Questions　31—35

　Fill　in　each　blank　with　the　correct　answer　from　the　list　A—F.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

31.　One　of　the　interesting　things　about　yawning　is　that　we　start　yawning　.

32.　The　reason　why　we　yawn　easily　at　meeting　may　be　that　our　body　need　inhale　more　oxygen　and　.

33.　The　“contagious”　yawn　could　be　a(n)　to　a　signal　from　one　member　of　the　prey　animals　reminding　the　others　to　stay　alert.

34.　Researchers　including　a　psychologist　proposed　that　yawning　is　used　for　within　a　narrow　range.

35.　Contagious　yawning　dont　frequently　occur　since　they　are　less　empathetic.

A.　exhale　excessive　carbon　dioxide

B.　in　nonautistic　kids

C.　regulation　of　brain　temperature

D.　instinctual　reaction

E.　in　autistic　children

F.　before　we　are　born

Part　Two>>>>>

Questions　36—42

　Read　the　following　passage　about　obstructive　sleep　apnea.

　Choose　the　best　answer　A,　B,　C　or　D.

　Mark　the　corresponding　letter　on　your　answer　sheet.

Obstructive　Sleep　Apnea

Your　spouse　says　your　snoring　is　driving　her　nuts.　You　wake　up　feeling　unrested　and　irritable.　These　are　common　signs　that　you　may　have　obstructive　sleep　apnea　(OSA),　a　sleep　disorder　that—left　untreated—can　take　its　toll　on　the　body　and　mind.　Untreated　OSA　has　been　linked　to　high　blood　pressure,　heart　attacks,　strokes,　car　accidents,　workrelated　accidents　and　depression.With　sleep　apnea,　your　breathing　pauses　multiple　times　during　sleep.　The　pauses　can　last　from　a　few　seconds　to　minutes　and　can　occur　more　than　five　times　per　hour,　to　as　high　as　100　times　per　hour　(Fewer　than　five　times　per　hour　is　normal.).　Sometimes　when　you　start　breathing　again,　you　make　a　loud　snort　or　choking　sound.

Obstructive　sleep　apnea,　the　most　common　type,　is　caused　by　a　blockage　of　the　airway,　usually　when　the　soft　tissue　in　the　back　of　the　throat　collapses.　The　less　common　form,　central　sleep　apnea,　happens　if　the　area　of　your　brain　that　controls　breathing　doesnt　send　the　correct　signals　to　your　breathing　muscles.

Sleep　apnea　is　almost　twice　as　common　in　men　as　it　is　in　women.　Other　risk　factors　include:　being　overweight，　being　over　age　40，　smoking　and　so　on.　Children　also　get　sleep　apnea,　most　commonly　between　ages　3　and　6.　The　most　common　cause　is　enlarged　tonsils　and　adenoids　in　the　upper　airway.

Polysomnogram　(PSG)　is　the　most　common　sleep　study　for　sleep　apnea　and　often　takes　place　in　a　sleep　center　or　lab　to　record　brain　activity,　eye　movement,　blood　pressure　and　the　amount　of　air　that　moves　in　and　out　of　your　lungs.

The　first　line　of　defense　can　be　behavioral.　Weight　loss　may　go　a　long　way　toward　improving　OSA.　It　may　also　help　by　stoping　using　alcohol　or　medicines　that　make　you　sleepy,　because　they　can　make　it　harder　for　you　to　breathe.

The　most　common　treatment　is　a　Continuous　Positive　Airway　Pressure　(CPAP)　machine.　CPAP　use　mild　air　pressure　to　keep　your　airways　open.　The　air　is　delivered　through　a　mask　that　fits　over　your　nose　and　mouth,　or　only　your　nose.

CPAP　is　not　the　only　medical　device　approved　for　treatment　of　OSA.　On　May　1,　2014,　Food　and　Drug　Administration　(FDA)　approved　the　first　implanted　medical　device　for　the　treatment　of　this　disorder.　The　Inspire　Upper　Airway　System　(UAS)　is　intended　for　consumers　with　moderate　to　severe　OSA　who　have　specific　characteristics　(a　Body　Mass　Index　under　32　and　the　absence　of　complete　collapse　in　the　back　of　the　throat)　and　were　not　helped　by　a　CPAP　device,　or　could　not　tolerate　the　CPAP　treatment.　The　Inspire　device　is　surgically　implanted　below　the　collarbone　and　works　with　electrical　impulses　to　stimulate　the　patients　tongue　muscles　and　keep　airways　open.

The　Inspire　UAS　consists　of　an　electrical　impulse　generator,　with　leads　and　sensors　that　stimulate　the　nerve　that　controls　the　tongue　and　that　senses　the　patients　breathing.

After　the　surgical　site　has　healed　(about　a　month),　the　physician　turns　the　unit　on　and　sets　up　the　pulse　generator.　Patients　may　need　to　undergo　one　or　more　sleep　studies　before　the　UAS　configuration　is　optimized　for　use.　The　patient　turns　the　system　on　before　going　to　sleep　and　off　upon　waking,　using　a　remote　control.

36.　What　is　the　meaning　of　the　Greek　word　“apnea”　in　obstructive　sleep　apnea?

A.　Breakout.B.　Without　breath.

C.　Dysfunction.

D.　Without　regulation.

37.　Which　one　of　the　breathing　pause　during　sleep　is　considered　as　normal?

A.　More　than　ten　seconds.B.　Not　less　than　ten　minutes.

C.　Ten　times　per　hour.

D.　Four　times　per　hour.

38.　What　is　the　cause　of　obstructive　sleep　apnea?

A.　Enlarged　tonsils　and　adenoids.

B.　Paralysis　of　respiratory　center　in　the　brain.

C.　Collapses　of　soft　tissue　of　the　throat.

D.　Hypertension　and　heart　attacks.

39.　Who　is　more　susceptible　to　sleep　apnea?

A.　Nonsmoking　and　young　female.

B.　Obese　older　smoking　male.

C.　Male　and　female　with　BMI　above　32.

D.　Teenagers　and　young　adults.

40.　Which　is　NOT　belonging　to　behavioral　change　for　treatment　of　OSA?

A.　Early　to　bed　and　early　to　rise.

B.　Giving　up　alcohol.

C.　Losing　weight.

D.　Withdrawing　of　sleeping　pills　administration.

41.　It　can　be　inferred　from　the　passage　that　.

A.　FDA　prefers　the　Inspire　UAS　to　CPAP　machine　because　of　its　cost

B.　as　a　noninvasive　procedure,　CPAP　treatment　has　something　in　common　with　the　Inspire　UAS

C.　the　Inspire　UAS　treatment　is　more　expensive　than　CPAP　treatment

D.　the　Inspire　UAS　treatment　is　a　kind　of　invasive　procedure

42.　Which　of　the　following　statements　is　true　according　to　the　passage?

A.　Obstructive　sleep　apnea　is　less　common　than　central　sleep　apnea.

B.　Sleep　apnea　is　as　common　in　men　as　it　is　in　women　and　children.

C.　Not　all　OSA　patients　are　candidates　for　Inspire　UAS　treatment.

D.　The　CPAP　should　be　turned　on　before　sleeping　and　off　upon　waking.

Part　Three>>>>>

Questions　43—50

　Read　the　following　introduction　of　program　provided　by　RMIT　University.

　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).

　Mark　the　corresponding　letter　on　your　answer　sheet.

PATHOLOGY　TESTING

C5283　Diploma　of　Laboratory　Technology　(Pathology　Testing)

Duration:　2　years

www.rmit.edu.au/programs/c5283

City　campus

The　Diploma　of　Laboratory　Technology　(Pathology　Testing)　will　give　you　the　practical　skills　and　knowledge　to　pursue　a　technical　career　in　pathology　laboratories　and　hospitals.

As　a　medical　laboratory　technician　or　medical　laboratory　assistant,　you　will　conduct　routine　laboratory　tests　for　pathologists,　microbiologists/bacteriologists,　biochemists,　clinical　chemists,　pharmacologists　and　veterinarians.

Working　under　supervision,　you　may　examine　microorganisms　or　changes　in　cells　and　tissues,　or　perform　chemical　analyses　of　blood　and　other　body　fluids.　You　may　also　assist　in　performing　experiments　for　research　into　biochemical　or　genetic　processes.

Class　sizes　are　small　and　the　stafftostudent　ratio　in　laboratories　allows　opportunities　for　individual　teaching.　Teachers　have　extensive　industry　experience　and　expertise　and　maintain　close　links　with　colleagues　in　the　industry.　RMIT　has　long　been　recognized　by　the　pathology　industry　as　providing　quality　training　in　the　field.

Working　with　industry

You　will　undertake　20　days　of　work　experience　during　the　second　year,　organized　by　RMIT.　This　provides　you　with　an　opportunity　to　gain　a　greater　understanding　of　the　industry　and　to　develop　your　laboratory　skills　in　an　area　that　also　require　teamwork,　attention　to　quality　control　and　working　to　timelines.

You　may　be　placed　in　a　variety　of　work　environments,　ranging　from　small　research　laboratories　to　large　pathology　companies.

What　you　will　study

Year　one

The　first　year　provides　you　with　a　foundation　in　chemistry,　maths,　biology,　scientific　communication,　computing,　biochemistry　and　occupational　health　and　safety.

You　will　learn　general　laboratory　skills　such　as　microscopy,　aseptic　techniques,　chemistry　techniques　and　the　use　of　laboratory　instruments.　Labs　have　latest　industry　standard　equipment　and　there　is　ample　opportunity　for　you　to　gain　handson　experience.

In　chemistry　you　will　become　skilled　at　preparing　solutions　that　meet　strict　quality　control　standards.　You　will　use　specialized　equipment,　and　learn　to　work　safely　with　potentially　dangerous　chemicals.

Year　two

The　second　year　involves　more　specialized　study　in　the　major　diagnostic　areas　relevant　to　a　pathology　lab.　These　include　haematology,　microbiology,　histology　and　clinical　chemistry,　as　well　as　quality　assurance.

You　will　learn　the　skills　to　undertake　blood　counts,　test　levels　of　chemicals　in　blood,　identify　bacteria　using　a　microscope　and　culture　methods,　as　well　as　how　to　prepare　thin　slices　of　liver　and　other　tissues　to　examine　microscopically.　All　of　these　tests　aid　in　the　diagnosis　of　all　types　of　diseases.

Teaching　methods

Classes　are　taught　in　a　combination　of　lecture,　workshop,　practical　and　laboratory　sessions.

Career　outlook

There　is　a　high　demand　for　technicians　to　work　in　pathology　laboratories　in　both　public　hospitals　and　large　private　pathology　providers　such　as　Gribbles,　Dorevitch　and　Melbourne　Pathology.

Professional　recognition

Students　are　eligible　for　student　membership　of　the　Australian　Society　for　Microbiology　and　the　Australian　Institute　of　Medical　Laboratory　Scientists,　and　upon　graduation　are　eligible　for　associate　membership.

Pathways

Graduates　of　the　Diploma　of　Laboratory　Technology　(Pathology　Testing)　who　are　successful　in　gaining　a　place　are　eligible　to　apply　for　exemptions　of　up　to　one　year　(96　credit　points)　from　the　following　programs:

Bachelor　of　Applied　Science　(Laboratory　Medicine)

Bachelor　of　Biomedical　Science　(Pharmaceutical　Science)

Bachelor　of　Science　(Biotechnology)

43.　Pathology　testing　is　concerned　with　various　tests　aiding　in　the　diagnosis　of　various　types　of　diseases.

A.　TrueB.　False

C.　Not　Given

44.　Pathology　laboratories　in　medical　universities　have　great　demand　for　technicians.

A.　True

B.　False

C.　Not　Given

45.　Work　experience　is　arranged　in　the　whole　second　year　in　small　research　laboratories.

A.　True

B.　False

C.　Not　Given

46.　Opportunities　for　individual　teaching　are　guaranteed　by　small　class　size　and　stafftostudent　ratio　in　laboratories.

A.　True

B.　False

C.　Not　Given

47.　Students　should　finish　all　courses　when　they　apply　for　exemptions　from　final　examination.

A.　True

B.　False

C.　Not　Given

48.　The　study　of　the　first　year　involves　both　the　foundational　and　specialized　subjects.

A.　True

B.　False

C.　Not　Given

49.　Graduates　of　the　Diploma　of　Laboratory　Technology　should　know　how　to　prepare　thin　slices　of　liver　and　other　tissues　to　examine　microscopically.

A.　True

B.　False

C.　Not　Given

50.　All　students　are　the　members　of　the　Australian　Society　for　Pathology.

A.　True

B.　False

C.　Not　Given

Part　Four>>>>>

Questions　51—55

　Read　the　following　passage　about　placebo　effect.　Five　sentences　have　been　removed　from　the　passage.

　Fill　in　each　blank　with　the　most　appropriate　sentence　from　the　list　A—F.　There　is　one　extra　sentence　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

Placebo　Effect

The　placebo　effect　has　sometimes　been　defined　as　a　physiological　effect　caused　by　the　placebo,　but　Moerman　and　Jonas　have　pointed　out　that　this　seems　illogical,　as　a　placebo　is　an　inert　substance　that　does　not　directly　cause　anything.　(51)　They　propose　that　the　placebo,　which　may　be　unethical,　could　be　avoided　entirely　if　doctors　comfort　and　encourage　their　patients　health.　Ernst　and　Resch　also　attempted　to　distinguish　between　the　“true”　and　“perceived”　placebo　effect,　as　they　argued　that　some　of　the　effects　attributed　to　the　placebo　effect　could　be　due　to　other　factors.

In　1985,　Irving　Kirsch　hypothesized　that　placebo　effects　are　produced　by　the　selffulfilling　effects　of　response　expectancies,　in　which　the　belief　that　one　will　feel　different　leads　a　person　to　actually　feel　different.　According　to　this　theory,　the　belief　that　one　has　received　an　active　treatment　can　produce　the　subjective　changes　thought　to　be　produced　by　the　real　treatment.　Placebos　can　act　similarly　through　classical　conditioning,　wherein　a　placebo　and　an　actual　stimulus　are　used　simultaneously　until　the　placebo　is　associated　with　the　effect　from　the　actual　stimulus.　(52)　Conditioning　has　a　longerlasting　effect,　and　can　affect　earlier　stages　of　information　processing.　The　expectancy　effect　can　be　enhanced　through　factors　such　as　the　enthusiasm　of　the　doctor,　differences　in　size　and　color　of　placebo　pills,　or　the　use　of　other　interventions　such　as　injections.　In　one　study,　the　response　to　a　placebo　increased　from　44%　to　62%　when　the　doctor　treated　them　with　“warmth,　attention,　and　confidence”.　(53)　Those　that　think　a　treatment　will　work　display　a　stronger　placebo　effect　than　those　do　not,　as　evidenced　by　a　study　of　acupuncture.

Because　the　placebo　effect　is　based　upon　expectations　and　conditioning,　the　effect　disappears　if　the　patient　is　told　that　their　expectations　are　unrealistic,　or　that　the　placebo　intervention　is　ineffective.　(54)　It　has　also　been　reported　of　subjects　given　placebos　in　a　trial　of　antidepressants,　that　“Once　the　trial　was　over　and　the　patients　who　had　been　given　placebos　were　told　as　such,　they　quickly　deteriorated.”

A　placebo　described　as　a　muscle　relaxant　will　cause　muscle　relaxation　and,　if　described　as　the　opposite,　muscle　tension.　A　placebo　presented　as　a　stimulant　will　have　this　effect　on　heart　rhythm,　and　blood　pressure,　but,　when　administered　as　a　depressant,　the　opposite　effect.　The　perceived　consumption　of　caffeine　has　been　reported　to　cause　similar　effects　even　when　decaffeinated　coffee　is　consumed,　although　a　2003　study　found　only　limited　support　for　this.　Alcohol　placebos　can　cause　intoxication　and　sensorimotor　impairment.　Perceived　ergogenic　aids　can　increase　endurance,　speed　and　weightlifting　ability,　leading　to　the　question　of　whether　placebos　should　be　allowed　in　sport　competition.　Placebos　can　help　smokers　quit.　(55)　Interventions　such　as　psychotherapy　can　have　placebo　effects.　The　effect　has　been　observed　in　the　transplantation　of　human　embryonic　neurons　into　the　brains　of　those　with　advanced　Parkinsons　disease.

A.　A　conditioned　pain　reduction　can　be　totally　removed　when　its　existence　is　explained.

B.　Both　conditioning　and　expectations　play　a　role　in　placebo　effect,　and　make　different　kinds　of　contribution.

C.　Expectancy　effects　have　been　found　to　occur　with　a　range　of　substances.

D.　They　occur　not　only　during　placebo　analgesia　but　after　receiving　the　analgesic　placebo.

E.　Instead　they　introduced　the　word　“meaning　response”　for　the　meaning　that　the　brain　associates　with　the　placebo,　which　causes　a　physiological　placebo　effect.

F.　Perceived　allergens　that　are　not　truly　allergenic　can　cause　allergies.

Part　Five>>>>>

Questions　56—65

　Read　the　following　passage　on　pharmacogenomics.

　Fill　in　each　blank　with　the　correct　choice　A,　B,　C　or　D.

　Mark　the　corresponding　letter　on　your　answer　sheet.

Pharmacogenomics

The　terms　pharmacogenomics　and　pharmacogenetics　are　often　used　interchangeably　to　describe　a　field　of　research　focused　on　how　genes　affect　individual　responses　to　medicines.　Whether　a　medicine　works　well　for　you　or　whether　it　causes　serious　side　effects　depends,　to　a　certain　extent,　on　your　genes.

Just　as　genes　contribute　to　whether　you　will　be　tall　or　short,　blackhaired　or　blond,　your　genes　also　(56)　how　you　will　respond　to　medicines.　Genes　are　like　recipes　and　they　carry　instructions　for　making　protein　molecules.　As　medicines　travel　through　your　body,　they　(57)　with　thousands　of　proteins.　Small　differences　in　the　composition　or　quantities　of　these　molecules　can　affect　how　medicines　do　their　jobs.

These　differences　can　be　due　to　diet,　level　of　activity,　or　the　medicines　a　person　takes,　but　they　can　also　be　due　to　differences　in　genes.　By　understanding　the　genetic　basis　of　drug　responses,　scientists　hope　to　enable　doctors　to　(58)　the　drugs　and　doses　best　suited　for　each　individual.

While　standard　doses　of　most　medicines　work　well　for　most　people,　some　medicines　dont　work　at　all　in　certain　people　or　cause　annoying　and　sometimes　dangerous　side　effects.　For　example,　codeine　is　useless　as　a　painkiller　in　nearly　10　percent　of　people,　and　an　anticancer　drug,　6mercaptopurine,　is　extremely　(59)　in　a　small　fraction　of　the　population.

Many　pharmacogenomic　findings　are　based　on　knowledge　of　biochemical　pathways　within　cells.　For　example,　scientists　already　knew　a　lot　about　the　enzymes　that　break　down　the　anticancer　drug　irinotecan　when　its　toxic　effects　in　certain　patients　came　to　light.　This　knowledge　allowed　researchers　to　rapidly　pinpoint　a　genetic　variant　of　one　of　these　enzymes　(60)　the　cause　of　the　dangerous　reaction.　Scientists　have　developed　a　genetic　test　for　this　variant　so　that　doctors　can　adjust　the　dosage　for　those　at　risk　for　serious　side　effects.

Advances　can　also　come　from　studies　that　accompany　clinical　drug　trials.　(61)　obtaining　permission　from　participants,　some　pharmaceutical　companies　collect　DNA　samples　from　people　in　clinical　trials.　Scientists　then　analyze　the　samples　together　with　results　of　the　clinical　trial　to　identify　genetic　variations　that　correlate　with　a　drugs　effectiveness　or　toxicity.

Pharmacogenomic　researchers　have　already　identified　many　genes　whose　variations　affect　drug　responses.　They　also　know　where　to　look　for　the　numerous　others　they　are　(62)　to　discover　in　the　future.　The　availability　of　the　human　genome　sequence,　(63)　was　completed　in　2003,　led　to　the　HapMap　project,　an　international　effort　to　catalog　common　genetic　differences　among　human　beings.　These　resources　are　providing　a　treasure　trove　of　genetic　information　that　is　expected　to　speed　advances　in　pharmacogenetics.

In　the　future,　pharmacogenomics　will　(64)　enable　doctors　to　prescribe　the　right　dose　of　the　right　medicine　the　first　time　for　everyone.　This　would　mean　that　patients　will　receive　medicines　that　are　safer　and　more　effective,　leading　to　better　health　care　overall.

Also,　if　scientists　could　identify　the　genetic　basis　for　certain　toxic　side　effects,　drugs　could　be　prescribed　only　to　those　who　are　not　genetically　at　risk　for　these　effects.　This　could　maintain　the　availability　of　(65)　lifesaving　medications　that　might　otherwise　be　taken　off　the　market.

56.　A.　predictB.　diagnoseC.　calculateD.　determine

57.　A.　contactB.　connectC.　interactD.　act

58.　A.　prescribeB.　deliberateC.　describeD.　banner

59.　A.　toxicB.　effectiveC.　beneficialD.　fierce

60.　A.　withB.　asC.　forD.　on

61.　A.　PreferB.　Due　toC.　BeforeD.　After

62.　A.　comeB.　boundC.　readyD.　account

63.　A.　whereB.　thatC.　whichD.　one

64.　A.　seriouslyB.　therapeuticallyC.　increasinglyD.　exclusively

65.　A.　frequentlyB.　consequentlyC.　infrequentlyD.　undoubtedly

ⅢWriting

Question　66

　Write　an　essay　of　about　150　words　on　the　topic　“Should　Nurses　Go　Abroad　to　Work?”.　You　should　base　your　essay　on　the　clues　given　below.

　Please　write　your　essay　on　the　answer　sheet.

Should　Nurses　Go　Abroad　to　Work?

1.　现在很多护士想出国工作。

2.　她们选择出国工作的原因。

3.　谈谈你的想法。

3

3

医护英语水平考试（三级）模拟训练（三）

医护英语水平考试（三级）

模拟训练（三）

Medical　English　Test　System　(METS)

Level　3

ⅠListening

Part　One>>>>>

Questions　1—5

　You　will　hear　five　extracts　from　conversations　taking　place　in　different　clinical　departments.

　Choose　which　case　each　doctor　is　discussing　from　the　list　A—F.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　each　extract　twice.

Doctor　11

Doctor　22

Doctor　33

Doctor　44

Doctor　55

A.　The　patient　had　a　history　of　dysuria,　weight　loss,　night　sweats　and　tiredness.

B.　The　patient　received　a　mitral　valve　replacement　three　years　ago.

C.　The　patient　complained　of　fatigue,　malaise,　weight　gain,　constipation　and　hair　loss.

D.　The　patient　was　diagnosed　as　having　malaria　after　he　returned　from　Africa.

E.　The　man　had　swollen　tonsils　with　no　exudates.

F.　The　rapid　streptococcal　antigen　test　of　the　patient　is　positive.

Part　Two>>>>>

Questions　6—13

　You　will　hear　a　conversation　between　a　chief　physician　and　a　patient.

　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　the　recording　twice.

6.　The　patient　had　a　persistent　pain　in　his　abdomen,　as　well　as　the　chest,　back　and　thigh.

A.　True　B.　False　C.　Not　Given

7.　The　patient　received　an　operation　for　the　pain　14　years　ago.

A.　True　B.　False　C.　Not　Given

8.　At　the　beginning,　the　pain　covered　a　wide　range　and　mainly　appeared　on　exertion.

A.　True　B.　False　C.　Not　Given

9.　In　recent　years,　the　pain　intensified　and　the　patient　can　hardly　turn　around.

A.　True　B.　False　C.　Not　Given

10.　The　patient　often　has　a　feeling　of　fullness　with　a　poor　appetite.

A.　True　B.　False　C.　Not　Given

11.　The　patient　has　visited　the　doctor　for　several　times,　but　the　condition　was　not　improved.

A.　True　B.　False　C.　Not　Given

12.　The　patient　complained　of　fatigue,　weakness,　constipation,　nocturia　and　cough.

A.　True　B.　False　C.　Not　Given

13.　Four　days　ago,　the　patient　was　admitted　to　the　emergency　room　in　a　confused　state.

A.　True　B.　False　C.　Not　Given

Part　Three>>>>>

Questions　14—20

　You　will　hear　a　conversation　between　the　patient　Krista　and　the　nurse　Shirley　about　her　concerns　on　Cesarean　section.

　For　questions　14—20,　choose　the　most　appropriate　answer.

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　the　conversation　twice.

14.　When　will　Krista　have　a　Cesarean　section?

A.　Eight　am　this　Friday.

B.　Three　pm　next　Monday.

C.　Nine　am　next　Monday.

15.　What　kind　of　anesthesia　will　Krista　have　for　her　scheduled　Csection?

A.　General　anesthesia.

B.　Epidural　anesthesia.

C.　Spinal　anesthesia.

16.　What　is　Kristas　conscious　state　during　the　Csection?

A.　She　is　semiconscious.

B.　She　is　in　deep　sleep.

C.　She　is　awake　and　alert.

17.　What　is　the　primary　role　of　Kristas　husband　in　the　operating　room?

A.　To　provide　support　for　Krista.

B.　To　observe　the　process　of　the　operation.

C.　To　hold　the　baby.

18.　Where　will　the　patient　be　sent　to　right　after　the　Csection?

A.　The　general　ward.

B.　The　post　anesthesia　care　unit.

C.　The　delivery　suite.

19.　Which　unit　will　the　patient　be　transferred　to　when　she　is　signed　off　by　the　anesthesiologist?

A.　The　postpartum　unit.

B.　The　intensive　care　unit.

C.　The　neonatal　intensive　care　unit.

20.　Which　of　the　following　about　breastfeeding　is　NOT　correct?

A.　The　mother　cant　breastfeed　the　baby　right　after　the　surgery　because　she　doesnt　have　any　milk　yet.

B.　Breastfeeding　is　encouraged　for　every　healthy　mother　no　matter　she　receives　a　Csection　or　not.

C.　Breastfeeding　is　good　for　the　recovery　of　the　uterus.

Part　Four>>>>>

Questions　21—25

　You　will　hear　a　talk　of　case　history　about　a　patient　Mr.　Zhang.

　Complete　the　notes.　In　each　blank,　write　only　one　word.

　Write　the　answers　on　your　answer　sheet.

　You　will　hear　the　talk　twice.

Case　history

Name：　Zhang　HangAge:　45Nationality:　Chinese　Canadian

Present　illnessPresented　on　September　14,　2017　with　lethargy　and　polyuria.　His　family　physicians　noted　a　high　serum　calcium　and　a　low　serum　(21)　.

Past　historyUndergone　an　emergency　portacaval　shunt　for　bleeding　esophageal　(22)　20　years　ago.　Received　one　blood　transfusion.

Physical　examinationFit　looking　with　considerable　anxiety.

Abdominal　ultrasound　examination　revealed　a　(23)　lesion　in　the　right　lobe　of　the　liver.　Soft　abdomen　with　no　organomegaly　or　ascites.

Dynamic　CT　scan　showed　a　middle　solid　(24)　lesion　in　right　lobe　of　the　liver.

Doppler　ultrasound　of　the　liver　vessels　confirmed　a　portacaval　shunt.

Initial　treatmentIntravenous　rehydration　and　(25)　.

ⅡReading

Part　One>>>>>

Questions　26—35

　Read　the　following　passage　about　sleep.

Sleep:　A　Dynamic　Activity

1Until　the　1950s,　most　people　thought　of　sleep　as　a　passive,　dormant　part　of　our　daily　lives.　We　now　know　that　our　brains　are　very　active　during　sleep.　Moreover,　sleep　affects　our　daily　functioning　and　our　physical　and　mental　health　in　many　ways　that　we　are　just　beginning　to　understand.

2Nervesignaling　chemicals　called　neurotransmitters　control　whether　we　are　asleep　or　awake　by　acting　on　different　groups　of　nerve　cells,　or　neurons,　in　the　brain.　Neurons　in　the　brainstem,　which　connect　the　brain　with　the　spinal　cord,　produce　neurotransmitters　such　as　serotonin　and　norepinephrine　that　keep　some　parts　of　the　brain　active　while　we　are　awake.　Other　neurons　at　the　base　of　the　brain　begin　signaling　when　we　fall　asleep.　These　neurons　appear　to　“switch　off”　the　signals　that　keep　us　awake.　Research　also　suggests　that　a　chemical　called　adenosine　builds　up　in　our　blood　while　we　are　awake　and　causes　drowsiness.　This　chemical　gradually　breaks　down　while　we　sleep.

3During　sleep,　we　usually　pass　through　five　phases　of　sleep:　stages　1,　2,　3,　4,　and　REM　(rapid　eye　movement)　sleep.　These　stages　progress　in　a　cycle　from　stage　1　to　REM　sleep,　then　the　cycle　starts　over　again　with　stage　1.　We　spend　almost　50　percent　of　our　total　sleep　time　in　stage　2　sleep,　about　20　percent　in　REM　sleep,　and　the　remaining　30　percent　in　the　other　stages.　Infants,　by　contrast,　spend　about　half　of　their　sleep　time　in　REM　sleep.

4During　stage　1,　which　is　light　sleep,　we　drift　in　and　out　of　sleep　and　can　be　awakened　easily.　Our　eyes　move　very　slowly　and　muscle　activity　slows.　People　awakened　from　stage　1　sleep　often　remember　fragmented　visual　images.　Many　also　experience　sudden　muscle　contractions　called　hypnic　myoclonia,　often　preceded　by　a　sensation　of　starting　to　fall.　These　sudden　movements　are　similar　to　the　“jump”　we　make　when　startled.　When　we　enter　stage　2　sleep,　our　eye　movements　stop　and　our　brain　waves　(fluctuations　of　electrical　activity　that　can　be　measured　by　electrodes)　become　slower,　with　occasional　bursts　of　rapid　waves　called　sleep　spindles.　In　stage　3,　extremely　slow　brain　waves　called　delta　waves　begin　to　appear,　interspersed　with　smaller,　faster　waves.　By　stage　4,　the　brain　produces　delta　waves　almost　exclusively.　It　is　very　difficult　to　wake　someone　during　stages　3　and　4,　which　together　are　called　deep　sleep.　There　is　no　eye　movement　or　muscle　activity.　People　awakened　during　deep　sleep　do　not　adjust　immediately　and　often　feel　groggy　and　disoriented　for　several　minutes　after　they　wake　up.　Some　children　experience　bedwetting,　night　terrors,　or　sleepwalking　during　deep　sleep.

5When　we　switch　into　REM　sleep,　our　breathing　becomes　more　rapid,　irregular,　and　shallow,　our　eyes　jerk　rapidly　in　various　directions,　and　our　limb　muscles　become　temporarily　paralyzed.　Our　heart　rate　increases,　our　blood　pressure　rises,　and　males　develop　penile　erections.　When　people　are　awakened　during　REM　sleep,　they　often　describe　bizarre　and　illogical　tales—dreams.

Questions　26—30

　Choose　the　most　appropriate　subheading　from　the　list　A—F　for　each　paragraph.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

26.　Paragraph　1

27.　Paragraph　2

28.　Paragraph　3

29.　Paragraph　4

30.　Paragraph　5

A.　Body　conditions　during　the　first　four　stages

B.　Too　much　beyond　what　we　know　about　sleep

C.　How　much　sleep　do　we　need?

D.　Neurons　and　chemicals　involved　in　sleep

E.　Body　reactions　during　REM　sleep

F.　Five　phases　of　sleep　in　human　being

Questions　31—35

　Fill　in　each　blank　with　the　correct　answer　from　the　list　A—F.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

31.　The　stages　of　sleep　from　stage　1,　2,　3,　and　4　to　REM　sleep.　Then　the　cycle　starts　over　again　with　stage　1.

32.　Whether　we　are　asleep　or　awake　is　controlled　by　called　neurotransmitters　acting　on　different　groups　of　neurons　in　the　brain.

33.　There　are　and　lower　brain　waves　during　50%　of　total　sleep　time　in　adults.

34.　Children　may　experience　bedwetting,　night　terrors　or　sleepwalking　.

35.　Dreams　often　occur　rather　than　deep　sleep.

A.　nervesignaling　chemicals

B.　during　deep　sleep

C.　growing　numbers

D.　progress　in　a　cycle

E.　during　REM　sleep

F.　no　eye　movements

Part　Two>>>>>

Questions　36—42

　Read　the　following　passage　about　irritable　bowel　syndrome.

　Choose　the　best　answer　A,　B,　C　or　D.

　Mark　the　corresponding　letter　on　your　answer　sheet.

Irritable　Bowel　Syndrome

Irritable　bowel　syndrome　(IBS)　is　a　common　intestinal　condition　characterized　by　abdominal　pain　and　cramps,　changes　in　bowel　movements　(diarrhea,　constipation,　or　both),　gassiness,　bloating,　nausea,　and　other　symptoms.　There　is　no　cure　for　IBS.　Much　about　the　condition　remains　unknown　or　poorly　understood;　however,　dietary　changes,　drugs,　and　psychological　treatment　are　often　able　to　eliminate　or　substantially　reduce　its　symptoms.

IBS　was　once　called—among　other　things—colitis,　spastic　colon,　nervous　colon,　and　spastic　bowel.　Some　of　these　names　reflected　the　now　outdated　belief　that　IBS　is　a　purely　psychological　disorder,　a　product　of　the　patients　imagination.　Although　modern　medicine　recognizes　that　stress　can　trigger　IBS　attacks,　medical　specialists　agree　that　IBS　is　a　genuine　physical　disorder—or　group　of　disorders—with　specific　identifiable　characteristics.

Researchers　remain　unsure　about　the　cause　or　causes　of　IBS.　It　is　called　a　functional　disorder　because　it　is　thought　to　result　from　changes　in　the　activity　of　the　major　part　of　the　large　intestine　(the　colon).　After　food　is　digested　by　the　stomach　and　small　intestine,　the　undigested　material　passes　in　liquid　form　into　the　colon,　which　absorbs　water　and　salts.　This　process　may　take　several　days.　In　a　healthy　person　the　colon　is　quiet　during　most　of　that　period　except　after　meals,　when　its　muscles　contract　in　a　series　of　wavelike　movements　called　peristalsis.　Peristalsis　helps　absorption　by　bringing　the　undigested　material　into　contact　with　the　colon　wall.　It　also　pushes　undigested　material　that　has　been　converted　into　solid　or　semisolid　feces　toward　the　rectum,　where　it　remains　until　defecation.　In　IBS,　however,　the　normal　rhythm　and　intensity　of　peristalsis　is　disrupted.　Sometimes　there　is　too　little　peristalsis,　which　can　slow　the　passage　of　undigested　material　through　the　colon　and　cause　constipation.　Sometimes　there　is　too　much,　which　has　the　opposite　effect　and　causes　diarrhea.

Some　kinds　of　food　and　drink　appear　to　play　a　key　role　in　triggering　IBS　attacks.　Food　and　drink　that　healthy　people　can　ingest　without　any　trouble　may　disrupt　peristalsis　in　IBS　patients,　which　probably　explains　why　IBS　attacks　often　occur　shortly　after　meals.　Chocolate,　milk　products,caffeine　(in　coffee,　tea,　colas,　and　other　drinks),　and　large　quantities　of　alcohol　are　some　of　the　chief　culprits.　Other　kinds　of　food　have　also　been　identified　as　problems,　however,　and　the　pattern　of　what　can　and　cannot　be　tolerated　is　different　for　each　person.　Characteristically,　IBS　symptoms　rarely　occur　at　night　and　disrupt　the　patients　sleep.

Stress　is　an　important　factor　in　IBS　because　of　the　close　nervous　system　connections　between　the　brain　and　the　intestines.　Although　researchers　do　not　yet　understand　all　of　the　links　between　changes　in　the　nervous　system　and　IBS,　they　point　out　the　similarities　between　mild　digestive　upsets　and　IBS.　Just　as　healthy　people　can　feel　nauseated　or　have　an　upset　stomach　when　under　stress,　people　with　IBS　react　the　same　way,　but　to　a　greater　degree.　Finally,　IBS　symptoms　sometimes　intensify　during　menstruation,　which　suggests　that　female　reproductive　hormones　are　another　trigger.

36.　What　do　the　changes　in　bowel　movements　refer　to　in　IBS?

A.　Diarrhea.

B.　Constipation.

C.　Diarrhea　alternating　with　constipation.

D.　All　of　above.

37.　Which　one　of　the　names　apparently　reflected　that　IBS　was　a　purely　psychological　disorder?

A.　Colitis.

B.　Spastic　colon.

C.　Nervous　colon.

D.　Spastic　bowel.

38.　Why　is　IBS　called　a　functional　disorder　according　to　the　passage?

A.　The　function　of　the　large　intestine　may　be　disturbed.

B.　There　are　some　morphologic　abnormalities　in　the　large　intestine.

C.　It　is　thought　to　result　from　structural　changes　of　the　colon.

D.　Researchers　do　not　know　the　causes　of　IBS.

39.　In　IBS　constipation　may　occur　when　.

A.　normal　treatment　is　disrupted

B.　the　rhythm　and　intensity　of　peristalsis　is　too　little

C.　a　patient　has　diet　with　too　much　fiber　and　lower　fat

D.　stress　is　removed

40.　What　may　be　the　meaning　of　the　word　“culprits”　in　the　fourth　paragraph?

A.　Mediators.B.　Therapeutic　agents.

C.　Pathogenic　factors.D.　Nerve　transmitters.

41.　Which　one　of　the　following　factors　does　NOT　contribute　to　the　IBS?

A.　Stress.B.　Hormones.

C.　Food　and　drink.

D.　Mild　digestive　upsets.

42.　Which　of　the　following　statements　is　true　about　IBS?

A.　The　symptoms　of　IBS　are　growing　steadily　worse　over　time.

B.　IBS　is　a　purely　psychological　disorder　rather　than　a　physical　disorder.

C.　There　is　abnormal　rhythm　and　intensity　of　peristalsis　in　IBS.

D.　Attacks　of　IBS　usually　disrupt　the　patients　sleep　at　night.

Part　Three>>>>>

Questions　43—50

　Read　the　following　passage　about　new　weapon　to　fight　cancer.

　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).

　Mark　the　corresponding　letter　on　your　answer　sheet.

New　Weapon　to　Fight　Cancer

British　scientists　are　preparing　to　launch　trials　of　a　radical　new　way　to　fight　cancer,　which　kills　tumors　by　infecting　them　with　viruses　like　the　common　cold.

If　successful,　virus　therapy　could　eventually　form　a　third　pillar　alongside　radiotherapy　and　chemotherapy　in　the　standard　arsenal　against　cancer,　while　avoiding　some　of　the　debilitating　sideeffects.

Leonard　Seymour,　a　professor　of　gene　therapy　at　Oxford　University,　who　has　been　working　on　the　virus　therapy　with　colleagues　in　London　and　the　US,　will　lead　the　trials　later　this　year.　Cancer　Research　UK　said　yesterday　that　it　was　exciting　by　the　potential　of　Prof　Seymours　pioneering　techniques.

One　of　the　countrys　leading　geneticists,　Prof　Seymour　has　been　working　with　viruses　that　kill　cancer　cells　directly,　while　avoiding　harm　to　healthy　tissue.　“In　principle,　youve　got　something　which　could　be　many　times　more　effective　than　regular　chemotherapy,”　he　said.

Cancerkilling　viruses　exploit　the　fact　that　cancer　cells　suppress　the　bodys　local　immune　system.　“If　a　cancer　doesnt　do　that,　the　immune　system　wipes　it　out.　If　you　can　get　a　virus　into　a　tumor,　viruses　find　them　a　very　good　place　to　be　because　theres　no　immune　system　to　stop　them　replicating.　You　can　regard　it　as　the　cancers　Achilles　heel.”

Only　a　small　amount　of　the　virus　needs　to　get　to　the　cancer.　“They　replicate,　they　get　a　million　copies　in　each　cell　and　the　cell　bursts　and　they　infect　the　tumor　cells　adjacent　and　repeat　the　process,”　said　Prof　Seymour.

Preliminary　research　on　mice　shows　that　the　viruses　work　well　on　tumors　resistant　to　standard　cancer　drugs.　“Its　an　interesting　possibility　that　they　may　have　an　advantage　in　killing　drugresistant　tumors,　which　could　be　quite　different　to　anything　weve　had　before.”

Researchers　have　known　for　some　time　that　viruses　can　kill　tumor　cells　and　some　aspects　of　the　work　have　already　been　published　in　scientific　journals.　American　scientists　have　previously　injected　viruses　directly　into　tumors　but　this　technique　will　not　work　if　the　cancer　is　inaccessible　or　has　spread　throughout　the　body.

Prof　Seymours　innovative　solution　is　to　mask　the　virus　from　the　bodys　immune　system,　effectively　allowing　the　viruses　to　do　what　chemotherapy　drugs　do—spread　through　the　blood　and　reach　tumors　wherever　they　are.　The　big　hurdle　has　always　been　to　find　a　way　to　deliver　viruses　to　tumors　via　the　bloodstream　without　the　bodys　immune　system　destroying　them　on　the　way.

“What　weve　done　is　making　chemical　modifications　to　the　virus　to　put　a　polymer　coat　around　it—its　a　stealth　virus　when　you　inject　it,”　he　said.

After　the　stealth　virus　infects　the　tumor,　it　replicates,　but　the　copies　do　not　have　the　chemical　modifications.　If　they　escape　from　the　tumor,　the　copies　will　be　quickly　recognized　and　mopped　up　by　the　bodys　immune　system.

The　therapy　would　be　especially　useful　for　secondary　cancers,　called　metastases,　which　sometimes　spread　around　the　body　after　the　first　tumor　appears.　“Theres　an　awful　statistic　of　patients　in　the　west...with　malignant　cancers;　75%　of　them　go　on　to　die　from　metastases,”　said　Prof　Seymour.

43.　Virus　therapy,　if　successful,　has　an　advantage　in　eliminating　sideeffects.

A.　True

B.　False

C.　Not　Given

44.　Cancer　Research　UK　is　quite　hopeful　about　Professor　Seymours　work　on　the　virus　therapy.

A.　True

B.　False

C.　Not　Given

45.　Virus　can　kill　cancer　cells　and　stop　them　from　growing　again.

A.　True

B.　False

C.　Not　Given

46.　Cancers　Achilles　heel　refers　to　the　fact　that　virus　may　stay　safely　in　a　tumor　and　replicate.

A.　True

B.　False

C.　Not　Given

47.　To　infect　the　cancer　cells,　a　good　deal　of　viruses　should　be　injected　into　the　tumor.

A.　True

B.　False

C.　Not　Given

48.　Researches　on　animals　indicate　that　virus　could　be　used　as　a　new　way　to　treat　drugresistant　tumors.

A.　True

B.　False

C.　Not　Given

49.　Uncoated　adenovirus　and　vaccinia　are　likely　to　be　examined　in　the　first　clinical　trials.

A.　True

B.　False

C.　Not　Given

50.　The　chemical　modifications　to　the　virus　are　Prof　Seymours　innovative　solution.

A.　True

B.　False

C.　Not　Given

Part　Four>>>>>

Questions　51—55

　Read　the　following　passage　about　tickling　and　laughter.　Five　sentences　have　been　removed　from　the　passage.

　Fill　in　each　blank　with　the　most　appropriate　sentence　from　the　list　A—F.　There　is　one　extra　sentence　which　you　DO　NOT　need　to　use.

　For　each　space　(51—55),　mark　one　letter　A—F　on　your　answer　sheet.

Tickling　and　Laughter

The　fingers　of　an　outstretched　arm　are　nearing　your　body;　you　bend　away　folding　your　torso,　bending　your　head　to　your　shoulder　in　hopes　that　you　dont　get　tickled;　but　the　inevitable　occurs　as　what　you　anticipated—you　are　tickled　and　in　hysterics　you　chuckle,　titter,　and　burst　into　uncontrollable　laughter.　(51)　.

Tickling　is　caused　by　a　light　sensation　across　our　skin.　At　times　the　light　sensation　can　cause　itching;　however,　most　of　the　time　the　light　touch　causes　giggling.　If　a　feather　is　gently　moved　across　the　surface　of　the　skin,　this　can　also　cause　tickling　and　giggling.　Heavy　laughter　is　caused　by　someone　or　something　placing　repeated　pressure　on　a　person　and　tickling　a　particular　area.　(52)　Yngve　Zotterman　from　Karolinksk　Institute　has　found　that　tickling　sensations　involve　signals　from　nerve　fibers.　These　nerve　fibers　are　associated　with　pain　and　touch.　Also,　Zotterman　discovered　tickling　sensations　to　be　associated　with　sense　of　touch　but　not　just　with　nerve　fibers　because　people　who　have　lost　pain　sensations　still　laugh　when　tickled.

(53)　Laughter　requires　the　coordination　of　many　muscles　throughout　the　body.　Laughter　also　increases　blood　pressure　and　heart　rate,　changes　breathing,　reduces　levels　of　certain　neurochemicals　(catecholamines,　hormones)　and　provides　a　boost　to　the　immune　system.　Can　laughter　improve　health?　It　may　be　a　good　way　for　people　to　relax　since　muscle　tension　is　reduced　after　laughing.　Human　tests　have　found　some　evidence　that　humorous　videos　and　tapes　can　reduce　feelings　of　pain,　prevent　negative　stress　reactions　and　boost　the　brains　biological　battle　against　infection.

(54)　In　one　new　study,　researchers　used　imaging　equipment　to　photograph　the　brain　activity　of　healthy　volunteers　while　they　underwent　a　sidesplitting　assignment　of　reading　written　jokes,　viewing　cartoons　from　The　New　Yorker　magazine　as　well　as　“The　Far　Side”　and　listening　to　digital　recordings　of　laughter.　Preliminary　results　indicate　that　the　humorprocessing　pathway　includes　parts　of　the　frontal　lobe　brain　area,　important　for　cognitive　processing;　the　supplementary　motor　area,　important　for　movement;　and　the　nucleus　accumbens,　associated　with　pleasure.　Investigations　support　the　notion　that　parts　of　the　frontal　lobe　are　involved　in　humor.　Subjects　brains　were　imaged　while　they　listened　to　jokes.　(55)　A　study　also　compared　healthy　individuals　with　people　who　had　damage　to　their　frontal　lobes,　and　the　subjects　with　the　damaged　frontal　lobes　were　more　likely　to　choose　a　wrong　punch　line　to　written　jokes　and　didnt　laugh　or　smile　as　much　at　funny　cartoons　or　jokes.

A.　Why　do　we　laugh　when　we　are　tickled?

B.　Researchers　believe　we　process　humor　and　laughter　through　a　complex　pathway　of　brain　activity　that　encompasses　three　main　brain　components.

C.　The　sites　tickled　often　are　feet,　toes,　sides,　underarms,　and　neck　which　cause　a　great　deal　of　laughter.

D.　The　brains　“funny　bone”　is　located　at　the　right　frontal　lobe　just　above　the　right　eye　and　appears　critical　to　our　ability　to　recognize　a　joke.

E.　Research　has　shown　that　laughing　is　more　than　just　a　persons　voice　and　movement.

F.　An　area　of　the　frontal　lobe　was　activated　only　when　they　thought　a　joke　was　funny.

Part　Five>>>>>

Question　56—65

　Read　the　following　passage　about　magnet　therapy.

　Fill　in　each　blank　with　the　correct　choice　A,　B,　C　or　D.

　Mark　the　corresponding　letter　on　your　answer　sheet.

Magnet　Therapy

Magnet　therapy,　which　is　a　$5billion　market　worldwide,　is　a　form　of　alternative　medicine　which　claims　that　magnetic　fields　have　healing　powers.　Magnetic　devices　that　are　claimed　to　be　(56)　include　magnetic　bracelets,　insoles,　wrist　and　knee　bands,　back　and　neck　braces,　and　even　pillows　and　mattresses.　Their　annual　sales　are　estimated　at　$300m　in　the　United　States　and　more　than　a　billion　dollars　globally.　They　have　been

(57)　to　cure　a　vast　array　of　ills,　particularly　pain.

The　therapy　works　on　the　(58)　of　balancing　electrical　energy　in　the　body　by　pulsating　magnetic　waves　through　different　parts　of　the　body.　The　electrical　currents　generated　by　magnets　increase　the　blood　flow　and　oxygen　which　helps　to　heal　many　of　the　ailments　and　countless　numbers　of　people　around　the　world　are　using　magnets　and　this　therapy　is　usually　prescribed　to　relieve　pain—(59)　muscle　and　joint　pains,　but　occasionally　headache,　carpal　tunnel　syndrome　and　other　types　of　pains　as　well.　(60)　its　many　applications　are　strains,　sprains　of　the　spine,　neck　or　limbs,　hip　and　joint　pain,　arthritis　and　chronic　pelvic　pain,　plus　healing　of　bone　fractures　and　some　proponents　even　advocate　magnets　to　relieve　stress,　combat　infections　and　prevent　seizures.

The　practice　of　magnetic　therapy　as　an　alternative　medication　has　led　to　the　growth　of　an　entire　industry　though　there　is　no　concrete　evidence　on　the　working　and　the　effectiveness　of　this　type　of　therapy.　Still　those　who　practice　it,　strongly　believe　that　certain　ailments　can　be　treated　if　the　patient　is　(61)　to　magnetic　fields　but　at　the　same　time　there　is　a　strong　resentment　from　the　medical　establishment　and　critics　claim　that　most　magnets　dont　have　the　strength　to　effect　the　various　organs　and　tissues　within　the　body　and　it　is　a　product　of　Pseudoscience　and　is　not　based　on　proper　research　and　analysis.　There　are　few　reported　complications　of　magnetic　therapy　and　the　World　Health　Organization　says　(62)　levels　of　magnetic　energy　is　not　harmful.　Documented　side　effects　are　not　lifethreatening　and　include　pain,　nausea　and　dizziness　that　disappeared　when　the　magnets　were　removed.　It　is　also　advised　that　pregnant　women　should　not　get　magnetic　therapy　treatments.　Those　with　pacemakers　should　avoid　magnetic　devices　as　well　as　those　who　are　taking　an　MRI　or　radiology　treatment,　(63)　the　magnetic　forces　can　disrupt　the　equipment　used　during　those　procedures.

Researchers　at　Baylor　University　Medical　Center　recently　conducted　a　doubleblind　study　(64)　the　use　of　concentriccircle　magnets　to　relieve　chronic　pain　in　50　postpolio　patients.　Active　as　well　as　placebo　magnets　ranging　from　300—500　gauss　were　placed　on　the　affected　area　of　each　patient　for　45　minutes.　A　(65)　number　of　patients　(76　percent)　reported　less　pain　when　using　the　active　magnets　as　opposed　to　those　who　reported　less　pain　while　using　a　placebo　magnet　(19　percent).

Magnet　therapy　is　gaining　popularity;　however,　the　scientific　evidence　to　support　the　success　of　this　therapy　is　lacking.　More　scientifically　sound　studies　are　needed　in　order　to　fully　understand　the　effects　that　magnets　can　have　on　the　body　and　the　possible　benefits　or　dangers　that　could　result　from　their　use.

56.　A.　therapeuticB.　diagnosticC.　stimulativeD.　aggressive

57.　A.　recommendedB.　advertisedC.　notedD.　installed

58.　A.　therapyB.　remedyC.　principleD.　dosage

59.　A.　effectivelyB.　fortunatelyC.　virtuallyD.　primarily

60.　A.　WithB.　ThroughC.　AmongD.　Between

61.　A.　evolvedB.　exposedC.　involvedD.　proposed

62.　A.　lowB.　minimalC.　fewerD.　less

63.　A.　byB.　asC.　inD.　owning

64.　A.　inB.　upC.　onD.　as

65.　A.　irrationalB.　equivalentC.　experimentalD.　significant

ⅢWriting

Question　66

　Write　an　essay　of　about　150　words　on　the　topic　“Should　Induced　Abortion　Be　Controlled?”　You　should　base　your　essay　on　the　clues　given　below.

　Please　write　your　essay　on　the　answer　sheet.

Should　Induced　Abortion　Be　Controlled?

1.　人工流产会影响女性健康

2.　人工流产是不人道的

3.　因此，……

4

4

医护英语水平考试（三级）模拟训练（四）

医护英语水平考试(三级)

模拟训练（四）

Medical　English　Test　System　(METS)

Level　3

ⅠListening

Part　One>>>>>

Questions　1—5

　You　will　hear　five　extracts　from　conversations　taking　place　in　different　clinical　departments.

　Choose　which　case　each　doctor　is　discussing　from　the　list　A—F.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　each　extract　twice.

Doctor　11

Doctor　22

Doctor　33

Doctor　44

Doctor　55

A.　The　patient　has　a　high　risk　of　having　cardiovascular　disease.

B.　The　patient　feels　some　discomfort　after　the　treatment　of　ovarian　carcinoma.

C.　The　patient　has　myelofibrosis　and　will　receive　treatment.

D.　The　patient　has　intertrochanteric　fracture.

E.　The　patient　has　severe　depression.

F.　The　patient　is　going　to　have　surgery.

Part　Two>>>>>

Questions　6—13

　You　will　hear　a　conversation　between　a　reporter　and　a　WHO　official.

　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　the　recording　twice.

6.　About　90%　of　all　deaths　worldwide　are　caused　by　NCDs.

A.　True　B.　False　C.　Not　Given

7.　People　who　died　prematurely　usually　died　before　reaching　70　years　of　age.

A.　True　B.　False　C.　Not　Given

8.　Tobacco　use　is　one　of　the　top　reasons　for　premature　death.

A.　True　B.　False　C.　Not　Given

9.　Prevention　and　control　of　NCDs　is　imperative　for　the　21st　century.

A.　True　B.　False　C.　Not　Given

10.　Most　NCD　deaths　occur　in　low　and　middleincome　countries.

A.　True　B.　False　C.　Not　Given

11.　Six　African　countries　have　failed　to　make　any　progress　against　such　deaths.

A.　True　B.　False　C.　Not　Given

12.　WHOs　mission　is　to　provide　leadership　and　the　evidence　base　for　international　action　on　surveillance,　prevention　and　control　of　NCDs.

A.　True　B.　False　C.　Not　Given

13.　A　global　dialogue　to　address　the　critical　gap　in　financing　for　national　NCD　responses　was　held　early　this　month.

A.　True　B.　False　C.　Not　Given

Part　Three>>>>>

Questions　14—20

　You　will　hear　a　discussion　among　an　instructor　and　two　medical　students.

　For　questions　14—20,　choose　the　most　appropriate　answer.

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　the　discussion　twice.

14.　Double　pneumonia　is　an　infection　of　.

A.　both　lungsB.　both　kidneys

C.　both　eyes

15.　Double　pneumonia　may　be　caused　by　the　following　EXCEPT　.

A.　bacteria

B.　virus

C.　pollutants

16.　Symptoms　of　pneumonia　include　the　following　EXCEPT　.

A.　a　high　fever,　chills,　or　shaking

B.　coughing　up　thick　mucus　or　phlegm

C.　stomach　pain　when　coughing　or　breathing

17.　What　are　the　complications　of　pneumonia?

A.　Spesis　and　tuberculosis.

B.　Spesis　and　lung　abscesses.

C.　Tuberculosis　and　abscesses.

18.　The　pleurae　are　two　membranes　that　line　the　outside　of　the　lungs　within　the　.

A.　chest　cavity

B.　oral　cavity

C.　abdominal　cavity

19.　Patients　who　have　bacterial　pneumonia　will　need　.

A.　antibiotic　therapy

B.　intravenous　antimicrobial　therapy

C.　hydrotherapy

20.　Which　of　the　following　statements　about　coughing　is　WRONG?

A.　Coughing　can　be　unpleasant.

B.　Coughing　helps　the　body　rid　itself　of　the　infection.

C.　People　who　have　double　pneumonia　should　take　a　cough　suppressant　medicine.

Part　Four>>>>>

Questions　21—25

　You　will　hear　a　speech　on　smoking　ecigarettes,　or　vaping.

　Complete　the　notes.　In　each　blank,　write　only　one　word.

　Write　the　answers　on　your　answer　sheet.

　You　will　hear　the　speech　twice.

Notes:

Many　people　might　be　tempted　to　turn　to　electronic　cigarettes　as　a　way　to　ease　the　transition　from　traditional　cigarettes　to　nonsmoking.　Here　are　some　truth　known　about　smoking　ecigarettes,　or　vaping.

　Vaping　is　less　harmful　than　traditional　smoking.

Regular　tobacco　cigarettes　contain　7,000　chemicals,　many　of　which　are　(21)　.

Ecigarettes　expose　you　to　fewer　toxic　chemicals　than　traditional　cigarettes.

　Vaping　is　still　bad　for　health　because　nicotine　is　still　the　primary　(22)　in　both　regular　cigarettes　and　ecigarettes.

Nicotine　is　a　toxic　substance　which　may　increase　the　heart　rate　and　the　likelihood　of　having　a　heart　attack　indirectly.

There　are　many　unknowns　about　vaping.

　Electronic　cigarettes　are　just　as　addictive　as　traditional　ones.

Ecigarette　users　may　get　even　more　nicotine　because　they　can　buy　extrastrength　cartridges,　which　have　a　higher　(23)　of　nicotine.

　Ecigarettes　have　not　received　Food　and　Drug　Administration　approval　as　smoking　(24)　devices.

　Ecigarettes　are　more　(25)　among　youth　than　any　traditional　tobacco　products.

ⅡReading

Part　One>>>>>

Questions　26—35

　Read　the　following　passage　about　diet　and　pregnancy.

Women　Who　Eat　Less　Fruit　and　More　Fast

Food　Take　Longer　to　Get　Pregnant

1Women　may　be　harming　their　chances　of　getting　pregnant　because　theyre　avoiding　fruit,　or　eating　too　much　junk　food,　a　study　has　found.　Australian　researchers　found　that　women　who　ate　fewer　than　three　pieces　of　fruit　a　month　took　50　percent　longer　to　conceive　than　women　who　ate　fruit　three　or　more　times　a　month.　Women　who　eat　less　fruit　and　more　fast　food　take　longer　to　get　pregnant　and　are　less　likely　to　conceive　within　a　year,　according　to　a　study　by　researchers　at　the　University　of　Adelaides　Robinson　Research　Institute.

2Junk　food　consumption　was　also　analyzed,　and　women　who　rarely　ate　fast　food　got　pregnant　a　month　quicker,　on　average　than　women　who　ate　fast　food　four　times　a　week　or　more.　While　the　intake　of　fruit　and　fast　food　affected　the　time　it　took　to　get　pregnant,　the　researchers　found　intake　of　green　leafy　vegetables　or　fish　did　not.

3As　parents　are　getting　older,　one　in　six　couples　trying　to　conceive　now　struggle　to　get　pregnant　and　keeping　a　healthy　weight　and　diet　is　a　key　way　to　improve　chances,　independent　experts　warned.　However　they　added　there　were　also　many　myths　about　fertility,　including　the　suggestion　that　fruit　should　be　avoided.　The　study,　which　is　published　in　the　journal　Human　Reproduction,　saw　5,598　women　questioned　about　their　diet　during　their　first　antenatal　visit.　The　women,　who　were　from　the　UK,　Ireland,　Australia　and　New　Zealand,　had　not　had　a　baby　before.

4Among　all　the　couples　in　the　study,　468　(8　percent)　were　classified　as　infertile　(defined　as　taking　longer　than　a　year　to　conceive)　and　2,204　(39　percent)　conceived　within　a　month.　When　researchers　looked　at　the　impact　of　diet　on　infertility,　they　found　that　in　women　with　the　lowest　intake　of　fruit,　the　risk　of　infertility　increased　from　8　percent　to　12　percent,　and　in　those　who　ate　fast　food　four　or　more　times　a　week,　the　risk　of　infertility　increased　from　8　percent　to　16　percent.　Professor　Claire　Roberts,　from　the　University　of　Adelaide,　who　led　the　study,　said:　“These　findings　show　that　eating　a　good　quality　diet　that　includes　fruit　and　minimizing　fast　food　consumption　improves　fertility　and　reduces　the　time　it　takes　to　get　pregnant.”　Melanie　McGrice,　who　was　not　involved　with　the　study,　said:　“As　a　fertility　dietician,　Im　seeing　more　and　more　women　who　incorrectly　think　that　they　should　be　avoiding　fruit　in　an　effort　to　help　them　conceive.”　Compared　to　women　who　ate　fruit　three　or　more　times　a　day　in　the　month　before　conception,　women　who　ate　fruit　less　than　one　to　three　times　a　month　took　half　a　month　longer　to　become　pregnant.　Similarly,　compared　to　women　who　never　or　rarely　ate　fast　food,　women　who　consumed　fast　food　four　or　more　times　a　week　took　nearly　a　month　longer　to　become　pregnant.

5This　study　demonstrates　that　fruit　consumption　is　not　only　safe,　but　beneficial　for　most　women　to　optimize　their　fertility.　Fruit　is　rich　in　antioxidants,　vitamins　and　phytochemicals,　and　should　not　be　lumped　into　the　same　basket　as　sugar　and　soft　drinks.　The　researchers　are　continuing　their　work　and　plan　to　identify　particular　dietary　patterns,　rather　than　individual　food　groups,　that　may　be　associated　with　how　long　it　takes　women　to　become　pregnant.

Questions　26—30

　Choose　the　most　appropriate　subheading　from　the　list　A—F　for　each　paragraph.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

26.　Paragraph　1

27.　Paragraph　2

28.　Paragraph　3

29.　Paragraph　4

30.　Paragraph　5

A.　Analysis　of　junk　food　consumption

B.　Roles　of　fruit　in　improving　conception

C.　Food　groups　that　may　affect　the　chances　of　conception

D.　Findings　showing　the　relation　between　diet　and　fertility

E.　The　key　way　to　improve　chances　of　conception

F.　Fruit　acting　as　sugar　and　soft　drinks

Questions　31—35

　Fill　in　each　blank　with　the　correct　answer　from　the　list　A—F.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

31.　A　study　made　by　researchers　at　the　University　of　Adelaides　Robinson　Research　Institute　showed　that　who　eat　less　fruit　and　more　junk　food　take　longer　to　and　are　less　likely　to　conceive　within　a　year.

32.　,　women　who　rarely　ate　fast　food　got　pregnant　a　month　quicker　than　women　who　ate　fast　food　four　times　a　week　or　more.

33.　Experts　added　there　were　many　including　the　suggestion　that　fruit　should　be　avoided.

34.　Melaine　McGrice,　a　,　holds　that　more　and　more　women　have　the　wrong　idea　that　they　should　be　avoiding　fruit　in　an　effort　to　help　them　conceive.

35.　Rich　in　antioxidants,　vitamins　and　phytochemicals,　fruit　should　not　the　same　basket　as　sugar　and　soft　drinks.

A.　On　average

B.　be　classified　as

C.　fertility　dietician(s)

D.　get　pregnant

E.　myth(s)　about　fertility

F.　be　lumped　into

Part　Two>>>>>

Questions　36—42

　Read　the　following　passage　about　NHS　cancer　screening.

　Choose　the　best　answer　A,　B,　C　or　D.

　Mark　the　corresponding　letter　on　your　answer　sheet.

Nearly　Half　a　Million　Women　Missed　out　on

National　Health　Service　Cancer　Screening

Nearly　half　a　million　women　missed　out　on　NHS　(National　Health　Service)　cancer　screening　because　of　an　IT　error,　the　government　has　admitted,　adding　that　hundreds　may　have　died　as　a　result.

Jeremy　Hunt,　the　health　and　social　care　secretary,　has　apologized　for　the　glitch　which　meant　450,000　women　were　never　sent　letters　inviting　them　to　routine　breast　cancer　checkups.　He　admitted　up　to　270　of　those　affected　could　have　died　prematurely　as　a　result　of　the　error　and　officials　told　The　Independent　there　may　be　more　women　whose　cancer　was　caught　at　a　later　and　less　treatable　stage.　The　government　announced　an　independent　inquiry　into　the　full　extent　of　what　charities　have　called　an　“appalling　error”,　and　said　it　would　begin　the　“distressing”　process　of　contacting　families　to　establish　whether　they　are　owed　compensation.

The　following　are　some　fast　facts　of　NHS　cancer　screening.

What　is　NHS　breast　cancer　screening?

Women　aged　50　to　70　are　invited　for　an　Xray　mammogram　every　three　years　to　detect　any　lumps　or　abnormalities　that　could　be　or　become　breast　cancer.

How　many　women　are　screened?

Around　2.5　million　women　are　invited　to　breast　screening　each　year.　In　2016/17　just　70　percent　took　up　screening—a　record　low—and　18,400　cancers　were　picked　up.

What　is　the　evidence　for　it?

The　benefits　of　national　breast　screening　are　contested,　particularly　in　older　women.　While　early　diagnosis　helps　maximize　chances　of　survival,　critics　say　large　numbers　of　women　are　subjected　to　harm　from　Xrays,　biopsies　and　preventative　mastectomies　for　lumps　that　may　never　become　cancer.

A　technical　issue　dating　back　to　2009　and　only　caught　in　2018　was　responsible　for　some　women　in　England　missing　out　on　the　last　of　their　regular　invitations　for　screening.

In　a　statement　today,　Mr.Hunt　announced　the　“best　estimate”　is　that　between　135　and　270　women　“had　their　lives　shortened　as　a　result”.

“I　am　advised　that　it　is　unlikely　to　be　more　than　this　range,　and　may　be　considerably　less,”　he　added.

“Tragically　there　are　likely　to　be　some　people　in　this　group　who　would　be　alive　today　had　this　failure　not　happened.”

These　numbers　are　based　on　statistical　estimates　of　the　rates　of　cancers　caught　for　every　woman　screened,　however　the　independent　review　will　establish　exactly　how　many　women　were　affected　by　reviewing　case　notes.

It　will　also　try　to　determine　how　the　issues　went　unnoticed　for　the　best　part　of　a　decade.

The　NHS　currently　screens　women　between　the　ages　of　50　and　70　for　breast　cancer　every　three　years,　but　only　women　aged　between　68　and　71　were　affected　by　this　issue.

The　glitch　first　came　to　light　in　January　after　an　upgrade　to　the　national　screening　IT　system　which　found　women　enrolled　in　a　longrunning　study,　the　AgeX　trial,　led　by　Oxford　University,　were　not　receiving　their　final　screening　invitation　around　age　70.

This　led　to　a　wider　review　which　the　problem　and　other　issues　were　replicated　across　England.

Of　the　affected　group,　309,000　women　are　believed　to　still　be　alive　and　will　receive　a　letter　by　the　end　of　May　telling　them　they　may　have　missed　screening　and　inviting　them　for　a　checkup　now.

Mr.Hunt　admitted　that　among　the　women　contacted　there　are　likely　to　be　people　who　have　recently　had　a　terminal　cancer　diagnosis　and　“apologized　wholeheartedly”　on　behalf　of　the　government,　NHS　England　and　Public　Health　England　for　the　failure.

“In　addition,　as　soon　as　possible　we　will　make　our　best　endeavor　to　contact　the　next　of　kin　of　those　we　believe　have　missed　a　scan　and　subsequently　died　of　breast　cancer,”　the　health　secretary　added.

“As　well　as　apologizing　to　families　affected,　we　wish　to　offer　any　further　advice　they　might　find　helpful　including　a　process　to　establish　whether　a　missed　scan　was　a　likely　cause　of　death　and　compensation　is　therefore　payable.

“We　recognize　this　will　be　incredibly　distressing　for　some　families.”

Public　Health　England　said　it　is　not　possible　to　estimate　how　many　women　in　this　group　may　have　cancer　that　was　picked　up　late,　or　is　currently　undiagnosed,　until　these　catchup　screenings　are　complete.

Across　England,　PHE　invites　2.5　million　women,　aged　50　to　70,　to　breast　cancer　screening　each　year,　around　70　percent　attended　in　201617　and　18,400　cancers　were　picked　up.

The　AgeX　trial　is　being　conducted　to　determine　the　usefulness　of　screening　women　younger　than　50　and　older　women,　up　to　the　age　of　73,　as　its　benefits　are　currently　disputed.

36.　Why　did　Health　and　Social　Health　secretary　Jeremy　Hunt　apologize?

A.　Because　400,000　women　were　never　sent　letters　inviting　them　to　routine　breast　cancer　checkups.

B.　Because　some　women　were　never　sent　letters　inviting　them　to　routine　breast　cancer　checkups.

C.　Because　450,000　women　were　never　sent　letters　inviting　them　to　routine　breast　cancer　checkups.

D.　Because　all　the　women　were　never　sent　letters　inviting　them　to　routine　breast　cancer　checkups.

37.　What　is　NHS　breast　cancer　screening?

A.　It　is　an　Xray　examination　for　women　between　the　age　of　60　and　70　to　detect　lumps　or　abnormalities　that　could　be　breast　cancer.

B.　It　is　an　Xray　mammogram　for　women　between　the　age　of　50　and　70　to　detect　lumps　or　abnormalities　that　could　be　breast　cancer.

C.　It　is　an　Xray　light　examination　for　women　between　the　age　of　40　and　70　to　detect　lumps　or　abnormalities　that　could　be　breast　cancer.

D.　It　is　an　Xray　light　for　women　between　the　age　of　30　and　70　to　detect　lumps　or　abnormalities　that　could　be　breast　cancer.

38.　How　many　women　took　up　breast　screening　in　2016?

A.　Around　1.75　million　women　took　up　breast　screening　in　2016.

B.　Around　2.50　million　women　took　up　breast　screening　in　2016.

C.　Around　2.00　million　women　took　up　breast　screening　in　2016.

D.　Around　1.84　million　women　took　up　breast　screening　in　2016.

39.　Which　of　the　following　statements　about　the　national　breast　screening　is　true?

A.　The　benefits　of　national　breast　screening　are　admitted,　particularly　in　older　women.

B.　The　benefits　of　national　breast　screening　are　applauded,　particularly　in　older　women.

C.　The　benefits　of　national　breast　screening　are　objected,　particularly　in　older　women.

D.　The　benefits　of　national　breast　screening　are　questioned,　particularly　in　older　women.

40.　What　does　the　“best　estimate”　mean?

A.　It　means　that　at　most　270　women　may　have　their　lives　shortened　because　of　the　error.

B.　It　means　that　at　least　135　women　may　have　their　lives　shortened　because　of　the　error.

C.　It　means　that　a　large　number　of　women　have　their　lives　shortened　because　of　the　error.

D.　It　means　that　it　is　still　unknown　that　how　many　women　have　been　influenced.

41.　What　will　NHS　do　for　women　who　missed　out　breast　cancer　screening?

A.　NHS　will　send　a　letter　telling　the　women　they　may　have　missed　screening.

B.　NHS　will　send　a　letter　telling　the　women　they　may　have　missed　screening　and　inviting　them　for　a　checkup　now.

C.　NHS　will　send　a　letter　telling　the　women　they　may　have　missed　a　checkup.

D.　NHS　will　send　a　letter　telling　the　women　they　may　have　missed　the　optional　cure　time.

42.　What　will　NOT　be　done　for　women　who　died　of　breast　cancer　as　a　result　of　missing　out　breast　cancer　screening?

A.　Their　families　may　be　contacted　and　receive　apologies.

B.　Their　families　may　be　offered　some　helpful　advice.

C.　Their　families　may　be　asked　questions　about　their　distress.

D.　Their　families　may　receive　compercations.

Part　Three>>>>>

Questions　43—50

　Read　the　following　passage　about　“thirdhand”　smoke.

　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).

　Mark　the　corresponding　letter　on　your　answer　sheet.

“　Thirdhand　”　Smoke　in　Carpet　and　Furniture

Could　Pose　Health　Risk

Scientists　have　called　for　more　research　into　the　risk　posed　by　“thirdhand　smoke”　after　finding　chemicals　from　cigarette　fumes　account　for　nearly　a　third　of　the　air　particles　in　nonsmoking　environments.

US　researchers　found　that　potentially　harmful　chemicals　from　tobacco　smoke　get　trapped　in　clothes,　furniture　and　carpets　but　can　become　airborne　again　and　be　circulated　through　office　blocks,　schools　or　other　nominally　smokefree　buildings.

Unlike　direct　smoking,　or　passive　“secondhand”　smoke—being　in　a　room　or　vehicle　while　someone　is　smoking—the　health　risks　of　thirdhand　smoke　on　surfaces　and　in　the　air　are　less　well　established.

Laboratory　tests　have　shown　indirect　exposure　with　tobacco　residues,　commonly　on　skin,　clothes　or　surfaces,　can　“detrimentally　affect　growth　and　immunity　in　mice”,　the　authors　write.

Experts　said　this　could　also　be　a　concern　for　babies　in　the　homes　of　smokers　who　are　lying　on　furniture　or　carpets　where　these　particles　may　have　settled.　Thirdhand　smoke　is　smoke　that　clings　to　carpets,　furniture,　clothing,　and　drapery,　therefore　contaminating　them　with　harmful　toxins　and　carcinogens　can　be　acquired　through　first　and　secondhand　smoke.　This　means　that　living　in　the　same　house　with　a　smoker　or　spending　a　large　amount　of　time　around　one　can　pose　a　great　threat,　and　it　can　especially　affect　babies　and　toddlers,　who　spend　a　lot　of　time　crawling　and　sitting　on　carpets　and　floors.　In　a　study　published　in　January　2009,　researchers　telephoned　laypeople　to　ask　whether　or　not　they　agreed　with　the　idea　that　“Breathing　air　in　a　room　today　where　people　smoked　yesterday　can　harm　the　health　of　infants　and　children.”　65　percent　of　people　who　didnt　smoke　believed　in　the　veracity　of　this　statement,　opposed　to　43　percent　of　smokers.

The　problem　is　caused　by　nicotine　residue　sticking　to　indoor　surfaces,　which　later　interacts　with　nitrous　acid　formed　from　the　gas　nitrous　oxide,　which　is　released　by　car　exhausts　and　gas　appliances.

When　these　chemicals　combine,　they　can　form　tobaccospecific　nitrosamines　(TSNAs)　which　can　cause　cancer,　previous　studies　have　shown.

The　latest　results,　published　in　the　journal　Science　Advances　today,　warn　that　not　only　are　these　chemicals　on　surfaces,　but　also　they　can　get　back　into　the　air　and　spread　further　afield.

This　could　also　occur　in　electronic　cigarettes,　which　also　contain　nicotine　and　are　used　in　indoor　public　spaces　much　more　frequently　than　conventional　cigarettes,　the　authors　said.

“In　an　empty　classroom,　where　smoking　has　not　been　allowed　in　some　time,　we　found　that　29　percent　of　the　entire　indoor　aerosol　mass　air　particles　contained　thirdhand　smoke　chemical　species,”　said　Dr.Anita　Avery　from　Drexel　University,　Philadelphia.

“This　was　obviously　quite　startling　and　raised　many　questions　about　how　that　much　thirdhand　smoke　could　be　lingering　in　a　nonsmoking,　ventilated　room.”

To　investigate　their　findings　further　the　researchers　ran　laboratory　trials　using　sealed　containers,　one　of　which　was　filled　with　cigarette　smoke,　and　then　subsequently　flushed　with　air　from　outdoors.

The　following　day　they　pumped　in　filtered　air　to　mimic　a　draft　or　ventilation　system　and　measured　the　particle　content　and　found　it　was　13　percent　higher　in　the　air　that　had　passed　through　the　smoking　container.

Its　clear　now　that　the　public　needs　to　be　more　aware　of　the　dangers　of　thirdhand　smoking,　because　it　poses　a　great　threat　to　friends　and　relatives—particularly　children　of　smokers.　Before　our　society　can　be　rid　of　smoking　and　its　harmful　effects,　we　need　to　understand　all　the　ways　in　which　we　can　be　harmed　by　it.

43.　US　researchers　found　that　potentially　harmful　chemicals　from　tobacco　smoke　may　get　trapped　in　clothes,　furniture　and　carpets.

A.　True

B.　False

C.　Not　Given

44.　The　toxic　ingredients　contained　in　thirdhand　smoke　include　hydrocyanic　acid,　butane,　toluene,　arsenic,　lead,　carbon　monoxide,　radioactive　polonium210　and　a　dozen　other　highly　carcinogenic　compounds.

A.　True

B.　False

C.　Not　Given

45.　Potentially　harmful　chemicals　from　tobacco　smoke　cannt　become　airborne　again.

A.　True

B.　False

C.　Not　Given

46.　Indirect　exposure　with　tobacco　residues　could　be　a　concern　for　babies　in　the　homes　of　smokers　who　are　lying　on　furniture　or　carpets　where　these　particles　may　have　settled.

A.　True

B.　False

C.　Not　Given

47.　Nicotine　reacts　with　nitrous　oxide,　which　is　released　from　car　exhausts　and　gas　appliances.

A.　True

B.　False

C.　Not　Given

48.　Thirdhand　smoke　can　have　a　big　impact　on　the　health　of　children,　and　it　can　also　harm　the　respiratory　system　of　adults.

A.　True

B.　False

C.　Not　Given

49.　Electronic　cigarettes　do　not　contain　nicotine.

A.　True

B.　False

C.　Not　Given

50.　Laboratory　trials　were　conducted　for　further　study.

A.　True

B.　False

C.　Not　Given

Part　Four>>>>>

Questions　51—55

　Read　the　following　passage　about　workplace　stress.　Five　sentences　have　been　removed　from　the　passage.

　Fill　in　each　blank　with　the　most　appropriate　sentence　from　the　list　A—F.　There　is　one　extra　sentence　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

Workplace　Stress　Should　be　Regulated　as　Safety　Hazard

A　third　of　people　in　Britain　have　experienced　suicidal　feelings,　according　to　one　of　the　largest　ever　reports　on　the　nations　mental　health　and　the　growing　toll　of　an　unchecked　stress　epidemic.　The　report　by　the　Mental　Health　Foundation　(MHF)　calls　for　societal　change　in　the　way　mental　health　is　treated,　alongside　new　rules　for　employers　to　treat　stress　and　mental　health　risks　as　seriously　as　physical　health　and　safety.　Launched　to　coincide　with　Mental　Health　Awareness　Week,　“The　Stress:　Are　We　Coping?”　Report　is　thought　to　be　the　most　comprehensive　look　at　the　damage　being　caused　by　selfneglect.　Figures　released　today　from　a　survey　of　more　than　4,600　UK　adults　found　three　out　of　four　have　felt　overwhelmed　or　are　unable　to　cope　in　the　past　year　because　of　stress—though　this　was　81　percent　among　women.　(51)

Thirtytwo　percent　of　adults　said　they　had　experienced　suicidal　feelings　as　a　result　of　stress,　while　16　percent　of　adults　said　they　had　selfharmed　as　a　result　of　stress　with　women　and　younger　adults　most　likely　to　be　affected.　(52)　To　address　this　crisis　the　MHF　is　calling　on　the　government　to　introduce　new　standards　for　employers,　to　consider　psychological　hazards　in　workplace　safety　assessments.　“There　are　very　few　workplaces　left　in　the　UK　in　which　employees　working　with　hazardous　chemicals　would　not　be　provided　with　protective　equipment,　and　failures　resulting　in　injury　or　even　death　prosecuted,”　the　report　says.

“We　do　not　currently　adopt　the　same　attitudes　and　behaviors　towards　psychological　hazards.”　These　hazards　are　any　mental　health　stressors　which　overwhelm　coping　mechanisms　which　include　taking　breaks　and　leaving　on　time　and　ability　to　work　safely,　and　breaches　should　be　enforced,　the　MHF　says.　It　also　calls　for　a　“minimum　of　two　mental　health　days”　for　nurses,　teachers,　police　officers　and　other　public　sector　staff　working　twice　as　hard　in　the　face　of　budget　cuts　and　staff　shortages.　(53)

“Introducing　and　incentivizing　the　use　of　mental　health　days　could　help　to　prevent　stress　escalating　and　turning　into　longerterm　sickness　absence　by　encouraging　selfcare,”　the　report　says.　“Stress　is　one　of　the　great　public　health　challenges　of　our　time,　but　it　still　isnt　being　taken　as　seriously　as　physical　health　concerns,”　said　MHF　director　Isabella　Goldie.

(54)　It　is　also　linked　to　physical　health　problems　like　heart　disease,　problems　with　our　immune　system,　insomnia　and　digestive　problems.　There　needs　to　be　equitable　access　to　specialist　support　and　awareness　of　how　stress　impacts　us　and　how　it　can　be　addressed.　“We　also　need　to　change　at　a　societal　level,”　Ms.　Goldie　said.　“This　includes　ensuring　that　employers　treat　stress　and　mental　health　problems　as　seriously　as　physical　safety.”　Catherine　Gamble,　professional　lead　for　Mental　Health　at　the　Royal　College　of　Nursing,　said:　“Stress　isnt　a　mental　illness　in　itself,　but　all　mental　health　nurses　know　that　we　are　all　vulnerable　to　it　and　that　if　left　unmanaged,　stress　can　be　a　precursor　to　more　serious　health　conditions.

“Whats　striking　is　the　amount　of　clinical　evidence　we　have　nowadays　about　the　physical　impact　of　stress—we　now　know　it　leads　to　an　increased　risk　of　heart　disease,　insomnia　and　damage　to　our　immune　systems.”　A　Department　of　Health　and　Social　Care　spokesperson　said:　“Tackling　stress　through　positive　mental　health　support　not　only　improves　our　lives　as　individuals,　but　makes　good　business　sense—failure　to　adequately　support　the　workforce　is　costing　our　economy　up　to　￡99bn　per　year.

“In　their　roles　as　employers　the　civil　service　and　NHS　are　adopting　new　standards　around　mental　health,　as　set　out　in　the　recent　independent　review　into　mental　health　in　the　workplace　commissioned　by　the　prime　minister.　(55)　”

A.　It　comes　the　week　after　Glasgow　University　research　found　that　one　in　nine　people　between　the　ages　of　18　and　34　in　Scotland　had　attempted　suicide.

B.　Workplace　stress　should　be　regulated　as　safety　hazard　because　one　third　of　Britons　admit　feeling　suicidal.

C.　This　includes　implementing　mental　health　plans　at　work,　developing　awareness,　and　monitoring　health　and　wellbeing.

D.　Stress　and　mental　health　is　the　fourth　most　common　reason　for　workplace　absence,　but　half　of　workers　make　up　another　excuse　when　they　feel　too　stressed　to　come　to　work.

E.　This　is　a　sign　of　pressures　going　beyond　the　stresses　of　everyday　life　which　can　lead　to　more　serious　mental　health　problems,　and　the　MHF　report　found　evidence　of　this.

F.　It　is　a　significant　factor　in　mental　health　problems　including　anxiety　and　depression.

Part　Five>>>>>

Questions　56—65

　Read　the　following　passage　about　genes　and　skin　tans.

　Fill　in　each　blank　with　the　correct　choice　A,　B,　C　or　D.

　Mark　the　corresponding　letter　on　your　answer　sheet.

Genes　Controlling　Whether　Skin　Tans　or

Burns　Discovered　by　Scientists

Largest　study　of　its　kind　helps　scientists　understand　genetic　basis　for　skin　cancer.　Sections　of　DNA　that　appear　to　play　a　role　in　controlling　whether　an　individuals　skin　burns　or　tans　have　been　located　by　scientists.　In　the　largest　genetic　study　of　its　kind,　which　used　data　from　nearly　200,000　people,　they　(56)　the　groundwork　for　genetic　tests　that　could　predict　peoples　responses　to　sunlight.　It　is　thought　the　discovery　could　also　help　researchers　understand　the　onset　of　skin　cancer—which　(57)　150,000　new　patients　in　the　UK　every　year.

Lead　author　of　the　study　Dr.Mario　Falchi,　a　researcher　at　Kings　College　London,　told　The　Independent　that　“a　good　percentage”　of　the　sunburn　genes　which　were　identified　also　involved　in　skin　cancer.　It　is　a　common　knowledge　that　sunburn　is　a　major　risk　factor　in　the　development　of　skin　cancer.　Understanding　the　genetics　of　tanning　therefore　also　means　understanding　the　genetics　of　this　condition,　which　is　the　most　common　type　of　cancer　in　people　of　European　descent.　Dr.　Falchi　said　their　work　also　helped　explain　the　phenomenon　familiar　to　many　of　the　friend　with　a　similar　complexion　who　turns　a　different　color　when　catching　some　rays.

Darkerskinned　people　are　(58)　more　resistant　to　the　harmful　effects　of　sunlight,　but　the　scientists　work　suggested　there　are　genetic　factors　besides　natural　skin　colour　that　can　(59)　people　from　the　sun.　“Some　of　these　genes　involved　in　skin　cancer　probably　have　nothing　to　do　with　pigmentation,”　he　said.　“This　may　explain　why　for　example　the　person　next　to　you　in　the　park　gets　completely　red,　while　you　get　tanned,　and　you　have　exactly　the　same　skin　colour.　There　is　(60)　for　people　with　the　same　pigmentation.”

The　research　was　(61)　using　an　enormous　quantity　of　genetic　data　taken　from　the　UK　Biobank,　which　contains　information　about　peoples　health　and　wellbeing　that　can　be　used　by　researchers.　Through　this　resource,　Dr.Falchi　and　his　colleagues　had　access　to　genetic　information　(62)　tens　of　thousands　of　people　of　European　ancestry　who　had　selfreported　on　their　tendency　to　tan　or　burn.

This　information　ranged　from　those　who　said　they　always　burned　and　never　tanned　to　those　who　tanned　without　burning.　The　scientists　then　explored　the　genetic　variability　between　all　of　these　people,　and　ultimately　pinpointed　10　new　genetic　regions　that　appeared　to　be　linked　with　tanning.　Their　results　were　published　in　the　journal　Nature　Communications.

This　discovery　confirmed　previous　work　(63)　the　genetic　underpinnings　of　tanning　and　sunburn,　and　doubled　the　number　of　regions　known　to　be　involved.

“By　using　a　very　large　sample　size　we　are　able　to　identify　almost　all　the　genes　involved　in　determining　a　particularly　trait—which　is　very　interesting　because　once　this　can　be　defined　you　can　develop　some　real　genetic　prediction　tests,”　said　Dr.　Falchi.

However,　he　noted　that　the　problem　of　sunburn　is　easy　to　(64)　without　genetic　tests,　as　it　is　essentially　an　issue　of　behavior　change.　“Getting　tanned　is　a　trend　that　started　in　the　1920—before　no　one　wanted　to　be　tanned　and　they　wanted　to　be　as　white　as　possible,”　he　noted.

The　history　of　tanning　itself　can　be　traced　back　to　the　fashion　designer　Coco　Chanel,　who　accidentally　became　sunburned　when　on　holiday　and　unintentionally　sparked　a　new　trend　that　has　continued　to　this　day.

According　to　Cancer　Research　UK,　almost　nine　out　of　10　cases　of　melanoma—the　most　serious　form　of　skin　cancer—could　be　(65)　by　“enjoying　the　sun　safely　and　avoiding　using　sunbeds”.　Dr.Falchi　said　that　regardless　of　genetics,　no　one　needs　to　expose　themselves　to　excess　levels　of　sunlight,　beyond　the　amount　needed　to　avoid　vitamin　D　deficiency.

56.　A.　laidB.　layC.　liedD.　lie

57.　A.　effectedB.　contractedC.　affectedD.　coughed

58.　A.　usuallyB.　naturallyC.　ordinarilyD.　normally

59.　A.　protectB.　preventC.　prohibitD.　probe

60.　A.　variableB.　variablesC.　variablyD.　variability

61.　A.　undertakeB.　undertakenC.　undergoD.　underwent

62.　A.　belong　toB.　pertain　toC.　belonging　toD.　pertaining　to

63.　A.　looking　atB.　looking　forC.　looking　intoD.　looking　out

64.　A.　involvedB.　involveC.　solvedD.　solve

65.　A.　avertedB.　avoidedC.　shunnedD.　eluded

ⅢWriting

Question　66

　Write　about　the　following　topic.

Doctor　is　a　respected　profession,　and　the　practitioners　shoulder　important　social　responsibility.　What　defines　a　qualified　doctor?

　Write　an　essay　of　no　less　than　150　words　on　your　answer　sheet.

5

5

医护英语水平考试（三级）模拟训练（五）

医护英语水平考试(三级)

模拟训练（五）

Medical　English　Test　System　(METS)

Level　3

ⅠListening

Part　One>>>>>

Questions　1—5

　You　will　hear　five　extracts　from　conversations　taking　place　in　different　clinical　departments.

　Choose　which　case　each　doctor　is　discussing　from　the　list　A—F.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　each　extract　twice.

Doctor　11

Doctor　22

Doctor　33

Doctor　44

Doctor　55

A.　The　patient　took　calcium　supplements　six　months　ago.

B.　The　patient　is　diagnosed　with　cholecystitis.

C.　The　patients　physiologic　status　meets　the　criteria　of　remote　or　no　chance　for　recovery.

D.　The　patient　has　some　problem　with　his　bowel.

E.　The　patient　is　a　smoker.

F.　The　patient　is　taking　antibiotics.

Part　Two>>>>>

Questions　6—13

　You　will　hear　a　conversation　between　a　reporter　and　a　cardiologist.

　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　the　recording　twice.

6.　In　the　USA,　now　physically　active　jobs　make　up　less　than　10%　of　workforce.

A.　True　B.　False　C.　Not　Given

7.　Sitting　for　long　periods　may　cause　heart　disease.

A.　True　B.　False　C.　Not　Given

8.　Dr.　Michos　is　physically　active　and　leads　a　completely　healthy　lifestyle.

A.　True　B.　False　C.　Not　Given

9.　High　levels　of　exercise　can　reduce　the　risk　of　heart　disease.

A.　True　B.　False　C.　Not　Given

10.　People　with　high　levels　of　activity　have　no　cardiovascular　risk.

A.　True　B.　False　C.　Not　Given

11.　Dr.　Michos　attends　some　meetings　which　are　held　outside　rooms.

A.　True　B.　False　C.　Not　Given

12.　People　who　have　to　be　sitting　in　front　of　the　computer　all　day　can　break　up　the　time.

A.　True　B.　False　C.　Not　Given

13.　According　to　Dr.　Michos,　11,000　steps　a　day　is　recommended.

A.　True　B.　False　C.　Not　Given

Part　Three>>>>>

Questions　14—20

　You　will　hear　a　discussion　among　an　instructor　and　two　medical　students.

　For　questions　14—20,　choose　the　most　appropriate　answer.

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　the　discussion　twice.

14.　Cellulitis　is　a　bacterial　infection　of　the　.

A.　skin

B.　cell

C.　lung

15.　A　break　in　the　skin　can　be　caused　by　the　following　EXCEPT　.

A.　burns

B.　grazes

C.　swelling

16.　The　symptoms　for　cellulitis　include　the　following　EXCEPT　.

A.　inflammation　of　the　affected　area

B.　inflammation　of　lymph　glands

C.　blisters,　skin　dimpling,　or　spots

17.　To　prevent　cellulitis,　we　should　do　the　following　EXCETP　.

A.　reducing　the　likelihood　of　scratching　the　skin

B.　avoid　using　of　moisturizers

C.　avoid　being　overweight

18.　Which　of　the　following　statements　about　cellulitis　treatment　is　true?

A.　Cellulitis　can　be　treated　at　home.

B.　Cellulitis　requires　no　treatment.

C.　Cellulitis　needs　to　be　treated　by　a　doctor.

19.　Some　people　have　suggested　using　tea　tree　oil　for　treatment　because　they　may　have　.

A.　antibacterial

B.　antibody

A.　antidote

20.　Which　of　the　following　statements　about　cellulitis　is　NOT　true?

A.　There　is　no　evidence　that　garlic　can　treat　cellulitis.

B.　Coconut　oil　can　be　used　to　treat　cellulitis.

C.　Without　timely　treatment,　cellulitis　can　be　lifethreatening.

Part　Four>>>>>

Questions　21—25

　You　will　hear　a　speech　on　natural　ways　to　adjust　sleeping　habits.

　Complete　the　notes.　In　each　blank,　write　only　one　word.

　Write　the　answers　on　your　answer　sheet.

　You　will　hear　the　speech　twice.

Notes:

There　are　easy,　natural　fixes　that　can　improve　your　sleep.

　Warm　(21)　,　chamomile　tea　and　tart　cherry　juice　are　recommended　for　patients　with　sleep　trouble.

　Moderate　(22)　exercise　boosts　the　amount　of　deep　sleep　you　get.

Endorphins　released　by　exercises　keep　people　awake　and　raise　core　body　temperature.

　Melatonin　supplements　is　a　(23)　released　in　the　brain　for　sleepiness.

Exposure　to　unnatural　light　prevents　melatonin　release.

Melatonin　is　available　at　local　pharmacies　as　an　overthecounter　supplement.

You　are　recommended　to　consistently　buy　the　same　brand　of　melatonin　supplements.

　Between　65　and　72　degrees　is　the　ideal　temperature.

Women　who　are　going　through　(24)　and　hot　flashes　should　keep　the　room　cool.

　You　are　recommended　to　use　a　flashlight　at　night　for　less　visual　(25)　.

ⅡReading

Part　One>>>>>

Questions　26—35

　Read　the　following　passage　about　an　outbreak　of　salmonella.

Egg　Farm　Responsible　for　Salmonella　Outbreak

1Perhaps　more　disturbing,　the　report　says,　is　that　“unacceptable　rodent　activity”　had　been　going　on　at　the　facility　for　months　before　the　first　of　the　salmonellarelated　illnesses　occurred,　but　the　facilitys　management　did　not　take　appropriate　actions　and　unsanitary　practices　continued.　Thirtyfive　people　who　consumed　eggs　traced　back　to　Rose　Acre　Farms　facility　in　Hyde　County,　North　Carolina,　have　been　sick　since　last　November,　the　Centers　for　Disease　Control　and　Prevention　said.　The　inspection　described　in　the　report　was　conducted　from　late　March　to　midApril,　in　response　to　the　outbreak　of　illness.

2Last　month,　Rose　Acre　Farms,　one　of　the　biggest　egg　producers　in　the　country,　recalled　nearly　207　million　eggs　because　of　fears　they　have　been　contaminated　with　salmonella.　In　a　statement,　the　familyowned　company　apologized　to　those　who　“may　have　been　sickened”　and　said　it　has　taken　“numerous　remedial　actions”　and　other　steps　“to　ensure　the　farm　meets　or　exceeds”　federal　standards.　Rose　Acre　Farms　takes　food　safety　and　the　welfare　of　our　hens,　workers　and　consumers　very　seriously.　“We　responsibly　follow　the　requirements　of　the　FDAs（Food　and　Drug　Administration）　Egg　Safety　Rule,　the　Food　Safety　Modernization　Act　and　the　Food　and　Drug　and　Cosmetic　Act　because　we　care　about　providing　safe,　nutritious　and　affordable　eggs,”　the　Seymour,　Indianabased　company　said.　“When　we　fall　short　of　expectations,　were　disappointed　in　ourselves　and　we　strive　to　correct　any　problems　and　institute　safeguards　that　ensure　those　problems　wont　occur　again.　We　vow　to　do　better　in　the　future.”

3The　report　says　that　rodent　infestation　had　been　a　problem　at　the　companys　Rose　Acre　Farms　since　at　least　last　September.　By　late　March　and　early　April　after　several　people　had　already　been　sick,　an　inspector　visited　the　facility　multiple　times　and　found　dozens　of　rodents　running　around　rows　of　poultry　houses.　A　few　carcasses　were　found　lying　in　and　outside　the　houses.　Sanitation　procedures　were　also　neither　implemented　nor　followed,　the　report　says.　Employees　were　seen　touching　their　faces,　hair,　buttocks　and　dirty　surfaces,　and　then　handling　food　without　changing　gloves　or　washing　their　hands.　Production　equipment　were　covered　in　dirt　and　food　debris　and　were　unclean　for　multiple　days　during　the　inspection.　One　employee　was　seen　cleaning　equipment　with　a　steel　wool　scrubber　that　had　been　stored　on　a　cart　in　a　dustpan　with　a　pool　of　dirty　water.　Condensation　was　also　seen　dripping　from　ceilings,　pipes,　and　walls　onto　production　equipment.

4The　“unsanitary　conditions　and　poor　employee　practices”　created　an　environment　allowed　for　pathogens　that　could　cause　egg　contamination　to　thrive　throughout　the　facility,　the　report　says.　200　million　eggs　recalled　because　of　salmonella　concerns.　“The　worst　thing　about　it　wasnt　like　this　was　news　to　Rose　Acre　Farms　when　the　FDA　got　out　there,”　said　Jory　Lange,　a　Houstonbased　attorney　representing　a　woman　who　was　infected　with　salmonella.　“If　Rose　Acre　Farms　had　just　taken　actions　last　year,　there　might　not　have　been　a　salmonella　outbreak.”　“The　problem　with　rodents　in　a　facility　thats　making　food　is　that　they　spread　pathogens　and　pathogens　can　be　deadly,”　added　Lange,　who　specializes　in　foodsafety　litigation.　“So　whatever　it　takes　to　get　rid　of　them,　youve　got　to　get　rid　of　them.　Otherwise,　youre　endangering　the　public.”　The　Hyde　County　facility　produces　2.3　million　eggs　a　day　from　3　million　hens.　Eggs　produced　at　the　farm　are　distributed　to　retail　stores　and　restaurants　in　Colorado,　Florida,　New　Jersey,　New　York,　Pennsylvania,　Virginia,　West　Virginia　and　the　Carolinas.　Illnesses　have　been　reported　in　all　those　states,　the　majority　of　which　were　from　New　York　and　Virginia,　the　CDC　said.

5Salmonella　can　come　from　contaminated　animal　products　such　as　beef,　poultry,　milk　and　eggs,　as　well　as　fruits　and　vegetables.　It　can　cause　fever,　diarrhea,　nausea,　vomiting　and　abdominal　pain　among　healthy　people,　but　can　lead　to　fatal　infections　among　children　younger　than　5,　adults　older　than　65　and　those　with　weak　immune　systems.　Salmonella　causes　about　1.2　million　illnesses,　23,000　hospitalizations　and　450　deaths　every　year　in　the　United　States,　according　to　the　CDC.　While　most　recover　completely,　some　people　suffer　from　longterm　effects　such　as　reactive　arthritis,　which　is　joint　pain　and　swelling　caused　by　infection.

Questions　26—30

　Choose　the　most　appropriate　subheading　from　the　list　A—F　for　each　paragraph.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

26.　Paragraph　1

27.　Paragraph　2

28.　Paragraph　3

29.　Paragraph　4

30.　Paragraph　5

A.　Unsanitary　and　irregular　practices　found　by　an　inspector　at　the　egg　farm　existing　rodent　infestation.

B.　Apologies　and　promises　made　by　the　Indiana—based　company.

C.　Outbreak　of　salmonella—related　illnesses　caused　by　rodent　infection　at　an　egg　farm.

D.　Source　of　Salmonella　and　damages　it　made　to　the　body.

E.　Unsanitary　and　irregular　practices　being　the　major　causes　of　large—scaled　egg　contamination　with　pathogens.

F.　Possible　long—term　effect　made　by　salmonella.

Questions　31—35

　Fill　in　each　blank　with　the　correct　answer　from　the　list　A—F.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

31.　Until　the　first　salmonella　related　illness　occurred,　the　management　of　the　facility　had　not　yet　taken　and　improved　unhygienic　practices.

32.　Were　ourselves　and　we　strive　to　correct　any　problems　and　institute　safeguards　that　ensure　those　problems　wont　occur　again.

33.　A　few　carcasses　were　found　and　outside　the　houses.

34.　Eggs　produced　at　the　farm　are　retail　stores　and　restaurants　in　Colorado,　Florida,　New　Jersey,　New　York,　Pennsylvania,　Virginia,　West　Virginia　and　the　Carolinas.

35.　Salmonella　can　come　from　such　as　beef,　poultry,　milk　and　eggs,　as　well　as　fruits　and　vegetables.

A.　appropriate　actions

B.　contaminated　animal　products

C.　disappointed　in

D.　lying　in

E.　coming　from

F.　distributed　to

Part　Two>>>>>

Questions　36—42

　Read　the　following　passage　about　Alzheimers　disease.

　Choose　the　best　answer　A,　B,　C　or　D.

　Mark　the　corresponding　letter　on　your　answer　sheet.

Alzheimers　Disease　and　Its　Causes

Dame　Barbara　Windsor,　one　of　the　most　recognizable　faces　in　Britain　known　for　her　roles　in　Eastenders　and　the　“Carry　On”　films,　has　been　diagnosed　with　Alzheimers　disease,　her　husband　has　revealed.

She　is　one　of　around　850,000　people　suffering　with　some　form　of　dementia　in　the　UK.

The　majority　have　Alzheimers　disease,　a　terminal　condition　affecting　the　brain　which　the　80yearold　was　diagnosed　with　four　years　ago.

The　following　are　some　fast　facts　about　Alzheimers　disease.

What　is　Alzheimers　disease?

Alzheimers　disease　is　the　most　common　cause　of　dementia,　which　is　a　collective　term　for　symptoms　including　problems　with　language　and　thinking,　and　commonly　memory　loss.The　hallmark　of　the　disease　is　the　buildup　in　the　brain　of　damaging　clumps　of　proteins,　known　as　“plaques”　and　“tangles”.These　buildups　gradually　kill　the　junctions　between　nerve　cells　in　the　brain,　known　as　synapses,　and　eventually　strangle　the　neurons　themselves　leading　to　the　death　of　brain　tissue.Brains　of　people　with　Alzheimers　also　have　much　lower　levels　of　neurotransmitter　chemicals　like　acetylcholine,　which　are　another　important　part　of　brain　signals.

What　causes　Alzheimers?

This　is　still　poorly　understood.　Scientists　do　not　fully　know　what　triggers　the　buildup　of　these　plaques　and　whether　theyre　a　symptom　or　cause　of　the　disease.　However　there　are　several　factors　which　increase　the　risk,　with　age　being　the　biggest,　one　sufferer　in　20　is　less　risk　than　that　under　the　age　of　65　and　early　onset　forms　of　the　disease　can　strike　from　around　40.

Lifestyle　factors　including　smoking,　obesity　and　diet　are　another　major　factor　in　increasing　risk,　and　suffering　a　head　injury,　including　a　minor　concussion,　can　increase　the　risk　by　as　much　as　twothirds.There　are　twice　as　many　women　with　Alzheimers　over　the　age　65　as　men　and　the　reason　for　this　is　also　not　fully　understood.There　are　also　some　inherited　genetic　risks,　and　other　health　conditions　such　as　having　a　learning　disability　can　increase　your　chances　of　suffering　from　the　disease.

What　are　its　symptoms?

In　many　cases,　the　disease　takes　a　long　time　to　develop　and　can　go　unnoticed　in　older　relatives　making　supportive　treatment　hard　to　deliver.Often　the　first　recognized　symptoms　are　onceroutine　tasks　such　as　preparing　a　meal　or　taking　a　trip　to　shops　become　more　difficult.　People　with　the　disease　may　get　lost　more　easily　or　forget　key　dates　or　the　names　and　faces　of　relatives.Depression　can　be　a　very　early　sign　which　may　occur　before　any　physical　hallmarks　in　the　brain.In　later　stages　people　can　become　nonverbal　and　it　can　cause　large　swings　in　behavior　leading　to　aggression　and　other　behaviors　which　make　caring　for　them　at　home　more　difficult.

Is　there　a　cure?

There　is　no　cure　for　the　disease,　though　it　is　a　major　research　area　along　with　developing　tests　for　earlier　diagnosis.Support　is　usually　focused　on　coming　to　terms　with　the　diagnosis　and　adapting　lifestyle　and　care　arrangements　to　maximize　quality　of　life,　as　well　as　teaching　coping　strategies　for　memory.There　are　drug　treatments　which　can　temporarily　improve　some　symptoms.In　earlier　stages　drugs　like　Exelon　or　Reminy　can　improve　memory　problems　and　concentration,　typically　by　addressing　the　imbalances　in　neurotransmitter　chemicals　like　acetylcholine.In　later　stages　drug　treatments　can　help　to　address　some　of　the　more　challenging　symptoms　such　as　delusions　or　aggression.

36.　What　is　Alzheimers　disease?

A.　Alzheimers　disease　is　the　most　common　cause　of　dementia,　which　is　a　collective　term　for　symptoms　including　problems　with　language　and　thinking,　and　commonly　memory　loss.

B.　Alzheimers　disease　is　the　most　common　cause　of　dementia,　which　is　a　collective　term　for　symptoms　including　problems　with　language　and　commonly　memory　loss.

C.　Alzheimers　disease　is　the　most　common　cause　of　dementia,　which　is　a　collective　term　for　symptoms　including　problems　with　thinking　and　commonly　memory　loss.

D.　Alzheimers　disease　is　the　most　common　cause　of　dementia,　which　is　a　collective　term　for　symptoms　including　problems　with　commonly　memory　loss.

37.　What　causes　Alzheimers?

A.　Buildup　of　plaques.

B.　The　aging　process.

C.　The　cause　is　poorly　understood.

D.　Early　onset　of　strokes.

38.　What　kind　of　people　are　more　susceptible　to　Alzheimers　disease?

A.　The　young　people　are　more　likely　to　develop　Alzheimers　disease.

B.　Males　are　more　likely　to　develop　Alzheimers　disease.

C.　Adults　are　more　likely　to　develop　Alzheimers　disease.

D.　The　aged　are　more　likely　to　develop　Alzheimers　disease.

39.　What　lifestyle　factors　can　lead　to　increased　risk　of　Alzheimer?

A.　Lifestyle　factors　including　sleeping　and　diet　are　major　factors　in　increasing　risk.

B.　Lifestyle　factors　including　smoking,　obesity　and　diet　are　major　factors　in　increasing　risk.

C.　Lifestyle　factors　including　obesity　and　diet　are　major　factors　in　increasing　risk.

D.　Lifestyle　factors　including　fruit　and　diet　are　major　factors　in　increasing　risk.

40.　Which　of　the　following　statements　about　the　symptoms　of　Alzheimers　is　NOT　true?

A.　The　first　symptom　to　be　found　is　that　the　onceroutine　tasks,　become　more　difficult.

B.　Depression　can　be　a　very　late　sign　that　comes　after　any　physical　feature　of　the　brain.

C.　In　later　stages　the　affected　individuals　may　have　problems　in　oral　communication.

D.　People　with　Alzheimers　may　become　aggressive.

41.　Which　of　the　following　statements　about　the　cure　for　Alzheimers　is　true?

A.　It　is　a　major　research　area　along　with　developing　tests　for　screening.

B.　It　is　a　major　research　area　along　with　developing　tests　for　prognosis.

C.　It　is　a　major　research　area　along　with　developing　tests　for　earlier　prevention.

D.　It　is　a　major　research　area　along　with　developing　tests　for　diagnosis.

42.　According　to　the　passage,　which　of　the　following　statements　is　true　about　the　treatment　of　Alzheimers　disease?

A.　The　radical　treatment　is　teaching　coping　strategies　for　memory.

B.　There　are　drug　treatments　which　can　temporarily　improve　some　symptoms.

C.　Drugs　like　Exelon　or　Reminy　can　improve　memory　problems　and　concentration.

D.　Drugs　like　Exelon　or　Reminy　can　address　symptoms　such　as　aggression.

Part　Three>>>>>

Questions　43—50

　Read　the　following　passage　about　American　ginseng　berry　and　colorectal　cancer.

　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).

　Mark　the　corresponding　letter　on　your　answer　sheet.

American　Ginseng　Berry　Enhances　Chemo　Preventive

Effect　of　5FU　on　Human　Colorectal　Cancer　Cells

Colorectal　cancer　is　one　of　the　most　common　malignancies　and　ranks　as　the　second　greatest　cause　of　cancer　death　in　both　men　and　women　worldwide.　Although　early　stage　colorectal　cancer　can　be　cured　by　surgical　resection,　surgery　is　often　combined　with　adjuvant　radiotherapy　and　chemotherapy　with　one　or　more　chemotherapeutic　agents.　Even　with　effective　strategies　that　continue　to　be　developed　for　treating　colorectal　cancer,　chemotherapy　has　the　drawbacks　of　severe　adverse　effects　and　doselimiting　toxicity.　Drugrelated　adverse　events　not　only　worsen　patients　quality　of　life,　but　can　also　lead　to　their　refusal　to　continue　chemotherapy.

Chemotherapyinduced　toxicity　can　be　reduced　by　chemoadjuvant　compounds　that　potentiate　tumoricidal　effects　with　lower　doses.　Identifying　nontoxic　chemoadjuvants　among　herbal　medicines　may　be　an　essential　step　in　advancing　the　treatment　of　cancer.　Due　to　the　increase　in　the　consumption　of　herbal　remedies　in　the　United　States　along　with　a　staggering　popularity　of　the　ginseng　herb　as　a　method　of　sustaining　good　health,　significant　focus　has　been　placed　on　American　ginseng　(Panaxquinquefolius　L.),　which　belongs　to　the　genus　Panax　L.　in　the　Araliaceae　family.　American　ginseng　has　been　reported　to　have　stressrelieving　qualities,　antiaging　effects　and　digestionaiding　effects.　Cancer　treatment　with　botanicals　like　American　ginseng　has　also　received　increasing　attention　in　recent　years.　The　major　active　components　of　ginseng　are　ginsenosides,　a　diverse　group　of　steroid　saponins.　Ginsenosides　are　distributed　in　many　parts　of　the　ginseng　plant,　including　the　root,　leaf　and　berry.　The　most　commonly　used　part　of　the　plant　is　the　root,　which　is　harvested　in　late　summer　to　fall　between　its　fourth　and　seventh　years.

It　is　well　documented　that　American　ginseng　berry　extract(AGBE)　could　improve　diabetic　conditions,　such　as　decreasing　the　blood　glucose　and　body　weight　in　mice,　attenuating　oxidant　stress　in　cardiomyocytes,　reducing　chemotherapyinduced　nausea/vomiting,　and　exerting　antiproliferative　activity　against　human　breast　carcinoma　cells.　Previously,　our　laboratory　analyzed　ginsenoside　compounds　in　AGBE　with　different　processing　methods,　and　pilot　data　showed　the　effects　on　colorectal　carcinoma　cells.　However,　the　mechanism　of　the　antiproliferative　effect　of　AGBE　is　not　known.　The　5Fluorouracil　(5FU)　is　one　of　the　most　widely　used　chemotherapeutic　agents　in　firstline　therapy　for　colorectal　cancer,　and　an　overall　survival　benefit　after　fluorouracilbased　chemotherapy　has　been　firmly　established.　But　for　the　treatment　of　metastatic　colon　cancer,　however,　higher　5FU　doses　produced　more　adverse　effects　while　not　necessarily　being　more　effective　than　lower　doses.　Therefore,　if　decreasing　the　dose　of　chemotherapy　and　increasing　its　anticancer　effect　could　be　accomplished　by　combining　5FU　with　other　agents,　patients　may　benefit.　However,　chemotherapy　with　5FU　and　herbal　medicines　has　rarely　been　studied.

Thus,　this　study　investigated　the　potential　synergistic　tumoricidal　effects　of　AGBE　on　5FU.　We　used　various　human　colorectal　cancer　cell　lines,　SW480,　HCT116　and　HT29,　which　have　undergone　extensive　laboratory　cancer　research　and　have　been　the　models　for　the　cellular　pathways　studies　of　chemotherapy　on　cancer　cells.　Furthermore,　we　observed　the　combined　effect　on　cell　apoptosis,　cell　cycle　and　cycle　A　in　SW480　cells　to　elucidate　the　possible　mechanism　in　these　cells.　This　is　an　important　preliminary　step　in　the　development　of　an　effective　chemo.　The　successful　treatment　regimens　for　cancer　include　combination　chemotherapy,　which　is　often　more　effective　than　single　chemotherapy　because　of　additive　or　synergistic　effects.

In　the　present　study,　we　evaluated　the　effects　of　AGBE　in　enhancing　the　chemopreventive　efficacy　of　5FU　on　human　colorectal　cancer　cells.　Our　data　suggest　that　AGBE　has　the　potential　to　heighten　the　tumoricidal　effects　of　5FU　and　that　5FUinduced　antiproliferation　of　human　colorectal　cancer　cells　can　be　strengthened　by　combination　with　AGBE.　The　mechanism　may　include　the　enhancement　of　AGBE　on　the　Sand　G2/M　phases　arrest　and　the　expression　level　of　cyclin　A,　but　not　the　induction　of　cell　apoptosis.

43.　Colorectal　cancer　is　considered　as　the　top　cause　of　cancer　death　in　both　men　and　women　worldwide.

A.　True

B.　False

C.　Not　Given

44.　It　has　been　reported　that　American　ginseng　can　be　used　to　relieve　stress　retard　the　aging　process,　and　aid　digetion.

A.　True

B.　False

C.　Not　Given

45.　The　5Fluorouracil　(5FU)　is　one　of　the　most　widely　used　chemotherapeutic　agents　in　firstline　therapy　for　colorectal　cancer.

A.　True

B.　False

C.　Not　Given

46.　The　concentrations　of　ginsenoside　compounds　vary　significantly　depending　on　genetics,　season,　geographical　distribution,　plant　growth,　and　production　and　extract　processes.

A.　True

B.　False

C.　Not　Given

47.　It　is　not　clear　whether　consuming　AGBE　with　chemotherapy　affects　the　efficacy　of　chemotherapeutic　agents.

A.　True

B.　False

C.　Not　Given

48.　Because　of　additive　or　synergistic　effects　combination　chemotherapy　is　often　less　effectine　than　single　chemotherapy.

A.　True

B.　False

C.　Not　Given

49.　The　5FU　induced　antiproliferation　of　human　colorectal　cancer　cells　may　be　weakened　by　combination　with　AGBE.

A.　True

B.　False

C.　Not　Given

50.　The　mechanism　of　AGBEs　potential　to　heighten　the　turmoricidal　effects　of　5FU　has　nothing　to　do　with　the　induction　of　cell　apoptosis.

A.　True

B.　False

C.　Not　Given

Part　Four>>>>>

Questions　51—55

　Read　the　following　passage　about　physical　health.　Five　sentences　have　been　removed　from　the　passage.

　Fill　in　each　blank　with　the　most　appropriate　sentence　from　the　list　A—F.　There　is　one　extra　sentence　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

Optimism　and　Physical　Health

Few　outcomes　are　more　important　than　staying　alive,　and　optimism　is　linked　to　life　longevity.　Maruta,　Colligan,　Malinchoc,　and　Offord　(2000)　examined　whether　explanatory　styles　served　as　risk　factors　for　early　death.　With　a　large　longitudinal　sample　collected　in　the　mid1960s,　the　researchers　categorized　medical　patients　as　optimistic,　mixed,　or　pessimistic.　Optimism　was　operationalized　using　parts　of　the　Minnesota　Multiphasic　Personality　Inventory.　(51)

Considering　that,　for　a　middleaged　person　of　average　health,　the　difference　between　sudden　death　risk　factors　for　smokers　and　nonsmokers　is　5%—10%,　the　protective　effect　of　optimism　found　in　this　study　is　massive.

Optimism　also　plays　a　role　in　the　recovery　from　illness　and　disease.　(52)

These　studies　have　found　that　optimistic　people　experience　less　distress　when　faced　with　potentially　lifethreatening　cancer　diagnoses.　For　example,　Schou　and　colleagues　(2005)　found　that　a　superior　“fighting　spirit”　found　in　optimists　predicted　substantially　better　quality　of　life　one　year　after　breast　cancer　surgery.　In　this　case,　optimism　appeared　to　protect　against　an　urge　to　withdraw　from　social　activities,　which　may　be　important　for　healing.　People　who　tend　to　be　more　optimistic　and　more　mindful　had　an　increase　in　sleep　quality.　(53)　A　sample　of　middleaged　women　was　tested　for　precursors　to　atherosclerosis　at　a　baseline　three　years　later.

Optimism　can　have　an　effect　on　a　persons　immune　system,　as　well.　In　one　study,　elderly　adults　were　immunized　for　influenza.　Two　weeks　later,　their　immune　response　to　the　vaccination　was　measured.　Greater　optimism　predicted　greater　antibody　production　and　better　immune　outcomes.　Five　studies　have　also　investigated　optimism　and　disease　progression　in　people　infected　with　HIV.　This　study　examined　a　sample　of　entering　law　students　over　five　time　points　in　their　first　year　of　law　school.　Dispositional　optimism　(the　tendency　to　be　generally　optimistic　about　your　life)　and　optimism　about　law　school,　in　particular,　were　assessed,　along　with　measures　of　positive　and　negative　affect　(to　determine　whether　any　relationships　between　optimism　and　immune　system　functioning　could　be　better　explained　through　positive　or　negative　affect).　This　study　found　that　optimism　predicted　superior　cellmediated　immunity,　an　important　part　of　the　immune　systems　response　to　infectious　agents.　Furthermore,　negative　affect　did　not　predict　changes　in　immune　function.　(54)

Thus,　it　appears　that　an　optimistic　outlook　appears　not　only　to　be　strongly　positively　related　to　a　healthy　immune　system　but　also　to　better　outcomes　for　people　with　compromised　immune　systems.

Optimism　has　also　been　investigated　in　healthrelated　behaviors.　In　examining　the　risk　of　developing　alcohol　dependence,　one　study　found　that　optimism　protected　against　drinking　problems　in　people　with　a　family　history　of　alcoholism.　As　family　history　is　one　of　the　greatest　risk　factors　for　developing　substance　dependence,　optimisms　protective　effects　against　its　influence　may　be　very　important　for　public　health　efforts.　Beyond　helping　to　prevent　substance　use　problems　from　developing,　optimism　may　predict　better　outcomes　from　efforts　to　quit　using.　Pregnant　women　who　are　higher　in　optimism　have　been　shown　to　be　less　likely　to　abuse　substances　while　pregnant.

(55)　The　mere　act　of　expecting　positive　outcomes　and　being　hopeful　can　boost　a　persons　immune　system,　protect　against　harmful　behaviors,　prevent　chronic　disease,　and　help　people　cope　following　troubling　news.　Optimism　can　even　predict　a　longer　life.　Among　psychological　constructs,　optimism　may　be　one　of　the　most　important　predictors　of　physical　health.

A.　Multiple　studies　have　investigated　the　role　of　optimism　in　people　undergoing　treatment　for　cancer.

B.　The　studies　described　above　share　a　common　theme:　optimism　can　have　profound　effects　on　a　persons　physical　health.

C.　What　this　means　is　that　optimism　appears　to　have　a　unique　value　among　the　factors　that　compose　a　persons　immune　system.

D.　The　researchers　found　that　for　every　10　points　increase　in　a　persons　score　on　their　optimism　scale,　the　risk　of　early　death　decreased　by　19%.

E.　There　is　also　evidence　that　optimism　can　protect　against　the　development　of　chronic　diseases.

F.　Optimists　are　also　able　to　recover　from　disappointments　more　quickly　by　attending　to　positive　outcomes　to　a　greater　extent　than　negative　ones.

Part　Five>>>>>

Questions　56—65

　Read　the　following　passage　about　kidney　transplantation.

　Fill　in　each　blank　with　the　correct　choice　A,　B,　C　or　D.

　Mark　the　corresponding　letter　on　your　answer　sheet.

Kidney　Transplantation

Kidney　transplantation　or　renal　transplantation　is　the　organ　transplant　of　a　kidney　into　a　patient　with　endstage　renal　disease.　Kidney　transplantation　is　(56)　classified　as　deceaseddonor　or　livingdonor　transplantation　depending　on　the　source　of　the　donor　organ.

One　of　the　earliest　mentions　about　the　real　possibility　of　a　kidney　transplant　was　by　American　medical　researcher　Simon　Flexner,　who　declared　in　a　reading　of　his　paper　on　“Tendencies　in　Pathology”　in　the　University　of　Chicago　in　1907　that　it　would　be　possible　in　the　thenfuture　for　diseased　human　organs　substitution　for　healthy　ones　by　surgery,　including　arteries,　stomach,　kidneys　and　heart.　Occasionally,　the　kidney　is　(57)　together　with　the　pancreas.　University　of　Minnesota　surgeons　Richard　and　William　Kelly　perform　the　first　successful　simultaneous　pancreaskidney　transplant　in　the　world　in　1966.　This　is　done　in　patients　with　diabetes　mellitus　type　1,　in　whom　the　diabetes　is　due　to　destruction　of　the　beta　cells　of　the　pancreas　and　in　whom　the　diabetes　has　caused　renal　failure.　This　is　almost　always　a　deceased　donor　transplant.　Only　(58)　living　donor　pancreas　transplants　have　been　done.　For　individuals　with　diabetes　and　renal　failure,　the　advantages　of　earlier　transplant　from　a　living　donor　are　far　superior　to　the　risks　of　continued　dialysis　until　a　combined　kidney　and　pancreas　are　available　from　a　deceased　donor.　A　patient　can　either　receive　a　living　kidney　followed　by　a　donor　pancreas　at　a　later　date　or　a　combined　kidneypancreas　from　a　donor.

Transplanting　just　the　islet　cells　from　the　pancreas　is　still　in　the　experimental　stage,　but　shows　promise.　This　involves　taking　a　deceased　donor　pancreas,　breaking　it　down,　and　extracting　the　islet　cells　that　make　insulin.　The　cells　are　then　injected　through　a　catheter　into　the　recipient　and　they　generally　lodge　in　the　liver.　The　recipient　still　needs　to　take　immune　suppressants　to　avoid　rejection,　but　no　surgery　is　required.　Most　people　need　two　or　three　such　injections,　and　many　are　not　completely　insulinfree.　Kidney　transplantation　is　a　lifeextending　procedure.　The　typical　patient　will　live　10　to　15　years　longer　with　a　kidney　transplant　than　being　kept　on　dialysis.　The　increase　in　longevity　is　greater　for　(59)　patients,　but　even　75yearold　recipients　gain　an　average　of　four　more　years　of　life.　People　generally　have　more　energy,　a　less　restricted　diet,　and　fewer　complications　with　a　kidney　transplant　than　if　they　stay　on　conventional　dialysis.

Some　studies　seem　to　suggest　that　the　longer　a　patient　is　on　dialysis　before　the　transplant,　the　less　time　the　kidney　will　last.　It　is　not　clear　why　this　occurs,　but　it　underscores　the　need　for　rapid　referral　to　a　transplant　program.　Ideally,　a　kidney　transplant　should　be　preemptive,　i.e.,　take　place　before　the　patient　begins　dialysis.　The　reason　why　kidneys　fail　over　time　after　transplantation　has　been　elucidated　in　recent　years.　(60)　recurrence　of　the　original　kidney　disease,　also　rejection　and　progressive　scarring　play　a　decisive　role.　Avoiding　rejection　by　strict　medication　adherence　is　of　utmost　importance　to　avoid　failure　of　the　kidney　transplant.

In　addition　to　nationality,　transplantation　rates　differ　based　on　race,　sex,　and　income.　A　study　done　with　patients　beginning　longterm　dialysis　showed　that　the　sociodemographic　barriers　to　renal　transplantation　are　relevant　even　before　patients　are　on　the　transplant　list.　For　example,　different　sociodemographic　groups　express　different　interest　and　complete　pretransplant　(61)　at　different　rates.　Previous　(62)　to　create　fair　transplantation　policies　have　focused　on　patients　currently　on　the　transplantation　waiting　list.

The　attainment　of　tolerance　(63)　a　highly　desirable　goal　in　recipients　of　kidney　transplants.　Achievement　of　this　goal　would　extend　graft　survival　and　eradicate　toxicities　related　to　longterm　immunosuppression.　Mechanistic　studies　of　spontaneously　tolerant　kidney　transplant　recipients　have　(64)　potential　roles　for　B　or　regulatory　T　cells,　or　both,　in　the　maintenance　of　tolerance.　Mixed　hematopoietic　chimerism　has　been　the　most　commonly　used　approach　to　induce　tolerance.　Distinct　protocols　at　three　major　transplant　centers　have　(65)　successful　withdrawal　of　immunosuppression　in　a　subset　of　living　donor　kidney　transplant　recipients　at　the　expense　of　complications　such　as　infections　and　graft　versus　host　disease.　The　addition　of　regulatory　cell　therapies　to　tolerance　induction　protocols　could　enhance　success　while　minimizing　complications.　This　review　summarizes　the　features　of　spontaneous　tolerance　in　kidney　transplant　recipients,　the　results　of　clinical　trials　of　tolerance　induction　in　the　context　of　living　donor　kidney　transplant,　and　potential　measures　to　improve　the　safety　and　efficacy　of　tolerance　induction　strategies.

56.　A.　typicalB.　atypicalC.　typicallyD.　atypically

57.　A.　transplantB.　transplantedC.　removeD.　removed

58.　A.　a　fewB.　fewC.　littleD.　a　little

59.　A.　oldB.　olderC.　youngD.　younger

60.　A.　Away　fromB.　Far　fromC.　Apart　fromD.　Suffer　from

61.　A.　workupB.　work　outC.　workoutD.　work　up

62.　A.　successesB.　effortsC.　achievementsD.　struggles

63.　A.　remainB.　remainsC.　keepD.　kept

64.　A.　coveredB.　coverC.　coveringD.　uncovered

65.　A.　led　toB.　resulted　toC.　brought　toD.　gave　to

ⅢWriting

Question　66

　Write　about　the　following　topic.

In　recent　years,　the　doctorpatient　relationship　has　become　increasingly　tense　and　complicated,　and　the　disputes　between　doctors　and　patients　are　becoming　worse.　Medical　activities　and　the　normal　order　of　hospitals　are　deeply　affected.　Please　give　some　suggestions　of　improving　the　doctorpatient　relationship.

　Write　an　essay　of　no　less　than　150　words　on　your　answer　sheet.

6

6

医护英语水平考试（三级）模拟训练（六）

医护英语水平考试（三级）

模拟训练（六）

Medical　English　Test　System　(METS)

Level　3

ⅠListening

Part　One>>>>>

Questions　1—5

　You　will　hear　five　extracts　from　conversations　taking　place　in　different　clinical　departments.

　Choose　which　case　each　doctor　is　discussing　from　the　list　A—F.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　each　extract　twice.

Doctor　11

Doctor　22

Doctor　33

Doctor　44

Doctor　55

A.　The　patient　has　an　early　lung　tumor.

B.　The　patient　is　not　recommended　to　take　hormone　therapy.

C.　The　patient　is　advised　to　have　the　surgery　immediately.

D.　The　patient　is　pregnant.

E.　The　patient　has　some　problem　with　his　pancreas.

F.　The　patient　has　kidney　disease.

Part　Two>>>>>

Questions　6—13

　You　will　hear　a　conversation　between　a　reporter　and　a　transplantation　expert.

　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　the　recording　twice.

6.　More　than　20　people　die　each　day　from　lack　of　a　transplant.

A.　True　B.　False　C.　Not　Given

7.　Living　donors　must　have　a　body　mass　index　that　is　more　than　35.

A.　True　B.　False　C.　Not　Given

8.　Living　donors　can　donate　one　of　their　kidneys　and　part　of　their　liver.

A.　True　B.　False　C.　Not　Given

9.　For　kidney　donors,　drinking　a　large　amount　of　water　after　the　surgery　is　good　for　recovery.

A.　True　B.　False　C.　Not　Given

10.　Living　donation　has　no　influence　on　life　expectancy.

A.　True　B.　False　C.　Not　Given

11.　People　having　a　medical　condition　cannot　donate　their　organs.

A.　True　B.　False　C.　Not　Given

12.　Organ　donors　can　receive　a　sum　of　money　for　postoperative　care.

A.　True　B.　False　C.　Not　Given

13.　Buying　or　selling　organs　is　illegal　in　the　USA.

A.　True　B.　False　C.　Not　Given

Part　Three>>>>>

Questions　14—20

　You　will　hear　a　discussion　among　an　instructor　and　two　medical　students.

　For　questions　14—20,　choose　the　best　appropriate　answer.

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　the　discussion　twice.

14.　How　many　new　cases　of　breast　cancer　were　diagnosed　in　2012?

A.　1.6　million

B.　1.7　million

C.　1.8　million

15.　Breast　cancer　risk　each　decade　until　menopause.

A.　increases

B.　levels　off

C.　decreases

16.　Generally,　survival　rates　for　breast　cancer　worldwide　.

A.　have　increased

B.　have　leveled　off

C.　have　decreased

17.　The　survival　rate　for　breast　cancer　diagnosed　at　advanced　stage　is　.

A.　80　percent

B.　90　percent

C.　24　percent

18.　Risk　factors　for　breast　cancer　include　the　following　EXCEPT　.

A.　early　menarche

B.　late　natural　menopause

C.　first　pregnancy　over　the　age　of　40

19.　Hormone　therapy　containing　increases　risk.

A.　androgen

B.　oestrogen

C.　testosterone

20.　Which　country　had　the　second　highest　rate　of　breast　cancer　in　2012?

A.　Belgium

B.　Denmark

C.　Netherlands

Part　Four>>>>>

Questions　21—25

　You　will　hear　a　speech　on　strategies　for　dementia.

　Complete　the　notes.　In　each　blank,　write　only　one　word.

　Write　the　answers　on　your　answer　sheet.

　You　will　hear　the　speech　twice.

Notes:

There　are　some　strategies　that　you　need　to　consider　after　you　or　your　families　receive　a　dementia　diagnosis：

　Allow　yourself　time　to　adjust,　be　gentle　and　(21)　with　yourself,　and　try　to　feel　all　the　feelings.

　Set　up　routines　and　expectations.

　Find　an　experienced　dementia　care　(22)　because　when　caregivers　and　people　with　dementia　sought　treatment　for　depression,　they　gained　greater　access　to　care,　services　and　support.

　Give　each　other　space.

Most　people　with　dementia　develop　behavioral　symptoms　or　(23)　problems　at　some　point　during　their　illness.

　Pace　yourself.

Keep　the　day　structured　and　(24)　,　the　environment　uncluttered　and　activities　simple.

　Make　time　for　daily　exercise.

A　daily　walk　can　be　an　effective　(25)　and　antianxiety　remedy.

ⅡReading

Part　One>>>>>

Questions　26—35

　Read　the　following　passage　about　mobile　phone　and　health.

Mobile　Phone　and　Health

1Can　talking　on　a　mobile　phone　be　hazardous　to　your　health?　It　is　difficult　to　know　for　sure.　Some　research　suggests　that　heavy　users　of　mobile　phones　are　at　a　greater　risk　of　developing　cancerous　brain　tumors.　However,　many　other　studies　suggest　there　are　no　links　between　cancer　and　mobile　phone　use.

2The　main　problem　with　the　current　research　is　that　mobile　phones　have　only　been　popular　since　the　1990s.　As　a　result,　it　is　impossible　to　study　longterm　exposure　to　mobile　phones.　This　concerns　many　health　professionals　who　point　out　that　certain　cancers　can　take　over　twenty　years　to　develop.　Another　concern　about　these　studies　is　that　many　have　been　funded　by　the　mobile　phone　industry　or　benefit　from　it.

3Over　five　billion　people　now　use　mobile　phones　on　a　daily　basis,　and　many　talk　for　more　than　an　hour　a　day.　Mobile　phone　antennas　are　similar　to　microwave　ovens.　While　both　rely　on　electromagnetic　radiation　(EMR),　the　radio　waves　in　mobile　phones　are　lower　in　frequency.　Microwave　ovens　have　radio　wave　frequencies　that　are　high　enough　to　cook　food,　and　they　are　also　known　to　be　dangerous　to　human　tissues　like　those　in　the　brain.　The　concern　is　that　the　lowerfrequency　radio　waves　that　mobile　phones　rely　on　may　also　be　dangerous.　It　seems　logical　that　holding　a　heat　source　near　your　brain　for　a　long　period　of　time　is　a　potential　health　hazard.

4Some　researchers　believe　that　other　types　of　wireless　technology　may　also　be　dangerous　to　human　health,　including　cordless　phones,　wireless　gaming　consoles,　and　laptop　or　tablet　computers　with　wireless　connections.　They　suggest　replacing　all　cordless　and　wireless　devices　with　wired　ones　where　possible.　They　also　say　that　many　cordless　phones　can　emit　dangerous　levels　of　electromagnetic　radiation　even　when　they　are　not　in　use.　They　even　suggest　keeping　electronic　devices　such　as　desktop　and　tablet　computers　out　of　the　bedroom,　or　at　least　six　feet　from　the　head　while　were　sleeping.

5A　growing　number　of　health　professionals　worldwide　are　recommending　that　mobile　phone　users　err　on　the　side　of　caution　until　more　definitive　studies　can　be　conducted.　They　use　the　example　of　tobacco　to　illustrate　the　potential　risks.　Many　years　ago,　people　smoked　freely　and　were　not　concerned　about　the　effects　of　cigarettes　on　their　health.　Today,　people　know　that　cigarettes　cause　lung　cancer,　though　it　is　still　unknown　exactly　how　or　why.　Some　doctors　fear　that　the　same　thing　will　happen　with　mobile　phones.　In　May　2016,　the　UKs　Independent　newspaper　reported　on　research　by　the　US　governments　National　Toxicology　Program　that　showed　a　slight　increase　in　brain　tumours　among　rats　exposed　to　the　type　of　radio　frequencies　commonly　emitted　by　mobile　phones.　This　doesnt　prove　that　mobile　phones　can　cause　brain　tumours　in　humans,　but　it　does　show　that　its　possible.　As　a　result,　many　experts　now　recommend　texting　or　using　head　sets　or　speaker　phones　instead　of　holding　a　mobile　phone　to　the　ear.

Questions　26—30

　Choose　the　most　appropriate　subheading　from　the　list　A—F　for　each　paragraph.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

26.　Paragraph　1

27.　Paragraph　2

28.　Paragraph　3

29.　Paragraph　4

30.　Paragraph　5

A.　Advice　from　researchers　about　the　use　of　electronic　devices.

B.　Potential　health　hazard　brought　by　radio　wave　frequencies.

C.　Two　conflicting　research　results　about　whether　there　is　a　link　between　using　mobile　phone　and　cancer.

D.　Close　relationship　between　mobile　phone　and　people’s　health.

E.　More　evidence　to　prove　the　possible　development　of　brain　tumor　caused　by　radio　frequencies　from　mobile　phones.

F.　Two　concerns　about　the　factors　affecting　the　research　results.

Questions　31—35

　Fill　in　each　blank　with　the　correct　answer　from　the　list　A—F.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

31.　According　to　some　research,people　who　use　mobile　phones　a　lot　have　a　of　developing　cancerous　brain　tumours.

32.　Research　funded　by　mobile　phone　industry　or　researchers　who　the　research　activity　may　be　the　factors　affecting　research　results.

33.　The　worry　is　that　the　radio　waves　that　mobile　phones　depend　on　may　also　be　hazardous.

34.　Some　researchers　also　point　out　that　many　cordless　phones　cansend　out　dangerous　levels　of　even　when　they　are　not　used.

35.　Therefore,　many　specialists　now　advise　texting　or　using　or　speaker　phones　instead　of　holding　a　mobile　phone　to　the　ear.

A.　lowerfrequency

B.　electromagnetic　radiation

C.　greater　risk

D.　benefit　from

E.　brain　tumours

F.　head　sets

Part　Two>>>>>

Questions　36—42

　Read　the　following　passage　from　a　news　website.

　Choose　the　best　answer　A,　B,　C　or　D.

　Mark　the　corresponding　letter　on　your　answer　sheet.

A　grieving　husband　has　described　his　shock　at　realizing　his　wife　may　have　been　among　those　whose　lives　were　cut　short　due　to　a　breast　cancer　screening　error.

Health　secretary　Jeremy　Hunt　said　a　“computer　algorithm　failure”　dating　back　to　2009　had　meant　many　women　aged　between　68　and　71　in　England　were　not　invited　to　their　final　routine　screening.

He　said　it　was　not　currently　known　whether　any　delay　in　diagnosis　resulted　in　avoidable　death,　but　that　it　is　estimated　between　135　and　270　women　had　their　lives　shortened　as　a　result.

Brian　Gough　said　his　wife　never　received　a　letter　inviting　her　to　go　for　routine　screening　in　2009—and　that　after　she　later　found　a　lump,　a　scan　in　October　2010　revealed　she　had　stage　three　breast　cancer.

He　said　he　was　watching　the　television　on　Wednesday　when　the　news　of　the　screening　error　broke,　leaving　him　“shell　shocked”.

He　said　he　was　convinced　his　wife　was　a　victim　of　the　“massive　error”　because　her　illness　struck　“right　absolutely　plum　in　the　centre　of　when　this　happened”.

Despite　his　shock,　Mr.Gough　said　he　admired　the　health　secretary　for　“getting　up　and　not　trying　to　hide　the　truth”.

“I　am　glad　the　truth　has　come　out,　and　I　just　hope　that　people　take　more　notice　of　these　glitches,”　he　said.

“Potentially　we　are　talking　about　450,000　women　who　could　have　died,　it　is　all　very　well　saying　only　a　percentage　but　we　are　not　born　as　a　percentage　of　anything,　we　are　a　person.”

Mr.Hunt　faced　questions　about　the　speed　with　when　women　who　have　been　affected　by　the　mistake　will　be　contacted,　and　was　asked　by　Labours　Liz　McInnes　whether　the　alarm　had　been　raised　by　GPs　wondering　why　their　patients　had　not　been　invited　to　a　screening.

Mr.Hunt　said:　“Im　not　aware　of　any　such　instances　but　thats　exactly　what　we　want　to　look　at　in　this　review.

“It　does　seem　strange　that　people　didnt　come　forward　who　were　expecting　to　be　invited　and　didnt　get　an　invitation　and　that　didnt　set　hares　running,　so　thats　one　of　the　things　we　need　to　look　at.”

The　health　secretary　apologized　“wholeheartedly　and　unreservedly　for　the　suffering　caused”　on　behalf　of　the　government,　Public　Health　England　and　the　NHS.

He　told　MPs　that　all　those　living　in　the　UK　who　are　registered　with　a　GP　would　be　contacted　before　the　end　of　May,　with　the　first　65,000　letters　going　out　this　week.

The　letters　will　tell　women　under　72　they　will　automatically　be　sent　an　invitation　to　a　catchup　screening,　and　those　aged　72　and　over　will　be　given　access　to　a　helpline　to　decide　whether　a　screening　is　appropriate　for　them.

Mr.Gough　said　that　following　her　diagnosis,　his　wife　Trixie　underwent　an　operation,chemotherapy,　radiotherapy　and　then　scans　every　three　months　during　which　her　cancer　was　under　control.

But　he　said　it　returned　again,　prompting　another　two　years　of　chemotherapy　and　treatment　during　what　he　described　as　an　“horrendous　situation”.

He　said　his　wife　died　three　days　after　Christmas　in　2015,　and　the　76yearold　never　once　complained　during　her　cancer　ordeal.

“She　missed　all　of　that　because　she　didnt　get　diagnosed　and　she　didnt　know　anything　about　it　until　a　year　ago,”　he　said.

Mr.Gough　believes　that　“maybe,　just　maybe”　his　wife　might　have　come　through　the　first　lot　of　cancer　treatment　and　survived　if　it　had　been　diagnosed　earlier.

36.　What　can　be　calculated　as　a　result　of　breast　cancer　screening　error?

A.　A　grieving　husband　was　shocked　when　he　knew　the　truth.

B.　His　wife　died　for　the　“computer　algorithm　failure”.

C.　A　lot　of　women　had　shortened　their　lives.

D.　Many　women　could　avoid　death　without　delay　in　diagnosis.

37.　What　made　Brian　Gough　“shell　shocked”?

A.　His　wife　didnt　receive　a　letter　for　routine　screening.

B.　His　wife　had　stage　three　breast　cancer.

C.　Something　was　wrong　with　screening.

D.　His　wife　could　live　longer　without　screening　error.

38.　Which　of　the　following　statements　is　NOT　true?

A.　Mr.Goughs　wife　was　a　victim　of　breast　cancer　screening　error.

B.　Jeremy　Hunt　told　the　fact　about　screening　error.

C.　Thousands　of　women　could　have　died　due　to　screening　error.

D.　All　the　women　would　be　invited　to　a　screening　in　order　to　correct　the　error.

39.　Mr.Hunt　wants　to　look　at　.

A.　why　such　mistakes　didnt　happen　before

B.　why　people　didnt　get　invited　to　have　a　check　up

C.　why　people　didnt　move　forward

D.　why　people　set　hares　running

40.　According　to　the　passage,　Mr.Goughs　wife　.

A.　used　chemical　substances　to　treat　her　disease

B.　received　the　treatment　of　disease　by　exposure　to　a　radioactive　substance

C.　experienced　a　painful　process　of　treatment

D.　all　the　above　answers　are　correct

41.　Mr.Gough　was　sad　for　his　wifes　death　because　of　the　following　reasons　EXCEPT　that.

A.　his　wife　might　have　survived　if　her　cancer　had　been　diagnosed　earlier

B.　it　was　too　late　when　his　wife　got　diagnosed

C.　he　could　be　sure　that　his　wife　would　recover　with　timely　treatment

D.　screening　error　was　accountable　for　his　wifes　death

42.　A　proper　title　for　this　text　could　be　.

A.　a　grieving　husbands　memory　of　his　wife

B.　a　mans　“shell　shocked”　about　breast　cancer　screening　error

C.　a　woman　patients　treatment　experiences

D.　diagnosis　and　treatment　of　the　breast　cancer

Part　Three>>>>>

Questions　43—50

　Read　the　following　passage　about　anorexia　nervous.

　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).

　Mark　the　corresponding　letter　on　your　answer　sheet.

Anorexia　Nervosa

Most　people　know　about　anorexia　nervosa—when　people　deliberately　starve　themselves　to　keep　their　weight　down—but　bulimia,　or　excessive　vomiting,　is　another　extreme　of　the　disorder.

Many　people　with　anorexia　see　themselves　as　overweight　even　though　they　are　in　fact　underweight.　If　asked　they　usually　deny　they　have　a　problem　with　low　weight.　Often　they　weigh　themselves　frequently,　eat　only　small　amounts,　and　only　eat　certain　foods.

Although　bulimics　have　near　normal　weight,　it　comes　at　a　price,　and　that　is　their　health.

They　delude　themselves　into　thinking　that　the　only　way　to　keep　the　calories　they　have　eaten　from　turning　into　fat　is　to　make　themselves　vomit　or　by　taking　excessive　amounts　of　laxatives.

What　they　dont　realise　is　that　it　is　not　an　effective　way　of　preventing　the　absorption　of　extra　calories.

It　isnt　just　women　who　can　suffer　from　anorexia　or　bulimia,　although　women　are　10　times　more　liable　to　succumb　to　eating　disorders.

Bulimia　may　start　after　months　or　years　of　anorexia.　It　is　essentially　a　teenage　problem,　though　it　may　extend　into　adult　life　or　even　begin　then.

The　frequent　food　binges　by　bulimics　can　lead　to　depression.　The　physical　and　psychiatric　complications　of　his　behaviour　lead　to　educational,　occupational,　social　and　family　problems.

One　of　the　obvious　signs　of　bulimia　is　hard　skin　or　marks　on　the　back　of　the　hand　due　to　repeated　abrasion　of　the　skin　as　the　hand　is　thrust　down　the　throat　to　produce　vomiting.

A　dentist　may　also　spot　the　condition　as　the　salivary　glands　can　become　enlarged　as　well　as　the　teeth　losing　their　enamel　through　repeated　vomiting—which　causes　the　teeth　to　come　into　contact　with　abnormal　amounts　of　gastric　acid.

And　it　is　not　just　the　outside　appearance　of　the　body　that　suffers.

Repeated　vomiting　also　upsets　the　chemical　balance　of　the　blood,　which　can　result　in　painful　cramps,　fits　and　even　kidney　damage.

A　sympathetic　ear　is　the　first　priority　when　it　comes　to　treating　the　disorder.

Once　the　problem　is　out　in　the　open,　the　sufferers　and　their　doctors,　friends　and　family　can　join　together　to　fight　it.

The　person　who　have　the　disorder　will　need　psychotherapy　to　tackle　and　overcome　their　behaviour.　This　will　reveal　why　they　feel　they　have　to　binge　and　vomit,　and　break　the　cycle.

There　is　help　out　there　for　anorexics　and　bulimics,　but　they　must　take　the　first　step　and　seek　help　from　their　doctors　as　soon　as　possible　before　they　seriously　damage　their　health.

43.　To　lose　weight,　people　with　anorexia　nervosa　starve　themselves　on　purpose.

A.　True

B.　False

C.　Not　Given

44.　Bulimics　think　that　they　can　prevent　themselves　from　absorbing　extra　calories　by　making　themselves　sick　or　taking　laxatives　beyond　normal　limits.

A.　True

B.　False

C.　Not　Given

45.　Female　tend　to　succumb　to　eating　disorders　than　male.

A.　True

B.　False

C.　Not　Given

46.　Eating　too　much　food　frequently　is　the　direct　reason　for　depression.

A.　True

B.　False

C.　Not　Given

47.　Because　of　abrasion　of　the　skin　many　times,　hard　skin　or　marks　will　appear　on　the　back　of　the　hand　as　one　of　the　signs　of　bulimia.

A.　True

B.　False

C.　Not　Given

48.　A　sympathetic　ear　can　treat　the　disorder.

A.　True

B.　False

C.　Not　Given

49.　Nutritionists　are　very　helpful　for　anorexics　and　bulimics,　for　they　can　give　advice　on　what　you　should　eat　to　remain　healthy.

A.　True

B.　False

C.　Not　Given

50.　Seeing　doctors　as　soon　as　possible　is　the　first　choice　for　anorexics　and　bulimics.

A.　True

B.　False

C.　Not　Given

Part　Four>>>>>

Questions　51—55

　Read　the　following　passage　about　trans　fat.　Five　sentences　have　been　removed　from　the　passage.

　Fill　in　each　blank　with　the　most　appropriate　sentence　from　the　list　A—F.　There　is　one

extra　sentence　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

Trans　Fat

Does　your　mouth　water　when　you　think　of　cookies,　donuts,　burgers　and　French　fries?　Many　people　prefer　junk　food　like　these　to　healthy　food　because　they　develop　a　taste　for　it.　Processed,　baked,　and　fried　foods　often　contain　a　high　amount　of　trans　fats.

Trans　fat,　or　transunsaturated　fatty　acids,　trans　fatty　acids,　are　a　type　of　unsaturated　fat　that　occur　in　small　amounts　in　nature,but　became　widely　produced　industrially　from　vegetable　fats　for　use　in　margarine,　snack　food,　packaged　baked　goods,　and　frying　fast　food　starting　in　the　1950s.

Trans　fats　raise　bad　cholesterol　and　lower　the　good　cholesterol　that　your　body　needs.　Fatty　foods　do　more　than　cause　obesity.　(51)　People　whose　diet　contains　a　high　percentage　of　trans　fats　are　at　risk　of　developing　heart　disease　or　having　a　stroke.

Trans　fat　is　a　semisolid　type　of　oil.　It　is　made　by　adding　hydrogen　to　liquid　oil.　Food　companies　and　restaurants　choose　to　use　trans　fat　oils　because　theyre　cheap　and　they　make　food　like　crackers　and　baked　goods　last　longer.　(52)　Trans　fats　became　very　popular　in　the　second　half　of　the　20th　century.　This　is　around　the　time　butter　got　a　bad　name　for　its　cholesterol　levels.　People　were　told　to　use　margarine　containing　trans　fats　instead　because　it　was　“healthier”,　but　we　now　know　that　butter　is　actually　the　healthier　option.

Today　doctors　know　how　dangerous　processed　foods　like　margarine　can　be.　In　countries　such　as　the　US　and　Canada　there　are　new　government　restrictions　on　food　production.　Food　and　beverage　makers　must　attach　a　Nutrition　Fact　label　to　their　products.　(53)　In　2007　New　York　City　banned　trans　fats　from　all　restaurants,　and　according　to　recent　studies　this　has　prevented　hundreds　of　heart　attacks　and　strokes.　Even　fast　food　chains　such　as　McDonalds　are　being　forced　to　change　their　recipes　as　people　become　more　healthconscious.

We　all　need　some　fat　in　our　diet.　There　are　three　different　types　of　fats:　saturated　fats,　unsaturated　fats　and　trans　fats.　Doctors　recommend　that　we　get　most　of　our　fatty　calories　from　unsaturated　fats.　Neither　butter　nor　margarine　fits　this　category,　though　other　spreads　like　peanut　butter　do.

(54)　Another　way　is　to　avoid　eating　out,　especially　in　fast　food　restaurants.　Also,　when　shopping　try　to　buy　the　majority　of　your　food　in　the　freshfood　section　and　limit　the　amount　of　processed　and　packaged　food　you　buy.　You　might　not　think　this　is　important　if　youre　young,　but　the　choices　you　make　now　will　affect　you　for　the　rest　of　your　life.　(55)

In　many　countries,　there　are　legal　limits　to　trans　fat　content.　Trans　fats　levels　can　be　reduced　or　eliminated　by　using　saturated　fats　such　as　lard,　palm　oil　or　fully　hydrogenated　fats,　or　by　using　interesterified　fat.　Other　alternative　formulations　can　also　allow　unsaturated　fats　to　be　used　to　replace　saturated　or　partially　hydrogenated　fats.

A.　Food　manufacturers　have　voluntarily　started　using　labels　that　clearly　show　how　healthy　each　product　is　according　to　a　simple　rating　system.

B.　These　labels　list　daily　recommendations　and　details　of　all　the　ingredients　in　a　product,　including　trans　fats　if　theyre　used.

C.　The　healthier　your　diet　is　now,　the　longer　and　healthier　your　life　will　be.

D.　Trans　fats　build　up　in　the　body　and　block　blood　flow　to　the　heart.

E.　Reading　the　list　of　ingredients　on　the　label　is　a　good　way　of　avoiding　dangerous　ingredients　like　trans　fats.

F.　They　also　improve　the　taste　and　texture　of　food.

Part　Five>>>>>

Questions　56—65

　Read　the　following　passage　about　night　cramp.

　Fill　in　each　blank　with　the　correct　choice　A,　B,　C　or　D.

　Mark　the　corresponding　letter　on　your　answer　sheet.

Night　Cramp

Night　cramp　is　something　from　which　a　great　many　people　occasionally　suffer—and　they　dont　easily　forget　it.　Even　the　healthiest　people　may　get　a　short,　sharp　pain　in　the　legs　after　a(n)　(56)　day.

Many　older　people　can　bring　it　on　by　making　powerful　stretching　movements　while　lying　down　in　bed.　If　this　sort　of　night　cramp　becomes　a　real　nuisance,　(57)　overstretching　and　taking　tablets　containing　quinine　sulphate　at　bedtime　may　be　all　that　is　needed.

A　very　small　number　of　patients,　however,　cannot　take　quinine　without　becoming　(58)　or　getting　buzzing　in　the　ears.　They　may　have　to　decide　whether　they　would　rather　have　cramp　and　no　dizziness,　or　the　reverse.

But　cramp　in　the　lower　limbs　in　the　daytime　and　in　younger,　active　patients

can　be　very　distressing　and　is　more　(59)　.　It　is　not　uncommon　and　has　the　rather　clumsy　name　of　intermittent　claudications.

The　patient　first　complains　of　aching　legs　after　exercise.　It　may　be　slight,　but　gradually　becomes　more　(60)　.　Then　the　pain　is　not　merely　an　ache,　but　a　definite,　crippling　cramp,　which　can　become　so　severe　that　the　patient　finds　he　or　she　cannot　(61)　after　much　walking.

Intermittent　claudication　is　caused　by　the　narrowing　of　the　arteries　and　often　starts　in　the　30s.　It　generally　means　that　the　arteries　everywhere　in　the　body　have　become　narrowed　and　blood　cannot　reach　the　muscles　fast　enough　when　it　is　in　use.　The　heart　muscles　may　be　equally　(62).

This　condition　may　be　a　good　enough　excuse　for　not　doing　jobs　you　dont　like　but　that　is　poor　consolation.　It　is　a　disease　which　affects　men　far　more　than　women　and　attacks　are　more　common　in　cold　weather,　or　even　after　sitting　in　a　chair　at　the　office　in　a　(63).　It　is　also　a　slightly　hereditary　complaint.

This　is　by　no　means　the　same　as　the　nighttime　cramp　already　mentioned,　and　there　is　no　absolute　cure.　The　patient　learns　to　(64)　the　amount　of　exercise　he　or　she　can　comfortably　take.

No　drugs　offer　a　complete　relief　but　there　is　one　habit　which　the　sufferer　must　(65)　—smoking.　Whatever　may　or　may　not　be　ones　views　about　the　habit,　it　undoubtedly　makes　intermittent　claudication　far　more　troublesome.

A　number　of　patients　will　secretly　admit　that　so　long　as　they　keep　off　tobacco　they　do　not　get　this　fearsome　cramp.

56.　A.　strenuousB.　workingC.　painfulD.　relaxed

57.　A.　doingB.　avoidingC.　takingD.　changing

58.　A.　dizzyB.　lazyC.　crazyD.　fuzzy

59.　A.　importantB.　interestingC.　seriousD.　dangerous

60.　A.　complexB.　difficultC.　likelyD.　pronounced

61.　A.　speakB.　continueC.　standD.　act

62.　A.　impressedB.　affectedC.　emphasizedD.　learned

63.　A.　draughtB.　droughtC.　draughtsD.　droughts

64.　A.　ruleB.　regulateC.　takeD.　understand

65.　A.　give　outB.　give　backC.　give　awayD.　give　up

ⅢWriting

Question　66

　Write　about　medical　reform　in　China.

Medical　reform　has　been　an　issue　that　affects　residents　livelihood.　Please　briefly　analyze　the　current　problems　in　health　care　system　and　give　your　own　advice　on　medical　reform.

　Write　an　essay　of　no　less　than　150　words　on　your　answer　sheet.

7

7

医护英语水平考试（三级）模拟训练（七）

医护英语水平考试（三级）

模拟训练（七）

Medical　English　Test　System　(METS)

Level　3

ⅠListening

Part　One>>>>>

Questions　1—5

　You　will　hear　five　extracts　from　conversations　taking　place　in　different　clinical　departments.

　Choose　which　case　each　doctor　is　discussing　from　the　list　A—F.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　each　extract　twice.

Doctor　11

Doctor　22

Doctor　33

Doctor　44

Doctor　55

A.　The　patient　is　allowed　to　leave　the　hospital.

B.　The　patient　is　going　to　receive　a　CT.

C.　The　patient　is　diagnosed　with　pneumonia　and　neuroleptic　malignant　syndrome.

D.　The　patient　has　to　take　insulin.

E.　The　patient　has　some　problem　with　the　eyes.

F.　The　patient　is　easily　fractured.

Part　Two>>>>>

Questions　6—13

　You　will　hear　a　conversation　between　a　reporter　and　a　hair　restoration　expert.

　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　the　recording　twice.

6.　Hair　loss　is　a　part　of　the　normal　aging　process　for　most　women.

A.　True　B.　False　C.　Not　Given

7.　Some　types　of　female　hair　loss　are　due　to　hormone　changes.

A.　True　B.　False　C.　Not　Given

8.　Women　may　experience　hair　loss　after　giving　birth.

A.　True　B.　False　C.　Not　Given

9.　Men　tend　to　see　hair　loss　start　at　the　temples.

A.　True　B.　False　C.　Not　Given

10.　It　is　necessary　to　see　a　doctor　for　sudden　hair　loss.

A.　True　B.　False　C.　Not　Given

11.　Minoxidil　is　an　overthecounter　drug.

A.　True　B.　False　C.　Not　Given

12.　Hair　transplantation　is　not　a　good　choice　for　women.

A.　True　B.　False　C.　Not　Given

13.　New　hair　growth　occurs　in　as　little　as　two　months.

A.　True　B.　False　C.　Not　Given

Part　Three>>>>>

Questions　14—20

　You　will　hear　a　discussion　among　an　instructor　and　two　medical　students.

　For　questions　14—20,　choose　the　most　appropriate　answer.

　Mark　the　corresponding　letter　on　your　answer　sheet.

　You　will　hear　the　discussion　twice.

14.　Efforts　with　gene　therapy　for　brain　cancer　were　largely　limited　because　.

A.　the　drug　could　not　be　delivered　into　the　brain

B.　the　drug　was　not　fully　effective

C.　the　drug　had　some　sideeffects

15.　What　prevents　drugs　from　reaching　the　cancer　cells　in　brain　tumor　patients?

A.　The　bloodbrain　block.

B.　The　bloodbrain　barrier.

C.　The　bloodbrain　defense.

16.　In　the　new　treatment,　the　blood　brain　barrier　is　bypassed　by　.

A.　directly　injecting　the　chemotherapy　into　the　region　of　the　tumor

B.　directly　injecting　the　gene　therapy　into　the　region　of　the　tumor

C.　directly　injecting　the　drugs　into　the　region　of　the　tumor

17.　The　MRIguided　process　provides　confirmation　that　adequate　amount　of　the　therapy　is　delivered　into　the　tumor.

A.　acoustic

B.　tactile

C.　visual

18.　Which　of　the　following　therapy　is　based　on　a　retrovirus　engineered　to　selectively　replicate　in　high　grade　brain　cancer　cells?

A.　The　gene　therapy.

B.　The　chemotherapy.

C.　The　hydrotherapy.

19.　When　chemotherapy　is　given,　how　many　cells　in　the　body　are　exposed　to　the　potential　sideeffects　of　the　drug?

A.　Almost　all　the　cells.

B.　Nearly　half　of　the　cells　in　the　body.

D.　It　depends　on　the　type　of　chemotherapy.

20.　What　are　the　risks　of　the　new　treatment?

A.　The　retrovirus.

B.　The　unintended　injury.

C.　The　surgical　procedure　itself.

Part　Four>>>>>

Questions　21—25

　You　will　hear　a　speech　on　diets　helping　some　people　with　Hashimotos　disease.

　Complete　the　notes.　In　each　blank,　write　only　one　word.

　Write　the　answers　on　your　answer　sheet.

　You　will　hear　the　speech　twice.

Notes:

　Hashimotos　disease　is　the　most　common　autoimmune　condition　and　the　leading　cause　of　(21)　.

The　thyroid　gland　plays　a　major　role　in　metabolism,　hormone　regulation,　and　body　temperature.

There　are　different　diets　that　can　help　people　with　Hashimotos　disease:

　Glutenfree　diets　remove　all　foods　with　containing　gluten,　which　is　a

(22)　found　in　wheat,　barley,　rye,　and　other　grains.

There　is　no　current　research　to　support　a　glutenfree　diet　for　all　people　with　Hashimotos.

　A　grainfree　diet　is　very　similar　to　glutenfree,　except　that　grains　are　also　offlimits.

　The　paleo　diet　emphasizes　on　whole　and　(23)　foods.

　People　who　do　not　want　to　focus　on　what　foods　to　cut　out　can　choose　a　nutrientdense　diet.

Having　foods　such　as　colorful　fruits　will　leave　less　room　for　processed　and　refined　sugar　foods.

(24)　spices　such　as　turmeric　are　also　encouraged.

　It　is　more　important　for　a　person　to　follow　a　(25)　diet.

People　with　Hashimotos　should　try　different　eating　styles　and　find　the　best　one　for　them.

ⅡReading

Part　One>>>>>

Questions　26—35

　Read　the　following　passage　about　lowsalt　diet.

Scientists　Advise:　LowSalt　Diet　Not　for　Everyone

1Lowsalt　diets　are　actually　harmful　to　our　bodies,　a　recent　study　found.　These　diets　may　actually　increase　the　risk　of　developing　heart　disease,　or　even　cause　death.These　findings,　says　WebMD,　a　public　health　website,　are　contrary　to　the　popular　wisdom　that　has　long　said　lowsalt　diets　are　healthy.

2Scientists　at　McMaster　Universitys　Population　Health　Research　Institute,　working　with　researchers　from　Hamilton　Health　Services,　conducted　the　study.　They　examined　medical　information　about　130,000　people　from　49　countries.The　scientists,　led　by　Andrew　Mente　of　McMaster　University,　wanted　to　find　out　if　the　relationship　between　salt,　strokes　and　heart　disease　is　different　for　those　who　have　high　blood　pressure.They　found　that　no　matter　whether　one　has　high　blood　pressure　or　not,　low　sodium　intake　increased　the　risk　of　stroke,　heart　attack　and　death.The　study　goes　on　to　suggest　that　only　certain　people　should　be　concerned　about　reducing　sodium　in　their　diets.　“The　findings　emphasize　the　importance　of　reducing　salt　intake　among　people　with　hypertension　and　who　eat　food　with　high　levels　of　sodium,”　Mente　said.

3McMaster　Universitys　Martin　ODonnell,　the　studys　coauthor,　said　in　a　press　release　in　May　2016,　“This　study　adds　to　our　understanding　of　the　relationship　between　salt　intake　and　health.　The　study　also　questions　the　correctness　of　present　guidelines　that　recommend　low　salt　intake　for　everyone.”He　noted,　“An　approach　that　recommends　salt　in　moderation,　particularly　focused　on　those　with　hypertension,　appears　more　inline　with　current　evidence.”　Mente　added　that　the　current　general　recommendations　relating　to　the　maximum　healthy　salt　intake　seems　too　low,　especially　since　they　do　not　consider　an　individuals　blood　pressure.“One　of　those　effects　includes　harmful　elevation　of　particular　hormones—and　this　offsets　any　benefits.　The　main　issue　is　not　whether　very　low　sodium　intake　lowers　blood　pressure,　but　whether　it　results　in　improved　health,”　Mente　said.

4In　the　McMaster　University　study,　the　researchers　found　that　only　around　10%　of　people　had　high　levels　of　both　hypertension　and　sodium　consumption.　In　general,　health　experts　consider　a　high　level　of　sodium　consumption　to　be　over　6　grams　daily.Mente　pointed　out　that　this　indicates　that　many　people　around　the　world　are　taking　in　healthy　amounts　of　salt.He　also　said　that　efforts　should　be　targeted　at　reducing　salt　intake　among　the　people　who　are　most　likely　to　get　hypertension　and　who　take　in　high　amounts　of　salt.Mente　does　not　agree　with　the　current　strategy　of　reducing　sodium　intake　in　almost　all　countries.

5At　present,　Canadians　normally　consume　about　4　grams　of　sodium　daily.　But　there　are　recommendations　that　they　should　lower　this　amount　to　less　than　2.3　grams　each　day.　US　guidelines　for　sodium　intake　are　for　people　under　50　to　have　less　than　2.3　grams　a　day.　For　those　over　51　and　persons　of　any　age　who　are　African　American　or　have　hypertension,　diabetes,　or　chronic　kidney　disease,　the　US　guidelines　suggest　having　less　than　1.5　grams　a　day.In　Kenya,　the　Ministry　of　Public　Health　and　Sanitation　recommends　general　reduction　of　salt　intake　to　levels　below　5　grams　as　recommended　by　the　World　Health　Organization.　This　is　as　a　measure　to　reduce　the　risk　of　hypertension　and　other　noncommunicable　diseases.　Less　than　5%　of　people　in　the　world　consume　such　low　levels　of　sodium.　Kenyans　are　the　lowest　consumers　of　salt,　averaging　4　grams　a　day.

Questions　26—30

　Choose　the　most　appropriate　subheading　from　the　list　A—F　for　each　paragraph.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

26.　Paragraph　1

27.　Paragraph　2

28.　Paragraph　3

29.　Paragraph　4

30.　Paragraph　5

A.　Brief　description　of　purpose,　methods,　results　and　suggestions　of　the　study.

B.　Most　people　taking　in　healthy　amounts　of　salt　while　level　of　sodium　consumption　for　some　people　depending　on　their　health　conditions.

C.　Proposing　the　idea　of　lowsalt　diets　being　harmful　to　human　bodies.

D.　Examples　of　recommendations　for　correct　sodium　intake　daily　in　different　countries.

E.　Some　doubts　about　current　recommendations　for　healthy　salt　intake.

F.　Researchers　recommending　people　to　have　the　same　sodium　intake　in　almost　all　countries.

Questions　31—35

　Fill　in　each　blank　with　the　correct　answer　from　the　list　A—F.

　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

31.　WebMD　points　out　that　these　findings　are　the　popular　wisdom　that　lowsalt　diets　are　good　for　health　for　a　long　time.

32.　The　study　continues　to　advise　that　only　some　people　should　be　worried　about　in　their　diets.

33.　The　research　also　doubts　the　correctness　of　，　which　suggests　low　salt　intake　for　everyone.

34.　Mente　disagrees　with　the　of　cutting　down　sodium　intake　in　almost　all　countries.

35.　The　U.S.　guidelines　recommend　having　less　than　one　point　five　grams　per　day　for　those　who　have　hypertension,　diabetes,　or　chronic　.

A.　kidney　disease

B.　present　guidelines

C.　sodium　consumption

D.　reducing　sodium

E.　contrary　to

F.　current　strategy

Part　Two>>>>>

Questions　36—42

　Read　the　following　passage　about　patient　history.

　Choose　the　best　answer　A,　B,　C　or　D.

　Mark　the　corresponding　letter　on　your　answer　sheet.

The　Patient　History

A　detailed　patient　history　and　physical　exam　form　the　foundation　of　patient　evaluation　and　vital　patient　data　that　enable　efficient,　quality　patient　rounds.　On　the　other　hand,　a　poorly　documented　history　and　physical　exam　may　lead　to　confusion,　serious　omission　of　vital　data　and　inefficiency　on　patient　rounds.

The　basic　outline　structure　for　the　patient　history　and　physical　exam　usually　includes　the　following:

Identification:　patient　name,　age,　gender,　race,　and　occupation

Chief　Complaint:　（in　the　patients　words）

HPI:　（history　of　present　illness）

PMHx:　（past　medical　history）

ROS:　review　of　systems

Social　Hx:　includes　family　situation（married,　divorced,　single),　habits,　cigarettes,　alcohol　or　illicit　drug　use,　sexual　behavior

Here　are　a　few　specific　points　about　each　section　of　the　history　outline:

Identification—This　should　include　the　patients　name,　age,　sex,　race　and　occupation.　For　example:　“Mr.　Jones　is　a　55yearold　Caucasian　male　who　works　as　a　farmer.”　The　patients　name　written　in　the　history　allows　future　interviewers　to　address　the　patient　by　his　name　which　conveys　a　sense　of　patient　respect.　The　age,　race,　sex　and　occupation　are　important　as　many　diseases　are　not　only　gender　and　age　dependent,　but　may　also　occur　more　commonly　in　specific　ethnic　and　occupation　groups.

Chief　Complaint—This　should　be　written　in　the　patients　words.　For　example,　“chest　pain”　rather　than　“angina”.　Also　the　duration　of　the　chief　complaint　should　be　noted　“chest　pain　for　1　hour”.　Before　moving　on　to　the　HPI,　it　would　be　appropriate　to　perform　a　“survey　of　problems”　asking　the　patient　if　there　are　any　other　current　problems　bothering　them.

HPI　(History　of　Present　Illness)—The　history　of　the　present　illness　is　a　more　elaborate　description　of　the　patients　chief　complaint　and　is　the　most　important　structural　element　of　the　medical　history.　This　section　should　give　the　following　details　about　the　chief　complaint　(s):

a.　Detailed　description　of　the　“chief　complaint”;　“a　dull　crushing　chest　pain”　including　body

location　of　the　complaint.

b.　A　chronological　history　and　sequence　of　the　chief　complaint.

c.　What　circumstances　precipitate　it:　climbing　stairs,　emotional　upset　such　as　anger,　or　sexual　intercourse.

d.　What　circumstances　relieve　it:　resting　for　a　few　minutes.

ROS　(Review　of　Systems)—This　section　is　too　often　omitted.　Although　it　is　somewhat　cumbersome　to　go　through　a　“complete”　review　of　systems　and　it　may　not　be　necessary　to　do　so　for　“each”　admission,　at　least　one　“complete”　review　of　systems　should　be　documented　in　the　patients　medical　record.　For　subsequent　admissions,　the　history　could　simply　refer　back　to　the　“complete　ROS”　documented　on　a　specified　date.

Social　History—This　section　is　the　most　neglected　section　of　the　patient　history　performed　in　China.　Vital　information　such　as　smoking　history,　use　of　alcohol　or　illicit　drugs　and　sexual　behavior　can　give　invaluable　clues　to　the　diagnosis.　Also　documentation　of　the　patients　marital　status　(divorced)and　family　situation　may　give　clues　to　the　early　diagnosis　of　anxiety　or　depression.

In　summary,　the　patient　history　is　the　most　important　aspect　of　patient　evaluation　as　it　guides　the　physician　teams　decisions　concerning　diagnostic　workup　and　formulation　of　a　treatment　plan.　As　mentioned　the　patient　history　contributes　more　towards　the　diagnosis　than　any　other　test.　Further　it　can　help　to　establish　rapport　where　the　patient　not　only　learns　to　trust　his/her　physician　but　also　is　more　likely　to　heed　his/her　advice.

36.　According　to　the　author,　a　poorly　documented　history　and　physical　exam　may　cause　the　following　results　EXCEPT　.

A.　a　lack　of　efficiency

B.　negligence　of　important　data

C.　the　situation　of　being　confused

D.　misdiagnosis

37.　Why　is　Identification　considered　an　important　part　of　the　patient　history?

A.　They　convey　a　sense　of　patient　respect.

B.　A　lot　of　diseases　are　gender　and　age　dependent.

C.　Many　diseases　occur　more　commonly　in　specific　ethnic　and　occupation　groups.

D.　All　the　above　answers　are　correct.

38.　According　to　the　passage,　which　of　the　following　is　NOT　the　basic　outline　structure　for　the　patient　history　and　physical　exam?

A.　Patients　history　of　present　and　past　sickness.

B.　Statement　of　sickness　should　be　written　in　patients　words.

C.　Treatment　plan.

D.　Patients　profession,　gender,　sexual　behavior,　and　illegal　drug　use.

39.　Which　of　the　following　statement　is　true?

A.　Chief　complaint　should　be　written　according　to　the　doctors　experience.

B.　In　the　course　of　the　chief　complaint,　it　would　be　proper　to　ask　patients　a　“survey　of　problems”　possibly　bothering　them.

C.　HPI　gives　a　more　detailed　presentation　of　the　patients　chief　complaint.

D.　HPI　should　present　what　circumstances　precipitate　illness　and　relieve　illness.

40.　According　to　the　passage,　what　is　NOT　true　about　ROS　and　Social　History?

A.　At　least　one　integral　review　of　systems　should　be　recorded.

B.　ROS　and　Social　History　are　the　most　omitted　section　of　the　patient　history　performed　in　China.

C.　Social　History　can　give　very　useful　clues　to　the　diagnosis.

D.　The　early　diagnosis　of　anxiety　or　depression　may　be　seen　in　the　patients　marital　status　and　family　situation.

41.　What　does　the　underlined　word　“rapport”　probably　mean?

A.　Good　relationship.

B.　Effective　communication.

C.　Favorable　environment.

D.　Welldeserved　reputation.

42.　The　authors　purpose　in　writing　this　passage　is　.

A.　to　introduce　the　basic　structure　of　the　patient　history

B.　to　introduce　negative　effects　of　a　poorly　documented　patient　history

C.　to　emphasize　the　importance　of　the　patient　history

D.　to　present　how　the　patient　history　affects　a　treatment　plan

Part　Three>>>>>

Questions　43—50

　Read　the　following　passage　about　a　coffee　cancer　warning.

　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).

　Mark　the　corresponding　letter　on　your　answer　sheet.

Coffee　Cancer　Warning:　What　Science　Says

about　the　Actual　Risk

Trouble　is　brewing　for　coffee　lovers　in　California,　where　a　judge　ruled　that　sellers　must　post　scary　warnings　about　cancer　risks.　But　how　frightened　should　we　be　of　a　daily　cup　of　coffee?　Not　very,　some　scientists　and　available　evidence　seem　to　suggest.

Scientific　concerns　about　coffee　have　eased　in　recent　years,　and　many　studies　even　suggest　it　can　help　health.“At　the　minimum,　coffee　is　neutral.　If　anything,　there　is　fairly　good　evidence　of　the　benefit　of　coffee　on　cancer,”　said　Dr.　Edward　Giovannucci,　a　nutrition　expert　at　the　Harvard　School　of　Public　Health.

CBS　News　medical　contributor　Dr.　David　Agus,　director　of　the　Westside　Cancer　Center　at　USC,　says　he　believes　it　is　too　early　to　put　this　kind　of　blanket　warning　on　coffee.

“When　you　put　a　bold　declaration　that　‘X　may　cause　cancer’　when　there　isnt　data　to　that　effect　in　humans,　to　me　it　causes　panic　rather　than　informed　knowledge,”　he　told

CBS　This　Morning.

The　World　Health　Organizations　cancer　agency　moved　coffee　off　the　“possible　carcinogen”　list　two　years　ago,　though　it　says　evidence　is　insufficient　to　rule　out　any　possible　role.

The　current　flap　isnt　about　coffee　itself,　but　a　chemical　called　acrylamide　thats　made　when　the　beans　are　roasted.　Government　agencies　call　it　a　probable　or　likely　carcinogen,　based　on　animal　research,　and　a　group　sued　to　require　coffee　sellers　to　warn　of　that　under　a　California　law　passed　by　voters　in　1986.

Coffee　and　your　health

The　problem:　No　one　knows　what　levels　are　safe　or　risky　for　people.　The　US　Environmental　Protection　Agency　sets　acrylamide　limits　for　drinking　water,　but　there　arent　any　for　food.

“A　cup　of　coffee　a　day,　exposure　probably　is　not　that　high,”　and　probably　should　not　change　your　habit,　said　Dr.　Bruce　Y.　Lee　of　Johns　Hopkins　Bloomberg　School　of　Public　Health.　“If　you　drink　a　lot　of　cups　a　day,　this　is　one　of　the　reasons　you　might　consider　cutting　that　down.”

The　chemical

Start　with　the　biggest　known　risk　factor　for　cancer—smoking—which　generates　acrylamide.　In　the　diet,　French　fries,　potato　chips,　crackers,　cookies,　cereal　and　other　highcarbohydrate　foods　contain　it　as　a　byproduct　of　roasting,　baking,　toasting　or　frying.

Whats　the　risk?

The　“probable”　or　“likely”　carcinogen　label　is　based　on　studies　of　animals　given　high　levels　of　acrylamide　in　drinking　water.　But　people　and　rodents　absorb　the　chemical　at　different　rates　and　metabolize　it　differently,　so　its　relevance　to　human　health　is　unknown.

A　group　of　23　scientists　convened　by　the　WHOs　cancer　agency　in　2016　looked　at　coffee—not　acrylamide　directly—and　decided　coffee　was　unlikely　to　cause　breast,　prostate　or　pancreatic　cancer,　and　that　it　seemed　to　lower　the　risks　for　liver　and　uterine　cancers.　Evidence　was　inadequate　to　determine　its　effect　on　dozens　of　other　cancer　types.

43.　According　to　some　available　evidence,　we　are　not　very　afraid　of　cancer　risks　that　coffee　may　cause.

A.　True

B.　False

C.　Not　Given

44.　Many　studies　even　show　that　coffee　can　help　health,　and　scientific　worries　about　coffee　have　decreased　in　recent　years.

A.　True

B.　False

C.　Not　Given

45.　There　is　a　concern　that　the　warning　label　may　cause　panic　instead　of　informed　knowledge.

A.　True

B.　False

C.　Not　Given

46.　The　World　Health　Organization　has　made　a　plan　to　prevent　possible　risk　of　cancer.

A.　True

B.　False

C.　Not　Given

47.　Government　agencies　are　sure　that　a　chemical　called　acrylamide　is　a　carcinogen.

A.　True

B.　False

C.　Not　Given

48.　According　to　Dr.　Bruce　Y.　Lee,　drinking　coffee　should　be　moderate.

A.　True

B.　False

C.　Not　Given

49.　Smoking　which　is　harmful　to　health　can　cause　lung　cancer.

A.　True

B.　False

C.　Not　Given

50.　In　2016,　the　WHOs　cancer　agency　convened　a　group　of　23　scientists,　who　considered　coffee　had　a　high　risk　of　causing　breast,　prostate　or　pancreatic　cancer.

A.　True

B.　False

C.　Not　Given

Part　Four>>>>>

Questions　51—55

　Read　the　following　passage　about　the　pills.　Five　sentences　have　been　removed　from　the　passage.

　Fill　in　each　blank　with　the　most　appropriate　sentence　from　the　list　A—F.　There　is　one　extra　sentence　which　you　DO　NOT　need　to　use.

　Mark　the　corresponding　letter　on　your　answer　sheet.

The　Pills

These　days　there　are　pills　for　just　about　everything.　If　you　cant　sleep,　take　a　pill.　If　youre　sad,　take　a　pill.　If　youre　in　pain,　take　a　pill.　But　what　about　people　who　are　overweight　or　lack　fitness?

(51)　Drug　companies　are　always　looking　for　new　pills　to　sell,　and　many　have　spent　lots　of　money　on　developing　a　pill　for　these　people　too.　In　the　1990s,　scientists　working　for　one　of　these　companies　found　a　new　drug　that　gave　mice　some　of　the　same　benefits　as　exercise.　Newspapers　began　reporting　on　this　new　drug,　calling　it　the　“fitness　pill”　or　“exercise　pill”.

The　reports　said　that　mice　with　no　previous　fitness　training　could　run　much　longer　distances　after　being　given　the　drug.　They　said　there　was　evidence　that　the　drug　could　also　help　humans　by　improving　fitness　and　building　up　muscles.　Many　people　who　read　these　articles　wanted　to　try　the　pills,　but　reports　about　problems　with　the　drug　soon　began　appearing.　(52)　This　meant　the　drug　would　never　be　approved　for　human　use　and　the　drug　company　stopped　developing　it.

Medical　researchers　are　still　looking　for　a　drug　similar　to　the　one　found　in　the　90s.　(53)　They　believe　such　a　drug　would　have　many　uses,　including　important　medical　uses.　It　could　benefit　people　who　cant　get　out　of　bed　due　to　ill　health.　It　could　also　benefit　people　with　diabetes　and　those　with　diseases　that　cause　musclewasting.　(54)　Most　adults　say　they　dont　have　enough　spare　time　to　do　the　40　minutes　of　daily　exercise　that　doctors　recommend.　For　these　people,　a　socalled　fitness　pill　or　exercise　pill　could　be　the　best　solution.　But　others　might　say　theyre　cheating　by　taking　a　pill　instead　of　exercising.　Would　you　take　such　a　pill　if　it　meant　you　no　longer　had　to　jog,　swim　or　use　a　treadmill　to　stay　fit?

(55)　They　fear　that　some　athletes　might　use　it　as　a　performanceenhancing　drug.　Even　though　the　drug　discovered　in　the　90s　was　never　approved　for　human　use,　some　athletes　may　have　used　it　to　cheat.　Top　athletes　already　go　through　extensive　drug　testing　before　national　and　international　events,　but　until　sports　authorities　know　about　a　new　drug,　it　wont　be　tested　for.　Some　people　think　top　athletes　who　pass　drug　tests　might　still　be　cheating,　and　in　some　cases　this　has　been　shown　to　be　true.　The　worldfamous　swimmer　and　Olympic　goldmedalist　Michael　Phelps　knew　this,　so　he　offered　to　go　through　extra　drug　testing　before　the　2008　Olympics.　He　knew　that　many　people　would　suspect　his　amazing　strength　and　stamina　came　from　using　performanceenhancing　drugs,　so　he　felt　he　had　to　prove　that　it　came　from　hard　work　and　training　alone.

A.　Medical　researchers　also　believe　such　a　drug　could　benefit　the　average　adult　as　well.

B.　Theyre　trying　to　find　a　new　drug　with　the　same　benefits　that　doesnt　also　cause　cancer.

C.　They　said　it　could　“build　muscle,　increase　stamina,　and　even　burn　fat.”

D.　The　best　solution　for　these　people　is　to　exercise,　but　many　people　dont　want　to　exercise　or　are　unable　to　exercise.

E.　Researchers　found　that　mice　had　an　increased　chance　of　developing　cancer　after　taking　it.

F.　Many　people　in　the　world　of　sports　are　concerned　about　a　pill　like　this.

Part　Five>>>>>

Questions　56—65

　Read　the　following　passage　about　a　study　of　weight.

　Fill　in　each　blank　with　the　correct　choice　A,　B,　C　or　D.

　Mark　the　corresponding　letter　on　your　answer　sheet.

Study:　Nearly　a　Third　of　World　Overweight

A　new　study　finds　one　third　of　the　worlds　population　is　overweight　or　considered　obese.　Since　1980,　obesity　rates　in　children　and　adults　have　doubled　in　73　countries.　And　rates　are　increasing　in　many　other　countries,　according　to　a　report　released　on　Monday.　The　report　was　published　in　the　New　England　Journal　of　Medicine.

Obesity　is　increasing　faster　in　children　than　adults　in　many　nations,　including　Algeria,　Turkey　and　Jordan,　the　report　said.　But　the　worlds　weight　problem　is　(56)　in　both　rich　and　poor　countries　alike.

Researchers　say　an　increasing　number　of　people　are　dying　of　(57)　health　problems　in　what　they　called　a　“disturbing　global　public　health　crisis.”

About　four　million　people　died　of　cardiovascular　disease,　diabetes,　cancer　and　other　diseases　linked　to　(58)　weight　in　2015,　according　to　the　study.

“People　who　shrug　off　weight　gain　do　so　at　their　own　risk,”　said　Christopher　Murray,　one　of　the　writers　of　the　report.

Researchers　studied　health　information　from　1980　through　2015.　They　(59)　obesity　rates,　average　weight　gain　and　the　cause　of　death　in　195　countries.　They　found　that　obesity　rates　are　three　times　greater　among　youth　and　young　adults　in　countries　like　China,　Brazil　and　India.

Almost　108　million　children　and　more　than　600　million　adults　were　found　to　be　obese.　Together,　that　represents　about　10　percent　of　the　worlds　population.

Among　the　top　20　most　(60)　countries　in　2015,　Egypt　had　the　highest　number　of　agestandardized　obese　adults.　Vietnam　had　the　least.　In　the　same　year,　the　United　States　had　the　highest　number　of　obese　children,　and　Bangladesh　had　the　least.

Researchers　say　the　extra　weight　people　are　carrying　increases　their　risk　of　(61)　diabetes　or　other　health　problems.

(62)　hunger　remains　a　problem　in　many　areas.　The　United　Nations　estimates　that　almost　800　million　people,　including　300　million　children,　go　to　bed　hungry　each　night.

Experts　said　poor　diets　and　lack　of　physical　activity　are　mainly　to　(63)　for　the　rising　numbers　of　overweight　people.

Growing　populations　have　(64)　rising　obesity　rates　in　poor　countries.　Often,　poor　people　will　eat　processed　foods　instead　of　choosing　a　diet　rich　in　vegetables.

“People　are　consuming　more　and　more　processed　foods　that　are　high　in　sugar　and　fat　and　exercising　less,”　said　Boitshepo　Giyose,　senior　nutrition　officer　at　the　UN　Food　and　Agriculture　Organization.

The　Londonbased　Overseas　Development　Institute　studied　the　price　of　food　in　five　countries:　Britain,　Brazil,　China,　Mexico　and　South　Korea.　It　found　that　the　cost　of　processed　foods　like　ice　cream　and　hamburgers　has　(65)　since　1990.　But　the　cost　of　fresh　fruits　and　vegetables　has　gone　up.

56.　A.　decreasingB.　growingC.　fallingD.　changing

57.　A.　relatedB.　bigC.　complexD.　annoying

58.　A.　extraB.　extensiveC.　excessD.　undue

59.　A.　sawB.　readC.　testedD.　examined

60.　A.　populousB.　developedC.　developingD.　vulnerable

61.　A.　gainingB.　acquiringC.　gettingD.　developing

62.　A.　AndB.　SoC.　YetD.　Though

63.　A.　blameB.　scoldC.　condemnD.　charge

64.　A.　resulted　fromB.　brought　about

C.　attributed　toD.　given　out

65.　A.　risenB.　climbedC.　fallenD.　surged

ⅢWriting

Question　66

　Write　about　the　following　topic.

Some　people　believe　that　the　best　way　to　lead　a　healthy　life　is　doing　regular　exercises,　while　others　assert　that　emotional　management　is　of　greater　importance.　What　do　you　think?

　Write　an　essay　of　no　less　than　150　words　on　your　answer　sheet.

METS测试与评析（三级）

听力文本、参考答案及解析

听力文本、参考答案及解析

医护英语水平考试(三级)

模拟训练（一）

听力文本

This　is　METS3　listening　test.　There　are　four　parts　in　the　test,　Part　One,　Two,　Three,　and　Four.　You　will　hear　each　part　twice.

We　will　now　stop　for　a　moment　before　we　start　the　test.　Please　ask　any　questions　because　you　must　not　speak　during　the　test.

Now,　look　at　the　instructions　for　Part　One.

You　will　hear　five　extracts　from　conversations　taking　place　in　different　clinical　departments.　Choose　which　case　each　doctor　is　discussing　from　the　list　A—F.　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　do　not　need　to　use.　Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　each　extract　twice.　Now　we　are　ready　to　start.

Extract　1

Youll　receive　an　intravenous　injection.　Make　a　tight　fist.　Now　open　it.　This　injection　contains　the　medicine　which　can　be　seen　by　the　machine　so　that　it　is　possible　for　us　to　scan　your　kidney.　You　have　to　wait　so　that　the　medicine　can　reach　your　kidney.　You　must　not　move　during　the　scan.　Well　send　the　results　to　your　doctor.

Extract　2

We　are　going　to　do　a　scan　of　the　brain　called　CT　scan　or　CAT　scan.　This　is　an　easy　test.　You　just　need　to　lie　on　a　special　stretcher　which　moves　and　runs　into　the　head　scanner.　Its　a　little　bit　like　putting　your　head　in　a　large　washing　machine.　You　lie　still　and　you　will　hear　the　machine　making　noises　while　it　takes　some　special　crosssectional　Xrays　to　give　us　a　picture　of　your　brain.

Extract　3

I　am　sorry　to　have　to　tell　you　that　you　do　have　an　eye　tumor　and　well　have　to　do　something　about　it.　Im　afraid　that　its　melanoma　of　the　eye.　Its　in　an　advanced　stage　so　it　is　very　likely　that　we　will　have　to　remove　the　eye　itself.　I　know　that　sounds　very　drastic　but　eye　tumors　behave　differently　from　other　tumors　in　the　body　so　theres　a　high　chance　that　once　we　take　the　eye　out,　that　will　be　the　end　of　the　tumor　and　the　cancer　will　be　removed　totally.

Extract　4

Mr.Brown,　open　your　eyes.　The　operation　is　over.　Take　deep　breaths.　Give　us　a　cough.　Im　going　to　clean　your　mouth.　Open　your　mouth　wide.　Spit　out　what　you　have　in　your　mouth.　Its　time　to　wake　up.　Can　you　breathe?　How　is　your　breathing?　Im　going　to　take　the　tube　out　of　your　mouth.　Do　you　feel　sick?　Are　you　in　any　pain?　We　are　going　to　transfer　you　to　the　recovery　room.

Extract　5

Well,　while　Im　feeling　his　stomach,　I　can　feel　a　little　lump　underneath　my　fingers　and　what　indicates　to　me　is　that　hes　got　some　overgrowth　of　the　muscle　at　the　exit　of　the　stomach,　and　thats　blocking　the　material　like　milk　draining　from　his　stomach.　So　I　think　its　likely　that　what　we　need　to　do　is　a　small　operation　to　cut　through　the　muscle　and　relax　it.

Now　youll　hear　Part　One　again.　This　is　the　end　of　Part　One.　Now　look　at　Part　Two.

You　will　hear　a　conversation　between　two　doctors.　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).　Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　the　recording　twice.

Doctor　A:　Hello,　Jim.　I　wonder　if　you　could　see　a　patient　for　me.

Doctor　B:　Certainly,　Mary.　Whats　the　story?

Doctor　A:　Well,　its　Mr.　Alan　Jameson,　a　53yearold　carpenter.　He　had　been　an　infrequent　attender　but　he　came　to　see　me　this　morning　complaining　of　pain　in　his　right　leg　and　his　back.

Doctor　B:　And　when　did　this　start?

Doctor　A:　Well,　it　came　on　about　six　weeks　ago　and　its　become　gradually　more　severe　over　the　past　couple　of　weeks.

Doctor　B:　Was　the　pain　localized?

Doctor　A:　No.　At　first　he　thought　hed　just　pulled　a　muscle.　But　its　got　so　bad　that　he　hasnt　been　able　to　do　his　work　properly.　Its　also　been　getting　to　the　stage　where　the　pain　is　waking　him　up　at　night.　Its　been　so　severe.　Hes　also　noticed　some　tingling　in　his　right　foot.　Hes　having　difficulty　in　carrying　on　with　his　work.　Hes　also　lost　three　kilos　and　become　quite　depressed.

Doctor　B:　Did　he　have　any　similar　symptoms　in　the　past?

Doctor　A:　No,　not　exactly,　but　he　has　suffered　from　intermittent　pain　in　the　back.　Paracetamol　gave　some　relief　but　didnt　solve　the　problem　completely.

Doctor　B:　Apart　from　that,　any　other　problems　with　health　in　the　past?

Doctor　A:　No,　perfectly　OK.

Doctor　B:　Did　you　find　anything　else　on　examination?

Doctor　A:　Yes,　as　well　as　the　pain　he　has　numbness　in　his　toes　on　the　right　foot.

Now　youll　hear　Part　Two　again.　This　is　the　end　of　Part　Two.　Now　look　at　Part　Three.

You　will　hear　a　discussion　among　a　supervising　physician　and　two　medical　students.　For　questions　14—20,　choose　the　most　appropriate　answer.　Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　the　discussion　twice.

Supervising　physician:　Today　Ill　explain　acute　severe　asthma.　Do　you　have　any　questions?

Student　1:　Ive　learned　that　asthma　is　prevalent　in　modern　society.

Supervising　physician:　Yes,　it　strikes　a　surprisingly　large　number　of　Americans.

Student　2:　What　is　the　cause　of　asthma?

Supervising　physician:　The　actual　triggers　of　asthma　are　varied,　but　some　of　the　common　ones　are　cold　air,　exercise,　infection,　common　viruses,　irritants　and　allergies.

Student　1:　Does　genetics　play　a　role　in　asthma?

Supervising　physician:　Several　studies　show　that　heredity　will　increase　the　chances　of　developing　asthma.　But　one　will　not　definitely　develop　it　because　of　heredity.

Student　2:　Is　it　serious?

Supervising　physician:　Yes,　it　can　cause　death.　Approximately　5,000　people　die　of　asthma　every　year.

Student　2:　Could　you　tell　us　what　happens　in　an　asthma　attack?

Supervising　physician:　What　have　you　learned　about　it?

Student　1:　I　think　there　are　three　components.

Supervising　physician:　Yes,　you　are　right.　It　is　usually　thought　to　involve　three　components:　swelling　of　the　airways,　constriction　of　the　muscles　around　the　airways,　and　inflammation.

Student　1:　How　about　acute　severe　asthma?

Supervising　physician:　It　is　also　called　status　asthmatics,　and　it　is　an　attack　of　severe　bronchospasm　that　is　unresponsive　to　routine　therapy.

Student　1:　What　are　the　characteristics　of　acute　severe　asthma?

Supervising　physician:　The　attack　may　be　sudden　and　may　be　rapidly　fatal,　often　before　medical　care　can　be　obtained.

Student　2:　Can　you　tell　us　the　symptoms　of　acute　severe　asthma?

Supervising　physician:　Patients　will　have　difficulty　in　talking,　and　they　use　accessory　muscles　of　inspiration,　and　they　will　have　orthopnea.

Student　1:　How　should　we　deal　with　this　problem?

Supervising　physician:　The　treatment　should　be　immediate　and　aggressive.

Student　2:　Do　we　have　to　monitor　blood　oxygen　saturation?

Supervising　physician:　Yes,　at　the　same　time　there　should　be　arterial　blood　gas　analysis　to　evaluate　hypercarbia.　And　we　should　measure　frequently　the　peak　expiratory　flow　rate.

Student　1:　What　special　attention　should　we　pay　to　these　patients?

Supervising　physician:　These　patients　require　continuous　direct　observation　and　monitoring.

Student　1:　That　means　the　patients　should　be　closely　watched?

Supervising　physician:　Yes,　it　is　one　kind　of　emergency　case.

Student　1:　Weve　got　it.　Thank　you.

Now　youll　hear　Part　Three　again.　This　is　the　end　of　Part　Three.　Now　look　at　Part　Four.

You　will　hear　a　speech　on　various　contraceptive　methods.　Complete　the　notes.　In　each　blank,　write　only　one　word.　Write　the　answers　on　your　answer　sheet.　You　will　hear　the　speech　twice.

Female:　There　are　different　types　of　contraceptive　pills　that　you　need　to　think　about　and　they　all　work　differently.　Theres　what　we　call　the　minipill　which　has　a　single　hormone　in　it　but　you　do　need　to　be　more　careful　about　when　you　take　it　because　it　only　has　a　threehour　gap　in　which　it　is　safe　and　if　you　take　it　any　later　than　that,　then　its　not　working　reliably.

The　combined　pill　on　the　other　hand　has　two　types　of　hormones　in　it,　and　it　has　a　much　wider　range.　You　can　be　up　to　12　hours　late　and　itll　still　work　reliably.　However　some　people　do　find　that　they　have　problems　with　both　types　of　pills,　for　example,　they　get　headaches　or　migraines　or　put　on　weight　and　some　people　also　have　problems　with　their　blood　pressure,　so　it　is　not　always　suitable.

Another　option　is　to　have　a　coil;　however,　we　dont　normally　recommend　this　to　women　until　theyve　had　at　least　one　child,　because　some　studies　have　shown　that　although　the　coil　isnt　necessarily　associated　with　causing　infections,　if　you　do　have　any　pelvic　inflammatory　diseases,　it　can　be　made　worse,　and　it　can　increase　the　risk　of　infertility.　Therefore,　it　is　usually　only　given　to　women　after　theyve　had　at　least　one　child.

The　cap　or　diaphragm　has　its　advantages　in　that　it　doesnt　involve　any　hormones,　therefore,　youre　not　messing　around　with　your　bodys　cycle　and　it　also　means　that　it　can　be　put　in　before　you　have　your　intercourse　not　like　the　sheath　or　anything　so　its　in　and　out　of　the　way　and　out　of　your　mind.　However,　you　do　have　to　have　it　quite　carefully　fitted　and　you　need　to　be　quite　confident　with　your　own　body　in　learning　how　to　put　it　in.　If　you　are　at　all　embarrassed,　it　can　be　very　difficult.

If　you　are　absolutely　certain　that　youve　finished　your　family　or　youre　not　planning　on　having　any　children,　its　possible　to　be　sterilized　or　as　it　is　sometimes　called　“have　your　tubes　tied”.　This　normally　involves　just　a　minor　operation.　You　are　just　in　for　a　day.　We　look　inside　your　tummy　with　a　telescope　and　cut　and　tie　off　each　of　your　tubes　to　stop　the　egg　from　reaching　the　womb,　and　it　stops　you　from　getting　pregnant.　Its　a　very,　very　reliable　method.　It　has　a　very　low　failure　rate,　but　its　main　drawback　is　that　it　should　be　regarded　as　being　absolutely　irreversible,　and　once　its　done　you　really　cant　have　it　changed　back.　So　you　have　to　be　very　sure　that　you　dont　want　any　more　children.

Coitus　interruptus,　also　called　the　rhythm　method,　is　a　very　unreliable　method　of　contraception,　where　the　man　withdraws　from　the　female　just　before　he　comes.　However,　there　is　often　a　small　quantity　of　sperm　released　even　before　the　man　comes,　and,　therefore,　its　an　extremely　unreliable　method.

Condoms　or　sheaths　are　quite　a　safe　and　reliable　method　of　contraception.　The　main　disadvantage　is　that　they　have　to　be　put　on　during　or　shortly　before　intercourse,　and　this　can,　therefore,　interrupt　the　spontaneity　of　lovemaking.　However,　they　do　have　the　advantage　of　protecting　against　sexually　transmitted　diseases.

Now　youll　hear　Part　Four　again.　This　is　the　end　of　Part　Four.

You　now　have　five　minutes　to　write　your　answers　on　the　answer　sheet.　You　have　one　more　minute.　This　is　the　end　of　the　listening　test.

参考答案与试题评析

ⅠListening

Part　One

1.　【语段大意】　医生正对患者解释静脉内肾盂造影(intravenous　pyelogram)。在此过程中，患者先握拳，再松开，进行静脉造影剂的注射,使注射液含有的造影物质慢慢到达肾部，便于扫描。

【解题思路】　F可听到intravenous　injection,　scan　your　kidney,　can　reach　your　kidney等关键信息。

2.　【语段大意】　医生正对患者解释脑部CT扫描术(brain　CT)。在此过程中，患者躺在特殊担架上(a　special　stretcher)被送入头部扫描仪(head　scanner)，保持不动，直到机器发出声音，照下脑部的断层扫描X片。

【解题思路】　B可听到a　scan　of　the　brain　called　CT　scan　or　CAT　scan,　head　scanner,　your　head,　a　picture　of　your　brain等关键信息。

3.　【语段大意】　患者疑患有眼部黑素瘤(melanoma　of　the　eye)，已晚期(in　an　advanced　stage)。医生可能会采取眼球切除(remove　the　eye)的方法，并向患者解释采取此措施的原因在于眼部肿瘤不同于其他区域的肿瘤，可通过眼球切除，彻底根除。

【解题思路】　A可听到an　eye　tumor,　the　eye,　eye　tumors,　take　the　eye　out等关键词。

4.　【语段大意】　患者刚接受完手术，医生试图通过引导患者深呼吸、咳嗽、清洗口腔等一系列动作来检查患者的意识状态，接着送患者至恢复室(recovery　room)。

【解题思路】　D可听到The　operation　is　over.　这一关键句。

5.　【语段大意】　本题描述的是一名正在接受医生体检的患者，医生通过指检，触摸到指下胃部硬块(a　little　lump　underneath　my　fingers)，疑为胃出口处肌肉增生(overgrowth　of　the　muscle　at　the　exit　of　the　stomach)，计划采取手术来治疗(cut　through　the　muscle　and　relax　it)。

【解题思路】　E可听到his　stomach,　the　stomach,　from　his　stomach等关键信息。

Part　Two

【语篇大意】　两位医生针对患者病情的讨论。

【解题思路】

6.　B对话开头就提到医生Jim非常乐意替Mary看看她患者的情况，故答案为B。

7.　B对话中Mary提及过去多年患者Alan　Jameson　很少来看病　(infrequent　attender)，故答案为B。

8.　A当Jim问到疾病发作时间时，　Mary提到约六周前开始　(about　six　weeks　ago)，所以答案为A。

9.　A起初病人以为是肌肉拉伤，但后来疼痛非常严重，以至于难以正常工作，夜间都会被疼痛折磨醒，所以A正确。

10.　B患者体重下降三公斤，精神抑郁，因此选B。

11.　B患者提及疼痛非常严重，在右足处可感到刺痛(tingling)，而并非在右手处，所以选B。

12.　B患者之前曾在背部出现间歇性疼痛(intermittent　pain)，用药也未见治愈，所以选B。

13.　C整篇对话并未提及患者诊断结果，故C正确。

Part　Three

【语篇大意】　两位医学生向临床老师咨询哮喘的相关问题。

【解题思路】

14.　A对话中提及哮喘诱因各不相同，但通常有冷空气、运动、感染、常见病毒、刺激物及过敏。本题B与C均对，故A为答案。　关键信息：What　is　the　cause　of　asthma?/The　actual　triggers　of　asthma　are　varied,　but　some　of　the　common　ones　are　cold　air,　exercise,　infection,　common　viruses,　irritants　and　allergies.

15.　C对话中提到研究表明遗传会增加哮喘的发病率，而非性格与饮食，故答案为C。关键信息：Several　studies　show　that　heredity　will　increase　the　chances　of　developing　asthma.　But　one　will　not　definitely　develop　it　because　of　heredity.

16.　B对话中提到哮喘会致死，每年大约5000人死于哮喘，所以答案应该选B。关键信息：Yes,　it　can　cause　death.　Approximately　5000　people　die　of　asthma　every　year.

17.　B对话中提到哮喘发作有三个方面组成：气道水肿　(swelling　of　the　airways)，气道周围肌肉收缩　(constriction　of　the　muscles　around　the　airways)及炎症。选项A和C均对，B选项的全身肌肉收缩，不符，故答案为B。关键信息：three　components:　swelling　of　the　airways,　constriction　of　the　muscles　around　the　airways,　and　inflammation.

18.　C关于急性严重哮喘(acute　severe　asthma)的发作，对话中提到它是一种严重支气管痉挛(bronchospasm)，对常规治疗无效，故A不符；它发作迅速，通常致命，故B不符；症状包括谈话困难与端坐呼吸(orthopnea)，显然C正确。关键信息：Can　you　tell　us　the　symptoms　of　acute　severe　asthma?/Patients　will　have　difficulty　in　talking,　and　they　use　accessory　muscles　of　inspiration,　and　they　will　have　orthopnea.

19.　A对话中提到急性严重哮喘(acute　severe　asthma)的治疗应该迅速、积极(immediate　and　aggressive)，故答案为A。关键信息：The　treatment　should　be　immediate　and　aggressive.

20.　A对话中提到对哮喘患者应进行血氧饱和度监控(monitor　blood　oxygen　saturation)，同时进行动脉血气分析(arterial　blood　gas　analysis)，防止出现高碳酸血症(hypercarbia)等，故答案为A。

关键信息：Do　we　have　to　monitor　blood　oxygen　saturation?/Yes,　at　the　same　time　there　should　be　arterial　blood　gas　analysis　to　evaluate　hypercarbia.

Part　Four

【语篇大意】　关于不同避孕方式利弊的一段讲座。

【解题思路】

21.　minipill此处为讲座中提到的第一个避孕方式，即为一种含有单个激素的小剂量避孕药片，因其仅房事前后三个小时有效，所以使用需特别小心。所以此处应填minipill。

22.　migraines文中讲述前两种避孕药使用时会出现头痛(headaches)、偏头痛(migraines)、体重增加、血压问题等副作用。所以此处应填migraines。

23.　infertility文章建议已育女性使用宫内避孕环（coil)，并且说明其副作用为加重盆腔炎(pelvic　inflammatory　diseases)的程度，及增加不孕症(infertility)风险。根据短文内容，此处应填infertility。

24.　irreversible文中讲述到输卵管结扎手术时，提到其主要缺点为手术的不可逆性(irreversible)，故此处应填irreversible。

25.　sexually文中提到避孕套这种避孕方式时，提到其主要优点即为防止性传播疾病(sexually　transmitted　diseases)。　故此处应填sexually。

ⅡReading

Part　One

【文章大意】　文章指出良好的饮食习惯与持之以恒的体育运动是健康的保证，并给出了一些营养饮食的建议。

【解题思路】

26.　A根据第一段第一句“Making　wise　food　choices　early　in　life　will　help　prevent　health　problems　that　can　effect　you　later.”和最后一句“Your　eating　habits...are　crucial　elements　on　the　path　to　a　healthier　body　and　self.”，合理饮食是保持健康的不二选择；第二句“It　is　reported　that　8　of　the　10　leading　causes　of　death　in　America　are　directly　related　to　what　we　eat　and　drink.”则是对这一主题的反面论证。

27.　B第二段段首提出应限制脂肪的摄入“Experts　recommend　limiting　your　fat　intake　to　30%　of　the　total　calories　you　consume　per　day.”，段中指出减肥应该少食多动“If　you　want　to　lose　weight...eat　less　and　exercise　more.”，而段末又提及过度节食伤及身体“Starvation　diets　or　losing　weight　too　fast　can　be　dangerous.”，由此归纳出，减肥不能一味节食，必须在节食和运动二者间找到平衡。

28.　C第三段第一句“A　consistent　pattern　of　daily　physical　activity　and　exercise　is　one　of　the　healthiest　habits　you　can　get　into.”以及倒数第二句“And　besides,　exercise　makes　you　feel　wonderful,　provided　that　you　do　not　overdo　it.”表明，适量运动不仅是一种积极的生活方式，还可以给人带来愉悦的体验。段落中间则举例说明运动的各种形式。

29.　D第四段第一句“Vegetarianism　is　becoming　increasingly　popular　among　college　students.”为主题句，其余部分给出了数据说明，讨论选择素食的原因并提供了一些饮食建议，均为支撑细节。

30.　E第五段第一句“A　healthy　outlook　about　your　body　and　appearance　and　how　it　relates　to　food　and　physical　activity　is　very　important　for　young　adults.”意指饮食和适量的运动对年轻人的健康非常重要，不要做有损健康的行为（Selfdestructive　behaviors），应尊重身体，善待身体（Keep　your　mind　and　body　in　shape　by　treating　them　both　with　respect）。

31.　F定位第一段第二句“It　is　reported　that　8　of　the　10　leading　causes　of　death　in　America　are　directly　related　to　what　we　eat　and　drink.”。

32.　D定位第二段第四句“If　you　want　to　lose　weight,　the　equation　is　simple,　eat　less　and　exercise　more.”。

33.　A定位第二段第七句“The　easiest　way　to　decrease　the　number　of　calories　your　body　stores　as　fat　is　to　not　consume　those　calories　in　the　first　place;　especially　since　it　is　much　more　difficult　to　burn　calories　once　they　are　consumed.”。

34.　B定位第四段第四句“Some　people　consider　themselves　vegetarian　simply　because　they　do　not　eat　red　meat.”。

35.　C定位第五段最后一句“A　healthy　selfimage　and　realistic　perception　of　yourself　is　one　of　the　healthiest　feats　you　can　achieve.”。

Part　Two

【文章大意】　主要介绍慢性阻塞性肺病的症状、致病因素、发病机制、分类和改善途径。

【解题思路】

36.　B根据第五段第一、二句“COPD　develops　slowly.　Symptoms　often　worsen　over　time　and　can　limit　your　ability　to　do　routine　activities.”选题。

37.　D第一段第二句“COPD　can　cause　coughing　that　produces　large　amounts　of　mucus　(a　slimy　substance),　wheezing,　shortness　of　breath,　chest　tightness,　and　other　symptoms.”指出慢性阻塞性肺病的症状包括咳痰、哮喘、气短和胸闷等，D选项提到的咳血则不是其症状。

38.　A文章第二段介绍了肺的工作原理，吸入的空气首先进入气管（windpipe），然后进入支气管（bronchial　tubes），再进入由支气管分化成的细支气管（bronchioles），最后进入细支气管末端的肺泡（alveoli）。肺泡外面包绕着许多毛细血管，当吸入的空气到达肺泡时，空气中的氧气透过肺泡壁和毛细血管壁进入血液，同时血液中的二氧化碳也透过毛细血管壁和肺泡壁进入肺泡，随呼气的过程排出体外。

39.　C根据第四段第六、七、八句“In　chronic　bronchitis,　the　lining　of　the　airways　is　constantly　irritated　and　inflamed.　This　causes　the　lining　to　thicken.　Lots　of　thick　mucus　forms　in　the　airways,　making　it　hard　to　breathe.”，慢性支气管炎是由于支气管黏膜不断受到刺激而引发炎症，导致黏膜增厚及分泌物增多，引发呼吸困难。C项指出气道发炎因而变得狭窄或阻塞符合文章意思，其他三选项指出慢性阻塞性肺病发作时肺组织弹性增强、黏液减少以及与肺泡中无气体交换与原文第四段相悖。

40.　C第四段最后两句“Most　people　who　have　COPD　have　both　emphysema　and　chronic　bronchitis.　Thus,　the　general　term　‘COPD’　is　more　accurate.”指出慢性阻塞性肺病患者同时患有肺气肿和慢性支气管炎，因此用“慢性阻塞性肺病”这一统称更为精确，而其他三个选项内容在文中均未给出。

41.　C参照文章第五段最后两句话“COPD　has　no　cure　yet,　and　doctors　dont　know　how　to　reverse　the　damage　to　the　airways　and　lungs.　However,　treatments　and　lifestyle　changes　can　help　you　feel　better,　stay　more　active,　and　slow　the　progress　of　the　disease.”，慢性阻塞性肺病目前尚无治愈方法，但治疗和改变生活方式可以提高生活质量，减慢疾病进程。另外，本段还指出气道与肺泡的损害具有不可逆性，此病非传染性疾病等。因而A、B、D均为错误选项。

42.　D从第一段第三句“Cigarette　smoking　is　the　leading　cause　of　COPD.”得知A选项正确，根据第四段第一句“In　the　United　States,　the　term　‘COPD’　includes　two　main　conditions...”和第五段内容判断B、C选项正确，而D选项则为错误表述，因而是本题正确答案。

Part　Three

【文章大意】　文章报道了埃博拉病毒分型、感染途径与症状、病毒爆发史、致病致死性、治疗和疫苗研制情况，并从生物伦理角度阐述了埃博拉疫苗临床试验阶段有关使用人群的争议问题。

【解题思路】

43.　C题目意为国际卫生条例在西非告知于众，此信息在文中没有给出，故选C。

44.　A根据第二段第二句　“The　West　Africa　outbreak　is　from　a　new　strain　of　the　Zaire　species,　with　a　reported　casefatality　rate　of　55%.”，题目正确。

45.　B根据第三段第二句　“Humantohuman　transmission　occurs　only　by　close　contact　with　infected　body　fluids.”，只有密切接触患者的体液才会在人与人之间传染，因此题目错误。

46.　B根据第四段第五句　“Of　greatest　concern　is　the　potential　urban　spread,　including　capital　cities.”，城市疫情扩散存在潜在风险，但还没有发生疫情，所以题目错误。

47.　A根据第五段第二句“There　are　no　licensed　vaccines　or　specific　antivirals　or　immunemediated　treatments　for　ill　patients　or　for　postexposure　prophylaxis.”，题目正确。

48.　B第六段最后一句　“...is　the　ethical　concern　of　administering　an　experimental　drug　to　African　patients　that　has　not　undergone　any　safety　testing　in　humans.”和第七段第六句　“Liberian　officials　apparently　did　not　approve　the　use　of　an　investigational　drug　administered　in　their　territory.”，　对非洲患者使用试验性病毒抗体既存在伦理上的问题，又存在事实上的阻力，所以题目是错误的。

49.　C第六段第一句　“...2　US　aid　workers　infected　in　Liberia　were　treated　with　an　experimental　antiEbola　antibody　prior　to　being　transported　to　Atlanta.”，　2名美国救援人员被运送到亚特兰大前注射了测试性埃博拉病毒抗体，并未提及治疗后痊愈。故选C。

50.　A文章第七段从生物伦理角度谈论疫苗在试验阶段进行治疗的种种问题，根据首尾两句话得知题目是正确的。

Part　Four

【文章大意】　文章阐述了过量服用阿司匹林中毒的种类，成人和儿童服用阿司匹林注意事项，过量服用阿司匹林而导致急慢性中毒的症状、处理方法以及避免过量服用或误食阿司匹林的建议。

【解题思路】

51.　A第一段第一句为段落主题句，指出过量服用阿司匹林中毒有两种类型。第二句是关于急性阿司匹林中毒的内容。第三、四句是关于过量服用阿司匹林慢性中毒及原因的内容。A选项是关于阿司匹林慢性中毒易发人群的内容，为合理选项。有助于正确选题的重要词句包括：there　are　two　forms　of　which/In　acute　aspirin　poisoning/Another　form　of　aspirin　overdose　is　called　chronic　overdose/The　chronic　form。

52.　D第二段第二句“In　children,　aspirin　is　not　recommended,　though　some　kids　with　heart　conditions　may　be　on　very　low　dose　amounts　to　prevent　blood　clotting.”谈到不推荐儿童服用阿司匹林，一些患有心脏疾病的儿童服用阿司匹林抗血凝时应注意低剂量使用。D选项接着指出具体的低剂量值。重要词汇为low　dose　amounts/Lowdose　aspirin。

53.　C第四段谈到人们处理阿司匹林中毒的具体方法和注意事项。作为本段第一句，C选项指出“急、慢性阿司匹林中毒都是紧急医疗事件，需要即刻进行医疗救助”，是下面三句话内容的主旨概括，是本段的主题句。重要词汇：need　immediate　attention/should/should　not/and　it　is　not　advisable　to/should。

54.　B第五段谈及人们在配合医疗人员救治中毒者时可以提供患者的一些信息，B选项在首句作为概括全段的主题句最为合理。内容和信息相关。重要词句：　they　can　help　greatly　by　having　some　information/If　they　know/this　is　great　information/but　whatever　extra　information　can　be　given　may　prove　helpful。

55.　E第七段第二句“Many　companies　still　make　forms　of　baby　aspirin　that　are　chewable.”指出很多公司目前还生产婴儿服用的阿司匹林咀嚼片；E选项接着讲述儿童喜欢这种阿司匹林的口味，因而也就容易过量服用；下一句“If　there　are　adults　(or　kids　with　heart　defects)　that　use　the　chewable　form,　keep　these　medications　far　out　of　reach　of　other　children.”说要把阿司匹林咀嚼片放在儿童接触不到的地方。内容都和儿童相关。重要词汇：“baby”aspirin/kids/children。

Part　Five

【文章大意】　文章介绍了运用激光手术治疗近视的原理、手术过程及术后注意事项。

【解题思路】

56.　Acontact　lenses：隐形眼镜，其他几个选项表达不准确。

57.　Cvision：视觉、视力。20/20　vision，也可写为twentytwenty/20—20　vision：非常好的视力　(the　ability　to　see　perfectly)。第一段主要内容是关于激光手术如何矫正视力，最后一句话的意思是：许多患者接受激光治疗后视力变得非常好。

58.　Battach　与to　固定搭配，意为“与……连接在一起”。The　laser　system　includes　a　large　machine　with　a　microscope　attached　to　it　and　a　computer　screen.　表示“此激光设备包括一台连接着显微镜和电脑视频的大型仪器”。clip:夹住；fasten扣住，捆住；implement：实施，执行。

59.　C根据“you　may　feel　the　pressure　and　experience　some　discomfort　during　this　part　of　the　procedure”，说明此时视力应该是“变模糊”，才会让人有压迫（pressure）和不适感（discomfort），　故选C。　blur：变模糊;　flag：衰退。

60.　CLaser　energy　is　focused　inside　the　cornea　tissue,　which　creates　thousands　of　small　bubbles　of　gas　and　water　that　expand　and　connect　to　separate　the　tissue　underneath　the　cornea　surface,　creating　a　flap.　此句句意为：“激光脉冲聚集到角膜组织中，产生成千上万的水泡和气泡并不断扩展，分离角膜组织，形成相应的分离面。”在“组织里面”产生水泡和气泡，然后“膨胀扩大（expand）”，故选C。

61.　DYou　will　be　able　to　see,　but　you　will　experience　fluctuating　degrees　of　blurred　vision　during　the　rest　of　the　procedure.　此句句意为：“术中你可以看见东西，但会出现不同程度的视力模糊，有时严重，有时程度稍轻。”选D：“波动性的”，符合句意。additive：成瘾的；agonizing：使人痛苦的；flexible：灵活的。

62.　A此处译为：“一旦激光准备好，这种光可以使眼球固定在一个位置。”选A符合语句逻辑。

63.　DAs　the　laser　removes　corneal　tissue,　some　people　have　reported　a　smell　similar　to　burning　hair.　此句意思：“当激光刀移除角膜组织时，有人说有像头发烧焦了的气味。”选D句意合理。screen：筛查；scrape：刮，擦；implant：植入；remove：移除，摘除。

64.　DBefore　the　start　of　surgery,　your　doctor　will　have　programmed　the　computer　to　vaporize　a　particular　amount　of　tissue　based　on　the　measurements　taken　at　your　initial　evaluation.此处译为：“根据术前的测量设定电脑程序，术中蒸发一定数量的角膜组织。”assessments、evaluations和estimations：对形势、情况、状况等做出的判断、评估、评价等；　measurements：测量、测定；take　measurements　为固定搭配。

65.　C...protect　your　eye　from　accidentally　being　hit　or　poked...此句译为：“防止眼睛受到意外碰撞或戳刺。”其他选项均不符合常理或逻辑。

ⅢWriting

66.　【范文】

Recent　years　have　seen　great　progress　in　Chinas　medical　reform,　but　people　still　find　it　difficult　and　expensive　to　see　a　doctor.

This　phenomenon　can　be　attributed　to　the　following　three　factors,　among　others.　The　first　one　is　the　uneven　distribution　of　medical　care　resources.　People　often　take　a　lot　of　time　and　trouble　in　getting　treatment　in　good　but　overcrowded　hospitals　in　big　cities.　Second,　current　medical　insurance　and　pricing　systems　still　have　defects.　Unreasonable　medicines　and　checkup　fees　increase　most　patients　financial　burden,　and　those　with　serious　illnesses　are　often　reduced　to　poverty.　To　make　matters　worse,　such　hospital　malpractices　as　bad　service　attitude,　giving　excessive　medical　treatment　and　receiving　patients　red　envelopes　increase　the　mental　and　economic　pressures　for　patients,　making　their　experience　of　seeing　a　doctor　a　painful　nightmare.

China　must　deepen　its　medical　care　reform　by　optimizing　the　distribution　of　medical　resources,　changing　the　medicines　pricing　mechanism　and　improving　medical　workers　professional　ethics,　letting　every　Chinese　citizen　enjoy　the　benefit　of　convenient　and　cheap　health　care　service.　(172　words)

【审题】

写作部分要求根据给定的情景——中国目前存在“看病难看病贵”的现象进行写作，要求分析造成这种现象的原因、列举解决问题的对策。文章应属说明文，除遵守说明文写作的基本要求外，写作中的一个重点和难点是如何正确写出一些涉及医疗卫生领域话题的英语表达，如“医疗改革、医疗卫生资源、看病、医疗保险、药费、大病、服务态度、过度治疗、收红包、医疗卫生服务、医疗卫生职业道德”等。

【范文评析】

文章首先根据作文任务给定的信息，直奔主题，指出目前存在的一种社会现象，以问题的提出开头。文章的重点放在问题成因的剖析上：第二段第一句总领全段，随后从三个方面给出具体的原因。第三段简明扼要，列举了解决问题的三个办法。

文章结构层次清晰，主题表达明确，阐述部分充分合理，每个主题句都有适当的扩展或说明；熟练使用first，　second　和To　make　matters　worse　等词语衔接手段，正确运用医学话题相关的一些词汇表达；现在分词短语状语结构的使用(making　their　experience　of　seeing　a　doctor　a　painful　nightmare/letting　every　Chinese　citizen　enjoy　the　benefit　of　convenient　and　cheap　health　care　service)则是本文句子中的一个亮点。

医护英语水平考试(三级)

模拟训练（二）

听力文本

This　is　METS3　listening　test.　There　are　four　parts　in　the　test.　You　will　hear　each　part　twice.　We　will　now　stop　for　a　moment　before　we　start　the　test.　Please　ask　any　questions　now　because　you　must　not　speak　during　the　test.　Now,　look　at　the　instructions　for　Part　One.

You　will　hear　five　extracts　from　conversations　taking　place　in　different　clinical　departments.　Choose　which　case　each　doctor　is　discussing　from　the　list　A—F.　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　do　not　need　to　use.

Mark　the　corresponding　letter　on　your　answer　sheet.

You　will　hear　each　extract　twice.　Now　we　are　ready　to　start.

Extract　1

You　will　need　to　take　some　medication　home　with　you.　I　have　prescribed　some　tablets　for　your　blood　pressure　and　you　need　to　take　one　twice　a　day　morning　and　evening.　I　have　also　prescribed　a　sublingual　tablet　which　you　should　take　when　the　pain　comes　in　your　chest.　Just　put　one　tablet　under　your　tongue　and　let　it　dissolve.　You　must　only　take　a　maximum　of　two　tablets　a　day.

Extract　2

The　ankle　is　very　swollen　and　it　is　possible　that　there　may　be　some　bleeding　within　the　joint.　You　need　to　have　a　support　bandage　applied　by　the　nurse.　You　must　keep　the　foot　elevated　as　much　as　you　can　for　3　days　or　until　the　swelling　goes　down　and　your　ankle　feels　better.　You　should　have　a　week　off.　If　your　ankle　isnt　better　in　a　week,　please　come　back　to　see　me.

Extract　3

Now　were　moving　on　to　examine　your　arms　and　legs　neurologically.　Start　by　putting　both　arms　out　in　the　air　in　front　of　you　and　shut　your　eyes.　Hold　the　arms　still　while　I　look　at　them.　Now　wiggle　your　fingers　as　though　you　were　playing　the　piano.　Open　your　eyes,　and　make　a　pointer　by　stretching　out　your　index　finger.　Now　touch　my　finger　and　then　touch　your　nose.　Now　try　this　on　the　other　side.

Extract　4

Well,　we　were　told　that　his　lungs　were　immature　because　he　was　preterm,　and　he　needed　to　have　help　with　his　breathing　with　a　machine.　I　do　know,　Doctor,　though,　that　he　had　extra　problems　because　he　had　an　infection　and　he　also　became　jaundiced,　and　at　the　time　the　doctor　explained　to　me　that　they　thought　he　may　have　developed　jaundice　both　because　he　was　premature　and　also　because　he　had　some　bleeding　in　the　brain.

Extract　5

Could　you　please　get　into　a　gown　and　Ill　examine　you...I　think　that　there　is　a　good　possibility　that　you　have　appendicitis　although　we　cannot　be　sure.　Well　get　some　blood　tests　looking　at　your　white　blood　count.　However,　based　on　your　symptoms　I　think　it　would　be　wise　to　admit　you　to　hospital,　and　start　you　on　an　IV,　and　if　you　dont　improve,　then　I　think　we　should　remove　the　appendix.

Now　youll　hear　Part　One　again.　This　is　the　end　of　Part　One.　Now　look　at　Part　Two.

You　will　hear　a　conversation　between　the　student　nurse　Barbara　and　her　instructor,　Mrs.　Baker.

For　each　of　the　following　statements,　decide　whether　it　is　True　or　False.　If　there　is　not　enough　information　to　answer　True　or　False,　choose　Not　Given.　Mark　the　corresponding　letter　on　your　answer　sheet.

You　will　hear　the　recording　twice.

Barbara:Mrs.　Baker,　I　will　be　taking　care　of　the　patient　in　Room　322　Bed　2.　Here　is　the　care　plan.

Mrs.　Baker:　All　right.　When　did　the　patient　have　the　surgery?

Barbara:He　was　sent　to　the　OR　early　in　the　morning　and　had　a　cholecystectomy.　He　came　back　to　the　floor　at　about　12　oclock.

Mrs.　Baker:　He　is　a　fresh　postoperative　patient.　Its　a　very　good　case　for　you　to　learn　postoperative　care.

Barbara:Yes.

Mrs.　Baker:　What　kind　of　procedure　did　he　have?

Barbara:Cholecystectomy.

Mrs.　Baker:　I　know,　but　was　it　open　or　laparoscopic?

Barbara:Oh,　sorry.　He　had　an　open　cholecystectomy.

Mrs.　Baker:　You　should　indicate　the　procedure　in　your　care　plan　because　the　care　would　not　be　the　same　when　the　procedure　is　different.

Barbara:Yes.　Thank　you.

Mrs.　Baker:　Tell　me　what　your　focus　of　care　would　be.

Barbara:Pain,　incision　care,　vital　signs,　circulation　and　perfusion...

Mrs.　Baker:　A　little　bit　more　detailed?

Barbara:Like　all　postoperative　patients,　the　patient　will　be　in　pain.　Right　now　he　has　patient　controlled　analgesia　(PCA)　running　morphine.　The　PCA　is　expected　to　be　replaced　by　PRN　IV　push　or　PO　pills　by　tomorrow　morning.

Mrs.　Baker:　Good.

Barbara:I　will　check　vital　signs　every　30　minutes　for　two　hours,　then　every　one　hour　for　four　hours,　then　every　four　hours　two　times.　This　is　the　routine　for　all　postoperative　patient　care.

Mrs.　Baker:　OK.　If　the　vitals　are　not　within　the　normal　limits,　what　do　you　do?

Barbara:Recheck　the　patient　first.　If　it　is　confirmed　the　vital　signs　are　not　within　the　normal　limits,　I　will　call　the　doctor.　For　example,　if　the　temperature　is　above　100　degrees,　I　will　call.

Mrs.　Baker:　All　right,　you　also　need　to　initiate　some　nursing　care　to　help　the　patient.

Barbara:Right,　such　as　checking　the　incision,　monitoring　the　labs,　giving　PRN　meds,　putting　an　ice　pack...

Mrs.　Baker:　Another　very　important　postoperative　nursing　care　activity　is　to　help　the　patient　cough　effectively.

Barbara:Yes.　I　forgot　to　put　that　in　my　care　plan.　I　will　do　patient　teaching　on　how　to　use　the　incentive　spirometer.

Mrs.　Baker:　Why　do　we　encourage　coughing　after　surgery?

Barbara:To　reduce　the　chance　of　getting　pneumonia,　which　is　one　of　the　most　common　complications　of　surgery.

Mrs.　Baker:　Right,　coughing　will　help　expand　the　lungs　and　clear　the　airway.　Its　an　evidencebased　practice　that　significantly　reduces　postoperative　pneumonia.

Barbara:Yes,　I　should　have　put　it　in　the　plan.　Ill　fix　the　care　plan　and　turn　it　in　to　you　a　little　bit　later.　Is　that　all　right?

Mrs.　Baker:　All　right.

Now　youll　hear　Part　Two　again.　This　is　the　end　of　Part　Two.　Now　look　at　Part　Three.

You　will　hear　a　ward　team　meeting　among　four　nurses　discussing　a　patient　with　stroke.　For　questions　14—20,　choose　the　most　appropriate　answer.　Mark　the　corresponding　letter　on　your　answer　sheet.

You　will　hear　the　discussion　twice.

Andrea:　Lets　start　with　Lidia.　Lidias　an　80yearold　Russian　lady　whos　been　living　in　her　own　home　for　40　years;　shes　a　very　independent　woman.　You　might　remember　that　her　daughters　had　visited　her　on　a　Sunday　morning　as　usual　and　found　her　to　be　uncoordinated;　um,　she　was　having　trouble　picking　up　her　cup　of　tea.　They　noticed　that　she　was　slurring　her　speech　as　well.　Lidia　said　shed　had　a　“funny　turn”　the　night　before,　unfortunately,　by　the　time　they　brought　her　to　hospital　it　was　well　over　the　initial　three　hours　from　the　onset　of　the　stroke.　Shes　been　with　us　for　two　weeks　now　and　has　been　working　really　hard　with　everyone　so　that　she　can　get　back　to　her　own　home.　The　purpose　of　this　meeting　is　for　us　to　report　back　on　what　weve　all　been　doing　for　Lidia.　Then　we　need　to　finalize　her　discharge　plan.　William,　do　you　want　to　kick　off?

William:　Mm,　I　examined　her　yesterday,　and　I　feel　that　shes　doing　well　medically.　I　asked　her　about　her　goals　and　going　home　seems　to　be　top　of　the　list.

Andrea:　Yes,　shes　spoken　to　me　about　how　she　was　managing　at　home　before　the　stroke.　At　this　moment,　shell　need　a　lot　of　help　with　her　ADLs　(activities　of　daily　living).　Kim,　how　did　you　find　her?

Kim:　I　agree　with　both　of　you.　Shes　been　trying　really　hard.　Shes　been　doing　all　the　physio　exercises　I　give　her.　Im　a　little　concerned　about　her　ability　to　perform　the　basic　ADLs,　especially　showering,　toileting,　eating　and　mobility.

William:　Yes,　Im　a　bit　worried　about　that　as　well.　Um,　why　dont　we　have　a　look　at　the　home　assessment?　Has　the　Occupational　Therapist　team　done　a　home　assessment　yet?

Andrea:　Not　yet.　Ive　booked　a　home　assessment　with　Occupational　Therapy　on　Monday,　12th　June.　Thatll　give　us　a　better　idea　about　the　sort　of　modifications　which　need　to　be　made　for　safety　and　to　allow　her　to　be　as　independent　as　possible.

Kim:　Good.　Im　pleased　with　her　progress.　The　weakness　on　her　left　side　has　partially　resolved.　Unfortunately,　shes　still　got　a　bit　of　trouble　with　vision　loss　on　that　side.　Ive　been　training　her　to　turn　to　the　left　to　look　for　anything　she　might　run　into.

Andrea:　Um,　Lidias　going　to　stay　with　her　daughter　until　the　safety　modifications　in　the　house　are　finished.

William:　Thats　good.　Tina,　what　about　speech　and　language　therapy?　Hows　she　doing?

Tina:　Well,　my　role　has　been　to　help　Lidias　swallow　reflex.　Ive　been　concentrating　on　her　swallowing　problem　and　speech　difficulties.　Remember　she　had　quite　a　lot　of　difficulty　swallowing　when　she　first　came　in.

Andrea:　Yes,　her　nutritional　status　was　quite　poor.　She　wasnt　used　to　the　food　they　serve　in　hospital.

Tina:　No,　its　very　different　from　her　usual　diet.　Her　daughters　brought　in　the　food　she　likes.　She　still　has　some　tongue　and　lip　weakness.　Its　quite　hard　for　her　to　speak　properly.　Ive　been　practicing　a　lot　of　mouth　exercises　with　her,　and　shes　certainly　improving.　Shes　always　been　a　very　social　person,　so　the　ability　to　communicate　is　important　to　her.

William:　Have　you　referred　her　for　speech　and　language　therapy　after　discharge?

Tina:　No,　I　havent　referred　her　to　a　Speech　Therapist　yet.　Thats　part　of　the　referral　to　the　District　Nurses.　Andrea,　youve　organized　that,　havent　you?

Andrea:　Not　yet.　I　wanted　to　wait　until　the　team　meeting　is　finished.　Ill　ring　this　afternoon.　So,　can　we　put　Lidias　expected　date　of　discharge　down　as　Friday,　9　June?

Now　youll　hear　Part　Three　again.　This　is　the　end　of　Part　Three.Now　look　at　Part　Four.

You　will　hear　a　speech　on　the　prostate　removal.Complete　the　notes　below　by　filling　each　space　21—25　with　a　single　word.　Write　the　answers　on　your　answer　sheet.　You　will　hear　the　speech　twice.

Male:　In　older　men　it　is　quite　common　for　the　prostate　to　enlarge　and　cause　the　symptoms　youve　been　experiencing.　To　relieve　these　symptoms,　it　may　be　necessary　to　remove　the　prostate　but　there　are　some　drugs　which　may　help.　Unfortunately,　I　dont　think　the　drugs　will　help　in　your　case　so　well　have　to　operate.

Before　your　operation,　I　would　like　to　explain　what　happens　when　your　prostate　gland　is　removed.　Youll　have　a　few　tests　before　your　operation,　like　blood　and　urine　tests,　heart　tracing,　a　chest　Xray　and　sometimes　an　IVP,　intravenous　pyelogram,　which　means　well　inject　some　contrasting　dye　into　your　vein　which　will　pass　through　the　kidneys　and　then　well　take　some　Xrays　of　your　kidneys.　You　will　speak　to　an　anesthetist　who　will　decide　on　your　type　of　anesthesia—a　general　when　you　would　be　completely　asleep　or　an　epidural　which　only　numbs　the　lower　part　of　your　body.

There　are　two　ways　of　removing　the　prostate.　One　is　by　operating　after　inserting　a　telescope　through　the　penis　or　by　making　a　cut　in　the　lower　abdomen.　Ill　decide　which　method　to　use　after　Ive　examined　you.

After　the　operation　your　urine　would　be　drained　by　a　tube　called　an　indwelling　catheter.　You　may　have　some　blood　in　the　tube.　Your　bladder　would　be　washed　with　water.　Youll　also　have　a　tube　in　your　arm　called　IV　which　may　supply　you　with　saline　or　blood.

Its　recommended　that　you　start　drinking　large　quantities　of　fluid　after　the　operation.　You　can　have　tea,　coffee,　squash　or　water　but　fizzy　drinks　are　not　recommended.　This　will　speed　up　your　recovery　and　wash　away　the　blood　in　the　catheter.

The　bladder　tube　will　be　removed　two　to　five　days　after　the　operation.　You　should　continue　to　drink　as　much　as　possible　and　pass　water　every　two　or　three　hours.　Depending　on　your　recovery,　you　are　usually　allowed　home　after　about　five　days.　Drink　a　lot　of　liquids　at　home　and　well　give　you　stool　softener　to　avoid　constipation.　If　you　have　any　problems,　call　your　doctor.

Your　sex　life　will　change　a　little.　You　can　have　intercourse　a　few　weeks　after　the　operation,　but　you　will　not　emit　any　semen　from　your　penis　at　sexual　climax.　Your　semen　will　flow　into　your　bladder　and　your　urine　may　be　cloudy　after　intercourse.　You　are　unlikely　to　produce　any　further　children　but　should　not　rely　on　this　as　safe　contraception.

Now　youll　hear　Part　Four　again.　This　is　the　end　of　Part　Four.　You　now　have　five　minutes　to　write　your　answers　on　the　answer　sheet.　You　have　one　more　minute.　This　is　the　end　of　the　test.

参考答案与试题评析

ⅠListening

Part　One

1.　【语段大意】　医生正对患者进行指导用药：针对血压的片剂，一日早晚两次，一次一片；针对胸部疼痛发作时的片剂，舌下给药(sublingual　tablet)，一日最多(a　maximum　of)两片。

【解题思路】　D可听到medication,　blood　pressure,　pain　comes　in　your　chest等关键信息。

2.　【语段大意】　患者踝部(ankle)水肿(swollen)，可能关节内有积血，医生建议使用绷带支撑(support　bandage)，足部抬高进行消肿，如不见缓解，须再次就医。

【解题思路】　C可听到ankle　is　very　swollen,　support　bandage等关键信息。

3.　【语段大意】　医生通过指导患者闭眼举臂，挥动手臂或指物等动作对患者进行双臂双腿神经检查(examine　your　arms　and　legs　neurologically)。

【解题思路】　A可听到examine，　arms　and　legs，　neurologically等关键信息。

4.　【语段大意】　患者为一早产(preterm)发育不全(immature)婴儿，须呼吸机辅助呼吸，且出现感染(infection)与黄疸(jaundice)，怀疑黄疸原因为早产及脑部出血(some　bleeding　in　the　brain)。

【解题思路】　F可听到immature,　preterm,　infection,　jaundiced等关键信息。

5.　【语段大意】　本题描述的是医生检查完患者后，发现患者极可能患有阑尾炎(appendicitis)，建议其住院接受静脉药物治疗(on　an　Ⅳ)，如无效，则将采取手术。

【解题思路】　B可听到appendicitis，　admit　you　to　hospital，　remove　the　appendix等关键信息。

Part　Two

【语篇大意】　护理实习生跟指导护士之间的对话。

【解题思路】

6.　A护理实习生Barbara负责322房间2床病人的护理，信息正确，故答案为A。

7.　B病人所做的是开腹胆囊切除术(open　cholecystectomy)，不是胃部手术，故答案选B。

8.　B该病人做的是开腹胆囊切除术(open　cholecystectomy)，不是腹腔镜胆囊切除术(laparoscopic　cholecystectomy)，故答案选B。

9.　A开腹胆囊切除术和腹腔镜胆囊切除术的术后护理是不相同的，故答案选A。

10.　C腹腔镜胆囊切除术作为胆结石(gallstones)病人的首选疗法已经取代了开腹胆囊切除术，句子本身并没有错，但对话中并没有提及，故答案选C。

11.　A术后病人的护理重点包括疼痛护理、切口护理、监测生命体征、循环和灌注，描述与对话中完全一致，故答案选A。

12.　A帮助术后病人有效咳嗽非常重要，因为有效咳嗽能减少术后肺炎的发病率，题目中描述完全正确，故答案选A。

13.　B咳嗽有益于肺部扩张(expand)、清洁气道，不是收缩肺部，故答案选B。

Part　Three

【语篇大意】　病人Lidia因中风住院一段时间后即将出院，康复病房的四位护士就Lidia的治疗进展召开的一次会议。

【解题思路】

14.　C本题是关于病人Lidia的基本情况，她是一位80岁的独居老人，俄罗斯人，显然答案为C。

15.　B本题是问Lidia的主要疾病，讨论中多次提到Lidia是因为中风住院的，所以答案为B。

16.　A本题是问Lidia什么时候被送到医院的，在病历介绍中提到她是在一个周日上午被女儿发现的，送到医院时已经过了中风发作的最初三小时，据此可推断她是在中风发作后的几小时被送到医院的，答案为A。

17.　B本题是针对讨论中这句话　“I　asked　her　about　her　goals　and　going　home　seems　to　be　top　of　the　list”而命题的，显然Lidia是想回到自己的家中，答案为B。

18.　C本题问家庭评估（home　assessment）预约的时间，Andrea明确提到是6月12日，周一，答案B中的6月9日，周五，是预计出院日期，故本题答案为C。

19.　A本题是关于Lidia出院后住处的问题，讨论中明确提到她将和女儿住在一起直到房屋安全改进完成。本题答案为A。

20.　B本题三个选项中，A是关于Lidia的视力问题，她的左眼视力受到影响，不是右眼，选项A错误。选项C中Tina　has　already　referred　Lidia　to　a　Speech　Therapist与文中不符，故本题答案为B。

Part　Four

【语篇大意】　关于前列腺切除手术的介绍。

【解题思路】

21.　enlarge此处为介绍开头提到老年人常见前列腺(the　prostate)肥大(enlarge)，并引起一系列症状。所以此处应填enlarge。

22.　intravenous文中讲述到医生认为针对此患者的前列腺肥大，药物治疗无效，建议考虑手术。在手术前，先做一系列检查，包括血液检查、尿液检查、心脏检查(heart　tracing)、胸部X光以及静脉内肾盂造影(intravenous　pyelogram)。所以此处应填intravenous。

23.　anesthesia文中讲述到手术前须与麻醉师(anesthetist)讨论麻醉类型(type　of　anesthesia)，一类是全身(general)麻醉，患者手术时处于安睡状态；一类是硬膜外(epidural)麻醉，仅麻醉下半身。根据短文内容，此处应填anesthesia。

24.　telescope文中讲述到两种切除前列腺的方法，一种从阴茎处(penis)插入手术操作镜(telescope)，一种在下腹部(the　lower　abdomen)直接开口。故此处应填telescope。

25.　indwelling文中提到在术后，尿液通过导尿管排泄，导尿管因插至下体内，并留置，所以称为indwelling　catheter。故此处应填indwelling。

ⅡReading

Part　One

【文章大意】　文章介绍了几种关于人们为何打呵欠的不同解释，以及打呵欠为何具有传染性的研究结果。

【解题思路】

26.　B第一段段首“We　do　know　lots　of　interesting　things　about　yawning”介绍了关于打呵欠有很多有趣的说法，段中与段尾“scientists　are　discovering　theres　more　to　yawning　than　most　people　think”，“However,　there　are　several　theories　about　why　we　yawn.”指出关于为何打呵欠还有更多的科学发现。

27.　A第二段段首“Scientists　propose　that　our　bodies　induce　yawning　to　draw　in　more　oxygen　or　remove　a　buildup　of　carbon　dioxide.”介绍有科学家指出打呵欠是人体排出二氧化碳，获得更多氧气的一种途径，可见这是从生理的角度探讨打呵欠的原因。

28.　F第三段首句“Some　think　that　yawning　began　with　our　ancestors,　who　used　yawning　to　show　their　teeth　and　intimidate　others.”介绍了一种观点，即祖先们打呵欠是为了以露齿的行为威吓对手，以及下文衍生出的理论“An　offshoot　of　this　theory　is　the　idea　that　yawning　developed　from　early　man　as　a　signal　for　us　to　change　activities.”早期人类打呵欠很可能是作为一种提示的信号。由此得知，此段是从进化论的角度来谈论打呵欠的原因。

29.　D第四段段首“A　more　recent　theory　proposed...its　a　way　to　cool　down　their　brains.”，以及段中“In　2007,　researchers...proposed　that　yawning　may　be　a　means　to　keep　the　brain　cool.”介绍了有研究认为，打呵欠是为了冷却大脑。故依据这一提法作答。

30.　C第五段首句“Recent　studies　show　contagious　yawning　may　be　linked　to　ones　capacity　for　empathy.”介绍了打呵欠有传染性可能与人的共情力有关，并在下文以对自闭症儿童和正常儿童的呵欠实验证明了这一观点。故据此选择。

31.　F定位第一段第一句话“We　do　know　lots　of　interesting　things　about　yawning:　you　start　yawning　in　uterus...”，uterus意思是“子宫”，即是指出生前就开始打呵欠，故选F。

32.　A定位第二段第三句话“Larger　groups　produce　more　carbon　dioxide,　which　means　our　bodies　would　act　to　draw　in　more　oxygen　and　get　rid　of　the　excess　carbon　dioxide.”，处理掉过量的二氧化碳与“exhale　excessive　carbon　dioxide”呼出多余的二氧化碳之意相符，故选A。

33.　D定位第三段最后一句话“Therefore,　the　‘contagious’　yawn　could　be　an　instinctual　reaction　to　a　signal　from　one　member　of　the　‘herd’　reminding　the　others　to　stay　alert.”，是本能的反应，故选D。

34.　C定位第四段第二句话“In　2007,　researchers,　including　a　professor　of　psychology,　from　the　University　of　Albany　proposed　that　yawning　may　be　a　means　to　keep　the　brain　cool.”，打呵欠是给大脑降温，保持大脑“凉爽”的一种途径，对应选项C，“regulation　of　brain　temperature”，调节大脑温度。

35.　E定位第五段第五句话“Since　autism　is　a　disorder　that　affects　a　persons　social　interaction　skills,　including　the　ability　to　empathize　with　others,　the　autistic　kids　lack　of　yawning　when　watching　others　do　so　could　indicate　theyre　less　empathetic.”，自闭儿童共情力差，故而少有受群体或环境感染而打呵欠的行为。对应选项E。

Part　Two

【文章大意】　本文在介绍阻塞性睡眠呼吸暂停综合征的影响因素和症状的基础上，指出不同类型的阻塞性睡眠呼吸暂停综合征诱因不同，不同人群患病风险不同。同时介绍了通过多导睡眠图技术研究睡眠呼吸暂停综合征，并提出了行为治疗、CPAP设备治疗和内置UAS等治疗方法。

【解题思路】

36.　B第一段第五句话“With　sleep　apnea,　your　breathing　pauses　multiple　times　during　sleep.”指出sleep　apnea意为“呼吸暂停”，故对应选项“without　breath”。

37.　D第一段第六句话　“The　pauses　can　last　from　a　few　seconds　to　minutes　and　can　occur　more　than　five　times　per　hour,　to　as　high　as　100　times　per　hour　(Fewer　than　five　times　per　hour　is　normal.)”括号中明确指出，每小时少于五次属于正常，故选项D“每小时四次”正确。

38.　C第二段第一句话“Obstructive　sleep　apnea,　the　most　common　type,　is　caused　by　a　blockage　of　the　airway,　usually　when　the　soft　tissue　in　the　back　of　the　throat　collapses.”指出气道阻塞是诱因，而这种情况常常出现于咽后部的软组织塌陷。据此作答。

39.　B第三段前两句话“Sleep　apnea　is　almost　twice　as　common　in　men　as　it　is　in　women.　Other　risk　factors　include:　being　overweight，being　over　age　40，smoking　and　so　on.”介绍了男性较女性更易出现睡眠呼吸暂停，另外，超重、吸烟、年龄超过40等也是危险因素，因而选B。

40.　A第五段首句“The　first　line　of　defense　can　be　behavioral.”介绍了以改变行为方式治疗睡眠呼吸暂停综合征，相关行为包括“weight　loss”“stop　using　alcohol　or　medicines”，即减重、戒酒与停止服用令人嗜睡的药物等。四个选项中只有A未提及。

41.　D第七段最后一句话“The　Inspire　device　is　surgically　implanted　below　the　collarbone　and　works　with...”指出这种呼吸装置是通过外科手术植入锁骨下方，因而是创伤性的手术；根据第六段最后两句话“CPAP　use　mild　air　pressure　to　keep　your　airways　open.　The　air　is　delivered　through　a　mask　that　fits　over　your　nose　and　mouth,　or　only　your　nose.”得知CPAP和UAS毫无相似点，因而B选项表述错误，而A、C两项均未提及。据此，只有D为正确的推论。

42.　C根据第二段“Obstructive　sleep　apnea,　the　most　common　type,　is　caused　by...The　less　common　form,　central　sleep　apnea,　happens　if...”判断A选项错误；根据第三段第一句话“Sleep　apnea　is　almost　twice　as　common　in　men　as　it　is　in　women.”判断B选项错误；第九段讨论的是UAS治疗睡眠呼吸暂停的原理和使用方法，因而该段最后一句话“The　patient　turns　the　system　on　before　going　to　sleep　and　off　upon　waking,　using　a　remote　control.”中“the　system”指的是“UAS”，故D错误；第七段第三句话“The　Inspire　Upper　Airway　System　(UAS)　is　intended　for　consumers　with　moderate　to　severe　OSA...”指出适合UAS手术的病患群体，因而C选项正确。

Part　Three

【文章大意】　这是一份病理检验专业的推介说明，介绍了课程目标、教学师生比、课程学制、学习内容、教学方法、实习和就业前景等。

【解题思路】

43.　A在“Year　two”关于第二学年学习内容与目标的介绍中指出“All　of　these　tests　aid　in　the　diagnosis　of　all　types　of　diseases.”，据此，病理检验所涉及的各种检验对诊断各类疾病均有辅助功能。题干说法正确。

44.　C在“Career　outlook”中指出“There　is　a　high　demand　for　technicians　to　work　in　...and　large　private　pathology　providers...”没有提到medical　universities有大量技术人员需求。故而题干说法错误。

45.　B“Working　with　industry”标题下第一段第一句话“You　will　undertake　20　days　of　work　experience　during　the　second　year,　organized　by　RMIT.”指出，第二学年里的实习时间仅为20天，而非整学年。题干说法错误。

46.　A“City　campus”标题下第四段第一句话“Class　sizes　are　small　and　the　stafftostudent　ratio　in　laboratories　allows　opportunities　for　individual　teaching.”指出小班教学与实验室师生比为个体化教学提供了保障。题干说法正确。

47.　C“Pathways”标题下　“Graduates　of　the　Diploma　of　Laboratory　Technology　(Pathology　Testing)　who　are　successful　in　gaining　a　place　are　eligible　to　apply　for　exemptions　of　up　to　one　year　(96　credit　points)　from　the　following　programs.”指出，病检毕业生成功考取以下专业有资格申请免修96学时的课程，而题干意为学生要完成所有课程方可申请期末考试免考，文中没有涉及此信息。题干说法错误。

48.　B“Year　one”标题下第一段“The　first　year　provides　you　with　a　foundation...”和　“Year　two”标题下第一段　“The　second　year　involves　more　specialized　study...”分别指出，学生在第一学年主要学习基础课程，而在第二学年才会学习更多的专业课程。题干说法错误。

49.　A“Year　two”标题下第二段第一句话“You　will　learn　the　skills　to...,　as　well　as　how　to　prepare　thin　slices　of　liver　and　other　tissues　to　examine　microscopically.”指出，学生在第二学年中习得如何准备肝脏薄片和其他组织切片用于显微镜检查，故毕业生具备该能力。题干说法正确。

50.　C“Professional　recognition”一段中首句“Students　are　eligible　for　student　membership　of　the　Australian　Society　for　Microbiology　and...”指出，学生有资格申请加入澳大利亚微生物学协会。题干说法，所有学生都一定是病理学协会成员，文中未提及。

Part　Four

【文章大意】　文章介绍了有关安慰剂的争议、安慰剂的效应原理、经典条件反射和预期效应对安慰剂效应的作用，并罗列了安慰剂被当作万能药剂的诸多事例。

【解题思路】

51.　E文章开篇指出，Moerman和Jonas认为将安慰剂效应定义为一种生理效应不合逻辑，因为安慰剂成分并无任何直接效用，并在下文进一步提出使用安慰剂是不道德的。E选项表达了Moerman和Jonas的看法，衔接紧密、逻辑合理。

52.　B此段段首介绍了Irving　Kirsch的猜想，即安慰剂效应来源于预期效应中的自我满足效应。结合所缺部分之后的两句，它们分别讨论了经典条件反射和预期效应对安慰剂效应的作用，因此缺失部分应为关于经典条件反射和预期效应的承接句，“Both　conditioning　and　expectations　play　a　role　in　placebo　effect”为合理衔接，因而选B。

53.　C所缺部分的上句提到，研究发现，患者对安慰剂应答率的提高来自医生的关怀、关注和信心；所缺部分的下句又再次提及患者的信念也会对安慰剂效应有影响。作为承接句，应选择预期效应的发生与一系列因素有关，因而选C。

54.　A此段首句指出，如果患者被告知他们的预期不现实或者安慰剂无效，安慰剂就不会起作用，这是因为安慰剂效应是建立在预期和条件反射基础上的。A选项“一旦向患者解释了这种效应机制，条件反射式的疼痛缓和效果就会完全消失”则是对以上理论的举例说明，因而是合理衔接。

55.　F此段首句为主题句，指出安慰剂的万能，被当作肌肉松弛剂、兴奋剂、镇静剂等，并给出了

例子，如所缺部分的上句以“安慰剂可以帮助吸烟者戒烟”举例说明安慰剂效应，下一句可能仍是举例，F选项则是举例说明想象中的过敏原导致过敏的情况，与前面例子呈并列关系，是合理衔接。

Part　Five

【文章大意】　文章介绍了基因能够决定人对药物的反应，科学家通过药物基因组学研究发现基因变异与药物毒理之间的联系。由此指出，未来对药物基因组学的研究能够有助于医生为患者开出更为有效的药物，尽可能避免药物的毒副作用。

【解题思路】

56.　D基因决定高矮、发色，基因同样能够决定人对药物的反应，D项正确。predict：预测；diagnose:诊断；calculate:计算，均不合适。

57.　C上文介绍了基因决定人对药物的反应，随着药物进入体内，药物和蛋白质相互作用，C项正确。contact:联系，connect：连接，均不合理；act:行动，不与with连接。

58.　A科学家希望能够帮助医生视不同的个体来开处方。prescribe:开药方；deliberate:慎重的，仔细考虑；describe:描绘；banner:旗帜，标语。

59.　A上句说明一些药物给部分病人带来严重的副作用，这句话则举例副作用，可描述副作用的只有A选项，toxic:有毒的。“可待因作为止疼药对10%的病人无效以及一种抗癌药物对极少部分人毒性甚强。”其他选项为effective:有效果的；beneficial:有利的；fierce:猛烈的。

60.　B“这一认知使得研究者迅速定位酶的基因变体，正是这种变体导致了危险反应的发生。”　依据句意，只有介词as符合逻辑和搭配。

61.　D“一些制药公司采集了临床病人的DNA”，这样的行为应该是在得到受试者同意之后，故依据句意，只能选After。

62.　B“药物基因组学研究者们已经识别出了很多基因因变异而影响了药物应答。”下一句“others”代指上句中的“genes”，意指“药物基因组学研究者们也知道何处可以找到更多的此类基因”，且“others”后连接了一个定语从句，关系代词that在从句中做宾语被省略。从句中，“be　bound　to”为固定短语，表示“必然”，从句意为“那些基因是研究者们未来必然会发现的”。

63.　C此部分为非限制性定语从句，以which指代“人类基因组序”，从句部分在全句中不充当成分，只用来补充信息。

64.　C“未来药物基因组学将使得医生初次诊疗就能给病人开出正确的药及正确的剂量。”为此句动词“使得”加上一个合适的副词，只有increasingly表示能力渐增。其他选项意思为seriously:　严重地、认真地；therapeutically:　治疗上地；exclusively:　专有地。

65.　A此处指识别药物毒副作用的基因基础将会使得常见救命药继续使用下去。常见救命药为frequently　lifesaving　medications，　其余选项意思为consequently：因此；　infrequently：罕见地；undoubtedly：毋庸置疑地。

ⅢWriting

66.　【范文】

Should　Nurses　Go　Abroad　to　Work?

Many　Chinese　nurses　want　to　go　abroad　to　work.　According　to　the　result　of　an　online　questionnaire,　81%　of　the　respondents,　most　of　whom　are　university　nursing　students,　say　that　they　want　to　work　in　a　hospital　in　the　USA　or　Australia.

There　are　at　least　two　reasons　behind　this　phenomenon.　First　of　all,　nurses　in　some　developed　countries　are　very　highly　paid.　It　is　said　that　in　Australia,　for　example,　a　nurse　with　a　working　experience　of　5　or　6　years　can　earn　as　much　as　60,　000　Australian　dollars　a　year.　Secondly,　working　in　a　foreign　country　gives　nurses　much　needed　experience.　This　will　certainly　add　some　weight　to　their　resumes　and　help　them　find　better　job　opportunities　when　they　return　to　China.

Considering　the　benefits　working　overseas　might　bring,　Chinese　nurses　enthusiasm　to　work　abroad　should　not　be　dampened.　But　nursing　abroad　can　also　pose　a　number　of　challenges　like　the　culture　difference　and　the　language　barrier.　Nurses　need　to　think　twice　before　they　make　the　final　decision.　(177　words)

【审题】

写作部分要求根据给定的话题“中国很多护士选择出国工作的现象”进行写作。本部分给出段落提示句，要求先提出这一现象，然后分析造成这种现象的原因，最后阐明自己关于这一现象的看法。文章的主体部分在第二、三两段，要求考生对这一社会现象进行解释并加以评论，第二部分一般使用列举法，要注意第三部分段落扩展的三种常见方法：同意的观点、反对的观点、折中的观点。

【范文评析】

文章根据段落提示句，第一段首句开门见山，指出目前存在的一种社会现象，而后列举统计数据加以支撑。文章的重点放在第二段的原因分析及第三段的作者观点阐述上。第二段第一句总领全段，随后从两个方面给出具体的原因，使用了举例子、列数据的方式，增强说服力。第三段简明扼要，从正反两方面表达观点，以but作为转折，既看到了护士出国就业的优势及热情，也不能忽视其中的困难和挑战。

文章主题明确，结构清晰，层次分明，阐述部分客观全面，每个主题句都有适当的扩展或说明；正确使用first　of　all,　secondly等列举用语，准确运用国外就业话题相关的一些词汇表达；句式多样，灵活运用了非限制性定语从句（most　of　whom　are　university　nursing　students）、插入语（for　example）、现在分词状语结构(Considering　the　benefits　working　overseas　might　bring)；词汇短语水平上的亮点有：as　much　as,　add　some　weight　to,　pose　a　number　of　challenges,　think　twice　before等。

医护英语水平考试(三级)

模拟训练（三）

听力文本

This　is　METS3　listening　test.　There　are　four　parts　in　the　test.　Part　One,　Two,　Three,　and　Four.　You　will　hear　each　part　twice.　We　will　now　stop　for　a　moment　before　we　start　the　test.　Please　ask　any　questions　now　because　you　must　not　speak　during　the　test.　Now,　look　at　the　instructions　for　Part　One.

You　will　hear　five　extracts　from　conversations　taking　place　in　different　clinical　departments.　Choose　which　case　each　doctor　is　discussing　from　the　list　A—F.　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　do　not　need　to　use.　Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　each　extract　twice.　Now　we　are　ready　to　start.

Extract　1

A　55yearold　housewife,　who　had　been　well　until　four　months　ago,　complained　of　tiredness　and　malaise.　She　had　gained　9　kg　in　weight　in　the　year　before　she　presented　to　her　GP　although　she　denied　eating　more　than　usual.　She　was　constipated　and　she　noticed　that　her　hair　had　started　to　fall　out.

Extract　2

A　48yearold　man　is　noted　to　have　a　2day　history　of　sore　throat,　subjective　fever　at　home,　and　no　medical　illnesses.　He　denies　cough　or　nausea.　On　examination,　his　temperature　is　38.3　°C,　and　he　has　some　tonsillar　swelling　but　no　exudates.　He　has　bilateral　enlarged　and　tender　lymph　nodes　of　the　neck.　The　rapid　streptococcal　antigen　test　is　negative.

Extract　3

A　22yearold　student　was　admitted　to　hospital　with　a　long　history　of　heart　problems.　She　had　been　increasingly　tired,　with　shortness　of　breath　on　exertion,　orthopnea,　and　palpitations.　A　mitral　valve　replacement　had　been　carried　out　3　years　previously　and　this　had　stabilized　the　symptoms　of　heart　failure　but　was　followed　by　episodes　of　atrial　fibrillation,　which　had　been　particularly　severe　for　the　6　months　before　admission.

Extract　4

A　64yearold　man　presents　to　the　emergency　department　(ED)　due　to　an　inability　to　urinate　for　the　past　24　hours.　In　addition,　he　complains　of　an　unintentional　weight　loss　of　20　lb　over　the　past　6　months,　night　sweats,　and　fatigue.　On　examination,　he　is　thin　and　in　moderate　distress.　His　blood　pressure　is　168/92　mmHg,　heart　rate　is　102　beats　per　minute,　temperature　is　37.7　℃,　and　respiratory　rate　is　22　breaths　per　minute.　The　abdominal　examination　reveals　a　tenderness　mass　in　the　suprapubic　area.　On　rectal　examination,　the　prostate　is　firm,　nontender,　and　somewhat　irregular.

Extract　5

On　examination,　he　looked　unwell.　His　pulse　rate　was　100/minute.　He　had　a　palpable　spleen.　The　combination　of　fever　and　rigors　in　a　patient　who　has　recently　returned　from　Africa　strongly　suggests　a　diagnosis　of　malaria.　The　incubation　period　is　usually　1014　days.　In　this　case,　the　patient　admitted　he　had　not　been　taking　prophylaxis　regularly.　The　diagnosis　was　confirmed　by　the　presence　of　parasites　in　his　blood　film.

Now　youll　hear　Part　One　again.　This　is　the　end　of　Part　One.　Now　look　at　Part　Two.

You　will　hear　a　conversation　between　a　chief　physician　and　a　patient.　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).　Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　the　recording　twice.

Chief　Physician:　How　are　you　today,　sir?

Patient:　Not　bad,　professor.　But　the　pain　still　bothers　me　much.

Chief　Physician:　Oh.　Could　you　point　the　positions　of　the　pain?

Patient:　Of　course.　Mainly　in　my　waist,　as　well　as　the　chest,　back　and　thigh.

Chief　Physician:　Always　such　painful?

Patient:　No.　At　the　beginning,　it　didnt　reach　such　a　large　range　and　mainly　appeared　after　activities　although　resulting　in　the　operation　14　years　ago.　I　did　feel　much　better　after　it.　But　during　recent　years,　the　pain　is　always　torturing　me　so　much　that　I　can　hardly　turn　around　and　have　to　use　great　efforts　for　each　sittingdown　or　standingup.

Chief　Physician:　Anything　else　uncomfortable?

Patient:　Yes.　My　appetite　has　become　less　and　less　in　recent　years.　However,　I　often　feel　hungry,　which　sometimes　causes　rapid　heartbeat　and　sweating.　So　I　have　to　eat　something　to　relieve　it,　but　you　see,　I　can　only　eat　a　little,　otherwise,　I　will　feel　abdominal　distention,　and　gastric　pain　sometimes.

Chief　Physician:　Oh,　gastric　pain.　What　time　do　you　feel　it　more　significant?　Will　you　get　better　after　meals?

Patient:　Oh,　its　irregular.　Whether　Im　empty　or　full,　it　may　come,　and　sometimes　it　wakes　me　up　during　midnight.

Chief　Physician:　And　anything　else?

Patient:　Oh,　Im　always　feeling　weakness　and　exhausted.

Chief　Physician:　Do　your　bowels　and　urine　always　go　well?

Patient:　Er...No.　In　fact　I　have　been　always　constipated　and　piss　much　at　night.

Chief　Physician:　Are　you　coughing　recently?

Patient:　No.

Chief　Physician:　Any　changes　in　your　body　weight?

Patient:　Yes.　I　have　been　always　becoming　thinner　these　years.　Now　I　have　lost　over　10　kg.

Chief　Physician:　Do　you　know　yourself　in　the　emergency　room　4　days　ago?

Patient:　Yes.　But　at　that　time　I　was　quite　confused,　just　feeling　thirsty　and　longing　for　water,　while　nausea　and　vomiting　at　the　same　time.　I　recognized　here　on　recovering　awareness.

Chief　Physician:　All　right.　Now　could　we　give　you　an　examination?

Patient:　Of　course.

Now　youll　hear　Part　Two　again.　This　is　the　end　of　Part　Two.　Now　look　at　Part　Three.

You　will　hear　a　conversation　between　the　patient　Krista　and　the　nurse　Shirley　about　her　concerns　on　Cesarean　section.　For　questions　14—20,　choose　the　most　appropriate　answer.　Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　the　conversation　twice.

Krista:　Hi,　Shirley,　I　am　scheduled　to　have　a　Csection　at　9　am　next　Monday.　May　I　ask　you　some　questions?

Shirley:　Sure,　please.

Krista:　What　kind　of　anesthesia　will　I　have　for　the　Cesarean?

Shirley:　You　are　going　to　have　epidural　anesthesia.

Krista:　I　am　not　going　to　be　put　to　sleep,　right?

Shirley:　Youre　right.　With　an　epidural,　you　will　be　awake　and　alert.　Once　the　baby　is　out　of　your　uterus,　the　doctor　probably　will　let　you　see　the　baby,　and　if　you　want,　you　can　hold　your　baby　for　a　while.

Krista:　Good,　thats　what　I　hope　to　do.　My　husband　will　be　allowed　to　stay　in　the　operating　room,　wont　he?

Shirley:　Yes.　On　the　scheduled　day,　you　come　here　with　your　husband.　The　nurse　will　prepare　you　first　and　transport　you　to　the　OR.　When　everything　is　ready　and　its　time　for　the　operation,　your　husband　will　be　called　in　to　sit　by　you.

Krista:　Will　the　operation　scare　him?

Shirley:　The　seat　for　your　husband　to　sit　in　will　be　behind　a　screen.　He　will　not　be　able　to　see　the　operation.

Krista:　Why　should　he　sit　behind　the　screen?

Shirley:　Because　his　role　in　the　OR　is　to　support　you.　He　is　not　there　to　observe　the　operation,　does　that　make　sense?

Krista:　Yes,　it　does.

Shirley:　It　is　not　recommended　that　a　lay　person　watch　the　operation.　We　have　had　husbands　passed　out　in　the　delivery　suite.

Krista:　I　am　also　worried　about　that.　OK,　Ill　tell　my　husband　he　wont　get　to　watch　the　operation.　But　he　can　hold　the　baby,　right?

Shirley:　Sure　he　can.　He　is　there　for　you　and　the　baby　as　well.

Krista:　What　about　recovery　after　the　Cesarean?

Shirley:　After　the　surgical　procedure　is　done,　you　will　be　sent　to　the　PACU,　the　post　anesthesia　care　unit.　You　are　going　to　stay　there　for　a　few　hours　until　your　vital　signs　are　stable.

Krista:　Will　the　baby　go　with　me　to　the　PACU?

Shirley:　No.　Usually　the　baby　will　be　sent　to　the　nursery,　where　the　nurse　will　give　him　or　her　a　bath　and　administer　some　required　medications.　A　pediatrician　might　come　to　see　the　baby　during　that　period　of　time.

Krista:　Thats　good.

Shirley:　When　the　anesthesiologist　signs　you　off,　you　will　be　transferred　to　the　postpartum　unit.

Krista:　Will　I　be　able　to　breastfeed　after　a　Csection?

Shirley:　Yes,　actually,　breastfeeding　is　encouraged.　You　can　start　breastfeeding　right　away　after　the　surgery　although　you　might　not　have　any　milk　produced.

Krista:　I　learned　this　from　a　book.　The　babys　suction　will　stimulate　milk　production　and　its　good　for　uterine　recovery.

Shirley:　Youre　right.

Krista:　Ill　try　to　breastfeed　my　baby.

Shirley:　Thats　good　for　you　and　your　baby.

Krista:　Thank　you　for　answering　my　questions.

Shirley:　Its　my　pleasure.

Now　youll　hear　Part　Three　again.　This　is　the　end　of　Part　Three.　Now　look　at　Part　Four.

You　will　hear　a　talk　of　case　history　about　a　patient　Mr.　Zhang.

Complete　the　notes.　In　each　Blank,　write　only　one　word.　Write　the　answers　on　your　answer　sheet.　You　will　hear　the　talk　twice.

Male:　Zhang　Hang,　a　45yearold　man　of　oversea　Chinese,　presented　in　September　14,　2017　with　lethargy　and　polyuria.　His　family　physicians　had　noted　a　high　serum　calcium　(3.4　mmol/L)　and　a　low　albumin　(30　g/L).　Twenty　years　ago,　just　two　years　after　he　had　immigrated　to　Canada,　he　had　undergone　an　emergency　portacaval　shunt　for　bleeding　esophageal　varices.　On　that　occasion,　but　on　no　other,　he　had　received　blood　transfusions.　He　routinely　drank　two　glasses　of　wine　with　his　evening　meal.　There　were　no　other　risk　factors　for　liver　disease　known.　In　the　interval,　he　had　been　well　and　had　required　medical　attention.　The　referring　specialist　had　assayed　the　parathyroid　hormone　(PTH)　level　at　21.6　pmol/L　(normal　0—5.8　pmol/L).　A　search　for　a　parathyroid　adenoma　or　metastatic　cancer　was　undertaken.　Ultrasound　examination　of　the　abdomen　revealed　a　solitary　lesion　in　the　right　lobe　of　the　liver.　CT　scan　of　the　neck　and　the　bone　scan　were　normal.　Initial　treatment　consisted　of　intravenous　rehydration　and　diuretics.　Subsequently,　the　patient　felt　much　better.

On　examination,　the　patient　has　a　fit　looking,　with　considerable　anxiety　regarding　the　state　of　his　health　and　his　prognosis,　with　no　evidence　of　confusion　or　amnesia.　Signs　of　liver　disease　included　scattered　spider　nevi　on　his　chest.　He　did　not　appear　jaundiced　or　anemic.　No　lymphadenopathy　was　palpable.　There　was　no　ankle　edema.　His　abdomen　was　soft,　with　no　organomegaly　or　ascites.

The　dynamic　CT　scan　showed　a　middle　(3　cm×3　cm)　solid　occupied　lesion　in　anatomic　right　lobe　of　the　liver.　Doppler　ultrasound　of　the　liver　vessels　confirmed　the　presence　of　a　side　to　side　portacaval　shunt　with　blood　flow　in　the　portal　vein　away　from　the　liver.　There　were　no　retroperitoneal　varices　and　the　spleen　was　of　normal　size.

Now　youll　hear　Part　Four　again.　This　is　the　end　of　Part　Four.　You　now　have　five　minutes　to　write　your　answers　on　the　answer　sheet.　You　have　one　more　minute.　This　is　the　end　of　the　test.

参考答案与试题评析

ⅠListening

Part　One

第一部分是信息配对题，考生在听完每一个病例描述后，需要选出正确的对该病例的概述。

1.　【语段大意】　本题中的患者是一位55岁的家庭主妇，主诉是疲劳和不适。否认进食增多但体重增加，有便秘及脱发等症状。

【解题思路】　C听到tiredness/fatigue，　malaise，　weight　gain，　constipation，　hair　loss等这些词。很显然，答案为C。

2.　【语段大意】　本题中的患者是一位48岁的男性，咽痛、发烧两天，否认咳嗽或恶心。体温38.3　℃，扁桃体肿大但无分泌物，双侧颈部淋巴结肿大触痛。快速链球菌抗原测定为阴性。

【解题思路】　E可听到swollen　tonsils，no　exudates故E为正确答案，F为错误干扰项。

3.　【语段大意】　本题中的患者是一名长期患有心脏疾病的22岁学生，疲劳、用力后气短、端坐呼吸、心悸。三年前接受二尖瓣置换术(mitral　valve　replacement)，心衰症状稳定，但伴有房颤发作，入院前半年尤其严重。

【解题思路】　B可听到mitral　valve　replacement故选项B为正确答案。

4.　【语段大意】　本题中的患者为一名64岁的男性，因24小时无尿来到急诊科。主诉为体重减轻、盗汗、疲劳。

【解题思路】　A可听到inability　to　urinate,　weight　loss,　night　sweats　and　fatigue与选项A吻合，故答案为A。

5.　【语段大意】　本题描述的是一名刚从非洲回来的病人，他可能患上了疟疾。

【解题思路】　D可听到having　malaria。显然答案为D。

Part　Two

【语篇大意】　第二部分是主任医师跟患者的对话，考生根据听到的对话内容判读正误。

6.　【解题思路】　B本题是一道细节题，文中病人描述疼痛主要在腰部，还有胸部、后背及大腿，但本题中描述成腹部、胸部、后背及大腿，故答案为B。

7.　【解题思路】　A对话中病人提及14年前曾接受手术来缓解疼痛，故答案为A。

8.　【解题思路】　B病人描述之前的疼痛部位没有这么广，主要是在活动后出现。本题关于疼痛范围的描述有误，所以答案为B。

9.　【解题思路】　A近几年，病人苦受疼痛折磨，几乎不能转身，每次坐下或站起都很费劲，题目中的描述完全吻合，故A正确。

10.　【解题思路】　B在询问病史时，病人提及食欲不佳，但常有饥饿感，并且一饿就觉得心慌、出冷汗。题目中描述病人有饱胀感、食欲不佳，与原文不符，因此选B。

11.　【解题思路】　C整篇对话并没有提到病人多次去看医生，但病情并无好转，故选C。

12.　【解题思路】　B病人主诉包括疲劳、无力、便秘、夜尿但无咳嗽，故选B。

13.　【解题思路】　A对话中提到四天前，病人意识模糊，进入急救室，故A正确。

Part　Three

【语篇大意】　第三部分是一位即将进行剖宫产手术的产妇(Krista)向护士(Shirley)咨询剖宫产的相关问题，要求考生在理解的基础上完成七道选择题。

14.　【解题思路】　C本题问Krista剖宫产的时间，对话开始明确提到是9　am　next　Monday，所以答案很显然是C。关键信息：I　am　scheduled　to　have　a　Csection　at　9　am　next　Monday.

15.　【解题思路】　B本题是Krista向Shirley咨询的第一个问题，即本次剖宫产中会采用何种麻醉。护士明确回答是硬膜外麻醉(epidural　anesthesia)，故B为正确答案。关键信息：What　kind　of　anesthesia　will　I　have　for　the　Cesarean?/You　are　going　to　have　epidural　anesthesia.

16.　【解题思路】　C本题还是跟麻醉有关的问题，硬膜外麻醉时，产妇是清醒的，故答案为C。关键信息：Youre　right.　With　an　epidural,　you　will　be　awake　and　alert.

17.　【解题思路】　A产妇丈夫在手术室中是坐在屏幕后的，因为他的主要任务不是观摩手术过程，也不是去抱孩子，而是给产妇提供支持。所以答案应该选A。

关键信息：

Because　his　role　in　the　OR　is　to　support　you.　He　is　not　there　to　observe　the　operation,　does　that　make　sense?/The　seat　for　your　husband　to　sit　in　will　be　behind　a　screen.　He　will　not　be　able　to　see　the　operation.

18.　【解题思路】　B剖宫产手术后，病人从产房(delivery　suite)出来，首先会被送到麻醉后监护室(PACU)，等麻醉清醒后才会送到产后恢复室(postpartum　unit)，所以本题答案为B。关键信息：After　the　surgical　procedure　is　done,　you　will　be　sent　to　the　PACU,　the　post　anesthesia　care　unit.

19.　【解题思路】　A麻醉师同意离开后，产妇应该转入产后恢复室(postpartum　unit)，所以本题答案为A。关键信息：When　the　anesthesiologist　signs　you　off,　you　will　be　transferred　to　the　postpartum　unit.

20.　【解题思路】　A本题涉及Krista问的最后一个问题，剖宫产后是否能够母乳喂养。事实上，我们提倡母乳喂养，剖宫产后尽管不能立刻产奶但也可以开始母乳喂养，婴儿的吮吸能刺激乳汁的分泌，对于子宫的恢复也是有帮助的。显然只有A是错误的，B和C都是正确的。本题答案为A。关键信息：You　can　start　breastfeeding　right　away　after　the　surgery　although　you　might　not　have　any　milk　produced.　The　babys　suction　will　stimulate　milk　production　and　its　good　for　uterine　recovery.

Part　Four

【语篇大意】　第四部分是一段病历描述，在听完后需要完成表格中的五个信息填空。如果考生对病历书写的格式以及内容比较熟悉的话，这一部分就相对容易了。

【解题思路】

21.　albumin文中提到家庭医生发现病人高血钙、低白蛋白。此处应填albumin.

22.　varices文中提到既往史部分提到病人20年前因食管静脉曲张出血而做了急诊门腔静脉分流术，此处应填varices。

23.　solitary文中提到腹部超声检查发现右肝叶有单个肿块，根据短文内容，此处应填solitary。

24.　occupied文中讲述动态CT扫描显示右肝叶有中等大小的实质性占位病变(solid　occupied　lesion)，故此处应填occupied。

25.　diuretics文中讲述最初治疗包括静脉补液和给予利尿剂(diuretics)，此处应填diuretics。

ⅡReading

Part　One

【文章大意】　文章指出神经递质和一些化学物质是主导人类睡眠的重要因素，同时介绍了夜间睡眠的五个阶段及各个阶段中的身体状态。

【解题思路】

26.　B参照第一段最后一句话“Moreover,　sleep　affects　our　daily　functioning　and　our　physical　and　mental　health　in　many　ways　that　we　are　just　beginning　to　understand.”。

27.　D参照第二段第一句话“Nervesignaling　chemicals　called　neurotransmitters　control　whether　we　are　asleep　or　awake　by　acting　on　different　groups　of　nerve　cells,　or　neurons,　in　the　brain.”，第二段其余部分举出脑干神经元、大脑基部神经元以及腺苷控制睡眠的例子。

28.　F参照第三段第一句“During　sleep,　we　usually　pass　through　five　phases　of　sleep:　stages　1,　2,　3,　4,　and　REM　(rapid　eye　movement)　sleep.”。

29.　A参照第四段“During　stage　1...When　we　enter　stage　2　sleep...In　stage　3...By　stage　4...”。

30.　E参照第五段　“When　we　switch　into　REM　sleep,　our　breathing...　our　eyes...　and　our　limb　muscles...Our　heart　rate...”。

31.　D定位第三段第二句话“These　stages　progress　in　a　cycle　from　stage　1　to　REM　sleep,　then　the　cycle　starts　over　again　with　stage　1.”。

32.　A定位第二段第一句话“Nervesignaling　chemicals　called　neurotransmitters　control　whether　we　are　asleep　or　awake　by　acting　on　different　groups　of　nerve　cells,　or　neurons,　in　the　brain.”。

33.　F定位第三段第三句话“We　spend　almost　50　percent　of　our　total　sleep　time　in　stage　2　sleep...”和第四段第六句话“When　we　enter　stage　2　sleep,　our　eye　movements　stop　and　our　brain　waves　become　slower...”。

34.　B定位第四段第九和第十二句话“It　is　very　difficult　to　wake　someone　during　stages　3　and　4,　which　together　are　called　deep　sleep.　Some　children　experience　bedwetting,　night　terrors,　or　sleepwalking　during　deep　sleep.”。

35.　E定位第五段最后一句话“When　people　awaken　during　REM　sleep,　they　often　describe　bizarre　and　illogical　tales—dreams.”。

Part　Two

【文章大意】　文章主要介绍了肠道易激综合征的症状、发病机制以及诱因等内容。

【解题思路】

36.　D参照第一段第一句话“Irritable　bowel　syndrome　(IBS)　is　a　common　intestinal　condition　characterized　by　abdominal　pain　and　cramps;　changes　in　bowel　movements　(diarrhea,　constipation,　or　both)...”。

37.　C参照第二段第一句话。

38.　A参照第三段第二句话“It　is　called　a　functional　disorder　because　it　is　thought　to　result　from　changes　in　the　activity　of　the　major　part　of　the　large　intestine　(the　colon).”。B和C选项意为形态上紊乱和结构上的改变，不符合原文。

39.　B参照第三段第九句话“Sometimes　there　is　too　little　peristalsis,　which　can　slow　the　passage　of　undigested　material　through　the　colon　and　cause　constipation.”。

40.　C第四段第一句话“Some　kinds　of　food　and　drink　appear　to　play　a　key　role　in　triggering　IBS　attacks.”指出一些食品和饮料是IBS的重要诱因，接着下句以巧克力、奶制品、咖啡因及大量酒精为例说明了这个问题，显然答案为C选项，意为致病因素。

41.　D文章第四段第一句话、第五段第一句和最后一句话提到了一些食物和饮料、压力及某些激素是IBS的诱因，而从第五段第二句话“Although　researchers　do　not　yet　understand　all　of　the　links　between　changes　in　the　nervous　system　and　IBS,　they　point　out　the　similarities　between　mild　digestive　upsets　and　IBS.”中看出，轻度消化不良与肠道易激综合征具有相似性，而不是肠道易激综合征的原因，因而选D。

42.　C根据第三段第八句话“In　IBS,　however,　the　normal　rhythm　and　intensity　of　peristalsis　is　disrupted.”判断C选项正确；根据第二段第三句话“Although　modern　medicine　recognizes　that　stress　can　trigger　IBS　attacks,　medical　specialists　agree　that　IBS　is　a　genuine　physical　disorder...”判断B选项错误；根据第四段最后一句话“Characteristically,　IBS　symptoms　rarely　occur　at　night　and　disrupt　the　patients　sleep.”判断D选项错误；而A选项未提及，因而本题选C。

Part　Three

【文章大意】　本文介绍了病毒抗癌疗法的优点、抗癌机制及相关研究成果。

【解题思路】

43.　B根据第二段“If　successful,　virus　therapy　could　eventually　form　a　third　pillar　alongside　radiotherapy　and　chemotherapy　in　the　standard　arsenal　against　cancer,　while　avoiding　some　of　the　debilitating　sideeffects.”可以看出，病毒疗法可避免导致患者身体虚弱的某些副作用，而不是完全没有副作用。

44.　A参照第三段最后一句话“Cancer　Research　UK　said　yesterday　that　it　was　exciting　by　the　potential　of　Prof　Seymours　pioneering　techniques.”。

45.　C病毒能够杀死癌细胞在文章前几段得到多次表述，而病毒能够抑制癌细胞再生在文中未提及。

46.　A参照第五段第三、四句话“If　you　can　get　a　virus　into　a　tumor,　viruses　find　them　a　very　good　place　to　be　because　theres　no　immune　system　to　stop　them　replicating.　You　can　regard　it　as　the　cancers　Achilles　heel.”。

47.　B参照第六段第一句话“Only　a　small　amount　of　the　virus　needs　to　get　to　the　cancer.”。

48.　A参照文章第七段。

49.　C题干在文中未提及。

50.　A参照第十段“‘What　weve　done　is　make　chemical　modifications　to　the　virus　to　put　a　polymer　coat　around　it—its　a　stealth　virus　when　you　inject　it,’　he　said.”。　本段承接上一段，因此，“he”指代“Prof　Seymour”。

Part　Four

【文章大意】　文章介绍了人被挠痒时发笑的原因，大笑对身体和健康的影响以及大笑时人脑活动状态。

【解题思路】

51.　A上几句中“but　the　inevitable　occurs:　what　you　anticipated—you　are　tickled　and　in　hysterics　you　chuckle,　titter,　and　burst　into　uncontrollable　laughter.”指出人被挠痒会咯咯笑，下段“Tickling　is　caused　by　a　light　sensation　across　our　skin.”分析了这种现象的原因，因而A是合理衔接。

52.　C上句提到“Heavy　laughter　is　caused　by　someone　or　something　placing　repeated　pressure　on　a　person　and　tickling　a　particular　area.”，在身体某个地方挠痒时会发出大笑，C选项紧接着列举具体部位。

53.　E本段谈到“Laughter　requires　the　coordination　of　many　muscles　throughout　the　body.　Laughter　also　increases　blood　pressure　and　heart　rate,　changes　breathing,　reduces　levels　of　certain　neurochemicals　(catecholamines,　hormones)　and　provides　a　boost　to　the　immune　system.”。大笑需要身体各部位肌肉的协调，会影响身体诸多健康指标，对健康也有促进作用，因而作为本段首句，E是合理衔接。

54.　B参照第四段第三句话“Preliminary　results　indicate　that　the　humorprocessing　pathway　includes　parts　of　the　frontal　lobe　brain　area,　important　for　cognitive　processing;　the　supplementary　motor　area,　important　for　movement;　and　the　nucleus　accumbens,　associated　with　pleasure.”。

55.　F在上文“Investigations　support　the　notion　that　parts　of　the　frontal　lobe　are　involved　in　humor.　Subjects　brains　were　imaged　while　they　listened　to　jokes.”谈及的实验中得到证实，前额叶部分区域参与了幽默信息处理过程。当受试者在听笑话时，他们大脑活动的成像表明只有他们觉得这个笑话很好笑时，前额叶的部分区域才会受到激发，F是合理衔接。

Part　Five

【文章大意】　文章介绍了磁疗的原理、副作用以及外界对这种疗法的态度。

【解题思路】

56.　A此处意为很多具有磁性的用品被认为有治疗功能，与上句中“therapy”相呼应。

57.　B此处意为广告宣称这些用品可以治疗百病，尤其是疼痛。

58.　C此处意为这些产品的治疗原理是平衡人体的电能，principle的意思是“原理”“准则”等。

59.　D此处意为这些产品可以缓解疼痛，最主要的是肌肉和关节疼痛，“primarily”一词与“occasionally”形成对照。

60.　C此处意为磁性用品可以用在身体的诸多部位，因此用“among”。

61.　B此处意为坚持磁疗的人认为只要患者处在磁场中，磁力疗法就可以治愈病痛。“be　exposed　to”意思是“暴露于”。

62.　A此处意为世卫组织声称少量磁能对人体无伤害。

63.　B此处意为装有起搏器、准备做磁共振或进行放射治疗的病患应避免磁力，这是因为这些医疗设备会受到磁力干扰。这里as表示原因。

64.　C“关于……的研究”用“study　on...”。

65.　D此处意为绝大多数的病人在进行磁疗后感觉疼痛减轻，“significant”表示“显著的”。

ⅢWriting

66.　【范文】

Should　Induced　Abortion　Be　Controlled?

For　a　long　time,　there　has　been　a　common　phenomenon　of　women　taking　induced　abortion.　But,　in　my　opinion,　induced　abortion　has　many　negative　effects.　First　of　all,　the　great　pain　and　huge　loss　of　blood　in　induced　abortion　will　certainly　affect　womens　health.　It　usually　takes　at　least　one　week　for　them　to　recover.　In　addition,　women　who　have　had　several　abortions　may　suffer　from　spontaneous　abortion　and,　as　a　result,　may　lose　the　right　to　be　mothers.

Abortion　is　inhumane.　In　most　cases,　women　are　forced　to　have　abortions,　so,　to　some　extent,　abortion　is　a　kind　of　murder　in　disguise.　Also,　abortion　provides　excuses　for　irresponsible　sex.　Many　abortion　cases　are　the　result　of　indecent　sexual　relationships　and　may　damage　public　morality.

So,　we　should　control　abortion,　and　only　under　certain　necessary　circumstances　(e.g.　deformed　embryo)　should　we　take　abortion　so　as　to　protect　womens　rights　and　ensure　the　good　health　of　our　children,　creating　a　harmonious　society.　（161　words）

【审题】

本部分给出段落提示句，要求考生从健康和人道这两个方面分析人工流产，然后阐明自己的观点。注意第三部分的结论要与前面的分析前后呼应，符合逻辑。文章属说明文，除遵守说明文写作的基本要求外，写作中的一个重点和难点是如何正确写出一些涉及医疗卫生领域话题的英语表达，如“人工流产、自然流产”等。

【范文评析】

首先根据作文任务给定的信息，指出目前存在的一种社会现象，点明文章的主题。文章的重点放在人工流产的危害分析上：第一段第二句总领全文，随后从两个方面进行论述。一方面是对女性身体造成伤害，另一方面讲述人工流产是不人道的。第三段简明扼要，进行总结，指出我们应该禁止人工流产。

整篇文章段落清晰，能恰当的表明主题，阐述部分充实有序，每个主题句都有适当的扩展或说明；In　addition，In　most　cases，Also　等词语较好地衔接文章；倒装结构的使用(we　should　control　abortion,　and　only　under　certain　necessary　circumstances　(e.g.　deformed　embryo)　should　we　take　abortion　so　as　to　protect　womens　rights　and　ensure　the　good　health　of　our　children,　creating　a　harmonious　society.)是文章比较精彩的地方。

医护英语水平考试(三级)

模拟训练（四）

听力文本

This　is　METS3　listening　test.　There　are　four　parts　in　the　test,　Part　One,　Two,　Three,　and　Four.　You　will　hear　each　part　twice.

We　will　now　stop　for　a　moment　before　we　start　the　test.　Please　ask　any　questions　because　you　must　not　speak　during　the　test.

Now,　look　at　the　instructions　for　Part　One.

You　will　hear　five　extracts　from　conversations　taking　place　in　different　clinical　departments.　Choose　which　case　each　doctor　is　discussing　from　the　list　A—F.　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　do　not　need　to　use.　Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　each　extract　twice.　Now　we　are　ready　to　start.

Extract　1

Preoperative　radiographs　show　a　nondisplaced　right　intertrochanteric　fracture.That　is　why　you　have　excruciating　pain　in　your　right　leg.　Your　right　leg　has　been　externally　rotated,　slightly　shorter　than　your　left　leg,　and　adducted.　Intraoperatively,　you　will　be　given　spinal　anesthesia　and　positioned　on　an　orthopedic　table　with　your　right　hip　abducted　and　secured　in　traction.

Extract　2

You　have　been　in　remission　for　14　months　from　aggressively　treated　ovarian　carcinoma.　It　is　common　that　you　have　mild　abdominal　distention　and　tenderness　on　deep　palpation　of　the　lower　pelvis.　It　is　reported　that　you　claimed　a　feeling　of　fullness　in　the　lower　abdomen,　loss　of　appetite,　and　inability　to　sleep　through　the　night.　To　avoid　possible　recurrence　or　sequelae　of　your　ovarian　cancer,　youd　better　have　a　followup　visit　with　your　oncologist　every　month.

Extract　3

Your　family　history　was　significant　for　cardiovascular　disease.　Your　father　died　at　the　age　of　62　of　an　acute　myocardial　infarction.　Your　mother　had　bilateral　carotid　endarterectomies　and　a　femoralpopliteal　bypass　procedure　and　died　at　the　age　of　72　of　congestive　heart　failure.　Your　older　sister　died　from　a　ruptured　aortic　aneurysm　at　the　age　of　65.　Your　ECG　on　admission　presented　tachycardia　with　a　rate　of　126　bpm　with　inverted　T　waves.

Extract　4

The　results　of　bone　marrow　aspiration　were　positive　for　myelofibrosis.　You　need　to　go　through　a　6month　therapy　regimen　of　iron　supplements　in　the　form　of　ferrous　sulfate　tablets　and　receive　weekly　vitamin　B12　injections.　Interferon　was　given　every　other　week　in　addition　to　erythropoiesis　therapy.

Extract　5

You　have　a　history　of　mild　asthma　since　age　4,　with　at　least　one　attack　per　week.　In　an　acute　attack,　you　will　have　mild　dyspnea,　diffuse　wheezing,　yet　an　adequate　air　exchange　that　responds　to　bronchodilators.　We　decide　to　send　you　to　pulmonary　health　services　for　a　consult　with　a　specialist　and　pulmonary　function　studies　to　clear　you　for　surgery.

Now　Youll　hear　Part　One　again.　This　is　the　end　of　Part　One.　Now　look　at　Part　Two.

You　will　hear　a　conversation　between　a　reporter　and　a　WHO　official.　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).　Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　the　recording　twice.

Reporter:　I　am　Christopher　Jones　Cruise.　I　am　interviewing　Douglas　Bettcher　who　is　the　WHO　director　for　the　prevention　of　noncommunicable　diseases.　Mr.　Bettcher,　the　WHO　says　progress　is　being　made　in　reducing　deaths　from　noncommunicable　diseases,　so　what　are　noncommunicable　diseases?

WHO　Official:　Noncommunicable　diseases,　or　NCDs,　including　heart　disease,　stroke,　cancer,　diabetes　and　chronic　lung　disease,　are　collectively　responsible　for　almost　70%　of　all　deaths　worldwide.　Every　year,　15　million　adults　die　before　they　reach　old　age.　Its　noted　they　often　die　in　the　most　productive　period　of　their　lives,　between　the　ages　of　30　and　70.

Reporter:　What　are　their　risk　factors?

WHO　Official:　The　rise　of　NCDs　has　been　driven　by　primarily　four　major　risk　factors:　tobacco　use,　physical　inactivity,　the　harmful　use　of　alcohol　and　unhealthy　diets.　The　epidemic　of　NCDs　poses　devastating　health　consequences　for　individuals,　families　and　communities,　and　threatens　to　overwhelm　health　systems.　The　socioeconomic　costs　associated　with　NCDs　make　the　prevention　and　control　of　these　diseases　a　major　development　imperative　for　the　21st　century.

Reporter:　Are　premature　deaths　from　NCDs　a　problem　in　most　countries?

WHO　Official:　Eighty　percent　of　the　deaths　are　in　countries　that　are　already　often　stressed;　their　health　systems　are　stressed　with　the　usual—the　conventional　burdens　of　disease,　communicable　diseases,　maternalchild　health　problems.　And,　then　this　is　an　added,　extremely　large　burden　for　the　health　system.　Costa　Rica　and　Iran　are　at　the　top　of　a　list　of　10　countries　that　have　been　most　successful　at　reducing　deaths　from　noncommunicable　diseases.　It　says　six　countries　have　failed　to　make　any　progress　against　such　deaths.　Five　of　the　six　are　in　Africa.　They　are　Angola,　Equatorial　Guinea,　GuineaBissau,　Sao　Tome　Principe　and　South　Sudan.　The　sixth　country　is　Micronesia　in　the　western　Pacific.

Reporter:　I　heard　progress　is　being　made　on　cutting　premature　death　from　NCDs　by　onethird　by　the　year　2030,　would　you　give　us　more　details?

WHO　Official:　Of　course.　What　you　just　mentioned　is　a　Sustainable　Development　Goal　for　United　Nations　member　countries.　Increasing　numbers　of　people—particularly　children　and　adolescents—are　suffering　from　obesity,　overweight　and　diabetes.　If　we　dont　take　action　now　to　protect　people　from　noncommunicable　diseases,　we　will　condemn　todays　and　tomorrows　youth　to　lives　of　illhealth　and　reduced　economic　opportunities.　WHOs　mission　is　to　provide　leadership　and　the　evidence　base　for　international　action　on　surveillance,　prevention　and　control　of　NCDs.　Urgent　government　action　is　needed　to　meet　global　targets　to　reduce　the　burden　of　NCDs.　By　the　way,　early　this　month,　WHO　and　Government　of　Denmark　hosted　a　Global　Dialogue　to　address　the　critical　gap　in　financing　for　national　NCD　responses.　The　goal　for　the　meeting　was　to　share　information　on　existing　and　potential　sources　of　finance　and　development　cooperation　at　the　local,　national,　regional　and　global　levels,　and　explore　new　opportunities　for　multistakeholder　and　multisectoral　partnerships　in　order　to　catalyse　action　for　effective　national　NCD　responses.

Now　youll　hear　Part　Two　again.　This　is　the　end　of　Part　Two.　Now　look　at　Part　Three.

You　will　hear　a　discussion　among　an　instructor　and　two　medical　students.

For　questions　14—20,　choose　the　most　appropriate　answer.

Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　the　discussion　twice.

Instructor:　Today　we　are　going　to　discuss　double　pneumonia.　Who　would　like　to　speak　first?

Student　1:　Double　pneumonia　is　an　infection　of　both　lungs.　People　who　have　the　influenza　virus　infection,　some　types　of　streptococcal　bacterial　infections,　respiratory　syncytial　virus　or　RSV,　and　some　other　infections　can　develop　double　pneumonia.

Student　2:　A　virus,　bacteria　or　fungus　causes　the　tiny　sacs　of　the　lungs,　called　alveoli,　to　become　inflamed　and　fill　with　fluid　or　pus,　causing　a　range　of　symptoms,　including　breathing　difficulties.

Instructor:　Yes.　Because　double　pneumonia　affects　both　lungs,　a　person　may　find　it　extremely　difficult　to　breathe.　It　is　impossible　to　tell　if　a　person　has　pneumonia　or　double　pneumonia　based　on　symptoms　alone　so　anybody　who　thinks　they　may　have　pneumonia　must　see　a　doctor　as　soon　as　possible.　What　are　common　symptoms　for　pneumonia?

Student　1:　Symptoms　of　pneumonia　include　a　high　fever,　chills,　or　shaking.　Rarely,　some　people　develop　an　unusually　low　temperature.

Student　2:　A　cough　that　gets　worse,　coughing　up　thick　mucus　or　phlegm,　and　chest　pain　when　coughing　or　breathing.

Instructor:　Right.　Nausea,　vomiting,　or　diarrhea　may　be　along　with　respiratory　symptoms.As　pneumonia　progresses,　it　can　cause　serious　complications　—　particularly　in　people　with　weakened　immune　systems　due　to　age,　illness,　or　debilitating　diseases,　such　as　HIV　or　AIDS.　What　are　the　complications　of　pneumonia?

Student　1:　Sepsis,　I　think.

Instructor:　Sepsis,　yes,　an　infection　that　causes　systemic　inflammation　in　the　body.　It　is　a　serious　illness　that　can　be　fatal.

Student　2:　Lung　abscesses　and　pleural　effusions.

Instructor:　Exactly.　The　pleurae　are　two　membranes　that　line　the　outside　of　the　lungs　within　the　chest　cavity.　Usually,　a　small　amount　of　pleural　fluid　fills　the　gap　between　the　membranes,　but　pneumonia　may　cause　an　accumulation　of　this　fluid.　If　there　is　a　buildup　of　fluid,　or　it　becomes　infected,　a　pleural　effusion　can　cause　death.　Though　it　is　a　serious　infection,　it　is　treatable.　Anyone　that　has　difficulty　breathing　and　a　high　fever　should　treat　it　as　a　medical　emergency.　Treatment　for　double　pneumonia　depends　on　what　caused　it　and　how　it　has　affected　the　body.

Student　2:　People　who　have　bacterial　pneumonia　will　need　antibiotic　therapy.

Instructor:　Exactly!　People　with　severe　infections　related　to　pneumonia,　such　as　infectious　pleural　effusion　or　sepsis,　will　need　intravenous　antimicrobial　therapy.　People　with　viral　pneumonia　will　not　respond　to　antibiotics,　which　do　not　work　to　treat　viral　infection.Other　treatments　for　pneumonia　focus　on　preventing　further　damage　to　the　lungs　and　ensuring　a　person　can　breathe.　Some　people　may　require　supplemental　oxygen　or　monitoring　in　a　hospital　setting.　Rest　and　remaining　hydrated　may　also　help.　While　coughing　can　be　unpleasant,　coughing　helps　the　body　rid　itself　of　the　infection.　People　who　have　double　pneumonia　should　not　take　a　cough　suppressant　medicine　unless　a　doctor　recommends　doing　so.

Now　youll　hear　Part　Three　again.　This　is　the　end　of　Part　Three.　Now　look　at　Part　Four.

You　will　hear　a　speech　on　ecigarettes,　or　vaping.　Complete　the　notes.　In　each　blank,　write　only　one　word.　Write　the　answers　on　your　answer　sheet.　You　will　hear　the　speech　twice.

Male:　If　you　have　thought　about　trying　to　kick　a　smoking　habit,　youre　not　alone.　Nearly　seven　out　of　10　smokers　say　they　want　to　stop.　Quitting　smoking　is　one　of　the　best　things　you　can　do　for　your　health.　Smoking　harms　nearly　every　organ　in　your　body,　including　your　heart.　Nearly　onethird　of　deaths　from　heart　disease　are　the　result　of　smoking　and　secondhand　smoke.

You　might　be　tempted　to　turn　to　electronic　cigarettes　as　a　way　to　ease　the　transition　from　traditional　cigarettes　to　not　smoking　at　all.　But　is　smoking　ecigarettes,　which　is　also　called　vaping,　better　for　you　than　using　tobacco　products?　Here　are　some　truth　you　need　to　know　about　vaping.

Truth　No.1:　Vaping　is　less　harmful　than　traditional　smoking.　Ecigarettes　heat　nicotine　flavorings　and　other　chemicals　to　create　water　vapor　that　you　inhale.　Regular　tobacco　cigarettes　contain　7,000　chemicals,　many　of　which　are　toxic.　While　we　dont　know　exactly　what　chemicals　are　in　ecigarettes,　experts　says　“theres　almost　no　doubt　that　they　expose　you　to　fewer　toxic　chemicals　than　traditional　cigarettes.”

Truth　No.　2:　Vaping　is　still　bad　for　your　health.　Nicotine　is　the　primary　agent　in　both　regular　cigarettes　and　ecigarettes,　and　it　is　highly　addictive.　It　causes　you　to　crave　smoke　and　suffer　withdrawal　symptoms　if　you　ignore　the　craving.　Nicotine　is　also　a　toxic　substance.　It　raises　your　blood　pressure　and　spikes　your　adrenaline,　which　increases　your　heart　rate　and　the　likelihood　of　having　a　heart　attack.　There　are　many　unknowns　about　vaping,　including　what　chemicals　make　up　the　vapor　and　how　they　affect　physical　health　over　the　long　term.

Truth　No.　3:　Electronic　cigarettes　are　just　as　addictive　as　traditional　ones.　Both　ecigarettes　and　regular　cigarettes　contain　nicotine,　which　research　suggests　may　be　as　addictive　as　heroin　and　cocaine.　Whats　worse,　many　ecigarette　users　get　even　more　nicotine　than　they　would　from　a　tobacco　product—you　can　buy　extrastrength　cartridges,　which　have　a　higher　concentration　of　nicotine,　or　you　can　increase　the　ecigarettes　voltage　to　get　a　greater　hit　of　the　substance.

Truth　No.　4:　Electronic　cigarettes　arent　the　best　smoking　cessation　tool.Although　theyve　been　marketed　as　an　aid　to　help　you　quit　smoking,　ecigarettes　have　not　received　Food　and　Drug　Administration　approval　as　smoking　cessation　devices.　A　recent　study　found　that　most　people　who　intended　to　use　ecigarettes　to　kick　the　nicotine　habit　ended　up　continuing　to　smoke　both　traditional　and　ecigarettes.

Truth　No.　5:　A　new　generation　is　getting　hooked　on　nicotine.Among　youth,　ecigarettes　are　more　popular　than　any　traditional　tobacco　products.　In　2015,　the　US　surgeon　general　reported　that　ecigarette　use　among　high　school　students　had　increased　by　900　percent,　and　40　percent　of　young　ecigarette　users　had　never　smoked　regular　tobacco.

Theres　a　strong　link　between　smoking　and　cardiovascular　disease,　and　between　smoking　and　cancer.　But　the　sooner　you　quit,　the　quicker　your　body　can　rebound　and　repair　itself.　Talk　to　your　doctor　about　what　smoking　cessation　program　or　tools　would　be　best　for　you.

Now　youll　hear　Part　Four　again.　This　is　the　end　of　Part　Four.　You　now　have　five　minutes　to　write　your　answers　on　the　answer　sheet.　You　have　one　more　minute.　This　is　the　end　of　the　listening　test.

参考答案与试题评析

ⅠListening

Part　One

1.　【语段大意】医生对患者右股骨粗隆间骨折术前X光片进行解释，阐明患者右腿疼痛的原因，包括右腿外旋，短于左腿，内收。随后，医生阐明手术将进行脊椎麻醉，对髋关节进行固定和牵引。

【解题思路】　D可听到　right　intertrochanteric　fracture,　pain　in　your　right　leg,　intraoperatively　等关键信息。

2.　【语段大意】　医生分析患者卵巢癌积极治疗14个月后的身体状况，认为轻微腹胀、下骨盆压痛、下腹部饱腹感、食欲不振、失眠等都是常见症状，建议每个月与肿瘤专家进行一次随访。

【解题思路】　B可听到ovarian　carcinoma,　recurrence　or　sequelae　of　your　ovarian　cancer,　have　a　followup　visit　with　your　oncologist　等关键信息。

3.　【语段大意】　患者有心血管疾病家族史。父亲死于心肌梗死,　母亲死于心力衰竭，姐姐死于主动脉瘤破裂，患者入院时心电图表现为心动过速等。

【解题思路】　A可听到　family　history,　cardiovascular　disease,　acute　myocardial　infarction,　congestive　heart　failure,　a　ruptured　aortic　aneurysm,　tachycardia等关键词。

4.　【语段大意】　骨髓穿刺结果显示患者骨髓纤维变性呈阳性。医生提供了一个6个月的治疗方案，建议补铁、注射维生素B12、进行促红细胞生成素疗法，并使用干扰素。

【解题思路】　C可听到　were　positive　for　myelofibrosis,　therapy　regimen等关键信息。

5.　【语段大意】　医生向患者阐述了其哮喘的发病情况，并告知患者，决定将患者送到肺部健康服务中心进行会诊，以便进行手术。

【解题思路】　F可听到We　decide　to　send　you　to　pulmonary　health　services　for　a　consult　with　a　specialist　and　pulmonary　function　studies　to　clear　you　for　surgery这一关键句。

Part　Two

【语篇大意】　一位记者对一位国际卫生组织官员关于非传染性疾病的采访。

【解题思路】

6.　B官员回答中提到非传染性疾病占到世界死亡人口的70%，故答案为B。

7.　A官员在回答中指出，患病人群通常在一生中最富生产能力（the　most　productive　period)的时期死亡，即30至70岁之间，故答案为A。

8.　A官员阐述了非传染性疾病的四大致病因素：吸烟(tobacco　use)、不运动(physical　inactivity)、有害饮酒(the　harmful　use　of　alcohol)　和不健康饮食(unhealthy　diets)，所以答案为A。

9.　A官员提到非传染性疾病的社会经济成本使得对这类疾病的防治成为21世纪的一项迫切任务，所以选A。

10.　C整篇听力未提及非传染性疾病死亡与国家经济水平有关系，因此选C。

11.　B官员提到有6个国家在防治非传染性疾病方面没有进步，其中有5个是非洲国家，所以选B。

12.　A官员提到，世界卫生组织的任务是领导监测、预防和控制非传染性疾病，所以选A。

13.　A听力最后部分，官员提到，本月初，世界卫生组织和丹麦政府主办了一次全球对话，以解决国家防治非传染性疾病筹资方面的严重缺口，故A正确。

Part　Three

【语篇大意】　两位医学生与老师讨论双侧肺炎的相关问题。

【解题思路】

14.　A双侧肺炎即两侧肺部感染，故答案为A。

15.　C对话中提到病毒和细菌会导致肺泡发炎，故答案为C。关键信息：A　virus,　bacteria　or　fungus　causes　the　tiny　sacs　of　the　lungs,　called　alveoli,　to　become　inflamed...

16.　C对话中提到肺炎的症状包括发烧、发冷或颤抖、少数人会出现体温过低、咳痰、胸痛或伴有恶心呕吐或痢疾等，所以答案应该选C。关键信息：Symptoms　of　pneumonia　include　a　high　fever,　chills,　or　shaking.　Rarely,　some　people　develop　an　unusually　low　temperature.../coughing　up　thick　mucus　or　phlegm,　and　chest　pain　when　coughing　or　breathing./Nausea,　vomiting,　or　diarrhea　may　be　along　with　respiratory　symptoms.

17.　B对话中提到双侧肺炎的并发症包括脓毒（sepsis)、　肺脓肿（lung　abscesses)　和胸腔积液(pleural　effusions)　,故答案为B。关键信息：Sepsis,　yes,　an　infection　that　causes　systemic　inflammation　in　the　body./Lung　abscesses　and　pleural　effusions.

18.　A对话中提到胸膜是连接肺部外的胸腔的两层膜，B为口腔，C为腹腔，显然A正确。关键信息：The　pleurae　are　two　membranes　that　line　the　outside　of　the　lungs　within　the　chest　cavity.

19.　A对话中提到患细菌性肺炎需抗生素治疗，B为静脉抗菌药物治疗，　C为水疗，故答案为A。关键信息：People　who　have　bacterial　pneumonia　will　need　antibiotic　therapy.

20.　C对话中提到咳嗽可能是不舒服的，故A项正确；　咳嗽可帮助身体摆脱疾病，故B项正确；若非医生建议，双肺炎患者不宜服用止咳药，故答案为C。关键信息：While　coughing　can　be　unpleasant,　coughing　helps　the　body　rid　itself　of　the　infection.　People　who　have　double　pneumonia　should　not　take　a　cough　suppressant　medicine　unless　a　doctor　recommends　doing　so.

Part　Four

【语篇大意】　关于电子烟的一段讲座。

【解题思路】

21.　toxic此处为讲座中提到的关于电子烟的第一个真相，即电子烟的危害小于传统烟。电子烟加热尼古丁调味品和其他化学物质，产生让使用者可以吸入的水蒸气。普通烟草香烟含有7000种化学物质，其中许多是有毒的。虽然我们不知道电子烟中到底含有什么化学物质，但专家们说：“几乎毫无疑问，电子烟让使用者吸入的有毒物质少于传统香烟。”所以此处应填toxic。

22.　agent此处为讲座中提到的关于电子烟的第二个真相，即吸电子烟仍然有害健康，因为尼古丁仍然是电子烟的主要成分。所以此处应填agent,　agent在此处是药剂的意思。

23.　concentration此处为讲座中提到的关于电子烟的第三个真相，即吸电子烟仍然会上瘾。听力中提到，许多电子烟使用者可能摄入更多的尼古丁，因为他们可以购买额外强度的烟盒，而这些烟盒含有更高浓度的尼古丁；他们也可以通过增加电子烟的电压以获得更多的尼古丁。所以此处应填concentration,　concentration在此处是浓度的意思。

24.　cessation此处为讲座中提到的关于电子烟的第四个真相，即电子烟不是戒烟的最好工具。听力中提到，电子烟还没有被食品和药物管理局批准为戒烟装置。所以此处应填cessation。

25.　popular此处为讲座中提到的关于电子烟的第五个真相，即新一代对尼古丁上瘾。听力中提到，电子烟在年轻人中比普通烟草香烟更受欢迎。故此处应填popular。

ⅡReading

Part　One

【文章大意】　文章指出女性的饮食（比如水果和快餐）对怀孕的影响，并给出了一些饮食帮助怀孕的建议。

【解题思路】

26.　C第一段第一句“Women　may　be　harming　their　chances　of　getting　pregnant　because　theyre　avoiding　fruit,　or　eating　too　much　junk　food.”　点出本文讨论的主题，　即　fruit　和junk　food两类食品（food　group)对女性受孕的影响。因此选择C。

27.　A第二段段首提出“Junk　food　consumption　was　also　analyzed　”之后提到，“and　women　who　rarely　ate　fast　food　got　pregnant　a　month　quicker,　on　average　than　women　who　ate　fast　food　four　times　a　week　or　more.”　即很少吃快餐的女性怀孕时间要比每周吃四次或更多快餐的女性平均要快一个月。因而匹配A选项。

28.　E第三段第一句后半句“　...　keeping　a　healthy　weight　and　diet　is　a　key　way　to　improve　chances”是本段的主题句，后面句子引出的5,598名参与调查的女性以及第四段的内容都证明保持健康饮食（eating　more　fruit,minimizing　fast　food　consumption）是提高受孕的最佳途径。因此选择E。

29.　D第四段都是在描述杂志Human　Reproduction对5,598名怀孕女性在做第一次产检时参与的调查结果和数据，并得出相应结论。因此选择D。

30.　B第五段第一句“This　study　demonstrates　that　fruit　consumption　is　not　only　safe,　but　beneficial　for　most　women　to　optimize　their　fertility.”　意指这项研究表明，水果的摄入不仅是安全的，而且对大多数妇女来说有利于提高她们的生育能力。　因此匹配到选项B。

31.　D定位第一段最后一句话。

32.　A定位第二段第一句。

33.　E定位第三段第二句。

34.　C定位第四段倒数第三句。

35.　F定位第五段第二句。

Part　Two

【文章大意】　主要报导了近50万女性错过NHS癌症筛查这一事件，并对NHS乳腺癌筛查进行了介绍。

【解题思路】

36.　C根据第二段第一句“has　apologized　for　the　glitch　which　meant　450,000　women　were　never　sent　letters　inviting　them　to　routine　breast　cancer　checkups.”。

37.　B第四段第一句“Women　aged　50　to　70　are　invited　for　an　Xray　mammogram　every　three　years　to　detect　any　lumps　or　abnormalities　that　could　be　or　become　breast　cancer.”年龄在50岁至70岁的女性每三年被邀请做一次乳房射线X光检查，以发现任何可能成为乳腺癌的肿块或异常，故选B。

38.　A文章第六段介绍了“Around　2.5　million　women　are　invited　to　breast　screening　each　year.　In　2016/17　just　70　percent　took　up　screening—a　record　low—and　18,400　cancers　were　picked　up”(每年约有250万妇女接受乳房检查。在2016/17年，只有70%的人接受了筛查——这一比例创历史新低——18400例癌症被确诊)，选A。

39.　D第九段第一句话中的contest的意思就是question,即批评家们质疑筛查给妇女带来的伤害。

40.　A第十一段第一句“In　a　statement　today,　Mr.　Hunt　announced　the　‘best　estimate’　is　that　between　135　and　270　women　‘had　their　lives　shortened　as　a　result’”指出在今天的一份声明中，亨特先生宣布了“最好的估计”，即135到270名女性“因此而缩短了生命”。由此得出选A。

41.　B根据文章“309,000　women　are　believed　to　still　be　alive　and　will　receive　a　letter　by　the　end　of　May　telling　them　they　may　have　missed　screening　and　inviting　them　for　a　checkup　now”（据信有309000名女性仍然活着，她们将在5月底收到一封信，信中告诉她们可能错过了筛查，并邀请她们现在就去做检查），因而A、C、D均为错误选项。

42.　C从“In　addition,　and　as　soon　as　possible　we　will　make　our　best　endeavor　to　contact　the　next　of　kin　of　those　we　believe　have　missed　a　scan　and　subsequently　died　of　breast　cancer,”　和“As　well　as　apologizing　to　families　affected,　we　wish　to　offer　any　further　advice　they　might　find　helpful　including...and　compensation　is　therefore　payable.”可以判断C选项正确。

Part　Three

【文章大意】　“三手烟”可能对身体造成危害。

【解题思路】

43.　A题目意思是美国研究人员发现，烟草烟雾中有害化学物质会附着在衣服、家具和地毯表面上，对人类健康造成潜在危害，此信息在文章中的第二段中出现“US　researchers　found　that　potentially　harmful　chemicals　from　tobacco　smoke　get　trapped　in　clothes,　furniture　and　carpets”，故题目正确。

44.　C文章没有提及题干内容，故选项选C。

45.　B根据第二段后半句“but　can　become　airborne　again　and　be　circulated　through　office　blocks,　schools　or　other　nominally　smokefree　buildings.”，但可以再次在空中传播，并在办公大楼、学校或其他通常禁烟建筑中传播。　因此题目错误。

46.　A根据第五段“Experts　said　this　could　also　be　a　concern　for　babies　in　the　homes　of　smokers　who　are　lying　on　furniture　or　carpets　where　these　particles　may　have　settled”，题目正确。

47.　B根据第六段“this　later　interacts　with　nitrous　acid　formed　from　the　gas　nitrous　oxide,　which　is　released　by　car　exhausts　and　gas　appliances.”，附着于门上的尼古丁残留物之后与亚硝酸发生反应，亚硝酸由汽车尾气和燃气用具排放出来的一氧化二氮气体形成。所以题目错误。

48.　C文章全文无提及，所以选C。

49.　B第九段“This　could　also　occur　in　electronic　cigarettes,　which　also　contain　nicotine　and　are　used　in　indoor　public　spaces　much　more　frequently　than　conventional　cigarettes,　the　authors　said.”，电子香烟也可能引发上述情况，电子香烟也含有尼古丁，并且在室内公共场所使用频率比传统香烟更高，故选B。

50.　A根据第十二段“为进一步发掘研究结果，研究人员用密封容器进行了实验室试验”，根据这句话得知题目正确。

Part　Four

【文章大意】　工作压力应作为安全隐患加以监管。

【解题思路】

51.　E第一段第二句为段落主题句，今日公布的一项针对4，600多名英国成年人的调查数据显示，在过去一年里，有四分之三的英国成年人因为压力过大而感到不堪重负或无力应对——尽管这一比例在女性中为81%。根据一份关于英国心理健康和不断增加的压力流行报告，英国有三分之一的人曾有过自杀的念头，E从而为合理选项。有助于正确选题的重要词句包括：lead　to　more　serious　mental　health　problems/and　the　MHF　report　found　evidence　of　this。

52.　A第二段第二句“Thirtytwo　percent　of　adults　said　they　had　experienced　suicidal　feelings　as　a　result　of　stress,　while　16　percent　of　adults　said　they　had　selfharmed　as　a　result　of　stress—with　women　and　younger　adults　most　likely　to　be　affected.”，谈到32%的成年人说他们因为压力而有过自杀的念头，而有16%的成年人说他们因为压力而自我伤害——女性和年轻的成年人很可能会受到影响。A选项接着指出就在一周前，格拉斯哥大学的研究发现，苏格兰18岁至34岁的年轻人中有九分之一曾试图自杀。

53.　D第三段中介绍“我们目前对心理危害的态度和行为不一样。MHF表示，这些心理危害是精神健康的压力源，它压倒了包括休息、按时离开以及安全工作能力在内的各种应对机制。MHF还呼吁应保证护士、教师、警察和其他公共部门工作人员即使在面临预算削减和员工短缺的情况下，也应有“至少两天精神健康日”。　D选项指出“压力和心理健康是旷工的第四大常见原因，但有一半的员工在感到压力太大而不愿去工作时会编造其他借口”。

54.　F第五段谈及压力引发心理健康问题和身体疾病。F选项在首句作为概括全段的主题句最为合理。内容和信息相关。重要词句：It　is　also　linked　to　physical　health　problems/insomnia　and　digestive　problem/this　is　great　information。

55.　C“这包括在工作中实施心理健康计划，增强意识，监测健康和幸福”，是对具体措施的描述。重要词汇：as　set　out　in　the　recent　independent　review　into/new　standards/by　the　prime　minister。

Part　Five

【文章大意】　文章介绍科学家发现了控制皮肤晒黑或灼伤的基因。

【解题思路】

56.　Alaid：铺设，其他几个选项表达不准确。

57.　Caffected：影响，其他几个选项表达不准确。

58.　B此处应填副词，根据“Darkerskinned　people　are”表示“深色皮肤的人”。usually:　通常；ordinarily：通常；naturally：自然。

59.　A本句句意为：“但科学家的研究表明，除了自然的肤色之外，还有其他的遗传因素”，故选A。secure：安全　protect：保护。

60.　D此句句意为：有相同色素沉着的人也会有所不同。根据词形变异应选variability。

61.　Bundertake此处意为：这项研究使用了大量来自英国生物银行的基因数据。根据意思选B符合语句逻辑。

62.　C此处意为：Falchi博士和他的同事获得了数以万计的欧洲血统的人的基因信息，这些人自称有晒黑或晒伤的倾向。选C符合语句逻辑。

63.　Alooking　at此处意为：这一发现证实了之前关于晒黑和晒伤基因基础的研究。　looking　at：查找；looking　for：寻找；looking　into：调查；looking　out：调查

64.　Dsolve此处意为：然而，他指出，晒伤的问题不需要基因测试就可以解决。　involve：包含；solve：解决

65.　Bavoided此处意为：根据英国癌症研究中心(Cancer　Research　UK)的数据，几乎90%的黑色素瘤(皮肤癌中最严重的一种)患者可“安全地享受阳光，避免使用日光浴床”。

ⅢWriting

66.　【范文】

How　to　Become　a　Qualified　Doctor

In　general,　it　is　widely　accepted　that　doctors　social　responsibility　is　to　save　lives　and　heal　the　wounded.　So　what　defines　a　qualified　doctor?　From　my　perspective,　to　become　a　respectful　doctor　recognized　by　the　public,　the　practitioner　should　be　both　benevolent　and　highly　skilled.

First,　a　respectful　doctor　must　remain　benevolent.　This　is　because　doctors　are　often　confronted　with　disease　and　death,　and　their　attitudes　to　life　often　have　an　important　impact　on　patients.　Only　with　benevolence　will　doctors　try　their　best　in　the　work　without　complaining.　Though　sometimes　there　exists　misunderstanding,　a　qualified　doctor　should　patiently　and　kindly　ease　the　tension　of　doctorpatient　relationship.

Second,　a　qualified　doctor　must　master　updated　skills.　In　order　to　give　patients　the　best　treatment,　doctors　should　constantly　absorb　new　knowledge　instead　of　practicing　in　a　single　way.　For　example,　at　present,　there　are　as　many　as　52　treatments　for　breast　cancer.　Doctors　should　no　longer　just　remove　the　breast.Therefore,　a　qualified　doctor　must　keep　learning.　He　or　she　should　always　focus　on　new　medical　discoveries　in　his/her　research　field,　and　try　to　find　out　every　opportunity　to　keep　up　with　the　latest　progress　and　practice.

So,　to　become　a　qualified　doctor,one　should　remain　benevolent　and　improve　himself/herself　all　the　time.　(210　words)

【审题】

写作部分要求写一篇说明文，阐述一个合格医生应该具备的素质。文章应遵守说明文写作的基本要求，逐条清楚论述好医生应具备的素质，并通过具体细节论证自己的观点。

【范文评析】

文章第一段根据题目内容，首先陈述了医生的社会职责，随后通过提问的方式明确文章主题，并给出自己的观点。第二段首句提出分论点，随后通过因果分析和举例论证支持分论点。第三段首句总领全段，通过具体例证展开。

文章观点明确，层次清晰，段落展开充分，熟练使用提问，first、　second和this　is　because、　in　order　to等衔接手段；倒装结构的使用(Only　with　benevolence　will　doctors　try　their　best　in　the　work　without　complaining.)则是本文句子水平上的一个亮点。

医护英语水平考试(三级)

模拟训练（五）

听力文本

This　is　METS3　listening　test.　There　are　four　parts　in　the　test,　Part　One,　Two,　Three,　and　Four.　You　will　hear　each　part　twice.

We　will　now　stop　for　a　moment　before　we　start　the　test.　Please　ask　any　questions　now　because　you　must　not　speak　during　the　test.

Now,　look　at　the　instructions　for　Part　One.

You　will　hear　five　extracts　from　conversations　taking　place　in　different　clinical　departments.　Choose　which　case　each　doctor　is　discussing　from　the　list　A—F.　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　do　not　need　to　use.　Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　each　extract　twice.　Now　we　are　ready　to　start.

Extract　1

I　have　read　the　report　that　you　were　admitted　to　the　pulmonary　unit　with　chest　pain　on　inspiration,　dyspnea,　and　diaphoresis.　You　know　smoking　is　bad　for　health　and　smoking　1/2　packs　of　cigarettes　per　day　is　really　too　much　for　a　52yearold.　In　addition,　you　were　treated　for　primary　giant　cell　sarcoma　of　the　left　lung　3　years　ago　with　a　lobectomy　of　the　left　lung　followed　by　radiation　and　chemotherapy.　Quitting　smoking　is　really　necessary.

Extract　2

I　am　sorry　that　your　mother　is　in　the　ICU　in　the　terminal　stage　of　multisystem　organ　failure.　She　has　a　20year　history　of　COPD.　She　is　not　conscious　and　is　unable　to　breathe　on　her　own.　Her　ABGs　are　abnormal,　and　she　has　been　diagnosed　with　refractory　ARDS.　I　suggest　a　permanent　tracheostomy　and　family　consideration　of　continuing　or　withdrawing　life　support.

Extract　3

Your　examination　on　admission　shows　rebound　tenderness　in　the　RUQ　with　a　positive　Murphy　sign.　Your　skin,　nails,　and　conjunctivae　are　yellowish　and　your　leukocyte　count　is　16,000.　An　ERCP　and　ultrasound　of　the　abdomen　suggest　many　small　stones　in　your　gallbladder　and　possibly　the　common　bile　duct.　Your　diagnosis　is　cholecystitis　with　cholelithiasis.

Extract　4

The　previous　barium　enema　shows　some　irregularities　in　the　sigmoid　and　rectal　segments　of　your　large　bowel.　Stool　samples　for　culture,　ova,　and　parasites　are　negative.　Your　tentative　diagnosis　is　irritable　bowel　syndrome.You　should　follow　a　lactosefree,　lowresidue　diet　and　take　Imodium　to　reduce　intestinal　motility.　I　recommend　a　colonoscopy.

Extract　5

It　is　said　that　you　were　admitted　to　the　inpatient　unit　from　the　ER　with　severe　right　flank　pain　unresponsive　to　analgesics.　And　your　pain　did　not　decrease　with　administration　of　100　mg　of　IV　meperidine.　It　is　also　said　that　you　had　a　3month　history　of　chronic　UTI.　The　problem　may　be　caused　by　the　calcium　supplements　for　low　bone　density　you　were　prescribed　six　months　ago.

Now　youll　hear　Part　One　again.　This　is　the　end　of　Part　One.Now　look　at　Part　Two.

You　will　hear　a　conversation　between　a　reporter　and　a　cardiologist.　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).　Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　the　recording　twice.

Reporter:　I　am　Alice　Austin.　According　to　the　American　Heart　Association,　sedentary　jobs　have　increased　83　percent　since　1950.　Physically　active　jobs　now　make　up　less　than　20　percent　of　the　US　workforce.　All　of　that　inactivity　is　taking　a　toll　on　health.　I　am　interviewing　Johns　Hopkins　cardiologist　Erin　Michos,　who　will　share　research　about　the　dangers　of　sitting　and　what　you　can　do　about　it.　Hello,　Erin,　how　does　so　much　sitting　affect　health?

Michos:　A　large　review　of　studies　published　in　2015　in　the　Annals　of　Internal　Medicine　found　that　even　after　adjusting　for　physical　activity,　sitting　for　long　periods　was　associated　with　worse　health　outcomes　including　heart　disease,　Type　2　diabetes　and　cancer.　Sedentary　behavior　can　also　increase　your　risk　of　dying,　either　from　heart　disease　or　other　medical　problems.

Reporter:　Even　fitness　buffs　can　be　sedentary,　as　you　recently　discovered?

Michos:　I　consider　myself　physically　active.　I　run　every　morning　for　four　or　five　miles,　and　Id　pat　myself　on　the　back　for　that.　But　then　I　got　a　steptracking　device　and　realized　I　wasnt　moving　much　the　rest　of　the　day.　I　have　a　long　commute,　so　I　was　spending　two　hours　in　my　car.　On　days　Im　not　doing　rounds,　Im　doing　research　or　teaching,　so　I　might　be　sitting　at　my　computer　for　eight　hours.　I　was　easily　sitting　more　than　10　hours　a　day.　Outside　of　my　run,　I　was　getting　very　few　steps　the　rest　of　the　day.

Reporter:　Does　all　that　sitting　cancel　out　the　benefits　of　your　daily　running?

Michos:　Not　entirely.　More　recent　research　shows　that　high　levels　of　exercise　can　lessen　some　of　the　risk.　Yet　even　for　people　with　high　levels　of　activity,　there　seems　to　be　a　threshold　around　10　hours　of　sitting.　Research　shows　that　if　you　sit　more　than　10　hours,　your　cardiovascular　risk　really　goes　up.

Reporter:　How　have　you　changed　your　own　habits?

Michos:　Ive　made　progress.　I　make　an　effort　to　get　up　and　move　around　every　hour.　I　try　to　find　as　many　excuses　as　possible　to　walk　throughout　the　day.　Ive　also　been　having　walking　meetings.　Well　do　loops　around　the　hospital　and　talk　as　we　walk.

Reporter:　What　advice　do　you　have　to　help　others　get　out　of　their　seats?

Michos:　Even　if　you　have　to　be　sitting　in　front　of　the　computer　all　day,　you　can　break　up　the　time.　You　dont　have　to　replace　sitting　with　time　at　the　gym.　Theres　benefit　to　light　activity　during　the　day.　For　every　20　minutes　of　sitting,　try　to　stand　for　eight　minutes　and　move　around　for　two　minutes.I　recommend　everybody　track　their　steps,　with　a　fitness　tracker,　your　phone　or　a　simple　pedometer.　We　usually　recommend　a　target　of　10,000　steps　a　day.

Now　youll　hear　Part　Two　again.　This　is　the　end　of　Part　Two.　Now　look　at　Part　Three.

You　will　hear　a　discussion　among　an　instructor　and　two　medical　students.

For　questions　14—20,　choose　the　most　appropriate　answer.

Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　the　discussion　twice.

Instructor:　Today　we　are　going　to　discuss　cellulitis.　Cellulitis　is　a　bacterial　infection　of　the　dermis—the　deep　layer　of　skin—as　well　as　the　subcutaneous　tissues,　the　fat　and　soft　tissue　layer　that　is　under　the　skin.

Student　1:　I　learnt　that　some　types　of　bacteria　are　naturally　present　on　the　skin　and　do　not　normally　cause　any　harm.

Instructor:　Yes.　Bacteria　from　the　streptococci　and　staphylococci　groups　are　commonly　found　on　the　surface　of　the　skin　and　cause　no　harm;　however,　if　they　enter　the　skin,　they　can　cause　infection.For　the　bacteria　to　access　the　deeper　skin　layers,　they　need　a　route　in,　which　is　usually　through　a　break　in　the　skin.　A　break　in　the　skin　can　be　caused　by　ulcers,　burns,　bites,　grazes,　cuts,　and　some　skin　conditions　such　as　eczema,　athletes　foot,　or　psoriasis.　Some　people　even　develop　cellulitis　without　being　able　to　identify　a　break　in　the　skin.

Student　2:　What　are　common　symptoms　for　cellulitis?

Student　1:　The　affected　area　will　become　warm,　tender,　inflamed,　swollen,　red　and　painful.

Instructor:　Right.　Some　people　may　develop　blisters,　skin　dimpling,　or　spots.　They　might　also　experience　a　fever,　chills,　nausea,　and　shivering.Lymph　glands　may　swell　and　become　tender.　If　the　cellulitis　has　affected　the　persons　leg,　the　lymph　glands　in　their　groin　may　also　be　swollen　or　tender.　So,　what　can　we　do　to　prevent　cellulitis?

Student　1:　If　the　skin　is　broken　because　of　a　cut,　bite,　or　graze,　it　should　be　kept　clean　to　reduce　risk　of　infection.

Student　2:　Reducing　the　likelihood　of　scratching　and　infecting　the　skin.　The　risk　of　the　skin　being　damaged　by　scratching　will　be　greatly　reduced　if　fingernails　are　kept　short　and　clean.　Taking　good　care　of　the　skin　is　also　helpful.　If　the　skin　is　dry,　moisturizers　should　be　used　to　prevent　skin　from　cracking.　However,　individuals　with　greasy　skin　will　not　need　to　do　this.　Moisturizers　will　not　help　if　the　skin　is　already　infected.

Instructor:　Exactly!　Because　obesity　may　raise　the　risk　of　developing　cellulitis,　controlling　weight　should　be　paid　attention　to.

Student　1:　After　being　infected,　how　to　treat　cellulitis?

Instructor:　There　is　no　way　to　treat　cellulitis　at　home,　and　this　condition　needs　to　be　treated　by　a　doctor.　If　someone　suspects　they　have　cellulitis,　they　should　call　a　doctor　right　away.　Of　course,　there　are　something　they　can　do.　Drinking　plenty　of　water,　keeping　the　affected　area　raised,　and　taking　painkillers　are　usually　recommended　by　a　doctor.

Student　2:　How　about　using　tea　tree　oil?

Instructor:　Some　people　have　suggested　using　tea　tree　oil,　coconut　oil,　and　garlic,　because　they　may　have　antibacterial,　antifungal,　and　other　properties.　However,　there　appears　to　be　no　evidence　that　they　can　treat　cellulitis.　Anyone　with　symptoms　needs　to　seek　medical　help　at　once.　Untreated,　cellulitis　can　be　lifethreatening.

Now　youll　hear　Part　Three　again.　This　is　the　end　of　Part　Three.　Now　look　at　Part　Four.

You　will　hear　a　speech　on　natural　ways　to　adjust　sleeping　habits.　Complete　the　notes.　In　each　blank,　write　only　one　word.　Write　the　answers　on　your　answer　sheet.　You　will　hear　the　speech　twice.

Male:　Disturbed　sleep　is　more　than　an　inconvenience　that　leaves　you　dragging　the　next　day:　it　can　affect　your　emotional　and　physical　health.　It　negatively　affects　your　memory,　concentration　and　mood,　and　it　boosts　your　risk　for　depression,　obesity,　Type　2　diabetes,　heart　disease　and　high　blood　pressure.

Happily,　there　are　easy,　natural　fixes　that　can　improve　your　sleep.　Its　not　always　necessary　to　get　a　prescription　for　a　sleep　aid.　There　are　natural　ways　to　make　adjustments　to　your　sleeping　habits.

No.　1　Drink　up.　Warm　milk,　chamomile　tea　and　tart　cherry　juice　are　recommended　for　patients　with　sleep　trouble.

Warm　milk　has　long　been　believed　to　be　associated　with　chemicals　that　simulate　the　effects　of　tryptophan　on　the　brain.　This　is　a　chemical　building　block　for　the　substance　serotonin,　which　is　involved　in　the　sleepwake　transition.　Chamomile　tea　can　also　be　helpful.　Its　believed　to　have　flavonoids　that　may　interact　with　benzodiazepine　receptors　in　the　brain　that　are　also　involved　with　the　sleepwake　transition.Plus,　chamomile　tea　doesnt　have　caffeine,　unlike　green　tea　or　Earl　Grey.　Finally,　tart　cherry　juice　might　support　melatonin　production　and　support　a　healthy　sleep　cycle.

No.　2　Exercise.　Its　known　that　moderate　aerobic　exercise　boosts　the　amount　of　deep　sleep　you　get.　But　you　have　to　time　it　right.　Aerobic　exercise　releases　endorphins,　chemicals　that　keep　people　awake.　This　is　why　you　feel　energized　after　a　run.　It　can　also　raise　core　body　temperature;　this　spike　signals　the　body　that　its　time　to　get　up　and　get　going.　If　youre　having　trouble　sleeping,　try　to　avoid　working　out　within　two　hours　of　bedtime.

No.3　Use　melatonin　supplements.　Melatonin　is　a　hormone　that　is　naturally　released　in　the　brain　four　hours　before　we　feel　a　sense　of　sleepiness.　Its　triggered　by　the　bodys　response　to　reducing　light　exposure,　which　should　naturally　happen　at　night.

These　days,　though,　lights　abound　after　its　dark　outside—whether　its　from　your　phone,　laptop　or　TV.　This　exposure　to　unnatural　light　prevents　melatonin　release,　which　can　make　it　hard　to　fall　asleep.　Luckily,　melatonin　is　available　in　pill　form　at　your　local　pharmacy　as　an　overthecounter　supplement.

Just　make　sure　that　you　consistently　buy　the　same　brand.　Because　melatonin　supplements　are　unregulated　by　the　FDA,　the　perpill　dosages　and　ingredients　may　differ　from　manufacturer　to　manufacturer.　Stick　with　one　brand,　and　dont　buy　it　online　from　an　unknown　source.

No.4　Keep　cool.　The　ideal　temperature　for　your　thermostat　is　between　65　and　72　degrees.　Women　who　are　going　through　menopause　and　experiencing　hot　flashes　should　keep　the　room　as　cool　as　possible　and　wear　cotton　or　breathable　fabrics　to　bed.

No.5　Go　dark.　Its　known　that　the　light　from　a　smartphone　interferes　with　sleep.　But　what　about　your　bathroom　light?　If　you　have　the　urge　to　go　at　night,　dont　flick　on　the　lights.　The　latest　recommendation　is　to　use　a　flashlight　if　you　need　to　get　up　at　night,　because　it　offers　less　visual　disruption.　And　remember:　If　you　do　wake　up　for　a　bathroom　break,　it　might　take　up　to　30　minutes　to　drift　back　off.　This　is　completely　normal.

Now　youll　hear　Part　Four　again.　This　is　the　end　of　Part　Four.　You　now　have　five　minutes　to　write　your　answers　on　the　answer　sheet.　You　have　one　more　minute.　This　is　the　end　of　the　listening　test.

参考答案与试题评析

ⅠListening

Part　One

1.　【语段大意】　医生通过对患者病史的了解，得知患者肺源性吸气胸痛（the　pulmonary　unit　with　chest　pain　on　inspiration）、呼吸困难（dyspnea）、发汗（diaphoresis）。3年前，患者对左肺原发性巨细胞肉瘤（　primary　giant　cell　sarcoma　）进行了左肺叶切除术（a　lobectomy　of　the　left　lung），随后进行放疗和化疗（radiation　and　chemotherapy）。医生提示吸烟对健康有害，每天吸1/2包香烟对52岁的人来说实在是太多了。戒烟确实是必要的。

【解题思路】　E可听到smoking　is　bad　for　health,　quitting　smoking　is　really　necessary等关键信息。

2.　【语段大意】　医生正对患者子女讲述患者情况：患者在ICU处于多器官功能衰竭的末期(in　the　terminal　stage　of　multisystem　organ　failure)，有20年的慢性阻塞性肺疾病史(COPD)，无意识、无法独自呼吸、动脉气血异常（Her　ABGs　are　abnormal）。患者被诊断为难治性呼吸窘迫综合征（refractory　ARDS）。医生建议永久性气管造口术（a　permanent　tracheostomy），家庭考虑继续或撤回生命支持。

【解题思路】　C可听到in　the　terminal　stage　of　multisystem　organ　failure,　refractory　ARDS，　family　consideration　of　continuing　or　withdrawing　life　support等关键信息。

3.　【语段大意】　医生分析患者情况：入院检查(examination　on　admission)显示阳性墨菲征（a　positive　Murphy　sign）的右上腹反跳痛（rebound　tenderness　in　the　RUQ），皮肤、指甲和结膜（skin,　nails,　and　conjunctivae）是黄色的，白细胞计数（leukocyte　count）是16000，内镜逆行胰胆管造影术（ERCP）和腹部超声检查（ultrasound　of　the　abdomen）提示胆囊（gallbladder）中可能有许多小结石（small　stones），而且可能是在胆总管（the　common　bile　duct）中。最终诊断是胆囊炎（cholecystitis）胆石症（cholelithiasis）。

【解题思路】　B可听到最后“Your　diagnosis　is　cholecystitis　with　cholelithiasis.”这一关键句。

4.　【语段大意】　医生分析患者情况：先前的（previous）钡灌肠（barium　enema）显示了大肠（large　bowel）的乙状结肠和直肠段（sigmoid　and　rectal　segments）的一些不规则性(irregularities)；粪便培养（stool　samples　for　culture）、卵子（ova）和寄生虫（parasites）是阴性的（negative）。初步诊断（tentative　diagnosis）是应激性肠综合征（irritable　bowel　syndrome）。医生提示遵循无乳糖低残留饮食（a　lactosefree,　lowresidue　diet），服用碘化钠（take　Imodium）以减少肠道蠕动（reduce　intestinal　motility）；建议做结肠镜检查（colonoscopy）。

【解题思路】　D可听到large　bowel，　irritable　bowel　syndrome等关键信息。

5.　【语段大意】　医生在为患者分析病因：患者从急诊室到住院部（admitted　to　the　inpatient　unit　from　the　ER），右侧腹痛严重（severe　right　flank　pain）,对止痛药无反应（unresponsive　to　analgesics）。100毫克IV哌替啶的给药（with　administration　of　100　mg　of　IV　meperidine），疼痛并没有减少。患者有3个月的慢性泌尿系感染史（3month　history　of　chronic　UTI）。问题可能是由六个月前开的低骨密度的钙补充剂（the　calcium　supplements　for　low　bone　density）引起的。

【解题思路】　A可听到the　calcium　supplements,　six　months　ago等关键信息。

Part　Two

【语篇大意】　一名记者与心脏病专家埃林·米霍斯之间的对话，关于久坐的危险以及应对方法。

【解题思路】

6.　B对话开头就提到“体力劳动的工作占比不到20%”，故答案为B。

7.　A对话中提及“久坐会导致更坏的结果，包括心脏病（heart　disease）、2型糖尿病（Type　2　diabetes）和癌症（cancer）”，故答案为A。

8.　B当记者问“健身爱好者也可以久坐不动吗”时，　Michos说“我认为自己热衷于锻炼身体。我每天早上跑步四到五英里，对此我要给自己点赞。但后来我用了一个计步的跟踪装置，并意识到我在一天中剩下的时间里都没有移动……”，题干中“leads　a　completely　healthy　lifestyle”不对，所以答案为B。

9.　C原文“研究表明，如果你坐超过10小时，你的心血管风险（cardiovascular　risk）确实上升”，没有提心脏病风险，所以选C。

10.　B原文“最近的研究表明，高水平的运动可以减少一些风险”，题干中“have　no　cardiovascular　risk”没有风险不对，因此选B。

11.　AMichos说“我也参加过散步会议。我们绕着医院，边走边说话”，所以选A。

12.　AMichos说“即使你必须整天坐在电脑前，你也可以合理拆分时间”，所以选A。

13.　BMichos说“我们通常推荐每天10000步的目标”，而非11000步，故选B。

Part　Three

【语篇大意】　老师与两位学生在讨论蜂窝组织炎（cellulitis）的引发、症状、预防和治疗。

【解题思路】

14.　A对话开头提及“蜂窝组织炎是一种细菌感染真皮——深层皮肤、皮下组织、脂肪组织层下的皮肤”，故A为答案。　关键信息：Cellulitis　is　a　bacterial　infection　of　the　dermis—the　deep　layer　of　skin—as　well　as　the　subcutaneous　tissues,　the　fat　and　soft　tissue　layer　that　is　under　the　skin.

15.　C对话中提到“皮肤破裂可能是由溃疡、烧伤、咬伤、擦伤、伤口和一些皮肤疾病如湿疹、脚癣或银屑病引起的”，没有swelling（肿胀），故答案为C。关键信息：　A　break　in　the　skin　can　be　caused　by　ulcers,　burns,　bites,　grazes,　cuts,　and　some　skin　conditions　such　as　eczema,　athletes　foot,　or　psoriasis.

16.　B对话中提到“蜂窝组织炎的常见症状：受影响的区域会发热、组织变软、发炎、肿胀、红肿和疼痛。有些人可能会出现水疱、皮肤凹陷或斑点。他们也可能经历发烧、寒战、恶心和颤抖。淋巴结可能肿胀并变得柔软。”，没有inflammation　of　lymph　glands淋巴结发炎，所以答案应该选B。关键信息：The　affected　area　will　become　warm,　tender,　inflamed,　swollen,　red　and　painful.Some　people　may　develop　blisters,　skin　dimpling,　or　spots.　They　might　also　experience　a　fever,　chills,　nausea,　and　shivering.Lymph　glands　may　swell　and　become　tender.

17.　B对话中提到“如果皮肤因割伤、咬伤或擦伤而破裂，应保持清洁，以减少感染的风险。减少搔痒和感染皮肤的可能性。如果指甲保持短而干净，皮肤划伤的风险会大大降低。如果皮肤干燥，应使用保湿剂来预防皮肤开裂。然而，油腻皮肤的人不需要这样做。如果皮肤已经被感染，保湿剂将无济于事。由于肥胖可能会增加蜂窝组织炎的风险，应重视体重控制。”avoid　using　of　moisturizers（使用保湿霜）是有前提条件的，故答案为B。关键信息：　If　the　skin　is　broken　because　of　a　cut,　bite,　or　graze,　it　should　be　kept　clean　to　reduce　risk　of　infection.　Reducing　the　likelihood　of　scratching　and　infecting　the　skin.　The　risk　of　the　skin　being　damaged　by　scratching　will　be　greatly　reduced　if　fingernails　are　kept　short　and　clean.　Taking　good　care　of　the　skin　is　also　helpful.　If　the　skin　is　dry,　moisturizers　should　be　used　to　prevent　skin　from　cracking.　However,　individuals　with　greasy　skin　will　not　need　to　do　this.　Moisturizers　will　not　help　if　the　skin　is　already　infected.　Because　obesity　may　raise　the　risk　of　developing　cellulitis,　controlling　weight　should　be　paid　attention　to.

18.　C对话中提到“家里没有办法治疗蜂窝组织炎，这种情况需要去看医生”，显然C正确。关键信息：　There　is　no　way　to　treat　cellulitis　at　home,　and　this　condition　needs　to　be　treated　by　a　doctor.

19.　A对话中提到“有些人建议使用茶树油、椰子油和大蒜，因为它们可能具有抗菌、抗真菌和其他特性”，故答案为A。关键信息：Some　people　have　suggested　using　tea　tree　oil,　coconut　oil,　and　garlic,　because　they　may　have　antibacterial,　antifungal,　and　other　properties.

20.　B对话最后提到“然而，似乎没有证据表明他们可以治疗蜂窝组织炎。任何有症状的人都需要立即寻求医疗帮助。未经治疗，蜂窝组织炎可能危及生命”，故答案为B。关键信息：However,　there　appears　to　be　no　evidence　that　they　can　treat　cellulitis.　Anyone　with　symptoms　needs　to　seek　medical　help　at　once.　Untreated,　cellulitis　can　be　lifethreatening.

Part　Four

【语篇大意】　一个关于调整睡眠习惯方法的演讲。

【解题思路】

21.　milk此处为演讲中提到的第一个调整睡眠习惯的方法，即喝一杯温牛奶、洋甘菊茶或酸樱桃汁。所以此处应填milk。

22.　aerobic此处为演讲中提到的第二个调整睡眠习惯的方法，即锻炼。众所周知，适度的有氧运动能增加你的深度睡眠。所以此处应填aerobic。

23.　hormone此处为演讲中提到的第三个调整睡眠习惯的方法，即使用褪黑激素补充剂。褪黑激素是一种荷尔蒙，在我们感觉昏昏欲睡之前四小时内自然释放。所以此处应填hormone。

24.　menopause此处为演讲中提到的第四个调整睡眠习惯的方法，即保持凉爽。经历更年期和潮热的妇女应尽量保持房间的凉爽。故此处应填menopause。

25.　disruption此处为演讲中提到的第五个调整睡眠习惯的方法，即使周围变暗。如果你需要在晚上起床，最好使用手电筒，因为手电筒的视觉干扰比电灯小。故此处应填disruption。

ⅡReading

Part　One

【文章大意】　文章描述了美国蛋类生产商玫瑰农场，因环境卫生不合格和员工的不规范操作而导致沙门氏菌爆发的来龙去脉，并在文章结尾指出了沙门氏菌的传染途径和感染后的各种不良后果。

【解题思路】　从列表A到F中选择每个段落的最合适的副标题。

26.　C根据第一段第一句、第三句和第四句可以断定选C。本段描述了第一起沙门氏菌感染病例以及疾病爆发后追查到其中35人致病原因为食用存在鼠患的同一农场蛋产品。

27.　B根据第二段第二句至最后一句，都是直接引述该蛋产品生产商的道歉和承诺。

28.　A根据第三段第二句至最后一句，都是描述检查人员在该农场发现的各类卫生状况和雇员不规范的生产操作行为。

29.　E根据第四段第一句“The　‘unsanitary　conditions　and　poor　employee　practices’　created　an　environment　that　allowed　for　pathogens　that　could　cause　egg　contamination　to　thrive　throughout　the　facility,　the　report　says.”为中心句，其余部分是人们对该问题的控诉，均为支撑细节。

30.　D第五段第一句就是说明沙门氏菌的来源；第二句至最后一句在描述健康人群感染沙门氏菌表现的症状以及沙门氏菌对幼儿和年老人群可能造成的严重后果。

31.　A定位第一段第一句“...‘unacceptable　rodent　activity’　had　been　going　on　at　the　facility　for　months,　before　the　first　of　the　salmonellarelated　illnesses　occurred　but　the　facilitys　management　did　not　take　appropriate　actions　and　unsanitary　practices　continued.”。

32.　C定位第二段倒数第二句“When　we　fall　short　of　expectations,　were　disappointed　in　ourselves　and　we　strive　to　correct　any　problems　and　institute　safeguards　that　ensure　those　problems　wont　occur　again.”。

33.　D定位第三段第三句“A　few　carcasses　were　found　lying　in　and　outside　the　houses.”。

34.　F定位第四段倒数第二句“Eggs　produced　at　the　farm　are　distributed　to　retail　stores　and　restaurants　in　Colorado,　Florida,　New　Jersey,　New　York,　Pennsylvania,　Virginia,　West　Virginia　and　the　Carolinas.”。

35.　B定位第五段第一句“Salmonella　can　come　from　contaminated　animal　products　such　as　beef,　poultry,　milk　and　eggs,　as　well　as　fruits　and　vegetables.”。

Part　Two

【文章大意】　文章主要介绍了阿尔茨海默氏症的定义、病因、症状以及缓解病情的可行手段。

【解题思路】

36.　A根据第六段第一句“Alzheimers　disease　is　the　most　common　cause　of　dementia,　which　is　a　collective　term　for　symptoms　including　problems　with　language　and　thinking,　and　commonly　memory　loss.”得知A选项正确。

37.　C文章第七段“导致阿尔茨海默氏症的原因是什么?”紧接着第八段开头给出了概述“This　is　still　poorly　understood.”因此选C。

38.　D根据第八段第三句“However　there　are　several　factors　which　increase　the　risk,　with　age　being　the　biggest,　one　sufferer　in　20　is　less　risk　than　that　under　the　age　of　65...”得知年龄是增加阿尔茨海默氏症患病风险的最大因素，年龄越大，患病风险越高。故A、C选项错误。同时，第九段提到“There　are　twice　as　many　women　with　Alzheimers　over　the　age　65　as　men...”65岁以上患阿尔茨海默氏的女性是男性的两倍，可知女性患病几率更大，B选项错误。

39.　B根据第九段第一句“Lifestyle　factors　including　smoking,　obesity　and　diet　are　another　major　factor　in　increasing　risk”，提到了增加阿尔茨海默氏症患病风险的另一主要因素包括吸烟、肥胖和饮食在内的生活方式。得知B选项正确。

40.　B根据第十一段第一句“Depression　can　be　a　very　early　sign　which　may　occur　before　any　physical　hallmarks　in　the　brain.”得知是before　，不是after，　B为正确答案。

41.　D根据文章第十三段第一句话“There　is　no　cure　for　the　disease,　though　this　is　a　major　research　area　along　with　developing　tests　for　earlier　diagnosis.”（虽然这是一个主要的研究领域，同时也在开发早期诊断的测试，但是这种疾病还没有治愈的方法。）因此选D。

42.　B最后一段第三句话总述了药物治疗仅可以缓解症状“There　are　drug　treatments　which　can　temporarily　improve　some　symptoms.”第四、五句话分述了早期阶段和后期阶段分别可以使用哪些药物来缓解哪些症状。因此B选项正确，而其他三个选项均有错误。

Part　Three

【文章大意】文章阐述了结直肠癌及化疗的副作用，化学佐剂西洋参可以降低化疗的毒性，研究数据表明西洋参浆果有可能提高5FU的肿瘤杀伤作用。

【解题思路】

43.　B根据第一段第一句“Colorectal　cancer　is　one　of　the　most　common　malignancies　and　ranks　as　the　second　greatest　cause　of　cancer　death　in　both　men　and　women　worldwide.”结直肠癌是第二大癌症死亡原因，因此题目错误。

44.　A根据第二段第五句“American　ginseng　has　been　reported　to　have　stressrelieving　qualities,　antiaging　effects　and　digestionaiding　effects.”（据报道，西洋参具有缓解压力的品质，抗衰老的功效和助消化作用。）题目正确。

45.　A根据第三段第四句“The　5Fluorouracil　(5FU)　is　one　of　the　most　widely　used　chemotherapeutic　agents　in　firstline　therapy　for　colorectal　cancer,　and　an　overall　survival　benefit　after　fluorouracilbased　chemotherapy　has　been　firmly　established.”[5氟尿嘧啶(5FU)是目前在大肠癌一线治疗中应用最广泛的化疗药物之一，氟脲基化疗后的整体生存效果已被肯定。]题目正确。

46.　C题目意思是“这些化合物的浓度随遗传、季节、地理分布、植物生长、生产和提取过程的不同而有显著差异”。此信息在文中没有给出，故选C。

47.　C题目意思是“目前尚不清楚在化疗时使用西洋参浆果提取物是否会影响化疗药物的疗效”。此信息在文中并未涉及，故选C。

48.　B根据第四段最后一句话“The　successful　treatment　regimens　for　cancer　include　combination　chemotherapy,　which　is　often　more　effective　than　single　chemotherapy　because　of　additive　or　synergistic　effects.　”（癌症的成功治疗方案包括联合化疗，由于附加或协同作用，联合化疗通常比单一化疗更有效。）关键词more，对比可知题目错误。

49.　B根据第五段第二句“Our　data　suggest　that　AGBE　has　the　potential　to　heighten　the　tumoricidal　effects　of　5FU　and　that　5FUinduced　antiproliferation　of　human　colorectal　cancer　cells　can　be　strengthened　by　combination　with　AGBE.”（我们的数据表明，AGBE有可能提高5FU的肿瘤杀伤作用，而5FU诱导的人类结直肠癌细胞的抗增殖能力可以通过与AGBE结合得到加强。）关键词can　be　可知，题目错误。

50.　A根据第五段最后一句话“The　mechanism　may　include　the　enhancement　of　AGBE　on　the　Sand　G2/M　phases　arrest　and　the　expression　level　of　cyclin　A,　but　not　the　induction　of　cell　apoptosis.”（这一机制可能包括增强沙G2/M期AGBE抑制和cyclin　A的表达水平，而不是诱导细胞凋亡。）题目正确。

Part　Four

【文章大意】　文章用研究例证的方式阐述了乐观对身体健康的影响：与寿命有关；在疾病和疾病的康复中的积极作用（乳腺癌、动脉粥样硬化）；影响人的免疫系统;对免疫受损的人的影响。

【解题思路】

51.　D第一段第一句是段落主题句，指出乐观与寿命有关。并用两个研究例证来佐证。第一个是2000年Maruta,　Colligan,　Malinchoc和Offord的研究；第二个是20世纪60年代中期的研究，将病人分为乐观、混合或悲观。其中对于乐观的研究运用了明尼苏达州的人格量表，并得出了51题的发现：一个人的乐观程度分数每增加10分，早逝的风险就会减少19%。有助于正确选题的重要词句包括Maruta,　Colligan,　Malinchoc,　and　Offord　(2000)　examined/With　a　large　longitudinal　sample　collected　in　the　mid1960s,　the　researchers　categorized/　using　parts　of　the　Minnesota　Multiphasic　Personality　Inventory。

52.　A第三段第一句是段落主题句，指出乐观态度也在疾病和疾病的康复中起重要作用。52题开始就用研究例证来支持这一论点。第四段开头“这些研究发现”和文中的“乳腺癌”提示52题选择多项研究调查了乐观在癌症治疗中的作用。有助于正确选题的重要词句包括recovery　from　illness　and　disease/These　studies　have　found　that/　breast　cancer。

53.　E第四段提到了乐观在乳腺癌治疗中的积极作用；社交活动的作用；睡眠质量；53题预防慢性疾病发展的作用（例证：动脉粥样硬化）。有助于正确选题的重要词句包括breast　cancer/social　activities/sleep　quality/atherosclerosis(动脉粥样硬化)

54.　C第五段第一句话是段落主题句，指出乐观也会影响人的免疫系统。分别用老人接种流感疫苗和法学院学生的性格乐观来例证。段落最后指出这项研究发现乐观预示了细胞介导的免疫能力，这是免疫系统对感染因子反应的重要组成部分。此外，负面影响也不能预测免疫功能的变化。引出最后一句54题这就意味着乐观确实在免疫系统中的独特价值。有助于正确选题的重要词句包括Optimism　can　have　an　effect　on　a　persons　immune　system,　as　well/　This　study　found　that　optimism　predicted　superior　cellmediated　immunity/Furthermore,　negative　affect　did　not　predict　changes　in　immune　function/　What　this　means　is　that/　unique　value。

55.　B最后一段是总结段落，本句话55题“上述研究有一个共同的主题：乐观对一个人的身体健康有深远的影响”也是对全篇例证的一个总结。有助于正确选题的重要词句包括boost　a　persons　immune　system/　protect　against　harmful　behaviors　/prevent　chronic　disease/and　help　people　cope　following　troubling　news/　predict　a　longer　life。

Part　Five

【文章大意】　文章介绍了肾脏移植的一些情况，肾胰腺移植的例子以及影响移植的一些因素。

【解题思路】

56.　Ctypically是副词，典型地，这个地方要用副词修饰动词classified，atypically词意表达不准确。

57.　Btransplanted，这句话表达的意思是：有时候，肾脏可以跟胰腺一起移植。

58.　A本句“Only　a　few　living　donor　pancreas　transplants　have　been　done”表达只有少数的人胰腺移植成功。用a　few来修饰可数名词人，表示有一些，但是few表示几乎没有人，与文章的意思相悖。

59.　D根据“but　even　75yearold　recipients　gain　an　average　of　four　more　years　of　life”，说明前面应该是意为年轻的会有更好的结果，　故选D,younger　较年轻的，而young是年轻人，这里表达比六七十岁更年轻的，不只是年轻人。

60.　C这里想表达“除了……之外还有……”，故选C，away　from,　far　from是表达远离……;　suffer　from是遭受某种疾病。

61.　A文中“For　example,　different　sociodemographic　groups　express　different　interest　and　complete　pretransplantat　different　rates.”意思为：“比如不同的社会层次有不同的兴趣，也以不同的速度来完成移植前的检查。”pretransplant　是移植前的，选项中work　out　解决，算出，　workout为锻炼、练习，work　up建立发展，只有A　选项workup意为诊断检查，故选A。

62.　B“Previous　efforts　to　create　fair　transplantation　policies　have　focused　on　patients　currently　on　the　transplantation　waiting　list.”此处意为：“以前为制定公平的移植政策所做的努力集中在目前在移植等待名单的病人身上。”选B符合语义。

63.　B此处译为：“在接受肾移植的患者中，达到耐受度仍然是一个非常理想的目标。”仍然用remain，注意主谓一致，故选B。

64.　D首先是从时态上排除，前面有have,故此处为完成时态，排除B，C。此处表达：对自发的肾移植受者的机械性研究发现了B或调节T细胞的潜在作用，故选D　uncovered,揭露，发现。

65.　A“...distinct　protocols　at　three　major　transplant　centers　have　successful　withdrawal　of　immunosuppression...”此句句意为：“在三个主要的移植中心有不同的协议导致了活体供肾移植受者的免疫抑制成功地退出。”lead　to意为导致，选其他选项句子意思均不符合常理或逻辑。

ⅢWriting

66.　【范文】

In　recent　years,　the　relationship　between　doctors　and　patients　has　come　under　heated　discussion　among　general　public.　With　the　tensions　increase,　it　is　imperative　to　find　out　some　ways　to　ease　the　tense　relations.　In　my　stance,　mutual　understanding　and　health　care　improvement　are　the　two　most　important　aspects　that　should　be　taken　to　solve　the　problem.

First,　to　effectively　ease　the　current　tensions　of　doctorpatient　relationship,　understanding　between　doctors　and　patients　and　their　families　should　be　enhanced.　To　be　specific,　doctors　should　fulfill　their　obligations　to　inform　the　patients　about　the　details　of　their　condition,　including　the　patients　diagnosis　and　treatment　options.　In　the　meantime,　they　should　offer　the　most　appropriate　treatment　for　the　patients,　and　give　advice　from　a　professional　point　of　view.　Conversely,　patients　should　actively　cooperate　with　the　doctors　with　complete　trust.

In　addition,　the　health　care　system　should　be　improved　step　by　step.　Another　possible　cause　for　the　tense　of　doctorpatient　lies　in　the　inadequate　health　care　system.　The　way　doctors　receive　their　salary　and　bonus,　the　drug　regulation,　and　the　percentage　of　medical　expenses　and　medical　insurance　paid　by　patients　themselves　are　underlying　reasons　for　the　worsening　relationship　between　doctors　and　patients.　From　this　perspective,　to　ease　the　conflicts,　the　government　should　try　to　optimize　the　health　care　system　by　mild　revolution　of　the　above　specific　aspects.

All　in　all,　it　is　high　time　that　doctors,　patients　and　the　government　should　make　joint　effort　to　deal　with　the　poor　relationship.　Only　in　this　way　can　we　create　a　harmonious　doctorpatient　relationship.　(255words)

【审题】

写作部分要求围绕“医患关系”进行写作。题目陈述了近年来，医患关系日趋紧张和复杂，医患纠纷愈演愈烈，医疗活动和医院的正常秩序受到严重影响这一社会现象，要求就如何处理好医患关系提出一些建议。文章应属说明文，写作中的一个重点是能就造成医患关系恶化的原因给出可行性建议，难点是如何正确写出一些涉及医疗卫生领域话题的英语表达，如“医护人员、医疗体系、医疗费用、药品监管”等。

【范文评析】

文章首先根据题目要求，指出解决医患关系迫在眉睫，并明确提出两点建议。第二段第一句总领全段，随后从医生和患者自身该如何做给出具体建议。第三段第一句总领全段，随后提出政府可从三方面着手改革。

文章观点明确，两个主题句有效支持全文主旨句，阐述合理，展开充分；语言表达准确，特别是使用了“to　some　extent”“step　by　step”“possible　cause”“mildly”等模糊限制语，精准地表达了作者的观点。

医护英语水平考试(三级)

模拟训练（六）

听力文本

This　is　METS3　listening　test.　There　are　four　parts　in　the　test,　Part　One,　Two,　Three,　and　Four.　You　will　hear　each　part　twice.

We　will　now　stop　for　a　moment　before　we　start　the　test.　Please　ask　any　questions　now　because　you　must　not　speak　during　the　test.

Now,　look　at　the　instructions　for　Part　One.

You　will　hear　five　extracts　from　conversations　taking　place　in　different　clinical　departments.Choose　which　case　each　doctor　is　discussing　from　the　list　A—F.　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　do　not　need　to　use.

Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　each　extract　twice.　Now　we　are　ready　to　start.

Extract　1

I　have　read　your　report.　You　have　had　chronic　glomerulonephritis　since　age　7.　And　you　have　been　managed　at　home　with　CAPD　for　the　last　16　months　as　waiting　a　kidney　transplant.　I　advise　you　to　go　immediately　to　the　ER　when　you　feel　chest　pain,　shortness　of　breath,　and　oliguria.

Extract　2

I　advise　a　surgical　referral.　You　are　diagnosed　with　bilateral　direct　inguinal　hernias　and　I　suggest　that　you　not　delay　surgery,　though　you　are　not　at　high　risk　for　a　strangulated　hernia.　About　your　question　that　whether　you　can　also　be　sterilized　at　the　same　time,　you　can　be　scheduled　for　bilateral　inguinal　herniorrhaphy　and　elective　vasectomy.

Extract　3

I　dont　recommend　hormone　therapy,　because　I　think　you　are　at　too　much　risk　for　excessive　bleeding　with　the　abnormal　cells　on　your　cervix.　Dont　forget　you　just　spent　3　months　under　the　care　of　gynecologist　for　treatment　of　postmenopausal　bleeding　and　cervical　dysplasia.　Not　to　mention　the　several　vaginal　examinations　with　Pap　smears,　a　uterine　ultrasound,　colposcopy　with　endocervical　biopsies,　and　a　D&C　with　cone　biopsy.

Extract　4

You　have　an　uneventful　pregnancy　with　good　health,　moderate　weight　gain,　good　fetal　heart　sounds,　and　no　signs　or　symptoms　of　pregnancyinduced　hypertension.　Xray　pelvimetry　reveals　CPD　with　the　fetus　in　right　occiput　posterior　position.　Changes　in　fetal　heart　rate　indicate　fetal　distress.　You　will　be　transported　to　the　OR　for　emergency　Csection　under　spinal　anesthesia.

Extract　5

You　should　know　that　severe　pancreatitis　has　a　mortality　rate　near　50%.　Its　lucky　that　you　have　survived　heart　surgery,　but　to　now　we　really　have　to　worry　about　multisystem　organ　failure.　Whats　worse,　you　have　severe　stabbing　midepigastric　pain　that　radiates　to　your　back,　nausea,　vomiting,　abdominal　distention　and　rigidity,　and　jaundice.

Now　youll　hear　Part　One　again.　This　is　the　end　of　Part　One.　Now　look　at　Part　Two.

You　will　hear　a　conversation　between　a　reporter　and　a　transplantation　expert.　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).　Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　the　recording　twice.

Reporter：　I　am　Cecilia　Austin.　It　is　reported　that　nearly　124,000　men,　women　and　children　are　awaiting　organ　transplants　in　the　United　States.　Every　10　minutes,　another　name　is　added　to　the　national　organ　transplant　waiting　list.　Twentyone　people　die　each　day　from　lack　of　a　transplant.

A　living　donor　can　eliminate　the　need　for　a　recipient　to　be　added　to　the　national　waiting　list.　I　am　interviewing　Andrew　MacGregor　Cameron,　a　Johns　Hopkins　transplantation　expert.　He　will　answer　frequently　asked　questions　about　live　organ　donation.Dr.　Cameron,　who　can　become　a　living　donor?

Cameron:　Living　donors　must　be　at　least　18　years　old,　in　good　physical　and　mental　health,　and　must　have　a　body　mass　index　that　is　less　than　35.　Living　donors　can　be　relatives,　friends,　neighbors,　inlaws　or　altruistic　strangers.

Reporter：　Altruistic　strangers?

Cameron:　Yes,　individuals　who　wish　to　donate　to　an　unknown　recipient　purely　out　of　selfless　motives.

Reporter:　What　can　I　donate?

Cameron:　As　a　living　donor,　you　can　donate　one　of　your　kidneys　and　part　of　your　liver.

Reporter:　What　are　the　risks　and　recovery　for　a　living　organ　donor?

Cameron:　Just　like　with　any　other　major　surgery,　there　are　risks　and　a　period　of　critical　recovery　time　for　transplantation　surgery.　For　kidney　donors,　the　remaining　kidney　will　enlarge　slightly　because　it　has　to　do　the　work　of　two　healthy　kidneys.　For　liver　donors,　the　liver　regenerates　and　regains　full　function.　The　recovery　time　after　surgery　is　typically　six　to　eight　weeks.　Living　donation　does　not　change　life　expectancy.　Most　donors　go　on　to　live　healthy　lives　after　recovering　from　the　surgery.　Specific　donorrelated　risks　should　be　discussed　with　your　transplant　team.

Reporter:　Can　I　donate　my　organs　if　I　have　a　medical　condition?

Cameron:　Possibly.　Most　people　can　donate,　but　there　are　a　few　exclusions,　such　as　HIV,　active　cancer　and　systemic　infection.　Your　doctors　will　evaluate　your　medical　condition　and　the　condition　of　your　organs　to　determine　if　you　are　qualified　to　be　a　living　organ　donor.

Reporter:　Who　pays　for　the　cost　of　an　organ　donation?

Cameron:　In　most　cases,　the　transplant　recipients　private　health　insurance,　Medicare　or　Medicaid　will　pay　for　the　donors　initial　evaluation,　surgery　and　postoperative　care.

Reporter:　Can　nonUS　citizens　donate　organs?

Cameron:　Yes.　NonUS　citizens　can　receive　and　donate　organs　in　the　United　States.

Reporter:　Can　I　sell　my　organs?

Cameron:　All　live　kidney　and　liver　donations　must　be　a　completely　voluntary　decision.　Donors　should　be　free　from　any　pressure　or　guilt　associated　with　the　donation,　and　they　cannot　be　paid　for　their　donation.　In　1984,　Congress　passed　the　National　Organ　Transplant　Act,　which　makes　it　illegal　to　buy　or　sell　organs.

Reporter:　How　can　I　become　a　donor?

Cameron:　If　you　are　interested　in　donating　a　kidney　to　someone　in　need,　please　call　4106149345　or　register　online.　If　you　are　interested　in　donating　a　liver　to　someone　in　need,　please　call　4106142989.

Now　youll　hear　Part　Two　again.　This　is　the　end　of　Part　Two.　Now　look　at　Part　Three.

You　will　hear　a　discussion　among　an　instructor　and　two　medical　students.

For　questions　14—20,　choose　the　best　appropriate　answer.

Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　the　discussion　twice.

Instructor:　Today　we　are　going　to　discuss　breast　cancer.　It　is　the　most　common　cancer　in　women　worldwide,　with　nearly　1.7　million　new　cases　diagnosed　in　2012.　This　represents　about　12%　of　all　new　cancer　cases　and　25%　of　all　cancers　in　women.　It　is　the　fifth　most　common　cause　of　death　from　cancer　in　women.　Who　would　like　to　start?

Student　1:　Breast　cancer　risk　doubles　each　decade　until　menopause,　after　which　the　increase　slows.　However,　breast　cancer　is　more　common　after　menopause.

Student　2:　Survival　rates　for　breast　cancer　vary　worldwide,　but　in　general　the　rates　have　improved.　This　is　because　breast　cancer　is　diagnosed　at　an　earlier　and　localised　stage　in　nations　where　populations　have　access　to　medical　care,　and　progressive　improvement　in　treatment　strategies.

Instructor:　Yes.　In　many　countries　with　advanced　medical　care,　the　fiveyear　survival　rate　of　early　stage　breast　cancers　is　80—90　percent,　falling　to　24　percent　for　breast　cancers　diagnosed　at　a　more　advanced　stage.　Most　breast　cancer　subtypes　are　hormonerelated.　The　natural　history　of　the　disease　differs　between　those　diagnosed　before　and　after　the　menopause,　which　may　be　due　to　different　kinds　of　tumour　and　possibly　different　effects　of　nutritional　factors　on　hormones　depending　on　menopausal　status.

Student　1:　What　are　the　risk　factors　for　breast　cancer?

Instructor:　Life　events　are　important　risk　factors　for　breast　cancer　including　early　menarche,　late　natural　menopause,　not　bearing　children　and　first　pregnancy　over　the　age　of　30,　as　they　all　increase　lifetime　exposure　to　oestrogen　and　progesterone　and　the　risk　of　breast　cancer.

Student　2:　So　the　reverse　also　applies　that　late　menarche,　early　menopause,　bearing　children　and　pregnancy　before　the　age　of　30　all　reduce　the　risk　of　breast　cancer.

Instructor:　You　are　right.　In　addition,　ionising　radiation　exposure　from　medical　treatment　such　as　Xrays,　particularly　during　puberty,　increases　the　risk　of　breast　cancer,　even　at　low　doses.

Student　1:　Does　hormone　therapy　have　any　correlation　with　breast　cancer?

Instructor:　The　answer　is　yes.　Hormone　therapy　containing　oestrogen　with　or　without　progesterone　increases　risk　of　breast　cancer　and　the　risk　is　greater　with　combined　oestrogen　plus　progesterone　preparations.　Plus,　oral　contraceptives　containing　both　oestrogen　and　progesterone　also　cause　a　small　increased　risk　of　breast　cancer　in　young　women,　among　current　and　recent　users　only.

Student　2:　How　about　the　prevalance　of　breast　caner　worldwide?

Instructor:　In　general,　the　highest　incidence　of　breast　cancer　was　in　Northern　America　and　Oceania,　and　the　lowest　incidence　was　in　Asia　and　Africa.　This　is　the　table　showing　the　countries　with　the　top　20　highest　incidence　of　breast　cancer　in　2012.　You　can　see　that　Belgium　had　the　highest　rate　of　breast　cancer,　followed　by　Denmark　and　the　Netherlands.　Slightly　more　cases　of　breast　cancer,　that　is,　53%,　were　diagnosed　in　less　developed　countries.

Now　youll　hear　Part　Three　again.This　is　the　end　of　Part　Three.　Now　look　at　Part　Four.

You　will　hear　a　speech　on　helpful　strategies　after　receiving　a　dementia　diagnosis.　Complete　the　notes.　In　each　blank,　write　only　one　word.　Write　the　answers　on　your　answer　sheet.　You　will　hear　the　speech　twice.

Male:　When　you　or　a　loved　one　first　receives　a　dementia　diagnosis,　you　may　feel　a　range　of　contradictory　emotions,　sometimes　simultaneously.　Many　people　undergo　a　period　of　profound　grief,　with　feelings　of　shock,　denial　and　deep　sadness.　The　prospect　of　facing　this　significant　life　change　can　make　you　feel　demoralized,　embarrassed　or　angry.　You　may　even　want　to　keep　the　diagnosis　secret　from　friends　or　other　family　members.

On　the　other　hand,　you　may　feel　a　sense　of　relief.　Finally,　your　suspicions　have　been　validated,　and　you　and　your　loved　ones　can　seek　out　more　support　and　therapeutic　interventions.

Even　after　youve　accepted　the　diagnosis,　your　emotions　can　vary　depending　on　the　situation—the　stage　of　the　illness,　your　financial　and　social　resources,　and　so　on.　Your　best　move—for　you　and　your　loved　one—is　to　be　educated　and　prepared,　and　here　some　strategies　can　help.

Allow　yourself　time　to　adjust.The　shock　of　the　diagnosis　can　be　paralyzing.　Be　gentle　and　compassionate　with　yourself;　allow　yourself　to　move　through　the　mourning　process.　Try　to　feel　all　the　feelings,　rather　than　deny　them,　and　be　upfront　with　your　family　and　friends　about　your　diagnosis.　Youll　likely　move　into　problemsolving　mode　faster.

Set　up　routines　and　expectations.People　with　dementia　dont　always　believe　they　need　help,　so　power　struggles　can　ensue　over　daily　tasks,　warns　Johnston.　Clearly　defined　routines　and　predictable　schedules　for　tasks　such　as　cleaning　and　eating　may　help　avoid　some　conflicts　and　help　you　both　feel　more　settled.　Orderly,　peaceful　environments　also　create　calm.

Find　an　experienced　dementia　care　counselor　for　both　of　you.One　of　Johnstons　studies　found　that　when　caregivers　and　people　with　dementia　sought　treatment　for　depression,　they　gained　greater　access　to　care,　services　and　support.　Caregivers　should　have　someone　to　talk　to　regularly,　who　can　provide　support,　educate　them　about　the　illness　and　coach　them　on　how　to　cope　as　it　progresses.

Give　each　other　space.　As　the　disease　progresses,　rapidly　swinging　moods　and　angry,　negative　outbursts　can　take　a　great　toll　on　caregivers.　Plus,　more　than　90　percent　of　people　with　dementia　develop　behavioral　symptoms　or　psychiatric　problems　at　some　point　during　their　illness.　Its　perfectly　OK　to　calmly　say,　“I　need　to　have　some　privacy,”　and　leave　the　room　to　have　a　moment　of　peace,　to　allow　both　of　you　to　calm　down.

Pace　yourself.　Caregivers　may　have　trouble　sleeping　due　to　worry　over　their　loved　ones　needs,　yet　still　not　have　anyone　to　relieve　them　the　next　day　when　theyre　exhausted.　The　weight　of　all　of　these　concerns　can　cause　even　the　most　resolute　caregivers　to　experience　stress,　resentment　and　even　depression.　Rest　when　you　can,　and　prioritize.　Keep　the　day　structured　and　predictable　as　much　as　possible,　the　environment　uncluttered　and　activities　simple.

Make　time　for　daily　exercise.　A　daily　walk　in　a　park　or　just　around　the　block　can　be　an　effective　antidepressant　and　antianxiety　remedy　for　both　of　you.　If　needed,　keep　a　sturdy　transport　wheelchair　stowed　in　the　trunk　to　broaden　your　options　for　walks　together　while　running　errands.

Now　youll　hear　Part　Four　again.　This　is　the　end　of　Part　Four.　You　now　have　five　minutes　to　write　your　answers　on　the　answer　sheet.　You　have　one　more　minute.　This　is　the　end　of　the　listening　test.

参考答案与试题评析

ⅠListening

Part　One

1.　【语段大意】　医生通过患者的报告了解到，患者从7岁起就患有慢性肾小球肾炎(chronic　glomerulonephritis)。在过去的16个月里，一直在家中接受(持续性非卧床式）腹膜透析［CAPD（Continuous　Ambulatory　Peritoneal　Dialysis)］的治疗，等待肾脏移植。医生建议，当患者感到胸痛、气短和少尿时，应立即去看急诊。

【解题思路】　F可听到chronic　glomerulonephritis，　waiting　a　kidney　transplant等关键信息。

2.　【语段大意】　患者被诊断为双侧腹股沟直疝，医生建议立即手术。关于患者提到是否可以同时进行绝育手术的问题，医生说可以安排双侧腹股沟疝修补术和择期输精管切除术。

【解题思路】　C可听到“I　suggest　that　you　not　delay　surgery”这一关键信息。

3.　【语段大意】　医生不建议患者接收激素治疗，因为患者宫颈有异常细胞并有过度出血的风险。

【解题思路】　B听力开始部分提到“I　dont　recommend　hormone　therapy”这一关键信息。

4.　【语段大意】　医生陈述这位孕妇身体健康，体重增加适度，胎儿心音良好，没有妊娠高血压的迹象或症状。但骨盆X线测量显示CPD与胎儿在右后枕位，胎儿心率的变化表明胎儿窘迫，医生认为患者需要剖宫产。

【解题思路】　D可听到pregnancy，　fetus等关键词。

5.　【语段大意】　医生认为患者心脏手术很成功，但患者罹患重症胰腺炎，这种疾病的死亡率接近50%，医生担心患者出现多系统器官衰竭。

【解题思路】　E听力开头部分可听到“You　should　know　that　severe　pancreatitis　has　a　mortality　rate　near　50%.”这一关键句。

Part　Two

【语篇大意】　一位记者对一位移植专家关于器官移植的采访。

【解题思路】

6.　A记者提到每天有21人因未进行（器官）移植而死亡，故答案为A。

7.　B专家提到，活体捐献者必须年满18岁，身心健康，体重指数必须小于35。故答案为B。

8.　A专家提到，活体捐献者可捐出一个肾脏和一部分肝脏。所以答案为A。

9.　C专家提到肾脏捐献者的剩余肾脏会稍微增大，未提及手术后的恢复事项，所以C正确。

10.　A专家提到，活体捐赠不会影响寿命，因此选A。

11.　B专家提到除艾滋病、癌症和全身性感染患者不能捐赠器官外，大部分人即使有健康问题也可以捐赠器官。所以选B。

12.　C专家提到，在大多数情况下，移植接受者的私人健康保险、医疗保险或医疗补助将用于支付捐赠者的初步评估、手术和术后护理费用,但并未提及捐赠者是否会得到一笔术后护理费，所以选C。

13.　A专家提到，1984年，国会通过了“国家器官移植法案”，规定买卖器官是非法的，故A正确。

Part　Three

【语篇大意】　两位医学生与老师讨论乳腺癌的相关问题。

【解题思路】

14.　B对话中提到，乳腺癌是妇女最常见的癌症，2012年诊断出近170万例新病例，故答案为B。

15.　A对话中提到，乳腺癌风险每十年增加一倍，直至绝经期，故答案为A。

16.　A对话中提到，全世界乳腺癌的存活率各不相同，但总的说来，生存率有所提高。所以答案应该选A。关键信息：Survival　rates　for　breast　cancer　vary　worldwide,　but　in　general　rates　have　improved.

17.　C对话中提到，在许多拥有先进医疗服务的国家，早期乳腺癌的5年生存率为80%—90%，在晚期（advanced　stage)　被诊断为乳腺癌的生存率降至24%，故答案为C。关键信息：In　many　countries　with　advanced　medical　care,　the　fiveyear　survival　rate　of　early　stage　breast　cancers　is　80—90　percent,　falling　to　24　percent　for　breast　cancers　diagnosed　at　a　more　advanced　stage.

18.　C对话中提到,　月经初潮早、自然更年晚、不生育、30岁以上第一次怀孕都增加了终生接触雌激素和黄体酮,以及患乳腺癌的风险。显然C正确。

关键信息：Life　events　are　important　risk　factors　for　breast　cancer　including　early　menarche,　late　natural　menopause,　not　bearing　children　and　first　pregnancy　over　the　age　of　30,　as　they　all　increase　lifetime　exposure　to　oestrogen　and　progesterone　and　the　risk　of　breast　cancer.

19.　B对话中提到含有雌激素的激素治疗，不管有没有黄体酮，都会增加乳腺癌的风险，雌激素加黄体酮联合制剂的风险更大。A为雄激素，C为睾丸素，故答案为B。关键信息：Hormone　therapy　containing　oestrogen　with　or　without　progesterone　increases　risk　of　breast　cancer　and　the　risk　is　greater　with　combined　oestrogen　plus　progesterone　preparations.

20.　B对话中提到，老师展示了2012年乳腺癌发病率最高的20个国家，并明确指出，比利时的乳腺癌发病率最高，其次是丹麦和荷兰。故答案为B。关键信息：This　is　the　table　showing　the　countries　with　the　top　20　highest　incidence　of　breast　cancer　in　2012.　You　can　see　that　Belgium　had　the　highest　rate　of　breast　cancer,　followed　by　Denmark　and　the　Netherlands.

Part　Four

【语篇大意】　关于如何应对自己或家人痴呆诊断的一段讲座。

【解题思路】

21.　compassionate此处为讲座中提到的第一个策略，即给自己一些调整的时间，要对自己温柔体恤，允许自己经历这个悲伤的过程。所以此处应填compassionate。

22.　counselor讲座中提到，可以找一位有经验的痴呆症护理顾问，所以此处应填counselor。

23.　psychiatric讲座中提到,超过90%的痴呆症患者在患病期间会出现行为症状或精神问题。所以此处应填psychiatric。

24.　predictable讲座中提到，应尽量保持一天的有序性和可预见性，保持环境整洁，活动简单。所以此处应填predictable。

25.　antidepressant讲座最后提到，应保持每天运动，每天在公园或街区附近散步可有效抵御抑郁和焦虑。故此处应填antidepressant。

ⅡReading

Part　One

【文章大意】　文章论述了手机使用和健康之间的关系，并给出了一些使用手机的建议。

【解题思路】

26.　C第一段第三句和第四句就手机是否对身体产生危害提出两种研究结论：一类研究认为只有频繁使用者具有较大的罹患脑瘤的风险，而另一类研究表明使用手机和癌症之间并无联系。

27.　F第二段第三和第四句描述了两方面因素对当前研究的影响，一是使用手机与癌症形成之间的时间问题，二是来自手机制造商或个人利益可能对研究结论造成的影响。

28.　B第三段第二句“Mobile　phone　antennas　are　similar　to　microwave　ovens.”,第四句“Microwave　ovens　have　radio　wave　frequencies　that　are　high　enough　to　cook　food,　and　they　are　also　known　to　be　dangerous　to　human　tissues　like　those　in　the　brain.”,　以及第五句　“The　concern　is　that　the　lowerfrequency　radio　waves　that　mobile　phones　rely　on　may　also　be　dangerous.”表明，手机天线和微波炉相似，而众所周知，微波炉对身体组织会产生危害，所以，手机依赖的低频无线电波可能是危险的。

29.　A第四段第二、第三和第四句都是研究者提出的建议。

30.　E第五段第一句就指出手机使用者目前对手机的危害还没有足够的警觉；第四句以烟草为例，证明现在人们对手机的危害的认知就好比以前对烟草和肺癌之间的关联性的认知；第五、第六句描述了2016年的研究结果：大鼠脑瘤患病率的上升与手机发射的无线电频率有关。

31.　C定位第一段第三句“Some　research　suggests　that　heavy　users　of　mobile　phones　are　at　a　greater　risk　of　developing　cancerous　brain　tumors.”。

32.　D定位第二段最后一句“Another　concern　about　these　studies　is　that　many　have　been　funded　by　the　mobile　phone　industry　or　those　who　benefit　from　it.”。

33.　A定位第三段第四句“The　concern　is　that　the　lowerfrequency　radio　waves　that　mobile　phones　rely　on　may　also　be　dangerous.”。

34.　B定位第四段第三句“They　also　say　that　many　cordless　phones　can　emit　dangerous　levels　of　Electromagnetic　Radiation　even　when　they　are　not　in　use.”。

35.　F定位第五段最后一句　“As　a　result,　many　experts　now　recommend　texting　or　using　head　sets　or　speaker　phones　instead　of　holding　a　mobile　phone　to　the　ear.”。

Part　Two

【文章大意】　文章讲述了Gough对于自己的妻子因为乳腺癌筛查出现错误，而错失最　佳的治疗时间的震惊和痛苦之情，以及卫生部部长Jeremy　Hunt对事件的相关处理。

【解题思路】

36.　C第三段“it　is　estimated　between　135　and　270　women　had　their　lives　shortened　as　a　result.”,　据估计，135至270名女性因为乳腺癌筛查出现错误，导致了寿命缩短。

37.　C第五段“He　said　he　was　watching　the　television　on　Wednesday　when　the　news　of　the　screening　error　broke,　leaving　him　‘shell　shocked’.”，可知，乳腺癌筛查出现错误使Brian　Gough感到吃惊。

38.　D原文并未提及所有的女性被邀请去做筛查。因此，D选项为错误选项，故选D。

39.　B文章十二段“It　does　seem　strange　that　people　didnt　come　forward　who　were　expecting　to　be　invited　and　didnt　get　an　invitation　and　that　didnt　set　hares　running,　so　thats　one　of　the　things　we　need　to　look　at.”，表明，Mr.Hunt想要弄清楚为什么人们没有被邀请去做检查。

40.　D文章倒数第四段和第五段提到了chemotherapy,　radiotherapy/But　he　said　it　returned　again,　prompting　another　two　years　of　chemotherapy　and　treatment　during　what　he　described　as　an　“horrendous　situation”,表明Gough的妻子接受了化疗，从Gough对化疗过程的描述，可以推测Gough的妻子经历了痛苦的治疗过程。

41.　C文中最后一段“Mr.Gough　believes　that　‘maybe,　just　maybe’　his　wife　might　have　come　through　the　first　lot　of　cancer　treatment　and　survived　if　it　had　been　diagnosed　earlier.”　可知，Gough假设疾病如果早点被诊断出来，他的妻子可能会幸存，而C项表述过于肯定。

42.　B文章讲述了Gough对于自己的妻子因为乳腺癌筛查出现错误，而错失最佳治疗时间的震惊和痛苦之情。因此，B选项的内容适合做文章的标题。

Part　Three

【文章大意】　文章介绍了神经性厌食症和贪食症，以及给出了相应的治疗建议。

【解题思路】

43.　A根据第一段“Most　people　know　about　anorexia　nervous—when　people　deliberately　starve　themselves　to　keep　their　weight　down—but　bulimia,　or　excessive　vomiting,　is　another　extreme　of　the　disorder.”，题目正确。

44.　A根据第四段“They　delude　themselves　into　thinking　that　the　only　way　to　keep　the　calories　they　have　eaten　from　turning　into　fat　is　to　make　themselves　vomit　or　by　taking　excessive　amounts　of　laxatives.”，题目正确。

45.　A根据第六段“It　isnt　just　women　who　can　suffer　from　anorexia　or　bulimia,　although　women　are　10　times　more　liable　to　succumb　to　eating　disorders.”，可知“女性比男性更容易饮食失调”，所以题目正确，选A。

46.　B根据第八段第一句“The　frequent　food　binges　by　bulimics　can　lead　to　depression.”，频繁地大吃大喝能够导致抑郁，但并不是抑郁的直接原因，所以题目错误。

47.　A根据第九段“One　of　the　obvious　signs　of　bulimia　is　hard　skin　or　marks　on　the　back　of　the　hand　due　to　repeated　abrasion　of　the　skin　as　the　hand　is　thrust　down　the　throat　to　produce　vomiting.”，题目正确。

48.　B根据倒数第四段“A　sympathetic　ear　is　the　first　priority　when　it　comes　to　treating　the　disorder.”，当治疗这种饮食失调时，富有同情心的倾听是优先考虑的，但并不是说它能治愈饮食失调，所以题目错误。

49.　C题目译为“营养学家能帮助治疗厌食症与暴食症，因为他们可以在如何健康饮食方面给予意见”，此信息在文中没有给出，故选C。

50.　A根据最后一段“There　is　help　out　there　for　anorexics　and　bulimics,　but　they　must　take　the　first　step　and　seek　help　from　their　doctors　as　soon　as　possible　before　they　seriously　damage　their　health.”，题目正确。

Part　Four

【文章大意】　文章介绍了反式脂肪酸的定义、用途、坏处，以及对如何摄取脂肪给出建议。

【解题思路】

51.　D第三段介绍了反式脂肪的坏处。第一句指出反式脂肪会提高胆固醇，降低身体所需的好胆固醇。第二句高脂肪食品不仅仅会导致肥胖。因此本句选D项：“Trans　fats　build　up　in　the　body　and　block　blood　flow　to　the　heart”，译为“体内的反式脂肪堆积并阻止血液流向心脏”，为合理选项。有助于正确选题的重要词句包括：raise　bad　cholesterol/lower　the　good　cholesterol/cause　obesity/at　risk　of　developing　heart　disease　or　having　a　stroke。

52.　F第四段第一句介绍了什么是反式脂肪酸。第二句指出食品公司和餐馆选择使用反式脂肪的原因——它们很便宜，由它们制作的食物像饼干和烘焙食品的保质期更长。此处选F项：“They　also　improve　the　taste　and　texture　of　food.”，译为“它们还能改善食物的味道和质地”。这也是在说明反式脂肪酸在制作食物上的作用，承接上文，因此为合理选项。有助于正确选题的重要词句包括：theyre　cheap　and　they　make　food　like　crackers　and　baked　goods　last　longer.

53.　B第五段第二句、第三句介绍了美国和加拿大这样的国家，政府对食品生产有新的限制，食品和饮料生产商必须在产品上贴上营养标签。此处选B项：“These　list　daily　recommendations　and　detail　all　the　ingredients　in　a　product,　including　trans　fats　if　theyre　used.”，译为“这些产品列出了每日建议，并详细介绍了产品中的所有成分，包括使用的反式脂肪酸”。此句承接上句，介绍标签上的具体内容，句意合理。有助于正确选题的重要词句包括：new　government　restrictions　on　food　production/attach　a　Nutrition　Fact　label.

54.　E第六段第二句指出医生建议我们从不饱和脂肪中获取大部分脂肪卡路里。空格的下文指出：另一种方法是避免外出就餐，尤其是快餐店。此外，

在生鲜部购买大多数你需要的食物，并且需要

限制加工和包装食品的数量。由此表明，上文的内容在讲如何正确地摄取脂肪卡路里，因此此处选E项：“Reading　the　list　of　ingredients　on　the　label　is　a　good　way　of　avoiding　dangerous　ingredients　like　trans　fats.”译为“阅读标签上的配料清单是避免危险成分如反式脂肪的好方法”，为合理选项。有助于正确选题的重要词句包括：get　most　of　our　fatty　calories　from　unsaturated　fats/avoid　eating　out/buy　the　majority　of　your　food　in　the　freshfood　section　and　limit　the　amount　of　processed　and　packaged　food　you　buy.

55.　C第六段倒数第二句话译为“如果你年轻，你可能不认为这很重要，但是你现在做出的选择会影响你的余生”。此处选C项：“The　healthier　your　diet　is　now,　the　longer　and　healthier　your　life　will　be.”，译为“你现在的饮食越健康，你的寿命越长，越健康”。承接上文，因此为合理选项。有助于正确选题的重要词句包括：You　might　not　think　this　is　important　if　youre　young,　but　the　choices　you　make　now　will　affect　you　for　the　rest　of　your　life.

Part　Five

【文章大意】　文章介绍了夜间痛性痉挛（夜间抽筋）的症状及一些治疗建议。

【解题思路】

56.　A此处句意为：即使是最健康的人也可能在紧张的一天之后腿部短促疼痛，选A符合语句逻辑。

57.　B“If　this　sort　of　night　cramp　becomes　a　real　nuisance,　avoiding　overstretching　and　taking　tablets　containing　quinine　sulphate　at　bedtime　may　be　all　that　is　needed.”此句意思：“如果这种夜间抽筋成为一种真正的麻烦，避免过度拉伸和在睡前服用含硫酸奎宁的药片也许就够了。”选B句意合理。

58.　A“A　very　small　number　of　patients,　however,　cannot　take　quinine　without　becoming　dizzy　or　getting　buzzing　in　the　ears.”此处句意为：“然而，有少数患者服用奎宁会晕眩或耳朵嗡嗡作响。”选A：引起头晕的，符合句意。B.　lazy：懒惰的；C.　crazy：疯狂的；D.　fuzzy：模糊的。

59.　C“But　cramp　in　the　lower　limbs　in　the　daytime　and　in　younger,　active　patients

can　be　very　distressing　and　is　more　serious.”此句意思：“然而，白天下肢抽筋以及年轻活跃的病人抽筋可能会非常痛苦并且更加严重。”故选C。

60.　D“The　patient　first　complains　of　aching　legs　after　exercise.　It　may　be　slight,　but　gradually　becomes　more　pronounced.”此处句意为：“病人首先主诉运动后腿痛。它可能是轻微的，但逐渐变得更加明显。”选D：明显的，符合句意。

61.　C“Then　the　pain　is　not　merely　an　ache,　but　a　definite,　crippling　cramp,　which　can　become　so　severe　that　the　patient　finds　he　or　she　cannot　stand　after　much　walking.”此句表明这种痉挛性抽筋的疼痛在病人长时间行走之后会变得很严重，所以病人无法站立，选C符合语句逻辑。

62.　B“It　generally　means　that　the　arteries　everywhere　in　the　body　have　become　narrowed　and　blood　cannot　reach　the　muscles　fast　enough　when　they　are　in　use.　The　heart　muscles　may　be　equally　affected.”此处译为：“它通常意味着身体周围的动脉已经变窄，血液不能快速到达肌肉。”所以可以判断，心肌可能也同样受到了影响。选其他选项句子意义均不符合常理或逻辑。

63.　AIn　a　draught意为“在风口”，故选A项，符合句意。

64.　B“The　patient　learns　to　regulate　the　amount　of　exercise　he　or　she　can　comfortably　take.”此句意思：“病人学会调节自身运动量，以舒适为度。”选B：调节，符合句意。

65.　D“No　drugs　offer　a　complete　relief　but　there　is　one　habit　which　the　sufferer　must　give　up—smoking.”此句句意为：没有药物能完全缓解，但有一种习惯必须让患者必须放弃——吸烟。选D：放弃，句意合理。A.　give　out:　分发　B.　give　back:　归还　C.　give　away:　赠送。

ⅢWriting

66.　【范文】

Recent　decades　have　witnessed　the　rapid　development　of　medical　and　health　system　in　China.　Medical　and　health　standards,　in　both　metropolis　and　rural　areas,　have　been　significantly　enhanced.However,　we　can　not　deny　that　some　problems　emerged　in　the　meantime.　Therefore,　medical　reform　is　imperative.

What　problems　need　prompt　solutions?　First,　uneven　distribution　of　medical　resources　is　a　burning　issue.　According　to　the　statistics　released　in　2018,　the　number　of　thirdclass　hospitals　in　developed　areas　are　almost　as　many　as　three　times　of　those　in　underdeveloped　areas.　Whats　more,　it　is　reported　that　most　medical　students　look　forward　to　working　in　hospitals　in　big　cities　after　graduation,　which　further　results　in　an　uneven　distribution　of　doctors.　Second,　high　drug　price　is　another　problem　crying　for　solution.　Though　some　medicine　can　be　paid　by　Medicare,　some　newly　developed　medicine,　fairly　expensive,　are　not　included　in　Medicare.　For　example,　patients　feel　desperate　if　they　are　diagnosed　with　cancer,　because　they　cannot　afford　the　treatment　even　after　selling　all　their　possessions.

To　solve　the　above　problems,　the　government　should　attract　more　medical　talents　to　work　in　relatively　underdeveloped　areas　by　properly　enhancing　their　welfare,　and　measures　to　encourage　medical　research　such　as　increasing　funds　should　be　taken.　(204　words)

【审题】

写作部分要求围绕“中国医疗改革”进行写作，要求分析目前我国医疗体系存在的问题，并给出自己对医疗改革的建议。文章应属说明文，写作的第一个重点是针对存在的问题，给出有针对性的具体建议。第二个重点是正确写出一些涉及医疗卫生领域话题的英语表达，如“医疗资源、三甲医院、医疗保险”等。

【范文评析】

文章首先陈述了近几十年来我国医疗卫生事业的发展，随后转折，指出目前仍存在问题，医疗改革刻不容缓。文章的重点放在问题的剖析上。第二段以问句开头，随后提出亟待解决的第一个问题，并列出数据展开论述。接着提出第二个亟须解决的问题，并通过具体事例展开论述。最后有针对性地提出两点建议。

文章语言表达准确，过渡自然，特别是第二段，并熟练运用“first”“what　is

more”“second”等表达引导观点陈述，运用“according　to”“for　example”等表达引导论证。插入语的使用(in　both　metropolis　and　rural　areas/fairly　expensive)是本文句子水平上的一个亮点。

医护英语水平考试(三级)

模拟训练（七）

听力文本

This　is　METS3　listening　test.　There　are　four　parts　in　the　test,　Part　One,　Two,　Three,　and　Four.　You　will　hear　each　part　twice.

We　will　now　stop　for　a　moment　before　we　start　the　test.　Please　ask　any　questions　now　because　you　must　not　speak　during　the　test.

Now,　look　at　the　instructions　for　Part　One.

You　will　hear　five　extracts　from　conversations　taking　place　in　different　clinical　departments.　Choose　which　case　each　doctor　is　discussing　from　the　list　A—F.　Use　each　letter　A—F　only　once.　There　is　one　extra　letter　which　you　do　not　need　to　use.

Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　each　extract　twice.　Now　we　are　ready　to　start.

Extract　1

Congratulations!　Now　your　calcium　level　has　improved　and　you　can　leave　the　hospital.

But　dont　forget　that　your　previous　pathology　report　showed　an　adenoma　of　the　abnormal　gland.　On　your　first　postoperative　day,　you　complained　of　perioral　numbness　and　tingling,　and　your　serum　calcium　was　subnormal.　Pay　attention　to　your　diet!

Extract　2

I　suggest　you　try　an　insulin　pump　to　give　yourself　more　freedom　and　enhance　your　quality　of　life.　It　is　about　the　size　of　a　beeper　with　a　thin　catheter　that　you　can　introduce　through　a　needle　into　your　abdominal　subcutaneous　tissue.　You　can　administer　your　insulin　in　a　continuous　subcutaneous　insulin　infusion　and　in　calculated　meal　bolus　doses.　Of　course　you　still　have　to　test　your　blood　for　hyperglycemia　and　hypoglycemia　and　your　urine　for　ketones　when　your　blood　sugar　is　too　high.

Extract　3

Your　daughter　is　diagnosed　with　pneumonia.　You　said　she　has　been　very　lethargic,　had　a　fever　of　104°F,　and　has　had　muscular　rigidity　for　3　days.　Actually,　she　took　Haldol　and　Cogentin.　Her　secondary　diagnosis　is　stated　as　neuroleptic　malignant　syndrome,　a　rare　and　lifethreatening　disorder　associated　with　the　use　of　antipsychotic　medications.

Extract　4

You　have　been　scheduled　for　surgery　for　a　cataract　and　relief　from　“floaters”.　You　should　report　to　the　ambulatory　surgery　center　an　hour　before　your　scheduled　procedure.　Before　transfer　to　the　operating　room,　youd　better　speak　with　your　ophthalmologist　and　review　the　surgical　plan.

Extract　5

I　am　sorry　that　your　boy　has　osteogenesis　imperfecta　type　III.　His　congenital　disease　is　manifested　by　a　defect　in　the　creation　of　bone　matrix,　which　gives　normal　bone　its　strength.　His　bones　are　very　brittle　and　broken　with　little　pressure　or　trauma.　He　also　has　a　pectus　cavernosus　of　his　chest,　an　inversion　or　concavity　of　the　sternum.

Now　youll　hear　Part　One　again.　This　is　the　end　of　Part　One.　Now　look　at　Part　Two.

You　will　hear　a　conversation　between　a　reporter　and　a　hair　restoration　expert.　For　each　of　the　following　statements,　decide　whether　it　is　True　(A)　or　False　(B).　If　there　is　not　enough　information　to　answer　True　(A)　or　False　(B),　choose　Not　Given　(C).　Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　the　recording　twice.

Reporter:　I　am　Ann　Lynn.　It　is　reported　that　as　many　as　half　of　all　women　are　affected　by　hair　loss　at　some　time　in　their　lives.　I　am　interviewing　Lisa　Ishii,　a　Johns　Hopkins　hair　restoration　expert.　She　will　answer　questions　about　hair　loss.　Hi,　Dr.Ishii,　why　many　women　lose　hair?

Ishii:　There　are　several　factors　that　may　cause　hair　loss.　Women,　most　commonly,　begin　losing　hair　as　a　part　of　the　normal　aging　process,　but　for　others,　it　can　be　caused　by　hormone　changes,　medications　taken　for　other　purposes　or　severe,　extreme　stress.

Reporter:　How　does　hair　loss　differ　between　men　and　women?

Ishii:　There　are　a　number　of　reasons　for　hair　loss,　but　women　go　through　unique　hormone　changes　that　contribute　to　specific　types　of　female　hair　loss.　For　example,　you　may　experience　hair　loss　after　going　through　pregnancy　or　if　you　have　polycystic　ovary　syndrome.　Hair　loss　patterns　also　vary　between　men　and　women.　Men　tend　to　see　hair　loss　start　at　the　temples,　the　hairline　in　an　M　shape　and　in　the　crown　area,　or　we　say,　the　“bald　spot”.　As　a　woman,　you　may　see　hair　thinning　at　the　top　of　your　head　while　your　hairline　remains　intact,　or　you　might　notice　a　Christmas　tree　shape　forming　as　the　part　of　your　hair　becomes　wider,　a　common　symptom　in　female　pattern　hair　loss.

Reporter:　When　it　is　necessary　to　talk　to　a　doctor　about　hair　loss?

Ishii:　For　women　who　are　concerned　about　changes　in　their　hair,　there　is　never　a　bad　time　to　talk　to　a　doctor.　If　there　is　a　sudden　onset　of　hair　loss,　it　is　important　to　talk　to　a　doctor　to　identify　the　root　cause.　If　there　is　a　noticeable　change　in　the　density　of　hair　or　if　the　hair　is　falling　out　in　clumps,　it　is　also　necessary　to　see　a　care　provider.

Reporter:　Is　there　anything　we　can　do　at　home　to　reduce　hair　loss　and　regrow　hair?

Ishii:　For　the　most　common　type　of　hair　loss　and　genetic　alopecia,　I　recommend　hair　treatments　containing　minoxidil,　an　FDAapproved　medication　for　treatment　of　hair　loss　that　is　available　over　the　counter.

Reporter:　What　are　treatment　options　for　hair　loss?

Ishii:　Depending　on　the　cause　of　hair　loss,　there　are　several　treatment　options　available　to　women.　Some　doctors　may　prescribe　new　medications,　such　as　minoxidil　and　finasteride.　Hair　transplantation　is　also　a　viable　option　for　many　women.　In　this　treatment,　hair　roots　from　the　back　and　sides　of　the　scalp　are　moved　to　the　area　we　are　trying　to　make　more　hair　dense.　The　procedure　takes　several　hours　to　complete,　depending　on　the　number　of　hair　roots,　and　can　be　performed　under　light　sedation　or　local　anesthesia.　New　hair　growth　occurs　in　as　little　as　four　months,　but　multiple　sessions　may　be　required　to　achieve　the　desired　effect.

Now　youll　hear　Part　Two　again.　This　is　the　end　of　Part　Two.　Now　look　at　Part　Three.

You　will　hear　a　discussion　among　an　instructor　and　two　medical　students.

For　questions　14—20,　choose　the　most　appropriate　answer.　Mark　the　corresponding　letter　on　your　answer　sheet.　You　will　hear　the　discussion　twice.

Instructor:　Today　we　are　going　to　discuss　the　MRI　navigational　technology.　The　new　treatment,　carried　out　by　neurosurgeons　at　the　UCSD　School　of　Medicine　and　the　UCSD　Moores　Cancer　Center,　uses　realtime　MRI,　that　is,　magnetic　resonance　imaging　as　a　way　of　guiding　the　delivery　of　the　new　gene　therapy　directly　into　brain　tumors.

Student　1:　How　does　the　MRI　guided　gene　therapy　work?　Previous　efforts　with　gene　therapy　for　brain　cancer　were　largely　limited　by　the　inability　to　deliver　the　drug　into　the　brain.　Under　normal　conditions,　the　brain　is　protected　by　a　physiological　system　called　the　bloodbrain　barrier.

Student　2:　This　natural　defense　mechanism　also　prevents　drugs　from　reaching　the　cancer　cells　in　brain　tumor　patients.　It　is　estimated　that　less　than　1%　of　all　available　drugs　will　cross　the　blood　brain　barrier.

Instructor:　Right.　In　the　new　treatment,　the　blood　brain　barrier　is　bypassed　by　directly　injecting　the　gene　therapy　into　the　region　of　the　tumor.　To　ensure　that　the　adequate　amount　of　agent　is　delivered　to　the　region　of　the　tumor,　a　stateoftheart　MRI　technology　is　utilized　to　monitor　the　delivery　and　injection　processes　in　real　time.The　MRIguided　process　provides　visual　confirmation　that　adequate　amount　of　the　therapy　is　delivered　into　the　tumor.　Additionally,　the　ability　to　visualize　the　delivery　catheter　in　realtime　prevents　any　unintended　injury　to　the　brain.

Student　1:　What　are　the　benefits　and　risks　of　using　this　treatment?

Instructor:　To　understand　the　benefits　of　the　therapy,　we　first　need　to　review　the　basis　of　the　gene　therapy.　The　gene　therapy　is　based　on　a　retrovirus　engineered　to　selectively　replicate　in　high　grade　brain　cancer　cells.This　virus　produces　an　enzyme　that　converts　the　FDA　approved　antifungal　drug　flucytosine,　or　5FC　into　the　anticancer　drug　5fluorouracil,　or　5FU.　After　the　injection　of　the　virus,　the　patients　are　treated　with　oral　formulations　of　5FC.　Tumor　kill　is　induced　when　5FC　comes　into　contact　with　cells　infected　with　virus.

Student　2:　Typically,　when　chemotherapy　is　given,　just　about　every　cell　in　the　body　is　exposed　to　the　potential　sideeffects　of　the　drug.　The　direct　injection　approach　limits　the　presence　of　the　active　drug　in　the　brain　tumor　and　not　elsewhere　in　the　body.　Consequently,　the　approach　protects　the　patient　from　many　of　the　intended　sideeffects　of　chemotherapy.

Instructor:The　virus　has　been　tested　in　a　large　number　of　patients　and　has　been　shown　to　be　safe.　So　the　risks　of　the　treatment　relates　to　the　surgical　procedure　itself.　The　MRI　technology　allows　the　surgeon　to　visualize　the　delivery　catheter　in　realtime.　In　doing　so,　the　surgeon　can　prevent　any　unintended　injury　to　the　brain　during　the　procedure.　So,　the　risk　of　the　procedure　is　lowered　to　an　absolute　minimum.

Now　youll　hear　Part　Three　again.　This　is　the　end　of　Part　Three.　Now　look　at　Part　Four.

You　will　hear　a　speech　on　diets　helping　some　people　with　Hashimotos　disease.　Complete　the　notes.　In　each　blank,　write　only　one　word.　Write　the　answers　on　your　answer　sheet.　You　will　hear　the　speech　twice.

Male:　Hashimotos　disease　is　the　most　common　autoimmune　condition　and　the　leading　cause　of　hypothyroidism.　It　is　sometimes　called　Hashimotos　thyroiditis　or　shortened　to　Hashimotos.

The　thyroid　gland　plays　a　major　role　in　metabolism,　hormone　regulation,　and　body　temperature.　When　a　person　has　Hashimotos,　his/her　thyroid　is　chronically　inflamed　and　cannot　function　as　well　as　a　healthy　thyroid.The　thyroid　often　slows　or　stops　the　production　of　essential　hormones,　which　can　cause　weight　gain,　dry　skin,　hair　loss,　fatigue,　constipation,　and　sensitivity　to　cold.

There　is　no　specific　diet　proven　to　treat　everyone　with　Hashimotos.　An　individualized　approach　to　nutrition　is　necessary.

Some　clinical　evidence　has　shown　that　the　following　diets　have　helped　some　people　with　Hashimotos,　which　are　glutenfree　diet,　grainfree　diet,　paleo　diet　and　nutrientdense　diet.　Now,　we　take　a　closer　look　at　some　of　these　diets.

First,　glutenfree　diet.Many　people　with　Hashimotos　also　experience　food　sensitivities,　especially　to　gluten.　There　is　no　current　research　to　support　a　glutenfree　diet　for　all　people　with　Hashimotos　unless　they　also　have　celiac　disease.　Glutenfree　diets　remove　all　foods　with　containing　gluten,　which　is　a　protein　found　in　wheat,　barley,　rye,　and　other　grains.Gluten　is　commonly　found　in　pasta,　bread,　baked　goods,　beer,　soups,　and　cereals.　The　best　way　to　go　glutenfree　is　to　focus　on　foods　that　are　naturally　glutenfree,　such　as　vegetables,　fruits,　lean　meats,　seafood,　beans,　legumes,　nuts,　and　eggs.

Second,　grainfree　diet.A　grainfree　diet　is　very　similar　to　glutenfree,　except　that　grains　are　also　offlimits.　These　grains　include　amaranth,　teff,　quinoa,　millet,　oats　and　buckwheat.　There　is　little　evidence,　however,　that　cutting　out　nongluten　grains　is　beneficial　for　health.　Cutting　out　these　grains　may　also　eliminate　fiber　and　other　sources　of　essential　nutrients,　such　as　selenium,　which　are　important　for　people　with　Hashimotos.

Third,　paleo　diet.The　paleo　diet　attempts　to　mimic　the　eating　patterns　of　our　early　ancestors,　with　an　emphasis　on　whole,　unprocessed　foods.Grains,　dairy,　potatoes,　beans,　lentils,　refined　sugar,　and　refined　oils　are　not　allowed.　Cagefree　and　grassfed　meats　are　encouraged,　as　are　vegetables,　nuts　(except　peanuts),　seeds,　seafood,　and　healthful　fats,　such　as　avocado　and　olive　oil.

Fourth,　nutrientdense　diet.　For　people　who　do　not　want　to　focus　on　what　foods　to　cut　out,　opting　for　a　nutrientdense　diet　plan　may　be　the　best　option.A　nutrientdense　diet　includes　variety　and　focuses　on　whole　foods　with　a　selection　of　colorful　fruits　and　vegetables,　healthy　fats,　lean　proteins,　and　fibrous　carbohydrates.　Foods　include　leafy　greens,fatty　fish,　a　variety　of　colored　vegetables,fruits,　healthful　fats,　lean　proteins,　fibrous　foods.　Having　these　foods　as　the　primary　focus　of　the　diet　will　leave　less　room　for　processed　and　refined　sugar　foods.　Antiinflammatory　spices　such　as　turmeric,　ginger,　and　garlic　are　also　encouraged.

It　is　more　important　for　a　person　to　follow　a　wellbalanced　diet　that　works　for　their　lifestyle　than　to　try　to　put　a　label　on　their　eating　habits.　People　should　focus　on　whole,　unprocessed　foods　and　eat　foods　that　grow　in　the　ground,　not　foods　that　come　in　a　box　or　a　bag.

People　with　Hashimotos　should　be　open　to　trying　different　eating　styles　until　they　find　the　one　that　makes　them　feel　best.　They　should　also　speak　to　a　doctor　or　dietitian　about　how　to　make　sure　they　get　all　of　the　essential　nutrients.

Now　youll　hear　Part　Four　again.　This　is　the　end　of　Part　Four.　You　now　have　five　minutes　to　write　your　answers　on　the　answer　sheet.　You　have　one　more　minute.　This　is　the　end　of　the　listening　test.

参考答案与试题评析

ⅠListening

Part　One

1.　【语段大意】　医生祝贺患者钙水平提高，可以出院，但提醒患者曾经的病理报告显示腺瘤，且术后第一天口周有麻木和刺痛感，提醒患者注意饮食。

【解题思路】　A听力开始部分可听到Now　your　calcium　level　has　improved　and　you　can　leave　the　hospital这一关键信息。

2.　【语段大意】　医生建议患者尝试使用胰岛素泵，并介绍了使用方法。

【解题思路】　D可听到try　an　insulin　pump,　administer　your　insulin　等关键信息。

3.　【语段大意】　医生告知，患者被诊断为患有肺炎和神经阻滞剂恶性综合征(neuroleptic　malignant　syndrome)。

【解题思路】　C可听到Your　daughter　is　diagnosed　with　pneumonia，　Her　secondary　diagnosis　is　stated　as　neuroleptic　malignant　syndrome　等关键信息。

4.　【语段大意】　患者已被安排白内障手术，工作人员建议患者在手术前一小时到门诊手术中心报告，并最好在手术前与眼科医生谈一谈。

【解题思路】　E可听到cataract，　ophthalmologist　等关键词。

5.　【语段大意】　医生告知患者家属，孩子患有Ⅲ型成骨不全（osteogenesis　imperfecta　type　Ⅲ），骨骼脆弱。

【解题思路】　F可听到His　bones　are　very　brittle这一关键句。

Part　Two

【语篇大意】　一位记者对一位植发专家的采访。

【解题思路】

6.　A专家提到开始脱发是女性正常衰老过程的一部分，故答案为A。

7.　A专家提到脱发有很多原因，但女性会经历独特的荷尔蒙变化而导致特定类型的脱发。故答案为A。

8.　C专家举例说，女性怀孕或患有多囊卵巢综合征(polycystic　ovary　syndrome)会导致脱发，未提及生产与脱发有关联，所以答案为C。

9.　A专家提到男性倾向于从太阳穴(temple)开始脱发，所以A正确。

10.　A专家提到，如果突然出现脱发，应去看医生，找出根本原因，因此选A。

11.　A对于最常见的脱发和遗传性脱发（genetic　alopecia）,专家推荐使用含有米诺地尔（minoxidil）的药物,　此药物是FDA批准的治疗脱发的非处方药，所以选A。

12.　B专家提到，植发是女性的可行性选择，所以选B。

13.　B听力最后部分提到，新发生长最少需四个月，故B正确。

Part　Three

【语篇大意】　两位医学生与老师讨论磁共振导航技术（MRI　navigational　technology）的相关问题。

【解题思路】

14.　A对话中提到，以前对脑肿瘤进行基因治疗的限制，很大程度上在于无法将药物输送到大脑。故答案为A。关键信息：Previous　efforts　with　gene　therapy　for　brain　cancer　were　largely　limited　by　the　inability　to　deliver　the　drug　into　the　brain.

15.　B一个学生提到，在正常情况下，大脑受到一种叫做血脑屏障（bloodbrain　barrier)的生理系统的保护。接着另一个学生补充说，这种天然防御机制也阻止药物到达脑肿瘤患者的癌细胞。故答案为B。关键信息：Under　normal　conditions,　the　brain　is　protected　by　a　physiological　system　called　the　bloodbrain　barrier./This　natural　defense　mechanism　also　prevents　drugs　from　reaching　the　cancer　cells　in　brain　tumor　patients.

16.　B对话中提到，在新疗法中，通过直接注射基因进入肿瘤区，绕开了血脑屏障。所以答案应该选B。关键信息：In　the　new　treatment,　the　blood　brain　barrier　is　bypassed　by　directly　injecting　the　gene　therapy　into　the　region　of　the　tumor.

17.　CMRI引导下，治疗传送过程是可视的。故答案为C。关键信息：The　MRIguided　process　provides　visual　confirmation　that　adequate　amount　of　the　therapy　is　delivered　into　the　tumor.

18.　A对话中提到基因治疗的基础是一种逆转录病毒，B是化疗，C是水疗，显然A正确。

关键信息：The　gene　therapy　is　based　on　a　retrovirus　engineered　to　selectively　replicate　in　high　grade　brain　cancer　cells.

19.　A对话中提到，在通常情况下，化疗的潜在副作用会影响到体内几乎所有细胞。故答案为A。关键信息：Typically,　when　chemotherapy　is　given,　just　about　every　cell　in　the　body　is　exposed　to　the　potential　sideeffects　of　the　drug.

20.　C对话中提到治疗的风险与手术有关。故答案为C。关键信息：So　the　risks　of　the　treatment　relates　to　the　surgical　procedure　itself.

Part　Four

【语篇大意】　关于淋巴细胞性甲状腺肿（Hashimotos　disease）的一段讲座。

【解题思路】

21.　hypothyroidism讲座一开始提到，淋巴细胞性甲状腺肿是最常见的自身免疫性疾病，也是甲状腺功能减退（hypothyroidism）的主要原因。　所以此处应填hypothyroidism。

22.　protein此处为讲座中提到的第一种能帮助淋巴细胞性甲状腺肿患者的饮食，即无麸质饮食（glutenfree　diets),麸质是一种在小麦、大麦、黑麦和其他谷物中发现的蛋白质。所以此处应填protein。

23.　unprocessed此处为讲座中提到的第三种能帮助淋巴细胞性甲状腺肿患者的饮食，即古旧饮食（paleo　diet）。古旧饮食试图模仿我们早期祖先的饮食模式，关键在于完整的，且未加工的食物。所以此处应填unprocessed。

24.　Antiinflammatory此处为讲座中提到的第四种能帮助淋巴细胞性甲状腺肿患者的饮食，即nutrientdense　diet　（营养密集型膳食)　。此部分最后提到，有抗炎作用的调味品，如姜黄、生姜和大蒜等，也鼓励食用。所以此处应填antiinflammatory。

25.　wellbalanced此处为讲座总结部分，遵循平衡饮食的生活方式比把自己的饮食习惯贴上标签更为重要。故此处应填wellbalanced。

ⅡReading

Part　One

【文章大意】　文章通过研究表明低盐饮食并不适合每一个人，同时介绍了一些国家食盐量的情况。

【解题思路】

26.　C根据第一段第一、第二句“Lowsalt　diets　are　actually　harmful　to　our　bodies,　a　recent　study　found.　These　diets　may　actually　increase　the　risk　of　developing　heart　disease,　or　even　cause　death.”直接指出：最近的一项研究表明低盐饮食可能会增加患心脏病，甚至猝死的风险。

27.　A第二段第一句介绍本次研究人员的身份；第二句介绍研究对象和方法；第三句介绍研究目的；第四句为研究结果；第五、第六句是本次研究提出的建议。

28.　E第三段开头“This　study　adds　to　our　understanding　of　the　relationship　between　salt　intake　and　health.　The　study　also　questions　the　correctness　of　present　guidelines　that　recommend　low　salt　intake　for　everyone.”和第三段倒数第三句“Mente　added　that　the　current　general　recommendations　relating　to　the　maximum　healthy　salt　intake　seems　too　low,　especially　since　they　do　not　consider　an　individuals　blood　pressure.”，表明，ODonnell和Mente对当前健康盐摄入量的准则和建议进行了质疑和否定。

29.　B第四段第一、第二句第三句指出世界上大多数人对钠的摄入量是健康的，即每天不超过6克；但是第四句指出对一些易患高血压人群以及高盐人群应降低盐摄入量；第五句作者表示不认同当前许多国家的关于降低钠摄入量的指导方法。

30.　D第五段列举加拿大、美国和肯尼亚三国对不同人群提出的盐摄入量指导标准进行描述。

31.　E定位第一段第三句“These　findings,　says　WebMD,　a　public　health　website,　are　contrary　to　the　popular　wisdom　that　has　long　said　lowsalt　diets　are　healthy.”。

32.　D定位第二段倒数第二句“The　study　goes　on　to　suggest　that　only　certain　people　should　be　concerned　about　reducing　sodium　in　their　diets.”。

33.　B定位第三段第二句“The　study　also　questions　the　correctness　of　present　guidelines　that　recommend　low　salt　intake　for　everyone.”。

34.　F定位第三段第二句　“Mente　does　not　agree　with　the　current　strategy　of　reducing　sodium　intake　in　almost　all　countries.”。

35.　A定位第五段第四句“For　those　over　51　and　persons　of　any　age　who　are　African　American　or　have　hypertension,　diabetes,　or　chronic　kidney　disease,　the　US　guidelines　suggest　having　less　than　1.5　grams　a　day.”。

Part　Two

【文章大意】　主要介绍病人病史的几个组成部分。

【解题思路】

36.　D第一段第二句“On　the　other　hand,　a　poorly　documented　history　and　physical　exam　may　lead　to　confusion,　serious　omission　of　vital　data　and　inefficiency　on　patient　rounds.”指写得差的病史记录和体检会导致的三个结果，D选项不是其结果。

37.　D在对“Identification”表述的段落中“The　patients　name　written　in　the　history　allows　future　interviewers　to　address　the　patient　by　his　name　which　conveys　a　sense　of　patient　respect.　The　age,　race,　sex　and　occupation　are　important　as　many　diseases　are　not　only　gender　and　age　dependent,　but　may　also　occur　more　commonly　in　specific　ethnic　and　occupation　groups.”，提到了身份认同的重要性，A、B、C选项都符合，故选D。

38.　CA、B、D选项中关于既往病史、病人主诉以及病人的职业、性别、性行为和非法药物使用的内容在文章中都有相关表述，C选项Treatment　Plan在最后一段提及，但治疗计划并不包含于病史之中。

39.　A文章在论述“Chief　Complaint”时，第一句话“This　should　be　written　in　the　patients　words.”，可知，病人主诉应该用病人的言语来表达，而非医生的经验。

40.　B“ROS　(Review　of　Systems)—This　section　is　too　often　omitted.　Social　History—This　section　is　the　most　neglected　section　of　the　patient　history　performed　in　China.”表明，系统回顾与社交史都是病史中容易忽略的部分，

社交史在中国病人病史中是最容易被忽略的

，因此B选项的表述是错误的。

41.　A最后一段中的“rapport”意思是关系，在原文指的是医患之间的良好关系，因此A选项为正确选项。

42.　C本题为主旨题。文章主要介绍病人病史的几个组成部分，最后一段总结了病人病史的作用，所以，文章的写作意图是强调病人病史的重要性，故选C选项。

Part　Three

【文章大意】　文章讨论了咖啡与健康的关系，尤其探讨了饮用咖啡是否会致癌。

【解题思路】

43.　A根据第一段“Trouble　is　brewing　for　coffee　lovers　in　California,　where　a　judge　ruled　that　sellers　must　post　scary　warnings　about　cancer　risks.　But　how　frightened　should　we　be　of　a　daily　cup　of　coffee?　Not　very,　some　scientists　and　available　evidence　seem　to　suggest.”，题目正确。

44.　A根据第二段第一句“Scientific　concerns　about　coffee　have　eased　in　recent　years,　and　many　studies　even　suggest　it　can　help　health.”，题目正确。

45.　A根据第三段　“CBS　News　medical　contributor　Dr.　David　Agus,　director　of　the　Westside　Cancer　Center　at　USC,　says　he　believes　it　is　too　early　to　put　this　kind　of　blanket　warning　on　coffee.”以及第四段“to　me　it　causes　panic　rather　than　informed　knowledge”，可知，Dr.　David　Agus认为贴警示会导致恐慌。

46.　C题目大意为世界卫生组织已经做好计划来预防癌症可能的风险，此信息在文中没有给出，故选C。

47.　B根据第六段“The　current　flap　isnt　about　coffee　itself,　but　a　chemical　called　acrylamide　thats　made　when　the　beans　are　roasted.　Government　agencies　call　it　a　probable　or　likely　carcinogen,　based　on　animal　research”，当豆子烤好的时候，一种叫做丙烯酰胺的化学物质产生了。政府机构基于动物研究的基础上，认为这种化学物质可能致癌，因此题目错误。

48.　A根据第八段“‘A　cup　of　coffee　a　day,　exposure　probably　is　not　that　high,’　and　probably　should　not　change　your　habit,　said　Dr.　Bruce　Y.　Lee　of　Johns　Hopkins　Bloomberg　School　of　Public　Health.　‘If　you　drink　a　lot　of　cups　a　day,　this　is　one　of　the　reasons　you　might　consider　cutting　that　down.’”表明，每天喝咖啡要适度，所以题目正确。

49.　C倒数第二段第一句“Start　with　the　biggest　known　risk　factor　for　cancer—smoking—which　generates　acrylamide.”，吸烟是患癌风险最大的因素，但原文没有提及吸烟可以导致肺癌，故选C。

50.　B最后一段“A　group　of　23　scientists　convened　by　the　WHOs　cancer　agency　in　2016　looked　at　coffee—not　acrylamide　directly—and　decided　coffee　was　unlikely　to　cause　breast,　prostate　or　pancreatic　cancer,　and　that　it　seemed　to　lower　the　risks　for　liver　and　uterine　cancers.”表明，参会专家认为咖啡不太可能引起乳腺癌、前列腺癌或胰腺癌，所以题目错误。

Part　Four

【文章大意】　文章介绍了一种新药，老鼠使用这种药物后，会带来和运动相同的益处。但不久药物出现问题，人未使用。但研究者一直研发类似但不会对人体造成危害的药物。同时，体育界很多人都担心运动员使用这样的药丸。

【解题思路】

51.　D第一段开头介绍药丸可以解决很多问题。随后第五句“But　what　about　people　who　are　overweight　or　lack　fitness?”（但是超重或缺乏健康的人怎么办呢？）D项：“The　best　solution　for　these　people　is　to　exercise,　but　many　people　dont　want　to　exercise　or　are　unable　to　exercise.”（对这些人最好的解决办法是锻炼身体，但很多人不想锻炼或不能锻炼。）恰好回答了上文中提出的问题，因此为合理选项。有助于正确选题的重要词句包括：But　what　about　people　who　are　overweight　or　lack　fitness?

52.　E第二段开头介绍了老鼠使用药物后的良好效果，以及不久后出现的问题。E项：“Researchers　found　that　mice　had　an　increased　chance　of　developing　cancer　after　taking　it.”（研究人员发现，小鼠服药后患癌症的概率增加了。）承接上文，为合理选项。有助于正确选题的重要词句包括：reports　about　problems　with　the　drug　soon　began　appearing./This　meant　the　drug　would　never　be　approved　for　human　use.

53.　B第三段首句介绍医学研究人员仍在寻找类似于90年代发现的药物，上文提到该药会导致癌症。B项：“Theyre　trying　to　find　a　new　drug　with　the　same　benefits　that　doesnt　also　cause　cancer.”（他们试图找到一种具有相同药效但不会导致癌症的新药物。）下文也提到了此药会有很多用途，所以选项符合句意表达，为合理选项。有助于正确选题的重要词句包括：looking　for　a　drug　similar　to　the　one　found　in　the　90s./They　believe　such　a　drug　would　have　many　uses.

54.　A该空的上一句话讲该药有利于糖尿病患者和那些患有肌肉萎缩疾病的患者。

下文也提到了很多成年人没时间做医生建议的运动量。

A项：“Medical　researchers　also　believe　such　a　drug　could　benefit　the　average　adult　as　well.”（医学研究者也相信这种药物对普通成年人也有好处。）因此，A选项为合理选项。

55.　F第四段第二句和第三句句意为：“他们担心一些运动员可能会用它作为一种提高运动成绩的药物。即使在90年代发现的药物从来没有被批准用于人类，一些运动员可能会用它来作弊。”F项：“Many　people　in　the　world　of　sports　are　concerned　about　a　pill　like　this.”（体育界很多人都担心这样的药丸。）选项内容与下文内容相符，因此为合理选项。

Part　Five

【文章大意】　本文介绍了许多国家的肥胖问题，以及肥胖给人身体带来的风险。

【解题思路】

56.　B本文讲的内容为肥胖问题，根据句意理解，世界性的体重问题在发达国家和贫穷国家应该都在增长，故选B。

57.　A根据句意理解，越来越多的人死于和健康相关的问题，因此选A。related：相关的。

58.　C“About　four　million　people　died　of　cardiovascular　disease,　diabetes,　cancer　and　other　diseases　linked　to　excess　weight　in　2015,　according　to　the　study.”此句意为：“根据这项研究，2015年，大约有四百万人死于心血管疾病、糖尿病、癌症和其他与超重有关的疾病。”选C：超重的，符合句意。extra:额外的；extensive：广泛的；undue：过分的。

59.　D“They　examined　obesity　rates,　average　weight　gain　and　the　cause　of　death　in　195　countries.”上句提到研究者研究了从1980年到2015年的健康信息，所以此句的句意是“他们调查了195个国家的肥胖率、平均体重增加和死亡原因”。故选examined：调查，仔细检查；其他选项不符合句意。

60.　A下文提到了埃及、越南、美国以及孟加拉国，这几个国家都是人口众多的国家，故选A.　populous：人口众多的。此句句意为“2015年人口数在前20的国家中”。

61.　D“Researchers　say　the　extra　weight　people　are　carrying　increases　their　risk　of　developing　diabetes　or　other　health　problems.”此句意为：“研究人员表示，人们额外增加的体重增加了患糖尿病或其他健康问题的风险。”选D：developing患（病），符合句意。

62.　C根据下文理解，此处为转折。故选C.　Yet：然而。

63.　A“Experts　said　poor　diets　and　lack　of　physical　activity　are　mainly　to　blame　for　the　rising　numbers　of　overweight　people.”此句意为：“专家说超重的人数不断增加归咎于饮食不好和缺乏体育锻炼。”因此选A.　blame　for：归咎于。B.　scold：责骂；C.　condemn:谴责;　D.　charge:指控。

64.　B“Growing　populations　have　brought　about　rising　obesity　rates　in　poor　countries.”此句句意为：“不断增长的人口导致贫困国家的肥胖率不断上升。”B.　brought　about：导致，符合句意。A.　resulted　from：起因于；C.　attributed　to：归因于；D.　given　out：分发。

65.　C“It　found　that　the　cost　of　processed　foods　like　ice　cream　and　hamburgers　has　fallen　since　1990.　But　the　cost　of　fresh　fruits　and　vegetables　has　gone　up.”此处下句句意为“新鲜水果和蔬菜的价格上涨了”，而且上下文是转折关系，所以，此句的意思为：“研究发现，自1990以来，加工食品如冰激淋和汉堡包的成本有所下降。”故选C.　fallen:下降。

ⅢWriting

66.　【范文】

With　the　rapid　development　of　society,　modern　people　have　been　paying　great　attention　to　leading　a　healthy　life.　Though　it　has　been　generally　accepted　that　sports　play　a　vital　role　in　physical　health,　some　claim　that　many　diseases　are　actually　caused　by　emotional　management　failure.

There　is　no　doubt　that　doing　regular　exercises　is　of　great　importance　in　living　a　healthy　life.　As　many　medical　researches　point　out,　aerobic　exercises　are　conducive　to　the　heart　and　lungs,　and　are　beneficial　to　the　blood　circulation　system,　the　respiratory　system　and　the　digestive　system.　Doing　physical　exercises　regularly　can　reduce　the　risks　of　many　deathcausing　diseases　such　as　heart　disease,　high　blood　pressure　and　diabetes.　In　addition,　physical　exercise　is　an　effective　way　to　treat　subhealth.

Nevertheless,　emotional　management　is　also　crucial.　As　we　all　know,　negative　emotions　such　as　sadness,　fear　and　anger　are　potentially　risky　to　health.　The　body　changes　in　a　number　of　ways　under　bad　emotions:　blood　pressure　and　pulse　rate　rise,　breathing　becomes　faster,　the　digestive　system　slows　down,　immune　activity　decreases,　the　muscles　become　rigid　and　a　heightened　state　of　alertness　prevents　sleep.　Mental　diseases　such　as　psychiatric　disorders　and　depression　may　be　caused　by　longterm　negative　emotions.　So　keeping　good　mood　is　an　effective　way　to　keep　healthy.　It　is　not　rare　to　hear　that　optimism　can　improve　the　cure　rate　of　diseases.

In　sum,　to　lead　a　healthy　life,　doing　exercises　and　controlling　emotions　are　of　equal　significance.　(245　words)

【审题】

写作部分要求讨论运动和情绪管理对“健康生活”的重要性。文章应属议论文，应就题目给出的两个方面进行讨论，并给出自己的观点。写作中的一个重点和难点是如何正确写出一些涉及医疗卫生领域话题的英语表达，如“有氧运动、血液循环系统、呼吸系统、消化系统、心脏病、高血压、糖尿病、亚健康、精神疾病、抑郁症”等。

【范文评析】

文章采用四段式写作结构。第一段根据作文任务给定的信息展开讨论，段落中运用“though”这一表转折关系词汇陈述两种观点，用“it　has　been　generally　accepted”　和“some　claim”不同表达分述人们对两种观点的不同认知程度。第二段和第三段为主体部分。第二段第一句总领全段，以“there　is　no　doubt”引入运动能带来的好处;　随后第三段从正反两方面阐述了情绪对健康的影响。最后一段简明扼要地给出作者的观点。

文章论证充分，用详实的例子就健康的两个方面进行了讨论；语言表达多样（people　pay　great　attention　to　health/is　of　great　importance/crucial/are　of　equal　significance)；熟练使用as　many　medical　researches　point　out,　as　we　all　know等衔接手段。