山东中医药大学西医内科学2005年考博真题试卷

医学考博历年真题回忆录(心内)协和医科大学2005年心内科（博士）二、简答题1.原发性肺动脉高压的药物治疗2.肝素诱导血小板减少症3.钙离子跨膜转运三、论述题1.慢性心力衰竭的治疗进展2.胸痛的鉴别诊断3.宽QRS的诊疗程序4.ACS的治疗措施2007年重庆医科大学心内1.为什么jnc-7指南非常强调收缩压的控制2.容栓适应症，禁忌症，再通指标3.CRT机制4.室性心律失常危险分级，治疗策略5.药物支架分类6.他丁类调脂药作用机理7.阿司匹林抵抗机理8.ACS治疗2008年重庆医科大学心内问答（10分每个）1.折返基本条件2.2001美国心衰abcd四期分类你的观点3.如何理解顽固性高血压4.CRT定义和指征5.心源性晕厥包括那些疾病6.溶栓适应症和再通指标7.说说今年courage 临床试验和你的观点8.右心梗诊治2009年华中科技大学同济医学院博士入学考试内科学试题公共题5X8‘1.急性肺损伤/急性呼吸窘迫综合征高危因素及诊断标准有哪些？2.试述急性心肌梗死溶栓治疗药物的种类及选择对象的条件？3.溃疡性结肠炎如何与结肠克罗恩病鉴别？4.慢性肾衰竭恶化的常见可逆因素有哪些？5.甲亢患者采用放射性131I治疗的适应证及禁忌证有哪些？心内科1名词解释4X5’Postinfarction syndrome Unstable angina pectorisRestrictive cardiomyopathy Myocardial concussion syndrome2问答题4X10’试述急性冠状动脉综合征的治疗进展？试述病毒性心肌炎的临床分型？心脏起搏器的作用机制及适应证有哪些？急性主动脉夹层应与哪些疾病相鉴别？09天津心内1、主动脉瓣关闭不全的主要体征2、梅毒性心血管病的临床变现3、房缺、室缺、PDA、肺狭听诊主要特点4、抗心律失常药物的分类及特点5、舒张性心衰与收缩性心衰的诊治异同6、抗血小板药物的分类7、心电图T波倒置的原因8、高血压的降压目标三、论述题（3题，每题10分，共30分）1、静脉血栓栓塞症的治疗2、房颤的复律方法及适应征3、急性心肌梗死PCI的时间窗掌握2009年广州医学院心血管内科考博真题论述题：1、血管内皮在心血管疾病发病中的作用。

山东中医药大学历年中内及西内考博真题（2000-2010）2000年中医内科1.请阐述水肿、淋证、癃闭、关格的临床特点及联系。

（10分）2.请论述内伤头痛与肝、脾、肾三脏的关系。

（10 分）3.胸痹的发病基础和病理因素是什么？其病理特点如何？怎样辨别阴寒证、痰浊证、气滞证、血瘀证的不同？各证型治疗要点是什么？（10分）4.如何理解“治痿独取阳明”的意义？（10分）5.试述“真中”“类中”的源流考略？（10分）6.痰饮发病的内在病理基础是什么？为什么?其治则如何？为什么？（10分）7.消渴病（糖尿病）临床常见哪些急慢性并发症？请写出消渴病（糖尿病）周围神经病变辨证分型（只写分型）、治法、方剂。

（10分）8.如何理解《血证论》提出的治血四法？（10分）9.调补脾肾为何是治疗虚劳的关键？请论述之。

（10分）10.通窍活血汤方义如何？你在临床应用如何体会？（10分）西内内科一、名词解释：Ⅰ型、Ⅱ型呼吸衰竭，卓－艾综合症，脾功能亢进，肾病综合症，Graves病，高血压危象。

二、试述肺气肿的治疗原则及具体措施。

三、试述PSVT的ECG 表现及临床表现。

四、试述再生障碍性贫血的诊断标准。

五、试述急性肾功能衰竭的分类及原因。

六、试述DM的诊断标准。

七、肝硬化腹水形成的主要原因有哪些?2001年中医内科1.你对中西医结合治疗风湿病的看法。

2.中风病（中脏腑、中经络）的临床表现。

3.“开鬼门、洁净府”结合心血管（心衰）的应用。

4.胃痞、胃胀、痞满的鉴别诊断。

5.试述扶正治疗肿瘤（祛邪需要扶正，邪去正自安）6.肝癌、积症的治疗方法，在何时用何法？7.石棉在《内经》的论述及其治法（3个）8.试述“病痰饮者当以温药和之”9.试述糖尿病的非药物治疗。

10.血府逐瘀汤的组成，能治疗心系的那些疾病？西医内科1.慢性腹泻的发病机理。

2.感染性心内膜炎的诊断标准。

3.白血病前期多发MDX 的分类标准。

4.再障的鉴别诊断。

5.癫痫及其处理。

2000FA TMD医学博士研究生入学外语考试――英语参考答案（部分）PAPER TWO31.A 32.B 33.C 34.D 35.A 36.B 37.C 38.C 39.A 40.B 41.C 42.C 43.C 44.D 45.B46.D 47.C 48.B 49.A 50.C51.C 52.B 53.D 54.A55.C 56.D 57.D 58.C59.C 60.C 61.D 62.D63.A 64.B 65.D 66.D67.C 68.B 69.C 70.A71.C 72.C 73.C 74.D 75.D2001FA TMD医学博士研究生入学外语考试――英语参考答案（部分）PAPER ONE1.A2.C3.D4.B5.A6.A7.C8.A9.D 10.C 11. PAPER TWO1.C2.C3.A4.B5.C6.D7.B8.D9.C 10.D 11.D 12.A 13.A 14.B 15.B 16.C 17.C 18.A 19.D 20.D 21.D 22.C 23.A 24.C 25.C 26.C 27.A 28.B 29.A 30.A31.C 32.A 33.B 34.A 35.A 36.B 37.C 38.C 39.D 40.B 41.C 42.C 43.A 44.B 45.B46.C 47.D 48.B 49.D 50.A51.C 52.A 53.A 54.D55.D 56.C 57.A 58.A59.C 60.C 61.D 62.A63.B 64.D 65.D 66.C67.A 68.A 69.D 70.D71.C 72.A 73.C 74.D 75.A2002FA TMD医学博士研究生入学外语考试――英语参考答案（部分）1.B2.C3.C4.A5.D6.B7.C8.C9.B 10.C 11.C 12.D 13.D 14.C 15.B16.A 17.C 18.B 19.B 20.A 21.D 22.D 23.C 24.C 25.C 26.A 27.D 28.A 29.C 30.B31.B 32.C 33.A 34.C 35.D 36.C 37.C 38.C 39.D40.D41.B 42.D 43.D 44.B 45.C 46.D 47.A 48.B 49.A50.B51.B 52.C 53.D 54.A 55.C 56.C 57.C 58.C 59.A60.A61.A 62.D 63.D 64.B 65.A 66.D 67.D 68.A 69.C70.C71.B 72.A 73.A 74.A 75.A 76.B 77.C 78.B 79.C80.D81.C 82.B 83.D 84.D 85.D 86.A 87.B 88.C 89.A 90.D2003FA TMD医学博士研究生入学外语考试――英语参考答案（部分）1.D 2.D 3.B 4.A 5.B 6.D 7.C 8.D 9.B 10.D 11.B 12.D 13.D 14.A 15.A16.C 17.A 18.D 19.D 20.D 21.C 22.D 23.D 24.A 25.C 26.D 27.D 28.B 29.C 30.D31.A 32.B 33.D 34.C 35.A 36.D 37.A 38.C 39.C 40.A 41.A 42.C 43.C 44.D 45.D 46.B 47.D 48.D 49.C 50.A51.B 52.A 53.C 54.A 55.C 56.B 57.A 58.C 59.B60.A61.C 62.B 63.C 64.B 65.C 66.C 67.B 68.D 69.A70.B71.D 72.A 73.D 74.C 75.D 76.B 77.D 78.C 79.C80.A81.A 82.A 83.D 84.C 85.B 86.B 87.C 88.A 89.D 90.B2004年全国医学考博英语试题答案（仅供参考）1.A2.B3.C4.C5.C6.B7.D8.A9.D 10.D11.A 12.B 13.C 14.C 15.D 16.D 17.A 18.C 19.B 20.A21.A 22.B 23.D 24.C 25.D 26.A 27.D 28.C 29.B 30.C31.B 32.A 33.D 34.A 35.B 36.B 37.A 38.B 39.C 40.B41.A 42.C 43.B 44.D 45.C 46.D 47.C 48.A 49.D 50.A51.A 52.B 53.D 54.A 55.B 56.C 57.A 58.A 59.B 60.C61.D 62.C 63.B 64.D 65.C 66.D 67.D 68.C 69.D 70.B71.B 72.D 73.B 74.C 75.B 76.B 77.A 78.D 79.A 80.B81.B 82.D 83.C 84.C 85.A 86.B 87.D 88.A 89.A 90.D2005年全国医学博士外语统一考试英语试卷答案1-5CACDA6-10CDBCB11-15CADBA16-20DDBCB21-25ABCBD26-30CCDAD31-35CABAA36-40CADAD41-45BACBA46-50ABDCC51-55BACBA56-60ACBCB61-65BCBBC66-70BDABC71-75CACBB76-80CACBB81-85CBACD86-90ADBCC2006年全国医学博士外语统一考试英语试卷答案31-40 CDCCB BCBDA41-50 ACACA ACDDB51-60 BCACA AADBC61-70 DDDDA ACABD71-80ACCCC BCAAD81-90DBDBD DDBBC2001part III vocabulary(15%)1.we are all overwhelmed with more facts and information than we can possibly____A.feedB.maintainC.absorbD.consume2.pleasure,or joy, is vital to ____health. vital.生死攸关的, 重大的, 生命的, 生机的, 至关重要的, 所必需的A.optimistic pessimistic悲观的B.optional可选择的, 随意的C.optimal最佳的, 最理想的near optimal近似最佳D.operational3.A ____ effort is required to achieve health.mitted 承担义务的；忠于既定立场的；坚定的B.restrictedposed镇静的, 沉着的D.sophisticated诡辩的, 久经世故的4.A person’s belief ____ and colors his experience.A.contradicts vt.同...矛盾, 同...抵触contradict a statement驳斥一项声明contradict oneself自相矛盾B.shapes shape the destiny of决定...的命运C.summarizes概述, 总结, 摘要而言D.exchanges交换, 调换, 兑换, 交流, 交易.exchange experience 交流经验5.Many professors encourage students to question and ____ their idearsA.convey vt.搬运, 传达, 转让I can't convey my feelings in words.我的情感难以言表。

博士内科学试题及答案考试时间：180分钟总分：100分第一部分：选择题（共80分）请将以下题目中最合适的答案填入答题卡上对应的编号处。

1. 下列哪种疾病最容易导致高血压？A. 糖尿病B. 高尿酸血症C. 肺炎D. 慢性肾脏病2. 人体内哪个器官负责产生胰岛素？A. 胰脏B. 肝脏C. 肾脏D. 心脏3. 白内障是由于眼睛中哪个部分出现混浊而引起的？A. 虹膜B. 角膜C. 晶状体D. 视网膜4. 慢性阻塞性肺疾病（COPD）主要表现为下列哪个症状？A. 呼吸困难B. 头痛C. 肌肉疼痛D. 口干舌燥5. 糖尿病最常见的并发症是下列哪一项？A. 肾病B. 高血压C. 心脏病D. 癌症6. 下列哪种药物可用于治疗抑郁症？A. 维生素CB. 阿司匹林C. 抗生素D. 抗抑郁药物7. 食物中所含的哪种营养素对骨骼生长发育至关重要？A. 维生素AB. 维生素BC. 维生素CD. 维生素D8. 下列哪个指标可以用于评估人体肥胖程度？A. 体重B. 身高C. 体脂肪率D. 血压9. 人体最大的器官是哪个？A. 肺B. 肝脏C. 皮肤D. 心脏10. 心肌梗死是由于下列哪个原因引起的？A. 血栓形成B. 细菌感染C. 高血压D. 高血糖第二部分：问答题（共20分）请回答以下问题，尽量详细地给出正确答案。

1. 乙肝病毒感染后，人体为何会产生乙肝病毒表面抗原（HBsAg）？2. 红斑狼疮是一种自身免疫性疾病，它主要影响哪些器官？3. 血液中的白细胞主要有哪几种类型？它们分别起到什么作用？4. 请简要介绍一下支气管哮喘的常见症状和发病机制。

5. 心电图是一种常用的心脏疾病诊断方法，请简述它的原理和常见结果的分析。

第三部分：综合题（共分两题，每题各占10分）题目1：阐述高血压的危害和预防措施。

题目2：介绍糖尿病的发病机制及治疗方法。

请根据题目要求，逐一回答。

考试结束，祝你取得优异的成绩！。

2005年协和血液考博题一.名词解释：1．APS2．W AS3．HES4．TPO5．ALIP6．MALT7．VOD8．ALCL9．PRCA10.?二.填空:传单分型Vk依赖的凝血因子CD34受体MYH-9高雪病朗格罕组织细胞病遗传性毛细血管扩张症基因遗传性球形红细胞增多症基因三.简答题ALL预后分组反应停治疗MM机理ITP治疗?四.论述题TTP发病机理AIHA治疗M5治疗协和医科大学2005年血液内科（博士）一、名词解释（30分）：APS、W AS、PRCA、HES、ALIP、LGLL、VOD、PV、TPO、MALT二、填空（？分记不清了）1.已发现与遗传性出血性毛细血管扩张症相关的基因有（）（）（）（）。

2.WHO将MDS分为（）（）（）（）（）（）（）七类。

3.先天性再生障碍性贫血包括（）（）（）。

4.遗传球主要的分子病变涉及（）（）（）（）。

5.EPO在胚胎期由（）合成，成体则主要由（）合成。

6.WHO关于伴有重现性细胞遗传学异常的AML分类为（）（）（）（）。

7.国际多发性骨髓瘤工作组在MM新的分期标准中采用的两项客观指标为（）（）。

8.国际组织细胞协会将langerhans细胞组织细胞增多症分为单系统疾病和多系统疾病。

其中单系统疾病中的单部位型有（）（）（），多部位型有（）（）。

9.诊断幼年型粒单细胞白血病的最低实验室标准有（）（）（）。

10.MYH-9相关性疾病包括（）（）（）（）（）。

11.VitK依赖的凝/抗凝因子包括（）（）（）（）（）（）（）。

12.Gaucher病分为（）（）（），Nieman-Pick病A/B型为（）缺乏所致，C型为（）缺乏所致。

13.Downey将传单患者异型淋巴分为（）（）（）。

14.B淋巴细胞在发育过程中首先表达的免疫球蛋白为（），其次为（）。

15.CD34基因在染色体体定位为（），相应的受体为（）。

16.Hodgdin's病的四种病理亚型为（）（）（）（）。

2005Part II vocabularysection A31.There was no_____but to close the road until February.A.dilemmaB.denyingC.alternativeD.doubt32.I______when I heard that my grandfather had died.A.fell apartB.fell awayC.fell outD.fall back33.I’m_____passing a new law that helps poor children get bettermedicine.A.taking advantage ofB.standing up forC.looking up toD.taking hold of34.In front of the platform,the students were talking with theprofessor over the quizzes of their_____subjects.pulsorypulsiveC.alternativeD.predominant35.The tutor tells the undergraduates that one can acquire____ina foreign language through more practice.A.proficiencyB.efficiencyC.efficacyD.frequency36.The teacher explained the new lesson_____to the students.A.at randomB.at a lossC.at lengthD.at hand37.I shall ___the loss of my reading-glasses in newspaper witha reward for the finder. A.advertise rm C.announceD.publish38.The poor nutrition in the early stages of infancy can ___adultgrowth. A.degenerate B.deteriorate C.boost D.retard39.She had a terrible accident,but___she was’t killed.A.at all eventsB.in the long runC.at largeD.in vain40.His weak chest___him to winter illness .A.predictsB.preoccupiesC.prevailsD.predisposesSection B41.The company was losing money,so they had to lay off some ofits employees for three months.A.oweB.dismissC.recruitD.summon42.The north American states agrreed to sign the agreement ofeconomical and military union in Ottawa.A.conventionB.convictionC.contradictionD.confrontation43 The statue would be perfect but for a few small defects in itsbase.A.faultsB.weaknessesC.flawsD.errors44.When he finally emerged from the cave after thirty days.John was startlingly pale. A.amazingly B.astonishingly C.uniquelyD.dramatically45.If you want to set up a company,you must comply with theregulations laid down by the authorities.A.abide byB.work outC.check outD.succumb to46.The school master applauded the girl’s bravery in his openingspeech.A.praiseB.appraisedC.cheeredD.clapped47.The local government leaders are making every effort to tacklethe problem of poverty.A.abolishB.addressC.extinguishD.encounter48.This report would be intelligible only to an expert in computing.A.intelligentprehensivepetentprehensible49.Reading a book and listening to music simultaneously seems tobe mo problem for them.A.intermittentlyB.constantlyC.concurrentlyD.continuously50.He was given a laptop computer in acknowledgement of his work forthe company.A.accomplishmentB.recognitionC.apprehensionmitmentPart III CloseIn Mr.Allen’s high school class,all students have to “get married”.However,the wedding ceremonies are not real ones but 51 .These mock ceremonies sometimes become so 52 that the loud laughter drowns out the voive of the “minister”.Even the two students getting married oftenbegin 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 53 take place after marriage.He believes that the need for these psychological and financial 54 should be understood before peoplemarry.Mr.Allen does’t only introduce his students to major problems 55 in marriage such as illness or unemployment.He also expose them to nitty-gritty problems they will face every day.He wants to introduce young people to all the trials and 56 that can strain a marriage to the breaking point .He even 57 his students with the problems of divorced men 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. 58 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 59 the course publicly.There statements and letters supporting the class have, 60 theschool to offer the course again,51. A.duplications B.imitations C.assumptionD.fantasies52. A.noisy B.artificial C.graceful D.real53. A.might B.would C.must D.need54. A.issues B.adjustments C.mattersD.expectancies55. A.to face B.facing C.having faced D.faced56. A.tribulations B.errors C.triumphsD.verdicts57. rms B.concerns C. triumphsD.associates58. A.Until B.Before C.After D.As.59. A.taken B.suggested C.endorsedD.reproched60. A.confined B.convinced promisedD.conceivedpassage oneWhy do people always want to get up and dance when they hear music? The usual explanation is that there is something embeded in every culture-----that dancing is a “cultural universal”. A researcher in Manchester thingks the impulse may be more deeply rooted than that. Hesays 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 moredirect,biological,explanation for the disre to dance,so he started tolook 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 thatorgans for balance,for insance,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 retain some sensitivity to sound.The sacculus is especially sensitive to extremely loud noise,above70 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 length 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 dances 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.”61.The passage begins with______A. a new explanation of musicB. a cultural universalquestionedC. a common psychological abnormalityD. a deep insight into humanphysical movenents62.What intrigued Todd was ______A.human instinct reflexesB.people’s biological heritagesC.people’s compulsion about loud musicD.the damages loud music wrecks on human hearing63.Todd’s biological explanation for the desire to dance refersto_____A.the mechanism of hearing soundsB.the response evoked from the sacculusC.the two main functions performed by the human earD.the segregation of the hearing and balance maintaining function64.When the sacculus is acoustically stimulated,according toTodd_____A.functional balance will be maintained in the earB.pleasure will be arousedC.decibel will shoot upD.hearing will occur65.What is the passage mainly about?A.The human ear does more than hearing than expcted.B.Dancing is capable of heighten the sensation of hearingC.Loud music stimulates the inner ear and generates the urge to danceD.The human inner ear does more to help hear than to help maintainbalance.passage 2Have you switch off your compter? 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 conrtol 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 does’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 redlights 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 responseble for the waste.But manufactures only get away with desinging 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 attractedmuch 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 forultra-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 inan ultra-light package.There are hundreds of other tricks you can discuss with colleagues while gathering around the proverbial water cooler—fillingup,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 sourcecorrectness.66. Fron the first two paragraphs,the author implies that______A.hitch has made life easy everywhereB.nobody seems to be innocent in polluting the planetC.recycling can potentially control environmental deteriorationD.everybody is joining the global battle against pollution in oneway or another67.The waste caused by household and office electrical applianceson stand-by mode seems to_____A.be a long-standing indoor problemB.cause nothing buttroubleC.get exaggeratedD.go unnoticed68.By idle electronic devices,the author means those appliances_____A.left on stand-by modeB.filling the atmosphere with carbon dioxideed by those who are mot energy-conscioused by those whose words spesk louder than actions69.Ultra-light packaging______A.is expected to reduce American waste bu one-thirdB.is an illustration of what is called “source reduction”C.can make both manufacturers and consumers intelligentD.is a villain of what the garnage experts call “source reduction”70.The conclusion the author is trying to draw is that______A.one person cannot win the battle against pollutionB.anybody can pick up tricks of environmental protection on the webC.noybody can be absolutely right in all the tricks of environmentalprotectionD.anybody can present or learn a trick of cutting down what is notneededpassage 3You 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:exetcising a partially paralyzed limb can help the brain “rewire”itself and replace neural connections destroyed by a clotin 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 dramaticimprovements.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 surruouding the original injury had also died. “The size of the injury doubled. It’s 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 adramatic 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 toxiceffects.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 bebeficial 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.71. Schallert issued a warning to those who____A.believe in the possibility of rewiring the brainB.are ignorant of physiotherapy in the clinicC.add exercise to partially paralyzed limbsD.are on the verge of a stroke72.Which of the following is Schallert’s hypothesis for hisinvestigation.?A.Earlier intervention should lead to even more dramaticimprovements.B.The critical period for braim damage is one week after injury.C.A partially paralyzed limb can cause brain damagesD.Physiotherapy is the key to brain recovery.73.The results from Schallert’s research____A.reinforced the singificance of physiotherapy after a strokeB.indicated the fault with his experiment designC.turned out the oppsiteD.verified his hypothesis74.The results made Schallert’s team aware of the fact that____A.glutamate can have toxic efforts on healthy nerve cellsB.exercise can boost the release of glutamateC.glutamate is a neurotransmitterD. all of the above75.Schallert would probably advise clinicians____A.to administer drugs to blick the effects of glutamateB.to be watchful of the amount of exercise for stroke victimsC.to prescribe vigorous exercise to stroke vivtims one week afterinjuryD.to reconsider the significance of phusiotherapy to brain damagePssage FourOur understanding of cities in anything more than casual terms usually starts with observations of their spatial form and structure atsome point or cross-section in time.This is 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 infrequent －ly ,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 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-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 thes standpoint in that routine trip-making behavior is the focus of study,its explanation being central to the notion that apatial structures are inert and long lasting.76.We ,according to the passage,tend to observe citiesA.chronologicallyB.longitudinallyC.sporadicallyD.horizontally77.we think about a city as____A.a spatial eventB.a symbolica worldC.a social environmentD.an intertelated system78.Cross-sectional studies show that cities ____A.are structured in three dimensiosB.are transformed rapidly inany aspectC.are resilient and long lasting rhrougy timeD.change slowly in spatial and social structrues79.The author is drawing our attention to ____A.the equilibrium of urban spatial structuresB.the intrinsic dynamics of urban changeC.the fixed spatial infrastructureD.all of the above80.The conventional notion,the aurhor contends,____A.presents the inherent nature of a cityB.underlies the fixed spatial infrastructuresC.places an emphasis on lesser cycles of timeD.hinders the physical change of urban structurePassane fiveWhen 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 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 mighthappen.This is not my usual work,of course.My usual work is to sit with patients and listen to them.Occasionslly 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 weekbefore 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’ll stack a few more bales snd 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.81.Which of the following is NOT true according to the story?A.The muscular work in the field has an emotional impact on thenarrator.B.The narrator gets tired easily working in the field.C.It is the first time for the narroator to do hayingD.The narrator is as physician82.In retrospection ,the narrator___A.feels guilty before his father and brotherB.defends his soft hands in a meaningful wayC.hates losing his muscular power before he knows itD.is shamed for the farmer callouses he does not possess83.As a physician,the narrator is ___A.empathicB.arrogantC.callousD.fragile84.His associations punctuate_____A.the similarities between medicine and agricultureB.the simplicity of muscular workC.the hardship of life everywhereD.the nature of medical practice85.The narrator would say that____A.it can do physicians good to spend a vacation doing muscular workB.everything is interlinked and anything can be anythingC.he is a shame to his fatherD.his trip is worth itPassage SixEveryone 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 commitmentand 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 energyavailable.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 around 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…………….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,snd more important,there are ways for organizations to change conditions that lead to burnout.86.The passage begins with____A.a personal transitionB.a contrast between two types of peopleC.a shift from conformity to individualityD.a mysterious physical and mental state87.Which of the following is related with the crisis of spirit?A.Emotional exhaustionB.DepersonalizationC.Reduced personal accomplishmentD.All of the above88.Job burnout is a crisis of spirit,which will result in ___A.a personal problemB.diminished productivityC.an economic crisis in a countryD.a failure to establish a pool of talent and energy89.Burnout can be ___A.fatalB.staticC.infectiousD.permanent90.Those who are burned-out,according to the passage,are potentiallyable___A.to find a quick fixB.to restore what they have lostC.to be aware of their status quoD.to challenge their organizationA.B.C.D. A.B.C.D. A.B.C.D.。