美国国家公共电台 NPR This Doctor Is Trying To Stop Heart Attacks In Their Tracks

This Doctor Is Trying To Stop Heart Attacks In Their Tracks

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As a physician and medical researcher for nearly 50 years, Dr. Harry² Selker has been a passionate³ advocate of translational medicine. That means he's dedicated⁴ to ensuring that innovations - his own and those of others - achieve their promise of saving and improving lives. It involves not just breaking through scientific barriers, but economic and political ones, too.

This month, we've been introducing you to bound-breakers - people who break through barriers to change the world around them. Dr. Selker is the dean of the Clinical and Translational Science Institutes and the executive director of the Institute for Clinical Research at Tufts. And that's where NPR's Arun Rath followed him around.

ARUN RATH, BYLINE⁵: When Harry Selker was working as a cardiologist in the 1970s, thrombolytic drugs, also known as clot⁶ busters, were showing great promise against heart attacks, but their lifesaving properties were very time-sensitive.

HARRY SELKER: So for example, if you give it within the first hour, it has a 47-percent reduction of mortality. If you wait another hour - for the second hour - it has a 28-percent reduction. Another hour - 23 percent. And people were taking about 90 minutes to make the decision. So they were losing the opportunity to save patients' lives.

RATH: Selker envisioned a predictive tool, a kind of calculator that would help make the decision sooner. He knew the data to create such a tool were already out there from the clot buster research.

SELKER: We made mathematical models that kind of represented that comparison from those data. And that helped us make these predictive instruments. We built them into electrocardiographs, and it helped make better decisions.

RATH: It led to earlier treatment. Building on this success, Selker and colleagues have gone on to develop other predictive tools in areas from knee replacement⁷ therapy to opioid addiction⁸ treatment. Selker grew up in a household where he was encouraged to tinker.

In his office, he proudly shows off the first automobile⁹ shock absorber, invented by his grandfather. And while Selker's own list of patents will attest¹⁰ to his passion for innovation, he's equally passionate about working to ensure those innovations will have an impact.

One medical treatment Selker is pursuing right now has never delivered on its early promise for saving lives. It's a cocktail¹¹ of glucose¹², insulin and potassium, or GIK. In studies with baboons¹³ and rabbits more than 50 years ago, it seemed to actually prevent heart attacks.

SELKER: So they would clamp off these coronary arteries¹⁴, simulating coronary thrombosis, but keep infusing them with glucose, insulin and potassium. And they would do that for about six hours.

RATH: More than enough time to create a well-established heart attack in the animal.

SELKER: And then they would unclamp it, and there was no heart attack, and they didn't have cardiac arrest, these animals. And so it was very encouraging. It was extraordinary, really.

RATH: But here was the problem in translation. In human studies, GIK didn't seem to do much of anything to prevent heart attacks or damage. The research sat on the shelf. But when Dr. Selker learned about the research from a colleague and they started to discuss it, he became convinced there were fatal flaws in the human studies, including administering the GIK too late to have an effect. Selker and his colleagues designed a new test to study GIK in humans. The results were stunning¹⁵.

SELKER: It reduced the composite of cardiac arrest or mortality by 50 percent in all comers. It also reduced the size of the heart attack by 80 percent.

RATH: Selker says that if additional research supports these findings, many lives could be saved with a simple therapy that costs about a hundred bucks¹⁶. But he soon discovered that knowing what needed to be done wasn't enough.

SELKER: Gee¹⁷, I thought, pretty much my work was done. And people would call me up and say, you know, where would we get this GIK stuff?

RATH: But there was nobody making it.

SELKER: So I started talking to the pharmaceutical¹⁸ companies, saying, you know, would you make this stuff? And they basically weren't interested.

RATH: GIK is a cocktail of existing off-the-shelf ingredients. A company could invest in the additional research and work to get it out to patients, but there'd be no big payoff.

SELKER: And that turns out to be one of the features that these companies are interested in. And, you know, so we have to figure out how to do that, you know? And I'm not - I won't be deterred¹⁹.

RATH: Selker is now in dialogue with the FDA about the details of a definitive²⁰ clinical trial that would confirm the effectiveness of GIK in acute coronary emergencies. And like so many times before, he's continuing to reach across professional boundaries.

SELKER: If you're going to try to improve things, you have to work on all angles. You have to work on all disciplines. You can't just work in biology. That would never get you anywhere. Probably the happiest moments I have in my research are - well, actually, you were at that one meeting, where there was a statistician and a cardiologist and myself.

And we often work in this very room when we're thinking up new ideas. And people in the room have ideas that I could have never thought of, but they wouldn't have bothered thinking about if I hadn't have kind of pushed them at it. The statistician has made mathematical models that are exquisite²¹. She didn't know really much about the clinical area, but I could help her with that.

And we got databases, and we did all that stuff. So working across disciplines and personalities²² and different perspectives, that's - that's the good stuff for me. That really - that makes a great day.

RATH: Dr. Selker is hopeful the next clinical trial for GIK will take place by early next year. Arun Rath, NPR News, Boston.

1 browser   

n.浏览者

参考例句：

• View edits in a web browser.在浏览器中看编辑的效果。
• I think my browser has a list of shareware links.我想在浏览器中会有一系列的共享软件链接。

2 harry   

vt.掠夺，蹂躏，使苦恼

参考例句：

• Today,people feel more hurried and harried.今天，人们感到更加忙碌和苦恼。
• Obama harried business by Healthcare Reform plan.奥巴马用医改掠夺了商界。

3 passionate   

adj.热情的，热烈的，激昂的，易动情的，易怒的，性情暴躁的

参考例句：

• He is said to be the most passionate man.据说他是最有激情的人。
• He is very passionate about the project.他对那个项目非常热心。

4 dedicated   

adj.一心一意的；献身的；热诚的

参考例句：

• He dedicated his life to the cause of education.他献身于教育事业。
• His whole energies are dedicated to improve the design.他的全部精力都放在改进这项设计上了。

5 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

6 clot   

n.凝块；v.使凝成块

参考例句：

• Platelets are one of the components required to make blood clot.血小板是血液凝固的必须成分之一。
• The patient's blood refused to clot.病人的血液无法凝结。

7 replacement   

n.取代，替换，交换；替代品，代用品

参考例句：

• We are hard put to find a replacement for our assistant.我们很难找到一个人来代替我们的助手。
• They put all the students through the replacement examination.他们让所有的学生参加分班考试。

8 addiction   

n.上瘾入迷，嗜好

参考例句：

• He stole money from his parents to feed his addiction.他从父母那儿偷钱以满足自己的嗜好。
• Areas of drug dealing are hellholes of addiction,poverty and murder.贩卖毒品的地区往往是吸毒上瘾、贫困和发生谋杀的地方。

9 automobile   

n.汽车，机动车

参考例句：

• He is repairing the brake lever of an automobile.他正在修理汽车的刹车杆。
• The automobile slowed down to go around the curves in the road.汽车在路上转弯时放慢了速度。

10 attest   

vt.证明，证实；表明

参考例句：

• I can attest to the absolute truth of his statement. 我可以证实他的话是千真万确的。
• These ruins sufficiently attest the former grandeur of the place. 这些遗迹充分证明此处昔日的宏伟。

11 cocktail   

n.鸡尾酒；餐前开胃小吃；混合物

参考例句：

• We invited some foreign friends for a cocktail party.我们邀请了一些外国朋友参加鸡尾酒会。
• At a cocktail party in Hollywood,I was introduced to Charlie Chaplin.在好莱坞的一次鸡尾酒会上，人家把我介绍给查理·卓别林。

12 glucose   

n.葡萄糖

参考例句：

• I gave him an extra dose of glucose to pep him up.我给他多注射了一剂葡萄糖以增强他的活力。
• The doctor injected glucose into his patient's veins.医生将葡萄糖注入病人的静脉。

13 baboons   

n.狒狒( baboon的名词复数 )

参考例句：

• Baboons could break branches and leaders. 狒狒会折断侧枝和顶梢。 来自辞典例句
• And as nonprimates, they provoke fewer ethical and safety-related concerns than chimps or baboons. 而且作为非灵长类，就不会产生像用黑猩猩或狒狒那样的伦理和安全方面的顾虑。 来自英汉非文学 - 生命科学 - 医学的第四次革命

14 arteries   

n.动脉( artery的名词复数 )；干线，要道

参考例句：

• Even grafting new blood vessels in place of the diseased coronary arteries has been tried. 甚至移植新血管代替不健康的冠状动脉的方法都已经试过。 来自《简明英汉词典》
• This is the place where the three main arteries of West London traffic met. 这就是伦敦西部三条主要交通干线的交汇处。 来自《简明英汉词典》

15 stunning   

adj.极好的；使人晕倒的

参考例句：

• His plays are distinguished only by their stunning mediocrity.他的戏剧与众不同之处就是平凡得出奇。
• The finished effect was absolutely stunning.完工后的效果非常美。

16 bucks   

n.雄鹿( buck的名词复数 )；钱；（英国十九世纪初的）花花公子；（用于某些表达方式）责任v.（马等）猛然弓背跃起( buck的第三人称单数 )；抵制；猛然震荡；马等尥起后蹄跳跃

参考例句：

• They cost ten bucks. 这些值十元钱。
• They are hunting for bucks. 他们正在猎雄兔。 来自《简明英汉词典》

17 gee   

n.马；int.向右！前进！，惊讶时所发声音；v.向右转

参考例句：

• Their success last week will gee the team up.上星期的胜利将激励这支队伍继续前进。
• Gee,We're going to make a lot of money.哇！我们会赚好多钱啦！

18 pharmaceutical   

adj.药学的，药物的；药用的，药剂师的

参考例句：

• She has donated money to establish a pharmaceutical laboratory.她捐款成立了一个药剂实验室。
• We are engaged in a legal tussle with a large pharmaceutical company.我们正同一家大制药公司闹法律纠纷。

19 deterred   

v.阻止，制止( deter的过去式和过去分词 )

参考例句：

• I told him I wasn't interested, but he wasn't deterred. 我已告诉他我不感兴趣，可他却不罢休。
• Jeremy was not deterred by this criticism. 杰里米没有因这一批评而却步。 来自辞典例句

20 definitive   

adj.确切的，权威性的；最后的，决定性的

参考例句：

• This book is the definitive guide to world cuisine.这本书是世界美食的权威指南。
• No one has come up with a definitive answer as to why this should be so.至于为什么该这样，还没有人给出明确的答复。

21 exquisite   

adj.精美的；敏锐的；剧烈的，感觉强烈的

参考例句：

• I was admiring the exquisite workmanship in the mosaic.我当时正在欣赏镶嵌画的精致做工。
• I still remember the exquisite pleasure I experienced in Bali.我依然记得在巴厘岛所经历的那种剧烈的快感。

22 personalities   

n. 诽谤，（对某人容貌、性格等所进行的）人身攻击； 人身攻击；人格, 个性, 名人( personality的名词复数 )

参考例句：

• There seemed to be a degree of personalities in her remarks.她话里有些人身攻击的成分。
• Personalities are not in good taste in general conversation.在一般的谈话中诽谤他人是不高尚的。