目的探讨经内镜括约肌切开（EST）和内镜乳头气囊扩张（EPBD）治疗胆总管结石的临床应用价值。方法胆总管结石160例中,男94例,女66例。年龄24～80岁,平均59.1岁。其中,65岁以上60例,占37.5%。胆囊结石合并胆总管结石21例,单纯胆总管结...目的探讨经内镜括约肌切开（EST）和内镜乳头气囊扩张（EPBD）治疗胆总管结石的临床应用价值。方法胆总管结石160例中,男94例,女66例。年龄24～80岁,平均59.1岁。其中,65岁以上60例,占37.5%。胆囊结石合并胆总管结石21例,单纯胆总管结石29例,胆囊切除术后胆总管结石110例。结石最大径〈1.0 cm 72例,1.0～2.0 cm 68例,〉2.0 cm 20例。44例合并乳头旁憩室,对于〈10 mm结石采用EPBD治疗,〉10 mm采用EST。结果91例经内镜乳头括约肌切开（EST）,69例采用内镜EPBD。自然排出者30例（18.7%）;采用网篮或取石球囊取出结石有100例（62.5%）,其中6例2次取石取尽,5例残留结石行外科手术治疗;采用碎石网篮碎石后取出结石者25例（15.7%）,其中单颗结石4例,多发性结石10例。13例1次碎石取出,10例2次取出,2例经3次内镜取石取净。1例继发急性胆管炎,4例急性胰腺炎。本组无消化道穿孔及死亡。结论EST和EPBD安全、有效、并发症少,是目前治疗胆总管结石的重要手段。展开更多
Buildings have contributed to the energy shortage, pollution and global climate change. To promote green buildings is the way access to the sustainable development. Currently, China has issued some regulations and sys...Buildings have contributed to the energy shortage, pollution and global climate change. To promote green buildings is the way access to the sustainable development. Currently, China has issued some regulations and systems to boost the green building. However, problems lie in China and the systems are not effective. USA and EU have rich experiences and fairly sophisticated legislation and policies to develop green building. China may get some lessens from these countries. This paper will make an overview of legal framework and main system of green building in China, then, analyses some important legal systems and typical case related green building in the USA and EU. Further, problems were pointed out in the China based on the comparative analysis of these countries. Lastly, according to the condition in China and lessons from USA and EU, this paper will put some suggests to promote green building, such as, take some measures to enhance the awareness of the stakeholders, create multi- incentive tools and so on.展开更多
文摘目的探讨经内镜括约肌切开（EST）和内镜乳头气囊扩张（EPBD）治疗胆总管结石的临床应用价值。方法胆总管结石160例中,男94例,女66例。年龄24～80岁,平均59.1岁。其中,65岁以上60例,占37.5%。胆囊结石合并胆总管结石21例,单纯胆总管结石29例,胆囊切除术后胆总管结石110例。结石最大径〈1.0 cm 72例,1.0～2.0 cm 68例,〉2.0 cm 20例。44例合并乳头旁憩室,对于〈10 mm结石采用EPBD治疗,〉10 mm采用EST。结果91例经内镜乳头括约肌切开（EST）,69例采用内镜EPBD。自然排出者30例（18.7%）;采用网篮或取石球囊取出结石有100例（62.5%）,其中6例2次取石取尽,5例残留结石行外科手术治疗;采用碎石网篮碎石后取出结石者25例（15.7%）,其中单颗结石4例,多发性结石10例。13例1次碎石取出,10例2次取出,2例经3次内镜取石取净。1例继发急性胆管炎,4例急性胰腺炎。本组无消化道穿孔及死亡。结论EST和EPBD安全、有效、并发症少,是目前治疗胆总管结石的重要手段。
基金the key research project on the selection and application of the regulated tools [CLS(2011)B13],awarded by the China Law Societythe foundation from the United States Agency of the International Development,awarded by the Vermont Law School
文摘Buildings have contributed to the energy shortage, pollution and global climate change. To promote green buildings is the way access to the sustainable development. Currently, China has issued some regulations and systems to boost the green building. However, problems lie in China and the systems are not effective. USA and EU have rich experiences and fairly sophisticated legislation and policies to develop green building. China may get some lessens from these countries. This paper will make an overview of legal framework and main system of green building in China, then, analyses some important legal systems and typical case related green building in the USA and EU. Further, problems were pointed out in the China based on the comparative analysis of these countries. Lastly, according to the condition in China and lessons from USA and EU, this paper will put some suggests to promote green building, such as, take some measures to enhance the awareness of the stakeholders, create multi- incentive tools and so on.
