ORIGINAL PAPER
Relationship of Resistant Hypertension and Treatment Outcomes With Total Arterial Compliance in a Predominantly African American
Hypertensive Cohort
Omid Bakhtar,DO;1Brian A.Ference,MD,MPhil,MSc;1,2Lowell A.Hedquist,BS;1,2Phillip D.Levy,MD,MPH;3
John M.Flack,MD,MPH1,2
From the Department of Internal Medicine;1the Division of Translational Research and Clinical Epidemiology,Department of Internal Medicine;2 and the Department of Emergency Medicine and Cardiovascular Research Institute,Wayne State University School of Medicine,Detroit,MI3
Resistant hypertension(RH)affects8%to30%of hyper-tensive patients.Blood pressure(BP)re?ects the interac-tion between vascular compliance,resistance to?ow, intravascular volume,and cardiac contractility.The rela-tionship of RH with total arterial compliance index(TACI) has not been adequately explored.The RH period preva-lence(RH at baseline or follow-up)was determined in a hypertensive cohort(N=156)and compared across quar-tiles of TACI.Age-and sex-adjusted systolic BP,diastolic BP,and antihypertensive therapeutic intensity score(TIS) were also determined at the time of?rst BP control.The cohort was85.3%African American and67.3%female. Median follow-up was7months.The prevalence of RH at baseline was14.7%while the period prevalence was 43.6%.The period prevalence of RH by ascending quar-tile for TACI was66%,36.8%,40%,and30.8% (P=.008).The average BP and antihypertensive TIS at ?rst BP control across TACI quartiles was122.3?73.4 mm Hg(2.26),120.7?72.5mm Hg(1.88),122.4?75.3mm Hg(1.71),and120.0?79.4mm Hg(1.64)(P=.62,P=.03, P=.13).Low TACI was linked to higher RH prevalence and antihypertensive TIS at?rst attainment of goal BP according to the Joint National Committee on Prevention, Detection,Evaluation and Treatment of High Blood Pres-sure.TACI provides prognostic information that is clini-cally and perhaps pathophysiologically relevant in RH. J Clin Hypertens(Greenwich).2012;14:618–622.ó2012 Wiley Periodicals,Inc.
Resistant hypertension(RH)affects a substantive pro-portion of the hypertensive population.1,2Detecting RH is important,in part,because approximately20% of patients have primary aldosteronism(PA)or other forms of secondary hypertension.3,4Despite signi?cant polypharmacy,a subset of individuals with RH exhibit persistently poor blood pressure(BP)control resulting in a high risk of cardiovascular morbidity.5–8 Measured BP represents an interaction between vascular compliance,resistance to?ow,intravascular volume,and ventricular contractility.Impedance cardi-ography(ICG;BioZ,Cardiodynamics,Davis Medical Electronics,Inc,Vista,CA)is a validated modality for obtaining various noninvasive hemodynamic measures.9–11
The existing understanding of the ICG-derived he-modynamic parameters in individuals with persistently elevated BP,particularly in those with RH,is limited. Accordingly,we sought to determine whether noninva-sive measures of vascular function were re?ective of BP control rates as well as the intensity of antihyper-tensive drug therapy needed to achieve BP target levels as de?ned by the Seventh Report of the Joint National Committee on Prevention,Detection,Evaluation,and Treatment of High Blood Pressure(JNC7).12We hypothesized that vascular compliance would relate inversely to the risk of RH as well as directly to the intensity of antihypertensive drug therapy at the time of JNC7BP control.
METHODS
Study Design and Population
We conducted a retrospective cohort study of156hyper-tensive patients seen between January2007and July 2009in the Wayne State University(WSU)Physician Group hypertension clinic after study approval by the WSU Human Investigations Committee.Clinic patients were eligible for inclusion in the study if they had suc-cessful ICG testing(noninvasive vascular measurements) as well as at least two follow-up clinic visits(or at least one follow-up clinic visit if they attained their JNC7BP target goal).The median participant observation period was7months(5clinic visits).
For each patient included in the study,we obtained de-identi?ed information for age,sex,race,body mass index(BMI),BP measurements,prescribed antihyper-tensive medications,ICG hemodynamic measurements, and laboratory values(B-type natriuretic peptide,spot urine albumin:creatinine ratio,and serum creatinine) from an electronic medical record(EMR).
All laboratory analyses were performed in the Detroit Medical Center central laboratory.Random urine specimens were analyzed for albumin by rate
Address for correspondence:John M.Flack,MD,Division of Translational Research and Clinical Epidemiology,Department of Internal Medicine,Wayne State University School of Medicine,4201St.Antoine, 2E-UHC,Detroit,MI48201
E-mail:j?ack@https://www.doczj.com/doc/4e9257650.html,
Manuscript received:February24,2012;revised:March19,2012; accepted:March21,2012
DOI:10.1111/j.1751-7176.2012.00653.x
nephelometry and creatinine content using a modi?ca-tion of the kinetic Jaffe reaction.Serum creatinine was determined by the Vitros Crea Slide method.
At each clinic visit,BP was measured with an oscil-lometric sphygmomanometer using an appropriately sized manually in?atable cuff.At the initial clinic visit, BP measurements were taken in both arms in the seated position.The arm with the highest recorded BP was documented in the EMR and used for compara-tive BP measurement at subsequent visits. Impedance cardiography is a noninvasive procedure that analyzes changes in electrical impedance using4 sensors placed on the patient’s body.These measure-ments were performed,typically at the beginning of a clinic visit,by trained clinic personnel using a BioZ ICG monitor with the patient in a supine position after 5minutes of rest.13The ICG recording date was con-sidered the index clinic visit in our analyses even if the patient had prior clinic visits.A total of147patients (94%)underwent ICG testing during their?rst visit to our clinic;another9patients underwent ICG testing at a subsequent clinic visit.There were no selection crite-ria used for ICG testing.Patients were tested consecu-tively unless the ICG machine?technician was not available during their initial visit.
For patients with diabetes mellitus and?or chronic kidney disease(CKD)(estimated glomerular?ltra-tion rate[eGFR]<60mL?min?1.73m2as calculated by the Modi?cation of Diet in Renal Disease formula and?or spot urine albumin:creatinine ratio>200mg?g), hypertension was de?ned as systolic blood pressure (SBP)!130mm Hg and?or diastolic blood pressure (DBP)!80mm Hg and?or taking antihypertensive medication.In all other patients,hypertension was de?ned as SBP!140mm Hg and?or DBP!90mm Hg and?or taking antihypertensive medication.
RH was de?ned as patients having BP above their JNC7goal level despite the use of!3optimally dosed antihypertensive medications from different classes with at least one of the drug classes being a diuretic or patients with BP less than their JNC7goal who were taking!4optimally dosed antihypertensive medica-tions,one of which was a diuretic.Optimal antihyper-tensive drug dosing was de?ned as each antihypertensive drug class being taken in a daily amount equivalent to at least50%of the maximum Food and Drug Administration(FDA)–approved daily dose for hypertension treatment.There were several important exceptions.First,chlorthalidone and spirono-lactone were both considered adequately dosed at 25mg?d.Second,spironolactone was considered an aldosterone antagonist;thus,its utilization did not sat-isfy the requirement of taking a diuretic.The period prevalence of RH was the number of patients with RH at the index visit or at any time during follow-up divided by the number of total patients meeting study entry cri-teria times100or(RH number?total number)?100. Period prevalence was calculated because a signi?cant number of patients developed RH after their initial visit
because their medication doses and drug classes were optimized,including the prescription of diuretics.
The antihypertensive therapeutic intensity score
(TIS)was based on the antihypertensive drugs pre-scribed at least2weeks prior to a clinic visit.The
class-speci?c antihypertensive TIS was calculated by
dividing the daily dose of a medication by the maxi-mum daily dose of the drug approved by the FDA for
the treatment of hypertension.When multiple antihy-
pertensive drug classes were prescribed,the class-speci?c antihypertensive TIS scores were summed into
an overall antihypertensive drug TIS score.
TACI in mL?m2?mm Hg was calculated by dividing stroke index by pulse pressure(PP):(1)stroke volume (SV)(mL):the volume of blood delivered to the vascu-
lature in one heart beat;(2)stroke index(SI)(mL?m2):
the SV indexed to body surface area(BSA)or SI=SV?BSA;(3)BSA(m2)was estimated by the DuBois
and DuBois formula BSA=weight0.425?height0.725?0.007184;(4)heart rate(HR)(beats per min):the number of heart beats in1minute;(5)cardiac output
(CO)(L?min):the total volume of blood pumped by
the heart in1minute or CO=SV?HR;(6)cardiac index(CI)(L?min?m2):the CO indexed to BSA or CI=CO?BSA;and(7)PP(mm Hg)=SBP)DBP. Analytical Methods
Descriptive statistics were generated using baseline
characteristics of patients,including age,sex,race,and
BP.Continuous variables were summarized as means and standard deviations or as medians and interquar-tile ranges(IQRs).Categorical variables were tabu-lated as frequencies.TACI was divided into quartiles. The period prevalence of RH,JNC7BP control rates, antihypertensive TIS,and attained BP level at the time of JNC7BP control were determined for each TACI quartile.Spearman rank order correlation coef?cients were used to explore the relationships between TACI, systemic vascular resistance index(SVRI),thoracic ?uid content(TFC),and CI.
Logistic regression models were utilized to estimate
odds ratios(ORs)for RH with adjustment for age and
sex.For clarity of presentation,we transformed the log odds of disease within each quartile into a pre-dicted probability.14Age-and sex-adjusted probabili-ties of RH and JNC7BP control rates were calculated for each TACI quartile using the following formula: 1?(1+e-(bo+bx)).The mean antihypertensive drug TIS score as well as the age-and sex-adjusted SBP and DBP averages at the time of attainment of the JNC7 target BP level across TACI quartiles were assessed for heterogeneity with analysis of covariance.Dunnett’s t test was used to contrast these means,respectively,in the lower three quartiles relative to the mean in the reference(highest)quartile4.All mean and frequency contrasts were deemed signi?cant when the two-tail P value was<.05.Statistical analyses were performed using SAS statistical software(SAS version9.2;SAS Institute,Cary,NC).
Resistant Hypertension Risk and Arterial Compliance|Bakhtar et al.
RESULTS
The cohort was largely African American and mostly female with average baseline BP in the JNC stage 1hypertensive range (Table I).The median cohort fol-low-up was 7months.The prevalence of RH at base-line was 14.7%(23of 156).However,the RH period prevalence during a median follow-up of 7months was several-fold higher (43.6%)after optimization of antihypertensive drug therapy regimens.
The period prevalence of RH was approximately twice as great in the lowest compared with the highest TACI quartile (Table II).A total of 113(72.4%)patients achieved their JNC 7BP target during follow-up.Table III displays the age-and sex-adjusted proba-bilities of BP control by TACI quartile.There were no signi?cant differences in BP control across TACI quar-tiles.Furthermore,the average SBP level attained dur-ing treatment among patients who did reach their JNC 7BP goal was not in?uenced by TACI levels (data not shown).However,attained DBP at time of ?rst BP control was directly related to the TACI quartile (Table IV).Similarly,the average antihypertensive TIS at the time of attainment of JNC 7BP goal did not differ signi?cantly across TACI quartiles,although the difference between quartiles 1and 4was statistically different.
All possible correlations between TACI,TFC,SVRI,and CI were explored.TACI was negatively correlated with SVRI ()0.65,P <.0001)but positively correlated with CI (r =0.58,P <.0001).SVRI was negatively related with CI (r =)0.87,P <.001).None of the other correlations were statistically signi?cant.
DISCUSSION
Our analysis demonstrates several new as well as clini-cally signi?cant observations.TACI was related to the period prevalence of RH as well as to the intensity of antihypertensive drug therapy necessary to achieve JNC 7BP control.This observation extends those of Abdelhammed and colleagues 15who showed that TACI was lower in individuals with stage 2compared with stage 1hypertension.The observation that TACI
TABLE I.Patient Characteristics
Characteristic Overall No Resistant
HTN Resistant HTN Patients,No.(%)156(100)88(56.4)68(43.6)Age,y 54.153.654.8Sex
Female,%105(67.3)65(73.9)40(58.8)Male,%51(32.7)23(26.1)28(41.2)Race
African American,%
133(85.3)73(82.9)60(88.2)Non-African American,%23(14.7)15(17.1)8(11.8)BMI,kg ?m 2
32.431.234.0Blood pressure,mm Hg Systolic 153.1147.7160.0Diastolic
91.891.891.9Antihypertensive drugs 2.4 1.8 3.1Antihypertensive TIS 1.40.9 2.0Estimated GFR,
mL ?min ?1.73m 2
80.984.776.0Total arterial compliance index,mL ?m 2
?mm Hg
0.680.740.59Systemic vascular resistance index,dyne s ?cm 5m 2
3352.83067.53722.1Thoracic ?uid content,?kOhm 26.826.427.4BNP,pg ?mL
100.9
100.9
100.8
Abbreviations:BMI,body mass index;BNP,B-type natriuretic pep-tide;GFR,glomerular ?ltration rate;HTN,hypertension;TIS,thera-peutic intensity score.Patient characteristics were determined from the impedance cardiography visit data.Resistant hypertension categories were based on the period prevalence of resistant hypertension.
TABLE II.Prevalence of Resistant Hypertension by
TACI Quartile
TACI Quartile Crude Period Prevalence Adjusted a Period Prevalence 1(0.15–0.44)66.7%67.3%2(0.45–0.66)36.8%38.1%3(0.67–0.85)40.0%42.3%4(0.86–1.84)30.8%44.3%P value
.01
.02
Abbreviation:TACI,total arterial compliance index.a Adjusted for age and sex.
TABLE III.JNC 7BP Control Rates a by TACI
Quartile TACI,mL ?m 2?mm Hg
158.1%279.4%382.0%466.4%P value
.21
Abbreviations:BP,blood pressure;JNC 7,the Seventh Report of the Joint National Committee on Prevention,Detection,Evaluation and Treatment of High Blood Pressure;TACI,total arterial compli-ance index.a Adjusted for age and sex.
TABLE IV.Antihypertensive TIS a and Attained BP a at
Time of BP Control by TACI Quartile
TACI Quartile Attained BP,mm Hg
Systolic Diastolic Antihypertensive TIS
1(0.15–0.44)122.373.4b 2.26b 2(0.45–0.66)120.772.5b 1.883(0.67–0.85)122.475.3b 1.714(0.86–1.84)120.079.4 1.64P value (f test)
0.62
0.03
0.13
Abbreviations:BP,blood pressure;TIS,therapeutic intensity score.a
Adjusted for age and sex.b P <.05relative to total arterial compli-ance index (TACI)quartile 4.
Resistant Hypertension Risk and Arterial Compliance |Bakhtar et al.
was inversely related to RH risk might be explained by data that strongly suggest that RH is exquisitely salt sensitive16and that the vasculature is abnormal in persons manifesting salt sensitivity.Accordingly,the peripheral arterial vasculature appears to be important in the chronic phases of salt sensitivity as salt-sensitive African Americans almost uniformly develop raised peripheral vascular resistance in response to dietary sodium intake.17Indeed,our data showed a strong negative correlation between SVRI and TACI.Given the much higher SVRI in those who had or developed RH as well as the strong inverse relationship between SVRI and TACI,we surmise that reduced arterial com-pliance is a likely vascular perturbation in salt-sensi-tive RH.This observation is consistent with the Bayliss theory of1902,18whereby high BP causes increased muscular tone of the vasculature,?rst on a myogenic then likely on a structural established basis. Nevertheless,we cannot exclude the possibility that reduced total arterial compliance preceded the BP ele-vation and was an important causative factor in such elevations.
An interesting observation in our study was the marked increase in the prevalence of RH over time in our cohort.The marked rise in RH over follow-up, despite incrementally lower BP over time,was almost assuredly the result of our judicious use of diuretics as well as the uptitration of antihypertensive agents that were suboptimally prescribed at baseline.
We are unaware of other studies that have explored the relationships between noninvasive measures of vas-cular function and the risk of RH over an extended period of follow-up.We are also unaware that any noninvasive measure of vascular function has been linked to either the likelihood of BP control or to the intensity of antihypertensive drug therapy utilized at the time of BP control.
STUDY STRENGTHS
Our study had several strengths.First,it was not exclusively cross-sectional as there was longitudinal follow-up of our cohort over an extended period. Therapeutic decisions were also made either directly or overseen by a hypertension specialist as certi?ed by the American Society of Hypertension(ASH).The noninvasive hemodynamic parameters were not uti-lized in any systematic way to select antihypertensive drug therapy.We also utilized a very rigorous de?ni-tion of RH that speci?ed optimal diuretic use and that all other antihypertensive agents(except chlorthali-done and spironolactone)were utilized in doses equiv-alent to at least50%of their FDA-approved maximal daily dose.Finally,there was no conscious selection bias regarding whether patients did or did not undergo noninvasive vascular testing.
LIMITATIONS
Nevertheless,our study does have limitations.It was derived from a largely African American and female
cohort precluding extrapolation to non-African Ameri-cans and men.Additionally,our patient cohort arose largely from a referral population that was speci?cally sent to our clinic for dif?cult to control hypertension. Thus,our?ndings are not directly applicable to pri-mary care or other nonreferral clinical settings.Fur-thermore,we did not differentiate between those who did and did not achieve JNC7BP target levels as long as they met the diagnostic criteria for RH.Finally,our overall sample size was small and therefore probably lacked the statistical power to con?rm some of the numerical trends observed in our data.
Although not standard practice,impedance cardiog-raphy has repeatedly been shown to be a valuable instrument in the management of hypertension.19–21 Smith and coworkers22demonstrated improved BP control with ICG-guided compared with non–ICG-guided https://www.doczj.com/doc/4e9257650.html,ing ICG-derived parameters to achieve BP targets was also veri?ed in a specialty hypertensive clinic23as well as in a community-based clinic.24More recently,a meta-analysis by Ferrario and colleagues25demonstrated optimal BP control with individualized ICG-guided therapy compared with standard care.
CONCLUSIONS
We have shown that TACI,a noninvasive measure of vascular function,is related to the risk of developing RH as well as the intensity of antihypertensive drug therapy required to achieve BP control.Our data fur-ther suggest that cross-sectional reports of RH preva-lence in many settings probably underestimate the true prevalence of RH.Several hemodynamic parameters linked to RH have been shown to be in?uential in the BP response to speci?c antihypertensive treatments.19–26 Thus,it is reasonable to believe that TACI might be useful prognostically or even as a therapeutic target as we move ever so deliberately toward personalized medicine.
References
1.Cushman WC,Ford CE,Cutler JA,et al.ALLHAT Collaborative
Research Group.Success and predictors of blood pressure control in diverse North American settings:the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial(ALLHAT).
J Clin Hypertens.2002;4:393–404.
2.Hajjar I,Kotchen TA.Trends in prevalence,awareness,treatment,
and control of hypertension in the United States,1988–2000.JAMA.
2003;290:199–206.
3.Calhoun DA,Nishizaka MK,Zaman MA,et al.Hyperaldosteronism
among black and white subjects with resistant hypertension.Hyper-tension.2002;40:892–896.
4.Gaddam KK,Nishizaka MK,Pratt-Ubunama MN,et al.Character-
ization of resistant hypertension:association between resistant hypertension,aldosterone,and persistent intravascular volume expansion.Arch Intern Med.2008;168:1159–1164.
5.Cuspidi C,Macca G,Sampieri L,et al.High prevalence of cardiac
and extra cardiac target organ damage in refractory hypertension.
J Hypertens.2001;19:2063–2070.
6.Muxfeldt ES,Cardoso CR,Dias VB,et al.Prognostic impact of the
ambulatory arterial stiffness index in resistant hypertension.
J Hypertens.2010;28:1547–1553.
7.Redon J,Campos C,Narciso ML,et al.Prognostic value of ambula-
tory blood pressure monitoring in refractory hypertension:a prospective study.Hypertension.1998;31:712–718.
Resistant Hypertension Risk and Arterial Compliance|Bakhtar et al.
8.Salles G,Cardoso CRL,Muxfeldt ES.Prognostic in?uence of of?ce
and ambulatory blood pressures in resistant hypertension.Arch Intern Med.2008;168:2340–2346.
9.Treister N,Wagner K,Jansen PR.Reproducibility of impedance car-
diography parameters in outpatients with clinically stable coronary artery disease.Am J Hypertens.2005;18:44S–50S.
10.Belardinelli R,Ciampani N,Costantini C,et https://www.doczj.com/doc/4e9257650.html,parison of
impedance cardiography with thermodilution and direct Fick meth-ods for noninvasive measurement of stroke volume and cardiac out-put during incremental exercise in patients with ischemic cardiomyopathy.Am J Cardiol.1996;77:1293–1301.
11.Sergi G,Bussolotto M,Perini P,et al.Accuracy of bioelectrical
impedance analysis in estimation of extracellular space in healthy subjects and in?uid retention states.Ann Nutr Metab.
1994;38:158–165.
12.Chobanian A,Bakris G,Black H,et al.The seventh report of the
joint national committee on prevention,detection,evaluation,and treatment of high blood pressure:the JNC-7Report.JAMA.
2003;289:2560–2572.
13.BioZ ICG Monitor Operator Manual.San Diego:CardioDynamics
International Corp;2004.
14.Knol MJ,Duijnhoven RG,Grobbee DE,et al.Potential misinterpre-
tation of treatment effects due to use of odds ratios and logistic regression in randomized controlled trials.PLoS ONE.
2011;6:e21248.Epub2011Jun16.
15.Abdelhammed AI,Smith RD,Levy P,et al.Noninvasive hemody-
namic pro?les in hypertensive subjects.Am J Hypertens.
2005;18:51S–59S.
16.Pimenta E,Gaddam KK,Oparil S,et al.Effects of dietary sodium
reduction on blood pressure in subjects with resistant hypertension: results from a randomized trial.Hypertension.2009;54:475–481.17.Schmidlin O,Forman A,Tanaka M,et al.NaCl-induced renal vaso-
constriction in salt-sensitive African Americans:antipressor and he-modynamic effects of potassium bicarbonate.Hypertension.
1999;33:633–639.
18.Bayliss WM.On the local reactions of the arterial wall to changes
of internal pressure.J Physiol.1902;28:220–231.
19.Aoka Y.Limitation of monotherapy and bene?t of impedance cardi-
ography as a guide for a combination therapy in achieving blood pressure control in essential hypertension.J Clin Hypertens.
2009;11:A21.
20.Sramek B,Tichy JA,Hojerova M,et al.Normohemodynamic goal-
oriented antihypertensive therapy improves the outcome.Am J Hy-pertens.1996;9:141A.
21.Sramek B,Badila E,Bartos D,et al.Treating hypertension as a he-
modynamic disorder results in three-fold improvement in outcomes.
J Clin Hypertens.2008;10(suppl A):A81.
22.Smith RD,Levy P,Ferrario CM.Value of noninvasive hemodynam-
ics to achieve blood pressure control in hypertensive subjects.
Hypertension.2006;47:771–777.
23.Taler SJ,Textor SC,Augustine JE.Resistant hypertension:compar-
ing hemodynamic management to specialist care.Hypertension.
2002;39:982–988.
24.Sharman DL,Gomes CP,Rutherford JP.Improvement in blood
pressure control with impedance cardiograph-guided pharmacologic decision making.Congest Heart Fail.2004;10:54–58.
25.Ferrario CM,Flack JM,Strobeck JE,et al.Individualizing hyperten-
sion treatment with impedance cardiography:a meta-analysis of published trials.Ther Adv Cardiovasc Dis.2010;4:5–16.
26.Flack JM.Noninvasive hemodynamic measurements:an important
advance in individualizing drug therapies for hypertensive patients.
Hypertension.2006;47:646–647.
Resistant Hypertension Risk and Arterial Compliance|Bakhtar et al.
如何写先进个人事迹 篇一：如何写先进事迹材料 如何写先进事迹材料 一般有两种情况：一是先进个人，如先进工作者、优秀党员、劳动模范等；一是先进集体或先进单位，如先进党支部、先进车间或科室，抗洪抢险先进集体等。无论是先进个人还是先进集体，他们的先进事迹，内容各不相同，因此要整理材料，不可能固定一个模式。一般来说，可大体从以下方面进行整理。 (1)要拟定恰当的标题。先进事迹材料的标题，有两部分内容必不可少，一是要写明先进个人姓名和先进集体的名称，使人一眼便看出是哪个人或哪个集体、哪个单位的先进事迹。二是要概括标明先进事迹的主要内容或材料的用途。例如《王鬃同志端正党风的先进事迹》、《关于评选张鬃同志为全国新长征突击手的材料》、《关于评选鬃处党支部为省直机关先进党支部的材料》等。 (2)正文。正文的开头，要写明先进个人的简要情况，包括：姓名、性别、年龄、工作单位、职务、是否党团员等。此外，还要写明有关单位准备授予他(她)什么荣誉称号，或给予哪种形式的奖励。对先进集体、先进单位，要根据其先进事迹的主要内容，寥寥数语即应写明，不须用更多的文字。 然后，要写先进人物或先进集体的主要事迹。这部分内容是全篇材料
的主体，要下功夫写好，关键是要写得既具体，又不繁琐；既概括，又不抽象；既生动形象，又很实在。总之，就是要写得很有说服力，让人一看便可得出够得上先进的结论。比如，写一位端正党风先进人物的事迹材料，就应当着重写这位同志在发扬党的优良传统和作风方面都有哪些突出的先进事迹，在同不正之风作斗争中有哪些突出的表现。又如，写一位搞改革的先进人物的事迹材料，就应当着力写这位同志是从哪些方面进行改革的，已经取得了哪些突出的成果，特别是改革前后的．经济效益或社会效益都有了哪些明显的变化。在写这些先进事迹时，无论是先进个人还是先进集体的，都应选取那些具有代表性的具体事实来说明。必要时还可运用一些数字，以增强先进事迹材料的说服力。 为了使先进事迹的内容眉目清晰、更加条理化，在文字表述上还可分成若干自然段来写，特别是对那些涉及较多方面的先进事迹材料，采取这种写法尤为必要。如果将各方面内容材料都混在一起，是不易写明的。在分段写时，最好在每段之前根据内容标出小标题，或以明确的观点加以概括，使标题或观点与内容浑然一体。 最后，是先进事迹材料的署名。一般说，整理先进个人和先进集体的材料，都是以本级组织或上级组织的名义；是代表组织意见的。因此，材料整理完后，应经有关领导同志审定，以相应一级组织正式署名上报。这类材料不宜以个人名义署名。 写作典型经验材料-般包括以下几部分： (1)标题。有多种写法，通常是把典型经验高度集中地概括出来，一
雅思口语素材汇总之端午节 雅思口语素材:Dragon Boat Festival(端午节) Qu Yuan The Dragon Boat Festival, also called the Duanwu Festival, is celebrated on the fifth day of the fifth month according to the Chinese calendar. For thousands of years, the festival has been marked by eating zong zi (glutinous rice(糯米)wrapped to form a pyramid using bamboo or reed leaves) and racing dragon boats. The festival is best known for its dragon-boat races, especially in the southern provinces where there are many rivers and lakes. This regatta(赛舟会)commemorates the death of Qu Yuan , an honest minister who is said to have committed suicide by drowning himself in a river. Qu was a minister of the State of Chu situated in present-day Hunan and Hubei provinces, during the Warring States Period (475-221BC)(战国时期). He was upright, loyal and highly esteemed for his wise counsel that brought peace and prosperity to the state. However, when a dishonest and corrupt prince vilified Qu, he was disgraced and dismissed from office. Realizing that the country was now in the hands of evil and corrupt officials, Qu grabbed a large stone and leapt into the Miluo River on the fifth day of the fifth month. Nearby fishermen rushed over to try and save him but were unable to even recover his body. Thereafter, the state declined and was eventually conquered by the State of Qin. The people of Chu who mourned the death of Qu threw rice into the river to feed his ghost every year on the fifth day of the fifth month. But one year, the spirit of Qu appeared and told the mourners that a huge reptile(爬行动物)in the river had stolen the rice. The spirit then advised them to wrap the rice in silk and bind it with five different-colored threads before tossing it into the river. During the Duanwu Festival, a glutinous rice pudding called zong zi is eaten to symbolize the rice offerings to Qu. Ingredients such as beans, lotus seeds(莲子), chestnuts(栗子), pork fat and the golden yolk of a salted duck egg are often
小学生个人读书事迹简介怎么写800字 书,是人类进步的阶梯,苏联作家高尔基的一句话道出了书的重要。书可谓是众多名人的“宠儿”。历来,名人说出关于书的名言数不胜数。今天小编在这给大家整理了小学生个人读书事迹,接下来随着小编一起来看看吧! 小学生个人读书事迹1 “万般皆下品,惟有读书高”、“书中自有颜如玉,书中自有黄金屋”,古往今来,读书的好处为人们所重视,有人“学而优则仕”,有人“满腹经纶”走上“传道授业解惑也”的道路……但是,从长远的角度看,笔者认为读书的好处在于增加了我们做事的成功率,改善了生活的质量。 三国时期的大将吕蒙,行伍出身,不重视文化的学习,行文时,常常要他人捉刀。经过主君孙权的劝导,吕蒙懂得了读书的重要性,从此手不释卷,成为了一代儒将,连东吴的智囊鲁肃都对他“刮目相待”。后来的事实证明,荆州之战的胜利,擒获“武圣”关羽,离不开吕蒙的“运筹帷幄,决胜千里”,而他的韬略离不开平时的读书。由此可见,一个人行事的成功率高低,与他的对读书,对知识的重视程度是密切相关的。 的物理学家牛顿曾近说过,“如果我比别人看得更远,那是因为我站在巨人的肩上”,鲜花和掌声面前,一代伟人没有迷失方向,自始至终对读书保持着热枕。牛顿的话语告诉我们,渊博的知识能让我们站在更高、更理性的角度来看问题,从而少犯错误,少走弯路。
读书的好处是显而易见的,但是,在社会发展日新月异的今天,依然不乏对读书,对知识缺乏认知的人,《今日说法》中我们反复看到农民工没有和用人单位签订劳动合同,最终讨薪无果;屠户不知道往牛肉里掺“巴西疯牛肉”是犯法的;某父母坚持“棍棒底下出孝子”,结果伤害了孩子的身心,也将自己送进了班房……对书本,对知识的零解读让他们付出了惨痛的代价,当他们奔波在讨薪的路上,当他们面对高墙电网时,幸福,从何谈起?高质量的生活,从何谈起? 读书,让我们体会到“锄禾日当午,汗滴禾下土”的艰辛;读书,让我们感知到“四海无闲田,农夫犹饿死”的无奈;读书,让我们感悟到“为报倾城随太守,西北望射天狼”的豪情壮志。 读书的好处在于提高了生活的质量,它填补了我们人生中的空白,让我们不至于在大好的年华里无所事事,从书本中,我们学会提炼出有用的信息,汲取成长所需的营养。所以,我们要认真读书,充分认识到读书对改善生活的重要意义,只有这样,才是一种负责任的生活态度。 小学生个人读书事迹2 所谓读一本好书就是交一个良师益友,但我认为读一本好书就是一次大冒险,大探究。一次体会书的过程,真的很有意思,咯咯的笑声,总是从书香里散发;沉思的目光也总是从书本里透露。是书给了我启示,是书填补了我无聊的夜空,也是书带我遨游整个古今中外。所以人活着就不能没有书,只要爱书你就是一个爱生活的人,只要爱书你就是一个大写的人,只要爱书你就是一个懂得珍惜与否的人。可真所谓
口语常用背诵素材 一，喜好和厌恶： 1.（释放压力）I guess most young people enjoy listening to music. It’s a perfect way to reduce stress/relieve stress. (*It’s a perfect stress-buster.) 2.（休闲）I think the best way to relax and kill time (kick back and relax) is to be with friends. Chatting with them helps me unwind/wind down (* Chatting with them is very therapeutic). 3.（放松）I found it pretty relaxing to flick through a magazine before going to bed (*before hitting the sack/hitting the hay). 4.（运动）Jogging on sunny days and simply basking in the sun(bathing in the sun) is super enjoyable(pleasurable). /Jogging is my favorite workout. It can always cheer me up after I’ve been down and depressed. And it can help me shed some unwanted weight. 5.（喜欢，提升心情）I’m quite into watching sitcom (I’m fascinated by, I’m crazy about, I adore, I’m very fond of...). Spending 20 minutes in front of the screen and having a good laugh after dinner really puts me in a better mood/ switch my mood/ lift my spirits. 6.（天气）I fancy spring most compared to the other three. Summer is simply too hot and stuffy (*muggy), and you can’t stay out for two minutes without getting sweaty and smelly. Autumn is too dry and winter too freezing cold. 7.（电影）I’m a movie buff (Movies are my biggest pastime), and I would either catch one on my couch or go to the movie theatre when they have the one I like on the big screen./ It's a great form of relaxation for me to while away the hours of a long flight, to keep my family together on the sofa, and to give me a bit of a thrill. 8.（无聊困难）I’m terrible at what I study now./(History is never my forte/ my strong suit). The classes are kind of a drag (It’s super dull/ *It’s mind-numbing), and there’s always loads of (tons of) homework to do. Memorizing those facts and years is a lot of effort (is tricky; is no picnic; is challenging for me). 9.（不能忍）I can’t stand (I hate, I totally dislike) the busy traffic in my city. I’m sick and tired of always getting stuck in traffic for a long time during rush hours. It really bothers me (It drives me crazy, *It drives me up the wall). 10. （受欢迎）Hip-hop is really trendy (is catching on, is all the rage) among young people these days. 二，时间和地点 11. （优点）What’s great about my home town is that there are plenty of shopping malls, coz I’m a shopaholic and I can shop for hours. 12. （远）The stadium is quite far away from where I live, and every time I want to do there, it takes me roughly 40 minutes by bus to arrive. (It’s one-hour drive from the city center.) 13. （方便）My apartment is in the center/heart of the city, a handy location where I can find supermarkets and clubs right on my doorstep. It’s a bit noisy though. 14. （近）I’m a movie-goer and and there’s a movie theater pretty close to my home, so I go there quite often (frequently). (close to my home= *within walking distance of my home , *in close proximity to my home) 15. （经常）I have a heavy workload at school, so I have to go to the library to study pretty much
雅思口语素材 Document serial number【LGGKGB-LGG98YT-LGGT8CB-LGUT-
Useful Expressions: Words and phrases Friends and communication: solidify/ strengthen/ enhance/ promote communication / connection with mutual understanding relationship network/circle of f r i e n d s cultivate/develop friendship with s b . keep steady relationship with sb. establish interpersonal networksac build up the social circle spur message transmission Knowledge and experience widen one’s outlook broaden one’s vision/horizon acquire knowledge and skills comprehensive/overall quality
expand/enlarge one’s scope of knowledge knowledge reserve/base/storage theoretical knowledge practical skills social experience broaden one’s knowledge base promote one’s overall/ comprehensive competence accumulate experiences learn lessons from past experiences Work and experience the scarcity of employment o p p o r t u n i t i lay the foundations for career p r o s p e r i t y
个人先进事迹简介 01 在思想政治方面,xxxx同学积极向上,热爱祖国、热爱中国共产党,拥护中国共产党的领导.利用课余时间和党课机会认真学习政治理论,积极向党组织靠拢. 在学习上,xxxx同学认为只有把学习成绩确实提高才能为将来的实践打下扎实的基础,成为社会有用人才.学习努力、成绩优良. 在生活中,善于与人沟通,乐观向上,乐于助人.有健全的人格意识和良好的心理素质和从容、坦诚、乐观、快乐的生活态度,乐于帮助身边的同学,受到师生的好评. 02 xxx同学认真学习政治理论,积极上进,在校期间获得原院级三好生,和校级三好生,优秀团员称号,并获得三等奖学金. 在学习上遇到不理解的地方也常常向老师请教,还勇于向老师提出质疑.在完成自己学业的同时,能主动帮助其他同学解决学习上的难题,和其他同学共同探讨,共同进步. 在社会实践方面,xxxx同学参与了中国儿童文学精品“悦”读书系,插画绘制工作,xxxx同学在班中担任宣传委员,工作积极主动,认真负责,有较强的组织能力.能够在老师、班主任的指导下独立完成学院、班级布置的各项工作. 03 xxx同学在政治思想方面积极进取,严格要求自己.在学习方面刻苦努力,不断钻研,学习成绩优异,连续两年荣获国家励志奖学金；作
为一名学生干部,她总是充满激情的迎接并完成各项工作,荣获优秀团干部称号.在社会实践和志愿者活动中起到模范带头作用. 04 xxxx同学在思想方面,积极要求进步,为人诚实,尊敬师长.严格 要求自己.在大一期间就积极参加了党课初、高级班的学习,拥护中国共产党的领导,并积极向党组织靠拢. 在工作上,作为班中的学习委员,对待工作兢兢业业、尽职尽责 的完成班集体的各项工作任务.并在班级和系里能够起骨干带头作用.热心为同学服务,工作责任心强. 在学习上,学习目的明确、态度端正、刻苦努力,连续两学年在 班级的综合测评排名中获得第1.并荣获院级二等奖学金、三好生、优秀班干部、优秀团员等奖项. 在社会实践方面,积极参加学校和班级组织的各项政治活动,并 在志愿者活动中起到模范带头作用.积极锻炼身体.能够处理好学习与工作的关系,乐于助人,团结班中每一位同学,谦虚好学,受到师生的好评. 05 在思想方面,xxxx同学积极向上,热爱祖国、热爱中国共产党,拥护中国共产党的领导.作为一名共产党员时刻起到积极的带头作用,利用课余时间和党课机会认真学习政治理论. 在工作上,作为班中的团支部书记,xxxx同学积极策划组织各类 团活动,具有良好的组织能力. 在学习上,xxxx同学学习努力、成绩优良、并热心帮助在学习上有困难的同学,连续两年获得二等奖学金. 在生活中,善于与人沟通,乐观向上,乐于助人.有健全的人格意 识和良好的心理素质.
U s e f u l E x p r e s s i o n s: Words and phrases Friends and communication: mutual understanding solidify/ strengthen/ enhance/ promote communication / connection with relationship network/circle of friends cultivate/develop friendship with sb. keep steady relationship with sb. establish interpersonal networksac build up the social circle spur message transmission Knowledge and experience widen one’s outlook broaden one’s vision/horizon acquire knowledge and skills comprehensive/overall quality expand/enlarge one’s scope of knowledge knowledge reserve/base/storage theoretical knowledge practical skills social experience broaden one’s knowledge base promote one’s overall/ comprehensive accumulate experiences competence learn lessons from past experiences Work and experience the scarcity of employment opportunities lay the foundations for career prosperity immerse oneself in endless job tasks boost/augment/enhance efficiency be adept in boost one’s c ompetitiveness Health and pressure diminish individuals' leisure time drive away lassitude lighten one’s burden homework/workforce overload
近期雅思口语卡片新题素材汇总 人物Describe a classmate of yours Describe a good friend Describe a happy person Describe a colleague Describe a neighbor Describe your own personality Describe a family member Describe a child you know Describe an old person Describe an old person who has influenced you the most Describe a successful person Describe a singer Describe a sportsman Describe a movie star Describe a character in TV or movie Describe a teacher of yours Describe a famous person that you want to spend a day with.地点Describe a building at schools Describe a historical place
Describe a monument Describe an interesting building Describe a lake, river or sea. Describe a peaceful place Describe a leisure place Describe a park Describe a place of interest Describe a natural beauty Describe a city you want to live in Describe a place you have visited Describe a place you always go for shopping
优秀党务工作者事迹简介范文 优秀党务工作者事迹简介范文 ***，男，198*年**月出生，200*年加入党组织，现为***支部书记。从事党务工作以来，兢兢业业、恪尽职守、辛勤工作，出色地完成了各项任务，在思想上、政治上同党中央保持高度一致，在业务上不断进取，团结同事，在工作岗位上取得了一定成绩。 一、严于律己，勤于学习 作为一名党务工作者，平时十分注重知识的更新，不断加强党的理论知识的学习，坚持把学习摆在重要位置，学习领会和及时掌握党和国家的路线、方针、政策，特别是党的十九大精神，注重政治理论水平的提高，具有坚定的理论信念;坚持党的基本路线，坚决执行党的各项方针政策，自觉履行党员义务，正确行使党员权利。平时注重加强业务和管理知识的学习，并运用到工作中去，不断提升自身工作能力，具有开拓创新精神，在思想上、政治上和行动上时刻同党中央保持高度一致。 二、求真务实，开拓进取 在工作中任劳任怨，踏实肯干，坚持原则，认真做好学院的党务工作，按照党章的要求，严格发展党员的每一个步骤，认真细致的对待每一份材料。配合党总支书记做好学院的党建工作，完善党总支建设方面的文件、材料和工作制度、管理制度等。
三、生活朴素，乐于助人 平时重视与同事间的关系，主动与同事打成一片，善于发现他人的难处，及时妥善地给予帮助。在其它同志遇到困难时，积极主动伸出援助之手，尽自己最大努力帮助有需要的人。养成了批评与自我批评的优良作风，时常反省自己的工作，学习和生活。不但能够真诚的指出同事的缺点，也能够正确的对待他人的批评和意见。面对误解，总是一笑而过，不会因为误解和批评而耿耿于怀，而是诚恳的接受，从而不断的提高自己。在生活上勤俭节朴，不铺张浪费。 身为一名老党员，我感到责任重大，应该做出表率，挤出更多的时间来投入到**党总支的工作中，不找借口，不讲条件，不畏困难，将总支建设摆在更重要的位置，解开工作中的思想疙瘩，为攻坚克难铺平道路，以支部为纽带，像战友一样团结，像家庭一样维系，像亲人一样关怀，践行入党誓言。把握机遇，迎接挑战，不负初心。
一.雅思P2相关话题 一日假期 和外国朋友一起吃饺子的建议 1.The best way to eat a dumpling is in one bite. “Dumplings are designed to be consumed in one mouthful, as it’s the best way to enjoy the combination of the meat filling and the very thin and springy flour wrapper,” If you can’t use chopsticks, eat your dumplings with your fingers. Avoid using a fork at all costs, as piercing the dumpling will compromise the flavour. 3.Mix two parts vinegar with one part soy sauce for the perfect dumpling sauce. Add young ginger slices too， Chili oil is also a great addition when available. 4.Dumplings are just one element of dim sum. “Dim sum doesn’t just include dumplings. It’s also braised dishes like pork ribs, chicken feet, and beef balls. It’s actually small tapas-style dishes that are eaten in Cantonese restaurants at lunchtime,” 5.Xiao long bao dumplings are different from others as they contain broth. They originated in the Jiangnan region of China and are prepared in bamboo steaming baskets called xiao long, hence the name. 6.When eating xiao long bao or a dumpling with a ~soupy~ interior, opt for chopsticks and a spoon. “As soon as the dumplings arrive at your table, lift one from the steamer basket onto a soup spoon. Next, tear the skin of the dumpling by pressing the chopsticks from the side of the dumpling onto the spoon. The broth will ooze out onto the spoon. Sip the soup then enjoy the dumpling in one mouthful.” 7.You can tell whether your dumpling was cooked fresh or frozen by looking at the skin. “The skin of a freshly made dumpling is springy and light. “Frozen ones tend to be soggy.” 8.When makingdumplingsat home, try to keep your packages small.
主要事迹简介怎么写 概括?简要地反映?个单位(集体)或个?事迹的材料。简要事迹不?定很短，如果情况 多的话，也有?千字的。简要事迹虽然“简要”，但切忌语?空洞，写得像?学?期末鉴定。 ?应当以事实来说话。简要事迹是对某单位或个?情况概括?简要地反映情况，?如有三个??很突出，就写三个??，只是写某???时，要把主要事迹突出出来。 简要事迹?般来说，?少要包括两个??的内容。?是基本情况。简要事迹开头，往往要??段?字来表述?些基本情况。如写?个单位的简要事迹，应包括这个单位的?员、 承担的任务以及?段时间以来取得的主要成绩。如写个?的简要事迹，应包括该同志的性 别、出?年?、参加?作时间、籍贯、民族、?化程度以及何时起任现职和主要成绩。这 样上级组织在看了材料的开头，就会对这个单位或个?有?个基本印象。?是主要特点。 这是简要事迹的主体部分，最突出的事例有?个??就写成?块，并按照?定的逻辑关系进 ?排列，把同类的事例排在?起，?个??通常由?个?然段或?个?然段组成。 写作时，特别要注意以下四点： 1.?第三?称。就是把所要写的对象，是集体的?“他们”来表述，是个?的称之为“他(她)”。 (她)”，单位可直接写名称，个?可写其姓名。 为了避免连续出现?个“他们”或“他 2.掌握好时限。?论是单位或个?的简要事迹，都有?个时间跨度，既不要扯得太远，也不 要故意混淆时间概念，把过去的事当成现在的事写。这个时间跨度多长，要根据实际情况 ?定。如上级要某个同志担任乡长以来的情况就写他任乡长以来的事迹;上级要该同志两年 来的情况，就写两年来的事迹。当然，有时为了需要，也可适当地写?点超过这个时间的 背景情况。 3.?点他?的语?。就是在写简要事迹时，可?些群众的语?或有关?员的语?，这样会给??种?动、真切的感觉，衬托出写作对象?较?的思想境界。在?他?语?时，可适当加?，但不能造假。 4.?事实说话。简要事迹的每?个??可分为多个层次，?个层次先??句话作为观点，再???两个突出的事例来说明。?事实说话时，要尽量把?个事例说完整，以给?留下深 刻印象。
雅思口语素材训练 by Tina Li Do you like music??A—肯定:Definitely yes, everyone enjoys music, and I am no exception! I love... 否定 :Well, honestly speaking, music is really not my cup of tea, simply because... ( 给出直接原因) What—pop, techno ( 电音音乐), hip-hop, rock, meditation ( 冥想乐) and especially light music.( 罗列名词) Where—Normally speaking, I would like to listen to music with my earphones when I take a ride on public transportation. ( 给出一个具体的场景) When—As long as I couldn’t go to sleep, I’d like to listen to some light music to calm myself down. ( 给出一个条件 :As long as I..., I would...)
Who—My most favourite singers include Adele, James Blunt, Avril Lavigne, and so forth. ( 喜欢的歌手) Why—I am fond of music mainly because it can cheer me up greatly when I feel down/low/ blue/bored/tired/depressed. ( 心情不好的时候让我高兴起来)?Besides, I also believe that music is an indispensable part of culture and tradition, through which I could have a better understanding of different cultures around the world, including cowboy culture, African-American street culture, the three main reli- gions and so on. ( 有助于理解不同的文化) Do you like watching movies?? A—Speaking of movies, yes, I am a big fan of all types of movies, such as...?What—comedy, action, romance, sci-fi, manga, vampire, zombie, animation...
树立榜样的个人事迹简介怎么写800字 榜样是阳光,温暖着我们的心;榜样如马鞭,鞭策着我们努力奋斗;榜样似路灯,照亮着我们前进的方向。今天小编在这给大家整理了树立榜样传递正能量事迹作文,接下来随着小编一起来看看吧! 树立榜样传递正能量事迹1 “一心向着党”,是他向着社会主义的坚定政治立场;“人的生命是有限的,可是,为人民服务是无限的,我要把有限的生命投入到无限的为人民服务中去”,是他的至理名言;“甘学革命的“螺丝钉”,是他干一行爱一行、钻一行的爱岗敬业态度。他——雷锋,是我们每一个人的“偶像”…… 雷锋的事迹传遍大江南北,他,曾被人们称为可敬的“傻子”。一九六零年八月,驻地抚顺发洪水,运输连接到了抗洪抢险命令。他强忍着刚刚参加救火工作被烧伤的手的疼痛,又和战友们在上寺水库大坝连续奋战了七天七夜,被记了一次二等功。望花区召开了大生产号召动员大会,声势很大,他上街办事,正好看到这个场面,他取出存折上在工厂和部队攒的200元钱,那时,他的存折上只剩下了203元,就跑到望花区党委办公室要为之捐献出来,为建设祖国做点贡献,接侍他的同志实在无法拒绝他的这份情谊,只好收下一半。另100元在辽阳遭受百年不遇洪水的时候,他捐献给了正处于水深火热之中的辽阳人民。在我国受到严重的自然灾害的情况下,他为国家建设,为灾区捐献出自已的全部积蓄,却舍不得喝一瓶汽水。就这样,他毫不犹豫的捐出了自己的所有积蓄,不求功名,不求名利,只求自己心安理得,只求为
革命献出自己的微薄之力,甘愿做革命的“螺丝钉”——在一次施工任务中,他整天驾驶汽车东奔西跑,很难抽出时间学习,他就把书装在挎包里,随身带在身边,只要车一停,没有其他工作时,就坐在驾驶室里看书。他曾经在自己的日记中写下这样一段话：”有些人说工作忙,没时间学习,我认为问题不在工作忙,而在于你愿不愿意学习,会不会挤时间来学习。要学习的时间是总是有的,问题是我们善不善于挤,愿不愿意钻。一块好好的木板,上面一个眼也没有,但钉子为什么能钉进去呢?这就是靠压力硬挤进去的。由此看来,钉子有两个长处：一个是挤劲,一个是钻劲。我们在学习上也要提倡这种”钉子“精神,善于挤和钻。”这就是他,用自己的实际行动来证明自己,用自己的亲生经历来感化世人,用自己的所作所为来传颂古今……人们都拼命地学习他的精神,他的精神被不同肤色的人所敬仰。现在,一切都在变,但是,那些决定人类向前发展的基本要素没有变,那些美好的事物没有变,那些所谓的“螺丝钉”精神没有变——而这正是他的功劳,是他开启了无私奉献精神的大门,为后人树立了做人的榜样…… 这就是他,一位中国家喻户晓的全心全意为人民服务的楷模,一位共产主义战士!他作为一名普通的中国人民解放军战士,在他短暂的一生中却助人无数。而且,伟大领袖毛泽东主席于1963年3月5日亲笔为他题词：“向雷锋同志学习”。 正是因为如此,全国刮起了学习雷锋的热潮。雷锋已经离开我们很长时间了。但是雷锋的精神却深深地在所有中国人心中扎下了根,现在它已经长成一株小树。正以其顽强的生命力,茁壮成长。我坚信,
做有偿工作的人 Describe a person you know who is doing a paid job. You should say: Who this person is What job it is; How long the job lasted; And explain why you or this person chose to do this job. 让你笑的小孩 Describe a time that a child did something that made you laugh. You should say: When this happened Who the child was What the child did And explain why it was funny 特殊的旅行 Describe an educational trip you went on when you were in school. You should say: When and where you went; Who you went with; What you did; And explain what you learned on this trip.
Describe an electronic machine you want to buy. You should say: What it is When you know this machine What specific And explain why you want this machine 难忘的广告 Describe an unforgettable advertisement (that you saw or heard liked) You should say: Where you saw or heard it What kind of advertisement it was What the contents of the advertisement were (or, what product or service was advertised) And explain how you felt when you saw or heard this advertisement/why you like it