AIM： To investigate the outcomes of early and delayed elective resection after initial antibiotic treatment in patients with complicated diverticulitis. METHODS： The study, a non-randomized comparison of the two app...AIM： To investigate the outcomes of early and delayed elective resection after initial antibiotic treatment in patients with complicated diverticulitis. METHODS： The study, a non-randomized comparison of the two approaches, included 421 consecutive patients who underwent surgical resection for complicated sigmoid diverticulitis （Hinchey classification I - II ） at the Department of Surgery, University Medical Center Hamburg-Eppendorf between 2004 and 2009. The operating procedure, duration of hospital and intensive care unit stay, outcome, complications and socioeconomic costs were analyzed, with comparison made between the early and delayed elective resection strategies. RESULTS： The severity of the diverticulitis and American Society of Anesthesiologists score were comparable for the two groups. Patients who underwent delayed elective resection had a shorter hospital stay and operating time, and the rate of successfully completed laparoscopic resections was higher （80% vs 75%）. Eight patients who were scheduled for delayed elective resection required urgent surgery because of complications of the diverticulitis, which resulted in a high rate of morbidity. Analysis of the socioeconomic effects showed that hospitalization costs were significantly higher for delayed elective resection compared with early elec- tive resection （9296 ± 694 vs 8423 ± 968 ; P = 0.001）. Delayed elective resection showed a trend toward lower complications, and the operation appeared simpler to perform than early elective resection. Nevertheless, delayed elective resection carries a risk of complications occurring during the period of 6-8 wk that could necessitate an urgent resection with its consequent high morbidity, which counterbalanced many of the advantages.展开更多
Thirty-seven years since reform and opening up, China has sustained rapid economic growth and urbanization. However, there was inadequate protection of natural, historical, and cultural heritage, especially in the pas...Thirty-seven years since reform and opening up, China has sustained rapid economic growth and urbanization. However, there was inadequate protection of natural, historical, and cultural heritage, especially in the past 17 years, which led to the outcome that urban and rural construction lacked features. To rebuild our urban features during urbanization, and avoid destroying them,we should probe into the reason of lacking features and how to protect them. Therefore, taking Jinan City as an example, this paper explored the crisis and its causes of urban characteristics during the period of rapid urbanization based on discussing roles of spring features, including economic effects, social effects, ecological effects and so on. What is more, this paper listed and analyzed those protection measures taken by Jinan. The results showed that spring groups spewed again and kept for 8 years through those measures, which meant that urban characteristics restored. Thus, Jinan City provides successful and significant reference for other cities in restoring urban features during urbanization construction. Also, the author deemed that cities could recollect their urban features as long as they take reasonable measures.展开更多
In recent years the European Union （EU） has struggled to become the leading force in the Knowledge Based Economy （KBE）. For that purpose, the EU defined the so-called ＂Lisbon Strategy＂. Additionally, since the s...In recent years the European Union （EU） has struggled to become the leading force in the Knowledge Based Economy （KBE）. For that purpose, the EU defined the so-called ＂Lisbon Strategy＂. Additionally, since the sixties the EU （formerly European Communities （ECs）） invested in human resources and in knowledge using the European Social Fund （ESF）. This research tries to assess analyse critically those ECs＇ and EUs＇ investments in knowledge in the light of the economic analysis of the knowledge market. It concludes that there is evidence that the ESF has been an important provider of knowledge in Europe, contributing to the increase of knowledge levels. However, it could be concluded that the economic consequences of that effort were not assessed properly; therefore, it is not clear what the effects of the investment were. The few studies I found that may base the sort of analysis I want to make point to small, if existing effects of the ESF were small. This in itself is an interesting finding that deserves careful consideration.展开更多
文摘AIM： To investigate the outcomes of early and delayed elective resection after initial antibiotic treatment in patients with complicated diverticulitis. METHODS： The study, a non-randomized comparison of the two approaches, included 421 consecutive patients who underwent surgical resection for complicated sigmoid diverticulitis （Hinchey classification I - II ） at the Department of Surgery, University Medical Center Hamburg-Eppendorf between 2004 and 2009. The operating procedure, duration of hospital and intensive care unit stay, outcome, complications and socioeconomic costs were analyzed, with comparison made between the early and delayed elective resection strategies. RESULTS： The severity of the diverticulitis and American Society of Anesthesiologists score were comparable for the two groups. Patients who underwent delayed elective resection had a shorter hospital stay and operating time, and the rate of successfully completed laparoscopic resections was higher （80% vs 75%）. Eight patients who were scheduled for delayed elective resection required urgent surgery because of complications of the diverticulitis, which resulted in a high rate of morbidity. Analysis of the socioeconomic effects showed that hospitalization costs were significantly higher for delayed elective resection compared with early elec- tive resection （9296 ± 694 vs 8423 ± 968 ; P = 0.001）. Delayed elective resection showed a trend toward lower complications, and the operation appeared simpler to perform than early elective resection. Nevertheless, delayed elective resection carries a risk of complications occurring during the period of 6-8 wk that could necessitate an urgent resection with its consequent high morbidity, which counterbalanced many of the advantages.
基金supported by National Natural Science Foundation[grant number 41371170]Technology Project of Shandong Province[grant number2012GSF12204]
文摘Thirty-seven years since reform and opening up, China has sustained rapid economic growth and urbanization. However, there was inadequate protection of natural, historical, and cultural heritage, especially in the past 17 years, which led to the outcome that urban and rural construction lacked features. To rebuild our urban features during urbanization, and avoid destroying them,we should probe into the reason of lacking features and how to protect them. Therefore, taking Jinan City as an example, this paper explored the crisis and its causes of urban characteristics during the period of rapid urbanization based on discussing roles of spring features, including economic effects, social effects, ecological effects and so on. What is more, this paper listed and analyzed those protection measures taken by Jinan. The results showed that spring groups spewed again and kept for 8 years through those measures, which meant that urban characteristics restored. Thus, Jinan City provides successful and significant reference for other cities in restoring urban features during urbanization construction. Also, the author deemed that cities could recollect their urban features as long as they take reasonable measures.
文摘In recent years the European Union （EU） has struggled to become the leading force in the Knowledge Based Economy （KBE）. For that purpose, the EU defined the so-called ＂Lisbon Strategy＂. Additionally, since the sixties the EU （formerly European Communities （ECs）） invested in human resources and in knowledge using the European Social Fund （ESF）. This research tries to assess analyse critically those ECs＇ and EUs＇ investments in knowledge in the light of the economic analysis of the knowledge market. It concludes that there is evidence that the ESF has been an important provider of knowledge in Europe, contributing to the increase of knowledge levels. However, it could be concluded that the economic consequences of that effort were not assessed properly; therefore, it is not clear what the effects of the investment were. The few studies I found that may base the sort of analysis I want to make point to small, if existing effects of the ESF were small. This in itself is an interesting finding that deserves careful consideration.
