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Background@#The influencing factors of diabetic kidney disease (DKD) in Chinese patients with type 2 diabetes mellitus (T2DM) were explored to develop and validate a DKD diagnostic tool based on nomogram approach for patients with T2DM. @*Methods@#A total of 2,163 in-hospital patients with diabetes diagnosed from March 2015 to March 2017 were enrolled. Specified logistic regression models were used to screen the factors and establish four different diagnostic tools based on nomogram according to the final included variables. Discrimination and calibration were used to assess the performance of screening tools. @*Results@#Among the 2,163 participants with diabetes (1,227 men and 949 women), 313 patients (194 men and 120 women) were diagnosed with DKD. Four different screening equations (full model, laboratory-based model 1 [LBM1], laboratory-based model 2 [LBM2], and simplified model) showed good discriminations and calibrations. The C-indexes were 0.8450 (95% confidence interval [CI], 0.8202 to 0.8690) for full model, 0.8149 (95% CI, 0.7892 to 0.8405) for LBM1, 0.8171 (95% CI, 0.7912 to 0.8430) for LBM2, and 0.8083 (95% CI, 0.7824 to 0.8342) for simplified model. According to Hosmer-Lemeshow goodness-of-fit test, good agreement between the predicted and observed DKD events in patients with diabetes was observed for full model (χ2=3.2756, P=0.9159), LBM1 (χ2=7.749, P=0.4584), LBM2 (χ2=10.023, P=0.2634), and simplified model (χ2=12.294, P=0.1387). @*Conclusion@#LBM1, LBM2, and simplified model exhibited excellent predictive performance and availability and could be recommended for screening DKD cases among Chinese patients with diabetes.
ABSTRACT
Background@#The influencing factors of diabetic kidney disease (DKD) in Chinese patients with type 2 diabetes mellitus (T2DM) were explored to develop and validate a DKD diagnostic tool based on nomogram approach for patients with T2DM. @*Methods@#A total of 2,163 in-hospital patients with diabetes diagnosed from March 2015 to March 2017 were enrolled. Specified logistic regression models were used to screen the factors and establish four different diagnostic tools based on nomogram according to the final included variables. Discrimination and calibration were used to assess the performance of screening tools. @*Results@#Among the 2,163 participants with diabetes (1,227 men and 949 women), 313 patients (194 men and 120 women) were diagnosed with DKD. Four different screening equations (full model, laboratory-based model 1 [LBM1], laboratory-based model 2 [LBM2], and simplified model) showed good discriminations and calibrations. The C-indexes were 0.8450 (95% confidence interval [CI], 0.8202 to 0.8690) for full model, 0.8149 (95% CI, 0.7892 to 0.8405) for LBM1, 0.8171 (95% CI, 0.7912 to 0.8430) for LBM2, and 0.8083 (95% CI, 0.7824 to 0.8342) for simplified model. According to Hosmer-Lemeshow goodness-of-fit test, good agreement between the predicted and observed DKD events in patients with diabetes was observed for full model (χ2=3.2756, P=0.9159), LBM1 (χ2=7.749, P=0.4584), LBM2 (χ2=10.023, P=0.2634), and simplified model (χ2=12.294, P=0.1387). @*Conclusion@#LBM1, LBM2, and simplified model exhibited excellent predictive performance and availability and could be recommended for screening DKD cases among Chinese patients with diabetes.
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Objective To discuss nursing ways to prevent frontal pressure sores for children after cochlear implantation.Methods A total of 267 cases with sensorineural deafness were selected and divided into the control group (admitted from December 2012 to July 2013,115 cases) and the observation group (admitted from August 2013 to March 2014,152 cases) randomly.Skin preparation was done routinely,general nutritional condition and frontal skin condition were evaluated before operation.The control group used conventional elastic bandage after surgery.The observation group used Allevyn Thin foam dressing to cover the forehead skin before pressure dressing by elastic bandage.The incidence of frontal pressure sores was compared between two groups.Results Two cases occurred frontal pressure sores in the observation group and 31 cases in the control group,x2=39.736,P ＜ 0.01.Patients in the control group with pressure sore focused within 1-2 years old,totally 18 cases.Conclusions Nurses should attach great importance to younger children with cochlear implantation to prevent pressure sores.Nursing staff should keep update knowledge of prevention and treatment of pres-sure ulcers,accurately assess skin conditions and risk factors in patients and adopt precautions predictably.
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Objective To evaluate the effect of nasointestinal tube in patients receiving mechanical ventilation.Methods Patients receiving mechanical ventilation were randomLy divided into two groups.The two groups were isocaloric and isonitrogen.The study group used nasointestinal tube feeding.The control group used nasogastric tube feeding.Nutrition status,ventilator days,aspiration incidence and pneumonia incidence were measured.Results 178 patients receiving me- chanical ventilation were divided into two groups.The study group showed reduction in aspiration incidence and pneumoni- a incidence.Other measurements showed no significant difference.Conclusion Nasointestinal tube feeding could reduce aspiration and pneumonia incidence in patients receiving mechanical ventilation.