问题 多项选择题 案例分析题

患者男,46岁。既往有慢性乙型肝炎病史,乙肝后肝硬化。发现尿蛋白阳性1个月来诊,无血尿,无恶心呕吐,发现双下肢水肿。既往否认糖尿病及高血压病史。查体:肝病病容,血压170/100mmHg,双肺未闻及干湿啰音,心律齐,无杂音,腹软,无压痛,双下肢水肿。实验室检查:尿常规发现血尿(-),蛋白(+++),24小时尿蛋白定量6.78g/d,血白蛋白19g/L,肌酐76μmol/L。

经治疗7年后,患者于右侧上腹部可触及包块,行全腹增强CT示肝内占位,实验室检查尿蛋白(+++),尿蛋白定量16g/d,肌酐124mmol/L,血白蛋白17g/d,HBVDNA<1.0×10,下列哪项治疗适合患者()

A.肝切除术

B.继续治疗应用免疫抑制剂治疗肾病综合征

C.应用大剂量激素治疗

D.继续抗病毒治疗

E.继续抗结核治疗

F.化疗

答案

参考答案:D, E

阅读理解与欣赏

课外文言文阅读,阅读下文,完成后面习题。(18分)

朱昭,字彦明,府谷人。以效用进,累官秉义郎,浮湛班行,不自表异。宣和末,为震威城兵马监押,知城事。金兵内侵,夏人乘虚尽取河外诸城镇。震威距府州三百里,最为孤绝。昭率老幼婴城,敌攻之力,昭募骁锐兵卒千余人,与约曰:“贼知城中虚实,有轻我心,若出不意攻之,可一鼓而溃。”于是夜缒兵出,薄其营,果惊乱。城上鼓噪之,杀获甚众。夏人设木鹅梯冲以临城,飞矢雨激,卒不能施,然昼夜进攻不止。其酋悟儿思齐介胄来,以毡盾自蔽,邀昭计事。昭常服登陴,披襟问曰:“彼何人,乃尔不武!欲见我,我在此,将有何事?”思齐却盾而前,宋朝失信,曰:“大金约我夹攻京师,为城下之盟,画河为界;太原旦暮且下,麟府诸垒悉已归我,公何而不降?”昭曰:“上皇知 * * 邪误国,改过不吝,已行内禅,今天子圣政一新矣,汝独未知邪?”乃取传禅诏赦宣读之,众愕眙,服其勇辩。是时,诸城降者多,昭故人从旁语曰:“天下事已矣,忠安所施?”昭叱曰:“汝辈背义偷生,不异犬彘,尚敢以言诱我乎?我唯有死耳!”因大骂引弓射之,众走。凡被围四日,城多圮坏,昭以智补御,皆合法,然不可复支。昭退坐厅事,召诸校谓曰:“城且破,妻子不可为贼污,幸先戕我家而背城死战,胜则东向图大功,不胜则暴骨境内,大丈夫一生之事毕矣。”部落子有阴与贼通者,告之曰:“朱昭与其徒将出战,人虽少,皆死士也。”贼大惧,以利啖守兵,得登城。昭勒众于通衢接战,自暮达旦,尸填街不可行。昭跃马从缺城出,马蹶坠堑,贼欢曰:“得朱 * * 矣!”欲生致之。昭目仗剑,无一敢前,旋中矢而死,年四十六。

(节选自《宋史•朱昭传》)

注释:①浮班行(háng):浮湛,随波逐流,随顺。班行,班次行列。本指在朝做官的位次,后亦指同列、同辈。

小题1:对下列加点词的解释,不正确的一项是(3分)

A.为震威城兵马监押,知城事摄:代理

B.宋朝失信      数:屡次

C.公何而不降     恃:依靠

D.城上鼓噪之,杀获甚众乘:追逐小题2:以下句子中,全部表明朱昭坚决主张抗敌的一组是(3分)

①今天子圣政一新矣             ②取传禅诏赦宣读之

③汝辈背义偷生,不异犬彘       ④妻子不可为贼污

⑤大丈夫一生之事毕矣           ⑥昭跃马从缺城出

①②④  B.①③⑥    C.②⑤⑥    D.③④⑤

小题3:下列对文章有关内容的概括与分析,不正确的一项是(3分)

A.朱昭凭着功绩官至秉义郎,他顺从时俗,不刻意地表现自己。在震威期间,夏人乘虚入侵,他招募千余勇猛精锐士卒,夜缒出城,乘势杀敌,获得胜利。

B.夏人部队昼夜进攻,其首领悟儿思齐邀请朱昭议事,数落宋朝失信,企图招降宋军。朱昭反驳说,宋朝国君内部禅让,新君政令一新;坚决拒绝投降。

C.在众多城池投降后,朱昭旧友也暗示他投降。朱昭厉声斥骂,张弓要射他;不久又表示,只要背城死战,获胜可再图功业,失败陈尸境内也问心无愧。

D.朱昭方面有人暗中与敌人串通,透露了朱昭准备突围的消息。敌人害死守兵,得到城池。朱昭不幸坠入沟堑,他怒目提剑,无人敢前,最后中箭而死。小题4:把文言文阅读材料中画横线的句子翻译成现代汉语。(6分)

①于是夜缒兵出,薄其营,果惊乱。(3分)

②汝辈背义偷生,不异犬彘,尚敢以言诱我乎?(3分)

单项选择题

"WHAT’S the difference between God and Larry Ellison" asks an old software industry joke. Answer: God doesn’t think he’s Larry Ellison. The boss of Oracle is hardly alone among corporate chiefs in having a reputation for being rather keen on himself. Indeed, until the bubble burst and the public turned nasty at the start of the decade, the cult of the celebrity chief executive seemed to demand bossly narcissism, as evidence that a firm was being led by an all-conquering hero.

Narcissus met a nasty end, of course. And in recent years, boss-worship has come to be seen as bad for business. In his management bestseller, "Good to Great", Jim Collins argued that the truly successful bosses were not the serf-proclaimed stars who adorn the covers of Forbes and Fortune, but instead self-effacing, thoughtful, monkish sorts who lead by inspiring example.

A statistical answer may be at hand. For the first time, a new study, "It’s All About Me", to be presented next week at the annual gathering of the American Academy of Management, offers a systematic, empirical analysis of what effect narcissistic bosses have on the firms they run. The authors, Arijit Chatterjee and Donald Hambrick, of Pennsylvania State University, examined narcissism in the upper levels of 105 firms in the computer and software industries.

To do this, they had to solve a practical problem: studies of narcissism have hitherto relied on surveying individuals personally, something for which few chief executives are likely to have time or inclination. So the authors devised an index of narcissism using six publicly available indicators obtainable without the co-operation of the boss. These are: the prominence of the boss’s photo in the annual report; his prominence in company press releases; the length of his "Who’s Who" entry; the frequency of his use of the first person singular in interviews; and the ratios of his cash and non-cash compensation to those of the firm’s second-highest paid executive.

Narcissism naturally drives people to seek positions of power and influence, and because great self-esteem helps your professional advance, say the authors, chief executives will tend on average to be more narcissistic than the general population. How does that affect a firm Messrs Chatterjee and Hambrick found that highly narcissistic bosses tended to make bigger changes in the use of important resources, such as research and development, or in spending and leverage; they carried out more and bigger mergers and acquisitions ; and their results were both more extreme (more big wins or big losses) and more transient than those of firms run by their humbler peers. For shareholders, that could be good or bad.

Although (oddly) the authors are keeping their narcissism ranking secret, they have revealed that Mr Ellison did not come top. Alas for him, that may be because the study limited itself to people who became the boss after 1991--well after he took the helm. In every respect Mr Ellison seems to be the classic narcissistic boss, claims Mr Chatterjee. There is life in the old joke yet.

We can infer from the passage that()

A. the results of the new study has already been publicized

B. the researchers think Mr. Ellison is more classic than narcissistic

C. the joke about Mr. Ellison is actually adapted from real life

D. the ranking might be different if the survey focused on an earlier period