Cholangiocarcinoma is the second most common primary hepatic cancer. Despite advances in diagnostic techniques during the past decade, cholangiocarcinoma is usually encountered at an advanced stage. In this review, we...Cholangiocarcinoma is the second most common primary hepatic cancer. Despite advances in diagnostic techniques during the past decade, cholangiocarcinoma is usually encountered at an advanced stage. In this review, we describe the classification, diagnosis, and initial management of cholangiocarcinoma with obstructive jaundice.展开更多
AIM: To determine the optimal initial treatment modality for acute superior mesenteric vein thrombosis (ASMVT) in patients with circumscribed peritonitis.
Knee dislocation is a serious and rare injury. Its rarity and the variety of injuries that result from it mean that there is no adequate management that is universally accepted. The aim of this study was to evaluate o...Knee dislocation is a serious and rare injury. Its rarity and the variety of injuries that result from it mean that there is no adequate management that is universally accepted. The aim of this study was to evaluate our emergency care strategy for these injuries. Materials and methodology: This was a retrospective study conducted from January 1992 to December 2004 on nine cases of knee dislocation. It consisted of six men and three women. The average age of these subjects was 35, ranging from 15 to 50 years. The causes for these injuries included: public road accidents (n = 4), household accidents (n = 3), a sporting accident and a dislocation that occurred following a fight. The dislocations were anteromedial (n = 4), posterolateral (n = 2), posterior (n = 2) and anterior (n = 1). Associated injuries were sore joint (n = 2), contusion of the common peroneal nerve (n = 1) and vascular injury (n = 1). An angiography was performed on one patient for a vascular injury and an Elecmyography (EMG) for a common peroneal nerve injury. Closed reduction was used for eight patients and open reduction for one patient. Results: Five knees were stable with normal range of motion and some residual pain. Four patients had knee instability;two anterior, one anteroposterior and one lateral. In three of these patients, the CT arthrography/arthro-scan confirmed central pivot damage, with meniscal damage in two of them. The four patients were referred to a knee surgeon in a private practice. The post-operational effects were minimal in vascular injury. The EMG performed for the common peroneal nerve detected a nerve contusion. Conclusion: Our emergency care strategy remains closed reduction. This therapeutic management is consistent, at least in the first 15 days, with the literature.展开更多
Small-and medium-sized enterprises(SMEs)play an important role in sustainable development not only for their significant contribution to China’s economy,but also for their large share of total discharged pollutants.T...Small-and medium-sized enterprises(SMEs)play an important role in sustainable development not only for their significant contribution to China’s economy,but also for their large share of total discharged pollutants.Therefore,this research takes the enterprises in Suzhou Industrial Park,China as the case study to investigate the environmental management practices of SMEs,and identify drivers and barriers to engaging businesses in environmental management initiatives.It is shown that,as in other countries,SMEs are less active in adopting environmental management initiatives than larger companies.Legislation remains the key driver to engage SMEs in environmental management initiatives.Based on the analysis,policy recommendations are also presented.展开更多
文摘Cholangiocarcinoma is the second most common primary hepatic cancer. Despite advances in diagnostic techniques during the past decade, cholangiocarcinoma is usually encountered at an advanced stage. In this review, we describe the classification, diagnosis, and initial management of cholangiocarcinoma with obstructive jaundice.
基金Supported by Grants from the National Science Foundation of China,No.81300278the Natural Science Foundation of Jiangsu Province,No.BK20130697the Jiangsu Provincial Special Program of Medical Science,No.BL2012006
文摘AIM: To determine the optimal initial treatment modality for acute superior mesenteric vein thrombosis (ASMVT) in patients with circumscribed peritonitis.
文摘Knee dislocation is a serious and rare injury. Its rarity and the variety of injuries that result from it mean that there is no adequate management that is universally accepted. The aim of this study was to evaluate our emergency care strategy for these injuries. Materials and methodology: This was a retrospective study conducted from January 1992 to December 2004 on nine cases of knee dislocation. It consisted of six men and three women. The average age of these subjects was 35, ranging from 15 to 50 years. The causes for these injuries included: public road accidents (n = 4), household accidents (n = 3), a sporting accident and a dislocation that occurred following a fight. The dislocations were anteromedial (n = 4), posterolateral (n = 2), posterior (n = 2) and anterior (n = 1). Associated injuries were sore joint (n = 2), contusion of the common peroneal nerve (n = 1) and vascular injury (n = 1). An angiography was performed on one patient for a vascular injury and an Elecmyography (EMG) for a common peroneal nerve injury. Closed reduction was used for eight patients and open reduction for one patient. Results: Five knees were stable with normal range of motion and some residual pain. Four patients had knee instability;two anterior, one anteroposterior and one lateral. In three of these patients, the CT arthrography/arthro-scan confirmed central pivot damage, with meniscal damage in two of them. The four patients were referred to a knee surgeon in a private practice. The post-operational effects were minimal in vascular injury. The EMG performed for the common peroneal nerve detected a nerve contusion. Conclusion: Our emergency care strategy remains closed reduction. This therapeutic management is consistent, at least in the first 15 days, with the literature.
基金This research was supported by the National Key Social Science Foundation of China(Grant No.06&ZD026)the Scientific Research Foundation of Graduate School of Nanjing University(No.2006CW04)the National Environmental R&D Project on Public Interest(200809074).
文摘Small-and medium-sized enterprises(SMEs)play an important role in sustainable development not only for their significant contribution to China’s economy,but also for their large share of total discharged pollutants.Therefore,this research takes the enterprises in Suzhou Industrial Park,China as the case study to investigate the environmental management practices of SMEs,and identify drivers and barriers to engaging businesses in environmental management initiatives.It is shown that,as in other countries,SMEs are less active in adopting environmental management initiatives than larger companies.Legislation remains the key driver to engage SMEs in environmental management initiatives.Based on the analysis,policy recommendations are also presented.
