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科技医疗:战胜疾病的巧妙新技术

更新时间:2019/3/18 20:35:19 来源:纽约时报中文网 作者:佚名

The ingenious new tricks to beat disease
科技医疗:战胜疾病的巧妙新技术

According to the World Health Organization, so-called Neglected Tropical Diseases (NTDs) affect more than one billion people and cost developing economies billions of dollars every year.

据世界卫生组织(World Health Organization)称,所谓“被忽视热带病”(NTDs)的这类疾病影响着全世界10多亿人,每年给发展中国家造成数十亿美元的损失。

Populations living in poverty, without adequate sanitation and in close contact with infectious vectors such as livestock are most affected by these communicable illnesses, which prevail in tropical conditions. To complicate matters, diseases like measles and tuberculosis, which were nearly eradicated a century ago, are again on the rise. And more common, eminently treatable infectious diseases – norovirus and flu, for example – are responsible for thousands of preventable deaths each year.

生活贫困、缺乏足够的卫生设施,以及与牲畜等传染媒介有密切接触的人群,最容易感染这些在热带环境中流行的传染病。令问题更为复杂的是,一个世纪前几乎已经灭绝的麻疹和肺结核又呈上升趋势。更常见的、完全可治疗的传染病,比如诺罗病毒和流感,每年都造成数千例本可以避免的死亡。

Fortunately, new medical technology has vast potential to control infection, contain outbreak, even deliver life-saving supplies to remote regions affected by these diseases. From antimicrobial paint to powdered vaccines to drone-delivered organs, these innovations are fast becoming a clinical reality.

幸运的是,新的医疗技术在预防感染、控制疫情,甚至在向受到这些疾病影响的偏远地区运送医疗物资方面,都有非常巨大的潜力。从抗菌涂料、粉状疫苗到无人机运送器官,这些创新技术正迅速成为临床手段。

In the short-term, such tools can improve survival rate for patients affected by a host of maladies; long-term, they may help us understand pathogen epidemiology, essential to the development of global disease control programs.

在短期内,这些手段可以提高多种疾病患者的存活率;从长期来看,或许有助于我们了解病原体流行病学,这对全球疾病控制规划的发展至关重要。

Ouchless insulin

免注射的口服胰岛素

Certain medicines can only be delivered by injection. The constant pinprick of needles is painful for patients and cumbersome for healthcare providers, while a shortage of sterile hypodermic needles in some areas can lead to infection. Now, researchers from MIT’s Koch Institute for Integrative Cancer Research and Harvard’s Brigham and Women's Hospital have engineered a coating that they claim can safely carry insulin beyond the obstacles of the digestive system and into the bloodstream – a kind of edible Swiss Army knife that can deliver life-saving medicine without the pain of needle injection.

有些药物的接受只能通过注射。但长期打针对患者来说是痛苦的,对医疗保健提供方也是很麻烦,在有些地区,因为缺乏无菌皮下注射针头有可能让接受注射者感染细菌。现在,麻省理工学院柯克综合癌症研究所(Koch Institute for Integrative Cancer Research)和哈佛大学布里格姆妇科医院(Brigham and Women's Hospital)的研究人员设计了一种涂层,他们声称此技术可以安全地携带胰岛素穿过消化系统的障碍物,进入人体血液,这就像一种可以食用的瑞士刀,可以提供救命药,又没有药物注射的痛苦。

Once swallowed, the pill issues a spring-activated dart of insulin directly into the wall of the stomach. Patients with type 1 diabetes – the version of the disease in which the immune system attacks pancreatic cells that produce blood sugar-regulating insulin – might soon be able to manage their condition with the help of this pea-sized device.

这种药片一旦吞下肚,就能够在胃壁上“打一针”,释放胰岛素直接进入血液。有了这种豌豆大小的装置,就能帮助1型糖尿病患者迅速控制病情。

The researchers reported their findings in the journal Science, explaining that they were “inspired by the leopard tortoise’s ability to passively reorient”: the pill’s applicator knows how to position itself so that its microscopic needle is trained directly toward stomach tissue, without perforating any gastric organs along the way.

这些研究人员在《科学》(Science)杂志上发表了他们的发现,并且解释说,他们是受到“豹纹陆龟”的启发:这种药丸的微型装置知道如何调整自己的位置,这样显微针头就可以直接对准胃组织,而不会刺穿胃部。

The antimicrobial paint that can kill ‘superbugs’

杀死“超级细菌”的抗菌涂料

About 10% of hospital patients contract a new illness during their stay – often after coming into contact with germ-laden equipment and surfaces. This results in about 100,000 deaths annually in the US alone; globally, 700,000 people die each year as a result of drug-resistant infections, including tuberculosis, HIV and malaria. The World Health Organization recently described antibiotic resistance as a “global health emergency”.

大约10%的住院病人会感染一种新疾病,通常是因为接触了医院的带菌的设备和物体表面。仅在美国,每年因此造成约10万人死亡。全球每年有70万人死于耐药感染,包括结核病、艾滋病毒和疟疾等。世界卫生组织最近将抗生素耐药性形容为“全球健康危机”。

In response, the US Food and Drug Administration and several leading paint companies have teamed up to develop a variety of antimicrobial coatings that can be applied to medical equipment and supplies. These additives are first introduced into a paint, ink or lacquer during the manufacturing process; the paint is then applied to a surface, which, once dried, becomes resistant to microbes, mould, and fungi. One company, BioCote, produces antimicrobial paint for purchase commercially, offering a promising mechanism for fighting so-called “superbugs”: the antibiotic-resistant bacteria that can infect hospital surfaces and harm patients who are already immunocompromised.

为此,美国食品和药物管理局(US Food and Drug Administration)和几家领先的涂料公司合作开发了多种可用于医疗设备和用品的抗菌涂料。这種抗菌添加剂在生产过程中加入到涂料、油墨或者油漆当中,然后将這种涂料覆盖在设备表面,干燥之后,就能抵御微生物、霉菌和真菌。一家名为BioCote的公司生产用于商业采购的抗菌涂料,为抵御所谓的“超级细菌”提供了一个充满希望的机制。这种耐药性细菌可以感染医院建筑或设备的表面,对免疫功能已经受损的病人会造成进一步的伤害。

Ironically, the same chemicals in antibacterial products – gels, antiseptics and hand sanitisers – used to scour hospitals and clean equipment are known to actually promote these antibacterial strains, killing off good and bad bacteria alike. Since their advent in the early 20th Century, antibiotics have saved countless lives, eradicating diseases caused by harmful bacteria; but, just as overuse of the drugs has weakened their efficacy, antimicrobial paint isn’t a fail-safe measure.

具有讽刺意味的是,用于医院和清洁设备的凝胶、防腐剂和洗手液等抗菌产品中所添加的同样的化学物质,实际上却能促进这些抗菌菌株的生长,不管细菌是好是坏全部杀死。抗生素自20世纪初问世以来,挽救了无数生命,根除有害细菌引起的疾病;但是,正如药物滥用会削弱药效一样,抗菌涂料也不是万无一失的措施。

It’s safe to say that, as long as they don’t rely exclusively on one method, hospitals can now add antibacterial paint to their disease-fighting toolbox.

可以肯定地说,只要不完全依赖于一种方法,医院现在就可以在他们的抗病手段中加入抗菌涂料。

Crypto-anchors may put an end to counterfeit pharmaceuticals

加密锚定机制(crypto-anchors)可能从此杜绝假药

Fraud costs the global economy more than £3tn a year. From corporate corruption to fake electronics to identity theft, double-dealing is pervasive in almost every industry, and that includes healthcare: in some countries, nearly 70% of certain drugs are counterfeit.

欺诈使得全球经济每年的损失超过3万亿英镑。从企业腐败到假冒电子产品,再到身份盗窃,几乎所有行业都存在不诚信的行为,其中也包括医疗保健行业:在有些国家,近70%的药品都是假药。

Earlier in February, the World Health Organization reported that fake leukemia medicine, packaged for the UK market to look like the genuine drug Iclusig, was circulating in Europe and the Americas. And physicians have found traces of ecstasy and Viagra ingredients in pills posing as antimalarial medicine.

2月初,世界卫生组织报告说,假冒的白血病药物正在欧洲和美洲传播,英国市场上架的普纳替尼(Iclusig)包装与正品看起来一样。医生们在假冒的抗疟疾药物中还发现了摇头丸和伟哥的成分。

It turns out that ensuring the authenticity of medicine is nearly as difficult as monitoring bank accounts or consumer electronics, for a few reasons. Complex supply chains, comprised of dozens of suppliers in multiple countries, make it difficult to prevent bad actors from tampering with drugs. The market for legal medicine has surpassed that of illegal narcotics, a fact not lost on drug dealers; and when a patient doesn’t blossom back to health after taking a (counterfeit) drug, doctors generally blame the illness, and not the pill.

事实证明,出于几个原因,确保药品的真实性与对银行账户或消费电子产品进行监控几乎一样困难。由多个国家数十个供应商组成的复杂供应链,使得阻止不法之徒对药品动手脚变得非常困难。合法药品的市场的利润已经超过了非法假药市场,对此假药贩子不会视而不见。而且当病人因服用假药而无法痊愈,医生通常会认为是疾病的原因,不会想到是药有问题。

That may all soon change, thanks to a team of IBM researchers who are developing crypto-anchors: tamper-proof digital fingerprints that can be embedded into products and linked to a blockchain to prove their authenticity (the blockchain is a growing list of digital records called blocks, which are linked through encrypted code).

因为IBM的一个研究小组正在开发加密锚定机制,上述状况可能很快就会改变。所谓加密锚定机制是将防篡改数字指纹嵌入到产品中,并与区块链相联,以证明药品的真实性(区块链是一长串数字记录,称之为区块,通过加密的代码相连)。

Smaller than a grain of sand, these crypto-anchors can take many forms: tiny edible computers or optical codes that can be put on pills to separate them from fake meds, in much the same way that diamonds are measured and marked to distinguish them from imitation stones.

加密锚比一粒沙子还小,可以采用多种形式,例如置于药片之上的光学编码,可以区别真药与假药,这与给钻石做测量和标记,以区别于真假钻石是一个道理。

Researchers offered the example of embedding a crypto-anchor in an edible shade of magnetic ink, which could then be used to dye a malaria pill. A drop of water would visibly activate the code, assuring consumers the pill is both authentic and safe to consume.

研究人员举了一个例子,他们将一个加密锚嵌入一种可食用的磁性墨水,这种墨水可以用来给疟疾药片上色。一滴水就能显现密码,从而向消费者确保该药的真实性和食用安全性。

Since their identifying codes cannot be duplicated or copied, crypto-anchors are highly secure, offering patients, doctors and healthcare providers added security in an increasingly fraudulent pharmaceutical landscape.

由于识别码无法复制,加密锚非常安全,在造假越来越多的制药领域为患者、医生和医疗保健提供商提供了额外的安全保障。

BRCK: free public Wifi

BRCK:免费公共Wifi

We take internet connectivity for granted, but many lack reliable access to a network connection. Breakdowns in digital communication during a health crisis can have devastating consequences: missed dosages, inaccurate records, poor decision-making, medical errors, and incomplete information regarding disease outbreaks.

我们认为互联网连接是理所当然的,但许多地区缺乏可靠的网络连接。如发生健康危机,数字通信的中断可能会带来灾难性的后果,如剂量记录丢失、记录不准确、决策失误、医疗错误以及关于疾病爆发的信息不完整之类。

In Africa, a continent whose 1.1 billion inhabitants rely mostly on mobile internet, connectivity is notoriously bad; the problem is compounded by the fact that users are often trying to access content that sits on a remote server somewhere in the United States or Europe.

在非洲大陆,11亿居民主要依靠连接性能很不理想的移动互联网,而用户又需要经常浏览位于美国或欧洲某个远程服务器提供的信息,这使得问题变得更加复杂。

Enter Moja, a free public Wifi device created by the BRCK team designed to be used in areas with limited internet access. More than just a hardware router, this content delivery network (CDN) effectively replaces spotty – and expensive –cellular data, allowing users to browse the internet and social media at no additional cost, since anyone within range of Moja’s signal can connect to the internet for free.

解决方法是连接到Moja。这是一个由BRCK团队设计的免费公共Wifi设备,专门为互联网接入受限的地区所设计。Moja不仅仅是一个硬件路由器,这个信息传送网络(CDN)有效地取代了不稳定和昂贵的蜂窝数据,用户无需额外成本,就可以浏览互联网和社交媒体,因为在Moja信号范围内的所有人都可以免费连接到互联网。

Moja’s network of servers hosts content for Facebook, Netflix and Youtube, but it’s easy to see how this improved connection might have tremendous impact for disease management: remote users will be able to message one another and share information in real time, thereby streamlining communication between doctors, patients, hospitals and healthcare volunteers.

Moja的服务器网络托管Facebook、Netflix和Youtube的内容,但很容易看出这种上网连接的改进,可能会对疾病防治管理产生巨大影响:远程用户能够相互发送并实时分享信息,从而简化医生、患者、医院和医疗志愿者之间的沟通。

Plus, BRCK’s hardware is designed to stand up to the challenges of weather and environment: Moja runs through sturdy, waterproof aluminium routers with multiple power ports, ensuring that applications run smoothly even when conditions are tough.

此外,BRCK的硬件设计还考虑到了天气和环境的挑战:Moja采用坚固的防水铝制路由器,带有多个电源端口,确保应用程序即使在恶劣环境下也能顺利运行。

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