目的:探究高海拔地区慢性阻塞性肺疾病(chronic obstructive pulmonary diseases,COPD)合并继发性红细胞增多患者的炎症和凝血水平,为改善患者预后及提高患者生存质量提供依据.方法:选取2016年1月至2019年9月青海大学附属医院的222例COPD患者,其中合并继发性红细胞增多的111例患者作为病例组,另外非合并继发性红细胞增多的111例患者作为对照组,回顾性收集患者住院期间的凝血相关指标、红细胞沉降率、C反应蛋白和红细胞参数,对两组患者的相应指标进行对比分析,并对COPD合并继发性红细胞增多患者的炎症和凝血指标进行相关性分析.结果:COPD合并继发性红细胞增多患者的凝血酶原时间延长且高于对照组水平,差异有统计学意义(P<0.05);对照组D-二聚体水平、红细胞沉降率、C反应蛋白和纤维蛋白原含量较病例组高,纤维蛋白原含量与红细胞沉降率和C反应蛋白呈正相关,红细胞压积与红细胞沉降率呈负相关,差异有统计学意义(P<0.05).结论:应警惕高海拔地区COPD合并继发性红细胞增多患者由于凝血机制发生改变而导致的出血风险,关注患者的炎症相关指标变化,及早合理地对这类患者的炎症及凝血水平进行干预,以改善患者预后.

目的 比较在慢性阻塞性肺疾病急性加重期(AECOPD)病原体诊断层面不同检验试验方法 ,从而探讨细菌感染在AECOPD中的作用及发病机制.方法 回顾性分析青海大学附属医院2016年1月-2019年9月2345例住院患者慢性阻塞性肺疾病(C O PD)合并肺部感染的临床资料,分析其病原菌分布特征;选取2019年住院患者6例诊断为A EC O PD的患者,采集肺泡灌洗液进行细菌培养,同时,对肺泡灌洗液进行微生物多样性高通量二代测序,从而比较微生物种类和分布情况.结果 研究对象共纳入1592例AECOPD患者的病历,整理分析感染病原体种类,分别为革兰阴性菌包括肺炎克雷伯菌、鲍氏不动杆菌、铜绿假单胞菌等,革兰阳性菌包括肺炎链球菌,金黄色葡萄球菌;临床采集的6例A EC O PD患者的肺泡灌洗液标本进行培养和测序,通过肺泡灌洗液标本培养检出的病原体分别为鲍氏不动杆菌和肺炎克雷伯菌,通过测序技术,细菌分类门水平的主要为蛋白质细菌、厚壁菌、放线菌门、拟杆菌、栖热菌门、梭杆菌门、蓝细菌、绿弯菌门、浮霉菌门、酸杆菌;属层面主要的病原体为链球菌、棒状杆菌、克雷伯菌、乳酸菌、贪铜菌属、假丝酵母、苍白杆菌属、嗜血杆菌、普雷沃菌属、葡萄球菌、通过聚类分析后热图结果 显示嗜血杆菌、链球菌、假丝酵母、苍白杆菌属等在不同的样本中序列较高.结论 从纵向患者人群数据,以及横向实验室数据进行比较,探讨在AECOPD病原体诊断层面,测序技术可能更优越于传统培养方法 .

Three Cu-P-Cr-Ni-Mo-Nb weathering steel samples of different grain sizes,which were of 11.9 μm,9.2 μm and 6.8 μm respectively,were prepared using Gleeble-1500D thermo-simulator system.The accelerating corrosion experiments of the bare weathering steel were carried out for 72 hours through the FI-65 dry wet cycle infiltrating corrosion tester.The rust layer and matrix of the trial steel had good combinability.The corrosion weight-loss method was exploited to obtain the corrosion mass,and the corrosion rate and depth were calculated.The results showed that the grain size does not significantly affect the atmosphere corrosion resistance.

It is described the reasons of chilling microstructure is easy to produce in the thin-wall ductile cast iron;in order to suppress the microstructure,the graphitization should be promoted and the amount of spherical graphite should be increased.Then the effects of chemical composition of C,Si,S,Mn,rare earth elements and spheroidization-inoculation on graphitization are introduced.To effectively restrain chill microstructure generation,graphitization should be prompted and the number of spherical graphite is increased by strictly controlling the composition of melting iron,strengthening inoculation and addinng appropriate RE.

The high strength thin walled ductile cast iron with no chill was produced by adding a certain amount of carbide forming element Mn and pearlite stabilizing element Cu,and its structure is all fine pearlite.The experimental results show that with 1.5% Cu addition the Y-shape sample has a tensile strength more than 900 MPa and an elongation of about 4%;while for the bar sample of Φ10 mm,its tensile strength is close to1 100 MPa and elongation is around 7%.