男性，45岁。查体发现肝硬化5年。3天前与朋友聚餐时出现呕血，鲜红色，量约1000ml。患者出现头晕、心慌、出冷汗等。经输血、补液和应用止血药物治疗后病情好转，血压和心率恢复正常。1天前出现睡眠障碍，并出现幻听和言语不清，化验检查示：血氨130g．g/dl，血糖5.6mmol/L，尿素氮7.2mmol/L。

患者最可能的诊断是

A．尿毒症

B．脑血管意外

C．乙型脑炎

D．肝性脑病

Alice Walker's graphic depiction of the lives of Black people in the south has established her as one of the most promising contemporary writers in the states.

A．optimistic

B．humorous

C．somber

D．vivid