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PAGEPAGE1READINGREADINGPASSAGE1Youshouldspendabout20minutesonQuestions1-13,whicharebasedonReadingPassage1below.SleepmedicationlinkedtobizarrebehaviourNewevidencehaslinkedacommonlyprescribedsleepmedicationwithbizarrebehaviours,includingacaseinwhichawomanpaintedherfrontdoorinhersleep.UKandAustralianhealthagencieshavereleasedinformationabout240casesofoddoccurrences,includingsleepwalking,amnesiaandhallucinationsamongpeopletakingthedrugzolpidem.Whiledoctorssaythatzolpidemcanoffermuch-neededreliefforpeoplewithsleepdisorders,theycautionthatthesenewlyreportedcasesshouldpromptacloserlookatitspossiblesideeffects.Zolpidem,soldunderthebrandnamesAmbien,StilnoctandStilnox,iswidelyprescribedtotreatinsomniaandotherdisorderssuchassleepapnea.Variousformsofthedrug,madebyFrenchpharmaceuticalgiantSanofi-Aventis,wereprescribed674,500timesin2005intheUK.AnewlypublishedreportfromAustralia’sFederalHealthDepartmentdescribes104casesofhallucinationsand62casesofamnesiaexperiencedbypeopletakingzolpidemsincemarketingofthedrugbegantherein2000.Thehealthdepartmentreportalsomentioned16casesofstrangesleepwalkingbypeopletakingthemedication.MidnightsnackInoneofthesesleepwalkingcasesapatientwokewithapaintbrushinherhandafterpaintingthefrontdoortoherhouse.Anothercaseinvolvedawomanwhogained23kilogramsoversevenmonthswhiletakingzolpidem.“Itwasonlywhenshewasdiscoveredinfrontofanopenrefrigeratorwhileasleepthattheproblemwasresolved,”accordingtothereport.TheUK’sMedicinesandHealthcareproductsRegulatoryAgency,meanwhile,hasrecorded68casesofadversereactionstozolpidemfrom2001to2005.ThenewlyreportedcasesintheUKandAustraliaaddtoagrowinglistofbizarresleepwalkingepisodeslinkedtothedruginothercountries,includingreportsofpeoplesleep-drivingwhileonthemedication.Inonecase,atransatlanticflighthadtobedivertedafterapassengercausedhavocaftertakingzolpidem.HypnoticeffectsThereisnobiologicalpathwaythathasbeenproventoconnectzolpidemwiththesebehaviours.Thedrugisabenzodiazepine-likehypnoticthatpromotesdeepsleepbyinteractingwithbrainreceptorsforachemicalcalledgamma-aminobutyricacid.Whilepartsofthebrainbecomelessactiveduringdeepsleep,thebodycanstillmove,makingsleepwalkingapossibility.Theproductinformationforprescribersadvisesthatpsychiatricadverseeffects,includinghallucinations,sleepwalkingandnightmares,aremorelikelyintheelderly,andtreatmentshouldbestoppediftheyoccur.Patientadvocacygroupssaytheywouldlikegovernmenthealthagenciesanddrugcompaniestotakeacloserlookatthepossiblerisksassociatedwithsleepmedicines.Theystressthatstrangesleepwalkingandsleep-drivingbehaviourscanhaveriskyconsequences.“Whenpeopledosomethinginwhichthey’renotinfullcontrolit’salwaysadanger,”saysVeraSharavoftheNewYork-basedAllianceforHumanResearchProtection,aUSnetworkthatadvocatesresponsibleandethicalmedicalresearchpractices.Triedandtested“Themorereportsthatcomeoutaboutthepotentialsideeffectsofthedrug,themoreresearchneedstobedonetounderstandifthesearerealsideeffects,”sayssleepresearcherKennethWrightattheUniversityofColoradoinBoulder,US.Millionsofpeoplehavetakenthedrugwithoutexperiencinganystrangesideeffects,pointsoutRichardMillmanatBrownMedicalSchool,directoroftheSleepDisordersCenterofLifespanHospitalsinProvidence,RhodeIsland,US.Hesaysthatunlikeoldertypesofsleepmedications,zolpidemdoesnotcarryasgreatariskofaddiction.AndWrightnotesthatsomeofthereportsof“sleep-driving”linkedtozolpidemcanbeeasilyexplained:somepatientshavewronglytakenthedrugrightbeforeleavingworkinhopesthatthemedicinewillkickinbythetimetheyreachhome.Doctorsstressthatthemedicationshouldbetakenjustbeforegoingtobed.TheUSFood&DrugAdministrationsaysitiscontinuingto"activelyinvestigate"andcollectinformationaboutcaseslinkingzolpidemtounusualsideeffects.TheAmbienlabelcurrentlylistsstrangebehaviourasa“specialconcern”forpeopletakingthedrug.“It’sapossiblerareadverseevent,”saysSanofi-AventisspokespersonMelissaFeltmann,addingthatthestrangesleepwalkingbehaviours“maynotnecessarilybecausedbythedrug”butinsteadresultfromanunderlyingdisorder.Shesaysthat“thesafetyprofile[ofzolpidem]iswellestablished”.ThedrugreceivedapprovalintheUSin1993.Questions1-6DothefollowingstatementsagreewiththeinformationgivenintheReadingPassage1?Inboxes1-6onyouranswersheetwriteTRUEifthestatementistrueaccordingtothepassageFALSEifthestatementisfalseaccordingtothepassageNOTGIVENiftheinformationisnotgiveninthepassage1.Ambien,StilnoctandStilnoxarebrandnamesofonesamedrugtreatinginsomnia.2.Thewoman’sobesityproblemwasn’tresolveduntilshestoppedtakingzolpidem.3.ZolpidemreceivedapprovalintheUKin2001.4.ThebizarrebehaviourofapassengeraftertakingzolpidemresultedinthediversionofaflightboundfortheothersideoftheAtlantic.5.Zolpidemistheonlysleepmedicationthatdoesn’tcauseaddiction.6.Thesleep-drivingoccurrenceresultedfromthewronguseofzolpidembyanofficeworker.Question7-9ChoosetheappropriatelettersA-DandWritetheminboxes7-9onyouranswersheet.7.HowmanycasesofbizarrebehavioursaredescribedinanofficialreportfromAustralia?A.68B.104C.182D.2408.WhichofthefollowingisNOTmentionedintheproductinformationaboutzolpidem?A.Treatmentshouldbestoppedifsideeffectsoccur.B.Medicationshouldbetakenjustbeforegoingtobed.C.Adverseeffectsaremorelikelyintheelderly.D.Sideeffectsincludenightmares,hallucinationsandsleepwalking.9.Whoclaimedthatthesafetydescriptionofzolpidemwaswellestablished?A.KennethWrightB.MelissaFeltmannC.RichardMillmanD.VeraSharavQuestions10-13AnswerthefollowingquestionswithNOMORETHANTHREEWORDSeachinboxes10-13.10.HowmanytimeswasFrench-madezolpidemprescribedin2005inBritain?11.Whatkindofhypnoticiszolpidemasadrugwhichpromotesdeepsleepinpatients?12.Whatcansleepwalkingandsleep-drivingbehaviourscauseaccordingtopatientadvocacygroups?13.WhatUSadministrationsaysthatithasbeeninvestigatingthecasesrelatingzolpidemtounusualsideeffects?READINGPASSAGE2Youshouldspendabout20minutesonQuestions14-26,whicharebasedonReadingPassage2below.Questions14-19
Thispassagehas7paragraphsA-G.
Choosethecorrectheadingforeachparagraphfromthelistofheadingsbelow.
Writethecorrectnumberi-ixinboxes14-19onyouranswersheet.
ListofHeadings
i.Howdoestorcetrapibwork?
ii.Contradictoryresultpriortothecurrenttrial
iii.Onefailuremaypossiblybringaboutfuturesuccess
iv.Thefailuredoesn’tleadtototallossofconfidence
v.Itistherightroutetofollow
vi.Whyit’sstopped
vii.Theymaycombineandtheoreticallyproduceidealresult
viii.What’swrongwiththedrug
ix.ItmightbewrongatthefirstplaceExampleanswer
ParagraphAiv
14.ParagraphB
15.ParagraphC
16.ParagraphD
17.ParagraphE
18.ParagraphF
19.ParagraphGWhydidapromisingheartdrugfail?
Doomeddrughighlightscomplicationsofmeddlingwithcholesterol.
A.Thefailureofahigh-profilecholesteroldrughasthrownaspotlightonthecomplicatedmachinerythatregulatescholesterollevels.Butmanyresearchersremainconfidentthatdrugstoboostlevelsof'good'cholesterolarestilloneofthemostpromisingmeanstocombatspirallingheartdisease.
B.DrugcompanyPfizerannouncedon2Decemberthatitwascancellingallclinicaltrialsoftorcetrapib,adrugdesignedtoraiseheart-protectivehigh-densitylipoproteins(HDLs).Inatrialof15000patients,asafetyboardfoundthatmorepeoplediedorsufferedcardiovascularproblemsaftertakingthedrugplusacholesterol-loweringstatinthanthoseinacontrolgroupwhotookthestatinalone.
C.Thenewscameasakickintheteethtomanycardiologistsbecauseearliertestsinanimalsandpeoplesuggesteditwouldlowerratesofcardiovasculardisease."Therehavebeennoredflagstomyknowledge,"saysJohnChapman,aspecialistinlipoproteinsandatherosclerosisattheNationalInstituteforHealthandMedicalResearch(INSERM)inPariswhohasalsostudiedtorcetrapib."Thiscancellationcameasacompleteshock."
D.TorcetrapibisoneofthemostadvancedofanewbreedofdrugsdesignedtoraiselevelsofHDLs,whichferrycholesteroloutofartery-cloggingplaquestotheliverforremovalfromthebody.Specifically,torcetrapibblocksaproteincalledcholesterolestertransferprotein(CETP),whichnormallytransfersthecholesterolfromhigh-densitylipoproteinstolowdensity,plaque-promotingones.Statins,incontrast,mainlyworkbyloweringthe'bad'low-densitylipoproteins.
Underpressure
E.Researchersarenowtryingtoworkoutwhyandhowthedrugbackfired,somethingthatwillnotbecomeclearuntiltheclinicaldetailsarereleasedbyPfizer.Onehintliesinevidencefromearliertrialsthatitslightlyraisesbloodpressureinsomepatients.Itwasthoughtthatthismildproblemwouldbeoffsetbytheheartbenefitsofthedrug.Butitispossiblethatitactuallyprovedfatalinsomepatientswhoalreadysufferedhighbloodpressure.Ifbloodpressureistheexplanation,itwouldactuallybegoodnewsfordrugdevelopersbecauseitsuggeststhattheproblemsarespecifictothiscompound.OtherprototypedrugsthatarebeingdevelopedtoblockCETPworkinaslightlydifferentwayandmightnotsufferthesamedownfall.
F.ButitisalsopossiblethatthewholeideaofblockingCETPisflawed,saysMotiKashyap,whodirectsatherosclerosisresearchattheVAMedicalCenterinLongBeach,California.WhenHDLsexcretecholesterolintheliver,theyactuallyrelyonLDLsforpartofthisprocess.SoinhibitingCETP,whichpreventsthetransferofcholesterolfromHDLtoLDL,mightactuallycauseanabnormalandirreversibleaccumulationofcholesterolinthebody."You'reblockingaphysiologicmechanismtoeliminatecholesterolandeffectivelyconstipatingthepathway,"saysKashyap.
Goingup
G.Mostresearchersremainconfidentthatelevatinghighdensitylipoproteinslevelsbyonemeansoranotherisoneofthebestroutesforhelpingheartdiseasepatients.ButHDLsarecomplexandnotentirelyunderstood.Oneapproveddrug,calledniacin,isknowntobothraiseHDLandreducecardiovascularriskbutalsocausesanunpleasantsensationofheatandtingling.Researchersareexploringwhethertheycanbypassthissideeffectandwhetherniacincanlowerdiseaseriskmorethanstatinsalone.Scientistsarealsoworkingonseveralothermeanstobumpuphigh-densitylipoproteinsby,forexample,introducingsyntheticHDLs."Theonlythingweknowisdeadinthewateristorcetrapib,notthewholeideaofraisingHDL,"saysMichaelMiller,directorofpreventivecardiologyattheUniversityofMarylandMedicalCenter,Baltimore.
Questions20-26Matchtorcetrapib,HDLs,statinandCETPwiththeirfunctionsWritethecorrectletterA,B,CorDinboxes20-26onyouranswersheet.
NBYoumayuseanylettermorethanonce.
20.Ithasbeenadministeredtoover10,000subjectsinaclinicaltrial.
21.Itcouldhelpridhumanbodyofcholesterol.
22.Researchersareyettofindmoreaboutit.
23.Itwasusedtoreducethelevelofcholesterol.
24.AccordingtoKashyap,itmightleadtounwantedresultifit’sblocked.
25.Itproducedcontradictoryresultsindifferenttrials.
26.ItcouldinhibitLDLs.
Listofchoices
A.Torcetrapic
B.HDLS
C.Statin
D.CETPREADINGPASSAGE3Youshouldspendabout20minutesonQuestions27-40,whicharebasedonReadingPassage3below.Seekinganenergyholytrinity1NEELIEKROES,theEuropeanUnion'scompetitioncommissioner,didnotminceherwordswhenreportingonEurope'senergymarketsonWednesdayJanuary10th.Europe'senergyfirmshavefailedtoinvestinnetworksandsocustomersaresuffering.Those“verticallyintegrated”energycompaniessuchasElectricitédeFrance(EDF)orGermany'sE.ON,widelydubbedas“nationalchampions”,areeffectivelybehavinglikelocalmonopolies.Shyofcompetition,eagerforartificiallyhighprices,theyarehelpingtoblocktheefficientgeneration,transmissionanddistributionofenergyonthecontinent.2EnergypricesvarywildlyacrossEurope.MsKroeswantstoseecheaperenergy,andintendstopushsupplierstodivesttheirdistributionnetworkandtogetthemtoinvestmoreintransportationsystemssothatmoreenergy—intheformofgas,orelectricity,forexample—canfloweasilyoverborders.Itisremarkablyhard,forexample,forgas-poorGermanytoimportfromtheneighbouring,gas-richNetherlands.Companiesthatdominatenationalmarketshave,sofar,hadlittleinterestinimprovingtheinterconnectionswhichwouldmeanlowerpricesforconsumersacrossthecontinent.3MsKroes,ofcourse,willstruggletogetherway.TheEuropeanCommission,whichonthesamedaypresenteditsrecommendationforimprovingEUenergypolicy,alsowantstoseetheunbundlingofownership,thelegalseparationofenergysuppliersandtransporters,somethingthattheintegratedenergycompaniesandinterestedgovernments,notablyinFranceandGermany,areboundtoopposeferociously.4ComplicatingthematterisanargumentoverthesecurityofenergysupplyinEurope.MuchhasbeenmadeoftheriskforwesternEuropeofdependingtooheavilyonRussianexportsofgas.RussiaunderVladimirPutinispronetousingenergyexportsasablunttoolofforeignpolicy,especiallywhentryingtobullycountriesinitshinterland.LastyearRussiainterruptedgasdeliveriestoUkraine,affectingsuppliesincentralandwesternEuropetoo.ThisweekitblockedoilexportspassingviaBelarustoEurope,thoughthatspatwassoonresolved.5TheriskisthatconcernsaboutsecurityofsupplymaybeusedspuriouslybythoseinEuropewhoopposethesortofliberalisationencouragedbyMsKroes.ThelikesofE.ONandEDFmayclaimthatonlyprotectednationalchampionsareabletosecuresupply,bystrikinglong-termdealswithpowerfulforeignsuppliers.TheCommissiondisagrees.Suchdealsaretoooftenpoliticallymotivatedandfarfromtransparent.Protectionhasbeentriedforlongenoughandevidentlyhasnotworkedfortheinternalmarket,norhavethesecompaniessecuredthebestdealsforconsumersfromtheRussians.6Incontrast,theCommission'snewpolicyproposes,ideally,abreak-upofthesecompaniesintosuppliersanddistributors.(Asasecondbestsolution,especiallyforFranceandGermany,itrecommendsthemanagementofthenetworksbyathirdparty.)ProperlyindependentmanagersofEurope'senergynetworkswouldhaveastrongincentivetobuildinterconnectingpipelinesandpowerlinesacrossborders.Forthegasmarketanothermeansofensuringcompetitionandsecuritywouldbefindingamorediverserangeofsuppliers,forexamplebybuildingmoreterminalsfortheimportofliquifiednaturalgas.Itwouldalsobelikelytomeanlowerprices,iftheexampleofliberalisedBritainoverthepasttenyearsisanythingtogoby.7Whetheranyofthisislikelytohappensoon,however,isanothermatter.TheCommissionisalsocallingforEuropeangovernmentstoagreeonacommonefforttoreducecarbonemissionsbyatleast20%by2020(comparedwith1990levels).IfAmericaiswillingtoplayball,theCommissionproposestoreduceemissionsbyasmuchas30%.Achievingeithertargetwouldmeanpromotingcleanercars,amoreeffectiveemissions-tradingsystemforEurope,wideruseofpublictransportandasharpincreaseintheuseofrenewablesourcesofenergy,likewindandsolarpower.Allthatislaudableenough,butwillalsorequirepoliticalhorse-tradingasgovernments—Europe'sleadersareduetomeetinMarchtodiscussthevariousenergyproposals—trytoavoidcommitmentsthatmayhurtdomesticenergycompaniesormakeEuropeanfirmslesscompetitivethanrivalsinAmerica,Asiaandelsewhere.Questions27-31Dothefollowingstatementsreflecttheviewsofthewriterinthereadingpassage?Inboxes27-31onyouranswersheetwriteYESifthestatementreflectstheviewsofthewriterNOifthestatementcontradictstheviewsofthewriterNOTGIVENifthereisnoinformationaboutthisinthepassage27.Europe'senergycompanieshavefundedtheconstructionofthedistributionnetwork.28.TherehasbeenawiderangeofenergypriceswithinEurope.29.Gas-poorGermanyhastopayapricehigherthanaveragetoimportgasfromitsneighbour.30.E.ONandEDFmayopposetheliberalisationduetotheirconcernsaboutthesecurityofenergysupply.31.TheEuropeanCommissionproposestoreducecarbonemissionsby30%iftheU.S.iswillingtocutits.Questions32-36Lookattheboxofcountriesbelow.ChooseOneorTwocountriestocompletethefollowingsentences.Writeyouranswersinboxes32-36onyouranswersheet.CountriesA.BelarusB.BritainC.FranceD.GermanyE.RussiaF.UkraineG.TheU.S.It'sdangerousforwesternEuropetodependtoomuchongasimportsfrom…………33.Aliberalisedpolicyofenergysupplywasenforcedovertenyearsin…………34.LastyearenergysuppliesincentralandwesternEuropewasaffectedowingtotheinterruptionofgasdeliveriesto…………35.Thegovernmentsin…………areboundtoopposetheseparationofenergysuppliersandtransporters?36.Oilexportspassingvia…………toEuropewasblockedthisweek.Questions37-40ChooseNOMORETHANTHREEWORDSfromthereadingpassageaboveforeachanswer.Writeyouranswersinboxes37-40.37.TheECdisagreeswithenergyfirmstostrikelong-termdealswithforeignsuppliersbecausesuchdealsareusuallyfarfrom…………38.TheECproposestosplitthose“nationalchampions”into…………39.Amorediverserangeofsupplierswouldguarantee…………intheEuropeangasmarket.40.Therealizationofcarbonemissionsreductionwouldrequirethepromotionofcleanercars,abetteremissions-tradingsystem,wideruseofpublictransportandmoreuseof…………ofenergy.READINGANSWERS&EXPLAINATION1.TrueSeepara.3fromthebeginning:Zolpidem,soldunderthebrandnamesAmbien,StilnoctandStilnox,iswidelyprescribedtotreatinsomniaandotherdisorderssuchassleepapnea.2.FalseSeepara.1underthesubtitle“Midnightsnack”:Anothercaseinvolvedawomanwhogained23kilogramsoversevenmonthswhiletakingzolpidem.“Itwasonlywhenshewasdiscoveredinfrontofanopenrefrigeratorwhileasleepthattheproblemwasresolved”…3.NotGivenSeepara.2underthesubtitle“Midnightsnack”:TheUK’sMedicinesandHealthcareproductsRegulatoryAgency,meanwhile,hasrecorded68casesofadversereactionstozolpidemfrom2001to2005.(ThetimethedrugwasapprovedintheUKwasnotmentioned.)4.TrueSeepara.3underthesubtitle“Midnightsnack”:Inonecase,atransatlanticflighthadtobedivertedafterapassengercausedhavocaftertakingzolpidem.5.FalseSeepara.2underthesubtitle“Triedandtested”:Hesaysthatunlikeoldertypesofsleepmedications,zolpidemdoesnotcarryasgreatariskofaddiction.6.NotGivenSeepara.3underthesubtitle“Triedandtested”:AndWrightnotesthatsomeofthereportsof“sleep-driving”linkedtozolpidemcanbeeasilyexplained:somepatientshavewronglytakenthedrugrightbeforeleavingworkinhopesthatthemedicinewillkickinbythetimetheyreachhome.(Nopatientsasofficeworkersarementionedinthepassage.)7.CSeepara.4fromthebeginning:AnewlypublishedreportfromAustralia’sFederalHealthDepartmentdescribes104casesofhallucinationsand62casesofamnesiaexperiencedbypeopletakingzolpidemsincemarketingofthedrugbegantherein2000.Thehealthdepartmentreportalsomentioned16casesofstrangesleepwalkingbypeopletakingthemedication.8.BSeethesentenceinpara.2underthesubtitle“Hypnoticeffects”(Theproductinformationforprescribersadvisesthatpsychiatricadverseeffects,includinghallucinations,sleepwalkingandnightmares,aremorelikelyintheelderly,andtreatmentshouldbestoppediftheyoccur.)andthesentenceinpara.3underthesubtitle“Triedandtested”(Doctors“nottheproductinformation”stressthatthemedicationshouldbetakenjustbeforegoingtobed.)9.BSeepara.5underthesubtitle“Triedandtested”:Sanofi-AventisspokespersonMelissaFeltmann…saysthat“thesafetyprofile[ofzolpidem]iswellestablished”.10.674,500(times)Seepara.3fromthebeginning:Variousformsofthedrug,madebyFrenchpharmaceuticalgiantSanofi-Aventis,wereprescribed674,500timesin2005intheUK.11.(a)benzodiazepine-like(hypnotic)Seepara.1underthesubtitle“Hypnoticeffects”:Thedrugisabenzodiazepine-likehypnotic(类苯二氮催眠药)thatpromotesdeepsleepbyinteractingwithbrainreceptorsforachemicalcalledgamma-aminobutyricacid.12.riskyconsequencesSeepara.3underthesubtitle“Hypnoticeffects”:Patientadvocacygroups…stressthatstrangesleepwalkingandsleep-drivingbehaviourscanhaveriskyconsequences.13.Food&Drug(Administration)Seepara.4underthesubtitle“Triedandtested”:TheUSFood&DrugAdministrationsaysitiscontinuingto"activelyinvestigate"andcollectinformationaboutcaseslinkingzolpidemtounusualsideeffects.14.vi15.Ii16.vii本段介绍了torcetrapib和statin的治病原理,但是同时短语“incontrast”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.v20.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。21.B见第四段“„toraiselevelsofHDLs,whichferrycholesteroloutofartery-cloggingplaquestotheliverforremovalfromthebody.”即HDLs的作用最终是将choleserol清除出人体:“„forremovalfromthebody”。22.B见第四段“ButHDLsarecomplexandnotentirelyunderstood.”23.C见第二段“„plusacholesterol-loweringsta
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