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KevinStone_2010U-_关节置换术的生物未来_
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| So let me just start with my story. |
现在开始讲述我的故事 |
| So I tore my knee joint meniscus cartilage playing soccer in college. |
在大学踢足球时 我将我的半月板软骨撕裂 |
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joint:n.关节; adj.共同的; v.连接,贴合; meniscus:n.[解剖]半月板;弯月面;新月形物; cartilage:n.软骨;
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| Then I went on to tear my ACL, the ligament in my knee, and then developed an arthritic knee. |
随后,我的前十字韧带也被撕裂了 但不久之后,人工膝盖出现了 |
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ligament:n.韧带;纽带,系带; arthritic:adj.关节炎的;n.[外科]关节炎患者;
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| And I'm sure that many of you in this audience have that same story, and, by the way , I married a woman who has exactly the same story. |
我确信在座的很多听众都经历过此类的事情 顺便说一句,我结婚了 我的妻子也经历过同样的事情 |
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by the way:顺便说一下;
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| So this motivated me to become an orthopedic surgeon and to see if I couldn't focus on solutions for those problems that would keep me playing sports and not limit me. |
这些事情促使我成为一名整形外科医生 我希望能够解决如何让我们 如何可以无拘束的运动问题 |
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motivated:adj.有动机的; v.使产生动机; orthopedic:adj.整形外科的(等于orthopaedic); surgeon:n.外科医生;
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| So with that, let me just show you a quick video to get you in the mood of what we're trying to explain. |
带着这个问题,我先让我们看一个简短的视频 让它带着你们了解我们所希望解决的问题 |
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in the mood of:有心情做;
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| Narrator : We are all aware of the risk of cancer , but there's another disease that's destined to affect even more of us: arthritis . |
视频旁白:我们都很关注癌症的风险 但是还有另一种疾病 能够比癌症还要影响更多的人—关节炎 |
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Narrator:n.讲述者;(电视节目中的)幕后解说员;旁白员; cancer:n.癌症;恶性肿瘤; disease:n.病,[医]疾病;弊病;vt.传染;使…有病; destined:adj.注定的;命定的;去往…的;v.注定;(destine的过去式和过去分词) arthritis:n.[外科]关节炎;
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| Cancer may kill you, but when you look at the numbers, arthritis ruins more lives. |
癌症也许会让你死亡,但关节炎 会毁掉更多人的生活 |
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ruins:n.遗迹(ruin的复数形式);废墟;v.毁灭(ruin的三单形式);
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| Assuming you live a long life, there's a 50 percent chance you'll develop arthritis. |
假设你可活得很长命,你将有50%的概率 患上关节炎 |
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Assuming:conj.假设…为真; adj.傲慢的; v.假定; (assume的现在分词)
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| And it's not just aging that causes arthritis. |
这并不是因为年老而引起的疾病 |
| Common injuries can lead to decades of pain, until our joints quite literally grind to a halt . |
常见的损伤可以导致数十年的伤痛 直到关节经过长时间磨损而停止工作 |
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injuries:n.伤害,损伤;挫伤;(injury的复数) joints:n.关节; v.接合,联合; (joint的第三人称单数和复数) literally:adv.按字面:字面上:确实地: grind to a halt:慢慢停止;
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| Desperate for a solution , we've turned to engineering to design artificial components to replace our worn-out body parts, but in the midst of the modern buzz around the promises of a bionic body, shouldn't we stop and ask if there's a better, more natural way? |
我们迫切地想得到解决的方法,随之我们转向工程学 以来设计人造关节 来替代我们早已磨损且不堪重负的身体器官 但在研究新方法时 都是围绕着仿生学这一前提 我们是否应该暂时停下脚步看看有没有更好、更自然的方法 |
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Desperate:adj.不顾一切的;令人绝望的;极度渴望的; solution:n.解决方案;溶液;溶解;解答; 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) artificial:adj.人造的;仿造的;虚伪的;非原产地的;武断的; components:n.部件;组件;成份(component复数); worn-out:adj.磨破的;穿旧的;不能再用的; midst:n.当中,中间;prep.在…中间(等于amidst); buzz:n.嗡嗡声; v.发出嗡嗡声; bionic:adj.仿生学的;利用仿生学的;
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| Let's consider an alternative path. |
让我们一起考虑一个替代方法 |
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alternative:adj.供选择的;选择性的;交替的;n.二中择一;供替代的选择;
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| What if all the replacements our bodies need already exist in nature, or within our own stem cells? |
如果我们将我们身体某一部分的需要替换为 已经存在的生物器官 又或者用我们自己的干细胞培养会怎么样 |
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What if:如果…怎么办? replacements:n.替代,替换件;补充; stem:n.花草的茎或梗;高脚酒杯的脚;烟斗柄;词干;v.阻止;封堵;遏止;
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| This is the field of biologic replacements, where we replace worn-out parts with new, natural ones. |
这就是生物置换领域 它将我们已磨损的器官替换为新的、自然的器官 |
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biologic:adj.生物的;生物学的;
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| Kevin Stone: And so, the mission is: how do I treat these things biologically ? |
Kevin Stone:任务就是 我们如何用生物学知识处理这类事情 |
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mission:n.使命,任务;代表团;布道;v.派遣;向…传教; treat:v.治疗;处理;招待;款待;n.款待;乐事;乐趣; biologically:adv.生物学上,生物学地;
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| And let's talk about both what I did for my wife, and what I've done for hundreds of other patients . |
下面然我们谈谈,我对我的妻子 以及数以百计的病人的治疗方法 |
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patients:n.接受治疗者,病人;(patient的复数)
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| First thing for my wife, and the most common thing I hear from my patients, particularly in the 40- to 80-year-old age group , 70-year-old age group , is they come in and say, "Hey, Doc, isn't there just a shock absorber you can put in my knee? |
这是从我的妻子那里最先听到的 以及从我的患者口中 尤其是那些40-80岁年龄组中的70岁年龄组 最常听到的是 嘿,医生,我的膝盖中的放得只是一个减震器对吗 |
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particularly:adv.特别地,独特地;详细地,具体地;明确地,细致地; age group:n.年龄组;年龄段; shock absorber:n.阻尼器;
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| I'm not ready for joint replacement." |
我并没有做好换关节的准备 |
| And so for her, I put in a human meniscus allograft donor right into that [knee] joint space. |
对我的妻子来说我对她进了半月板手术 在膝盖连接处行了同种异体的植入 |
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allograft:n.[病理]同种异体移植物; donor:n.捐赠者;供者;赠送人;adj.捐献的;经人工授精出生的;
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| And [the allograft] replaces [the missing meniscus]. |
这种异基因移植物替换了缺失的半月板 |
| And then for that unstable ligament, we put in a human donor ligament to stabilize the knee. |
随后对原来的韧带进行替换 我们放入了其他人捐赠的韧带 以使她的膝盖得到稳定的支撑 |
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unstable:adj.不稳定的;变化莫测的;(行为、情绪)反复无常的 stabilize:vt.使稳固,使安定;vi.稳定,安定;
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| And then for the damaged arthritis on the surface, we did a stem cell paste graft, which we designed in 1991, to regrow that articular cartilage surface and give it back a smooth surface there. |
第三,则是对关节表面的损坏 我们进行了干细胞黏贴移植 这个则是我们在1991年设计出来的 可以使得关节软骨组织再生 使他们还原为光滑的表面 |
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stem cell:干细胞; paste:v.粘贴; n.面团; adj.人造的; regrow:vt.再生;重新长出;vi.重新生长;
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| So here's my wife's bad knee on the left, and her just hiking now four months later in Aspen , and doing well. |
左边这个是我爱人原已损坏的膝盖 但是看右边,她在四个月后的Aspen 已经可以徒步旅行了,并且一切都很好 |
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Aspen:adj.山杨的;类似白杨的;颤抖的;n.山杨;
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| And it works, not just for my wife, but certainly for other patients. |
手术成功了,但并这个成功并不仅仅局限于我的爱人,其他患者也同样受益 |
| The girl on the video, Jen Hudak, just won the Superpipe in Aspen just nine months after having destroyed her knee, as you see in the other image -- and having a paste graft to that knee. |
视频中的女孩,Jen Hudak 刚刚在Aspen赢得了雪道滑雪 而这发生在她膝盖损坏后的九个月 正如你们看到视频 她有着经过干细胞修复过的膝盖 |
| And so we can regrow these surfaces biologically. |
所以我们从生物学的角度将是可以修复关节表面的 |
| So with all this success, why isn't that good enough, you might ask. |
所以经过了这些的成功 你们也许会问为什么还不够好呢 |
| Well the reason is because there's not enough donor cycles. |
这是因为还没有足够的数据来支撑这个实践 |
| There's not enough young, healthy people falling off their motorcycle and donating that tissue to us. |
没有足够健康的年轻人 从他们的模特车上摔倒 并且将他们的器官捐赠给我们 |
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donating:v.捐赠,赠送;(donate的现在分词) tissue:n.纸巾,手巾纸;(人、动植物细胞的)组织;
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| And the tissue's very expensive. |
并且这个手术十分昂贵 |
| And so that's not going to be a solution that's going to get us global with biologic tissue. |
这就是这个办法没有得到普及的原因 也使得我们将事业放眼于全球去寻找合适的生物组织 |
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global:adj.全球的;总体的;球形的;
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| But the solution is animal tissue because it's plentiful , it's cheap, you can get it from young, healthy tissues , but the barrier is immunology . |
随后我们用动物组织进行替代 因为生物组织可以随处找到,并且价格也不高 并且可以得到年轻、健康的生物组织 但是,该种方法的障碍就是免疫问题 |
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plentiful:adj.丰富的;许多的;丰饶的; tissues:n.纸巾,手巾纸;(人、动植物细胞的)组织;(tissue的复数) barrier:n.屏障;障碍;障碍物;关口;v.用栅围住; immunology:n.[免疫]免疫学;
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| And the specific barrier is a specific epitope called the galactosyl, or gal epitope. |
这种特别的障碍是由 特殊的抗原决定基所导致 这种抗原决定基就是”半乳糖基“ |
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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; epitope:n.[免疫]表位;抗原决定部位;抗原决定基;
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| So if we're going to transplant animal tissues to people, we have to figure out a way to get rid of that epitope. |
所以,如果我们想将动物组织移植到人类的身体上 则必须找到一种方法去除掉半乳糖基 |
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transplant:v.移植;迁移;使移居;n.移植;移居者;
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| So my story in working with animal tissues starts in 1984. |
所以我的工作 从1984年开始研究动物组织 |
| And I started first with cow Achilles tendon , where we would take the cow Achilles tendon , which is type-I collagen , strip it of its antigens by degrading it with an acid and detergent wash and forming it into a regeneration template . |
我首先从 牛的跟腱开始 我们可以将牛的跟腱中的 一种胶原质 从其抗原中分离 进过一种酸和清洁剂的冲洗降解 使其成为一种再生模板 |
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Achilles tendon:n.[解]跟腱; collagen:n.[生化]胶原,胶原质; strip:n.带; v.夺; adj.脱衣舞的; antigens:n.[免疫]抗原(antigen的复数); degrading:adj.降低身份的; v.降低…身份; (degrade的现在分词) detergent:n.清洁剂;去垢剂; regeneration:n.[生物][化学][物]再生,重生;重建; template:n.模板,样板;
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| We would then take that regeneration template and insert it into the missing meniscus cartilage to regrow that in a patient's knee. |
我们随后可以将这个再生模板 插入半月板软骨撕裂处 让其在患者的膝盖再生 |
| We've now done that procedure , and it's been done worldwide in over 4,000 cases, so it's an FDA-approved and worldwide-accepted way to regrow the meniscus. |
直到现在,通过使用这种方法 我们已经在全球范围内治愈了逾4000位患者 所以这是一个可以被美国食品及药物管理局以及全世界所接受的 膝盖半月板再生法 |
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procedure:n.步骤;手术;(商业、法律或政治上的)程序; worldwide:adj.全世界的;adv.在世界各地;
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| And that's great when I can degrade the tissue. |
而且当我们能够降解生物组织时将会更好 |
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degrade:v.降低…身份;使受屈辱;(使)退化,降解;分解;降低;
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| But what happens for your ligament when I need an intact ligament? |
但是,当你需要一个完整的韧带时 |
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intact:adj.完整的;原封不动的;未受损伤的;
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| I can't grind it up in a blender . |
我不能将其在搅拌机里将其磨碎 |
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blender:n.(电动)食物搅拌器;
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| So in that case, |
所以,这种情况下 |
| I have to design -- and we designed with Uri Galili and Tom Turek -- an enzyme wash to wash away, or strip, those galactosyl epitopes with a specific enzyme. |
我必须进行研究设计,与我一起设计的还有Uri Galili和Tom Turek 我们一起设计一种酶洗之法 用一种特殊的酶 以洗掉或脱离掉 那些半乳糖抗原决定基 |
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enzyme:n.[生化]酶; epitopes:[免疫]表位;
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| And we call that a "gal stripping " technique . |
这种酶素洗法我们称之为“半乳糖脱离”技术 |
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stripping:v.脱光衣服;表演脱衣舞;除去;(尤指)剥光;(strip的现在分词) technique:n.技巧,技术;手法;
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| What we do is humanize the tissue. |
我们所做的就是将组织做的更加人性化 |
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humanize:vt.教化;赋予人性;使通人情;vi.变为有人性;有教化;
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| It's by gal stripping that tissue we humanize it (Laughter), and then we can put it back into a patient's knee. |
用半乳糖脱离法 我们可以将其处理的更加接近人的组织 然后我们就可以 将这个组织放回患者的膝盖处 |
| And we've done that. Now we've taken pig ligament -- young, healthy, big tissue, put it into 10 patients in an FDA-approved trial -- and then one of our patients went on to have three Canadian Masters Downhill championships -- on his "pig-lig," as he calls it. So we know it can work. |
我们已经做过这个实验,现在我们采用猪的韧带 年轻的、健康的、大的组织 将其放入是为患者的体内,当然这个实验是经过美国食品药品监督管理局的批准 不久,其中一位患者就继续参加了 三个加拿大斜坡大师冠军赛 当然,这都是经过他自己称之为“猪膝盖”的做功。这让我们了解到这种方法管用 |
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Downhill:adv.下坡;向下;每况愈下;adj.下坡的;容易的;n.下坡;滑降; championships:n.锦标赛,冠军(championship的复数);
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| And there's a wide clinical trial of this tissue now pending . |
而且,一个更大规模的临床试验将要进行 |
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clinical:adj.临床的;诊所的; pending:adj.悬而未决的; prep.在等待…时期; v.悬而未决; (pend的现在分词)
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| So what about the next step? |
那么我们的下一步将会做什么 |
| What about getting to a total biologic knee replacement, not just the parts? |
做一个整体生物膝盖置换怎么样 不再局限于一个部分 |
| How are we going to revolutionize artificial joint replacement? |
我们如何对人在关节置换进行革命性改变 |
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revolutionize:vt.发动革命;彻底改革;宣传革命;vi.革命化;从事革命;
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| Well here's how we're going to do it. |
这就是我们如何做这件事情 |
| So what we're going to do is take an articular cartilage from a young, healthy pig, strip it of its antigens, load it with your stem cells, then put it back on to that arthritic surface in your knee, tack it on there, have you heal that surface and then create a new biologic surface for your knee. |
我们将会用一个 来自年轻、健康的猪的 关节软骨 剥离掉它的抗原 载上你自己的干细胞 然后将其放回 你自己膝盖处的关节 将其固定,让你自己治愈破损的表面 并让其自己为你的膝盖生长一个新的生物表面 |
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tack:n.方针;方法;大头钉;v.抢风行驶;钉住; heal:v.复原;治疗(病人);使又愉快起来;(使)结束
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| So that's our biologic approach right now. |
这就是我们现在的生物方法 |
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approach:n.方法;路径;v.接近;建议;着手处理;
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| We're going to rebuild your knee with the parts. |
我们可以用部分组织让你的膝盖得以重生 |
| We're going to resurface it with a completely new surface. |
我们将原组织表面生成一个全新的表面 |
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resurface:v.重新露面;浮上水面;
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| But we have other advantages from the animal kingdom. |
但是,我们可以从动物王国哪里得到其他的利益 |
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advantages:n.有利条件; v.有利于;
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| There's a benefit of 400 million years of ambulation . |
这个利益是他们有四亿年的 移动历史 |
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ambulation:n.步行;移动;
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| We can harness those benefits. |
我们可以利用那些有事 |
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harness:vt.治理; n.马具;
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| We can use thicker, younger, better tissues than you might have injured in your knee, or that you might have when you're 40, 50 or 60. |
我们可以利用那些更加厚实、年轻 比你自身更好的组织 或比你40、50、60岁时更好的组织 |
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injured:adj.受伤的:委屈的: v.伤害,使受伤: n.伤员;
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| We can do it as an outpatient procedure. |
我们可以将其发展为门诊式的程序 |
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outpatient:n.门诊病人;
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| We can strip that tissue very economically , and so this is how we can get biologic knee replacement to go global. |
我们还可以将脱离技术发展为更为经济的方法 这就是我们如何在全球范围内 获得生物膝盖置换的方法 |
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economically:adv.经济地;在经济上;节俭地;
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| And so welcome to super biologics . |
欢迎进入生物学的世界 |
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biologics:n.生物制品;生物制剂;生物产品;
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| It's not hardware . |
他不是硬件 |
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hardware:n.计算机硬件;五金器具;
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| It's not software. |
也不是软件 |
| It's bioware. |
是生物部件 |
| It's version 2.0 of you. |
是你身体部件的第二代 |
| And so with that, coming to a -- |
我深信不久人们将会在 |
| (Laughter) |
（笑声） |
| coming to an operating theater near you soon, I believe. |
各个医院中见到它的使用 |
| Thank you very much. |
谢谢 |
| (Applause) |
（掌声） |