1 . Culture influences an individual’s health beliefs, behaviours, activities and medical treatment outcomes. ___________ the significant influence of culture upon health and related outcomes, health care ___________ should be culturally competent in order to provide ___________ health care to patients. Cultural competency means considering many options and being more careful about making judgments. For example, scars and bruises that suggest abuse in western culture could ___________ be symbols of accepted healing methods or sacred rituals. ___________, different parts of the body are considered sacred in different cultures.

Cultural competency in healthcare ___________ four major challenges for providers. The first is the straightforward challenge of recognizing clinical ___________ among people of different ethnic and racial groups, e. g. , higher ___________ of hypertension in African Americans and of diabetes in certain Native American groups.

The second, and far more complicated, challenge is ___________. This deals with everything from the need for interpreters to nuances of words in various languages. Many patients, even in western cultures, are ____________to talk with their doctors about such personal matters as sexual activity or chemical use. How do we overcome this ____________ among more restricted cultures?

The third challenge is ethics. ____________ western medicine is among the best in the world, we do not have all the ____________. Respect for the belief systems of others and the effects of those beliefs on well-being are critically important to competent care.

The final challenge involves ____________. For some patients, authority figures are immediately mistrusted, sometimes for good reason. Having seen or been victims of atrocities (暴行) at the hands of authorities in their homelands, many people are as ____________ of caregivers themselves as they are of the care.

2 . On September 3, 1928, Alexander Fleming was hard at work. His _______ was to study bacteria in a lab. While working, Fleming found mold (霉菌) on one of his Petri dishes. And when he looked _______, he saw something _______. The bacteria he studied were also _______ all over the dish, but they weren't growing on the spots that had mold. He _______ whether the bacteria were driven away by the mold. After more tests, Fleming found that it was doing just that. And he learned that the mold was a _______ called Penicillium.

Fleming believed that he could turn the mold into medicine to _______ infections. This medicine was the world's first antibiotic (抗生素). Fleming first _______ it “mold juice.” Later, he _______ the name to “penicillin.” Soon, a team at Oxford University ________ to help. Scientists Howard Florey, Ernst Chain and Norman Heatley worked with Fleming. Together, they further ________ penicillin.

The first patient treated with the new drug had a bad ________. His name was Albert Alexander. After a few ________ with penicillin, he felt much better. However, they ________ the medicine. The infection came back, and ________ Alexander passed away. Still, the doctors had learned that penicillin could fight bacteria. They just needed to ________ more of it. Later, Florey and Chain flew to the United States. There, they found ways to grow the mold ________. Starting in 1942, penicillin was used to treat World War Ⅱ soldiers.

At that time, diseases were just as ________ for soldiers at war as enemy forces were. Bacterial pneumonia (肺炎) alone ________ 18% of American soldiers to die in the first World War. Thanks to penicillin, that ________ to less than one percent in World War Ⅱ.

The four scientists saved lives and changed the world of medicine forever. Today, antibiotics are used to treat many illnesses.

3 . Last month, I slept through a flight from London to Beijing. Upon waking up, I was shocked to discover that I could no longer _______ my right arm and fingers. My arm just simply did not follow my brain’s _______ , as if it no longer _______ my body.

The doctor at the Sino Japanese Friendship Hospital _______ me to have suffered neural (神经的) injury. Aside from _______ that I see a physiotherapist (理疗师), he only told me, “Rest for two months first and come back for_______ check-up. ”

In that moment of _______ , a long-time family friend, who is an acupuncturist in Sichuan, _______to help. I started my acupuncture _______ the next day. I was sceptical at first, but my ________ was soon beaten by the results. After a few days, I could move my ________ Two weeks later, I could have meals using chopsticks. After a month, my arm and fingers were almost back to their ________ functions.

In that clinic, I heard many other patients’ ________ . One 11-year-old boy, who was born with ________ autism (自闭症), was treated at the age of three, and now he communicates quite ________ One lady, who suddenly became deaf two months ago, has just ________ her hearing.

I’m surprised at how these ________ needles can cure so many illnesses, many of which even big hospitals with expensive medical devices ________ with. Is it magic? No! But it is the right ________ of the Chinese tradition that brings ________ and happiness to friends here and farther.

4 . Rwanda is a small country in East Africa with about more than 13 million people. The landlocked country is one of the fastest growing economies in Africa. _________, almost half of the population still live in poverty.

Many people live in _________ where there is no doctor. Medical supplies such as _________, vaccines (疫苗) or even blood are _________ to reach these areas.

Zipline, an American start-up company, now helps people in remote areas to get better _________. A multinational team of engineers has been _________ to build a drone (无人机) that can deliver medicine to where it is most needed.

Rwanda is where their plans have been met with _________ from the government and the country’s civil aviation (民用航空) authority.

“Rwanda is the first country to _________ us through the design process of the drone to figure out how to do this,” said Keenan Wyrobek, a _________ of Zipline.

If a hospital or a __________ is in an area that is difficult to __________, the Zipline drone can deliver the medical supplies easily and much quicker than via road transport.

Doctors or healthcare workers just need to send a __________ to the base station and the delivery will be dispatched (派遣) via drone quickly and __________. So the vital supplies are dropped off by the drone where the items are __________. Now it only takes 30 minutes from the time the __________ is placed to the delivery.

“I used to see the drones fly and think they must be __________ until the same drone came to me and saved my __________. They are amazing,” said Alice Mutimutuje, a mother who fell seriously ill once.

The drones have already successfully completed more than 12,000 __________in the last years. In January 2019, the company__________ their project in Africa and the 29 million people in the West Africa Ghana will soon benefit from this new__________, too.

5 . I watched a wonderful video showing my friend Kieran Jordan dancing beautifully. I felt very_____________to see how she had responded to her illness.

Kieran has been living with Lyme disease (莱姆病) for two years. She first fell_______________in the summer of 2017, feeling tired, but the cause went undiagnosed and___________. After ten months, a medical provider recognized it as Lyme, but a lot of___________had been done._____________most health insurance plans do not cover Lyme disease, helpful   friends_________________a GoFundMe page,_________________more than $39,000 for Kieran.

She said,“GoFundMe saved my life. The disease is_______for two years. It’s been long and difficult, but not everyone has the kind of community _______________that I have.”

At the first signs   of the illness, she saw several medical   professionals. She said,“The__________ is that for ten months they________the diagnosis. They didn’t even test me for Lyme.”However, she is now making progress. “I am getting back some________________.”

Kieran is now seeing two physicians who specialize in Lyme. But she said________________that the health care system is so far behind in dealing with Lyme. “It’s not a__________disease, but Lyme disease is not included in our healthcare system and our insurance system.”In a Facebook post, Kieran told her friends,“I can see that I AM________. But I’m sometimes smiling through the tears!”

6 . On September 11,2001, Tom Frey reported to duty as a detective for the New York Police Department. However, he was assigned to work for ___and recovery after the Twin Towers collapsed. Like many on that ___morning, he never imagined it would be the day when his life_____forever. He, together with other first responders, spent 8 months ____looking for human remains in the dust and rubble.

In February 2016, after routine check-up and ___examination in hospital, Frey got a __ from a nurse the following day. His white blood cells increased, and after more___，he was diagnosed with Hodgkin's lymphoma, a cancer____among the first responders of 9/11 terrorist attack due to the dust____when the towers fell down.“I asked the doctor what we should do to treat it, and he said, ‘nothing'."

Frey began____the Internet to learn more about Hodgkin's lymphoma. His searching____him to the Hodgki's lymphoma Foundation, a website which has made all the___in his journey with the disease. Frey's cancer cells are now in____Once he has been cancer-free for five years, he will be ____for a lung transplant. "If you keep moving,you keep______Today, the retired ____is an ambassador for the Hdegkin's lymphoma Fudation, traveling the country to____others with the disease “Go to the foundation’s website and support group meetings. Doctor only have 15 minutes to___you, but these people are __ the same thing.Some have lived with this for years. They give you____as well as help."

7 . When you first hear the words “lung cancer”, you will think that’s the end of the world. Camille, a 53 -year-old mother of two teens is not ________. But fortunately, science is progressing rapidly, a series of tests help to ________ that the right medicine reaches the right patient at the right time. Many people, like Camille, are ________ from cancer diagnostic testing.

With proper ________ and medical care, Camille is now able to keep her daily ________ while treating her disease. She gets a CT scan every three months to ________ for any changes. Now she’s swimming a quarter of a mile twice a week and she can ________ with her kids’ school. She said. “There are some things that I know I should take slowly, but ________, it’s mostly back to ________ for us. I couldn’t even ________ when I was first diagnosed (诊断). However, I became very ________.”

As part of that gratitude, ________ has become even more important to Camille since her diagnosis.

“I’ve always been the caretaker and the volunteer, but people have helped me, particularly in the last couple of months, so I really want to ________ that back,” she said. “I want to help people who are in the same ________ as I am. I would tell them there’re a lot of ________ out there and that it’s not hopeless.”

8 . After persuading most of his patients, his wife and son to go back to France following the lockdown of Wuhan, Philippe Klein, a French doctor, decided to stay in the epicenter during the COVID-19 outbreak.

"I am a doctor, so I have to do my job and do my______," said Klein, a general practitioner at Wuhan Union Hospital in Hubei province.

Before authorities in Wuhan______the city, suspending all outbound flights and trains in late January to______the highly infectious disease, Klein had______about 500 foreigners living in Wuhan, most of them French.

Following the outbreak, he closed his______at the hospital to reduce the chances of infection for his patients. Instead, he began to give______and treatment at patients' homes.

But while he continued to see his patients, Klein found some had fever and he might be______with the virus, so he decided to send his wife and son back to France.

"When I came back home after seeing patients, I didn't feel very comfortable. I really did not want to put my family______, so I asked my wife to leave Wuhan on the second plane organized by the French government," he said. "My son was crying when we______, but it was better for them to leave Wuhan and let me do my job. Also they were very proud because I was doing my duty here."

In addition to his sense of duty as a doctor, he said he also chose to stay because of his deep______for the people and the city, where he has lived for six years.

“People in Wuhan are very friendly to French, and here I feel like a star sometimes,” he said.

____the lockdown of a vast city with 11 million people, which is rare in human history, has made a big______on Klein. He said he is touched by the______Wuhan residents have made to contain the outbreak.

“The last month was the craziest month in my______life,” he said. “and I would like to say to the people of Wuhan and to the Chinese people that they are going to overcome this epidemic. And their sacrifice, their courage, their unity, will______. It will be an example to the world to make such a sacrifice to protect the rest of the world.”

9 . What the scientists are saying…

The first primate (灵长目动物) clones

For the first time, scientists have used the technique that produced Dolly the sheep to clone monkeys. The Chinese researchers who produced the two macaques say that having access to genetically identical primates will be a huge ____ to medical research. It will give scientists a clearer understanding of genetic ____ by enabling them to compare animals who are identical except for one tweaked gene; when ____ drugs, it will make it possible to rule out the possibility that variations in outcomes are down to genetic ____. But other experts have raised a host of ____. The somatic cell nuclear transfer (SCNT) technique involves ____ a cell nucleus to a donated nucleus-free egg that is then prompted to develop into an embryo(胚胎). Although 23 species have been cloned in this way, primates have only been cloned before using a less complex embryo-splitting technique. Similar to the process that creates twins, it can only lead to a very ____ number of genetically identical individuals. SCNT can in ____ lead to a far larger number of clones, but in the Chinese experiment, the fail rate was very high. The team implanted scores of embryos, but only two monkeys survived beyond a few days. ____ to that is the concern that by cloning a primate species, the team has broken down a significant ____ on the way to cloning humans.

Herbal remedy danger

Herbal remedies such as St. John’s wort and ginseng may be ___ when used alongside conventional drugs, reports The Guardian. In a review of medical literature, researchers at Stellenbosch University in South Africa found several __ of alternative treatments appearing to ____ with prescription drugs, resulting in potentially dangerous side effects. In one case, the autopsy (解剖) of a 55-year-old who died while swimming concluded that the ginkgo biloba supplements he had been taking may have ____ his anti-seizure (防止发作) medicine. Other cases documented patients on statins appearing to suffer complications linked to flaxseed, St. John’s wort and green tea. “If you are taking herbal remedies, you should ____it to your clinician,” said one of the report’s authors, Dr Charles Awortwe.

10 . “Don’t get sick in July!”

This is a common concern in teaching hospitals in the U.S. It’s driven by the academic calendar: July is when the new interns, fresh out of medical school, start work. In other words, it’s when everyone is most ________. The theory is that this disadvantage leads to mistakes.

So is medical experience good or bad? Well, in most cases, your doctor’s experience is very helpful, allowing her to pick up on a(n) ________ symptom early in a disease process, when machines still can’t take a hand. She can also determine the right treatment when your condition falls outside of what is in the ________, where newbies get most of their ideas. For many medical treatments, there’s a direct connection between physician experience and your treating outcome.

In a variety of situations, though, experience can backfire. The reason is simple ________. Doctors are humans too and they ________ tricks of the mind—like believing that an ineffective treatment really works. In fact, entire fields of research are devoted to understanding why these errors of thought occur. They ________ from so-called cognitive prejudice that can mislead even ________ practitioners into making the wrong decisions.

Doctors are usually locked onto a diagnosis early and disregard new and ________ information. For example, a patient may be diagnosed with a quickly fatal cancer, but then ends up trying various herbal remedies and lives for 30 more years. Instead of analyzing the ________ diagnosis, the patient, and maybe even the doctor, may assume that the herbal remedies cured the cancer.

Also, some experienced doctors tend to believe evidence when it supports their previous opinion while subconsciously ignoring information opposing it. Let’s say your doctor is pretty certain you have ill digestion and orders a test to________ the suspicion, which produces negative result. But she treats you for ill digestion anyway because she was ________ with the prior diagnosis by experience.

In fact, there are clearly many benefits to having a highly experienced doctor, such as technical proficiency. But there may actually be some unexpected benefits to having a less-experienced one too. She may have a more up-to-date education, boundless energy and perhaps is less vulnerable to biases, freed from the same ________ for years.

To safeguard yourself as a patient, one thing you should always do is ________. It may not always be possible to determine that your doctor has met with an unconscious thinking ________. But asking questions does force your doctor to think twice and ________ her decision about your case.