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Nobel Prize in in Physiology or Medicine,2015 Nobel prise gainer,William C. Campbells,Satoshi mura,Youyou Tu,William C. Campbells Satoshi mura,For their discoveries concerning a novel therapy against infections caused by roundworm parasites,William C. Campbell and Satoshi mura discovered a new drug, Avermectin, the derivatives of which have radically lowered the incidence of River Blindness and Lymphatic Filariasis, as well as showing efficacy against an expanding number of other parasitic diseases.,威廉C坎貝爾和大智村發(fā)現(xiàn)了一種新的藥物，阿維菌素，其衍生物從根本上降低河盲癥和淋巴絲蟲病的發(fā)病率，以及對擴大其他寄生蟲病的治療。,Youyou Tu,Youyou Tu discovered Artemisinin, a drug that has significantly reduced the mortality rates for patients suffering from Malaria.,屠呦呦發(fā)現(xiàn)青蒿素，一種藥物，顯著地降低了患瘧疾的死亡率。,Summary,These two discoveries have provided humankind with powerful new means to combat these debilitating diseases that affect hundreds of millions of people annually. The consequences in terms of improved human health and reduced suffering are immeasurable.,這兩個發(fā)現(xiàn)為人類提供了強大的新的手段來治療這些使人衰弱的疾病，每年影響數(shù)以百萬計的人。改善人類健康和減少痛苦的價值是無法估量的。,2011 Nobel prise gainer,Bruce A. Beutler,Jules A. Hoffmann,Ralph M. Steinman,Bruce A. BeutlerJules A. Hoffmann,their discoveries concerning the activation of innate immunity,關(guān)于激活先天免疫的發(fā)現(xiàn),Ralph M. Steinman,his discovery of the dendritic cell and its role in adaptive immunity,他的樹突狀細胞的發(fā)現(xiàn)及其在適應(yīng)性免疫中的作用,Summary,This years Nobel Laureates have revolutionized our understanding of the immune system by discovering key principles for its activation.Scientists have long been searching for the gatekeepers of the immune response by which man and other animals defend themselves against attack by bacteria and other microorganisms. Bruce Beutler and Jules Hoffmann discovered receptor proteins that can recognize such microorganisms and activate innate immunity, the first step in the bodys immune response. Ralph Steinman discovered the dendritic cells of the immune system and their unique capacity to activate and regulate adaptive immunity, the later stage of the immune response during which microorganisms are cleared from the body.The discoveries of the three Nobel Laureates have revealed how the innate and adaptive phases of the immune response are activated and thereby provided novel insights into disease mechanisms. Their work has opened up new avenues for the development of prevention and therapy against infections, cancer, and inflammatory diseases.,今年的諾貝爾獎獲得者已經(jīng)徹底改變了我們對免疫系統(tǒng)的理解為其激活發(fā)現(xiàn)關(guān)鍵原則?？茖W(xué)家們一直在尋找免疫應(yīng)答的守門者，人類和其他動物保衛(wèi)自己抵御細菌和其他微生物的攻擊。布魯斯博伊特勒和Jules Hoffmann發(fā)現(xiàn)了能識別微生物并激活先天免疫的受體蛋白，在機體的免疫應(yīng)答反應(yīng)的第一步。Ralph Steinman發(fā)現(xiàn)了免疫系統(tǒng)的樹突狀細胞和激活并調(diào)節(jié)適應(yīng)性免疫的獨特的能力，對以后的免疫反應(yīng)中，微生物是從身體清除階段。這三位諾貝爾獎獲得者的發(fā)現(xiàn)揭示了先天的免疫反應(yīng)和適應(yīng)性階段被激活，從而為疾病機理提供了新的見解。他們的工作為預(yù)防和治療感染、癌癥和炎癥性疾病的發(fā)展開辟了新的途徑。,Malaria(瘧疾),瘧疾的病因主要分為3大方面：病因，病原體為瘧原蟲，感染紅細胞所致；發(fā)病機制：瘧原蟲寄生在紅細胞內(nèi)，并大量破壞紅細胞；流行病學(xué)，瘧疾是世界上危害最嚴(yán)重的寄生蟲病之瘧疾的臨床癥狀完全由瘧原蟲的無性生殖所引起，患者血中瘧原蟲必須達到相當(dāng)濃度才能引起臨床發(fā)作。臨床發(fā)冷期是因瘧原蟲成熟裂殖體引起紅細胞破裂，大量裂殖子進入血漿，與瘧原蟲的代謝產(chǎn)物所產(chǎn)生的異性蛋白反應(yīng)有關(guān)。因瘧原蟲裂殖體成熟時間各不相同，所以各型瘧疾的發(fā)作時間也隨之而異。瘧原蟲寄生在紅細胞內(nèi)，并大量破壞紅細胞，引起選行性貧血疾可引起全身網(wǎng)狀內(nèi)皮細胞增生，故有肝脾腫大；惡性瘧疾的腦型患者還可出現(xiàn)腦組織充血、水腫、白質(zhì)內(nèi)有彌漫性小出血點。,My interesting,病因與分類,瘧疾的病原體為瘧原蟲。可感染人類的瘧原蟲共有4種，即間日瘧原蟲（Plasmodiumvivax）、卵形瘧原蟲（P.ovale）、三日瘧原蟲（P.malariae）和惡性瘧原蟲（P.falciparum）。間日瘧和卵圓瘧發(fā)作開始為突然寒戰(zhàn)發(fā)抖，隨即反復(fù)發(fā)熱，出汗。為期一周形成間歇性發(fā)作的典型模式。頭痛或短期不適后，隨即寒戰(zhàn)發(fā)抖，發(fā)熱持續(xù)18小時。熱退后，病人感到舒適，直到下次寒戰(zhàn)前。間日瘧新發(fā)作趨向于每48小時發(fā)一次。惡性瘧發(fā)作開始為寒戰(zhàn)，體溫逐漸上升，然后突然下降。發(fā)作可持續(xù)2036小時。病人感到比間日瘧重和嚴(yán)重頭痛。發(fā)作間期為3672小時，此期常感難受和低熱。三日瘧常為突然發(fā)作。發(fā)作類似間日瘧，但為每72小時發(fā)一次。瘧疾為單細胞病原體，瘧原蟲感染紅細胞所致。瘧疾的傳播為受染雌性按蚊叮咬，輸入含瘧原蟲血，或用注射過瘧疾病人的針注射所致。瘧原蟲有4種間日瘧原蟲，卵圓瘧原蟲，惡性瘧原蟲和三日瘧原蟲能感染人而致瘧疾。,My interesting,瘧原蟲的生活史,My interesting,青蒿素治療,青蒿素是我國學(xué)者從中藥青蒿中提取的新藥，其衍生物已用于臨床的有青蒿琥酯、蒿甲醚及雙氫青蒿素。青蒿琥酯（artesunate）：常用的是5天療法，2次/d，50mg/次，首日劑量加倍，連服5天。復(fù)發(fā)率為5.1%。不能口服的患者可以肌內(nèi)注射或靜脈注射，肌注l次/d，60mg/次，首劑加倍，療程7天，復(fù)發(fā)率為25%。靜脈注射總劑量240mg，分4次于0.4、24及48小時注射，可迅速控制癥狀。其平均退熱時間為14.62.0小時，平均原蟲消除時間為64.l68.2小時，但復(fù)發(fā)率高達51.3%，需繼續(xù)口服片劑。蒿甲醚：為油劑，有口服膠囊及肌內(nèi)注射劑?？诜?次/d，80mg/次，連服5天。不能口服者可以肌內(nèi)注射油劑1次/d，80mg/次，首劑加倍，共5天，平均退熱時間為2