专业英语考试试卷.docx

昆明医科大学附属甘美医院2017级外科学硕士专业外语试卷一、汉译英题(每题40分，共40分)致病细菌一旦通过人类呼吸道、伤口进入人体将会导致感染，引起一系列临 床病症。据调查显示，有超过80%的人类伤口慢性感染是与生物膜相关的，这种 感染最常见于表皮葡萄球菌(Staphylococcus epider midis)、铜绿假单胞菌、 金黄色葡萄球菌(Staphylococcus aureus)和肠杆菌，如大肠埃希菌。当细菌侵 入机体后，可以附着在生物和非生物外表，并形成由黏多糖、蛋白质等组成的生 物膜，生物膜一旦形成，细菌可适应机体微环境，引发耐药性和炎症，并导致持 续性感染。Once pathogenic bacteria enter the human body through the human respiratory tract and wounds, it will cause infection and cause a series of clinical symptoms. According to investigations, more than 80% of chronic infections in human wounds are related to biofilms. This infection is most common in Staphylococcus epider midis, Pseudomonas aeruginosa, Staphylococcus aureus and Enterobacteria, such as Escherichia coli. When bacteria invade the body, they can attach to biological and non-biological surfaces and form a biof i Im composed of mucopolysaccharides, proteins, etc. Once the biofilm is formed, the bacteria can adapt to the bodys mi croenv i ronment, triggering drug resistance and inf lamination, and leading to continuous Sexual infection.二、英译汉题(每题60分，共60分)Lung retransplantation is associated with lower survival compared with primary lung transplantation. According to the ISHLT registry, patients who underwent lung retransplantation between January 1990 and June 2012 had a 64% survival at 1 year and a median survival of 2.5 years, whereas patients who underwent primary lung transplantation in this period had an 80% 1 -year survival and a median survival of 5.7 years . In patients undergoing primary lung transplantation, extracorporeal membrane oxygenation (ECMO) has been used as a bridge to transplantation with variable results . The purpose of this study was to determine the effect of ECMO on outcomes when used as a bridge to lung retransplantation. In this study, authors conducted a retrospective review of data from the Scientific Registry of Transplant Recipients (SRTR), which includes data on consecutive adult lung transplant recipients transplanted between 1988 and 2012. A cohort of patients who underwent lung retransplantation were identified, and survival was compared between lung retransplant recipients who had and had not undergone ECMO support as a bridge to retransplantation. The authors identified 854 adults who underwent lung retransplantation and did not have missing data, of which 55 (6.8%) had undergone ECMO as a bridge to retransplantation. Patients in the ECMO group were more likely to have bronchiolitis obliterans and be in the ICU and on mechanical ventilation than those in the non-ECMO group. Number of retransplants and use of ECMO increased over time. Statistically significant lower 30-day (67% vs 91%), 90-day (59% vs 83%), 1-year (44% vs 69%) and 5-year (21% vs 38%) survival rates were seen in the ECMO group compared with the non-ECMO group. In the propensity score-adjusted analysis, the hazard ratio of risk of death was 1.77 (1.14 to 2.78; 95% confidence interval) in the ECMO compared to nonECMO group.This was the first study to date to report outcomes when ECMO was used as a bridge to lung retransplantation. The study includes patients retransplanted over a wide range of time, and survival after retransplantation has improved over time. In addition, the majority of patients (60%) who underwent ECMO did so within the last 7 years of the study period, but data are not provided regarding differences in mortality during the different periods of the study. Advances in ECMO technology such as use of awake ECMOM may have affected mortality in more recent years . Individual center lung transplant volume and prior experience using ECMO to bridge patients to lung transplantation are important factors in determining the impact of ECMO on survival following lung transplant but were not included as variables in the propensity adjustment. Clinicalcondition of the patients that led to ECMO initiation, type of ECMO used, duration of ECMO, and the outcomes of patients who did not receive transplantation are unknown.In summary, although results of this study suggest that ECMO utilization as a bridge to lung retransplantation leads to worse survival, more information is needed. Future studies should focus on more recent data as well as outcomes from high volume centers and awake and ambulatory patients.与原发性肺移植相比，肺再移植与较低的存活率相关。根据ISHLT登记，在 1990年1月至2012年6月期间接受肺再移植的患者的1年生存率为64%, 中位生存率为2.5年，而在此期间接受原发性肺移植的患者的1年生存率为 80%o生存和中位生存5.7年。在接受原发性肺移植的患者中，体外膜肺氧合 (ECMO)已被用作移植的桥梁，但结果不一。本研究的目的是确定ECMO在用作 肺再移植的桥梁时对结果的影响。在这项研究中，作者对移植受者科学登记处 (SRTR)的数据进行了回顾性审查，其中包括1988年至2012年间连续移植的成 人肺移植受者的数据。在接受和未接受ECMO支持作为再移植桥梁的肺再移植受 者之间进行了比拟。作者确定了 854名接受肺再移植且没有缺失数据的成年人， 其中55名(6.8%)接受了 ECMO作为再移植的桥梁。与非ECMO组患者相比, ECMO组患者更可能患有闭塞性细支气管炎，并入住ICU接受机械通气治疗。随 着时间的推移，再移植的次数和ECMO的使用增加。观察到30天(67%对 91%)、90 天(59% 对 83%)、1 年(44% 对 69%)和 5 年(21% 对 38%) 存活率在统计学上显着降低ECMO组与非ECMO组的比拟。在倾向评分调整分 析中，与非ECMO组相比，ECMO组的死亡风险风险比为1.77 (1.14至2.78： 95%置信区间)。这是迄今为止第一项报告当ECMO用作肺再移植桥梁时结果的 研究。该研究包括在很长一段时间内再移植的患者，再移植后的生存率随着时间 的推移而提高。此外，大多数接受ECMO治疗的患者（60%）发生在研究期间的最 后7年内，但未提供有关研究不同期间死亡率差异的数据。近年来，ECMO技术 的进步，例如“清醒ECMO”的使用，可能已经影响了死亡率。个体中心肺移植 体积和先前使用ECMO将患者与肺移植联系起来的经验是确定ECMO对肺移植 后生存率影响的重要因素，但并未作为变量纳入倾向调整。导致启动ECMO的患 者的临床状况、使用的ECMO类型、ECMO的持续时间以及未接受移植的患者的 结果尚不清楚。总之，尽管这项研究的结果说明，将ECMO用作肺再移植的桥梁会导致更差 的存活率，但仍需要更多信息。未来的研究应侧重于更近期的数据以及来自大量 中心和清醒和门诊患者的结果。