中国医科大学病理学英文3课件

1、 CHAPTER Tissue repair1. RegenerationComplete regeneration:Incomplete regeneration: fibrous repair scarPhysiologic: cell renewingPathologic: cell injury regeneration一. Cell cycle and proliferative potential1. Cell cycle Interphase G1 (presynthetic) S (DNA synthesis) G2 (premitotic) Mitotic phase (M)

2、 Go : quiescent cells in a physiologic state 2.Types(1) Labile cells (continuously dividing C) Definition: continue to proliferate replacing destroyed cells aged cells(2) Stable (quiescent) cells: Definition: These cells not divide or at a very slow rate and undergo rapid division in response to inj

3、ury. Cell groups: Parenchymal cells of glandular organ: liver, kidneys tubuel epithelial. Mesenchymal cells: fibroblast, osteoblast(3) Permanent (nondividing) cells: Definition: no capacity of regeneration Cell groups: Nerve cells: Neurons destroyed are permanent lost replaced by the proliferation o

4、f glial C.Skeletal muscle cellsCardiac muscle cells2. Glandular epithelium:Base membrane intact restored cellBase membrane destroyed difficult Liver: Resected partly liver cell proliferation Necrosis of liver C, reticular framework intact : hepatocyte proliferation restore the structure Necrosis wid

5、ely, framework collapsed hepatocyte nodular regeneration, FT(二) Fibrous tissueFibroblast proliferation synthesis collagen derived from quiescent fibrocyte undifferentiated mesenchymal C(三) BV regeneration1. Capillary: EC budding proteolytic degradation of BM EC budding maturation of EC secrete colla

6、gen IV, laminin, fibronectin BM2. Large BV EC proliferation SMC CT proliferationRegeneration of capillary(四) Cartilage and bone tissue1. Cartilage: proliferation capacity (chondroblast)2. Bone: proliferation capacity (osteoblast)(五) muscle regeneration Muscle tissue: lower regenerative capacity Musc

7、le fiber spilt completely FTscar(六) Nervous tissue NC cant regenerate replaced by glial cell glial scarNevous fiber- schwann cell proliferation Granulation tissue Granulation tissue 二、Scar （一）Concept granulation tissue CT（二）MorphologyGross：contract, pallor, semitransparent tough less elasticity. LM：

8、 composed of collagen parallel fasciculi (hyaline change), less fibrous cells, and BVScar（三）effect and harm of scar 1benefits：filling the wound and ulcer, make tissue, organ intact;stronger resist pull；if lack of elasticityhernia.2disbenefit and harm:contractobstruction.conglutination.excess hyperpl

9、asia，hypertrophic scar (keloid). 三 wound healing:1.early change: an acute inflammatory process by the initial injury 2.contraction of wound3. proliferation of granulation tissue and formation of scar4. migration and regeneration of epithelium and other tissues2. types of wound healing1) Healing by f

10、irst intention (wounds with opposed edges) a clean, uninfected surgical incision2) Healing by second intention (wounds with separated edges) more extensive loss of cells and tissue, as occurs in infarction, inflammatory ulceration, abscess formation, and surface wounds that create large defects(二) b

11、one fracture healing 1. basic process hematoma formation：1-2days fibrous bone scab formation： 2-3days, granulation tissue form osteal bone scab: osblast osloid tissue calcium deposition woven bone osteal bone scab. rebuild or remodel: woven bone ply bone normal relationship normal struture. 2. facto

12、rs of affect fracture healing correct reposition timely firmly fixation timely take exercise early, keep local blood supply well.骨痂 NearthrosisCPC病例3王，男，12岁，因“车祸左小腿疼痛活动受限2小时“入院。患者2小时前被车撞倒在地，当时左小腿弯曲、疼痛，不能活动。入院检查：体温37。C，脉搏100次/分，血压90/60mmHg，左小腿肿胀，短缩，局部有压痛，可触及骨擦感，左小腿不能活动。 B超：腹内脏器未见异常。 实验室检查：血常规、尿常规均正常。X线检查： 左胫骨中下段1/3斜形完全性骨折，左腓骨上1/3骨折临床处理：术后X线报告对位、对线尚可。术后一周再次复查，结果同前。一月后复查，对位、对线良好，见少量骨痂形成。牵引一月后改为石膏固定二月。术后三月复查：骨性骨痂形成骨折愈合过程组织病理学改变血肿形成：骨折断端间形成血肿 血肿机化：幼稚结缔组织含新生毛细血管，包围并侵入血肿纤维及软骨性骨痂形成 软骨性骨痂及骨性骨痂形成 Masson染色 骨痂形成：软骨细胞肥大，基质钙化，以软骨内化骨的方式成骨。 骨痂形成：软骨性骨痂以软骨内化骨化的方式形成幼稚的编织骨 masson染色 骨痂形成：骨痂中新生骨为编织骨小梁表面为成