秘密練習

New Brain-Image Database Could Help People With Chronic Pain
新的腦成像資料庫可以對人類的慢性疼痛有幫助

(The human brain is seen with scanning technology. 人類的大腦已經可以透過科技掃描被觀看了。)

Today we tell about a World Health Organization report on spinal cord injuries. Then, we tell how American scientists have used stem cells to create lung cells in a laboratory. But first, we report on efforts to create an international database, or electronic record, of brain images. Organizers say the database could help researchers develop better ways to treat chronic, long-lasting pain.
今天我們將會介紹世界衛生組織（WHO）有關脊椎神經傷害的報導，接下來，我們會介紹美國科學家如何在實驗室裡用幹細胞創造出肺細胞，但是首先，我們將會報導一項在建造一座腦成像的世界性資料庫或是電子資料，組織者說這個資料庫可以幫助研究者在治療慢性以及持久性的疼痛上能夠發展地更好。

New Brain Image Database Could Help Chronic Pain Sufferers
新的腦成像資料庫可以幫助慢性疼痛患者

Many people suffer from chronic pain. Their joints might hurt. They might develop a migraine headache, with sharp pain in the head. Others might have pain in the stomach or abdomen. Many scientists now believe that chronic pain -- in any part of the body -- is linked to the brain. Scientists in California are now developing an international database of brain images of hundreds of chronic pain patients. The goal is to speed up research and develop better ways to treat people whose pain never completely goes away.
許多人深受慢性疼痛所苦，他們的關節也許受損，他們可能發展成偏頭痛，一種很劇烈的頭痛，其他人可能會胃痛或是腹痛的毛病，現在有許多科學家相信慢性疼痛—不管是什麼地方的慢性疼痛—都與腦部息息相關，加州的科學家現在正在發展一座多達數百個慢性疼痛患者 腦成像的資料庫，目標在於加速研究並且讓那些疼痛從未離開過他們身上的病患能得到更好的治療。

Emeran Mayer is a gastroenterologist at UCLA, the University of California Los Angeles. Doctors like him study the stomach and intestines.
艾莫蘭‧梅耶爾是加州大學洛杉磯分校的腸胃病學家，像他這樣的醫生是專門研究腸胃的。

“One of the big things in pain research has been the failure to really come up with major breakthroughs in, in treatments.”
「疼痛研究最大的問題是一直未能真正在治療方面取得重大突破。」

Dr. Mayer hopes to develops for people with chronic pain. He is working on a new field that links chronic pain to biological changes in the brain. The Oppenheimer Center for Neurobiology of Stress at UCLA is the headquarters for the first standardized database of brain imaging linked to chronic pain.
梅耶爾醫生希望可以往慢性疼痛患者這方面發展，他正在一個將慢性疼痛與大腦中的生物變化聯繫起來的新研究領域工作，加州大學洛杉磯分校奧本海默中心應激神經生物學研究是腦成像與慢性疼痛第一標準化資料庫的主要中心。

“So I think a lot of people now agree with the concept that chronic pain is a brain disease -- it may start anywhere in the body when you have acute pain but once it becomes a chronic pain syndrome it does become a brain disease.”
「所以我認為很多人現在接受這一概念,即慢性疼痛是一種大腦疾病—當你感到劇烈疼痛它可能在身體的任何地方已經開始，但是一旦成為慢性疼痛綜合征它就成了一種大腦疾病。」

Kirsten Tillisch is a professor at the Division of Digestive Diseases at UCLA. She says the imaging database lets doctors look at treating the whole body, not just parts of it.
柯爾斯頓•特利西是加州大學洛杉磯分校消化疾病部門的教授，她說成像資料庫讓醫生能夠在治療方面看得更全面，而不只是一部分而已。

“One of the, the failures of Western medicine and I think our research approaches is how we’ve diced up the human body and how we’ve diced up research into these little silos that work very independently.”
「這是西醫失敗的其中一個原因，而且我認為我們的研究方法是如何劃分人體，以及我們研究如何劃分成非常獨立的工作。」

Professor Mayer says Western scientists are starting to look more closely at how the mind, body and environment influence each other.
梅耶爾教授表示西方科學家正開始更仔細地研究思想、身體和環境如何互相影響。

“Big data, medicine, and analysis is essentially doing the same thing that, you know, the ancient Chinese did by observation. We do it by observing and analyzing very large data sets and trying to see are there patterns in there that, that hang together biologically.”
「龐大資料、醫學及分析本質上和中國古人通過觀察做的事情有異曲同工之處，我們通過觀察和分析非常龐大的資料找出是否有生物性結合在一起的模式。」

Professor Tillisch says new technology makes that possible.
而特利西教授稱新技術使這成為可能。

“You know when I started this type of work ten years ago there wasn’t -- we didn’t have computing power to do these types of analysis. So, in the brain alone in the, in the last decade it’s really exploded what we could look at.”
「你知道當我十年前開始這種類型的研究，我們沒有電腦進行這種類型的分析，所以過去十年裡單單憑藉大腦，真的讓我們對所見感到抓狂。」

The database now has the brain scans of more than 500 patients from North America and Europe. UCLA is working to gather more. Professor Mayer hopes to include brain images of people from Asian countries in the database.
資料庫目前存有超過500例來自北美和歐洲病人的大腦掃描，而加州大學洛杉磯分校正在獲取更多，梅耶爾教授希望最終包括來自亞洲國家的大腦圖像。

Up To 500,000 Spinal Cord Injuries Per Year Worldwide
全球每年的脊椎神經傷害上升至五十萬例

The World Health Organization says as many as 500,000 people suffer spinal cord injuries every year. And it says people with such injuries are much more likely to die early.
WHO表示每年有五十萬人受苦於脊椎神經傷害，他也表示有這種傷害的人更有可能死得早。

Recently, the World Health Organization released a report called “International Perspectives on Spinal Cord Injuries.” Alana Officer works at the WHO. She says spinal cord injuries do more than just cause paralysis, or lack of movement.
最近WHO發表了一則報告叫做「脊椎神經傷害的世界性觀點」，艾蘭娜‧奧菲斯在WHO工作，她說脊椎神經傷害更可能造成癱瘓或是行動遲緩。

“There are a lot more associated health problems, such as difficulty with bowel and bladder function, difficulty with sexual function, associated problems around mental health conditions. So it’s much broader than just experiencing paralysis.”
「還有更多相關的健康問題，像是腸道和膀胱功能上的障礙，還有性功能障礙，相關的問題都與主要的健康狀態有關，所以那其實比癱瘓還要再涉及更多問題。」

Alana Officer is the WHO’s Coordinator for Disability and Rehabilitation. She says the main causes of spinal cord injuries are traffic accidents, falls and violence. She says some causes are more common in certain areas.
艾蘭娜‧奧菲斯是WHO殘障與康復項目的協調員，她說造成脊椎神經傷害最主要的原因是交通意外、跌倒和暴力行為，而有些原因在一些特定的地區會更普遍。

“For example, road traffic crashes are the main contributors of spinal cord injury in Africa and the Western Pacific region. Falls tend to be the leading cause in Southeast Asia and the Middle East. And then we have high rates of violence in certain countries. We have high rates in the U.S. We have high rates in South Africa. And then we’ve also got the non-traumatic causes of spinal cord injuries, such as tumors and cancers, tuberculosis and spinabifida.”
「舉例來說，道路交通撞擊在非洲和西太平洋地區為主要的脊椎神經傷害造成因素，南亞和中東的因素則是傾向跌倒為多，而暴力行為在一些特定的國家則是會很高比例的出現，像在美國就很高，南非也很高，當然也有一些造成脊椎神經傷害的非外傷原因，像是腫瘤和癌症，還有結核病以及脊髓露出體外癱瘓症。」

Most people think of tuberculosis as a lung disease. But in some African countries, it is responsible for about one third of the non-violent spinal cord injuries.
大部分的人認為結核病是一種肺部疾病，但是在某些非洲國家，結核病佔了非外傷脊椎神經傷害原因的三分之一。

The birth defect spinabifida causes damage to the spine. In severe cases, it can affect walking and daily activities. Health officials say they do not yet know the exact cause of spinabifida. But they say it may be linked to genes and the environment.
脊髓露出體外癱瘓症會造成脊椎的破壞，如果嚴重的話，會影響到走路與日常行為，衛生官員說他們還不能確切知道造成脊髓露出體外癱瘓症的原因，但是有可能與基因和環境有關。

Alana Officer says more men than women suffer spinal cord injuries.
艾蘭娜‧奧菲斯說在承受脊椎神經傷害的人裡，男性比女性多。

“There’s a ratio of about two-to-one of males to females. Men tend to be more likely to experience spinal cord injury between the ages of about 20 and 29 -- women, or certainly girls much younger, between sort of 15 and 19. So that’s our first peak in young people. And then we get a second peak, interestingly, in older people. And the major driver of that is falls, tumors, cancer, et cetera.”
「男性和女性的比例大概是二比一，男性發生脊椎神經傷害的年齡大概介於20到29歲—女人或是大部分的女孩會發生在比較年輕的時候，大概是介於15到19歲，這就是我們發生比例最高的年輕人，而有趣的是，比例第二高的竟然是老年人，而主要的因素是跌倒、腫瘤和癌症…等等。」

She says the main reason people with spinal cord injuries are more likely to die early is lack of medical care.
她說患有脊椎神經傷害容易早死最主要的因素，是因為缺乏醫療照護。

“A lot of people with spinal cord injuries, certainly in low- and middle- income countries, do not get appropriate emergency response care. Mortality rates are very strongly affected by the quality of the health care system. For example, if you’re in a low-income country, you are three times more likely of dying in (a) hospital following a spinal cord injury than you would be in a high-income country.”
「很多主要在中、低收入國家的脊椎神經傷害的患者都沒有得到適當的緊急救護，死亡率深受醫療照護系統品質的影響，例如說，如果你是在一個低收入國家，你因為脊椎神經傷害而死在醫院的機率會比高收入國家多出三倍。」

Ms. Officer says many of the causes of spinal cord injury deaths in poor countries are preventable. These include urinary tract infections and pressure sores, also known as bedsores. These are areas of damaged skin caused by a person staying in one position too long. Bedsores are usually not life-threatening problems in wealthy countries.
奧菲斯小姐說，在赤貧國家，很多脊椎神經傷害的造成原因是可以預防的，這些包括了泌尿道感染與褥瘡，也叫做壓瘡，人如果長時間待在同一個地方，一直壓著的那塊皮膚會被傷害，進而形成壓瘡，而壓瘡在富裕的國家裡並不會威脅到生命。

“People with spinal cord injuries can live pretty much the same amount of time as somebody without a spinal cord injury. There’s a slight difference, but certainly life expectancy has increased considerably in high-income countries. And it’s not the case in low- income countries.”
「在高收入國家裡，患有脊椎神經傷害的患者跟健康的人相比，並不會活得比較短，雖然只有一點點的不一樣，但是大概的平均壽命已經頗有增加了，但這樣的狀況並不存在於低收入國家。」

Experts suggest immediate action if a spinal cord injury is suspected, including immobilization of the spine, restricting its movement. The WHO says that should be followed by what it calls, “care appropriate to the level and severity of the injury, degree of instability of the spine and compression of nerves.” It also suggests “skilled rehabilitation and mental health services.” The WHO notes that up to 30 percent of people with spinal cord injuries show “clinically-significant signs of depression.”
專家建議如果發現可能患有脊椎神經傷害，應該立即處理，包括把脊柱固定，限制它的活動，WHO說應該要看情形而定，「適當的照護應該要按照受傷的嚴重程度治療，還有脊椎的不穩定性跟擠壓神經的程度。」他們也建議：「技術性的修復跟心理健康諮詢。」WHO提到，有30%患有脊椎神經傷害的人在臨床上有意志消沉的狀況。

There is currently no cure for paralysis from spinal cord injuries, but many researchers are looking for one. Alana Officer says there is much that can be done to prevent such injuries -- including building safer roads and vehicles, reducing drinking and driving and wearing seatbelts. Other measures include improving safety in sports and the workplace, and adding window guards to windows. She says spinal cord injuries would be reduced if doctors could identify and treat tuberculosis earlier and by improving nutrition to reduce spinabifida cases.
現在由脊椎神經傷害造成的癱瘓是沒有辦法治癒的，但是有許多研究者正在尋找治療的辦法，艾蘭娜‧奧菲斯說有許多方法可以預防這些傷害，包括建造更安全的道路和交通工具，減少酒駕的機會，還要繫上安全帶，還有其他的方法，像是提升運動場合和工作場合的安全性，把窗戶加上欄杆，她說如果醫生提早發現結核病並且治療，進而改進脊柱裂需要的營養，那就可以減少脊椎神經傷害的發生。

Scientists Create Lung Tissue from Stem Cells
科學家從幹細胞中創造出肺組織

Finally, scientists have used stem cell technology to create working lung cells. Researchers say stem cells also could be used to create new drugs to treat diseases that restrict breathing. And they think the cells could one day create tissue for lung transplant operations. The research is another step toward what is being called personalized medicine.
終於，科學家終於利用幹細胞科技創造出可行的肺組織，研究者說幹細胞也可以用來創造呼吸困難急病的新藥，而他們也認為這個細胞有一天可以創造出用於肺移植手術的組織，研究者也正在朝著發展個人化藥劑的方向發展。

Over the past several years, scientists have used stem cells and growth factors to force the body’s master cells to create other cells. This process has created heart, intestinal, liver, nerve and insulin-producing cells as possible replacements for diseased organs.
過去幾年來，科學家已經用幹細胞還有發展因素強迫種細胞創造出其他細胞，這項計畫已經創造出心臟細胞、腸細胞、肝細胞、神經細胞和胰島細胞，當這些內臟受到傷害時，就可以用來替換。

(Human embryonic stem cells are examined under a microscope. 人類的胚胎幹細胞在顯微鏡下被觀察的成像。)

Now, scientists at Columbia University in New York City have changed stem cells into working, functioning lung cells, at least in the laboratory. The scientists say this could help researchers develop drugs and transplants to treat deadly diseases.
現在，在紐約哥倫比亞大學的科學家已經改變了幹細胞的用途，至少在實驗室裡讓它變成功能性肺細胞，科學家說這可以幫助研究者發展治療致死疾病的新藥以及器官移植。

Hans Snoeck is a professor of microbiology and immunology at Columbia’s medical school. He led the study. He says researchers were able to create six human lung and airway cells. One of the cells produced a substance called surfactant. In the lungs, surfactant keeps the body’s air passageways open, letting people breathe.
漢斯‧史諾克是哥倫比亞醫學院的微生物學和免疫學教授，他帶領這項研究，他說研究者已經可以創造出六個人體的肺跟肺氣道細胞，其中一種細胞會製造出一種叫作界面活性劑的物質，在肺裡面，界面活性劑會保持人體的呼吸道暢通，讓人可以持續呼吸。

“And we know that the cells that we made can make surfactant, can recycle it, can secrete it again. So we know that they do what they’re supposed to do. And these cells are very essential in lung diseases.”
「而我們也知道我們創造的這種細胞可以製造界面活性劑，可以循環再利用，可以再次分泌，所以我們可得知這種細胞應該做些什麼事情，而這種細胞在肺部疾病裡是不可或缺的。」

He adds that impaired surfactant production causes pulmonary fibrosis, a deadly lung condition.
他也補充，受損的界面活性劑會造成肺部纖維化，一種會致死的肺部狀況。

In experiments, researchers showed they could make embryonic stem cells become lung tissue. They used proteins that tell the body’s master cells to become lung tissue. Some people have criticized the use of embryonic stem cells because they come from human embryos. That is why the researchers turned to what they call induced pluripotent stem cells. These are skin and other kinds of cells that can act like progenitor cells.
在實驗中，研究者表示他們可以讓胚胎幹細胞變成肺組織，他們用蛋白質讓身體裡的種細胞變成肺組織，有些人會批評這種使用胚胎幹細胞的做法，因為這些細胞是取自於人類的胚胎，這也就是為什麼研究者把研究轉向人工多能幹細胞，這些是皮膚細胞和其他種類可以有像祖細胞一樣功能的細胞。

All of the experiments produced human lung tissue. The researchers placed this tissue into the kidneys of mice. Dr. Snoeck says the implanted cells grew and began acting like lung tissue. Researchers will be able to use the cells as a model for treatments for disabling and deadly lung diseases, like cystic fibrosis.
這些所有的實驗都製造出了人體的肺組織，研究者把這些組織放進老鼠的腎臟裡，史諾克博士說這些移植細胞或開始成長並且開始擁有像肺組織一樣的作用，研究者將可以以細胞為樣本，研究出為了治療喪失肺功能或是可以致死的肺部疾病，像是囊胞性纖維症。

Dr. Snoeck says lung transplants often are not successful. But in the future, he says, scientists may be able to engineer transplantable donor lungs by removing all of their cellular material. They would then seed the remaining structures with lung cells created from the skin cells of the transplant patient.
史諾克博士說通常肺移植都不會成功，但是他說，在未來，科學家也許可以藉著去除所有由細胞組成的物質，而建造出可移植的捐贈者的肺。

“In this way we hope to be able to one day -- but this is years away -- to make a lung that a recipient -- someone who is in need of a transplant -- will not reject because all the cells in this lung are made from the same patient.”
「在這條路上，我們希望總有一天—但也可能是數年以後—創造出一個肺給真正需要器官移植的器官等待者，這顆肺絕對不會排斥病人的身體，因為所有的細胞都是取自於同一個病人身上。」

A report on the creation of lung tissue from stem cells was published in the journal Nature Biotechnology.
這是一篇刊登在自然微生物科技期刊上，關於從幹細胞創造肺組織的報告。