1.This is actually a painting that hangs at the Countway Library at Harvard Medical School.
这实际上是一幅画， 它挂在哈佛医学院Countway图书馆的墙上
2.And it shows the first time an organ was ever transplanted.
记录了第一次器官移植。
3.In the front, you see, actually, Joe Murray getting the patient ready for the transplant while in the back room you see Hartwell Harrison,
在前面，你看，那是约翰.穆雷 正为病人做准备，接受移植 在房间后面，你会看见哈德威.哈罗孙
4.the Chief of Urology at Harvard, actually harvesting the kidney.
哈佛医学院泌尿科主任 正在摘除肾脏。
5.The kidney was indeed the first organ ever to transplanted to the human.
这个肾脏是第一个 移植到人体上的器官。
6.That was back in 1954, 55 years ago.
这发生在1954年 55年前，
7.Yet we’re still dealing with a lot of the same challenges as many decades ago.
那时他们正应对非常多挑战， 如同多年前一样。
8.Certainly many advances, many lives saved.
当然有很多进步，拯救了很多生命，
9.But we have a major shortage of organs.
但我们却非常缺乏器官。
10.In the last decade the number of patients waiting for a transplant has doubled.
在过去十年，等待移植的病人数量 已经翻倍，
11.While, at the same time, the actual number of transplants has remained almost entirely flat.
但与此同时，移植的数量 却基本不变。
12.That really has to do with our aging population.
这主要是因为我们老龄化的人口。
13.We’re just getting older.
我们正在变老。
14.Medicine is doing a better job of keeping us alive.
医疗效果变好了， 使我们能活得更长。
15.But as we age, our organs tend to fail more.
但随着我们变老，器官也越来越容易生病
16.So, that’s a challenge, not just for organs but also for tissues.
所以，这是一个挑战。 对于器官，组织都是如此。
17.Trying to replace pancreas, trying to replace nerves that can help us with Parkinson’s.
试图替换胰腺， 试图替换神经，来帮助治疗帕金森综合症，
18.These are major issues.
那些是主要的组织。
19.This is actually a very stunning statistic.
这事实上是非常惊人的数据，
20.Every 30 seconds a patient dies from diseases that could be treated with tissue regeneration or replacement.
每30秒钟 就有一个病人死于 可用替换组织治疗的疾病。
21.So, what can we do about it?
那，我们要怎么解决？
22.We’ve talked about stem cells tonight.
今晚我们已谈论了干细胞
23.That’s a way to do it.
这是一个解决的办法。
24.But still ways to go to get stem cells into patients, in terms of actual therapies for organs.
但仍需方法把干细胞植入病人体中。 如果说我们要真（用干细胞）治疗（得病了的）器官。
25.Wouldn’t it be great if our bodies could regenerate?
若我们的身体能再生岂不是很好？
26.Wouldn’t it be great if we could actually harness the power of our bodies, to actually heal ourselves?
若我们能管理身体的力量 来治愈自己，岂不是很好？
27.It’s not really that foreign of a concept, actually; it happens on the Earth every day.
事实上，这不是一个怪异的概念， 每天地球上都在发生。
28.This is actually a picture of a salamander.
这是火蜥蜴的一幅图片，
29.Salamanders have this amazing capacity to regenerate.
火蜥蜴就有这种自我再生的奇特能力。
30.You see here a little video.
请看这个小片段
31.This is actually a limb injury in this salamander.
这是火蜥蜴腿上受的伤
32.And this is actually real photography, timed photography, showing how that limb regenerates in a period of days.
这是一幅真的图片， 按时间排列的照片，展示了受伤的腿 经过一段时间后再生的过程。
33.You see the scar form.
请看这个伤疤，
34.And that scar actually grows out a new limb.
这个伤疤会长出来 一条新腿。
35.So, salamanders can do it.
所以，火蜥蜴能做到再生。
36.Why can’t we? Why can’t humans regenerate?
为什么我们不能？为什么人类不能再生？
37.Actually, we can regenerate.
事实上，我们可以再生。
38.Your body has many organs and every single organ in your body has a cell population that’s ready to take over at the time of injury. It happens every day.
你的身体有很多器官。 你身体的每一个器官， 都有一定数量的细胞 在你受伤时，会进行替代。这每天都在发生。
39.As you age, as you get older.
当你变老，
40.Your bones regenerate every 10 years.
你的骨骼会每十年再生一次，
41.Your skin regenerates every two weeks.
你的皮肤每两周再生一次。
42.So, your body is constantly regenerating.
所以，你的身体一直再进行着再生。
43.The challenge occurs when there is an injury.
当受伤时，我们就有挑战了。
44.At the time of injury or disease, the body’s first reaction is to seal itself off from the rest of the body.
当受伤或生病时， 身体的第一个反应 是将这部分与身体其它部分隔离开
45.It basically wants to fight off infection, and seal itself, whether it’s organs inside your body, or your skin, the first reaction is for scar tissue to move in,
来抵抗感染。 进行治疗，你身体内的器官 或是你的皮肤，第一个反应 就是让伤疤组织行动
46.to seal itself off from the outside.
与外界进行隔离
47.So, how can we harness that power?
那我们要怎么管理这种能力呢？
48.One of the ways that we do that is actually by using smart biomaterials.
方法之一是 使用智能生物材料
49.How does this work? Well, on the left side here you see a urethra which was injured.
这是怎么生效的呢？在左边 是一个受伤的尿道
50.This is the channel that connects the bladder to the outside of the body.
这是连接膀胱与身体外部的通道。
51.And you see that it is injured.
你看它已经受伤
52.We basically found out that you can use these smart biomaterials, that you can actually use as a bridge.
基本上，我们发现你可以使用那些智能材料 （在受伤的地方）作为桥梁。
53.If you build that bridge, and you close off from the outside environment, then you can create that bridge, and cells that regenerate in your body,
受伤的组织会（愈合然后） 与外部环境隔离开来， 有了这座桥梁， 你身体内再生的细胞
54.can then cross that bridge, and take that path.
可以爬上这座桥，用它作为通道（来重建尿道）。
55.That’s exactly what you see here.
这就是你现在看到的事实
56.It’s actually a smart biomaterial that we used, to actually treat this patient.
这实际上是一个智能生物材料。 我们使用它治好了这位病人。
57.This was an injured urethra on the left side.
这是在左边的一个受伤的尿道。
58.We used that biomaterial in the middle.
我们在中间使用智能材料，
59.And then, six months later on the right-hand side you see this reengineered urethra.
6个月后，在右边， 你看这是再生的尿道。
60.Turns out your body can regenerate, but only for small distances.
其实我们的身体可以再生 但只能在小距离的情况下
61.The maximum efficient distance for regeneration is only about one centimeter.
再生细胞能走的最大距离 是1厘米。
62.So, we can use these smart biomaterials but only for about one centimeter to bridge those gaps.
所以，我们可以用这些智能材料 进行1厘米的再生 来治愈这些伤口
63.So, we do regenerate, but for limited distances.
所以，我们可以再生，但只能短距离再生
64.What do we do now, if you have injury for larger organs?
我们怎么做才能（治疗病人） 如果你有大一点的器官的损伤呢？
65.What do we do when we have injuries for structures which are much larger than one centimeter?
我们该怎么做 当受伤的组织 大于1厘米时？
66.Then we can start to use cells.
我们可以使用细胞
67.The strategy here, is if a patient comes in to us with a diseased or injured organ, you can take a very small piece of tissue from that organ,
现在战略是，如果一个病人向我们求诊 他有得病或受伤的器官。 你从那个器官上取下非常小的一块组织，
68.less than half the size of a postage stamp, you can then tease that tissue apart, and look at its basic components, the patient’s own cells,
比邮票的一半还小， 然后分离这块组织 研究它的基本成分， 也就是这个病人自己的细胞。
69.you take those cells out, grow and expand those cells outside the body in large quantities, and then we then use scaffold materials.
你把这些细胞取出来 在身体外，进行大量繁殖，生长， 然后我们使用一种支架材料
70.To the naked eye they look like a piece of your blouse, or your shirt, but actually these materials are fairly complex and they are designed to degrade once inside the body.
用肉眼看，它们像你外套或衬衣的一块布。 但事实上 这些材料相当复杂。 一旦植入身体，在数月后
71.It disintegrates a few months later.
它们会降解。
72.It’s acting only as a cell delivery vehicle.
这就像是一个细胞运输机
73.It’s bringing the cells into the body. It’s allowing the cells to regenerate new tissue, and once the tissue is regenerated the scaffold goes away.
它把细胞带入到身体内。 使细胞能创造新的组织 一旦组织形成，这个支架就会消失。
74.And that’s what we did for this piece of muscle.
这就是我们为这块肌肉进行的治疗。
75.This is actually showing a piece of muscle and how we go through the structures to actually engineer the muscle.
这展示了一块肌肉，以及我们 怎么通过这些支架来建造肌肉。
76.We take the cells, we expand them, we place the cells on the scaffold, and we then place the scaffold back into the patient.
我们取出一些细胞，扩展他们 我们把这些细胞放在一块支架上， 然后把整个支架放回到病人体内。
77.But actually, before placing the scaffold into the patient, we actually exercise it.
事实上，在我们把这块支架放在病人身体里之前， 我们要锻炼它。
78.We want to make sure that we condition this muscle, so that it knows what to do once we put it into the patient.
我们要保证我们 教会肌肉，这样它就知道 放进体内后要做什么。
79.That’s what you’re seeing here. You’re seeing this muscle bio-reactor actually exercising the muscle back and forth.
这就是你现在看到的情况。 你看，这是肌肉生物反应装置， 它在让肌肉做前后拉伸练习。
80.Okay. These are flat structures that we see here, the muscle.
好的。那些就是我们现在看到的平面结构 肌肉
81.What about other structures?
那其他结构呢？
82.This is actually an engineered blood vessel.
这是一个人造的血管
83.Very similar to what we just did, but a little bit more complex.
非常类似于刚才的情况，但更复杂
84.Here we take a scaffold, and we basically — scaffold can be like a piece of paper here.
现在我们有一个基底材料 基本上我们–这里基底材料可以像一张纸
85.And we can then tubularize this scaffold.
然后我们能把它做成管状
86.And what we do is we, to make a blood vessel, same strategy.
我们用同样的战略来造一根血管。
87.A blood vessel is made up of two different cell types.
血管由两种不同的细胞组成
88.We take muscle cells, we paste, or coat the outside with these muscle cells, very much like baking a layer cake, if you will.
我们取下肌肉细胞，进行粘贴， 或把细胞涂在外部。 非常像制作一层蛋糕。
89.You place the muscle cells on the outside.
你把肌肉细胞植在外部，
90.You place the vascular blood vessel lining cells on the inside.
你把血管细胞植在里面。
91.You now have your fully seeded scaffold.
现在你就有一个内外都植入细胞的基底材料。
92.You’re going to place this in an oven-like device.
接下来，把它放在一个像烤箱的设备里。
93.It has the same conditions as a human body, 37 degrees centigrade, 95 percent oxygen.
它的环境跟人体类似： 37度 95％的氧气。
94.You then exercise it, as what you saw on that tape.
然后让它练习，就像你在那个录像里看到的一样
95.And on the right you actually see a carotid artery that was engineered.
在右边，你看到的是一个造好的颈动脉
96.This is actually the artery that goes from your neck to your brain.
它是从颈部延伸到脑部的血管。
97.And this is an x-ray showing you the patent, functional blood vessel.
这张X光片给你展示了 一个病人的健全的血管
98.More complex structures such as blood vessels, urethras, which I showed you, they’re definitely more complex because you’re introducing two different cell types.
更复杂的结构 比如我之前给你们看的血管，尿道 他们绝对更复杂 因为你要引进两种不同的细胞
99.But they are really acting mostly as conduits.
但大部分时候，他们真的像管道一样运行
100.You’re allowing fluid or air to go through at steady states.
你要允许液体，气体通过 并要稳定的速度。
101.They are not nearly as complex as hollow organs.
他们远没有中空器官复杂。
102.Hollow organs have a much higher degree of complexity, because you’re asking these organs to act on demand.
中空器官更加复杂， 因为那些器官要根据要求来工作。
103.So, the bladder is one such organ.
而膀胱就是这种器官。
104.Same strategy, we take a very small piece of the bladder, less than half the size of a postage stamp.
用同样的战略，我们取下膀胱的一小片组织 比邮票的一半还小
105.We then tease the tissue apart into its two individual cell components, muscle, and these bladder specialized cells.
然后我们把这片组织分解成 两个独立的细胞成分 肌肉以及那些膀胱特有的细胞
106.We grow the cells outside the body in large quantities.
在体外，大量培植那些细胞
107.It takes about four weeks to grow these cells from the organ.
它们的生长大约需4周时间
108.We then take a scaffold that we shape like a bladder.
然后我们用一个智能材料，做成膀胱形状
109.We coat the inside with these bladder lining cells.
在内部，我们把衬细胞植入
110.We coat the outside with these muscle cells.
在外部，我们植入肌肉细胞
111.We place it back into this oven-like device.
我们把它放回到这个像烤箱一样的装置
112.From the time you take that piece of tissue, six to eight weeks later you can put the organ right back into the patient.
在你取下这片组织的6到8周后 你就能把器官植入到病人体中
113.This actually shows the scaffold The material is actually being coated with the cells.
这展示了智能材料 这个材料外部布满了细胞
114.When we did the first clinical trial for these patients we actually created the scaffold specifically for each patient.
我们对病人进行第一次临床试验 我们为每个病人制造特殊的智能材料。
115.We brought patients in, six to eight weeks prior to their scheduled surgery, did x-rays, and we then composed a scaffold specifically for that patient’s size
我们让病人来医院， 在他们手术日期前的6到8周，进行X光检查 然后我们制造符合该病人尺寸的特殊材料
116.pelvic cavity.
根据他们的盆腔尺寸。
117.For the second phase of the trials we just had different sizes, small, medium, large and extra-large.
试验的第二阶段 我们就只是预备了不同的型号，小号，中号，大号，特大
118.(Laughter) It’s true.
（笑） 真的。
119.And I’m sure everyone here wanted an extra-large. Right?
我想大家都想要加大号，是吧？
120.(Laughter) So, bladders are definitely a little bit more complex than the other structures.
（笑） 所以，膀胱肯定比其它结构 更复杂。
121.But there are other hollow organs that have added complexity to it.
但现在有一些中空器官复杂性更多。
122.This is actually a heart valve, which we engineered.
这是我们制造出的一个心脏瓣膜
123.And the way you engineer this heart valve is the same strategy.
我们用同样的战略制造这个心瓣膜。
124.We take the scaffold, we seed it with cells, and you can now see here, the valve leaflets opening and closing.
我们有智能材料，我们植入细胞， 你看，这些瓣膜小叶正一开一合。
125.We exercise these prior to implantation.
在植入人体前，这些材料会得到锻炼，
126.Same strategy.
同样的战略
127.And then the most complex are the solid organs.
最复杂的是实质器官
128.For solid organs, they’re more complex because you’re using a lot more cells per centimeter.
实质器官更复杂 因为他们每厘米使用的器官更多
129.This is actually a simple solid organ like the ear.
这是一个简单的实质器官，像耳朵
130.It’s now being seeded with cartilage.
现在植入了软骨
131.That’s the oven-like device; Once it’s coated it gets placed there.
那是那个像烤箱一样的装置 植入细胞后，我们就把整个材料放入其中，
132.And then a few weeks later we can take out the cartilage scaffold.
数周后，我们就能取出这个特殊材料。
133.This is actually digits that we’re engineering.
这记录了我们的制造过程，
134.These are being layered, one layer at a time, first the bone, we fill in the gaps with cartilage.
我们植入很多层，一次一层， 首先是骨头，我们在缝隙中填入软骨。
135.We then start adding the muscle on top.
在上面，我们植入肌肉。
136.And you start layering these solid structures.
然后你可以开始一层层的建成一个实体结构，
137.Again, fairly more complex organs.
得到更复杂的器官。
138.but by far, the most complex solid organs are actually the vascularized, highly vascularized, a lot of blood vessel supply, organs such as the heart,
但到目前为止，最复杂的实体器官是 是包含很多血管的实体器官。 器官连接很多血管的， 比如心脏，
139.the liver, the kidneys.
肝脏，肾脏。
140.This is actually an example — several strategies to engineer solid organs.
这是一个例子——我们有很多战略 来制造实体器官
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