日月如梭，时光似箭。
从2006年中华医学会第八届骨科学术会议暨第一届国际CORS学术大会开始，骨科基础科学会议已经成功举办了5届，昭示着我国骨科基础研究水平正稳步发展。即将在北京举办的第六届国际CORS学术大会将向世界示以崭新的面貌，会议不再独立出来提前1天举行，而是分为国内和国际两个会场同时与整个大会同步举行两天半时间，届时将有更多的国内外学者走上讲台，展示和交流自己的最新研究成果，表明骨科学界对基础研究的重视程度不断提高，预示着我国骨科基础研究水平正逐步与国际骨科学界接轨！
通过参加本次COA大会基础学组审稿会，本次CORS学术大会稿件内容主要集中在骨科基础科学研究的热点问题上，比如：生物工程技术、干细胞研究、组织工程材料、生物力学分析、骨关节与脊柱退变的基础研究、解剖学基础研究以及动物模型制作等方面；同时，我们可喜地看到近两成稿件的研究内容涉及到一些新兴的发展方向，如：力学生物学及力学信号转导、骨科流行病学、骨关节发育生物学、骨科疾病遗传学、影像学在骨科基础研究中的应用等领域。由此可见，研究内容几乎涉及骨科基础研究领域的方方面面。
成绩固然可喜，但我们也留意到，多数基础研究停留在“为学术而学术”的层面，基础与临床脱节现象严重。许多研究是在单一的科研单位内完成，研究成果一经发表就束之高阁，无人问津了。有些研究虽然是在联合多学科的通力合作基础上完成的，但是研究成果、专利难觅伯乐和有实力的投资机构，导致研究成果迟迟不能应用于临床，研究们者只能发出“知音难求”的哀叹！
如此种种，我们不得不反思：基础研究的目的是什么？毫无疑问，服务临床，造福人类才是基础研究的终极目标！
科学的反思促成了转化医学的到来！
转化医学或转换医学（Translational Medicine）是近年来医学界最炙手可热的前沿领域之一。2003年美国国立卫生研究院(NIH) Elias Zerhouni的文章在Science上发表后，掀起了国际上对转化医学的高度重视，J Transl Med， Sci Transl Med、Am J Translres等转化医学专业杂志相应出现，很多知名杂志辟出转化医学专栏，仅Pubmed收录转化医学的学术论文就有7万篇左右。欧美众多名校和科研机构纷纷建立了进行转化研究的医学中心或医学转化中心。
哪么什么是转化医学？戴尅戎院士等对转化医学的定义和内涵作了合理的概括。转化医学主要涉及基础医学与临床应用间的双向转化过程，是基础医学与临床应用之间的桥梁，是循环式的科学体系。即基础研究的新成果及时转化到临床应用领域( 包括医疗、预防、护理等多个方面) ，为疾病的诊断和治疗提供更先进的措施和方法( bench to bedside) ，并在临床应用中及时反馈、修正，再进一步转入相对领域深入研究( bedside to bench) 的不断转化、提升，最终目的是更好地提高人民健康水平。转化医学的实现需要有综合性转化医学团队共同完成。这一团队由转化医学中心或转化型研究机构、医院、预防与保健机构、社区服务机构、医药企业等系统化的综合构成。广义上讲，转化型研究主要指基础研究与应用领域的双向转化过程的相关研究。转化型研究应用于医学领域就产生了转化医学。
“架起基础研究和临床医疗之间的桥梁”是对转化医学的形象比喻。它倡导以患者为中心，从临床工作中发现和提出问题，由基础研究人员进行深入研究，然后再将基础科研成果快速转向临床应用。因此转化医学研究主张打破以往研究课题组学科单一、合作有限的模式，强调多学科组成课题攻关小组，团结协作、发挥各自优势。
根据2010 年“香山会议(S13)”精神，对照政府提出的“十二五”期间防治重大疾病、控制健康危险因素的目标，结合目前国内转化医学发展现状，提出应该从推广转化医学理念、搭建平台、建设专业人才队伍和运行机制、促进研究成果向卫生政策转化、注重“创新”理念的贯穿和原创性中医药理论和药物的研究等方面加强推进力度，以促进转化医学在国内的发展。
转化医学研究在发达国家已经初具规模，我国虽然起步较晚，但发展迅速。我国各地医学院与理工科院校的合并以及综合性大学的建立间接促进了生物学、心理学、理学、机械学、材料学等与医学的沟通和联系，便于形成研究团队，给转化医学中心的建立创造更为有利的环境和机遇。目前已成立各级转化医学研究平台30多个。很多大学、科研机构、医院和生物医药公司之间开展合作，开展转化医学相关研究，专门的转化医学中心也已经开始建立。
尽管如此，我们应该清醒地认识到，转化医学是一个新概念，它的发展、完善会需要一个很长的时期。在这个过程中要注意集中优势项目、建成大平台，不能遍地开花、重复建设，对有前景的项目给予有重点、有阶段、有层次的扶植和培养。同时，还需要政府部门、各级科研机构和医务工作者群策群力、发挥聪明才智、付出辛勤劳动才能有所突破。
Focus on the Combination of Basic and clinical research and promote the development of Translational Medicine
Anmin Chen
As autumn welcoming winter, here opens the 13th orthopedic academic conference of Chinese Medical Association and the sixth International COA academic conference. Since the eighth Orthopedic academic conference of Chinese Medical Association and the first International CORS academic conference opened in 2006, the orthopedics foundation science conference had successfully hold six times, which imply that the level of Orthopedics foundation research in our country is developing stably, so will be this CORS conference.
According to the statistics of the Organizing Committee of COA, the quality of manuscripts improved considerably coming through subject selection, novel method, substantial content, and reasonable conclusion. The topic of manuscripts mainly focused on popular issues of orthopedic basic science research including biotechnology, stem cell research, tissue engineering materials, bio-mechanical analysis, joint and spine degeneration basic research, basic anatomy and animal model studies, etc; also new fields such as mechanics and mechanical signal transduction biology, epidemiology orthopedics, bone and joint development biology, bone diseases, genetics, imaging in orthopedic application. Thus, the manuscripts involves almost all aspects of the field of basic research in orthopedics.
Though we have achieved gratifying successes, we also notice that a lot of the fundamental research remains in the level of ‘researching for the sake of research’, and fundamental research is divorced from clinical work. Many studies are accomplished by a single research institution. Once the results are published, people just put them aside and nobody will continue to pay attention to them. Although some projects are completed by the collaboration of multi-institutions, it is not easy to find a qualified organization to make them into use in the clinical field in time. Researchers couldn’t help sighing with emotion: ‘It’s not easy for a swift horse to come across a talent scout’.
So we need to think over the purpose of basic research after witnessing all of these phenomenons. There is no doubt that the ultimate goal of basic research is servicing in clinical practices for the benefit of mankind.
Scientific reflections leadto the establishmentof Translational Medicine!
Translational Medicine is one of the hottest projects in the field of medicine in recent years. Elias Zerhouni, a researcher from US National Institutes of Health (NIH), published an article in Science about the Translational Medicine in 2003. After that, people all over the world began to pay high attention to translational medicine. J. Trans. Med, Sci Transl Med, Am J Translres and other journals about Translational Medicine appeared one by one, many well-known journals open new columns about Translational Medicine. Pubmed has collected more than seventy thousand articles about Translational Medicine. Numerous prestigious universities and research institutions in Europe have set up their Translational Medicine Research Centers nowadays.
What is the Translational Medicine? Academician Dai Kerong reasonably generalizes the definition and connotation of Translational Medicine. Translational Medicine, which is mainly related to two-way conversion process between basic medicine and clinical application, is a bridge between them, and also a cyclic scientific system. That is to say, new achievements of basic research would be applied to clinical sectors in a timely manner (including medical treatment, prevention, nursing and other aspects), provide diagnosis and treatment of diseases with more advanced measures and methods (bench to bedside), and feedback and revise timely in the clinical application, then transform to and promote the research of relative study (bedside to bench) continually, whose ultimate goal is to improve nation's healthy level.
The realization of Translational Medicine calls for a joint effort of the comprehensive team of translational medicine. This team is systematically composed of translational medicine centers or translational institutions, hospitals, prevention and healthcare institutions, community service institutions, pharmaceutical companies and other respective component organically. In a broad sense, translational research mainly refers to the research of two-way conversion between basic research and application area. The application of translational researches to medical field produced an emerging view--Translational Medicine.
There is a vivid
metaphor to explain the Translational Medicine, which it just likes
the bridge between basic research and clinical work. “Patients first” stays always in the center point; Problems are discovered and asked by the doctors in the clinical work and then lucubrated by basic-researchers. The basic scientific achievements from the basic research used for clinical application quickly. The Translational Medicine emphasizes the cooperation by the Key Project Group of serious subjects instead of single discipline and limited teamwork.
According to the spirit of "Xiangshan-Science Conferences(S13)"，the government puts forward the aim that prevention and curing of severe diseases and controlling of risk factors of health during the period of "Twelfth Five-Year Plan". Combined with the condition of Medical Transformation of our country, It should emphasize from several aspects: spreading the idea of medical transformation, establishing the platform, constructing professional group and running mechanism, promoting the transformation from the research result to the policy of health, noticing the idea of innovation and the study of original theory and drug of traditional Chinese medicine, thus accelerate the development of medical transformation in our country。
In some western countries, the development of Translational Medicine has already begun to take shape. Although late at the start line, Translational Medicine had made a fast development in China. The combination of medical colleges with science and engineering colleges, and establishment of comprehensive universities have been indirectly promoted the communication and cooperation of medicine with biology, psychology, science, mechanics, materials science, etc. Those contexts may help to found interdisciplinary teams and create more favorable environment and opportunities for the foundation of Translational Medicine center. At present, more than 30 research platforms of Translational Medicine have been established in the world. More and more researches related to Translational Medicine have been done by the cooperation among universities, scientific institutions, hospitals and biological pharmaceutical companies. A number of specialized Translational Medicine centers have also started to build.
However，we must be clearly aware that Translational Medicine, as a new concept, needs a long term to develop and improve. During this process, we must pay attention to gather all forces to the advantaged projects and platforms，give priority to foster and maintain these projects with developing foreground in a planned way, and also should avoid to indiscriminately spring up and build redundant projects. On the other hand, it is important to break through in the developing process by cooperating with government, research institutions and medical staffs.
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