ABOUT THE SPEAKER
Quyen Nguyen - Surgeon
Quyen Nguyen uses molecular probes that make tumors -- and just the tumors -- glow, as an extraordinary aid to surgeons.

Why you should listen

Dr. Quyen Nguyen’s research (working with Roger Tsien, Nobel Laureate in Chemistry) is focused on the development of fluorescently labeled probes for molecular navigation during surgery. Their first collaborative effort yielded a “smart” probe that makes tumors margins fluoresce, or “glow” and thus easier for surgeons to see and remove accurately during surgery. Their most recent joint effort resulted in another type of probe that can make nerves “glow” during surgery, thus helping surgeons repair injured nerves and avoid inadvertent injury.

She is a professor of surgery and director of the Facial Nerve Clinic at the University of California, San Diego.

More profile about the speaker
Quyen Nguyen | Speaker | TED.com
TEDMED 2011

Quyen Nguyen: Color-coded surgery

Quyen Nguyen: 荧光手术

Filmed:
1,224,438 views

医学教科书为人体各组织标上颜色以便未来的外科医生学习,而真实的人体组织却不是那样的。但是现在情况改变了。在TEDMED 上,Quyen Nguyen 向大家展示分子是如何照亮肿瘤使其呈氖绿色,向外科医生标明确切需要切除的部位。
- Surgeon
Quyen Nguyen uses molecular probes that make tumors -- and just the tumors -- glow, as an extraordinary aid to surgeons. Full bio

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

00:15
I want to talk to you
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我今天想和你们谈谈
00:17
about one of the biggest最大 myths神话 in medicine医学,
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医学上最大的误区之一。
00:19
and that is the idea理念
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这个误区认为
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that all we need are more medical breakthroughs突破
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只要有更多的医学突破,
00:24
and then all of our problems问题 will be solved解决了.
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一切问题都会迎刃而解。
00:27
Our society社会 loves to romanticize浪漫
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我们的社会热衷于
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the idea理念 of the single, solo独奏 inventor发明者
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把单枪匹马的发明者浪漫化:
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who, working加工 late晚了 in the lab实验室 one night,
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想象他某一天在实验室工作到深夜,
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makes品牌 an earthshaking翻天 discovery发现,
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有了惊天动地的发现,
00:38
and voila, overnight过夜 everything's一切的 changed.
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于是, 一夜之间一切都改变了。
00:42
That's a very appealing吸引人的 picture图片,
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这的确是很吸引人的画面
00:44
however然而, it's just not true真正.
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但是,却不真实。
00:47
In fact事实, medicine医学 today今天 is a team球队 sport运动.
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实际上,今天的医学是一个团队项目。
00:50
And in many许多 ways方法,
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从很多方面看,
00:52
it always has been.
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它总是这样。
00:54
I'd like to share分享 with you a story故事
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我想告诉你
00:56
about how I've experienced有经验的 this very dramatically显着
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我是怎样在我的工作中
00:59
in my own拥有 work.
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深深体会到这点的。
01:01
I'm a surgeon外科医生,
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我是一名外科医生
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and we surgeons外科医生 have always had
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我们外科医生总是
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this special特别 relationship关系 with light.
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和灯光关系很特别。
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When I make an incision切口 inside a patient's耐心 body身体, it's dark黑暗.
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给病人体内动手术时,体内是黑暗的
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We need to shine闪耀 light to see what we're doing.
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所以需要灯光帮助照明。
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And this is why, traditionally传统,
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所以,一直以来,
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surgeries手术 have always started开始 so early in the morning早上 --
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手术总是在凌晨开始
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to take advantage优点 of daylight阳光 hours小时.
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因为可以利用日光
01:22
And if you look at historical历史的 pictures图片
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如果你看早期手术室的
01:24
of the early operating操作 rooms客房,
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老照片,
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they have been on top最佳 of buildings房屋.
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手术室都建在房子的顶部。
01:29
For example, this is the oldest最老的 operating操作 room房间 in the Western西 world世界,
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例如,这是西方世界最古老的一个手术室,
01:31
in London伦敦,
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建于伦敦。
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where the operating操作 room房间
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这个手术室
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is actually其实 on top最佳 of a church教会
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实际上是建在一个教堂的顶部,
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with a skylight天空之光 coming未来 in.
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带有一个天窗。
01:39
And then this is a picture图片
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看看这幅画吧,
01:41
of one of the most famous著名 hospitals医院 in America美国.
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这是美国最著名的医院之一,
01:44
This is Mass General一般 in Boston波士顿.
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波士顿的麻省总医院。
01:46
And do you know where the operating操作 room房间 is?
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你知道手术室建在哪里吗?
01:48
Here it is
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在这里
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on the top最佳 of the building建造
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房子的顶上,
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with plenty丰富 of windows视窗 to let light in.
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窗够多,阳光可以泄入。
01:55
So nowadays如今 in the operating操作 room房间,
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现在的手术室
01:57
we no longer need to use sunlight阳光.
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不再用自然光了,
02:00
And because we no longer need to use sunlight阳光,
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因为我们不需要自然光。
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we have very specialized专门 lights灯火
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我们有专为手术室制造
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that are made制作 for the operating操作 room房间.
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的非常特别的灯。
02:07
We have an opportunity机会
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我们有机会
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to bring带来 in other kinds of lights灯火 --
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引入其它类型的灯--
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lights灯火 that can allow允许 us to see
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那种灯可以让我们看见
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what we currently目前 don't see.
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我们目前看不见的东西。
02:16
And this is what I think
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这就是我觉得荧光的
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is the magic魔法 of fluorescence荧光.
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神奇之处。
02:20
So let me back up a little bit.
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我想再解释一下。
02:22
When we are in medical school学校,
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我们在医学院学习的时候,
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we learn学习 our anatomy解剖学 from illustrations插图 such这样 as this
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从人体图解上学习解剖学,
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where everything's一切的 color-coded颜色编码.
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图解上全都标上颜色
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Nerves神经 are yellow黄色, arteries动脉 are red,
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黄色的是神经,红色的是动脉,
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veins are blue蓝色.
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蓝色是静脉。
02:35
That's so easy简单 anybody任何人 could become成为 a surgeon外科医生, right?
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那太容易了,那样的话每个人都可以做外科医生了,是吧?
02:39
However然而, when we have a real真实 patient患者 on the table,
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但是,当我们有真的病人躺在手术台上时,
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this is the same相同 neck颈部 dissection解剖 --
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同样的颈部解剖,
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not so easy简单 to tell the difference区别
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却不太容易分辨
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between之间 different不同 structures结构.
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不同的结构。
02:49
We heard听说 over the last couple一对 days
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最近,我们听说
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what an urgent紧急 problem问题
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现在癌症
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cancer癌症 still is in our society社会,
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还是我们社会中的一个紧迫问题。
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what a pressing紧迫 need it is
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我们迫切的希望,
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for us to not have
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不会
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one person die every一切 minute分钟.
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每分钟都有人死于癌症。
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Well if cancer癌症 can be caught抓住 early,
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但是如果癌症可以被及早发现
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enough足够 such这样 that someone有人 can have their cancer癌症 taken采取 out,
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早到可以用手术将
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excised切除 with surgery手术,
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肿瘤切除,
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I don't care关心 if it has this gene基因 or that gene基因,
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我就不在乎肿瘤是否有这个基因、那个基因。
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or if it has this protein蛋白 or that protein蛋白,
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或者有这个蛋白、那个蛋白的,
03:17
it's in the jar.
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它已经在罐子了。
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It's doneDONE, it's out, you're cured治愈 of cancer癌症.
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动了手术,取出来,癌症被治好了。
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This is how we excise摘除 cancers癌症.
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这就是我们治疗癌症的方法。
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We do our best最好, based基于 upon our training训练
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我们尽力,根据我们受到的训练,
03:27
and the way the cancer癌症 looks容貌 and the way it feels感觉
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根据肿瘤的外观和感觉,
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and its relationship关系 to other structures结构 and all of our experience经验,
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根据它与其它身体结构的关系,根据我们所有的经验,
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we say, you know what, the cancer's癌症的 gone走了.
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我们说,你知道吗?你的癌症已经没有了。
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We've我们已经 made制作 a good job工作. We've我们已经 taken采取 it out.
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很好,我们把肿瘤取出来了。
03:39
That's what the surgeon外科医生 is saying in the operating操作 room房间
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这是手术医生在手术室
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when the patient's耐心 on the table.
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对手术台上的病人说的话。
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But then we actually其实 don't know that it's all out.
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但是我们实际上并不知道肿瘤是否已被完全切除。
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We actually其实 have to take samples样本 from the surgical外科 bed,
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我们需要从手术台上拿样本
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what's left behind背后 in the patient患者,
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把从病人身上切除的样本
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and then send发送 those bits to the pathology病理 lab实验室.
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送到病理实验室
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In the meanwhile与此同时, the patient's耐心 on the operating操作 room房间 table.
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同时,病人还躺在手术台上。
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The nurses护士, anesthesiologist麻醉师, the surgeon外科医生,
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护士、麻醉师、手术医生
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all the assistants助理 are waiting等候 around.
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还有所有的助手都等在一边。
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And we wait.
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等啊等。
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The pathologist病理学家 takes that sample样品,
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病理学家拿到样本,
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freezes冻结 it, cuts削减 it, looks容貌 in the microscope显微镜 one by one
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冷冻、切割、拿着显微镜一个一个看,
04:08
and then calls电话 back into the room房间.
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然后给手术室打电话。
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And that may可能 be 20 minutes分钟 later后来 per piece.
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每个样本检查要20分钟
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So if you've sent发送 three specimens标本,
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因此如果送去三个样本
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it's an hour小时 later后来.
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就要等一个小时。
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And very often经常 they say,
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经常他们会说:
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"You know what, points A and B are okay,
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“你知道吗?A点和B 点还行,
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but point C, you still have some residual剩余的 cancer癌症 there.
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但是C点,还有些残留肿瘤在上面。
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Please go cut that piece out."
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请把那块切掉。”
04:26
So we go back and we do that again, and again.
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所以我们回头再干,一次又一次。
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And this whole整个 process处理:
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这就是整个过程。
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"Okay you're doneDONE.
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“好了,完成了。
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We think the entire整个 tumor is out."
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我们认为整个肿瘤都切除了。‘
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But very often经常 several一些 days later后来,
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但是,经常是几天后,
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the patient's耐心 gone走了 home,
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病人已经回家了,
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we get a phone电话 call:
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我们接到电话说:“
04:42
"I'm sorry,
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对不起
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once一旦 we looked看着 at the final最后 pathology病理,
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我们看了最后的病理报告
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once一旦 we looked看着 at the final最后 specimen标本,
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我们看了最后的抽样,
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we actually其实 found发现 that there's a couple一对 other spots斑点
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我们发现有几个地方,
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where the margins利润率 are positive.
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边缘呈阳性。
04:54
There's still cancer癌症 in your patient患者."
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你的病人身上还有肿瘤。”
04:57
So now you're faced面对 with telling告诉 your patient患者, first of all,
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所以我们就不得不首先告诉病人他们
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that they may可能 need another另一个 surgery手术,
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可能还要进行另一次手术,
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or that they need additional额外 therapy治疗
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或者需要其它的治疗
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such这样 as radiation辐射 or chemotherapy化疗.
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比如放射疗法和化疗。
05:08
So wouldn't不会 it be better
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所以最好就是
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if we could really tell,
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我们,
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if the surgeon外科医生 could really tell,
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手术医生在动手术时,
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whether是否 or not there's still cancer癌症 on the surgical外科 field领域?
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就知道肿瘤是否都切除了。
05:18
I mean, in many许多 ways方法, the way that we're doing it,
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我的意思是,从很多方面说,我们现在的操作方式,
05:21
we're still operating操作 in the dark黑暗.
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还是在黑暗中摸索。
05:25
So in 2004, during my surgical外科 residency住院医师,
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因此在2004年,在我担任外科住院医生期间,
05:28
I had the great fortune幸运
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我有幸
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to meet遇到 Dr博士. Roger罗杰 Tsien钱学森,
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遇到了Roger 陈医生,
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who went on to win赢得 the Nobel诺贝尔 Prize for chemistry化学
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他后来获得了诺贝尔化学奖,
05:36
in 2008.
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是在2008年。
05:38
Roger罗杰 and his team球队
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那时Roger和他的团队
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were working加工 on a way to detect检测 cancer癌症,
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正在寻找发现肿瘤的方法。
05:43
and they had a very clever聪明 molecule分子
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他们发明了一种
05:45
that they had come up with.
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非常聪明的分子,
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The molecule分子 they had developed发达
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这种分子
05:49
had three parts部分.
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有三个部分。
05:51
The main主要 part部分 of it is the blue蓝色 part部分, polycation聚阳离子,
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主要部分是这个蓝色的部分,叫聚阳离子,
05:54
and it's basically基本上 very sticky
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它是很黏的物质
05:56
to every一切 tissue组织 in your body身体.
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能粘住身体里的每个组织。
05:58
So imagine想像 that you make a solution
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所以想象我们制作一个
06:00
full充分 of this sticky material材料
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充满这种粘稠物体的溶液
06:02
and inject注入 it into the veins of someone有人 who has cancer癌症,
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并将其注入癌症病人的静脉中,
06:04
everything's一切的 going to get lit发光的 up.
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一切都被照亮了,
06:06
Nothing will be specific具体.
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每个部位,无一例外
06:08
There's no specificity特异性 there.
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没有特殊性。
06:10
So they added添加 two additional额外 components组件.
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之后他们又加了两个附加组件
06:12
The first one is a polyanionic聚阴离子 segment分割,
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第一个是聚阴离子部分
06:15
which哪一个 basically基本上 acts行为 as a non-stick不粘 backing后盾
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它就像是黏胶纸的背面
06:17
like the back of a sticker贴纸.
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执行不粘的功能
06:19
So when those two are together一起, the molecule分子 is neutral中性
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所以当这两者在一起时,分子是中性的,
06:22
and nothing gets得到 stuck卡住 down.
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不会粘任何东西。
06:24
And the two pieces are then linked关联
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这两个部分又通过其它部分相连,
06:27
by something that can only be cut
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只有用合适的分子剪刀,
06:30
if you have the right molecular分子 scissors剪刀 --
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才能剪掉这个部分。
06:32
for example, the kind of protease蛋白酶 enzymes
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譬如说,这种肿瘤制造的
06:34
that tumors肿瘤 make.
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蛋白酶
06:36
So here in this situation情况,
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在这种情况下,
06:38
if you make a solution full充分 of this three-part三部分 molecule分子
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如果用这三种分子制作溶液,
06:42
along沿 with the dye染料, which哪一个 is shown显示 in green绿色,
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加上染料,就显出绿色。
06:44
and you inject注入 it into the vein静脉
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把液体注入癌症病人的
06:47
of someone有人 who has cancer癌症,
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静脉
06:49
normal正常 tissue组织 can't cut it.
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一般的组织是不能剪断它的。
06:51
The molecule分子 passes通行证 through通过 and gets得到 excreted排出.
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分子经过它,排泄。
06:54
However然而, in the presence存在 of the tumor,
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但是,有肿瘤的地方,
06:56
now there are molecular分子 scissors剪刀
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我们有分子剪刀,
06:58
that can break打破 this molecule分子 apart距离
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可以把这种分子剪开
07:00
right there at the cleavable裂解 site现场.
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就在这个分裂的地方。
07:02
And now, boom繁荣,
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现在,嘭,
07:04
the tumor labels标签 itself本身
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肿瘤自己挂上了标签
07:06
and it gets得到 fluorescent.
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发出荧光。
07:08
So here's这里的 an example of a nerve神经
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这是一根神经,
07:11
that has tumor surrounding周围 it.
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周围有肿瘤
07:13
Can you tell where the tumor is?
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你知道肿瘤在哪里吗?
07:15
I couldn't不能 when I was working加工 on this.
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我以前也不知道
07:18
But here it is. It's fluorescent.
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但是,现在,你看,在这里,就是闪荧光的地方。
07:20
Now it's green绿色.
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是绿色的。
07:22
See, so every一切 single one in the audience听众
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所以,每一位观众,
07:25
now can tell where the cancer癌症 is.
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现在都知道肿瘤在哪里了。
07:28
We can tell in the operating操作 room房间, in the field领域,
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我们在手术室里,当场就知道了。
07:31
at a molecular分子 level水平,
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在有分子的地方,
07:33
where is the cancer癌症 and what the surgeon外科医生 needs需求 to do
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肿瘤在哪里,手术医生需要做什么,
07:35
and how much more work they need to do
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他们还需要做多少工作
07:37
to cut that out.
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把肿瘤切除。
07:40
And the cool thing about fluorescence荧光
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荧光的好处在于
07:42
is that it's not only bright,
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它不仅发光
07:45
it actually其实 can shine闪耀 through通过 tissue组织.
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实际上它可以使组织发光。
07:48
The light that the fluorescence荧光 emits发射
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荧光发出的亮光
07:51
can go through通过 tissue组织.
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可以穿透组织。
07:53
So even if the tumor is not right on the surface表面,
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因此即使肿瘤表面不亮,
07:56
you'll你会 still be able能够 to see it.
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我们仍然可以看到它。
07:59
In this movie电影, you can see
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在这个影片中,你可以看到,
08:01
that the tumor is green绿色.
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肿瘤是绿色的,
08:04
There's actually其实 normal正常 muscle肌肉 on top最佳 of it. See that?
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实际上它的表面是正常的肌肉,看到了吗?
08:07
And I'm peeling去皮 that muscle肌肉 away.
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我正在把那层肌肉剥离。
08:09
But even before I peel that muscle肌肉 away,
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但即使就在我剥离那层肌肉之前
08:11
you saw that there was a tumor underneath.
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你仍可以看到有肿瘤在下面。
08:14
So that's the beauty美女 of having a tumor
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这就是用荧光分子标记肿瘤的
08:17
that's labeled标记 with fluorescent molecules分子.
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美妙之处。
08:20
That you can, not only see the margins利润率
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你不仅可以看到
08:22
right there on a molecular分子 level水平,
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在荧光分子处看到肿瘤的边缘
08:24
but you can see it even if it's not right on the top最佳 --
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即使它不是在正上方
08:27
even if it's beyond your field领域 of view视图.
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超越你视野所及的范围。
08:30
And this works作品 for metastatic转移性 lymph淋巴 nodes节点 also.
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这种方法也用于治疗淋巴结转移癌。
08:33
Sentinel哨兵 lymph淋巴 node节点 dissection解剖
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前哨淋巴结解剖
08:35
has really changed the way that we manage管理 breast乳房 cancer癌症, melanoma黑色素瘤.
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已经改变了我们治疗乳腺癌和黑素瘤的方式。
08:39
Women妇女 used to get
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以前妇女要
08:41
really debilitating衰弱 surgeries手术
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做大伤元气的手术,
08:43
to excise摘除 all of the axillary lymph淋巴 nodes节点.
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来切除全部的腋淋巴结。
08:46
But when sentinel哨兵 lymph淋巴 node节点
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但是按照我们治疗
08:49
came来了 into our treatment治疗 protocol协议,
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前哨淋巴结的方案,
08:52
the surgeon外科医生 basically基本上 looks容貌 for the single node节点
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手术医生会首先寻找单个的,
08:55
that is the first draining排水 lymph淋巴 node节点 of the cancer癌症.
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肿瘤首先损害的淋巴结。
08:58
And then if that node节点 has cancer癌症,
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如果那个淋巴结有肿瘤
09:01
the woman女人 would go on to get
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妇女才会继续
09:03
the axillary lymph淋巴 node节点 dissection解剖.
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进行腋淋巴结切除手术。
09:05
So what that means手段
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这就是说
09:07
is if the lymph淋巴 node节点 did not have cancer癌症,
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如果那个淋巴结没有肿瘤,
09:10
the woman女人 would be saved保存
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这位妇女就不需要
09:12
from having unnecessary不必要 surgery手术.
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进行不必要的手术。
09:14
But sentinel哨兵 lymph淋巴 node节点, the way that we do it today今天,
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但是我们今天做前哨淋巴结手术的方式
09:17
is kind of like having a road map地图
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有点像拿着一张地图
09:19
just to know where to go.
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就能知道往哪里走。
09:21
So if you're driving主动 on the freeway高速公路
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就像你在高速公路上开车
09:23
and you want to know where's哪里 the next下一个 gas加油站 station,
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你想知道下一个加油站在哪
09:25
you have a map地图 to tell you that that gas加油站 station is down the road.
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你的地图会显示前面有一个加油站。
09:28
It doesn't tell you whether是否 or not
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但是地图不会告诉你
09:30
the gas加油站 station has gas加油站.
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加油站里是否有油。
09:32
You have to cut it out, bring带来 it back home,
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你必须把油管拔下来,带回家,
09:35
cut it up, look inside
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打开看里面,
09:37
and say, "Oh yes, it does have gas加油站."
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才知道: "哦,是的,里面有油。”
09:39
So that takes more time.
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但是这样要花很多时间。
09:41
Patients耐心 are still on the operating操作 room房间 table.
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病人还躺在手术台上。
09:43
Anesthesiologists麻醉医师, surgeons外科医生 are waiting等候 around.
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麻醉医师,手术医生都等在周围。
09:45
That takes time.
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上述做法要花不少时间。
09:47
So with our technology技术, we can tell right away.
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但是用我们的技术立即就可以知道。
09:50
You see a lot of little, roundish圆形 bumps颠簸 there.
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你看这里有许多小小圆圆的肿块。
09:53
Some of these are swollen lymph淋巴 nodes节点
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这其中的一些是肿胀的淋巴结
09:56
that look a little larger than others其他.
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看起来比其他的要大些。
09:58
Who amongst其中包括 us hasn't有没有 had swollen lymph淋巴 nodes节点 with a cold?
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我们中间有谁在感冒时淋巴结不肿胀呢?
10:01
That doesn't mean that there's cancer癌症 inside.
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这并不说明其中有癌症。
10:03
Well with our technology技术,
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但是用我们的技术
10:05
the surgeon外科医生 is able能够 to tell immediately立即
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医生可以立即知道
10:08
which哪一个 nodes节点 have cancer癌症.
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哪个淋巴结有肿瘤。
10:10
I won't惯于 go into this very much,
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我不想再继续深入阐述,
10:12
but our technology技术, besides除了 being存在 able能够
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但是我们的技术,除了可以
10:14
to tag标签 tumor and metastatic转移性 lymph淋巴 nodes节点 with fluorescence荧光,
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用荧光标记肿瘤和转移性淋巴结,
10:18
we can also use the same相同 smart聪明 three-part三部分 molecule分子
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我们还可以用同样的智能三元分子
10:22
to tag标签 gadolinium onto the system系统
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在系统上标注轧元素
10:25
so you can do this noninvasively无创.
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这样做是无创的。
10:27
The patient患者 has cancer癌症,
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病人患有癌症,
10:29
you want to know if the lymph淋巴 nodes节点 have cancer癌症
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我们想在动手术前
10:31
even before you go in.
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就知道他的淋巴结是否有肿瘤
10:33
Well you can see this on an MRIMRI.
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这可以从核磁共振上看。
10:36
So in surgery手术,
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在手术中
10:38
it's important重要 to know what to cut out.
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重要的是要知道切割什么
10:41
But equally一样 important重要
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同样重要的是
10:43
is to preserve保留 things
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保留什么。
10:46
that are important重要 for function功能.
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这对于病人的恢复很重要。
10:49
So it's very important重要 to avoid避免 inadvertent非故意的 injury.
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因此要小心,不要因为疏忽使病人受伤。
10:52
And what I'm talking about
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我指的是
10:54
are nerves神经.
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神经。
10:56
Nerves神经, if they are injured受伤,
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如果伤害了神经
10:58
can cause原因 paralysis麻痹,
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可能导致瘫痪,
11:00
can cause原因 pain疼痛.
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可能导致疼痛。
11:03
In the setting设置 of prostate前列腺 cancer癌症,
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拿前列腺癌来举例,
11:05
up to 60 percent百分 of men男人
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百分之六十的病人
11:07
after prostate前列腺 cancer癌症 surgery手术
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在手术后
11:09
may可能 have urinary尿 incontinence失禁
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会出现小便失禁
11:11
and erectile勃起 disfunction功能不全.
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以及勃起功能障碍。
11:13
That's a lot of people to have a lot of problems问题 --
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很多人出现很多的问题--
11:16
and this is even in
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这种情况甚至出现在
11:18
so-called所谓 nerve-sparing神经保留 surgery手术,
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所谓的神经保留手术中。
11:20
which哪一个 means手段 that the surgeon外科医生 is aware知道的 of the problem问题,
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这说明外科医生已经意识到了问题,
11:24
and they are trying to avoid避免 the nerves神经.
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并且努力避免伤害神经。
11:26
But you know what, these little nerves神经 are so small,
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但是,你知道吗?这些神经在
11:29
in the context上下文 of prostate前列腺 cancer癌症,
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前列腺癌中太小
11:32
that they are actually其实 never seen看到.
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基本看不到。
11:34
They are traced追踪
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只能根据
11:36
just by their known已知 anatomical解剖 path路径
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已知的解剖路径
11:38
along沿 vasculature血管.
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沿着脉管系统找到它们。
11:40
And they're known已知 because somebody has decided决定 to study研究 them,
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因为有人对此进行研究,我们才得以了解。
11:44
which哪一个 means手段 that we're still learning学习
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但是我们还在研究
11:46
about where they are.
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这些神经的位置。
11:48
Crazy to think that we're having surgery手术,
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如果我们要动手术,
11:51
we're trying to excise摘除 cancer癌症, we don't know where the cancer癌症 is.
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切除肿瘤,但是却不知道肿瘤在哪里,那简直是疯了。
11:54
We're trying to preserve保留 nerves神经; we can't see where they are.
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我们努力保护神经,但是不知道神经在哪里。
11:57
So I said, wouldn't不会 it be great
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所以我说,
11:59
if we could find a way
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如果我们能找到一种方法
12:01
to see nerves神经 with fluorescence荧光?
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用荧光看到神经,不是很好吗?
12:04
And at first this didn't get a lot of support支持.
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刚开始,没有很多人支持我。
12:08
People said, "We've我们已经 been doing it this way for all these years年份.
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有人说:“我们这样做已经很多年了。
12:10
What's the problem问题?
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有什么问题呢?
12:12
We haven't没有 had that many许多 complications并发症."
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我们没有那么多的并发症嘛。“
12:15
But I went ahead anyway无论如何.
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但是我还是继续研究。
12:17
And Roger罗杰 helped帮助 me.
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Roger 帮助了我。
12:19
And he brought his whole整个 team球队 with him.
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他把他的整个队伍带来了。
12:22
So there's that teamwork团队合作 thing again.
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所以我们又是进行团队研究,
12:26
And we eventually终于 discovered发现 molecules分子
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并且最终发现了
12:29
that were specifically特别 labeling标签 nerves神经.
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可以明确标记神经的分子。
12:31
And when we made制作 a solution of this,
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当我们做好
12:33
tagged标记 with the fluorescence荧光
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这样的溶液,标记上荧光
12:35
and injected注射 in the body身体 of a mouse老鼠,
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注射进老鼠身体的时候,
12:38
their nerves神经 literally按照字面 glowed闪着.
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它们的神经真的发光了。
12:40
You can see where they are.
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你可以看到神经在哪里。
12:42
Here you're looking at a sciatic坐骨神经 nerve神经 of a mouse老鼠,
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这里你看一只老鼠的坐骨神经,
12:46
and you can see that that big, fat脂肪 portion一部分 you can see very easily容易.
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这个部分大大肥肥的,很容易看到。
12:49
But in fact事实, at the tip小费 of that where I'm dissecting解剖 now,
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可是实际上,从我现在解剖的顶部看,
12:52
there's actually其实 very fine arborizationsarborizations
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那只是非常精细的神经分支,
12:55
that can't really be seen看到.
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用肉眼根本看不到。
12:57
You see what looks容貌 like little Medusa美杜莎 heads coming未来 out.
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你看,这个看起来就像小美杜莎的头伸在外面。
13:01
We have been able能够 to see nerves神经
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我们可以看到神经--
13:03
for facial面部 expression表达, for facial面部 movement运动, for breathing呼吸 --
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面部表情、面部运动和呼吸的
13:06
every一切 single nerve神经 --
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每一根神经--
13:08
nerves神经 for urinary尿 function功能 around the prostate前列腺.
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前列腺周围排尿功能的神经。
13:11
We've我们已经 been able能够 to see every一切 single nerve神经.
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我们可以看到每一根神经,
13:14
When we put these two probes探头 together一起 ...
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当我们把两根探针放到一起时。。。
13:18
So here's这里的 a tumor.
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所以这是一个肿瘤,
13:20
Do you guys know where the margins利润率 of this tumor is?
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你知道肿瘤的边缘在哪儿吗?
13:23
Now you do.
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现在你知道了。
13:26
What about the nerve神经 that's going into this tumor?
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那么这个肿瘤里的神经呢?
13:29
That white白色 portion一部分 there is easy简单 to see.
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那个白色的部分很容易看到
13:31
But what about the part部分 that goes into the tumor?
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但是肿瘤里面的部分呢?
13:33
Do you know where it's going?
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你知道在哪儿么?
13:35
Now you do.
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现在知道了。
13:37
Basically基本上, we've我们已经 come up with a way
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实际上,我们找到了一种
13:39
to stain弄脏 tissue组织
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将组织染色的方法,
13:41
and color-code色标 the surgical外科 field领域.
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也就是色码手术。
13:43
This was a bit of a breakthrough突破.
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这比以前有些突破。
13:46
I think that it'll它会 change更改 the way that we do surgery手术.
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我想这会改变我们现在动手术的方式。
13:50
We published发表 our results结果
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我们的研究结果刊登在
13:52
in the proceedings诉讼 of the National国民 Academy学院 of Sciences科学
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国家科学院期刊
13:54
and in Nature性质 Biotechnology生物技术.
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和自然生物技术期刊上。
13:56
We received收到 commentary评论 in Discover发现 magazine杂志,
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探索杂志
13:59
in The Economist经济学家.
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和经济学家杂志也作了评论。
14:01
And we showed显示 it to a lot of my surgical外科 colleagues同事.
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我们把研究结果给很多外科医生同行看
14:04
They said, "Wow!
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他们说:“哇!”
14:06
I have patients耐心
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我的病人
14:08
who would benefit效益 from this.
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将会从中受益。
14:10
I think that this will result结果 in my surgeries手术
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我想这会为我的手术
14:12
with a better outcome结果
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带来更好的效果和
14:14
and fewer complications并发症."
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更少的并发症。
14:17
What needs需求 to happen发生 now
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现在我们需要的是
14:19
is further进一步 development发展 of our technology技术
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进一步的技术
14:22
along沿 with development发展
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和医疗器械
14:24
of the instrumentation仪器仪表
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的发展。
14:26
that allows允许 us to see
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这可以让我们在手术室
14:28
this sort分类 of fluorescence荧光 in the operating操作 room房间.
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看到这种荧光。
14:31
The eventual最终 goal目标
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最终的目标是
14:33
is that we'll get this into patients耐心.
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我们可以将此用于病人。
14:36
However然而, we've我们已经 discovered发现
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但是我们发现
14:39
that there's actually其实 no straightforward直截了当 mechanism机制
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实际上没有一个简单的机制
14:41
to develop发展 a molecule分子
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可以发展一次性使用的
14:43
for one-time一次 use.
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分子。
14:45
Understandably可以理解, the majority多数 of the medical industry行业
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我们了解到,医疗行业
14:48
is focused重点 on multiple-use多种用途 drugs毒品,
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主要是集中在开发用途广泛的药物
14:52
such这样 as long-term长期 daily日常 medications药物治疗.
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如可每日长期服用的药物。
14:55
We are focused重点 on making制造 this technology技术 better.
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我们专注于改进技术、
14:58
We're focused重点 on adding加入 drugs毒品,
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提高药效、
15:01
adding加入 growth发展 factors因素,
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添加生长因子、
15:03
killing谋杀 nerves神经 that are causing造成 problems问题
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杀死招致麻烦的神经
15:05
and not the surrounding周围 tissue组织.
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而不是周边组织。
15:08
We know that this can be doneDONE and we're committed提交 to doing it.
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我们知道这可以做到,我们也在尽全力去做。
15:12
I'd like to leave离开 you with this final最后 thought.
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最后,我想和大家分享的是
15:16
Successful成功 innovation革新
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成功的创新
15:18
is not a single breakthrough突破.
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不是来自某一次的突破,
15:21
It is not a sprint短跑.
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或某一次的冲刺。
15:24
It is not an event事件 for the solo独奏 runner跑步者.
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创新不来自个人。
15:28
Successful成功 innovation革新
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成功的创新
15:30
is a team球队 sport运动, it's a relay中继 race种族.
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是一个团队项目,是接力赛跑。
15:33
It requires要求 one team球队 for the breakthrough突破
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它要求一支队伍合作突破
15:37
and another另一个 team球队
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接着另一支队伍
15:39
to get the breakthrough突破 accepted公认 and adopted采用.
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使这项突破被接受并采用。
15:41
And this takes the long-term长期 steady稳定 courage勇气
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这需要长期坚韧不拔的勇气
15:44
of the day-in日式 day-out一天出 struggle斗争
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每天与困难作斗争
15:46
to educate教育, to persuade说服
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去教育、说服人们
15:49
and to win赢得 acceptance验收.
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接受新技术。
15:52
And that is the light that I want to shine闪耀
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这就是我想和大家分享的
15:54
on health健康 and medicine医学 today今天.
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当今健康和医疗的新发展。
15:56
Thank you very much.
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谢谢。
15:58
(Applause掌声)
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(掌声)
Translated by Yingzhi Vera Gu
Reviewed by Ting Huang

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ABOUT THE SPEAKER
Quyen Nguyen - Surgeon
Quyen Nguyen uses molecular probes that make tumors -- and just the tumors -- glow, as an extraordinary aid to surgeons.

Why you should listen

Dr. Quyen Nguyen’s research (working with Roger Tsien, Nobel Laureate in Chemistry) is focused on the development of fluorescently labeled probes for molecular navigation during surgery. Their first collaborative effort yielded a “smart” probe that makes tumors margins fluoresce, or “glow” and thus easier for surgeons to see and remove accurately during surgery. Their most recent joint effort resulted in another type of probe that can make nerves “glow” during surgery, thus helping surgeons repair injured nerves and avoid inadvertent injury.

She is a professor of surgery and director of the Facial Nerve Clinic at the University of California, San Diego.

More profile about the speaker
Quyen Nguyen | Speaker | TED.com

Data provided by TED.

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