患者男，42岁，饱餐后上腹部剧痛6h，伴恶心、呕吐，呕吐物为胃内容物，吐后腹痛更加剧，如刀割样。查体：体温37.8℃，脉搏124次/min，血压80/50mmHg，呼吸25次/min，痛苦面容，巩膜轻度黄染，腹胀，全腹肌紧张，压痛及反跳痛，上腹部为重，肠鸣音消失，肝浊音区存在，移动性浊音阳性，右下腹穿刺得淡红色血性液体，白细胞12×10/L，血淀粉酶3200U/L，血脂肪酶1600U/L，血钙1.5mmol/L。
需要的治疗是（）（提示此患者进一步治疗后病情缓解不明显，同时影像学检查发现胆囊、胆总管结石。）
A.广谱高效抗生素治疗
B.急诊手术胆囊切除、胆管引流
C.经皮经肝胆囊穿刺引流术
D.十二指肠 * * 切开取石/引流术
E.腹腔穿刺引流
F.急诊胰腺坏死组织清除引流术
参考答案：A, D, E
Directions: For each blank in the following passage there are four words or phrases marked A, B, C and D. Fill in each blank with the word or phrase that best fits the context. As we all know, Chinese handwriting has infinite power to express differences of character and cultivation. But we have to admit that traditional handwriting has become a __50__ art, now that kids start using keyboards as soon as they begin school. However, writing things out by hand may be a __51__ way we train our brains, several studies suggest. Many psychologists think that handwriting can make you __52__! Writing by hand is different from __53__ because it requires using strokes to create a letter, __54__ just selecting the whole letter by touching a key, says Virginia Berninger, a professor of psychology at the University of Washington. These __55__ movements activate large regions of the brain __56__ in thinking, memory, and language. Handwriting helps children learn letters and shapes, improves their composition of ideas, and may also __57__ fine-motor skills development. A study by Berninger found that in grades two, four, and six, children wrote more words, faster, and expressed more __58__ when writing essays by hand than when typing on a keyboard. A separate study by researchers at Indiana University found that children who practiced printing by hand had more active__59__than kids who __60__ looked at letters. It’s not just children who __61__ from writing things out by hand, says a study in the Journal of Cognitive Neuroscience. Adults learning a new language remember its __62__ better if they write them out by hand than if they produce them with a keyboard. As more people __63__ their days on the computer, says neuroscientist P. Murali Doraiswamy of Duke University, “__64__ people in handwriting skills could be a useful cognitive exercise.”
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