问题 多项选择题

患者男性,48岁。上腹饱胀不适、纳差乏力1月余,体重明显减轻,近1周来牙龈时有出血。2年前发现乙肝大三阳,肝功能异常,白球比(A/G)下降。体检:腹水征阳性、肝肋下7cm,质硬,表面结节状,边缘不规则,脾肋下3cm,双下肢凹陷性水肿。实验室检查:血常规:WBC12.8×109/L,RBC3.08×1012/L,PLT35×109/L。肝肾功能:TP56.9g/L,ALB24.0g/L,球蛋白32.9g/L,A/G0.7,TBil93,9μmol/L,DBil46.7μmol/L。AFP>1000μg/L。腹水细胞学:未找到癌细胞。B超:肝右叶内见10cm×12cm强回声光团。治疗过程中因高热、感染、呕血、黑便、少尿、昏迷而死亡。

对于该患者的诊断应包括().

A.转移性肝癌

B.原发性肝炎

C.乙型肝癌

D.肝硬化

E.肝脓肿

F.肝结核

答案

参考答案:B, C, D

解析:诊断依据:①症状:腹胀,乏力,纳差等;②体征:腹水,肝脾肿大,下肢水肿,体重下降等;③影像学:B超提示肝脏占位性病变;④既往有肝炎病史;⑤AFP高>1000μg/L,肝功能不良。诊断为原发性肝癌,但还应包括乙型肝炎、肝硬化。根据题干,可能的死因包括肝功能衰竭、感染、消化道出血、休克、肝性脑病。因肝肿块大小是10cm×12cm,故为巨块型。

选择题
单项选择题

Until the late 1940s, when television began finding its way into American homes, companies relied mainly on print and radio to promote their products and services. The advent of television (1) a revolution in product and service. Between 1949 and 1951, advertising on television grew 960 percent. Today the Internet is once again (2) promotion. By going online, companies can communicate instantly and directly with prospective customers. (3) on the World Wide Web includes advertising, sponsorships, and sales promotions (4) sweepstakes, contests, coupons, and rebates. In 1996 World Wide Web advertising revenues (5) $ 300 million.

Effective online marketers don’t (6) transfer hard-copy ads to cyberspace. (7) sites blend promotional and non-promotional information indirectly delivering the advertising messages. To (8) visits to their sites and to create and (9) customer loyalty, companies change information frequently and provide many opportunities for (10) .

A prototype for excellent (11) promotion is the Ragu Web site. Here visitors can find thirty-six pasta recipes, take Italian lessons, and view an Italian film festival, (12) they will find no traditional ads. (13) subtle is the mix of product and promotion that visitors hardly know an advertising message has been (14) . Sega of America, maker of computer games and hardware, uses its Web site for a (15) of different promotions, such as (16) new game characters to the public and supplying Web surfers the opportunity to (17) games. Sega’s home page averages 250,000 visits a day. To heighten interest in the site, Sega bought an advertising banner on Netscape (18) increasing site visits by 15 percent. Online (19) in Quaker Oats’ Gatorade promotion received a free T-shirt in exchange for answering a few questions. Quaker Oats reports that the online promotion created product (20) and helped the company know its customers better.

Read the following text. Choose the best word(s) for each numbered blank and mark A, B, C or D on ANSWER SHEET 1.18()

A.thereby

B.though

C.nonetheless

D.hereafter