AIM: To assess the management and outcome of hilar cholangiocarcinoma (Klatskin tumor) in a single tertiary referral center.METHODS: The notes of all patients with a diagnosis of hilar cholangiocarcinoma referred to o...AIM: To assess the management and outcome of hilar cholangiocarcinoma (Klatskin tumor) in a single tertiary referral center.METHODS: The notes of all patients with a diagnosis of hilar cholangiocarcinoma referred to our unit for over an 8-year period were identified and retrospectively reviewed. Presentation, management and outcome were assessed.RESULTS: Seventy-five patients were identified. The median age was 64 years (range 34-84 years). Male to female ratio was 1:1. Eighty-nine percent of patients presented with jaundice. Most patients referred were under Bismuth classification 3a, 3b or 4. Seventy patients required biliary drainage, 65 patients required 152percutaneous drainage procedures, and 25 had other complications. Forty-one patients had 51 endoscopic drainage procedures performed (15 failed). Of these,36 subsequently required percutaneous drainage. The median number of drainage procedures for all patients was three, 18 patients underwent resection (24%), nine had major complications and three died post-operatively.The 5-year survival rate was 4.2% for all patients, 21%for resected patients and 0% for those who did not undergo resection (P = 0.0021). The median number of admissions after diagnosis in resected patients was two and three in non-resected patients (P＜0.05).Twelve patients had external-beam radiotherapy, seven brachytherapy, and eight chemotherapy. There was no significant benefit in terms of survival (P = 0.46) or hospital admissions.CONCLUSION: Resection increases survival but carries the risk of significant morbidity and mortality.Percutaneous biliary drainage is almost always necessary and endoscopic drainage should be avoided if possible.展开更多
AIM: To explore recent trends, modes of diagnosis, ethnic distribution and the mortality to incidence ratio of primary liver cancer by subtypes in England and Wales.
The National Health Service(NHS)is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom.There are several challenges militating against the...The National Health Service(NHS)is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom.There are several challenges militating against the effective laboratory service delivery in the NHS in England.Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients.They provide the"engine room"of modern medicine with 70%of diagnosis based on the laboratory results generated by them.This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England.Laboratory service delivery in the NHS in England faces numerous daunting challenges;staffing levels in the last few years have become dangerously low,less remunerated,relatively less experienced and predominantly band 5's,multidisciplinary rather than specialty based,associated with working more unsocial hours without adequate recovery time,de-banding of staff,high staff turnaround,profit and cost driven rather than quality.These factors has resulted in burn out,low morale,high sickness absences,increased error rate,poor team spirit,diminished productivity and suboptimal laboratory service delivery.There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix,ensuring adequate remuneralion of laboratory staff,implementing evidenced-based specialty oriented service,determining the root cause/s for the high staff turnover and implementing corrective action,identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.展开更多
Background： Forest biodiversity is the foundation of many ecosystem services, and the effect of biodiversity on ecosystem functioning and processes （BEF） has been a central issue in biodiversity studies. Although m...Background： Forest biodiversity is the foundation of many ecosystem services, and the effect of biodiversity on ecosystem functioning and processes （BEF） has been a central issue in biodiversity studies. Although many hypotheses have been developed to interpret global gradients of biodiversity, there has not been complete agreement on mechanisms controlling biodiversity patterns and distributions. Differences may be due to limited observation data and inconsistencies of spatial scales in analysis. Methods： In this study, we take advantage of USDA Forest Service forest inventory and analysis （FIA） data for exploring regional forest biodiversity and BEF in New England forests. The FIA data provide detailed information of sampled plots and trees for the region, including 6000 FIA plots and more than 33,000 individual trees. Biodiversity models were used to analyze the data. Results： Tree species diversity increases from the north to the south at a rate about 2-3 species per latitudinal degree. Tree species diversity is better predicted by tree height than forest age or biomass. Very different distribution patterns of two common maple species, sugar maple （Acer sdcchorum） and red maple （Acer rubrum）, highlight the vulnerability of sugar maple and its potential replacement by red maple on New England landscapes. Red maple generally already outperforms sugar maple, and will likely and continuously benefit from a changing climate in New England. Conclusions： We conclude that forest structure （height） and resources （biomass） are more likely foundational characteristics supporting biodiversity rather than biodiversity determining forest productivity and/or biomass. The potential replacement of red maple for sugar maple in the New England areas could affect biodiversity and stability of forest ecosystem functioning because sugar maple plays important ecological roles distinct from red maple that are beneficial to other tree species in northern hardwood forests. Such a change may not affect forest resilience in terms of forest productivity and biomass as these are similar in red maple and sugar maple, however, it would almost certainly alter forest structure across the landscape.展开更多
Louisa Ellis is a protagonist in "A New England Nun" which is written by Mary Eleanor Wilkins Freeman.She deliberately refuses to marry her fiancé Joe after he returns from Australia where he wants to m...Louisa Ellis is a protagonist in "A New England Nun" which is written by Mary Eleanor Wilkins Freeman.She deliberately refuses to marry her fiancé Joe after he returns from Australia where he wants to make a fortune.This paper aims at analyzing the complicated feelings of Louisa from a feminist angle.The conclusion is that she lives in a delicate no-man’s world so that she sees him—the carrier of masculine power as a threat to her serenity and security of a spinster’s life.展开更多
BACKGROUND Outcomes for cholangiocarcinoma(CCA)are extremely poor owing to the complexities in diagnosing and managing a rare disease with heterogenous sub-types.Beyond curative surgery,which is only an option for a m...BACKGROUND Outcomes for cholangiocarcinoma(CCA)are extremely poor owing to the complexities in diagnosing and managing a rare disease with heterogenous sub-types.Beyond curative surgery,which is only an option for a minority of patients diagnosed at an early stage,few systemic therapy options are currently recommended to relieve symptoms and prolong life.Stent insertion to manage disease complications requires highly specialised expertise.Evidence is lacking as to how CCA patients are managed in a real-world setting and whether there is any variation in treatments received by CCA patients.AIM To assess geographic variation in treatments received amongst CCA patients in England.METHODS Data used in this cohort study were drawn from the National Cancer Registration Dataset(NCRD),Hospital Episode Statistics and the Systemic Anti-Cancer Therapy Dataset.A cohort of 8853 CCA patients diagnosed between 2014-2017 in the National Health Service in England was identified from the NCRD.Potentially curative surgery for all patients and systemic therapy and stent insertion for 7751 individuals who did not receive surgery were identified as three end-points of interest.Linear probability models assessed variation in each of the three treatment modalities according to Cancer Alliance of residence at diagnosis,and for socio-demographic and clinical characteristics at diagnosis.RESULTS Of 8853 CCA patients,1102(12.4%)received potentially curative surgery.The mean[95%confidence interval(CI)]percentage-point difference from the population average ranged from-3.96(-6.34 to-1.59)%to 3.77(0.54 to 6.99)%across Cancer Alliances in England after adjustment for patient sociodemographic and clinical characteristics,showing statistically significant variation.Amongst 7751 who did not receive surgery,1542(19.9%)received systemic therapy,with mean[95%CI]percentage-point difference from the population average between-3.84(-8.04 to 0.35)%to 9.28(1.76 to 16.80)%across Cancer Alliances after adjustment,again showing the presence of statistically significant variation for some regions.Stent insertion was received by 2156(27.8%),with mean[95%CI]percentage-point difference from the population average between-10.54(-12.88 to-8.20)%to 13.64(9.22 to 18.06)%across Cancer Alliances after adjustment,showing wide and statistically significant variation from the population average.Half of 8853 patients(n=4468)received no treatment with either surgery,systemic therapy or stent insertion.CONCLUSION Substantial regional variation in treatments received by CCA patients was observed in England.Such variation could be due to differences in case-mix,clinical practice or access to specialist expertise.展开更多
Conceived as countering market outcomes,British planning focuses on the development and design of land use and the built environment,with a close relationship with the economy.The public and politicians in the UK ofte...Conceived as countering market outcomes,British planning focuses on the development and design of land use and the built environment,with a close relationship with the economy.The public and politicians in the UK often associate planning with rigorous regulations that prevent economic growth,and many stakeholders complain about the restrictions that planning puts on their autonomous activities.To explore this,this essay focuses on the definition and the nature of ‘inhibit’,‘regulate’,‘guide’ and ‘initiate’ features through the plan-making process and management in England,finding out a more proactive role for planning as guiding and initiating development.展开更多
Colonial New England urban economy was growing prosperity from 17th century to 18th century, all kinds of urban public space was increasing in number, the increasingly rich on the function, which became important plac...Colonial New England urban economy was growing prosperity from 17th century to 18th century, all kinds of urban public space was increasing in number, the increasingly rich on the function, which became important place for colonial population aggregation and consumption. What people from different place come into the big and small cafes, taverns, shops, and the most important Town House took sharing information, emotional communication, business negotiation and other matters, which reflecting the colonial town＇s economic and social progress.展开更多
In England,Christmas is the most important of all the ’Bank Holidays’ in the year.Two important things,apart from itsreligious significance,help to set this holiday apart fromall others:the custom of giving gifts an...In England,Christmas is the most important of all the ’Bank Holidays’ in the year.Two important things,apart from itsreligious significance,help to set this holiday apart fromall others:the custom of giving gifts and the habit ofspending it with family. In the present highly commercialised age we arereminded of Christmas many weeks before the event.展开更多
In England, Christmas Day and Good Friday havebeen holidays (literally ’Holy Days’) for religious reasonssince the establishment of Christianity in this country.Christmas is celebrated on December 25, not ChristmasE...In England, Christmas Day and Good Friday havebeen holidays (literally ’Holy Days’) for religious reasonssince the establishment of Christianity in this country.Christmas is celebrated on December 25, not ChristmasEve as in several other European countries. The otherpublic holidays (or ’Bank Holidays’) are Easter Monday,May Day (May 1st), the Spring Bank Holiday (the lastMonday in May), the Summer Bank Holiday (the展开更多
New Criticism is an important theory in deciphering poetry.With the help of New Criticism,the meanings and the charms of the poetry are shown.“Song to the Men of England”and“Large Rat”are from different countries ...New Criticism is an important theory in deciphering poetry.With the help of New Criticism,the meanings and the charms of the poetry are shown.“Song to the Men of England”and“Large Rat”are from different countries with the same emotions of accusing the cruelty of the exploiter and the miserable life of the exploited.However,“Song to the Men of England”is full of hatred to the exploiter,hoping to destroy the society.Nevertheless,the exploited of“Large Rat”keep the hope of moving to a new free land.The two poems show different characteristics of Englishmen and Chinese.展开更多
Medieval European feudal society laid the foundation for the development of modern western society and it is also a historic organic body full of complexity and contradiction. Overall research shows that feudalism did...Medieval European feudal society laid the foundation for the development of modern western society and it is also a historic organic body full of complexity and contradiction. Overall research shows that feudalism didn't have monopoly on medieval England society; the non-feudal elements coexisted with the feudal elements in one united body and occupied an important place in the social structure.展开更多
English proverbs and idioms are quite common in the language use due to its expressiveness.However,without the deep understanding of the cultures,history,folktales or legends behind them,English proverbs and idioms ma...English proverbs and idioms are quite common in the language use due to its expressiveness.However,without the deep understanding of the cultures,history,folktales or legends behind them,English proverbs and idioms may easily lead to con⁃fusion or even misinterpretation.From a number of European-nation-related proverbs and idioms listed,the readers can have a glimpse of Greek legends,Roman wisdom,Anglo-Spanish and Anglo-Dutch Wars,and joking with their neighbouring coun⁃tries,and thus feel the love and hate between England and those nations in the profound historical background.展开更多
1819 was a year of revolution in Europe and it was a year of great upheavalsin English history.The British people were passing through three historical stor-ms——The Industrial Revolution,The American Revolution,The ...1819 was a year of revolution in Europe and it was a year of great upheavalsin English history.The British people were passing through three historical stor-ms——The Industrial Revolution,The American Revolution,The French Revolu-tion. On one hand,the British people were fighting with the bourgeois for theirown existence.They destroyed the machines and went on strikes.On the otherhand,the reactionary authorities cruelly and savagely suppressed the workers mo-vements.The conflict of two classes was extremely intense.In August 1819,about80,000 workers in Manchester city were going out on strike.The reactionary au-thorities brutally suppressed the strike by arm forces.Hundreds of jobless work-ers were killed and wounded.Thus happened the infamous Peterloo Massarce.展开更多
Some countries never have snow,and some have only a little on the top of very high mountains. In the north of England,there is quite a lot of snow every winter,but in the south of England,there is usually little. When...Some countries never have snow,and some have only a little on the top of very high mountains. In the north of England,there is quite a lot of snow every winter,but in the south of England,there is usually little. When a student from a warm country comes to England in autumn for the first time,he feels cool at first. There are often dark clouds,grey sky and cold rain in England in autumn,and most students from warm countries do not like these.展开更多
Last October,my classmates and I went to England with my bilingual teacher,Ms.Yu Xiaofang and my classmates.We stayed there and studied there for about one month.That trip was so wonderful that it will be unforgettabl...Last October,my classmates and I went to England with my bilingual teacher,Ms.Yu Xiaofang and my classmates.We stayed there and studied there for about one month.That trip was so wonderful that it will be unforgettable.We learned a lot during the trip.展开更多
文摘AIM: To assess the management and outcome of hilar cholangiocarcinoma (Klatskin tumor) in a single tertiary referral center.METHODS: The notes of all patients with a diagnosis of hilar cholangiocarcinoma referred to our unit for over an 8-year period were identified and retrospectively reviewed. Presentation, management and outcome were assessed.RESULTS: Seventy-five patients were identified. The median age was 64 years (range 34-84 years). Male to female ratio was 1:1. Eighty-nine percent of patients presented with jaundice. Most patients referred were under Bismuth classification 3a, 3b or 4. Seventy patients required biliary drainage, 65 patients required 152percutaneous drainage procedures, and 25 had other complications. Forty-one patients had 51 endoscopic drainage procedures performed (15 failed). Of these,36 subsequently required percutaneous drainage. The median number of drainage procedures for all patients was three, 18 patients underwent resection (24%), nine had major complications and three died post-operatively.The 5-year survival rate was 4.2% for all patients, 21%for resected patients and 0% for those who did not undergo resection (P = 0.0021). The median number of admissions after diagnosis in resected patients was two and three in non-resected patients (P＜0.05).Twelve patients had external-beam radiotherapy, seven brachytherapy, and eight chemotherapy. There was no significant benefit in terms of survival (P = 0.46) or hospital admissions.CONCLUSION: Resection increases survival but carries the risk of significant morbidity and mortality.Percutaneous biliary drainage is almost always necessary and endoscopic drainage should be avoided if possible.
文摘AIM: To explore recent trends, modes of diagnosis, ethnic distribution and the mortality to incidence ratio of primary liver cancer by subtypes in England and Wales.
基金Supported by grant(NEI001)from the management of Nelson Biomedical Limited UK
文摘The National Health Service(NHS)is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom.There are several challenges militating against the effective laboratory service delivery in the NHS in England.Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients.They provide the"engine room"of modern medicine with 70%of diagnosis based on the laboratory results generated by them.This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England.Laboratory service delivery in the NHS in England faces numerous daunting challenges;staffing levels in the last few years have become dangerously low,less remunerated,relatively less experienced and predominantly band 5's,multidisciplinary rather than specialty based,associated with working more unsocial hours without adequate recovery time,de-banding of staff,high staff turnaround,profit and cost driven rather than quality.These factors has resulted in burn out,low morale,high sickness absences,increased error rate,poor team spirit,diminished productivity and suboptimal laboratory service delivery.There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix,ensuring adequate remuneralion of laboratory staff,implementing evidenced-based specialty oriented service,determining the root cause/s for the high staff turnover and implementing corrective action,identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.
基金the project NRS-6“Climate,Fire,and Carbon Cycle Sciences”supported by the USDA Forest ServiceBeijing Forestry University for covering the trip to the conference and generous conference venue facilitating this study
文摘Background： Forest biodiversity is the foundation of many ecosystem services, and the effect of biodiversity on ecosystem functioning and processes （BEF） has been a central issue in biodiversity studies. Although many hypotheses have been developed to interpret global gradients of biodiversity, there has not been complete agreement on mechanisms controlling biodiversity patterns and distributions. Differences may be due to limited observation data and inconsistencies of spatial scales in analysis. Methods： In this study, we take advantage of USDA Forest Service forest inventory and analysis （FIA） data for exploring regional forest biodiversity and BEF in New England forests. The FIA data provide detailed information of sampled plots and trees for the region, including 6000 FIA plots and more than 33,000 individual trees. Biodiversity models were used to analyze the data. Results： Tree species diversity increases from the north to the south at a rate about 2-3 species per latitudinal degree. Tree species diversity is better predicted by tree height than forest age or biomass. Very different distribution patterns of two common maple species, sugar maple （Acer sdcchorum） and red maple （Acer rubrum）, highlight the vulnerability of sugar maple and its potential replacement by red maple on New England landscapes. Red maple generally already outperforms sugar maple, and will likely and continuously benefit from a changing climate in New England. Conclusions： We conclude that forest structure （height） and resources （biomass） are more likely foundational characteristics supporting biodiversity rather than biodiversity determining forest productivity and/or biomass. The potential replacement of red maple for sugar maple in the New England areas could affect biodiversity and stability of forest ecosystem functioning because sugar maple plays important ecological roles distinct from red maple that are beneficial to other tree species in northern hardwood forests. Such a change may not affect forest resilience in terms of forest productivity and biomass as these are similar in red maple and sugar maple, however, it would almost certainly alter forest structure across the landscape.
文摘Louisa Ellis is a protagonist in "A New England Nun" which is written by Mary Eleanor Wilkins Freeman.She deliberately refuses to marry her fiancé Joe after he returns from Australia where he wants to make a fortune.This paper aims at analyzing the complicated feelings of Louisa from a feminist angle.The conclusion is that she lives in a delicate no-man’s world so that she sees him—the carrier of masculine power as a threat to her serenity and security of a spinster’s life.
基金Supported by AMMFNational Disease Registration Service,National Health Service England.
文摘BACKGROUND Outcomes for cholangiocarcinoma(CCA)are extremely poor owing to the complexities in diagnosing and managing a rare disease with heterogenous sub-types.Beyond curative surgery,which is only an option for a minority of patients diagnosed at an early stage,few systemic therapy options are currently recommended to relieve symptoms and prolong life.Stent insertion to manage disease complications requires highly specialised expertise.Evidence is lacking as to how CCA patients are managed in a real-world setting and whether there is any variation in treatments received by CCA patients.AIM To assess geographic variation in treatments received amongst CCA patients in England.METHODS Data used in this cohort study were drawn from the National Cancer Registration Dataset(NCRD),Hospital Episode Statistics and the Systemic Anti-Cancer Therapy Dataset.A cohort of 8853 CCA patients diagnosed between 2014-2017 in the National Health Service in England was identified from the NCRD.Potentially curative surgery for all patients and systemic therapy and stent insertion for 7751 individuals who did not receive surgery were identified as three end-points of interest.Linear probability models assessed variation in each of the three treatment modalities according to Cancer Alliance of residence at diagnosis,and for socio-demographic and clinical characteristics at diagnosis.RESULTS Of 8853 CCA patients,1102(12.4%)received potentially curative surgery.The mean[95%confidence interval(CI)]percentage-point difference from the population average ranged from-3.96(-6.34 to-1.59)%to 3.77(0.54 to 6.99)%across Cancer Alliances in England after adjustment for patient sociodemographic and clinical characteristics,showing statistically significant variation.Amongst 7751 who did not receive surgery,1542(19.9%)received systemic therapy,with mean[95%CI]percentage-point difference from the population average between-3.84(-8.04 to 0.35)%to 9.28(1.76 to 16.80)%across Cancer Alliances after adjustment,again showing the presence of statistically significant variation for some regions.Stent insertion was received by 2156(27.8%),with mean[95%CI]percentage-point difference from the population average between-10.54(-12.88 to-8.20)%to 13.64(9.22 to 18.06)%across Cancer Alliances after adjustment,showing wide and statistically significant variation from the population average.Half of 8853 patients(n=4468)received no treatment with either surgery,systemic therapy or stent insertion.CONCLUSION Substantial regional variation in treatments received by CCA patients was observed in England.Such variation could be due to differences in case-mix,clinical practice or access to specialist expertise.
文摘Conceived as countering market outcomes,British planning focuses on the development and design of land use and the built environment,with a close relationship with the economy.The public and politicians in the UK often associate planning with rigorous regulations that prevent economic growth,and many stakeholders complain about the restrictions that planning puts on their autonomous activities.To explore this,this essay focuses on the definition and the nature of ‘inhibit’,‘regulate’,‘guide’ and ‘initiate’ features through the plan-making process and management in England,finding out a more proactive role for planning as guiding and initiating development.
文摘Colonial New England urban economy was growing prosperity from 17th century to 18th century, all kinds of urban public space was increasing in number, the increasingly rich on the function, which became important place for colonial population aggregation and consumption. What people from different place come into the big and small cafes, taverns, shops, and the most important Town House took sharing information, emotional communication, business negotiation and other matters, which reflecting the colonial town＇s economic and social progress.
文摘In England,Christmas is the most important of all the ’Bank Holidays’ in the year.Two important things,apart from itsreligious significance,help to set this holiday apart fromall others:the custom of giving gifts and the habit ofspending it with family. In the present highly commercialised age we arereminded of Christmas many weeks before the event.
文摘In England, Christmas Day and Good Friday havebeen holidays (literally ’Holy Days’) for religious reasonssince the establishment of Christianity in this country.Christmas is celebrated on December 25, not ChristmasEve as in several other European countries. The otherpublic holidays (or ’Bank Holidays’) are Easter Monday,May Day (May 1st), the Spring Bank Holiday (the lastMonday in May), the Summer Bank Holiday (the
文摘New Criticism is an important theory in deciphering poetry.With the help of New Criticism,the meanings and the charms of the poetry are shown.“Song to the Men of England”and“Large Rat”are from different countries with the same emotions of accusing the cruelty of the exploiter and the miserable life of the exploited.However,“Song to the Men of England”is full of hatred to the exploiter,hoping to destroy the society.Nevertheless,the exploited of“Large Rat”keep the hope of moving to a new free land.The two poems show different characteristics of Englishmen and Chinese.
文摘Medieval European feudal society laid the foundation for the development of modern western society and it is also a historic organic body full of complexity and contradiction. Overall research shows that feudalism didn't have monopoly on medieval England society; the non-feudal elements coexisted with the feudal elements in one united body and occupied an important place in the social structure.
文摘English proverbs and idioms are quite common in the language use due to its expressiveness.However,without the deep understanding of the cultures,history,folktales or legends behind them,English proverbs and idioms may easily lead to con⁃fusion or even misinterpretation.From a number of European-nation-related proverbs and idioms listed,the readers can have a glimpse of Greek legends,Roman wisdom,Anglo-Spanish and Anglo-Dutch Wars,and joking with their neighbouring coun⁃tries,and thus feel the love and hate between England and those nations in the profound historical background.
文摘1819 was a year of revolution in Europe and it was a year of great upheavalsin English history.The British people were passing through three historical stor-ms——The Industrial Revolution,The American Revolution,The French Revolu-tion. On one hand,the British people were fighting with the bourgeois for theirown existence.They destroyed the machines and went on strikes.On the otherhand,the reactionary authorities cruelly and savagely suppressed the workers mo-vements.The conflict of two classes was extremely intense.In August 1819,about80,000 workers in Manchester city were going out on strike.The reactionary au-thorities brutally suppressed the strike by arm forces.Hundreds of jobless work-ers were killed and wounded.Thus happened the infamous Peterloo Massarce.
文摘Some countries never have snow,and some have only a little on the top of very high mountains. In the north of England,there is quite a lot of snow every winter,but in the south of England,there is usually little. When a student from a warm country comes to England in autumn for the first time,he feels cool at first. There are often dark clouds,grey sky and cold rain in England in autumn,and most students from warm countries do not like these.
文摘Last October,my classmates and I went to England with my bilingual teacher,Ms.Yu Xiaofang and my classmates.We stayed there and studied there for about one month.That trip was so wonderful that it will be unforgettable.We learned a lot during the trip.
