早期预警评分在ICU护理工作中的应用

目的 观察早期预警评分在ICU护理工作中的作用及效果。方法 选择2018年6月~2019年6月在我院ICU治疗的患者144例,采用随机数字表法分为对照组和观察组,各72例。对照组采用常规护理,观察组应用早期预警评分进行护理,比较两组意外事件发生率、并发症发生率、平均ICU留住时间、护理满意度。结果 观察组意外事件发生率为6.94%,低于对照组的18.05%,并发症发生率为8.33%,低于对照组的23.61%,差异均有统计学意义（P＜0.05）;观察组ICU留住时间为（7.13±2.16）d,短于对照组的（11.01±2.98）d,差异有统计学意义（P＜0.05）;观察组护理满意度为98.61%,高于对照组的81.94%,差异有统计学意义（P＜0.05）。结论 早期预警评分在ICU护理中具有重要的作用,可降低意外事件和并发症发生率,缩短ICU入住时间,提高临床护理满意度,具有良好的临床应用效果。     

扣分法综合评价甲襞微循环

在甲襞微循环加权积分法和上海简易标准基础上，提出了扣分法评价标准，新标准增加了新观察项目及其变化程度分级，建立了各项指标扣分标准，以百分制扣分计算法代替积分计算法，并介绍一些指标的判别方法和甲襞微循环变化特征。用三种方法对１２０例诊断结果进行ＫＡＰＰＡ分析有一致性     

Testicular Biopsy Score Count After Vasectomy in Albino Rats

Context: One of the challenging problems faced by the entire world is population explosion. The vasectomy is simple, safe, quick and effective vital method of male sterilization. In the recent years a large number of vasectomies have been performed in India, since the inception of National Family Planning Program in 1956. Thus the number of request for the restoration of fertility is also increased. Aim: The present study was carried out to know whether the testicular biopsy score count, indicating the process of spermatogenesis remains normal after vasectomy. Material & Methods: The testicular biopsy count of testes of 50 male albino rats was studied one, two, three and four months after vasectomy, in 10 male albino rats of each case and 10 male albino rats served as control. Result: After vasectomy seminiferous tubules are cut in various planes covered externally by connective tissue stroma with normal microscopic picture. The spermatogonia, spermatocytes, spermatids, Sertoli cells and spermatozoa show normal structure with normal size blood vessels in interstitial connective tissue, in vasectomised and control rats. In some seminiferous tubules granular cytoplasmic vesicle like structures are seen filling the lumen and spermatids in metamorphosis phase to spermatozoa. Many round or elongated heads of spermatozoa are present at apical portion of Sertoli cells. The control rats as well as vasectomised rats at four after vasectomy have shown the testicular biopsy score count of nine (9) and ten (10) on TBSC of Johenson. Conclusion: On critical analysis it is concluded that the testicular biopsy score count remains normal at four months after vasectomy.     

Mainz急诊评分在急诊护理的应用

目的探讨Mainz急诊评分系统在急诊护理中的应用。方法按照Mainz急诊评分要求设计调查表格,由急诊科首次接诊护士和各接诊医生在患者就诊时对各项参数进行测量记录,并根据评分分为四个分数段：1-5分,6-15分,16-25分,25-28分。根据评分制定相应级别的护理计划,并追踪各分数段患者的去向和预后,加以比较。结果 25-28分17例,瞩其回家观察;16-25分109例,在急诊留观治疗2-24h后离院,给予一般护理;6-15分154例,予以一级护理,38例入ICU,116例收住专科病房（HDU）;1-5分患者72例,予以特级护理,收入我院ICU。结论 Mainz急诊评分能较好的预判急诊患者的病情危重和病死危险性,根据评分对患者施行相应的分流转诊和制定护理方案可提高急诊科护士的工作效率,减少工作量。     

The Power and Robustness of Maximum LOD Score Statistics

The maximum LOD score statistic is extremely powerful for gene mapping when calculated using the correct genetic parameter value. When the mode of genetic transmission is unknown, the maximum of the LOD scores obtained using several genetic parameter values is reported. This latter statistic requires higher critical value than the maximum LOD score statistic calculated from a single genetic parameter value.
In this paper, we compare the power of maximum LOD scores based on three fixed sets of genetic parameter values with the power of the LOD score obtained after maximizing over the entire range of genetic parameter values. We simulate family data under nine generating models. For generating models with non-zero phenocopy rates, LOD scores maximized over the entire range of genetic parameters yielded greater power than maximum LOD scores for fixed sets of parameter values with zero phenocopy rates. No maximum LOD score was consistently more powerful than the others for generating models with a zero phenocopy rate. The power loss of the LOD score maximized over the entire range of genetic parameters, relative to the maximum LOD score calculated using the correct genetic parameter value, appeared to be robust to the generating models.     

创伤TI评分在急诊室创伤急救中的价值

目的 探讨TI(创伤指数)评分在急诊室伤员快速救治中的价值.方法 对1989例伤员实施救治的同时,进行出、入急诊室的创伤TI评分.结果 入急诊室TI＜10分占34.99%,10分≤TI≤16分占29.11%,17分≤TI≤20分占20.92%,TI≥21分占14.98%;出急诊室TI＜10分占46.36%,10分≤TI≤16分占24.00%,17分≤TI≤20分占17.74%,TI≥21分占11.90%;随着TI分值增大,伤情加重、并发症多、死亡率上升.结论 急诊室首诊医生用创伤TI评分快速、较准确评估伤情,指导创伤抢救,合理分流伤员,提高创伤急救效率.     

Predicting Mortality of Korean Geriatric Trauma Patients: A Comparison between Geriatric Trauma Outcome Score and Trauma and Injury Severity Score

PurposeThe Geriatric Trauma Outcome Score (GTOS) is a new prognostic tool used to predict mortality of geriatric trauma patients. We aimed to apply this model to Korean geriatric trauma patients and compare it with the Trauma and Injury Severity Score (TRISS) method.Materials and MethodsPatients aged ≥65 years who were admitted to a level 1 trauma center from 2014 to 2018 were included in this study. Data on age, Injury Severity Score (ISS), packed red blood cell transfusion within 24 h, TRISS, admission disposition, mortality, and discharge disposition were collected. We analyzed the validity of GTOS and TRISS by comparing the area under the survival curve. Subgroup analysis for age, admission disposition, and ISS was performed.ResultsAmong 2586 participants, the median age was 75 years (interquartile range: 70–81). The median ISS was 9 (interquartile range: 4–12), with a transfusion rate (within 24 h) of 15.9% and mortality rate of 6.1%. The areas under the curve (AUCs) were 0.832 [95% confidence interval (CI), 0.817–0.846] and 0.800 (95% CI, 0.784–0.815) for GTOS and TRISS, respectively. On subgroup analysis, patients with ISS ≥9 showed a higher AUC of GTOS compared to the AUC of TRISS (p<0.05). Other subgroup analyses showed equally good power of discrimination for mortality.ConclusionGTOS can be used to predict mortality of severely injured Korean geriatric patients, and also be helpful in deciding whether invasive or aggressive treatments should be administered to them.     

大学生体育成绩差异与心理健康状况调查

目的了解体育成绩存在差异的大学生心理健康状况,对体育成绩较差的大学生存在的心理健康问题,有针对性地提出改善的方法和建议。方法通过对本学院不同专业的152名大学生,进行症状自评量表（SCL-90）调查,检测出体育成绩有差异的大学生心理健康水平的不同。结果体育成绩较好的大学生心理问题检出率明显低于体育成绩较差的大学生。经2χ检验,其差异具有统计学意义（P〈0.05）。体育成绩较好的大学生在SCL-90各因子检测中,各项因子的得分均明显低于体育成绩较差者。其中躯体化、强迫症、人际关系、抑郁、焦虑、恐怖、偏执症状,经t检验,差异有统计学意义（P均〈0.01）。结论体育成绩的优劣与大学生的心理健康水平有一定的相关,体育成绩较差的大学生心理健康状况存在一定问题。     

延期或过期妊娠宫颈低评分者普贝生引产探讨

目的探讨延期或过期妊娠宫颈低Bishop评分者应用普贝生引产的临床应用方法。方法分析我院45例延期或过期妊娠宫颈低Bishop评分者使用普贝生引产的促宫颈成熟有效率、辅助方法、引产成功率、剖宫产率及对新生儿的影响,并与现有文献作对比。结果延期或过期妊娠宫颈低Bishop评分者宫颈条件差,与现有文献相比,其使用普贝生引产时促宫颈成熟有效率、引产成功率、剖宫产率及对新生儿的影响无明显差异。结论延期或过期妊娠宫颈低Bishop评分者普贝生引产有效率,如果应用得法,是这类孕妇促宫颈成熟的理想药物。     

认知评价对军队医院护士工作压力反应的影响

目的 探讨认知评价对护士工作压力反应的影响.方法 以377名护士为调查对象,采用功能失调性态度问卷、工作压力反应量表和护士工作压力源量表进行调查分析.结果 ①认知评价与压力反应评分呈正相关(r=0.244);②不同认知歪曲水平的护士其压力反应得分有显著性差异(F=12.710,P＜0.001);③认知评价与压力源的压力反应得分存在交互效应.结论 减少对工作压力源的不良认知成分,可有效改善压力反应.     

超声半定量评分在小儿肌性斜颈诊治中的应用

评价超声对先天肌性斜颈半定量分级评分诊断的价值。对SCM依据声像图特征进行分型及半定量分级评分。（1）Ⅰ型弥漫型4例;Ⅱ型结节型7例;Ⅲ型瘤样团块型27例。（2）三型在SCM粗细及血流方面存在显著差异。（3）随访观察,血流信号评分显著下降。超声对先天肌性斜颈分型诊断并半定量分级评分诊断,有利于临床有针对性设计治疗方案及客观评价疗效。     

基于VAS评分改进的护理模式对糖尿病足患者的影响

目的 探讨视觉模拟评分在糖尿病足患者护理中的应用效果。方法 选取2016年1月~2017年3月对84例糖尿病足患者进行常规护理的同时采用VAS量表进行疼痛评分,根据评分结果给予及时有效的护理,观察患者护理干预前后疼痛程度、血糖达标率以及满意度情况。结果 干预后患者疼痛症状1~3分者占64.29%,4~6分者占29.76%,7~9分者占5.95%,无疼痛症状10分者,疼痛程度较干预前减轻,差异具有统计学意义（P＜0.05）。干预后血糖达标率和满意度分别为85.71%和94.27%,均高于干预前的8.33%和65.12%,差异具有统计学意义（P＜0.05）。结论 采用VAS评分改进的护理模式,可以有效改善糖尿病足患者的疼痛症状,控制血糖水平,提高其生活质量。     

Validation of the Revised Pretransplant Assessment of Mortality Score in Patients with Acute Myelogenous Leukemia Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

Despite recent advances, allogeneic hematopoietic stem cell transplantation (allo-HSCT) continues to be accompanied by a high rate of morbidity and mortality. Several scores have been developed to predict outcome after allo-HSCT. The recently revised Pretransplant Assessment of Mortality (PAM) score is based on patient age, donor type, disease risk, cytomegalovirus (CMV) serostatus of patient and donor, and forced expiratory volume in 1 second (FEV₁). The aim of this study was to analyze the predictive power of the PAM score in an independent large cohort of patients with acute myelogenous leukemia (AML). We selected adult patients with AML who underwent a first allo-HSCT at the University Hospital of Dresden, a tertiary care hospital with a large transplantation program. All adult patients treated between January 1, 2003, and July 1, 2015, were included. The PAM score was calculated as described previously. Overall survival (OS), cumulative incidence of relapse (CIR), and nonrelapse mortality (NRM) after allo-HSCT were analyzed. Age, AML type, sex match, CMV match, donor type, European Leukemia Net risk classification, type of conditioning, disease stage, and PAM score as a continuous variable were selected a priori for multivariate Cox regression analyses. A total of 544 patients met the inclusion criteria. The median patient age was 57 years. With a median follow-up of 47 months (range, 1 to 161 months), the estimated OS for the whole cohort at 4 years was 43%, with a CIR of 30% and an NRM of 31%. The probability of OS at 4 years was 65% for patients with a PAM score of 0, 52% in those with a PAM score of 1, 33% in those with a PAM score of 2, and 22% in those with a PAM score of 3 (P?<?.001, log-rank test). Both the CIR and NRM increased with higher PAM scores (P?=?.005 and P?<?.001, respectively, Gray test). In multivariate analysis, age (hazard ratio [HR], 1.02 per year; P?=?.004), disease stage (primary induction failure versus first complete remission (CR1); HR, 1.5; P?=?.03), and the PAM score (HR 1.04; P?=?.03) had a significant impact on OS. This is the first independent validation of the revised PAM score allowing for simple and valid estimation of transplantation outcomes. It can serve as an important tool in counseling patients with AML, as well as in designing future trials.     

Forgotten Joint Score: Comparison between total and unicondylar knee arthroplasty

BackgroundThe aim of this study is to assess the Forgotten Joint Score (FJS) for total knee arthroplasty (TKA) and unicondylar knee arthroplasty (UKA) with both short- and long-term follow-up.MethodsFor a consecutive period of eight months, the FJS was sent to all patients who had undergone either a primary TKA or UKA either one, five or ten years previously at our institution. Patient demographics and operative details were recorded retrospectively. FJS were collected for three different TKA prosthesis and two different UKA prosthesis.ResultsA total of 588 FJS questionnaires were completed consisting of 482 TKA and 106 UKA procedures.The mean FJS for patients with TKA and UKA were 50.2 and 65.4 respectively (p < 0.001). Mean FJS for the ZUK were statistically superior to the Oxford UKA, 73.1 versus 60.1 (p = 0.020). For TKA mean FJS were statistically better at five compared to one year follow up, 53.8 versus 44.8 (p = 0.007). For UKA the mean FJJs were greatest at 10 year follow up (69.0), but the difference between scores at one (60.4) and five (68.4) years was not statistically significant (p = 0.243).ConclusionThis cross-sectional study has shown; superior FJSs for UKA compared to TKA and superior FJSs for a fixed bearing compared to a mobile bearing UKA and therefore supports the use of UKA opposed to TKA where the indications for UKA are satisfied. For TKA the FJS in the five-year post-operative group were significantly superior to those in the one-year post-operative group.     

浅谈“甲襞微循环加权积分法”

作者观测了2763例不同病种不同病期患者的甲襞微循环,对于1984年闻世的“甲襞微循环加权积分法”给予高度的评价。同时指出,这种检查方法需要在临床实践中加以充实和提高。作者认为,“管襻脱落”的发生机理和临床意义不同于“管襻出血”,应该把“管襻脱落”作为一项独立的观测指标。汗腺导管的出现率差别很大,应重视其临床意义,增加其权值。甲襞微循环形态,流态及襻周状态部分指标的分值宜作适当的补充和修订。为了把对病人甲襞微循环连续观测的结果更形象更直观地表示出来,作者提出了b=2a-X的校正公式。     

单胎足月新生儿神经行为NBNA评分相关影响因素研究

目的 分析单胎足月新生儿的行为神经能力,并研究影响单胎足月新生儿神经行为能力的相关因素。方法 选取2017年1月1日~6月30日在德阳第五医院分娩并采用NBNA量表进行神经行为评分的单胎足月新生儿80例,结合NBNA量表评分结果分析所选新生儿神经行为能力,并结合新生儿出生基本资料分析影响单胎足月新生儿神经行为能力的相关因素。结果 本次研究所选80例新生儿平均NBNA评分为（36.11±1.05）分,神经行为正常和异常的概率分别为90.00%、10.00%;单因素分析中,新生儿体重、胎先露部位成为影响NBNA评分的因素;多因素分析中,新生儿体重、产妇年龄、分娩方式、胎儿先露方位、高危儿成为影响NBNA评分的因素。结论 影响单胎足月新生儿神经行为评分的因素涉及新生儿体重、新生儿先露方位、新生儿分娩方式、产妇年龄、高危儿等,通过产前合理干预,可以降低微脑损伤新生儿,提高新生儿NBNA评分。     

Guy's结石评分和改良Clavien分级方法预测PCNL术后结石清除率和并发症的研究

目的 探讨Guy's结石评分（GS）预测经皮肾镜碎石取石术（PCNL）术后结石清除率及利用改良Clavien分级方法（MCC）预测PCNL术后并发症发生的可靠性。方法 选取2015年1月~2016年12月我院收治的155例行PCNL的肾结石患者（160个肾单位）,所有患者根据术前泌尿系CT结果应用GS进行肾结石分组,利用术后KUB结果评估患者术后结石清除率,并且通过MCC预测患者术后并发症的发生。结果 160个行PCNL的肾单位中,GS1、GS2、GS3及GS4分别为15、63、73和9个。每个组的结石最大直径:GS1=25 mm,GS2=28 mm,GS3=48 mm,GS4=69 mm,差异具有统计学意义（P＜0.05）。根据GS进行数据分析,四组手术时间［GS1=（32.50±14.10）min,GS2=（55.80±29.70）min,GS3=（80.80±35.10）min,GS4=（116.30±54.80）min］,通道数［GS1=1个,GS2=（1.10±0.30）个,GS3=（1.20±0.50）个,GS4=（2.00±1.30）个］,结石立即清除率（GS1=100.00%,GS2=87.30%,GS3=67.10%,GS4=66.70%）,患者术后并发症（GS1=6.70%,GS2=28.60%,GS3=31.50%,GS4=44.40%）比较,组间差异有统计学意义（P＜0.05）。首次PCNL失败的患者,无论最终再次PCNL成功与否,患者的结石最终清除率比较,差异无统计学意义（P＞0.05）。结论 GS和MCC可精确评估患者经皮肾镜术后结石清除率及有效预测患者术后并发症的发生。     

Prognosis Prediction for Colorectal Cancer Patients: A Risk Score Based on The Metabolic-Related Genes

Risk assessment has high prognostic value in patients with colorectal cancer (CRC), and the use of proper models is an effective approach frequently used to evaluate cancer progression for further treatment plans. Alterations in metabolism are confirmed to be a significant feature of tumor cells and have been an intense focus in disease research. Here, we mined the genes that were differentially expressed in CRC tissues compared to paired normal samples from a public database and then constructed a novel assessment system for the prognosis of patients based on the value of a risk score considering the expression status of metabolism-related genes after screening. The score successfully stratified patients by risk and was externally verified in our study. Moreover, we built a nomogram combining the score and clinical parameters to predict patient survival using a visual method. The results suggested that the risk score was well fit and could provide assistance for the individual treatment of CRC patients in the clinic.