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AaronMorris_2020F-_你的身体如何成为自己的诊断实验室？——亚伦_莫里斯_-
[SHAPE YOUR FUTURE] [塑造你的未来]
(Slam) Ow! （砰！） 我的妈！
As anyone who's stubbed a toe in the dark or spent an hour searching for their keys knows we're often limited by what we can or cannot see. 在黑暗里撞到过脚趾 或是曾花一小时找钥匙的人知道, 我们时常受限于 自身看到或看不到的东西。
In fact, even our own bodies can be black boxes. 实际上,甚至我们的身体, 也可以是黑匣子。
Today, I want to take you through a vision of health care that scientists and engineers, myself included, are building. 今天,我想带你了解 科学家和工程师们,包括我, 正在构建的一个医疗保健愿景。
stubbed:adj.多梗株的; v.使…碰踢; toe:n.脚趾;鞋头;v.用脚趾踩;用脚尖踢; limited:adj.有限的; n.高级快车; v.限制; (limit的过去分词和过去式) vision:n.视力;美景;幻象;想象力;v.想象;显现;梦见; health care:n.卫生保健;
We are creating a diagnostic lab inside your body that can provide a continuous analysis of your health so that we can better see what's happening in patients . 我们正在创造一个 位于身体内部的诊断实验室, 这个实验室 可以持续提供健康分析报告, 从而我们能更好地了解病人的情况。
Currently , if someone is sick, we may diagnose them by using a biopsy to bring disease tissue outside the body where we can see it. 最近,如果一个人病了, 我们或许可以通过活检 进行诊断—— 也就是将病变组织取到身体外 我们能看到的地方。
We do this if we suspect , for instance , that a growth might be cancerous . 如果有怀疑病因,才会进行活检, 比如细胞生长可能出现癌变。
diagnostic:adj.诊断的;特征的;n.诊断法;诊断结论; continuous:adj.连续的,持续的;继续的;连绵不断的; analysis:n.分析;分解;验定; patients:n.接受治疗者,病人;(patient的复数) Currently:adv.当前;一般地; diagnose:vt.诊断;断定;vi.诊断;判断; biopsy:n.活组织检查;切片检查法;v.活组织检查;切片检查法; disease:n.病,[医]疾病;弊病;vt.传染;使…有病; tissue:n.纸巾,手巾纸;(人、动植物细胞的)组织; suspect:n.犯罪嫌疑人;v.怀疑;不信任;adj.可疑的; instance:n.实例;情况;建议;v.举...为例; cancerous:adj.癌的;生癌的;像癌的;
Unfortunately , this approach can't work all the time because of two major problems. 不幸的是,由于以下两个主要问题, 这种方法并不通用。
First, some tissues , like brains or spinal cords , can't be routinely biopsied . 首先,大脑或脊髓等组织 是无法进行常规活检的。
And second, doctors often don't know which tissue is causing the problem, so they don't know what to biopsy. 其次,医生通常不知道 哪个组织出了问题, 因此他们无法判断 针对哪个组织进行活检。
Unfortunately:adv.不幸地; approach:n.方法;路径;v.接近;建议;着手处理; tissues:n.纸巾,手巾纸;(人、动植物细胞的)组织;(tissue的复数) spinal:adj.脊髓的;脊柱的;针的;脊骨的;尖刺的;n.脊椎麻醉; cords:n.(结实的)粗线,细绳;灯芯绒裤子;(cord的复数) routinely:adv.例行公事地;老一套地; biopsied:v.活组织检查;切片检查法;(biopsy的过去式和过去分词)
So far, we've dealt with these issues using external medical tests, like MRIs or blood tests. 时至今日,为解决上述问题, 我们借助体外测试, 例如磁共振成像或血液测试。
These provide a broad overview of the health of a patient, but they can't see the molecular and cellular changes that occur within tissues, and they certainly can't provide enough information to proactively treat patients before symptoms develop. 这些测试可以为病人健康 提供一个宽泛的概览, 但是,它们无法检测到 并且无法在症状出现之前 给予足够的信息用以积极治疗。
external:n.外部;外观;形式;外部情况;adj.外部的;外面的;外界的;外来的; overview:n.[图情]综述;概观; molecular:adj.[化学]分子的;由分子组成的; cellular:adj.细胞的;多孔的;由细胞组成的;n.移动电话;单元; occur:v.发生;出现;存在于;出现在; proactively:adv.前摄地;主动地; treat:v.治疗;处理;招待;款待;n.款待;乐事;乐趣; symptoms:n.症状;征候;征兆;(symptom的复数)
This is unfortunate because it's these invisible changes that ultimately cause disease. 这很不幸, 因为这些看不见的变化 最终会导致疾病。
Our inability to measure these changes results in a disparity between what we can see on a test and what we know is happening in patients. 我们对测量这些变化的束手无策 造成了差异—— 和我们所了解的病人症状的差异。
Let's take multiple sclerosis as an example. 让我用多发性硬化症（MS）举例。
invisible:adj.看不见的;n.看不见的人或物; ultimately:adv.最终;最后;归根结底;终究; inability:n.无能力;无才能; disparity:n.不同;不一致;不等; multiple sclerosis:n.多发性硬化;
In MS, which is an autoimmune disease, the immune system attacks two specific tissues: the brain and the spinal cord , resulting in damage and in some cases, paralysis . MS 是一种自身免疫性疾病, 免疫系统会攻击两个特定组织: 大脑和脊髓, 因此造成损害, 有些病例则致瘫痪。
Now, we obviously can't catch MS by routinely biopsying people's brains, where there would be abundant and active disease-inducing cells. 现在,我们显然无法通过对人脑 进行常规活检来诊断 MS , 即使在人脑处可能聚集着 大量且活跃的病变细胞。
And we can't catch it using a blood test because the MS-inducing cells are so rare and inactive in the blood that we simply can't see them. 而且我们无法用血液测试来诊断 MS , 因为血液中含有的 MS 病变细胞 很少且不活跃, 我们单纯就看不到它们。
autoimmune:adj.自身免疫的;自体免疫的; immune system:n.免疫系统; specific:adj.特殊的,特定的;明确的;详细的;[药]具有特效的;n.特性;细节;特效药; spinal cord:n.脊髓; paralysis:n.麻痹;无力;停顿; biopsying:n.活组织检查;活组织切片检查;切片检查法; abundant:adj.丰富的;充裕的;盛产; blood test:n.验血;vi.作血液检查; inactive:adj.不活跃的;不活动的;怠惰的;闲置的;
Even brain imaging technologies like MRI can't provide the information we need to be proactive about MS. 即使磁共振成像检查这类脑成像技术 也无法提供充足的信息 让我们积极预防 MS 。
So we need to rethink how we see. 所以我们需要重新思考“看”的方式,
My coworkers at the University of Michigan and I decided to do just that. 我和我在密歇根大学的同事 就决定做这件事。
Instead of taking an outside-in approach to diagnostics , we're taking an inside-out approach. 与前面说的 从外到内的诊断方式不同, 我们正在使用由内至外的方式。
imaging:n.[物]成像;造像;v.反映;想像;作…的像;象征;(image的现在分词形式) technologies:n.技术;科技(technology的复数); rethink:v.重新考虑;再想;n.重新考虑;反思;新想法; coworkers:n.同事;合作人;(coworker的复数形式) Michigan:n.密歇根;美国密歇根州; diagnostics:n.诊断学(用作单数);
We are creating implantable sites that have similarities to other sites in the body, and will improve our vision by giving us real-time access to molecular and cellular information about diseased tissues. 我们正在创造可植入的部位—— 它们和身体的其它部位 具有相似性, 并能通过对病变组织的 分子和细胞信息的实时访问
These insights will enable us to predict the onset of disease and even identify therapies likely to work in an individual patient. 对于这些信息的洞察 能使我们预测发病时间, 甚至分辨出对某一位病人 哪种治疗手段可能有效。
So what does this inside-out approach look like? 所以这种由内至外的方法 到底是怎样的？
implantable:adj.可移植的,可植入的; sites:n.网站(site的复数);遗址,举办地点;v.使...位于(site的单三形式); similarities:n.相仿性;类似性;相像处;(similarity的复数) improve:v.改进;改善; real-time:adj.实时的;接到指示立即执行的; diseased:adj.不健全的;患病的;病态的;v.使生病;传染;(disease的过去式和过去分词) insights:n.洞察力;眼力;深刻见解(insight的复数); enable:v.使能够;使有机会;使成为可能;使可行; predict:v.预报;预言;预告; onset:n.开始,着手;发作;攻击,进攻; identify:v.识别:鉴定:确认:发现: therapies:n.治疗方法(therapy复数形式); individual:n.个人;有个性的人;adj.单独的;个别的;
Step one is to engineer new tissues just under the skin. 第一步就是在皮肤下 设计新的组织。
These tissues have similarities to other inaccessible sites in the body, like the brain or the lungs. 这些新组织和身体中其它 无法接触到的部分,如大脑或肺部, 有着相似之处。
By implanting a porous plastic disk made of FDA-approved biomaterials , 通过植入由 FDA 批准的生物材料 制成的多孔塑料盘,
I can harness the body's natural responses to allow cells to migrate into the disk, survive at the site and form a tissue. 我可以利用身体的自然反应 把细胞转移到塑料盘中, 在盘中得以生存并形成组织。
inaccessible:adj.难达到的;难接近的;难见到的; implanting:n.移植;v.移植;灌输(implant的ing形式); porous:adj.多孔渗水的;能渗透的;有气孔的; biomaterials:n.[材]生物材料(biomaterial的复数); harness:vt.治理; n.马具; responses:n.回答,答复;反应;响应;(response的复数) migrate:vi.移动;随季节而移居;移往;vt.使移居;使移植;
Eventually , we're left with an engineered tissue with integrated immune cells, just the cells we need for diagnosis . 最终,我们得到了 一个携带集成免疫细胞的 工程组织, 只是我们诊断所需的细胞。
Although these tissues are complex and chronically inflamed , they're also innocuous and after a few weeks, nearly imperceptible . 尽管这些组织十分复杂 且长期处于发炎状态, 但它们是无害的, 在植入的几周后 几乎无法察觉到它们的存在。
Our engineered tissues contain information not present in the blood, and they can help bridge the gap between what we can see on a traditional test and cellular changes we know occur in disease. 我们的工程组织 可以检测到血液无法显示的信息, 并且能填补 我们在传统测试中看到的 以及我们所知晓的细胞病变的差异。
Eventually:adv.最后,终于; integrated:adj.综合的; v.整合; (integrate的过去式和过去分词) diagnosis:n.诊断; complex:adj.复杂的;合成的;n.复合体;综合设施; chronically:adv.长期地;慢性地;习惯性地; inflamed:adj.发炎的;红肿的;v.使发炎(inflame的过去分词);使燃烧;使火红;激起; innocuous:adj.无害的;无伤大雅的; imperceptible:adj.感觉不到的;极细微的; gap:n.差距;间隙;缺口;间隔;v.使豁裂;豁开; traditional:传统的,惯例的,
Step two is to read this signal. 第二步,就是阅读这个信号。
Currently, I could take a biopsy of my engineered site and analyze it because I made them accessible just under the skin. 因为我把这些工程组织 就植在皮肤之下, 所以我可以在这个部位 做活检并进行分析。
But it would certainly be better if we could incorporate and read a sensor noninvasively. 但当然如果我们能使用 无创感应器并读取它的数字会更棒。
Within the next decade, rapidly converging technologies could enable diagnosis at such an implant by harnessing simple detectors , like a blood pressure cuff or smartwatch does now. 在未来 10 年内, 快速发展的融合技术 可以利用简单的检测器 促进对上述的植入方式的诊断, 好比如今的 血压袖带和智能手表,
analyze:v.对…进行分析,分解(等于analyse); incorporate:vt.包含,吸收; vi.合并; adj.合并的; sensor:n.传感器; converging:n.合并,会聚;adj.会聚的,收敛;v.聚合,集中于一点(converge的现在分词); harnessing:v.给(马等)装上挽具(harness的现在分词);治理,利用; detectors:n.探测器;侦测设备(detector的复数); blood pressure:n.[医]血压; cuff:n.袖口,裤子翻边; vt.给…上袖口; vi.殴斗,拳击; smartwatch:n.智能手表;
The mechanisms for diagnosing and monitoring disease could be as simple as opening an app, like Candy Crush on your phone. 诊断和监测疾病的机制 可以和打开你手机上的 应用程序一样简单。
Step three is to harness the huge array of knowledge in fields like engineering and material science to improve these implants and our ability to read their data. 第三步,利用广泛的 工程和材料科学等领域的知识, 来改进这些植入设备 以及我们从中读取信息的能力。
mechanisms:n.机制;[机]机构(mechanism的复数);机械;[机]机构学; diagnosing:n.诊断;v.诊断(diagnose的现在分词); Crush:v.压碎;弄皱,变形;使…挤入;n.粉碎;迷恋;压榨;拥挤的人群; array:n.数组,阵列;排列,列阵;大批,一系列;衣服;v.排列,部署;打扮; engineering:n.工程;工程学;v.密谋策划;设计制造;改变…的基因;(engineer的现在分词) implants:n.移植物;埋植剂(implant的复数);v.灌输(implant的第三人称单数);
Eventually, tens, if not hundreds of individual engineered tissues with integrated sensors may be implantable with a single application . 最终,如果不是上百个, 也有几十个个性化携带集成感应器的 工程组织 或许可以通过 一个简单的应用程序植入。
Now, this approach to diagnosis is unconventional , to be sure , but it is robust . 现在,可以确定的是 这个诊断方法非常创新, 但也是稳健的。
So far, my colleagues and I have used it to diagnose models of metastatic cancer, type 1 diabetes , multiple sclerosis and organ transplant rejection . 至今,我和我的同事 已经用这个方法 来诊断各种疾病的模型—— 例如转移性癌症、 1 型糖尿病、 多发性硬化症和器官移植排斥。
sensors:n.[自]传感器,感应器;感测器(sensor的复数); application:n.应用;申请;应用程序;敷用; unconventional:adj.非常规的;非传统的;不依惯例的; to be sure:诚然;的确;哎呀(表惊奇); robust:adj.强健的;健康的;粗野的;粗鲁的; colleagues:n.同事;同行(colleague的复数); metastatic:adj.(癌细胞的)转移性的;变形的;新陈代谢的; diabetes:n.糖尿病;多尿症; organ:n.[生物]器官;机构;风琴;管风琴;嗓音; transplant:v.移植;迁移;使移居;n.移植;移居者; rejection:n.抛弃;拒绝;被抛弃的东西;盖帽;
But this is just the beginning of what we can see. 但这只是我们所“看”的开端。
With continuous improvements , we will be able to truly create a diagnostic lab inside your body that provides a continuous analysis of your health. 随着方法的不断改进, 我们将能真正地创建 一个可以提供连续健康报告的 体内诊断实验室。
By changing how we see what's going wrong in patients, we will be able to diagnose and treat diseases better and faster than ever before. 通过改变我们看到患者问题的方式, 我们便可以达到一个前所未有的 诊断和治疗疾病的质量和速度。
If you're willing to rethink how you see, you may be surprised what comes into view. 如果你愿意重新思考“看”的方式, 你或许会为自己看到的风景 感到惊讶。
improvements:n.改善;改进;改善的事物;(improvement的复数) diseases:n.[医]病(disease的复数);[医]疾病;[植保]病害;疾病种类;
Thank you. 谢谢。