医学护理中英文对照外文翻译文献word版
乳腺癌护理中英文对照外文翻译文献
乳腺癌护理中英文对照外文翻译文献(文档含英文原文和中文翻译)翻译：宗教信仰在应对乳腺癌患者以后生活中的作用目的：识别并检查新诊断为乳腺癌的老年患者中是否存在宗教和精神应对策略现象。
方法：一个简易样本，由被招募来进行为期6个月的诊断的33名65岁女性组成。
受访者被要求参加一个会提出灵活性问题的结构式访谈。
访谈的誊本由三名研究人员各自独立分析讨论其主题,直至达成共识。
结果：参加者的宗教背景为:17名新教徒,五,六名犹太人,天主教和另外四个其它教徒。
她们在出席宗仪式的频率上存在着很大的不同。
而在健康危机期她们的宗教和/或精神信仰或增加或保持不变。
誊本分析显示出了三个主题。
宗教和宗教信仰为受访者提供了必要的情感支持（91%)、社会支持(70%)来面对她们的乳腺癌，以及赋予了她们一些使日常生活变得有意义的能力,特别是癌症经验(64%)。
结论：宗教和宗教信仰为新诊断为乳腺癌的老年女性患者提供了一些重要的应对这些疾病的方法,这些方法也得到了诊断医生的认可。
这可能对于鼓励这些患者寻求宗教的支持和/或重新与她们的宗教团体再结合是非常重要的。
引言一个关于乳腺癌的新的诊断已被证实对女性有重大的影响(格里，1979;琼斯和格林伍德1994；罗兰和马西，1996分;安徒生,1998)。
在老年妇女中，乳腺癌是最常见的癌症，其影响还会因为人口老龄化继续上升。
更好的了解老年妇女如何应对乳腺癌可以使人们更好的增强功能和改善生活质量。
最近日益让人们产生浓厚兴趣的是，宗教或信仰在患者对乳腺癌的反应中所扮演的角色。
在这些老年人中，宗教经常可以帮助她们缓解生理疾病中的固有压力,比如那些伴随着医师会诊、治疗及其它事件所产生的相关压力(包括罗斯,1982;考恩威博士(1985 - 1986);曼弗雷德和皮克特,1987)。
宗教或者精神依赖的正面效应，一直被认为是社会支持的次要规定，其通过与社会性的或教会有关的方式来进行宗教活动。
人们去教堂敬拜时通过培养友情和社会关系来获得能够提供正式的和非正式的社会网络的支持。
医院中英文常用语对照表
医院中英文常用语对照表医院中英文常用语对照表急诊室Emergency Room医院Hospital内科病房Medical Ward外科病房Surgical Ward儿科病房Pediatric Ward接生房Labor and Delivery手术室Operation Room (OR)心脏重症室Coronary Care Unit (CCU)重症室Intensive Care Unit (ICU)内科重症室Medical Intensive Care Unit (MICU)初生婴儿重症室Neonatal Intensive Care Unit (NICU)儿科重症室Pediatric Intensive Care Unit (PICU)外科重症室Surgical Intensive Care Unit (SICU)末期护理Hospice 末期病患者照料居家健康服务Home Health Service 药疗、物理治疗等化验所Laboratory 进行化验研究门诊手术中心Outpatient Surgical Center 一般非严重性手术药房Pharmacy 药物、医疗用品Health Care Provider 医疗服务Physician 医生Acupuncture 针灸Allergy and Immunology 过敏性专科Anesthesiology 麻醉科Cardiology 心脏科Cardio-Thoracic Surgery 心胸外科Chiropractic 脊椎神经科Colorectal Surgery 结肠直肠外科thermocouple pyrometer 热电偶高温计Dentistry 牙科Dermatology 皮肤科Endocrinology 内分泌科Family Practice 家庭科Gastroenterology 肠胃科General Practice 普通全科General Surgery 普通外科Geriatrics 老人病专科Hematology 血液科Hepatology 肝病专科Infectious Disease 传染病科Internal Medicine 内科Nephrology 肾脏科Neurology 神经科Neurosurgery 神经外科Obstetrics-Gynecology 妇产科Oncology 癌症专科Ophthalmology 眼科Optometry 验光科Orthopedic Surgery 骨外科Osteopathy 整骨疗科Otolaryngology (ENT) 耳鼻喉科Pathology 病理科Pediatrics 小儿科Plastic surgery 整形外科Podiatry 足科Psychiatry 精神治疗科Physiatrics 物理疗法Physical Medicine and Rehabilitation 物理疗法及恢复正常生活护理Pulmonary Medicine 肺科Radiation Oncology 癌症放射疗科Radiology Ｘ光科Urology 泌尿科Vascular Surgery 血管外科Other Health Care Professionals 其它医疗专业人员Audiologist 听觉学专家Dental Assistant 牙医助理Dietitian 饮食指导员Genetic Counselor 遗传病辅导员Health Technician 健康技员Laboratory Technician 化验技员Medical Assistant 医务助理Medical Technologist 医学技师Nurse 护士Home Visiting Nurse 家访护士Nurse Midwife 接生护士Nutritionist 营养专家Pharmacist 药剂师Pharmacologist 药理学专家Physical Therapist 物理治疗员Physician's Assistant 医生助手Psychologist 心理学专家Psychologic Counselor 心理辅导员Respiratory Therapist 呼吸治疗员X-Ray Technician Ｘ光科技员。
医学文献翻译(中英对照)
The clinical and cost-effectiveness of Pharmalgen®for the treatment of bee and wasp venom allergy1 TITLE OF PROJECTThe clinical and cost effectiveness of Pharmalgen®for the treatment of bee and wasp venom allergy2 TAR TEAMLiverpool Reviews and Implementation Group (LR i G), University of Liverpool Correspondence to:Rumona Dickson, MsDirector, LR i GUniversity of LiverpoolRoom 2.12WhelanBuildingThe QuadrangleBrownlow HillLiverpoolL69 3GBTel: +44 (0) 151 794 5682Fax: +44 (0)151 794 5585Email: R.DicksonFor details of expertise within the TAR team, see section 7.3 PLAIN ENGLISH SUMMARYAllergic reactions to bee and wasp venom may occur in venom-sensitive patients immediately following a sting, and can vary in severity, with initially mild symptoms sometimes progressing to critical conditions within seconds. The most severe systemic allergic reactions (generalised reactions) are known as anaphylaxis, a reaction characterised by abnormally low blood pressure, fainting or collapse, and in extreme reactions these symptoms can cause death.Each year in the UK there are between two and nine deaths from anaphylaxis caused by bee and wasp venom. The immediate treatment for severe allergic reactions to bee and wasp venom consists of emergency treatment with drugs to decrease the patient’s response to the venom and support breathing, if required.To avoid further reactions, the use of sensitisation to bee and wasp venom, through a process known as venom immunotherapy (VIT), has been investigated. Venom immunotherapy consists of subcutaneous injections of increasing amounts of venom into patients with a history of anaphylaxis to bee and wasp venom. Pharmalgen®has had UK marketing authorisation for the diagnosis and treatment (using VIT) of allergy to bee venom (using Pharmalgen®Bee Venom) and wasp venom (using Pharmalgen®Wasp Venom) since March 1995, and it is used by more than 40 centres across the UK. This review aims to assess whether using Pharmalgen®in VIT is clinically useful when treating people with a history of severe reaction to bee and wasp stings. The review will compare preventative treatment withPharmalgen®to other treatment options, including high dose antihistamines, advice on the avoidance of bee and wasp stings and adrenaline auto-injector prescription and training. If suitable data are available, the review will also consider the cost effectiveness of using Pharmalgen®for VIT and other subgroups including children and people at high risk of future stings or severe allergic reactions to future stings.4 DECISION PROBLEM4.1 Clarification of research question and scopePharmalgen®is used for the diagnosis and treatment of immunoglobin E (IgE)-mediated allergy to bee and wasp venom. The aim of this report is to assess whether the use of Pharmalgen®is of clinical value when providing VIT to individuals with a history of severe reaction to bee and wasp venom and whether doing so would be considered cost effective compared with alternative treatment options available in the NHS.4.2 BackgroundBees and wasps form part of the order Hymenoptera (which also includes ants), and within this order the species that cause the most frequent allergic reactions are the Vespidae (wasps, yellow jackets and hornets), and the Apinae (honeybees).1Bee and wasp stings contain allergenic proteins. In wasps, these are predominantly phospholipase A1,2 hyaluronidase2 and antigen 5,3 and in bees are phospholipase A2 and hyaluronidase.4 Following an initial sting, a type 1 hypersensitivity reaction may occur in some individuals which produces the IgE antibody. This sensitises cells to the allergen, and any subsequent exposure to the allergen may cause the allergen to bind to the IgE molecules, which results in an allergic reaction.These allergens typically produce an intense, burning pain followed by erythema (redness) and a small area of oedema (swelling) at the site of the sting. The symptoms produced following a sting can be classified into non-allergic reactions, such as local reactions, and allergic reactions, such as extensive local reactions, anaphylactic systemic reactions and delayed systemic reactions.5-6 Systemic allergic reactions may occur in venom-sensitive patients immediately following a sting,7 and can vary in severity, with initially mild symptoms sometimes progressing to critical conditions within seconds.1The most severe systemic allergic reaction is known as anaphylaxis. Anaphylactic reactions are of rapid onset (typically up to 15 minutes post sting) and can manifest in different ways. Initial symptoms are usually cutaneous followed by hypotension, with light-headedness, fainting or collapse. Some people develop respiratory symptoms due to an asthma-like response or laryngeal oedema. In severe reactions, hypotension, circulatory disturbances, and breathing difficulty can progress to fatal cardio-respiratory arrest.Anaphylaxis occurs more commonly in males and in people under 20 years of ageand can be severe and potentially fatal.84.3 EpidemiologyIt is estimated that the prevalence of wasp and bee sting allergy is between 0.4% and 3.3%.9 The incidence of systemic reactions to wasp and bee venom is not reliably known, but estimates range from 0.15-3.3%,10-11 Systemic allergic reactions are reported by up to 3% of adults, and almost 1% of children have a medical history of severe sting reactions.9, 12 After a large local reaction, 5–15% of people will go on to develop a systemic reaction when next stung.13 In people with a mild systemic reaction, the risk of subsequent systemic reactions is thought to be about 18%.13 Hymenoptera venom are one of the three main causes of fatal anaphylaxis in the USA and UK.14-15 Insect stings are the second most frequent cause of anaphylaxis outside of medical settings.16 Between two and nine people in the UK die each year as a result of anaphylaxis due to reactions to wasp and bee stings.17 Once an individual has experienced an anaphylactic reaction, the risk of having a recurrent episode has been estimated to be between 60% and 79%.13In 2000, the register of fatal anaphylactic reactions in the UK from 1992 onwards was reported by Pumphrey to determine the frequency at which classic manifestations of fatal anaphylaxis are present.18 Of the 56 post-mortems carried out, 19 deaths were recorded as reactions to Hymenoptera venom (33.9%). A retrospective study in 2004 examined all deaths from anaphylaxis in the UK between 1992 and 2001, and estimated 22.19% to be reactions to Hymenoptera venom (47/212). This further breaks down into 29/212 (13.68%) as reactions to wasp stings, and 4/212 (1.89%) as reactions to bee stings. The remaining 14/212 were unidentified Hymenoptera stings (6.62%).194.4 Current diagnostic optionsCurrently, individuals can be tested to determine if they are at risk of systemic reactions to bee and wasp venom. The primary diagnostic method for systemic reactions to bee and/or wasp stings is venom skin testing.Skin testing involves intradermal injection with the five Hymenoptera venom protein extracts, with venom concentrati ons in the range of 0.001 to 1.0 μg/ml. This establishes the minimum concentration giving a positive result (a reaction occurring in the individual). As venom tests show unexplained variability over time,20 and as negative skin tests can occur following recent anaphylaxis, it is recommended that tests be repeated after 1 to 6 months.21Other methods of diagnosis in patients following an anaphylactic reaction include radioallergosorbent test (RAST), which detects allergen-specific IgE antibodies in serum. This test is less sensitive than skin testing but is useful when skin tests cannot be done, for example in patients with skin conditions.22-234.5 Current treatment optionsPreventative treatments include education on how to avoid bee and wasp venom,and prescription of high dose antihistamines. Patients with a history of moderate local reactions should be provided with an emergency kit,24 containing aH1-blocking antihistamine and a topical corticosteroid for immediate use following a sting. Patients with a history of anaphylaxis should be provided with an emergency kit containing a rapid-acting H1-blocking antihistamine, an oral corticosteroid and an auto-injector for self administration, containing epinephrine.Injected epinephrine (a sympathomimetic drug which acts on both alpha and beta receptors) is regarded as the emergency treatment of choice for cases of acute anaphylaxis as a result of Hymenoptera stings.25 For adults, the recommended dose is between 0.30 mg/ml and 0.50 mg/ml I.M, and 0.01 ml/kg I.M. for children. Individuals with a history of anaphylactic reactions are recommended to carry auto injectors containing epinephrine (commonly known as EpiPen®, Adrenaclick®, Anapen®or Twinject®). These are intended for immediate self-administration by individuals with a history of hypersensitivity to Hymenoptera stings and other allergens.Preventive measures following successful treatment of a systemic allergic reaction to Hymenoptera venom consists of either allergen avoidance or specific allergen immunotherapy, known as VIT. Venom immunotherapy is considered to be a safe and effective treatment.26 Currently, VIT can be used with several regimes, including Pharmalgen®(manufactured by ALK Abello, and licensed in the UK), Aquagen®and Alutard SQ®(both manufactured by ALK Abello and unlicensed in the UK but licensed in some parts of Europe), VENOMENHAL®(HAL Allergy, Leiden, Netherlands, unlicensed in the UK), Alyostal®(Stallergenes, Antony Cedex, France, unlicensed in the UK), and Venomil®(Hollister-Stier Laboratories LLC, unlicensed in the UK). Venom immunotherapy is recommended to prevent future systemic reactions. It is recommended that VIT is considered ‘when positive test results for specific IgE antibodies correlate with suspected triggers and pa tient exposure’.27 Venom immunotherapy consists of subcutaneous injections of increasing amounts of venom, and treatment is divided into two periods: the build up phase and maintenance phase. Venom immunotherapy is now the standard therapy for Hymenoptera sting allergy,28 and is a model for allergen-specific therapy,29-30 with success rates (patients who will remain anaphylaxis free) being reported as more than 98% in some studies.4, 31 There are now 44 centres across the UK which provide VIT to people for bee and wasp sting allergy. Venom immunotherapy is normally discontinued after 3 to 5 years, but modifications may be necessary when treating people with intense allergen exposure (such as beekeepers) or those with individual risk factors for severe reactions. There is no method of assessing which patients will be at risk of further anaphylactic reactions following administration of VIT and those who will remain anaphylaxis free in the long term following VIT.27Local or systemic adverse reactions may occur as a result of VIT. They normally develop within 30 minutes of the injection. Each patient is monitored closely following each injection to check for adverse reactions. Progression to anincreased dose only occurs if the previous dose is fully tolerated.4.6 The technologyPharmalgen®is produced by ALK Abello, and has had UK marketing authorisation for the diagnosis (using skin testing/intracutaneous testing) and treatment (using VIT) of IgE-mediated allergy to bee venom (Pharmalgen®Bee Venom) and wasp venom (Pharmalgen®Wasp Venom) since March 1995 (marketing authorisation number PL 10085/0004). The active ingredient is partially purified freeze dried Vespula spp. venom in Pharmalgen®Wasp Venom and freeze dried Apis mellifera venom in Pharmalgen®Bee Venom, each provided in powder form for solution for injection.Before treatment is considered, allergy to bee or wasp venom must be confirmed by case history and diagnosis. Treatment with Pharmalgen®Bee or Wasp Venom is performed by subcutaneous injections. The treatment is carried out in two phases: the initial phase and the maintenance phase.In the build up phase, the dose is increased stepwise until the maintenance dose (the maximum tolerable dose before an allergic reaction) is achieved. ALK Abello recommends the following dosage proposals: conventional, modified rush (clustered) and rush updosing. In conventional updosing, the patient receives one injection every 3-7 days. In modified rush (clustered) updosing, the patient receives 2-4 injections once a week. If necessary this interval may be extended up to two weeks. The 2-4 injections are given with an interval of 30 minutes. In rush updosing, while being hospitalised the patient receives injections with a 2-hour interval. A maximum of four injections per day may be given in the initial phase.The build up phase ends when the individual maintenance dose has been attained and the interval between the injections is increased to 2, 3 and 4 weeks. This is called the maintenance phase, and the maintenance dose is then given every 4 weeks for at least 3 years.Contra-indications to VIT treatment are immunological diseases (e. g. immune complex diseases and immune deficiencies); chronic heart/lung diseases; treatment with β-blockers; severe eczema. Side effects include superficial wheal and flare due to shallow injection; local swelling (which may be immediate or delayed up to 48 hours); mild general reactions such as urticaria, erythema, rhinitis or mild asthma; moderate or severe general reactions such as more severe asthma, angioedema or an anaphylactic reaction with hypotension and respiratory embarrassment; anaphylaxis (often starting with erythema and pruritus, followed by urticaria, angioedema, nasal or pharyngial congestion, wheezing, dyspnoea, nausea, hypotension, syncope, tachycardia or diarrhoea). 324.7 Objectives of the HTA projectThe aim of this review is to assess the clinical and cost effectiveness of Pharmalgen®in providing immunotherapy to individuals with a history of type 1 IgE-mediated systemic allergic reaction to bee and wasp venom. The review willconsider the effectiveness of Pharmalgen®when compared to alternative treatment options available in the NHS, including advice on the avoidance of bee and wasp stings, high dose antihistamines and adrenaline auto-injector prescription and training. The review will also examine the existing health economic evidence and identify the key economic issues related to the use of Pharmalgen®in UK clinical practice. If suitable data are available, an economic model will be developed and populated to evaluate if the use of Pharmalgen®for the treatment of bee and wasp venom allergy, within its licensed indication, would be a cost effective use of NHS resources.5 METHODS FOR SYNTHESISING CLINICAL EFFECTIVENESS EVIDENCE5.1 Search strategyThe major electronic databases including Medline, Embase and The Cochrane Library will be searched for relevant published literature. Information on studies in progress, unpublished research or research reported in the grey literature will be sought by searching a range of relevant databases including National Research Register and Controlled Clinical Trials. A sample of the search strategy to be used for MEDLINE is presented inAppendix 1.Bibliographies of previous systematic reviews, retrieved articles and the submissions provided by manufacturers will be searched for further studies.A database of published and unpublished literature will be assembled from systematic searches of electronic sources, hand searching, contacting manufacturers and consultation with experts in the field. The database will be held in the Endnote X4 software package.Inclusion criteriaThe inclusion criteria specified in Table 1 will be applied to all studies after screening. The inclusion criteria were selected to reflect the criteria described in the final scope issued by NICE for the review. However, as there is likely to be a limited amount of RCT data, the inclusion criteria of study design may be expanded to include comparative studies and descriptive cohorts. The clinical and cost effectiveness of Pharmalgen®for the treatment of bee and wasp venom allergy Page 11 of 21Table 1: Inclusion criteria Intervention(s) Pharmalgen®for the treatment of bee and wasp venom allergy,Population(s) People with a history of type 1 IgE-mediatedsystemic allergic reactions to:wasp venom and/or bee venomComparators Alternative treatment options available inthe NHS, without venom immunotherapyincluding:advice on the avoidance of bee and wasp venom,high-dose antihistamines,adrenaline auto-injector prescription andtrainingStudy design Randomised controlled trialsSystematic reviewsOutcomes Outcome measures to be considered include:number and severity of type 1 IgE-mediatedsystemic allergic reactionsmortalityanxiety related to the possibility of futureallergic reactionsadverse effects of treatmenthealth-related quality of lifeOther considerations If the evidence allows, considerations willbe given to subgroups of people, according totheir:risk of future stings (as determined, forexample, by occupational exposure)risk of severe allergic reactions to futurestings (as determined by such factors asbaseline tryptase levels and co-morbidities)If the evidence allows, the appraisal willconsider separately people who have acontraindication to adrenaline.If the evidence allows, the appraisal willconsider children separately.Two reviewers will independently screen all titles and abstracts of papers identified in the initial search. Discrepancies will be resolved by consensus and where necessary a third reviewer will be consulted. Studies deemed to be relevant will be obtained and assessed for inclusion. Where studies do not meet the inclusion criteria they will be excluded.Data extraction strategyData relating to study design, findings and quality will be extracted by one reviewer and independently checked for accuracy by a second reviewer. Study details will be extracted using a standardised data extraction form. If time permits, attempts will be made to contact authors for missing data. Data from studies presented in multiple publications will be extracted and reported as a single study with all relevant other publications listed.Quality assessment strategyThe quality of the clinical-effectiveness studies will be assessed accordingto criteria based on the CRD’s guidance for undertaking reviews in healthcare.33-34 The quality of the individual clinical-effectiveness studies will be assessed by one reviewer, and independently checked for agreement by a second. Disagreements will be resolved through consensus and if necessary a third reviewer will be consulted.Methods of analysis/synthesisThe results of the data extraction and quality assessment for each study will be presented in structured tables and as a narrative summary. The possible effects of study quality on the effectiveness data and review findings will be discussed. All summary statistics will be extracted for each outcome and where possible, data will be pooled using a standard meta-analysis.35 Heterogeneity between the studies will be assessed using the I2 test.34 Both fixed and random effects results will be presented as forest plots.6 METHODS FOR SYNTHESISING COST EFFECTIVENESS EVIDENCEThe economic section of the report will be presented in two parts. The first will include a standard review of relevant published economic evaluations. If appropriate and data are available, the second will include the development of an economic model. The model will be designed to estimate the cost effectiveness of Pharmalgen®for VIT in individuals with a history of anaphylaxis to bee and wasp venom. This section of the report will also consider budget impact and will take account of available information on current and anticipated patient numbers and service configuration for the treatment of this condition in the NHS.6.1 Systematic review of published economic literatureThe literature review of economic evidence will identify any relevant published cost-minimisation, cost-effectiveness, cost-utility and/or cost-benefit analyses. Economic evaluations/models included in the manufacturer submission(s) will be included in the review and critiqued as appropriate.Search strategyThe search strategies detailed in section 5 will be adapted accordingly to identify studies examining the cost effectiveness of using Pharmalgen®for VIT in patients with a history of allergic reactions to bee or wasp venom. Other searching activities, including electronic searching of online health economic journals and contacting experts in the field will also be undertaken. Full details of the search process will be presented in the final report. The search strategy will be designed to meet the primary objective of identifying economic evaluations for inclusion in the cost-effectiveness literature review. At the same time, the search strategy will be used to identify economic evaluations and other information sources which may include data that can be used to populate a de novo economic model where appropriate. Searching will be undertaken in MEDLINE and EMBASE as well as in the Cochrane Library, which includes the NHS Economic Evaluation Database (NHS EED).Inclusion and exclusionIn addition to the inclusion criteria outlined in Table 1, specific criteria required for the cost-effectiveness review are described in Table 2. In particular, only full economic evaluations that compare two or more options and consider both costs and consequences will be included in the review of published literature. Any economic evaluations/models included in the manufacturer submission(s) will be included as appropriate. Studies that do not meet all of the criteria will be excluded and their bibliographic details listed with reasons for exclusion.Table 2: Additional inclusion criteria (cost effectiveness) Study design Full economic evaluations that consider both costs and consequences (cost-effectiveness analysis,cost-utility analysis,cost-minimisation analysis and cost benefit analysis)Outcomes Incremental cost per life year gainedIncremental cost per quality adjustedlife year gainedData extraction strategyData relating to both study design and quality will be extracted by one reviewer and independently checked for accuracy by a second reviewer. Disagreement will be resolved through consensus and, if necessary, a third reviewer will be consulted. If time constraints allow, attempts will be made to contact authors for missing data. Data from multiple publications will be extracted and reported as a single study.Quality assessment strategyThe quality of the cost-effectiveness studies/models will be assessed according to a checklist updated from that developed by Drummond et al.36 This checklist will reflect the criteria for economic evaluation detailed in the methodological guidance developed by NICE.37 The quality of the individual cost-effectiveness studies/models will be assessed by one reviewer, and independently checked for agreement by a second. Disagreements will be resolved through consensus and, if necessary, a third reviewer will be consulted. The information will be tabulated and summarised within the text of the report.6.2 Methods of analysis/synthesisCost effectiveness review of published literatureIndividual study data and quality assessment will be summarised in structured tables and as a narrative description. Potential effects of study quality willbe discussed.To supplement findings from the economic literature review, additional cost and benefit information from other sources, including the manufacturer submission(s) to NICE, will be collated and presented as appropriate.Development of a de novo economic model by the AGa. Cost dataThe primary perspective for the analysis of cost information will be the NHS. Cost data will therefore focus on the marginal direct health service costs associated with the intervention.Quantities of resources used will be identified from consultation with experts, primary data from relevant sources and the reviewed literature. Where possible, unit cost data will be extracted from the literature or obtained from other relevant sources (drug price lists, NHS reference costs and Chartered Institute of Public Finance and Accounting cost databases).Where appropriate costs will be discounted at 3.5% per annum, the rate recommended in NICE guidance to manufacturers and sponsors of submissions. 37 b. Assessmentof benefitsA balance sheet will be constructed to list benefits and costs arising from alternative treatment options. LRiG anticipates that the main measures of benefit will be increased QALYs.Where appropriate, effectiveness and other measures of benefit will be discounted at 3.5%, the rate recommended in NICE guidance to manufacturers and sponsors of submissions. 37b. ModellingThe ability of LRiG to construct an economic model will depend on the data available. Where modelling is appropriate, a summary description of the model and a critical appraisal of key structures, assumptions, resources, data and sensitivity analysis (see Section d) will be presented. In addition, LRiG will provide an assessment of the model’s strengths and weaknesses and discuss the implications of using different assumptions in the model. Reasons for any major discrepancies between the results obtained from assessment group model and the manufacturer model(s) will be explored.The time horizon will be a patient’s lifetime in order to reflect the chronic nature of the disease.A formal combination of costs and benefits will also be performed, although the type of economic evaluation will only be chosen in light of the variations in outcome identified from the clinical- effectiveness review evidence.If data are available, the results will be presented as incremental cost per QALY ratios for each alternative considered. If sufficient data are not available to construct these measures with reasonable precision, incrementalcost-effectiveness analysis or cost-minimisation analysis will be undertaken. Any failure to meet the reference case will be clearly specified and justified, and the likely implications will, as far as possible, be quantified.d. Sensitivity analysisIf appropriate, sensitivity analysis will be applied to LRiG’s model in order to assess the robustness of the results to realistic variations in the levels of the underlying parameter values and key assumptions. Where the overall results are sensitive to a particular variable, the sensitivity analysis will explore the exact nature of the impact of variations.Imprecision inthe principal model cost-effectiveness results with respect to key parameter values will be assessed by use of techniques compatible with the modelling methodology deemed appropriate to the research question and to the potential impact on decision making for specific comparisons (e.g. multi-way sensitivity analysis, cost-effectiveness acceptability curves etc).7 HANDLING THE MANUFACTURER SUBMISSION(S)All data submitted by the drug manufacturers arriving before 22nd March 2011 and meeting the set inclusion criteria will be considered for inclusion in the review. Data arriving after this date will only be considered if time constraints allow. Any economic evaluations included in the manufacturer submission(s) will be assessed. This will include a detailed analysis of the appropriateness of the parametric and structural assumptions involved in any models in the submission and an assessment of how robust the models are to changes in key assumptions. Clarification on specific aspects of the model may be sought from the relevant manufacturer.Any 'commercial in confidence' data taken from a manufacturer submission will be clearly marked in the NICE report according to established NICE policy and removed from the subsequent submission to the HTA8 EXPERTISE IN THIS TAR TEAM AND COMPETING INTERESTS OF AUTHORSThis TAR team will be made up of the following individuals:Juliet HockenhullTeam lead /clinical systematicreviewerSenior economic modeller Professor Adrian BagustSystematic reviewer (clinical) Gemma CherrySystematic reviewer (economics) Dr Angela BolandEconomic modeller Dr Carlos Martin SaboridoInformation specialist Dr Yenal DundarMedical statistician James OyeeDirector Ms Rumona DicksonClinical advisor A team of clinical experts will beestablished to address clinicalquestions related to the technologyand to provide feedback on drafts ofthe final report9 REFERENCES1. Freeman T. Hypersensitivity to hymenoptera stings. NEJM. 2004;351:1978-84.。
医药学类文献双语版_汉译英
介导性shRNA能抑制肺癌细胞中livin沉默基因的表达从而促进SGC-7901细胞凋亡背景—由于肿瘤细胞抑制凋亡增殖,特定凋亡的抑制因素会对于发展新的治疗策略提供一个合理途径。
Livin是一种凋亡抑制蛋白家族成员，在多种恶性肿瘤的表达中具有意义。
但是, 在有关胃癌方面没有可利用的数据。
在本研究中,我们发现livin基因在人类胃癌中的表达并调查了介导的shRNA能抑制肺癌细胞中livin沉默基因的表达，从而促进SGC-7901细胞凋亡。
方法—mRNA及蛋白质livin基因的表达用逆转录聚合酶链反应技术及西方吸干化验进行了分析。
小干扰RNA真核表达载体具体到livin基因采用基因重组、测序核酸。
然后用Lipofectamin2000转染进入SGC-7901细胞。
逆转录聚合酶链反应技术和西方吸干化验用来验证的livin基因在SGC-7901细胞中使沉默基因生效。
所得到的稳定的复制品用G418来筛选。
细胞凋亡用应用流式细胞仪(FCM)来评估。
细胞生长状态和5-FU的50%抑制浓度(IC50)和顺铂都由MTT比色法来决定。
结果—livin mRNA和蛋白质的表达检测40例中有19例(47.5%)有胃癌和SGC-7901细胞。
没有livin基因表达的是在肿瘤邻近组织和良性胃溃疡病灶。
相关发现在livin基因的表达和肿瘤的微小分化和淋巴结转移一样(P < 0.05)。
4个小干扰RNA真核表达矢量具体到基因重组的livin基因建立。
其中之一,能有效地减少livin基因的表达,抑制基因不少于70%(P < 0.01)。
重组的质粒被提取和转染到胃癌细胞。
G418筛选所得到的稳定的复制品被放大讲究。
当livin基因沉默,胃癌细胞的生殖活动明显低于对照组(P < 0.05)。
研究还表明,IC50上的5-Fu 和顺铂在胃癌细胞的治疗上是通过shRNA减少以及刺激这些细胞(5-Fu proapoptotic和顺铂)(P < 0.01)。
医用英语医学文献翻译4（缺5,9整理版）
医⽤英语医学⽂献翻译4（缺5,9整理版）UNIT 1 TEXT B刷⽛，使⽤⽛线，以及每年2次的⽛齿检查是⼝腔卫⽣保健标准，但是保护你珍珠样洁⽩的⽛齿的好处远⽐我们知道的还要多。
在⼀篇评论⽂章中，塔夫茨⼤学⽛科医学院的⼀个教员破除了常见的⽛科神话，并概述了饮⾷和营养如何影响⼉童，青少年，孕妇，成年⼈和⽼年⼈的⼝腔健康。
误区1：⼝腔卫⽣的不良后果是限制嘴巴准妈妈也许不知道她们所吃的⾷物会影响到胎⼉的⽛齿发育。
在怀孕过程中的营养缺乏也许会使未出⽣的孩⼦在今后的⽣活中更容易出现蛀⽛。
“在14周到4个⽉⼤的时候，缺乏钙，维⽣素D，维⽣素A，蛋⽩质和卡路⾥会导致⼝腔软组织缺损，” Carole Palmer说。
Carole Palmer是，教育学博⼠(EdD)，注册营养师(RD)，塔夫茨⼤学教授，公共健康和社会服务系营养和⼝腔健康推进部的负责⼈。
有数据表明缺乏⾜够的维⽣素B6和B12可能是导致患唇裂和阻碍味觉形成的危险因素。
在童年的时候，最普遍的疾病是蛀⽛，⼤约⽐⼉童哮喘⾼五倍。
“如果⼀个⼉童因为蛀⽛⽽嘴巴受伤，他/她在学校会⽐较难集中注意⼒，⽽且会更喜欢吃容易咀嚼的⾷物，这些⾷物含有的营养往往更少些。
甜甜圈和点⼼这样的⾷物⼤多营养品质低下，含糖量⾼于其他需要咀嚼的富含营养的⾷物，⽐如⽔果和蔬菜，” Palmer说。
“⼝腔并发症与不良的饮⾷习惯会造成认知和⽣长发育问题，以及导致肥胖。
”误区2：吃越多糖，越容易蛀⽛这与你吃了多少糖⽆关，⽽是糖和⽛齿接触的时间有多少。
“⾷物，⽐如慢慢溶解的糖果和苏打⽔在嘴巴⾥停留的时间会⽐较久。
这增加了⽛齿暴露在⼝腔细菌由糖产⽣成的酸中的时间，” Palmer说。
有研究表明，⼗⼏岁的青少年⼤约40%的碳⽔化合物是由软饮料中摄取的。
这些源源不断地软饮料增加了⽛齿腐烂的风险。
⽆糖碳酸饮料和酸性饮料，⽐如柠檬⽔，往往被认为⽐含糖饮料对⽛齿更安全，但是经常⾷⽤的话仍会造成⽛齿釉质脱矿。
医学英文翻译文献
英文文献翻译第1 篇 Effects of sevoflurane on dopamine, glutamate and aspartate release in an vitro model of cerebral ischaemia七氟醚对离体脑缺血模型多巴胺、谷氨酸和天冬氨酸释放的影响兴奋性氨基酸和多巴胺的释放在脑缺血后神经损伤中起重要作用。
在当前的研究中，采用离体脑缺血模型观察七氟醚对大鼠皮质纹状体脑片中多巴胺、谷氨酸和天冬氨酸释放量的影响。
脑片以34℃人工脑脊液灌流，缺血发作以去除氧气和降低葡萄糖浓度（从4mmol/l至2mmol/l）≤30分钟模拟。
多巴胺释放量用伏特法原位监测，灌流样本中的谷氨酸和天冬氨酸浓度用带有荧光检测的高效液相色谱法测定。
脑片释放的神经递质在有或无4%七氟醚下测定。
对照组脑片诱导缺血后，平均延迟166s（n=5）后细胞外多巴胺浓度达最大77.0μmol/l。
缺血期4%七氟醚降低多巴胺释放速率，（对照组和七氟醚处理组脑片分别是6.9μmol/l/s和4.73μmol/l/s，p<0.05），没有影响它的起始或量。
兴奋性氨基酸的释放更缓慢。
每个脑片基础（缺血前）谷氨酸和天冬氨酸是94.8nmol/l和69.3nmol/l，没有明显被七氟醚减少。
缺血大大地增加了谷氨酸和天冬氨酸释放量（最大值分别是对照组的244%和489%）。
然而，4%七氟醚明显减少缺血诱导的谷氨酸和天冬氨酸释放量。
总结，七氟醚的神经保护作用与其可以减少缺血引起的兴奋性氨基酸的释放有关，较小程度上与多巴胺也有关。
第2篇The Influence of Mitochondrial K ATP-Channels in the Cardioprotection of Proconditioning and Postconditioning by Sevoflurane in the Rat In Vivo线粒体K ATP通道在离体大鼠七氟醚预处理和后处理中心肌保护作用中的影响挥发性麻醉药引起心肌预处理并也能在给予再灌注的开始保护心脏——一种实践目前被称为后处理。
医学常用护理学术语中英文翻译
医学常用护理学术语中英文翻译一、导言近年来，医学领域的国际合作与交流日益频繁，为确保交流的准确性与一致性，医学常用护理学术术语的中英文翻译显得尤为重要。
本文旨在对一些常用的护理学术术语进行准确的中英文翻译，以促进医学护理领域的国际交流与合作。
二、常用护理学术术语中英文对照1. 护士 (Nurse)护士是指从事护理工作的专业人员，主要负责照顾患者的生活起居和医疗护理。
2. 护理 (Nursing)护理是指通过采取一系列措施，帮助患者维持或恢复健康，提高患者的自理能力。
3. 患者 (Patient)患者是指接受医学护理服务的人员，通常因患病或需要专业护理而入院或就诊。
4. 病历 (Medical Record)病历是指记录患者个人信息、疾病状况、治疗过程和效果等医学护理信息的文件。
5. 诊断 (Diagnosis)诊断是指通过收集、分析患者的病史、体征和实验室检查等信息，确定患者所患疾病的过程。
6. 治疗 (Treatment)治疗是指为了缓解疾病症状、恢复患者健康，而采取一系列医疗手段、药物或操作的过程。
7. 医嘱 (Medical Order)医嘱是指医生根据患者的具体情况，书写的包括用药、操作、护理措施等在内的治疗建议。
8. 预防护理 (Preventive Care)预防护理是指通过健康宣教、疫苗接种等手段，预防疾病，减少疾病发生的护理措施。
9. 术前护理 (Preoperative Care)术前护理是指在患者进行手术前，通过准备环境、术前教育等方法，为手术创造有利条件的护理措施。
10. 术后护理 (Postoperative Care)术后护理是指在患者完成手术后，通过监测、处理手术创面、预防并发症等方法，促进患者康复的护理。
11. 吸氧 (Oxygen Therapy)吸氧是指通过给患者供应纯氧或含氧气体的方法，提高患者体内氧气浓度，促进组织的氧合作用。
12. 静脉输液 (Intravenous Infusion)静脉输液是指将药物或溶液通过静脉注射进入患者体内，以快速达到治疗目的的方法。
病历中英文对照文献
病历中英文对照文献Medical records play a crucial role in the healthcare system, serving as comprehensive documentation of a patient's medical history, treatment, and ongoing care. In an increasingly globalized world, where patients may seek medical attention in different countries or work with healthcare providers from diverse linguistic backgrounds, the need for bilingual medical records has become paramount. This essay will explore the importance of bilingual medical records, the challenges associated with their implementation, and the potential benefits they can offer to both patients and healthcare professionals.One of the primary reasons for the growing demand for bilingual medical records is the increasing mobility of patients. As people travel more frequently for work, education, or leisure, they may find themselves in need of medical care in a country where the primary language differs from their own. Providing these patients with medical records that are easily understood in both their native language and the language of the healthcare system can significantly improve the quality of care they receive. By ensuring that all relevant information is accurately conveyed, healthcare providers can makemore informed decisions, tailor treatments to the patient's specific needs, and reduce the risk of misunderstandings or medical errors.Moreover, the importance of bilingual medical records extends beyond the needs of traveling patients. In many countries, particularly those with diverse immigrant populations, healthcare providers often encounter patients who do not speak the dominant language fluently. In these situations, the availability of bilingual medical records can greatly facilitate communication and ensure that the patient's medical history, symptoms, and treatment preferences are accurately documented and understood by the healthcare team. This can lead to more effective and personalized care, as well as a more positive patient experience.The implementation of bilingual medical records, however, is not without its challenges. One of the primary obstacles is the need for accurate and consistent translation of medical terminology and documentation. Medical language can be highly specialized, with a vast array of technical terms and abbreviations that may not have direct equivalents in other languages. Ensuring the accuracy and consistency of these translations is crucial, as any discrepancies or errors could have serious implications for patient care.Another challenge lies in the standardization and integration of bilingual medical records within existing healthcare systems.Healthcare providers often rely on established electronic medical record (EMR) systems, and the integration of bilingual functionality into these systems can be a complex and resource-intensive process. Factors such as data storage, user interfaces, and data exchange protocols must all be carefully considered to ensure the seamless integration of bilingual medical records.Despite these challenges, the potential benefits of bilingual medical records are significant. By facilitating better communication and understanding between patients and healthcare providers, bilingual medical records can lead to improved health outcomes, reduced medical errors, and enhanced patient satisfaction. Patients who are able to access and understand their medical records in their native language are more likely to be actively engaged in their own healthcare, leading to better adherence to treatment plans and a stronger partnership between the patient and the healthcare team.Moreover, the availability of bilingual medical records can also have broader societal benefits. In regions with diverse immigrant populations, the provision of bilingual medical records can help to address healthcare disparities and ensure that all members of the community have equal access to quality medical care, regardless of their linguistic background. This can contribute to the overall well-being of the population and promote social equity in the healthcare system.In conclusion, the importance of bilingual medical records cannot be overstated. As the world becomes increasingly interconnected, the need for effective communication and understanding between patients and healthcare providers has become more critical than ever. By addressing the challenges associated with the implementation of bilingual medical records and embracing the potential benefits they offer, healthcare systems can strive to provide more inclusive, personalized, and effective care for all patients, regardless of their linguistic background. This commitment to bilingual medical records represents a crucial step towards a more equitable and accessible healthcare system, one that can truly meet the diverse needs of the global community.。
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医学护理中英文对照外文翻译文献
宗教信仰在应对乳腺癌患者以后生活中的作用
目的：
识别并检查新诊断为乳腺癌的老年患者中是否存在宗教和精神应对策略现象。
方法：
一个简易样本，由被招募来进行为期6个月的诊断的33名65岁女性组成。
受访者被要求参加一个会提出灵活性问题的结构式访谈。
访谈的誊本由三名研究人员各自独立分析讨论其主题,直至达成共识。
结果：
参加者的宗教背景为:17名新教徒,五,六名犹太人,天主教和另外四个其它教徒。
她们在出席宗仪式的频率上存在着很大的不同。
而在健康危机期她们的宗教和/或精神信仰或增加或保持不变。
誊本分析显示出了三个主题。
宗教和宗教信仰
为受访者提供了必要的情感支持(91%)、社会支持(70%)来面对她们的乳腺癌，以及赋予了她们一些使日常生活变得有意义的能力,特别是癌症经验(64%)。
结论：
宗教和宗教信仰为新诊断为乳腺癌的老年女性患者提供了一些重要的应对这些疾病的方法,这些方法也得到了诊断医生的认可。
这可能对于鼓励这些患者寻求宗教的支持和/或重新与她们的宗教团体再结合是非常重要的。
引言
一个关于乳腺癌的新的诊断已被证实对女性有重大的影响(格里，1979;琼斯和格林伍德1994;罗兰和马西，1996分;安徒生,1998)。
在老年妇女中，乳腺癌是最常见的癌症，其影响还会因为人口老龄化继续上升。
更好的了解老年妇女如何应对乳腺癌可以使人们更好的增强功能和改善生活质量。
最近日益让人们产生浓厚兴趣的是，宗教或信仰在患者对乳腺癌的反应中所扮演的角色。
在这些老年人中，宗教经常可以帮助她们缓解生理疾病中的固有压力,比如那些伴随着医师会诊、治疗及其它事件所产生的相关压力(包括罗斯,1982;考恩威博士(1985 - 1986);曼弗雷德和皮克特,1987)。
宗教或者精神依赖的正面效应，一直被认为是社会支持的次要规定，其通过与社会性的或教会有关的方式来进行宗教活动。
人们去教堂敬拜时通过培养友情和社会关系来获得能够提供正式的和非正式的社会网络的支持。
另一些人认为,宗教允许人们获得一种在某种意义上能够控制她们的命运的感觉。
虽然我们知道宗教和精神信仰有助于应对癌症诊断的影响以及随后的调整，但是信念所给予的帮助机制却还没有得到很好的阐明。
在这个探索性研究中,我们调查了宗教和精神在确诊为乳腺癌的老年妇女的生活中所扮演的角色。
研究的问题包括:宗教和精神在乳腺癌的确诊后扮演什么角色?宗教和精神有没有提供一种应对确诊时的不幸感的方法?如果是这样的话,又该如何?
这里所讨论的数据来自于一个更大的研究，是在加州大学洛杉矶分校家庭医学部门正在进行的关于老年女性乳腺癌患者的生命质量的研究。
本研究使用定性方法,为了评估新诊断出患有乳腺癌的老年患者的心理、社会、信息、健康需求。
本研究的长期目标是为了发展使病人能够获取信息、情感和社会支持的干预能力,这会提高她们的生活质量。
方法：
样本
我们使用了一个方便抽样策略,招收来自8个研究基地的参与者,这其中就有社区及医院乳癌和癌症研究中心、私人外科病房和肿瘤实验所,分别坐落于洛杉矶县的五个不同地区(东洛杉矶,洛杉矶市中心,长长的海滩上,圣莫尼卡和西洛杉矶)。
参与的社区医师(包括外科医师、医学肿瘤学家,放射肿瘤学家)在之前的6个月被要求能够分辨出65岁以及年龄更大的确诊患有乳腺癌的女性。
规定半年期限制是为了保证受试者能够足够接近准确地回忆起，当得知确诊为乳腺癌时对她们的生活所造成的影响。
其它入选标准包括是否能够熟练掌握英文或西班牙语中的其中一种语言，以及在面试时的认知能力。
医生写信邀请她们参与研究，写信者们并不知道所发信函的总人数。
90个病人收到了信,49个(54%)表示出参与这项研究的兴趣。
49个人中,2位(4%)妇女拒绝了，因为她们住在洛杉矶，地理距离超过100英里,6人(12%)尽管在调查人员的不懈努力下也不可能到达,7人(14%)在定性访谈研究结束后才回复，1个(2%)不符合纳入标准。
剩下的33名女性完成了面试。
每场面谈都为参与者提供了一个方便的位置选择(94%的人选择了她们自己的家园)。
为了符合社会大众的经济利益标准,受试者被给予30美元现金以激励她们继续参与。
面试被结构化的录下来,然后原封不动地选取转录。
工具：
一份有着开放性主题的结构式问卷被用于个人采访中。
问题集中在参与者与她们的诊断医生的交往,在得到乳腺癌的诊断后她们需要什么样的社会心理支持，反抗什么样的心理支持,得了乳腺癌决定如何治疗等等。
面试官也会提问关于宗教和精神方面的问题。
这些问题集中在宗教对这些参加者的日常生活的影响，特别突出在乳腺癌方面。
例如一个关于宗教/精神的开放性问题是这样的:你的宗教或者精神信仰在乳腺癌期间起到了什么作用?每场面谈都持续大约2小时。
数据分析：
面谈内容被不同理论背景的研究人员(一位在宗教中培养的社会学家,一个家庭医生和老年医学专家，一位医科学生研究助理) 独立鉴定了循环主题审核并且进行了文本分析。
谈话内容的简版和主题由每个研究员写一部分。
访谈内容被分成不同段落并根据主题重新编排。
每个研究员在结果进行比较和讨论之前都会独立的编排数据并且分类。
最终的分类都是寻求饱和主题——就是观察哪个主题最终会从数据中显露出来。
之所以会认同这个模式是因为一致性是定性分析的标志，以及等价于定量工作的有效性。
现在的工作中值得注意的是, 虽然每个研究员都会在她们的训练中给出特定的敏感性分析，但是共识却是在宗教和精神的主题中达成的。
结果
这33个人的平均年龄是74.4岁，受访者年龄范围为65 - 86岁。
尽管大约。