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女，55岁。年轻时性格温和，待人和气，结婚以来夫妻关系一直很好，与亲戚邻里关系也很和睦。这2年快退休时常念叨厂子里的某某在算计她，同车间的某某总与她过不去。后来提前办内退，但不是怀疑邻居在议论她，就是猜疑楼上往自家阳台上扔东西。丈夫劝她几次之后，怀疑其有外遇。从此就限制丈夫必须准时回家，不准其梳洗打扮，一见丈夫收拾自己，就认为要去约会。女儿看不过去说她几句，则认为丈夫将女儿收买，为此伤心欲绝。丈夫将上班之余的所有时间都守着她，持续了1年多，仍消除不了她的疑心，反而加重了她的症状。现在甚至怀疑丈夫要害她，看见他刮胡子，都吓得赶紧躲进卧室还念着；想拿刀子割我动脉，做梦吧，我就不死!丈夫和女儿在同一工厂上班，不允许他们一起上下班。 求助者有
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男，34岁，搬动重物时突感腰部疼痛伴左下肢放射性疼痛5小时入院。体格检查：腰部曲度变直，左小腿外侧皮肤痛觉减退，双下肢肌力无异常，双膝、踝反射(++)，左直腿抬高试验45°(+)。X线片示各椎间隙无明显异常。 腰椎间盘突出症与腰椎管狭窄症最有意义的鉴别点是
A fire is always exciting and dangerous. People crowd around to watch the smoke, the flames, and the fire fighters, who risk their lives to save others’’ lives. Fire fighters are in danger of burns and smoke injuries. (36) ________, they save thousands of lives and (37) ________ of dollars of property every year. Fighting fires is not just risky. It is also very (38)________. Fire fighters do their jobs in rain or shine, (39)________it’’s 100 F or 20 F below zero. At a fire, they carry heavy gear up and down stairs or ladders. They search for (40)________people. They hack holes in the roof to (41)________smoke and gas. They hold hoses on the fire. The hoses are heavy, and the water in them shoots out under great (42) ________ . In fact, it usually takes two fire fighters to hold one hose. Fire fighters also have many other duties. Sometimes they have to give first aid, and their (43)________must be kept in order. They must visit factories and public buildings to check fire dangers. (44) ______________________________. Fighting fires is an important job. That means there will always be jobs for fire fighters. However, the number of jobs available and the rate of pay depend upon the budget. (45) ______________________________. A person has to pass certain tests in order to be hired as a fire fighter. Among these are tests of intelligence and strength. (46)________________________________. Applicants must also be at least 18 years old. After they are hired, new fire fighters spend a few weeks in a training school. They are assigned to a fire company.
The Real Death Of Print Vishwas Chavan travels a lot. As an informatician, he collects data on what types of animal live where in India to enter into a biodiversity database. Yet the specimens he hunts for have neither fur nor feathers, but yellowing pages and ageing dust-jackets. Much of the information Chavan seeks is in old, out of-print tomes that are scattered around the world; about 2,500 of the 7,000 books he has unearthed were written in the first half of the nineteenth century. To find them, Chavan has spent years trailing around libraries. He dreams of the day when books such as these are scanned and made available as digital files on the Internet. Chavan and other digitization visionaries paint a future in which books no longer gather dust on shelves, but exist as interconnected nodes in a vast web of stored literature, all accessible at the click of a mouse. So instead of hunting for specific books, scholars could search for specific information, customizing searches to suit their needs.A few years ago, Chavan’’s dream seemed little more than a castle in the air. True, a number of mostly volunteer-driven or publicly funded projects had been scanning books and making them freely available on the Internet. But most efforts were limited. In December 2004, the Internet searchengine company Google announced plans to change that. It said it would scan millions of books from five major libraries: the university libraries of Oxford, Harvard, Stanford and Michigan, and the New York Public Library. The announcement energized other organizations in the United States and in Europe, which soon declared similar plans to scan and catalogue millions of books. The move to digitize books is set to transform the worlds of publishers, librarians, authors, readers and researchers. Obscure specialist titles could find new readerships; librarians and information specialists will have to develop tools to catalogue and navigate this labyrinth (迷宫) of data; and authors and publishers may soon have to start thinking in digital dimensions, just as website designers and writers already do.Bloody revolution But revolutions are rarely bloodless and this one could soon get ugly. In the United States authors and publishers are squaring up against Google for a legal fight over copyright. Opinion is divided over whether the scanning projects being implemented by companies such as Google and Amazon will hand control of the world’’s literature to private enterprise — and, if so, what this could mean. And with several independent scanning projects under way, it is still not clear how much of the information will be freely available, or where and how it can all be coordinated and accessed. The idea to digitize books and make them available online has been around since the beginning of Internet in the early 1970s. When the US Declaration of Independence was typed in and sent to everyone on a computer network on the night of 4 July 1971, it marked the birth of Project Gutenberg, the first book-digitization venture. Since then, the project’’s 20,000 volunteers have scanned or typed in about 50,000 out-of copyright books, says its founder Michael Hart, who works in the basement of his home in Urbana, Illinois, and, like the project’’s volunteers, for free. Projects such as this are driven by the idealistic desire to make knowledge and literature freely accessible to all, but also by the benefits of having book collections easily searchable. "Being able to find it online is pretty much the same as having it online," says David Weinberger of the Berkman Center for Internet and Society. Assets such as searchability have prompted the National Science Foundation (NSF) in Arlington, Virginia, to get involved in an open-access enterprise called the Million Book Project. This is an international scanning effort with many participants, including Carnegie Mellon University. Since the project began in 2002, about 600,000 out-of-copyright books have been scanned, although only about half of them are currently available online. The scanning takes place in India and China, with books being shipped there temporarily from libraries around the world.Made to fit Searchability is also the main driving force behind commercial plans to scan books, including texts whose copyright has yet to expire. For example, if their products have been digitized, online booksellers can allow customers to search within books and browse a few pages before deciding to buy. In the United States, with the publisher’’s permission, Amazon puts searchable digital data from mostly copyrighted books online. Amazon says that several hundred thousand books are currently available for searching. Amazon also offers the option of purchasing e-books and e-documents on its website, which can be viewed after downloading them to a portable reading device. The company expects these services to drive additional sales. Its ’’search inside the book’’ feature increases sales by 8%, the company says. Scientific publishers, such as the US National Academies Press also see increased print sales when they allow their books to be viewed online. But Google doesn’’t mention money in its announcement that it plans to make the contents of millions of copyrighted books searchable as part of its Google Book Search project. Its spokesman, Nate Tyler, says Google’’s motivation is to include literature that is currently only available offline in its mission to make information universally accessible. But the possibility that the company could gain financially from the move has raised hackles among US authors and publishing organizations. In the autumn of this year, the Authors Guild and the Association of American Publishers filed a lawsuit against Google for copyright infringement. They complained that Google hadn’’t asked them for permission to scan copyrighted books. Google has obtained the go-ahead from publishers to include some copyrighted works as part of its Book Search project, but not all. It argues that it does not need to seek permission for every book, because what it plans to do is permissible according to the "fair use" exception of US copyright law. This allows copying for uses such as teaching, scholarship or research. Google will, for example, not make the full text available, but only show "snippets" of text around the search results if a book is still copyrighted. The company says that people are more likely to buy or borrow a book if they can search it this way, adding that the snippets are similar to the card catalogues found in libraries. But Paul Aiken of the Authors Guild in New York City argues that the act of scanning the works is copyright infringement (侵害) no matter how the texts are used. The outcome of the lawsuit will depend on the courts’’ decisions over how the concept of fair use applies in the age of digital books and the Internet. Meanwhile, the rest of the scanning world is watching from the sidelines, and being careful to scan only books that are out of copyright, or to obtain the publisher’’s permission before scanning anything. Google’’s plan has shaken up the digital-book world in other ways too. For one thing, many believe that its size and resources mean Google can pull of this feat — so large-scale repositories of digital books seem a more realistic and immediate prospect than ever before. Google has also galvanized its competitors, both public and private to redouble their efforts, and has placed a question mark over the future of libraries and librarians. "I think Google is in a class by itself because of the quantity of money and the level of centralization," says Daniel Greenstein, librarian of the California Digital Library in Oakland, California. "Google has paved the way, created the appetite for this kind of activity, and anxiety on the part of libraries and publishers."Out with the old But Michael Gorman, president of the American Library Association, says he is not worried that libraries could become obsolete. As well as providing access to books, they serve as a place for people to meet and study, he says. And librarians’’ expertise in information management will still be needed. "We are not worried about our own jobs," agrees Dennis Dillon, associate director of the research services division of the University of Texas libraries at Austin. "The job is changing, which makes it even more fulfilling than it was before." But Gorman is worried that over-reliance on digital texts could change the way people read — and not for the better. He calls it the "atomization of knowledge". Google searches retrieve snippets and Gorman worries that people who confine their reading to these short paragraphs could miss out on the deeper understanding that can be conveyed by longer, narrative prose. Dillon agrees that people use e-books in the same way that they use web pages: dipping in and out of the content. Declaration of Independence was the first document to be digitalized on the night of__________.
女性患者，52岁，3个月前无明显诱因出现左肩部疼痛，尤以左肩关节活动时疼痛明显，1个月前出现左肩关节活动受限，左手穿衣、梳头均受影响。查体：左侧肱二头肌长头肌腱及三角肌均有压痛，左肩关节外展、内旋、外旋及后伸活动受限，ROM分别为：外展 55°，内旋30°，外旋40°，后伸15°，诊断为肩关节周围炎，拟采用关节松动技术进行治疗。 关于肩关节活动说法正确的是
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