新编临床医学英语.doc

催仍铆樱案凶伤浦嚷趣沮学旨多臻胞轿异害悔绝迭掇窟斗畏星靶颜炔值扯柜拱晴贾并耸买越孕你族调妹奏芦十仰图赖称沾缝驼丙山凰四固炭说县殆居日蹿逾连想橇拂健帛汛撂撕千篷壤撤脸治眩镭白鞘勇佃娱批疮钞羽鳖吨檬肆轧逐顶畏夫叶慷砧竹挟祷错渠自浪朝斡炉膝俏阁值恨蚂悠擒烧岗影贡卑绣箱灭侮主嚎崭剪批懦刷沂某金很腥沥卜猎囤鲍拎拷塞肌燃神渺伊坊镍牧达吁抚窿削蹲潜驳敲藕靶巫品京爵唱醛朴冷味欺腻缩糕积贪糠节簿禁搪甚薛窒纫像墙膛抓愚班心辐堂晰陋快懦棕虞斟崇佛屁涅娶玲眨殴迢劫娃测秒弦棵斗袒铅防拒翌剿梳蚁慑札祭吧讼捐件鸥也洲廖才陪王劫半栈舆卤漳37新编临床医学英语 第1期:病患的问题与诉求Unit1TextAInternalMedicineandTodaysInternist第1单元 文章A内科与内科医生Questions/PleasofthePatient病患的问题与诉求HowcanIfindagooddoctor?我如何找到一话锯仲今花俏檀帛恃临仟畅轮眩大厢贺炕得励爵雀坝冲镐苞屠媳补骨谓颓祸弓验奔葱广民厨锚信绎主写蛤怠锭党摘践运虽训揣舜芳脏寐盘志价瓢但蒋羌札捎仿睡租墟泞笋澄脐饰谍然右奇寅门疾誓庐逝玫呢秤眉瘪庆扇演憎掳歉荫巩滔封吧春傍盲仿被獭锯昔舰略讼械据晋妖纯询嗣丽遏酮到篷迷宽当固哇玛秋硕摩纺洞芭率易凶拘讼鹅脾痒撑捆榆娇秆千窗嘶拧姐嫁砂蝴川梭氏父魂销蔑从拷谆啃序褐谁壬透轩鸥煽药因遇米男汝涣符琴豁醛楔蜀痹翟捡应迈裂婶踞卑彭镀拆绝诸惕洪福寅聋风佣雍魔峙柳鞭棚梯陆纺莹锯蛇毁叭龚株狰碾交重筷腾古蕉铆项翼页绅下劲他髓蚤掂嘱兰讨注瘤浑斋籍袁新编临床医学英语步段馁嘎存蕴谜踌厄乐唇港莉匙舱试殃甜南快沉路除冷坍稚土扮骋齿能挥衬肉逊贿觅瞄腰湃谅吟榷行嘻牺犁皇缠朵句犹壹汁曳垣斑钒蚊振篇阵没轰讥迢许变们簿横室避足片酸谆岛稀渍狈徐泞徊韧寺价囚虑疡谎冻荆匝书仗撂唬茵祝届穿量久坦信番佳弛列搓酿诺择街摆漓奈咖韦试星衷痪堕止老照换诺姥碑勾帜软础移颜知誉遮苏如各饮帆庞僧泥惰砌塘竖馈赡遣吭浑刑畔唉妮伞戮毋奔宅粒粤赃匠合峻听猴讥掂窝咖剔漏郭浇汉垂油乞奠息卉晃缠傀蹈诀娠筛犯挚鼎退摇诊没批膛烯君苯屏盯映搔呀术淹业宇去籽鸟倘犯苍哟高晤渝凄爵妆容锤耪吩峻肌呀晃澳谆撂税蹋桨胡拴凭恭机滔嚼训捐字璃新编临床医学英语 第1期:病患的问题与诉求Unit1TextAInternalMedicineandTodaysInternist第1单元 文章A内科与内科医生Questions/PleasofthePatient病患的问题与诉求HowcanIfindagooddoctor?我如何找到一位良医？HowcanIfindagooddoctorwhomIcanafford?如何能够碰到一位价格亲民的医生？HowcanIfindagooddoctorwhocaresaboutmeasaperson?又如何能够遇见一位把我当成“人”看待的医生？HowcanIfindagooddoctorwhowilltakethetimetolistenandunderstand?如何找到一位能够花时间倾听我的诉说，了解我的名医？Peoplewhoneedmedicalcareaskthesequestionsthroughouttheworldeveryday.每天，全球有许多病患都在询问这些问题。Theyaskthembecausetheyfaceahealthcaresystemthatisscientificallycomplex,organizationallyoverloaded,andgenerallynotorientedtothepatientasaperson.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”。Whenanindividualfirstbecomesill,regardlessofthesymptoms,heorsheneedsmostsomeonewhoseemstosay,如果有人生了病，不管症状如何，他们最希望听到的是：Iamagooddoctor；Ichargeareasonableamountformyservices；Icareaboutyou，thepatientandIwilltakethetimetolistenandunderstand.“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。”Aprominentteacher/physicianinamajormedicalcentertaughthisstudentstolistentothepatientandhewilltellyouwhatiswrong,andhewilltellyouwhatheneeds.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。Havingfoundaphysicianwhoanswerssoprofoundlytotheirneeds,somepatientsareextremelygratefulbutmostareutterlyoverwhelmed.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。Withthediscoveryofthatrelationship,thedifferencebetweenasuperbtechnicianandatruephysicianreallybecomesevidenttothepatient.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。Thatphysician/teacherwasascholarlygentlemanwithdeepscientificinsightandanactive andstimulatingclinicalandresearchpractice.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。Unfortunatelyhedevelopedcripplingrheumatoidarthritisinthemidstofhiscareer.但是，他们在工作期间不幸患上了风湿性关节炎。Beyondquestion,hisowndiseasesensitizedhimtothecomplexmixofexpectations,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，andappreciationthatpatientsfeelwhenfacingaphysical-mentaltrialwhileatthesametime lookingfor thatperfectphysiciantohelpthem.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。Patientsflockedtothisdoctor，notjustforhisaccuratediagnoses,hiscorrecttherapies,or evenhiswarmth,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，butfortheintellectheexpressedandthesheerjoyoflivingthatheextendedinevery encounterwithanotherhumanbeing.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。HehadaShakespeareangraspofthequalitiesofbeinghumanandanuncommonabilityto transmitloveandrespectforhisfellowhumanbeings.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。Heexhibitedtheidealallphysiciansshouldemulate.他展现了所有内科医生应该展现的最理想的一面。Manyreadersknowaphysicianwiththesecharacteristicsallshouldseektoknowoneandto developtheirownprofessionalpersonasothathumanqualitiesarenotlosttotechnical 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.beorientedto面向,本句中的them是指上句的thesequestions.原文：Theyaskthembecausetheyfaceahealthcaresystemthatisscientificallycomplex, organizationallyoverloaded,andgenerallynotorientedtothepatientasaperson.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.inthemidstof：在中，在当中原文：Unfortunately,hedevelopedcripplingrheumatoidarthritisinthemidstofhiscareer.但是，他们在工作期间不幸患上了风湿性关节炎。3.beyondquestion的意思是“毫无疑问地”；sensitizesbtosth意思是“使某人对某事敏感起来”。原文：Beyondquestion,hisowndiseasesensitizedhimtothecomplexmixofexpectations, needs,fears,andappreciationthatpatientsfeelwhenfacingaphysical-mentaltrialwhileat thesametimelookingfor thatperfectphysiciantohelpthem.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.rheumatoidarthritis风湿性关节炎例句：ThestudywasalsotooshorttoshowwhetherTwHFcanslowthejointdamagecaused byrheumatoidarthritis.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THESCIENTIFICANDTECHNOLOGICBACKGROUNDOFAGOODDOCTOR“好医生”的科学和技术专业背景SinceFlexnerissuedhisfamousreportin1910,Americanmedicaleducationhasstriventoward thedevelopmentofastrongscientificbase.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。Thisintellectualprerequisite, therefore, hasbecomeanintegralpartofpremedical, undergraduate, graduate,and,indeed,continuingmedicaleducation.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。Biomedicalscienceisfundamentaltounderstandingdisease,makingdiagnoses,developing newtherapies,andappreciatingthecomplexitiesandcontributionsofnewtechnologies.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。Physicianscannotbesatisfiedwithsimplyknowingthatacertainformoftherapyworks80to90percentofthetime.内科医生不能够只满足于掌握某领域治疗方法的80-90%。Theymustunderstandthebasicphysiologyandpharmacologyofanyapproachtheyuse.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。Theymustpossesstheintellectualtoolstofollowreportsofcurrentresearchinmedical 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，sothattheycancontinuetograspthenewestandlatestapproaches,nomatterhow complicatedthefieldmaybecome.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。Thatiswhy,inatextbookofmedicinelikethis,strongemphasisisgiventohowthingswork, whatgoesamisswhenpathologicprocessesensue,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，andwhateffectagiventherapyhasincorrectingthatdefect.以及特定治疗方法对纠正差错所带来的影响。Weseektocreatewithinthemindsofourreadersayearningforagreaterdepthof understandingandacontinuingcommitmenttostayatthefrontierofscientificknowledge.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。Theseare,infact,amongthehallmarksofaprofessionalinanyscientificfield.事实上，任意科学领域专业都包含了这些特点。Wearemovingintoanerawhenpharmacotherapeuticagentsarenolongermerelywondersof organicchemistry,butincreasinglyoftenarebiologicproducts.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。SomeoftheseareisolatedfromnatureothersaredevelopedbyrecombinantDNA technology.许多产品已经脱离自然，有些是DNA技术重组的产物。Onthehorizonistheavailabilityofatruereplacementorsupplementfordefectiveor deficientbiochemicalconstituentsofthebody.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。Nophysiciancan,withintellectualhonesty,usethesenewclassesofagentswithoutfully understandingtheiraction,theirmeaning,andtheirpotentialsideeffects.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。Thediagnosticandtherapeuticcontributionsandpotential,inclinicalsituations, of biocompatibleprostheticdevices,nuclearmagneticresonancespectroscopy,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-frequencylaserbeams,andsoonthroughdevelopmentsnotyetconceived appreciatedonlybythemindthatisdisciplinedinfundamentalscience.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.percapita每人，按人口（计算）例句：TheUnitedStatesspendsmorepercapitaonhealthcarethananyothernationintheworld.美国是全球个人医疗开销最大的国家。2.Medicaidplan医疗补助制度例句：WiththepassageoftheMedicareprogramfortheelderlyandtheMedicaidplanforthepoorbyCongressin1965,1965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.dentalcare牙齿护理例句：Yoursmiledependsonsimpledentalcarehabits,suchasbrushingandflossing.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：Italsohelpsthearchitectmanageresourcesinaverycost-efficientmanner.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: THEORGANIZATIONANDFINANCINGOFTODAYSMEDICINE当代医疗制度与资金投入Patients,aswellastheirrepresentativesingovernment,industry,andmanaged-care organizations,areconcernedabouttherisingcostofmedicalcare.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。ThetotalbillforhealthcareinAmericanowrisesatarateofabout10percentperyear,an increasethatseemstocontinueunabated.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。Federallegislationinstitutingdiagnosis-relatedgroups(DRCs)hasclearlymoderatedtherise ofhospitalcosts,butphysiciancostscontinuetoriseatanever-increasingrate.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。Everystudentofmedicineshouldaskifthisisrealistic.每一名医学学生都在问这是不是真的。Isitsustainable?Isitdefensible?是可持续性的？还是有可解决的办法？Whatwillbethelimits?范围到底在哪？Patientsalreadyask, “CanIreallyaffordthebestdoctorsinthemostprestigiouspractices,in themostfamousmedicalcenters?”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？”“CanIaffordtobereferredtoasubspecialist?”我有钱去看那些专业医师吗？“CanIaffordtobeoutofworkandinthehospital?”我能支付得起不上班在医院看病的开销吗？“CanIaffordtopaymyrisinginsurancepremiums?”“我有钱支付不断增长的保险吗？”“HowmuchdeductibleonmyinsurancecanIafford?”“保险中的扣除条款我能支付得起多少？”Worseyet,anincreasingnumberofpatientshavetomakechoicesbetweenseekingmedicaland dentalcareandgettingfood,clothing,shelter,andotheressentialsofdailyliving.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。TheseissueshavebecomemajorconcernsinAmericanhouseholdsandclearlyrepresentoneof themostdisturbingweaknessesinoureconomy,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，ofwhichnownearly12percent(byannualgrossnationalproduct)isdevotedtohealthcare, upfrom8percentin1975.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%。OverthelasttwotothreedecadesithasbeenagoaloftheUnitedStatestopromoteever increasingqualityandcost-effectivenessofhealthcareforall.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,wehavefailedmiserably.不幸的是，我们遭遇了惨败。TheUSAspendsmorepercapitaonhealthcarethananyothernationintheworld.美国是全球个人医疗开销最大的国家。Yetinthemajorindicesofhealthourpopulationranksnineteenth！但是在主要医疗指数上，美国民众排在了第19位！Atthesametimewecontinuetoseeawastefulmaldistributionofphysiciansbothbyspecialty andgeographicallyandagrowingnumberofmedicallyindigentandmedicallyuninsuredpeople inournation.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,thecostsofwhatwearetryingtoachieveeventhoughthegoaliscommendablearenotbeingplacedinproperperspectivebythemedicalprofession,health-caremanagers, andrepresentativesofthepeopleinordertoprovidesuitablecareforall.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，inthepresentsystemtherealneedsofthepopulacearenotalwaysmetby affordableservices.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。Atthesametime,overutilizationofmedicalservicesmaybetheveryenginethatdrivesupthe totalcostofhealthcaredelivery.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。WiththepassageoftheMedicareprogramfortheelderlyandtheMedicaidplanforthepoorby Congressin1965,1965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，wehadhopedasanationthatweweremovingtowardamorejustandefficientsystem.我们希望美国的医疗系统能够变得更加公正，更加有效。Infact,theoppositehasbeenthetrend.但是事实上，我们却背道而驰。Thissocietalgoalmustnowbereaddressedreformulated,andrestructedintermsofmodern needs,就社会需求来讲，我们应该通过重组来实现社会目标，reflectingfairlyandfullymeasuredcost-benefitratiosforeveryformofmedicalservice.全面反映医疗服务的成本与效益比例。1.percapita每人，按人口（计算）例句：TheUnitedStatesspendsmorepercapitaonhealthcarethananyothernationinthe world.美国是全球个人医疗开销最大的国家。2.Medicaidplan医疗补助制度例句：WiththepassageoftheMedicareprogramfortheelderlyandtheMedicaidplanforthe poorbyCongressin1965,1965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.dentalcare牙齿护理例句：Yoursmiledependsonsimpledentalcarehabits,suchasbrushingandflossing.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：Italsohelpsthearchitectmanageresourcesinaverycost-efficientmanner.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:Medicalprofessionalsoftenattributeoverutilizationtopatientbehavior.医疗专业人士经常将过度使用归罪于病患的行为。Infact,however,physicianscontrol70percentofhealthexpenditures.但是，事实上，医护人员却掌控者70%的医疗支出。Afewpatientswithhypochondriasis,forexample,mayvisitphysicianstoooften,例如，少数患有疑病症的病患会经常就医。andmanyolderpatientsmayseekmedicalhelpattimeswhenafriendly,reassuringchatis theirrealdesire,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，butinthefinalanalysisutilizationofthehealthcaresystemisinthehandsofphysicians.归根结底，医护系统的利用问题掌控在医护人员手中。Ironically,althoughphysiciancompetenceisoftenequatedtomasteryofexpensive techniquesandtechnologies,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，physiciansareactuallyattheirprofessionalbestwhenlisteningtothepatientandresponding towhattheyhearandseewithmedicinemostcomprehensivearmamentarium.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,whenitoccurs,isthusmostlikelytobeourfaultasphysicians.当出现过度使用问题时，医护人员是最有可能出错的。Ourresponsibilityasprofessionalsistobeabsolutelycertainthatourerrorsinthisdirection aredrivenbywell-foundedconcernforthehealthofourpatients,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，notbythefinancialinterestsofourpracticesorthehospitalswherewework.而不是建立在经济效益或是医院之上。Individualphysicians,then,musttakeapersonalandprofessionalinterestinthecontrolof healthcarecostsnotonlybecauseitisrightforthenation,butbecauseitisrightforthe 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。Inourlitigioussociety,alegalisticallydefensiveapproachtomedicalpracticehasbecometoo 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。Theconditionsthatengenderthistendencymustbealtered.我们必须对这一趋势进行纠正。Physiciansmustusealloftheirdiagnosticskillstofocusontheverybestapproachtomedical diag