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2025届黑龙江省哈尔滨市哈十七中学九年级英语第一学期期末达标测试试题含解析

2025届黑龙江省哈尔滨市哈十七中学九年级英语第一学期期末达标测试试题请考生注意：1．请用2B铅笔将选择题答案涂填在答题纸相应位置上，请用0．5毫米及以上黑色字迹的钢笔或签字笔将主观题的答案写在答题纸相应的答题区内。

写在试题卷、草稿纸上均无效。

2．答题前，认真阅读答题纸上的《注意事项》，按规定答题。

Ⅰ. 单项选择1、–– What are you looking for?––I’m looking for the book _______ you bought last Sunday.A．who B．when C．that2、Waste sorting (分类)has been around for years in China. If you have food waste, you will most probably throw it into ________.A． B．C．D．3、James took the magazines off the little table to make ______ for the television.A．fun B．time C．room D．noise4、Two ____ students ____ to the opening ceremony last Friday.A．hundreds; were invited B．hundred; were invitedC．hundreds of ; invited D．hundred of; invited5、--Could you tell me some information about the hotels in your city?--Why not ______________ on the Internet?A．look for it B．to look for it C．look it up D．to look it up6、I think ______ important to prepare more food for tomorrow’s party.A．that B．it C．this D．us7、It’s reported that people throw plastic bags along this street every day.A．hundred B．hundreds C．hundred of D．hundreds of8、—Did you see Tom yesterday? —No, I him for a long time.A．didn’t see B．hasn’t seen C．saw D．haven’t seen9、The silk ________ very soft.A．feels B．is felt C．feel10、My little daughter is watching some ants ________ bread on the ground.A．carry B．to carry C．carrying D．carriedⅡ. 完形填空11、Jessica was born without arms and she had learned to live her life with her feet. There were many questions about whether Jessica would be able to live a(n) 1 life. However, Jessica’s father had full confidence in 2 . With the support of her family, Jessica became 3 in herself and continued to explore(探索) the world withher 4 .As a child, Jessica studied 5 in her hometown. When the first performance arrived, she asked herself to be put in the back 6 . Her dance teacher told her there was no back row. She appeared on the stage with other students and performed 7 . When she finished, the applause(喝彩) from the audience gave her encouragement and confidence to 8 dancing for 14 years.After graduating from high school, Jessica attended the University of Arizona where she 9 bachelor’s degree. 10 talking about her degree, she explained that the way people think has a 11 influence on their lives than a physical limitation.Jessica’s most famous achievement was learning how to 12 . She received the Guinness World Records13 being the first person certified(被认证的) to fly an airplane with only her feet.Jessica now works as a motivational(激发性的) 14 . She travels the world sharing her 15 and encouraging people to be creative and confident. She often says, “Think outside the shoes.”1．A．important B．normal C．popular D．painful2．A．them B．us C．him D．her3．A．confident B．amazed C．pleasant D．interested4．A．feet B．arms C．legs D．mouths5．A．drawing B．singing C．writing D．dancing6．A．row B．line C．yard D．room7．A．terribly B．simply C．well D．badly8．A．stop B．continue C．start D．teach9．A．found B．got C．enjoyed D．caught10．A．Before B．After C．When D．Until11．A．greater B．smaller C．worse D．less12．A．drive B．act C．ride D．fly13．A．for B．to C．in D．with14．A．speaker B．artist C．singer D．dancer15．A．mistake B．sadness C．story D．moodⅢ. 语法填空12、二、语法填空：用所给单词的适当形式填空，未给词的限填一词。

比较高通量血液透析(HFHD)与常规血液透析(HD)联合血液透析滤过

比较高通量血液透析（HFHD）与常规血液透析（HD）联合血液透析滤过（HDF）治疗尿毒症患者的有效性和安全性发表时间：2016-10-08T10:33:46.523Z 来源：《健康世界》2016年第17期作者：林超师[导读] HD联合HDF方案和HFHD方案的疗效相当，但HFHD方案血磷的清除、血压的控制效果良好。

广东省佛山市顺德区均安医院 528329摘要：目的：对常规血液透析（HD）联合血液透析滤过（HDF）与高通量血液透析（HFHD）治疗尿毒症患者的有效性和安全性进行比较。

方法：我院2013年6月至2015年6月收治的80例尿毒症患者随机分为两组各40例，对照组予以HD联合HDF治疗，治疗组予以HFHD治疗，比较两组患者的血压、β2-微球蛋白（β2-MG）、血磷指标和不良反应。

结果：两组治疗前后血磷、β2-MG、血压的对比无统计学差异（P＞0.05），但治疗组治疗后6个月的血磷值和血压的改善明显优于治疗前（P＜0.05）；治疗组肺部感染发生率的5.0%与对照组的22.5%对比具有统计学差异（P＜0.05）。

结论：HD联合HDF方案和HFHD方案的疗效相当，但HFHD方案血磷的清除、血压的控制效果良好，且不良反应较少，可作为临床治疗尿毒症患者的最佳方案。

关键词：血液透析滤过；高通量；尿毒症高通量血液透析（HFHD）可有效清除大、中分子物质，且是临床治疗尿毒症的重要手段[1]。

本研究以我院2013年6月至2015年6月收治的尿毒症患者为对象，对常规血液透析（HD）联合血液透析滤过（HDF）与HFHD治疗尿毒症的效果进行了比较，并证实了HFHD治疗尿毒症的有效性和安全性。

现报告有关内容如下。

1资料与方法1.1一般资料选取我院2013年6月至2015年6月收治的尿毒症患者共80例，采用随机数字表法分为两组各40例。

对照组：男22例，女18例；年龄40-75岁，平均（52.5±4.6）岁；透析时间6个月-14年，平均（10.2±3.5）年。

黑龙江省哈尔滨市哈尔滨风华中学2023-2024学年中考英语模拟试题含答案

黑龙江省哈尔滨市哈尔滨风华中学2023-2024学年中考英语模拟试题含答案注意事项：1．答题前，考生先将自己的姓名、准考证号填写清楚，将条形码准确粘贴在考生信息条形码粘贴区。

2．选择题必须使用2B铅笔填涂；非选择题必须使用0．5毫米黑色字迹的签字笔书写，字体工整、笔迹清楚。

3．请按照题号顺序在各题目的答题区域内作答，超出答题区域书写的答案无效；在草稿纸、试题卷上答题无效。

4．保持卡面清洁，不要折叠，不要弄破、弄皱，不准使用涂改液、修正带、刮纸刀。

Ⅰ. 单项选择1、Diao Yu Island is Japan. It belongs to our China forever. Anyone can’t part with China.A．in B．to C．on D．at2、Yu Guangzhong is a famous writer and poet______ wrote the well-known poem Nostalgia (《乡愁》) and passed away on December 14th, 2017.A．who B．which C．what D．whose3、The third line of Zhengzhou Subway by the end of December of 2020.A．will complete B．was completed C．is completing D．will be completed4、Mr Hu is my favorite P.E. teacher because he aways gives us clear in class.A．encouragement B．instructions C．introductions D．invitations5、I like dancing, ________ I don’t have enough time to practice it.A．if B．but C．and D．so6、— The food looked bad, but it ________ OK.—So we can’t judge a man by his appearance.A．is tasted B．tasted C．was tasted D．taste7、Getting a driver’s license a lot of time, but many people think it’s worth it.A．costs B．pays C．takes D．spends8、He remembered ________ the windows, but they’re open now.A．closed B．close C．closing D．to close9、Of course, the boy will be recommended to be this year's Top Ten Teenagers in Wuxi, because he is easy-going, smart and _____ hard-working.A．after all B．above all C．in all D．first of all10、—How about raising some money for the people in the earthquake-hit area?—__________! They can buy some food and clothes with the money.A．I disagree B．Not at all C．Good idea D．I’m sorryⅡ. 完形填空11、 A man was walking through a forest. He was holding an axe(斧子) in his hand. A little tree stopped him and said, ＂Please use your axe to 1 those tall trees, my friend. Because of them, the sunlight cannot fall on me, and I have no room at all to spread myself. 2 them, I’ll be the pride of this part of the forest. ＂The man decided to help the 1ittle tree. He used his axe to cut down the trees. Then the little tree had enough3 . The little tree felt happy and said4 to the man. When the sun came out. the little tree lost water and it became very5 . Later, when a storm came, the little tree6 all its leaves and branches(树枝).＂Oh, poor little tree!＂a bird said, ＂you shouldn’t have asked the man to cut down the 7 . The tall trees protected you 8 you didn’t worry about heat or wind and rain. As time went by, you have 9 . when you get tall and 10 , you can have enough strength to fight against the sun and the storms. So I don’t think you should do that. ＂After hearing the words of the bird，the little tree felt regretful.1．A．put down B．look down C．turn down D．cut down2．A．With B．Because of C．Without D．As for3．A．money B．room C．memory D．time4．A．sorry B．hello C．no D．thanks5．A．happy B．hungry C．thirsty D．sad6．A．1oved B．threw C．caught D．1ost7．A．trees B．plants C．grass D．forests8．A．although B．so that C．if D．while9．A．grown up B．got up C．used up D．stayed up10．A．1ow B．weak C．strong D．ShortⅢ. 语法填空12、根据短文内容及首字母提示写出所缺单词，并将完整单词写在下面对应题号后的横线上。

第二十六章治疗心力衰竭的药物

蛋白结合率% 97
肝肠循环%
26
消除方式
肾排泄
t1/2
5-7d
中效
短效
地高辛 50-90 25 7 肾排泄
33-36h
毒-K 3-30 少少肾排泄 21h
地高辛(digoxin)
【药理作用】对心脏的作用
✓ 对心肌收缩力作用 ✓ 对心率影响 ✓ 对心肌耗氧量影响 ✓ 心肌电生理特性影响 ✓ 对ECG影响
治疗CHF药物的分类
1.肾素-血管紧张素-醛固酮系统抑制药（1）ACEI抑制药：卡托普利、（2）AT1受体拮抗药：氯沙坦（3）醛固酮拮抗药：螺内酯 2.强心苷类：地高辛 3.利尿药：噻嗪类，螺内酯（抗醛固酮药) 4.血管扩张药：硝普钠 5.受体阻断药：卡维地洛 6.非苷类正性肌力药：米力农
强心苷类(cardiac glycosides)
房颤
f
ff
房扑
【不良反应与注意事项】
✓ 胃肠道反应：注意与CHF未控制症状相区别 ✓ CNS：眩晕、头痛、疲倦、失眠；视觉障碍
（黄视、绿视、复视等，中毒先兆，停药指征）
✓ 心脏反应：各种心律失常，危险！！！
快速型心律失常：室早、二联律 (33%) ,室性心动过速甚至室颤。与胞内失K+有关。
过缓性心律失常：窦性心动过缓(<60bpm)、房室传导阻滞。
坦,valsartan）,伊白沙坦（irbesartan）
-受体阻断药
【作用机制】
✓ 拮抗CHF时过高的交感神经活性（HR、心肌收缩力、肾素分泌、 RAS） ✓ 上调受体，抗心律失常 ✓ 卡维地洛兼有阻断α受体、抗生长及抗氧自由基等作用，
长期应用降低死亡率，提高生存率。 ✓ 可选用的受体药物：拉贝洛尔（labetalol）、卡维洛尔

LF, HF, UHF都分别代表什么

LF, HF, UHF都分别代表什么和我们听的收音机道理一样，射频标签和阅读器也要调制到相同的频率才能工作。

LF,HF,UHF 就对应着不同频率的射频。

LF代表低频射频，在125KHz左右，HF代表高频射频，在左右，UHF代表超高频射频，在860至960MHz范围之内。

对一个RFID系统来说，它的频段概念是指读写器通过天线发送、接收并识读的标签信号频率范围。

从应用概念来说，射频标签的工作频率也就是射频识别系统的工作频率，直接决定系统应用的各方面特性。

在RFID系统中，系统工作就像我们平时收听调频广播一样，射频标签和读写器也要调制到相同的频率才能工作。

射频标签的工作频率不仅决定着射频识别系统工作原理（电感耦合还是电磁耦合）、识别距离，还决定着射频标签及读写器实现的难易程度和设备成本。

RFID应用占据的频段或频点在国际上有公认的划分，即位于ISM波段。

典型的工作频率有：125kHz、133kHz、、、433MHz、902MHz～928MHz、、等。

按照工作频率的不同，RFID标签可以分为低频（LF）、高频（HF）、超高频（UHF）和微波等不同种类。

不同频段的RFID工作原理不同，LF和HF频段RFID电子标签一般采用电磁耦合原理，而UHF及微波频段的RFID一般采用电磁发射原理。

目前国际上广泛采用的频率分布于4种波段，低频（125KHz）、高频（）、超高频（850MHz～910MFz）和微波（）。

每一种频率都有它的特点，被用在不同的领域，因此要正确使用就要先选择合适的频率。

低频段射频标签，简称为低频标签，其工作频率范围为30kHz～300kHz。

典型工作频率有125KHz 和133KHz。

低频标签一般为无源标签，其工作能量通过电感耦合方式从阅读器耦合线圈的辐射近场中获得。

低频标签与阅读器之间传送数据时，低频标签需位于阅读器天线辐射的近场区内。

低频标签的阅读距离一般情况下小于1米。

低频标签的典型应用有：动物识别、容器识别、工具识别、电子闭锁防盗（带有内置应答器的汽车钥匙）等。

DNA含量检测在尿脱落细胞病理学漏诊可疑膀胱癌患者中的临床价值

ә通信作者,E -m a i l :w h -y a n gx i n @163.c o m ㊂㊃临床研究㊃ d o i :10.3969/j.i s s n .1671-8348.2024.03.020D N A 含量检测在尿脱落细胞病理学漏诊可疑膀胱癌患者中的临床价值高渝霞1,杨新2ә(1.丰都县人民医院病理科,重庆408200;2.中国人民解放军陆军特色医学中心病理科,重庆400042) [摘要] 目的探讨D N A 含量检测在可疑膀胱癌但尿脱落细胞病理学检查(简称尿检)阴性或不确定患者中的应用价值㊂方法挑选临床初诊怀疑膀胱癌但尿检(H E 染色)阴性或不确定的患者56例,采用F e u l -ge n 染色检测尿脱落细胞D N A 含量,以手术切除标本组织病理学诊断结果作为金标准进行比对分析㊂结果 56例患者中,尿检阴性35例,不确定21例;D N A 含量检测阴性31例,阳性患者25例;组织病理学诊断阴性23例,阳性33例㊂D N A 含量检测的灵敏度为51.52%(17/33),特异度为65.22%(15/23)㊂尿检准确度为33.93%(19/56),D N A 含量检测准确度为57.14%(32/56),两者比较差异有统计学意义(P <0.01)㊂D N A 含量检测在尿检阴性患者中的灵敏度和特异度分别为25.00%(4/16)㊁73.68%(14/19);在不确定患者中的灵敏度和特异度分别为76.47%(13/17)㊁25.00%(1/4)㊂D N A 含量检测的检出率在漏诊的高级别膀胱癌患者中为75.00%(6/8),在低级别膀胱患者中为44.00%(11/25),在阴性患者中为34.78%(8/23)㊂结论尿脱落细胞D N A 含量检测在尿检阴性和不确定患者中的灵敏度和特异度均较高,可有效降低尿检漏检率㊂[关键词] 尿;脱落细胞;D N A 染色;膀胱癌[中图法分类号] R 446.9[文献标识码] A[文章编号] 1671-8348(2024)03-0431-04T h e c l i n i c a l v a l u e o f D N A c o n t e n t d e t e c t i o n i n s u s p e c t e d b l a d d e r c a n c e r p a t i e n t s w i t h p a t h o l o g i c a l m i s s e d d i a gn o s i s o f u r i n e e x f o l i a t e d c e l l s G A O Y u x i a 1,Y A N G X i n2ә(1.D e p a r t m e n t o f P a t h o l o g y ,P e o p l e s H o s p i t a l o f F e n g d u ,C h o n g q i n g 408200,C h i n a ;2.D e p a r t m e n t o f P a t h o l o g y ,P L A A r m y C h a r a c t e r i s t i c M e d i c a l C e n t e r ,C h o n g q i n g 400042,C h i n a ) [A b s t r a c t ] O b je c t i v e T o i n v e s t i g a t e t h e a p p l i c a t i o n v a l u e of D N A c o n t e n t d e t e c t i o n i n p a t i e n t s w i t h s u s p e c t e d b l a d d e r c a n c e r b u t n eg a t i v e o r u n c e r t a i n u r i n e c y t o l o g y.M e t h o d s A t o t a l o f 56p a t i e n t s w i t h s u s -p e c t e d b l a d d e r c a n c e r b u t n e g a t i v e o r u n c e r t a i n u r i n e c y t o l o g y (H E s t a i n i n g )w e r e s e l e c t e d .w a s d e t e c t e d b yF e u l g e n s t a i n i n g ,a n d t h e r e s u l t s w e r e a n a l y z e d .T h e p a t h o l o g i c a l d i a g n o s i s o f s u r g i c a l s pe c i m e n w a s u s e d a s t h e s t a n d a r df o r c o m p a r a t i v e a n a l y s i s .R e s u l t s A m o ng th e 56p a ti e n t s d i a g n o s e d b y u r i n e c y t o l o g y,35c a s e s w e r e n e g a t i v e a n d 21c a s e s w e r e u n c e r t a i n .D N A c o n t e n t w a s n e ga t i v e i n 31c a s e s a n d p o s i t i v e i n 25c a s e s .A -m o n g t h e p a t i e n t s w i t h n e g a t i v e p a t h o l o g i c a l r e s u l t s o f u r i n e c y t o l o g y ,23p a t i e n t s h a d n e g a t i v e h i s t o p a t h o l o gi -c a l d i a g n o s i s a n d 33p a t i e n t s h a d p o s i t i v e h i s t o p a t h o l o g i c a l d i a g n o s i s .A m o n g t h e L B P n e ga t i v e c a s e s ,t h e h i s -t o l o g i c a l d i a g n o s i s w a s n e g a t i v e i n 23a n d p o s i t i v e i n 33.I n t h e 56c a s e s w i t h n e ga t i v e o r u n c e r t a i n r e s u l t s o f u -r i n e c y t o l o g y ,t h e s e n s i t i v i t y o f D N A c o n t e n t d e t e c t i o n w a s 51.52%(17/33)a n d t h e s p e c i f i c i t y wa s 65.22%(15/23).T h e a c c u r a c y o f u r i n e c y t o l o g y d e t e c t i o n w a s 33.93%(19/56),a n d t h e a c c u r a c y of D N A c o n t e n t d e -t e c t i o n w a s 57.14%(32/56),a n d t h e d i f f e r e n c e w a s s t a t i s t i c a l l y s ig n i f i c a n t (P <0.01).Th e s e n si t i v i t y an d s p e c i f i c i t y o f D N A c o n t e n t d e t e c t i o n i n u r i n e n e ga t i v e p a t i e n t s w e r e 25.00%(4/16)a n d 73.68%(14/19),r e -s p e c t i v e l y ;T h e s e n s i t i v i t y a n d s p e c i f i c i t y in u n c e r t a i n p a t i e n t s w e r e 76.47%(13/17)a n d 25.00%(1/4),r e -s p e c t i v e l y .T h e d e t e c t i o n r a t e o f D N A c o n t e n t d e t e c t i o n w a s 75.00%(6/8)i n h i g h -gr a d e b l a d d e r c a n c e r p a -t i e n t s w h o m i s s e d d i a g n o s i s ,44.00%(11/25)i n l o w -g r a d e b l a d d e r p a t i e n t s ,a n d 34.78%(8/23)i n n e ga t i v e p a t i e n t s .C o n c l u s i o n T h e s e n s i t i v i t y a n d s p e c i f i c i t y o f D N A c o n t e n t d e t e c t i o n i n u r i n e e x f o l i a t e d c e l l s a r e h i gh i n p a t i e n t s w i t h n e g a t i v e a n d u n c e r t a i n u r i n e c y t o l o g y ,w h i c h c a n e f f e c t i v e l yr e d u c e t h e m i s s e d d e t e c t i o n r a t e o f u r i n e e x f o l i a t e d c e l l s .[K e y wo r d s ] u r i n e ;e x f o l i a t e d c e l l ;l i q u i d -b a s e d p r e p a r a t i o n s ;D N A s t a i n i n g ;b l a d d e r c a n c e r 134重庆医学2024年2月第53卷第3期膀胱癌是泌尿系统恶性肿瘤中最常见的恶性肿瘤,复发率较高[1]㊂临床上常用的检查方法包括尿脱落细胞病理学检查(简称尿检)和膀胱镜检查,但尿检的灵敏度较低[2-3],且对于较早期的少量异型细胞并不足以通过形态学给予诊断㊂膀胱镜检查费用昂贵,又具有侵入性,且对于微小的肿瘤病灶依然难以发现[4]㊂故临床期待寻找一种灵敏度㊁特异度均较高且无创的膀胱癌诊断方法㊂D N A染色是一种病理科常规的染色技术,用F e u l g e n染色法可显示D N A的含量,用于肿瘤的诊断和研究,有助于判断肿瘤的良恶性及分化程度,并评估肿瘤患者的预后㊂对于泌尿系统肿瘤D N A含量检测是一项较新型的检测方法[5],检测的标本类型可以是尿脱落细胞㊁常规手术切除组织等㊂本研究利用尿脱落细胞进行D N A含量检测,专门挑选常规尿检阴性的患者进行比对分析,探讨其临床应用价值㊂1资料与方法1.1一般资料选取2019年1月至2020年6月在中国人民解放军陆军特色医学中心住院且病理科尿检3次为非阳性的患者56例,其中男37例,女19例,中位年龄62.3岁(25.0~86.0岁)㊂纳入标准:(1)年龄25~86岁;(2)行膀胱术;(3)行组织病理学检查;(4)患者及家属签署知情同意书㊂排除标准:尿脱落细胞病理学检查确诊为膀胱癌㊂1.2方法1.2.1薄层白片制作取清晨起床后第1次尿的中后段100m L送检病理科㊂取50m L500ˑg离心10m i n,弃上清液,再取50m L,重复离心,至肉眼可观察到底部沉淀㊂向沉淀中加5m L缓冲液,振荡均匀,转移至10m L离心管中500ˑg离心5m i n,弃上清液㊂加0.5~1.0m L 缓冲液,振荡均匀,制成重悬细胞液,用于苏木素-伊红(H E)染色制片和F e u l g e n染色制片,H E染色制片采用沉降法液基细胞制片技术(l i q u i d-b a s e d p r e p a r a-t i o n s,L B P):取300~500μL重悬细胞液,滴到直径为13mm的沉降仓,静置30m i n,倒掉上清液,滴无水乙醇1m L固定细胞,倒掉,再滴无水乙醇1m L再次固定,倒掉,制成薄层白片㊂F e u l g e n染色制片采用离心甩片法:取1m L重悬细胞液,滴入甩片仓,调整离心甩片机转速至4000r/m i n,离心4m i n(要求在低倍镜下细胞紧凑平铺,不重叠,高倍镜下可见8~12个上皮细胞),取出玻片,即制成薄层白片㊂1.2.2 H E染色L B P法所制细胞薄层白片苏木素染色1m i n,水洗,无水乙醇脱水2m i nˑ3次,0.5%伊红染色30s,无水乙醇脱水2m i nˑ3次,自然风干,封片㊂片子由1名住院医师初诊,1名主治医师复诊,1名副主任医师对疑难标本会诊㊂诊断结果按照2022版‘尿液细胞学巴黎报告系统“[6],将未查见肿瘤细胞未见癌细胞尿液巴黎2类划为阴性, 查见极个别非典型异型细胞不确定尿液巴黎3类划为不确定, 癌可疑癌尿液巴黎4类及以上划为阳性㊂1.2.3 F e u l g e n染色F e u l g e n染色是一种D N A染色,所制细胞薄层白片染色后可用D N A定量图像分析仪自动分析,自动出具结果㊂F e u l g e n染色步骤:离心甩片法所制细胞薄层白片,垂直放入95%乙醇染缸中固定10m i n,再转入无水乙醇固定15m i n,在320m L甲醇+60m L 甲醛+20m L冰醋酸的混合液中分化15m i n,水漂洗5~6次㊂5m o l/L盐酸60m i n,水漂洗5~6次㊂D N A染液染色约67m i n(根据染液配制时间长短,可进行调整,需在25ħ电热恒温培养箱中避光操作),水漂洗5~6次㊂95%乙醇脱水2m i n,伊红染色约15 s(具体时间根据染液使用情况定)㊂95%乙醇浸泡(2次,2m i n/次)洗去多余染液,无水乙醇(2次,2m i n/次)进一步洗去多余染液并脱水,晾干,封片㊂片子由1名住院医师初诊,1名主治医师复诊,1名副主任医师对疑难标本会诊㊂1.2.4 D N A图像分析本研究采用武汉兰丁医学高科技有限公司的全自动扫描分析系统,根据细胞着色深浅㊁形态㊁面积㊁积分光密度(i n t e g r a t e d o p t i c a l d e n s i t y,I O D),分析其D N A含量㊂这里的D N A含量不是绝对值,是一个相对值,标准对照细胞为同张玻片上的100个正常上皮细胞,对每张玻片上6000个以上细胞核进行扫描,扫描细胞的变异系数(c o e f f i c i e n t o f v a r i a n t i o n,C V)< 5%㊂D N A含量检测以D N A指数(D N A i n d e x,D I)来表示,D I1~<2为正常细胞,不正常细胞的情况有以下3种:(1)D I>2.5的细胞;(2)D I=2的细胞,即在M期,细胞数大于被检测细胞总数的10%(正常细胞M期约占整个细胞生长周期的5%~10%);(3)出现非整倍体细胞峰㊂1.3统计学处理采用S P S S23.0软件进行数据统计学分析,计数资料采用例数和百分比表示,比较行χ2检验,以P< 0.05为差异有统计学意义㊂2结果2.1尿检结果与组织病理学诊断结果比较56例患者中,尿检阴性35例,其中16例组织病理学诊断为阳性,19例为阴性;尿检不确定21例,其中17例组织病理学诊断为阳性,4例为阴性㊂尿检与组织病理学诊断一致率(即准确度)为33.93%(19/ 56)㊂234重庆医学2024年2月第53卷第3期2.2 D N A含量检测与组织病理学诊断结果比较组织病理学诊断为阳性的33例患者中,D N A含量检测阳性17例(真阳),D N A含量检测阴性16例(假阴);组织病理学诊断为阴性的23例患者中,D N A 含量检测阳性8例(假阳),D N A含量检测阴性15例(真阴);故D N A含量检测的灵敏度为51.52%(17/ 33),特异度为65.22%(15/23),准确度为57.14% (32/56),高于尿检准确度,差异有统计学意义(P< 0.01)㊂2.3 D N A含量检测、尿检与组织病理学诊断比较尿检阴性的35例患者中,D N A含量检测阳性9例,其中组织病理学诊断阳性4例,组织病理学诊断阴性5例;D N A含量检测阴性26例,其中组织病理学诊断阳性12例,组织病理学诊断阴性14例㊂尿检不确定的21例中,D N A含量检测阳性16例,其中组织病理学诊断阳性13例,组织病理学诊断阴性3例;D N A含量检测阴性5例,组织病理学诊断阳性4例,组织病理学诊断阴性1例㊂D N A含量检测在尿检阴性患者中的灵敏度和特异度分别为25.00%(4/16)㊁73.68%(14/19);在不确定患者中的灵敏度和特异度分别为76.47%(13/17)㊁25.00%(1/4)㊂2.4不同级别患者尿脱落细胞D N A含量检测结果对比在组织病理学诊断为高级别膀胱癌的8例患者中,D I>2.5的患者6例(75.00%),1例细胞数高达627个(图1);在组织病理学诊断为低级别膀胱癌的25例患者中,D I>2.5的患者11例(44.00%),1例出现非整倍体细胞峰;在组织病理学诊断为阴性23例中,D I>2.5的患者8例(34.78%)㊂图1 D N A含量检测结果3讨论尿液在肾脏形成,流经肾小管㊁肾盂㊁输尿管㊁膀胱,最后由尿道排出,故尿液中混入了泌尿系统各部位的脱落细胞,同时由于尿液中细胞易发生退变,且细胞本身存在细胞形态非典型性特点,时常给细胞学诊断带来困难,漏诊颇多㊂D N A含量检测,并不是一种新兴技术,但是在泌尿系统肿瘤方面的研究较少㊂有研究显示,非整倍体现象在正常情况下非常罕见,是癌症的标志特征之一[7]㊂细胞发生癌变时,M 期(有丝分裂期)发生错误,造成染色体的不稳定性和非整倍性[8-10]㊂近年研究发现,D N A倍体分析在诸多恶性肿瘤的鉴别诊断中具有良好的应用价值,如宫颈癌[11]㊁口腔癌[12-13]等㊂1992年之前在美国主要盛行流式细胞术对细胞内D N A含量进行评估[14],但1993年的一篇研究利用自动图像分析系统分析了膀胱癌石蜡标本D N A含量,确立了自动化图像分析的地位,该技术也可应用于尿液沉淀物的涂片或经尿道切除的肿瘤切片[15]㊂本研究采用国内武汉兰丁医学高科技有限公司的全自动图像分析仪进行分析[16-18],对D N A采用F e u l g e n染色,国内此技术在肺癌[19-22]㊁宫颈癌[23-26]等诸多癌症中已取得良好效果㊂本研究前期成果证实,D N A含量检测联合尿检,可明显提高尿路上皮癌的检出率[27]㊂国内亦有很多研究证实了D N A倍体检测可提高早期癌变的诊断率,并能客观评估癌症的恶性程度,联合尿检能有效减少漏诊率[28-29]㊂本研究重点分析尿检结果不能佐证临床可疑膀胱癌的患者,实验结果显示,尿检为阴性和不确定的56例患者中,经组织病理学诊断确诊为膀胱癌的患者33例,证明尿检存在很大漏检㊂D N A含量检测阳性的患者25例中有17例组织病理学确诊为真阳㊂之所以存在D N A含量检测检出率高于尿检,很大一部分原因可能是细胞核内染色体数目的对数改变先于形态学改变,故较早期的癌变很难用肉眼根据形态学做出正确评估㊂假阴患者可能与肿瘤的部位有关,如果肿瘤部位较深,脱落的肿瘤细胞不足或当次尿液中并没有癌细胞,故不易检出㊂综上所述,尿脱落细胞D N A含量检测可通过对染色体倍数的测定诊断出病变,对肿瘤细胞的良恶性鉴别做出判断,尤其在怀疑膀胱癌患者但尿检阴性和不确定患者中,D N A含量检测可为临床提供一个补充依据,有效减少尿检的漏检率,具有很高的临床应用价值㊂参考文献[1]S U N G H,F E R L A Y J,S I E G E L R L,e t a l.G l o b a lc a n c e r s t a t i s t i c s2020:G L O B O C A N e s t i m a t e s o fi n c i d e n c e a n d m o r t a l i t y w o r l d w i d e f o r36c a n c e r s i n185c o u n t r i e s[J].C A C a n c e r J C l i n,2021,71:209-249.[2]MA A S M,B E D K E J,S T E N Z L A,e t a l.C a n u-r i n a r y b i o m a r k e r s r e p l a c e c y s t o s c o p y[J].W o r l d J U r o l,2019,37:1741-1749. [3]徐涛,秦彩朋.尿液D N A甲基化检测在膀胱癌无创诊断中的研究进展[J].中华泌尿外科杂志, 2020,41:721-723.[4]T S E R T,Z H A O H,WO N G C Y,e t a l.U r i n a r yc e l l-f r e e D N A i n b l ad de r c a n c e r d e t e c t i o n[J].334重庆医学2024年2月第53卷第3期D i a g n o s t i e s(B a s e l),2021,11:306.[5]李金泽,曹德宏,魏强,等.尿游离D N A在膀胱癌诊治中应用的研究进展[J].中华泌尿外科杂志,2022,6(43):469-472.[6]W O J C I K E M,K U R T Y C Z D F I,R O S E N T H A LD L.W e l l a l w a y s h a v e p a r i s t h e p a r i s s y s t e m f o r r e p o r t i n g u r i n a r y c y t o l o g y2022[J].J A m S o c C y-t o p a t h o l,2022,11(2):62-66.[7]S I MO N E T T I G,B R U N O S,P A D E L L A A,e ta l.A n e u p l o i d y:c a n c e r s t r e n g t h o r v u l n e r ab i l i-t y[J].I n t J C a n c e r,2019,144(1):8-25.[8]W I L H E L M T,S A I D M,N A I M V.D N A r e p l i-c a t i o n s t r e s s a nd c h r o m o s o m a l i n s t a b i l i t y:d a n-ge r o u s l i a i s o n s[J].G e n e s(B a s e l),2020,11(6): 642.[9]R O S S J S.D N A p l o i d y a n d c e l l c y c l e a n a l y s i s i nc a n c e rd i a g n o s i s a n d p r o g n o s i s[J].O n c o l o g y, 1996,10(6):867-890.[10]王文芳,吴忆寒,侯岩峰,等.机会性宫颈癌筛查中D N A倍体分析的临床价值[J].当代临床医刊,2022,35(3):51-52.[11]G U O Y,P E N G Q,WA N G Y,e t a l.T h e a p p l i-c a t i o n o f D N A p l o id y a n a l y s i s i n l a r g e-s c a l ep o p u l a t i o n s c r e e n i n g f o r c e r v i c a l c a n c e r[J].A c-t a C y t o l,2021,65(5):385-392. [12]L I C X,WU L,D E N G Y W,e t a l.D N A a n e u-p l o i d y w i t h i m a g e c y t o m e t r y f o r d e t e c t i n g d y s-p l a s i a a n d c a r c i n o m a i n o r a l p o t e n t i a l l y m a l i g-n a n t d i s o r d e r s:a p r o s p e c t i v e d i a g n o s t i c s t u d y[J].C a n c e r M e d i c i n e,2020,9(17):6411-6420.[13]D A T T A M,L A R O N D E D,P A L C I C B,e t a l.T h e r o l e o f D N A i m a g e c y t o m e t r y i n s c r e e n i n go r a l p o t e n t i a l l y m a l i g n a n t l e s i o n s u s i n g b r u s h-i n g s:a s y s t e m a t i c r e v i e w[J].O r a l O n c o l,2019,9(96):51-59.[14]P A L M E I R A C A,O L I V E I R A P A,S E I X A S F,e t a l.D N A i m a g e c y t o m e t r y i n b l a d d e r c a n c e r: s t a t e of t h e a r t[J].A n t i c a n c e r R e s,2008,28(1B):443-450.[15]S TÖC K L E M,S T E I N B A C H F,V O G E S G,e ta l.I m a g e a n a l y s i s D N A c y t o m e t r y o fb l a d d e rc a n c e r[J].R e c e n t R e s u l t s C a n c e r R e s,1993,126:151-163.[16]王蕊,王珩,吴娟,等.全自动D N A图像分析系统在胰腺恶性肿瘤诊断中的价值[J].癌变㊃畸变㊃突变,2021,33(6):451-454.[17]杨新,杨光,肖华亮.全自动D N A图像分析技术提高胸水细胞病理学的阳性检出率[J].现代肿瘤医学,2021,29(23):4093-4095. [18]孙小蓉,车东媛,涂洪章,等.细胞D N A倍体分析评估宫颈上皮内瘤变[J].中华肿瘤杂志, 2006,28(11):831-835.[19]王娟,杨震,朱强,等.一种基于人工智能的细胞病理诊断系统在肺癌诊断中的初步应用[J].解放军医学院学报,2020,41(9):897-900. [20]徐建平,叶伟,吕莉萍,等.细胞D N A图像自动扫描与分析(D N A-I C M)技术在胸科恶性肿瘤诊断中的应用[J].临床与实验病理学杂志, 2018,34(3):263-266.[21]陈学敬,周立娟,杜伟丽,等.细胞D N A定量分析技术在肺癌诊断中的应用价值[J/C D].中华临床医师杂志(电子版),2021,5(15):331-334.[22]王彩霞,刘崇梅,陈萍,等.细胞D N A倍体分析及C Y F R A21-1㊁C E A㊁C A125水平检测在老年良恶性胸腔积液诊断中的价值[J].中华老年学杂志,2017,37(5):1158-1160.[23]刘华,李青,曹磊,等.D N A定量分析在子宫颈A S C-U S患者中的分层管理作用[J].临床与实验病理学杂志,2021,37(4):455-457. [24]杨雯迪,李亚军,张立静.细胞D N A定量分析检测在阴道镜检查中的应用[J].中国研究型医院, 2021,8(1):52-56.[25]王立锋,朱昀恒,朱修香,等.D N A异倍体定量检测用于中老年宫颈病变女性分流诊治的临床价值[J].中华老年医学杂志,2019,38(11): 1285-1288.[26]刘华,李青,朱修香,等.D N A定量分析在子宫颈A S C-U S患者中的分层管理作用[J].临床与实验病理学杂志,2021,37(4):455-457. [27]魏世蓉,王秋实,杨新,等.细胞D N A定量分析在尿脱落细胞学鉴别诊断中的应用[J].诊断病理学杂志,2018,25(4):285-288. [28]吴康,满艳茹,唐文潇,等.自动尿液细胞D N A定量分析对泌尿系统炎症与膀胱癌的鉴别诊断价值[J].中国临床医学,2016,23(5):629-632.[29]王启龙,李明.尿液细胞D N A倍体检测对于泌尿系肿瘤诊断的意义[J].中国城乡企业卫生, 2019,34(6):180-181.(收稿日期:2023-08-18修回日期:2023-10-27)(编辑:姚雪)434重庆医学2024年2月第53卷第3期。

哈尔滨市风华中学2023-2024学年英语九上期末达标检测试题含解析

哈尔滨市风华中学2023-2024学年英语九上期末达标检测试题注意事项：1．答卷前，考生务必将自己的姓名、准考证号填写在答题卡上。

2．回答选择题时，选出每小题答案后，用铅笔把答题卡上对应题目的答案标号涂黑，如需改动，用橡皮擦干净后，再选涂其它答案标号。

回答非选择题时，将答案写在答题卡上，写在本试卷上无效。

3．考试结束后，将本试卷和答题卡一并交回。

Ⅰ. 单项选择1、—Daniel, I’ m still not sure.— Why not? No one is better than you in our class.A．how I can prepare for the competitionB．whether I should take part in the competitionC．who I can ask for more information about the competitionD．when I can enter the competition2、My right foot was hurt in the boys’ 1500-metre race, and the pain ________until I couldn’t walk any longer. A．rose B．raised C．increased D．added3、—Could you tell me ? I must find him.—Sorry, I have no idea. But he was here just now.A．where Tom was B．where Tom isC．where can I find Tom D．where has Tom gone4、It’s reported that people throw plastic bags along this street every day.A．hundred B．hundreds C．hundred of D．hundreds of5、I always play basketball to relax myself Saturdays.A．on B．in C．at D．by6、---We must work as a team or we will fail a second time. --- Yes. Just as a saying goes: .A．One finger can’t lift a small stone B．He who laughs last laughs best.C．One stone kills two birds. D．One is never too old to learn.7、The painting by the artist is world-famous , but several years ago, no one could imagine what an important role he in the painting field.A．was playing B．would play C．played D．had played8、All of us went to the park ______ Bob. He had to look after his sister.A．besides B．with C．except D．beside9、- Why did he make no _______ to be understood or liked?- He didn't care what others think of him.A．balance B．risk C．reply D．effort10、— Everybody is going to climb the mountain. Can I go too, mom?— ______ Wait till you are old enough, dear.A．Good idea. B．Why not? C．I hope so. D．I’m afraid not.Ⅱ. 完形填空11、It was a quiet village in which there was a military camp (军营). It was far from the towns and cities and there were some high mountains 1 . Of course it was a good place for training the new soldiers. But it was 2 for the young men to go outside. Mr. White, an officer of forty, was strict with them and he 3 let them leave the camp.Once Mr. White was ill in bed. He couldn’t work and a young officer, Mr. Hunt, began to train the new soldiers4 him. Having stayed with them for some time, Mr. Hunt5 the young men well and let nine soldiers go to the nearest town to have a holiday. But night6 and none came back to the camp. He was worried about it and stood at the gate. It was five to twelve7 Mr. Hunt decided to go to the town and see what8 to the young men. He started the car quickly and set off. At that moment the nine soldiers came back. It seemed they were all drunk. Of course they found the officer was9 .“I’m sorry, sir,” said the first soldier, “I left the town on time. But something was wrong with my 60. 10 on my way here. I had to buy a horse and made 11 run fast. Bad luck! It died and I had to run 12 .”And the other seve n soldiers said they were late for the same reason. It was the last soldier’s 13 . He said, “I’m sorry, sir. I got on a bus on time, but... ”Having heard this, the officer became even angrier and stopped him at once. He called out,“14 you say something w as wrong with your bus, I’ll punish (惩罚) you at once!”“No, no, sir,” said the young man. “My bus was all right, but the dead horses were 15 its way!”1．A．along B．around C．beside D．inside2．A．easy B．necessary C．difficult D．impossible3．A．hardly B．sometimes C．usually D．always4．A．next to B．in front of C．together with D．instead of5．A．liked B．knew C．cared D．hated6．A．appeared B．passed C．fell D．reached7．A．that B．when C．why D．while8．A．has happened B．is happening C．happens D．was happening9．A．excited B．angry C．surprised D．happy10．A．bus B．horse C．car D．bike11．A．itself B．this C．it D．that12．A．back B．out C．away D．around13．A．decision B．choice C．speech D．turn14．A．If B．Since C．Before D．When15．A．by B．under C．on D．inⅢ. 语法填空12、Champion Swim Club 1．(found) in 2006 by former World Cup Swimming Champion Ms. Vivian Wang and is the first competitive organization for expats’ childre n and adults in Shanghai. The club 2．(provide) a structured program focused on the long-term development of its swimmers. Members will be assessed and given the opportunity3．(train) with swimmers of a similar standard and level under the supervision of 4．(lead) internationally experienced swimming coaches.So far, we5．(create) a program that caters to swimmers of all ages and abilities. In addition to ensuring proper technique and conditioning, Swimmers6．(place) in groups by the coaching staff after a stroke technique assessment session. The program has been designed by a world class coaching team that focuses on all of the elements and techniques that will result students maximizing their potential to enjoy and7．(compete) at a competitive level.The coaching team comprises former World Cup Swimming Champion Vivian Wang as Head Coach and a number of highly experienced professional coaches will work together8．(provide) a developmental swimming program where there is avenue for advancement through to higher le vels. The leader of the club said, “I think we9．(do) some useful things. If everyone spread the spirit, there 10．(be) more champions in China. ”Ⅳ. 阅读理解A13、Foods that are well known to you may not be familiar to people from different places around the world. Tourists and travelers often get to try some unfamiliar food. That is part of the fun of traveling. Here are four people’s experiences with foreign food.1．Chandra is afraid to try new foods because_________.A．she can’t eat food with beefB．she doesn’t like their appearanceC．she doesn’t like foreign foodD．she doesn’t need any food at all2．Nathan worked as _______ in China for a year.A．a worker B．a dentistC．a teacher D．a student3．The passage tells us that ___________.A．David King often drinks milkB．flake and shark are the same fishC．a Hindu eats meat from the cowD．the egg is put in the earth for a hundred yearsB14、Many people believe the human race is divided into two groups. There are cat people, and there are dog people. Friends often ask me if I am a cat person or a dog person. I don’t know. Let’s have a discussion first.Cat people adore cats because they are beautiful and independent. Cats don’t need much care. They go out for a walk by themselves, and don’t need baths. Cat lovers say that dogs are dirty and very dependent on people.Dog people love dogs, because dogs love people. Dog owners believe that dogs make people happy, and people make dogs happy. Dog lovers say cats are too proud. But what influence do cats and dogs have on people? Personally, I believe cat people are arty and independent. They say that cat people pay more attention to personal expressions, and they respect individual differences. Typical dog people love family life: they are warm and friendly people, and they are very loyal totheir friends.In my house I have two cats and a dog. I think I am a cat and dog person. What about you? Do you like dogs or cats? 1．According to the passage, we can know the writer is the person _____.A．who likes neither dogs nor catsB．who likes both dogs and catsC．who only likes dogsD．who only likes cats2．What does the third paragraph about?A．It’s about how to take care of pet s.B．It’s about what dog owners think of dogs.C．It’s about why people don’t like cats.D．It’s about what cat owners think of cats.3．Typically, the people who love dogs are _____.A．arty B．independentC．lazy D．loyal4．What’s the best title of the pa ssage?A．Cat People and Dog PeopleB．Advantages of Keeping Dogs and CatsC．Stay Away from Dogs and CatsD．Get to Know People’s PersonalityC15、A French-language daily in Belgium has issued(出版) what is thought to be Europe’s first 3D newspaper. But you must read it with a pair of special glasses.All the photos and ads in La Derniere Heure’s (DH) special edition(版) were given a three-dimensional effect(3D效果), but the text remained the same.DH’s editor said there were no further 3D plans because of the cost s.Reviewers in France spoke highly of the paper, but they said the overall result was “far from perfect”.Editor Hubert Leclercq said it took two months to get ready for the special edition, which had a higher than normal print run of 115,000 copies for the stores selling newspapers.“We hear about 3D cinema, television and video games, so we took up the challenge,” Mr. Leclercq told the AFP news agency.According to PC World’s French edition, readers could get the best results by holding the paper 50cm fr om the eyes in awell-litarea.“It takes a few minutes to get used to pictures in 3D,” it said, noting the limited quality of the viewing lenses(镜片). It’s said some of the images - especially the ads - had a good 3D effect, but that other pictures were not clear or difficult to look at.1．The Europe’s first 3D newspaper was from.A．Belgium B．France C．Germany2．in La Derniere Heure’s (DH) special edition had a three-dimensional effect.A．All the pictures and the textB．All the ads and the textC．All the pictures and ads3．From the forth paragraph, we know that .A．the 3D newspaper is very goodB．they should improve the 3D newspaperC．they should stop issuing the 3D newspaper4．The underlined word “well-lit” in Paragraph 7 means in Chinese.A．照明条件好的B．火燃烧得好的C．光线良好的5．Which of the following is right?A．It took two months to get ready for the 3D newspaper.B．It will take you a few minutes to read the pictures in 3C．D．All the images had a good 3D effect.D16、First Aid，Learn It by Y ourselfWhen we are injured or suddenly feeling unwell, what we need to do is to treat it in the right way. How can we dothat? First aid (急救) is here to help.First aid is the first steps you can take to care for someone who’s inju red. It includes keeping safe, helping someone feel better and staying calm. It also includes getting help, either by telling an adult or calling 120.Sept 14 is World First Aid Day. It’s time for us to learn about this useful life skill.NosebleedAsk the person to lean (倾斜) forward and pinch (捏) his/her nosefor five to six minutes. Do not move the head backward, as the bloodcan run into their mouth or even lungs.ChokingStand behind the choking (因噎住而窒息) person, put your arms around their waist and lean him or her forward. Make fists with your hands and thrust (猛烈施压) your fists into their stomach. Do this up to five times. You can also do back blows – firmly slap (拍打) their back with your hand. If the object still doesn’t come out, call 120.Broken boneIf the bone is broken, keep it still. You can support it with yourhands or clothes to stop movement. Then, find an adult or call 120 forfurther help.BurnQuickly cool the burned area with cold running water. You shoulddo this for at least 10 minutes. Then, call an adult for help or go to thehospital. Do not use ice. It can make the injury even worse.1．First Aid is the first step you can ______.A．take to care for someone injured B．treat it in the helpful wayC．try the useful skill D．keep safe2．If someone is choking, you’d better ________.A．keep the person still B．cool the area for 10 minutesC．slap the person’s back with your hand D．ask the person to lean and pinch his/her nose 3．When somebody gets burned, you should not ______.A．move the head backward B．use ice to cool the areaC．support it with your hands D．put your arms around their waistE17、Team games are important in school life. They help the children learn the importance of working together for a common goal. Team building activities help the students understand themselves and give them a chance to improve on their weaknesses.Build a Story：This team game is about building a story from some pictures. Each team is supposed to build a story according to the picture given to each of its members. On understanding what each pictures means，the team needs to put the pictures into order. The team that is first to build the story wins.Team Craft(剪纸)：For this activity，the class is put into groups of three or four members. Each team is given some art material like colour pens，art paper and a knife. Each team should come up with something creative and special. The one who finishes first or does best in making craft will be the winner.Team Sports：Outdoor activities and sports are some of the best team games for schools. Volleyball，soccer and basketball are some of the very interesting team games. Exercise mixed with fun is one of the most important interests of playing sports.Dog and the Bone：This game is played between two teams. The teams line up in front of each other. Each team member is given a number or a letter of the alphabet. The same pair of names is used for both the teams. An object is placed in an area between the two teams. The host of the game calls out a name. The members from both the teams with the name rush to get the object. The member，who get the “bone” first，make a point for his/her team.1．What does the passage mainly talk about?A．Team sports. B．Team games.C．Building a story. D．Team art.2．How can we build a story according to the second paragraph?A．To put the pictures into order.B．To say a sentence one by one.C．To talk about the same picture.D．To talk about different pictures.3．In which team game do you have to use color pens and a knife?A．Dog and the Bone. B．Playing volleyball.C．Team Craft. D．Build a Story.4．Which of the following is surely a team sport?A．Swimming. B．RunningC．Basketball D．Walking5．What is the “bone” in the game Dog and the Bone?A．The child who gets the object first.B．The child who can’t get the object.C．The child who hosts the game.D．The object between the two teams.F18、Every day in China，about 200 million children go to school．Many of them take school buses．What should we do to keep these students safe on the road?On April 5，the State Council （国务院）published new rules about school bus safety．These new rules are stricter than the old ones.Under the new rules，local governments must make sure that students go to nearby schools or boarding （寄宿的）schools to reduce traffic risks．Also，local governments must help kids in the countryside reach their school buses. From now on，school buses have a speed limit （限制）of 80 km/h on highways and 60km/h on normal roads．While on the road，other cars must let school buses go first.The new rules also say that school buses must never be overloaded （超载的）.There are many other rules as well．A school bus must have more than seven seats．On each bus，there must be at least one adult to keep an eye on the kids．Each school bus must have a fire extinguisher （灭火器），a first aid kit （急救箱）and a GPS.Last year，a series of school bus accidents happened in China．To stop such accidents，the Central Government decided to strengthen （加强）the rules for school buses.The most serious accident happened in Gansu in November，when a nine-seat minibus crashed （碰撞）．There were 62children inside，and 21 of them died.1．What did the State Council publish on April 5?A．New rules about school bus safety.B．New rules about students’ safety.C．New rules about stude nts’ home.D．New rules about class.2．Under the new rules，which of the following is NOT true?A．School buses can go first when there are other cars.B．School buses must drive 80 km/h or less on highways.C．School buses must drive 50 km/h or less on normal roads.D．School buses must have at least one adult to look after the kids.3．According to the new rules，a school bus must have the following EXCEPT _______.A．a GPSB．more than seven seatsC．a parents of one of the studentsD．a fire extinguisher and a first aid kit4．According to the passage，the government made new rules because __________.A．21 students died in school bus accidents last yearB．school buses in China were not safe enough beforeC．200 million children in China go to school by bus every dayD．the government encourages all students to take school busesⅤ.书面表达19、广州某电台英文频道将开设Welcome to Guang zhou栏目,目前面向全市中学生征集“微州”英文介绍。

2024-2025学年初升高中英语衔接国际音标教学设计

②在板书中加入图片或图标，如猫咪和狗狗的插图，表示相应的单词。
③设计互动环节，如让学生上台标注单词，增加课堂参与度。
作业布置与反馈
1.作业布置：
（1）学生需选择十个单词，用国际音标正确标注并在练习本上写出这些单词的音标。
（2）学生需找一段英语文章或对话，用国际音标标注其中的单词，并尝试朗读。
（3）学生需总结本节课学习的国际音标发音规则，并在练习本上列出。
（3）dog [dɒg]
（4）house [haʊs]
（5）water [ˈwɔːtər]
2.请用国际音标标注以下句子中的单词：
I have a cat.
答案：
I have a cat. [aɪ hæv ə kæt]
3.请总结本节课学习的国际音标发音规则。
答案：
本节课学习了国际音标的基本符号及其代表的音素。音标符号包括元音符号和辅音符号，元音符号有/i:/、/e/、/æ/、/ɑ:/、/ɔ:/、/ʊ/、/u:/、/ʌ/、/ə/、/ɪ/、/eɪ/、/aɪ/等，辅音符号有/b/、/d/、/f/、/g/、/h/、/k/、/l/、/m/、/n/、/p/、/r/、/s/、/t/、/v/、/w/、/z/、/ʒ/等。发音规则包括元音和辅音的拼写规则，以及单词的重音和连读现象。
课程重点：
-掌握国际音标的基本符号及其代表的音素。
-学习音标拼写规则及其在单词发音中的应用。
-提高学生辨别和拼读单词的能力。
课程难点：
-音标符号与实际发音之间的对应关系。
-不同音素在单词中的发音特点和规则。
-单词的重音和连读现象。
教学目标：
-知识与技能：学生能够识别并运用国际音标正确标注单词。
-过程与方法：通过听、说、读、写的练习，学生能够自主学习新单词并正确发音。

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谢谢主席，各位评委，各位同学大家下午好，很高兴今天能够站在这里与对方辩友探讨电视相亲利大于弊还是弊大于利的问题。

开宗明义，何谓电视相亲。

电视相亲作为中国打开国门向外开放的新鲜产物，是指电视媒介为适龄或大龄的未婚青年男女提供的婚介平台而应运而生的具有三性，即娱乐性，盈利性，社会性的文化符号。

其产生有其深刻的社会根源。

社会经济的发展，导致教育年限延长、工作压力增大、使得“剩男剩女”剧增，电视网络的发展，使人们通过各种渠道，了解彼此，我们讨论电视相亲利大于弊还是弊大于利，应当本着尊重辩题的原则来讨论有电视相亲和无电视相亲的利弊问题。

我们判断的标准是电视相亲的存在对人民对社会,对人性的发展是积极的还是有害的。

我方认为，电视相亲利大于弊，理由有三：第一、从个人层面讲，电视相亲的盛行为青年男女创造了相亲交友的平台，为他们提供了更多的邂逅机会，有利于拓展他们的交友面。

这些为当下“剩男剩女”、“宅男宅女”打造的相亲交友类情感真人秀节目，共同建构一个相亲交友的个性化平台。

不可否认，在节目中出现拜金主义、享乐主义的不良观念，但是瑕不掩瑜，电视相亲为我们在现实相亲之外又搭建了一座沟通彼此的桥梁，让银汉迢迢不再成为牛郎织女的催泪源，让相隔千里的有情人终成眷属，可谓功于电视，利在天下。

第二、从利益相关体层面讲，电视相亲有利于提高电视台的收视率，扩大赞助商的影响力，提高经济效益。

众多节目中特色鲜明的嘉宾、炙手可热的话题、言辞犀利的表达，共同构成了一系列有特点的符号，因此，在目前的近10档此类卫视节目中，很多节目的收视率也屡创新高。

赞助商在节目环节中间接直接的起到了宣传的作用，扩大了其产品在消费者中的影响力，成为企业无形的资产。

第三、从社会层面讲，电视相亲节目有利于促进思想解放。

电视交友节目之所以这么火，在于和世俗心理与人性本真的相符合，它无比真实地反映了当今社会的择偶观以及价值观。

它成为观众借以感慨或唏嘘的平台，在信息爆炸的时代,人们选择这样的方式敞开自我、不惧怕公开的表白是一种思想进步的体现。

延胡索酸水合酶缺陷型平滑肌瘤的研究进展

综述作者单位：130000 长春，吉林大学第二医院妇产科通信作者，赵淑华，E -mail: zhaoshuhua -************延胡索酸水合酶缺陷型平滑肌瘤的研究进展王晴郑晶莹丁连英赵韦欣王梦齐赵淑华【摘要】延胡索酸水合酶（FH ）缺陷型平滑肌瘤是子宫平滑肌瘤的一种罕见病理类型，它是FH 基因胚系或体系突变引起，且以后者居多。

该病虽较为罕见，但当它作为遗传性平滑肌瘤病和肾细胞癌（HLRCC ）综合征的前哨表现时，严重的症状体征导致的早期手术以及术后病理为HLRCC 综合征提供了早期诊断的可能。

FH 缺陷型平滑肌瘤的诊断以系统化的诊断方法为主，形态学和免疫组织化学染色有助于提高检出率，但价值有限。

虽然FH 缺陷型平滑肌瘤的生物学潜能低，但突变来源不同导致患者治疗和预后也大不相同。

因此对于临床医师而言，散发性和遗传性FH 缺陷型子宫肌瘤的鉴别是一个巨大挑战。

该文就FH 缺陷型子宫平滑肌瘤的临床表现、形态学特征、诊断与鉴别诊断、治疗及预后做一综述。

【关键词】子宫平滑肌瘤；延胡索酸水合酶；遗传性平滑肌瘤病和肾细胞癌；基因突变；鉴别诊断Research progress on fumarate hydratase -deficient unterine leiomyoma Wang Qing， Zheng Jingying， Ding Lianying， Zhao Weixin， Wang Mengqi， Zhao Shuhua. Department of Gynaecology and Obstetrics， the Second Hospital of Jilin University， Changchun 130000， ChinaCorresponding author， Zhao Shuhua， E -mail: zhaoshuhua -************【Abstract 】 Fumarate hydratase （FH ）-deﬁcient uterine leiomyoma is a rare pathological type of uterine leiomyoma ， whichis caused by FH gene germ -line or system mutations ， primarily the latter cause. Although this disease is rare ， when it is a sentinel manifestation of hereditary leiomyomatosis and renal cell carcinoma （HLRCC ） syndromes ， its severe symptoms and signs lead to early surgery and post -operative pathology that o ff ers the possibility of early diagnosis of the aggressive consequences of this hereditary disease. Systematic diagnosis is the main diagnostic methods. Morphological and immunohistochemical staining are helpful to improve the detection rate ， whereas their values are limited. Although the biological potential of FH -deﬁcient uterine leiomyoma is low ， the treatment and prognosis of patients signiﬁcantly vary due to di ff erent sources of mutations. Therefore ， how to distinguish sporadic andhereditary uterine ﬁbroids is a great challenge for clinicians. In this article ， clinical manifestations ， morphological features ， diagnosis and di ff erential diagnosis ， treatment and prognosis of FH -deﬁcient uterine leiomyoma were reviewed.【Key words 】 Uterine leiomyoma ； Fumarate hydratase ； Hereditary leiomyomatosis and renal cell carcinoma ； Gene mutation ； Di ff erential diagnosis子宫平滑肌瘤是女性生殖系统最常见的良性肿瘤，恶变率极低。

2024届哈尔滨市风华中学中考五模英语试题含答案

2024届哈尔滨市风华中学中考五模英语试题含答案注意事项：1．答卷前，考生务必将自己的姓名、准考证号、考场号和座位号填写在试题卷和答题卡上。

用2B铅笔将试卷类型（B）填涂在答题卡相应位置上。

将条形码粘贴在答题卡右上角"条形码粘贴处"。

2．作答选择题时，选出每小题答案后，用2B铅笔把答题卡上对应题目选项的答案信息点涂黑；如需改动，用橡皮擦干净后，再选涂其他答案。

答案不能答在试题卷上。

3．非选择题必须用黑色字迹的钢笔或签字笔作答，答案必须写在答题卡各题目指定区域内相应位置上；如需改动，先划掉原来的答案，然后再写上新答案；不准使用铅笔和涂改液。

不按以上要求作答无效。

4．考生必须保证答题卡的整洁。

考试结束后，请将本试卷和答题卡一并交回。

Ⅰ. 单项选择1、We must make full use of our valuable time to review lessons in the following days. It is important to study in the right ways. We should avoid______.① listening to teachers carelessly② having a rest as often as possible③ sleeping in class④ writing down the important points and review them after class⑤ practicing more with our teachers or classmatesA．①③⑤B．②④⑤C．①②③2、﹣Can you catch what I said？﹣Sorry，I can ______understand it because you speak very quickly．A．almost B．probably C．mostly D．hardly3、—Who will send you to the new school, your mum or your dad?—__________, I’ll go there alone.A．Both B．Either C．None D．Neither4、--Stop playing with your phone. It’s time to have a meeting.--Thank you for __________ me.A．inviting B．reminding C．encouraging5、----I think Hao Haidong is the best football player in China. He can take our team to the world.----I don’t think so.______________.A．A single flower does not make a spring.B．Many hands make light work.C．The early bird catches the worm.D．Every dog has its day.6、In order to protect the environment, we shouldn’t ________ any trees.A．put down B．count down C．cut down D．look down7、—Do you plan to watch a talent show or a sports show tonight?—. I can't stand them. I plan to see a movie.A．Both B．Either C．Neither8、--- _______ fine weather it is!--- Yes, shall we go boating together?A．What a B．How C．What D．So9、Li Ming is an active boy student and he always tries his best to make his life colorful though he is in Grade 9. The table below shows that he spends ________ minutes on after-class activities every week.A．250 B．850 C．60010、---I called you at about ten o’clock this morning. But you didn’t answer the phone.---Oh, I’m sorry. _________.A．I was having a meeting with clients B．I had a meeting with clientsC．I have had a meeting with clients D．I would have a meeting with clientsⅡ. 完形填空11、These days, some middle schools in China are trying to do something different.The students choose classes according to their own needs. For each subject, they can make a choice from different levels (等级) of difficulty. So instead of staying in the 1 classroom, they go to different rooms to have their lessons. And the teachers make special teaching plans for 2 .There are different opinions 3 it.Xia Rui, a 13-year-old girl, said, “I really love it. I think it’s nice that we can 4 classes by ourselves. My English is poor. I used to be afraid to answer questions in class. I think that the good students may 5 me when I make mistakes.Now I feel much more relaxed.”But her classmate Chen Gang didn’t agree. “I don’t think it is so good 6 it is difficult for students to find where the classrooms are, he said. “During the break, students can be seen here and there, running and sh outing to find their 7 .”“I’m worried that some students may think they are in the lower class 8 lose interest in the subject,” their math teacher, Mr Wang said. “I also 9 that some parents may feel unhappy if their kids study a subject at an easy level.”“In my eyes, it is good for both students and teachers,” Mr Wang also said. “As teachers, we can make teaching plans more 10 and the students will develop better.”1．A．clean B．same C．bright D．empty2．A．us B．him C．them D．you3．A．about B．at C．from D．with4．A．play B．teach C．choose D．work5．A．laugh at B．listen to C．look after D．wait for6．A．whether B．because C．when D．before7．A．parents B．friends C．books D．classrooms8．A．and B．but C．till D．or9．A．hope B．report C．cry D．worry10．A．slowly B．easily C．quietly D．luckilyⅢ. 语法填空12、Do you know Stephen Hawking? He’s one of the most well-known 1．（scientist）on space and time in the world. He was born in England in 1942. Hawking is 2．（study）how the universe began and how it ends.When he studied math and science at Oxford University, he fell 3．(serious) ill, which made him unable to speak or breathe. Till now, he can’t move or feed 4．(him). however, he has a wheelchair with 5．special computer, with which he can communicate with others.6．he was facing all these difficulties, he refused to give up his hope of living. Because 7．his illness, it was difficult for him to draw diagrams or to write. So he started 8．(think) in pictures. With this new way of thinking, he is respected by people in the world.Once he 9．(invite) to China to give lectures. His self-confidence and humorous conversations impressed us deeply.He once said, “When something unfair happens, 10．is no need to worry about it! You just have to do the best in your own situation.”Ⅳ. 阅读理解A13、1．Which movie lasts the longest time?A．Brave. B．The Grey. C．Chimpanzee. D．Mirror Mirror. 2．Which statement about the movies is true?A．Mirror Mirror is directed by Lily Collins and Julia Roberts. B．The Grey directed by Ian Mackenzie Jeffers is based on a short story. C．Y ou can’t see many beautiful nature sig hts in Chimpanzee.D．Brave is about a princess who obeys her heart.3．Who played the lead role in one of the movies?A．Lily Collins and Julia Roberts.B．Alastair Fothergill and Mark Linfield.C．Ian Mackenzie Jeffers.D．Merida and her family.B14、All in th e memory…Many people complain that their memory is bad, especially as they get older. Phone numbers, names, facts we studied only a few days ago – life would be so much easier if we could remember them all effortlessly. So how can we improve our memory?Many people think that repeating things is the best way to remember them. While this undoubtedly helpsshort-term memory (remembering a telephone number for a few seconds, for example), psychologists (心理学家) doubt whether it ca help you to remember things for very long. The British psychologist Ec Stanford seemed to prove this point when he tested himself on five prayers (祈祷文) that he had read aloud every morning for over 25 years. He found that he could remember no more than three words of some of them! More helpful, especially for remembering numbers, is grouping the information. The following numbers would be impossible for most of us to remember: 1492178919931848. But look at them in chunks, and it becomes much easier: 1492 1789 1993 1848.So what about “memory training”? We’ve all heard about people who can memorize packs of cards by heart—how is this done and can anyone learn how to do it? According to experts, there are many ways of training your memory. Many of them involve forming a mental picture of the things to be memorized. One method, which may be useful in learning foreign languages, is to create a picture in your mind connected to a word you want to remember.Another method is to invent a story that includes all the things you want to remember. In experiments, people were asked to remember up to 120 words using this skill; when tested afterwards, on average, they were able to recall 90% of them!However, not all of us are interested in learning long lists of names and numbers just for fun.For those studying large number of information, psychologists suggest that the best way to form meaningful connections is to ask yourselflots of questions as you go along. So, for example, if you were reading about a particular disease (疾病), you would ask yours elf questions like: “Do people get it from water?”, “What parts of the body does it influence?” and so on. This is said to be far more effective than time spent “passively” reading and re-reading notes.1．Which of the following is true about repeating things according to the passage?A．It helps short-term memory for sure. B．It makes remembering things interesting.C．It helps to remember things for long. D．It makes remembering prayers effortlessly.2．The word “chunks” in Paragraph 2 probably means “______”.A．details B．turns C．groups D．lines3．What can we infer from the passage?A．Creating a picture is useful in learning math.B．Inventing a prayer trains our memory quickly.C．Remembering long numbers is easy for people.D．Asking yourself questions activates the memory.4．What’s the writer’s main purpose in writing this passage?A．To complain that his memory is bad.B．To recognize some memory problems.C．To explain some memory experiments.D．To share some ways of improving memory.C15、Huang XiaomingChinese actor Huang Xiaoming visited the panda base(据点) in Sichuan province.During his visit, Huang put on a keeper’s suit and tried cutting bamboo, cleaning cages andfeeding the pandas.Huang also adopted a pair of panda twins with a gift of one million yuan.Angelina JolieHollywood actress Angelina Jolie can do all kinds of things on screen. It looks like she’s goodat everything, shooting, fighting and killing. But there’s one thing she’s afraid of — cooking.The 33-year-old actress says she was never able to master cooking skills. ＂I don’t cook —it’s the one thing I can’t do!＂she says.Chen LuyuChinese hostess Chen Luyu is famous for her popular talk show. She set up an online versionof her show at .People have grown tired of Chen’s show, especially her habit of constantly asking guests, ＂really?＂.But the producer of the show supports Chen. ＂She’s one of the few Chinese hosts whoknows how to control her desire to express herself and let the guests speak freely in aninterview.＂1．What kind of animals does Huang Xiaoming like?A．Pandas. B．Monkeys.C．Tigers. D．Lions.2．Which is TRUE about Angelina Jolie?A．She is good at everything. B．She can’t shoot well.C．She can’t cook by herself.D．She can cook well.3．Why have people grown tired of Chen Luyu’s show according to the passage?A．Because she isn’t famous for her talk show.B．Because she set up an online version of talk show.C．Because she has the habit of constantly asking, ＂Really?＂.D．Because she likes to express herself.4．What does the underlined word＂adopt＂mean in the first paragraph?A．批准B．继承C．采纳D．收养5．We can know from the passage that __________.A．Angelina Jolie is a shy actressB．Chen Luyu isn’t famous any moreC．Huang Xiaoming is a kind manD．All the three stars are ChineseD16、When I was a child, I used to dream about becoming a fireman.I thought, “Wow, wouldn’t it be great to help people put out fires.”As I got older, I want to be like my father.He taught in a university, and I always look up him.So th at’s why I became a teacher.In many ways, I feel that I’m living my dream, I am lucky.Sometimes we have dreams when we are younger,“I want to be a singer,I want to be a scientist...”Well, life may push it in another direction.But don’t worry, go f or it!We should actively pursue(追求) our dreams.Our dreams won’t often pursue us,We should cherish (珍惜) our dreams and make them come true.Everyone has a dream, the question isCan you make yours reality(现实)!1．This poem mainly talks about _______.A．fathers B．happiness C．Fires D．dreams2．The writer’s dream was becoming a _______, when he was a child.A．fireman B．scientist C．singer D．teacher3．What is the writer’s father?A．A fireman. B．A teacher. C．A singer. D．A scientist.4．Which one is true according to the poem?A．The writer can help people put out fires.B．The writer is living his dreams and lucky.C．Our dream will often pursue us actively.D．Everyone can make his dream come true.E17、For most people, the word “fashion” means “clothes”. But people may ask the question, “What clothes are in fashion?” And they use the word “fashionable” in the same way: “She was wearing a fashionable coat. His shirt was really a fashionable colour.”But of course there are fashions in many things, not only in clothes. There are fashions in holidays, in restaurants, in films and books. There are even fashions in school subjects, jobs… and in languages.Fashions change as time goes. If you look at pictures of people or things from the past, you will see that fashions havealways changed. An English house of 1750 was different from one of 1650. A fashionable man in 1780 looked very different from his grandson in 1860.Today fashions change quickly. Some of this is natural. We hear about things much more quickly than in the past. Newspapers, radios, telephones and televisions send information from one country to another in a few hours.New fashions mean that people will buy new things, so you see there is money in fashion.1．Most people think that “fashion” means ________.A．books B．clothes C．holidays2．By _______ we can see that fashions change as time goes.A．wearing a fashionable coat B．eating in a new restaurantC．looking at pictures of people3．In the 4th paragraph the writer mentions _______ kinds of ways to send information.A．three B．four C．five4．“There is money in fashion.” means ______.A．people like fashion and moneyB．fashionable things are expensiveC．one can make money through fashion5．The passage is mainly about _____.A．the changes of fashion B．the kinds of fashions C．the money in fashionF18、“Without music, life would be a mistake,” famous German philosopher（哲学家）Friendrich Nietzsche said over a century ago. Music is a big part of our lives. But in recent years, some US schools have cut music classes to control budgets（预算）.For example, Chicago public schools hurt arts education when it fired over 1,000 teachers. Among them, 10 percent of the teachers taught art or music, according to The Washington Times. In fact, this is not just a problem in the US. In other countries, such as China and the UK, music classes are not thought to be as important as ones like science, math and history. That’s partly because music is not seen as a very important life skill, and it isn’t tested. Many students are busy with schoolwork, so parents and students choose to focus（关注）on subjects that are tested more often. However, learning music is useful in many ways.When playing music, you need different abilities to work together. It is not as simple as it looks, according to Kenneth Guilmartin of Music Together, an early childhood music development program. For example, when playing the piano, people see music notes and decode（解码）them in their brains. They also use their fingers to make sounds. You need todeal with all these things at the same time.Music has a special connection with science as well. Y ou can see that many scientists are good at playing music: Einstein played the violin, and German physicist Max Planck did well in playing the piano.1．Some schools in the US cut music classes, because ______.A．they were too difficult to learn B．students in the US weren’t interested in musicC．the schools wanted to control budgets D．there weren’t enough music teachers in the US2．In Paragraph 2, what does the underlined word “them” refer to（指代）?A．Fired teachers. B．Public schools. C．Parents in Chicago. D．Students in Chicago.3．What’s the main idea of Paragraph 4?A．Playing the piano needs people to see music notes.B．Playing the piano needs people to use fingers to make sounds.C．Decoding music notes is needed while we are playing music.D．Different abilities are needed to work together while we are playing music.4．How many scientists who are good at playing music are mentioned in this passage?A．One. B．Two. C．Three. D．Four.5．What’s the writer’s opinion according to this passage?A．Music is as simple as it looks. B．Music classes should be cut in some schools.C．Music is a big part of our lives. D．Music isn’t a very important life skill for us.Ⅴ.书面表达19、同学们，四年的初中生活就要结束了，在我们的成长过程中，既有快乐，也有烦恼。

hgfhgf

F1 cos mg F1 sin
mg
由（1）（2）（3）式解得：
图1
y
N2
F2
代入数据：得
x
f2
2 11
F2 cos f 2 4 N 2 mg(5)
mg
如图2，由牛顿第二定律： F2 sin 由平衡条件：
例：质量m=5Kg的物体放在水平面上，受到与水平方向成θ=37O角斜向右上方拉力F1=10N作用,恰能在水平面上匀速运动 .求当物体受到与水平方向成θ=37O角斜向右上方拉力F2=20N作用时的加速度。解：如图1，物体做匀速运动由平衡条件：
y N1 F1
F1 cos f1 1 F1 sin N1 mg(2)
学
＆
方
法
教
学
程
序
导入：利用多媒体播放汽车启动，飞机起飞等资料．
提出问题：它们的速度变化快慢即加速度由哪些因素决
定？（通过实际总是及现象分析，激发学生的兴趣，培养学生发现问题的能力．）提出问题，让学生复习回顾：１，质量一定时，加速度与所受外力的关系？２所受外力一定时，加速度与质量之间的关系如何？当m一定时, 当F一定时, F∝a m∝a
进一步提出问题，完成对牛顿第二定律的探究的引入．物体的加速度与其质量的所受外力有什么样的关系？由当m一定时, F∝a 当F一定时, m∝a
可知：Ｆ＝Kma 当Ｋ取值刚好为１时，则：Ｆ＝ma 学生进行分析讲座讨论之后，进一步提出问题：１牛顿第二定律的内容应该如何表达？２它的公式如何？３各物理量的单位是什么？力的单位是如何定义的？
图2
又 f 2 N 2 (6)
F2 cos m g F2 sin a m

肝豆状核变性

脑型
①帕金森综合症； ②运动障碍：扭转痉挛、手足徐动、舞蹈症状、步态异
常、共济失调等； ③口-下颌肌张力障碍：流涎、讲话困难、声音低沉、
吞咽障碍等；④精神症状。
其他类型以肾损害、骨关节肌肉损害、溶血性贫及角
膜色素环为主。
混合型以上各型的组合。
角膜色素环(K-F环)
角膜边缘可见宽约2---3mm左右的棕黄或绿褐色色素环，用裂隙灯检查可见细微的色素颗粒沉积，为本病重要体征，一般于 7岁之后可见。
诊断及鉴别诊断
1.诊断依据
临床上主要依据： ①肝病史、肝病征或椎体外系病征； ②血清CP显著降低和（或）肝铜增高； ③角膜K-F环； ④阳性家族史等四条进行诊断。符合①②③或①②④可确诊WD；符合①③④极可能为不典型
的WD；符合②③④极可能为症状前WD；如符合4条中的2条很可能是WD。
2.鉴别诊断
遗传学
WD基因ATP7B定位于13q14.3，80kb，21外显子/20内含子，1411aa，细胞膜铜转运P型-ATP酶。
WD蛋白是重金属转运P型-ATP酶家族中的一员，具有高度的进化保守性，主要分布在肝脏和肾脏中。
迄今为止，WD基因突变类型超过200种，其中大多数是错义突变或无义突变，其中东方人群的突变热区为8号外显子，主要是Arg778Leu和Arg778Gly；而西方人的突变热区是14号外显子，为 His1069Gln。
病理改变
3.肾脏
铜在近曲小管沉着，显示肾小管脂肪变性和水样变性。
4.角膜
铜沉着在角膜后Descemet膜的周围形成棕绿色的色素沉着，称Kayser-Fleischer环。
临床分型及表现
本病大多在10~25岁间出现症状，男稍多于女，同胞中常有同病患者。

FH的临床处理治疗

(二)降血脂药物
（4）普罗布考：渗入到脂蛋白颗粒中影响脂蛋白代谢，产生调脂作用，其作用与抗氧化有关，可降低TC和LDL-C。适应症高胆固醇血症尤其是纯合子型家族高胆固醇血症，常用剂量为：0.5g，每天2次。能使动脉粥样硬化病变明显减轻，冠心病发病率明显减少，特别是能有效消除纯合子FH的皮肤和肌腱黄色瘤。常见副作用为恶心；偶见QT间期延长，为最严重的不良反应。
(二)降血脂药物
（2）胆酸螯合剂（树脂类）：属碱性阴离子交换树脂，在肠道内与胆酸不可逆结合，阻碍胆酸的肝肠循环，促使胆酸随粪便排出，阻断其胆固醇的重吸收。通过反馈机制，上调肝细胞表面的LDL-R，加速血中LDL清除，降低TC和LDL-C。适应症：高胆固醇血症和以胆固醇升高为主的混合型高脂血症。如考来烯胺、考来替泊
FH的临床处理，治疗
(一)饮食控制：(二)降血脂药物：纠正血脂异常，降低心血管疾病发生率和死亡率。降低胆固醇还可使黄色瘤停止生长、甚至减少消失，对FH患者药物治疗是必要的。纯合子的家族性高胆固醇血症常因为基因缺损造成饮食及药物治疗效果不理想时，更进一步新治疗有 (三)LDL分离术：血液透析方法加速降低LDL，改善皮肤的黄色瘤及心血管病变。 (四)肝脏移植：移植正常肝脏组织，分泌酵素发挥排除LDL功能，须终身免疫控制剂服用。 (五)未来发展基因疗法。
(二)降血脂药物
（7）n-3脂肪酸制剂：n-3长链多不饱和脂肪酸包括二十碳五烯酸EPA和二十二碳六烯酸DHA等，是海鱼油的主要成分。调脂机制不清，可降低TG和轻度升高HDL-C，对TC、LDL-C无影响。适应症为高TG血症和以甘油三酯升高为主的混合型高脂血症。
(二)降血脂药物
小结
药物类别
主要适应症
(二)降血脂药物
（6）烟酸类烟酸类药物属B族维生素，当用量超过其作为维生素作用的剂量时，可有明显的降脂作用。该类药物的适用范围较广，可用于除纯合子型家族性高胆固醇血症，及I型高脂蛋白血症以外的任何类型高脂血症。大剂量能降低TG和VLDL，与他汀类或胆汁酸结合树脂合用降LDL作用增强。烟酸能升高HDL。烟酸能降低cAMP水平，使脂肪酶活性下降，脂肪组织中TG不易分解出FFA，肝脏合成TG原料不足，难以进一步合成和释放VLDL，继而LDL来源减少。烟酸升高HDL是由于使TG浓度降低导致HDL分解减少所致。

THK 滚针凸轮导向器

cfsfu型a196分类表带内六角孔的螺柱型cfhra球面外圈cfha圆筒形外圈带螺丝刀安装用沟槽的螺柱型cfhr球面外圈cfh圆筒形外圈有油孔型cfhtr球面外圈cfht圆筒形外圈带螺丝刀安装用沟槽的螺柱型cfr球面外圈cf圆筒形外圈有油孔型cftr球面外圈cft圆筒形外圈带内六角孔的螺柱型cfb圆筒形外圈cfa圆筒形外圈cfra球面外圈带螺丝刀安装用沟槽的螺柱型cfsfu圆筒形外圈cfsfur球面外圈带内六角孔的螺柱型cfs圆筒形外圈带内六角孔的螺柱型cfnra球面外圈滚针凸轮导向器偏心普通型内装止推钢球外圈紧凑型简易安装型a197选择的要点滚针凸轮导向器额定寿命00静态安全系数基本静额定负荷c0是指具有方向和大小都一定的静态负荷其应满足使处于承受最大负荷状态下的滚柱和滚动面之间的接触区域中心计算接触应力为4000mpa的条件
表1 静态安全系数(fS、 fM) 负荷条件普通负荷冲击负荷 fS和fM的下限 1～2 2～3
滚针凸轮导向器
【额定寿命】
滚针凸轮导向器的使用寿命可由下式计算。
L=
L
fT • C fW • PC
10 3
10
6
∶额定寿命（一批相同的滚针凸轮导向器在相同条件下分别运动时,其中的90%不因滚动疲劳产生表面剥落所能到达的总转数。）
A
特长与类型
滚针凸轮导向器的特长
带内六角孔的滚针凸轮导向器
对于滚针凸轮导向器CF型、内装止推钢球的滚针凸轮导向器CFN型以及偏心滚针凸轮导向器CFH型,提供易于进行偏心调整的带内六角孔的螺柱。如果要求在螺柱头上加工内六角孔,则请在公称型号的末尾加上A；如果要求在螺柱的螺纹处加工内六角孔,则加上B （B适用于CF12型或其以上的型号）。
A
B 辅助手册(别册)