, including their emotional, psychological, and social well-being. However, the application of humanistic nursing in the context of hemodialysis for DKD patients remains relatively unexplored. AIM To explore the experience of humanistic nursing in hemodialysis nursing for DKD patients. METHODS Ninety-six DKD patients treated with hemodialysis from March 2020 to June 2022 were included in the study and divided into the control cluster (48 cases) and the study cluster (48 cases) according to different nursing methods; the control cluster was given routine nursing and the study cluster was given humanized nursing. The variances of negative emotion mark, blood glucose, renal function, the incidence of complications, life mark and nursing satisfaction before and after nur-sing were contrasted between the two clusters. RESULTS No significant difference in negative emotion markers between the two clusters were observed before nursing (P > 0.05), and the negative emotion markers of the two clusters decreased after nursing. The Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale markers were lower in the study cluster than the control cluster. The healing rate of patients in the study cluster was significantly higher than the control cluster (97.92% vs 85.42%, P < 0.05). Blood glucose parameters were not significantly different between the groups prior to nursing (P > 0.05). However, after nursing, blood urea nitrogen and serum creatinine (SCr) levels in the study cluster were lower than those in the control cluster (P < 0.05). The incidence rate of complications was significantly lower in the study group compared to the control cluster (6.25% vs 20.83%, P < 0.05). There was no significant difference in the life markers between the two clusters before nursing. While the life markers increased after nursing for both groups, the 36-item health scale markers in the study cluster were higher than those within the control cluster (P < 0.05). Finally, the nursing satisfaction rate was 93.75% in the study cluster, compared to 75% in the control cluster (P < 0.05). CONCLUSION In hemodialysis for DKD patients, the implementation of humanistic nursing achieved ideal results, effectively reducing patients’ psychological negative emotion markers so that they can actively cooperate with the diagnosis and nursing, facilitate the control of blood glucose and the maintenance of residual renal function, reduce the occurrence of complications, and finally enhance the life quality and nursing satisfaction of patients. It is worthy of being widely popularized and applied.
背景 糖尿病肾病(DKD)是糖尿病的一种常见并发症,通常需要进行血液透析治疗。在护理领域,越来越多的人认识到人文关怀的重要性,它关注患者的整体需求,包括情感、心理和社会福祉。然而,人文护理在 DKD 患者血液透析中的应用仍相对欠缺。目的 探讨 DKD 患者血液透析护理中的人文护理经验。方法 将2020年3月至2022年6月期间接受血液透析治疗的96例DKD患者纳入研究,按照不同的护理方法分为对照组(48例)和研究组(48例),对照组给予常规护理,研究组给予人性化护理。对比两组患者护理前后负性情绪指数、血糖、肾功能、并发症发生率、生活指数和护理满意度的差异。结果 护理前两组患者的负性情绪指标无明显差异(P>0.05),护理后两组患者的负性情绪指标均有所下降。研究组的汉密尔顿焦虑量表和汉密尔顿抑郁量表指标均低于对照组。研究组患者的痊愈率明显高于对照组(97.92% vs 85.42%,P < 0.05)。两组患者在护理前的血糖指标无明显差异(P > 0.05)。但在护理后,研究组的血尿素氮和血清肌酐(SCr)水平低于对照组(P < 0.05)。与对照组相比,研究组的并发症发生率明显较低(6.25% vs 20.83%,P < 0.05)。在护理前,两个组群的生命指标没有明显差异。护理后,两组的生活指数均有所上升,但研究组的 36 项健康量表指数高于对照组(P < 0.05)。最后,研究组的护理满意度为 93.75%,而对照组为 75%(P < 0.05)。结论 在DKD患者血液透析中,实施人性化护理取得了理想的效果,有效降低了患者的心理负性情绪指标,使其能够积极配合诊疗护理,有利于血糖的控制和残余肾功能的维持,减少并发症的发生,最终提高了患者的生活质量和护理满意度。值得广泛推广应用。
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引用次数: 0
Identification of hub genes associated with Helicobacter pylori infection and type 2 diabetes mellitus: A pilot bioinformatics study 幽门螺杆菌感染与 2 型糖尿病相关枢纽基因的鉴定:生物信息学试验研究
Pub Date : 2024-02-15 DOI: 10.4239/wjd.v15.i2.170
Han Chen, Guo-Xin Zhang, Xiao-Ying Zhou
BACKGROUND Helicobacter pylori (H. pylori ) infection is related to various extragastric diseases including type 2 diabetes mellitus (T2DM). However, the possible mechanisms connecting H. pylori infection and T2DM remain unknown. AIM To explore potential molecular connections between H. pylori infection and T2DM. METHODS We extracted gene expression arrays from three online datasets (GSE60427, GSE27411 and GSE115601). Differentially expressed genes (DEGs) commonly present in patients with H. pylori infection and T2DM were identified. Hub genes were validated using human gastric biopsy samples. Correlations between hub genes and immune cell infiltration, miRNAs, and transcription factors (TFs) were further analyzed. RESULTS A total of 67 DEGs were commonly presented in patients with H. pylori infection and T2DM. Five significantly upregulated hub genes, including TLR4 , ITGAM , C5AR1 , FCER1G , and FCGR2A , were finally identified, all of which are closely related to immune cell infiltration. The gene-miRNA analysis detected 13 miRNAs with at least two gene cross-links. TF-gene interaction networks showed that TLR4 was coregulated by 26 TFs, the largest number of TFs among the 5 hub genes. CONCLUSION We identified five hub genes that may have molecular connections between H. pylori infection and T2DM. This study provides new insights into the pathogenesis of H. pylori -induced onset of T2DM.
背景幽门螺杆菌(H. pylori)感染与包括 2 型糖尿病(T2DM)在内的各种胃肠外疾病有关。然而,幽门螺杆菌感染与 T2DM 的可能关联机制仍不清楚。目的 探讨幽门螺杆菌感染与 T2DM 之间的潜在分子联系。方法 我们从三个在线数据集(GSE60427、GSE27411 和 GSE115601)中提取了基因表达阵列。确定了幽门螺杆菌感染和 T2DM 患者中常见的差异表达基因 (DEG)。利用人类胃活检样本对枢纽基因进行了验证。进一步分析了枢纽基因与免疫细胞浸润、miRNA 和转录因子(TFs)之间的相关性。结果 共有 67 个 DEGs 常见于幽门螺杆菌感染和 T2DM 患者。最终确定了五个明显上调的中枢基因,包括 TLR4、ITGAM、C5AR1、FCER1G 和 FCGR2A,它们都与免疫细胞浸润密切相关。基因-miRNA分析发现了13个至少有两个基因交叉连接的miRNA。TF-基因相互作用网络显示,TLR4受26个TF的核心调控,是5个枢纽基因中TF数量最多的。结论 我们发现了幽门螺杆菌感染与 T2DM 之间可能存在分子联系的五个枢纽基因。这项研究为幽门螺杆菌诱发 T2DM 的发病机制提供了新的见解。
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引用次数: 0
Analysis of the influencing factors and clinical related characteristics of pulmonary tuberculosis in patients with type 2 diabetes mellitus 2 型糖尿病患者肺结核的影响因素和临床相关特征分析
Pub Date : 2024-02-15 DOI: 10.4239/wjd.v15.i2.196
Han Shi, Yuan Yuan, Xue Li, Yan-Fang Li, Ling Fan, Xue-Mei Yang
BACKGROUND In China, the prevalence of type 2 diabetes mellitus (T2DM) among diabetic patients is estimated to be between 90%-95%. Additionally, China is among the 22 countries burdened by a high number of tuberculosis cases, with approximately 4.5 million individuals affected by active tuberculosis. Notably, T2DM poses a significant risk factor for the development of tuberculosis, as evidenced by the increased incidence of T2DM coexisting with pulmonary tuberculosis (T2DM-PTB), which has risen from 19.3% to 24.1%. It is evident that these two diseases are intricately interconnected and mutually reinforcing in nature. AIM To elucidate the clinical features of individuals diagnosed with both T2DM and tuberculosis (T2DM-PTB), as well as to investigate the potential risk factors associated with active tuberculosis in patients with T2DM. METHODS T2DM-PTB patients who visited our hospital between January 2020 and January 2023 were selected as the observation group, Simple DM patients presenting to our hospital in the same period were the control group, Controls and case groups were matched 1:2 according to the principle of the same sex, age difference ( ± 3) years and disease duration difference ( ± 5) years, patients were investigated for general demographic characteristics, diabetes-related characteristics, body immune status, lifestyle and behavioral habits, univariate and multivariate analysis of the data using conditional logistic regression, calculate the odds ratio (OR) values and 95%CI of OR values. RESULTS A total of 315 study subjects were included in this study, including 105 subjects in the observation group and 210 subjects in the control group. Comparison of the results of both anthropometric and biochemical measures showed that the constitution index, systolic blood pressure, diastolic blood pressure and lymphocyte count were significantly lower in the case group, while fasting blood glucose and high-density lipoprotein cholesterol levels were significantly higher than those in the control group. The results of univariate analysis showed that poor glucose control, hypoproteinemia, lymphopenia, TB contact history, high infection, smoking and alcohol consumption were positively associated with PTB in T2DM patients; married, history of hypertension, treatment of oral hypoglycemic drugs plus insulin, overweight, obesity and regular exercise were negatively associated with PTB in T2DM patients. Results of multivariate stepwise regression analysis found lymphopenia (OR = 17.75, 95%CI: 3.40-92.74), smoking (OR = 12.25, 95%CI: 2.53-59.37), history of TB contact (OR = 6.56, 95%CI: 1.23-35.03) and poor glycemic control (OR = 3.37, 95%CI: 1.11-10.25) was associated with an increased risk of developing PTB in patients with T2DM, While being overweight (OR = 0.23, 95%CI: 0.08-0.72) and obesity (OR = 0.11, 95%CI: 0.02-0.72) was associated with a reduced risk of developing PTB in patients with T2DM. CONCLUSION T2DM-PTB patients are prone to w
背景 在中国,糖尿病患者中 2 型糖尿病(T2DM)的患病率估计在 90%-95% 之间。此外,中国是 22 个结核病高发国家之一,约有 450 万人患有活动性结核病。值得注意的是,T2DM 是肺结核发病的重要危险因素,T2DM 并发肺结核(T2DM-PTB)的发病率已从 19.3% 上升到 24.1%。由此可见,这两种疾病之间存在着错综复杂的联系,并且在本质上相互促进。目的 阐明同时被诊断为 T2DM 和肺结核(T2DM-PTB)患者的临床特征,并研究与 T2DM 患者活动性肺结核相关的潜在风险因素。方法 选取 2020 年 1 月至 2023 年 1 月期间来我院就诊的 T2DM-PTB 患者为观察组,同期来我院就诊的单纯 DM 患者为对照组,对照组与病例组按照 1:按照性别相同、年龄相差(±3)岁、病程相差(±5)年的原则进行1:2配对,调查患者的一般人口学特征、糖尿病相关特征、机体免疫状态、生活方式和行为习惯等,采用条件Logistic回归对数据进行单变量和多变量分析,计算比值比(OR)值和OR值的95%CI。结果 本研究共纳入 315 名研究对象,其中观察组 105 名,对照组 210 名。人体测量和生化指标的比较结果显示,病例组的体质指数、收缩压、舒张压和淋巴细胞计数明显低于对照组,而空腹血糖和高密度脂蛋白胆固醇水平则明显高于对照组。单变量分析结果显示,血糖控制不良、低蛋白血症、淋巴细胞减少、结核接触史、高感染、吸烟和饮酒与 T2DM 患者的 PTB 呈正相关;已婚、高血压史、口服降糖药加胰岛素治疗、超重、肥胖和经常运动与 T2DM 患者的 PTB 呈负相关。多变量逐步回归分析结果发现,淋巴细胞减少(OR = 17.75,95%CI:3.40-92.74)、吸烟(OR = 12.25,95%CI:2.53-59.37)、结核病接触史(OR = 6.56,95%CI:1.23-35.03)和血糖控制不佳(OR = 3.37,95%CI:1.11-10.25)与 T2DM 患者患 PTB 的风险增加有关。而超重(OR = 0.23,95%CI:0.08-0.72)和肥胖(OR = 0.11,95%CI:0.02-0.72)与 T2DM 患者患 PTB 的风险降低有关。结论 T2DM-PTB 患者的血糖控制较差,感染频率较高,吸烟、饮酒和缺乏运动的比例较高。淋巴细胞减少症、吸烟、结核病接触史、血糖控制不佳是 T2DM-PTB 的独立危险因素,而超重和肥胖与 T2DM 患者并发 PTB 的风险降低有关。
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引用次数: 0
Age-specific differences in the association between prediabetes and cardiovascular diseases in China: A national cross-sectional study 中国糖尿病前期与心血管疾病相关的年龄差异:一项全国性横断面研究
Pub Date : 2024-02-15 DOI: 10.4239/wjd.v15.i2.240
Shuo Xie, Liping Yu, Fei Chen, Yao Wang, Ruifen Deng, Xue-Lian Zhang, Bo Zhang
BACKGROUND Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide, the global burden of which is rising. It is still unclear the extent to which prediabetes contributes to the risk of CVD in various age brackets among adults. To develop a focused screening plan and treatment for Chinese adults with prediabetes, it is crucial to identify variations in the connection between prediabetes and the risk of CVD based on age. AIM To examine the clinical features of prediabetes and identify risk factors for CVD in different age groups in China. METHODS The cross-sectional study involved a total of 46239 participants from June 2007 through May 2008. A thorough evaluation was conducted. Individuals with prediabetes were categorized into two groups based on age. Chinese atherosclerotic CVD risk prediction model was employed to evaluate the risk of developing CVD over 10 years. Random forest was established in both age groups. SHapley Additive exPlanation method prioritized the importance of features from the perspective of assessment contribution. RESULTS In total, 6948 people were diagnosed with prediabetes in this study. In pre-diabetes, prevalences of CVD were 5 (0.29%) in the younger group and 148 (2.85%) in the older group. Overall, 11.11% of the younger group and 29.59% of the older group were intermediate/high-risk of CVD for prediabetes without CVD based on the Prediction for ASCVD Risk in China equation in ten years. In the younger age group, the 10-year risk of CVD was found to be more closely linked to family history of CVD rather than lifestyle, whereas in the older age group, resident status was more closely linked. CONCLUSION The susceptibility to CVD is age-specific in newly diagnosed prediabetes. It is necessary to develop targeted approaches for the prevention and management of CVD in adults across various age brackets.
背景心血管疾病(CVD)是全球发病率和死亡率的主要原因,其全球负担正在不断加重。目前还不清楚糖尿病前期在多大程度上会导致不同年龄段的成年人罹患心血管疾病。要为中国成人糖尿病前期患者制定有针对性的筛查计划和治疗方法,关键是要明确糖尿病前期与心血管疾病风险之间因年龄而异的联系。目的 研究中国不同年龄组糖尿病前期的临床特征,并确定心血管疾病的风险因素。方法 从 2007 年 6 月到 2008 年 5 月,共对 46239 名参与者进行了横断面研究。研究人员进行了全面的评估。根据年龄将糖尿病前期患者分为两组。采用中国动脉粥样硬化心血管疾病风险预测模型来评估 10 年内罹患心血管疾病的风险。两个年龄组都建立了随机森林。SHapley Additive exPlanation 方法从评估贡献的角度对特征的重要性进行优先排序。结果 本研究中共有 6948 人被诊断为糖尿病前期。在糖尿病前期患者中,年轻组的心血管疾病发病率为 5 例(0.29%),老年组为 148 例(2.85%)。总体而言,根据《中国 ASCVD 风险预测方程》,10 年后无心血管疾病的糖尿病前期患者中,11.11% 的年轻组和 29.59% 的老年组为心血管疾病中/高风险。研究发现,在年轻组中,心血管疾病的十年风险与心血管疾病家族史而非生活方式的关系更为密切,而在老年组中,与居民身份的关系更为密切。结论 在新诊断的糖尿病前期患者中,心血管疾病的易感性与年龄有关。有必要制定有针对性的方法,预防和管理不同年龄段成年人的心血管疾病。
{"title":"Age-specific differences in the association between prediabetes and cardiovascular diseases in China: A national cross-sectional study","authors":"Shuo Xie, Liping Yu, Fei Chen, Yao Wang, Ruifen Deng, Xue-Lian Zhang, Bo Zhang","doi":"10.4239/wjd.v15.i2.240","DOIUrl":"https://doi.org/10.4239/wjd.v15.i2.240","url":null,"abstract":"BACKGROUND\u0000 Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide, the global burden of which is rising. It is still unclear the extent to which prediabetes contributes to the risk of CVD in various age brackets among adults. To develop a focused screening plan and treatment for Chinese adults with prediabetes, it is crucial to identify variations in the connection between prediabetes and the risk of CVD based on age.\u0000 AIM\u0000 To examine the clinical features of prediabetes and identify risk factors for CVD in different age groups in China.\u0000 METHODS\u0000 The cross-sectional study involved a total of 46239 participants from June 2007 through May 2008. A thorough evaluation was conducted. Individuals with prediabetes were categorized into two groups based on age. Chinese atherosclerotic CVD risk prediction model was employed to evaluate the risk of developing CVD over 10 years. Random forest was established in both age groups. SHapley Additive exPlanation method prioritized the importance of features from the perspective of assessment contribution.\u0000 RESULTS\u0000 In total, 6948 people were diagnosed with prediabetes in this study. In pre-diabetes, prevalences of CVD were 5 (0.29%) in the younger group and 148 (2.85%) in the older group. Overall, 11.11% of the younger group and 29.59% of the older group were intermediate/high-risk of CVD for prediabetes without CVD based on the Prediction for ASCVD Risk in China equation in ten years. In the younger age group, the 10-year risk of CVD was found to be more closely linked to family history of CVD rather than lifestyle, whereas in the older age group, resident status was more closely linked.\u0000 CONCLUSION\u0000 The susceptibility to CVD is age-specific in newly diagnosed prediabetes. It is necessary to develop targeted approaches for the prevention and management of CVD in adults across various age brackets.","PeriodicalId":509005,"journal":{"name":"World Journal of Diabetes","volume":"21 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139835576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of the influencing factors and clinical related characteristics of pulmonary tuberculosis in patients with type 2 diabetes mellitus 2 型糖尿病患者肺结核的影响因素和临床相关特征分析
Pub Date : 2024-02-15 DOI: 10.4239/wjd.v15.i2.196
Han Shi, Yuan Yuan, Xue Li, Yan-Fang Li, Ling Fan, Xue-Mei Yang
BACKGROUND In China, the prevalence of type 2 diabetes mellitus (T2DM) among diabetic patients is estimated to be between 90%-95%. Additionally, China is among the 22 countries burdened by a high number of tuberculosis cases, with approximately 4.5 million individuals affected by active tuberculosis. Notably, T2DM poses a significant risk factor for the development of tuberculosis, as evidenced by the increased incidence of T2DM coexisting with pulmonary tuberculosis (T2DM-PTB), which has risen from 19.3% to 24.1%. It is evident that these two diseases are intricately interconnected and mutually reinforcing in nature. AIM To elucidate the clinical features of individuals diagnosed with both T2DM and tuberculosis (T2DM-PTB), as well as to investigate the potential risk factors associated with active tuberculosis in patients with T2DM. METHODS T2DM-PTB patients who visited our hospital between January 2020 and January 2023 were selected as the observation group, Simple DM patients presenting to our hospital in the same period were the control group, Controls and case groups were matched 1:2 according to the principle of the same sex, age difference ( ± 3) years and disease duration difference ( ± 5) years, patients were investigated for general demographic characteristics, diabetes-related characteristics, body immune status, lifestyle and behavioral habits, univariate and multivariate analysis of the data using conditional logistic regression, calculate the odds ratio (OR) values and 95%CI of OR values. RESULTS A total of 315 study subjects were included in this study, including 105 subjects in the observation group and 210 subjects in the control group. Comparison of the results of both anthropometric and biochemical measures showed that the constitution index, systolic blood pressure, diastolic blood pressure and lymphocyte count were significantly lower in the case group, while fasting blood glucose and high-density lipoprotein cholesterol levels were significantly higher than those in the control group. The results of univariate analysis showed that poor glucose control, hypoproteinemia, lymphopenia, TB contact history, high infection, smoking and alcohol consumption were positively associated with PTB in T2DM patients; married, history of hypertension, treatment of oral hypoglycemic drugs plus insulin, overweight, obesity and regular exercise were negatively associated with PTB in T2DM patients. Results of multivariate stepwise regression analysis found lymphopenia (OR = 17.75, 95%CI: 3.40-92.74), smoking (OR = 12.25, 95%CI: 2.53-59.37), history of TB contact (OR = 6.56, 95%CI: 1.23-35.03) and poor glycemic control (OR = 3.37, 95%CI: 1.11-10.25) was associated with an increased risk of developing PTB in patients with T2DM, While being overweight (OR = 0.23, 95%CI: 0.08-0.72) and obesity (OR = 0.11, 95%CI: 0.02-0.72) was associated with a reduced risk of developing PTB in patients with T2DM. CONCLUSION T2DM-PTB patients are prone to w
背景 在中国,糖尿病患者中 2 型糖尿病(T2DM)的患病率估计在 90%-95% 之间。此外,中国是 22 个结核病高发国家之一,约有 450 万人患有活动性结核病。值得注意的是,T2DM 是肺结核发病的一个重要危险因素,T2DM 并发肺结核(T2DM-PTB)的发病率从 19.3% 上升到 24.1%。由此可见,这两种疾病之间存在着错综复杂的联系,并且在本质上相互促进。目的 阐明同时被诊断为 T2DM 和肺结核(T2DM-PTB)患者的临床特征,并研究与 T2DM 患者活动性肺结核相关的潜在风险因素。方法 选取 2020 年 1 月至 2023 年 1 月期间来我院就诊的 T2DM-PTB 患者为观察组,同期来我院就诊的单纯 DM 患者为对照组,对照组与病例组按照 1:按照性别相同、年龄相差(±3)岁、病程相差(±5)年的原则进行1:2配对,调查患者的一般人口学特征、糖尿病相关特征、机体免疫状态、生活方式和行为习惯等,采用条件Logistic回归对数据进行单变量和多变量分析,计算比值比(OR)值和OR值的95%CI。结果 本研究共纳入 315 名研究对象,其中观察组 105 名,对照组 210 名。人体测量和生化指标的比较结果显示,病例组的体质指数、收缩压、舒张压和淋巴细胞计数明显低于对照组,而空腹血糖和高密度脂蛋白胆固醇水平则明显高于对照组。单变量分析结果显示,血糖控制不良、低蛋白血症、淋巴细胞减少、结核接触史、高感染、吸烟和饮酒与 T2DM 患者的 PTB 呈正相关;已婚、高血压史、口服降糖药加胰岛素治疗、超重、肥胖和经常运动与 T2DM 患者的 PTB 呈负相关。多变量逐步回归分析结果发现,淋巴细胞减少(OR = 17.75,95%CI:3.40-92.74)、吸烟(OR = 12.25,95%CI:2.53-59.37)、结核病接触史(OR = 6.56,95%CI:1.23-35.03)和血糖控制不佳(OR = 3.37,95%CI:1.11-10.25)与 T2DM 患者患 PTB 的风险增加有关。而超重(OR = 0.23,95%CI:0.08-0.72)和肥胖(OR = 0.11,95%CI:0.02-0.72)与 T2DM 患者患 PTB 的风险降低有关。结论 T2DM-PTB患者的血糖控制较差,感染频率较高,吸烟、饮酒和缺乏运动的比例较高。淋巴细胞减少症、吸烟、结核病接触史、血糖控制不佳是 T2DM-PTB 的独立危险因素,而超重和肥胖与 T2DM 患者并发 PTB 的风险降低有关。
{"title":"Analysis of the influencing factors and clinical related characteristics of pulmonary tuberculosis in patients with type 2 diabetes mellitus","authors":"Han Shi, Yuan Yuan, Xue Li, Yan-Fang Li, Ling Fan, Xue-Mei Yang","doi":"10.4239/wjd.v15.i2.196","DOIUrl":"https://doi.org/10.4239/wjd.v15.i2.196","url":null,"abstract":"BACKGROUND\u0000 In China, the prevalence of type 2 diabetes mellitus (T2DM) among diabetic patients is estimated to be between 90%-95%. Additionally, China is among the 22 countries burdened by a high number of tuberculosis cases, with approximately 4.5 million individuals affected by active tuberculosis. Notably, T2DM poses a significant risk factor for the development of tuberculosis, as evidenced by the increased incidence of T2DM coexisting with pulmonary tuberculosis (T2DM-PTB), which has risen from 19.3% to 24.1%. It is evident that these two diseases are intricately interconnected and mutually reinforcing in nature.\u0000 AIM\u0000 To elucidate the clinical features of individuals diagnosed with both T2DM and tuberculosis (T2DM-PTB), as well as to investigate the potential risk factors associated with active tuberculosis in patients with T2DM.\u0000 METHODS\u0000 T2DM-PTB patients who visited our hospital between January 2020 and January 2023 were selected as the observation group, Simple DM patients presenting to our hospital in the same period were the control group, Controls and case groups were matched 1:2 according to the principle of the same sex, age difference ( ± 3) years and disease duration difference ( ± 5) years, patients were investigated for general demographic characteristics, diabetes-related characteristics, body immune status, lifestyle and behavioral habits, univariate and multivariate analysis of the data using conditional logistic regression, calculate the odds ratio (OR) values and 95%CI of OR values.\u0000 RESULTS\u0000 A total of 315 study subjects were included in this study, including 105 subjects in the observation group and 210 subjects in the control group. Comparison of the results of both anthropometric and biochemical measures showed that the constitution index, systolic blood pressure, diastolic blood pressure and lymphocyte count were significantly lower in the case group, while fasting blood glucose and high-density lipoprotein cholesterol levels were significantly higher than those in the control group. The results of univariate analysis showed that poor glucose control, hypoproteinemia, lymphopenia, TB contact history, high infection, smoking and alcohol consumption were positively associated with PTB in T2DM patients; married, history of hypertension, treatment of oral hypoglycemic drugs plus insulin, overweight, obesity and regular exercise were negatively associated with PTB in T2DM patients. Results of multivariate stepwise regression analysis found lymphopenia (OR = 17.75, 95%CI: 3.40-92.74), smoking (OR = 12.25, 95%CI: 2.53-59.37), history of TB contact (OR = 6.56, 95%CI: 1.23-35.03) and poor glycemic control (OR = 3.37, 95%CI: 1.11-10.25) was associated with an increased risk of developing PTB in patients with T2DM, While being overweight (OR = 0.23, 95%CI: 0.08-0.72) and obesity (OR = 0.11, 95%CI: 0.02-0.72) was associated with a reduced risk of developing PTB in patients with T2DM.\u0000 CONCLUSION\u0000 T2DM-PTB patients are prone to w","PeriodicalId":509005,"journal":{"name":"World Journal of Diabetes","volume":"47 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Experience of humanistic nursing in hemodialysis nursing for patients with diabetic kidney disease 糖尿病肾病患者血液透析护理中的人文护理体会
Pub Date : 2024-02-15 DOI: 10.4239/wjd.v15.i2.186
Xiaoying Chai, Xiao-Yan Bao, Ying Dai, Xing-Xing Dai, Yu Zhang, Yu-Ling Yang
BACKGROUND Diabetic kidney disease (DKD) is a prevalent complication of diabetes that often requires hemodialysis for treatment. In the field of nursing, there is a growing recognition of the importance of humanistic care, which focuses on the holistic needs of patients, including their emotional, psychological, and social well-being. However, the application of humanistic nursing in the context of hemodialysis for DKD patients remains relatively unexplored. AIM To explore the experience of humanistic nursing in hemodialysis nursing for DKD patients. METHODS Ninety-six DKD patients treated with hemodialysis from March 2020 to June 2022 were included in the study and divided into the control cluster (48 cases) and the study cluster (48 cases) according to different nursing methods; the control cluster was given routine nursing and the study cluster was given humanized nursing. The variances of negative emotion mark, blood glucose, renal function, the incidence of complications, life mark and nursing satisfaction before and after nur-sing were contrasted between the two clusters. RESULTS No significant difference in negative emotion markers between the two clusters were observed before nursing (P > 0.05), and the negative emotion markers of the two clusters decreased after nursing. The Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale markers were lower in the study cluster than the control cluster. The healing rate of patients in the study cluster was significantly higher than the control cluster (97.92% vs 85.42%, P < 0.05). Blood glucose parameters were not significantly different between the groups prior to nursing (P > 0.05). However, after nursing, blood urea nitrogen and serum creatinine (SCr) levels in the study cluster were lower than those in the control cluster (P < 0.05). The incidence rate of complications was significantly lower in the study group compared to the control cluster (6.25% vs 20.83%, P < 0.05). There was no significant difference in the life markers between the two clusters before nursing. While the life markers increased after nursing for both groups, the 36-item health scale markers in the study cluster were higher than those within the control cluster (P < 0.05). Finally, the nursing satisfaction rate was 93.75% in the study cluster, compared to 75% in the control cluster (P < 0.05). CONCLUSION In hemodialysis for DKD patients, the implementation of humanistic nursing achieved ideal results, effectively reducing patients’ psychological negative emotion markers so that they can actively cooperate with the diagnosis and nursing, facilitate the control of blood glucose and the maintenance of residual renal function, reduce the occurrence of complications, and finally enhance the life quality and nursing satisfaction of patients. It is worthy of being widely popularized and applied.
背景 糖尿病肾病(DKD)是糖尿病的一种常见并发症,通常需要进行血液透析治疗。在护理领域,越来越多的人认识到人文关怀的重要性,它关注患者的整体需求,包括情感、心理和社会福祉。然而,人文护理在 DKD 患者血液透析中的应用仍相对欠缺。目的 探讨 DKD 患者血液透析护理中的人文护理经验。方法 将2020年3月至2022年6月期间接受血液透析治疗的96例DKD患者纳入研究,按照不同的护理方法分为对照组(48例)和研究组(48例),对照组给予常规护理,研究组给予人性化护理。对比两组患者护理前后负性情绪指数、血糖、肾功能、并发症发生率、生活指数和护理满意度的差异。结果 护理前两组患者的负性情绪指标无明显差异(P>0.05),护理后两组患者的负性情绪指标均有所下降。研究组的汉密尔顿焦虑量表和汉密尔顿抑郁量表指标均低于对照组。研究组患者的痊愈率明显高于对照组(97.92% vs 85.42%,P < 0.05)。两组患者在护理前的血糖指标无明显差异(P > 0.05)。但在护理后,研究组的血尿素氮和血清肌酐(SCr)水平低于对照组(P < 0.05)。与对照组相比,研究组的并发症发生率明显较低(6.25% vs 20.83%,P < 0.05)。在护理前,两个组群的生命指标没有明显差异。护理后,两组的生活指数均有所上升,但研究组的 36 项健康量表指数高于对照组(P < 0.05)。最后,研究组的护理满意度为 93.75%,而对照组为 75%(P < 0.05)。结论 在DKD患者血液透析中,实施人性化护理取得了理想的效果,有效降低了患者的心理负性情绪指标,使其能够积极配合诊疗护理,有利于血糖的控制和残余肾功能的维持,减少并发症的发生,最终提高了患者的生活质量和护理满意度。值得广泛推广应用。
{"title":"Experience of humanistic nursing in hemodialysis nursing for patients with diabetic kidney disease","authors":"Xiaoying Chai, Xiao-Yan Bao, Ying Dai, Xing-Xing Dai, Yu Zhang, Yu-Ling Yang","doi":"10.4239/wjd.v15.i2.186","DOIUrl":"https://doi.org/10.4239/wjd.v15.i2.186","url":null,"abstract":"BACKGROUND\u0000 Diabetic kidney disease (DKD) is a prevalent complication of diabetes that often requires hemodialysis for treatment. In the field of nursing, there is a growing recognition of the importance of humanistic care, which focuses on the holistic needs of patients, including their emotional, psychological, and social well-being. However, the application of humanistic nursing in the context of hemodialysis for DKD patients remains relatively unexplored.\u0000 AIM\u0000 To explore the experience of humanistic nursing in hemodialysis nursing for DKD patients.\u0000 METHODS\u0000 Ninety-six DKD patients treated with hemodialysis from March 2020 to June 2022 were included in the study and divided into the control cluster (48 cases) and the study cluster (48 cases) according to different nursing methods; the control cluster was given routine nursing and the study cluster was given humanized nursing. The variances of negative emotion mark, blood glucose, renal function, the incidence of complications, life mark and nursing satisfaction before and after nur-sing were contrasted between the two clusters.\u0000 RESULTS\u0000 No significant difference in negative emotion markers between the two clusters were observed before nursing (P > 0.05), and the negative emotion markers of the two clusters decreased after nursing. The Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale markers were lower in the study cluster than the control cluster. The healing rate of patients in the study cluster was significantly higher than the control cluster (97.92% vs 85.42%, P < 0.05). Blood glucose parameters were not significantly different between the groups prior to nursing (P > 0.05). However, after nursing, blood urea nitrogen and serum creatinine (SCr) levels in the study cluster were lower than those in the control cluster (P < 0.05). The incidence rate of complications was significantly lower in the study group compared to the control cluster (6.25% vs 20.83%, P < 0.05). There was no significant difference in the life markers between the two clusters before nursing. While the life markers increased after nursing for both groups, the 36-item health scale markers in the study cluster were higher than those within the control cluster (P < 0.05). Finally, the nursing satisfaction rate was 93.75% in the study cluster, compared to 75% in the control cluster (P < 0.05).\u0000 CONCLUSION\u0000 In hemodialysis for DKD patients, the implementation of humanistic nursing achieved ideal results, effectively reducing patients’ psychological negative emotion markers so that they can actively cooperate with the diagnosis and nursing, facilitate the control of blood glucose and the maintenance of residual renal function, reduce the occurrence of complications, and finally enhance the life quality and nursing satisfaction of patients. It is worthy of being widely popularized and applied.","PeriodicalId":509005,"journal":{"name":"World Journal of Diabetes","volume":"190 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139834746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diabetes is affecting everyone everywhere 糖尿病正在影响世界各地的每一个人
Pub Date : 2024-02-15 DOI: 10.4239/wjd.v15.i2.305
Parul Chawla Gupta, Mona Duggal, A. Morya
The article titled “Accessibility and Utilization of Healthcare Services Among Diabetic Patients: Is Diabetes a Poor Man’s Ailment?” gave insights into a pandemic systemic disease known as diabetes mellitus. This modern-era pandemic affects everyone, regardless of their financial background. As a result, diabetes is not a systemic disease which just involves people of low socioeconomic status.
题为 "糖尿病患者获得和利用医疗服务的情况:糖尿病是穷人的疾病吗?"的文章对糖尿病这一流行性系统疾病进行了深入分析。这种现代流行病影响着每一个人,无论其经济背景如何。因此,糖尿病并不是一种只涉及社会经济地位低下者的系统性疾病。
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引用次数: 0
Elucidating the cardioprotective mechanisms of sodium-glucose cotransporter-2 inhibitors beyond glycemic control 阐明钠-葡萄糖共转运体-2 抑制剂在控制血糖之外的心脏保护机制
Pub Date : 2024-02-15 DOI: 10.4239/wjd.v15.i2.137
Ke-Xin Zhang, Cheng-Xia Kan, Fang Han, Jing-Wen Zhang, Xiao-Dong Sun
Sodium-glucose cotransporter-2 (SGLT2) inhibitors have emerged as a pivotal intervention in diabetes management, offering significant cardiovascular benefits. Empagliflozin, in particular, has demonstrated cardioprotective effects beyond its glucose-lowering action, reducing heart failure hospitalizations and improving cardiac function. Of note, the cardioprotective mechanisms appear to be inde-pendent of glucose lowering, possibly mediated through several mechanisms involving shifts in cardiac metabolism and anti-fibrotic, anti-inflammatory, and anti-oxidative pathways. This editorial summarizes the multifaceted cardiovascular advantages of SGLT2 inhibitors, highlighting the need for further research to elucidate their full therapeutic potential in cardiac care.
钠-葡萄糖共转运体-2(SGLT2)抑制剂已成为糖尿病治疗的关键干预措施,可为心血管带来显著益处。特别是 Empagliflozin,除了降糖作用外,还具有心脏保护作用,可减少心衰住院次数并改善心脏功能。值得注意的是,心脏保护机制似乎与降糖无关,可能是通过涉及心脏代谢转变和抗纤维化、抗炎和抗氧化途径的多种机制介导的。这篇社论总结了 SGLT2 抑制剂在心血管方面的多方面优势,强调了进一步研究的必要性,以阐明其在心脏护理方面的全部治疗潜力。
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引用次数: 0
Serum tumor markers expression (CA199, CA242, and CEA) and its clinical implications in type 2 diabetes mellitus 2 型糖尿病患者血清肿瘤标志物(CA199、CA242 和 CEA)的表达及其临床意义
Pub Date : 2024-02-15 DOI: 10.4239/wjd.v15.i2.232
Mei Meng, Li-Li Shi
BACKGROUND Glucose and lipid metabolic disorder in patients with type 2 diabetes mellitus (T2DM) is associated with the levels of serum tumor markers of the digestive tract, such as cancer antigen (CA)199. Therefore, tumor markers in T2DM are important. AIM To evaluate the expression of serum tumor markers [CA199, CA242, and car-cinoembryonic antigen (CEA)] and the clinical implications of the expression in T2DM. METHODS For this observational study conducted at Hefei BOE Hospital, China, we enrolled 82 patients with first-onset T2DM and 51 controls between April 2019 and December 2020. Levels of fasting blood glucose (FBG), tumor markers (CA199, CEA, and CA242), glycosylated hemoglobin (HbA1c), etc . were measured and group index levels were compared. Moreover, FBG and HbA1c levels were correlated with tumor marker levels. Tumor markers were tested for diagnostic accuracy in patients with > 9% HbA1c using the receiver operating curve (ROC) curve. RESULTS The T2DM group had high serum FBG, HbA1c, CA199, and CEA levels (P < 0.05). A comparative analysis of the two groups based on HbA1c levels (Group A: HbA1c ≤ 9%; Group B: HbA1c > 9%) revealed significant differences in CEA and CA199 levels (P < 0.05). The areas under the ROC curve for CEA and CA199 were 0.853 and 0.809, respectively. CA199, CEA, and CA242 levels positively correlated with HbA1c (r = 0.308, 0.426, and 0.551, respectively) and FBG levels (r = 0.236, 0.231, and 0.298, respectively). CONCLUSION As compared to controls, serum CEA and CA199 levels were higher in patients with T2DM. HbA1c and FBG levels correlated with CA199, CEA, and CA242 levels. Patients with poorly controlled blood sugar must be screened for tumor markers.
背景 2 型糖尿病(T2DM)患者的血糖和血脂代谢紊乱与消化道血清肿瘤标志物(如癌抗原(CA)199)的水平有关。因此,T2DM 中的肿瘤标志物非常重要。目的 评估血清肿瘤标志物[CA199、CA242 和癌胚抗原 (CEA)]的表达及其在 T2DM 中的临床意义。方法 在中国合肥京东方医院进行的这项观察性研究中,我们在 2019 年 4 月至 2020 年 12 月期间招募了 82 例初发 T2DM 患者和 51 例对照组。研究人员测量了空腹血糖(FBG)、肿瘤标志物(CA199、CEA和CA242)、糖化血红蛋白(HbA1c)等指标的水平,并对各组指标水平进行了比较。此外,FBG 和 HbA1c 水平与肿瘤标志物水平相关。利用接收器操作曲线(ROC)检测肿瘤标志物对 HbA1c > 9% 患者的诊断准确性。结果 T2DM 组血清 FBG、HbA1c、CA199 和 CEA 水平较高(P < 0.05)。根据 HbA1c 水平对两组进行比较分析(A 组:HbA1c ≤ 9%;B 组:HbA1c > 9%),发现 CEA 和 CA199 水平存在显著差异(P < 0.05)。CEA和CA199的ROC曲线下面积分别为0.853和0.809。CA199、CEA和CA242水平与HbA1c(r=0.308、0.426和0.551)和FBG水平(r=0.236、0.231和0.298)呈正相关。结论 与对照组相比,T2DM 患者的血清 CEA 和 CA199 水平较高。HbA1c 和 FBG 水平与 CA199、CEA 和 CA242 水平相关。血糖控制不佳的患者必须接受肿瘤标志物筛查。
{"title":"Serum tumor markers expression (CA199, CA242, and CEA) and its clinical implications in type 2 diabetes mellitus","authors":"Mei Meng, Li-Li Shi","doi":"10.4239/wjd.v15.i2.232","DOIUrl":"https://doi.org/10.4239/wjd.v15.i2.232","url":null,"abstract":"BACKGROUND\u0000 Glucose and lipid metabolic disorder in patients with type 2 diabetes mellitus (T2DM) is associated with the levels of serum tumor markers of the digestive tract, such as cancer antigen (CA)199. Therefore, tumor markers in T2DM are important.\u0000 AIM\u0000 To evaluate the expression of serum tumor markers [CA199, CA242, and car-cinoembryonic antigen (CEA)] and the clinical implications of the expression in T2DM.\u0000 METHODS\u0000 For this observational study conducted at Hefei BOE Hospital, China, we enrolled 82 patients with first-onset T2DM and 51 controls between April 2019 and December 2020. Levels of fasting blood glucose (FBG), tumor markers (CA199, CEA, and CA242), glycosylated hemoglobin (HbA1c), etc . were measured and group index levels were compared. Moreover, FBG and HbA1c levels were correlated with tumor marker levels. Tumor markers were tested for diagnostic accuracy in patients with > 9% HbA1c using the receiver operating curve (ROC) curve.\u0000 RESULTS\u0000 The T2DM group had high serum FBG, HbA1c, CA199, and CEA levels (P < 0.05). A comparative analysis of the two groups based on HbA1c levels (Group A: HbA1c ≤ 9%; Group B: HbA1c > 9%) revealed significant differences in CEA and CA199 levels (P < 0.05). The areas under the ROC curve for CEA and CA199 were 0.853 and 0.809, respectively. CA199, CEA, and CA242 levels positively correlated with HbA1c (r = 0.308, 0.426, and 0.551, respectively) and FBG levels (r = 0.236, 0.231, and 0.298, respectively).\u0000 CONCLUSION\u0000 As compared to controls, serum CEA and CA199 levels were higher in patients with T2DM. HbA1c and FBG levels correlated with CA199, CEA, and CA242 levels. Patients with poorly controlled blood sugar must be screened for tumor markers.","PeriodicalId":509005,"journal":{"name":"World Journal of Diabetes","volume":"60 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139775340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Application of non-mydriatic fundus photography-assisted telemedicine in diabetic retinopathy screening 非眼底照相辅助远程医疗在糖尿病视网膜病变筛查中的应用
Pub Date : 2024-02-15 DOI: 10.4239/wjd.v15.i2.251
Wan Zhou, Xiao-Jing Yuan, Jie Li, Wei Wang, Hao-Qiang Zhang, Yuan-Yuan Hu, Shan-Dong Ye
BACKGROUND Early screening and accurate staging of diabetic retinopathy (DR) can reduce blindness risk in type 2 diabetes patients. DR’s complex pathogenesis involves many factors, making ophthalmologist screening alone insufficient for prevention and treatment. Often, endocrinologists are the first to see diabetic patients and thus should screen for retinopathy for early intervention. AIM To explore the efficacy of non-mydriatic fundus photography (NMFP)-enhanced telemedicine in assessing DR and its various stages. METHODS This retrospective study incorporated findings from an analysis of 93 diabetic patients, examining both NMFP-assisted telemedicine and fundus fluorescein angiography (FFA). It focused on assessing the concordance in DR detection between these two methodologies. Additionally, receiver operating characteristic (ROC) curves were generated to determine the optimal sensitivity and specificity of NMFP-assisted telemedicine, using FFA outcomes as the standard benchmark. RESULTS In the context of DR diagnosis and staging, the kappa coefficients for NMFP-assisted telemedicine and FFA were recorded at 0.775 and 0.689 respectively, indicating substantial intermethod agreement. Moreover, the NMFP-assisted telemedicine’s predictive accuracy for positive FFA outcomes, as denoted by the area under the ROC curve, was remarkably high at 0.955, within a confidence interval of 0.914 to 0.995 and a statistically significant P -value of less than 0.001. This predictive model exhibited a specificity of 100%, a sensitivity of 90.9%, and a Youden index of 0.909. CONCLUSION NMFP-assisted telemedicine represents a pragmatic, objective, and precise modality for fundus examination, particularly applicable in the context of endocrinology inpatient care and primary healthcare settings for diabetic patients. Its implementation in these scenarios is of paramount significance, enhancing the clinical accuracy in the diagnosis and therapeutic management of DR. This methodology not only streamlines patient evaluation but also contributes substantially to the optimization of clinical outcomes in DR management.
背景:对糖尿病视网膜病变(DR)进行早期筛查和准确分期可降低 2 型糖尿病患者失明的风险。糖尿病视网膜病变的发病机制复杂,涉及多种因素,因此仅靠眼科医生的筛查不足以预防和治疗糖尿病视网膜病变。通常情况下,内分泌科医生是最早接诊糖尿病患者的医生,因此应筛查视网膜病变,以便及早干预。目的 探讨非眼底照相(NMFP)增强型远程医疗在评估 DR 及其不同阶段的疗效。方法 这项回顾性研究纳入了对 93 名糖尿病患者的分析结果,同时检查了 NMFP 辅助远程医疗和眼底荧光素血管造影 (FFA)。研究重点是评估这两种方法在检测 DR 方面的一致性。此外,还生成了接收器操作特征曲线 (ROC),以 FFA 结果为标准基准,确定 NMFP 辅助远程医疗的最佳灵敏度和特异性。结果 在 DR 诊断和分期方面,NMFP 辅助远程医疗和 FFA 的卡帕系数分别为 0.775 和 0.689,表明方法间的一致性很高。此外,以 ROC 曲线下面积表示的 NMFP 辅助远程医疗对 FFA 阳性结果的预测准确度高达 0.955,置信区间为 0.914 至 0.995,统计学意义上的 P 值小于 0.001。该预测模型的特异性为 100%,灵敏度为 90.9%,尤登指数为 0.909。结论 NMFP 辅助远程医疗是一种实用、客观、精确的眼底检查方式,尤其适用于内分泌科住院病人护理和糖尿病患者的初级医疗保健环境。在这些情况下使用该方法具有重要意义,可提高糖尿病诊断和治疗管理的临床准确性。这种方法不仅能简化患者评估,还能大大有助于优化 DR 管理的临床效果。
{"title":"Application of non-mydriatic fundus photography-assisted telemedicine in diabetic retinopathy screening","authors":"Wan Zhou, Xiao-Jing Yuan, Jie Li, Wei Wang, Hao-Qiang Zhang, Yuan-Yuan Hu, Shan-Dong Ye","doi":"10.4239/wjd.v15.i2.251","DOIUrl":"https://doi.org/10.4239/wjd.v15.i2.251","url":null,"abstract":"BACKGROUND\u0000 Early screening and accurate staging of diabetic retinopathy (DR) can reduce blindness risk in type 2 diabetes patients. DR’s complex pathogenesis involves many factors, making ophthalmologist screening alone insufficient for prevention and treatment. Often, endocrinologists are the first to see diabetic patients and thus should screen for retinopathy for early intervention.\u0000 AIM\u0000 To explore the efficacy of non-mydriatic fundus photography (NMFP)-enhanced telemedicine in assessing DR and its various stages.\u0000 METHODS\u0000 This retrospective study incorporated findings from an analysis of 93 diabetic patients, examining both NMFP-assisted telemedicine and fundus fluorescein angiography (FFA). It focused on assessing the concordance in DR detection between these two methodologies. Additionally, receiver operating characteristic (ROC) curves were generated to determine the optimal sensitivity and specificity of NMFP-assisted telemedicine, using FFA outcomes as the standard benchmark.\u0000 RESULTS\u0000 In the context of DR diagnosis and staging, the kappa coefficients for NMFP-assisted telemedicine and FFA were recorded at 0.775 and 0.689 respectively, indicating substantial intermethod agreement. Moreover, the NMFP-assisted telemedicine’s predictive accuracy for positive FFA outcomes, as denoted by the area under the ROC curve, was remarkably high at 0.955, within a confidence interval of 0.914 to 0.995 and a statistically significant P -value of less than 0.001. This predictive model exhibited a specificity of 100%, a sensitivity of 90.9%, and a Youden index of 0.909.\u0000 CONCLUSION\u0000 NMFP-assisted telemedicine represents a pragmatic, objective, and precise modality for fundus examination, particularly applicable in the context of endocrinology inpatient care and primary healthcare settings for diabetic patients. Its implementation in these scenarios is of paramount significance, enhancing the clinical accuracy in the diagnosis and therapeutic management of DR. This methodology not only streamlines patient evaluation but also contributes substantially to the optimization of clinical outcomes in DR management.","PeriodicalId":509005,"journal":{"name":"World Journal of Diabetes","volume":"427 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139834387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
World Journal of Diabetes
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