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For Southwestern Margin of Aqikekule Lake ophiolite, their field geological, petrological, minerological, petrochemical and geochemical characteristics show that:① it outcropped as tectonic slices along the near west-to-east strike Kunzhong fault and is composed of metamorphic perodotties, cumulates and volcanic rocks, in which, chromites are distributed in the upper part of metamorphic peridotites as pods, or in the lower part of cumulates as near-strata;② metamorphic peridotites include serpentinites, chromite-bearing serpentinites, chlorite-epidote schists and chromitites, of which, chromitites have nodular and orbicular structure, and cumulates include pyroxenits, serpentinites, chromite-bearing serpentinites, chromites and metamorphically mafic rocks and only basalts are seen in volcanic rocks;③ Cr# of chromites suggest that they formed in the SSZ and Al〓O〓 and TiO〓 of metamorphic peridotites also suggest SSZ environment;④ metamorphic peridotites have V type and enriched LREE patterns, cumulates have from strongly depleted LREE, flat REE to enriched LREE patterns with universally striking positive Eu anomalies and basalts show flat REE or slight enriched LREE patterns with no Eu anomalies;⑤ trace element and Sm-Nd isotope characteristics of metamorphic peridotites imply their strikingly heterogeneous mantle character ε〓(t+4.39~+26.20 and later Nb, Ta fertilization;⑥ trace element characteristics of basalts and their tectonic diagrams show they probably formed in the rifted island arc or back-arc basin environment.

对阿其克库勒湖西南缘蛇绿岩,野外地质、岩石学、矿物学、岩石化学以及地球化学等特征表明:①该蛇绿岩以近东西向、沿昆中断裂呈构造岩片出露,由变质橄榄岩、堆晶岩和火山岩三个单元组成,其中见铬铁岩呈豆荚状产于变质橄榄岩的上部,或呈似层状产于堆晶岩的下部;②变质橄榄岩包括蛇纹岩、含铬铁矿蛇纹岩、绿帘绿泥片岩和铬铁岩等类型,其中,豆荚状铬铁矿具有结核状构造和球状构造,堆晶岩包括辉石岩、蛇纹岩、含铬铁矿蛇纹岩、铬铁岩和变质基性岩等类型,火山岩仅见玄武岩;③铬铁矿的Cr#表明其形成在俯冲带,变质橄榄岩的Al〓O〓和TiO〓成分也指示了SSZ环境;④变质橄榄岩的稀土配分型式见V型和LREE富集型两种型式,堆晶岩表现出从LREE强烈亏损、REE平坦分布到LREE富集的配分特征,并且普遍具有醒目的正Eu异常,玄武岩的稀土配分型式表现为平坦型或LREE略富集,无Eu异常;⑤变质橄榄岩的微量元素及Sm-Nd同位素特征指示了其地幔的显著不均一性ε〓(t为+4.39~+26.20以及Nb、Ta在后期的富集;⑥玄武岩的微量元素特征及构造图解表明其可能形成在裂谷岛弧或不成熟的弧后盆地环境。

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。

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如果仍然有此规则无法限制的不恰之处,则须在公众舆论检查中寻找它的补充。现在我将要履行我的同胞再次召唤我的职责,并将要以他们所认可的那些原则的精神来履行。我无惧于任何可能使我迷途的利益目的;我没有感到任何能引诱我明知是离开公正之途的欲望,但是,人性的弱点和我自身感知的局限将会造成对你们利益有损的错误判断。

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