女性，24岁，发热腰痛3天，体温38℃，巩膜黄染，肝肋下1．0cm，脾肋下4cm，尿
题型：单项选择题
问题：
女性，24岁，发热腰痛3天，体温38℃，巩膜黄染，肝肋下1．0cm，脾肋下4cm，尿胆原（++），血清胆红素25μmol／L，HGB80g／L，WBC13．0×109／L，血象可见晚幼红细胞，骨髓增生明显活跃，中晚幼红细胞增多，粒红比0．8：1，最可能的诊断为（）
A.急性黄疸性肝炎
B.慢性肝炎急性发作
C.急性红白血病
D.自身免疫性溶血性贫血
E.巨幼细胞贫血
题型：单项选择题
[A] However, the production of TG is controlled by an enzyme that is, in turn, encoded by a gene called UGT2B17. This gene comes in two varieties, one of which has a part missing and therefore does not work properly. A person may thus have none, one or two working copies of UGT2B17, since he inherits one copy from each parent. Dr Schulze guessed that different numbers of working copies would produce different test results. She therefore gave healthy male volunteers whose genes had been examined a single 360mg shot of testosterone (the standard dose for legitimate medical use) and checked their urine to see whether the shot could be detected.
[B] Dr Schulze also says there is substantial ethnic variation in UGT2B17 genotypes. Two-thirds of Asians have no functional copies of the gene (which means they have a naturally low ratio of TG to EG), compared with under a tenth of Caucasians--something the anti-doping bodies may wish to take into account.
[C] The test usually employed for testosterone abuse relies on measuring the ratio of two chemicals found in the urine, testosterone glucuronide (TG) and epitestosterone glucuronide (EG). The former is produced when testosterone is broken down, while the latter is unrelated to testosterone metabolism, and can thus serve as a reference point for the test. Any ratio above four of the former to one of the latter is, according to official Olympic policy, considered suspicious and leads to more tests.
[D] The result was remarkable. Nearly half of the men who carried no functional copies of UGT2B17 would have gone undetected in the standard doping test. By contrast, 14% of those with two functional copies of the gene were over the detection threshold before they had even received an injection. The researchers estimate this would give a false-positive testing rate of 9% in a random population of young men.
[E] The agencies have had remarkable success. Testing for anabolic steroids (in other words, artificial testosterone) was introduced in the 1970s, and the incidence of cheating seems to have fallen dramatically as a result (see chart). The tests, however, are not foolproof. And a study just published in the Journal of Clinical Endocrinology & Metabolism by Jenny Jakobsson Schulze and her colleagues at the Karolinska Institute in Sweden suggests that an individual’s genetic make-up could confound them in two different ways. One genotype, to use the jargon, may allow athletes who use anabolic steroids to escape detection altogether. Another may actually be convicting the innocent.
[F] Cheating in sport is as old as sport itself. The athletes of ancient Greece used potions to fortify themselves before a contest, and their modern counterparts have everything from anabolic steroids and growth hormones to doses of extra red blood cells with which to invigorate their bodies. These days, however, such stimulants are frowned on, and those athletes must therefore run the gauntlet of organisations such as the World Anti-Doping Agency, which would rather they competed without resorting to them.
[G] In the meantime, Dr Schulze’ s study does seem to offer innocents a way of defending themselves. Athletes travelling to Beijing for the Olympic games later this year may be wise to travel armed not only with courage and the "spirit of Olympianism", but also with a copy of their genetic profile, just in case.
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