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患者，女，30岁，妊娠26周以前正常，随后腹部迅速膨隆，出现腹部胀痛、呼吸困难和下肢水肿，于妊娠29周来院。查宫底在剑突下3横指，腹围100cm，胎位触不清，胎心听不清，隐约触到胎动。 该患者腹部迅速膨隆的原因是
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案例分析题利用战略性采购解决采购问题在美国家用和商用建筑所需的乙烯壁板产品市场中，某公司是居于市场领先地位的制造商。今年，公司创下了2.5亿美元的销售记录，比去年增长了15%，总裁S先生对今年的销售数字非常满意，但是他越来越关心盈利数字的趋势。因为，在过去的几年里，净利润率已经从2000年的7.2%下降到今年的4.5%。在每月的高级主管小组会议上，S先生指出了净利润的下滑趋势，并要求明年的利润上升一到两个百分点。S先生指出来自竞争对手的价格压力和不断增加的成本是利润率下滑的主要原因，他要求每一位主管人员为完成利润目标制定一个战略计划。采购部主管M先生开始研究采购部门为制定采购战略计划而收集的采购数据。首先是采购成本占销售额的比例从2000年的57%增加到今年的65%，同期采购人员增加了五个人。目前，公司有1500SKU生产规模，这需要采购5000SKU的原料来支持产成品线的生产、销售和配送。所采购的原料包括乙烯基本产品、涂料、办公用品、包装、集装箱木材、库存设备、维修和营业物品以及运输服务。本年度，公司为这些物品的采购费用和采购部的营业费用总计支出1.625亿美元。M先生计算出采购支出每减少1%，净利润就会增加0.65%。在采购部门，大部分的采购都是手工完成的。拥有一台电脑主要是用于内部控制存货水平和打印发票，没有相应的电脑采购系统，也没有使用电子商务进行采购。采购人员主要是由负责某一具体产品的购买人员组成。几年来，采购员习惯于从供应商那里获得价格折让。然而这种做法也造成了很严重的库存问题。由于只有一个仓库，所以公司必须得最大限度地利用这个仓库。如果公司必须使用外部的仓库进行短期储存则会因较高的储存、拣单和运输费用遭受15%的损失。另外，美储联的货币政策使公司去年的资金成本增加，采购总费用包括冻结在存货上的资金成本。由于去年人员增加而年订单数下降，M先生认为采购员劳动生产率在下降。采购人员注意到需要更多的时间来研究潜在供应商以及同供应商保持良好关系，但这还是导致效率下降的主要原因。M先生的主要目标是在保持产品质量和提高采购效率的同时降低采购成本。供应商提供的价格折让，特别是对基本的乙烯原料而言，似乎并不能成为节约的主要方面。并且，他认为提高效率的主要方法是利用计算机化和电子商务。案例分析要求： 简述战略采购管理的要点。
账簿与账户有着十分密切的联系。账户存在于账簿之中，账簿中的每一账页就是账户的存在形式和载体。( )
W: Mr. Saffo, you’ve been called a "futurist," but you say you hate that term. Talk about that.M: Mm I dislike the term because it’s not an accurate description of what I do. For me, futurists are people who’re excited about the future. They usually have an agenda of some sort. But what I am is something more boring. That is, I just forecast, I don’t predict. I am a technology forecaster, and I spend most of my time looking at electronic technologies. So, I’m looking at information technology very largely, and typically out 5 to 10 years, sometimes as long as 30 years, depending on the project.W: who pays you to de this Do you work for companies who need this informationM: The Institute for the Future is a non-profit foundation that does work for private companies and government agencies. A whole variety of different folks pay us to help them understand things, and we also do free work. Being a non-profit foundation, our basic mission is to encourage people to think systematically about the long-range future. The heart of what we try to do is convince people that it is a meaningful exercise to think systematically about the long range future.W: What are the personal qualities that make you good at what you doM: Mm, curiosity, er, what else Being flexible. Because forecasting is really nothing more than applying common sense. The qualities that make for a good forecaster are the same qualities that make one successful in anything—being flexible, being curious, and being open to change.W: You’ve mentioned that your organization wants to stay small, whyM: It has to do with community. Our unit of work is the team, and you need to have high levels of trust and cooperation among team members. People need to really like and trust each other. What does Saffo consider to be essential to the work of a team
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