数据中心油机、市电逐级投切管理方案简析

分析大型数据中心市电电源与油机电源切换过程中,突加重载及容性带载对油机系统带来的较大压力可能造成油机系统无法稳定可靠地进行带载的问题,进而提出在电源切换过程中对负载进行逐级投切的管理方案,并根据实际应用案例分析具体操作顺序。

不稳定顶板普采工作面切顶线管理与工效研究

针对采煤工作面切顶线管理所存在的问题，从人类工效学的角度出发，立足于安全、高效，探讨了适合于不稳定顶板工作面切顶排支护方式和回柱工艺过程，并从两个方面提出了改进措施，即：一是利用倾斜抬棚代替倾斜戗棚，改善切顶线特殊支护的承载方式；二是利用倾斜抬棚的支设位置缩小工作面回柱步距，改变回柱工序施工环境．经现场试验取得了显著效果．

5G核心网切片运维管理关键技术研究

随着5G 核心网商用部署需求的日渐强烈,部署计划已经提上日程。与此同时,作为5G 核心网关键技术之一,核心网切片的相关研究也日趋成熟。因此,伴随着5G 核心网的商用部署,核心网切片的运维管理方案也将日趋紧迫。探讨了核心网切片运维管理的几个关键技术,包括核心网切片的设计、部署、闭环保障3 个方面,是5G 核心网商用部署的重要前提。

煤矿安全切块管理方法

直到今天,煤矿重大恶性事故尚未从根本上得到控制,零星事故时有发生,安全始终是困扰各级领导和煤矿全体职工的首要问题。新汶矿务局良庄煤矿大胆革新传统的安全管理方法,创造性地运用先进管理理论,探索实施了"切块管理、专业负责;专监为主、群监结合;严格考核、重奖重罚"的安全管理办法,实现了安全工作持续、稳定、健康地发展。文章详细介绍"切块管理"的理论依据、内容和实施经验,很值得从事煤矿安全工作的同志学习和借鉴。

乡镇财政切块管理的做法和效果

1989年初，江苏省东台市财政局试行由农财股对乡（镇）财政业务工作归口统一管理，简称“切块管理”。具体做法有“五个统一”：一统预决算管理；二、统一拨款管理；三、统一指标管理；四、统一财务管理；五、统一汇编报表。

高职院校班级“切块制”管理的探索

时代在进步,同学们在成长,每一届的学生有每一届的特点,由于学生家庭成长环境、生活水平、社会环境等差异造成了学生不同阶段特色的变化.所以班级管理要因时制宜,随着时代的变化,顺应学生特色的变化,适时调整班级管理模式.

98例气管切开患者应用可冲洗气管套管的护理体会

目的介绍可冲洗气管套管在气管切开病人治疗过程中对呼吸机相关性肺炎(VAP)发生率及带机时间的影响。重点阐述有效清理以前普通气管套管无法清除的气囊上存留的口咽部分泌物的操作方法,有效降低应用呼吸机治疗时VAP的发生率,并且缩短了带机时间及相关并发症的发生,达到较满意效果。

调度管理由生产型转向经营型的转变

该文结合翟镇煤矿调度室由单一的生产管理型转向经营管理型 ,从岗薪动态化及“三个闭合”入手 ,实行了调度内部切块承包管理 ,为逐步走向调度管理市场化打下了坚实的基础。

切块搞活 分兵突围——对老矿井扭亏脱困的调查和思考

目前,在十五届四中全会精神指引下,国企转机改制和扭亏攻坚正如火如荼进行。作为煤炭行业特殊困难的老矿井,如何以此为契机,通过改革攻坚,二次创业,实现新生。这是国有煤炭企业改革迫切需要重点解决的问题,本文结合汾西矿务局两渡矿实际提出一些思路和看法。

Comparative study of laparoscopic vs open gastrectomy in gastric cancer management

AIM:To compare long-term results of gastric cancer patients undergoing laparoscopic and open gastrec-tomy in a single unit.METHODS:From February 2000 to September 2004,all patients with adenocarcinoma of the stomach were assessed to entry in this longitudinal prospective non-randomized trial.Primary endpoint was cancer-related survival and secondary endpoints were overall survival,evaluation of surgical complications and mortality.RESULTS:Fifty-eight patients were enrolled.Forty-seven patients were followed-up(range 11-103,me-dian 38 mo).Four patients were lost at follow up.Twenty-two patients underwent a laparoscopic gastric surgery(LGS)and 25 had a standard open procedure(OGS).No statistical difference was found between the two groups in terms of 5 years cancer-related mortality rate(50% vs 52%,P = 1),and 5 years overall mortal-ity rate(54.5% vs 56%,P = 1).Accordingly,cancer-related and overall survival probability by Kaplan-Meier method showed comparable results(P = 0.81 and P = 0.83,respectively).We found no differences in surgical complications in the 2 groups.There was no conversion to open surgery in this series.CONCLUSION:LGS is as effective as OGS in the man-agement of advanced gastric cancer.However LGS can-not be recommended routinely over OGS for the treat-ment of advanced gastric cancer.

Current management strategy of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) still remains a considerable challenge for surgeons.Surgery,including liver transplantation,is the most important therapeutic approach for patients with this disease.HCC is frequently diagnosed at advanced stages and has a poor prognosis with a high mortality rate even when surgical resection has been considered potentially curative.This brief report summarizes the current status of the management of this malignancy and includes a short description of new pharmacological approaches in HCC treatment.

Perioperative management of primary liver cancer

AIM:To minimize the complications and mortality and improve the survival in primary liver cancer (PLC) patients undergoing hepatic resection. METHODS: We conducted a retrospective analysis of 2143 PLC patients treated from January 1990 to January 2004. The patients were divided into two groups using January 1997 as a cut-off. Small tumor size (< 5 cm), preoperative redox tolerance index (RTI), vascular control method, and postoperative arterial ketone body ratio (AKBR) were used as indicators of surgical outcome. RESULTS: Small tumors had less complications and lower mortality and higher overall survival rate. Use of RTI for selecting patients and types of hepatectomy, reduced complications (21.1% vs 11.0%) and mortality (1.6% vs 0.3%). The half liver vascular occlusion protocol (n = 523) versus the Pringle method (n = 476) showed that the former significantly reduced the postoperative complications (25.8% vs 11.9%) and mortality (2.3% vs 0.6%) respectively, and cut mean hospital stay was 3.5 d. Postoperative AKBR was a reliable indicator of the energy status in survivors. CONCLUSION: RTI is of value in predicting hepatic functional reserve, half liver occlusion could protect the residual liver function, and AKBR measurement is a simple and accurate means of assessing the state of postoperative metabolism. Optimal perioperative management is an important factor for minimizing complications and mortality in patients undergoing hepatic resection.

Efficacy of surgical resection in management of isolated extrahepatic metastases of hepatocellular carcinoma

AIM:To clarify the benefit of surgical excision for patients with extrahepatic metastases of hepatocellular carcinoma(HCC). METHODS:We retrospectively reviewed the medical records of 140 patients with pathologically proven extrahepatic metastases of HCC and evaluated the outcomes of those who had undergone surgical resection(SR)for extrahepatic metastatic lesions.Prognoses made on the basis of extrahepatic metastatic sites were also examined. RESULTS:The survival rates of patients who underwent SR of extrahepatic metastases were significantly better than those of patients who did not receive SR. For the SR group,1-and 3-year survival rates were 24%and 7%,respectively,while for the non-resection group,the survival rates were 8%and 0%,respec- tively(P<0.0001).Survival rates related to metastatic sites were also significantly superior after SR of extrahepatic metastases:median survivals were 32 mo with lung metastasis,10 mo with bone metastasis,6.1 mo with brain metastasis. CONCLUSION:SR can provide survival benefits forpatients with 1 or 2 isolated extrahepatic metastases and who concurrently exhibit good hepatic functional reserve and general performance status as well as successful treatment of intrahepatic HCC.

Clinicopathologic characteristics of esophagectomy for esophageal carcinoma in elderly patients

AIM： To evaluate the risk of esophagectomy for carcinoma of the esophagus in the elderly （70 years or more） compared with younger patients （〈70 years） and to determine whether the short-term outcomes of esophagectomy in the elderly have improved in recent years. METHODS： Preoperative risks, postoperative morbidity and mortality in 60 elderly patients （≥70 years） with esophagectomy for carcinoma of the esophagus were compared with the findings in 1 782 younger patients （〈70 years） with esophagectomy between 3anuary 1990 and December 2004. Changes in perioperative outcome and short-time survival in elderly patients between 1990 to 1997 and 1998 to 2004 were separately analyzed. RESULTS： Preoperatively, there were significantly more patients with hypertension, pulmonary dysfunction, cardiac disease, and diabetes mellitus in the elderly patients as compared with the younger patients. No significant difference was found regarding the operation time, blood loss, organs in reconstruction and anastomotic site between the two groups, but elderly patients were more often to receive blood transfusion than younger patients. Significantly more transhiatal and fewer transthoracic esophagectomies were performed in the elderly patients as compared with the younger patients. Resection was considered curative in 71.66% （43/60） elderly and 64.92% （1 157/1 782） younger patients, which was not statistically significant （P〉0.05）. There were no significant differences in the prevalence of surgical complications between the two groups. Postoperative cardiopulmonary medical complications were encountered more frequently in elderly patients. The hospital mortality rate was 3.3% （2/60） for elderly patients and 1.1% （19/1 782） for younger patients without a significant difference. When the study period was divided into a former （1990 to 1997） and a recent （1997 to 2004） period,operation time, blood loss, and percentage of patients receiving blood transfusion of the elderly patients significantly improved from the former period to the recent period. The hospital mortality rate of the elderly patients dropped from the former period （5.9%） to the recent period （2.3%）, but it was not statistically significant. CONCLUSION： Preoperative medical risk factors and postoperative cardiopulmonary complications after esophagectomy are more common in the elderly, but operative mortality is comparable to that of younger patients. These encouraging results and improvements in postoperative mortality and morbidity of the elderly patients in recent period are attributed to better surgical techniques and more intensive perioperative care in the elderly.

Practical approaches to effective management of intestinal radiation injury:Benefit of resectional surgery

AIM:To study the outcome of patients undergoing surgical resection of the bowel for sustained radiation-induced damage intractable to conservative management.METHODS:During a 7-year period we operated on 17 cases (5 male,12 female) admitted to our surgical department with intestinal radiation injury (IRI).They were originally treated for a pelvic malignancy by surgical resection followed by postoperative radiotherapy.During follow-up,they developed radiation enteritis requiring surgical treatment due to failure of conservative management.RESULTS:IRI was located in the terminal ileum in 12 patients,in the rectum in 2 patients,in the descending colon in 2 patients,and in the cecum in one patient.All patients had resection of the affected region(s).There were no postoperative deaths,while 3 cases presented with postoperative complications (17.7%).All patients remained free of symptoms without evidence of recurrence of IRI for a median follow-up period of 42 mo (range,6-96 mo).CONCLUSION:We report a favorable outcome without IRI recurrence of 17 patients treated by resection of the diseased bowel segment.

Is delayed gastric emptying so terrible after pylorus-preserving pancreaticoduodenectomy? Prevention and management

AIM： To explore some operative techniques to prevent the occurrence of delayed gastric emptying （DGE） alter pylorus-preserving pancreaticoduodenectomy （PPPD）.METHODS： One hundred and eighty-six patients in a single medical center who accepted PPPD were retrospectively studied. The incidence of DGE was investigated and the influence of some operative techniques on the prevention of DGE was analyzed.RESULTS： During the operative process of PPPD, the methods of detached drainage of pancreatic fluid and bile and gastric fistulization were used. Postoperatively, six patients suffered DGE among the 186 cases; the incidence was 3.23% （6/186）. One of them was complicated with intraabdominal infection at the same time, and two with pancreatic leakage.CONCLUSION： Appropriate maneuvers during operation are essential to avoid postoperative DGE in PPPD. The occurrence of DGE is avoidable. It should not be used as an argument to advocate hemigastrectomy in PPPD.

Optimal fuzzy switch placement to increase automation level of electric distribution network considering asset management principles

Since distribution sector is inherent into high amount of failures, distribution companies (DISCOs) are responsible of attaining an acceptable value for the reliability indices and otherwise they will face up to complaints. So they are usually obligated by regulators to invest on reliability improvement of network. But this investment on reliability is usually from the DISCO’s viewpoint and is also irrespective of customer satisfaction level. In other words, customers are not at the same level of sensitivity to interruptions but DISCO improves the reliability of network without considering the differences in importance degree of loads and their level of reliability requirement. On the other hand DISCOs attempt to reduce their investment costs as much as possible. This paper introduces a novel approach in the field of joint switch placement that can reduce the switch cost from the perspective of asset management policies. To this end, two switch placement plannings in different types of strategies are performed to compare their results. Firstly as witch placement is performed based on reducing the total energy not supplied (ENS) of the system. Then by revising the strategy, a fuzzy switch placement is performed from the DISCO’s point of view which just considers the total ENS of load points most sensitive to interruptions known as important or critical loads. Furthermore, by meeting the related constraints, the reliability of low sensitive customers is disregarded. This is a load importance based planning which can result in switch cost reduction relative to the amount achieved in previous strategy and implies the management of risks associated with reliability and respective constraint. Fuzzy method and new switching mechanism in fuzzy environment of network are implemented to modeling and controlling the risks associated to ENS of critical loads and also the ENS of system.

Incidental gallbladder cancer during laparoscopic cholecystectomy:Managing an unexpected finding

AIM:To evaluate the impact of incidental gallbladder cancer on surgical experience.METHODS:Between 1998 and 2008 all cases of cholecystectomy at two divisions of general surgery,one university based and one at a public hospital,were retrospectively reviewed.Gallbladder pathology was diagnosed by history,physical examination,and laboratory and imaging studies [ultrasonography and computed tomography(CT)].Patients with gallbladder cancer(GBC) were further analyzed for demographic data,and type of operation,surgical morbidity and mortality,histopathological classification,and survival.Incidental GBC was compared with suspected or preoperatively diagnosed GBC.The primary endpoint was diseasefree survival(DFS).The secondary endpoint was the difference in DFS between patients previously treated with laparoscopic cholecystectomy and those who had oncological resection as first intervention.RESULTS:Nineteen patients(11 women and eight men) were found to have GBC.The male to female ratio was 1:1.4 and the mean age was 68 years(range:45-82 years).Preoperative diagnosis was made in 10 cases,and eight were diagnosed postoperatively.One was suspected intraoperatively and confirmed by frozen sections.The ratio between incidental and nonincidental cases was 9/19.The tumor node metastasis stage was:pTis(1),pT1a(2),pT1b(4),pT2(6),pT3(4),pT4(2);five cases with stageⅠa(T1 a-b);two with stageⅠb(T2 N0);one with stage Ⅱa(T3 N0);six with stage Ⅱb(T1-T3 N1);two with stage Ⅲ(T4 Nx Nx);and one with stage Ⅳ(Tx Nx Mx).Eighty-eight percent of the incidental cases were discovered at an early stage(≤Ⅱ).Preoperative diagnosis of the 19 patients with GBC was:GBC with liver invasion diagnosed by preoperative CT(nine cases),gallbladder abscess perforated into hepatic parenchyma and involving the transversal mesocolon and hepatic hilum(one case),porcelain gallbladder(one case),gallbladder adenoma(one case),and chronic cholelithiasis(eight cases).Every case,except one,with a T1b or more advanced invasion underwent Ⅳb + Ⅴ wedge liver resection and pericholedochic/hepatoduodenal lymphadenectomy.One patient with stage T1b GBC refused further surgery.Cases with Tis and T1a involvement were treated with cholecystectomy alone.One incidental case was diagnosed by intraoperative frozen section and treated with cholecystectomy alone.Six of the nine patients with incidental diagnosis reached 5-year DFS.One patient reached 38 mo survival despite a port-site recurrence 2 years after original surgery.Cases with non incidental diagnosis were more locally advanced and only two patients experienced 5-year DFS.CONCLUSION:Laparoscopic cholecystectomy does not affect survival if implemented properly.Reoperation should have two objectives:R0 resection and clearance of the lymph nodes.