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Welcome to Pathophysio logy Contents of the lecture Introduction 1 2 Conspectus of Disease What is Pathophysiology? A subject to explore the rule of origin and evolution of diseases and the underlying mechanisms. Subjects involved in Pathophysiology All diseases seen in all clinical departments  All diseases reproduced in animal models  Differences from Physiology      Physiopathology Physiology of Disease Clinical Physiology Medical Physiology Physiology of Disordered Function Physiology under diseased situation Differences from Pathology  “Pathology” emphasizes the structural changes  pathophysiology deals with functional and metabolic alterations and the mechanisms. The Methodologies Used in Pathophysiology As a subject, the experiments are assigned in systemic or organic levels.  Animal study  Clinical observation  Epidemiological study For scientific research, studies in cellular and molecular levels are required. Why Is Pathophysiology Important? An essential introduction to clinical medicine.  A bridge: basic medicine and diseases.  Enables us to understand why and how diseases develop and various clinical manifestations appear.  What are the underlying mechanisms, and in so doing devise rational therapeutics.  How Pathophysiology is Arranged? Introduction: what pathophysiology is and what disease is.  Fundamental pathological processes: fluids and electrolytes imbalance, acid and base disturbances, stress, fever, edema, ischemia and reperfusion, shock, multiorganic dysfunction, and hypoxia.  Fundamental pathological processes Some common and whole set alterations in metabolism, function and structure, which may appear in different disorders How Pathophysiology is Arranged? (cont.) Organic pathophysiology: heart, lung, liver, kidney and brain  Cellular and molecular pathophysiology: signal transduction and diseases and cell apoptosis in diseases  Major Points in Learning Pathophysiology The general concepts  The etiology and pathogenesis  The alterations of metabolism and function  The principles for prevention and therapies  How to Learn Pathophysiology    Grasp the major points: causes, pathogenesis, alterations in metabolism and functions Use dialectical thinking and methods, such as views of contradictory and unification, transformation, etc. Selectively review related knowledge learned previously, such as physiology, biochemistry, molecular biology, immunology, pathology, and so on. How to Learn Pathophysiology   Pay attention to experimental courses Pay attention to clinical practices Disease Concept of Disease  Aberrant manifestation of deregulated homeostasis caused by harmful agents.  The development of a disease is a pathologic process with a characteristic set of signs and symptoms involved in the whole body or any of its parts. Concept of Health  The state of the organism when it functions optimally without any evidence of disease.  The definition of health from WHO: Without any evidence of disease, and a state of complete well-being physically, socially and psychologically. Etiology of Disease  Etiology is to study the causative agents, microorganisms, environmental, social factors and personal habits as contributing factors that cause diseases.  Answer the question why disease happens. Etiology Dis-beneficial (Inducer) (+) Healthy body Pathogen Diseased body () Beneficial Pathogeny: causes disease and endue the characteristics of the diseases Etiological Factors 1. Extrinsic Factors  Biological agents: microorganisms and parasites: Roup virus  Chemical agents: non-specific and specific  Physical agents: mechanical injuries, extremes of temperature, electricity, and radiation  Nutritional imbalance: excesses or deficiencies 2. Intrinsic Factors  Genetic factors: gene mutation, sickle cell anemia, colorblindness  Congenital factors: abnormal embryonic developmental error  Immunological factors: the immune response is deficient or inappropriately strong or misdirected.  Psychological factors: Anxiety, strong or persistent psychological stress, such as hypertension, peptic ulcer, coronary heart disease, and depression. Predisposing factors     Genetic constitution Physiological diathesis Psychological characteristics Psychological characteristics Basic Mechanisms for Disease  Neural regulations  Hormonal regulations  Organic regulations  Cellular regulations  Molecular regulations General rules for the onset and development of diseases (1) (2) (3) (4) Disruption of homeostasis Process of damage and anti-damage Reversal role of cause and result Correlation between systemic and local regulations Radiation Trauma Microbe Monocyte Detoxification Carcinoma Physic barrier Coagulation Stress Eyewinker Teratologic Inflammation Immunoreaction Pyrogen Stressor Process of damage and anti-damage Reversal rule of cause and result (-) (+) Primary causes Further alterations Responses Secondary alterations (cause) Systemic and local regulations  Interact and restrict each other  Learn to grasp the key Outcome of Disease Recovery Complete recovery Incomplete recovery Outcome of a disease Death Phases of Diseases 高潮 序曲 前奏 尾声 Clinic symptoms Disease Prodrome Latency Recovery Death  The body as a whole stop working forever  Brain dearth is the marker for the diagnosis Brain Death (WHO criteria) Cessation of spontaneous respiration Irreversible coma Absence of cephalic reflexes Dilated or fixed pupils Absence of any electrical activity of the brain  Absence of brain blood flow      Significance for diagnosis of brain death  In favor of recording the time of death  Define the time to terminate for the rescue  In favor of organ transplantation