ABOUT THE SPEAKER
David Agus - Cancer Doctor
Although a highly-accomplished conventional doctor, David Agus has embraced the future of medicine and is constantly exploring ways that new technologies can help in the fight against cancer.

Why you should listen

David Agus is a medical doctor and a Professor of Medicine at the University of Southern California. However, he is also the founder of a couple of game-changing medical initiatives. In 2006, he co-founded Navigenics with Dietrich Stephan, Ph.D., to form a company that would provide people with their individual genetic information, allowing them to act on any predispositions to disease that they might have and prevent onset. He also founded Oncology.com which was the largest cancer Internet resource and community.

Dr. Agus’ research is focused on the application of proteomics and genomics in the study of cancer, as well as developing new therapeutic treatments for cancer. He serves as Director of the USC Center for Applied Molecular Medicine and the USC Westside Prostate Cancer Center. Agus is also the recipient of several honors and awards, including the American Cancer Society Physician Research Award, a Clinical Scholar Award from the Sloan-Kettering Institute and the International Myeloma Foundation Visionary Science Award.

More profile about the speaker
David Agus | Speaker | TED.com
TEDMED 2009

David Agus: A new strategy in the war on cancer

抗癌斗争的新策略

Filmed:
830,903 views

David Agus说传统的癌症治疗目光短浅,仅关注于攻击个体细胞。他提出一个跨学科的新方法,使用非典型药物、计算机模拟和蛋白分析去治疗和分析整个机体。
- Cancer Doctor
Although a highly-accomplished conventional doctor, David Agus has embraced the future of medicine and is constantly exploring ways that new technologies can help in the fight against cancer. Full bio

Double-click the English transcript below to play the video.

00:15
I'm a cancer癌症 doctor医生, and I walked out of my office办公室
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我是个癌症医生,三、四年前的一天我走出办公室
00:18
and walked by the pharmacy药店 in the hospital醫院 three or four years年份 ago,
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经过医院的药房,
00:22
and this was the cover of Fortune幸运 magazine杂志
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一本封面为“为何我们被癌症战败的”的《财富》杂志
00:25
sitting坐在 in the window窗口 of the pharmacy药店.
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摆放在药房的橱窗里
00:27
And so, as a cancer癌症 doctor医生, you look at this,
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作为一个癌症医生,你看到这个,
00:29
and you get a little bit downhearted消沉.
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会有些沮丧。
00:31
But when you start开始 to read the article文章 by Cliff悬崖,
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里面有一篇克里夫的文章,
00:34
who himself他自己 is a cancer癌症 survivor幸存者,
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他本人也是癌症幸存者,
00:36
who was saved保存 by a clinical临床 trial审讯
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临床试验性治疗挽救了他的生命。
00:38
where his parents父母 drove开车 him from New York纽约 City to upstate北部 New York纽约
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当时他的父母开车从纽约市到纽约州北部
00:42
to get an experimental试验 therapy治疗 for --
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接受试验性治疗,
00:44
at the time -- Hodgkin's何杰金氏 disease疾病, which哪一个 saved保存 his life,
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他患有霍金斯病(淋巴瘤),试验性治疗救了他的命。
00:47
he makes品牌 remarkable卓越 points here.
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他在这篇文章里提出了一个很重要的问题。
00:50
And the point of the article文章 was that we have gotten得到
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这篇文章的核心是
00:53
reductionist还原 in our view视图 of biology生物学,
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用简化论者的眼光
00:56
in our view视图 of cancer癌症.
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来看待生物学、看待癌症。
00:58
For the last 50 years年份, we have focused重点 on treating治疗
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这50年里,我们一直关注于
01:01
the individual个人 gene基因
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个体基因治疗
01:03
in understanding理解 cancer癌症, not in controlling控制 cancer癌症.
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和对癌症的认识,而不是控制癌症。
01:06
So, this is an astounding惊人 table.
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这是一张让人吃惊的图表,
01:09
And this is something that sobers解酒 us in our field领域 everyday每天
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它使我们每天在我们这个领域保持清醒。
01:12
in that, obviously明显, we've我们已经 made制作 remarkable卓越 impacts影响
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很明显,我们在心血管病方面
01:14
on cardiovascular心血管 disease疾病,
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取得了显著的进步。
01:16
but look at cancer癌症. The death死亡 rate in cancer癌症
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但看看癌症呢?50年里癌症死亡率
01:19
in over 50 years年份 hasn't有没有 changed.
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没有改变。
01:22
We've我们已经 made制作 small wins in diseases疾病 like chronic慢性 myelogenous粒细胞 leukemia白血病,
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我们在某些疾病的治疗上取得了一点点成绩,象慢性粒细胞性白血病,
01:26
where we have a pill that can put 100 percent百分 of people in remission缓解,
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我们有一种药片可以使100%的病人缓解。
01:29
but in general一般, we haven't没有 made制作 an impact碰撞 at all in the war战争 on cancer癌症.
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但是,总的来说,我们并没有在抗击癌症的战斗中取得进展。
01:35
So, what I'm going to tell you today今天,
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所以今天我要讲的是
01:38
is a little bit of why I think that's the case案件,
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为什么我会这样想,
01:41
and then go out of my comfort安慰 zone
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然后走出我自己舒适区,
01:43
and tell you where I think it's going,
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告诉你我认为它会走向哪里,
01:46
where a new approach途径 -- that we hope希望 to push forward前锋
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新的方法在哪里——
01:49
in terms条款 of treating治疗 cancer癌症.
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我们希望推进癌症的治疗。
01:53
Because this is wrong错误.
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因为这样是错的。
01:56
So, what is cancer癌症, first of all?
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所以,首先癌症是什么?
01:58
Well, if one has a mass or an abnormal不正常 blood血液 value, you go to a doctor医生,
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如果一个人血液检测不正常,就会去看医生。
02:03
they stick a needle in.
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医生会给病人扎一针,
02:05
They way we make the diagnosis诊断 today今天 is by pattern模式 recognition承认:
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我们今天诊断癌症的方法是通过型态辨识。
02:09
Does it look normal正常? Does it look abnormal不正常?
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它看起来正常吗?还是看起来异常?
02:13
So, that pathologist病理学家 is just like looking at this plastic塑料 bottle瓶子.
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病理学家就象这样盯着这个塑料瓶看。
02:16
This is a normal正常 cell细胞. This is a cancer癌症 cell细胞.
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这是正常细胞,这是癌细胞。
02:19
That is the state-of-the-art最先进的 today今天 in diagnosing诊断 cancer癌症.
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这就是今天最先进的癌症诊断。
02:24
There's no molecular分子 test测试,
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没有分子检测,
02:27
there's no sequencing测序 of genes基因 that was referred简称 to yesterday昨天,
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没有以前提到的基因测序,
02:30
there's no fancy幻想 looking at the chromosomes染色体.
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也别对染色体有任何幻想。
02:33
This is the state-of-the-art最先进的 and how we do it.
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这就是我们用的最先进的技术。
02:36
You know, I know very well, as a cancer癌症 doctor医生, I can't treat对待 advanced高级 cancer癌症.
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我很清楚作为一名癌症医生,我无法治疗晚期癌症。
02:42
So, as an aside在旁边, I firmly牢牢 believe in the field领域 of trying to identify鉴定 cancer癌症 early.
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顺便提一句,我坚信要早期诊断癌症,
02:49
It is the only way you can start开始 to fight斗争 cancer癌症, is by catching it early.
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这是你可以有效抗击癌症的唯一途径,通过早期发现它。
02:54
We can prevent避免 most cancers癌症.
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我们能够预防很多癌症。
02:57
You know, the previous以前 talk alluded暗示 to preventing防止 heart disease疾病.
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前面我们提及预防心脏疾病,
03:00
We could do the same相同 in cancer癌症.
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对于癌症我们也同样可以这样做。
03:02
I co-founded共同创立 a company公司 called NavigenicsNavigenics公司,
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我和别人共同创立了一个公司叫基因导航公司,
03:04
where, if you spit into a tube --
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如果你把痰吐到一个试管里,
03:06
and we can look look at 35 or 40 genetic遗传 markers标记 for disease疾病,
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我们可以看到35或40种疾病遗传标记物,
03:12
all of which哪一个 are delayable可延时 in many许多 of the cancers癌症 --
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在许多癌症中都可以检测得到。
03:14
you start开始 to identify鉴定 what you could get,
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如果早期检测到这些标记分子,
03:18
and then we can start开始 to work to prevent避免 them.
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那么就可以做些工作来预防癌症。
03:21
Because the problem问题 is, when you have advanced高级 cancer癌症,
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因为当前对于晚期癌症
03:24
we can't do that much today今天 about it, as the statistics统计 allude暗示 to.
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我们还做不了很多,并不象某些统计数字所说的那样。
03:28
So, the thing about cancer癌症 is that it's a disease疾病 of the aged.
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癌症是一种老年人的疾病。
03:32
Why is it a disease疾病 of the aged?
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为什么是老年人的疾病?
03:34
Because evolution演化 doesn't care关心 about us after we've我们已经 had our children孩子.
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因为在我们有了孩子之后,进化不再对我们感兴趣。
03:39
See, evolution演化 protected保护 us during our childbearing生育 years年份
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我们在生育年龄之内时进化保护我们,
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and then, after age年龄 35 or 40 or 45,
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但在我们35或40或45岁后,
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it said "It doesn't matter anymore, because they've他们已经 had their progeny子孙."
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进化和我们不再有什么关系了,因为我们已经有后代了。
03:50
So if you look at cancers癌症, it is very rare罕见 -- extremely非常 rare罕见 --
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所以如果你注意观察癌症的话,可以看到
03:55
to have cancer癌症 in a child儿童, on the order订购 of thousands数千 of cases a year.
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小孩患癌症非常非常罕见,大约一年几千例。
04:00
As one gets得到 older旧的? Very, very common共同.
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但当年龄大了以后,就非常非常普遍了。
04:04
Why is it hard to treat对待?
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为什么癌症很难治疗?
04:06
Because it's heterogeneous异质,
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是因为它的多样化,
04:08
and that's the perfect完善 substrate基质 for evolution演化 within the cancer癌症.
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这种多样化对于癌症进化来说,是一个很理想的环境。
04:13
It starts启动 to select选择 out for those bad, aggressive侵略性 cells细胞,
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它挑选出那些坏的有攻击性的细胞,
04:17
what we call clonal克隆 selection选择.
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我们叫做克隆选择。
04:21
But, if we start开始 to understand理解
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但是如果我们开始认识到
04:24
that cancer癌症 isn't just a molecular分子 defect缺陷, it's something more,
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癌症并不只是一个分子的缺陷,其实更复杂,
04:29
then we'll get to new ways方法 of treating治疗 it, as I'll show显示 you.
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那么我们就会寻找新的治疗方法,就象我将向你们展示的那样。
04:33
So, one of the fundamental基本的 problems问题 we have in cancer癌症
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癌症的根本问题之一是
04:35
is that, right now, we describe描述 it by a number of adjectives形容词, symptoms症状:
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我们用一些形容词、它的一些症状来进行描述。
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"I'm tired, I'm bloated, I have pain疼痛, etc等等."
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我感觉疲倦,我有浮肿,我有疼痛等等。
04:42
You then have some anatomic解剖的 descriptions说明,
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还有一些解剖学描述,
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you get that CTCT scan扫描: "There's a three centimeter厘米 mass in the liver."
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你做了CT扫描,肝脏有一个3厘米的异物。
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You then have some body身体 part部分 descriptions说明:
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然后是身体部位的描述,
04:51
"It's in the liver, in the breast乳房, in the prostate前列腺."
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它在肝脏、在乳房、在前列腺。
04:53
And that's about it.
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就是这样。
04:56
So, our dictionary字典 for describing说明 cancer癌症 is very, very poor较差的.
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我们用来描述癌症的词语非常非常少,
05:00
It's basically基本上 symptoms症状.
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基本上是症状,
05:02
It's manifestations表现 of a disease疾病.
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是疾病的临床表现。
05:05
What's exciting扣人心弦 is that over the last two or three years年份,
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让人兴奋的是在过去2到3年中,
05:08
the government政府 has spent花费 400 million百万 dollars美元,
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政府投入4亿美元,
05:10
and they've他们已经 allocated分配 another另一个 billion十亿 dollars美元,
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他们还投入了另10亿美元
05:13
to what we call the Cancer癌症 Genome基因组 Atlas舆图 Project项目.
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给我们叫做癌症基因组图谱的项目。
05:15
So, it is the idea理念 of sequencing测序 all of the genes基因 in the cancer癌症,
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目的是对癌症的所有基因进行测序,
05:19
and giving us a new lexicon词库, a new dictionary字典 to describe描述 it.
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它给了我们一个新的词汇,用一个新的词汇对癌症进行描述。
05:24
You know, in the mid-中-1850's in France法国,
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18世纪50年代中期法国
05:27
they started开始 to describe描述 cancer癌症 by body身体 part部分.
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开始用身体部位描述癌症,
05:30
That hasn't有没有 changed in over 150 years年份.
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150年来一直这样。
05:34
It is absolutely绝对 archaic古老 that we call cancer癌症
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我们把癌症叫做前列腺癌、乳腺癌,
05:38
by prostate前列腺, by breast乳房, by muscle肌肉.
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这显然太老套了。
05:42
It makes品牌 no sense, if you think about it.
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仔细想想,它没有任何意义。
05:45
So, obviously明显, the technology技术 is here today今天,
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所以,很明显,我们现在拥有的技术,
05:48
and, over the next下一个 several一些 years年份, that will change更改.
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几年以后又会改变。
05:51
You will no longer go to a breast乳房 cancer癌症 clinic诊所.
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你不用再去乳腺癌诊所,
05:53
You will go to a HER2 amplified放大 clinic诊所, or an EGFREGFR activated活性 clinic诊所,
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你会去HER2扩增诊所,或EGFR激活诊所,
05:58
and they will go to some of the pathogenic lesions病变
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他们会检测一些病理学损害
06:00
that were involved参与 in causing造成 this individual个人 cancer癌症.
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就是引发癌症的独特病因。
06:04
So, hopefully希望, we will go from being存在 the art艺术 of medicine医学
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所以我们希望我们能从艺术医学
06:07
more to the science科学 of medicine医学,
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走向科学医学,
06:09
and be able能够 to do what they do in infectious传染病 disease疾病,
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能象对传染性疾病那样,
06:12
which哪一个 is look at that organism生物, that bacteria,
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检查微生物,细菌,
06:15
and then say, "This antibiotic抗生素 makes品牌 sense,
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然后说这个抗生素有意义,
06:18
because you have a particular特定 bacteria that will respond响应 to it."
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因为细菌对它有反应。
06:22
When one is exposed裸露 to H1N1, you take Tamiflu达菲,
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如果一个人接触了H1N1,服用达菲,
06:26
and you can remarkably异常 decrease减少 the severity严重 of symptoms症状
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他的症状就会明显减轻,
06:29
and prevent避免 many许多 of the manifestations表现 of the disease疾病.
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并且会预防许多其它临床症状。
06:32
Why? Because we know what you have, and we know how to treat对待 it --
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因为我们知道你有什么病,我们知道如何进行治疗。
06:37
although虽然 we can't make vaccine疫苗 in this country国家, but that's a different不同 story故事.
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虽然我们现在不能生产疫苗,但那是另一回事。
06:41
The Cancer癌症 Genome基因组 Atlas舆图 is coming未来 out now.
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癌症基因图谱就要问世了。
06:44
The first cancer癌症 was doneDONE, which哪一个 was brain cancer癌症.
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所做的第一个癌症是脑癌。
06:48
In the next下一个 month, the end结束 of December十二月, you'll你会 see ovarian卵巢 cancer癌症,
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下个月,12月底,就会看到卵巢癌,
06:52
and then lung cancer癌症 will come several一些 months个月 after.
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几个月后是肺癌。
06:56
There's also a field领域 of proteomics蛋白质组学 that I'll talk about in a few少数 minutes分钟,
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另外还有蛋白质组学方面,我要讲几分钟,
06:59
which哪一个 I think is going to be the next下一个 level水平
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我认为从对疾病的认识和分类来讲
07:02
in terms条款 of understanding理解 and classifying分类 disease疾病.
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它将提升一个水平。
07:06
But remember记得, I'm not pushing推动 genomics基因组学,
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但记住,我不是要推动基因组学、
07:08
proteomics蛋白质组学, to be a reductionist还原.
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蛋白组学,做一个简化论者。
07:11
I'm doing it so we can identify鉴定 what we're up against反对.
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我这样做,我们才能够确定我们面临什么问题。
07:14
And there's a very important重要 distinction分别 there that we'll get to.
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我们要达到什么目标现在还有很大的分歧。
07:18
In health健康 care关心 today今天, we spend most of the dollars美元 --
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今天的医疗保健,我们在疾病治疗上
07:21
in terms条款 of treating治疗 disease疾病 --
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花了很多钱——
07:24
most of the dollars美元 in the last two years年份 of a person's人的 life.
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大部分钱花在一个人一生中最后两年。
07:28
We spend very little, if any, dollars美元 in terms条款 of identifying识别 what we're up against反对.
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而在明确我们所面临的问题上我们只花了很少的钱,或者没花。
07:33
If you could start开始 to move移动 that, to identify鉴定 what you're up against反对,
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如果我们能够开始向这个方向走,确定我们面临什么问题,
07:37
you're going to do things a hell地狱 of a lot better.
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我们就会做得好得多。
07:40
If we could even take it one step further进一步 and prevent避免 disease疾病,
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如果我们做得能够再进一步并预防疾病,
07:44
we can take it enormously巨大 the other direction方向,
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我们就可以完全朝着另一个方向去做。
07:47
and obviously明显, that's where we need to go, going forward前锋.
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很明显,那就是我们需要的方向,向前走。
07:51
So, this is the website网站 of the National国民 Cancer癌症 Institute研究所.
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这是国家癌症研究院的网站。
07:54
And I'm here to tell you, it's wrong错误.
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在这里我要告诉你们它是错的。
07:57
So, the website网站 of the National国民 Cancer癌症 Institute研究所
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国家癌症研究院网站
07:59
says that cancer癌症 is a genetic遗传 disease疾病.
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说癌症是遗传性疾病。
08:03
The website网站 says, "If you look, there's an individual个人 mutation突变,
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这个网站说,癌症就是有个体突变,
08:07
and maybe a second第二, and maybe a third第三,
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或有第2个,第3个,
08:09
and that is cancer癌症."
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那就是癌症。
08:11
But, as a cancer癌症 docDOC, this is what I see.
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但是,作为一个癌症医生,就我所了解的
08:15
This isn't a genetic遗传 disease疾病.
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它不是一种遗传性疾病。
08:17
So, there you see, it's a liver with colon结肠 cancer癌症 in it,
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你看那,那是个肝脏,有结肠癌,
08:20
and you see into the microscope显微镜 a lymph淋巴 node节点
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你从显微镜看,有一个淋巴结,
08:22
where cancer癌症 has invaded入侵.
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癌症就是从那侵入的。
08:24
You see a CTCT scan扫描 where cancer癌症 is in the liver.
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你看CT扫描能知道肿瘤在肝脏的哪个位置。
08:28
Cancer癌症 is an interaction相互作用 of a cell细胞
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癌症是细胞与环境相互作用的结果,
08:31
that no longer is under growth发展 control控制 with the environment环境.
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使细胞的生长不再受控制。
08:36
It's not in the abstract抽象; it's the interaction相互作用 with the environment环境.
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它不是抽象的,它与环境相互作用。
08:40
It's what we call a system系统.
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这就是我们所说的系统。
08:43
The goal目标 of me as a cancer癌症 doctor医生 is not to understand理解 cancer癌症.
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作为一名癌症医生,我的目标不是去认识癌症。
08:47
And I think that's been the fundamental基本的 problem问题 over the last five decades几十年,
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我认为这50年来的根本问题
08:50
is that we have strived努力 to understand理解 cancer癌症.
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是我们一直致力于去认识癌症,
08:53
The goal目标 is to control控制 cancer癌症.
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我们的目标是去控制癌症。
08:56
And that is a very different不同 optimization优化 scheme方案,
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这是非常不同的优化方案,
08:58
a very different不同 strategy战略 for all of us.
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对于我们所有人来说是非常不同的策略。
09:01
I got up at the American美国 Association协会 of Cancer癌症 Research研究,
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我参加了美国癌症研究协会的
09:03
one of the big cancer癌症 research研究 meetings会议, with 20,000 people there,
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一个最大的癌症研究会议,20,000人参加。
09:07
and I said, "We've我们已经 made制作 a mistake错误.
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当时我说,我们犯了个错误,
09:10
We've我们已经 all made制作 a mistake错误, myself included包括,
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我们都犯了个错误,包括我自己,
09:13
by focusing调焦 down, by being存在 a reductionist还原.
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我们的重点错了,我们成为简化论者。
09:15
We need to take a step back."
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我们需要倒退一步。
09:17
And, believe it or not, there were hisses嘶嘶声 in the audience听众.
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无论你相信与否,观众中有嘘声。
09:19
People got upset烦乱, but this is the only way we're going to go forward前锋.
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人们感到不安了,但这是我们向前走的唯一一条路。
09:23
You know, I was very fortunate幸运 to meet遇到 Danny丹尼 Hillis希利斯 a few少数 years年份 ago.
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几年前我非常幸运遇到了Danny Hillis。
09:27
We were pushed together一起, and neither也不 one of us really wanted to meet遇到 the other.
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我们被推到了一起,但最初我们谁也没打算见面。
09:31
I said, "Do I really want to meet遇到 a guy from Disney迪士尼, who designed设计 computers电脑?"
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我说:“我真的想见一个从迪斯尼来的家伙吗?一个设计电脑的家伙?”
09:35
And he was saying: Does he really want to meet遇到 another另一个 doctor医生?
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而他说,他真想会见另一个医生。
09:38
But people prevailed盛行 on us, and we got together一起,
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但人们说服了我们,我们凑到了一起,
09:40
and it's been transformative变革 in what I do, absolutely绝对 transformative变革.
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我做了非常具有革新性的,绝对革新的项目。
09:46
We have designed设计, and we have worked工作 on the modeling造型 --
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我们一起设计、一起建立模型——
09:49
and much of these ideas思路 came来了 from Danny丹尼 and from his team球队 --
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许多主意都是来自Danny,来自他的团队——
09:53
the modeling造型 of cancer癌症 in the body身体 as complex复杂 system系统.
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体内癌症模型是非常复杂的系统。
09:56
And I'll show显示 you some data数据 there
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我会给你们显示一些数据,
09:58
where I really think it can make a difference区别 and a new way to approach途径 it.
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我真的认为它可以用一种不同的新方法达到目标。
10:02
The key is, when you look at these variables变量 and you look at this data数据,
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关键是当你看成这些变量、这些数据时,
10:06
you have to understand理解 the data数据 inputs输入.
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你必须了解数据的输入。
10:10
You know, if I measured测量 your temperature温度 over 30 days,
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如果我给你量体温超过30天,
10:14
and I asked, "What was the average平均 temperature温度?"
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然后我问平均体温是多少,
10:16
and it came来了 back at 98.7, I would say, "Great."
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当它回落到98.7,我会说太好了。
10:20
But if during one of those days
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但是如果其中一天
10:22
your temperature温度 spiked to 102 for six hours小时,
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有6个小时你的体温峰值达到102,
10:25
and you took Tylenol泰诺 and got better, etc等等.,
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然后你服用泰诺感觉好多了...
10:27
I would totally完全 miss小姐 it.
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而我却丢失了这个数据。
10:29
So, one of the problems问题, the fundamental基本的 problems问题 in medicine医学
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所以医学上一个根本的问题
10:32
is that you and I, and all of us,
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是你和我,以及我们所有的人,
10:34
we go to our doctor医生 once一旦 a year.
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我们一年看一次医生。
10:36
We have discrete离散的 data数据 elements分子; we don't have a time function功能 on them.
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我们的数据元素互不关联,我们对此没有时间函数。
10:40
Earlier it was referred简称 to this direct直接 life device设备.
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不久前,我们使用了这个叫做第一手生命的设备。
10:43
You know, I've been using运用 it for two and a half months个月.
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我已用了2个半月。
10:46
It's a staggering踉跄 device设备, not because it tells告诉 me
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它真是个令人难以置信的装置,不是因为它告诉我
10:48
how many许多 kilocalories千卡 I do every一切 day,
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每天我有多少卡路里,
10:51
but because it looks容貌, over 24 hours小时, what I've doneDONE in a day.
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而是因为它24小时监测我一天中做了什么。
10:55
And I didn't realize实现 that for three hours小时 I'm sitting坐在 at my desk,
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我没有意识到我在桌子前已经坐了3小时,
10:58
and I'm not moving移动 at all.
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没有一点活动。
11:00
And a lot of the functions功能 in the data数据 that we have as input输入 systems系统 here
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这个类似输入系统中有许多功能
11:05
are really different不同 than we understand理解 them,
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与我们所了解的完全不同,
11:08
because we're not measuring测量 them dynamically动态.
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因为我们不是动态地进行测定。
11:10
And so, if you think of cancer癌症 as a system系统,
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你可以把癌症想象为一个系统,
11:15
there's an input输入 and an output产量 and a state in the middle中间.
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它有输入、输出和中间状态。
11:19
So, the states状态, are equivalent当量 classes of history历史,
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状态相当于病史、
11:22
and the cancer癌症 patient患者, the input输入, is the environment环境,
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癌症病人;输入就是环境、
11:25
the diet饮食, the treatment治疗, the genetic遗传 mutations突变.
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饮食、治疗、遗传变异;
11:29
The output产量 are our symptoms症状:
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输出就是症状:
11:32
Do we have pain疼痛? Is the cancer癌症 growing生长? Do we feel bloated, etc等等.?
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有疼痛吗?肿瘤在发展吗?有浮肿吗等等。
11:36
Most of that state is hidden.
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许多情况是隐藏的。
11:40
So what we do in our field领域 is we change更改 and input输入,
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所以我们能做的是我们要改变输入,
11:43
we give aggressive侵略性 chemotherapy化疗,
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我们给与积极的化疗。
11:45
and we say, "Did that output产量 get better? Did that pain疼痛 improve提高, etc等等.?"
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然后我们说输出好些吗?疼痛有所改善吗?等等。
11:50
And so, the problem问题 is that it's not just one system系统,
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所以,问题不仅仅是一个系统,
11:54
it's multiple systems系统 on multiple scales.
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它是多维度上的多个系统,
11:57
It's a system系统 of systems系统.
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是多系统中的一个系统。
12:00
And so, when you start开始 to look at emergent应急 systems系统,
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在你观察新出现的系统时,
12:02
you can look at a neuron神经元 under a microscope显微镜.
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你在显微镜下看到神经细胞。
12:05
A neuron神经元 under the microscope显微镜 is very elegant优雅
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镜下的神经细胞非常漂亮,
12:07
with little things sticking症结 out and little things over here,
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有些小的突起,
12:10
but when you start开始 to put them together一起 in a complex复杂 system系统,
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当你把它们放到一起,放到一个复杂的系统中时,
12:14
and you start开始 to see that it becomes a brain,
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你看到它变成了大脑,
12:16
and that brain can create创建 intelligence情报,
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大脑可以产生智慧。
12:19
what we're talking about in the body身体,
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我们谈论的是机体内的事,
12:21
and cancer癌症 is starting开始 to model模型 it like a complex复杂 system系统.
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癌症就是这样模仿它的,象个复杂的系统。
12:24
Well, the bad news新闻 is that these robust强大的 --
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坏消息是这些旺盛——
12:27
and robust强大的 is a key word --
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旺盛是一个关键词——
12:29
emergent应急 systems系统 are very hard to understand理解 in detail详情.
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系统要详细了解它们是很困难的。
12:33
The good news新闻 is you can manipulate操作 them.
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好消息是你可以操纵它们,
12:36
You can try to control控制 them
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也可以努力控制它们
12:38
without that fundamental基本的 understanding理解 of every一切 component零件.
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即使你并不是完全了解其每个元素。
12:41
One of the most fundamental基本的 clinical临床 trials试验 in cancer癌症
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二月份的新英格兰医学杂志
12:44
came来了 out in February二月 in the New England英国 Journal日志 of Medicine医学,
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刊登了一篇关于癌症的最基本的临床试验,
12:47
where they took women妇女 who were pre-menopausal绝经前 with breast乳房 cancer癌症.
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对象是停经前患乳腺癌的妇女。
12:51
So, about the worst最差 kind of breast乳房 cancer癌症 you can get.
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这里有最糟糕的乳腺癌病例。
12:54
They had gotten得到 their chemotherapy化疗,
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他们都接受化疗,
12:56
and then they randomized随机 them,
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然后把他们随机分成2组,
12:58
where half got placebo安慰剂,
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1组用安慰剂,
13:00
and half got a drug药物 called Zoledronic唑来膦 acid that builds建立 bone.
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另1组用唑来磷酸,一种影响骨代谢的药物,
13:04
It's used to treat对待 osteoporosis骨质疏松,
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它过去一直用于治疗骨质疏松,
13:06
and they got that twice两次 a year.
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一年用2次。
13:08
They looked看着 and, in these 1,800 women妇女,
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他们观察到
13:12
given特定 twice两次 a year a drug药物 that builds建立 bone,
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每年给这1800名妇女用2次药,
13:15
you reduce减少 the recurrence循环 of cancer癌症 by 35 percent百分.
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癌症的复发率减少了35%。
13:21
Reduce减少 occurrence发生 of cancer癌症 by a drug药物
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降低癌症复发率所用的药物
13:23
that doesn't even touch触摸 the cancer癌症.
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根本就没有接触到癌症。
13:25
So the notion概念, you change更改 the soil, the seed种子 doesn't grow增长 as well.
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它的概念是土地改变了,种子也就不生长了。
13:30
You change更改 that system系统,
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你改变了癌症系统,
13:33
and you could have a marked effect影响 on the cancer癌症.
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对癌症有明显成效。
13:35
Nobody没有人 has ever shown显示 -- and this will be shocking触目惊心 --
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从没有人展示过——这是很令人震惊的——
13:38
nobody没有人 has ever shown显示 that most chemotherapy化疗
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从没有人展示过大多数化疗
13:41
actually其实 touches触摸 a cancer癌症 cell细胞.
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实际上触及了癌细胞。
13:43
It's never been shown显示.
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从未展示过。
13:45
There's all these elegant优雅 work in the tissue组织 culture文化 dishes碗碟,
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在组织培养皿中做了所有这些工作,
13:48
that if you give this cancer癌症 drug药物, you can do this effect影响 to the cell细胞,
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如果给肿瘤药物,那么对细胞也可以这样做,
13:51
but the doses剂量 in those dishes碗碟 are nowhere无处 near
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但是培养皿所用剂量
13:54
the doses剂量 that happen发生 in the body身体.
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与机体所用剂量是不同的。
13:58
If I give a woman女人 with breast乳房 cancer癌症 a drug药物 called Taxol紫杉醇
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如果我给乳腺癌妇女使用紫杉醇这种药物,
14:01
every一切 three weeks, which哪一个 is the standard标准,
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每三周使用一次,这是标准剂量,
14:03
about 40 percent百分 of women妇女 with metastatic转移性 cancer癌症
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大约40%转移癌患者
14:05
have a great response响应 to that drug药物.
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对这个药都有很大的反应。
14:08
And a response响应 is 50 percent百分 shrinkage收缩.
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一种反应是50%人的肿瘤缩小了。
14:10
Well, remember记得 that's not even an order订购 of magnitude大小,
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记住,这不是一个数量级,
14:12
but that's a different不同 story故事.
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它是另一回事。
14:14
They then recur复发, I give them that same相同 drug药物 every一切 week.
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有人复发了,我每周给他们相同的药物,
14:18
Another另一个 30 percent百分 will respond响应.
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又有30%的人有反应。
14:21
They then recur复发, I give them that same相同 drug药物
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又复发了,我还是给他们同样的药物
14:23
over 96 hours小时 by continuous连续 infusion注入,
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96小时以上连续输注,
14:26
another另一个 20 or 30 percent百分 will respond响应.
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又20或30%的人有反应。
14:29
So, you can't tell me it's working加工 by the same相同 mechanism机制 in all three size尺寸.
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这样,你不能说对这三批病人我采用了同样的治疗机制。
14:33
It's not. We have no idea理念 the mechanism机制.
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它不是。我们对此机制也没有什么概念。
14:36
So the idea理念 that chemotherapy化疗 may可能 just be disrupting妨害
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可能是化疗破坏了
14:39
that complex复杂 system系统,
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那个复杂的系统,
14:42
just like building建造 bone disrupted破坏 that system系统 and reduced减少 recurrence循环,
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就象骨代谢药破坏了那个系统而减少了复发一样,
14:47
chemotherapy化疗 may可能 work by that same相同 exact精确 way.
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化疗可能也是完全同样的作用。
14:50
The wild野生 thing about that trial审讯 also,
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关于这项试验还有一件离奇的事情,
14:53
was that it reduced减少 new primaries初选, so new cancers癌症, by 30 percent百分 also.
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它减少了新的原发癌,新的癌症,也是30%。
15:02
So, the problem问题 is, yours你的 and mine, all of our systems系统 are changing改变.
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所以问题是,包括你的和我的问题,我们所有的系统都在变化,
15:07
They're dynamic动态.
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它们是动态的。
15:09
I mean, this is a scary害怕 slide滑动, not to take an aside在旁边,
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这是一张可怕的幻灯片,没把它拿掉,
15:12
but it looks容貌 at obesity肥胖 in the world世界.
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它展示的是世界上的肥胖人口。
15:14
And I'm sorry if you can't read the numbers数字, they're kind of small.
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我很遗憾,如果你读不到这些数字,有些小。
15:17
But, if you start开始 to look at it, that red, that dark黑暗 color颜色 there,
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但如果你仔细看,红色和黑色的,
15:21
more than 75 percent百分 of the population人口
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那些国家
15:24
of those countries国家 are obese肥胖.
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75%以上的人口肥胖。
15:27
Look a decade ago, look two decades几十年 ago: markedly明显地 different不同.
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看看10年前,20年前,非常不同。
15:31
So, our systems系统 today今天 are dramatically显着 different不同
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所以今天我们的系统与10年、20年前相比
15:34
than our systems系统 a decade or two ago.
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有很大的不同。
15:38
So the diseases疾病 we have today今天,
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我们今天的疾病
15:41
which哪一个 reflect反映 patterns模式 in the system系统 over the last several一些 decades几十年,
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所反应的是过去几十年里的系统模式,
15:45
are going to change更改 dramatically显着 over the next下一个 decade or so
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而在以后10年里或在这个基础上
15:49
based基于 on things like this.
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将会发生巨大的变化。
15:52
So, this picture图片, although虽然 it is beautiful美丽, is a 40-gigabyte-gigabyte picture图片
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这张照片,看起来挺漂亮,是整个蛋白质组400亿字节的
16:02
of the whole整个 proteome蛋白质组.
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一张照片。
16:04
So this is a drop下降 of blood血液 that has gone走了 through通过 a superconducting超导 magnet磁铁,
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它只用一滴血经过超导磁,
16:08
and we're able能够 to get resolution解析度
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我们就能够得出结论:
16:10
where we can start开始 to see all of the proteins蛋白质 in the body身体.
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我们从哪可以开始看到机体所有蛋白质。
16:14
We can start开始 to see that system系统.
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我们可以看整个系统了。
16:16
Each of the red dots are where a protein蛋白 has actually其实 been identified确定.
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每个红点就是蛋白质被鉴定的地方。
16:20
The power功率 of these magnets磁铁, the power功率 of what we can do here,
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这些磁力,我们在这里所能做的
16:22
is that we can see an individual个人 neutron中子 with this technology技术.
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是用这个技术我们能看到个体的中子。
16:27
So, again, this is stuff东东 we're doing with Danny丹尼 Hillis希利斯
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这就是我们与Danny Hillis
16:30
and a group called Applied应用的 Proteomics蛋白质组学,
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和一个叫做应用蛋白组学的团队所做的事情,
16:32
where we can start开始 to see individual个人 neutron中子 differences分歧,
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我们可以看到个体中子的差异,
16:36
and we can start开始 to look at that system系统 like we never have before.
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过去我们从来没有见过。
16:40
So, instead代替 of a reductionist还原 view视图, we're taking服用 a step back.
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我们用后退一步取代了从简化论者的角度看待这个问题。
16:44
So this is a woman女人, 46 years年份 old,
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这个妇女,46岁,
16:48
who had recurrent复发 lung cancer癌症.
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肺癌复发。
16:51
It was in her brain, in her lungs, in her liver.
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她的脑部、肺脏、肝脏都有癌细胞。
16:55
She had gotten得到 Carboplatin卡铂 Taxol紫杉醇, Carboplatin卡铂 Taxotere泰索帝,
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她接受了紫杉醇卡铂、卡铂泰索帝、
16:59
Gemcitabine吉西他滨, Navelbine诺维本:
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Gemcitabene和诺维本。
17:01
Every一切 drug药物 we have she had gotten得到, and that disease疾病 continued继续 to grow增长.
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我们有的每一种药她都用了,但是癌症继续发展。
17:06
She had three kids孩子 under the age年龄 of 12,
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她的三个孩子都在12岁以下,
17:10
and this is her CTCT scan扫描.
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这是她的CAT扫描。
17:12
And so what this is, is we're taking服用 a cross-section横截面 of her body身体 here,
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这是什么?是我们为她做的横截面图。
17:15
and you can see in the middle中间 there is her heart,
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中间是她的心脏,
17:18
and to the side of her heart on the left there is this large tumor
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心脏左边有一个很大的肿瘤,
17:22
that will invade入侵 and will kill her, untreated未处理, in a matter of weeks.
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如果不治疗,几周内肿瘤就会侵犯她并杀死她。
17:28
She goes on a pill a day that targets目标 a pathway,
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她每天服用一片药,药物目标是影响代谢过程的途径,
17:33
and again, I'm not sure if this pathway was in the system系统, in the cancer癌症,
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我也不确定在这个系统中,在这个癌症里,这个途径是否存在
17:37
but it targeted针对 a pathway, and a month later后来, powPOW, that cancer's癌症的 gone走了.
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但药物起效了,一个月后,肿瘤消失了。
17:43
Six months个月 later后来 it's still gone走了.
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六个月后,仍然没有复发。
17:46
That cancer癌症 recurred复发, and she passed通过 away three years年份 later后来 from lung cancer癌症,
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3年后,癌症又复发了,她死于肺癌,
17:51
but she got three years年份 from a drug药物
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但是她通过服药又活了3年,
17:55
whose谁的 symptoms症状 predominately主要 were acne粉刺.
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主要症状是痤疮。
17:57
That's about it.
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就是这样。
17:59
So, the problem问题 is that the clinical临床 trial审讯 was doneDONE,
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临床试验已经做了,
18:03
and we were a part部分 of it,
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我们参与了其中一部分,
18:05
and in the fundamental基本的 clinical临床 trial审讯 --
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在基本的临床试验中,
18:07
the pivotal关键的 clinical临床 trial审讯 we call the Phase Three,
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关键的一个试验我们叫它第三阶段,
18:09
we refused拒绝 to use a placebo安慰剂.
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我们拒绝使用安慰剂。
18:12
Would you want your mother母亲, your brother哥哥, your sister妹妹
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如果你的母亲、兄弟、姐妹是晚期肺癌,
18:14
to get a placebo安慰剂 if they had advanced高级 lung cancer癌症 and had weeks to live生活?
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生命只有几个星期的时间了,你愿意让他们使用安慰剂吗?
18:18
And the answer回答, obviously明显, is not.
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很明显,答案是不。
18:20
So, it was doneDONE on this group of patients耐心.
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所以这一组病人是这样做的。
18:22
Ten percent百分 of people in the trial审讯 had this dramatic戏剧性 response响应 that was shown显示 here,
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试验中10%的病人有明显的反应,正如这里显示的,
18:28
and the drug药物 went to the FDAFDA,
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然后我们把药物送到FDA,
18:31
and the FDAFDA said, "Without没有 a placebo安慰剂,
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FDA说没有安慰剂,
18:33
how do I know patients耐心 actually其实 benefited受益 from the drug药物?"
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我怎么知道病人是真正从这个药物获益的?
18:38
So the morning早上 the FDAFDA was going to meet遇到,
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所以这天早上FDA开会,
18:40
this was the editorial社论 in the Wall Street Journal日志.
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这是华尔街杂志的编辑部。
18:43
(Laughter笑声)
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(笑声)
18:45
And so, what do you know, that drug药物 was approved批准.
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你知道,那个药物被批准了。
18:49
The amazing惊人 thing is another另一个 company公司 did the right scientific科学 trial审讯,
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令人惊讶的一件事是另一个公司也恰好做了这项科学试验,
18:53
where they gave half placebo安慰剂 and half the drug药物.
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他们用一半安慰剂,一半药物。
18:56
And we learned学到了 something important重要 there.
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我们从那也听说了一些重要的事情。
18:58
What's interesting有趣 is they did it in South America美国 and Canada加拿大,
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有意思的事情是他们在南美和加拿大做的,
19:01
where it's "more ethical合乎道德的 to give placebos安慰剂."
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在那些地方“给予安慰剂更道德一些”。
19:04
They had to give it also in the U.S. to get approval赞同,
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这个药物在美国也要得到批准,
19:06
so I think there were three U.S. patients耐心
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我想在纽约州北部有3个美国病人
19:08
in upstate北部 New York纽约 who were part部分 of the trial审讯.
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参与了试验。
19:10
But they did that, and what they found发现
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试验发现
19:12
is that 70 percent百分 of the non-responders无应答
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70%的无反应病人
19:15
lived生活 much longer and did better than people who got placebo安慰剂.
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比使用安慰剂的病人生存时间更长、生活质量更高。
19:20
So it challenged挑战 everything we knew知道 in cancer癌症,
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它对我们所了解的癌症提出了挑战,
19:23
is that you don't need to get a response响应.
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那就是你不需要有什么反应,
19:25
You don't need to shrink收缩 the disease疾病.
357
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你不需要在疾病面前退缩。
19:27
If we slow the disease疾病, we may可能 have more of a benefit效益
358
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如果我们能够延缓疾病的发展,
19:31
on patient患者 survival生存, patient患者 outcome结果, how they feel,
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比我们在疾病面前退缩,
19:35
than if we shrink收缩 the disease疾病.
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对于病人的存活、病人的后果及病人的感受会有更多好处。
19:37
The problem问题 is that, if I'm this docDOC, and I get your CTCT scan扫描 today今天
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问题是,如果我就是这个医生,今天我拿到你的CAT扫描,
19:40
and you've got a two centimeter厘米 mass in your liver,
362
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你的肝脏有个2厘米的东西,
19:43
and you come back to me in three months个月 and it's three centimeters公分,
363
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3000
3个月后你回来找我,那个东西3厘米了,
19:46
did that drug药物 help you or not?
364
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2000
那么那个药物对你是否有帮助?
19:48
How do I know?
365
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我怎么知道呢?
19:50
Would it have been 10 centimeters公分, or am I giving you a drug药物
366
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4000
它可能原本会长到10厘米,或我给你的药
19:54
with no benefit效益 and significant重大 cost成本?
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没有任何作用而且非常昂贵?
19:57
So, it's a fundamental基本的 problem问题.
368
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所以这是根本问题。
19:59
And, again, that's where these new technologies技术 can come in.
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也就是这些新技术产生的原因。
20:04
And so, the goal目标 obviously明显 is that you go into your doctor's医生 office办公室 --
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所以很明显你进医生办公室的目标是——
20:08
well, the ultimate最终 goal目标 is that you prevent避免 disease疾病, right?
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预防疾病的发生,对。
20:11
The ultimate最终 goal目标 is that you prevent避免 any of these things from happening事件.
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最终目标是防止疾病发生。
20:15
That is the most effective有效, cost-effective经济有效,
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这是我们今天能做的
20:18
best最好 way we can do things today今天.
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最有效、最经济的做法。
20:20
But if one is unfortunate不幸的 to get a disease疾病,
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但如果你不幸患病了,
20:23
you'll你会 go into your doctor's医生 office办公室, he or she will take a drop下降 of blood血液,
376
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3000
你就会去看医生,医生就会为你抽点血,
20:26
and we will start开始 to know how to treat对待 your disease疾病.
377
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然后就知道如何治疗你的疾病。
20:31
The way we've我们已经 approached接近 it is the field领域 of proteomics蛋白质组学,
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3000
我们的方法还是蛋白组学方面的,
20:34
again, this looking at the system系统.
379
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就是这个系统,
20:36
It's taking服用 a big picture图片.
380
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2000
一张大图。
20:38
The problem问题 with technologies技术 like this is
381
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3000
这种技术的问题是
20:41
that if one looks容貌 at proteins蛋白质 in the body身体,
382
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2000
如果观察机体的蛋白质,
20:43
there are 11 orders命令 of magnitude大小 difference区别
383
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3000
在高丰度蛋白和低丰度蛋白之间
20:46
between之间 the high-abundant高丰度 and the low-abundant低丰度 proteins蛋白质.
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有11个数量级的差异。
20:49
So, there's no technology技术 in the world世界 that can span跨度 11 orders命令 of magnitude大小.
385
1234000
5000
世界上没有一种技术能够跨越11个数量级。
20:54
And so, a lot of what has been doneDONE with people like Danny丹尼 Hillis希利斯 and others其他
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5000
所以我们与Danny Hillis和其他人所做的很多事情
20:59
is to try to bring带来 in engineering工程 principles原则, try to bring带来 the software软件.
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4000
是想引进工程原理,引进软件。
21:03
We can start开始 to look at different不同 components组件 along沿 this spectrum光谱.
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5000
我们就可以看到频谱间的不同组分。
21:08
And so, earlier was talked about cross-discipline跨学科, about collaboration合作.
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5000
前面谈论过跨学科,谈论了合作。
21:13
And I think one of the exciting扣人心弦 things that is starting开始 to happen发生 now
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1258000
3000
我认为一个令人激动的事情是
21:16
is that people from those fields领域 are coming未来 in.
391
1261000
3000
其它领域的人们已开始介入。
21:19
Yesterday昨天, the National国民 Cancer癌症 Institute研究所 announced公布 a new program程序
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3000
昨天,国家癌症研究所公布了一个新的项目,
21:22
called the Physical物理 Sciences科学 and Oncology肿瘤科,
393
1267000
3000
叫做物理科学和肿瘤学,
21:25
where physicists物理学家, mathematicians数学家, are brought in to think about cancer癌症,
394
1270000
4000
物理学家、数学家都介入研究癌症,
21:29
people who never approached接近 it before.
395
1274000
3000
而这些人以前从未接触过。
21:32
Danny丹尼 and I got 16 million百万 dollars美元, they announced公布 yesterday昨天,
396
1277000
3000
Danny和我拿到了1600万美元,他们昨天公布了,
21:35
to try to attach连接 this problem问题.
397
1280000
2000
尝试解决这个问题。
21:37
A whole整个 new approach途径, instead代替 of giving high doses剂量 of chemotherapy化疗
398
1282000
4000
一个全新的方法,不是给予高剂量的化疗药物,
21:41
by different不同 mechanisms机制,
399
1286000
2000
而是通过不同的机制
21:43
to try to bring带来 technology技术 to get a picture图片 of what's actually其实 happening事件 in the body身体.
400
1288000
6000
能够有一种技术可以得到一张照片告诉我们机体内究竟发生了什么。
21:49
So, just for two seconds, how these technologies技术 work --
401
1294000
4000
所以,用2秒钟,这些技术是如何工作的——
21:53
because I think it's important重要 to understand理解 it.
402
1298000
3000
因为我认为了解它是重要的。
21:56
What happens发生 is every一切 protein蛋白 in your body身体 is charged带电,
403
1301000
3000
它是怎么回事呢?你身体里的每个蛋白都是带电的,
21:59
so the proteins蛋白质 are sprayed in, the magnet磁铁 spins自旋 them around,
404
1304000
4000
磁性物质围绕蛋白质旋转,
22:03
and then there's a detector探测器 at the end结束.
405
1308000
2000
最后有一个检测器,
22:05
When it hit击中 that detector探测器 is dependent依赖的 on the mass and the charge收费.
406
1310000
5000
它何时能碰到那个检测器要根据它的质量和电荷。
22:10
And so we can accurately准确 -- if the magnet磁铁 is big enough足够,
407
1315000
3000
所以很精确地,如果它磁性很强,
22:13
and your resolution解析度 is high enough足够 --
408
1318000
2000
你的分辨率也很高,
22:15
you can actually其实 detect检测 all of the proteins蛋白质 in the body身体
409
1320000
3000
你就可以检测机体内所有的蛋白质,
22:18
and start开始 to get an understanding理解 of the individual个人 system系统.
410
1323000
4000
就可以了解这个个体系统。
22:22
And so, as a cancer癌症 doctor医生,
411
1327000
2000
作为一名癌症医生,
22:24
instead代替 of having paper in my chart图表, in your chart图表, and it being存在 this thick,
412
1329000
5000
你、我都不需要这么厚的纸质文件,
22:29
this is what data数据 flow is starting开始 to look like in our offices办事处,
413
1334000
4000
可以用办公室的数据流代替,就象这样,
22:33
where that drop下降 of blood血液 is creating创建 gigabytes千兆字节 of data数据.
414
1338000
3000
一滴血产生千兆字节的数据。
22:36
Electronic电子 data数据 elements分子 are describing说明 every一切 aspect方面 of the disease疾病.
415
1341000
4000
电子数据可以描述疾病的每一个方面。
22:40
And certainly当然 the goal目标 is we can start开始 to learn学习 from every一切 encounter遭遇
416
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4000
当然目标是我们可以从每一个问题中了解问题,
22:44
and actually其实 move移动 forward前锋, instead代替 of just having encounter遭遇 and encounter遭遇,
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就能够前进一步,而不仅仅是反复遇到问题
22:49
without fundamental基本的 learning学习.
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而没有根本的了解。
22:51
So, to conclude得出结论, we need to get away from reductionist还原 thinking思维.
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结论是我们需要远离简化论的思想。
22:57
We need to start开始 to think differently不同 and radically根本.
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我们需要完全不同的想法。
23:01
And so, I implore恳求 everyone大家 here: Think differently不同. Come up with new ideas思路.
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所以我请求在座的每一位,用不同的方法去思考,提出新的思路。
23:05
Tell them to me or anyone任何人 else其他 in our field领域,
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去告诉我们这个领域里的每一个人,
23:08
because over the last 59 years年份, nothing has changed.
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因为在过去59年里,什么也没改变。
23:11
We need a radically根本 different不同 approach途径.
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我们需要一个完全不同的方法。
23:14
You know, Andy安迪 Grove树林 stepped加强 down as chairman主席 of the board at Intel英特尔 --
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当Andy Grove辞去英特尔董事会主席时——
23:17
and Andy安迪 was one of my mentors导师, tough强硬 individual个人.
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他是我的顾问之一,很强硬的一个人
23:20
When Andy安迪 stepped加强 down, he said,
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当他辞职时,他说
23:22
"No technology技术 will win赢得. Technology技术 itself本身 will win赢得."
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“没有任何技术能够赢,技术本身才会赢”。
23:25
And I'm a firm公司 believer信徒, in the field领域 of medicine医学 and especially特别 cancer癌症,
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我坚信在医学领域,特别是癌症领域,
23:29
that it's going to be a broad广阔 platform平台 of technologies技术
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有一个广阔的技术平台
23:32
that will help us move移动 forward前锋
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可以帮助我们前进,
23:34
and hopefully希望 help patients耐心 in the near-term短期.
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也有希望在近期内帮助病人。
23:36
Thank you very much.
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非常感谢。
Translated by xiaomei he
Reviewed by xiang fei

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ABOUT THE SPEAKER
David Agus - Cancer Doctor
Although a highly-accomplished conventional doctor, David Agus has embraced the future of medicine and is constantly exploring ways that new technologies can help in the fight against cancer.

Why you should listen

David Agus is a medical doctor and a Professor of Medicine at the University of Southern California. However, he is also the founder of a couple of game-changing medical initiatives. In 2006, he co-founded Navigenics with Dietrich Stephan, Ph.D., to form a company that would provide people with their individual genetic information, allowing them to act on any predispositions to disease that they might have and prevent onset. He also founded Oncology.com which was the largest cancer Internet resource and community.

Dr. Agus’ research is focused on the application of proteomics and genomics in the study of cancer, as well as developing new therapeutic treatments for cancer. He serves as Director of the USC Center for Applied Molecular Medicine and the USC Westside Prostate Cancer Center. Agus is also the recipient of several honors and awards, including the American Cancer Society Physician Research Award, a Clinical Scholar Award from the Sloan-Kettering Institute and the International Myeloma Foundation Visionary Science Award.

More profile about the speaker
David Agus | Speaker | TED.com