This indication is soon followed by illnesses among **s and about a week later by increased hospital admissions of patients with influenza-related complications.

　　随后的表现有成人的发病，一周以后感冒相关的并发症引起的入院病人增加。

 

　　Hospitalization rates in high-risk persons increase two- to five fold during major epidemics.

　　在感冒大流行期间，高危住院病人住院率可能增加二到五成。

 

　　School and employment absenteeism increases, as does mortality from pneumonia and influenza, especially in older persons.

　　缺学和旷工的情况增加，肺炎流感死亡率提高，尤其是老年人。

 

　　The latter finding is a highly specific indicator of influenza activity.

　　后一项发现是流感活动高度特异性指标。

 

　　Chapter 36 Endoscopic ultrasonograhy

 

　　The incorporation of an ultrasonic transducer in tip of a flexible endoscope or the use of stand-alone ultrasound probes has now made it possible to obtain images of gastrointestinal lesions that are not apparent on superficial views, including lesions within the wall of the gut as well those that lie beyond(e.g., pancreatic or lymph node lesions)。

　　将超声换能器并入内镜的头部或仅仅使用超声探头就现在就可以获得无法从浅表探测到的胃肠疾病的影像,包括肠壁内或这肠表面(如胰腺疾病或淋巴结病变）。

 

　　A further role of EUS is to guide fine-needle aspiration, which often provides pathologic confirmation of suspicious lesions.

　　超声内镜另外被用作细针穿刺的引导，可以对可疑的病灶进行病理学的确诊。

　　

　　In many cases, this approach appears to be even more accurate than conventional radiologic techniques such abdominal ultrasonography or CT.

　　在许多病例中，这种方法比常规的放射学检查如腹部超声、CT更精确。

 

　　Thus, EUS is probably the single best test for diagnosing pancreatic tumors, particularly the small endocrine varieties, with sensitivities approaching 95%.

　　因此，EUS可能是最好的胰腺肿瘤诊断方法，尤其对小的内分泌肿瘤，灵敏度可达95％。

 

　　It is also the procedure of choice for imaging submucosal and other wall lesions of the gastrointestinal tract (overall accuracy of 65 to 70%) as well as for staging of a variety of gastrointestinal tumors (overall accuracy of 90% or more).

　　EUS同时是粘膜下层和其他胃肠道壁疾病的常规检查方法（总体准确率为65％到70％），也是很多胃肠道肿瘤分期的方法（总体准确率超过90％）

 

　　Preoperative staging is a critical element in the management strategy for tumors such as esophageal and pancreatic cancer,

　　肿瘤治疗的术前分期是非常关键的因素，尤其对食道癌和胰腺癌。

 

　　EUS can complement more conventional radiologic tests to help determine the resectability and curative potential of surgery in these cases.

　　EUS可以弥补常规的放射学检查方法来确定外科切除和治疗的可能性。

 

　　Chapter 54 Benefit of Early enteral feeding versus parenteral nutrition

 

　　The studies that compared enteral and parenteral nutrition in the trauma population, as discussed earlier, concluded that enteral was superior because of an attenuated inflammatory response and a decrease in septic morbidity.

　　败血症发病率由于感染率和败血症发病率低，正如先前所进行的创伤病人有关肠内和肠外营养的结果得出，肠内营养超过肠外营养。

 

　　When these studies are examined more closely, it is clear that patients who were fed enterally usually received significantly less calories than those fed parenterally.

　　经过严密的研究发现肠内营养的病人吸收的热量明显少于肠外营养病人。

 

　　This discrepancy of “relative overfeeding” in the TPN groups in many instances led to hyperglycemia, presumably predisposing patients to immune dysfunction and nosocomial infection.

　　TPN组相对营养过度使许多病人产生高血糖症，据推测可以导致免疫功能下降和院内感染。

 

　　Thus, poor glucose control alone may account for the observed differences in outcome.

　　因此，血糖控制不佳可以解释说观察到的结果的差异。

 

　　In more contemporary studies where feeds are carefully advanced in a manner that avoids hyperglycemia and groups are fed equivalent protein and calories, there appears to be little difference in clinical outcome between enteral and parenteral routes of feeding.

　　当代的研究发现，如果肠外营养经过改进避免高血糖的可能，给予与肠内营养相似的蛋白质和热量，两组之间的预后差异不大。

 

　　Enteral nutrition also can endanger patient safety in unique ways.

　　肠内营养也可以危及病人的安危。

 

　　Deaths in persons receiving enteral nutrition are often due to aspiration, for example when gastric motility suddenly is impaired with the onset of sepsis