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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