西安f_8地裂缝局部详勘分析

建设场地或场地附近有地裂缝穿过时,工程设计和施工前应进行专门的场地地裂缝勘察。建设在地裂缝场地的建筑物应根据建筑物的重要性类别、结构形式和地裂缝的活动性质合理确定避让距离,以确保建筑物的安全。文章以西安f8地裂缝局部详勘为例,根据次生地裂缝分布在主地裂缝南侧的规律及初勘时所确认的南侧地裂缝坐标,推断场地北侧应该不存在次生地裂缝,据此制订了以南为主、排查北侧的勘察方案。经过现场勘察,确认了场地南侧为主地裂缝、北侧不存在次生地裂缝的推断,缩短了勘察时间并节约了勘察费用,对同类场地的地裂缝勘察有一定的参考作用。     

Equitable fiscal consolidations

Empirical research has uncovered an equity-efficiency trade-off in alternative fiscal consolidation strategies. Spending-based adjustments are associated with more limited output losses but greater inequality than tax-based adjustments. Moreover, spending-based adjustments are less likely to be reversed, but an increase in inequality reduces the likelihood of achieving a successful consolidation. We investigate the issue of designing a debt consolidation plan which is achieved through a reduction in public consumption and yet is equitable because temporary targeted transfers and tax reductions stabilize consumption of the poorer part of the population. This causes a limited slow-down in the pace of debt reduction because fiscal multipliers associated to the tax/transfer policies are large.     

VSD治疗四肢软组织缺损创面的医疗成本分析

目的:通过对负压封闭引流技术(VSD)与传统换药(CDC)两种方法治疗四肢软组织缺损创面医疗成本进行分析,为医疗医疗决策提供理论依据.方法:收集西安交通大学附属第一医院创伤整形科2008年1月至2011年6月期间收治入院的四肢软组织缺损创面患者共216例,VSD治疗者106例,CDC治疗者110例.通过比较两组病人治疗过程中提供医疗服务所需直接医疗费用,进行医疗成本分析.结果:VSD组住院总费用高于普通换药组；VSD组手术费用低于CDC组,特殊耗材费用VSD组高于CDC组；VSD组换药费用低于CDC组.结论:与传统换药相比,VSD治疗皮肤软组织缺损创面总成本相对较高,临床效果优于CDC组,成本效果比相对较低,具有很好的卫生经济学前景.     

上部无砌体挑梁与砌体开裂原因分析及优化方案

上部无砌体时的挑染，结构计算通常采用简支方案，在其根部与砌体接触面之间易出现裂缝。文章分析了裂经同现的力学原因。并根据力学理论提出了改进办法－采用固端方案。从而大大降低了这类裂缝出现的可能性。     

高层建筑梁柱节点强度等级混凝土不同时的施工方法

随着我国城市化进程的加快，高层建筑随处可见，但是高层建筑框架梁柱节点区混凝土如何浇筑才能满足承载力要求，是长期困扰设计和施工人员的问题，文章为此总结出一种节点区简易施工方法。     

Surgical treatment,complications, and reimbursement among patients with clavicle fracture and acromioclavicular dislocations: a US retrospective claims database analysis

Abstract

Aims: To assess rates of surgical treatment, post-surgical complications, reoperations, and reimbursement in patients with clavicle fractures and acromioclavicular (AC) dislocations.

Materials and methods: This US retrospective study used data from patients with ≥1 diagnosis of clavicle fracture or AC dislocation (index) between 2012–2016. Surgical treatment was defined as a procedure within 4 weeks after clavicle fracture/AC dislocation. Rates of complications (infection, non-union, mal-union), reoperations (device removal or revisions), and all-cause healthcare reimbursement (adjusted to 2016$) were evaluated 2 years post-index among surgical patients.

Results: A total of 95,243 patients with clavicle fracture and 52,100 patients with AC dislocation were identified. Mean (SD) age for clavicle fracture and AC dislocation was 23.8 (18.6) and 33.0 (15.6) years, respectively. Most clavicle fracture and AC dislocation patients were male (70.9% and 78.0%, respectively), and had few comorbidities (86.4% and 84.8% had a Charlson Comorbidity Index?=?0 and 73.1% and 66.0% had Elixhauser?=?0, respectively). Only 15.2% of clavicle fracture and 5.3% of AC dislocation patients received surgical treatment. Among patients undergoing surgical treatment, 2-year rates of infection, non-union, and mal-union were 1.0%, 4.2%, and 0.9%, respectively, for clavicle fracture, and 2.0%, 0.9%, and 0.1%, respectively, for AC dislocation. Reoperations occurred in 83.0% of clavicle fracture and 67.5% of AC dislocation patients. Mean (SD) 2-year reimbursement was $27,635 ($68,173) for clavicle fracture and $23,096 ($28,746) for AC dislocation.

Limitations: Administrative claims data lack clinical information, limiting inferences that can be made. This data may not be generalizable to other patients.

Conclusions: Rates of surgical treatment for clavicle fractures and AC dislocation and rates of infection, non-union, and mal-union among surgically-treated patients were low. However, surgical patients had high rates of device removal or revision surgery during 2-year follow-up. Improved surgical methods and technologies could reduce non-planned reoperations and device removals, thereby reducing healthcare system costs.     

压裂工艺现场施工的质量控制措施

水力压裂是油井实现增产增储、水井实现增注的强有力措施之一。在国内外,水力压裂工艺目前已经非常成熟,但工艺现场施工这个环节的质量控制手段还有待进一步的完善。通过分析华北油田碳酸岩盐水力压裂施工中出现的问题,探讨了如何确保压裂工艺现场施工质量,实现设计与实际的有效衔接。     

浅析砌体结构裂隙的成因和控制

结构裂隙控制看着是一个比较简单、普遍存在的问题,但却是一门与力学、热工学、材料学等专业知识关系十分密切的综合性学科,是建筑工程中确保工程质量不容忽视的重要环节。在该领域中,目前国内尚无统一的规范和技术指标可循。本文仅从一般理论和多年实践经验方面,通过对砌体结构裂隙成因的分析,阐述控制裂隙的措施和加固方法。     

论健康教育在促进患者康复中的价值及作用

本文通过对骨折病人进行健康教育,得出分析结论:在护理骨折病人时,重视健康教育可提高病人对疾病知识的掌握程度,有利于提高病人的自理能力,防止并发症发生,促进病人早日康复,提高其生活质量。     

煤层气井压裂裂缝参数计算方法

通过调研煤层气井压裂裂缝参数计算方法,认为吉尔兹玛方法适合用来计算煤层气井压裂裂缝参数。