中國(guó)醫(yī)科大學(xué)病理學(xué)英文3課件

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歲，因“車禍左小腿疼痛活動(dòng)受限2小時(shí)“入院?；颊?小時(shí)前被車撞倒在地，當(dāng)時(shí)左小腿彎曲、疼痛，不能活動(dòng)。入院檢查：體溫37。C，脈搏100次/分，血壓90/60mmHg，左小腿腫脹，短縮，局部有壓痛，可觸及骨擦感，左小腿不能活動(dòng)。 B超：腹內(nèi)臟器未見異常。 實(shí)驗(yàn)室檢查：血常規(guī)、尿常規(guī)均正常。X線檢查： 左脛骨中下段1/3斜形完全性骨折，左腓骨上1/3骨折臨床處理：術(shù)后X線報(bào)告對(duì)位、對(duì)線尚可。術(shù)后一周再次復(fù)查，結(jié)果同前。一月后復(fù)查，對(duì)位、對(duì)線良好，見少量骨痂形成。牽引一月后改為石膏固定二月。術(shù)后三月復(fù)查：骨性骨痂形成骨折愈合過程組織病理學(xué)改變血腫形成：骨折斷端間形成血腫 血腫機(jī)化：幼稚結(jié)締組織含新生毛細(xì)血管，包圍并侵入血腫纖維及軟骨性骨痂形成 軟骨性骨痂及骨性骨痂形成 Masson染色 骨痂形成：軟骨細(xì)胞肥大，基質(zhì)鈣化，以軟骨內(nèi)化骨的方式成骨。 骨痂形成：軟骨性骨痂以軟骨內(nèi)化骨化的方式形成幼稚的編織骨 masson染色 骨痂形成：骨痂中新生骨為編織骨小梁表面為成