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     

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。     

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。     

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。     

Validation of Biomarker-Based ABCD Score in Atrial Fibrillation Patients with a Non-Gender CHA2DS2-VASc Score 0–1: A Korean Multi-Center Cohort

PurposeAtrial fibrillation (AF) patients with low to intermediate risk, defined as non-gender CHA₂DS₂-VASc score of 0–1, are still at risk of stroke. This study verified the usefulness of ABCD score [age (≥60 years), B-type natriuretic peptide (BNP) or N-terminal pro-BNP (≥300 pg/mL), creatinine clearance (<50 mL/min/1.73 m²), and dimension of the left atrium (≥45 mm)] for stroke risk stratification in non-gender CHA₂DS₂-VASc score 0–1.Materials and MethodsThis multi-center cohort study retrospectively analyzed AF patients with non-gender CHA₂DS₂-VASc score 0–1. The primary endpoint was the incidence of stroke with or without antithrombotic therapy (ATT). An ABCD score was validated.ResultsOverall, 2694 patients [56.3±9.5 years; female, 726 (26.9%)] were followed-up for 4.0±2.8 years. The overall stroke rate was 0.84/100 person-years (P-Y), stratified as follows: 0.46/100 P-Y for an ABCD score of 0; 1.02/100 P-Y for an ABCD score ≥1. The ABCD score was superior to non-gender CHA₂DS₂-VASc score in the stroke risk stratification (C-index=0.618, p=0.015; net reclassification improvement=0.576, p=0.040; integrated differential improvement=0.033, p=0.066). ATT was prescribed in 2353 patients (86.5%), and the stroke rate was significantly lower in patients receiving non-vitamin K antagonist oral anticoagulant (NOAC) therapy and an ABCD score ≥1 than in those without ATT (0.44/100 P–Y vs. 1.55/100 P-Y; hazard ratio=0.26, 95% confidence interval 0.11–0.63, p=0.003).ConclusionThe biomarker-based ABCD score demonstrated improved stroke risk stratification in AF patients with non-gender CHA₂DS₂-VASc score 0–1. Furthermore, NOAC with an ABCD score ≥1 was associated with significantly lower stroke rate in AF patients with non-gender CHA₂DS₂-VASc score 0–1.     

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.     

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.     

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.     

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.     

Author's Response to Diaphragm Evaluation and Lung Ultrasound Score during Weaning

How to cite this article: Amara V, Chaudhuri S. Author''s Response to Diaphragm Evaluation and Lung Ultrasound Score during Weaning. Indian J Crit Care Med 2022;26(9):1056–1057.     

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。     

老年烧伤患者康复期抑郁评分与血清BDNF、MIF、NPY的相关性分析

目的 研究烧伤后康复期老年患者抑郁评分与血清脑源性神经营养因子(brain derived neurotrophic factors,BDNF)、巨噬细胞移动抑制因子(macrophage migration inhibitory factor,MIF)、神经肽(neuropeptide Y,NPY)的关系.方法 选取2015年2月至2016年8月我院收治的56例烧伤康复期老年患者为观察组,另选同期56例健康体检老年人为对照组.对比两组血清BDNF、MIF、NPY水平,并分析其与抑郁程度的相关性.结果 观察组血清BDNF水平显著低于对照组,而MIF、NPY水平均显著高于对照组;随着抑郁程度的逐渐加重,患者血清中BDNF水平逐渐降低,而MIF、NPY水平逐渐升高.经由相关性分析,患者抑郁评分与血清BDNF呈显著负相关(R=-0.452,P=0.004),而与MIF、NPY均呈显著正相关(R=0.563,P=0.000;R=0.587,P=0.000).结论 烧伤后康复期老年患者抑郁评分与血清BDNF呈显著负相关,与MIF、NPY呈显著正相关,上述三项血清指标可作为诊断及判断患者抑郁程度的参考指标.