问题 单项选择题 A1型题

患者,男,70岁。进行性排尿困难7年,夜尿3~4次,尿流变细、费力,经非那雄胺治疗症状改善不明显。B超检查示前列腺54mm×45mm×38mm,残余量100ml,双肾无积水。最大尿流率8ml/s。心、肺、肝肾功能正常。下一步首选的治疗方案是()。

A.耻骨上经膀胱前列腺切除术

B.改用口服雄激素

C.经 * * 前列腺切除术

D.加α受体阻滞剂

E.膀胱穿刺造瘘

答案

参考答案:C

解析:如最大尿流率<15ml/s表明排尿不畅;如<10ml/s则表明梗阻较为严重,常是手术指征之一。残余尿量超过50ml也是手术指征之一。该患者心、娜、肝肾功能正常,更加适合手术。经 * * 前列腺切除术是最常用手术方法之一。

单项选择题
问答题

Green space facilities are contributing to an important extent to the quality of the urban environment. Fortunately it is no longer necessary that every lecture or every book about this subject has to start with the proof of this idea. (46) At present it is generally accepted, although more as a self-evident statement than on the basis of a closely-reasoned scientific proof. The recognition of the importance of green space in the urban environment is a first step on the right way. (47) This does not mean, however, that sufficient details are known about the functions of green space in towns and about the way in which the inhabitants are using these spaces. As to this rather complex subject I shall, within the scope of this lecture, enter into one aspect only, namely the recreative function of green space facilities.
(48) The theoretical separation of living, working, traffic and recreation, which for many years has been used in town-and-country planning, has in my opinion resulted in disproportionate attention for forms of recreation far from home, whereas there has been relatively little attention for improvement of recreative possibilities in the direct neighborhood of the home. (49) We have come to the conclusion that this is not right, because an important part of the time which we do not pass in sleeping or working is used for activities at and around home. So it is obvious that recreation in the open air has to begin at the front door.
(50) The urban environment has to offer as many recreation activities as possible, and the design of these has to be such that more obligatory activities can also have a recreative aspect. The very best standard of living is nothing if it is not possible to take a pleasant walk in the district, if the children cannot be allowed to play in the streets, because the risks of traffic are too great, if during shopping you can nowhere find a spot for enjoying for a moment the nice weather, in short, if you only feel yourself at home after the front door is shut.