1 . Medical Examination Instructions

These medical instructions are being issued as your immigration (移民) application has reached the stage where medical examination results are required.

When, who and how to complete your Immigration Medical Examination

You are required to have the medical examination within 30 days of the date of this letter; your medical examination must be performed by a doctor from the IRCC list of Panel Physicians; book an appointment with a Panel Physician in your area as soon as possible.

Once your medical examination has been completed, the Panel Physician will submit medical results to IRCC for assessment. To obtain a copy of your Immigration Medical Examination, please ask the Panel Physician at the time of your appointment.

Paying for your Immigration Medical Examination

Any costs related to the medical examination are your responsibility and are payable to the Panel Physician at the time of examination. This payment is for the Panel Physician's services and cannot be returned even if your immigration application is refused or the validity period (有效期) of your immigration medical examination ends.

Note: If you are qualified for coverage under the Interim Federal Health Program, the costs related to your immigration medical examination may be covered by the IFHP. Please confirm with the Panel Physician in your area that they are registered with the IFHP.

What must I bring to my appointment?

★ The attached Medical Report form

★Identification, including your passport if one is available (Proof of identity must include at least one government-issued document with photograph and signature, such as a passport.)

★Eye glasses or contact lenses (隐形眼镜), if worn

★Four recent photographs

★For individuals qualified for Migration Medical Examination coverage under the Interim Federal Health Program, please bring one of the following documents:

●Refugee Protection Claimant Document

●The Interim Federal Health Certificate

●Acknowledgement of Claim and Notice to Return for Interview

If available, you may be offered vaccinations (接种疫苗) by the Panel Physician.

1. After your medical examination, _________.

A．the previous health reports ought to be consulted

B．you will submit the results to IRCC for assessment

C．the Panel Physician will present the results to IRCC

D．you will surely obtain a copy of examination results by the physician

2. If your immigration application is refused, which statement is right about the costs?

A．The IFHP will cover them.	B．They cannot be returned.
C．The Panel Physician will pay in cash.	D．They will be returned if you apply.

3. Which of the following must be brought to the appointment?

A．Proof of identity.	B．The Federal Health Certificate.
C．The application form.	D．Medical examination instructions.

2 . 听下面一段较长对话，回答以下小题。
1. Why does Tom want to make an appointment to see Dr. Sharp?

A．To do a physical check-up.

B．To take some medicine.

C．To find a new job.

2. How will the woman inform Tom after receiving the form?

A．By writing to him.

B．By e-mailing him.

C．By calling him.

3 . 听下面一段较长对话，回第以下小题。
1. What does the man think he still has a problem with?

A．His nose.

B．His head.

C．His mouth.

2. Where are the speakers?

A．In a hospital.

B．In a school lab.

C．At a research center.

3. What will the man work out during the experiment?

A．His smell.

B．His taste.

C．His muscle.

4. What is the main topic of the conversation?

A．Taking new medicines.

B．Using new treatments.

C．Finding new senses.

4 . I was shocked to see my baby Dani with a cleft(唇裂) at his birth. After the delivery, I wasn’t _______ to see my baby. All I could do was to ask for information about Dani. Dani had his surgery on the seventh day! It was a terrible experience. I buried myself in great _______.

Things _______ when I met Dr. Anastassov, who brought Smile Train—sponsored cleft care to Bulgaria. Dr. Anastassov was my _______ from the moment we met. He helped me build the confidence in Dani’s _______. At six, Dani finished his speech therapy(矫治) and could speak as _______ as everyone else.

Dani wanted to be a _______. When he began his formal training, the medical exam was very _______ for him. They knew he was different, even if they couldn’t immediately tell how. So they worked him harder than the others. But Dani showed great _______ and passed. He is now ________ his dream as a pilot!

Being Dani’s mother is a(n) ________. He has been so successful because we ________ him to understand that people with clefts should not be ________, because they can do anything.

Now I ________ Smile Train to help those like my son. I ________ my experience with them. I’m happy to work here and make change for the better every day.

1.

A．persuaded

B．invited

C．allowed

D．forced

2.

A．relief

B．pain

C．security

D．loneliness

3.

A．changed

B．continued

C．worsened

D．mattered

4.

A．challenge

B．choice

C．evidence

D．inspiration

5.

A．attitude

B．gift

C．recovery

D．virtue

6.

A．loudly

B．firmly

C．clearly

D．gently

7.

A．pilot

B．trainer

C．doctor

D．spaceman

8.

A．valuable

B．difficult

C．interesting

D．practical

9.

A．excitement

B．difference

C．contribution

D．strength

10.

A．living

B．spreading

C．breaking

D．discovering

11.

A．chance

B．fact

C．mission

D．honor

12.

A．promised

B．raised

C．ordered

D．begged

13.

A．pitied

B．supported

C．compared

D．controlled

14.

A．set up

B．work with

C．turn to

D．care about

15.

A．replace

B．draft

C．confirm

D．share

5 . When patients are discharged (出院) from the hospital, effective summaries from doctors’ notes are essential to capture their health status in the medical record. Whereas, most are filled with technical languages that are hard to understand and increase patients’ anxiety.

To address the problem, researchers from New York University (NYU) Langone Health have been testing the capabilities of generative artificial intelligence (AI). It tries to develop likely options for the next word in any sentence based on how most people use words in context on the Internet.

NYU Langone Health received access to the latest tool from a famous tech company to explore generative AI. One of the studies by the researchers published in JAMA Network Open, looked at how well the tool could convert (转换) the text in 50 patient discharge notes into patient-friendly language. Specifically, generative AI made the discharge notes drop from 11th-grade reading level on average to a 6th-grade level.

Two physicians were asked to review the AI discharge summary based on a 6th-grade level. The reviewing physicians awarded 54 percent of the AI-generated discharge notes the best-possible accuracy rating. They also found that 56 percent of notes created by AI were entirely complete. The result signified that even at the current performance level, providers of discharge notes would not have to make a single change in more than half of the AI summaries reviewed.

“That more than half of the AI reports generated are accurate and complete is an amazing start,” said Jonah Zaretsky, associate chief of medicine at NYU Langone Hospital — Brooklyn. “Even at the current level of performance, which we expect to improve shortly, the achievement of the AI tool suggests that it can be taught to recognize subtleties (微妙之处).”

Within the following years, the team expects to launch a pilot program to provide lay language discharge summaries that have been generated by AI and reviewed by physicians to patients on a larger scale.

1. What is generative AI used for by the researchers?

A．Submitting discharge summaries.	B．Accessing patients’ health status.
C．Making discharge notes clear to patients.	D．Offering technical languages to doctors.

2. What is generative AI’s function based on?

A．Probable predicting.	B．Actual thinking.
C．Free imagining.	D．Strict instructing.

3. Why were the two physicians asked to review the AI discharge summaries?

A．To correct their mistakes.	B．To measure their accuracy.
C．To compete with the AI tool.	D．To make up the missing parts.

4. How did Jonah Zaretsky find the performance of AI in dealing with discharge summaries?

A．Misleading.

B．Dismissive.

C．Challenging.

D．Promising.

6 . When I turned 12, I started hiding how I looked with jackets and oversized T-shirts for fear of comments about my body. I wouldn’t talk about things I loved because I was afraid that people would think I was odd for liking them or that I was talking too much.

At the age of 14, I’d had what I now know were panic attacks over grades in the middle of the hallways in school, or in loud, crowded queues in theme parks. This led to some long talks with my parents and failed meetings with my school advisors, And I eventually decided it was time for me to try mental therapy (治疗).

I still remember going to my first therapy session,almost four years ago. Before I went to it, I feared it’d be scary, but I was wrong. The first few sessions were just used for the two of us to get to know each other. The following few sessions were used for me to figure out why I was there. I tested fairly high on the anxiety scale.and ever since then I’ve kept going there. Two years later, I started going there every two weeks rather than every week. My anxiety levels have gone up and down because of exams, issues with friends and just plain old bad days. For now though,they seem to remain stable for the most part.

To this day, I still think that going to therapy was one of the best decisions I’ve made so far in life. From the first session that I attended to the last one I went to, I’ve learned so many life skills and coping strategies that I use at least once a week.

I’ve always said to my friends and family that they should try therapy if it’s necessary. For people suffering panic attacks, going to therapy means talking to someone who you know won’t judge you about anything, who won’t tell anyone about what you say or how you feel, and who helps you understand yourself and your life.

1. What was the author’s problem when she was 12?

A．She had a poor relationship with classmates.

B．She had a strange dressing style.

C．She would run into anxiety easily.

D．She iost interest in studying.

2. What’s the probable result of the author’s talking to her parents and school advisors?

A．They helped find the cause of her panic attacks.

B．They failed to help her get out of her trouble.

C．They strongly advised her to see a doctor.

D．They lost patience with her.

3. What can we know about the author’s therapy according to Paragragh 3?

A．It had negative side effects on the author.

B．It was effective in helping keep his anxiety scales steady.

C．It strengthened the author’s confidence quickly.

D．It offered solutions to problems of school and friendship.

4. Why does the author most probably share her experience in the text?

A． To teach us to better,understand ourselves.

B．To give tips on ways to overcome anxiety.

C．To explain the working process of mental therapy.

D．To encourage readers to accept therapy if necessary.

7 . A man with advanced Parkinson’s disease (帕金森氏症) is now able to walk almost normally again thanks to electrodes implanted (电极植入) in his spinal cord (脊椎), researchers said on Monday. The medical first was achieved by Swiss researchers who had previously pioneered similar breakthroughs to help disabled people walk again.

“This could be a game-changing technology to help bring back movement in people with advanced Parkinson’s,” said David Dexter, research director at Parkinson’s UK.

Marc Gauthier, the 62-year-old patient who lives in France, has suffered from the brain disorder for about 30 years. Like more than 90 percent of people with advanced Parkinson’s, Mar c has had great difficulty walking. What are known as “freezing” experiences — during which patients are unable to move for a limited time, putting them at risk of falling — are particularly awful, Marc told AFP.

Much remains unknown about Parkinson’s disease, making treatment difficult. But the disease can seriously affect the lives of patients, sometimes keeping them to bed or a wheelchair. So when the opportunity came to go through an operation in Switzerland, Marc gladly accepted the chance.

“Now I can do whatever I want,” Marc says. “I can go for a walk and go out shopping by myself.” He adds that he can now walk much more easily — he is even planning a trip to Brazil — but it still requires concentration, particularly when climbing upstairs.

The Swiss team, led by surgeon Jocelyne Bloch and neuroscientist Gregoire Courtine , implanted a complex system of electrodes called a “neuroprosthesis (神经假体)” at important points along Marc’s spinal cord. The neuroprosthesis was first tested on animals, and then implanted in Marc, who has used it for roughly eight hours a day over nearly two years.

The Swiss team has expanded their experiment to a group of six Parkinson’s patients, aiming to know how it could help others, given the disease affects people in different ways. However, treatment using the implant could be quite expensive, potentially limiting how many patients would have access.

1. What is David Dexter’s attitude to the Swiss breakthrough?

A．Unconcerned.

B．Doubtful.

C．Positive.

D．Unclear.

2. What can Marc do after the surgery?

A．Volunteer as a tour guide in Brazil.	B．Run to his heart’s content.
C．Go to the supermarket alone.	D．Make a phone call while climbing the stairs.

3. What do we know about the surgery?

A．It was first tested on Marc Gauthier.	B．It is hardly affordable for ordinary people.
C．It has been performed on many patients.	D．It was done by researchers in the UK.

4. What is the best title for the text?

A．A Spinal Implant Allows a Parkinson’s Patient to Walk Again

B．Parkinson’s Patients Have to Deal With Difficulties in Life

C．Swiss Experts Have Created a Drug to Treat Parkinson’s

D．New Technology Prevents People From Developing Parkinson’s

8 . Personalized medicine changes conventional medicine which typically offers blanket recommendations and offers treatments designed to help more people than they bam but that might not work for you. The approach recognizes that we each possess unique characteristics, and they have an out size impact on our health.

Around the world, researchers are creating precision tools unimaginable just a decade ago: superfast DNA sequencing(排序); tissue engineering, cell reprogramming, gene editing, and more. The science and technology soon will make it possible to predict your risk of cancer, heart disease, and countless other illnesses years before you get sick. The work also offers prospects for changing genes in removing some diseases.

Last spring, researchers at the National Cancer Institute reported the dramatic recovery of a woman with breast cancer, Judy Perkins. The team, led by Steven Rosenberg, an immune(免疫的) treatment pioneer, had sequenced her cancer cells’ DNA to analyze the sudden change. The team also removed a sampling of immune cells and tested them to see which ones recognized her cancer cells' genetic faults. The scientists reproduced the winning immune cells by the billions and put them into Perkins to attack her cancer cells. More than two y cars later. Perkins, a retired engineer from Florida, shows no signs of cancer.

Thirty years ago, scientists thought that it would be impossible to understand our genetic rules and sequence the 3.2 billion pairs of different elements in our DNA. “It was like you were talking fairytales,” Kurzrock said. “The conventional wisdom was that it would never happen. Never And then in 2003, never was over.”

It took the Human Gene Project 13 years, roughly one billion dollars, and scientists from six countries to sequence one gene complex. Today sequencing costs about a thousand dollars. The latest machines can produce the results in a day. The technology, combined with advanced cell analysis, clarifies the astonishing biochemical variations that make every human body unique.

1. What can we know about personalized medicine?

A．It has emerged a decade before.

B．It offers blanket recommendations.

C．It uses genetic information to help patients.

D．It administers treatment intended for most people.

2. Which best describes those precision tools?

A．Promising.

B．Highly risky.

C．Fruitless.

D．Strictly confidential.

3. What happened in the process of treating Judy Perkins' breast cancer?

A．Sequencing her immune cells.

B．Reprogramming her cancer cells

C．Analysis of her life style changes.

D．Identification of cancer-fighting cells.

4. What's the last paragraph mainly talking about concerning sequencing?

A．Its wide applications.	B．Its recent advances.
C．Its major disadvantages.	D．Its attractive prospects.

9 . 阅读下面短文，在空白处填入1个适当的单词或括号内单词的正确形式。

Bacteriophages (phages) and other mobile genetic elements (MGEs) exert an immense selective pressure on     1    (bacterium), which in response have developed a broad arsenal of defence mechanisms.     2     these, CRISPR–Cas (clustered regularly interspaced short palindromic repeats–CRISPR-associated proteins) is a group of widespread RNA-guided adaptive immune systems that are classified into two broad classes, six types and numerous subtypes according to their genetic composition and interference mechanism1. The CRISPR–Cas immune response starts with the    3    (acquire) of short DNA fragments (protospacers) from invading MGEs. The protospacers are inserted as spacers between repeats in the CRISPR array to create a memory of the infection. Next, the CRISPR array is expressed    4     a long transcript that is processed into small, mature CRISPR RNAs (crRNAs), each    5    (carry) a spacer sequence flanked by part of the repeat. Finally, the interference complexes, composed     6     a crRNA and one (class 2) or more (class 1) Cas proteins, degrade the complementary nucleic-acid targets that are often found next to a short protospacer-adjacent motif (PAM). The specificity and programmability of the CRISPR–Cas machinery     7    (lead) to the development of various biotechnological applications in genome editing, molecular diagnostics and more.

In the evolutionary arms race with CRISPR–Cas, phages and other MGEs have evolved diverse strategies to block or circumvent immunity. One widespread evasion mechanism uses protein-    8    (base) CRISPR–Cas inhibitors called anti-CRISPRs (Acrs). So far, more than 100 Acr protein families have been identified    9     inhibit different stages of the CRISPR–Cas immune response, mainly by interacting directly with Cas proteins. For example, Acrs prevent crRNA loading, effector-complex formation, and target DNA binding and cleavage. Notably, the discovery of these natural ‘off switches’ has presented new opportunities    10    (control) the activity of CRISPR–Cas technologies.

10 . Reasonable people should not have blind faith in the medical profession.     1     We have to check out the medicine we take. We have to ask for second and even third opinions. We must do some research. We have to use our common sense and be informed about our health care.

While it is true that modern Western medicine has risks, we shouldn’t reject it totally.     2     Most people who get good medical care are healthier and live longer.

If this is the case why has “alternative” health care become so popular in North America and Europe? Often the fear of surgery motivates people to look for these alternatives. Many people think that these treatments will help even when the situation seems hopeless to Western doctors.     3     Surgeons perform dangerous surgery, but natural healers (治疗师) do not seem to give dangerous treatments. People don’t think alternative care would kill anyone by mistake.     4     No one wants to go to a doctor in a cold hospital clinic. Since some doctors don’t have a nice “bedside manner”, people like the attention they get from alternative healers.

    5     All doctors and healers are human beings who can make mistakes. They can miss things and waste valuable time. No matter what happens, we have to think about all of the different options. Remember, there are millions of patients who are alive and well today because of “conventional” Western medicine.

A．Some alternative treatments are ineffective.

B．In addition everyone wants to be treated warmly.

C．We have to realize that there will be risks in almost any treatment.

D．Alternative treatments are attractive because they seem less harmful.

E．Patients who trust their doctors are more likely to follow treatment plans.

F．We all have to get more information about the treatments that we are given.

G．The harm to the patients usually comes from not getting medical treatment immediately.