2017年全国医学博士外语统一考试英语试卷（阅读部分）
Passage One
If you are reading this article，antibiotics have probably saved your life—and not once but several times.A rotten tooth，a knee operation，a brush with pneumonia；any number of minor infections that never turned nasty.You may not remember taking the pills，so unremarkable have these one-time wonder drugs become.
Modern medicine relies on antibiotics—not just to cure diseases，but to augment the success of surgery，childbirth and cancer treatments.Yet now health authorities are warning， in uncharacteristically apocalyptic terms，that the era of antibiotics is about to end.In some ways，bacteria are continually evolving to resist the drugs.But in the past we’ve always developed new ones that killed them again.
Not this time.Infections that once succumbed to everyday antibiotics now require last-resort drugs with unpleasant side effects.Others have become so difficult to treat that they kill some 25，000 Europeans yearly.And some bacteria now resist every known antibiotic.
Regular readers will know why：New Scientist has reported warnings about this for years. We have misused antibiotics appallingly，handing them out to humans like medicinal candy and feeding them to livestock by the tonne，mostly not for health reasons but to make meat cheaper. Now antibiotic-resistant bacteria can be found all over the world—not just in medical facilities， but everywhere from muddy puddles in India to the snows of Antarctica（南极洲）.
How did we reach this point without viable successors to today’s increasingly ineffectualdrugs？The answer lies not in evolution but economics.Over the past 20 years，nearly every major pharmaceutical company has abandoned antibiotics.Companies must make money，and there isn’t much in short-term drugs that should be used sparingly.So researchers have discovered promising candidates，but can’t reach into the deep pockets needed to develop them.
This can be fixed.As we report this week，regulatory agencies，worried medical bodies and Big Pharma are finally hatching ways to remedy this market failure.Delinking profits from the volume of drug sold（by adjusting patent rights，say，or offering prizes for innovation） has worked for other drugs，and should work for antibiotics—although there may be a worryingly long wait before they reach the market.
One day，though，these will fall to resistance too.Ultimately，we need，evolution-proof cures for bacterial infection：treatments that stop bacteria from causing disease，but don’t otherwise inconvenience the little blighters.When resisting drugs confers no selective advantage，drugs will stop breeding resistance.
Researchers have a couple of candidates for such treatment.But they fear regulators will drag their feet over such radical approaches.That，too，can be fixed.We must not neglect development of the sustainable medicine we need，the way we have neglected simple antibiotic R&D.
If we do，one day another top doctor will be telling us that the drugs no longer work— and there really will be no help on the way.
61.In the first paragraph，the author is trying to____.
A.warn us against the rampant abuse of antibiotics everywhere
B.suggest a course of action to reduce antibiotic resistance
C.tell us a time race between humans and bacteria
D.remind us of the universal benefit of antibiotics
62.The warning from health authorities implies that____.
A.the pre-antibiotic era will return
B.the antibiotic crisis is about to repeat
C.the wonder drugs are a double-edged sword
D.the development of new antibiotics is too slow
63.The appalling misuse of antibiotics，according to the passage，____.
A.has developed resistant bacteria worldwide
B.has been mainly practiced for health reasons
C.has been seldom reported as a warning in the world
D.has been particularly worsened in the developing countries
64.The market failure refers to____.
A.the inability to develop more powerful antibiotics
B.the existing increasingly ineffectual drugs in the market
C.the poor management of the major pharmaceutical companies
D.the deprived investment in developing new classes of antibiotics
65.During the presentation of the two solutions，the author carries a tone of____.
A.doubt B.urgency
C.indifference D.helplessness
Passage Two
This issue of Science contains announcements for more than 100 different Gorgon Research Conferences，on topics that range from atomic physics to developmental biology. The brainchild（某人的主意）of Neil Gordon of Johns Hopkins University，these week-long meetings are designed to promote intimate，informal discussions of frontier science.Often confined to fewer than 125 attendees，they have traditionally been held in remote places with minimal distractions.Beginning in the early 1960s，I attended the summer Nucleic Acids Gordon Conference in rural New Hampshire，sharing austere（简朴的）dorm facilities in a private boy’s school with randomly assigned roommates.As a beginning scientist，I found the question period after each talk especially fascinating，providing valuable insights into the personalities and ways of thinking of many senior scientists whom I had not encountered previously.Back then，there were no cellphones and no Internet，and all of the speakers seemed to stay for the entire week.During the long，session-free afternoons，graduate students mingled freely with professors.Many life-long friendships were begun，and—as Gordon intended—new scientific collaborations began.Leap forward to today，and every scientist can gain immediate access to a vast store of scientific thought and to millions of other scientists via the Internet.Why，nevertheless，do in-person scientific meetings remain so valuable for a life in science？
Part of the answer is that science works best when there is a deep mutual trust and understanding between the collaborators，which is hard to develop from a distance.But most important is the critical role that face-to-face scientific meetings play in stimulating a random collision of ideas and approaches.The best science occurs when someone combines the knowledge gained by other scientists in non-obvious ways to create a new understanding of how the world works.A successful scientist needs to deeply believe，whatever the problem being tackled，that there is always a better way to approach that problem than the path currently being taken.The scientist is then constantly on the alert for new paths to take in his or her work，which is essential for making breakthroughs.Thus，as much as possible， scientific meetings should be designed to expose the attendees to ways of thinking and techniques that are different from the ones that they already know.
66.Assembled at Gordon Research Conference are those who____.
A.are physicists and biologists B.just start doing their sciences
C.stay in the forefront of science D.are accomplished senior scientists
67.Speaking of the summer Nucleic Acids Gordon Conference，the author thinks highly of____.
A.the personalities of senior scientists
B.the question period after each talk
C.the austere facilities around
D.the week-long duration
68.It can be inferred from the author that the value of the in-person scientific conference____.
A.does not change with times
B.can be explored online exclusively
C.lies in exchanging the advances in life science
D.is questioned in establishing a vast store of ideas
69.The author believes that the face-to-face scientific conferences can help the attendees better____.
A.understand what making a breakthrough means to them
B.expose themselves to novel ideas and new approaches
C.foster the passion for doing science
D.tackle the same problem in science
70.What would the author most probably talk about in the following paragraphs？
A.How to explore scientific collaborations.
B.How to make scientific breakthroughs.
C.How to design scientific meetings.
D.How to think like a genius.
Passage Three
Back in 1896，the Swedish scientist Svante Arrhenius realized that by burning coal we were adding carbon dioxide to the air，and that this would warm the Earth.But he mentioned the issue only in passing（顺便地），for his calculations suggested it would not become a problem for thousands of years.Others thought that the oceans would soak up any extra CO2，so there was nothing much to worry about.
That this latter argument has persisted to this day in some quarters highlights our species’propensity（倾向）to underestimate the scale of our impact on the planet.Even the Earth’s vast oceans cannot suck up CO2 as quickly as we can produce it，and we now know the stored CO2 is acidifying the oceans，a problem in itself.
Now a handful of researchers are warning that energy sources we normally think of as innocuous could affect the planet’s climate too.If we start to extract immense amounts of power from the wind，for instance，it will have an impact on how warmth and water move around the planet，and thus on temperatures and rainfall.
Just to be clear，no one is suggesting we should stop building wind farms on the basis of this risk.Aside from the huge uncertainties about the climatic effects of extracting power from the wind，our present and near-term usage is far too tiny to make any difference.For the moment，any negative consequences on the climate are massively outweighed by the effects of pumping out even more CO2.That poses by far the greater environmental threat；weaning ourselves off fossil fuels should remain the priority.
Even so，now it is the time to start thinking about the long-term effects of the alternative energy sources we are turning to.Those who have already started to look at these issues report weary，indifferent or even hostile reactions to their work.
That’s understandable，but disappointing.These effects may be inconsequential，in which case all that will have been wasted is some research time that may well yield interesting insights anyway.Or they may turn out to be sharply negative，in which case the more notice we have，the better.It would be unfortunate to put it mildly，to spend countless trillions replacing fossil-fuel energy infrastructure（基础建设）only to discover that its successor（替代物）is also more damaging than it need be.
These climatic effects may even be beneficial.The first，tentative models suggest that extracting large amounts of energy from high-altitude jet streams would cool the planet，counteracting the effects of rising greenhouse gases.It might even be possible to build an energy infrastructure that gives us a degree of control over the weather：turning off wind turbines here，capturing more of the sun’s energy there.
We may also need to rethink our long-term research priorities.The sun is ultimately the only source of energy that doesn’t end up altering the planet’s energy balance.So the best bet might be invested heavily in improving solar technology and energy storage—rather than in efforts to harness，say，nuclear fusion.
For the moment，all of this remains supposition（推测）.But our species has a tendency to myopia.We have nothing to lose，and everything to gain by taking the long view for a change.
71.In the first two paragraphs，the author is trying to draw our attention to____.
A.the escalating scale of the global warming
B.the division of scientists over the issue of global warming
C.reasons for us to worry about extra CO2 for the oceans
D.the human tendency to underestimate the harmful effects on the planet
72.The author’s illustration of wind-power extraction reflects____.
A.the priority of protecting the environment
B.the same human propensity as mentioned previously
C.the best strategy of reducing the environmental threat
D.the definite huge uncertainties about the climatic effects
73.The author argues that it would be unfortunate to replace fossil fuels only to find out that____.
A.the successors are also damaging
B.the countless trillions spent are wasted
C.the alternative energy sources don’t work
D.the research invites indifferent or even hostile reactions
74.According to the author，the best strategy is____.
A.to counteract the effects of rising greenhouse gases
B.to develop a degree of control over the weather
C.to extract large amounts of energy from wind
D.to explore solar energy and its storage(https://www.daowen.com)
75.It can be concluded from the passage that we need to take a long view on____.
A.human existence on the planet B.humanity’s energy supplies
C.our environmental threats D.our tendency to myopia
Passage Four
It is a well-known problem：A junior research group leader must somehow compete against the seniors，who have larger laboratories，good funding，and clout with the journals. Furthermore，in the normal grant system，preliminary data requirements make it hard to start new directions in research.Beginning scientists must build on their postdoctoral work， which forces them to continue along already-trodden paths.Once a laboratory has been established，it is reasonable for the reviewers of competitive grant applications to look for evidence of an investigator’s likely success in the form of“preliminary results”.But beginning group leaders should be judged only by their demonstrated excellence and their creativity in finding new directions.Such a change would greatly stimulate innovation.
I experienced the advantages of such a system 20 years ago，when moving to Germany from a postdoctoral position in the United States.A hierarchical system that emphasized seniority was rampant in Europe，and independent research positions for younger scientists were few，and I was lucky in joining the European Molecular Biology Laboratory（EMBL） in Heidelberg，which was exploring alternative ways to organize science，with the aim of promoting innovation and research excellence.
The EMBL had created a group leader system in which，apart from a few senior scientists to provide some stability，new researchers were directly funded for up to 9 years to do as they pleased，before being required to move on to a senior job elsewhere.This model was a success in large part because this type of funding encouraged a focus on innovation， but also because it provided a separate funding stream in Europe for starting scientists，The EMBL was not alone in this endeavor，as analogous thinking was beginning to take hold at other European institutions and funding agencies.But in 2007，the European system moved an important step further with the introduction of the European Research Council（ERC）.The ERC currently runs a pan-European competition that in 2012 funded 536 proposals after receiving more than 4，700 applications from beginning group leaders，each for 5 years for as much as 1.5 million euro per year.This grant is specifically targeted at providing additional opportunities for young investigators who are making the transition from working under a supervisor to being independent researchers in their own right.A crucial aspect of the ERC is that the reviewing criteria specifically focus on novelty，interdisciplinarity，and high-risk/high-gain research.The ERC runs other competitions to fund established investigators.
76.When it comes to the well-known problem for beginning scientists，what concerns the author is____.
A.how to facilitate their creativity
B.how to motivate them to do science
C.how to judge their grant applications fairly
D.how to help them establish their own laboratories
77.To stimulate innovation，the author argues that the current grant system focuses on____.
A.the excellence and creativity in exploring new directions
B.the evidence-based preliminary result for grant application
C.fair competition between the novel scientists and their seniors
D.a deep commitment to postdoctoral research on the part of beginning scientists
78.From his personal experience in Germany，the author is trying to tell us that he____.
A.realized the universal seniority of the hierarchical grant system
B.was lucky enough to switch to molecular biology
C.was a victim of the current grant system
D.benefited from the system he advocates
79.The funding model created by the EMBL was intended____.
A.to ensure the stability of doing science
B.to place a focus on doing basic sciences
C.to encourage starting scientists to be innovative
D.to provide senior positions for qualified scientists
80.Under the grant program of the ERC，starting scientists____.
A.are highly recognized by their innovations and discoveries
B.work as an interdisciplinary team without exception
C.are independent in doing innovative science
D.gather from different parts of the world
Passage Five
In 2007，surgeons in Aalst，Belgium，were taken aback when part of a surgical robots arm broke off inside a patient with prostate cancer.The fracture bent the da Vinci robot’s instrument so badly that it could not be removed through the original keyhole incision.That meant the urologists had to enlarge the wound to get the instrument out.
Today more than 2，500 of the$1.7 million da Vinci robots are at work in hospitals worldwide taking part in nearly 1.5 million operations in the past decade.Most patients go home with smaller scars，and the firm that makes da Vinci，Intuitive Surgical of Sunnyvale， California，claims post-operative pain and recovery time are also reduced.But reports of adverse events have risen，recently prompting the US Food and Drug Administration（FDA） to survey surgeons about the system in January.Bloomberg Businessweek reported earlier this month that 10 product liability lawsuits have been filed against da Vinci’s makers in the past 14 months.
The lawsuits，which the firm is defending，make for grisly reading—they allege， variously，that da Vinci has caused liver and spleen punctures during heart surgery，rectal damage during a prostate operation，and a vaginal hernia after a hysterectomy.There are also a number of cases of unintended burns from the robot’s cauterizing tools.The FDA’s inquiry，says spokeswoman Synim Rivers，aims to“determine if the rise in reports is a true reflection of problems，or simply an increase due to other factors”.
Is there cause for concern？Rates of adverse events or death for da Vinci surgery have not increased over the past several years，says Intuitive Surgical spokeswoman Lauren Burch，who refused to comment on the lawsuits.“The clinical evidence shows that da Vinci is safer than open surgical alternatives in many common procedures，”she says.
The robot aims to offer minimally invasive，highly accurate surgery with a human in control at all times.The surgeon handles the instruments on the robot’s four arms from a console with a stereoscopic 3D view of the operation，magnified up to 10 times.
“The console has brilliant，unsurpassed 3D vision，unlike laparoscope systems with 2D screens”，says Ben Challacombe，a consult urologist at Guy’s and St.Thomas’NHS Foundation Trust in London.“It also has fantastic control instruments that filter out hand tremors，whereas long laparoscopic tools only enhance tremor.”As a regular da Vinci user， Challacombe says the legal issues Intuitive Surgical faces are far more likely to be down to incorrect use by surgeons rather than robot faults.
That view is backed by James Breeden，president of the American Congress of Obstetricians and Gynecologists.“Studies show there is an increased complication rate，”he says.And some surgeons only get two-day’s training on da Vinci.
What’s more，healthcare providers are pushing the benefits of robot surgery，Breeden says，advertising less pain，lower blood loss and faster recovery.That drives demand beyond the evidence，he believes.There may not even be good data，claims Breeden，showing “that robotic hysterectomy is even as good as，let alone better than，far less costly minimally invasive alternatives”.
81.The increasing uses of robotic surgeries worldwide，according to the passage，____.
A.reduce significantly malpractice lawsuits thanks to their safety
B.put surgeons at a high risk of being sued for malpractice
C.help hit the record of 1.5 million operations every year
D.are accompanied by a rise in product liability lawsuits
82.The growing number of the lawsuits____.
A.leads to an enquiry by the FDA
B.reflects the real problems with the firm
C.has much to do with da Vinci with defects
D.is ascribed to the improper installation of da Vinci
83.From Burch to Challacombe，we can learn that____.
A.such advantages of da Vinci as minimal invasion and high accuracy are questionable
B.the lawsuits do have the real evidence to be taken seriously
C.the issue concerning the safety of da Vinci does exist
D.the surgical robot is not problematic but safe
84.As Breeden argues，the problem lies in____.
A.the wrong hands of the surgeons without any qualification
B.the hidden faults within the instruments on the four arms
C.the surgical benefits exaggerated by the healthcare providers
D.a lack of sufficient training on the part of surgeons
85.Which of the following can serve as the best title for the passage？
A.Four Arms Better Than Two？ B.A Revolution in Surgery？
C.The True Cost of Surgery？ D.Too Good to Be True？
Passage Six
In a poor，inland，gang-infested part of Los Angeles，there is a clinic for people with type 1 diabetes.As part of the country’s healthcare system，it serves persons who have fallen through all other safety-net options，the poorest of the poor.Although type 2 diabetes is rampant in this part of town，type 1 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 1 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.
86.At the beginning，the author describes the patients with an emphasis on____.
A.their financial status B.their living in injustice
C.their specialty care of any kind D.their ignorance of type 1 diabetes
87.As a diabetologist working for the Type 1 Clinic，the author is quite concerned about those who____.
A.misunderstand the concepts on blood glucose maintenance
B.have no ideas about what medical problems they are having
C.don’t care about acting as their own exogenous pancreas
D.lack access to property and sufficient clinical care
88.Not until the recession of 2008 did the medical staff____.
A.feel proud of their dedication and persistence in clinical practice
B.know how severe the complications of type 1 diabetes could be
C.regret about more they could have done for the patients
D.feel a sense of accomplishments in treating the patients
89.As witnessed by the dialectologist during the recession of 2008，many poor patients____.
A.developed poor eating habits with the progression of type 1 diabetes
B.struggled with their survival，let alone with their medical care
C.became losers in the investment with Bernie Madoff
D.switched from full-time to part-time jobs
90.Which of the following tones does the passage most probably carry？
A.Indifference. B.Sympathy.
C.Passion. D.Guilt.