参考文献中英对照

第一篇：参考文献中英对照

[1]雷斌，肖建庄.再生混凝土抗碳化性能的研究[J].建筑材料学报，2008(10):605-611 [1] LeiBin ,XiaoJianZhuang.Research on Carbonation Resistance of Recycle Aggregate Concret [J].Journal of building materials, 2008(10): 605-611.[2]张雷顺，王娟，黄秋风，邓宇.再生混凝土抗冻耐久性实验研究[J].工业建筑，2005(9):64-66 [2] Zhang Leishun, wang Juan, Huang Qiufeng Deng Yu.Study on frost resistance frost durability of recycled aggregate concrete.[J].Industrial construction, 2005(9): 64-66.[3]叶青，纳米复合水泥结构材料的研究与开发[ J].新型建筑材料，2002(1):15-19 [3] Ye Qing, the research and development of nanometer composite cement structure [J].Journal of new building materials, 2002(1): 15 to 19

[4]黄功学，谢晓鹏，纳米SiO2对水工混凝土耐久性影响试验研究[J].人民黄河，2011(70): 138-140 [4]Huang Gongxue, Xie Xiaopeng, Experimental Study on the Effect of Nano-SiO_2 to Durability in Hydraulic Concrete.[J].The people of the Yellow River, 2011(70): 138-140

[5]肖建庄，刘琼，李文贵，Vivian Tam.再生混凝土细微观结构和破坏机理研究[J].青岛理工大学学报，2009(4):24-30 [5] Xiao Jianzhuang, Liu Qiong Li Wengui, Vivian Tam, On the Micro-and Meso-Struture and Failure Mechanism of Recycle Concrete.[J].journal of qingdao technological university , 2009(4): 24 to 30

[6]杨青，钱晓倩，钱匡亮，王章夫，周堂贵.再生混凝土纳米复合强化实验[J].材料科学与工程学报，2011(10):66-69 [6]Yang qing ,Qian Xiaoqian, Qian Kuangliang, Wang Zhangfu, Zhou, Tanggui.Recycled Concrete Intensified by Nano-materious [J].Journal of materials science and engineering, 2011(10): 66-69

[7]7]J.Camiletti,A.M.Soliman, M.L.Nehdi..Effects of nano-and micro-limestone addition on early-age properties of ultra-high-performance concrete[J].Materials and Structures，2012(10)[8][8]P.Hosseini,A.Booshehrian,A.Madari.Developing Concrete Recycling Strategies by Utilizationof Nano-SiO2 Particles[J].Waste Biomass Valor，2011(2):347–355

[9]杜江涛.再生混凝土细观结构研究综述[M].广东建材，2010(4):55-57 [9] Du Jiangtao.The Review of recycled concrete mesoscopic structure review [M].Guangdong building materials, 2010(4): 55 to 57

[10]肖建庄，兰阳，李佳彬，王军龙.再生混凝土长期使用性能研究进展[J].结构工程师，2005(6): 72-76 [10]Xiao jianzhuang.lan-yang, Li Jiabin Wang Junlong.The Research of Long-term recycled concrete.[J].Journal of structural engineers, 2005(6): 72-76

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第二篇：文献中英对照

11.1 BMC Family Practice IF：2.032 一个实用临床试验的原理和设计，以评估家庭血压监测和降压药自滴定对控制不良的高血压的影响

摘要：

Lack of control of hypertension is one of the most prevalent problems encountered by general practitioners(GPs).Self-measured blood pressure monitoring at home(SMBP)and self-titration of medication could be a good strategy to improve hypertension management, however, evidence is limited and not conclusive.We aimed to assess the effectiveness, in the primary care setting, of an intervention that includes educational components, SMBP and self-titration of antihypertensive medication to decrease systolic blood pressure compared to usual care, in a population with poorly controlled hypertension, during a 12-month period.背景:高血压控制不足是全科医生遇到的最普遍的问题之一。家庭自测血压(SMBP)和药物自滴定可能是改善高血压管理的一个好策略，然而，证据有限，没有结论性。我们的目的是评估在基层医疗机构中，在高血压控制不足的人群中，相比于常规治疗，包含教育、SMBP和自滴定降压药的干预措施在12个月内降低收缩压的效果。

Methods: Pragmatic, controlled, randomized, unblinded clinical trial with two parallel groups assigned in a ratio of 1:1 to self-management(which includes educational components, SBMP and self-titration of antihypertensive medication based on a patient s GP s pre-established adjustment plan)or to usual care(with educational components too)

方法:采用实用的、随机对照非盲的临床试验，将两平行组按1:1的比例分配给自我管理组(其中包括教育成分、SBMP和基于患者的家庭医生预先制定的调整计划自我滴定降压药）或常规护理组(也包括教育成分)。

Discussion: If the data from this trial show positive results, the study may contribute to a change of strategy in the treatment of hypertension, focusing on the patient as the main actor to achieve blood pressure control.Furthermore, this approach might contribute to the financial sustainability of the National Health Service

讨论:如果本试验数据显示为阳性，本研究可能有助于改变高血压治疗策略，以患者为主要角色控制血压。此外，这种做法可能有助于国家卫生服务的财政可持续性。

试验注册:本试验已在数据库中注册，编号EudraCT: 2016-003986-25。2017年5月5日注册 关键词:自我监测;血压;高血压；自我滴定；基层医疗；实用的临床试验

背景：

The presence of hypertension is one of the most important issues in the global burden of disease [1].In developed countries, the degree of control of hypertension has increased progressively over the last 15 years and has contributed to a decline in cardiovascular morbidity and mortality [2 8].However, a recent study carried out in 12 European countries showed that more than 50% of patients treated for hypertension continued to have uncontrolled blood pressure(BP)[9] and that results are far from ideal.As a large part of hypertension management is carried out in primary care(PC)and it is one of the most prevalent problems encountered by General Practitioners(GP), interventions aimed at improving its management should preferably be made in this setting.Recent hypertension clinical guidelines put emphasis on self-measured blood pressure monitoring(SMBP)by patients and on team-based systems to manage the condition [10].高血压的存在是全球疾病负担[1]中最重要的问题之一。在发达国家，高血压的控制程度在过去15年中逐步提高，心血管发病率和死亡率下降[2-8]。然而，最近在12个欧洲国家进行的一项研究表明，50%以上接受高血压治疗的患者仍然无法控制血压(BP)[9]，这一结果远非理想。由于高血压管理的很大一部分是在基层医疗(PC)中进行的，它是全科医生遇到的最普遍的问题之一，因此改善管理的干预在这种机构下进行可能更好。最近的高血压临床指南强调由患者在家庭自行测量血压(SMBP)和基于团队的系统来管理[10]。

Self-measured blood pressure monitoring at home(SMBP)is practiced extensively nowadays.In the United Kingdom and Canada it is highly recommended by GPs and used by more than 30% of patients [11, 12].Systematic reviews have shown disparate information regarding the effectiveness of SMBP alone in reducing blood pressure(BP).On the other hand, self-monitoring in conjunction with co-interventions(including systematic medication titration by doctors, pharmacists, or patients;education;or lifestyle counseling)has been shown to lead to clinically significant BP reduction, which persists for at least 12 months.Nevertheless, the effectiveness of SMBP requires additional evaluation given that its definition in those studies is highly heterogeneous(different clinical protocols, different strategies for additional support and management)and given the fact that most studies have short follow-ups(1 year or less)[13, 14].目前家庭自测血压广泛应用。在英国和加拿大，全科医生高度推荐它（家庭自测血压），超过30%的患者使用[11,12]。系统评价显示单独SMBP降低血压(BP)有效性的不同信息。另一方面，自我监测与联合干预相结合(包括医生、药剂师或患者的系统药物滴定;教育;或者生活方式咨询)已经被证明会引起显著临床意义的血压下降，至少持续12个月。然而，鉴于SMBP在那些研究中的定义高度异质性(不同的临床方案，不同的额外支持和管理策略)，并且考虑到大多数研究的随访时间较短(1年或更短)，SMBP的有效性需要额外的评估[13,14]。

Regarding home titration of antihypertensive medication, evidence is more limited and shows mixed results.Two clinical essays, the TASMINH2 [15]and the TASMINH-SR[16], both in the United Kingdom and developed in the primary care setting by the same research team, are some of the most recent and interesting clinical trials carried out in this field.In these studies, SMBP together with self-titrate medications(according to a previously agreed plan), combined with telemedicine components, was compared with usual care.In both studies systolic blood pressure(SBP)decreased from baseline to 12 months, with significant differences between the intervention and control group(5.4 and 9.2 mmHg, respectively).Frequency of side effects was similar in both groups [15, 16].The TASMINH-SR study is of special relevance because it was carried out with high risk patients(with a personal history of stroke, ischemic cardiopathy, diabetes or kidney failure), a population of special interest to achieve BP targets [16].On the other hand, a clinical trial carried out in the US in a low-income, predominantly minority population, aimed to determine whether health coaching, SMBP and home titration of antihypertensive medications could improve BP control compared with SMBP and health coaching alone.The results showed that both the home-titration arm and the no–home-titration arm had a reduction in SBP, with no significant differences between them from baseline to 6 months [17].关于降压药的家庭滴定，证据更有限，结果不一。两篇临床论文，TASMINH2[15]和TASMINH-SR[16]，都在英国，由同一研究小组在基层医疗环境下进行的，是在这个领域最新和令人关注的临床试验。在这些研究中，将SMBP和自滴定药物(根据先前商定的计划)，以及远程医疗成分，与常规治疗进行比较。在这两项研究中，从基线到12个月收缩压(SBP)在干预组和对照组之间下降有显著差异(分别为5.4mmHg和9.2 mmHg)。两组不良反应发生频率相似[15,16]。TASMINH-SR研究之所以具有特殊意义，是因为它是针对高风险患者(有中风、缺血性心脏病、糖尿病或肾衰竭的个人病史)进行的，而这些患者对达到BP目标[16]特别感兴趣。另一方面，美国在一个以少数族裔为主的低收入人群中进行了一项临床试验，目的是确定，与单独进行SMBP和健康指导相比，健康指导、SMBP和降压药家庭滴定是否能改善血压控制。结果表明，家庭滴定和非家庭滴定SBP均有降低，从基线到6个月[17]无显著差异。

Finally, when interpreting hypertension studies over time, it is important to procede with caution, as the definition of the condition changes almost with every update of guidance.For instance, earlier versions of guidelines such as those of the the Joint National Committee(JNC)and of the European Society of Hypertension(ESH)/European Society of Cardiology(ESC), suggested more restrictive BP control objectives than recent versions(especially in patients over 60 years old, diabetics and patients with renal failure)[18-20].These objectives may be modified again in the light of the results of recent studies [21 23].最后，随着时间的推移，在解释高血压研究时，必须谨慎行事，因为这种情况的定义几乎随着指南的更新而改变。例如,早期版本的指南如联合国委员会的(JNC)和欧洲高血压协会（ESH）/欧洲心脏病学会(ESC)的,相比最新的指南，提出更加严格的血压控制目标(特别是在60岁以上患者,糖尿病患者和肾衰患者){18-20]。根据最近的研究结果，这些目标可能会再次修改[21 23]。

研究目的

The primary aim of the ADAMPA TRIAL is to assess the effectiveness, in the primary care setting, of an intervention that includes educational components, SMBP and self-titration of antihypertensive medication to decrease SBP compared to usual care, in a population with poorly controlled hypertension, during a 12-month period.In addition, an extension with passive follow-up is planned for 24 months, collecting a reduced set of outcome variables as secondary variables.ADAMPA试验的主要目的是评估在基层医疗机构中，在高血压控制不足的人群中，相比于常规治疗，包含教育、SMBP和自滴定降压药的干预措施在12个月内降低收缩压的效果。此外，计划进行24个月的被动随访延伸，收集结果变量减少的组作为次要变量。

Main research questions 1.Does a self-management intervention based on SMBP and self-titration medication allow for better control of blood pressure? 2.What is the impact of this intervention on adherence to treatments, lifestyle changes, quality of life, clinical outcomes and use of health services? 3.Is this intervention cost-effective? 4.What are patients , caregivers and health professionals views and experiences of SMBP plus self-titration in poorly controlled hypertension 主要研究问题 1.2.3.4.基于SMBP和自滴定药物的自我管理干预能够更好地控制血压吗? 这种干预对治疗依从性、生活方式改变、生活质量、临床结局和医疗服务的使用有什么影响? 这种干预是否具有成本效益? 在控制不良的高血压中，患者、护理人员和卫生专业人员对SMBP加自滴定有什么看法和经验

Methods

Study design and setting

The ADAMPA study is a pragmatic, controlled, randomized, unblinded clinical trial with two parallel groups assigned in a ratio of 1:1 to self-management(which includes educational components, SBMP and self-titration of antihypertensive medication based on a patient sGP s pre-established adjustment plan)or to usual care(with educational components too).方法

研究设计和设置

ADAMPA研究是一个务实的,控制,随机选取临床试验和两个平行组分配比例1:1的自我管理(包括教育部分,SBMP和s基于患者的全科医生预先制定的调整计划进行降压药自滴定)或常规治疗(也有教育部分)。

All participants belong to a Health Area in the Valencia Region(Spain), with a population coverage of 345,500 inhabitants and a geographical area covering the north-east of the city of Valencia and some surrounding towns that are served by sixteen Primary Care Centers(PCC), two Hospitals and a Medical Specialty Centre.This trial has been registered in the https://eudract.ema.europa.eu/ database with reference number EudraCT: 2016 003986-25.所有参与者属于瓦伦西亚地区的卫生区域(西班牙),人口为345500的人口覆盖率，地理区域覆盖瓦伦西亚城市的东北部和一些周边城镇，有十六个基层医疗中心(PCC),两家医院和医疗专业中心提供服务。

该试验已在数据库注册https://eudract.ema.europa。eu/，编号为EudraCT: 2016 003986-25。

Study participants

Identification and recruitment Potential patients eligible to participate in the study will be selected by their General Practitioners(GP)among all patients attending their general practice(case-finding).In their general practice at the PCC, the GPs will inform patients of the study objective and in the case that they meet the inclusion criteria and none of exclusion criteria, GPs will give them the information sheet and informed consent form, responding to all queries and concerns.研究参与者 识别和招募

有资格参与研究的潜在患者将由他们的全科医生(GP)在就诊的所有患者中选择(病例发现)。在基层医疗中心，如果患者符合纳入标准而没有排除标准，全科医生会告知患者研究目的，全科医生会给他们信息表和知情同意书，同时对所有的怀疑和忧虑作出回应。

Eligibility criteria Eligibility criteria will aim to recruit patients with treated hypertension managed in primary care, who are aged 40 years or older, have a diagnosis of hypertension in their electronic history(coded),haveameanBPreading on the reference arm of SBP > 145 or diastolic blood pressure(DBP)> 90 mmHg on the baseline examination, who voluntarily accept participation in the study and sign the corresponding informed consent.The mean BP will be obtained as follows: In the first visit, BP should be measured on both arms.If there are differences, the reference arm should be that with the highest value of BP.Subsequently, the average BP of at least two measurements, in the sitting position, spaced 1-2 min apart should be calculated.If the first two readings are very different, an additional measurement should be done and the mean BP will be the average of the two readings considered valid [8].合格的纳入标准

合格的标准旨在招募在基层医疗管理且高血压在治疗的患者，40岁以上,在电子病历诊断过高血压(编码), 基线检查时参照臂的SBP平均值 > 145或舒张压(DBP)的平均值> 90 mmHg,自愿参与研究并签署相应的知情同意。平均血压得到的方法如下:第一次就诊时，血压需要测量双上臂。如果有差异，参考臂应该是BP值最高的那个。随后，至少两次坐姿血压测量的平均值，间隔1-2分钟计算。如果前两个读数区别不同，则需要进行额外测量，两次有效的读数的平均值即为血压平均值[8]。

Exclusion criteria

Exclusion criteria will include inability to self-manage their BP, including dementia or significant cognitive impairment(at the discretion of the researcher performing the recruitment), a history of orthostatic hypotension(fall> 20 mmHg from SBP after taking the orthostatic position), SBP > 200 or DBP > 100 mmHg in the baseline examination, being prescribed more than 4 antihypertensive drugs, inclusion in another hypertension study or clinical trial, presence of tremor or neurological disease that makes it difficult to perform SMBP, presence of arrhythmia, presence of terminal illness, chronic incapacitation to leave home, an acute cardiovascular event in the last 3 months, hypertension managed directly by other specialist doctors outside the primary care environment，pregnant women or those actively seeking to become pregnant, having a household member already enrolled in the study and non-or temporary residents.排除标准

排除标准包括,没有自己管理血压的能力的，包括痴呆或重大的认知损害(由负责招募的研究者判断),直立性低血压病史(立位后SBP下降> 20毫米汞柱),在基线检查时SBP > 200或DBP> 100毫米汞柱,开超过4种降压药,参与另外的高血压研究或临床试验,存在震颤或神经系统疾病，使得SBPM有困难的，存在心律失常，存在终末期疾病，长期不能离开家，在过去3个月发生急性心血管事件，高血压在基层医疗机构之外的由其他专科医生直接管理的。怀孕妇女或那些积极准备怀孕的，家庭成员已经登记参加研究和非或临时居民。

Randomization Patients with uncontrolled hypertension will be randomized in a 1:1 ratio to receive either usual care or self-management using a computer randomization system via internet.Minimization will be used [24], taking into account age, gender, SBP > 160 mm HG, diabetes, cardiovascular disease(ischemic heart disease, heart failure, cardiomyopathy and peripheral arterial disease), stroke(chronic stroke)and chronic kidney disease status.Similar approaches have been used in previous clinical trials of self-monitoring in the control of hypertension [15, 16].随机化

通过互联网使用计算机随机化系统将高血压控制不好的患者以1:1的比例随机化分为常规医疗或自我管理。将使用最小化[24]，考虑年龄、性别、SBP > 160mm HG、糖尿病、心血管疾病(缺血性心脏病、心力衰竭、心肌病和外周动脉疾病)、中风(慢性中风)和慢性肾病状态。在以往高血压控制的自我监测的临床试验中也使用了类似的方法[15,16]。

Participant flow through the study该研究参与者经过

An overview of the schedule of enrolment, interventions, and assessments in the ADAMPA study, according to the SPIRIT guidelines is shown in Fig.1.Each aspect will be described in more detail throughout the present protocol.在ADAMPA研究中，根据SPIRIT指南的注册、干预和评估的时间表概述如图1所示。每一个方面都将在本协议中详细描述。

Recruited hypertensive patients who meet the inclusion criteria and none of the exclusion criteria, who have been duly informed(by their GP)of the characteristics of the study, have signed the informed consent and been randomly assigned to the intervention or control group, will proceed as follows

招募符合纳入标准但没有排除标准的高血压患者，他们已经(由他们的家庭医生)充分被告知研究的特征，已经签署知情同意书并被随机分配到干预组或对照组，将按照如下步骤进行 干预组

At their practice, the GPs will have established, with each patient in the intervention group, the BP target according to the European Guide for the management of Hypertension 2013 [19] and how to act according to their BP measurements(Fig.2), including instructions for medication self-adjustment(if necessary).At the same time, the GP will inform them that they will be recalled to make an appointment with a member of the research team, who will provide them with additional information about their self-management of BP and for completing data corresponding to the baseline visit.在他们的实践中，全科医生(GPs)与干预组的每个患者一起，根据2013年欧洲高血压管理指南[19]设定血压目标值和如何根据他们测量的血压采取行动(图2)，包括药物自我调整的说明(如果必要的话)。同时，全科医生将告知他们，他们将被召回（通知）与研究小组中的那名向他们提供关于血压自我管理信息成员预约，完成与基线来访相对应的数据。

Subsequently, patients will be given-and trained in the use of-a validated home blood pressure monitor(Omron M3 model HEM-7131-E), as well as the Intervention group booklet containing: the patient s code, the reference arm on which BP is measured, the BP target, general information and basic recommendations for improving BP control, instructions to manage the home blood pressure monitor, how to act according to their BP(Fig.2)and the monthly registration sheets for a six month period in order to register their blood pressure twice a day, once in the morning and once in the evening(for the first seven days of each month)and to register contacts related to their BP(by phone, regular or urgent consultation at the office or hospital consultation)during that follow-up period.随后，患者将接受验证过的家用血压计(欧姆龙M3型hemi-7131-e)的使用培训，以及包含以下内容的干预组小册子:病人编码,血压测量的手臂,血压目标,改善BP控制的一般信息和基本建议、家庭血压计管理说明,根据他们的BP(图2)如何行动和在六个月内的每月登记表，这个表一天登记两次的血压，每天早上和晚上一次(每月的头七天)，并登记随访期间与BP相关的联系(通过电话、定期或紧急咨询诊室或医院咨询)。

对照组

Patients will be informed by their GP that they will continue their usual care regarding their BP and that they will be recalled to make an appointment with a member of the research team, who will provide them with information and basic recommendations for improvement of BP control and for completing the data corresponding to the baseline visit.Subsequently, members of the research team will deliver the Control group booklet containing the patient s code, general information and basic recommendations for improving BP control, as well as the monthly registration sheets for a six month period in order to register contacts related to their BP(by phone, regular or urgent consultation at the general practice or hospital consultation)during the follow-up period.全科医生告知病人,继续他们血压的常规治疗,他们将被召回与研究小组中那名向他们提供改善血压控制基本建议的成员预约，完成与基线来访相对应的数据。随后,研究团队的成员给对照组小册子，包含病人编号,一般信息和改善BP控制的基本建议,以及在六个月内的每月登记表，这个表登记随访期间与BP相关的联系(通过电话、定期或紧急咨询诊室或医院咨询)。

Patients in the control and intervention groups will be informed that the research team will phone them four weeks after the baseline visit to clarify any doubts raised.If necessary, on-site visits will be arranged for further clarification.对照组和干预组的患者将被告知，研究小组将在基线随访4周后给他们打电话，以阐明任何疑问。如有需要，将安排现场随访进一步澄清。

Both groups will be contacted by phone at 3 months to clarify any doubts and at 6 months a follow-up visit will be established at the PCC, where the corresponding variables will be collected.The same will be done at 12 months.The follow-up variables will be collected up to a maximum of 6 weeks after the end of the follow-up period.An extension of the study will be performed with passive follow-up at 24 months, collecting a reduced set of outcome variables as secondary variables.Participants flow through the trial is outlined in Fig.3.3个月后，都会通过电话联系两组阐明任何疑问，6个月后将在PCC进行随访，收集相应的变量。12个月后也是如此（在PCC随访）。随访变量将在随访期结束后最多6周内收集。本研究的延伸将在24个月的被动随访中进行，收集一组结局变量减少作为次要变量。试验的参与者流程如图3所示。

Patients have the right to leave the study at any time.In addition, the researcher may discontinue a patient from the study if deemed necessary for any reason including: non-eligibility(retrospective if not detected at the time of inclusion, or prospective e.g.pregnancy during the follow up), an adverse event or disease progression involving incapacity to comply with trial procedures.患者有权随时退出研究。此外，如有必要，研究者可终止患者参与本研究，理由包括:不合格(回顾时发现，纳入时未发现，或未来发现，随访时怀孕)，不良事件或包括无法遵守试验规定的疾病进展。样本量估算

A sample size of 382 patients was estimated in order to have 90% power to detect a difference in SBP of 5 mmHg(SD 15 mmHg)between the intervention and the control group with a contrast of two-tailed hypotheses and an alpha error of 0.05.This figure represents a clinically relevant difference(which should represent a reduction of approximately 19% in strokes)and is in line with the results observed in previous trials in this field(TASMINH2 and TASMINH-SR)[15, 16].These figures will be increased by 20% to compensate for possible drop-outs and follow-up loss, resulting in a total sample size of 458 participants.我们对382名患者的样本量进行了估计，以便有90%的能力检测干预组和对照组之间SBP 5 mmHg(SD 15mmhg)的差异，采用双尾假设对比，α误差为0.05。这一数据（α）代表了一个临床相关的差异(这应该代表中风减少了大约19%)，并且与该领域以前的试验结果一致(TASMINH2和TASMINH-SR)[15,16]。这些数字将增加20%，以弥补可能的退出和失访，从而使总样本量达到458人。干预组

Blood pressure self-monitoring Patients will be trained to perform SMBP by the research team through a validated home blood pressure monitor(Omron model M3 HEM-7131-E).Patients will take their BP in the morning and in the afternoon, every day of the first week of each month.This will be done in the morning, before breakfast and before taking their medication(between 6 am.and 9 am.)and in the evening before dinner and before taking their medication(between 6 pm.and 9 pm.).These measurements will be recorded by the patients for the first seven days of each month on the monthly registration sheets located in the Intervention group booklet.If patients want to monitor their BP during the remaining weeks of the month, it is recommended that they just do so one day a week.Patients are instructed to act according to a table that contains easy-to-follow colour coded action steps.This guideline prompts the patient to contact the GP or visit the health center when BP values are very high or very low.Four or more above target readings in a month will require a change in medication(See Fig.2).研究小组训练血压自我监测的患者用经验证的家庭血压计(欧姆龙M3型HEM-7131-E)来SMBP。患者将在每个月的第一周的每天早上和下午进行血压检查。这将在早上，早餐之前和服药之前(早上6点到9点之间)完成。在晚餐前和服药前(下午6点到9点之间)。这些测量数据将由患者在每个月的头七天记录在干预组手册的每月登记表上。如果病人想在每月的最后几周监测他们的血压，建议他们一周只监测一天。病人被指示根据一张表格采取行动，表格中包含易于遵循的彩色编码动作步骤。当血压值非常高或非常低时，该指南提示患者联系全科医生或医疗中心就诊。一个月内超过目标值4次以上的患者需要改变用药(见图2)。

Target blood pressure

Patients will be informed of their target BP, which will be established by their own GP and individualized for each patient based on the Guidelines for the management of arterial hypertension of the European Society of Hypertension(ESH)and European Society of Cardiology(ESC)[19].Recommendations on target BP, according to cardiovascular risk and reflecting home as compared to office readings are shown in Table 1.目标血压 患者将被告知他们的目标血压，目标血压将由他们全科医生根据欧洲高血压协会(ESH)和欧洲心脏病学会(ESC)[19]高血压管理指南个性化制定。根据心血管风险和与诊室读数相比反映家庭的目标血压的建议如表1所示。

Self-titration

In order to reach their target BP, each patient will be given a self-management plan to adjust medication if necessary depending on blood pressure measurements(See Fig.2).The self-adjustment plan will consist of either an increase in the dose or additional medication.Therapeutic plan choice will be at the discretion of the GP, who will receive a copy of the Clinical Practice Guidelines of the European Society of Cardiology [19] to aid decision-making.If self-adjustment takes place, the participant will have an appointment with his/her GP within 3 weeks following self-adjustment, and a new tailored self-management plan will be provided.自我滴定 为了达到目标血压，给每个患者自我管理计划，必要时根据血压测量情况调整药物(见图2)。自我调整计划包括增加剂量或加其他药物。治疗方案的选择将由GP决定，GP将收到欧洲心脏病学会[19]临床实践指南的副本，以帮助决策。如果进行自我调整，参与者将在自我调整后的3周内预约全科医生，并提供新的量身定制的自我管理计划。对照组

Patients allocated to the control group will receive routine hypertension care with appointments and medication changes following the GP s criteria in the context of routine clinical practice.在对照组的患者将接受常规高血压治疗，并按照全科医生在常规临床实践中的准则进行预约和调药。

In both, the intervention and control group, all relevant concomitant care within usual clinical practice will be at the discretion of the GP.在干预组和对照组中，所有日常临床实践相关的将由全科医生决定。结果

The primary outcome will be the change in mean SBP-mmHg-between baseline and 12 months.Secondary outcomes will include:

1.Change in mean SBP at 6 and 24 months of follow-up.2.Change in mean DBP at 6, 12, and 24 months of follow-up.3.Percentage of patients with SBP < 140 mmHg and DBP < 90 mmHg at 6, 12 and 24 months of follow-up.4.Quality of life(as measured by EuroQoL-5D)at 6, 12 and 24 months of follow-up.5.Adherence measured by proportion of days covered(PDC)at 6 and 12 months of follow-up.6.Persistence, defined as period of continuous use of the corresponding drug from the beginning of the follow-up until its discontinuation at 6 and 12 months of follow-up.7.Therapeutic inertia(TI), defined as the number of patients whose pharmacological treatment had not been modified, divided by the number of patients not reaching the target values(SBP and/or DBP measurements taken at 6 and 12 months of follow-up), according to the recommendations of the European Society of Hypertension and European Society of Cardiology [19].主要结果是在基线和12个月之间平均SBP-mmhg的变化。次要结果包括: 1.2.3.4.5.6.7.随访6个月和24个月时平均SBP的变化。随访6个月、12个月和24个月时平均DBP变化。

随访6、12、24个月，SBP < 140 mmHg, DBP < 90 mmHg的患者百分比。随访6个月、12个月和24个月时的生活质量(以EuroQoL-5D衡量)。随访6个月和12个月时，以覆盖天数占比(PDC)来测量依从性。持久性，指从随访开始到随访6个月和12个月停止使用相应药物的时间。

治疗惯性(TI),定义为没有调药的患者数量除以没有目标(在6和12个月的随访时测量的SBP和/或DBP)病人的数量,目标值是根据欧洲高血压协会和欧洲心脏病学会的建议[19]。其他结果指标：

1.Changes in lifestyle(smoking, exercise, body weight)at 6, 12, and 24 months compared to these characteristics at baseline.2.Clinical events: We will assess if any of the following adverse events are present during the follow-up: angina, myocardial infarction, stroke, hypotensive crisis and death.3.Use of health services for hypertension at 6, 12 and 24 months.4.Incremental cost per quality-adjusted life year gained in the intervention group compared to the control group.5.Views and experiences of patients and health professionals on the self-management(SMBP plus self-titration)of hypertension.1.6个月、12个月和24个月时与基线时相比生活方式(吸烟、锻炼、体重)的变化。

2.临床事件:我们将评估在随访期间是否存在以下不良事件:心绞痛、心肌梗死、中风、低血压危机和死亡。3.4.5.在6个月、12个月和24个月因高血压医疗服务的使用。干预组与对照组相比，每质量调整生命年增加的成本。

患者和医疗专家对高血压自我管理(SMBP +自我滴定)的看法和经验。

数据收集

Data will be collected at the different participant study sites.Details on type of data and timing of collection are shown in Fig.1.Data entry, coding, security, and storage, including any related processes to promote data quality(eg, double data entry, etc)and other aspects related to data management such as data monitoring of the ADAMPA study, will be performed by the SCReN platform(for more information on the Screen platform and its role regarding the ADAMPA study, see:https://www.xiexiebang.complete cases.We will use mixed models(general linear modeling GLM)to compare SBP at 12 months between the intervention and control groups.This analysis will be presented in both crude and adjusted forms for the different covariates of interest(baseline BP, gender, GP/PCC-random effect, diabetes, etc.).A sensitivity analysis will be performed to examine the potential effect of missing data, which will include substitution by multiple imputation, replacement of data lost by the most recent data or by the mean of the series.Additionally, analyses of the main outcome measure by subgroups of age, gender, comorbidity, level of chronicity, better control at baseline, etc.will be performed.分析将基于为了案列完整的意向性治疗。我们将使用混合模型(通用线性建模GLM)来比较干预组和对照组12个月的SBP。该分析将以粗糙和调整的形式呈现，以适应不同的协变量(基线血压、性别、GP/ pccs随机效应、糖尿病等)。将进行敏感性分析，以检查缺失数据的潜在影响，这将包括通过多重插补替代，用序列的平均值或最近数据替代缺失的数据。此外，还将根据年龄、性别、合并症、慢性程度、基线控制的更好等亚组分析主要结果指标。

Differences in secondary outcome measures(DBP, percentage of patients controlled, PDC, persistence and TI)will be analyzed using methods similar to those used for analysis of the main outcome measure.将使用与主要结果分析方法类似的方法分析次要结果(DBP、患者控制百分比、PDC覆盖天数占比、持久性和TI治疗惯性)的差异。经济分析

The economic analysis will include a cost-consequence analysis, estimating both the costs(hospitalizations, outpatient visits, emergency visits and antihypertensive drugs)and the potential benefits(e.g.reduced incidence of stroke, myocardial infarction, etc.)in natural units.In addition, we will collect information on Health-Related Quality of Life(HRQOL)through the EQ-5d questionnaire, which will allow us to obtain utilities and therefore perform a cost-utility analysis with the estimated benefits in terms of Quality-Adjusted Life-Years(QALY).经济分析将包括成本-后果分析，估计成本(住院、门诊、急诊和抗高血压药物)和潜在效益(如减少卒中、心肌梗死等)在自然单元。此外，我们将通过EQ-5d问卷收集与健康有关的生活质量(HRQOL)的信息，（欧洲五维健康量表）可以让我们获得效用值，从而进行成本-效用分析，根据质量调整生命年(QALY)来估计效益。

A modeling will be performed to obtain longer-term predictions of the results observed in the trial.The results on which this modeling will be based will be survival, quality of life and costs associated with clinical events.A sensitivity analysis(deterministic and probabilistic)will be performed to analyze the robustness of the results.Key parameters will be modified to determine their impact on results.All analyses will be performed using STATA version 14.将进行建模以获得对试验中观察到的结果的长期预测。这个模型所基于的结果是生存，生活质量和与临床事件相关的成本。将进行敏感性分析(确定性和概率性)来分析结果的稳健性。将修改关键参数以确定它们对结果的影响。所有分析将使用STATA 14进行。质量亚组分析

Qualitative research techniques will seek to provide an in-depth understanding of the positive elements and areas of improvement related to self-titration and self-monitoring intervention.To this end, two meetings will be held, one with professionals(GPs and nurses)and one with patients, using the Nominal Group Technique(NGT).The NGT is a working methodology that establishes a framework for highly structured interaction that enables participation and equal consideration of the contributions of all members of the working group, and allows the identification of priorities, consensus and disagreement, solution generation and decision-making in an agile and objective manner [25

定性研究技术将力求深入了解与自我滴定和自我监测干预有关的积极因素和改进领域。为此目的，将举行两次会议，一次与专业人员(全科医生和护士)和一次与病人，使用名义群体技术(NGT)。NGT是一种工作方法，它为高度结构化的交互建立了一个框架，允许工作组所有成员参与和平等地考虑其贡献，并允许以敏捷和客观的方式确定优先级、共识和分歧、生成解决方案和决策[25] 讨论

The ADAMPA trial is a clinical research project that aims to improve the control of BP through training the patient for self-management of their hypertension.Hypertension is a risk factor of high prevalence that, even today, presents an unacceptable percentage of uncontrolled patients, according to the recommendations of the guidelines of clinical practice for BP control.ADAMPA试验是一项临床研究项目，目的是通过训练患高血压自我管理来改善血压控制。根据《血压控制临床实践指南》的建议，高血压是高患病率的危险因素，即使在今天，仍有不可接受的比例的患者不受控制。

If the data from this trial show positive results, the study may contribute to a change of strategy in the treatment of hypertension, focusing on the patient as the main actor to achieve these objectives.Furthermore, this approach might contribute to the financial sustainability of the National Health Service.如果本次试验的数据显示阳性结果，本研究可能有助于改变高血压治疗策略，以患者为主以达到这些目标。此外，这种做法可能有助于国家卫生服务的财政可持续性。

第三篇：供应商质量管理文献翻译(外文翻译,中英对照)

互利共赢的供应商质量控制

前言

近年来，随着对供应链的重视，供应商管理正逐渐成为企业和学术界的关注对象，IS09000族标准以及QS 9000标准都对供应商的管理提出了相应的要求，与供应商管理有关的研究成果正逐渐增多，一些软件巨头也推出了供应商关系管理的软件，但是在这些研究成果和应用软件中，涉及到的供应商质量控制的内容只是一些最基本的要求，而供应商质量控制恰恰是供应商管理的最基本、最重要的内容。另一方而，质量管理界对质量控制的研究取得了大量的成果，遗憾的是这些成果大多依然局限于企业的内部控制，仅仅研究从企业内部各环节如何改善产品的质量，而基于供应链的角度来研究质量控制的成果尚不多见。因此，系统地研究经济全球化形势下供应商质量控制的理论与方法，将有助于推动我国企业产品质量的快速提高和供应链竞争优势的形成与巩固。

1、质量与企业共存

质量一直是一个随着时代的变化而不断变化的概念，人们对质量的认识也往往因关注点不同而有所不同。如，早在1908年，通用汽车公司的工程师们在皇家汽车俱乐部会员们的面前拆解了3辆凯迪拉克轿车，并把这些零件混在一起，而后从中选择零件重新组装成车，然后驾车绝尘而去。这令在场的会员极为震惊，认为凯迪拉克车质量之高令人惊叹。显然在当时，汽车零件具有互换性是一种了不起的质量特性，这也是福特公司的N型车和T型车取得辉煌成功的重要原因。时至今日，即使农用三轮车的零部件也具有极高的互换性，零部件的标准化和互换性已经是理所当然的事情，不再是吸引顾客的重要质量特性。可见质量的内涵是不断变化的。那么究竟什么是质量呢?（1）市场竟争就是企业间对“顾客”的争夺，在日益激烈的“顾客”争夺战中，质量、价格、交付(交付日期、方式和手段)和服务是企业常用的四个法宝，其中质量是根本，离开质量其他三项将变得毫无意义，因此可以说质量己成为市场竞争的焦点。它反映了产品是否能够反映顾客需求、能否满足顾客需求，从面决定了产品的市场前途。有鉴于此，质量己成为一项全球性运动，世界上所有优秀企业无一不把质量作为企业战略的关键内容，从战略的角度来规划质量。

（2）对于企业经营者来说，认识到质量对企业的重要意义只是经营企业的第一步，重要的是如何利用科学的方法来保证产品和服务的质量，使顾客满意，来保证过程和工作的质量来获互利共炭的供应商质量控制得良好的业绩。

众所周知，企业管理是社会生产力发展到一定程度的历史产物，质量管理作为企业管理的组成部分，同样也是社会发展的客观要求，特别是顾客处于主导地位的今天，要使顾客满意，就必须有过硬的产品质量和服务质量，这就要求企业积极推行先进的质量管理理论与方法，不断进行质量管理创新。

2、企业与供应商质量控制

随着生产社会化的不断发展，企业的生产活动分工越来越细，专业化程度越来越强，促使生产技术水平越来越高，产品质量得到大幅度改善。通常，某一产品不可能由一个企业从最初的原材料开始加工直至形成顾客最终使用的产品，往往是通过多个企业分工协作来完成。另外，先进生产方式的广泛应用，如准时生产、敏捷制造、零库存等，使企业与供应商的关系愈加紧密，企业与供应商的关系也由单纯的买卖关系向互利共底的合作关系演变。

ISO 9000族标准自1987年诞生以来受到了世界各国的一致追捧，全球约50多万家企业通过ISO 9001质量管理体系认证足以说明这套管理标准在引领国际管理潮流方面的巨大成功。在备受企业欢迎的新版标准ISO 9000:2000中，互利的供应商关系被作为八项质量管理原则之一，充分体现了供应商关系管理在企业经营实践中的作用和价值。企业要贯彻这一原则，就必须从思l 想上认识到供应商的重要性，重视与供应商良好关系的培育，并采取有力措施与之建立一种互利共赢的合作性关系。

3、供应商选择

选择合适的供应商是对供应商进行质量控制最有效手段，如果供应商选择不当，无论后续的控制方法多么先进、控制手段多么严格，都只能起到事倍功半的效果。因此要对供应商进行质量控制首先必须科学合理地选择供应商。

（1）企业在生产经营过程中，所需要的原材料和零部件不可能都由自己生产提供，决定其中哪些应由供应商提供不是一个简单的买不买的问题，因为这涉及企业的业务流程，甚至涉及到企业与供应商之间的业务流程再造，属于企业战略层次的问题。因而对零部件的自产和外购的选择必须综合考虑企业的经营环境、企业自身实际情况以及供应商的总体情况。

1）经营环境分析

企业对于零部件自产还是外购的决策需要建立在对其经营环境的准确分析和把握的基础之上。企业所在行业的整体状况与发展态势、国家宏观经济形势、企业产品的社会需求现状及未来预侧等因素都会影响到企业产品的产销量。而预期的企业产销量是企业进行各项决策如互利共赢的供应商质量控制投资规模、设备配置的主要依据，也是企业零部件自产与外购决策的重要依据。另外，竞争对手的零部件自产与外购情况也是企业进行决策的重要参考依据。

2)市场供应情况

零部件的社会供应状况也是企业决定自产还是外购的重要依据。企业与其供应商的关系的实质就是相互依存的关系，正如一家势力雄厚、规模巨大的企业会吸引很多供应商在其周围投资设厂一样，具有完善配套供应商的区域也常常吸引大的企业甚至跨国公司前来投资办厂。某种零部件的社会供应能力、价格、质量和服务水平在很大程度上影响着企业的自产与外购决策。因此，企业应全面了解其产品中零部件的社会供应情况，注意从互联网上、展览会、供应商来信等渠道收集供应商的企业介绍、产品样本、获奖证书、代理商授权书、营业执照、产品实物质量水平以及市场行情等方面的信息。然后，按照供应商提供物资种类，可分别建立原材料、零部件、包装材料等不同类别的潜在供应商档案。

（2）供应商的检测设备是供应商赖以测量、分析和改进的基础条件。如果供应商不具备必要的检测手段，就无法提供真实准确的质量数据，供应商的质量控制就如空中楼阁。所以，在初选供应商时，了解供应商的检测设备的配备情况和先进程度同样是十分必要的。

（3）过程能力指数和过程性能指数是反映供应商生产过程质量保证能力的两个重要参数。过程能力指数反映供应商短期的过程能力满足公差要求的程度。过程性能指数反映供应商长期的过程能力满足公差要求的程度。供应商是否进行过程能力指数和过程性能指数的计算分析，可以在一定程度上反映其是否在生产过程中进行了预防控制。过程能力指数和过程性能指数的变化则可以反映供应商的质量保证能力和质量改进潜力的大小，在很大程度上反映供应商的实力和管理水平。因此，调查供应商的过程能力指数和过程性能指数是选择供应商的重要依据。

4、供应商的质量控制

质量管理的一项重要原则是“过程方法”，企业为了有效运作，必须识别并管理许多相互关联的过程，特别是这些过程之间的相互作用。供应商是过程管理的源头之一，是过程输入的重要因素，因而，供应商提供的产品质量如何，对于企业的过程质量、体系质量和产品质量具有举足轻重的作用。

（1）产品开发设计阶段，根据不同产品的不同要求，在产品开发设计建议书或产品设计开发任务书中提出先行试验项目和课题，有针对性地为采用新原理、新结构、新材料、新工艺，进行先行试验，为了确保试验的效果和以后批量生产的需要，这一阶段的一项重要工作就是对供应商进行初步控制，确保在新产品设计的各个阶段以及批量生产时，都能够有适合新产品或新服务需要的合格供应商。

l（2）企业在批量生产过程中，对供应商的质量控制主要包括监控供应商的过程能力指数和过程性能指数、监控供应商的测量系统、审核供应商的质量管理体系、进货质量检验、推动供应商的质量改进、以及来自供应商的不合格品的处置和质量问题的解决等活动。

1）批量生产阶段，供应商提供的产品或服务的质量直接决定了企业向顾客提供的产品或服务的质量特性，企业在供应商合作的过程中，应监控供应商的质量保证能力的变化，为了使监控有效，企业应就此与供应商达成一致，并遵循协商一致的标准和程序进行。监控的目的一般有两个，一是防止供应商的质量保证能力出现下降的情况，确保最终产品或服务的质量，实现顾客满意;二是与供应商共同发现改进的机会，寻找改进的切人点，在更高层次上创造价值。

由于在批量生产阶段供应商大批量连续供货，采购产品的质量、价格、供货的及时性等对企业产品的质量和企业实现其经营方针、目标都有十分重要的作用，为了更加科学地评价和选择供应商，这一阶段的供应商评价应尽量采用定量分析的方法。根据产品和服务的不同，定量分折的方法也不同，以下简单介绍常用的过程能力分析、测量系统分析、质量管理体系评价、水平对比法和优秀模式等方法。

①供应商过程能力分析

过程能力是指过程加工质量方面的能力，而不是加工数量方面的能力。在批量生产阶段，为了保证批量生产的产品满足顾客的需求和期望，供应商生产过程的稳定性就十分重要了，决定供应商是否有能力稳定地连续提供符合质量要求的产品的众多因素中，供应商的过程能力是一个决定性的因素。因为当供应商的过程能力不足时，供应商提供合格产品只是个良好的愿望，即便是加大检验力度，也只能是在短期内有效，难以持续。所以，对过程能力不足，短期改进无望的供应商，应该停止合作。

②供应商测量系统分析

企业对供应商的质量控制，包括对供应商的选择、评价和控制，都离不开数据和对数据的分析，缺少足够的数据，仅仅靠经验和直觉对供应商进行选择和评价，其风险是不言而喻的。对供应商的评价和控制所使用的数据大多是由测量提供的，如果测量数据失真或误差很大，都会导致采购行为的缺陷或失败。因此，在批量生产阶段，为了确保采购的质量，应该对供应商的测量系统进行监控。

2）与供应商的沟通

与供应商沟通的方式是多种多样的，但是这些方式的目的是一致的，企业和供应商共同关注顾客，建立企业和供应商共同满意的融洽的合作伙伴关系，共同对产品和服务进行持续的改进，以便及时、有效地适应市场的变化。满足顾客的需求和期望，实现企业和供应商共同的价值，共同追求并实现卓越。

（3）不合格品的判定、分析和处置

虽然有了以上各种控制措施，但是不合格品的出现仍然是正常现象，除单件或少数几件产品、安全性要求较高的产品等少数产品以外，在许多情况下不合格品的出现是难以完全避免的。这时候就要根据不合格的性质、对最终产品的影响程度、供应商的信誉等因素对不合格品进行必要的评审，然后采取适当的措施处置不合格品，以防止不合格品的非预期使用或交付当出现不合格品以后，要分析产生不合格的囚素，采取纠正和预防措施。防止不合格的再次发生。对由于异常因素发生的不合格品，供应商要采取相应的措施，消除这些异常因素。

1）一致的技术标准和抽样方案

使用、提出和制定规格的部门必须合理地描述出拟采购的产品是什么，以便使供应商得到准确的理解，使采购人员能够准确地采购所需的产品。根据ISO 9001:2000标准的要求和企业的实际情况，这些技术标准一般是由设计、采购、管理、生产等部门制定，但在采购的实施时，采购部门要使用这些标准，因此.采购部门从一开始就应该介入这些标准的策划、起草和修订，否则，一旦这此标准止式发布实施，可能会使采购部门处于被动的地位，给采购工作带来麻烦。

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2）不合格品的质量责任

当采购产品出现超出技术规范规定界限的不合格时，企业和供应商应在协商的原则下确定不合格产品的原因、商定解决产品质量的办法，并据此进行改进。当企业与供应商对不合格的认定分歧很大，双方无法协商解决，需要诉诸法律时，不合格产品质量责任的性质就发生了变化，必要时不排除需要追究某一方的法律责任。所以对产品技术要求和其他采购信息，企业一定要表述清除、完整、准确，并经过授权人员评审后再与供应商沟通，在与供应商达成一致的前提下再签订合同，并妥善保存采购、检验文件和记录。

3）不合格品的控制

当出现不合格品，如果是抽样检验，且不合格品的数量小于或等于合格判定数时，这种不合格属于正常现象，只要将不合格品更换成合格品，就应该判定交验批合格，企业应根据文件要求接受该批产品。这些个别的不合格产品可能属于正常波动引起的不合格，可以不必专门查找原因供应商可以作为止常的质量改进，逐步提高过程能力，减少这些不合格。

5、供应商的契约化控制

为了保证顾客对产品与服务的满意，企业必须对产品形成的全过程进行严格的管理与控制。为了使整个供应链中每一个环节，即合作伙伴，明确他们对质量的责任与义务，并保证实现，伙伴之间必须以契约的形式形成承诺，并按照承诺的内容测量质量与服务。这里所说的契约仅指得到相关方签署的，规定供应链各环节之间质量责任的文件化条款，包括合同和协议。严肃合理的契约对双方不仅起到可靠的约束作用，而且可以有效保护双方的利益。

（1）保证契约内容与标准、法规和企业制度的统一性

契约可引用或借鉴既定的法律、法规或规章制度、标准等。如可规定进厂检验抽样标准执行GB2828 抽样标准;电器产品安全性能必须符合GB4706等。如发现有与相关法律、法规、标准、制度不一致之处，发现方应及时提出修改。如在执行过程中发现不一致，发现方应及时通知不知情方，并按符合法律、法规、标准、制度的方式执行。

（2）契约内容应实际有效

起草与签署契约时，必须考虑产品形成过程中的实际情况，考虑契约执行的可操作性。有些协议在制定时可能需要考虑的因素较多，规定需较为详细，但如果过于繁琐，缺乏可操作性，反而起不到应有的作用。例如，某公司需从供应商采购大量的加工轴承用的钢材。由于轴承对材料要求较严，加工精度较高，公司为保证质量，在协议中要求对方对每一批材料进行化学成分分析和物理性能试验。供应商如果引进整套试验设备，势必耗费大量的成本，同时要配备相应的技术人员。如果不增加资源配置，那么每次都要送社会检验机构检验，支付昂贵的试验费用。象这种契约，如果供应商仔细审验的话，他就会考虑进行利润-成本-风险分析，在价格上提高要求。这种协议履行起来就有较大难度，同时也容易引起一些不必要的纠纷，不利于供应链的稳固和质量价值链的形成。

（3）契约应明确双方的权利和责任，鼓励供应商的持续改进与创新

契约中应明确供需双方的权利和责任，同时也应规定必要的奖惩性条款，一方面约束供应商的质量行为，另一方面鼓励供应商不断提高产品质量。对供应商的奖惩包括两种类型。其一是因质量责任的划分而产生的奖惩;其二是根据业绩考核而产生的奖惩。在实际的操作中，适当的奖励可能会产生意想不到的管理效果。某供应商的产品在顾客手中出现了较为严重的质量问题，企业立即通知供应商分析原因，采取整改措施。供应商接通知后，积极地派人到现场进行协助调查和分析，使问题很快得到了解决。本来根据双方的协议规定，该供应商除应承担全部质量责任外，还应承担数额不菲的罚款。但企业考虑到该供应商是自己的重要供应商，一直合作很顺利，质量稳定，决定奖励供应商对质量问题的快速反应和积极的态度，免除了所有的罚款。结果年终评定发现该供应商的产品合格率比上年有较大幅度的提高。

（4）契约的内容应公正、公平

l 契约应是经过双方充分协商达成的共识，不应只是一方对另一方的宣言或要求，内容要经过双方认可和确认。另外，契约内容应涵盖从产品开发、试制、检验、包装运送到不合格品处理、售后服务的全过程，所以契约可包含多个层次，如供货合同、质量保证协议、技术协议、售后服务协议等。

6、供应商的业绩评定与动态管理

供应商作为产品实现的重要资源之一必然要讲求其有效性。2000版ISO9000标准就把管理体系的有效性作为一个重点来考虑，因此对供应商进行业绩评定十分重要，它是进行动态管理、择选劣汰的依据。

（1）评定方法

按照采购要求，对关键材料、主要材料和次要材料定期进行质量缺陷分级评定。规定关键参数的缺陷分记为3分，主要缺陷为2分，次要缺陷为1分。一批材料中根据规定的抽样方法最大分数为6分。质量工程师据此对供应商进行等级评定，并向供应商发出通知。这种方法操作简单，节省人力，但评价指标偏少。

（2）动态管理

根据业绩记录，定期对所有供应商进行动态分级评定。将所有供应商划分为A、B、C、D四级，根据材料价值、质量要求、加工难易程度、社会供应状况等因素确定供应商定点个数。定点个数为1的A类供应商，订单分配为100%;定点个数为1的B类供应商，订单分配为100%，但需开发该材料的新供应商;定点个数为2的A、B类供应商分别分配订单60%和40%;定点个数为3的A、B、C类供应商分别分配订单55%、30%和15%;D类供应商应被淘汰。这种分级评定与管理将供货订单与供应商绩效、材料分级结合起来，使订单的分配比较科学合理。当然，这种方法对企业管理的整体水平也提出了很高的要求。

l Mutually beneficial supplier quality control Preface In recent years, with the emphasis on the supply chain, vendor management is becoming a business and academia about the object, IS09000 standards QS 9000 family of standards and vendor management are all put forward the corresponding requirements, and supplier management-related Research is gradually increased, the software giant also introduced a number of supplier relationship management software, but in these research results and application software, related to the quality control of the content provider is only the most basic requirements, and supplier quality control Supplier management is precisely the most fundamental and important content.The other party, quality management, quality control sector made a lot of research results, unfortunately, most of these results is still limited to the company's internal controls, only the link from the internal study how to improve product quality, and based on supply chain Point of view of the results of quality control is still rare.Therefore, the systematic study of the economic globalization supplier quality control theories and methods, will help promote China's rapid increase in product quality and supply chain formation and consolidation of competitive advantage.1、Quality and corporate co-existence Quality has been a change with the times changing the concept of people's understanding of quality is often due to concerns vary.For example, as early as 1908, GM engineers at the Royal Automobile Club members in front of dismantling the three Cadillac cars, and these components mixed together, and then choose the parts re-assembled into a car, then driving Pull away.This makes the presence of members of a very shocked that the high quality Cadillac amazing.Obviously at the time, with interchangeable parts is a great quality features, this is Ford's Model N Model T achieved brilliant success and an important reason.Today, even if the farm also has a very high tricycle parts interchangeability, standardization and interchangeability of parts is already a matter of course, is no longer an important quality characteristics to attract customers.Visible quality content is constantly changing.So what is the quality?（1）Market competition among enterprises is the “customer ” of the competition, in the increasingly fierce “customers” in the battle, quality, price, delivery(delivery dates, means and methods)and the service is commonly used in the four magic, where quality is Simply leave the quality of the other three will become meaningless, it can be said the quality has become the focus of market competition.It reflects whether a product can reflect the customer needs, can meet customer needs, from the surface determines the future of products in the market.In view of this, quality has become a global movement, all the world's best companies are all the quality as a key element of corporate strategy, from a strategic perspective to planning quality.（2）For business operators, it recognizes the importance of quality on business enterprises is the first step, it is important how to use scientific methods to ensure l product and service quality, customer satisfaction, to ensure the quality of the process and work to Be mutually beneficial and win-win supplier quality control with good results.As we all know, corporate management is the development of social productive forces to a certain degree of historical product, quality management as an integral part of business management, is also the objective requirement of social development, especially in today's dominant customer, make customer satisfaction, there must be strong Product quality and service quality, which requires enterprises to actively implement the advanced quality management theories and methods of continuous quality management innovation.2、Quality control of enterprises and suppliers With the continuous development of socialization of production, the production activities of the division of labor is getting smaller, growing degree of specialization, prompting increasing the level of production technology, product quality has been greatly improved.Typically, a product can not be from a business started from the initial processing of raw materials until the formation of the product end-use customers, often through multiple corporate division of labor to complete.In addition, the extensive application of advanced production methods, such as JIT, agile manufacturing, zero inventory, so that the relationship between enterprises and suppliers increasingly close relationship between companies and suppliers are from a simple buyer-seller relationship to the mutual cooperation between the end of a total evolution of.ISO 9000 family of standards since its inception in 1987 has been the consistent pursuit of the world, more than 50 million businesses around the world through the ISO 9001 quality management system certification standards sufficient to explain this management trend in the leading international management's great success.Welcome to the new business in much the standard ISO 9000:2000, the mutually beneficial supplier relationships is one of eight quality management principles as a fully embodied the supplier relationship management practice in the business role and value.Enterprises to implement this principle, we must recognize the ideological importance of supplier and attach importance to good relations with suppliers cultivation, and to take effective measures with the establishment of a mutually beneficial and win-win cooperative relations.3、Vendor Selection Choose the right supplier is a supplier of the most effective means of quality control, supplier selection if improper, no matter how advanced the follow-up control, controls how strict, can only play a less effective results.So to the quality control of suppliers must first be scientific and rational choice of suppliers.（1）Enterprises in the production process, raw materials and parts needed for production can not be provided by their own to decide which of them should be suppliers of buying a not a simple issue because it involves business processes, even involving Between enterprises and suppliers to the business process reengineering, strategic-level issues in enterprises.Thus parts of the self-produced and purchased options to be taken into account the business environment, the l actual situation of their own and suppliers in general.1）Analysis of business environment Enterprises are outsourcing parts production for the decision or need to create in the accurate analysis of their operating environment and grasp basis.The overall position of companies and the industry development trend, the national macroeconomic situation, the social needs of enterprise products for predicting the future status and other factors will affect production and sales of enterprise products.Anticipated production and sales of enterprise decision-making enterprise for the mutual benefit of suppliers, such as quality control of the scale of investment, mainly based on device configuration, but also business and outsourcing parts production for an important basis for decision making.In addition, competitors and the outsourcing of parts production for corporate decision-making situation is an important reference.2）Market supply Supply situation in parts of the social enterprise decision is an important basis for self-produced or purchased.Business relationships with its suppliers is the essence of interdependence, as a strong power, large-scale enterprises will attract many suppliers set up plants in their surroundings, like, a complete set of regional suppliers often attract large enterprises and even Multinational companies to invest and set up factories.Some parts of the social supply capacity, price, quality and service levels of the enterprise is largely self-produced and outsourcing decisions.Therefore, enterprises should fully understand the social components of their products, availability, attention from the Internet, exhibitions, suppliers and other channels to collect letters from suppliers of business introduction, product samples, award certificates, power of attorney agents, business license, Products quality level and market conditions and other information.Then, in accordance with the types of suppliers to provide materials, were established to raw materials, components, packaging materials, such as different types of potential suppliers file.（2）Testing equipment supplier which the supplier measurement, analysis and improvement of basic conditions.If the supplier does not have the necessary means of detection, we can not provide true and accurate quality data, quality control of suppliers like castles in the air.Therefore, in the primary suppliers to understand the supplier's testing equipment and advanced levels with the situation is also very necessary.（3）Process capability index and process performance index of the production process is reflected in supplier quality assurance capabilities of the two important parameters.Process capability index reflects the ability of suppliers to meet short-term course of the degree of tolerance requirements.Process performance index reflects the ability of suppliers to meet long-term process requirements of the degree of tolerance.Does the supplier to process capability index and process performance index calculation and analysis, to a certain extent, reflect the production process is conducted in the prevention and control.Process capability index and the change process performance index can reflect the ability of the supplier quality assurance and quality improvement of the size of the potential, l largely reflecting the strength and supplier management.Therefore, the investigation supplier process capability index and process performance index is an important basis for selection of suppliers.4、Supplier Quality Control Quality management is an important principle is the “process approach”, enterprises in order to function effectively, must identify and manage the many interrelated processes, especially the interaction between these processes.Supplier is one of the sources of process management is an important factor in the process input, and thus, the quality of suppliers to provide products for business process quality, system quality and product quality has a pivotal role.（1）Product development and design stage, according to the different requirements of different products, product development, design or product design and development of proposals put forward in the book first pilot project tasks and issues, targeted for the introduction of new principles, new structures, new materials, new processes, The first test, in order to ensure test results and future production needs, an important task at this stage is that of the suppliers under control, to ensure that all stages of new product design and mass production, are to have fit the new Product or service needs of qualified suppliers.（2）Enterprises in the production process, quality control of suppliers include monitoring supplier process capability and process performance index, monitor supplier measurement system, the audit supplier quality management system, purchase quality inspection, and promote supplier Quality improvement, and defective products from suppliers, disposal and quality of problem solving and other activities.1）Production stage, suppliers of products or services directly determine the quality of the business to provide customers with the quality of the product or service features, enterprises in the process of suppliers, vendors should monitor changes in the quality assurance capabilities, in order to Monitoring effective, enterprises should reach agreement on this with the supplier, and follow the agreed standards and procedures.The purpose of monitoring generally have two, one supplier's quality assurance to prevent the decline in capacity, to ensure that the quality of the final product or service to achieve customer satisfaction;the second is working with vendors to find opportunities for improvement, looking for people to improve the cutting Point, at a higher level to create value.Production stage due to high volume supplier of continuous availability, purchase products, quality, price, availability, timeliness and other quality products for enterprises and businesses realize their operating principles, and target has a very important role, in order to more scientific Evaluation and selection of suppliers, supplier evaluation at this stage should be a quantitative analysis.According to the different products and services, quantitative differences in methods of folding points, the following brief analysis of commonly used process capability, measurement system analysis, quality management system assessment, comparing the level of law and good models and other methods.①Supplier process capability analysis l Process capability refers to the ability of the process of processing quality, rather than the number of processing capacity.In the production stage, in order to ensure mass production of products to meet customer needs and expectations, supplier stability of the production process is very important to determine whether the supplier has ability to consistently meet the quality requirements to provide continuous product of many factors, Supplier process capability is a decisive factor.Because when the supplier's process capability is insufficient, to provide qualified products supplier is only a good will, even if efforts to increase testing, can only be effective in the short term, unsustainable.Therefore, lack of process capability, supplier of short-term improvement of hopelessness, should stop cooperation.②Measurement System Analysis provider Company quality control of suppliers, including supplier selection, evaluation and control, are inseparable from the data and analysis of the data, the lack of sufficient data, experience and intuition alone the supplier selection and evaluation of the risk Is self-evident.Supplier evaluation and control of the data used are mostly provided by the measure, if the measurement error of the data distortion or large, will lead to purchases defect or failure.Therefore, in the mass production stage, in order to ensure the quality of procurement, suppliers should monitor the measurement system.2）Communication with suppliers Way of communicating with suppliers are diverse, but the purpose of these approaches is consistent, enterprise customers and suppliers of common concern, the establishment of enterprises and suppliers satisfaction of harmonious cooperation partnership for sustainable products and services Improvements in order to timely and effectively adapt to market changes.Meet customer needs and expectations of enterprises and suppliers of common values and common aspirations and achieve excellence.（3）Determination of nonconforming product, analysis and disposal of Even with these various control measures, but there is still substandard products is a normal phenomenon, in addition to single or a few pieces of products, products with higher security requirements and a few other products, in many cases, the emergence of non-conforming product Is hardly avoidable.This time will be based on the nature of failure, the degree of influence on the final product, the supplier's reputation and other factors necessary for the assessment of nonconforming product, and then take appropriate measures to deal with nonconforming product to prevent unintended non-conforming product When a nonconforming use or delivery of goods after the prisoners failed to analyze the factors have to take corrective and preventive measures.To prevent the failure from happening again.Anomalies occur due to defective products, suppliers to take appropriate measures to eliminate these abnormal factors.1）Consistent technical standards and sampling plan Use, and develop specifications proposed department must reasonably describe what the products to be purchased, to enable vendors to get an accurate understanding of the procurement staff to purchase the required products l accurately.According to ISO 9001:2000 standards and the actual situation, the technical standard is normally provided by the design, procurement, management, production and other departments to develop, but in the implementation of the procurement, the procurement departments should use these standards, so.Procurement from Beginning, these standards should be involved in the planning, drafting and revision, otherwise, if only for publish this implementation of this standard, may make the purchasing department in a passive position, to the procurement of trouble.2）Responsibility for substandard quality of goods When purchasing products in excess of unqualified technical specification limits, companies and suppliers should be identified in consultation with substandard products under the principle of reason, the agreed approach to solve product quality and make improvements accordingly.When the enterprise failed and suppliers found great differences on the two sides can not be resolved through consultation, need to resort to the law, the substandard nature of the responsibility of product quality changes, if necessary, do not rule out the need to pursue a party's legal responsibility.Therefore, the product requirements and other procurement information, enterprises must express clear, complete, accurate, and after review by authorized personnel to communicate with suppliers, in agreement with the supplier under the premise of re-signing of the contract, and retain procurement, Inspection documents and records.3）Control of nonconforming product When nonconforming product, if it is sampling, and the number of unqualified or less qualified to determine the number, this failure is a normal phenomenon, as long as the replacement of defective products into the qualified product, you should determine the approved inspection Qualified enterprises should be based on documents required to accept the batch.The failure of these individual products may be part of the normal fluctuations of the failure, you can not find the cause of the specialized supplier of quality can be improved as the only constant, and gradually improve the process capability and reduce the failure.5、Control of contract suppliers In order to ensure customer satisfaction with products and services, companies must form the whole process of product management and strict control.In order to make the whole supply chain, every link, that is, partners, specifically the quality of their responsibilities and obligations, and to ensure implementation of the contract between the partners must be in the form of the formation of commitment, and commitment to the contents of the measure in accordance with quality and service.Mentioned here refers only to the contract signed by the relevant parties to provide the quality of the supply chain responsibilities between the terms of documentation, including contracts and agreements.Serious and reasonable contract for both sides not only play the role of reliable constraints, and can effectively protect the interests of both.（1）Content and standards to ensure that contracts, regulations, and the unity of enterprise system l Contract may be quoted or learn from the established laws, regulations or rules and regulations, standards.Such as to require incoming inspection standards GB2828 random sample of standard;electrical products must comply with GB4706 and other security features.If found with the relevant laws, regulations, standards, system inconsistencies found shall timely changes.If found inconsistencies in the implementation process, that party shall promptly notify the innocent party, according to compliance with laws, regulations, standards, institutional manner.（2）Content of the contract should be practical and effective Drafting and signing of contract, we must consider the actual process of product formation, considering the operability of contract enforcement.Some protocols may need to consider in the development of many factors that need more detailed provisions, but if too cumbersome, the lack of maneuverability, but would not achieve its proper role.For example, a company should purchase from a supplier of processing a large number of bearing steel.As bearing on the material requirements more stringent, higher precision, quality assurance company, ask for in the agreement for each batch of material chemical composition analysis and physical properties.If the introduction of full set of suppliers of test equipment, is bound to spend a lot of cost, while equipped with the appropriate technical staff.If you do not increase the allocation of resources, so each must be sent to community inspection institutions, to pay for expensive testing costs.Like this contract, if the supplier careful testing, he will consider the profitsrisk analysis, the price increase request.Such an agreement more difficult to perform up there, but also easily lead to unnecessary disputes, is not conducive to the stability and quality of supply chain value chain formation.（3）Contract should be clear rights and responsibilities of both parties, to encourage suppliers to continuous improvement and innovation Contract should be clear rights and responsibilities of both supply and demand, but also should provide the necessary incentive provisions, on the one hand the quality of binding behavior of suppliers, on the other hand encourage suppliers to continuously improve product quality.Incentive of suppliers, including two types.One is the division of responsibility for the quality of the resulting rewards and punishments;the other is based on performance appraisal and reward and punishment generated.In the actual operation, the appropriate reward management may produce unexpected results.A supplier of the product in the hands of customers appeared more serious quality problems, companies immediately notify the supplier of the cause and take corrective measures.Suppliers take notice, sent to the site to actively assist in the investigation and analysis of the problem was quickly resolved.According to the agreement originally provided that the supplier should bear all the responsibility for quality in addition, we must also bear the amount of money in fines.However, taking into account the supplier companies is their key suppliers, have been working very smoothly, stable quality, decided to reward quality supplier of rapid response and a positive attitude, eliminating all of the fine.Year-end evaluation results found that the rate of qualified products suppliers are more substantial than the increase over the previous year.l（4）The contents of the contract should be fair and equitable Contract should be negotiated through the full consensus of both parties, not just one party against another or request a declaration, content to go through both the recognition and confirmation.In addition, the contract terms should cover product development, trial production, testing, packaging, delivery to non-conforming product processing, service the whole process, so the contract can contain multiple levels, such as supply contracts, quality assurance agreements, technology agreements, service Agreement.6、Supplier performance evaluation and dynamic management Suppliers as an important resource for product realization is bound to emphasize its effectiveness.2000 put the ISO9000 standard management system effectiveness to consider as a priority, so the assessment of supplier performance is important, it is the dynamic management, eliminating the basis by choosing inferior.（1）Evaluation Method Accordance with the procurement requirements of key materials, the main material and secondary materials on a regular basis for quality assessment of defect classification.Provisions of sub-critical parameters of the defects recorded as 3 points, 2 points for major defects, minor defects was 1.Some materials, in accordance with the provisions of the sampling method the maximum score is 6 points.Quality Engineer accordingly suppliers rating, give notice to the supplier.This method is simple, save manpower, but the index below normal.（2）Dynamic Management Based on performance records, all suppliers on a regular basis for dynamic classification assessment.All suppliers will be divided into A, B, C, D four, according to the material value, quality, ease of processing, social availability and other factors point to determine the number of the supply agreement.A fixed number of classes is 1 supplier order allocation was 100%;fixed number of Class B-1 supplier order allocation is 100%, but the need to develop new supplier of the material;fixed number of 2 A, B type distribution of order suppliers respectively 60% and 40%;fixed number 3 of the A, B, C category vendors were assigned the order 55%, 30% and 15%;D class of suppliers should be eliminated.The assessment and management of hierarchical order with the supplier to supplier performance, material grade combine to make more scientific and rational allocation of orders.Of course, this method the overall level of enterprise management also made very high demands.l

第四篇：工程造价与管理论文英文文献中英对照

英文文献

Engineering cost management Project cost control emphasis should be transferred to the project construction early days, is transferred to the project decision and design stage.Project cost control in construction projects throughout the entire process, the key lies in the pre construction investment decision-making with design phase, whereas in the investment decision is made, the key lies in designing.According to expert analysis: architectural design, in the preliminary design stage, design stage, construction design stage to the engineering effect were 75% ~ 95%, 35% ~ 75%, 5% ~ 35%;while in the construction phase, through the optimization of construction organization design, construction cost saving the possibility of only 5% to 10%.We should put the focus shifted to the design stage, in order to get twice the result with half the effort.Pay attention to the technical and economic optimization combination.The combination of technology with economy is most effective way to control engineering cost.China engineering fields for a long time did not do this.The lack of technical personnel economy idea, design thought is conservative, the design of the outcome of the economy are not fully reflect.Therefore, we should solve the problem is to improve economic efficiency as the goal, in the construction process, organization, technology and economy organic ground union rises.Through the economic analysis, comparative study and effect evaluation, correct processing of advanced technology and reasonable in economy between the relation of unity of opposites, strive to advanced technology under the conditions of economic rational, reasonable in economy based on advanced technology.Carry out “limitation is designed” method.To be consciously put the application of value engineering to the specific design, actively promote quota design in engineering design contract, by way of bidding.This has been proven in practice is an effective way, it is not only an economic problem, more precisely a technical and economic problems.This “limitation is designed” to effectively control the project cost.In order to make the “limitation is designed” to achieve the desired objectives, should be involved in the design personnel must be experienced skilled economic designer.Their design results must be practical, advanced and reasonable cost.Control of engineering cost on the other hand is the need for comparison, because the outcome is a process of gradual improvement, and not to decide, so the comparison is a measure of its practical, advanced and economical means.Do good project cost control in the process.(1)compilation of economic and feasible construction scheme.Before construction, construction enterprises should be combined with the construction drawings and the actual situation at the scene, their mechanical equipment, construction experience, the management level and technical specification acceptance criteria, a set of practical and feasible construction scheme.The construction scheme is engineering implementation of the programme of action.(2)to technical personnel, materials, machinery and personnel staff communication

and coordination.In the process of construction, construction technology, materials and mechanical personnel should cooperate closely, understand each other, to management as the core, to reduce costs for the purpose of.(3)to the project completion settlement.Strict supervision system.Control project cost effectively, in the early phase of the project shall be subject to supervision(including cost management)system.Through analyzing the design process of supervision, make the design more reasonable, cost control to limit the scope of, accomplish truly with the smallest investment maximize output.Strict supervision system.Control project cost effectively, in the early phase of the project shall be subject to supervision(including cost management)system.Through analyzing the design process of supervision, make the design more reasonable, cost control to limit the scope of, accomplish truly with the smallest investment maximize output.To establish and perfect the independent project cost advisory body, cultivate a Zhi De have both engineering team.To establish a real sense of independent engineering cost consulting agencies.Through improving the laws and regulations, normative behavior, separate government functions from enterprise management, the establishment of independent business partnership, share-holding system, the limited responsibility system and other forms of organization, an industry-based, diversified services integrated project consulting company, build and development and reform the engineering cost intermediary service institutions, make construction project management of a gradual transition by an independent specialized agency in charge of project cost whole process tracking management, truly between owner and contractor plays an intermediary role.To strengthen engineering cost consulting industry association construction, establish project cost consulting industry self-discipline mechanism, and constantly improve the Engineering Cost Association in engineering cost consulting industry status, to be truly representative of the interests of the majority of the industry practitioners, government and enterprises to become connection link and the bridge.At the same time to strengthen the project cost specialty in higher education and in service education.As a result of project cost management in construction projects and various economic interests are closely related, and the whole social economic activities play a very important role, it requires the cost engineering technical personnel should have different levels of knowledge, in addition to their professional knowledge and have a deep understanding, also deal with the design content, design process, construction technology, project management, economic laws and regulations have a comprehensive understanding of.Therefore, the project cost management, project cost per unit of society groups, has already obtained a cost engineer qualification personnel, in order to carry out plan, has the goal, multiple levels of continuing education and training, to understand and master Chinese bilateral agreements with countries project cost technology, regulations, management system and its development trend, to expand domestic and foreign exchanges, and actively participate in international or regional engineering activities, improve their professional quality, so that the current practitioners in intelligent

structure, theory and working experience three aspects can meet the needs of engineering cost management.Cost engineering professionals need to strengthen their own learning, in addition to the professional knowledge to upgrade, should also work in combination with a broad understanding and master the relevant engineering and technical expertise, educational organizations and industry regulatory bodies constitute a complete education system, so as to the field of engineering senior talent development to create good conditions.中文译文：

工程造价与管理

工程造价控制重点应转移到项目建设的前期，即转移到项目决策和设计阶段。工程造价控制贯穿于项目建设全过程，关键在于施工前的投资决策和设计阶段，而在做出投资决策后，关键在于设计。据有关专家分析：建筑设计方案，在初步设计阶段、技术设计阶段、施工图设计阶段对工程的影响分别达75％～95％、35％～75％、5％～35％；而在施工阶段，通过优化组织施工设计，节约工程造价的可能性只有5％～10％。所以应该把重点转移到设计阶段，以取得事半功倍的效果。

注重技术与经济的优化结合。技术与经济相结合是控制工程造价最有效的手段。中国工程设计领域长期以来没有做到这点。技术人员缺乏经济观念，设计思想保守，使设计成果的经济性得不到充分体现。因此，我们现在应该解决的问题是以提高经济效益为目的，在工程建设过程中将组织、技术与经济有机地结合起来。通过经济分析、技术比较及效果评价，正确处理技术先进与经济合理两者之间的对立统一的关系，力求在技术先进条件下的经济合理，在经济合理基础上的技术先进。

推行“限额设计”方法。要自觉地把价值工程运用到具体的设计中去，积极推行限额设计，在工程设计发包中采用招投标方式。这是被实践证明的有效途径，它不单纯是一个经济问题，更准确地说是一个技术经济问题。这种“限额设计”能有效地控制整个项目的工程造价。为使“限额设计”达到预期目的，应该做到参与设计人员必须是有经验懂技术经济的设计师。他们设计的成果必须实用、先进而且造价合理。控制工程造价的另一方面是必须进行多方案比较，因为设计成果是一个逐步完善的过程，并不是一开始就能确定下来，所以多方案比较是衡量其实用性、先进性和经济性的重要手段。

做好工程实施过程中的造价控制。（1）编制经济可行的施工方案。施工前，施工企业要结合施工图纸及现场实际情况、自身的机械设备、施工经验、管理水平和技术规范验收标准，编制一套切实经济可行的施工方案。该施工方案是工程实施的行动纲领。（2）做好技术人员、材料人员、机械人员的沟通与配合。施工过程中，施工技术人员，材料人员和机械人员要密切配合，互相了解，以经营管理为核心，以节约成本为目的。（3）做好工程竣工结算。

严格实行监理制度。有效地控制工程造价，在项目建设前期阶段必须实行监理（含造价监理）制度。通过对设计过程的监理，使设计趋于合理，造价控制在限额范围内，真正做到用最小的投入取得最大的产出。

建立和完善独立的工程造价咨询机构，培养一支德才兼备的工程造价队伍。要建立一批真正意义上独立的工程造价咨询机构。通过健全法规，规范行为，政企分开，建立自主经营的合伙制、股份制、有限责任制等多种组织形式，一业为主、多种经营服务的综合性工程项目咨询顾问公司，建立和发展与改革相适应的工程造价中介服务机构，使建设项目管理逐步过渡到由一个独立的专业化中介机构负责对工程造价进行全过程跟踪管理，真正在业主与承包商之间起中介作用。要加强工程造价咨询行业协会的建设，建立工程造价咨询行业自律机制，不断提高工程造价协会在工程造价咨询行业的地位，使之成为真正代表行业内多数从业

者的利益，成为政府与企业联系的纽带和桥梁。同时要加强工程造价专业高等教育及在职人员的再教育。由于工程造价管理在建设项目中和各方经济利益密切相关，且对全社会的经济活动起着十分重要的导向作用，它要求造价工程专业技术人员应具有多层次的知识，他们除了要对本专业的知识有深入的了解外，还应对设计内容、设计过程、施工技术、项目管理、经济法律法规等有全面的了解。为此，工程造价行业管理机构，工程造价学会团体等部门单位，对目前已经获得造价工程师资格的人员，要进行有计划、有目标、多层次的继续教育及培训，了解和掌握与中国达成双边协议的国家的工程造价技术、法规、管理体系及其发展动向，扩大内外交流，积极参与国际性或区域性工程造价组织的活动，不断提高他们的业务素质，使目前从业人员在智能结构、理论水平和工作经验三方面都能满足工程造价管理工作的需要。工程造价专业人员也要加强自身的学习，除了对本专业的知识进行更新提高外，还应该结合工作广泛了解和掌握有关工程技术专业的知识，国民教育机构和行业管理机构构成完备的教育体系，从而为工程造价领域高级人才的成长创造良好的条件。

第五篇：中英对照

行政主体在对行政相对人作出不利行政决定时，是否必须说明理由，二战之后伴随民主法治的发展，经历从无到有的过程。法国、德国、美国、日本及我国台湾地区和澳门地区的行政程序法都有相关规定，说明理由已成为行政程序中一项重要的制度。行政主体在作出影响对人权利义务的行政行为时，向相对人说明作出该行为的事实根据、法律根据及进行自由裁量时所考虑的公共利益、社会习惯、政策考量等因素。这一方面有利于规范行政主体依法行使行政权，保障行政合法性和合理性，降低行政恣意和专断的风险；另一方面，将作出行政决定所依据的事实、法律根据及裁量因素告知行政相对人，可以增强相对人对行政决定的理解和认同。此外，如果相对人对行政决定不服，可根据行政决定的依据和理由寻求法律救济，保障其合法权益。本文以行政程序中的说明理由制度为视角，以我国工商系统推行的说理式行政处罚决定的相关案例，总结我国工商系统说明式行政处罚决定书的特点和问题，并在此基础之上提出完善建议，以期将说理式行政决定书推广适用到行政处罚、行政强制等执法领域，增强行政决定的合理性和正当性，更有效地规范行政权力，保障公民合法权益。

Whether the administrative subject has to give the reasons why making negative administrative decision on administrative counterpart, which appears accompany with the development of democracy and the rule of law.The administrative procedure law in France, Germany, the United States, Japan, Taiwan and Macao of china has relative regulations, and giving the reasons has become an important system in administrative procedure system.When the administrative subject takes administrative actions that will impact the rights and obligations of the administrative counterpart, it should explain to the administrative counterpart the fact and foundation and the law, on which it take the action, also it should explain the public interests, social habits, policy considerations and other factors that it has to take into account when make discretions.on one hand, this is conductive to standardize the administrative subject to execute administrative power according to the law, and guarantee the administrative legality and rationality, reduce administrative arbitrariness and abuse of administrative power;on the other hand, to inform the administrative decision basis of facts, law and discretion factors to the administrative counterpart could enhance the understanding and recognition of the decisions for the administrative counterpart.Besides, if the administrative counterpart doesn’t accept the decisions, could according to the foundations and reasons of the administrative decisions seek for legal redress to protect his/her legal interests.This report base on the reasons explanation system to summarize the characteristics and existing problems of the persuasive administrative penalties notifications in our country’s industrial and commercial systems, and make suggestions on how to improve it, in order to make the administrative decision be applicable to administrative penalty, administrative compulsory enforcement and other executive fields, to enhance the rationality and legitimacy of the administrative decision, effectively regulate the use of the administrative power, protect the legal rights and interests of the citizens.本文分为五部分：

The report has five parts:

引言部分简单介绍我国学界关于行政程序中说明理由制度的研究概况，说明当前关于说明理由制度研究重心和热点问题。

The brief introduce the general situation of the study of the reasons explanation system in administrative procedure of our law circles, and illustrates the focus and hot issues in current study of the reasons explanation system.第一部分为全文概述，简要介绍选题依据和来源，从宪政角度分析行政决定的说理性理论基

础，并从行政机关、行政相对人和受理争议机关复审三方面分析行政决定说理性的价值所在。第二部分着重研究我国工商系统推行的说理式行政处罚决定书案例，总结工商系统说理式行政处罚决定书的特点及存在的问题。

The first part is the general overview of the report, give a brief introduction to the basis and resource of the selection of the topic, analyze the rationality theory foundation of the administrative decision from the constitutional perspective, and analyze the value of the administrative decision rationality from the administrative organ, the administrative counterpart and the request of the controversy dispute acceptance organ.Part two focuses on the study of the cases on the persuasive administrative penalty notification pushed by our country’s industrial and commercial system, and summarize the characteristics and existing problems of the persuasive administrative penalties notifications in our country’s industrial and commercial systems.第三部分对我国目前关于行政决定说理性的立法规范进行分析，指出当前我国相关立法存在的缺陷和问题。

The third part analyzes the current legal regulations in our country on the rationality of the administrative decisions, and point out the existing defects and problems in our country’s relative laws.