比较YEARS评分与简化Wells联合年龄校正D-二聚体评分用于疑似肺栓塞患者的诊断价值

目的通过前瞻性研究比较YEARS评分与简化Wells联合年龄校正D-二聚体评分(sWells-Age)用于疑似肺栓塞患者的诊断价值。方法纳入2021年3月3日到2022年4月30日于宜宾市第二人民医院就诊且符合纳排标准的可疑肺栓塞病人522名,采用前瞻性观察研究,由临床医师对照YEARS评分收集患者基线信息,计算患者YEARS评分及sWells-Age评分判断其目前肺栓塞临床可能性。所有排除肺栓塞且未进行抗凝治疗的患者进行3个月随访。以CTPA检查结果作为诊断金标准,分别计算YEARS评分及sWells-Age评分敏感度、特异度、κ值等指标,绘制两者ROC曲线并计算AUC值。结果sWells-Age评分及YEARS评分灵敏度分别为85.71%、93.41%(P<0.001),特异度分别为69.23%、56.92%(P<0.001),AUC值分别为0.775(95%CI 0.688~0.816)、0.752(95%CI 0.711~0.838),与CTPA的κ值分别为0.526、0.465,均>0.410,结果一致性均属于中等,两者灵敏度比较(χ^(2)=5.143,P<0.025),差异具有统计学意义,两者特异度比较(χ^(2)=12.500,P<0.001),差异具有显著统计学意义。结论sWells-Age评分优于YEARS评分,但YEARS评分项目少,灵敏度及安全性高,可应用于早期肺栓塞患者的筛查。

血清同型半胱氨酸检测联合Wells评分对慢性阻塞性肺疾病急性加重期患者发生静脉血栓栓塞症的预测价值研究

目的探究血清同型半胱氨酸(Hcy)检测联合Wells评分对慢性阻塞性肺疾病急性加重期患者发生静脉血栓栓塞症(VTE)的预测价值。方法选取2021年4月-2023年4月我院收治的94例慢性阻塞性肺疾病急性加重期患者,根据是否发生VTE分为VTE组20例和非VTE组74例。采用酶联免疫吸附测定(ELISA)法检测血清中Hcy水平。对全部患者进行Wells评分。Spearman相关性分析Hcy表达水平与Wells评分的关系;ROC曲线分析血清Hcy检测联合Wells评分对慢性阻塞性肺疾病急性加重期患者发生VTE的预测价值;Logistic回归分析影响慢性阻塞性肺疾病急性加重期患者VTE发生的因素。结果与非VTE组相比,VTE组患者C-反应蛋白(CRP)、D-二聚体(D-D)、Hcy水平以及Wells评分水平显著升高,动脉血氧分压(PaO_(2))水平显著降低(P<0.05)。Pearson相关性分析显示,慢性阻塞性肺疾病急性加重期患者Hcy表达水平与Wells评分呈正相关关系(r=0.491,P<0.05)。二者联合预测慢性阻塞性肺疾病急性加重期患者发生VTE的AUC高于血清Hcy表达水平与Wells评分单独预测的AUC值(Z=5.303,P<0.001;Z=9.151,P<0.001)。Logistic回归分析结果显示Hcy、Wells评分为VTE发生的影响因素(P<0.05)。结论慢性阻塞性肺疾病急性加重期发生VTE患者血清Hcy水平和Wells评分显著上升,二者联合检测对慢性阻塞性肺疾病急性加重期发生VTE的预测价值优于单一指标检测。

Physical, Mental and Social Wellbeing and Quality of Life among Current Smokers

Cigarette smoking has known negative effects on physical and mental health. Over 16 million Americans suffer from smoking-related illnesses, and one-third of individuals with mental health issues are also cigarette smokers. Both physical and mental health are associated with measures of overall quality of life, a critical outcome that can influence treatment, intervention, and prevention decision-making. However, the direct relation between smoking and quality of life is not clear and requires further investigation. The present study utilized data from 34,309 adults who participated in Wave 5 of the Population Assessment of Tobacco and Health (PATH) to examine the relation between smoking and quality of life while considering the mediating effects of physical and mental health, and the moderating effect of social satisfaction. Using Conditional Process Analyses to integrate mediation and moderation approaches, the present study found that smoking had indirect associations with quality of life mediated through both physical and mental health and that social satisfaction moderated these relationships. Additionally, smoking had an independent direct effect on quality of life that was not moderated by social satisfaction. Results suggest the negative impacts associated with smoking reach beyond its effect on physical, social and mental well-being.

微小RNA物质、血栓标志物、Wells评分系统联合预测高龄髋部骨折DVT风险价值

目的探究微小RNA物质、血栓标志物、下肢深静脉栓塞评分(Wells评分)系统联合对高龄髋部骨折深静脉血栓形成(DVT)风险的预测价值,为减少DVT发生提供诊断依据。方法选取2020年10月—2022年10月我院收治的105例高龄髋部骨折患者,根据术后1周是否发生DVT分为DVT组(34例)、未DVT组(71例)。比较两组临床资料,于入院后术前进行Wells评分评估,并检测两组微小RNA物质[微小RNA-374b-5p(miR-374b-5p)、微小RNA-664b-3p(miR-664b-3p)]、血栓标志物[凝血酶-抗凝血酶复合物(TAT)、可溶性血栓调节蛋白(sTM)、纤溶酶α2抗纤溶酶复合物(PIC)、组织型纤溶酶原激活物-抑制剂复合物(t-PAIC)],分析DVT发生的影响因素,通过受试者工作特征曲线(ROC)、决策曲线分析(DCA)Wells评分、miR-374b-5p、miR-664b-3p、sTM、PIc、TAT、t-PAIC联合对高龄髋部骨折DVT风险的预测价值及临床效用。结果DVT组术前血浆FDP水平及Wells评分高度可能占比高于未DVT组(P<0.05);DVT组miR-374b-5p相对表达量高于未DVT组,miR-664b-3p相对表达量低于未DVT组(P<0.05);DVT组血浆sTM、PIC、TAT、t-PAIC水平均高于未DVT组(P<0.05);FDP、Wells评分、miR-374b-5p、miR-664b-3p、sTM、PIC、TAT、t-PAIC均为高龄髋部骨折患者发生DVT的影响因素(P<0.05);Wells评分、miR-374b-5p、miR-664b-3p、sTM、PIC、TAT、t-PAIC预测高龄髋部骨折DVT风险的AUC值分别为0.666、0.734、0.750、0.730、0.764、0.761、0.800,各指标联合预测高龄髋部骨折患者发生DVT的AUC最大,为0.921,且具有良好临床效用(P<0.05)。结论miR-374b-5p、miR-664b-3p、sTM、PIC、TAT、t-PAIC、Wells评分系统联合预测高龄髋部骨折DVT风险的预测效能较高,临床效用良好。

血清白细胞表面分化抗原40配体联合Wells评分对产褥期深静脉血栓的诊断价值及其与凝血、血小板功能及炎症指标的相关性

目的探讨血清白细胞表面分化抗原40配体(CD40 ligand,CD40L)联合Wells评分对产褥期深静脉血栓(deep vein thrombosis,DVT)的诊断价值及其与凝血、血小板功能及炎症指标的相关性。方法选取2013年8月至2023年7月秦皇岛市妇幼保健院收治的107例产褥期DVT患者作为研究对象,设为DVT组。选取同期在秦皇岛市妇幼保健院分娩的健康产妇100例作为对照组。比较两组基本资料、血清CD40L、Wells评分及凝血、血小板功能及炎症指标,进行Pearson相关性分析,并采用受试者操作特征(receiver operating characteristic,ROC)曲线评价CD40L、Wells评分对产褥期DVT的诊断价值。结果两组研究对象的基本资料差异无统计学意义(均P>0.05)。相比于对照组,DVT组血清CD40L、Wells评分、凝血指标[D-二聚体(D-dimer,D-D)、纤维蛋白原(fibrinogen,FIB)]、血小板功能指标[血小板黏附率(platelet adhesion rate,PAdT)、血小板聚集率(platelet aggregation rate,PAgT)、P选择素(P-selection)]、炎症因子[白细胞介素-6(interleukin-6,IL-6)/IL-1β、高敏C反应蛋白(high-sensitivity c-reactive protein,hs-CRP)]更高(P<0.05),凝血指标(凝血酶原活化时间、凝血酶原时间)更低(P<0.05)。经过Pearson相关性分析,D-D、FIB、PAdT、PAgT、P-selection、IL-6、IL-1β、hs-CRP与产褥期VTE患者血清CD40L、Wells评分均呈正相关(P<0.05),APTT、PT与血清CD40L、Wells评分呈负相关(P<0.05)。ROC曲线显示,血清CD40L联合Wells评分诊断产褥期DVT的AUC、敏感度均显著高于各指标单独诊断(P<0.05)。结论血清CD40L联合Wells评分可提高产褥期DVT的诊断效能,有利于疾病的早期确诊,并及时采取治疗措施。

A Method for Forecasting Failures of Sucker Rod-pumped Wells

An exact forecast of the failures of a sucker rod-pumped well in a production area means much for an oilfield’s operation budget, operational arrangement and production plan. In this paper, according to the characteristics of failed sucker rod-pumped well randomness and strong outburst, with the gray GM (1,1) forecast model and the Markov forecast model combined, gray GM (1,1) forecast model is utilized to handle the primary data of an oilfield, and Markov forecast model is utilized to calculate the state transfer probability of forecast value. Then, the gray Markov forecast model considering the influence of randomness factors is formed. Field results prove that the calculation precision of this method is higher and the practicability is greater.

Application of Horizontal Well Seismic Geo-Steering Technology in XX Block Development

During the development phase horizontal wells are very efficient way to improve the production in the deep coal bed methane. The 8# coal seam in the XX block on the eastern edge of the Ordos Basin has challenges such as deep burial depth (>2000 m), thin coal sweet spot (3 m), and significant short-distance structural fluctuations. The challenges caused a high risk of missing targets and running out of the target layers, as well as difficulties in cementing and completion due to uneven well trajectories. To address these challenges, this paper focuses on solving the issues through detailed precise geological modeling, optimized trajectory design, and accurate seismic geology Steerable Drilling. 1) Based on reasonable velocity field construction and Time-Depth transformation, a precise directional model is constructed using the layer-by-layer approximation principle with reference to marker layers, improving the accuracy of the target spot and avoiding premature or delayed entry into the target;2) Based on a precise geological model, the dip angle of the strata ahead and the development of sweet spots are clearly defined, enabling optimized trajectory design for horizontal wells;3) Using “1 + N” dynamic modeling to update the geological model in real-time during the drilling process, and actively guide the drill bit through the horizontal segment smoothly by using multi-information judgment of the drill bit position. The actual drilling of 80 completed horizontal wells in this area show: That this approach effectively ensures the smooth trajectory and high-quality drilling rate of the horizontal well in the coal seam, providing a basis for subsequent hydraulic fracturing and increasing single-well production. At the same time, it has certain potential value and significance for similar coalbed methane developments under similar geological conditions.

Fractal Correction of Well Logging Curves

It is always significant for assessing and evaluation of oil bearing layers, especially for well logging data processing and interpretation of non marine oil beds to get more accurate physical properties in thin and inter thin layers. This paper presents a definition of measures and the measure presents power law relation with the corresponded scale described by fractal theory. Thus, logging curves can be reconstructed according to this power law relation. This method uses the local structure nearby concurrent points to compensate the average effect of logging probes and measurement errors. As an example, deep and medium induced conductivity (IMPH and IDPH) curves in ODP Leg 127 Hole 797C are reconstructed or corrected. Corrected curves are with less adjacent effects through comparison of corrected curves with original one. And also, the power spectra of corrected well logging curve are abounding with more resolution components than the original one. Thus, fractal correction method makes the well logging more resoluble for thin beds.

Integrated risk management: a Petrobras application in offshore well construction safety to minimize critical emergency disconnections

In order to avoid mistakes and to save a great deal of time in analysis, an innovative methodology was developed that can analyze the well operations and rig characteristics involved to define the best emergency disconnect sequence （EDS） available. A solution was developed based on the characteristics of the rigs and blowout preventers （BOPs）, and six variables were considered that directly affect the choice of EDS. All possible combinations of 64 scenarios were analyzed, and the priority of choice of the EDS was defined empirically. This paper presents an approach to EDS risk management and examples of exposure time （time without riser safety margin and shear capability） for the same well, which can be lowered from 13% to 0.1%. The impact of this reduction is related to the ability of the BOP to cut some of the heavy casings, in addition to improved availability of EDS modes. This implementation opened up many possibilities for the performance of risk exposure analysis, enabling comparison of several BOP configurations of contracted rigs and selection of the best options. This innovative approach allowed a better management of the rig schedules, prioritizing safety aspects and making it possible to allocate the fleet in a systematic way.

The temperature dependence of single-event transients in 90-nm CMOS dual-well and triple-well NMOSFETs

This paper investigates the temperature dependence of single-event transients（SETs） in 90-nm complementary metat-oxide semiconductor（CMOS） dual-well and triple-well negative metal-oxide semiconductor field-effect transistors（NMOSFETs）.Technology computer-aided design（TCAD） three-dimensional（3D） simulations show that the drain current pulse duration increases from 85 ps to 245 ps for triple-well but only increases from 65 ps to 98 ps for dual-well when the temperature increases from-55℃ to 125℃,which is closely correlated with the NMOSFET sources.This reveals that the pulse width increases with temperature in dual-well due to the weakening of the anti-amplification bipolar effect while increases with temperature in triple-well due to the enhancement of the bipolar amplification.

Optimization of well pad design and drilling-well clustering

A model accounting for more than 30 parameters of drilling projects, and a computer program to enumerate groupings of the wells of a pad with consequent calculations of technical-economic characteristics, are developed and tested. Seven drilling scenarios for a 24-well pad with different starting oil flow rates for the wells are studied. Optimal well groupings in terms of Net Present Value (NPV) for three discount rates and five oil production decline rates have been found. The results show that: NPV-maximizing well pad designs with unequal (varying) numbers of wells in groups (clusters) may require only slight alterations of existing designs (changing the configurations of a couple of well clusters);relative NPV gain is inversely proportional to the absolute value of NPV;observed increases in NPV in groupings with varying numbers of wells reach up to 1% with respect to groupings with equal (constant) numbers of wells in groups for conventional projects, and could reach 2% and more for shale formation development projects, and up to 45% for marginal projects.

Wells量表和修正的Geneva评分对肺栓塞的预测价值

【目的】为减少肺栓塞误漏诊,探讨并应用受试者工作特征曲线(ROC)比较修正的Geneva和Wells评分系统对肺栓塞的预测价值。【方法】收集1998-2008年10月中山大学附属第三医院可疑肺栓塞65例,其中临床确诊肺栓塞44例,记录、归纳整理、统计分析,应用ROC曲线比较Geneva和Wells评分对肺栓塞的预测价值。【结果】Wells评分<2分肺栓塞可能性33.3%(8/24),2～6分87.2%(34/39),6分以上100%(2/2),评分增加肺栓塞可能性增大(P=0.000);Geneva评分:0～3分肺栓塞可能性22.2%(4/18);4～10分82.1%(32/39);≥11分100%(8/8)。肺栓塞可能性与Geneva评分高低有关(P=0.000)。Wells评分预测肺栓塞的ROC曲线下面积(AUC)0.785±0.060(P=0.000),最佳分界值2分,以≥2分预测肺栓塞,其敏感性81.8%,特异性76.2%;Geneva评分ROC的AUC为0.900±0.038(P=0.000),最佳分界值6.5分,以≥6.5分预测的敏感性为72.7%,特异性100%;两条曲线所对应AUC的差异有统计学意义(P<0.05)。【结论】Wells评分和Geneva评分对肺栓塞的预测均具有较好的临床价值;Geneva评分的敏感性和特异性总体上优于Wells评分。

Wells评分联合D-二聚体排除下肢深静脉血栓形成的应用价值研究

目的评估Wells评分联合D-二聚体在排除下肢深静脉血栓形成(DVT)中的应用价值。方法选取2011—2012年重庆医科大学附属永川医院收治的髋/膝关节术后疑似下肢DVT患者195例,根据Wells评分分为高风险(Wells评分>1分)、低风险(Wells评分≤1分);D-二聚体>500μg/L为阳性;以压缩超声检查及随访确诊下肢DVT。计算Wells评分联合D-二聚体排除下肢DVT的灵敏度、特异度、阳性预测值、阴性预测值。结果 195例患者中,压缩超声检查及随访确诊下肢DVT 37例(19.0%),排除下肢DVT 158例(81.0%)。195例患者中,高风险52例,其中压缩超声检查及随访确诊下肢DVT 32例;低风险143例,其中压缩超声检查及随访确诊下肢DVT 5例。195例患者中,D-二聚体检查阳性56例,其中压缩超声检查及随访确诊下肢DVT 31例;D-二聚体检查阴性139例,其中压缩超声检查及随访确诊下肢DVT 6例。Wells评分联合D-二聚体诊断下肢DVT 49例(Wells评分高风险且D-二聚体检查阳性),其中压缩超声检查及随访确诊下肢DVT 32例;可能为下肢DVT 9例(Wells评分低风险,D-二聚体检查阳性或者Wells评分高风险,D-二聚体检查阴性),其中压缩超声检查及随访确诊下肢DVT 4例;排除下肢DVT 137例(Wells评分低风险且D-二聚体检查阴性),其中压缩超声检查及随访确诊下肢DVT 1例。Wells评分联合D-二聚体排除下肢DVT的灵敏度为97.0%、特异度为88.9%、阳性预测值为65.3%、阴性预测值为99.3%。结论Wells评分联合D-二聚体在排除下肢DVT中有很好的应用价值。

Wells评分联合D-二聚体检测对急性肺栓塞的诊断价值

目的:评价Wells评分联合D-二聚体(D-Dimer)检测在急性肺栓塞(APE)诊断中的作用。方法:收集我院2012年3月至2014年9月疑诊APE患者共42例进行前瞻性调查,以Wells评分表结合DDimer检测对患者进行评估,以预测其发生肺栓塞的临床可能性。结果 :42例疑诊患者中,共有26例经肺动脉造影(CTPA)确诊。采用Wells评分临床评估为低度、中度、高度疑似肺栓塞者分别为7、24、11例,其中经CTPA确诊为肺栓塞者分别为1、15、10例,确诊率分别为14.2%(1/7)、62.5%(15/24)、90.9%(10/11)。肺栓塞组D-Dimer水平明显高于非肺栓塞组(P<0.01)。肺栓塞组Wells评分中度可能性及高度可能性组D-Dimer水平明显高于Wells评分低度可能性组(P<0.05)。结论:Wells评分联合D-Dimer检测对急性肺栓塞临床可能性预测方面,具有方便、准确、安全、无创等优点,值得临床推广应用。

Wells评分和血浆D-二聚体对肺栓塞的诊断价值分析

目的探讨采用Wells评分、血浆D-二聚体检测和二者相结合对肺栓塞（PE）的诊断和排除价值。方法2008—03-2010—05在昆明医学院第二附属医院呼吸内科住院的疑似PE患者，均进行CT肺动脉造影（CTPA）、血浆D-二聚体检测，采用Wells评分进行临床可能性评估。以CTPA结果为标准，分析各组患者的PE诊断率。结果入选的126例疑似PE患者，进行CTPA检查后诊断PE32例，D-二聚体阳性、Wells评分阳性、二者均为阳性的PE发生率分别为49．1％、41．7％、51．5％，三组比较差异无统计学意义（P〉0．05）。D-二聚体阴性、Wells评分阴性、二者均为阴性的PE发生率分别为8．2％、30．0％、2．2％，三组比较差异有统计学意义（P〈0．01）。D-二聚体检测和Wells评分诊断PE的敏感性和特异性相似，分别为81．3％、78．1％和71．3％、62．8％；二者阴性预测值也相似，分别为91．8％、89．4％；二者均为阳性诊断PE的敏感性为53．3％，特异性为83．0％，阴性预测值为83．9％；二者均为阴性排除PE的敏感性为93．8％，特异性为47．8％，阴性预测值为97．9％。结论D-二聚体阳性、Wells评分阳性和二者均为阳性对PE的诊断率相近；D-二聚体和Wells评分均为阴性时并不能完全排除PE；D-二聚体检测结合Wells评分能更准确地预测PE的发病风险，当二者均为阴性时，排除疑似PE更加安全有效。

Wells评分、Kahn评分、St. André评分、Constans评分对下肢深静脉血栓的诊断价值研究

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(P<0.05)。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。

基于well-being分析的电网设备重要度评估与排序方法

设备重要度评估是电网风险评估与管控的重要内容,现有的方法无法考虑天气条件等不确定因素的影响,同时存在评价角度单一、实用性不强的问题。为此,提出一种电网设备重要度评估与排序的新方法。在well-being风险分析的框架下结合风险追踪模型和三状态天气模型,研究了单个设备对系统运行风险贡献程度的量化方法。在推导系统well-being风险指标分配模型的基础上,定义了设备紧急重要度指标(emergency importance indicator,EII)和警戒重要度指标(alert importance indicator,AII),分别从不同角度表征设备的重要程度。通过状态枚举法选取具有代表性的预想故障集,逐次将预想故障的运行风险分配给各个设备,最终完成考虑天气状态下的设备重要度评估与排序。RBTS系统和IEEE-RTS系统的仿真结果验证了所提方法的科学性和可靠性。

规则往复流中Wells透平自起动过程的数值模拟和实验研究

基于稳态透平切向力实验数据,在准定常流动假设下对规则往复流中Wells透平的自起动过程进行了数值模拟,数值模拟结果与实测数据的比较结果表明,该文建立的数值模拟过程可替代实验方法用以分析规则往复流中Wells透平的自起动过程。

简化版Wells评分、修订版Geneva评分和D-二聚体水平在恶性肿瘤并发肺血栓栓塞症诊断中的应用价值

目的:探讨简化版Wells评分、修订版Geneva评分和D-二聚体(DD)水平在恶性肿瘤并发肺血栓栓塞症(PTE)诊断中的应用价值,为临床诊断PTE提供参考。方法:回顾性分析疑似诊断为PTE并行CT肺动脉造影(CTPA)检查的142例恶性肿瘤患者的临床资料,依据CTPA结果将72例恶性肿瘤并发PTE患者作为PTE组,70例不并发PTE患者为非PTE组,对2组患者形成PTE的相关风险因素进行统计分析,绘制受试者工作特征曲线(ROC曲线),采用Z检验比较上述评分的ROC曲线下面积(AUC),评价其在恶性肿瘤并发PTE诊断中的应用价值。结果:病理类型为腺癌、肿瘤发生转移、并发深静脉血栓(DVT)和DD阳性是恶性肿瘤患者发生PTE的独立危险因素(P<0.05);简化版Wells评分、修订版Geneva评分和DD水平的灵敏度分别为87.5%、87.5%及97.2%,阴性预测值分别为74.3%、70.0%及83.3%,上述2种评分量表与DD水平联合评价的灵敏度均为100%,漏诊率较低,且其阴性预测值可达100%,排除价值较大;简化版Wells评分、修订版Geneva评分、DD水平、修订版Geneva评分联合DD水平和简化版Wells评分联合DD水平的AUC分别为0.762、0.687、0.649、0.741及0.786,简化版Wells评分联合DD水平的AUC最大,大于其他种类量表(P<0.05)。结论:简化版Wells评分联合DD水平对恶性肿瘤并发PTE患者诊断更具有参考价值。

论话语标记语WELL语用功能在英译汉中的再现

本文以狄更斯的原著《大卫·考坡菲》及张谷若先生的译本为语料，分析并阐述了话语标记语well的不同语用功能及其翻译处理方法。本文分析了张谷若先生在译文中保留well语用功能的成功例子，同时也指出一些译文的语用功能缺失问题。作者提出首先可以通过研究对话的上下文来识别说话者的言外之意，从而认定well在对话中的语用功能，然后可选择符合汉语习惯的词语来发挥相同的语用功能，使译文保留well原有的语用功能。