临床执业医师考试第一单元真题2014年
临床执业医师考试第一单元真题2014年
Dangers Await Babies with Altitude
Women who live in the world’s highest communities tend to give birth to underweight babies, a new study suggests. These babies may grow into adults with a high risk of heart disease and strokes.1
Research has hinted that newborns in mountain communities are lighter than average. But it wasn’t clear whether this is due to reduced oxygen levels at high altitudes or because their mothers are under-nourished — many people who live at high altitudes are relatively poor compared with those living lower down.
To find out more, Dino Giussani and his team at Cambridge University studied the records of 400 births in Bolivia during 1997 and 1998. The babies were bom in both rich and poor areas of two cities: La Paz and Santa Cruz. La Paz is the highest city in the world, at 3.65 kilometers above sea level, while Santa Cruz is much lower, at 0.44 kilometers.
Sure enough, Giussani found that the average birthweight of babies in La Paz was significantly lower than in Santa Cruz. This was true in both high and low-income families. Even babies bom to poor families in Santa Cruz were heavier on average than babies born to wealthy families in lofty La Paz. “We were very surprised by this result,” says Giussani.
The results suggest that babies bom at high altitudes are deprived of2 oxygen before birth. “This may trigger the release or suppression of hormones that regulate growth of the unborn child,3 ”says Giussani.
His team also found that high-altitude babies tended to have relatively larger heads compared with their bodies4. This is probably because a fetus starved of oxygen will send oxygenated blood to the brain in preference to the rest of the body.5
Giussani wants to find out if such babies have a higher risk of disease in later life. People born in La Paz might be prone to heart trouble in adulthood, for example. Low birthweight is a risk factor for coronary heart disease. And newborns with a high ratio of head size to body weight are often predisposed to high blood pressure and strokes in later life.
词汇：
altitude / ’æltɪtju:d /n．维度，（海拔）高度
stroke /strəʊk / n．中风
birthweight n．出生体重
coronary / ’kɒrənəri /adj．冠状的
under-nourished adj．营养不足的
underweight /’ʌndəweɪt / adj．重量不足的
hint / hɪnt / vt．暗示
hormone /’hɔ:məʊn / n．荷尔蒙
fetus / ’fi:təs / n．胚胎
注释：
1．... grow into adults with a high risk of heart disease and strokes：……长大成人后得心脏病和中风的风险很大
2．... are deprived of ...：被剥夺了……，缺乏……
3．This may trigger the release or suppression of hormones that regulate growth of the unborn child：这可能会触发调节未出生儿成长的荷尔蒙的释放或抑制。这里的release是名词。
4．relatively larger heads compared with their bodies：相对身体来说较大的头部
5．... a fetus starved of oxygen will send oxygenated blood to the brain in preference to the rest of the body：……一个缺乏氧的胚胎会首先把充氧的血液输送到脑部，然后才送到身体的其他部位。starved of是分词短语，修饰fetus, in preference to表示的是第二位的选择，如：I chose to study English in preference to Russian in university.读大学时，我选了英语，而不是俄语。
Giussani did not expect to find that the weight of a baby had little to do with the financial conditions of the family he was bom into.
A:Right B:Wrong C:Not mentioned
Chicken Soup for the Soul：Comfort Food Fights Loneliness
Mashed potatoes, macaroni and cheese, may be bad for your arteries． 1 according to a study in Psychological Science, they’re good for your heart and 2 ．The study focuses on “comfort food1” and how it makes people feel．
"For me 3 ,food has always played a big role in my family,” says Jordan Troisi, a graduate student2 at the University of Buffalo3, and lead author4 on the study．The study came out of the research program of his co—author Shira Gabriel．It has 4 non-human things that may affect human emotions．Some people reduce loneliness by bonding with their 5 TV show, building virtual relationships with a pop song singer or looking at pictures of loved ones．Troisi and Gabriel wondered if comfort food could have the same effect 6 making people
think of their nearest and dearest5.
In one experiment, in order to make 7 feel lonely, the researchers had them write for six minutes about a fight with someone close to them．Others were given an emotionally neutral writing assignment. Then, some people in each 8 wrote about the experience of eating a comfort food and others wrote about eating a new food． 9 ,the researchers had participants 10 questions about their levels of loneliness6．
Writing about a fight with a close person made people feel lonely．But people who were generally 11 in their relationships would feel less lonely by writing about a comfort food．"We have found that comfort foods are consistently associated with those close to us．"says Troisi．"Thinking about or consuming these foods later then serves as a reminder of those close others．"In 12 essays on comfort food, many people wrote about the 13 of eating food with family and friends.
In another experiment, 14 chicken soup in the lab made people think more about relationships, but only if7 they considered chicken soup to be a comfort food．This was a question they had been asked long before the experiment, along with many other questions, so they wouldn’t remember it.
Throughout everyone’s daily lives8 they experience stress, often associated with our 15 with others," Troisi says．"Comfort food Can be an easy remedy for loneliness．
词汇：
mashed /mæʃt/ adj．被捣成糊浆的
macaroni/ macaroni/ n．通心粉
cheese / tʃi:z / n．奶酪
artery/ artery / n．动脉
assignment / ə"sainmənt / n．指定作业
reminder / reminder/ n．起提醒作用的东西
remedy /remedy/ n．治疗方法，药物
virtual/"və:tʃuəl/ adj．虚拟的
注释：
1.comfort food：爽心食品
2. graduate student：研究生
3. The University of Buffalo：布法罗大学，建校于1846 年，位于水牛城（ Buffalo City) ，属于纽约州立大学，因此称为纽约州立大学水牛城分校。
4. lead author：首席作者
5. their nearest and dearest：他们最接近和最亲爱的人
6. levels of loneliness：孤独程度
7. only if: 只有（在……情况下）
8. Throughout everyone"s daily lives：在每一个人的日常生活中。through 有“贯穿”的意思。
空4
A:looked for B:looked at C:looked after D:looked up
A Success Story
At 19, Ben Wayis already a millionaire, and one of a growing number of teenagers who have___1___ Their fortune through the Internet. ___2___ makes Ben"s story all the more remarkable1 is that he is dyslexic, and was___3___ by teachers at his junior school that he would never be able to read or write___4___. "I wanted to prove them___5___ ", says Ben, creator and director of Waysearch, a net search engine which can be used to find goods in online shopping malls.
When he was eight, his local authorities___6___ him with a PC to help with school work. Although he was___7___ to read the manuals, he had a natural ability with the computer, and ___8___ by his father, he soon began___9___ people $l0 an hour for his knowledge and skills. At the age of 15 he___10___ up his own computer consultancy, Quad Computer, which he ran from his bedroom, and two years later he left school to___11___ all his time to business.
"By this time the company had grown and I needed to take on a___12___ of employees to help me", says Ben. "That enabled me to start___13___ business with bigger companies.” It was. his ability to consistently___14___ difficult challenges2 that led him to win the Young Entrepreneur of the Year award in the same year that he formed Waysearch, and he has recently signed a deal___15___ $25 million with a private investment company, which will finance his search engine.
remarkable /ri"ma:kəbl/ a．卓越的，值得注意的
dyslexic /dis"leksik/ a．诵读困难的n．诵读困难者
authority /ɔ:"θɔriti/n．权威，权力，当权
consultancy /kən"sʌltnsi/ n．咨询公司，顾问工作
overcome /əuvə"kʌm/ v．克服，胜过
entrepreneur /ɔntrəprənə:/ n．企业家，主办者
investment /in"vestmənt/n．投资，投入
1. What makes Ben"s story all the more remarkable ... : 使得 Ben 的故事更引人注意的是…...
空4
A:absolutely B:totally C:properly D:thoroughly
Clone Farm
Factory farming could soon enter a new era of mass production. Companies in the USare developing the technology needed to "clone" chickens on a massive scale1. Once a chicken with desirable traits has been bred or genetically engineered2, tens of thousands of eggs, which will hatch into identical copies3 , could roll off the production lines every hour. Billions of clones could be produced each year to supply chicken farms with birds that all grow at the same rate, have the same amount of meat and taste the same.
This, at least, is the vision of theUS"s National Institute of Science and Technology, which has given Origen Therapeutics of Burlingame, California, and Embrex of North Carolina $4.7 million to help fund research4. The prospect has alarmed animal welfare groups, who fear it could increase the suffering of farm birds.
That"s unlikely to put off5 the poultry industry, however, which wants disease-resistant birds that grow faster on less food. "Producers would like the same meat quantity but to use reduced inputs to get there," says Mike Fitzgerald of Origen. To meet this demand, Origen aims to "create an animal that is effectively a clone", he says. Normal cloning doesn"t work in birds because eggs can"t be removed and implanted. Instead, the company is trying to bulk-grow6, embryonic stem cells7 taken from fertilized eggs as soon as they"re laid. "The trick is to culture8 the cells without them starting to distinguish, so they remain pluripotent," says Fitzgerald.
Using a long-established technique, these donor cells will then be injected into the embryo of a freshly laid, fertilized recipient egg9, forming a chick that is a "chimera". Strictly speaking a chimera isn"t a clone, because it contains cells from both donor and recipient. But Fitzgerald says it will be enough if, say, 95 percent of a chicken"s body develops from donor cells. "In the poultry world, it doesn"t matter if it"s not 100 percent," he says.
Another challenge for Origen is to scale up10 production. To do this, it has teamed up with11 Embrex, which produces machines that can inject vaccines into up to 50,000 eggs12 an hour. Embrex is now trying to modify the machines to locate the embryo and inject the cells into precisely the right spot without killing it.
In future, Origen imagines freezing stem cells from different strains of chicken13. If orders come in for a particular strain, millions of eggs could be produced in months or even weeks. At present, maintaining all the varieties the market might call for is too expensive for breeders, and k takes years to breed enough chickens to produce the billions of eggs that farmers need.
词汇:
Clone/ kləʊn /n. & v.克隆，无性繁殖
embryo / ˈembriəʊ /n.胚胎
implant / "ɪmplɑ:nt /v.植入；移植
chimera / kaɪˈmɪərə /n.嵌合体
embryonic / ˌembriˈɒnɪk /adj.胚胎的
fertilise / "fɜ:tɪlaɪz /v.使受精
pluripotent / plʊə"rɪpətənt /adj.多能的
vaccine / "væksi:n /n.疫苗
注释：
1. on a massive scale:大规模
2. genetically engineered：经过基因改造。genetical engineering：遗传工程
3. hatch into identical copies：孵出如出一辙的（小）鸡
4. help fund research： 资助研究。fund用作动词，research是它的宾语。
5. put off：意为 “discourage”（使……气馁）。
6. bulk-grow： 大量繁殖
7. stem cell：干细胞
8. culture：动词，意思是：培育。
9. a freshly laid, fertilized recipient egg:新产下的；已受精的；要接受细胞植入的鸡蛋
10. scale up： 提高，按比例增加。
11. team up with：与 合作。
12. up to 50,000 eggs：多达 5 万只鸡蛋。
13. different strains of chicken：不同品种的鸡。
In the third paragraph,by saying "Producers would like the same meat quantity but to usereduced inputs to get there". Mike Fitzgerald means that he wishes____
A:chickens" quality could be maintained but with less investment B:chickens" taste could be improved but at less costs C:chickens" growth rate could be quickened but with less inputs D:chickens could grow to the same weight but with less feed
A Success Story
At 19, Ben Wayis already a millionaire, and one of a growing number of teenagers who have___1___ Their fortune through the Internet. ___2___ makes Ben"s story all the more remarkable1 is that he is dyslexic, and was___3___ by teachers at his junior school that he would never be able to read or write___4___. "I wanted to prove them___5___ ", says Ben, creator and director of Waysearch, a net search engine which can be used to find goods in online shopping malls.
When he was eight, his local authorities___6___ him with a PC to help with school work. Although he was___7___ to read the manuals, he had a natural ability with the computer, and ___8___ by his father, he soon began___9___ people $l0 an hour for his knowledge and skills. At the age of 15 he___10___ up his own computer consultancy, Quad Computer, which he ran from his bedroom, and two years later he left school to___11___ all his time to business.
"By this time the company had grown and I needed to take on a___12___ of employees to help me", says Ben. "That enabled me to start___13___ business with bigger companies.” It was. his ability to consistently___14___ difficult challenges2 that led him to win the Young Entrepreneur of the Year award in the same year that he formed Waysearch, and he has recently signed a deal___15___ $25 million with a private investment company, which will finance his search engine.
remarkable /ri"ma:kəbl/ a．卓越的，值得注意的
dyslexic /dis"leksik/ a．诵读困难的n．诵读困难者
authority /ɔ:"θɔriti/n．权威，权力，当权
consultancy /kən"sʌltnsi/ n．咨询公司，顾问工作
overcome /əuvə"kʌm/ v．克服，胜过
entrepreneur /ɔntrəprənə:/ n．企业家，主办者
investment /in"vestmənt/n．投资，投入
1. What makes Ben"s story all the more remarkable ... : 使得 Ben 的故事更引人注意的是…...
空4
A:absolutely B:totally C:properly D:thoroughly
胰岛B细胞产生的激素是（）
A:胰高血糖素 B:胰岛素 C:抗利尿激素 D:促黑激素 E:褪黑素
胰岛B细胞产生的激素是（）
A:胰高血糖素 B:胰岛素 C:抗利尿激素 D:促黑激素 E:褪黑素
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