胸呼吸系统疾病基础与临床整合大纲

课程介绍 呼吸系统解剖学 呼吸系统组织学 胸呼吸系统正常生理 胸呼吸系统病理生理 胸呼吸系统药理 胸呼吸系统临床药理学 胸呼吸系统呼吸机能实验 胸呼吸系统病理 胸呼吸系统影像学 胸呼吸系统核医 胸呼吸系统疾病 胸呼吸系统疾病专科护理 胸呼吸系统疾病肺康复学 “胸呼吸系统疾病基础与临床”课程介一、课程基本信息英文名 学时：120（54.565.5） 课程 华西医院胸外科华西医院呼吸内科 华西医院呼吸与危重症医学科华西医院胸外科骨干教师：唐玉 生理学教研 黄 病生机能学实药理学教研室 陈道邦 解剖教研室 白红利华西医院放射科程德云华西医院呼吸科梁国鹏华西医院ICU 华西医院呼吸科华西医院胸外科严郁华西医院药剂科三、课程教学目的系统常见、多发疾病的与防治知识技能教学目标：巩固胸呼吸系统疾病的病史与体格检查技能；掌握本系统常见、统相关的影像学和检查结果判读能力。四、教学计划11188459663胸呼吸系统疾病专科护369336五、教学进度1 课讲14气体的、氧饱和度和氧解离曲44酸碱平衡指标及意义，血气1低氧血症的概念、4谢改变，低氧耐受及氧1功能、V/Q↑↓，呼吸衰竭2211实验/操作训4机能学2实验/操作训41后111实验/操作训1后实验/操作训1实验/操作训2实验/操作训13实验/操作训3像3像实验/操作训3 2312吸内3321吸内23212663633六、七、主要参考资8版人民卫生TheGlobalInitiativeforChronicObstructiveLungDisease(GOLD)TheGlobalInitiativeforGlobalInitiativeforChronicObstructiveLungDisease.GlobalStrategyforDiagnosis,Management,andPreventionofCOPD.[EB/OL]..November2008.GlobalInitiativeforAsthma.GINAReport,GlobalStrategyforAsthmaManagementandPrevention.[EB/OL]..December2007.朱元珏，陈文彬《呼吸病学。人民卫生八、成绩评成绩构成绩比考核方实验技能/书观察（大课、带习教师问题解决/（ClinicalAnatomyofRespiratory一、知识点与教学要(一 TheLungsandPleura肺和胸Master:1.Thestructuralcharacteristics,subdivisionsandreflectionsofthepleura,andtheconceptofpleurarecessesTheshapes,fissures,andsubdivisionsoftheThehilumofthelungandtherootoftheThesurfaceanatomyofthepleuraandthe掌握 1.胸膜的结构特点、分部与返折;胸膜窦的概Befamiliarwith:1.Theinnervationofthe2.Theactionofthepleuralandmainimportant熟悉：1.胸膜的神经分2.（二）Mediastinum纵Master:1.Thedefinitionofthemediastinum,andits2.Thegeneralprincipleofthedispositionofthecontentsofthesuperiorandposteriormediastinum掌握：1.纵隔的概念和分2.上、下纵隔中、结构的位BefamiliarThesubdivisionsoftheaorta,therelationshipsoftheascending,archanddescendingaortainthethorax.Thecourses,relationshipsofthethreelargebranchesofthearchoftheThecourses,relationships,anddistributionsofthebranchesofthedescendingaortainthethorax.Thepositionandimportantrelationshipsofthepulmonaryartery,anditsbranchesandligamentumarterosumTheposition,structuralcharacteristics,relationshipsofthetrachea,andtwomainbronchi，thevertebrallevelofthebifurcationofthetrachea主动脉的分部,Thedifferencesbetweenthetwomainbronchi（includingtheirdirectionofcourse, anglesformingwiththetrachea,andtherelationships）TheconceptsofthebronchialtreeandthebronchiopulmaonaryTheorigin,course,endingofthethoracicduct;anditscontentanddrainingThecoursesofthephrenicnervesinthethorax,andthestructuresdbyThecoursesandimportantbranchesofthetwovagusnervesinthethorax;thepositionandrelationshipwithaorticarchofleftrecurrentlaryngealnerveTheformationofthesympathetictrunk,thecourseandimportantbranches（greaterlessersplanchnicnerves）ofthesympathetictrunksintheThelocation,drainageofeachgroupofthethoraciclymphnodes,andtheirclinical胸腔淋的分群、位置、和临床意（三）DiaphragmMaster:Thedivisionofthediaphragmandthreeopeningsonthediaphragm,andstructurespassingthroughtheopenings掌握：Understand:1.theactionofthe2.Theweakareasonthediaphragmandlookbacktheirimportant了解：1.膈的运二、教学时数：1学时，大课讲授【classhour】1classhoursLecture:1classhours.三 四、参 实地解剖学.羊惠君主编,“十一五”国家级规划,人民卫生（HistologyofRespiratory知识点与教学要Master（掌握Teralstructureoftrachea,bronchusandlung.Thestructuralcharacteristicsandthechangingruleofconductingportionoflung.Thestructuralcharacteristicsofrespiratoryportionoflung.Thestructureandfunctionof2epithelialcelltypesofpulmonaryalveolus.Thestructureandfunctionofalveolarseptumandblood-airbarrier.befamiliaTheconceptofpulmonary熟悉：肺小叶的概Thecharacteristicsofpulmonaryblood了解：肺血循环的特学时1【classhour】1classhoursLecture:1classhours.三、高英茂、李和主编组织学与胚胎学（八年制．第二版．：人民卫生出 TextbookofHistology．第一版．：科学，2006成令忠、、蔡文琴主编现代组织学：科学技术文献（Respiratory一、识点与教学要Pulmonaryventilation:Respiratorymovement,intrapulmonarypressure,intrapleuralpressure;Elasticandcomplianceoflung,pulmonarysurfactantanditssignificance,airway;Tidalvolume,vitalcapacityandforcedexpiratoryvolume,functionalresidualcapacity;Pulmonaryventilationvolume,alveolarventilationvolume.Gasexchange:Factorsaffectinggasexchangeinlungs;PulmonarydiffusionGastransportinblood:Oxygencapacity,contentandsaturation;Oxygendissociationcurveofhemoglobinandfactorsaffectingit;TransportofCO2informsofbicarbonatesandcarbaminohemoglobin.Regulationofrespiratorymovement:Basiccenterinmedulla,potaxiccenterinponsandvoluntarycenterincerebralcortexforrespiratorycontrol;Chemoreceptorreflex;Pulmonarystretchreflex.肺换气和组织换气：影响肺换气的因素，肺扩散容量气体：氧容量，氧含量，氧饱和度。血红蛋白氧解离曲线及其影响因素。二氧化碳的两种化学结合形式。befamiliarPulmonaryventilation:Changesofintrapulmonarypressureandintrapleuralpressureduringrespiration;Elasticandcomplianceofthorax,inertial,;Inspiratoryreservevolume,expiratoryreservevolume,residualvolume;alvoluntaryventilation;Deadspacesandtheireffects.Gasexchange:Principleofgasexchange;Processofgasexchangeinlungsandintissues;Factorsaffectinggasexchangeintissues.Gastransportinblood:ReversiblechemicalcombinationofO2withhemoglobin;Carbondioxidedissociationcurveandfactoraffectingit.Regulationofrespiratorymovement:Mechanismsofgenesisofrespiratoryrhythm;Proprioceptivereflex;Coughreflex;Sneezereflex.气体：氧与血红蛋白的可逆性结合，解离曲线及其影响因素呼吸运动的调节：呼吸节律的产生机制，本体感受性反射，咳嗽反射，喷嚏反射Functionsofrespiratorytract;Artificialventilation;Gastransportinphysicallydissolvedformanditsrelationtotransportinchemicallycombinedform;Respiratoryneuronsandgroupsofrespiratoryneurons.呼吸道的功能，人工通气，气体的物理溶解形式及其与化学结合形式的二、学时8【classhour】8classLecture:8class三、 泰主编．生理学（八年制．第二版．：人民卫生 泰主编．TextbookofPhysiology（英文：人民卫生，2008．GuytonAC,HallJE.TextbookofMedicalPhysiology,12thed,Saunders, 泰主编．生理学．第三版．：人民卫生 煜主编．生理学．：高等教育于英心主编医学生理学教学指导医学p139- 第一部分：呼吸衰竭（PathophysiologyofRespiratory一、知识点与教学要求Master:（1）conceptofrespiratoryfailure，classificationofrespiratoryfailure，etiologyandpathogenesisofrespiratoryfailure（2）consequencesofrespiratory（acid-baseandelectrolytesdisturbances,alterationofrespiratorysystem，circulatorysystem-corpulmonaleorpulmonalheartdisease，CNS-pulmonaryencephalopathy）（1）（2）熟悉内容Befamiliarwith:(1)concept，etiologyandpathogenesisofARDS；(2)alterationofkidneyanddigestivesystemofrespiratoryfailure了解内容Understand:Pathophysiologicbasisofpreventionandtreatmentofrespiratory二、学时：2学时【classhour2classhoursLecture:2classhours.三、教学内LecturingConceptandclassificationofrespiratoryConcept，etiology，pathogenesisandchangesofbloodgasesofrestrictiveConcept，etiology，pathogenesisandchangesofbloodgasesofobstructiveConcept，etiology，pathogenesisandchangesofbloodgasesofdiffusionEtiologyandchangesofbloodgasesofmismatchingofV/Q(venousadmixture,deadspace-likeventilation)Conceptandetiologyoftrueshunt,differentiationoffunctionalshuntandtrueConcept,etiologyandpathogenesisofAcid-basedisturbancesandelectrolytedisturbancesinrespiratoryAlterationofrespiratorysysteminrespiratoryEffectofrespiratoryfailureoncirculatorysystem(conceptandpathogenesisofcorpulmonale)CNSalteration（conceptandpathogenesisofpulmonaryAlterationofAlterationofdigestivePathophysiologicbasisofpreventionandtreatmentofrespiratory授课内弥散的概念、原因及血气变化特点呼吸衰竭时循环系统变化（肺源性心脏病的的概念及机制呼吸衰竭时中枢神经系统的变化（肺性脑病的概念及发生机制重点英文词respiratoryfailure，externalrespiratory，restrictivehypoventilation，obstructivehypoventilation，diffusiondisorder，mismatchingofV/Q，functionalshunt，venoussyndrom（ARDScorpulmonale(pulmonalheartdisease，pulmonaryencephalopathy呼吸衰竭，外呼吸功能，限制性通气不足，阻塞性通气不足，弥散，V/Q失调，（ARDS四、《病理生理学》规划8年制7年制李桂源主编人民卫生2010，8（2版。KaufmanPA，2002，1(英文影印版)第二 ysisofbloodMaster（1）conceptbalance（2）conceptandindexandclassificationofhypoxia；（3）judgmentofrespiratoryfailure（1）（2）（3）2．熟悉内容Befamiliarwith:etiologyofacid-basedisordersanddifferentiationofacid-basedisorders熟悉：酸碱平衡紊乱的病因及酸碱平衡紊乱的判了解内Know：judgmentofoxygendissociation二、学时：2【classhour：2classhoursLecture:2classhours.三、学内LecturingRelatedknowledgeofhypoxia（concept，indexandclassificationofregulationofacid-basebalance,laboratoryparametersofacid-basebalance,etiologyofsimpleacid-basedisordersysisof bloodgases：judgmentofrespiratorydysfunction，judgmentofrespiratoryfailure，judgmentof ODCoffset，judgmentofacid-basedisturbances．授课内容缺氧相关知识复习（缺氧概念、指标及缺氧类型等酸碱平衡紊乱相关知识复习（酸碱来源；酸碱平衡调节；指标，四种血气结果分析：呼吸功能的判断；呼吸衰竭的判断；氧离曲线偏移的断；酸碱平衡紊乱的判断重点英文词metabolicacidosis，respiratoryacidosis，metabolicalkalosis，respiratoryalkalosis,partialpressureofcarbondioxide(PaCO2),standardbicarbonate(SB),actualbicarbonate(AB),bufferbase(BB),baseexcess(BE)，hypoxia，oxygendissociationcurve（ODC，respiratoryfailure代谢性酸呼吸性酸代谢性碱呼吸性碱动脉血CO2分压(PaCO2)，（SB（AB（BB（BE（ODC，呼吸衰竭四、《病理生理学》规划8年制7年制李桂源主编人民卫生2010，8（2。五、参考1（7《临床病理生理学，，主编，人民卫生《Pathophysiology，，金惠铭主编，人民卫生《EssentialsofPathophysiology，KaufmanCE&MckeePA，中国协和医学，，2002，1(英文影印版)呼吸系统药物治（Respiratory第一部分：作用于呼（PartⅠ：Drugsforrespiratorysystem）(一)β2受体激动剂的作用、临床应Anti-asthmaticSympathomimeticagents:mechanism,action,andclinicuses;Selectivieβ2receptor:mechanism,action,andclinicuses;Theophylline:mechanism,action,andclinicSodiumcromoglycate:mechanism,action,andclinicuses;Glucocorticoids:mechanism,action,clinicuses,andadversereaction.Antitussives:mechanism,classification,andclinicuseExpectorants:mechanism,classification,andclinic(二)β2受体激动剂的不良反应。BefamiliarwithAnti-asthmaticSympathomimeticagents:pharmacokineticproperty,adversereaction;SodiumCromoglycate:pharmacokineticproperty,adversereaction;Theophylline:pharmacokineticproperty,adversereaction;AntimuscarinicDrugs:mechanism,action,andclinicuses;Ketotifen:thesecondgenerationofH2-receptorantagonist.Thecomponentsofcommonusedagentofantitussivesandexpectorants.H1受体拮抗剂酮替芬在哮喘中的应用了解抗IgE单克隆抗体在哮喘治疗中的应用ThepropertyofTheLeukotrienePathway;Pharmacologicalpropertyofotheragents:Calciumchannelblockers,Nitricoxidedonors,Potassiumchannelactivators,Anti-IgEmonoclonalantibodies二、教学时数：大课讲授2学【classhour：2classhoursLecture:2classhours.三、专业词汇Antiasthmatic福Membrane倍氯MuscarinicmIpratropiumSympathomimeticLeukotrieneAmine四 主编.药理学（八年制．第二版．：人民卫生Goodman&Gilman'sManualofPharmacologyand五、参考资料杨宝峰主编.药理学.第七版．：人民卫生BertramGKatzungBasicandClinicalPharmacology）版，2009（全文可 林源、李胜男主编FundamentalMedicalPharmacology（2版）—高等医科院校双语教学基础医学英文版系列书，吉林科学技术，2008MITNationalAsthmaEducationandPreventionProgram---expertPanelReport3,GuidelinesfortheDiagnosisandManagementofAsthma.MIT开放式课程,药理学原理 中华医学会呼吸病学分会哮喘学组,支气管哮喘防治指南.（支气管哮喘的定义、、治疗和管理方案）,2008第二部分：抗结核药（PartII：Antimycobacterial一、知识点与教学要求（Goalsandobjectives）、掌握常用抗结核病药物的分类：一线药物：异烟肼、链霉素、乙胺丁醇、、掌握的药理作用、作用机制、临床应用以及不良反应Thecommonusedagent:the-lineagents:isoniazid(INH),rifampin(rimactane),streptomycin,ethambutol,pyrazinamide;thesecond-lineagents:amikacin(amikin),aminosalicylicacid,capreomycin,ciprofloxacin(cipro),cycloserine,ethionamide,ofloxacin(floxin)Mechanism,action,clinicuses,andadversereactionofisoniazid,rifampin,streptomycin.Mechanism,action,andclinicusesofethambutol,andpyrazinamide.(二)熟悉异烟肼、的体内过程BefamiliarPharmacokineticpropertyofisoniazid,rifampin(rimactane),streptomycin.Usageprincipleofanti-tuberculosisagent.二、教学时数：大课讲授1学【classhour：1classhoursLecture:1classhours.三、专业词汇 mycolicacid Antimycobacterialdrugs LineDrugs SecondLineDrugs Isoniazid(INH) Rifampin(Rimactane) growingmycobacteria non-growingmycobacteria 期结核菌 吡嗪酰 乙胺丁四、主编.药理学（八年制．第二版．：人民卫生Goodman&Gilman'sManualofPharmacologyand五、参考资料杨宝峰主编.药理学.第七版．：人民卫生BertramGKatzung.BasicandClinicalPharmacology）版，2009（全文可 林源、李胜男主编.FundamentalMedicalPharmacology（2版）—高等医科院校双语教学基础医学英文版系列书，吉林科学技术，2008MITNationalAsthmaEducationandPreventionProgram---expertPanelReport3,GuidelinesfortheDiagnosisandManagementofAsthma.MIT开放式课程, 中华医学会呼吸病学分会哮喘学组,支气管哮喘防治指南.（支气管哮喘的定义、、治疗和管理方案）,2008。（ClinicalPharmacyofRespiratory（一）（二）呼吸系统特色治疗方式——（三）1、ProgressintheRespiratorySystemDrugs2、InhalationTherapy3、ReasonableApplicationofRespiratory二、学时数：1学【classhour：1classhoursLecture:1classhours.三、教学内容（一）1抗炎平喘药物：糖皮质激素的新进展：吸入型糖皮质激素支气管扩张药：β受体激动新进展：高选择性β2受体激动剂 碱类药物新进展：多索茶碱、磷酸二酯酶4抑制剂胆碱能M2（二）呼吸系统特色治疗方式——（三）13、药物所致肺损害（简略LearningTheprogressofthefollowingdrugs：InhaledCorticosteroids、Selectivieβ2receptor、Anti-Cholinergic、Theophyllin、LeukotrieneReceptorAntagonistsandExpectorants.TheadvantageofInhalationTherapyandthetypeofInhalationReasonableapplicationofRespiratorydrugs：Guideline mendations；FDAsafetyinformationupdate；Druginducedlungdamagelong-actingβagonists(LABAlong-actinganti-inhibitrapplication,InhalationTherapy五、参

4,18版人民卫生2、TheGlobalInitiativeforChronicObstructiveLungDiseaseGOLD20113、TheGlobalInitiativeforAsthma（GINA）2010（FunctionalScienceinRespiratory实验Ⅰ：急性肺水肿（ExperimentⅠ：AcutePulmonaryEdemaand一、知识点与教学要求Master（1）Pathogenesis（2）Classificationandcharacteristicsofhypoxia（hypotonichypoxia，hemichypoxia，circulatoryhypoxia,histogenoushypoxia掌握（1）急性肺水肿的发生机制Befamiliarwith: (1)Observationmethodofthechangesofacutepulmonaryedemainrabbitmodel；（2）Changesofrespiratorysystemandcolorofskinandmucousmembraneinhypoxiamouse.熟悉（1）家兔急性肺水肿模型的观测方法（2）Understand:（1）ReplicamethodofacutepulmonaryedemainReplicamethodsofhypoxiainmouse：atmospherichypoxia；COintoxication;nitritepoisoning,KCNintoxication；Effectofcentralnervoussystem(CNS)status(caffeine,wintermin)andoutsidetemperatureonanoxiatolerance；Treatmentmethodsofnitritepoisoning:methyleneblue了解（1）家兔急性肺水肿模型的方法小鼠缺氧模型的方法：大气性缺氧，CO，亚硝酸盐；亚硝酸盐的方法：亚甲蓝治疗。二、教学时数：4学时【classhour】4classhoursPractice:4classhours三、实验内Experiment（1)Replicationandobservationofacutepulmonaryedemainrabbit：epinephrineinjectionviaearmarginalvein（2)Replicationandobservationofhypoxiainatmospherichypoxia：toreplicateatmospherichypoxiainmouseandobservetheeffectofcentralnervoussystem(CNS)status(caffeine,wintermin)andoutsidetemperatureonanoxiatoleranceCONitritepoisoningandthetreatmentmethodofnitritepoisoning:methyleneblueKCN实验内家兔急性肺水肿模型的及观察：耳缘静脉注射肾上腺小鼠缺氧模型的及观CO亚硝酸盐：亚硝酸盐模型的及其方法：亚甲蓝治KCN四、《机能实验学，主编，高等教育五、参考资《病理生理学，规划（8年制，7年制李桂源主编，人民卫生社2010，8（2版），，《生理学》规 （8年制，7年制）主编，人民卫生，，《药理学，规划（8年制，主编，人民卫生（第一版实验Ⅱ：呼吸运动调节及急性实验性呼吸功（ExperimentⅡ：RegulationofRelatedFactorsonRespiratoryMovementandAcuteExperimentalRespiratoryFailure）一、识点与教学要求Master（1MechanismmovemntInhled othorax；Deadspace↑；Vagotomy; Electricalstimulationtothevagusnerve,ｅｔ（2）Pathogenesisofrespiratoryfailure:Ventilationdisorders（restrictivehypoventilationDifusion(V/Q)（1）塞性通气不足；弥散；V/Q失调等。Befamiliarwith:Replicamethodofrespiratoryfailurein熟悉：家兔呼吸衰竭模型的Understand（1）Methods(2)Puncturetechnicofpleural（1）（2）二、教学时数：4学时【classhour】4classhoursPractice:4classhours三、实验内ExperimentRegulationofrelatedfactorsonrespiratorymovement1）InhaledCO2↑ Deadspace↑：invalid↑5）Vagotomy6）ElectricalstimulationtothevagusReplicaandobservationmethodsofrespiratoryfailureinrabbit1）Obstructivehypoventilation：cliptrachealintubationRestrictive Permeabilitypulmonaryedema：10%glucosedrippedintotracheal实验内死腔样通气↑家兔呼吸衰竭模型及观10%葡萄糖四、《机能实验学，主编，高等教育五、参考资《病理生理学，规划（8年制，7年制李桂源主编，人民卫生社2010，8（2版），，《生理学》规 主编，人民卫生，，《药理学，规 （8年制 主编，人民卫生（第一版实验 肺功能的测一、识点与教学要

（Experiment1、掌握：主要检查项目，包括肺通能、换能、肺容量的临床意义Master:clinicalsignificationsofventilation,gasexchangeandlungFamiliarwith:theusualmethodsoflungfunctiontest.Clinicalsignificationsandassaymethodsofbronchialprovocationtestandbronchialdilationtest.3、了解：各个检查项目的测定原理，术前肺功能评估原则Understand:Thetheoryofdifferentassaymethodsforlungfunctions.Theprincipleofpreoperationassessmentofpulmonaryfunction.二、教学时数：4学【classhour】4classhoursPractice:4classhours三、实验内肺通能的测肺换能的测ExperimentEvaluationofpulmonaryventilationEvaluationofpulmonarygasexchangeEvaluationofpulmonaryysisofpulmonaryfunction四、参考资2《肺功能学――基础与临床 主编，科 ，2007，8（第1版一、识点与教学要求

Respiratory慢性支气管炎 机制和临床表现，的、病因、发病机制和分类，型的定义和Mastertheincidence,etiology,pathogenesis,morphologicalchangeandclinicalpresentationofchronicbronchitis；definitionandclinicalcourseofbronchieis；definition,pathogenesis,classificationandclinicalcourseofasthma；pathogenesisandclinicalpresentationofCorpulmonale；etiology,pathogenesis,classificationofponia；definitionandclinicalcourseofatypicalponia.；etiology,pathogenesisandclinicalcourseoflungcarcinoma.熟悉内容的大体形态学改变，大叶性和小叶性的区别（包括临床表现、影像学表显微镜下形态学改变，肺癌的组织学分类及各种类型的形态学特征（，、（健康状况差、发展中国家免疫抑制者的机会致病等）和继发结核的区（途径、病变部位、大体和显微镜下改变、影像学和结局；各种形式肺结核（n征、活化复发、空洞性、粟粒性、播散性或孤立性肺结核）的发病机制、形态学、临床表现和。，、Befamiliarwiththedefinitionofchronicbronchitisandemphysema；grossandmicroscopicmorphologicalchangesofemphysema；grossmorphologicalchangesofCorpulmonale；differencesoflobarponiaandlobularponia(bronchoponia)intermsofclinicalpresentation,radiographicpresentation,andclinicalcourse-prognosis(complications)；grossandmicroscopicmorphologicalchangesoflobarponiainhepatizationstage，lobularponiaaswellasinterstitialponia；classificationoflungtumorsonthebasisofhistologictypes；grossmorphologicalchangesoflungcarcinomaincludingsquamouscellcarcinoma,adenocarcinomasmalllungetiology,geographicaldistribution,histologictypes,clinicalpresentationandclinicalcourse-prognosisofnasopharyngealcarcinoma；etiologyandpathogenesisoftuberculosisintermsofpredisposingfactorsandepidemiologicfactors(poorlyhealthconditions,develocountries,opportunisticinfectionto promisedhost,ect)；differencebetweenprimary,secondaryforms(ageofhost,infectivepathway,localizationofthelesion,grossandmicroscopicchanges,radiographyandsequelae)oftuberculosis；pathogenesis，morphology，clinicalpresentation,anddiagnosisofpulmonarytuberculosisincludingGhoncomplex,reactivation,cavitary,miliaryanddisseminatedorisolatedorganforms.了解内容Understandthedifferencesofpanacinar(panlobular)emphysema,centriacinar(centrolobular)emphysemaandperiacinar(paraseptal)emphysemainthecontextofdefinition,clinicalbronchitisandemphysemausuallycoexist；grossandmicroscopicmorphologicalchangesofbronchie 二、教学时数：9学【classhour】9classLecture：4classhours；Practice:5class三、教学内授课内性、小叶性、间质性、型；肺癌；鼻咽癌；肺结核见习内COPD:chronicbronchiti，emphysema，Corpulmonale；asthma，bronchie onia：lobarp onia，lobularp onia，interstitialp onia；lungcancer；nasopharyngealcarcinoma；pulmonarytuberculosisCOPD:chronicbronchiti，emphysema，Corpulmonale；bronchieis；ponia：lobarponia，lobularponia，interstitialponia；lungcancer；nasopharyngealcarcinoma；pulmonarytuberculosis四、重点英文词汇（Keyglobetcigarettesquamousreid小叶型肺 (panlobular)全腺泡型肺periacinar (paraseptal)小叶周围型肺 barrelchest 代偿性过度interstitialemphysema Alpha1-α1-抗胰蛋proteolyticbacterialp细菌性grayred 支气管Atypical 型interstitial 间质性hyalinebronchogenicsquamouscellsmallcelllargecell结核分枝杆Epstein-acidfastEBcellmediated细胞介导免epithelioidLanghan’sgiant郎格罕巨细caseaousSecondaryMiliaryprimary“cold”night五、病理学(供8年制及7年制临床医学等专业)李甘编第2版人民生六、参考资RobbinsBasicPathology7thedition医学(ChestImaging：Mediastinumand一、知识点与教学要求Master：theimagingexaminationtechniquesforthemediastinumandthenormalappearancesofthemediastinumandlungonconventionalX-rayandCTtheX-rayimagingappearancesofbasicpathologicalchangesofthemediastinumand熟悉纵隔及肺的正常X线、CT熟悉纵隔及肺的基本病变的XMaster:thetypicalX-rayandCTimagingfeaturesof(1)lobarp onia,lobular onia,andinterstitial onia;(2)acuungabscess;(3)pulmonary(4)lungcancer.（5） PulmonaryEmbolism,(6) othorax,(7)掌握大叶性、小叶性、间质性、急性肺脓肿、肺结核、肺栓塞、肺癌、气胸、COPDXCT表现Understand：theX-rayfeaturesofbronchialforeignbody,traumaofthechest,andCTimagingfeaturesofbronchieis.了解支气异物及胸部的X线表现：了解支气管扩张的CT表现肺结核，肺肿瘤：性支气管肺瘤、转移癌，胸部外伤，纵隔肿瘤，急性肺栓【TeachingcontentsTheX-rayimagingexaminationtechniquesforrespiratoryThenormalappearancesofthemediastinumandlungonconventionalX-rayandCTThebasicimagingappearancesofbasicpathologicalchangesofthemediastinumandlung:pulmonaryaeis,pulmonaryemphysema,thebasicpathologicalchangesoflungparenchyma,thebasicpathologicalchangesoflunginterstitialsubstanceandthepathologicalchangesofpleura.Thecommonimagingappearancesofthemediastinumandlung:bronchieis,theforeignbodyoftracheaorbronchia.,ponia,pulmonaryabscess,pulmonarytuberculosis,pulmonaryneoplasm:primarybronchocarcinoma，metastaticcancer,traumaofthechest,primarycancerofthemediastinum,acutepulmonaryembolism,pulmonaryhypertention,corpulmonale,COPD,pothoraxandpleuraleffusion.三、重点英文词pulmonaryaeis,pulmonaryemphysema,pulmonaryexudation,consolidation,proliferation，fibrosis，pleuraleffusion(dissciotiveorlocalized),pothoraxandhydropothorax,pleuralthickening(adhesionorcalcification),bronchieis,lobarponia,sphericalponia，bronchoponia,pulmonaryabscess,pulmonarytuberculosis,primarybronchocarcinoma.四、教学学时：12学66【classhour】12classLecture：6classhours；Practice:6class五、医学影像学，周翔平主编，国家11.5规划，高等教育，2008年12月1版；2003125胸呼吸疾病核医（NuclearMedicineofRespiratorySystem）1、掌握内容Master:(1)Pulmonaryperfusionimaging(principle,indicationsandclinical(2)18F-FDGPET/CT(fluorin-18-deoxyglucose)pulmonarytumorimaging(principle,imageysisandclinicalapplication).，)2、熟悉内容Befamiliarwith:(1)Imagingprocedureandimageinterpretationofpulmonaryperfusion ventilationimaging.ClinicalapplicationsofV/QUnderstand:(1)Pulmonaryventilationimaging(principle,indicationsand (2)Gallium-67tumorimaging(principle,imageysisandclinical（1）像呢分析和临床应用。V/Q显像在其它疾病中的应用二、教学内容V/Q2．18F-FDGPET/CTGallium-67肿瘤显像(原理、图像分析和临床应用：V/QV/Qimaging(principle,indicationsandclinical18F-FDGPET/CT(fluorin-18-deoxyglucose)pulmonarytumorimaging(principle,imageysisandclinicalapplication).Gallium-67tumorimaging(principle,imageysisandclinicalSelf-study:applicationsofV/Qimaginginother三、重点英文词99mTc-MAA,macroaggregatedalbum,microspheres,Pulmonaryperfusionimaging，pulmonaryventilationimaging，Gallium-67tumorimaging，fluorin-18-deoxyglucose，18F-FDGPET/CT四、教学时数：3学大课讲授1.5学时；见.5学【classhour】3classLecture: classhours.Practie:1.5class五《核医学，匡安仁主编，国家十一五规划，高等教育，2008年6月第1、NuclearMedicineDiagnosisandTreatment.2、ClinicalNuclearMedicine。3、NuclearMedicine4、秩主编《临床核医学，人民卫生，2003年9月第2(Respiratory一、教学目的及要掌握内容：掌握哮喘的定义、发病机制、临床表现、及鉴别；掌握重症【ObjectivesMaster:thepathogenesis,clinicalmanifestations,diagnosisanddifferentialdiagnosisofasthma.Tomastertheclinicalmanifestationsand-aidprinciplesofsevereexacerbationsofasthma.Tomasterthetreatmentsandpreventionsofasthma.Familiarwith:thepharmacologicactionsandusagesofdrugsforUnderstand:therelationshipbetweenasthmaanditscausative二、教学时数：5学大数2学时，见习时数3学时【classhour】5classLecture:2classhours.Practice:3class三 教学内（一）（二）（三）病理改变（（四）临床表现：发作性呼吸的特点，主要的症状和体征支气管舒张试验X线检查、特异性变异原检查等。（六）和鉴别典型及不典型哮喘的标准鉴别（七）抗炎药物（控制或预防哮喘发作支气管扩张剂（缓解哮喘发作免疫疗法（为主（八）哮喘的教育与管理（为主（九）预后：(为主DefinitionandEtiologyandClinicalLabDiagnosisanddifferentialEducationandmonitoringofpatientswithasthma.(Self-prognosis.(Self-四、见习要哮喘的症状、体征及KeypointsforSymptoms,physicalsignsanddiagnosisofDiagnosisofatypicalasthma:bronchialprovocationtest,bronchialdialationtest,variationratioofPEF.stagesandgradesofcontrollevelsofTherapyandmanagementprocedureof五、重点英文词汇asthmawheezing,expiratorydyspneasilentchest,atypicalasthma,CVA(coughvariantasthma),bronchialprovocationtest,bronchialdialationtest,variationratioofPEF,SABA,LABA,bronchodilator.第二节： 一、教学目的及掌握内容：的定义、分类。社区获得性的定义，临床表现、标准，重症标准。社区获得性的治疗原则。医院获得性的定义。链球菌的发病机制、病理、临床表现、及治疗。：熟悉内容病原体检查方法社区获得性及医院获得性常见病原体；熟悉葡萄球菌、白杆菌、支原体的临床特点、和：了解内容：医院获得性的发病机制、临床表现、治疗及预防控制【ObjectivesMaster:thedefinitionandclassificationsofponia.Tomasterthedefinition,clinicalmanifestations,diagnosisstandardsandtreatmentsofcommunityacquiredponia(CAP).Tomasterthediagnosisprinciplesofseverepnemomia.Tomasterthedefinitionofhospitalacquiredponia(HAP).Tomasterthepathogenesis,pathologicalchanges,clinicalmanifestations,diagnosisandtreatmentofstreptococcusponia.Familiarwith:thelabtestsofpathogens.TobefamiliarwiththecommonpathogensofCAPandHAP.Tobefamiliarwiththeclinicalmanifestations,diagnosisandtreatmentsofstaphylcoccalponia,klebsiellarponiaandmycoplasmalponia.Understand:thepathogenesis,clinicalmanifestations,treatmentsandpreventionofHAP.二、教学时数2.5课堂讲授：1学时。见.5学【classhour】2.5classhourLecture:1hour,Practice:1.5三、教学内（一）的定义（二 的分类：解剖学分类，病程分类，病原体分类发病场所及宿主状态分类（三 ：病史及查体，影像学检查，病原学检查（四）社区获得性临床表现及：临 标准，病原 ，病情评估（包括重 标准（五）医院获得性（为主C)临床表现及d)：临床，病原学，病情评估（六）细菌性（为主a)链球菌b)葡萄球 白杆菌d)支原体【LecturingContentsDefinitionof Classificationsof Diagnosisof standardsandtreatments).HAP(definition,pathogenisis,clinicalmanifestations,labtests,diagnosisstandards,treatmentsandpreventions).[Self-study]Bacterialp onia(streptococcusp onia,staphylcoccalp klebsiellarp oniaandmycoplasmalp onia).[Self-study]四、见习要CAPHAPKeypointsfor diagnosisand differentialdiagnosisof Evaluatetheseverityof TreatmentprinciplesofCAPand五、重点英文词汇Ponia,ponitis,lobalponia,lobularponia,interstitialponia,CAP(communityacquiredponia),HAP(hospitalacquiredponia),HCAP(healthcareassociatedponia),bacterialponia,pococcusponia,streptococcusponia,staphylcoccalponia,klebsiellarponia,mycoplasmalponia.第三节：胸腔积液（pleural一 教学目的及要熟悉内容：病因及胸水中各项指标的临床意义。胸腔积液的及鉴别【ObjectivesMaster:Masterthedifferentialpointsbetweentransudateandexudate.Mastertheclinicalmanifestationsandtreatmentsoftuberculouspleuritis.Familiarwith:Etiologicalfactorsandtheclinicalsignificanceoftheindexwiththeeffusion.Tobefamiliarwiththediagnosisanddifferentialdiagnosis.Know:Pathogenesisandthetreatmentprinciplesofmalignantpleuraleffusionand二、教学时数3大课讲授1.5学时，见.5学时【classhour】 classLecture:1.5classhour.Practice:1.5class三 教学内（一）（二）（三）（五）和鉴别：胸液性质的鉴别：漏出液、渗出液、血性胸液。重点讲结核性胸腔积液与癌性胸水的鉴别。脓胸的。（六）【LecturingContentsEtiologyandpathogenesisofpleuralClinicalLaboratoryDiagnosisanddifferential四、见习要结核性胸膜炎的治疗KeypointsforTodifferentiateexudatefromdiagnosisandtreatmentoftuberculous点英文词汇pleuraleffusion,exudate,transudate,tuberculouspleuritisempyema,thoracentesis,biopsyofpleura,malignantpleuraleffusion. 一 教学目的及要【ObjectivesMaster:mastertheclassifications,clinicaltypes,clinicalmanifestationsandFamiliarwith:befamiliarwiththeetiologicalUnderstand:pathogenesisandpathophysiological二 教学时0.5（【classhour】0.5classhourforDept.ofrespiratorydiseases.(Treatmentsof othoraxshouldbeinstructedbysurgeonofDept.ofthoracicsurgery.)三、教学内（一）（二