患儿，男，5岁。咳嗽40天，多为夜间、清晨和运动后咳嗽，无痰，无发热。曾用阿奇霉素、头孢克洛等治疗效果不佳。PPD试验（-），胸片未见异常。其母有过敏性鼻炎。最可能的诊断是（）
A.过敏性鼻炎
B.咳嗽变异性哮喘
C.支气管炎
D.支气管肺炎
E.原发性肺结核
参考答案：B
解析：
咳嗽变异性哮喘诊断标准为：
①咳嗽持续或反复发作>1个月，常伴夜间或清晨发作性咳嗽，痰少，运动后加重。
②临床无感染征象，或经长期抗生素治疗无效，除外其他引起慢性咳嗽的疾病。
③用支气管扩张剂可使咳嗽发作缓解（是诊断本病的基本条件）。
④过敏史或过敏性家族史。
⑤气道呈高反应性，支气管激发试验阳性（可作为辅助诊断条件）。
My brother and I were in Orlando Florida to witness our first Space Shuttle Launch. The Discovery was to soar at 10:14 AM on a blue sky September day. I’d seen it so many times on television, now I was only minutes away from seeing it launch. And it’s the final demonstration of the of success: Success Takes Off Like a Rocket. Witnessing the Take Off: Standing close to the Space Shuttle home one unforgettable point—the Shuttle is the height of a 15-story building—it 4.5 million pounds—and NASA is trying to lift it 200 miles off the ground. On TV the accomplishments look so much , so much easier. Crowds of people are standing around with you to watch the Shuttle go. The countdown begins through the small of hundreds of portable radios all tuned to the NASA station. It’s enough to get your heart beating . When time is up, the side booster rockets are lit up and the eight explosive bolts . The first things you see are large white clouds exploding away. Through the steam, you see the fire power. Then the Space Shuttle begins to inch off the pad and climb its way . Thousands upon millions of pounds of can hardly lift the shuttle at all. But with ever increasing ease, the shuttle picks up and roars into the sky, headed into space attaining a of over 17,000 mph. It is within the first two minutes to launch the Space Shuttle that the great success lesson is . Fact: 85% of the shuttle’s fuel is consumed within the first 2 minutes just to get the 15-story super structure to its orbital . And that’s exactly how success : The first steps you take towards launching a successful career are the and will require an enormous consumption of energy—a great big push. However, you persist through the launch period, which can seem almost for quite some time, everything gets easier and easier and your results get bigger and bigger.
|