问题 多项选择题

患者女性,54岁:上腹部隐痛不适1年半,加重3个月入院,上腹痛不规则,偶伴嗳气,饭后饱胀。近一个月体重减轻3公斤,大小便正常,原有慢性萎缩性胃炎病史,体验:消瘦,左锁骨上可扪及一约花米大小淋巴结,质中偏硬。腹平软,剑突下偏左轻压痛,左上腹近剑突下似可扪及一肿块,界线不清,肝脾肋下未及,腹水征(-)。

术中见胃癌主要在胃体部,哪些淋巴结分站与本病例相符?()

A.第一站:1、3、4、5、6组淋巴站

B.第二站:2、7、8、9、10、11组淋巴结

C.第三站:12、13、14、15、16组淋巴结

D.第一站:1、2、3、4、5组淋巴结

E.第M站:6、7、8、9、10组淋巴结

F.第三站:11、12.13、14、15、16组淋巴结

G.第四站:17、18组淋巴结

答案

参考答案:A, B, C

解析:胃周围的湃巴结可分为18组:1贲门右,2贲门左.3胃小弯.4胃大弯.5幽门上,6幽门下.7胃左动脉旁.8肝总动脉旁.9腹腔动脉旁.10脾门.11脾动脉旁.12肝十二指肠韧带鞘内.16腹主动脉旁.13胰头后.14肠系膜根.15结肠中动脉周围.17胰头前.18胰下.胃肿瘤如在全胃则第一站淋巴结为:1~6;第二站为:7~11:第三站为:12~18.远侧部胃癌第一站:3~6:第二站:1.7~9:第三站:2.10~18.胃体部胃癌第一站淋巴结:1.3~6:第二站:2.7~11:第三站:12~16.近侧部胃癌第一站淋巴结:1~4:第二站:5~11:第三站:12~18.此病人为胃体部癌,故第1、2、3项备选答案正确。

单项选择题
单项选择题

In 1998 consumers could purchase virtually anything over the Internet. Books, compact discs, and even stocks were available from World Wide Web Sites that seemed to spring up almost daily. A few years earlier, some people had predicted that consumers accustomed to shopping in stores would be reluctant to buy things that they could not see or touch in person. For a growing number of time-starved consumers, however, shopping from their home computer was proving to be a convenient alternative to driving to the store.

A research estimated that in 1998 US consumers would purchase $ 7.3 billion of goods over the Internet, double the 1997 total. Finding a bargain was getting easier, owing to the rise of online auctions and Web sites that did comparison shopping on the Internet for the best deal.

For all the consumer interest, retailing in cyberspace was still a largely unprofitable business, however. Internet pioneer Amazon. com, which began selling books in 1995 and later branched into recorded music and videos, posted revenue of $153.7 million in the third quarter, up from $37.9 minion in the same period of 1997. Overall, however, the company’s loss widened to $45.2 million from $9.6 million, and analysts did not expect the company to turn a profit until 2001. Despite the great loss, Amazon. com had a stock market value of many billions, reflecting investors’ optimism about the future of the industry.

Internet retailing appealed to investors because it provided an efficient means for reaching millions of consumers without having the cost of operating conventional stores with their armies of salespeople. Selling online carried its own risks, however. With so many companies competing for consumers’ attention, price competition was intense and profit margins thin or nonexistent. One video retailer sold the hit movie Titanic for $9.99, undercutting the $19.99 suggested retail price and losing about $6 on each copy sold. With Internet retailing still in its initial stage; companies seemed willing to absorb such losses in an attempt to establish a dominant market position.

Investors are interested in Internet retailing because()

A. selling online involves little risk

B. Internet retailing is in its initial stage

C. they can make huge profits from it

D. it can easily reach millions of consumers