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患者男，56岁，因“活动后心悸、呼吸困难32年，加重伴夜间不能平卧1年”来诊。诊断为风湿性心脏病，联合瓣膜病变，左房室瓣狭窄，主动脉瓣关闭不全，肺动脉高压，心功能Ⅲ级。目前口服氢氯噻嗪、美托洛尔和地高辛。查体：体重65kg；意识清醒，合作，HR88次/min，律不齐；BP135/55mmHg；R18次/min，双肺呼吸音粗糙。头颈及四肢均未见异常，双下肢无水肿，肝颈静脉回流征（－）。ECG：心房颤动；胸部X线片：心胸比例为0.77，肺血增多；超声心动图：左心房、左心室明显增大，左房室瓣增厚，解剖面积0.74cm2；主动脉瓣增厚、瓣尖有钙化，关闭不全，彩色多谱勒：舒张期主动脉瓣有大量反流，左心室舒张末径81mm。术前血常规、凝血功能和生化检查基本正常。拟在中低温体外循环（CPB）下行左房室瓣和主动脉瓣机械瓣替换术。出现此情况的可能原因和处理方法是（提示手术结束后，患者由手术台移至转运床后，血压由105/65mmHg降至80/40mmHg。）（）。
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You work as the enterprise exchange administrator at TestKing.com. TestKing.com makes use of Microsoft Exchange Server messaging solution. The TestKing.com network consists of a single ActiveDirectory forest. TestKing.com has a headquarters and two offices. Each of these offices contains an Active Directory. Theheadquarters contain six domain controllers that are configured to run Windows Server 2008 （x64）. Theother two offices contain one Windows Server 2008 read only domain controller （RODC）. The domain controllers in the forest are all configured as global catalog servers. You are planning toinstall an Exchange Server 2010 server at every office. You have received instructions to change theActive Directory to make sure that the Exchange servers’ branch office site is able to make a connectionto their respective domain controllers. What should you do？（）
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。
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。
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。
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