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1、www.XiYuS锡育软件So,before I became a dermatologist,I started in generalmedicine,as most dermatologists do in Britain.在成为皮肤科医生之前 我最初在一般内科（实习）正如英国的大多数皮肤科医生所经历的那样00:12At the end of that time,I went off to Australia,about 20 yearsago.在实习结束前我去了澳大利亚 那是大约20年前了。00:20What you learn when you go to Australia is t
2、he Australiansare very competitive.去了澳大利亚 你就知道那里的人非常争强好胜00:23And they are not magnanimous in victory.他们对于获胜可谓是斤斤计较00:28And that happened a lot:You pommies,you cant playcricket,rugby.这类事情经常发生:“你们英国佬不会打板球和橄榄球。”00:30I could accept that.这个我能接受00:35But moving into work-and we have each week whats calleda
3、 journal club,when youd sit down with the other doctorsand youd study a scientific paper in relation to medicine.但换到工作中 我们每周有一次期刊俱乐部的活动,我跟别的医生们一起坐下来 研究一篇科学论文 只要与医学相关00:37And after week one,it was about cardiovascular mortality,adry subject-how many people die of heart disease,whatthe rates are.第一个星期
4、后,课题是关于心血管疾病的死亡率,这很枯燥 多少人死于心脏病,死亡率是多少。00:48And they were competitive about this:You pommies,yourrates of heart disease are shocking.他们就抬杠说“你们英国佬的心脏病率令人震惊。”00:56dermatologist:n.皮肤科医生;皮肤学者 in general:总之,通常;一般而言 dermatologists:n.皮肤科医生;皮肤学者magnanimous:adj.宽宏大量的;有雅量的;宽大的 cardiovascular:adj.解剖心血管的 mortali
5、ty:n.死亡数,死亡率;必死性,必死的命运And of course,they were right.当然,他们没错01:01Australians have about a third less heart disease than we do-less deaths from heart attacks,heart failure,less strokes-theyre generally a healthier bunch.澳大利亚人的心脏病发病率比我们少三分之一 心脏病、心率衰竭、以及中风等病致死的概率也低他们（跟英国人比）是个更健康的人群01:03And of course the
6、y said this was because of their fine moralstanding,their exercise,because theyre Australians andwere weedy pommies,and so on.当然他们说这是因为 澳大利人道德高尚,喜爱运动因为他们是澳大利亚人,而我们是瘦弱的英国佬,等等。01:13But its not just Australia that has better health than Britain.但是不只是澳大利亚人比英国人健康。01:21Within Britain,there is a gradient o
7、f health-and this iswhats called standardized mortality,basically your chancesof dying.在英国内部,健康也是有梯度的 这就是所谓的标准化死亡率 大致来说就是你死亡的概率01:26This is looking at data from the paper about 20 years ago,but its true today.论文引用的是20年前的数据 在今天也适用01:33Comparing your rates of dying 50 degrees north-thats theSouth,that
8、s London and places-by latitude,and 55degrees-the bad news is thats here,Glasgow.对比北纬50度以北地区的死亡率 这是南方的伦敦和周边地区 北纬55度 这里情况不太好,是格拉斯哥01:38Im from Edinburgh.Worse news,thats even Edinburgh.我来自爱丁堡。更糟的是,这里也有爱丁堡。01:49strokes:n.中风 weedy:adj.瘦弱的;似杂草的;尽是杂草的 gradient:n.数物梯度;坡度;倾斜度/adj.倾斜的;步行的standardized:adj.标准
9、的;标准化的;定型的/v.使合乎标准;按标准校准;制定标准(standardize的过去分词)latitude:n.纬度;界限;活动范围(Laughter)So what accounts for this horrible space herebetween us up here in southern Scotland and the South?（笑声）是什么导致了这些地方的数据如此恐怖在苏格兰南部 和英格兰南部之间？01:52Now,we know about smoking,deep-fried Mars bars,chips-the Glasgow diet.现在,我们知道愿意包括
10、吸烟、油炸的巧克力棒、薯片这些都是格拉斯哥的饮食。02:03All of these things.所有这些都是。02:07But this graph is after taking into account all of these knownrisk factors.但这张图是综合考虑了 所有这些已知风险因素的02:08This is after accounting for smoking,social class,diet,allthose other known risk factors.排除了吸烟,社会地位,饮食,以及其他所有已知的危险因素的影响02:13We are left
11、with this missing space of increased deaths the这里有个空白区域 越往北,死亡率越高02:19TED演讲者：Richard Weller|理查德.威勒演讲标题：Richard Weller:Could the sun be good for your heart?|晒太阳对心脏有益吗?内容概要：Dermatologist Richard Weller wants to know:Why are Scots so sick?人体通过晒太阳来合成维生素D，可是皮肤科医生理查德.威勒指出，阳光还可以带来另一个惊人的益处。他的团队通过新研究表明:一氧化氮这
12、种大量储存在皮肤中的化学传递质，能通过紫外线照射而释放出来，对血压和心血管系统产生很大益处。这是什么意思呢?那好，就从解释为什么苏格兰人比澳大利亚人更容易生病开始吧We are left with this missing space of increased deaths thefurther north you go.Now,sunlight,of course,comes into this.现在,日照这个因素参与了进来02:25And vitamin D has had a great deal of press,and a lot ofpeople get concerned abo
13、ut it.媒体有过大量关于维生素D的报道 许多人也开始关注02:27And we need vitamin D.Its now a requirement that childrenhave a certain amount.我们需要维生素D。现在对儿童每天的摄入量有所规定。02:32My grandmother grew up in Glasgow,back in the 1920s and30s when rickets was a real problem and cod liver oil wasbrought in.我祖母在格拉斯哥长大 在20世纪二三十年代,佝偻病是个大问题 鱼肝
14、油被采用,02:36deep-fried:adj.油炸的;炒的/vt.油炸(deep-fry的过去分词)accounting:n.会计,会计学;账单/v.解释(account的ing形式);叙述 a great deal of:大量 rickets:n.内科佝偻病 cod:n.鱼鳕鱼;愚弄;哄骗/vi.欺骗;愚弄/vt.愚弄;欺骗And that really prevented the rickets that used to becommon in this city.真正起到了预防佝偻病这种常见病的作用02:44And I as a child was fed cod liver oil
15、 by my grandmother.小时候,祖母就给我吃过。02:48I distinctly-nobody forgets cod liver oil.无疑,没人会忘记鱼肝油。02:51But an association:The higher peoples blood levels ofvitamin D are,the less heart disease they have,the lesscancer.可是有一个关联:血液里维生素D越高的人 患心脏病和癌症的几率越低02:54There seems to be a lot of data suggesting that vitam
16、in D isvery good for you.有很多数据标明维生素D对人体有益。03:03And it is,to prevent rickets and so on.它会预防佝偻病,等等。03:06But if you give people vitamin D supplements,you dontchange that high rate of heart disease.但如果你给人们维生素D补充剂,并不会改变心脏病的高发率。03:09And the evidence for it preventing cancers is not yet great.它预防癌症的证据还不太具说
17、服力03:15So what Im going to suggest is that vitamin D is not the onlystory in town.我的想法是,维生素D不是唯一的影响因素03:19Its not the only reason preventing heart disease.它不是预防心脏病的唯一原因。03:23High vitamin D levels,I think,are a marker for sunlightexposure,and sunlight exposure,in methods Im going toshow,is good for h
18、eart disease.维生素D高,是常晒太阳的结果 我将要说明,多晒太阳 能减少患心脏病的风险03:27prevented:v.阻止;避免;被阻止(prevent的过去式,过去分词)distinctly:adv.明显地;无疑地,确实地 supplements:n.补充品;增补物;昆补脉(supplement的复数)not yet:还没有,还没 marker:n.记分员;书签;标识物;作记号的人Anyway,I came back from Australia,and despite the obviousrisks to my health,I moved to Aberdeen.不管怎样
19、,我从澳大利亚回来了,我冒着生命危险搬到了阿伯丁03:37(Laughter)Now,in Aberdeen,I started my dermatologytraining.（笑声）现在,在阿伯丁,我开始进行皮肤科的培训03:42But I also became interested in research,and in particular Ibecame interested in this substance,nitric oxide.可我也对研究感兴趣,特别是对一氧化氮这种物质感兴趣。03:48Now these three guys up here,Furchgott,Ignar
20、ro andMurad,won the Nobel Prize for medicine back in 1998.这三个人 弗奇戈特、伊格纳罗和穆拉德 是1998年诺贝尔医学奖的得主03:53And they were the first people to describe this new chemicaltransmitter,nitric oxide.他们是最早来描述 这种新的化学传递物一氧化氮的人03:59What nitric oxide does is it dilates blood vessels,so it lowersyour blood pressure.一氧化氮会扩
21、张血管,降低血压。04:05It also dilates the coronary arteries,so it stops angina.它也能扩张冠状动脉,从而缓解心绞痛。04:10dermatology:n.皮肤医学,皮肤皮肤病学 in particular:尤其,特别 nitric:adj.氮的;含氮的;硝石的 oxide:n.化学氧化物transmitter:n.电讯发射机,通信发报机;传达人 dilates:v.扩大,详述(dilate第三人称单数);膨胀 vessels:n.血管(vessel的复数);船舶;容器 lowers:工资(海洋法用语)coronary:adj.冠的;
22、冠状的;花冠的 arteries:n.解剖动脉(artery的复数)/v.给提供动脉(artery的单数第三人称)angina:n.心绞痛;咽喉痛;咽峡炎And what was remarkable about it was in the past when wethink of chemical messengers within the body,we thoughtof complicated things like estrogen and insulin,or nervetransmission.它与众不同的是 过去当我们想到体内的化学信使时,我们会想到一些复杂的诸东西,如雌激素、
23、胰岛素、或神经传导。04:14Very complex processes with very complex chemicals that fitinto very complex receptors.非常复杂的流程伴有非常复杂的化学物质 存在于非常复杂的受体中。04:24And heres this incredibly simple molecule,a nitrogen andan oxygen that are stuck together,and yet these are hugelyimportant for unclear our low blood pressure,for
24、neurotransmission,for many,many things,but particularlycardiovascular health.这是个非常简单的分子,一个氮和一个氧粘在一起,但这些对我们的维持较低的血压至关重要,它作用于神经传递和许多许多东西,尤其是心血管健康。04:30And I started doing research,and we found,very excitingly,that the skin produces nitric oxide.我们开始研究,并且非常激动地发现,皮肤会生成一氧化氮。04:46So its not just in the ca
25、rdiovascular system it arises.所以它不只是在心血管系统中才出现04:52www.XiYuS锡育软件It arises in the skin.它在皮肤上也出现。04:55Well,having found that and published that,I thought,well,whats it doing?将这个发现发表之后 我就想,它在干啥呢？04:57How do you have low blood pressure in your skin?你皮肤上怎么能有低血压呢？05:00messengers:n.东京速递(电视剧)estrogen:n.雌性激素
26、 insulin:n.生化药胰岛素 receptors:n.生化受体;接受器;神经末梢(receptor的复数)molecule:n.化学分子;微小颗粒,微粒 excitingly:adv.刺激地;振奋人心地Its not the heart.What do you do?不是心脏。你是干啥呢？05:02So I went off to the States,as many people do if theyregoing to do research,and I spent a few years in Pittsburgh.This is Pittsburgh.于是我去了美国,很多人都去美
27、国做研究 我在匹斯堡呆了几年,这就是匹斯堡。05:04And I was interested in these really complex systems.我对这些超级复杂的系统感兴趣。05:12We thought that maybe nitric oxide affected cell death,andhow cells survive,and their resistance to other things.我们认为也许一氧化氮影响细胞死亡,影响细胞存活,也影响细胞的免疫05:14And I first off started work in cell culture,growi
28、ng cells,andthen I was using knockout mouse models-mice thatcouldnt make the gene.我先开始研究细胞文化,细胞生长 接着用被击昏了的老鼠作为模特 那些老鼠不能生产基因。05:21We worked out a mechanism,which-NO was helping cellssurvive.我们研究出一个机理:一氧化氮帮助细胞存活05:28And I then moved back to Edinburgh.后来我搬回爱丁堡。05:33And in Edinburgh,the experimental ani
29、mal we use is themedical student.在爱丁堡,我的实验动物是医学院学生。05:36Its a species close to human,with several advantages overmice:Theyre free,you dont shave them,they feedthemselves,and nobody pickets your office saying,Save thelab medical student.是接近人类的一个物种,跟老鼠相比有以下几个好处:不用付费,不用给他们剃毛,不用喂养他们 没人查你的办公室,还要说:“管好你实验室
30、的医科学生。”05:39So theyre really an ideal model.所以说,他们真是理想的模特。05:51knockout:adj.淘汰的;击倒的;迷人的/n.淘汰赛;击倒;给人留下深刻印象的人;绝代佳人 pickets:n.雪桩,雪椿;系绳尖桩(picket的复数)But what we found was that we couldnt reproduce in manthe data we had shown in mice.但我们发现 我们不能在人身上复制出在老鼠身上得到的数据。05:54It seemed we couldnt turn off the produ
31、ction of nitric oxidein the skin of humans.看来我们不能停止 人体皮肤产生一氧化氮06:01We put on creams that blocked the enzyme that made it,weinjected things.We couldnt turn off the nitric oxide.我们涂上乳液就能阻挡制造它的酶,我们能注射药品。但我们无法停住一氧化氮。06:07And the reason for this,it turned out,after two or three yearswork,was that in the
32、skin we have huge stores not of nitricoxide,because nitric oxide is a gas,经过两三年的工作,我们终于找出了原因,我们皮肤里大量储存的并非一氧化氮 因为一氧化氮是气体06:14and its released-(Poof!)-and in a few seconds its away,but it can be turned into these forms of nitric oxide-nitrate,NO3;nitrite,NO2;nitrosothiols.它要挥发的（噗！)几秒钟就没影了,但一氧化氮能转化成 硝酸
33、盐、硝酸盐、亚硝酸盐、二氧化氮、亚硝基硫醇。06:25And these are more stable,and your skin has got really largestores of NO.这些形式更稳定 你的皮肤就得到了大量的一氧化氮06:35And we then thought to ourselves,with those big stores,Iwonder if sunlight might activate those stores and releasethem from the skin,where the stores are about 10 times asb
34、ig as whats in the circulation.我们就寻思 阳光是否会活化这大量的一氧化氮 将它们从皮肤中释放出来 这些一氧化氮的存量10倍于参与新陈代谢的一氧化氮量06:40creams:n.面霜(cream的复数);奶油类/v.把搅成奶油状物;加奶油于;抽取精华(cream的三单形式)enzyme:n.生化酶injected:充血的/注入的 nitrate:n.硝酸盐/vt.用硝酸处理 nitrite:n.亚硝酸盐 activate:vt.刺激;使活动;使活泼;使产生放射性/vi.激活;有活力 circulation:n.流通，传播；循环；发行量Could the sun a
35、ctivate those stores into the circulation,andthere in the circulation do its good things for yourcardiovascular system?太阳能不能激活这些存量让它们参与新陈代谢,从而作用于心血管系统呢？06:52Well,Im an experimental dermatologist,so what we did waswe thought wed have to expose our experimental animals tosunlight.我呢,是个实验皮肤科医生,所以我们想到 应
36、该让实验动物多晒太阳07:00And so what we did was we took a bunch of volunteers andwe exposed them to ultraviolet light.于是,我们找来了一群志愿者 让他们接受紫外线照射07:07So these are kind of sunlamps.这些是太阳灯。07:14Now,what we were careful to do was,vitamin D is made byultraviolet B rays and we wanted to separate our story fromthe vit
37、amin D story.这里我们要小心 维生素D是通过中波紫外线（UVB）射线生成的 而我们想排除维生素D的干扰07:16So we used ultraviolet A,which doesnt make vitamin D.所以,我们使用了不生成维生素D的长波紫外线（UVA）07:25When we put people under a lamp for the equivalent ofabout 30 minutes of sunshine in summer in Edinburgh,whatwe produced was,we produced a rise in circula
38、ting nitricoxide.我们对受试者进行照射 强度相当于暴露在爱丁堡夏日阳光中30分钟 结果是我们得到了 新陈代谢中一氧化氮的提升07:29So we put patients with these subjects under the UV,andtheir NO levels do go up,and their blood pressure goesdown.我们让心血管病的患者接受紫外线照射 他们的一氧化氮水平上升了 而他们的血压下降了07:41a bunch of:一群;一束;一堆 ultraviolet:adj.紫外的；紫外线的/n.紫外线辐射，紫外光 rays:n.射线
39、;光线(ray的复数);日光浴/v.辐射(ray的三单形式);照射 lamp:n.灯;照射器/vt.照亮/vi.发亮 equivalent:adj.等价的,相等的;同意义的/n.等价物,相等物 circulating:adj.循环的;流通的/v.循环(circulate的ing形式);流通Not by much,as an individual level,but enough at apopulation level to shift the rates of heart disease in a wholepopulation.就个人而言不算多 但对于整个人群而言有显著意义 足以改变整个人
40、群的心脏病患病率07:48And when we shone UV at them,or when we warmed themup to the same level as the lamps,but didnt actually let therays hit the skin,this didnt happen.给他们照射紫外线 或者使他们的皮肤太阳灯的温度那样温暖 但不让光线接触皮肤,同样的结果就不会发生07:57So this seems to be a feature of ultraviolet rays hitting theskin.这似乎说明了其中关键在于紫外线要接触到皮肤
41、08:06Now,were still collecting data.我们至今仍在收集数据08:10A few good things here:This appeared to be more marked inolder people.有几样好的发现:这在年长者身上效果更明显08:12Im not sure exactly how much.我不确定具体的数量08:17One of the subjects here was my mother-in-law,and clearly Ido not know her age.其中一个被试是我的岳母大人 很显然我不太清楚她的年龄08:18B
42、ut certainly in people older than my wife,this appears to bea more marked effect.但肯定比我太太年纪要大 在她身上效果更明显08:23And the other thing I should mention was there was nochange in vitamin D.我要提到的另一点是 在整个过程中维生素D并没有发生变化08:29This is separate from vitamin D.维生素D的影响是被分离的08:33So vitamin D is good for you-it stops r
43、ickets,it preventscalcium metabolism,important stuff.维生素D对人有益它预防佝偻病 还能预防钙流失,是很重要的微量元素08:35shone:vi.发光(shine的过去式及过去分词)warmed:adj.温暖的;热情的/vi.同情;激动;变温暖/vt.使兴奋;使温暖;使感兴趣/n.取暖;加热 lamps:n.灯具(lamp的复数);眼睛;日月星辰/v.看;照亮;发亮;放松(lamp的第三人称单数)mother-in-law:n.岳母;婆母 calcium:n.化学钙 metabolism:n.生理新陈代谢But this is a separ
44、ate mechanism from vitamin D.但（我们研究的）这是一个与维生素D相分离的机制08:39Now,one of the problems with looking at blood pressure isyour body does everything it can to keep your bloodpressure at the same place.现今在血压的问题上有一点要注意 就是你的身体会竭尽所能 去把血压维持在同一个水平08:42If your leg is chopped off and you lose blood,your body willcla
45、mp down,increase the heart rate,do everything it can tokeep your blood pressure up.如果你的腿被剁断,你会失血,你的身体会施加压力,增加心跳,来尽可能地维持你的正常血压。08:47That is an absolutely fundamental physiological principle.这是一个绝对的基本生理原则。08:54So what weve next done is weve moved on to looking atblood vessel dilatation.所以我们接下来做的 就是转而研
46、究血管扩张08:57So weve measured-this is again,notice no tail and hairless,this is a medical student.我们测试了同一批（实验动物）注意他们没有尾巴也没有皮毛,这是个医科学生。09:03In the arm,you can measure blood flow in the arm by howmuch it swells up as some blood flows into it.你测量手臂上的血流 测量血流通过时血管扩张了多少09:09And what weve shown is that doing
47、a sham irradiation-this is the thick line here-this is shining UV on the arm so itwarms up but keeping it covered so the rays dont hit theskin.这里显示的是在做假射机 这里有条粗线 紫外线照射到手臂上,皮肤升温 但我们盖住皮肤,所以紫外线就接触不到了09:15clamp:vt.夹紧,固定住/n.夹钳,螺丝钳 physiological:adj.生理学的，生理的 dilatation:n.扩张;详述;膨胀度 hairless:adj.无毛的;秃顶的 swe
48、lls:v.涌浪;胀罐(swell的第三人称单数形式)/n.肿胀(swell的复数)irradiation:n.照射;发光,放射There is no change in blood flow,in dilatation of the bloodvessels.血流量没有变化,血管也没有扩张09:25But the active irradiation,during the UV and for an hour afterit,there is dilation of the blood vessels.但如果让紫外线接触皮肤 在紫外线照射期间及照射后一小时 血管都有所扩张09:29This
49、is the mechanism by which you lower blood pressure,bywhich you dilate the coronary arteries also,to let the blood这就是降低血压的机制 你的冠状动脉也扩张了 给心脏提供更多的血液09:37which you dilate the coronary arteries also,to let the bloodbe supplied with the heart.So here,further data that ultraviolet-thats sunlight-hasbenefit
50、s on the blood flow and the cardiovascular system.这里有更多有关紫外线也就是太阳光的作用数据显示紫外线有益于血流和心血管系统。09:43So we thought wed just kind of model-Different amountsof UV hit different parts of the Earth at different times ofyear,so you can actually work out those stores of nitric oxide-我们认为我们只是一种模型-不同时节照射到不同地域的紫外线是不