文档视界 最新最全的文档下载
当前位置:文档视界 › 《经济学人》杂志若干篇文章

《经济学人》杂志若干篇文章

《经济学人》杂志若干篇文章
《经济学人》杂志若干篇文章

城市土地空间和都市

Urban land

城市土地

Space and the city

空间和都市

Poor land use in the world's greatest cities carries a huge cost

糟糕的土地利用方式已经成为世界大都市不能承受之重

BUY land, advised Mark Twain; they're not making it any more. In fact, land is not really scarce: the entire population of America could fit into Texas with more than an acre for each household to enjoy. What drives prices skyward is a collision between rampant demand and limited supply in the great metropolises like London, Mumbai and New York. In the past ten years real prices in Hong Kong have risen by 150%. Residential property in Mayfair, in central London, can go for as much as 55,000 (82,000) per square metre. A square mile of Manhattan residential property costs 16.5 billion.

马克吐温曾建议说“都去买地吧”,但现在他们已经不这么做了。事实上,土地并非真的如此稀缺:仅一个德克萨斯州就能容纳整个美国人口,而且每户能有一英亩之多。在伦敦、孟买、纽约这种大都市里,地价飞涨的现实是疯狂的需求和有限的供给共同作用的结果。在过去10年里,香港的房地产价格上涨了150%。伦敦中心的梅菲尔区的住宅价格能飙至55000英镑每平米(相当于82000美元)。曼哈顿,一平方英里的的住宅价格为165亿美元。Even in these great cities the scarcity is artificial. Regulatory limits on the height and density of buildings constrain supply and inflate prices. A recent analysis by academics at the London School of Economics estimates that land-use regulations in the West End of London inflate the price of office space by about 800%; in Milan and Paris the rules push up prices by around 300%. Most of the enormous value captured by landowners exists because it is well-nigh impossible to build new offices to compete those profits away.

即便是在这样的城市里,稀缺性也是人为造成的。从法律层面上对建筑的高度和密度进行限制,降低了供给,也助推了房价。伦敦经济学院的一项最新学术分析表明,土地使用管理条例令伦敦西区办公用房的价格上涨了800%,令米兰和巴黎的上涨了约300%。巨额资产掌握在现有的土地所有者手中,因为在这里建新办公楼引入竞争、分享收益,是几乎不可能的事。

The costs of this misfiring property market are huge, mainly because of their effects on individuals. High housing prices force workers towards cheaper but less productive places. According to one study, employment in the Bay Area around San Francisco would be about five times larger than it is but for tight limits on construction. Tot up these costs in lost earnings and unrealised human potential, and the figures become dizzying. Lifting all the barriers to urban growth in America could raise the country's GDP by between 6.5% and 13.5%, or by about 1 trillion-2 trillion. It is difficult to think of many other policies that would yield anything like that. 一潭死水的房地产市场所带来的社会成本是巨大的,因为它影响了这里的每个人。高昂的房价迫使务工者搬到更便宜但生产力更低下的地方。根据一项研究结果显示,如果不是因为对建筑业的严格限制,旧金山湾区的就业应该比现在多五倍;再加上损失的收入和未能实现的人的潜力,这个数字能把你吓晕。如果能扫清美国境内所有限制城市增长的阻碍因素,那么

国家GDP将会增加6.5%~13.5%,即10亿~20亿美元。这是任何其他政策都难以产生的巨大影响。

Metro stops

停滞的都市

Two long-run trends have led to this fractured market. One is the revival of the city as the central cog in the global economic machine. In the 20th century, tumbling transport costs weakened the gravitational pull of the city; in the 21st, the digital revolution has restored it. Knowledge-intensive industries such as technology and finance thrive on the clustering of workers who share ideas and expertise. The economies and populations of metropolises like London, New York and San Francisco have rebounded as a result.

两个长期趋势致使房产市场变得如此令人抓狂。其一是,城市的复兴成为了全球经济运转中必不可少的中心环节。在20世纪,糟糕的交通削弱了城市的吸引力;到了21世纪,数字革命修复了这一缺陷。像科技、金融这种知识密集型产业只有在人们能互相交流思想和专业技能的地方才能繁荣兴旺。伦敦、纽约和旧金山这样的大城市,其经济和人口之所以能复苏,正是得益于此。

What those cities have not regained is their historical ability to stretch in order to accommodate all those who want to come. There is a good reason for that: unconstrained urban growth in the late 19th century fostered crime and disease. Hence the second trend, the proliferation of green belts and rules on zoning. Over the course of the past century land-use rules have piled up so plentifully that getting planning permission is harder than hailing a cab on a wet afternoon. London has strict rules preventing new structures blocking certain views of St Paul's Cathedral. Google's plans to build housing on its Mountain View campus in Silicon Valley are being resisted on the ground that residents might keep pets, which could harm the local owl population. Nimbyish residents of low-density districts can exploit planning rules on everything from light levels to parking spaces to block plans for construction.

然而,这些城市失去了一项它们曾经有过的能力:扩张以容纳所有想要移居进来的人们。一个不错的理由就是:19世纪晚期无限制的城市扩张成为了犯罪和疾病的温床。那么第二个趋势就显而易见了:城市绿化带的泛滥和分区管制。纵观整个上世纪,政府出台了数不清的土地使用法规,以至于获取一个规划许可比在雨天的下午打出租还要困难。伦敦严格控制新建任何构筑物,以防止圣保罗大教堂的景观被破坏。Google计划在其所有的山景城园区建造房屋,却以“居民可能会养宠物、并且这会令当地猫头鹰的数量减少”为理由遭到拒绝。低密度社区Nimbyish的居民可以拿规划法规做挡箭牌为所欲为,从要求亮度水平到停车空间再到阻止一切建设。

A good thing, too, say many. The roads and rails criss-crossing big cities already creak under the pressure of growing populations. Dampening property prices hurts one of the few routes to wealth-accumulation still available to the middle classes. A cautious approach to development is the surest way to preserve public spaces and a city's heritage: give economists their way, and they would quickly pave over Central Park.

很多人认为,这样也不错啊。日益增长的人口已经令大城市的道路和十字交叉口不堪重负。被抑制的房地产价格虽然令一部分人的财富积累受到损失,但对于中产阶级来说仍然是可以

承受的。发展一定要慎重,要百分之百确保公共空间和保护城市遗产:如果把决策权交给经济学家,他们一定会以迅雷不及掩耳之势把中央公园铺成水泥大道。

However well these arguments go down in local planning meetings, they wilt on closer scrutiny. Home ownership is not especially egalitarian. Many households are priced out of more vibrant places. It is no coincidence that the home-ownership rate in the metropolitan area of downtrodden Detroit, at 71%, is well above the 55% in booming San Francisco. You do not need to build a forest of skyscrapers for a lot more people to make their home in big cities. San Francisco could squeeze in twice as many and remain half as dense as Manhattan.

然而,这些理由经不起本地规划会议的仔细斟酌。房屋所有权不是人人均等的。很多家庭被高房价挡在充满活力的地区之外。都市区的房屋所有权比例在日渐式微的底特律都达到71%,这一数字比日益兴旺的旧金山的55%要高得多,这可不是巧合。你不需要建造一片摩天大楼的森林来容纳越来越多在大城市安家的人们。旧金山的面积即便折叠两次,其人口密度也才只有曼哈顿的一半。

Property wrongs

歧路上的房地产

Zoning codes were conceived as a way to balance the social good of a growing, productive city and the private costs that growth sometimes imposes. But land-use rules have evolved into something more pernicious: a mechanism through which landowners are handed both unwarranted windfalls and the means to prevent others from exercising control over their property. Even small steps to restore a healthier balance between private and public good would yield handsome returns. Policymakers should focus on two things.

为了平衡不断增长且生产力强的城市中的社会利益与增长所附加的私人成本,人们想到了分区规范这个办法。但是,土地使用法规已经演变成了一个极为有害的机制:土地所有者一方面能躺着吃天上掉下来的馅饼,一方面还能光明正大地阻止任何人染指他们的不动产。现在即使能在健康地平衡公私利益方面迈出一小步,都将获得相当可观的回报。政治决策者应该把精力放在两方面。

First, they should ensure that city-planning decisions are made from the top down. When decisions are taken at local level, land-use rules tend to be stricter. Individual districts receive fewer of the benefits of a larger metropolitan population (jobs and taxes) than their costs (blocked views and congested streets). Moving housing-supply decisions to city level should mean that due weight is put on the benefits of growth. Any restrictions on building won by one district should be offset by increases elsewhere, so the city as a whole keeps to its development budget.

第一,他们应该确保涉及城市规划的决策是自上而下制定的。当决策权在本地政府手中时,通常对土地使用的限制会更加严格。就单个街区而言,大量都市人口是弊(受阻碍的视野和拥挤的街道)大於利(就业和税收)。而将住房供应量的决定权交给城市政府,则更能全面地考虑城市发展所带来的好处。如果一个街区对建设作出限制,就要以另一个街区增加建设作为补偿,因此城市作为一个整体就可以确保其应有的开发预算。

Second, governments should impose higher taxes on the value of land. In most rich countries,

land-value taxes account for a small share of total revenues. Land taxes are efficient. They are difficult to dodge; you cannot stuff land into a bank-vault in Luxembourg. Whereas a high tax on property can discourage investment, a high tax on land creates an incentive to develop unused sites. Land-value taxes can also help cater for newcomers. New infrastructure raises the value of nearby land, automatically feeding through into revenues—which helps to pay for the improvements.

其次,政府应该对地价征收重税。在大部分发达国家,地价税只占总收入中很小的一部分。地税是很有效的手段,因为你很难像藏钱一样把土地塞进卢森堡的银行保险柜里以逃避纳税。对不动产课重税会影响投资,而对土地课重税则会刺激人们开发尚未被使用的土地。地价税也有利于新来的居民。新建的基础设施能够增加附近土地的价值,然后自动转变成收入——反过来能补偿基建翻新的费用。

Neither better zoning nor land taxes are easy to impose. There are logistical hurdles, such as assessing the value of land with the property stripped out. The politics is harder still. But politically tricky problems are ten-a-penny. Few offer the people who solve them a trillion-dollar reward.

鉴于还有很多前期困难亟待解决,想要实施更好地分区规划或开始征收地税并不是件容易的事,比如如何刨除土地上面的房产而单独计算地价。政治方面也是个问题,但这些困难都不值一提,因为这些问题一旦解决,将会带来难以计数的丰厚回报。

托利党巨人退休才华横溢国会议员告别

Bratain

英国

A Tory titan retires

一托利党巨人退休

William, it was really nothing

威廉,真的没关系

The Conservatives bid farewell to a talented parliamentarian

保守党向一名才华横溢的国会议员告别

THE high esteem in which William Hague is held was evident on March 26th even amid the Conservative leader of the House of Commons's shabby last act. To mark the end of the parliament, which also concluded his 26-year-long career as an MP, Mr Hague launched a surprise, failed, bid to oust the speaker, John Bercow, who many Tories dislike. It was typical of the Tories' bungling in Parliament; but, MPs tutted, also an unseemly exit for one of its best performers of modern times.

就算这位下议院保守党领导人在3月26号的最后一举显得低劣,威廉·黑格享有的崇敬还是显而易见的。为了标记议会的结束,也将他26年的议员生涯画上句号,黑格让人们大吃一惊,他企图将不受托利党人欢迎的约翰·伯科赶下台,但失败了。这是托利党人在议会拙劣之举的典型,但对于近代最佳演员之一的黑格来说,引得议员们嘘声一片,这也是一个不体面的退场。

They were wrong. Because the 54-year-old Yorkshireman was following party orders—and that,

even more than his laconic drawl and brilliance at the dispatch box, epitomises his career. The episode was also typical of the sort of orders Mr Hague has often had to follow, as an absurdly young Welsh secretary under John Major, as his successor as party leader, and, between 2010 and 2014, as foreign secretary.

他们错了。因为这位54岁的约克郡人执行的是党的指令——这一举甚至超越了他简洁、慢吞吞的调子和在政务上的傲人之处,成为了他政治生涯的标志。这一插曲也是黑格经常需要遵从的典型指令,无论是作为约翰·梅杰手下年轻得不可思议的威尔士事务大臣,或是梅杰的继任党派领导人,还是作为2010到2014年间的外事大臣,都是如此。

So what did he achieve? In an interview in his parliamentary office, Mr Hague names, without hesitation, a law he got passed in 1995 to outlaw discrimination against the disabled as his proudest legislative achievement. His spell as party leader (“I don't regret taking the leadership on, or giving it up; somebody had to do it”) is harder to enthuse about. After a stab at forging a kinder Conservatism—which remains elusive—he fell back on Euroscepticism, was humiliated in the 2001 election and resigned. That he remained an MP was an act of courage, which he burnished with dazzling speeches and unshakable loyalty to his successors. David Cameron, who took the helm in 2005, called him the Tories' deputy leader in all but name.

那他到底获得了什么成果呢?在他的议员会议室里进行的一次采访里,黑格毫不犹豫地将1995年他推动通过的一项禁止歧视残疾人的法律视为他最值得骄傲的立法成就。他作为政党领导的魅力(“我不后悔扛上领导的担子,或者将它卸下来,总有人要做这件事”)更难笼络人心。在试图创造一个更为温和的保守主义(仍令人难以捉摸)后,黑格又回到了欧洲怀疑主义,在2001年的选举中颜面全失随后辞职。他仍留任议员实属勇气之举,他用言辞闪闪发光的演讲和对继任者不可动摇的忠诚来修饰了这一行为。2005年掌权的大卫·卡梅伦称其为托利党非名义上的实际代理领导。

This made Mr Hague the most powerful foreign secretary since Tony Blair, a globe-trotting prime minister, emasculated the job. Even in a time of cuts—which Mr Hague ensured were lighter at the Foreign Office than they might have been—he had an opportunity to strengthen his office (“the best job in the world”) and Britain's place in the world. He did not really take it.

这使得黑格成为了最有权威的外事大臣,因为托尼·布莱尔这位游历世界的总理无法胜任这份工作。即使在预算削减的时期(黑格保证外事办公室的削减程度比想象中轻),他仍有机会加强办公室的力量(“世上最好的工作”)并提升英国在世界上的地位。他并没有把握住这个机会。

He did some excellent things—restoring confidence to a department he found to be “shockingly” demoralised, including through a renewed emphasis on learning languages and other lapsed skills. He also expanded its operations, opening 20 missions, especially in India and China, the focus of a commercial push. He was also bold, early on, supporting Mr Cameron's championing of the Arab spring, including the intervention in Libya in 2011. Mr Hague describes their failure to win parliamentary support for strikes on Syria's regime in 2013 as one of his “worst experiences”. 他做了一些了不起的事:重塑这个他发现道德”惊人“沦丧的部门的信誉,包括重新强调学习语言和其他失效技能的重要性。他还扩大了部门的运作范围,新派出了20个驻外使团,特别是在印度和中国这些商业动力的中心。早些时候,他也十分大胆地支持卡梅伦对阿拉伯之春的拥护,还包括2011年对利比亚的干预。黑格认为他们在2013年没能赢得议会对叙

利亚统治下罢工的支持是他”最糟的体验“之一。

But after that setback Mr Cameron seemed to lose interest in the world. And Mr Hague did nothing obvious to fill the gap. He did not demur when Mr Cameron ordered a pullout from Afghanistan more abrupt than Britain's allies wanted. “We would have been there for decades” otherwise, he says; NATO only wanted Britain to stay, with a tiny force, for a year or two.

但那次挫折之后,卡梅伦似乎对全球事务失去了兴趣。黑格也没有做什么明显的事来填补空白。当卡梅伦以超乎英国盟友期望的速度突然命令从阿富汗撤军时,黑格并没有提出异议。他说,不然“我们本可以在那儿呆上几十年”。NATO希望英国仅在那儿保留少量武力一到两年。

Mr Hague's absence from the early Franco-German efforts to end the Ukraine crisis seemed similarly indicative of shrunken ambition. “You can't be everywhere”, he protests. But when it comes to tackling the continent's biggest security threats, Britain should always be with its main European allies. That Mr Hague was meanwhile more prominent in campaigning against rape in war, often alongside the film star Angelina Jolie, seemed a bit odd. The cause was important, but there was little in the history of such campaigns to suggest it would succeed, and the foreign secretary was required elsewhere.

在早期法德希望结束乌克兰危机的努力中,黑格的缺席似乎同样是其野心缩减的暗示。他抗议道:“你不可能无处不在。”但若到了处理这片大陆最大安全威胁的关头,英国应该始终与主要的欧洲同盟站在一条线上。黑格在反对战争强奸方面似乎更为闻名,他经常与电影明星安吉丽娜·朱莉一起参加相关活动,这看起来有一点奇怪。原因很重要,但历史证明这种活动鲜有成功,其他地方更需要外事大臣操心。

He retires to a pile in Wales and the 18th century, about which he writes fine books. It has been a thoroughly commendable political career; but, especially when set against Mr Hague's gifts, not a great one.

他在威尔士衣锦而归,还写了一些关于18世纪的好书。这是一段完全值得赞赏的政治生涯,但与黑格的天分相比,这又略显逊色。

梦中的吊车中世纪以来最大的建造活动

Oxford

牛津

Dreaming cranes

梦中的吊车

It is the biggest construction boom since the Middle Ages

这是中世纪以来最大的建造活动

IN HIS book “Notes from a Small Island”, Bill Bryson, an American author, took exception to some of Oxford's 20th-century architecture. It is, he wrote, as though the city had said to itself, “We've been putting up handsome bui ldings since 1264; let's have an ugly one for a change.”

美国作家Bill Bryson在书中如此写道“源自一个小岛的记录‘。他把牛津地区20世纪的一

些建筑物当做特例。他写道,“1264年以来我们已经建造了许多美观的建筑;为了改变,来造一个丑陋的吧。”

Much of Oxford is beautiful. A quarter of the university is listed. Some buildings date back to 1424. But in the 1960s planners added ugly shopping centres, offices and even college buildings that drain the beauty from the city centre. Now a building programme is under way that aims to avoid such errors, and even reverse a few.

牛津有许多漂亮建筑。这所大学四分之一的建筑物都名列在册。一些的建筑日期可以追溯到1424年。不过在20世纪60年代,设计者新建了难看的商业中心、办公楼,甚至学院建筑都叫城市中心失去美丽。现在有一个建筑计划正在施行,这个计划将避免上述错误,并且可以挽救些许失去的美好。

Some of the construction is driven by the need to upgrade facilities in order to keep Oxford globally competitive. In 2014 it was ranked Britain's top research university, yet some departments are still housed in converted Victorian houses. Post-war buildings in the Science Area have been demolished. Their replacements will encourage inter-disciplinary work. There is a push, too, for links with business, as pioneered by Oxford's old rival, Cambridge, where builders have also been busy. One new hub outside Oxford city centre, the BioEscalator, promotes commercial research in life sciences alongside academia; another, the Innovation Accelerator, focuses on advanced engineering.

有些建筑之所以修建,是为了更新设施以保证牛津大学在全球的竞争力。在2014年,尽管它有些部门还在维多利亚时代的屋子中办公,它还是英国最顶尖的研究型大学。战后科学区修建的建筑已经拆掉了。继而修建的建筑将促进跨学科研究的发展。将之与商业联系在一起也是有推力的,牛津的老对手剑桥早就开始这么做了,剑桥的建筑修建活动也在热火朝天地进行。位于牛津城市中心之外的一个新实验中心,BioEscalator,加强了生命科学的学术研究的同时也加强了其商业研究;另外,Innovation Accelerator则将注意力集中在先进引擎技术上。

Other buildings are being renovated. On March 21st the Weston Library (formerly the New Bodleian) opened to the public. In September a shiny new China Centre opened in the grounds of St Hugh's College. Construction is about to begin on the Beecroft physics building. The boldest newcomer, located next to the new Mathematical Institute, will be the Blavatnik School of Government (pictured), a glass-and-metal spaceship designed by the architects responsible for the “bird's nest” Olympic stadium in Beijing.

其他的建筑正在改造中。在3月21日,韦斯顿图书馆(前身是新牛津大学图书馆)对公共开放。10月在圣·休学院,将成立一座崭新的中国中心。Beecroft物理楼也要开始进行改造。位于新数学研究所旁最大胆的建筑,Blavatnik政府学院(图示),是由设计建造北京奥运会建筑“鸟巢”的建筑家负责督造的玻璃-金属建筑。

Private funding has been crucial, the names on the buildings reflecting those following in the footsteps of Balliol, Bodley and Wadham—from Ukrainian businessmen to British financiers. The university plans to spend another 1.8 billion (2.7 billion) over the next decade, says William James, the pro-vice chancellor for planning. He hints at bigger projects to come.

私人募捐变得十分关键。建筑上的名字如Balliol、, Bodley、Wadham反映了从乌克兰生意人到不列颠金融家的脚步。牛津大学计划在下一个十年花费18亿英镑(27亿美金),该计划

前副经理William James说。他暗示未来将有更大的项目。

Oxford City Council is building, too, redeveloping Oxpens, a down-at-heel area near the railway station, into homes and offices. It has demolished the monstrous Westgate car park to make way for a 500 million shopping centre. The railway station is getting a 200m refit, with plans for a “continental boulevard” outside to greet some of the 9.5m tourists who arrive in Oxford each year. A second railway station is under construction in the north of the city. Separately, an old branch line that links to the Mini factory in Cowley should open for passengers by 2020.

牛津城市议会也在建设中。这次将改建Oxpens区,把这个临近火车站的糟烂区域改造成住宅区和办公区。这次改造拆除了巨大丑陋的Westgate汽车公园,将修建价值5亿英镑的购物中心。火车站获得了2亿英镑的重修费用,计划在火车站外周建成一个“大陆林荫道”,以此吸引每年来牛津旅游的9500万游客中的一部分。在这个城市北部,第二座火车站正在建设中。另外,在2020年,通往Cowley的Mini工厂的一条旧支线也将向游人开放。

Yet if all this makes Oxford more attractive, it will accentuate another problem. Many people want to live or study there. Commuting to London is rising. Hedge funds are setting up in the city centre. The number of graduate students has doubled (to 10,000) since 2001. And yet the green belt around the city does not permit Oxford to expand, driving house prices higher than anywhere in the country, proportional to income. Local opposition to a development of badly needed graduate student accommodation near Port Meadow, a beauty spot, has led to the biggest town-gown bust-up in years.

不过尽管所有这些都让牛津更富魅力,这种情形导致了另外的问题。很多人希望在此学习或者生活。往返伦敦的费用一直上扬。Hedge基金正落户在这个城市的中心。毕业学生的数量自2001年以来翻倍。环绕这座城市的绿化带限制了牛津城的扩张。这使得房屋价格相对于收入的比例而言高于全国其他地方。当地人反对发展靠近Port Meadow的毕业生居住区。这本是一个漂亮的景点,这些年已经成为最大的城镇增长点。

Oxford has many articulate, conservation-minded residents. It is surrounded by pretty countryside and hemmed in by decades-old planning regulations. Its building boom is impressive. But growth will always be uncomfortable.

牛津有许多口齿清晰、内心保守的居民。它为漂亮的乡村所环绕,也被数十年陈旧的管理所束缚。蓬勃的建造工程颇具震撼。但增长的同时总是带来不适。

法国省议会选举三雄争霸

French elections

法国省议会选举

Menage a trios

三雄争霸

The National Front's strength makes French politics a three-way affair

极右翼国民前线实力增强,法国政治陷三雄争霸局面

SOMETIMES small elections are markers of major political change.France's latest vote, a

two-round ballot on March 22nd and 29th to elect deputies to the 98 assemblies of France's “departments”, may well turn out to be just such an election. On the face of it, the outcome will be a straightforward victory for the centre-right, led by Nicolas Sarkozy, a former president. In reality, it marks a shift in France from alternating two-party politics to a more fluid tripartite system.

有时小型选举可以导致重大的政治变化。22日和29日,法国分别举行了第一轮和第二轮98个省议会的议员选举投票。这次选举极有可能正中其说。表面来看,由法国前总统尼克拉斯·萨科齐领导的中右翼派将在选举中获得直接胜利。但实际上,这次选举标志着法国由两党轮流执政向更加不固定的三党制的转变。

The first element in this new political order is the performance of the populist National Front (FN), with its anti-immigration, anti-Europe and anti-establishment message. The party's combative leader, Marine Le Pen, had hoped it would come top in first-round voting and become, in her words, “the first party ofFrance”. In the end, Mr Sarkozy's UMP scored 29%, while the FN finished second with 25%, short of the triumph she had hoped for.

奉行民粹主义的国民前线在选举中的言行是造成这种政治新格局的首要因素。此前,该党宣扬三反政策(反移民、反欧洲和反政府),其斗志昂扬的领导人马琳·勒庞希望该党在首轮选举中斩获第一,用她的话说,“成为法国第一大党”。而结果呢,以萨科齐为首的右翼派人民运动联盟赢得29%的票数,而国民前线以25%的票数位居第二,并未达到勒庞所希冀的大胜。

For some commentators, this amounted to a defeat. Manuel Valls, the Socialist prime minister whose party came third with 21%, reportedly lit a cigar to celebrate the FN's failure to place first. It was, he said, an “honourable” result for his party, and he congratulated “republican” voters for rejecting a party which, he judges, does not share the country's founding values. Certainly the polls, which had predicted Ms Le Pen's party would win about 30%, turned out to have been a poor guide, in part because voter turnout was higher than usual for this sort of election.

有些评论员认为这相当于失败告终。社会党以21%的票数居于第三,据报道,该党成员曼纽尔·瓦尔斯总理点燃一根雪茄,庆祝国民前线名列第一梦破碎。他表示,此种结果对其政党来说是一大幸事,并且他祝贺“拥护共和政体”的选民:他们没有支持他个人认为不具有法国最初价值观的政党。不可否认的是,民意调查曾预测以勒庞为首的政党会以30%左右的票数获胜,但事实证明它起了错误的导向作用,这主要因为此类选举的投票人数多于以往数量。

Yet it is a measure of how far the FN has come to shape the French political debate that her result could be considered a disappointment. It was the party's best-ever score at national level, just above that achieved at European elections in 2014. The party came top in nearly half the country's departments, including some of the rural constituencies that have become its new frontier. In the run-offs, the FN is set to pick up scores of councillors, up from just two in 2011.

然而,这可以衡量国民前线对于其选举结果是否令选民大失所望之争的作用大小。该结果是该党在国家级竞选史上的最好成绩,超过2014年的欧洲选举成果。国民前线掌控了近半数省份,其中包括一些边远的乡村新选区。决选时期,国民前线很可能赢得几十个议员的支持,一改2011年仅仅两位的记录。

In other words, the FN is transforming itself from a fringe movement that throws up periodic freak results into a regular feature of French politics, with the electoral ups and downs that this

implies. This increasingly makes it an alternative opposition party to the governing Socialists, with a solid quarter or so of voters. Such a position is all the more remarkable given that the UMP's first-place score was achieved only thanks to an alliance with the UDI and Modem, two centrist parties.

换言之,国民前线不断提升自身实力,由产生周期性反常结果的边缘运动向法国的固定政党转变,这表现出选举胜败无常的道理。这种转变让该党日益成为与稳拿1/4左右票数的执政党社会党轮流执政的反对党。右翼派人民运动联盟与独立民主联盟、Modem两个中间派组成竞选联盟,鉴于此,国民前线获得如此地位实属非凡。

All the same, Mr Sarkozy will take comfort from the result, which is likely to hand his party a sweeping victory in the second round. Hitherto the ex-president's political comeback had been faltering. Mr Sarkozy was elected UMP chief last November on the back of a lower-than-expected score, and has struggled to convince a divided party and its centre-right voters that he is the leader of the future. The latest result will strengthen his hand, and his chances of securing the party's presidential nomination for elections in 2017.

而此结果依然会让萨科齐感到欣慰,它有可能在第二轮投票中促成其政党大获全胜。至今,这位前任总统是否会东山再起仍是不定之事。去年十一月,萨科齐在票数低于预期的情况下当选人民运动联盟主席,他经百般努力,试图让这个四分五裂的政党及其中右翼派选民相信他是未来的领导者。最新投票结果将增强其影响力,加大其稳获2017年总统大选党内提名的机会。

As for President Fran?oisHollande, the result was a downright humiliation, however much MrValls tried to argue otherwise. The Socialists are set for crushing losses in the second round–they have lost every mid-term election since MrHollande took office. This election exposes a cruel calculation on the left, as the party turns its eyes towards 2017. The Socialists' poor score reflects a failure in most constituencies to join up with the Greens and other parties of the left. If the party has any hope of making it into the presidential run-off in 2017, it needs friends. Yet the ideological differences between the moderates around MrValls and the rest of the French left have never looked so wide, nor the chances of bridging them so slim.

对弗朗索瓦·奥朗德总统来说,无论瓦尔斯总理怎样另找说辞,选举结果绝对是一大耻辱。社会党准备好在第二轮中迎接彻底的失败——自奥朗德执政以来,在所有的中期选举中,社会党无一胜出。虽然该党将目光转向2017年,但这次省议会选举暴露了盘算左翼派的残忍方法。社会党赢得的可怜票数反映出其未能联合在大部分选区的绿党和左翼派其他政党。如果该党希望参加2017年的总统决选,那么它需要朋友。然而,瓦尔斯总理身边的温和派与法国左翼派其他人士之间的意识形态从未产生过如此大的差异,而减少差异的机会也是前所未有的渺茫。

宗教与自由言论粗鲁的权利

Religion and free speech

宗教与自由言论

The right to be rude

粗鲁的权利

An offensive preacher acquires some unlikely allies

一名无礼牧师获得一些意想不到的盟友

MICHAEL OVERD is an evangelical Christian with strong views on the sinfulness of homosexuality and the wrongness of Islam (except, presumably, on the issue of homosexuality). He likes to hold forth among the shoppers of Taunton, a quiet town in south-west England. But on March 23rd MrOverd was found guilty of using threatening or abusive language—although a more serious charge of causing “religiously aggravated”offence was rejected. The judge, Shamim Qureshi, ordered him to pay £250 ($375) in compensation to a man who said he was left feeling “ashamed and belittled” by the preacher's stance on same-sex relations.

迈克尔·奥维德是一名福音基督徒,他认为同性恋是一种原罪,而伊斯兰教是错的(不过可能在认为同性恋有罪上或许他们是一致的),对此他持有强硬的态度。他喜欢在英格兰西南部的一个安静小镇汤顿里,向顾客作长篇大论的演讲。但在3月23号,奥维德被判使用恐吓性或侮辱性语言的罪名,尽管更严重的指控给—造成“宗教骚扰”被驳回了。法官沙米姆·库勒西令其向一名男士支付250镑(374美元)的赔偿金,这名男士表示因牧师在同性关系所持立场令他感到“羞愧和轻视”。

When MrOverd objected to “paying 250 to a sodomite” the judge threatened him with 45 days in prison. The preacher then agreed to pay compensation but said he would appeal. “I find it quite incredible that a Muslim judge finds a Christian guilty and wants to protect homosexuals, whom I have no personal hatred against,” he declared on leaving the courtroom.

当奥维德拒绝“付250镑给一个同性恋者”时,法官威胁警告他将面临45天的牢狱之灾。这位牧师最终答应了支付赔偿金但表示将会上诉。在离开法庭时他声明:“我觉得一名穆斯林法官判定一名基督徒有罪还想保护同性恋是不可思议的,但我对同性恋并没有个人恩怨。”The evangelist has acquired some unlikely defenders. The National Secular Society (NSS), which fights religious privilege of all kinds, says the case vindicates its long-running campaign to safeguard free speech from sloppy legislation. MrOverd was prosecuted under the Public Order Act, which outlaws “threatening, insulting or abusive” language and can result in prison sentences of up to seven years if the offence is deemed to be racially or religiously motivated.

这位福音传道者获得了一些令人意想不到的捍卫者。英国世俗协会(NSS)反对任何形式的宗教特权,该协会表示这个案子证明了在漏洞百出的法律下争取自由言论的长期运动是正确的。奥维德在公共秩序法之下被迫害,这部法律将“威胁性、污蔑性或侮辱性”话语定为非法,如果罪行是种族或宗教问题而引发的话,可能会被判高达七年的有期徒刑。

Thanks to a campaign by the NSS and others, the law has been amended so that insulting language no longer incurs prosecution merely because the police think it has the potential to offend. It must be shown that an insult was directed at a particular person or group, and that offence was taken. But civil libertarians want the law further amended to protect insulting speech and take away the reference to religious aggravation. Although Britain has abolished its ancient ban on blasphemy, which punished insults against Christianity, the concept of religious aggravation amounts to a new sort of blasphemy law that could be used to prevent criticism of any religion, argues Keith Porteous Wood, executive director of the NSS.

由于NSS和其他人推动,这项法律已被修订。因此警方再也不能认为公民的言语有冒犯倾向而对其提出诉讼,警方必须要证明侮辱是针对某个特定的人或群体,并且该冒犯行为已被

人当真。但公民自由主义者希望法律进行进一步修订,保护侮辱性的言语并取消关于宗教骚扰的条文。尽管英国已取消亵渎神明这一禁止侮辱基督教的古老禁令,宗教骚扰这一概念意味着一种新的亵渎神明法,可以被用来阻止对任何宗教的批判,NSS的执行理事基斯·波蒂厄斯·伍德如是说。

One of Britain's best known gay-rights campaigners, Peter Tatchell, has offered to speak in court in favour of the preacher's right to hold forth. He thinks that MrOverd's views are bigoted and would protest against them. But being spared offence is not a human right, he says: “In a free, democratic society, the criminalisation of unpleasant opinions is a step too far.”

皮特·塔切尔是英国最著名的同性恋权利捍卫者之一,他提出要在法庭上发言支持牧师演讲的权利。他认为奥维德的观点是僵化的并会抵制这些言行。但他说,不受冒犯不是一项人权,“在一个自由民主的社会,对不受欢迎的意见定罪未免太过了。”

英国经济虚伪的乔治

Britain's economy

英国经济

Spurious George

虚伪的乔治

The chancellor is poised to put forward a long-term plan for Britain—about the wrong thing

英国财政大臣信誓旦旦的准备在错误的事上为英国提出一个长期计划。

THE British government's great boast is its resolve. Fainter hearts might have trembled before the political law that you cannot cut your way to re-election. But the Conservative-Liberal Democrat coalition, forged in the dark days following the financial crisis, formed a plan for the economy and stood its ground. Its reward has been to see unemployment tumble and Britain grow faster than any other big rich country in 2014.

英国政府的自我吹捧是其解决问题的手段。不能阻止连任,就意味着你脆弱的心脏将在政治法律面前颤抖。但保守党和自由民主党组成的联合政府,在金融危机后的黑暗的日子里,形成了计划经济,稳如磐石。奥斯本指出,2014年英国的失业率大幅下降,且经济增长速度远高于其他发达国家。

It is a rousing refrain. And when George Osborne, the chancellor of the exchequer, gives the budget speech on March 18th, less than two months before a general election that will revolve around the economy, he is sure to utter the words “long-term economic plan” and to affirm his iron commitment to a fiscal surplus for Britain by 2018-19 (see Bagehot).

最能鼓舞人心的消息则是在3月18日,英国财务大臣乔治·奥斯本做了预算演讲,使得还有不到两个月就要开始的大选将会始终围绕经济展开。在演讲中他明确提出“长期计划经济”,并许下铁一般的承诺,声称于2018到2019年度英国将会出现盈余。

The shabby truth, however, is that the success of Mr Osborne stems from the goals he has abandoned, rather than the guns he has stuck to. And next week, unless his budget plans are more apt, Britain risks paying a heavy price.

然而,事实的真相则是,奥斯本的成功源于被其遗弃的目标,而不是他一直以来所坚持的武

器。除非他的计划非常贴切,否则英国极有可能在下周为此付出沉重的代价。

The government has done sensible things with Mr Osborne as chancellor—not least cutting corporation tax, raising the income-tax threshold and pinching Mark Carney from Canada for the Bank of England. But it has been at its best when it has been at its least consistent, in three main areas.

政府与财政大臣奥斯本做出了一个明智的决定。尤其是削减公司所得税,提高所得税阈值和任命加拿大央行行长马克·卡尼为英国央行行长这几个方面上。然而在这最主要的三个方面上,虽然他们已经尽力,但仍未能使其统一战线。

The first is fiscal policy. Five years ago the Conservatives pledged to eliminate almost all of Britain's structural deficit—then estimated at 8.7% of GDP—by the end of their term. They now lead a coalition government that is only half way there. Borrowing this year will probably be about 5% of GDP or £90 billion ($135 billion), £55 billion more than first planned. After two years of weak growth, because of austerity and a European slump, the chancellor pushed back his deadline for closing the deficit. So much for what was then know n as “Plan A”.

第一条财政政策就指出,五年前,保守党在任期结束前,曾承诺将要剔除近乎所有的英国结构性赤字,并预估其GDP为8.7%。而现在,联合政府只做到了一半。今年的借款可能约占GDP的5%或约900亿欧元(约1350亿美元),远超出第一计划时的550亿欧元。因为经济紧缩和欧洲经济衰退,英国经过了两年的经济增长疲软,为此,财政大臣推迟了缩小财政赤字的最后期限。这些计划在当时被称为“计划A”。

Red box, black box

红盒,黑盒

That change was welcome and necessary. Sticking to the plan would have meant tax rises or bigger cuts to public spending, or a combination of the two. It would probably have pitched the economy back into recession, and might have wrecked public services. As it is, the state has coped with deep but steady cuts. Crime is down and the sky has not fallen on local government or the National Health Service.

改变是受欢迎同时也是必要的。继续坚持这个计划意味着税收的提高或者公共基础设施花费的大幅减少,甚至是两者同时进行。它可能会使得经济回到之前的萧条,并且不能更好的服务大众。即便如此,在面对大幅削减的情况下国家经济仍然能保持稳定。犯罪率下降,地方政府和国家医疗保健服务上也没有出现差错。

A second change of course was equally welcome. After coming to power in 2010, the coalition first stuck to the previous Labour government's plans to slash capital budgets. Public investment—always the easiest bill to cut quickly—fell by 35% in two years. That was foolish. Spending on infrastructure is essential to long-term growth and is chronically low in Britain. Mr Osborne tempered the cuts in infrastructure spending starting in 2011. Again, his change of heart was good.

第二个改变同样也受到欢迎。联合政府在2010年上台后,首先坚持前工党政府的计划,削减资本预算。其中削减公共基础设施的投资是最容易的法案(两年内就降低了35%)。但这真是个愚蠢的决定。毕竟基础设施开支对英国的长期增长和持续低迷是至关重要的。奥斯本的

这项削减计划是从2011年开始的,当再次谈到这个话题时,只希望他要是能改变主意会更好

The biggest and best departure from the blueprint is also the most embarrassing. Before he became prime minister, David Cameron pledged to reduce annual net migration to the “tens of thousands”. The coalition government has never abandoned that go al. Yet at the last count net migration stood at a UKIP-maddening 298,000 and rising. Because they are young, healthy, hardworking and enterprising, immigrants have boosted growth and swelled the public purse. A big fall in net migration would have weighed on the economy: GDP has risen by 7.8% over this parliament; GDP per person is up by only 4.2%.

在计划实施的最大最好时撤离也是极为尴尬的。在大卫·卡梅伦成为首相之前, 他承诺每年减少“成千上万”的净移民。联合政府从来没有放弃这一目标,然而最后净移民达到足以让英国独立党发狂(UKIP-maddening)的298000且还在上升。因为他们年轻,健康,勤奋进取,新移民促进增长且增加公众的收入。但是净移民会使得国家经济大幅下挫:议会上就宣布了英国全年GDP增长达7.8%,而人均GDP增长却只有4.2%。

You might think that the government's vacillations are ancient history or that doing the right thing is more important than saying it. But plans focus the mind. And in the upcoming budget Mr Osborne risks focusing minds on the wrong issue.

你可能会认为政府的犹豫不决已是过去式,相比下做对的事情比把事情做对更重要。但计划很侧重于关键点。相比即将到来的预算风险,奥斯本的焦点则在错误的问题上。

Britain's biggest problem today is not the deficit but stagnant productivity growth that leaves output per hour 2% below its peak in 2008.The country's economic future depends far more on boosting how much Britons produce at work than how quickly the deficit is cut. Mr Osborne surely knows that and may secretly plan to shift priorities later. But he is making good policy less likely. U-turns are embarrassing, so plans tend to last for too long. By preparing for deficit-cutting and neglecting productivity, government departments are dissipating their efforts. Mr Osborne did well to change course before. The right thing today is to make a plan for productivity—and stick to it.

如今,英国最大的问题不是赤字,而是生产力的停滞不前使得输出量相较于2008年的峰值正以每小时2%的速率下降。该国的经济前景更取决于英国人在工作中产生量能比赤字削减的速度快多少。奥斯本当然知道这一问题,且可能正在秘密计划再稍后调整计划顺序。在准备削减赤字和忽视生产力这一问题上,政府部门正在努力解决。奥斯本先生也改变了观点。现如今最需要做的事是提出关于提高生产力的计划并坚持下去。

《中华放射学杂志》投稿时注意的问题

投稿时请注意以下问题: 1.本刊要求撰写论文时,“材料与方法”应简洁、清楚,所有在“结果”中出现的检查结果均应清楚地交待其检查方法。“讨论”中,应就本文交代的方法和得出的结果结合文献进行讨论,而未在“方法”和“结果”中出现者不能首次出现在“讨论”中,应先在前两者中交代清楚。文字表达应清楚,尤其应注意标点符号的准确应用。 2.本刊要求表格应完整(表格包括表题、表头、表身)且自明(仅看表格就可基本明白表内各项的数据及其来源,包括总例数及各个项目的例数,等等);表的内容从左至右读应呈主谓语的语法格式。 3.统计学:(1)本刊要求统计学设计和计算应请统计学专家进行,并请统计学专家签字(或医学统计室盖章)证明统计学结果无误。(2)材料与方法中应明确说明所用的统计学方法,分别对哪些数据进行统计学比较。(3)本刊根据统计学原则规定30例以下为小样本(不能用百分数表达,说明具体例数和比例即可)。本文如为小样本,统计学处理应符合小样本原则(如:相应的精确检验)。(4)本刊要求统计学处理时,应先给出具体统计学结果(如t、x2值),再在给出P值。 4.图:图片均应连续编码,并在正文内相应部位顺序标明图序号。 5.如本刊有相应文献,请优先引用本刊近年文献。请逐条核对参考文献无误。正文内文献角码应按其出现的先后顺序排列,所有引用或来自文献的内容均请标明文献源。文献格式请严格参照本刊。本刊要求英文作者姓在前用全称,名在后用缩写;所有文献均需标明年份、起-止页码;期刊应标明卷次(增刊);专著书籍应标明出版城市:出版商。并请到https://www.docsj.com/doc/7a3008570.html,/entrez/query.fcgi网站逐一检索本文英文文献,并将其原样复制于文后;或逐一核对后提供PMID号。 6.所有英文缩写首次出现时均请准确标明中文全称。 7.中英文摘要的结果中应包含本文结果的主要数据,摘要应简洁、干练。 8.讨论:应针对本文提出的问题及所得结果结合文献进行讨论,应总结出本文的特点。讨论应简洁、明了,为避免重复、方便读者,讨论的各段前请冠以小标题,小标题应清楚明确。 9.修改稿请将作者写在文题下,邮编及单位写在首页下。英文摘要须将全部作者姓名列出,并注明与中文格式相同的英文单位。如果为基金项目,请在首页下方“作者单位”的上一行注明基金及批准号。 10.请将本文修改稿和图片打印出一份纸样,寄回编辑部以备存档。全文文字部分汇成

《中华放射学杂志》投稿须知

《中华放射学杂志》投稿须知 信息来源:《中华放射学杂志》编辑部作者:发布时间:2015-1-13 《中华放射学杂志》为中华医学会主办的放射学专业学术期刊,以广大放射学工作者为主要读者对象,报道放射学领域领先的科研成果和临床诊疗经验,以及对放射学临床有指导作用、且与放射学临床密切结合的基础理论研究。本刊的办刊宗旨是:贯彻党和国家的卫生工作方针政策,贯彻理论与实践、普及与提高相结合的方针,反映我国放射学临床科研工作的重大进展,促进国内外放射学学术交流。本刊实行同行审稿制,所收稿件均经相关专业专家评审。 一、本刊欢迎论著类、病例报告、急诊经验、综合报道、经验介绍、技术交流、讲座、综述、会议(座谈)纪要、临床病理(病例)讨论、读片集萃、国内外学术动态、医学见闻等类型的稿件。述评、专论及专家论坛等稿件主要为约稿。来稿邮箱:zhfsxqk@https://www.docsj.com/doc/7a3008570.html, 二、对来稿的要求 1.文稿应具有科学性、实用性,论点明确,资料可靠,文字精炼,层次清楚,数据准确,书写工整规范,必要时应做统计学处理。论著类、综述、讲座等一般不超过5000字,病例报告、简报等不超过1500字。 2.文题:力求简明、醒目,反映出文章的主题。中文文题一般以20个汉字以内为宜。 3.作者:投稿时作者姓名须另页书写,按序排列,排序应在投稿时确定,在编排过程中不应再作更动;作者单位名称及邮政编码、常用联络电话、Email地址注于同页。作者应是:(1)参与选题和设计,或参与资料的分析和解释者;(2)起草或修改论文中关键性理论或其他主要内容者;(3)能对编辑部的修改意见进行核修,在学术界进行答辩,并最终同意该文发表者。以上3条均需具备。仅参与获得资金或收集资料者不能列为作者,仅对科研小组进行一般管理也不宜列为作者。对文章中的各主要结论,均必须至少有1位作者负责。集体署名的文章必须明确对该文负责的关键人物,指定通信作者;其他对该研究有贡献者应列入志谢部分。作者中如有外籍作者,应征得本人同意,并有证明信。 4.摘要:论著类文章须附中、英文摘要,摘要必须包括目的、方法、结果(应给出主要数据)、结论四部分,各部分冠以相应的标题。采用第3人称撰写,不用“本文”、“笔者”等主语。考虑到我国读者可参考中文原著资料,为节省篇幅,中文摘要可简略些(200字左右),英文摘要则相对具体些(400个实词左右)。英文摘要须单列一纸,除上述要求外尚应包括文题、作者姓名(汉语拼音)、单位名称、所在省市名称及邮政编码,并在邮政编码后加列国名。作者应全部列出,当作者不属同一单位时,在第一作者姓名右上角加“*”,同时在单位名称首字母左上角加“*”。例如:LIN Xian-yan*, WU Jian-ping, QIN Jiong. First Hospital, Beijing University, Beijing 100034,China

免收审稿费的国内医药学期刊

注:请区别审稿费和版面费。杂志社可能会根据需要再次启动收费。 《世界华人消化杂志》核心 《国际病理科学与临床》不收审稿费,作者还有一定稿费可拿 《临床与实验病理学杂志》“中国期刊方阵”双效期刊,为中国科技核心期刊和中文临床医学类核心期刊。审稿周期不超过两个月,也有稿费可拿 《检验医学》双核心期刊。 《中国肺癌杂志》中文的核心免审稿费的 《中国普外基础与临床杂志》免收审稿费 《南方医科大学学报》 《中国当代儿科杂志》工作作风严谨,审稿快。网站直接投稿。 《儿科临床杂志》审稿严谨,审稿较慢。 《中国实验诊断学》 《生物医学工程学杂志》 《国际病毒学杂志》 《中国药房》科技核心,周刊,稿件量大,中稿相对比较容易。 《中国实验方剂学杂志》双核心,半月刊,稿件要求不太高,比较好中。 《环球中医药》科技核心,稿件要求质量不高,审稿周期短,可以一试。 《科学技术与工程》双核心,旬刊,稿件要求低,审稿周期短,审稿费可以在录用以后和版面费一起寄,权当免审稿费。 《中国人兽共患病学报》中国科技论文统计源期刊,CSCD核心库期刊,审稿周期短,版面费400/版。 《中国医学伦理学》科技核心期刊,无需单位推荐信。 《肿瘤防治研究》本刊免收审稿费。由于《肿瘤防治研究》为OA期刊,按照国际惯例,对确认刊载的稿件收取一定费用。稿件刊登后酌致稿酬(已含其他形式出版稿酬),并赠当期杂志两册。 《Biomedical and Environmental Sciences》 SCI 《Hepatobiliary & Pancreatic Diseases International》 SCI 《中国中药杂志》双核心,本刊免收稿件处理费。 《中草药》双核心,本刊不收论文审稿费。 《江苏中医药》科技核心,本刊不收审稿费。 《辽宁中医杂志》科技核心,凡投本刊的稿件一律不收审稿费。 《中医杂志》 《天津医科大学学报》核心期刊,郝希山院士任主编 《河北医药》“中国科技论文统计源期刊”(中国科技核心期刊)收录期刊。 《中华内分泌代谢杂志》中华老牌期刊。 《华西医学》核心期刊,四川大学华西医院主办。 《中国烧伤创疡杂志》科技核心,不但不要审稿费而且不要版面费。 《环境科学》环境类核心期刊 《环境科学学报》环境类核心期刊 《山东中医药大学学报》核心期刊 《中国运动医学》核心期刊 《中医药学报》核心期刊,黑龙江中医药大学出版

床旁超声心动图监测重症患者血容量及心脏功能的临床研究

床旁超声心动图监测重症患者血容量及心脏功能的临床研究 发表时间:2019-03-14T14:44:53.643Z 来源:《中国结合医学杂志》2019年1期作者:刘会兵 [导读] 研究床旁超声心动图监测重症患者血容量及心脏功能的临床效果。 湖南省岳阳市广济医院有限公司 414000 【摘要】目的:研究床旁超声心动图监测重症患者血容量及心脏功能的临床效果。方法:我院2016年5月到2018年3月期间收治的重症患者60例,分别使用连续心输出量(PiCCO)导管法和床旁超声心动图对患者的血容量和心脏功能相关指标进行监测,比较两种监测方式的准确性。结果:患者扩容治疗后床旁超声心动图监测指标均较治疗前升高,数据对比P<0.05。并且床旁超声心动图监测指标与PiCCO 导管监测指标的变化呈正相关。结论:床旁超声心动图监测重症患者血容量及心脏功能的准确性较高,能有效完成对重症患者病情变化的监测,并且能弥补PiCCO导管法的不足,临床价值较高。 【关键词】床旁超声心动图;重症患者;血容量;心脏功能 对于各种重症患者,其在治疗过程中病情变化较快,有效监测其病情变化情况并给予其针对性的治疗措施是提升其治疗效果的必要措施[1]。根据临床实践,血容量与心脏功能监测是重症患者治疗过程中最容易发生变化的指标,并且其指标变化与患者的病情变化直接相关,因此,有效完成对患者血容量及心脏功能的监测是确保患者治疗效果的基础。本研究对床旁超声心动图监测重症患者血容量及心脏功能的临床价值进行分析,报道如下。 1.资料与方法 1.1一般资料 我院2016年5月到2018年3月期间收治的重症患者60例,其中男32例,女28例,年龄29~78岁,平均(52.687.95)岁,所有患者均为感染性休克,患者均无严重心脏器质性病变、肺栓塞和气胸等严重疾病,并且治疗过程中均需要使用气管插管呼吸支持,治疗期间机械通气均采用容量控制模式,潮气量控制在6~8ml/㎏。 1.2方法 使用彩色多普勒超声诊断仪完成对患者的床旁超声心动图监测,探头频率设定在2~8MHz。PiCCO监测主要是在患者股动脉留置PiCCO导管,颈内静脉留置中心静脉导管。先在患者镇静状态下从颈内静脉穿刺并放置中心静脉导管,对患者中心静脉压进行监测,零点参考右房水平。股动脉穿刺留置PiCCO导管,连接监测仪器对患者的动脉压和血流动力学指标进行监测,将冰盐水从患者颈内静脉导管注入,对患者全新舒张末期容积指数(GFDD)、心排指数(CI)、每搏指数(SVI)和全心射血分数(GEF)进行测定,使用床旁超声心动图监测对患者左室舒张末期容积(LVEDV)、每搏量(SV)、心输出量(CO)、下腔静脉管径(IVC)和左室射血分数(LVEF)进行测定。用药后的测定,主要是在PiCCO的指导下,对患者的血流动力学进行管理,根据实际情况使用去甲肾上腺素和多巴酚丁胺等血管活性药物对患者进行扩容治疗,主要以中心静脉微量注射泵泵入完成治疗。 1.3观察指标 对患者扩容治疗前后的各项指标变化情况进行观察,并对两种监测方式的准确性进行判断。 1.4统计学方法 SPSS22.0软件处理数据,百分率和()表示计数资料与计量资料,X2检验和t检验数据差异,两种监测方式的相关性分析使用线性相关分析完成,P<0.05为有统计学意义。 2.结果 2.1两种监测方式血容量的指标比较 扩容治疗前患者的中心静脉压为(8.69±2.56)mmhg,较治疗前的(6.25±2.14)mmHg更高,其中超声心动图的各项指标与治疗前相比均明显增加,且扩容前后LVEDV与GEDI、SV与SVI均呈正相关变化,数据对比P<0.05,详见表1。 2.2两种监测方式心脏功能指标比较 表2显示,超声心动图检测指标中CO与LVEF与治疗后均高于治疗前,数据对比P<0.05。且使用血管活性药物前后CO与CI及LVEF与GEF均呈正相关,P<0.05。 表1 两种检查方式血容量指标比较() 3.讨论 重症患者的病情变化较快,及时掌握其病情变化情况并给予其针对性的治疗是保障其生命安全的有效方式。严重感染和感染性休克是临床上常见的危重症疾病,患者治疗过程中不恰当的用药很容易导致其出现器官功能恶化的情况,严重时导致患者死亡[2]。因此,在患者治疗期间准确评估其血流动力学指标,并以评估结果对其治疗方案进行调整,是确保患者治疗顺利完成的重要措施。连续心输出量导管法是临床上用于监测重症患者血容量和心脏功能的常见方式,其能有效完成对患者各项指标变化的监测,因此其在临床上的应用十分广泛[3]。床旁超声心动图检测是近年来应用于危重症患者病情监测中的一种方式,其借助心动图对患者血容量和心脏功能指标进行确定,以此

中华放射学杂志历届编委会及编辑部名单

中华放射学杂志第一届编辑委员会 名誉总编辑谢志光 总编辑汪绍训 副总编辑梁铎胡懋华 编辑总干事张益英 编辑委员丁德泮孔庆德尹崇斌王家璘王云钊史元明左立梁余贻倜朱德球吴桓兴周孝珍李松年李果珍李春山汪绍训谷铣之孟炎胡懋华徐秀凤徐汝芹 徐海超徐宪明梁铎高育璈张秉彝张益英张发初郭绍纶陈又新陈玉人 陈官玺汤浈汤慧黄世章解毓章杨济荣独山刘玉清刘庚年黎光煦 龙名杨戴志升谢志光兰宝森杜持礼 编辑部成员:陈英杰 1954年调整后的第一届编辑委员会 总编辑汪绍训 副总编辑梁铎胡懋华 编辑总干事张益英 编辑委员丁德泮孔庆德王家璘王云钊左立梁余贻倜朱德球吴桓兴周孝珍李松年李果珍谷铣之沈成武杜持礼徐汝芹徐秀凤徐海超徐宪明徐惊伯高育璈 张秉彝张发初郭绍纶陈又新陈玉人陈官玺汤浈汤慧黄世章解毓章 杨济荣独山鲁宗铮刘玉清刘庚年黎光煦龙名杨戴志升谢志光兰宝森1955年增补徐海超、兰宝森、张益英为副总编辑 1958年副总编辑再次调整,调整后的副总编辑为梁铎、胡懋华、徐海超、张益英 编辑部成员:陈英杰 中华放射学杂志第二届编辑委员会 总编辑汪绍训 副总编辑李松年李果珍荣独山胡懋华 编辑委员王云钊王永生王应才王伟王钟琪王家璘方昆豪孔庆德龙名杨冯亮朱德球刘子江刘玉清刘闽生刘庚年汤钧汤慧孙强生孙鼎元杜持礼 李生光李春山杨竞飞吴腾飞吴恩惠何伟华邹仲余贻倜谷铣之汪源 游高原张去病张令羽张国忱张铁梁张益英张慕骞陈凡陈王善继陈玉人 陈官玺陈星荣陈种范焱周立斋周前周祥麟赵惠扬姜树铭戴自祯 夏宝枢钱致中钱铭辉徐惊伯高育璈郭广柏郭绍纶唐庆尧唐谨曹来宾 常国钧董季平解毓章蔡锡类黎光煦魏大藻魏若林魏宝清 1981年11月第二届编委会第一次会议增补徐智章、陈英杰为编辑委员 编辑部成员:陈英杰薛爱华蔡红叶 中华放射学杂志第三届编辑委员会 咨询编委汪绍训荣独山邹仲朱大成胡懋华李果珍谷铣之刘玉清刘庚年徐惊伯孔庆德冯亮王云钊张益英李松年陈玉人解毓章 总编辑汪绍训(兼)

分析动态心电图联合心脏彩超对早期急性病毒性心肌炎的诊断价值

分析动态心电图联合心脏彩超对早期急性病毒性心肌炎的诊断价值 发表时间:2019-07-02T09:16:33.453Z 来源:《医师在线(学术版)》2019年第08期作者:王昊 [导读] 动态心电图与心脏彩超联合用于早期急性病毒性心肌炎诊断中可提升疾病检测阳性率,值得临床应用。黑龙江省农垦总局总医院 150088 【摘要】目的:将动态心电图与心脏彩超联合用于早期急性病毒性心肌炎诊断中,对其诊断价值进行评价。方法: 对我院收治的115例早期急性病毒性心肌炎患者临床资料进行回顾性分析,所有患者均实施动态心电图、心脏彩超、联合检测,对其诊断结果进行分析。结果:动态心电图联合心脏彩超检查ST段改变、Q-T间期延长、Q波异常、QRS低电压、房性早搏、室性早搏、阵发性室上性心动过速、I度房室传导阻滞检出率与心脏彩超、动态心动图检出率相比,均明显更高(p<0.05);动态心电图、心脏彩超检测阳性率分别为92.17%、84.35%,与联合检测97.39%相比,均明显更低(p<0.05)。结论:动态心电图与心脏彩超联合用于早期急性病毒性心肌炎诊断中可提升疾病检测阳性率,值得临床应用。 【关键词】:动态心电图;心脏彩超;早期急性病毒性心肌炎 病毒性心肌炎为临床常见的一种感染性心肌疾病,为心肌局限性或弥漫性炎症病变[1]。急性病毒性心肌炎发病病因与肠道、上呼吸道病毒感染相关,临床表现与病变程度、部位相关,病情较轻者可表现为无症状,病情较重者可出现心源性休克、心力衰竭等症状,为临床诊治带来一定困难。选择合理、精准的检查手段,对疾病诊治、预后判断意义重大。本研究将动态心电图与心脏彩超联合用于早期急性病毒性心肌炎患者诊断中,旨在评价其诊断价值。报道见下: 1资料与方法 1.1一般资料 资料收集时间在2017年2月~2018年8月,对象为我院收治的早期急性病毒性心肌炎患者,共115例,男72例,女43例,年龄19~57岁,平均(37.42±4.31)岁,临床症状:胸闷12例,气促17例,心前区不适32例,头晕乏力41例。 1.2纳入、排除标准 纳入:均符合《病毒性心肌炎诊断标准》;患者均自愿签署同意书。排除:先天性心脏疾病者;精神疾病者;临床资料不完整者;检查配合性较差者。 1.3方法 本组患者均给予动态心电图、心脏彩超、联合诊断,具体方法见下: 动态心电图检查:对患者心肌酶、心肌肌钙蛋白等指标进行检测,使用动态心电图分析仪对患者进行心电信号持续24h监测,并采用相关系统对检测结果进行自动分析,随后由影像科专业副主任医师复查检测结果。 心脏彩超检查:使用多普勒超声诊断仪对患者进行检测,将探头频率设置在3.5MHz左右,检查范围包括心脏四腔、左室长轴切面等,期间仔细观察患者室壁运动、常规切面等,测量并记录心室内径、厚度、心脏收缩功能等。 1.4观察指标 比较两种诊断方式检查结果、检测阳性率。 1.5统计学方法 分析软件采用SPSS19.0, %表示计数资料,经x2检验,以 p<0.05表示差异有统计学意义。 2结果 2.1不同检查方式检测结果差异 观察表1可知,动态心电图联合心脏彩超检查ST段改变、Q-T间期延长、Q波异常、QRS低电压等检出率,与心脏彩超、动态心动图检出率相比,均明显更高(p<0.05)。 注:#表示与心脏彩超相比,p<0.05,*表示与动态心动图相比,p<0.05。 2.2不同检查方式检测阳性率分析 通过表2可知,动态心电图、心脏彩超检测阳性率分别为92.17%、84.35%,与联合检测97.39%相比,均明显更低(p<0.05)。 3讨论 急性病毒性心肌炎为心内科常见疾病,近年来发病率在持续增长,发病病因主要为病毒感染。因疾病感染源与个体差异,临床表现也存在不同,为临床诊断与治疗增加困难。因此选择合理的检查方式诊断疾病,对临床制定合理的治疗方案、判断预后有重要指导意义。 王静[2]研究认为,将心电图用于急性病毒性心肌炎患者诊断中应用价值较高,其敏感性与心肌酶、心肌肌钙蛋白检测相对更高。邵华[3]研究认为,将心电图用于ST-T段改变、心律失常等严重性病毒性心肌炎中诊断准确率较高,但在早期急性病毒性心肌炎患者诊断中准确率较低,容易出现漏诊情况。近年来动态心电图逐渐用于病毒性心肌炎诊断中,其可以记录患者24小时内10至14万个心动周期心电变化,可对患者静息、睡眠、动态状态下心电变化进行持续记录[4]。与传统心电图相比,动态心电图可有效弥补缺陷,提升疾病阳性检出率,可发现固定性、持续心律失常、T波低平或倒置等,在急性病毒性心肌炎诊断中具有较高价值。蓝菲菲[5]研究表示,将常规心电图与动态心电图联合用于早期病毒性心肌炎患者诊断中应用价值较高,可提升疾病诊断阳性率。本次研究中,对患者使用联合检测后,其检测阳性率为97.39%,与动态心电图、心脏彩超检测阳性率相比,均明显更高,与蓝菲菲研究一致。 综上所述,动态心电图与心脏彩超联合用于早期急性病毒性心肌炎诊断中应用价值较高,可提升疾病检测阳性率,为临床诊治提供更加可靠的依据。 【参考文献】 [1]刘博, 蔡颖, 张素丽. 彩超评估病毒性心肌炎患者心功能准确性分析[J]. 国际病毒学杂志, 2016, 23(1):32-34.

中文杂志影响因子

序号刊名影响因子 1 中华护理杂志 1.611 2 中国组织工程研究与临床康复0.473 3 中华结核和呼吸杂志0.959 4 中华儿科杂志 1.244 5 中华放射学杂志 1.065 6 中华口腔医学杂志0.445 7 中华骨科杂志 1.064 8 中华心血管病杂志 1.543 9 中国中药杂志0.998 10 中国中西医结合杂志0.883 11 中华流行病学杂志 1.373 12 中华肿瘤杂志0.984 13 WORLD JOURNAL OF GASTROENTEROLOGY 0.792 14 中草药 1.224 15 中国药理学通报0.971 16 中华医学杂志0.806 17 癌症0.800 18 中华妇产科杂志0.976 19 中国实用外科杂志0.943 20 中国病理生理杂志0.788 21 中华外科杂志0.706 22 中华神经科杂志0.916 23 中华耳鼻咽喉头颈外科杂志0.7 24 中华医院感染学杂志0.469 25 药学学报 1.189 26 中华肝脏病杂志0.994 27 生理学报0.516 28 中国心理卫生杂志0.871 29 CHINESE MEDICAL JOURNAL 0.904 30 中国药学杂志0.632 31 中华神经外科杂志0.702 32 第四军医大学学报0.288 33 第三军医大学学报0.393 34 中华泌尿外科杂志0.646 35 中国危重病急救医学 1.18 36 中华内科杂志0.739 37 中华病理学杂志0.726 38 中国公共卫生0.828 39 北京大学学报医学版0.797 40 中华消化杂志0.469 41 中华眼科杂志0.688 42 中华放射肿瘤学杂志0.73

IL-17在消化道炎症中的发生及促炎症、抗感染作用

遵义医学院医学与科技学院 医学免疫学综述 系别: 年级: 班级: 综述题目: 组员:学号: 年月日

IL-17在消化道炎症中的发生及促炎症、抗感染作用 摘要: IL-17是一种新的细胞因子,表达于特异的淋巴细胞亚群,并受到严格调控;其在细胞增殖分化、生物因子转录与表达及免疫调节方面发挥重要作用,与肿瘤、器官移植、感染及多种炎症过程密切相关,特别是在消化道的炎症中。本文是对IL-17的来源、在胃肠道炎症中的的发生及其促炎症、抗感染作用进行论述。 【研究背景】: 1 、白细胞介素是一庞大家族,到1994年已发现了15种,随着深入研究,其数目还在不断增加。近年来,对白细胞介素(IL) 在溃疡性结肠炎(UC)肠道炎性反应的主要作用有了较为深入地研究,肠黏膜免疫功能异常被公认为在UC发病中具有极为重要的作用,有多种细胞因子参与免疫反应和炎症过程[4] 2、幽门螺杆菌(Helicobacter pylori , HP)是世界各地最常见的感染性病原之一,目前HP感染是慢性胃炎、消化性溃疡、胃腺癌的主要病,世界卫生组织将其归为一类致癌因子。但是HP感染引起的人类胃肠疾病机制尚不清楚,目前认为可能与宿主基因多态性、细菌毒力的高低即HP基因多态性及环境等因素有关[3]。 【目的】: 本文主要论述白细胞介素-17(IL-17) 的来源以及在胃肠道炎症中,发生、发展的促炎症、抗感染作用。 【关键词】:Th-17 白细胞介素-17,幽门螺杆菌,溃疡性结肠炎

1、Th-17的发现及IL-17 来源: Thl7是近年发现的一种不同于传统Th l和Th 2的细胞亚群,因其以分泌IL-17为主,故命名为Th-l7。研究表明,CD4+T细胞在IL-6及转化生长因子-β(TGF-β)的共同作用下分化为Th-l7细胞,而IL-23在后期维持Th-l7细胞的存活以及促进其分泌IL-17的过程中必不可少[1、18]。过去认为自身免疫性炎症只与IL-12诱导的Th l过度应答有关,近年来发现在多种自身免疫疾病如UC、类风湿性关节炎的进程及靶组织中都可检测到IL-17的表达,这提示IL-17在自身免疫性疾病中发挥重要作用[11]。 Th-17细胞分泌IL-17,IL-17F,IL-21及IL-22等炎症因子,而且由于IL-17受体广泛分布于多种细胞表面,因此IL-17能作用于许多类型细胞(如内皮细胞、上皮细胞,成纤维细胞,星形细胞等),诱导众多的细胞因子(如IL-6、粒单细胞集落刺激因子、粒细胞刺激因子等)和趋化因子(如IL-8、CXC 趋化因子配体、CC趋化因子配体等)的表达[1]。 除了Th17之外,其他的T细胞也可分泌IL-17,例如CD8+T细胞,γδT细胞和i NKT细胞(i NKT细胞(invariant nature killer T, i NKT)是T淋巴细胞中独特的亚群。它们表达T细胞受体TCR又表达NK细胞的表面标志CD161(NK1.1)。)等。在某些情况下,γδT细胞不仅有能力产生IL-17,而且其产生IL-17的能力比CD4+Th17细胞更强[14]。而且,Marie-Laure Michel等发现i NKT细胞中有一小群缺乏NK1.1标志,这群细胞高表达IL-17.[1]。除了Th-l7之外,γδT细胞和i NKT细胞可能是感染早期产生IL-17的细胞来源。[14] 2、胃肠道炎症的发病机制 炎症性肠病主要包括:溃疡性结肠炎(UC)[11、13]和克罗恩病( CD):

相关文档