Three people went to a hotel together. A room costs 30 yuan a night The next day when the check-out. 3 people a person out of 10 yuan. Raised 30 yuan to the boss After the boss collected the money, he said to the waiter: today's discount. Only 25 yuan So the boss took 5 yuan to the waiter and asked him to return it to the guest But the waiter was greedy. He deducted 2 yuan and gave back 1 yuan to the guest Here's the problem: Three people and one person took out 10 yuan. They took back 1 yuan. That is, one person took out 9 yuan Plus the 2 yuan deducted by the waiter. So it's 3 * 9 + 2 = 29 yuan Excuse me: where's 1 yuan left?

Three people went to a hotel together. A room costs 30 yuan a night The next day when the check-out. 3 people a person out of 10 yuan. Raised 30 yuan to the boss After the boss collected the money, he said to the waiter: today's discount. Only 25 yuan So the boss took 5 yuan to the waiter and asked him to return it to the guest But the waiter was greedy. He deducted 2 yuan and gave back 1 yuan to the guest Here's the problem: Three people and one person took out 10 yuan. They took back 1 yuan. That is, one person took out 9 yuan Plus the 2 yuan deducted by the waiter. So it's 3 * 9 + 2 = 29 yuan Excuse me: where's 1 yuan left?

The reason is: (1) three people went to bed, the result was 10 yuan per person, a total of 10 × 3 = 30 yuan. (2) each person returned 1 yuan, that is, each person spent 9 yuan, three people spent 27 yuan. The boss left 25 yuan, the server hidden 2 yuan. (3) plus the returned

The definition of knowledge gap theory
It's all right,

Knowledge gap theory: when the knowledge growth of the rich reaches a certain degree, it will stop. At this time, the knowledge of the poor will increase with the dissemination of information by the surrounding environment and the mass media, and the knowledge gap between the two will decrease. But in fact, it will become larger

Explain the mechanism of hepatic encephalopathy with biochemical knowledge

1. Ammonia poisoning Theory: the increase of blood ammonia is one of the clinical characteristics of hepatic encephalopathy. Urease and amino acid oxidase of intestinal bacteria can act on nitrogenous substances to produce ammonia. Normal people absorb 4 grams of ammonia from gastrointestinal tract every day, and the kidney and skeletal muscle also produce ammonia. When a large amount of ammonia in brain tissue combines with α - ketoglutarate to synthesize glutamate, it leads to the disorder of trihydroxy acid circulation, There are also many factors that affect ammonia poisoning, such as: 1 pH.NH3 The mutual transformation between ammonia and NH4 + is affected by pH. NH3 is easy to pass through the blood brain barrier and cause ammonia poisoning. All factors that can cause alkalosis can increase the toxicity of ammonia. Ammonia can stimulate the respiratory center, so hepatic encephalopathy often has hyperventilation and respiratory alkalosis, The increase of blood ammonia is very important in the pathogenesis, and clinical treatment often receives certain effect, but the increase of blood ammonia is not parallel to the degree of coma. Some cases of blood ammonia does not increase, indicating that ammonia poisoning is not the only cause of hepatic encephalopathy
2. Synergetic toxicity of ammonia, mercaptan and short chain fatty acids. Methylmercaptan is the product of methionine metabolized by bacteria in the intestine. Methylmercaptan and its converted dimethyl sulfoxide can cause coma. Liver odor may be the volatile odor of methylmercaptan and dimethyl disulfide. The concentration of methylmercaptan in blood of patients with severe liver disease increases, especially in patients with hepatic encephalopathy
Short chain fatty acids (mainly valeric acid, caprylic acid and caprylic acid) increased significantly in plasma and CSF of patients with hepatic encephalopathy
In animal experiments, the use of ammonia, mercaptan and short chain fatty acid alone, if the dose is small, the concentration into the brain is low, which is not enough to cause hepatic encephalopathy; if combined use, even if the dose remains unchanged, it can also cause encephalopathy symptoms. Therefore, it is suggested that the synergistic effect of the three may play an important role in the pathogenesis
3. Pseudo neurotransmitter Theory: tyrosine, phenylalanine and other aromatic amino acids in food are transformed into tyramine and phenylethylamine respectively by the action of decarboxylase of enterobacteria, and they are formed into Channa (β - hydroxytyramine) and phenylethanolamine respectively by the action of hydroxylase in brain. The chemical structure of the latter two amino acids is similar to that of neurotransmitter noradrenaline, but their function of transmitting nerve impulse is very weak, Therefore, it is called pseudo neurotransmitter, which causes abnormal inhibition of cerebral cortex, disturbance of consciousness and coma
The basal ganglia of normal extrapyramidal system maintains the balance of inhibition and excitation. When dopamine is replaced by a pseudo neurotransmitter, acetylcholinergic energy is dominant and flutter tremor occurs. Levodopa can pass through the blood-brain barrier, so it has been used in the treatment of hepatic encephalopathy, but the curative effect is not sure
So far, the theory of pseudo neurotransmitter has not been fully confirmed
4. Imbalance of amino acid metabolism Theory: aromatic amino acids such as phenylalanine, tyrosine and tryptophan increased in patients' plasma, while branched chain amino acids such as valine, leucine and isoleucine decreased, resulting in imbalance of metabolism of the two amino acids, The increase of tryptophan in the brain can produce more neurotransmitter 5-hydroxytryptamine which has inhibitory effect on the central nervous system. It can antagonize norepinephrine and cause coma. Gamma aminobutyric acid (GABA) is the main inhibitory neurotransmitter in mammalian brain, In recent years, it has been found that the plasma concentration of GABA is increased, the receptor in brain tissue is increased, and the permeability of blood-brain barrier is also increased in the animal model of experimental hepatic encephalopathy. Some people think that coma is related to it
5. Increased brain sensitivity, severe liver disease, hypoxia, infection, hypotension, hypoglycemia, electrolyte disorders, morphine barbiturates benzodiazepines abnormal sensitivity, prone to mental symptoms, even coma