人纤维蛋白原对急诊外伤致创伤性凝血病疗效及相关因素分析

目的:探讨人纤维蛋白原(fibrinogen，FIB)对急诊创伤性凝血病患者的临床疗效及相关因素。方法:将2015年6月至2018年6月本院收治的100例严重创伤患者纳入本研究，根据是否创伤性凝血病分为凝血病组(80例)和非凝血病组(20例)。比较凝血病组和非凝血病组患者收住后第1个24 h的急性生理和慢性健康评分(acute physiology and chronic health evaluation II，APACHE II)、创伤严重程度评分(injury severity score，ISS)、低体温及低灌注发生率等指标。采用Logistic多因素回归方法分析严重创伤患者发生创伤性凝血病的相关因素。将80例创伤性凝血病患者随机分为观察组(40例)和对照组(40例)。对照组按照常规诊疗措施治疗，观察组在对照组处理基础上给予人FIB，比较治疗前后观察组和对照组的凝血功能指标，及治疗后的临床用血量、住院时间及病死率。结果:与治疗前相比，治疗后观察组和对照组的凝血酶原时间(prothrombin time，PT)、活化部分凝血活酶时间(activated partial thromboplastin time，APTT)及D-二聚体水平降低(P<0.05)，FIB水平明显升高(P<0.05)。观察组的红细胞(red blood cell，RBC) 输注量、新鲜冰冻血浆(fresh frozen plasma，FFP)输注量、重症加强护理病房(intensive care unit，ICU)时间及病死率均明显低于对照组，差异具有统计学意义(P<0.05)。创伤性凝血病患者PT>18 s(r=0.623，P=0.024)、APTT>60 s(r=0.722，P=0.018)、凝血酶时间(thrombin time，TT)>15 s(r=0.719，P=0.033)与ISS评分呈正相关。碱缺失(base deficit，BD)≥6(OR=3.678，95%CI=1.065～9.417)、格拉斯哥评分(Glasgow coma scale，GCS)≤8(OR=5.299，95%CI=1.122～8.711)和血小板(platelet，PLT)计数(OR=0.982，95%CI=0.971～0.996)是严重创伤患者发生创伤性凝血病的独立预测因素。结论:人FIB可有效改善创伤性凝血病患者的凝血功能，降低病死率、缩短ICU时间，创伤性凝血病与创伤严重程度、合并休克、低体温和重型颅脑损伤存在一定的相关性。     

环境中污染源废气检测方法及影响因素分析

对污染源废气监测原理进行了简单分析,阐述了当前我国常用的环境中污染源废气检测方法,并对废气检测影响因素及质量控制进行了深入探究。     

Aripiprazole as a potential pharmacotherapy for stimulant dependence: Human laboratory studies with d-amphetamine.

Amphetamine and cocaine dependence present significant public health concerns, yet no broadly effective pharmacotherapy for stimulant dependence has been developed. Two human laboratory studies are reviewed that tested the ability of aripiprazole, a novel antipsychotic with partial agonist activity at D2 dopamine receptors, to alter the behavioral effects of stimulants using d-amphetamine as a model agent. In each of these experiments, volunteers learned to discriminate 15 mg d-amphetamine (i.e., ≥80% drug-appropriate responding over 4 consecutive sessions). The effects of a range of doses of d-amphetamine (0, 2.5, 5, 10, and 15 mg) were then tested alone and following pretreatment with aripiprazole (20 mg in Experiment 1; 10 mg in Experiment 2). In Experiment 1, aripiprazole (20 mg) attenuated the discriminative stimulus and many of the subject-rated effects of amphetamine. Aripiprazole alone produced performance decrements. To determine whether a lower dose of aripiprazole would also attenuate the behavioral effects of d-amphetamine without impairing performance, Experiment 2 was conducted. Aripiprazole (10 mg) failed to alter the discriminative-stimulus effects but attenuated some of the subject-rated effects of d-amphetamine. This dose of aripiprazole did not impair performance. The results of these experiments indicate that aripiprazole may have clinical utility in treating stimulant dependence. Future human laboratory research should better model the clinical use of aripiprazole by examining the effects of chronic aripiprazole combined with either methamphetamine or cocaine in dependent individuals. A large-scale clinical trial is also needed to evaluate the efficacy of aripiprazole for the treatment of stimulant dependence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

接轨站设置位置和布置图型的影响因素及其分类

通过对接轨站设置位置和布置图型主要影响因素的分析。按照能够充分反映接轨站作业特点的交接方式。对接轨站所采用的布置图型进行了归纳和分类。     

双河油田注入水适应性及注水井酸化解堵研究

考察了双河油田双河联、江河联注入水堵塞地层的因素;膨胀性黏土，悬浮固体颗粒。细菌及悬浮污油。含膨胀性黏土的双河南、双河北及不含膨胀性黏土的双江岩心粉，在注入水中相对于地层水中的体积膨胀度分别为14．5％、11．1％及0．02％；注入100PV不含悬浮颗粒的等体积比地层水、注入水混合水使双河、双江岩心渗透率分别下降7％和4％、9％和7％。注入水中悬浮颗粒引起岩心渗透率下降，粒径越大、颗粒浓度越大、注入量越大，则渗透率越低。在粒径2．1μm或颗粒浓度3mg／L前后下降幅度变化较大。注入水中硫酸盐还原菌引起岩心渗透率下降，含菌量越大则渗透率开始下降时的注水量越小，注入含菌50个／L的水100PV使岩心渗透率下降7％。岩心对注水合油量敏感，注入含油量20mg／L的水50PV使岩心渗透率下降20％。在岩心注水实验中渗透率下降最严重的是双河南岩心，其次是双河北岩心．江河岩心较轻，注入精细过滤水的双河北岩心渗透率下降大大减少．说明悬浮固体是造成注水堵塞的主要因素。为了解除双河油田注水井的堵塞，研制了含黏土稳定剂、缓蚀剂、铁离子稳定剂、互溶剂的土酸液，与南阳油田使用的低伤害酸液一起，用于1口注水井的解堵，效果良好。图7表4参5。     

关于以能力建设为基础的培训工作研究

提高对人才能力建设的培训水平,是国有企业培训机构在人才培训工作与人力资源开发过程中需要深入研究、探索的重要课题。针对中国石油化工集团公司推进改革发展、实现企业战略目标对高级管理人才的需求,以企业高级管理人才任职前培训为目标,在培训需求研究、课程设计与内容开发、教学手段和方法、培训过程管理与质量保证机制、培训效果评估等方面进行研究。     

复合材料层合曲梁分层问题的解析解法

根据叠加原理将含有分层的复合材料层合曲梁在横向载荷作用下的受力状态分解为在面受力状态与出面受力状态,再将出面受力状态分解为无分层曲梁受横向载荷状态与含分层曲梁承受附加剪切载荷状态。将分层问题归结为在附加剪切载荷状态中,层合梁附加位移与附加应力的分析,并据此建立了一个简单的力学模型。最后得到了由分层引起的附加位移与应力的解析解答,并用能量释放率方法确定了应力强度因子。     

醇解技术在制备皮革加脂剂方面的研究进展

本文介绍了醇解反应的动力学、影响醇解反应收率的因素以及醇解反应在合成加脂剂方面的应用。     

Occupational Factors and 5-Year Weight Change Among Men in a Danish National Cohort.

This study explored whether factors related to the work environment could predict changes in body mass index (BMI) and whether the effect of psychosocial factors was dependent on baseline BMI. The sample consisted of 1,980 male employees from the Danish National Work Environment Cohort Study. Changes in BMI between 1995 and 2000 were analyzed, by multiple regression, as a function of background variables and a series of occupational variables obtained in 1995. Age, baseline BMI, job insecurity, and psychological demands predicted changes in BMI. Job insecurity and high or low psychological demands increased the likelihood of weight gain among obese employees, whereas they increased the likelihood of weight loss among employees with a low BMI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

变换域数字水印处理技术

数字水印是信息安全领域的一项新技术,给出了相对明确的定义。着重分析了变换域数字水印系统的特征及常见攻击,给出了一些相应的对策。最后指出变换域水印的重要问题,即频率的选择问题。