单选题Some problems can be readily identified simply by looking around. These problems concern the pollution of our environment by technology as a result of sudden upsets in the physical, economic and social balance. The most obvious of these are the general pollution of our physical environment and the destruction of irreplaceable natural resources. Not so obvious as these, but just as painfully significant to some, are the disappearing and changing of jobs which overnight often create large groups of jobless citizens. Can technology be used to undo what it has done, replace what it has destroyed or substitute for what it has caused to disappear? No one knows. Many wonder whether or not all of the sources of pollution have yet been identified, whether or not they are being arrested and whether or not they will be prevented from recurring. Another set of problems relates to what technological advancement has done to the quality of life. An improved social life has not been unfortunately, either the goal or the chief beneficiary of technological change. Rather, any improvements that have occurred have been more accidental than intended. Too much has happened too fast. The changes demanded of marriage and family relationships remain largely unexamined. It is often a matter of " put up or shut up " , and a person has to a-dapt his life-style to ever-changing conditions with little time for choice. The "no-move-no-advancement" type is an example of one such problem. Many people are coming to think that the reward is simply not worthy the struggle, and they are taking jobs with less responsibility and lower pay.

单选题Cardiologists have pioneered the world's first non-surgical bypass operation to turn a vein into an artery using a new technique to divert blood flow in a man with severe heart disease. The keyhole procedure, which avoids the extensive invasive surgery of a conventional bypass, will offer hope to ten of thousands of people at risk from heart attacks. Coronary heart disease, where the arteries are progressively silted up with fatty deposits, is responsible in a major industrial country like Britain for more than 160, 000 deaths each year. Although major heart surgery is becoming commonplace, with more than 28, 000 bypass operations in the UK annually, it is traumatic for patients and involves a long recovery period. The new technique was carried out by an international team of doctors who performed the non-invasive surgery on a 53-year-old German patient. According to a special report in Circulation, journal of the American Heart Association, cardiologists developed a special catheter which was inserted into one of his leg arteries, threaded up through the aorta to the top of the diseased artery, which was the only part still open and receiving blood. Then, guided by ultrasound, a physician pushed a needle from inside the catheter through the artery wall and into the adjacent vein. A thin, flexible wire was threaded through the needle and the needle and catheter were withdrawn, leaving the wire behind and a small angioplasty balloon, which was used to widen the cannel. Finally, the vein was blocked of just above the new channel allowing blood from the artery to be re-routed down the vein. After the procedure, the vein effectively became an artery, carrying blood in the reverse direction from the previous way, and feeding the starved heart tissue with oxygen. Dr. Stephen Oesterle, who led the team, said: "This milestone marks the first coronary artery bypass performed with a catheter. The technology offers a realistic hope for truly minimally invasive bypass procedures in the future. One of the most invasive things you can do in medicine is coronary artery bypass surgery. Our ultimate goal is to replace traditional coronary artery bypass with a procedure that does not require surgery. " Dr. Oesterle is director of cardiology at Massachusetts General Hospital and associated professor of medicine at Harvard Medical School in Boston, Melanie Raddon, cardia nurse at the British Heart Foundation, said it was likely to be many years before the procedure was routinely used in hospitals.

单选题When I was first diagnosed as diabetic in 1962, it was almost impossible for a diabetic on insulin to get life insurance, except at the most abnormal, penal rates. Today, we can obtain insurance at almost normal premiums, even though insurance companies are not in the habit of throwing their money away! They can see the improvement. Today we, the diabetic community, feel more in control and know that we can have a normal life. We can fit our diabetes into our lives and not fit our lives into the diabetes. This tremendous achievement is one result of the improved health technologies which are of benefit to all. Glucose test strips are simple and inexpensive, yet to me they are the elixir of life. Because thanks to them I can monitor my own blood sugar, and I can vary my diet and dietary requirements accordingly. This is why, to the diabetic on insulin, the availability of blood glucose monitoring equipment has been almost as important as the discovery of insulin. We know what the unavailability of such basic equipment may mean in terms of quality of life. I was very fortunate to be able to visit Romania immediately after the 1989 revolution to see for myself the problems there. Although they had excellent, dedicated doctors and health workers, I was horrified to see the number of patients who had suffered amputations, who were blind, who suffered other complications from diabetes and who clearly were no longer able to perform a useful job or enjoy a full and happy life-style. How can this be today? Those who are governing us should be asking this question themselves. 1 refer not only to people from central and eastern Europe, but also to those from sophisticated "Western" economies. I understand that in one of the latter countries(perhaps the most sophisticated and the wealthiest)there is a problem in obtaining free distribution of glucose strips because the health insurance companies say they are too expensive. Too expensive to whom is the right question to ask. Improved and affordable health procedures can work wonders everywhere, and there is still a lot to do if we want this simple fact to be acknowledged.

单选题The more medical science discovers about the complex interplay between nature and nurture, genetics and environment, the larger the role family history appears to play in disease. Last month's announcement that most of the 30, 000-plus genes in the human genome had been identified is likely to prompt a better understanding of family-related illness and new gene-based treatments. But until such treatments are available, people with a family history of certain diseases need to be watchful. They also need to remember that for most diseases, family history is not destiny. If you have what's known as a first-degree relative — a parent or sibling — who has been diagnosed with an illness, say, cancer, then your risk of developing the same illness rises. Having two affected first-degree relatives, or family members across generations — your mother and your grandmother — increases your risk further. "If the illness is occurring in multiple, close relatives, at younger ages than is typical for that disease, and over more than one generation, you have a truly problematic family history, says Robin Bennett of the Medical Genetics Clinic at the University of Washington Medical Center. In families afflicted with certain inherited disorders such as sickle cell anemia and cystic fibrosis, genes alone seem to determine who gets sick. But for most people, family history, lifestyle, and environment all influence which illnesses they develop, and at what age. Even if you have strong family history of, say, breast cancer, heart disease, or diabetes, taking advantage of the proven screening tests and treatments and changing your lifestyle may tip the odds back in your favor. Nearly everyone faces some kind of genetic risk. By comparing the health histories of twins with same genetic makeup, scientists have estimated the contribution genes make to trait like weight, cholesterol level, and blood pressure. Kenneth Kendler, a professor of psychiatry and genetics at the medical College of Virginia, has found that genes contribute heavily to some mental disorders, too. "We're pretty sure that with schizophrenia and bipolar disorders, 70 or 80 percent is inherited. Alcohol and drug dependence, 50 to 60 percent. Depression, 35 to 40 percent, . " Even so, he adds, "The strongest predictor of major depression is still your life experience. There aren't genes that make you depressed; there are genes that make you vulnerable to depression. "

单选题OFF THE CHANNEL ISLANDS, California—Large numbers of giant endangered blue whales have gathered offshore attracting dozens of marine biologists who want to know why. Scientists aboard six ships from the National Oceanic and Atmospheric Administration and other experts are working on a three-week project this summer to tag and track the whales electronically. Three blue whales were tagged and followed last week, but scientists have seen many more. " This is cetascean soup out here," said Fred Benko, owner of a private charter boat that shuttles scientists to and from their research area. The mammals, some up to 30 metres long, have congregated about 30 kilometres west of the Channel Islands, which are about 40 kilometres southwest of Santa Barbara and 120 kilometres northwest of Los Angeles. Scientists first noticed the increase in blue whales in local waters in 1991, and a 1993 study indicated about 2,000 blue whales along the California coast. Preliminary research suggests that the Channel Islands National Marine Sanctuary contains the most concentrated blue whale population in the world. The US Government has listed the animals as endangered since 1966, victims of the over zealous whaling industry in the first half of the century. Scientists believe there once were 400,000 blue whales roaming the world' s oceans, but now only about 12,000. The blue whales feed on krill, bright red crustaceans similar to shrimp. But since the Channel Islands are hardly the only place where krill thrive, researchers wonder what else might be drawing the whales to the area. To tag the whales, scientists use a crossbow to fire a dart into blubber on the creature' s back. A computer records the depth and length of every dive the whale takes. " It' s important for me that people know that they have a treasure out here," said sanctuary Manager Ed Cassano. " This is something everybody should be proud of. It' s the jewel in the crown. "

单选题By the year 2020 more than 1000 million of the people in the world will be over 60 years old, and more than two-thirds of them will be living in developing countries. In the early 1950s, average life expectancy at birth was 47 years worldwide. In 1995 it was more than 65 years, and in several countries it was almost 80. Change of this magnitude amounts to a revolution in both demographic and cultural terms. It has been brought about partly by socioeconomic factors, such as better nutrition and living conditions, and partly by improvements in health care. Not only do we have drugs and treatments to cure diseases that in the past led to premature death, we also have vaccines to prevent many of these diseases, and in some cases even to eradicate them. Furthermore, a larger proportion of the world" s population has ready access to effective medicine. If the main public health challenge of this century has been survival, that of the next will be quality of life. With the steadily rising number of children who reach adulthood and adults who reach old age, the most pressing concern becomes that of ensuring that all of them enjoy the highest attainable level of well-being. To help promote a global response to this major societal concern. WHO launched a new programme on ageing and health in 1995. Its perspectives and activities are described in this issue of World Health, together with some of the ways in which society is responding to this new phenomenon of a growing elderly population. Health is generally felt to be of paramount importance for the quality of life, especially in old age, when physiological and other difficulties tend to accumulate and the end of life approaches. There are many more ways of protecting and improving health than people generally realize, and these articles provide valuable insights into the possibilities that exist.

单选题In a poor, inland, gang-infested part of Los Angeles, there is a clinic for people with type I diabetes. As part of the country health care system, it serves persons who have fallen through all other safety-net options, the poorest of the poor. Although type II diabetes is rampant in this part of town, type I diabetes exists as well. Yet these latter individuals generally lack access to any specialty care—a type of treatment they desperately need due to a complexity of dealing with type 1 diabetes in the setting of poverty and psychosocial stress. The Type I Clinic meets one morning per week and is staffed by four endocrinology fellows and a diabetologist, often me. I have the unique perspective of working part of the time in a county setting and the other part of the time in a clinic for people with health insurance, in Beverly Hills. I know what is possible in the treatment of type 1 diabetes. East Los Angeles teaches me what happens when access to care is not available. Most of our patients, in their 20s and 30s and 40s, already have complications of their diabetes; many near end stage. Concepts about maintaining near-normal blood glucose levels often miss their mark—lack of education or money or motivation or factors I can't even imagine make the necessity of a patient acting as his or her own exogenous pancreas nearly impossible, especially when there are acute consequences to hypoglycemia and few to moderate hyperglycemia. Historically, in spite of these barriers, we persisted and thought we made a difference. Often, teaching simple carbohydrate counting or switching therapy to long-acting insulin improved patients control and their quality of life. The fellows felt they made a positive impact in the health of their patients. Driving home I would be encouraged by what we had accomplished, although saddened by the severity of the complications suffered by many of our patients. Yet everything changed with the recession of 2008. In Beverly Hills I heard a lot about the demise of the financial markets. Patients of mine had invested with Bermie Madoff. Some, once billionaires, were now millionaires. Personal assistants and housekeepers were laid off, vacation homes were put on the market, and parties became less lavish. But all still live in safe, clean homes, wear designer clothes, and eat high-quality food. The landscape is very different for many of my East LA patterns. The temporary, part-time jobs they had cobbled together to keep food on the table and pay for housing are gone. I — naively — didn't realize how much worse poverty could get. But now many of our patients are young without food and are becoming homeless. One young man, a college student trying to work his way out of poverty by going to school, lost his job and is living in his car. He is still taking classes but is unable to afford more than a dollar meal from a fast-food restaurant once every day or two. Management of his diabetes involves simply keeping him alive with his erratic, poor eating habit.

单选题It used to be so straightforward. A team of researchers working together in the laboratory would submit the results of their research to a journal. A journal editor would then remove the authors" names and affiliations from the paper and send it to their peers for review. Depending on the comments received, the editor would accept the paper for publication or decline it. Copyright rested with the journal publisher, and researchers seeking knowledge of the results would have to subscribe to the journal. The Internet-and pressure from funding agencies, who are questioning why commercial publishers are making money from government-funded research by restricting access to it-is making access to scientific results a reality. The Organization for Economic Co-operation and Development(OECD)has just issued a report describing the far-reaching consequences of this. The report, by John Houghton of Victoria University in Australia and Graham Vickery of the OECD, makes heavy reading for publishers who have, so far, made handsome profits. But it goes further than that. It signals a change in what has, until now, been a key element of scientific endeavor. The value of knowledge and the return on the public investment in research depends, in part, upon wide distribution and ready access. It is big business. In America, the core scientific publishing market is estimated at between $7 billion and $11 billion. The International Association of Scientific, Technical and Medical Publishers say that there are more than 2,000 publishers worldwide specializing in these subjects. They publish more than 1.2 million articles each year in some 16,000 journals. This is now changing. According to the OECD report, some 75% of scholarly journals are now online. Entirely new business models are emerging; three main ones were identified by the report"s authors. There is the so-called big deal, where institutional subscribers pay for access to a collection of online journal titles through site-licensing agreements. There is open-access publishing, typically supported by asking the author(or his employer)to pay for the paper to be published. Finally, there are open-access archives, where organizations such as universities or international laboratories support institutional repositories. Other models exist that are hybrids of these three, such as delayed open-access, where journals allow only subscribers to read a paper for the first six months, before making it freely available to everyone who wishes to see it. All this could change the traditional form of the peer-review process, at least for the publication of papers.

单选题During the past 30 years or so, health care has increasingly become a form of business. In addition, the environment surrounding health care has been greatly altered by the advent of more sophisticated medical technologies and increased specialization. It is no longer true to say that doctors regard their profession as a sacred calling, and while the doctor-patient relationship still remains, it is not the relationship based solely on trust which it used to be. Of course there are many doctors who have endeavored to increase the transparency of their behavior as medical professionals, and patients can receive effective treatment when such doctors work closely together and share notes. An example of such cooperation can be found in the field of remote health care, which has been introduced on an experimental basis in several regions. Since most medical specialists live in cities, patients who live in the country have to travel a long distance to consult a specialist. This is especially hard on the elderly, both financially and physically. Through a computer network, patients who live in the country can consult a medical specialist in the city, tell him their symptoms, and receive advice without the need for a journey to the specialist's office. Also, with several doctors being assigned to a single patient, the transparency of each doctor's behavior is further ensured. On the other hand, however, it is also true that remote health consultation is not generally regarded as a form of medical treatment. For any sort of consultation to be regarded as medical treatment, most people feel that the patient must actually visit the doctor, and undergo an examination by the doctor in person. Remote health care is essentially a means for doctors to work as a team. In order for this to be practicable, it is important to establish a system whereby financial support can be extended to a doctor who, as a member of a medical team, provides only information. Establishment of such a system will further advance the cause of" free access to information" in the health care field.

单选题Do you believe that only boys do well in science? Does it seem to you that girls have better vocabularies than boys? In your opinion, are boys better at building things? If your answer to each of those questions is "Yes", you are right according to an article in Current Science. There are exceptions, but here are the facts. On the average, males score higher on tests that measure mathematical reasoning, mechanical ability, and problem-solving skills. Females show superior ability in tests measuring vocabulary, spelling, and memory. But these difference will probably not always exist. In the future, a person"s abilities may not be determined by sex. As one scientist says, "Nothing is impossible for a person to be or do." In several recent studies, young babies have been observed and tested to discover how different abilities are developed. A scientific team headed by Jerome Kagan, a psychologist at Harvard University, is studying the thinking ability of children 9 months old. The test is a simple one. The baby, while seated on its mother"s lap, watches a "show" on a theater stage. In act 1 of the show, an orange-colored block is lifted from a blue box and moved slowly across the stage. Then it is returned to the box. This is repeated six times. Act 2 is similar, except that the orange block is smaller. Baby boys do not seem to notice the difference in the size of the block, but girls immediately become excited and begin to make noises that sound like language. They seem to be trying to talk. It is known that bones, muscles, and nerves develop faster in baby girls. Usually, too, baby girls talk at an earlier age than boys do. Scientists think there is a physical reason for this. They believe that the nerve endings in the left side of the brain develop faster in girls than in boys. And it is this side of the brain that strongly influences an individual"s ability to use words, to spell, and to remember things. By the time they start to school, therefore, little girls have an advantage that boys do not have. Girls are physically more ready to remember facts, to spell, and to read. These, of course, are skills that are important in elementary school. But what have the boys been doing in the years before starting school? They have been developing something called aggression. An aggressive person has courage and energy. He feels strong and independent. He is often the first one to start a fight.

单选题Can the internet help patients jump the line at the doctor"s office? The Silicon Valley Employers Forum, a sophisticated group of technology companies, is launching a pilot program to test online "virtual visits" between doctors at three big local medical groups and about 8,000 employees and their families. The six employers taking part in the Silicon Valley initiative, including heavy hitters such as Oracle and Cisco Systems, hope that online visits will means employees won"t have to skip work to tend to minor ailment or to follow up on chronic conditions. "With our long commutes and traffic, driving 40 miles to your doctor in your hometown can be a big chunk of time," says Cindy Conway, benefits director at Cadence Design Systems, one of the participating companies. Doctors aren"t clamoring to chart with patients online for free; they spend enough unpaid time on the phone. Only 1 in 5 has ever E-mailed a patient, and just 9 percent are interested in doing so, according to the research firm Cyber Dialogue. "We are not stupid," says Stirling Somers, executive director of the Silicon Valley Employers group. "Doctors getting paid is a critical piece in getting this to work." In the pilot program, physicians will get $ 20 per online consultation; abut what they get for a simple office visit. Doctors also fear they"ll be swamped by rambling E-mails that tell everything but what"s needed to make a diagnosis. So the new program will use technology supplied by Healinx, an Alameda, Calif, -based start-up. Healinx"s "Smart Symptom Wizard" questions patients and turns answers into a succinct message. The company has online dialogues for 60 common conditions. The doctor can then diagnose the problem and outline a treatment plan, which could include E-mailing a prescription or a face to face visit. Can E-mail replace the doctor"s office? Many conditions, such as persistent cough, require a stethoscope to discover what"s wrong—and to avoid a malpractice suit. Even Larry Bonham, head of one of the doctor"s groups in the pilot, believes the virtual doctor"s visits offer a "very narrow" sliver of service between phone calls to an advice nurse and a visit to the clinic. The pilot program, set to end in nine months, also hopes to determine whether online visits will boost worker productivity enough to offset the cost of the service. So far, the internet"s record in the health field has been underwhelming. The experiment is "a huge roll of the dice for Healinx," notes Michael Barrett, and analyst at internet consulting from Forester Research. If the "Web visits" succeed, expect some HMOs(Health Maintenance Organizations)to pay for online visits. If doctors, employers, and patients aren"t satisfied, figure on one more E-health start-up to stand down.

单选题Binge eating changes the way the body responds to Leptin(瘦素) , the key appetite-suppressing hormone, say researchers in New York. Their experiments with rats could explain why people who overeat continue to crave food despite ginning weight. As we eat, Leptin levels in our blood gradually rise and suppress the appetite until more energy is needed. Leptin also speeds up the metabolism, so that less food is converted to fat. "The object is to take you back to the original point," says Luciano Rossetti, a diabetes researcher at the Albert Einstein College of Medicine. But a popular theory holds that if Leptin worked too well, it would defeat the purpose of fat, which is to store energy for lean times. Animals that can build up fat reserves when meals abound have a better chance of survival than their skinny companions should famine strike. To understand how Leptin keeps fat in check without preventing it from accumulating vital reserves, Rossetti and his colleagues created feast and famine conditions for two groups of rats. Over three days, members of one group could eat all they wanted, while the other rats were kept on a restricted diet. Normally, Leptin moderates its own production slightly by reducing the activity of the Leptin gene in fat cells. In the rats with a skimpy diet, however, an injection of Leptin into the bloodstream hardly reduced the activity of the gene in fat tissue at all. By contrast, in the overeaters the injection cut Leptin gene activity in half. That came as a surprise, says Rossetti, as it means the overeaters would counteract an appetite-suppressing boost in Leptin, such as that caused by a meal, more quickly than the dieting rats. One possible outcome is that the guzzlers would be ready to eat again sooner. Similar mechanisms in humans may have given them an evolutionary advantage in prehistoric times, when food was probably scarce. But today it may lead to a spiral of overeating, Rossetti says, with each binge making a person more prone to the next: "People go on numerous circles of increased feeding." Since the tendency toward obesity varies from person to person, Rossetti plans to look for differences in the Leptin binge response in lean and fat strains of rats. Jeffrey Flier, a Leptin researcher at Beth Israel Hospital in Boston, says it would also be important to check whether moderately overweight people fail to increase the activity of their Leptin gene when they overeat. Without such experiments, he says, it's hard to conclude that Rossetti has discovered why inflated waist lines are so common. "At this stage, it's still purely hypothetical."

单选题The biggest thing in operating rooms these days is a million-dollar, multi-armed robot named da Vinci, used in nearly 400, 000 surgeries nationwide last year—triple the number just four years earlier. But now the high-tech helper is under scrutiny over reports of problems, including several deaths that may be linked with it and the high cost of using the robotic system. There also have been a few disturbing, freak incidents: a robotic hand that wouldn't let go of tissue grasped during surgery and a robotic arm hitting a patient in the face as she lay on the operating table. Is it time to curb the robot enthusiasm? Some doctors say yes, concerned that the "wow" factor and heavy marketing have boosted use. They argue that there is not enough robust research showing that robotic surgery is at least as good or better than conventional surgeries. Many U. S. hospitals promote robotic surgery in patient brochures, online and even on highway billboards. Their aim is partly to attract business that helps pay for the costly robot. The da Vinci is used for operations that include removing prostates, gallbladders and wombs, repairing heart valves, shrinking stomachs and transplanting organs. Its use has increased worldwide, but the system is most popular in the United States. For surgeons, who control the robot while sitting at a computer screen rather than standing over the patient, these operations can be less tiring. Plus robot hands don't shake. Advocates say patients sometimes have less bleeding and often are sent home sooner than with conventional laparoscopic surgeries and operations involving large incisions. But the Food and Drug Administration is looking into a spike in reported problems during robotic surgeries. Earlier this year, the FDA began a survey of surgeons using the robotic system. The agency conducts such surveys of devices routinely, but FDA spokeswoman Synim Rivers said the reason for it now "is the increase in number of reports received" about da Vinci. Reports filed since early last year include at least five deaths. Whether there truly are more problems recently is uncertain. Rivers said she couldn't quantify the increase and that it may simply reflect more awareness among doctors and hospitals about the need to report problems. Doctors aren't required to report such things; device makers and hospitals are. Company spokesman Geoff Curtis said Intuitive Surgical has physician-educators and other trainers who teach surgeons how to use the robot. But they don't train them how to do specific procedures robotically, he said, and that it's up to hospitals and surgeons to decide "if and when a surgeon is ready to perform robotic cases. " A 2010 New England Journal of Medicine essay by a doctor and a health policy analyst said surgeons must do at least 150 procedures to become adept at using the robotic system. But there is no expert consensus on how much training is needed. New Jersey banker Alexis Grattan did a lot of online research before her gallbladder was removed last month at Hackensack University Medical Center. She said the surgeon's many years of experience with robotic operations was an important factor. She also had heard that the surgeon was among the first to do the robotic operation with just one small incision in the belly button, instead of four cuts in conventional keyhole surgery.

单选题The popular idea that classical music can improve your maths is falling from favor. New experiments have failed to support the widely publicized finding that Mozart" s music promotes mathematical thinking. Researchers reported six years ago that listening to Mozart brings about short-temporal reasoning , the type of thinking used in maths. Gordon Shaw of the University of California at Irvine and Frances Rauscher of the University of Wisconsin in Oshkosh had asked students to perform spatial tasks such as imagining how a piece of paper would look if it were folded and cut in a certain pattern. Some of the students then listened to a Mozart sonata and took the test again. The performance of the Mozart group improved, Shaw found. He reasoned that listening to Mozart increases the number of connections between neurons. But Kenneth Steele of Appalachian State University in North Carolina learnt that other studies failed to find this effect. He decided to repeat one of Shaw" s experiments to see for himself. Steele divided 125 students into three groups and tested their abilities to work out how paper would look if cut and folded. One group listened to Mozart, another listened to a piece by Philip Glass and the third did not listen to anything. Then the students took the test again. No group showed any statistically significant improvement in their abilities. Steele concludes that the Mozart effect doesn" t exist. " It" s about as unproven and as unsupported as you can get," he says. Shaw, however, defends his study. One reason he gives is that people who perform poorly in the initial test get the greatest boost from Mozart, but Steele didn" t separate his students into groups based on ability. "We"re still at the stage where it needs to be examined," Shaw says. "I suspect that the more we understand the neurobiology, the more we" 11 be able to design tests that give a robust effect. "

单选题"I got cancer in my prostate. " Detective Andy Sipowicz of the fictional 15th Precinct, a stoic, big bear of a man, is clearly in a world of pain in a 1998 episode of NYPD Blue. The story line deals not only with cancer but also with medical screw-ups, hospital indignities and physician arrogance. The malapropism (Andy, of course, meant "prostate") is about the only medical detail the show got wrong— and it was deliberate, in keeping with Sipowicz's coarse but tenderhearted character. Television, which can still depict death as an event akin to fainting, is beginning to try harder to get its health information right. And a handful of foundations and consultants are working to get the attention of writers, producers and assorted Hollywood moguls, trying to convince them that, in the area of medicine, the truth is as compelling as fiction. The stakes are high. Surveys show a surprising number of Americans get much of their basic health information not from their doctors, not even from newspapers or news magazines, but from entertainment television. A survey by the federal Centers for Disease Control and Prevention found that among people who watch soap operas at least twice a week — more than 38 million people — about half learned something about disease and its prevention from the daytime serials. Some 7 percent actually visited a doctor because of something they viewed. Certain television shows are naturals for health education. The Clinton administration has been quick to recognize the potency of the entertainment media as a health promoter. Secretary Donna Shalala, whose Department of Health and Human Services educates the public through traditional brochures and public service announcements, has offered TV writers the sources of her department to help them ensure accuracy. "Entertainment television reaches the hearts and minds of millions of Americans, " she told U. S. News. "In recent years, I have challenged television talk-show hosts, writers, and producers — as professionals, parents, and citizen—to use this incredible power to help Americans get accurate public health information. "

单选题Humans are the only species known to have consciousness, awareness that we have brains and bodies【C1】______adaptability that we can affect the course our lives take, that we can make choices【C2】______that vastly affect the quality of our lives—biologically, intellectually, environmentally, and spiritually. As humans, we have the ability to mold our【C3】______beings to become what or who we wish to become. While some of us may,【C4】______, have genetic and biological imperatives that may require medication or training to overcome, or at least to modulate, the vast majority of us do, in fact, hold our emotional【C5】______in our hands. All that【C6】______, until the last decade, scientists believed that the human brain and its connections were formed during gestation and infancy and remained【C7】______unchanged through childhood. They believed that humans had a given number of neurons in a specific brain structure, and【C8】______the number might vary among people, once you were done with childhood development, you were set in this【C9】______. Your connections were already made, and the learning and growing period of your brain was over. In the last decade, however, researchers have found【C10】______evidence that this is not so, and that something called neuroplasticity continues throughout our lives.

单选题Children are getting so fat they may be the first generation to die before their parents, an expert claimed yesterday. Today's youngsters are already falling prey to potential killers such as diabetes because of their weight. Fatty fast-food diets combined with sedentary lifestyles dominated by televisions and computers could mean kids will die tragically young, says Professor Andrew Prentice, from the London School of Hygiene and Tropical Medicine. At the same time, the shape of the human body is going through a huge evolutionary shift because adults are getting so fat. Here in Britain, latest research shows that the average waist size for a man is 36 -38 in and may be 42 -44 in by 2032. This compares with only 32. 6 in 1972. Women' s waists have grown from an average of 22 inches in 1920 to 24 inches in the Fifties and 30 inches now. One of the major reasons why children now are at greater risk is that we are getting fatter younger. In the UK alone, more than one million under 16s are classed as overweight or obese—double the number in the mid-Eighties. One in ten four-year-olds are also medically classified as obese. The obesity pandemic—an extensive epidemic—which started in the U. S. , has now spread to Europe, Australia, Central America and the Middle East. Many nations now record more than 20 percent of their population as clinically obese and well over half the population as overweight. Prof Prentice said the change in our shape has been caused by a glut of easily available high-energy foods combined with a dramatic drop in the energy we use as a result of technology developments. He is not alone in his concern. Only last week one medical journal revealed how obesity was fueling a rise in cancer cases. Obesity also increases the risk factor for strokes and heart disease. An averagely obese person's lifespan is shortened by around nine years while a severely obese person by many more. Prof Prentice said: "So will parents outlive their children, as claimed recently by an American obesity specialist?" The answer is yes—and no. Yes, when the offspring becomes grossly obese. This is now becoming an alarmingly common occurrence in the U. S.. Such children and adolescents have a greatly reduced quality of life in terms of both their physical and psychosocial health. So say No to that doughnut and burger.

单选题Scientists used to believe adult brains did not grow any new neurons, but it has emerged that new neurons can sprout in the brains of adult rats, birds and even humans. Understanding the process could be important, for finding ways to treat diseases such as Alzheimer"s in which neurons are destroyed. Most neurons sprouting in adulthood seem to be in the hippocampus, a structure involved in learning and memory. But they rarely survive more than a few weeks. "We thought they were possibly dying because they were deprived of some sort of input," says Elizabeth Gould, a neuroscientist at Princeton. Because of the location, Gould and her colleagues suspect that learning itself might bolster the new neurons" survival, and that only tasks involving the hippocampus would do the trick. To test this, they injected adult male rats with a substance that labeled newborn neurons so that they could be tracked. Later, they gave some of the rats standard tasks. One involved using visual and spatial cues, such as posters on a well, to learn to find a platform hidden under murky water. In another, the rats learnt to associate a noise with a tiny shock half a second later. Both these tasks use the hippocampus — if this structure is damaged, rats can"t do them. Meanwhile, the researchers gave other rats similar tasks that did not require the hippocampus finding a platform that was easily visible in water, for instance. Other members of the control group simply paddled in a tub of water or listened to noises. The team reported in Nature Neuroscience that the animals given the tasks that activate the hippocampus kept twice as many of their new neurons alive as the others. "Learning opportunities increase the number of neurons," says Gould. But Fred Gage and his colleagues at the Salk Institute for Biological Studies in La Jolla, California, dispute this. In the same issue of Nature Neuroscience, they reported that similar water maze experiments on mice did not help new neurons survive. Gould thinks the difference arose because the groups labeled new neurons at different times. She gave the animals tasks two weeks after the neurons were labeled. When the new cells would normally be dying, she thinks the Salk group put their mice to work too early for new neurons to benefit. "By the time the cells were degenerating, the animals were not learning anything." she says.

单选题Breast cancer is second only to skin cancer as the most common malignancy diagnosed in women in the United States. In 2001, about 192, 200 new cases of invasive breast cancer were diagnosed and 40, 200 women died of the disease. Only lung cancer accounts for more cancer deaths in women. The incidence of breast cancer has increased over the last 20 years. Although some of the increase can be attributed to changes in reproductive patterns, such as delayed childbearing and having fewer children, much of the rise is due to the increased detection of smaller, earlier-stage cancers with the widespread adoption of mammography screening in asymptomatic women. According to data from the Surveillance, Epidemiology, and End Results Program, incidence rates of tumors less than 2. 0 cm in diameter more than doubled from 1980 to 1987, whereas rates of tumors greater than 3. 0 cm decreased by 27%. In particular, incidence rates of in situ breast cancer have risen dramatically over the last 25 years. The annual increase in age-adjusted ductal carcinoma in situ incidence rates from 1983 to 1992 was 17. 5%. Although the incidence of breast cancer has been increasing, there has been a decline in breast cancer mortality. Death rates decreased 1. 6% annually between 1989 and 1995, then 3. 4% annually between 1995 and 1998. This improvement in the mortality rate has been attributed to both mammography screening and improvements in breast cancer treatment. Breast cancer has a number of identifiable risk factors. Aside from a personal history of breast cancer, the most important risk factor in women is age. Between 1994 and 1998, 77% of new cases of breast cancer and 84% of breast cancer deaths occurred in women older than 50 years. Other nonmodifiable risk factors include family history, age at birth of the woman's first child, early menarche, and late menopause. Potentially modifiable risk factors include alcohol consumption, use of postmenopausal hormones, and obesity after menopause. Risk factors and their relative risk are listed in table 1 in order of the strength of their association. Although most breast cancer cases are sporadic, up to 10% are linked to genetic predisposition. Women with a family history of breast cancer, especially in a first-degree relative (ie, mother, sister, or daughter), have an increased risk of breast cancer. In general, a "positive family history" of breast cancer confers a relative risk of 2. 0 to 3. 0, with the degree of risk varying directly with the closeness of the relationship. Paternal and maternal relatives with breast cancer contribute similarly to the increased risk. Most women with a family history of breast cancer do not have a history striking enough to suggest the presence of an inherited breast cancer syndrome. In many cases, primary care physicians can readily distinguish between families with heritable cancers and those with several sporadic cases. Women at high risk of inherited breast cancers typically have several relatives with breast cancer diagnosed before age 45 to 50 and may also have a family history of bilateral breast cancer, ovarian cancer, or male breast cancer.

单选题For eight months he has floated in his private ocean. This morning he awakens, opens his eyes, yawns and kicks vigorously several times. His umbilical cord drifts by his questing fingers. He plays with it briefly, brings his hands up to his mouth and sucks his thumb. Over his mother" s heartbeat and the gurgles of her digestive tract, he can hear her talking with his father. Interested, he stops sucking to listen. Until recent years, we could only speculate on what life was like for an unborn baby. Then, major advances in ultrasound scanning began opening a window to the womb; doctors could view every movement of the baby on a television—like screen. The pictures show unborn babies yawning, sucking, grasping, stretching, blinking and making faces—in short, all the things they will do after birth. Normally an unborn baby never experiences hunger or thirst. But if a mother does not consume sufficient nutrients, the baby" s diet will not be adequate either. When an unborn baby is severely malnourished—for instance, because his mother" s heavy smoking restricts blood flow to the placenta—Dr, Jason Birnholz, an ultrasound expert, believes he has seen the baby" s chest and throat making crying motions. A radio startles him awake. He blinks and grimaces at the new sensation, but then becomes interested in the music. He turns his head to bring his ear closer to the outside world. He notices the pressure of the book his mother is resting on her belly. He kicks at it, her laugh comes to him as a dull, echoing rumble. She pats the spot he kicked and, entering into the spirit of the game, he kicks back. They play several rounds before he loses interest and falls asleep. Can a mother" s stress, anger, shock or grief harm her baby? No. The normal stresses and strains of life won" t hurt him. As the expert Maurers put it, such periods are the womb equivalent of having a spell of " bad weather". Some are startled when exposed to a series of loud buzzes, but some then turn an ear to listen. Severe continuous stress may be another story. It remains unclear whether problems arise from the stress itself or from the poor nutrition, smoking, drinking or drug taking that likely accompany it. In any case the baby is affected.