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Ow! As anyone who's stubbed a toe in the dark or spent an hour searching for their keys knows we're often limited by what we can or cannot see.
哎呦！在黑暗中碰过头或者花了一个小时时间找钥匙的人都知道，我们经常受到我们能看到的或者看不到的东西的限制。
In fact, even our own bodies can be black boxes.
就连我们自己的身体其实也可以是黑盒。
Today, I want to take you through a vision of health care that scientists and engineers, myself included, are building.
今天，我想带你们了解科学家和工程师(包括我自己)正在构建的医疗保健方面的愿景。
We are creating a diagnostic lab inside your body that can provide a continuous analysis of your health so that we can better see what's happening in patients.
我们正在病人体内建立一个诊断实验室，它可以对病人的健康状况提供持续的分析，这样我们就可以更好地了解病人的情况。
Currently, if someone is sick, we may diagnose them by using a biopsy to bring disease tissue outside the body where we can see it.
目前，如果有人生病了，我们可以通过活检把疾病组织带到我们能看到的体外进行诊断。
We do this if we suspect, for instance, that a growth might be cancerous.
如果我们怀疑，比如，肿瘤可能是癌变肿瘤，那么我们就会这样做。
Unfortunately, this approach can't work all the time because of two major problems.
不幸的是，这个方法并非一直行得通，因为存在两大问题。
First, some tissues, like brains or spinal cords, can't be routinely biopsied.
首先，一些组织，比如大脑和脊髓，不能进行常规活组织检查。
And second, doctors often don't know which tissue is causing the problem, so they don't know what to biopsy.
其次，医生通常不知道是哪个组织出了问题，所以他们不知道要对哪个组织进行活检。
So far, we've dealt with these issues using external medical tests, like MRIs or blood tests.
目前为止，我们都是使用外部医学测试来处理这些问题，比如核磁共振或血液测试。
These provide a broad overview of the health of a patient, but they can't see the molecular and cellular changes that occur within tissues,
这些测试能够检测出病人大概的健康状况，但无法看到组织内发生的分子和细胞变化，
and they certainly can't provide enough information to proactively treat patients before symptoms develop.
当然，它们也无法在症状出现之前提供足够的信息来为患者进行治疗。
This is unfortunate because it's these invisible changes that ultimately cause disease.
这很不幸，因为正是这些看不见的变化最终导致了疾病的产生。
Our inability to measure these changes results in a disparity between what we can see on a test and what we know is happening in patients.
我们无法判断这些变化，导致我们在测试中看到的和我们所知道的正在患者身上发生的二者之间出现了偏差。
Let's take multiple sclerosis as an example.
我们以“多发性硬化症”为例。
In MS, which is an autoimmune disease, the immune system attacks two specific tissues: the brain and the spinal cord, resulting in damage and in some cases, paralysis.
多发性硬化症是一种自身免疫性疾病，在多发性硬化症下，免疫系统会攻击两个特定的组织：大脑和脊髓，致其损伤，有时甚至瘫痪。
Now, we obviously can't catch MS by routinely biopsying people's brains, where there would be abundant and active disease-inducing cells.
现在，我们显然不能通过对人的大脑进行常规活组织检查来发现多发性硬化症，因为那里有大量活跃的诱发疾病的细胞。
And we can't catch it using a blood test because the MS-inducing cells are so rare and inactive in the blood that we simply can't see them.
我们也无法通过血液测试发现它，因为诱导多发性硬化症的细胞非常罕见，而且在血液中不活跃，我们根本看不到它们。
Even brain imaging technologies like MRI can't provide the information we need to be proactive about MS.
即使是像MRI(磁共振成像)这样的大脑成像技术也无法提供我们需要的信息以积极应对多发性硬化症。
So we need to rethink how we see. My coworkers at the University of Michigan and I decided to do just that.
所以我们需要重新思考“看的方式”。我在密歇根大学的同事我俩决定这样做。
Instead of taking an outside-in approach to diagnostics, we're taking an inside-out approach.
我们采用的是一种由内而外、而非由外而内的诊断方法。
We are creating implantable sites that have similarities to other sites in the body, and will improve our vision by giving us real-time access to molecular and cellular information about diseased tissues.
我们正在创造与身体其他部位相似的可植入部位，通过实时获取病变组织的分子和细胞信息来改善我们的视力。
These insights will enable us to predict the onset of disease and even identify therapies likely to work in an individual patient.
这些见解将使我们能够预测疾病的发作，甚至确定可能对单个患者的有效的治疗方法。
So what does this inside-out approach look like?
这个由内而外的方法是什么样的呢？
Step one is to engineer new tissues just under the skin. These tissues have similarities to other inaccessible sites in the body, like the brain or the lungs.
第一步是在皮肤下制造新的组织，这些组织与身体中其他难以接近的部位(如大脑或肺)有相似之处。
By implanting a porous plastic disk made of FDA-approved biomaterials, I can harness the body's natural responses to allow cells to migrate into the disk, survive at the site and form a tissue.
通过植入一个由FDA(食品及药物管理局)批准的生物材料制成的多孔塑料圆盘，我可以利用身体的自然反应，让细胞迁移到椎间盘，在这个部位存活并形成组织。
Eventually, we're left with an engineered tissue with integrated immune cells, just the cells we need for diagnosis.
最终，我们得到了一个带有整合免疫细胞的工程组织，这正是我们诊断所需的细胞。
Although these tissues are complex and chronically inflamed, they're also innocuous and after a few weeks, nearly imperceptible.
这些组织虽然是复杂的慢性炎症，但它们也是无害的，几周后几乎觉察不到。
Our engineered tissues contain information not present in the blood, and they can help bridge the gap between what we can see on a traditional test and cellular changes we know occur in disease.
我们的工程组织包含血液中不存在的信息，它们可以帮助我们在“传统测试中看到的”和“我们知道的疾病中发生的细胞变化”之间建立桥梁。
Step two is to read this signal.
第二步是读取该信号。
Currently, I could take a biopsy of my engineered site and analyze it because I made them accessible just under the skin.
目前，我可以对工程部位进行活检并分析，因为我可以让它们在皮肤下变得容易触及。
But it would certainly be better if we could incorporate and read a sensor noninvasively.
但如果我们能无创地结合和读取传感器那肯定会更好。
Within the next decade, rapidly converging technologies could enable diagnosis at such an implant by harnessing simple detectors, like a blood pressure cuff or smartwatch does now.
在接下来的十年里，快速融合的技术可以通过利用简单的探测器实现对这种植入物的诊断，就像现在的血压袖带或智能手表一样。
The mechanisms for diagnosing and monitoring disease could be as simple as opening an app, like Candy Crush on your phone.
诊断和监测疾病的机制可以像打开一个应用程序一样简单，比如打开手机上的《糖果粉碎传奇》(游戏)。
Step three is to harness the huge array of knowledge in fields like engineering and material science to improve these implants and our ability to read their data.
第三步是利用工程和材料科学等领域的大量知识来提高这些植入物和我们读取它们的数据的能力。
Eventually, tens, if not hundreds of individual engineered tissues with integrated sensors may be implantable with a single application.
最终，不说几百，也有几十个单独的工程组织与集成传感器可以植入一个单一的应用。
Now, this approach to diagnosis is unconventional, to be sure, but it is robust.
现在这种诊断方法肯定属于非常规性诊断，但它很稳健。
So far, my colleagues and I have used it to diagnose models of metastatic cancer, type 1 diabetes, multiple sclerosis and organ transplant rejection.
到目前为止，我和同事们已经用它来诊断转移癌、1型糖尿病、多发性硬化症和器官移植排斥反应的模型。
But this is just the beginning of what we can see.
但这只是我们所能看到的一切的开始。
With continuous improvements, we will be able to truly create a diagnostic lab inside your body that provides a continuous analysis of your health.
通过不断的改进，我们将能够真正地在病人体内建立一个诊断实验室，为大家的健康状况提供持续的分析。
By changing how we see what's going wrong in patients, we will be able to diagnose and treat diseases better and faster than ever before.
通过改变“我们看待病人病症的方式”，我们将能够比以往更好、更快地诊断和治疗疾病。
If you're willing to rethink how you see, you may be surprised what comes into view. Thank you.
如果你愿意重新思考自己“看的方式”，你可能会对眼前的景象感到惊讶。非常感谢。
