學(xué)術(shù)英語（醫(yī)學(xué)）課后問題答案

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Unit1

1、Somefactorsthatmayleadtothecomplaint:

·Neuronoverload

·Patients*highexpectations

·Mistrustandmisunderstandingbetweenthepatientandthedoctor

2、Mrs.Osorio’cosndition:

·A56-year-oldwoman

·Somewhatoverweight

·Reasonablywell-controlleddiabetesandhypertension

·Cholesterolonthehighsidewithoutanymedicationsforit

·Notenoughexercisessheshouldtake

·HerbonesalittlethinonherlastDEXAscan

3、Goodthings:

·Bloodtestsdone

·Glucosealittlebetter

·HerbloodpressurealittlebetterbutnotsogreatBadthings:

·Cholesterolnotsogreat

·Herweightalittleup

·HerbonesalittlethinonherlastDEXAscan4

4、Thesituation:

·Theauthorwasinamoderatestateofpanic:jugglingsomanythoughtsabout

Mrs.Osorio’sconditionsandtryingtoresolvethemallbeforetheclockrandown.

·Mrs.Osoriomadeatrivialrequest,notsoimportantascomparedtoher

conditions.

·Mrs.Osorioseemedtocareonlyabouther“innocentan—dcompletelyjustified

—request”：theformsignedbyherdoctor.

·Thedoctortriedtooratleastpretendedtopayattentiontothepatientwhile

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completingdocumentation.

5Similarities:

Incomputermultitasking,amicroprocessoractuallyperformsonlyonetaskata

time.Likemicroprocessors,wehumanbeingscarftactuallyconcentrateontwo

thoughtsatthesameexacttime.Multitaskingisjustanillusionbothincomputers

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.

7Possiblesolutions:

Computer-generatedreminders

2

Casemanagers

Ancillaryservices

Thesimplestsolution:time

Unit2

1Theauthorimplies:

Peoplesinadequateconsciousnessabouttheconsequenceofneglectingthere

emerginginfectiousdiseases

-

Unjustifiabilityofpeoplescomplacencyaboutthepreventionandcontrolofthe

infectiousdiseases

Unfinishedwaragainstinfectiousdiseases

2Victorydeclarations:

SurgeonGeneralWilliamStewart'shyperbolicstatementofclosing

infectiousdisease.

thebookon

Astringofimpressivevictoriesincurredbyantibioticsandvaccines

Thethoughtthatthewaragainstinfectiousdiseaseswasalmostover

Whatfollowedeversince:

AppearanceofnewdiseasessuchasAIDSandEbola

Comebackoftheoldafflictions:

DiphtheriaintheformerSovietUnion

TBinurbancenterslikeNewYorkCity

RisingGroupAstreptococcalconditionslikescarletfever

Thefearofapowerfulnewflustrainsweepingtheworld

3Elaborateonthejoinedbattle:

3

WHOestablishedanewdivisiondevotedtoworldwidesurveillanceandcontrol

ofemergingdiseaseinOctober1995.

CDClaunchedapreventionstrategyin1994.

Congressraisedfundfrom$6.7millionin1995to$26millionin1997.

4Thebordersaremeaninglesstopathogenicmicrobes,whichcantravelfrom

onecountrytoanotherremotecountryinaveryshorttime.

5TB:

PrisonsandhomelesssheltersasidealplacesforTBspread

Emergingofdrug-resistantstrainorevenmulti-drug-resistantstrain

ArideontheHIVw^onbyattackingtheimmunocompromised

GroupAstrep:

Achangeinvirulence

Mutationintheexteriorofthebacterium

Flu:

Constantchangesinitscoat(surfaceantigens)andresultantchangesinitslevel

ofvirulence

6Examples:

ExperimentinEnglandisseeingthewaningimmunitybecauseofnovaccination.

Duetopoorvaccinationefforts,thediphtheriasituationintheformerSoviet

Unionisserious.

'

ThevaccinationratesaredroppinginsomeAmericancities,anditwillleadto

morediphtheriaandwhoopingcough.

7Thefourareasoffocus:

4

Theneedforsurveillance

Updatedsciencecapableofdealingwithdiscoveriesinthefield

Appropriatepreventionandcontrol

Strongpublichealthinfrastructure

8TheinfectiousdiseasessuchasTB,flu,diphtheriaandscarletfeverwillnever

reallygoaway,andthewaragainstthemwillneverend.

Unit3

1Terry'slifebefore

ShelovedpracticingTaeKwonDo

Shelovedthesurgeofadrenalinethatcamewiththecontrolledcombatof

tournaments.

Shecompetednationally,evenwonbronzemedalinthetrialsforthePan

AmericanGames.

Sheattendedmedicalschool,practicedasaninternalmedicineresident,and

becameanacademicgeneralinternist.

Shegotmarriedandgotasonandadaughter.

2ThesymptomsofMSandautoimmunedisease:

Lossofstaminaandstrength

Problemswithbalance

Boutsofhorrificfacialpain

Dipsinvisualacuity

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3Terrydidthefollowingbeforesheself-experimented:

Shestartedinjections.

Sheadoptedmanypharmacotherapies.

Shebeganherownstudyofliterature:

ShereadarticlesonwebsitessuchasPubMed.

ShesearchedforarticlestestingnewMSdrugsinanimalmodels.

Sheturnedtoarticlesconcerningneurodegenerationofalltypes

Parkinson'sdisease,Huntington'sdisease,andLouGehrig'sdisease.

dementia

Sherelearnedbasicsciencessuchascellularphysiology,biochemistry,and

neurophysiology.

4ApproachesTerrymainlyused:

Self-experimentationwithvariousnutrientstoslowneurodegenerationbasedon

literaturereportsonanimalmodels

Self-experimentationwithneuromuscularelectricalstimulationwhichisnotan

approvedtreatmentforMS

Onlinesearchtoidentifythesourcesofmicronutrientsandhavinganewdiet

Reductionoffoodallergiesandtoxicload

5Casesmentionedinthetext:

Increasedmercurystoresinthebrainsofpeoplewithdentalfillings

HighlevelsoftheherbicideatrazineinprivatewellsinIowa

Thestrongassociationbetweenpesticideexposureandneurodegeneration

Theassociationofsinglenucleotidepolymorphismsinvolvingmetabolismof

sulfurand/orBvitamins

Inefficientclearingoftoxins

6

6With70%to90%oftheriskfordiabetes,heartdisease,cancer,and

autoimmunitybeingduetoenvironmentalfactorsotherthanthegenes,wecan

takemanyhealthproblemsandthehealthcarecrisisunderourcontrol,for

example,optimizingournutritionandreducingourtoxicload.

Unit4

1Twoconcepts:

Complementarymedicinereferstotheuseofconventionaltherapiestogetherwith

alternativetreatmentssuchasusingacupunctureinadditiontousualcaretohelp

lessenpain.ComplementaryandalternativemedicineisshortenedasCAM.

Alternativemedicinereferstohealingtreatmentsthatarenotpartofconventional

therapieslikeacupuncture,massagetherapy,orherbalmedicine.Theyare

calledsobecausepeopleusedtoconsiderpracticesliketheseoutsidethe

mainstream.

2

TCMdoesnotrequireadvanced,complicated,andinmostcases,expensive

facilities.

TCMemploysneedles,cups,coins,tomentionbutafew.

MostproceduresandoperationsofTCMarenoninvasive.

Thesubstancesusedasmedicinearerawherbsorabstractsfromthem,and

theyareindeedallnatural,fromnature.

TCMhasbeenpracticedaslongastheChinesehistory,sotheefficiencyis

provenandensured.

7

Ongoingresearcharoundtheworldonacupuncture,herbs,massageandTaiChi

haveshedlightonsomeofthetheoriesandpracticesofTCM

3Itmaybeusedasanadjuncttreatment,analternative,orpartofa

comprehensivemanagementprogramforanumberofconditions:post-operative

andchemotherapyinducednauseaandvomiting,post-operativedentalpain,

addiction,strokerehabilitation,headache,menstrualcramps,tenniselbow,

fibromyalgia,myofascialpain,osteoarthritis,lowbackpain,carpaltunnel

syndrome,andasthma.

4Awell-justifiedNO:

Moreintenseresearchtouncoveradditionalareasfortheuseofacupuncture

Higheradoptionofacupunctureasacommontherapeuticmodalitynotonlyin

treatmentbutalsoinpreventionofdiseaseandpromotionofwellness

Explorationandperfectionofinnovativemethodsofacupuncturepoint

stimulationwithtechnologicaladvancement

Improvedunderstandingofneuroscienceandotheraspectsofhuman

physiologyandfunctionbybasicresearchonacupuncture

Greaterinterestbystakeholders

Anincreasingnumberofphysicianacupuncturists

5

Appropriateusesofherbsdependonproperguidance:

ProperTCMdiagnosisofthezhengofthepatient

Correctselectionofthecorrespondingtherapeuticstrategiesandprinciples

thatguidethechoiceofherbsandherbalformulas

Digressionfromeitheroftheaboveguidencewillleadtomisusesofherbs,and

willresultincomplicationsinpatient

8

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=1trials

Advantages

Easytomanage

Inexpensive

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Limitations

Findingsdifficulttobegeneralizedtothewholepopulation

Weakestevidenceduetothenumberofthesubject

7

Synthesisofevidenceiscompletelydependenton:

Thecompletenessoftheliteraturesearch(unavailableforforeignstudies)

Theaccuracyofevaluation

Therearesituationsinwhichnoanswercanbefoundforthequestionsof

interestinRCTsanddatabaseanalyses.

There'stherequirementofusinglessstringentinformationratherthanhard

data

8

Assessmentoftheintrinsicvalueoftraditionalmedicineinsociety

Researchandeducation

Political,economic,andsocialfactors

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Unit5

1

Dis-easereferstotheimbalancearisingfrom

Continuousstress

Pain

Hardships

Diseaseisahealthcrisisascribabletovariousdis-eases.

Promptingeliminationofdis-easescanalleviatesomediseases.

2

Wellnessisastateinvolvingeveryaspectofourbeing:body,mindandspirit.

Manifestationsofahealthyperson:

Energyandvitality

Acertainzipingait

Awarmfeelingofpeaceofheartseenthroughbehavior

3

Constantmessages,positiveandnegativearesenttoourmindaboutthe

healthofourbody.

Physicalsymptomsaresuppressedbypeoplewhogothroughlifeonautomatic

pilot.

Beingwellequalstobeingdisease-orillness-freeinthemindsofthem.

Theyconfusedwellnesswithanabsenceofsymptoms.

4

People'smindsareinfectedbyspin:

Half-truth

Fearfulfictions

Blatantdeceit:someasaformofself-deceit

Spinisaresultofunconsciousliving.

12

Thekindoffalsenessispandemic.

5

Ourbodyintelligenceissuppressedordormantfromalackofuse.

Therearetremendousamountofstressonadailybasis.

Ourbodiesareeasilyignoredforyearsbecauseofalackofrecreationtime.

Limiting,self-defeatingandevenself-destructivebehaviorsundermineour

wellbeingandkeepthemfromachievingourfullpotential.

6

Wegrowmorereluctanttotakerisks.

Welosetheabilitytofeelandacknowledgeourdeepestfeelingsandthe

couragetospeakourtruth.

Wecontinuetodenyandrepressourfeelingstoprotectourselves.

Fear,denialanddisconnectionfromourbodiesandfeelingsbecomean

unconscious,self-protectivehabit,akindofdefaultresponsetolife.

7

Amulti-facetedprocess:

Lookingforrootsofandresolutionsfortheissuesindifferentdimensions

Buildingourwellnesstoolboxslowly

Picturingourwholestateofbeing

Attentiontothelittlestuff:

Examiningourliveshonestlyandsettingclearintentionstochange

Strivingtomaintainabalanceofourmind,bodyandspirit

Takingsmallstepsinthewaytoperceiveandresolveconflict

8

Trytoawakenandevolveinordertolivemoreconsciously.

Getintouchwithourgenuinefeelingsandemotions.

Cometotermswiththetoxicemotions

13

Unit6

1Inthepast,mostpeoplediedathome.Butnow,moreandmorepeoplearecared

inhospitalsandnursinghomesattheirendoflife,whichofcoursebringsanew

setofquestionstoconsider.

2

Sixty-fouryearsoldwithahistoryofcongestiveheartfailure

Decidingtodoeverythingmedicallypossibletoextendhislife

Availabilityofaround-the-clockmedicalservicesandafullrangeoftreatment

choices,tests,andothermedicalcare

Relaxedvisitinghours,andpersonalitemsfromhome

3Availabilityofaround-the-clockmedicalresources,includingdoctors,nurses,and

facility.

4

Takingonajobwhichisbigphysically,emotionally,andfinancially

Hiringahomenurseforadditionalhelp

Arrangingforservices(suchasvisitingnurses)andspecialequipment(likea

hospitalbedorbedsidecommode)

5

Healthinsurance

Planningbyaprofessional,suchasahospitaldischargeplaimerorasocial

worker

Helpfromlocalgovernmentalagencies

Doctor'ssupervisionathome

6

Traditionally,itisonlyaboutsymptomcare.

Recently,itisacomprehensiveapproachtoimprovingthequalityoflifefor

peoplewhoarelivingwithpotentiallyfataldiseases.

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7

Stoppingtreatmentspecificallyaimedatcuringanillnessequalsdiscontinuingall

treatment.

Choosingahospiceisapermanentdecision.

Unit7

1

Adyingpatient

Decisionwhethertowithdrawlife-supportmachinesandmedicationandstart

comfortmeasures

Thefamily'srefusaltomakeanydecisionorwithdrawanytreatments

2

Thedoctorasexclusivedecision-maker

Thepatientasparticipantwithlittlesayinthefinalchoice

3

4

Respectforthepatient,especiallythepatientsautonomy

Patient-centeredcare

Thepatientasdecision-makerbasedontheinformationprovidedbythedoctor

Patientsareforcedtomakedecisionstheyneverwantto.

Patients,atleastalargemajorityofthem,prefertheirdoctorstomakefinal

decisions.

Shiftingresponsibilityofdecision-makingtopatientswillbringaboutmorestress

topatientsandtheirfamilies,especiallywhenthebestoptionforthepatientis

uncertain.

15

5Doctorsareverymuchcautiousaboutcommittingsomekindofethical

transgression.

6

Shoulderingresponsibilitytogetherwiththepatientmaybebetterthanhaving

thepatientmakedecisionsontheirown.

Balancingbetweenpaternalismandrespectforpatientsautonomyconstitutesa

largepartofmedicalpractice.

Unit8

1

Research:

Anactivitytotesthypothesis,topermitconclusionstobedrawn,andtherebyto

developorcontributetogeneralizableknowledge

Practice:

Interventionssolelytoenhancethewell-beingofanindividualpatientorclien