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男，44岁。因急性继发性腹膜炎入院，行非手术治疗。观察10小时，如决定手术治疗，不属于其手术适应证的是______
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男，20岁，持续性左上腹痛2小时。查体：T38.7℃，P128/分，R24/分，BP60/40mmHg，谵妄，全身皮肤湿冷。左侧季肋部皮下淤血、全腹部压痛、反跳痛(+)，移动性浊音(+)，肠鸣音未闻及。紧急的处理措施是______
女，44岁。上腹绞痛伴高热1天，皮肤黄染2小时，呕吐1次，伴寒战、高热，发病后小便色深。既往反复发作上腹部隐痛3年，向右肩部放射。查体：T39.1℃，P108次/分，R30次/分，BP150/95mmHg，皮肤、巩膜黄染，上腹部肌紧张，压痛、反跳痛(+)。 若患者出现休克，最有效的治疗措施是______
变异性心绞痛的治疗宜选用药______
【F1】During the past generation, the American middle-class family that once could count on hard work and fair play to keep itself financially secure has been transformed by economic risk and new realities.Now a pink slip, a bad diagnosis, or a disappearing spouse can reduce a family from solidly middle class to newly poor in a few months.In just one generation, millions of mothers have gone to work, transforming basic family economics. Scholars, policymakers, and critics of all stripes have debated the social implications of these changes, but few have looked at the side effect: family risk has risen as well. Today"s families have budgeted to the limits of their new two-paycheck status.【F2】As a result, they have lost the parachute they once had in times of financial setback—a back-up earner(usually Mom)who could go into the workforce if the primary earner got laid off or fell sick.This "added-worker effect" could support the safety net offered by unemployment insurance or disability insurance to help families weather bad times. But today, a disruption to family fortunes can no longer be made up with extra income from an otherwise-stay-at-home partner.During the same period, families have been asked to absorb much more risk in their retirement income.【F3】Steelworkers, airline employees, and now those in the auto industry are joining millions of families who must worry about interest rates, stock market fluctuation, and the harsh reality that they may outlive their retirement money.For much of the past year, President Bush campaigned to move Social Security to a saving-account model, with retirees trading much or all of their guaranteed payments for payments depending on investment returns. For younger families, the picture is not any better. Both the absolute cost of healthcare and the share of it borne by families have risen—and newly fashionable health-savings plans are spreading from legislative halls to Wal-Mart workers, with much higher deductibles and a large new dose of investment risk for families" future healthcare.【F4】Even demographics are working against the middle class family, as the odds of having a weak elderly parent—and all the attendant need for physical and financial assistance—have jumped eightfold in just one generation.【F5】From the middle-class family perspective, much of this, understandably, looks far less like an opportunity to exercise more financial responsibility, and a good deal more like a frightening acceleration of the wholesale shift of financial risk onto their already overburdened shoulders.The financial fallout has begun, and the political fallout may not be far behind. 【F1】
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