《科学秀》
Modern medicine is pretty incredible.
现代医学成就让人叹为观止
But even in a world where open-heart surgery
但即便在心脏直视手术
and brain-scanning headsets sound almost mundane,
和耳机式脑扫描仪都很寻常的当今世界
some medical advances do truly
一些医学进展确实
seem like science fiction.
看起来像科幻小说一样
So here are five recent developments
下面五项近期医学进展
that sound like they’re straight out of the future,
尽管听起来像是来自未来
but are already around today.
但如今已成为现实
Robots and surgeons go way back—
机器人外科医生很早就有
in fact, robots have been in operating rooms
实际上 机器人在手术室中应用
since the late 1980s,
开始于20世纪80年代末
helping out with all types of routine procedures.
用于辅助完成各种常规的工作
But in February 2020,
但是 2020年2月
surgeons in the Netherlands kicked things up a notch.
荷兰外科医生提高了机器人应用水平
They used a very precise robotic arm
他们使用了非常精确的
with teeny tiny tools on the end
末端带有微型工具的机械臂
to operate on blood vessels just a few times the size of a human hair.
能在只有几倍头发直径的血管内进行操作
It was the first human trial
这是人类进行的首次
of robot-assisted supermicrosurgery,
机器人辅助超显微外科手术试验
which is surgery on vessels smaller than eight-tenths of a millimeter.
手术是在小于8/10毫米的血管内进行的
Surgeries at these scales are really tricky for humans,
这样微观级别的手术对人类是很困难的
because our hands do shake— maybe just a little bit,
因为人手难免会抖动 哪怕幅度很小
but at these scales, every millimeter counts.
但在这个级别一毫米都很重要
So only highly-trained surgeons
所以只有训练有素的外科医生
are capable of doing these procedures.
才能够完成这类手术
One of these very precise surgeries,
此类精确手术的其中一种
called a lymphatico-venous anastomosis, or an LVA,
被称为淋巴静脉吻合术 或LVA
is a treatment for breast cancer patients
它是针对淋巴液不能正常回流的
whose lymph isn’t draining properly.
乳腺癌患者的一种治疗方法
Lymph is a fluid that transports white blood cells
淋巴液是一种在体内输送白细胞
and other nutrients around the body—
和其它营养物质的液体
and when it doesn’t drain properly,
如果不能正常回流
it can cause swelling and pain.
会引起肿胀和疼痛
But with surgery, tiny lymph vessels can be connected to blood vessels
但通过手术将小淋巴管与血管相连
to give the lymph another way out.
给了淋巴液另一个引流途径
This surgery is at the very limit of human capabilities,
这项手术几乎超出了人类能力的极限
but the team of surgeons and roboticists in the Netherland
但是荷兰的外科医生和机器人团队
thought they might just be able to
认为他们也许能够
make the procedure easier and safer.
让手术变得更容易 更安全
They devised a robot called MUSA,
他们设计了一款名叫MUSA的机器人
which mimics a surgeon.
完全模仿外科医生
It has two arms that go over the patient,
它用两条机械臂给病人实施精细操作
with tiny surgical tools on the ends instead of hands.
其末端的微型手术工具可代替人的双手
To manipulate the robot,
为了操控机器人
a surgeon looks at the patient through a microscope
外科医生通过显微镜观察病人身体
and moves a set of controllers
并操作一组控制器
as if they were operating directly on a person.
就像直接在病人身上操作一样
But it’s the robot’s tiny tools that are actually performing the surgery.
但实际上是机器人的微形工具在完成手术
The robot mimics the surgeon’s movements exactly,
机器人可以精确地模拟外科医生的动作
except it filters out tremors.
只是滤除了抖动
It also scales those movements down,
机器人也缩小了动作幅度
since the surgeon is looking at the patient through a microscope
因为医生在用显微镜观察患者
and making bigger motions.
手上动作幅度较大
Out of 20 surgeries, MUSA assisted in eight,
MUSA协助了20例手术中的8例
and all of them were a success.
都获得了成功
Unlike a human, the robot didn’t twitch or get tired,
与人类不同 机器人不会痉挛或疲劳
and it could hold an awkward position forever if it had to.
需要的话它可以永远保持一个别扭的姿势
This success is really exciting,
这次成功很令人鼓舞
because a robot like MUSA could
因为MUSA这类机器人
make this type of complex surgery possible for more surgeons—
能够帮更多外科医生进行此类的复杂手术
which means more people could get the treatment they need.
这意味着更多人可以获得所需的手术治疗
The reason a lot of people who are paralyzed can’t move their limbs
许多瘫痪的人无法移动四肢是因为
is because the nerves that should be taking signals
本应在大脑与其他身体部位间
from the brain to the rest of the body
传递信号的神经组织
aren’t working the way they should.
没有正常工作
And for many people with this kind of nerve damage,
对许多此类神经损伤患者
the condition is permanent.
这种病是终身的
But in a case study published in 2019 in the journal
但在2019年《柳叶刀神经病学》 期刊的
The Lancet Neurology,
一项病例研究中
a team of researchers in France found a creative way
一个法国研究团队发现了一个开创性方法
for a man who was paralyzed below the neck
可以让一个脖子以下瘫痪的男子
to control his limbs again.
再次控制自己的四肢
Their idea was to bypass the nerves completely—
他们的方案是完全绕开神经
by recording messages straight from the brain
直接记录来自大脑的消息指令
and sending them to a machine that could carry out its orders.
并将其发送给能执行指令的机器
The solution combined incredible advances
方案结合了两项不可思议的先进科技
in both brain scanning and robotics.
脑扫描和机器人技术
First, the team inserted two small implants into the patient’s brain
首先研究团队将两个小装置植入患者大脑
to measure activity in the areas that control movement.
以检测运动控制区域的大脑活动
The implants were hooked up wirelessly to a computer system,
植入装置以无线方式连接到计算机系统
which decoded the brain signals
对大脑信号进行解码
and translated them into instructions
将其转换为控制虚拟化身
for a virtual avatar or a full-body exosuit.
或全身机械装置的指令
But it was not as straightforward as it sounds.
但这并不像听起来那样简单
See, scientists know which regions
科学家知道大脑的哪些区域
of the brain broadly control movement,
在大体控制人的运动
but for this contraption to work,
但是要使这些装置起作用
the system needed to match up an exact pattern of active brain cells
该系统需要将确切的脑细胞活跃模式
with a specific movement.
与特定的运动相匹配
And that’s not exactly easy.
而这并不容易
Like, what does [this] look like on a brain scan, compared to, like, [this]?
“这样”和“这样”时 脑扫描有什么区别呢？
The team started by having the patient think about a specific action —
该团队先让患者思考一个特定的动作
like rotating his wrist or moving a wheelchair forward.
比如旋转手腕或向前移动轮椅
The computer—which was hooked up wirelessly to his brain—
无线连接到患者大脑的计算机
would record the signals that thought created.
会记录思考时产生的大脑信号
Then, over the course of two years,
这样 在两年的时间里
the computer created a model of the patient’s brain—
计算机创建了一个患者大脑活动的模型
basically like a dictionary that matched brain patterns to movements.
就像是将脑的活动模式与特定运动相匹配的字典
In a way, he was both training the computer
一方面 患者要训练计算机
to understand his brain signals,
理解他的大脑信号
and training himself to think in a structured and focused way
同时训练自己有条理地 专注地思考
that a computer would understand.
以便于计算机理解
And in the end, the patient was able to use the system
最终 患者能够使用该系统
to do all sorts of things!
执行各种操作
He drove a wheelchair and made virtual hands do things
可以开动轮椅 让虚拟手臂做诸如
like turn over or touch a target.
翻转或触摸目标的动作
He also gained the ability to start and stop an exoskeleton.
患者还有了启动和停止机械外骨骼的能力
It was attached to a harness mounted on the ceiling,
外骨骼与装在天花板上的系带相连
so while he wasn’t completely independent,
因此虽然患者不是完全独立
he could essentially walk.
但他确实可以走路
Now, this wasn’t the first time scientists created an interface
这不是科学家们第一次创建
between a brain and a computer,
大脑和计算机的接口
but the small surgery it required
但这次所需的小手术
was much less invasive than other methods.
比其它方法带来的伤害小得多
And while it’s still a long ways from widespread use,
尽管该系统离广泛使用还很遥远
it’s a big step toward developing a way for paralyzed people
但在为瘫痪人士开发出仅用意念
to control robotic limbs with nothing but their thoughts.
就能控制义肢方法的道路上前进了一大步
In March 2020, doctors in Oregon announced that
2020年3月 俄勒冈州的医生宣布
they had used the DNA-editing tool CRISPR-Cas9
他们首次在活人身上使用了
in a living person for the first time.
基因编辑工具CRISPR-Cas9
Their goal was to treat a rare genetic condition that causes blindness
他们的目标是通过修复出错的基因编码
by just fixing the faulty code in the DNA.
来治疗导致失明的罕见遗传病
Which is actually possible
这其实是可能的
because Cas9 is an enzyme that can cut apart molecules,
因为Cas9是一种能切开分子链的酶
and it allows researchers to snip a strand of DNA
它使研究人员可以在精确的位置
at a precise location
把DNA链剪断
and replace faulty code with new instructions.
并用新基因编码替换错误的编码
This technology itself isn’t that new.
这项技术本身并不是特别新奇
Scientists have been using it to edit genes
2013年以来 科学家们一直在用它
in bacteria, fruit flies, plants, and other organisms since 2013.
编辑细菌 果蝇 植物和其它生物的基因
And in a different study, also published in February of 2020,
2020年2月发表的另一项研究显示
doctors actually edited the white blood cells of three people with cancer—
医生实际上编辑了三名癌症患者的白细胞
but they did the editing outside the patients’ bodies.
但他们是在患者体外进行编辑的
That same month, though,
不过 就在同月
the team in Oregon took gene-editing a step further
俄勒冈州团队将基因编辑向前推进了一步
when they announced that they had used it directly in the human body
他们宣布已开始使用该技术直接在人体内
to edit the genes of living cells—
编辑活细胞的基因
although when we filmed this video,
不过我们录制此视频时
they didn’t yet have their results.
他们的结果还没有出来
This clinical trial involved a patient
该临床试验涉及的患者
with a rare inherited eye disease
患有一种罕见的遗传性眼病
called Leber congenital amaurosis,
叫作利伯氏先天性黑矇
which affects the cells of the retina and causes blindness.
能影响视网膜细胞 并可导致失明
And this disease can be caused by
这种疾病可能是由于
a mistake in a gene called CEP290 –
CEP290基因的突变而引起的
that’s what researchers wanted to fix.
这就是研究人员想要修复的问题
In the trial, doctors used a needle to inject a few drops
在试验中 医生用针头将几滴
of a solution containing the CRISPR-Cas9 system
含有CRISPR-Cas9系统的溶液
into the space just behind the retina.
注入视网膜后方的空间
The idea was that CRISPR-Cas9 would find the cells of the retina
医生设想CRISPR-Cas9会找到视网膜细胞
and snip away the mutation,
并剪除突变基因
leaving behind a functional gene.
留下一个功能正常的基因
If it works, it should be a permanent cure.
如果起作用的话 应该能永久性治愈该病
And the retina is a good place to test out gene editing in humans,
视网膜是测试人体内基因编辑的好地方
because it’s isolated from the rest of the body—
因为它独立于人体其他部位
so changes made on one eye won’t affect any other part of the body.
一只眼的变化不会影响身体的其它部位
After all, there are a lot of valid reasons
毕竟 在人体内做基因编辑
to be concerned about doing gene-editing in humans—
我们是有足够理由感到忧虑的
but this is a pretty safe place to start.
但这是一个非常安全的起点
And if the procedure does cure the patient’s blindness,
如果该手术确实治愈了患者的失明症
it’s not just good news for people with this rare disease;
这不仅对患有该罕见病的人是个好消息
it could open up the possibility for other gene therapy treatments as well.
它也许会为其它基因疗法开辟可能性
These days, there’s not much you can do
现如今 要是你刮破了膝盖
if you scrape up a knee or get any injury that breaks the skin.
或受到任何皮肤损伤 你能做的很有限
It’s just got to heal, and it takes as long as it takes.
只能等它愈合 而且需要的时间很长
But in 2018,
但在2018年
researchers at the University of Wisconsin-Madison
威斯康星大学麦迪逊分校的研究人员称
reported that they had built a device
他们制作的装置
that healed injuries in rats four times
能使老鼠伤口的愈合速度
faster than they heal on their own.
比其自然愈合速度提高四倍
The device itself is really simple:
装置本身非常简单
It’s basically a little electric bracelet
其实就是一个小的电子手镯
that delivers gentle electric pulses to the site of an injury.
可以向受伤部位传递柔和的电脉冲
Now electricity naturally plays a role in helping wounds heal.
电流天然地就有帮助伤口愈合的作用
Scientists have known since the 1800s that
从19世纪初期 科学家就己经知道
anytime you get an injury,
如果你受伤了
your body naturally creates an electric field around it.
你的身体会自然地在伤口周围产生电场
And in more recent studies, researchers have even watched
在最近的研究中 研究人员甚至观察到
cells move around and restructure themselves
细胞在电场作用下
in response to an electric field.
开始移动并自行重组
You know. As they do.
研究人员做这些试验时
They still don’t know exactly
他们仍不清楚
how the cells are responding to that electricity,
细胞对于电流的反应的确切原理
but electricity seems to promote the growth of new cells,
但是电流似乎可以促进新细胞的生长
which is what it takes to close a wound.
而这恰好是伤口愈合所需要的
So this device was designed to speed up healing
因此 该装置的作用是为创伤区域
by providing additional electricity to the injured region.
提供额外的电流以加快伤口愈合速度
And in rats, the results were kind of incredible.
在老鼠身上试验的结果出人意料的好
An injury that normally took almost two weeks to heal
通常几乎要两周才能愈合的伤口
closed up in three days.
三天就愈合了
Eventually, researchers hope to
最终 研究人员希望
test something like this on human skin.
在人类皮肤上测试类似装置
And in the meantime, they’ve found evidence that
同时他们发现 有证据表明
this technology may even have an extra perk—
该技术甚至可能还有一个意外功效
it might reverse baldness.
可能会逆转脱发进程
In a separate experiment,
在另一个实验中
they applied a patch with the same technology
他们把运用相同技术的贴片
to mice with a genetic condition
用到患遗传病的老鼠身上
keeping them from producing certain chemicals that make hair grow.
该病会阻止老鼠产生某些促进毛发生长的化学物质
So the mice are naturally hairless,
所以这些老鼠天然是没有毛发的
but after just nine days,
然而仅仅过了9天
they’d grown hair under the electric patch.
老鼠电极贴片下的皮肤长出了毛发
Researchers believe the patch works
研究人员认为 这些贴片
by stimulating the cells in the area
通过刺激该区域的细胞起作用
so they release those chemicals that tell hair to grow.
释放出了促进毛发生长的化学物质
Now, you may have noticed that
你可能已经注意到
your head is not mouse skin.
你的头皮不同于老鼠皮肤
But if tests in humans go well,
但如果人体试验顺利的话
products with this technology could eventually hit the market,
采用该技术的产品有望最终推向市场
but in the meantime— in case you need me to say it—
但同时 我要提醒大家的是
don’t try this at home.
请不要在家中尝试
Everywhere around the world,
在世界各地
there are more people who need organs than there are donors.
需要器官的人都比捐献者要多
Like, right now, there are over 100,000 people in the U.S. waiting for kidneys.
比如目前 美国有超过10万人在等待肾源
And even in a record-setting year like 2019,
即使在2019年这一创纪录的年份
fewer than a quarter of those people will get them.
也只有不到1/4的人能得到所需肾脏
So lives depend on finding more kidneys.
所以 生命的延续有赖于寻找更多的肾脏
And in 2015, doctors in the U.K. found a new way
2015年 英国医生发现了一个
to put kidneys from deceased donors back in business,
能将死者肾脏恢复正常功能的新方法
using a technique called ex-vivo normothermic perfusion.
使用了一种称为体外常温灌注的技术
This technique uses a jolt of nutrients
该技术使用了一些营养素
to repair kidneys from deceased donors
来修复已故器官捐献者的肾脏
and make them usable again—which is not easy.
并使它们可以再次使用 这并不容易
Because, as soon as a person dies, their organs start to deteriorate.
因为人一旦死亡 器官状况就开始恶化
Doctors can slow that deterioration by chilling an organ,
医生可以通过冷却器官减缓恶化进程
but even then, kidneys have to be transplanted within a day or two,
即便如此 肾脏必须在一两天内移植
or they’re often too far gone.
否则通常就不能用了
This new procedure helps by putting new life into kidneys
这项新技术通过给肾脏注入新的生机
that have passed the usual point of no return.
来挽救通常已经过了使用时限的肾脏
First, the kidney gets removed from the deceased donor
先像平常一样 将肾脏从捐献者体内取出
and kept cold, just like usual.
并保持冷藏状态
Then it has to travel—
然后是运送过程
sometimes down the hall, other times to a different city.
或运过大厅 或运送到另一个城市
Once it gets where it’s going,
一旦到达目的地
it goes into a special machine that’s kind of like a spa
肾脏会被放入一台类似水疗的特殊机器
But for kidneys,it pumps warm blood and nutrients
它专为肾脏设计 通过器官向肾脏输送
through the organ until it’s working at peak efficiency.
温热的血液和营养 直至其达到最强功能
Then it’s good to go back to work in the world of the living.
然后欣然回到一个有活力的身体继续工作
What’s cool about this procedure is
该技术的优点在于
it doesn’t just wake the kidney back up—
它不仅可以唤醒肾脏
it also gives the surgeons a chance to make sure
还能让外科医生有机会确认
the kidney works on a machine, before it goes into a human.
肾脏在进入人体之前 能先在机器上运作
Kidneys that were borderline become healthy enough
处于生死边缘的肾脏在水疗之旅后
to use after this little trip to the kidney spa.
就能重获健康 再次应用
And, so far, the early results are promising.
目前为止 早期结果比较乐观
Initial studies show that the revived kidneys are at least
初始研究表明 机器恢复的肾脏至少
as safe as kidneys typically used for transplants.
与通常用于移植的肾脏一样安全
Other trials are still in progress to make sure it’s completely safe,
其他试验仍在进行 以确保其绝对安全
but if things go well, this could save a lot of lives.
但如果一切顺利 它能挽救很多人的生命
For now, many of these advances are proofs of concept
目前 这些进展还处于概念验证阶段
and still far from being your everyday reality,
距离我们的日常生活还很遥远
but they show how quickly science fiction can become science
但这展示了科幻小说正快速变为科学现实
and help us to live longer, healthier lives.
并让我们更加长寿和健康
Thanks for watching this episode of SciShow!
感谢收看本期《科学秀》
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特别感谢我们在Patreon上的支持者
who make it possible for us to share
让我们得以跟大家分享
all this amazing science with you.
这些惊人的科学资讯
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如果您想加入我们优秀的赞助人团
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可在patreon.com/SciShow找到更多信息