新世纪社会医学英语翻译.doc

Unit2 AAmerica is experiencing a major epidemic today.现今美国正在经历一场重要的流行病。Unlike epidemics of the past, it is not a disease transmitted by bacteria or viruses.不同于过去的流行病，它不是由细菌或病毒传染的疾病。This epidemic is an increase in diseases and problems related to stress, and it touches all of our lives.这个流行病的增加是与压力有关的疾病和问题引起的，它涉及我们生活的方方面面。In 1900 the average life expectancy in this country was 47, and the major killer diseases included tuberculosis pneumonia,influenza, cholera, typhoid, and smallpox infectious diseases which struck people of all ages, regardless of their lifestyle.1900年，这个国家的平均预期寿命为47岁，其主要致命疾病包括肺结核肺炎，流行性感冒，霍乱，伤寒，天花-这些传染性疾病袭击了所有年龄层的人，不管他们的生活方式怎样。Today, on the other hand, life expectancy has been extended to 74, thanks in large part to the conquest of the acute infectious disease through improved sanitation, better distribution and storage of foods, and the introduction of immunization and antibiotics.如今，在另一方面，预期寿命已延长至74岁，这在很大程度上是由于对于急性传染病的征服，通过改善卫生条件，更好地分配和储存食物，以及引进免疫方法和抗生素。 People today are dying of different diseases than they did at the turn of the 20th century, and the principal causes of death today are heart disease, stroke, cancer, cirrhosis of the liver, and diabetes.当今人们死于的疾病与20世纪初不同，现在死亡的主要原因是心脏病，中风，癌症，肝硬化，糖尿病等。These noninfectious, chronic diseases have been shown to be directly related to the way we live, and one of the dominant factors in their development is stressan element of modern life which is taking an increasing toll on our physical and mental well-being.这些非传染性，慢性疾病已被证明是与我们的生活方式有直接联系的，使其发展的主要因素之一是压力这一现代生活元素，正对我们的身体和精神健康造成越来越严重的危害。Technically speaking, stress is a physiological state of the body, a state of arousal in response to a perceived danger or threat.从技术上来说，压力是机体对感知到的危险或威胁反应而表现的一种生理性兴奋状态。We are all familiar with the physical signs and symptoms of the stress state.我们都熟悉压力状态下的身体信号和症状。Think about how you felt that last time you had to swerve to avoid a collision which driving: your heart raced, your palms became sweaty, your muscles tensed, and your stomach knotted.想想你上一次在驾驶时突然转向以避免碰撞是何感觉：你的心狂跳起来，你的手掌变得多汗，你的肌肉紧张，而你的心也揪在一起了。Such a combination of sensations is the result of a complex physical chain reaction which occurs in your body in response to a threat.这种感觉的结合是一个复杂的身体连锁反应的结果，出现在你的身体对威胁做出反应的时候。These changes are universal and predictable, and they happen to everyone.这些变化是普遍的并且可以预见的，可以发生在每一个人身上。Our prehistoric ancestors, upon encountering a dangerous animal in the wild, would have felt exactly the same response as their bodies switched into a stress-induced “high-gear” to deal with the emergency.我们的史前祖先，一旦在野外意外地遇见危险动物，就会感受到完全一样的反应，当他们的身体转入一种紧张引起的“高速挡”，以应对紧急状况。Physiologist Walter Cannon, back in the 1920s, labeled this reaction the fight-or-flight response.生理学家沃尔特坎农，追溯到20世纪20年代，把这种反应称为打或逃跑反应。As the term implies, the original purpose of the fight-or-flight response was to prepare the body to respond either by fighting the enemy, or by fleeing.这个术语暗示，战或逃跑反应的最初目的是准备让身体作出反应，要么对抗敌人，要么逃离。Whether the primitive hunter succeeded in killing the mountain lion or in running away from it, the result was the same: once the threat was resolved, the body could relax, eventually returning to its normal baseline functioning.无论是成功杀死美洲狮或远离它的原始猎人，其结果是一样的：一旦威胁得到解决，身体能放松，最终恢复到自身正常的基础运作状态。Interestingly enough, situations which provoke the fight-or-flight response are not necessarily unpleasant ones.非常有趣的是，引起战或逃跑反应的情况发生并不必然是不愉快的。Pleasant experiences, if they are sufficiently intense, can produce the same combination of physiological symptoms.愉快的经验，如果它们足够的强烈，可以产生相同组合的生理症状。When your boss tells you that hes recommended you for a promotion, you are most likely experiencing some of the same physiological responses that you experience when you swerve to avoid a traffic accident: sweaty palms, racing heart, changes in breathing.当你的老板告诉你，他已经推荐你晋升，你是最有可能体验到一些与当你拐弯去避免一宗交通意外所产生的相同的生理反应：手心出汗，心跳加速，呼吸的变化。Pleasant or unpleasant, its the intensity of the experience that produces the stress.愉快或不愉快的，取决于产生压力的感觉的强度。Dr. Hans Selye, an endocrinologist whose ground-breaking research was a major contribution to our understanding of stress, defined stress as the nonspecific or general response of the body to any demand made upon it to readjust.汉斯薛利医生，一名内分泌学家，其开创性研究在我们对压力的理解上是一个重大的贡献，把压力定义为身体根据它的任何需要作出重新调整的非特异性或一般应激反应。Selye emphasized that stress is not necessarily something to be avoided.薛利强调，压力是不可避免的。It is a natural part of our lives; any normal activity, pleasant or unpleasant, produces some degree of stress.它是我们生命自然的一部分，任何正常活动，愉快或不愉快，都会产生一些程度的压力。As Selye said “The absence of stress is death.”正如薛利说的：“没有压力是死亡。Just as stress prepared primitive man to confront the fight with his enemy or to run away, so in modern life it helps the athlete to achieve peak performance or the executive to meet impossible deadlines.“正像原始人因压力做好面对敌人是斗争或是逃跑的准备一样，在现代生活中它也可以帮助运动员达到最佳表现或主管人员处理不可能的最后期限。Under such circumstances, stress can be a very useful response, contributing to heightened achievement and a greater sense of personal satisfaction.在这种情况下，压力可以是一个非常有用的反应，有助于提高成绩和个人满足感。When stress is associated with such a positive experience, Selye called it eustress (something also called prostress); when it becomes unpleasant or damaging, it is called distress.当这种压力是与一种积极的经验有联系时，薛利称之为好的压力（也被称为积极压力），当它变得不愉快或具破坏性时，它被称为不好的压力。Eventsthat provoke stress are known asstressors.引起压力的事件被称为压力源。Its easy to identify many such triggers of stress in our daily lives.在我们的日常生活中，识别许多这样的压力源是容易的。Some sources of stress can be classified as environmental: weather changes, temperature, noise, air pollution, crowding, and uncomfortable living or work space can all have an influence on your stress level.有些压力源同环境一样可被归类为：天气变化，温度，噪音，空气污染，拥挤和不舒服的生活或工作空间，都可以对你的压力水平造成影响。A major source of stress in our modern world is change; more than ever before in history we are forced constantly to adapt to rapid change in many important aspects of our liveschanging values, family structure, and sex roles, the decline of religious faith, and the changing nature of work.在我们现代世界的一个主要压力来源是变化，我们比过去任何时候更加被迫地去不断适应生活中许多重要方面的快速变化价值观改变，家庭结构，性别角色，宗教信仰的减弱，和工作性质的变化。Interpersonal stressors emerge from your relationships with other peopleyour boss, your fellow workers, your family and friends.人际关系的压力源来自你同别人的交往中你的老板，你的同事，你的家人和朋友们。And a significant source of stress in many of our lives today is work stressorsthe structure of your employers organization, your position within it, your interaction with other people, and your feelings about job are all factors that can contribute to raising your overall stress level.今天我们生活中很明显的一个压力源来自工作你所在单位的机构组成，你在其中的职位，你与其他人互动，你对工作的感受都是能提高你的总体压力水平的因素。You may have notice that many of the stressors we have been describing dont actually represent threats to your physical survival.你可能已经注意到许多我们描述的压力源事实上并不代表会威胁你的身体生存。Rather, they are psychological or social in nature.相反地，它们本质上是心理或社会性质的。Imagined threats to your sell-esteem or security can arouse the fight-or-flight response just as readily as an attacking mountain lion or an oncoming car.想象你的自尊或安全的威胁会激发战或逃反应，就像面对攻击性的美洲狮或迎面而来的汽车反应一样。Moreover, our psychological and emotional reactions to stressful situation, such as anxiety or guilt, can actually become potent stressors in their own right.此外，我们心理上和情绪上对有应激情况的反应，比如焦虑或内疚，实际上可以凭借它们本身的能力成为强大的压力源。What arouse a high level of stress in one person may not be perceived as threatening to another, for our individual perception of the stressor is what ultimately makes the situation stressful or not.能激起一个人高水平的压力的（事件）可能不被视为能对另一个人构成威胁，因为我们个人对压力的感觉，最终决定了是否产生压力感We are all different in our biochemical make-up, physical strength, psychological and emotional characteristics, values, attitudes, habits, and social roles.我们在我们的生化结构，体力，心理和情感特征，价值观，态度，习惯和社会角色上都是不一样的。And all these factors influence our interpretation of events and, therefore, the way we respond physically and psychologically to them.而所有这些因素影响我们对事件的理解，因此，也决定了我们对他们作出的生理和心理上的反应。As a primitive survival mechanism, the fight-or flight response served our ancestors well as a means of mobilizing the bodys defenses in times of emergency.作为一种原始的生存机制，战或逃跑反应为我们祖先在紧急情况下及时动员身体防御服务很好。Why, then, has stress become such a problem in modern life?为什么，随后，在现代生活中压力会变成一个难题呢？In the case of the primitive hunter, once the danger had been dealt with by fighting or fleeing, the problem was resolved and the stress was relieved.就原始猎人来说，一旦通过战或逃跑使危险得到了处理，问题解决了，压力才会被缓解。However, if we look around us today, we notice that the options of fighting or fleeing are rarely appropriate in our modern world.但是，今天如果我们回过头来看今天，我们注意到当今现代社会战或逃跑的选择很少是合适的。For example, if you have an argument with your boss, you may feel all the symptoms of stress but you cant relieve your stress by striking out at him, nor would it do to run away.例如，如果你和你的老板发生争论，你可能会感到压力所有的症状 - 但你不能通过揍他一顿来减轻你的压力，也不会逃跑。And so the level of anger and arousal persists in the absence of a socially acceptable outlet, and at the end of the confrontation you still feel as if you want to fight someone or run away.所以气愤和激发的兴奋状态在现实社会中缺乏得到合理的发泄途径，最后你仍觉得好像你想和人打架或逃跑。The fight-or flight response has now become an internalized feeling that you carry about with you, like a ticking time bomb.战或逃跑反应现在已经变成了随时随地的一种内在感觉，就像你随身携带一个开始倒计时的定时炸弹。If the fight-or flight response is activated without being used to its intended purpose, it can become a major source of distress.如果战或逃跑反应没有被用于其预期目标的激活，它可以成为不好的压力的主要来源。If it is fired off too often, or persists too long, the body will remain in a state of continual alarm or mobilization，and the potent hormones released in the stress response can actually damage the bodys vital organs, nervous system, and immune mechanisms.如果它被激发过于频繁，或持续时间过长，身体会留在一个不断报警或调节的状态，压力反应中大量释放的激素实际上可以破坏人体的重要器官，神经系统，和免疫系统。Ironically, it appears that the stress response, which was a vital survival mechanism for our remote ancestors, may in fact be killing us today.讽刺的是，它似乎是我们的远古祖先生存的重要机制的应激反应，实际上现今可能杀死我们。Before it kills us in the end, stress can make us fat.在它最终杀死我们之前，压力可以使我们发胖。Unit3aAntibiotics are nonrenewable resources.抗生素是不可再生的资源。 In the past we have managed to develop new antibiotics to replace those that had become ineffective, but that has changed now that some bacteria have become resistant to all available drug treatments.在过去，我们设法去开发新的抗生素，以取代那些已变得无效的抗生素，但那种情况已经变了，由于一些细菌对所有可用的药物治疗已具耐药性。Until recently infections caused by multi-resistant Staphylococcus aureus (MRSA), which is common in most hospitals, could be treated using vancomycin.直到最近多重耐药金黄色葡萄球菌（MRSA）所引起的感染，这是大部分医院常见的感染，可使用万古霉素治疗。Compared with many other bacteria, S.aureus is a very virulent or aggressive bacterium and can produce life-threatening infections.与许多其他细菌相比，金黄色葡萄球菌是种有剧毒或具有攻击性的细菌，并且能够产生致命的感染。In Japan and the US, strains resistant to vancomycin have been found, placing a death sentence on patient with these infections.在日本和美国，对万古霉素抗药的菌株已经被发现，这是对这些感染病人判死刑。Antibiotic resistance is not only confined to hospitals; multi-resistant strains of Golden Staph are now appearing in the Australian community.抗生素耐药性不仅局限于医院;金黄色葡萄球菌多重耐药菌株现已在澳大利亚社区出现。These strains, unlike their hospital-based cousins, usually remain sensitive to agents such as erythromycin and tetracycline.不像它们在医院里的同类菌株，这些菌株通常对药剂保持敏感，如红霉素和四环素。However, this was also the case for the MRSA strains in hospitals 10-15 years ago.不过，这也是10-15年前医院里MRSA菌株的情况。One approach would be to treat all cases of Golden Staph infection with vancomycin.万古霉素的使用可治疗所有感染金黄色葡萄球菌的病例。The problem with this tactic is that it would increase the likelihood of resistance to this drug of last resort.这种方法的问题所在是，它将增加对这最后一招的药物耐药的可能性。We are safe while these bacteria remain sensitive to erythromycin or tetracycline but, given the experience with their hospital-based cousins, it will only be a matter of time before these become ineffective too.在这些细菌对红霉素或四环素仍然敏感的时候，我们是安全的，但是，考虑到它们在医院里的同类菌株的经验，在这些药物也变得无效之前这将只是一个时间上的问题。There are other examples of life-threatening infections that are resistant to multiple antibiotics.还有其他对多种抗生素耐药的致命感染的例子。One of these is tuberculosis, with multi-resistant strains of TB common in many countries.其中之一是肺结核，它以多耐药结核菌株常见于许多国家。Because of the migration patterns and travel of people around the world, these strains can easily be introduced into other countries.由于移民的情况与世界各地的人们的旅游，这些菌株可以很容易地被引入到其他国家。At present many of these bacteria are still treatable but more toxic drugs are needed and treatment takes longer.目前许多这些细菌仍是可处理的，但需要更多有毒的药品和延长了治疗时间。In the US, outbreaks of multi-resistant strains have occurred in both health settings and prisons, causing the deaths of many who came into contact with the original infected person.在美国，出现在健康环境和监狱的多耐药菌株的疫情爆发，造成很多与接触到最初的感染者的人的死亡。COMMON BACTERIA.常见的细菌。Respiratory tract infectionsparticularly pneumonia, middle ear infections and sinusitisare often caused by Streptococcus pneumoniae.呼吸道感染尤其是肺炎，中耳炎，窦炎通常是由肺炎链球菌引起的。This organism is also a common cause of bacterial meningitis.这种微生物也是一种细菌性脑膜炎的常见病因。Since the late 1980s we have seen an exponential rate of increase in the antibiotic resistance of this organism.20世纪80年代末以来，我们已经经历了这种微生物的抗生素耐药呈指数的速度增长。In the late 1980s, approximately 1% of these isolates in Australia were resistant to penicillin.在20世纪80年代末，在澳大利亚大约1的这种分离菌株对青霉素耐药。In a study performed a few years ago, the rate of resistance had risen to 7% and more recently the rate of resistance appears to have been growing at about 20%.在几年前完成的一项研究中显示，耐药率已经上升到7，而且较近期的耐药率似乎已在以约20的速度增长。This rising resistance has particular relevance for meningitis, which was uniformly fatal in the pre-antibiotic era.这上升的耐药性对脑膜炎有特殊的相关性，脑膜炎在前抗生素时代是一律致命的。Antibiotics have made a huge difference to this condition, but we are now getting to the stage where we no longer have effective and proven therapy that works against some of these higher level resistance strains.抗生素对这种情况起到了巨大的作用，但我们现在进入了不再有抵抗这些高浓度耐药株有效的和已经被证明的治疗方法的阶段。If early treatment doesnt occur, patients can be left with profound problems such as neurological impairment or deafness.如果早期治疗不被发现，患者可遗留下严重问题，如神经损伤或失聪。NEW RESEARCH.新的研究。Bacteria continually develop resistance to antibiotics.细菌不断发展对抗生素耐药性。It is therefore essential that there should be ongoing research and development so new antibiotics are developed.因此，必须要有不间断的研制和开发，从而开发新的抗生素。To be successful in our treatment of bacterial infections in the future we will need to design completely new classes of antibiotics.将来要在我们的细菌性感染治疗上取得成功，我们将需要设计全新种类的抗生素。We need the equivalent of the discovery of penicillin by Fleming and its development by Florey to be repeated every 10-20 years if we want to keep ahead of bacterial infections.如果我们想要在细菌感染面前保持领先，我们需重复地每隔10-20年就得有相当于由弗莱明发现的并由弗洛里开发的青霉素的等同物。New antibiotic development has slowed down for many reasons.新抗生素的研发速度因很多原因而放慢了。There are huge costs involved in developing and marketing antibiotics.有关抗生素的开发和营销需要巨额费用。It is estimated that at present it costs about US$300 million per new compound released on the international markets.据估计，目前在国际市场上每推出一种新药约耗费300美元。This means that a drug has to look very promising before pharmaceutical companies will invest such huge amounts.这意味着，在制药公司将投资如此巨大的数额之前该药必须能看得到相当有前景。In addition to the development costs, there has been general complacency on the part of the community, medical profession and pharmaceutical industry during the 1980s.除了开发成本，在20世纪80年代期间，社会，医疗职业和制药工业各界普遍出现自满。At that time, infectious diseases appeared to be under control with the available antibiotics.当时，传染性疾病似乎是用有效的抗生素控制住了。Many pharmaceutical companies lowered the emphasis on new drug development for antibiotics and in some cases left the field altogether.许多制药公司降低新抗生素药物开发的重视，并在某些情况下一起离开这个领域。While research and development have been winding back, the pace of bacterial adaptability has been accelerating.在研究及开发一直在倒退的时候，细菌的适应力的步伐一直在加速。Previously, most of the antibiotic resistance was due to the breakdown of the drug by bacterial enzymes.以前，大多数的抗生素耐药是由于细菌的酶对该药物的分解。An example is the breakdown of penicillin by the beta-lactamase enzyme.一个例子是-内酰胺酶对青霉素的的分解。We overcame this problem by developing enhanced antibiotics from existing products, chemically engineering them so that they were resistant to these enzymes.我们通过从现有产品开发增强抗生素来克服了这个问题，通过用化学方法设计增强抗生素而使它们抵抗这些酶。However, the bacteria adapted to this change.然而，细菌适应了这种改变。Usually, antibiotics recognize and attack a particular site on the bacteria.通常情况下，抗生素识别和攻击细菌上特定的位置。However, the bacteria modified these target sites so that the antibiotics could not lock onto the bacteria.但是，细菌修正了这些目标位置以致抗生素无法锁定细菌。This is analogous to the bacteria moving the goal posts.这是类似于细菌改变目标靶点的位置。Therefore, even though the antibiotics were no longer destroyed by the bacterial enzymes they now had no site on which to act.因此，即使抗生素不再被细菌酶破坏，它们现在已经没有作用的位置。COMMUNITY OVERUSE.社区过度使用。The total tonnage use of antibiotics in the general community is also a problem.抗生素使用的总吨数在整个社区的也是一个问题。We are frequently using antibiotics when they are unlikely to give any benefit, such as the treatment of viral respiratory tract infections.我们在抗生素不太能给任何益处的时候仍频繁使用抗生素，如病毒性呼吸道感染的治疗。We are, however, also using antibiotics in ways that appear to be wasteful of this precious resource.可是，我们似乎也是采用对这一宝贵资源的浪费的方式使用抗生素。Large amounts of antibiotics are used in animals as growth promoters.大量的抗生素是用来作为动物助长剂。While there are commercial and economic benefits to this, the cost in the form of antibiotic resistance is high.虽然对于这一点具有商业和经济利益，但抗生素抗药性的形成所付出的代价是高的。Vancomycin-resistant enterococcus is thought to have developed from t