医学论文英文摘要翻译——实例讲解(1)
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Published Online: 28 April 2015
Promotion of rapid testing for HIV in primary care (RHIVA2): a cluster-randomised群组随机的 controlled trial
初诊治疗中快速检测HIV的推广(艾滋病协会康复分会试验 之二): 一个群组随机对照试验 primary care (由医护人员提供的)最初保健护理(其后病人可转到专 科就诊);初诊治疗;初级治疗;初级医疗保健.
Methods
In this cluster randomised controlled trial in Hackney (London, UK), general practices were randomly assigned (1:1) to offer either opt-out rapid HIV testing to newly registering adults or continue usual care. All practices were invited to take part. Practices were randomised by an independent clinical trials unit statistician with a minimisation program最小化程序, maintaining allocation concealment隐秘性. 在哈克尼（英国伦敦）进行的群组随机对照试验中，全科医生被 〔1 随机分配（1：1），一组对新注册的成年病人进行opt-out 〕 HIV快速检测 / 常规HIV快速检测 ；另一组则继续常规护理。
CD4细胞计数低于200个/ μL的患者在干预组中和对照组中分 别为28％及46％（0.60，0.32〜1.13）（增译法） 所有快速检测诊断出的患者均顺利转入专科治疗。无不良事 件发生。
Interpretation Promotion of opt-out rapid testing in general practice led to increased rate of diagnosis, and might increase early detection of HIV. We therefore recommend implementation 实施 of HIV screening筛查 in general practices in areas with high HIV prevalence. 在全科诊疗中推广常规HIV快速检测不仅增加诊断率，还可促 使HIV的早期发现。 因此，我们建议在HIV高流行地区的全科诊疗中实施HIV筛查。
HIV: human immunodeficiency virus
AIDS: Acquired immunodeficiency syndrome opt-out rapid HIV testing：...尽管新检测咨询策略仍
强调知情同意和自愿检测，但采取“知情不拒绝(opt．
out)”。即将检测作为一种常规服务，如果就诊者不提
Rate of HIV diagnosis was 0· 30 (95% CI 0· 11 to 0· 85) per 10000 patients per year in intervention practices versus 0· 07 (0· 02 to 0· 20) in control practices (adjusted ratio of geometric means几何平均数 4· 51, 95% CI 1· 27 to 16· 05; p=0· 021). 55% of patients in intervention practices versus 73% in control practices had CD4 count less than 350 cells per μL (risk ratio 0· 75, 95% CI 0· 53 to 1· 07). 干预组每年每10000名患者的HIV诊断率为0.30（95％Cl 0.11 至0.85）,对照组为0.07（0.02至0.20）（几何平均数调整率为 4.51，95％Cl 1.27〜16.05，P=0.021）。 CD4细胞计数低于350个/ μL的患者在干预组中和对照组中分 别为55％及73％（风险率为0· 75，95％Cl 0.53〜1.07）。 （句型转译）
Mean CD4 count at diagnosis was 356 cells per μL (SD 254)in intervention practices versus 270 (SD 257) in control practices (adjusted difference of square root平方根差 CD4 count 3·1, 95% CI −1·2 to 7·4; p=0·16); in a pre-planned预设 sensitivity敏感性 analysis excluding patients diagnosed via antenatal产前的 care, the difference was 6· 4 (95% CI, 1· 2 to 11· 6; p=0· 017). 干预组诊断时CD4细胞平均计数为356个/μL（SD 254），对照 组为270个/μL（SD 257）（CD4计数调整平方根差3.1，95％Cl -1.2-7.4,;P =0.16）; 在排除产前检查确诊患者的预设敏感性分析中，其差为6.4（95 ％Cl，1.2-11.6，P=0.017）。
Patients and inves assigned treatments. 该研究注册于, 注册号： ISRCTN63473710。 患者和研究人员设盲治疗分配。
Findings 40 of 45 (89%) general practices agreed to participate: 20 were assigned to the intervention group (44 971 newly registered adult patients) and 20 to the control group (38 464 newly registered adult patients), between April 19, 2010, and Aug 31, 2012. Intervention practices diagnosed 32 people with HIV versus 14 in control practices. 45个全科医生中有40人（89％）同意参加：20个被分配到干预 组（44971新注册成人患者），20个被分配到对照组（38464新 注册成人患者），时间从2010年4月19日到2012年8月31日。 干预组和对照组医生确诊的HIV感染者分别为32人与14人。 （转译法---句型转译）
RHIVA 2： the RHIVA 2 trial （ findings from the RHIVA 2 trial）
Summary 摘要
Background
Many people with HIV are undiagnosed. Early diagnosis saves lives and reduces onward transmission. We assessed whether an education programme promoting rapid HIV testing in general practice would lead to increased and earlier HIV diagnosis. 许多 HIV(艾滋病病毒)携带者未被诊断出来。早期诊断可 我们在全科诊疗中推广 HIV快速检测，并评估该教育计 以挽救生命并减少传染进一步扩散。 划是否能促使HIV诊断率的提高及早期诊断。（拆句法） 我们评估在全科诊疗中推广 HIV快速检测的教育计划是 否能促使HIV诊断率的提高及早期诊断。
28% versus 46% had CD4 count less than 200 cells per μL (0·60, 0·32 to 1·13). All patients diagnosed by rapid testing were successfully transferred into转入 specialist care. No adverse events occurred.
Funding UK Department of Health, NHS City and Hackney
英国卫生部 国民卫生服务体系 受托基金机构City & Hackney （增译法）
National Health Service trusts include NHS City & Hackney, NHS South West Essex, NHS Wigan, NHS Oxfordshire. /wiki/Event_Marketing_Solu tions
所有全科医生都受邀参加，并由一个独立的临床试验单位的统 计员进行最小化随机分配，以确保分配的隐秘性。 注解：1 . 该测试采取“知情不拒绝(opt．out)”原则。即将检测 作为一种常规服务，如果就诊者不提出拒绝，就进行HIV检测。
Neither patients nor investigators were masked遮盖，掩 饰 to treatment allocation. The primary outcome was CD4 count at diagnosis. Secondary outcomes were rate of diagnosis, proportion with CD4 count less than 350 cells per μL, and proportion with CD4 count less than 200 cells per μL微升. This study is registered , number ISRCTN63473710. 患者和研究人员均未设盲治疗分配。 主要终点为诊断时CD4细胞计数；次要终点为诊断率, CD4细胞计 数比例低于350个/μL.，及CD4细胞计数比例低于200个/μL 。
出拒绝，就进行HIV检测；不再提供检测前咨询服务，
而是提供HIV检测前信息服务(pre—test information)
，其差别在于没有个人危险因素评估和行为改变的内容
Promotion of rapid testing for HIV in primary care (RHIVA2): a cluster-randomised群组随机的 controlled trial
初诊治疗中快速检测HIV的推广(艾滋病协会康复分会试验 之二): 一个群组随机对照试验 primary care (由医护人员提供的)最初保健护理(其后病人可转到专 科就诊);初诊治疗;初级治疗;初级医疗保健.
Methods
In this cluster randomised controlled trial in Hackney (London, UK), general practices were randomly assigned (1:1) to offer either opt-out rapid HIV testing to newly registering adults or continue usual care. All practices were invited to take part. Practices were randomised by an independent clinical trials unit statistician with a minimisation program最小化程序, maintaining allocation concealment隐秘性. 在哈克尼（英国伦敦）进行的群组随机对照试验中，全科医生被 〔1 随机分配（1：1），一组对新注册的成年病人进行opt-out 〕 HIV快速检测 / 常规HIV快速检测 ；另一组则继续常规护理。
CD4细胞计数低于200个/ μL的患者在干预组中和对照组中分 别为28％及46％（0.60，0.32〜1.13）（增译法） 所有快速检测诊断出的患者均顺利转入专科治疗。无不良事 件发生。
Interpretation Promotion of opt-out rapid testing in general practice led to increased rate of diagnosis, and might increase early detection of HIV. We therefore recommend implementation 实施 of HIV screening筛查 in general practices in areas with high HIV prevalence. 在全科诊疗中推广常规HIV快速检测不仅增加诊断率，还可促 使HIV的早期发现。 因此，我们建议在HIV高流行地区的全科诊疗中实施HIV筛查。
HIV: human immunodeficiency virus
AIDS: Acquired immunodeficiency syndrome opt-out rapid HIV testing：...尽管新检测咨询策略仍
强调知情同意和自愿检测，但采取“知情不拒绝(opt．
out)”。即将检测作为一种常规服务，如果就诊者不提
Rate of HIV diagnosis was 0· 30 (95% CI 0· 11 to 0· 85) per 10000 patients per year in intervention practices versus 0· 07 (0· 02 to 0· 20) in control practices (adjusted ratio of geometric means几何平均数 4· 51, 95% CI 1· 27 to 16· 05; p=0· 021). 55% of patients in intervention practices versus 73% in control practices had CD4 count less than 350 cells per μL (risk ratio 0· 75, 95% CI 0· 53 to 1· 07). 干预组每年每10000名患者的HIV诊断率为0.30（95％Cl 0.11 至0.85）,对照组为0.07（0.02至0.20）（几何平均数调整率为 4.51，95％Cl 1.27〜16.05，P=0.021）。 CD4细胞计数低于350个/ μL的患者在干预组中和对照组中分 别为55％及73％（风险率为0· 75，95％Cl 0.53〜1.07）。 （句型转译）
Mean CD4 count at diagnosis was 356 cells per μL (SD 254)in intervention practices versus 270 (SD 257) in control practices (adjusted difference of square root平方根差 CD4 count 3·1, 95% CI −1·2 to 7·4; p=0·16); in a pre-planned预设 sensitivity敏感性 analysis excluding patients diagnosed via antenatal产前的 care, the difference was 6· 4 (95% CI, 1· 2 to 11· 6; p=0· 017). 干预组诊断时CD4细胞平均计数为356个/μL（SD 254），对照 组为270个/μL（SD 257）（CD4计数调整平方根差3.1，95％Cl -1.2-7.4,;P =0.16）; 在排除产前检查确诊患者的预设敏感性分析中，其差为6.4（95 ％Cl，1.2-11.6，P=0.017）。
Patients and inves assigned treatments. 该研究注册于, 注册号： ISRCTN63473710。 患者和研究人员设盲治疗分配。
Findings 40 of 45 (89%) general practices agreed to participate: 20 were assigned to the intervention group (44 971 newly registered adult patients) and 20 to the control group (38 464 newly registered adult patients), between April 19, 2010, and Aug 31, 2012. Intervention practices diagnosed 32 people with HIV versus 14 in control practices. 45个全科医生中有40人（89％）同意参加：20个被分配到干预 组（44971新注册成人患者），20个被分配到对照组（38464新 注册成人患者），时间从2010年4月19日到2012年8月31日。 干预组和对照组医生确诊的HIV感染者分别为32人与14人。 （转译法---句型转译）
RHIVA 2： the RHIVA 2 trial （ findings from the RHIVA 2 trial）
Summary 摘要
Background
Many people with HIV are undiagnosed. Early diagnosis saves lives and reduces onward transmission. We assessed whether an education programme promoting rapid HIV testing in general practice would lead to increased and earlier HIV diagnosis. 许多 HIV(艾滋病病毒)携带者未被诊断出来。早期诊断可 我们在全科诊疗中推广 HIV快速检测，并评估该教育计 以挽救生命并减少传染进一步扩散。 划是否能促使HIV诊断率的提高及早期诊断。（拆句法） 我们评估在全科诊疗中推广 HIV快速检测的教育计划是 否能促使HIV诊断率的提高及早期诊断。
28% versus 46% had CD4 count less than 200 cells per μL (0·60, 0·32 to 1·13). All patients diagnosed by rapid testing were successfully transferred into转入 specialist care. No adverse events occurred.
Funding UK Department of Health, NHS City and Hackney
英国卫生部 国民卫生服务体系 受托基金机构City & Hackney （增译法）
National Health Service trusts include NHS City & Hackney, NHS South West Essex, NHS Wigan, NHS Oxfordshire. /wiki/Event_Marketing_Solu tions
所有全科医生都受邀参加，并由一个独立的临床试验单位的统 计员进行最小化随机分配，以确保分配的隐秘性。 注解：1 . 该测试采取“知情不拒绝(opt．out)”原则。即将检测 作为一种常规服务，如果就诊者不提出拒绝，就进行HIV检测。
Neither patients nor investigators were masked遮盖，掩 饰 to treatment allocation. The primary outcome was CD4 count at diagnosis. Secondary outcomes were rate of diagnosis, proportion with CD4 count less than 350 cells per μL, and proportion with CD4 count less than 200 cells per μL微升. This study is registered , number ISRCTN63473710. 患者和研究人员均未设盲治疗分配。 主要终点为诊断时CD4细胞计数；次要终点为诊断率, CD4细胞计 数比例低于350个/μL.，及CD4细胞计数比例低于200个/μL 。
出拒绝，就进行HIV检测；不再提供检测前咨询服务，
而是提供HIV检测前信息服务(pre—test information)
，其差别在于没有个人危险因素评估和行为改变的内容