中山痔疮啥症状(中山引起痔疮的原因有哪些) (今日更新中)

ENCINITAS (CNS) - A man was killed after being hit by an Amtrak Pacific Surfliner train in Encinitas Saturday morning, sheriff's deputies said.It happened at about 5:30 a.m. on the tracks near the intersection of San Elijo Avenue and Cornish Drive in Encinitas, according to Deputy Christopher Campbell of the San Diego County Sheriff's Department.The train had been heading north at about 60-65 mph when the train engineer noticed a man running toward the tracks from the east, Campbell said. The engineer sounded the train's horn, but the man continued running toward thetracks and dove in front of the oncoming train. The engineer activated the train's brakes but wasn't able to stop in time.Authorities pronounced the man dead at the scene, Campbell said. His identity wasn't immediately released.The train involved in the crash was delayed for about three hours, according to the Pacific Surfliner Twitter page. At least four other trains were also delayed while authorities investigated the crash. 1011

EPA Administrator Scott Pruitt's 24-hour security in Washington extends to at least some of his personal trips, according to a letter Democratic Sen. Sheldon Whitehouse sent to the department's inspector general and shared with CNN.The letter, written based on information that Whitehouse says he confidentially obtained from an unnamed source, raises new questions about the cost of Pruitt's unprecedented EPA-funded security, and alleges that Pruitt has used his security detail while on non-official business, including trips home to Tulsa, Oklahoma, a family vacation to Disneyland and the Rose Bowl game.Whitehouse, D-Rhode Island, says the new details should be added to the inspector general's ongoing investigation into Pruitt's travel expenses and use of a 24/7 security detail. The documents, he wrote, raise concern "significant agency resources are being devoted to administrator Pruitt's 'round-the-clock security, even when he is traveling on non-official business."Whitehouse adds, "While I consider matters of personal security to be extremely serious, personal security should never be used as a pretext to obtain special treatment."The letter alleges that six weekly schedules and other explanatory documents that were provided to him show that Pruitt used between two and three dozen different agents during a six-week period.Asked about the letter, the EPA told CNN that "Administrator Pruitt follows the same security protocol whether he's in his personal or official capacity," but declined to further elaborate on those protocols.The EPA has said that Pruitt has faced unprecedented threats, including direct threats on his life, leading to equally unprecedented security measures.CNN reached out to the EPA's Office of Inspector General, which did not comment on the case.Pruitt has been under increased scrutiny for citing security as the reason he flew first class on the government's tab, racking up nearly 0,000 in travel costs. On one trip to Italy, from June 5-12 of last year, his security detail alone amounted to more than ,000.Several Trump Cabinet members have faced criticism for their travels. Interior Secretary Ryan Zinke has several open investigations into his use of private aircraft and attendance at political events. Health and Human Services Secretary Tom Price left after probes of his use of private planes. And recently fired Veterans Affairs Secretary David Shulkin began his downward spiral after an inspector general report found he used agency funds on a trip for his wife.Whitehouse's office would not allow the documents or schedules to be reviewed, saying they contain sensitive security information. In addition to the family trips to Disneyland and the Rose Bowl game, the letter also alleges the security officials accompanied Pruitt on a trip to a December 29 University of Kentucky basketball game in Lexington.Whitehouse's letter also states that "more than one source" says Pruitt "frequently requested per diem lodging expenses in excess of the federal government's established daily rate."Pruitt's travel and security costs have gotten the attention of the EPA's inspector general and his fellow Republicans, including House Oversight Committee Chairman Trey Gowdy, who recently made Pruitt turn over all of his travel records for his first year.In a letter to Gowdy, Pruitt said his security team required him to be near the front of the plane for a quick exit in the case of an emergency. However, Pruitt did not turn over the waivers that are necessary to fly in an upgraded cabin.Whitehouse's letter asks the inspector general to see if Pruitt flies first class on non-official trips, and if so, whether the EPA pays for the security detail's flights, accommodations and per diems.Pruitt told CBS News recently: "There's a change coming" in the way he travels, "including flying coach," and in the way his staff will accommodate security threats.In October, CNN reported the EPA was beefing up Pruitt's 24/7 security, hiring a dozen more agents. At the time CNN calculated salaries alone for the full team would cost at least million per year, according to figures compiled from public documents. Those numbers do not include costs such as training, equipment, and travel.CNN also reported that some agents were pulled from other EPA jobs where they had been charged with investigating environmental crimes, and Whitehouse asks the inspector general to look at the impact of the shift in personnel.The-CNN-Wire 4496

Erika Jayne, a cast member of the "Real Housewives of Beverly Hills," has filed for divorce from her husband of 21 years, Tom Girardi.In a statement to E!, the reality TV star said this was "not a step taken lightly or easily."Legal documents obtained by The Blast state that the reality TV star filed for the dissolution of marriage.According to People, the couple married in 1999 at the restaurant they first met each other when Erika was a waitress.The couple does not have any children together, and in an interview with Andy Cohen on his Bravo talk show in 2017, Erika stated they do not have a prenup, E! reported.Erika was previously married to Thomas Zizzo, with whom she shares 26-year-old son Tommy Zizzo, People reported. 740

ENCINITAS (KGTV) -- The Encinitas Environmental Commission is considering a proposal to ban natural gas hookups in all new construction projects as a way to combat climate change.The plan, which will be heard by the commission again next month, was authored by environmental commissioner Jim Wang. Wang spearheaded the city’s bans on plastic bags and polystyrene containers, commonly known as styrofoam.“The problem is that methane is a much more potent global warming gas than CO2, it’s approximately 85 times as potent,” he said. “Even a small amount of natural gas causes a big problem with global warming.”RELATED: Encinitas proposes ban on gas-powered leaf blowersWang’s proposal would impact both residential and commercial construction, but would not affect existing buildings. In July, Berkley passed a ban on natural gas infrastructure in new construction that will take effect next year. Twenty other California cities are considering similar bans, Wang said.“I’ve never seen a restaurant run on electric stove-tops. It would be quite the challenge,” said Daniel England, the corporate chef behind Union Kitchen and Tap in Encinitas and other restaurants.England said he would not consider renting a building for a restaurant if it lacked natural gas.RELATED: Encinitas restaurant fined for allowing customers to dance“As a chef, it’s something we’ve been trained on from day one from culinary school. I couldn’t imagine cooking without natural gas. I’ve tried to cook on an electric stove at home and you don’t get the same consistency,” he said.Michael McSweeney of the Building Industry Association of San Diego County said the cost of electricity is typically about three times more than natural gas, so the cost of home ownership in Encinitas would rise.“It seems that they want to reduce their carbon footprint, which is great, but the biggest source of greenhouse gas emissions in Encinitas is automobile transportation,” he said. “Cutting down on car transportation, they’d get more bang for their buck.”Transportation accounts for 54 percent of the greenhouse gas emissions in Encinitas. Electricity accounts for 23 percent. Natural gas ranks third on the list, at 13 percent, according to the city’s 2018 Climate Action Plan.“Yes, it may be a little more expensive but it’s for the greater good,” Wang said.In addition to cutting greenhouse gas emissions, restrictions on natural gas could provide safety and health benefits, Wang argued, citing the 2010 San Bruno pipeline explosion that killed 8 people.Homes that cook with natural gas at least once per week have air quality that would be illegal outdoors, he said, with levels of nitrogen dioxide and formaldehyde that exceed outdoor federal air quality standards.The Environmental Commission will consider the proposal at its Dec. 12 meeting at 5:30 pm. If the commission approves it, the plan will move to the city council for consideration. 2925

Exhaustion, sadness, stress and anger. That is how one Arizona nurse describes working inside one of the busiest COVID-19 units in the state right now.Charge Nurse Debra, who requested we not use her last name or the name of the hospital in which she works, said she wanted to share "her truth" with a community that seemed divided over wearing masks and social distancing."I never ever want to get this virus, and I don't wish this on anybody," said Debra.After almost 20 years of working in an intensive care unit, nurses like Debra are used to seeing pain and suffering, but Debra said what she is seeing with COVID-19 is on another level."It's intense, very stressful, very, very challenging. I never would have guessed that this would have happened in my career," said Debra.In March, Debra and her team were informed their unit would be turning into a COVID-19 unit."At that time, I think we had about eight patients. Now we're full, we're overflowing into other units. It's difficult. It's challenging," said Debra.Debra began posting about what it was like inside her hospital. In one social media post, she said:"On the very first night there, we only had about 8 patients and by looking at how sick each of them were, I got teary/emotional and thought to myself, I can’t do this!!!! The amount of tubes, machines and continuous IV meds attached to these patients was barbaric!!!As each bed opened, or became available due to a patient’s untimely demise, I have witnessed an amazing team of healthcare providers work relentlessly for each patient. But in a lot of cases, it was never enough. I have watched us try every concoction of ventilator settings and continuous IV infusions to help a patient let the ventilator do its work for them, but in many cases, it still didn’t work.We try everything we can if the patient tolerates it. Five team members will go into rooms and sort out a vast array of tubes, IV lines, cables, equipment and wires, so we can flip a patient onto their stomach. This will sometimes help patients through the extremely severe inflammatory process that COVID causes.Most people are not in perfect shape – we have to position pillows and foam pieces underneath their body just right to avoid pressure sores, to avoid their belly from pushing against the mattress which can also prevent the ventilator from working adequately and to prevent the lines, tubes and cables from becoming detached. This process can take an hour depending on the situation."Debra also admitted she, along with experienced team members, had moments where they broke down and cried during their shifts."We all understand and are just there to help each other through it," said Debra. Their supervisors often asked them if they needed a break or some time off, but Debra said for her, that was not an option. She knew her team members and her patients needed her.For Debra, it is hard to describe the suffering she witnessed."Some patients, they cannot breathe. They're struggling to get comfortable. I don't know if you've ever felt you cannot get your breath, you cannot catch that breath, the anxiety that goes with it," said Debra.There is also a fine line when giving patients medication to calm down. There is a risk the medication could slow down or stop a patient’s breathing.Debra says she is sharing her experience with the community because she knows that numbers, charts and graphs shown by the state's health officials may be difficult for people to understand. Numbers can also be interpreted differently, based on how you looked at them. So, her clear message to people: what is happening inside our hospitals’ COVID-units today is very real."The last night that I worked, we had one COVID bed available. There are other intensive care unit beds, but people are still having car accidents, heart attacks, strokes, things like that. We need to keep those open for them," said Debra.In her social media post, Debra stated medical professionals were doing everything they possibly could to save patients’ lives, but they desperately needed more medical professionals. She also further described how they must flip patients several times during a shift and how complicated that process can be:"Placing a patient on their stomach is called proning. There are some shifts I work where we may flip patients 16 times (total flips for all patients). If anything emergent happens, we have to flip them back. This can happen to multiple patients at once and we only have so many staff members. A respiratory therapist has to be in the rooms when we flip as well. If they are in another room or we don’t have enough hands on deck to help, the patient in need just waits while their body suffers the lack of oxygen. Kidneys are being damaged and many patients have to go on dialysis.Some may be from the lack of oxygen, some are from the problems caused in the blood by COVID and others because of the septic shock and lack of adequate vital signs to ensure the kidneys actually receive enough blood flow. If a patient can not tolerate regular dialysis due to how badly their body is in shock, they are placed on a continuous type of dialysis. This requires one nurse to provide dedicated care to that patient. This nurse cannot take care of other patients.(Side note, we do not have enough nurses so every patient can have one for themselves) When everything we do is no longer enough, some patients may qualify for a treatment called ECMO. Very large tubes are placed into the patient. Blood flows out of the patient through this tube, goes through a machine that works like lungs should and puts oxygen into the blood, then the blood is returned to the body so it can deliver oxygen to the body."Nurses like Debra are also doing what they can to comfort patients in the last moments of their lives. The hospitals have chaplains, but sometimes it is too late by the time the chaplain arrives. Debra says some hospitals are allowing family members in to say their last goodbyes, but often, a nurse is the only one holding the patient's hand as they pass away."We never let them pass alone. One of us is always in the room when they do pass away, but I've definitely prayed over patients," said Debra.In her letter to the community, Debra went on to say:"As our hospital has been told to go into emergency mode, we are preparing for things to get worse. We are barely afloat now. My words here cannot do the gravity of the situation enough justice but I hope they leave you considering a few things. Imagine not being able to breathe, struggling for air and no help comes. Imagine the same for your parents, siblings, children and no help comes.People are tired of being advised to stay home, people disagree with what the numbers say, people don’t grasp exactly what it takes to make and staff an ICU room. People don’t understand the supplies and equipment needed and just how far that stuff goes.What can you do? Be a little more cautious and considerate. Be more mindful of how you interact and whether things can wait a bit longer. Be safe! Be smart! It is so much easier than being a patient right now." 7128

来源：资阳报