MEDITERRANEAN LIVING HERITAGE (MedLiHer) APPRAISAL

2022-2023高三上英语期末模拟试卷注意事项1．考试结束后，请将本试卷和答题卡一并交回．2．答题前，请务必将自己的姓名、准考证号用0．5毫米黑色墨水的签字笔填写在试卷及答题卡的规定位置．3．请认真核对监考员在答题卡上所粘贴的条形码上的姓名、准考证号与本人是否相符．4．作答选择题，必须用2B铅笔将答题卡上对应选项的方框涂满、涂黑；如需改动，请用橡皮擦干净后，再选涂其他答案．作答非选择题，必须用05毫米黑色墨水的签字笔在答题卡上的指定位置作答，在其他位置作答一律无效．5．如需作图，须用2B铅笔绘、写清楚，线条、符号等须加黑、加粗．第一部分（共20小题，每小题1.5分，满分30分）1．Philips won 8 gold medals at the Beijing Olympic Games, __________astonished the world.A．that B．which C．what D．who2．I wanted some more cold meat but there was _____ left.A．none B．no one C．any D．some3．—Jack has been out of consciousness since the accident.Will he come to himself，doctor?—It’s going to be tough but we anticipate that he will .A．put through B．pull throughC．put over D．pull over4．After seven hours’ drive, they reached ______ t hey thought was the place they had been dreaming of.A．that B．whatC．where D．which5．The petrol in the car _____ on our way to the beach, so we had to walk there. A．gave up B．gave off C．gave in D．gave out6．— Don't put the waste on the ground, young man.— Oh, I'm sorry. I ______ the dustbin there.A．hadn't seen B．haven’t seenC．didn't see D．wasn't seeing7．(2013·天津，9)No one________ be more generous；he has a heart of gold. A．could B．must C．dare D．need8．“ ________ I went through ups and downs in life，” Gordon said, “I never found the importance of being self­disciplined as well as the significance of life.”A．If B．SinceC．Until D．Unless9．_____ the lawyers, volunteers from the Libyan Red Cross Society also joined the efforts in helping the Chinese go home safely.A．Except for B．In spite of C．Apart from D．Instead of10．_____ the plant once a week if you are to get fruit in the autumn.A．Watered B．Watering C．To water D．Water11．The only problem was ______ we kept getting lost! But people in Tianjin are very friendly and helpful.A．why B．whetherC．that D．how12．If ________ in the elevator, please press the emergency button immediately. A．trapped B．trappingC．having trapped D．to be trapped13．As things didn’t work out the way we ________, we found ourselves trying to force them and struggling to finish them.A．plan B．are planning C．had planned D．will be planning14．If you want to improve your figure and health, the most effective thing to do is to show up at the gym every time you ________ be there.A．can B．willC．may D．shall15．It is one thing to enjoy listening to good music, but it is quite ______ to perform skillfully yourself.A．another B．other C．the other D．others16．It s a good idea to get students to retell a story their own words．A．of B．in C．by D．through17．You have a big mouth,Tom. You have told everybody the secret. A．shouldn’t B．mustn’t C．can’t D．mightn’t18．“It might have saved me a lot of money”, Mr. Chen sighed, “________ timely from the stock market this July”.A．did I withdraw B．should I withdrawC．have I withdrawn D．had I withdrawn19．— Mary looks hot and dry.— So ________ you if you had a high fever.A．could B．would C．may D．must20．Paul could be a very attractive boy but he ______ to his behaviour.A．paid no attention B．were paying no attentionC．pays no attention D．had paid no attention第二部分阅读理解（满分40分）阅读下列短文，从每题所给的A、B、C、D四个选项中，选出最佳选项。

人,诗意地安居英文版Living Harmoniously: An English Version of "人,诗意地安居"Living harmoniously, a concept deeply rooted in the Chinese culture, encompasses the idea of finding inner peace and contentment in one's living environment. It emphasizes the importance of creating a serene and poetic atmosphere that nurtures the body, mind, and soul. Translating this concept into English, we can refer to it as "Living Harmoniously."Living harmoniously involves several aspects that contribute to a fulfilling and balanced life. Firstly, it involves creating a physical space that promotestranquility and relaxation. This can be achieved through minimalist and clutter-free designs, natural elements such as plants, and the use of soft colors and natural light. A serene living space can have a profound impact on our well-being and overall outlook on life.Secondly, living harmoniously embraces the notion of living in harmony with nature. It encourages us to appreciate and respect the natural world around us. This can be achieved by incorporating sustainable practices into our daily lives, such as conserving energy and water, recycling, and choosing eco-friendly products. By doing so, we not only reduce our ecological footprint but also cultivate a deeper connection with the environment.Furthermore, living harmoniously extends beyond the physical realm and delves into the realm of the mind and spirit. It emphasizes the importance of cultivating inner peace, mindfulness, and emotional well-being. This can be achieved through practices such as meditation, yoga, and self-reflection. By nurturing our mental and emotional health, we enhance our ability to cope with stress, find joy in the present moment, and maintain harmonious relationships with others.Living harmoniously also involves finding a balance between work and leisure. It encourages us to prioritizeself-care, rest, and recreation. By allowing ourselves time to recharge and pursue activities that bring us joy, we can prevent burnout and maintain a healthy work-life balance. This balance is crucial for our overall well-being and happiness.In conclusion, "Living Harmoniously" encompasses the idea of creating a serene and poetic living environmentthat promotes physical, mental, and emotional well-being. It involves designing a tranquil living space, living in harmony with nature, nurturing our inner peace, and finding a balance between work and leisure. By embracing these principles, we can cultivate a harmonious and fulfilling life.。

人教版Book 7 Unit 1 Living wellMARTY’S STORYHi, my name is Marty Fielding and I guess you could say I am "one in a million”. In other words， there are not many people in the world like me. You see, I have a muscle disease which makes me very weak， so I can't run or climb stairs as quickly as other people。

In addition, sometimes I am very clumsy and drop things or bump into furniture。

Unfortunately, the doctors don't know how to make me better, but I am very outgoing and have learned to adapt to my disability. My motto is: live one day at a time.Until I was ten years old I was the same as everyone else. I used to climb trees, swim and play football。

In fact， I used to dream about playing professional football and possibly representing my country in the World Cup。

Then I started to get weaker and weaker， until I could only enjoy football from a bench at the stadium. In the end I went into hospital for medical tests。

单项选择He hasn’t got any hobbies pared D.matched【3】A.parents B.adolescents C.psychologists D.youths【4】A.assistance B.protection C.involvement D.preference【5】A.differences B.similarities C.choices D.relations【6】A.slightly B.passively C.highly D.fairly【7】A.in case of B.in spite of C.in view of D.in fear of【8】A.equal B.safe C.long D.short【9】A.fault B.turn C.job D.attitude【10】A.when B.how C.why D.what【11】A.confused B.disappointed C.amazed D.satisfied【12】A.however B.still C.yet D.thus【13】A.unreasonable B.changeable C.understandable D.avoidable 【14】A.confirmed B.convinced C.realized D.reflected【15】A.decides B.lowers C.helps D.stimulates【16】A.appearance B.performance C.establishment D.development 【17】A.value B.devote C.fill D.save【18】munication B.conflicts C.cooperation petitions【19】A.start B.ignore C.consider D.stop 【20】A.home B.school C.career D.profession 【答案】【1】B【2】C【3】A【4】C【5】A【6】C【7】A【8】B【9】C【10】B【11】A【12】D【13】C【14】A【15】B【16】D【17】C【18】B【19】A【20】D【解析】【1】本空考查动词短语基本含义的辨析。

及家庭成员对患者的影响,导致结果可能存在偏倚,下一步将结合临床实践㊁采用多中心研究方法完善预测偏瘫患者康复效果不佳风险的列线图预测模型㊂综上所述,基于年龄㊁饮酒㊁高血压㊁康复训练开始时间以及居住环境构建的列线图预测模型,可较好地个体化预测康复训练效果不佳风险,有助于临床制定个体化干预方案,对改善康复训练效果有积极作用㊂ʌ参考文献ɔ[1]㊀Kuriakose D,Xiao Z.Pathophysiology and treatment ofstroke:present status and future perspectives[J].Int MolSci,2020,21(20):1-24.[2]㊀彭美娣,陈玉培,冯扣兰,等.急性缺血性脑卒中患者生活质量影响因素研究[J].交通医学,2022,36(5):532-534.[3]㊀Lou Y T,Yang J J,Ma Y F,et al.Effects of different acu-puncture methods combined with routine rehabilitation ongait of stroke patients[J].World Clin Cases,2020,8(24):6282-6295.[4]㊀Vluggen T P M M,van Haastregt J C M,Verbunt J A,et al.Feasibility of an integrated multidisciplinary geriatric rehabil-itation programme for older stroke patients:a process evalua-tion[J].BMC Neurol,2020,20(1):1-13.[5]㊀Shi R,Zhang T,Sun H,et al.Establishment of clinical pre-diction model based on the study of risk factors of stroke inpatients with type2diabetes mellitus[J].Front Endocrinol(Lausanne),2020,11(1):1-14.[6]㊀Sacco R L,Kasner S E,Broderick J P,et al.An updated def-inition of stroke for the21st century:a statement for health-care professionals from the American Heart Association/A-merican Stroke Association[J].Stroke,2013,44(7):2064-2089.[7]㊀Alex C.Activities of Daily Living(ADL)[M].Berlin germa-ny:springer netherlands,2014.19-20.[8]㊀Yan Q,Wang X,Zhang Y,et al.Analysis of influencing fac-tors of rehabilitation treatment effect in patients with first-episode stroke[J].Am Transl Res,2021,3(12):14046-14056.[9]㊀Yang C,Zhao J,Xie H,et al.Effects of early rehabilitationnursing intervention on nerve function and daily living in pa-tients with stroke hemiplegia[J].Am Transl Res,2021,13(10):11842-11850.[10]㊀Sun C,Li X,Song B,et al.A NADE nomogram to predictthe probability of6-month unfavorable outcome in Chinesepatients with ischemic stroke[J].BMC Neurol,2019,19(1):1-8.[11]㊀Zhou Z,Yin X,Niu Q,et al.Risk factors and a nomogramfor predicting intracranial hemorrhage in stroke patients un-dergoing thrombolysis[J].Neuropsychiatr Dis Treat,2020,16(1):1189-1197.[12]㊀Wang CY,Miyoshi S,Chen C H,et al.Walking ability andfunctional status after post-acute care for stroke rehabilita-tion in different age groups:a prospective study based onpropensity score matching[J].Aging(Albany NY),2020,12(11):10704-10714.[13]㊀Lv X,Chen H.Effect of virtual reality combined with intelli-gent exercise rehabilitation machine on the nursing recoveryof lower limb motor function of patients with hypertensivestroke[J].Healthc Eng,2022,2022(1):1-10. [14]㊀Lv Y,Zhang Q,Rong L,et al.Butylphthalide soft capsulescombined with modified tonic exercise therapy on neurologi-cal function and ability of daily living of patients with strokehemiplegia[J].Am Transl Res,2021,13(12):13803-13810.[15]㊀朱翠平.农村脑卒中偏瘫患者家庭康复护理干预的效果研究[J].护理管理杂志,2018,18(10):745-748.ʌ文章编号ɔ1006-6233(2023)09-1538-06关节镜下双滑轮结合双排缝线桥技术治疗肩袖损伤的效果及对肩关节功能恢复的影响张小钰,㊀马敬祖,㊀于㊀佳,㊀万㊀钧,㊀马㊀军(宁夏回族自治区人民医院,㊀宁夏㊀银川㊀750012)ʌ摘㊀要ɔ目的:探究关节镜下双滑轮和双排缝线桥联合技术治疗肩袖损伤(rotator cuff tears,RCT)的效果及对肩关节功能恢复的影响㊂方法:回顾性分析2018年7月至2022年6月于我院接受传统缝线桥技术治疗的52例RCT患者临床资料,纳入对照组,回顾性分析同期于我院接受关节镜下双滑轮结合双排缝线桥技术治疗的53例RCT患者临床资料,纳入观察组㊂比较两组患者手术指标,随访6个月㊃8351㊃ʌ基金项目ɔ宁夏回族自治区重点研发计划项目,(编号:2021BEG03050)ʌ通讯作者ɔ马㊀军后,比较两组患者治疗效果[愈合率㊁再撕裂率㊁视觉模拟评分(visual Analogue Scale,VAS)],术前和术后6个月关节活动度(前屈上举㊁体侧外旋㊁体侧内旋)㊁肩关节功能[美国肩肘外科协会评分(american Shoulder and Elbow Surgeons,ASES)㊁Constant-Murley评分(constant-Murley Score,CMS)㊁加州大学洛杉矶分校评分(university of California at Los Angeles,UCLA)],统计术后并发症发生情况㊂结果:两组患者手术时间㊁手术出血量㊁住院时间及疼痛缓解时间均差异无统计学意义(P均>0.05);术后6个月,两组患者VAS评分较术前降低,观察组低于对照组(P<0.05);前屈上举㊁体侧外旋㊁体侧内旋度数㊁ASES评分㊁UCLA评分及CMS评分均较术前升高,观察组高于对照组(P均<0.05)㊂结论:关节镜下双滑轮结合双排缝线桥技术在RCT治疗中效果显著,可加强RCT患者关节灵活度,有利于RCT患者肩关节功能恢复㊂ʌ关键词ɔ㊀肩袖损伤;㊀关节镜下双滑轮;㊀双排缝线桥;㊀肩关节功能;㊀关节灵活度ʌ文献标识码ɔ㊀A㊀㊀㊀㊀㊀ʌdoiɔ10.3969/j.issn.1006-6233.2023.09.023Effect of Arthroscopic Double Pulley Combined with Double Row Suture Bridge Technique on Rotator Cuff Tear and ItsInfluence on Shoulder Function RecoveryZHANG Xiaoyu,MA Jingzu,YU Jia,et al(The People's Hospital of Ningxia Hui Autonomous Region,Ningxia Yinchuan750012,China)ʌAbstractɔObjective:To explore the effect of combined technique of arthroscopic double pulley and double row suture bridge in the treatment of rotator cuff tear(RCT)and its influence on shoulder function re-covery.Methods:The clinical data of52patients with RCT who received traditional suture bridge technique in the hospital from July2018to June2022were retrospectively analyzed and the patients were included in control group.The clinical data of53patients with RCT who received arthroscopic double pulley combined with double row suture bridge technique in the hospital during the same period were retrospectively analyzed and the patients were enrolled as observation group.The surgical indicators,therapeutic effects[healing rate, re-tear rate,Visual Analogue Scale(VAS)]after6months of follow-up,the joint range of motion(forward flexion and upward lift,lateral external rotation,lateral internal rotation)and shoulder function[American Shoulder and Elbow Surgeons(ASES),Constant-Murley Score(CMS),University of California at Los An-geles(UCLA)]before surgery and at6months after surgery were compared between the two groups,and the postoperative complications were counted.Results:There were no significant differences in surgical time,sur-gical blood loss,hospital stay,and pain relief time between both groups(all P>0.05).At6months after sur-gery,VAS score in both groups was reduced compared to before the surgery,and the score in observation group was lower than that in control group(P<0.05).Forward flexion and upward lift,lateral external rota-tion,lateral internal rotation,ASES score,UCLA score and CMS score were enhanced compared with those before surgery,and the above indicators were higher in observation group than those in control group(all P< 0.05).Conclusion:Arthroscopic double pulley combined with double row suture bridge technique has a sig-nificant effect in the treatment of RCT,and it can enhance the joint flexibility of patients with RCT and is ben-eficial to shoulder function recovery in patients with RCT.ʌKey wordsɔ㊀Rotator cuff tear;㊀Arthroscopic double pulley;㊀Double row suture bridge;㊀Shoulder function;㊀Joint flexibility㊀㊀肩袖损伤(rotator cuff tears,RCT)由慢性劳损㊁间接暴力或退行性变等导致㊂据报道,60岁以上群体发病率为20%~30%,70岁以上群体则占50%左右[1]㊂RCT患者多伴有肩部疼痛㊁肌肉萎缩㊁肩关节活动受限等症状,随着病情加重将影响肱骨头稳定性,且大多高龄患者存在关节粘连现象,若不及时治疗[2]㊂临床㊃9351㊃上,小型肩袖损伤采用保守治疗,中㊁大㊁巨大型RCT 则需通过手术治疗缓解患者症状[3]㊂传统手术创伤大,不利于RCT患者术后康复㊂近年来,肩关节镜下手术趋于成熟,已成为肩袖损伤治疗的 金标准 ,其修补方式主要包括内排缝合㊁双排缝合㊁双排缝线桥缝合及双滑轮结合缝线桥技术等,但目前尚未明确那种修补方法效果最佳[4]㊂本研究回顾性分析我院肩袖损伤患者临床资料,探究关节镜下双滑轮结合双排缝线桥技术在肩袖损伤中的治疗效果及对肩关节功能影响㊂报道如下㊂1㊀资料与方法1.1㊀一般资料:回顾性分析2018年7月至2022年6月于我院接受传统缝线桥技术治疗的52例RCT患者临床资料,纳入对照组,回顾性分析同期于我院接受关节镜下双滑轮结合双排缝线桥技术治疗的53例RCT 患者临床资料,纳入观察组㊂纳入标准:①经影像学确诊为RCT;②Cofield分型为中型㊁大型撕裂;③术后随访ȡ6个月㊂排除标准:①不可修复型肩袖撕裂者;②合并其他肩部疾病者;③术后无法康复训练者;④既往肩关节手术史者;⑤术后外伤导致再撕裂者;⑥治疗依从性差者;⑦精神异常或沟通障碍者;⑧临床资料不全者㊂患者一般资料差异无统计学意义(P>0.05)㊂见表1㊂表1㊀患者一般资料比较[ xʃs,n(%)]组别n性别男㊀㊀㊀㊀㊀女年龄(岁)症状持续时间(月)撕裂部位左肩㊀㊀㊀右肩撕裂程度中型㊀㊀㊀大型观察组5332(60.38)21(39.62)58.46ʃ6.137.94ʃ1.3828(52.83)25(47.17)36(67.92)17(32.08)对照组5228(53.85)24(46.15)58.84ʃ6.258.05ʃ1.4225(48.08)27(51.92)33(63.46)19(36.54)χ2/t0.4570.3150.4030.2370.232P0.4990.7540.6880.6260.6301.2㊀方法:两组患者术前均接受X射线㊁MRI㊁常规身体检查及感染预防㊂观察组:关节镜下双滑轮结合双排缝线桥㊂全麻后患者仰卧于手术台,肩部悬空,向前30度㊁向外45度牵引上肢,采用肩峰后㊁前㊁外三种不同路径放置关节镜,观察肩袖关节㊁盂肱关节㊁肱二头肌等处损伤情况及是否存在粘连,根据损伤程度,进行肱二头肌长头腱修整㊁回缩,清理肩袖间隙㊁上肱唇㊁肩峰下滑囊,松解关节粘连处㊂测定肩袖损伤形态㊁尺寸及厚度,清除损伤残端,松解肩袖,打磨肱骨足印区,清洁肩袖至止点,将2根内排锚钉(各带蓝㊁白色2根缝线)插入足印区内侧关节软骨边缘,缝合肩袖,将1根蓝线打结作为内排滑轮,然后向肩关节方向牵引,形成一个内排双轮滑,压紧肩袖,将1根蓝线和2根白线系于肱骨大结节远端,剪余线,清洗并封闭切口㊂对照组采用传统缝线桥技术㊂采用与观察组相同方法置入关节镜㊁修整㊁清理,在足印区肱骨关节软骨边缘置入2枚内排锚钉(各带2根缝线),用缝合器将其通过肩袖进行过线,将缝线打结,并固定与肌腱上,构成缝线桥,随后外排锚钉固定,剪余线,清洗并封闭切口㊂术后接受常规抗感染㊁止痛等处理,佩戴4~6周上肢外展支具,术后4周进行被动前屈㊁外展㊁内外旋等康复训练,术后4~6周活动达到正常范围者进行自主上肢肌肉训练,术后6周逐渐加强训练及关节协调训练,每次训练后可局部冰敷㊂术后1㊁3㊁6个月复查㊂1.3㊀观察指标:①手术指标:比较患者手术时间㊁手术出血量㊁住院时间㊂②治疗效果:统计随访期间患者愈合及再撕裂发生率,用视觉模拟评分(visual Analogue Scale,VAS)[5]评估疼痛程度,分数0~10分,分值越高,疼痛程度越强㊂③关节活动度:术前和术后6个月,采用量角器测量两组患者前屈上举㊁体侧外旋㊁体侧内旋的角度㊂④肩关节功能:术前和术后6个月,采用美国肩肘外科协会评分(american Shoulder and El-bow Surgeons,ASES)[6]㊁加州大学洛杉矶分校评分(u-niversity of California at Los Angeles,UCLA)[7]㊁Constant -Murley评分(constant-Murley Score,CMS)[8]评估, ASES含疼痛㊁生活功能,总分100分,分数与肩关节功能成正比,UCLA含肩关节前屈度㊁疼痛㊁功能㊁力量及治疗满意度,总分35分,分数与肩关节功能成正比, CMS含疼痛㊁肩关节活动角度㊁日常生活㊁肌力,总分100分,分数与肩关节功能成正比㊂⑤并发症:统计术后关节粘连㊁切口感染㊁神经血管损伤㊁骨折发生情况㊂1.4㊀统计学分析:采用SPSS19.0软件进行数据处理㊂㊃0451㊃计量资料年龄㊁症状持续时间㊁手术指标㊁VAS㊁ASES㊁UCLA及CMS评分以( xʃs)表示,组内比较行配对样本t检验,组间比较行独立样本t检验,计数资料性别㊁撕裂程度㊁撕裂部位以n(%)表示,采用χ2检验,P<0. 05表示差异有统计学意义㊂2㊀结㊀果2.1㊀患者手术指标比较:两组患者手术时间㊁手术出血量㊁住院时间差异均无统计学意义(P均>0.05)㊂见表2㊂表2㊀患者手术指标比较( xʃs)组别n手术时间(min)术中出血量(mL)住院时间(d)观察组5385.36ʃ6.7560.72ʃ5.84 5.12ʃ0.77对照组5284.03ʃ6.6162.11ʃ5.93 5.34ʃ0.82 t 1.020 1.210 1.417 P0.3100.2290.1592.2㊀患者治疗效果比较:观察组愈合率高于对照组,再撕裂率低于对照组(P均<0.05);术前,患者VAS评分差异无统计学意义(P均>0.05);术后6个月,患者VAS评分降低,观察组降幅大于对照组(P均<0.05)㊂见表3㊂表3㊀患者治疗效果比较[n(%), xʃs]组别n VAS评分㊀术前㊀㊀㊀㊀㊀术后6个月差值愈合再撕裂观察组53 5.94ʃ1.15 1.03ʃ0.31∗ 4.94ʃ0.6148(90.57)5(9.43)对照组52 5.81ʃ1.12 1.45ʃ0.43∗ 4.36ʃ0.5739(75.00)13(25.00) t/χ20.587 5.749 5.032 4.477 4.477 P0.559<0.001<0.0010.0340.034㊀㊀与同组术前比较,∗P<0.052.3㊀患者肩关节活动度比较:术前,患者前屈上举㊁体侧外旋㊁体侧内旋角度差异无统计学意义(P均>0.05);术后6个月,患者前屈上举㊁体侧外旋㊁体侧内旋角度均显著升高,观察升幅大于对照组(P均<0.05)㊂见表4㊂表4㊀患者肩关节活动度比较( xʃs,度)组别n前屈上举术前㊀㊀㊀术后6个月㊀㊀差值体侧外旋术前㊀㊀㊀术后6个月㊀㊀差值体侧内旋术前㊀㊀㊀术后6个月㊀㊀差值观察组5363.28ʃ6.42149.76ʃ15.13∗86.48ʃ7.2427.15ʃ3.1447.54ʃ5.66∗20.39ʃ2.12 4.15ʃ1.039.35ʃ2.43∗ 5.20ʃ1.14对照组5262.97ʃ6.51141.38ʃ14.75∗78.41ʃ6.9527.48ʃ3.3642.69ʃ5.23∗15.21ʃ1.63 4.21ʃ1.068.27ʃ2.24∗ 4.06ʃ1.07 t0.246 2.873 5.8250.520 4.55814.0170.294 2.367 5.281P0.8060.005<0.0010.604<0.001<0.0010.7690.020<0.001㊀㊀注:与同组术前比较,∗P<0.052.4㊀患者肩关节功能比较:术前,患者UCLA评分㊁CMS评分㊁ASES评分差异无统计学意义(P均>0.㊃1451㊃05);术后6个月,患者UCLA评分㊁CMS评分㊁ASES评分均显著升高,观察组升幅大于对照组(P均<0.05)㊂见表5㊂表5㊀患者肩关节功能比较( xʃs,分)组别n ASES评分术前㊀㊀㊀术后6个月㊀㊀差值UCLA评分术前㊀㊀㊀术后6个月㊀㊀差值CMS评分术前㊀㊀㊀术后6个月㊀㊀差值观察组5341.82ʃ4.5875.46ʃ6.92∗33.64ʃ3.2812.43ʃ1.7728.59ʃ2.25∗13.16ʃ1.3544.35ʃ5.2782.52ʃ8.76∗38.17ʃ4.06对照组5242.13ʃ4.6570.88ʃ6.67∗28.75ʃ2.9112.68ʃ1.8424.86ʃ2.17∗12.18ʃ1.3144.93ʃ5.5478.65ʃ8.24∗33.72ʃ4.18 t0.344 3.4528.0750.7108.644 3.7740.550 2.331 5.534P0.7310.001<0.0010.480<0.001<0.0010.5840.022<0.001㊀㊀注:与同组术前比较,∗P<0.052.5㊀两组患者并发症比较:两组患者均未有术后并发症发生㊂3㊀讨㊀论肩袖能够稳定肩关节㊁协调肩关节活动,创伤㊁慢性撞击㊁局部供血不足㊁磨损等因导致肩部肌肉机械性能降低,肩关节稳定性失衡,关节囊退行性变,引发肩部疼痛㊁功能损伤,严重影响患者日常生活[9]㊂老年人群尤其是长期重体力劳动者群体中该病发病率较高,且常伴有由炎症反应引起的粘连,进一步加重病情,降低患者肩关节活动能力,关节镜因其创伤小㊁术后疼痛轻㊁恢复快等优势已被广泛应用于肩袖损伤治疗㊂目前,临床上主要采用单排㊁双排㊁缝线桥等固定方式修复RCT,关节镜下双排缝线桥技术为一种新型修复方式,能够缩小肌腱与骨之间间隙,增加腱骨接触面积,进而增加固定效果,还可通过数条网状线阻断关节液渗入肌腱骨,有利于肩关节功能恢复㊂双滑轮结合双排缝线桥技术联合外排间断缝合与内排双轮滑技术,增加肌腱与骨的接触面积,增强肩袖修复的初始稳定性,促进肌腱修复[10]㊂本研究显示,两组患者手术指标均无显著性差异,但观察组愈合率高于对照组,再撕裂率及疼痛程度低于对照组,提示关节镜下双滑轮结合双排缝线桥技术能够提高RCT治疗效果,但对手术指标无明显影响㊂这可能是因为两组所用肩袖修复固定方式均是在关节镜下进行,该术创伤小,对病灶周围组织损伤小,能降低手术中的出血量,对病人的术后康复也有好处㊂,因此,两组患者手术时间㊁术中出血量及住院时间等无明显差异㊂但与传统缝线桥技术相比,双滑轮结合双排缝线桥技术改良内排锚钉缝线打结方式,与外排缝线桥技术相结合,将肩袖向骨面牵拉,使其充分接触,增强肩关节稳定性,且滑轮线可封闭关节,抑制关节液向腱骨面渗透,促进肌腱愈合㊂RCT修复后再撕裂因素包括肌腱与骨面未愈合㊁缝线断裂㊁锚钉松动㊁肌腱质量差及术后不当康复训练等,本研究中缝合术不仅能够增加固定强度,还能通过外锚钉缝合桥构成肩袖足印区网状固定,降低内排锚钉张力,缓解疼痛,避免组织缺血㊁坏死,促进肌腱愈合,减少肩袖再撕裂,此外,该术可以把压力转移到外侧锚钉,从而降低肌腱和缝线的剪切和收窄,降低再次撕裂的可能性[11]㊂本研究发现,观察组肩关节活动度大于对照组,且肩关节功能优于对照组,此结果与郭伟康等[12]研究结果一致㊂提示双滑轮结合双排缝线桥技术能够提高RCT患者肩关节活动度及功能㊂可能内排锚钉缝线打结可有效避免锚钉松动,同时结合外排缝线桥增加肌腱㊁骨接触,改善肩部稳定,促进术后功能恢复,为提高患者肩关节活动度打下良好基础,且接触面积增加能够使足印区覆盖充分㊁受压均匀,增强旋转力与抗剪切力,有利于术后康复训练,避免术后肩关节出现粘连㊁痉挛等促进肩关节功能恢复㊂综上所述,双滑轮结合双排缝线桥技术在肩袖损伤治疗中效果显著,能够减轻疼痛,提高肩关节活动度,促进肩关节功能恢复㊂ʌ参考文献ɔ[1]㊀张凯搏,唐新,李箭,等.2019年美国骨科医师学会(AAOS)肩袖损伤临床实践指南解读[J].中国运动医学杂志,2020,39(5):403-412.[2]㊀薛辉,周医斋,帖小佳,等.关节镜下松解术结合肩袖修复术治疗肩袖损伤合并冻结肩疗效分析[J].中国临床医生杂志,2020,48(4):469-472.[3]㊀朱周玮,刘旺鑫,孙晖晖,等.肩袖损伤治疗研究进展[J].新中医,2021,53(23):27-30.[4]㊀杨军,李志国,刘昭,等.关节镜下双排单滑轮缝线桥治疗全层肩袖损伤的临床效果分析[J].中国医刊,2022,57(7):771-774.[5]㊀严广斌.视觉模拟评分法[J].中华关节外科杂志(电子㊃2451㊃版),2014(2):273.[6]㊀Richards RR ,An KN ,Bigliani LU ,et al.A standardizedmethod for the assessment of shoulder function [J ].JShoul-der Elbow Surg ,1994,3(6):347-352.[7]㊀王少杰,石磊,张同恩,等.肩关节镜下肱二头肌长头肌腱转位增强修复巨大肩袖撕裂的疗效[J ].中华创伤杂志,2023,39(1):31-37.[8]㊀Conboy VB ,Morris RW ,Kiss J ,et al.An evaluation of theconstant -murley shoulder assessment [J ].Bone Joint SurgBr ,1996,78(2):229-232.[9]㊀Huntington L ,Coles -Black J ,Richardson M ,et al.The use ofsuturetape and suture -wire in arthroscopic rotator cuff re-pair :a comparative biomechanics study [J ].Injury ,2018,49(11):2047-2052.[10]㊀齐鹏坤,智猛,韩煜.肩关节镜下双滑轮结合双排缝合技术治疗肩袖撕裂[J ].临床骨科杂志,2019,22(3):292-295.[11]㊀骆勇刚,陈俊,庄万强,等.肩关节镜下不同缝合固定修复技术治疗肩袖损伤的临床疗效[J ].局解手术学杂志,2021,30(6):535-540.[12]㊀郭伟康,黄健,刘松浪,等.肩关节镜下双滑轮结合缝线桥技术固定修复肩袖损伤的应用研究[J ].中华实用诊断与治疗杂志,2020,34(2):173-176.ʌ文章编号ɔ1006-6233(2023)09-1543-07改良悬雍垂腭咽成形术治疗OSAHS 伴认知功能障碍患者疗效及对呼吸功能脑电图和MMSE 评分的影响朱玉博,㊀程蕾蕾,㊀朱荣飞,㊀刘秋蕊,㊀徐艳红(四川省雅安市人民医院耳鼻咽喉头颈外科,㊀四川㊀雅安㊀625000)ʌ摘㊀要ɔ目的:观察改良悬雍垂腭咽成形术(H -UPPP )治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS )伴认知功能障碍患者疗效及对呼吸功能㊁脑电图和蒙特利尔认知评估量表(MMSE )评分的影响㊂方法:选取雅安市人民医院耳鼻喉头颈外科于2020年2月至2022年2月收治的中重度OSAHS 伴认知功能障碍患者124例为研究对象,采用简单随机法分为两组,单组62例㊂保守组采用行为治疗干预,观察组采用H -UPPP 联合行为治疗干预㊂比较两组多导睡眠参数㊁蒙特利尔认知评估量表(MO-CA )评分㊁睡眠评估量表(ESS )评分㊁LMT 延迟回忆(LMT DR )评分㊁Rey -Osterrieth 复杂图形测试(CFT )㊁逻辑记忆测试(LMT )㊁CFT 延迟回忆(CFT DR )评分㊁MMSE 评分及P300潜伏期的差异,统计两组6个月后脑电图异常率和总有效率㊂结果:保守组治疗6个月后呼吸暂停低通气指数(AHI )较前下降,LSpO 2较前升高(P <0.05)㊂观察组治疗6个月后AHI ㊁SaO 2<90%的时间占总监测时间百分比(TS90%)㊁(N1+N2)%较前下降,LSpO 2㊁N3%㊁快眼动睡眠期占总监测时间百分比(REM%)较前升高(P <0.05)㊂观察组AHI ㊁LSpO 2㊁TS90%㊁(N1+N2)%㊁N3%㊁REM%治疗前后差值高于保守组(P <0.05)㊂保守组治疗6个月后ESS 评分较前下降(P <0.05)㊂观察组治疗6个月后ESS 评分较前下降,MMSE 评分㊁MOCA 评分较前升高(P <0.05)㊂观察组治疗6个月后ESS 评分低于保守组(P <0.05)㊂保守组治疗6个月后CFT ㊁LMT 评分及其延迟回忆评分与治疗前比较,差异无统计学意义(P >0.05)㊂观察组治疗6个月后LMT 评分㊁LMT DR 评分较前升高,但CFT 评分㊁CFT DR 评分与治疗前比较,差异无统计学意义(P >0.05)㊂观察组MMSE 评分㊁MOCA 评分㊁ESS 评分治疗前后差值高于保守组(P <0.05)㊂保守组治疗6个月后P300潜伏期结果与治疗前比较,差异无统计学意义(P >0.05)㊂观察组治疗6个月后Fz ㊁Cz ㊁Pz ㊁C4点P300潜伏期较前下降,但C3点P300潜伏期与治疗前比较,差异无统计学意义(P >0.05)㊂观察组P300潜伏期治疗前后差值高于保守组(P <0.05)㊂观察组6个月后脑电图异常率为24.19%(15/62)明显低于保守组的50.00%(31/62),总有效率为88.71%(55/62)明显高于保守组的56.45%(35/62),有统计学差异(P <0.05)㊂结论:改良悬雍垂腭咽成形术治疗OSAHS 伴认知功能障碍可有效改善患者睡眠结构和脑电活动状态,有利于患者认知功能的恢复㊂ʌ关键词ɔ㊀改良悬雍垂腭咽成形术;㊀阻塞性睡眠呼吸暂停低通气综合征;㊀认知功能障碍;㊀睡眠结构;㊀脑电活动状态;㊀呼吸功能ʌ文献标识码ɔ㊀A㊀㊀㊀㊀㊀ʌdoi ɔ10.3969/j.issn.1006-6233.2023.09.024㊃3451㊃ʌ基金项目ɔ四川省医学科研课题,(编号:S20049)ʌ通讯作者ɔ徐艳红。

海德格尔诗意栖居英文原文Heidegger's Poetically DwellingMartin Heidegger, a renowned German philosopher, introduced the concept of "poetically dwelling" in hislater works, particularly in his essay "Building Dwelling Thinking." This concept emphasizes the interconnectedness between human beings and their environment, highlightingthe importance of dwelling in a poetic manner.According to Heidegger, poetically dwelling involves a deep engagement with the world around us, not just as passive observers but as active participants in itscreation and preservation. It is a way of being in theworld that is attuned to the rhythms and patterns of nature, allowing us to cultivate a sense of belonging andconnection to our surroundings.Poetically dwelling also entails a heightened awarenessof the significance of language and poetry in shaping our understanding of the world. Language, for Heidegger, is not just a tool for communication but a means of revealing the hidden meanings and truths that lie beneath the surface ofthings. Poetry, in particular, has the power to evoke a sense of wonder and awe, opening up new possibilities for experiencing and interpreting the world around us.In his essay, Heidegger explores the idea of building as a form of dwelling that is intimately connected to the poetic dimension of human existence. He argues that true dwelling is not merely a matter of constructing physical structures but of creating spaces that resonate with the deeper rhythms and meanings of existence. Building, for Heidegger, is a poetic act that allows us to express our relationship to the world in a tangible and meaningful way.Furthermore, Heidegger suggests that poetically dwelling requires a shift in our perspective from a purely instrumental view of the world to a more contemplative and reverent one. This involves a reorientation of our relationship to technology and the environment, moving away from a mindset of exploitation and domination towards one of stewardship and care.Overall, Heidegger's concept of poetically dwelling challenges us to reconsider our place in the world and to cultivate a deeper sense of connection and belonging to thenatural world. By embracing a more poetic way of being, we can open ourselves up to new ways of experiencing and understanding the world around us, fostering a greater sense of harmony and balance in our lives.海德格尔的诗意栖居马丁·海德格尔是一位著名的德国哲学家，在他的后期作品中，特别是在他的文章《建筑栖居思维》中，引入了“诗意栖居”的概念。

四川省绵阳市三台中学2025届高三二诊模拟考试英语试卷注意事项1．考生要认真填写考场号和座位序号。

2．试题所有答案必须填涂或书写在答题卡上，在试卷上作答无效。

第一部分必须用2B 铅笔作答；第二部分必须用黑色字迹的签字笔作答。

3．考试结束后，考生须将试卷和答题卡放在桌面上，待监考员收回。

第一部分（共20小题，每小题1.5分，满分30分）1．The engineer is thought to be capable and modest, so his promotion to manager is a popular _____. A．achievement B．appointment C．commitment D．employment2．The college examination is ________________ easier this year than I have expected.A．fairly B．quiteC．rather D．very3．Nobody knows why the boy can tell what’s written on the paper in another room without looking at it. It really_______ explanation.A．prevents B．challenges C．interrupts D．confuses4．If it _____ earlier, the printing machine would not have broken down．A．has been repaired B．is repairedC．had been repaired D．was repaired5．It's ________ me why Alice gave up her job and got married.A．under B．above C．over D．beyond6．Following the girl, we went into a hall; on __________ walls hung a few pictures of some famous scientists.A．its B．whichC．whose D．those7．The TV stat ion will be ______ the game live on Saturday afternoon, and we can’t miss it.A．covering B．improving C．handling D．canceling8．______ his love, Chris sent his mom a thank-you note on Mother’s Day.A．Expressing B．Expressed C．To express D．Having expressed9．________is known to us is that tobacco contains nicotine and other harmful products，so you should give up smoking. A．As B．ItC．What D．Which10．-----Good evening. Huangshan Hotel.-----Good evening. ______________?A．Do you still have a room for tonight B．What would you like, pleaseC．Is there anything I can do for you D．Who is that speaking, please11．My mother is always warning me when I go out, “Don’t get off the bus ________ it is stopping.”A．until B．whileC．before D．after12．Once y ou’ve ________ the items you ordered, put this record in your file.A．checked in B．checked offC．checked out D．checked with13．He started school the same day as I did and________to it like a duck to water.A．appealed B．tookC．catered D．saw14．As often happens after long sleeplessness, he was ________ by an unreasoning panic.A．seized B．fascinatedC．impressed D．embarrassed15．When the old man woke up, he found someone his TV in the living room.A．stole B．steal C．stealing D．stolen16．We were scared to death when the fire______. Fortunately, it was put out before it caused much damage. A．broke out B．came outC．gave out D．turned out17．One hundred and fifteen Chinese companies hit the newly released Fortune 500 list for 2017, ______ an increase for the 14th straight year, domestic website reported on Thursday.A．to realize B．realizedC．realizing D．having realized18．---I don’t understand why Catherine stopped short _____ she ought to have continued.---It’s obvious that she lacked self-confidence.A．when B．whileC．if D．as19．volleyball is her main focus, she is also great at basketball.A．Since B．OnceC．Unless D．While20．Eventually, she has recognized ____, whatever happens and however bad ____ seems today, life still goes on and everything will be better tomorrow．A．that; it B．it; that C．it; what D．that; what第二部分阅读理解（满分40分）阅读下列短文，从每题所给的A、B、C、D四个选项中，选出最佳选项。

Unit 7 Living with disease文化背景A篇About 25 million children in developing countries have no homes. So they live on city streets. United Nations Children’s Fund says most of these children do not receive education or health care.The private organization k nown as “Child Hope USA〞is trying to do something to help these children. The group has many goals. Child Hope USA wants to stop the spread of AIDS and the use of illegal〔非法的〕drugs among children. It wants to protect young girls from being mistreated sexually〔性别上的〕. It wants to tell children how to protect themselves, how to survive〔存活〕conditions on the streets and how to feel good about themselves.Child Hope USA is trying to set up educational programs for the children. It is working with local groups to get their help in protecting the rights of street children. And it is trying to make international development groups more informed about street children. Some children begin on the streets when they are five years old or younger. Four-year-olds can be found selling goods on the street corner or begging for food and money. Some of these children have lost their families because of wars or natural disasters, such as earthquakes and floods. Some are helping their families earn enough money to survive.Studies show that more than one million children live and work on the streets in the Philippines. Seven million children live on the streets in Brazil. About 250 thousand children live on the streets of Mexico. Child Hope USA works closely with international and local groups. It has offices in Brazil, Guatemala, the Philippines, Britain, Canada and the United States. Child Hope USA works to improve child labor laws. In 1992, Pakistan approved new laws to make sure children repay the loan〔贷款〕by working in factories. Yet, about eight million children still are working in Pakistan to repay loans.1.Acording to the passage, there are about ____ million street children in developing countries.A.25B.75.C.100D.102.Which of the following is NOT the goal of the Child Hope USA? It wants to ____.A.build a school and a hospital to help the childrenB.help the children not to use illegal drugsC.teach the children ways to protect themselvesD.help the children to go to school3.Which of the following is t he reason for the children’s working on the street?A.They have no parents.B.They earn money to help their parents.C.They break away from their families, so they have to make a living by themselves.D.Either A or B4.Which of the following is TRUE?A.Child Hope USA is trying to help the children through its own effort.B.Child hope USA has an office in China.C.Street children’s condition has improved, but the problems remain unsolved.D.Under the pressure of the law, no child in Pakistan is still working to repay loans.Key: 1-4 ADCBB篇The latest United Nations report on the AIDS spread paints a sad picture. It concludes that the regions of the world most affected by AIDS will experience rapid increases in deaths among young adults. This will have serious social and economic results.The spread of AIDS and the virus that causes it, HIV, is particularly destructive in Africa. It is estimated(估计)that insub-Saharan Africa, over twenty-four million adults and children are now living with HIV. In sixteen sub-Saharan countries, according to the UN, at least ten percent of the people between the ages of fifteen and forty-nine are HIVpositive(阳性). In South Africa and Zimbabwe, half the people between those ages may die of AIDS. In Botswana, about one in three adults is infected(感染), and some two-thirds of the country’s fifteen-year-old boys may die before they grow up.As a result, agriculture, business, education, and health care are already suffering serious loss. The United States is spending millions of dollars to do it. Funding(基金) is being used for prevention campaigns and to make AIDS treatment more affordable. Money is also being used to reduce mother-to-child transmission rates, support home-and-community-based care, and provide care for children orphaned by AIDS. The Peace Corps will soon make an all-out effort to bring AIDS education to the countries most at risk. It is important that the governments and citizens of those nations most affected by AIDS do their part to fight against it. Some, like Senegal and Uganda, have already begun programs for disease prevention. These countries are experiencing falling or stable(稳定) HIV rates and less suffering. But for other nations, much remains to be done.1. The report shows that ______.A. more places are affected by AIDSB. more deaths are caused by AIDSC. more young adults are dying of AIDSD. the spread of AIDS can never be controlled2. Which of the following statements is TRUE?A. The spread of AIDS is getting worse and more dangerous in Africa.B.In sub-Saharan Africa, 90% of the population are not affected by AIDS.C. In South Africa and Zimbabwe, 50% of the population may die of AIDS.D.In Botswana, onethird of the grown-ups are infected by AIDS.3.The money used to fight against AIDS doesn’t include t hat for ______.A. prevention and treatmentB.reduction of mother-to-child transmissionC.home-and-community-based careD. orphans infected by AIDS4. The phrase “at risk〞in the passage probably means “______〞.A. likely to be affected by AIDSB. dangerousC. poor in medical careD. poor in education5. _____ have (has) done better in prevention and treatment for AIDS.A.Sixteen sub-Saharan countriesB. South Africa and ZimbabweC.BotswanaD. Senegal and UgandaKey: 1-5 CDABDC篇Thousands of years ago man used handy rocks for his surgical〔外科〕operations. Later he used sharp bone or horn, metal knives and, more recently, rubber and plastic. And that was what were used for many years. In the 1960s a new tool was developed, one which was, first of all, to be of great practical use to the armed forces and industry, but which was also, in time, to revolutionize the art and science of surgery.The tool is the laser〔激光〕and it is being used by more and more surgeons all over the world, for a very large number of different cases〔病例〕. As we all know, light is hot; any source of light ---from the sun itself down to a small match burning ---will give warmth. But light is usually spread out over a wide area. The light in a laser beam, however, is concentrated〔集中〕. This means that a light with no more power than that produced by an ordinary electric light lamp becomes quite strong as it is concentrated to a pinpoint–sized beam.Experiments with these pinpoint beams have shown researchers that different energy sources produce beamsthat have a particular effect on certain living cells. It is now possible for eye surgeons to carry out an operation on the back of the human eye without harming the front of the eye, simply by passing a laser beam right through the eyeball. No knives, no needles, no unwanted damage---a true surgical wonder.Operations which once left patients tired and in need of long periods of recovery time now leave them feeling relaxed and comfortable. So much more difficult operations can now be tried.The rapid development of laser techniques in the past ten years has made it clear that the future is likely to be very exciting. Perhaps some cancers will be treated with laser in a way that makes surgery not only safer but more effective. Altogether, tomorrow may see more and more information coming to light on the diseases which can be treated medically.1. We find that after the development of the laser in the 1960s,___.A. medical help became hard for industrial workersB. the study of surgical techniques went through a complete revolutionC. more and more surgeons began using surgical instrumentsD. man’s whole thought to surgery changed completely2. The laser beam is so strong because_____.A. it is a highly intensified〔强化〕beam of lightB. its strength is increased by the sunC. it can be connected to strong light sourcesD. it is a concentration of light from different sources3. Surgeons can now carry out operations which____.A. can be performed successfully only on the human eyeB. result in long periods of recovery time for patientsC. result in very little damage to the patientsD. are made much more complicated by using the laser beam4. The rapid development of laser techniques means that_____.A. in another ten years we shall be able to cure cancerB. surgery is likely to improve greatlyC. we shall be able to treat all the diseases we suffer fromD. we are now able to treat most forms of cancerKey: 1-5 DACB。

医学人类学英文书单以下是一些医学人类学方面的英文书单，这些书籍可以帮助你深入了解医学人类学的相关内容：1. "The Anthropology of Medicine: From Culture to Method" by Clara Han 《医学人类学：从文化到方法》2. "Medical Anthropology: A Biocultural Approach" by Andrea S. Wiley《医学人类学：生物文化方法论》3. "Body and Emotion: The Aesthetics of Illness and Healing in the Nepal Himalayas" by Robert R. Desjarlais《身体与情感：尼泊尔喜马拉雅地区的疾病和康复美学》4. "The Birth of the Clinic: An Archaeology of Medical Perception" by Michel Foucault《诊所的诞生：医学知觉的考古学》5. "Illness Narratives: Suffering, Healing, and the Human Condition" by Arthur Kleinman《疾病叙事：苦难、康复与人类状况》6. "Medicine and Culture: Revised Edition" by Lynn Payer《医学与文化：修订版》7. "The Scalpel's Edge: The Culture of Surgeons" by David J. Rothman《手术刀的边缘：外科医生的文化》8. "The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures" by Anne Fadiman《灵魂抛洒：一位苗族儿童、她的美国医生和两种文化的碰撞》9. "Disease and Social Diversity: The European Impact on the Health of Non-Europeans" by George Armelagos and Peter J. Brown《疾病与社会多样性：欧洲对非欧洲人健康的影响》10. "The Cultural Politics of Health: A Handbook for Medical Anthropology" edited by Margaret Lock and Nancy Scheper-Hughes《健康的文化政治：医学人类学手册》这些书籍涵盖了医学人类学的不同方面，从文化、方法论到疾病叙事和医疗实践等。