问题 单项选择题 A1/A2型题

有关烧伤焦痂切开减张,以下哪项是正确的()。

A.凡肢体、躯干、颈部环形焦痂束缚,均可行焦痂切开减张术

B.以深Ⅱ度创面为主的烧伤患者,即使是环匝状烧伤,也不需行焦痂切开减张术

C.非环匝状烧伤创面,不需行焦痂切开减张术

D.行焦痂切开减张术时,往往将表层坏死皮肤全层切开即可

E.必须在麻醉下进行

答案

参考答案:A

解析:深Ⅱ度烧伤创面,有时也需行焦痂切开减张术,尤其是环匝形烧伤创面;应该高度警惕,不可延误,以免给患者带来难以弥补的损失。即使非环匝形烧伤创面,有时也会出现严重的束缚、压迫症状,需行焦痂切开减张术,尤其是创面较深等情况。行焦痂切开减张术时,往往需将表层坏死皮肤全层切开,直至深筋膜,甚至达肌膜层,才能保证减张充分。焦痂切开减张,一般不需麻醉;紧急情况下,更应争分夺秒,及时减张,以减轻患者的损失。

解答题
单项选择题

In his book The Tipping Point, Malcolm Gladwell argues that "social epidemics" are driven in large part by the actions of a tiny minority of special individuals, often called influentials, who are unusually informed, persuasive, or well connected. The idea is intuitively compelling--we think we see it happening all the time--but it doesn’t explain how ideas actually spread.

The supposed importance of influentials derives from a plausible-sounding but largely untested theory called the "two-step flow of communication": Information flows from the media to the influentials and from them to everyone else. Marketers have embraced the two-step flow because it suggests that if they can just find and influence the influentials, those select people will do most of the work for them. The theory also seems to explain the sudden and unexpected popularity of certain looks, brands, or neighborhoods. In many such cases, a cursory search for causes finds that some small group of people was wearing, promoting or developing whatever it is before anyone else paid attention. Anecdotal evidence of this kind fits nicely with the idea that only certain special people can drive trends.

In their recent work, however, some researchers have come up with the finding that influentials have far less impact on social epidemics than is generally supposed. In fact, they don’t seem to be required at all.

The researchers’ argument stems from a simple observation about social influence, with the exception of a few celebrities like Oprah Winfrey--whose outside presence is primarily a function of media, not interpersonal influence--even the most influential members of a population simply don’t interact with that many others. Yet it is precisely these non-celebrity influentials who, according to the two-step-flow theory, are supposed to drive social epidemics, by influencing their friends and colleagues directly. For a social epidemic to occur, however, each person so affected must then influence his or her own acquaintances, who must in turn influence theirs, and so on; and just how many others pay attention to each of these people has little to do with the initial influential. If people in the network just two degrees removed from the initial influential prove resistant, for example, the cascade of change won’t propagate very far or affect many people.

Building on the basic truth about interpersonal influence, the researchers studied the dynamics of populations, manipulating a number of variables relating to people’s ability to influence others and their tendency to be influenced.

The author suggests that the "two-step-flow theory" ()

A. serves as a solution to marketing problems

B. has helped explain certain prevalent trends

C. has won support from influentials

D. requires solid evidence for its validity