男,36岁,慢性上腹痛1年,上消化道出血1次,用H2受体阻断剂无效。钡透:十二指肠降部多发溃疡,空腹血清促胃液素(胃泌素)测定为500ng/L。诊断应考虑
A. 十二指肠球后溃疡
B. 复合性溃疡
C. Zollinger-Ellison综合征
D. 十二指肠球部溃疡活动期
Controlling the Growing TB Crisis in China
China needs to take urgent action to address a "vicious cycle" of poverty and tuberculosis (TB) affecting a considerable number of Chinese people, especially in underdeveloped areas, the World Health Organization said on Monday.
The Chinese government needs to take "immediate necessary action" to control the spread of TB, which is "threatening the future of its 1.3 billion people", WHO said in a report released at the start of a three-day meeting to discuss TB in the Western Pacific region.
Poor living conditions and health care in rural China mean the TB infection rate is nearly three times higher than in urban areas, the report said. There are some factors that make the rural TB burden heavier such as insufficient funds for local health programs and increased charges for medical care, it said.
"This has uniformly produced a negative impact on TB diagnosis and treatment, especially in areas without specific funding targeted towards TB-related services," it said. The report, which is meant to foreshadow the seriousness of the TB crisis in China, suggests that China adopt a two-year program to control the disease.
The government should fund free TB drugs and diagnosis, health promotion and training, and supervised treatment programs at all levels, it said. "TB control should be considered as a key development issue and poverty reduction strategy," WHO Western Pacific regional director Dr. Shigeru Omi said at the opening of the meeting in Beijing.
A World Bank-funded project in 13 of China's 31 provinces produced "astonishing" results, reducing the incidence of TB by 38 per cent in less than 10 years, WHO said. "This tremendous achievement tells us that the regional target of reducing the prevalence of TB by half in 10 years, though ambitious, is achievable," Omi said.
But TB "remains a relentless killer in the Western Pacific region", claiming around 1,000 lives daily in the region -- more than half of them in China, a WHO press statement said. "The worsening burden of TB has resulted in a great human tragedy and has had a profound impact on economic development in several countries in the region," the statement said.
At present in China the TB infection rate
A. in rural areas is three times as high as that in urban areas.
B. in rural areas is nearly four times as high as that in urban areas.
C. in urban areas is two times lower than that in rural areas.
D. in urban areas is four times lower than that in rural areas.
Which of the following is NOT mentioned in the passage as a factor making the rural TB burden heavier in China?
A. Insufficient funds for local health programs.
B. Increased charges for medical care.
C. No specific funding targeted towards TB-related services in some areas.
D. Lack of sufficient physical training.