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男,45岁,农民。发热伴发冷、头痛、全身痛、乏力4天,咳嗽、血痰及咯血1天于8月25日来诊。当地正值洪水灾害,有数十人发病。查体:T39℃,神志清,球结膜充血,腓肠肌压痛,腹股沟淋巴结蚕豆大。最有可能的诊断是

A、肾综合征出血热
B、败血症
C、钩端螺旋体病
D、大叶性肺炎
E、流感
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正确答案:

C

答案解析:

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OneproblemwithostrichfarminginBritainis____.

1.AEuropeanspacecrafttookofftodaytospearheadthesearchforanother"Earth"amongthestars.

2.TheCorotspacetelescopeblastedoffaboardaRussianSoyuzrocketfromtheBaikonurcosmodromeinKazakhstanshortlyafter2.20pm.

3.Corot,shortforconvectionrotationandplanetarytransits,isthefirstinstrumentcapableoffindingsmallrockyplanetsbeyondthesolarsystem.Anysuchplanetsituatedintherightorbitstandsagoodchanceofhavingliquidwateronitssurface,andquitepossiblylife,althoughaleadingscientistinvolvedintheprojectsaiditwasunlikelytofind"anylittlegreenmen".

4.DevelopedbytheFrenchspaceagency,CNES,andpartneredbytheEuropeanSpaceAgency(ESA),Austria,Belgium,Germany,BrazilandSpain,Corotwillmonitoraround120,000starswithits27cmtelescopefromapolarorbit514milesabovetheEarth.Overtwoandahalfyears,itwillfocusonfivetosixdifferentareasofthesky,measuringthebrightnessofabout10,000starsevery512seconds.

5."Atthepresentmomentwearehopingtofindoutmoreaboutthenatureofplanetsaroundstarswhicharepotentialhabitats.Wearelookingathabitableplanets,notinhabitedplanets.Wearenotgoingtofindanylittlegreenmen,"ProfessorIanRoxburgh,anESAscientistwhohasbeeninvolvedwithCorotsinceitsinception,toldtheBBCRadio4Todayprogramme.

6.ProfRoxburghsaiditwashopedCorotwouldfind"rockyplanetsthatcoulddevelopanatmosphereand,iftheyaretherightdistancefromtheirparentstar,theycouldhavewater".

7.Tosearchforplanets,thetelescopewilllookforthedimmingofstarlightcausedwhenanobjectpassesinfrontofastar,knownasa"transit".Althoughitwilltakemoresophisticatedspacetelescopesplannedinthenext10yearstoconfirmthepresenceofanEarth-likeplanetwithoxygenandliquidwater,Corotwillletscientistsknowwheretopointtheirlenses.

8.MeasurementsofminutechangesinbrightnesswillenablescientiststodetectgiantJupiter-likegasplanetsaswellassmallrockyones.Itistherockyplanets-thatcouldbenobiggerthanabouttwicethesizeoftheEarth-whichwillcausethemostexcitement.Scientistsexpecttofindbetween10and40ofthesesmallerplanets.

9.Corotwillalsoprobeintostellarinteriorsbystudyingtheacousticwavesthatrippleacrossthesurfaceofstars,atechniquecalled"asteroseismology".

10.Thenatureoftheripplesallowsastronomerstocalculateastar’sprecisemass,ageandchemicalcomposition.

11."Aplanetpassinginfrontofastarcanbedetectedbythefallinlightfromthatstar.Smalloscillationsofthestaralsoproducechangesinthelightemitted,whichrevealwhatthestarismadeofandhowtheyarestructuredinternally.Thisdatawillprovideamajorboosttoourunderstandingofhowstarsformandevolve,"ProfRoxburghsaid.

12.Sincethediscoveryin1995ofthefirst"exoplanet"-aplanetorbitingastarotherthantheSun-morethan200othershavebeenfoundbyground-basedobservatories.

13.Untilnowtheusualmethodoffindingexoplanetshasbeentodetectthe"wobble"theirgravityimpartsonparentstars.ButonlygiantgaseousplanetsbiggerthanJupitercanbefoundthisway,andtheyareunlikelytoharbourlife.

14.Inthe2010s,ESAplanstolaunchDarwin,afleetoffourorfiveinterlinkedspacetelescopesthatwillnotonlyspotsmallrockyplanets,butanalysetheiratmospheresforsignsofbiologicalactivity.

15.Ataroundthesametime,theUSspaceagency,Nasa,willlaunchTerrestrialPlanetFinder,anotherspacetelescopedesignedtolocateEarth-likeplanets.

ChoosetheappropriateletterfromA-Dforquestion1.

1.Corotisaninstrumentwhich

(A)canhelptosearchforcertainplanets

(B)isusedtofindplanetsintheorbit

(C)canlocateplanetswithhumanbeings

(D)canspotanyplanetswithwater.

Dothefollowingstatementsagreewiththeinformationgiveninthereadingpassage?Forquestions2-5write

TRUEifthestatementagreeswiththeinformation

FALSEifthestatementcontraictstheinformation

NOTGIVENifthereisnoinformationonthisinthepassage

2.Scientistsaretryingtofindoutabouttheplanetsthatcanbeinhabited.

3.BBCRadio4recentlyfocusesonthebroadcastingofCorot.

4.Passingobjectsmightcauseafallinlight.

5.CorotcantellwhetherthereisanotherEarth-likeplanet.

Basedonyourreadingofthepassage,completethesentencesbelowwithwordstakenfromthepassage.UseNOMORETHANTHREEWORDSforeachanswer.

Withmeasurements,scientistswillbeabletosearchforsomegaseousandrockyplanets.Theywillbeextremelyexcitediftheycandiscoversomesmall6.__________,theexpectednumberofwhichcouldbeupto7.__________.

Corotwillenablescientiststostudythe8.__________ofstars.Inthisway,astar’smass,ageandchemicalcompositioncanbecalculated.

AccordingtoProfRoxburgh,changesinlightcanbecausedbypassingplanetsorstar9.__________.Therelatedstatisticscangainusabetter10.__________ofthestarformationandevolvement.

Observatorieshavefoundmanyexoplanets,whichare11.__________otherstarsthantheSun.Thecommonwayusedinfindingexoplanetscanonlydetecthugegasplanets,whichdonot12.___________.

WiththelaunchingofDarwin,astronomerswillbeabletoanalysewhetherthoserockyplanetshave13.__________forlife.

newweapontofightcancer

1.Britishscientistsarepreparingtolaunchtrialsofaradicalnewwaytofightcancer,whichkillstumoursbyinfectingthemwithviruseslikethecommoncold.

2.Ifsuccessful,virustherapycouldeventuallyformathirdpillaralongsideradiotherapyandchemotherapyinthestandardarsenalagainstcancer,whileavoidingsomeofthedebilitatingside-effects.

3.LeonardSeymour,aprofessorofgenetherapyatOxfordUniversity,whohasbeenworkingonthevirustherapywithcolleaguesinLondonandtheUS,willleadthetrialslaterthisyear.CancerResearchUKsaidyesterdaythatitwasexcitedbythepotentialofProfSeymour’spioneeringtechniques.

4.Oneofthecountry’sleadinggeneticists,ProfSeymourhasbeenworkingwithvirusesthatkillcancercellsdirectly,whileavoidingharmtohealthytissue."Inprinciple,you’vegotsomethingwhichcouldbemanytimesmoreeffectivethanregularchemotherapy,"hesaid.

5.Cancer-killingvirusesexploitthefactthatcancercellssuppressthebody’slocalimmunesystem."Ifacancerdoesn’tdothat,theimmunesystemwipesitout.Ifyoucangetavirusintoatumour,virusesfindthemaverygoodplacetobebecausethere’snoimmunesystemtostopthemreplicating.Youcanregarditasthecancer’sAchilles’heel."

6.Onlyasmallamountofthevirusneedstogettothecancer."Theyreplicate,yougetamillioncopiesineachcellandthecellburstsandtheyinfectthetumourcellsadjacentandrepeattheprocess,"saidProfSeymour.

7.Preliminaryresearchonmiceshowsthatthevirusesworkwellontumoursresistanttostandardcancerdrugs."It’saninterestingpossibilitythattheymayhaveanadvantageinkillingdrug-resistanttumours,whichcouldbequitedifferenttoanythingwe’vehadbefore."

8.Researchershaveknownforsometimethatvirusescankilltumourcellsandsomeaspectsoftheworkhavealreadybeenpublishedinscientificjournals.Americanscientistshavepreviouslyinjectedvirusesdirectlyintotumoursbutthistechniquewillnotworkifthecancerisinaccessibleorhasspreadthroughoutthebody.

9.ProfSeymour’sinnovativesolutionistomaskthevirusfromthebody’simmunesystem,effectivelyallowingthevirusestodowhatchemotherapydrugsdo-spreadthroughthebloodandreachtumourswherevertheyare.Thebighurdlehasalwaysbeentofindawaytodelivervirusestotumoursviathebloodstreamwithoutthebody’simmunesystemdestroyingthemontheway.

10."Whatwe’vedoneismakechemicalmodificationstothevirustoputapolymercoataroundit-it’sastealthviruswhenyouinjectit,"hesaid.

11.Afterthestealthvirusinfectsthetumour,itreplicates,butthecopiesdonothavethechemicalmodifications.Iftheyescapefromthetumour,thecopieswillbequicklyrecognisedandmoppedupbythebody’simmunesystem.

12.Thetherapywouldbeespeciallyusefulforsecondarycancers,calledmetastases,whichsometimesspreadaroundthebodyafterthefirsttumourappears."There’sanawfulstatisticofpatientsinthewest...withmalignantcancers;75%ofthemgoontodiefrommetastases,"saidProfSeymour.

13.Twovirusesarelikelytobeexaminedinthefirstclinicaltrials:adenovirus,whichnormallycausesacold-likeillness,andvaccinia,whichcausescowpoxandisalsousedinthevaccineagainstsmallpox.Forsafetyreasons,bothwillbedisabledtomakethemlesspathogenicinthetrial,butProfSeymoursaidheeventuallyhopestousenaturalviruses.

14.Thefirsttrialswilluseuncoatedadenovirusandvacciniaandwillbedeliveredlocallytolivertumours,inordertoestablishwhetherthetreatmentissafeinhumansandwhatdoseofviruswillbeneeded.Severalmoreyearsoftrialswillbeneeded,eventuallyalsoonthepolymer-coatedviruses,beforethetherapycanbeconsideredforuseintheNHS.Thoughtheapproachwillbeexaminedatfirstforcancersthatdonotrespondtoconventionaltreatments,ProfSeymourhopesthatonedayitmightbeappliedtoallcancers.

Questions1-6

Dothefollowingstatementsagreewiththeinformationgiveninthereadingpassage?Forquestions1-6write

TRUEifthestatementagreeswiththeinformation

FALSEifthestatementcontradictstheinformation

NOTGIVENifthereisnoinformationonthisinthepassage

1.Virustherapy,ifsuccessful,hasanadvantageineliminatingside-effects.

2.CancerResearchUKisquitehopefulaboutProfessorSeymour’sworkonthevirustherapy.

3.Viruscankillcancercellsandstopthemfromgrowingagain.

4.Cancer’sAchilles’heelreferstothefactthatvirusmaystaysafelyinatumorandreplicate.

5.Toinfectthecancercells,agooddealofvirusesshouldbeinjectedintothetumor.

6.Researchesonanimalsindicatethatviruscouldbeusedasanewwaytotreatdrug-resistanttumors.

Question7-9

Basedonthereadingpassage,choosetheappropriateletterfromA-Dforeachanswer.

7.Informationaboutresearchesonviruseskillingtumorcellscanbefound

(A)onTV

(B)inmagazines

(C)oninternet

(D)innewspapers

8.Totreattumorsspreadingoutinbody,researcherstryto

(A)changethebody’immunesystem

(B)injectchemotherapydrugsintobloodstream.

(C)increasetheamountofinjection

(D)disguisethevirusesonthewaytotumors.

9.Whenthechemicalmodifiedvirusintumorreplicates,thecopies

(A)willsoonescapefromthetumorandspreadout.

(B)willbewipedoutbythebody’simmunesystem.

(C)willbeimmediatelyrecognizedbytheresearchers.

(D)willeventuallystopthetumorfromspreadingout.

Questions10-13

Completethesentencesbelow.Chooseyouranswersfromthelistofwords.Youcanonlyuseeachwordonce.

NBTherearemorewordsinthelistthanspacessoyouwillnotusethemall.

Inthefirstclinicaltrials,scientistswilltryto……10……adenovirusandvaccinia,soboththeviruseswillbelesspathogenicthanthe……11…….Theseuncoatedviruseswillbeapplieddirectlytocertainareastoconfirmsafetyonhumanbeingsandtheright……12……needed.Theexperimentswillfirstlybe……13……tothetreatmentofcertaincancers

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