患者女,45岁。10年前因胃出血行胃大部切除术,近1年诉头昏、乏力、面色苍白就诊。实验室检查:RBC3.1×1012/L,Hb78g/L,白细胞及血小板正常,网织红细胞0.015,骨髓检查:幼红细胞增生明显活跃,以中、晚幼红细胞增生为主。最可能的诊断为
A
暂无解析
Wecanbeginourdiscussionof“populationasglobalissue”withwhatmostpersonsmeanwhentheydiscuss“thepopulationproblem”:toomanypeopleonearthandatoorapidincreaseinthenumberaddedeachyear.Thefactsarenotindispute,Itwasquiterighttoemploytheanalogythatlikeneddemographicgrowthto“along,thinpowderfusethatburnssteadilyandhaltinglyuntilitfinallyreachesthechargeandexplodes.”
Tounderstandthecurrentsituation,whichischaracterizedbyrapidincreasesinpopulation,itisnecessarytounderstandthehistoryofpopulationtrends.Rapidgrowthisacomparativelyrecentphenomenon.Lookingbackatthe8,000yearsofdemographichistory,wefindthatpopulationshavebeenvirtuallystableorgrowingveryslightlyformostofhumanhistory.Formostofourancestors,lifewashard,oftennasty,andveryshort.Therewashighfertilityinmostplaces,butthiswasusuallybalancedbyhighmortality.Formostofhumanhistory,itwasseldomthecasethatoneintenpersonswouldlivepastforty,whileinfancyandchildhoodwereespeciallyriskyperiods.Often,societieswereincleardangerofextinctionbecausedeathratescouldexceedtheirbirthrates.Thus,thepopulationproblemthroughoutmostofhistorywashowtopreventextinctionofthehumanrace.
Thispatternisimportanttonotice.Notonlydoesitputthecurrentproblemsofdemographicgrowthintoahistoricalperspective,butitsuggeststhatthecauseofrapidincreaseinpopulationinrecentyearsisnotasuddenenthusiasmformorechildren,butanimprovementintheconditionsthattraditionallyhavecausedhighmortality.
Demographichistorycanbedividedintotwomajorperiods:atimeoflong,slowgrowthwhichextendedfromabout8,000BC.tillapproximatelyAD.1650.Inthefirstperiodofsome9600years,thepopulationincreasedfromsome8millionto500millionin1650.Between1650andthepresent,thepopulationhasincreasedfrom500milliontomorethan4billion.Anditisestimatedthatbytheyear2000therewillbe6.2billionpeoplethroughouttheworld.Onewaytoappreciatethisdramaticdifferenceinsuchabstractnumbersistoreducethetimeframetosomethingthatismoremanageable.Between8000BCand1650,anaverageofonly50,000personswasbeingaddedannuallytotheworld’spopulationeachyear.Atpresent,thisnumberisaddedeverysixhours.Theincreaseisabout80,000,000personsannually.
1.Whichofthefollowingdemographicgrowthpatternismostsuitableforthelongthinpowderfuseanalogy?
A.Avirtuallystableorslightlydecreasingperiodandthenasuddenexplosionofpopulation.
B.Aslowgrowthforalongtimeandthenaperiodofrapid,dramaticincrease.
C.Toomanypeopleonearthandafewrapidincreaseinthenumberaddedeachyear.
D.Alongperiodwhendeathratesexceedsbirthratesandthenashortperiodwithhigherfertilityandlowermortality.
2.Duringthefirstperiodofdemographichistory,societieswereoftenindangerofextinctionbecause___.
A.onlyoneintenpersonscouldlivepast40.
B.therewashighermortalitythanfertilityinmostplaces.
C.itwastoodangeroustohavebabiesduetothepoorconditions.
D.ourancestorshadlittleenthusiasmformorechildren.
3.Whichstatementistrueaboutpopulationincrease?
A.Theremightbeanincreaseof2.2billionpersonsfromnowtotheyear2000.
B.About50,000babiesareborneverysixhoursatpresent.
C.Between8000BCandthepresent,thepopulationincreaseisabout80,000,000personseachyear.
D.Thepopulationincreasedfasterbetween8000BCand1650thanbetween1650andthepresent.
4.Theauthorofthepassageintendsto___.
A.warnpeopleagainstthepopulationexplosioninthenearfuture.
B.comparethedemographicgrowthpatterninthepastwiththatafter1650.
C.findoutthecauseforrapidincreaseinpopulationinrecentyears.
D.presentusaclearandcompletepictureofthedemographicgrowth.
5.Theword“demographic”inthefirstparagraphmeans___.
A.statisticsofhuman.
B.surroundingsstudy.
C.accumulationofhuman.
D.developmentofhuman.
IamsorryIhavenotimeatpresentto____moredetailorgiveyouanaccountofothercitiesofinterest.
Insomecountrieswhereracialprejudiceisacute,violencehassocometobetakenforgrantedasameansofsolvingdifferences,thatitisnotevenquestioned.Therearecountrieswherethewhitemanimposeshisrulebybruteforce;therearecountrieswheretheblackmanprotestsbysettingfiretocitiesandbylootingandpillaging.Importantpeopleonbothsides,whowouldinotherrespectsappeartobereasonablemen,getupandcalmlyargueinfavorofviolence–asifitwerealegitimatesolution,likeanyother.Whatisreallyfrightening,whatreallyfillsyouwithdespair,istherealizationthatwhenitcomestothecrunch,wehavemadenoactualprogressatall.Wemaywearcollarsandtiesinsteadofwar-paint,butourinstinctsremainbasicallyunchanged.Thewholeoftherecordedhistoryofthehumanrace,thattediousdocumentationofviolence,hastaughtusabsolutelynothing.Wehavestillnotlearntthatviolenceneversolvesaproblembutmakesitmoreacute.Thesheerhorror,thebloodshed,thesufferingmeannothing.Nosolutionevercomestolightthemorningafterwhenwedismallycontemplatethesmokingruinsandwonderwhathitus.Thetrulyreasonablemenwhoknowwherethesolutionsliearefindingitharderandherdertogetahearing.Theyaredespised,mistrustedandevenpersecutedbytheirownkindbecausetheyadvocatesuchapparentlyoutrageousthingsaslawenforcement.Ifhalftheenergythatgoesintoviolentactswereputtogooduse,ifoureffortsweredirectedatcleaninguptheslumsandghettos,atimprovingliving-standardsandprovidingeducationandemploymentforall,wewouldhavegonealongwaytoarrivingatasolution.Ourstrengthissappedbyhavingtomopupthemessthatviolenceleavesinitswake.Inawell-directedeffort,itwouldnotbeimpossibletofulfilltheidealsofastablesocialprogramme.Thebenefitsthatcanbederivedfromconstructivesolutionsareeverywhereapparentintheworldaroundus.Genuineandlastingsolutionsarealwayspossible,providingweworkwithintheframeworkofthelaw.Beforewecanevenbegintocontemplatepeacefulco-existencebetweentheraces,wemustappreciateeachother'sproblems.Andtodothis,wemustlearnaboutthem:itisasimpleexerciseincommunication,inexchanginginformation."Talk,talk,talk,"theadvocatesofviolencesay,"allyoueverdoistalk,andwearenonethewiser."It'sratherlikethestoryofthefamousbarristerwhopainstakinglyexplainedhiscasetothejudge.Afterlisteningtoalengthyargumentthejudgecomplainedthatafterallthistalk,hewasnonethewiser."Possible,mylord,"thebarristerreplied,"nonethewiser,butsurelyfarbetterinformed."Knowledgeisthenecessaryprerequisitetowisdom:theknowledgethatviolencecreatestheevilsitpretendstosolve.
1.Whatisthebesttitleforthispassage?
[A]AdvocatingViolence.
[B]ViolenceCanDoNothingtoDiminishRacePrejudice.
[C]ImportantPeopleonBothSidesSeeViolenceAsaLegitimateSolution.
[D]TheInstinctsofHumanRaceAreThirstyforViolence.
2.Recordedhistoryhastaughtus
[A]violenceneversolvesanything.[B]nothing.[C]thebloodshedmeansnothing.[D]everything.
3.Itcanbeinferredthattrulyreasonablemen
[A]can'tgetahearing.
[B]arelookeddownupon.
[C]arepersecuted.
[D]Havedifficultyin
advocatinglawenforcement.
4."Hewasnonethewiser"means
[A]hewasnotatallwiseinlistening.
[B]Hewasnotatallwiserthannothingbefore.
[C]Hegainsnothingafterlistening.
[D]Hemakesnosenseoftheargument.
5.Accordingtheauthorthebestwaytosolveraceprejudiceis
[A]lawenforcement.[B]knowledge.[C]nonviolence.[D]Moppinguptheviolentmess.
Hewasluredintoacrimehewouldnot____________havecommitted.
Heresented_____towait.Heexpectedtheminister_____himatonce.
不属于新生儿特殊生理状态的是
患儿,5岁。因发热3周,双膝关节痛2周入院。查体:体温38℃,脉搏101次/分,咽稍充血,心肺(一),双膝关节红、肿,活动受限。实验室检查示:血沉98mm/小时,C反应蛋白阳性,心电图示P-R间期延长。为确诊需化验的指标是
某患者因上消化道大出血伴休克紧急入院抢救,护士采取的措施中不妥的是
患者,女性,40岁。胰腺癌术后第4天,患者出现心慌、出冷汗,测血糖为3.2mmol/L,护士正确的护理是
患者,女性,68岁。诊断为慢性呼吸衰竭,当天的实验室检查结果,下列结果提醒需要做进一步核实的是
患者,女性,25岁。诊断为滴虫性阴道炎,询问用自助坤洗器灌洗阴道的方法,护士应告知患者最适宜的冲洗液为是
下列符合早产儿外观特点的是
患者,男性,45岁。在野外工作时足底不慎被锈钉刺伤,出现金身肌肉强直性收缩,阵发性痉挛,来急诊就诊,考虑可能为破伤风。对破伤风患者的治疗和护理,下列措施正确的是
患者,男性,78岁。饮用红酒600ml后出现脸色潮红,轻微眩晕,语言增多,诊断为酒精中毒。下列医嘱中,对治疗酒精中毒无效的是
患者,女性,35岁。人院行经腹腔镜输卵管绝育术,术前护士发现以下哪种情况需及时告知医师考虑更改手术时间