1、 no enough money have no time to watch TV argument between parents have an argument with friends. There is something wrong with my computer. Section B(1a-2c) Period 3 SECTION B 1a When you choose clothes, what is important to you? They are original. adj. 新颖的, 首创的 They are in style. 时髦的；流行的 When you
2、choose clothes, what is important to you? They are inexpensive. adj. not expensive When you choose clothes, what is important to you? They are colorful. When you choose clothes, what is important to you? They are the same as my friends clothes. When you choose clothes, what is important to you? A: W
3、hen you choose clothes, what is important to you ? B: Its important to me that _1、They are original. _2、They are comfortable _3、They are the same as my friends clothes. _4、They are in style. _5、They are inexpensive . _6、They are colorful. uncomfortable original in style inexpensive comfortable copy
4、out of style expensive Listening: Whats Erins problem? _My friend has nicer clothes than I do. _My friend wears the same clothes and has the same haircut as I do. _I dont like my friends clothes and haircut. 2b What advice do the people give Erin? Listen again and fill in the chart. PersonAdvice Kim
5、 Nicole Emilio She should tell her friend to get different clothes and a different haircut. She should be happy that her friend likes her clothes and haircut. She should find a new best friend. Language points: tell sb. to do sth. 告诉某人做某事 Mother told me to have healthy food to keep fit. tell sb. not
6、 to do sth. 告诉某人不做某事 The teacher tells us not to talk in class. Advice: You could ask him why. You should talk to your best friend. You could . You could . Please give him some advice. 1. What is the boys problem? His friends didnt invite him to a birthday party. And he didnt know why. 2. T(True) F(
7、False) or DK(Dont know): 1. The lonely Kid didnt think he was popular at school. 2. Everyone except him in the class was invited to the party. 3. The Lonely Kid will go to the party. F T DK Language points: 1. find out，找出；查明 find out 意为“找出” “发现” “ 查出（真相） ” find和find out都有发现的意思，二者的语义差别是 ：find往往指凭一时的直
8、接感觉或偶然发现，而find out则需经一番努力后发现出来，有“查明，弄清”的 意思。 He found a bag on the chair. Please find out when the train will leave. 2. Everyone else in my class was invited except me, and I dont know why. else修饰不定代词（something, everything, somebody, anybody等），疑问代词（who, which, whom等）和疑问副词（when, where等） 要用在这些词后面，译为“别
9、的”。 eg. What else can you do? Is there anything else ？ Fail 的一些用法 Fail 动词 失败 Fail the test=not pass the test译为考试 不及格 而fail to do sth.表示为在.上失败，或 失败做某事 但是fail to do sth.还可以表示为不能去 做某事 Language Points Except and besides except的意思是除.以外,和besides的意思一样 但是except的描述范围是不包括其所跟的词 如： I invited everyone except Geo
10、rge 除了乔治之外我请了每一个人 而besides的含义完全相反 如I invited three people besides George 除了乔治外我还请了三个人 3. I dont know what to do. 我不知道该做什么。 疑问词 + 动词不定式结构，表示一个完整的 含义，在句中可以做主语，宾语，表语等。 这种结构经常放在tell，show，teach，forget，find out等词后作宾语。 I cant decide where to go for vacation. I asked her how to make dumplings. He doesnt kno
11、w which one to choose. Dear Lonely Kids, There are a lot of things you could do. You could call him/her up and ask him/her why you were not invited. If you did something wrong, you should say you are sorry. Or maybe you should write your best friend a letter. In the letter, you could ask him/her if
12、you did something wrong and tell him/her that you want to come to his/her birthday party. Good luck! Yours, Mary Writing practice : Give me a hand.(仿写): First think about what troubles you have recently and write a letter to an advice column. Then exchange the letters and write back to give some adv
13、ice. Dear Dr. Know, I have a problem, and I need your help. I am very upset and dont know what to do. What do you think? Can you help me? Yours, Lonely Kid Page 14 What should you do? call upcall up talktalk argueargue saysay found outfound out Language points 1. argue with 与某人争吵 I dont want to argu
14、e with him. 我不想和他吵架 。 2. My clothes are out of style. 我的衣服过时了 。out of style “过时的，落伍的” 3. maybe, may be表示“可能，也许” 表示推测。 maybe一般放在句首，引导句子。may be由情态 动词may加系动词原形be构成。其后所接词决定 于be，可以是名词、形容词等，一般放在句中。 Maybe he is Johns father. 也许他是约翰的父亲 。 He may be a student. 也许他是一名学生。 4. call up 表示“打电话”，可以与名词、 代词连用。连接代词时，把代
15、词放在call与up之 间。 Please call me up. Dont forget to call up your uncle. 5. on the phone 用/通过电话 I want to know the weather on the phone. 我想 通过电话查一下天气。 6. ask for 要求，索要，完整形式为ask sb. for sth. 向某人要某物 Please ask him for the book. 请向他要那本书。 7. be angry with sb. about sth. 因为某事而对 某人生气，注意be动词及介词with Jim is angr
16、y with me. 吉姆生我气了。 8. get on 相处，get on / along well 相处融洽 get on / along well with sb 与某人相处融洽 1. What did her cousin do last week? She borrowed a math book from the reader. 2. Why couldnt the reader do her homework? Her cousin didnt return the math book. 3. Did she want to have a fight with her cousi
17、n? No, she didnt. Page15 2 Expanation: the same age as me the same as 和一样 get on 相处 我们要好好相处 We should get on well with each other. 互相 Return 归还: 你必须按时将书本还给图书馆。 You must return the books to the library on time. 少小离家老大 回 I left my hometown when I was very young and return ( when I was) old. 2 Reading
18、Read the letter to Aunt Chens advice column and then write some advice. Dear Looking for Help, There are lots of things you could do. First, _ _ _ _ you should talk to her about the problem. Maybe she just forgot borrowing your things. You can just ask her to return the book to you. Or you could wri
19、te a letter to her about it. Everyone needs help. No one can sail the ocean of life single handed. 人人都需要帮助， 没有人能独自在人生的海洋中航行。 1. 我的哥哥有着和我的一样的发型。 2. 他和比尔盖茨一样富裕。 My brother has the same haircut as I do. He is as rich as Bill Gates. Do you after school? Pre-reading I do .after school Fast reading Read t
20、he new words and phrases football until fit as as possible pressure complain include pushy send all kinds of comparewith crazy themselves adult organized on the one hand on the other hand 1.Where does Cathy Taylors take her sons and daughter to? 2. What does Dr. Alice Green say about the children un
21、der the pressure? She takes her sons to from football to basketball. She says that they may find it hard to think for themselves when they are older. Skim reading: Answer to questions True or false: 1.Cathy Taylors children do many after- school activities. 2.Doctors say many children arent under to
22、o much pressure. 3.Few children take part in after school activities. 4.Parents dont think their children should do the same as others. T F F F 5.Its crazy for parents to compare their children with others. 6.Competition between families starts at a young age. 7.Parents shouldnt learn to give their
23、kids a bit more time. 8.Children should have time to relax. T T F T 1.When do Taylors children get home? 2.Do American and British children do many after-school activities? 3. What after-school clubs do children take part in after school ? 4.Are many children under pressure? Till 7p.m. Yes ,they do.
24、 Yes,they are. Language club Scan reading:answer eight questions 5. Do parents push their children too hard these days ? 6.When does competition between families start? 7. What is difficult for these children when theyre adults ? 8.Whats the result of this passage? Yes ,they do. At a young age. Its
25、difficult for them to plan things for themselves. Children need freedom to relax 他在有压力的情况下工作很出色. He works well under pressure. 例句 n. 压力；压迫 词义 pressure 我们没有自由做自己喜欢的事。 We do not have the freedom to do just what we like. 例句 n. 自由 词义 freedom 将这个与那个比较一下，你就会知 道哪个比较好了。 Compare this with that, and you will
26、see which is better. 例句 vt. 比较；对照 词义 compare 望子成龙古而有之，但如今家长好像 对给孩子的压力大多了。 Pushy parents are nothing new, but now parents seem to push their children a lot more. 例 句 adj. 争强好胜的；事业心强的 词 义 pushy 一方面，孩子们需要有组织的活动。 On the one hand, children need organized activities. 例句 adj. 有组织的；有系统的 词义 organized The tir
27、ed children dont get home until 7 pm. until :一直到 not until 直到才 直到昨天我才知道这件事情。 I dont know it until yesterday. 他直到作完工作才回家。 He didnt go home until he finished his work. 疲劳的孩子直到7点才回家 Its time for homework Its time to do sth 午餐时间到了 Its time for lunch. =its time to have lunch. Try to fit as much as possib
28、le into their kids lives. fit 合适： 这件大衣不合我身 This coat doesnt fit me well. fit into 找到时间做 asas possible 尽快 As soon as possible 尽量多 As much as possible compare with : 把相对比 12班和13班对比的话，12班更活跃一点。 Compare Class 12 with Class 13, Class 12 is a little more active. 在字典中查找 look upin a dictionary 与打架 have a fi
29、ght with sb 与比较 compare with 向抱怨某事 complain to sb about sth 处于(太多的)压力之下 be under (too much) pressure 买不同的衣服 get different clothes 把从带到 take sb from to 直到才 notuntil 尽可能多地充实到孩子们的生活中来 fit as much as possible into their kids lives 屡见不鲜 nothing new 厉害地强迫某人 push sb hard 总是在做某事 be always doing 计划做某事 plan t
30、o do 一方面另一方面on the one hand on the other hand 从很小的年龄开始 start from a very young age 独自 by oneself Useful expressions Read these statements. Is the situation the same in China? 1. American and British children do many after-school activities. 2. Many children are under pressure. 3. Parents these days
31、push their children much harder than before. 4. Competition between families starts at a young age. 5. Children should have free time to relax. Reading for comprehension organized pushy pressure complain compare freedom 造句 Life for Cathy Taylors three children is very busy. Their school days are Aft
32、er school, Cathy takes the two boys_ _. She has to take her daughter to_ _. The tired children _get home _7pm. They have a quick supper ,and _homework. What do you think of the Taylors and their children? busy enough. from football to basketball piano lessons dont until its time for Read carefully a
33、nd fill in the blanks. Careful reading: After reading carefully, finish the questions. ( )1. The teachers teach _ in school these days. A. some crazy students B. some lazy students C. some pushy students D. some tired student血液透析充分性及影响因素血液透析充分性及影响因素 中山大学附属第一医院肾内科中山大学附属第一医院肾内科 余余 学学 清清 主要内容 透析充分性的定义
34、透析充分的临床意义 透析充分的评估方法 透析充分的评估指标 影响透析充分的因素 血液透析充分性的定 义 从从最初的维持生命最初的维持生命 最佳透析方案最佳透析方案 减少短、长期并发症和死亡率 易于操作和实施 保持病人较高的生活质量 透析充分性 病人预后 生活质量 社会回归 患病率 死亡率 溶质清除充分 酸中毒纠正 达到干体重、血压控制 营养良好 贫血纠正钙磷代谢 Santoro, Kidnye Int, 2000 症状少，并发 症少或无 周围神经病 变少或无 血液透析充分性的目标 透析充分的临床意义透析充分的临床意义 水负荷过多的危害 水潴留 高超滤率 口渴导致水分摄入 未达到目标干体重 高血
35、压 透析中低血压 心脑血管疾病 高钠透析 注射高渗溶液 提前结束治疗 Kt/V与死亡相对危险性 RR Kt/V 1.20 P=0.11 0.87 P=0.26 1.00 (ref) 0.69 P=0.01 0.71 P=0.01 N=463N=462N=462N=462N=462 RR=0.93/0.1 Kt/V (P70%死亡率没再下降 Owen 1998 回顾性 18100 1yr URR与死亡率明显 负相关 透析充分与生存质量 KDQOL-SFTM将一般健康相关的生存质量项目和肾 病、透析相关的生存质量项目综合考虑而来，是专 门为评估维持性透析患者生存质量而设计。 KDQOL-SFTM内
36、容包括 一般健康相关生存质量（SF-36） 肾病和透析相关生存质量(KDTA) 广州市血透患者生存质量与国外同类 研究的对比 SF-36 Zheng ZH et al JASN:2003 (abstract) 广州市血透患者生存质量与欧日同类 资料的对比 KDTA Zheng ZH et al JASN:2003 (abstract) CaP 、Kt/V与生存质量关系 生存质量领域 肾病、透析相关生活质量 症状与不适（ SPL) 肾病对日常生活的影响(EKD) 肾病给生活带来的负担(BKD) 工作状况(WS) 认知功能(CF) 社交质量(QSI) 性功能(SeX) 睡眠(Sleep) 社会支持
37、(SoS) 透析医护人员的鼓励(DSE) Ca X P r p -0.220.049 -0.248 0.033 -0.221 0.047 -0.159 0.156 -0.217 0.044 -0.061 0.589 -0.084 0.457 0.1020.38 -0.261 0.010 0.0910.443 0.0240.829 Kt/V r p 0.2730.039 0.2340.046 0.2570.044 0.0550.684 0.0090.948 0.1680.213 0.0040.978 0.1790.2 0.0420.754 0.0970.473 0.0180.896 甲状旁腺素、
38、2微球蛋白与生存质量关系 生存质量领域 透析相关生活质量 症状与不适 肾病对日常生活的影响 肾病给生活带来的负担 工作状况 认知功能 社交质量 性功能 睡眠 社会支持 透析医护人员的鼓励 患者满意度 2微球蛋白 r p -0.053 0.683 -0.088 0.498 -0.073 0.574 -0.107 0.408 0.0240.854 -0.127 0.325 -0.157 0.224 -0.043 0.742 0.1870.146 -0.095 0.464 0.0060.961 0.0940.466 甲状旁腺素 r p -0.525 0.001 -0.581 0.001 -0.351
39、 0.002 -0.086 0.455 -0.176 0.127 -0.225 0.049 -0.163 0.156 -0.118 0.317 -0.545 0.001 -0.211 0.066 0.0710.539 0.0210.856 钙磷代谢对预后的影响 Ca x P 乘积(mg2/d L2) Block et al. AJKD, 1998 透析充分性的评估指标 血液透析水分清除的评估 水分的清除非常重要，但往往被忽视 透析后能达到干体重 用或不用降压药，血压控制正常 无浮肿、心力衰竭 在线血容量监测 超滤使血液中细胞成分和固体密度升高 血细胞和固体密度与血容量的改变成反比 pp示踪稀释
40、技术示踪稀释技术 p低频电导技术 p超声血液容量监测 p光学反射方法 p血粘稠度法 血透中血容量变化的三种典型曲线 血容量变化的三种典型曲线 A型血容量变化曲线 p透析结束时血容量没有或轻微减少 p隐性或显性水负荷过度，未达干体重 B型血容量变化曲线 p透析结束时血容量减少适当，已达干体重 C型血容量变化曲线 p脱水速度或总量过度，血容量明显减少 p提示患者可能发生容量型低血压 生物电阻抗(BIA) 生物电阻抗仪分别测定TBW、ICF、ECF 对比透析前后TBW、ICF、ECF的变化，并与正常人比 较，确定脱水量是否适当 BIA提示TBW低的患者透析中更容易发生低血压和低 血容量 高血压者BI
41、A提示TBW和ECF高于无高血压者 有作者认为生物电阻抗与容量负荷无相关性(Trans Am Soc Artif Organs 1993, 39: M584) ASAIO 1993, 39: 368 JASN 1993, l4 : 333 溶质清除充分性的评估指标溶质清除充分性的评估指标 溶质的血浓度 p小分子溶质 尿素氮、肌酐 p中大分子溶质 维生素B12、 2-微球蛋白 透析充分性尿素动力学模型(UKM)评价指标 p整体尿素清除率(kt/v)和尿素下降率(URR) p时间平均尿素浓度TACurea p溶质清除指数SRI Kt/V和URR与透析充分性 是评估透析充分性的基本客观指标 反映小分子毒素的清除 间接反映分子量大、难测定的氮源性毒素 多数研究表明，Kt/V和URR与预后呈正相关 Kt/VKt/V和和URRURR的的计算公式计算公式 Kt/V=-ln(R-0
