Section ADirections: In this section you will hear five conversations. At the end of each conversation, you will hear three questions about the conversation. The question will be spoken only once. After you hear the question, read the four possible answers marked A, B, C and D. Choose the best answer and mark the letter of your choice on the
ANSWER SHEET. Section BDirections: In this section you will hear five passages. At the end of each passage, you will hear three questions about the passage. The question will be spoken only once. After you hear the question, read the four possible answers marked A, B, C and D. Choose the best answer and mark the letter of your choice on the
ANSWER SHEET. Section ADirections: In this section, all the sentences are incomplete. Four words or phrases marked A, B, C and D are given beneath each of them. You are to choose the word or phrase that best completes the sentence, then mark your answer on the
ANSWER SHEET. Section BDirections: Each of the following sentences has a word or phrase underlined. There are four words or phrases beneath each sentence. Choose the word or phrase which can best keep the meaning of the original sentence if it is substituted for the underlined part. Mark your answer on the
ANSWER SHEET. Part Ⅲ ClozeDirections: In this section there is a passage with ten numbered blanks. For each blank, there are four choices marked A, B, C and D. Choose the best answer and mark the letter of your choice on the
ANSWER SHEET. Scientists have long known a fairly reliable way to extend the life span in lab animals: reduce the amount of calories they eat by 10 to 40 percent.
This strategy, known 1 calorie restriction, has been shown to increase the life span of various organisms and reduce their rate of cancer and other age-related ailments. 2 it can do the same in people has been an open question. But an intriguing new study suggests that in young and middle-aged adults, chronically restricting calorie 3 can affect their health.
In this study, researchers looked at 143 healthy men and women who 4 in age from 21 to 50. They were instructed to 5 calorie restriction for two years. They could eat the foods they wanted 6 they cut back on the total amount of food that they ate to reduce the calories they consumed by 25 percent. Many did not 7 that goal. But the group saw many of their metabolic health markers improve 8 they were already in the normal range.
Some of the benefits in the calorie-restricted group 9 from impressive weight loss, on average about 16 pounds during the study period. But the extent to which their metabolic health got better was greater than expected from weight loss alone, 10 that calorie restriction might have some unique biological effects on disease pathways. Part Ⅳ Reading ComprehensionDirections: In this part there are six passages, each of which is followed by five questions. For each question there are four possible answers marked A, B, C, and D. Choose the best answer and mark the letter of your choice on the
ANSWER SHEET. Gianluca Vialli, manager of Chelsea Football Club, expressed it explicitly enough: "The foot is the tool of the trade of the footballer." You might therefore expect footballers to take particularly good care of their feet. But results presented at a recent conference of dermatologists in Amsterdam suggest otherwise. Professional footballers seem as likely to suffer from fungal infections of the foot as other people.
One study, called Achilles Project, looked at 76,475 pairs of feet belonging to people from 18 European countries. It found that 26% of the sample had Tinea pedis, better known as athlete's foot, while 30% had Onychomycosis, an infection that causes toenails to become thickened, discolored and distorted. The results showed that East European countries have consistently higher rates of infection. On average, 30% of Britons, Germans and Belgians had some form of fungal infection, compared with 85%of Russians, and less than 10% of Spaniards.
Furthermore, adults under the age of 40 who took regular exercise had a 40% greater risk of fungal infection than those who did not. Leisure centers and swimming pools were identified as potential health hazards to the very people who visit them to stay fit. Communal showers and changing rooms are perfect breeding-grounds for the highly infectious fungi that spread foot and nail infection: up to 1,500 fungally-infected skin fragments per square meters have been found in some leisure facilities. Sweaty socks and warm, damp sports shoes provide equally hospitable environments.
All of which goes some way to explaining the footballers. No doubt all that time spent in showers and changing-rooms is partly responsible. But Dr. Caputo, a dermatologist, also found another factor: footballers are often reluctant, for superstitious reasons, to discard their old boots. He found that players get attached to particular boots ; if they score a goal with one, they will wear it again and again. The risk of athlete's foot may be a small price to pay for a goal. A decade ago, most patients were informed over the phone or in person by the doctors. But in the past few years, hospitals and medical practices have urged patients to sign up for portals, which allow them rapid, round-the-clock access to their records. Lab tests are now released directly to patients.
The push for portals has been fueled by several factors: the widespread embrace of technology, incentive payments to medical practices and hospitals that were part of 2009 federal legislation to encourage "meaningful use" of electronic records, and a 2014 federal rule giving patients direct access to their results. Policymakers have long regarded electronic medical records as a way to foster patient engagement and improve patient safety.
Are portals delivering on their promise to engage patients9 Or are these results too often a source of confusion and alarm for patients and the cause of more work for doctors because information is provided without adequate—or sometimes any—guidance?
Although what patients see online and how quickly they see it differs—sometimes even within the same hospital system—most portals contain lab tests, imaging studies, pathology reports and less frequently, doctors' notes. It is not uncommon for a test result to be posted before the doctor has seen it.
Katharine Treadway, an internist, knows what it's like to obtain shocking news from an electronic medical record. The experience, she said, has influenced the way she practices. More than a decade ago—long before most patients had portals—Treadway, with her husband' s permission, pulled up the results of his MRI scan on a hospital computer while waiting to see the specialist treating his sudden, unbearable arm pain.
"It showed a massive tumor and widespread metastatic disease," Treadway recalled. She never suspected that her 59-year-old husband had cancer, let alone a highly aggressive and usually fatal form of advanced lymphoma.
Treadway, whose husband has been cancer-free for more than a decade, said she remembered intently checking the name and date of birth, certain she had the wrong patient, then rebooting the computer several times "like I was going to get a different answer." In planning for the health needs of these immigrant families, Francesca Weissman, a healthcare practitioner, asked two questions: (1) "What are the most urgent needs of this population?" and (2) "How can this population be induced to use the health services that are available?" In some respects, the second question is more important because persuading immigrant families to utilize services is a basic problem.
Building trust is a primary goal. Employing caregivers who can speak the clients' language will do much to lower ethnic barriers and reduce suspicion on the part of the potential clients. Many traditional families are slow to develop personal relationships, and this holds true in the interactions with caregivers. Unless the families can communicate with caregivers, they cannot begin to trust them. Without trust, they are not likely to seek or even accept assistance.
Communication is a two-way channel. Caregivers, Francesca realized, have an obligation to become acquainted with the culture of the growing ethnic populations, and of their diverse subgroups. By becoming informed and by conveying respect, caregivers can make interactions with immigrant families less frightening and more productive. Awareness of the economic climate and other concitions in the place of origin helps caregivers recognize that the suspiciousness of immigrant families towards officials may not be wholly irrational.
A family approach to health care is recommended for immigrant groups. If the whole family can be involved in the healthcare program, the individual members are likely to be less fearful. Family-oriented programs may begin with practical advice about the neighborhood : locations of grocery stores, where to apply for food stamps, and how to look for work. Any programs developed for immigrant families must be offered at convenient times and places because they may not have the knowledge or resources to travel freely in their new community. This year mark the 100th anniversary of the deadliest event in U. S. history: the Spanish influenza epidemic of 1918. Although science and technology have advanced tremendously over the past century, the pandemic peril remains; a recent exercise at the Johns Hopkins Center for Health Security showed that an epidemic of an influenza—like virus could kill 15 million Americans in a single year.
The medical community's response to this danger is, understandably, focused on research and response-discovering new vaccines, therapeutics, and diagnostics and fighting ongoing epidemics, such as the current Ebola outbreak in Congo. But these urgent undertakings are not sufficient. If the World is to tackle many factors that raise our risk of a devastating pandemic, the medical community may have to enter theatres of operation beyond the laboratory bench and the treatment unit and publicly engage with controversial issues that some observers would consider nonmedical. Indeed, I believe that only such efforts can save us from the social trends, political movements, and policy failures that are elevating our risk of a pandemic. There are three aspects in particular where the medical community's intervention is urgently needed.
First is the rising tide of isolationism and xenophobia (排外) in many high-income nations, particularly the United States and European countries. The belief that isolating ourselves from the world can prevent the spread of diseases is irrational: we can build no wall high enough to keep out infectious diseases and disease-bearing vectors.
The second trend is the growing tide of antiscientific thinking and resistance to evidence-based medicine. In low-income countries, skepticism about vaccines is an everlasting challenge, but what we are seeing in the United States and Europe is something very different, and very dangerous. The growing refusal of parents in high-income countries to vaccinate their children is the tip of an iceberg that could sink us all in the event of an epidemic demanding rapid vaccine deployment and acceptance.
Finally, and perhaps most fundamentally, medical professionals can step into the public arena to take on unpleasant and contentious political issues such as climate change and isolationism. Many members of the medical community prefer to avoid becoming involved in controversial issues that seem to be outside the scope of medical concerns, but their voices are needed to confront such issues. In medical terminology, the words history and physical almost always appear together in that order. As a physician, you do not engage a patient in the neurological examination until you've gathered the details of his or her debilitating headaches.
But at one time in our medical careers, we are instructed to perform the most thorough physical examination possible without learning so much as the patient' s name. All we are given is all anatomy table number, an age, and a cause of death. We work our way through the anatomy lab—inspecting, searching, and feeling every muscle, bone, and organ—and we write our patients' histories ourselves.
To better understand the life of the woman who had donated her body for my education, I created the Obituary (讣告)Writing Program at Georgetown University during my first year of medical school. I worked with an obituary writer, Emily Langer, to develop a workshop to help interested medical students reflect on the lives that their corpses may have lived. She instructed us on the art of weaving disconnected memories into a single story. A series of creative writing prompts resulted in one student's story of a dramatic football injury occurring in the middle of a competitive match. This moment in his corpse's life was imagined from a pink prosthetic (假体的) hip beneath massive layers of muscle.
The first conversation with my donor's son lasted over an hour despite my initial fear that I would ask the wrong questions or offer the wrong words of sympathy. His mother was a small-town farm girl from Wisconsin, Dr. Carol Kennedy, Georgetown University School of Medicine, Class of 1972. She was a devout Catholic who considered being a physician a privilege and an opportunity to serve others. She wanted to continue to serve even after her death by donating her body to Georgetown University in order to educate future medical students like me.
We have finally put the history in its rightful place before the physical—students now interview the families of their donors before making the first cut in the anatomy lab. Our corpses are our first counterparts in the privileged patient-physician relationship, and now we are able to begin that partnership just as we hope to do throughout the rest of our medical careers. There may be no better example of what is meant by preventive medicine than the strategy of Vaccination. A healthy person is given a tiny taste of a virus—flu or polio, say—that's too weak to cause illness but just enough to introduce the body to the pathogen. If the virus later shows up for real, the immune system is primed and waiting for it.
That's close to how a cancer vaccine works, but not precisely. Most experts see cancer vaccines as a hybrid of treatment and prevention. While it' s true that the U. S. Food and Drug Administration has approved vaccines against cervical and liver cancer, both are designed to fight the viruses most responsible for causing the disease, as opposed to targeting cancer itself—human papilloma virus (HPV;人乳头瘤病毒) in the case of cervical cancer and hepatitis B in the case of liver tumors.
Using vaccines to prevent nonviral cancers in someone who is disease-free is a whole different matter. For one thing, it's much more difficult to determine a person's chance of developing a particular type of cancer than it is to determine the likelihood of being exposed to, say, the influenza virus or chicken pox. What passes for "exposure" in the case of nonviral cancers is a combination of genes and environment and a range of other X factors that can vary from person to person. How do you vaccinate against your family legacy of breast cancer or your constant exposure to secondhand cigarette smoke?
But that doesn't mean the immune system can' t be exploited in a different way. Cancer vaccines would ideally be used in patients whose disease has already been diagnosed and treated with surgery, chemotherapy or radiation. They would then be immunized as a way to prevent the cancer from coming back and spreading. Such metastases are actually the leading cause of death from cancer. "The charm of working with the immune system is that we can use the body's own defense mechanisms to possibly get to that last cancer cell or at least create a surveillance system that keeps that cancer under control," says an oncologist. Part Ⅴ Writing1. Directions: In this part there is an essay in Chinese. Read it carefully then write a summary of 200 words in English on the
ANSWER SHEET. Make sure that your summary covers the major points of the passage.
抗生素滥用
美国一女子因为尿路感染去医院就医,随后医生在其体内检查出了“超级细菌(super bacterium)”,这个细菌几乎对所有治疗尿路感染的药物都耐受,产生这种细菌的原因就是抗生素的滥用(antibiotic abuse)。那么滥用抗生素的危害有哪些呢?
抗生素通过杀灭有害细菌而达到治疗作用,但是细菌也很聪明,它们会不断和抗生素斗争,在斗争中增强自己的适应性,提升自己的存活能力。随着抗生素的使用增多,我们体内的细菌就越强,抗生素的作用就越小。如果平时有个头疼脑热就用抗生素,那么当真遇到需要抗生素治疗的细菌时,抗生素的帮助可能就很有限了。
众所周知,我们的肠胃里其实有很多菌群(flora)。要知道,这些菌群也是我们身体免疫系统的一部分,可以使我们免受病菌侵害。长期服用抗生素会使胃肠菌群失衡,从而导致免疫力随之下降。这是因为我们服用的抗生素会杀死细菌,但是它却不会辨别这些细菌是有益的还是有害的,会好坏通吃,永久改变免疫功能和神经系统。滥用抗生素会导致儿童遭受真菌感染,诱发湿疹(eczema)、过敏、哮喘等疾病,尤其是三岁以下小孩处于生长发育期,一些器官组织尚未发展成熟,更容易受到抗生素的永久伤害。
中国有句老话,“是药三分毒”。大量使用抗生素会对肝脏和肾脏造成很严重的负担。甚至一些抗生素对牙齿、骨骼也有伤害。尤其是对一些身体发育还没有完全的儿童来说。抗生素的使用更是要慎重,不要平时有个头疼脑热就使用抗生素类药物,对身体没什么好处。对于中国老百姓来说,对待伤风感冒这些小病要做的是尽量减少用药,通过提升免疫力来消除病症,而不是考虑用什么药好得快。
[范文] Antibiotic Abuse
The abuse of antibiotics becomes prevalent as it is easy for us to approach. But people are also aware of the peril of too much use of it.
Firstly, the side effect of antibiotics is that it also enhances the adaptability and resistance of bacteria. The more antibiotics are used, the more tenacious the bacteria become. If the antibiotics are used at will, there will be no use to resort to antibiotics when it is absolutely necessary. Secondly, antibiotics will also destroy the living environment of gastrointestinal flora and make gastrointestinal flora unbalanced. Antibiotics kill not only harmful bacteria but also beneficial bacteria, permanently changing immune function and the nervous system. In addition, excessive use of antibiotics will also increase the burden of the liver and kidneys. Some antibiotics are even harmful to teeth and bones. For immature children, especially those under three years old, the harm of antibiotics even cannot be recovered.
More and more examples prove that the use of antibiotics should be more cautious. Don't rely too much on antibiotics for some minor illnesses caused by colds. The best way we should choose is to eliminate the disease by improving our own immunity.
[解析] [写作点金]
本题要求对所给文章做总结概括。所以要用最简洁的语言概括原文的全部要点,且要抓主要论点,论点要清晰,逻辑要合理。切忌直译原文。