Newsletter No. 426

4 No. 426, 4.11.2013 M arshall 教授的講座題為「幽門螺旋桿 菌：古代細菌的現代用法」，是新鴻基 地產諾貝爾獎得獎學人傑出講座系列之一， 假威爾斯親王醫院逸夫講學堂舉行，吸引逾 六百名學者、學生、醫護人員和公眾人士參 加。幽門螺旋桿菌是引致消化性潰瘍和胃癌的 病原體，但在1980年代中期以前，醫學界仍然認為胃 潰瘍是由遺傳、生活壓力，或辛辣食物引起的慢性病。為 了求證，Marshall教授不惜喝下細菌誘使發病，然後自行 以抗生素治癒，從此改變世人對胃病的認識。 講座上，Marshall教授介紹幽門螺旋桿菌的分子流行病學 研究，並探討如何透過菌株追蹤人類的遷徙，藉以理解人 類的共生物，甚或與幽門螺旋桿菌生物「附近共生」的關 係。最新研究顯示，幽門螺旋桿菌或有助於控制二十一世 紀人類過度活躍的免疫系統。Marshall教授亦講述新發 展的幽門螺旋桿菌產品將有利於人類和病菌的共生關係， 減輕病菌的危害。 P rofessor Marshall’s talk ‘ Helicobacter Pylori : Modern Uses for the Ancient Bacterium’ was one of the Sun Hung Kai Properties Nobel Laureates Distinguished Lectures. Held at the Shaw Auditorium of the Prince of Wales Hospital, the lecture drew a full house of over 600 academics, students, medical professionals and the general public. The bacterium Helicobacter pylori is recognized as the pathogen that causes peptic ulcer and stomach cancer. But before the mid-1980s, medical 兩榮譽理學博士漫談醫道 Two Honorary Doctors of Science on Medicine Barry James Marshall 教授和 鍾南山 教授在10月17日早上獲中大 頒授榮譽理學博士學位後，旋即在大學主講兩場講座，分別道出他們在 研究消化道和呼吸道疾病時的曲折經歷。 Prof. Barry James Marshall and Prof. Zhong Nanshan , after receiving the degree of Doctor of Science, honoris causa on 17 October, hosted two public lectures to share their unique experiences in the search for cures in gastrointestinal and respiratory diseases. doctrine still held that ulcers were hereditary or caused by stress and the consumption of hot and spicy foods. Professor Marshall used his own body to test his theories. He drank the bacterium, triggered the symptoms and cured it with antibiotics. His research breakthrough discovered new ways of treating gastritis and peptic ulceration. In the lecture, Professor Marshall reviewed the molecular epidemiology of Helicobacter and described the way that certain strains can be used to trace human migrations. 鍾 南山教授主講的大學五十 周年傑出學人講座以「從 非典到H7N9禽流感─中國呼吸 疾病感染控制」為題，於祖堯堂舉 行。鍾教授說當年沙士（SARS，當時亦 稱為非典型肺炎）肇始，大陸的軍事醫學科學院早就找 到致病的冠狀病毒，但基於保密，別人無從得知。十年過 去，現在無論是互通研究消息或對新病毒的警覺性，均大 有進步。H7N9出現幾個人感染的情況，醫學界已鍥而不 捨追尋。現在，衞生局規定所有醫學人員呈報病例，共同 研究。「早診斷、早隔離、早治療」是他針對防治呼吸疾病 提出的金科玉律。 鍾教授指出，H7N9含有雞的基因，再混合來自浙江和韓 國的鴨基因，現在的病例中，七成病人是從禽類批發和零 售市場，或與禽類有密切接觸而感染，但有幾個病例出現 疑是有限度的人傳人情況。而中國學者利用雪貂做H7N9 流感實驗，發現病毒可透過飛沫經空氣傳播。他提醒今年 冬天要特別警惕H7N9禽流感散播。此外，他還提到空氣 質素問題：「PM2.5（細懸浮微粒）是我最擔心的，這種粒 子可能成為病毒或其他危險物質的載體，一旦到達肺泡， 問題就十分大。」 P rof. Zhong Nanshan’s talk ‘From SARS to H7N9— Management of Acute Respiratory Virus Infection in China’ was held at Cho Yiu Hall as one of CUHK 50th Anniversary Distinguished Lectures. He recalled that at the beginning of the SARS epidemic, a coronavirus had already been identified as the culprit by a military medical institute. But it was not made known to the public. Ten years later, progress had been phenomenal, both in terms of the sharing of research findings and alertness to emerging strains. The few cases of the latest avian flu infections had very soon attracted the attention of medical practitioners, and no time was wasted in investigation and identifying the culprit as H7N9. Moreover, mandatory reporting has ensured that new and suspected cases would be studied together by the experts. ‘Early diagnosis, early quarantine, and early treatment’ that he advocated have become the golden rule of combating respiratory diseases. Professor Zhong pointed out that traces of genetic matter from chickens and ducks from Zhejiang and Korea are found in the H7N9 virus. In 70 per cent of the confirmed cases, patients were infected at the fowl markets or through direct contact with fowls. But a few cases suggested that the infection might have come from human beings. Chinese researchers experimented with ferrets and found that the virus could be airborne. He warned about the possible spread of H7N9 in the winter months ahead. He also worried about the air quality: ‘I fear PM2.5 (suspended particles known as fine particulate matter) the most because these could be the vector for the virus or other dangerous substances. They would wreak havoc once they reach the pulmonary alveoli.’ Consideration was given to its possible benefits which might have thrown light on human associations with commensal and perhaps ‘near commensal’ organisms like Helicobacter . New evidence has arisen suggesting the bacterium might play a beneficial role in controlling what could be an overactive immune system in the 21st century. He also explained that the development of new Helicobacter products can provide the benefits of this ancient human-bacteria association without the more modern pathogenic outcomes. 窮究病源不惜身試 Risking Health to Find a Cure 及早通報防患未然 Early Alert Crucial for Prevention