In premodern times and even today in some developing countries, basic hygiene, clean water, and adequate nutrition have been the most important ways to promote health and reduce disease.
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, are cornorstones to reducing the epidemics 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 than nearly any other imaginable health intervention.
(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。
Vital signs Page 15
生命体征 第１５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 signs 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 patient’s quantitative assessment 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 patient’s 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 nonthreatening initial contact with the patient allows the physician to determine whether the patient has a regular 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 greatest 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 -8 to +10/+2 to +8mmHg. (mmHg: millimeter of mercury)
许多成人需用大号的成人袖套，如果使用窄袖套能够影响收缩压-8~10mmHg ，舒张压2~8mmHg。
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１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 is released (phase 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20~30mmHg上方，Korotkoff音变钝，当压力释放， Korotkoff音消失（第５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 nearest 2mmHg. (be round up to the nearest 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２mmHg整数。
The respiratory rate should be assessed at the same time the patient is observed to determine whether there is any 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 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 slow or 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, which is defined by increased alvealar ventilation resulting 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 tachypnea only 63% of the 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。
Rectal 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 ……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-1.2~1.6度)，不宜用于住院病人。
Why Geriatric Patients Are Different
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 is the frequent occurrence of comorbidities and of subclinical disease.
(comorbidities 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 in the 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 age 65 and older, 50% have two or more chronic disease, and these diseases can confer additive risk 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.
(cognitive 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 individuals with 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 becoming 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。
