上海419论坛-上海后花园论坛-爱上海龙凤419

Caisson installation of No.1-No.3 berths in Hanjiang Operation Area of Xinghua Port Area of Putian Port. (Photo courtesy of Xiamen Branch of CCCC No.3 Navigation Bureau)

Integral hoisting technology of steel bars in berth 6, No.5, Shihu Operation Area, Shihu Port Area, Quanzhou Port, Fujian Province. (Photo courtesy of No.5 Engineering Company of CCCC No.4 Navigation Bureau)

　　People-centered, pursuing the essential safety of the project; Guided by standards, build excellent engineering quality.

　　Since August 2015, Fujian Provincial Bureau of Traffic Construction Quality and Safety Supervision (referred to as Fujian Provincial Bureau of Traffic Quality Supervision for short) has vigorously promoted the standardization of waterway engineering construction with engineering quality and safety as the core in accordance with the requirements of the Ministry of Transport and the Fujian Provincial Party Committee and Government, forming a replicable and expandable basic model of "three three three three three" construction standardization of waterway engineering, namely "three centralization" of site construction (centralized mixing, centralized processing, Centralized prefabrication), "three enhancements" of quality control (strengthening the quality inspection of the first project, strengthening the quality of foundation construction and strengthening the treatment of common quality defects), and "three in place" of safety measures (personnel and equipment are in place, temporary electricity consumption is set in place, and safety protection measures are in place). Constantly improve the standardized construction management system, compile the "Fujian Waterway Engineering Construction Standardization Guide", organize special training, hold on-site meetings, special investigations, etc., and carry out achievements promotion and exchange. At the same time, we will intensify technological innovation, focus on the "Thirteenth Five-Year" development plan of transportation science and technology, carry out research on topics such as "Research on Quality Inspection Technology of Port Underwater Engineering Based on Multi-beam Sounding and 3D Sonar Scanning", and conduct pilot applications in demonstration projects.

　　During this period, a number of water transport engineering construction standardization demonstration projects with "safe and civilized construction, reliable and advanced technology, orderly and controlled management" have emerged in Fujian Province, including berth No.3 in Houshi Port Area of Xiamen Port, berth No.1-3 in Hanjiang Operation Area of Xinghua Port Area of Putian Port, berth No.5 and 6 in Shihu Operation Area of Shihu Port Area of Quanzhou Port, and berth No.1 and No.2 in Gu Lei Operation Area of Gu Lei Port Area of Xiamen Port. Up to now, the demonstration projects in Fujian have accumulated 14 achievements in site layout standardization, 23 achievements in construction technology standardization and 30 achievements in management behavior standardization, and most of the achievements have been compiled into the construction technology section of the Guide to Construction Standardization of Waterway Engineering by the Ministry of Transport (wharf engineering fascicle).

　　China Communications Third Navigation Bureau Xiamen Branch

　　Enhance the "wisdom content" of engineering standardization

　　Entering the berths No.1 and No.2 North of Gu Lei Operation Area in Gu Lei Port Area of Xiamen Port, which Xiamen Branch of CCCC No.3 Engineering Co., Ltd. participated in, the layout of white and blue board houses is patchy, the layout of steel yard and site safety enclosure are uniform, and the full of green in the 45,000-square-meter prefabricated yard is integrated with the nearby landscape.

　　Building a green construction site is an important link for Xiamen Branch of China Communications Third Navigation Bureau to promote the standardization of water transport construction. "Site environmental protection measures are not only the implementation and refinement of relevant construction management regulations and methods of traffic quality supervision departments, but also the spontaneous requirements for enterprises to build a platform with clear responsibilities, scientific management and efficient operation." Zhang lijie, Party Secretary of Xiamen Branch of CCCC No.3 Aviation Administration, told reporters.

　　Innovating management and creating an "upgraded version" of standardization construction

　　In the overall deployment of Fujian waterway engineering construction standardization, Xiamen Branch of CCCC No.3 Navigation Bureau established its own unique management mode in each project department on the basis of the basic model of "Three Three Three Three" standardization promoted by the whole province by analyzing the difficulties in control of each process.

　　Berth No.1-No.3 of Hanjiang Operation Area in Xinghua Port Area of Putian Port is based on the basic mode of construction standardization, and with reference to Fujian Waterway Engineering Standardization Guide Series, the construction standardization control is carried out from six aspects: system management standardization, site construction standardization, construction technology standardization, process control standardization, safety protection standardization and construction project informatization.

　　At the beginning of the project, we will adhere to the principles of green, safety and environmental protection in site construction, rationally plan the layout of the construction site, implement the standardized construction of the resident office and living area, mixing and processing area and construction work area, and realize the four concentrations of site construction; In the process of caisson prefabrication, fine management has been strengthened, and fine construction control has been carried out in the aspects of steel bar binding and positioning control, permeable formwork cloth application, drum rubber strip application, rubber plug or rubber plate application, caisson reserved hole repair, embedded iron corrosion prevention, automatic spray maintenance, two-dimensional code identification technology, caisson handling process optimization and so on.

　　The Project Department of No.7 Berth in Douwei Operation Area of Douwei Port Area of Meizhou Bay has established a system of "five strictness of system management" for subcontractor qualification examination, construction scheme examination, quality and safety disclosure, quality and safety rewards and punishment, and quality information traceability, and at the same time strengthened the control of precast beam and slab construction quality, thus forming an upgraded version of "five three strictness" (namely, five strictness of system management, three centralization of site construction and four intensification of quality control). Drawing on the experience of information management, the project department has established an "ID card" for all 437 components of this project: by reading the QR code through the mobile phone, we can clearly understand each process and responsible person from component production to site installation and site construction of cast-in-place components, thus realizing quality control. The project department has also arranged six monitoring probes along the line, and each technician can remotely monitor the construction line for 24 hours through the mobile App. On the basis of selecting the subcontracting team, the project department has formulated 57 quality rewards and punishment systems and 61 safety rewards and punishment rules, which are assessed through the quarterly special meeting on safety and quality assessment of subcontracting projects.

　　The quality of the "face value" of the common disease treatment project is "online"

　　At the site of Berth No.1-No.3 of Hanjiang Operation Area in Xinghua Port Area of Putian Port, the reporter saw that the caisson was towed to the tidal waiting area at low tide after leaving Xinghua Bay channel, and then accurately positioned to the dive pit after high tide, and then dive to the floating crane for installation.

　　"Xinghua Bay Port Area is located in a natural tidal flat. At low tide, the draft of the ship is not enough, and the towing ship cannot sail. If the most convenient excavation method is adopted, the cost is high and it is easy to destroy the ecology. The project department fully demonstrated all aspects of caisson hauling, and finally put forward a new technology to set up the tide waiting area for ships. " Wu Guanghui, deputy production manager of Hanjiang Project, told reporters that this not only overcame the limit of shallow water and deep use of hydraulic projects, but also provided reference for the future expansion of hydraulic market.

　　There are a large number of breeding areas around the construction area, which are also feeding places for egrets, loons and other birds. It is necessary to steadily push forward the construction and do a good job in ecological protection, which puts forward higher requirements for dredging technology and equipment selection.

　　Therefore, the project department brainstormed, through the analysis of the geological soil layer and the comparison of the technical performance of the ship, and finally decided to use the cutter suction dredger and the grab dredger to work alternately, forming an innovative combination of "twisting-loosening-twisting-blowing" dredging technology. The research on the topic of "Research and Application of Excavation Technology of Coagulated Pebble Layer" has minimized the impact on the surrounding environment and added a layer of safety guarantee to the coastal ecology.

　　The No.7 berth project of Douwei Port has also made outstanding achievements in the treatment of common quality problems. Because of the strong winds all the year round in the construction sea area, and there are many submarine solitary rocks and oblique rock faces, the pile foundation construction is difficult. After many discussions, analysis and comparison, the project department adopted the erection scheme of 28-meter-wide full platform and 8-meter-wide long steel temporary bridge, which changed the water construction into land construction and opened up a green channel for the safety and quality of the project. In addition, the project department infiltrated the quality control into the construction details, and put forward six control measures for the treatment of common quality defects, such as "reinforcement engineering, reserved orifice, concrete alignment, maintenance technology, roughening technology and non-edging technology". If the adjustable combined rigid inner membrane is used to replace the inner membrane of the airbag, the inner cavity structure of the beam slab and the thickness of the protective layer of the steel bar meet the requirements; The sealing of the reserved hole abandons the conventional plastic tape winding method, adopts the custom rubber cover technology, and uses the tiny deformation force of rubber to eliminate the gap between the reserved hole mold and the template, so as to achieve the effect of slurry stop and beauty.

　　Similarly, there are also berths No.1 and No.2 in Gu Lei Port Gu Lei Operation Area. They take the ERP system of the mixing station of the Third Navigation Project as the main system, and integrate the third-party software for secondary development, which realizes the informationization of the mixing station and can effectively supervise the quality of self-mixed concrete. "The system can realize the graphic collection of raw material weighing data, collect vehicle images when weighing the gross weight and weighing the leather back, and prevent vehicle changing from weighing or virtual data. At the same time, the real-time inventory of raw materials of each mixing station can be automatically calculated and displayed, and materials personnel can purchase materials according to the information of material surplus. The most important thing is that the system can check the production records, and can check the transportation vehicles, the transportation details of each vehicle and the consumption of each plate, so as to monitor the whole production process and trace the whole quality process. " Zhang Xinwei, the project manager, said that the system meets the needs of various departments for process quality control.

　　Scientific planning, site safety, civilization and wisdom

　　On the uniform construction platform of No.7 berth project in Douwei Port, there are dozens of pile foundations with holes, holes and concrete poured simultaneously on the construction platform at peak hours. Surprisingly, after reasonable planning, it is very different from the pile foundation construction site where mud splashes.

　　"The pile foundation construction of this project is a big deal. The project department has adopted’ customized’ protective measures for different working procedures and working periods, such as the combination enclosure with warning signs in punching; The pile position of the bored pile driver is protected by steel mesh and white safety net bag; If the hole has been formed, the self-made light cover plate is used to cover the enclosure, which eliminates the safety hazards of pile foundation construction and the phenomenon of’ dirty and messy’ on site. " Liu Chuang, the chief engineer of the project, said that the project department also specially asked the power company to design a cable tray to fix the cable on the outside of the temporary bridge, which improved the messy phenomenon of pulling the cable everywhere in the traditional construction site.

　　In terms of smart site construction, the berths No.1 and No.2 in Gu Lei Operation Area in Gu Lei Port Area of Xiamen Port are unique. Facing the increasing requirements of safety management, the project department introduced the concept of "real-name registration system+face recognition", collected the information of workers entering and leaving the construction site by real-name registration system, adopted the biometric combination verification technology, realized effective real-name registration system control over the personnel entering and leaving the construction site, and effectively supervised and managed the construction site by integrating data statistics, information release and inquiry, so as to realize an all-round intelligent platform system of "attendance, access control, supervision and control and information release".

　　More than that. In order to reduce or break away from the manual control of maintenance spraying, and achieve the purpose of automatic spraying and water saving, the automatic spraying maintenance platform was applied in Gu Lei project.

　　"The staff only need to set the control script and control the solenoid valve and relay switch as required. The platform monitors the external air humidity with sensors, and the valve will automatically close in rainy days. " Ji Yunfeng, the chief engineer of the project, said that the maintenance platform can be controlled in different places with the help of the current Web server, and cross-platform design can be used to achieve the purpose of sharing mobile phones and computers. In addition, the platform can automatically generate maintenance records, and prevent the maintenance records from being delayed or even artificially falsified.

　　The reporter learned that the project has also achieved automatic monitoring. "Traditional soft foundation treatment and revetment monitoring require at least three monitoring personnel in the daily observation stage, and there are cases where observation is not timely and data early warning processing is not timely. The project selects land soft foundation treatment for automatic monitoring. Compared with traditional monitoring methods, it will reduce the investment of monitoring personnel, realize the whole process collection and real-time analysis of monitoring data, and realize the real-time early warning mechanism of data out of tolerance, and guide the on-site stacking construction in time and effectively. " Ji Yunfeng said.

　　In the next step, Xiamen Branch of CCCC No.3 Navigation Bureau will further promote the standardization of waterway engineering construction. In the follow-up projects, the level of information management will be further improved, scientific research results will be refined, and the project quality and engineering efficiency will be continuously improved.

　　The fifth engineering company of CCCC No.4 Navigation Bureau

　　Standardization promotes management refinement.

　　In November, the engineering site of Berths No.5 and No.6 in Shihu Operation Area, Shihu Port Area, Quanzhou Port, Fujian Province, was surrounded by green hills and sea breeze. The reporter saw at the construction site that the signs such as "tea room", "smoking room" and "rest area" are very eye-catching, and new machinery and equipment are widely used. The well-organized project site is very different from the chaotic and noisy construction scene in the traditional impression.

　　"The Fifth Engineering Co., Ltd. of CCCC No.4 Harbor Engineering Bureau (hereinafter referred to as No.5 Harbor Engineering Bureau) has carried out the standardization demonstration project of waterway engineering construction, carried out the construction such as standardization of management system, standardization of site construction, standardization of construction technology, standardization of process control and standardization of safe production, made great efforts to practice people-oriented, safe construction and civilized construction, and created quality engineering, and implemented refined production management through the popularization and application of a series of standardization measures. Lu Shuming, general manager of sihang 5 company, said.

　　Standardization of typical demonstration construction is deeply rooted in people’s hearts.

　　At 3 o’clock in the afternoon, the reporter came to the steel processing workshop in Shihu operation area. After autumn, the air was cool, but the construction site was busy. There were advanced numerical control devices for steel bars and bending machines for steel bars, which could realize semi-automatic streamlined construction. The raw materials are packed neatly, the stacking area, processing area and finished product area are arranged in an orderly manner, the safety operation procedures are complete, the operators are dressed uniformly, and the whole workshop is busy without losing order.

　　This is a scene of "Four Concentrations" (centralized residence, centralized processing, centralized mixing and centralized prefabrication) of the site construction carried out by No.5 and No.6 berths in Shihu Operation Area of Shihu Port Area of Quanzhou Port. In the office and living camps, office areas, canteens, activity rooms, shower rooms, toilets, basketball courts and parking lots are all available and clean; In the concrete mixing station, the main roads and sites are hardened by cement, and the steel structure rainproof shed is erected on the top of the silo, which is environmentally friendly and energy-saving; In the prefabrication yard, the storage area and reserved area are arranged in parallel with the production line, which is efficient and convenient … centralized and unified management, which makes the image of civilized construction and standardized construction in Shihu operation area deeply rooted in people’s hearts.

　　In the No.3 berth of Houshigang District of Xiamen Port, standardization construction is another scene. The No.3 berth project in Houshi Port Area of Xiamen Port has been standardized from six aspects: system construction, site construction, construction technology, construction process control, safety production and informatization, and it has taken the lead in carrying out exploratory quality inspection on underwater concealed works by using multi-beam technology. Caisson prefabrication adopts non-edging technology, which solves the common quality problems of slurry leakage and damage at the edges and corners of components, and also improves the visual quality of components. In addition to the "four concentrations" of site construction, the project department also set up a home for migrant workers, implemented centralized and unified management of migrant workers, and strengthened team management.

　　There are still many projects that actively implement construction standardization. In the three years since the founding activities, a number of water transport engineering construction projects with "safe and civilized construction, reliable and advanced technology and orderly management" have emerged in No.4 Navigation Bureau and No.5 Company. Each project has "standardized implementation, regulated operation, controlled process and assessed results". On the basis of implementing the "prescribed actions", we constantly innovate and expand the "optional actions" and form a series of experiences that can be replicated and popularized.

　　Innovating technology to reduce construction risk

　　The height of a caisson is 18.1 meters. How to ensure the accuracy of steel bar binding when working at high altitude?

　　Through the innovation of construction technology, the No.5 and No.6 berths in Shihu Operation Area of Quanzhou Port have given their own answers: the project adopts the integral hoisting technology for the steel bars on the standard floor of caisson, and changes the high-altitude operation of steel bar binding into ground operation, which not only improves the binding accuracy, but also reduces the construction risk of high-altitude operation.

　　"The standard layer steel bar adopts integral hoisting technology, and the spreader beam and lifting point are checked by software, and the maximum deformation in the maximum span is only 9 mm, so as to ensure the installation accuracy of the overall standard layer steel cage. In this way, the workers’ work moved from the caisson prefabrication flow operation area to the fixed special binding area and moved back to the ground from high altitude. " Chen Guangyuan, deputy general manager and chief engineer of Sihang No.5 Company, said.

　　Technological innovation is reflected in all construction links of the project. According to reports, in the process of steel bar processing, the project department introduced CNC cutting machines and CNC bending machines. Workers only need to simply set the data and put in the steel bar, and the machine can automatically process the steel bar into a standard length and shape to meet the construction requirements. In the process of standardized construction of concrete engineering, in order to effectively control the common problems of concrete on the front and rear toe slopes of caisson, the project department adopted permeable formwork cloth to stick on the front and rear toe and side toe formwork of caisson, which solved the problem that bubbles in the inclined concrete could not be discharged in the past, and the concrete was full of luster and improved the visual effect.

　　Do a project and set up a monument. Adhering to the concept of quality and cultural characteristics of "quality and continuous improvement", No.4 Navigation Bureau and No.5 Company promoted the standardization of waterway engineering construction by carrying out process innovation in various projects.

　　In the binding process of bottom steel bars in berths No.5 and No.6 of Shihu operation area of Quanzhou Port, the steel bars are limited by the limiting frame, which effectively controls the outer contour size of steel bars and the spacing of steel bar binding, and effectively ensures the thickness of protective layer. In addition, the "U"-shaped steel bar horizontal and vertical cross control measures are adopted for the steel bar mesh, which greatly improves the safety of personnel operation.

　　At berth 14 of Kemen operation area in Luoyuanwan port area of Fuzhou Port, the project department carried out quality management activities such as "improving the coordinate correction rate of steel pipe pile sinking position" and "controlling and reducing concrete cracks in cast-in-place pavement" with QC team activities as the carrier, which played a significant role in solving quality problems in construction and improving work quality. The QC team of this project was awarded "Excellent (First Prize) Quality Management Team of Fujian Province in 2017".

　　In the process of caisson prefabrication in No.3 berth project of Houshi Port Area of Xiamen Port, in the process of repairing reserved platform nut holes, a special pull rod hole chisel machine was used to chisel the concrete on the inner wall of the hole, so as to improve the bonding effect of new and old concrete. At the same time, mortar with strength and chloride ion penetration resistance not lower than that of the parent concrete is used to block the eyelets, and adhesive tape is pasted for water conservation.

　　"There are many hidden links and frequent process changes in the construction of water transport projects. Construction standardization can effectively control construction risks and manage loopholes. In addition, the large-scale components of water transport engineering, the extensive use of ship machinery and equipment, and the high degree of construction mechanization have the necessary conditions for implementing construction standardization. " Chen Guangyuan said that since the company started the standardization of water transport engineering construction, the quality and construction efficiency of various demonstration projects have been effectively improved.

　　Start from the source and build a security line.

　　As soon as we stepped into the site of No.5 and No.6 berths in Shihu Operation Area of Quanzhou Port, the project safety experience area came into view. Here, workers can try hard hat impact experience, seat belt use experience, hole falling experience, comprehensive electricity safety experience and other projects to deepen construction safety awareness.

　　"The project department has carefully created a safety experience zone, and at the same time, it uses multimedia safety training system to carry out safety education and real-name assessment by means of video and animation, in order to further enrich and deepen the forms of safety publicity and education, improve the safety awareness of operators from the source, and build a safe defense line." The project manager of Shihu Project introduced to the reporter.

　　Safety is more important than Mount Tai. Waterway engineering has the characteristics of working above and below water and near water, and there are some risks. In this regard, in addition to safety education, the Fifth Company of No.4 Navigation Bureau has also established a "three in place" system of safety management-safety protection measures, temporary power consumption settings and personnel access to ensure construction safety. Each project also explores unique safety protection measures in combination with its own reality.

　　The area where Shihu Project is located is greatly affected by typhoon and monsoon every year. The project department installs wave retaining walls on the edge of the prefabrication yard and adds windproof cables to the steel processing shed and gantry crane. Windproof cables are added to the mixing building, storage tank (full tank during typhoon) and silo in the mixing station; The containers in migrant workers’ dormitory area are integrally connected with steel wires to ensure construction safety.

　　Kemen Project Department strictly controls the entry and exit of construction personnel, and specially-assigned personnel will check and verify the identity information of the personnel entering the site, check the special qualification certificate of special personnel, and establish a personnel roster and a list of special operations personnel. At the same time, corresponding safety disclosure, safety education and safety examination shall be conducted for different types of work, and those who fail the examination shall be prohibited from entering the site.

　　Houshi Project Department organizes to identify and evaluate the hazards existing in the construction site, formulate corresponding control measures, and set up hazard notice boards on the construction site for publicity. At the same time, organize regular safety inspections and hold safety inspection summary meetings; Every day, full-time safety officers conduct safety supervision and inspection on the construction site, issue a safety hazard rectification notice or engineering business contact list in time when finding safety hazards, and arrange relevant personnel to follow up and implement the safety hazard rectification, with the rectification rate reaching 100%.

　　"Since the implementation of safety and quality standardization activities, it has not only reduced the randomness of project management and construction operations, but also enhanced standardization and scientificity, and also promoted the continuous improvement of standardization, which has an important role in reducing and curbing accidents." Lu Shuming said that next, the fifth company of the Fourth Navigation Bureau will carry out the promotion and exchange of various construction standardization achievements, providing a solid backing for more projects to complete the construction with good quality and quantity.

　　(Reporter: Jiang Li Correspondent: Chen Burst Gu Yunxia Liu Lifen)

Hypertension in the elderly is one of the main diseases that threaten the health and life of the elderly. Epidemiological survey data show that the prevalence rate of hypertension in the elderly in China is as high as 40%~60%, which has become the most important risk factor for the incidence and death of cardiovascular and cerebrovascular diseases in the elderly in China. Because hypertension in the elderly is different from non-elderly people in terms of pathogenesis, clinical manifestations, diagnosis and treatment, understanding and mastering these characteristics will help improve the diagnosis and treatment level of hypertension in the elderly.

Hypertension in the elderly refers to those who are over 60 years old and have a systolic blood pressure of ≥140mmHg and/or a diastolic blood pressure of ≥90mmHg through three different blood pressure measurements. If the systolic blood pressure is ≥140mmHg and the diastolic blood pressure is < 90mmHg, it is called isolated systolic hypertension (ISH), which usually occurs in old age. Both systolic blood pressure and diastolic blood pressure increase, which is called mixed hypertension, and it is mostly inherited from middle-aged hypertension.

High prevalence rate　 　 　

GAOXUEYADAIFU

At present, there are more than 54.5 million elderly hypertensive patients in China, and the number continues to increase. The main reasons for the increase are:

② The prevalence of hypertension among the elderly in China is increasing. In 1991, the national hypertension sampling survey showed that the prevalence of hypertension among people aged 64-74 was 41.9%. From 2000 to 2001, a sampling survey of hypertension among people in 12 provinces and cities in China showed that the prevalence rate of hypertension among people aged 64-74 was 48.8%, an increase of 16.5% compared with 1991. The huge number of elderly patients with hypertension in China makes the national medical resources and the prevention and treatment of cardiovascular and cerebrovascular diseases face severe challenges.

Regional and gender differences

GAOXUEYADAIFU

The regional differences in the prevalence of hypertension among the elderly do not show the characteristics of "high in the north and low in the south". The prevalence of hypertension among elderly women is close to or even higher than that of men, but the gender difference among the elderly over 80 years old is narrowing.

Simple systolic hypertension is more common

GAOXUEYADAIFU

Research reports show that isolated systolic hypertension accounts for 47.4%~74.8% in elderly hypertensive patients, which is a remarkable feature of elderly hypertension. And with the increase of age, ISH gradually increased, while mixed hypertension decreased.ISH in the elderly is mainly caused by the decrease of compliance due to atherosclerosis of aorta.

Studies have shown that reducing aortic compliance by 35% can increase systolic blood pressure by 25mmHg and decrease diastolic blood pressure by 12mmHg. Because systolic blood pressure can predict the occurrence of cardiovascular events more accurately than diastolic blood pressure, more attention should be paid to the treatment of ISH in clinic.

　Increased pulse pressure　 　 　 　 　 　 　　

G 　AOXUEYADAIFU

The elderly patients with ISH can’t effectively buffer the systolic pressure caused by the increase of intra-aortic pressure when they eject blood, and at the same time, they don’t have enough elastic contraction when they relax, so the diastolic pressure decreases or remains unchanged, which eventually leads to the increase of pulse pressure, which is another feature of elderly ISH.

Pulse pressure reflects the fluctuation of blood circulation and is a reliable index to measure the stiffness of aorta. Increased pulse pressure is an independent risk factor for cardiovascular events and death in the elderly, and its predictive value is greater than systolic blood pressure and diastolic blood pressure.

When the pulse pressure is greater than 65mmHg, the incidence of cardiovascular disease, stroke and peripheral vascular disease increases obviously. For every 10mmHg increase in pulse pressure, the incidence of coronary heart disease increased by 36%, stroke increased by 11%, and the total mortality increased by 16%.

Recent studies have shown that diastolic blood pressure is still the strongest predictor of cardiovascular events in the group under 50 years old; The predictive value of diastolic blood pressure, systolic blood pressure and pulse pressure in 50~59 years old is similar; The pulse pressure of the elderly over 60 years old is the most important predictor of cardiovascular events, and almost all of them are accompanied by an increase in systolic blood pressure.

For the elderly, pulse pressure and systolic pressure have replaced diastolic pressure and become the most important indicators for predicting cardiovascular events.

Blood pressure wave is large.　 　　

GAOXUEYADAIFU

With the increase of age, the sensitivity of baroreceptor decreases and the function of blood pressure regulation decreases, which makes the blood pressure fluctuation range of elderly hypertensive patients significantly larger than that of non-elderly, especially women and systolic blood pressure. The main influencing factors are:

① Eating:The incidence of postprandial hypotension in elderly hypertensive patients is 48.9%, and that in hospitalized elderly patients is as high as 78.5%. It usually happens 20~80 minutes after breakfast, and the blood pressure generally drops by 20~ 40/10~25mmHg, which is obvious after high carbohydrate diet. Its mechanism may be related to the increase of visceral blood perfusion after meals, the decrease of baroreceptor sensitivity and the insufficient sympathetic nerve tension after meals.

② Body position:Orthostatic hypotension can occur in elderly hypertensive patients when they quickly change from squatting position and lying position to sitting position and upright position, which can be reduced by 80/30mmHg in severe cases, and the recovery time is longer than that of non-elderly people. It is mainly related to the decrease of baroreceptor sensitivity in elderly patients;

③ Day and night:The circadian rhythm of hypertension in general elderly patients has not changed significantly, but the blood pressure can fluctuate by 40/20mmHg in one day, reaching 90/40mmHg in some cases, which is easy to be mistaken for pheochromocytoma.

④ Season:The blood pressure of 1/3 elderly patients changes seasonally, and the systolic blood pressure can fluctuate (61 36) mmhg within one year, which is usually low in summer and high in winter. The blood pressure of the elderly fluctuates widely, which not only affects the overall level of blood pressure and the evaluation of therapeutic effect, but also requires special caution in drug selection.

Complications are numerous and serious.

G 　AOXUEYADAIFU

The incidence of complications in elderly patients with hypertension was 40.0%, which was significantly higher than that in non-elderly patients (20.4%). With the progress of the disease, blood pressure continues to rise, causing damage to target organs and eventually leading to various complications.

① Complications related to hypertension itself:Heart failure, cerebral hemorrhage, hypertensive encephalopathy, renal arteriosclerosis, renal failure, aortic dissection;

② It is related to accelerating atherosclerosis:Coronary heart disease, transient ischemic attack, cerebral infarction, renal artery stenosis, peripheral vascular disease. The occurrence of these complications is closely related to blood pressure. When systolic blood pressure rises by 10~12mmHg or diastolic blood pressure rises by 5~ 6mmHg, the risk of stroke increases by 35%~40%, and acute coronary syndrome increases by 20%~25%. Compared with those with normal blood pressure, the incidence of heart failure and coronary heart disease in elderly hypertensive patients is 2 times higher and 3 times higher.

White coat hypertension is more common.

GAOXUEYADAIFU

White-coat hypertension refers to the phenomenon that patients only measure blood pressure rise in the clinic and blood pressure outside the clinic is normal, also known as "clinic hypertension".

White coat hypertension accounts for about 20% of primary hypertension, which is more common in elderly patients with systolic hypertension. About 42% of elderly patients with systolic hypertension have normal ambulatory blood pressure monitoring.

The vascular compliance of the elderly decreases, the systolic blood pressure reactivity increases due to stress reactions such as tension, and the sensitivity of baroreceptors decreases due to the increase of blood pressure fluctuation, which makes it more prone to "white coat phenomenon". The incidence of ISH in women is 43% higher than that in men, which may be related to the "white coat phenomenon" among women. 24-hour ambulatory blood pressure monitoring can identify "white coat phenomenon".

Pseudohypertension is common.

G 　AOXUEYADAIFU

The elderly patients with hypertension still have the problem of pseudohypertension (PHT). The reports about senile pseudohypertension at home and abroad are basically the same, and the detection rate is about 50%. Pseudohypertension means that the blood pressure measured by conventional cuff manometry is higher than that directly measured by arterial puncture. Most scholars believe that PHT can be diagnosed if the systolic pressure and/or diastolic pressure measured by cuff pressure measurement are 10mmHg higher than those measured by direct pressure measurement. Clinically, PHT includes three different situations:

① The first case is that the direct pressure measurement is completely normal, but the cuff pressure measurement is higher than normal, which is a simple PHT；;

② In the second case, the direct pressure measurement is higher than normal, but the cuff pressure measurement is higher, and the appearance of PHT cannot rule out the real hypertension, which is PHT phenomenon;

③ The third case is that the direct pressure measurement is completely normal, and the cuff pressure measurement is also normal, but the latter is more than 10mmHg higher than the former, which is also a PHT phenomenon. But what we usually call PHT refers to the first two situations.

Pseudohypertension in the elderly is related to arteriosclerosis, which reflects the degree of arteriosclerosis to some extent. If it is found that the reading of blood pressure in the elderly is high, but there is no target organ involved, and the peripheral blood vessels lack elasticity during palpation, PHT should be highly suspected. Its clinical significance lies in: if the elderly with normal blood pressure have PHT phenomenon, drug antihypertensive treatment may bring serious side effects; However, if PHT exists in elderly hypertensive patients, the severity of hypertension will be overestimated and may lead to over-treatment.

Treatment is difficult.　 　

G 　AOXUEYADAIFU

Among the patients who failed to meet the standard after systematic drug treatment, the elderly accounted for 68%, suggesting that the treatment of hypertension in the elderly is more difficult than that in the non-elderly. Among the elderly patients, 58% failed to meet the standard, and most of them were ISH. Combined medication can make the systolic blood pressure and diastolic blood pressure reach the standard of 60% and 90% respectively, indicating that it is more difficult to control systolic blood pressure. Compared with diastolic blood pressure, systolic blood pressure is a more important risk factor. Hypertension in the elderly often coexists with diabetes, hyperlipidemia, atherosclerosis, prostatic hypertrophy, renal insufficiency and other diseases. These diseases interact with each other, which complicates the treatment of hypertension in the elderly.

　The mortality rate is high.

G 　AOXUEYADAIFU

Most of them are caused by serious complications caused by target organ damage. Such as cerebrovascular accident, coronary heart disease, myocardial infarction, heart failure and renal failure.

　　CCTV News:On October 31, the Ministry of Transport held a regular press conference, which introduced the current work of ensuring traffic and logistics in China and the national highway construction projects in the first three quarters.

　　At present, the national transportation network is generally smooth, and the main logistics indicators are stable and good. October 1st &mdash; On the 25th, the average daily freight volume of the whole society increased by 2% compared with the same period of last year, and the average daily freight volume or business volume of railways, highways, waterways and postal express increased by 3.6%, 0.3%, 9.8% and 1.6% compared with the same period of last year. The average daily cargo and mail volume of civil aviation is basically the same as that of the same period last year.

　　The Ministry of Transport said that it will continue to adhere to 24-hour duty, unblock emergency transportation support telephones at all levels, strengthen regional coordination, and do its best to ensure the transportation of key production and living materials such as medical materials, people’s livelihood materials and energy materials.

　　In addition, 1&mdash; In September, 299 new expressway and provincial highway projects were started nationwide, with a total construction mileage of 9,645 kilometers and a total investment of 882.6 billion yuan. Among them, 34 new major projects were started in September, with a construction mileage of 2,132 kilometers and an investment of 385.3 billion yuan, accounting for about 43.7% of the total investment of projects started this year, an increase of about 277% from the previous month.

　　The "Measures for the Administration of Internet Domain Names" clarifies responsibilities; Hiring a non-auctioneer to preside over the auction will be fined within 10 thousand yuan; Insurance companies will fully implement "double recording"; The General Administration of Customs clarifies the administrative licensing matters of the workplace under customs supervision; You are not allowed to travel by WeChat group in Guangdong without permission; Trucks under 4.5 tons in Hebei need not apply for a business license, and the maximum penalty for revealing consumers’ personal information is 500,000 yuan &hellip; &hellip; From November 1st, a batch of new regulations will be implemented, which will affect our lives.

　　Measures for the Administration of Internet Domain Names: Clear responsibilities will be implemented on November 1.

　　On September 1, the Ministry of Industry and Information Technology promulgated the revised Measures for the Administration of Internet Domain Names (Order No.43 of the Ministry of Industry and Information Technology). The revision of the Measures for the Administration of Internet Domain Names (hereinafter referred to as the Measures) is necessary to implement the central government’s requirements for strengthening the management of Internet basic resources, and to maintain network and information security. It is necessary to refine the supervision system of domain name services in the Measures.

　　The Ministry of Industry and Information Technology said that the revised Measures are divided into six chapters, including general rules, domain name management, domain name services, supervision and inspection, penalties and supplementary provisions, with a total of 58 articles. The main contents include clarifying the division of responsibilities between the Ministry and the provincial communications administration, improving the domain name service licensing system, standardizing the domain name registration service activities, improving the domain name registration information registration and personal information protection system, and strengthening the supervision after the event.

　　Miao Wei, Minister of the Ministry of Industry and Information Technology, said that the Measures were reviewed and approved at the 32nd ministerial meeting of the Ministry of Industry and Information Technology on August 16, 2017, and will come into force on November 1, 2017. The Measures for the Administration of Internet Domain Names in China promulgated by the former Ministry of Information Industry on November 5, 2004 (Order No.30 of the former Ministry of Information Industry) shall be abolished at the same time.

　　Hiring a non-auctioneer to preside over the auction will be fined within 10 thousand yuan.

　　On October 13th, the State Administration for Industry and Commerce issued the Measures for the Supervision and Administration of Auctions, which will take effect on November 1st, 2017. The Measures stipulate that clients shall not participate in bidding or entrust others to bid on their behalf in auction activities. The auctioneer who hires a non-auctioneer to preside over the auction shall be given a warning by the administrative department for industry and commerce, and may be fined up to 10,000 yuan.

　　The "Measures" stipulate that an auctioneer may not use property or other means to bribe for business; Using auction announcements or other methods to make misleading false propaganda on auction targets; Fabricating and spreading false facts to damage the commercial reputation of other auctioneers; Infringe on other people’s business secrets by unfair means; Auctioneers and their staff participate in their own auction activities as bidders, or entrust others to bid on their behalf; Auction one’s own articles or property rights in the auction activities organized by oneself; Hire a non-auctioneer to preside over the auction; And other acts in violation of laws, regulations and rules.

　　Insurance companies will fully implement double recording.

　　Recently, the official website of the China Insurance Regulatory Commission released a message, and the China Insurance Regulatory Commission recently issued the Interim Measures for the Retrospective Management of Insurance Sales Behavior (hereinafter referred to as the "Measures"). Through the retrospective management of insurance sales behaviors of insurance companies and insurance intermediaries, the Measures record and save key links in the insurance sales process, and realize that sales behaviors can be replayed, important information can be queried, and problem responsibilities can be confirmed. This method will be implemented on November 1, 2017.

　　What is double recording? That is, when insured, audio and video recording. There are two recording methods: one is synchronous acquisition of audio and video recording. The second is to collect audio recordings, photos and insurance statements simultaneously.

　　The General Administration of Customs clarifies the administrative licensing matters of customs supervision workplaces.

　　The Interim Measures for the Administration of People’s Republic of China (PRC) Customs Supervision Zone was deliberated and adopted at the executive meeting of the General Administration of Customs on December 27th, 2016, and will come into force on November 1st, 2017. Article 6 of the Measures for the Administration of People’s Republic of China (PRC) Customs Supervision Places promulgated by Order No.171 of the General Administration of Customs on January 30, 2008 and the Decision of the General Administration of Customs on Amending Some Rules promulgated by Order No.227 of the General Administration of Customs on April 27, 2015 shall be abolished simultaneously.

　　The Interim Measures for the Administration of Customs Supervision Zones in People’s Republic of China (PRC) clarifies that customs supervision zones include special customs supervision zones, bonded supervision sites, customs supervision workplaces, duty-free shops and other places and places with customs supervision business, and makes principled and overall provisions on the management of customs supervision zones and customs supervision workplaces.

　　Guangdong’s two new regulations will be implemented on November 1, 2017.

　　1. The number and time for lawyers to meet with suspects in custody are not limited.

　　On July 27th, the Measures for Implementing the Lawyers Law of People’s Republic of China (PRC) in Guangdong Province was voted by the 34th meeting of the Standing Committee of the 12th National People’s Congress of Guangdong Province, and came into force on November 1st, 2017, becoming the first local regulation to implement the lawyers law in China.

　　The "Implementation Measures" takes "the rights and obligations of lawyers" as its core content, and makes comprehensive and specific provisions on the rights of investigation and evidence collection, meeting, communication, marking, information and relief during lawyers’ practice. According to the "Implementation Measures", defense lawyers can meet with criminal suspects and defendants in custody or under surveillance with relevant practice certification materials, and the detention center should make timely arrangements, and the number and time of meetings are not limited. During the meeting, the case-handling organ shall not send personnel to be present, and shall not monitor in any way.

　　2. You are not allowed to travel by WeChat group without permission.

　　The Regulations on Tourism in Guangdong Province was adopted at the 34th meeting of the Standing Committee of the 12th People’s Congress of Guangdong Province on July 27th, 2017, and will come into force on November 1st, 2017.

　　The Regulations on Tourism in Guangdong Province highlights the protection of the rights and interests of tourists, tour operators and tourism professionals, and provides regulations on homestays, online tourism business, travel search engine and smart tourism, and strengthens comprehensive tourism supervision, credit files, civilized tourism and legal responsibilities.

　　It is worth noting that for the popular social platforms such as WeChat and Blog to engage in group activities, the Guangdong Tourism Regulations clearly stipulates that units and individuals who have not obtained the business license of travel agencies may not engage in tourism business in the name of organizing tourism, using social platforms such as WeChat and Blog or in the form of industry associations, societies, motorists’ clubs, etc.

　　Hebei’s three new regulations will be implemented on November 1, 2017.

　　1. Regulations of Hebei Province on Road Transportation: No business license is required for trucks under 4.5 tons.

　　On September 15, 2017, the Information Office of the Hebei Provincial Government held a press conference on "Interpretation, Publicity and Implementation of the Regulations on Road Transportation in Hebei Province". The meeting announced that the Regulations on Road Transportation in Hebei Province (hereinafter referred to as the Regulations) will come into effect on November 1, 2017. Cars with a weight of less than 4.5 tons engaged in general freight transportation can no longer apply for a road transportation business license.

　　The promulgation of the Regulations on Road Transportation in Hebei Province provides a favorable legal guarantee for maintaining the order of the road transportation market, protecting the legitimate rights and interests of all parties and promoting the healthy development of the road transportation industry. The implementation of the "Regulations" will further promote the safe, stable, efficient and green development of road transportation in the province and make greater contributions to building a strong economic province and beautiful Hebei.

　　2. Regulations on the Protection of Consumers’ Rights and Interests in Hebei Province: The maximum penalty for disclosing consumers’ personal information is 500,000 yuan.

　　On July 28th, the 31st meeting of the Standing Committee of the 12th National People’s Congress of Hebei Province deliberated and passed the Regulations on the Protection of Consumers’ Rights and Interests in Hebei Province, which will be officially implemented on November 1st. The Regulations highlight the protection of consumers’ legitimate rights and interests, strengthen the obligations and responsibilities of operators, and strengthen the social supervision of the Consumer Protection Committee. Conciliation of consumer disputes has been refined, especially in view of the hot and difficult issues in the current consumption field, and the protection system of consumer rights, operator obligations and consumer rights have been improved.

　　The "Regulations" stipulate that the use of consumers’ personal information requires the consent of consumers; Operators shall keep the personal information of consumers strictly confidential and shall not disclose, sell or illegally provide it to others. If consumers explicitly ask operators to delete or modify their personal information, operators should delete or modify it. Operators who violate these regulations will be ordered to make corrections, and may be given a single warning or a warning according to the circumstances, confiscate the illegal income, and impose a fine of more than one time but less than ten times the illegal income. If there is no illegal income, a fine of less than 500,000 yuan will be imposed; If the circumstances are serious, it shall be ordered to suspend business for rectification and revoke its business license.

　　3. The Patent Regulations of Hebei Province will be implemented on November 1, 2017.

　　On September 28th, the Patent Regulations of Hebei Province was voted by the 32nd meeting of the Standing Committee of the 12th National People’s Congress of Hebei Province, and will be implemented on November 1st, 2017. As a professional, practical and operational local law, the Regulations provide all-round legal protection for encouraging inventions, promoting the transformation and application of patents, cracking down on infringement, protecting the legitimate rights and interests of patentees, and standardizing the management and service of patent work.

　　Gansu: The public resource trading platform shall not be for profit.

　　The Regulations on Tendering and Bidding in Gansu Province will come into force on November 1, 2017. The "Regulations" clarify that projects that must be tendered according to law should enter the public resource trading platform that meets the requirements. If it is really necessary to charge fees for public services provided by public resource trading platform operation service institutions, they shall not be for profit. Encourage the use of information networks for electronic bidding, and if conditions permit, electronic bidding shall be conducted. The bidding activities in the form of data message and paper form have the same legal effect.

　　"Chongqing tax collection and management measures" will be implemented on November 1.

　　Recently, the Chongqing Municipal Government issued the Measures for Safeguarding Tax Collection and Management in Chongqing (hereinafter referred to as the Measures for Safeguarding Tax Collection and Management), which will be officially implemented in the whole city from November 1, 2017.

　　It is understood that compared with the original "Chongqing Local Tax Collection and Management Safeguard Measures", the new "Safeguard Measures" include the contents of the collection and management of Chongqing national tax authorities in the scope of protection, and improve the organizational requirements, assistance requirements, information channels and other specific aspects to achieve full coverage of tax collection and management protection. In terms of tax assistance departments, the administrative departments of science and technology, transportation, commerce, state-owned assets, statistics and other central units in Chongqing have been added. In addition, in terms of tax-related information exchange, it not only increases the tax-related information exchange of traditional tax sources such as project planning permission and agricultural land transfer, but also increases the tax-related information exchange of emerging industries such as cross-border transactions.