问题 单项选择题 案例分析题

患者男,62岁。慢性萎缩性胃炎病史,定期复查胃镜时角切迹后壁侧病变(范围约2cm×2.5cm)见下图。

对该病变行胃镜下活检病理组织学检查,提示重度异型增生,最佳处理方法是()。

A.暂不处理,半年后复查胃镜决定下一步处理

B.EMR

C.EPMR

D.ESD

E.APC

F.外科手术

答案

参考答案:D

解析:

1.该病变有隆起,中心略凹陷,小凹结构不规整,中心处小凹结构消失,在萎缩胃黏膜背景下要考虑异型增生或早期癌可能。

2.放大胃镜有助于进一步了解胃小凹形态,病变中心凹陷处活检能提高诊断阳性率,腹部CT和超声胃镜检查有助于了解病变浸润情况。

3.50%~90%的重度异型增生经过3个月至2年可进展至早期癌,一旦发现应该进行处理。应该说目前EMR与ESD没有绝对的界限,完整、安全切除病变且少复发与不复发是我们主要关注的要点。≥2cm的巨大平坦病变经ESD一次性切除是最佳选择。

4.A、D都是组织学病变完整切除的标准,以D更为客观。

阅读理解

阅读理解。

     It is widely accepted that television is playing an important part in people's lives. But, there is a heated

discussion as to whether television does good or harm.

     Television keeps one learning more about present events, allows one to follow the most re-cent

developments in politics and science, and offers various programs which are.both instructive and exciting.

The most distant countries, the strangest customs and the most attractive scenes of nature are brought right

into one's room or house.

     However, some people insist that television is bad rather than good. They argue that it has brought about

many serious problems. The major one is its effects on young people. Children are now so used to getting

their information and entertainment from television that their ability to read and write as well as physical ability

has been greatly weakened. Even worse than that, vulgar( 庸俗的) advertisements and poor programs may

develop their bad tastes, shape their view points badly towards human life to such a degree that their minds

might be destroyed.

      In a word, television has both advantages and disadvantages. Whatever effects it has, one point is certain,

television in itself is neither good nor bad. It is the use to which it is put that decides its value to society.

1. What are people discussing nowadays?

    ___________________________________

2. What are the advantages television has brought us? (至少2点)

     ___________________________________

3. Why do some people think television is bad rather than good?

    ___________________________________

4. It is the use to which it is put that decides its value to society.

    ___________________________________

5. What's your opinion about television? 

    ___________________________________

多项选择题