obsity 2

glaucoma drainage implant surgery for Asian patients with refractory glaucoma with cataract. Am J ophthalmol, 2004,137(2):294-300.［7］ Nolan WP, See JL, Aung T, et al. Changes in angle configurationafter phacoemulsification measured by anterior segment optical coherence tomography. Ophthalmology, 2008, 17(6):455-459.［收稿日期：2014-09-15］利拉鲁肽对初诊肥胖2型糖尿病患者的疗效观察赵冬　时艺珊【摘要】　目的　观察利拉鲁肽对初诊肥胖2型糖尿病患者的疗效及安全性。

方法　初诊肥胖的2型糖尿病患者经口服二甲双胍治疗后血糖仍未达标者40例, 在继续口服二甲双胍的基础上联合利拉鲁肽治疗12周, 观察治疗前后空腹血糖(FPG)、空腹C 肽(FC-P)、餐后2 h 血糖(2 h PG)、糖化血红蛋白(HbA1c)、腰围及体质量指数(BMI)的变化, 记录不良反应。

结果　治疗后患者的FPG、2 h PG、HbA1c、腰围、BMI 均较治疗前降低, 差异有统计学意义(P<0.05)；FC-P 升高, 差异有统计学意义(P<0.05)；部分患者有恶心、腹泻等症状, 但均可耐受, 无低血糖发生。

结论　对于初诊肥胖的2型糖尿病患者, 在口服二甲双胍后血糖未达标, 加用利拉鲁肽治疗可有效降低患者的血糖, 减轻体重, 改善胰岛功能。

【关键词】　2型糖尿病；肥胖；利拉鲁肽Observation of curative effect of liraglutide in the treatment of patients with newly diagnosed obesity type 2 diabetes mellitus ZHAO Dong, SHI Yi-shan. Department of Endocrinology, The Second Affiliated Hospital of Shenyang Medical College, Shenyang 110002, China【Abstract 】　Objective To observe the curative effect and safety of liraglutide in the treatment of newly diagnosed obesity type 2 diabetes mellitus. Methods A total of 40 patients with newly diagnosed obesity type 2 diabetes mellitus were selected as study subject, who had abnormal blood glucose after oral administration of melbine. They received additional liraglutide treatment for 12 weeks. The changes of fasting plasma glucose (FPG), fasting C-peptide (FC-P), 2 h plasma glucose (2 h PG), glycosylated hemoglobin (HbA1c), waistline, and body mass index (BMI) were all compared before and after treatment. Adverse reactions were recorded. Results After the treatment, the levels of FPG, 2 h PG, HbA1c, waistline and BMI were significantly decreased, and the difference had statistical significance (P <0.05). The level of FC-P was increased, and the difference had statistical significance (P <0.05). Some of the patients had tolerable symptoms of nausea and diarrhea, and had no hypoglycemia. Conclusion The additional liraglutide to melbine oral treatment can effectively control blood glucose, reduce weight, and improve pancreas islet function in patients with newly diagnosed obesity type 2 diabetes mellitus, who have blood glucose blow the standard.【Key words 】　Type 2 diabetes mellitus; Obesity; Liraglutide 作者单位：110002　沈阳医学院附属第二医院内分泌科通讯作者：时艺珊以往的许多研究证实：对初诊的2型糖尿病患者进行短期胰岛素强化治疗, 可以使患者的血糖在较短时间内得到有效控制, 使受损的胰岛β细胞得以休息和恢复, 改善胰岛素抵抗, 从而提高自身胰岛素分泌功能。

肥胖会有什么危害英语作文Title: The Hazards of Obesity。

Obesity, defined as an excessive accumulation of body fat, is a global health concern that poses numerous hazards to individuals and society at large. This essay will delve into the multifaceted dangers associated with obesity, spanning from physical health to psychological well-being and societal implications.First and foremost, obesity significantly increases the risk of developing various chronic diseases. Conditionssuch as type 2 diabetes, hypertension, cardiovascular diseases, and certain types of cancer are closely linked to obesity. These diseases not only reduce life expectancy but also diminish the quality of life, often requiringextensive medical interventions and leading to disabilities.Furthermore, obesity places a tremendous strain on the musculoskeletal system. Excessive weight puts unduepressure on joints, leading to conditions likeosteoarthritis and back pain. Mobility issues arise, limiting individuals' ability to engage in physical activities, further exacerbating the cycle of weight gain and health complications.Beyond physical health, obesity takes a toll on mental and emotional well-being. Many individuals grappling with obesity face societal stigma and discrimination, leading to low self-esteem, depression, and anxiety. Body image issues are prevalent, contributing to a negative self-perception and hindering social interactions and personal relationships.Economically, the ramifications of obesity are substantial. Healthcare costs skyrocket as a result of obesity-related medical treatments, medications, and hospitalizations. Lost productivity due to illness and disability further burdens economies, impacting both individuals and society as a whole.From a public health perspective, the prevalence ofobesity contributes to the overall burden of disease. Governments and healthcare systems must allocatesignificant resources to address obesity-related health issues, diverting attention and funds from other pressing healthcare needs.Education and awareness play a crucial role in combating obesity. Promoting healthy lifestyles, including balanced nutrition and regular physical activity, from an early age is paramount. Schools, communities, andworkplaces can implement initiatives to encourage healthy choices and provide support for individuals struggling with weight management.Policy interventions are also essential in curbing the obesity epidemic. Implementing regulations on food labeling, advertising of unhealthy foods, and sugar-sweetened beverages can help steer individuals towards healthier options. Taxation on high-calorie, low-nutrient foods can also deter consumption and fund public health initiatives.In conclusion, the hazards of obesity are vast andmultifaceted, encompassing physical, mental, social, and economic dimensions. Addressing obesity requires a comprehensive approach that encompasses education, awareness, policy interventions, and societal support. By tackling this complex issue collectively, we can mitigate its adverse effects and promote a healthier future for generations to come.。

intelligence和obesity阅读理解Inttelligence：An intelligence test measures a person's ability to solve different kinds of problems. There are many kinds of intelligence tests. The tests that are sometimes given in schools are called Stanford－Binet I. Q. tests. They were first developed in 1905 by a French psychologist named Alfred Binet and later revised(修订) for use on children in the United States by psychologists at Stanford University.Binet had observed that on the average a 10－year－old learns more quickly and can solve more difficult problems than a 9－year －old; an 11－year－old learns more quickly than a 10－year－old, and so on. As a rule a child's intelligence tends to increase year by year. Therefore Binet arranged his tests by age levels：the first problems in any test can be solved by all children of the age level being tested; the problems become more and more difficult until few, if any, children of that age can solve them.After a child has completed a Stanford－Binet test, the psychologist figures out the score and then compares it with theaverage score of other children of the same age. If a child solves the same number of problems as the average child of the same age solves, his I. Q. will be 100．If he solves more problems, his I. Q. will be more than 100．If he solves fewer, it will be less than 100．By comparing a child's score in this test with his score on an earlier one, the psychologist can tell how fast the child's abilities are growing in relation to his age.1．Stanford－Binet I. Q. tests are ________.A．the tests given in schools at the end of each yearB．intelligence tests for adultsC．intelligence tests given to school childrenD．the tests in psychology for all the people2．After observation, Binet learned that on average ________.A．a 9－year－old child learns more quickly than a 10－year－old oneB．a 10－year－old child learns as quickly as a 11－year－old oneC．all the children of one age can solve more difficult problems D．a child's intelligence tends to rise with his age3．If a child cannot solve the same number of problems as the average child of the same age solves, we may say, his I. Q. ________.A．will be tenB．will be a hundredC．will be less than a hundredD．will be more than a hundred4．The psychologist can tell how fast a child's abilities are growing ________.A．by figuring out his score in the I. Q. testB．by making sure that a child's I. Q. is more than 100C．by comparing a child's score in the test with the average score of the same ageD．by comparing a child's score in the test with his sire on an earlier one5．According to the passage, which of the following is true?A．The I. Q. test was first developed by an American psychologist at Stanford University.B．Binet arranged his tests by age level and by levels of difficulty as well.C．There is only one type of intelligence test now in use that is called Stanford－Binet I. Q. test.D．Intelligence tests are designed to test children's learning ability.Obesity：Obesity (肥胖症定)is becoming a problem in our busy society, and almost one in three American aduts is now considered to be obese.Childrenobesity is also at an all-time high.Obesity meas being very overweigh.If you are obese, you have too much body fat. If you eat more food than your body can use, this will makeyou put on weight.Food that your body does not need will be stored as fat by your body.The following are the major factors that increase the risk of obesity.What you eat plays a major role in weight gan.Eating a lot of fast food such as hamburgers, sweet drinks, ice creams and other sweet foodcanincrease the risk of becoming obese.lf you do not do enough exercise, you will put on weight as the food you eat is not being used to make energy for physical activities.The chances of you being obese are greater if your parents are obese.There are many psychological factors that cause people to eat too much.People who are worried, unhappy or bored will often eat to makethemselves feel better. This is known as comfort eating.Age is another factor, as you tend(趋于)to be lss active when you get older.When you get older, you need to eat less, and if you do not eat less,you will put on weight.Oesity can cause nmany health problems such as heart problems, ligh blood pressure and many other serious medical conditions.【小题1】The underlined sentence in paragraph 1 means that_A. obesity does not do harm to health.B. there are more obese children than before.C. all the American children are obese.D. there are less obese children in the USA.【小题2】According to the passage, there are_major factors that increase the risk of obesity.A. threeB. fourc. fiveD. six【小题3】What will the writer most probably talk about after the last paragraph?A. How to avoid obesity.B. How to live in the busy USA.C. What illnesses are caused by obesity.D. How doctors treat heart problems.。

利拉鲁肽治疗肥胖型2型糖尿病疗效观察曹德云【摘要】Objective To explore the efect of of liraglutide in treatment of Obesity diabetes 2.Methods 15 cases of patients with type 2 diabetes obesity were randomly divided into two groups.They were hospitalized in 2013 to 2014 in June.The control group and the treatment group,the blood glucose and body weight changes before and after treatment was compared.Results The treatment group was better than the control,there was statistical significance(P<0.05).Conclusion The efects on 2 diabetes obese treatment,can significantly reduce body weight and blood glucose.We can promote this treating method.%目的：观察利拉鲁肽治疗肥胖型2型糖尿病的临床效果。

方法选取2013年6月～2014年6月我院收治的肥胖型2型糖尿病患者15例作为研究对象，采用利拉鲁肽治疗，比较治疗前后患者的各血糖及体重变化情况。

结果治疗后，患者的血糖降低程度以及体重变化显著优于治疗前，差异具有统计学意义（0.01＜P＜0.05）。

结论利拉鲁肽治疗肥胖型2型糖尿病疗效确切，可明显降低患者的体重和血糖水平，建议广泛推广与使用。

Obesity,Type 2Diabetes,and the MetabolicSyndromePathophysiologic Relationships and Guidelines for Surgical InterventionLaurent Genser,MD 1,James Rossario Casella Mariolo,MD 1,Lidia Castagneto-Gissey,MD 1,Spyros Panagiotopoulos,MD,PhD ,Francesco Rubino,MD *Conflicts of Interests:None.Funding:L.Genser is a research fellow and was supported by the Institute of Cardiometabolismand Nutrition (ICAN),Socie ´te ´Franc ¸aise de Chirurgie Digestive (SFCD),Fondation Obe´lisque and APPERT Institute (UPPIA).Bariatric and Metabolic Surgery,Division of Diabetes and Nutritional Sciences,King’s College London and King’s College Hospital,London SE59RS,UK1These authors equally contributed to the present work.*Corresponding author.E-mail address:Francesco.rubino@KEYWORDSObesity Metabolic syndrome Diabetes Bariatric metabolic surgery Insulin resistance Gut MicrobiotaKEY POINTSVisceral obesity is associated with systemic low-grade inflammation leading to insulin resistance,b -cell dysfunction,and cardiometabolic diseases.The gastrointestinal tract is a key organ in metabolic regulation;hence,it is a biologically rational target for interventions aimed at treating metabolic syndrome,obesity,and type 2diabetes (ie,metabolic surgery).Recent randomized clinical trials show that bariatric/metabolic surgery causes greater improvement of type 2diabetes and reduction of cardiovascular risk compared with life-style modification and medical therapies.Based on such clinical and mechanistic evidence,several international professional orga-nizations and government agencies have recently suggested expanding the indications for bariatric/metabolic surgery to include patients with inadequately controlled type 2dia-betes and a body mass index as low as 30kg/m 2and 27.5kg/m 2for Asians.Surg Clin N Am 96(2016)681–701/10.1016/ 0039-6109/16/$–see front matter Ó2016Elsevier Inc.All rights reserved.INTRODUCTIONObesity represents one of the primary causes of preventable deaths.In 2014,an esti-mated 1.9billion adults were considered overweight and more than 600million were obese,translating to 13%of the worldwide adult population.1,2Also,the prevalence of morbid obesity (defined by a body mass index [BMI]>40kg/m 2)has almost doubled since 1980.1Such increase in the prevalence of obesity and morbid obesity has been related to a variety of factors including sedentary lifestyle,disproportionate caloric intake,stress,socioeconomic status,in addition to ethnicity and genetic susceptibil-ity.Obese men and women are at significantly higher risk of developing type 2dia-betes mellitus (T2DM).3,4In fact,the prevalence of T2DM has increased in parallel with the augmented prevalence of obesity.Currently,T2DM affects about 285million people worldwide,a number predicted to almost double by 2030.5The term “metabolic syndrome”(MS)is generally used to indicate the cluster of cen-tral obesity,insulin resistance (IR),hypertension,and hyperlipidemia.Metabolic syn-drome results in a greater risk of developing T2DM and cardiovascular disease,2of the principal causes of death worldwide.6Bariatric surgery causes significant and sustained weight loss and can considerably reduce IR,with dramatic clinical improvement or remission of insulin-resistant states (ie,dyslipidemia,hypertension,hyperuricemia,sleep apnea).Experimental evidence from animals shows that the effects of bariatric surgery on insulin sensitivity and glucose homeostasis are not just the consequence of mechanical reduction of food intake or energy absorption but derive from a variety of physiologic mechanisms,including changes in gut hormones,biliary acids metabolism,nutrient sensing,and microbiota.7This knowledge corroborates evidence of a critical role of the gut in glucose and en-ergy homeostasis and supports consideration of the gastrointestinal (GI)tract as a rational biological target for interventions aimed at treating obesity,diabetes,and metabolic disorders.8Recent randomized clinical trials show that bariatric surgery re-sults in better control of T2DM and greater reduction of cardiovascular risk factors compared with a variety of lifestyle interventions and medical therapies.9–12Based on such mounting mechanistic and clinical evidence,conventional bariatric proce-dures are now increasingly being proposed not only as mere surgical management of obesity but also as a valuable approach to intentionally treat T2DM—a new concept and practice referred to as “metabolic surgery.”13–15Obesity and the Adipose TissueObesity has become a pandemic and has received increasing attention over the past decades for the implications it carries in the development of numerous chronic dis-eases.In the last 30years,the average BMI has increased at a rate of 0.4kg/m 2per decade worldwide.16Among high-income countries,the United States has the highest prevalence of obesity,with one third of the population having a BMI of 30or greater.17Even though the prevalence of obesity in the United States tended to stabi-lize after 2005,the prevalence of severe (BMI >35kg/m 2)and morbid (BMI >40kg/m 2)obesity has continued to increase.Between 1986and 2000,the prevalence of sub-jects with a BMI of 40or greater quadrupled and that of subjects with a BMI of 50or greater quintupled.17,18Obesity is a condition characterized by an excess of body adiposity and for practical reasons is commonly measured by BMI,an expression of body weight as a nonlinear function of height.A BMI 30kg/m 2indicates the presence of obesity;when BMI ex-ceeds 40kg/m 2,the subject is regarded as morbidly obese.19Genser et al682Guidelines for Surgical Intervention683 However,using BMI as a unit of measure assumes that adipose tissue has an even distribution throughout the body,because it does not take into account the diverse topographic deposition of body fat among individuals.Thus,BMI is not a measureof dysfunctional adipose tissue nor an accurate metrics of metabolic disease.Infact,an excessive and preferential accumulation of fat in visceral depots may notbe necessarily associated with a high BMI;nonetheless,it strongly correlates withthose metabolic disturbances that increase the risk of developing cardiovascular dis-ease.20A significant number of individuals present hyperglycemia,hyperinsulinemia,IR,hyperlipidemia,and hypertension despite a lean body type and a normal BMI,a phenotype often referred to as“metabolically obese but normal weight subjects.”21,22 Conversely,many persons categorized as obese by BMI lack all the components ofMS and display average risk of developing cardiovascular disease compared withthe general population;this group of subjects is referred to as“metabolically healthy obese.”23It has been shown that subcutaneous adipose tissue(SAT)distribution,common in women,is related to metabolic protection,conversely to central or intra-abdominal obesity,typical of men,which frequently accompanies MS.24,25In addition,ectopicfat accumulation in organs such as liver,skeletal muscles,heart,kidneys,pancreasis associated with metabolic comorbidities.26In consideration of the importance offat distribution in metabolic disease,waist circumference(WC)is widely considereda more reliable predictor of cardiometabolic risk than BMI.A WC 88cm in womenand WC 102cm in men is considered an independent risk factor for developing car-diovascular disease and atherogenic dyslipidemia,and a rough measure of the degreeof IR.19The exact reasons behind the differential deposition of adipose tissue in the variousregions of the body are unclear;both modifiable factors(eg,physical activity,nutri-tional status,growth hormone,glucocorticoids,sex steroids)and nonmodifiable fac-tors(such as gender,age,ethnicity,and genetic susceptibility)seem to play a role.19The adipose tissue exerts metabolic and endocrine functions and is characterizedby great pliability and expandability.Whereas adipocytes in the subcutaneous tissuecan become both hyperplasic and hypertrophic,visceral adipose tissue(VAT)appearsto have a limited capacity of recruitment and differentiation of new adipose cells and ismore prone to develop hypertrophic cells with impaired adipocyte function.27Such dysfunctional adipocytes cause altered secretion of adipocytokines(ie,adipokines)and an elevation of free fatty acids(FFAs)release into the circulation that ultimatelyleads to the onset of obesity-related IR,the common denominator of MS and other metabolic disorders.19,28,29Metabolic Syndrome:Definitions and Pathophysiologic AspectsIn the late1970s,the term“metabolic syndrome”was proposed to identify a cluster of interrelated factors,comprising visceral obesity,IR,hypertension,and dyslipidemia,that were associated with an augmented risk of developing T2DM and cardiovascular disease.30In the1980s,Reaven31proposed that IR could be the primary defect of the syndrome,arguing that insulin-resistant subjects could develop MS even though theywere not obese.The World Health Organization(WHO)1and the American Heart As-sociation subsequently recognized MS32as a distinct clinical entity with its owncode(277.7)in the WHO’s ICD-9classification.However,in the following years,other scientists and clinicians have challenged the idea of MS as a separate clinical entity.In2012,a joint statement by the American Diabetes Association(ADA)and the European Association for the Study of Diabetes was particularly critical of the idea of MS as adistinct clinical entity.33In particular,this statement argued that existing definitionsof MS are based on ambiguous or unclear criteria and that the cutoff points used to define abnormal levels of the individual components ignore the continuum in risk asso-ciated with glucose,blood pressure,and lipids levels.This statement also questioned the evidence that the syndrome as a whole adds to cardiovascular disease prediction beyond the contribution of the individual component risk factors.Despite this,MS continues to be considered a distinct entity by many researchers that investigate the link between IR and metabolic disease,whereas clinical cardiolo-gists rely on MS for their assessment of cardiometabolic morbidity and mortality in in-dividual patients.One of the most commonly used definitions of MS was proposed in 2001by the National Cholesterol Education Program (NCEP)Adult Treatment Panel III (ATP III)34and includes criteria such as WC,triglycerides,high-density lipoprotein (HDL)-cholesterol,blood pressure,and fasting glycemia.The presence of abnormal levels of 3of these 5variables,listed in Table 1,is used for a diagnosis of MS.The definition of MS by the International Diabetes Federation (IDF)slightly differs from the one reported because it recommends considering a different cutoff for WC in relation to the ethnicity of the individual;this is based on knowledge that persons of Asian descent can have abdominal obesity and an elevated risk for cardiovascular disease at lower BMI levels compared with individuals of other ethnicities.35Using the NCEP-ATP III definition,the prevalence of MS among US adults was estimated to range from 22%36to 34%and up to 39%when using the IDF criteria.37Prospective population studies showed that the relative risk for the development of atherosclerotic cardiovascular disease in patients with MS is twice as high as that of the general population;the risk of developing T2DM is 5-fold greater.38–44A diet rich in lipids and carbohydrates contributes to the emergence of 2of the essential factors for the diagnosis of MS:visceral obesity and IR.The increased VAT contains hypertrophic,dysfunctional adipocytes at increased lypolytic activity;this can cause high release of FFAs in the splanchnic circulation,thus directly reaching the liver.45It is also thought that when peripheral adipocytes have surpassed their ca-pacity and are no longer capable of storing triglycerides,these will be deposited in other tissues (mainly liver and skeletal muscle),favoring the establishment of periph-eral and hepaticIR.Genser et al684Guidelines for Surgical Intervention685 The augmented flow of FFAs to the liver causes an increase in hepatic neoglucogen-esis contributing to the development of hyperglycemia.46,47In addition,in the pres-ence of IR,high circulating levels of FFAs induce hepatic triglyceride synthesisleading to hypertriglyceridemia and overproduction of very low-density lipoproteins (LDL),rich in Apo B and triglycerides.48In the setting of hypertriglyceridemia,LDLand HDL undergo alterations of their composition.LDL triglyceride content increasesat the expense of phospholipids,and esterified and nonesterified cholesterol.As aresult,LDL particles become smaller in size and denser,possibly becoming more atherogenic.Similarly,the cholesterol portion of the HDL lipoprotein core is reducedwith an inconstant increase in triglycerides,resulting once again in small,dense par-ticles that undergo a higher rate of clearance from the circulation.49–51In fact,reducedserum levels of HDL,elevated triglycerides,and small,dense LDL represent the typicallipidic profile present in MS-related dyslipidemia.Hypertension is one of the components of MS with the latest onset.Adipocytes are capable of producing several biologically active peptides,including angiotensinogen, angiotensin converting enzyme,and cathepsins.An expanded adipose tissue couldresult in increased production of angiotensinogen,which in turn may lead to the onsetof obesity-associated hypertension.Moreover,IR might also contribute to the devel-opment of hypertension because of reduced stimulation of nitric oxide,causing a decreased vasodilation.52,53LINKING OBESITY TYPE2DIABETES MELLITUS AND METABOLIC SYNDROME: PATHOPHYSIOLOGIC EVIDENCEObesity,T2DM,and cardiometabolic disorders are associated with IR.31Neverthe-less,most obese subjects with IR do not develop hyperglycemia.Physiologically,the pancreatic islet b cells present adaptative features allowing an increased insulinrelease to overcome IR and maintain normal glucose tolerance.However in patientswith T2DM,IR is not completely compensated by B cells.54,55Herein,the principal pathophysiologic mechanisms associated with obesity,T2DM,and other metabolic disorders are presented.Insulin ResistanceIR is considered the most important pathophysiologic aspect linking obesity and car-diometabolic diseases.31,56IR is an impairment of insulin action on insulin-sensitivetissues characterized by a decreased glucose access in muscles and an increased neoglucogenesis in the liver,resulting in fasting as well as postprandial hyperglycemia.IR has systemic impact causing arterial endothelial dysfunction,atherosclerosis, increased lipolysis,sarcopenia,decreased bone mass,and b-cell mass.27,57Pancreatic b-Cell Dysfunction and Defective Insulin SecretionStudies have shown that the basal insulin secretion rate and the insulin output in response to an oral glucose tolerance test grow in a linear fashion as BMI increases.58A hyperbolic correlation instead has been found between b-cell function and insulin sensitivity.59Hence,on a background of IR,the b cell must enhance its insulin releasein order to compensate and maintain a state of euglycemia.60b-Cell failure is a requisite for the development of T2DM,whereas skeletal muscle IRis evident decades before b-cell failure and overt hyperglycemia occur.61,62High-risk individuals with IR who are prone to develop diabetes show a progressively reducedb-cell function over time,whereas“nonprogressors”can maintain increased insulin secretion that compensates for the worsening insulin sensitivity.62This capacity of b cells to adjust their secretive function to the grade of insulin sensi-tivity is known as disposition index (DI).DI is calculated as the product of b -cell sensi-tivity multiplied by the insulin sensitivity.The disposition curve typically follows a hyperbolic function 59;this implies that the product of insulin sensitivity and secretion should yield a constant for a given degree of glucose tolerance and thereby provide a measure of b -cell function.Progression from normal glucose tolerance to impaired fasting glycemia,impaired glucose tolerance,and finally,T2DM,is likely the result of various contributing factors,including high-caloric diet,lack of physical activity,and genetic predisposition.In a first compensatory phase,the insulin-resistant state causes an increase in total insulin secretion rate,determining hyperinsulinemia.63In this stage,greater insulin secretion is mainly due to b -cell hyperplasia and to a lesser extent hypertrophy,globally contrib-uting to an increased islet mass,as found in human autopsies.63–65Subsequently,as a consequence of increasing glucose levels (ie,glucotoxicity hypothesis),a loss of acute glucose-stimulated insulin secretion develops,resulting in the inability to promptly respond to glycemic increments.The prolonged exposure to hyperglycemia and increased circulating FFAs favor a constant,low-grade inflammation,leading to stress of endoplasmic reticulum,altered function of mitochondria,increased release of reac-tive oxygen species,and ultimately,oxidative stress in the b cell.Oxidative stress in the b cell in turn is responsible for changes observed in b -cell phenotype,differentia-tion,and gene expression,which might be responsible for such loss of acute secretory action.66–69Moreover,a higher insulin request,caused by a state of IR,conduces to increase cosecretion of insulin and islet amyloid polypeptide.The presence of amyloid in high concentrations is toxic and contributes to inducing b -cell apoptosis.70,71Chronic hyperglycemia and worsening of IR cause a critical decline in b -cell mass,ul-timately leading to overt diabetes.71Inside the b cells,insulin granules ready for the secretion are docked to the cell membrane;when glucose binds to the glucose transporter isoform GLUT2,they fuse with the membrane and secrete packages of insulin.Diabetic subjects lose the capacity to promptly secrete such already synthesized insulin granules and therefore characteristically lack the first phase of insulin secretion in response to a glucose load;they also usually show an exaggerated second phase of insulin secretion.Although loss of first-phase insulin secretion was thought to be an irreversible defect,bariatric metabolic surgery (BMS)has been shown to promptly restore the first phase of insulin secretion within 1month of the operation,suggesting that such defect is instead a reversible phenomenon rather than a structural defect of the b cell.72,73The Adipose Tissue in Metabolic DiseasesAdipose tissue affects metabolism by releasing FFAs and adipocytokines.The over-secretion of some of these cytokines may act as a potential mediator of inflammation leading to IR.Factors with deleterious effects on metabolismFree fatty acids Increased FFAs levels are observed in human obesity and T2DM and are strongly correlated with the level of IR.54,74FFAs have anti-insulin action and are produced during the metabolism of lipids.When reaching insulin-sensitive tissues,increased FFAs levels lead to increased liver glucose production and muscular lipid storage,leading to IR state in T2DM patients.74,75In obesity,which is considered a low-grade inflammatory state,increased circulating levels of FFAs appear to be posi-tively correlated with plasma levels of pro-inflammatory cytokines,which are known to be associated with IR and T2DM.74Genser et al686Guidelines for Surgical Intervention687 Proinflammatory adipocytokinesObesity and T2DM are associated with the overproduction of proinflammatory cyto-kines such as Tumor necrosis factor-a(TNF-a)Interleukin-6(IL-6).76These cytokinesare produced by the adipocytes among many other cell types and inhibit insuling signaling which in turn promote IR.TNF-alfa may also have direct deleterious effecton Beta-cells by inhibiting insulin secretion and promoting B-cell apoptosis as observed in-vitro.76,77An associaton has been demonstrated between IL-6signaling pathway in the adipose tissue and IR,with a positive correlation between IL-6serumlevels and IR levels.77,78Other cytokines such as IL-1beta,Resistin,Retinol bindingProtein-4,Visfatin,Plasminogen Activator-1(PAI-1),Monocyte ChemoattractantProtein-1,fibrinogen and angiotensin are increasingly produced by the adipose tissuein obesity and T2DM.These cytokines contribute to inflammation,lipid accumulationand participate to the develoment of endothelial dysfunctions and therefore myocar-dial infarction,stroke and cardiomyopathy.76Protective adipocyte-derived factorsLeptin is an adipocytokine that reduces appetite and IR along with improvement of metabolic disturbances associated with T2DM.Increase in tissue sensitivity of insulinby leptin may be due to its action on oxidation of FFAs,leading to decreased FFAsin the circulation.78Unlike other adipocytokines,serum levels of adiponectin are decreased in obesity and T2DM.This cytokine has insulin-sensitizing and antiathero-genic actions.In human obesity and T2DM,this adipocytokine has been shown to stimulate FFAs oxidation,and therefore decrease plasma FFAs oxidation,reduce lipid accumulation and increase insulin sensitivity.Adiponectin reduces endothelial dysfunction by increasing nitric-oxide synthesis and decreasing the expression of adhesion molecules and also prevents atherosclerosis by inhibiting LDL oxidation.79,80Other adipocytokines,such as Apelin,appear to have antiobesity and antidiabetic actions,because of its possible positive role in energy metabolism and insulin sensitivity.78Body fat distributionAnother critical factor involved in IR and metabolic diseases is body fat distribution.All definitions of MS include a measure of WC(Table1).Obesity is often associatedwith IR;however,insulin sensitivity varies markedly in lean individuals and in obese subjects because of differences in body fat distribution.19Lean individuals with amore peripheral type of fat distribution(ie,SAT)are more insulin sensitive than obese subjects who have predominantly central fat distribution(ie,VAT).54VAT is more resis-tant to the antilipolytic action of insulin than SAT,which may explain the association between VAT,IR,and T2DM.81,82Tissular and Systemic InflammationObesity,T2DM,and MS are associated with low-grade systemic83,84and tissular inflammation in the adipose tissue,the liver,the pancreas,and the intestine.85–87Infil-tration of immune cells,including macrophages,mast cells,and lymphocytes,wasfound in these tissues with a modification in cell population into a proinflammatory pro-file.These cells produce proinflammatory cytokines that interfere with insulin signalingin insulin-sensitive tissues,cause b-cell dysfunction,and consequently,insulin defi-ciency.Obese and T2DM patients show increased white blood cell counts,plasmalevels of coagulation factors(fibrinogen and PAI-1),C-reactive protein(CRP),serumamyloid A,and proinflammatory cytokines(TNF-a,IL-1b,and IL-6).78The overexpres-sion of these cytokines,and especially CRP,contribute to systemic inflammation andlipid accumulation,which in turn have deleterious effects on blood vessels,leading toendothelial dysfunction,myocardial infarction,cardiomyopathy,and death in the gen-eral population as well as in patients presenting with MS.79These markers are strongly associated with central adiposity,88IR,and MS.87Obstructive Sleep Apnea SyndromeObstructive sleep apnea (OSA)is linked to obesity and affects 15%of men and 6%of women.89OSA is characterized by airway obstruction during sleep,responsible for chronic hypoxia;this leads to the activation of the hypothalamic-pituitary-adrenal axis,causing oxidative stress,systemic and tissular inflammation (adipose tissue and liver),and increased secretion of proinflammatory adipocytokines (Resistin,TNF-a ,IL-6,plasminogen activator-1).These disturbances result in decreased insulin sensitivity and pancreatic b -cell dysfunction.OSA is known as a critical independent risk factor of cardiovascular disease,hypertension,MS,and T2DM.90,91Sympathetic Nervous System OverdriveRecent evidence from experimental and human studies has linked obesity,T2DM,and other metabolic comorbidities to a chronic activation of sympathetic nervous system (SNS),possibly caused by different types of stimuli (ie,food intake,hyperinsulinemia,glucose consumption,increased adiposity,and hyperleptinemia;hypothalamic-pituitary-adrenal axis activation).92Chronic activation of SNS results in increased adrenergic outflow with high levels of circulating catecholamines and glucocorticoids,leading to IR.SNS activation increases glucose release from the liver,reduces insulin,increases glucagon release by the pancreas,and increases lipolysis in the adipose tissue.92These effects are associated with vasoconstriction in peripheral arteries,which also results in impaired glucose uptake in skeletal muscle.92The effects of chronic SNS activation can therefore predispose to IR,hypertension,renal disease,and cardiac dysfunctions (ie,diastolic dysfunction,left ventricular hypertrophy).93THE GUT AS A BIOLOGICALLY RATIONAL TARGET FOR THE TREATMENT OFCARDIOMETABOLIC DISEASESMechanisms Linking the Gut to Cardiometabolic DiseasesA growing body of evidence has accumulated,especially in the last decade,support-ing a role of the gut in the physiology of metabolic regulation and in the pathophysi-ology of cardiometabolic disorders.This evidence comes from physiologic studies as well as from investigations regarding the mechanisms of weight loss and glycemic improvement after bariatric/metabolic surgery.Here the role of various aspects of intestinal physiology in metabolic regulation and metabolic disease is briefly reviewed.Gut microbiotaThe human gut microbiota (GM)is a complex entity composed of more than 1000spe-cies of comensal microorganisms.94GM is present across the GI tract with greater concentrations in the ileum and colon.In physiologic conditions,the GM contributes to intestinal system maturation,host defense against pathogens,degradation of non-digestible polysaccharides and plays an important role in body fat distribution and control of energy homeostasis.95The GM is influenced by diet,lifestyle,physical ex-ercise,antibiotics,and genetic background.96GM modulates energy harvesting from dietary fibers,fat storage,lipopolysaccharides (LPS)content,and the production of short-chain fatty acids which in turn regulate host food intake,insulin signaling andGenser et al688Guidelines for Surgical Intervention689 generate low-grade inflammation.88,97–99Interestingly,germ-free mice appear to be protected from high-fat diet(HFD)-induced obesity and metabolic alterations.100In addition,mice transplanted with GM isolated from obese donors develop increasedbody fat content and IR.101,102Metformin administration in mice is associated withan increase of Akkermansia muciniphila,a mucin-degrading bacteria known to posi-tively impact obesity and diabetes,103resulting in improved weight loss,glycemic control,and reduced systemic inflammation.104,105In humans,obesity and T2DMhave been associated with altered GM composition,reduced diversity,and gene richness.106,107Recently,metabolomics studies of human plasma samples allowedthe identification of GM products,such as trimethylamine-N-oxide,involved in athero-genesis and therefore linked to cardiovascular risk.108Alterations of intestinal permeability and metabolic endotoxemiaIntestinal permeability,a feature of the intestinal barrier,regulates the passage of mol-ecules from the lumen into the interstitium.This function is finely regulated by GM andother local factors.109In rodent models of diet-induced obesity(ie,HFD),modifica-tions of GM are associated with altered intestinal permeability characterized by a reduced expression of tight junction proteins(ie,zonula occludens-1,occludin,clau-dins)in the intestinal epithelial cells and an increase in the passage of nutrients and/or bacterial antigens/components(ie,LPS)responsible for systemic inflammation(ie, endotoxemia)and IR.110Consistent with this model,GM composition modulationinduced by antibiotics or prebiotics/probiotics in rodents improves gut permeabilityand reduces metabolic endotoxemia and glucose intolerance.103However,despite encouraging results111intestinal permeability alterations and its role in the crosstalk between GM and inflammation at systemic and tissular levels are still poorly charac-terized in human obesity and metabolic diseases.111Gut Adaptation to Bariatric/Metabolic SurgeryBMS is currently the most effective treatment for severe obesity and T2DM,providing sustained weight loss as well as reduction and prevention of obesity-related cardio-metabolic comorbidities.9,15Given its dramatic clinical effectiveness,BMS providesan opportunity to better understand the role of the gut in physiology and disease.In addition to weight loss,BMS can cause changes in various mechanisms of GI phys-iology,including changes in satiety-promoting gut hormones(ie,glucose-dependent insulinotropic peptide,glucagon-like peptide1[GLP-1],peptide YY,and Oxyntomo-dulin)and increased gastric emptying.Certain bariatric/metabolic procedures suchas Roux-en-Y gastric bypass(RYGB)and sleeve gastrectomy(SG)cause a shift inbile acids(BAs)metabolism composition,bile flow,and increased BAs signalingthrough the BAs nuclear receptor Farnesoid X(FXR).GI modifications imposed bycertain procedures,particularly those involving a re-re-routing of the small intestine(ie,RYGB,duodenal-jejunal bypass,DJB),can cause changes in microbiota compo-sition and nutrient sensing;all of these effects appear to be involved in the metabolic benefits of BMS.112–114Gastrointestinal hormonesRYGB and SG are characterized by an excessive postprandial response of the enter-oendocrine intestinal L cells responsible for a rapid increase in postprandial GI hor-mones.115The increase in GLP-1causes a rapid postprandial“incretin effect,”increasing insulin secretion.This mechanism is thought to be at least in part respon-sible for the improvement of glucose tolerance observed after these procedures.116 However,the underlying mechanisms supporting this phenomenon remain unclear。

2014年全国硕士研究生招生考试英语(二)答案详解SectionⅠUse of English文章分析本文是一篇关于肥胖与健康关系新说法的议论文。

第一段引出作者对身材的看法：并不是越瘦就证明人越健康。

第二段中作者介绍了一种定义肥胖症的指标BMI。

第三段中作者指出BMI其实揭示的是人体的脂肪量，并不是说明身材好坏的指数。

第四段中讲述了整个社会其实会给肥胖者贴上消极标签，无论是在电视节目中还是在孩子们的心目中，胖人的形象总是与消极联系起来。

最后一段讲述了人们以健康的角度去考虑肥胖的影响，和已经采取的一些对抗肥胖的种种策略。

试题解析Thinner isn't always better.A number of studies have__1__that normalweight people are in fact at higher risk of some diseases compared to those who are overweight.And there are healthy conditions for which being overweight is actually__2__.For example,heavierwomen are less likely to develop calcium deficiency than thin women.__3__, among the elderly,being somewhat overweight is often an__4__of good health.【译文】太瘦也不总是好事。

一些研究已经得出结论：正常体重的人实际上比一些超重的人更容易患上某些疾病。

有些肥胖对健康还有保护作用。

例如稍微超重的女性跟消瘦的女性相比，不易受到钙质缺乏的影响。

同样的，在老年人中，一定程度上超重是身体健康的标志。

1.[A]denied否认[B]concluded得出结论[C]doubled两倍，加倍努力[D]ensured确保【答案】B【考点】词义辨析【直击答案】空格所在句意为“一系列的研究已经________，事实上，正常体重的人患病风险要高于超重的人”。

2017英语二Text 1Every Saturday morning, at 9 am, more than 50,000 runners set off to run 5km around their local park. The Parkrun phenomenon1 began with a dozen friends and has inspired2 400 events in the UK and more abroad. Events are free, staffed3 by thousands of volunteers. Runners range from four years old to grandparents; their times range from Andrew Baddeley’s world record 13 minutes 48 seconds up to an hour.Parkrun is succeeding where London’s Olympic “legacy4” is failing. Ten years ago on Monday, it was announced that the Games of the 30th Olympiad would be in London. Planning documents pledged that the great legacy of the Games would be to level a nation of sport lovers away from their couches5. The population would be fitter, healthier and produce more winners. It has not happened. The number of adults doing weekly sport did rise, by nearly 2 million in the run—up to 2012—but the general population was growing faster. Worse, the numbers are now falling at an accelerating rate. The opposition claims primary school pupils doing at least two hours of sport a week have nearly halved6. Obesity7 has risen among adults and children. Official retrospections8continue as to why London 2012 failed to “inspire a generation.” The success of Parkrun offers answers.Parkrun is not a race but a time trial9: Your only competitor is the clock. The ethos welcomes anybody. There is as much joy over a puffed-out first-timer being clapped over the line as there is about top talent shining. The Olympic bidders, by contrast, wanted to get more people doing sports and to produce more elite athletes10. The dual aim11 was mixed up: The stress on success over taking part was intimidating12 for newcomers.Indeed, there is something a little absurd13in the state getting involved in the planning of such a fundamentally “grassroots”, concept as community sports associations. If there is a role for government, it should really be getting involved in14providing common goods—making sure there is space for playing fields and the money to pave15tennis and netball courts, and encouraging the provision16 of all these activities in schools. But successive governments17 have presided over18selling green spaces, squeezing19money from local authorities20and declining attention on sport in education. Instead of wordy, worthy strategies, future governments need to do more to provide the conditions for sport to thrive21. Or at least not make them worse.21. According to Paragraph1, Parkrun has ________.[A] gained great popularity[B] created many jobs[C] strengthened community ties22[D] become an official festival22. The author believes that London’s Olympic “legacy” has failed to ________.[A] boost population growth23[B] promote sport participation24[C] improve the city’s image25[D] increase sport hours26 in schools23. Parkrun is different from Olympic games in that it ________.[A] aims at discovering talents[B] focuses on mass competition[C] does not emphasize elitism[D] does not attract first-timers24. With regard to27 mass sport28, the author holds that governments should ________.[A] organize “grassroots” sports events[B] supervise29 local sports associations[C] increase funds for sports clubs[D] invest30 in public sports facilities3125. The author’s attitude to what UK governments have done for sports is ________.[A] tolerant32[B] critical33[C] uncertain34[D] sympathetic35【干货笔记】1. phenomenon n. 现象（写作词汇）2. inspire v. 激励；鼓舞（= encourage）inspiration n. 激励；鼓舞（= encouragement）3. staff ed v. 雇用( staff的过去式和过去分词); 担任…的职员（或雇员）;为…配备工作人员;4. legacy n. 遗产legacy business 传统行业legacy product 传统产品，老字号产品5. level a nation of sport lovers away from their couches让全国的运动爱好者远离他们的沙发6. halved v. 平分; 减半7. obesity n. 肥胖, 过胖; 肥胖症8. retrospection n. 回顾9. trial n. 试验；试用；审判；审讯；磨难；努力trait n.特质; (人的个性的)特征，特性，特点10. elite athletes 精英运动员11. dual aim 双重目标12.【恐吓，威胁】①threat n. 威胁，恐吓；构成威胁的人（或事物）；凶兆，征兆；（律）恐吓，威胁②terrorists n. 恐怖分子；恐吓者③horrifies v. 惊吓;使厌恶;恐吓horrify的第三人称单数④intimidate v. 恐吓，威胁13. absurd adj. 荒谬的；荒唐的; 无理性的，杂乱无章的；荒诞主义的，荒诞的14. get involved in参与15. pave v. 铺设pave tennis and netball courts 铺网球场和投球场16. provision n. 供应, 提供; 准备; 预备; 规定, 条款; (pl.) 食品供给, 粮食; 供应品17. successive adj. 连续的, 相继的successive governments 历届政府18. preside over 主持19. squeeze v. 挤, 榨, 捏; 压榨, 压迫20. local authorities 地方当局21. thrive v. 茂盛；兴隆；蔓延；成功；致富；繁茂22. strengthen ed community ties 加强了社区联系23. boost population growth 促进人口增长24. promote sport participation 促进体育运动的参与25. improve the city’s image 改善城市形象26. increase sport hours 增加运动时间27. with regard to prep. 关于28. mass sport 群众体育29.【监视，监督，监管】①supervise v. 监督；管理；指导；审阅；审查supervision n. 监督, 管理；指导；督学职权②monitor n. 班长；监视器v. 监听，监督③oversee v. 监督；管理;偷看；偷窥；偶然看到;30. invest v. 投资31.【设备】equipment n. 设备instrument n. 乐器；设备devices n. 元器件；设备facility n. 设备；设施；场所；有利条件32. tolerant adj. 宽大的, 容忍的; 有耐药力的33. critical adj. 批判的; 至关重要的34. uncertain adj. 不确定的（=dubious adj. 不确定的; 可疑的）35. sympathetic adj. 同情的。

往年考研英语二真题完形填空没有足够的单词量啥技巧都约等于白扯，而背单词最笨也是最好的方法就是反复多轮，没错，靠一遍就记住是很难的，所以单词需要每天坚持去背。

下文是我为你精心编辑整理的往年考研英语二真题完形填空，希望对你有所帮助，更多内容，请点击相关栏目查看，谢谢!往年考研英语二真题完形填空1Directions:Read the following text。

Choose the best word(s)for each numbered blank and markA，B，C or D on ANSWER SHEET 1(10 points) In our contemporary culture，the prospect of communicating with-or even looking at-a stranger is virtually unbearable Everyone around us seems to agree by the way they fiddle with their phones，even without a 1 undergroundIts a sad reality-our desire to avoid interacting with other human beings-because theres 2 to be gained from talking to the strange r standing by you. But you wouldnt know it，3 into your phone. This universal armor sends the 4 ：Please dont approach me.What is it that makes us feel we need to hide 5 our screens?One answer is fear, according to Jon Wortmann, executive mental coach We fear rejection，or that our innocent social advances will be 6ascreep,We fear weII be 7 We fear weII be disruptive Strangers are inherently 8 to us，so we are more likely to feel 9 when communicating with them compared with our friends and acquaintances To avoid this anxiety, we 10 to our phones.Phones become our security blanket，Wortmann says.They are our happyglasses that protect us from what we perceive is going to be more 11 .But once we rip off the bandaid，tuck our smartphones in our pockets and look up，it doesnt 12 so bad. In one 2023 experiment，behavioral scientists Nicholas Epley and Juliana Schroeder asked commuters to do the unthinkable: Start a 13 . They had Chicago train commuters talk to their fellow 14 . When Dr.Epley and Ms. Schroeder asked other people in the same train station to 15 how they would feel after talking to a stranger, the commuters thought their 16 would be more pleasant if they sat on their own, the New York Times summarizes. Though the participants didnt expect a positive experience, after they 17 withthe experiment, not a single person reported having been snubbed.18 , these commutes were reportedly more enjoyable compared with those sans communication, which makes absolute sense, 19 human beings thrive off of social connections. Its that 20 : Talking to strangerscan make you feel connected.1. [A] ticket [B] permit [C]signall [D] record2. [A] nothing [B] link [C]another [D] much3. [A] beaten [B] guided [C]plugged [D] brought4. [A] message [B] cede [C]notice [D] sign5. [A] under [B] beyond [C] behind [D] from6. [A] misinterprete [B] misapplied [C] misadjusted [D] mismatched7. [A] fired [B] judged [C] replaced [D] delayed8. [A] unreasonable [B] ungreatful [C] unconventional [D] unfamiliar9. [A] comfortable [B] anxious [C] confident [D] angry10. [A] attend [B] point [C] take [D] turn11. [A] dangerous [B] mysterious [C] violent [D] boring12. [A] hurt [B] resis [C] bend [D] decay13. [A] lecture [B] conversation [C] debate [D] negotiation14. [A] trainees [B] employees [C] researchers [D] passengers15. [A] reveal [B] choose [C] predictl [D] design16. [A] voyage [B] flight [C] walk [D] ride17. [A] went through [B] did away [C] caught up [D] put up18. [A] In turn [B] In particular [C]In fact [D] In consequence19. [A] unless [B] since [C] if [D] whereas20. [A] funny [B] simple [C] Iogical [D] rare往年考研英语二真题完形填空2Directions:Read the following text. Choose the best word (s) for each numbered blank and mark A, B, C or D on the ANSWER SHEET. (10 points) Why do people read negative Internet comments and do other things that will obviously be painful? Because humans have an inherent need to 1 uncertainty, according to a recent study in Psychological Science. The new research reveals that the need to know is so strong that people will 2 to satisfy their curiosity even when it is clear the answer will 3 .In a series of four experiments, behavioral scientists at the University of Chicago and the Wisconsin School of Business tested. Student’s willingness to 4 themselves to unpleasant stimuli in an effortto satisfy curiosity. For one 5 each participant was shown a pile of pens that the researcher claimed were from a previous experiment. The twist? Half of the pens would 6 an electric shock when clicked.Twenty-seven students were told which pens were electrified, another twenty-seven were told only that some were electrified 7 left alone in the room, the students who did not know which ones would shock them clicked more pens and incurred more shocks than the students who knew what would 8 subsequent experiments reproduced,this effect with other stimuli 9 the sound of finger nails on a chalkboard and photographs of disgusting insects.The drive to_10_is deeply rooted in humans. Much the same as the basic drives for_11_or shelter, says Christopher Hsee of the University of Chicago Curiosity is often considered a good instinct-it can _12_New Scientific advances, for instance-but sometimes such_13_can backfire, the insight that curiosity can drive you to do _14_things is a profound one.Unhealthy curiosity is possible to 15 , however, in a final experiment, participants who were encouraged to 16 how they would feel after viewing an unpleasant picture were less likely to 17 to see such an image. These results suggest that imagining the 18 of following through on one’s curiosity ahead of time can help determine 19 it is worth the endeavor. ” Thinking about long-term 20 is key to reducing the possible negative effects of curiosity. Hsee says “in other words, don’t read online comments”.1. [A]Protect [B] resolve [C] discuss [D] ignore2. [A]refuse [B] wait [C] regret [D] seek3. [A]hurt [B] last [C]mislead [D] rise4. [A]alert [B] tie [C] treat [D] expose5. [A]message [B] review [C] trial [D] concept6.[A] remove [B] weaken [C] interrupt [D] deliver7.[A]when [B] if [C] though [D] unless8.[A] continue [B] happen [C] disappear [D] change9.[A] rather than [B] regardless of [C] such as [D] owing to10.[A] discover [B] forgive [C] forget [D] disagree11.[A] pay [B] marriage [C] schooling [D] food12.[A] lead to [B]rest on [C] learn from [D] begin with13.[A] withdrawal [B] persistence [C] inquiry [D] diligence14.[A] self-reliant [B] self-destructive [C] self-evident [D]self-deceptive15.[A] define [B] resist [C]replace [D] trace16.[A] overlook [B] predict [C] design [D] conceal17.[A] remember [B] promise [C] choose [D] pretend18.[A] relief [B] plan [C] duty [D] outcome19.[A] why [B] whether [C] where [D] how20.[A] consequences [B] investments [C] strategies [D] limitations往年考研英语二真题完形填空3Directions:Read the following text. Choose the best word(s) for each numbered blank and mark A, B, C or D on ANSWER SHEET. (10 points) Thinner isn’t always better. A number of studies have __1___ that normal-weight people are in fact at higher risk of some diseases compared to those who are overweight. And there are health conditionsfor which being overweight is actually ___2___. For example, heavier women are less likely to develop calcium deficiency than thin women. ___3___ among the elderly, being somewhat overweight is often an___4___ of good health.Of even greater ___5___ is the fact that obesity turns out to be very difficult to define. It is often defined ___6___ body mass index, or BMI. BMI ___7__ body mass divided by the square of height. An adult with a BMI of 18 to 25 is often considered to be normal weight. Between 25 and 30 is overweight. And over 30 is considered obese. Obesity,___8___,can be divided into moderately obese, severely obese, and very severely obese.While such numerical standards seem 9 , they are not. Obesity is probably less a matter of weight than body fat. Some people with a high BMI are in fact extremely fit, 10 others with a low BMI may be in poor 11 .For example, many collegiate and professional football players 12 as obese, though their percentage body fat is low. Conversely, someone with a small frame may have high body fat but a 13 BMI.Today we have a(an) _14 _ to label obesity as a disgrace.The overweight are sometimes_15_in the media with their faces covered. Stereotypes _16_ with obesity include laziness, lack of will power,and lower prospects for success.Teachers,employers,and health professionals have been shown to harbor biases against the obese. _17_very youngchildren tend to look down on the overweight, and teasing about body build has long been a problem in schools.1. [A] denied [B] conduced [C] doubled [D] ensured2. [A] protective [B] dangerous [C] sufficient [D]troublesome3. [A] Instead [B] However [C] Likewise [D] Therefore4. [A] indicator [B] objective [C] origin [D] example5. [A] impact [B] relevance [C] assistance [D] concern6. [A] in terms of [B] in case of [C] in favor of [D] in of7. [A] measures [B] determines [C] equals [D] modifies8. [A] in essence [B] in contrast [C] in turn [D] in part9. [A] complicated [B] conservative [C] variable [D] straightforward10. [A] so [B] unlike [C] since [D] unless11. [A] shape [B] spirit [C] balance [D] taste12. [A] start [B] quality [C] retire [D] stay13. [A] strange [B] changeable [C] normal [D] constant14. [A] option [B] reason [C] opportunity [D] tendency15. [A] employed [B] pictured [C] imitated [D] monitored16. [A] [B] combined [C] settled [D] associated17. [A] Even [B] Still [C] Yet [D] Only18. [A] despised [B] corrected [C] ignored [D] grounded19. [A] discussions [B] businesses [C] policies [D] studies20. [A] for [B] against [C] with [D] without往年考研英语二真题完形填空4Read the following text. Choose the best word(s) for each numbered blank and mark A, B, C or D on ANSWER SHEET 1. (10 points) Given the advantages of electronic money, you might think that we would move quickly to the cashless society in which all payments are made electronically. 1 a true cashless society is probably not around the corner. Indeed, predictions have been 2 for two decades but have not yet come to fruition. For example, Business Week predicted in 1975 that electronic means of payment would soon revolutionize the very 3 of money itself, only to 4 itself several years later. Why has the movement to a cashless society been so 5 in coming?Although electronic means of payment may be more efficient than a payments system based on paper, several factors work 6 the disappearance of the paper system. First, it is very 7 to set up the computer, card reader, and telecornmunications networks necessary to make electronic money the 8 form of payment Second, paper checks have the advantage that they 9 receipts, something thai many consumers are unwilling to 10 . Third, the use of paper checks gives consumers several days of float - it takes several days 11 a check is cashed and funds are 12 from the issuers account, which means that the writer of the check can cam interest on the funds in the meantime. 13electronic payments arc immediate, they eliminate the float for the consumer.Fourth, electronic means of payment may 14 security and privacy concerns. We often hear media reports that an unauthorized hacker has been able to access a computer database and to alter information 15 there. The fact that this is not an 16 occurrence means that dishonest persons might be able to access bank accounts in electronic payments systems and 17 from someone elses accounts. The 18 of this type of fraud is no easy task, and a new field of computer science is developing to 19 security issues. A further concern is that the use of e lectronic means of payment leaves an electronic 20 that contains a large amount of personal data. There are concerns that government, employers, and marketers might be able to access these data, thereby violating our privacy.1. [A] However [B] Moreover [C] Therefore [D] Otherwise2. [A] off [B] back [C] over [D] around3. [A] power [B] concept [C] history [D] role4. [A] reward [B] resist [C] resume [D] reverse5. [A] silent [B] sudden [C] slow [D] steady6. [A] for [B] against [C] with [D] on7. [A] imaginative [B] expensive [C] sensitive [D] productive8. [A] similar [B] original [C] temporary [D] dominant9. [A] collect [B] provide [C] copy [D] print10. [A] give up [B] take over [C] bring back [D] pass down11. [A] before [B] after [C] since [D] when12. [A] kept [B] borrowed [C] released [D] withdrawn13. [A] Unless [B] Until [C] Because [D] Though14. [A] hide [B] express [C] raise [D]ease15. [A] analyzed [B] shared [C] stored [D] displayed16. [A] unsafe [B] unnatural [C] uncommon [D] unclear17. [A] steal [B] choose [C] benefit [D] return18. [A] consideration [B] prevention [C] manipulation [D] justification19. [A] cope with [B] fight against [C] adapt to [D] call for20. [A] chunk [B] chip [C] path [D] trail往年考研英语二11。

2型糖尿病文献综述范文模板例文English Answer:Introduction.Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia and insulin resistance. It is a major global health concern, affecting approximately 463 million people worldwide. T2DM is a highly prevalent disease with significant morbidity and mortality, accounting for 1.5 million deaths annually. The disease is associated with various complications, including cardiovascular disease, nephropathy, neuropathy, and retinopathy.Pathophysiology.Insulin resistance is the primary defect in T2DM. Insulin resistance refers to the reduced responsiveness of tissues, particularly muscle and liver, to the metabolicactions of insulin. As a result, glucose uptake and utilization are impaired. The pancreas initially compensates by increasing insulin secretion to maintain glucose homeostasis. However, over time, the pancreas fails to meet the increased insulin demand, leading to hyperglycemia. Beta-cell dysfunction is another factor contributing to T2DM, characterized by impaired insulin secretion and reduced insulin sensitivity.Risk Factors.Various factors contribute to the development of T2DM, including:Genetics: Family history and specific genetic variants increase the risk of T2DM.Obesity: Obesity is strongly linked to T2DM, as it promotes insulin resistance and inflammation.Age: The risk of T2DM increases with age, especially after 45 years.Physical inactivity: Regular physical activity improves insulin sensitivity and reduces the risk of T2DM.Unhealthy diet: A diet high in processed foods, sugary drinks, and saturated fats can promote insulin resistance.Certain ethnicities: Individuals of certain ethnicities, such as African Americans, Hispanics, and Native Americans, have a higher prevalence of T2DM.Other medical conditions: Conditions like Polycystic Ovary Syndrome (PCOS) and Gestational Diabetes Mellitus (GDM) can increase the risk of developing T2DM.Symptoms.Early stages of T2DM may be asymptomatic or have mild symptoms, such as:Increased thirst and urination.Hunger and weight loss.Fatigue and weakness.Blurred vision.Frequent infections.Diagnosis.T2DM is diagnosed based on clinical symptoms and laboratory tests. The primary diagnostic criteria include:Fasting plasma glucose (FPG) ≥ 126mg/dL (7.0mmol/L)。