腹腔手术后重症患者心肌损伤的危险因素

目的探讨腹腔手术后重症患者心肌损伤的发生情况及可能的危险因素。方法回顾性分析北京大学人民医院2017年1月至2019年1月腹腔手术后重症患者的一般临床资料及心肌损伤情况,收集并观察基础病史、术中(手术时间、是否急诊手术、术中出血>800 ml和术中低血压等)及术后指标(改良氧合指数、血乳酸、急性肾损伤和术后24 h内使用升压药情况等)。根据术后是否发生心肌损伤,将患者分为心肌损伤组和非心肌损伤组,采用Logistic回归分析腹腔手术后重症患者心肌损伤的危险因素。结果在纳入的803例腹腔手术后重症患者中,心肌损伤发生率为17. 2%(138/803),而急性心肌梗死发生率仅为0. 9%(7/803)。单因素分析显示,慢性肾功能不全病史、手术时间、急诊手术、术中低血压、术后24 h内使用升压药、高APACHEⅡ评分及术后即刻急性肾损伤与术后重症患者心肌损伤相关(P<0. 05)。多因素回归分析显示,急诊手术(OR=3. 14,95%CI:1. 76～5. 60,P<0. 001)、术后24 h内使用升压药(OR=2. 26,95%CI:1. 23～4. 15,P=0. 008)、APACHEⅡ评分(OR=1. 05,95%CI:1. 01～1. 09,P=0. 008)和术后急性肾损伤(OR=3. 18,95%CI:1. 78～5. 69,P <0. 001)与腹腔手术后重症患者发生心肌损伤独立相关。结论重症患者腹腔手术后心肌损伤发生率高,急诊手术、术后24 h内使用升压药、高APACHEⅡ评分和术后急性肾损伤是导致腹腔手术后重症患者发生心肌损伤的独立危险因素。     

Survey of domestic food purchases and related home handling practices in the Abruzzo region (central Italy): Data collection and analysis through a language-independent classification system

A telephone survey was carried out on 13,486 randomly selected households located in the Abruzzo region (central Italy). Three questionnaires were specifically designed in relation to three different groups of foods (Meat and meat products, Fishery products, Fruit and vegetables). Questions were mainly focused on the amount and number of purchases, type of retailer, and home food handling practices with respect to the week prior to the interview. Data were classified according to a multilingual thesaurus system (LanguaL). Results allowed to estimate domestic purchases (in kg) per capita for different food categories. The category “Red meat/Cattle” accounted for a large part of purchases in the “meat and meat products” group (10.9 kg per capita/year; 32.2% of purchases in the group) while the category “Fish or related organism/Fish” was the most purchased in the “fishery products” group (6.9 kg per capita/year; 63.3%). The aggregation of more detailed characteristics enabled the identification of popular categories of foods, such as “Red meat/Cattle/Divided into pieces” (25% of the “meat and meat products” group). Significant differences (p < 0.05) were found between the four different provinces (L'Aquila, Chieti, Pescara and Teramo) with respect to “Poultry/Chicken” and “Red meat/Cattle” categories. Householders were also asked about post-purchase food handling practices that might be hazardous to food safety. More than 20% of those surveyed stated that they thawed frozen meat at room temperature. The degree of doneness after cooking of different food categories was generally high: over 90% of products purchased in the majority of meat and fish categories were properly cooked. However a noticeable proportion of householders (about 15%) reported medium or rare cooking of “Red meat/Cattle” and “Red meat/Swine”. Differences (p < 0.05) were also found between consumers of different ages, with people over 65 years old being more prone to freeze meat and cook it thoroughly.The survey was carried out in a specific geographic area and on a statistically significant sample of households, thus allowing a collection of data on domestic habits relating to food purchases and home food handling practices. This information should be included in the framework of quantitative microbial risk assessment (QMRA) models as a measure of the actual exposure of consumers to pathogenic microorganism. The LanguaL system also proved to be a practical language-independent method useful not only to identify and describe food items but also to classify them according to specific food safety characteristics.     

管道风险管理方法研究

按照管道风险管理的流程分别对管道风险评价、风险控制和决策支持、效能测试和响应进行了论述。针对目前国内管道行业的情况，提出了进行管道风险评价的有效方法及维护措施。着重介绍了国外管道风险可接受标准的情况，作为国内制定管道风险评价标准的参考。     

信息安全风险评估的模糊多准则决策方法

基于ISO/IEC17799标准建立了一个综合的信息系统风险分析框架,并运用模糊多准则决策(FMCDM)方法计算信息安全风险,根据风险等级矩阵(RLM)对信息资产风险进行级别划分,最终建立评估信息资产相关风险的完整模型。     

A note on the Gauss-Jacobi quadrature formulae for singular integral equations of the second kind

A fast and efficient numerical method based on the Gauss-Jacobi quadrature is described that is suitable for solving Fredholm singular integral equations of the second kind that are frequently encountered in fracture and contact mechanics. Here we concentrate on the case when the unknown function is singular at both ends of the interval. Quadrature formulae involve fixed nodal points and provide exact results for polynomials of degree 2n − 1, where n is the number of nodes. Finally, an application of the method to a plane problem involving complete contact is presented.     

浅谈如何搞好加油站的风险评价

阐述了加油站实施HSE管理，进行加油站风险评价的必要性，介绍了评价方法及其应用范围，评价组织的建立和工作流程及注意事项，指出：进行加油站风险评价，在选择评估方法时应从加油站的生产实际出发，针对不同的区域，采用适当的，可操作的方法；找出身边存在的危害因素，采取适当的措施来控制和化解风险，提高加油站安全管理水平，才能适应加入WTO后所面临的挑战。     

先张法预应力桥梁板施工工艺及应用实例

结合太原市向阳店桥梁板施工实例，介绍了采用先张法进行预应力桥梁板施工的过程。阐述了桥梁板的施工工艺，该工艺实现了整体张拉、整体放张，使钢绞线逐根受力均匀，施工速度快，能保证梁端的质量。指出拉杆系统的使用，降低了成本，增加了效益。     

Salt-water up-coning during extraction of fresh water from a tropical island

Rainwater can collect in a lens-shaped region within the rock of a tropical island, and may be separated from the underlying salt water by a sharp interface. This paper presents a nonlinear theory for determining the shape of this interface. The island is assumed to be saturated with rain, and provision is made for the outflow of rain-water through the sides of the island. The effect of a bore well on the shape of the interface is investigated, and the problem is solved using a spectral method. An integral-equation method is also presented for the case when the island has infinite width.     

A new stereological principle for test lines in three-dimensional space

A new principle is presented to generate isotropic uniform random (IUR) test lines hitting a geometric structure in three-dimensional space (3D). The principle therefore concerns the estimation of surface area, volume, membrane thickness, etc., of arbitrary structures with piecewise smooth boundary. The principle states that a point-sampled test line on an isotropic plane through a fixed point in 3D is effectively an invariant test line in 3D. Particular attention is devoted to the stereology of particles, where an alternative to the surfactor method is obtained to estimate surface area. An interesting case arises when the particle is convex. The methods are illustrated with synthetic examples.