Altman’s Z-Score模型在企业风险管理中的应用研究

随着市场竞争的加剧,信息化、高科技化进程的加快,企业决策难度、经营成本和收益的波动增大,企业风险管理彰显出重要性。笔者通过对沪、深证券交易所2007年～2009年暂停上市或终止上市的32家公司的Z值分析,认为用Altman’s Z-Score模型预测企业风险是有效的。根据对Altman’s Z-Score模型组成变量的比较分析,笔者提出了企业防范风险的有关措施。

An Analysis of Interpersonal Function of the Dialogues in the Film The King's Speech

Based on the framework of Halliday's theory of interpersonal function, this study intends to analyze the dialogues in the film The King's Speech from the three aspects of mood type, modal operator and vocative address by adopting both quantitative and qualitative methods. The significances of successful realizations of interpersonal function to the role characterization, plot development and thematic construction in the film are also demonstrated, thus deepening the understanding and appreciation of the film.

基于King达标理论的培训方案对临床护士叙事能力及人文关怀能力的影响

目的:探讨基于King达标理论构建临床护士叙事护理培训方案对临床护士叙事护理能力、人文关怀能力及共情能力的影响。方法:2023年3月—5月选取淄博市某三级甲等医院138名护士,采用随机数字表法分为试验组和对照组。对照组实施常规叙事护理培训,试验组在对照组的基础上实施基于King达标理论指导下的叙事护理方案。采用医学叙事能力量表(NCS)、关怀能力评价量表(CAI)、杰弗逊共情量表(JSE-HP)进行效果评价。结果:干预后,试验组护士NCS、CAI及JSE-HP得分均高于对照组,差异均有统计学意义(P<0.05)。结论:基于King达标理论构建的临床护士叙事培训方案可有效提高临床护士叙事护理能力、促进人文关怀能力并提升护士共情能力。

Sequential organ failure assessment score is superior to other prognostic indices in acute pancreatitis

BACKGROUND Acute pancreatitis(AP)is a common surgical condition,with severe AP(SAP)potentially lethal.Many prognostic indices,including;acute physiology and chronic health evaluation II score(APACHE II),bedside index of severity in acute pancreatitis(BISAP),Glasgow score,harmless acute pancreatitis score(HAPS),Ranson’s score,and sequential organ failure assessment(SOFA)evaluate AP severity and predict mortality.AIM To evaluate these indices'utility in predicting severity,intensive care unit(ICU)admission,and mortality.METHODS A retrospective analysis of 653 patients with AP from July 2009 to September 2016 was performed.The demographic,clinical profile,and patient outcomes were collected.SAP was defined as per the revised Atlanta classification.Values for APACHE II score,BISAP,HAPS,and SOFA within 24 h of admission were retrospectively obtained based on laboratory results and patient evaluation recorded on a secure hospital-based online electronic platform.Data with<10%missing data was imputed via mean substitution.Other patient information such as demographics,disease etiology,and patient outcomes were also derived from electronic medical records.RESULTS The mean age was 58.7±17.5 years,with 58.7%males.Gallstones(n=404,61.9%),alcohol(n=38,5.8%),and hypertriglyceridemia(n=19,2.9%)were more common aetiologies.81(12.4%)patients developed SAP,20(3.1%)required ICU admission,and 12(1.8%)deaths were attributed to SAP.Ranson’s score and APACHE-II demonstrated the highest sensitivity in predicting SAP(92.6%,80.2%respectively),ICU admission(100%),and mortality(100%).While SOFA and BISAP demonstrated lowest sensitivity in predicting SAP(13.6%,24.7%respectively),ICU admission(40.0%,25.0%respectively)and mortality(50.0%,25.5%respectively).However,SOFA demonstrated the highest specificity in predicting SAP(99.7%),ICU admission(99.2%),and mortality(98.9%).SOFA demonstrated the highest positive predictive value,positive likelihood ratio,diagnostic odds ratio,and overall accuracy in predicting SAP,ICU admission,and mortality.SOFA and Ranson’s score demonstrated the highest area under receiver-operator curves at 48 h in predicting SAP(0.966,0.857 respectively),ICU admission(0.943,0.946 respectively),and mortality(0.968,0.917 respectively).CONCLUSION The SOFA and 48-h Ranson’s scores accurately predict severity,ICU admission,and mortality in AP,with more favorable statistics for the SOFA score.

基于King达标理论的心理干预结合亲情干预模式对BPH患者行PKEP术后恢复情况及GQOLI-74、IPSS评分的影响

目的研究基于King达标理论的心理干预结合亲情干预模式对前列腺增生(BPH)患者行经尿道双极等离子前列腺剜除术(PKEP)术后恢复情况及生活质量综合评定问卷(GQOLI-74)、国际前列腺症状评分(IPSS)的影响。方法选择2017年8月~2019年2月浙江省嘉兴市第二医院收治的BPH患者120例作为研究对象,采用随机数字表法将其分为对照组和观察组,每组60例.两组患者均采取PKEP治疗,手术治疗后,对照组患者采取常规护理措施,观察组患者采取基于King达标理论的心理干预结合亲情干预模式,两组患者的护理时间均为4周。比较两组患者的围术期指标、症状改善情况、并发症、生命质量以及依从性之间的差异。结果两组IPSS评分、最大尿流速(Qmax)、残余尿量(RUV)组内治疗前后比较,差异均有统计学意义(均P<0.05),治疗后两组手术时间、术中出血量、切除组织量、IPSS评分、Qmax、RUV之间比较,差异均无统计学意义(P>0.05);治疗后,两组患者的生命质量评分均升高,且观察组患者的生命质量评分均显著高于对照组,差异有统计学意义(P<0.05),两组患者的遵医嘱服药行为以及不良服药行为、日常生活管理行为、烟酒嗜好管理行为、依从性总分均高于治疗前,且观察组各项评分均高于对照组,差异均有统计学意义(P<0.05)。结论通过对BPH患者基于King达标理论的心理干预结合亲情干预模式护理,患者GQOLI-74、IPSS评分显著改善,患者的并发症显著下降,对患者的治疗具有积极的意义。

Short-term efficacy of robotic and laparoscopic spleen-preserving splenic hilar lymphadenectomy via Huang’s three-step maneuver for advanced upper gastric cancer: Results from a propensity scorematched study

BACKGROUND Robotic surgery has been considered to be significantly better than laparoscopic surgery for complicated procedures.AIM To explore the short-term effect of robotic and laparoscopic spleen-preserving splenic hilar lymphadenectomy(SPSHL)for advanced gastric cancer(GC)by Huang’s three-step maneuver.METHODS A total of 643 patients who underwent SPSHL were recruited from April 2012 to July 2017,including 35 patients who underwent robotic SPSHL(RSPSHL)and 608 who underwent laparoscopic SPSHL(LSPSHL).One-to-four propensity score matching was used to analyze the differences in clinical data between patients who underwent robotic SPSHL and those who underwent laparoscopic SPSHL.RESULTS In all,175 patients were matched,including 35 patients who underwent RSPSHL and 140 who underwent LSPSHL.After matching,there were no significant differences detected in the baseline characteristics between the two groups.Significant differences in total operative time,estimated blood loss(EBL),splenic hilar blood loss(SHBL),splenic hilar dissection time(SHDT),and splenic trunk dissection time were evident between these groups(P<0.05).Furthermore,no significant differences were observed between the two groups in the overall noncompliance rate of lymph node(LN)dissection(62.9%vs 60%,P=0.757),number of retrieved No.10 LNs(3.1±1.4 vs 3.3±2.5,P=0.650),total number of examined LNs(37.8±13.1 vs 40.6±13.6,P=0.274),and postoperative complications(14.3%vs 17.9%,P=0.616).A stratified analysis that divided the patients receiving RSPSHL into an early group(EG)and a late group(LG)revealed that the LG experienced obvious improvements in SHDT and length of stay compared with the EG(P<0.05).Logistic regression showed that robotic surgery was a significantly protective factor against both SHBL and SHDT(P<0.05).CONCLUSION RSPSHL is safe and feasible,especially after overcoming the early learning curve,as this procedure results in a radical curative effect equivalent to that of LSPSHL.

Short-term and long-term outcomes of laparoscopic vs open ileocolic resection in patients with Crohn's disease: Propensityscore matching analysis

BACKGROUND Laparoscopic ileocolic resection(LICR)is the preferred surgical approach for primary ileocolic Crohn’s disease(CD)because it has greater recovery benefits than open ICR(OICR).AIM To compare short-and long-term outcomes in patients who underwent LICR and OICR.METHODS Patients who underwent ICR for primary CD from 2006 to 2017 at a single tertiary center specializing in CD were included.Patients who underwent LICR and OICR were subjected to propensity-score matching analysis.Patients were propensityscore matched 1:1 by factors potentially associated with 30-d perioperative morbidity.These included demographic characteristics and disease-and treatment-related variables.Factors were compared using univariate and multivariate analyses.Long-term surgical recurrence-free survival(SRFS)in the two groups was determined by the Kaplan-Meier method and compared by the log-rank test.RESULTS During the study period,348 patients underwent ICR,211 by the open approach and 137 laparoscopically.Propensity-score matching yielded 102 pairs of patients.The rate of postoperative complication was significantly lower(14%versus 32%,P=0.003),postoperative hospital stay significantly shorter(8 d versus 13 d,P=0.003),and postoperative pain on day 7 significantly lower(1.4 versus 2.3,P<0.001)in propensity-score matched patients who underwent LICR than in those who underwent OICR.Multivariate analysis showed that postoperative complications were significantly associated with preoperative treatment with biologics[odds ratio(OR):3.14,P=0.01]and an open approach to surgery(OR:2.86,P=0.005).The 5-and 10-year SRFS rates in the matched pairs were 92.9%and 83.3%,respectively,with SRFS rates not differing significantly between the OICR and LICR groups.The performance of additional procedures was an independent risk factor for surgical recurrence[hazard ratio(HR):3.28,P=0.02].CONCLUSION LICR yielded better short-term outcomes and postoperative recovery than OICR,with no differences in long-term outcomes.LICR may provide greater benefits in selected patients with primary CD.

Histopathological assessment of the microscopic activity in inflammatory bowel diseases:What are we looking for?

Advances in diagnostics of inflammatory bowel diseases(IBD)and improved treatment strategies allowed the establishment of new therapeutic endpoints.Currently,it is desirable not only to cease clinical symptoms,but mainly to achieve endoscopic remission,a macroscopic normalization of the bowel mucosa.However,up to one-third of IBD patients in remission exhibit persisting microscopic activity of the disease.The evidence suggests a better predictive value of histology for the development of clinical complications such as clinical relapse,surgical intervention,need for therapy escalation,or development of colorectal cancer.The proper assessment of microscopic inflammatory activity thus became an important part of the overall histopathological evaluation of colonic biopsies and many histopathological scoring indices have been established.Nonetheless,a majority of them have not been validated and no scoring index became a part of the routine bioptic practice.This review summarizes a predictive value of microscopic disease activity assessment for the subsequent clinical course of IBD,describes the most commonly used scoring indices for Crohn's disease and ulcerative colitis,and comments on current limitations and unresolved issues.

TRUE KINGLY HONOUR IN SHAKESPEARE′S HENRY IV PART I

Honour, one of the eternal themes in Shakespeare, is again in the spotlightin Henry IV Part I. In this play, the rivalry between Prince Hal and Hotspuremerges actually out of their cravings for the title of royal honour and valour.Hotspur appears to be formidable, courageous and energetic. He is exactly

Multi-locus genetic risk score predicts risk for Crohn's disease in Slovenian population

AIM: To develop a risk model for Crohn&#x02019;s disease (CD) based on homogeneous population.METHODS: In our study were included 160 CD patients and 209 healthy individuals from Slovenia. The association study was performed for 112 single nucleotide polymorphisms (SNPs). We generated genetic risk scores (GRS) based on the number of risk alleles using weighted additive model. Discriminatory accuracy was measured by area under ROC curve (AUC). For risk evaluation, we divided individuals according to positive and negative likelihood ratios (LR) of a test, with LR &#x0003e; 5 for high risk group and LR &#x0003c; 0.20 for low risk group.RESULTS: The highest accuracy, AUC of 0.78 was achieved with GRS combining 33 SNPs with optimal sensitivity and specificity of 75.0% and 72.7%, respectively. Individuals with the highest risk (GRS &#x0003e; 5.54) showed significantly increased odds of developing CD (OR = 26.65, 95%CI: 11.25-63.15) compared to the individuals with the lowest risk (GRS &#x0003c; 4.57) which is a considerably greater risk captured than in one SNP with the highest effect size (OR = 3.24). When more than 33 SNPs were included in GRS, discriminatory ability was not improved significantly; AUC of all 74 SNPs was 0.76.CONCLUSION: The authors proved the possibility of building accurate genetic risk score based on 33 risk variants on Slovenian CD patients which may serve as a screening tool in the targeted population.

Midnight Salivary Cortisol and Other Effective Factors in the Graduation of Clinical Suspect of Cushing Syndrome: Is There Any Reasonable Clinical Score?

Background: Diagnosis of Cushing’s Syndrome (CS) at the right time and with the right method is getting more important for the patients and clinicians due to high mortality rate. The most appropriate laboratory test will provide great benefits in terms of cost-effectiveness in the well-chosen group of patients. Selection of the high risk group is of crucial importance for the true diagnosis and treatment on time. Aim: The aim of this study was to evaluate the worth of the midnight salivary cortisol and to establish other effective factors in the graduation of clinical suspect of CS. Material and Methods: 115 patients were evaluated in weight, height, body mass index (BMI), waist/hip ratio, systolic, diastolic blood pressures, hirsutism, weight gain, purple-stria, plethore, buffalo-hump, supraclavicular fullness, temporal fat cushion, acnea, moonface, proximal muscle weakness, lower limb edema, ecchymosis, loss of libido, depression, diabetes mellitus, hypertension, allopecia of all patients were noted in the evaluation forms (23 findings). Patients were grouped according to clinical scores, low (16). Results: When we compare the groups in terms of midnight salivary cortisol, morning salivary cortisol after overnight dexamethasone suppression test, we found statistically significant relationship between the low and high clinical score groups, as well as between medium and high score groups (p: 0.0001). Urinary free cortisol was statistically significant only between low and high clinical score groups (p: 0.0001). Conclusion: This clinical scoring system which includes clinical signs and laboratory findings both, can be used for selection of the high risk group.

Nutech functional score: A novel scoring system to assess spinal cord injury patients

AIM To develop a new scoring system, nutech functional scores(NFS) for assessing the patients with spinal cord injury(SCI).METHODS The conventional scale, American Spinal Injury Association's(ASIA) impairment scale is a measure which precisely describes the severity of the SCI.However, it has various limitations which lead to incomplete assessment of SCI patients.We have developed a 63 point scoring system, i.e., NFS for patients suffering with SCI.A list of symptoms either common or rare that were found to be associated with SCI was recorded for each patient.On the basis of these lists, we have developed NFS.RESULTS These lists served as a base to prepare NFS, a 63 point positional(each symptom is sub-graded and get points based on position) and directional(moves in direction BAD → GOOD) scoring system.For non-progressive diseases, 1, 2, 3, 4, 5 denote worst, bad, moderate, good and best(normal), respectively.NFS for SCI has been divided into different groups based on the affected part of the body being assessed, i.e., motor assessment(shoulders, elbow, wrist, fingers-grasp, fingers-release, hip, knee, ankle and toe), sensory assessment, autonomic assessment, bed sore assessment and general assessment.As probability based studies required a range of(-1, 1) or at least the range of(0, 1) to be useful for real world analysis, the grades were converted to respective numeric values.CONCLUSION NFS can be considered as a unique tool to assess the improvement in patients with SCI as it overcomes the limitations of ASIA impairment scale.

The Application of the Emerging Market Score Model in China During the Global Crisis Period： A Countertrend

The global economic crisis that blew up at the end of 2006 in the United States has had extremely negative impacts on the social, political, and economic fields. The countries operating in the most affected macro areas---the United States and Europe---have put through the wringer the domestic trade relationships as well as the international ones, by injecting a chain reaction into the global economic scenario. However, there are countries that seem to be free from the economic and financial contagion overflowing over the past years, as they are moved by an ＂invincible projection toward the growth＂. The present study aims to analyze how much the main emerging market of China has been effectively involved in this vicious circle. More specifically, the study intends to propose an empirical analysis on the real connection between the macroecnnomic data and the strong structure of the Chinese publicly listed companies. This paper investigates the prediction of failure among 3,220 Chinese publicly traded companies （listed companies） during the global crisis period. By analysing the financial accounting data over the past seven years （2008 to 2014）, the emerging market score （EMS） has been adopted in order to investigate the impact of the crisis on financial distress in the main emerging market of China. The results confirm the following hypotheses： On one hand, the great majority of companies have not been suffering the downturn, since 71.93% of the entire samples present no risk of financial distress during the global crisis; on the other hand, only 6.18% have a reasonable risk of financial distress.

Assessing gestational age of babies: Performance of obstetric ultrasound scan compared to that from the combination of Naegle’s rule and Dubowitz score in the 21st century

Background: Some researchers have suggested that when Naegle’s rule (NR) and Dubowitz score (DS) are combined, it could out-perform obstetric ultrasound scan (USS). Others still believe that obstetric USS alone is still effective relative to the combination of NR rule and DS in assessing the gestational age (GA) of babies. Objectives: To determine and compare the GA of babies using obstetric USS, NR and DS;and to provide relevant public health information on obstetric USS in the 21st century. Methods: Subjects were selected using systematic random sampling and the GA of babies was determined using obstetric USS, NR, and DS. Statistical package for social science (SPSS) statistical software version 16, Illinois, Chicago USA was used for all data analysis. Results: Eightyfive mother-baby pairs were studied. Forty-four babies (52%) were males and 41 (48%) females. Sixty four (75%) were term with a mean (SD) BW of 3.02 (0.59) at 95%CI (2.89 -?3.14) kg. The overall mean GA of the babies was 38.49 (2.89) at 95%CI (38.14 -?38.85) weeks. The mean GA using obstetric USS, NR and DS were 38.52 (1.98) at 95%CI (38.14 -?38.99), 38.09 (4.13) at 95%CI (37.20-?38.99) and 38.82 (2.02) at 95%CI (38.39 -?39.26), but comparison of these means was not significant (p = 0.256). Combined mean GA by NR and DS was 38.46 (3.26) at 95%CI (37.96 -?38.95). Comparing this mean with mean GA obtained by obstetric USS was also not significant (p = 0.885). Conclusion: The GA assessments by Obstetric USS, NR and DS were all reliable, and Obstetric USS performed effectively relative to combined NR and DS.

Jordan＇s King Hussein＇s Peace Initiative and the Treaty with Israel： Overcoming Domestic and Foreign Pressures

The Wadi ＇Araba peace treaty which Jordan＇s King Hussein signed with Israel on October 26, 1994 became a target of criticism ever since it became known to the Jordanian public. Intense pressure was exerted on the Jordanian government to revoke the treaty even before its signature. The opposition to it reached its peak in the following year, when the tension in the holy sites in Jerusalem mounted. Given the persistence of the Arab-Israeli conflict and the fact that the Palestinian issue remained unresolved, it was clear that the King was aware of the potential danger of signing a peace accord with Israel, and that he was prepared to face criticism not only from the Arab states but also from nationalists, Islamists and Leftists all of whom disapproved of his decision. Yet the King remained undeterred and boldly carried on the discussions that culminated in the peace treaty＇s signature. Bearing in mind the fact the Egypt was the first country to sign a peace treaty with Israel it seemed as if there was little risk involved in the normalization process, and that the opposition to the treaty would soon subside. As it turned out, however, the pressure to abrogate it continues to mount.

＂From a Utopia to a Dystopia＂ On Mark Twain＇s Compliance with and Deviation from Heterotopology in A Connecticut Yankee in King Arthur＇s Court

In this paper, the author intends to parallelize Mark Twain＇s A Connecticut Yankee in King Arthur＇s Court with Foucault＇s theorizations about heterotopia, or heterotopology. For Foucault, heterotopia is a paradox because it is paces that are both real and placeless. Twain＇s novel is a time travel story, which juxtaposes the temporalities of the 6th and 19th centuries. In the story, Hank, the hero, is allowed access to Camelot, King Arthur＇s court. Above all, he has introduced to it quite a few elements of modem technology and civilization. So far Twain seems to have complied with Foucault＇s heterotopology. That is, there is a textual heterotopia created in his novel. However, the last principle of Foucault＇s heterotopology states that a heterotopia can be comparable to a utopia because of its contrastive function. A typical time travel story has the same contrastive function as well. That is, in either case there should be a utopia, a dystopia, or a mixture of them. However, Twain＇s novel fails to contrast the 6th century with the 19th century simply because the heterotopia Hank has created leaps from a utopia to a dystopia. It is at this point where Twain has deviated from heterotopology. The shifting nature of this heterotopia not only disables its contrastive mechanism but also jeopardizes its thematic clarity. Most of all, it indicates that Twain has a considerably ambivalent attitude towards the industrial civilization, and that as a consequence, he is indecisive about the direction of this novel.

臂丛颈丛神经阻滞麻醉联合瑞芬太尼在锁骨骨折中的应用及对OAA/S评分、VAS评分的影响

目的:观察臂丛颈丛神经阻滞麻醉联合瑞芬太尼用于锁骨骨折手术的效果。方法:选取吉安市永丰县中医院2019年1月~2022年11月就诊的锁骨骨折患者140例为研究对象,按照收治的先后顺序随机分为试验组和对照组各70例,对照组予以臂丛颈丛神经阻滞麻醉,试验组在对照组基础上加用瑞芬太尼。记录两组麻醉前(T0)、臂丛颈丛神经阻滞麻醉后15 min(T1)、辅助用药后3 min(T2)、手术开始后5 min(T3)、手术开始后15 min(T4)、手术结束时(T5)的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO 2)。同时观察两组期间的不良反应以及血管活性药麻黄碱、阿托品、尼卡地平以及艾司洛尔的例数。比较两组患者麻醉满意度的差异。结果:对照组T2时血压降低、心率减慢均不明显,与T0比较差异无统计学意义(P>0.05)。试验组T3、T4时血压升高、心率增快明显,与T0和对照组比较差异有统计学意义(P<0.05)。试验组T2血压降低、心率减慢明显,与对照组和T0比较差异有统计学意义(P>0.05),随后趋于平稳。试验组血管活性药物尼卡地平以及艾司洛尔的例数少于对照组,差异有统计学意义(P<0.05)。两组视觉模拟评分(VAS)及镇痛效果满意率比较差异有统计学意义(P<0.05)。结论:臂丛颈丛神经阻滞麻醉联合瑞芬太尼用于锁骨骨折切开复位内固定手术,镇静镇痛效果确切,呼吸循环稳定,患者麻醉满意度高,是一种安全、有效的麻醉方法。

Re-Formulation of Mean King’s Problem Using Shannon’s Entropy

Mean King’s problem is formulated as a retrodiction problem among noncommutative observables. In this paper, we reformulate Mean King’s problem using Shannon’s entropy as a first step of introducing quantum uncertainty relation with delayed classical information. As a result, we give informational and statistical meanings to the estimation on Mean King problem. As its application, we give an alternative proof of nonexistence of solutions of Mean King’s problem for qubit system without using entanglement.

TCL——King Brand Colour TV Rivals the World's Famous Brands

World famous colour TVs,such asSony,National and Toshiba,usedto monopolize China’s large-screencolour TV market.But recently the KingBrand colour TV made by the TCL ElectronicsGroup has begun to challenge them.In1995,the TCL King Brand colour TV notonly ranked first for its sales volume on theChinese market among the domestically-produced TVs of its kind,but also

An Analysis of Shakespeare's Treatment of Women in King Lear

This paper analyzes Shakespeare’s different treatment of the male and female antagonists Edmond and Goneril in King Lear from their entrance,actions and ending,aiming at exploring his attitude toward women through the comparative studies of these two equally evil characters with different gender.Through the analysis,the author found that Shakespeare’s treatment of women is different from that of men.He is less tolerant and mercy to women than to men,from which a conclusion can be drawn that Shakespeare cannot totally get rid of the traditional conceptions that women is inferior than men even though he is a humanist.