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患者男，35岁，洗澡时发现右侧胸壁直径3.0cm的肿物来就诊。体检：右胸壁可及一波动性包块，表面无红肿，无压痛，边界较清楚。

经左侧胸腔闭式引流和清创缝合处理后，下列哪项是紧急剖胸指征？（）

A.伤后4小时出冷汗，胸腔闭式引流出500ml血液，观察3小时又引流出200ml

B.伤侧胸腔穿刺抽出不凝血液

C.心率144次／分，血压10/6kPa，胸腔穿刺抽出的血液很快凝固

D.出现寒战，高热，血白细胞数1.5×109/L，中性粒细胞0.85

E.红细胞数3.5×1012/L，血红蛋白80g/L，红细胞压积0.30

答案

参考答案：C

解析：咳出脓痰不能说明血胸合并感染；胸水红、白细胞比值，正常为500：1，如白细胞计数上升，则表示有感染；抽出暗红色血液，说明陈旧性出血，不一定是合并感染；抽出不凝血液，说明出血已停止，未并发感染；伤侧胸痛更不能表示合并感染。

判断题

预算一经批准，作为信息化项目的最高限额，是安排项目资金计划的重要依据；预算是确定合同价格的依据。
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单项选择题

Personality is to a large extent inherent. A-type parents usually (1) A-type offspring. But the environment must also have a profound effect (2) if competition is important to the parents, it is (3) to become a major factor in the lives of their children.

One place where children (4) A characteristics is school, which is, (5) its very nature, a highly competitive institution. Too many schools (6) the "win at all costs" moral standard and measure their success by sporting achievements. The current (7) for making children compete against their classmates or against the (8) produces a two-layer system, in which competitive A types seem in some way better than their B type fellows. Being too (9) to win can have dangerous consequences: remember that Pheidippides, the first marathon runner, (10) dead seconds after saying. "Rejoice, we conquer!"

(11) the worst form of competition in schools is the disproportionate emphasis on examinations. There is, for example, a (12) school that allows pupils to concentrate on those things they do well. The (13) of competition by examination are somewhat questionable, but competition in the certain (14) of failure is positively harmful.

(15) , it is neither practical nor desirable that all A youngsters change into B’s. The world needs types, and schools have an important duty to try to (16) a child’s personality to his possible future employment. It is top management.

If the preoccupation of schools with academic work was (17) , more time might be spent teaching children surer values. Perhaps selection (18) the caring professions, especially medicine, could be made less by good grades in chemistry and more by such (19) as sensitivity and sympathy. It is surely a mistake to choose our doctors exclusively from A type stock. B’s are important and should be (20) .

1（）

A. bring about

B. care for

C. carry on

D. keep up
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