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急诊危重患者的代谢特点有哪些?

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急诊危重病患者均存在应激代谢,表现为持续的高代谢和高分解,能量消耗剧增和迅速发展的营养不良。其代谢特点为:(1)蛋白质分解加速:出现负氮平衡,故临床表现为肌肉萎缩。(2)血糖升高和糖耐量异常。(3)脂肪分解代谢加速:血中甘油三酯升高,产生脂肪酸和甘油可直接氧化供能,同时还产生酮体作为能源。(4)能量消耗增加。(5)其他代谢变化:休克时体内儿茶酚胺、促肾上腺素、胰高血糖素、生长激素等分泌增加,这是机体应激的代偿性反应;感染性休克时,某些细胞因子,如肿瘤坏死因子、白介素1、白介素6等增加。

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Bill Gates receives honorary knighthood


Britain’s Queen Elizabeth stands with Microsoft chairman and philanthropist Bill Gates after presenting him with an honorary knighthood at Buckingham Palace, London, March 2, 2005.
Sir Bill Not quite. Proclaiming himself "humbled and delighted," Microsoft founder Bill Gates received an honorary knighthood Wednesday from Queen Elizabeth Ⅱ—an accolade that allows the recipient to use "KBE" after his (1) , but not to put "Sir" in front of it.
One of the world’s richest men, Gates, 49, was (2) honored for his charitable activities around the world and his contribution (3) enterprises in Britain.
Past recipients of the honorary knighthood (4) from Irish singer Bob Geldof to former U.S. President Ronald Reagan.
"This (5) is particularly poignant given the deep connections Microsoft enjoys (6) the United Kingdom," said Gates, whose company employs about 2000 people in (7) .
Gates’ royal honor—bestowed by the queen on the advice of the (8) —was announced in January 2004, but a "mutually convenient" date to (9) it had not been available until now.
British recipients of knighthoods are entitled to be (10) with a "Sir" before their names. The honor was long the (11) of senior soldiers, judges and other servants of the state, but recent years have seen the creation of Sir Paul McCartney, (12) Mick Jagger and Sir Elton John.
As an American, Gates is not entitled to use (13) before his name, but he can put the initials KBE—Knight Commander of the (14) Empire—after his name.
Gates joins a roster of American (15) that includes former presidents Reagan and George H.W. Bush, comedian (16) Hope, retired U.S. Army Gen. Tommy Franks and former Secretary of (17) Colin Powell.
Gates said he was proud of what he called (18) "special relationship" with Britain.
"The U.K. was the first country in (19) Microsoft set up a subsidiary outside the U.S., and our experience in the (20) has been significant in shaping our international growth," he said.
Microsoft’s British facilities include Research Cambridge, a laboratory established in 1997 in the university town that employs 80 scientists. In 2000, the Bill & Melinda Gates Foundation announced a donation of $210 million to Cambridge University to create a scholarship program for graduate students from outside Britain.

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