目的 对天津市体系建设现状进行分析,结合新冠疫情防控工作成效,提出完善重大疫情防控体系建设等方面的建议.方法 主要采用文献分析法和专家访谈法,总结分析公共卫生应急管理与重大疫情防控的经验与成效.结果 文献分析发现,近年来我国对公共卫生的财政投入逐年上升,城市社区网格化管理等新技术帮助了服务体系更加高效运转.天津市医疗卫生资源总量逐年提高,但人均卫生资源总量相对较低.通过专家访谈认为,我国包括天津市目前的公共卫生体系是有效且相对健全的,但仍需进一步完善和强化.结论 现有公共卫生体系有效且相对健全,建议应进一步加强医学教育,提高实际动手能力,培养高层次预防医学专业人才,重视应用性研究的实际应用转化.

Based on titanium mesh membrane electrode assembly(Ti-MEA),passive direct methanol fuel cell(DMFC) was designed and made.Titanium metal mesh was used as Ti-MEA electrode substrate material,Nafion 117 membrane was used as Ti-MEA proton exchange membrane,PtRu/XC-72R and Pt/XC-72R were used as Ti-MEA anode catalyst and cathode catalyst respectively.Passive DMFC shell made of organic glass material,seals made of silicon sheet,standard parts was used as fasteners.Polarization performance of passive DMFC,based on Ti-MEA,was tested with different concentration of methanol electrolyte under room temperature and air-breathing.The research results show that:(1) when the methanol concentration increase from 0.5 mol/L through 1.0 mol/L,and to 1.5 mol/L,the peak power density of passive DMFC increases firstly,decreases later;(2) When the methanol concentration is 1.0 mol/L,the peak power density of passive DMFC is 3.91 mW/cm2.

Objective To investigate the structure of the hospitalization expenses of type 1 diabetes patients and to provide reference for controlling the medical expense effectively.Methods 15% of cases of type 1 diabetes per year were randomly selected from Tianjin residents'medical insurance database during 2003 to 2007,737 qualified cases were collected.Descriptive analysis,Kruskal-Wallis H Test and multinomial linear regression analysis were used.Results The mean of medical expenses of type 1 diabetes patients were 8 473.23 yuan,the median were 6 432.12 yuan.56.27% and 17.35% of the total expenses were attributed to medication and examinations,respectively.The major influencing factors were days of hospitalization,grade of hospitals,proportion of medication fees,and numbers of complications.Conclusions Curtailing hospitalization duration,reducing medication and examination fees rationally,improving the supervision mechanism of health care system may be the effective ways to ease the financial burden of inpatients with diabetes mellitus.

目的:观察不同强度的有氧运动对肥胖成年女性血清内脂素水平的影响。方法:选取120例肥胖成年女性,按照随机数字表随机分为1个对照组和3个有氧运动组,每组30例。3个有氧运动组分别以大、中、小运动强度进行12周的有氧运动(每周3次,每次30min),于试验前后检测4组的体质量指数(BMI)、胰岛素抵抗指数(HOMA-IR)及血清内脂素水平。结果:试验前各组的BMI、HOMA-IR和血清内脂素水平差异无统计学意义(P>0.05)。运动12周后,3个有氧运动组的BMI、HOMA-IR和血清内脂素较运动前均明显下降(P<0.05),其中中等强度有氧运动组下降最明显,与大、小运动组比较差异有统计学意义(P<0.05),而对照组的BMI、HOMA-IR和血清内脂素水平在试验前后差异无统计学意义(P>0.05)。结论:有氧运动,尤其是中等强度的有氧运动,可以显著降低肥胖成年女性血清内脂素水平。

In order to research the effect of working conditions upon titanium mesh MEA(Ti-MEA) performance,titanium mesh was used as electrode substrate material,Nafion 117 membrane as proton exchange membrane,and PtRu/XC-72R and Pt/XC-72R as anode catalyst and cathode catalyst respectively,the anode and cathode of Ti-MEA were prepared by drip-coated method.Ti-MEA was prepared by hot-pressing under 5 MPa for 180 s with 135 ℃ and tested under different working conditions.The research results show that:(1) whether the temperature condition is at room temperature(25 ℃) or high temperature(60 ℃),the maximum power density of Ti-MEA with the cathode oxidant by 0.1 MPa 100 mL/min oxygen are higher than by air-breathing;(2) whether the temperature condition is at room temperature(25 ℃) or high temperature(60 ℃),and whether the cathode oxidant is with air-breathing or 0.1 MPa 100 mL/min oxygen,the effect of methanol concentration upon Ti-MEA shows the consistency.When the methanol concentration enlarges from 0.5 mol/L to 1.0 mol/L,the peak power density of Ti-MEA increases;when the methanol concentration increases from 1.0 mol/L to 2.0 mol/L through 1.5 mol/L,the peak power density of Ti-MEA decreases;(3) When working temperature increases from 25 ℃ to 80 ℃,the peak power density of Ti-MEA increases from 5.19 mW/cm2 to 17.10 mW/cm2,gradually.

Optical microscopy and thickness gauge were used to study the interface structure of cross section and longitudinal section of hard anodic oxidation film and complex anodic oxidation film with n-SiC addition.The results of SEM and EDS show that n-SiC entered into the oxide film.Performance of the complex anodic oxidation film was tested by friction and abrasion testing and salt-fog corrosion testing.The results show that the complex anodic oxidation film with n-SiC addition had better properties.

Objective In order to probe the advantages and feasibility of Generalize Additive Models(GAM) being used to analyze the factors influencing hospitalization costs.Methods All information of Cataract patients were collected in Tianjin hospitals from January,2003 to December,2007.The data ware analyzed with GAM by using Professional statistical software S-PLUS6.2 and SAS9.2.Results GAM found the factors influencing hospitalization costs were days of hospitalization,rank of hospitalization,the insure year,the proportion of material costs,age and occupation.The structure of a smooth map of GAM found independent variables(days of hospitalization,the proportion of material costs,age) with outcome variables(total hospitalization costs) was not a linear relationship.Conclusion GAM does not assume a linear model,normal distribution,and can find a wealth of information.The advantages and feasibility of GAM can be further elaborated so that it can be used as a powerful tool to explore the complex relationships between variables.

Objective To comprehend the health status and its influential factors of health status among government employee in a district of Tianjin.Methods The objects were obtained from a district by cluster sampling method during September to December,2008.705 valid questionnaires from 740 subjects were collected and used to established decision tree model by SAS8.2 Enterprise Miner.Their health status and the influential factors were analyzed and predicted.Results The total prevalence rate was 47.0%,and the top four diseases among them were hypertension(17.87%),high blood lipid(17.73%),fatty liver(15.89%),neck and lumbar disease(12.77%).The main risk factors for health status by the decision tree analysis were as follows:age(1.000 0),smoking(0.835 9),the situation of regular meals(0.797 2),mental health scores(0.586 0),BMI(0.474 8),passive smoking(0.367 3),occupation(0.287 6),education(0.283 2),and alcohol drinking(0.136 5);protective factors and importance were sleep time(0.387 3),sport time(0.284 5),gender(0.263 6),sub-health scores(0.236 4).The forecast accuracy of decision tree was 80%,the area under the ROC curve was 0.8881(95% CI:0.864 3～0.911 9).Conclusion The health conditions of government employee were far from ideal for some chronic diseases.The health management should be emphasized in those personals in the future.

The seismic analysis of bucket foundation is carried out by using ANSYS software,the sand liquefaction and the reduction of bearing capacity are calculated,and both setting-up a contact unit and using node coupling on the bucket soil interface are used in finite element model to compare the influences on the obtained results.It has been shown that the node coupling method can ensure the precision of calculation and improve the calculation efficiency.Furthermore,several bucket foundations with different slenderness are analyzed to obtain the depth of sand liquefaction and the reduction of bearing capacity,indicating that the more slender bucket foundations will benefit the bearing capacity.

Tensile strengths and creep properties of the Mg-6Zn-（Al,Ca） series magnesium alloy are tested by using WD-10A electronic universal testing machine and RD2-3 creep tester,and the effect of microstructure on high temperature properties are investigated.The microstructure analysis of specimens is carried out by means of the metallographic microscope,scanning electron microscope and X-ray diffraction analysis et al.The results show that as-cast microstructure Mg-6Zn-2Al-0.3Mn（ZA62） alloy consists of the α-Mg and eutectic phase Mg51Zn20,the eutectic Mg51Zn20 have been gradually replaced by Ca-containing MgZn phases and τ phases when Ca is added into the ZA62 alloy,further addition of Ca leads to the increasing of grain boundary phases with another new Mg-Zn-Al-Ca phases.Though the grains have been refined by addition of 0.5% Ca obviously,both strength and ductility drops at ambient temperatures with the increase of Ca.For Ca additions,improved elevated temperature properties are obtained as compared to the ZA62 based alloy due to the thermal stability of Ca-containing phases.At the creep condition of 175 ℃/70 MPa,the creep strains of alloys Mg-6Zn-2Al-xCa increase with the decrease of grains size.

Objective To evaluate the correlation between multiple cardiovascular risk factors and severity of coronary heart disease (CHD) in patients undergoing coronary angiography. Methods Seven hundred and twenty eight patients who underwent coronary angiography were selected from Qilu Hospital from October 2008 to December 2009. The clinical data about cardiovascular risk factors including age, gender, hypertension, smoking status, type 2 diabetes mellitus, dyslipidemia, high uric acid level, low total bilirubin level, and coronary angiography results were collected. The severity and extent of coronary stenosis was evaluated by ACC/AHA coronary scoring system and CHD was diagnosed by angiography. Analyses were achieved by multiple regression analysis. Results Multiple regression analysis showed that age, gender, hypertension, type 2 diabetes mellitus and low HDL-C were prominent predictors of severity and extent of coronary heart disease. DM was the primary controllable risk factor of CHD (OR=3. 1179, P=0. 005). Conclusions The age, gender,hypertension, type 2 diabetes mellitus and low HDL-C are correlated with angiographic severity and extent of CHD. Consequently, controlling these five risk factors is important in the intervention and prevention of CHD.

Analysis of key problems proposed in the serial experiments of pipeline buckling-crushing is given.Through the experiments,the solution is proposed to greatly reduce the experiments period,manpower,material,financial and other consumption,and to improve experiments quality,speed up the schedule.

It's found in the tests of pipelines' buckling that the original sealing technique of the deep-water pressure container is time-consuming,ineffective,insecure and always unsuccessful.For these phenomena,a brand-new method and process of sealing technique is adopted to greatly improve the situation: numbering and cleaning the studs in the preliminary process to prevent jamming during the installation of nuts,taking a new accuracy-control method to avoid leakage and rework,dividing for sealing technology and choosing different sealing solutions according to different working pressures.The experiments show that the new method significantly upgrades the reliability,availability,security and efficiency of the sealing technique.

Objective To evaluate the significance of risk factors in the diagnosis of coronary heart disease(CHD) in patients underwent coronary angiography.Methods A total of 812 patients underwent coronary angiography were selected according to the inclusion criteria in Qilu Hospital from October 2008 to December 2009.Cardiovascular risk factors included age,gender,hypertension,smoking status,type 2 diabetes mellitus,dyslipidemia,high uric acid level,and low total bilirubin level.The sensitivity and specificity of the cardiovascular risk factors for diagnosis of CHD were analyzed.Analyses were aconducted with multiple logistic regression analysis.Results Gender,age,low high-density lipoprotein cholesterol(HDL-C) level,hypertension,and type 2 diabetes mellitus were significant predictors of CHD by logistic regression analyses,with a sensitivity of 95.47% and a specificity of 64.00%.The positive predictive value and negative predictive value were 92.13% and 76.19%.The area under curve(AUC) of receiver operating characteristic curve(ROC) was 0.75.Conclusion Age,gender,hypertension,type 2 diabetes mellitus,and low HDL-C correlate with CHD and have a high sensitivity and specificity for the diagnosis of CHD.

Economic globalization and internationalization of medical science raise a higher demand for medical doctoral students' English ability.To ensure and enhance the quality of medical doctoral student education and to improve the English teaching effect,this paper investigates and analyzes the situation of English learning to explore English learning needs of content of course,teaching method and model,etc.Thus the authors have provided objective and reliable theoretical basis to carry out further English teaching reform for medical doctoral students.

In order to observe the pipeline buckling process in the test and measure the pipeline strain in the whole process,a process flow and method are designed and used in the deepwater submarine pipeline buckling experiment data acquisition.The key to the data acquisition is how to protect the strain gages to make sure that it can output precisely test data in simulated deepwater environment.Finally,it presents an example to explain the feasibility of this method in deepwater submarine pipeline buckling experiment data acquisition.

[Objective]To analyze the carrying status and distribution of hepatitis B virus(HBV) among employees of catering units and public places in Nankai Ditrict of Tianjin City,and develop related control measures to reduce HBV transmission among people.[Methods]Preventive physical examination was performed on 34 323 employees in Nankai District of Tianjin City.ELISA was adopted to detect serum HBsAg and HBeAg.[Results]HBsAg positive rate of employees from catering units and public places was 2.67%,that for male and female was 3.37% and 2.10%,the difference was significant(P0.01).HBeAg positive rate of employees was 0.70%,that for male and female was 1.07% and 0.41%,the difference was significant(P0.01).The difference of HBsAg positive rate among 5 age groups was significant(P0.01),the maximum was in 20-year-old age group.The difference of HBsAg positive rate was not significant among employees from foods producing,catering business,and public places,but HBsAg positive rate of employees from hotels was significantly higher than that of employees from supermarkets(P0.01).[Conclusion] Relevant departments should strengthen the health education about hepatitis B to enhance the consciousness of the public,increase hepatitis B vaccination rate to protect people's health.The newly published The Food Safety Law of the People's Republic of China should be put into practice,and it is suggested that the detection of HBsAg should be continued in the employees engaged in restaurants and hotels

Aiming at that the bridge vehicle pumping on highway is a phenomenon that can not be eliminated in the highway construction,it accords to get conclusion and analysis on cause of bridge vehicle pumping,and discusses prevention measures of the bridge vehicle pumping,thus improving vehicle condition.

Non-degree graduate education,which has a diverse education system and a flexible learning style,complements with degree graduate education,thus forming a complete system of graduate education in China.Non-degree graduate education functions as an important form of education for on-the-job postgraduates because of the characteristics of non-degree graduate education meeting their demands.Medicine is a practical subject,and non-degree medical graduate education has become the first choice of many on-the-job medical workers for their further education.What's more,it plays a very important role in the process of training senior medical and health personnel in medical practice.This article discusses the characteristics and major problems of the current non-degree medical graduate education,and puts forward our views about how to strengthen non-degree medical graduate education.