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1、 医学英语细胞移植治疗糖尿病遇尴尬细胞移植法治疗糖尿病遭受为难 The cell transplants did free patients from insulin shots， but only temporarily： within two years， 86 percent needed insulin again， according to a report to be published Thursday in The New England Journal of Medicine. 星期四登载在新英格兰医学杂志上的报告显示，细胞移植确实免除了患者注射胰岛素之苦，但是作用却只是临时
2、的：86%的患者在2年以内再次需要新的胰岛素。 The patients had severe Type 1 diabetes， also called juvenile diabetes， in which the body lacks insulin and people must inject it several times a day to control blood sugar. They were given islet cells from the pancreas of a dead organ donor. 患有严峻的型糖尿病，也称为青少年糖尿病的患者体内缺少胰岛素，为了掌
3、握血糖必需每天屡次注射胰岛素。他们被移植了死亡的器官捐献者的胰脏细胞。 The transplants do not require major surgery， just a tube inserted into a vein in the abdomen so that the cells can be dripped into the liver， where they take up residence in tiny blood vessels. Because the transplanted cells come from someone else， recipients mus
4、t take immune-suppressing drugs for life to prevent rejection. 移植手术不需要动大手术，只需要在患者腹部的血管中插入一个导管把细胞倒入患者的肝脏，细胞就依附在肝脏细小的血管上。由于细胞来自于别人体内，承受移植的患者必需终生服用免疫抑制药物，预防产生排异现象。 The study， involving 36 patients at nine centers in the United States， Canada and Europe， was inspired by a smaller trial published in 2022
5、 that sparked excitement about a transplant technique called the Edmonton protocol， developed at the University of Alberta. In that initial test， none of the patients needed insulin shots-but when the report was published， none had been followed for more than 14 months. Later， many did need the shot
6、s again. 这项讨论是在来自于美国、加拿大和欧洲9个中心的36名患者身上进展的。讨论受到2022年公布的一项小规模的试验结果的启发，那一试验提出了让人兴奋的移植技术，即在埃尔伯塔大学进展起来的埃德蒙顿方案。在起初的试验中，没有一个患者需要注射胰岛素。医学教.育网搜集但是到试验报揭发布的时候，全部的病人跟踪观看还不到14个月。后来，很多患者还是需要接着注射胰岛素。 In the newer study， the transplants failed completely within a year in 10 of the 36 patients； but 16 others were o
7、ff insulin completely， and the remaining 10 needed less insulin than before. By two years， only five were still free of insulin shots. A quarter of the patients had to switch immune-suppressing drugs because of side effects， which sometimes included a drop in kidney function. 在新近的讨论中，在细胞移植的36例患者中，1年
8、以内有10例移植完全失败；但是另外16例患者完全不在需要胰岛素注射，另外10例需要的胰岛素的量也比以前削减了。到2年的时候，仅有5例依旧不需要注射胰岛素。由于副作用的缘由，包括消失肾功能下降的状况，四分之一的患者不得不停顿使用免疫抑制药物。 For now， the cell transplants are not recommended for most patients. 所以现在绝大局部患者都没有建议采纳细胞移植法。 “I dont think this is ready for prime time，“ said Dr. Jonathan S. Bromberg， director o
9、f transplantation at Mount Sinai Hospital in Manhattan. He was not involved in the research， but wrote an editorial about it in the same journal. “我认为时机还不成熟，” 曼哈顿西奈山医院器官移植主任乔纳森S布隆伯格博士说。他没有参加这次讨论，但是他在同一期刊上撰写了关于讨论报告的社评。 But he also said the field was advancing so fast that the transplants may actually
10、 become a viable option in the not-so-distant future. 但是他说，这一领域进展很快，实际上移植可能在不远的将来成为牢靠的治疗方法。 “I think weve got every reason to believe there will be significant progress，“ Dr. Bromberg said. 他表示：“我认为我们有足够的理由信任这一技术将会取得重大的进步。” In the meantime， even in their present form， the cell transplants may still
11、help some people - approximately 10 percent of those with Type 1 diabetes， who frequently suffer from severe episodes of low blood sugar， or hypoglycemia， that strike without warning and can cause confusion， fainting or even seizures. 同时，即便是在他们现在的情形下，细胞移植对于大约10%的患有I型糖尿病的患者可能依旧有用。这些患者常常受到严峻的低血糖病症或者低血
12、糖症的熬煎，这些疾病会在没有任何征兆的状况下发生，并能诱发神志不清、昏迷甚至惊厥。 This kind of hypoglycemia can be so severe that patients “cant function in society，“ said Dr. A.M. James Shapiro， who led the study and is director of the islet transplant program at the University of Alberta. His team developed the Edmonton protocol. 这种低血糖症
13、会特别严峻，可以导致患者“不能正常活动”，领导这项讨论的埃尔伯塔胰岛移植工程主任A.M. 詹姆斯夏皮罗博士表示。他领导的团队开创了埃德蒙顿方案。 Patients in the study had the condition， but the transplants diminished their hypoglycemic attacks， even when the cells were only partly effective. 讨论中的患者都有上述状况，但在细胞移植后，甚至即便在这些细胞只有局部发挥作用时，他们都免受了低血糖症的困扰。 In the United States， th
14、e cell transplants are considered experimental and are available only in studies. They are more widely available in Canada， Dr. Shapiro said. 在美国，细胞移植还在试验阶段，只有在讨论中可以使用。夏普罗博士介绍说，但在加拿大，细胞移植应用更加广泛。 Transplanting the entire pancreas can reverse Type 1 diabetes， but it is a major operation and in this co
15、untry is usually done only when the diabetes is so severe that the patient needs a kidney transplant as well. About 1，500 pancreas transplants a year are performed in the United States. The transplants tend to work for 5 to 10 years， Dr. Bromberg said. Eventually most patients need insulin again. 完全移植整个胰脏可以彻底治疗型糖尿病，但是这是一项大手术，而且在美国只有糖尿病已经严峻到需要肾移植的时候才通常会被采纳。布隆伯格博士说，移植往往可以保证5到10年，但大多数患者最终还是需要注射胰岛素。 But people with Type 1 do not really need a whole pancreas： they need just the islet cells， which make up only about 3 percent of the organ.
