秋博士生期末考试A卷题.docx

秋博士生期末考试A卷题.docx

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秋博士生期末考试A卷题

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I.Errorcorrection（10X1=10）

Directive:

Underlinetheerror（s）inthefollowingsentencesandwriteyourcorrection（s）rightbelow.

1.Malestudentshadahigherrateofsmokingexposurecomparingtofemalestudents.（ONEerror）

2.Nosignificantlydifferencesfoundbetweentwogroupsintermsoftheirsatisfactionwithorattitudestothemedicalads.（TWOerrors）

3.Therewereoverone-thirdoftheparticipantsthoughtthatthecanteenfoodwasnotdeliciousandone-thirdofthemweretiredofwaitinginline.（ONEerror）

4.Acutepainisconsideredasaprotectiveandadaptivesense,whichkeepusawayfromthenoxiousstimulation.（TWOerrors）

5.Similarlytolackofsleep,thepoorqualityofsleepwasassociatedwithmentalsymptomssuchasinattention.（ONEerror）

6.Thesupportersthoughtthatfoodfordeliverywasmoreconvenience,richerinvarietyandmoredeliciousthanthefoodintheschoolcanteen.（ONEerror）

7.Generally,theprocedureswerewelltoleratedbymajorityofpatients.（ONEerror）

8.Nocomparativestudyonthisissuecanbefoundinmedicalliteratures.（ONEerror）

9.Atotalof4,164Chineseindividualswhohadstrokeinvolvedinthismulticenterstudy.（ONEerror）

10.Internetalsoplayedanimportantroleinspreadsex-relatedknowledgetoyoungpeople.（ONEerror）

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II.Revision（5X2=10）

Directive:

Revisethefollowingsentencestomakethemacademicallyappropriate.

1.Inourstudy,itrevealednosignificantdifferencebetweendifferentgenderinchoosingahospital.

2.Methodsincludeddescriptiveanalysismainly.

3.Abouttwogroupsonwhethertousetheequipmentprotectionintheprocessofmovement,therewasnodifferencebetweenthesetwogroups.

4.Inthisstudy,wereportedforthefirsttimeapplyingtargetedtherapyforHCSs.

5.AllrespondentswereMDcandidatesinthemedicalschoolofFudanUniversity.Amongthesestudents,48respondents（57.83%）wereinanemergencydepartment,17respondents（20.48%）inaninternalmedicinedepartment,and18respondents（21.69%）inasurgerydepartment.

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III.Translation（5X2=10）

Directive:

TranslatethefollowingintoEnglish.

1.在筛查前获得书面知情同意书。

2.新的研究让人们对于GISTs的病理生理和治疗有了新的理解。

3.在这项研究中，我们确认童年时期较高的BMI值与成年后患冠心病的风险有关。

4.既然所有P值均大于0.15，就没对分析进行研究基地、性别、种族和民族的调整。

5.对初级干预后需要哪种随访以及确诊复发后的管路尚未达成共识。

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IV.Writing（10）

Directive:

BelowispartoftheIntroductionofajournalarticle,wheretheliteraturereviewfromthreesources（numbered4,5,and12inthereferencelist）istakenaway.Writeoutthemissingliteraturereviewbasedontheirabstractprovidedtoyou（Onesentenceforeachsource）.Thereferencescitedinthispartaregiven.

SuddenCardiacArrestduringParticipationinCompetitiveSports

Theoccurrenceofsuddencardiacarrestinyoungpersonsduringparticipationincompetitivesportsisararebuttragicevent.Innumerousjurisdictions,preparticipationscreeningsystemshavebeenimplementedontheassumptionthatmostcasesofsuddencardiacarrestthatoccurduringsportsactivitiescanbepredictedandpreventedbyidentifyingpersonsatrisk,withdrawingthemfromcompetitivesports,andinselectedcases,applyingtherapeuticpreventivemeasures.1,2.

Thereportedincidenceofsuddencardiacdeathintheyoung（usuallydefinedas

<35yearsofage）—withsuddencardiacdeathreferringexclusivelytosuddencardiacarrestthatresultsindeath—rangeswidely,from1.0to6.4casesper100,000patient-years.3

Theuncertaintyregardingthepreciseincidenceofsuddencardiacarrestintheyoung,particularlyduringparticipationinasport,canbeattributedinparttoimperfectdatacollectionsystemsthathavebeenusedinpreviousstudies.Almostallthestudieshavefocusedonpersonswhocouldnotberesuscitated（suddencardiacdeaths）,andinmostofthestudies,deathcertificates,hospitalrecords,autopsyreports,orsearchesofpubliclyavailablerecordswereusedtoidentifycasesofsuddencardiacarrest.3-10Theseapproachesarelimitedbecausesystematicmethodswerenotusedtoidentifyallpersons

inaparticularcommunitywhohadsuddencardiacarrestandbecausesurvivorswere

notincluded.

RescuEpistryisaprospective,comprehensiveregistryofallpersonswhohadout-of-hospitalcardiacarrestandwhoseeventwasattendedbyemergencymedicalservices（EMS）personnelinadefinedregionoftheprovinceofOntario,Canada.Thisvalidatedregistryallowsanopportunitytosystematicallyexaminethecircumstancesandcausesofout-of-hospitalcardiacarresttoquantifyhowmanyoftheeventsaretrulysuddenandhowmanyaretrulycardiacinorigin.11Weusedthisregistrytoascertaintheincidenceofsuddencardiacarrestduringparticipationincompetitiveandnoncompetitivesportsactivitiesamongyoungpersonsandtodeterminetheunderlyingcauses.

Thecurrentanalysisallowedustoestimatethepotentialefficacyofsystematicpre-participationscreening.

References

1.PellicciaA,ZipesDP,MaronBJ.BethesdaConference#36andtheEuropeanSocietyofCardiologyConsensusRecommendationsrevisited:

acomparisonofU.S.andEuropeancriteriaforeligibilityanddisqualificationofcompetitiveathleteswithcardiovascularabnormalities.JAmCollCardiol2008;52:

1990-6.

2.CorradoD,BassoC,SchiavonM,PellicciaA,ThieneG.Pre-participationscreeningofyoungcompetitiveathletesforpreventionofsuddencardiacdeath.JAmCollCardiol2008;52:

1981-9.

3.AckermanM,AtkinsDL,TriedmanJK.Suddencardiacdeathintheyoung.Circulation2016;133:

1006-26.

4.FinocchiaroG,PapadakisM,RobertusJL,etal.Etiologyofsuddendeathinsports:

insightsfromaUnitedKingdomregionalregistry.JAmCollCardiol2016;67:

2108-15.

5.MarijonE,TaffletM,CelermajerDS,etal.Sports-relatedsuddendeathinthegeneralpopulation.Circulation2011;124:

672-81.

6.HarmonKG,DreznerJA,WilsonMG,SharmaS.Incidenceofsuddencardiacdeathinathletes:

astate-of-the-artreview.BrJSportsMed2014;48:

1185-92.

7.-10.…

11.MorrisonLJ,NicholG,ReaTD,etal.Rationale,developmentandimplementationoftheResuscitationOutcomesConsortiumEpistry-CardiacArrest.Resuscitation2008;78:

161-9.

12.LithwickDJ,FordyceCB,MorrisonBN,etal.Pre-participationscreeningintheyoungcompetitiveathlete:

internationalrecommendationsandaCanadianperspective.BCMJ2016;58:

145-51.

Abstracts

EtiologyofSuddenDeathinSports:

InsightsfromaUnitedKingdomRegionalRegistry

BACKGROUND:

Accurateknowledgeofcausesofsuddencardiacdeath（SCD）inathletesanditsprecipitatingfactorsisnecessarytoestablishpreventativestrategies.

OBJECTIVES:

ThisstudyinvestigatedcausesofSCDandtheirassociationwithintensivephysicalactivityinalargecohortofathletes.

METHODS:

Between1994and2014,357consecutivecasesofathleteswhodiedsuddenly（mean29±11yearsofage,92%males,76%Caucasian,69%competitive）werereferredtoourcardiacpathologycenter.Allsubjectsunderwentdetailedpost-mortemevaluation,includinghistologicalanalysisbyanexpertcardiacpathologist.Clinicalinformationwasobtainedfromreferringcoroners.

RESULTS:

Suddenarrhythmicdeathsyndrome（SADS）wasthemostprevalentcauseofdeath（n

=149[42%]）.Myocardialdiseasewasdetectedin40%ofcases,includingidiopathicleftventricularhypertrophy（LVH）and/orfibrosis（n=59,16%）;arrhythmogenicrightventricularcardiomyopathy（ARVC）（13%）;andhypertrophiccardiomyopathy（HCM）（6%）.Coronaryarteryanomaliesoccurredin5%ofcases.SADSandcoronaryartery

anomaliesaffectedpredominantlyyoungathletes（≤35yearsofage）,whereas

myocardialdiseasewasmorecommoninolderindividuals.SCDduringintenseexertionoccurredin61%ofcases;ARVCandleftventricularfibrosismoststronglypredictedSCDduringexertion.

CONCLUSIONS:

ConditionspredisposingtoSCDinsportsdemonstrateasignificantagepredilection.ThestrongassociationofARVCandleftventricularfibrosiswithexercise-inducedSCDreinforcestheneedforearlydetectionandabstinencefromintenseexercise.However,almost40%ofathletesdieatrest,highlightingtheneedforcomplementarypreventivestrategies.

Sports-relatedsuddendeathinthegeneralpopulationBACKGROUND:

Althoughsuchdataareavailableforyoungcompetitiveathletes,theprevalence,

characteristics,andoutcomeofsports-relatedsuddendeathhavenotbeenassessedpreviouslyinthegeneralpopulation.

METHODSANDRESULTS:

AprospectiveandcomprehensivenationalsurveywasperformedthroughoutFrancefrom2005to2010,involvingsubjects10to75yearsofage.Casedetectionforsports-relatedsuddendeath,includingresuscitatedcardiacarrest,wasundertakenvianational

ambulanceservicereportingandWeb-basedscreeningofmediareleases.Theoverallburdenofsports-relatedsuddendeathwas4.6casespermillionpopulationperyear,with6%ofcasesoccurringinyoungcompetitiveathletes.Sensitivityanalysesusedtoaddresssuspectedunderreportingdemonstratedanincidencerangingfrom5to17newcasespermillionpopulationperyear.Morethan90%ofcasesoccurredinthecontextofrecreationalsports.Theageofsubjectswasrelativelyyoung（mean±SD46±15years）,withapredominanceofmen（95%）.Althoughmostcaseswerewitnessed（93%）,bystandercardiopulmonaryresuscitationwasonlycommencedin30.7%ofcases.Bystandercardiopulmonaryresuscitation（oddsratio3.73,95%confidenceinterval

2.19to6.39,P<0.0001）andinitialuseofcardiacdefibrillation（oddsratio3.71,95%confidenceinterval2.07to6.64,P<0.0001）werethestrongestindependentpredictorsforsurvivaltohospitaldischarge（15