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(完整版)学术英语(医学)课后问题答案--第1页
Unit1
1、Somefactorsthatmayleadtothecomplaint:
·Neuronoverload
·Patients*highexpectations
·Mistrustandmisunderstandingbetweenthepatientandthedoctor
2、’scondition:
·A56-year-oldwoman
·Somewhatoverweight
·Reasonablywell-controlleddiabetesandhypertension
·Cholesterolonthehighsidewithoutanymedicationsforit
·Notenoughexercisessheshouldtake
·HerbonesalittlethinonherlastDEXAscan
3、Goodthings:
·Bloodtestsdone
·Glucosealittlebetter
·HerbloodpressurealittlebetterbutnotsogreatBadthings:
·Cholesterolnotsogreat
·Herweightalittleup
·HerbonesalittlethinonherlastDEXAscan4
4、Thesituation:
·Theauthorwasinamoderatestateofpanic:jugglingsomanythoughtsabout
’sconditionsandtryingtoresolvethemallbeforetheclockrandown.
·,notsoimportantascomparedtoher
conditions.
·“innocent—andcompletelyjustified
—request”:theformsignedbyherdoctor.
·Thedoctortriedtooratleastpretendedtopayattentiontothepatientwhile
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completingdocumentation.
5、Similarities:
·Incomputermultitasking,amicroprocessoractuallyperformsonlyonetaskata
,wehumanbeingscarftactuallyconcentrateontwo
andhumanbeings.
Differences:
·Theconceptofmultitaskingoriginatedincomputerscience.
·Atbest,humanbeingscanjuggleonlyahandfulofthoughtsinamultitasking
manner,butcomputerscandomuchbetter.
·Themorethoughtshumanbeingsjuggle,thelesshumanbeingsareableto
attunefullytoanygiventhought,butcomputerscandomuchbetter.
6、
·7medicalissuestoconsider
·5separatethoughts,atleast,foreachissue
·7x5=35thoughts
·10patientsthatafternoon
·35x10=350thoughts
·5residentsundertheauthorssupervision
·4patientsseenbyeachresident
·10thoughts,atleast,generatedfromeachpatient
·5x4x10=anther200thoughts
·350+200=550thoughtstobehandledintotal
·Ifthedoctordoesagoodjobjuggling98%ofthetime,thatstillleavesabout10
thoughtsthatmightgetlostintheprocess.
7、Possiblesolutions:
·Computer-generatedreminders
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·Casemanagers
·Ancillaryservices
·Thesimplestsolution:time
Unit2
1、Theauthorimplies:
•Peoplesinadequateconsciousnessabouttheconsequenceofneglectingthere-
emerginginfectiousdiseases
·Unjustifiabilityofpeoplescomplacencyaboutthepreventionandcontrolofthe
infectiousdiseases
·Unfinishedwaragainstinfectiousdiseases
2、Victorydeclarations:
·SurgeonGeneralWilliamStewart'shyperbolicstatementofclosing“thebookon
infectiousdisease”.
·Astringofimpressivevictoriesincurredbyantibioticsandvaccines
·Thethoughtthatthewaragainstinfectiousdiseaseswasalmostover
Whatfollowedeversince:
·AppearanceofnewdiseasessuchasAIDSandEbola
·Comebackoftheoldafflictions:
»DiphtheriaintheformerSovietUnion
»TBinurbancenterslikeNewYorkCity
»RisingGroupAstreptococcalconditionslikescarletfever
·Thefearofapowerfulnewflustrainsweepingtheworld
3、Elaborateonthejoinedbattle:
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·WHOestablishedanewdivisiondevotedtoworldwidesurveillanceandcontrol
ofemergingdiseaseinOctober1995.
·CDClaunchedapreventionstrategyin1994.
·Congressraisedfundfrom$$26millionin1997.
4、Thebordersaremeaninglesstopathogenicmicrobes,whichcantravelfrom
onecountrytoanotherremotecountryinaveryshorttime.
5、TB:
·PrisonsandhomelesssheltersasidealplacesforTBspread
·Emergingofdrug-resistantstrainorevenmulti-drug-resistantstrain
·ArideontheHIVw^onbyattackingtheimmunocompromised
GroupAstrep:
·Achangeinvirulence
·Mutationintheexteriorofthebacterium
Flu:
Constantchangesinitscoat(surfaceantigens)andresultantchangesinitslevel
ofvirulence
6、Examples:
·ExperimentinEnglandisseeingthewaningimmunitybecauseofnovaccination.
·Duetopoorvaccinationefforts,thediphtheriasituationintheformerSoviet
Unionisserious.'
•ThevaccinationratesaredroppinginsomeAmericancities,anditwillleadto
morediphtheriaandwhoopingcough.
7、Thefourareasoffocus:
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·Theneedforsurveillance
·Updatedsciencecapableofdealingwithdiscoveriesinthefield
·Appropriatepreventionandcontrol
·Strongpublichealthinfrastructure
8、TheinfectiousdiseasessuchasTB,flu,diphtheriaandscarletfeverwillnever
reallygoaway,andthewaragainstthemwillneverend.
Unit3
1、Terry'slifebefore
·ShelovedpracticingTaeKwonDo
·Shelovedthesurgeofadrenalinethatcamewiththecontrolledcombatof
tournaments.
·Shecompetednationally,evenwonbronzemedalinthetrialsforthePan
AmericanGames.
·Sheattendedmedicalschool,practicedasaninternalmedicineresident,and
becameanacademicgeneralinternist.
·Shegotmarriedandgotasonandadaughter.
2、ThesymptomsofMSandautoimmunedisease:
·Lossofstaminaandstrength
·Problemswithbalance
·Boutsofhorrificfacialpain
·Dipsinvisualacuity
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3、Terrydidthefollowingbeforesheself-experimented:
·Shestartedinjections.
·Sheadoptedmanypharmacotherapies.
·Shebeganherownstudyofliterature:
»ShereadarticlesonwebsitessuchasPubMed.
»ShesearchedforarticlestestingnewMSdrugsinanimalmodels.
»Sheturnedtoarticlesconcerningneurodegenerationofalltypes—dementia,
Parkinson'sdisease,Huntington'sdisease,andLouGehrig'sdisease.
»Sherelearnedbasicsciencessuchascellularphysiology,biochemistry,and
neurophysiology.
4、ApproachesTerrymainlyused:
·Self-experimentationwithvariousnutrientstoslowneurodegenerationbasedon
literaturereportsonanimalmodels
·Self-experimentationwithneuromuscularelectricalstimulationwhichisnotan
approvedtreatmentforMS
·Onlinesearchtoidentifythesourcesofmicronutrientsandhavinganewdiet
·Reductionoffoodallergiesandtoxicload
5、Casesmentionedinthetext:
·Increasedmercurystoresinthebrainsofpeoplewithdentalfillings
·HighlevelsoftheherbicideatrazineinprivatewellsinIowa
·Thestrongassociationbetweenpesticideexposureandneurodegeneration
·Theassociationofsinglenucleotidepolymorphismsinvolvingmetabolismof
sulfurand/orBvitamins
·Inefficientclearingoftoxins
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6、With70%to90%oftheriskfordiabetes,heartdisease,cancer,and
autoimmunitybeingduetoenvironmentalfactorsotherthanthegenes,wecan
takemanyhealthproblemsandthehealthcarecrisisunderourcontrol,for
example,optimizingournutritionandreducingourtoxicload.
Unit4
1、Twoconcepts:
·Complementarymedicinereferstotheuseofconventionaltherapiestogetherwith
alternativetreatmentssuchasusingacupunctureinadditiontousualcaretohelp
.
·Alternativemedicinereferstohealingtreatmentsthatarenotpartofconventional
therapies—likeacupuncture,massagetherapy,
calledsobecausepeopleusedtoconsiderpracticesliketheseoutsidethe
mainstream.
2
·TCMdoesnotrequireadvanced,complicated,andinmostcases,expensive
facilities.
·TCMemploysneedles,cups,coins,tomentionbutafew.
·MostproceduresandoperationsofTCMarenoninvasive.
·Thesubstancesusedasmedicinearerawherbsorabstractsfromthem,and
theyareindeedallnatural,fromnature.
·TCMhasbeenpracticedaslongastheChinesehistory,sotheefficiencyi
s
provenandensured.
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·Ongoingresearcharoundtheworldonacupuncture,herbs,massageandTaiChi
haveshedlightonsomeofthetheoriesandpracticesofTCM
3、Itmaybeusedasanadjuncttreatment,analternative,orpartofa
comprehensivemanagementprogramforanumberofconditions:post-operative
andchemotherapyinducednauseaandvomiting,post-operativedentalpain,
addiction,strokerehabilitation,headache,menstrualcramps,tenniselbow,
fibromyalgia,myofascialpain,osteoarthritis,lowbackpain,carpaltunnel
syndrome,andasthma.
4、Awell-justifiedNO:
·Moreintenseresearchtouncoveradditionalareasfortheuseofacupuncture
·Higheradoptionofacupunctureasacommontherapeuticmodalitynotonlyin
treatmentbutalsoinpreventionofdiseaseandpromotionofwellness
·Explorationandperfectionofinnovativemethodsofacupuncturepoint
stimulationwithtechnologicaladvancement
·Improvedunderstandingofneuroscienceandotheraspectsofhuman
physiologyandfunctionbybasicresearchonacupuncture
·Greaterinterestbystakeholders
·Anincreasingnumberofphysicianacupuncturists
5、
·Appropriateusesofherbsdependonproperguidance:
»ProperTCMdiagnosisofthezhengofthepatient
»Correctselectionofthecorrespondingtherapeuticstrategiesandprinciples
thatguidethechoiceofherbsandherbalformulas
·Digressionfromeitheroftheaboveguidencewillleadtomisusesofherbs,and
willresultincomplicationsinpatient
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6、
·Randomizedcontrolledtrials
Advantages:
»Eliminationofthepotentialbiasintheallocationofparticipantstothe
interventiongrouporcontrolgroup
»Tendencytoproducecomparablegroups
»Guaranteedvalidityofstatisticaltestsofsignificance
Limitations:
»Difficultyingeneralizingtheresultsobtainedfromtheselectedsamplingtothe
populationasawhole
»Apoorchoiceforresearchwheretemporalfactorsarean
issue
»Extremelyheavyresources,requiringverylargesample
groups
•Quasi-experiments
Advantages:
»Controlgroupcomparisonspossible
»Reducedthreatstoexternalvalidityasnaturalenvironmentsdonot
sufferthesameproblemsofartificialityascomparedtoawell-controlled
laboratorysetting.
»Generalizationsofthefindingstobemadeaboutpopulationsince
quasiexperimentsarenaturalexperiments
Limitations:
»Potentialfornon-equivalentgroupsasquasi-experimentaldesignsdo
notuserandomsamplinginconstructingexperimentalandcontrol
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groups.
»Potentialforlowinternalvalidityasaresultofnotusingrandomsampling
methodstoconstructtheexperimentalandcontrolgroups
•Cohortstudies
Advantages:
»Clearindicationofthetemporalsequencebetweenexposureand
outcome
»Particularuseforevaluatingtheeffectsofrareorunusualexposure
»Abilitytoexaminemultipleoutcomesofasingleriskfactor
Limitations:
»Larger,longer,andmoreexpensive
»Pronetocertaintypesofbias
»Notpracticalforrareoutcomes
•Case-controlstudies
Advantages:
»Theonlyfeasiblemethodinthecaseofrarediseasesandthosewithlong
periodsbetweenexposureandoutcome
»Timeandcosteffectivewithrelativelyfewersubjectsascomparedtoother
observationalmethods
Limitations:
»Unabletoprovidethesamelevelofevidenceasrandomizedcontrolledtrials
asitisobservationalinnature
»Difficulttoestablishthetimelineofexposuretodiseaseoutcome
•“N=1”trials
Advantages
»Easytomanage
»Inexpensive
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Limitations:
»Findingsdifficulttobegeneralizedtothewholepopulation
»Weakestevidenceduetothenumberofthesubject
7、
•Synthesisofevidenceiscompletelydependenton:
»Thecompletenessoftheliteraturesearch(unavailableforforeignstudies)
»Theaccuracyofevaluation
·Therearesituationsinwhichnoanswercanbefoundforthequestionsof
interestinRCTsanddatabaseanalyses.
·There'stherequirementofusinglessstringentinformationratherthan“hard
data”
8、
·Assessmentoftheintrinsicvalueoftraditionalmedicineinsociety
·Researchandeducation
·Political,economic,andsocialfactors
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Unit5
1、
·Dis-easereferstotheimbalancearisingfrom:
»Continuousstress
»Pain
»Hardships
·Diseaseisahealthcrisisascribabletovariousdis-eases.
·Promptingeliminationofdis-easescanallevi