A Study on the Application of TBA in College English Teaching
肝功能生化检验在诊断肝炎肝硬化患者中的临床应用价值
①厦门大学附属第一医院 福建 厦门 361003通信作者：郑燕青肝功能生化检验在诊断肝炎肝硬化患者中的临床应用价值赵元勋① 郑燕青①【摘要】 目的：探讨肝功能生化检验在诊断肝炎肝硬化患者中的临床应用价值。
方法：选择2022年1—12月厦门大学附属第一医院收治的肝炎肝硬化患者60例，设为观察组，选择同时段入院进行体检的健康人士60例，设为对照组，均进行肝功能生化检验，比较研究对象的肝功能指标，与此同时对比观察组中不同肝功能患者的总胆汁酸（TBA）、白蛋白（ALB）、总胆固醇（TC）、血清胆碱酯酶活性（CHE）、谷氨酰转肽酶（GGT）等指标，统计观察组各级患者肝功能生化检验阳性检出率。
结果：与对照组比较，观察组TBA、GGT 指标均明显高，差异均有统计学意义（P <0.05），ALB、TC、CHE 指标均明显低，差异均有统计学意义（P <0.05）。
在各级别肝炎肝硬化患者中，A 级与C 级患者的TBA、GGT、ALB、TC、CHE 差异均有统计学意义（P <0.05），其中C 级患者TBA、GGT 最高，ALB、TC、CHE 最低，而B 级患者各项指标居中。
在阳性检出率方面，TC 检测在B 级、C 级患者中阳性检出率达到100%，CHE 指标则在所有肝炎肝硬化患者中的阳性检出率为100%。
结论：采用肝功能生化检验指标为肝炎肝硬化患者进行诊断，检测方便，可为疾病诊断及疾病发展程度提供参考。
【关键词】 肝功能生化检验 肝炎肝硬化 肝功能指标 阳性检出率 临床诊断 Clinical Value of Biochemical Examination of Liver Function in the Diagnosis of Hepatitis and Cirrhosis/ZHAO Yuanxun, ZHENG Yanqing. //Medical Innovation of China, 2023, 20(22): 127-131 [Abstract] Objective: To investigate the clinical application value of biochemical examination of liver function in the diagnosis of patients with hepatitis cirrhosis. Method: Sixty patients with hepatitis cirrhosis admitted to the First Affiliated Hospital of Xiamen University from January to December 2022 were selected as the observation group, and 60 healthy people admitted for physical examination at the same time were selected as the control group. Biochemical examination of liver function were performed on 120 subjects to compare liver function indexes of the subjects. At the same time, total bile acid (TBA), albumin (ALB), total cholesterol (TC), serum cholinesterase activity (CHE), glutamyl transpeptidase (GGT) and other indicators of patients with different liver functions in the observation group were compared. Finally, the positive detection rates of liver function biochemical examination of patients at all levels in the observation group were statistically analyzed. Result: Compared with the control group, TBA and GGT indexes were significantly higher than those in the observation group (P <0.05), and ALB, TC and CHE indexes were significantly lower (P <0.05). Among hepatitis cirrhosis patients of all levels, TBA, GGT, ALB, TC and CHE of grade A and grade C patients were significantly different (P <0.05), among which grade C patients had the highest TBA and GGT, and the lowest ALB, TC and CHE, while grade B patients were in the middle. In terms of positive detection rate, TC detection rate reached 100% in grade B and grade C patients, and CHE index detection rate was 100% in all patients with hepatitis cirrhosis. Conclusion: The biochemical test of liver function is used to diagnose patients with hepatitis cirrhosis. The detection is convenient and can provide reference for disease diagnosis and disease development. [Key words] Biochemical examination of liver function Hepatitis cirrhosis Liver function indexes Positive detection rate Clinical diagnosis First-author's address: The First Affiliated Hospital of Xiamen University, Xiamen 361003, China doi：10.3969/j.issn.1674-4985.2023.22.030 肝炎是临床上常见的疾病，主要因为患者受到肝炎病毒侵蚀感染而引发，一旦未得到及时有效的治疗，患者肝脏部位遭到炎症的长时间影响，功能性损伤，就会逐渐出现食欲减退、乏力、静脉曲张等症状，若不及时诊治，病情可能会发展至肝纤维化甚至肝硬化，严重影响人们生存质量和身体健康[1]。
儿童颅内蛛网膜囊肿诊断及治疗研究进展
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v i r u l e n c eg e n e s o f c a r i o ge n i c o r a l p a t h o g e n S t r e p t o c o c c u s m u t a n s [J ].A r c h O r a l B i o l ,2020,116:104762.(收稿日期:2021-11-18 修回日期:2022-02-11)ә通信作者,E -m a i l :z h a i x u a n @163.c o m ㊂㊃综 述㊃儿童颅内蛛网膜囊肿诊断及治疗研究进展陈晓棋综述,翟 瑄ә审校(重庆医科大学附属儿童医院/国家儿童健康与疾病临床研究中心/儿童发育疾病研究教育部重点实验室/儿科学重庆市重点实验室,重庆400014) [摘 要] 颅内蛛网膜囊肿(I A C s )分为先天性与后天性,大多数不能自行消散,且无明显临床表现㊂不同位置的I A C s 症状稍有不同,其严重程度与囊内压力显著相关㊂对于I A C s 的治疗方式,目前尚存在争议,神经内镜手术治疗因其住院时间短㊁手术创伤小㊁中出血少㊁长短期并发症少成为目前首选治疗方式㊂该文对I A C s的相关研究进行了综述,旨在为I A C s 的临床诊疗提供一定帮助㊂[关键词] 儿童; 蛛网膜囊肿; 临床特点; 神经内镜治疗D O I :10.3969/j.i s s n .1009-5519.2022.09.023中图法分类号:R 726.1文章编号:1009-5519(2022)09-1535-06文献标识码:A儿童颅内蛛网膜囊肿(I A C s)发生率为1%~3%,影像学检查发现该疾病的概率为2.6%[1]㊂I A C s 好发于中颅窝,其次为鞍上池㊁后颅窝㊁前颅窝等,其他位置如硬膜下等较少见[2-3]㊂多数情况下,㊃5351㊃现代医药卫生2022年5月第38卷第9期 J M o d M e d H e a l t h ,M a y 2022,V o l .38,N o .9I A C s患儿参加体育活动是安全的[4]㊂87.6%的I A C s患儿无明显临床症状,头部创伤后偶然发现I A C s的概率为0.4%,I A C s在影像学随访上呈现为较低概率的囊肿增大[5-6],大部分不能自行消散,关于自行消失的文献报道较少见[7-8]㊂本文对I A C s发生机制㊁临床及影像学表现㊁手术指征㊁鉴别诊断及治疗进展进行了综述㊂1概述I A C s可分为先天性和后天性㊂先天性I A C s因先天性胚胎发育异常,导致蛛网膜分离或复制,包裹囊液而形成,并可沿神经轴的任何地方发生;后天性I A C s多因头部创伤㊁炎症㊁颅内出血或手术创伤等引起[2,9-11]㊂MA T U S H I T A等[12]的研究显示,产前发现胎儿I A C s的概率为0.003%~0.008%,而产后为0.230%~3.500%,提示生产过程中的脑损伤(如使用产钳)会导致I A C s的发生㊂关于囊肿增大的机制,有以下几方面的解释㊂(1)分子层面上为囊壁分泌机制㊂有研究显示,编码N a-K-2C L协同转运蛋白1 (N K C C1)的基因表达在A C基底膜与顶侧膜显著上调[13]㊂共转运机制可使N K C C1蛋白不依赖浓度梯度进行水转运,其透水性与水通道蛋白相当,从而导致囊内液体量增加㊂B E R L E等[14]对蛛网膜囊肿液和脑脊液蛋白质进行定量比较时发现了46个有显著差异的蛋白质,可能提示膜壁分泌机制或选择性转运导致囊肿增大㊂(2)组织结构层面上为单向活瓣机制㊂在北京天坛医院统计的247例鞍上池蛛网膜囊肿(S A C)患儿中,213例存在单向活瓣[15]㊂另有研究显示,82.4%的S A C患儿存在活瓣[16]㊂因此,单向活瓣机制可能存在于部分I A C s患儿中㊂2临床与影像学表现I A C s常见的临床症状与囊肿占位效应及囊肿破裂出血有关,表现为颅骨进行性隆起或变薄㊁脑积水㊁头痛㊁呕吐㊁癫痫发作㊁精神运动迟缓和失语症㊂颅内不同部位所表现的症状略有不同,术前症状的严重程度与囊内压力显著相关[17]㊂癫痫常见于颞叶蛛网膜囊肿,关于癫痫发作与I A C s存在确切联系的研究较少见㊂在脑电图方面,I A C s患儿发作期与发作间期定位可能与I A C s位置不一致;在磁共振波谱方面, I C A s和对侧对照区相邻组织之间的N-乙酰天冬氨酸/肌酸㊁胆碱/肌酸和肌醇/肌酸比率无显著差异,但术后I A C s大小变化确与癫痫症状改善相关[17-21]㊂S A C在婴儿中主要表现为巨颅症和运动障碍,儿童和青少年的主要表现为颅内压升高㊁内分泌功能障碍和视力㊁视野缺陷㊂S A C患儿需长期随访内分泌功能,必要时应进行相应治疗㊂韩国首尔大学医学院报道的14例S A C患儿在初诊及治疗时无内分泌症状,晚期却出现性早熟和生长激素缺乏等内分泌异常[22-23]㊂后颅窝蛛网膜囊肿(P F A C)通常表现为无症状或非特异性症状,偶有患儿表现为后组脑神经㊁小脑㊁锥体征等相关特异性症状㊂有研究显示,P F A C患儿表现出斜颈畸形㊁胃食管反流综合征[24-25]㊂此外,P F A C可能对颞叶的功能活动产生影响,从而表现出行为和学习障碍㊁社交困难[26]㊂侵蚀颅底并延伸至鼻旁窦的I A C s患儿,可表现为鼻漏和鼻腔症状[27]㊂有研究显示,无明显症状体征的I A C s患儿神经心理学测试评分低于健康人群,提示I A C s可影响患儿认知㊁情感水平[28-29]㊂至于I A C s破裂引起的症状,常与头部创伤史㊁囊肿大小(直径大于5c m)有关,且好发于中颅窝[30]㊂有症状性I A C s患儿破裂率为4.6%,而中颅窝蛛网膜囊肿(M C F A C)破裂率较高,为12%[31-32]㊂M C F A C易破裂的原因之一可能是囊肿外壁较正常脑受到更大的剪切力[33]㊂M C F A C患儿磁共振成像(M R I)检查表现为长T1㊁长T2信号,与脑脊液信号一致,边界清晰,增强囊壁无强化㊂C T扫描表现为与脑脊液等密度㊁边界清楚的占位病变,囊肿压力增高者挤压周边结构时可表现为局部颅骨变薄㊁膨隆,以及脑室受压推移及中线移位等㊂有研究发现,左侧M C F A C组右侧顶上小叶㊁角回㊁缘上回㊁岛盖部及左侧枕叶皮层厚度较对照组增厚,提示I A C s会影响邻近脑组织功能,从而导致对侧代偿[34]㊂3手术指征O K A N O等[11]认为,M C F A C手术指征为有症状的G a l a s s iⅡ㊁Ⅲ型,并且有M R I证据提示囊肿可通过造瘘与基底池沟通,其中G a l a s s i分型Ⅰ型为囊肿小,呈纺锤状,局限于中颅窝前部,与周边脑池沟通;Ⅱ型为沿外侧裂向上延伸,颞叶移位,与周边脑池不沟通;Ⅲ型为囊肿巨大,充满整个中颅窝,额/颞/顶叶移位,与周边脑池不沟通,颅骨受压变薄/凸起㊂G U I 等[35]认为,进展性扩大的囊肿㊁首次内镜手术后症状加重或囊肿体积大的患儿需要积极治疗㊂C O P L E Y 等[36]认为,内镜手术为有症状或无症状但囊肿进行性增大I A C s的一线治疗方式㊂C O U V R E U R等[3]研究发现,有颅内高压㊁急性神经功能缺失㊁巨脑为症状的I C A s患儿术后效果较好,但对于有行为问题㊁精神运动迟缓的I C A s患儿则效果不佳㊂因此,有明确症状的患儿或提示囊肿进行性增大的患儿建议手术[11,37]㊂此外,就诊年龄较小㊁囊肿较大为手术的预测因素[38]㊂4鉴别诊断I A C s需与神经肠囊肿㊁先天性脑膜膨出㊁脑膜血管瘤相鉴别,建议行手术治疗的I A C s患儿应取局部组织做病理学检查㊂有文献报道过1例4年后癫痫复发误诊为I C A s的神经肠囊肿患儿[39]㊂神经肠囊肿理想治疗方法为完全切除,部分切除存在复发可能㊂I A C s有可能延伸到颅外,A N B A Z H A G A N 等[40]报道过1例三脑室囊肿跨越幕下和幕上间隙,并疝入颅外间隙的蛛网膜囊肿患儿,其中颅外部分被认为是先天性脑膜膨出㊂此外,文献还报道了表现为症㊃6351㊃现代医药卫生2022年5月第38卷第9期J M o d M e d H e a l t h,M a y2022,V o l.38,N o.9状性M C F A C的脑膜血管瘤患者,脑膜血管瘤在影像学上区别于I A C s表现为T2等或高信号[41]㊂以上几种情况发生率低,因此需要病理学检查辅助诊断㊂5治疗目前,关于I A C s的手术方式主要有3种,分别为神经内镜下囊肿造瘘术㊁C-P分流术及显微镜下囊肿壁切除术㊂3种手术方式的临床与放射学改善率相似㊂神经内镜手术患儿住院时间最短,且短期并发症(硬膜外血肿㊁硬膜下积液㊁偏瘫㊁神经麻痹㊁脑膜炎㊁脑脊液漏和伤口感染等)或长期并发症(复发或失败㊁感染㊁梗阻性分流失败㊁分流感染㊁分流功能不全㊁分流依赖㊁分流阻塞㊁心理影响等)发生率低[42-43]㊂囊肿造瘘后体积可达到平衡状态,于术后7个月维持稳定[44-45]㊂术中除头痛㊁呕吐等常见症状在术后能缓解外,认知功能㊁神经症状可得到改善[46]㊂不同学者对神经内镜下囊肿造瘘术提出了各自的建议:(1)增加造瘘口面积,最好选择浅蓝色或白色㊁半透明样鼓起的囊壁造瘘[47],在不损伤神经血管前提下,造瘘口面积应足以沟通囊肿与第三脑室或侧脑室,同时尽可能扩大造瘘口面积,防止囊肿再次形成及脑积水发生[10]㊂(2)术中应避免出血并及时清理血凝块,出血不仅影响手术视野,也会引起术后高热㊁脑膜刺激等不良反应,此外还可能导致造瘘口堵塞或诱发炎性反应导致造瘘口早期闭塞㊂L I等[48]认为,出血导致的并发症是内镜治疗的最大弊端,因此应在术中及时清除血凝块㊂(3)对于囊壁内侧膜的造瘘口可能靠近于大脑中动脉分支与斜裂池之间的患儿不建议行内镜手术,并且造瘘失败的患儿也不适合在同一位置反复造瘘[11]㊂(4)对于S A C,脑室囊肿脑池造瘘术(V C C)优于脑室囊肿造瘘术㊂一项m e t a分析显示,V C C相对于脑室囊肿造瘘术能更好地改善S A C患儿临床症状,降低手术失败率[15,44]㊂合并P F A C和小脑扁桃体下疝的患儿,外科治疗不应以囊肿完全消失或扁桃体疝完全缓解为目标,而应以恢复脑脊液在后颅窝的流动及脑室㊁囊肿和蛛网膜下腔之间的动态平衡为主要目的[49]㊂6相关研究进展6.1新辅助检查与药物应用 T B A K OW等[50]尝试在21例S A C患儿术中造瘘前后行磁共振囊肿造影,结果显示,术中磁共振囊肿造影是安全的,术中可清楚地显示囊肿的形态㊂在药物治疗方面,B E I等[51]曾用阿托伐他汀治疗1例M C F A C破裂并反复发展成硬膜下血肿患儿,经3个月随访,患儿血肿消失㊂有研究发现,阿托伐他汀通过增强血管生成和减少炎性反应来减少硬膜下血肿的形成[52]㊂6.2手术进展对于1例经囊肿腹腔引流㊁囊壁与脑室造瘘手术干预2月后症状无缓解的横跨额颞顶叶巨大I C A s患儿,G HO R B A N I等[53]首次使用了神经血管支架维持造瘘口通畅,术后随访4年,患儿症状明显改善,且囊肿缩小㊂L I B Y等[54]对1例12个月大的巨大型P F A C患儿非常规利用了经前额㊁导水管的通道行囊肿造瘘和第三脑室造瘘,术后患儿症状明显好转㊂为了使S A C患儿造瘘口面积达到理想大小,F U J I O等[55]首次尝试了双通道路径,于术中分别使用2个内镜进行操作,在活动度好的内镜下提囊肿壁,在较固定的内镜下剪囊壁,并顺利完成手术㊂术后随访,患儿术后无明显并发症,且1年后患儿囊肿已部分消失㊂虚拟内镜可对I C A s的决策起到一定帮助㊂L I等[56]研究显示,虚拟内镜所呈现的视野与手术中的视野相似度有81%㊂因此,对于手术难度大㊁手术风险高的患儿,可事先使用虚拟内镜进行练习与术前决策㊂7小结I A C s为颅内良性占位病变,采用神经内镜手术具有较佳治疗效果,对于有明确症状或囊肿进行性增大的I A C s患儿应积极手术治疗㊂参考文献[1]C A N D E L A S,P U E R T A P,A L AMA R M,e ta l.E p i d e m i o l o g y a n d c l a s s i f i c a t i o n o f a r a c h n o i dc y s t s i n c h i ld re n[J].N e u r o c i r u g i a,2015,26(5):234-240.[2]L I L,A L I M,M E N E Z E S A H,e t a l.I n t r a c r a n i-a l e x t r a d u r a l a r a c h n o i d c y s t i n a c h i l d[J].C h i l d s N e r v S y s t,2017,33(12):2201-2204.[3]C O U V R E U R T,H A L L A E R T G,V A N D E 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h n o i d c y s t s [J ].W o r l d N e u r o s u r g ,2016,88(4):76-82.(收稿日期:2021-06-27 修回日期:2022-01-18)ә通信作者,E -m a i l :345505491@q q.c o m ㊂㊃综 述㊃年轻乳腺癌诊断延迟影响因素及现状叶 丹1综述,李 勇1,林 琅2,罗 静2,袁业伟2ә审校(1.资中县妇幼保健计划生育服务服务中心,四川内江641000;2.四川省妇幼保健院,四川成都610045) [摘 要] 目前年轻乳腺癌发生率呈逐年上升趋势㊂年轻乳腺癌恶性程度高,延迟诊断会导致确诊时多为晚期㊂为改善年轻乳腺癌患者预后,提高年轻乳腺癌早期诊断率,该文对近年来有关年轻女性乳腺癌诊断延迟影响因素的研究进行了综述㊂[关键词] 年轻女性; 乳腺癌; 诊断延迟; 综述D O I :10.3969/j.i s s n .1009-5519.2022.09.024中图法分类号:R -1文章编号:1009-5519(2022)09-1540-04文献标识码:A乳腺癌是40岁以下女性最常见的恶性肿瘤,每年全世界新发病例约24.4万;乳腺癌也是40岁以下女性癌症死亡的第二大原因,每年全世界死亡44800例[1]㊂对于年轻女性,乳腺癌总发生率虽然较低,但呈增高趋势㊂欧洲40岁以下女性乳腺癌发生率每年增加约1.2%,其中35岁以下女性人群明显增加㊂在美国20~40岁女性乳腺癌患者占乳腺癌患者的比例从20%增加至40%以上[2]㊂我国乳腺癌发生率也呈现年轻化趋势,30~50岁女性乳腺癌发生率和病死率的增长趋势较显著[3]㊂2020年欧洲肿瘤学院和欧洲医学学会(E S O -E S MO )‘年轻女性乳腺癌国际共识指南“将年轻乳腺癌定义为年龄小于40岁的乳腺癌患者[4]㊂年轻乳腺癌发病原因尚未清楚,但危险因素多,如家族史㊁初潮年龄㊁吸烟史㊁长期服用避孕药及不良的生活方式等㊂目前,我国年轻乳腺癌患者存在就诊时间晚㊁确诊时多数为晚期㊁肿瘤T NM 分级靠后㊁激素受体阳性率低㊁易复发㊁预后较差等特点[5]㊂因此,为了提高年轻乳腺癌的早期诊断率,改善患者预后,本文对近年来有关年轻女性乳腺癌延迟诊断影响因素的研究进行了综述㊂1 延迟概念及分类根据英联邦工作组制定的奥胡斯声明 ,从患者首次发现可疑症状到确诊后开始治疗这一段时间称为延迟,其可分为诊断延迟和治疗延迟㊂诊断延迟指患者从首次发现可疑症状至首次确诊疾病这一段时间,包括就诊延迟和医疗系统延迟㊂患者从首次发现可疑症状至首次去医疗机构就诊时间间隔称为就诊延迟;患者从首次去医疗机构就诊至确诊疾病时间间隔称为医疗系统延迟㊂治疗延迟指患者从确诊疾病至开始治疗的时间间隔[6-8]㊂2019年,L I 等[9]对1433例中国乳腺癌患者进行回顾性研究时发现,56.6%的患者为就诊延迟,4.6%的患者为医疗系统延迟,2.9%的患者为治疗延迟㊂由此可见,诊断延迟是导致我国乳腺癌延迟的主要因素㊂2 诊断延迟现状随着全世界年轻乳腺癌发生率的逐年上升,年轻患者呈现出延迟情况,特别是发展中国家的年轻乳腺癌患者发生延迟的情况较明显㊂大量研究证实,年轻乳腺癌具有更强的侵袭性㊁较高的病理分级和不良的激素状,可影响患者预后和生存㊂P A R T R I D G E㊃0451㊃现代医药卫生2022年5月第38卷第9期 J M o d M e d H e a l t h ,M a y 2022,V o l .38,N o .9。
高二英语科学创新案例精彩单选题40题及答案
高二英语科学创新案例精彩单选题40题及答案1.In the scientific innovation project, the researchers need to ______ data carefully.A.collectB.gatherC.accumulateD.harvest答案：A。
“collect”侧重于有目的、有计划地收集；“gather”强调把分散的东西集中到一起；“accumulate”着重逐渐地、连续不断地积累；“harvest”主要指收获庄稼等。
在科学创新项目中，研究者有目的地收集数据，所以选“collect”。
2.The new scientific innovation ______ a breakthrough in technology.A.representsB.symbolizesC.indicatesD.implies答案：A。
“represents”表示代表、象征；“symbolizes”侧重以象征的方式表达；“indicates”指表明、暗示；“implies”暗示、含有……的意思。
新的科学创新代表着技术上的突破，所以选“represents”。
3.Scientific innovation often requires ______ thinking.A.creativeB.imaginativeC.inventiveD.original答案：A。
“creative”强调有创造力的；“imaginative”富有想象力的；“inventive”善于发明创造的；“original”有独创性的。
科学创新通常需要有创造力的思维，所以选“creative”。
4.The success of scientific innovation depends on ______ cooperation.A.teamB.groupC.collaborativeD.joint答案：D。
高二英语科研项目实施练习题50题(答案解析)
高二英语科研项目实施练习题50题(答案解析)1.In our research project, we need to analyze ______ data.A.aB.anC.theD./答案解析：C。
本题考查定冠词的用法。
这里表示特指在我们的科研项目中需要分析的那些数据，所以用定冠词the。
选项 A 和B 用于泛指一个可数名词单数，此处data 是不可数名词且不是泛指一个；选项D 不填冠词的话意思不明确。
2.The number of participants in our scientific research project is ______.A.two hundredsB.two hundredC.hundreds ofD.hundred of答案解析：B。
本题考查数词的用法。
表示具体数字时hundred 不用复数，也不和of 连用，所以two hundred 正确。
选项A 错误；选项C 和D 是表示不确定的“数百”，此处题干是具体数字。
3.There are ______ kinds of methods used in our research.A.aB.anC.theD.several答案解析：D。
本题考查数词和量词的用法。
several 表示“几个、一些”，可以修饰可数名词复数kinds。
选项 A 和 B 用于可数名词单数；选项C 定冠词the 不符合语境。
4.We need to collect ______ sample for our research.A.aB.anC.theD./答案解析：A。
本题考查不定冠词的用法。
sample 是可数名词单数，且此处表示“一个样本”，用不定冠词a。
选项 B 用于元音音素开头的单词前；选项C 定冠词the 表示特指；选项D 不填冠词时用法不对。
5.Our research project involves ______ steps.A.a fewB.a littleC.fewD.little答案解析：A。
细化中药涂药技术干预慢性胆汁淤积性肝病患者皮肤瘙痒的护理效果评价
http ：/ / 中西医结合护理Chinese Journal of Integrative Nursing2024 年第 10 卷第 1 期Vol.10， No.1， 2024OPEN ACCESS细化中药涂药技术干预慢性胆汁淤积性肝病患者皮肤瘙痒的护理效果评价李雪， 赵海芹， 白丽荣， 刘晓静（首都医科大学附属北京地坛医院 中西医结合一科， 北京， 100102）摘要： 目的 观察细化关键技术操作环节的中药涂药疗法干预胆汁淤积性肝病患者皮肤瘙痒症状的效果，提升中医肝病专科护理质量。
方法 选取2021年1月—2022年12月医院收治的慢性胆汁淤积性肝病并发皮肤瘙痒症患者112例为研究对象，将患者随机分为对照组55例和中药组57例。
结合患者皮肤瘙痒症状常出现的时间、频率及温度对其瘙痒程度影响的特点，对涂药前清洁皮肤水温的设定和涂药时间进行细化研究。
在此基础上，采用中药涂药技术干预两组患者皮肤瘙痒症状，分别给予对照组炉甘石洗剂和中药组清热利湿止痒方外涂进行干预。
对比两组患者护理效果。
结果 中药组护理干预愈显率80.70%（46/57），高于对照组的40%（22/55），差异有统计学意义（P ＜0.01）。
干预后，中药组总胆红素（TBIL ）和总胆汁酸（TBA ）水平低于对照组，差异有统计学意义（P ＜0.01）；与对照组比较，中药组瘙痒程度积分降低，瘙痒持续时间缩短，差异有统计学意义（P ＜0.01）；中药组患者睡眠时间较对照组延长，但差异无统计学差异（P ＞0.05）；中药组皮损状态积分低于对照组，差异有统计学意义（P ＜0.05）；中药组皮肤干燥情况改善优于对照，差异有统计学意义（P ＜0.01）。
结论 临床护理慢性胆汁淤积性肝病患者皮肤瘙痒症状时，采用细化后的中药涂药技术涂抹清热利湿止痒方效果良好，有助于提高治疗效果，改善患者生活质量。
关键词： 胆汁淤积性肝病； 皮肤瘙痒； 症状护理； 中药涂药； 炉甘石洗剂中图分类号： R 248.1 文献标志码： A 文章编号： 2709-1961（2024）01-0066-05Effect of modified Traditional Chinese Medicine externalapplication in the treatment of pruritus in patients withchronic cholestatic liver diseaseLI Xue ，ZHAO Haiqin ，BAI Lirong ，LIU Xiaojing（First Department of Integrative Medicine ， Beijing Ditan Hospital Capital Medical University ， Beijing ， 100102）ABSTRACT ： Objective To observe the effect of modified Traditional Chinese Medicine exter⁃nal application in the treatment of pruritus in patients with chronic cholestatic liver disease ， and to improve the quality of Tradition Chinese Medicine nursing of liver diseases.Methods Totally 112 patients with chronic cholestatic liver disease complicated with pruritus were randomly divid⁃ed into the control group （n =55） and Traditional Chinese Medicine （TCM ）group （n =57）. Ac⁃cording the occurrence time ， frequency and influence of skin temperature on itch ， the Traditional Chinese Medicine external application method was modified. Modified Traditional Chinese Medi⁃cine external application with calamine lotion and Qingre -Lishi -Zhiyang recipe was carried out in the control group and TCM group ， respectively. The effect of nursing interventions was measured and compared between two groups.Results The rate of cured and remarkably improved outcome in the TCM group was 80.70%（46/57） and 40%（22/55）in the control group ， with a significant difference （P ＜0.01）. The levels of total bilirubin （TBIL ） and Total bile acid （TBA ）in the TCM group were lower than those in the control group after intervention （P ＜0.01）. A lower pruritus symptom score and shorter duration of itching were found in the TCM group compared with those in the control group （P ＜0.01）. Patients in the TCM group had a longer sleep time comparedDOI ： 10.55111/j.issn 2709-1961.202308019· 中医特色护理 ·收稿日期：2023-08-19基金项目：北京地坛医院青年人才发展基金“萌芽”支持计划项目（DTMY201814）··66Vol.10， No.1， 2024Chinese Journal of Integrative NursingOPEN ACCESShttp ：/ / with that in the control group after nursing intervention （P ＞0.05）. The lesion symptom score in the TCM group was lower than that in the control group （P ＜0.01）. A better improvement of dry skin was observed in the TCM group compared with that in the control group after intervention （P ＜0.01）.Conclusion The modified Traditional Chinese Medicine external application with Qin⁃gre -Lishi -Zhiyang recipe is effective in the treatment of pruritus in patients with chronic cholestat⁃ic liver disease.KEY WORDS ： cholestatic liver disease ； pruritus ； symptom -based nursing ； Traditional Chinese Medicine external application ； calamine lotion 各种原因使肝脏病变导致胆汁淤积为主要表现的肝胆疾病统称胆汁淤积性肝病，其临床表现主要有黄疸、皮肤瘙痒、疲劳等［1］。
高等学校英语应用能力考试A级全真试题6月含答案详解
高等学校英语应用能力考试A级全真试题6月含答案详解高等学校英语应用能力考试A级全真试题6月含答案详解高等学校英语应用能力考试6月A级试卷Part I Listening Comprehension (15minutes)Directions:This part is to test your listening ability. It consists of 3 sections.Section ADirections: This section is to your ability to understand short dialogues .There are 5 recorded dialogues in it .After each dialogue ,there is recorded question .Both the dialogues and questions will be spoken only once. When you hear a question ,you should decide on the correct answer form the 4 choices marked A),B) ,C) and D) given in your test paper .Then you should mark the corresponding letter on the Answer Sheet with a single line through the center .Example: You will hear:You will read: A) New York City. B) An evening party.C) An air trip.D) The man’s job.From the dialogue we learn that the man is to take a flight to New York. Therefore, C) An air trip is the correct answer. You should mark C) on the Answer Sheet with a single line through the center. 【A】【B】【C】【D】Now the test will begin.1. A.A football game. B. A rock concert.C. A new film.D. A talk show.2.A. A computer programmer. B. An office secretary.C. An assistant manager.D. A chief engineer.3. A. In a bookstore. B. Ina library.C. In a supermarket.D. In a restaurant.4. A. Cash a check. B. Open an account.C. Change some money.D.Make a deposit.5. A. He is selling a product. B. He is looking for a job.C. He is making a welcome speech.D. He is interviewing a job applicant.Section BDirections:This section is to test your ability to understand short conversations. There are 2 recorded conversations in it. After each conversation, there are some recorded questions. Both the conversations and questions will be spoken two times. When you hear a question, you should decide on the correct answer from the 4 choices marked A), B), C) and D) given in your test paper. Then you should mark the corresponding letter on the Answer Sheet with a single line through the center.Conversation 16. A. Buying a knife. B. Having a security check.C. Looking for his luggage.D. Bookinga flight ticket.7. A. As a gift for his brother. B. As a bottle opener.C. As a weapon.D. As a souvenir.8. A. Leave it at the airport. B. Give it to his friend.C. Take it with him.D. Throw it away.9. A. At 14:35. B. At 15:35. C. At 16:35. D. At 17:35.10. A. A weekly ticket. B. A single ticket.C. A monthly ticket.D. A return ticket.Section CDirections: This section is to test your ability to comprehend short passages. You will hear a recorded passage. After that you will hear five questions. Both the passage and the questions will be read two times. When you hear a question, you should complete the answer to it with a word or a short phrase (in not more than 3 words). The questions and incomplete answers are printed in your test paper. You should write your answers on the Answer Sheet correspondingly. Now listen to the passage.11. What is the question the speaker tries to answer?How to ___ __ _ in a job interview.12. What is the most important thing for a job interview?To arrive __ ____.13. Why shouldn’t you be nervous?Because it may affect your __ ____.14. Why does the speaker think being confident in a job interview is also important?Because it can bring you to ____ __.15. What is the last piece of advice from the speaker?Be honest about yourself and never tell _ _____.Part II Structure (15 minutes)Directions: This part is to test your ability to construct grammatically correct sentences. It consists of 2 sections.Section ADirections: In this section, there are 10 incomplete sentences. You are required to complete each one by deciding on the most appropriate word or words from the 4 choices marked A), B), C) and D). Then you should mark the corresponding letter on the Answer Sheet witha single line through the center.16.The service there was ____ poor that we went to another restaurant down the street.A. soB. suchC. veryD. too17. It was soon after the economic crisis _____sales of e-business started to grow.A. whyB. howC. whereD. that18. ______ we receive your application, we’ll send you an e-mail to confirm it.A. OnceB. WhateverC. WhetherD. However19. Make a list of what you have to do and put the items ______ order of importance.A. onB. inC. forD. about20.When you have filled in the form, keep the top part and send _____ part to the bank.A. othersB. otherC. the otherD. the others21. All our: spare parts are guaranteed if you have your car ______ with us each year.A. servicedB. be servicingC. to serviceD. servicing22.We are confident that we ___ our export sales by 15 percent by the end of this year.A. increaseB. had increasedC.would increase D. will have increased 23. If you leave your preparation ______ the last minute, you’ll reduce your chances of passing the exam.A. atB. withC. overD. until24. Only after we really understand your business _____________ a suitable insurance program for you.A. can we recommendB. we can recommendC. recommend we canD. recommend can we25.The course comes in three books of case studies, ___________ a variety of business activities in different parts of the world.A. being coveredB. coveringC. coverD. coveredSection BDirections: There are 10 incomplete statements here. You should fill in each blank withthe proper form of the word given in brackets. Write the word or words in the corresponding space on the Answer Sheet.26. He asked the applicant to have her cell phone (turn) _____ off during the interview. 27. We hope to bring together all the parties (direct) ______ involved in the conflict.28.We shall continue to give full and (act) ________ support to the United Nations.29. Budgeting is an important part of the (manage) _________control process in any organization.30.We’re pleased to announce that your (apply) ___ for membership has been accepted.31. Both teachers and parents believe that young children should (teach) ______ road safety rules to avoid accidents.32. Young volunteers enjoy (help) ______ the senior citizens in their everyday life.33.At the end of yesterday’s interview, she (offer) ______ the position advertised in the newspaper.34. We’ve agreed (transfer) ______ part of our business to a new owner.35.The company offers a variety of roles (suit) ______ for the goals, backgrounds and talents of its employees.Part III Reading Comprehension (40 minutes)Directions: This part is to test your reading ability. There are 5 tasks for you to fulfill. You should read the reading materials carefully and do the tasks as you are instructed.Task 1Jack Welch is among the famous CEOs because his management style is taught at business schools throughout the country. He has been with the General Electric Company (GE) since 1960. Having taken GE with a market value of about $12 billion, Jack Welch turned it into one of the largest and most admired companies in the world, with a market value of about $500 billion, when he stepped down as itsCEO 20 years later, in .As Jack Welch wrote in a l etter to shareholders: “In the old culture, managers got their power from secret knowledge: profit margins, market share, and all that... In the new economy, the role of the leader is to express a vision, and put it into practice. That calls for open, caring relations with every employee, and face-to-face communication. People who can’t convincingly (有说服力的) express a vision won’t be successful. But those who can will become even more open——because success builds up self-confidence.”Welch believed that great business leaders have to:· possess large amounts of energy, and· know how to use that energy to motivate others. Welch moves from meeting to meeting, conveying that message—and many more others as well, some of which have become his trademarks:· Busin ess is simple.· Don’t make it complicated.· Face reality.· Don’t be afraid of change.· Use the brains of your workers.36. According to the first paragraph, Jack Welch, as a CEO, is famous for his ______.A. technical knowledgeB. overseas experienceC. family backgroundD. management style37. When Jack Welch took charge of the company, it had a market Value of about ____. A. $12 billion B. $20 billion C. $500 billion D. $ billion38. According to Jack Welch, the relations between the employer and employees should be ______.A. personal and friendlyB. casual and naturalC. open and caringD. strict and formal39. In the sentence "... some of which have become his trademarks", the word "trademarks" means ______.A. product brandsB. speaking mannerC. advertising strategyD. special characteristics40. This passage is mainly about ______.A. relations between the employer and employeesB. Jack Welch’s view of business managementC. development history of GE companyD. courses taught in business schoolsTask 2Directions: This task is the same as Task 1. The 5 questions or unfinished statements are numbered 41 to 45.From: Linda SmithTo: Clarice RyanSubject: Report on Employees’ Use of Time Clarice, I agree that waste of work time is aserious issue. The Human Resources Department recently surveyed the employees. They are wasting nearly two hours per day. Here are my ideas to reduce this waste. First we need to agree on what are the Most important behaviors to stop. For example, look at activity No.1 in the table below. Many people are doing this; however, it is the most difficult to stop. I recommend that we focus on activities No. 2, 4, and 5.Making phone calls shows the largest difference between men and women. Women do this much more than men. We should ask all employees to limit these calls. They should return non-urgent messages at their lunch break.For No. 4, we should focus on the younger age group. We will tell them that we are going to check their work accounts for personal messages. For No. 5, we can ask managers to watch this more carefully. Perhaps activity No. 3 should continue. This allows employees to know eachother and it can increase their motivation. The managers will know if someone is spending too much time talking and not enough time working.Are you available tomorrow? I’d like to meet with you to discuss our next step.Time Spent on Non-work-related Activities Activities MenWomen 1. Going online 85% 83%55% 80%2. Making personalphone calls3. Talking to60% 70% colleagues45% 45%4. Writing personale-mails5. Taking long breaks 30% 20%*Percentage (%) of employees who do this three times per week or more.41. What problem does the writer find from the survey by the Human Resources Department?A. Working conditions are to be improved.B.Some employees need re-training.C. Employees lack motivation.D. Much work time is wasted.42. The greatest difference between men and women in the non-work-related activities is ______. A. taking long breaksB. making phone callsC. talking with colleaguesD. sending non-urgent messages43. The employees are advised to return non-urgent messages ______.A. after workB. back at homeC. before office hoursD. during their Lunch break44.The table shows that the non-work-related activities employees most often do was ________. A. going onlineB. talking with each otherC. writing personal emailsD. making personal phone calls45. Why does the writer suggest that activityNo.3 should continue?A. It can help employees increase motivation.B. It can help managers to check on the work accounts.C. It can show how much time employees actually work.D. It can encourage young employees to work more efficiently.Task 3Directions: Read the following passage. After reading it, you are required to complete the outline below it (No.46 to No.50). You should write your answers briefly (in not more than three words) on the Answer Sheet correspondingly.If you want to get around Vancouver easily, then you will want to take the Sky Train around the city. Launched in 1986, Sky Train is the oldest and one of the longest fully-automated, driverless, rapid transit systems in the world .It runs on a guide way, high above city streets, though there are a few stations locatedunderground. The Blue and Red Lines connect downtown Vancouver with the cities of Burnaby and Surrey. The Green Line connects downtown Vancouver to the Vancouver International Airport and the city of Richmond.You can buy a day pass which can take you around the city as well as provide you with side trips to the North Shore with the ferry (轮渡). You can also ride Vancouver’s metro bus systemand travel around downtown, and many other beautiful areas.If you are visiting Vancouver, the Sky Train is your best bet at seeing every corner of the city. You can buy Sky Train day passes at most grocery stores like Safeway and Save on Foods. You can also purchase passes at the Sky Train station and the Ferry terminal.Sky Train in VancouverYear of launching: 1986Features: 1. Oldest2. Fully-automated。
左卡尼汀(左旋肉碱)在早产儿肠外营养中的应用
第50卷第12期2020年12月新禮医学X I N J I A N G M E D I C A L J O U R N A LV〇1.50N〇.12D e c e m b e r.2020.论著•左卡尼汀(左旋肉碱)在早产儿肠外营养中的应用巴依尔才次克，朱艳萍，王莉(新疆医科大学第一附属医院新生儿科，乌鲁木齐830054)摘要：目的探讨左旋肉碱在早产儿肠外营养中应用的临床作用。
方法选取新疆医科大学第一附属医院新生儿重症监护室自2016年08月至2018年08月收治的早产儿75例，采取盲法并根据数字表随机分成两组，对照组37例给予常规治疗干预,研究组38例在与对照组相同常规治疗基础上联合应用左旋肉碱静脉治疗，对比两组早产儿的体重、头围、身长在不同时间点的增长情况。
结果两组早产儿治疗后第7 d、第14 d及第28 d时的体重、身长、头围均有显著性差异,/><0.05,有 显著性差异;研究组早产儿住院期间静脉营养时间及平均住院日显著低于对照组,P<0.05,有统计学意义。
结论给予早产儿于肠外营养中联合应用左旋肉碱静脉治疗可改善早产儿生长发育情况，缩短早产儿住院期间静脉营养时间及平均住院日，值 得临床推广应用。
关键词：左旋肉碱;早产儿;体重增长;发育中图分类号:R722.6 文献标识码:A 文章编号：1001—5183(2020)12—1269~06Application of L-carnitine in parenteral nutrition of premature infantsBayiercaicike.ZHU Yanping,WANG Li(Department of Neonatal, Hie First AfiG liated Hospital of Xinjiang Medical University, Urumqi, 830054, China)Abstract: Objective To investigate the clinical effect of L-carnitine in p>arenteral nutrition of premature infants. Methods 75 cases of premature infants admitted to neonatal intensive care unit of xinjin medical university first affiliated hospital from August 2016 to August 2018 were selected and randomly divided into two groups according to the number table. 37 cases in the control group were given conventional treatment intervention, while 38 cases in the study group were treated with L-carnitine intravenous therapy on the basis of the same conventional treatment as the control group. The body weight, head circumference and body length of the two groups were compared Time point growth. Results There were significant differences in body weight, length and head circumference between the two groups on the 7th, 14th and 28th days after treatment, P<0.05, with significant difference; the time of intravenous nutrition and the average length of stay in the study group were significantly lower than that of the control group, P <0.05, with statistical significance. Conclusions Parenteral nutrition combined with L - carnitine intravenous therapy can improve the growth and development of preterm iniiEints, shorten the duration of intravenous nutrition and the average length of stay, which is worthy of clinical application.Key words：L-carnitine; Preterm Infants; Weight Gain; Development随着医疗技术的进步和围产期孕产妇健康管 理的加强,围生期早产儿的死亡率大幅度下降'早 产儿的存活和救治与早产儿静脉营养的密切相关，如果不能保证早产儿的营养均衡和正常发育，将 会给早产儿家庭带来沉重的压力，甚至给社会和国 家造成经济负担。
学术英语(社科)-Unit1含答案
Unit 1 Decision-Making Behaviors in Economic Activities
单击此处添加正文，文字是您思想的提炼，请尽量言简意赅地阐述观点。
Lead-in
questions for discussion
Reading critically:
Lead-in
Reading critically: questions for discussion
Unit 1 Decision-Making Behaviors in Economic Activities
Text A
Key terms
rational people: 理性人 Those people who systematically and purposefully do the best they can achieve their objectives, given the available opportunities.
Text A
Critical reading and thinking
Unit 1 Decision-Making Behaviors in Economic Activities
Rational people respond to incentives.
Example 2: a tax on gasoline How people respond to incentives? Encourage people to □ drive small, more fuel-efficient cars; □ carpool □ take public transportation; □ live closer to where they work; □ drive hybrid cars; □ drive electric cars.
浙江省杭州市第二高中高二英语上学期期末试题含部分解析
浙江省杭州市第二高中高二英语上学期期末试题含解析一、选择题1. The manager was unable to attend the meeting but he sent his assistant as a ________.A. comfortB. substituteC. favorD. draft参考答案：B2. ______ with children before, I don’t know what to expect in my new job.A. Having not workedB. Not having workedC. Not workingD. Not to have worked参考答案：B3. Please remind me of the meeting again tomorrow ________I forget.A．though B．so that C．in case D．until参考答案：C4. Most people on this island are recreational(消遣的，娱乐的) fishers, and _____, fishing forms an actual part of their leisure time.A. accidentallyB. purposefullyC. obviouslyD. formally参考答案：C5. ——John, when shall we play badminton again, Friday or Saturday ?——.I’ll be off to Shanghai then.A. EitherB. NeitherC. BothD. None参考答案：B6. My teacher’s words had a great _____ my studying science at college.A. influence inB. effect inC. influence onD. effect for 参考答案：B略7. When they moved to Canada，the children_______ _the change very well.A．adapted to B．adopted to C．used to D．attempted to参考答案：A8. —You can take a walk daily if you want to keep healthy.—__________.A. I’m glad you like itB. Thanks for your adviceC. I like surfing the InternetD. Well, that’s OK参考答案：C9. He is ____ an expert at computers; you see, he solved the complex problem in a few minutes.A. curiouslyB. comfortablyC. lyD. unlikely参考答案：C10. The students running on the playground are all in their uniforms, so it’s hard for you to _____ my sister among them.A. carry outB. leave outC. give outD. pick out参考答案：D11. He often thinks of ______ he can do more for the four modernizations.A. whatB. howC. thatD. which参考答案：B12. Many Chinese brands, __________their reputations over centuries, are facing new challenges from the modern market.A. having developedB. being developedC. developedD. developing参考答案：A考查非谓语动词。
高三英语学术论文的阅读单选题40题答案解析版
高三英语学术论文的阅读单选题40题答案解析版1.The main idea of the passage is that_____.A.science is difficult to understand.cation is important for everyone.C.academic papers are useful for research.D.technology is changing our lives.答案：C。
本题考查对文章主旨的理解。
选项 A 中“science is difficult to understand”文章中未提及科学难以理解这一内容。
选项B“education is important for everyone”文章重点并非在论述教育对每个人的重要性。
选项C“academic papers are useful for research”符合文章围绕学术论文在研究中的作用展开论述的主旨。
选项D“technology is changing our lives”文章中未涉及科技改变生活这一话题。
11.The author mentions “data analysis” in the passage to show that _____.A.it is a complex processB.it is crucial for researchC.it requires advanced skillsD.it can be time-consuming答案：B。
解析：文中提到“data analysis”是为了说明它对于研究很关键。
A 选项“它是一个复杂的过程”文中未提及；C 选项“它需要高级技能”文中未体现；D 选项“它很耗时”文中没有相关表述。
12.According to the passage, the main purpose of the study is _____.A.to solve a practical problemB.to test a new theoryC.to compare different methodsD.to explore an unknown area答案：A。
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A Study on the Application of TBA in College English Teaching作者：Liaoning University of Technology/Bi Ran来源：《校园英语·上旬》2015年第12期【Abstract】To investigate whether there are some significant differences in English teaching for the two teaching methods （TBA and PPP），An experiment is conducted， which focuses on the effectiveness of task-based classes model and aims at finding out whether the students’ English proficiency can be improved.【Key words】Study on application； TBA； College English teaching1. The definition and features of TBATBA is a teaching approach that puts tasks at the center of the methodological focus. It considers the learning process as a set of communicative tasks that are directly linked to the curricular goals.Nunan （1991）have summarized characteristics of TBA from different aspects.1）An emphasis on learning to communicate through interaction in the target language.2）The introduction of authentic texts into the learning situation.3）Provision of opportunities for learners to focus not only on language， but also on the learning process itself.4）An enhancement of the learners’ own personal experiences as important contributing elements to classroom learning.5）An attempt to link classroom language learning with language activation outside the classroom.2. Methodologies2.1 Hypothesisa. TBA is more effective than the PPP （presentation， practice and production）teaching method in college English teaching.b. The application o f TBA can improve students’ achievement.2.2 SubjectsThe experiment was carried out in two classes of Grade one in Liaoning University of Technology. They were chosen as respectively the experimental group （EG）and the control group （CG）. Traditional teaching method —PPP approach is used in the control group and TBA is used in the experimental class.2.3 InstrumentsThe instrument is language tests. A pre-test and a post-test are provided to find out whether there are any c hanges in the participants’ achievement after the experiment.3. Results of the experiment and analysisTo provide an objection， scientific and comprehensive analysis， the following two statistical analysis ways were conducted： the ordinary analysis and the z-value analysis （SPSS）， which can provide the same result from different perspectives.The results were reported in the following table.To describe the differences between the two classes more explicitly .Table 1 and Table2 are given as follows：Table1 exposes that levels in the mean score， the excellence ratio， and the passing rate in EGhad significantly increasedTable1 the comparison of pre-test and post-test in EGGroup N Mean Score of every part Excellence Passing ratePart I Part II Part III Part IV Part V Total N （%） N （%）Pre-test 37 9.1 14 23 12 6.4 64.5 3 8.1% 19 51.4%Post-test 37 13 16 25 14 7.9 75.9 8 21.6% 28 75.7%Table 2 the comparison of pre-test and post-test in CGGroup N Mean Score of every part Excellence Passing ratePart I Part II Part III Part IV Part V Total N （%） N （%）pre-test 38 9.2 14 23 12 6.7 64.9 4 10.5% 19 50.0%Post-test 38 11 15 24 13 6.8 68.8 5 13.2% 22 57.9%（12.4point， 13.5%， 24.3% respectively）； the results show clearly that that TBA worked well.Table2 fully indicates that increased degrees in the mean score， the excellence ratio， and the passing rate in CG were less， so we can say the traditional teaching method applied in CG worked not as well as the TBA in EG.By comparison，the above-mentioned results show preliminarily that Task-based language teaching developed the overall English level. The average English achievements in EG is apparently higher than that in CG. In that way， TBA is more effective than the PPP teaching method in vocational college English teaching.To further prove the difference between the experimental class and the control class in the two tests， another samples Z-score was conducted. The results were reported in the following tables.Table3 the comparison of pre-test and post-test in EGItem Group Number Mean S.D Z-score P-valuePart I Pre-test 37 9.1 1.58 3.42 0.01Post-test 37 13 1.26Part II Pre-test 37 14 1.86 2.94 0.02Post-test 37 16 1.75Part III Pre-test 37 23 1.78 3.01 0.02Post-test 37 25 1.57Part IV Pre-test 37 12 2.01 2.84 0.03Post-test 37 14 1.75Part V Pre-test 37 6.4 1.22 4.21 0.03Post-test 37 7.9 1.11Total Pre-test 37 64.5 7.46 3.28 0.024Post-test 37 75.9 6.98As showed in table 3 ， z-value is above 2.58， pFrom the results of the above four tables， two conclusions can be drawn as follows： 1）there is no significant difference between the two groups in pre-test scores. 2）There is significant difference between the two groups in post-test scores. To be specific， the experimental group performs better than the control group in post-test. Therefore it can be concluded that TBA is conducive to improving learners’ English proficiency more effectively than the traditional 3Ps teaching model.。