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某女，孕35周，感外阴灼痛3天就诊，妇科查体：外阴，小阴唇可见多个小水疱，部分破溃，患者感疼痛显著，细胞学找到具有特征性的多核巨细胞。 此患者可能的初步诊断为
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45岁女性，阴道不规则流血2个月，G2P1A1L1，BMI=30kg/m2，诊刮：宫腔8.5cm，病理示子宫内膜样腺癌。以下哪项是错误的
23岁，未婚女性，素食主义者，单位B超查体发现右附件区低回声囊性包块(5cm×6cm)伴少量腹水2天就诊。近期乏力、盗汗，月经量较多，伴下腹坠痛。查体：体型偏瘦，腹部柔韧感，无压痛。外阴发育正常，肛诊右附件区可触及囊性包块，欠规则及活动。 适宜的确诊方法为
How Exercise Makes You Smarter Exercise does more than build muscles and help prevent heart disease. New science shows that it also boosts brainpower--and may offer hope in the battle against Alzheimer(痴呆症). The stereotype of the "dumb jock" has never sounded right to Charles Hillman. A jock himself, he plays hockey four times a week, but when he isn’t body-checking his opponents on the ice, he’s giving his mind a comparable workout in his neuroscience and kinesiology lab at the University of Illinois. Recently he started wondering if there was a vital and overlooked link between brawn and brains--if long hours at the gym could somehow build up not just muscles, but minds. With colleagues, he started an experiment. He rounded up 259 Illinois third and fifth graders, measured their body-mass index and put them through classic PE routines: the "sit-and-reach", a brisk run and timed push-ups and sit-ups. Then he checked their physical abilities against their math and reading scores on a statewide standardized test. Sure enough, on the whole, the kids with the fittest bodies were the ones with the fittest brains, even when factors such as socioeconomic status were taken into account. Sports, Hillman concluded, might indeed be boosting the students’ intellect. Hillman’s study, which will be published later this year, isn’t definitive enough to stand alone. But it doesn’t have to: it is part of a recent and rapidly growing movement in science showing that exercise can make people smarter. Other scientists have found that vigorous exercise can cause nerve cells to form dense, interconnected webs that make the brain run faster and more efficiently. And there are clues that physical activity can stay away from the beginnings of Alzheimer’s disease, ADHD and other cognitive disorders. No matter your age, it seems, a strong, active body is crucial for building a strong, active mind. Some scientists have always suspected as much, although they have not been able to prove it. Now, however, armed with brain-scanning tools and a sophisticated understanding of biochemistry, researchers are realizing that the mental effects of exercise are far more profound and complex processes than they once thought. The processes start in the muscles. When the exercise is available, the muscle sends out chemicals, including a protein called IGF-1 that travels through the bloodstream, across the blood-brain barrier and into the brain itself. And then the brain issues orders fuels almost all the activities that lead to higher thought. With regular exercise, the body builds up its levels of BDNF, and the brain’s nerve cells start to branch out, join together and communicate with each other in new ways. This is the process that underlies learning: every change in the junctions between brain cells signifies a new fact or skill that’s been picked up for future use. BDNF makes that process possible. Brains with more of it have a greater capacity for knowledge. On the other hand, says UCLA neuroscientist Fernando G6mez-Pinilla, a brain that’s low on BDNF shuts itself off to new information. Most people maintain fairly constant levels of BDNF in adulthood. But as they age, their individual neurons (神经)slowly start to die off. Until the mid-90s, scientists thought the loss was permanent-that the brain couldn’t make new nerve cells to replace the dead ones. But animal studies over the last decade have overturned that assumption, showing that "neurogenesis" (神经发生)in some parts of the brain can be induced easily with exercise. Last week’s study, published in the Proceedings of the National Academy of Sciences, extended that principle to humans for the first time. After working out for three months, all the subjects appeared to regain new neurons. This, too, might be BDNF at work, transforming stem cells into full-grown, functional neurons. "It was extremely exciting to see this exercise effect in humans for the first time," says Scott Small, a Columbia University Medical Center neurologist who coauthored the study with Salk Institute neurobiologist Fred Gage. "In terms of trying to understand what it means, the field is just exploding." As far as scientists know, the new neurons created by exercise are produced in only one place: the dentate gyrus, an area that controls learning and memory. This region helps the brain match names to faces--one of the first skills to erode as we age. New neurons can’t grow throughout the rest of the brain. But other regions benefit from exercise in many secondary ways. Blood volume, like brain volume, increases with exercise. Active adults have less inflammation in the brain. They also have fewer "little possibility of strokes that can impair cognition without the person even knowing," says Kristine Yaffe, a neuroscientist from University of California. Still other researchers have found that athletes have more cells that support neurons and increase neurotransmitters after they’re used to send messages from cell to cell. And even the levels of those neurotransmitters are higher in people who exercise frequently. Unlike neurogenesis, which can take weeks to occur, most of these additional effects appear almost immediately. Get off the treadmill (踩单车) after a half-hour workout, says Hillman, and "within 48 minutes" your brain will be in better shape. But alas, these benefits are somewhat transient(短暂的). Like weight, mental fitness has to be maintained. New neurons, and the connections between them, will stick around for years, but within a month of inactivity, "it will shrink down, and then the neurons don’t function as well anymore," says William Greenough, a psychologist at the University of Illinois. Let your body go, then, and your brain will follow. To keep the effects, you’ve got to keep working out. "If you’re thinking that by exercising at age 20 you’re going to have some effect on what you’re like at age 70," Greenough adds, you’d better be willing to commit to 50 years of hitting the gym. Unless, that is, you’re a kid. Most studies of exercise and cognition have focused on older people--the folks who are just starting to worry that their minds aren’t what they used to be--but the effects of physical exertion on the brain aren’t limited to that group at all. In fact, in young children, they’re even more potent. Exercise probably has "a more long-lasting effect on brains that are still developing," says Phil Tomporowski, a professor of exercise science at the University of Georgia. In kids, as in adults, the brain reaps many benefits from exercise. This won’t surprise parents of kids with ADHD, many of whom already use physical activity as a substitute or supplement for drugs. According to Phil Tomporowski, compared with those older people, effects of exercise on the brains are probably more long-lasting to those ______.
How Exercise Makes You Smarter Exercise does more than build muscles and help prevent heart disease. New science shows that it also boosts brainpower--and may offer hope in the battle against Alzheimer(痴呆症). The stereotype of the "dumb jock" has never sounded right to Charles Hillman. A jock himself, he plays hockey four times a week, but when he isn’t body-checking his opponents on the ice, he’s giving his mind a comparable workout in his neuroscience and kinesiology lab at the University of Illinois. Recently he started wondering if there was a vital and overlooked link between brawn and brains--if long hours at the gym could somehow build up not just muscles, but minds. With colleagues, he started an experiment. He rounded up 259 Illinois third and fifth graders, measured their body-mass index and put them through classic PE routines: the "sit-and-reach", a brisk run and timed push-ups and sit-ups. Then he checked their physical abilities against their math and reading scores on a statewide standardized test. Sure enough, on the whole, the kids with the fittest bodies were the ones with the fittest brains, even when factors such as socioeconomic status were taken into account. Sports, Hillman concluded, might indeed be boosting the students’ intellect. Hillman’s study, which will be published later this year, isn’t definitive enough to stand alone. But it doesn’t have to: it is part of a recent and rapidly growing movement in science showing that exercise can make people smarter. Other scientists have found that vigorous exercise can cause nerve cells to form dense, interconnected webs that make the brain run faster and more efficiently. And there are clues that physical activity can stay away from the beginnings of Alzheimer’s disease, ADHD and other cognitive disorders. No matter your age, it seems, a strong, active body is crucial for building a strong, active mind. Some scientists have always suspected as much, although they have not been able to prove it. Now, however, armed with brain-scanning tools and a sophisticated understanding of biochemistry, researchers are realizing that the mental effects of exercise are far more profound and complex processes than they once thought. The processes start in the muscles. When the exercise is available, the muscle sends out chemicals, including a protein called IGF-1 that travels through the bloodstream, across the blood-brain barrier and into the brain itself. And then the brain issues orders fuels almost all the activities that lead to higher thought. With regular exercise, the body builds up its levels of BDNF, and the brain’s nerve cells start to branch out, join together and communicate with each other in new ways. This is the process that underlies learning: every change in the junctions between brain cells signifies a new fact or skill that’s been picked up for future use. BDNF makes that process possible. Brains with more of it have a greater capacity for knowledge. On the other hand, says UCLA neuroscientist Fernando G6mez-Pinilla, a brain that’s low on BDNF shuts itself off to new information. Most people maintain fairly constant levels of BDNF in adulthood. But as they age, their individual neurons (神经)slowly start to die off. Until the mid-90s, scientists thought the loss was permanent-that the brain couldn’t make new nerve cells to replace the dead ones. But animal studies over the last decade have overturned that assumption, showing that "neurogenesis" (神经发生)in some parts of the brain can be induced easily with exercise. Last week’s study, published in the Proceedings of the National Academy of Sciences, extended that principle to humans for the first time. After working out for three months, all the subjects appeared to regain new neurons. This, too, might be BDNF at work, transforming stem cells into full-grown, functional neurons. "It was extremely exciting to see this exercise effect in humans for the first time," says Scott Small, a Columbia University Medical Center neurologist who coauthored the study with Salk Institute neurobiologist Fred Gage. "In terms of trying to understand what it means, the field is just exploding." As far as scientists know, the new neurons created by exercise are produced in only one place: the dentate gyrus, an area that controls learning and memory. This region helps the brain match names to faces--one of the first skills to erode as we age. New neurons can’t grow throughout the rest of the brain. But other regions benefit from exercise in many secondary ways. Blood volume, like brain volume, increases with exercise. Active adults have less inflammation in the brain. They also have fewer "little possibility of strokes that can impair cognition without the person even knowing," says Kristine Yaffe, a neuroscientist from University of California. Still other researchers have found that athletes have more cells that support neurons and increase neurotransmitters after they’re used to send messages from cell to cell. And even the levels of those neurotransmitters are higher in people who exercise frequently. Unlike neurogenesis, which can take weeks to occur, most of these additional effects appear almost immediately. Get off the treadmill (踩单车) after a half-hour workout, says Hillman, and "within 48 minutes" your brain will be in better shape. But alas, these benefits are somewhat transient(短暂的). Like weight, mental fitness has to be maintained. New neurons, and the connections between them, will stick around for years, but within a month of inactivity, "it will shrink down, and then the neurons don’t function as well anymore," says William Greenough, a psychologist at the University of Illinois. Let your body go, then, and your brain will follow. To keep the effects, you’ve got to keep working out. "If you’re thinking that by exercising at age 20 you’re going to have some effect on what you’re like at age 70," Greenough adds, you’d better be willing to commit to 50 years of hitting the gym. Unless, that is, you’re a kid. Most studies of exercise and cognition have focused on older people--the folks who are just starting to worry that their minds aren’t what they used to be--but the effects of physical exertion on the brain aren’t limited to that group at all. In fact, in young children, they’re even more potent. Exercise probably has "a more long-lasting effect on brains that are still developing," says Phil Tomporowski, a professor of exercise science at the University of Georgia. In kids, as in adults, the brain reaps many benefits from exercise. This won’t surprise parents of kids with ADHD, many of whom already use physical activity as a substitute or supplement for drugs. As far as scientists know, the new neurons created by exercise are only produced in the dentate gyrus controlling ______.
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