英语(规范化培训)

CLINICALMEDENGLISH英语基本都在里面了，我们那年多了个单词“体温表”中翻英I.WORDSLIST替代与补充治疗alternativeandcomplementarytherapies营养nutrition健康的生活方式healthylifestyles免疫接种immunizations收缩压/舒张压systolic/diastolicbloodpressure呼吸困难dyspnea呼吸急促tachypnea呼吸减弱hypopnea并存病comorbidities亚临床疾病subclinicaldisease不良后果adverseoutcomes消化性溃疡（病）pepticulcer（disease）关节炎arthritis（静默型）心肌梗死（silent）myocardialinfarction疾病谱spectrumofdiseases体重减轻weightloss动脉粥样硬化atherosclerosis慢性疾病终末期end-stagechronicdisease心力衰竭heartfailure理疗physicaltherapy生物人工肝装置bioartificialliverdevices自体细胞autologouscells生长因子growthfactors胃肠道出血gastrointestinalbleeding上消化道和下消化道upperandlowergastrointestinaltracts绝经前的premenopausal活检biopsy炎性肠病inflammatoryboweldisease血管造影术angiography胶囊小肠镜capsuleenteroscopy哮喘asthma慢性支气管炎chronicbronchitis肺气肿emphysema低氧，缺氧hypoxia肺栓子（塞）pulmonaryemboli（sm）肺顺应性lungcompliance糖尿病性肾病diabeticnephropathy预期寿命（预期生存时间）lifeexpectancy自然病程naturalhistory高血糖hyperglycemia微量白蛋白尿microalbuminuria原发肿瘤primarytumor病因学etiology晚期癌症advancedcancer未足月产pretermlabor流行性感冒epidemicinfluenza影像学检查imagingtests急性胆囊炎acutecholecystitis胆石gallstones内镜超声检查endoscopicultrasonography胰腺肿瘤pancreatictumors术前分期preoperativestaging慢性胰腺炎chronicpancreatitis心律失常cardiacarrhythmia冠状动脉疾病coronaryarterydisease肥厚型心肌病hypertrophiccardiomyopathy心肌炎myocarditis（持续性单一型）室性心动过速（sustainedmonomorphic）ventriculartachycardia特发性扩张型心肌病idiopathicdilatedcardiomyopathy胃肠穿孔gastrointestinalperforation剖腹术celiotomy免疫抑制immunosuppression肠吻合术intestinalanastomoses择期胃肠手术electivegastrointestinalsurgery腹腔脓肿intra-abdominalabscess切口（创口）感染woundinfections院内感染nosocomialinfection误吸aspirationII.PARAGRAPHTRASLATIONi.Thepatient-physicianinteractionproceedsthroughmanyphasesofclinicalreasoninganddecisionmaking.Theinteractionbeginswithanelucidationofcomplaintsorconcerns,followedbyinquiriesorevaluationtoaddresstheseconcernsinincreasinglypreciseways.Theprocesscommonlyrequiresacarefulhistoryorphysicalexamination,orderingofdiagnostictests,integrationofclinicalfindingswiththetestresults,understandingoftherisksandbenefitsofthepossiblecoursesofaction,andcarefulconsultationwiththepatientandfamilytodevelopfutureplans.Physiciansincreasinglycancallonagrowingliteratureofevidence-basedmedicinetoguidetheprocesssothatbenefitismaximized,whilerespectingindividualvariationsamongdifferentpatients.医患沟通需要通过多阶段的临床循证和决策来进行。这种沟通始于对担忧或关注的事物的阐述，接着进行咨询或评价，从而以更精确的方式处理这些所关注的事物。这个过程通常要求了解详细的病史或体格检查，需要进行诊断性试验，结合临床发现和试验结果，了解各种行为过程可能的益处与风险，并与患者和家属仔细商议从而制定今后的计划。医生越来越依靠不断增加的循证医学文献来指导这一过程，为的是使患者获益最大化，并能注重不同患者间个体的差异。ii.Fourth,cognitiveimpairmentincreasesinprominenceaspeopleage.Cognitiveimpairmentisariskfactorforawiderangeofadverseoutcomes,includingfalls,immobilization,dependency,institutionalization,andmortality.Cognitiveimpairmentcomplicatesdiagnosisandrequiresadditionalcaregivingtoensuresafety.第四方面，认知损害会随着年龄的增长而逐渐凸显。认知损害是一系列不良后果的危险因素之一，包括摔跤，运动不能，依赖他人，居住于社会慈善机构以及死亡。认知损害使得诊断变得复杂，并需要额外的看护以确保病人安全。iii.Inthefaceofcontinuedbloodlossandnoidentifiedetiology,intraoperativeendoscopymayprovidesimultaneousdiagnosisandtherapy.Duringtheprocedure,thesurgeonplicatesthebowelovertheendoscope.Asthescopeiswithdrawn,endoscopicfindingscanbeidentifiedforsurgicalresectionortreatment.Theyieldofthisprocedureexceeds70%.Insomeclinicalsituations,thesiteofbleedingcannotbeidentified,andthepatientrequireslong-termtransfusiontherapy.当出血继续而无法确定病因时，术中内窥镜检查可以同时提供诊断和治疗。在这一过程中，外科医生需将内窥镜穿过小肠。当内窥镜退出时，内镜下的发现可以为外科切除或明确治疗手段提供依据。这个检查过程的获益率超过70%。在某些临床情况下，出血部位仍然不能确定，而病人就需要长期的灌注治疗。iv.Anincreaseddrivetoventilatemayalsocausedyspnea.Suchstimuliincludehypoxia,usuallywhenarterialoxygentensionsarelessthan60mmHg,andstimulifrominflamedlungparenchyma,asoccurinbacterialpneumoniaoralveolitisandthatdrivetherespiratorycentersofthebrain.Thesestimulioftenlowertherestingcarbondioxidepressure(Pco2)tolessthanthenormallevelof40mmHgandcausedyspnea,especiallyonmildexertion.刺激通气增加的因素也可产生气促。这类因素包括低氧和肺实质炎症，低氧常发生于动脉血氧分压低于60mmHg时，肺实质炎症则可源于细菌性肺炎或肺泡炎，并能刺激大脑的呼吸中枢。这些刺激因素常常会使二氧化碳分压降低到正常水平下40mmHg并引起气促，尤其是。v.Afterseveralyears,mostdiabeticpatientsexhibitdiffuseglomerulosclerosis,althoughaminorityhavepathognomonicKimmelsteil-Wilsonnodularlesions.Althoughpathologicchangescontinuetomountthroughoutthedisease,glomerulosclerosisextensiveenoughtocauseESRDdevelopsinaminorityofpatients;inthesecases,overtalbuminuria(3000mg/day)beginsapproximately15yearsafterdiagnosis.Soonafter,followingavariableperiodontheorderof3to5years,theGFRbeginsarelentlessdecline(≥10ml/min/year),whichiseventuallyreflectedbyanincreaseinserumcreatinine.TheappearanceofmassiveproteinuriaandthenephriticsyndromeiscommoninthiscontextandoftenheraldsprogressiontoESRD.Oncetheserumcreatininerises(reflectinganapproximately50%declineinGFR),ESRDdevelopsinmostpatientswithin10years.Thiscourseishighlyvariable,however,particularlyintype2diabetics,whomayexhibitmoderateproteinuriaforseveralyearswithoutasubstantialdeteriorationofrenalfunction.Asimplebutusefulmethodofmonitoringprogressiontorenalfailureistoplotthereciprocaloftheserumcreatinineasafunctionoftime.Thistechniqueallowsbetterassessmentofboththerapeuticinterventionsandthetimewhenrenalreplacem