Skilled clinical history-taking and physical examination remain essential as the basis of the disease di¬agnosis and management, aided by investigations such as radiological or biochemical tests. Technological advances over the past few decades mean that such investigations now can be refined, or even replaced in some cases, by the measurement of genetic or genomic biomarkers. The molecular characteristics of a disorder or the genetic make-up of an individual can fine tune a diagnosis and inform its management. These new capabilities, often termed "stratified （分层的）"or "personalized" medicine, are likely to have profound effect on the practice of medicine and service delivery.
Genetic medicine, which uses genetic or genomic biomarkers in this way, has, until recently, been the province of a small minority of specialized physicians who have used it to diagnose or assess risk of in¬herited disease. Recognition that most disease has a genetic component, the development and applica¬tion of new genetic tests to identify important disease subsets and the availability of cost-effective interven¬tions mean that genetic medicine must be integrated more widely across healthcare services. In order to optimize benefit equitably across the population, physicians and services need to be ready to change and adapt to new ways of working.
Perhaps the greatest challenge is to ensure the readiness of physicians to use these genomic technol¬ogies for maximum effect, so that genetic medicine is incorporated into mainstream specialties. For some clinicians, particularly those involved in clinical research, these advances are already a reality. However, a sizable majority do not yet recognize the relevance of genetics for their clinical practice, perceiving genetic conditions to be rare and untreatable. Maximizing genomic opportunities also means being aware of their limitations, media portrayals that indicate that genetic information gives clear-cut answers are often unreal¬istic. Indeed, knowing one's entire genomic sequence is not the crystal ball of our future that many hope it to be, and physicians will need to be more familiar with what is hype（鼓吹）and what is reality for the inte¬gration of genetics into mainstream medicine to be successful.
Finally, both professional and the public should have a realistic view of what is possible. Although the discovery of genetic risk factors in common diseases such as heart disease and cancer has led to impor¬tant insights about disease mechanisms, the predictive power of individual genetic variants is often very low. Developments in bioinformatics will need to evolve considerably before the identification of a particular combination of genetic variants in an individual will have clinical utility for them.
1. Which of the following statements does the author most probably agree with?
2. What, according to the second paragraph, can be said of genetic medicine?
3.The future of the genomic technologies, for the most part, lies in（ ）.
4. In the last paragraph, the author cautions against（ ）.
5. Which of the following can best summarize the main idea of the passage?
问题1选项
A.Personalized medicine will greatly change the practice of medicine.
B.Genetic biomarkers have been largely refined over the past.
C.Physical examination remains essential in fine tuning a diagnosis.
D.Clinical history-taking is no longer important in the genetic era.
问题2选项
A.It can offer solutions to all inherited diseases.
B.It has been widely recognized among the physicians.
C.It necessitates adaptation of the healthcare community.
D.It is monopolized by a small minority of specialized physicians.
问题3选项
A.the greater potential of treating rare diseases
B.the greater efforts in the relevant clinical research
C.the greater preparedness of the physicians to employ them
D.the greater publicity of their benefits in the media portrayals
问题4选项
A.underestimation of the importance of the genetic risk factors
B.unrealistic expectation of the genetic predicative power
C.abuse of genetic medicine in treating common diseases
D.unexpected evolution of the bioinformatics
问题5选项
A.Genetic medicine should be the mainstream option for physicians.
B.Genetic medicine poses great challenges to medical practice.
C.Genetic medicine will exert great influence on medicine.
D.Genetic medicine is defined as "stratified" medicine.
第1题:A
第2题:C
第3题:C
第4题:B
第5题:C
第1题:
【选项释义】
Which of the following statements does the author most probably agree with? 以下哪一种说法作者最可能同意？
A. Personalized medicine will greatly change the practice of medicine. A. 个性化医疗将极大地改变医学实践。
B. Genetic biomarkers have been largely refined over the past. B. 遗传生物标记物在过去已经有了很大的改进。
C. Physical examination remains essential in fine tuning a diagnosis. C. 体格检查在诊断中仍是必不可少的。
D. Clinical history-taking is no longer important in the genetic era. D. 在基因时代，临床病史的收集已不再重要。
【答案】A
【考查点】事实细节题。
【解题思路】第一段最后一句“这些经常被称为‘分层’或‘个性化’医疗的新功能可能对医疗实践和提供服务产生深远影响（have profound effect）。”由此句可知个性化医疗将极大地改变医疗实践。所以A选项“个性化医疗将极大地改变医学实践。”符合题意。
【干扰项排除】
B选项“遗传生物标记物在过去已经有了很大的改进。”，文中没有提到属于无中生有；
C选项“体格检查在诊断中仍是必不可少的。”，根据第一段第二句“过去几十年的技术进步意味着，这些研究现在可以通过对遗传或基因组生物标记物的测量来完善，甚至在某些情况下取代。”这些研究指的就是上文的熟练的临床病史和体格检查，因此体格检查有可能被替代，并不是必不可少的，属于反向干扰；
D选项“在基因时代，临床病史的收集已不再重要。”，文中没有提及，属于无中生有。
第2题:
【选项释义】
What, according to the second paragraph, can be said of genetic medicine? 根据第二段，遗传医学可以被说什么？
A. It can offer solutions to all inherited diseases. A. 它可以为所有遗传性疾病提供解决方案。
B. It has been widely recognized among the physicians. B. 它已被内科医生广泛认可。
C. It necessitates adaptation of the healthcare community. C. 它需要医疗保健社区的适应。
D. It is monopolized by a small minority of specialized physicians. D. 它被一小部分专科医生垄断了。
【答案】C
【考查点】推理判断题。
【解题思路】根据题干信息可定位到第二段最后一句“为了使人们公平地享有最优化的利益，医生和服务机构需要随时准备改变和适应新的工作方式”，而这里新的工作方式即上一句提及的“遗传医学必须更广泛地整合到医疗保健服务中（genetic medicine must be integrated more widely across healthcare services）”。综合理解，可知C选项“它需要医疗保健社区的适应。”符合题意。
【干扰项排除】
A选项“它可以为所有遗传性疾病提供解决方案。”，可定位到第二段第一句“遗传医学以这种方式使用遗传或基因组生物标记物，直到最近，一直是少数专业医生的领域，他们使用遗传医学来为遗传疾病诊断或评估风险”，这里只是说是少数医生用遗传医学，并没有说遗传医学可以为所有的遗传性疾病提供解决方案，属于过度推断；
B选项“它已被内科医生广泛认可。”，根据第二段最后一句“为了使整个人口的利益最大化，医生和服务部门需要准备好改变和适应新的工作方式。”，虽然此句提到“医生……准备好改变和适应新的工作方式”，但未说选项中“被内科医生广泛认可”，属于无中生有；
D选项“它被一小部分专科医生垄断了。”文中没有提及，属于无中生有。
第3题:
【选项释义】
The future of the genomic technologies, for the most part, lies in（ ）. 基因技术的未来在很大程度上取决于____。
A. the greater potential of treating rare diseases A. 治疗罕见病的更大潜力
B. the greater efforts in the relevant clinical research B. 相关临床研究更多的努力
C. the greater preparedness of the physicians to employ them C. 使用它们的医生的更好准备
D. the greater publicity of their benefits in the media portrayals D. 在媒体的描述中对它们的好处进行更大的宣传
【答案】C
【考查点】事实细节题。
【解题思路】根据题干信息可定位到第三段，需要注意解题关键点在于for the most part“主要”，因此需要找的是主要因素。在段首即提到Perhaps the greatest challenge is to ensure the readiness of physicians to use these genomic technologies for maximum effect “也许最大的挑战是确保医生准备好使用这些基因技术以获得最大的效果”，可知此处提到了这个最大因素是医生的准备，因此C选项“使用它们的医生的更好准备”正确。
【干扰项排除】
A选项“治疗罕见病的更大潜力”，文中没有提及属于无中生有；
B选项“相关临床研究更多的努力”来自第三段第三句“然而相当多数医生还没意识到临床实践中基因的相关性……”，但此处并未提及其“最重要”的地位，属于本末倒置；
D选项“在媒体的描述中对它们的好处进行更大的宣传”，原文中说的是“媒体刻画的是，基因信息给出明确答案的描述往往不切实际”，与题干没有关系属于无中生有。
第4题:
【选项释义】
In the last paragraph, the author cautions against（ ）. 在最后一段中，作者对____提出了警告。
A. underestimation of the importance of the genetic risk factors A. 低估了遗传危险因素的重要性
B. unrealistic expectation of the genetic predicative power B. 对遗传预测能力的不切实际的期望
C. abuse of genetic medicine in treating common diseases C. 滥用遗传医学治疗常见病
D. unexpected evolution of the bioinformatics D. 生物信息学的意外进化
【答案】B
【考查点】推理判断题。
【解题思路】最后一段说到“尽管在心脏病和癌症等常见疾病中发现的遗传风险因素已导致对疾病机制的重要认识，但个体遗传变异的预测能力往往非常低”。由此可推断，作者是在警告不要对遗传预测能力有不切实际的期望。所以B选项“对遗传预测能力的不切实际的期望”符合题意。
【干扰项排除】
A选项“低估了遗传危险因素的重要性”，最后一段中说到已经认识到了遗传风险因素，并没有说低估了重要性，因此该选项属于无中生有；
C选项“滥用遗传医学治疗常见病”，文中没有滥用的意思，该选项无中生有；
D选项“生物信息学的意外进化”，文中提到“生物信息学的发展需要在相当大的程度上进化，才能对个体中特定的遗传变异组合进行鉴定，使其具有临床效用。”，但文中并没有选项“意外进化”的意思。该选项属于无中生有。
第5题:
【选项释义】
Which of the following can best summarize the main idea of the passage? 下列哪项最能概括文章的主要观点？
A. Genetic medicine should be the mainstream option for physicians. A. 遗传医学应该成为医生的主流选择。
B. Genetic medicine poses great challenges to medical practice. B. 遗传医学对医学实践提出了巨大的挑战。
C. Genetic medicine will exert great influence on medicine. C. 遗传医学将对医学产生巨大的影响。
D. Genetic medicine is defined as “stratified” medicine. D. 遗传医学被定义为“分层”医学。
【答案】C
【考查点】主旨大意题。
【解题思路】全文是围绕遗传医学展开的：属于总分总。首先是介绍；其次提到它纳入主流医学的阻碍和条件，表示会对现存的医学产生重大影响；最后呼吁要对遗传预测能力有现实看法。因此选C。
【干扰项排除】
A选项“遗传医学应该成为医生的主流选择。”，是第三段对文章的片面概括，属于以偏概全；
B选项“遗传医学对医学实践提出了巨大的挑战。”，文中没有提及，属于无中生有；
D选项“遗传医学被定义为‘分层’医学。”，是第一段对文章的片面概括，属于以偏概全。
【参考译文】
熟练的临床病史采集和体格检查仍然是疾病诊断和管理的基础，并辅以放射学或生化检验等检查。过去几十年的技术进步意味着，现在可以通过测量基因或基因组生物标志物来完善这些检查，甚至在某些情况下可以取而代之。疾病的分子特征或个体的基因构成可以对诊断进行微调，并指导其管理。这些新能力通常被称为“分层的”或“个性化”的医学，很可能对医学实践和服务提供产生深远影响。
基因医学以这种方式使用基因或基因组生物标志物，直到最近一直是少数专科医生的专利，他们用这种方法诊断或评估遗传疾病的风险。人们认识到大多数疾病都有遗传因素，开发和应用新的基因检测方法来确定重要的疾病亚群，以及提供具有成本效益的干预措施，这些都意味着基因医学必须更广泛地融入医疗保健服务。为了在整个人群中公平地优化受益，医生和服务机构需要随时准备改变和适应新的工作方式。
也许最大的挑战是确保医生做好准备，利用这些基因组技术发挥最大作用，从而将基因医学纳入主流专科。对于一些临床医生，尤其是从事临床研究的医生来说，这些进步已经成为现实。然而，相当多的人还没有认识到遗传学与他们临床实践的相关性，认为遗传病是罕见的、无法治疗的。最大限度地利用基因组机会也意味着要意识到其局限性，媒体所描述的基因信息能给出明确答案的说法往往是不切实际的。事实上，了解一个人的整个基因组序列并不像许多人希望的那样是我们未来的水晶球，医生需要更加熟悉什么是鼓吹，什么是现实，才能成功地将基因学融入主流医学。
最后，专业人员和公众都应实事求是地看待可能发生的事情。虽然心脏病和癌症等常见疾病的遗传风险因素的发现使人们对疾病机制有了重要的认识，但个体遗传变异的预测能力往往很低。生物信息学的发展还需要有长足的进步，才能确定个体的特定基因变异组合对其具有临床效用。
