On the all-important question of power-the efficacy of power, the morality of power, the desirability of power-American and European perspectives are diverging. 16 Europe is turning away from power, or to put it a little differently, it is moving beyond power into a self-contained world of laws and rules and transnational negotiation and cooperation. It is entering a post-historical paradise of peace and relative prosperity, the realization of Kant’s "Perpetual Peace." The United States, meanwhile, remains indulged in history, exercising power in the anarchic (无政府的) Hobbesian world where intemational laws and rules are unreliable and where true security and the defense and promotion of a liberal order still depend on the possession and use of military might. 17 That is why on major strategic and international questions today, Americans are from Mars and Europeans are from Venus: They agree on little and understand one another less and less. And this state of affairs is not transitory-the product of one American election or one catastrophic event. The reasons for the transatlantic divide are deep, long in development, and likely to endure. 18 When it comes to setting national priorities, determining thi’eats, defining challenges, and fashioning and implementing foreign and defense policies, the United States and Europe have parted ways. Europeans are more conscious of the growing differences, perhaps because they fear them more. European intellectuals are nearly unanimous in the conviction that Americans and Europeans no longer share a common "strategic culture." The European caricature at its most extreme depicts America’s warlike temperament the natural product of a violent society. 19 But even those who do not make this crude link agree there are profound differences in the way the United States and Europe conduct foreign policy. The United States, they argue, resorts to force more quickly and, compared with Europe, is less patient with diplomacy. Americans generally see the world divided between good and evil, between friends and enemies, while Europeans see a more complex picture. 20 When confronting real or potential adversaries, Americans generally favor policies of coercion rather than persuasion, emphasizing sanctions over inducements to better behavior, the stick over the carrot. Americans tend to seek finality in international affairs: They want problems solved, threats eliminated. And, of course, Americans increasingly tend toward unilateralism in international affairs. They are less inclined to act through international institutions such as the United Nations, less inclined to work cooperatively with other nations to pursue common goals, more skeptical about international law, and more willing to operate outside its strictures.
女性患者,32岁,肥胖多毛。24小时尿17-羟皮质类固醇增高,小剂量地塞米松不能抑制,大剂量地塞米松能抑制。最可能的诊断是
A. 肾上腺皮质结节性增生
B. 单纯性肥胖
C. 肾上腺皮质腺瘤
D. 肾上腺皮质增生
What is making the world so much older There are two long-term causes and a temporary blip that will continue to show up in the figures for the next few decades. 11 The first of the big causes is that people everywhere are living far longer than they used to, and this trend started with the industrial revolution and has been slowly gathering pace. In 1900 average life expectancy at birth for the world as a whole was only around 30 years, and in rich cotmtries under 50. The figures now are 67 and 78 respectively, and still rising. For all the talk about the coming old-age crisis, that is surely something to be grateful for-especially since older people these days also seem to remain healthy, fit and active for much longer. 12 A second, and bigger, cause of the ageing of societies is that people everywhere are hang far fewer children, so the younger age groups are much too small to counterbalance the growing number of older people. This trend emerged later than the one for longer lives, first in developed countries and now in poor countries too. In the early 1970s women across the world were still, on average, having 4.3 children each. The current global average is 2.6, and in rich countries only 1.6. 13 The UN predicts that by 2050 the global figure will have dropped to just two, so by mid-century the world’s population will begin to level out. The numbers in some developed countries have already started shrinking. Depending on your point of view, that may or may not be a good thing, but it will certainly turn the world into a different place. The temporary blip that has magnified the effects of lower fertility and greater longevity is the babyboom that arrived in most rich countries after the Second World War. 14 The tinting varied slightly from place to place, but in America-where the effect was strongest-it covered roughly the 20 years from 1945, a period when nearly 80 million Americans were born. The first of them are now coming up to retirement. For the next 20 years those baby-boomers will be swelling the ranks of pensioners, which will lead to a rapid drop in the working population all over the rich world. As always, the averages mask considerable diversity. 15 Most developing countries do not have to worry about ageing-yet, in the longer term, however, the same factors as in the rich world-fewer births, longer lives-will cause poorer countries to age too.
It was an admission of cultural defeat; but then Hong Kong is nothing if not pragmatic about such things. 21 On June 6th its education minister lifted restrictions that forced four-fifths of the territory’s more than 500 secondary schools to teach in the "mother tongue", i.e. Cantonese, the main language of its residents. Schools may switch to English, the language of the former colonial oppressor, from next year. Tiffs reverses a decade-old policy adopted after Hong Kong’s reversion to China in 1997, in an assertion of independence from both formre and present sovereign powers. Emotion may have played a large role in the decision. But it made some sense. Students speak Cantonese at home, and so using it is the easiest way to impart information and promote discussion. 22 It is also the first language of most teachers: a study done at the time concluded that schools labeled "English-medium" were actually teaching in Cantonese but using English-language textbooks. 23 After much bureaucratic rearrangement, 20% of schools were permitted to continue teaching in English, which may have made sense to teachers and administrators, but not to ambitious parents. They know that their offspring will need English to get ahead. Those who could flee the public system for costly private schools, or for the eight semi-private schools run on the British system, did so. The rest made extraordinary efforts to enter the minority of English-language schools. They have huge waiting lists; Cantonese ones gaping holes. That helps explain the minister’s change of heart, for which no reason was given. 24 So does a survey published last year, which concluded that students from the Cantonese schools did far worse than their peers in getting into universities-a result that would horrify Hong Kong’s achievement-obsessed parents. And whatever the educators think, employers from coffee bars to banks either require people to be bilingual or pay more to those who are. Private schools offering supplementary English tuition have mushroomed. 25 Hong Kong’s educational bureaucracy has devoted much thought to how English could be offered without harming other studies, and without sacrificing a generation of teachers with strong interest in a system based on their first language. The minister has skirted these difficult issues. A much debated but still undisclosed formula will allow an increasing number of subjects to be taught in English. Every step is controversial. Pragmatists want Hong Kong to drop Cantonese entirely in favor of English and Mandarin. But that may demand a level of cultural indifference which even Hong Kong cannot muster.