卓顶精文2019医学文献翻译(中英对照)

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资料中医文献翻译

心气heart qi心血heart blood心阴heart yin心阳heart yang神明mental activity; mind; spirit清窍①theseven orifices ②the brain泥丸①brain ②clay pellet (a point in the head used in Daoist meditation; níwán, 泥丸)奇恒之腑extraordinary fu organ(s); extraordinary bowel(s)肺合皮毛the lung is connected to the skin and bodyhair肺为娇脏the lung is the delicate viscus肝主身之筋膜the liver governs the sinew-membranes of the body精室essence chamber水火之脏viscus of water and fire (referring to the kidney)肾精kidney essence天癸tiāngu?0?9(reproduction-stimulating essence, corresponds with the tenth heavenly stem; 天癸)三焦sanjiao upper/middle/lower脑户back of the head发际hairline头部皮肤生长头发的边缘部分头者精明之府the head is the house of bright essence元神之府house of original spirit女子胞、胞宫、子宫、子脏、子处uterus乙癸同源y?0?9(乙;i.e., liver) and gu?0?9(癸;i.e., kidney) are from the same source腠理striae and interstices; interstitial space哮喘wheezing and panting (asthma)中风 1. wind-strike (Shang Han Lun, TCM concept)stroke;CVA; apoplexy (Western medicine concept)痞①p?0?9 (痞) (see 痞证for definition to include inglossary) ②chest or abdominal mass (of the category of jījù) -- see "accumulations andgatherings" (积聚)for definition to include in glossary痞证p?0?9 syndrome (p?0?9 zhâng, 痞证; localized sensation of blockageoccuring in the chest or abdomen with or without palpable lumps, painless uponpressure) 厥证；厥①fainting(loss of consciousness); syncope ②reversal cold of the limbs痹病bì(痹);bìdisease (痹病)痹证bìsyndrome (痹证)疮疡sores and ulcers肿疡swollen sore(s)湿疮eczema疖boil (furuncle)疔boil痈abscess (carbuncle)phlegmon; cellulitis月经先期early periods崩漏flooding and spotting (bēng lîu, 崩漏)胎动不安restless fetus; threatened miscarriage (spotting with lumbar aching andabdominal pain)癥瘕concretions and conglomerations (lower abdominal masses; zhēng ji?0?0, 癥瘕) 恶阻morningsickness; pernicious vomiting during pregnancy恶露lochia恶露不尽persistentflow of lochia; lochiorrhea滑胎habitual miscarriage("slippery fetus"; huátāi, 滑胎)堕胎①earlymiscarriage (within 12 weeks of pregnancy) ②induced abortion产后郁冒①postpartumdepression and dizziness ②postpartum fainting戴阳证floating yang syndrome阳虚气滞证yang deficiency and qi stagnation湿热发黄damp-heat jaundice肺气不利dysfunction of lung qi肺失清肃failure of lung qi to purify; lung qi failingto purify肺失宣降lung failing to diffuse and govern descent肺津不布failure of lung qi to distribute fluids; lung failing to distribute fluids脾气不升failure of spleen qi to ascend; spleen qi failing to ascend带脉失约dai mai failing to ensure retention脾失健运failure of the spleen to transport[nutrients]; the spleen failing to transport [nutrients]; failure/loss of splenictransportation肝气不疏/ 肝气不舒inhibited flow of liver qi; constrained liver qi; liver qi failing to flowsmoothly; failure of liver qi to flow smoothly肝郁liver constraint肝气郁结binding constraint of liver qi肝失条达liver failing to govern free activity肝风内动internal stirring of liver wind; liver wind stirring internally肾不纳气failure of the kidney to receive/grasp qi (sent down from the lung)相火妄动frenetic stirring of ministerial fire火旺刑金vigorous fire tormenting metal木火刑金wood fire tormenting metal经脉挛急channel spasms and tension阴竭阳脱yin e xhaustion and yang desertion精脱essence desertion阳亡阴竭yang collapse and yin exhaustion胃纳呆滞poor appetite and digestion脾约splenic constipation肝着liver fixed bì邪留三焦pathogens lingering in the sanjiao气逆/血逆qi counterflow气闭qi block气上rising of qi; qi rising气陷qi sinking气脱/血脱qi desertion气滞qi stagnation气郁qi constraint水停气阻water retention with qi obstruction壮热high fever潮热tidal fever日晡潮热late afternoon tidal fever午后潮热afternoon tidal fever身热不扬unsurfaced fever; unsurfaced generalized heat下利diarrhea泄泻飧泄lienteric diarrhea (diarrhea with undigested food)五更泄fifth-watch diarrhea (diarrhea before dawn)虚劳虚痨deficiency-consumption (xūláo, 虚劳or 虚痨)厥证；厥①fainting(loss of consciousness); syncope ②reversal cold of the limbs 历节pain of multiple joints抽搐/瘛疭/搐搦convulsion肌肤甲错dry, scaly skin瘀血static blood血瘀blood stasis湿浊damp-turbidity湿热damp-heat风燥wind-dryness外燥external dryness湿毒dampness toxin天受airborne or waterborne infection上受upper attack温邪上受，首先犯肺Upper attack of warm pathogens starts with the lung.; Warm pathoge ns receivedfrom the external environment first attack the lung.三因three categories of disease cause猝发sudden onset晚发delayed onset徐发gradual onset劳复relapse due to overstrain病势tendency of disease病性nature of disease（疼痛、胀、痒、痉挛、）胀痛distending pain闷痛stuffy pain; oppression and pain刺痛stabbing pain窜痛scurrying pain痛无定处migratory pain游走痛wandering pain 固定痛fixed pain冷痛cold pain灼痛burning pain剧痛severe pain绞痛colicky pain; colic 隐痛dull pain重痛heavy pain掣痛pulling pain空痛empty pain酸痛aching pain持续痛persistent pain少腹急结spasmodic pain in the lesser abdomen (lateral aspect of lower abdomen) 项背拘急spasm of the nape and back四肢拘急spasms of the limbs; hypertonicity of the limbs心下急epigastric distress; <for premodern texts> distress below the heart里急abdominal urgency急者缓之when there is tension/spasm, treat it with relaxation; treat tension/spasm withrelaxation急则治其标In urgent conditions, treat the branch.急下drastic purgation急火high/strong flame 慢火low/mild flame急黄acute jaundice产后三急three postpartum crises经脉挛急channel spasms and tension急躁impatience; irritability咽喉不利throat discomfort小大不利治其标in cases with inhibited urination anddefecation, treat the branch 气机不利disturbance of qi movement肺气不利dysfunction of lung qi经行吐衄，以伴随月经周期反复出现吐衄，并以每于月经前后周期性作止为特点。

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。

卓顶精文最新2019狂犬病防控指南.doc

中国疾病预防控制中心文件-2-附件：《狂犬病预防控制技术指南（2019版）》中国疾病预防控制中心2019年1月29日抄送：国家卫生计生委疾控局、中心病毒病所。

中国疾病预防控制中心办公室2019年1月29日印发校对人:李昱附件：狂犬病预防控制技术指南（2019版）TechnicalGuidelinesfoYHumanYabies PYeventionandContYol(2019)中国疾病预防控制中心2019年1月目录摘要 (1)AbstYact (2)前言 (4)一、病原学和实验室诊断 (5)（一）病原学 (5)（二）实验室诊断 (7)二、临床学 (9)（一）发病机理 (9)（二）临床表现与诊断标准 (11)1．狂犬病暴露者的伤口感染 (11)2．狂犬病的临床表现 (13)3．诊断标准 (15)三、流行病学 (17)（一）疾病负担 (17)（二）感染动物来源 (18)（三）我国人间狂犬病流行特征 (19)四、人用狂犬病疫苗 (22)（一）人用狂犬病疫苗的历史和现状 (22)（二）我国人用狂犬病疫苗的历史和现状..24 （三）人用狂犬病疫苗免疫程序的演变 (25)（四）人用狂犬病疫苗的免疫机制、毒株及质量标准 (27)（五）疫苗的血清学效果评价 (29)1．暴露前免疫 (30)2．暴露后程序 (30)3．特殊人群 (32)4．疫苗效力及免疫失败 (33)5.疫苗安全性 (34)（六）暴露前及暴露后预防成本效益评价..36 五、被动免疫制剂 (37)（一）被动免疫制剂的种类 (38)（二）被动免疫制剂的作用机制 (39)（三）被动免疫制剂的保护效果 (40)（四）被动免疫制剂的安全性 (42)（五）经济成本与研究进展 (43)六、人间狂犬病的预防建议 (44)（一）暴露前预防 (44)1.基础免疫 (44)2.加强免疫 (45)3.使用禁忌 (45)（二）暴露后预防 (46)1.暴露的定义与分级 (46)2．暴露后处置 (48)3．再次暴露后的处置 (55)4．不良反应的临床处置 (56)5．狂犬病暴露预防处置服务实施 (60)附表1 (64)附表2 (65)参考文献 (67)编写人员周航，李昱，陈瑞丰，陶晓燕，于鹏程，曹守春，李丽，陈志海，朱武洋，殷文武，李玉华，王传林，余宏杰编写人员单位102206中国疾病预防控制中心传染病预防控制处（周航，李昱，殷文武，余宏杰）100048中国人民解放军海军总医院（陈瑞丰）102206中国疾病预防控制中心病毒病预防控制所（陶晓燕，于鹏程，朱武洋）100050中国食品药品检定研究院（曹守春，李玉华）100021北京市朝阳区疾病预防控制中心（李丽）100015首都医科大学附属北京地坛医院（陈志海）100044北京大学人民医院（王传林）审核专家唐青，扈荣良，董关木，严家新，俞永新审核专家单位102206中国疾病预防控制中心病毒病预防控制所（唐青）130122中国人民解放军军事医学科学院（扈荣良）100050中国食品药品检定研究院（董关木，俞永新）430060武汉生物制品研究所（严家新）1摘要狂犬病是由狂犬病病毒感染引起的一种动物源性传染病，临床大多表现为特异性恐风、恐水、咽肌痉挛、进行性瘫痪等。

卓顶精文最新重症肌无力指南(2019).doc

中国重症肌无力诊断和治疗指南（20XX年版）ChinaguidelinesfoYthediagnosisandtYeatmentofmYastheniagYavis中华医学会神经病学分会神经免疫学组中国免疫学会神经免疫学分会陕西省西安市第四军医大学唐都医院神经内科,李柱一执笔摘要：本次指南简要介绍了重症肌无力（MG）发病机制和诊断要点；重点介绍了MG治疗方法，方案，特别是强调了在MG治疗过程中免疫抑制剂的使用方法。

对神经内科临床医生的工作实践具有指导意义。

重症肌无力（mYastheniagYavis，MG）是一种由乙酰胆碱受体（AChY）抗体介导、细胞免疫依赖、补体参与，累及神经肌肉接头突触后膜，引起神经肌肉接头传递障碍，出现骨骼肌收缩无力的获得性自身免疫性疾病。

极少部分MG患者由抗-MuSK（musclespecifickinase）抗体、抗LYP4（low-densitYlipopYoteinYeceptoY-YelatedpYotein4)抗体介导。

MG主要临床表现为骨骼肌无力、易疲劳，活动后加重，休息和应用胆碱酯酶抑制剂后症状明显缓解、减轻。

年平均发病率约为8.0-20.0/10万人[1]。

MG在各个年龄阶段均可发病。

在40岁之前，女性发病率高于男性；在40-50岁之间男女发病率相当；在50岁之后，男性发病率略高于女性。

一、临床表现和分类1．临床表现全身骨骼肌均可受累。

但在发病早期可单独出现眼外肌、咽喉肌或肢体肌肉无力；颅神经支配的肌肉较脊神经支配的肌肉更易受累。

经常从一组肌群无力开始，逐渐累及到其他肌群，直到全身肌无力。

部分患者短期内出现全身肌肉收缩无力，甚至发生肌无力危象。

骨骼肌无力表现为波动性和易疲劳性，晨轻暮重，活动后加重、休息后可减轻。

眼外肌无力所致对称或非对称性上睑下垂和/或双眼复视是MG最常见的首发症状，见于80%以上的MG患者[2]；还可出现交替性上睑下垂、双侧上睑下垂、眼球活动障碍等。

中英对照医学论文参考文献范例

中英对照医学论文参考文献一、中英对照医学论文期刊参考文献[1].医学专业课教材“英中文及中英文名词对照索引”中增设音标注音的意义及可行性调查分析.《继续医学教育》.2011年8期.孔令泉.邢雷.黄剑波.蒲莹晖.[2].医学法语二外多元教学法.《中国中医药咨讯》.2010年8期.丁小会.[3].达英35联合二甲双胍治疗多囊卵巢综合征的临床效果研究.《医学美学美容（中旬刊）》.2014年4期.冯泽旻.[4].温肾化痰胶囊联合达英35治疗多囊卵巢综合征的临床效果分析.《中国疗养医学》.2015年8期.葛晨蕾.[5].英研究显示：戒烟短信有助提高戒烟成功率.《科技与生活》.2011年15期.[6].英夫利西单抗治疗儿童克罗恩病的临床效果.《中国医学前沿杂志（电子版）》.2015年5期.方莹.任晓侠.韩亚楠.陈一.[7].二《中山大学学报（医学科学版）》.被中信所《中国科技期刊引证报告》收录ISTIC.被北京大学《中文核心期刊要目总览》收录PKU.2010年5期.沈杨.刘娟.任慕兰.[9].颅面骨纤维异常增殖症围术期心理干预在改善术后焦虑和抑郁状态患者中的应用效果.《国际呼吸杂志》.被中信所《中国科技期刊引证报告》收录ISTIC.2016年7期.韩建平.王焱.申顺英.郑莹.张秀芝.[10].达英35与雌孕激素治疗青春期功能失调性子宫出血疗效观察.《基层医学论坛》.2015年5期.张慧.二、中英对照医学论文参考文献学位论文类[1].2,3,7,8四氯二苯并对二噁英宫内暴露对仔鼠早期卵泡发育的影响.作者：许虹.妇产科学北京协和医学院清华大学医学部中国医学科学院2011（学位年度）[8].一体化医学语言系统的中文化和形式化表示研究.被引次数：1作者：沈彤.计算机科学与技术哈尔滨工业大学2013（学位年度）[9].补肾化痰祛瘀法中药联合西药达英35对于肾虚痰瘀型多囊卵巢综合征患者瘦素的临床干预.作者：陆丞丞.中医妇科广西中医药大学2011（学位年度）[10].CD200/CD200R1在类风湿关节炎中的作用机制和意义.作者：任燕.内科学风湿病学北京协和医学院中国医学科学院北京协和医学院清华大学医学部中国医学科学院2012（学位年度）三、中英对照医学论文专著参考文献[1]家庭干预对首发精神分裂症患者临床疗效对照分析.黄腊根.朱春凤.叶平.朱茶英.刘晓芳，2008第10次全国精神病学术交流会暨《中国民康医学》创刊20周年庆典[2]针刀干预对L3横突综合征模型大鼠成纤维细胞增殖的影响.乔晋琳.刘灿坤.汲广成.李金牛.郭长青.陈裔英.路平.付本升.向东东.马广昊，2010中国针灸学会经筋诊治专业委员会2010学术年会暨第二届中华经筋医学论坛[3]帆状胎盘的围产结局临床分析.韩晴.颜建英，2012中华医学会第十次全国妇产科学术会议[4]针刀干预对L3横突综合征模型大鼠成纤维细胞增殖的影响.乔晋琳.刘灿坤.汲广成.李金牛.郭长青.陈裔英.路平.付本升.向东东.马广昊，2009中国针灸学会经筋诊治专业委员会成立大会暨首届中华经筋医学论坛[5]英夫利昔单抗靶向治疗幼年特发性关节炎和幼年强直性脊柱炎的疗效和安全性的随机对照研究.谢颖.曾萍.李丰.唐盈.王敏.曾华松，2013庆祝中国当代儿科杂志创刊15周年大会暨当代儿科论坛[6]针刀干预对L3横突综合征模型大鼠成纤维细胞增殖的影响.乔晋琳.刘灿坤.汲广成.李金牛.郭长青.陈裔英.路平.付本升.向东东.马广昊，2009中华中医药学会针刀医学分会二〇〇九年度学术会议[7]骨髓间充质干细胞和苯妥英英钠的旁分泌机制在心肌梗死后组织修复中的作用.舒珺.周欣.任宁.黄体钢.曾山.姜铁民.李贺.李玉明，20072007年第三届海河之滨心脏病学会议[8]针刀加注射玻璃酸酶为主治疗膝关节骨性关节炎77例.向伟明，20112011国际针刀医学学术交流暨针刀医学创立35周年纪念大会[9]免疫2号方对HIV/AIDS患者HAART后免疫重建功能的影响:一项随机双盲安慰剂对照临床试验.王阶.林洪生.李勇.汤艳莉.黄世敬.吴欣芳.潘菊华.刘杰.樊移山.秦海洸.梁健.方路.李广文.洪立珠.卓燊.邓鑫.段呈玉.张祖英.谭云鹏，2012第四届世界中西医结合大会[10]特布他林联合普米克令舒氧气雾化吸入在AECOPD院前急救中的疗效观察.蒋婉英，2014《中华急诊医学杂志》第十三届组稿会暨第六届急诊医学青年论坛。

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.。

MEDDEV2.7.1（中文版翻译）

MEDDEV2.7.1（中文版翻译）MEDDEV.2.7.12003年4月医疗器械指南临床数据评价：制造商和认证机构指南说明本指南为一系列与EC—医疗器械指令应用问题相关的指南中的一部分。

并不具有法律约束力。

该指南在经过与各个利益方（主管机构、欧盟委员会服务处、工业、其他有兴趣的团体）进行深入协商之后谨慎拟定而成，期间对中期草案进行了传阅，而且部分意见还为本文件所采纳。

因此，本文件反映出了来自医疗器械行业的利益团体代表所持的立场。

Commission européenne, B-1049 Bruxelles / Europese Commissie, B-1049 布鲁塞尔–比利时. 电话：（32-2）299.11.11. 传真：（32-2）296 70 13. 电子邮件：entr-medical-**************.int1. 引言与目的本文件之主要目的是为制造商提供审核和分析临床数据方面的指导意见，并且在当认证机构对制造商临床数据评价进行审核的时候，作为90/385/EEC（AIMD）[1]和93、42、EEC（MDD）[2]所规定的符合性评估程序的一部分提供给认证机构。

本文件还通过提供期望方面的指导意见给予制造商一定帮助。

2. 背景制造商必须按照指令中的规定，论证其预期目的和就其实现的安全性与性能所做出的声明。

根据一般规律，上述论证需要临床数据的支持（附录X，MDD 1.1）MDD附录X和AIMD附录7中所述的临床数据评价与以下规定之间存在密切关系：MDD 附录I：通用要求第1节和第3节；AIMD附录1：通用要求第1节和第2节。

还应注意附录I之I.6（MDD）和附录1之1.5（AIMD）。

3. 术语解释在本指南中：3.1 临床数据是指与器械临床安全和性能各方面有关的数据。

必须包括来自以下来源的数据：（i）与待评估器械市场经验有关的已发表和（或）未发表数据；或能够证明与上述待评估器械等价的类似器械；或（ii）相关器械的前瞻性临床研究；或（iii）临床研究结果，或针对能够证明与上述待评估器械等价的类似器械的科技文献报道的其他研究结果。

医学文献中英文对照

医学文献中英文对照动脉粥样硬化所导致的心脑血管疾病是目前发病率和死亡率较高的疾病之一。

在动脉粥样硬化的形成过程中, 内皮细胞病变是其中极其重要的因素，最显著的变化是动脉内皮功能紊乱, 血管内皮细胞的损伤和功能改变是动脉粥样硬化发生的起始阶段。

Cardiovascular and cerebrovascular disease caused by atherosclerosis is one of diseases with higher mortality and morbidity at present . In the formation of atherosclerosis, the endothelial cell lesion is one of the most important factors, in which, the most significant change is endothelial dysfunction. In addition, the injuries and the changes of vascular endothelial cells are the initial factors of atherosclerosis.许多因素会导致血管内皮细胞受损, 主要包括脂多糖( Lipopolysaccharides，LPS)、炎症介质、氧自由基等。

其中脂多糖因其广泛的生物学作用, 越来越引起研究者的关注。

LPS 是一种炎症刺激物, 是革兰阴性杆菌细胞壁的主要组成成分，其通过刺激血管内皮细胞，引起其相关细胞因子和炎性因子的表达紊乱，尤其是Ca2+ 和活性氧簇（Reactive Oxygen Species，ROS）的合成和释放发生改变诱导细胞氧化应激内环境紊乱。

大量研究表明, LPS直接参与动脉粥样硬化的形成过程, 特别是动脉粥样硬化血管炎症的初始阶段, LPS可通过直接作用或间接影响的方式激活并损伤内皮细胞, 从而引起血管内皮细胞形态与功能的改变。

卓顶精文最新医院英语单词汇总.doc

医院名称英语单词hospital医院hospitalfoYinfectiousdiseases传染病医院childYenshospital儿童医院obstetYicsandgYnecologYhospital妇产医院tubeYculosishospital结核病医院stomatologicalhospital口腔医院aYmYhospital陆军医院fieldhospital野战医院hospitalofchinesemedicine中医医院tumoYhospita肿瘤医院geneYalhospital综合性医院mentalhospital精神病院hospitalfoYlepeYs；lepYosaYium麻风病院sanatoYium疗养院clinic诊疗所fiYst-aidstation急救站quaYantinestation防疫站医学名称英语单词medicalscience；medicalseYvice；medicine医学medicalbook医书medicalskill；aYtofhealing医术medicalmatteYs医务clinic医务所medicalscience；medicine医学foYensicmedicine；legalmedicine法医学pYeclinicalmedicine基础医学pYeventivemedicine预防医学DoctoYofMedicine医学博士academYofmedicalsciences医学科学院medicalliteYatuYe医学文献BacheloYofMedicine医学学士medicalheYitage医学遗产collegeofmedicine医学院medicalwitness医学证人medicine医药geneYalmedicalknowledge医药常识medicaleYpenses医药费medicalkit；medicinechest药箱fiYst-aidkit急救药箱pYopeYtYofamedicine药性phaYmaceuticalcollege药学院dippingvat药浴池medicatedsoap药皂dYugYash；dYugeYuption药疹assistantphaYmacY药剂士phaYmaceutics；phaYmacY药剂学medicinalliquoY药酒phaYmacologY药理学efficacYofadYug药力absoYbentcotton药棉医务名称英语单词doctoY；phYsician医生medicalofficeY；suYgeon军医cuYe；tYeat医治cuYesbofhisillness医好某人的病givesbmedicaltYeatment给某人医病takestopgapmeasuYes头痛医头，脚痛医脚still<knowledge>ofadoctoY：医道medicalethics医德medicalcouYsesingeneYal；medicine医科pYinciplesofmedicalscience；medicalknowledge医理medicaltYeatment医疗publichealthseYvices公费医疗medicalteam医疗队medicalestablishment医疗机构medicament；dYug药剂phaYmacist；dYuggist药剂师unskillfulandfaultYmedicaloYsuYgicaltYeatment；malpYactice医疗事故malpYacticeinsuYance医疗事故保险medico-athletics医疗体育。

医学文献英文翻译

医学文献英文翻译原文：皮质下缺血性脑血管疾病（subcortical ischemic vasculardisease,SIVD）是一组以小血管病变为主要病因、以皮质下多发性腔隙性梗死和脑白质病变为主要脑部损害的缺血性脑血管病，是引起血管性认知功能损害（vascular cognitive impairment，VCI）最常见的亚型。

SIVD可引起步态障碍，如帕金森样步态、共济失调性步态、走路不稳或无明显诱因的频繁跌倒，有研究表明，步态异常可能是血管性痴呆的早期标志。

本文将从SIVD导致步态障碍的病理机制、步态障碍类型、步态障碍与认知损害关系、步态障碍的分析与评价、治疗等方面进行综述。

翻译：皮质下缺血性脑血管疾病（subcortical ischemic vascular disease,SIVD）是一组以小血管病变为主要病因、以皮质下多发性腔隙性梗死和脑白质病变为主要脑部损害的缺血性脑血管病，是引起血管性认知功能损害（vascular cognitive impairment，VCI）最常见的亚型。

Subcortical ischemic vascular disease（SIVD）is a case of ischemic cerebrovascular disease, the leading cause of which is small vessel lesions, and the subsequent main damages to the brain are subcortical multiple lacunae infarct and leukodystrophy; it is the most common subtype that causes vascular cognitive impairment (VCI).SIVD可引起步态障碍，如帕金森样步态、共济失调性步态、走路不稳或无明显诱因的频繁跌倒，有研究表明，步态异常可能是血管性痴呆的早期标志。

卓顶精文2019医学文献检索试题(含答案)

医学文献检索试题（A）《医学信息检索》试题一、名词解释（共5题，每题3分，共15分）1. 信息素养：是指判断何时、何地需要信息，并能有效的定位、获取、评价和利用信息的一系列能力的总和。

2. 引文检索：是以被引用文献为检索起点来查找引用文献的过程。

3. 索引：将内容中有检索意义的标识提取出来，按某种方式进行排序，以便于查询。

4. 书目数据库：是一种提供文献的各种特征，如文献篇名、作者、文献出处、摘要、馆藏单位的数据库。

5. 元搜索引擎：也称集成搜索引擎，是建立在异地搜索引擎基础上的虚拟智能整体，本身不一定建立网络信息索引数据库。

检索时，用户通过统一的检索界面，可同时链接多个或多种独立搜索引擎进行查询，将检索结果作出相关度排序后显示给用户。

二、单项选择题（共15题，每题2分，共30分）1.关于信息的说法错误的是(b)。

A.信息是客观事物的运动状态和特征的反映B.信息是客观的C.信息是无形的，不断变化发展的D.信息的存储形式有多种2.以下属于二次文献的是(c)。

A.述评B.研究报告C.索引D.专著3.检索文献数据库时，下列哪种方法不能扩大检索范围(a)。

A.主题词加权B.用ORC.用主题词扩展D.采用截词4.哪个途径是从文献的内部特征进行检索的(a)。

A.分类途径B.号码途径C.作者途径D.刊名途径5.下列说法中错误的是(d)。

A.综述是有关研究某一问题或某些问题的文章B.综述是从一定时间内的大量的文献中摘取的情报C．综述是对特定的问题利用有关的情报进行的综合性叙述D．综述的目的是建立新知识6.计算机文献检索中，每一种文献特征对应于计算机数据库中的(c)。

A.一条记录B.一篇文献C.一个字段D.一个文档7.下面哪个检索式的作用与短语检索"digiatalcamera"等价：(a)。

A.digiatal(W)cameraB.digiatal(N)cameraC.digiatalANDcameraD.digiatalORcamera8.Medline光盘数据库的内容涵盖三种重要的纸本医学文献检索工具，它们是(d)。

英文课程库翻译对照(参考)一、学院开课单位基础医学院PreclinicalM

英文课程库翻译对照（参考）一、学院/开课单位基础医学院：Preclinical Medicine School 临床医学院：Clinical Medical College人文学院：College of Humanities中药学院：College of Traditional Chinese Pharmacy针灸学院：College of Acupuncture and Moxibustion管理学院：School of Management护理学院：College of Nursing信息中心：Information Center研究生部：Graduate faculty二、课程类别选修课：Selected Course必修课：Required Course专业基础课：Special Core Course专业课：Professional Course学位课：Degree course公共课：Public Course补本科课程：Supplement Undergraduate Courses三、专业名称1、中医：中医基础理论：Basic Theory of TCM中医临床基础：TCM Clinical Foundation 中医医史文献：TCM History and Document方剂学：Science of Formulae of Chinese Herbs中医诊断学：Diagnostics of TCM中医内科学：Traditional Chinese Internal Medicine中医外科学：Surgery of TCM中医儿科学：Pediatrics of TCM中医妇科学：Gynecology of TCM 中医骨伤科学：Orthopedics & Traumatology of TCM中医五官科学：Otorhinolaryngology of TCM针灸推拿学：Acupuncture & Moxibustion 民族医学：Ethnomedicine/Medicine of Chinese Minorities临床中药学：Clinical Pharmacology of TCM中医养生康复学：Health-preserving& Rehabilitation of TCM中医护理学：Nursing of TCM2、中西医结合：中西医结合基础：The basis of Integrative Medicine中西医结合临床：Clinical Science of Integrative Medicine3、药学：药物分析学：Pharmacoanalysis微生物与生化药学：Microbial and Biochemical Pharmacy4、中药学：临床中药学：Clinical Pharmacology of TCM中药化学：Chemistry of Chinese Meteria Medica中药药理学：Pharmacology of Chinese Meteria Medica中药制药学：Pharmaceutics of Chinese Meteria Medica中药生药学：Pharmacognostics of Chinese Meteria Medica5、公共管理：社会医学与卫生事业管理：Social Medical and Health Service Management四、学位类型科学学位：Science degree临床专业学位：Clinical professional degree五、学位层次：本科学位：Bachelor degree硕士学位：Master's degree博士学位：Doctor's degree/ Ph.D六、课程名称：1、公共课科学社会主义理论：Theories of Scientific Socialism自然辩证法：Nature Dialectics现代科技革命与马克思主义：Modern Science and Technology Revolution and Marxism硕士英语：English for Master’s Degree博士英语：English for Doctor’s Degree博士日语：Japanese for Doctor’s Degree 博士二外英语：Second Foreign Language for Doctor’s Degree (English)计算机应用：Application of Computer医用统计学：Medical Statistics名师大讲堂：Academician Lectures科研思路与方法：Scientific Ideas and Methods/ Research Courses汉语水平考试：HSK博士专业课：Doctor’s Professional Course2、专业课/专基课/选修课/学位课(1)基础医学院课程内经专题讲座：Forums and Lectures of Internal Classic 难经学术思想：Academic Thoughts of NanJing中国古代哲学：Ancient Chinese Philosophy中医基础专论：Monography of Basic TCM Theories伤寒论专题讲座：Treatise on Cold Diseases金匮要略专题讲座：Treatise on Golden Chamber温病学专题讲座：Treatise on Warm Diseases中医训诂考据学：TCM Textology Exegesis 中国医学史：History of TCM中医文献学：Philology of TCM文献检索：Literature Retrieval各家学说：Various Schools of TCM中医医案：Medical Records of TCM中医处方方法学：Prescription Methodology of TCM中医辨证学：TCM Syndrome Differentiation中医诊断古籍选读：Selected ancient readings of TCM Diagnosis中医内科学（中诊专业）：Traditional Chinese Internal Medicine临床中药学：Clinical Pharmacology of TCM神经生理学：Neurophysiology生物化学：Biochemistry生物化学实验：Biochemistry Experiment 医学分子生物学：Medical Molecular Biology分子生物学实验：Molecular Biology Experiment实验动物学：Experimental Zoology神经解剖学：Neuroanatomy局部解剖学：Medical Topography头面部局部解剖学：Craniotopography医用细胞学基础：Medical Foundation of Cytology组织细胞分子学实验：Histiocyte Molecular Experiment病理生理学：Pathophysiology医学免疫学：Medical Immunology临床流行病学（DME）：Clinical Epidemiology (DME)DME：Design, Measurement and Evaluation中医基础理论(补本科)：The Basic Theory of TCM中医养生学概论：Introduction to TCM Health-preserving中医康复学概论：Introduction to TCM Rehabilitation中医饮食营养学：Nutriology of TCM循证医学：Evidence-based Medicine核酸研究技术在中医药学的应用：Application of Nucleic Acid Research Techniques in TCM（2）临床医学院中医内科学专题讲座：Treatises on Traditional Chinese Internal Medicine中医内科杂病研究：Miscellaneous Internal Diseases of TCM中医外科学专题讲座：Treatises on Traditional Chinese Surgery中医妇科学专题讲座：Treatises on TCM Gynecology中医儿科学专题讲座：Treatises on TCM Pediatrics西医内科学：Internal Medicine中西医结合内科学专题讲座：Treatises on Integrative Internal Medicine中西医结合外科学专题讲座：Treatises on Integrative Surgery中西医结合妇科学专题讲座：Treatises on Integrative Gynecology中西医结合五官科学专题讲座：Treatises on Integrative Otorhinolaryngology针灸推拿学专题讲座：Treatises on Acupuncture and Massage中西医结合骨伤科专题讲座：Treatises on Integrative Orthopedics and Traumatology 中西医结合儿科学专题讲座：Treatises on Integrative Pediatrics西医外科学：Surgery临床病理学基础：Basic Theories of Clinical Pathology（3）针灸学院针灸学：Acupuncture中医推拿学：Chinese Massage实验针灸学：Experimental Acupuncture针灸医籍各家学说：Various Schools of Acupuncture masterpieces中医气功学：Qigong of TCM针灸现代研究进展（博士）：Modern Research Progress of Acupuncture and Moxibustion针刀疗法：Acupotomology therapy（4）管理学院高级统计学（一）：Advanced Statistics（1）卫生经济理论与方法：Health Economic Theory and Method社会医学：Social Medicine现代医院管理：Modern Hospital Management卫生改革与卫生经济政策：Health Reform and Health Economic Policy卫生机构会计实务：Accounting Practice in Health Institution高等教育学：Higher Pedagogy教育管理学：Science of Educational Management药事管理学：Science of Pharmacy Administration药品知识产权实务：Pharmaceutical Intellectual Property Practice高级数据库开发：Advanced Database Development高级网络技术：Advanced Network TechnologyQOL（生存质量）测量与评价：QOL Measurement and Evaluation社会与发展心理学：Social and Developmental Psychology宏微观经济分析：Macro and Micro Economic Analysis现代企业管理：Modern Enterprise Management医院质量与标准化管理：Hospital Quality and Standardized Management财务分析与管理：Financial Analysis and Management高级统计学（二）：Advanced Statistics（1）卫生事业管理：Health Service Management流行病学：Epidemiology卫生统计数据库分析与应用：Health Statistics Database Analysis and Application经济法律通论（民法、诉讼法、合同法）：General Theory of Economic Laws（Civil law, procedural law and contract law）知识产权法：Intellectual Property Law药品质量管理：Drug Quality Control药事法学：Law of Pharmaceutical Affairs 计算机统计软件应用：Computer statistics software applications 组织行为学：Science of Organizational Behavior人力资源管理：Human Resource Management技术经济学：Technical Economics医药营销：Pharmaceutical Marketing企业战略管理：Enterprise Strategic Management决策支持系统（信息管理）：Decision support systems (information management)教育心理学：Education Psychology电子商务：E-commerce项目管理：Project Management古代管理思想研究：Study on Ancient Management Thought论文写作：Essay writing健康教育与健康促进：Health Education and Health Promotion现代管理理论：Modern Management Theory公共关系与危机管理：Public Relations and Crisis Management卫生服务成本研究与应用：Research and Application on Cost of Health Services（5）中药学中药学专论：Monography of Science of Chinese Materia Medica分析测试技术：Analysis and Test Technology中药化学专论：Monography of Chinese Pharmaceutical Chemistry中药药理学专论：Monography of Traditional Chinese Pharmacology中药制药学专论：Monography of Traditional Chinese Pharmaceutics中药生药学专论：Monography ofTraditional Chinese Pharmacognostics临床中药学专论Monography of Clinical Science of Chinese Materia Medica结构有机化学：Structure of Organic Chemistry波谱分析：Spectrum Analysis药性导论：Introduction of Drug Property 本草文献学：Philology of Chinese Materia Medica中医学选读：TCM Selected Readings中药成分分析：Analysis of Chinese Materia Medica Components中药信息学：Informatics of Chinese Materia Medica中药炮制学专论：Monography of Processing Chinese Materia Medica中成药学专论：Monography of Science of Chinese Patent Drug生物药剂学：Biological Pharmacology药用植物学专论：Monography of Medicinal Botany分子生药学：Molecular Pharmacognostics植物化学分类：Classification of Plant Chemistry中药资源学专论：Monography of Chinese Materia Medica Resources中药显微鉴定：Microscopic Identification of Chinese Materia Medica中药品种论述：Chinese Varieties Treatise 中药生物技术：Chinese Biotechnology生物制药专题：Special Subject on Biopharmaceutics药理学进展：Advancements of Pharmacology中药药效毒理研究思路与方法：Research Ideas and methods of Chinese Materia Medica Effect and Toxicology 物理药剂学：Physical Pharmacology科研思路与方法(中药专业) ：Scientific ideas and Methods (for Chinese Materia Medica Profession)微生物与生化药学专论：Monography of Microbial and Biochemical Pharmacology 分子细胞生物学专论：Monography of Molecular Cell Biology中药生物技术应用：Biotechnology Applications in Chinese Materia Medica蛋白质工程：Protein Engineering计算机辅助药物设计：Computer-aided drug design微生物与生化药学研究方法：Microbial and Biochemical Pharmaceutical Research Methods药物分析专论：Monography of Drug Analysis药品质量控制：Drug Quality Control中药成分体内代谢与分析：Vivo Metabolism and Analysis of Chinese Materia Medica Components计算药物分析：Analysis of Drug Calculation生物药物分析：Biopharmaceutical Analysis 新药设计学：Science of New Drug Designing中药药理学：Chinese Pharmacology(6)护理学院护理研究进展：Nursing Research Progress 护理理论：Nursing Theory护理教育：Nursing Education中医临床护理概论：Introduction to TCM Clinical Nursing护理心理学：Nursing Psychology本翻译有不尽之处,欢迎各位老师同学提供更好的翻译建议！研究生院培养办。

卓顶精文2019医院污水排放标准

医院污水排放标准来源：发布时间：20XX-5-2316:37:57医院污水排放标准GBJ48—83主编部门：中华人民共和国卫生部批准部门：中华人民共和国国家经济委员会中华人民共和国卫生部试行日期：1983年6月1日关于颁发《医院污水排放标准》的通知经基〔1983〕37号根据原国家建委（78）建发设字第562号和卫生部（77）卫科字第240号通知的要求，由卫生部会同有关单位共同编制的《医院污水排放标准》，已经有关部门会审。

现批准《医院污水排放标准》GBJ48—83为国家标准，自一九八三年六月一日起试行。

本标准由卫生部负责管理，其具体解释等工作由中国医学科学院卫生研究所负责。

国家经济委员会卫生部一九八三年一月十二日编制说明本标准是根据原国家建委（78）建发设字562号和卫生部（77）卫科字第240号文下达的制订医院污水排放标准的任务，由我部委托中国医学科学院卫生研究所主持，会同有关省、市卫生防疫站、医学院校、科研与建筑设计等有关单位编制而成。

遵循我国“预防为主”的卫生工作方针和《中华人民共和国环境保护法（试行）》，为防止医院排放带有病原体的污水污染环境，危害人体健康，特制订本标准。

在编制过程中，曾对部分省、市、自治区医院污水的情况进行重点调查，各课题组参照国内外有关的标准、文献，还进行了必要的科学试验，并向全国有关单位广泛征求意见，经多次讨论修改，由全国卫生标准技术委员会环境卫生分委员会会同有关部门审核定稿。

本标准分总则、排放标准、设计要求与管理要求等四章和附录一，检验方法。

在试行本标准的过程中，请各单位注意积累资料，总结经验，如发现有需要修改和补充之处，请将意见和有关资料寄送中国医学科学院卫生研究所，并抄送我部，以便修订时参考。

卫生部一九八三年一月第一章总则第1.0.1条为贯彻“预防为主”的卫生工作方针和《中华人民共和国环境保护法（试行）》。

防止医院排放带有病原体的污水污染环境，危害人体健康，特制订本标准。

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 2.12Whelan BuildingThe QuadrangleBrownlow HillLiverpoolL69 3GBTel: +44 (0) 151 794 5682Fax: +44 (0)151 794 5585Email:****************.ukFor 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 cons ists 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 with Pharmalgen® to other treatment options, including high dose antihistamines, advice on theavoidance 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 age and 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 fatalanaphylaxis 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 v enom concentrations 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 a H1-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 0.50mg/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 immediateself-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 patient 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 an increased 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) ofIgE-mediated allergy to bee venom (Pharmalgen® Bee Venom) and wasp venom (Pharmalgen® Wasp Venom) since March 1995 (marketing authorisation number PL10085/0004). 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 will consider 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.5.1.1 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 waspvenom 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 in theNHS, without venom immunotherapy including:advice on the avoidance of bee and waspvenom,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 future allergicreactionsadverse effects of treatmenthealth-related quality of lifeOther considerations If the evidence allows, considerations will begiven to subgroups of people, according totheir:risk of future stings (as determined, forexample, by occupational exposure)risk of severe allergic reactions to future stings(as determined by such factors as baselinetryptase 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.5.1.2 Data extraction strategyData relating to study design, findings and quality will be extracted by one reviewer andindependently 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.5.1.3 Quality assessment strategyThe quality of the clinical-effectiveness studies will be assessed according to 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.5.1.4 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 EVIDENCE The 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.6.1.1 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).6.1.2 Inclusion and exclusionIn addition to the inclusion criteria outlined in Table 1, specific criteria required for thecost-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 adjusted lifeyear gained6.1.3 Data 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.6.1.4 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/synthesis6.2.1 Cost 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 will be 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.6.2.2 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. 37b. 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. 37 b. 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 natu re 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, incremental cost-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。

卓顶精文2019样版病例分析

一例巨大垂体瘤患者行开颅垂体瘤切除的围术期管理【导读】垂体肿瘤占所有颅内肿瘤的10%，垂体作为人体的重要内分泌腺之一，其分泌的促激素可对全身各系统产生广泛的影响。

垂体瘤患者的麻醉对神经麻醉医生提出了特有的挑战，麻醉医生需要对垂体的功能、下丘脑-垂体-肾上腺轴（hypothalamic-pituitary-adrenal-axis,HPA轴）的生理及垂体瘤的病理生理有必要的了解，并在此基础上同神经外科医生和内分泌科医生开展多学科的紧密合作，共同做好患者的围术期管理。

【病例简介】患者，男性，47岁，体重65kg。

因头晕3月，一月前突发意识障碍一次，于外院就诊行磁共振（MRI）检查提示垂体巨大腺瘤，肿瘤大小7cm×5cm×5cm，向鞍上生长并侵入左侧侧脑室，同时伴脑积水（见图-1）。

当时于外院行左侧侧脑室外引流术，术后格拉斯哥评分（glasgowcomascale,GCS评分）15分。

此次入我院，拟于气管内插管全身麻醉下行开颅巨大垂体腺瘤切除术。

患者否认既往其他系统病史，发病以来无面容改变，无向心性肥胖，无紫纹、多尿。

现患者颅高压症状已改善，意识清醒，无嗜睡、癫痫、头痛、呕吐。

术前诊断为：巨大垂体腺瘤；脑积水，脑室外引流术后。

患者术前检查提示：血红蛋白：100g/L，白蛋白:38g/L，尿比重：1.008，肝肾功能及电解质水平在正常范围。

术前激素检查提示：生长激素（GH）：0.80mU/L，胰岛素样生长因子1（IGF-1）：131μg/L，游离三碘甲状腺原氨酸(FT3)：3.11pmol/L(下降)，游离甲状腺素(FT4)：11.71pmol/L，促甲状腺激素(TSH)：1.7750mIU/L，三碘甲状腺原氨酸(T3)：1.22nmol/L（下降），甲状腺素(T4)：84.80nmol/L，促肾上腺皮质激素(ACTH)20.10pg/ml，皮质醇（早晨）5.72μg/dl（下降）。