心衰患者蛋白质的持续治疗
DXY: Hi Dr Chen, I am Kitty from DXY media.
丁香园：陈医生，你好，我是来自丁香园的Kitty。
Chen: Hi, nice to meet you.
陈：很高兴见到你。
DXY: Seeing from Your Chinese name, Horng H. Chen, are you Chinese?
丁香园：从您的名字来看，陈医生应该是中国人吧？
Chen: Yeah, I grow up in Singapore.
陈：是的，我是在新加坡长大的。
DXY: You have published many papers on humoral peptides and heart failure, when did you enter this filed?
丁香园：您发表过多篇关于体液肽和心衰竭的论文，请问您是何时开始该领域的研究的呢？
Chen: I started in 1996 when I was doing my fellowship. I research on natriuretic peptides which have many actions related kidney.
陈：从1996年我还是个研究员的时候便开始了该领域的研究。主要研究利钠肽，利钠肽许多功能都与肾脏有关。
DXY: Are you working with Dr. John C. Burnett?
丁香园：您是与约翰·伯纳特博士一起工作吗？
Chen: Yes, he’s my mentor and he’s been doing the research in this area since 1980s.
陈：是的，他是我的导师而且他在该领域从事研究已有30年之久了。
DXY: You have published a large number of papers on the therapeutic and diagnostic effects of different types of peptides, where do you see your research leading in the future?
丁香园：就不同类型肽的治疗和诊断效果您已经发表了大量的论文，您觉得您的研究在未来的发展方向是怎样的？
Chen: Heart failure patients have a problem in producing enough natriuretic peptides, so we give them shots through subcutaneous injection of the peptides which help their heart.
陈：心功能衰竭的患者不能产生足够的利钠肽，因此我们通过皮下注射的方法给他们注射利钠肽维持心脏功能。
DXY: What do you consider the major challenge doing your research?
丁香园：您认为研究中存在的主要困难是什么？
Chen: The major challenge would be the cost for making the peptides. It’s very expensive to make the peptides. So if we are giving the patients these peptides every day, it needs a lot of grant to do the research.
陈：主要的困难应该是制取肽的费用。非常昂贵。所以如果我们每天给患者进行注射，那将需要相当大的经费来进行这一研究。
DXY: Is there any unanswered issue in your research?
丁香园：目前在您的研究中有尚未解决的难题吗？
Chen: Yeah, we need to overcome two issues actually. The first one is, if we give these peptides to patients for long-term period, will it indeed help patient’s heart to become better. The second one is we need to have the patients give themselves shots/injections.
陈：有。事实上我们需要克服两个难题。第一，若我们给予患者长期的利钠肽注射，是否真的对其心脏功能有效；第二，我们需要患者自己进行注射。
DXY: If your research is put into application for heart failure patients in the future, would it have any social or political implication?
丁香园：如将来您的研究投入生产，将会对社会或是政治方面有何影响？
Chen: Yeah, I think if this treatment works, it may be able to treat patients with a weak heart and improve the function of their heart. The patients come to the hospital very often, so if we can give this therapy and prevent their heart from getting worse, they can be less hospitalized and have better quality of life and eventually cut down costs. In the USA, the annual cost spent in heart failure is 1 billion dollars. So if we can cut down hospitalization, we can reduce costs.
陈：恩，我想如果该治疗真的有效，它将能够帮助那些心脏不好的人来改善他们的心脏功能。这些患者来医院的次数很频繁，因此，如果我们能够对他们进行该治疗帮助他们预防情况的恶化，那么他们将可以减少住院的次数，提高生活质量，并最终减少花费。在美国，治疗心脏衰竭一年的费用高达10亿美元。所以减低住院率，便是减少了开支。
DXY: I found from your publications that the research have been done in humans, so is there any of these peptides in clinical trial?
丁香园：从您的出版物来看，您的研究是以人为研究对象的，那么这些肽是否有应用在临床试验上？
Chen: We’ve done this and are looking for more clinical funding to do more clinical studies so that more patients could give themselves injections.
陈：我们的确是这样做的，而且我们也在争取更多的临床经费来做更多的研究使得更多的患者能自己进行注射。
DXY: Which stage is this trial?
丁香园：试验到了什么阶段了？
Chen: We are at phase 2. We had 40 patients in finished clinical phase 1 study and next step, we are doing it in 300-400 patients in stage 2. And we will go to phase 3 later.
陈：我们现在处于第二个阶段。在已完成的第一阶段中，一共有40名患者参加，在接下来的第二个阶段，患者为300~400名，之后我们会展开第三阶段的研究。
DXY: This clinical study is about which type of peptide? The ANP, BNP or CNP?
丁香园：该临床研究是关于那种类型的肽？心钠素，脑利钠肽，还是C型钠尿肽？
Chen: It’s about BNP.
陈：是关于脑利钠肽的。
DXY: I saw that Mayo clinic has three branches, the Mayo research, Mayo education and Mayo diagnosis and treatment, so how are you involved in three of them?
丁香园：我们都知道梅奥诊所有三大分支，研究，教育以及诊疗，那请问您是如何看待这三方面的呢？
Chen: The three branches you mentioned are actually three goals of Mayo clinic, patient care, education and research. All of us are supposed to do everything. The main focus is patient care and the mail goal is patient comes first but as a doctor, we also need to do educate our younger colleagues and we need to educate our patients and we also need to do research. So we have to meet all three goals, I mean, I am a doctor, I need to see patients, educate young doctors, and I do research as well.
陈：你所提到的三大分支确实是梅奥诊所的三大努力目标，即关爱患者，坚持教育和研究。大家都希望我们能够面面俱到。重点是对于患者的关爱，把患者放在首位，而作为一名医生，我们还需要对年轻的同事有所提携，需要让患者知道更多，也需要坚持做研究。因此，我们必须达到这三个要求，我的意思是，我作为一个医生，我需要关爱我的病人，帮助我的同事，并从事研究。
DXY: In China, the doctors are overwhelmed with patients and they don’t have much time for research actually, so how do doctors from Mayo balance the time?
丁香园：在中国，医生们每天要诊疗太多的病人而往往没有太多的时间来进行研究，那梅奥诊所的医生是如何来安排时间的呢？
Chen: We need to get grants and we need to get research time. The good thing is that the clinic protect our time, so I can see patients half of my time and the other 50% my time doing research. And we must get our own research grant to pay for our research.
陈：我们要争取到经费，而且要有时间来进行研究。所幸的是诊所确保了我们的时间，使得我们能在诊疗病人之余将另一半的时间投入到研究之中。此外，我们必须为自己的研究争取经费。
DXY: So that’s what is unique about Mayo clinic?
丁香园：难道那就是梅奥诊所的独特之处吗？
Chen: We have a lot of what we call “physician scientists” or “doctor scientists”. Doctors do both care of patients and do research. That is the strong point of Mayo clinic.
陈：我们拥有一大批我们称之为“科学家医生”的人士。这些医生同时负责患者的治疗和研究的进行。这便是梅奥诊所的强大之处。
DXY: So you liked it very much?
丁香园：这么说您很享受在梅奥的工作？
Chen: Yeah, I’ve stayed there for 18 years.
陈：是的，我已经待了18年了。
DXY: As you mentioned, doctors in Mayo clinic do patient care and research both at the same time. So I mean if you physicians meet a problem in the clinic, you find a way through the laboratory.
丁香园：正如您所说的，梅奥诊所的医生同时负责患者的治疗和研究的进行。也就是医生在临床上遇到的难题便可以在实验室里找到答案？
Chen: Absolutely, that is another strong point of Mayo. We find that something is not working in the clinic. We got back to the bench, to the laboratory and try to find out why. So it is a two-way street, from bench to bedside, from bedside to the bench. This research on the whole is translational medicine. And Mayo has got 50 million dollar grant from NIH to set up our CTSA program for translational study.
陈：当然，那也是梅奥诊所的另一个强大之处。当我们在临床上遇到问题，我们便进行试验，从而找出答案。所以这是一个双向的过程，从临床到实验室，从实验室到临床的双向转化研究。整个研究便是一个医学转换的过程。此外，梅奥已经从国家卫生研究所得到5000万美元的经费来支持转换医学的研究。
DXY: Thank you very much Dr. Chen for your time and detailed answer to my question.
丁香园：非常感谢陈医生能够抽空接受我的采访。
Chen: It’s my great pleasure and thank you very much.
陈：这是我的荣幸。也感谢你。
