2005年医学博士外语真题试卷

In Mr. Allen’ s high school class, all the students have to “get married”. However, the wedding ceremonies are not real ones but【C1】___These mock ceremonies sometimes become so【C2】___that the loud laughter drowns out the voice of the “ minister”. Even the two students getting married often begin to giggle.

The teacher, Mr. Allen, believes that marriage is a difficult and serious business. He wants young people to understand that there are many changes that【C3】___take place after marriage. He believes that the need for these psychological and financial【C4】___should be understood before people marry.

Mr. Allen doesn’t only introduce his students to major problems【C5】___in marriage such as illness or unemployment. He also exposes them to nitty-gritty problems they will face every day. He wants to introduce young people to all the trials and【C6】that can strain a marriage to the breaking point. He even【C7】___his students with the problems of divorced men who must pay child support money for their wives.

It has been upsetting for some of the students to see the problems that a married couple often faces.【C8】___they took the course, they had not worried much about the problems of marriage. However, both students and parents feel that Mr. Allen’ s course is valuable and have【C9】the course publicly. Their statements and letters supporting the class have【C10】___the school to offer the course again.

Why do people always want to get up and dance when they hear music? The usual explanation is that there is something embedded in every culture—that dancing is a “cultural universal”. A researcher in Manchester thinks the impulse may be more deeply rooted than that. He says it may be a reflex reaction.

Neil Todd, a psychologist at the University of Manchester, told the BA that he first got an inkling that biology was the key after watching people dance to deafeningly loud music. “There is a compulsion about it. ” he says. He reckoned there might be a more direct, biological, explanation for the desire to dance, so he started to look at the inner ear.

The human ear has two main functions, hearing and maintaining balance. The standard view is that these tasks are segregated so that organs for balance, for instance, do not have an acoustic function. But Todd says animal studies have shown that the sacculus, which is part of the balance-regulating vestibular system, has retained some sensitivity to sound. The sacculus is especially sensitive to extremely loud noise, above 70 decibel.

” There’ s no question that in a contemporary dance environment, the sacculus will be stimulated. “ says Todd. The average rave, he says, blares music at a painful 110 to 140 decibels. But no one really knows what an acoustically stimulated sacculus does. Todd speculates that listening to extremely loud music is a form of “vestibular self-stimulation” : it gives a heightened sensation of motion. “We don’t know exactly why it causes pleasure. ” he says. “But we know that people go to extraordinary lengths to get it. ” He list bungee jumping, playing on swings or even rocking to and fro in a rocking chair as other example of pursuits designed to stimulate the sacculus.

The same pulsing that makes us feel as though we are moving may make us get up and dance as well, says Todd. Loud music sends signals to the inner ear which may prompt reflex movement. “The typical pulse rate of dance music is around the rate of locomotion. ” he says, “It’s quite possible you’ re triggering a spinal reflex. “

Have you switched off your computer? How about your television? Your video? Your CD player? And even your coffee percolator? Really switched them off, not just pressed the button on some control panel and left your machine with a telltale bright red light warning you that it is ready to jump back to life at your command?

Because if you haven’ t, you are one of the guilty people who help pollute the planet. It doesn’ t matter if you’ ve joined the neighborhood recycling scheme, conscientiously sorted your garbage and avoided driving to work. You still can’ t sleep easy while just one of those little red lights is glowing in the dark.

The awful truth is that household and office electrical appliances left on stand-by mode are gobbling up energy, even though they are doing absolutely nothing. Some electronic products—such as CD players-—can use almost as much energy on stand-by as they do when running. Others may use a lot less, but as your video player spend far more hours on stand-by than playing anything, the wastage soon adds up.

In the US alone, idle electronic devices consume enough energy to power cities with the energy needs of Chicago or London—costing consumers around $ 1 billion a year. Power stations fill the atmosphere with carbon dioxide just to do absolutely nothing.

Thoughtless design is partly responsible for the waste. But manufactures only get away with designing products that waste energy this way because consumers are not sensitive enough to the issue. Indeed, while recycling has caught the public imagination, reducing waste has attracted much less attention.

But “source reduction” , as the garbage experts like to call the art of not using what you don’t need to use, offers enormous potential for reducing waste of all kinds. With a little intelligent shopping, you can cut waste long before you reach the end of the chain.

Packaging remains the big villain. One of the hidden consequences of buying products grown or made all around the world, rather than produced locally, is the huge amount of packaging. To help cut the waste and encourage intelligent manufacturers the simplest trick is to look for ultra-light package.

The same arguments apply to the very light but strong plastic bottles that are replacing heavier glass alternatives, thin-walled aluminum cans, and cartons made of composites that wrap up anything drinkable in an ultra-light package.

There are hundreds of other tricks you can discuss with colleagues while gathering around the proverbial water cooler—filling up, naturally, your own mug rather than a disposable plastic cup. But you don’ t need to go as far as one website which tells you how to give your friends unwrapped Christmas presents. There are limits to source correctness.

You can have too much of a good thing, it seems—at least when it comes to physiotherapy after a stroke. Many doctors believe that it is the key to recovery; exercising a partially paralyzed limb can help the brain “rewire” itself and replace neural connections destroyed by a clot in the brain.

But the latest animal experiments suggest that too much exercise too soon after a brain injury can make the damage worse. “It’ s something that clinicians are not aware of,” says Timothy Schallert of the University at Austin, who led the research.

In some trials, stroke victims asked to put their good arm in a sling—to force them to use their partially paralyzed limb—had made much better recoveries than those who used their good arm. But these patients were treated many months after their strokes. Earlier intervention, Schallert reasoned, should lead to even more dramatic improvements.

To test this theory, Schallert and his colleagues placed tiny casts on the good forelimbs of rats for two weeks immediately after they were given a small brain injury that partially paralyzed one forelimb. Several weeks later, the researchers were astonished to find that brain tissue surrounding the original injury had also died. “The size of the injury doubled. It’ s a very dramatic effect. ” says Schallert.

Brain-injured rats that were not forced to overuse their partially paralyzed limbs showed no similar damage, and the casts did not cause a dramatic loss of brain tissue in animals that had not already suffered minor brain damage. In subsequent experiments, the researchers have found that the critical period for exercise-induced damage in rats is the first week after the initial brain injury.

The spreading brain damage witnessed by Schaller’ s team was probably caused by the release of glutamate, a neurotransmitter, from brain cells stimulated during limb movement. At high doses, glutamate is toxic even to healthy nerve cells. And Schallert believes that a brain injury makes neighboring cells unusually susceptible to the neurotransmitter’ s toxic effects.

Randolph Nudo of the University of Texas Health Science Center at Houston, who studies brain injury in primates, agrees that glutamate is the most likely culprit. In experiments with squirrel monkeys suffering from stroke-like damage, Nudo tried beginning rehabilitation within five days of injury. Although the treatment was beneficial in the long run, Nudo noticed an initial worsening of the paralysis that might also have been due to brain damage brought on by exercise.

Schallert stresses that mild exercise is likely to be beneficial however soon it begins. He adds that it is unclear whether human victims of strokes, like brain-injured rats, could make their problems worse by exercising too vigorously, too soon.

Some clinics do encourage patients to begin physiotherapy within a few weeks of suffering a traumatic head injury or stroke, says David Hovda, director of brain injury research at the University of California, Los Angeles. But even if humans do have a similar period of vulnerability to rat, he speculates that it might be possible to use drugs to block the effects of glutamate.

Our understanding of cities in anything more than casual terms usually starts with observations of their spatial form and structure at some point or cross-section in time. This is the easiest way to begin, for it is hard to assemble data on how cities change through time, and, in any case, our perceptions often betray us into thinking of spatial structures as being resilient and long lasting. Even where physical change is very rapid, this only has an impact on us when we visit such places infrequently , after years away. Most of our urban theory, whether it emanates from the social sciences or engineering, is structured around the notion that spatial and social structures change slowly, and are sufficiently inert for us to infer reasonable explanations from cross-sectional studies. In recent years, these assumptions have come to be challenged, and in previous editorials I have argued the need for a more temporal emphasis to our theories and models, where the emphasis is no longer on equilibrium but on the intrinsic dynamics of urban change. Even these views, however, imply a conventional wisdom where the real focus of urban studies is on processes that lead to comparatively slow changes in urban organization, where the functions determining such change are very largely routine, accomplished over months or years, rather than any lesser cycle of time. There is a tacit assumption that longer term change subsumes routine change on a day-to-day or hour-by-hour basis, which is seen as simply supporting the fixed spatial infrastructures that we perceive cities to be built around. Transportation modeling, for example, is fashioned from this standpoint in that routine trip-making behavior is the focus of study, its explanation being central to the notion that spatial structures are inert and long lasting.

When it is sunny in June, my father gets in his first cutting of hay. He starts on the creek meadows, which are flat, sandy and hot. They are his driest land. This year, vacationing from my medical practice, I returned to Vermont to help with the haying.

The heft of a bale(大捆)through my leather gloves is familiar; the tautness of the twine, the heave of the bale, the sweat rivers that run through the hay chaff on my arms. This work has the smell of sweet grass and breeze. I walk behind the chug and clack of the baler, moving the bales into piles so my brother can do the real work of picking them up later. As hot as the air is, my face is hotter. I am surprised at how soon I get tired. I take a break and sit in the shade, watching my father bale, trying not to think about how old he is, how the heat affects his heart, what might happen.

This is not my usual work, of course. My usual work is to sit with patients and listen to them. Occasionally I touch them, and am glad that my hands are soft. I don’t think my patients would like farmer callouses and dirty hands on their tender spots. Reluctantly I feel for lumps in breasts and testicles, hidden swellings of organs and joints, and probe all the painful places in my patients’ lives. There are many, perhaps I am too soft, could stand callouses of a different sort.

I feel heavy after a day’ s work, as if my patients were inside me, letting me carry them. I don’t mean to. But where do I put their stories? The childhood beatings, ulcers from stress, incapacitating depression, fears, illness? These are not my experiences, yet I feel them and carry them with me. Try to find healthier meanings, I spent the week before vacation crying.

The hay field is getting organized. Piles of three and four bales are scattered around the field. They will be easy to pick up. Dad climbs, tired and lame, from the tractor. I hand him a jar of ice water, and he looks with satisfaction on his job just done. I’ 11 stack a few more bales and maybe drive the truck for my brother. My father will have some appreciative customers this winter, as he sells his bales of hay.

I’ve needed to feel this heaviness in my muscles, the heat on my face. I am taunted by the simplicity of this work, the purpose and results, the definite boundaries of the fields, the dimensions of the bales, for illness is not defined by the boundaries of bodies; it spills into families, homes, schools, and my office, like hay tumbling over the edge of the cutter bar. I feel the rough stubble left in its wake. I need to remember the stories I’ ve helped reshape, new meanings stacked against the despair of pain, I need to remember the smell of hay in June.

Everyone has seen it happen. A colleague who has been excited, involved, and productive slowly begins to pull back, lose energy and interest, and becomes a shadow or his or her former self. Or, a person who has been a beacon of vision and idealism retreats into despair or cynicism. What happened? How does someone who is capable and committed become a person who functions minimally and does not seem to care for the job or the people that work there?

Burnout is a chronic state of depleted energy, lack of commitment and involvement, and continual frustration, often accompanied at work by physical symptoms, disability claims and performance problem. Job burnout is a crisis of spirit, when work that was once exciting and meaningful becomes deadening. An organization’ s most valuable resource—the energy, dedication, and creativity of its employees—is often squandered by a climate that limits or frustrates the pool of talent and energy available.

Milder forms of burnout are a problem at every level in every type of work. The burned-out manager comes to work, but he brings a shell rather than a person. He experiences little satisfaction, and feels uninvolved, detached, and uncommitted to his work and co-workers. While he may be effective by external standards, he works far below his own level of productivity. The people a-round him are deeply affected by his attitude and energy level, and the whole community begins to suffer.

Burnout is a crisis of the spirit because people who burn out were once on fire. It’ s especially scary and consequential because it strikes some of the most talented. If they can’ t maintain their fire, others ask who can? Are these people lost forever, or can the inner flame be rekindled? People often feel that burnout just comes upon them and that they are helpless victims of it. Actually, the evidence is growing that there were ways for individuals to safeguard and renew their spirit, and more important, there are ways for organizations to change conditions that lead to burnout.