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2018年02月23日 16:40:16

黄浦区第九人民医院开双眼皮手术价格费用Science and technology科学技术Stem-cell therapies干细胞治疗Prometheus unbound普罗米修斯自由了Researchers have yet to realise the old dream of regenerating organs. But they are getting closer亘古以来,器官再生便是人类的夙愿。如今研究人员虽然还未真正实现,但成功的脚步已经越来越近PROMETHEUS, a Titan bound to a rock by Zeus, endured the daily torture of an eagle feasting on his liver, only to have the organ regrow each night.在希腊神话之中,提坦普罗米修斯被宙斯束缚在一块巨石之上,白天忍受着老鹰啄食他的肝脏,夜晚他的肝脏却又总会再次生长。Compared with this spectacle, a on the website of Nature this week seems decidedly dull.与生动的故事情节相比,本周《自然》网站上的一段视频就显得如此枯燥。It shows a collection of pink dots consolidating into a darker central glob.这段视频向世人展示了无数粉红色的小点向中心聚拢,成为一个颜色更深的团状物的过程。But something titanic is indeed happening.但这正是普罗米修斯自由的曙光。The pink dots are stem cells, and the shows the development of a liver bud, something which can go on to look and act like a liver.那些粉红色的小点就是干细胞,而视频显示的正是肝芽生长的过程,并且这个肝芽可以进一步发育为,无论是外表还是功能都与肝脏类似的组织。Takanori Takebe and Hideki Taniguchi of Yokohama City University, in Japan, who made the , have created working human-liver tissue.日本横滨市立大学的武部孝则和谷口英机拍摄了这段视频,这次他们培养出了具有功能性的人类肝脏组织。Researchers have long dreamed that stem cells might be used to repair or replace damaged tissue, an aspiration known as regenerative medicine.研究人员长期以来都设想干细胞能够用来修复或替换受损组织,该研究领域则被冠名为再生医学。Embryonic stem cells, in particular, are pluripotent, meaning they are able to become any other type of cell.多能的胚胎干细胞被再生医学家们寄予厚望,所谓多能就意味着这些干细胞可以分化出多种其他类型的细胞。And it is now possible to induce pluripotency in cells that have not come from embryos, thus circumventing the ethical minefield previously associated with obtaining them.现在的技术已经可以在非胚胎细胞中诱导细胞的多能性,这样就可以绕过之前直接使用胚胎细胞时所引发的伦理争议。Last year Shinya Yamanaka of Kyoto University won a Nobel prize for the invention of induced pluripotency.日本京都大学的山中伸弥由于成功诱导细胞的多能性而于去年荣获诺贝尔奖。He had shown how four signal proteins can reprogram adult cells into a pluripotent state.他公开发表了借助四种信号蛋白,重组成人细胞并使其具有多能性的实验过程。Beside dealing with the ethical problems of embryonic cells, Dr Yamanakas induced pluripotent stem cells allow—at least in theory—a treatment to be created from a patients own body.除了成功躲开了胚胎细胞的伦理问题,山中士发明的诱导多能干细胞,使得再生医学可以从患者体内提取细胞进行再生治疗。This would have his own genetic make up and would thus not attract the attention of his immune system.这样就可以取得患者自身的基因组合,避免了患者免疫系统的排异反应。Realising such treatments has been fiendishly difficult.要真正实现这种干细胞治疗仍然困难重重,But Dr Takebes paper in Nature is one of several signs that the Promethean dream is slowly coming to life.但是武部士发表于《自然》的论文则是人类又一次向解放普罗米修斯迈出了坚实的一步。Budding hope星星之火Clinical trials of pluripotent cells are aly happening, though they hark back to the days when only cells derived from embryos were available.多能细胞的临床试验其实早已开始进行,只是这种多能细胞还是由胚胎干细胞所培养。An American firm called Advanced Cell Technology is using them to treat macular degeneration, a cause of blindness.美国先进细胞技术公司正运用多能细胞治疗可能致盲的黄斑变性。Last year it reported promising results in two patients and Gary Rabin, the firms boss, says tests continue.去年该公司报告了两例有望好转的临床病患,公司老总加里·拉宾也表示,试验仍会继续。Even if this specific approach works, though, it is likely to be overtaken by iPS technology.不过,即使这一临床试验终获成功,也有可能会被iPS技术所取代。The Japanese, not surprisingly, are in the lead.日本在iPS技术方面无疑领先于世界其他各国。Soon, the countrys health ministry is expected to approve the first clinical trial of iPS cells, also for macular degeneration.该国卫生部应该不久便会批准iPS细胞的第一例临床试验,同样也是治疗黄斑变性。But ACT is not far behind.然而ACT也并未脱离战队,It hopes to begin a trial of platelets made from iPS cells.该公司希望开始一项iPS细胞培养血小板的试验。And other firms want to treat everything from Parkinsons disease to glaucoma to multiple sclerosis.还有些公司则希望透过iPS技术治疗其他疾病,包括帕金森病、青光眼、多发性硬化等。Academia is pushing ahead as well.学术界则正在进一步地研究iPS技术。Inspired by Dr Yamanakas work, people are looking for other shortcuts to pluripotency.受到山中教授研究成果的启发,人们纷纷开始探究诱导细胞多能性更为便捷的其他途径。Marius Wernig of Stanford University, for instance, has worked out how to use three proteins to turn connective-tissue cells into neurons.斯坦福大学的马吕斯·维米格就发现了使用三种蛋白质,将结缔组织细胞转化为神经细胞的方法。Deepak Srivastava of the University of California, San Francisco, meanwhile, has shown how to convert connective tissue into heart cells.加州大学旧金山分校的迪帕克·司里瓦斯德瓦则发表了将结缔组织转化为心肌细胞的过程。Other research is going beyond simple cell cultures.还有一些研究就没有局限于简单的细胞培养领域。左使良树任职于神户的理化研究所发育生物学中心。In 2011 Yoshiki Sasai of the RIKEN Centre for Developmental Biology, in Kobe, showed how mouse embryonic stem cells, if mixed with a few appropriate growth factors, quickly form a three-dimensional cluster made of the precursor cells to neurons.他于2011年发表论文,阐述了老鼠胚胎干细胞在给予一些适当的生长因子后,快速形成一个三维立体簇集物的过程。This cluster then turns into something resembling the back of an eye.而这种簇集物由多种细胞构成,并进而发育成一种类似于眼底结构的组织。Last year Dr Sasai repeated the trick with human cells.去年左使士使用人类细胞再次重复了这一实验过程。The dream is to make a complex organ from scratch.人们的梦想就是从无到有地创造出一个复杂的器官。With this in mind researchers at Wake Forest University in North Carolina have used a three-dimensional printer to produce an artificial kidney using immature kidney cells.为了实现这个梦想,北卡罗来纳州维克森林大学的研究员们使用三维打印技术,用不成熟的肾脏细胞做出了一个人造肾脏。But if such organs are to work in people, they will need blood vessels to deliver oxygen and nutrients.不过要让这样的肾脏在人体内正常工作,其中还是缺少了用于输送氧气和营养物质的血管。The way to do that might, paradoxically, be for scientists to do less. Instead of making the whole organ in a laboratory, they might create a less-developed form, as Dr Sasai did with his proto-retina, and then leave the rest of the work to the body.如果真要实现这个梦想,科学家可能用不着在肾脏中再造血管—这听起来可能有些自相矛盾—他们其实不必在实验室中造出完整的人体器官。科学家可以先造出还没发育完全的器官试样,然后在活体体内完成剩下的研究工作。This is what Dr Takebe has done with his liver buds.武部士的肝芽生长研究正是遵照这样的器官再造思路而完成的。He coaxed some iPS cells into becoming liver endodermal cells.他小心地将一些iPS细胞导入合适的肝脏内胚层细胞。He then cultured them with two other cell types: endothelial cells, which make up the inner linings of blood vessels, that were derived from umbilical cord; and mesenchymal stem cells, derived from bone marrow, which can differentiate into several kinds of cells, though not as many as pluripotent cells.然后将这些肝脏内胚层细胞与其他两种细胞一起培养。一种是取自脐带的内皮细胞,这种细胞构成了血管内层;另一种细胞是取自骨髓的间充质干细胞,这种细胞可以分化成多种细胞类型。Cultures without mesenchymal stem cells failed to form a cluster.实验明,如果培养过程中缺少间充质干细胞,就不会形成簇集物;Those without endothelial cells failed to create a network of blood vessels.而如果没有内皮细胞,就无法形成血管网络。But together, the three types of cell, with little additional prodding, formed a bud within two days.只有将肝脏内胚层细胞与这两者结合,并配合少量的其他刺激,才最终能在两天内形成肝芽。At six days this bud was expressing genes known to be early markers of the liver.到了第六天,肝芽开始表达一些在肝脏早期形成阶段具有标志性的基因。And when Dr Takebe implanted such buds into the brains of mice whose immune systems had been disabled to prevent rejection, he observed that they connected with the mouses blood system within two days.随后,武部士将这些肝芽结构植入一些丧失免疫能力的老鼠的脑中,这样老鼠就不会对肝芽组织形成排斥反应。武部士发现,两天内肝芽结构就与这些老鼠脑中的血液循环系统相互融合了。After two months the buds not only looked like liver, they acted like it.两个月后,肝芽结构除了看上去像肝脏外,也具有了肝脏的生理功能—他们产生出了肝脏独有的蛋白质。They produced liver-specific proteins. And if Dr Takebe transplanted them to their hosts abdominal cavity, having first caused the animals real liver to fail, they often kept the mouse alive when an animal without the transplant would have died.然后武部士又将这些肝芽结构移植到了相应老鼠的腹腔中,起初肝芽结构会破坏老鼠体内自身的肝脏,但是接着很多老鼠并没有死亡。Translating this work into a way of growing new livers for people whose old ones have stopped working will take time.诚然,要将这个过程在人类身上临床试验仍需时日。But it is a big step forward.但在老鼠体内的实验已是继往开来的重要一步。After years of promise, regenerative medicine may be coming close to delivering.在人们年复一年的期盼中,再生医疗终会有实现梦想的那一天。 /201310/262804上海宝山区中西医结合医院双眼皮多少钱上海九院整形美容科祛除腋臭多少钱

松江区妇幼保健医院美容整形科青浦区妇幼保健医院抽脂多少钱上海市第二人民医院光子脱毛多少钱Science and technology科学技术Alternative medicine替代医疗Think yourself better往好处想Alternative medical treatments rarely work. But the placebo effect they induce sometimes does替代疗法的治疗效果见效甚微,但是所产生的安慰效果往往有所疗效ON MAY 29th Edzard Ernst, the worlds first professor of complementary medicine, will step down after 18 years in his post at the Peninsula Medical School, in south-west England.5月29日,作为世界首位互补性医学专家艾德撒.恩斯特将从位于英国西北部的半岛医学院退休,他在这里曾效力了18年。Despite his job title, Dr Ernst is no breathless promoter of snake oil.跟他的职务头衔相反Dr Ernst 并不是那种推销起蛇油舌灿莲花的人。Instead, he and his research group have pioneered the rigorous study of everything from acupuncture and crystal healing to Reiki channelling and herbal remedies.其实,他和他的研究团队是缜密研究针灸,水晶疗法,灵气疗法以及草药治疗的先驱。Alternative medicine is big business.替代性医疗是一个很大的商业市场。Since it is largely unregulated, reliable statistics are hard to come by.由于这一市场在很大程度上没有得到监管,所以很难获取可靠的数据统计。The market in Britain alone, however, is believed to be worth around £210m, with one in five adults thought to be consumers,然而,该市场仅在伦敦就达到约2亿1千万英镑,其中5个成年人中就有一个是替代性疗法的消费者,and some treatments available from the National Health Service.并且有些疗法还是国家医疗务制度中所提供的务项目。Around the world, according to an estimate made in 2008, the industrys value is about billion.根据2008年的评估,该产业在全球的价值约为600亿美元。Over the years Dr Ernst and his group have run clinical trials and published over 160 meta-analyses of other studies.在过去的几年中,恩斯特士和他的团队进行了临床实践并发表了160多份关于其他研究的再分化分析报告,并有了全然的发现。His findings are stark. According to his Guide to Complementary and Alternative Medicine, around 95% of the treatments he and his colleagues examined—in fields as diverse as acupuncture, herbal medicine, homeopathy and reflexology—are statistically indistinguishable from placebo treatments.根据其《补充替代医学指南》,在他及其同事所验的治疗方法中从针灸到草药,从顺势疗法到反射疗法,约有95%在数据统计上等同于安慰疗法。In only 5% of cases was there either a clear benefit above and beyond a placebo, or even just a hint that something interesting was happening to suggest that further research might be warranted.在仅有的5%的病例中,其中要么明显属于非安慰疗法所带来的疗效,要么暗示了有某些有趣的因素使得需要进一步的研究。It was, at times, a lonely experience.这一研究在过去有时很少有人涉足。Money was hard to come by.资金难以筹集。Practitioners of alternative medicine became increasingly reluctant to co-operate as the negative results piled up, while traditional medical-research bodies saw investigations into things like Ayurvedic healing as a waste of time.并且由于负面效应的积累越来越多的替代性医疗从业者不愿意参与合作,于此同时传统医疗研究组织也将针诸如对阿育吠陀疗法的研究调查视作是浪费时间。Yet Dr Ernst believes his work helps address a serious public-health problem.而恩斯特士相信他的工作将有助于解决一系列公共健康问题。He points out that conventional medicines must be shown to be both safe and efficacious before they can be licensed for sale.他指出传统药品必须在确保安全和有效后才能许可出售。That is rarely true of alternative treatments, which rely on a mixture of appeals to tradition and to the natural wholesomeness of their products to reassure consumers.但是替代性疗法却不需要,这些疗法依赖于其产品的传统性以及天然健康性的综合体来赢得消费者的放心。That explains why, for instance, some homeopaths can market treatments for malaria, despite a lack of evidence to suggest that such treatments work, or why some chiropractors can claim to cure infertility.这解释了为什么一些顺势疗法在疟疾的治疗上具有市场,尽管缺乏据显示其疗效效,以及为什么脊椎推拿师声称他们可以治疗不育症的原因。Despite this lack of evidence, and despite the possibility that some alternative practitioners may be harming their patients, Dr Ernst also believes there is something that conventional doctors can usefully learn from the chiropractors, homeopaths and Ascended Masters.虽然缺乏医疗据以及存在一些替代性疗法从业者伤害患者的可能,但是恩斯特士相信传统医生仍然可以从脊椎推拿师,顺势疗法以及上师那里学到一些有用的东西。This is the therapeutic value of the placebo effect, one of the strangest and slipperiest phenomena in medicine.作为医学中最奇怪以及最棘手的医疗现象之一,这些东西是安慰疗法的医疗价值所在。Mind and body思想与身体A placebo is a sham medical treatment—a pharmacologically inert sugar pill, perhaps, or a piece of pretend surgery.安慰疗法是一种虚假性医疗方法在药物上使用糖丸,或者进行一次虚假手术。Its main scientific use at the moment is in clinical trials as a baseline for comparison with another treatment.其主要科学应用在于它可以作为其他疗法对比基准的临床实践性。But just because the medicine is not real does not mean it doesnt work.但是不使用真实药物并不代表没有疗效。That is precisely the point of using it in trials: researchers have known for years that comparing treatment against no treatment at all will give a misleading result.这也恰恰是在实践中使用它们的原因:研究者多年以来已经明白将完全不治疗跟某种治疗法做比较往往会产生误导的结果。Giving pretend painkillers, for instance, can reduce the amount of pain a patient experiences.比如,假的止疼药可以在一定程度上缓解患者的疼痛。A study carried out in 2002 suggested that fake surgery for arthritis in the knee provides similar benefits to the real thing.2002年进行的一次研究显示针对膝部关节炎患者进行一次虚假手术所带来的疗效如同对其进行了一次真实的手术。And the effects can be harmful as well as helpful.并且产生的效果有好有坏。Patients taking fake opiates after having been prescribed the real thing may experience the shallow breathing that is a side-effect of the real drugs.而处方规定需用鸦片制剂的患者实则用了假的鸦片制剂后会出现呼吸短促这种真实药物所带来的副作用症状。Besides being benchmarks, placebos are a topic of research in their own right.除了作为基准,安慰疗法在其自身领域内也是一个研究主题。On May 16th the Royal Society, the worlds oldest scientific academy, published a volume of its Philosophical Transactions devoted to the field.5月16日,作为世界最悠久的科学研究组织,皇家学会发表了一期此领域的《哲学会报》。One conclusion emerging from the research, says Irving Kirsch, a professor at Harvard Medical School who wrote the preface to the volume,为该会报撰写前言的是来自哈佛医学院的专家欧文.克尔斯,is that the effect is strongest for those disorders that are predominantly mental and subjective, a conclusion backed by a meta-analysis of placebo studies that was carried out in 2010 by researchers at the Cochrane Collaboration,其称这些研究所得出的一个结论是安慰疗法对于那些主要是脑力和主观紊乱的患者最为有效,这一结论同样得到另一个安慰疗法再分化研究的持,an organisation that reviews evidence for medical treatments.该项研究由医疗据审核组织科克仑合作所的研究者们在2010年开展。In the case of depression, says Dr Kirsch, giving patients placebo pills can produce very nearly the same effect as dosing them with the latest antidepressant medicines.对于抑郁症病例,克尔斯称给患者用安慰性药物将产生和给患者用最新抗抑郁症药物同样的疗效。Pain is another nerve-related symptom susceptible to treatment by placebo.疼痛是另一种容易得到安慰性治疗的神经性症状。Here, patients expectations influence the potency of the effect.在这里,患者的期望值可以影响治疗的效果。Telling someone that you are giving him morphine provides more pain relief than saying you are dosing him with aspirin—even when both pills actually contain nothing more than sugar.告诉患者你给他们用的是吗啡要比告诉他们用的是阿司匹林具有更好的阵痛效果其实两种药物的成分都只是糖。Neuro-imaging shows that this deception stimulates the production of naturally occurring painkilling chemicals in the brain.神经元成像显示这种欺骗行为可以促进大脑中自然分泌的阵痛化学物质的产生。A paper in Philosophical Transactions by Karin Meissner of Ludwig-Maximilians University in Munich concludes that placebo treatments are also able to affect the autonomic nervous system, which controls unconscious functions such as heartbeat, blood pressure, digestion and the like.来自路德维希马克西米利安慕尼黑大学的卡琳.梅斯诺在《哲学会报》上发表的一份论文称安慰疗法同样可以影响控制诸如心跳,血压,消化等等这些无意识功能的自主神经系统。Drama is important, too. Placebo injections are more effective than placebo pills, and neither is as potent as sham surgery.表演在安慰疗法中也很重要。安慰性注射虽然比安慰药丸有效果,但是却没有虚假手术来得见效。And the more positive a doctor is when telling a patient about the placebo he is prescribing, the more likely it is to do that patient good.并且在向患者描述疗效的时候,医生显得越积极,对于患者来说安慰治疗的疗效越好。Despite the power of placebos, many conventional doctors are leery of prescribing them.尽管安慰疗法有着强大的力量,但是很多常规医生仍怀有猜疑。They worry that to do so is to deceive their patients.他们担心这种做法是在欺骗患者。Yet perhaps the most fascinating results in placebo research—most recently examined by Ted Kaptchuk and his colleagues at Harvard Medical School, in the context of irritable-bowel syndrome—is that the effect may persist even if patients are told that they are getting placebo treatments.然而,也许在安慰治疗研究中最引人入胜的研究结果便是即使患者之道他们所接受的是安慰治疗,其疗效却依然存在,这一发现由来自哈佛医学院的泰德.凯普扎克及其同事近期在过敏性肠综合症的研究中所确认。Unlike their conventional counterparts, practitioners of alternative medicine often excel at harnessing the placebo effect, says Dr Ernst.恩斯特士称与常规医生不同,替代性疗法的从业者善于利用安慰治疗的疗效。They offer long, relaxed consultations with their customers.他们会在轻松的气氛下向患者提供咨询。And they believe passionately in their treatments, which are often delivered with great and reassuring ceremony.并且他们对于治疗工作充满热情,使用杰出而令人放心的医疗方式进行治疗。That alone can be enough to do good, even though the magnets, crystals and ultra-dilute solutions applied to the patients are, by themselves, completely useless.仅此已足够,而那些用在患者身上的磁铁,水晶以及高稀释溶液本身就没有什么用处。 /201304/234897上海九院激光除皱手术多少钱

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