Практика Shadowing: Artificial Liver Program: Mayo Clinic Radio - Изучайте разговорный английский по видео

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Welcome back to Mayo Clinic Radio.

I'm Dr. Tom Shives.

And I'm Tracy McRae.

Tracy, every year, 40 ,000 people die of liver disease in the U .S.

And the only proven therapy for end -stage liver disease is still a liver transplant.

Unfortunately, there aren't enough organs to go around for those who need them.

In fact, there are more than 150 ,000 people who are on the waiting list for a donor liver.

Now, hopefully, treatment for liver disease is about to change for the better.

Research at Mayo Clinic is focusing on new regenerative liver therapies to help repair diseased livers

and improve the treatment options for liver disease patients.

Here to discuss is Dr. Scott Nyberg, a transplant surgeon at Mayo Clinic.

Dr. Nyberg is the director of the liver program at the Mayo Clinic Center for Regenerative Medicine

and head of Mayo Clinic's artificial liver program.

Welcome to the program, Dr. Nyberg.

It's nice to meet you.

It's great to be here, Tracy and Tom.

Thank you for having me.

Yeah, you bet.

You have been studying the liver and liver disease for a long time, long enough to get all those titles, right?

I started back in the early 80s, probably.

I was both a chemical engineer and then a biomedical engineer.

Had a mentor who said with that engineering background, why don't you build a liver dialysis machine?

I asked him, how should I do that?

That was in 1989, and he said, you figure it out.

You're the engineer.

So I've been working on this for almost 30 years.

Well, I want to learn a lot more about the artificial liver program, but before we go there, we should probably just set the table.

What is liver disease?

What causes liver disease?

I mean, there are many causes.

They can range from Tylenol overdose, a common drug like Tylenol, alcohol.

People are familiar with that, along with genetic causes.

In the United States, I would say obesity is becoming a number one cause.

Overweight contributes to a disease called NASH.

It had been hepatitis C.

Now there are pretty effective treatments for hepatitis C, so we're seeing a decrease.

But the number one cause would be NASH, followed by alcohol, and then these others.

Now explain NASH to us.

And you mentioned that obesity is becoming a more common cause of liver disease.

How does obesity cause liver disease?

And I suspect that NASH is the answer.

Right.

It's not fully understood as far as the mechanisms, but there has been this association with as Americans and people around the world become heavier,

there's more liver disease.

If a pathologist looks at a biopsy of a NASH liver, it looks similar to an alcoholic liver, so it's probably a nutritional problem.

Where too many calories cause an inflammatory response and do this over a long period of time,

there becomes scarring and eventually cirrhosis and the manifestations of end -stage liver disease.

And cirrhosis is pretty much just scarring of the liver.

Advanced scarring to a point where the liver isn't able to regenerate.

Fortunately, a healthy liver, if we cut it in half, will grow back to a full size within a couple of weeks.

That's a normal response, but due to the scarring of fibrosis and cirrhosis,

that regenerative response is impaired and the only real treatment for those end -stage livers is a liver transplant currently.

Does NASH stand for something?

Non -alcoholic steatohepatitis.

So it looks pathologically like alcoholic liver injury,

but it's non -alcoholic related presumably to diet and weight.

How long can people live with liver disease before they need a transplant?

well we have a scoring system now

that was developed here at mayo called the meld score initially

it was called the mayo end -stage liver disease score to

predict how long people would survive what's their likelihood of being alive in two months

it's been adopted nationally for organ allocation

because it's very good at predicting the name was changed they took mayo out of the name

and now it's just the model for end -stage liver disease so that's probably the best predictor.

And in transplant, we use that score to determine who has highest priority.

So it ranges from zero to 40, where if you have a score of 40, it's unlikely you're going to survive more than a few weeks.

What can make if a patient is not eligible for transplant?

I mean, there's being on the list means that you're eligible, but why would patients not be eligible for transplant?

I mean, there's a variety of reasons.

If you're an alcoholic that continues to drink

and haven't recovered you wouldn't be eligible

that wouldn't be a wise use of an organ

if you have a disease that may involve other organs that's not corrected by a liver transplant

or if you have a cancer that's spread outside of the liver that we wouldn't be able to help you and

transplant an immunosuppressive patient you could actually shorten their life and that

so there are a number

you can be too old though we don't have a cutoff as far as age goes

so you're still doing a lot of liver transplant right and

and a fair number of those are from deceased donors

but also you're using live donors yeah here at mayo

we have a large living donor program one of the largest in the united states

which means we do over 20 per year of the 130 liver transplants that we do.

So that's a living donor, a family member, our friend who donates half of their liver.

Two weeks later, the liver has regenerated, did you say, to its normal size?

Probably two weeks in the donor, we do CAT scans to measure the volume.

And they're within 90 % of the original volume within two weeks.

So it's very rapid.

In my lab, we have a number of animal models studying regeneration

and we see this very quickly also all right what's new

and regenerative medicine

and artificial liver well here at mayo the the biggest problem in transplant is the shortage of organs

so the things we do in regenerative medicine are to address

that shortage of organs one option is a liver dialysis machine to allow the the liver to regenerate

and hopefully avoid a liver transplant so that would be

that would save the liver it could be used for someone else

and avoid big surgery

and all the immunosuppression lifelong immunosuppression for a patient that'd be a patient maybe with a tylenol overdose

we also have a special pig that we've developed a genetically engineered pig

and the goal there is to grow transplantable human livers in this pig sounds science fiction

100

but in my lab we recently had a pig named eddie who beautiful a little piggy

101

if you look at my instagram site

102

you'll see a picture of eddie who essentially was created by a stem cell transplant into a day four embryo

103

and this is sort of the future i see of organ production

104

and then we're also

105

so this is hopefully someday eddie's liver can be transplanted into a human eddie will eddie

106

and pigs like eddie will be incubators to grow human livers.

107

The concept would be to take a cell, reprogram it into a cell from a patient liver disease, reprogram it into a stem cell,

108

fuse it with an embryo, and then grow a liver from that human stem cell.

109

Whoa.

110

I got to sit down.

111

Oh, I am sitting down.

112

Good.

113

That's good.

114

How are you using the patient's own liver cell?

115

Is that what you're saying when you take a cell to help?

116

In this case, you could even take a blood sample, like a white blood cell from just a blood sample.

117

The Nobel Prize for Medicine about four years ago was a way to reprogram cells, adult cells, to become stem cells.

118

And the theory would be that you could use those stem cells to grow livers.

119

Well, hopefully you and Eddie will get the Nobel Prize next year.

120

I think we're still a little ways off.

121

eddie and pigs like eddie the other option that we're working with a local company is to take

122

livers decellularize them and then repopulate them with cells from a patient

123

so again you could avoid the need for immunosuppression

124

so these would be a tissue engineered liver

125

that would be identical to the patient so they wouldn't need an anti -rejection drug after the transplant

126

If it works using your own cells, you shouldn't need to.

127

We had a paper recently published in one of the science journals, Science Translational Medicine, showing that this concept would work in pigs,

128

and it's a matter of scaling it up to humans.

129

It's all really exciting.

130

Thanks so much for being with us.

131

Thank you very much.

132

An update on the treatment of liver disease with Dr. Scott Nyberg,

133

transplant surgeon and director of the liver program at the Mayo Clinic Center for Regenerative Medicine

134

and head of Mayo Clinic's artificial liver program.

135

Thanks, Dr. Nyberg.

136

Yeah, thank you, Tom, Tracy.

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Лексика и советы по произношению к этому уроку

Этот урок разговорной практики построен на видео «Artificial Liver Program: Mayo Clinic Radio». Чаще всего повторяются слова: liver, disease, transplant, cell, mayo. В этом видео 136 предложений и 1533 слов для шедоуинга. Речь длится 9:08. Говорящий говорит в естественном темпе, около 168 слов в минуту, близком к повседневной речи. Только 76% слов входят в 3000 самых частых слов английского языка, поэтому лексика сложная.

Ключевая лексика этого видео

15 слов из видео, которые стоит выучить, с произношением и значением:

Слово	Произношение	Значение
transplant глагол	/tɹænzˈplænt/	переса́живать, пересади́ть
organ существительное	/ˈɔːɡən/	о́рган
liver существительное	/ˈlɪvɚ/	пе́чень, печёнка
donor существительное	/ˈdəʊnə/	же́ртвователь, до́нор
stem существительное	/stɛm/	род
alcoholic существительное	/ˌæl.kəˈhɔ.lɪk/	алкого́лик, алкоголи́чка
eligible прилагательное	/ˈɛl.ɪ.d͡ʒɪ.bəl/	го́дный, приго́дный
artificial прилагательное	/ˌɑː.tɪˈfɪʃ.əl/	иску́сственный
scar существительное	/skɑɹ/	шрам, рубе́ц
pig существительное	/ˈpɪɡ/	свинья́, бо́ров
obesity существительное	/ə(ʊ)ˈbiːsɪti/	ожире́ние, ту́чность
surgeon существительное	/ˈsɝd͡ʒən/	хиру́рг
predict глагол	/pɹɪˈdɪkt/	предска́зывать, предсказа́ть
shortage существительное	/ˈʃɔː(ɹ)tɪd͡ʒ/	недоста́ток, нехва́тка
overdose существительное	/ˈəʊvə(ɹ)ˌdəʊs/	передозиро́вка

Фразовые глаголы, которые вы услышите

Слово	Значение
sit down глагол	сади́ться, сесть

Фразы, которые стоит повторять

Короткие законченные фразы из видео, которые пригодятся в повседневном разговоре:

It's nice to meet you.
I asked him, how should I do that?
I mean, there's a variety of reasons.
How are you using the patient's own liver cell?
Is that what you're saying when you take a cell to help?

Грамматика в этом видео

Конструкции, которые говорящий использует чаще всего, с точными словами из видео:

Конструкция	В видео
Present Perfect Continuous have/has been + -ing — действие началось раньше и продолжается	have been studying · I've been working
Пассивный залог be + причастие прошедшего времени — важно, что происходит, а не кто это делает	is impaired · was developed · was called
Present Perfect have/has + причастие прошедшего времени — прошлое действие, важное сейчас	has been · it's been adopted · haven't recovered
Придаточные определительные who / which + предложение — уточнение о человеке или предмете	those who need · people who are · friend who donates

Произношение, на которое стоит обратить внимание

Говорящий использует 28 сокращённых и редуцированных форм, например you're, we're, wouldn't. Произносите их коротко, так, как слышите.

Звуки «sh» и «zh»: artificial /ˌɑː.tɪˈfɪʃ.əl/, shortage /ˈʃɔː(ɹ)tɪd͡ʒ/, fiction /ˈfɪkʃən/, essentially /ɪˈsɛnʃəli/, tissue /ˈtɪʃ.(j)u/
Длинные слова — следите за ударением: alcoholic /ˌæl.kəˈhɔ.lɪk/, eligible /ˈɛl.ɪ.d͡ʒɪ.bəl/, artificial /ˌɑː.tɪˈfɪʃ.əl/, obesity /ə(ʊ)ˈbiːsɪti/, hepatitis /ˌhɛpəˈtaɪ̯tɪs/

Звуки, трудные для русскоязычных:

/w/ — губы округлены, это не /v/: whoa /woʊ/, overweight /ˌoʊvɚˈweɪt/
/h/ — лёгкий выдох, а не русское «х»: alcoholic /ˌæl.kəˈhɔ.lɪk/, hepatitis /ˌhɛpəˈtaɪ̯tɪs/, likelihood /ˈlaɪklihʊd/
Звонкие согласные в конце слова — не оглушайте их: pig /ˈpɪɡ/, shortage /ˈʃɔː(ɹ)tɪd͡ʒ/, rapid /ˈɹæp.ɪd/, involve /ɪnˈvɑlv/, likelihood /ˈlaɪklihʊd/

Как заниматься с этим видео

Прослушайте всё видео один раз молча и выпишите незнакомые слова.
Начните со скорости 0,75×, повторяйте предложение за предложением и вернитесь к обычной скорости, когда станет легко.
Запишите себя и сравните с оригиналом, обращая внимание на такие слова, как transplant, organ, liver.

Что такое техника Shadowing?

Shadowing — это научно обоснованная техника изучения языка, изначально разработанная для подготовки профессиональных переводчиков и популяризированная полиглотом доктором Александром Аргуэльесом. Метод прост, но эффективен: вы слушаете аудио на английском от носителей языка и немедленно повторяете вслух — как тень, следующая за говорящим с задержкой в 1–2 секунды. В отличие от пассивного прослушивания или грамматических упражнений, Shadowing заставляет мозг и мышцы рта одновременно обрабатывать и воспроизводить реальные речевые паттерны. Исследования показывают, что это значительно улучшает точность произношения, интонацию, ритм, связную речь, понимание на слух и беглость речи — что делает его одним из самых эффективных методов для подготовки к IELTS Speaking и реального общения на английском.

Техника шедоуинга: читать полное пошаговое руководство →

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