病历摘要女性,30岁。消瘦伴烦躁、易怒、心悸3个月。3个月前患者无明显诱因开始出现消瘦,体重至来诊时已下降10千克,伴烦躁、易怒,做事缺乏耐性,稍活动即感心悸,手心易出汗,上楼时尤为显著。多食易饥,难以入睡,大小便基本正常。既往史:体健,否认结核及肝病史,无药物过敏及手术、外伤史。月经量减少。家族中无类似患者。查体:T37.1℃,P124次/分,R22次/分,BP120/60mmHg。神志清楚,自动体位,查体合作,突眼(±),甲状腺Ⅱ度肿大,弥漫对称,质地软,双侧上极可闻及血管杂音。双肺未见异常。心界不大,心率124次/分,律齐,各瓣膜区未闻及杂音。腹部检查未见异常。手震颤(+),双胫前无水肿。实验室检查:FT3、FT4增高,TSH下降;生化检查正常;ECG:窦性心动过速;甲状腺彩超:甲状腺弥漫性增大,血流丰富,呈"火海征"。要求:根据以上病历摘要,请写出初步诊断及诊断依据、鉴别诊断、进一步检查与治疗原则。
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Wise buying is a positive way in which you can make your money go further. The ()you go about purchasing an article or a service can actually ()you money or can add ()the cost. Take the ()example of a hairdryer. If you are buying a hairdryer, you might ()that you are making the ()buy if you choose one ()look you like and which is also the cheapest ()price. But when you get it home you may find that it ()twice as long as a more expensive ()to dry your hair. The cost of the electricity plus the cost of your time could well ()your hairdryer the most expensive one of all. So what principles should you ()when you go out shopping? If you ()your home, your car or any valuable ()in excellent condition, you’ll be saving money in the long () Before you buy a new (),talk to someone who owns one. If you can, use it or borrow it to check it suits your particular () Before you buy an expensive (),or a service, do check the price and ()is on offer. If possible, choose ()three items or three estimates. 请在第()处填上正确答案。
A. run
B. interval
C. period
D. time
Wise buying is a positive way in which you can make your money go further. The ()you go about purchasing an article or a service can actually ()you money or can add ()the cost. Take the ()example of a hairdryer. If you are buying a hairdryer, you might ()that you are making the ()buy if you choose one ()look you like and which is also the cheapest ()price. But when you get it home you may find that it ()twice as long as a more expensive ()to dry your hair. The cost of the electricity plus the cost of your time could well ()your hairdryer the most expensive one of all. So what principles should you ()when you go out shopping? If you ()your home, your car or any valuable ()in excellent condition, you’ll be saving money in the long () Before you buy a new (),talk to someone who owns one. If you can, use it or borrow it to check it suits your particular () Before you buy an expensive (),or a service, do check the price and ()is on offer. If possible, choose ()three items or three estimates. 请在第()处填上正确答案。
A. of
B. in
C. by
D. from
根据下述事实,指出不符合GB/T19001—ISO9001中最适用的条款,并说明理由: 审核员接着与随同人员到塑料制品车间,在车间发现单独堆放着一批产品的塑料外壳。车间主任介绍,这堆外完是要报废的,主要原因是由于划伤和磕碰。审核员在生产线上,又发现了不少划伤和磕碰的产品。在车间办公室,审核员请主任出示产品不合格记录,车间主任拿出95.8—96.2的不合格记录,发现车间每个月都对划作、磕碰率作了统计,这七个月分别为27%、29%、32%、24%、25%、27%、29%。审核员问车间主任,为什么不采取措施减少操作呢?主任说,这些多是因搬运、存放造成的,当95年10月损伤超过30%,我们非常重视并采取了措施。11月初我们开了全车间大会,每个班组制订了保证书,增加了责任心,所以后几个月都低于30%,11月份损伤率只有24%,审核员又查阅了车间主任签署的“纠正措施”内容是近期召开大会采取纠正措施使磕碰率降低为29%以下,纠正期限为95年12月。
舜田臧公吴车驾涌澜公岳也年将六旬为人多怒多欲胸膈否胀饮食少时医治以平胃散枳术丸香砂丸不效复以槟榔三棱莪术之类日消之而大便溏泻两足跟踝皆浮肿渐及两手背医又以其手足浮肿而认为黄胖者以针砂丸与之肿益加面色黄且黑自二月医至八月身重不能动止又有以水肿治者车驾公雅善予因延诊之脉沉而濡弱予曰此气虚中满症也法当温补兼升提庶清阳升则大便可实浊阴降则胸膈自宽以人参白术各三钱炮姜回阳陈皮各一钱茯苓黄芪各二钱泽泻升麻肉桂苍术防风各七分三十帖而安客有疑而诘予曰此症诸家非消导则淡渗而先生独以温补收功腹中积而为满为肿者从何道而去也予曰胀满非肿满比也故治不同肿满由脾虚不能摄水水渗皮肤遍身光肿今胀满者先因中虚以致皮胀外坚中空腹皮胀紧象鼓故俗名鼓胀盖由气虚以成中满若气不虚何中满之有气虚为本中满为标是以治先温补使脾气健运则清浊始分清浊分而胀斯愈也(孙一奎《赤水玄珠医案·三吴治验》)