题目内容
A complex operation called spinal fusion has emerged as the treatment of choice for many kinds of back pain. But a number of researchers say there is little scientific evidence to show that for most patients, spinal fusion works any better than a simpler operation, the lamineetomy (椎板切除术). Some people would be better off with no surgery at all. Even doctors who favor fusions say that more research is needed on their benefits. In the absence of better data, critics point to a different reason for the fusion operation’s fast rise: money. Medicare can pay a surgeon as much as four times more for a spinal fusion as for a laminectomy. Hospitals also collect two to four times as much. "We all cave in to market and economic forces," said Dr. Edward C. Benzel. Though doctors, as a rule, should favor the least complicated treatment—with surgery being the last resort — Dr. Benzel estimated that fewer than half of the spinal fusions done today were probably appropriate. Doctors and hospitals are not the only players with a financial stake in fusion operations. Critics blame the companies that make the hardware for promoting more complex fusions without evidence that they are significantly more effective. Some sort of hardware is used in almost 90 percent of lower-back fusions and the national bill for the hardware alone has soared to $ 2.5 billion a year. The hardware makers acknowledge giving surgeons millions of dollars for consulting and researches, but say the money promotes technical and medical advances that improve back care. But a lawsuit brought by Scott A. Wiese, a former sales representative of Medtronic-the biggest maker of spinal hardware, accused the company of trying to persuade surgeons to use its products with offers of first-class plane tickets to Hawaii and nights at the finest hotels. Medtronic said it did nothing wrong, and it denied the accusations in the lawsuit. But the company disclosed earlier this year that the federal government was investigating charges that it paid illegal kickbacks to surgeons. Federal officials declined to comment on the investigation, and Medtronic said it would vigorously defend itself. Still, between the allure of money and the quest for breakthroughs in treatment, some prominent spinal surgeons say that back care has gone astray. The author’s attitude towards spinal fusion is probably ______.
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Questions 11 to 18 are based on the conversation you have just heard.
Children are getting so fat that they may be the first (36) to die before their parents, an expert claimed yesterday. Today’s youngsters are already falling (37) to potential killers such as diabetes because of their weight. Fatty fast-food diets combined with sedentary lifestyles (38) by televisions and computers could mean kids will die (39) young, says Professor Andrew Prentice, from the London School of Hygiene and Tropical Medicine. One of the major reasons why children now are at greater risk is that we are getting fatter younger. Many nations now (40) more than 20 per cent of their population as (41) obese and well over half the populations overweight. At the same time, the shape of the human body is going through a huge (42) shift because adults are getting so fat. Professor Prentice said the change in our shape has been caused by easily available high-energy foods combined with a (43) drop in the energy we use as a result of technology developments. He is not alone in his concern. (44) . Obesity also increases the risk factor for strokes and heart disease as well as a diabetes . (45) . So will parents outlive their children Yes, when the offspring become grossly obese. (46) .
Secretary: ______ Manager: Definitely.
Fear and its companion pain are two of the most useful things that men and animals possess, if they are properly used. If fire did not hurt when it burnt, children would play it until their hands were burnt away. Similarly, if pain existed but fear did not, a child would burn itself again and again, because fear would not warn it to keep away from the fire that had burn it before. A really fearless soldier—and some do exist—is not a good soldier because he is soon killed; and a dead soldier is of no use to his army. Fear and pain are therefore two guards without which men and animals might soon die out. In our first sentence we suggested that fear ought to be properly used. If, for example, you never go out of your house because of the danger of being knocked down and killed in the street by a car, you are letting fear rule you too much. Even in your house you are not absolutely safe: an airplane may crash on your house, or ants may eat away some of the beams in your roof so that the latter falls on you, or you may get cancer! The important thing is not to let fear rule you, but instead to use fear as your servant and guide. Fear will warn you of dangers; then you have to decide what action to take. In many cases, you can take quick and successful action to avoid the danger. For example, you see a car coming straight towards you; fear warns you, you jump out of the way, and all is well. In some cases, however, you decide that there is nothing that you can do to avoid the danger. For example, you cannot prevent an airplane crashing onto your house. In this case, fear has given you its warning; you have examined it and decided on your course, of action, so fear of this particular danger is no longer of any use to you, and you have to try to overcome it. A really fearless soldier______.
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