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。     

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     

高强IF钢析出物的析出特征

高强ＩＦ钢是汽车用深冲钢板中深冲性能最好的高强度钢板。目前，国际上对该钢种的研究十分活跃。本文在实验条件下，通过对高强ＩＦ钢析出物的观察研究了高强ＩＦ钢析出物的析出特征，发现了新的析出相ＴｉＦｅＰ，并对磷对深冲性能影响的作用机制，进行了探讨。     

析出物对IF钢性能的影响

一种阻性的晶闸管控制制动器被用于阻尼向串联补偿传输供电的热电发电机中的瞬态扭。重点放在开发适用的控制算，并通过多种不同的运行方式验证算法。作为一种制动器最优控制的可能方法，本文研究了离散等级一般化预先控制（ＧＰＣ），讨论了系统上ＧＰＣ执行过程中存在一些问题。用Ｐｒｏｎｇ分析来辩识系统传递函数，此传递函数与控制方案的考虑及强度特性有关。     

高浓度焦化废水的预氧化-混凝处理研究

焦化废水成分十分复杂,污染物浓度高,性质非常稳定且水量大,是典型的难降解有机废水。使用H2O2为氧化剂,FeSO4.7H2O为催化剂的Fenton氧化法对钢铁焦化厂废水的终冷水进行了试验研究,氧化处理后用FeCl3为混凝剂对COD,NH3-N,色度及浊度的去除率进行了系统的考查。确定了氧化反应的影响因素和最佳的混凝实验条件。结果表明:当pH值控制在3左右,反应时间为30 min,反应温度为80℃,焦化废水的COD,NH3-N,浊度和色度去除率分别达到了93.1%,96.2%,90.8%和90.2%。     

含油废水处理

在水量水质调查的基础上，本文提出了以出水回用为目的的含油废水隔油调节沉淀－混凝沉淀－砂滤处理工艺，动态模型试验表明，废水中油和ＣＯＤ的去除率分别达到９５％和９０％，出水浊度低于２，此水质完全可回用于有关生产车间。     

石英砂加载混凝工艺的DOM去除特征与混凝机理

为处理未纳入管网的市政污水,采用石英砂加载混凝工艺,考察石英砂的粒径及其投加量对处理效能的影响,分析了溶解性有机物(dissolved organic matters,DOM)的去除特征,并探讨了石英砂加载混凝机理。结果表明,与常规混凝相比,当石英砂的粒径和投加量分别为200目和 1.0 mg/L 时,石英砂加载混凝工艺对污水中浊度、COD的去除率分别为97.55%、59.2%,优于常规混凝;石英砂加载混凝工艺可明显去除芳香类、共轭双键、疏水性有机物,主要促进了腐殖质类物质的削减;石英砂通过架桥作用增加了絮体的密度,进而显著改善了絮体的沉降性能、强度;絮体的沉降性能、强度及再稳性能随着石英砂粒径的降低而升高。     

新型高温合金700℃时效组织及力学性能

利用微观组织分析和高温力学性能测试方法，研究了1种新型Ni—Cr—Co基高温合金在700℃长期时效过程中的组织稳定性及其一些力学性能。结果表明：试验合金在700℃时效过程中，析出物有MC，M23C6和γ’；晶内和晶界碳化物MC和M23C6的稳定性好，γ'的粗化为扩散控制的生长过程；在700℃时效初期，室温硬度变化小，随时效时间的增加而减小，这与γ'的粒度、形貌和分布有关；合金的高温拉伸强度和持久强度比Nimonic 263显著提高，且韧塑性好；试验合金在700℃具有稳定的显微组织和较高的高温力学性能。     

The Role of Circulating Biomarkers in Peripheral Arterial Disease

Peripheral arterial disease (PAD) of the lower extremities is a chronic illness predominantly of atherosclerotic aetiology, associated to traditional cardiovascular (CV) risk factors. It is one of the most prevalent CV conditions worldwide in subjects >65 years, estimated to increase greatly with the aging of the population, becoming a severe socioeconomic problem in the future. The narrowing and thrombotic occlusion of the lower limb arteries impairs the walking function as the disease progresses, increasing the risk of CV events (myocardial infarction and stroke), amputation and death. Despite its poor prognosis, PAD patients are scarcely identified until the disease is advanced, highlighting the need for reliable biomarkers for PAD patient stratification, that might also contribute to define more personalized medical treatments. In this review, we will discuss the usefulness of inflammatory molecules, matrix metalloproteinases (MMPs), and cardiac damage markers, as well as novel components of the liquid biopsy, extracellular vesicles (EVs), and non-coding RNAs for lower limb PAD identification, stratification, and outcome assessment. We will also explore the potential of machine learning methods to build prediction models to refine PAD assessment. In this line, the usefulness of multimarker approaches to evaluate this complex multifactorial disease will be also discussed.