英国新闻听力 私人医疗检测设备的创新（在线收听）

Personal Medicine Innovation(私人医疗检测设备的创新)

想象一下，如果你患有心脏病，你的医生要时刻的关注您是否很好。他们可能要你留院进行检查。但是在将来，只需在你的胸上贴上特制的膏药，并同时使用一些感应器，医生只需要通过无线电话就可以检查你的心脏，你的温度，甚至你躺着的姿势。这是科技在数字医学上另一个新发展，使得医疗更加的个人化。

注释：

parameter n. 参数，参量

intrusion n. 侵扰，闯入

sensor n. 传感器

diabetic adj. 糖尿病的

ECG n. 心电图

pancreas n. 胰腺

insulin n. 胰岛素

glucose n. 葡萄糖

syringe n. 注射器

CLAUDIA HAMMOND: Imagine you’re got a heart problem and your doctor wants to keep an eye on you to know that you’re ok. They could keep you in hospital for tests. But in the future, by sticking a special plaster paced with senses onto your chest, doctors can monitor your heart, your temperature and even the position you’re lying just by looking them by mobile phones. This is just one development in the new field of digital medicine using technology to make treatments more personal. I went along to Imperial College in London to find out what’s in store for the doctors and the patients of the future. So I come to the brand new institute of bio-medical engineering at Imperial college, uh, and there’s various things we’re gonna be trying out today and uhm Chris Tumazu who’s the director of the institute and professor of medical electronics is here. First of all what is the idea of personal medicine, what does it mean?

CHRIS TUMAZU: Well, first of all, although I call myself a professor of bio-medical engineering. I’m a bit of an imposter. I’m actually an engineer and electrical engineer. And I’ve spent probablely 20 years of my academic life developing technologies that you find in devices like the mobile phone. And we realized several years ago that if you just apply a fraction of this technology to health care, we can make major innovation. And so the whole area personalized health care is if you like to take the technology away from this consumer product which is the mobile and apply it in a human space to allow people to go about their daily life, but use this technology to monitor to monitor parameters, such as heart rate, blood pressure, in a non-obtrusive wireless way out of the hospital and into the home type environment. So that’s really what we called personalized healthcare. Cause it’s health care that’s personalized to the individual which means the individual can go about their daily lifestyle without worrying about having the intrusion of medical device technology measurements in a hospital or a GPS surgery.

CLAUDIA HAMMOND: So you’re got one of these sensors here and we’re gonna have a go with it. And we’re got Doctor Nick Oliver here as well who’s a diabetic’s specialist. So what’s the sensor consist of?

NICK OLIVER: This sensor has a single lead ECG monitor on it, so it’s able to monitor your heart rate every 24 hour period, detect any irregularities with your heart rate and detect if your heart rate is going too fast or too slow. Uh it’s also got a activity monitor which is able to detect if you’re moving in any three directions forward, backward or up and down, uh, and it’s also got here a temperature sensor which you’re able to place either on the body or in your environment to assess your temperature.

CLAUDIA HAMMOND: It seems to be uh like a sort of plaster like quite a big plaster, sort of about four or five inches long.

NICK OLIVER: Yeah, that’s right and all we have to do is feel off the backing and place it on the chest.

CLAUDIA HAMMOND: Do do do stick here, doctor, after all do do go sticking.

NICK OLIVER: There we go, let’s try it there, that should just about work.

CLAUDIA HAMMOND: So you…your sticking this uh on my chest just here and you stuck it sort of diagonally across, and it’s not particularly big, so it doesn’t feel particularly uncomfortable, it’s sort of feels like a plaster really. And you’ve got this screen just here, so can we see already whether I’m alive or not?

NICK OLIVER: Yeah, absolutely, we can see that if you stand a little a little get used to your heart rate and you can see those spikes are your individual heart beats uh in a second it will tell you your heart rate.

CLAUDIA HAMMOND: Uh, so I am breathing, that’s good.

NICK OLIVER: You are, you are, there you go there is some nice spikes of your heart beats.

CLAUDIA HAMMOND: Oh, look at that one, that went right up in there

NICK OLIVER: Yeah, I think you’re live

CHRIS TUMAZU: The important thing, Claudia, is the fact that Nick could actually be in the states right now. And he could be reading your ECG continuously in real time when he wants and there is an anomaly or a problem, then he will just download the data from the sensor the last day’s worth of information, check if this was an anomaly or whether there was a consistent problem. And there was a consistent problem, he’d just phone an ambulance and ask you to go to hospital. So effectively that’s the beauty of this sort of wireless technology.

CLAUDIA HAMMOND: So the information can go from my plaster here to your mobile phone wherever your are.

CHRIS TUMAZU: Yeah, absolutely, because on the plaster we’ve got a very very low power radio. And it’s that very very low power radio which connects your plaster to a standard mobile phone. And therefore the mobile phone can be anywhere. You could be with the mobile phone in the states anywhere in the world and effectively therefore Nick can read the ECG on his mobile phone, he can send an sms signal back to interrogate the sensor, download the last worth of in formation, and if there’s an anomaly he will know and he will then call an ambulance in to pick you up and take you to hospital.

CLAUDIA HAMMOND: Well, we’re gonna go up to the lab now and see a completely different example of personalized medicine that you’ve got there and see how that’s gonna work.So I’ve come up to the lab now and and what is it were got here? This is to do with diabetes, isn’t it?

CHRIS TUMAZU: Yeah, absolutely, and and and its another piece if you like sort of bioinspired personal health care uh, the the idea of this technology is that we’re designing very very small silicon chips as you can see this is just a few millimeters in dimension,

CLAUDIA HAMMOND: That’s tiny, really tiny.

CHRIS TUMAZU: And this silicon chip chip is mimicking the behavior of the beta cell in the pancreas. The idea is to provide some intelligence to an insulin pump. So that one uh type one diabetic who needs a constant uh, amount of insulin throughout the day that insulin can be regulated by the intelligence of this beta cell which is the way biology effectively works.

CLAUDIA HAMMOND: So when a pancreas is working properly those cells decide when to release more insulin when we need that

CHRIS TUMAZU: A-a-absolutely, absolutely, but, but current technology as Nick will talk to you about in a moment. Current technology is is very primitive because it will only given you a spot measurement to your glucose and you can only at that stage compensate with with injections of insulin. This device would allow continuous injection of insulin depending upon your own physiology which will therefore counter a lot of the side effects that you get if you’re a type one diabetic.

CLAUDIA HAMMOND: So, in a sense, what’s gonna do is what a normally functioning pancreas would do for you which is to do what your body needs?

NICK OLIVER: Yeah, absolutely, uh, and at the moment, and the way the type one diabetics have to test their blood sugar, several times a day using a monitor like this and they have to inject themselves between two and four times a day, using a pen device or needle and syringe like this, and it’s uncomfortable it’s inconvenient uh, and also importantly it’s not normal control of blood glucose. So it doesn’t cure diabetics or make blood glucose normal. What we have here is bio-inspired technology which means that we’ve looked at the beta cell which normally secretes insulin and we’ve tried to replicate that behavior on a piece of silicon, uh and you can see on the screen that there there’s some little spikes and what they represent is how the beta cell would normally respond to changes in glucose concentration. So it spikes like that and with each spike it release a little bit of insulin and it does that in different ways according to different glucose concentrations. What we hope to be able to do is integrate this with a glucose sensor and with a pump and by doing so make glucose control much better for patients with type one diabetic and get rid of the need to stamp yourself between 2and 8 time a day which is a real pain for those patients

CLAUDIA HAMMOND: So how long’s it gonna be do you think before we start seeing technology like this actually used on patients on everyday basis?

CHRIS TUMAZU: Well, I think that uh we have to appreciate that even current technology for diabetics has become consumer oriented uh, a diabetic probablely goes to a hospital now less than10%, 20%of of the year, most of the time they’re in the home looking after their own disease management. So so there is therefore the model for patients to look after their own health in the same place. what we’re providing is technology which is a lot more unobtrusive as we said earlier, uh, disposable, cheap and effectively the wireless nature of the technology keep them connected as well. So it’s like the big brother of wireless technology. And so all in all I think the future we’ve talked about therapy, we’ve talked about diagnostics when you saw the digital plaster, I think the future’s gonna be using this technology for early detection. And I think soon we’ll be able to go to the GPS and they’ll be able to detect the genetic makeup of a particular individual using silicon technology on the spot to determine whether or not you predisposed to a particular disease. And I think that it is when we get the killer applications, this technology going.

CLAUDIA HAMMOND: As professor Tumazu said the genes we’re born with affect our likelihood of getting all sorts of diseases and new research has found they can also influence our liking for alcohol and tobacco.

克劳迪娅?哈蒙德：想象一下，如果你患有心脏病，你的医生要时刻的关注您是否很好。他们可能要你留院进行检查。但是在将来，只需在你的胸上贴上特制的膏药，并同时使用一些感应器，医生只需要通过无线电话就可以检查你的心脏，你的温度，甚至你躺着的姿势。这是科技在数字医学上另一个新发展，使得医疗更加的个人化。我们来看一下伦敦皇家学院为医生和患者的将来提供了什么样的服务。现在我来到了皇家学院著名的生物医学工程院。今天我们将在这里进行各种仪器的试验，克里斯?图马祖先生是该学院的主任和医学电子系的教授。首先我们先来了解一下私人医疗的概念，这是什么意思呢？

克里斯?图马祖：首先，虽然我自称是生物医学工程院的教授，但我觉得自己是一个冒充者。实际上，我是个工程师和电子工程师。我几乎花费了20年的时间在发展科技理论上，所以你会发现有类似移动电话的仪器的诞生。几年前我们就意识到，如果我们只把这种科技的一小部分应用于医疗卫生领域，我们就可以做出巨大的创新。所以整个私人化医疗的领域就是，把科技从这种可移动消费品分离开，应用到人类领域，允许人们在生活中携带它，应用这种技术去测量各个参数，比如心率、血压，在不冒犯患者的情况下在医院以外无线控制、并把这种技术带入家庭生活，这就是我们所称的私人化医疗。由于私人化医疗是针对个人的，这就意味着在无需担心被在医院医疗设备冒犯或定位检查的条件下，个人能在日常生活中照常实施医疗。

克劳迪娅?哈蒙德：所以这里有个感应器。我们来试试。这里是尼克?奥利弗医生，他也是一位糖尿病医疗专家。这个感应器是由什么组成的？

尼克?奥利弗：这个感应器的上面有一个单一主导心电图，这样就可以每24小时检查一次你的心率，检查你心脏的任何无规律跳动，检查它是否跳动过快或过慢。还有一个活动检查器，可以检查出是否你向前后或上下的任意三方向运动。还有一个温度感应器，你既可以放在身体上，也可以放在你生活的环境中，这样就可以检查出你的温度状况。

克劳迪娅?哈蒙德：它有点像种膏药，像种很大的膏药，大概有4、5英寸那么长的膏药。

尼克?奥利弗：是的。我们这样做的目的就是让人感觉不到它附在人的胸上。

克劳迪娅?哈蒙德：是一定要粘在这儿吗，还是粘在哪儿都可以？

尼克?奥利弗：我们到这边来，粘到那里才可以有效。

克劳迪娅?哈蒙德：这样，把它粘在我胸的这个部位。你是交错粘的。不是很大，感觉不到不舒服，真的就像某种膏药。你在这里放上屏幕，所以可以看到我是否活着？

尼克?奥利弗：正是这样的。你可以看到如果你站得直一点，你的正常心率就是这样。这些尖矛就是你心脏的跳动，隔一秒它就会告诉你你的心律。

克劳迪娅?哈蒙德：哦，所以我还活着。真的不错。

尼克?奥利弗：是啊，是啊。这里是你心跳的尖矛图。

克劳迪娅?哈蒙德：噢，看那向上走的那个。

尼克?奥利弗：我觉得你是活着的。

克里斯?图马祖：克劳迪娅，重要的方面是，如果有症状，尼克实际上应该马上投入状态中。当他想要的时候，他可以随时持续的读出你的心电图，如果有不正常的症状或问题，他就会从感应器上把前一天有价值的信息下载下来，检查这只是个特例，还是是持续的一问题。如果这是一个持续的问题，他会叫上救护车，要求你马上去医院，这就是无线技术的妙处。

克劳迪娅?哈蒙德：所以不管你在什么地方，信息都可以从我身上的膏药汇到你的那里去。

克里斯?图马祖：是的，绝对是这样的。因为在膏药上我们附上了一个非常非常低能量的收音机。这是一种非常非常低能量的收音机，用来连接你的膏药和我的标准移动电话。因此，移动电话可以在任何的地方。你无论在世界的哪个角落，移动电话都可以联系到你。尼克也可以有效的在他的移动电话上读到你的心电图，他可以向感应器发送一个询问信号，下载到上次有价值的信息，如果有什么不正常，他就可以叫救护车接你，送到医院。

克劳迪娅?哈蒙德：现在我们要去实验室看看与你刚才所见截然不同的私人化仪器，看看它们是怎样工作的。我们现在来到了实验室，都有些什么呢？这些是治疗糖尿病的吧？

克里斯?图马祖：是的，非常正确。还有一件是那种非常有灵感性的私人医疗设备。这种技术的理念是，我们在设计时，把一个非常非常小的硅片，你可以看到只有几毫米的硅片放入其中。

克劳迪娅?哈蒙德：真的非常非常小。

克里斯?图马祖：这种硅片是模仿了胰腺中的β 细胞。这样就使胰岛素的吸收富有了灵性。这样，一个类型的糖尿病人所需的胰岛素就能够通过β 细胞灵性的控制而变得有规律，要知道糖尿病人每天需要经常吸收大量的胰岛素。这就是生物科技的有效工作。

克劳迪娅?哈蒙德：所以当胰岛素工作恰当时，这些细胞就会根据我们的需要释放胰岛素。

克里斯?图马祖：当然，当然，但是，但是现有的技术，这个尼克一会将和你谈谈。现有的技术还是很简单的，因为它只能测量出葡萄糖的量，你也只能相应的补充一剂的胰岛素。这种仪器可以根据你自己的生理需要允许持续的注射胰岛素，因此如果你是一类型的糖尿病患者就会引发很大的副作用。

克劳迪娅?哈蒙德：所以，在某种意义上来说，它的工作原理和人体所需的正常胰腺的工作原理是一样的。

尼克?奥利弗：是，完全是这样的。现在一类型的糖尿病患者在检查血糖时，一天几次要使用像这样的仪器，必须每天注释2-4次，使用注射笔或针和注射器，像这样，非常的不舒服，也非常的不方便。更重要的是，他不能正常的控制血液中葡萄糖的含量。所以这样并不能治愈糖尿病或是控制正常的血糖量。我们这里的所指的具有生物灵性的技术，是说，我们研究发现β细胞可以正常的分泌胰岛素，同时我们也尽力的把这一动作复制在一片硅片上，这样通过屏幕你可以看到一些小的尖矛，这就反映出β细胞是怎样正常的调节葡萄糖的集中变化情况。所以，尖矛的运动是这样的，而每个尖矛都分泌些胰岛素，根据葡萄糖的集中变化情况而进行不同的分泌变化。我们所希望的就是把葡萄糖感应器和胰岛素的分泌情况结合起来，这样就更加有利于一类型的糖尿病患者控制血糖，也免除了一天2-8次的测量，这种测量对病人来说是个巨大的痛苦的原始医疗过程。

克劳迪娅?哈蒙德：那么，你认为还要过多久，这项技术才能够像我们看到的这样应用于每天的临床治疗?

克里斯?图马祖：我认为，我们不得不感谢这项医疗糖尿病的现行技术，因为它是以消费者为导向的，现在糖尿病患者的住院时间不到每年的10%或 20%，他们的一年中的大部分时间是在家中自己做医疗护理，所以这就为所有的患者制造了在同一个地方照顾自己的身体范例。我们所提供的是技术，这样才会像我们先前说过的那样不会出现唐突的现象，而所提供技术的地区一定要能够自由、便宜和有效的使用无线电话，这样才能够进行连接和联系。所以这项技术就像是无线电技术的大哥。总之，我认为当你看到数字膏药的时候，我们所说的治疗和诊断的未来，就是用这种技术做早期的检测。我认为我们将很快的能够进入全球定位系统，通过硅片就能检测出基因的组成，检测出是哪一点决定和导致了疾病的发生。我认为当我们找到致病因素，这项技术就能真正应用了。

克劳迪娅?哈蒙德：就像克里斯?图马祖教授说的那样，我们生来而具有的基因影响了我们患有疾病的类型和可能，新的调查发现基因也可以影响我们对酒精和烟草的喜爱。