双管的

When in senior high school ,it left behind so many regret for me,at first,for the junior high school failure exam,I went to a unliked school to continue my student time,at the same time ,I also left dad's words to behind my head,everyday,I just look at the surrounding teachers and classmates ,I can't adapt me into that serious atmosphere ,more serious it that I more hated that environment ,in order to avoid it ,I started to skip classes ,as the time of skiping classes grew,some teachers and classmates began to think me as a bad student,honestly,in that school,there were so many this kind guys,however,it seemed to me that all teachers just had a couple eyes of caring of me .subsequently,in order to go on my studying,I had to make some promise of it for teachers,as a matter of fact ,I wrote it fully and also read it to the class.at the bottom of my hear,I apparently had the feeling that would like to stay to the class to keep my normal studying,but everytime,it seemed that something was not under my controul.but just now for me ,it may be just a little depressed.so that written guarantee didn't take some effect for me,as usual ,I also choosed to skip classes,at last ,related teachers had to call for my dad to school and required him to write some words to promise something in order to keep me in school ,at that momment,I refused all ,I can' t eudure dad do it as so.

上高中了，是我这辈子遗憾最多的日子。起先，在那所我极不愿去的学校里，我没有记住爸爸的话，看着身边的老师、同学，都找不着感觉，并且越来越讨厌那种环境，后来干脆开始逃课。逃课的日子多了，就成了老师眼中的坏孩子，其实在那所学校里逃课的学生多的是，但是老师好象长了一双只可以看到我逃课的眼睛。后来，老师要我来写保证书，保证我以后不再逃课，否则就走人。我写了，并且在班上念了。因为从心里我是真的想读书，可是每次总是管不住自己，有一种想逃走的感觉。现在想来，我那时应该是或多或少有些郁忧症了。所以保证书过后，我又逃课时，老师叫来了我的爸爸，并且要求爸爸写保证书，保证我以后不再逃课，而且要当着班上的同学念。我马上拒绝了，只说了句：&我自己走吧。&

objective to evaluate efficacy of extracorporeal shock wave lithotripsyfor treating ureteral stones in situ,investigate the cause of higher re-treatment rate.methods total of 687 patients with ureteral stone were received eswl between january 2000 and december 2004,included 455 male(66.2%) and 232 female(33.8%) patients,6 cases have bilateral ureteral calculi,12 cases have unilateral multiple calculi.hence,together 709 ureteral calculi were treated.patients upper ureteral calculi were treated in the supine position,for lower ureteral calculi patients were turned prone.to reduce eswl-induced renal trauma and pain,using lower energy source,adjusted power setting from 9.8 to 13.2kv,limited 1500 shock wavs per one session.no auxiliary procedure were used before eswl.the stone size was measured as the surface area of stone length by stone width on x-ray film.the interval between two treatment sessions was two weeks.results of 709 ureteral calculi,the overall stone free rate was 97.3%(690 calculi),re-treatment rate was 34.1%(292 calculi).according to the performed treatment sessions,one session 467 calculi,the mean stone size 37.27mm2,stone free rate 65.4%(464 calculi).two sessions 138 calculi,the mean stone size 62.48mm2,stone free rate 18.4%(131calculi).three sessions 52 calculi,the mean stone size 79.60mm2,stone free rate 7.1%(50calculi).four sessions 19 calculi,the mean stone size 101.63mm2,stone free rate 2.4%(17calculi).fivesessions 33 calculi,the mean stone size 119.33mm2,stone free rate 3.9%(28 calculi).overall 19 cases(2.7%)turned to other treatment modalities.of 335 upper ureteral calculi,303 achieved stone free (95.8%),re-treatment rate was 38.5%(129 calculi).of 374 lower ureteral calculi,369 achieved stone free(98.7%),re-treatment rate was 30.2%(113 calculi).the re-treatment rate of upper ureteral calculi was higher than lower ureteral calculi(p＜0.05,χ2=5.40).the difference of stone-free rate between upper and lower ureteral calculi was no significant(p＞0.05,χ2=0.15).conclusion eswl should be considered first line therapy for ureteral stone still.stone burden are the main variable of higher re-treatment rate,upper ureteral stone may moving with respiring during eswl.so efficinet shock wave was decreared,re-treatment rate become higher.

目的 评估体外震波碎石治疗输尿管结石的疗效，探讨再治疗率高的原因及输尿管结石的治疗选择。方法回顾2000年1月～2004年12月间eswl治疗输尿管结石的临床资料687例，男455例（66.2%），女232例（33.8%），平均年龄46.6岁（15～83岁）。有双侧输尿管结石6例，单侧多发性输尿管结石12例（4颗1例，3颗2例，2颗9例），共计输尿管结石709颗（含透光结石13颗）。应用上海爱申公司生产的desunit6030型碎石机，c臂x线球管做结石定位。上段输尿管结石（肾盂输尿管交界处至骶髂关节上缘）取仰卧位，下段输尿管结石（骶髂关节上缘下至输尿管口）取俯卧位。为减少eswl引起的肾损伤和疼痛，应用较低的能量，震波发生器电压从9.8～13.2kv，震波频率1.5s。每次治疗设定为1500次震波。治疗后3天摄腹部平片或b超，以后每隔7日重复检查。假如结石未碎或有残留结石最长径＞3mm以上，再次eswl，两次治疗的间隔时间为两周。结石的大小用x线片上的表面积（mm2表示。结果 709颗输尿管结石总的治愈率为97.3%（690颗），再治疗率34.1%（242颗）。其中一次治疗467颗，平均结石大小37.27mm2，治愈464颗（65.4%），3颗改治疗；两次治疗138颗，平均结石大小62.48mm2，治愈131颗（18.5%），7颗改治疗；第1和第2次治疗治愈率（1个月治愈率）为83.8%。3次治疗52颗，平均结石大小79.60mm2，治愈50颗（7.1%），2颗改治疗；4次治疗19颗，平均结石大小101.63mm2，治愈17颗（2.4%），2颗改治疗；5次及5次以上治疗33颗，平均结石大小119.33mm2，治愈28颗（3.9%），5颗改治疗。总计19颗（2.7%）结石改变治疗方式。上段输尿管结石335颗，治愈321颗（95.8%），再治疗129颗（38.5%）。下段输尿管结石374颗，治愈369颗（98.7%），再治疗113颗（30.2%）。经χ2检验，上、下段输尿管结石的再治疗率差异有显著性（χ2=5.40，p＜0.05），治愈率差异无显著性（χ2=0.15，p＞0.05）。不良反应：血压升高13例（1.9%），震波区域疼痛26例（3.8%），震波进入处皮肤点状淤血33例（4.8%），肉眼血尿128例（18.6%），均于第2、3天自行消失。结论 eswl目前仍是输尿管结石的第一线治疗，结石的大小是再治疗率高的主要因素。结石的位置有影响，上段输尿管结石可随呼吸移动，有效震波次数减少，再治疗率比下段输尿管结石高。eswl前注重病例筛选可降低再治疗率。

Yangtze River glacier retreat has little to do with human factors Yangtze River glacier retreat has little to do with human factors Shangguan Dong-hui said that the short term, the glacier melt water to the Yangtze River has brought plenty of water, the surface, in the Northwest seems to be a good thing, but this supply led to the uneven seasonal river runoff in winter The early release of melt water, resulting in spring flood summer drought.

Yangtze River glacier retreat has little to do with human factors ；是由上海埃非凯阀门有限公司提供的阀门新闻，中文译文仅供参考(上海埃非凯阀门有限公司还生产疏水阀隔膜阀旋塞阀柱塞阀鸭嘴阀及电动调速蝶阀，气动通风蝶阀，美标波纹管闸阀，c，平行式双闸板闸阀，欢迎您的选购。)长江源冰川的退缩与人为因素关系不大上官冬辉说，短期内，冰川的融水给长江带来了充沛的水量，表面上看，对西北地区似乎是一件好事，但是，这种补给导致江河的径流量季节性不均，冬季的融水提前释放，从而造成春汛夏旱。

I didn't watch TV last night, because it .

昨晚我没有看电视，因为电视机坏了。

Since this year, in a lot of villages of Beijing, TV of elevator liquid crystal was removed.

今年以来，在北京的很多小区里，电梯液晶电视被撤了下来。