Many intervention trials indicate that disability can be prevented or its severity decreased; one trial showed improvements in functioning with resistance and aerobic exercise in older adults with osteoarthritis of the knee. (aerobic exercise 有氧運動 osteoarthritis 骨關節(jié)炎)
許多干預試驗揭示能力不足可預防或減輕；一個試驗顯示膝骨關節(jié)炎老年人用對抗運動和有氧運動改善功能。
Chapter 13 Tissue Engineering Page 36 第十三章 組織工程 第36頁
The loss or failure of an organ or tissue is devastating. (devastating 毀滅性的)
器官、組織的喪失或衰竭是毀滅性的。
Current treatment methods include transplantation of organs, surgical reconstruction, use of mechanical devices, or supplementation of metabolic products. (device 裝置)
現(xiàn)有的治療方法有器官移植、外科重建、機械裝置的應用以及代謝性產(chǎn)品的補充治療。
However, the ultimate goal of transplantation should reside in the ability to restore living cells to maintain or even enhance existing tissue function. (reside 居住、屬于、存在于)
移植的最終目的應該基于重建活細胞群以維持甚至增進現(xiàn)有組織的功能。
By developing replacement tissues that remain intact with bioactive properties after implantation, retaining physiologic functions as well as structure to the tissue or organ damaged by disease or trauma, tissue engineering could provide an alternative to transplantation and other forms of reconstruction.
remain 剩下、留下、保持、屬于 retain 保留、保持
intact 完整無缺的、未受損傷的 property 特征、特性
通過植入后仍有生物活性的替換組織發(fā)展，保持因病變或創(chuàng)傷而損害器官的生理功能和組織結構，組織工程能提供移植和其它重建方式的一種替代選擇。
Skin replacement products are the most advanced, with several tissue-engineering wound care materials currently on the market worldwide.
皮膚替代產(chǎn)品最為成熟，最近有好幾個組織工程（產(chǎn)商)將在全球市場經(jīng)營這些材料。
The potential impact of this field is endless, offering unique solutions to the medical field for tissue and organ replacement. (impact 撞擊、沖擊 frail unique 唯一的、獨特的)
這個領域的沖力是無限的，它提供了組織、器官替代領域獨特的解決方法。
Tissue engineering may eventually be applied to the regeneration of diverse tissues such as the liver, small intestine, cardiovascular structures, nerve, and cartilage.
regeneration 再生、重建 diverse 不同的、變化多的
組織工程可能最終能應用于各種組織的重建，如肝、小腸、心血管結構、神經(jīng)和軟骨。
Work on bioartificial liver devices has been under way for several years.
(bioartificial liver 生物人工肝 under way 進行中) 生物人工肝裝置的研究工作已經(jīng)進行了好幾年。
The sources of cells required for tissue engineering are summarized by three categories, autologous cells (from the patient), allogeneic cells (from donor, but not immunologically identical), and xenogeneic cells (donor form a different species).
autologous 自體 allogeneic 同種異體 xenogeneic 異基因的、異種
組織工程所需的細胞源被總結為三大類，自體細胞（來源于病人)、同種異體細胞（來源于供者，但不是免疫同源的)和異種細胞（不同物種的供者)。
each category may be further delineated in terms of stem cells (adult or embryonic) or “differentiated” cells obtained from tissue, where the cell population obtained from tissue dissociation comprises a mixture of cells at different maturation stages and includes rare stem and progenitor cells.
delineate 描繪 differentiated 區(qū)別、區(qū)分 dissociation 分裂、分離
maturation 成熟 rare 稀奇的 progenitor祖先、起源
每一類可以用術語干細胞進一步描述（成人的或胚胎的)，或從組織獲得的“不同”細胞進一步描述，組織分離獲得的細胞群包含著不同成熟時期的細胞混合體，包括半成熟細胞和原始細胞。
Recent discoveries have indicated that stem cells of one type can transdifferentiate to repair damaged tissue of another type (i.e., hematopoietic stem cells home to infarcted myocardium and repair the tissue).
transdifferentiate 轉(zhuǎn)分化 hematopoietic 造血的
最近的發(fā)現(xiàn)提示一種類型的干細胞能夠轉(zhuǎn)分化以修補另一類型的損傷組織（這就是說，造血干細胞可植入梗死的心肌進行修復)。
Tissue engineering will remain an area of intense research.
(intense 強烈的、熱切的、激烈的) 組織工程學將保持一個富有希望的研究熱園。
Advances in the areas of growth factors, stromal matrices, gene encapsulation, and gene delivery will all play a role.(stromal 間質(zhì)的 matrix 基質(zhì) encapsulation 封閉包裝 delivery 傳遞)
在這個熱園中，已有進展的生長因子、間質(zhì)其質(zhì)、基因封閉、基因傳遞都將扮演一份角色
Chapter 20 Nonsurgical Infections in Surgical Patients 二十章 外科病人的非外科感染
Postoperative patients are at increased risk for a variety of nonsurgical postoperative nosocomial infections.
(nosocomial 醫(yī)院的)術后病人發(fā)生各種各樣術后非外科醫(yī)院內(nèi)感染的風險不斷增加。
The most common of these is urinary tract infection (UTI).最常見的院內(nèi)感染是泌尿道感染。
Any patient who has had an indwelling urinary catheter is at increased risk for a UTI.
(indwell 存在…之中、居住)任何留置尿路導管的病人都是UTI的高風險者。
Despite the benign course of most UTIs, the occurrence of one in a surgical patient is associated with a threefold increase in death occurring during hospitalization. (threefold 三倍的、三重的)
盡管大多數(shù)的尿路感染過程是良性的，但外科病人發(fā)生這樣一個感染，住院死亡率提高了三倍。
The best prevention is to use urinary catheters sparingly and for specific indications and short durations and to employ strict closed –drainage techniques for those that are used.
sparingly 節(jié)儉的、保守的 employ 使用、利用
最好的預防方法是少用導尿管、針對特殊指征、短時間使用，并應用嚴格的閉合引流技術。
Lower respiratory tract infections are the third most common cause of nosocomial infection in surgical patients (after SSIs and UTIs) and are the leading cause of death due to nosocomial infection. (SSIs 手術部位感染、局部感染)
下呼吸道感染是外科病人院內(nèi)感染是第三常見原因（排在局部感染和泌尿系感染之后)，并且是院內(nèi)感染首要的死亡因素。
Diagnosis is usually relatively straightforward in a patient who is breathing spontaneously.
straightforward 一直向前、簡單的、明確的 spontaneously 自然的、自發(fā)的、不由自主的
對一個呼吸自然的病人，診斷通常相對容易。
However, a patient who is intubated and being ventilated because of adult respiratory distress syndrome presents an extremely difficult diagnostic problem. (intubate 以管插入……腔道)
但是，對一個正在插管通氣的成人呼吸窘迫癥病人，診斷是非常困難的。
Patients with this syndrome commonly have abnormal chest radiographic findings, abnormal blood gas values, and elevated temperatures and white blood cell counts even in the absence of infection. (radiographic X線照相術的)
這種患者甚至未存在感染，卻常有陽性胸部X線發(fā)現(xiàn)、血氣值異常、體溫升高、白細胞計數(shù)升高。
Both false-positive and false-negative diagnosis of pneumonia is common.
假陽性和假陰性的肺炎診斷都很常見。
New chest radiographic infiltrates with signs of infection constitute a good indication for bronchoalveolar lavage, a method being used to diagnose and identify bacteria causing ventilator-associated pneumonia, which has proven to minimize the indiscriminate use of antibiotics and possesses a higher specificity than previous methods.
infiltrate 透入、滲透 constitute 構成、指定 indiscriminate 不加區(qū)別的、任意的
possess 擁有、撐握、具有 specificity 明確性、具體性
胸部X線新滲出（陰影)伴有感染征象是支氣管肺泡灌洗的良好指征，這種方法用于診斷和鑒別通氣相關肺炎的病原菌，它被證明最小化了抗生素使用的任意性，比先前的方法更有針對性。
As part of the work-up for fever in a surgical patient, central lines used for monitoring or treatment should always be considered.
work-up 診斷檢查 central 中央的、主要的、近的、便利的 line 線路、方法
作為外科病人發(fā)熱診斷檢查的一部分，用于監(jiān)測或治療的深部導管始終應用考慮。
Catheter-related sepsis is diagnosed when an organism is isolated from blood cultures and from a segment of the catheter in question, without any other source if septicemia and with clinical findings consistent with sepsis.
organism 生物、有機體、有機組織 in question 在考慮中、討論中
當血培養(yǎng)中和有懷疑的導管節(jié)段中分離到病原菌，未發(fā)現(xiàn)其它部位的感染源，而敗血癥臨床表現(xiàn)持續(xù)存在，導管膿毒敗血癥診斷就成立。
Infection of the catheter site is defined as presence of erythema, warmth, tenderness, and/or pus at the site of the catheter insertion. (erythema 紅斑)
導管插入處有紅、（腫)、熱、痛和／或有膿液是導管局部感染的特點。
Both require removal of the catheter, and if a new central line is needed, a new puncture is warranted. (puncture 穿刺 warrant 保證、批準、證明)
兩種情況都要拔除導管，假如需要新的深部導管，要保證從新的部位刺入。
Furth treatment usually depends on the organism isolated.
通常根據(jù)分離到的病菌進行進一步治療。
Placement of lines should be done following standard aseptic and antiseptic technique including wide drapes and full gown and glove for the inserting physician.
drape 窗簾、幔 gown 長禮服、手術衣
