[ Abs tract] Since entering of 21st Century,two paradigm shifts have been achieved in medical science.The first is the birth of translational medicine, and the second is precision medicine.The translational medicine improves the collaborations among the basic scientist, clinician, academy and pharmaceutical enterprise, which pushes forward translations from basic scientific discovery to clinical application.However, focusing on regulatory approval as only goal and criteria, the effect of transla-tional medicine practice was far from satisfactory, and effective rate of most products are less than 50%in real world.Besides failure to bring in true values to patients, some new translated products add extra burden to the society, and in this case, the major beneficiary is pharmaceutical compa-nies.It is not surprised that the conclusions generated by clinical studies tends to be obscure, and sometimes, even misleading if the translational studies are based on inaccurate diagnostic criteria, arbitrated disease staging and evaluation system.It is time to reconsider the rational goal of transla-tional medicine.Instead of targeting at regulatory approval only, we should redefine the disease based on its molecular driver and underline mechanism.A new classification of disease needs to be developed by building a knowledge network for biomedical Research.Through multidisciplinary colla-borations, the precision medicine, i.e.precise prevention, precise diagnosis, precise staging and precise evaluation of disease is pursued.Therefore, precision medicine is the ultimate goal of transla-tional medicine, evidence based medicine is the tool for practice of translational medicine, and translational medicine is the pathfinder for realization of precision medicine.%进入21世纪，医学领域有两大理念革命诞生，第一个是转化医学，第二个是精准医学。转化医学促进基础研究科学家、临床医生、学院及药企合作，将研究成果向临床应用转化。但是，以药品及医疗器械注册为目标的转化医学运动，并没有达到预期效果，即使实现了注册获批，多数药品在真实世界的临床疗效也不超过50％。许多转化成果仅仅是给医药企业带去经济效益，而为患者创造的价值有限，甚至给社会增加了负担。究其原因发现，基于对疾病模糊的诊断、模糊的评估、模糊的分期、模糊的预后而开展的基础及临床转化医学研究成果，无法实现对疾病100％有效控制、无法实现治愈、无法实现患者利益的最大化。因此，必须思考转化医学新的目标。精准医学（ precision medicine）的真谛是从分子生物学本质思考疾病，依据驱动因子（ molecular driver）将疾病重新分类，以驱动因子为靶向，寻找并验证治疗手段，在精准诊断的基础上，实现对疾病精准的评估、精准分期及精准治疗。实现对疾病的重新分类，需要利用循证医学手段，基于系统生物学理念，建立个人信息港，结合生物学样本，形成健康大数据体系。不难理解，精准医学是医学科学的最高境界，转化医学应该以精准医学为目标。而实现精准医学的过程，需要基础研究和临床的结合，医学、社会学、环境学、现代信息技术跨学科的合作，政府、社区、家庭、企业的合力，推动研究成果向应用转化。因此，精准医学是转化医学的目标，循证医学是转化医学的手段，转化医学是实现精准医学的必由之路。
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