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  • The largest organ in your body isn't your liver or your brain.

    人類身體最大的器官既不是肝臟,也不是大腦,

  • It's your skin, with a surface area of about 20 square feet in adults.

    而是你的皮膚。成人的皮膚表面積可達 20 平方英尺 (1.85平方公尺)。

  • Though different areas of the skin have different characteristics, much of this surface performs similar functions,

    儘管不同部位的皮膚有不一樣的特性,大部分皮膚表層都有相同的作用,

  • such as sweating, feeling heat and cold, and growing hair.

    例如排汗、感覺溫度冷熱,以及生長毛髮。

  • But after a deep cut or wound, the newly healed skin will look different from the surrounding area,

    但是如果有很深的傷口,癒合後的新皮膚與其周圍看起來會有所不同,

  • and may not fully regain all its abilities for a while, or at all.

    並且有可能暫時性或永久性地失去機能。

  • To understand why this happens, we need to look at the structure of the human skin.

    若要了解為何會如此,我們需要一窺人類皮膚的構造。

  • The top layer, called the epidermis, consists mostly of hardened cells, called keratinocytes, and provides protection.

    皮膚的最表層稱為表皮,主要由硬化的細胞-「角質」所組成,而表皮可以提供保護作用。

  • Since its outer layer is constantly being shed and renewed, it's pretty easy to repair.

    由於皮膚外層不斷地脫落與再生,所以很容易就可以修補傷口。

  • But sometimes a wound penetrates into the dermis,

    但有時候傷口穿透了真皮,

  • which contains blood vessels and the various glands and nerve endings that enable the skin's many functions.

    真皮包含了血管、各種腺體及神經末梢賦予皮膚許多功能。

  • And when that happens, it triggers the four overlapping stages of the regenerative process.

    而當傷口傷至真皮時,皮膚會啟動四個相互重疊的階段來進行再生過程。

  • The first stage, hemostasis, is the skin's response to two immediate threats:

    第一階段:止血期,是皮膚對於兩種直接威脅的反應,

  • that you're now losing blood and that the physical barrier of the epidermis has been compromised.

    其一為人開始失血,其二為表皮的物理屏障受到損害。

  • As the blood vessels tighten to minimize the bleeding,

    此時血管開始繃緊以抑制出血,

  • in a process known as vasoconstriction, both threats are averted by forming a blood clot.

    這個過程稱為血管收縮,接著血塊的形成減緩了前述兩種威脅。

  • A special protein known as fibrin forms cross-links on the top of the skin,

    一種稱為纖維蛋白的特殊蛋白質,會在皮膚表層形成交叉連結,

  • preventing blood from flowing out and bacteria or pathogens from getting in.

    以避免血液流出皮膚,細菌或病原體進入皮膚。

  • After about three hours of this, the skin begins to turn red, signaling the next stage, inflammation.

    大約三小時過後,皮膚開始轉為紅色,表示下個階段的開始:發炎期 。

  • With bleeding under control and the barrier secured,

    在出血受到控制,以及有屏障掩護的情況下,

  • the body sends special cells to fight any pathogens that may have gotten through.

    人體會派出特殊細胞,來對抗任何可能入侵的病原體。

  • Among the most important of these are white blood cells, known as macrophages,

    其中最重要的是白血球細胞,也就是巨噬細胞,

  • which devour bacteria and damage tissue through a process known as phagocytosis,

    此細胞會進行吞噬作用,來吞噬細菌以及受損的組織,

  • in addition to producing growth factors to spur healing.

    除此之外,此細胞也會製造生長因子來促進傷口癒合。

  • And because these tiny soldiers need to travel through the blood to get to the wound site,

    而因為這些小戰士們需要透過血液移動到受傷處,

  • the previously constricted blood vessels now expand in a process called vasodilation.

    先前緊縮的血管會開始擴張,此過程稱為血管舒張。

  • About two to three days after the wound, the proliferative stage occurs, when fibroblast cells begin to enter the wound.

    傷口形成後的二至三天增生期發生,此時纖維母細胞開始進入傷口。

  • In the process of collagen deposition, they produce a fibrous protein called collagen in the wound site,

    在膠原蛋白沉積的過程中,纖維母細胞會在傷口處產生一種稱為膠原蛋白的纖維性蛋白質,

  • forming connective skin tissue to replace the fibrin from before.

    形成皮膚結締組織來取代原先的纖維蛋白。

  • As epidermal cells divide to reform the outer layer of skin, the dermis contracts to close the wound.

    當表皮細胞分裂,重建外層皮膚之時,真皮便收縮以閉合傷口 。

  • Finally, in the fourth stage of remodeling,

    最後,在第四階段的重塑期,

  • the wound matures as the newly deposited collagen is rearranged and converted into specific types.

    隨著新沉積的膠原蛋白重新排列及轉換成特殊形態,傷口逐漸成熟。

  • Through this process, which can take over a year, the tensile strength of the new skin is improved,

    這個階段需時超過一年,在此過程新皮膚的張力增加,

  • and blood vessels and other connections are strengthened.

    血管與其他連接處也會增強。

  • With time, the new tissue can reach from 50-80% of some of its original healthy function,

    漸漸地,新組織可以恢復約五成至八成其原有的健康功能,

  • depending on the severity of the initial wound and on the function itself.

    恢復程度取決於原有傷口的嚴重性,以及原有的功能為何。

  • But because the skin does not fully recover,

    但因為皮膚並不會完全恢復,

  • scarring continues to be a major clinical issue for doctors around the world.

    傷疤一直是全世界醫師需要處理的重要醫療問題。

  • And even though researchers have made significant strides in understanding the healing process,

    即使相關研究人員對於傷口癒合過程已經有明顯的進步,

  • many fundamental mysteries remain unresolved.

    許多基本的謎團仍未被解開。

  • For instance, do fibroblast cells arrive from the blood vessels or from skin tissue adjacent to the wound?

    例如,纖維母細胞是由血管還是由皮膚組織到達鄰近的傷口?

  • And why do some other mammals, such as deer, heal their wounds much more efficiently and completely than humans?

    以及為何有些哺乳類動物,例如麋鹿傷口癒合的速度及完整度都優於人類?

  • By finding the answers to these questions and others, we may one day be able to heal ourselves so well that scars will be just a memory.

    藉由找到這些問題與其他問題的答案,人類或許終有一天能夠完全治癒好傷口,到時傷疤將只是記憶 。

The largest organ in your body isn't your liver or your brain.

人類身體最大的器官既不是肝臟,也不是大腦,

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