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The Berry That Keeps Asia Looking Young[1]

枸杞:亞洲人不老的秘密

But times are changing for this simple berry, including how it is consumed. The ancient goji berry, which has long been part of Chinese culture, is now being viewed as a superfood both in China and beyond.

但是在時代的變遷之下，對枸杞的看法和食用方式也在改變。長久以來，枸杞一直是中華文化的一部分，不過現在枸杞不僅在中國，也在全球其他地區被視為超級食品。

Asia’s younger generations are embracing the goji berry, but giving it their own twist. For example, members of Gen Z are now buying “wellness kettles” for their goji berry tea. Their parents might recognise these as traditional soup kettles that have been repackaged by brands such as Buydeem and turned a more Instagram-worthy shade of pink. A 2019 study by Agility Research & Strategy on Gen Z in China showed that this generation sees living a healthy life as a key priority, even over money, career, personal enjoyment and having a family.

亞洲年輕人對枸杞的接納度正在提高，不過接納的方式與過去不同。例如，Z世代青年會買「養生壺」來泡枸杞茶。他們的父母可能會認為這些養生壺就是傳統的湯鍋，經過北鼎等品牌重新包裝後，再漆上粉嫩的夢幻粉色而已。根據市場研究公司Agility Research＆Strategy在2019年對中國Z世代青年進行的一項研究顯示，這一代的人將健康生活視為重中之重，甚至比賺錢、工作、個人享樂和成家還重要。

The berry has also become popular with international consumers. Hooked on the “superfood”, people in the West are paying up to US$10 for a packet of the berries, around three times the price in Asia.

枸杞也受到國際消費者的喜愛。迷上「超級食品」的西方人，願意花上高達300台幣的價格買一包枸杞，這個價格大概是亞洲的三倍。

The superfood price tag is encouraging farmers to make sure that their crop reaches the supermarket shelves faster. While the farmers in Ningxia pluck 180,000 tonnes of fresh goji berries each year from the vines, they sell most of their produce in dried form as the fresh berry’s shelf-life is short. The berries will ripen quickly in the hot summer sun, which means that farmers need to work quickly to gather their crop.

超級食品如此的價格更鼓勵農民盡快將農產品送達超市上架。寧夏的農民每年能從枸杞藤上採收18萬噸新鮮的枸杞，但是由於新鮮枸杞的保存期短，他們多半都是將枸杞乾燥處理後才販售。枸杞經過夏日陽光的曝曬會迅速成熟，所以農民採收的速度要快。

In times gone by, berries would be left to dry on large trays in the sun, though modern technology has sped up this process to meet the increase in demand. Ningxia Baishi Hengxing’s owner, Mr An Weijun, who was born to goji berry farmers, launched an organic farm eight years ago. He also built a state-of-the-art laboratory where his team can dry their berries and those of other regional organic producers in a fraction of the time.

過去會將枸杞鋪在枸杞盤上放在陽光下曬乾，但是現代技術卻能加快這個乾燥的過程，滿足增長的需求。寧夏百事恆興的老闆安為君出生於枸杞農家，他在八年前創辦了一間有機農場。他還建造了一座最先進的實驗室，讓團隊和其他當地的有機生產商可以快速地完成枸杞的乾燥過程。

The power of the goji berry doesn’t look as if it will dim anytime soon as there were a record number of goji berries (179 tonnes) sold in China during the recent Singles Day sales (China’s version of Black Friday). Asian trend spotters such as Amrita Banta, managing director of Agility Research & Strategy, has also seen young Asians embrace a healthier way of living:

在最近的雙11 購物節（中國版的黑色星期五），中國創下售出179噸枸杞的紀錄中，可以看出枸杞的熱度仍然不減其威力。Agility Research & Strategy董事總經理班塔（Amrita Banta）等專門觀察亞洲趨勢潮流的人士還發現，亞洲的年輕人選擇採取更健康的生活方式：

 “After many years of Chinese consumers shunning everything made in China as old and unscientific, we believe there is in China a renewed pride in many traditional products and practices,” she said. “Yet, the popularity of goji berries comes on the back of a global awareness of their properties. Today, Chinese youth eat them because they are considered a superfood, not necessarily because TCM indicates that they treat eye, liver and kidney ailments. It is fascinating to see China becoming so proud of its past, yet so connected to the rest of the world.”

她說：「多年以來，中國消費者一直在迴避購買一切中國製、過時而不講究科學的商品，但當前的中國卻再次對許多傳統產品與做法感到自豪。不過，枸杞會流行是因為世界對枸杞的特性有所認識。當今中國年輕人會吃枸杞是因為枸杞是超級食品，而不一定是因為中醫認為枸杞可以治療眼、肝和腎的疾病。看到中國一邊為自己的歷史感到驕傲，一邊又與世界各地緊密相連，相當有趣。」

Young chefs in Asia are also using goji berries in their dishes to give them a little local flavour. It was the goji berry that Chef Anna Lim turned to when she was invited to make a limited-edition breakfast dish for fast food giant McDonald’s. The Soup Spoon owner created a savoury porridge with goji berries, and it became so popular in Singapore that it was added to the permanent menu.

亞洲的年輕廚師還會在菜中加入枸杞，添加一點當地的風味。林如萍廚師在受邀為速食業巨頭麥當勞製作限量版早餐時，使用的正是枸杞。新加坡餐飲品牌「The Soup Spoon」的店主就是用枸杞做出風靡新加坡的粥品，還因此將這道粥加到常駐菜單中。

 “Adding goji berries gives a natural sweetness to the porridge, and with the combination of the colours of the green coriander, white tofu and the red goji berries, it became an eat your colours meal, elevating a simple rice porridge to something that is nutritious and healthy,” said Lim.

林如萍說:「在粥裡加入枸杞可以增添一股天然的甜味，結合綠色的香菜、白色的豆腐和紅色的枸杞，看起來可口又好吃，將簡單的粥提升為營養又健康的料理。」

While Lim is helping to introduce the fruit to a new generation, chefs such as Chef Chang Hon Cheong of the One Harbour Road restaurant at the Grand Hyatt Hong Kong hotel is still giving people the chance to enjoy dishes as Asian families would have done in their own mother’s kitchens. Dedicating a page of his menu to herbal tonic soups, the goji berry features among his traditional ingredients.

林廚師目前致力將枸杞介紹給更多年輕一代的人知道，而另一邊，香港君悅酒店港灣壹號主廚陳漢章師傅等廚師則為顧客提供品嚐各種亞洲家常美食的機會。在他的菜單中專門有一頁是提供各種藥膳，而枸杞正是他所使用的傳統食材之一。

Guests can take a seat in the Shanghainese mansion-style restaurant where Chang serves the double-boiled soups that he created with TCM in mind. Each day, Chang’s team methodically chops the health-giving ingredients and places them in a ceramic pot, which they immerse into a pot of boiling water. This slow-food process pays homage to TCM and to the farmers who have grown the produce. “Double boiling is a much slower and gentle process,” said Chang. “By double-boiling soup I can fully extract the nutrients and flavours in the ingredients.”

客人們可以坐在這間充滿上海豪華府邸風的餐廳之中，品嘗陳師傅以中醫理念所精心烹製的煲湯。每天，陳師傅的團隊都會有條不紊地備上各種健康的食材，然後將食材放入陶瓷鍋中，再將它們浸入沸水之中。這種慢食烹煮過程是他對中醫和農民的致敬。陳師傅說：「煲湯是個緩慢而溫和的過程。藉由煲湯的過程，可以充分地釋出食材中的營養和風味。」

Beyond dining out, health-conscious consumers wanting to embrace the superfood as Asian families have done for generations, can simply throw some goji berries into their soup or tea, and enjoy the taste of the sweet raisin-like superfood that keeps Asia looking and feeling young.

若不吃外食，健康意識強的消費者也希望能像老一輩的傳統家庭一樣享受超級食品，他們會將枸杞加入湯中或茶中，品嘗枸杞這具有類似於葡萄乾甜味的超級食品，邊享受枸杞所帶來的年輕外表與心態。

[1] 資料來源(Source): http://www.bbc.com/travel/story/20200226-the-berry-that-keeps-asia-looking-young?xtor=ES-213-[BBC%20Features%20Newsletter]-2020March6-[Travel|%20Button]

The Berry That Keeps Asia Looking Young-1[1]

枸杞:亞洲人不老的秘密(上)

The goji berry, which has been part of Chinese culture since the 3rd Century, is now being viewed as one of the hottest superfoods available today.

自三世紀起即被寫入中華文化的枸杞，被視為當今最熱門的超級食品之一。

By Claire Turrell

27 February 2020

克萊爾·特雷爾（Claire Turrell）於2020年2月27日發布

High in the upper reaches of North-West China lies a land filled with riches. For it’s here, on the banks of the Yellow River and in the shade of the mist-covered Liupan Mountains that the people of the Ningxia region have been growing one of Asia’s most sought-after foods for centuries.

中國西北部的上游是一片富饒之地。因為就在這裡，在這片地處黃河流域兩岸與薄霧繚繞的六盤山之間，寧夏地區的人民幾個世紀以來就在這裡栽種著一種亞洲最受歡迎的食物。

This small, oval-shaped berry has been called the “red diamond” as it is thought to have anti-ageing powers and has achieved newfound global status as a superfood, but to the people of China, who have being using it medicinally since the 3rd Century, it’s simply called the goji berry or wolfberry.

因為具有抗衰老的功效，這種橢圓形的果子被稱為「紅色鑽石」，並登上全球超級食品的地位，但對自三世紀起即在醫學上使用這種果子的中國人而言，它被稱為「枸杞」。

The goji berry is grown across China, but it’s Ningxia’s unique geology that has created the most revered version of the fruit. “It’s the combination of cool mountain breezes, mineral-rich soil and vines irrigated by the famed Yellow River that make the goji berries from the Ningxia region so prized,” said Evan Guo, sales manager for Ningxia Baishi Hengxing Food Technology Co, an organic goji berry farm.

中國各地都有種植枸杞，但由於寧夏獨特的地理條件，才造就了最廣為推崇的寧夏枸杞。寧夏百事恆興食品科技有限公司的銷售經理郭文說:「正是這涼爽的山風、富含礦物質的土壤，以及由著名的黃河水所灌溉而成的枸杞藤，才造就出珍貴的寧夏枸杞。」寧夏百事恆興食品科技有限公司是一家有機食品企業。

The farmers in Ningxia still harvest the fruit in the same way they have done throughout history. From July to September each year, farmhands crouch in front of waist-high bushes laden with the plump tomato-coloured berries. They deftly pluck a handful of the sweet treats at one time from the vines before they drop them into a woven bamboo basket.

寧夏農民以過去傳承下來的方法栽種水果。每年的7至9月，農場的主人都會蹲在齊腰高、結滿番茄色果子的樹叢前，以巧妙地手法，每次從藤蔓上摘採一大把豐碩的果實，將之放入竹編提籃中。

China’s love of the goji berry dates back hundreds of years, and Traditional Chinese Medicine (TCM) practitioners have long believed that it has medicinal powers. The earliest record of this is in the Compendium of Materia Medica, a historical medical text written by the famed herbalist Li Shizhen in the 16th Century. Ms Zhang Ruifen, a TCM doctor for Eu Yan Sang Traditional Chinese Medicine Clinic that has locations in China, Malaysia and Singapore, said, “It is a very extensive, celebrated record and goji berry is recorded in that book. Li stated what each herb looked like and how you should use it.”

中國人對枸杞的熱愛可回溯至數百年前，中醫一直認為枸杞具有藥用功效。關於枸杞可入藥最早的記載是由著名的藥學家李時珍在16世紀所著的醫學著作《本草綱目》之中。余仁生中醫診所的張瑞芬中醫師說:「這是一本內容豐富的藥學名著，而枸杞也被收錄在該書之中。李時珍在書中詳細記載每種草藥的樣子與使用方法。」余仁生中醫診所於中國、馬來西亞及新加坡皆有設點。

The Chinese view the goji berry as a both a fruit and a herb, and the berry that’s packed with vitamin C, antioxidants, amino acids and trace minerals, is prescribed by TCM doctors to boost liver and kidney function. “Chinese mothers may say that you need to eat it as it is good for the eyes, as it contains carotene,” said Zhang, who studied Chinese medicine in Beijing. “I would prescribe it to help boost the kidney and liver system, of which TCM believes that the eyes are a part.”

中國人認為枸杞既是水果亦是藥草，這個富含維生素C、抗氧化劑、氨基酸和微量礦物質的果實是中醫師常開來為病人補肝腎的藥材。在北京學中醫的張醫師說：「中國的媽媽們可能會說吃枸杞可以明目，因為枸杞含有胡蘿蔔素，對眼睛好。但若是我來開藥，則是為了枸杞可以促進腎臟和肝臟系統的功效，中醫認為眼睛與肝腎的好壞有關。」

At home, Chinese men and women will sprinkle dried goji berries over homemade chicken, red date and ginger in their “old fire simmer soup” (a clear broth cooked over a low heat) or into a flask of chrysanthemum tea to give themselves a vitamin boost. When Zhang prescribes it to patients, she combines it with a potent combination of other herbs: “We usually don’t use a single herb for the whole treatment; it is a part of a concoction,” she said.

中國不論男女，在家裡自己煲老火湯（用小火燉煮的湯）時，除了放入雞肉、紅棗和薑以外，也會撒上乾燥的枸杞，或是在喝菊花茶時加入枸杞，補充點維生素。在開藥時，張醫師也會將枸杞與其他草藥組合使用，增強功效。她說:「我們通常給藥不會只給一種藥。這也是中藥炮制的一環。」

However, there are certain times that as a TCM practitioner Zhang says she will choose not to prescribe it so it doesn’t exacerbate the patient’s condition. “If a person has a fever, inflammation or sore throat, which we call ‘heaty’ in Chinese medicine, I would advise the patient to stop taking goji berry during that period of time,” she said. “If they were also suffering from ‘dampness’ and diarrhoea, which we call spleen deficiency, we say that you shouldn’t take it as well. But when you are fine, generally goji berry is suitable for everybody.”

但是，張醫生也說有時候為了避免加重病情，她會選擇不將枸杞放入處方之中。她說：「如果有發燒、發炎或咽喉痛，也就是中醫上所稱的『發熱』的情形，我會建議患者在這段時間內暫停使用枸杞。如果患者有『濕邪』或是腹瀉，也就是我們稱為脾虛的情形，我們也會建議患者先不要吃枸杞。不過對於健康的人來說，一般都是可以吃的。」

Goji berries have long been part of Chinese culture. Legend has it that more than 2,000 years ago a doctor visited a village in China where everyone was more than 100 years old. He discovered that they all drank from a well that was surrounded by goji berries. And the theory was that, as the fruit ripened, it would fall into the well and its vitamin-packed contents would seep into the water. Tales are also told of a 17th-Century herbalist called Li Qing Yuen who ate goji berries every day and was said to have lived until he was 252 years old. If this wasn’t enough to encourage future generations to eat the traditional old fire simmer soups that were garnished with goji berries, Chinese mothers would tell their children that the berries would stop them from needing glasses to get them to finish their bowls.

枸杞一直是中華文化的一環。傳說在兩千多年以前，曾有一位醫生到一個村莊裡，發現那裡的人都超過了一百歲。他發現這些人飲用水的來源是一口被枸杞叢所包圍的井。據推想，當果實成熟後，枸杞就會掉入井中，其中所富含的維生素也會隨之溶入水中。還有另外一個傳說是17世紀時，有一位叫作李清淵的中醫每天都會吃枸杞，據傳他活到了252歲。如果這還不足以說動孩子們喝下加有枸杞的傳統煲湯，中國的媽媽們還會和孩子說，吃枸杞對眼睛好，可以不用戴眼鏡，想辦法讓他們將枸杞吃完。

[1] 資料來源(Source): http://www.bbc.com/travel/story/20200226-the-berry-that-keeps-asia-looking-young?xtor=ES-213-[BBC%20Features%20Newsletter]-2020March6-[Travel|%20Button]

Covid-19: How long does the coronavirus last on surfaces?[1]

新冠病毒(COVID-19)能在物體表面上存留多久？

We can pick up the Covid-19 by touching surfaces contaminated with the new coronavirus, but it is only just becoming clear how long the virus can survive outside the human body.

接觸到沾有新冠病毒的物體表面可能會染上武漢肺炎(Covid-19)，不過也漸漸有研究顯示這種病毒可以在人體外存活多長的時間。

By Richard Gray

17th March 2020

理查德·格雷（Richard Gray）於2020年3月17日發表

As Covid-19 has spread, so has our fear of surfaces. There are now some familiar scenes in public places around the world – people trying to open doors with their elbows, commuters studiously surfing their way through train journeys to avoid grabbing a handle, office workers rubbing down their desks each morning.

隨著新冠病毒的散播，我們對各種物體表面的恐懼也隨之蔓延。目前在世界各地的公共場所都能看到某些相似的畫面，例如有人會想用手肘開門、通勤者搭火車時身體會擺出像要衝浪的樣子，盡可能地保持平衡，也不願意用手握手把、坐辦公室的則會每天早上勤奮地擦桌子。

In the areas worst hit by the new coronavirus, teams of workers in protective clothing have been dispatched to spray a fog of disinfectant in plazas, parks and public streets. Cleaning regimes in offices, hospitals, shops and restaurants have been increased. In some cities, well-meaning volunteers even venture out at night to scrub the keypads of cash machines.

在新冠病毒疫情嚴重的地區，則會派出身穿防護服的工作人員到各個廣場、公園和街道上噴灑消毒劑。各地都在加強辦公室、醫院、商店和餐廳的清潔衛生。在某些城市，甚至有好心人冒著大半夜的危險擦洗自動提款機的鍵盤。

Like many respiratory viruses, including flu, Covid-19 can be spread in tiny droplets released from the nose and mouth of an infected person as they cough. A single cough can produce up to 3,000 droplets. These particles can land on other people, clothing and surfaces around them, but some of the smaller particles can remain in the air. There is also some evidence that the virus is also shed for longer in faecal matter, so anyone not washing their hands thoroughly after visiting the toilet could contaminate anything they touch.

和許多呼吸道病毒（包括流感）一樣，新冠病毒也能藉由感染者咳嗽時從鼻子和嘴裡噴出的微小飛沫中傳播。每次咳嗽最多可以產生3000滴飛沫。這些顆粒會附著在其他人的身上、衣服和周圍的物體表面上，而有些更小的顆粒則能停留在空氣中。還有一些證據顯示，這種病毒在糞便中能存活更長的時間，所以在上廁所後沒有徹底洗乾淨手的人都可能會污染他們接觸到的任何東西。

It is worth noting that, according to the Centers for Disease Control and Prevention, touching a surface or object with the virus and then touching one's own face "is not thought to be the main way the virus spreads". Even so, the CDC, the World Health Organization and others health authorities, have emphasised that both washing one's hands and cleaning and disinfecting frequently touched surfaces daily are key in preventing Covid-19's spread. So although we still don't know exactly how many cases are being caused directly by contaminated surfaces, experts advise exercising caution.

值得注意的是，據美國疾病控制與預防中心(CDC)所稱，接觸到沾染上病毒的表面或物體後，再碰到自己的臉，「並不是這種病毒主要的傳播方式」。即便如此，美國疾病控制與預防中心、世界衛生組織(WHO)和其他衛生機構也強調，每天勤洗手和消毒常被觸摸的物體表面都是防止病毒傳播的關鍵。因此，儘管我們仍然不清楚直接接觸到沾有病毒的物體表面而受到感染的案例到底有多少起，但是專家們仍然建議應謹慎防疫。

One aspect that has been unclear is exactly how long Sars-CoV-2, the name of the virus that causes the disease Covid-19, can survive outside the human body. Some studies on other coronaviruses, including Sars and Mers, found they can survive on metal, glass and plastic for as long as nine days, unless they are properly disinfected. Some can even hang around for up to 28 days in low temperatures.

目前尚不清楚的是Sars-CoV-2（導致武漢肺炎的病毒名稱）可以在人體外存活多長的時間。一些對其他冠狀病毒（包括SARS和MERS）的研究發現，若沒有進行適當的消毒，它們可以在金屬、玻璃和塑膠上存活長達9天的時間。有些病毒甚至可以在低溫下存活長達28天。

Coronaviruses are well known to be particularly resilient in terms of where they can survive. And researchers are now beginning to understand more about how this affects the spread of the new coronavirus.

眾所周知，冠狀病毒對環境具有高適應性，目前研究人員也在研究這個特性對新冠病毒傳播的影響。

Neeltje van Doremalen, a virologist at the US National Institutes of Health (NIH), and her colleagues at the Rocky Mountain Laboratories in Hamilton, Montana, have done some of the first tests of how long Sars-CoV-2 can last for on different surfaces. Their study, which has been published in the New England Journal of Medicine, shows that the virus could survive in droplets for up to three hours after being coughed out into the air. Fine droplets between 1-5 micrometres in size – about 30 times smaller than the width of a human hair – can remain airborne for several hours in still air.

美國國家衛生研究院（NIH）的病毒學家多雷瑪倫（Neeltje van Doremalen）和她在落基山實驗室(位於蒙大拿州漢密爾頓)的同事們對Sars-CoV-2在不同物體表面上能存活多久進行各種試驗。他們的研究已發表在《新英格蘭醫學雜誌》上，該研究顯示，新冠病毒在被咳出進入空中後，還能在飛沫中存活長達三個小時的時間。在靜止空氣中，直徑為1-5微米之間的飛沫（約比人髮小30倍）可以在空中停留數小時。

It means that the virus circulating in unfiltered air conditioning systems will only persist for a couple of hours at the most, especially as aerosol droplets tend to settle on surfaces faster in disturbed air.

也就是說在沒有加裝過濾設備的空調中流通的病毒最多只能存活幾個小時，而在不流通的空氣中，懸浮微粒更會快速地附著在物體表面上。

But the NIH study found that the Sars-CoV-2 virus survives for longer on cardboard – up to 24 hours – and up to 2-3 days on plastic and stainless-steel surfaces.

但NIH的研究發現，Sars-CoV-2病毒在紙板上存活的時間更長(長達24小時)；在塑膠和不銹鋼表面上存活的時間更可長達2-3天。

The findings suggest the virus might last this long on door handles, plastic-coated or laminated worktops and other hard surfaces. The researchers did find, however, that copper surfaces tended to kill the virus in about four hours.

這些結果表示，這種病毒可以在門把、塑膠塗層或層壓材料製的台面上，以及其他堅硬的表面上存活如此長的時間。不過研究人員確實也發現，病毒在銅材表面上往往只能存活大約四小時。

But there is a speedier option: research has shown that coronaviruses can be inactivated within a minute by disinfecting surfaces with 62-71% alcohol, or 0.5% hydrogen peroxide bleach or household bleach containing 0.1% sodium hypochlorite. Higher temperatures and humidity also tend to result in other coronaviruses dying quicker, although research has shown that a related coronavirus that causes Sars could be killed by temperatures above 56°C or 132°F (hotter than even a bath scalding enough to cause injury) at a rate of about 10,000 viral particles every 15 minutes.

但是，還有一個更快的選擇：研究顯示，用62-71％的酒精、0.5％的過氧化氫(雙氧水)漂白水或0.1％的次氯酸鈉漂白水消毒物體表面，就能在一分鐘內殺死冠狀病毒。高溫和高濕度也會使其他冠狀病毒死得更快，不過研究顯示，需要至少56°C或132°F以上的溫度（若用這個溫度的水洗澡可能會被燙傷）才能殺死造成SARS疫情的冠狀病毒，在這個條件下，大約每15分鐘能殺死1萬顆病毒顆粒。

The US Environmental Protection Agency (EPA) has now published a list of disinfectants and active ingredients that can be used against the Sars-CoV-2 virus. Ultraviolet light can also be used to disinfect some surfaces, but is not currently recommended for use on human skin.

目前美國國家環境保護署（EPA）公布了一張產品清單，載明了各種可以對抗Sars-CoV-2病毒的消毒劑和活性成分。紫外線也可以用來消毒某些物體表面，但是還不建議使用在人體皮膚上。

Although there is no data on how many virus particles will be in a single droplet coughed up by an infected person, research on the flu virus suggests smaller droplets can contain many tens of thousands of copies of the influenza virus. However, this can vary depending on the virus itself, where in the respiratory tract it is found and at what stage in the infection the person is.

儘管目前還沒有關於感染者咳出的每滴飛沫中會帶有多少病毒顆粒的相關數據，但是對流感病毒的研究卻顯示，較小的飛沫可帶有成千上萬的流感病毒顆粒。不過，這還要看病毒是在呼吸道的哪個部位以及感染者是處在哪個感染階段而定。

On clothing and other surfaces harder to disinfect, it is not yet clear how long the virus can survive. The absorbent natural fibres in cardboard, however, may cause the virus to dry up more quickly than on plastic and metal, suggests Vincent Munster, head of the virus ecology section at Rocky Mountain Laboratories and one of those who led the NIH study.

目前還不清楚在衣服等其他難以消毒的表層上，病毒可以存活多長的時間。落基山實驗室病毒生態學部負責人，同時也是上述NIH研究主要研究員之一的文森特·蒙斯特（Vincent Munster）表示，紙板中的親水性天然纖維可能是導致病毒死亡速度比在塑膠和金屬上更快的原因。

 “We speculate due to the porous material, it desiccates rapidly and might be stuck to the fibres,” he says. Changes in temperature and humidity may also affect how long it can survive, and so may explain why it was less stable in suspended droplets in the air, as they are more exposed. “[We’re] currently running follow-up experiments to investigate the effect of temperature and humidity in more detail.”

他說：「我們推測，可能是因為多孔材料的緣故，讓病毒乾掉死亡的速度變快，還會讓病毒黏在纖維上。」溫度和濕度的變化也會影響其生存的時間，所以可以解釋為什麼在空氣中以懸浮微粒形式存在的病毒，穩定性會比較差，因為它們接觸到空氣中溫度濕度的機會比較大。「目前[我們]正在進行一些後續實驗，仔細研究溫度和濕度對病毒的影響力。」

The ability of the virus to linger for so long only underlines the importance of hand hygiene and cleaning of surfaces, according to Munster.

蒙斯特說：「病毒持久的存活能力只是在提醒我們保持手部衛生和清潔物體表面有多重要。」

“There is a potential for this virus to be transmitted via a variety of routes,” he says.

他說：「因為這種病毒還可能可以藉由更多途徑來進行傳播。」

* This article was edited on 18 March 2020 to add the fact that the research paper by Neeltje van Doremalen and colleagues has now been published in the New England Journal of Medicine. It has also been clarified that the virus's survival on natural fibres has only been tested on cardboard. The article was edited further on 24 March 2020 to add a link to the EPA's list of disinfectants and active ingredients that have claims for use against Sars-CoV-2.

*本文修改於2020年3月18日，補上目前多雷瑪倫及其同事的研究已在《新英格蘭醫學雜誌》上發表這件事。同時說明有關該病毒在天然纖維上的存活率，目前僅在紙板上進行過測試。2020年3月24日再度進行修改，補上EPA所列出能夠對抗Sars-CoV-2的消毒劑和活性成分清單的連結。

[1] 資料來源(Source):https://www.bbc.com/future/article/20200317-covid-19-how-long-does-the-coronavirus-last-on-surfaces?xtor=ES-213-[BBC%20Features%20Newsletter]-2020March20-[Future%7c+Button]

The Scold’s Bridle — How Men In The Middle Ages Dealt With Gossiping Wives[1]

By Katie Serena

Published February 2, 2018

中世紀的男人是如何利用「毒舌鈎」對付他們八卦的妻子呢?

Katie Serena 於2018年2月2日發布

Women who gossipped in the Middle Ages faced public humiliation at the hands of their husbands when they were forced to wear the Scold's Bridle for hours on end.

中世紀時期，丈夫會懲罰喜愛八卦閒聊的妻子，逼迫她們連續數小時戴上「毒舌鈎」(Scold's Bridle)，示眾羞辱。

Like modern people occasionally do, the ladies of the Middle Ages often got together to discuss the latest gossip. They would get together over what I like to imagine as a medieval Sunday brunch and chit-chat about the newest rumors. However, while women today face almost no repercussions for their idle chatter, women of the Middle Ages faced an extreme sort of corporal punishment: the Scold’s Bridle.’ The Scold’s Bridle is one of those things that proves no matter how hard being a woman can sometimes seem, compared to the Middle Ages, women today are doing just fine.

中世紀的婦女小姐們也會像現代人一樣偶爾聚在一起討論最新的八卦。在我的想像之中，應該就像是中世紀版的早午餐一樣，她們會聚在一起閒聊。不同的是，當今的女性不會因為閒聊受到什麼負面的影響，中世紀的女性卻會因為八卦而受到極端的處罰，這種體罰被稱為「毒舌鈎」。看到像是毒舌鈎這類的刑具，讓我們不禁覺得，儘管現今社會的女性仍然會面臨某些侷限與困難，但與中世紀的女性相比，身為當代女性其實還是相當不錯的。

The Scold’s Bridle was comprised of several strips of iron that surrounded an iron muzzle, that would be wrapped around a woman’s face like a mask. A small piece of iron, known as the “bridle bit,” would be placed inside a woman’s mouth and pressed upon the tongue to prevent her from speaking.

毒舌鈎是一種由幾根鐵條圍繞而成的鐵製口套，可以像面具一樣包住女性的臉。其中還會將一小塊被稱為「口銜」的鐵器，放入女人的口中，壓在舌頭上，不讓她說話。

Kind of like that thing you put in a horse’s mouth when you want to control it. Sometimes, the bit even had a spike on it which would puncture the tongue if speaking was attempted. The woman’s husband, upon hearing that his wife had been engaging in a round of gossip, would secure the bridle to his wife’s face to teach her a lesson.

這有點像放在馬的嘴裡，用來控制馬匹的馬銜(馬嚼子)。有時候，口銜上還會配有長釘，若配戴者試圖說話，舌頭就會被刺穿。當丈夫知道自己的妻子在和人閒聊時，就會讓妻子戴上毒舌鈎，給她一點教訓。

As if the iron mask and its mouthpiece weren’t humiliating enough, the husband would then attach a leash to his iron masked wife and take her on a literal walk of shame around the town, encouraging passersby to insult or spit on her. Occasionally a bell would be affixed to the top of the bridle, to draw more attention during the walk.

不僅如此，就好像戴上這個鐵面具和口銜還不夠屈辱似的，丈夫還會在帶著毒舌鈎的妻子身上綁條牽繩，帶她到鎮上遊街示眾，鼓勵路人對其辱罵或吐口水。有時候還會在毒舌鈎上繫上鈴鐺，好在遊街的過程中引起更多的關注。

The “Scold” part of “Scold’s Bridle” comes from the term that was usually applied to a woman in a derogative sense, who is seen to be nagging or constantly displeased. The “Bridle” part, of course, comes from the headpiece worn by horses, used when their riders want more control over their movements.

英文中的毒舌鈎是由「Scold(斥責)」與「Bridle(韁繩)」所組成。「Scold(斥責)」是一個用來貶低女性的詞，常常指嘮嘮叨叨或不停抱怨的女人。而「Bridle(韁繩)」當然就是指配戴在馬頭上的籠頭，讓騎手能夠更好的控制馬匹前進的方向。

The idea behind the corporal punishment of a scold was not an innovative one by any means. In the Christian religion, the most widely followed one at the time, it was believed that punishing one’s body was the only way to atone for one’s sins, and deeper understand the weight of one’s crimes against the church. It was only through pain that true understanding, and therefore innocence, could be achieved.

這種用體罰來進行懲處的想法其實屢見不鮮。這是中世紀基督教最常採取的處罰形式，因為當時認為對肉體的懲罰是贖罪的唯一途徑，也能讓人深入體會質疑教會是多麼深重的罪。只有通過痛苦，才能真正理解苦難的意義，從而回歸本真。

The idea of the Scold’s Bridle was also not a new one. Similar head cages had been used to control slaves for hundreds of years and would continue to be used to do so, almost until the 19th century.

毒舌鈎背後設計的概念也非首創。當時相似的套頭鐵籠早已用來控制奴隸長達數百年之久，而這種鐵籠的使用一直到19世紀才消失。

Thankfully, by the end of the 16th century, the Scold’s Bridle had begun to see a decrease in popularity. Whether women began to gossip less, or whether men decided that other forms of punishment were more effective, the bridle began to fall by the wayside. And, indeed, by the time the colonists were settling the New World, the bridle had been almost eliminated from use.

好在，毒舌鈎的熱度在16世紀末漸漸消退。不論這是因為八卦的婦女減少了，還是男人找到其他更有效的方法來處罰妻子，毒舌鈎開始淡出歷史舞台。確實，當殖民者在新大陸紮根時，幾乎不再使用這種毒舌鈎了。

Though, of course, public humiliation was still commonplace, as the new and exciting practice of placing people in the stocks became the preferred method of public shaming.

當然，示眾羞辱仍然相當普遍，不過在那時，人們更喜歡將人帶上頸手枷這種更新、更刺激的公開羞辱手段。

For more macabre medieval practices like the Scold’s Bridle, check out the most painful medieval torture devices, and the way that medieval humans mutilated their dead to avoid them becoming zombies.

對毒舌鈎這種令人毛骨悚然的中世紀刑具有興趣的話，可參考:「最恐怖的中世紀刑具」，以及「為了不要死後變成喪屍，中世紀人乾脆讓人死後不留全屍」。(註:此兩篇未翻譯)

[1] 資料來源(Source):https://allthatsinteresting.com/scolds-bridle

Who is 'patient zero' in the coronavirus outbreak?

新冠肺炎的「零號病人」是誰？

24th February 2020[1]

2020年2月24日

As the cases of coronavirus increase in China and around the world, the hunt is on to identify "patient zero". But can singling out one person as causing an outbreak do more harm than good?

隨著中國與全球新冠肺炎(COVID-19，又稱武漢肺炎)病例的增加，開始有人在找誰是「零號病人」。但是，或許將這個導致疫情爆發的罪魁禍首找出來並沒有什麼好處。

Chinese authorities and experts are at odds about the origin of the ongoing coronavirus outbreak. More specifically, who is "patient zero" for the outbreak. Also known as an index case, patient zero is a term used to describe the first human infected by a viral or bacterial disease in an outbreak.

中國政府和專家對當前新冠肺炎疫情的源頭存有分歧。更確切地說，爭議點在於誰是疫情中的「零號病人」。零號病人又稱索引病例，是指第一個因為感染某種病毒或細菌性疾病而導致疾病迅速傳染開來的人。

Advances in genetic analysis now make it possible to trace back the lineage of a virus through those it has infected. Combined with epidemiological studies, scientists can pinpoint individuals who may have been the first people to start spreading the disease and so trigger the outbreak.

基因分析技術的進步使我們得以通過被感染的病人來追溯病毒的源頭。結合流行病學研究，科學家可以精準找出最早使疾病散播開來並因此引發疫情爆發的第一群病患。

Identifying who these people are can help address crucial questions about how, when and why it started. These can then help to prevent more people from getting infected now or in future outbreaks.

找出這些人是誰，有助於解決疫情是如何開始、何時開始，以及為什麼開始等關鍵問題，還能阻止當前及未來更多人被感染的可能。

Do we know who patient zero is in the Covid-19 coronavirus outbreak that started in China?

那麼，我們知道武漢肺炎的零號病人是誰了嗎？

The short answer is – no.

最直接的答案是:不知道。

Chinese authorities originally reported that the first coronavirus case was on 31 December and many of the first cases of the pneumonia-like infection were immediately connected to a seafood and animal market in Wuhan, in the Hubei province.

中國政府所通報的首位病例是在12月31日，而許多最初類肺炎的病例則與一間位於湖北省武漢市的海鮮與動物市場有關。

This region is the epicentre of the outbreak, with almost 82% of the 75,000-plus cases registered so far in China and globally are from here, according to statistics complied by Johns Hopkins University.

根據約翰霍普金斯大學（Johns Hopkins University）的統計，該地區是疫情爆發的中心，迄今為止，在中國和全球通報的75,000多起病例中，有近82％的病例都是從這裡出現。

However, a study, by Chinese researchers published in the Lancet medical journal, claimed the first person to be diagnosed with Covid-19, was on 1 December 2019 (a lot of earlier) and that person had "no contact" with the Huanan Seafood Wholesale Market.

然而，一項由中國研究人員發表在《柳葉刀》(The Lancet)醫學雜誌上的研究聲稱，早在2019年12月1日就已經出現第一位病例，但此人卻與華南海鮮批發市場「沒有任何接觸」。

Wu Wenjuan, a senior doctor at Wuhan's Jinyintan Hospital and one of the authors of the study, told the BBC Chinese Service that the patient was an elderly man who suffered from Alzheimer's disease.

武漢市金銀潭醫院的醫生，同時也是上述研究作者之一的吳文娟告訴BBC中國事務部，該患者是一名患有阿茲海默症的老人。

"He (the patient) lived four or five buses from the seafood market, and because he was sick he basically didn't go out,” Wu Wenjuan said.

吳文娟說：「他（病人）住在距離海鮮市場大約四、五站公車站的地方，而且因為生病了，所以他基本上沒有出過門。」

She also said that three other people developed symptoms in the following days – two of whom had no exposure to Huanan either.

她還說，接下來的幾天中另有三人出現武漢肺炎的症狀，其中兩人也沒有到過華南市場。

However, the researchers also found that 27 people of a sample of 41 patients admitted to hospital in the early stages of the outbreak "had been exposed to the market".

不過研究人員也發現，在疫情初期就入院的41名患者之中，有27人「去過該市場」。

The hypothesis that the outbreak started at the market and could have been transmitted from a living animal to a human host before spreading human-to-human is still considered the most likely, according to the World Health Organization (WHO).

根據世界衛生組織（WHO）的說法，目前被認為最有可能的假說仍然是疫情是從該市場開始，由動物傳給人類，再由人類傳給人類。

So can one person really trigger a massive outbreak?

那麼，真的有人能夠憑一己之力就引發這麼大規模的爆發嗎？

The 2014 to 2016 Ebola outbreak in West Africa was the largest since the virus responsible was first discovered in 1976. It killed in excess of 11,000 people and infected over 28,000, according to the World Health Organization.

根據世界衛生組織的資料顯示，2014年至2016年在西非爆發的伊波拉疫情是自1976年首次發現該病毒以來最大規模的傳染。該病毒造成超過11,000人死亡，並感染超過28,000人。

The outbreak lasted more than two years and was found in 10 countries, mostly in Africa but there were also cases reported in the US, Spain, the United Kingdom and Italy.

伊波拉疫情持續了兩年多並在10個國家中傳播，其中主要是在非洲，但在美國、西班牙、英國和義大利也有病例通報。

Scientists concluded this outbreak of a new strain of Ebola started with just one person – a two-year-old boy from Guinea – who may have been infected by playing in a hollow tree housing a colony of bats.

科學家得出的結論是，這種新型伊波拉病毒的爆發始於一個來自幾內亞的兩歲小男孩，他可能是因為在一棵蝙蝠群棲息過的空心樹裡玩耍，才會被感染。

They made the connection on an expedition to the boy's village, Meliandou, taking samples and chatting to locals to find out more about the Ebola outbreak's source before publishing their findings.

為了進一步了解伊波拉病毒的來源，他們對這個男孩居住的美良度村（Meliandou）進行訪查，包括採樣以及訪問當地人，最後再發表調查結果。

But perhaps the most well known “patient zero” is Mary Mallon, who earned the nickname Typhoid Mary for causing an outbreak of typhoid fever in New York in 1906.

不過，也許瑪麗·馬倫（Mary Mallon）才是最著名的「零號病人」，她更在1906年紐約爆發的傷寒中獲得「傷寒瑪麗」這個稱號。

Originally from Ireland, Mallon emigrated to the US, where she began working for rich families as a cook. After clusters of typhoid cases among wealthy families in New York, doctors traced the outbreak to Mallon. Anywhere she worked, members of the household started to develop typhoid fever.

馬倫最初從愛爾蘭移民到美國給有錢人當廚師。當紐約一些有錢人家出現傷寒案例之後，醫生將疫情追溯到了馬倫身上。她到哪裡工作，那個家庭就會染上傷寒。

Doctors called her a healthy carrier – someone infected by a disease but who display little or no symptoms of the disease, which means they often go on to infect many other people.

醫生稱她為「健康帶原者」，也就是雖然帶有某種疾病病原，卻很少或沒有出現該疾病症狀的人，這表示他們通常會不斷感染更多的人。

There is now growing evidence that some people are more "efficient" than others at spreading viruses and Mallon is one of the earliest recorded cases of a person having this "ability" known as a "super-spreader".

目前有越來越多的證據顯示，有些人會比其他人能更「有效率的」傳播病毒，馬倫正是史上最早具有此種「能力」的人之一，他們被稱為「超級傳播者」。

At that time the disease afflicted several thousand New Yorkers annually and had a 10% fatality rate.

當時，這種疾病每年折磨數千名紐約人，其死亡率為10％。

But the term “patient zero” comes loaded with meaning and stigma. Many health experts are against identifying the first documented case of an outbreak, for fear that it might lead to disinformation about the disease or even victimisation of the person.

但是「零號病人」這個詞卻已具備各種負面意義與汙名。許多醫衛專家都反對找出第一個有記錄的病例，就是擔心會傳出錯誤的疫情資訊，甚至使該病患受害。

A famous example is a man who was mistakenly identified as "patient zero" of the Aids epidemic.

一個著名的例子就是一個被誤認為是愛滋病「零號病人」的病患。

Gaetan Dugas, a Canadian homosexual flight attendant, is one of the most demonised patients in history, being blamed for spreading HIV to the US in the 1980s. But three decades later, scientists revealed he couldn't be the first case – a 2016 study showed the virus had moved from the Caribbean to America at the beginning of the 1970s.

加拿大同性戀空服員蓋爾坦·杜加(Gaëtan Dugas)是史上最被妖魔化的病人之一，人們一直認為是他在1980年代將HIV傳到美國。但是三十年後，科學家發現他不可能是第一個病例，因為在2016年的一項研究顯示，HIV早在1970年代初就已經從加勒比海地區傳到美國了。

Curiously, it was during the HIV epidemic that the term patient zero was accidently created.

奇怪的是，正是在愛滋病流行期間，才意外創造出「零號病人」這個詞。

Whilst investigating the spread of the disease in Los Angeles and San Francisco in the early 80s, researchers from the Centers for Disease Control and Prevention (CDC) used the letter "O" to refer a case of someone "outside the state of California".

在1980年代初期調查愛滋病在洛杉磯和舊金山傳染的情形時，美國疾病控制與預防中心（CDC）的研究人員使用字母「O」來指稱「加州以外的」某個病例。

Other researchers wrongfully interpreted the letter as a number 0 – and so the concept of patient zero was born.

其他研究人員卻錯誤地將字母O解讀成數字0，所以才產生零號病人的概念。

[1]資料來源(Source): https://www.bbc.com/future/article/20200221-coronavirus-the-harmful-hunt-for-covid-19s-patient-zero

Understanding Type 2 Diabetes(3)

認識第二型糖尿病(三)[1]

Receiving a type 2 diabetes diagnosis

接受診斷

Whether or not you have prediabetes, you should see your doctor right away if you have the symptoms of diabetes. Your doctor can get a lot of information from blood work. Diagnostic testing may include the following:

無論是否患有早期型糖尿病，如果出現糖尿病的症狀，應該盡快就醫。醫生可以從血液測試中取得大量的資訊。診斷測試可能包括：

A hemoglobin A1C test is also called a glycosylated hemoglobin test. It measures average blood glucose levels for the previous two or three months. You don’t need to fast for this test, and your doctor can diagnose you based on the results.

糖化血色素測試可以測出近兩三個月內的平均血糖水平。檢測前可以不用禁食，醫生會根據結果來診斷。

You need to fast for eight hours before having a fasting plasma glucose test. This test measures how much glucose is in your plasma.

在進行空腹血糖測試之前，需要先禁食8小時。這項測試是測量血漿中的葡萄糖含量。

During an oral glucose tolerance test, your blood is drawn before and two hours after you drink a dose of glucose. The test results show how well your body deals with glucose before and after the drink.

在進行口服葡萄糖耐量試驗時，要先抽一次血，接著服用一劑葡萄糖，兩小時之後，再抽一次血。測試的結果能反映出在服用前後，身體處理葡萄糖的能力。

If you have diabetes, your doctor will provide you with information about how to manage the disease, including:

若確診糖尿病的話，醫生會提供患者有關如何控管糖尿病的資訊，包括：

how to monitor blood glucose levels on your own

如何自己監測血糖水平

dietary recommendations

飲食的建議

physical activity recommendations

體能活動的建議

information about any medications that you need

所需的藥物資訊

You may need to see an endocrinologist who specializes in the treatment of diabetes. You’ll probably need to visit your doctor more often at first to make sure your treatment plan is working.

患者還可能需要去找專門治療糖尿病的內分泌科醫生。剛開始的時候可能會需要經常回診，確定治療方案有沒有效。

Complications associated with type 2 diabetes

與第二型糖尿病相關的併發症

For many people, type 2 diabetes can be effectively managed. It can affect virtually all your organs and lead to serious complications, including:

對許多人而言，第二型糖尿病是一種能夠有效控管的疾病，但它卻幾乎能影響到所有身體器官，引發嚴重的併發症，包括：

skin problems, such as bacterial or fungal infections

皮膚問題，如細菌或真菌感染

nerve damage, or neuropathy, which can cause a loss of sensation or numbness and tingling in your extremities as well as digestive issues, such as vomiting, diarrhea, and constipation

神經損傷或神經病變，可能導致四肢無知覺或麻木和刺痛，以及消化問題，如嘔吐、腹瀉和便秘

poor circulation to the feet, which makes it hard for your feet to heal when you have a cut or an infection and can also lead to gangrene and loss of the foot or leg

足部的血液循環不良，使腳上有切傷或感染時難以癒合，也會導致壞疽，甚至導致足部或腿部的截肢

hearing impairment

聽覺受損

retinal damage, or retinopathy, and eye damage, which can cause deteriorating vision, glaucoma, and cataracts

視網膜損傷、視網膜病變和眼睛損傷會導致視力惡化、青光眼和白內障

cardiovascular diseases such as high blood pressure, narrowing of the arteries, angina, heart attack, and stroke

心血管疾病，如高血壓、動脈狹窄、心絞痛、心臟病發作和中風

kidney damage and kidney failure

腎臟功能損害和腎衰竭

Hypoglycemia

低血糖

Hypoglycemia can occur when your blood sugar is low. The symptoms can include shakiness, dizziness, and difficulty speaking. You can usually remedy this by having a “quick-fix” food or drink, such as fruit juice, a soft drink, or a hard candy.

當血糖較低時，會產生「低血糖」的反應，症狀可能包括身體顫抖、頭暈和說話困難。通常在食用或飲用能夠「快速恢復」的食品或飲品，像是果汁、不含酒精的飲料或硬糖後，就能恢復正常。

Hyperglycemia

高血糖

Hyperglycemia can happen when blood sugar is high. It’s typically characterized by frequent urination and increased thirst. Exercising can help lower your blood sugar level.

當血糖較高時，會產生「高血糖」的反應，典型的特徵有頻尿和口渴。運動能把血糖降下來。

Complications during and after pregnancy

懷孕期間和懷孕後的併發症

If you have diabetes while you’re pregnant, you’ll need to monitor your condition carefully. Diabetes that’s poorly controlled can:

如果在懷孕期間罹患糖尿病，孕婦需要仔細監測糖尿病的病情。若病情控制不良的話會造成：

complicate labor and delivery

分娩與生產的難度增加

harm your baby’s developing organs

傷害寶寶的發育器官

cause your baby to gain too much weight

導致寶寶體重過重

increase your baby’s risk of developing diabetes during their lifetime

提高寶寶一生中罹患糖尿病的風險

Statistics about type 2 diabetes

相關的統計數據

The U.S. Centers for Disease Control and Prevention reports the following statistics about diabetes in the United States:

美國疾病控制及預防中心公布了以下有關美國糖尿病的統計數據：

Over 29 million people have diabetes. That’s 9.3 percent of the population.

有超過2900萬的人患有糖尿病，占總人口的9.3％。

One in four people have no idea they have diabetes.

有四分之一的人不知道自己患有糖尿病。

More than one in three adults have prediabetes, and 15 to 30 percent of them will develop type 2 diabetes within five years.

超過三分之一的成年人患有早期型糖尿病，其中15-30％的人將在五年內罹患第二型糖尿病。

Non-Hispanic black, Hispanic, and American Indian, including Alaska Native, adults are about twice as likely to have diabetes as non-Hispanic white adults.

非西班牙裔黑人、西班牙裔美國人和美洲印第安人(包括阿拉斯加原住民)患有糖尿病的可能性是非西班牙裔成年白人的兩倍。

The American Diabetes Association reports the following statistics:

美國糖尿病協會公布了以下的統計數據：

In 2012, diabetes cost the United States $245 billion in direct medical costs and reduced productivity.

2012年，糖尿病耗費了美國直接醫療費用2450億美元，使生產力降低。

The average medical expenses for people with diabetes are about 2.3 times higher than they would be in the absence of diabetes.

糖尿病患者的平均醫療費用比沒有糖尿病時高出約2.3倍。

Diabetes is the seventh leading cause of death in the United States, either as the underlying cause of death or as a contributing cause of death.

糖尿病是美國的第七大死因，無論是直接或間接死因。

The World Health Organization reports the following statistics:

世界衛生組織公布了以下的統計數據：

The 2014 global prevalence of diabetes was about 9 percent for adults.

2014年全球糖尿病的成人患病率約為9％。

About 90 percent of people with diabetes have type 2 diabetes.

大約90％的糖尿病患者都有第二型糖尿病。

Diabetes caused about 1.5 million deaths worldwide in 2012.

2012年糖尿病導致全球約150萬人死亡。

About half of people with diabetes die of cardiovascular disease, including heart disease and stroke.

大約一半的糖尿病患者死於心血管疾病，包括心臟病和中風。

Diabetes is also a leading cause of kidney failure.

糖尿病也是造成腎衰竭的主因。

Managing type 2 diabetes

控管第二型糖尿病

Managing type 2 diabetes requires teamwork. You’ll need to work closely with your doctor, but a lot of the results depend on your actions.

控管第二型糖尿病不是一個人就可以辦得到的，需要與醫生密切配合，不過，許多結果其實都取決於患者自身的行為。

Your doctor may want to perform periodic blood tests to determine your blood sugar levels. This will help determine how well you’re managing the disease. If you take medication, these tests will help gauge how well it’s working.

醫生可能會希望進行定期的血液測試，檢測血糖的水平，幫助確定疾病管控的程度。若有服用藥物，這些測試還能幫忙衡量藥物的使用效果。

Because diabetes increases your risk of cardiovascular disease, your doctor will also monitor your blood pressure and blood cholesterol levels. If you have symptoms of heart disease, you may need additional tests. These tests may include an electrocardiogram or a heart stress test.

糖尿病會提高心血管疾病的風險，所以醫生也會一同監測患者的血壓和血膽固醇(血脂)。若有出現心臟病的症狀，可能還需要進行其他額外的測試。這些測試可能包括心電圖或心臟壓力測試。

Follow these tips to help manage your diabetes:

可以遵循下列幾個方法來控制糖尿病的病情：

Maintain a diet high in nutrient-rich carbohydrates and fiber but low in unhealthy fats and simple carbohydrates.

飲食上多吃營養豐富的碳水化合物和纖維，減少攝入不健康的脂肪和單一的碳水化合物。

Exercise daily.

每天運動。

Take all your medication as recommended.

遵循醫囑服藥。

Use a home monitoring system to test your own blood sugar levels between visits to your doctor. Your doctor will tell you how often you should do that and what your target range should be.

在去看醫生的前後，使用家用血糖儀檢測血糖。醫生會告訴你應該多久進行一次檢測以及目標範圍應該是多少。

It may also be helpful to bring your family into the loop. Educate them about the warning signs of blood sugar levels that are too high or too low so that they can help in an emergency. If everyone in your home follows a healthy diet and participates in physical activity, you’ll all benefit.

讓家屬參與治療過程或許也能有所幫助。讓他們了解有關血糖過高或過低的警訊，在有緊急狀況的時候，他們就能提供幫忙。如果大家都能養成健康的飲食習慣，多參加運動，就能造福家中的所有人。

[1] Source(資料來源): https://www.healthline.com/health/type-2-diabetes

Understanding Type 2 Diabetes (2)

認識第二型糖尿病(二)[1]

Medications for type 2 diabetes

治療第二型糖尿病的藥物

In some cases, lifestyle changes are enough to keep type 2 diabetes under control. If not, there are several medications that may help. Some of these medications are:

有些情況下，光是改變生活方式就足以使第二型糖尿病得到控制。如果不行的話，還有幾種藥物或許能夠幫忙控制病情，其中包括：

• metformin, which can lower your blood sugar levels and improve how your body responds to insulin


• 二甲雙胍：可以降低血糖水平，改善身體對胰島素的反應


• sulfonylureas, which help your body make more insulin


• 硫醯基尿素類：能讓身體產生更多的胰島素


• meglitinides or glinides, which are fast-acting, short-duration medications that stimulate your pancreas to release more insulin


• 美格替耐類或美格替耐類類似物：一種能夠快速生效且藥效短的藥物，它可以刺激胰臟釋出更多胰島素


• thiazolidinediones, which make your body more sensitive to insulin


• 噻唑烷二酮類(TZDs)：能使身體對胰島素更加敏感


• dipeptidyl peptidase-4 inhibitors, which are milder medications that help reduce blood sugar levels


• 二肽基肽酶-4抑製劑(DPP-4 inhibitors)：一種較為溫和且有助於降低血糖水平的藥物


• glucagon-like peptide-1 receptor agonists, which slow digestion and improve blood sugar levels


• 類升糖素胜肽-1受體促效劑(GLP-1 agonists)：能夠減緩消化速度並改善血糖水平


• sodium-glucose cotransporter-2 inhibitors, which help prevent the kidneys from reabsorbing sugar into the blood and sending it out in your urine


• 鈉-葡萄糖共同轉運蛋白-2抑製劑(SGLT-2 inhibitors)：有助於防止腎臟重新吸收糖分進入血液並將糖分經由尿液排出

Each of these medications can cause side effects. It may take some time to find the best medication or combination of medications to treat your diabetes.

上述的每種藥物都可能引起副作用，所以患者可能需要花些時間才能找到最適合治療自己病症的藥物或藥物組合。

If your blood pressure or cholesterol levels are a problem, you may need medications to address those needs as well.

如果患者的血壓或膽固醇也有問題，可能也會需要其他藥物來解決這些問題。

If your body can’t make enough insulin, you may need insulin therapy. You may only need a long-acting injection you can take at night or you may need to take insulin several times per day.

如果體內無法分泌足夠的胰島素，可能會需要接受胰島素治療。有些患者可能只需要在晚上使用長效型注射劑，或者也可能需要每天多次注射胰島素。

Type 2 diabetes in children

兒童及青少年第二型糖尿病

Type 2 diabetes in children is a growing problem. According to the American Diabetes Association, approximately 208,000 Americans under age 20 have diabetes.

兒童及青少年罹患第二型糖尿病已經成為一個日益嚴重的問題。根據美國糖尿病協會(ADA)的統計，20歲以下患有糖尿病的美國人大約有208,000名。

The reasons for this are complex, but risk factors include:

造就這個現象的原因很複雜，不過其中的危險因子有：

• being overweight, or having a body mass index above the 85th percentile


• 體重超重，或者身體質量指數(BMI)的常態分布高於85%區段


• having a birth weight of 9 pounds or more


• 出生體重9磅(4公斤)以上


• being born to a mother who had diabetes while she was pregnant


• 生母於懷孕期間患有糖尿病


• having a close family member with type 2 diabetes


• 血親患有第二型糖尿病


• having a sedentary lifestyle


• 久坐不動的生活方式


• being American Indian, Alaska Native, African-American, Asian-American, Latino, or Pacific Islander


• 美洲印第安人、阿拉斯加原住民、非裔美國人、亞裔美國人、拉丁裔或太平洋島民

The symptoms of type 2 diabetes in children include:

兒童及青少年第二型糖尿病的症狀包括：

• excessive thirst      極度口渴


• excessive hunger極度飢餓


• increased urination排尿增加


• sores that are slow to heal潰瘍癒合緩慢


• frequent infections經常被感染


• fatigue感到疲勞


• blurry vision視力模糊


• areas of darkened skin身體某些部位變黑(黑棘皮病)

See your child’s doctor immediately if your child has symptoms of diabetes. Untreated diabetes can lead to serious and even life-threatening complications.

如果你的孩子有糖尿病的症狀，請立即帶他去看醫生。不去治療糖尿病的話，可能會引發嚴重甚至危及生命的併發症。

A random blood sugar test may reveal high blood sugar levels. A hemoglobin A1C test can provide more information about average blood sugar levels over a few months. Your child may also need a fasting blood sugar test.

隨機血糖測試可能會出現高血糖的結果；糖化血色素測試則能提供更多有關近幾個月內的平均血糖水平。除此之外，可能還需要進行空腹血糖測試。

If your child’s doctor diagnoses them with diabetes, your doctor will need to determine if it’s type 1 or type 2 before suggesting a specific treatment.

如果孩子被確診患有糖尿病，在進行任何治療之前，醫生需要先確定這是第一型還是第二型糖尿病。

You can help lower your child’s risk by encouraging them to eat well and to be physically active every day.

父母可以鼓勵孩子天天吃得健康，多運動，來減少他們罹患的風險。

Risk factors for type 2 diabetes

第二型糖尿病的危險因子

We may not understand the exact causes of type 2 diabetes, but we do know that certain factors can put you at increased risk.

目前還無法確切得知第二型糖尿病的成因，不過已知的是，具備某些因子會使人面臨更高的風險。

Certain factors are out of your control:

有些因子卻不是你能控制的：

• Your risk is greater if you have a brother, sister, or parent who has type 2 diabetes.


• 如果你的父母或兄弟姊妹患有第二型糖尿病，你的風險會比其他人還要大。


• You can develop type 2 diabetes at any age, but your risk increases as you get older. Your risk is particularly high after age 45.


• 無論任何年齡，都有可能罹患第二型糖尿病，但是隨著年齡的增長，風險也會跟著增加。45歲以後的風險特別高。


• African-Americans, Latinos, Asian-Americans, and American Indians are at higher risk than Caucasians.


• 非裔美國人、拉丁裔、亞裔美國人和美洲印第安人的風險高於白人。


• Women who have a condition called polycystic ovarian syndrome are at increased risk.


• 患有多囊性卵巢症候群的女性，患有第二型糖尿病的風險會增加。

You may be able to change these factors:

你可能可以改變的因子有：

• Being overweight means that you have more fatty tissue, which makes your cells more resistant to insulin. Extra fat in the abdomen increases your risk more than extra fat in the hips and thighs.


• 體重超重表示脂肪組織比一般人還要多，使細胞對胰島素的抵抗增加。腹部多餘的脂肪比臀部和大腿多餘的脂肪所增加的風險更高。


• Your risk increases if you have a sedentary lifestyle. Regular exercise uses up glucose and helps your cells respond better to insulin.


• 久坐不動的生活方式會使風險增加。規律運動能消耗葡萄糖，並幫助細胞對胰島素產生更好的反應。


• Eating a lot of junk foods or eating too much wreaks havoc on your blood glucose levels.


• 吃太多垃圾食品或吃得過飽會嚴重破壞血糖水平。

You’re also at increased risk if you’ve had gestational diabetes or if you have prediabetes, two conditions caused by elevated glucose levels.

罹患妊娠糖尿病或早期型糖尿病的話，風險也會增加。這兩個疾病都是由高血糖所引起的。

Tips for how to prevent type 2 diabetes

預防第二型糖尿病的方法

You can’t always prevent type 2 diabetes. There’s nothing you can do about your genetics, ethnicity, or age.

要完全預防第二型糖尿病的發生是不可能的，因為我們無法改變遺傳、種族或年齡等因素。

If you have prediabetes or other diabetes risk factors and even if you don’t, a few lifestyle tweaks can help delay or even prevent the onset of type 2 diabetes. These changes in diet, exercise, and weight management work together to help keep your blood sugar levels within the ideal range all day long:

如果患有早期型糖尿病或是具備其他誘發糖尿病的危險因子，或是即使沒有上述的情形，仍然可以藉由調整生活方式來延緩甚至預防第二型糖尿病的發病。在同時運用改變飲食、運動和體重控管的方式之下，能夠使血糖整天保持在理想的範圍之內：

Diet飲食

Your diet should be high in nutrient-rich carbohydrates and fiber. You also need heart-healthy omega-3 fatty acids from certain kinds of fish and monounsaturated and polyunsaturated fats. Dairy products should be low in fat. It’s not only what you eat, but also how much you eat that matters. You should be careful about portion sizes and try to eat meals at about the same time every day.

飲食上應該多吃富含營養的碳水化合物和纖維，也要攝取魚類中對心臟有益的omega -3脂肪酸以及單元不飽和脂肪和多元不飽和脂肪。乳製品的話，應該選擇低脂肪的產品。飲食的問題不僅僅是關於吃了些什麼，更是吃了多少有營養的東西，還得注意份量的大小，並且盡量每天在同一個時間點吃飯。

Exercise運動

Type 2 diabetes is associated with inactivity. Getting 30 minutes of aerobic exercise every day can improve your overall health. Try to add in extra movement throughout the day, too.

第二型糖尿病與運不運動有關。每天進行30分鐘的有氧運動可以改善整體的健康狀況，也可以試著在日常生活中加入一些額外的運動。

Weight management體重控管

You’re more likely to develop type 2 diabetes if you’re overweight. Eating a healthy, balanced diet and getting daily exercise should help you keep your weight under control. If those changes aren’t working, your doctor can make some recommendations for losing weight safely.

如果體重超重就更有可能罹患第二型糖尿病。健康均衡的飲食和每日運動就已經足以控制體重了，但是如果這些改變都沒用的話，醫生也可以提供一些安全的減肥方法。

[1] Source(資料來源): https://www.healthline.com/health/type-2-diabetes

Understanding Type 2 Diabetes(1)

認識第二型糖尿病(一)[1]

Diabetes is a chronic medical condition in which sugar, or glucose, levels build up in your bloodstream. The hormone insulin helps move the sugar from your blood into your cells, which are where the sugar is used for energy.

糖尿病是一種會使糖分或葡萄糖堆積在血液中的慢性疾病。胰島素激素能將血液中的糖分轉移到細胞之內，而細胞則會將糖份轉為能量使用。

In type 2 diabetes, your body’s cells aren’t able to respond to insulin as well as they should. In later stages of the disease, your body may also not produce enough insulin.

患有第二型糖尿病的人，他的細胞會無法正常回應胰島素的作用，甚至在糖尿病晚期時，患者的身體也可能無法產生足夠的胰島素。

Uncontrolled type 2 diabetes can lead to chronically high blood sugar levels, causing several symptoms and potentially leading to serious complications.

未有效控制的第二型糖尿病可能會導致長期高血糖，引起多種症狀並可能衍生出嚴重的併發症。

Symptoms of type 2 diabetes

第二型糖尿病的症狀

In type 2 diabetes your body isn’t able to effectively use insulin to bring glucose into your cells. This causes your body to rely on alternative energy sources in your tissues, muscles, and organs.

患有第二型糖尿病的人，他的身體無法有效地利用胰島素將葡萄糖帶入細胞之中，使身體只能依賴組織、肌肉和器官等來源所供給的替代能量。

This is a chain reaction that can cause a variety of symptoms. Type 2 diabetes can develop slowly. The symptoms may be mild and easy to dismiss at first.

這會引起多種症狀的連鎖反應。第二型糖尿病的病情可能發展地比較慢，有些症狀較為輕微，所以一開始容易被忽略。

The early symptoms may include:

早期症狀可能包括：

constant hunger 不斷的感到飢餓

a lack of energy 缺乏活力

fatigue 感到疲勞

weight loss 體重減輕

excessive thirst      極度口渴

frequent urination 頻尿

dry mouth       口乾

itchy skin        皮膚發癢

blurry vision 視力模糊

As the disease progresses, the symptoms become more severe and potentially dangerous.

隨著病情的發展，症狀會變得更加嚴重，更具有潛在的危險性。

If your blood sugar levels have been high for a long time, the symptoms can include:

如果血糖的水平長時間處於高血糖的狀態，那麼症狀可能包括：

yeast infections 酵母菌感染

slow-healing cuts or sores 傷口或潰瘍的癒合緩慢

dark patches on your skin 皮膚上有黑斑

foot pain 腳痛

feelings of numbness in your extremities, or neuropathy 四肢麻木或神經病變

If you have two or more of these symptoms, you should see your doctor. Without treatment, diabetes can become life-threatening.

若具有上述兩種以上的症狀，就應該去看醫生。若不去治療，更可能會危及生命安全。

Diabetes has a powerful effect on your heart. Women with diabetes are twice as likely to have another heart attack after the first one. They’re at quadruple the risk of heart failure when compared to women without diabetes. Diabetes can also lead to complications during pregnancy.

糖尿病會對心臟產生很大的影響。患有糖尿病的女性在第一次心臟病發作後再次發作的可能性將提高兩倍。相較於沒有患有糖尿病的女性，她們患有心衰竭的可能性更高出4倍。糖尿病也可能導致在懷孕期間引起併發症。

Diet for type 2 diabetes

第二型糖尿病的飲食

Diet is an important tool to keep your heart healthy and blood sugar levels within a safe and healthy range. It doesn’t have to be complicated or unpleasant. The diet recommended for people with type 2 diabetes is the same diet just about everyone should follow. It boils down to a few key actions:

飲食是使心臟和血糖維持在安全健康範圍內的重要工具。健康的飲食不一定得吃得太複雜或讓人吃得不開心。適合第二型糖尿病患者的飲食其實跟一般人應該遵循的飲食原則相同，可以歸納成以下幾個重點：

Eat meals and snacks on schedule. 遵守飲食計畫。

Choose a variety of foods that are high in nutrition and low in empty calories. 選擇營養豐富且空熱量少的各種食物。

Be careful not to overeat.   小心不要吃得過飽。

Read food labels closely.    仔細閱讀食品標籤。

Treatment for type 2 diabetes

第二型糖尿病的治療

You can effectively manage type 2 diabetes. Your doctor will tell you how often you should check your blood glucose levels. The goal is to stay within a specific range.

第二型糖尿病是可以有效控管的，醫生都會告訴患者多久該測量一次血糖水平。控管血糖的目的是為了能夠讓血糖保持在一定的範圍之內。

Follow these tips to manage type 2 diabetes:

可以依照下列的指示控管第二型糖尿病：

Include foods rich in fiber and healthy carbohydrates in your diet. Eating fruits, vegetables, and whole grains will help keep your blood glucose levels steady.

在飲食中加入富含纖維和健康碳水化合物的食物。多吃水果、蔬菜和全穀物等食物有助於保持血糖的穩定。

Eat at regular intervals. 規律的用餐時間。

Only eat until you’re full. 不要吃得過飽。

Control your weight and keep your heart healthy. That means keeping refined carbohydrates, sweets, and animal fats to a minimum.

控制體重，保持心臟的健康，也就是將精製碳水化合物、糖果和動物脂肪的攝入量減到最低。

Get about half an hour of aerobic activity daily to help keep your heart healthy. Exercise helps to control blood glucose, too.

每天大約進行半小時的有氧運動，保持心臟健康。運動也有助於控制血糖。

Your doctor will explain how to recognize the early symptoms of blood sugar that’s too high or too low and what to do in each situation. Your doctor will also help you learn which foods are healthy and which foods aren’t.

醫生會告訴患者該如何識別血糖過高或過低的早期症狀，以及在這兩種情況之下該如何應對的方法。醫生也會幫助患者了解哪些食物是健康的，哪些食物不是。

Not everyone with type 2 diabetes needs to use insulin. If you do, it’s because your pancreas isn’t making enough insulin on its own. It’s crucial that you take insulin as directed. There are other prescription medications that may help as well.

並非所有患有第二型糖尿病的人都需要使用胰島素。會需要使用到胰島素是因為病患的胰臟無法自行製造足夠的胰島素，所以遵循醫囑注射胰島素就相當重要。除了胰島素之外，也有其他的處方藥能夠治療糖尿病。

Causes of type 2 diabetes

第二型糖尿病的成因

Insulin is a naturally occurring hormone. Your pancreas produces it and releases it when you eat. Insulin helps transport sugar from your bloodstream to cells throughout your body, where it’s used for energy.

胰島素是一種能夠自然分泌的激素，它是由胰臟所分泌並在我們進食時釋出。胰島素能將在人體中被當成能量使用的糖分從血液中送入細胞。

If you have type 2 diabetes, your body becomes resistant to insulin. Your body is no longer using the hormone efficiently. This forces your pancreas to work harder to make more insulin. Over time, this can damage cells in your pancreas. Eventually, your pancreas may not be able to produce any insulin.

若患有第二型糖尿病，患者的身體會對胰島素產生抵抗，無法再有效地使用此種激素，這使得胰臟得更加努力地製造更多的胰島素。久而久之，會損害胰臟中的細胞。最終可能導致胰臟無法再產出任何胰島素。

If you don’t produce enough insulin or if your body doesn’t use it efficiently, glucose builds up in your bloodstream. This leaves your body’s cells starved for energy.

如果無法分泌足夠的胰島素，或者身體無法有效地使用胰島素，葡萄糖就會堆積在血液中，使體內的細胞因缺乏能量而「餓死」。

Doctors don’t know exactly what triggers this series of events.

醫生無法確切地了解為什麼會造成這一連串的事件。

It may have to do with cell dysfunction in the pancreas or with cell signaling and regulation. In some people, the liver produces too much glucose. There may be a genetic predisposition to developing type 2 diabetes.

它可能與胰臟中的細胞功能障礙或是細胞訊息傳遞和調節有關。有些患者是因為肝臟釋出的葡萄糖過多。第二型糖尿病的發展可能存有遺傳傾向。

There’s also a genetic predisposition to obesity, which increases the risk of insulin resistance and diabetes. There could also be an environmental trigger.

肥胖也存有遺傳傾向，它會增加胰島素抵抗和糖尿病的風險。此外，也可能存有環境觸發因素。

Most likely, it’s a combination of factors that increases the risk of type 2 diabetes. Research into the causes of type 2 diabetes is ongoing.

不過，第二型糖尿病的風險會增加最有可能是因為一連串的原因所引起。目前就有研究正在探討第二型糖尿病的成因。

[1] Source(資料來源): https://www.healthline.com/health/type-2-diabetes

What is Cardiovascular Disease?[1]

心血管疾病是什麼？

Cardiovascular disease can refer to a number of conditions:

心血管疾病可指多種疾病：

Heart disease

心臟病

Heart and blood vessel disease (also called heart disease) includes numerous problems, many of which are related to a process called atherosclerosis.

心臟血管疾病（也稱為心臟病）涉及許多問題，這些問題多與一個被稱為「動脈粥樣硬化」的過程有關。

Atherosclerosis is a condition that develops when a substance called plaque builds up in the walls of the arteries. This buildup narrows the arteries, making it harder for blood to flow through. If a blood clot forms, it can block the blood flow. This can cause a heart attack or stroke.

動脈粥樣硬化是一種斑塊積聚在動脈壁上的疾病。這種斑塊積聚會使動脈變窄，造成血液難以流過血管。若形成血凝塊，更會阻止血液流過，堵塞血管，導致心臟病發作或中風。

Heart attack

心臟病發作

A heart attack occurs when the blood flow to a part of the heart is blocked by a blood clot. If this clot cuts off the blood flow completely, the part of the heart muscle supplied by that artery begins to die.

當流向心臟某部分的血液被血凝塊阻塞時，會造成心臟病發作。如果血凝塊完全阻斷血液流過動脈，那麼，該部分由動脈供給血液的心肌將會死亡。

Most people survive their first heart attack and return to their normal lives, enjoying many more years of productive activity. But experiencing a heart attack does mean that you need to make some changes.

第一次心臟病發作時，大多數的人都能倖存下來，恢復正常生活，再保有幾年的生產力。但是有過心臟病發作卻也表示是時候做些改變了。

The medications and lifestyle changes that your doctor recommends may vary according to how badly your heart was damaged, and to what degree of heart disease caused the heart attack.

醫生建議使用的藥物和應改變的生活方式可能會因患者心臟受損的嚴重程度以及引起心臟病發作的心臟病程度而有所不同。

Stroke

中風

An ischemic stroke (the most common type of stroke) occurs when a blood vessel that feeds the brain gets blocked, usually from a blood clot.

當輸送血液到大腦的血管被堵塞時(通常是血凝塊)，會發生缺血性中風(最常見的中風類型)。

When the blood supply to a part of the brain is cut off, some brain cells will begin to die. This can result in the loss of functions controlled by that part of the brain, such as walking or talking.

當流向大腦某部分的血液供給被切斷時，腦細胞就會開始死亡，造成該部分大腦所控制的功能喪失，例如走路或說話。

A hemorrhagic stroke occurs when a blood vessel within the brain bursts. This is most often caused by uncontrolled hypertension (high blood pressure).

當大腦內的血管破裂時就會造成出血性中風，而這通常是因未控制的高血壓所引起。

Some effects of stroke are permanent if too many brain cells die after being starved of oxygen. These cells are never replaced.

若有過多的腦細胞在缺氧後死亡，某些由中風所造成的影響就會變成永久性的影響，而且這些腦細胞永遠無法被替換掉。

The good news is that sometimes brain cells don’t die during stroke — instead, the damage is temporary. Over time, as injured cells repair themselves, previously impaired function improves. (In other cases, undamaged brain cells nearby may take over for the areas of the brain that were injured.)

好在，並非所有的中風都會造成腦細胞的死亡，這種情形所造成的損傷只是暫時性的。隨著時間的過去，通過受損細胞的自我修復，能使先前受損的功能得到改善。（有些時候可能是由附近未受損的腦細胞接管受傷的大腦區域。）

Either way, strength may return, speech may get better and memory may improve. This recovery process is what stroke rehabilitation is all about.

無論是哪種情形，力量可能會恢復、言語可能會好轉，而記憶力也可能會改善。這個恢復的過程就是中風康復的過程。

Heart failure

心衰竭

Heart failure, sometimes called congestive heart failure, means the heart isn’t pumping blood as well as it should. Heart failure does not mean that the heart stops beating — that’s a common misperception. Instead, the heart keeps working, but the body’s need for blood and oxygen isn’t being met.

心衰竭，有時又被稱為鬱血性心衰竭，是指心臟幫浦血液的程度達不到應有的力度。心衰竭並不代表心臟停止跳動，這是一個常見的誤解。心臟還是繼續工作著，只是身體對血液和氧氣的需求沒有得到滿足。

Heart failure can get worse if left untreated. If your loved one has heart failure, it’s very important to follow the doctor’s orders.

若放著不治療，會使心衰竭更加嚴重。所以，如果你的親人患有心衰竭，遵循醫囑是非常重要的一件事。

Arrhythmia

心律不整

Arrhythmia refers to an abnormal heart rhythm. There are various types of arrhythmias. The heart can beat too slow, too fast or irregularly.

心律不整就是異常的心律，有許多種類型，心臟可以跳得太慢、太快或不規律。

Bradycardia, or a heart rate that’s too slow, is when the heart rate is less than 60 beats per minute. Tachycardia, or a heart rate that’s too fast, refers to a heart rate of more than 100 beats per minute.

心搏過緩或心率過慢是指心跳每分鐘低於60次。心搏過速或心率過快則是指心跳每分鐘超過100次。

An arrhythmia can affect how well your heart works. With an irregular heartbeat, your heart may not be able to pump enough blood to meet your body’s needs.

心律不整會影響心臟的運作。不規則的心跳可能會使心臟無法幫浦足夠的血液來滿足身體的需求。

Heart valve problems

心臟瓣膜的問題

When heart valves don’t open enough to allow the blood to flow through as it should, a condition called stenosis results. When the heart valves don’t close properly and thus allow blood to leak through, it’s called regurgitation. If the valve leaflets bulge or prolapse back into the upper chamber, it’s a condition called prolapse.

當心臟瓣膜打開的程度無法讓足夠的血液流過時，就會引起一種被稱為「狹窄」的疾病。當心臟瓣膜無法正確地關閉而使血液回漏時，則稱為「逆流」。如果瓣膜瓣葉突出或脫垂回到上腔室，則稱為「脫垂」。

Common treatments

常見的治療方法

Here are some common treatments for different types of cardiovascular disease:

以下是一些針對不同類型的心血管疾病常見的治療方法：

1. Heart Valve Problems心臟瓣膜問題

Medications藥物

Heart valve surgery心臟瓣膜手術

2. Arrhythmia心律不整

Medications藥物

Pacemaker心律調節器

3. Heart Attack心臟病發作

Medications — clotbusters (should be administered as soon as possible for certain types of heart attacks)

藥物:溶栓治療（對於特定類型的心臟病發作應盡快給予用藥）

Coronary angioplasty冠狀動脈成形術

Coronary artery bypass graft surgery冠狀動脈繞道手術

4. Stroke中風

Medications – clotbusters (must be administered within three hours from onset of stroke symptoms for certain types of strokes)

藥物:溶栓治療（對於特定類型的中風，必須在發作後三個小時內給予用藥）

Carotid endarterectomy頸動脈內膜切除術

Diagnostic tests, surgical procedures and medications

診斷測試、外科手術和藥物治療

In the hospital and during the first few weeks at home, the doctor may perform several tests and procedures. These tests help the doctor determine what caused the stroke or heart attack, and how much damage was done. Some tests monitor progress to see if treatment is working.

在醫院和最初在家的幾週之內，醫生可能會進行多項測試與治療程序。這些測試有助於醫生確定中風或心臟病發作的原因，以及造成的損傷程度。有一些測試會監測過程來確定治療是否有效。

Cardiac medications

心臟藥物

The medications prescribed in the wake of a cardiac event can aid in recovery and work to prevent another stroke or heart attack.

在與心臟疾病有關的事件發生後，醫生開出來的藥物可以用來幫助恢復並預防再一次發生中風或心臟病發作。

If you’re a caregiver, make it your responsibility to help your loved one take medications as directed and on time. Educate yourself about the medications that your loved one must take. Know what those medicines do, and what their goal is.

如果你是看護者，請依照指示和按時幫助你的親人服用藥物。多學習有關這些藥物的相關資訊，了解這些藥物的作用和目的。

It’s important to follow your doctor’s directions closely, so ask questions and take notes.

密切遵循醫囑是一件非常重要的事，所以應該多提問、多做筆記。

[1] Source(資料來源): https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease

What's the Difference Between Palliative Care and Hospice Care?

緩和醫療與安寧療護的不同[1]

If you or loved ones are facing a serious illness, you’ve probably been hearing a lot about treating pain. You may have heard the terms “palliative care” or “hospice.”

假如你或你的親人患有重病，你可能已經聽過許多關於治療疼痛的資訊，也可能聽過「緩和醫療」或「安寧療護」這兩個說法。

Both are meant to bring comfort and relief, but they differ in some important ways. To get the right kind of care in your situation, you need to have a good idea of what each service offers.

照理而言，這兩者都是為病患帶來舒適與慰藉，但在某些重要的方面上，它們卻有所不同。為了能夠針對病情，取得正確的照護，得先好好了解這兩者所提供的服務有哪些。

What Is Palliative Care?

什麼是緩和醫療？

This program aims to ease pain and help with other problems if your illness is serious but not considered to be life-threatening for now.

緩和醫療的目的在於緩解疼痛並幫助解決其他問題，這適合雖然嚴重但目前還不會危及生命的疾病。

It helps people live with the symptoms of long-running things such as cancer, kidney disease or AIDS, or with the side effects of the treatments.

它可以幫助病患適應具有長期症狀的疾病，如癌症、腎臟疾病或愛滋病，或者幫助病患適應治療時的副作用。

Palliative medicine doesn’t replace other treatments. It’s an addition that helps you and your family deal with things such as nausea, nerve pain, or shortness of breath.

緩和醫學並不能取代其他的治療方法，但是可以輔助病患處理噁心、神經疼痛或呼吸短促等問題。

If an illness makes it harder to work, play, get around, or causes depression, palliative care can address that, too. People have said they feel more in control of their lives as a result.

若患有的疾病會造成工作上、玩樂，甚至走動上的困難或導致憂鬱症，那麼也能利用緩和醫療來解決這些問題。患者們都說在接受治療後，覺得更能掌控自己的生活。

Even in cases where an illness is expected to be fatal, this type of care can help you live as active a life as possible.

即使在疾病是致命的情況之下，這種類型的照護也能幫病患盡可能地過上積極的生活。

What Is Hospice Care?

什麼是安寧療護？

This is for people who have learned from doctors that they are not expected to recover from their condition. It’s about easing pain and helping families prepare for the end of life. Palliative care is part of that, but it’s just one part.

安寧療護適用於醫生確診可能無法康復的病患，它主要是用來幫助病患緩解痛苦以及幫助家屬為病患生命中的最後一段路程做好準備。緩和醫療也包含在此，但只是這其中的一環。

People in hospice care generally are expected to have less than 6 months to live. They’re often at home, where family members and professional caregivers look after them. But you could also choose a specialized center for hospice care. It’s also offered at many nursing homes and hospitals.

受安寧療護的患者通常只剩下大概不到6個月的生命。這類的病患通常由家屬和專業的護理人員在家照顧，但也可以選擇專門的安寧療護中心。許多療養院和醫院也有提供安寧療護的服務。

This kind of care can involve not only doctors and nurses, but family members, clergy, counselors, or social workers who can address the grief of dying and emotions (such as anger, sadness, or regret) that often come with it.

此種照護的參與人員不僅包括醫生和護士，還包括家庭成員、神職人員、輔導員或能夠處理伴隨著死亡而來的悲傷和情緒（如憤怒、難過或遺憾）的社會工作者。

Easing Your Pain

緩解疼痛

Both palliative care and hospice care offer medicines that can ease your pain.

緩和醫療和安寧療護皆有提供緩解疼痛的藥物。 

Those can range from over-the-counter drugs such as ibuprofen to stronger relief with opioid medications such as oxycodone or morphine.

這些藥物的範圍可以從ibuprofen等非處方藥物到強效緩解的鴉片類藥物，例如oxycodone或嗎啡。

The misuse of opioiods has become a big concern, and you or a loved one might not want to take them because you’re afraid of becoming addicted. This can be a particular worry if you’ve already had problems with drugs or alcohol. But you might be rejecting pain drugs needlessly.

鴉片類藥物的濫用已成為一大問題，病患可能會因為害怕上癮，而不想使用這些藥物，尤其是那些已經有毒品或酗酒問題的病患更會擔心這個問題。不過，其實大可不必拒絕服用止痛藥。

Researchers say people who are prescribed opioids during these kinds of cases, and use them as directed, rarely become addicted to them. It’s OK to take them instead of suffering.

研究人員表示，在這類病例中，依照指示服用醫生所開出的鴉片類藥物的患者，很少會對藥物上癮。所以服用這些藥物是可以的，不用選擇承受痛苦。

These drugs do have side effects such as drowsiness, nausea, and constipation. Those problems usually fade as your body gets used to the medication. Your doctor should be able to help you decide whether to start taking them and how much you need.

這些藥物確實是有副作用，例如嗜睡、噁心和便秘。但是當身體習慣這些藥物時，這些問題通常都會逐漸消失，而醫生會幫助病患判定是否要開始服用藥物以及需要服用的劑量。

Will Insurance Help Pay for This?

保險有給付嗎？(美國)

Medicare, the federal health insurance program for seniors, pays all charges related to hospice care. So does Medicaid, the federal-state health program for the poor. Most private insurers cover it as well.

聯邦醫療保險(Medicare)是針對老年人的聯邦健康保險計劃，它能給付所有與安寧療護有關的費用。針對窮人的聯邦政府健康計劃，即低收入戶政府醫療補助(Medicaid)也是如此。此外，大多數的私人保險公司也有承保安寧療護的部分。

Palliative care is not as well-covered. Medicare and private insurers cover some medicines, but not others. You may want to check your policy or call your insurance company to find out.

緩和醫療卻沒有完全承保在內。聯邦醫療保險和私人保險公司僅包含部分藥品。完整的細節則需自行查看保單或致電保險公司查詢。

[1] Source(資料來源): https://www.webmd.com/palliative-care/difference-palliative-hospice-care#1