问题 多项选择题 共用题干题

患者女,26岁,农民。因无明显诱因出现烦躁、焦虑、抑郁、怀疑被人议论和被害5个月,2月前出现四肢近端阵发性发绀,腕、足、踝关节红、肿、热、痛并指端发麻,进行性出现皮肤变黑、色素沉着、双侧颜面部呈对称性皮疹,口唇色素沉着并增厚,面部及四肢皮肤红斑、脱发,间歇性低热,全身乏力,食欲降低,体重下降5kg。于2008年5月30日入院。

SLE病因不明,其中最可能的因素包括以下哪些()。

A.遗传因素

B.性激素

C.女性孕期

D.环境因素(如日光、感染、食物等)

E.某些药物

F.青春期女性

G.更年期妇女

答案

参考答案:A, B, C, D, E

单项选择题
填空题

[A] However, the production of TG is controlled by an enzyme that is, in turn, encoded by a gene called UGT2B17. This gene comes in two varieties, one of which has a part missing and therefore does not work properly. A person may thus have none, one or two working copies of UGT2B17, since he inherits one copy from each parent. Dr Schulze guessed that different numbers of working copies would produce different test results. She therefore gave healthy male volunteers whose genes had been examined a single 360mg shot of testosterone (the standard dose for legitimate medical use) and checked their urine to see whether the shot could be detected.

[B] Dr Schulze also says there is substantial ethnic variation in UGT2B17 genotypes. Two-thirds of Asians have no functional copies of the gene (which means they have a naturally low ratio of TG to EG), compared with under a tenth of Caucasians--something the anti-doping bodies may wish to take into account.

[C] The test usually employed for testosterone abuse relies on measuring the ratio of two chemicals found in the urine, testosterone glucuronide (TG) and epitestosterone glucuronide (EG). The former is produced when testosterone is broken down, while the latter is unrelated to testosterone metabolism, and can thus serve as a reference point for the test. Any ratio above four of the former to one of the latter is, according to official Olympic policy, considered suspicious and leads to more tests.

[D] The result was remarkable. Nearly half of the men who carried no functional copies of UGT2B17 would have gone undetected in the standard doping test. By contrast, 14% of those with two functional copies of the gene were over the detection threshold before they had even received an injection. The researchers estimate this would give a false-positive testing rate of 9% in a random population of young men.

[E] The agencies have had remarkable success. Testing for anabolic steroids (in other words, artificial testosterone) was introduced in the 1970s, and the incidence of cheating seems to have fallen dramatically as a result (see chart). The tests, however, are not foolproof. And a study just published in the Journal of Clinical Endocrinology & Metabolism by Jenny Jakobsson Schulze and her colleagues at the Karolinska Institute in Sweden suggests that an individual’s genetic make-up could confound them in two different ways. One genotype, to use the jargon, may allow athletes who use anabolic steroids to escape detection altogether. Another may actually be convicting the innocent.

[F] Cheating in sport is as old as sport itself. The athletes of ancient Greece used potions to fortify themselves before a contest, and their modern counterparts have everything from anabolic steroids and growth hormones to doses of extra red blood cells with which to invigorate their bodies. These days, however, such stimulants are frowned on, and those athletes must therefore run the gauntlet of organisations such as the World Anti-Doping Agency, which would rather they competed without resorting to them.

[G] In the meantime, Dr Schulze’ s study does seem to offer innocents a way of defending themselves. Athletes travelling to Beijing for the Olympic games later this year may be wise to travel armed not only with courage and the "spirit of Olympianism", but also with a copy of their genetic profile, just in case.

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