EricTopol_未来医疗的无线化【中英文对照】

1.Does anybody know when the stethoscope was invented?
有人知道听诊器是什么时候发明的吗？
2.Any guesses? 1816.
大家试着猜一猜，有人说是1816年。
3.And what I can say is in 2016, doctors aren’t going to be walking around with stethoscopes.
而我认为是在2016年。 那个时候医生就不需要拿着听诊器跑来跑去了
4.There is a whole lot better technology coming.
更好的医疗技术已经呈现在我们面前
5.And that is part of the change in medicine.
而这也是医疗革命的一部分。
6.What has changed our society has been wireless devices.
已经改变我们人类社会的 是那些无线设备
7.But the future are digital medical wireless devices. Okay?
但我们的未来是数字化的医用无线设备，OK？
8.So, let me give you some examples of this to kind of make this much more concrete.
因此，让我来通过一些例子 更具体地描述这个概念。
9.This is the first one. This is an electrocardiogram.
这是第一个，这是一组心电图
10.And, as a cardiologist, to think that you could see in real time a patient, an individual, anywhere in the world on your smartphone,
作为一名心脏病专家， 无论在世界的哪一个角落， 都能用智能手机及时诊断病人，观察他们的心电图，
11.watching your rhythm, that’s incredible.
这是不可思议的。
12.And it’s with us today.
然而今天，这种不可思议已经成为现实
13.But that’s just the beginning.
但这仅仅是个开始
14.You check your email while you’re sitting here.
今天你可以坐在这里查收邮件
15.In the future you’re going to be checking all your vital signs, all your vital signs, your heart rhythm, your blood pressure, your oxygen, your temperature, etc.
不久的将来你就可以坐在这里查询你的生命体征 你所有的生命体征，像心律、 血压、体内的含氧量以及体温等等
16.This is already available today.
其实这些今天都已经实现了
17.This is AirStrip Technologies.
那就是AirStrip Technologies公司的技术。
18.It’s now wired, or I should say wireless by taking the aggregate of these signals in the hospital, in the intensive care unit, and putting it on a smartphone for physicians.
现在它是有线的， 如果我将医院、重症监护室的数据信息进行汇总， 输入到我的智能手机里发送给医生， 这个意义上可以说是无线的。
19.If you’re an expectant parent, what about the ability to monitor, continuously, fetal heart rate, or intrauterine contractions, and not having to worry so much that things are
如果你是一位准爸爸或者准妈妈 如果你可以随时持续获知胎儿的心率、你的宫缩确保临产时各项指标都正常 如果你可以随时持续获知胎儿的心率、你的宫缩确保临产时各项指标都正常 如果你可以随时持续获知胎儿的心率、你的宫缩确保临产时各项指标都正常
20.fine as the pregnancy, and moving over into the time of delivery.
如果你可以随时持续获知胎儿的心率、你的宫缩确保临产时各项指标都正常 并及时送往医院生产，将会怎样？
21.And then as we go further, today we have continuous glucose sensors.
进一步讲 今天在我们的皮肤下
22.Right now they are under the skin.
可以安装葡萄糖检测器，
23.But in the future they won’t have to be implanted.
但在不久的将来这些将无需植入体内。
24.And of course, the desired range, trying to keep glucose between 75 and less than 200, checking it every five minutes in a continuous glucose sensor.
当然，我们需要每隔5分钟查一下葡萄糖传感器， 确认我们的葡萄糖是否保持在75-200之间 确认我们的葡萄糖是否保持在75-200之间
25.You’ll see how that can impact diabetes.
大家可以看到这一变革将怎样影响糖尿病人的生活。
26.And what about sleep?
那么我们的睡眠是否也可以如上所述呢？
27.We’re going to zoom in on that a little bit.
在这里，我们花一点时间稍作解释
28.We’re supposed to spend a third of our life in sleep.
我们的一生大约有三分之一的时间用于睡眠
29.What if, on your phone, which will be available in the next few weeks, you had every minute of your sleep displayed.
假如在几个星期后， 你的手机可以显示你每一分钟的睡眠情况， 会怎么样？
30.And this is, of course, as you can see, the awake is the orange.
大家请看，当你醒着的时候，这里的显示为橙色，
31.The REM sleep, rapid eye movement, dream state is in light green.
当你处于快速眼动睡眠（REM=rapid eye movement sleep睡眠中眼睛迅速转动） 状态时，显示为绿色
32.And light is gray, light sleep.
当你处于轻度睡眠状态时，显示为灰色
33.and deep sleep, the best restorative sleep is that dark green.
当你处于深度睡眠（恢复体力的睡眠）状态时 呈现的是深绿色
34.How about counting every calorie?
那么，如何计算你消耗和吸收的卡路里呢？
35.And this is ability, in real time, to actually take measurements of caloric intake as well as expenditure, through a band-aid.
这里可以通过这个类似创可贴的东西 来实时计算出你卡路里的摄入和支出 来实时计算出你卡路里的摄入和支出
36.Now, what I’ve talked about are physiologic metrics.
好，我刚才给大家讲述的是生理上的度量标准体系
37.But what I want to get to, the next frontier, very quickly, and why the stethoscope is on its way out, is because we can transcend listening to the valve sounds,
但我接下来想很快地， 为大家介绍的是另一项前沿科技。 为什么说听诊器快落伍了呢？ 因为通过GE引进的手持超声装置，
38.and the breath sounds, because now, introduced by G.E. is a handheld ultra-sound.
我们的可听域超出了肠蠕动音、呼吸音的范围 我们的可听域超出了肠蠕动音、呼吸音的范围
39.Why is this important? Because this is so much more sensitive.
为什么这是一项重要的技术？因为它更为灵敏。
40.Here is an example of an abdominal ultrasound.
这里有三个范例，一个是关于腹部超声的
41.And also a cardiac echo, which can be sent wireless.
第二个可以通过无线传输心脏超声
42.And then there is an example of fetal monitoring on your smartphone.
第三个可以用你的智能手机进行胎儿监控
43.So, we’re not just talking about physiologic metrics, the key measurements of vital signs, and all those things in physiology, but also all the imaging
在这里，我们所讨论的不仅仅是生理指标 或者是关键的生命体征值 以及生理学的其他指标，
44.that one could look at in your smartphone.
还包括可以通过智能手机看到的所有成像结果。
45.Now, this is an example of another obsolete technology, soon to be buried, the Holter Monitor.
现在，我给大家展示另一项即将过时的技术 霍尔行氏心电动态监控仪
46.24 hour recording, lots of wires.
它可以24小时监控，大家可以看到有好多线连着
47.This is now a little tiny patch.
现在改进为一个小贴片
48.You can put it on for two weeks and send it in the mail.
你可以将这个放在身上长达2个星期 并且可以通过邮件传输
49.Now, how does this work? Well, there is these smart band-aids or these sensors that one would put on, on a shoe or on the wrist.
那么这是如何实现的呢？ 测试者可以把这些类似创可贴的小贴片和传感器 戴在手腕上或者放在鞋子里面
50.And this sends a signal.
这个装置就可以发送信号
51.It creates a body area network to a gateway.
从而建立通往网关的一个人体局域网
52.Gateway could be a smartphone or it could be a dedicated gateway, as today many of these things are dedicated gateways, because they are not so well-integrated.
网关可以是你的智能手机或者是专用网关 我们现在使用的网关大多是专用网关 因为他们还没有很好地兼容
53.That signal goes to the web, the cloud, and then it can be processed and sent anywhere, to a caregiver, to a physician, back to the patient, etc.
信号被传到网络，经过云计算 这样信号就可以被处理并传输到任何地方 比如说给护士、医生 或者病人自己等等
54.So, that’s basically very simplistic technology of how this works.
这基本是这一技术工作原理的简单介绍。 这基本是这一技术工作原理的简单介绍。
55.Now, I have this device on.
现在我的身上有一个类似的设备
56.I didn’t want to take my shirt off to show you, but I can tell you it’s on.
我不想把衬衫脱掉给各位看，但是可以告诉大家我的确戴着它
57.This is a device that not only measures cardiac rhythm, as you saw already, but it also goes well beyond that.
这项设备不仅能够测量你的心律—— 正如你已经看到的， 它能做的事情远比这个要多。
58.This is me now. And you can see the ECG.
我现在就站在这里，你可以看到我的心电图
59.Below that is the actual heart rate and the trend.
它的下面是我的实际心率和心脏跳动的趋势
60.to the right of that is a bioconductant.
右边是一个生理参量，
61.That’s the fluid status, fluid status, that’s really important if you’re monitoring somebody with heart failure.
这是动态的 这对于患有心力衰竭的病人非常重要 这对于患有心力衰竭的病人非常重要
62.And below that is temperature, and respiration, and oxygen.
再下面是体温 呼吸强度以及体内含氧量
63.And then the position activity.
这是我的位置活动
64.So, this is really striking, because this device measures seven things that are very much vital signs for monitoring someone with heart failure. Okay?
这些的确是振奋人心的，因为这项设备 能够监控心力衰竭患者7大项重要的生命体征 能够监控心力衰竭患者7大项重要的生命体征 能够监控心力衰竭患者7大项重要的生命体征
65.And why is this important? Well, this is the most expensive bed.
为什么说很重要呢？大家看 这是世界上最贵的一种床
66.What if we could reduce the need for hospital beds?
假如我们能减少人们对医院病床的需求，这将会产生什么影响？
67.Well, we can’t. First of all, heart failure is the number one reason for hospital admissions and readmissions in this country.
遗憾的是，我们不能。首先， 在美国，入院的病人中， 心力衰竭患者所占的比例是最大的
68.The cost of heart failure is 37 billion dollars a year, which is 80 percent related to hospitalization.
心力衰竭患者每年的花费将近370个亿 其中80%属于住院治疗的费用
69.And in the course of 30 days after a hospital stay for a Medicare, greater than 65 years or older, is 27 percent are readmitted in 30 days.
经过住院治疗30天后 65岁以上患者中会有27%的人30天内再次入院 65岁以上患者中会有27%的人30天内再次入院
70.Otherwise, over six months, over 56 percent are readmitted.
否则，6个月后将会有56%的患者再次入院
71.So, can we improve that? Well the idea is we take this device that I’m wearing, and we put it on 600 patients with heart failure, randomly assigned, versus 600 patients
因此，我们能否改善一下这种情况呢？ 我们的想法是，把我现在戴的这个装置， 戴在600名随机抽取的心力衰竭患者身上， 同时，我们对比另外
72.who don’t have active monitoring, and see whether we can reduce heart failure readmissions.
600名没有佩戴这种装置的心力衰竭患者 以便查证对比一下，这个装置是否可以降低患者再次入院的比例
73.And that’s exciting. And we’ll start that trial, and you’ll hear more about how we’re going to do that.
结果将会是令人惊叹的。我们即将开始这个试验 大家将会听到更多关于我们如何进行这项试验的消息
74.But that’s a type of wireless device trial that could change medicine in the years ahead.
这是一项能在未来几年将改变医疗现状的无线设备试验 这是一项能在未来几年将改变医疗现状的无线设备试验
75.Why now? Why is this all of a sudden become a reality, an exciting direction in the future of medicine?
什么是现在？为什么这会突然变成现实， 成为未来医疗界令人振奋的方向？
76.What we have is, in a way, a perfect positive storm.
从某种程度上说，我们现在所经历的是一场积极变革
77.This sets up consumer driven healthcare.
它引起了以消费者为导向的医疗革命
78.That’s where this is all starting.
而这就是一切的根源
79.Let me just give you specifics about why this is a big movement if you’re not aware of it.
如果你还没有意识到这一点，让我给大家举个例子来解释为什么这是一项重大举动 如果你还没有意识到这一点，让我给大家举个例子来解释为什么这是一项重大举动
80.1.2 million Americans have gotten a Nike shoe, which is a body area network that connects the shoe, the sole of the shoe to the iPhone, or an iPod.
120万美国人 都有一双耐克鞋，通过人体局域网链接了他们的Iphone、Ipod以及鞋子 都有一双耐克鞋，通过人体局域网链接了他们的iPhone、iPod以及鞋子
81.And this Wired Magazine cover article really captured a lot of this. It talked a lot about the Nike shoe and how quickly that’s been adopted to monitor exercise physiology
这本《连线》的封面文章集合了很多这样的应用。 它提到了耐克鞋如何迅速监控人们的生理运动和能量消耗 它提到了耐克鞋如何迅速监控人们的生理运动
82.and energy expenditure.
和能量消耗
83.Here is some things, the principles that are guiding principles to keep in mind: “A data-driven health revolution promises to make us all
这些是需要我们牢记于心的指导原则 这些是需要我们牢记于心的指导原则 以数字技术为导向的医疗卫生革命， 将会让我们生活地更好、更快、更强
84.better, faster, and stronger. Living by numbers.”
将会让我们生活地更好、更快、更强
85.And this one, which was really telling, This was from July, this cover article.
看一下这个，这的确很有说服力 这是7月的封面文章
86.”The personal metrics movement goes way beyond diet and exercise. It’s about tracking every facet of life, from sleep to mood to pain,
个人的监控远不止日常饮食和运动， 它涉及到生活的方方面面， 从睡眠到情绪到疼痛感，
87.24/7/365.”
贯穿一天24小时，一周7天，一年365天。
88.Well, I tried this device.
因此，我尝试使用这种设备。
89.A lot of you have gotten that Phillips Direct Life.
我知道你们中的很多人使用飞利浦的Direct Life
90.I didn’t have one of those, but I got the Fitbit.
我没有那个东西 不过我有个Fitbit
91.That looks like this.
就是这个
92.It’s like a wireless accelerometer, pedometer.
它看起来就像是一个无线加速器或计步器
93.And I want to just give you the results of that testing, because I wanted to understand about the consumer movement.
在这里，我只想给大家展示这个东西监控的结果 因为我想知道消费者的运动情况
94.I hope the, by the way, the Phillips Direct Life works better.
我希望Phillips Direct Life会更好用一些
95.I hope so.
希望如此
96.But this monitors food. It monitors activity and tracks weight.
但这个还监控饮食，运动和体重
97.However you have to put in most of this stuff.
然而，你需要输入大部分信息到这个设备中
98.The only thing it really tracks by itself is activity.
它能够独立监控的只有运动
99.And even then, it’s not complete.
即便是这样，它还不是完整的。
100.So, you exercise and it picks up the exercise.
因此，当你运动的时候，这个装置就会记录你运动的情况。
101.You put in your height and weight, it calculates BMI.
你输入你的身高和体重，它就会计算出你的体质指数。
102.And of course it tells you how many calories you’re expending from the exercise, and how many you took in, if you go in and enter all the foods.
当然，它还会告诉你在运动过程中你消耗了多少卡路里， 吃东西吸收了多少卡路里， 不过，前提是你必须先输入有关食物的信息。
103.But it really wants you to enter all your activity.
使用这个装置，你必须要输入所有有关你运动的信息。
104.And so I went to this, and of course I was gratified that it picked up the 42 minutes of exercise, elliptical exercise I did.
我一直使用这个， 我很高兴Fitbit监控了我42分钟的运动 我所做的42分钟椭圆机运动
105.But then it wants more information.
但是它还需要更多的信息
106.So, it says, “You want to log sexual activity.
因此，它显示：“请录入性爱活动”
107.How long did you do it for?”
你和你的爱人做爱多长时间
108.(Laughter) And it says, “How hard was it?”
（笑声） 它又显示：“做爱的力度是怎样的？”
109.(Laughter) Furthermore it says, “Start time.”
（笑声） 然后它又显示：“开始的时间是？”
110.Now, this doesn’t appear … now this just doesn’t work.
但现在它什么也不显示了…它停止工作了
111.I mean this just doesn’t work.
我的意思是说，这样是不行的
112.So, now I want to move to sleep.
好的，让我们转向下一个，睡眠
113.Who would ever have thought you could have your own EEG at your home, tagged to a very nice alarm clock, by the way.
顺便问一下，有谁想过在自己家里的闹钟上 就可以看到自己的心电图？
114.This is the headband that goes with this alarm clock.
这是和闹钟配套的头带
115.It monitors your brainwaves continuously, when you’re sleeping.
当你睡觉的时候，它能够监控你的脑电波
116.So, I did this thing for seven days getting ready for TEDMed.
为了准备TEDMed的演讲，我拿自己做试验， 检测了我7天以来的睡眠状况。
117.This is an important part of our life, one third supposed to be sleeping.
睡眠是我们生命非常重要的一部分，我们三分之一的时间都用于睡觉。
118.Of course how many here have any problems with sleeping?
请问在座的各位 有哪些睡眠存在问题？
119.It’s usually 90 percent. So, you tell me you sleep better than expected.
一般的比例高达90%，你们的情况比我想象得要好。