男孩，3岁，生后发现口唇青紫，活动后加剧，半年内曾晕厥2次，均于吃奶或哭闹后发作，经2～3分钟自行恢复。今又出现晕厥，持续5分钟，即来就诊。体检：神志半清，发绀明显，轻度杵状指、趾，血压10/7kpa，心率102次/分，胸骨左缘第2～3肋间闻及Ⅱ～Ⅲ级收缩期杂音，无震颤，肺动脉瓣第2音减弱。
最有效的抢救措施是（）
A.取胸膝位
B.皮下注射吗啡
C.加压吸氧
D.静脉滴注心得安
E.静脉滴注碳酸氢钠
参考答案：D
TEXT B
| Whenever two or more unusual traits or situations are found in the same place, it is tempting to look for more than a coincidental relationship between them. The high Himalayas and the Tibetan plateau certainly have extraordinary physical characteristics and the cultures that are found there are also unusual, though not unique. However there is no intention of adopting Montesquieu’s view of climate and soil as cultural determents. The ecology of a region merely poses some of the problems faced by the inhabitants of the region, and while the problems facing a culture are important to its development, they do not determine it. The appearance of the Himalayas during the late Tertiary Period and the accompanying further raising of the previously established rages had a marked effect on the climate of the region. Primarily, of course, it blocked the Indian monsoon from reaching Central Asia at all. Secondly, air and moisture from other directions were also reduced. Prior to the raising of the Himalayas, the land now forming the Tibetan uplands had a dry, continental climate with vegetation and animal’s life similar to that of much of the rest of the region on the same parallel, but somewhat different from that of the areas farther north, which were already drier. With the coming of the Himalayas and the relatively sudden drying out of the region, there was a severe thinning out of the animal and plant population. The ensuing incomplete Pleistocene glaciations had a further thinning effect, but significantly did not wipe out life in the area. Thus after the end of the glaciations there were only n few varieties of life extant from the original continental species. Isolated by the Kunlun range from the Tarim basin and Turfan depression, species that had already adapted to the dry steppe climate, and would otherwise have been expected to flourish in Tibetan, the remaining native fauna and flora multiplied. Armand described the Tibetan fauna as not having great variety, but being "striking" in the abundance of the particular species that are present. The plant life is similarly limited in variety, with some observers finding no more than seventy varieties of plants in even the relatively fertile Eastern Tibetan valleys, with fewer than ten food crops. Tibetan "tea" is a major staple, perhaps replying the unavailable vegetables. The difficulties of living in an environment at once dry and cold, and populated with species more usually found in more hospitable climates, are great. These difficulties may well have influenced the unusual polyandrous societies typical of the region. Lattimore sees the maintenance of multi-husband households as being preserved from earlier forms by the harsh conditions of the Tibetan uplands, which permitted no experimentation and "froze" the cultures that came there. Kawakiwa, on the other hand, sees the polyandry as a way of easily permitting the best householder to become the head husband regardless of age. His detailed studies of the Bhotea village of Tsumje do seem to support this idea of polyandry as a method of talent mobility in a situation where even the best talent is barely enough for survival. In sum, though arguments can be made that a pre-existing polyandrous system was strengthened and preserved (insofar as it has been) by the rigors of the land, it would certainly be an overstatement to lay causative factors of any per nature to the ecological influences in this case. |
The author’s knowledge of Tibet is probably ______.
A．based on firsthand experience
B．the result of lifelong studies
C．derived from books only
D．limited to geological history