问题 问答题 案例分析题

某男,42岁,患者因低热、消瘦、乏力及食欲减退来医院就诊。触诊有胸骨压痛和脾中度肿大,血象检查可见白细胞数可高达60×10/L,主要为中性中幼粒、晚幼粒和杆状核细胞。原粒细胞不超过5%,嗜酸和嗜碱粒细胞增多,血中偶见幼红细胞。骨髓象:粒细胞增生极度活跃,粒红比例12:1,原粒细胞5%,早幼粒7%,中幼粒占21%、晚幼粒25%和杆状核粒细胞31%,分叶核13%。染色体检查可见t(9;22)(q34;q11)染色体。试分析该病例。

答案

参考答案:

该病人是较典型的CML患者,CML病人脾肿大最显著的临床表现,实验室检查血象明显增高,骨髓象检查以中、晚幼粒细胞增殖为主,染色体检查有90%左右的患者存在t(9;22)(q34;q11)染色体,即Ph染色体,如果进一步做细胞化学染色NAP积分则显著降低或为0。

阅读理解

It was so dark outside the car window that it was hard to see anything.

“ Can I have a carrot, Mom?” Bruce asked.

“I don’t have any carrots,” his mom said. “How about an apple?”

“No,” said Bruce. “It has to be a carrot.”

“Why do you want a carrot?” asked his mom

“You always say carrots help your eyes.” said Bruce. “If I eat one now, it might help me see in the dark.”

Would eating a carrot really help Bruce? What is special about carrots? What makes a carrot special is its color. Carrots are orange because they contain(包含) bta-carotene( 胡萝卜素). Beta-carotene is a way of saying vitamin A. Your eyes need vitamin A. It helps them work.

When light hits your eye, very small parts inside turn the light into messages. The messages go to your brain(大脑), and then you know what you’re looking at. Your eye can only turn light into messages when it has a special chemical(化学物质). Your eyes use vitamin A to make the special chemical. Every time your eye changes light into messages, a little bit of the chemical is used up. By the end of the day, you’ve looked at hundreds of things. That uses up a lot of the chemical. Your eyes need to make more.

What should you eat if you don’t like carrots? Don’t worry. Other fruits and vegetables have vitamin A, too. The secret is in their color. Most orange or red fruits and vegetables contain beta-carotene, or vitamin A, Sweet vegetable, red peppers(胡椒), Mangoes(芒果) are a few foods that have the same orange secret.

小题1: Bruce wanted a carrot because he thought _______.

A. he liked it

B. it could help him see in the dark

C.  it was sweet and delicious

小题2:How does vitamin A help your eyes work?

A. The special chemical can stop your eyes from using up vitamin A.

B. The special chemical is used to make Vitamin A which turns the light into messages

C. Vitamin A is used to make the special chemical which turns light into messages.

小题3: Which of the following is NOT true according to the passage?

A. Carrots are orange because they store beta-carotene.

B. Any food which is orange or red must have some Vitamin A.

C. Most fruits that are orange or red store some beta-carotene or Vitamin A.

小题4: Sweet vegetable, red peppers, and mangoes don’t have the same orange secret, do they?

A. No, they don’t.     B. Yes, they do.     C. I’m not sure.

小题5: The passage mainly tells us that _______.

A. we can’t see in the dark unless we eat many carrots every day

B. we can’t see unless we eat a lot of orange or red food every day

C. we should eat some food containing vitamin A so that we can see well

名词解释