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A. 誰知道Louis Caldera的人生經歷

美國加州議員路易斯·卡爾德拉(Louis Caldera)第一份工作是10歲時作了一個停車場的清潔員,雖然每天早上要三點鍾起來,而且每次清潔之後都是疲憊地睡在父親的車上回到家中,但他從中懂得了自我約束(discipline)工作的責任感(work ethic)和協調生活中相互矛盾的各種興趣的重要性(how to balance life』s competing interest)而且在上高三的時候在一家快餐店做漢堡包,每周工作40小時,同時學習全部大學預科課程,這次經歷使他明白:所有的工作都有尊嚴(there is dignity in all work ),只要人們能自食其力,養家糊口,就該受到尊重。經過一番汗水的努力,他最終考上了美國軍事學院,之後又獲得了哈佛法學和商業碩士學位
墨西哥移民的兒子, 破火山口出生 . 他和他的家庭離開得克薩斯當時他才四歲, 簡要地居住在公共住房裡在 Boyle 高度 鄰里 在行動向郊區之前 . 1978 年他贏得了理學士學位, 然後服務在現役從1978 年到1983 年, 在1987 贏得了一個碩士學位在企業教育和a 程度。Louis Caldera 被實踐的法律從1987 年到1990 年在O'Melveny & Myers 企業, 然後工作作為一位代理律師為 洛杉磯縣.
Louis Caldera然後擔當了加利福尼亞狀態議員從1992 年到1997 年, 代表第46 個區的幾乎400,000 位居民, 位於和在街市洛杉磯附近。 如同他擔當銀行業務主席和財政委員會的議員, 收支和征稅委員會, 和預算委員會。 在完成他的第二個期限之前在大會, Louis Caldera離開開始起總經理和營運首長官員作用對於總統 在2003 年8月。

當學習在哈佛, 他遇見了他的妻子, Eva Orlebeke 破火山口; 他們一起有三女兒、Allegra 、Sophia 和Camille 。

B. 怎樣確定椎弓根螺釘在椎體中心

本貼收到3朵鮮花
全脊柱椎弓根螺釘技術

一、簡史

於1959 年首先將椎弓根螺釘固定應用於腰椎的融合。1969年Harrington和Tullor運用經椎弓根螺釘內固定使2例高位脊柱滑脫患者得以復位。1970年法國和瑞士的醫生開始把椎弓根螺釘用於臨床,CotrelandDubousset、Dick、Roy—Camille和Louis相繼報道了臨床成功的病例。隨著上世紀80年代以後椎弓根螺釘器械經過不斷的改善得到廣泛的接受,應用椎弓根螺釘結合植骨融合逐漸成為相關疾病的治療金標准。Whitecloud[2]認為,椎弓根是脊椎上最為堅強的部分,是對脊柱進行操作和制動的有效作用點。通過椎弓根器械的正確安放,就可以免除脊柱的鉤-桿系統中的固定鉤或luque系統中的椎板下鋼絲對腰椎管造成的醫源性的狹窄。而且與前代固定系統相比,椎弓根器械可以在獲得有效固定的同時,維持脊柱的正常解剖,最大限度地保留脊柱的運動節段。在同一器械的不同節段,可以分別進行牽開、壓縮、旋轉、恢復前凸以及椎體的向前和向後平移。Vanden- berghe[3] 等在屍體研究中發現,與先前的其它器械如 harrington、hartshill 框架及luque 技術相比,椎弓根器械的力學優點更勝一籌。在控制各個方向的異常活動包括旋轉活動方面作用明顯,並且由於椎弓根器械對於三柱均有良好的穩定作用和其自身的通用性,在保持和重建腰椎生理前凸方面的作用也非常可靠。
二、基礎研究

1、解剖學研究
a、頸、胸、腰段的椎弓根形態各異,腰段椎弓根髓腔寬均小於相應的髓腔高,故應以髓腔寬確定螺釘直徑,L1、L2髓腔寬不足其高的1/2。Ebraheim.測量認為椎弓根內側至硬膜囊間距離,椎弓根至鄰近上下神經根的距離分別為1.5、5.3、1.5mm,神經根上下徑3.8-4.6mm,神經根走行33.7-39.20,認為偏內側偏尾側操作應避免[4]。Saillent
報道椎弓根軸線在L1~L3位於橫突中線上方1.4~3.9mm,在L4~L5 位於橫突中線附近。
b、胸段椎弓根除T1有少部分(佔23.3%)髓腔寬大於其髓腔高外,其餘均小於其髓腔高,T4~6髓腔寬度僅為3.0mm左右,髓腔斷面T1多為圓形或橫橢圓形,T11、T12多為縱橢圓形,其餘近似「耳形」或「鞋底形」,多為上寬下窄,中間凹陷處被肋頸所佔且肋頸側椎弓根骨皮質極薄,對螺釘幾乎無阻力,易穿入肋椎關節內或損傷鄰近結構,應引起臨床足夠的重視[5]。上胸椎椎弓根短,窄而薄,椎弓根的上緣與椎體上面終板相平行,椎弓根的上下緣位於椎體的上2/3處。椎弓根後部稍高,前部稍低。侯樹勛等[10]對椎弓根軸線與關節突和橫突的關系作了定量測量, 發現 T9~T12 椎弓根軸線位於關節突中點和外緣所作垂直線與橫突中點和上緣所作水平線構成的四邊形的內上方,從 L1以下逐漸移到外下方,而L5 到關節突外緣之外 5mm 處。胸椎周圍重要組織較多,當螺釘沿椎弓根軸線向前穿透椎前皮質外2~10mm時,胸椎右側可能傷及的組織有肋間上血管(T4~5)、食道(T4~9)、奇靜脈(T5~8)、上腔靜脈(T11~12)、胸導管(T4~12);胸椎左側可能傷及的組織包括食道(T4~9)、主動脈(T5~12)。當偏向椎弓根外側的螺釘向前穿透椎前皮質時,胸椎左側可能傷及肺組織、節段血管、交感神經鏈(T4~12)和主動脈(T5~10);右側可能傷到肺組織、節段血管、交感神經鏈和奇靜脈(T5~11)[11]。當螺釘偏於椎弓根內側時,可能傷及脊髓和神經組織。胸膜反折位於椎弓根外下方,故螺釘偏外下可能損及胸膜和節段血管。事實上,硬膜囊兩側平均各有2.6mm的緩沖區,正是有了這一緩沖區,使大部分穿透椎弓根內側皮質的螺釘未對神經組織造成傷害。由於肋骨頭對胸膜的保護作用,當螺釘穿透或完全在椎弓根外側皮質6mm以內時,胸膜可以免受螺釘損傷。
c、C6、C7髓腔寬度大於其高度,樞椎椎弓根上部寬明顯大於其中部及下部,但其骨皮質厚度也為上部大於中下部,故其髓腔斷面多呈縱橢圓或圓形,頸胸椎椎弓根外緣皮質骨極薄,對螺釘幾乎無阻力。Ugur等[6]研究了頸椎椎弓根內徑平均值,與硬脊膜囊、上下神經根和椎動脈等毗鄰重要結構的距離及頸椎椎弓根與椎體的夾角角度等,其椎弓根直徑波動於6.0~7.5mm,椎弓根與椎體水平面成角波動於37~45°,矢狀面成角波動於1~8.6°,偏內上側皮質骨較厚,外下方皮質骨較薄,但存在個體差異。Panjabi等[7-9]進行了頸椎椎弓根內徑的解剖學測量,發現C3和C4內徑最小,平均約3mm,C7椎弓根內徑最大,平均約5mm,C5和C6居中,平均約3.5~4.5mm,並提出決定椎弓根釘的穩定性及抗拔出力量主要是由其內徑來決定,而不由外徑大小決定。頸椎弓根在水平面上位於椎管和橫突孔、椎體後緣與關節突之間。C2椎弓根是從側後方斜指向內上方,位於橫突孔的後內側,內側由上關節面覆蓋。C3-C6的椎弓根走行是從後外側指向前內側,與上下關節突間側塊的前內側面相連。椎動脈從C6到C2的上升過程中,逐漸向前向內側走行,在C2橫突孔內,從下內方向上外側方走行,而後上行穿過寰椎橫突孔後轉向後內方繞側塊之後,經寰椎後弓上面的椎動脈溝向中央走行,穿過寰枕後膜進入顱內形成基底動脈。椎動脈溝前方為上關節凹,與枕骨的枕髁相關節。C7側塊薄,椎弓根寬大,僅5%有椎動脈孔,適合椎弓根螺釘固定。
d、骶1椎體前上緣向前凸出,為岬部,骶骨前後各四對骶前孔與骶後孔,骶骨間無椎間盤。腹主動脈位於椎體左前方,於腰4平面分出左右髂總,分叉後方分出骶中動脈,再於骶1處分出髂內外動脈。下腔靜脈位於其右側,分叉於腰4/5間,同名血管與動脈伴行。骶靜脈叢位於骶前筋膜與骶骨間,一旦損傷較難止血。骶神經前支較重要,應避免損傷。了解以上解剖對置釘有著重要的作用。

2、 影像學研究
標准胸腰段正位X線片上椎弓根橢圓形投影的中心點作一水平線和一垂直線,過上一椎同側下關節突下極作一水平線和過該關節突外側緣作一垂直線。比較兩水平線及兩垂直線的距離,可以准確的選定椎弓根螺釘的入釘點—X線片上椎弓根橢圓形投影的中心點外移0.5~1.0mm[12]。側位X線片,可看出椎弓根的高度,椎弓根中軸線是否與終板平行,椎弓根頭向或尾向角度,以及是否存在畸形或缺如。需注意有時兩側椎弓根的頭尾向角度並不一致。
左前斜位片上可以清楚地顯示右側椎弓根螺釘頂端和椎體前外側骨皮質,右前斜位片可以顯示左側椎弓根螺釘及椎體前外側骨皮質。此部分骨皮質恰是椎弓根螺釘穿出的部位。進釘角度不同,出針點的位置也不相同,當0~5°時,出釘點在椎體側方;5~10°時在椎體前外側方;10~20°時出針點在椎體前方。這就為研究如何判斷進釘深度提供了可靠的形態學基礎。斜位片上椎體前方顯影部位是椎弓根螺釘穿出骨皮質的部位,當進釘角度在5~10°時,斜位片可准確地判斷螺釘進釘深度[13]。
研究發現除T10、11少部分外,T12~L5全部及大部分T10、11的棘突上緣根部都位於椎弓根上、下平面范圍內,這就使棘突定位法具備了最基本的條件。L1~4棘突上緣根部極接近椎弓根中軸線,大多在椎弓根中軸線上下2mm左右范圍內。L5則明顯位於中軸線下方5mm左右的范圍內 [14]。利用側位X線片上椎弓根影像與棘突上緣之間的距離來確定進針平面,利用正位片上椎弓根卵圓形投影與棘突側緣的距離來選擇進針位置。
CT對椎弓根的E角有直觀的判斷,同時可了解其橫徑及椎弓根形態,以及椎弓根中軸線與關節突的關系,這些對准確的置釘有著重要的作用,如支持三維重建,則可更直觀的判斷進釘點、進釘深度和釘的直徑。只有通過影像學資料,才能很好的制定置釘方案,從而准確的通過中軸線及達到合適的深度。
通常確定矢狀面傾角(頭向尾向角)需根據側位X片,術中伏卧位會有一定程度改變。其實還是有規律可循的,脊柱有頸、胸、腰椎生理彎曲,一般來說頸5;胸6、7;腰3為水平椎,其進釘可垂直,水平椎上下椎體,矢狀面傾角呈相反趨勢,越遠角度越大,至頸胸、胸腰交界處再度減小。
三、臨床應用
Rol-camille[15]進釘點為關節突關節面垂直延長線與橫突水平中位線交點,進釘方向為筆直向前;Magerl[16]或Weistein等[17]取上關節突外緣垂直延長線與橫突水平中位線交點為進釘點,在胸椎也可取關節突關節面垂直延長線與橫突水平中位線交點偏外2-3mm進釘,向前向內傾斜100-200;第三類是介於兩者之間的louis[18]和Ebraheim等[19]方法,進釘點的垂直線在下胸椎取關節突關節面外1/3,在腰椎取關節間隙最外側,水平線為關節突關節面下緣上方1mm,二者交點為進釘點,亦筆直向前置入螺釘。還有人主張在胸腰段以00進釘,每向下一節應向前向內傾斜增加50。實踐中發現不同個體椎弓根軸線並不同,故有人提出個體化置釘,術前仔細讀片,確定進釘點及角度,對於椎弓根較細小的情況尤其重要。

1、 腰椎椎弓根技術

在腰椎人字嵴出現率為94.5%,人字嵴恆定存在,變異少。操作時將人字嵴頂點稍咬平後,可用手錐緩緩進入椎弓根,進釘全過程手感均保持在松質骨內行進,既無明顯落空感又無很大阻力,進錐時根據術前胸腰椎側位X線片保持SSA角0°位,並保持TSA角為5~15°[20]。利用棘突上緣根部平椎弓根平面,也可作為定位標志。參照CT可確定螺釘直徑和長度,通常取骨性通道的80%較安全。

2、 胸椎椎弓根技術
胸椎椎弓根螺釘進釘點水平線為T1、T12為橫突根部中點,T2、T11為橫突根部中上1/3,其餘為橫突根部上緣。喬栓傑[21]將胸椎分為3組,第1組T1-2,第2組T3-8,第3組T9-12。第1組進釘點定為下關節突下緣外的垂直線與橫突嵴相交處;第2組定為下關節突下緣中間垂直線與橫突嵴水平線交點處,其下關節突下緣至橫突嵴之間即為進釘點。第三組為下關節突外1/3與橫突上1/3交點。至於與矢壯面的夾角,多數學者認為需結合CT測量來判斷。Louis[22]認為不同水平應有不同進針點,T3 以上為上位胸椎下關節突下3mm 和關節突外緣內3mm; T4~ T10位於關節突外緣更內側一些。椎弓根螺釘進針點在內外側面上位置比上下方向上的位置更重要,因為除了T1 、T2 ,胸椎椎弓根寬度明顯比高度小得多。上段胸椎內傾角為150-200,中下段胸椎螺釘直向前。T11、12節段椎弓根E角較特殊,多數略為負值, Louis進釘點進釘,椎弓根穿破量較少,以70-80方向進釘最佳。椎弓根螺釘後傾角除根據側位片外,還可依照與椎板關系,T1-T10椎弓根軸線與椎板垂直,T11、T12為800-850 。椎弓根螺釘直徑可參考以下標准[23]選擇:T4至T7為3.5~4.0mm;T3、T8、T9為4.0~4.5mm,其餘均為5.0mm以上。長度T1至T10應為24.0~33.0mm,且隨椎骨序數增加而逐漸增加1.0mm,T11、T12則較T10短,小於32 0mm,通過CT及正側位片可判斷。對於椎弓根形態不規則或較細,置釘有困難,可切除部分椎板,用探針定位椎弓根的上壁、內壁,便可准確置釘。偏外側突破椎弓根外側皮質少許多無大礙,但影響固定強度。注意存在無髓腔或部分硬質骨占據髓腔的情況,開道較困難,置釘需謹慎。對於側彎時置釘,凹側硬膜緊貼椎弓根,置於凸側較安全。

對於成人,椎弓根螺釘直徑小於5mm,將有斷釘隱患。中胸椎很多情況下,無法置入大於5mm直徑螺釘(椎弓根崩裂),另外不同椎弓根與矢壯面的夾角變化大,易導致裝配困難。有些學者採用椎弓根外側置入,很好的解決了這些問題。進釘點選橫突的尖端,橫突中線水平,先轉一小洞,錐子的指向與該椎小關節外側緣相交。與矢壯面的夾角為25—40度,自T12向上度數逐漸增加。置入的螺釘將經過橫突、部分的肋橫突及肋椎關節、椎體的側壁,由於進釘途徑位於小關節外側,不可能進入椎管,較安全,另外傾角增加使螺釘較長、較粗,固定強度增加,植入角度范圍大,螺釘可位於一條線上,裝配較方便。

3、 頸椎椎弓根技術

a、下頸椎
目前進針方法主要有:Abumi法、解剖標志定位法、計算機輔助成像定位法等。Abumi等最早報道了應用磨鑽打磨穿椎板外側塊骨皮質後,X線透視下將小探針經椎弓根髓腔插入椎體中,擴髓後,結合術前CT掃描可見經椎板外側塊骨皮質、椎弓根到椎體前沿的長度及椎弓根髓腔內徑大小,再置入合適的椎弓根釘。王東來等[24]
進釘點定位是以下關節中點劃縱線,兩關節間隙中點劃橫線,C3~C6 位於關節突背面外上象限的中點,C7
位於關節突中垂線接近上關節面的下緣。而吳戰勇等[25]認為於關節突背面畫三條垂線,將上關節突分成四等分,三條線分別為外 1/3 線、中線、內 1/3 線. 椎弓根進釘點在c3~c5 位於外 1/3 垂線上,距上關節面下緣3mm;c6~c7在中垂線上,距上關節面下緣2mm。進釘方向與椎體矢狀線夾角c3~c5 為 400, c6~c7 為350;與椎體水平線夾角 c5 為水平位,其上節段為從後下向前上傾斜,c6、c7為從後上向前下傾斜約 50。去除椎板後用神經剝離器探測椎弓根的上下壁及內壁,應用2.5mm 磨鑽鑽孔或小刮匙開道,絲錐擴孔,插入細克氏針拍頸椎側位、斜位片觀察進釘點及方向准確無誤後方可擰入椎弓根螺釘。閆德強等發現上下關節突間側凹、關節突後平面為下頸椎定位標志。垂直於關節突後平面的椎弓後上緣高度水平線與上下關節突間側凹外緣的矢狀線的交點為進釘點。從解剖可知,操作時應靠下靠內,以減少突破的可能。根據CT片確定螺釘長度,一般達椎體80%即可。

b、上頸椎
對於寰椎馬向陽等[26]發現其椎弓根寬度為7.78mm,以樞椎下關節突中心點的縱垂線與垂線經過處的寰椎後弓上緣下方3.0mm的水平線的交點作為螺釘的進針點,內斜100,上仰50鑽孔便可,無須顯露寰樞間的血管神經叢,也避開了椎動脈。進行寰椎椎弓根螺釘固定是可行的,其決定因素是椎動脈溝處的寰椎後弓高度,小於4mm則改為側塊螺釘。而對於樞椎Xu等[27]通過解剖研究,將進釘點確定為:樞椎椎板上緣水平線下5mm與椎管內側緣外7mm的交點處。Howington等[28]也通過解剖研究,確定了另一種進釘點定位方法:樞椎棘突正中垂線外側26mm與樞椎下關節突的最下緣上方9mm的交點處。若術中樞椎關節突外側的椎動脈得以顯露,則該進釘點與椎動脈內緣的垂直距離為1.38mm。李志軍等[29]則將進釘點確定為樞椎橫突下緣水平線與關節突的中外1/4垂線的交點處。Howington等[28]發現顯露樞椎椎弓根內緣和上緣,按他們確定的新進釘點,
螺釘內斜35.2°、上傾38.8°置釘,20枚螺釘均准確置入,各個方向均沒有突破椎弓根。直徑一般選用3.5mm的皮質骨螺釘[27,28,30,31],樞椎椎弓根的高度或寬度<5mm,則不宜行螺釘固定。

4、 骶骨釘技術

在骶椎,通常進釘點為S1關節突外緣縱線與下緣水平切線交點,指向中線或平行於骶髂關節。椎弓根螺釘可以從標準的往前內側方指向骶骨體或岬部,或者是向前外方進入骶骨翼。Edwards發現骶骨螺釘在S1處的植入角度在前內側25°,或者在骶骨翼外側成角35°具有最大的拔出力量。Zindrik發現在S2椎弓根螺釘固定的力量最弱,如果要提高螺釘的拔出力量應從偏外側45°角擰入[32]。Mirkovic使用椎弓根螺釘通過骶骨前後兩面骨皮質以增強固定時,判定S1螺釘放置時易損傷腰骶神經干,髂內靜脈和骶髂關節,S1螺釘放置有2個安全區域,其中前內側最為安全[33]。
四、展望
經皮椎弓根置入等微創技術正逐步開展,給椎弓根技術帶來了新思路。C臂型CT三維計算機定位系統、虛擬X線導航等技術,為椎弓根准確置釘提供了保障,但費用高,操作復雜,基層醫院難於推廣應用。如何置釘時更准確的定位,如何避免突破椎弓根,成為椎弓根技術的關鍵,目前採用柔性鑽技術將有望解決此問題,而無需昂貴的定位系統。

C. 求關於法國的英文演講稿

has long inspired opinionated outbursts, from delusional to denouncing, but on one matter travelers remain in agreement: it』s among the most stimulating cities in the world. Paris assaults all the senses, demanding to be seen, heard, touched, tasted and smelt. From luminescent landmarks to fresh poodle droppings on the pavement, the city is everything it should be - the very essence of all French things. If you come here expecting all you』ve heard to be true, you won』t leave disappointed.

Paris is at its best ring the temperate spring months (March to May), with autumn coming in a close second. In winter, there are all sorts of cultural events to tempt the visitor, but school holidays can clog the streets with the little folk. August is usually hot and sticky, and it』s also when many Parisians take their yearly vacations, so businesses are likely to be closed.

Musée Louvre

Louvre is probably one of the most world-renowned sightseeing places in Paris. This enormous building, constructed around 1200 as a fortress and rebuilt in the mid-16th century for use as a royal palace, began its career as a public museum in 1793. As part of Mitterand』s grands projets in the 1980s, the Louvre was revamped with the addition of a 21m (67ft) glass pyramid entrance. Initially deemed a failure, the new design has since won over those who regard consistency as inexcusably boring. Vast scrums of people puff and pant through the rooms full of paintings, sculptures and antiquities, including the Mona Lisa, Venus de Milo and Winged Victory (which looks like it』s been dropped and put back together). If the clamor becomes unbearable, your best bet is to pick a period or section of the Louvre and pretend that the rest is somewhere across town.

Eiffel Tower

This towering edifice was built for the World Fair of 1889, held to commemorate the centennial of the French Revolution. Named after its designer, Gustave Eiffel, it stands 320m (1050ft) high and held the record as the world』s tallest structure until 1930. Initially opposed by the city』s artistic and literary elite - who were only affirming their right to disagree with everything - the tower was almost torn down in 1909. Salvation came when it proved an ideal platform for the antennas needed for the new science of radio telegraphy. When you』re done peering upwards through the girders, you can visit any of the three public levels, which can be accessed by lift or stairs. Just south-east of the tower is a grassy expanse that was once the site of the world』s first balloon flights and is now used by teens as a skateboarding arena or by activists bad-mouthing Chirac.

Avenue des Champs-élysées

A popular promenade for the ostentatious aristos of old, the Avenue des Champs-élysées has long symbolised the style and joie de vivre of Paris. Encroaching fast-food joints, car showrooms and cinemas have somewhat lled the sheen, but the 2km (1mi) long, 70m (235ft) wide stretch is still an ideal place for evening walks and relishing the food at overpriced restaurants.

Centre Georges Pompidou

The Centre Georges Pompidou, displaying and promoting modern and contemporary art, is far and away the most visited sight in Paris. Built between 1972 and 1977, the hi-tech though daffy design has recently begun to age, prompting face-lifts and closures of many parts of the centre. Woven into this mêlée of renovation are several good (though pricey) galleries plus a free, three-tiered library with over 2000 periodicals, including English-language newspapers and magazines from around the world. A square just to the west attracts street musicians, Marcel Marceau impersonators and lots of unsavoury types selling drugs or picking pockets.

Notre Dame

The city』s cathedral ranks as one of the greatest achievements of Gothic architecture. Notre Dame was begun in 1163 and completed around 1345; the massive interior can accommodate over 6000 worshippers. Although Notre Dame is regarded as a sublime architectural achievement, there are all sorts of minor anomalies as the French love nothing better than to mess with things. These include a trio of main entrances that are each shaped differently, and which are accompanied by statues that were once coloured to make them more effective as Bible lessons for the hoi polloi. The interior is dominated by spectacular and enormous rose windows, and a 7800-pipe organ that was recently restored but has not been working properly since. From the base of the north tower, visitors with ramrod straight spines can climb to the top of the west fa?ade and decide how much aesthetic pleasure they derive from looking out at the cathedral』s many gargoyles - alternatively they can just enjoy the view of a decent swathe of Paris. Under the square in front of the cathedral, an archaeological crypt displays in situ the remains of structures from the Gallo-Roman and later periods.

Sainte Chapelle

Lying inside the Palais de Justice (law courts), Sainte Chapelle was consecrated in 1248 and built to house what was reputedly Jesus』 crown of thorns and other relics purchased by King Louis IX earlier in the 13th century. The gem-like chapel, illuminated by a veritable curtain of 13th-century stained glass (the oldest and finest in Paris), is best viewed from the law courts』 main entrance - a magnificently gilded, 18th-century gate. Once past the airport-like security, you can wander around the long hallways of the Palais de Justice and, if you can find a court in session, observe the proceedings. Civil cases are heard in the morning, while criminal trials - usually reserved for larceny or that French speciality crimes passionnel - begin after lunch.

Musée d』Orsay

Spectacularly housed in a former railway station built in 1900, the Musée d』Orsay was reinaugurated in its present form in 1986. Inside is a trove of artistic treasures proced between 1848 and 1914, including highly regarded Impressionist and Post-impressionist works. Most of their paintings and sculptures are found on the ground floor and the skylight-lit upper level, while the middle level has some magnificent rooms showcasing the Art-Nouveau movement. Nearby, the Musée Rodin displays the lively bronze and marble sculptures by Camille Claudel and Auguste Rodin, including casts of some of Rodin』s most celebrated works. There』s a shady sculpture garden out the back, one of Paris』 treasured islands of calm.

Cimetière Père Lachaise

[R-p5]Established in 1805, this necropolis attracts more visitors than any similar structure in the world. Within the manicured, evergreen enclosure are the tombs of over one million people including such luminaries as the composer Chopin; the writers Molière, Apollinaire, Oscar Wilde, Balzac, Marcel Proust and Gertrude Stein; the artists David, Delacroix, Pissarro, Seurat and Modigliani; the actors Sarah Bernhardt, Simone Signoret and Yves Montand; the singer édith Piaf; and the dancer Isadora Duncan. The most visited tomb, however, is that of The Doors lead singer, Jim Morrison, who died in Paris in 1971. One hundred years earlier, the cemetery was the site of a fierce battle between Communard insurgents and government troops. The rebels were eventually rounded up against a wall and shot, and were buried where they fell in a mass grave.

Place des Vosges

The Marais district spent a long time as a swamp and then as agricultural land, until in 1605 King Henry IV decided to transform it into a residential area for Parisian aristocrats. He did this by building Place des Vosges and arraying 36 symmetrical houses around its square perimeter. The houses, each with arcades on the ground floor, large dormer windows, and the requisite creepers on the walls, were initially built of brick but were subsequently constructed using timber with a plaster covering, which was then painted to look like brick. Duels, fought with strictly observed formality, were once staged in the elegant park in the middle. From 1832-48 Victor Hugo lived at a house at No 6, which has now been turned into a municipal museum. Today, the arcades around the place are occupied by expensive galleries and shops, and cafés filled with people drinking little cups of coffee and air-kissing immaculate passersby.

Bois de Boulogne

The modestly sized Bois de Boulogne, on the western edge of the city, is endowed with forested areas, meandering paths, belle époque cafes and little wells of naughtiness. Each night, pockets of the Bois de Boulogne are taken over by prostitutes and lurkers with predacious sexual tastes. In recent years, the police have cracked down on the area』s sex trade, but locals still advise against walking through the area alone at night.

Outer ?le de France

The relatively small region surrounding Paris - known as the ?le de France (Island of France) - was where the kingdom of France began its 12th-century expansion. Today, it』s a popular day-trip destination for Parisians and Paris-based visitors. Among the region』s many attractions are woodlands ideal for hiking, skyscrapered districts endowed with sleekly functional architecture, the much-maligned EuroDisney, elegant historical towns and Versailles, the country』s former political capital and seat of the royal court. The latter is the site of the Chateau de Versailles, the grandest and most famous palace in France. Built in the mid-1600s ring the reign of Louis XIV, the chateau is a keen reminder of just how much one massive ego and a nation』s wealth could buy in days of old (eat your heart out, Bill Gates). Apart from grand halls, bedchambers, gardens, ponds and fountains too elaborate to discuss, there』s also a 75m (250ft) Hall of Mirrors, where nobles dressed like ninnies could watch each other dancing.

Canal Saint Martin

The little-touristed Saint Martin canal, running through the north-eastern districts of the Right Bank, is one of Paris』 hidden delights. The 5km (3mi) waterway, parts of which are higher than the surrounding land, was built in 1806 to link the Seine with the much longer Canal de l』Ourcq. Its shaded towpaths - specked with sunlight filtering through the plane trees - are a wonderful place for a romantic stroll or bike ride past locks, metal bridges and unassuming but well turned-out Parisian neighbourhoods.

Paris has two airports, Aéroport d』Orly, south of central Paris, and Aéroport Charles de Gaulle, in the north, is a major international hub, so you shouldn』t have any trouble finding a flight, regardless of where you』re flying. Paris is also famous for its sophisticated underground system, known as Metro. No matter where you are, chances are that there』s a metro station within a few blocks.

Europe is famous for its fascinating cultural background and the same is true to Paris. Why shall you wait? It』s well worth visiting it.

D. 推薦幾本英語原版書吧

參考一下吧:
我有這本書,但是太大了。十多兆吧。發送太慢了,所以……

你自己到新浪讀書去下載吧。

戰爭與和平 War And Peace
作者:列夫·托爾斯泰 by Leo Tolstoy
悲慘世界 Les Miserables
作者:維克多·雨果 by Victor Hugo
雙城記 A Tale of Two Cities
作者:查爾斯·狄更斯 by Charles Dickens
簡·愛 Jane Eyre
作者:夏洛特·勃朗特 by Charlotte Bronte
呼嘯山莊 Wuthering Heights
作者:艾米略·勃朗特 by Emily Bronte
傲慢與偏見 Pride And prejudice
作者:簡·奧斯汀 by Jane Austen
德伯家的苔絲
Tess of the D'Urbervilles
作者:托馬斯·哈代 by Thomas Hardy
基督山伯爵 The Count of Monte Cristo
作者:大仲馬 by Alexandre Dumas Pere
茶花女 La Dame aux camélias (Camille)
作者:小仲馬 by Alexandre Dumas fils
愛麗絲漫遊奇境記 Alice's Adventures In Wonderland
作者:劉易斯·卡洛爾 by Lewis Carroll
魯賓遜飄流記 Robison Crusoe
作者:丹尼爾·笛福 by Daniel Defoe
湯姆·索亞歷險記 The Adventures of Tom Sawyer
作者:馬克·吐溫 by Mark Twain
哈克貝里·芬歷險記 The Adventures of Huckleberry Finn
作者:馬克·吐溫 by Mark Twain
嘉莉妹妹 Sister Carrie
作者:西奧多·德萊塞 by Theodore Dreiser
娜娜 Nana
作者:左拉 by Emile Zola
馬丁·伊登 Martin Eden
作者:傑克·倫敦 by Jack London
紅字 The Scarlet Letter
作者:霍桑 by Nathaniel Hawthorne
查太萊夫人的情人 Lady Chatterley's Lover
作者:D·H·勞倫斯 by D·H·Lawrence
寶島 Treasure Island
作者:羅伯特·路易斯·史蒂文森 by Robert Louis Stevenson
八十天環游地球 Around the World In 80 Days
作者:儒勒·凡爾納 by Jules Verne
尤利西斯 Ulysses
作者:喬伊斯 by James Joyce

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