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规培要求-文献翻译英译汉2(总6页)--本页仅作为文档封面，使用时请直接删除即可----内页可以根据需求调整合适字体及大小--Thyroid cancer detection significance of Bcl-2[Abstract] Objective To investigate the expression of Bcl-2 in theincidence of thyroid cancer, development and immunohistochemical methods, mouse anti-human monoclonal antibodies to Bcl-2 mark 77 cases of thyroid cancer, 58 cases of thyroid adenoma and 40 cases of adjacent thyroid tissue and 28 cases of normal thyroid tissue. observe the different thyroid tissue expression of Bcl-2, and compare the positive rate of Bcl-2 positiveresults seen in thyroid cancer, thyroid adenoma and adjacent thyroid tissue. in thyroid carcinoma Bcl-2 positive rate was %, higher than the thyroid adenoma %) (P = , adjacent thyroid tissue %) (P = and normal thyroid Organizations (0) (P = . anaplastic thyroid carcinoma and follicular carcinoma of the Bcl-2 positive rate was significantly higher. presence lymph node metastasis and clinical stage Ⅲ, Ⅳ cases, Bcl-2 positive rate significantly increased. Conclusions Bcl-2 overexpression may be associated with the occurrence of thyroid tumors, cancer tissue expression of Bcl-2can be used as a reference indicator of thyroid cancer prognosis.[Keywords:] Thyroid Cancer, Bcl-2 Gene, Proto-Oncogenes, Gene Expression, ImmunohistochemistryThyroid cancer is a common endocrine cancer, women with a high incidence of clinical thyroid tumors in 5% to 10% of thyroid cancer [1] which differentiated thyroid cancer accounts for 90 percent, including papillary thyroid carcinoma and follicular thyroid carcinoma , undifferentiated carcinoma are rare, its high degree of malignancy and poor prognosis. domestic data show that the incidence of thyroid cancer in a significant increase in [2] In recent years, thyroid cancer-related genes and tumor marker studies progressed very quickly. study confirmed [3,4], Bcl-2 geneis an apoptosis suppressor gene, first discovered in follicular B-cell lymphomas, and its product Bcl-2 protein inhibits apoptosis and prolongcell survival. The Studies using immunohistochemical techniques, bydetecting Bcl-2 in thyroid cancer, thyroid adenoma, thyroid cancer tissue and normal thyroid tissue levels of Bcl-2 study in thyroid cancer incidence in the development process role in order to reveal the Bcl-2 and thyroid cancer biological behavior and prognosis of relationships.1 Materials And MethodsMaterialsAll specimens were obtained from Peking University Shenzhen HospitalGeneral Surgery from 2001 to 2009 cases of thyroid surgery between specimens, including: thyroid cancer, 77 cases (28 males and 8 females, mean 50 years), 58 cases of thyroid adenoma (male 22 cases, 36 females, mean 36 years), while taking 40 cases of adjacent thyroid tissue (10 males and 30 females, with an average 37 years old, had no diagnosed by pathological examination of thyroid cancer invasion), 28 cases of normal thyroid tissue ( 9 males and females l9 cases, mean 35 years). pair of 77 cases of thyroid cancer histological classification according to WHO criteria: 55 cases of papillary carcinoma, follicular carcinoma l4 cases, undifferentiated carcinoma in 8 cases, according to standard clinical AJCC staging : I period of 30 cases, Ⅱ 23 cases, Ⅲ of 16 cases, Ⅳ of eight cases, of which 33 patients with lymph node metastasis, no lymph node metastasis in 44 cases. specimens were fixed in 10% formalin solution, embedded in paraffin buried, routine biopsy, 60 ℃ baking sheet 2 h, 37 ℃ overnight reserve.Immunohistochemistry ReagentsBcl-2 mouse anti-human monoclonal antibody, for the United States ZYMED company's products.SP-9000 Universal kit . ZYMED Company. Using knownBcl-2-positive tonsil as a positive control, with PBS instead of primary antibody as negative space controls.Test MethodsDewaxing hydration, 3% H2O2 treatment at room temperature 15 min, microwave antigen retrieval, normal goat serum incubated 30 min, dropping a resistance, 4 ℃ refrigerator overnight incubation. Dropping biotinylated secondary antibody sign incubated at room temperature 30 min, dropping horseradish peroxidase-labeled streptavidin at room temperature 30 min, DAB color. dyed by hematoxylin, dehydrated, transparent, mounted.criteria Bcl-2 located in the cell membrane and cytoplasm to the cell membrane and cytoplasm appear yellow to dark yellow granules positive cells without Bcl-2 positive cells was negative, there are positive Bcl-2positive cells in all specimens are two pathologists blinded read the piece, the results are inconsistent harmonization judge the final result.Statistical AnalysisAll data using SPSS statistical package on a computer for statistical analysis, for χ.2 test to P ≤ was considered statisticallysignificant.2 ResultsBcl-2 In Different Tissues Of The Thyroid Condition, Are Shown In Table 1.Bcl-2 light microscope showed positive reaction cell membrane and cytoplasm stained tan, brown granules seen as negative.Bcl-2 positive rate of thyroid cancer was %, higher than the thyroid adenoma %) (P ≤ and adjacent thyroid tissue %) (P ≤ , while the normal thyroid tissue were negative. shown in Table 1.thyroid cancer Bcl-2 expression and thyroid cancer related pathological parameters, see Table expression levels and histological type of thyroid cancer, lymph node metastasis and clinical staging a significant relationship. Higher in malignant undifferentiated carcinoma and follicular carcinoma, Bcl-2 were significantly higher than lower grade papillary carcinoma with lymph node metastasis and clinical stage Ⅲ, Ⅳ cases, Bcl-2 was higher than the corresponding without lymph node metastasis andclinical I, Ⅱ stage cases, the di fferences were statistically significant (P <. posted on free download DiscussionApoptosis, also known as programmed cell death, regulated by genes, regulatory genes can be divided into apoptosis gene and apoptosis-promoting genes, both of the shift, the regulation of apoptosis, cells of their research will be solved The fundamental mechanism of apoptosis, but its exact mechanism of action is still not so far fully understood.bcl-2 gene family in the regulation of apoptosis plays an important role, is one of the hot.Bcl-2 gene that B-cell lymphoma / leukemia gene -2 (B-cell lymphoma/leukemia-2), is Tsujimoto, etc. [ 5] in 1984 for the first time in follicular lymphoma B found thus named Bcl-2. normally located in the long arm of chromosome 18 Zone 2 a band to start is by chromosomal translocation (14,18) breaking point Molecular cloning method, fromfollicular lymphoma in the isolated, is believed to be human follicular lymphoma cytogenetics mark by two exons, and its gene product expression in humans cell longevity related to recent years, people discovered throughextensive research, Bcl-2 gene block cell apoptosis effect, it isconsidered to be anti-apoptotic genes [6]. their anti-apoptotic mechanisms, previously reported general said by preventing apoptosis signaling thefinal common pathway and work. Through the bcl-2 and bcl-2 binding protein homologous protein research on the regulation of apoptotic bcl-2 family,the basic model has a new understanding. bcl-2 homolog proteins includingbcl-2, bcl-xL, bax, bad and nematode ced-9, bcl-2, bax can form homodimers can also form heterodimers, bax homodimer formation, induction of apoptosis, bax - bcl-2 heterodimer formation, inhibition of apoptosis, and when thebcl-xs exists, preferentially form heterodimers bcl-2, bax to make free homodimer formation and induce apoptosis, therefore, sometimes bcl-2 expression does not necessarily inhibit cell apoptosis. generally believed, bcl-2 gene expression and tumor cell differentiation and proliferation related to the low degree of differentiation, proliferative ability of the tumor cells, the bcl-2 overexpression trend showed in this study, the authors systematically examined thyroid cancer, thyroid adenoma, thyroid cancer tissue and normal thyroid tissue and other thyroid tissue Bcl -2 expression, as shown in thyroid cancer tissue expression of Bcl-2 was %, significantly higher than the thyroid adenoma %, P = , thyroid cancer adjacent tissues %, P = and normal thyroid tissue (0, P = , reveals the thyroid follicular cell adenomas bcl-2 positive staining intensity and number of positive cells compared with normal thyroid follicular epithelial cells enhanced increase in thyroid cancer has more than adenoma, suggesting bcl-2 may regulate thyroid epithelial apoptosis associated with play an important role in thyroid epithelial cells have more ability to evade apoptosis, the incidence of thyroid cancer may be associated with overexpression of bcl-2 related study showed that For thyroid cancer, tumor histological type, age, lymph node metastasis and clinical staging is to assess the prognostic indicators [7,8] in this group research results showa very low degree of differentiation of undifferentiated carcinoma and relatively low follicular carcinoma, Bcl-2 expression rates were 100% and %, significantly higher than papillary carcinoma of Bcl-2 expression rate %), the differences were statistically significant, in patients with lymph node metastasis or III, IV cases of thyroid cancer, carcinoma of Bcl-2expression was significantly increased, the differences were statistically significant. Bcl-2 in all types of thyroid cancer were expressed, and the higher the degree of differentiation of the poorer expression, Therefore,it is reasonable that, Bcl-2-positive prompts thyroid cancer with poor prognosis, and the higher the degree of expression is also worse prognosis. cancer tissue expression of Bcl-2 high degree of differentiation of thyroid cancer, histological subtype, value invasion , lymph node metastasis and prognosis, thyroid cancer prognosis could be used as an important reference. Therefore, thyroid adenoma patients for tumor tissue Bcl-2 positive cases detected and close follow-up may have important significance.甲状腺肿瘤检测Bcl-2的意义【摘要】目的探讨Bcl-2的表达与甲状腺癌的发生、发展及预后的关系。
临床医学英语Chapte r 1 Patien t-Physic ian Intera ction Page 1第一章医患沟通第１页The patien t-physic ian intera ction procee ds throug h many phases of clinic al reason ing and decisi on making.procee d 进行、开展reason ing 推论、推理clinic al reason ing 诊断clinic al decisi on 确定治疗方案making decisi on 做出决定医患沟通在临床诊断和治疗决策的许多阶段中进行着。
The intera ction begins with an elucid ation of compla intsor concer ns, follow ed by inquir ies or evalua tionto addres s theseconcer ns in increa singl y precis e ways.elucid ation说明、阐明inquir e 询问、调查evalua tion评估、评价这种沟通开始于病人诉说或所关注问题，然后通过询问、评估不断精确地确定这些问题。
The proces s common ly requir es a carefu l histor y or physic al examin ation, orderi ng of diagno stictests, integr ation of clinic al findin gs with the test result s, unders tandi ng of the risksand benefi ts of the possib le course s of action, and carefu l consul tatio n with the patien t and family to develo p future plans.integr ation综合 consul tatio n 磋商、会诊这个过程通常需要细致的病史询问和体格检查，进行诊断性化验，综合临床发现和化验结果，理解分析拟行治疗过程中的风险和疗效，并与病人及家属反复磋商以形成治疗方案Physic iansincrea singl y can call on a growin g litera tureof eviden ce-basedmedici ne to guidethe proces s so that benefi t is maximi zed,whilerespec tingindivi dualvariat ionsamongdiffer ent patien tsrespec ting注意到、关系、说到eviden ce-basedmedici ne 循证医学医生们越来越容易查阅不断增长的循证医学文献来指导这个过程，使得疗效最大化，但要考虑到不同病人中个体差异是存在的。
astrointestinal perforation胃肠穿孔erythema 红斑active treatment积极疗法echocardiography超声心动图acoustic window 声窗emphysema肺气肿Angiodysplasia 血管发育畸形enteroclysis 小肠造影advance cancer 晚期癌enteroscopy 肠镜检查autopsy尸检ectopic pregnancy异位妊娠antidepressant抗抑郁药epidemicn. 传染病acute abdomen急腹症endoscopic内窥镜检查的atherosclerosis动脉粥样硬化evidence-based medicine 循证医学aerobic exercise有养运动etiology病原学arthritis关节炎glandular lumina 腺腔appendicitis阑尾炎growth factor生长因子arterial oxygen tension动脉血养分压genetic information遗传信息asthma哮喘genetic diseases遗传疾病antibiotic抗生素genetic markers基因标记bioartificial liver生物人工肝genetics遗传学biopsy specimen 活检标本genomics基因组学blood culture血培养gallbladder 胆囊breast carcinoma 乳腺癌Gallstones胆石bacterial pneumonia细菌性肺炎hypopnea 呼吸减弱biopsy活组织检查human genome project人类基因组计划biliary tree 胆道系统health care 卫生保健cerebrovascular accident脑血管意外hypertension高血压coronary angiography冠脉造影Hyperplasia 超常增生carbohydrate糖类hypopnea 呼吸减弱carcino-embryonic antigen癌胚抗原hyperventilation 换气过度combination therapy联合治疗heart and lung failure 心肺衰竭clinical trials 临床试验inflammation炎症complication并发症influclinical reasoning 诊断Cytochrome细胞色素intensive treatment 强力疗法chest radiogrph 胸片intestinal ischemia肠缺血cholecustectomy胆囊切除术initial history 原始病史clinical setting临床环境lung compliance肺顺应性clinician 临床医师laparoscopy腹腔镜检查术clinical evaluation临床评价lassification 分类clinical course临床过程macromolecules 大分子蛋白colonoscopy 结肠镜malignancy恶性肿瘤dyspnea 呼吸困难motion artifact运动伪差diastolic pressure舒张压microscopic examination显微镜检查dizziness头晕myocardial infarction心肌梗死mortality 死亡数、死亡率osteoarthrits骨关节炎nostril鼻孔ovarian cyst卵巢囊肿Nucleic Acid核苷酸pelvis骨盆,肾盂prostate-specific antigen (PSA)前列腺特异性抗原prostate serum acid phosphatase(PSAP) 血清酸性磷酸酶Pharmacological 药理学sphygmomanometer 血压计Proteolytic 蛋白水解的stem cell干细胞prostate 前列腺symptom症状prostatic 前列腺的small intestine小肠peritoneal cavity腹膜腔stratification 层化成层pleural space胸膜腔symptoms症状progenitor cell祖细胞telangiectasia 毛细血管扩张peptic ulcer消化性溃疡tubo-ovarian abscess输卵管-卵巢脓肿perfusion 灌注total parenteral nutrition全胃肠外营养palliative姑息性治疗transfusion 输血pneumonia 肺炎tomographic DSA体层摄影数字减影血管造影physical examination体格检查threshold concentration阈浓度primary tumor原发性肿瘤tumor marker肿瘤标记物primary site基本位点ureteral calculi输尿管结石pathologic病理学的underlying cancer 潜在癌pneumo peritoneum气腹percutaneous drainage孔经皮穿刺引流placebo安慰剂visceral内脏的prostatitis 前列腺炎viscus (复viscera) 内脏puncture 穿刺renal肾脏的rebound tenderness反跳痛respiratory illness呼吸系疾病respiratory syncytial viruses呼吸道合胞病毒radiographic X线照相术的rationale 基本原理replacement therapy代替治疗radiologic 放射学的regimen 养生法、食物疗法astrointestinal perforation胃肠穿孔erythema 红斑active treatment积极疗法echocardiography超声心动图acoustic window 声窗emphysema肺气肿Angiodysplasia 血管发育畸形enteroclysis 小肠造影advance cancer 晚期癌enteroscopy 肠镜检查autopsy尸检ectopic pregnancy异位妊娠antidepressant抗抑郁药epidemicn. 传染病acute abdomen急腹症endoscopic内窥镜检查的atherosclerosis动脉粥样硬化evidence-based medicine 循证医学aerobic exercise有养运动etiology病原学arthritis关节炎glandular lumina 腺腔appendicitis阑尾炎growth factor生长因子arterial oxygen tension动脉血养分压genetic information遗传信息asthma哮喘genetic diseases遗传疾病antibiotic抗生素genetic markers基因标记bioartificial liver生物人工肝genetics遗传学biopsy specimen 活检标本genomics基因组学blood culture血培养gallbladder 胆囊breast carcinoma 乳腺癌Gallstones胆石bacterial pneumonia细菌性肺炎hypopnea 呼吸减弱biopsy活组织检查human genome project人类基因组计划biliary tree 胆道系统health care 卫生保健cerebrovascular accident脑血管意外hypertension高血压coronary angiography冠脉造影Hyperplasia 超常增生carbohydrate糖类hypopnea 呼吸减弱carcino-embryonic antigen癌胚抗原hyperventilation 换气过度combination therapy联合治疗heart and lung failure 心肺衰竭clinical trials 临床试验inflammation炎症complication并发症influclinical reasoning 诊断Cytochrome细胞色素intensive treatment 强力疗法chest radiogrph 胸片intestinal ischemia肠缺血cholecustectomy胆囊切除术initial history 原始病史clinical setting临床环境lung compliance肺顺应性clinician 临床医师laparoscopy腹腔镜检查术clinical evaluation临床评价lassification 分类clinical course临床过程macromolecules 大分子蛋白colonoscopy 结肠镜malignancy恶性肿瘤dyspnea 呼吸困难motion artifact运动伪差diastolic pressure舒张压microscopic examination显微镜检查dizziness头晕myocardial infarction心肌梗死mortality 死亡数、死亡率osteoarthrits骨关节炎nostril鼻孔ovarian cyst卵巢囊肿Nucleic Acid核苷酸pelvis骨盆,肾盂prostate-specific antigen (PSA)前列腺特异性抗原prostate serum acid phosphatase(PSAP) 血清酸性磷酸酶Pharmacological 药理学sphygmomanometer 血压计Proteolytic 蛋白水解的stem cell干细胞prostate 前列腺symptom症状prostatic 前列腺的small intestine小肠peritoneal cavity腹膜腔stratification 层化成层pleural space胸膜腔symptoms症状progenitor cell祖细胞telangiectasia 毛细血管扩张peptic ulcer消化性溃疡tubo-ovarian abscess输卵管-卵巢脓肿perfusion 灌注total parenteral nutrition全胃肠外营养palliative姑息性治疗transfusion 输血pneumonia 肺炎tomographic DSA体层摄影数字减影血管造影physical examination体格检查threshold concentration阈浓度primary tumor原发性肿瘤tumor marker肿瘤标记物primary site基本位点ureteral calculi输尿管结石pathologic病理学的underlying cancer 潜在癌pneumo peritoneum气腹percutaneous drainage孔经皮穿刺引流placebo安慰剂visceral内脏的prostatitis 前列腺炎viscus (复viscera) 内脏puncture 穿刺renal肾脏的rebound tenderness反跳痛respiratory illness呼吸系疾病respiratory syncytial viruses呼吸道合胞病毒radiographic X线照相术的rationale 基本原理replacement therapy代替治疗radiologic 放射学的regimen 养生法、食物疗法。
Primary Care Medicine Recommendations目录1 Principles of Primary Care 基本医疗原则 4 Practice of Primary Care 基本医疗的实践Diagnostic Tests 诊断性试验Health Maintenance and Role of Screening 保健和筛查Risk and Prognosis 风险和预后Choosing Treatment Options 治疗的选择Immunization 免疫接种2 Systemic Problems 全身性问题 22 Chronic Fatigue 慢性疲劳Fever 发热HIV-1 Infection HIV感染Lymphadenopathy 淋巴结病Overweight and Obesity 超重和肥胖Weight loss 消瘦3 Cardiovascular Problems 心血管问题 30 Aortic Regurgitation主动脉瓣反流Aortic Stenosis主动脉瓣狭窄Arterial Insufficiency动脉供血不足Asymptomatic Systolic Murmur 无症状的收缩期杂音Atrial Fibrillation心房颤动Bacterial Endocarditis细菌性心内膜炎Cardiovascular Rehabilitation心血管疾病康复Chest Pain 胸痛Congestive Heart Failure充血性心力衰竭Deep Vein Thrombophlebitis 深静脉血栓Exercise锻炼Hypercholesterolemia高胆固醇血症Hypertension 高血压Leg Edema 下肢水肿Mitral Regurgitation二尖瓣返流Rheumatic Fever风湿热Stable Angina稳定型心绞痛Stress Testing应激试验Superficial Thrombophlebitis血栓性浅静脉炎Syncope晕厥Valvular Heart Disease心脏瓣膜疾病Varicose Veins静脉曲张Venous Insufficiency静脉机能不全Ventricular Irritability心室激惹状态4 Respiratory Problems 呼吸问题 34 Asthma 哮喘Bronchitis and Pneumonia 气管炎和肺炎Chronic Cough 慢性咳嗽Chronic Dyspnea 慢性呼吸困难Chronic Obstructive Pulmonary Disease慢性阻塞性肺疾患Clubbing杵状指Common Cold普通感冒Hemoptysis 咯血Interstitial Lung Disease间质性肺病Occupational and Environment Respiatory Disease 职业和环境性肺疾病Pleural Effusions 胸腔积液Sarcoidosis结节病Sleep Apnea 睡眠呼吸暂停Smoking Cessation 戒烟Solitary Pulmonary Nodule 孤立性肺结节Tuberculosis 肺结核5 Gastrointestinal Problems 胃肠道问题 36 Abdominal Pain 腹痛Anorectal Complaints肛门直肠不适Cirrhosis and Chronic Liver Failure肝硬化和慢性肝衰竭Constipation便秘Diarrhea腹泻Diverticular Disease憩室病Dysphagia吞咽困难External Hernia外疝Gallstones胆结石Gastrointestinal Bleeding胃肠道出血Heartburn and Reflux烧心和反流Inflammatory Bowel Disease炎性肠病Irritable Bowel Syndrome肠应激综合征Jaundice黄疸Nausea and Vomiting恶心和呕吐Nonulcer Dyspepsia无溃疡性消化不良Pancreatitis胰腺炎Peptic Ulcer Disease消化性溃疡病Serum Transaminase(Aminotransferase)Elevation血清转氨酶升高Viral Hepatitis病毒性肝炎6 Hematologic Problems血液系统问题 39 Anticoagulant Therapy抗凝治疗Anemia贫血Bleeding Problems出血问题Erythrocytosis红细胞增多Sickle Cell Disease镰状细胞(贫血)病7 Oncologic Problems肿瘤学问题 40 Bladder Cancer膀胱癌Breast Cancer乳腺癌Cancer(General)癌症(总论)Cervical Cancer子宫颈癌Colorectal Cancer结肠直肠癌Endometrial Cancer子宫内膜癌Esophageal Cancer食管癌Gastric Cancer胃癌Hodgkin’s Disease霍奇金病Lung Cancer肺癌Non-Hodgkin’a Lymphoma非霍奇金淋巴瘤Oral Cancer口腔癌Ovarian Cancer卵巢癌Pancreatic Cancer胰腺癌Renal Cell Carcinoma(Hypernephroma)肾细胞癌(肾上腺样瘤)Skin Cancer皮肤癌Testicular Cancer睾丸癌Thyroid Nodules and Thyroid Cancer甲状腺结节和甲状腺癌Tumor of Unknown Origin起源不明的肿瘤Vaginal Cancer阴道癌Vulvar Cancer外阴癌8 Endocrinologic Problems内分泌学问题Diabetes Insipidus尿崩症Diabetes Mellitus糖尿病Galactorrhea and Hyperprolactinemia乳头溢液高催乳素血症Glucocorticoid Therapy糖皮质激素治疗Gynecomastia男子女性型乳房Hirsutism多毛症Hypercalcemia高钙血症Hyperthyroidism甲状腺机能亢进Hypoglycemia低血糖Hypothyroidism甲状腺机能减退9 Gynecologic Problems妇产科学问题Breast Masses and Nipple Discharge乳房肿块和乳头溢液Fertility Control节育Infertility不育症Menopause绝经Menstrual or Pelvic Pain月经或痛经Secondary Amenorrhea继发性闭经Unplanned Pregnancy计划外妊娠Vaginal Bleeding阴道出血Vaginal Discharge阴道分泌物Vulvar Pruritus外阴搔痒10 Genitourinary Problems泌尿生殖器问题Benign Prostatic Hyperplasia良性前列腺增生Chlamydial Infection衣原体感染Gonorrhea淋病Hematuria血尿Incontinence and Lower Urinary Tract Dysfunction尿失禁和下尿路功能不全Nephrolithiasis肾结石Prostatitis前列腺炎Proteinuria蛋白尿Renal Failure肾衰Scrotal Pain,Masses,and Swelling阴囊痛、肿块和肿胀Sexually Transmitted Diseases性传播疾病Syphilis梅毒Urethritis in Men男性尿道炎Urinar Tract Infection尿路感染11 Musculoskeletal Problems肌肉与骨骼问题 42 Asymptomatic Hyperuricemia无症状性高尿酸血症Back Pain背痛Elbow,Wrist,and Hand Pain肘,腕和手痛Fibromyalgia纤维肌痛Foot and Ankle Pain脚和踝痛Giant Cell Arteritis巨细胞性动脉炎Gout痛风Hip Pain髋痛Knee Pain膝痛Lyme Disease莱姆病Monoarticular Arthritis单关节的关节炎Muscle Cramps肌肉痛性痉挛Neck Pain颈痛Osteoarthritis骨关节炎Paget’s Disease佩吉特病Polyarticular Complaints多关节的问题Polymyalgia Rheumatica风湿性多发性肌痛Raynaud’s Phenomenon雷诺现象Rheumatoid Arthritis类风湿性关节炎Shoulder Pain肩痛12 Neurologic Problems神经病学问题Bell’s Palsy面瘫Dementia痴呆Dizziness头晕Focal Neurologic Complaints局部神经的主诉Headache头痛Multiple Sclerosis多发性硬化Parkinson’s Disease震颤麻痹Seizures癫痫发作Transient Ischemic Attack and Asymptomatic Carotid Bruit短暂性缺血发作和无症状性颈动脉杂音Tremor震颤Trigeminal Neuralgia(Tic Douloureux) 三叉神经痛13 Dermatologic Problems皮肤病学问题 47 Acne痤疮Aphthous Stomatitis溃疡性口炎Bites(Animal and Human)咬伤(动物和人)Cellulitis蜂窝织炎Corns and calluses鸡眼和胼胝Dermatitis(Atopic or Contact) 皮炎(过敏或接触性) Dermatitis(Seborrheic) 皮炎(脂溢性)Dry Skin干性皮肤Excessive Sweating出汗过多Fungal Infections霉菌感染Hair Loss脱发Herpes Simplex单纯疱疹Herpes Zoster带状疱疹Intertrigo and Intertriginous Dermatoses间擦疹和擦烂性皮肤病Minor Burns轻度烧伤Pigmentation Disturbances色素沉着障碍Pruritus搔痒症Psoriasis银屑病Purpura紫癜Pyoderma脓皮病Rosacea and Other Acneiform Dermatoses酒渣鼻和其它痤疮样的皮肤病Scabies and Pediculosis疥疮和虱病Skin Ulceration皮肤溃疡Urticaria and Angioedema荨麻疹和血管性水肿Warts疣14 Ophthalmologic Problems眼科学问题Age-Related Macular Degeneration与年龄相关的黄斑退行性改变Cataracts白内障Contact Lenses接触镜Diabetic Retinopathy糖尿病性视网膜病Dry Eyes干眼Excessive Tearing多泪Exophthalmos眼球突出Eye Pain目痛Glaucoma青光眼Impaired Vision视觉损伤Red Eye红眼Refractive Surgery屈光手术Visual Disturbances视觉障碍15 Ear,Nose,and Throat Problems耳鼻喉问题 48 Epistaxis鼻衄Facial Pain and Swelling面痛和肿胀Halitosis口臭Hearing Loss听力损失Hiccups呃逆Hoarseness声嘶Nasal Congestion and Discharge鼻充血和分泌物Otitis耳炎Pharyngitis咽炎Sinusitis鼻窦炎Smell Disturbances嗅觉障碍Snoring打鼾Taste Disturbances味觉障碍Temporomandibular Joint Dysfunction颞下颌关节功能障碍Tinnitus耳鸣16 Psychiatric and Behavioral Problems精神病学和行为问题Alcohol Abuse酗酒Angry Patient生气的病人Anxiety焦虑Depression抑郁Eating Disorders进食障碍疾患Insomnia失眠Nonmalignant Pain非恶性的痛Sexual Dysfunction性功能障碍Somatization Disorders躯体化障碍Substance Abuse精神性药物滥用17 Allied Fields相关领域Adolescents青春期Alternative Therapies替代疗法Practice of Primary Care基本医疗的实践Management处理Organize PCP practice to provide coordinated, comprehensive, and personal care, available on first contact and continuous basis.Tasks of primary care include组织初级保健医生行医以提供协调的、全面的、个体化的保健服务，具有首诊的可及性和以连续性为基础的服务。
住院医师英语As a resident doctor, I have the important responsibility of caring for patients who are admitted to the hospital. This is a challenging role that requires both medical knowledge and interpersonal skills.One of the most important tasks of a resident doctor is to establish good communication with patients and their families. This involves providing clear explanations of medical conditions, treatment options, and possible outcomes. Effective communication helps to build trust and confidence between healthcare providers and patients.Another important responsibility is to manage patients’ symptoms and medical conditions. This often involves working with a team of healthcare professionals to provide coordinated care. Resident doctors may need to order medical tests, adjust medications, or provide other specialized treatments.In addition to caring for patients, resident doctors are also responsible for maintaining accurate medical records. This involves documenting patient information, treatment plans, and any changes in medical status. Accurate documentation is essential for providing high-quality care and ensuring smooth transitions between healthcare providers.Resident doctors also play an important role in medical education. They may work with medical students, nurses, and other healthcare professionals to provide training and support. This helps to ensure that healthcare providers are well-informed and capable of providing high-quality care to patients.Overall, being a resident doctor is a challenging but rewarding experience. It requires dedicated, compassionate individuals who are committed to providing the best possible care to their patients. As a resident doctor, I feel privileged to be part of a team that is making a positive impact o n people’s lives every day.。
Anesthetic 麻醉剂alternative and complementary therapies 替代与补充治疗atherosclerosis动脉粥样硬化Asthma 哮喘Acute cholecystitis急性胆囊炎antibacterial spectrum 抗菌谱acute abdomen 急腹症aspiration误吸anastomoticdehiscenc吻合口破裂anuric renal failure无尿性肾衰竭adverse outcomes不良后果arthritis关节炎autologous cells自体细胞angiography血管造影术advanced cancer晚期癌症abdominal tenderness腹部压痛appendectomy阑尾切除术ascites腹水abscess脓肿Bowel obstruction 肠梗阻biopsy 活检bioartificial liver devices 生物人工肝装置blood cultures血培养Contrast material 显影剂colonic polyps 结肠息肉cholecystectomy 胆囊切除术Chronic bronchitis慢性气管炎chronic pancreatitis慢性胰腺炎cardiac arrhythmia 心律失常coronary artery disease.冠心病comorbidities 并存症celiotomy 剖腹术capsule enteroscopy胶囊小肠镜cognitive impairment认知障碍chemotherapy化疗diabetic nephropathy糖尿病肾病diagnosis of sudden cardic death(SCD)心源性猝死的诊断Diagnostic laparoscopy 诊断性腹腔镜技术dyspnea 呼吸困难disease free survival无病生存Etiology 病因学Epidemic influenza 流行性感冒end-stage chronic disease晚期慢性疾病endoscopic ultrasonography内镜超声检查Emphysema 肺气肿elective surgery择期手术elective gastrointestinal surgery 择期胃肠手术Fine needle aspiration (FNA) 细针穿刺fatal complication致命性并发症Geriatric Patients 老年病人Gallstones 胆结石gastrointestinal perforation胃肠道穿孔gastrointestinal bleeding胃肠道出血guarding 肌卫growth factors生长因子health promotion 健康促进healthy lifestyles 健康的生活方式heart failure 心力衰竭Hypoxia 低氧血症hypopnea 呼吸减弱Hypokalemia 低钾血症hyperglycemia 高血糖hypertrophic cardiomyopathy 肥厚心肌病inflammatory bowel disease炎症性肠疾病Imaging tests 影像学检查immunosuppression免疫抑制immune dysfunction免疫功能障碍immunizations 免疫接种intestinal ischemia 肠缺血intestinal anastomose肠吻合术intra-abdominal abscess腹腔脓肿idiopathic dilated cardio-myopathy特发性扩张型心肌病muscle relaxant 肌松药物laparotomy 剖腹术Laparoscopy 腹腔镜检查lung compliance肺顺应性life expectancy 预期寿命Malpractice 医疗过失Mortality 死亡率medicare医疗保险myocarditis心肌炎myocardial infarction心肌梗塞（silent）myocardial infarction（静默型）心肌梗死microalbuminuria 微量蛋白尿major operation大手术malnutrition营养不良NPO禁食nosocomial infection院内感染natural history 自然病程nephrotic syndrome肾病综合症nasogastric suction鼻胃管引流nasogastric 鼻胃的nutrition 营养nutritional status 营养状况osteoporosis 骨质疏松症ovarian cysts卵巢囊肿Placebo安慰剂physical activity 体力活动physical therapy 理疗preoperative consultation术前会诊premenopausal women绝经前妇女premenopausal绝经前的pleural space胸膜腔Pulmonary embolism 肺栓塞pulmonary capillary wedgepressure 肺毛细血管锲压Pneumonia 肺炎proteinuria 蛋白尿Prophylactic antibiotic therapy预防性抗生素治疗proximal bowel obstruction近端肠梗阻peritonitis 腹膜炎preterm labor未足月产peptic ulcer（disease）消化性溃疡（病）primary tumor原发肿瘤pancreatic tumors胰腺肿瘤preoperative staging术前分期Palliative care姑息性治疗rebound tenderness 反跳痛referred pain牵涉痛rectal examination直肠指检stem cells 干细胞spectrum of diseases 疾病谱supportive care 支持治疗systolic/diastolic blood pressure收缩压/舒张压subclinical disease亚临床疾病surgical complications 外科手术并发症side effect 副作用symptoms and signs症状和体征sroke中风transfusion therapy.输血治疗tachypnea 呼吸急促total parenteral nutrition 全胃肠外营养TPNtenderness,guarding,andrebound tenderness 压痛，腹肌紧张和反跳痛upper and lower gastrointestinal（sustained monomorphic）ventricular tachycardia（持续性单一型）室性心动过速tracts上消化道和下消化道tissue engineering 组织工程学weight loss 体重下降wound infections切口感染Chapter1Patient-Physician Interaction医患沟通The patient-physicianinteraction proceeds throughmany phases医患沟通的优势体现在临床诊断和治疗的全过程中。
临床医学英语Chapter 1 Patient-Physician Interaction Page 1第一章医患沟通第１页The patient-physician interaction proceeds through many phases of clinical reasoning and decision making.proceed 进行、开展reasoning 推论、推理clinical reasoning 诊断clinical decision 确定治疗方案making decision 做出决定医患沟通在临床诊断和治疗决策的许多阶段中进行着。
The interaction begins with an elucidation of complaints or concerns, followed by inquiries or evaluation to address these concerns in increasingly precise ways.elucidation 说明、阐明inquire 询问、调查evaluation 评估、评价这种沟通开始于病人诉说或所关注问题，然后通过询问、评估不断精确地确定这些问题。
The process commonly requires a careful history or physical examination, ordering of diagnostic tests, integration of clinical findings with the test results, understanding of the risks and benefits of the possible courses of action, and careful consultation with the patient and family to develop future plans.integration 综合consultation 磋商、会诊这个过程通常需要细致的病史询问和体格检查，进行诊断性化验，综合临床发现和化验结果，理解分析拟行治疗过程中的风险和疗效，并与病人及家属反复磋商以形成治疗方案Physicians increasingly can call on a growing literature of evidence-based medicine to guide the process so that benefit is maximized,while respecting individual variations among different patientsrespecting 注意到、关系、说到evidence-based medicine 循证医学医生们越来越容易查阅不断增长的循证医学文献来指导这个过程，使得疗效最大化，但要考虑到不同病人中个体差异是存在的。
The increasing availability of randomized trials to guide the approach to diagnosis and therapy should not be equated with “cookbook” medicineavailability可利用性，可得到randomize 随机的cookbook 食谱，烹调书approach 接近越来越多的可用于指导临床诊断与治疗的随机试验资料不应变成“烹调书”医学。
Evidence and the guidelines that are derived from it emphasize proven approaches for patients with specific characteristics.Evidence 证据，迹象guideline指导方针emphasize 强调因为随机试验获得的现象和思路是着重于特征性病人的求证过程。
Substantial clinical judgment is required to determine whether the evidence and guidelines apply to individual patients and to recognize the occasional.substantial clinical 真实的，实在的individual 个体occasional 偶尔的，特殊的实际的临床判断需要确定这些现象和思路能否应用于某个病人个体，并能找出例外。
Even more judgment is required in the many situations in which evidence is absent or inconclusive.inconclusive 不确定性，非决定性许多情况下，临床表现缺乏或不典型，需要考虑更多的判断。
Evidence also must be tempered by patients’ preferences, although it is a physician’s responsibility to emphasize when presenting alternative options to the patient.temper 脾气，调音preference 偏爱emphasize 强调，详述，阐明presenting 提出alternative 可选择的，二选一病人还会根据自己的倾向调节着临床症状，但医生有责任通过选择性问题搞清事实。
The adherence of a patient to a specific regimen is likely to be enhanced if the patient also understands the rationale and evidence behind the recommended option.adherence 坚持、固执regimen 养生法、食物疗法enhance 提高、加强rationale 基本原理假如病人也懂得医生问题的基本原理和表现，有特殊生活方式病人的固执容易被强化。
To care for a patient as an individual, the physician must understand the patient as a person.care for 喜欢、照料为了把病人作为一个个体进行治疗(为了个体化的照料病人)，医生必须理解病人是一个人（不是一群人）。
This fundamental precept of doctoring includes an understanding of the patient’s social situation, family issues,financial concerns, and preferences for different types of care and outcomes, ranging from maximum prolongation of life to the relief of pain and suffering.fundamental 基本的，根本的precept 训戒doctoring 行医prolongation 延长这个最基本的行医原则包括了解病人的社会地位，家庭问题，资金状况以及对不同治疗方法、不同治疗结果的选择，从最大限度地延长生命到临时缓解疼痛和折磨。
If the physician does not appreciate and address these issues, the science of medicine cannot be applied appropriately, and even the most knowledgeable physician fails to achieve appropriate outcomes.appreciate 欣赏、感谢、评价appropriate 适当的、恰当的假如医生没有正确理解和定位这个问题，医学就不可能恰当地应用于临床，甚至一个知识最渊博的医生也不能取得理想的治疗结果。
Even as physicians become increasingly aware of new discoveries, patients can obtain their own information from a variety of sources, some of which are of questionable reliability.aware of 意识到，知道questionable 可疑的、成问题的、不可靠的reliability 可靠、可信赖的甚至，当医生越来越容易知道新发现的同时，病人也能够通过各种资源得到他们的信息，当然，某些信息是不可靠的。
The increasing use of alternative and complementary therapies is an example of patients’ frequent dissatisfaction with prescribed medical therapy.alternative 选择，替代complementary 补充的、相配的prescribe 规定、指定、开处方替代疗法和辅助疗法的应用不断增加就是病人对常规疗法经常不满意的一个例子。
Physicians should keep an open mind regarding unproven options but must advise their patients carefully if such options may carry any degree of potential risks, including the risk that they may relied on to substitute for proven approachessubstitute 代替、代用rely on 依赖、信任医生对未证实的疗法应该保持开放的思想，但是，如果这些疗法可能带来任何程度的潜在风险，医生都必须细致地告知病人，包括可能需要用已证实的常规疗法去替代的风险。
It is crucial for the physician to have an open dialogue with the patient and family regarding the full range of options that either may considercrucial 严酷的、决定性的either 两者任一对医生来说，对病人及家属开诚布公地介绍所有能考虑的治疗选择，是极及关键的。
