Medical English | Day25
2014/12/4 医学生

    

    ectoderm['ekt?(?)d?m]

     n. 外胚层，外细胞层

     词根ec-/ecto-表示外层

     ectoenzyme 胞外酶

     ectoblast 外胚叶

     词组Secondary ectoderm次级外层；次级外胚层

     primary ectoderm初级外层；初级外胚层

     provisional ectoderm临时外胚层

     Embryonic ectoderm外胚层

     例句The little tadpole about the size of a sesame seed is now made up of three layers: the ectoderm mesoderm and endoderm.

     芝麻籽大小的小蝌蚪现在已经分成了三层：外胚层、中胚层和内胚层。

     article.yeeyan.orgQuestion肖锋 翻译和整理

     Oral medications are sometimes believed to be inappropriate for the management of acute agitation in the ED, yet current guidelines recommend treating acute agitation with oral second-generation antipsychotics instead of IM medications. Why?

     口服药物治疗急性躁狂在急诊科有时被认为是不适合的，但目前的指南建议治疗急性躁狂时可用口服第二代抗精神病药物。为什么呢？

     AnswerOral SGAs are as effective in rapidly reducing psychotic agitation in the ED, their use poses less risk to both patient and staff, and they have a more favorable side effect profile.

     口服第二代抗精神病药物有效快速地控制精神病人的躁动，它们的使用对病人和工作人员的风险更小，并且有较少的副作用(J EmergMed 2014 Jun;46(6):808-13)。

     Impact of sepsis on risk of postoperative arterial and venous thromboses: large prospective cohort study.

     败血症对术后动静脉血栓形成的影响：大型前瞻性队列研究

     Jacques D Donzé ,Paul M Ridker ,Samuel R G Finlayson ,David W Bates

     BMJ

     2014-09-08

     索引：BMJ 2014 09;349:g5334

     中文摘要来源：张旭翻译 穆冰审核

     OBJECTIVES

     To evaluate the impact of preoperative sepsis on risk of postoperative arterial and venous thromboses.

     DESIGN

     Prospective cohort study using the National Surgical Quality Improvement Program database of the American College of Surgeons (ACS-NSQIP).

     SETTING

     Inpatient and outpatient procedures in 374 hospitals of all types across the United States, 2005-12.

     PARTICIPANTS

     2?305?380 adults who underwent surgical procedures.

     MAIN OUTCOME MEASURES

     Arterial thrombosis (myocardial infarction or stroke) and venous thrombosis (deep venous thrombosis or pulmonary embolism) in the 30 days after surgery.

     RESULTS

     Among all surgical procedures, patients with preoperative systemic inflammatory response syndrome or any sepsis had three times the odds of having an arterial or venous postoperative thrombosis (odds ratio 3.1, 95% confidence interval 3.0 to 3.1). The adjusted odds ratios were 2.7 (2.5 to 2.8) for arterial thrombosis and 3.3 (3.2 to 3.4) for venous thrombosis. The adjusted odds ratios for thrombosis were 2.5 (2.4 to 2.6) in patients with systemic inflammatory response syndrome, 3.3 (3.1 to 3.4) in patients with sepsis, and 5.7 (5.4 to 6.1) in patients with severe sepsis, compared with patients without any systemic inflammation. In patients with preoperative sepsis, both emergency and elective surgical procedures had a twofold increased odds of thrombosis.

     CONCLUSIONS

     Preoperative sepsis represents an important independent risk factor for both arterial and venous thromboses. The risk of thrombosis increases with the severity of the inflammatory response and is higher in both emergent and elective surgical procedures. Suspicion of thrombosis should be higher in patients with sepsis who undergo surgery.

     目的：评估术前败血症对术后动静脉血栓形成风险的影响。

     设计：使用美国外科协会的全国手术质量改善计划数据库(ACS-NSQIP)的前瞻性队列研究。

     设定：美国2005-2012年374所医院中所有类型的门诊及住院操作。

     受试者：2305380例接受外科操作的成年患者。

     主要结果指标：术后30日内的动脉血栓(心肌梗死或卒中)及静脉血栓形成(深静脉血栓或肺栓塞)。

     结果：对于所有外科操作，术前有全身炎症反应综合征或任何败血症的患者中，术后动静脉血栓的发生率是普通患者的3倍(比值比3.1，95%置信区间3.0-3.1)。动脉血栓和静脉血栓形成的调整比值比分别为2.7(2.5-2.8)和3.3(3.2-3.4)。对于SIRS患者调整后的血栓发生的比值比位2.5(2.4-2.6)，败血症患者位3.3(3.1-3.4)，严重败血症患者位5.7(5.4-6.1)。对于术前存在败血症的患者，急诊或择期手术发生血栓的风险均提高两倍。

     结论：术前发生败血症是动静脉血栓形成的重要独立危险因素之一。无论是接受急诊手术还是择期手术，血栓形成的风险随着炎症反应严重程度增加而升高。因此，对于接受手术的败血症患者，应谨慎血栓栓塞的发生。

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