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Directions: In this part there is an essay in Chinese. Read it carefully then write a summary of 200 words in English on the ANSWER SHEET. Make sure that your summary covers the major points of the passage.警惕抗菌药物的耐药性微生物引发感染后需要药物治疗，但是这些微生物渐渐对特效药产生了抗药性。细菌的抗药性逐渐成为全球关注的公众卫生事件。一些细菌通过改变自身机理，对许多用于治疗感染的抗生素药物产生了抗药性（这就是所谓的“多重耐药菌”），从而使治疗变得很棘手，因为在治疗过程中人们只有很少的选择，甚至已经没有选择。这些问题成为一个日趋严重的全球性公众健康问题。世界卫生组织建议各国应准备实施医院感染控制措施，以限制多重耐药菌的种类，并加强全国性政策谨慎使用抗生素以减少耐药菌的产生。2010年8月11日刊登在《柳叶刀——传染病》期刊上的一篇文章中提到一种基因，这种基因可以是多种类型的细菌对几乎所有的抗生素产生极强的耐药性，引起了世人对AMR（即“耐药性”），尤其是对多重耐药菌感染的关注。多重耐药菌不是新生细菌，并且还会不断出现，这就需要对其实施监控和深入研究，以便了解多重耐药菌传播的范围和方式，从而采取有效手段进行防控。这就要求人们提高对细菌耐药性的警惕，并且消费者、医院管理人员、病人、政府、药品生产企业以及国际机构都要采取适当的行动。世界卫生组织强烈呼吁各国政府在以下领域采取集中控制和防御措施：AMR监管，抗生素合理使用，对公众及医务人员正确使用抗生素的教育，立法限制非处方购买抗生素以及感染的预防和控制措施，包括洗手这种方法，尤其是在医疗界。对多重耐药菌的成功防控已经在许多国家得到了证实，只要能够系统地运用，现有的预防和控制手段可以有效地减少多重耐药菌的传播。世界卫生组织将一如既往地支持各国实施相关措施，并协调所有国家，努力与细菌耐药性进行斗争。

With the rapid development of network connection, the popularity of smart phones and the constant changes of insurance standards, more and more medical service providers begin to use electronic communication equipment to complete their work. More than 15 million Americans received some form of telemedicine last year, according to the American Telemedicine Association. The group predicts that the number will increase by 30% next year. In the past year, the number of patients, medical organizations and employers using telemedicine services in the United States has increased.Through telephone, video and email, customers can establish contact with doctors they have never met. Usually, these customers are consulting about less serious diseases, such as colds, flu, ear pain and rashes, which cost about $45 each time. In the same way, it costs $100 to go to the doctor’s office, $160 to the emergency clinic, and $750 to the emergency room. Many health care plans and employers can’t wait to provide these services to their members, so that they can get convenient medical services without having to go out of the house. This year, nearly 75% of employers in large companies will provide telemedicine services to their employees as a benefit. The number is 48% higher than last year.But the above data does not show that telemedicine has entered every household. Recently, Health-mine conducted a survey of 500 tech savvy consumers and found that 39% still don’t know what telemedicine is. Of these people, 42% tend to communicate with doctors face to face. In another survey of 1,500 family doctors, only 15% had ever used telemedicine at work. In the case of rapid growth, telemedicine industry still has significant problems and challenges. For example, the rules governing the definition and regulation of telemedicine vary widely among states in the United States and are constantly changing. Some critics question whether the quality of service has kept pace with the rapid expansion of telemedicine.A study published last month in the dermatology edition of the Journal of the American Medical Association showed that a patient with a skin disease asked for help on 16 telemedicine websites with disturbing results. Less than one-third of doctors provided doctor’s certificates or gave patients the right to choose doctors in 62 cases; only 32% of doctors mentioned possible side effects of prescribed drugs. Several websites have even misdiagnosed a serious illness because they didn’t ask more questions.The American Telemedicine Association and other organizations have begun to certify some quality telemedicine websites. In particular, patients should be reminded to pay attention to websites that sell products.The American Medical Association approved a new code of ethics for telemedicine this month, calling on telemedicine practitioners to recognize the limitations of the service and to make medical recommendations when they have enough information about patients.However, there is not always a consensus on the limitations of telemedicine examination. Jason Gorevic, CEO of Teladoc, which went public last year, said his group has designed more than 100 treatment guidelines based on the characteristics of telemedicine, including a five point scale to guide doctors’ telemedicine behavior. Even so, the Centers for Disease Control and Prevention recommends that doctors take a quick test or throat test before prescribing antibiotics.Employers and Medicare programs are willing to pay for telemedicine, but insurers are less happy with the way patients call, email or video to consult doctors about long-standing health problems. “Unless you go to the scene to consult a doctor, it’s very difficult to cover the cost of seeing a doctor.” Peter Rasmussen, medical director of the Cleveland Clinic telemedicine center, said he believes that as hospitals are undergoing the transition from “paying for services” to “long-term health management”, more and more hospitals will tend to invest in telemedicine systems.The Johns Hopkins School of medicine, Stanford University Medical Center, Harvard affiliated medical alliance and other academic centers have also started to provide remote counseling services. American Well, an old telemedicine company, has started to provide software system support for telemedicine projects in many hospitals.1. What is the purpose for the author to mention the number in the first paragraph?2. What seems to be the problem in the development of telemedicine?3. The new code of ethics for telemedicine made by AMA ____.4. What is the attitude for health insurers to the bill of telemedicine?5. What can be inferred about the future of the telemedicine?

Eating is related to emotional as well as physiologic needs. Sucking, which is the infant’s means of gaining both food and emotional security, conditions the association of eating with well-being or with deprivation. If the child is breast-fed and has supportive body contact as well as good milk intake, if the child is allowed to suck for as long as he or she desires, and if both the child and the mother enjoy the nursing experience and share their enjoyment, the child is more likely to thrive both physically and emotionally. On the other hand, if the mother is nervous and resents the child or cuts him/her off from the milk supply before either the child’s hunger or sucking need is satisfied, or handle the child hostilely during the feeding, or props the baby with a bottle rather than holding the child, the child may develop physically but will begin to show signs of emotional disturbance at an early age. If, in addition, the infant is further abused by parental indifference or intolerance, he or she will carry scars of such emotional deprivation throughout life.Eating habits are also conditioned by family and other psychosocial environments. If an individual’s family eats large quantities of food, then he or she is inclined to eat large amounts. If an individual’s family eats mainly vegetable, then he or she will be inclined to like vegetables. If mealtime is a happy and significant event, then the person will tend to think of eating in those terms. And if a family eats quickly, without caring what is being eaten and while fighting at the dinner table, then the person will most likely adopt the same eating pattern and be adversely affected by it. This conditioning to food can remain unchanged through a lifetime unless the individual is awakened to the fact of conditioning and to the possible need for altering his or her eating patterns in order to improve nutritional intake. Conditioning spills over into and is often reinforced by religious beliefs and other customs, so that, for example, a Jew, whose religion forbids the eating of pork, might have guilt feeling if he or she ate pork. An older Roman Catholic might be conditioned to feel guilty if he or she eats meat on Friday, traditionally a fish day.1. A well-breast-fed child .2. While sucking, the baby is actually .3. A bottle-fed child .4. From the list of eating habits, we learn that .5. A Jew or an older Roman Catholic .

Scientists have a duty to talk to the public. Why? Because social policies need to be decided on the basis of rational grounds and facts. These include important issue ranging from climate change, to the goals of the space program, to the protection of endangered species, to the use of embryonic stem cells or animals in biomedical research. Both the public and policy makers need to understand not only the scientific justification for our work but also, in some cases, why we deem our studies to be morally justifiable.The time is ripe for a more open, public and honest debate about the role of scientific experimentation in animals. What follows are some of my thoughts on this topic. I hope this perspective encourages other scientists to join the discussion and prompts opponents of animal research to create an atmosphere where civil discourse can take place, free of the threats, harassment and intimidation (恐吓) that are increasingly directed at biomedical scientists and their families.Criticism to the use of animals in biomedical research rests on varied scientific and ethical arguments. One extreme view holds that information gathered from animal research cannot, even in principle, be used to improve human health. It is often accompanied by catchy slogan such as “If society funds mouse models of cancer, we will find more cures for cancer in mice.” It is argued that the physiology of animals and humans are too different to allow results from animal research to be extrapolated (推断) to humans.Such a blanket statement is falsified by numerous cases where experimentation on animals has demonstrably contributed to medical breakthroughs. The experiments on cardiovascular and pulmonary function in animals that began with Harvey and continued with the Oxford physiologists established the understanding of what the heart and lungs do and how they do it, on which the modern practice of internal medicine rests. Modern medical practice is inconceivable in the absence of the insights gained from these experiments. Anticoagulants were first isolated in dogs: insulin was discovered in dogs and purified in rabbits; lung surfactants were first extracted and studied in dogs; rabbits were used in the development of in vitro fertilization; mice in the development of efficient breast cancer drugs and so on.For the sake of completeness, it must be noted that the other extreme—the notion that all medical advances are a result of animal research—is false as well. Important medical advances, such as sanitation and the discovery of aspirin, were conducted without the use of animals.1. The scientists need to talk to the public for the purpose of .2. In the second paragraph, what topic is raised for discussion?3. On which of the following do the opponents of the animal research base their extreme view?4. To falsify the blanket statement, the author cites all the following EXCEPT .5. What message does the author try to convey about the scientific experimentation in animals?

For half a century, researchers have dreamed of giving cancer patients a vaccine that helps the immune system detect the tumors as foreign tissue and wipe them out. Now, a new approach that tailors a personalized vaccine to the mutated proteins in an individual’s tumor appears to have prevented early relapses in 12 people with skin cancer.“We’re in this very exciting, new moment” for personalized cancer vaccines, says Catherine Wu of the Dana-Farber Cancer Institute in Boston, whose team presented results last week at the annual meeting of the American Association for Cancer Research (AACR) in Washington, D. C. A second team has similarly encouraging data. The two small studies, mainly designed to test safety and immune responses, are indeed “promising,” says Drew Pardoll of Johns Hopkins University in Baltimore, Maryland. But, he cautions, it is “way too early” to draw firm conclusions about whether the vaccines will extend the lives of cancer patients.Whereas earlier, unsuccessful cancer vaccines usually targeted a single distinctive cancer protein shared among patients, these new ones contain multiple mutated proteins, or “neoantigens,” that are specific to an individual patient’s tumor. Giving patients a dose of their tumor neoantigens, which look foreign to the immune system, should help activate immune cells called T cells to attack the cancer cells.One new study was conducted in six patients with melanoma that had spread to their lymph nodes and sometimes other sites. The patient’s tumors had been removed surgically, but were likely to regrow. Wu’s team sequenced the DNA from each patient’s tumors and used computational methods to predict mutations that coded for neoantigens. Then they made each patient a personal vaccine containing about 20 of these neoantigens. The researchers injected the vaccine under the patients’ skin periodically for 5 months. They had no serious side effects and showed “strong, potent T cell responses” specific to many of their vaccine neoantigens. All are now cancer-free up to 32 months later.The two patients with the most advanced disease did relapse, but Wu’s team deployed an additional weapon: an immunotherapy drug called a PD-1 checkpoint inhibitor. These antibody drugs block receptors on T cells that tumors use to hide from the immune system. On their own, the drugs have vanquished tumors in people with certain cancers who otherwise had no hope.Similar results come from an international trial using a vaccine developed by Ugur Sahin of University Medical Center of Johannes Gutenberg University in Mainz, Germany. The team injected RNA coding for up to 10 tumor neoantigens into the lymph nodes of 13 advanced melanoma patients whose tumors had been removed. Eleven remain cancer-free up to 26 months later, including two whose tumors reappeared, then shrank or were surgically removed, Sahin says. Another patient whose cancer returned received a PD-1 inhibitor and is also tumor-free.Pardoll and others caution, however, that it’s not possible to know whether neoantigen vaccines perform better than a PD-1 inhibitor alone without doing larger studies. Other questions remain about how best to design and deliver neoantigen vaccines. Right now the vaccines are costly and take months to make, which may be too long for some patients with metastatic disease.Meanwhile, several biotech companies are launching trials combining neoantigen vaccines and checkpoint inhibitors for various cancers. The Parker Institute for Cancer Immunotherapy in San Francisco, California, launched a year ago by Napster co-founder and biotech billionaire Sean Parker, is trying to figure out how to tailor the best possible vaccines through a competition.1. What is new of the tumor vaccines in Professor Wu’s study?2. What is true about the new study conducted in 6 patients?3. What is the attitude toward the personalized tumor vaccine according to the experts?4. What are the similarity between Professor Wu’s trial and Ugur Sahin one?5. Which of the following could NOT be the problems for personal tumor vaccine’s development?

When a disease of epidemic proportions rips into the populace, scientists immediately get to work, trying to locate the source of the affliction and find ways to combat it.Oftentimes, success is achieved, as medical science is able to isolate the parasite, germ or cell that causes the problem and finds ways to effectively kill or contain it. In the most serious of cases, in which the entire population of a region or country may be at grave risk, it is deemed necessary to protect the entire population through vaccination, so as to safeguard lives and ensure that the disease will not spread.The process of vaccination allows the patient’s body to develop immunity to the virus or disease so that, if it is encountered, one can ward it off naturally. To accomplish this, a small weak or dead strain of the disease is actually injected into the patient in a controlled environment, so that his body’s immune system can learn to fight the invader properly. Information on how to penetrate the disease’s defenses is transmitted to all elements of the patient’s immune system in a process that occurs naturally, in which genetic information is passed from cell to cell. This makes sure that, should the patient later come into contact with the real problem, his body is well equipped and trained to deal with it, having already done so before.There are dangers inherent in the process, however. On occasion, even the weakened version of the disease contained in the vaccine proves too much for the body to handle, resulting in the immune system succumbing, and therefore, the patient’s death. Such is the case of the smallpox vaccine, designed to eradicate the smallpox epidemic that nearly wiped out the entire Native American population and killed massive numbers of settlers.Approximately 1 in 10,000 people who receives the vaccine contract the smallpox disease from the vaccine itself and dies from it. Thus, if the entire population of the United States were to receive the Smallpox Vaccine today, 3,000 Americans would be left dead.Fortunately, the smallpox virus was considered eradicated in the early 1970s, ending the mandatory vaccination of all babies in America. In the event of a reintroduction of the disease, however, mandatory vaccinations may resume, resulting in more unexpected deaths from vaccination. The process, which is truly a mixed blessing, may indeed hide some hidden curses.1. The best title for the text may be .2. What does the example of the Smallpox Vaccine illustrate?3. The phrase “ward it off naturally” (Para. 3) most probably means .4. Which of the following is true according to the text?5. The purpose of the author in writing this passage is .

BY EARLY 1920, nearly two years after the end of The First World War and the first outbreak of Spanish flu, the disease had killed as many as 100m people—more than both world wars combined. Yet few would name it as the biggest disaster of the 20th century. Some call it the “forgotten flu”. Almost a century on, “Pale Rider”, a scientific and historic account of Spanish flu, addresses this collective amnesia.Influenza, like all viruses, is a parasite. Laura Spinney traces its long shadow over human history; records are patchy and uncertain, but Hippocrates’s “Cough of Perinthus” in 412 BC may be its first written description. Influenza-shaped footprints can be traced down the centuries: the epidemic that struck during Rome’s siege of Syracuse in 212 BC; the febrisitalica that plagued Charlemagne’s troops in the ninth century. The word “influenza” started being used towards the end of the Middle Ages from the Italian for “influence”—the influence of the stars. That was the state of knowledge then; in some ways at the start of the 20th century it was little better.Ms. Spinney, an occasional contributor to The Economist, recreates the world that Spanish flu came into. At the beginning of the 20th century science was on the rise. Scientists had switched miasma theory of disease for germ theory: they understood that many diseases were caused not by “bad airs”, but by microscopic organisms like bacteria. This led to improvements in hygiene and sanitation, as well as the development of vaccines. But viruses were almost unknown. The magnification of optical microscopes was too weak to show them up. People could spot bacteria, but not viruses, which are smaller than the wavelength of visible light. Until the electron microscope was invented in the 1930s, influenza was, like the Higgs boson before 2012, a theoretical entity: its existence was deduced from its effects. In the face of such uncertainty, public faith in medicine wavered. People reverted to superstition: sugar lumps soaked in kerosene, and aromatic fires to clear “miasmas”.Even so, Spanish flu was exceptionally deadly—about 25 times more so than seasonal flu. No one fully understands why. Ms. Spinney ties the virulence of Spanish flu to its genetic irregularities and does a good job of explaining containment strategies through epidemiology. She draws on contemporary research, too, including the recent controversy about recreating the strain responsible for the pandemic. Ms. Spinney is sanguine about the risks of such experiments: influenza appears to have all the ingredients for another catastrophic pandemic and scientists, using caution, should probably do all they can to learn more about it.Perhaps the most valuable aspect of this book, though, is its global perspective, tracing the course of the disease in Brazil, India, South Africa and Australia, among other places. In Europe and North America the First World War killed more than Spanish flu; everywhere else the reverse is true. Yet most narratives focus on the West, and only partly because that is where the best records are. Ms. Spinney’s book goes some way to redress the balance.1. Which of the following description about Spanish flu is true?2. What was the world like when Spanish flu came into according to Ms. Spinney?3. Why did the public turn to superstition when the Spanish flu broke out?4. What does “sanguine” mean in the Paragraph 4?5. The global perspective of Spinney makes us know ____.

Historically, humans get serious about avoiding disasters only after one has just struck them. On that logic, 2006 should have been a breakthrough year for rational behavior. With the memory of 9/11 still 51 in their minds, Americans watched hurricane Katrina, the most expensive disaster in U. S. history, on live TV. Anyone who didn’t know it before should have learned that bad things can happen. And they are made 52 worse by our willful blindness to risk as much as our reluctance to work together before everything goes to hell.Granted, some amount of delusion is probably part of the 53 condition. In A. D. 63, Pompeii was seriously damaged by an earthquake, and the locals immediately went to work 54, in the same spot—until they were buried altogether by a volcano eruption 16 years later. But a review of the past year in disaster history suggests that modern Americans are particularly bad at 55 themselves from guaranteed threats. We know more than we ever did about the dangers we face. But it turns 56 that in times of crisis, our greatest enemy is rarely the storm, the quake or the surge itself. More often, it is ourselves.So what has happened in the year that 57 the disaster on the Gulf Coast? In New Orleans, the Army Corps of Engineers has worked day and night to rebuild the flood walls. They have got the walls to where they were before Katrina, more or less. That’s not 58, we can now say with confidence. But it may be all that can be expected from one year of hustle.Meanwhile, New Orleans officials have crafted a plan to use buses and trains to 59 the sick and the disabled. The city estimates that 15,000 people will need a ride out. However, state officials have not yet determined where these people will be taken. The 60 with neighboring communities are ongoing and difficult.

The applications of genetic engineering are abundant and choosing one appropriate for this case can be rather difficult.

For years an acrimonious debate over how to protect heroin users impeded efforts in the U. S. to control the spread of AIDS.

When patients spend extended periods in hospital, they tend to become overly dependent and lose interest in taking care of themselves.

The anxious parent was vigilant over the injured child in spite of a full array of emergency room of doctors and nurses.

Proper exercise plays a significant role in the rehabilitation of patients with various back ailment.

The doctor vacillated so frequently on disease-prevention techniques that his colleagues accused him of inconsistency.

The thrombus forms in a blood vessel or within the heart and obstructs the circulation.

Recent research into aging suggests that the body’s defense mechanisms may lose the ability to distinguish what is alien.

Hippocrates is credited with writing the Hippocratic oath, although experts wonder if this is true.

10,000 deaths a year from chronic lung disease are attributable to smoking.

For many patients, institutional care is the most ____ and beneficial form of care.

You may ____ weight-loss medication for obesity, if your BMI is thirty or more, or if your BMI is twenty seven or more, and you also have an obesity related health problem.

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