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患者，女性，46岁。近期出现声音嘶哑。查体，甲状腺左叶可触及一圆形结节约4cm×3cm，边界清楚，随吞咽活动。T3、T4降低，TSH升高，B超示左叶孤立结节伴微钙化边界欠清，血流丰富，FNAC提示乳头状癌。 该患者被怀疑有双肺转移，131I全身显像影响其转移灶判断的因素不包括
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This part is to test your reading ability. There are 5 tasks for you to fulfill. You should read the reading materials carefully and do the tasks as you are instructed. Tast 1After reading the following passage, you will find 5 questions or unfinished statements, numbered 36 to 40. For each question or statement there are 4 choices marked A) , B) , C) and D) .Broken Bones: Do not move the patient. Send for ambulance at once. Treat for shock if necessary. Bleeding: A little bleeding does not harm. It washes the dirt from the wound. But if the bleeding continues, try to stop it by placing a clean cloth (the inside of a folded handkerchief, for example) firmly over the wound until the bleeding stops or until help arrives. If the wound is a small one and made by something clean, wash it carefully with soap and water. Then bend it firmly but not too tightly. A large wound, or a dirty one, should be treated by a doctor. Poison: A person who has swallowed poison should be taken to a hospital at once. With some poisons and sleeping pills, for example, it is a good thing to make a patient sick by pushing your finger down to his throat. But if he swallowed some kind of acid, anything that burns, it would be a bad thing to make him sick. The poison would burn his throat as it came up. It is therefore, the best to take the patient to hospital at once. But try to find out what the patient has taken so that you can tell the doctor. If a boy falls off a bike and gets his leg broken, you should______first.
松狮犬，雄性，2岁。随主人散步时被汽车撞伤前腹部，入院观察，第1天，该犬用力咳嗽后，腹痛加剧，呜叫不安。检查：触诊腹部柔软，叩诊脾区疼痛，心率136次/min。 此时首先行哪项检查（）
老年人的肾清除率降低，半衰期延长
某公司中标承建中压A燃气管线工程，管道直径DN30，长26km，合同价3600万元。管道沟槽开挖过程中，遇到地质勘察时未探明的废弃砖沟，经设计人验收地基，并提出处理意见后，施工项目部按设计图样和要求施工，及时清除了砖沟，进行换填级配砂石处理。 沟槽的支撑应在管道两侧及管顶以上0.5m回填完毕并压实后，在保证安全的情况下进行拆除，并应采用( )填实缝隙。
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