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(6～7题共用病例)林女士，54岁，孕5产4。慢性咳嗽多年，阴道口脱出肿物已1年多，近半年来，经休息亦不能回纳，阴道分泌物增多。妇科检查：会阴Ⅱ度裂伤，阴道前壁有球形膨出，宫颈及部分子宫体脱出于阴道外，子宫颈表面可见溃疡，两侧附件未触及。 患者出现的l临床症状，应除外
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The mental health movement in the United States began with a period of considerable enlightenment．①Dorothea Dix was shocked to find the mentally ill in jails and almshouses(养老院)and crusaded for the establishment of asylums in whish people could receive humane care in hospital like environments and treatment which might help restore them to sanity．By the mid 1800s，20 states had established asylums， but during the late 1800s and early 1900s，in the face of economic depression， legislatures were unable to appropriate sufficient funds for decent care．Asylums became overcrowded and prison like. Additionally, patients were more resistant to treatment than the pioneers in the mental health field had anticipated, and security and restraint were needed to protect patients and others. Mental institutions became frightening and depressing places in which the rights of patients were all but forgotten. These conditions continued until after World War Ⅱ. ②At that time, new treatments were discovered for some major mental illnesses theretofore considered untreatable(penicillin for syphilis of the brain and insulin treatment for schizophrenia) and depressions), and a succession of books, motion pictures, and newspaper exposes called attention to the plight of the mentally ill. Improvements were made and Dr. David Vail’s Humane Practices Program is a beacon for today. But changes were slow in coming until the early 1960s. ③At that time, the Civil Rights movement led lawyers to investigate America’s prisons, which were disproportionately populated by blacks, and they in turn followed prisoners into the only institutions that were worse than the prisons--the hospital for the criminally insane . The prisons were filled with angry young men that, encouraged by legal support, were quick to demand their rights. ④The hospital for the criminally insane, by contrast, were populated with people who were considered "crazy" and who were often kept obediently in their place through the use of severe bodily restraints and large doses of major tranquilizers, The young cadre (骨 干) of public interest lawyers liked their role in the mental hospitals. The lawyers found a population that was both passive and easy to champion. These were, after all, people who, unlike criminals, had done nothing wrong. And in many states, they were being kept in horrendous institutions, an injustice, which once exposed, was bound to shock the public and, particularly, the judicial conscience. Patients’ rights groups successfully encouraged reform by lobbying in state legislatures. Judicial interventions have had some definite positive effects, but there is growing awareness that courts cannot provide the standards and the review mechanisms that assure good patient care. ⑤The details of providing day-to-day care simply cannot be mandated by a court, so it is time to take from the courts the responsibility for delivery of mental health care and assurance of patient right and return it to the state mental health administrators to whom the mandate was originally given. Though it is a difficult task, administrators must undertake to write roles and standards and to provide the training and surveillance (监督) to assure that treatment is given and patient rights are respected. The tone of the final paragraph can best be described as ______.
St.Paul didn’t like it. Moses warned his people against it. Hesiod declared it "mischievous" and "hard to get rid of it", but Oscar Wilder said, "Gossip is charming." "History is merely gossip," he wrote in one of his famous plays. "But scandal is gossip made tedious by morality." In times past, under Jewish law, gossipmongers might be fined or flogged(鞭笞). The Puritans put them in stocks or ducking stools, but no punishment seemed to have the desired effect of preventing gossip, which has continued uninterrupted across the back fences of the centuries. Today, however, the much maligned human foible(弱点) is being looked at in a different light. Psychologists, sociologists, philosophers, even evolutionary biologists are concluding that gossip may not be so bad after all. "Gossip is a valuable activity," philosophy professor Aaron Ben-Ze’ev states in a book he has edited, entitled Good Gossip. For one thing, gossip helps us acquire information that we need to know that doesn’t come through ordinary channels, such as: "What was the real reason so-and-so was fired from the office Gossip also is a form of social bonding," Dr. Ben-Ze’ev says. It is "a kind of sharing" that also "satisfies the tribal need--namely, the need to belong to and be accepted by a unique group". What’s more, the professor notes, "Gossip is enjoyable." ①Another gossip groupie, Dr.Ronald de Sousa a professor of philosophy at the University of Toronto, describes gossip basically as are from of indiscretion and a "saintly virtue", by which he means that the knowledge spread by gossip will usually end up being slightly beneficial. "It seems likely that a world in which all information were universally available would be preferable to a world where immense power resides in the control of secrets," he writes. Still, everybody knows that gossip can have its ill effects, especially on the poor wretch being gossiped about. And people should refrain from certain kinds of gossip that might be harmful, even though the ducking stool is long out of fashion. ②By the way there is also an interesting strain of gossip called medical gossip, which in its best form, according to researchers Jerry M.Suls and Franklin Gookin, can motivate people with symptoms of serious illness, but who are unaware of it to seek medical help. So go ahead and gossip. But remember, if (as often is the case among gossipers) you should suddenly become one of the gossips instead, it is best to employ the foolproof defense recommended by Plato, who may have learned the lesson from Socrates, who as you know was the victim of gossip spread that he was corrupting the youth of Athens: when men speak ill of you, so live that nobody will believe them. Or, as Will Rogers said, "Live so that you wouldn’t be ashamed to sell the family parrot to the town gossip.\ We learn from the last paragraph that ______.
①Many people seem to think that science fiction is typified by the covers of some of the old pulp magazines" the Bug Eyed Monster. embodying every trait and feature that most people find repulsive is ahout to grab, and presumably ravish, a sweet, blonde curvaceous scantily clad Earth girl. This is unfortunate because it demeans and degrades a worthwhile and even important literary endeavor. In contrast to this unwarranted stereotype, science fiction rarely emphasizes sex, and when it does, it is more discreet than other contemporary fiction. Instead, the basic interest of science fiction lies in the relation between man and his technology and between man and the universe. ②Science fiction is a literature of change and a literature of the future, and while it would be foolish to claim that science fiction is a major literary genre at this time. the aspects of human life that it considers make it well worth reading and studying for no other literary from does quite the same things. What is science fiction To begin, the following definition should be helpful: science fiction is a literary sub-genre which postulates a change (for human beings ) from conditions as we know them and follows the implications of these changes to a conclusion. Although this definition will necessarily he modified and expanded, it covers much of the basic groundwork and provides a point of departure. The first point that science fiction is a literary sub-genre is a very important one, but one which is often overlooked or ignored in most discussions of science fiction. Specifically, science fiction is either a short story or a novel. There are only a few dramas which could be called science fiction, with Karel Capek’s RUR (Rossum’s Universal Robots) being the only one that is well known; the body of poetry that might be labeled science fiction is only slightly larger. ③To say that science fiction is a sub- genre of prose fiction is to say that it has all the basic characteristics and serves, the same basic functions in much the same way as prose fiction in general, that is, it shares a great deal with all other novels and short stories. Everything that can be said about prose fiction, in general, applies to science fiction. Every piece of science fiction, whether short story or novel, must have a narrator, a story, a plot, a setting, characters, language, and theme. And like any prose, the themes of science fiction are concerned with interpreting man’s nature and experience in relation to the world around him. Themes in science fiction are constructed and presented in exactly the same ways that themes are dealt with in any other kind of fiction. They are the result of a particular combination of narrator, story, plot, character, setting, and language. In short, the reasons for reading and enjoying science fiction, and the ways of studying and analyzing it, are basically the same as they would be for any other story or novel. An appropriate title for this passage would be ______.
If an occupation census had been taken in the eleventh century，it would probably have revealed that quite 90%of the people were country dwellers who drew their livelihood from farming，herding，fishing，or the forest．An air photograph taken at that time would have revealed a sprinkling of villages，linked together by un—surfaced roads and more than 10，000 persons．A second picture，taken in the mid—fourteenth century would show that the villages had grown larger，more numerous，and also more widespread，for Europeans had pushed their frontier outward by clearing，draining，and settling new areas．There would be more people on the road，rivers and seas，carrying food or raw materials to towns which had increased in number，size and importance． But a photograph taken about 1450 would reveal that little further expansion had taken place during the preceding hundred years． Any attempt to describe the countryside during those centuries is beset by two difficulties．In the first place we have to examine the greater part of Europe’s 3,50,000 square miles，and not merely the Mediterranean lands．In the second place the inhabitants of that wide expanse refuse to fit into one standard pattern or to stand still． There is variety and there is change．①Consequently, as a distinguished student of medieval rural life once remarked, "In the history of land problems, there is no sin like the sin of generalization" and "There is no heresy about the Middle Ages quite so pernicious(有害的)as the theory that they were unchanging." In the early days of studying economic history it was customary to describe a "typical" manor and give the impression that all rural life was of this kind. But a vast amount of research has been done since then, for the field is an interesting one, the documents are abundant in some countries, the work calls for great patience and skill, and the results may be revolutionary. From such arduous (辛勤的) labor Professor Eileen Power emerged with the conclusion that "manor" was a term about as descriptive as the word "mammal". ②After equally arduous effort Professor Kosminsky defined the manor as a community in which unfree villagers (villains, serfs")cultivated their lord’s domain as the price of their serfdom and of their use of a holding of land. He then discovered that even in the English midlands, the stronghold of manors, only about 60% of the territory was "manorial" in 1279. The remaining 40% was non-manorial; it had no unfree tenants, or it had no domain, or it was all domain and had no villain holdings. In France and other continental regions research is revealing similar diversity. After reading a recent study of the seigniorial (领主的) system in Lorraine, one reviewer threw up his hands and exclaimed, "The more we look at things, the more they appear complicated.\ In the eyes of the author, the life in the country in medieval times ______.
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