住院医师规范化培训英语(2)(2)
2011-01-11 17:11阅读： 来源：爱爱医论坛责任编辑：爱医培训
[导读] 第四十一章 心源性猝 Most patients should undergo comprehensive evaluation of myocardial function and coronary anatomy. 大多数病人应该进行全面的心肌功能评价和冠状动脉解剖。
吸困难的基础通常是左心室充盈压增高导致肺毛细血管和肺动脉压的增加，从而肺血流量提高，肺顺应性降低。
If the pulmonary capillary wedge pressure is in the range of 25 mmHg, capillary fluid transudates into the pulmonary matrix, thereby reducing lung compliance, increase the work of breathing, and causing dyspnea.
如果肺毛细血管楔压在25mmHg左右，毛细血管液就会漏出至肺基质，从而降低了肺顺应性，导致呼吸用力增加，引起呼吸困难。
Echocardiography is usually diagnostic of abnormal ventricular or valvular function and should be performed in any patient in whom the cause of dyspnea is not readily apparent.
超声心动图通常被用来诊断心室和瓣膜异常，对任何呼吸困难病因不明确的病人均可采用。
Chapter 25 Cancer of unknown primary origin
In the majority of patients with cancer of unknown primary site, the diagnosis of advanced cancer is strongly suspected after the initial history and physical examination.
大多数原发灶不明的肿瘤病人，经过初步的病史和体格检查，基本能够确定晚期癌症的诊断。
A brief additional evaluation, including complete blood cell counts, chemistry profile, and computed tomography of the chest and abdomen should be performed.
其他的附加检查，包括全血细胞计数，生化检查和胸部腹部CT。
In addition, specific symptoms or signs should be evaluated with appropriate radiologic and endoscopic studies.
有特殊症状和体征的病人可以使用合适的放射学和内镜检查。
If a primary site is located, management should follow guidelines for the specific cancer identified.
如果确定了原发部位，应根据特定的肿瘤治疗指南进行治疗。
In patients with no obvious primary site, the most accessible site should be biopsied.
那些无明显原发病灶的病人，应对最可疑的部位进行活检。
Fine needle aspiration may or may not provide sufficient material for optimal histologic examination and special pathologic procedures.细针穿刺能否取得足够的组织进行组织学和特殊的病理学检查。
If tissue is inadequate, a larger biopsy sample should be obtained so that all necessary stains and procedures can be performed.
如果组织不够，需要进行较大的活检样本以便进行必要的染色和操作。
Chapter 28 Surgical complications
Surgeons can do much to avoid complications by the careful preoperative screening process.
外科医生可以在术前进行精心筛选以避免术后并发症。
When the surgeon sees the potential surgical candidate the first time, a host of questions come to mind, such as the nutritional status of the patients and questions about the health of the heart and lungs.
当外科医生第一次见到即将手术的病人时，需要考虑很多问题，如这个病人的营养状况或者心肺功能是否正常。
The surgeon will make a decision regarding performing the correct operation for the appropriate disease.
外科医生需要为病人作出正确的手术方式选择。
Similarly, the timing of the operation is often an important issue
同样的，手术时机也是一个重要的因素。
Some operations can be performed in a purely elective fashion, whereas others have some urgency about an expeditious surgical solution.
一些手术可以择期进行，而有些可能需要进行急诊手术。
Occasionally, the surgeon will demand that the patient lost weight before the operation so that the likelihood of a successful outcome is improved.
有时候，外科医生会要求病人术前减轻体重以提高手术的成功率。
Occasionally, the wise surgeon will request preoperative consultation from a cardiologist or pulmonary specialist to make certain that patient will be able to tolerate the stresses of a particular procedure.
有时，明智的外科医生会请心脏或呼吸系统专家进行术前会诊以确定病人是否能耐受特定手术。
Chapter 30 Epidemic influenza
流行性感冒是指一个地理区域中的感冒的爆发。
In a given community, epidemics of influenza A virus infection often have a characteristic pattern.
在某些特定的社区，流感病毒A型的传播通常有特征性的模式。
They usually begin rather abruptly, reach a sharp peak in 2 or 3 weeks, and last 6 to 10 weeks.
通常爆发性流行，在2至3周内直线到达峰值，并持续6至10周。
Increased numbers of schoolchildren with febrile respiratory illness are often the first indication of influenza in community.
社区中流感发生的第一个迹象就是学生发热呼吸道疾病。
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