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。     

On basic definitions of unified fracture mechanics terminology

The adoption of unified fracture mechanics terminology (UFMT) will promote efficient communication between specialists in different fields of fracture research, harmonization of national and international standards relating to fracture mechanics, and last but not least improvement of the existing methodology for teaching and education in fatigue and fracture. In this paper the definitions of some basic and related terms included in different standards on fracture mechanics terminology are confronted with one another. Alternative definitions of the same terms are offered. By this strategy the author tries to show that the definitions of basic and related terms appropriate for the UFMT should emerge as a consequence of harmonizing a crack model with an actual crack and then both taken together with a fracture model, laboratory test methods, and failure assessment codes.Published in Problemy Prochonsti, No. 1, pp. 17–29, January, 1996.This paper is published as a matter of discussion.     

Superconductivity and magnetism in niobium doped YBa2Cu3O7 Related high Tc ceramics

Magnetic characterization has been performed on the members of the cuprateniobate RBa₂Cu₂NbO₈ (R = Pr, Nd, and La) series and R_1.5Ce_0.5Sr₂Cu₂NbO₁₀ (R = Pr, Eu, Nd, and Sm) series. The PrBCNO samples show a signature in the magnetization of a magnetic ordering at 12K. The PrCSCNO sample is nonsuperconducting and shows two distinct orderings at 17K and 53K. No such magnetic phase transition is observed down to 2K in the Nd and La based RBCNO materials or the Nd, Sm, and Eu based RCSCNO materials. Measurements of the lower critical field curve, dc irreversibility line, and critical curent densities are reported for each of the superconducting NdCSCNO, SmCSCNO, and EuCSCNO compounds.     

Appraisal as a Pervasive Determinant of Anger.

L. Berkowitz and E. Harmon-Jones (see record 2004-15096-001) challenge appraisal theories of emotion by describing 2 sets of conditions (physical discomfort and anger-related muscle actions) in which anger appears to be elicited in the absence of theoretically predicted appraisals. In response, the authors discuss the ability of the specific appraisal model they have developed (e.g., C. A. Smith & L. D. Kirby, 2000, 2001; C. A. Smith & R. S. Lazarus, 1990) to account for such instances of anger. First, a number of issues are clarified relevant to the authors' model, including the nature of both the cognitive operations underlying appraisal and the specific appraisals hypothesized to evoke anger. The authors then describe how their model can account for the instances of anger described by L. Berkowitz and E. Harmon-Jones and how both accounts might be tested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

浅谈国际项目成功投标的几点认识

投标竞争的胜负不仅取决于各投标人的综合实力，也取决于投标人的投标策略和投标技巧运用得是否得当。结合莱钢成功招标的经验，从几个方面介绍了成功投标需要注意的一些事项，对今后国际项目投标具有借鉴意义。     

对我国酱油酿造几项新技术应用之浅见

本文概述了三十年来我国酿造酱油工业开展研究的六项新技术在现阶段的投产可行性，及进一步研究方向的看法。     

Toward an Understanding of the Determinants of Anger.

Research bearing on several popular conceptions of the major determinants of anger arousal indicates that the particular appraisals often identified as causes of anger frequently only serve to affect the intensity of the anger that is generated. Research into effects of physical pain or other physically unpleasant conditions or involving social stresses suggests that decidedly aversive conditions are a major spur to anger. Experiments are also reviewed showing that anger-related muscular movements can also lead to anger-related feelings, memories, cognitions, and autonomic responses. Alternative explanations for the findings are discussed. The authors urge emotion theorists to widen their methodology and analyses so that they give careful, detailed attention to the many different factors that can influence anger. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

科研项目管理信息系统的设计

介绍了用自顶向下的结构化方法进行科研项目管理信息系统设计的过程。该系统的应用节省了大量人力、物力和财力,提高了企业科研项目管理水平。     

SDH光通信设备工程测试

结合实际介绍了SDH光通信设备工程测试项目和测试方法，及相关的技术指标，包括平均发送光功率测试、接收机灵敏度测试、接收机过载功率测试、误码测试、抖动和漂移测试、定时同步测试、保护倒换测试、开销和维护信号测试、网管功能测试等。     

舰船用断路器抗冲击欠压脱扣器的设计

对断路器的欠压脱扣器结构进行分析和研究 ,采用平衡机构、弹性球效应等抗冲击设计方法 ,并通过理论计算和验证 ,将H—DW14舰船用断路器的欠压脱扣器设计成具有抗冲击能力的产品 ,以适应舰船的要求。