1. Pathology Introduction Su Min Department of pathology Shantou University Medical College

2. Why should we study pathology? Students often ask me this question in the class I also have a question to ask you I also have a question to ask you Why did you come here? Why did you come here? The your goal is very clearly The your goal is very clearly want to be Medical Doctor! want to be Medical Doctor!

3. Severe Acute Respiratory Syndrome (SARS) make a surprise attack on people anybody could stand aside except medical staffers Quoted from 21cn.com

4. Cure Severe Acute Respiratory Syndrome (SARS) patient (extracted from 21cn.com) Angell: heal the wounded and rescue the dyingSevere Acute Respiratory Syndrome (SARS) Quoted from 21cn.com

5. Question Patients just want to know: Patients just want to know: What disease am I suffering from? How to cure it?

6. The key point of medical science To prevent To prevent To diagnose Disease To diagnose Disease To treat To treat ( Control) ( Control)

7. What is Pathology (Pathologia) Prefix: Path(pathos) means suffering, disease Postfix: Ology(logos) means study, science

8. The concept of pathology Pathology is the scientific study of disease.

9. The contents of pathology The contents of pathology   the causes (aetiology )   mechanisms (Pahogenesis)   pathologic changes: structural & funcional abnormalities   the descriptions of the manifestations   its progress and sequels.

10. 1. Causes of disease 1). Genetic factors (1) Abnormal the chromosomes and component genes Occur spontaneously (or without known cause); Occur spontaneously (or without known cause); In some cases, radiations, chemical or infective agents can be incriminated. In some cases, radiations, chemical or infective agents can be incriminated. (2) Susceptibility to some diseases Genetic polymorphisms among or between individuals, families, or races strongly influence susceptibility and resistance to disease Genetic polymorphisms among or between individuals, families, or races strongly influence susceptibility and resistance to disease

11. Quoted from Dr. T.M. Schroeder-Kurth congenital mentally retarded children

12. Quoted from Dr. Vogel. Motulsky Human Genetics

13. 2). Environmental factors (1) Physical agents. i. e. injury, radiations, extremes of heat or cold, electrical power… (2) Chemical poisons. Some act in a general manner, some act locally, and some exhibit a predilection for certain organs. (3) Nutritional imbalance (4) Abnormal immunological reactions. (5) Psychological factors

14. Although the causes of disease are divided into above two main groups, but both groups are interlaced in most disease.

15. 2. 2. Pathogenesis Means Mechanisms: Most are still investigating. Some of them should be known, for instance: Thrombosis Myocardial infarction

16. 3. Pathologic changes Naked eye level: Level A. Naked eye level: gross changes in diseased organs. gross changes in diseased organs. Light microscopic level: Level B. Light microscopic level: in histological and cytological level. in histological and cytological level. Electron-microscopic(EM) level: Level C. Electron-microscopic(EM) level: in the ultrastructure (cellular organelles). in the ultrastructure (cellular organelles). Molecular level: Level D. Molecular level: inspect aberrant in DNA, RNA, and protein. inspect aberrant in DNA, RNA, and protein.

17. 4. M 4. Manifestations Clinical significance: Clinical significance: The functional consequences of the morphologic changes. The functional consequences of the morphologic changes.

18. 5. 5. Progress and sequels Progress Progress simple intricate simple intricate short-term long-term short-term long-term Sequels Sequels healing healing un-healing: delay & complications un-healing: delay & complications spread even death spread even death

19. Investigation of disease In medical practice the objective of the study of disease is twofold. In medical practice the objective of the study of disease is twofold. To determine the nature of the disease for establishing a diagnosis. To control the extent and progress of the disease for treating.

20. The classification of pathology General pathology: A discussion of disease fundamentals oriented horizontally (nature of process). injury, repair, inflammation, neoplasia. Systemic pathology: A more detailed discussion of diseases oriented vertically. i. e. cardiovascular diseases, respiratory diseases, alimentary diseases, endocrine diseases, renal diseases, infectious diseases. e.g. What is the commonest disease in the clinic trachoma, common cold, gastritis, hepatitis,athlete's foot

21. The location and importance of pathology in medical education Pathology is a bridge between basic science and clinical medicine. All of the medical students have to stride over the bridge! Pathology is a bridge between basic science and clinical medicine. All of the medical students have to stride over the bridge!

22. Methods in pathology Autopsy: Autopsy: An examination of a dead body was done by cutting it open to discover the cause of death.

24. Biopsy

25. Quoted from CIBA COLLECTION MEDICAL ILLUSTRATIONS An examination of pathologic samples from living body to set up diagnosis

26. Cellular examination

27. Animal experimentation

28. Se-deficiency animal model National Natural Science Foundation of China (No. 30170832 ) Su Min, Zhang Rui- Juan et al.

29. Tissue and cell culture

30. One Newly Established esophageal carcinoma(EC) Cell Line CSEC-215 from EC patient in Chaoshan Region of China. Lu Shan-Ming, Su Min et al.

31. Neural stem cell National Natural Science Foundation of China (No. 30170832 ) Tian Dong-Ping, Su Min et al.

32. Immunohistochemistry and immuno- cytochemistry

33. Esophageal carcinoma E-cad + in membrane Wu Ming-Yao et al. GFAP+ in cytoplasm of neuroglia cell. Tian Dong-Ping, Su Min et al. Fos+ in nucleus

34. Electron microscopic examination

35. Atypia of tumor cells(Pleomorphism of nuclei) in CSEC-215 generation 13 EM×3000

36. Confocal laser scanning microscopic examination

37. neuron nuclear division DNA content Confocal laser scanning microscopy three-dimensional

38. In situ hybridization In situ hybridization

40. Chromosome analysis & Gene clone

42. Biochip

44. History and development of pathology Humoral Pathology Hippocrates (460-377 BC)

45. History and development of pathology Organ PathologyMorgagni (Italian,1682-1771 DC)

46. History and development of pathology CellularPathologyVirchow (German, 1882-1902 DC)

47. 胡正祥 教授 （ 1896-1968 ） 梁伯强 教授 （ 1899-1968 ）

48. Modern Pathology (1920S-) Ultrastructural Pathology Molecular Pathology Immunopathology Genetic Pathology

49. How to study pathology Summary Students should pay a more attention to following six aspects: lots of concept is basic processes of studying pathology. Concepts to master: lots of concept is basic processes of studying pathology. Cause(why) + Location (where) +Change(what) Cause(why) + Location (where) +Change(what)

50. Diseases Pathology Clinical Practice Variations of structure function outside normal range (1) Causes (aetiology) (2) Mechanisms (Pathogenesis) (3) Pathological changes (4) Manifestations (5) Progress and sequels Diagnosing disease Treating disease Preventing disease

51. MAIN REFERENCE 1. Alasdair D. T. Govan, Peter S. Macfarlane, Robin Callander. 1. Alasdair D. T. Govan, Peter S. Macfarlane, Robin Callander. Pathology Illustraed. Churchill livingstone, 1981. Pathology Illustraed. Churchill livingstone, 1981. 2. 2. Robin A. Cooke, Brian stewart. Colour atlas of Anatomical Pathology. Churchill Livingstone, 1995 Colour atlas of Anatomical Pathology. Churchill Livingstone, 1995 3. 3. Ramzi S. Cotran, Vinay Kumar, Tucker Collins. Pathologic Basis of Disease. 7 th.W.B. Saunders company. 1999. Pathologic Basis of Disease. 7 th.W.B. Saunders company. 1999. 4. 4. Vinay Kumar, Ramzi S. Cotran, Stanley L. Robbins. Robbins Basic Pathology. W.B. Saunders company, 2003 Robbins Basic Pathology. W.B. Saunders company, 2003 5. 5. Michael F. Dixon. Aids to Pathology 2 th. Churchill Livingstone, 1981. 6. 6. Su Min et al. GRAPHIC PATHOLOGY(in Chinese). Shantou University Medical College. 2001 Shantou University Medical College. 2001 7. Shantou University Medical College 7. Shantou University Medical College Pathologic teaching net http://202.192.145.9:95/ Pathologic teaching net http://202.192.145.9:95/

52. Examination 1. Practice: specimens oral test description + diagnosis description + diagnosis 2. Paper: national test base bank 2. Paper: national test base bank

54. Apple tree and Newtonian the law of gravity