“我可以告诉你一些恐怖的故事，”美国医学生学会主席杰雅·阿格拉瓦说。阿格拉瓦经营着一个网站，住院医生们可以在那里匿名留言，讲一些奇闻轶事。有一些故事非常可怕。“我当时在做手术，已经有36个小时没有睡觉了，”其中一人写道。“我差不多站着睡着了，而且我的脸几乎碰到了伤口。”

“实际上我认识的每个外科住院医生都曾经有过在下班开车回家的路上趴在方向盘上睡着的经历，”另一人写道。“我听说有三个人还曾经撞在停放好的汽车上。另一个人在纽约收费公路上行驶时以65英里的时速撞上了一个收费站栏杆。”“你自己的病人都成了敌人，”第三个人写道，因为“是他们使你无缘几个小时的睡眠。”

阿格拉瓦的组织支持由密歇根众议员约翰·科尼尔斯去年11月提出的“2001年病人和医生安全保护规定”。该规定模仿纽约州的法规，其关键规定包括一周工作80小时，最多24小时轮一次班等。不过，大多数医生讨厌这种干涉。查尔斯·宾克利是密歇根大学的一位资深住院外科医生，他也认为需要采取一些措施，但在他看来“医生应该受到个人良心的约束，而不是政府的管制。”

在美国，飞行员和卡车司机的工作时间都有着严格的控制。但除非也给医生们制定这样一套规定，否则病人就得听天由命了。如果你担心给你或你爱的人治病的人，你可以大胆问他们每天睡几个小时，可不可以找到休息得更好的职员。对医生来说，他们不能继续摆出一副从不出错的样子，而应该得到必要的休息。





Unit 90


Watching a child struggle to breathe during an asthma attack is frightening for any parent. So it is only natural that most moms and dads will try just about anything——including spending a lot of money——to keep an attack at bay. Trouble is, more than half of parents are trying strategies that simply don't work and wasting hundreds of dollars in the process, according to a study published last week in the Journal of Allergy and Clinical Immunology.

The report, based on interviews with the parents of 896 asthmatic children in 10 different cities, contained some good news. Eighty percent of parents had a handle on at least one of the triggers that worsened their children's asthma. After that, however, many parents seemed to go astray, taking precautions that weren't helpful “and made little sense,”according to Dr. Michael Cabana, a pediatrician at the University of Michigan's C. S. Mott Children's Hospital, who led the study.

One of the most common mistakes was to buy a mattress cover to protect against dust mites for a child whose asthma was exacerbated instead by plant pollen. Many of those parents then neglected to do what would have helped a lot more: shut the windows to keep pollen out. Another was using a humidifier for a child who was allergic to dust mites; a humidifier tends to be a place where dust mites like to breed. With those allergies, a dehumidifier works better.

Worst of all was the number of smokers with asthmatic children who didn't even try to quit or at least limit themselves to smoking outdoors rather than just moving to another room or the garage. Second-hand smoke has been proved, over and over again, to be a major trigger of asthma attacks. Many smoking parents purchased expensive air filters that have what Cabana called “questionable utility.”

Part of the problem, Dr. Cabana and his colleagues believe, is that parents are bombarded by television ads that encourage them to buy products such as air and carpet fresheners, ionizers and other remedies that are often expensive but medically unnecessary. And doctors may not always take the time, or have the time, to explain to parents what will and won't work in their child's particular case. For example, allergies are usually a problem for older children with asthma, while kids 5 and younger more frequently have trouble with viral respiratory infections. So make sure you understand what's really triggering your child's asthma. And remember, the best solutions are not always the most expensive ones.

注（1）：本文选自Time；

注（2）：本文习题命题模仿对象为2004年真题Text 1。

1. What does the study by Dr. Michael Cabana indicate?

A) Parents are eager to cure their children's disease.

B) Many parents are wasting money for their children's frightening disease.

C) Many parents fail to find the effective way for their children's disease.

D) Parents feel worried about their children's disease.

2. Which of the following is NOT the trigger of asthma attacks?

A) Humidifier.

B) Second-hand smoke.

C) Plant pollen.

D) Dust mites.

3. The expression “to keep an attack at bay”（Line 3, Paragraph 1) most probably means______.

A) to ease the attack

B) to lessen the attack

C) to continue the attack

D) to prevent the attack

4. Why are the parents in such a dilemma?

A) The doctors are not responsible enough.

B) Parents are influenced much by ads.

C) Parents are ignorant of the disease.

D) The quality of medical products is not good.

5. Which of the following is TRUE according to the text?

A) Parents shouldn't spend too much money on the children.

B) The expensive products are not always good.

C) To know the real trigger of the disease is very important.

D) Parents often make mistakes.





篇章剖析


本文采用提出问题——说明问题——分析问题的模式，指出哮喘病患儿的家长在防治哮喘方面存在的问题及错误。第一段提出有关哮喘病的一项研究成果；第二段进一步补充第一段的论点，指出很多家长对孩子的病情无计可施这一现象；第三段和第四段指出家长的错误做法；第五段分析其原因并提出建议。





词汇注释


asthma /ˈæsmə;(US)ˈæzmə/ n. 【医】哮喘

keep at bay 阻止；挡住

allergy /ˈælədʒi/ n. 【医】敏感症；〈口〉反感

immunology /ɪmjuːˈnɒlədʒi/ n. 【生】免疫学

have a handle on 理解，明白

trigger /ˈtrɪgə(r)/ n. 能引起反应的刺激物

go astray 误入迷途

pediatrician /ˌpiːdɪəˈtrɪʃən/ n. 儿科医师

dust mite尘螨

humidifier /hjuːmɪdɪˈfaɪə(r)/ n. 加湿器

allergic /əˈlɜːdʒɪk/ adj. 【医】过敏的, 患过敏症的

bombard /bɒmˈbɑːd/ vt. 炮轰；轰击；攻击；质问

ionizer /ˈaɪənaɪzə/ n. 离子发生器

respiratory /rɪˈspɪrətəri;(US)-tɔːri/ adj. 呼吸的





难句突破


Part of the problem, Dr. Cabana and his colleagues believe, is that parents are bombarded by television ads that encourage them to buy products such as air and carpet fresheners, ionizers and other remedies that are often expensive but medically unnecessary.

主体句式：Part of the problem is that…

结构分析：本句有一个表语从句。句子主语是part of the problem，Dr. Cabana and his colleagues believe是插入语，that引导表语从句；在从句中，又有that引导的定语从句修饰ads；在定语从句中又有that引导的定语从句修饰remedies。

句子译文：卡巴娜博士和他的同事认为，部分问题在于家长经不住电视广告的狂轰滥炸。这些电视广告怂恿他们购买那些往往昂贵却没有医疗效果的产品，比如空气和地毯清洁剂、离子发生器和其他一些药品。





题目分析


1. C 推理题。原文对应信息是首段的“Trouble is, more than half of parents are trying strategies that simply don't work and wasting hundreds of dollars in the process.”在第二段中，作者又进一步论证了这一点，指出家长采取的预防措施是“ weren't helpful ‘and made little sense'”。

2. A 细节题。文章第三段提到了两种过敏源：尘螨和花粉；第四段提到的过敏源是二手烟；加湿器不是过敏源，而是在某种情况下会为过敏源提供滋生地，从而诱发哮喘。

3. D 语义题。本文开头第一、二句为因果关系。第一句提到“Watching a child struggle to breathe during an asthma attack is frightening for any parent. ”那么家长为了避免孩子哮喘病发作想尽一切办法甚至花费大笔钱财的做法是再自然不过的了。根据短语所在的语境可猜出语义。

4. B 细节题。原文对应信息是“Part of the problem is that parents are bombarded by television ads that encourage them to buy products such as… that are often expensive but medically unnecessary.”做父母的爱子心切，只要是对孩子的病情有用的东西真是不惜一切代价弄到。广告的强大攻势更是对父母产生了较强的影响，加之对孩子的病情又不是特别了解，从而丧失了判断力。

5. C 细节题。原文对应信息是末段的“So make sure you understand what's really triggering your child's asthma.”





参考译文


对每一位家长来说，看到自己的孩子哮喘病发作而挣扎着呼吸真是令人胆战心惊。因此，大多数父母想尽一切办法甚至不惜花费大笔钱财来预防其子女哮喘病发作的做法也就再自然不过了。但问题是，有一多半父母采取的应对措施并没有发挥效应，他们只是在浪费大把的钱财——这个结论是依据上周出版的《过敏症和临床免疫学》杂志上刊载的一项研究结果得出来的。

这篇报道采访了10个不同城市的896名哮喘患儿的父母，其中还是有好消息的。80%的父母至少知道一种使孩子病情恶化的诱因。但是，除此以外，很多家长就无计可施了，采取的预防措施帮助不大，“而且毫无道理”，迈克尔·卡巴纳博士如是说。他是牵头这一研究的密歇根大学C. S. Mott儿童医院的儿科医生。

其中一种最为常见的错误就是为由于植物花粉过敏而导致哮喘病加重的孩子购买床褥保护套去抵挡尘螨的侵扰。很多家长忘记了一个更为有效的办法：关紧窗户，避免花粉干扰。另一种常见错误就是为对尘螨过敏的孩子购买加湿器；殊不知加湿器是尘螨最易于繁殖的地方。对于这类过敏症，使用干燥器作用会更大些。

最糟糕的一种情况是家有患哮喘病的孩子，可抽烟的家长不但不戒烟，还不到外面抽，也不换个房间或到车库去抽。吸二手烟一次又一次地被证实是哮喘病发作的主要诱因。很多抽烟的家长不惜花大价钱购买被卡巴纳称为“值得怀疑的器具”的空气过滤器。

卡巴纳博士和他的同事认为，部分问题在于家长经不住电视广告的狂轰滥炸。这些电视广告怂恿他们购买那些往往昂贵却没有医疗效果的产品，比如空气和地毯清洁剂、离子发生器和其他一些药品。医生可能也不会花时间，或者说有时间去向父母解释对于孩子的具体病例什么有用、什么没用。比如说，大龄哮喘病儿童患者通常是过敏症，而五岁或五岁以下的儿童常常是病毒性呼吸道感染疾病。所以你一定得弄清楚孩子患哮喘病的真正诱因，并且记住，花钱最多的办法并不一定就是最好的办法。





Unit 91


IF YOU'RE CONFUSED BY ALL the news about the health effects of eating fish, you're not alone. On one hand, the omega-3 fatty acids in fish are known to reduce the risk of heart disease, as the American Heart Association reminded us two weeks ago when it restated its recommendation that everybody eat at least two fish servings a week. On the other hand, fish that live in contaminated waterways contain high levels of mercury, which can lead to cognitive problems in developing brains. That's why pregnant women and nursing mothers are advised to limit their consumption.

As if that weren't confusing enough, two new studies published last week in the New England Journal of Medicine investigated the possible effects of mercury on the heart, and they seem to have reached contradictory conclusions. One found no clear link between mercury levels and heart disease; the other found that men with high levels of mercury in their toenails were more likely to suffer a heart attack than those with low levels. What are we to make of this? The first thing to remember is that this is how science proceeds, by fits and starts and seemingly contradictory results that get resolved only by further study. The second is that not all fish are created equal.

Compared with all the other things you might eat, fish are an excellent source of protein. They tend to eat algae as part of their natural life cycle, converting it into omega-3 fatty acids that can improve your cholesterol profile. But it's also true that our waterways have become increasingly contaminated with all sorts of pollutants, including mercury, and that these pollutants tend to accumulate at different levels in different species. The fish most at risk are predators high in the pelagic food chain, such as swordfish and sharks.

It was to test the effects of mercury on the heart that the two new studies compared the mercury levels in clippings from toenails, where heavy metals tend to be deposited. In one study, researchers led by Dr. Eliseo Guallar at Johns Hopkins found that European and Israeli men with the highest mercury levels were nearly 2.2 times as likely to have a heart attack as those with the lowest levels. The other study, led by Dr. Walter Willett at the Harvard School of Public Health, looked at a selection of American men and found no connection between mercury exposure and risk of heart disease, although Willett told me a “weak association”cannot be ruled out.

For most of us, eating two servings of fish a week should not pose any problems. Guallar, who hails from coastal Spain, continues to flavor his paella with salmon, which has negligible mercury levels. Willett eats swordfish only about twice a month——because of its expense, not any fear of mercury. Fish-oil supplements are high in omega-3 fatty acids and probably don't contain as much mercury as whole fish. But they don't taste nearly as good.

注（1）：本文选自Time；

注（2）：本文习题命题模仿对象为2005 真题Text 1。

1. In the opening paragraph, the author introduces his topic by______.

A) making a comparison

B) justifying an assumption

C) posing a contrast

D) explaining a phenomenon

2. The phrase “by fits and starts”（Line 6, Paragraph 2) most probably means______.

A) something happens smoothly

B) something keeps starting and then stops again

C) something deserves a lot of effort

D) something is troublesome

3. Clippings from toenails were chosen for the research most probably because______.

A) they are more likely to contain mercury

B) they influence a person's heart

C) they can be easily obtained

D) they are connected with the heart

4. The views of Dr. Eliseo Guallar and Dr. Walter Willett are______.

A) identical

B) similar

C) opposite

D) complementary

5. What can we infer from the last paragraph?

A) Fish is no threat to humans.

B) Do not be frightened by some fish.

C) Eat fish-oil supplements instead of fish.

D) Taste is more important than the safety of the food.





篇章剖析


本文采用提出问题——分析问题的模式，指出吃鱼对心脏有好处，但是其中所含的汞却对心脏有害，探讨二者该如何取舍。第一段指出人们对吃鱼对健康究竟有无影响、有何影响这一问题感到困惑；第二段以两项新课题为例，进一步说明人们的这一困惑；第三段指出鱼类自身所具有的优点及其存在的一些潜在的危险；第四段详细介绍这两类新课题的研究发现；第五段间接指出我们该如何取舍。





词汇注释


omega-3 fatty acids (不饱和）脂肪酸

contaminate /kənˈtæmɪneɪt/ v. 污染

by fits and starts间歇地，一阵一阵地

algae /ˈældʒiː/ n. 藻类，海藻

at risk有危险

predator /ˈpredətə(r)/ n. 掠夺者，食肉动物

pelagic /pɪˈlædʒɪk/ adj. 浮游的，远洋的

swordfish /ˈsɔːdfɪʃ/ n. 旗鱼

rule out删除，排除，取消

hail from来自

paella /pɑːˈelə/ n. （西班牙）肉菜饭

negligible /ˈneglɪdʒɪb(ə)l/ adj. 可以忽略的，不予重视的





难句突破


It was to test the effects of mercury on the heart that the two new studies compared the mercury levels in clippings from toenails, where heavy metals tend to be deposited.

主体句式：It was… that…

结构分析：本句是强调句型。判断是否是强调句型的办法是把“It was that”去掉，看是否仍是一个完整的句子。

句子译文：脚趾甲是重金属易于沉积的地方。这两个新课题通过对比脚趾甲中汞的含量检测汞对心脏的影响。





题目分析


1. C 论证方式题。在引入论题时，作者在第一段用了on one hand… on the other hand，意思是“一方面…另一方面”，就吃鱼与否引出两种完全不同的观点，从而导致很多人就此问题感到困惑。

2. B 语义题。习语by fits and starts所在语境为“The first thing to remember is that this is how science proceeds, by fits and starts and seemingly contradictory results that get resolved only by further study.”从此句我们可看出科学的进程并不是一蹴而就的。此题我们可考虑使用排除法。

3. A 细节题。原文对应信息在第四段：“It was to test the effects of mercury on the heart that the two new studies compared the mercury levels in clippings from toenails, where heavy metals tend to be deposited. ”本题的理解请见“难句突破”。

4. C 情感态度题。Dr. Eliseo Guallar和Dr. Walter Willett做的实验相似，但是得出的结论却完全不同。

5. B 推理题。原文对应信息在末段“For most of us, eating two servings of fish a week should not pose any problems.”然后，作者又给出了两个例子来进一步说明这一观点。





参考译文


如果吃鱼对人体健康方面有所影响的报道令你感到困惑的话，那么有你这种感觉的并不单单是你一个人。一方面，美国心脏学会两周前再次建议大家每人每周至少吃两次鱼，他们是这样提醒我们的：鱼肉中所含的不饱和脂肪酸可以降低心脏病的发病率。另一方面，生长于污染水域的鱼体内存有高含量的汞，这可能对发育中的大脑造成认知方面的不良影响。这就是为什么要建议孕妇和哺乳期妇女减少鱼类摄入的原因。

这好像还不足以使你感到困惑不解。上周刊载于《新英格兰医学杂志》上的两项新课题，就汞对心脏可能造成的影响进行了调查研究，两项研究却得出了似乎相互矛盾的结论：一项研究发现汞含量和心脏病之间没有必然联系；另一项研究发现脚趾甲中汞含量高的人与汞含量低的人相比，更容易患心脏病。我们该如何理解？首先要牢记这就是科学的进程，那些时进时退并且看起来相互矛盾的结论只能通过进一步的研究才能得以解决；其次，并不是所有的鱼类天生都一样的。

与其他可食用物相比，鱼类是蛋白质的最佳来源。它们把食用海藻作为自然界生命循环的一部分，并将其转化为能促进胆固醇代谢的不饱和脂肪酸。但是我们越来越多的水源被各种污染物（其中包括汞）所污染也是事实，这些污染物在不同的生物体内以不同程度的含量积聚下来。最危险的鱼是处于海洋上层食物链中的食肉鱼，比如旗鱼和鲨鱼。

脚趾甲是重金属易于沉积的地方。这两个新课题通过对比脚趾甲中汞的含量检测汞对心脏的影响。其中一个课题的研究员由约翰霍普金斯大学的埃利塞奥·瓜利亚尔博士领导，他们发现在欧洲人和以色列人当中，体内汞含量最高的人犯心脏病的几率几乎为汞含量最低的人的2.2倍。另一项课题由哈佛公共卫生学院的沃尔特·威利特博士领导。通过对那些选出来的美国男性公民的研究，他们并未发现人体接触汞元素和心脏病发病之间有什么关系，虽然威利特说不能完全排除其中会有某种“微弱的联系”。