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患者，女性，53岁。1个月来乏力、纳差，上腹不适，腹胀，1周来皮肤瘙痒。查体：皮肤、巩膜黄染，腹软，上腹部轻压痛，无反跳痛，肝脾未及，移动性浊音(-)。提示：腹部CT示轻度脂肪肝，肝左叶囊肿，肝内外胆管不扩张。抗线粒体抗体(-)，血IgG、IgM正常，IgA轻度增高。问题5：与患者发生黄疸有关的因素包括 1．慢性胆囊炎 2．药物性黄疸 3．肝囊肿 4．酒精性肝病 5．非酒精性脂肪肝 6．原发性硬化性胆管炎 7．壶腹部结石

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患者，女性，53岁。1个月来乏力、纳差，上腹不适，腹胀，1周来皮肤瘙痒。查体：皮肤、巩膜黄染，腹软，上腹部轻压痛，无反跳痛，肝脾未及，移动性浊音(-)。提示：ALT 70u/L，AST 47U/L，ALP421U/L，GGT 84U/L，甲、乙、丙、戊型肝炎病毒指标均阴性，Tbil 328μmol/L，Dbil 186μmol/L。问题3：该患者黄疸的原因初步考虑 1．Gilbert综合征 2．肝炎后高胆红素血症 3．药物性黄疸 4．溶血 5．酒精性肝病 6．原发性胆汁性肝硬化 7．原发性肝癌

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胃食管反流瘤外科治疗方法为

A. 制酸剂
B. H2受体阻滞剂或促动力剂
C. 腹腔镜下胃折叠术
D. Heller手术
E. 促动力剂+质子原抑制药

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Passage 3Questions 33 to 35 are based on the passage you have just heard.

A. How to make a powerful rocket engine.
B. How to ensure the safety of the crew.
C. How to choose qualified crewmen for the trip.
D. How to enable the spacecraft break free of gravity.

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Questions 11 to 18 are based on the conversation you have just heard.

A. He doesn’t have any idea about what he wants to do.
B. He’d like to work this summer.
C. He wonders whether the woman has a job.
D. He can’t decide where to go on vacation.

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