临床医生

The quality of interior environment in nursing home residents will become one of the attention-getting subjects due to the gradual increase of aging populations This paper directs at the research of nursing home's interior environment factors in Tainan We use the standard of international practice to analyze the intrinsical data of environmental monitoring and establish the characteristics which from environmental physical reaction of nursing home The research items are air environments (PM10 CO CO2 formaldehyde TVOC) temperate environments and light environment (illumination average brightness daylight factor) etc There are the inductive conclusions of this research: 1 In basic medicine the clinical diagnosis means the theory and technique about physical examination with patients The definition of clinical diagnosis in architecture should be the diagnosis of building preserve and improve the feasible way to extend building's service life and assure the residents of the healthy quality of interior environment The object of clinical diagnosis in architecture is not only to ensure the use of structure and environment quality but also keep the structure and environment quality in sustainable; therefore creating an efficient system of preserving plan is needed 2 It is an accurate and technical circumstance which about improving remedying and reconstructing the problems of structure space This circumstance includes finding questions ensuring causation ascertaining ultimate strength evaluating environment quality estimating the necessary of restoration and implementing on a suitable way Furthermore when reconstructing and ameliorating the appearance of structure space it should be respected and the memories of it should be preserved 3 In clinical diagnosis of environment quality of space the question of physical environment and the deficiencies of structure must be separated The structure space of construction and the high quality of space should be inspected strictly then observed the crucial reason that can find out any invisible and hidden causes The diagnosis of construction is to observe the reason of destroyed structure The environmental diagnosis of indoor and outdoor is to find out the crucial reason that influences health 4 In order to decrease the iterant problems the construction and environment of space should be diagnosed However the destruction by natural strength and artificial using by human are important causes that can affect the service life of construction Searching the cause of disease just like curing the patient which includes inspection diagnosis cure and prevention We tested the thermal conductivity of siding material in this research and then found out the roof east vertical face and west vertical face have most radiant heat especially the construction of RC The characteristics of opaquely outer casing have relations with the thermal conductivity of wall to wiz the ability of heat insulation Therefore increasing the efficiency of heat insulation and decreasing the endoergic factor of insolation are very important to temperate environments

而随著国内老年人人口逐渐增加，逐渐迈向高龄化之同时，对於高龄者使用空间之室内环境品质相关议题之探讨，亦成为未来我们需加以关注之议题之一。主要为针对台南某安养中心室内环境因子进行检测调查工作，利用现场室内环境测定以取得有效的实测数据；再藉由汇整相关国际评估基准，并进行实测数据比对分析，建立老人安养中心对物理环境反应之特性。并以前期相关研究文献回顾与老人安养中心实测案例现场的实验，来了解不同空间物理环境特性之影响，并将结果回馈实际建筑及室内设计之用。调查工作项目包含：空气环境之PM10、CO、CO2、甲醛、TVOC；温热环境之室内温度、相对湿度、人体PMV、PPD；光环境之照度、均齐度、昼光率等因子调查。本研究结果可归纳以下几点结论： 1 所谓临床诊断医学乃相对於基础医学而言，是指实际与病人接触的医疗及护理行为中牵涉到的理论和技术；而建筑的临床诊断的定义应为建筑本体与室内外诊断、维护及改善所有可行的方式来延长建筑物的寿命，并确保人与室内环境空间品质的健康。建筑临床诊断目的为确保结构体与环境品质能继续使用，而能维持所需要的效能及承受能力。一个有效的维护计画体系是必须建立的 2 在建筑空间之问题改善、治疗与修复执行中，是一个精确与技术性的事项，其中包含找出问题、确定原因、评估结构应力强度、评估环境品质、评估修复与改善必要性、选择及执行一个适当的过程。其改善与修复也必须尊重建筑空间原有色彩与形貌，并保留原有记忆及文化。 3 在临床诊断中空间环境品质中，物理性环境问题与结构构件缺陷必须分别判断，诊断建筑空间之结构与空间舒适品质必须详细观察其症结性问题，才能发现任何隐藏及有潜伏性缺陷的原因。建筑本体诊断是观察出建筑本体之破坏原因，而是内外空间环境诊断目的在於的找出影响健康因素之症结性问题。 4 建筑本体与空间环境之预防评估目的为降低与抑制问题的再发生。然而，自然力的破坏与人为使用因素皆是影响建筑生命期之主要因素，找出病源问题就如同医生对病人的处理，包含了侦查、诊断、治疗以及预防。 5 本研究以外墙材料热传导率测试结果发现，屋面与东西向立面是承受辐射热最多的地方，尤以 RC 的建筑更甚，不透明部分的外壳能特性主要与壁体的热传透率即隔热能力有关，但是承受来自日射的吸热影响，因此增加隔热性能与降低日射吸热因子是对温热环境是非常重要的。

Addison also meets the rest of the gang at the cooperative — a widowed alternative medicine doctor, a self-doubting therapist and a male gynecologist who knows little about women — and concludes that while the personal lives of the people around her may be a mess, professionally they stand out. Sounds like those crazy interns, right?

她还见到了合作医院里其他的人：一个另类的寡妇医生、一个没自信的临床医师、和一个不怎么了解女人的妇科男医生，从而她得出的结论时：尽管她周围的人私生活都很糟糕，但在职业技能上却又都很出众（听起来很像那些疯狂的实习医生对吧？）。

This book, edited by two experienced surgeons and a clinical psychologist in cooperation with numerous worldwide leading experts, presents clinically relevant information for gastroenterologists, internists, surgeons, residents and also nurses who frequently care for GERD patients.

这本书，和许多全世界的主要专家合作到两位有经验的外科医生和一个临床的心理学家编辑，为胃肠病学家，内科医生，外科医生，经常照顾格尔德病患的居民和护士临床提出相关的讯息。

Urinary calcium levels aid the clinician in understanding how the kidneys handle calcium in certain diseases of the parathyroid gland.

尿液中钙的水平帮助临床医生了解肾脏如何处理某些甲状旁腺引起的疾病。

Only 7% of ascitic fluid cytologies are positive50 yet cytological examination is 60–90% accurate in the diagnosis of malignant ascites, especially when several hundred millilitres of fluid is tested and concentration techniques are used.12 Clinicians should liaise with their local cytology department to discuss fluid requirements before paracentesis.

只有7％的腹水细胞学检查阳性50，不过在恶性腹水的诊断中细胞学检查准确率达60-90％，尤其是当腹水检测量达数千ml并且应用浓缩技术时。12在腹穿进行前临床医生应该与本地细胞学实验室保持联络以讨论所需要的腹水量。

Nowadays the therapy of malignant brain tumors is still a challenge to neurosurgeons. One of the most important reasons is the initial mechanisms of brain tumors have never been well illustrated.

脑肿瘤，特别是恶性脑肿瘤的治疗目前仍是临床医生面临的一个难题，重要的原因之一是由于对脑肿瘤的发生发展机制尚不明了。

"Despite evidence that the incidence of stroke increases with age, outcome from medical treatment is worse in the elderly, and early surgical outcome is reasonable in octogenarians, clinicians still have doubts about the overall benefit of CEA in these patients," the authors write.

尽管有证据显示中风会随著年龄增加老年人治疗效果差，再加上八十几岁的病人早期手术是合理的，但是临床医生仍然对八十岁以上的老人进行CEA的总体利益存有疑虑，作者认为，这些八十岁以上的病人CEA 之后的长期相对生存率好於对照组，不会因为年老对CEA造成危险，而且做了CEA可能活得更长久。

Although very small, it is nonetheless important for clinicians and women to be aware of and to recognize the risk. Postmastectomy irradiation is associated with a slight increase in the risk of developing a sarcoma or lung cancer after a latency period of more than 10 years.

虽然危险度很小，但是对于临床医生和妇女而言，了解并认识到乳房切除术后放疗在经历超过十年的潜伏期后会有患肉瘤和肺癌的危险度轻度升高仍然是重要的。

Although ery small, it is nonetheless important for clinicians and women to be aware of and to recognize the risk. Postmastectomy irradiation is associated with a slight increase in the risk of deeloping a sarcoma or lung cancer after a latency period of more than 10 years.

虽然危险度很小，但是对于临床医生和妇女而言，了解并认识到乳房切除术后放疗在经历超过十年的潜伏期后会有患肉瘤和肺癌的危险度轻度升高仍然是重要的。

Bottomline is that you need to havecomminication with the clinician to express your worry for this case and suggest women to have bx.

低线是你必须跟临床医生沟通表明你对这个病例的担心和建议必须进行活检。

According to the clear water experiment, aeration performance of the new equipment is good with high total oxygen transfer coefficient and oxygen utilization ratio.

曝气设备的动力效率在叶轮转速为120rpm～150rpm时取得最大值，此时氧利用率和充氧能力也具有较高值。

The environmental stability of that world - including its crushing pressures and icy darkness - means that some of its most famous inhabitants have survived for eons as evolutionary throwbacks, their bodies undergoing little change.

稳定的海底环境─包括能把人压扁的压力和冰冷的黑暗─意谓海底某些最知名的栖居生物已以演化返祖的样态活了万世，形体几无变化。