统考医学博士2010年英语试题

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Sleep Deprivation Linked to Weight Gain这是原文，试题对文章略做了修改 ZB)`*z>*  
May 24, 2006 (San Diego) — A new study presented here at the American Thoracic Society International Conference shows that middle-aged women who sleep 5 or fewer hours each night weigh an average of 2.5 kg more than those who sleep for at least 7 hours."Sleep deprivation has important effects on a patient's health, so clinicians should really ask their patients about their sleep habits," said study presenter Sanjay Patel, MD, an assistant professor of medicine at Case Western Reserve University in Cleveland. "Getting a good's night sleep has already been shown to have effects on diabetes and heart disease and now we see it affects weight as well."Dr. Patel told Medscape that previous studies had already shown that women, men, and children who sleep less tend to weigh more than those who sleep more. But what had not been clear, he explained, is whether the loss of sleep caused the weight gain or vice versa.The prospective database of the Nurses Health Study offered an opportunity to answer the question, Dr. Patel said. For the current analysis, the researchers studied 68,183 women, aged 40 to 65 years, who were first asked about their typical night's sleep in 1986. As part of routine questionnaires every 2 years for the next 16 years, they were also asked to report their weight.In addition to weighing more at baseline, the women who slept less tended to gain more weight over time, Dr. Patel reported. After adjustment for age, those who slept for 5 or fewer hours per night gained 1.5 kg more during the next 10 years than those who slept at least 7 hours per night (P < .001).After adjusting for other factors including smoking, snoring, caffeine and alcohol intake, medication, and menopausal status, those who slept for 5 or fewer hours per night gained 0.7 kg more during the next 10 years than those who slept at least 7 hours per night (P < .001).Put another way, the researchers found that the women sleeping 5 or fewer hours per night were 32% more likely to experience major weight gain, defined as an increase of 33 lb or more, and 15% more likely to become obese during the 16-year study period than the women who slept at least 7 hours per night.In addition, women who slept for 6 hours were 12% more likely to have major weight gain and 6% more likely to become obese compared with women who slept at least 7 hours per night.One of the most surprising findings, Dr. Patel said, was that the women who slept less actually ate less as well."A study from the University of Chicago suggested that healthy people who get less sleep may eat more because of changes in levels of the hormones leptin and ghrelin. But this was not the case," Dr. Patel pointed out."We don't really understand why sleep deprivation predicts weight gain at this point, but it could be that because they are more tired, the women are less likely to exercise — become couch potatoes, if you will," Dr. Patel suggested. "Or, sleeping deprivation may cause changes in a person's basal metabolic rate."Safwan Badr, MD, chief of pulmonary medicine at Wayne State University in Detroit, Michigan, said that like many other findings of the prospective Nurses Health Study, these results “should have a very important impact on medical practice.“The practicing physician really needs to stress to her patient that getting a good night’s sleep is not just a luxury,” Dr. Badr told Medscape. “It’s a mandatory way to improve your health.” mM> L0  
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When Your Teen Wants You to Say No题目 &V`~ z e  
I am the meanest mother in the neighborhood. I'm too strict. I ask too many questions. No one else's parents are as difficult as I am. Don't I know that all the cool kids are out until 2:00 or 3:00 in the morning and can go wherever they want?This is the point of view of my 16-year-old daughter. Although she is frequently annoyed when I try to gather what I consider basic information — about where she's going, who's driving, and what the plan is for getting home — I know she is also relieved that someone is watching out for her. Discipline — or, to use today's more popular phrase, setting limits — takes on a whole new meaning when your child hits adolescence. "When kids are very young and do something unsafe, parents have no trouble saying no," says Daniel Kindlon, Ph.D., assistant professor of child psychology at the Harvard School of Public Health, who has two daughters, 15 and 12. "You don't care that your two-year-old cries if you don't let him put the fork in the toaster. But saying yes to your teen can almost become a reflex, because you so desperately want to avoid conflict."New research confirms what parents have known all along: Adolescents simply lack the ability to make smart decisions consistently. For example, peer relationships — which are so important to teenagers — can easily overwhelm the need to be safe. Scientists have discovered that this has to do with the way the human brain grows. During the teen years, the brain develops rapidly, but some areas mature much earlier than others. "Teens are likely to be impulsive and push back intensely," says David Walsh, Ph.D., a psychologist and the author of a book on teen behavior.But you have to hold the line. Your teen is secretly counting on you to do so. And too much is at stake if you don't. With their immature brains, teens routinely underestimate the risks they take, whether they're experimenting with drinking or getting "carried away" by sexual excitement. Below, what parents need to do.Keep your head out of the sand. You have to assume your teen isn't going to tell you everything and sometimes may outright lie. After all, what kid in his right mind is going to come home after the prom and say, "Oh yeah, Dad, I smoked a joint with my girlfriend, and then we fooled around in the back of the car"? Teens are thrill seekers who don't realize the risks they're taking, but they do know enough to try not to get caught. And that puts the onus on you to try to figure out what's really going on. One mother gives her 16-year-old daughter a big hug and kiss whenever she comes home from a party. "Of course I love her," says the mom, "but I'm really checking to see whether she's been smoking or drinking."Make clear rules in advance.Setting limits on day-to-day behavior helps keep the peace and can provide a foundation if bigger problems hit. Kate Stewart, who lives in rural Henryville, Indiana, was fighting with her 14-year-old son, Zach, because he constantly wanted his parents to drive him 20 miles into town so he could hang out with his friends. "At Zach's age, the kids concoct activities at the drop of a hat," she says. "But he never told us about them until the last minute, and then he would have a complete fit if we said no."Kate and her husband devised a rule: If Zach wanted to go into town on a weekend, his parents required 24 hours' notice. "We explained that it was not reasonable for me or his dad to drop everything when we had our own responsibilities," says Kate. Now, instead of fighting, Kate reminds Zach about the rule. Meanwhile, Zach is learning how to plan ahead. You also need to be clear about the big stuff — where you stand on smoking, drinking, curfews, etc. — and what the consequences will be if your child violates the rules. (Don't forget that teens loathe hypocrisy, so you'd better walk the walk.)I often say to my daughter, "I get only one of you. I can't get a replacement if you get broken." She doesn't like the restrictions that come with that, but she knows I'm not setting them because I'm mad at her. Don't back down.Any parent of a teenager knows what a struggle it can be to resist an adolescent's anger, defiance, or whining, especially at the end of a long day."That's why it's important to have your limits-and-consequences conversation ahead of time and not in the heat of the moment," says Walsh. "Then, rather than getting angry when your kids misbehave, you can remind them of the rules." He relates an incident when his son, then 17, challenged him about his curfew. Instead of getting angry, Walsh reminded him that if he didn't keep the curfew, he'd lose access to the family car. His son stormed off, furious — but later that night, he pulled into the driveway on time.Teens need this kind of structure, says child and adolescent development expert Mel Levine, M.D., author of Ready or Not, Here Life Comes. After all, he adds, the adult world is full of nonnegotiable expectations. Grown-ups, for example, must fulfill the demands of their jobs and pay their bills on time. "Teens gain the tools they need to meet these demands by living up to their parents' expectations at home, where people who love them can help them when they fail," says Dr. Levine. Stay engaged.Ultimately, says Walsh, no amount of discipline will work if you haven't built up a bank account of goodwill with your kid. During your child's adolescence, you'll start to feel like you're drawing down that account. You can build it back by hanging out with your teen and listening to what she thinks. And, when appropriate, you can admit you made a mistake.You also want to engrave on your kid's innermost being that if something goes radically wrong, she can count on you. If your teen gets pregnant, gets arrested, or has a car accident (or something worse), you want to be the first one to know. So while you're enforcing limits, make sure you're not so rigid that your teen doesn't trust you to be on her side in case of real trouble.The good news, says Kindlon, is that a lot of teens actually respect their parents' (and society's) rules. "Kids have more leeway to say no today. To avoid drinking, they can volunteer to be the designated driver, and that's accepted. Or they can say 'My parents would kill me,' and that's OK too."Finally, realize that adolescence is a nail-biter for parents all the way. I've never experienced so many ups and downs as I have since I became a parent of teens. But most kids turn out just fine. After all, we did.

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Experts say about one-percent of young women in the United States are almost starving themselves to death. They are suffering from a sickness called anorexia nervosa. These young women have an abnormal fear of getting fat. They have purposely starved themselves so they weigh at least fifteen percent less than their normal weight.The National Institute of Mental Health says one in ten cases of anorexia nervosa leads to serious medical problems. These problems can cause death from heart failure. Or, anorexia can lead young women to kill themselves.At first, a person with anorexia develops joint and muscle problems. There is a lack of iron in the blood. As the sickness progresses, a young woman's monthly menstrual periods stop. Her breathing, heartbeat and blood pressure rates decrease.The thyroid gland slows production of chemicals needed for healthy performance of the body's cells. The important substance calcium is lost from the bones, sometimes causing bones to break. Sometimes the brain gets smaller, causing changes in how a person thinks and acts.Scientists say many anorexia nervosa patients have other mental and emotional problems. Anorexics have poor opinions about themselves. They feel helpless. Their attempts to become extremely thin may represent efforts to take control of their lives. They may suffer from fearfulness or continued deep sadness called depression. They may become dependent on illegal drugs.Some anorexic people also have obsessive-compulsive disorder. They feel a need to continually repeat an action. For example, they may repeatedly wash their hands although their hands are clean.Researchers suspect a connection between depression and anorexia. Important chemical messengers in the central nervous system known as neurotransmitters control hormone production. The neurotransmitters serotonin and norepinephrine do not perform normally in people with depression. Recently researchers have discovered that these neurotransmitters also are decreased in anorexia patients. smJ#.I6/L  
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ADOLF HITLER survived an assassination attempt in 1944 with the help of penicillin made by the Allies, a microbiologist in the UK claims. If the Nazi leader had died from bacterial infection of his many wounds, the second world war might have been over a year earlier, saving millions of lives, says Milton Wainwright of the University of Sheffield, a noted historian of microbiology.In a paper to be published soon in Perspectives in Biology and Medicine, Wainwright reveals first-hand evidence that Hitler was treated with penicillin by his personal doctor, Theo Morrell, following an assassination attempt in which a bomb in a suitcase exploded next to Hitler's desk. Hitler was badly hurt, fleeing the scene with his hair and trousers on fire, a badly bleeding arm and countless wooden splinter wounds from the oak table that probably saved his life.Wainwright found confirmation that Morrell gave Hitler antibiotics as a precaution in a recent translation of Morrell's own diary. "I happened to be reading it for interest when the word penicillin jumped out at me," he says. He then set about trying to establish where Morrell might have got the drug.At the time, penicillin was available only to the Allies. German and Czechoslovakian teams had tried without much success to make it, Wainwright says, but the small quantities that were available were weak and impure. "It's generally accepted that it was no good," says Wainwright.He reasons that Morrell would only have risked giving Hitler penicillin to prevent infections if he were confident that the antibiotic would cure, not kill the German premier. "My research shows that Morrell, in a very dodgy position as Hitler's doctor, would only have used pure stuff." And the only reliable penicillin was that made by the Allies. So where did Morrell get it?Wainwright's investigations revealed that Allied airmen carried penicillin, so the Germans may have confiscated some from prisoners of war. The other more likely source is from neutral countries such as Spain, which received penicillin from Allied countries for humanitarian purposes, perhaps for treating sick children."I have proof the Allies were sending it to these countries," says Wainwright. "I'm saying this would have got through in diplomatic bags, reaching Hitler's doctor and the higher echelons of the Nazi party." So this was almost certainly pure, Allied penicillin.""We can never be certain it saved Hitler's life," says Wainwright. But he notes that one of Hitler's henchmen, Reinhard Heydrich, otherwise known as the "Butcher of Prague", died from blood poisoning after surviving a car-bomb assassination attempt. "Hair from his seat went into his wounds and gave him septicaemia," says Wainwright. Morrell may have been anxious to ensure that Hitler avoided the same fate.

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药物作用于人体的病变部位，而病人的心理作用会或多或少地影响药物的作用。为了使药物治疗达到最佳疗效，人们必须研究药物心理学，讲究服药心理。 (V:)`A_-  
现代医药学认为：药物大多能产生两种效应。药物通过其药理作用来达到治病的目的，此为药物的生理作用。药物还可通过其非生理作用，在病人的心理上产生良好的感觉，加速疾病的康复，此为药物的心理效应。药物的心理效应可促使药物取得更好的疗效，为治疗奠定良好的基础。 \O G`+"|L  
药物的心理效应是指由医生的威信，病人对药物的信任感，接受药物治疗的体验、评价，治疗时外界的暗示及药物的广告效应等心理共同作用而产生的综合效应。药物心理学正是建立在药物心理效应基础之上的一门新兴边缘学科。众所周知，用同样的药物，由专家、名医开出的则效果会更好，这就是药物心理学最简单而明显的例子。 {u@w^ hZ$  
有人做了一个形象的比喻：药物是治疗疾病的“种子”，而心理状态是种子赖以生长、开花和结果的“土壤”。药物的药理作用是药物治疗疾病的基础，而药物的心理效应则在疾病治疗过程中起着十分微妙的作用。特别是在治疗心因性疾病和心理精神疾病中，良好的心态显得更为重要。 i^ _?C5  
与服药心理关系最密切的是药物的信誉。原因为：虔诚的信念和愉快的心情能影响人体的生理机能，增加肾上腺皮质激素的分泌；而适量的肾上腺素能耐受200～400倍致死量的细菌内毒素。药物的良好信誉，能树立人对药物治病救人的坚定信念。 ?'%9  
为什么不良心态会降低药物的生理效应呢？人体是一个复杂的有机整体，不良心态会影响内分泌、心脑血管系统等的功能，从而减弱人体的抗病能力，体内病菌就乘机繁衍滋生，药效当然就降低了。积极的服药心理，可激活内分泌和潜在的免疫功能，药物在免疫器官泌抗体增多时，能发挥最佳疗效。 qV&ai{G:  
药物心理学对人体的作用，在某些人中表现尤为明显：特别是有神经质、意志薄弱、心理缺陷和易受暗示的人。药物心理学揭示了安慰剂止痛和心理安慰的奥秘：安慰剂可通过心理暗示作用刺激大脑产生内源性脑啡肽，其结构类似天然吗啡，作用于疼痛部位，从而减轻疼痛。 9zac[tno  
许多人有以自觉症状为主的慢性病。许多慢性病有明显的自觉症状，如恶心呕吐、头晕目眩、失眠多梦、食欲不振、腹胀和隐痛等，些症状与心理和精神状态密切相关。而药物的心理作用正是通过心暗示来调整人的心态，在不知不觉中治愈或缓解了原有的慢性病。 <HMmsw  
医护人员的语言、举止和行为对病人的用药心理影响很大。目前世界各国对癌症、类风湿性疾病和自身免疫病等尚无特效药。但医生绝不可对患者说：“此病为绝症，无药可治。”如对症适时选用安慰剂，有时会收到真正特效药所没有的神奇作用，至少可解除病人精神上的痛苦，在心灵上得到安慰和鼓励，从而增强战胜疾病的信心。 ,Z aPY  
药物心理学的重要组成部分是暗示疗法和安慰剂。安慰剂通过心理暗示作用而影响病人的心理状态，进而影响机体的生理功能，从而起到积极的治疗作用。现代医学证明：药物心理效应不但具有心理上的安慰作用，而且还有改变器官功能活动和躯体症状的多种作用，故可用于治疗某类躯体疾病及多种心理疾病

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请问阅读理解有标准答案的吗？谢谢。

作文还真是难

谢谢楼主啊！！