READING
READING PASSAGE 1
You should spend about 20 minutes on Questions 1-13, which are based on Reading Passage 1 below.
Sleep medication linked to
bizarre behaviour
New evidence has linked a commonly prescribed sleep medication with bizarre behaviours, including a case in which a woman painted her front door in her sleep.
UK and Australian health agencies have released information about 240 cases of odd occurrences, including sleepwalking, amnesia and hallucinations among people taking the drug zolpidem.
While doctors say that zolpidem can offer much-needed relief for people with sleep disorders, they caution that these newly reported cases should prompt a closer look at its possible side effects.
Zolpidem, sold under the brand names Ambien, Stilnoct and Stilnox, is widely prescribed to treat insomnia and other disorders such as sleep apnea. Various forms of the drug, made by French pharmaceutical giant Sanofi-Aventis, were prescribed 674,500 times in 2005 in the UK.
A newly published report from Australia’s Federal Health Department describes 104 cases of hallucinations and 62 cases of amnesia experienced by people taking zolpidem since marketing of the drug began there in 2000. The health department report also mentioned 16 cases of strange sleepwalking by people taking the medication. Midnight snack
In one of these sleepwalking cases a patient woke with a paintbrush in her hand after painting the front door to her house. Another case involved a woman who gained 23 kilograms over seven months while taking zolpidem. “It was only when she was
discovered in front of an open refrigerator while asleep that the problem was resolved,” according to the report.
The UK’s Medicines and Healthcare products Regulatory Agency, meanwhile, has recorded 68 cases of adverse reactions to zolpidem from 2001 to 2005.
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The newly reported cases in the UK and Australia add to a growing list of bizarre
sleepwalking episodes linked to the drug in other countries, including reports of people sleep-driving while on the medication. In one case, a transatlantic flight had to be diverted after a passenger caused havoc after taking zolpidem. Hypnotic effects
There is no biological pathway that has been proven to connect zolpidem with these behaviours. The drug is a benzodiazepine-like hypnotic that promotes deep sleep by interacting with brain receptors for a chemical called gamma-aminobutyric acid. While parts of the brain become less active during deep sleep, the body can still move, making sleepwalking a possibility.
The product information for prescribers advises that psychiatric adverse effects,
including hallucinations, sleepwalking and nightmares, are more likely in the elderly, and treatment should be stopped if they occur.
Patient advocacy groups say they would like government health agencies and drug companies to take a closer look at the possible risks associated with sleep medicines. They stress that strange sleepwalking and sleep-driving behaviours can have risky consequences.
“When people do something in which they’re not in full control it’s always a danger,” says Vera Sharav of the New York-based Alliance for Human Research Protection, a US network that advocates responsible and ethical medical research practices. Tried and tested
“The more reports that come out about the potential side effects of the drug, the more research needs to be done to understand if these are real side effects,” says sleep researcher Kenneth Wright at the University of Colorado in Boulder, US.
Millions of people have taken the drug without experiencing any strange side effects, points out Richard Millman at Brown Medical School, director of the Sleep Disorders Center of Lifespan Hospitals in Providence, Rhode Island, US. He says that unlike older types of sleep medications, zolpidem does not carry as great a risk of addiction. And Wright notes that some of the reports of “sleep-driving” linked to zolpidem can be easily explained: some patients have wrongly taken the drug right before leaving work in hopes that the medicine will kick in by the time they reach home. Doctors stress that the medication should be taken just before going to bed.
The US Food & Drug Administration says it is continuing to \"actively investigate\" and collect information about cases linking zolpidem to unusual side effects.
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The Ambien label currently lists strange behaviour as a “special concern” for people taking the drug. “It’s a possible rare adverse event,” says Sanofi-Aventis spokesperson Melissa Feltmann, adding that the strange sleepwalking behaviours “may not necessarily be caused by the drug” but instead result from an underlying disorder. She says that “the safety profile [of zolpidem] is well established”. The drug received approval in the US in 1993.
Questions 1-6
Do the following statements agree with the information given in the Reading Passage1? In boxes 1-6 on your answer sheet write
TRUE if the statement is true according to the passage FALSE if the statement is false according to the passage NOT GIVEN if the information is not given in the passage
1. Ambien, Stilnoct and Stilnox are brand names of one same drug treating insomnia. 2. The woman’s obesity problem wasn’t resolved until she stopped taking zolpidem. 3. Zolpidem received approval in the UK in 2001.
4. The bizarre behaviour of a passenger after taking zolpidem resulted in the diversion of a flight bound for the other side of the Atlantic.
5. Zolpidem is the only sleep medication that doesn’t cause addiction.
6. The sleep-driving occurrence resulted from the wrong use of zolpidem by an office worker.
Question 7-9
Choose the appropriate letters A-D and Write them in boxes 7-9 on your answer sheet. 7. How many cases of bizarre behaviours are described in an official report from Australia? A. 68 B. 104 C. 182 D. 240
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8. Which of the following is NOT mentioned in the product information about zolpidem? A. Treatment should be stopped if side effects occur. B. Medication should be taken just before going to bed. C. Adverse effects are more likely in the elderly.
D. Side effects include nightmares, hallucinations and sleepwalking. 9. Who claimed that the safety description of zolpidem was well established? A. Kenneth Wright B. Melissa Feltmann C. Richard Millman D. Vera Sharav
Questions 10-13
Answer the following questions with NO MORE THAN THREE WORDS each in boxes 10-13.
10. How many times was French-made zolpidem prescribed in 2005 in Britain? 11. What kind of hypnotic is zolpidem as a drug which promotes deep sleep in patients? 12. What can sleepwalking and sleep-driving behaviours cause according to patient advocacy groups?
13. What US administration says that it has been investigating the cases relating zolpidem to unusual side effects?
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READING PASSAGE 2
You should spend about 20 minutes on Questions 14-26, which are based on Reading Passage 2 below.
Questions 14-19
This passage has 7 paragraphs A-G.
Choose the correct heading for each paragraph from the list of headings below. Write the correct number i-ix in boxes 14-19 on your answer sheet. List of Headings i. How does torcetrapib work?
ii. Contradictory result prior to the current trial
iii. One failure may possibly bring about future success iv. The failure doesn’t lead to total loss of confidence v. It is the right route to follow vi. Why it’s stopped
vii. They may combine and theoretically produce ideal result viii. What’s wrong with the drug ix. It might be wrong at the first place Example answer Paragraph A iv 14. Paragraph B 15. Paragraph C 16. Paragraph D 17. Paragraph E 18. Paragraph F 19. Paragraph G
Why did a promising heart drug fail?
Doomed drug highlights complications of meddling with
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cholesterol.
A.The failure of a high-profile cholesterol drug has thrown a spotlight on the complicated
machinery that regulates cholesterol levels.But many researchers remain confident that drugs to boost levels of 'good' cholesterol are still one of the most promising means to combat spiralling heart disease.
B.Drug company Pfizer announced on 2 December that it was cancelling all clinical trials of torcetrapib,a drug designed to raise heart-protective high-density lipoproteins (HDLs).In a trial of 15000 patients,a safety board found that more people died or suffered cardiovascular problems after taking the drug plus a cholesterol-lowering statin than those in a control group who took the statin alone.
C.The news came as a kick in the teeth to many cardiologists because earlier tests in animals and people suggested it would lower rates of cardiovascular disease.\"There have been no red flags to my knowledge,\" says John Chapman,a specialist in lipoproteins and atherosclerosis at the National Institute for Health and Medical Research (INSERM) in Paris who has also studied torcetrapib.\"This cancellation came as a complete shock.\"
D.Torcetrapib is one of the most advanced of a new breed of drugs designed to raise levels of HDLs,which ferry cholesterol out of artery-clogging plaques to the liver for removal from the body.Specifically,torcetrapib blocks a protein called cholesterol ester transfer protein (CETP),which normally transfers the cholesterol from high-density lipoproteins to low density,plaque-promoting ones.Statins,in contrast,mainly work by lowering the 'bad' low-density lipoproteins. Under pressure
E.Researchers are now trying to work out why and how the drug backfired,something that will not become clear until the clinical details are released by Pfizer.One hint lies in evidence from earlier trials that it slightly raises blood pressure in some patients.It was thought that this mild problem would be offset by the heart benefits of the drug.But it is possible that it actually proved fatal in some patients who already suffered high blood pressure.If blood pressure is the explanation,it would actually be good news for drug
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developers because it suggests that the problems are specific to this compound.Other prototype drugs that are being developed to block CETP work in a slightly different way and might not suffer the same downfall.
F.But it is also possible that the whole idea of blocking CETP is flawed,says Moti Kashyap,who directs atherosclerosis research at the VA Medical Center in Long Beach,California.When HDLs excrete cholesterol in the liver,they actually rely on LDLs for part of this process.So inhibiting CETP,which prevents the transfer of cholesterol from HDL to LDL,might actually cause an abnormal and irreversible accumulation of cholesterol in the body.\"You're blocking a physiologic mechanism to eliminate cholesterol and effectively constipating the pathway,\" says Kashyap. Going up
G.Most researchers remain confident that elevating high density lipoproteins levels by one means or another is one of the best routes for helping heart disease patients.But HDLs are complex and not entirely understood.One approved drug,called niacin,is known to both raise HDL and reduce cardiovascular risk but also causes an unpleasant sensation of heat and tingling.Researchers are exploring whether they can bypass this side effect and whether niacin can lower disease risk more than statins alone.Scientists are also working on several other means to bump up high-density lipoproteins by,for example,introducing synthetic HDLs.\"The only thing we know is dead in the water is torcetrapib,not the whole idea of raising HDL,\" says Michael Miller,director of preventive cardiology at the University of Maryland Medical Center,Baltimore.
Questions 20-26
Match torcetrapib,HDLs,statin and CETP with their functions
Write the correct letter A, B, C or D in boxes 20-26 on your answer sheet. NB You may use any letter more than once.
20.It has been administered to over 10,000 subjects in a clinical trial. 21.It could help rid human body of cholesterol. 22.Researchers are yet to find more about it. 23. It was used to reduce the level of cholesterol.
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24. According to Kashyap, it might lead to unwanted result if it’s blocked. 25. It produced contradictory results in different trials. 26. It could inhibit LDLs.
List of choices A. Torcetrapic B. HDLS C. Statin D. CETP
READING PASSAGE 3
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You should spend about 20 minutes on Questions 27-40, which are based on Reading Passage 3 below .
Seeking an energy holy trinity
1 NEELIE KROES, the European Union's competition commissioner, did not mince her words when reporting on Europe's energy markets on Wednesday January 10th. Europe's energy firms have failed to invest in networks and so customers are suffering. Those “vertically integrated” energy companies such as Electricité de France (EDF) or Germany's E.ON, widely dubbed as “national champions”, are effectively behaving like local monopolies. Shy of competition, eager for artificially high
prices, they are helping to block the efficient generation, transmission and distribution of energy on the continent.
2 Energy prices vary wildly across Europe. Ms Kroes wants to see cheaper energy, and intends to push suppliers to divest their distribution network and to get them to invest more in transportation systems so that more energy—in the form of gas, or electricity, for example—can flow easily over borders. It is remarkably hard, for example, for gas-poor Germany to import from the neighbouring, gas-rich Netherlands. Companies that dominate national markets have, so far, had little interest in improving the
interconnections which would mean lower prices for consumers across the continent. 3 Ms Kroes, of course, will struggle to get her way. The European Commission, which on the same day presented its recommendation for improving EU energy policy, also wants to see the unbundling of ownership, the legal separation of energy suppliers and transporters, something that the integrated energy companies and interested governments, notably in France and Germany, are bound to oppose ferociously. 4 Complicating the matter is an argument over the security of energy supply in Europe. Much has been made of the risk for western Europe of depending too heavily on Russian exports of gas. Russia under Vladimir Putin is prone to using energy exports as a blunt tool of foreign policy, especially when trying to bully countries in its hinterland. Last year Russia interrupted gas deliveries to Ukraine, affecting supplies in central and western Europe too. This week it blocked oil exports passing via Belarus to Europe, though that spat was soon resolved.
5 The risk is that concerns about security of supply may be used spuriously by those in
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Europe who oppose the sort of liberalisation encouraged by Ms Kroes. The likes of E.ON and EDF may claim that only protected national champions are able to secure supply, by striking long-term deals with powerful foreign suppliers. The Commission disagrees. Such deals are too often politically motivated and far from transparent. Protection has been tried for long enough and evidently has not worked for the internal market, nor have these companies secured the best deals for consumers from the Russians.
6 In contrast, the Commission's new policy proposes, ideally, a break-up of these companies into suppliers and distributors. (As a second best solution, especially for France and Germany, it recommends the management of the networks by a third party.) Properly independent managers of Europe's energy networks would have a strong incentive to build interconnecting pipelines and power lines across borders. For the gas market another means of ensuring competition and security would be finding a more diverse range of suppliers, for example by building more terminals for the import of liquified natural gas. It would also be likely to mean lower prices, if the example of liberalised Britain over the past ten years is anything to go by.
7 Whether any of this is likely to happen soon, however, is another matter. The Commission is also calling for European governments to agree on a common effort to reduce carbon emissions by at least 20% by 2020 (compared with 1990 levels). If America is willing to play ball, the Commission proposes to reduce emissions by as much as 30%. Achieving either target would mean promoting cleaner cars, a more effective
emissions-trading system for Europe, wider use of public transport and a sharp increase in the use of renewable sources of energy, like wind and solar power. All that is laudable enough, but will also require political horse-trading as governments—Europe's leaders are due to meet in March to discuss the various energy proposals—try to avoid commitments that may hurt domestic energy companies or make European firms less competitive than rivals in America, Asia and elsewhere.
Questions 27-31
Do the following statements reflect the views of the writer in the reading passage? In boxes 27-31 on your answer sheet write
YES if the statement reflects the views of the writer NO if the statement contradicts the views of the writer NOT GIVEN if there is no information about this in the passage
27.Europe's energy companies have funded the construction of the distribution network.
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28.There has been a wide range of energy prices within Europe.
29.Gas-poor Germany has to pay a price higher than average to import gas from its neighbour.
30.E.ON and EDF may oppose the liberalisation due to their concerns about the security of energy supply.
31.The European Commission proposes to reduce carbon emissions by 30% if the U.S. is willing to cut its.
Questions 32-36
Look at the box of countries below.
Choose One or Two countries to complete the following sentences. Write your answers in boxes 32-36 on your answer sheet. Countries
A. Belarus B. Britain C. France D. Germany E. Russia F. Ukraine G. The U.S.
32. It's dangerous for western Europe to depend too much on gas imports from………… 33. A liberalised policy of energy supply was enforced over ten years in………… 34. Last year energy supplies in central and western Europe was affected owing to the interruption of gas deliveries to…………
35. The governments in…………are bound to oppose the separation of energy suppliers and transporters?
36. Oil exports passing via…………to Europe was blocked this week.
Questions 37-40
Choose NO MORE THAN THREE WORDS from the reading passage above for each answer.
Write your answers in boxes 37-40.
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37. The EC disagrees with energy firms to strike long-term deals with foreign suppliers because such deals are usually far from…………
38. The EC proposes to split those “national champions” into…………
39. A more diverse range of suppliers would guarantee…………in the European gas market.
40. The realization of carbon emissions reduction would require the promotion of cleaner cars,a better emissions-trading system,wider use of public transport and more use of…………of energy.
READING ANSWERS&EXPLAINATION
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1. True
See para.3 from the beginning: Zolpidem, sold under the brand names Ambien, Stilnoct and Stilnox, is widely prescribed to treat insomnia and other disorders such as sleep apnea. 2. False
See para.1 under the subtitle “Midnight snack”: Another case involved a woman who gained 23 kilograms over seven months while taking zolpidem. “It was only when she was discovered in front of an open refrigerator while asleep that the problem was resolved”… 3. Not Given
See para.2 under the subtitle “Midnight snack”: The UK’s Medicines and Healthcare products Regulatory Agency, meanwhile, has recorded 68 cases of adverse reactions to zolpidem from 2001 to 2005. (The time the drug was approved in the UK was not mentioned.) 4. True
See para.3 under the subtitle “Midnight snack”: In one case, a transatlantic flight had to be diverted after a passenger caused havoc after taking zolpidem. 5. False
See para.2 under the subtitle “Tried and tested”: He says that unlike older types of sleep medications, zolpidem does not carry as great a risk of addiction. 6. Not Given
See para.3 under the subtitle “Tried and tested”: And Wright notes that some of the reports of “sleep-driving” linked to zolpidem can be easily explained: some patients have wrongly taken the drug right before leaving work in hopes that the medicine will kick in by the time they reach home. (No patients as office workers are mentioned in the passage.) 7. C
See para.4 from the beginning: A newly published report from Australia’s Federal Health Department describes 104 cases of hallucinations and 62 cases of amnesia experienced by people taking zolpidem since marketing of the drug began there in 2000. The health department report also mentioned 16 cases of strange sleepwalking by people taking the medication. 8. B
See the sentence in para.2 under the subtitle “Hypnotic effects” (The product information for prescribers advises that psychiatric adverse effects, including hallucinations, sleepwalking
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and nightmares, are more likely in the elderly, and treatment should be stopped if they occur.) and the sentence in para.3 under the subtitle “Tried and tested” (Doctors “not the product information” stress that the medication should be taken just before going to bed.) 9. B
See para.5 under the subtitle “Tried and tested”: Sanofi-Aventis spokesperson Melissa Feltmann … says that “the safety profile [of zolpidem] is well established”. 10. 674,500 (times)
See para.3 from the beginning: Various forms of the drug, made by French pharmaceutical giant Sanofi-Aventis, were prescribed 674,500 times in 2005 in the UK. 11. (a) benzodiazepine-like (hypnotic)
See para.1 under the subtitle “Hypnotic effects”: The drug is a benzodiazepine-like hypnotic (类苯二氮催眠药)that promotes deep sleep by interacting with brain receptors for a chemical called gamma-aminobutyric acid. 12. risky consequences
See para.3 under the subtitle “Hypnotic effects”: Patient advocacy groups … stress that strange sleepwalking and sleep-driving behaviours can have risky consequences. 13. Food & Drug (Administration)
See para.4 under the subtitle “Tried and tested”: The US Food & Drug Administration says it is continuing to \"actively investigate\" and collect information about cases linking zolpidem to unusual side effects. 14. vi 15. Ii
16. vii 本段介绍了torcetrapib和statin的治病原理,但是同时短语“in contrast”与之前第二段后半段的内容呼应,暗示了这两种药在理论上能相辅相成,是理想的搭配。第一个选项无法涵盖整段意义,故选择i是错误的。
17. iii 本段分析了可能导致torcetrapibl临床试验失败的原因,后半段指出如果以上推测正确,那么未来的药物可借鉴这个试验,设法避免torcetrapib的缺陷,研制出有效的药物。viii选项无法涵盖后半段的意思。 18. ix 见首句。 19. v
20. A 见第二段。题目中administer一词意为“用药”,subject一词为“实验对象”之意。
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21. B 见第四段“„ to raise levels of HDLs, which ferry cholesterol out of artery-clogging plaques to the liver for removal from the body.”即HDLs的作用最终是将choleserol清除出人体:“„ for removal from the body”。
22. B 见第四段“But HDLs are complex and not entirely understood.”
23. C 见第二段“„ plus a cholesterol-lowering statin”,即statin是可以降低cholesterol的。
24. D 见第六段“So inhibiting CETP, „ might actually cause an abnormal and irreversible accumulation of cholesterol in the body. 25. A 见第三段。
26. C 见第四段“Statins, in contrast, mainly work by lowering the 'bad' low-density lipoproteins.” 27. No
See para.1: Europe's energy firms have failed to invest in networks… 28. Yes
See para.2: Energy prices vary wildly across Europe. 29. Not Given
See para.2: It is remarkably hard, for example, for gas-poor Germany to import from the neighbouring, gas-rich Netherlands. 30. No
See para.5: The risk is that concerns about security of supply may be used spuriously by those in Europe who oppose the sort of liberalisation encouraged by Ms Kroes. The likes of E.ON and EDF may claim that… 31. Yes
See para.7: If America is willing to play ball, the Commission proposes to reduce emissions by as much as 30%. 32. E
See para.4: Much has been made of the risk for western Europe of depending too heavily on Russian exports of gas. 33. B
See para.6: It would also be likely to mean lower prices, if the example of liberalised Britain over the past ten years is anything to go by. 34. F
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See para.4: Last year Russia interrupted gas deliveries to Ukraine, affecting supplies in central and western Europe too. 35. C, D
See para.3: …the legal separation of energy suppliers and transporters, something that the integrated energy companies and interested governments, notably in France and Germany, are bound to oppose ferociously. 36. A
See para.4: This week it blocked oil exports passing via Belarus to Europe, though that spat was soon resolved. 37. transparent
See para.5: by striking long-term deals with powerful foreign suppliers. The Commission disagrees. Such deals are too often politically motivated and far from transparent. 38. suppliers and distributors
See the sentences in para.1 (Those “vertically integrated” energy companies such as Electricité de France (EDF) or Germany's E.ON, widely dubbed as “national champions”…) and para.6 (…the Commission's new policy proposes, ideally, a break-up of these companies into suppliers and distributors.) 39. competition and security
See para.6: For the gas market another means of ensuring competition and security would be finding a more diverse range of suppliers… 40. renewable sources
See para.7: Achieving either target would mean promoting cleaner cars, a more effective emissions-trading system for Europe, wider use of public transport and a sharp increase in the use of renewable sources of energy…
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