2001年医学博士外语真题试卷

Applied research, undertaken to solve specific practical problems, has an immediate attractiveness because the results can be seen and enjoyed. For practical reasons, the sums spent on applied research in any country always【B1】___for basic research, and the proportions are more unequal in the less developed countries. Leaving aside the funds【B2】by industry—which is naturally far more concerned with【B3】because these increase profits quickly—the funds the U. S. Government allots to basic research currently amount to about 7 percent of its over-all research and development funds. Unless adequate safeguards are provided, applied research invariably tends to【B4】Then, as Dr. Waterman has pointed out, “ Development will【B5】prematurely, career incentives will gravitate strongly toward applied science, and the opportunities for making【B6】will be lost. Unfortunately , pressures to emphasize new developments, without corresponding emphasis upon【B7】science, tend to【B8】___the quality of the nation’ s technology in the long run, rather than to improve it.”

Reading to oneself is a modern activity which was almost unknown to the scholars of the classical and medieval worlds, while during the fifteenth century the term “reading”undoubtedly meant reading aloud. Only during the nineteenth century,【C1】______silent reading become commonplace.

One should be【C2】___, however, of assuming that silent reading came about【C3】because reading aloud is a distraction to others. Examination of factors related to the historical development of silent reading reveals that it became the usual【C4】___of reading for most adult reading tasks mainly because the tasks themselves changed in character.

The last century【C5】___a steady gradual increase in literacy, and thus in the number of readers. As readers increased, so the number of potential listeners declined, and【C6】there was some reduction in the need to read aloud. As reading for the benefit of listeners grew less common,【C7】came the flourishing of reading as a private activity in such public places as libraries, railway carriages and offices,【C8】___reading aloud would cause distraction to other readers.

Towards the end of the century there was still considerable argument over whether books should be used for information or treated respectfully, and【C9】___whether the reading of material such as newspapers was in【C10】way mentally weakening. Indeed this argument remains with us still in education. However,【C11】its virtues, the old shared literacy culture had gone and was replaced by the printed mass media on the one hand and by books and periodicals for a specialized readership【C12】___.

By the end of the century students were being recommended to【C13】___attitudes to books and to use skills in reading them which were inappropriate,【C14】not impossible, for the oral reader. The social, cultural, and technological changes in the century had greatly altered 【C15】___the term “reading” implied.

During the past 30 years or so, health care has increasingly become a form of business. In addition , the environment surrounding health care has been greatly altered by the advent of more sophisticated medical technologies and increased specialization. It is no longer true to say that doctors regard their profession as a sacred calling, and while the doctor-patient relationship still remains, it is not the relationship based solely on trust which it used to be. Of course there are many doctors who have endeavored to increase the transparency of their behavior as medical professionals, and patients can receive effective treatment when such doctors work closely together and share notes.

An example of such cooperation can be found in the field of remote health care, which has been introduced on an experimental basis in several regions. Since most medical specialists live in cities, patients who live in the country have to travel a long distance to consult a specialist. This is especially hard on the elderly, both financially and physically. Through a computer network, patients who live in the country can consult a medical specialist in the city, tell him their symptoms, and receive advice without the need for a journey to the specialist’ s office. Also, with several doctors being assigned to a single patient, the transparency of each doctor’ s behavior is further ensured.

On the other hand, however, it is also true that remote health consultation is not generally regarded as a form of medical treatment. For any sort of consultation to be regarded as medical treatment, most people feel that the patient must actually visit the doctor, and undergo an examination by the doctor in person. Remote health care is essentially a means for doctors to work as a team. In order for this to be practicable, it is important to establish a system whereby financial support can be extended to a doctor who, as a member of a medical team, provides only information. Establishment of such a system will further advance the cause of “ free access to information” in the health care field.

For months Gina Cruz, a Manila grandmother, played Pepsi Cola’ s “Numbers Fever” promotion lottery, buying several bottles a day and saving the caps, in the hope that one of the magic number, imprinted inside them would win her a 1 million peso($40,000)prize. When the magic number, 349 was announced in May 1992, Cruz was overjoyed to find she had not one, but two caps bearing the winning digits. She promptly fainted. “ My blood pressure shot up,” she explained later, “probably from drinking too much Pepsi. ” Then she learned that her son also had a 349 cap—and she nearly collapsed again.

Cruz’ s indignation after discovering the next day that she was not, after all, a double millionaire , is shared by thousands of contestants who feel equally cheated. Instead of marking out 18 winning numbers, on which Pepsi had planned, a computer had wrongly generated 800,000. The company explained that it simply did not have the $ 32 billion it would take to pay all claimants. The real winners, it said, would be identified by a security code that had been placed on caps; the losers were offered apologies.

When Pepsi’ s explanation was not accepted, a promotion that initially boosted the company’ s market share by 5% turned into a nightmare. The winners felt like losers of a second, surprise lottery; the security code had been publicized as an authentication tool, not as a necessary second winning number. Feeling hoodwinked, the players have banded together in protest groups, fanning anti-Pepsi flames at frequent demonstrations and marches. More than 22,000 people holding the 349 number have filed 689 civil suits seeking damages, as well as 5,200 criminal complaints alleging fraud and deception. Some Pepsi employees have received death threats and now change their daily routines to avoid being attacked. Explosives have been thrown at Pepsi plants and offices, and 37 of the company’ s delivery trucks have been stoned, overturned or set on fire. In the worst incident , a school-teacher and a five-year-old girl were killed last. February when a grenade pitched at a Pepsi truck bounced off and exploded in front of a store.

Young discoverers need not despair—though there are few blanks left on today’ s map of the world, there are still unexplored realms to be charted in the depths of the oceans, the most remote recesses of the rain forests and the furthest reaches of outer space. Some scientists speculate there maybe 10 million species—perhaps even 100 million—living on the ocean floor that are yet to be discovered. Recent research suggests that all told some 90% of the world’ s plants and before they are even described and named(that is, if their habitats are not destroyed before they are even found). Given these remarkable statistics, it’ s clear that the physical world still offersintrepidexplorers new frontiers of discovery.

In this section on recent discoveries of the world around us, TIME travels 500m beneath the surface of the Pacific Ocean with Bruce Robison as he encounters a new species of luminous “jelly ,” we make our way deep into the world’ s tropical rain forests, where more than half of all life-forms on the planet live; we look into outer space to examine the role asteroids may have played in mass extinctions of the past and the potential threat they pose to our own civilization; and we ask whether there is life—intelligent or otherwise—elsewhere in the universe.

John Hemming, former director of London’ s royal Geographical Society, arguably the world’ s epicenter of exploration, defines an explorer as someone “who goes to the edge of knowledge and brings back something new. ” The people profiled in this section fit that description perfectly. The discoveries they have brought back from their explorations form new pieces in the puzzle of how the world works. As the pieces fit together, we get a glimpse of what a strange and beautiful mosaic it is.

“Back in the Victorian era, seven out of ten ulcer sufferers were woman. By the 1950s, the trend had reversed, nine of ten were men. Now, the trend is shifting back, ulcer cases are only four times as frequent among men. This may be a consequence of the changing roles of women in the labor market,” writes Philip Goldberg in Executive Health.

Ulcers have long been linked to stress and the particular kind of frustration that stems from dissatisfaction with one’ s work performance or one’ s life. Digestive enzymes gnaw away at the stomach lining, causing painful sores, or ulcers, which are found mainly in the lining of the stomach or the small intestine. The acids which cause ulcers are triggered by the vagus nerve, which is linked to the brain. Under stress, the brain may stimulate the release of a hormone called gastrin, which, in turn, stimulates the acid secretions. “ Although there is no clear-cut ulcer personality, there is no doubt that emotional tension, acting through the vagus nerve, can precipitate an ulcer. A person who is under constant strain, who is anxious, worried, frustrated—regardless of his or her station in life or apparent demeanor—is more apt to develop an ulcer,” writes Jane Broky in her guide to personal health, adding, “Seemingly calm, relaxed people are as prone to ulcers as the hard-driving, high-pressure kind. Ulcers occur as often in bus drivers, fanners, and construction workers as in business executives and writers with deadlines. It is not the existence of stress, but how a person reacts to stress, that, seems to make the difference. “

Some women appear to “inherit” ulcers but they also can be caused by aspirin, alcohol, coffee , and cigarette smoking(which may account for the increase of ulcers among women, since smoking among women is on the rise.)It is important to see a physician if an ulcer is suspected, since ulcers can eat through the stomach lining into other organs and occasionally be fatal. Doctors will usually recommend a number of treatments, including emotional counseling and diet changes. Stress-reducing techniques also have been successful in treating ulcers.

In a seeming contradiction, the growth of computer-augmented work will probably create a need for less-skilled workers rather than the reverse. While early computers required much knowledge and skill to operate, comprehensive software packages have virtually eliminated the requirement for technical knowledge.

Indeed, advanced software may lead to a decreased need for certain job-related skills. For example , word processing has reduced the need for secretarial typing accuracy, since mistakes can be corrected quickly and easily with no trace of correction. Spell-checking programs can be relied on to prevent common mistakes, thus decreasing the need for that language skill. We have already encountered cashiers who have no need to compute a customer’ s change. Instead, they merely enter the purchase amount and then the amount offered in payment. The machine calculates the change and, in some cases, automatically dispenses it.

This effect is seen in more complex jobs, too. Nurses in intensive-care units often monitor several patients from a central station. Digital readouts continuously report patients’ vital signs. A-larms sound if values exceed an expected range. Despite the obvious advantages computerization has brought to both patient and staff, some health-care professionals are concerned that they may be losing important “ soft” skills. The most important of these may be the intuition born of experience acquired in personally observing hundreds or thousands of patients. The look in a patient’ s eyes, the coloring of skin and the appearance of pain or restlessness are among many indicators used by medical personnel to anticipate changes in patient condition. These cannot be captured on a digital display.

It cannot be denied that computers have made great contributions to productivity, nor would any reasonable person encourage scrapping the technology. However, we must pay more attention to human needs, and to the long-range effects of making jobs less interesting and decreasing skill requirements.

I was invited to present a lecture to a class of graduate nurses who were studying the “ Psychosocial Aspects of Aging. ” I started my lecture with the following case presentation: The patient is a white female who appears her reported age. She neither speaks nor comprehends the spoken word. Sometimes she babbles incoherently for hours on end. She is disoriented about person, place, and time. She does, however, seem to recognize her own name. I have worked with her for the past 6 months, but she still does not recognize me.

She shows complete disregard for her physical appearance and makes no effort whatsoever to assist in her own care, she must be fed, bathed, and clothed by others. Because she is edentulous, her food must be pureed, and because she is incontinent of both urine and stool, she must be changed and bathed often. Her shirt is generally soiled from almost incessant drooling. She does not walk. Her sleep pattern is erratic. Often she awakens in the middle of the night, and her screaming awakens others.

Most of the time she is friendly and happy. However, several times a day she gets quite agitated without apparent cause. Then she screams loudly until someone comes to comfort her.

After the case presentation, I asked the nurses how they would feel about taking care of a patient such as the one described. They used words such as “ frustrated,” “ hopeless, ” “ depressed, ” and “annoyed” to describe how they would feel.

When I stated that I enjoyed taking care of her and that I thought they would too, the class looked at me in disbelief. I then passed around a picture of the patient; my 6-month-old daughter.

After the laughter had subsided, I asked why it was so much more difficult to care for a 90-year-old than a 6-month-old with identical symptoms. We all agreed that it is physically easier to take care of a helpless baby weighing 15 pounds than a helpless adult weighing 100, but the answer seemed to go deeper than that.

The infant, we all agreed, represents new life, hope, and almost infinite potential. The demented senior citizen, on the other hand, represents the end of life, with little potential for growth.

We need to change our perspective. The aged patient is just as lovable as the child. Those who are ending their lives in the helplessness of old age deserve the same care and attention as those who are beginning their lives in the helplessness of infancy.

Some problems can be readily identified simply by looking around. These problems concern the pollution of our environment by technology as a result of sudden upsets in the physical, economic and social balance. The most obvious of these are the general pollution of our physical environment and the destruction of irreplaceable natural resources. Not so obvious as these, but just as painfully significant to some, are the disappearing and changing of jobs which overnight often create large groups of jobless citizens.

Can technology be used to undo what it has done, replace what it has destroyed or substitute for what it has caused to disappear? No one knows. Many wonder whether or not all of the sources of pollution have yet been identified, whether or not they are being arrested and whether or not they will be prevented from recurring.

Another set of problems relates to what technological advancement has done to the quality of life. An improved social life has not been unfortunately, either the goal or the chief beneficiary of technological change. Rather, any improvements that have occurred have been more accidental than intended. Too much has happened too fast. The changes demanded of marriage and family relationships remain largely unexamined. It is often a matter of “put up or shut up” , and a person has to a-dapt his life-style to ever-changing conditions with little time for choice. The “no-move-no-advancement” type is an example of one such problem. Many people are coming to think that the reward is simply not worthy the struggle, and they are taking jobs with less responsibility and lower pay.