不支持的理论，肺炎，ACE2和nCOV
Unsupported Theories, Pneumonia, & ACE2 & nCOV (lecture 12)
Welcome to another MedCram coronavirus update! And before we begin, I just wanted to reach out to a lot of new people that are joining us because of these coronavirus updates. We’ve been doing videos for about eight years, and we do a No-nonsense Explain Clearly approach to medical issues. So I just want you to be aware that we also do videos on chronic diseases like COPD (chronic obstructive pulmonary disease) heart failure ventilator management, acid-base inhalers and things of that nature. So check out the rest of our channel for those videos, and also come visit us at our website.
欢迎来到另一个MedCram冠状病毒更新！在我们开始之前，我只是想联系到许多因为这些冠状病毒更新而加入我们的新人们。我们从事视频工作已经有大约八年的时间了，我们对医疗问题进行了清晰的讲解。因此，我只想让您知道，我们还制作了有关慢性疾病的视频，例如COPD（慢性阻塞性肺疾病）心力衰竭呼吸机管理，酸碱吸入器以及类似性质的东西。因此，请查看我们频道其他部分的这些视频，并通过我们的网站访问我们。
So getting back to the coronavirus: deaths today 565, confirmed cases is 28,274. Interestingly, the recovered is 1178. And we did say earlier in the week to look for these to go up because of the time period that takes the longest to have a recovered case.
回到冠状病毒：今天死亡565，确诊病例为28,274。有趣的是，恢复的时间是1178年。我们确实在本周早些时候说过，希望这些时间有所增加，因为该时间段花费的时间最长。
It hasn’t taken a lot of time at all to have confirmed case, takes a little bit more time to have a death because it takes some time for the patient to decompensate. But if they don’t die and they recover, it takes time for them to recover and finally for the virus to be undetectable. Then you have these recovered patients. So, whereas at the beginning of last week or even toward the end of last week, the recovered were less than the deaths, which was kind of concerning now, now the recovered is more than double the deaths at this point.
确诊病例根本不需要花费很多时间，而死亡要花更多的时间，因为患者需要花费一些时间进行失代偿。但是，如果它们没有死亡并且能够恢复，则需要花费时间使它们恢复，最终使病毒无法被检测到。然后，您有这些康复的患者。因此，尽管在上周开始甚至上周末，恢复的人数少于死亡人数，这现在令人担忧，但现在恢复的人数是死亡人数的两倍多。
So I wanted to also address is a lot of comments especially regarding this conspiracy idea where numbers were released, and then taken down, and then put back up again with different numbers.
因此，我也想谈谈很多意见，特别是关于这个阴谋论，即先发布数字，然后删除数字，然后再放回不同的数字。
Let’s go over what those numbers were. So, the deaths that they had were 24,589, and the number of total confirmed cases was 154,023. Now if you look at this ratio, which if we take the null hypothesis and say that this was the correct number, then what you’re looking at here is more like a 16% rate of deaths to confirm cases.
让我们看看这些数字是多少。因此，他们的死亡人数为24,589，确诊病例总数为154,023。现在，如果您看这个比率，如果我们采用零假设并说这是正确的数字，那么您在这里所看到的就是确认病例的死亡率高达16％。
But let’s look at it objectively. So, if we take this ratio, and again it’s not a case fatality rate or a mortality rate. But let’s look at that number 16. I mean if that were the case, we could look at the number of cases that we currently have outside of China. This 16% ratio, whatever you want to call that ratio, should stand regardless of whether the patients are in China outside of China. And if in fact the xxx are covering up the numbers while the xxx can’t cover up numbers that are not in China, right?
但是，让我们客观地看一下。因此，如果我们采用该比率，那么病死率或死亡率也不是。但是，让我们看一下第16个数字。我的意思是，如果是这样的话，我们可以看看目前在中国境外的案例数量。无论您是否要称该比率为16％，无论患者是否在中国境外，该比率都应保持不变。如果实际上xxx掩盖了数字，而xxx无法掩盖不在中国的数字，对吗？
So we can look at Japan, and based on the current infected numbers there now, we should have up to about seven deaths. And how many deaths do we have in Japan? 0. If you look at Singapore, if you look at the number of cases that we have in Singapore and apply this ratio, we should have four deaths. And how many deaths do we have in Singapore? Well, the answer is 0. Why is it so high in XXX? But we’re not seeing that in Japan or Singapore.
因此，我们可以看看日本，根据目前日本的当前感染人数，我们最多应该有7人死亡。在日本有多少人死亡？ 0.如果您查看新加坡，如果您查看我们在新加坡拥有的病例数并应用该比率，我们应该有四人死亡。在新加坡，我们有多少人死亡？好吧，答案是0。为什么XXX这么高？但是我们在日本或新加坡都没有看到。
The other thing I wanted to address that has come up recently is this idea about ACE2? So what is this Angiotensin-converting enzyme 2? Well, if you look in the bronchi, bronchioles tubes, fairly low on down, close to the alveoli, is a receptor on the type 2 Nuuma site called ACE2. and it’s this protein deep down here in the airways when you get down to the very bottom, there is a protein and that is the target of the coronavirus.
我最近想解决的另一件事是关于ACE2的想法？那么，血管紧张素转换酶2是什么？好吧，如果您在支气管中看，细支气管管（其向下高度相当低，靠近肺泡）是2型Nuuma 2型位点ACE2的受体。当您深入到最深处时，正是这种蛋白质在呼吸道的深处，存在一种蛋白质，这就是冠状病毒的靶标。
Not only is it the target of the coronavirus, which allows the virus to enter into the cells, it is also the target of SARS back in 2002. And so there has been a lot of talk about this potentially, because of its similarity to SARS, we could use the same type of vaccinations and treatments that blocks SARS trying to get into the respiratory epithelium. We’ll talk more about that later.
它不仅是冠状病毒的靶标，它可以使病毒进入细胞，而且还是2002年SARS的靶标。因此，由于其与SARS的相似性，对此有很多潜在的讨论。 ，我们可以使用相同类型的疫苗和治疗方法来阻止SARS进入呼吸道上皮。我们稍后再讨论。
But the issue is that there’s been again another unpublished, not peer-reviewed, article that looks at ACE2 expression with respect to gender and race, etc. Etc. And what it found was a very small study. It only had about eight subjects in it. But what they found was that the Asian sample had a huge amount of ACE2 expressed whereas the African-American and Caucasian had relatively low ACE2 levels. And their conclusion was potentially that this could explain why there was such a huge outbreak in China as opposed to other areas with different groups.
但是问题在于，还有另一篇未发表的，未经同行评审的文章，着眼于关于性别和种族等方面的ACE2表达。它只有大约八个主题。但他们发现，亚洲样本中表达了大量的ACE2，而非洲裔美国人和高加索人的ACE2水平相对较低。他们的结论可能是，这可以解释为什么与其他地区不同群体的中国相比，中国爆发了如此大规模的疫情。
And so this has been making the rounds on the comments, and I wanted to address that. First of all, I think a better reason why we’re seeing a huge outbreak in China is because it started in XXX, and that’s where it’s going to be precipitating the most. Secondly, any study with an n out of 8 has to be taken with a grain of salt. So as it stands, there’s actually another study that we can look at that tells us far more. So we end this.
因此，这一直围绕评论展开，我想解决这个问题。首先，我认为在中国看到大规模疫情的一个更好的原因是，它始于XXX，这将是疫情最严重的地方。其次，任何n等于8的研究都必须一粒盐。因此，实际上，还有另一项研究可供我们参考，它可以告诉我们更多信息。因此，我们结束了这一点。
Other study, which looked at the tissue of lung cancer patients, but obviously they were not looking at the cancer itself, but the normal tissue in the lung cancer patients. When they did a multivariate analysis, there were no racial differences. There were no gender differences in the expression of ACE2, but what they did see a difference, statistically significant, in this other study that had an n of 224 patients was that those who smoked had an increase in ACE2 distribution.
其他研究着眼于肺癌患者的组织，但显然他们不是在观察癌症本身，而是在肺癌患者的正常组织。当他们进行多变量分析时，没有种族差异。 ACE2的表达没有性别差异，但是在另一项有224名患者的研究中，他们确实看到了统计学上的差异，即吸烟者的ACE2分布有所增加。
Now, you should know that in China on average 48 percent of men smoke, and only 1.9 percent of women smoke in China based on statistics that go back to 2017. And so this might explain some of the gender differences in terms of those people hospitalized in China.
现在，您应该知道，根据追溯到2017年的统计数据，在中国，中国平均有48％的男性吸烟，而只有1.9％的女性吸烟。因此，这也许可以解释住院患者的性别差异在中国。
But we’ve got two different studies. We’ve got one study that shows n out of 8, which seems to be making the rounds on the internet that Asians have a higher expression of ACE2. Therefore, more targets, therefore more possible infections by the virus. Whereas in another study, 224 different samples, there were no racial differences, no gender differences, but they did notice an increase in ACE2 protein when patients smoked or had a history of smoking in the tissue.
但是我们有两个不同的研究。我们已经进行了一项研究，显示8人中有n人，这似乎在互联网上表明亚洲人对ACE2的表达较高。因此，有更多的目标，因此有更多的可能由病毒感染。在另一项研究中，有224个不同的样本，没有种族差异，没有性别差异，但他们确实注意到当患者吸烟或组织中有吸烟史时ACE2蛋白增加。
I want to talk a little bit about what goes on. So, here’s the coronavirus, and it’s got these proteins on the outside of it, and these proteins are called S proteins or spike. And they interact with the cell, and specifically interact with a protein called ACE2, and that is the receptor that allows internalization of the virus.
我想谈谈发生的事情。因此，这是冠状病毒，并且这些蛋白质位于其外部，这些蛋白质称为S蛋白或刺突。它们与细胞相互作用，特别是与称为ACE2的蛋白质相互作用，而后者是允许病毒内部化的受体。
Now inside the virus is a very large RNA molecule that encodes for all of the proteins that are needed for this virus. And there’s the S protein; there are membrane proteins; there’s a whole bunch of other proteins.
现在，病毒内部是一个非常大的RNA分子，该分子编码该病毒所需的所有蛋白质。还有S蛋白；有膜蛋白；还有一大堆其他蛋白质。
So what they’re looking at is potentially blocking this interaction. So how could you do that? Well, you could get proteins like ACE2 that bind this and prevent that from binding. You could also get proteins that look like the virus to bind on here preventing that interaction. You could also put that on an antibody, and if you were to put these soluble proteins here on the antibody, that could bind onto here, and this antibody would then call in the immune system to try to get rid of the virus. So there’s a number of ways that this can be looked at.
因此，他们正在寻找潜在地阻碍这种互动的方式。那你怎么做呢？好吧，您可以获得类似ACE2的蛋白质，该蛋白质可结合该蛋白质并阻止其结合。您还可以获取看起来像病毒的蛋白质，从而在此处阻止相互作用。您也可以将其放在抗体上，如果要将这些可溶蛋白放在抗体上，可以与此处结合，然后该抗体会调用免疫系统以试图清除病毒。因此，有很多方法可以解决这个问题。
And the interesting thing is that this S protein, and specifically this ACE2, is exactly the same protein that was targeted with SARS back in 2002. And so there’s a lot of work that’s already been done on ACE2 in terms of trying to figure out a way of preventing a virus which targets it from getting inside.
有趣的是，这种S蛋白（尤其是ACE2）与2002年SARS靶向的蛋白完全相同。因此，在ACE2上已经做了很多工作，试图找出一种一种防止针对其的病毒进入内部的方法。
And so, I’ve also included in the link two expert opinions on the RNA sequence of the coronavirus. This thing here. Whereas before they were talking that this is from snakes. They were saying that this looks actually very similar to bats. And the fact that it also targets the exact same protein that the SARS virus did, which was also from a bat, and that this coronavirus is targeting human ACE2, and that’s why we’re having a problem.
因此，我在链接中还包括了两个有关冠状病毒RNA序列的专家意见。这东西在这里。而在他们谈论这是蛇之前。他们说这看起来实际上与蝙蝠非常相似。而且它还靶向与SARS病毒完全相同的蛋白质（也来自蝙蝠），并且该冠状病毒靶向人类ACE2，这就是我们遇到问题的原因。
They also note that ACE2 is somewhere lower down in the respiratory epithelium, and that’s why we’re seeing more of an ammonia rather than upper airway symptoms that we would see with flu for instance.
他们还注意到，ACE2位于呼吸道上皮的下方，这就是为什么我们看到的氨更多而不是像流感那样出现上呼吸道症状的原因。
So, does ACE2 exist more in Asians? I would say at this point, the data seems to indicate the answer is NO, at least with a better-powered study. But is it also possible that it might be related to smoking? Well, it’s possible that smoking may cause a change in the expression of these proteins on the cell surface, which may make you more susceptible to getting coronavirus infections. I think more study needs to be done in that department.
那么，ACE2在亚洲人中是否存在更多？我要说的是，目前看来，数据似乎表明答案是否定的，至少对于功能更强大的研究而言。但是是否也可能与吸烟有关？好吧，吸烟可能会导致这些蛋白质在细胞表面的表达发生变化，从而使您更容易受到冠状病毒感染。我认为该部门需要做更多的研究。
We’ll see you next time. Thanks for joining us!
下次见。感谢您加入我们！
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