Ted演講：男性與女性的健康護(hù)理(中英文)

　　健康是大家一定要關(guān)心的，以下是小編推薦的Ted演講：男性與女性的健康護(hù)理(中英文)，歡迎閱讀!

　　Some of my most wonderful memories of childhood are of spending time with my grandmother, Mamar, in our four-family home in Brooklyn, New York. Her apartment was an oasis. It was a place where I could sneak a cup of coffee, which was really warm milk with just a touch of caffeine. She loved life. And although she worked in a factory, she saved her pennies and she traveled to Europe. And I remember poring over those pictures with her and then dancing with her to her favorite music.

　　我童年一些最美好的時(shí)光 是和我奶奶一塊兒 在我們紐約，布魯克林的四口之家度過(guò)的。 她的公寓就像一個(gè)樂(lè)園。 在那兒我可以偷著喝點(diǎn)咖啡， 其實(shí)就是熱牛奶兌了一點(diǎn)點(diǎn)咖啡。 她熱愛(ài)生活。 盡管她只在一個(gè)工廠上班， 她還是一點(diǎn)一滴攢下錢去歐洲旅游。 記得那會(huì)兒我和她一起細(xì)細(xì)品味那些照片， 然后伴著她最喜歡的音樂(lè)一起跳舞。

　　And then, when I was eight and she was 60, something changed. She no longer worked or traveled. She no longer danced. There were no more coffee times. My mother missed work and took her to doctors who couldn't make a diagnosis. And my father, who worked at night, would spend every afternoon with her, just to make sure she ate.

　　后來(lái)，當(dāng)我8歲，她60歲的時(shí)候， 這一切都變了。 她不再上班或者旅游了。 也不再跳舞了。 我們?cè)僖矝](méi)有咖啡時(shí)間了。 我媽媽請(qǐng)了假帶奶奶去看醫(yī)生， 卻無(wú)法得到一個(gè)診斷。 我爸爸上夜班，他每個(gè)下午都陪著奶奶， 就為了保證她吃了東西。

　　Her care became all-consuming for our family. And by the time a diagnosis was made, she was in a deep spiral.

　　全家人一門心思地?fù)涞搅四棠躺砩稀?當(dāng)終于有一個(gè)診斷的時(shí)候， 她的情況已經(jīng)岌岌可危了。

　　Now many of you will recognize her symptoms. My grandmother had depression. A deep, life-altering depression, from which she never recovered. And back then, so little was known about depression.

　　現(xiàn)在在座的很多人能推斷出她的癥狀。 我奶奶得的是抑郁癥。 顛覆了她生活的重度抑郁癥， 她再也沒(méi)有恢復(fù)過(guò)來(lái)。 當(dāng)時(shí)，人們對(duì)抑郁癥知之甚少。

　　But even today, 50 years later, there's still so much more to learn. Today, we know that women are 70 percent more likely to experience depression over their lifetimes compared with men. And even with this high prevalence, women are misdiagnosed between 30 and 50 percent of the time.

　　但即使是50年以后的今天， 也還有很多需要去了解。 如今，我們知道，一生中女性患上抑郁癥 的幾率比男性高出 70%。 而即使有這樣高的患病率， 30% 到 50%的女性還是會(huì)被誤診。

　　Now we know that women are more likely to experience the symptoms of fatigue, sleep disturbance, pain and anxiety compared with men. And these symptoms are often overlooked as symptoms of depression.

　　現(xiàn)在我們知道，與男性相比， 女性更可能會(huì)出現(xiàn)疲勞、 睡眠紊亂、 疼痛、以及焦慮的癥狀。 這些癥狀往往被忽視 而未能推斷出是抑郁癥的癥狀。

　　And it isn't only depression in which these sex differences occur, but they occur across so many diseases.

　　這類性別差異并非只存在于抑郁癥中， 還存在于很多其他疾病中。

　　So it's my grandmother's struggles that have really led me on a lifelong quest. And today, I lead a center in which the mission is to discover why these sex differences occur and to use that knowledge to improve the health of women.

　　所以，正是由于我奶奶的種種掙扎 促使了我進(jìn)行終身探索。 如今，我?guī)ьI(lǐng)著一個(gè)團(tuán)隊(duì)，其使命 就是去探尋出現(xiàn)這些性別差異的原因 并利用這些知識(shí) 來(lái)改善女性健康。

　　Today, we know that every cell has a sex. Now, that's a term coined by the Institute of Medicine. And what it means is that men and women are different down to the cellular and molecular levels. It means that we're different across all of our organs. From our brains to our hearts, our lungs, our joints.

　　今天，我們知道每個(gè)細(xì)胞都有性別。 這是個(gè)由醫(yī)學(xué)機(jī)構(gòu)所創(chuàng)造的詞。 它的意思是，男人和女人的區(qū)別， 直達(dá)細(xì)胞和分子的層面。 這意味著我們之間的區(qū)別反映在各個(gè)器官上。 從我們的大腦、到我們的心臟、 我們的肺部、 我們的關(guān)節(jié)。

　　Now, it was only 20 years ago that we hardly had any data on women's health beyond our reproductive functions. But then in 1993, the NIH Revitalization Act was signed into law. And what this law did was it mandated that women and minorities be included in clinical trials that were funded by the National Institutes of Health. And in many ways, the law has worked. Women are now routinely included in clinical studies, and we've learned that there are major differences in the ways that women and men experience disease. But remarkably, what we have learned about these differences is often overlooked.

　　僅僅在20 年前， 我們還幾乎沒(méi)有任何關(guān)于女性健康的數(shù)據(jù)， 除了我們的生殖功能。 但后來(lái)在 1993 年， 《美國(guó)國(guó)家衛(wèi)生研究院復(fù)興法 》 通過(guò)簽署成為法律。 這項(xiàng)法律規(guī)定 由國(guó)家衛(wèi)生研究院資助的臨床試驗(yàn) 需要包含女性和少數(shù)族裔。 從許多方面看，這項(xiàng)法律起到了作用。 現(xiàn)如今女性通常會(huì)參與臨床研究， 我們也了解了男性和女性 在罹患疾病時(shí)的 主要區(qū)別。 但值得注意的是， 我們已知的這些區(qū)別往往被忽視。

　　So, we have to ask ourselves the question: Why leave women's health to chance? And we're leaving it to chance in two ways. The first is that there is so much more to learn and we're not making the investment in fully understanding the extent of these sex differences. And the second is that we aren't taking what we have learned, and routinely applying it in clinical care. We are just not doing enough.

　　所以，我們必須問(wèn)自己這個(gè)問(wèn)題： 為什么女性的健康得看運(yùn)氣? 從兩方面來(lái)看，我們?cè)诳窟\(yùn)氣。 第一是要研究的內(nèi)容甚多， 而我們并沒(méi)有在這方面投資 以全面了解這些性別差異。 第二是我們是沒(méi)有把已經(jīng)學(xué)到的東西 應(yīng)用在常規(guī)的臨床護(hù)理中。 我們做得實(shí)在不夠。

　　So, I'm going to share with you three examples of where sex differences have impacted the health of women, and where we need to do more.

　　所以，我要與你分享三個(gè)例子， 關(guān)于性別差異如何影響了女性的健康 以及我們需要努力的地方。

　　Let's start with heart disease. It's the number one killer of women in the United States today. This is the face of heart disease. Linda is a middle-aged woman, who had a stent placed in one of the arteries going to her heart. When she had recurring symptoms she went back to her doctor. Her doctor did the gold standard test: a cardiac catheterization. It showed no blockages. Linda's symptoms continued. She had to stop working. And that's when she found us. When Linda came to us, we did another cardiac catheterization and this time, we found clues. But we needed another test to make the diagnosis. So we did a test called an intracoronary ultrasound, where you use soundwaves to look at the artery from the inside out.

　　我們先看心臟疾病。 這是如今美國(guó)女性的頭號(hào)殺手。 這是患心臟病的人。 琳達(dá)是一名中年女子， 在她到心臟的一根動(dòng)脈中 做了一個(gè)血管支架。 當(dāng)她有復(fù)發(fā)癥狀的時(shí)候，她再次回去看醫(yī)生。 醫(yī)生給她做了一個(gè)萬(wàn)無(wú)一失的標(biāo)準(zhǔn)測(cè)試： 心導(dǎo)管檢查。 顯示沒(méi)有堵塞。 琳達(dá)的癥狀繼續(xù)著。 她不得不停止了工作。 那時(shí)是她找上我們的時(shí)候。 當(dāng)琳達(dá)來(lái)我們那兒的時(shí)候，我們做了另一次心導(dǎo)管檢查 而這次，我們找到了些線索。 但我們需要另一個(gè)測(cè)試 才能做診斷。 于是我們做了一個(gè)叫冠狀動(dòng)脈內(nèi)超聲波的測(cè)試， 也就是用聲波從里到外 來(lái)看動(dòng)脈。

　　And what we found was that Linda's disease didn't look like the typical male disease. The typical male disease looks like this. There's a discrete blockage or stenosis. Linda's disease, like the disease of so many women, looks like this. The plaque is laid down more evenly, more diffusely along the artery, and it's harder to see. So for Linda, and for so many women, the gold standard test wasn't gold.

　　我們發(fā)現(xiàn) 琳達(dá)的病看起來(lái)不像 典型的男性心臟病。 典型的男性疾病看起來(lái)像這樣。 會(huì)有離散堵塞或著狹窄癥。 琳達(dá)的病，像很多女性的心臟病 看起來(lái)像這樣。 匾沿著動(dòng)脈分布得更均勻、 更擴(kuò)散， 也更難看出來(lái)。 所以對(duì)琳達(dá)，和眾多女性來(lái)說(shuō)， 萬(wàn)無(wú)一失標(biāo)準(zhǔn)測(cè)試不那么萬(wàn)無(wú)一失了。

　　Now, Linda received the right treatment. She went back to her life and, fortunately, today she is doing well. But Linda was lucky. She found us, we found her disease.

　　如今，接受了正確的治療之后， 琳達(dá)非常幸運(yùn)地又回歸了正常生活， 現(xiàn)在她情況不錯(cuò)。 但琳達(dá)是幸運(yùn)的。 她找到了我們，我們搞清了她的疾病。

　　But for too many women, that's not the case. We have the tools. We have the technology to make the diagnosis. But it's all too often that these sex diffferences are overlooked.

　　但對(duì)于太多的女性而言，她們的遭遇并非如此。 我們有工具， 并有技術(shù)來(lái)做診斷。 但太多時(shí)候，這些性別上的區(qū)別 被忽略了。

　　So what about treatment? A landmark study that was published two years ago asked the very important question: What are the most effective treatments for heart disease in women? The authors looked at papers written over a 10-year period, and hundreds had to be thrown out. And what they found out was that of those that were tossed out, 65 percent were excluded because even though women were included in the studies, the analysis didn't differentiate between women and men. What a lost opportunity. The money had been spent and we didn't learn how women fared. And these studies could not contribute one iota to the very, very important question, what are the most effective treatments for heart disease in women?

　　那么治療呢? 一篇兩年前發(fā)表的標(biāo)志性研究 問(wèn)了個(gè)很重要的問(wèn)題： 對(duì)女性而言，最有效的治療心臟病的方法是什么? 其作者搜索了10 年的文獻(xiàn)， 而不得不棄用其中數(shù)百個(gè)文獻(xiàn)。 他們發(fā)現(xiàn)棄用的文獻(xiàn)中， 有65%必須棄用是由于 即使其中的研究包括了女性， 分析部分也沒(méi)有區(qū)分女性和男性。 真是個(gè)錯(cuò)失了的機(jī)會(huì)。 錢用掉了 而我們卻不知道女性的情況如何。 這些研究無(wú)法對(duì)這一個(gè)非常、非常重要的問(wèn)題 作出絲毫的貢獻(xiàn)： 治療女性心臟病 最有效的方法是什么?

　　I want to introduce you to Hortense, my godmother, Hung Wei, a relative of a colleague, and somebody you may recognize -- Dana, Christopher Reeve's wife. All three women have something very important in common. All three were diagnosed with lung cancer, the number one cancer killer of women in the United States today. All three were nonsmokers. Sadly, Dana and Hung Wei died of their disease. Today, what we know is that women who are nonsmokers are three times more likely to be diagnosed with lung cancer than are men who are nonsmokers. Now interestingly, when women are diagnosed with lung cancer, their survival tends to be better than that of men. Now, here are some clues. Our investigators have found that there are certain genes in the lung tumor cells of both women and men. And these genes are activated mainly by estrogen. And when these genes are over-expressed, it's associated with improved survival only in young women. Now this is a very early finding and we don't yet know whether it has relevance to clinical care. But it's findings like this that may provide hope and may provide an opportunity to save lives of both women and men.

　　我想向你們介紹我的教母霍滕斯， 一位同事的親戚，洪魏， 還有一位你也許認(rèn)得 — — 達(dá)娜，克里斯托弗 · 里夫的妻子。 這三位女性都有一個(gè)很重要的共同點(diǎn)。 她們?nèi)�位都診斷為患有肺癌， 這是如今美國(guó)女性的 頭號(hào)癌癥殺手。 她們?nèi)齻�(gè)人都不抽煙。 可悲的是，達(dá)娜和洪魏死于肺癌。 今天，我們知道，不抽煙的女性 得到肺癌的診斷要比不抽煙的男性 高三倍。 有趣的是，當(dāng)女性診斷為患有肺癌時(shí)， 他們的生存率往往比男性好。 那么這其中有些線索。 我們的調(diào)查人員 在女性和男性的肺腫瘤細(xì)胞中發(fā)現(xiàn)了某些基因。 這些基因主要 是由雌激素來(lái)激活。 而當(dāng)這些基因過(guò)度釋放時(shí)， 它與提升生存率的'關(guān)聯(lián) 只存在于年輕女性中。 現(xiàn)在這還是個(gè)非常早期的發(fā)現(xiàn)， 我們還不知道它對(duì)臨床護(hù)理 是否有意義。 但像這樣的研究結(jié)果或許能創(chuàng)造希望 并且提供機(jī)會(huì)來(lái)拯救女性和男性 的生命。

　　Now, let me share with you an example of when we do consider sex differences, it can drive the science. Several years ago a new lung cancer drug was being evaluated, and when the authors looked at whose tumors shrank, they found that 82 percent were women. This led them to ask the question: Well, why? And what they found was that the genetic mutations that the drug targeted were far more common in women. And what this has led to is a more personalized approach to the treatment of lung cancer that also includes sex.

　　現(xiàn)在，讓我與大家分享一個(gè)例子， 說(shuō)的是我們對(duì)性別差異的考慮能夠驅(qū)動(dòng)科學(xué)發(fā)展。 前幾年，一種新的肺癌藥物 正接受評(píng)估， 當(dāng)研究人員觀察哪些人的腫瘤縮小的時(shí)候， 他們發(fā)現(xiàn) 82% 是女性。 這使得他們提出了這個(gè)問(wèn)題： 這是為什么呢? 他們發(fā)現(xiàn)的是 這種藥物針對(duì)的的基因突變 在女性中更為常見(jiàn)。 這帶出的結(jié)果是 對(duì)肺癌的治療更加個(gè)人化的方法 也需考慮性別差異。

　　This is what we can accomplish when we don't leave women's health to chance. We know that when you invest in research, you get results. Take a look at the death rate from breast cancer over time. And now take a look at the death rates from lung cancer in women over time. Now let's look at the dollars invested in breast cancer -- these are the dollars invested per death -- and the dollars invested in lung cancer. Now, it's clear that our investment in breast cancer has produced results. They may not be fast enough, but it has produced results. We can do the same for lung cancer and for every other disease.

　　這就是我們能做到的， 只要我們不放任女性健康于運(yùn)氣。 我們知道當(dāng)你投資在研究上， 你就會(huì)有收獲。 來(lái)看看乳腺癌隨著時(shí)間推移的死亡率。 再看看女性肺癌 隨著時(shí)間推移的死亡率。 現(xiàn)在再看看投在乳腺癌上的金額 -- 這些是每個(gè)死亡人數(shù)的投資金額數(shù) -- 對(duì)比投在肺癌上的金額數(shù)。 那么顯然，我們?cè)谌橄侔┑耐顿Y 取得了成果。 或許不足夠快， 但確實(shí)有成果。 而我們也能 為肺癌以及其他各種疾病創(chuàng)造出同樣的成果。

　　So let's go back to depression. Depression is the number one cause of disability in women in the world today. Our investigators have found that there are differences in the brains of women and men in the areas that are connected with mood. And when you put men and women in a functional MRI scanner -- that's the kind of scanner that shows how the brain is functioning when it's activated -- so you put them in the scanner and you expose them to stress. You can actually see the difference. And it's findings like this that we believe hold some of the clues for why we see these very significant sex differences in depression.

　　那么，讓我們回來(lái)說(shuō)說(shuō)抑郁癥。 抑郁癥是導(dǎo)致當(dāng)今世界女性 殘疾的第一大原因 我們的調(diào)查人員發(fā)現(xiàn) 女性和男性大腦中 的區(qū)別存在于 與情緒相關(guān)的區(qū)域。 當(dāng)你把男人和女人 放入功能性磁共振成像掃描儀中 — — 這是那種顯示被激活的大腦是如何工作的掃描儀 — — 把這些人放在掃描儀中，然后給他們壓力。 你真的可以看到其中的區(qū)別。 我們相信像這樣的研究結(jié)果， 對(duì)于為什么在抑郁癥上 我們觀察到這些非常顯著的性別差異 提供著某些思路。

　　But even though we know that these differences occur, 66 percent of the brain research that begins in animals is done in either male animals or animals in whom the sex is not identified.

　　但即使我們知道 這類差異的存在， 66% 的 動(dòng)物大腦研究 是在雄性動(dòng)物中完成的 或是在未鑒定性別的動(dòng)物中完成的。

　　So, I think we have to ask again the question: Why leave women's health to chance? And this is a question that haunts those of us in science and medicine who believe that we are on the verge of being able to dramatically improve the health of women. We know that every cell has a sex. We know that these differences are often overlooked. And therefore we know that women are not getting the full benefit of modern science and medicine today. We have the tools but we lack the collective will and momentum.

　　所以，我認(rèn)為我們要再次問(wèn)這個(gè)問(wèn)題： 為什么女性的健康得看運(yùn)氣? 這是一個(gè)縈繞在我們 科學(xué)界和醫(yī)學(xué)界的問(wèn)題， 我們相信我們即將有能力去顯著改進(jìn) 女性健康。 我們知道每個(gè)細(xì)胞都男女有別。 我們知道這些差異往往被忽視。 因此我們知道女性沒(méi)有得到今時(shí)今日 現(xiàn)代科學(xué)和醫(yī)學(xué)的充分好處。 我們有工具， 但我們?nèi)狈�集體意志和勢(shì)頭。

　　Women's health is an equal rights issue as important as equal pay. And it's an issue of the quality and the integrity of science and medicine. (Applause) So imagine the momentum we could achieve in advancing the health of women if we considered whether these sex differences were present at the very beginning of designing research. Or if we analyzed our data by sex.

　　女性的健康是一個(gè)平等權(quán)利問(wèn)題， 和同工同酬一樣重要。 這是一個(gè)科學(xué)和醫(yī)學(xué)的 質(zhì)量以及廉正性的問(wèn)題。 (掌聲) 所以想象一下我們?cè)谕七M(jìn)女性的健康上 可以達(dá)到的勢(shì)頭， 假如我們?cè)陂_始設(shè)計(jì)研究的時(shí)候 就考慮了這些性別差異是否存在， 或者，我們根據(jù)性別分析了我們的數(shù)據(jù)。

　　So, people often ask me: What can I do? And here's what I suggest: First, I suggest that you think about women's health in the same way that you think and care about other causes that are important to you. And second, and equally as important, that as a woman, you have to ask your doctor and the doctors who are caring for those who you love: Is this disease or treatment different in women? Now, this is a profound question because the answer is likely yes, but your doctor may not know the answer, at least not yet. But if you ask the question, your doctor will very likely go looking for the answer. And this is so important, not only for ourselves, but for all of those whom we love. Whether it be a mother, a daughter, a sister, a friend or a grandmother.

　　所以，人們常常問(wèn)我： 我能做什么? 這里是我的建議： 第一，我建議你們看待女性健康 就如同看待 其他任何對(duì)你重要的事業(yè)一樣，進(jìn)行思考和關(guān)注。 第二，同樣重要的是， 作為一名女性， 你得問(wèn)問(wèn)治療你 和你身邊的人的醫(yī)生： 這個(gè)疾病，或者治療，在女性中有不同之處嗎? 這是一個(gè)深刻的問(wèn)題，答案很可能是肯定的， 但你的醫(yī)生可能不知道答案，至少現(xiàn)在還不知道。 但如果你問(wèn)了這個(gè)問(wèn)題，你的醫(yī)生很有可能 會(huì)去尋找答案。 這是如此重要， 不僅僅對(duì)我們自己而言， 對(duì)我們身邊的人也是如此。 無(wú)論是一個(gè)母親、 一個(gè)女兒、 一個(gè)姐妹、 一位朋友或祖母。

　　It was my grandmother's suffering that inspired my work to improve the health of women. That's her legacy. Our legacy can be to improve the health of women for this generation and for generations to come.

　　我奶奶遭受的痛苦 激勵(lì)了我致力于 提高女性健康的工作。 這就是她留給我的。 而我們留給后人的可以是提高女性健康， 為這一代， 也為子孫后代。

　　Thank you. (Applause)

　　謝謝。 (掌聲)

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