通过效应代数中的中心元引入效应代数中的Well Inside关系,研究了效应代数中的Well Inside关系的性质;在此基础上得出了效应代数成为布尔代数的一个充要条件。

The relationship of Well Inside in effect algebra is introduced by the center elements of effect algebra, and the proper-ties of the relationship of Well Inside are studied. Based on the relationship of Well Inside, a necessary and sufficient condition which effect algebra becomes Boole algebra has been obtained.

目的为减少肺栓塞误诊漏诊,探讨并应用受试者工作特征曲线(receiver operator characteristic curve,ROC曲线),比较改良Geneva评分和Wells评分系统对肺栓塞的预测价值。方法选择临床疑似诊断为肺栓塞并接受经CT肺动脉造影(CTPA)检查的患者637例,确诊肺栓塞256例,临床医师用Wells评分和改良Geneva评分对患者进行临床评分,应用ROC曲线比较两种评分法对肺栓塞的预测价值。结果 Wells评分2分肺栓塞可能性为7.7%,2~6分为57.3%,6分为83.3%;改良Geneva评分0~3分肺栓塞可能性12.1%,4~10分为46.6%,≥11分为60.0%。Wells评分预测肺栓塞的ROC曲线下面积(AUC)0.849(95%Cl:0.817~0.881),最佳分界值2.75分;改良Geneva评分ROC的AUC为0.813(95%Cl:0.778~0.849),最佳分界值6.5分;两条曲线所对应AUC的差异有统计学意义(P0.05)。结论 Wells评分和改良Geneva评分对肺栓塞的预测均具有较高的临床价值;Wells评分的敏感性和特异性优于改良Geneva评分。

Objective To reduce misdiagnosis and underdiagnosis rates of pulmonary embolism ,the prediction of the Wells score and revised Geneva score for pulmonary embolism were compared and analyzed by receiver operating characteristic curves .Meth-ods Six hundred and thirty-seven cases with suspected pulmonary embolism ( PE) were collected ,among whom 256 cases with PE were clinically confirmed .Before CTPA test or on condition that test results were unknown ,clinical scoring was assessed prospectively by the Wells score and the Revised Geneva score .ROC curves was used to evaluate the probability of PE predicted by the Wells and the re -vised Geneva scores.Results The prevalence of PE was 7.7% with a low clinical probability (Wells Score 6 points).The confirmed PE was 12.1%with a low probability(Geneva score 0-3 points),46.6% in intermediate probability(4-10 points),60.0% in high probability(score≥11 points).The area under curve (AUC) of the ROC curve in the Wells and Geneva scores

探讨改良Geneva评分和Wells评分在肺栓塞诊治中的价值进行。方法:以2010年2月至2013年10月我院住院病人中86例疑似肺栓塞患者作为研究对象,分别对其进行改良Geneva评分和Wells评分,应用两种评分标准对肺栓塞的筛查效果进行比较分析。结果:改良Geneva评分≤3分的患者其诊断肺栓塞的可能性为24.0%,4-10分的可能性为81.0%,而≥11分的可能性则为100%,Wells评分2分确诊肺栓塞的可能性为31.3%,2-6分的可能性为88.2%,而超过6分其可能性则为100%,两种评分法各分值间的差异均具有统计学意义(P0.05)。结论:改良Geneva评分和Wells评分其分值越高,则肺栓塞的可能性则越大,建议将Wells评分超过6分或改良Geneva评分超过11分作为确诊肺栓塞的临床指标。

Objective:To analyze the value of improved Geneva score and Wells score in diagnosis and treatment of pulmonary embolism .Method:86 cases of patients with suspected pulmonary embolism in our hospital from February 2010 to October 2013 were as the research objects , separately took the improved Ge-neva score and Wells score , compared the screening effect of the two criteria in diagnosis and treatment of pulmonary embolism .Result: The possibility diagnosis of pulmonary embolism of patients with less than 3 points in improved Geneva score was 24.0%, 4-10 points was 81.0%, and 11 points was 100%, the possi-bility of pulmonary embolism diagnosis of patients with less than 2 points in the Wells score was 31.3%, 2-6 points was 88.2%, and more than six points was 100%, the different score in two kinds of evaluation method were statistically significant ( P<0.05) .Conclusion:The higher score of the improved Geneva score and Wells score , the higher possibility of pulmonary embolism is .It can

探讨Wells评分结合D-二聚体检测在预防骨科手术患者下肢深静脉血栓形成(DVT)中的应用及护理对策。方法:将198例骨科手术患者随机分为观察组100例和对照组98例,观察组利用Wells评分结合D-二聚体检测的数据制定分级强化护理措施进行护理干预,对照组采用常规护理。结果:观察组DVT发生率明显低于对照组(P0.05)。结论:根据Wells评分结合D-二聚体检测的数据制定分级强化护理措施能有效预防骨科手术患者DVT形成。

Objective :To explore the application of Wells score combined with D -dimer detection in the prevention of lower ex-tremity deep vein thrombosis (DVT) in patients with orthopedic surgery and to study the nursing countermeasures .Methods :198 patients undergoing orthopedic operation were randomly divided into the observation group (n=100) and the control group (n=98) .The Wells score combined with D -dimer detection was applied to grading and strengthening nursing care in the observation group and the patients in this group were given nursing intervention according to the formulated nursing measures and routine nursing care was taken in the control group .Results :The incidence of DVT was significantly lower in the observation group than the control group (P<0 .05) .Conclusion:Developing nursing measures according to the data of Wells score combined with D -di-mer detection can effectively prevent the incidence of DVT in patients with orthopedic surgery .

目的评价Wells评分、Kahn评分、St.André评分、Constans评分对下肢深静脉血栓(DVT)的诊断价值。方法选择2006年7月—2009年3月在宁夏医科大学总医院行直接CT静脉造影(CTV)、间接CTV、下肢B超检查的疑诊DVT的住院患者278例,分别行下肢Wells评分、Kahn评分、St.André评分、Constans评分。以各评分低度可能DVT作为阴性结果,中度可能DVT和高度可能DVT作为阳性结果;以CTV检查和/或下肢B超作为诊断DVT的金标准,分别计算各评分诊断DVT的灵敏度、特异度、阳性预测值、阴性预测值和ROC曲线下面积(AUC)。结果各评分诊断DVT的灵敏度、特异度、阳性预测值、阴性预测值、AUC,Wells评分为92.3%、48.9%、65.7%、85.7%、0.845;Kahn评分为64.3%、29.6%、49.2%、44.0%、0.526;St.André评分为90.2%、51.8%、66.5%、83.3%、0.761;Constans评分为95.8%、23.0%、56.8%、83.8%、0.755。Z检验结果显示,除St.André评分与Constans评分诊断DVT的AUC差异无统计学意义外,其他评分两两比较,差异均有统计学意义(P0.05)。结论通过比较Wells评分、Kahn评分、St.André评分、Constans评分对DVT的诊断价值发现,Wells评分在4种评分中诊断效能最高,比较适用于中国人群。

Objective To evaluate the values of the scores of Wells,Kahn,St. André,Constans in diagnosis of deep venous thromboembolism( DVT). Methods A total of 278 suspected DVT patients hospitalized in General Hospital of Ningxia Medical University from July 2006 to March 2009 underwent scores of Wells,Kahn,St. André,Constans,respectively. We take low possibility of DVT of each score as negative result,middle and high possibility of DVT as positive result,and CT venog-raphy( CTV)and( or)ultrasonography as gold standard. The sensitivity,specificity,positive predictive value,negative pre-dictive value and ROC area under curve( AUC) of the scores in DVT diagnosis were calculated. ResUlts The sensitivity,spe-cificity,positive predictive value and negative predictive value,ROC AUC of Wells Score in DVT diagnosis were 92. 3%, 48. 9%,65. 7%,85. 7%,0. 845,respectively;those of Kahn Score were 64. 3%,29. 6%,49. 2%,44. 0%,0. 526,re-spectively;those of St. André Score were 90. 2%,51. 8%,66. 5