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The Touch, the Feel—and Now, the Heal—of Cotton
By Erin K. Peabody
棉花的轻柔、透气性及临床应用之探索
艾林•K•皮博迪 著
[1] Its cultivation may be ancient—dating as far back as 5,000 years ago—but cotton, and its characteristically soft, downy fibers, could be just what modern medicine has been waiting for.
[1]棉花的种植历史也许非常悠久——可以追溯到迄今5,000年前——但它和它富有特性、柔软光滑的纤维可能正是现代医学所要寻找的东西。
[2] Believed to have first been grown in the Indus Valley of current-day Pakistan and India, cotton is a favorite fiber in terms of its innate softness, breathability , and agronomic abundance. Nothing wicks moisture away better on a steamy August day. No other fabric feels as naturally smooth and airy against the skin.
[2]据认为，棉花首先种植于位于今天的巴基斯坦和印度的印度河流域，就其天然的柔软性透气性和生产方面的丰富性来说，它是最受欢迎的一种纤维。在潮湿的八月份，没有什么能比棉花更能吸去潮气的了。没有其他纤维在皮肤上触摸起来更自然光滑和轻盈。
[3] And now, thanks to research done by an ARS chemist in New Orleans, Louisiana, this fabric basic is poised to help address one of our healthcare system’s most costly medical conditions : debilitating chronic wounds.
[3] 现在，由于路易斯安那州新奥尔良美国农业研究所的一位化学家的研究，人们将准备利用这种纤维的基础本质来帮助应对医疗体系中花费最多的疾病之一——令人身体变虚弱的慢性创伤。
An Increasing Concern
[4] Chronic open wounds—also known as “bedsores” or “pressure ulcers”—are a painful and sometimes fatal condition afflicting about 5 million Americans. Sufferers of these hard-to-heal wounds mostly include elderly patients restricted to hospital beds or wheelchairs and diabetics beset by circulation problems.
受到越来越多的关注
[4] 慢性开放性伤口（也叫"褥疮"或"压力溃疡"）是一种很痛苦，有时是致命性的疾病，困绕着大约500万美国人。这种难以治愈的伤口的患者主要是卧病在医院病床或轮椅的老年病人，或者是循环系统有问题的糖尿病患者。
[5] Brought about by the constant pressure of lying on a stationary surface, painful ulcers can involve substantial skin loss, sometimes exposing muscle and even bone.
[5] 由于躺在静止的平面上持续产生的压力，疼痛性溃疡会伴随大面积皮肤脱落，有时露出肌肉，甚至骨头。
[6] The annual healthcare costs associated with treating these wounds are currently estimated to exceed $7 billion. This figure is expected to grow by as much as 10 percent annually as the nation’s population ages and the incidence of pressure ulcers increases.
[6] 目前据估计，每年用于治疗这种伤口所需的医疗费用超过70亿美元。随着（美国）全国人口的老龄化和压力溃疡病例的增加，这一数字预期将以每年高达10%的速度增长。
[7] And while several products are currently on the market for treating chronic wounds, there’s vast opportunity for improvement, says ARS chemist Vince Edwards. “That’s largely because of ongoing advances in the medical community’s understanding of wound physiology,” he says, “coupled with a recent growth in innovative textiles.”
[7] 农业研究所的化学家文斯•爱德华兹说，目前推向市场治疗慢性伤口的几种产品尚有许多完善之处。“这主要是由于医学界对于创伤学的认识不断进步，再加上最近纺织品的创新，”他说。
[8] Edwards’s research is perfect evidence of how these two worlds are merging. Weaving together a keen interest in wound medicine and an expert knowledge of cotton chemistry, Edwards has already invented a novel wound dressing that could reach hospitals and nursing homes in the next couple of years.
[8] 爱德华兹的研究很好地表明这两个领域怎样正在结合。一面搞纺织，同时对创伤学有浓厚的兴趣，而且在棉花化学方面有专业知识，爱德华兹已发明了一种包扎伤口的新型绷带，这种绷带在未来几年将应用于医院和养老院。
[9] But that’s not all. Cotton fibers in Edwards’s lab, located at the agency’s Southern Regional Research Center in New Orleans, are being spun into all kinds of medically promising materials. The inventive chemist and his group are creating an array of valuable medical products that can halt bleeding, soothe burns, fight microbes, and more—all from farm-grown cotton.
[9] 但这并不是全部。坐落在研究所设在新奥尔良南部地区实验中心的爱德华兹实验室里的棉花纤维被织成各种各样的医用替代材料。这位富有创新精神的化学家和他的研究小组正在研制一系列重要的医疗产品，这些医疗产品能止血，疗伤，杀菌，还有其他用途——所有这些都来自农田里种植的棉花。
A Bandage With a Brain
智能绷带
[10] One technology that’s inching ever closer to the marketplace is a wound dressing Edwards and his group developed that targets destructive enzymes called proteases (pronounced pro-tea-ACE-es) which collect in chronic wounds.
[10] 爱德华兹和他的研究小组研发的一项技术（一种逐渐推向市场的疗伤绷带）以针对叫做蛋白酶（读作普洛地-ACE-ES）的破坏性酶为目标，这些蛋白酶聚集在慢性伤口中。
[11] In most chronic wounds, the problem’s not that the body has a deficient immune system; it’s, ironically, that the body’s natural defenses are laboring in overdrive, dispatching too many “foot soldiers” to break down dead and dying tissue.
[11] 在大多数慢性伤口中，问题不是身体的免疫系统存在缺陷；具有讽刺意味的是，身体的自然防御系统过度劳累，调动了过多的“步兵”分解坏死和正在坏死的组织。
[12] Having enough of these enzyme-producing armies, or structures called “neutrophils,” is critical to healing. But too many can jam up the process, leaving it locked in a vicious, harmful inflammatory cycle.
[12] 有足够多这种产生酶的队伍，或者叫“中性白细胞”的结构，对于伤口痊愈是至关重要的。但是，太多会干扰这个过程，将其卡在一个恶性、不良的炎症循环中。
[13] Edwards’s dressing, licensed by Tissue Technologies in Richmond, Virginia, was the first bandage of its kind with the proven ability to sop up excess protease. Tissue Technologies president Kel Cohen says the dressing, which was approved by the U.S. Food and Drug Administration in 2006, now has a manufacturer and marketer. A major goal is to introduce the product to the Veterans Administration system, where it could have significant impact.
[13] 由弗吉尼亚州里士满的“组织技术”许可的爱德华兹绷带是同类绷带中最早的绷带，已经证实能够吸干过多的蛋白酶。“组织技术”总裁凯尔•科亨说，由美国食品和药品管理局于2006年批准的这种绷带现在有了制造商和营销商。他们的一个主要目标是把这种产品介绍给退伍军人管理系统，在那里它能够产生重大影响。
[14] Edwards hopes the dressing will be a cost-effective alternative to similar dressings currently available. “Especially,” he says, “since we’ve found it’s even better at sequestering protease than a comparable wound dressing currently in production.”
[14] 爱德华兹希望这种绷带会成为目前市场上同类绷带中价格低廉的替代产品。他说：“特别是，当我们发现隔离蛋白酶比目前正在生产的包扎伤口的同等绷带要好得多。”
[15] In a recent study in the Journal of Biomedical Materials Research, Edwards details how his bandages curtail protease activity 40 to 80 percent more effectively than untreated cotton wound dressings do.
[15] 爱德华兹在《生物医学材料研究》刊登的一项最新研究中详细地说明了他研制的绷带如何比未经处理的棉制绷带更加有效地遏制蛋白酶40-80%的活动。
[16] And based on recent investigations, Edwards believes the cotton dressing may not only be suppressing overzealous enzyme-producing neutrophils, but it may also be recruiting protein-building macrophages, which are necessary for proper skin healing.
[16] 通过最近的一项调查，爱德华兹相信棉制绷带也许不是仅仅抑制过度活跃的造酶中性白细胞，也许它也调集制造蛋白质的巨噬细胞。这些巨噬细胞对于皮肤的彻底愈合是必要的。
[17] So how does an ordinary cotton bandage accomplish such healing magic? “It’s simply a matter of attraction,” says Edwards. He discovered that when negatively charged phosphoric acid is incorporated into cotton fibers, the dressing is able to pull positively charged proteases up and away from a wound.
[17] 那么，一种普通的棉制绷带是怎样完成这种愈合奇术的呢？爱德华兹说：“这只是一个吸引问题。”他发现当把带负电荷的磷酸添加到棉花纤维中后，绷带能够把带正电荷的蛋白酶吸入，使之远离伤口。
Not Your Ordinary Bedsheet
不是普通的床单
[18] As with most medical conditions, a real reduction in health-care costs is best realized through prevention. The same applies to pressure ulcers, says Edwards. They become much more difficult to treat once they reach an advanced stage.
[18] 大多数疾病可以通过预防最大程度地减少医疗费用。爱德华兹说这同样适用于压力溃疡。它一旦发展到晚期就很难治疗。
[19] Specially engineered foam mattresses are one treatment alternative. Now, improved bedsheets are being designed to be compatible with that technology. When woven from the smoothest of cotton fibers, they might even prevent pressure sores from forming in the first place .
[19] 特制的泡沫垫是一种治疗手段。现在，与这一技术相配套的改进床单正在设计当中。当用最柔滑的棉纤维织成后，它们也许甚至能够首先防止压力溃疡的形成。
[20]“There’s a lot of potential in this field,” says Edwards, “as hospital sheets haven’t changed much in the last 100 years.” He’s exploring how to best reduce the two forces that play a major role in pressure ulcer development: friction and shear .
[20] 爱德华兹说：“这一领域有很大的潜力，因为医院的床单在最近100年没有多大变化。”
他正在探索怎样最大限度地减少压力溃疡发展过程中起主要作用的两种力，即摩擦力和剪应力。
[21] The slightest motion of a patient in bed creates friction between skin and sheets and results in loss of cells from the skin’s outermost layer. Pressure and gravity—which might result, for instance, when a patient sits up in bed—create additional shear forces that compound cell loss.
[21] 卧床病人最轻微的活动就会在皮肤和床单之间产生摩擦力，结果就会引起皮肤最外层脱落。压力和重力（例如，当病人在床上坐起时会产生）造成额外的剪应力，同时造成细胞的死亡。
[22] To blunt their cumulative rub, Edwards and his group are developing super-smooth, wrinkle-free cotton sheets that can also battle microbes. And shrimp, oddly enough, can be thanked for this added benefit. The shells of these small crustaceans are composed of a unique carbohydrate, chitosan, that’s a natural microbe fighter.
[22] 为减轻摩擦的增加，爱德华兹和他的研究小组正在研制超光滑不起皱同时也能抗菌的的棉制床单。更加奇妙的是，这一附加优点要归公于虾。这种小型甲壳类动物的壳是由一种特殊的碳水化合物壳聚糖构成的。壳聚糖是一种天然的细菌杀手。
[23] Since medical-based protocols don’t yet exist for evaluating a bedsheet’s performance, the team is relying on tests developed by the high-end garment industry to measure the sheeting material’s smoothness, feel, and tendency to wrinkle.
[23] 由于以医疗为基础的协议尚不能评估床单的性能，这个小组正依靠高端服装业开发的
测试方法评估制单材料的平滑度，手感和起皱的倾向性。
[24] “Eventually, we’re looking at creating a multilayered sheeting system,” Edwards says. “It would be made of a porous layer to address low levels of moisture, a more absorbent layer for higher levels of moisture, and a core layer for absorbing fluids such as urine.” Absorbency properties in the fabric help keep the skin dry and cool, providing further protection against friction and shear.
[24] 爱德华兹说：“最后，我们正在探索制造一种多层的床单系统。它将由这些层组成：多孔层处理低层的水份，吸水性更强的一层吸收高一层的水份，核心层吸收液体（如尿液）。”纤维的吸水特性有助于保持皮肤干爽凉快，为避免摩擦力和剪应力的伤害提供了进一步的保护。
For the War-Wounded, Too
也是为战争伤员准备的
[25] In addition to his concerted efforts to improve treatment options for victims of pressure ulcers, Edwards has also turned his attention to patients on the battlefield.
[25] 除了努力为压力溃疡患者改善治疗措施以外，爱德华兹也已经把注意力转向战场上的病人。
There, the existence of a superior blood-clotting bandage can mean the difference between life and death. More than 90 percent of all combat deaths occur before the injured reach a field hospital, many of them a result of runaway hemorrhaging, or blood loss.
在那儿，如果有优良的凝血绷带就意味着生死之差。所有的死亡事件超过90%发生在伤员到达医院之前，其中很多是由于流血过多或失血。
[26] While a handful of coagulant-inducing bandages are already on the market, there’s always room for improved technology that boasts greater comfort and lower cost.
[26]因为只有少数凝血绷带已经投入市场，所以总是有机会改进技术以取得更舒适的效果的较低的费用。
[27] Turn again to chitosan, a true natural wonder. In addition to its antibacterial qualities, the shrimp-based compound is also a natural clot promoter. Dressings modified with it are currently available to members of the military, but Edwards is working to engineer them to be less brittle and more homogeneously formulated.
[27] 再说壳聚糖，一个自然奇迹。除了它的抗菌特质以外，这种从虾中提炼的化合物也是一种天然的凝固催化剂，用它处理过的绷带目前已经在军人中使用，但是爱德华兹正改造
它们，使其不那么易碎，设计更均匀。
[28] Cotton is ideal for dressings because it’s soft, pliable, and a ready substrate for locking in health-promoting compounds. It also, as Edwards sees it, opens the door to the possibility of high-tech military clothing that could halt blood loss in a hemorrhaging event—providing protection that could prove as vital as any body armor.
[28] 棉花是制作绷带的理想材料，因为它柔软柔韧并且是一种锁定促进健康的化合物可利用的培养基。而且，正如爱德华兹说所预见的，它也开启了通向高科技军用服装的机会之门，这些服装能够在出血事件中阻止失血，同时提供证明为像身体的防护性外套一样至关重要的保护。
[29] Moving towards this goal, Edwards has developed an improved method for more uniformly embedding chitosan in cotton fibers. He’s already turning out a variety of chitosan-laced cotton materials in his lab, including fabric for clothing, hospital sheeting, and gauze.
[29] 朝着这个目标，爱德华兹已经研发了一种改进了的方法,在棉纤维中更加均匀地嵌入壳聚糖。他已经在办公室里生产出了各种各样织入壳聚糖的棉材料，包括服装面料，医用床单和纱布。
[30] And by using digital imaging analysis, he and colleagues are gauging their progress, observing how well the materials perform when splattered with actual blood droplets. High-speed images are snapped, allowing the scientists to watch in slow motion as the modified cotton gauze helps red blood cells aggregate on the spot .
[30] 通过利用数字成像分析，他和同事们正在测量他们的进展情况，观察当这些材料和真实血液微滴溅污时的性能。抓拍到高速图像，让科学家们能够在慢速播放时观察改良的棉纱帮助红细胞迅速聚集。
[31] Like hospital bedsheets, though, any chemically amended clothing item would need to stand up to the rigors of wear and tear and multiple launderings. And, as for his hopes to develop bedsheets that can actually prevent chronic wounds, the hurdles are great too—especially given the many complex factors involved in the wounds’ formation.
[31]任何用化学方法改造的布料（比如像医用床单之类的东西）都要接受严格的耐磨性，撕扯和反复洗涤的检验。至于他研制能够真正预防慢性创伤的希望，困难还很大——特别是涉及创伤形成中的诸多复杂因素。
[32] But Edwards isn’t discouraged. He recently met with researchers at the U.S. Army Soldier Systems Center in Natick, Massachusetts, to discuss his hemostatic technologies. He stays motivated by the possibility that one day, bacteria-fighting, blood-stopping textiles made from cotton might save a life.
[32] 但是爱德华兹并不气馁。他最近和马萨诸塞州纳泰科美国陆军士兵系统中心的研究人员会面，讨论了他的止血技术。对于有一天由棉花制造的抗菌止血的纺织品会拯救生命这一可能性他仍然充满信心。