PASSAGE 51
　　Ulcers²
　　Even though ulcers appear to run in families, lifestyle plays more of a role than genetic³ factors in causing the illness, according to a report in the April 13th Journal of Internal Medicine. In particular, smoking and stress in men and the regular use of pain-releasing medicines in women were linked with an increased risk of developing an ulcer¹.
　　Overall, 61% of ulcer risk appears to be due to environmental factors, such as smoking, and the remaining 39% is due to genes⁴ according to Dr. Ismo Raiha of the University of Turky and colleagues at the University of Helsinki, Finland. Some researchers had suggested that families may spread Helicobacteria pylori, the bacteria that can cause ulcers. However, the new study suggests this is unlikely, according to the report.
　　Raiha and colleagues studied data from more than 13,000 pairs of twins "to examine the roles of genetic and environmental factors in the origin of peptic ulcer disease," they explain. Both twins were more likely to develop an ulcer if the pair were genetically⁵ the same as compared with a pair of fraternal twins, suggesting that there must be some genetic susceptibility to ulcer development.
　　However, the risk was no greater in twins living together compared with twins living apart, suggesting that shared exposure to H. pylori was not to blame. "Environment effects were not due to factors shared by family members, and they were related to smoking and stress in men and the use of analgesics⁶ in women," the authors wrote. "The minor⁷ effects of shared environment to disease liability do not support the concept that the grouping of risk factors, such as H. pylori infection, would explain the genetic factor of peptic ulcer disease," they concluded.
　　1. According to the passage, which of the following is a very likely cause of ulcer in men?
　　A) Smoking and stress.
　　B) Drinking and smoking.
　　C) Genes and children.
　　D) Use of a certain medicine.
　　2. What factors contribute to over half the ulcers?
　　A) Hereditary⁸ factors.
　　B) Economic factors.
　　C) Environmental factors.
　　D) Genetic factors.
　　3. In relation to ulcers, experts study twins in order to examine
　　A) the roles of genetic factors.
　　B) the roles of environmental factors.
　　C) the roles of both factors.
　　D) the roles of brotherhood⁹.
　　4. What does "environmental effects" in the fifth paragraph refer to?
　　A) A clean environment with no smoke and dust surrounding the living area.
　　B) Smoking and stress in men and use of pain-killing medicine in Women.
　　C) Factors shared by family members such as genes and the food they eat.
　　D) Shared exposure to H. pylori infection in the unclean environment.
　　5. The passage argues that
　　A) ulcers are related to genes.
　　B) ulcers are related to lifestyle.
　　C) ulcers appear in men and women.
　　D) ulcers are caused by pylori infection.
　　KEY: ACCBB
　　PASSAGE 52
　　First Aid
　　First aid is emergency care for a victim of sudden illness or injury until more skillful medical treatment is available. First aid may save a life or improve certain vital signs including pulse, temperature, an unobstructed airway¹⁰, and breathing. In minor emergencies, first aid may prevent a victim’s condition from worsening and provide relief from pain. First aid must be administered as quickly as possible. In the case of the critically injured, a few minutes can make the difference between complete recovery and loss of life.
　　First-aid measures depend upon a victim’s needs and provider’s level of knowledge and skill. Knowing what not to do in an emergency is as important as knowing what to do. Improperly¹¹ moving a person with a neck injury, for example, can lead to permanent spinal¹² injury and paralysis¹³.
　　Despite the variety of injuries possible, several principles of first aid apply to all emergencies. The first step is to call for professional medical help. The victim, if conscious, should be reassured¹⁴ that medical aid has been requested, and asked for permission to provide any first aid. Next, assess the scene, asking other people or the injured person’s family or friends about details of the injury or illness, any care that may have already been given, and preexisting conditions such as diabetes¹⁵ or heart trouble. The victim should be checked for medical bracelet¹⁶ or card that describes special medical conditions. Unless the accident scene becomes unsafe or the victim may suffer further injury, do not move the victim.
　　First aid requires rapid assessment¹⁷ of victims to determine whether life-threatening conditions exist. One method for evaluating a victim’s condition is known by the acronym¹⁸ ABC, which stands for:
　　A- Airway: is it open and unobstructed?
　　B- Breathing: is the person breathing? Look, listen, and feel for breathing.
　　C- Circulation: is there a pulse? Is the person bleeding externally? Check skin color and temperature for additional indications of circulation problems.
　　Once obvious injuries have been evaluated, the injured person’s head should be kept in a neutral position in line with the body. If no evidence exists to suggest potential skull¹⁹ or spinal injury, place the injured person in a comfortable position. Positioned on one side, a victim can vomit²⁰ without choking or obstructing²¹ the airway.

1. It is very important in first aid to
　　A) move the injured person from the scene of accident immediately.
　　B) spend a few minutes for making the difference between recovery and death.
　　C) know what to do and what not to do according to the condition of the victim.
　　D) remove the medical bracelet or card from the victim.
　　2. One of the following practices is NOT right in the first aid, that is,
　　A) to check whether the victim is breathing.
　　B) to let the victim lie on one side.
　　C) to telephone a hospital at once.
　　D) to wait patiently for more skillful medical treatment before carrying on first aid.
　　3. The article implies that the provider of first aid should be especially careful
　　A) in handing the victim only if he learns that the victim has both diabetes and heart trouble.
　　B) in handing the victim if he learn that the victim has diabetes or heart trouble.
　　C) not to move the victim if he finds a medical bracelet on the victim.
　　D) not to move the victim if he finds the accident scene to be unsafe.
　　4. According to this article, first aid is usually provided by
　　A) professional doctors.
　　B) the victim’s family members.
　　C) the victim’s friends.
　　D) those people who are not necessarily professional doctors.
　　5. This article can be said to be one to
　　A) give basic knowledge about how to practice first aid.
　　B) give a brief introduction to the history of first aid.
　　C) give some knowledge to anyone who may be injured in an accident.
　　D) give warning that first aid is dangerous to those who do not know to do it.
　　Key: CDBDA
　　PASSAGE 53
　　Sleeplessness²³
　　Insomnia²⁴ or sleeplessness is a common complaint of women as they enter into menopause.
　　Insomnia means having trouble falling asleep or staying asleep or the feeling that your sleep was not adequate for you. For women who are having night sweats, their sleep is broken by frequent awakening²⁵ and therefore not refreshing²⁶. Generally once the night sweats are controlled a normal sleep pattern returns. If it doesn’t it may be, or have become chronic²⁷ insomnia. How do you know?
　　If you suffer from insomnia every night or most nights for a period of one month then you have chronic insomnia. If you’re not having night sweats then it’s time to look for other causes of sleeplessness. Depression and anxiety disorders²⁸ are the most common causes of chronic insomnia. If you feel depressed²⁹ you need to be checked by a qualified³⁰ health care provider. Movement disorders such as restless leg syndrome³¹ are second on the list of insomnia for them; there are new medicines that may help. Other common causes are shift working, and pain.
　　In up to 30% of people with chronic insomnia no cause can be identified. Medical treatment of these people has generally been with sleeping pills. It is estimated that 25% of the adult population in America took some type of medicines for sleep last year. It is generally agreed that sleeping pills should only be in the lowest dose and for the shortest possible time.
　　Sleep hygiene³² is directed at changing bad sleep habits. The recommendations are:-Go to bed only when sleepy.-Do not wait up to a specified³³ time.-Avoid caffeine and alcohol in the evening, etc.
　　1. The word "insomnia" means
　　A) having trouble falling asleep.
　　B) feeling that sleep is enough.
　　C) Having no sweats at night.
　　D) Having normal sleep pattern.
　　2. How many possible causes of sleeplessness are mentioned in the second paragraph?
　　A) Five
　　B) Six
　　C) Seven
　　D) Numerous
　　3. The expression "Second on the list" in the second paragraph means
　　A) the second cause of all kinds of sleeplessness.
　　B) The second most important cause of sleeplessness.
　　C) The second on the doctor’s list about sleepless²² people.
　　D) The second on the writer’s list recording³⁴ sleeplessness.
　　4. Concerning the use of sleeping pills, which of the following statements is true?
　　A) Most adult Americans use sleeping pills for sleep.
　　B) Doctors seldom give sleepless people sleeping pills.
　　C) Sleeping pills should be used for a very fixed³⁵ period.
　　D) Sleeping pills should be used in a very small amount.
　　5. Which of the following does not fit with sleep hygiene?
　　A) Make a rule to go to bed at a specific time every day.
　　B) Go to bed when sleepy, not always at the same time.
　　C) Try not to drink any caffeine and alcohol in the evening
　　D) Change bad sleep habits and follow doctors’ advice
　　Key: ABBDA