临床医学英语

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1、临床医学英语Chapter 1 Patient-Physician Interaction Page 1第一章 医患沟通 第页The patient-physician interaction proceeds through many phases of clinical reasoning and decision making.proceed 进行、开展 reasoning 推论、推理 clinical reasoning 诊断clinical decision 确定治疗方案 making decision 做出决定医患沟通在临床诊断和治疗决策的许多时期进行着。The interacti

2、on begins with an elucidation of complaints or concerns,followed by inquiries or evaluation toaddress these concerns in increasingly precise ways.elucidation 说明、阐明 inquire 询问、调查 evaluation 评估、评价这种沟通开始于病人主诉或所关注问题的阐明，然后通过交流、评估不断精确地确定这些问题。The process commonly requires a careful history or physical exam

3、ination,ordering of diagnostic tests,integration of clinical findings with the test results,understanding of the risks and benefits of the possiblecourses of action,and careful consultation with the patient and family to develop future plans.integration 综合 consultation 磋商、会诊这个过程通常需要细致的询问病史和体格检查，开具诊断

4、性化验医嘱，综合临床发现和化验结果，理解分析拟行治疗过程中的风险和疗效，然后与病人及家属反复磋商以完善治疗方案Physicians increasingly can call on a growing literature of evidence-based medicine to guide the process sothat benefit is maximized,while respecting individual variations among different patientsrespecting 注意到、关系、说到 evidence-based medicine 循证医学

5、尽管考虑到不同病人中个体差异是存在的，但医生们越来越容易查阅不断增长的循证医学文献来指导这个过程，使得疗效最大化。The increasing availability of randomized trials to guide the approach to diagnosis and therapy should not beequated with cookbook medicineavailability可利用性，可得到 randomize 随机的cookbook 食谱，烹调书 approach 接近但是，不断增加的可用于指导临床诊断与治疗的随机试验资料不应当作烹调书使用。Eviden

6、ce and the guidelines that are derived from it emphasize proven approaches for patients with specificcharacteristics.Evidence 证据，迹象 guideline指导方针 emphasize 强调那些随机试验获得的临床表现和诊断思路是侧重于求证具有某些特征病人而来的。Substantial clinical judgment is required to determine whether the evidence and guidelines apply to indivi

7、dualpatients and to recognize the occasional.substantial clinical 真实的，实在的 individual 个体 occasional 偶尔的，特殊的实际的临床判断需要确定这些临床表现和诊断依据标准是否能应用于普通病人的个体，并能找出例外。Even more judgment is required in the many situations in which evidence is absent or inconclusive.inconclusive 不确定性，非决定性在许多情况下，临床表现缺乏或不典型，甚至需要考虑得更多。E

8、vidence also must be tempered by patients preferences,although it is a physicians responsibility toemphasize when presenting alternative options to the patient.1临床医学英语temper 脾气，调音 preference 偏爱 presenting 提出 alternative 可选择的，二选一虽然医生喜欢提出选择性问题让病人回答，但病人肯定会根据自己的倾向调节临床症状。The adherence of a patient to a s

9、pecific regimen is likely to be enhanced if the patient also understands therationale and evidence behind the recommended option.adherence 坚持、固执 regimen 养生法、食物疗法enhance 提高、加强 rationale 基本原理假如还懂得所提供问题的基本原理和表现，有特殊生活方法病人的固执容易强化这种倾向To care for a patient as an individual,the physician must understand the

10、 patient as a person.care for 喜欢、照料为了把病人作为一个个体进行治疗，医生必须理解病人是一个人（不是一群人）。This fundamental precept of doctoring includes an understanding of the patients social situation,family issues,financial concerns,and preferences for different types of care and outcomes,ranging from maximumprolongation of life t

11、o the relief of pain and suffering.precept 训戒 doctoring 行医 prolongation 延长这个最基本的行医原则包括了解病人的社会地位，家庭问题，资金状况以及正确理解病人对不同治疗方法、不同治疗结果的选择，从最大限度地延长生命到临时缓解疼痛和症状。Even as physicians become increasingly aware of new discoveries,patients can obtain their own informationfrom a variety of sources,some of which are

12、 of questionable reliability.questionable 可疑的、成问题的、不可靠的 reliability 可靠、可信赖的甚至，当医生越来越容易知道新发现的同时，病人也能够通过各种途径得到他们的信息，某些信息是不可靠的。The increasing use of alternative and complementary therapies is an example of patients frequentdissatisfaction with prescribed medical therapy.alternative 选择，替代 complementary

13、补充的、相配的 prescribe 规定、指定、开处方不断增加的替代疗法和辅助疗法的应用就是病人对常规疗法经常不满意的一个例子。Physicians should keep an open mind regarding unproven options but must advise their patients carefully ifsuch options may carry any degree of potential risks,including the risk that they may relied on to substitute forproven approaches

14、substitute 代替、代用 rely on 依赖、信任医生对新疗法应该保持开放的思想，但是，如果这些疗法具有任何程度的潜在风险，都必须细致地告知病人，包括可能需要用已证实的常规疗法去替代的风险。It is crucial for the physician to have an open dialogue with the patient and family regarding the full range ofoptions that either may considercrucial 严酷的、决定性的 either 两者任一对医生来说，对病人及家属开诚布公地介绍所有可考虑的治疗选

15、择，是非常重要的。The physician does not exist in a vacuum but rather as part of a complicated and extensive system of medicalcare and pubic health.vacuum 真空 extensive 广阔的、大量的医生不是生存在真空中，而是作为一个复杂而庞大的医疗和公共健康体系中的一部分。In premodern times and even today in some developing countries,basic hygiene,clean water,and ade

16、quatenutrition have been the most important ways to promote health and reduce disease.2临床医学英语adequate 足够的、恰当的在未发达时代，甚至当今在一些发展中国家，基本卫生条件、清洁饮用水和最低营养保障是促进健康的最重要方法。In developed countries,the adoption of healthy lifestyles,including better diet and appropriate exercise,arecornorstones to reducing the epi

17、demics of obesity,coronary disease,and diabetes.adoption 采纳、采用 epidemic 流行、传染在发达国家中，健康的生活方式包括良好饮食和适当锻炼，是减少肥胖、冠心病和糖尿病的基础。Public health interventions to provide immunizations and to reduce injuries and the use of tobacco,illicit drugs,and excess alcohol collectively can produce more health benefit tha

18、n nearly any other imaginable healthintervention.illicit 非法的、违禁的 collectively 全体地、共同地 produce 生产、创造公共健康干预如进行疫苗接种、减少损伤、减少吸烟、减少吸毒、减少酗酒等措施共同产生的健康效果比几乎可想象的任何其它健康干预措施都要好得多。Chapter Vital signs Page 15第六章 生命体征 第页A nurse or assistant often obtains the vital signs.护士或护士助手经常可得到生命体征Traditionally the vital sign

19、s include pulse rate,blood pressure,respiratory rate,and body temperature.传统的生命体征包括脉搏（率）、血压、呼吸（频率）和体温。More recently,advocates of various causes have advocated for a fifth vital sign.advocate 提倡、主张最近，人们以多种理由提出 第五生命体征的建议。The most cogent of these new vital signs is the patients quantitative assessment

20、of pain.cogent 今人信服的，切实的，有力的这些新的生命体征中，最今人信服的是病人疼痛的定量评判。The pulse should be recorded as not just the rate but also the rhythm.脉搏不仅要记录频率，而且要记录节律。Physicians may prefer to initiate the examination by holding the patients hand while palpating the pulse.initiate 开始，创始医生喜欢握住病人的手，触摸脉搏，开始检查。This nonthreateni

21、ng initial contact with the patient allows the physician to determine whether the patient has aregular or irregular rhythm.这个对病人无威胁性的最初接触让医生确定了脉搏是否具有节律性。When the blood pressure is abnormal,many physicians repeat the measurement.当测得的血压不正常，许多医生重复这个测量。The instrument error that contributes to the greate

22、st variability is the cuff size of the sphygmomanometer.variability 变化，易变性 sphygmomanometer 血压计变异性中占比例最大的设备误差是血压计袖套的大小。Many adults require a large-size adult cuff;using a narrow cuff can alter systolic/diastolic blood pressure by-8to+10/+2 to+8mmHg.3临床医学英语mmHg:millimeter of mercury许多成人需用大号的成人袖套，如果使用

23、窄袖套能够影响收缩压-810mmHg，舒张压 28mmHg。The appearance of repetitive sounds(Korotkoff sounds,phase 1)constitutes the systolic pressure.constitute 构成，设立，指定重复脉搏音（Korotkoff 音，第相）的出现定为收缩压。After the cuff is inflated about the palpated pressure,the Korotkoff sounds muffle and disappear as pressure isreleased(phase

24、5).inflate 充气、膨胀 muffle 含糊不清当袖套充气压力约在可触摸脉搏压力的2030mmHg 上方，Korotkoff 音变钝，当压力释放，Korotkoff 音消失（第相）。The level at which the sounds disappear is the diastolic pressure.声音消失的水平就是舒张压The American Heart Association recommends that each measure should be rounded upward to the nearest2mmHgbe round up to the near

25、est whole number取最近的整数美国心脏病协会建议每次测量取最近的mmHg 整数。The respiratory rate should be assessed at the same time the patient is observed to determine whether there isany respiratory discomfort(dyspnea).dyspnea 呼吸困难测量呼吸频率的同时要观察病人以确定是否存在呼吸困难。The subjective sensation of dyspnea is caused by an increased work of

26、 breathing.subjective 主观的呼吸困难的主观感觉是由于呼吸功增加起的。The examiner should decide whether patients have tachypnea(a rapid rate of breathing)or hypopnea(a slowor shallow rate of breathing).tachypnea 呼吸急促 hypopnea 呼吸减弱检查者要确定病人是否存在呼吸急促（呼吸频率快）或呼吸减弱（呼吸频率慢或浅）Tachpnea is not always associated with hyperventilation,w

27、hich is defined by increased alvealar ventilationresulting in a lower arterial carbon dioxide level.hyperventilation 换气过度 resulting in 导致、引起呼吸急促不是都伴有过度换气，过度换气的定义是肺泡通气量增高引起动脉血二氧化碳水平降低。In the evaluation of patients suspected of having pneumonia,examiners agree on the presence of tachypneaonly 63%of th

28、e time.agree on 对取得一致意见对一组疑为肺炎患者的评估中，检查者认为当时呼吸急促的出现率仅为63%。The body temperature of adults usually is measured with an oral electric thermometer.成人体温通常用口腔电子体温计测定。These thermometers correlate well with the traditional mercury thermometer and are safer to use.mercury 汞这种体温计与传统的汞体温计高度相关，使用安全。4临床医学英语Recta

29、l thermometers reliably record temperatures 0.4 higher than oral thermometers.直肠体温计可靠地记录了高于口表0.4的温度。By comparison,newer tympanic thermometers may vary too much compared with oral thermometers(-1.2 to+1.6 versus the oral temperature)to be reliable among hospitalized patients.tympanic 鼓膜的、鼓室的 too much

30、 to be 太以致于不相比较，新型的鼓式体温计相对口表可能误差太大（与口表相差-1.21.6 度），不宜用于住院病人。Chapter 8 Why Geriatric Patients Are Different Page 20第八章 老年病人的特殊性 第 20 页Older patients differ from young or middle-aged adults with the same disease in many ways,one of which isthe frequent occurrence of comorbidities and of subclinical or

31、bidities 并存病 subclinical 亚临床的同样的疾病，年龄大的病人在许多方面与青中年病人是有区别的，其中之一是并存病多和亚临床疾病多。As a function of the high prevalence of disease,comorbidity(or the co-occurrence of two or more diseases inthe same individual)is also common.prevalence 流行、普遍 co-occurrence 同时发生作为高发疾病的结果，并存病（两个或更多的疾病在同一个体同时发生）也是多见的。Of people

32、age 65 and older,50%have two or more chronic disease,and these diseases can confer additiverisk of adverse outcomes,such as mortality.confer 授予、给予 additive 附加的、附属物65 岁以上的老年中，50%患有两种以上的慢性疾病，这些疾病能够增加不利预后的风险，如死亡率。In some patients,cognitive impairment may mask the symptoms of important conditions.cognit

33、ive 认知的、认识的 impairment 损害 mask 口罩、假面具、掩饰在一些病人中，认知损害可以掩盖重要病情的症状。Treatment for one disease may affect another adversely,as in the use of aspirin to prevent stroke in individualswith a history of peptic ulcer disease.stroke 中风 peptic ulcer 消化性溃疡对一种疾病的治疗可能加重另一种疾病，例如，对有消化性溃疡病史的病人使用阿斯匹林预防中风。The risk for b

34、ecoming disabled or dependent also increases with the number of diseases present.disabled 残废的、有缺陷的 dependent 依靠的、依赖的病残或生活不能自理发生的风险也随着并存的疾病数而增高。Specific pairs of diseases can increase synergistically the risk of disability.synergistic 协同的特殊的成对疾病可以协同增加病残的风险。Arthritis and heart disease coexist in 18%of

35、 older adults;although the odds of developing disability areincreased by three-fold to four-fold with either disease alone,the risk of disability increases 14-fold if both arepresent.arthritis 关节炎有 18%的老年人同时患有关节炎和心脏病，虽然每个疾病可以增加34 倍的病残率，但两个疾病同时存在，可使病残率提高 14 倍。5临床医学英语A second way in which older adults

36、 differ from younger adults is the greater likelihood that their diseasespresent with nonspecific symptoms and signs.likelihood 可能性老年与青中年的第二个差异是更容易出现非典型的症状和体症。Pneumonia and stroke may present with nonspecific changes in mentation as the primary symptom.pneumonia 肺炎 mentation 精神作用、心理活动 primary 初始的、首要

37、的、主要的肺炎和中风时可出现非典型意识变化作为主要的症状。Similarly,the frequency of silent myocardial infarction increases with increasing age,as does the proportion ofpatients who present with a change in mental status,dizziness,or weakness rather than typical chest pain.silent 沉默的、静止的 proportion 成比例的、相称的同样地，隐匿性心肌梗塞发生频度随着年龄的增

38、大而增加，这些病人相应地频发精神状态改变、眩晕、虚弱而不是典型的胸痛症状。As a result,the diagnostic evaluation of geriatric patients must consider a wider spectrum of diseases thangenerally would be considered in middle-aged adults.spectrum 谱、光谱因此，老年病人的诊断应考虑更广泛的疾病谱，要超过通常对中年病人所考虑的范围。A third condition that is found primarily in older ad

39、ults is frailty,frailty is thought to be a wasting syndrome thatpresents with multiple symptoms and signs,including reduced muscle mass,weight loss,weakness,poorexercise tolerance,slowed motor performance,and low physical activity.primarily 起初、首先、原来 frailty 脆弱、虚弱、意志薄弱tolerance 宽容、忍耐、耐受主要出现在老年人的第三个情况

40、是衰弱，衰弱被认为属于衰竭综合症，它有许多症状和体征中，包括肌肉萎缩、体重下降、虚弱、运动耐受差、动作慢、身体活动少。Some estimates indicate that the full syndrome is found in 7%of community-dwelling people age 65 and older,and in 25%of community-dwelling people age 85 and older.estimate 估计、评价、看法 indicate 指出、表时、象征、适应征一些人估计 7%的 65 岁以上社区老人和 25%的 85 岁以上社区老人上述

41、症状全部出现。Many institutionalized older adults also are frail.institutionalized 使成公共团体、将收容在公共设施里frail 身体虚弱的、易损坏的、意志薄弱的许多老人院里的老人也是衰弱的。Frailty is a state of decreased reserve and increased vulnerability to all kinds of stress,from acute infection orinjury to hospitalization,and may identify individuals wh

42、o cannot tolerate invasive therapies.reserve 保存、克制 vulnerability 易受伤、易受责难衰弱是对各种压力耐受下降、损害增加的一种状态，从急性感染、损伤到住院治疗，都可以发现一些人不能忍受侵入性诊疗措施。The syndrome of frailty is associated with high risk of falls,needs for hospitalization,disability,and mortality.fall 跌倒、下降 frail 身体虚弱的、易损坏的、意志薄弱的衰弱的症状与易于病倒、需要住院治疗、病残、死亡的

43、高风险是相关的。6临床医学英语There is early evidence that a core component of frailty is sarcopenia,or loss of muscle mass associated withaging,which occurs in 13 to 24%of persons age 65 to 70 and in 60%of persons age 80 and ponent 成分、构成要素 sarcopenia 肌减少（症）、与年龄相关的骨骼肌质量下降衰弱一个主要成分的早期表现是肌肉减少，或说随年龄增长的肌肉减少，它发生在1324%的

44、6570 岁的老人，60%的 80 岁以上的老人。It is likely that dysregulation of multiple physiologic systems,including inflammation,hormonal status,andglucose metabolism,underlies the syndrome,with resulting decreased ability to maintain homeostasis in theface of stress.dysregulation 失调 homeostasis 内环境稳定多种生理系统易于失调，包括炎症

45、、激素状态、糖的代谢，结果是在压力面前保持内环境的稳定的能力下降。Subclinical disease(e.g.,atherosclerosis),end-stage chronic disease(e.g.,heart failure),or a combination ofcomorbid diseases may precipitate the syndrome.atherosclerosis 动脉粥样硬化亚临床疾病(如动脉粥样硬化),晚期慢性疾病(如心力衰竭），或多种疾病并存可共同形成症状。Evidence from randomized,controlled trials show

46、s that resistance exercise,with or without nutritionalsupplements,and home-based physical therapy can increase lean body mass and strength in even the frailestolder adults.随机对照试验的迹象显示无论有无营养支持和家庭身体疗法，即使是最虚弱的老年人，对抗运动能够增加瘦弱躯体的质量和力量。This evidence suggests that earlier stages of frailty may be remediable

47、,although end-stage frailty likelypresages death.remediable 可挽回的 presage 预兆、预示这个结果提示早期衰弱是可挽回的，尽管末期衰弱常提示死亡。Fourth,cognitive impairment increases in prominence as people age.prominence 突出、显著第四，人们变老时认知损害显著增加。Cognitive impairment is a risk factor for a wide range of adverse outcomes,including falls,immo

48、bilization,dependency,institutionalization,and mortality.immobilization 活动能力减少 institutionalization 制度化、专门照料认知损害是大量不利结果的风险因子，包括摔倒、活动能力下降、不能自理、需住老人院护理、死亡。Cognitive impairment complicates diagnosis and requires additional care giving to ensure safety.认知损害使诊断复杂，为保证安全需要更多的照料。Finally,a serious and common

49、 outcome of chronic diseases of aging is physical disability,defined as havingdifficulty or being dependent on others for the conduct of essential or personally meaningful activities of life,from basic self-care(e.g.,bathing or toileting)to tasks required to live independently(e.g.,shopping,preparin

50、gmeals,or paying bills)to a full range of activities considered to be productive and/or personally meaningful.最后，老年人慢性病严重又常见的结果是身体能力不足，描述为个人最基本的或有意义的日常活动有困难或不得不依靠别人帮助指导，从基本的自理（如洗澡或如厕）到独立生活需要的各种任务（如购物、做饭、支付各种账单），到具有集体和或个人意义的所有活动。7临床医学英语Of older adults,40%report difficulty with tasks requiring mobilit

51、y,and difficulty with mobility predicts the futuredevelopment of difficulty in instrumental activities of daily living(IADL;household management tasks)andactivities of daily living(ADL;basic self-care tasks).在老年人中，40%对需要运动的任务有困难，运动困难提示将来开展日常工具锻炼（IADL；家庭护理项目）和目常锻炼（ADL；基本自理项目）的困难。In persons age 65 and

52、 other,difficulty with IADL is reported by 20%,and difficulty with ADL is reported by 11%;for both,the prevalence increases with age.prevalence 流行大于 65 岁的老人或其它人，IADL 困难报导为 20%，ADL 困难报导为 11%；随年龄增加两个都困难成为普遍现象。People who have difficulty with tasks of IADL and ADL are at high risk of becoming dependent.

53、IADL 和 ADL 困难的人处于不能自理演变的高风险中。Of persons older than age 65,5%reside in nursing homes,largely as a result of dependency in IADL and/orADL secondary to severe disease.reside 居住 nursing home 疗养院小于 65 岁的老人中，5%住在疗养院里，大多数是严重疾病后依赖IADL 和 ADL 的结果。Generally,woman live more years with disability,whereas men who

54、 become similarly disabled are more likelyto die at a younger age.一般来说，同样的能力不足，男性常死得更年轻，女性比男性能多活几年。Although physical disability is primarily a result of chronic diseases and geriatric conditions,its onset andseverity are modified by other factors,including treatments that control the underlying dise

55、ases,physicalactivity,nutrition,and smoking.Primarily 首先、起初、主要、根本 onset 进攻、有力的开始、发作虽然身体能力不足是慢性疾病和年老状态的一个主要结果，它的发生和严重程度被其它因素影响着，包括基础疾病的治疗和控制、身体锻炼、营养和吸烟。Many intervention trials indicate that disability can be prevented or its severity decreased;one trial showedimprovements in functioning with resista

56、nce and aerobic exercise in older adults with osteoarthritis of the knee.aerobic exercise 有氧运动 osteoarthritis 骨关节炎许多干预试验揭示能力不足可预防或减轻；一个试验显示膝骨关节炎老年人用对抗运动和有氧运动改善功能。Chapter 13 Tissue Engineering Page 36第十三章 组织工程 第 36 页The loss or failure of an organ or tissue is devastating.devastating 毁灭性的器官、组织的丧失或衰竭是

57、毁灭性的。Current treatment methods include transplantation of organs,surgical reconstruction,use of mechanicaldevices,or supplementation of metabolic products.device 装置现有的治疗方法有器官移植、外科重建、机械装置的应用以及代谢性产品的补充治疗。8临床医学英语However,the ultimate goal of transplantation should reside in the ability to restore living

58、 cells to maintain oreven enhance existing tissue function.reside 居住、属于、存在于移植的最终目的应该基于重建活细胞群以维持甚至增进现有组织的功能。By developing replacement tissues that remain intact with bioactive properties after implantation,retainingphysiologic functions as well as structure to the tissue or organ damaged by disease o

59、r trauma,tissueengineering could provide an alternative to transplantation and other forms of reconstruction.remain 剩下、留下、保持、属于 retain 保留、保持intact 完整无缺的、未受损伤的 property 特征、特性通过植入后仍有生物活性的替换组织发展，保持因病变或创伤而损害器官的生理功能和组织结构，组织工程能提供移植和其它重建方式的一种替代选择。Skin replacement products are the most advanced,with several

60、 tissue-engineering wound care materialscurrently on the market worldwide.皮肤替代产品最为成熟，最近有好几个组织工程（产商）将在全球市场经营这些材料。The potential impact of this field is endless,offering unique solutions to the medical field for tissue and organreplacement.impact 撞击、冲击 frail unique 唯一的、独特的这个领域的冲力是无限的，它提供了组织、器官替代领域独特的解决

61、方法。Tissue engineering may eventually be applied to the regeneration of diverse tissues such as the liver,smallintestine,cardiovascular structures,nerve,and cartilage.regeneration 再生、重建 diverse 不同的、变化多的组织工程可能最终能应用于各种组织的重建，如肝、小肠、心血管结构、神经和软骨。Work on bioartificial liver devices has been under way for se

62、veral years.bioartificial liver 生物人工肝 under way 进行中生物人工肝装置的研究工作已经进行了好几年。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(donorform a different

63、 species).autologous 自体 allogeneic 同种异体 xenogeneic 异基因的、异种组织工程所需的细胞源被总结为三大类，自体细胞（来源于病人）、同种异体细胞（来源于供者，但不是免疫同源的）和异种细胞（不同物种的供者）。each category may be further delineated in terms of stem cells(adult or embryonic)or differentiated cellsobtained from tissue,where the cell population obtained from tissue di

64、ssociation comprises a mixture of cellsat different maturation stages and includes rare stem and progenitor cells.delineate 描绘 differentiated 区别、区分 dissociation 分裂、分离maturation 成熟 rare 稀奇的 progenitor 祖先、起源每一类可以用术语干细胞进一步描述（成人的或胚胎的），或从组织获得的 不同细胞进一步描述，组织分离获得的细胞群包含着不同成熟时期的细胞混合体，包括半成熟细胞和原始细胞。Recent disco

65、veries have indicated that stem cells of one type can transdifferentiate to repair damaged tissueof another type(i.e.,hematopoietic stem cells home to infarcted myocardium and repair the tissue).9临床医学英语transdifferentiate 转分化 hematopoietic 造血的最近的发现提示一种类型的干细胞能够转分化以修补另一类型的损伤组织（这就是说，造血干细胞可植入梗死的心肌进行修复）。T

66、issue engineering will remain an area of intense research.intense 强烈的、热切的、激烈的组织工程学将保持一个富有希望的研究热园。Advances in the areas of growth factors,stromal matrices,gene encapsulation,and gene delivery will all play arole.stromal 间质的 matrix 基质 encapsulation 封闭、包装 delivery 传递在这个热园中，已有进展的生长因子、间质其质、基因封闭、基因传递都将扮演一份角色Chapter 20 Nonsurgical Infections in Surgical Patients Page 57第二十章 外科病人的非外科感染 第 57 页Postoperative patients are at increased risk for a variety of nonsurgical postoperative nosocomial infections.nos