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患者在试验过程中出现血压升高达200／120mmHg，心率10次／分，此时的处理是
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最适合于转移性、复发性嗜铬细胞瘤定位诊断的检查方法是
On the all-important question of power-the efficacy of power, the morality of power, the desirability of power-American and European perspectives are diverging. 16 Europe is turning away from power, or to put it a little differently, it is moving beyond power into a self-contained world of laws and rules and transnational negotiation and cooperation. It is entering a post-historical paradise of peace and relative prosperity, the realization of Kant’s "Perpetual Peace." The United States, meanwhile, remains indulged in history, exercising power in the anarchic (无政府的) Hobbesian world where intemational laws and rules are unreliable and where true security and the defense and promotion of a liberal order still depend on the possession and use of military might. 17 That is why on major strategic and international questions today, Americans are from Mars and Europeans are from Venus: They agree on little and understand one another less and less. And this state of affairs is not transitory-the product of one American election or one catastrophic event. The reasons for the transatlantic divide are deep, long in development, and likely to endure. 18 When it comes to setting national priorities, determining thi’eats, defining challenges, and fashioning and implementing foreign and defense policies, the United States and Europe have parted ways. Europeans are more conscious of the growing differences, perhaps because they fear them more. European intellectuals are nearly unanimous in the conviction that Americans and Europeans no longer share a common "strategic culture." The European caricature at its most extreme depicts America’s warlike temperament the natural product of a violent society. 19 But even those who do not make this crude link agree there are profound differences in the way the United States and Europe conduct foreign policy. The United States, they argue, resorts to force more quickly and, compared with Europe, is less patient with diplomacy. Americans generally see the world divided between good and evil, between friends and enemies, while Europeans see a more complex picture. 20 When confronting real or potential adversaries, Americans generally favor policies of coercion rather than persuasion, emphasizing sanctions over inducements to better behavior, the stick over the carrot. Americans tend to seek finality in international affairs: They want problems solved, threats eliminated. And, of course, Americans increasingly tend toward unilateralism in international affairs. They are less inclined to act through international institutions such as the United Nations, less inclined to work cooperatively with other nations to pursue common goals, more skeptical about international law, and more willing to operate outside its strictures.
女性患者，32岁，肥胖多毛。24小时尿17－羟皮质类固醇增高，小剂量地塞米松不能抑制，大剂量地塞米松能抑制。最可能的诊断是
What is making the world so much older There are two long-term causes and a temporary blip that will continue to show up in the figures for the next few decades. 11 The first of the big causes is that people everywhere are living far longer than they used to, and this trend started with the industrial revolution and has been slowly gathering pace. In 1900 average life expectancy at birth for the world as a whole was only around 30 years, and in rich cotmtries under 50. The figures now are 67 and 78 respectively, and still rising. For all the talk about the coming old-age crisis, that is surely something to be grateful for-especially since older people these days also seem to remain healthy, fit and active for much longer. 12 A second, and bigger, cause of the ageing of societies is that people everywhere are hang far fewer children, so the younger age groups are much too small to counterbalance the growing number of older people. This trend emerged later than the one for longer lives, first in developed countries and now in poor countries too. In the early 1970s women across the world were still, on average, having 4.3 children each. The current global average is 2.6, and in rich countries only 1.6. 13 The UN predicts that by 2050 the global figure will have dropped to just two, so by mid-century the world’s population will begin to level out. The numbers in some developed countries have already started shrinking. Depending on your point of view, that may or may not be a good thing, but it will certainly turn the world into a different place. The temporary blip that has magnified the effects of lower fertility and greater longevity is the babyboom that arrived in most rich countries after the Second World War. 14 The tinting varied slightly from place to place, but in America-where the effect was strongest-it covered roughly the 20 years from 1945, a period when nearly 80 million Americans were born. The first of them are now coming up to retirement. For the next 20 years those baby-boomers will be swelling the ranks of pensioners, which will lead to a rapid drop in the working population all over the rich world. As always, the averages mask considerable diversity. 15 Most developing countries do not have to worry about ageing-yet, in the longer term, however, the same factors as in the rich world-fewer births, longer lives-will cause poorer countries to age too.
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