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1、-2008PartReading Comprehension (40 points)Directions: In this part there are four passages for you to read. After eachpassage there are five questions, below each of which there are four answers marked A, B, C and D. Choose the best answer and mark the corresponding letter with a pencil on the Machi
2、ne-Scoring Answer Sheet with a single line through the center.Passage OneA TIME columnist bears witness to an operation to help triplets with cerebral palsy walk like other boysCindy Hickman nearly bled to death the day she gave birth - three months prematurelyto her triplet sons.Weighing less than
3、2 lbs. each, her babies were al ve, b t barely. They clung so tenuously to life that her doctorsrecommended she name them A, B and C. Then, after a year of heroic interventionsbrain shunts, tracheotomies,skull remodelingoften requiring emergency helicopter rides to the hospital nearest their rural T
4、ennessee home,the Hickmans learned that their triplets had cerebral pals .Fifteen years ago there wasnt much that could be done about cerebral palsy, a disorder caused by damage to the motor centers of the brain. But pediatric medicine has come a long way since then, both in intervention before birt
5、h, with better prenatal care and various techniques to postpone delivery, and surgical interventions after birth to correct physical deficiencies. So althoug the incidence of cerebral palsy seems to be increasing (because the odds of preemies surviving are so much better), so too are the number of s
6、uccess stories.This is one of them. Lane, Codie and Wyatt (as the Hickman boys are called) have spastic cerebral palsy, the most common form, accounting for nearly 80% of cases. We first noticed that they werent walking when they should, Cindy recalls. Instead they were only doing the combat crawl.
7、Their brains seemed to be developing age appropriately, but their muscles were unnaturally stiff, making walking difficult if not impossible.Happily, spastic cerebral palsy is also the most treatable form of CP, largely thanks to a procedure known as selective dorsal rhizotomy, in which the nerve ro
8、ots that are causing the problem are isolated and severed. Among the first to champion SDR in the U.S. in the late 1980s was Dr. T.S. Park, a Korean-born pediatric neurosurgeon at Washington University in St. Louis, Mo., who has performed more than 800 of these operations and hopes to do an addition
9、al 1,000 before he retires.Having performed the operation myself as a resident in neurosurgery, I was eager to see how the countrys most prolific SDR surgeon does it. Last month I got an opportunity to stand by his side as he operated on 3-year-oldLane Hickman.Peering through a microscope and guided
10、 by an electric probe, we were able to distinguish between the two groups of nerve roots leaving the spinal cord. The ventral roots send information to the muscle; the dorsal roots send information back to the spinal cord. The dorsal roots cause spasticity, and if just the right ones are severed, th
11、e symptoms can be greatly reduced.Nearly half a million Americans suffer from cerebral palsy. Not all are candidates for SDR, but Park estimates that as many as half may be. He gets the best results with children between ages 2 and 6 who were born prematurely and have stiffness only in their legs. H
12、e is known for performing the operation very high up in the spine, right where the nerve roots exit the spinal cord. Its riskier that way, but the recovery is faster, and in Parks skilled hands, the success rate is higher.Cindy and Jeremy Hickman will testify to that. Just a few weeks after the proc
13、edure, two of their sons arewalking almost normally and the third is rapidly improving.1. When the triplets were born.A. both the triplets and their mother nearly diedB. they didnt have cerebral palsyC. doctors didnt believe they were going to surviveD. they received medical intervention like brain
14、shunts2. Cerebral palsy is.A. deadly diseaseB. a kind of brain disorderC. not treatable for children who are over 6 and have stiffness in their legsD. to be cured by isolating and cutting off the right nerve roots3. There are more and more cases of cerebral palsy .A. because there are more and more
15、tripletsB. because more and more babies prematurely born are able to surviveC. so there are more cases of successful treatmentD. so there are more candidates for SDR4. Dr. T. S. Park .A. is a successful pioneer in adopting SDR operations in CP treatmentB. is famous because of his success with the tr
16、iplets who are very difficult casesC. is ambitious by hoping to do another 1000 SDR operationsD. is not cautious enough by taking risks to perform the operation very high up the spine5. SDR is a procedure of .A. prenatal intervention using delivery postponing techniquesB. surgical intervention after
17、 birth to reduce spastic symptomsC. isolating and severing either of the two groups of nerve roots leaving the spinal cordD. great risk and high efficiencyPassage TwoModern lore has it that in England death is imminent, in Canada inevitable and in California optional Small wonder. Americans life exp
18、ectancy has nearly doubled over the past century. Failing hips can be replaced, clinical depression controlled, cataracts removed in a 30-minute surgical procedure. Such advances offer the aging population a quality of life that was unimaginable when I entered medicine 50 years ago. But not even a g
19、reathealth-care system can cure deathand our failure to confront that reality now threatens this greatness of ours.Death is normal; we are genetically programmed to disintegrate and perish, even under optimal conditions. We all understand that at some level, yet as medical consumers we treat death a
20、s a problem to be solved. Shielded by third-party payers from the cost of our care, we demand everything that can possibly be done for us, even if its futile. The most obvious example is late-stage cancer care. A vast industry pushed for aggressive and expensive therapy forprostate cancer, despite a
21、 lack of demonstrable benefit for many patients. Physicians - frus rated by their inability tocure the disease and fearing loss of hope in the patienttoo often offer aggressive treatment far beyond what isscientifically justified. Meanwhile, the kind of palliative care provided in hospices is taught
22、 derogatorily to medical students as atreatment of last resort. In 1950 the United States spent SI 2.billion, or 4.4 percent of gross domestic product, onhealth care. In 2002 the cost will be $ 1.54 trillion - nearly 14 percent of GDP, by far the largest percentage spent by any developed country.Any
23、one can see that this trend is unsustainable. Yet few seem willing to try to reverse it. Some ethicists concludethat a government with finite resources should simply stop paying for medical care that sustains life beyond a certainagesay 83 or so. Former Colorado governor Richard Lamm has been quoted
24、 as saying that the old and infirm havea duty to die and get out of the way so that younger, healthier people can realize their potential.I wouldnt go that far. Not long ago similar arguments were used to justify mandatory retirement ages as young as 55 for employees in industry, academia and govern
25、ment. The message was Step aside -1 want your desk and your paycheck. Energetic people now routinely work through their 60s and beyond, and remain dazzlingly productive. At78, Viacom chairman Sumner Redstone jokingly claims to be 53. Supreme Court Justice Sandra Day OConnor is in her 70s, and former
26、 surgeon general C. Everett Koop chairs an Internet start-up in his 80s. These leaders are living proof that prevention works and that we can manage the maladies that come naturally with age. As a mere68-year-old, I aspire to age as productively as they have.Yet there are limits to what a society ca
27、n spend in this pursuit, or should. Ive watched as the lives of my family members and friends have been painfully prolonged. Its a stark contrast with the inexpensive and compassionate deaths of my parents a generation ago.As a medical consumer, I may want Medicare to buy me multiple coronary bypass
28、 operations or a desperateround of bone-marrow transplantation. As a taxpaying citizen, I knowintellectually, if not emotionally - that thevalue of such measures must be weighed against other social goods, such as housing, defense and education. And as a physician, I know the most costly and dramati
29、c measures may be ineffective and painful. I also know that people in Japan and Sweden, countries that spend far less on medical care, have achieved longer, healthier lives than we have. As a nation, we may be overfunding the quest for unlikely cures while underfunding research on humbler therapies
30、that could improve peoples lives. For example, the field of alternative and complementary medicine receives just a .5 percent chunk of the National Institutes of Health budget.To create a humane system of health care, we must acknowledge that death and dying are not themselves fee enemies. As the po
31、st-World War II British epidemiologist Archie Cochrane once observed, cures in medicine are rare, but the need for care - attention and reassurance from approachable, sympathetic physicians and caregivers - is widespread. Cochrane worried that by pursuing cures at all cost, we would restrict the sup
32、ply of care that patients can receive. This is precisely the crisis of contemporary medicine: billions for cures, and pennies for care. Medicine can accomplish great things for the generation now passing 50, but only if were wi e enough not to ask too much of it.6. People different attitudes towards
33、 death show that.A. people in other countries dont have a great health-care system as Americans doB. Americans rely too much on their health-care system even to challenge deathC. Americans are optimisticD. Palliative care works wonders in Americans7. The best health careA. can even change our geneti
34、c programs to prolong our liesB. can guarantee the old an unimaginable life of high qualityC. should do everything possible to save the patients lifeD. has limits to what it can do and should do8. Palliative care provided in hospices.A. is not thought much of because it doesnt cure patientsB. needs
35、much more money than health care and is unsustainableC. is for poor people who cant afford to stay in hospital for a long timeD. should be attached more importance9. The government with finite resources had better .A. balance its budget for research into cures and that into therapies that can help p
36、eople live healthier and happier livesB. stop paying for medical care that sustains life beyond age 83 so that younger and healthier people can realize their potentialC. make it a rule that people in industry, academia and government who are over 55shouId retireD. spend less on health and more on ho
37、using, defense and education10. What patients need most is .A. a solution to the problem of deathB. courage, optimism and sympathy for othersC. attention, care and reassurance from friendly physicians and caregiversD. a great health-care system that can provide them the most expensive and best thera
38、piesPassage ThreeIn economics, demand implies something slightly different from the common meaning of the term. The layman, for example, often used the term to mean the amount that is demanded of an item. Thus, if the price were to decrease and individuals wanted more of the item, it is commonly sai
39、d that demand increases. To an economist, demand is a relationship between a series of prices and a series of corresponding quantities that are demanded at these prices. If one reads the previous sentences carefully, it should become apparent that there is a distinction between the quantity demanded
40、 and demand. This distinction is often a point of confusion and we all should be aware of and understand the difference between these two items. We repeat, therefore, that demand is a relationship between price and quantities demanded, and therefore suggests the effect of one (e.g., price) on the ot
41、her (e.g. quantity demanded). Therefore, knowledge of the demand for a product enables one to predict how much more of a product will be purchased if price decreases. But the increase in quantity demanded does not mean demand has increased, since therelationship between price and quantity (i.e., the
42、 demand for the product) has not chan ed. Demand shifts when thereis a change in income, expectations, tastes, etc., such that a different quantity of te p oduct is demanded at the same price.In almost all cases, a consumer wants more of an item if the price decreases. This relationship between pric
43、e and quantity demanded is so strong that it is referred to as the law of demand. This law can be explained by the income and substitution effects. The income eff ct occurs because price increases reduce the purchasing power of the individual and, thus, the quantity demanded of goods must decrease.
44、The substitution effect reflects the consumers desire to get the best buy. Accordingly, if the price of product A increases, the individual will tend to substitute another product and purchas less of goods A. The negative correlation between price and quantity demanded is also explained by the law o
45、f diminishing marginal utility. According to this law, the additional utility the consumer gains from consuming a product decreases as successively more units of the product are consumed. Because the additional units yield less utility or satisfaction, the consumer is willing to purchase more only i
46、f the price of the product decreases.Economists distinguish between individual and market demand. As the term implies, individual demand concerns the individual consumer and illustrate the quantities that individuals demand at different prices. Market demand includes the demand of all individuals fo
47、r particular goods and is found by summing the quantities demanded by all individuals at the various prices.The other side of the price system is supply. As in the case of demand, supply is a relationship between a series of prices and the associated quantities supplied. It is assumed that as price
48、increases the individual or firm will supply greater quantities of a product. There is a positive correlation between quantity supplied and product price.Economists also distinguish between a change in supply and quantity supplied. The distinction is similar to die one made with respect to demand. Also, as in the case of demand* economists distinguish between individual firm supply and market supply, which is
