参考译文



全球的政府都在想尽办法来对付不断上涨的医疗费用，尤其是药品价格。很多富国已经采取措施来控制价格，一些美国左翼人士也对此表现出积极支持的态度。但是美国的制药公司却认为，正是因为美国的制药公司拥有为其专利药品定价的自由，因此美国才能成为世界新药研发的生力军。而相比之下，采取价格控制措施的欧洲则坐享其成。设在华盛顿的制药行业游说团体美国药品研究与制造商协会（PhRMA）认为，因为其他富国采取的价格管制措施“阻碍创新，使病人无法使用最新药物，致使创新者不得不选择到公共政策更为宽松的国家去进行创新”。

斯坦福大学客座教授唐纳德·莱特所做的最新研究指出，即使面临价格管制，欧洲医药企业的创新性也高于美国企业。这种观点与2006年同一本期刊的另一篇较有影响力的文章正好相反，该文章检验了1982年至2003年注册药品的地理来源，结论是，有利的公共政策确实帮助美国成为了第一大医药国家。PhRMA迅速反驳了莱特先生的研究，坚持认为莱特的研究曲解和低估了美国国内创新的影响。

这场争论暴露了从国家的角度来看全球化药业时容易产生的两个误解。双方都把新药的产生归结于特定的源头国家（即那些最先开发出新药的公司的总部所在地）。但是沃顿商学院的帕特里夏·当宗认为这一观点没什么说服力，因为大部分医药巨头都在多个国家同时拥有实验室，而且经常从其他国家的生物科技公司获取正在开发的药品。同样，斯坦福大学的艾伦·加伯发现，企业不仅为本地市场开发药品，更是着眼全球市场。所以由于出口的诱惑，特定国家的价格管制不会阻碍当地的创新。

当然美国是个例外，其药品销量占到全球的40%以上。如果美国国会实行价格管制，那么会产生怎样的影响？如果下降幅度较大，世界其他地方新药研发者的获利也将减少。但是根据斯坦福伯恩斯坦金融研究公司的结论，在改革方案和措施不是很激进的情况下，价格改革不会抹杀创新。报告分析了如果政府针对老年人的医保计划Medicare中药品的价格降低20%可能会产生的影响，其结论是大型医药企业每股收益将因此下降3%～8%。

我们甚至还有理由认为价格改革可能会促进创新。英国和德国正在率先开展对药品疗效的比较和成本——收益分析，目的是以企业表现来决定对新药的资助力度。杨森药厂说服英国健康服务部门接受其昂贵的抗癌药物万珂，同时承诺若药品达不到预期疗效，将予以退款。

美国医药企业游说团体强烈反对强制推行类似的方法。一些人猜测，美国医药界反对的原因是害怕很多价格昂贵且获利丰厚的新药被发现物非所值。但是就像当宗女士所指出的那样：“对比较疗效的评价是一种间接的价格控制——但同样可以鼓励创新。”





Unit 89


Sleep is a funny thing．We’re taught that we should get seven or eight hours a night，but a lot of us get by just fine on less，and some of us actually sleep too much．① A study out of the University of Buffalo last month reported that people who routinely sleep more than eight hours a day and are still tired are nearly three times as likely to die of stroke—probably as a result of an underlying disorder that keeps them from snoozing soundly.

Doctors have their own special sleep problems．Residents are famously sleep deprived．When I was training to become a neurosurgeon，it was not unusual to work 40 hours in a row without rest．Most of us took it in stride，confident we could still deliver the highest quality of medical care．Maybe we shouldn’t have been so sure of ourselves．An article in the Journal of the American Medical Association points out that in the morning after 24 hours of sleeplessness，a person's motor performance is comparable to that of someone who is legally intoxicated．② Curiously，surgeons who believe that operating under the influence is the reason for dismissal often don’t think twice about operating without enough sleep.

“I could tell you horror stories,” says Jaya Agrawal，president of the American Medical Student Association，which runs a website where residents can post anonymous anecdotes．Some are terrifying．“I was operating after being up for over 36 hours,” one writes．“I literally fell asleep standing up and nearly face planted into the wound.”

“Practically every surgical resident I know has fallen asleep at the wheel driving home from work,” writes another．“I know of three who have hit parked cars．Another hit a ‘Jersey barrier’ on the New Jersey Turnpike，going 65 m．p．h.”“Your own patients have become the enemy,” writes a third，because they are“the one thing that stands between you and a few hours of sleep.”

Agrawal's organization is supporting the Patient and Physician Safety and Protection Act of 2001，introduced last November by Representative John Conyers Jr．of Michigan．Its key provisions，modeled on New York State's regulations，include an 80-hour workweek and a 24-hour work-shift limit．Most doctors，however，resist such interference．Dr．Charles Binkley，a senior surgery resident at the University of Michigan，agrees that something needs to be done but believes“doctors should be bound by their conscience，not by the government.”

The U.S．controls the hours of pilots and truck drivers．But until such a system is in place for doctors，patients are on their own．If you’re worried about the people treating you or a loved one，you should feel free to ask how many hours of sleep they have had and if more-rested staffers are available．Doctors，for their part，have to give up their pose of infallibility and get the rest they need.


注（1）：本文选自Time；

注（2）：本文习题命题模仿对象：第1、2题分别模仿1999年真题Text 4第1题和Text 2第2题；第3题模仿1998年真题Text 3第2题；第4、5题分别模仿2004年真题Text 2第3题和Text 3第5题。



1．We can learn from the first paragraph that ______.

A) people who sleep less than 8 hours a day are more prone to illness

B) poor sleep quality may be a sign of physical disorder

C) stroke is often associated with sleep

D) too much sleep can be as harmful as lack of sleep

2．Speaking of the sleep problems doctors face，the author implies that ______.

A) doctors often need little sleep to keep them energetic

B) doctors’ sleep is deprived by residents

C) doctors tend to neglect their own sleep problems

D) sleep-deprived doctors are intoxicated

3．Paragraphs 3 and 4 are written to ______.

A) entertain the audience with some anecdotes

B) discuss the cause of doctors’ sleep problems

C) show the hostility doctors harbor against their patients

D) exemplify the danger doctors face caused by lack of sleep

4．By“doctors should be bound by their conscience，not by the government” （Lines 5～6，Paragraph 5），Dr．Charles Binkley means that ______.

A) doctors should not abide by government's regulations

B) the government is interfering too much

C) the regulations about workweek and work shift are too specific

D) law cannot force a doctor to sleep while his conscience can

5．To which of the following is the author likely to agree?

A) Patients should control the working hours of their doctors.

B) Pilots and truck drivers work in safer environments than that of doctors’.

C) Patients are facing more risks if their doctors are not adequately-rested.

D) People concerned have the right to remove their doctors from their positions.





篇章剖析


本篇文章采用提出问题——分析问题——解决问题的模式指出了医生睡眠不足会带来的危害以及解决办法。第一段说明了睡眠对人的影响；第二段指出了医生睡眠不足的问题以及医生对此的态度；第三段至第四段以两个事例说明医生睡眠不足可能带来的危害；第四段介绍了政府针对这一问题所采取的措施以及医生对此的反应；最后一段分别对病人、相关人员及医生提出建议。





词汇注释


underlying /ˈʌndəˈlaɪɪŋ/ adj. 潜在的，隐晦的

resident /ˈrezɪdənt/ n. 住院医生

deprived /dɪˈpraɪvd/ adj. 缺乏的，不足的

neurosurgeon /ˌnjʊərəʊˈsɜːdʒən/ n. 神经外科医生

intoxicated /ɪnˈtɒksɪkeɪtɪd/ adj. 醉酒的

dismissal /dɪsˈmɪsəl/ n. 免职，解雇

anonymous /əˈnɒnɪməs/ adj. 匿名的

Turnpike /ˈtɜːnˌpaɪk/ n. 〈美〉 收费公路，收通行税的公路

provision /prəˈvɪʒən/ n. 规定；条款

staffer /ˈstɑːfə/ n. 职员

infallibility /ɪnˌfæləˈbɪlɪti/ n. 绝无错误，绝对可靠





难句突破


① A study out of the University of Buffalo last month reported that people who routinely sleep more than eight hours a day and are still tired are nearly three times as likely to die of stroke—probably as a result of an underlying disorder that keeps them from snoozing soundly.

主体句式：A study reported that...

结构分析：本句是个复杂长句，包含一个宾语从句（reported之后由that引导），两个定语从句（who引导的修饰people的从句和that引导的修饰disorder的从句），一个比较结构的省略形式（three times as likely to...）和一个容易理解错误的动词短语keep..．from...。

句子译文：上个月由布法罗大学所做的一项研究显示那些每天习惯睡八个小时以上但仍然感觉疲劳的人死于中风的危险是普通人的近三倍——也许这是一种潜在的紊乱导致的结果，正是这种紊乱才让他们难以安睡。

② Curiously，surgeons who believe that operating under the influence is the reason for dismissal often don't think twice about operating without enough sleep.

主体句式：Surgeons don't think twice.

结构分析：本句涉及定语从句（who引导的修饰surgeons的从句），宾语从句（believe后面由that引导的从句），和一个英语习语think twice about something以及容易引起歧义的介词without。

句子译文：令人好奇的是，那些认为酒后作业应该被免职的外科医生却很少认真思考在睡眠不足的情况下操刀手术的后果。





题目分析


1．B 推理题。从第一段最后一句话中的“probably as a result of an underlying disorder that keeps them from snoozing soundly”可以看出潜在的紊乱可能导致人们睡眠质量不高，虽然睡眠时间长，但仍然感到疲惫。因此B项是正确的。

2．C 推理题。文章第二段最后一句话说医生们虽然认为醉酒后给病人做手术应该受到严惩，但对于在睡眠不足的情况下做手术却并不“think twice”。由此可见C是正确的。

3．D 细节题。文章第二段指出医生睡眠不足以及医生对此缺乏重视的问题，紧接着就在第三、四段里举了几个例子：医生的脸差点碰到伤口，医生开车时趴在方向盘上睡着、撞车或撞到公路收费站栏杆等。可见这些例子是要说明睡眠不足可能带来的危害。

4．B 语义题。对于政府制定法规解决医生睡眠不足的问题，文章第五段第三句说“Most doctors，however，resist such interference”，并进一步引用Charles Binkley医生的话进行论证，可见Charles Binkley也认为政府干预过多了。所以应该选择B。

5．C 细节题。文章在最后给医生提出建议，认为医生应该改正认为他们绝不出错的态度，得到充足的休息，否则“patients are on their own”，病人就只能听天由命了。由此可见C是正确答案。





参考译文



睡眠是一件有趣的事情。我们被教导每晚要睡七八个小时，但我们很多人并没有睡够这个时间却依然身体健康，而我们中的一些人实际上睡得过多。上个月由布法罗大学所做的一项研究显示，那些每天习惯睡八个小时以上但仍然感觉疲劳的人死于中风的危险是普通人的近三倍——也许这是一种潜在的紊乱导致的结果，正是这种紊乱才让他们难以安睡。

医生们也有自己特殊的睡眠问题。住院医生以缺少睡眠而著称。我在受训成为一名神经外科医生的时候，时常会连续工作40个小时。我们大多数人对此不以为意，自信我们仍然能够给病人提供最高质量的医疗护理。也许我们不应该对自己这么自信。《美国医学会杂志》上刊登的一篇文章指出，一个人如果连续24小时不睡，那么到了早晨，他的运动能力就和那些饮酒后酒精浓度超标的人差不多。令人好奇的是，那些认为醉酒后做手术应该被免职的外科医生却很少认真思考在睡眠不足的情况下操刀手术的后果。

“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.