安康看男科哪里比较好飞度管家云管家

来源:搜狐娱乐
原标题: 安康看男科哪里比较好度排名免费平台
Guru An overly flattering title added to words like ;social media;。背后的意思:吹牛,随便什么人都能贯上“guru”两字。Guru 专家、大牛。造句:This is Mr. Kai-Fu Lee, Weibo guru.这位是微专家李开复先生。Synergy A fancy way to say ;works well together;。背后的意思:“一起工作配合挺好”的优雅说法。Synergy 配合、合作。造句:There#39;s a lot of synergy between the two companies.两家公司合作很多。Loop in More email in your inbox。背后的意思:亲,今后你会收到更多邮件哦。Loop in 让某人知道、参与进来。造句:I noticed you weren#39;t on the email so I#39;ll loop you in.我注意到你没在这封email里,我会把你加进来。Ping me Let me continue to bother you in a different electronic medium。背后的意思:你跑不掉,我会以另一种方式来继续骚扰你的。Ping me (在msn、qq、skype上)提醒我。造句:Feel free to ping me if I haven#39;t gotten back to you by Friday morning!如果我周五早上还没给你回复记得skype我。Sync up Let#39;s rehash whatever just happened because I wasn#39;t paying attention。背后的意思:咱们来重复一下刚刚的讨论,因为……我刚刚没在听。Sync up 同步。造句:Let#39;s sync our efforts.咱们一起努力吧。 /201309/257334

During a cocktail party in Robert Galbraith’s (a.k.a. J. K. Rowling’s) endlessly entertaining detective novel “The Silkworm,” the publisher Daniel Chard gives a toast in which he observes that “publishing is currently undergoing a period of rapid changes and fresh challenges, but one thing remains as true today as it was a century ago: Content is king.”罗伯特·加尔布雷思(Robert Galbraith,又名J·K·罗琳[J.K. Rowling])的侦探小说《蚕》(The Silkworm)非常有趣,书中写到了一次鸡尾酒会,席间出版商丹尼尔·查德(Daniel Chard)做了致辞,说:“出版业目前正在经历巨变与崭新的挑战,但是有一件事百年至今从未改变:内容为王。”Coming from an obscure, midlist, mystery author named Robert Galbraith such a statement might go unnoticed. But when the same passage is written by J. K. Rowling, author of the Harry Potter series and one of the most successful authors of all time, the words cannot help having a far greater impact.这样的话若是来自籍籍无名、在书榜上名列中游、名叫罗伯特·加尔布雷思的神秘作家,可能根本不会有人注意。但同样的话如果是由哈利·波特(Harry Potter)系列的作者,也是史上最成功的作家之一J·K·罗琳写下来的,影响力可就大多了。Therein lies the problem and the great joy of this book.问题就在这里,它也是这本书给人带来的巨大乐趣之一。You want to judge “The Silkworm” on its own merit, author be damned. It is, in fact, this critic’s job to do so. But writing that type of blind review in this case, while a noble goal, is inauthentic if not downright disingenuous. If an author’s biography always casts some shadow on the work, here, the author is comparatively a total solar eclipse coupled with a supermassive black hole.你希望以《蚕》本身的价值来评判这本书,不去管作者怎么样。事实上,这是家的责任。但是,在这种情况下,写这种“盲评”,虽然目的是高尚的,但却显得不真诚,至少也是不大可靠。如果一个作家的生平总会在他的作品中投下阴影,在这本书里,这位作家投下的不只是日全食,简直就是一个特大号黑洞。This is especially true because Rowling (let’s stop pretending) makes matters worse (or better) by taking on the world of publishing. Leonora Quine, the dowdy wife of the novelist Owen Quine, hires our hero, the British private detective Cormoran Strike (first seen last year in Rowling’s “The Cuckoo’s Calling”), to investigate the disappearance of her husband. Owen Quine has just written a nasty novel that reveals dark, life-#173;ruining secrets of almost everyone he knows. Owen, his wife tells Strike, is probably at a writer’s retreat. Finding him should be a routine matter.更何况罗琳(还是别用假名称呼她了)还挑战了出版界,这让事情变得更糟(或更好)。本书主角是英国克莫伦·斯特莱克(Cormoran Strike),去年在罗琳的《布谷鸟的呼唤》(The Cuckoo’s Calling)中首度登场;小说家欧文·奎恩的妻子利奥诺拉·奎恩(Leonora Quine)长相俗气,她雇用斯特莱克寻找失踪的老公。欧文·奎恩刚写完一本令人不快的小说,几乎所有熟人的黑暗丑陋秘密都被他端出来了。奎恩太太告诉斯特莱克,欧文可能呆在一个作家的疗养地,寻找他可能会变成常事。But, of course, nothing here is what it seems. When Owen Quine ends up gruesomely slaughtered — in a murder scene ripped from his new novel — Strike and his comely sidekick, Robin Ellacott (think Sherlock and Watson, Nick and Nora, Batman and, well, Robin), enter the surprisingly seedy world of book publishing. They investigate those who were thinly disguised in Quine’s final manuscript, all of whom offer insights into the world of the writer.但是,当然啦,一切都不是表面上看起来的那样。欧文·奎恩最后被残酷地杀害了,犯罪场景正来自他的新小说。斯特莱克和他的漂亮助手罗宾·埃拉科特(Robin Ellacott,他俩的关系就像福尔斯和华生、尼克和诺拉、蝙蝠侠和,那个,也是罗宾)进入了图书出版的世界,这个世界令人惊讶地名声狼藉。他们调查了奎恩最后的手稿中那些几乎没做任何掩饰就提到的人,他们都能让人洞察到作家世界的内部。The suspect pool includes his editor, Jerry Waldegrave (“Writers are different. . . . I’ve never met one who was any good who wasn’t screwy”); his agent, Elizabeth Tassel (“Have you any idea . . . how many people think they can write? You cannot imagine the crap I am sent”); his publisher, Daniel Chard (“We need ers. . . . More ers. Fewer writers”); and the pompous literary novelist Michael Fancourt (“Like most writers, I tend to find out what I feel on a subject by writing about it. It is how we interpret the world, how we make sense of it”).嫌疑人中包括奎恩的编辑杰里·沃德格雷夫(Jerry Waldegrave,“作家们都很不一样……我从来没见过不古怪的作家能写出好东西”);他的经纪人伊丽莎白·塔塞尔(Elizabeth Tassel,“你知不知道……到底有多少人觉得自己能写作?你没法想像人们拿给我什么样的垃圾”);他的出版商丹尼尔·查德(“我们需要读者……更多的读者。更少的作家”);还有高傲的文学小说家迈克尔·范克特(Michael Fancourt,“和大多数作家一样,我也喜欢通过写作某个主题来找出自己对它的真实感受。这是我们阐释世界的方式,是我们为之赋予意义的方式”)。As written by Rowling, “The Silkworm” takes “write what you know” and raises it to the 10th power. Is this crime fiction, a celebrity tell-all, juicy satire or all of the above? The blessing/curse here is that you turn the pages for the whodunit, but you never lose sight that these observations on the publishing world come from the very top. This makes complete escape, something mandatory for a crime novel, almost impossible — but then again, who cares? If you want a more complete escape, pick up another book. Reading Rowling on writing is delicious fun.《蚕》由罗琳创作,是那种“写你熟悉的事情”,然后再把它增加到十级马力的小说。它究竟是一部犯罪小说,还是一部名流曝光,抑或生动的讽刺文学,或者以上皆是呢?这里面的好处/坏处在于,你把它当做一部侦探小说来阅读,但你总会注意到书中充满对出版界的观察,这种观察正来自出版界的顶层。这使得纯粹的消遣——对于一本侦探小说来说所必须提供的——成为几乎是不可能的事情;但是这里问题又来了,谁会在乎呢?如果你想要更彻底的放松,那还是换一本书吧。不过读罗琳谈写作还是很有意思的。Even the title of the novel (and the English translation of the poisoned-pen manuscript) is “The Silkworm” because a silkworm’s life is “a metaphor for the writer, who has to go through agonies to get at the good stuff.” On envy: “If you want a lifetime of temporary alliances with peers who will glory in your every failure, write novels.” On Internet trolls: “With the invention of the Internet, any subliterate cretin can be Michiko Kakutani.” On a literary male writer’s inability to create realistic female characters: “His women are all temper . . . and tampons.” On a writer named Dorcus Pengelly (some of these names are straight out of Hogwarts): “She writes pornography dressed up as historical romance,” but our murder victim still would “have killed for her sales.”小说的名字叫做《蚕》(小说中那本毒舌手稿的名字也是这个),就连这个名字也和写作有关系,因为蚕的一生“是对作家的隐喻,他们经历痛苦去获得好东西”。她谈起嫉妒时说,“如果你希望一生都只能获得暂时的同盟者,这些伙伴们还会对你的每次失败欢呼雀跃,那就去写小说吧。”她谈起互联网上的喧嚣:“有了互联网,随便什么会写几个字的白痴都能当角谷美智子(美国著名家——译注)了。”还有一个无法写好逼真女性角色的男作家:“他笔下的女人都很情绪化……像经前综合征。”关于一个名叫多克斯·潘格利(Dorcus Pengelly,书中有些名字是直接从霍格沃兹学校来的)的女作家:“她写的是伪装成历史浪漫小说的色情文学”,而我们的受害者“会因为她的销量而杀人”。There is even a debate on the merits of self-publishing when Quine’s mistress whines that she’s going the “indie” route because “traditional publishers wouldn’t know good books if they were hit over the head with them.”书中甚至还讨论了自费出版的价值,奎恩的情妇抱怨说自己走上了“独立”的道路,因为“传统出版社不知道什么才是好书,就算好书砸到他们脑袋上也认不出来”。Are these opinions shared by Rowling? Don’t know, don’t care. In the end, despite the window dressing, Rowling’s goal is to entertain and entertain she does. If we can’t forget that she is a celebrity, we’re also constantly reminded that she is a master storyteller. Push aside J. K. Rowling (a gender-neutral pseudonym Joanne Rowling took so that boys would Harry Potter) and judge the book on the merits of Robert Galbraith (a full-fledged male pseudonym with no such neutrality), and “The Silkworm” is still a suspenseful, well-written and assured British detective novel.这些观点罗琳都认同?没人知道,也没人关心。尽管有这些装点门面的东西,罗琳最终的目的还是,她也提供了。如果我们总忘不了她是个名人,那么也应该时常提醒自己,她是讲故事的大师。抛开J·K·罗琳(这是个中性化的笔名,用来代替她的原名“琼尼·罗琳”,好让男孩子也来读哈利·波特)的名气,独立判断罗伯特·加尔布雷思(一个完全是男性化的笔名,并没有做中性化处理)这本书的价值,会发现《蚕》同样是一本充满悬疑、文笔精、彻头彻尾的英国侦探小说。Strike, who lost his leg to a land mine in Afghanistan, is described as a “limping prize fighter,” a man who looms so large, “the room seemed much smaller with his arrival.” Potter fans will want to make a connection between Cormoran Strike and Rubeus Hagrid, the beloved giant in the Harry Potter novels, but such comparisons feel forced. If J. K. Rowling never leaves our minds while ing “The Silkworm,” the world of Harry Potter, to Rowling/Galbraith’s credit, never enters it. We are squarely in the gritty, gloomy and glitzy real world of the Muggles, except maybe when she describes a noisy piece of furniture in Strike’s office as the “farting leather sofa.” For a moment, the er can almost see the sofa coming to life in the halls of Slytherin House.斯特莱克在阿富汗战场上因为地雷而失去了一条腿,被描述为“跛脚的荣誉战士”,一个非常有存在感的男人,“因为他的到来,房间显得小多了。”哈利·波特的粉丝们会希望在克莫伦·斯特莱克和哈利·波特小说里受人喜爱的巨人鲁伯·海格(Rubers Hagrid)找到共同点,但这样的比较感觉很牵强。如果在在阅读《蚕》的时候,J·K·罗琳从未离开你的脑海,那么,值得称道的是,罗琳或加尔布雷思从未让哈利·波特的世界进入这本书。我们完全置身于这个坚实、阴郁、浮华,由麻瓜组成的现实世界里,或许只除了她描写斯特莱克办公室里一件吱嘎作响的家具是“老放屁的皮沙发”。在那一刻,读者可能会感觉斯莱特林学院大厅里的沙发回来了。“The Silkworm” most often feels like a traditional British crime novel albeit set in the present day, complete with eccentric suspects, a girl Friday (Oh, when will they see that they are meant for each other?) and a close friend in the police department whose life Strike saved in the war. But Rowling gives some of the old saws a new spin. Robin, for example, isn’t a longtime friend or ex-lover — she starts out as a young temp Strike first meets in “The Cuckoo’s Calling.”虽然发生在现在,《蚕》几乎可以被视为传统的英国犯罪小说,再加一堆古怪的嫌犯,一个女孩版“礼拜五”(啊,他俩什么时候才能明白他们是天生一对?),一个在警察局的密友,斯特莱克曾在战争中救了他的命。不过罗琳给这些老套路赋予了新元素。比方说,罗宾不再是斯特莱克的老朋友或前女友,她和斯特莱克在《布谷鸟的呼唤》中初遇时是个年轻的临时秘书。Strike himself may at first appear to be something we have seen too often — a brooding, damaged detective, with a life-#173;altering war injury, financially on the brink, who’s recently lost his longtime girlfriend — but there is an optimism to him that is refreshing and endearing. Even though he’s hobbling down the street, often in great pain, “Strike was unique among the men not merely for his size but for the fact that he did not look as though life had pummeled him into a quiescent stupor.”斯特莱克本人一开始可能很像我们经常遇到的那种形象——一个多思、受过伤害的侦探,战争中受的伤改变了他的生活、经济在崩溃边缘,前不久又失去了多年女友——但他身上有一种乐观主义,这非常令人喜爱,也让人耳目一新。尽管他在街上一瘸一拐地走着,时常都很痛苦。“斯特莱克是独一无二的,不仅是因为他的身材,也因为他并不觉得生活一直在打击他,把他打到人事不省。”Strike also shares a trait with many great fictional detectives: He is darn good company.斯特莱克还有一个特点是很多伟大的虚构侦探都具有的:他是个好伙伴。There are musings on fame (Strike is the illegitimate son of the rock star Jonny Rokeby), the media (the book opens with a passing shot at the British phone hacking scandal that engulfed many celebrities, including Rowling), book marketing (Quine’s wife on her husband’s sluggish sales: “It’s up to the publishers to give ’em a push. They wouldn’t never get him on TV or anything like he needed”), not to mention e-books and the digital age of publishing.书中有很多思考,诸如名誉(斯特莱克是摇滚明星约翰尼·洛克比[Jonny Rockeby]的私生子)、媒体(这本书一开头就写了英国电话窃听丑闻,包括罗琳在内的很多名人都身陷其中)、图书市场(奎恩的妻子谈起丈夫的书卖不动:“完全要靠出版商来推动。他们从不让他上电视,或者提供他类似的机会”),当然还有电子书和数字出版时代了。But Rowling saves her most poignant observations for the disappointments of marriage and relationships. The likable Robin is engaged to a pill named Matthew and cannot see, as Strike and the er can, that “the condition of being with Matthew was not to be herself.” When he thinks about his own sister’s marriage and those like it, Strike wonders about the “endless parade of suburban conformity.” His private-eye job of catching straying spouses makes him lament “the tedious variations on betrayal and disillusionment that brought a never-ending stream of clients to his door.” He sees the “willfully blind allegiance” of long-suffering wives and the false “hero worship” of male writers by the women who supposedly love them. When his sister asks Strike if he puts up with his destructive ex-girlfriend “because she’s beautiful,” Strike’s honest answer is devastating: “It helps.”但罗琳最深刻辛酸的观察还要算是对婚姻和恋爱关系的失望。可爱的罗宾和一个名叫马修的讨厌鬼订婚了,但她看不到斯特莱克和读者们所能看出的东西——“她和马修在一起时的状态完全不是她自己。”斯特莱克想起自己姊的婚姻,还有那些有着相似婚姻的人,不禁思忖,这是一条通往“市郊常规生活的漫长队列”。他的寻找失踪配偶的工作让他哀叹“背叛与幻灭是冗长乏味的变奏,为他带来永无穷尽的客户”。他看到长期受苦的妻子们保持着“故意盲目的忠诚”,以及那些声称爱着男性作家们的女人虚假的“英雄崇拜”。他的姊问他能够忍受那冤家前女友是不是“只因为她很漂亮”,斯特莱克的回答诚实而可怕:“的确有帮助”。Do these observations take on more weight when we know that the writer is a superstar female author rather than a semi-obscure male one? I think they do.如果我们知道这些观察来自一位明星女作家,而不是一个几乎没有名气的男作家,会不会觉得它们更有分量?我觉得是这样。The book isn’t perfect. It’s a tad too long, and the suspect interrogations grow repetitive. Sometimes the er feels Rowling may be trying too hard to move away from Hogwarts. The fair amount of swearing reminds one of a rebellious teenager set free.这本书并不完美。它稍微有点冗长,对疑犯的质询愈来愈啰嗦。有时候读者会觉得罗琳过于努力摆脱霍格沃茨。大堆脏话有点像叛逆的青少年好不容易得到自由。Some will also argue that while Harry Potter altered the landscape in a way no children’s novel ever has, here Rowling does the opposite: She plays to form. “The Silkworm” is a very well-written, wonderfully entertaining take on the traditional British crime novel, but it breaks no new ground, and Rowling seems to know that. Robert Galbraith may proudly join the ranks of English, Scottish and Irish crime writers such as Tana French, Ian Rankin, Val McDermid, John Connolly, Kate Atkinson and Peter Robinson, but she wouldn’t overshadow them. Still, to put any author on that list is very high praise.有些人会说,从没有任何一本童书像哈利·波特这样改变了出版界,在这里罗琳做的事正相反,她在努力建设。《蚕》是一本文笔极佳、极具性的读物,以传统英国犯罪小说的面目出现,没有打破任何常规,罗琳似乎也知道这一点。罗伯特·加尔布雷思可能会骄傲地加入塔娜·法兰琪(Tana French)、伊恩·兰金(Ian Rankin)、薇儿·麦克德米德(Val McDermid)、约翰·康诺利(John Connolly)、凯特·阿特金森(Kate Atkinson)和彼得·罗宾森(Peter Robinson)等英格兰、苏格兰和爱尔兰犯罪小说作家的行列,但她不会超越他们。不过,能跻身这些作家的行列已经是很高的荣誉了。The upside of being as well known as Rowling is obvious — sales, money, attention. That’s not what she’s after here. The downside — and her reason for using the pseudonym — is that telling a story needs a little bit of anonymity. Rowling deserves that chance, even if she can’t entirely have it. We can’t unring that bell, but in a larger sense, we ers get more. We get the wry observations when we can’t ignore the author’s identity and we get the escapist mystery when we can. In the end, the fictional publisher Daniel Chard got it right: “Content is king,” and on that score, both J. K. Rowling and Robert Galbraith triumph.随“罗琳”的名气而来的好处是显而易见的——销量、金钱和关注。但这并不是她所追求的。至于坏处——这也正是她使用化名的原因——就是讲故事确实需要一点匿名性。就算无法彻底享有,罗琳也理应获得这样的机会。我们不能忘记她的名气,但从大一点的角度来说,我们读者获得的东西更多。如果我们注意到作者的身份,就会理解到书中观点的讽刺之处;如果我们忘记作者的身份,就能体会到一种避世的神秘感。不管怎样,书中虚构的出版商丹尼尔·查德说得对——“内容为王”,就这一点而言,J·K·罗琳和罗伯特·加尔布雷思都赢了。 /201407/311478

Can there ever be a good reason for drinking 300 shots of baijiu, China#39;s distilled liquor famed for burning the esophagus and causing calm people to burst into song? For American Derek Sandhaus, the answer is yes.这种令食道产生灼烧感、让沉稳的人突然唱起歌来的中国蒸馏酒吗?对美国人德里克#12539;桑德豪斯(Derek Sandhaus)来说,是肯定的。All that #39;research#39; paid off for Mr. Sandhaus, who lived in China from 2006 to 2013. His book, #39;Baijiu: The Essential Guide to Chinese Spirits,#39; will be released this month by Penguin China. The author, who now lives in Virginia, also has a blog called #39;300 Shots at Greatness,#39; where he posts pictures of his liquor cabinet, describes his Kansas-born parents trying baijiu, and recounts a story of President Nixon nearly burning down the White House after attempting to set some baijiu on fire.桑德豪斯的“研究”终于有了成果,他的新书《白酒:中国烈酒必备指南》(Baijiu: The Essential Guide to Chinese Spirits)本月将由企鹅中国(Penguin China)出版。现居住在美国弗吉尼亚州的桑德豪斯曾在2006至2013年间在中国生活,他还有一个名叫“300 Shots at Greatness”的客,该客张贴有自己酒柜的照片,描述了自己出生在堪萨斯州的父母试饮白酒的故事,还讲述了美国总统尼克松(Richard Nixon)试着点燃白酒结果险些在白宫引发大火的轶事。Mr. Sandhaus admits he probably imbibed closer to 600 shots of baijiu in the course of his work. Scene Asia talked to the 31-year-old about his love of China#39;s national drink. Edited excerpts:桑德豪斯坦言说,自己在创作这本书的过程中可能喝了将近600杯白酒。“风尚亚洲”(Scene Asia)栏目与31岁的桑德豪斯聊了聊他对这一中国名酒的热爱。以下是经编辑的访谈摘录:How did you get the idea for the book?问:你是如何想到要写这本书的?It came to me several years ago, when I was on my way back from one of the banquets that people in China often get invited to. I was thinking how unpleasant I found the experience of drinking lots of shots of baijiu. I wanted to figure out why foreigners dislike the experience so much, whereas the people of China love and celebrate it.答:几年前我参加了一场酒宴;在中国人们经常会受邀参加此类酒宴。在回去的路上我在想,白酒喝多了的感觉非常不舒。我想弄清楚为什么外国人如此厌恶这一体验,而中国人却酷爱并且颂扬它。Did you ever learn to like it?问:那你后来喜欢上白酒了吗?There was a theory going around that if you drank 300 shots that was the threshold - you would go from someone who hated it to someone who appreciated it. That theory sounded like hogwash.答:如今流传有一种理论,说如果你喝够了300杯白酒,那你就能对白酒由恨转爱。这理论听着很扯。Did it take you 300 shots?问:你是在喝了300杯白酒后喜欢上它的吗?It didn#39;t even take 100 shots. It came down to just finding types of baijiu that appealed to my tastes. China has around 10,000 distilleries of almost all shapes and sizes. There is almost certainly one that is better suited to your taste.答:连100杯都不到我就喜欢上了。其实就是要找到能迎合自己口味的白酒。中国有上万家酿酒厂,产品种类繁多,几乎各种规格都有,肯定有一款白酒更符合你的口味。I hate baijiu.问:我很讨厌白酒。When someone tells you they hate baijiu, the first thing to remember is that baijiu at the standard level is about 50%-60% alcohol by volume, whereas vodka or whiskey is around 40%. So the trouble is not the taste, but the taste of that much alcohol. Some baijiu are watered down to 38%-40%, which might make it easier, although you#39;re still dealing with a lot of weird tastes and flavors.答:当有人说讨厌白酒时,首先要记住的是,标准白酒的酒精含量在50%至60%之间,而伏特加和威士忌的酒精含量在40%左右。所以说问题出在了白酒酒精含量太高,而并非酒的味道本身。有些白酒的酒精含量被冲淡至了38%到40%,喝起来可能会舒一点。不过你仍要在千奇百怪的口感和香型中进行挑选。Also, baijiu is the Chinese word for all of their traditional spirits. When a lot of people say they don#39;t like the taste, they don#39;t like the specific taste of the type of baijiu they#39;re drinking.还有一点,白酒是中国所有传统烈酒的统称。很多人说自己不喜欢白酒,实际上指的是其所喝某一类白酒的特定口感。Any big surprises?问:这一过程中,你有什么惊奇的发现吗?I found out that I actually did like baijiu. Another thing is that I found out just how essential alcohol is to Chinese culture. Evidence shows that the Chinese might have been making alcohol even before they formed a civilization, and that alcohol might have played a central role in the creation of their civilization.答:我发现我其实挺喜欢白酒的。还有就是我发现,酒对于中国文化有着极其重要的意义。有据显示,中国人在其文明形成以前可能就开始酿酒了,而酒可能在中国文明的创造过程中扮演了一个至关重要的角色。The book seems to be everything you ever wanted to know about baijiu. So your ers are not Chinese?问:这本书似乎是以对白酒的全面介绍为内容。所以说本书的读者定位并不是中国人?I don#39;t think the Chinese need my help in appreciating their culture. But outside of China, the level of understanding is low, even in people who are experts in spirits: bartenders, wine and spirit writers. This is the book I wish had existed when I first started researching baijiu. It allows you to walk into a Chinese liquor store and know what#39;s on the shelf. Normally, you walk into a store and see a wall filled with Chinese characters. You have no idea what you#39;re looking at.答:我觉得中国人并不需要我来帮助他们品鉴本国文化。然而在中国以外,人们对白酒知之甚少,甚至连烈酒专家--调酒师、葡萄酒和烈酒作家亦是如此。我多么希望在我研究白酒之初就能有这样一本书。它让你在走进一家中国酒水店的时候能知道架子上摆的是什么。而通常情况下,你走进一家酒水店,眼前是一整 的汉字,你根本不知道那都是些什么。Where did you live in China?问:此前你住在中国的哪里?Shanghai and then Chengdu (the capital of Sichuan province). Sichuan is the center of China#39;s baijiu industry, so I got a chance to do a lot of firsthand research, visit distilleries, and see the business inside out.上海,然后是四川省省会成都。四川是中国白酒产业的中心,因而我有机会做了许多第一手调查,走访了一些酿酒厂,并透彻地观察了这个行业。Do you have a favorite baijiu?问:有哪款白酒是你的最爱吗?Since the book lists about 90 baijiu, I probably shouldn#39;t pick a favorite. But there are some I really like. One is called Lao Guilin by Guilin Sanhua. It#39;s a really smooth kind of sweet, but not cloyingly, so it#39;s kind of reminiscent of sake. Another is Laobai Fenjiu by Xinghuacun Fenjiu. And then my go-to favorite Sichuan baijiu is Luzhuo Laojiao.答:这本书列出了大约90种白酒,所以我不太应该说哪个是自己最喜欢的。不过有几款白酒我都觉得很棒。一款是桂林三花股份有限公司生产的老桂林,它有种滑而不腻的甘甜口感,有点像日本的米酒。还有一款是山西杏花村汾酒集团生产的老白汾酒。四川的白酒中我最喜欢泸州老窖。You must have some good drinking stories.问:可否和我们分享一些有趣的品酒故事?We were at a lunch banquet thrown by the Sichuan government affairs office and only had two or three shots of baijiu. It was upper-end baijiu and that was the first time I drank it and thought, this is something I could really start liking. Then, in the afternoon, they put us in some ridiculous traditional costumes and marched us out to a big performance in the center of town. There were tens of thousands of people there.答:有一次在四川政府事务办公室举办的午宴上,当时我只喝了两三杯白酒。那是一款高档白酒,也是我头一次喝下后觉得这酒味道真不错。之后那天下午,他们给我们穿上了一些很滑稽的传统装,并带着我们去市中心参加一场大型表演。当时那里有上万人在场。They got me up and had me perform a traditional Chinese drum dance with all these 8-year-old girls who had been rehearsing for months. I kind of think it would have pissed me off but for the fact that I had a few shots of baijiu at lunch, which made the whole thing so hilarious and fun. It is one of my best memories of living in Sichuan.他们把我推上台,让我和一群演排了好几个月的小女孩一起表演传统的中国鼓舞。现在想来,若不是因为那几杯酒,我或许就不会感觉整件事那么好玩,反而会很生气了吧。这是我在四川生活的日子里最美好的记忆之一。So baijiu makes everything better?问:所以说,白酒让一切都变得更好了?That for me was the crucial insight in my quest to understand baijiu. Whether you enjoy the drink itself, the fact is, if you can go with it and learn to at least tolerate baijiu, you will have a much better time in China. It#39;s one of the only times when random people will cut loose and show you this jovial, fun side of themselves that they don#39;t show strangers.这是我在探寻白酒的过程中所洞察到的重要收获。实际上无论你是否喜欢白酒,如果你能放宽心去接纳它,你就可以在中国收获一段更加美好的时光。白酒能让人摆脱束缚,展示出自己平时不会呈现给陌生人的愉快有趣的一面。 /201403/279626The unnamed youngster astounded mourningrelatives and friends when she moved her head during the ceremony at a churchin the Philippineson Sunday.周日,在菲律宾某教堂,这名姓名未知的小女孩在自己的葬礼上扭动了脑袋,这可吓坏了正在哀悼的亲人朋友们。 Police confirmed the startling incident atthe church in Aurora, Zamboanga del Sur. They refused to name the child or thefamily in order to protect their identities.警察实了发生在南三宝颜省(ZamboangaDel Sur)一教堂的惊人事件。为了保护家人和孩子的身份,警方拒绝透露他们的姓名。 Video footage of the event, which showedthe girl#39;s parents rushing to remove her from the wooden coffin, went viralafter they were posted on a social network yesterday.从该事件的录像片段中可以看到,女孩的父母冲到棺材前将她抱了出来。自昨天视频被发到社交网络上后就快速传播开来 Although it could not be confirmed, localreports suggest the child experienced a very high fever for days and wasbrought to the clinic in the town for medical attention last Friday.虽然视频无法得到实,但据当地新闻报道,这名女童连日高烧不退,上周五被送到小镇的诊所接受医疗救助。 ;During that time, the attending clinicpersonnel and physician confirmed that the young patient had no more pulse andwas clinically dead last Saturday morning about 9 a.m.,; said Aurora policechief Heidil Teelan.警长HeidilTeelan说:“在接受救助期间,诊所出诊人员和医生于上周六早上9时许请确认小女孩没有脉搏,并宣告她临床死亡。” /201407/312259There are varying opinions as to the origin of Valentine#39;s Day. Some experts state that it originated from St. Valentine, a Roman who was martyred for refusing to give up Christianity. He died on February 14, 269 A.D., the same day that had been devoted to love lotteries.关于情人节的起源有许多种说法。一些专家认为情人节源于一个名叫圣·瓦伦丁的人。他是罗马人,因为拒绝放弃基督教而于公元前269年2月14日惨遭杀害,这一天也正好是全城举行爱情抽签的日子。Legend also says that St. Valentine left a farewell note for the jailer#39;s daughter, who had become his friend, and signed it ;From Your Valentine;.相传圣·瓦伦丁曾留下一本日记给了狱卒的女儿,署名为“你的瓦伦丁”,据说这名狱卒的女儿是桑特·瓦伦丁的朋友。Other aspects of the story say that Saint Valentine served as a priest at the temple during the reign of Emperor Claudius. Claudius then had Valentine jailed for defying him. In 496 A.D. Pope Gelasius set aside February 14 to honour St. Valentine.还有别的说法。有人认为在克劳迪亚斯君王统治时期,圣·瓦伦丁曾经是一名神父,因为公然挑战克劳迪亚斯君王的权威身陷囹圄。所以公元前496年罗马教皇格莱西亚斯特意将2月14日作为一个特别的日子以纪念圣·瓦伦丁。Gradually, February 14 became the date for exchanging love messages and St. Valentine became the patron saint of lovers. The date was marked by sending poems and simple gifts such as flowers. There was often a social gathering or a ball.此后2月14日就成为了一个具有特殊意义的日子。这天人们向自己心仪的人表示爱意。而圣·瓦伦丁也就成为了爱的守护神。在2月14日这天,人们会用诗或者类似鲜花的小礼物送给自己心爱的人,还会组织聚会或舞会来庆祝这个特殊的节日。In the ed States, Miss Esther Howland is given credit for sending the first valentine cards. Commercial valentines were introduced in the 1800#39;s and now the date is very commercialized.艾斯特·霍兰德是美国第一位发送情人节卡片的人。早在19世纪初,情人节就已初露商业化的端倪,而如今这节日已经完全被商业化了。 /201401/272169

Traveling is a priority for many people during the National Day holiday, and college students are no exception. But with landmarks swamped with tourists, and transportation and accommodation costs even higher during Golden Week, how to travel on a budget is a tricky question.对于许多人而言,在过去的国庆假期里,旅行是头等大事,而大学生们自然也不例外。但是鉴于黄金周各大景点人山人海,交通、住宿费用水涨船高,如何“穷游”成为一个棘手的问题。Earn on the trip边旅行边赚钱For some, asking their parents for travel money is outdated. Saving up on your own is the trend now. But what about earning money on the trip?对于一些人而言,“啃老旅行”已经OUT了。时下最IN的是自助游。但边旅行边赚钱这种方式,你觉得如何?Chen Yirong, 22, a senior majoring in journalism at Shantou University, had a great idea to solve her budgeting problem.22岁的陈一荣(音译)是汕头大学新闻系的大四学生。她想到了一个解决经费问题的好主意。Chen traveled from Shantou to Nanjing during the holiday. Before her departure, she offered to write an article about her trip for the school newspaper when she came back.国庆假期,陈一荣离开汕头,到南京旅行。出发前,她主动要求回来后为校报撰写一篇游记。“I was paid for the story and the photos I submitted. Even if it’s just a small sum of money, it eases part of the pressure of financing the trip,” says Chen.陈一荣说:“我有偿提供文章和图片。尽管稿费不多,但这笔钱可以缓解一下出行的经济压力。”Another option is providing news stories to local newspapers. “One of my classmates took a bus from Shantou to Xiamen. After being stuck in traffic for several hours, she called a local newspaper to inform them of the situation and got 50 yuan as a reward,” says Chen.还有一个方法是为当地报纸提供新闻素材。陈一荣说:“我有一个同学乘汽车从汕头到厦门。她在路上被堵了好几个小时,后来打电话将该情况告知了当地一家报纸,得到了50元报酬。”Couchsurfing or camping沙发客或帐篷客Instead of paying for an expensive hotel, you can try to score a free nights on someone’s couch. There are a number of websites to help pave the way, and you can offer couchsurfing opportunities in your dormitory as you travel and meet people on the way.不必为酒店一掷千金,你可以免费留宿在别人的沙发上。很多网站可以助你一臂之力,你也可以在外出旅行、结交朋友时,向“沙发客”们提供免费留宿你寝室的机会。Zheng Xiao, 22, a senior majoring in law at Fudan University, found a couch in Wuhan, where he stayed for one night.22岁的郑晓(音译)就读于复旦大学法律系大四年级。在武汉时,他便做了一晚的“沙发客”。“I found the opportunity on cnsfk.com. It’s free and, more importantly, I can contact and stay with local hosts in their home. I chatted with them and got great advice on where to find traditional local food,” Zheng says.郑晓说:“我在沙发客网上找到了这个机会。这是免费的,更重要的是,我可以接触到当地人并住在他们家里。我和他们聊天,也因此收获了当地传统美食地图。As it’s still summer in southern China, students traveling there can bring a tent and ask farmers if they can camp on their land, or just camp on a beach in costal cities.由于华南地区还是夏季,去南方旅行的同学可以带上一顶帐篷,询问当地老乡是否可以在他们的土地上宿营,或者干脆在海滨城市的沙滩上做“帐篷客”。Jin Ji, 18, a freshman majoring in Chinese literature at Guangxi University, traveled to Beihai with two friends. “We rented a tent. It was really fun to sleep on the beach at night. You can listen to the waves and see the sunrise. It’s much cheaper than a hotel,” says Jin.28岁的金吉(音译)今年是广西大学中文系的一名大一新生,他刚刚与两个朋友结束了北海之行。金吉说:“我们租了一顶帐篷,晚上就睡在沙滩上,有趣极了。你可以听到海浪声,还可以看日出。这比住酒店要便宜多了。”Cycling骑行者With train tickets not easily available and flights too expensive, bicycles are a popular method of transportation for many budget travelers.由于火车票一票难求而飞机票又太贵了,骑单车成为许多“穷游族”的热门出行方式。“The bicycle is a tremendously efficient means of transportation. It’s small, light and maneuverable. In fact, cycling is more efficient than any other method of travel in such a popular season. You can avoid traffic jams in cities and reach rural areas without the noise and pollution from cars,” says Wu Xinxin, 20, a sophomore majoring in ideological and political education at Sichuan Normal University.20岁的吴欣欣(音译)是来自四川师范大学思想政治教育专业的一名大二学生。她说:“单车是十分高效的出行方式。它小巧,轻便,机动灵活。事实上,在这样的旅游旺季,相对于其他出行方式,骑行的效率更高。你不必忍受城市塞车之苦,而可以去往那些远离汽车噪音与尾气的郊外。”Wu rode from Chengdu to Mount Emei with five classmates. They started at 7 am and arrived at 4 pm. “We enjoyed the scenery along the way, took some photos and rested at noon. It wasn’t so tiring as we selected a route that we could finish in one day,” says Wu.吴欣欣和五位同学从成都一路骑行到峨眉山。他们早上7点出发,下午4点到达。吴欣欣说:“我们欣赏了沿途的风景,拍了些照片,顺带还午休了一下。这并不累,因为我们选择了一条可以当日走完的线路。” /201311/262965The rare Pepquino melon measures just an over inch (3cm) from tip-to-tip but has the identical external pattern and distinctive shape of traditional watermelons.稀有的佩普基诺西瓜有着和传统西瓜相同的条纹和截然不同的形状,长度总共只有3厘米。The Pepquino melon, less than a centimetre in diameter, most closely resembles the All sweet variety of watermelon.佩普基诺西瓜的直径小于1厘米,外形和全甜西瓜非常类似。 小编注:全甜西瓜(all sweet watermelon)比普通西瓜更细长,呈椭圆形。It was discovered by Dutch food producers in South America who brought it to the Netherlands and cultivated it in greenhouses.一家荷兰食品商在南美发现了这种西瓜,并把它带回荷兰,在温室里培育。While it resembles its larger cousins, it has a fresh crisp taste similar to a cucumber.尽管这种西瓜和全甜西瓜长相类似,但脆爽的口感却很像黄瓜。With its distinctive appearance and slightly sour taste producer Koppert Cress believes it is set to become a new food fad in top London restaurants.食品商Koppert Cress 相信,它独特的外观和微酸的口感将使其成为伦敦顶级餐馆的新食尚。Prices start at #163;10 per 250g box, which contains around 50 melons.它的价格是10英镑一盒,每盒重250克,内有约50个西瓜。Anneke Cuppen, marketing manager at Koppert Cress said: ;Demand for the melons has so far come from the restaurant and hotel trade. We#39;re hoping to sell 50-100 boxes a week.Koppert Cress的市场部经理安内可·库本说:“目前,对这种西瓜的需求来自餐馆和酒店。我们希望每周能卖出50到100盒。”;We#39;re very excited about the product. It is highly versatile and can be used in a variety of ways - from salads to dessert.;“我们对这个产品感到非常兴奋。它的用途非常多样,从沙拉到甜点都能胜任。” /201406/307752

A patient with abdominal pain dies from a ruptured appendix after a doctor fails to do a complete physical exam. A biopsy comes back positive for prostate cancer, but no one follows up when the lab result gets misplaced. A child#39;s fever and rash are diagnosed as a viral illness, but they turn out to be a much more serious case of bacterial meningitis. 如果医生没能做好全面身体检查,腹痛病人可能会死于阑尾破裂。前列腺癌活体组织检查结果呈阳性,但却没人跟进,因为实验室结果被弄混了。小孩发烧和出疹被诊断为病毒性疾病,但最后却发现是严重得多的细菌性脑膜炎。 Such devastating errors lead to permanent damage or death for as many as 160,000 patients each year, according to researchers at Johns Hopkins University. Not only are diagnostic problems more common than other medical mistakes -- and more likely to harm patients -- but they#39;re also the leading cause of malpractice claims, accounting for 35% of nearly billion in payouts in the U.S. from 1986 to 2010, measured in 2011 dollars, according to Johns Hopkins. 约翰霍普金斯大学(Johns Hopkins University)研究人员表示,每年有多达16万名病人因此类致命失误而出现永久损伤或死亡。研究人员称,诊断问题比其他医疗失误更为普遍,而且更容易伤害到病人,同时它们也是医疗过失诉讼的主因,按照2011年美元价值计算,它们在1986年至2010年间共计近390亿美元的赔偿额中占35%。 The good news is that diagnostic errors are more likely to be preventable than other medical mistakes. And now health-care providers are turning to a number of innovative strategies to fix the complex web of errors, biases and oversights that stymie the quest for the right diagnosis. 好消息是,误诊比其他医疗失误更容易预防。现在医疗机构开始采用一系列创新措施来纠正失误、偏误和疏忽等妨碍医生做出正确诊断的问题。 Part of the solution is automation -- using computers to sift through medical records to look for potential bad calls, or to prompt doctors to follow up on red-flag test results. Another component is devices and tests that help doctors identify diseases and conditions more accurately, and online services that give doctors suggestions when they aren#39;t sure what they#39;re dealing with. 其中一个解决办法是自动化──用电脑筛查医疗记录从而找出可能的误诊,或提醒医生跟进标有红色警示的检查结果。另一方面是帮助医生更准确诊断疾病和病情的设备和测试,还有在医生对病人病情不确定时给他们建议的网上务。 Finally, there#39;s a push to change the very culture of medicine. Doctors are being trained not to latch onto one diagnosis and stick with it no matter what. Instead, they#39;re being taught to keep an open mind when confronted with conflicting evidence and opinion. 最后还有推动医疗文化的改革。医生受到的教导是不能抓住一种诊断不放,而是应该在面对相互冲突的据和观点时保持开放的思想。 #39;Diagnostic error is probably the biggest patient-safety issue we face in health care, and it is finally getting on the radar of the patient quality and safety movement,#39; says Mark Graber, a longtime Veterans Administration physician and a fellow at the nonprofit research group RTI International. 美国退伍军人事务部(Veterans Administration)资深医师、非营利研究机构RTI International研究员马克#12539;格雷伯(Mark Graber)说:“误诊可能是我们在医疗行业面临的最大的病人安全问题,现在终于纳入到了病人诊治质量和管理运动中。” The effort will get a big boost under the new health-care law, which requires multiple providers to coordinate care -- and help prevent key information like test results from slipping through the cracks and make sure that patients follow through with referrals to specialists. 这些举措在最新的医疗法律下将会得到大大的推进。法规要求多家医疗机构协调护理治疗,并帮助预防检查结果等关键信息被遗漏,确保病人按照医生的推荐去找专家。 There are other large-scale efforts in the works. The Institute of Medicine, a federal advisory body, has agreed to undertake a million study of the impact of diagnostic errors on health care in the U.S. 另外还有一些大规模的举措正在进行中。为美国联邦政府提供咨询的医学研究所(Institute of Medicine)已经同意承担一项100万美元的有关误诊对美国医疗影响的研究。 In addition, the Society to Improve Diagnosis in Medicine, which Dr. Graber founded two years ago, is working with health-care accreditation groups and safety organizations to develop methods to identify and measure diagnostic errors, which often aren#39;t revealed unless there is a lawsuit. In addition, it#39;s developing a medical-school curriculum to help trainees improve diagnostic skills and assess their competency. 此外,格雷伯士两年前创立的改善医疗诊断协会(Society to Improve Diagnosis in Medicine)正在与医疗认机构及安全组织合作,研究确定和衡量诊断失误的方法,通常情况下除非有人起诉,否则误诊是不会公之于众的。另外,协会还在设计一个医学院课程表,帮助学员提高诊断技能并对他们的能力进行评估。 Robert Wachter, associate chairman of the department of medicine at the University of California, San Francisco, says defining and measuring diagnostic errors is an important step. #39;Right now, none of the incentives for improvement in health care are based on whether the doctor made the correct diagnosis,#39; Dr. Wachter says. But equally important, he adds, #39;we need to nurture bottom-up innovation.#39; 加州大学旧金山分校(University of California, San Francisco)医药部副主任罗伯特#12539;瓦赫特(Robert Wachter)说,对诊断失误进行确定和衡量是重要的一个步骤。他说:“目前医疗改善的激励措施没有一项是基于医生是否做出了正确诊断的。”不过他又说,同样重要的是,“我们需要鼓励从下至上的创新”。 That#39;s aly happening. Large health-care systems are mining their electronic records for missed signals. At the Southern California Permanente Medical Group, part of managed-care giant Kaiser Permanente, a #39;Safety Net#39; program periodically surveys its database of 3.6 million members to catch lab results and other data that might fall through the cracks. 创新已经开始。大型医疗系统正在筛查他们的电子记录以查找误诊的迹象。在管理式医疗行业巨头凯泽永久医疗集团(Kaiser Permanente)旗下的南加州永久医疗机构(Southern California Permanente Medical Group),其“安全网”(Safety Net)项目会定期对其数据库中360万名会员进行问卷调查,从而捕捉到有可能被遗漏的实验室结果及其他数据。 In one of the first uses of the system, a case manager reviewed 8,076 patients with abnormal PSA test results for prostate cancer, and more than 2,200 patients had follow-up biopsies. From 2006 to 2009, 745 cancers were diagnosed among those patients -- and Kaiser had no malpractice claims related to missed PSA tests. 在首次使用该系统的过程中,一位病例管理员查到8,076名病人的前列腺癌PSA检查结果不正常,2,200多名病人随后有做活体组织检查。2006至2009年,这些病人中有745人被诊断患有癌症,而凯泽并未接到有关遗漏的PSA检查的过失起诉。 The program is also being used to find patients with undiagnosed kidney disease, which is often found via an abnormal test result for creatinine, which should be repeated within 90 days. From 2007 to 2012, the system found 7,218 lab orders placed for patients with an abnormal test that had not been repeated. Of those, 3,465 were repeated within 90 days of a notice to patients that they needed a repeat test, and 1,768 showed abnormal results. The majority, 1,624, turned out to be new cases of the disease. 该项目还被用于查找患有未被诊断的肾脏疾病的病人。肾脏疾病通常是通过异常肌酸酐检查结果发现的,并且应在90天内进行复查。2007年至2012年,系统发现有7,218张做异常检查的实验室检查单未进行复查。其中3,465单在通知病人90天内需要复查后进行了复查,1,768人呈现异常结果。最后大多数人,也就是1,624人被诊断为患有肾脏疾病。 Michael Kanter, regional medical director of quality and clinical analysis, says the system enables clinicians to go back #39;as far as is feasible to find all of the errors that we can and fix them.#39; 负责质量和临床分析的区域医学主任迈克尔#12539;坎特(Michael Kanter)说,该系统使得临床医师能够“尽最大可能回去查找并弥补所有的失误”。 Because the disease is slow moving, Dr. Kanter says, people with a five-year-old undiagnosed case may not have been harmed. Likewise, with many early prostate cancers, #39;in many of these cases it doesn#39;t mean harm would have reached the patient,#39; he says. #39;But we don#39;t want patients not to have the information they should have had through some kind of lapse in the system.#39; 坎特士说,由于这种病是慢性病,所以五年没有被诊断出来的人可能并不会有大碍。同样的,他说,对于早期前列腺癌来说,“在很多案例中并不意味着病患已经危及到了病人,但我们不想因为系统里的某种过失导致病人对本应知道的信息不知情”。 Electronic records aren#39;t a panacea, of course, and can even lead to information overload. In a survey of Veterans Administration primary-care practitioners reported last March in JAMA Internal Medicine, more than two-thirds reported receiving more patient-care-related alerts than they could effectively manage -- making it possible for them to miss abnormal test results. 当然,电子纪录并非万应良药,而且还有可能导致信息过载。去年3月,在《美国医学会杂志#12539;内科学》(JAMA Internal Medicine)上发表的对美国退伍军人事务部初诊医师所做的一项调查显示,超过三分之二的医师收到的有关看病的通报数量超过了自己所能有效管理的范围──这就有可能导致他们遗漏异常的检查结果。 Some researchers suggest the best solution isn#39;t to flood doctors with information but to provide a second set of eyes to find things they may have missed. 有研究人员表示,最佳的解决办法并不是把海量的信息塞给医生,而是为他们提供第二双眼睛查找他们有可能遗漏的东西。 The focus now is preventing dangerous delays in follow-ups of abnormal test results. In a pilot program, researchers at the Houston VA developed #39;trigger#39; queries -- a set of rules -- to electronically identify medical records of patients with potential delays in prostate and colorectal cancer evaluation and diagnosis. Records included charts that had no documented follow-up for abnormal findings suspicious for cancer after a certain period, according to the research team#39;s leader, Hardeep Singh, chief of health policy and quality at Michael E. DeBakey VA Medical Center in Houston and an assistant professor of medicine at Baylor College of Medicine. 目前的重点在于防止在异常检查结果的跟进过程中出现危险性延误。在一个试点项目中,退伍军人事务部休斯顿分部的研究人员设计出了“触发”查询,这是一套规则,通过计算机确认在前列腺和结肠直肠癌评估和诊断中可能有延误的病人的病历记录。研究小组负责人哈迪普#12539;辛格(Hardeep Singh)表示,记录包括特定时期后对表明有疑似癌症的异常检查结果无正式跟进记载的图表。辛格是休斯顿Michael E. DeBakey VA Medical医学中心医疗政策及质量主任,以及贝乐医学院(Baylor College of Medicine)医药学助理教授。 The queries were run on nearly 600,000 records of patients seen at one VA facility in 2009 and 2010. Dr. Singh says the use of triggers, which helped find abnormal PSA tests and positive fecal occult blood tests, could detect an estimated 1,048 instances of delayed or missed follow-up of abnormal findings annually and 47 high-grade cancers. 2009年和2010年,在退伍军人事务部下属一家医院就诊过病人的近60万份记录得到了这样的查询。辛格士说,使用“触发”查询帮助找到了异常PSA检查和阳性大便潜血检查,每年可以查到约1,048例异常检查结果的后续跟进被延误或遗漏,以及47例重度癌症。 The VA has funded a randomized trial to test whether an automated surveillance system of triggers can improve timely diagnosis and follow-up for five common cancers. 退伍军人事务部资助了一个随机试验,测试“触发”自动化监测系统是否能改善五种常见癌症的及时诊断和跟进。 #39;This program is like finding needles in a haystack, and we use information technology to make the haystack smaller and smaller so it#39;s easier to find the needles,#39; Dr. Singh says. 辛格士说:“这个项目就像是在干草堆中找针,我们利用信息技术让干草堆变得越来越小,这样就更容易找到针。” More health-care systems are also turning to electronic decision-support programs that help doctors rank possible diagnoses by likelihood based on symptoms and notes in the medical record. In a study of one such system, called Isabel, researchers led by Dr. Graber found that it provided the correct diagnosis 96% of the time when key clinical features from 50 challenging cases reported in the New England Journal of Medicine were entered into the system. The American Board of Internal Medicine is studying how Isabel could be linked to assessments of physician skill and knowledge. 越来越多的医疗系统也开始采用电子决策持程序来帮助医生根据症状和病历笔记为诊断结果的可能性进行排序。在一个名为“伊莎贝尔”(Isabel)的程序的研究中,由格雷伯士带领的研究小组发现,刊登在《新英格兰医学杂志》(New England Journal of Medicine)上的50个疑难案例中的关键临床特征输入系统时,系统96%的情况下都给出了正确的诊断。美国内科学委员会(The American Board of Internal Medicine)正在研究如何将“伊莎贝尔”与医师技能和知识的评估联系起来。 Another system, DXplain, developed at Massachusetts General Hospital in Boston, was shown in a study last year to significantly improve diagnostic accuracy among first-year medical residents. 另外一个名叫DXplain的系统是由波士顿麻省总医院(Massachusetts General Hospital)开发的。去年的一项研究显示,该系统能显著增强第一年住院医师诊断的准确性。 Edward Hoffer, associate clinical professor at Harvard and senior computer scientist at Mass General who leads the DXplain program, says the aim now is to have DXplain #39;push#39; diagnostic suggestions to physicians through an electronic-medical-records system rather than requiring doctors to initiate a query, which some are still reluctant to do. #39;We have to focus our attention on dealing with situations where doctors think they know what the diagnosis is, but they don#39;t,#39; Dr. Hoffer says. 负责DXplain项目的是哈佛大学(Harvard)临床副教授、麻省总医院高级计算机科学家爱德华#12539;霍弗(Edward Hoffer),他说,当前的目标是让DXplain通过电子病例记录系统向医生“推送”诊断建议,而不是要求医生发起查询,有些医生仍然不愿意主动查询。霍弗士说:“我们要把重点放在处理医生自以为知道诊断结果、但事实上不知道的情况。” New devices also hold promise for confirming a diagnosis and avoiding unnecessary tests. A number of companies are rushing to provide aids such as portable diagnostic equipment and lab tests that can analyze tiny samples of blood and other bodily fluids quickly to detect disease. 新设备也有望对确认诊断和避免不必要的检查提供帮助。多家公司正加速提供便携式诊断设备和实验室结果等援助,可以帮助分析微小的血样及其他体液,从而迅速发现疾病。 Consider MelaFind, which came to market in the U.S. in 2011. The device allows dermatologists to noninvasively examine moles as deep as 2.5 millimeters beneath the surface to gauge the level of #39;disorganization,#39; an indicator of irregular growth patterns that are a sign of melanoma, among the deadliest cancers. 以2011年进入美国市场的MelaFind为例。皮肤科医生可使用该设备无创检查在皮下深达2.5毫米处的痣,从而检测“组织破坏”的水平。“组织破坏”的水平可反应不规则生长模式,不规则生长模式是黑色素瘤等最致命癌症的迹象。 New York dermatologist Macrene Alexiades-Armenakas says she uses MelaFind to confirm that a mole is to be removed and prioritize the level of disorganization in multiple abnormal moles. In some cases, when another doctor or the patient has been concerned about a mole, MelaFind supported #39;clinical diagnosis of a benign mole, thereby sparing them a biopsy,#39; she says. 纽约皮肤专家麦克兰纳#12539;亚历克西亚德斯-阿门内卡斯(Macrene Alexiades-Armenakas)说,她用MelaFind实某颗痣是否需要去除,以及对多颗异常痣的“组织破坏”水平进行排序。她说,有时候,当其他医生或病人对某颗痣表示担心时,MelaFind会持“良性痣的临床诊断,从而让他们省去了活体组织检验的程序”。 But such devices will never replace a thorough physical exam with a trained eye and careful follow-up, says Dr. Alexiades-Armenakas: #39;These diagnostic tools are aids to increase our accuracy and adjuncts to good physical diagnosis, not a substitute.#39; 亚历克西亚德斯-阿门内卡斯士说,不过这样的设备永远替代不了全面的体检以及训练有素的眼睛和仔细的后续跟进。她说:“这些诊断工具是提高准确性和好的检体诊断的辅助手段,而不是替代手段。” Some efforts to cut down on errors take a different route altogether -- and try to improve diagnoses by improving communication. 有些尝试减少失误的措施则走的是完全不同的路线──尝试通过改善沟通来改善诊断质量。 For instance, there#39;s a push to get patients more engaged in the diagnostic process, by encouraging them to speak up about their symptoms and ask the doctor, #39;What else could this be?#39; At Kaiser Permanente, a pilot program provides patients with a pamphlet that encourages them to think about and write down their symptoms and what concerns or fears they have, encouraging them to ask specific questions to be sure they understand their diagnosis and the next steps they must take. 例如,有的机构在促使病人在诊断过程中更积极主动,鼓励病人说出自己的症状并且询问医生:“这还会是什么病?”凯泽永久的一个试点项目为病人提供小册子,鼓励他们思考并写下自己的症状以及他们的担忧或恐惧,鼓励他们提出具体的问题,从而确保他们理解自己的诊断结果以及下一步需要采取的步骤。 Medical schools, meanwhile, are teaching doctors to be more receptive to patient input and avoid #39;anchoring,#39; the habit of focusing on one diagnosis and excluding other possible scenarios, and #39;premature closure,#39; not even considering the correct diagnosis as a possibility. 与此同时,医学院也在教导医生们更加虚心听取病人的意见并避免“锚定”,即习惯集中在一种诊断上,不考虑其他可能的情形,还要避免“过早下结论”,即根本不把正确诊断作为一种可能性进行考虑。 The Critical Thinking program at Dalhousie University in Halifax, Nova Scotia, established last year, aims to help trainees step back and examine how biases may affect their thinking. Developed by Pat Croskerry, a physician known for his research on the role of cognitive error in diagnosis, it uses a list of 50 different types of bias that may lead to diagnostic error. 加拿大新斯科舍省哈利法克斯(Halifax)的达尔豪斯大学(Dalhousie University)去年创立了批判性思考项目。该项目旨在帮助学员退一步思考,审视偏误会对自己的思维有何影响。该项目由帕特#12539;克罗斯克里(Pat Croskerry)开发,他是一名以研究诊断过程中认知错误的影响而闻名的医师。项目列出了50种不同种类可能导致诊断失误的偏误。 The program is being integrated throughout four years of the medical school. Students study cases such as a psychiatric patient with shortness of breath who was assumed to be merely having an anxiety attack; doctors overlooked that she was a smoker on birth-control pills, a risk for the blood clot that later traveled to her lung and killed her. 该项目被整合到了达尔豪斯大学医学院的四年制教学中。学生们会学习很多案例,比如呼吸短促的精神病人被认为只是焦虑发作,医生没注意到她是用避药的吸烟者,这导致她体内产生血块,随后血块到了肺里,最终令她丧命。 #39;If we can teach physicians how to think more critically,#39; Dr. Croskerry says, #39;they would be more effective in delivering good care and arriving at the right diagnosis.#39; 克罗斯克里士说:“如果我们教会医生们如何以更批判性的思维思考,他们就会更有效地给病人看病并做出正确诊断。” /201312/2681563. Tim Holmes. Dunalley, Australia. Jan. 4, 2013.2013年1月4日,澳大利亚南塔斯马尼亚沿海小镇达纳利,摄影:蒂姆·霍姆斯On the January 4, 2013, a bush fire swept through our small coastal township of Dunalley in Southern Tasmania. My wife and I and our five grandchildren took refuge in the sea bordering our property as massive columns of fire consumed everything in their path.2013年1月4日,一场野火席卷了南塔斯马尼亚我家所在的沿海小镇达纳利。当时大火所到之处,一片废墟。我妻子和五个孙儿只能在浅海边处避难。The grand children had lived next door to us in a beautiful, sun-filled timber farmhouse. It had a picket-fenced garden strewn with children’s toys, sandpits and colorful flowers. There was a pathway that ran through the trees to an old wooden boatshed and jetty where the children would often play.我的孙儿们原来住在我家旁边一所美丽、阳光的木屋。尖木桩做篱笆的花园里到处都是他们的玩具、沙坑和鲜花。一条小路穿过树林通向一所古老的木头船和防波堤,他们常在那儿玩耍嬉戏。On that day the jetty became our shelter, the water was cold and the fire was intensely hot on our faces but the biggest problem was the lack of air to breathe. We found a shallow area of breathable air between the toxic smoke and the water.那天防波堤成为我们的避难地,海水刺骨冰凉,大火却灼烧着我们的脸庞,但是最大的问题是缺氧。我们在呛人的烟雾和水之间争取着一小块可供呼吸的空气。The fire burned right down to the water’s edge and the jetty itself caught on fire, but we were able to put it out. We spent two and half hours under the jetty and I took the photograph with my wife’s iPhone to send by text message to our daughter so that she could see that we were all together. Our lives were spared but houses and all possessions were lost.大火直接烧到了水面,防波堤也着了火,但是我们设法把火扑灭。在防波堤下我们待了两个半小时,我用妻子的苹果手机拍了照发给女儿,让她看到我们都在一起。我们得救了,但是房子等财产都失去了。 /201312/269451The Most Awkward Maternity Photos Ever史上最尴尬的妇照片Maternity photos are typically taken to celebrate the new life that is being welcomed into the world.怀妈妈的照片被用来庆祝迎接新生命的到来,倍受人们喜爱。Most maternity photo shoots are filled with lots of thoughtfulness, love and a meaningful theme, if there even is one, but there will always be those people who just dare to be different.正常情况下,这些照片大多数都充满了温暖,爱意和有意义的主题,但是总是有人敢不走寻常路。Check out this roundup of the most awkward, maternity photos from World Wide Interweb that will either make you laugh out loud or force you to wonder ;What were these people thinking?;如这张来自全球互联网尴尬的照片,这个妈妈让你不得不大笑,惊奇的猜:“这些人到底在想什么?” /201409/328993

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