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女，45岁，发热、咳脓痰1周，胸片右下背段浸润阴影。用青霉素治疗体温稍下降，但痰量增多，为脓血痰，有臭味。胸片大片浸润阴影中出现空腔。目前最佳处理为
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女性45岁发热咳脓痰1周胸片右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有臭味胸片大片浸
祛痰药
甲硝唑
阿米卡星
红霉素
女45岁发热咳脓痰1周胸片示右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有臭味胸片大片浸
祛痰药
甲硝唑
阿米卡星
红霉素
女45岁发热咳脓痰1周胸片示右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有臭味胸片示大片
2周
3周
4周
8周
女45岁发热咳脓痰1周胸片示右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有臭味胸片大片浸
2周
3周
4周
8周
女45岁发热咳脓痰1周胸片右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有臭味胸片大片浸润
左侧卧位
右侧卧位
头低仰卧位
头低俯卧位
坐位
治疗2周后患者临床症状明显改善胸片空腔缩小抗生素总疗程一般宜持续
2周
3周
4周
6周
8周
女45岁发热咳脓痰1周胸片示右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有臭味胸片示大片
祛痰药
甲硝唑
阿米卡星
红霉素
假如作体位引流应实行的体位是
左侧卧位
右侧卧位
头低仰卧位
头低俯卧位
坐位
女45岁发热咳脓痰1周胸片右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有臭味胸片大片浸润
左侧卧位
右侧卧位
头低仰卧位
头低俯卧位
女45岁发热咳脓痰1周胸片示右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有臭味胸片大片浸
左侧卧位
右侧卧位
头低仰卧位
头低俯卧位
女45岁发热咳脓痰1周胸片示右下背段浸润阴影用青霉素治疗体温稍下降但 痰量增多为脓血痰
7.5%
50%
45%
52.5%
女45岁发热咳脓痰1周胸片右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有臭味胸片大片浸润
2周
3周
4周
8周
女45岁发热咳脓痰1周胸片右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有臭味胸片大片浸润
祛痰药
甲硝唑
阿米卡星
红霉素
女45岁发热咳脓痰1周胸片右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有
7.5%
50%
45%
52．5%
女45岁发热咳脓痰1周胸片右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有臭味胸片大片浸润
2周
3周
4周
6周
8周
患者女性45岁发热咳脓痰1周胸片右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有臭味胸片大
祛痰药
甲硝唑
阿米卡星
红霉素
安络血
患者女性45岁发热咳脓痰1周胸片右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有臭味胸片可
祛痰药
甲硝唑
阿米卡星
红霉素
安络血
治疗中需加用
祛痰药
甲硝唑
阿米卡星
红霉素
卡巴克洛
女性45岁发热咳脓痰1周胸片右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有臭味胸片大片浸
2周
3周
4周
8周
女45岁发热咳脓痰1周胸片右下背段浸润阴影用青霉素治疗体温稍下降但痰量增多为脓血痰有
祛痰药
甲硝唑
阿米卡星
红霉素
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Everybodylovesafatpayrise.Yetpleasureatyourowncanvanishifyoulearnthatacolleaguehasbeengivenabiggerone.Indeedifhehasareputationforslackingyoumightevenbeoutraged.Suchbehaviourisregardedasalltoohumanwiththeunderlyingassumptionthatotheranimalswouldnotbecapableofthisfinelydevelopedsenseofgrievance.ButastudybySarahBrosnanandFransdeWaalofEmoryUniversityinAtlantaGeorgiawhichhasjustbeenpublishedinNaturesuggeststhatitisalltoomonkeyaswell. Theresearchersstudiedthebehaviouroffemalebrowncapuchinmonkeys.Theylookcute.Theyaregood-naturedco-operativecreaturesandtheysharetheirfoodreadily.Aboveallliketheirfemalehumancounterpartstheytendtopaymuchcloserattentiontothevalueofgoodsandservicesthanmales. SuchcharacteristicsmakethemperfectcandidatesforDr.Brosnan’’sandDr.deWaal’’sstudy.Theresearchersspenttwoyearsteachingtheirmonkeystoexchangetokensforfood.Normallythemonkeyswerehappyenoughtoexchangepiecesofrockforslicesofcucumber.Howeverwhentwomonkeyswereplacedinseparatebutadjoiningchamberssothateachcouldobservewhattheotherwasgettinginreturnforitsrocktheirbehaviourbecamemarkedlydifferent. Intheworldofcapuchinsgrapesareluxurygoodsandmuchpreferabletocucumbers.Sowhenonemonkeywashandedagrapeinexchangeforhertokenthesecondwasreluctanttohandhersoverforamerepieceofcucumber.Andifonereceivedagrapewithouthavingtoprovidehertokeninexchangeatalltheothereithertossedherowntokenattheresearcheroroutofthechamberorrefusedtoacceptthesliceofcucumber.Indeedthemerepresenceofagrapeintheotherchamberwithoutanactualmonkeytoeatitwasenoughtoinduceresentmentinafemalecapuchin. Theresearcherssuggestthatcapuchinmonkeyslikehumansareguidedbysocialemotions.Inthewildtheyareaco-operativegroup-livingspecies.Suchco-operationislikelytobestableonlywheneachanimalfeelsitisnotbeingcheated.Feelingsofrighteousndignationitseemsarenotthepreserveofpeoplealone.Refusingalesserrewardcompletelymakesthesefeelingsabundantlycleartoothermembersofthegroup.Howeverwhethersuchasenseoffairnessevolvedindependentlyincapuchinsandhumansorwhetheritstemsfromthecommonancestorthatthespecieshad35millionyearsagoisasyetanunansweredquestion. ThestatementitisalltoomonkeyLastlineParagraph1impliesthat
Humanbeingsinalltimesandplacesthinkabouttheirworldandwonderattheirplaceinit.Humansarethoughtfulandcreativepossessedofinsatiablecuriosity.61Furthermorehumanshavetheabilitytomodifytheenvironmentinwhichtheylivethussubjectingallotherlifeformstotheirownpeculiarideasandfancies.ThereforeitisimportanttostudyhumansinalltheirrichnessanddiversityinacalmandsystematicmannerwiththehopethattheknowledgeresultingfromsuchstudiescanleadhumanstoamorehannoniouswayoflivingwiththemselvesandwithallotherlifeformsonthisplanetEarth."Anthropology."derivesfromtheGreekwordsanthropos"human"andlogos"thestudyof."Bvitsverynameanthropologyencompassesthestudyofallhumankind.Anthropologyisoneofthesocialsciences.62Socialscienceisthatbranchofintellectualenquirywhichseekstostudyhumansandtheirendeavorsinthesamereasonedorderlysystematicanddispassionedmannerthatnaturalscientistsuseforthestudyofnaturalphenomena.Socialsciencedisciplinesincludegeographyeconomicspoliticalsciencepsychologyandsociology.Eachofthesesocialscienceshasasubfieldorspecializationwhichliesparticularlyclosetoanthropology.Allthesocialsciencesfocusuponthestudyofhumanity.Anthropologyisafield-studyorienteddisciplinewhichmakesextensiveuseofthecomparativemethodinanalysis.63Theemphasisondatagatheredfirst-handcombinedwithacross-culturalperspectivebroughttotheanalysisofculturespastandpresentmakesthisstudyauniqueanddistinctlyimportantsocialscience.Anthropologicalanalysesrestheavilyupontheconceptofculture.SirEdwardTylor’’sformulationoftheconceptofculturewasoneofthegreatintellectualachievementsof19thcenturyscience.64Tylordefinedcultureas"...thatcomplexwholewhichincludesbeliefartmoralslawcustomandanyothercapabilitiesandhabitsacquiredbymanasamemberofsociety."Thisinsightsoprofoundinitssimplicityopenedupanentirelynewwayofperceivingandunderstandinghumanlife.ImplicitwithinTylor’’sdefinitionistheconceptthatcultureislearnedsharedandpatternedbehavior.65Thustheanthropologicalconceptof"culture"liketheconceptof"set"inmathematicsisanabstractconceptwhichmakespossibleimmenseamountsofconcreteresearchandunderstanding. Tylordefinedcultureas...thatcomplexwholewhichincludesbeliefartmoralslawcustomandanyothercapabilitiesandhabitsacquiredbymanasamemberofsociety.
1effectofthecountry’’sgrowinghumanpopulationonitswildlife 2possiblereasonfortheeffect 3yoursuggestionforwildlifeprotection
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Everybodylovesafatpayrise.Yetpleasureatyourowncanvanishifyoulearnthatacolleaguehasbeengivenabiggerone.Indeedifhehasareputationforslackingyoumightevenbeoutraged.Suchbehaviourisregardedasalltoohumanwiththeunderlyingassumptionthatotheranimalswouldnotbecapableofthisfinelydevelopedsenseofgrievance.ButastudybySarahBrosnanandFransdeWaalofEmoryUniversityinAtlantaGeorgiawhichhasjustbeenpublishedinNaturesuggeststhatitisalltoomonkeyaswell. Theresearchersstudiedthebehaviouroffemalebrowncapuchinmonkeys.Theylookcute.Theyaregood-naturedco-operativecreaturesandtheysharetheirfoodreadily.Aboveallliketheirfemalehumancounterpartstheytendtopaymuchcloserattentiontothevalueofgoodsandservicesthanmales. SuchcharacteristicsmakethemperfectcandidatesforDr.Brosnan’’sandDr.deWaal’’sstudy.Theresearchersspenttwoyearsteachingtheirmonkeystoexchangetokensforfood.Normallythemonkeyswerehappyenoughtoexchangepiecesofrockforslicesofcucumber.Howeverwhentwomonkeyswereplacedinseparatebutadjoiningchamberssothateachcouldobservewhattheotherwasgettinginreturnforitsrocktheirbehaviourbecamemarkedlydifferent. Intheworldofcapuchinsgrapesareluxurygoodsandmuchpreferabletocucumbers.Sowhenonemonkeywashandedagrapeinexchangeforhertokenthesecondwasreluctanttohandhersoverforamerepieceofcucumber.Andifonereceivedagrapewithouthavingtoprovidehertokeninexchangeatalltheothereithertossedherowntokenattheresearcheroroutofthechamberorrefusedtoacceptthesliceofcucumber.Indeedthemerepresenceofagrapeintheotherchamberwithoutanactualmonkeytoeatitwasenoughtoinduceresentmentinafemalecapuchin. Theresearcherssuggestthatcapuchinmonkeyslikehumansareguidedbysocialemotions.Inthewildtheyareaco-operativegroup-livingspecies.Suchco-operationislikelytobestableonlywheneachanimalfeelsitisnotbeingcheated.Feelingsofrighteousndignationitseemsarenotthepreserveofpeoplealone.Refusingalesserrewardcompletelymakesthesefeelingsabundantlycleartoothermembersofthegroup.Howeverwhethersuchasenseoffairnessevolvedindependentlyincapuchinsandhumansorwhetheritstemsfromthecommonancestorthatthespecieshad35millionyearsagoisasyetanunansweredquestion. Dr.BrosnanandDr.deWaalhaveeventuallyfoundintheirstudythatthemonkeys
Doyourememberallthoseyearswhenscientistsarguedthatsmokingwouldkillusbutthedoubtersinsistedthatwedidn’’tknowforsureThattheevidencewasinconclusivethescienceuncertainThattheantismokinglobbywasouttodestroyourwayoflifeandthegovernmentshouldstayoutofthewayLotsofAmericansboughtthatnonsenseandoverthreedecadessome10millionsmokerswenttoearlygraves. Thereareupsettingparallelstodayasscientistsinonewaveafteranothertrytoawakenustothegrowingthreatofglobalwarming.ThelatestwasapanelfromtheNationalAcademyofSciencesenlistedbytheWhiteHousetotellusthattheEarth’’satmosphereisdefinitelywarmingandthattheproblemislargelyman-made.Theclearmessageisthatweshouldgetmovingtoprotectourselves.ThepresidentoftheNationalAcademyBruceAlbertsaddedthiskeypointintheprefacetothepanel’’sreport:Scienceneverhasalltheanswers.Butsciencedoesprovideuswiththebestavailableguidetothefutureanditiscriticalthatournationandtheworldbaseimportantpoliciesonthebestjudgmentsthatsciencecanprovideconcerningthefutureconsequencesofpresentactions. Justasonsmokingvoicesnowcomefrommanyquartersinsistingthatthescienceaboutglobalwarmingisincompletethatit’’sOKtokeeppouringfumesintotheairuntilweknowforsure.Thisisadangerousgame:bythetime100percentoftheevidenceisinitmaybetoolate.Withtherisksobviousandgrowingaprudentpeoplewouldtakeoutaninsurancepolicynow. FortunatelytheWhiteHouseisstartingtopayattention.Butit’’sobviousthatamajorityofthepresident’’sadvisersstilldon’’ttakeglobalwarmingseriously.Insteadofaplanofactiontheycontinuetopressformoreresearch―aclassiccaseofparalysisbyanalysis. Toserveasresponsiblestewardsoftheplanetwemustpressforwardondeeperatmosphericandoceanicresearch.Butresearchaloneisinadequate.IftheAdministrationwon’’ttakethelegislativeinitiativeCongressshouldhelptobeginfashioningconservationmeasures.AbillbyDemocraticSenatorRobertByrdofWestVirginiawhichwouldofferfinancialincentivesforprivateindustryisapromisingstart.Manyseethatthecountryisgettingreadytobuildlotsofnewpowerplantstomeetourenergyneeds.Ifweareevergoingtoprotecttheatmosphereitiscrucialthatthosenewplantsbeenvironmentallysound. AccordingtotheauthorwhatshouldtheAdministrationdoaboutglobalwarming
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肌丝滑行理论的直接证据是骨骼肌收缩时
心火亢盛证与膀胱湿热证均可出现小便赤涩灼痛如何从病机及症状加以鉴别
Doyourememberallthoseyearswhenscientistsarguedthatsmokingwouldkillusbutthedoubtersinsistedthatwedidn’’tknowforsureThattheevidencewasinconclusivethescienceuncertainThattheantismokinglobbywasouttodestroyourwayoflifeandthegovernmentshouldstayoutofthewayLotsofAmericansboughtthatnonsenseandoverthreedecadessome10millionsmokerswenttoearlygraves. Thereareupsettingparallelstodayasscientistsinonewaveafteranothertrytoawakenustothegrowingthreatofglobalwarming.ThelatestwasapanelfromtheNationalAcademyofSciencesenlistedbytheWhiteHousetotellusthattheEarth’’satmosphereisdefinitelywarmingandthattheproblemislargelyman-made.Theclearmessageisthatweshouldgetmovingtoprotectourselves.ThepresidentoftheNationalAcademyBruceAlbertsaddedthiskeypointintheprefacetothepanel’’sreport:Scienceneverhasalltheanswers.Butsciencedoesprovideuswiththebestavailableguidetothefutureanditiscriticalthatournationandtheworldbaseimportantpoliciesonthebestjudgmentsthatsciencecanprovideconcerningthefutureconsequencesofpresentactions. Justasonsmokingvoicesnowcomefrommanyquartersinsistingthatthescienceaboutglobalwarmingisincompletethatit’’sOKtokeeppouringfumesintotheairuntilweknowforsure.Thisisadangerousgame:bythetime100percentoftheevidenceisinitmaybetoolate.Withtherisksobviousandgrowingaprudentpeoplewouldtakeoutaninsurancepolicynow. FortunatelytheWhiteHouseisstartingtopayattention.Butit’’sobviousthatamajorityofthepresident’’sadvisersstilldon’’ttakeglobalwarmingseriously.Insteadofaplanofactiontheycontinuetopressformoreresearch―aclassiccaseofparalysisbyanalysis. Toserveasresponsiblestewardsoftheplanetwemustpressforwardondeeperatmosphericandoceanicresearch.Butresearchaloneisinadequate.IftheAdministrationwon’’ttakethelegislativeinitiativeCongressshouldhelptobeginfashioningconservationmeasures.AbillbyDemocraticSenatorRobertByrdofWestVirginiawhichwouldofferfinancialincentivesforprivateindustryisapromisingstart.Manyseethatthecountryisgettingreadytobuildlotsofnewpowerplantstomeetourenergyneeds.Ifweareevergoingtoprotecttheatmosphereitiscrucialthatthosenewplantsbeenvironmentallysound. AccordingtoBruceAlbertssciencecanserveas
Itmayseemanexaggerationtosaythatambitionisthelinchpinofsocietyholdingmanyofitsdifferentelementstogetherbutitisnotanexaggerationbymuch.Removeambitionandtheessentialelementsofsocietyseemtoflyapart.Ambitionasopposedtomerefantasizingaboutdesiresimpliesworkanddisciplinetoachievegoalspersonalandsocialofakindsocietycannotsurvivewithout.Ambitionisintimatelyconnectedwithfamilyformenandwomennotonlyworkpartlyfortheirfamilies;husbandsandwivesareoftenambitiousforeachotherbutharborsomeoftheirmosteagerambitionsfortheirchildren.Yettohaveafamilynowadays-withbirthcontrolreadilyavailableandinflationagoodeconomicargumentagainsthavingchildren-isnearlyanexpressionofambitioninitself.Ambitionandfuturity-asenseofbuildingfortomorrow-areinescapable.Workingsavingplanning-thesethedailyaspectsofambition-havealwaysbeenthedistinguishingmarksofarisingmiddleclass.Theattackagainstambitionisnotincidentallyanattackonthemiddleclassandwhatitstandsfor.Likeitornotthemiddleclasshasdonemuchofsociety’’sworkinAmerica;anditthemiddleclasshasfromthebeginningrunonambition. Itisnotdifficulttoimagineaworldstrippedofambition.Itwouldprobablybeakinderworld:withoutdemandsanddisappointments.Peoplewouldhavetimeforreflection.Suchworkastheydidwouldnotbeforthemselvesbutforthecollectivity.Competitionwouldneverenterin.Conflictwouldbeeliminatedtensionbecomeathingofthepast.Thestressofcreationwouldbeatanend.Thefamilywouldbecomesuperfluousasasocialunitwithallitsformerpowerforbringingaboutneurosisdrainedaway.Longevitywouldbeincreasedforfewerpeoplewoulddieofheartattackorstrokecausedbyconfusedendeavor.Anxietywouldbeextinct.Timewouldstretchonandonwithambitionlongdepartedfromthehumanheart. Wedonotchooseourparentsourhistoricalepochthecountryofourbirthortheimmediatecircumstancesofourupbringing.Wedonotmostofuschoosetodie;nordowechoosethetimeorconditionsofourdeath.Butwithinallthisrealmofchoicelessnesswedochoosehowweshalllive:courageouslyorincowardicehonorablyordishonorablywithpurposeorindrift.Wedecidewhatisimportantandwhatistrivialinlife.Wedecidethatwhatmakesussignificantiseitherwhatwedoorwhatwerefusetodo.Butnomatterhowindifferenttheuniversemaybetoourchoicesanddecisionsthesechoicesanddecisionsareourstomake.Wedecide.Wechoose.Andaswedecideandchoosesoareourlivesformed.Intheendformingourowndestinyiswhatambitionisabout. Theauthorbelievesthatwithoutambition
腐苔与腻苔在形态和主病上有何不同
Itmayseemanexaggerationtosaythatambitionisthelinchpinofsocietyholdingmanyofitsdifferentelementstogetherbutitisnotanexaggerationbymuch.Removeambitionandtheessentialelementsofsocietyseemtoflyapart.Ambitionasopposedtomerefantasizingaboutdesiresimpliesworkanddisciplinetoachievegoalspersonalandsocialofakindsocietycannotsurvivewithout.Ambitionisintimatelyconnectedwithfamilyformenandwomennotonlyworkpartlyfortheirfamilies;husbandsandwivesareoftenambitiousforeachotherbutharborsomeoftheirmosteagerambitionsfortheirchildren.Yettohaveafamilynowadays-withbirthcontrolreadilyavailableandinflationagoodeconomicargumentagainsthavingchildren-isnearlyanexpressionofambitioninitself.Ambitionandfuturity-asenseofbuildingfortomorrow-areinescapable.Workingsavingplanning-thesethedailyaspectsofambition-havealwaysbeenthedistinguishingmarksofarisingmiddleclass.Theattackagainstambitionisnotincidentallyanattackonthemiddleclassandwhatitstandsfor.Likeitornotthemiddleclasshasdonemuchofsociety’’sworkinAmerica;anditthemiddleclasshasfromthebeginningrunonambition. Itisnotdifficulttoimagineaworldstrippedofambition.Itwouldprobablybeakinderworld:withoutdemandsanddisappointments.Peoplewouldhavetimeforreflection.Suchworkastheydidwouldnotbeforthemselvesbutforthecollectivity.Competitionwouldneverenterin.Conflictwouldbeeliminatedtensionbecomeathingofthepast.Thestressofcreationwouldbeatanend.Thefamilywouldbecomesuperfluousasasocialunitwithallitsformerpowerforbringingaboutneurosisdrainedaway.Longevitywouldbeincreasedforfewerpeoplewoulddieofheartattackorstrokecausedbyconfusedendeavor.Anxietywouldbeextinct.Timewouldstretchonandonwithambitionlongdepartedfromthehumanheart. Wedonotchooseourparentsourhistoricalepochthecountryofourbirthortheimmediatecircumstancesofourupbringing.Wedonotmostofuschoosetodie;nordowechoosethetimeorconditionsofourdeath.Butwithinallthisrealmofchoicelessnesswedochoosehowweshalllive:courageouslyorincowardicehonorablyordishonorablywithpurposeorindrift.Wedecidewhatisimportantandwhatistrivialinlife.Wedecidethatwhatmakesussignificantiseitherwhatwedoorwhatwerefusetodo.Butnomatterhowindifferenttheuniversemaybetoourchoicesanddecisionsthesechoicesanddecisionsareourstomake.Wedecide.Wechoose.Andaswedecideandchoosesoareourlivesformed.Intheendformingourowndestinyiswhatambitionisabout. Theauthorholdsambitiontobe
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