病历摘要： 男性，55岁。胸痛3小时，伴出冷汗入院。既往有高血压病史，吸烟史。体检：BP150/70mmHg，心率80次/分，律齐，心音减弱，未闻及病理性杂音，两肺底可闻及细湿啰音。心电图显示 如图1 图2 图3 图4

此时的诊断为　提示：患者检查结果显示：肌钙蛋白阳性，复查心电图又显示为见图2：

A:急性心包炎 B:冠心病 C:急性前间壁心肌梗死 D:急性下壁心肌梗死 E:肺栓塞 F:I3度房室传导阻滞 G:室性逸搏心律 H:交界性逸搏心律 I:心功能KillipI1级 J:心功能KillipI2级

患者男性，40岁。1周来因头痛,头晕而入院体检。既往体健。吸烟20年，20支／日，其母死于高血压脑出血。查体：BP 175/100mmHg，P 65次／分，肥胖体型，双肺（-），心脏不大，A>P，下肢无水肿。

提示：2年后，患者BP 160/90mmHg，心率88次／分，尿蛋白(+)，血肌酐458μmol/L，空腹血糖7.0mmol/L，超声心动图示：左心室肥厚，左室舒张末内径60mm。问题：此时患者宜选用的治疗药物是

A:卡托普利25mg，每日3次 B:氨氯地平5mg，每日1~2次 C:氯沙坦100mg，每日1次 D:呋塞米40mg，每日1次 E:氢氯噻嗪50mg，每日1次 F:螺内酯40mg，每日1次 G:特拉唑嗪2mg，每日1次

某男性患者，41岁，1周来因头痛、头晕而入院体检。既往体健。吸烟20年，20支／日，其母死于高血压脑出血。查体：BP 175/100mmHg，P 65次／分，肥胖体型，双肺（-），心脏不大，A>P，下肢无水肿。

提示：2年后，患者BP 160/90mmHg，心率88次／分，尿蛋白(+)，血肌酐458μmol/L，空腹血糖7.0mmol/L，超声心动图示：左心室肥厚，左室舒张末内径60mm。问题：此时患者宜选用的治疗药物是

A:卡托普利25mg，每日3次 B:氨氯地平5mg，每日1～2次 C:氯沙坦100mg，每日1次 D:呋塞米40mg，每日1次 E:氢氯噻嗪50mg，每日1次 F:螺内酯40mg，每日1次 G:特拉唑嗪2mg，每日1次

Experts Call for Local and Regional Control of Sites for Radioactive Waste

The withdrawal of Nevada’s Yucca Mountain as a potential nuclear waste repository¹ has reopened the debate over how and where to dispose of spent nuclear fuel and high-level nuclear waste. In an article in the July 10 issue of Science, University of Michigan² geologist Rodney Ewing and Princeton University³ nuclear physicist Frank von Hippel argue that, although federal agencies should set standards and issue licenses for the approval of nuclear facilities, local communities and states should have the final approval on the siting of these facilities. The authors propose the development of multiple sites that would service the regions where nuclear reactors are located.

“The main goal…, should be to provide the United States with multiple alternatives and substantial public involvement in an open siting and design process that requires acceptance by host communities and states,”the authors write.

Ewing and von Hippel also analyze the reasons why Yucca Mountain, selected by Congress⁴ in 1987 as the only site to be investigated for long-term nuclear waste disposal, finally was shelved⁵ after more than three decades of often controversial debate. The reasons include the site’s geological problems, management problems, important changes in the Environmental Protection Agency’s standard, unreliable funding and the failure to involve local communities in the decision-making process.

Going forward, efforts should be directed at locating storage facilities in the nation’s northeastern, southeastern, midwestern and western regions, and states within a given region should be responsible for developing solutions that suit their particular circumstances. Transportation of nuclear waste over long distances, which was a concern with the Yucca Mountain site, would be less of a problem because temporary storage or geological disposal sites could be located closer to reactors.

“This regional approach would be similar to the current approach in Europe, where spent nuclear fuel⁶ and high-level nuclear waste⁷ from about 150 reactors and reprocessing plants is to be moved to a number of geological repositories in a variety of rock types⁸,”said Rodney Ewing, who has written extensively about the impact of nuclear waste management on the environment and who has analyzed safety assessment criteria for the controversial Yucca Mountain nuclear waste repository.

词汇:

radioactive adj.放射性的   

geologist n.地质学家

shelve v.搁置      

reactor n.反应堆，反应器

repository n.储藏地，储藏室   

geological adj. 地质的

controversial adj. 有争议的     

注释:    

1. The withdrawal of Nevada’s Yucca Mountain as a potential nuclear waste repository: Nevada’s Yucca Mountain:美国境内的内华达州尤卡山。 nuclear waste repository:核废物处理库。美国能源部部长朱棣文 2009年 3月 5日表示，拟在内华达州尤卡山建设的核废物昀终处理库将不再是美国储存高放废物的一个选项。

2. University of Michigan:美国密歇根大学，建于 1817年。

3. Princeton University:美国普林斯顿大学，建于 1746年。

4. Congress:美国国会，美国昀高立法机关，由参议院 (Senate)和众议院(House of Representatives)组成。

5.…was shelved: ……被束之高阁。 6. spent nuclear fuel:也叫做 used nuclear fuel，一般译为“乏核燃料”。

7. high-level nuclear waste:高（强度）放（射性）核废物。

8. geological repositories in a variety of rock types:各种不同岩层中的地质处置库。 geological repositories指的是地表以下 300~1500米的稳定的地质体中建造的用于昀终处置高放废物和乏核燃料的工程设施。处置库是一个多重屏障系统，工程屏障由废物体、废物罐、外包装和缓冲回填材料组成，而天然屏障则是能有效阻滞放射性核素迁移的地质体，包括花岗岩、粘土岩、凝灰岩和岩盐等。许多专家认为地质处置是安全的，技术上是可行的，对环境是无害的。

What is NOT true about the 1987 decision by Congress concerning siting of nuclear waste disposal?

A:Yucca Mountain was selected as the only site for a nuclear waste repository. B:The selection of Yucca Mountain for nuclear waste disposal caused much controversy. C:The decision by Congress was put aside due to a number of problems. D:

The decision by Congress was accepted by local communities.

Across the Deserts

　　The SaharaDesertis the largest desert in the world. It stretches across Africa fromSenegaltoEgypt. TheSaharaDesertis an unfriendly environment. During the day it"s very hot, and at night it’s sometimes very cold. It is also difficult to find water in theSahara.

　　In 2006, Kevin Lin, Ray Zahab, and Charlie Engle decided to do something very difficult. They made the decision to run across the Sahara Desert 4,300 miles (6,920km). It seemed impossible to do, but they wanted to try. The three men liked to test themselves, and this would be a very big test.

　　On the morning of November 2, Kevin, Ray, and Charlie started their trip across theSahara. Every morning they began running at 5:00. At11 a.m. they stopped and rested until 5 p.m. Then they ran again until 9:30 in the evening. Each day they ran about 40 miles (64 km). Every day it was the same thing. They got up and ran. They listened to music on their iPods, and they ran and ran.

　　Kevin, Ray, and Charlie needed to eat a lot of food during their trip. Most people need about 2,000 calories of food each day. Kevin, Ray, and Charlie needed between 6,000 and 9,000 calories every day. That"s a lot of food! They also needed to drink a lot of water.

　　The three men had some problems on their trip, and many times they wanted to quit and go home. It was often very hot (140°F/60°C) during the day, and the heat made them sick. Their legs and feet hurt. Sometimes it was very windy, and they couldn"t see. One time they got lost. But they didn"t quit. After 111 days, Kevin, Ray; and Charlie successfully finished their trip across theSaharaDesert. They hugged each other and put their hands in the water of theRed Sea. Then they ran to a hotel to take a long shower.

　　词汇：

　　Stretch / strɛtʃ / v. 延伸，伸展

　　Calorie / "kælərɪ / n. 卡(路里)，小卡，大卡

　　Quit / kwɪt / v. 停止，放

　　注释：

Each day the men ran for approximately eight hours.

A:Right B:Wrong C:mentioned

Across the Deserts

　　The SaharaDesertis the largest desert in the world. It stretches across Africa fromSenegaltoEgypt. TheSaharaDesertis an unfriendly environment. During the day it"s very hot, and at night it’s sometimes very cold. It is also difficult to find water in theSahara.

　　In 2006, Kevin Lin, Ray Zahab, and Charlie Engle decided to do something very difficult. They made the decision to run across the Sahara Desert 4,300 miles (6,920km). It seemed impossible to do, but they wanted to try. The three men liked to test themselves, and this would be a very big test.

　　On the morning of November 2, Kevin, Ray, and Charlie started their trip across theSahara. Every morning they began running at 5:00. At11 a.m. they stopped and rested until 5 p.m. Then they ran again until 9:30 in the evening. Each day they ran about 40 miles (64 km). Every day it was the same thing. They got up and ran. They listened to music on their iPods, and they ran and ran.

　　Kevin, Ray, and Charlie needed to eat a lot of food during their trip. Most people need about 2,000 calories of food each day. Kevin, Ray, and Charlie needed between 6,000 and 9,000 calories every day. That"s a lot of food! They also needed to drink a lot of water.

　　The three men had some problems on their trip, and many times they wanted to quit and go home. It was often very hot (140°F/60°C) during the day, and the heat made them sick. Their legs and feet hurt. Sometimes it was very windy, and they couldn"t see. One time they got lost. But they didn"t quit. After 111 days, Kevin, Ray; and Charlie successfully finished their trip across theSaharaDesert. They hugged each other and put their hands in the water of theRed Sea. Then they ran to a hotel to take a long shower.

　　词汇：

　　Stretch / strɛtʃ / v. 延伸，伸展

　　Calorie / "kælərɪ / n. 卡(路里)，小卡，大卡

　　Quit / kwɪt / v. 停止，放

　　注释：

In the middle of the day: the men usually stopped running.

A:Right B:Wrong C:mentioned

Across the Deserts

　　The SaharaDesertis the largest desert in the world. It stretches across Africa fromSenegaltoEgypt. TheSaharaDesertis an unfriendly environment. During the day it"s very hot, and at night it’s sometimes very cold. It is also difficult to find water in theSahara.

　　In 2006, Kevin Lin, Ray Zahab, and Charlie Engle decided to do something very difficult. They made the decision to run across the Sahara Desert 4,300 miles (6,920km). It seemed impossible to do, but they wanted to try. The three men liked to test themselves, and this would be a very big test.

　　On the morning of November 2, Kevin, Ray, and Charlie started their trip across theSahara. Every morning they began running at 5:00. At11 a.m. they stopped and rested until 5 p.m. Then they ran again until 9:30 in the evening. Each day they ran about 40 miles (64 km). Every day it was the same thing. They got up and ran. They listened to music on their iPods, and they ran and ran.

　　Kevin, Ray, and Charlie needed to eat a lot of food during their trip. Most people need about 2,000 calories of food each day. Kevin, Ray, and Charlie needed between 6,000 and 9,000 calories every day. That"s a lot of food! They also needed to drink a lot of water.

　　The three men had some problems on their trip, and many times they wanted to quit and go home. It was often very hot (140°F/60°C) during the day, and the heat made them sick. Their legs and feet hurt. Sometimes it was very windy, and they couldn"t see. One time they got lost. But they didn"t quit. After 111 days, Kevin, Ray; and Charlie successfully finished their trip across theSaharaDesert. They hugged each other and put their hands in the water of theRed Sea. Then they ran to a hotel to take a long shower.

　　词汇：

　　Stretch / strɛtʃ / v. 延伸，伸展

　　Calorie / "kælərɪ / n. 卡(路里)，小卡，大卡

　　Quit / kwɪt / v. 停止，放

　　注释：

They sometimes felt sick because it was so hot.

A:Right B:Wrong C:mentioned

Across the Deserts

　　The SaharaDesertis the largest desert in the world. It stretches across Africa fromSenegaltoEgypt. TheSaharaDesertis an unfriendly environment. During the day it"s very hot, and at night it’s sometimes very cold. It is also difficult to find water in theSahara.

　　In 2006, Kevin Lin, Ray Zahab, and Charlie Engle decided to do something very difficult. They made the decision to run across the Sahara Desert 4,300 miles (6,920km). It seemed impossible to do, but they wanted to try. The three men liked to test themselves, and this would be a very big test.

　　On the morning of November 2, Kevin, Ray, and Charlie started their trip across theSahara. Every morning they began running at 5:00. At11 a.m. they stopped and rested until 5 p.m. Then they ran again until 9:30 in the evening. Each day they ran about 40 miles (64 km). Every day it was the same thing. They got up and ran. They listened to music on their iPods, and they ran and ran.

　　Kevin, Ray, and Charlie needed to eat a lot of food during their trip. Most people need about 2,000 calories of food each day. Kevin, Ray, and Charlie needed between 6,000 and 9,000 calories every day. That"s a lot of food! They also needed to drink a lot of water.

　　The three men had some problems on their trip, and many times they wanted to quit and go home. It was often very hot (140°F/60°C) during the day, and the heat made them sick. Their legs and feet hurt. Sometimes it was very windy, and they couldn"t see. One time they got lost. But they didn"t quit. After 111 days, Kevin, Ray; and Charlie successfully finished their trip across theSaharaDesert. They hugged each other and put their hands in the water of theRed Sea. Then they ran to a hotel to take a long shower.

　　词汇：

　　Stretch / strɛtʃ / v. 延伸，伸展

　　Calorie / "kælərɪ / n. 卡(路里)，小卡，大卡

　　Quit / kwɪt / v. 停止，放

　　注释：

On their trip across the desert: the three men ran through five countries.

A:Right B:Wrong C:mentioned