问题 单项选择题

男,20岁,1周来发热食欲减退厌油恶心呕吐尿黄,黄疸急剧上升至血清总胆红素170μmol/L,凝血酶原活动度35%,近2天出现嗜睡烦躁不安伴牙龈出血,皮下瘀斑。肝肋下未扪及,该患者的诊断首先应想到:()

A.急性肝炎

B.中毒肝炎

C.急性重症肝炎

D.淤胆肝炎

E.慢性肝炎

答案

参考答案:C

解析:急性重型肝炎又称暴发型肝炎,发病多有诱因。以急性黄疸型肝炎起病,但病情发展迅猛.2周内出现极度乏力,严重消化道症状,出现神经、精神症状,表现为嗜睡、性格改变、烦躁不安、昏迷等,体检可见扑翼样震颤及病理反射,肝性脑病在Ⅱ度以上(按Ⅳ度划分)。黄疸急剧加深,胆酶分离,肝浊音界进行性缩小,有出血倾向,PTA小于40%,血氨升高,出现中毒性鼓肠,肝臭,急性肾衰竭(肝肾综合征)。即使黄疸很轻,甚至尚未出现黄疸,但有上述表现者,应考虑本病的诊断。

问答题

某汽车生产公司现有厂区位于市区北部,拥有2万辆小型汽车生产能力,拟投资30亿元新建年产8万辆小型汽车生产线,新厂区位于某市工业开发区内,地形简单,位于环境空气质量功能二类区,距市中心约15km。主要工程内容包括冲压车间、焊接车间、涂装车间、总装车间,以及配套的仓储物流、研发中心、办公楼等工程。在该生产项目投产后(2年建设期)淘汰现有厂区所有落后生产设备,现有厂区按照城市规划将建设为住宅区。

新建生产线主要原辅料消耗是冷轧汽车板、溶剂和涂料等,其中溶剂和涂料年用量2000 t(甲苯平均含量1.8%,二甲苯平均含量9.2%)。涂装车间工艺和现有厂区一样,为喷漆—晾干—烘干。主要废气污染源是涂装车间的烘干室、晾干室和喷漆室产生的含有机物的废气,主要污染物是甲苯和二甲苯,其中,喷漆室废气采用水旋喷漆室进行净化,废气中的漆雾分别经水幕阻挡和吸收过滤去除后,经风机从排气筒排放至室外,漆雾净化的循环水中加入了漆的凝聚剂,净化率>80%,外排二甲苯19.6t/a,甲苯量5.2t/a;烘干室排出的热废气进入燃烧装置,燃烧装置对有机物的净化率>90%,外排二甲苯7t/a,甲苯量0.6t/a;晾干室二甲苯排放量12.8t/a,甲苯3.5t/a,直接通过管道送排气筒外排。以上废气汇合后均经过1根28m高排气筒外排,废气总量30万m3/h,年运行时间300天,每天工作24小时。本项目生产工艺废水主要来自涂装车间,包括脱脂清洗废水、磷化清洗废水、电泳清洗废水和喷漆废水,主要污染物为COD、石油类、总镍、总锌和六价铬,排入厂区污水综合处理站与其他废水混合后,经生化处理进入城市污水处理厂,产生的工业固体废物有漆渣、磷化滤渣,污水处理站的污泥。目前,现有厂区COD排放总量尚不能满足当地环保局批复的总量指标,待新厂建成后,老厂区全部淘汰可满足总量要求。

[问题]

假如按照大气导则估算模式计算,二甲苯最大落地浓度出现在厂区办公楼区域,为0.105mg/m3,在距离源2000m、3000m位置(均在厂外)落地浓度分别为0.07mg/m3和0.03mg/m3,请判断该项目大气评价等级并给出判定依据,确定评价范围。(说明:《工业企业卫生标准》(TJ36—79)中居民区大气中二甲苯的最高容许浓度一次值标准为0.30mg/m3)

单项选择题

A child who has once been pleased with a tale likes, as a rule, to have it retold in almost the same words, but this should not lead parents to treat printed fairy stories as formal texts. It is always much better to tell a story than read it out of a book, and, if a parent can produce what, in the actual situation of the time and the child, is an improvement on the printed text, so much the better.

A charge made against fairy tales is that they harm the child by frightening him or making him sad thinking. To prove the latter, one would have to show in a controlled experiment that children who have read fairy stories were more often sorry for cruelty than those who had not. As to fears, there are, I think, some cases of children being dangerously terrified by some fairy story. Often, however, this arises from the child having heard the story once. Familiarity with the story by repetition turns the pain of fear into the pleasure of a fear faced and mastered.There are also people who object to fairy stories on the grounds that they are not objectively true, that giants, witches, two-headed dragons, magic carpets, etc. do not exist; and that, instead of being fond of the strange side in fairy tales, the child should be taught to learn the reality by studying history. I find such people, I must say so peculiar that I do not know how to argue with them. If their case were sound, the world should be full of mad men attempting to fly from New York to Philadelphia on a stick or covering a telephone with kisses in the belief that it was their beloved girl-friend. No fairy story ever declared to be a description of the real world and no clever child has ever believed that it was.

According to the passage, great fear can take place in a child when the story is()

A. in a realistic setting

B. heard for the first time

C. repeated too often

D. told in a different way