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胃溃疡的惊人原因 – 鲁沙·莫迪(Rusha Modi) – 译学馆
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胃溃疡的惊人原因 - 鲁沙·莫迪(Rusha Modi)

The surprising cause of stomach ulcers - Rusha Modi

1984年 一心求上进的澳大利亚医生巴里•马歇尔
In 1984, an enterprising Australian doctor named Barry Marshall
决定冒险做个实验
decided to take a risk.
当时 他的不少病人都抱怨由胃溃疡引起的剧烈腹痛
Too many of his patients were complaining of severe abdominal pain due to stomach ulcers,
这是因为上消化道内层产生了溃疡
which are sores in the lining of the upper intestinal tract.
但当时几乎没有什么治疗溃疡的有效方法
At the time, few effective treatments for ulcers existed
许多患者都需要住院治疗甚至做手术
and many sufferers required hospitalization or even surgery.
焦急的马歇尔
Desperate for answers,
吞下了一瓶由病人胃部细菌
Dr. Marshall swallowed a cloudy broth of bacteria
制成的浑浊培养液
collected from the stomach of one of his patients.
很快 他就感受到了病人口中抱怨的剧烈腹痛
Soon, Dr. Marshall was experiencing the same abdominal pain,
腹胀
bloating,
和呕吐
and vomiting.
十天后
Ten days later,
马歇尔使用一种类似相机的内窥镜观察身体内部的情况
a camera called an endoscope peered inside his insides.
结果发现与病人身体里相同的细菌侵占了他的胃部
Marshall’s stomach was teeming with the same bacteria as his patient.
他得了胃炎 还出现了很严重的炎症感染
He’d also developed gastritis, or severe inflammation of the stomach,
这都是典型的胃溃疡早期症状
the hallmark precursor of ulcers.
马歇尔的观点
Dr. Marshall’s idea challenged
向一个至今仍然存在的误解发起了挑战:
a misconception that still persists to this day:
通常认为溃疡是由压力
that ulcers are caused by stress,
食物
food,
或者过多的胃酸造成的
or too much stomach acid.
而马歇尔认为细菌感染才是罪魁祸首
Marshall thought the culprit was bacterial infections.
刚开始 世界上最具天赋的的医学专家们都觉得
Initially, his idea was considered crazy
他疯了
by the brightest medical minds on the planet.
直到2005年 他才得以正名 因为在这一年
But in 2005, he and Dr. Robin Warren received the ultimate validation
马歇尔和罗宾沃伦两人被授予了诺贝尔医学奖
when they were awarded the Nobel Prize for medicine.
我们的胃是一个J形状的器官
Our stomachs are J-shaped organs with surprisingly intricate ecosystems
里面的各种激素和化学物质构成了一个非常复杂的生态系统
awash in hormones and chemicals.
消化酶
The stomach is under constant attack by digestive enzymes,
胆汁
bile,
蛋白质
proteins,
微生物
microbes,
和胃酸不断进攻我们的胃
and the stomach’s own acid.
我们的胃也不甘示弱 产生碳酸氢盐
In response, it produces bicarbonate,
粘液
mucus,
和叫前列腺素的磷脂
and phospholipids called prostaglandins
来保全自己
to maintain the integrity of its own lining.
这种脆弱的平衡能被持续掌控
This delicate balance is constantly regulated
多亏了胃黏膜的防御作用
and referred to as mucosal defense.
从19世纪中叶起 医生认为大多数胃溃疡都是由压力引起的
Since the mid-1800s, doctors thought stress alone caused most stomach ulcers.
就给病人门开了一些抗抑郁药和安定剂
Patients were given antidepressants or tranquilizers
还告诉他们去温泉健康疗养院试试
and told to visit health spas.
马歇尔的观点最终否定了辛辣食物
This belief eventually shifted to the related notion of spicy foods
和压力是发病的诱因
and stress as culprits.
目前还没有有力的证据显示情绪低落
Yet no convincing study has ever demonstrated that emotional upset,
心理压力
psychological distress,
和辛辣食物
or spicy food
直接引发了胃溃疡
directly causes ulcer disease.
在20世纪中期 人们普遍认为如果盐酸含量超标
By the mid-20th century, it was widely accepted that excess hydrochloric acid
胃就会开始啃食自己
prompted the stomach to eat itself.
坚定支持这一想法的人将其称之为“酸液黑手党”
Fervent proponents of this idea were referred to as the acid mafia.
但这个观点最大的漏洞在于 即使抗酸药也只能
The biggest hole in this theory was that antiacids only provide
暂时缓解疼痛
temporary relief.
不过现在我们知道一些不常见的溃疡
We now know that some rare ulcers
的确由盐酸引起
are indeed caused by too much hydrochloric acid.
但是这种病例还不到1%
But they make up less than 1% of all cases.
马歇尔和沃伦两位医生查明 一种螺旋状的
Dr. Marshall and Dr. Warren pinpointed a spiral-shaped bacteria
幽门螺杆菌才是真凶
called Helicobacter pylori, or H. pylori, as the real offender.
幽门螺杆菌是人类最古老和最常见的小伙伴
H. pylori is one of humanity’s oldest and most frequent companions,
至少从5万年前就开始陪伴我们
having joined us at least 50,000 years ago,
现在世界上的一半人口身体里都能发现它
and now found in 50% of people.
以前 人们认为胃里没有细菌
Previously, we thought the stomach was sterile
毕竟在这样恶劣的酸性环境里求生存似乎是不太可能的
on account of it being such an acidic, hostile environment.
谁也没料到在胃里酸液的动荡起伏中 幽门螺杆菌顽强的生存了下来
Yet H. pylori survives the acidic turmoil of the stomach
凭借着一系列手段瓦解了粘膜液的防御
with a variety of features that disrupt mucosal defense in its favor.
比如 它产生尿素酶来自我保护
For example, it produces an enzyme called urease
胃酸对它也无可奈何
that helps protect it from the surrounding gastric acid.
幽门螺杆菌还能改造多达1500个蛋白质
H. pylori can make over 1,500 proteins,
最大化增强自身攻击力
many of which are dedicated to maximizing its virulence.
有些问题依旧是谜
We still have unanswered questions,
例如 有些人为什么在特定时期患溃疡
like why specific people develop ulcers at particular times.
不过 我们已经了解到 个体遗传
However, we do know individual genetics,
其他医学问题
other medical problems,
某些药物治疗
use of certain medications,
抽烟
smoking,
幽门螺杆菌的差异遗传都可能对此产生影响
and the genetic diversity of Helicobacter strains all play a role.
研究发现 特别是一些缓解关节炎的止痛药
In particular, certain pain medications used to reduce inflammation in joints
搭配幽门螺杆菌
have been discovered to work with H. pylori
能引起很严重的胃溃疡
to create more severe stomach ulcers.
马歇尔做了那出了名的的危险实验之后 没什么大事
Dr. Marshall ended up being fine after his famous, albeit dangerous, experiment.
吃了一个疗程的抗生素就痊愈了 跟现在的疗法差不多
He ingested a course of antibiotics similar to the ones taken now for ulcers.
简单吃抗生素就能击败一项
To be treated by simple antibiotics is a modern triumph
原本需要手术才可治愈的疾病 这是医学界的伟大胜利
for a disease that previously needed surgery.
马歇尔的成功也告诉我们在科学探索的道路上并不总是一帆风顺
Marshall’s work also reminded us that scientific progress is not always smooth.
不过这也告诉我们 相信显而易见又时而可靠的直觉
But there’s value in trusting your proverbial,
可能会带来一定的价值
and sometimes literal, gut.

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视频概述

胃溃疡究竟是何原因而诱发的呢?恶劣动荡的胃部环境中,细菌如何自保?

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