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2023年全國醫(yī)學英語水平考試（METS四級）考前沖刺試題及答案一,更多相關資訊請繼續(xù)查看易考吧全國醫(yī)護英語水平考試
1). Patients Are a Virtue■Many years ago at dental school I wrote a sketch for the hospital Christmas Revue about a lady with the first name of Patience who married a man with the surname Patient.Attempting to make an appointment in a busy department of the dental hospital she had to keep holding on the telephone and thus became Patience Patient the Patient Patient.( )■When I travel on a train or a plane I think of myself as a passenger， when I eat in a restaurant I am a diner and when I consult a health professional I am a patient.Am I old-fashioned? ( )Do the majority of those who seek our help， care and treatment on a regular basis think of themselves as patients or as consumers?■( )Thus various parties involved in dentistry have become muddled of recent times about the meaning of service in the context of dental practice.Way back in the last century we were all shocked by the contentions of certain business gurus who declared that dentists were in competition for the spending power of consumers who might instead choose foreign holidays or haircuts over dental care.The consequent tailspin resulted in acres of new carpet being laid in waiting rooms (excuse me， reception lounges) ， hundreds of pounds being spent annually on floral displays and gallery-worths of prints being nailed to practice walls to make the whole “patient journey” more palatable.■While this may have been the beginnings of treating patients more like people and less like items on a conveyer belt， it did not and should not have heralded a change in the actual dental care they received.( )the outcome remained the same； quality clinical dentistry provided by a trained and experienced professional.I am sure that the overwhelming majority of the patients of every reader of this editorial choose to return to see him or her for advice and treatment not because they are reminded of a supermarket chain， nor because they have gone to a price comparison website to discover if they are getting the best deal， but because they like and trust you.■What we each like and trust varies enormously， that is the nature of the human condition.Amongst these decisions are the supermarkets we patronise， or not.W hat makes us choose?( )Probably a combination of all these things and probably a similar process of selection as we might make in choosing， and maintaining， visits to a dentist or dental practice.■So， there is nothing wrong with choice， ( ).The key essential here is that dentists are competent and that the treatment they provide is safe and effective as dictated and guided by scientific rigor， regulation and standards as generated and applied personally， institutionally， legally and ethically.I get the feeling that there is a lack of perspective at work here.As I have written previously the current furor over the rise in complaints needs to be set against the background of the huge number of dental professionals registered and the millions of courses of treatment successfully provided in the U.K.year in， year out.We need to differentiate more carefully though.Failure to provide good clinical care is quite different from a complaint that someone in the practice“l(fā)ooked at me in a funny way.”■Patient care is something that we are individually and collectively extremely good at.( )We must be clear and vocal that this is quite different from customer care，client care， consumer care or any other type of care.Patience was under no illusion all that time ago and her care is as relevant to us today as it was then.( )
A.nor with providing a range of varied services
B.thanks to the way in which we organize our society we have the opportunity to express and exert our choices
C.Location， convenience， price， quality， our own status?
D.Part of the problem is due to a confusion between service and outcome
E.How surprised she would be in the twenty first century to learn that she was now a consumer rather than a patient
F.We are respected， frequently thanked and often commended by our patients whose trust in us is demonstrated by their loyalty over years and often decades and generations
G.While the non-clinical service showed improvement
H.Am I alone?

正確答案：E
2). (一)■Age-dependent Changes in Pancreatic Function Related to Diabetes Identified■1Age-related changes in the human pancreas govern how our bodies respond to rising and filling blood sugar levels throughout our lifetimes， and could affect whether we develop diabetes as adults.But it′s been nearly impossible to study this process in detail because human pancreatic tissue is not readily available.Instead， most researchers have relied on animal models to learn more about the development and function of the pancreas.■2 Now researchers at the Stanford University School of Medicine has made an advance in studying the human islet cells.“Studying human islet cells has been a major challenge in the field of diabetes research for decades because the pancreas essentially digests itself shortly after a person′s death，” said professor of developmental biology Seung Kim， MD， PhD.“We′ve developed a nationwide network capable of removing and studying pancreatic tissue from organ donors as young as 6 months and as old as 66 within about a day and half after death.This gave us an unprecedented opportunity to chart changes in gene expression spanning the course of a lifetime.” Kim is the senior author of the study.Postdoctoral scholar Efsun Arda， PhD， is the lead author.The study has been published in the April 28 issue of Cell Metabolism.■3In the study， Kim， Arda and their colleagues identified two proteins never before directly implicated in pancreatic function whose expression increases as a person ages.Increasing the expression of one of the proteins， SIX3， in the insulin-producing cells isolated from younger donors enhanced their ability to respond efficiently to rising glucose levels.“Pancreatic islets， which are the sites of insulin production， mature and change in their function after a baby is born，” said Kim.“We think our findings suggest that this maturation process goes on for nearly a decade.There′s been a growing realization among diabetes researchers that human islet development differs significantly from islet development in typical laboratory animals like mice.”■4Cells in the pancreatic islets called beta cells are responsible for modulating the body′s response to the rise and fall of blood glucose levels after a meal.When glucose levels rise， the beta cells release insulin to cue cells throughout the body to squirrel away the sugar for later use.Type 1 diabetes is caused by a failure to produce insulin； Type 2 diabetes is caused by combined deficits in the body to respond to and make insulin.Both types have been linked to reductions in the number of insulin-producing beta cells.Although beta cells proliferate robustly during the first decade or so of life， this proliferation slows dramatically with age.Understanding the age-related signals that cause this slowdown could one day lead to new diabetes treatments.But something more significant than the changes in cell number is also going on.Studies in rodents and in human fetal beta cells have showed that the responses of very young beta cells to increases in blood glucose are blunted when compared to their more-mature counterparts.■5 Kim and his colleagues worked for over six years to develop a multi -institutional collaboration to quickly collect pancreatic tissue and isolate and analyze islet cells from newly deceased donors.They also developed a unique cell- sorting technique to isolate islet cells from other cells in the pancreas.Once they had pure populations of cells， they compared their patterns of gene expression， as well as changes in the structure of the DNA.■6“We identified hundreds of genes that are dynamically regulated in islet beta cells during the journey from childhood to adulthood，” said Kim.“One gene，SIX3， turns on sometime around age 9.We wondered whether its expression might change the function of the beta cell.” Forcing the expression of SIX3 in beta cells obtained from children under the age of 9 improved the ability of the cells to secrete insulin in the presence of glucose， the researchers found.SIX3and a related gene， SIX2， with a similar pattern of expression in human beta cells，encode proteins known as transcription factors that control the expression of many other genes in the cell.Although they have not been implicated directly in pancreatic function， genomewide association studies have linked the presence of a mutation near： the genes to an impaired ability to properly；manage fasting blood-glucose levels.“This is a tantalizing link，” said Kim.“It appears that genes whose expression changes from childhood to adulthood may be disproportionately associated with an increased risk for diabetes.”■7 Importantly， SIX3 and SIX2 are not expressed in mouse beta cells.“This is why it is so important to study human tissue，” said Kim.“Until now there has been no way of knowing the gradual changes that happen over a period of years.”Besides， “This study is a tour de force，” said Andrew Stewart， MD， the director of the Diabetes， Obesity and Metabolism Institute at the Mount Sinai School of Medicine who is unconnected with the study.“It is very important to the field of diabetes research.”■8Kim and his colleagues are planning to continue their studies of pancreatic and islet- cell development as part of a Stanford focus on diabetes and metabolism research.The researchers also anticipate that their gene expression data and newly described islet-cell isolation technique， coupled with the ongoing tissue procurement effort， will be helpful to others studying pancreatic development and diabetes.“This is a unique and valuable resource for researchers wishing to begin to understand how gene expression is dynamically regulated in human islet cell，”said Kim.“Our study charts a new road map for researchers working to use stem cells to replace human islet cells by highlighting changes that normally occur and should perhaps be taken into consideration when analyzing cells for transplant.”■(二)■It was unlikely to study the effect of age-dependent changes in pancreatic functions on the diabetes before.Now， Stanford-led collaboration to( )and analyze human pancreatic tissue from deceased donors on a ( )level illustrates how the organ′s function changes as we age， and could point the way toward new diabetes treatments.■The researchers at the Stanford University School of Medicine have for the first time compared the patterns of gene expression in the insulin- producing cells and other cells of the pancreas from dozens of deceased donors ( )in age from 6months to 66 years.They have found significant differences in gene expression patterns and DNA( ) between donors at different ages.The findings， published on April 28 in Cell Metabolism， ( ).the importance of two genes not previously implicated directly in pancreatic function， and show that the pancreas continues to develop and ( ) during the first decade of life.They may also have implications for current clinical trials testing stem- cell-based therapies for diabetes.choose the most suitable subheading from list A-J for Paragraph 4 ( )
A.How changes in gene expression patterns affect glucose levels
B.Sorting islet cells
C.SIX3 and SIX2 identified only in humans
D.Prospects of the study
E.A great step in the study of human islet cells
F.The relationship of beta cells with two types of diabetes
G.Limitations of previous research on the pancreas
H.The significance of the study only in humans
I.A brief introduction of results of the study
J.Changes in the function of islet cells with their maturation

正確答案：J

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