1、专业英语八级(健康类阅读理解)模拟试卷 1及答案与解析 0 Older men considering robotic surgery for prostate cancer shouldnt trust the rosy ads promoting the expensive technology over low-tech surgery. Thats according to a new survey that found complaints about sexual problems and urinary leakage were equally common after the
2、two procedures. “I wasnt surprised at all,“ said Dr. Otis Brawley, chief medical officer of the American Cancer Society, who wasnt involved in the study. “Unfortunately, robotic prostatectomy like many things in prostate cancer has gotten a lot more hype than it should.“ Robotic prostatectomy has ca
3、ught on rapidly in the U.S., despite the fact that there is no good evidence to show its better than traditional prostate removal. It is, however, much more costly, adding some $2,000 in hospital costs per procedure. The new study, published in the Journal of Clinical Oncology, is based on responses
4、 from more than 600 prostate cancer patients on Medicare, the governments health insurance for the elderly. About 400 of them had so-called robotic-assisted laparoscopic prostatectomy, in which the surgeon uses a robot to access the prostate through multiple small holes in the belly. The rest of the
5、 patients had traditional open surgery, in which the prostate is removed through one long cut in the belly. Nearly nine out often men had a moderate or big problem with sexual functioning 14 months after their surgery, Dr. Michael Barry of Massachusetts General Hospital in Boston and colleagues foun
6、d. And about a third of the men said they had incontinence trouble after their surgery. Overall, there were no differences between the two patient groups, although urinary problems appeared to be slightly more common after the robot procedure. An editorial in the journal called the findings “soberin
7、g,“ but added that its hard to compare the two procedures directly based on the new data. Its possible, for instance, that men with high hopes for the robot procedure would be extra bothered by side effects afterward. “The problem that is revealed in this paper is this question of expectations,“ sai
8、d Dr. Matthew Cooper-berg, a urologist who co-wrote the editorial. “There is a known issue of regret related to robotic surgery.“ Part of the problem is heavy promotion, he told Reuters Health, which has catapulted robot surgery to its current status. Out of the tens of thousands prostate removals d
9、one annually in the US, some 85 percent are estimated to be robotic. “To an extent its the manufacturer, to an extent its surgeons, to an extent its a culture that tends to put great faith in technology, even when the patient doesnt understand it,“ said Cooper-berg, of the University of California,
10、San Francisco. “The robot is impressive technology, allowing the surgeon to sit at a console and direct a camera and two or three laparoscopic arms with six degrees of wristed motion for cutting, retracting, cauterizing, or suturing all with high magnification and three-dimensional visualization,“ C
11、ooperberg and his colleagues write. The robots, which cost a couple of million dollars each, do have some advantages. For instance, they reduce blood loss, which helps surgeons see better when operating. But Cooperberg, who uses the technology himself, readily acknowledges that it probably doesnt tr
12、eat cancer any better than the old surgery and doesnt have proven benefit in terms of side effects. He said patients considering surgery should look for experienced surgeons rather than focus on technology. “At the end of the day, these operations should only be done by surgeon who can demonstrate t
13、hey have good outcomes,“ Cooperberg told Reuters Health. “The patients should be asking the question, Dr. Jones, What are your personal outcomes?“ he added. “If a surgeon cant answer that question, I would suggest that patients look elsewhere.“ Brawley agreed. “I would not be afraid to go interview
14、doctors,“ he said. “Go with your gut feeling about who you trust. Realize that every doctor you interview is going to try to make themselves look good.“ But he added that many people with early-stage prostate cancer might not need treatment at all. One study found that more than 120,000 American men
15、 diagnosed with prostate cancer every year are ideal candidates for observation, or watchful waiting. Still, the majority of them end up having surgery, radiation or other treatment instead. “For a man who chooses to be aggressively treated I use that study to say, you have time to sit down and rati
16、onally choose what procedure to use,“ Brawley told Reuters Health. From Reuters, January 6, 2012 1 We can infer from the passage that_. ( A) robotic surgery is no more expensive than low-tech surgery ( B) both kinds of surgeries have sexual problems and urinary leakage ( C) robotic surgery is better
17、 than traditional one ( D) all the ads about robot prostatectomy are untruthful 2 Which of the following statements about robotic-assisted prostatectomy or its effect is TRUE? ( A) A robot itself did surgery on the prostate. ( B) Nine men had a moderate or big problem with sexual functioning 14 mont
18、hs after their surgery. ( C) About a third of men said they had urinary leakage trouble after their surgery. ( D) Patients appeared to have urinary problems after the robotic surgery instead of traditional surgery. 3 According to Cooperberg, many factors may have helped promote robot surgery to its
19、current EXCEPT_. ( A) patients common sense ( B) manufacturers ( C) surgeons ( D) great faith in technology 4 Patients who are considering surgery should focus their attention on_. ( A) surgery ( B) surgeons ( C) rosy ads ( D) responses from prostate cancer patients 5 The authors attitude towards ro
20、bot prostatectomy is_. ( A) subjective ( B) indifferent ( C) ambiguous ( D) objective 5 Seven years ago I stood on a bridge over the M40 doing a “piece to camera“ for a report about spinal repair. The aim was to come up with a metaphor for how researchers at University College London were trying to
21、overcome spinal cord paralysis. It went something like this: “Imagine your spinal cord as a motorway, the cars travelling up and down are the nerve fibres carrying messages from your brain to all parts of the body. If this gets damaged the cars cant travel. The messages are blocked, the patient is p
22、aralysed. Normally there is no way of repairing a severed spinal cord. But the team at UCL took nasal stem cells, and implanted them into the area of damage. These formed a bridge, along which the nerve fibres re-grew and re-connected. The research at the Spinal Repair Unit at UCL involved rats, not
23、 humans. In my TV report we showed rats unable to climb a metal ladder after one of their front paws had been paralysed to mimic a spinal cord injury. But after an injection of stem cells, the rats were able to move nearly as well as uninjured animals. The hope then and now is that such animal exper
24、iments will translate into similar breakthroughs with patients. Seven years on and the team at UCL led by Professor Geoff Raisman are still working on translating this into a proven therapy for patients. He told me “this is difficult and complex work and we want to ensure we get things right.“ So it
25、 was with a sense of caution that I approached some Swiss research in the latest edition of the journal Science in which paralysed rats were able to walk again after a combination of electrical-chemical stimulation and rehabilitation training. The research prompted some newspaper reports talking of
26、“new hope“ for paralysed patients. The lead researcher, Professor Gregoire Courtine enthused: “This is the World-Cup of neuro-reha-bilitation. Our rats have become athletes when just weeks before they were completely paralysed.“ A brief summary of the research is this: the team at the Federal Instit
27、ute of Technology (FIT) in Lausanne injected chemicals into the paralysed rats aimed at stimulating neurons that control lower body movement. Shortly after the injection their spinal cords were stimulated with electrodes. The rats were placed in a harness on a treadmill which gave them the impressio
28、n of having a working spinal column and they were encouraged to walk towards the end of a platform where a chocolate reward was waiting. Over time the animals learned to walk and even run again. The major question is this: What does this mean for humans who are paralysed? Prof. Courtine said he was
29、optimistic patient trials would begin in “a year or two“ at Balgrist University Hospital Spinal Cord Injury Centre in Zurich. Other scientists gave a mixed response to the findings. Dr Elizabeth Bradbury, Medical Research Council Senior Fellow, Kings College London, described the Swiss experiments a
30、s “elegant“ and “ground-breaking“. But she said questions remained before its usefulness in humans could be determined. She said: “Firstly, will this approach work in contusion/compression type injuries? These injuries involve blunt trauma, bruising and compression of the spinal cord and are the mos
31、t common form of human spinal cord injury. Very few human spinal cord injuries occur as a result of a direct cut through spinal tissue (as was the injury model in the Courtine study). “Secondly, will this technique work in chronic (long-term) spinal injuries? It is not yet known whether it is possib
32、le to generate extensive neuroplasticity in a system that has been injured for a long time and now contains many more complications such as abundant scar tissue, large holes in the spinal cord and where many spinal nerve cells and long range nerve fibres have died or degenerated.“ That term “neuropl
33、asticity“ is crucial. It refers to the ability of the brain and spinal cord to adapt and recover from moderate injury something which researchers have been trying to exploit for years. Prof. Raisman of UCL said few people, even doctors, were aware that around half of all patients who become paralyse
34、d will walk again no matter what treatment they have. He questioned whether the improvements in the paralysed rats might in part be due to spontaneous recovery neuroplasticity rather than the combination of interventions. Prof. Raisman is now conducting trials with paralysed patients in Poland, who
35、are all at least 18 months post-injury which removes any doubt that spontaneous repair may be the cause of any improvement. From BBC, June 1,2012 6 Which of the following statements about spinal cord is TRUE? ( A) The cars travel up and down on spinal cord. ( B) Spinal cord carries messages from one
36、s brain to all parts of the body. ( C) When the spinal cord gets damaged, the patient will become paralysed. ( D) When severed, the spinal cord is impossible to be repaired. 7 According to Professor Geoff Raisman, a therapy for paralyzed patients is_. ( A) proven ( B) difficult and complex ( C) ques
37、tionable ( D) reliable 8 Prof. Courtines attitude towards the Swiss experiments is_. ( A) optimistic ( B) doubtful ( C) ambiguous ( D) critical 9 We can infer from the passage that_. ( A) this technique definitely works in long-term spinal injuries ( B) contusion/compression type injuries involve bl
38、unt trauma, bruising and compression of the spinal cord ( C) many spinal nerve cells and long range nerve fibres have died or degenerated in the spinal cord ( D) the trials conducted by Prof. Raisman may prove that the improvements are not due to spontaneous repair 9 Independent drugstores are raisi
39、ng questions about the states effort to save tens of millions of dollars by rolling pharmacies into Medicaid managed care. Not long after the state rolled pharmacies into Medicaid managed care in March an effort to save tens of millions of dollars a year Ronald Barrett noticed something unusual at h
40、is store, Oak Cliff Pharmacy in southern Dallas. When he entered a childs prescription into his computer to see how much he would be reimbursed by CVS Caremark, the managed care plans pharmacy benefit manager, he got an error message. A phone call indicated that the prescription had already been fil
41、led, at a CVS pharmacy down the road. “I asked the childs mother, Did you have the prescriptions sent over there? And she said, No, I dont even go over there, “ said Mr. Barrett, most of whose customers are covered by Medicaid, the state and federal health plan for the disabled and poor.“We called t
42、he prescriber, and they said they didnt know how they got over there either.“ Another pharmacist, in Harlingen, received a fax from a health plan managed by CVS Caremark rejecting a claim for diabetic test strips with the message, “Please route patient to a CVS pharmacy.“ Such stories have fueled su
43、spicions among independent pharmacies that CVS Caremark is capitalizing on Medicaid changes to expand its retail business at the expense of locally owned pharmacies. CVS Caremark, which this spring became one of seven pharmacy benefit managers handling Medicaid recipients claims, said that its rates
44、 are competitive and there is a firm barrier between its benefit management program and CVS retail pharmacies. The transition to managed care this spring was bumpy, with numerous computer errors and miscommunications between the State Health and Human Services Commission, pharmacists and the pharmac
45、y benefit managers. Although the state said that the program has become more stable and that the health plans quickly resolved the problems, many independent pharmacists particularly those who serve a high volume of Medicaid patients are still upset. They say the drastically reduced reimbursement ra
46、tes set by the managed care plans to save the state money are forcing them out of business. “I cant pay my employees; I cant pay my light bill,“ said Mr. Barrett, who estimated that the overhaul decreased his revenue by 65 percent. He is currently living on his savings, he said. “I have no earthly i
47、dea why the Legislature thinks that this is acceptable.“ Texas lawmakers, who expect to save $100 million in the 2012 13 biennium by including prescription drugs in managed care, have held hearings to address pharmacists concerns. The Health and Human Services Commission is conducting an audit to ev
48、aluate the reimbursement rates. Under the old Medicaid system, the rates were the same statewide. Now, pharmacists sign managed-care contracts agreeing to accept the “maximum allowable cost“ reimbursement for medications, as determined by the health plans pharmacy benefit manager. Because the rates
49、are proprietary information and are not subject to open-records laws, pharmacists do not know before signing a contract how much a health plan will reimburse or how its rates compare with those of other plans before signing a contract. Stephanie Goodman, a spokeswoman for the commission, said that the decrease in reimbursement rates is “very much in line“ with what the agency expected, and that it is the same for independent and chain pharmacies. The average dispensing fee paid to pharmacists for Medica
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