医学英语视听说参考范本

精品精品感谢下载载感谢下载载MedicalEnglishWatchingListeningandSpeaking医学英语视听说考试资料TestIntroduction ：Part1：名词解释Part2：简答Part3：病例分析Part4：体检QuestionsForDiagnosis&Treatment-ChestPain1．PossibleDiseaseM.I.(myocardialinfarction) 心肌梗塞Angina 心绞痛Pericarditis 心包炎Pulmonaryembolism 肺栓Pneumothorax 气胸Cholecystitis 胆囊炎Severeindigestion 严重消化不良Pneumonia 肺炎Pancreatitis 胰腺炎Musculoskelrtal 骨骼系统性疼痛．DescriptionsofPainAches 疼痛 ,,throbbing 悸痛,pulsing 疼痛，stings 刺痛\likestabbingpain,Sharppain,comesinwaves,suddenpain,MychestfeelstightItfeelslikeatightbandaroundmychestPressure,压迫感UsefulSentencesForChestPainHowLongWhatdoesthepainfeellike?Showmewherethepainis?Isthepainjustinthatareaordoesitspeadanywhereelse?Douhaveanypaininurshoulderordownurleftarm?Isthepainconstantthereallthetime?Doesthepaingetworsewhenu----breatheinorout?----walk around or do heavywork?Whatpainkillersdiduhave?Aspirin （阿司匹林,paracetamol( 扑热息痛)Herearethe Forms（化验单Needtohavesomebloodtest, X-ray,andECGrightaway ！Ur results showthat uhave Iamafraid uwillhavetobeadmittedinto hospitalfortreatment (住院治疗)U need to have intravenous antibiotics (静脉输液)，oralmedication( 口服药)。QuestionforDiagnosis&Treatment ---- Diarrhea( 泻)PossibleDiseaseFoodpoisoning 食物中毒Dysentery 痢疾IntestinalObstruction 肠梗Dehydration 脱水Intussusception 肠套叠Enteritis 肠炎小肠炎)nse 节段性回肠炎Irritablebowelsyndrome 过敏性结肠炎BowelTumour 肠瘤Constipation 便秘DescriptiveWordsforFaeces 粪便 andDiarrheaLiquid 液 体watery 水样

Lumpy 粒状Semi-soft 半软

Mucous 粘液Bloodybloody and likejelly 带血胶状Dark brown 啡色Beige浅褐色Dry 干燥Blackandsticky黑色呈柏油Beige浅褐色Dry 干燥Blackandsticky黑色呈柏油Smelly 发臭的Pus脓Milkdeposits牛奶沉淀Un-digested未消化的Pale 白色Green 青色精品精品感谢下载载感谢下载载QuestionforDiarrhea （顺序为横）Howlong HowmanytimesBloody? Stool （大便） looklike?Dotheysmell? Painwhenuhavediarrhea?Vomit? Eatsomethingwrong?Abletoeat?Howaboutfluids Anyfeverorheadache?Doufeel dehydrated 脱水)?Specimen （样品）ofstools;bloodtest;x-ray; ultrasound( 声) Umusttakefluids,andjusthavealightdietuntilfeelbetterPossiblebowelcancer （肠癌顺序为横）3timesaweek 2or3timesadayAbitsoft,darkbrown Notsmellpain going with Abdominal pain discomfortFeel bloated 腹胀 Press on stomach andpalpateDotestofspecimenofurstools,bloodtestMight need endoscopic 内窥镜的,内窥镜检查的 sigmoidoscopy 乙状结肠镜检查[术]QuestionsForDiagnosis&Treatment AbdominalPain1..PossibleDiseaseAbdominalObstruction 腹胀[?b?m?n?lAppendicitis 阑尾炎FoodPoisoning 食物中毒Hepatitis 肝炎Cholecystitis(gallstones) 胆囊炎胆结石）GynecologicalProblems 妇科疾病StomachUlcer 胃溃疡[Pancreatitis 胰腺炎kriUrologicalProblems 泌尿系统问题Respiratoryproblems 呼吸系统问题?:riCardiovascularproblems 心血管问题[skj2.UsefulSentencesHowlong?where?howpainfulisit?Didthepainstratthereorsomewhereelse?Doesithurtmoreaftercertainexercisesoractions?Doufeelthatuhavehadfeveratanytime?Areupassingurineok?( 你排尿正常吗？ )Whatdoesururinelooklike?Areuhavingyourbowelsopenregularly?( 排便正常吗Areumenstruating?isitnormalBleeding?isitnormal?Havingaperiod?isitnormal?(females 月经来了吗？Areuvomiting?Whatdouvomit?Isthereapattern?( 一般什么情况下呕吐 Areuabletoeatordrink?Dougetpainaftereatinganddrinking?Pleaselaydown,IneedtoexamineuIwillneedtodosomeinvestigations:bloodtests,x-rayandultrasound,urinetestsandstooltestsCholecystitisD:Hello,mynameisDrpan,howcanIhelpu?:I e d l n for a few s d tsworse.D;howlonghaveuhadabdominalpain?P;aboutthreedays.D;whereisit?canushowme?P:yes,justhere.D;howpainfulisit?P:atfirstitwasjust onandoff, butnowitseemstobethereallthetime.D: on a scale of 1 to 10;if no pains is 1 and very 10,whatnumberwouldugiveyourpain?;Ideta7D;didthepainstartthereorsomewhereelse?;itss nthere.D;doesithurtmoreafterexerciseoractions?P；ifiamwalingaroundalot,itwillhurtabitmore.D;doufeelthatuhavehadafeveratanytime?;no,I nt think so ,I e felt t t I nt taken temperature.D；Ineedtotakeurtemperature,pulse,andB/PAreupassingurineok?P;yesD;whatdoesururinelooklike?P;normalD;areuhavingurbowelsopenregulatly?;usuallyIo,butIn tdmysnforacoupleofdays.D;haveuvomited?P;no,IthoughtIwasgoingtotodaybutthefeelingpassed.D;areuabletoeatanddrinkanything?;ImgtIn treallyfelteD:whathaveubeendrinking?P：Ihavehadacoupleofglassesofwaterandacoupleofcupsofcoffee.D:doesthepaingetworseaftereatingordrinking 、;no,notthatI veD;I need to examine you.please lay down,and loosen clothingforme.P;ok.D;showmewhereithurts.P:ithurtsjustthere.D;ok take a nice big breth, breathe in and out ,now try andrelax.P:ouch,thathurts.D；OKthanks,ucangetdressednow.P:Iwillneedtodosomeinvestigations::bloodtests,x-rayandultrasound,urinetestsandstooltestsD;hello ,your results show that u might have cholecystitis,uneed to be admitted to hospital for observation treatment,andwemayneedtodomoretestsbeforewehaveacorrectdiagnosis.;do I really d to e d o , nt anythingucangivemeforthepainandtohelptheproblem?D;sorry,no,itisbestthatuareadmittedforfurthertest,wecancheckthatun ttsrsomethingseriouslywithurliver.P;allright,PPTofAbdomialPainAlloedmuchefthepfcasesknowngenerallyastheacuteabdomenwillprobablyagreethatinthatconditionearlydiagnosisisexceptional Typesofabdominalpain? Colicky （绞痛 0pain-causedbydistention （膨胀）ofahollowviscus （空脏器） ,suchasbowel.? Somatic （躯干身体） pain-causedbyinflammation （炎症）oftheparietalperitoneum （层腹膜）;? Visceral（）paincausedbyinflammationofthevisceralperitoneumandcapsuleofsolidorgans.Quadrant （象限） ViewoftheAbdomenRightUpperCholecystitis （胆囊炎）? Inflammationofthegallbladder 胆囊,causedbyobstruction （管道堵塞）withagallstone.? Painisusuallysteadyforanhourormoreafteronsetandmadeworsebyeating.? Ifthereissignificantinflammationassociatedwiththecholecystitis,theremaybelocalperitonealpain(somaticpain)腹膜性疼痛.? Painmaybereferredtothescapular( 肩胛的)areaaccompaniesnausea 恶心,vomiting,andfeverwithoutjaundice 黄疸.? Diagnosedwithultrasound( ).Cholangitis 胆管炎? Causedbyobstructionofthebiliarytract( 胆道)leadingbacterialovergrowthinthegallbladder.? Markedy t sTriad（查科三联征）–RUQ(右上腹)pain,jaundiceandfever.? Diagnosedbyultrasound.? IsanemergencyandmustbetreatedwithIVantibiotics( 静脉抗生素).? Mayrequiredecompression( 解压凭借窥镜的)orsurgicalmeans.Hepatitis （肝炎）? Causedbyinflammation （感染） oftheliverbyviruses （毒）,alcoholorcertaindrugs.? Markedbytender,enlargedliverwithmalaise （不舒服）,feverandjaundice.? Diagnosedbyhistoryandlaboratoryevaluation-liverfunctiontestsandviralserologies. （病毒血清学的检查）? Treatmentdependsonetiology （病因，病原）ofdisease.Pancreatitis （胰腺炎）? Most commonly caused by alcoholism (50%) and gallstones(30%)obstructingthecommonbile （胆汁）duct（管道）.? Constantmid-epigastric （上腹部的） visceral（内脏的）painusuallyoccurringafteraheavymealoralcoholicbinge.? Painmayradiatetotheback(50%)andisaccompaniedbynausea,vomitingandanorexia （厌食症）.? Diagnosedbyamylase （淀粉酶）andlipase 脂肪酶.ImagingbyCTscanmaybedesirableinsomecases.LeftUpperPepticUlcer （胃溃疡）? Causedbyincreasedgastricacidproduction （胃酸容物）ordecreasedmucosal （粘膜的）protection.? Increasedgastricacidproductionmaybecausedbyalcoholism （酒精中毒）orgastrinproducingtumor(Zollinger-EllisonSyndrome 佐林格-埃利森综合征? DecreasedmucosalprotectionmaybecausedbyefD （非类固醇抗炎药） rynHelicobacterpylori 幽门螺旋杆菌.? Painisvisceralandmaybecomesomatic （腹膜性疼痛ifperforation （穿孔Theremayberadiationtotheback.? Diagnosedby H.pylori antigen （抗原）intheserum （清）,endoscopy 内镜检查LeftLower（（）RightLowerAppendicitis? Causedbyobstructionoftheappendiceal （阑尾的）lumen( 腔)? Painstartsasperiumbilical( 脐周的)andmigrates( 迁移theQ(McBurney sPoint)? Isaccompaniedbynausea,vomitingandanorexia( 厌食症).Mayhavefever-especiallyifruptured.? DiagnosedbyultrasoundorCTscan.? Treatmentissurgicalandisanemergencyifruptured.GeneralAbdominalPain? Somecausesofabdominalpainaregeneralizedandnotrestrictedtoanyspecificquadrant.Gastritis( 胃炎)? Causedbyinflammationofthegastrointestinaltractbymicroorganisms( 微生物),radiation （放射物）andotherirritants （刺激物）.? Describedasdiffuse （扩散）crampy（痉挛）痛 abdominalpain.? Oftenaccompaniedbydiarrhea,nauseavomiting,dehydration （脱水）andfever.? DiagnosisisbyhistoryandsoonBowelObstruction （肠梗阻）? Causedbyobstructionofthebowellumen （空腔）bymass,volvulus（肠扭转）,intussusception （肠套叠）aroundscar（伤疤）adhesions （粘连）.? Painiscolickyinnature ，accompaniedbyvomiting? Maybeaccompaniedbywaterydiarrhea-? Diagnosedbyabdominalx-rayslookingfordistended( 胀的)loops 环结 ofbowelandair-fluidlevels （气液面）.KidneyStones? Causedbyobstructionoftheupperurinarytract （上泌尿道）byastonethatisinduced （导致）bydehydration （水）,infection,hypercalcemia （血钙过多）andothermetabolicimbalances. （代谢不平衡）? Painisdescribedascolickyandlocatedanywherefromtheflank （侧面）tothegroin （腹股沟）.? Diagnosedbyintravenouspyelogram （图）,ultrasoundorCTscan.AppropriateExam? Vitalsignstoevaluateforsignsofinfection,dehydration,shock,instability.? Inspectvisuallyfordistention,scars,jaundice,signsofhernias 疝ormasses.? Auscultate-highpitchedbowelsoundsmayindicateearlyobstruction.Nobowelsoundsindicateileus （阻）Increasedbowelsoundsmaybeassociatedwithgastritis.? PalpateandPercuss-fortenderness （疼痛）,masses（块）,pulsation （脉动),hernias 疝,,CVAtenderness0 （脊肋角疼痛）liverandspleensize,ascites（腹水）andhyperresonance（过清音）.? Pelvicexaminwomen? Rectalexam （直肠检查）GeneralIntroductionStrokeClassificationofStroke? IschemicStroke 缺血性脑卒中...(75% BrainInfarct 脑梗死 )Occlusive:闭塞性? Thrombosis 血栓形成? Embolism 栓塞AnteriorCirculation前循环?Occlusionofcarotidartery（颈动脉）involvecerebralhemispheres（大脑两半球）PosteriorCirculation后循环?Vertebro-basilarartery（椎基底动脉）distributioninvolvebrainstem（脑干）orcerebellum（小脑）?HemorrhagicStroke出血性卒中Subarachnoid蛛网膜下的? Aneurysm (mostcommon)? Arteriovenousmalformation 动静脉型血管畸形Intracerebral 大脑内的? Hypertension (mostcommon)? Amyloidangiopathy （淀粉样脑血管病） inelderlyStroke FactorsModifiableHypertensionTobaccouse--TIA(Transientischemicattack)HeartDiseaseDiabetesMellitusSickleCell 镰状细胞 andincreasedRBCUnmodifiableAgeGenderRacePreviousCVA （脑血管意外）Heredity （遗传）Stroke andSymptomsIschemic( 缺血性的)---CarotidCirculation(. 颈动脉循环)Unilateralparalysis 单侧的瘫痪(oppositeside)Numbness 麻痹 (oppositeside)Languagedisturbance （障碍）Aphasia 失语症–difficult comprehension, nonsense 胡说,difficultreading/writingDysarthria 发音困难 speech 语言不清,abnormalpronunciation.Visualdisturbance (oppositeside)Monocularblindness （单眼盲）(sameside)---VertebrobasilarCirculation 椎基底动脉循环Vertigo 眩晕Visualdisturbance 视力障碍(Botheyessimultaneously)Diplopia 复视ParalysisNumbnessDysarthriaAtaxia 共济失调Diabetes 糖尿病Patient: Recently I'vebeenfeeling verythirsty and passingalotofurine,Isthereanywrongwithme?最近我总觉得口渴和尿量很多。是有了什么毛病吧？Doctor:Howisyouappetite?Howdoyoufeelotherwise?你的胃口怎么样？一般健康状况好吗？P:I'velostweightdespitemygoodappetite,andIfeelweakallthetime.尽管我的食欲很好，我的体重还是减轻了。我整天觉得很疲劳D:Letmeexamineyoururine.Youmayhavediabetes.我给你检查一下尿吧。很可能你得了糖尿病。P:Whatisthat?Canitbecured? 吗？D:Diabetesisachronicdiseaseduetopoorfunctioningofthe pancreas. It upsets the metabolism of sugar, fat protein.Rightnow,itcan'tbecured,butitcanbecontrolledsothatyoucanenjoylifeandfeelwell.Youshouldsticktoaspecial diet and avoid sugar and sweets.病，由于胰腺功能不良引起。它使糖、脂肪喝蛋白质的代谢发生异常。目前还没有治愈办法。但是可以被控制，因此你能生活得很愉快。你应坚持控制饮食，不吃糖和甜食。P:CanIsmoke? 我能吸烟吗？D:Smokingisharmfultoanyone'shealth.Bettergiveitup. 对任何人都是有害的。我劝你戒烟。P:CanIdrinkalcohol? 我能饮酒吗？D:Inmoderation.Asyouknowalcoholcontainscaloriesandmustbecountedinyourmealplan. 精能增加热卡，因此必须计算在你的食谱之内。P:HowcanIkeeptoagooddiet?我怎样才能保持一个良好的饮食方案呢？D:Youshouldlearnasmuchasyoucanaboutdiabetes,haveyour urine tested regularly, stick to your diet, take medicineandhavesomeregularexercise.Thenyoucanliveafull,usefulandmeaningfullife.你应当尽量学习一些有过糖尿病的知识，定期检查你的小便。坚持食谱中的规定，按时服药。要有定量的运动。于是你能生活得美满、有益和有意义。SymptomsofDiabetes( 糖尿病)? Fewglucosecanreachmusclecell>weakandfatigue? Breakdownproteintoreleaseenergy>feelshungry,lossweight? Kidneyextractexcessglucose>thirsty,frequenturinaion,kidneydamage消化系统疾病 *PepticUlcer 消化性溃疡Patient:Ihaveapaininmystomach 我胃疼。Doctor:Howlonghaveyouhadit? 疼了多久？P:Ihavehaditoffandon(intermittently)forthepastthreeyears.Ithasbeenreallybadthesepasttwoweeks.断断续续已经疼了三年，近两周来疼的很厉害。D:Doyoufeelitonlywhenyourstomachisempty?是在肚子空的时候才觉得疼痛吗？P:Yes.AfterIeat,itgoesawayforawhile.是的，吃了东西以后疼痛缓解一会儿。D:Whendoyougetit?什么时候才疼呢？P:UsuallywhenIgetverynervous.Sometimesitwakesmeupinthemiddleofthenight.通常是在我兴奋激动时，有时半夜把我疼醒了。D:Whatkindofpaindoyouhave?是怎样一种疼痛？P:Itgivesmea burningsensation.象烧灼一样地疼。D:Usually howdoyougetrelief?平常您是怎样止疼的呢？P:AfterItakesome sodiumbicarbonate ,thepaingoesawaytemporarily.在服小苏打后，疼痛可暂时缓解。D:Haveyouhadanynauseaorvomiting?你恶心呕吐过吗？P:Yes,occasionally.是的，有时候有。D:Areyour bowels regular?Haveyouobservedyourstools?你大便正常吗？你注意过你的粪便吗？P:Iusuallyhavetogoonceeveryotherday.IwasveryworriedbecauselastnightIwenttwiceandthecolorwasblack(tarry).平常我隔日大便一次。昨晚我大便了两次，颜色还是黑（象柏油似）的，我很担心。D:Letmeexamineyourabdomen.Liedownonyourbackandbendyourkneesupplease.让我检查一下您的肚子，请仰躺，把腿卷起来。Itsoundslikeaduodenalulcer,butwehavetodosometests,andtakeanx-rayfirst,beforewecanbecertain.看起来象十二指肠溃疡，但需做一些化验和拍张 X线片才能确诊。You should have a complete rest and give your stomach little work as possible. Take only fluids. There is nothingbetter than boiled tepid milk taken regularly in smallquantities. In addition, I will giveyousomemedicine.Iftheblackstoolspersistoryourconditiongetsworse,comebacktothehospitalatonce.您应当彻底休息并尽量减轻胃的工作， 应当吃流食。按时少量吃些过的温牛奶是最好不过了。此外，我还要给您一些药。如果持续有黑便或病情有恶化，就马上来看。P:Thankyou.I'llfollowyouradvice.谢谢您，我将遵嘱。Peptic-duodenalUlcer （胃十二指肠溃疡）Patient:MystoolshavebeenblackforthepasttwodaysandIfeelweak.这两天我大便发黑而且感到虚弱。Doctor:Havetheyeverbeenblackbefore?以前你的大便发黑过吗？P:No.Thisisthefirsttime.没有。这是第一次。D:Haveyouhadanypain?你感到有什么地方疼痛吗？P:Yes,inmystomach.是的，我胃痛。D:Howlonghaveyouhadit?你痛了多久？P:I'vehaditonandoffforthepasttwoyears,butitwasneverasbadasthisbefore.我好好坏坏疼了两年，但从来没有象这次那样疼过。D:Whendoyoufeelthepain?什么时间疼？P:Justaftermealsmystomachaches.Sometimenvomited.刚吃完饭就疼，有时还吐。Now I have it almost every day. It often awakensme 2 to hoursafterIgotosleep.我几乎每天都疼，常常在夜间入睡两、三小时就把我疼醒了。D:Whatkindofapainisit?是什么性质的疼呢？P:likeheartburn.烧心样疼。D:Does spicyfood affectif?辛辣食物会加重疼痛吗？P:Yes.It'softenworseafterIeatspicyfoodoronions.是的，吃了辛辣的食物或洋葱都加重疼痛。D:Doyouhavelesspainaftereating?吃东西后疼痛就缓和些吗？P:Yes,alittle.是的，稍缓和些。D:Didyouvomitsometimes?你吐过吗？P:Yes,Idid.吐过。D:Whatdidyouvomit,foodorblood?吐出的是什么东西，食物还是血？P:Foodwithalittleblood.食物和一点血。D:Whatwasthecoloroftheblood,redorblack?吐出的血是鲜红的，还是黑的？P:Likecoffee.象咖啡似的。D:I'llexamineyouabdomen.Liedownonyourbackandloosenyouclothes.Pleasebendyourknees.Ithinkwe'dbettertakeax-rayfilmofyourgastrointestinaltract.Ithinkyou'vegotapepticulcer(duodenalulcer).I'llgiveyousomemedicine.Haveagoodrestathome.让我检查一下你的腹部。躺下，松开衣服请屈膝。我想我们最好照个胃肠X线片像。我看你得的是胃（十二指肠）好好在家休息。P:IsthereanythingelseIshoulddo?还要注意些什么吗？D: If possible avoid all alcohol. Whenever you have bleeding,comeimmediatelytothehospital.如果可能应戒酒，若再有出血马上到医院来。Yourproblemprobablycomesfromaduodenalulcer.Youaresufferingfromshockduetobleeding.Themedicinewehavebeen using has not been effective and so we feel that it necessarytoperformanoperation.你可能是十二指肠溃疡。 你的休克是因失血引起的。 我们用过许多药效果都不好。所以我们认为需要手术治疗。P:DoanythingyoufeelisnecessaryDoctor! 就做吧！D: I would like to talk about the operation with you. operationmaybethebestwaytocureyou.However,therearecentain dangers in operating, such as the hazards anesthetics,oryoumaybeunabletowithstandthestressofthe operation. Moreover, after the operation, complicaionsmayoccur,suchasbleeding,infectionsorevencontinuedintestinalobstruction.我要和你谈谈手术的问题。手术也许是治疗的最好办法。但是手术也有一定的危险。如麻醉的危害或你的身体经受不住手术，同时手术后可能会出现并发症，如出血、感染，甚至持续肠梗阻。VomitingandDiarrhea （呕吐和腹泻）Parent:Mychildhasbeenvomitingfrequently.从什么时候开始的？一天大概几次？Doctor:Whendiditstart?Howfrequently?有十天了。一天吐五次左右。P:Itstartedaboouttendaysago.Hevomitsaboutfivetimesaday.他通常在什么时候吐？D:Whendoesheusuallyvomit?他通常在进食以后吐。P:Usuallyaftertakingfood.每次吐的量多还是少？D:Doeshevomitalargeorsmallamounteachtime?每次吐的不太多。P:Nottoomuch. 每次吐的不太多。D:Ishisstoolnormal? 大便正常吗P:正常。D:Howabouthisappetite? 他的胃口怎样？P:It'sgood. 他的胃口是好的。D:Ishelosingweight? 他的体重减轻了吗？P:No.Everythingelseseemstobeallright. 正常D:Mostlikelythisisduetoimproperfeeding.Afterfeeding,thebabyshouldbehelderectoveryourshoulderandpattedgentlyontheback,sothatanyswallowedaircancomeout.Afterburpinghim,puthiminhiscriponhisrightsidewithhisheadslightlyraised.Ifheshouldvomit,youshouldturnhimontohissidewithhisfacedown,sohecan'tinhalehisvomit.他的呕吐看来是喂养不当。每次喂完奶，应该把孩子竖起来，靠在您的肩膀上，然后轻轻拍他的后背。这样吞咽的气可以排出来。让他打嗝以后，孩子应向右侧躺，头稍稍微抬起一点。如果他吐的话，应使他脸朝下，他就不致于把吐的东西吸进去了。D:Hashegotdiarrhea? 他腹泻吗？P:Yesfortwodays. 已经腹泻两天了。D:Howmanytimesaday?Isstoolwatery(veryloose,largeinamount)?Istherepus,bloodormucusinit?一天大便几次？是水样便（很稀，量很多）吗？里面有没有脓、血或粘液？P:Aboutfivetimesaday.Theyarequiteloosewithmilkcuredandundigestedfoodinthem.一天大约五次，很稀，还有奶瓣和不消化的食物。D:He'sprobablygotindigestion.Pleasestopallfoodexceptmilk. Try to give him a little less milk than usual. Now, prescribesomemedicineforhim 。他大概是消化不良。请停用所有的辅食，只给他奶吃，要减少一点奶量，我给他开点药。精品精品感谢下载载感谢下载载1 总则1.1 为了加强公司的环境卫生管理，创造一个整洁、文明、温馨的购物、办公环境，根据《公共场所卫生管理条例》的要求，特制定本制度。1.2 集团公司的卫生管理部门设在企管部，并负责将集团公司的卫生区域详细划分到各部室，各分公司所辖区域卫生由分公司客服部负责划分，确保无遗漏。2 卫生标准2.1 室内卫生标准2.1.1 地面、墙面：无灰尘、无纸屑、无痰迹、无泡泡糖等粘合物、无积水，墙角无灰吊、无蜘蛛网。2.1.2 门、窗、玻璃、镜子、柱子、电梯、楼梯、灯具等，做到明亮、无灰尘、无污迹、无粘合物，特别是玻璃，要求两面明亮。2.1.3 柜台、货架：清洁干净，货架、柜台底层及周围无乱堆乱放现象、无灰尘、无粘合物，货架顶部、背部和底部干净，不存放杂物和私人物品。2.1.4 购物车（筐）、直接接触食品的售货工具（包括刀、叉等）：做到内外洁净，无污垢和粘合物等。购物车（筐）要求每天营业前简单清理，周五全面清理消毒；售货工具要求每天消毒，并做好记录。2.1.5 商品及包装：商品及外包装清洁无灰尘（外包装破损的或破旧的不得陈列）。2.1.6 收款台、服务台、办公橱、存包柜：保持清洁、无灰尘，台面和侧面无灰尘、无灰吊和蜘蛛网。桌面上不得乱贴、乱画、乱堆放物品，用具摆放有序且干净，除当班的购物小票收款联外，其它单据不得存放在桌面上。2.1.7 垃圾桶：桶内外干净，要求营业时间随时清理，不得溢出，每天下班前彻底清理，不得留有垃圾过夜。2.1.8 窗帘：定期进行清理，要求干净、无污渍。2.1.9 吊饰：屋顶的吊饰要求无灰尘、无蜘蛛网，短期内不适用的吊饰及时清理彻底。2.1.10 内、外仓库：半年彻底清理一次，无垃圾、无积尘、无蜘蛛网等。2.1.11 室内其他附属物及工作用具均以整洁为准，要求无灰尘、无粘合物等污垢。2.2 室外卫生标准2.2.1 门前卫生：地面每天班前清理，平时每一小时清理一次，每周四营业结束后有条件的用水冲洗地面（冬季可根据情况适当清理），墙面干净且无乱贴乱画。2.2.2 院落卫生：院内地面卫生全天保洁，果皮箱、消防器械、护栏及配电箱等设施每周清理干净。垃圾池周边卫生清理彻底，不得有垃圾溢出。2.2.3 绿化区卫生：做到无杂物、无纸屑、无塑料袋等垃圾。3 清理程序3.1 室内和门前院落等区域卫生：每天营业前提前10分钟把所管辖区域内卫生清理完毕，营业期间随时保洁。下班后5-10分钟清理桌面及卫生区域。3.2 绿化区卫生：每周彻底清理一遍，随时保持清洁无垃圾。4 管理考核4.1 实行百分制考核，每月一次（四个分公司由客服部分别考核、集团职4.2 集团坚持定期检查和不定期抽查的方式监督各分公司、部门的卫生工作。每周五为卫生检查日，集团检查结果考核至各分公司，各分公司客服部的检查结果考核至各部门。4.3 集团公司每年不定期组织卫生大检查活动，活动期间的考核以通知为准。5 监督考核部门：企管部、分公司客服部。感谢下载!MedicalEnglishWatchingListeningandSpeaking医学英语视听说考试资料TestIntroduction ：Part1：名词解释Part2：简答Part3：病例分析Part4：体检QuestionsForDiagnosis&Treatment-ChestPain1．PossibleDiseaseM.I.(myocardialinfarction) 心肌梗塞Angina 心绞痛Pericarditis 心包炎Pulmonaryembolism 肺栓Pneumothorax 气胸Cholecystitis 胆囊炎Severeindigestion 严重消化不良Pneumonia 肺炎Pancreatitis 胰腺炎Musculoskelrtal 骨骼系统性疼痛．DescriptionsofPainAches 疼痛 ,,throbbing 悸痛,pulsing 疼痛，stings 刺痛\likestabbingpain,Sharppain,comesinwaves,suddenpain,MychestfeelstightItfeelslikeatightbandaroundmychestPressure,压迫感UsefulSentencesForChestPainHowLongWhatdoesthepainfeellike?Showmewherethepainis?Isthepainjustinthatareaordoesitspeadanywhereelse?Douhaveanypaininurshoulderordownurleftarm?Isthepainconstantthereallthetime?Doesthepaingetworsewhenu----breatheinorout?----walk around or do heavywork?Whatpainkillersdiduhave?Aspirin （阿司匹林,paracetamol( 扑热息痛)Herearethe Forms（化验单Needtohavesomebloodtest, X-ray,andECGrightaway ！Ur results showthat uhave Iamafraid uwillhavetobeadmittedinto hospitalfortreatment (住院治疗)U need to have intravenous antibiotics (静脉输液)，oralmedication( 口服药)。QuestionforDiagnosis&Treatment ---- Diarrhea( 泻)PossibleDiseaseFoodpoisoning 食物中毒Dysentery 痢疾IntestinalObstruction 肠梗Dehydration 脱水Intussusception 肠套叠Enteritis 肠炎小肠炎)nse 节段性回肠炎Irritablebowelsyndrome 过敏性结肠炎BowelTumour 肠瘤Constipation 便秘DescriptiveWordsforFaeces 粪便 andDiarrheaLiquid 液 体watery 水样

Lumpy 粒状Semi-soft 半软

Mucous 粘液Bloodybloody and likejelly 带血胶状Dark brown 啡色Beige浅褐色Dry 干燥Blackandsticky黑色呈柏油Beige浅褐色Dry 干燥Blackandsticky黑色呈柏油Smelly 发臭的Pus脓Milkdeposits牛奶沉淀Un-digested未消化的Pale 白色Green 青色精品精品感谢下载载感谢下载载QuestionforDiarrhea （顺序为横）Howlong HowmanytimesBloody? Stool （大便） looklike?Dotheysmell? Painwhenuhavediarrhea?Vomit? Eatsomethingwrong?Abletoeat?Howaboutfluids Anyfeverorheadache?Doufeel dehydrated 脱水)?Specimen （样品）ofstools;bloodtest;x-ray; ultrasound( 声) Umusttakefluids,andjusthavealightdietuntilfeelbetterPossiblebowelcancer （肠癌顺序为横）3timesaweek 2or3timesadayAbitsoft,darkbrown Notsmellpain going with Abdominal pain discomfortFeel bloated 腹胀 Press on stomach andpalpateDotestofspecimenofurstools,bloodtestMight need endoscopic 内窥镜的,内窥镜检查的 sigmoidoscopy 乙状结肠镜检查[术]QuestionsForDiagnosis&Treatment AbdominalPain1..PossibleDiseaseAbdominalObstruction 腹胀[?b?m?n?lAppendicitis 阑尾炎FoodPoisoning 食物中毒Hepatitis 肝炎Cholecystitis(gallstones) 胆囊炎胆结石）GynecologicalProblems 妇科疾病StomachUlcer 胃溃疡[Pancreatitis 胰腺炎kriUrologicalProblems 泌尿系统问题Respiratoryproblems 呼吸系统问题?:riCardiovascularproblems 心血管问题[skj2.UsefulSentencesHowlong?where?howpainfulisit?Didthepainstratthereorsomewhereelse?Doesithurtmoreaftercertainexercisesoractions?Doufeelthatuhavehadfeveratanytime?Areupassingurineok?( 你排尿正常吗？ )Whatdoesururinelooklike?Areuhavingyourbowelsopenregularly?( 排便正常吗Areumenstruating?isitnormalBleeding?isitnormal?Havingaperiod?isitnormal?(females 月经来了吗？Areuvomiting?Whatdouvomit?Isthereapattern?( 一般什么情况下呕吐 Areuabletoeatordrink?Dougetpainaftereatinganddrinking?Pleaselaydown,IneedtoexamineuIwillneedtodosomeinvestigations:bloodtests,x-rayandultrasound,urinetestsandstooltestsCholecystitisD:Hello,mynameisDrpan,howcanIhelpu?:I e d l n for a few s d tsworse.D;howlonghaveuhadabdominalpain?P;aboutthreedays.D;whereisit?canushowme?P:yes,justhere.D;howpainfulisit?P:atfirstitwasjust onandoff, butnowitseemstobethereallthetime.D: on a scale of 1 to 10;if no pains is 1 and very 10,whatnumberwouldugiveyourpain?;Ideta7D;didthepainstartthereorsomewhereelse?;itss nthere.D;doesithurtmoreafterexerciseoractions?P；ifiamwalingaroundalot,itwillhurtabitmore.D;doufeelthatuhavehadafeveratanytime?;no,I nt think so ,I e felt t t I nt taken temperature.D；Ineedtotakeurtemperature,pulse,andB/PAreupassingurineok?P;yesD;whatdoesururinelooklike?P;normalD;areuhavingurbowelsopenregulatly?;usuallyIo,butIn tdmysnforacoupleofdays.D;haveuvomited?P;no,IthoughtIwasgoingtotodaybutthefeelingpassed.D;areuabletoeatanddrinkanything?;ImgtIn treallyfelteD:whathaveubeendrinking?P：Ihavehadacoupleofglassesofwaterandacoupleofcupsofcoffee.D:doesthepaingetworseaftereatingordrinking 、;no,notthatI veD;I need to examine you.please lay down,and loosen clothingforme.P;ok.D;showmewhereithurts.P:ithurtsjustthere.D;ok take a nice big breth, breathe in and out ,now try andrelax.P:ouch,thathurts.D；OKthanks,ucangetdressednow.P:Iwillneedtodosomeinvestigations::bloodtests,x-rayandultrasound,urinetestsandstooltestsD;hello ,your results show that u might have cholecystitis,uneed to be admitted to hospital for observation treatment,andwemayneedtodomoretestsbeforewehaveacorrectdiagnosis.;do I really d to e d o , nt anythingucangivemeforthepainandtohelptheproblem?D;sorry,no,itisbestthatuareadmittedforfurthertest,wecancheckthatun ttsrsomethingseriouslywithurliver.P;allright,PPTofAbdomialPainAlloedmuchefthepfcasesknowngenerallyastheacuteabdomenwillprobablyagreethatinthatconditionearlydiagnosisisexceptional Typesofabdominalpain? Colicky （绞痛 0pain-causedbydistention （膨胀）ofahollowviscus （空脏器） ,suchasbowel.? Somatic （躯干身体） pain-causedbyinflammation （炎症）oftheparietalperitoneum （层腹膜）;? Visceral（）paincausedbyinflammationofthevisceralperitoneumandcapsuleofsolidorgans.Quadrant （象限） ViewoftheAbdomenRightUpperCholecystitis （胆囊炎）? Inflammationofthegallbladder 胆囊,causedbyobstruction （管道堵塞）withagallstone.? Painisusuallysteadyforanhourormoreafteronsetandmadeworsebyeating.? Ifthereissignificantinflammationassociatedwiththecholecystitis,theremaybelocalperitonealpain(somaticpain)腹膜性疼痛.? Painmaybereferredtothescapular( 肩胛的)areaaccompaniesnausea 恶心,vomiting,andfeverwithoutjaundice 黄疸.? Diagnosedwithultrasound( ).Cholangitis 胆管炎? Causedbyobstructionofthebiliarytract( 胆道)leadingbacterialovergrowthinthegallbladder.? Markedy t sTriad（查科三联征）–RUQ(右上腹)pain,jaundiceandfever.? Diagnosedbyultrasound.? IsanemergencyandmustbetreatedwithIVantibiotics( 静脉抗生素).? Mayrequiredecompression( 解压凭借窥镜的)orsurgicalmeans.Hepatitis （肝炎）? Causedbyinflammation （感染） oftheliverbyviruses （毒）,alcoholorcertaindrugs.? Markedbytender,enlargedliverwithmalaise （不舒服）,feverandjaundice.? Diagnosedbyhistoryandlaboratoryevaluation-liverfunctiontestsandviralserologies. （病毒血清学的检查）? Treatmentdependsonetiology （病因，病原）ofdisease.Pancreatitis （胰腺炎）? Most commonly caused by alcoholism (50%) and gallstones(30%)obstructingthecommonbile （胆汁）duct（管道）.? Constantmid-epigastric （上腹部的） visceral（内脏的）painusuallyoccurringafteraheavymealoralcoholicbinge.? Painmayradiatetotheback(50%)andisaccompaniedbynausea,vomitingandanorexia （厌食症）.? Diagnosedbyamylase （淀粉酶）andlipase 脂肪酶.ImagingbyCTscanmaybedesirableinsomecases.LeftUpperPepticUlcer （胃溃疡）? Causedbyincreasedgastricacidproduction （胃酸容物）ordecreasedmucosal （粘膜的）protection.? Increasedgastricacidproductionmaybecausedbyalcoholism （酒精中毒）orgastrinproducingtumor(Zoll