People with diabetes are more likely to have hypertension？

A 57-year-old man with long-standing diabetes mellitus and newly diagnosed hypertension presents to his primary care physician for follow-up. The patient has been trying to alter his dietary habits and now exercises more frequently, but the hypertension has persisted. The patient is started on an angiotensinconverting enzyme inhibitor (ACE inhibitor) with good results. He is instructed to continue this medication and follow up in several months. Questions: 1. What are the effects of angiotensin II? 2. How would inhibition of ACE decrease blood pressure?

A．measles, HIV, hepatitis.

B．diabetes, hypertension, HIV.

C．hepatitis, syphilis, diabetes.

D．HIV, hepatitis, syphilis.

Children have been said to have brain-injured child syndrome, hyperactive (极度活跃的) child syndrome and attention-deficit disorder (ADD). As early as the 1940's, psychiatrists have【62】children with hyperactivity and extremely distracted and impulsive. These frequent name changes show how【63】researchers are about the causes of the problem and the diagnostic (诊断的)【64】for the disorders.

In the past several years, the people who study attention deficit hyperactivity disorder (ADHD) have【65】to clarify the disorder's causes and【66】, and have reasons to believe that it may be【67】. Today's view on this disorder is very different from the beliefs of just a few years ago.

Researchers are finding that ADHD is not a disorder of just attention, but is from a developmental【68】in the brain's circuitry and self-control. The loss of self-control【69】other important brain functions compulsory for【70】attention. ADHD【71】two sets of symptoms: inattention and a【72】of hyperactive and impulsive behaviors. Most children are more active and【73】than adults are. Children are more inconsistent,【74】by brief actions. The younger the child, the【75】aware they are. This behavior. is a【76】of a problem when it is displayed more in them than in their【77】. Boys are at least three times more【78】than girls to have ADHD. Studies have found that ADHD in boys outnumbers girls 9 to 1; this is because boys are genetically likely to develop disorders in the nervous system. These behaviors【79】occur between the ages of 3 and 5.【80】, some children don't start to develop the disorder until late childhood or early adolescence. Researchers are unable to find the reasons for this【81】.

(63)

A．formulated

B．labeled

C．patented

D．licensed

Scientists have discovered a genetic defect that appears to cause deficit-hyperactivity disorder, more commonly known as hyperactivity. People afflicted with this disorder have trouble focusing their attention and controlling impulses, and tend to be rest-less and aggressive. The defect occurs in a gene that regulates the body's use of the thyroid hormone. This finding was made in continuing study organized by the National Institute of Diabetes and Digestive and Kidney Diseases in which 70 percent of children inheriting the gene were hyperactive while only 20 percent of the children not inheriting the gene were hyperactive. And although the researchers admit that this defective gene probably accounts for only a fraction of cases of hyperactivity, this discovery will allow doctors to spot newborn babies likely to have the disorder, and also to provide clues for its cause and treatment.

Children have been said to have brain-injured child syndrome, hyperactive(极度活跃的)child syndrome and attention-deficit disorder(ADD). As early as the 1940's, psychiatrists have【C1】______children with hyperactivity and extremely distracted and impulsive(冲动的). These frequent name changes show how【C2】______researchers, are about the causes【C3】______the problem and the diagnostic criteria for the disorders. In the past several years, the people who【C4】______attention deficit hyperactivity disorder(ADHD)have【C5】______to clarify the disorder's causes and【C6】______, and have reasons to believe that it may be genetic. Today's view【C7】______this disorder is very different from the beliefs of just a few years ago. Researchers are finding that ADHD is not a disorder of just attention, but is from a developmental【C8】______in the brain's circuitry and self-control. The loss of self-control【C9】______other important brain functions mandatory for maintaining【C10】______. ADHD involves two sets of symptoms: inattention and a【C11】______of hyperactive and impulsive behaviors. Most children are more active and distractive than adults are. Children are more inconsistent, affected by brief actions. The younger the child, the less【C12】______they are. This behavior. is a【C13】______of a problem when it is displayed more in them than in their【C14】______. Boys are at least three times more【C15】______than girls to have ADHD. Studies have found that ADHD in boys outnumbers girls 9 to 1, this is because boys are genetically likely to【C16】______disorders in the nervous system. These behaviors generally【C17】______between the ages of 3 and 5.【C18】______, some children don't start to develop the disorder until【C19】______childhood or early adolescence. Researchers are unable to find the reasons for this【C20】______.

【C1】

A．labeled

B．treated

C．regarded

D．handled

Scientists have discovered a genetic defect that appears to cause deficit-hyperactivity disorder, more commonly known as hyperactivity. People afflicted with this disorder have trouble focusing their attention and controlling impulses, and tend to be rest-less and aggressive. The defect occurs in a gene that regulates the body's use of the thyroid hormone. This finding was made in continuing study organized by the National Institute of Diabetes and Digestive and Kidney Diseases in which 70 percent of children inheriting the gene were hyperactive while only 20 percent of the children not inheriting the gene were hyperactive. And although the researchers admit that this defective gene probably accounts for only a fraction of cases of hyperactivity, this discovery will allow doctors to spot newborn babies likely to have the disorder, and also to provide clues for its cause and treatment.

Many millions of people have high blood pressure(hypertension 高血压). What's so frightening about this so called silent killer is that it often does not produce (51) for years, secretly damaging arteries and organs throughout the body until it erupts (爆发) in the form. of stroke, heart attack, congestive heart failure(充血性尽力衰竭) or kidney disease. (52) left untreated, even mild hypertension can reduce the life expectancy of a 35-year-old (53) several years. (Readings of 140 to 159 over 90 to 99 are mildly high; about 120/80 is normal. )

That's why high blood pressure is commonly treated with anti-hypertensive drugs. But studies (54) that in some people an increase in calcium(钙) consumption can help (55) blood pressure without medication(药物治疗)。

Calcium also seems to help prevent high blood pressure. (56) the results of 13-year survey (57) by the U.S. National Center for Health Statistics, James H. Dwyer, associate professor of (58) medicine at the University of Southern California School of Medicine, found that people who consumed 1300 milligrams of calcium a day were 12 percent (59) likely to develop hypertension than those (60) only 300 mg. a day. In people under age 40, risk was reduced by up to 25 percent.

Soon doctors may (61) some hypertension patients to increase their calcium intake, (62) the way they now advise sodium(钠) restriction. "It's (63) to add food or supplements than to go on a low-sodium diet," (64) Dr. David McCarron, professor of medicine at Oregon Health Sciences University. "Our studies show that people who try the low-sodium (65) don't stay with it very long. "

(51)

A．evidence

B．symptoms

C．marks

D．sign

If you have high blood pressure, youre in good【C1】______. Hypertension affects 67 million Americans, including nearly two-thirds of people over age 60. But it isnt an inevitable part of the aging【C2】______Its better to think of it as【C3】______sodium poisoning. And, theres a way to prevent the problem—and to save many, many lives. A lifetime of【C4】______too much sodium (mostly in the form. of table salt) raises blood pressure, and high blood pressure kills and disables people by【C5】______strokes and heart attacks. In the United States, according to best estimates,【C6】______sodium is killing between 40,000 and 90,000 people and running up to $20 billion in medical costs a year. Americans on average【C7】______about 3,300 milligrams of sodium per day, but experts recommend less than 2,300 milligrams—and less than 1,500 milligrams for people over age 50, black people, or those who already have hypertension, diabetes or kidney disease, which【C8】______a majority of American adults. Either【C9】______is far below where most Americans are now. The reason that nearly everyone eats【C10】______too much sodium is that our food is loaded with it, and often where we dont【C11】______or expect it. Of course ham and canned soup are full of salt, but so are many foods that are【C12】______: A blueberry cake can have more than double the salt of a serving of potato chips.【C13】______healthy-sounding food can pack【C14】______sodium loads. Many restaurant main courses have far more sodium than is recommended for an【C15】______day. Doctors warn people with high blood pressure to go on a low-salt diet, but thats virtually impossible in todays world,【C16】______nearly 80 percent of the sodium that Americans eat comes in【C17】______and restaurant food. You cant take it out. And【C18】______everyone, not just people with hypertension【C19】______over food labels, should be taking in less sodium. The only way to prevent millions of Americans from developing high blood pressure is for companies and restaurants to stop loading up their food with sodium. Its not easy,【C20】______it isnt impossible either.

【C1】

A．shape

B．company

C．therapy

D．trouble

Culture influences an individuals health beliefs, behaviours, activities and medical treatment outcomes.【C1】______ the significant influence of culture upon health and related outcomes, health care【C2】______ should be culturally competent in order to provide【C3】______ health care to patients. Cultural competency means considering many options and being more careful about making judgements.【C4】______, scars and bruises that suggest abuse in western culture could【C5】______ be symbols of accepted healing methods or sacred rituals.【C6】______, different parts of the body are considered sacred in different cultures. Cultural competency in healthcare【C7】______ four major challenges for providers. The first is the straightforward challenge of recognizing clinical【C8】______ among people of different ethnic and racial groups, e.g., higher【C9】______ of hypertension in African Americans and【C10】______ diabetes in certain Native American groups. The second, and far more complicated, challenge is【C11】______. This deals with everything from the need for interpreters to nuances of words in various languages. Many patients, even in western cultures, are【C12】______ to talk with their doctors about【C13】______ personal matters as sexual activity or chemical use. How do we overcome this【C14】______ among more restricted cultures? The third challenge is ethics.【C15】______ western medicine is among the best in the world, we do not have all the【C16】______. Respect for the belief systems of【C17】______ and the effects of those beliefs on well-being are critically important to competent care. The final challenge involves【C18】______. For some patients, authority figures are immediately mistrusted,【C19】______ for good reason. Having seen or been victims of atrocities at the hands of authorities in their homelands, many people are as【C20】______ of caregivers themselves as they are of the care.

【C1】

A．Because of

B．Due to

C．Thanks to

D．In regard to