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1、一、英译汉A30-year-oldwomanpresentedtotheofficewithacomplaintofintermittentepisodesofpain,stiffness,andswellinginbothhandsandwristsforapproximately1year.Theepisodeslastedforseveralweeksandthenresolved.Morerecently,shenoticedsimilarsymptomsinherkneesandankles.Joint
2、spainandstiffnessweremakingitharderforhertogetoutofbedinthemorningandwereinterferingwithherabilitytoperformherdutiesatwork.Thejointstiffnessusuallylastedforseveralhoursbeforeimproving.Shealsoreportedmalaiseandeasyfatigabilityforthepastfewmonths,butshedeniedha
3、vingfever,chills,skinrashes,andweightloss.Physicalexaminationrevealedawell-developedwoman,withbloodpressure120/70mmHg,heartrate82bpm,andrespiratoryrate14breathsperminute.Herskindidnotrevealanyrashes.Herhead,neck,cardiovascular,chest,andabdominalexaminationswe
4、renegative.Therewasnohepatosplenomegaly.Thejointexaminationrevealedthepresenceofbilateralswelling,rednessandtendernessofmostproximalinterphalangeal(PIP)joints,thewrists,andknees.二、汉译英你可能会出现下列症状和体征:1、关节肿胀、疼痛、局部发热；2、晨僵，常超过1个小时；3、手臂包块(类风湿结节)；4、疲劳或体重减轻。早期类风湿关节炎以影
5、响手足的小关节常见，如掌指关节、近端指间关节。随病情发展，症状常蔓延至腕、肘、肩、膝和踝部。大多数情况下，类似的关节症状会在身体两侧出现，我们称之为“对称性”。类风湿关节炎的严重程度因患者不同有所差异，而同一患者的病情也常反复。最终可导致关节变形和功能受限。三、阅读写作Adult-onsetStill’sdisease(AOSD)isanuncommonsystemicinflammatorydiseaseofunknownaetiology.Althoughitsclinicalpicturetendstobe
6、veryheteroge-neous,ittypicallypresentswithspikingfever,arthritisorarthralgia,anevanescentrashandleukocytosis.Upto80%ofAOSDcasescanbecontrolledwithcorticosteroids;however,reportsoncasesunresponsivetocortico-steroids,conventionaldiseasemodifyingdrugsandbiolog-i
7、calagents,includinganti-IL1inhibitors,areemerging.WepresentacaseofAOSDwithseverepoylarthritisunrespon-sivetocorticosteroids,methotrexate,anakinraandetaner-cept,butsuccessfullystabilisedwithahumanizedmonoclonalanti-IL-6receptorantibody,tocilizumab.A35-yearoldm
8、anpresentedwithafeverofupto40°C,severearthralgiaandmyalgia,andapalpablehepatomeg-aly.Laboratorytestsshowedleukocytosis(upto23×109/l;normal,4–10×109/l;16.5×109/lgranulocytes),elevatedliver
