问题 问答题

原发性胆汁性肝硬化有哪些临床表现

答案

参考答案:原发性胆汁性肝硬化的临床表现:本病绝大多数见于中年女性,起病隐匿、缓慢。早期症状较轻,乏力和皮肤瘙痒为本病最常见的首发症状,乏力的严重程度与肝脏的病变程度不相关。瘙痒常在黄疸发现前数月至2年左右出现,夜间加剧。少数患者瘙痒和黄疸同时出现,先有黄疸后出现瘙痒者少见。黄疸出现后尿色深黄,粪色变浅,皮肤渐有色素沉着。因长期肝内胆汁淤积导致分泌和排泄至肠腔的胆汁减少,影响脂肪的消化吸收,可有脂肪泻和脂溶性维生素吸收障碍,出现皮肤粗糙和夜盲症(维生素A缺乏)、骨软化和骨质琉松(维生素D缺乏)、出血倾向(维生素K缺乏)等。由于组织细胞吞噬过量的胆固醇易引起黄瘤,为黄色扁平斑块,常见于眼睑内眦附近和后发际。当肝衰竭时,血清脂类下降。黄瘤亦逐渐消散。体检提示肝脾肿大,晚期出现腹水、门静脉高压症与肝衰竭,病变长期发展可并发肝癌。此外,还可伴有干燥综合征、甲状腺炎、类风湿关节炎等自身免疫性疾病的临床表现。

单项选择题
单项选择题

A deal is a deal—except, apparently, when Entergy is involved. The company, a major energy supplier in New England, provoked justified outrage in Vermont last week when it announced it was reneging on a longstanding commitment to abide by the state’s strict nuclear regulations.

Instead, the company has done precisely what it had long promised it would not challenge the constitutionality of Vermont’s rules in the federal court, as part of a desperate effort to keep its Vermont Yankee nuclear power plant running. It’s a stunning move.

The conflict has been surfacing since 2002, when the corporation bought Vermont’s only nuclear power plant, an aging reactor in Vernon. As a condition of receiving state approval for the sale, the company agreed to seek permission from state regulators to operate past 2012. In 2006, the state went a step further, requiring that any extension of the plant’s license be subject to Vermont legislature’s approval. Then, too, the company went along.

Either Entergy never really intended to live by those commitments, or it simply didn’t foresee what would happen next. A string of accidents, including the partial collapse of a cooling tower in 207 and the discovery of an underground pipe system leakage, raised serious questions about both Vermont Yankee’s safety and Entergy’s management—especially after the company made misleading statements about the pipe. Enraged by Entergy’s behavior, the Vermont Senate voted 26 to 4 last year against allowing an extension.

Now the company is suddenly claiming that the 2002 agreement is invalid because of the 2006 legislation, and that only the federal government has regulatory power over nuclear issues. The legal issues in the case are obscure: whereas the Supreme Court has ruled that states do have some regulatory authority over nuclear power, legal scholars say that Vermont case will offer a precedent-setting test of how far those powers extend. Certainly, there are valid concerns about the patchwork regulations that could result if every state sets its own rules. But had Entergy kept its word, that debate would be beside the point.

The company seems to have concluded that its reputation in Vermont is already so damaged that it has noting left to lose by going to war with the state. But there should be consequences. Permission to run a nuclear plant is a public trust. Entergy runs 11 other reactors in the United States, including Pilgrim Nuclear station in Plymouth. Pledging to run Pilgrim safely, the company has applied for federal permission to keep it open for another 20 years. But as the Nuclear Regulatory Commission (NRC) reviews the company’s application, it should keep in mind what promises from Entergy are worth.

According to Paragraph 4, Entergy seems to have problems with its()

A. managerial practices

B. technical innovativeness

C. financial goals

D. business vision