同济医学英语06.doc

Part I Words and Expressionsmulti- centerlipid n. 脂类 lipidic adj. 脂类的，含脂的lip(o)- comb. form (combining form 构词成分) lipo- protein hyper- chole- ster- -ol -em- -ic adj. hyper- chole- ster- -ol -em- -ia n. (chole- comb. form 胆汁; -ol comb. form 醇，酚； sterol 固醇; -emia 血症 )maturation 7mAtju5reiFEn, 7mAtFu5reiFEnstatus 身份, 地位,资格; 情形, 状况, 状态, 体质state (尤指高的)社会地位, 身分, 社会阶层, 资格; 状态，情况，体质; 临界期（疾病发作的转折点）Part II Text and its TranslationReducing Blood Cholesterol Levels in Children降低儿童血胆固醇水平.1 The main findings of the multicentre Dietary Intervention Study in Children (DISC) are presented in this issue of THE JOURNAL. 本刊这一期发表了多中心的儿童饮食节制研究(DISC)的主要研究成果。present to offer for observation, examination, or consideration; show or display 提供, 提出；显示, 呈现；发表（文章）The national project sought to evaluate the safety and efficacy of lowering dietary total fat, saturated fat, and cholesterol in reducing low-density lipoprotein cholesterol (LDL-C) in healthy hypercholesterolemic children. 这项全国性科研项目试图评估在健康的血胆固醇过高的儿童中，减少饮食中的脂肪总量、饱和脂类和胆固醇对降低低密度脂蛋白胆固醇（LDL-C）的安全性和效果。project (a plan for) work or activity of any kindseek to try toThe results have important implications for clinicians who provide care for children, public health officials, and future research in cardiovascular disease prevention. 这项研究成果对儿科保健医生、公共卫生官员以及未来的心血管预防研究有重要意义。cardiovascular disease prevention the prevention of cardiovascular diseases.2 DISC represents an intense effort to modify food intake in healthy free-living children by dietary education of students and their parents. DISC力图通过对学生及其父母进行饮食宣传教育来调整健康贪食儿童的饮食。represent an intense effort try hard 力图modify to change in form or character 在形式或特征上改变 syn.: change改变, revise修改, reshape改造, adjust调整, reorganize改组, transform转换; to make less extreme, severe, or strong 在极端程度、严厉程度或强度上减轻 syn.: moderate缓和, modulate调节, restrain抑制, restrict约束, control控制, narrow使变小, soften使变柔和, reduce减少, lower降低intake the act of taking in 摄入; the quantity taken in摄入量ingestion the act of taking in free-living living for pleasure, esp. for food and drink 贪食The intervention was well designed and used current behavioral modification techniques to change eating patterns. 饮食节制是精心设计的，应用了最新的行为改进技术来改变饮食模式。modification improvement Note 2. The results of DISC deserve serious consideration given the study size and quality of the design. 考虑到这项研究的规模和设计的质量，其结果很值得重视。given prep. considering; if there is/are e.g. Given their inexperience (Given that they are inexperienced), they have done a good job. Given the same treatment again, he is sure to get well. 这种治疗如果再进行，他肯定会康复。.3 The first finding relates to the safety of a low-fat diet, which some have suggested is deleterious to the growth and development of children. 第一个成果有关低脂饮食的安全性，有些人认为低脂饮食对儿童的生长发育有害。be deleterious to be harmful toDISC clearly shows that these dietary recommendations do not affect growth, sexual maturation, or blood levels of vitamins. DISC清楚地表明，这些饮食方面的建议并不会影响生长、性成熟或血中维生素的含量。The recommended diet, which is identical to eating patterns advocated by the American Heart Association, is a healthy one. 所推荐的饮食是有利健康的，与美国心脏病协会所提倡的饮食模式完全一致。be identical to be the same asThe second safety concern originates from cholesterol-lowering trials using medications in adults in which small increases in violent deaths have been observed. 有关安全的第二个考虑源于用药物降低成人胆固醇的试验，在这些试验中，发现横死现象略有上升。concern consideration originate from start from, come fromviolent death 横死 猝死 sudden deathIncreased depression has also been found to be associated with lower cholesterol levels in some studies. 在某些研究中还发现，抑郁增长与胆固醇水平较低有关。DISC evaluated these children with a variety of psychosocial instruments and found no harmful differences in the intervention group compared with the controls. DISC用各种社会心理学手段来评估这些儿童，发现试验组与对照组相比并无有害的差别。psychosocial instruments psychosocial meansintervention group control (control group)Clearly, DISC finds the cholesterol-lowering diet, as recommended, to be safe. DISC认为所推荐的低胆固醇饮食是安全的。.4 The second major finding is that of significant LDL-C and total cholesterol reductions in the intervention group at 3 years along with nonsignificant changes in HDL-C values and triglyceride levels. 第二个重大成果是，在 3 年中，试验组的低密度脂蛋白胆固醇和胆固醇总量有明显下降，而高密度脂蛋白胆固醇值和甘油三脂水平却没有显著变化。These measurements averaged 0.09mmol/L (3.3mg/dL) for LDL-C and 0.08mmol/L (3.3mg/dL) for total cholesterol. 测得数据为，低密度脂蛋白胆固醇平均降低0.09mmol/L (3.3mg/dL)，总胆固醇平均降低0.08mmol/L (3.3mg/dL)。measurement C the dimension, quantity, or capacity determined by measuring 测得的尺寸、数量、容量mol 化 (=mole) 摩尔, 克分子The changes in blood lipid levels were associated with reported reductions in fat intake. 血脂水平变化与所报道的脂类摄取量降低有关。DISC thus achieved its goals of dietary change and of blood lipid differences. 因此，DISC达到了改变饮食和血脂水平的目的。.5 Despite these positive outcomes, some may question the small size of the lipid changes in a hypercholesterolemic population. 尽管有这些肯定的成果，有人可能会对在血胆固醇过高的儿童中血脂仅有很小变化这一点提出质疑。reference values:LDL-C: 0.00 3.12mmol/Ltotal cholesterol: 2.90 5.20mmol/LThis is particularly true of clinicians, who are accustomed to observing larger cholesterol changes, particularly when using lipid-lowering medications. 尤其是临床医生，他们习惯于观察到胆固醇较大幅度的变化，特别是当使用降脂药物时。be true of 符合于；对.适用 (sth. be true of sb./sth.)be accustomed to be used toSome will ask whether this means that dietary intervention does not work or is too weak to be effective in children. 有人会问，这是否意味着在儿童当中饮食节制不起作用，或者作用太小以致无效。It is apparent that this is not the case as a closer look at DISC provides answers to these questions. 显然，事实并非如此，因为仔细地看一下DISC就能提供这些问题的答案。.6 Note 4 The first observation is found in a clinical trial designed with the intention-to-treat principle. 最初的观察结果来自一个以意向性治疗原则设计的临床试验。This principle means that all randomized students whether (they are) compliant with the intervention or not, are included in the analysis. 这一原则意味着所有随机入选的学生，不论其是否遵守节制规定，都被列为分析对象。Clearly, those who are not compliant or respond poorly to dietary intervention dilute the mean effects. 显然，那些不遵守规定者或对饮食节制反应不佳的学生，冲淡了试验的平均效果。The differences in lipid levels observed here are smaller than clinical series of dietary intervention on similar pediatric patients. 在此观察到的血脂水平差异比起临床上对类似的儿科病人进行一系列饮食节制所产生的差异要小。In these series poor adherers and poor diet responders are usually unavailable for follow-up. 在后一种情况下，对不遵守节制者和反应不明显者通常无法进行随访调查。poor adherers: those who are not compliantpoor diet responders: those who respond poorly to dietary interventionfollow-up the act of following up, as to review new developments 追踪的行动, 追踪调查, 随访.7 Note 5 Second is a recognition of limited knowledge about the effects of diet in this period of rapid growth and sexual maturation, events recognized to affect blood lipid levels. 其次，要承认对于快速生长发育及性成熟阶段中的饮食效果方面的知识有限，而已知发育和性成熟是会影响血脂水平。Most metabolic studies of diet and lipids are in adults at stable weight, not growing children. 脂类与饮食的大多数代谢研究是在体重稳定的成人而不是在生长中的儿童中进行的。These conflicting forces may have modified the effects of dietary fat on blood lipid levels, lessening the short-term impact. 这些相互对抗的力量可能减弱了饮食中的脂肪对血脂水平产生的效果，降低了短期的影响。More research on diet in children is needed to better understand the interaction of diet and maturation with blood cholesterol. 需要对儿童饮食做更多的研究，以便更好地了解饮食与成熟和血胆固醇水平之间的相互作用。.8 Finally, the control group also had significant reductions in blood lipid levels along with lower fat intake, reducing the differences between the two groups. 最后，随着脂肪摄入量减少，对照组的血脂水平也有明显的下降，从而减少了两组之间的差异。Like many control groups in clinical trials of healthy behaviors, this group made changes after becoming aware of their high-risk status. 象对健康行为者所做的临床试验中的许多对照组一样，这一组的人员在认识到他们的高危状态后做出了相应的改变。The dietary information used in this trial is readily available to patients and their physicians. 该研究中使用的饮食资料，病人及其医生很容易获得。.9 How should these findings be used by the clinician who provides care for children? 为孩子们提供保健的医生们应如何利用这些成果呢？These data support the recommendations of the recent Report of the Expert Panel on Blood Cholesterol Levels on Children and Adolescents of the National Cholesterol Education Program (NCEP). 这些成果支持全国胆固醇教育规划署最近发表的关于儿童和青少年血胆固醇水平的专家小组的报告中的建议。Dietary interventions are safe among youth and should be used as first therapy for elevated blood cholesterol levels. 饮食节制在青年人中是安全的，应该作为高血胆固醇水平的首选疗法。首选疗法：first therapy, therapy of first choice, therapy of choice首选药物：first medicine, medicine of first choice, medicine of choiceAlso apparent in the DISC findings is the magnitude of effort needed to produce changes. DISC的研究成果还清楚地表明，要改变状况需要作出多大的努力。The level of dietary education used in DISC is far beyond the time available to most practitioners, implying that formal nutrition counseling for these patients is crucial. 用于DISC的饮食教育规模远远超过大多数开业医生可以利用的时间，这意味着对这些病人做正规的营养咨询是很关键的。Along with this counseling, regular follow-up, including measurement of blood (lipid) levels, is crucial. 此外，定期随访，包括测定血脂水平，也至关重要。along with this counseling besides, in addition, moreover.10 For public health professionals, DISC has similar implications for safety and generalization. 对于公共卫生专业人员来说，DISC也类似的安全性及普遍性方面的意义。A lower-fat, balanced diet is safe and should become the norm in a society with widespread obesity, elevated population levels of cholesterol, and epidemic coronary heart disease. 低脂而均衡的饮食是安全的，在一个肥胖普遍、全民胆固醇水平升高、冠心病流行的社会中，应当成为标准饮食。Efforts to provide healthy, low-fat menus in school cafeterias, restaurants, and homes should be encouraged. 应当鼓励学校食堂、餐馆和家庭努力提供健康和低脂的菜谱。.11 DISC also may increase the pressure for screening of youth by clinicians and health officials to detect elevated blood cholesterol levels. DISC也可能对临床医生和卫生官员在青年人中筛选以便测定胆固醇水平升高方面增加了压力。This interpretation of the study is not appropriate. 这样解释该项研究是不适当的。The biological and laboratory variability of a single blood cholesterol measurement, the dangers of labeling children as high risk (o