Transcript 绪论 - 南通大学医学院：：《病理学》课程网站

Pathology
Nantong Medical College
Chen Li
Introduction to pathology
The role of pathology in medicine
Pathology is the study of disease by scientific methods.
Pathology is a discipline bridging clinical practice and
basic science;
pathologists are doctors who are concerned primarily
with the study of disease in all it aspects, that is,
causation diagnosis, pathogenesis, mechanisms, natural
history, anatomic and biochemical features, progression,
and prognosis.
The content and task of pathology
The object of pathological study aim at
diseases.
What is disease?
Disease may be identified as an abnormal
variation in the morphological, structure and
function of any part of body. In other words, a
disease is a normal condition of body caused
a loss of normal health (dis-ease)
• Old adage that pathologist are doctor’s
doctors and consultants with specialized
knowledge that can be helpful to the
clinician who is caring directly for the
patients.
• Pathology is the foundation of medical
science and practice. Without
pathology ,the practice of medicine would
be reduced to myths and folk.
Each separated name disease
characterized by a distant set
features. including:
is
of
Etiology: The cause of a disease
Pathologenesis: The mechanism causing the
disease
Pathological and clinical manifestations: The
structure and functional features of the disease
Complication and sequelae: The second,
systematic or remote consequence of a disease
Prognosis: The anticipated course of the disease
in terms of cure, remission, or fate of the patient
Epidemiology: The incidence and population
distribution of a disease
Pathology focuses on four aspects of disease:
(1) Its cause (etiology)
(2) The mechanism of its development (pathogenesis)
(3) The structural alterations induced in cells and tissues
(morphology)
(4) The functional consequences of the morphologic
changes, as observed clinically.
Modern pathology has some major subdivisions:
(1) Histopathology. The investigation and diagnosis of disease from the
examination of tissues
(2) Cytopathology. The investigation and diagnosis of disease from the
examination of isolated cells.
(3) Haematopathology. The study of disorders of the cellular and
coagulable components of blood.
(4) Microbiopathology. The study of infectious diseases and the
organisms responsible for them.
(5) Immunopathology. The study of the specific defence mechanisms of
the body.
(6) Chemical pathology. The study and diagnosis of disease from the
chemical changes in tissues and fluids
(7) Genetics pathology. The study of abnormal chromosomes and genes,
those influence on the disease.
(8) Toxicology pathology. The study of the effects of known or suspected
poisons.
(9) Forensic pathology the application of pathology to legal purposes (e.g.
investigation of death in suspicious circumstances).
Pathology includes two major parts
General Pathology is the study of the basic principles of
pathological processes involved in disease (e.g. congenital versus
acquired diseases, inflammation, tumor, and degeneration);
Systematic pathology in the study of structure and functional
abnormalities of a specific disease of body organs or system, such
as respiratory system (lung cancer), digestive system (appendities)
and so forth.
The methods of pathological research
Clinical Pathology
experimental Pathology
autopsy (A)
animal experiment
biopsy
cell culture .
(B)
cytology (C)
Clinical pathology
Clinical pathology is studying a patient's illness
which is based on the patient's history,
morphological manifestation and make a
diagnosis, and the treatment in clinical.
1. Autopsy
Autopsy (necropsy and postmortem examination are
synonymous) means to see for oneself.
The autopsy continues to have an important role.
Determine the cause of death
Make the accuracy of clinical diagnosis
Education of medical students and clinicians
Research into the causes and mechanisms of disease
Gathering accurate statistics about disease incidence
The autopsy rate has declined precipitously throughout
the United States.
2.Biopsy
Biopsy is often favored because it provides
generous amounts of tissue for diagnosis and may
itself afford sufficient surgical therapy for some tumors.
frozen sections
permanent sections
3.Cytology
Cytology is used for both screening and
diagnosing of lesions. This study of disease
processes involves cell smears from various
orifices (e.g., vagina, mouth, bronchus) of the
fine needle aspiration (FNA) of any mass of
lymph node.
All future clinicians should recognize that
modern pathologists cannot operate in a
vacuum, but must coordinate their
impressions with the clinical situation.
Experimental pathology
1.Animal experiment
The animal experimental methods are applied to
replicate some models of human disease in order to
investigate the etiology, pathogenesis, pathological
change and the results of the disease.
It is an important reference to human disease
2. Cell
culture
Cell cultures are widely used in research and
diagnosis. They are an attractive medium for
research because of the ease with which the
cellular environment can be modified and the
responses to it monitored.
Diagnostically, cell cultures are used to
prepare chromosome spreads for cytogenetic
analysis.
The method of pathological observations
Gross pathology
Light microscopy
Histochemistry
Immunohistochemistry
Electron microscopy
History of pathology
Humoral pathology
Ancient Greek
Organic pathology
Antonio Benivieni (1440-1502)
Giovanni Battista Morgagni (1682-1771)
Cellular pathology
Application of microscopy
Rudolf Virchow (1821 -1905)
Molecular pathology
Polymerase chain reaction (PCR)
Flow cytometry
• We are now entering an era in which it will
be more important to identify markers that
help to predict the response to new and
different therapeutic modalities.
• It has not yet reached standard practice but
promises a golden age for pathology in the
next decade.
陈莉，教授，硕士生导师，病理教研室主任，曾在中山医科大学
作为高级访问学者，多次赴香港、美国、韩国等地高访与进修。擅长
于肿瘤病理研究。近年来主持完成并通过省级鉴定的科研成果共8项，
其中《鼻咽癌中EBV、癌基因、抑癌基因的研究》课题、《皮肤鳞癌
研究》课题分别获00年、02年南通市人民政府科技进步一等奖。02年带
领病理学科成为江苏省一类优秀课程。03年被评为南通市师德典型。
学术团体任职：
1 中国抗癌协会肿瘤病理专业委员会委员
2 中国病理主任联会委员
3 中华医学会江苏省第四、五届病理专科委员会委员
4 中华医学会南通市医学会第六届常务理事
5 中华医学会南通市第三届病理专科学会主任委员
6 南通市抗癌协会第一届肿瘤病理专业委员会主任委员
7 南通市红十字会专家会诊中心特聘病理专家
8 南通市医学会医疗事故鉴定委员会特聘专家
9 交通医学杂志编委
10 南通医学院学科带头人