新编临床医学英语
第1期:病患的问题与诉求
Unit 1 Text A Internal Medicine and Today's Internist
第1单元文章A 内科与内科医生
Questions/Pleas of the Patient
病患的问题与诉求
How can I find a good doctor?"
我如何找到一位良医？
How can I find a good doctor whom I can afford?"
如何能够碰到一位价格亲民的医生？
How can I find a good doctor who cares about me as a person?〃
又如何能够遇见一位把我当成“人”看待的医生？
How can I find a good doctor who will take the time to listen and understand?"
如何找到一位能够花时间倾听我的诉说，了解我的名医？
People who need medical care ask these questions throughout the world every day.
每天，全球有许多病患都在询问这些问题。
They ask them because they face a health care system that is scientifically complex, organizationally overloaded, and generally not oriented to the patient as a person.
他们之所以问这些问题，是因为他们所面对的医疗保健体系技术深奥、机构臃肿，而且一般都没有意识到病人首先是一个“人”。
When an individual first becomes ill, regardless of the symptoms, he or she needs most
someone who seems to say,
如果有人生了病，不管症状如何，他们最希望听到的是：
"I am a good doctor；I charge a reasonable amount for my services；I care about you，the
patient and I will take the time to listen and understand."
“我是医生；我只收取亲民价格，我关心病患，我将倾听你的诉求，理解你。”
A prominent teacher/physician in a major medical center taught his students to listen to the patient and he will tell you what is wrong, and he will tell you what he needs".
主要医疗中心的知名学者/内科医生都会教授学生要学会倾听，病人会告诉你哪里不舒服，也将会告诉你他们的需求。Having found a physician who answers so profoundly to their needs, some patients are
extremely grateful but most are utterly overwhelmed.
有些内科医生完全满足了病患的需求，有些患者表现出了极大的感激之情，但是绝大部分都激动不已。
With the discovery of that relationship, the difference between a superb technician and a true physician really becomes evident to the patient.
有了这层关系之后，专业技师和内科医生的区别在病患面前展露无遗。
That physician/teacher was a scholarly gentleman with deep scientific insight and an active
and stimulating clinical and research practice.
内科医生/教授都是学术人才，他们对学科有着科学的深刻见解，并活跃在临床和研究领域中。
Unfortunately he developed crippling rheumatoid arthritis in the midst of his career.
但是，他们在工作期间不幸患上了风湿性关节炎。
Beyond question, his own disease sensitized him to the complex mix of expectations, needs, fears, 毫无疑问，他自身的疾病使他对病人交织着期待、需要、恐惧和感激的复杂心情十分敏感，
and appreciation that patients feel when facing a physical-mental trial while at the same time looking for that perfect physician to help them.
这是患者们在经历身心煎熬、同时又盼望有那么一位德高望重的名医能给他进行诊治时所共有的感觉。
Patients flocked to this doctor，not just for his accurate diagnoses, his correct therapies, or
even his warmth,
患者都去找这样的医生看病，并不是因为他们准确无误的诊断，正确的治疗方法，甚至是所给予的温暖，
but for the intellect he expressed and the sheer joy of living that he extended in every
encounter with another human being.
而是他们所散发的智慧之光，以及他在面对每一个“人”时所展现的喜悦之情。
He had a Shakespearean grasp of the qualities of being human and an uncommon ability to
transmit love and respect for his fellow human beings.
他既能像莎翁那样对人性特点有着深刻的了解，又身具异秉能把关爱和尊重传递给全人类。
He exhibited the ideal all physicians should emulate.
他展现了所有内科医生应该展现的最理想的一面。
Many readers know a physician with these characteristics all should seek to know one and to develop their own professional persona so that human qualities are not lost to technical acumen. 许多读者都认为拥有这些特征的内科医生都应该去了解，并培养自己的职业形象，只有这样，人类的本质才不会在技术面前甘拜下风。
1.be oriented to 面向,本句中的 them 是指上句的 these questions.
原文：They ask them because they face a health care system that is scientifically complex, organizationally overloaded, and generally not oriented to the patient as a person.
他们之所以问这些问题，是因为他们所面对的医疗保健体系技术深奥、机构臃肿，而且一般都没有意识到病人首先是一个“人”。
2.in the midst of：在…中，在…当中
原文：Unfortunately, he developed crippling rheumatoid arthritis in the midst of his career.
但是，他们在工作期间不幸患上了风湿性关节炎。
3.beyond question 的意思是“毫无疑问地”；sensitize sb to sth 意思是“使某人对某事敏感起来”。
原文：Beyond question, his own disease sensitized him to the complex mix of expectations, needs, fears, and appreciation that patients feel when facing a physical-mental trial while at
the same time looking for that perfect physician to help them.
毫无疑问，他自身的疾病使他对病人交织着期待、需要、恐惧和感激的复杂心情十分敏感。这是患者们在经历身心煎熬、同时又盼望有那么一位德高望重的名医能给他进行诊治时所共有的感觉。
4.rheumatoid arthritis 风湿性关节炎
例句：The study was also too short to show whether TwHF can slow the joint damage caused
by rheumatoid arthritis.
这项研究时间也太短，不能显示雷公藤是否能减缓由风湿性关节炎引起的关节损伤。
第2期:好医生的科学和技术专业背景
THE SCIENTIFIC AND TECHNOLOGIC BACKGROUND OF A "GOOD DOCTOR"
“好医生”的科学和技术专业背景
Since Flexner issued his famous report in 1910, American medical education has striven toward
the development of a strong scientific base.
自从1910年弗莱克斯纳的著名研究报告问世以来，美国的医学教育致力于培养深厚的科学基础。
This intellectual prerequisite, therefore, has become an integral part of premedical, undergraduate, graduate, and, indeed, continuing medical education.
所以，以学术知识为前提的教育就成为了医学预科、本科生、研究生以及继续医学教育的主要组成部分。Biomedical science is fundamental to understanding disease, making diagnoses, developing
new therapies, and appreciating the complexities and contributions of new technologies.
生物医学是掌握病情、作出诊断、研究新型治疗方法的基础，同时它还是研发新技术的基础。
Physicians cannot be satisfied with simply knowing that a certain form of therapy works 80 to90 per cent of the time.
内科医生不能够只满足于掌握某领域治疗方法的80-90%。
They must understand the basic physiology and pharmacology of any approach they use.
他们必须对所应用的生理学和药物学的基本疗法了如指掌。
They must possess the intellectual tools to follow reports of current research in medical journals 他们必须能够利用学术方法来掌握医学杂志的最新研究成果，
so that they can continue to grasp the newest and latest approaches, no matter how
complicated the field may become.
不管该领域变得多么复杂多变，他们都能够掌握最新的治疗方法。
That is why, in a textbook of medicine like this, strong emphasis is given to how things work,
what goes amiss when pathologic processes ensue,
这就是为什么像这样的医学教科书要着重强调事物的运作方法，以及在病理过程中所出现的差错，
and what effect a given therapy has in correcting that defect.
以及特定治疗方法对纠正差错所带来的影响。
We seek to create within the minds of our readers a yearning for a greater depth of
understanding and a continuing commitment to stay at the frontier of scientific knowledge.
我们希望我们的读者能够从内心有着更加深入的了解，并继续处在科学的最前沿。
These are, in fact, among the hallmarks of a professional in any scientific field.
事实上，任意科学领域专业都包含了这些特点。
We are moving into an era when pharmacotherapeutic agents are no longer merely wonders of organic chemistry, but increasingly often are biologic products.
当今时代，药剂已经不仅仅是有机化学的奇迹，它也逐渐变成了生物制品。
Some of these are isolated from nature others are developed by recombinant DNA technology.
许多产品已经脱离自然，有些是DNA技术重组的产物。
On the horizon is the availability of a true replacement or supplement for defective or
deficient biochemical constituents of the body.
我们即将要面对的是真正能够替代或是能够补充生物化学成分中不足的产品。
No physician can, with intellectual honesty, use these new classes of agents without fully understanding their action, their meaning, and their potential side effects.
任何一位有学术诚信的医生都不会在没有充分了解这些新型药剂的功能、作用以及潜在副作用的情况下就使用它们。The diagnostic and therapeutic contributions and potential, in clinical situations, of biocompatible prosthetic devices, nuclear magnetic resonance spectroscopy,
通过一系列的发展（还没有被确认），诊疗对未来临床中的生物兼容性假肢器官、核磁共振谱、
high-frequency laser beams, and so on through developments not yet conceived
appreciated only by the mind that is disciplined in fundamental science.
高频激光等所作出的贡献只有在基础科学中才能得以实现。
1.per capita 每人，按人口（计算）
例句：The United States spends more per capita on health care than any other nation in theworld.
美国是全球个人医疗开销最大的国家。
2.Medicaid plan 医疗补助制度
例句：
With the passage of the Medicare program for the elderly and the Medicaid plan for thepoor by Cong ress in 1965,
1965年，美国国会通过了补助老人的退休医疗福利，以及补助穷人的穷人医疗补助，
3.dental care 牙齿护理
例句：Your smile depends on simple dental care habits, such as brushing and flossing.
自信的笑容取决于简单的牙齿护理习惯，如刷牙和使用牙线。
4.cost-efficient有成本效益的
例句：It also helps the architect manage resources in a very cost-efficient manner.
它还有助于架构师采用一种非常具有成本效益的方式来管理各种资源。
第3期:
THE ORGANIZATION AND FINANCING OF TODAY'S MEDICINE
当代医疗制度与资金投入
Patients, as well as their representatives in government, industry, and managed-care organizations, are concerned about the rising cost of medical care.
政府、产业、管理型医疗保险代表以及病患都对不断增加的看病价格给予了高度关注。
The total bill for health care in America now rises at a rate of about 10 per cent per year, an increase that seems to continue unabated.
在美国，医疗开销以每年10%的价格增长，而这一趋势还将继续下去。
Federal legislation instituting diagnosis-related groups (DRC's) has clearly moderated the rise
of hospital costs, but physician costs continue to rise at an ever-increasing rate.
联邦立法已经开设了诊断相关组，并已经降低了医院开销，但是内科医生的开销仍然在不断增加。
Every student of medicine should ask if this is realistic.
每一名医学学生都在问这是不是真的。
Is it sustainable? Is it defensible?
是可持续性的？还是有可解决的办法？
What will be the limits?
范围到底在哪？
Patients already ask, “Can I really afford the best doctors in the most prestigious practices, in
the most famous medical centers?”
病患在问，“我能去最好的医疗中心，最好的科室，找最好的医生看病吗？”
“Can I afford to be referred to a subspecialist?”
我有钱去看那些专业医师吗？
“Can I afford to be out of work and in the hospital?”
我能支付得起不上班在医院看病的开销吗？
“Can I afford to pay my rising insurance premiums?”
“我有钱支付不断增长的保险吗？”
“How much deductible on my insurance can I afford?”
“保险中的扣除条款我能支付得起多少？”
Worse yet, an increasing number of patients have to make choices between seeking medical and dental care and getting food, clothing, shelter, and other essentials of daily living.
更糟糕的是，有许许多多的病患不得不在看病，看牙和基本日常生活之间做出选择。
These issues have become major concerns in American households and clearly represent one of
the most disturbing weaknesses in our economy,
这些问题已经成为美国家庭关心的主要问题,并且是美国经济中最令人担心的薄弱环节，
of which now nearly 12 per cent ( by annual gross national product) is devoted to health care,
up from 8 per cent in 1975.
医疗费用所占每年国民生产总值的比例已由1975年的8%增加到现在的12%。
Over the last two to three decades it has been a goal of the United States to promote ever increasing quality and cost-effectiveness of health care for all.
在过去的二三十年中，美国的目标就是要为全体民众提供质量高，成本高效益的医疗制度。
Unfortunately, we have failed miserably.
不幸的是，我们遭遇了惨败。
The USA spends more per capita on health care than any other nation in the world.
美国是全球个人医疗开销最大的国家。
Yet in the major indices of health our population ranks nineteenth！
但是在主要医疗指数上，美国民众排在了第19位！
At the same time we continue to see a wasteful maldistribution of physicians both by specialty
and geographically and a growing number of medically indigent and medically uninsured people
in our nation.
与此同时，无论在专业还是在地域上，内科医生的分配不合理，没有保险，没钱看病的人数还在不断增加。Somehow, the costs of what we are trying to achieve—even though the goal is commendable— are not being placed in proper perspective by the medical profession, health-care managers,
and representatives of the people in order to provide suitable care for all.
尽管我们要实现的目标值得赞扬，但是我们要实现的看病价格并没有得到医疗人士、医疗卫生监管人士、以及代表的认真对待。
Unfortunately，in the present system the real needs of the populace are not always met by affordable services.
不幸的是，就目前的制度而言，大众所能够支付得起的医疗费用无法满足人们的要求。
At the same time, overutilization of medical services may be the very engine that drives up the
total cost of health care delivery.
与此同时，医疗服务的过度使用或许也是增加医疗费用的引擎。
With the passage of the Medicare program for the elderly and the Medicaid plan for the poor by Congress in 1965,
1965年，美国国会通过了补助老人的退休医疗福利，以及补助穷人的穷人医疗补助，
we had hoped as a nation that we were moving toward a more just and efficient system.
我们希望美国的医疗系统能够变得更加公正，更加有效。
In fact, the opposite has been the trend.
但是事实上，我们却背道而驰。
This societal goal must now be readdressed reformulated, and restructed in terms of modern needs, 就社会需求来讲，我们应该通过重组来实现社会目标，
reflecting fairly and fully measured cost-benefit ratios for every form of medical service.
全面反映医疗服务的成本与效益比例。
1.per capita 每人，按人口（计算）
例句：The United States spends more per capita on health care than any other nation in the world.
美国是全球个人医疗开销最大的国家。
2.Medicaid plan 医疗补助制度
例句：With the passage of the Medicare program for the elderly and the Medicaid plan for the
poor by Congress in 1965,
1965年，美国国会通过了补助老人的退休医疗福利，以及补助穷人的穷人医疗补助，
3.dental care 牙齿护理
例句：Your smile depends on simple dental care habits, such as brushing and flossing.
自信的笑容取决于简单的牙齿护理习惯，如刷牙和使用牙线。
4.cost-efficient有成本效益的
例句：It also helps the architect manage resources in a very cost-efficient manner.
它还有助于架构师采用一种非常具有成本效益的方式来管理各种资源。
第4期:
Medical professionals often attribute overutilization to patient behavior.
医疗专业人士经常将过度使用归罪于病患的行为。
In fact, however, physicians control 70 per cent of health expenditures.
但是，事实上，医护人员却掌控者70%的医疗支出。
A few patients with hypochondriasis, for example, may visit physicians too often,
例如，少数患有疑病症的病患会经常就医。
and many older patients may seek medical help at times when a friendly, reassuring chat is
their real desire,
许多老年患者有时也会寻求医疗帮助，他们希望能够得到友好，舒心的交谈，
but in the final analysis utilization of the health care system is in the hands of physicians.
归根结底，医护系统的利用问题掌控在医护人员手中。
Ironically, although physician competence is often equated to mastery of expensive
techniques and technologies,
具有讽刺意味的是，虽然医术常常等同于掌握价格高昂的仪器设备和科技手段，
physicians are actually at their professional best when listening to the patient and responding
to what they hear and see with medicine most comprehensive armamentarium.
但医生达到炉火纯青境地，往往是在能够倾听患者心声并应用最先进的医疗设备对他们听到、看到的患者状况采取相应措施的时候。
Overutilization, when it occurs, is thus most likely to be our fault as physicians.
当出现过度使用问题时，医护人员是最有可能出错的。
Our responsibility as professionals is to be absolutely certain that our errors in this direction
are driven by well-founded concern for the health of our patients,
作为专业人士，我们的责任就是要坚决确保这些错误是建立在对病患健康的关心之上，
not by the financial interests of our practices or the hospitals where we work.
而不是建立在经济效益或是医院之上。
Individual physicians, then, must take a personal and professional interest in the control of
health care costs not only because it is right for the nation, but because it is right for the patient.
对于个体医护人员来说，他们必须从专业角度和个人角度来对医疗费用产生兴趣，这不仅对国家有益，还将有益于病患。
In our litigious society, a legalistically defensive approach to medical practice has become too prevalent.
在我们这个喜欢诉讼的社会里，有关医疗的法律保护方法就变得非常普遍了。
The conditions that engender this tendency must be altered.
我们必须对这一趋势进行纠正。
Physicians must use all of their diagnostic skills to focus on the very best approach to medical diagnosis and therapy
医护人员必须使用其所有的诊断技能来关注医疗诊断和理疗方法，
and to steer away from unnecessary use or repetition of expensive procedures such as
computed tomography, magnetic resonance imaging, and cardiac catheterization.
并避免不必要的使用，或是重复价格昂贵的诊治，例如计算机体层摄影、核磁共振成像或是心导管插入术。
The physician must use intellect scientific knowledge and analytical skills to best serve the
patient without inundating the system with unnecessary costs
医生必须运用智慧（包括科学知识和分析能力）来为病人提供最佳服务，既不要给医疗保健体系增加不必要的费用，and the patient with a financial burden he simply cannot continue to bear.
也不要给病人造成不必要的、无法继续承受的经济负担。
1.take（an）interest in 对……发生兴趣
例句：We take interest in your canned goods and wish to have the catalogues.
我们对你方的罐头食品有兴趣，希望能收到目录。
2.on the final analysis 归根结底
例句：Nowadays, the competition of technology and strength is the competition of humans and human capital on the final analysis.
当今世界科技和实力的竞争，归根到底是人的竞争，是人力资本的竞争。
3.steer away from 避开
例句：We wanted to make a clean break from actresses and steer away from blondes and cleanse the palette.
我们不想再用女演员代言，也不想要金发女郎，我们重新做出选择。
4. financial burden 财政负担
例句：Bearing the financial burden of commercial and investment arbitrations is difficult for any country, but most especially so for a small country like Uruguay.
承担商业和投资仲裁决定的财政负担对任何国家都很艰难，对于乌拉圭这样的小国来说更是如此。
第5期:
Costs can be controlled only if physicians are convinced of the need and are willing to participate in providing this vital service.
只有医护人员能够真正明白这些需求，并愿意参与到提供重大服务上来，价格才能够得到控制。
One aspect of this control is attention to various possible means of health care finance,
控制价格的其中一个方面就是要重视各种卫生保健,
including prepaid plans, preferred provider organizations health maintenance organizations, and other managed care systems.
包括重点服务计划、优先医疗服务提供者组织、健康维护组织以及其他管理式医疗系统。
All of these must be carefully explored with a view to making health care accessible where it is most needed.
为了让最需要医疗保障的民众接受到该服务，我们必须对这些系统进行细致地探究。
Clearly, multiple tools and programs may be necessary, but they should not be thrust upon the patient simply to satisfy doctrines of free enterprise.
显然，这些措施和项目或许是不可或缺的，但是不能够仅仅是为了满足自由主义的信条而将其强加于病患身上。
To provide the best health care in a finite economy we need systems that provide such care in the most efficient way, regardless of the payment scheme.
为了在有限的经济体中提供最好的医疗保障，不论支付计划如何，我们需要利用最有效的措施来提供医疗服务Another aspect of our cost-control job is to support and participate in research on outcomes,
在这项成本控制工作中，另一个方面就是要参与到对支出的研究上来，
aiming toward systematic evaluation of cost-effectiveness of the medical procedures we choose in the light of all the interests of our patient.
考虑到病患的利益，我们的目的就是要对医疗程序的成本效益进行系统的评估。
For example, we do not know why treatment of prostatic hypertrophy is more commonly medical in some parts of the nation, surgical in others.
例如，我们不知道为什么有些地区对会利用内科的方式来治疗前列腺增生，有的地方会利用手术的治疗方式。
Why does the incidence of caesarean sections vary so widely?
为什么实施剖腹产的范围会如此之广？
The costs and benefits of coronary angioplasty versus bypass surgery remain obscure.
冠状动脉成形术和心脏搭桥手术的成本和效益仍然不明确。
Every year billions of dollars are spent as a result of clinical decisions that may hinge on these or similar issues.
每年，政府都会在相似的临床问题上花费数十亿美金。
Physicians must involve themselves in the processes of change with an eye first to the individual patient and then to society.
内科医生必须亲身参与到变革的过程中来，这么做首先是为了病患，其次这也有利于社会。
1.with a view to 为了要
例句：Time after time, he read such sentences as: “Please cause an investigation be made with
a view to ascertaining the truth.
马弗里克一次又一次看到这样的句子：“敬请以查明事实真相为宗旨，展开一番调查。”
2.be thrust on 把…强加于
例句：Specific challenges will be thrust on Mrs Clinton from Day 1.
希拉里从第一天开始就会面临具体的挑战。
3.in the light of 根据
例句：They will adjust their bequests in the light of yours.
他们将根据你的赠予调整自己的遗产分配。
4.hinge on 靠...转动
例句：Somewhat surprisingly, the answer turns out to hinge on what you mean by best and
what you mean by long-run.
有些令人惊讶的是，答案取决于在你看来最好的和长期的是一个什么概念。
第6期:
THOSE WHO CARE
那些关爱病患的医生
"How can I find a good doctor who cares about me as a person?"
如何找到一位拿病患当“人”看的医生？
When speaking of caring, one has to define specifically what is meant.
说到关爱，人们不得不将其明确定义。
A physician can diagnose and prescribe in a technically correct and scientific but insensitive
way and the patient may be made better even cured.
医生在确诊病患时能够保证在技术和科学上的准确性，但是却不添加个人感情，患者能够在这种情况下有所好转，或是得到治愈。
On the other hand, when the patient asks the question, "Does my physician really care?〃
另一方面，当病人问道：我的医生真的关心我吗？
the patient means, Does it matter to the physician what happens to me?
病患的意思是：“我的情况对医生来说重要吗？
Does my doctor show sensitivity and compassion beyond the mere technical qualities ofmedicine?〃
医生是否仅仅超越了技术层面而展现出同情和敏感。
It is in this sense that we address ourselves to the nature of those who care.
我们正是要从这一层面去了解那些医护人员的本质。
It may seem odd to talk about caring as a skill, but in a real sense it is just that.
把关爱当做一种技能来讨论似乎有一些奇怪，但是事实就是这样。
Those involved in the education of students realize that at least some forms of compassion have to b e learned.
那些接受了医学教育的学生意识到他们至少要习得某些形式的同情。
The developing physician must see such traits in action in order to acquire and apply them in interaction with patients and their families.
为了在与病患和家属的沟通中获得并应用这种同情，成长中的医生必须将这些特点付诸行动。
Sometimes this involves learning how to demonstrate compassion.
有时，这些要涉及到如何展现同情心。
Kahlil Gibran has taught us, "You give but little when you give of your possessions? it is when
you give of yourself that you truly give."
纪伯伦教导过我们：“给予财产算不上给予，只有当你献出自己，那才算是真正的给予。”
Giving of ourselves? with ease, with grace, and with meaning is for most of us an acquired skill.
轻松，完美的献出自己，这对于我们大多数人来说是一种习得的技能。
Sometimes it involves a deep sense of reawakening within to bring out an innate sensitivity
and compassion that perhaps has not expressed itself since childhood.
有时，这包括内心深处的苏醒，并迸发出自从童年时期就没有表现过的同情和敏感。
At other times, learning to care may involve a complete transformation of behavior and
attitudes toward people, particularly those who are not from our own cultural background.
在其他时候，学习关爱或许要把对待他人的行为和态度进行全面的改变，特别是对那些拥有不同文化背景的人。Many believe that the greatest responsibility in medical education today is to foster
compassion within the student of medicine.
许多人相信当今医学教育中最重要的是将同情心渗透到医科大学学生的心中。
To receive medical care, patients must trust their bodies and their very lives to physicians, and
so to be in an honest position to give medical care，physicians must earn such radical trust.
为了获得关爱，病患必须对自己的身体有着足够的信心，并能够将自己的生命交到医生手中，那么医生就完全能够给予关爱，医生必须获得百分百的信任。
Mere technical treatment of disease does not suffice.
仅仅是对于疾病的技术治疗是不能够满足的。
Patients must be able reasonably to believe that their physicians care about them in an extraordinarily personal way.
病患必须合理地相信，他们的医生从个人层面对他们非常关心。
This exchange of care for trust, while not identical to friendship or love, is equally binding.
这种用关爱换取信任同样相互关联，这与友情和爱完全不同。
From it develops an interdependence that is far from unwholesome rather, it potentiates care
and promotes healing.
这种造成的相互依赖远远不会对身心造成伤害，反而这会增强关爱，提高治愈率。
Our late twentieth century sophistication and technologic orientation have too often cost us warmth, humor, and humanity, leaving us in social isolation.
20世纪晚期以复杂和技术为目的的医疗经常让我们失去了温暖、幽默以及仁慈，并让我们被社会所孤立。
We do far better as professionals to err on the side of being human with our patients than to
try to play deus ex machina, the god from the machine.
作为专业人员，我们对待病人要人性化，这么做即使犯些小错也比扮演冷冰冰的解围之神要好。
1.identical to/with：与…完全相同的
例句：His appearance was identical to his mother, Anyone could identify that he was her son.
他的面容和母亲是同样的。任何人都可以识别他是她的儿子。
2.in a position to do 能够作某事
例句：The people you're in a position to do something nice for, even if they've got no ability
to reciprocate.
你能做一些力所能及的事情的人，哪怕他们有没有能力来报答。
3.acquired skill 习得的技能
例句：Failing to recognize that speaking is an acquired skill.
没有认识到演讲是一个可以后天习得的技巧。
4.happen to 发生于
例句：Yes, it could happen to any of us, but yesterday it happened to them.
是的，这可能发生在我们任何一个人身上，但是昨天却发生在他们身上了。
第7期
HE SOCIAL RESPONSIBILITIES AND HUMANISTIC QUALITIES OF "THE GOODDOCTOR"
“好医生”的社会责任和人道主义素质
The patient says, "Take charge, make me well, help me feel comfortable, show me compassion? listen to my problems and I will give you trust."
病患称：“负责任，治好病，舒适感，同情心，倾听我的诉求，我将信任你。”
Dag Hammarskjold reminds us of "the humility which comes from others having faith in you".
哈马舍尔德提醒我们“要谦虚，谦虚来自于别人对你的信任”。
The natural outcome of this giving and receiving of trust is that the physician must accept
some degree of obligation to the patient.
信任别人和得到信任的自然结果是医生必须要承担一些对病患的义务。
Of course, the patient, if able, keeps some responsibility for the healing process, but the
physician must be willing to answer the patient's needs,
当然，如果病患可以的话，他们也需要在治疗过程中承担一些责任，但是医生必须愿意满足病患的需求。
however demanding, however changing, however at times unreasonable or falsely perceived.
尽管这样的要求过高，变动性较大，有时还会是不合理的，或是不正确的需求。
Generalists in internal medicine undertake a long-term commitment to a patient's care.
内科医生对病患所承担的责任需要持续很长一段时间。
They are reminded daily that this commitment continues beyond a particularly insightful diagnosis or the completion of an endoscopic procedure；
他们每天都会被提醒，这些责任超越了某一类高深的诊断，或是完成一次内镜检查；
that the patient still needs care when the numbers are back from the most recent cardiac catheterization
就是当病人完成最常见的心导管插手术，
or when the final stitch is completed in a complex procedure and the patient is rolled from the operating suite.
或是完成了复杂手术的最后一针，就算病人从手术室中推出来，他们仍需要呵护。
The internist continues to care for and nurture the patient through the whole process of
healing in a way that requires enormous skill in close personal interaction.
内科医生在全部治疗过程中都会继续对病患进行关爱和呵护，而这种关爱方式需要人际交流中的诸多技能。
1.long-term 长期的
例句：You should also have long-term goals, not only for your business but for your own career.
同时，你也应该为你的职业生涯设定一个长期的目标，而不仅仅是为了眼前的工作。
2.care for 关心
例句：Lily spent years caring for her sick uncle.
莉莉照顾了她生病的叔叔好多年。
3.endoscopic procedure内镜检查
例句：It is usually done in the hospital or an endoscopic procedure room.
通常结肠镜检查是在医院或专门的内镜检查室内进行。
4.internal medicine 内科
例句：The study was published on Monday in the Archives of Internal Medicine.
这项研究在星期一发表在内科医学档案上。
第8期
HELP WITH FAMILY INTERACTIONS
了解家庭关系
The woman who comes into her physician's office with a history of fatigue, listlessness,
inability to sleep, and irritability may be describing the early symptoms of a morbid disease.
进入医生办公室的这位女性患者拥有疲劳史，精神萎靡，并患有失眠症和烦躁症，这位病患或许还会描述她疾病的早期症状。
She may, however, be showing signs of depression secondary to her inability to cope any
longer with an alcoholic husband,
或许，由于她无力应对酗酒的丈夫，
with a teenage son addicted to cocaine, or with an elderly mother for whom she must care.
吸毒成瘾的孩子，以及她必须要照顾的老母亲而显出抑郁状态。
The wise physician considers organic pathology but also realizes that presenting symptoms
may be only part of what is really troubling the patient.
睿智的医生认为应该运用器官病理学的方法来治疗，但是医生又意识到目前所展现的症状或许仅仅是烦恼病患的一部分。
This requires an unusual sensitivity and an ability to pursue in a cautious, understanding, and careful way and to listen to the concerns and needs the patient describes--traits, again, that
can and must be developed and practiced.
这就需要医生非常敏感并且能小心谨慎、善解人意、细致入微地去探寻并倾听病人的忧虑和需求,医生的这些能力能够且必须加以完善和实践。
The physician's role is to help the patient understand the connections between unpleasant situations, emotional disturbances, and organic symptoms.
医生的角色就是要帮助病患了解不良状况、情绪困扰以及身体症状之间的联系。
Sometimes patients are helped simply by understanding those relationships and being aware
that the doctor appreciates them and reassures, listens with a sympathetic ear, and seldom
advises in a direct way, but does express concern.
有时候，帮助病人只需要让他们知道这三者之间的关系并意识到：医生了解他们，愿意安慰和倾听他们，很少直言相劝、却能表达关心之情。
In earlier days, when most medical care was delivered at home, the physician was quickly made aware of living situations and family inter actions, if he or she did not already know the entire
family and their circumstances.
早些时候，当时绝大多数医生都会在病人家中进行医护治疗，如果医生并没有完全了解病患的家庭和环境状况，那么医生也会很快察觉到病患的生活状况以及家庭关系。
Today when the patient comes to the office, generally alone and certainly out of socioeconomic context, it is much more difficult to perceive what is going on.
如今，病患来到医生的办公室，通常病患会独自一人来，完全无法得知病患的社会经济背景，医生就很难做出正确的判断。
The physician must exercise a much greater degree of skill and understanding in exploring
family interrelationships during a history and physical examination or in an even shorter visit.
通过既往史，体检甚至是通过简短拜访的方式，医生必须要提高他们了解家庭关系的技能。
1.addicted to 上瘾
例句：He became addicted to drugs.
他已吸毒成瘾。
2.medical care 医疗护理
例句：So far, however, two panels of government experts who have looked at the issue have
not found significant impediments to research or medical care caused by gene patents.
可是到目前为止，关注该案的两个政府专家小组还没有发现基因检测专利制度对医学研究和医疗护理方面明显的障碍。
3.physical examination 体检
例句：A careful history and physical examination were obtained, but there was no obvious
reason for the patient's problem.
也得到了一份详细的病史和身体检查，但是没有任何明显的证据表明病人患有该疾病。
4.sympathetic ear 同情心
例句：Women need a sympathetic ear.
女士们需要一位具有同情心的听众。
第9期
HELP WITH OBTAINING NECESSARY ADDITIONAL PROFESSIONAL SERVICES
帮助病患获得必要的额外专业服务
The warm and intimate relationship that any patient seeks is not one that a typical patient can have with many physicians at the same time.
病患所需要的亲密关系并不是哪位病患能够在同一时间与多位医生所拥有的。
The internist must demonstrate a variety of skills, attitudes, and abilities and a store of
diverse information that allows him or her to be the patient's health care manager as well as his confidant, keeping in mind that the average patient does not understand the system of
medical referrals for subspecialty consultation.
内科医生必须具有各种技能、观点、能力和丰富的信息。这会让他们既成为病人健康的管理者也成为患者的知心人。他们还要时刻牢记，普通病人对分科就诊和转诊这套制度并不了解。
An oncologist/internist recently described for me how she weaves the fabric of health care management for a patient who has been referred with a positive biopsy for a malignant disease.
一位肿瘤医师/内科医生最近对我说她是如何为病患建立医疗管理的，这名病患因恶性病接受了活性切片检查。
In this situation the oncologist has to view herself as the captain of a rather complicated ship.
在这种情况下，肿瘤医师不得不将自己看成是一艘大船船长。
She has to talk with the referring physician，obtain the biopsy slides, have them re-read by
her own consulting pathologist, and review them herself.
她需要与转诊医师进行沟通，获取切片，请病理学家再次分析，之后自己审查。
She then has to review the chart and the radiographs with a consulting radiologist and decide,
given all the data, how best to institute therapy.
之后，她需要与放射学家就X光和图表进行分析，并根据所有数据制定治疗方案。
This may require interaction with the surgeon, with the radiation oncologist, and with additional specialists with the skills for exploration, including various techniques for interventional radiology or endoscopy.
这或许会需要与外科医生、放射性肿瘤学家、以及掌握介入性放射学或是内窥镜检查技术的专家进行沟通。
1.a variety of 各种各样的
例句：The department store carries a variety of leather shoes.
这家百货商店经售各种皮鞋。
2.keep in mind 记住
例句：Keep in mind that we are using the default package and folders in our example for illustration purposes.
请记住出于演示的目的，在我们的示例中，我们使用的是缺省包和文件夹。
3.intimate relationship 亲密关系
例句：God wants us to know him; but he wants an intimate relationship with us, not just a
surface one.
上帝希望我们来感知他的存在；但是他希望我们之间是一个亲密的关系，而不仅仅是一个表面上的。
4.as well as 和…一样
例句：She can play tennis as well as basketball.
她也会打篮球，也会打网球。
第10期
Having decided on the course to take, she then has to become the patient's advocate and interact with the surgeon, the radiation oncologist, or other consultants on the patient's behalf and with the patient's best interests in mind.
决定好治疗方法之后，医生不得不化身为患者的支持者，并与外科医生、放射肿瘤学家，或者是其他能够代表病患和把病患的利益放在心中的顾问进行交谈。
It is then necessary to spend time with the patient to explain the disease and what is to
be expected and with the family to answer their questions and as much as possible to
enlist them as allies for the hard times to come.
之后，医生要对患者解释病情，对手术的期望，回答家属的问题，并尽自己的最大可能将家属变成自己的同盟，一同度过难关，这些都是非常有必要的。
Further, she has to commit herself to the long-term counseling, reassurance, and constant caring needed by a patient with a chronic and possibly fatal disease.
此外，对于身患慢性病甚至是致命疾病的病患来说，她还要投身到对他们的关心、安慰当中来。
This physician's role is much different from that of a physician-technician who performs a procedure and then sends the patient back to the doctor who will care for the long-term needs.
对于技师来说，医生与其截然不同，技师只是完成流程，之后将病人送到那些关心病患需求的医生手里。
While technicians' roles in this process are often crucial,
their interactions with the patient are brief.
而在此流程中，技师所扮演的角色通常也是非常重要的，他们与病患的沟通是简短的。
The health care manager, in this case the oncologist, knits the technical information Together and confers with her patient about the best way to proceed.
在这里作为肿瘤学家的健康管理者需要将技术信息整合，并将最佳的治疗方案告诉病患。
The physician who takes responsibility for the total oversight of the patient's needs
as related to the disease is the one who really must captain the ship and with whom
the patient needs a very special, trusting relationship.
医生全权负责照料病人、满足他们与疾病相关的各种需求；医生负责掌控全局，病人也需要与其保持一种十分特殊而又相互信任的关系。
1.interactions with 交流
例句：Not just in the contract but in my interactions with them.
不仅仅局限于合同，而是我与他们的相互交流。
2.different from 与…不同
例句：Now it is different from the past.
现在和过去不同了。
3.necessary to 必要的
例句：I don't think it necessary to rake up their old quarrels.
我认为没有必要再提他们过去吵架的事。
https://www.doczj.com/doc/d916557650.html,mit to 致力于
例句：Other social people who have undergraduate or above experience and want to commit oneself to international legal affairs later.
本科或本科以上学历，致力于从事国际化法律事务的其他社会人员。
第11期:
HELP WITH SUFFERING
帮助遭受病痛的患者
Most chronic diseases involve physical, mental, and emotional suffering to some degree during their courses.
在患病过程中，绝大多数慢性病都会对病患的身心造成一定的痛苦。
Some patients do beautifully because of their own intrinsic personalities, strong wills, or deep convictions.
许多病患的性格坚毅，内心坚强，对战胜疾病有着坚定的信心，所以他们能够获胜。
Others have great difficulty and sometimes even the toughest break under the severe suffering of a chronic illness.
而还有一些病患会遭遇到困难，有时甚至会在极端痛苦的情况下败下阵来。
Physicians must develop skills of interpersonal relationship based on familiarity with all sides of life and especially with suffering.
基于对生活各个方面的了解，特别是对处理病痛的了解，医生必须提高与病患交往的技能。
They need to participate in suffering.
他们需要亲身参与到病患的痛苦之中。
They need to be able to relate it to a broad range of experience so that they can deal with an enormous variety of patients at many different stages of coping with their suffering.
他们需要对病患的痛苦有着更加广泛的理解，这样在不同阶段处理病患痛苦时，他们就能够应对各种各样的病人。Students sometimes get a glimpse of this in dealing with patients on inpatient services, but most often in outpatient clinics where they treat chronic diseases that continue unabated for many years.
在应对住院病人时，学生有时也会面对这样的状况，但是那些接收慢性病患者的急诊室学生多年来依旧如此。
Often the physician has little specific therapy to offer except a kind touch, a gentle presence, and a knowing acknowledgement.
除了送上亲切的问候，无微不至的探望外，通常情况下医生并没有具体的治疗方法。
Students of medicine learn through experience with patients as their own involvement in the practice of medicine grows through the years.
医学专业学生通过实践来增长知识，同时在这几年当中，他们的亲身经历也将让他们的行医技术有所提高。
The best physicians are always learning, because each patient teaches something new about the way in which a particular kind of suffering must be considered and ameliorated.
杰出的医生总是在不断的学习之中，因为医生能够从每名患者身上学习到新东西，那就是病患的痛苦需要得到关怀和改善。
In the last two decades, patient support groups have become more numerous and more widely sought by patients.
在过去20年里，病患对这些组织表示了支持，这些组织在数量上也不断增加，越来越多的病患也在广泛寻求着组织的帮助。
Many are now associated with major medical centers.
如今，许多组织已经与一些主要医疗中心相结合。
These groups play a vitally important role in allowing patients to express their concerns and fears and to hear other patients in similar situations share their concerns and frustrations.
病患能够讲述自己的担心，忧虑，病患之间能够分享自己相同的痛苦，而这些组织在整个过程中占据着重要地位。
As important as these are, as constructive as they are? and as meaningful as they have become in the overall care of patients, physicians still must understand the circumstances and the degree of suffering of each patient.
尽管这样的活动对患者的综合治疗很重要、很有建设性、很有意义，但医生仍需要了解每个患者所处的环境和病痛的程度。
Each one's needs are unique.
每名患者的需求是不同的。
Merely sharing them does not make them go away, and merely knowing that someone else also carries burdens does not solve the problem.
而仅仅是分享忧虑并不能驱走病痛，仅仅对同样受此痛苦的人有所了解并不能解决问题。
The physician must be interactive and supportive，even when the ways to change the physical situation may be sadly limited.
即使这对于改变病情本身的影响不大，但是医生也必须要与病患进行互动，给予他们支持。
1.carry burden 承受负担
例句：It was simply too heavy and too painful to carry the burden of hating millions of people.
仇恨数百万人是一种太过沉重、太过痛苦的负担。
2.strong will 坚强的意志
例句：She had a strong will and power of rapid decision.
她具有坚强的意志和速决的才能。
3.based on 基于
例句：The plan of our country is based on a rising economy.
我国的计划建立在不断发展的经济的基础上。
4.interpersonal relationship 人际关系
例句：But fairly quickly, the interpersonal relationship becomes more intimate and from that moment the two potential lovers may be defined as a …cyber couple?.
但很快地，这种人际关系会变得更为密切，从那一刻起，这两位潜在的情侣就可能被定义为“网络夫妇”。
第12期
HELPING WITH AGING
帮助老年人
The past several decades have seen a remarkable increase in the proportion of the
population over 65, over 75, and even over 85 years of age，
the last being the fastest-growing of all age groups.
在过去几十年间，65岁，75岁，甚至是85岁以上的老年人口比例明显增加，而85岁以上人口的增长速度最快。These proportions will continue to increase significantly.
而这一比例仍将会大幅度增长。
Already the average age of the practice population in the offices of many general internists
exceeds 70 years.
对于许多内科医生来说，病患的平均年龄也已经超过了70岁。
This demographic shift has been accompanied by increasing awareness of the general field of geriatric medicine and expanding knowledge of the biologic processes involved in aging.
随着人口结构发生改变，老年医学知识得到普及，衰老的生物学进程被逐步认识。
Projected population trends indicate that every general internist must become experienced
in the needs of the geriatric population as the aging process involves essentially every organ system.
预计的人口趋势表明，每名内科医生都必须在治疗老年患者上有足够经验，器官系统也将随之发生老龄化过程。
However, there are at least two，the nervous system and the musculoskeletal system，with
which essentially every person reaching the seventh, eighth, and ninth decades of life will experience trouble to an increasing degree.
但是，神经系统和肌肉骨系统，至少这两个系统会让每名70,80以及90岁的老人承受因老年化所带来的痛苦。Memory loss of some degree is essentially universal in the elderly, although it clearly is more pronounced in some than others and may or may not be associated with the true clinical syndrome of Alzheimer's disease.
从某种程度上来说，失忆症会普遍发生在老年人身上，尽管有些人的症状更为明显，失忆症与老性痴呆的真正临床表现或许有关，也或许无关。
Memory loss affects the individual's self-perception, ability to interact with friends and family,
and ability to accommodate to the pressures of our changing world.
失忆症对个人的自我认知，家人朋友的沟通能力，以及因变化所产生的压力适应程度都构成了影响。
It can put barriers between the individual and those he or she most needs.
这种病症会让病患的迫切需求和自身产生分歧。
This is true even for the very lucky individual who is able to maintain work activities, friends, and family as he or she did in his prime.
而这对于那些能够像在盛年时期那样维持工作，与家人和朋友进行往来的幸运病患来说，这也一样会发生在他们身上。The same situation develops with osteoarthritis, as gait problems, muscle fatigue, and
weakness become more prevalent with advancing age.
失忆症会发展成骨关节炎，步伐问题，肌肉疲劳以及虚弱，这些在老年人中更加普遍。
These effectively limit the individual's ability to get away from home and sustain a normally
active lifestyle.
这些将限制病患外出，维持积极的生活态度。
Physical difficulties simply prohibit him or her from doing the things he or she likes to do.
身体上的障碍仅仅会阻碍病患去做他们喜欢做的事情。
Much of the focus of the general internist, therefore, is to keep the elderly individual as
physically and mentally active and as personally and emotionally interactive with others as possible.
所以，内科医生的重中之重就是要让老年病患在身体和心理上保持活跃，让他们尽可能的与他人进行情感上的沟通。1.nervous system 神经系统
例句：They now almost invariably study the nervous system in relationship to one or another behavior.
人们现在研究神经系统一定会考虑与这种或那种行为的关系。
2.prohibit him 禁止
例句：Bush hopes to go to Alaska to start a new life on the road, Bush let Philip prohibit him
from the mother to do list and is ready to let him try one by one.
布什希望到阿拉斯加去开始新的生活，路上，布什让菲利普把母亲禁止他做的事一一列出并准备让他逐个尝试。
3.musculoskeletal system 肌肉骨系统
例句：Vitamin D strengthens the bone and musculoskeletal system.
维生素D可增强骨骼和肌肉骨骼系统。
4.interactive with 互动
例句：In the way maybe not so much in China. They have to be very interactive with their professors. 可能和中国的情况不太一样，他们必须和他们的导师进行互动，要有自己的想法。
第13期
Loneliness, despair, chronic illness, and depression are all prevalent in the geriatric population. 在老年群体中，孤独、绝望、慢性病以及抑郁症非常常见。
Our effort must be to treat individual symptoms and organ system failure as they appear, but
most important, to help aging individuals develop an overall lifestyle that gives them a sense of
well-being，of being useful, of being appreciated, and of having meaning in their lives.
当个体出现症状，或是器官系统衰竭时，我们必须采取措施，但是最重要的是让老年人得到幸福感，让他们感觉自己还有用武之地，能够得到人们的肯定，让他们的生活更有意义。
The internist must devote increasing time and effort to aging patients and must be particularly sensitive to subtle changes in their environments,
内科医生要增加他们对待老年病患的时间和精力，并对周围环境中的细微变化特别敏感，
including the loss of a loved one, shrinking income relative to cost of living, dislocation from
their homes, and the despair that comes from being unable to adjust to new surroundings
such as a retirement center or nursing home.
包括失去至亲的痛苦，生活收入减少，远走他乡，以及因无法适应新环境而带来的绝望感，例如在退休疗养中心或是养老院。
Each of these profoundly affects the way a patient reacts to physical diseases.
这些都将对病人对抗疾病造成深远的影响。
The responsibility of the internist extends beyond the usual in this situation and requires a very special integration of medical knowledge and knowledge of how people adjust to their changing needs.
内科医生的责任范围超过了他通常遇到的情况，这就需要他们将医疗知识与如何让病人适应需求的认识结合起来。HELP WITH DYING
帮助临终患者
Rarely does an individual really wish to die, but when the time does come patients want to die
with dignity.
很少有人想要终结生命，但是当这一天来临的时候，病人希望能够有尊严的死去。
What most of us desire above all is not just life, but a satisfactory quality of life, and we may sometimes quite rationally risk death to escape an unacceptable life.
最重要的是，绝大多数人不仅仅需要生活，他们需要的是一个令他们满意的生活质量，但是有时，我们会为了逃避那不可接受的生活而走向死亡。
Issues surrounding dying patients and even the realistic definition of death are topics
frequently encountered by today's internist.
如今，围绕着临终病患，甚至是关于死亡的真正定义等问题一直围绕着内科医生。
It is an often, if sometimes faintly, praised triumph for modern medicine that we now have the technologic skills and instrumentation to keep essential body functions such as circulation
and respiration operating almost indefinitely.
我们现在已经拥有这样的技术和设备来维持重要的机体功能如循环、呼吸，使它们几乎无限期地运转，这一点是人们经常称颂的现代医学成就。
The ability to continue these functions regardless of the expected outcome for the patient has produced considerable ethical conflict for many who deal with patients in critical life support areas and intensive care units.
无论这样做会给病患带来什么样的后果，对于那些工作在重症监护室治疗病患的医生来说，继续维持机体功能引发了诸多道德冲突。
1.regardless of 不管
例句：The fields give high and stable yields regardless of climatic circumstances.
不管天气条件如何，这块地总是保持稳产高产。
2.wish to 希望做
例句：Take any of the things you wish to do (It doesn't matter which one.), and do it, and only it.
在你想要做的事情中任选一件（任一件都可以），只做这一件，把它做完。
3.react to 作出反应
例句：He reacted well to penicillin.
他对青霉素的反应良好。
4.sensitive to 对…敏感
例句：If you are sensitive to caffeine, avoid it in the afternoon and evening.
如果你对咖啡因敏感的话，在中午和晚上就避免饮用。
第14期:
Young people in medical training must make an effort to become "comfortable" with the process
and the event of dying.
医学培训期间，年轻医生要能够对整个过程以及临终病人坦然面对。
The problems of when to withdraw life support mechanisms or to withhold resuscitation
may present deep emotional conflicts for medical students as well as for many very
experienced physicians.
不管是对医学学生还是对资深医生，何时停掉生命维持器，或是何时停止抢救病患都会带来情感冲突。
Although medical ethics touches almost every aspect of health and the practice of medicine, the particular problems related to dying patients, stemming in part from legal considerations and
from highly publicized special cases, put the physician in an especially difficult position.
尽管医学道德问题几乎牵扯到医疗以及治病救人的方方面面，然而这种特殊问题却让医生处在非常被动的位置上，部分是来自法律方面的考虑，而部分原因是它是公众高度关注的问题。
Only recently have objective conclusions begun to emerge from clinical investigation of
outcomes from intensive care units.
直到最近，我们才从重症监护室的临床研究中得到了客观结论。
Although striking successes do occur, the survival rate with a high quality of life upon
discharge from intensive care units is less than one would hope.
尽管我们取得过胜利，但是在病患本身条件良好的基础上，重症监护室的病患存活率要比人们所期望的低。Therefore, the physician frequently may be required to make difficult decisions for or with the patient and his or her family.
以至于医生要被频繁要求与病患，或是病患家属作出艰难抉择。
Ultimately, society at large will have to make policy regarding those decisions, using information based on careful clinical studies and analyses of the costs of sustaining life in truly hopeless situations.
所以，社会需要就这些决策制定政策，并以细致的临床研究，对费用分析的基础之上利用这些信息，前提是这些费用是在无希望治愈，为了维持生命的情况下而产生的费用。
But that policy has not yet been established.
但是社会并没有制定这样的政策。
In this area the skilled internist plays a uniquely personal role in preparing patients for terminal situations, becoming their teacher and confidant as they come to understand the disease
process and what to expect.
在这方面，资深的内科医生在帮助病患为临终做准备时扮演了非常特殊的个人角色，在让病患了解疾病过程以及期望时，他们变成了病患的老师和知己。
The physician is also called upon to help the patient's loved ones prepare for the outcome.
医生还要帮助病患的至亲做好准备。
Every patient must be considered individually, keeping in mind previously expressed wishes,
the nature of the terminal illness, the likelihood of recovery with an acceptable quality of
life, and family wishes and interactions.
每一名病患情况都必须进行考虑，把对之前的期许，疾病晚期的特征，治愈的可能性以及家属的希望和谈话牢记在心。Although these factors are difficult to weigh in the care of dying patients, objective evaluation
and an unswerving concern for the patient will lead the physician to the best course of action.
尽管，在治疗临终病患时这些因素很难权衡，但是对病患作出客观评估，对病患无微不至的关怀都将让医生采取最佳的诊疗方法。
1.objective evaluation客观评价
例句：One of the important features of CCT programs is that many have advanced monitoring components that allow an objective evaluation of their results.
有条件现金资助项目的显著特点之一是，很多项目都设有现金的监测子项目，这便于对项目成果进行客观评价。
https://www.doczj.com/doc/d916557650.html,fortable with 舒适
例句：I feel very comfortable with the familiar quiet of the villagers.
我觉得非常舒适与熟悉的安静的村民。
3.make decision作决定
例句：I see. I would discuss it with my family and make decision as soon as possible.
我明白了。我要和家人商量一下然后尽快做出决定。
4.emotional conflict情感冲突
例句：Strong spiritual impact on the intense emotional conflict, leading them to produce
art on the evolution of the concept, but also so that they release a tremendous artistic passion. 强烈的心灵震荡，激烈的情感冲突，在导致他们在艺术观念上产生嬗变的同时，也使他们释放出了巨大的艺术激情。第15期:
While an internist may be defined as one trained in the principles and practice of medicine,
内科医生可以被定义为既有理论，又有实践，
a fuller description emphasizes his possession of uncommon knowledge of biologic science ranging from molecular events to whole organ system physiology,
内科医生侧重的是对从分子到所有身体器官机能等生物科学知识的掌握，
a special appreciation for human life and the needs of suffering people,
他们需要对生命怀着特殊的感激之情，并对病患的需求给与关注，
and a comprehensive perspective on modem society，its influence on our lives and its
stresses on our social structure.
现代社会对生命所产生的影响，以及它对社会结构的重要性，内科医生要对这些有着全方面的了解。
Although this chapter has emphasized patient/physician interaction, we must recognize that
basic biomedical science provides the infrastructure for our profession.
尽管这一章节我们强调的是医患关系，但是我们必须要认识到的是，基础生物科学是医学的基本。
新编大学基础英语综合教程第一册教案 -CAL-FENGHAI-(2020YEAR-YICAI)_JINGBIAN
本科课程教案 2017-2018 学年(第 1 学期) 课程名称：大学英语CI 课程性质：□通识必修课□大类基础课□专业核心课 □专业拓展课□通识限选课□通识任选课 授课班级：17产品设计1班(32人）、环境设计七班（30人）学生数：共62人 授课教师：庞海才 学分/学时： 6/75 学时分配：理论讲授学时，课堂讨论学时 实验/课内实践学时，在线学习学时 课程设计(周) 系（教研室）负责人（签名）： 主管教学院长（签名）：
审核通过日期：年月日
Unit 4 What’s On? I．教学目标Objectives Students will be able to: ?Talk about free time activities ?Match descriptions to photos ?Introduce and practise the use of the -ing verb form after go, like and love ?Use expressions of frequency to talk about habits in a quiz II. 课时安排Time Allotment（体现重点、难点） 1st period:Lesson 1) 2nd period: Lesson 2 3rd period: Lesson 3 4th period: Lesson 4 III. 教学方法与手段 Teaching Methodology ?Student-centered approach Student-centered learning requires students to be active, responsible participants in their own learning. Instead of lecturing through the whole class, the teacher t akes students interests into account, follows their passions, capitalizes on their strengths and helps students form a strong learning community. ?Task-based approach The main aim of this approach to learning is task completion. Usually, relevant and interesting tasks are set by the teacher and students are expected to draw on their pre-existing knowledge of English to complete the task. IV. 教学内容及过程Tasks and Process Lesson 1 Time Out ?Lexical Preparation ?Vocabulary &Listening 1. Work in pairs. Find phrases to describe the photos below. Key: a. I go swimming. b. We go to concerts. c. We go rollerblading on the seafront. d. I sit in a café and read the paper. e. We spend hours playing computer games. f. I work out in the gym. 2. Work in pairs. Look at the above list and ask your partner: What do you do in your free time? 3. Listen to Nikki and Martin answering the same questions. Tick the activities they mention. 4.Listen again. Match the answers to the questions and write the name of the person w ho’s speaking (Nikki or Martin).
选词填空： 1.AS is the case with so many organs ，the function of the heart is rather complicated 2.An electronic sound system represents the integration（整合）of thousands of components。 3.A drastic（激烈的）action is one that is violent ，and perhaps desperate 4.Anxiety（焦虑）is best allayed by the prompt institution of the measures already mentioned and strong reassurance 5.Because of the dilatation（扩张）the total muscle mass of the ventricle increased，and the most obvious hypertrophy is seen in the trabeculae of the inner layers of the ventricular wall 6.Chewing ginseng is a prophylaxis（预防）against infections 7.Diabetes（糖尿病）is one of the leading causes of death and remains a serious health problem in all parts of the world 8.Disease is a concomitant （伴随物）with poor sanitation 9.In case in which standard therapy（治疗）fails，pulmonary artery catheterization can help define the need for additional vasodilator therapy。 10.If the pain should recur（复发），take this medicine 11.In patients who are hypoxemic ，normocapnia or hypercapnia （高碳酸血症）may reflect severe flow obstruction and fatigue 12.In the process of living，organisms（有机体），may get into our bodies。 13. It is becoming increasingly clear that atrioventricular junction ablation（消融）is no longer considered by many a tactic of last resort
临床医学英语的课文参考译文整理版
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第二单元 骨质疏松与骨骼的危险因素 骨质疏松可能几十年也没有任何症状。因为除非骨折，它不会引起任何症状。有些骨质疏松性骨折数年后才能诊断出来。因此，只有发生带来痛苦的骨折时，患者才能意识到自己的骨质疏松。而骨质疏松症状和骨折部位有关。 脊椎骨折可引起严重的带状疼痛，疼痛从后背扩散到身体的两侧。几年时间，反复的脊椎骨折可引起身高变矮，脊椎弯曲和后背下端长期疼痛。脊椎弯曲使得患者出现驼背现象，通常称为“罗锅”。 日常生活中发生的骨折叫做压迫性骨折。例如：有些骨质疏松患者走路或下台阶时，脚部会出现压迫性骨折。 跌倒时通常发生髋部骨折。如果患有骨质疏松，非常轻微的磕碰都能造成髋部骨折。由于骨骼的质量较差，即使行外科手术治疗，髋部骨折也很难治愈。 根据国际骨质疏松基金会今天在世界骨质疏松日公布的报告披露，如果吸烟，每天饮酒两杯以上，不锻炼身体或饮食不佳，晚年就会患骨质疏松。 国际骨质疏松基金会主席Daniel Navid在迪拜召开的记者招待会上说：“预计到2050年，因骨质疏松造成的髋部骨折发生率，男性将增至310%，女性将增至240%。骨质疏松导致的骨折通常意味着疼痛，功能丧失，严重病例会导致死亡。” “战胜骨折”报告作者及国际骨质疏松基金会成员Cyrus Cooper教授说：“世界范围内，骨质疏松发病率正以流行病的发病增长——50岁以上,有1/3的女性和1/5的男性患骨质疏松性骨折。但是，如果人们年轻时就认识到骨质疏松的危害并采取适当措施，将对晚年时期的骨骼健康有着巨大的积极影响。” 国际骨质疏松基金会敦促人们接受国际骨质疏松基金会一分钟骨质疏松危险因素检查。此外，采取对骨骼有益的生活方式，如营养饮食，定期锻炼，不吸烟，不酗酒，这些都会有助于形成健壮的骨骼，防止骨折。 危险因素主要分为两大类：可修正的和不可修正的危险因素。尽管我们无法控制危险因素，如年龄，性别，家族史，但还是有些能减轻其影响的办法。 可修正的危险因素 可修正的危险因素主要源于不健康的饮食或生活方式的选择，包括营养不良，身高体重比偏低,饮食失调，喝酒，吸烟和缺乏锻炼。这些危险因素大部分直接影响骨骼健康，导致骨密度降低。（BMD） 喝酒 欧洲,北美洲及澳大利亚的研究表明，无论男性还是女性，每天饮酒量超过两杯会就加大骨质疏松和髋关节骨折的危险。 吸烟 吸烟同样增加人的骨折危险。国际研究已经表明，吸烟使髋关节骨折的危险增加1.5倍。在瑞典进行的研究表明，18到20岁的男性吸烟者，其骨密度降低。这项研究结果尤其令人担忧。因为它表明，年轻人吸烟可以降低骨质峰值——而骨质在20岁到25岁形成——因此增加他得晚年患骨质疏松的危险。 身高体重比偏低 身高体重比（BMI）偏低是检测人瘦的尺度，也可以用来提示患骨质疏松的危险度。医生认为，BMI在20到25之间是理想值。19以下表明BMI太低，有患骨质疏松的危险。 营养不良、饮食钙摄取量低 营养不良与BMI低紧密相连，它能影响骨骼健康。当饮食中钙的摄取量不足时尤其如此。钙是骨矿物质的基本成分，对肌肉，神经和人体的其它细胞也是十分重要的。 维生素D缺乏 主要通过皮肤暴露在阳光下获得的维生素D十分重要，因为它帮助从肠中吸收的钙进入到血液中。通常，儿童和成人每天把面部、手和胳膊暴露在阳光下10到15分钟就足够了。 饮食失调 饮食失调，如神经性厌食、贪食，也能引起骨质疏松。这些情况都能大大降低钙摄取量，加速骨矿物质流失。 运动量不足 久坐的人比经常运动的人更容易发生髋关节骨折。例如：每天坐9个小时以上的女性，其髋关节骨折的机率比坐6个小时以下的女性高50%。 经常跌跤 90%的髋关节骨折都源于跌跤。视力障碍、丧失平衡、肌肉神经紊乱，痴呆、卧床及老年人中常见的服用安眠药
Unit1肺和肾的功能 肺的血管系统 肺从两个血管系统----支气管循环系统和肺循环系统获得血液供应。它的营养血液来自于支气管循环系统，流向肺部除肺泡外的所有组织，因为支气管循环系统始于主动脉及上肋间动脉，接受大约1%的心输出量。大约三分之一的支气管循环的静脉输出流入全身静脉，然后回到右心房。剩余的输出流入肺静脉，并在心脏最小静脉的作用下，在正常情况下，以1%-2%的量自右向左分流。 肺动脉系统沿着气道从肺门向外周延伸，向下连接下段气道（直径大约2毫米）的动脉，它们壁薄且富有弹性。从这儿开始，动脉成肌肉化发展，直至其达到30微米，此时肌层消失。因为这些小肌肉动脉起着积极控制肺部血流分布的作用，所以大部分动脉压降产生在这些小肌肉动脉中。肺小动脉将血液排空，送入广泛分布的毛细血管网，进入肺静脉。肺静脉的壁很薄，它们最终在肺门处与动脉和支气管汇合，出肺进入左心房。 肾结构成分 人类肾脏在解剖学上位于腹膜后隙，与下胸椎和上腰椎平行。每个成年人的肾脏大约重150克，长、宽、厚分别为12厘米、6厘米以及3厘米。肾脏的冠状部分分为/由两个明确的区域（组成）。外周部的皮质大约1厘米厚，深部的髓质由几个肾锥体构成。这些锥体状结构的底部位于皮髓质结合处。锥体的顶部伸入肾门，称为肾**。每个肾**被一个肾小盏包裹。肾小盏与肾大盏相聚组成肾盂。经肾**流出的尿液汇集在肾盂，通过输尿管排入膀胱。 由主动脉分支出来的肾总动脉为两肾输送血液。肾总动脉通常分为两个主侧支，这两个侧支又进一步分为叶动脉，为肾脏上、中、下区域供应血液。当这些血管进入肾实质，变成叶间动脉通向肾皮质时，（这些血管）又进一步细分。细分后的更小血管在皮髓质结合处成为竖支--弓状动脉。从弓状动脉伸出的叶间动脉进入皮质。由于传入小动脉始于这些末端叶间动脉，所以为肾小球毛细血管输送血液。 组织学上，肾脏是由一个叫做“肾单位”的基本单位组成。每个肾脏约含有一百万个肾单位，“肾单位”有两个主要成分：过滤成分―紧包着毛细血管网（肾小球）和一个附着在上面的小管组成。这个小管包含几个明显的解剖和功能成分。 Unit 2细胞与衰老 衰老是一种正常的生理过程，伴有肌体内平衡适应性反应的进行性改变。研究老年人健康问题和保健的特殊分支称作老年医学。 衰老的明显特征众所周知：头发花白和脱落，牙齿脱落，皮肤起皱，肌肉减少，脂肪积存增加。衰老的生理征兆是肌体对环境压力反应的功能和能力逐渐减退.。如同保持不断地体内平衡应对温度、饮食和氧供反应变慢一样，机体代谢也减慢了。衰老的这些迹象与机体中细胞数的净减少及存余细胞的功能缺失有关。 衰老的另一个表现是组织的细胞外成分也随年龄的变化而变化。负责肌腱力量的胶原纤维的数量增加，而质量却随着衰老降低。动脉壁胶原质中的变化造成动脉壁伸展性缺失，如同动脉壁上的积聚物造成动脉粥样硬化（即动脉壁脂肪物质堆积）一样。弹性蛋白是另一种细胞外成分，主要负责血管和皮肤的弹性。随着年龄的变化，它的变粗，变碎并需要获得更大的钙亲和力，这些可能也是造成动脉粥样硬化的原因。 葡萄糖在机体中是最丰富的糖类，它在衰老的过程中也可能起作用。根据一个假设，任意给细胞内外的蛋白质增加葡萄糖，结果会在相邻蛋白质分子间形成不可逆交联。当人衰老时，会形成更多的交联，这可能导致正在衰老的组织变得僵化，丧失弹性。 虽然正常情况下，每分钟会有好几百万的新细胞产生，但人体有几种细胞：心脏细胞，骨骼
本科课程教案 2017-2018学年(第 1 学期 ) 课程名称：大学英语 CI 课程性质：□通识必修课□大类基础课□专业核心课 □专业拓展课□通识限选课□通识任选课 授课班级：17 产品设计 1 班(32 人）、环境设计七班（ 30 人）学生数：共 62 人 授课教师：庞海才 学分 / 学时：6/75 学时分配：理论讲授学时，课堂讨论学时 实验 / 课内实践学时，在线学习学时 课程设计( 周) 系（教研室）负责人（签名）：
审核通过日期：年月日 《大学英语 CI 》是教授英语语言知识和英语学习策略，培养学生外语综 合应用能力和跨文化交际为主要内容的必修课，教学对象是艺术专业大一学 生。课程以外语教学理论为指导，以“课堂教学+计算机和网络的自主学 习”模式为主，集多种教学模式和教学手段为一体，旨在培养学生的英语 课程简介综合应用能力，尤其是听说能力；同时，提高他们的自主学习的能力和综合 文化素养，以适应我国社会发展的需要和国际交流的需要。 该课程采用形成性评估和终结性评估两种形式来评估学生学习效果。形成 性评估包括课堂活动记录、课后任务记录等形式。终结性评估包括期中测评、 期末总评。 教材名称、新编大学基础英语综合教程1、 2 高等教育出版社 出版社、出版新视野大学英语（第三版）视听说教程1、 2 时间、版次新编大学基础英语训练与自测1、 2高等教育出版社 （含中英文教 材） （含参考书目、案例材料、阅读材料，网络教学资源等） 新编大学基础英语训练与自测1、 2 新视野大学英语（第三版）长篇阅读1、 2 参考书目 及文献（或 网络教学资源） 形成性评估：平时作业、网络学习、课堂表现、期中考试、期末考试考试考核方式 （含期中考试、 小测验、作业）
第一单元 A 篇 预防保健与整体医疗 预防保健 预防保健指的是某种生活方式和医疗保健（例如疾病筛查）的实施，其目的在于延长健康的状态和避免某一特定常见病的发生（如心脏病，癌症，和由于谷蛋白和其他饮食敏感引起的免疫系统疾病）。我认为更多的精力和卫生保健资金应该用于预防疾病，这样一来治疗疾病所需资金会相应减少（由于疾病减少）。 这种方法同样适用于筛查某一特定疾病。这就是我用谷蛋白敏感性作一例子的理由。现在我们拥有技术在儿童的生长过缓之前，在不可逆的骨质疏松症发生之前，在其它自身免疫疾病产生之前，在淋巴瘤和其他癌症发生之前，应用科学技术在早期来测试其对谷蛋白的免疫反应。我认为对可测出的谷蛋白敏感和（或）肠功能异常不应该置之不理，我坚持对小肠的伤害情况应该饮食调节之前进行活组织检查。多年来病理学家已知道组织损害常伴有功能损伤。恰恰是功能损伤而不是组织损害应当引起重视。谷蛋白敏感进行饮食调节只是在人生中为了达到最佳健康而实施的保健措施的一个方面。其它更为重要的方面包括其它保健干预措施，比如避免吸烟、防止过量饮酒、不使用毒品，锻炼身体，健康营养摄入，以及良好口腔卫生。详情，请见下文“健康和营养十步曲”。 整体医疗 整体医疗观或整体医疗，虽然有时易混同于一种可供选择的医疗实践，但实际指的是人的全面整体健康的保持（包括生理，情感，心理和精神），而不仅仅指健康或身体系统的某个方面。例如，作为胃肠道疾病专家，人们通常只咨询胃肠类疾病的相关问题。仅关注肠道疾病的症状并进行药物治疗是典型的传统医疗法。但是，我更支持整体医疗方法。众所周知，情感因素、饮食因素、压力和体育活动（如过度运动）都会极大影响肠功能。为了取得胃肠疾病治疗或任何其它身体系统疾病治疗的最长期效的成功，以上所有这些方面都应重视。因此，对有症状或无症状的个人最好的医疗服务就是提供一种针对整个人（因而被称为“整体”）的评估和治疗的方法来保持其健康，而决非仅针对某一特定部位。 我的“健康和营养十步曲”就体现了我的整体医疗观。 “健康和营养十步曲” 摄入品种广泛富于营养，能量适当，益于吸收和健康的食品； 充足睡眠，遵循最适合你的有规律的生物钟（夜间睡眠至少8小时，日出前起床最佳）； 每天进行体育锻炼，最好在户外阳光下； 每天用非药物减轻压力方式（尤其通过锻炼、沉思、祈祷，以有可能避免压力）； 不吸烟，不饮酒，及其它可以改变情绪的物质； 采用各种方法保持口腔清洁（经常刷牙并用牙线清洁牙齿）； 如果可能，尽量避免接触食物、水和空气中的毒素； 想办法玩，大笑、以愉快感恩积极的心态面对自己的人生； 帮助他人，已所不欲，勿施与人； 在生活中力求平静、安宁、谦逊、简朴与爱。
Unit2 The Musculoskeletal System 骨骼肌系统 骨骼肌系统的构成 ⑴骨骼肌系统包括骨骼系统和肌肉系统。骨骼系统由骨骼和骨关节之间构成各种连接的各种组织组成。成人的骨骼系统一般有206块骨和200多个关节，约占人体总重量的12%到15%。 ⑵肌肉群织有三种：骨骼肌、内脏肌（平滑肌）和心脏肌肉（心肌）。但肌肉系统仅指的骨骼肌。内脏和心脏肌肉组织属于其他系统。只有在心脏可见到的心脏肌肉组织属心血管系统。同样，消化道壁的肌肉是消化系统的一部分。肌肉系统大约有640块骨骼肌。占非运动员女性总体重的36%；男性45%。 ⑶骨骼肌是人体的“动力站”，使体能够进行自主随意的运动。所有肌肉的最重要特性是其伸缩性，即产生拉力，需要时，在保持牵张力的同时，改变长度。该性能在骨骼各肌肉组织中得到高度发展。每个完整的骨骼肌由大量长的肌肉细胞组成，这些长肌肉细胞由多层结缔组织联结。在多数肌肉中，肌肉细胞位于肌腹，而肌肉的两端完全由变粗的将肌肉固定在骨骼上的几乎不能伸展的索状结缔组织构成。这些结缔组织的形状由肌肉和所附骨骼面决定。通常，骨骼肌有两种基本形状：束状（狭窄的带状，称肌腱）和宽带状（称腱膜）。 ⑷通常，骨骼肌及其腱和腱膜称为肌肉肌腱器单位。骨骼肌聚合成组，每组附着在骨骼上，这样骨骼肌就越过一个或多个关节。因为肌肉只能朝一个方向牵引，每个关节的运动由一对或多对作用相反的肌肉群控制：一肌肉群负责朝一个方向移动关节，另一肌肉群负责朝相反的方向移动这个关节。因此，肌肉群的各对肌肉称为作用相反的拮抗肌。通过协调关节的每对拮抗肌间的活动，关节的运动范围和速度能得到微妙地控制。例如，踢球，股四头肌和腘绳肌腱作为一对拮抗肌控制髋部关节和膝关节的运动。 ⑸膝关节一般沿轴面横向（一侧到另一侧）运动。但是，其他关节，如髋关节和肩关节可以朝多个面运动。这样，两对或多对拮抗肌就可以同时控制这些关节的运动。 骨骼肌系统的功能 ⑹人的动作由中枢神经系统控制的骨骼肌产生。通过协调不同肌肉群的活动，肌肉所产生的力通过骨和关节传递，使人体保持直立或部分直立的体态，进行自主运动。 ⑺骨骼肌开放性的链条式连结使身体可以采取并完成多种体态和运动。但是，人体为此付出了代价：除平躺外，各种姿态和运动均使肌肉、骨骼和关节承受很大压力。为此，骨骼肌的各个部分承受着张力。压力越大，张力越大。 ⑻体位是指人体的各个部分相对方向，一般指坐姿和站姿。直立时，有两种力作用于人体：身体的重量和地面的反作用力。这两种力综合产生一个使人体瘫倒的压缩负荷。这一压缩负载随着人体负重的增加而增加。显然，在进行各种运动时，要防止人体摔倒，各种关节的运动应当由神经系统控制的骨骼肌很谨慎地控制。 ⑼各肌肉群协调运动通过肌肉产生力，通过骨骼和关节传递使人体保持直立的体位，并进行自主、随意运动。例如，站立时，颈部、躯干和腿部关节必须防止由肌肉引起的运动，否则人体就会瘫倒。这样，整个人体的重量就经两足传导到地面，而两足以各个部分（头、手臂、躯干和腿）的重量由头、躯干和腿部的骨骼和关节形成的骨骼链间接地传了地面。 ⑽在保持直立姿态的同时，身体重量被传到地面，表明力的产生（由肌肉）和传送（通过骨骼和关节）。肌肉产生、关节传送的力是内部力量。身体重量和地面的反作用力是外部力。其他的外部力包括水的阻力、空气阻力以及在与其他物体接触时所产生的力。骨骼肌系统以产生和传递内部力量来消除作用在人体的外部力。 ⑾在任何体位或运动中，肌肉群间的协调运动控制着关节的运动。以便各种力可以通过骨骼传递。这样，人体可以采取不同姿态去承受各种试图使人体变形或移动人体的力（如体重），通常通过手和足的帮助或躲闪身体或使用工具将这些力转到其他物体。 ⑿所以，骨骼肌系统又叫运动系统。本质上讲是机器，一个有动力的机器，用以产生和传递送力量对抗万有引力效应，做出自己想做的运动。
1.London is a very cosmopolitan city伦敦是个非常国际化的大城市。 2. Her mother grew up in the hectic urbon environment.她的母亲是在一种喧嚣的都市环境中长大的。 3 .New York is supposed to be very touristy.纽约被认为是一个充满旅游特色的城市。 4 .The city where I lived a few years ago was dynamic one.我几年前住过的那个城市是一个充满活力的城市。 5. Thetrain was crowded.那班火车非常拥挤。 6. The English often drink tea.英国人经常喝茶。 7 .The earth moves around the sun.地球围绕太阳转。 8 .Last year, I often went to the library of that university.去年我常去那所大学的图书馆。 9 .He left ten minutes ago.他十分钟前离开了。 10. Where did you got last night.昨晚你去哪里了？ 11. Who phoned last night?昨晚是谁打的电话？ 12 .What happened last night?昨晚发生了什么事情？ 13. What does your brother do?你的哥哥是做什么的? 14. Whom is he talking with?他正在与谁说话？ 15. When did they leave?他们是什么时候离开的？ 16. Nowadays young people like to surf the net to get all kinds of information.现在的年轻人都喜欢上网冲浪，获取各种信息。 17 .The Internet is a good place where people can chat and exchange ideas.网络是一个大家可以聊天交流的好地方。 18 .These days I’ve been looking for materials for my paper.这些天来，我一直都在为我的论文寻找资料。
CONTENTS Unit 1Section A Terminology Section B Passages Passage A The Skeletal System Passage B Amplication of DNA by the Polymerase Chain Reaction Unit 2Section A Terminology Section B Passages Passage A The Brain and Its Functions Passage B Other Parts of the Nervous System Unit 3Section A Terminology Section B Passages Passage A Blood Passage B General Principle of Physical Examination Unit 4Section A Terminology Section B Passages Passage A The Endocrine System Passage B Action and Secretion of Hormones Unit 5Section A Terminology Section B Passages Passage A The Digestive System Passage B Clinical and Pathological Conditions of the Diges tive System Unit 6Section A Terminology Section B Passages Passage A Urine Formation Passage B Pathophysiology of the Kidneys Unit 7Section A Terminology Section B Passages Passage A Uterus and Menstrual Cycle Passage B Fertilization,Implantation and Early Develop-ment Unit 8Section A Terminology Section B Passages Passage A The Cardiovascular System Passage B Factors Determining Arterial Pressure and Hypert en-sion Unit 9Section A Terminology Section B Passages Passage A Respiratory System(Ⅰ) Passage B Respiratory System(Ⅱ) Unit 10Section A Terminology Section B Passages Passage A Tumor Passage B Cancer Unit 11Section A Terminology Section B Passages Passage A Cell Death
新编临床医学英语 第1期:病患的问题与诉求 Unit 1 Text A Internal Medicine and Today's Internist 第1单元文章A内科与内科医生 Questions/Pleas of the Patient 病患的问题与诉求 How can I find a good doctor?" 我如何找到一位良医？ How can I find a good doctor whom I can afford?" 如何能够碰到一位价格亲民的医生？ How can I find a good doctor who cares about me as a person? 〃 又如何能够遇见一位把我当成入”看待的医生？ How can I find a good doctor who will take the time to listen and understand ?" 如何找到一位能够花时间倾听我的诉说，了解我的名医？ People who need medical care ask these questions throughout the world every day. 每天，全球有许多病患都在询问这些问题。 They ask them because they face a health care system that is scientifically complex , organizationally overloaded, and generally not oriented to the patient as a person. 他们之所以问这些问题，是因为他们所面对的医疗保健体系技术深奥、机构臃肿，而且一般都没有意识到病人首先是 一个人”。 When an individual first becomes ill, regardless of the symptoms, he or she needs most someone who seems to say, 如果有人生了病，不管症状如何，他们最希望听到的是： "I am a good doctor ；I charge a reasonable amount for my services ；I care about you ，the patient and I will take the time to listen and understand ." 我是医生；我只收取亲民价格，我关心病患，我将倾听你的诉求，理解你。” A prominent teacher/ physician in a major medical center taught his students to listen to the patient and he will tell you what is wrong, and he will tell you what he needs". 主要医疗中心的知名学者/内科医生都会教授学生要学会倾听，病人会告诉你哪里不舒服，也将会告诉你他们的需求。 Having found a physician who answers so profoundly to their needs, some patients are extremely grateful but most are utterly overwhelmed. 有些内科医生完全满足了病患的需求，有些患者表现出了极大的感激之情，但是绝大部分都激动不已。 With the discovery of that relationship, the difference between a superb technician and a true physician really becomes evident to the patient. 有了这层关系之后，专业技师和内科医生的区别在病患面前展露无遗。 That physician /teacher was a scholarly gentleman with deep scientific insight and an active
第一单元肺、肾的结构 肺的血管系统 肺从两个血管系统----支气管循环系统和肺循环系统获得血液供应。它的营养血液来自于支气管循环系统，流向肺部除肺泡外的所有组织，支气管循环系统始于主动脉及上肋间动脉，接受大约1%的心输出量。大约三分之一的支气管循环的静脉输出流入全身静脉，然后回到右心房。剩余的输出流入肺静脉，并在心脏最小静脉的作用下，在正常情况下，以1%-2%的量自右向左分流。 肺动脉系统沿着气道从肺门向外周延伸，向下连接下段气道（直径大约2毫米）的动脉，它们壁薄且富有弹性。从这儿开始，动脉成肌肉化发展，直至其达到30微米，此时肌层消失。因为这些小肌肉动脉起着积极控制肺部血流分布的作用，所以大部分动脉压降产生在这些小肌肉动脉中。肺小动脉将血液排空，送入广泛分布的毛细血管网，进入肺静脉。肺静脉的壁很薄，它们最终在肺门处与动脉和支气管汇合，出肺进入左心房。 肾结构成分 人类肾脏在解剖学上位于腹膜后隙，与下胸椎和上腰椎平行。每个成年人的肾脏大约重150克，长、宽、厚分别为12厘米、6厘米以及3厘米。肾脏的冠状部分分为/由两个明确的区域（组成）。外周部的皮质大约1厘米厚，深部的髓质由几个肾锥体构成。这些锥体状结构的底部位于皮髓质结合处。锥体的顶部伸入肾门，称为肾乳头。每个肾乳头被一个肾小盏包裹。肾小盏与肾大盏相聚组成肾盂。经肾乳头流出的尿液汇集在肾盂，通过输尿管排入膀胱。 由主动脉分支出来的肾总动脉为两肾输送血液。肾总动脉通常分为两个主侧支，这两个侧支又进一步分为叶动脉，供应肾脏上、中、下区域的血液。当这些血管进入肾实质，变成叶间动脉通向肾皮质时，（这些血管）又进一步细分。细分后的小血管在皮髓质结合处成为竖支--弓状动脉。从弓状动脉伸出的叶间动脉进入皮质。由于传入小动脉始于这些终叶间动脉，所以为肾小球毛细血管输送血液。 组织学上，肾脏是由一个叫做“肾单位”的基本单位组成。每个肾脏约含有一百万个肾单位，“肾单位”有两个主要成分：过滤成分—紧包着毛细血管网（肾小球）和一个附着在上面的小管组成。这个小管包含几个明显的解剖和功能成分。 第二单元细胞与老化 衰老是一种正常的生理过程，伴有机体内平衡适应性反应的进行性改变。研究老年人健康问题和保健的特殊分支称作老年医学。 衰老的明显特征众所周知：头发花白和脱落，牙齿脱落，皮肤起皱，肌肉减少，脂肪积存增加。衰老的生理征兆是机体对环境压力反应在功能和能力上逐渐减退，如同保持不断地体内平衡（稳态）应对温度、饮食和氧供反应变慢一样，肌体代谢也减慢了。衰老的这些迹象与机体中细胞数的净减少及存余细胞的功能缺失有关。 衰老的另一个表现是组织的细胞外成分也随年龄的变化而变化。负责肌腱力量的胶原纤维的数量增加，而质量却随着衰老降低（而改变）。动脉壁胶原质中的变化造成动脉壁伸展性缺失，如同动脉壁上的积聚物造成动脉粥样硬化（即动脉壁脂肪物质堆积）一样。弹性蛋白是另一种细胞外成分，主要负责血管和皮肤的弹性。随着年龄的变化，它的变粗，变碎并需要获得更大的钙亲和力，这些可能也是造成动脉粥样硬化的原因。 人体最丰富的糖—葡萄糖，或许也会促使老化。根据一假设，向细胞内外的蛋白质随意地补充葡萄糖，在相邻蛋白分子之间会形成不可逆的交联。随着人的老化，会形成越来越多的交联，这很有可能造成老化组织的僵硬与弹性丧失。 虽然每分钟有数以百万计的细胞产生，人体内有几种细胞却无法再生/复制/被取代，如
教案课程名称大学英语 1
教案书写规范与要求 一、以每次课为一个备课单元书写。 二、每一备课单元书写下列内容： 1.周次、课次、授课时间、章节名称； 2.简要说明：教学目的、重点、难点、教学方法和授课手段（包 括与课程相关的上机和实验、课件制作等）； 3.教学主要内容（教案主体）及教学方法手段； 4.作业内容。 注：其余授课电子版文件待本课程结束后，交教务处统一刻成光盘存档。
大学英语 1课程授课总体计划书 课程《新编大学实用英语英语教程》林立总主编教育科学出版社2011 年 7 月第一次出版 采用 教材 教本课程是学校每个专业的必修课，也是各个专业学生学习高等英语教育的必备。 本教材严格按照教育部颁布的《高等学校英语应用能力考试大纲》和《高职高 学专教育英语课程教学基本要求》进行编写。教学过程中，不仅要结合专业基础 目知识的增强，还需提高学生的实际应用能力。使学生得到听、说、读、写、译的提高。通过本教材的学习，学生们应该具备套用口语句型的基本口语交流； 的在工具书的辅助下翻译基本的英文句子和文段；基础日程英文写作的掌握等一系列基础英语应用能力，以适应未来社会发展和个人职业规划的需求。 教材共分为四册，对于内容的难度的梯度都进行了较为科学的设置。文章以一 般性阅读材料为主，在文章的长度和生词量的设计上梯次递进。在课文长度的 安排上，第一册分 8 个单元，每篇课文 300 字左右；第二册分 10 个单元，每篇 教课文 400 字左右；第三册分 10 个单元，每篇课文500 字左右；第四册分为 10 学个单元，每篇课文 600 字左右。难度也相应的由浅入深。在高中水平的基础上，（从第一册开始，逐步达到高度学校英语应用能力考试(Practical English Test for 包Colleges) B 级水平，从第二册第六单元开始逐步过渡到高等学校英语应用能力 括考试 A 级水平，第三册达到 A 级水平，第四册达到大学英语(非英语专业 )四级实水平。 践通过教学，提高学生基本的语言掌握和运用能力，尤其是实际运用的能力。随着教学的深入，学生需要达到的水平是： 环 （ 1）听：听懂基本的对话，和短的成段的文字。在整体理解听力材料的基础上， 节 提取特定信息完成练习和应对考试； ） （ 2）说：能应对基本的口语对话和交流，以应对最基本的日常生活或者工作的 基 要求。 本 （ 3）读：掌握基本的阅读技巧，在高中的基础上提高阅读水平。通过课文学习，要同时课后适当补充一定的课外阅读材料，可以完成日常基本的阅读训练，培养 求阅读兴趣，提高阅读能力。 （4）写：运用基本的词汇语法完成基本的英文写作，掌握基本的英文写作格式和 表达习惯，同时能够完成英文的基本情况的表格填写。能够表达清楚，语句 基本通顺，无重大语法错误，有恰当的格式。
学术英语医学U n i t课 文翻译 集团文件发布号：（9816-UATWW-MWUB-WUNN-INNUL-DQQTY-
学术英语unit1,unit3,unit4,unit9课文翻译 Unit 1 Text A 神经过载与千头万绪的医生 患者经常抱怨自己的医生不会聆听他们的诉说。虽然可能会有那么几个医生确实充耳不闻，但是大多数医生通情达理，还是能够感同身受的人。我就纳闷为什么即使这些医生似乎成为批评的牺牲品。我常常想这个问题的成因是不是就是医生所受的神经过载。有时我感觉像变戏法，大脑千头万绪，事无巨细，不能挂一漏万。如果病人冷不丁提个要求，即使所提要求十分中肯，也会让我那内心脆弱的平衡乱作一团，就像井然有序同时演出三台节目的大马戏场 突然间崩塌了一样。有一天，我算过一次常规就诊过程中我脑子里有多少想法在翻腾，试图据此弄清楚为了完满完成一项工作，一个医生的脑海机灵转动，需 要处理多少个细节。 奥索里奥夫人 56 岁，是我的病人。她有点超重。她的糖尿病和高血压一直控制良好，恰到好处。她的胆固醇偏高，但并没有服用任何药物。她锻炼不够多，最后一次 DEXA 骨密度检测显示她的骨质变得有点疏松。尽管她一直没有爽约，按时看病，并能按时做血液化验，但是她
形容自己的生活还有压力。总的说来，她健康良好，在医疗实践中很可能被描述为一个普通患者，并非过于复杂。 以下是整个 20 分钟看病的过程中我脑海中闪过的念头。 她做了血液化验，这是好事。 血糖好点了。胆固醇不是很好。可能需要考虑开始服用他汀类药物。 她的肝酶正常吗 她的体重有点增加。我需要和她谈谈每天吃五种蔬果、每天步行 30 分钟的事。 糖尿病：她早上的血糖水平和晚上的比对结果如何她最近是否和营养师谈过她是否看过眼科医生足科医生呢 她的血压还好，但不是很好。我是不是应该再加一种降血压的药药片多了是否让她困惑更好地控制血压的益处和她可能什么药都不吃带来的风险孰重孰轻
Unit1 1.London is a very cosmopolitan city伦敦是个非常国际化的大城市。 2. Her mother grew up in the hectic urbon environment.她的母亲是在一种喧嚣的都市环境中长大的。 3 .New York is supposed to be very touristy.纽约被认为是一个充满旅游特色的城市。 4 .The city where I lived a few years ago was dynamic one.我几年前住过的那个城市是一个充满活力的城市。 5. The train was crowded.那班火车非常拥挤。 6. The English often drink tea.英国人经常喝茶。 7 .The earth moves around the sun.地球围绕太阳转。 8 .Last year, I often went to the library of that university.去年我常去那所大学的图书馆。 9 .He left ten minutes ago.他十分钟前离开了。 10. Where did you go last night.昨晚你去哪里了？ 11. Who phoned last night?昨晚是谁打的电话？ 12 .What happened last night?昨晚发生了什么事情？ 13. What does your brother do?你的哥哥是做什么的? 14. Whom is he talking with?他正在与谁说话？ 15. When did they leave?他们是什么时候离开的？ Unit2 16. Nowadays young people like to surf the net to get all kinds of information.现在的年轻人都喜欢上网冲浪，获取各种信息。