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患者女，49岁，因“发现左乳外上象限肿物1周”来诊。查体：左乳外上象限4cm×3cm肿物，质硬，活动，乳腺皮肤正常，双侧锁骨上区和腋窝未触及肿大淋巴结。双乳钼靶X线片：左乳外上象限肿物，恶性倾向。肿物细针穿刺活检：癌。胸部、腹部CT和骨扫描未见转移。入院后行左侧乳腺癌改良根治术。术后病理：左乳浸润性导管癌，Ⅱ级，3cm×2cm×2cm；ER（+++），PR（++），HER-2（－），腋淋巴结转移6/22。

关于患者锁骨上区放射治疗，叙述正确的有（提示拟行胸壁和锁骨上区放射治疗。）（）。

A.单前野向健侧给10°~15°角以避开脊髓、气管和食管

B.采用前后对穿野，以使靶区内剂量分布均匀

C.选择合适能量的高能X射线或电子线

D.计算深度一般为皮下3cm

E.常规分割时，总剂量为50Gy

F.与胸壁电子线野衔接处应有0.5~1.0cm的间隔，以免衔接处剂量过高

答案

参考答案：A, C, D, E

单项选择题 案例分析题

患者18岁，牙龈出血、溃疡数日，皮肤出现剥脱性皮炎，肝脾、淋巴结肿大，原始细胞35%。

急性白血病与慢性白血病的分类根据是（）

A.白血病细胞的数量

B.白血病细胞的类型

C.患者出血的严重程度

D.血红蛋白和血小板的数量

E.白血病细胞的分化程度
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单项选择题

For many people today, reading is no longer relaxation. To keep up their work they must read letters, reports, trade publications, interoffice communications, not to mention newspapers and magazines: a never ending flood of words. In (1) a job or advancing in one, the ability to read and comprehend (2) can mean the difference between success and failure. Yet the unfortunate fact is that most of us are (3) readers. Most of us develop poor reading (4) at an early age, and never get over them. The main deficiency (5) in the actual stuff of language itself—words. Taken individually, words have (6) meaning until they are strung together into phrases, sentences and paragraphs. (7) , however, the untrained reader does not read groups of words. He laboriously reads one word at a time, often regressing to (8) words or passages. Regression, the tendency to look back over (9) you have just read, is a common bad habit in reading. Another habit which (10) down the speed of reading is vocalization—sounding each word either orally or mentally as (11) reads.

To overcome these bad habits, some reading clinics use a device called an (12) , which moves a bar(or curtain) down the page at a predetermined speed. The bar is set at a slightly faster rate (13) the reader finds comfortable, in order to "stretch" him. The accelerator forces the reader to read fast, (14) word by word reading, regression and subvocalization practically impossible. At first (15) is sacrificed for speed. But when you learn to read ideas and concepts, you will not only read faster, (16) your comprehension will improve. Many people have found (17) reading skill drastically improved after some training. (18) Charlie Au, a business manager, for instance. His reading rate was a reasonably good 172words a minute (19) the training; now it is an excellent 1,378 words a minute. He is delighted that how he can (20) a lot more reading material in a short period of time.

第（3）空应选择（）

A．good

B．curious

C．poor

D．urgent
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