Many intervention trials indicate that disability can be prevented or its severity decreased; one trial showed improvements in functioning with resistance 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毁灭性的。
Current treatment methods include transplantation of organs, surgical reconstruction, use of mechanical devices, 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。
However, the ultimate goal of transplantation should reside in the ability to restore living cells to maintain or even 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, retaining physiologic functions as well as structure to the tissue or organ damaged by disease or trauma, tissue engineering 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 tissue-engineering wound care materials currently 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 organ replacement. (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方法。
Tissue engineering may eventually be applied to the regeneration of diverse tissues such as the liver, small intestine, 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 several 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 (donor form a different 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” cells obtained from tissue, where the cell population obtained from tissue dissociation comprises a mixture of cells at 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 discoveries have indicated that stem cells of one type can transdifferentiate to repair damaged tissue of another type (i.e., hematopoietic stem cells home to infarcted myocardium and repair the tissue).
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)。
Tissue 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 a role.(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 二十章 外科病人的非外科感染
Postoperative patients are at increased risk for a variety of nonsurgical postoperative nosocomial infections.
(nosocomial 医院的)术后病人发生各种各样术后非外科医院内感染的风险不断增加。
The most common of these is urinary tract infection (UTI).最常见的院内感染是泌尿道感染。
Any patient who has had an indwelling urinary catheter is at increased risk for a UTI.
(indwell 存在…之中、居住)任何留置尿路导管的病人都是UTI的高风险者。
Despite the benign course of most UTIs, the occurrence of one in a surgical patient is associated with a threefold increase in death occurring during hospitalization. (threefold 三倍的、三重的)
尽管大多数的尿路感染过程是良性的，但外科病人发生这样一个感染，住院死亡率提高了三倍。
The best prevention is to use urinary catheters sparingly and for specific indications and short durations and to employ strict closed –drainage techniques for those that are used.
sparingly 节俭的、保守的 employ 使用、利用
最好的预防方法是少用导尿管、针对特殊指征、短时间使用，并应用严格的闭合引流技术。
Lower respiratory tract infections are the third most common cause of nosocomial infection in surgical patients (after SSIs and UTIs) and are the leading cause of death due to nosocomial infection. (SSIs 手术部位感染、局部感染)
下呼吸道感染是外科病人院内感染是第三常见原因（排在局部感染和泌尿系感染之后)，并且是院内感染首要的死亡因素。
Diagnosis is usually relatively straightforward in a patient who is breathing spontaneously.
straightforward 一直向前、简单的、明确的 spontaneously 自然的、自发的、不由自主的
对一个呼吸自然的病人，诊断通常相对容易。
However, a patient who is intubated and being ventilated because of adult respiratory distress syndrome presents an extremely difficult diagnostic problem. (intubate 以管插入……腔道)
但是，对一个正在插管通气的成人呼吸窘迫症病人，诊断是非常困难的。
Patients with this syndrome commonly have abnormal chest radiographic findings, abnormal blood gas values, and elevated temperatures and white blood cell counts even in the absence of infection. (radiographic X线照相术的)
这种患者甚至未存在感染，却常有阳性胸部X线发现、血气值异常、体温升高、白细胞计数升高。
Both false-positive and false-negative diagnosis of pneumonia is common.
假阳性和假阴性的肺炎诊断都很常见。
New chest radiographic infiltrates with signs of infection constitute a good indication for bronchoalveolar lavage, a method being used to diagnose and identify bacteria causing ventilator-associated pneumonia, which has proven to minimize the indiscriminate use of antibiotics and possesses a higher specificity than previous methods.
infiltrate 透入、渗透 constitute 构成、指定 indiscriminate 不加区别的、任意的
possess 拥有、撑握、具有 specificity 明确性、具体性
胸部X线新渗出（阴影)伴有感染征象是支气管肺泡灌洗的良好指征，这种方法用于诊断和鉴别通气相关肺炎的病原菌，它被证明最小化了抗生素使用的任意性，比先前的方法更有针对性。
As part of the work-up for fever in a surgical patient, central lines used for monitoring or treatment should always be considered.
work-up 诊断检查 central 中央的、主要的、近的、便利的 line 线路、方法
作为外科病人发热诊断检查的一部分，用于监测或治疗的深部导管始终应用考虑。
Catheter-related sepsis is diagnosed when an organism is isolated from blood cultures and from a segment of the catheter in question, without any other source if septicemia and with clinical findings consistent with sepsis.
organism 生物、有机体、有机组织 in question 在考虑中、讨论中
当血培养中和有怀疑的导管节段中分离到病原菌，未发现其它部位的感染源，而败血症临床表现持续存在，导管脓毒败血症诊断就成立。
Infection of the catheter site is defined as presence of erythema, warmth, tenderness, and/or pus at the site of the catheter insertion. (erythema 红斑)
导管插入处有红、（肿)、热、痛和／或有脓液是导管局部感染的特点。
Both require removal of the catheter, and if a new central line is needed, a new puncture is warranted. (puncture 穿刺 warrant 保证、批准、证明)
两种情况都要拔除导管，假如需要新的深部导管，要保证从新的部位刺入。
Furth treatment usually depends on the organism isolated.
通常根据分离到的病菌进行进一步治疗。
Placement of lines should be done following standard aseptic and antiseptic technique including wide drapes and full gown and glove for the inserting physician.
drape 窗帘、幔 gown 长礼服、手术衣
