：致命的军团杆菌

　　Legionnaires disease is a serious and sometimes fatal form of pneumonia. Legionnaires disease is caused by infection with Legionella bacteria which are found naturally in the environment and thrive in warm water and warm damp places. Man-made water systems sometimes provide environments that let Legionella bacteria increase to large numbers. These man-made systems include showers, spa pools, fountains, and air conditioning cooling towers. People usually get Legionnaires disease by breathing in mists that come from a water source contaminated with Legionella bacteria.

　　An estimated 8,000 to 18,000 people get Legionnaires disease in the United States each year. Some people can be infected with Legionella bacteria and have mild symptoms or no illness at all. Patients with Legionnaires disease usually have fever, chills, and a cough, which may be dry or may produce sputum. Some patients also have muscle aches, headache, tiredness, loss of appetite, and, occasionally, diarrhea. From the time of infection with Legionella bacteria, it takes 2-10 days for symptoms to appear. In most cases, symptoms begin after 5-6 days. Legionnaires disease is treated with antibiotics, such as erythromycin. The earlier that treatment is begun, the better the outcome.

　　The first known outbreak of Legionnaires disease was in Philadelphia, USA, in 1976. A total of 221 people contracted the disease and 34 died. Most of those that died were Legionnaires and thats how the disease got its name. The second largest outbreak was at the Stafford hospital in England in 1985; a total of 101 people contracted the disease and 28 died.

　　军团病是一种非常严重的、有时可以致命的肺炎。军团病是由军团杆菌引起，这种细菌产生在自然环境中，在温水里及潮热的地方蔓延。人工供水系统有时也能为军团杆菌的大量繁殖提供生存环境。这些系统包括淋浴器、矿泉池、喷泉以及空调设备的冷却水塔。人们通常是由于呼吸了被军团杆菌污染的水源散发的水雾而传染上军团病的。

　　据估计，在美国每年都有国每年都有8000~18000人感染上军团病。有些军团病感染者所表现出来的症状比较温和，甚至根本就没有得病的迹象。军团病患者通常有发烧、畏寒及干咳或咳痰等表现。部分患者还有肌肉疼痛、头痛、疲劳、食欲不振及偶尔腹泻等症状。这种病的潜伏期约为的潜天。许多病例表明，出现症状需要状需要5~6天的时间。军团病可以用红霉素等抗生素进行治疗，越早治疗效果越好。

　　军团病已知的首次爆发是在发是1976年美国费城，221人感染疾病，其中死亡34人。由于大多的死者都是军团成员，因此称为军团病。该病的第二次大爆发是1985年在英国的斯塔福德医院。这次101个被感染者中有28人死亡。

　　：循证医学

　　Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research, By individual clinical expertise we mean the proficiency and judgment that individual clinicians acquire through clinical experience and clinical practice. By best available external clinical evidence we mean clinically relevant research, often from the basic sciences of medicine, but especially from patient centered clinical research into the accuracy and precision of diagnostic tests (including the clinical examination), the power of prognostic markers, and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens, External clinical evidence both invalidates previously accepted diagnostic tests and treatments and replaces them with new ones that are more powerful, more accurate, more efficacious, and safer.

　　循证医学是一种明确、谨慎、合理运用最佳依据以决定个体患者的医学方法。循证医学实践意味着综合个人临床专业知识与系统研究中可得的最佳外部临床依据。所谓个人临床专长是指临床医师本人从临床经验与临床实践中所获得的熟练程度与判断力。而最佳外部临床依据是指临床相关研究，一般来自基础医学研究，尤其是针对患者的临床研究转化为准确的诊断试验(包括临床检查)、预后标志效应、治疗、康复及预防疗法的效果与安全性。外部临床依据旨在废除过去既定的诊断试验与疗法，并代之以更有力、更准确、更有效、更安全的新方法。