问题 判断题

当芳环中连有供电子基时,芳环不易发生烷基化反应。

答案

参考答案:

完形填空
Scientists said that in the past 100 years, as the global(全球的) temperatures went up by 0.74℃, the temperature in North China has climbed 1.4℃ in only 50 years.
China needs to cut down carbon dioxide(二氧化碳) emission(排放),because it’s the main reason for global warming. The good news is that China has seen the importance of going green. China has decided to cut energy use down by 20% and pollution emission by 10% in the 11th Five-Year Plan.
Can you slow down global warming? Sure! You and your family can take some steps.
Here are some pieces of advice to help you save the earth.
Wear used clothes. It means that you save the energy when you wear your brother’s, sister’s or dad’s old T-shirts.
Change your light bulbs(灯泡). Use energy-saving light bulbs. And don’t forget to turn off the lights when you leave a room and turn off your television and computer when they are not in use!
Take a bus. Taking a bus saves a lot of oil(石油) every year.
Say no to plastic bags. The next time your parents go to the market, ask them to use baskets. Open the windows. Don’t use the air conditioner(空调). Let some fresh air in. When you have to use the conditioner,setthetemperature higher in summer and lower in winter to save energy.
The main  小题1:for global warming
Too much carbon dioxide in the air.
小题2: to save the earth.
1. Wear 小题3:  clothes.
2. Use energy-saving light bulbs and  小题4:
to turn off the lights and your television or computer when you don’t need them.
3. Take a bus.
4. Use baskets instead of plastic bags when you or your family go 小题5:
5. Try to use the air conditioner less.
问答题 案例分析题

患者女,33岁,因左侧颈部出现肿块,并迅速增大7天入院。入院后体格检查患者左侧颈部有一肿块,气管明显受压移位,其余无异常,颈部B超显示患者左侧甲状腺有一7cm×5cm大小的囊性肿瘤,囊内有出血,血液生化及甲状腺功能检查正常。既往体健,无服药史。拟在全麻下行左侧甲状腺肿块切除术。麻醉诱导用药为异丙酚200mg,芬太尼100μg,阿曲库铵40mg。诱导后行气管插管,吸入七氟醚、笑气用于麻醉维持,同时给予对乙酰氨基酚1g、酮络酸30mg、吗啡5mg,切口用1%利多卡因.5ml做局部浸润后手术开始,术中分离开囊肿时可见气管移位明显、颈部神经和血管受压,病变侧的甲状腺已经增大,并突出于甲状腺峡部,此时患者血压突然升高,MAP达到160mmHg,随后出现心动过缓、ST段下移,血压自行下降,但仍高于正常水平,即硝酸甘油8mg?h-1静脉注入,血压迅速降低而ST段下移未改善,同时指脉搏血氧饱和度下降,听诊肺部闻及湿啰音,即调整呼吸通气参数为I:E为1:1、PEEP10cmH2O,吸入100%氧,硝酸甘油注射速度调至4mg?h-1,静脉注射呋塞咪10mg,血压过低时单次静脉注射间羟胺,经治疗后下降的ST段有所回升,血流动力学趋于平稳,手术顺利完成。术毕患者转入重症治疗病室观察,数小时后心电图恢复正常,患者恢复顺利,血流动力学平稳。T3、T4、TSH水平术前、术后均正常,肌钙蛋白I术后第二天升高至3.26μg.1-1(正常上限为0.032μg.1-1),手术后2天超声心动图显示心脏解剖及功能正常,3天后患者康复出院。切除标本组织学检查结果为甲状腺胶质性囊肿,未发现异位儿茶酚胺分泌型组织。

1.血流动力学变化的主要原因。 2.有哪些预防措施?