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问题 单项选择题

患者男，25岁，因突发头晕、心慌、面色苍白就诊。查体：神志清醒、面色苍白，P120次/分，BP70/50mmHg，上腹部压痛，反跳痛。B超提示腹腔积液，脾脏增大并不均质回声；腹腔穿刺抽出不凝血。9天前患者不慎自4米高处坠落，左侧身体先落地，感左侧腹疼痛，休息2天后继续工作。最可能的诊断是（）

A.肝破裂

B.肝被膜下破裂

C.延迟性脾破裂

D.胃十二指肠破裂

E.上消化道出血

答案

参考答案：C

解析：脾脏是腹内脏器中最易受伤的器官，脾破裂根据损伤的范围分中央型破裂、被膜下破裂和真性破裂。前两种因被膜完整，出血量受到限制，可无失血性休克的表现。此时仍有潜在的延迟性破裂可能性，如不注意绝对卧床休息，即使在微弱的外力作用下，也可发生严重的内出血。延迟性脾破裂通常发生在受伤后1～2周。故答案应选C。

选择题

X与Y两元素的单质能化合生成XY型的离子化合物，则X、Y可能属于(    )

A．ⅠA族和ⅣA族

B．ⅡA族和ⅥA族

C．ⅠA族和ⅦA族

D．ⅥA族和ⅦA族
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填空题

Part of the debate about culture revolves around issues of perspective and ownership. Within a nation such (1) the United States—a nation whose cultural heritage includes elements from every corner of the world (2) are a great many perspectives coexisting and intertwining in the cultural fabriC．When we all ask (3) as individuals, "what belongs to me, to my culture " we are rewarded with a spectacular variety of (4) ; in this way, different perspectives and ownership of different cultural traditions enriches everyone. But when we ask " (5) belongs to us, to our culture " we ask a much harder question. Do the people of the (6) States, or of any culturally complex human society, necessarily share common cultural elements If so, who gets (7) decide what those elements are
This debate is a crucial one in many cultures throughout the world (8) . In the US, the debate promises to impact the way we educate our children—that is, (9) manner and shape in which culture reproduces itself—and the way we write our laws. In (10) countries, equally crucial issues are at stake.
For many people, what is at stake is the character (11) US national identity. Hirsch argues that this identity needs to become less culturally fragmented; others, like Walker, (12) that the national character gets its strength from cultural diversity, from the freedom (at home and in (13) ) to celebrate, honor, and reproduce different cultural traditions. Those who take this latter view follow the reasoning (14) Shweder, arguing that we need to accept that there are multiple valid cultural perspectives and that two (15) perspectives can both be valid even though they might contradict one another.
Recognize that the position you (16) in this debate about culture—whatever position you take—is a political one with implications (17) what we should value, what we should praise, what we should accept, what we should teach. When (18) reflect on this debate, when you contribute your own voice to the discussion, try to be (19) of the implications that follow from your position. When you listen to the voices of others, try to (20) with awareness, deciding for yourself what is at stake and how their positions relate to your own.
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