男性,41岁,不规则发热3个月,右肋下胀痛,颈肩部见蜘蛛痣,肝肋下4cm,质硬轻触痛

题型:单项选择题

问题:

男性,41岁,不规则发热3个月,右肋下胀痛,颈肩部见蜘蛛痣,肝肋下4cm,质硬轻触痛,脾肋下一指,血白细胞数4.8x109/L,中性60%,GPT60u,γ-GT为400U,AKP 350U(正常35~150),最大可能是

A.肝炎后肝硬化
B.肝脓肿
C.慢性活动性肝炎
D.肝硬化并肝细胞癌
E.慢性胆囊炎

考点:临床执业医师内科学肝脏疾病(二)
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( )的税额随课税对象实物量的变化而变化,不受价格影响,在商品经济不发达时期曾被普遍采用,在现代市场经济条件下,只宜对少数税种采用。

A.直接税

B.间接税

C.从量税

D.从价税

题型:单项选择题

由正中神经损伤引起的肌肉麻痹和皮肤感觉障碍是()

A.小鱼际肌麻痹

B.大鱼际肌麻痹

C.手掌桡侧三个半手指感觉障碍

D.手背桡侧两个半手指感觉障碍

E.手掌尺侧一个半手指感觉障碍

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Addiction is such a harmful behavior, in fact, that evolution should have long ago weeded it out of the population: if it’s hard to drive safely under the influence, imagine trying to run from a saber-toothed tiger or catch a squirrel for lunch. And yet, says Dr. Nora Volkow, director of NIDA and a pioneer in the use of imaging to understand addiction, "the use of drugs has been recorded since the beginning of civilization. Humans in my view will always want to experiment with things to make them feel good."

That’s because drugs of abuse co-opt the very brain functions that allowed our distant ancestors to survive in a hostile world. Our minds are programmed to pay extra attention to what neurologists call salience—that is, special relevance. Threats, for example, are highly salient, which is why we instinctively try to get away from them. But so are food and sex because they help the individual and the species survive. Drugs of abuse capitalize on this ready-made programming. When exposed to drugs, our memory systems, reward circuits, decision making skills and conditioning kick in—salience in overdrive—to create an all consuming pattern of uncontrollable craving. "Some people have a genetic predisposition to addiction," says Volkow. "But because it involves these basic brain functions, everyone will become an addict if sufficiently exposed to drugs or alcohol."

That can go for nonchemical addictions as well. Behaviors, from gambling to shopping to sex, may start out as habits but slide into addictions. Sometimes there might be a behavior-specific root of the problem. Volkow’s research group, for example, has shown that pathologically obese people who are compulsive eaters exhibit hyperactivity in the areas of the brain that process food stimuli—including the mouth, lips and tongue. For them, activating these regions is like opening the floodgates to the pleasure center. Almost anything deeply enjoyable can turn into an addiction, though.

Of course, not everyone becomes an addict. That’s because we have other, more analytical regions that can evaluate consequences and override mere pleasure seeking. Brain imaging is showing exactly how that happens. Paulus, for example, looked at drug addicts enrolled in a VA hospital’s intensive four-week rehabilitation program. Those who were more likely to relapse in the first year after completing the program were also less able to complete tasks involving cognitive skills and less able to adjust to new rules quickly. This suggested that those patients might also be less adept at using analytical areas of the brain while performing decision-making tasks. Sure enough, brain scans showed that there were reduced levels of activation in the prefrontal cortex, where rational thought can override impulsive behavior. It’s impossible to say if the drugs might have damaged these abilities in the relapsers an effect rather than a cause of the chemical abuse—but the fact that the cognitive deficit existed in only some of the drug users suggests that there was something innate that was unique to them. To his surprise, Paulus found that 80% to 90% of the time, he could accurately predict: who would relapse within a year simply by examining the scans.

Another area of focus for researchers involves the brain’s reward system, powered largely by the neurotransmitter dopamine. Investigators are looking specifically at the family of dopamine receptors that populate nerve cells and bind to the compound. The hope is that if you can reduce the effect of the brain chemical that carries the pleasurable signal, you can loosen the drug’s hold.

According to Dr. Nora Volkow, the use of drugs()

A. is a very harmful behavior that evolution failed to get rid of

B.makes it hard for people to drive safely under its influence

C. has to do with people’s desire to achieve pleasant feelings

D.is understandable behavior because it dates back long ago

题型:单项选择题

在双侧电源供电或环形供电线路中,必须采用()

A.速断保护

B.过流保护

C.方向保护

D.任何一种保护

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EPS砌块标准尺寸为()

A.2m×0.5m×0.5m

B.2m×2m×1m

C.2m×lm×0.5m

D.1m×lm×0.5m

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