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。     

Quantifying and characterizing contemporary riparian sedimentation

Fluvial processes of erosion, sediment transport and deposition determine the changing form and sedimentary structure of naturally adjusting riparian zones. Riparian sediment storage has both scientific and management importance in relation to: (i) the quantities of sediment that are involved; (ii) the quality of the sediment; and (iii) the dispersal of biological materials, notably the vegetation propagules that are transported and deposited in association with the sediment. After discussing the significance of riparian sedimentation processes, this paper reviews methods for quantifying contemporary sediment deposition within water bodies and their margins. Methods for investigating contemporary riparian sedimentation are given particular emphasis, and the extent to which different methods provide comparable estimates and have been used to support the analysis of different physical and chemical properties of the sediment are outlined. The importance of the following are stressed: (i) selecting a sampling method that is suited to the sedimentation environment; (ii) incorporating careful cross‐calibration if measurements from different methods are to be combined; and (iii) replicating measurements to give more robust estimates if small traps are employed. It is concluded that artificial turf mats provide a useful design of sediment trap across a range of environmental conditions because: (i) their surface roughness reduces problems of sediment removal by flood waters or rainfall; (ii) their pliability permits installation on irregular surfaces; (iii) they can be securely attached to the ground with metal pins to resist high shear stresses from river flows; (iv) they are robust and light and so easily manipulated in the field and laboratory; (v) it is possible to fully recover the deposited sediment to accurately determine the amount of sediment deposited and to support a range of other analyses. Results are presented to illustrate how artificial turf mats can be used to estimate the quantity and quality of deposited sediment and to explore the associated deposition of viable seeds. This provides one example of the important hydroecological role of riparian sedimentation processes and of the potential for the development of innovative, interdisciplinary research on riparian sediment dynamics. Copyright © 2003 John Wiley & Sons, Ltd.     

利用黄河泥沙加固下游大堤

黄河是一条举世闻名的多泥沙河流，善淤、善决、善徒给沿河人民带来对过深重灾难，防洪问题一直是国家的心腹之患。泥沙问题是黄河防洪问题的症结所在。在总结固大堤经验的基础，进行挖河疏浚，淤筑“相对地下河”，已作为黄河治理的一项重大决策付诸实施。     

黄河龙青段主要环境工程地质问题分析思路

介绍了黄河上游龙青段主要环境工程地质问题的分析思路，以达到抛砖引玉，交流和提高电工程地质勘测水平的目的。     

永定新河治理工程几个关键问题的研究

永定新河是天津市防洪的北部防线。由于受海相来沙淤积 ,河道行洪能力大幅度下降。针对永定新河治理工程设计中涉及到的河道淤积治理方案、闸位比选、防潮闸结构型式及施工方法、闸下减淤清淤措施等诸多问题进行了分析和研究 ,提出了相应的措施和建议     

Treatment of low turbidity water by sweep coagulation using bentonite

A novel strategy of sweep coagulation to treat low turbidity water is presented herein. Study findings demonstrated that an Na⁺‐saturated bentonite with medium cation exchange capacity (CEC) resulted in significant turbidity removal at a bentonite dosage of 30 mg dm^?3. Bentonite dispersion with fully delaminated platelets tended to undergo a more porous type of coagulation with intense face‐to‐face interactions of platelets and effectively entrapped TiO₂ particles in band‐type structures. This type of coagulation usually results in a large volume of settled flocs with a fluffy structure and excellent turbidity removal efficiency for sweep coagulation. The sign and magnitude of electrical charge on TiO₂ particles has a minor effect on the efficiency of sweep coagulation. Copyright © 2005 Society of Chemical Industry     

悬沙中D〉0．06mm粗粒的粒析级配组成及其改正方法

本文首先简述Ｄ＞０．０６ｍｍ泥沙的粒析沉降特性及其粒径偏粗的原因。继之对悬沙中粒径大于０．０６ｍｍ的粒析级配组成机理，及级配组成不同对标准粒径Ｄｂ与粒析粒径ＤＬ关系的影响进行了详细研究。在以上研究工作的基础上，开展了Ｄｂ与ＤＬ的比较试验，得出了粗、中、细型悬沙的Ｄｂ～ＤＬ关系和对ＤＬ的改正方法。     

坨五站中间乳化层快速增长原因及治理方案

胜利采油厂坨五站高含水(95％)原油化学预脱水中，二级沉降罐内油水相之间的中间乳化层增长迅速，引起了一系列问题。现场调查和大量室内测试结果表明，产生这一现象的原因有：油溶性破乳剂WD-1加入点不合理。有2／3的含水原油在通过油水分离器之后才与破乳剂混合；二级沉降罐进油口伸入油相内，油流的冲击达不到中间层；WD-1对坨五站混合原油中的稠油破乳脱水性能欠佳，不能适应坨五站混合原油组成和含水的变化。针对上述各种原因筛选出了性能更好的一种破乳剂1916。根据确定的几种原因采取了相应的措施：将破乳剂加入点改在3个并联油水分离器之前；将二级沉降罐的进油口移到水相内；改用筛选出的破乳剂1916，结果使中间乳化层的增长受到了抑制。图2表4参2。     

微型灌注桩托换技术在地基基础加固工程中的应用

因场地淤泥等软土层深厚,在填方荷载作用下,软弱土层产生固结沉降,引起局部构筑物的不均匀沉降,发生结构破坏。采用微型灌注桩加固满足现场各个限制条件的要求,达到了加固目的。