论著

基于Caprini量表评估的干预模式联合充气加压泵预防慢性阻塞性肺疾病急性加重期患者静脉血栓的效果

Effect of intervention mode based on Caprini score combined with inflatable pump in preventing VTE in patients with AECOPD

:507-512
 
      目的 观察慢性阻塞性肺疾病急性加重期(AECOPD)患者应用基于Caprini量表评估的干预模式联合充气加压泵(IPC)预防静脉血栓(VTE)的效果。方法 选取河南省人民医院在2023年11月—2024年11月收入的82例AECOPD患者作为研究对象,经随机数表法分为对照组41例予以VTE常规干预,观察组41例在对照组的基础上接受基于Caprini量表评估的干预模式联合IPC预防。比较两组AECOPD患者肢体情况及深静脉血栓(VTE)发生情况、凝血指标及股静脉血流速度。结果 观察组肢体肿胀率、肢体疼痛率及VTE发生率均低于对照组(P<0.05)。干预前,两组AECOPD患者凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体水平比较差异无统计学意义(P>0.05);干预后,两组患者TT、PT、APTT、D-二聚体水平均降低,观察组较低(P<0.05)。干预前,两组AECOPD患者平均流速、血流峰速及阻力指数比较差异无统计学意义(P>0.05);干预后,两组患者平均流速、血流峰速均升高,观察组高于对照组(P<0.05);阻力指数均降低,观察组低于对照组(P<0.05)。结论 AECOPD患者应用基于Caprini量表评估的干预模式联合IPC能有效降低肢体肿胀率、肢体疼痛率及VTE发生率,改善凝血指标与股静脉血流速。
   Objective To observe the effect of a Caprini score?based intervention model combined with intermittent pneumatic compression(IPC)in preventing venous thromboembolism(VTE)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 82 AECOPD patients admitted to Henan Provincial People’s Hospital from November 2023 to November 2024 were selected as subjects and randomly divided into a control group(41 cases)and an observation group(41 cases)using a random number table.The control group received routine VTE prevention,while the observation group received the Caprini score?based intervention combined with IPC in addition to the routine care.The extremity conditions,occurrence of VTE,coagulation parameters,and femoral venous blood flow velocity were compared between the two groups.Results The rates of extremity swelling,extremity pain,and VTE incidence in the observation group were lower than those in the control group(P<0.05).Before the intervention,there were no statistically significant differences in thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),or D?dimer levels between the two groups(P>0.05).After the intervention,TT,PT,APTT,and D?dimer levels decreased in both groups,with lower values in the observation group(P<0.05).Before the intervention,there were no statistically significant differences in mean flow velocity,peak flow velocity,or resistance index between the two groups(P>0.05).After the intervention,mean flow velocity and peak flow velocity increased in both groups,with higher values in the observation group(P<0.05),while the resistance index decreased,with a lower value in the observation group(P<0.05).Conclusions The application of a Caprini score?based intervention model combined with IPC in AECOPD patients can effectively reduce the rates of extremity swelling,extremity pain,and VTE incidence,and improve  coagulation parameters and femoral venous blood flow velocity.

衰弱综合征的中医量表编制及信效度检验

Development and Validity and Reliability Testing of a Traditional Chinese Medicine Scale for Debility Syndrome

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目的 编制适用于老年人群的衰弱综合征中医评估量表并检验其信度与效度。方法 通过文献研究及《中华医典》检索构建条目池,采用4轮德尔菲专家咨询及预调查筛选条目形成初量表;便利抽取300例老年患者行横断面调查,以Fried表型衰弱量表为校标,进行项目分析、Cronbach’s α系数、探索性因子分析及ROC曲线分析。 结果 经条目筛选最终形成含5个核心症状条目(表A)及38个证候条目(表B)的量表。表A校标关联效度r=0.929(P<0.05),AUC=0.957,灵敏度0.949,特异度0.859;表A+B校标关联效度r=0.648(P<0.05),AUC=0.827,灵敏度0.606,特异度0.911;总量表Cronbach's α=0.872。结论 所研制的衰弱综合征中医量表信效度良好,可用于老年人衰弱状态筛查及中医证型判别。
Objective: To develop a Traditional Chinese Medicine (TCM) assessment scale for frailty syndrome in the elderly and to evaluate its reliability and validity. Methods: An item pool was constructed through literature review and searches of the *Chinese Medical Canon*. A preliminary scale was developed through four rounds of Delphi expert consultation and a pilot survey. A cross-sectional survey was conducted using a convenience sample of 300 elderly patients. Using the Fried Phenotypic Frailty Scale as the gold standard, item analysis, Cronbach’s α coefficient, exploratory factor analysis, and ROC curve analysis were performed. Results: After item screening, the final scale comprised 5 core symptom items (Table A) and 38 syndrome items (Table B). For Table A, the criterion-related validity was r = 0.929 (P < 0.05), AUC = 0.957, sensitivity = 0.949, and specificity = 0.859; Table A+B showed a test-retest reliability of r = 0.648 (P < 0.05), an AUC of 0.827, a sensitivity of 0.606, and a specificity of 0.911; the total scale had a Cronbach’s α of 0.872. Conclusion: The developed Traditional Chinese Medicine (TCM) frailty syndrome scale demonstrates good reliability and validity and can be used for screening frailty in the elderly and for distinguishing TCM syndrome patterns.

改良后本科生临床医学课堂教学评价量表的应用研究

Applied Research on the Revised Classroom Teaching Evaluation Scale for Undergraduate Clinical Medical Education

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目的 探讨改良后本科生临床医学课堂教学评价量表在时效性、有效性和易用性方面的变化。方法 2018年9月-2019年9月选取四川大学华西医院2017级临床医学和口腔医学五年制本科生共30名,以及3名授课教师作为研究对象,将既往版、现行版以及改良版教学质量评价量表应用课堂,并采用问卷调查方法对其进行分析评估。评估经改良后的教学质量评价表在及时性、有效性和易用性方面的变化差异。结果 共计向研究对象发放99份教学质量评价量表和33份调查问卷,回收率为100%。针对授课教师能及时获取教学质量反馈,教师认为课后评教工具的最佳评价时机为课后当天晚上12点前(33.3%)或课后24小时内(66.7%),高于课后立即评价(0%)和期末评价(0%)。对三个版本教学评价表问卷调查结果显示,改良版教学评价量表的时效性、有效性和易用性为优的比例分别为86.67%,60%和76.67%,均高于现行版的43.33%,60%和46.67%,同时均高于既往版的23.33%,23.33%和36.67%,差异有统计学意义(P<0.05)。结论 改良后的本科生临床医学课堂教学评价量表在时效性、有效性和易用性方面均得以显著提高。通过不断优化量表设计和评价指标,可以提高教学质量评价的科学性和准确性。
Objective: To investigate the changes in timeliness, validity, and usability of the modified classroom teaching evaluation scale for undergraduate clinical medical education. Methods: From September 2018 to September 2019, a cohort comprising 30 fifth-year undergraduate students majoring in clinical medicine and stomatology from West China Hospital, Sichuan University, along with three faculty instructors, was enrolled. Three versions of teaching evaluation scales (historical, current, and modified) were implemented in classroom settings, followed by questionnaire-based comparative analyses. The revised scale was systematically assessed for improvements in feedback timeliness, measurement validity, and operational usability. Results: A total of 99 evaluation forms and 33 questionnaires were distributed, with a 100% response rate. Regarding timely feedback acquisition, faculty preferred receiving evaluations by midnight on the teaching day (33.3%) or within 24 hours post-class (66.7%), outperforming immediate
论著

癌症患者生命质量测定量表体系之肾癌量表(QLICP-RE V2.0)的条目筛选

Items selection on the Specific Module of Quality of Life Instruments for patients with renal cancer(QLICP-REV2.0)

:77-81
 
目的 开发适合中国肾癌患者的生命质量测定量表的特异模块。方法 采用议题小组和核心小组的程序化决策方式,提出条目池,形成初步量表,采用医生及患者重要性评分法、相关系数法、变异度法、因子分析法和克朗巴赫系数α对20例肾癌患者和20名医护人员进行的数据进行统计分析。结果 经过上述方法进行筛检,结合专家小组的建议,最终得到含有11个条目的肾癌生命质量测定量表的特异模块。结论 肾癌的生命质量测定量表特异模块严格按照程序执行,具有较好的内容效度。
Objective To develop the specific module of the quality of life instruments for patients with renal cancer(QLICP-RE).Methods With the structured group(nominal group and focus group)methods,the item pool was put forward and a preliminary instrument was formed.The data from 20 renal cancer patients and 20 doctors/nurses were analyzed by statistical procedures.Doctors and patients' importance rating procedure,correlation analysis,method of coefficient of variation,factor analysis,and Cronbach's α.Results By above statistical procedures and advises of expert panel,11-items of the specific module were formed finally.Conclusions The specific module of QLICP-RE developed on the strict procedures has good content validity and representativeness.
论著

婴儿孤独症观察量表中文版的临床应用研究

Clinical application of the Chinese version of the Autism Observation Scale for Infants

:360-364
 
目的 检验婴儿孤独症观察量表中文版(AOSI)临床应用的灵敏度与特异度,评价其临床应用效果。方法 随机抽取1岁时曾在清远市妇幼保健院行AOSI评估,于2~3岁时诊断为孤独症谱系障碍(ASD)的48例患儿为ASD组,诊断为正常发展的46例幼儿作为对照组。比较两组患儿的18个条目得分和总分,采用受试者操作特征(ROC)曲线计算AOSI的特异度、灵敏度、阳性预测值与阴性预测值,并判断AOSI的最佳诊断(阳性)分界值;分析AOSI评估结果与《精神障碍诊断与统计手册(第5版)》(DSM-5)中ASD诊断标准的一致性。结果 两组研究对象性别、年龄比较差异无统计学意义(P>0.05)。ASD组各条目得分和总分均高于对照组,且差异具有统计学意义(P<0.01)。AOSI的曲线下面积(AUC)为1.00(P<0.01),95%置信区间为(1.00,1.00)。不同阳性分界线的灵敏度、特异度、阳性预测值、阴性预测值及一致性相比较,当约登指数等于1.00时AOSI的最佳诊断(阳性截断值)界线为9分时,其上述值均为1.00。AOSI评估结果与DSM-5中ASD的诊断标准完全相一致(Kappa=1,P<0.01)。结论 AOSI应用于评估1岁的婴儿,当取9分为诊断界值时,具有高度的灵敏度与特异度,能较好地预测该婴儿在2~3岁时是否患ASD;AOSI是婴儿期ASD筛查的重要工具,其评估结果可作为ASD高危儿早期干预的证据和ASD的辅助诊断工具,适合于临床推广应用。
Objective To test the sensitivity and specificity of the Chinese version of the Autism Observation Scale for Infants(AOSI)in clinical application and evaluate its clinical application effect.Methods Forty-eight children with autism spectrum disorder(ASD)diagnosed at the age of 2 to 3 years who had undergone AOSI evaluation in Qingyuan Maternal and Child Health Hospital at the age of 1 year(2021)were randomly selected as the ASD group,and 46 children with normal development were randomly selected as the control group.The scores of 18 items and total scores of the two groups of subjects were compared.The specificity,sensitivity,positive predictive value and negative predictive value of AOSI were calculated using the receiver operating characteristic curve(ROC),and the best diagnostic(positive)cut-off value of AOSI was confirmed.The consistency of AOSI evaluation results with the ASD diagnostic criteria in DSM-5 were compared.Results There was no statistically significant difference in genders or age between two groups(P>0.05).The scores of each item and total scores in the ASD group were significantly higher than those in the control group,and the difference was statistically significant(P<0.01).The area under the curve of AOSI(AUC=1.00,P<0.01)had a 95% confidence interval of(1.00,1.00).Comparing the sensitivity,specificity,positive predictive value,negative predictive value and consistency of different positive boundary points,when the Youden index was equal to 1.00,the optimal diagnostic(positive cut-off value)boundary for AOSI was 9 points,and all of the above values were 1.00. The AOSI evaluation results were completely consistent with the diagnostic criteria for ASD in DSM-5(Kappa=1,P<0.01).Conclusions AOSI has high sensitivity and specificity when it is used to evaluate the 1-year-old infant.When “9 points” is taken as the diagnostic threshold,it can better predict whether the infant has ASD at the age of 2~3 years.AOSI is an important tool for screening ASD in infancy.Its evaluation results can be used as evidence for early intervention of high-risk infants with ASD and as a assisting tool to diagnosis ASD,which is suitable for clinical application.
论著

阿尔茨海默病患者APOE4等位基因与多项神经心理学量表的相关性研究

The correlations of APOE4 alleles and multiple psychological tests in people with Alzheimer's disease

:9-13
 
目的 探讨具有不同载脂蛋白E4等位基因(Apolipoprotein E4 alleles,APOE4)阿尔茨海默病患者的神经心理学量表差异。方法 纳入2014年1月—2017年12月广州市第一人民医院收治阿尔茨海默病患者28人,分别予简易精神状态检查量表、阿尔茨海默病评定量表-认知部分、临床医师通过面谈对变化的印象、日常生活活动能力量表、神经精神问卷,并检测量表间相关关系。之后随访18个月,观察量表评测的各功能变化及互相间相关性。检测不同载脂蛋白E4等位基因等阿尔茨海默病相关基因分布及与量表间相关关系。结果 认知评定量表间、认知评定量表与整体评价量表间、以及认知评定量表与日常活动能力评定量表间具有相关性。精神与行为症状量表分数与其他评定量表无明显相关性。随访中各量表分数变化间均无相关性。各基因组间功能变化无显著性差异,载脂蛋白E4等位基因变异主要影响患者的认知功能。等位基因分布与患病年龄,日常活动能力及精神与行为症状无相关性。结论 阿尔茨海默病量表评测的各认知领域间相关性不同,功能变化间无相关关系。载脂蛋白E4等位基因变异主要影响患者的认知功能。
Objective The present study aimed to elucidate the performance of multiple psychological tests among different Apolipoprotein E4 alleles (APOE4) in people with Alzheimer's disease (AD). Methods 28 patients were enrolled from January 2014 to December 2017 in Guangzhou First People'S Hospital. All patients were tested by using Mini-mental State Examination (MMSE), Alzheimer's disease Assessment Scale (ADAS-cog), Clinician's Interview-Based Impression of Change (CIBIC-Plus), Activities of Daily Living (ADL) and the NeuroPsychiatric Inventory (NPI). After 18 months follow-up visit, the change of the tests points were recorded. AD pathogenic genes, including Apolipoprotein E4 allele's variations, were detected in all patients. Then the correlations of APOE4 alleles and multiple psychological tests were analyzed. Results The correlations were confirmed between MMSE and ADAS-cog, MMSE and CIBIC-plus, MMSE and ADL, ADAS-cog and CIBIC-plus, ADAS-cog and ADL. NPI showed no correlation with the others. No correlation was found between changes of multiple psychological tests after 18 months follow-up. APOE4 alleles' variation affected cognitive function mainly. The effects of APOE4 on ADL and NPI showed no statistical significance in AD patients. No correlation was found among patients groups with different APOE4 alleles in all psychological tests and age of onset. Conclusion The correlations were existed among multiple cognitive domains while levels were different. The changes between psychological tests showed no correlations. APOE4 alleles' variation affected cognitive function mainly.
论著

癌症患者生命质量测定量表体系之肾癌量表(QLICP-REV2.0)的条目筛选

Items selection on the Specific Module of Quality of Life Instruments for patients with renal cancer (QLICP-REV2.0)

:77-81
 
       目的   开发适合中国肾癌患者的生命质量测定量表的特异模块。   采用议题小组和核心小组的程序化决策方式,提出条目池,形成初步量表,采用医生及患者重要性评分法、相关系数法、变异度法、因子分析法和克朗巴赫系数α对20例肾癌患者和20名医护人员进行的数据进行统计分析。结果   经过上述方法进行筛检,结合专家小组的建议,最终得到含有11个条目的肾癌生命质量测定量表的特异模块。结论 肾癌的生命质量测定量表特异模块严格按照程序执行,具有较好的内容效度。
      Objective  To develop the specific module of the quality of life instruments for patients with renal cancer(QLICP-RE).Methods  With the structured group(nominal group and focus group)methods,the item pool was put forward and a preliminary instrument was formed.The data from 20 renal cancer patients and 20 doctors/nurses were analyzed by statistical procedures.Doctors and patients’ importance rating procedure,correlation analysis,method of coefficient of variation,factor analysis,and Cronbach’s α.Results  By above statistical procedures and advises of expert panel,11-items of the specific module were formed finally.Conclusions  The specific module of QLICP-RE developed on the strict procedures has good content validity and representativeness.
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