题目内容
男性，30岁，40分钟前骑摩托车摔伤，急送来院。神志朦胧，烦躁不安，四肢乱动，呼吸困难；咯血，口鼻均有泥沙夹血外溢，左侧胸腹部、左大腿严重擦伤、肿胀，左大腿大面积淤血.来院时，可首先排除的损伤是（）
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Questions 21 to 25 are based on the following passage. Lead deposits, which accumulated in soil and snow during the 1960’s and 70’s, were primarily the result of leaded gasoline emissions originating in the United States. In the twenty years that the Clean Air Act has mandated unleaded gas use in the United States, the lead accumulation worldwide has decreased significantly. A study published recently in the journal Nature shows that air-borne leaded gas emissions from the United States were the leading contributor to the high concentration of lead in the snow in Greenland. The new study is a result of the continued research led by Dr. Charles Boutron, an expert on the impact of heavy metals on the environment at the National Center for Scientific Research in France. A study by Dr. Boutron published in 1991 showed that lead levels in arctic (北极的) snow were declining. In his new study, Dr. Boutron found the ratios of the different forms of lead in the leaded gasoline used in the United States were different from the ratios of European, Asian and Canadian gasolines and thus enabled scientists to differentiate (区分) the lead sources. The dominant lead ratio found in Greenland snow matched that found in gasoline from the United States. In a study published in the journal Ambio, scientists found that lead levels in soil in the Northeastern United States had decreased markedly since the introduction of unleaded gasoline. Many scientists had believed that the lead would stay in soil and snow for a longer period. The authors of the Ambio study examined samples of the upper layers of soil taken from the same sites of 30 forest floors in New England, New York and Pennsylvania in 1980 and in 1990. The forest environment processed and redistributed the lead faster than the scientists had expected. Scientists say both studies demonstrate that certain parts of the ecosystem (生态系统) respond rapidly to reductions in atmospheric pollution, but that these findings should not be used as a license to pollute. The study published in the journal Nature indicates that （）
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