Xia Qiang（夏强） , PhDDepartment of PhysiologyRm C518, Block C, Research Building, Zhejiang University School of Medicine, Zijingang CampusTel: 88206417, 88208252Email: xiaqiang@zju.edu.cn

作为医学生，我们应该如何学习？传统的医学生现代的医学生

国内 国外

At an HMS graduation in the late 1940s, he said “…Half of what we have taught you is wrong. Unfortunately, we don’t know which half.”

Dr. Burwell was a cardiologist who specialized in circulation changes associated with heart disease. He is credited with bringing attention to obstructive sleep apnea syndrome. In 1944, while Dr. Burwell was Dean, women entered Harvard Medical School for the first time on an equal basis with men.

"It has been estimated that, from the beginning of civilization — 5,000 yearsago or more — until 2003, humanity created a total of five exabytes (billiongigabytes) of information. From 2003 to 2010, we created this amount every

twodays. By 2013, we will be doing so every ten minutes, exceeding within hoursall the information currently contained in all the books ever written.

So it isn't that we need more knowledge; it is that we need to distinguishbetween what we know and what we don't know, through what Firestein calls“controlled neglect”. Researchers must selectively ignore vast quantities offacts and data that block creative solutions, and focus on a narrow range ofpossibilities.

"To make discoveries, researchers need to look beyond the facts.”

Ignorance includes an important discussion about scientific errors and theirpropagation in textbooks. I admit that I passed one on in my last book, TheBelieving Brain (Times Books, 2011): I repeated as gospel the 'fact' that thehuman brain contains about 100 billion neurons. Firestein reports that it isactually around 80 billion, and that the number of glial cells is an order ofmagnitude smaller than most textbooks state.

The 'neural spike' recorded by neuroscientists as a fundamental unit of brainactivity, Firestein reminds us, is an artefact of our measuring devices andignores other forms of neural activity. Even the famous and widely printed'tongue map', which shows sweet flavours sensed on the tip of the tongue,bitter on the back and salt and sour on the sides, is wrong — the result of amistranslation of a German physiology paper. These and other errors arise as

aresult of our lack of scepticism towards the knowledge we have.”

课程面向对象——已经是成人的大学生成人学习的主要特点：

学习是有目的的 学习是自愿的 学习应当是主动的，不是被动的 应该设定清晰的学习目的和最后目标 需要反馈 应该提供思考的机会

21世纪医学人才的培养目标： 医学与自然科学、社会科学、生命科学越来越广泛的交叉渗透 现行的基于学科的课程体系无法适应社会对医学人才的需求

国际的： 世界医学教育联合会 1999年提出的《医学教育全球标准》 世界卫生组织和世界医学教育联合会 2001年联合提出的《本科医学教育国际标准》

国际医学教育专门委员会 2002年提出的《全球医学教育最基本要求》

国内的： 我国教育部卫生部 2008年联合提出的《本科医学教育标准》

基于学科的课程体系 通识、基础医学、临床医学“三段式” 以学科为主的教学模式

基于系统的课程体系 按照人体器官系统组织课程的教学模式

基于模块的课程体系 通常是根据器官系统或某一主题组织课程，综合了医学、人文社科、伦理等知识内容

以问题为中心的课程体系

Medicine is the art and science of healing. It encompasses a range of practices evolved to maintain and restore human health by the prevention and treatment of illness

The word medicine is derived from the Latin ars medicina, meaning the art of healing

The science of diagnosing, treating, or preventing disease and other damage to the body or mind (http://www.thefreedictionary.com/medicine)

Medicine is concerned with maintaining or restoring human health through its study, diagnosis, and treatment (http://www.bio-medicine.org/medicine-definition/Medicine/)

The Rod of Asclepius, with its single snake, is an ancient Greek symbol associated with medicine

医神之蛇杖 (rod of Asclepius)：一條蛇盤繞一根杖的，稱為醫神之蛇杖 (rod of Asclepius)。所說的醫神叫阿斯克勒庇奧斯，他是太陽神阿波羅的兒子。

赫密斯之杖 (caduceus)：兩條蛇之上有一對翼的，稱為赫密斯之杖 (caduceus)。赫密斯 (Hermes)是希臘神話裡神的信使，專管冶煉金術士。因為到了十六世紀末，煉金術士與醫學關係密切，赫密斯之杖漸漸地成為一些醫療組織採用的象徵。现代人将双蛇杖视为贸易和运输行业的象征，也象征著医学以及炼金术。

但專業醫療組織認為醫神之杖才是最正統的，而採用赫密斯之杖的多是醫療行業的商業組織。

蓝色生命之星交叉的六条臂象征着急救医疗系统的六大功能：发现、报告、反应、现场抢救、运输途中监护、转至院内救治

Basic sciences of medicine (基础医学 ): this is what every physician is educated in, and some return to in biomedical research

Medical specialties (专科 ) Interdisciplinary fields (跨学科领域 ):

where different medical specialties are mixed to function in certain occasions

Anatomy (解剖学 ) is the study of the physical structure of organisms. In contrast to macroscopic or gross anatomy, cytology and histology are concerned with microscopic structures.

Biochemistry (生物化学 ) is the study of the chemistry taking place in living organisms, especially the structure and function of their chemical components.

Biostatistics (生物统计学 ) is the application of statistics to biological fields in the broadest sense. A knowledge of biostatistics is essential in the planning, evaluation, and interpretation of medical research. It is also fundamental to epidemiology and evidence-based medicine.

Cytology (细胞学 ) is the microscopic study of individual cells. Embryology (胚胎学 ) is the study of the early development of organisms. Epidemiology (流行病学 ) is the study of the demographics of disease processes, and includes, but is not limited

to, the study of epidemics. Genetics (遗传学 ) is the study of genes, and their role in biological inheritance. Histology (组织学 ) is the study of the structures of biological tissues by light microscopy, electron microscopy

and immunohistochemistry. Immunology (免疫学 ) is the study of the immune system, which includes the innate and adaptive immune

system in humans, for example. Medical physics (医学物理学 ) is the study of the applications of physics principles in medicine. Microbiology (微生物学 ) is the study of microorganisms, including protozoa, bacteria, fungi, and viruses. Neuroscience (神经科学 ) includes those disciplines of science that are related to the study of the nervous

system. A main focus of neuroscience is the biology and physiology of the human brain and spinal cord. Nutrition (营养学 ) is the study of the relationship of food and drink to health and disease, especially in

determining an optimal diet. Medical nutrition therapy is done by dietitians and is prescribed for diabetes, cardiovascular diseases, weight and eating disorders, allergies, malnutrition, and neoplastic diseases.

Pathology as a science (病理学 ) is the study of disease—the causes, course, progression and resolution thereof. Pharmacology (药理学 ) is the study of drugs and their actions. Physiology (生理学 ) is the study of the normal functioning of the body and the underlying regulatory

mechanisms. Toxicology (毒理学 ) is the study of hazardous effects of drugs and poisons.

Surgery (外科学 ): "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in "General Surgery." General surgery (普通外科学 ) Trauma surgery (创伤外科学 ) Cardiovascular surgery (心血管外科学 ) Neurosurgery (神经外科学 ) Maxillofacial surgery (颌面外科学 ) Orthopedic surgery (骨科学 ) Otolaryngology (耳鼻喉学 ) Plastic surgery (整形外科学 ) Oncologic surgery (肿瘤外科学 ) Vascular surgery (血管外科学 ) Pediatric surgery (小儿外科学 ) Anesthesiology (麻醉学 )

Medicine (内科学 ): "Medicine" refers to the practice of non-operative medicine, and most subspecialties in this area require preliminary training in "Internal Medicine". Cardiology (心脏病学 ) Critical care medicine (危重医学 ) Endocrinology (内分泌学 ) Gastroenterology (胃肠病学 ) Hematology (血液病学 ) Hepatology (肝病学 ) Infectious diseases (感染病 ) Nephrology (肾脏病学 ) Oncology (肿瘤学 ) Proctology (直肠病学 ) Pulmonology (肺脏病学 ) Rheumatology (风湿病学 ) Sleep disorder (睡眠障碍 ) Neurology (神经病学 ) Geriatrics ( 老年病学 ) Pediatrics (儿科学 ) Family Practice (全科医学 )

Diagnostic specialties: Clinical laboratory sciences (临床检验学 ) are the clinical diagnostic services which apply

laboratory techniques to diagnosis and management of patients. In the United States these services are supervised by a pathologist. The personnel that work in these medical laboratory departments are technically trained staff who do not hold medical degrees, but who usually hold an undergraduate medical technology degree, who actually perform the tests, assays, and procedures needed for providing the specific services. Subspecialties include Transfusion medicine, Cellular pathology, Clinical chemistry, Hematology, Clinical microbiology and Clinical immunology.

Pathology as a medical specialty (病理学 ) is the branch of medicine that deals with the study of diseases and the morphologic, physiologic changes produced by them. As a diagnostic specialty, pathology can be considered the basis of modern scientific medical knowledge and plays a large role in evidence-based medicine. Many modern molecular tests such as flow cytometry, polymerase chain reaction (PCR), immunohistochemistry, cytogenetics, gene rearrangements studies and fluorescent in situ hybridization (FISH) fall within the territory of pathology.

Radiology ( 放射学 ) is concerned with imaging of the human body, e.g. by x-rays, x-ray computed tomography, ultrasonography, and nuclear magnetic resonance tomography.

Clinical neurophysiology (临床神经生理学 ) is concerned with testing the physiology or function of the central and peripheral aspects of the nervous system. These kinds of tests can be divided into recordings of: (1) spontaneous or continuously running electrical activity, or (2) stimulus evoked responses. Subspecialties include Electroencephalography, Electromyography, Evoked potential, Nerve conduction study and Polysomnography. Sometimes these tests are performed by techs without a medical degree, but the interpretation of these tests is done by a medical professional.

Other: Ophthalmology ( 眼科学 ) exclusively concerned with the eye and ocular adnexa. Combines

conservative and surgical therapy, and has its own College. Dermatology ( 皮肤科学 ) is concerned with the skin and its diseases. In the UK, dermatology is

a subspecialty of general medicine. Emergency medicine (急诊医学 ) is concerned with the diagnosis and treatment of acute or life-

threatening conditions, including trauma, surgical, medical, pediatric, and psychiatric emergencies.

Obstetrics and gynecology ( 妇产科学 ) (often abbreviated as OB/GYN) are concerned respectively with childbirth and the female reproductive and associated organs. Reproductive medicine and fertility medicine are generally practiced by gynecological specialists.

Palliative care ( 姑息护理 ) is a relatively modern branch of clinical medicine that deals with pain and symptom relief and emotional support in patients with terminal illnesses including cancer and heart failure.

Pediatrics (儿科学 ) is devoted to the care of infants, children, and adolescents. Like internal medicine, there are many pediatric subspecialties for specific age ranges, organ systems, disease classes, and sites of care delivery.

Physical medicine and rehabilitation (or physiatry) (物理医学和康复【物理疗法】 ) is concerned with functional improvement after injury, illness, or congenital disorders.

Psychiatry ( 精神病学 ) is the branch of medicine concerned with the bio-psycho-social study of the etiology, diagnosis, treatment and prevention of cognitive, perceptual, emotional and behavioral disorders. Related non-medical fields include psychotherapy and clinical psychology.

General practice, family practice, family medicine or primary care (全科医学 ) is, in many countries, the first port-of-call for patients with non-emergency medical problems.

Many other health science ( 健康科学 ) fields, e.g. dietetics (营养学 ) Bioethics (生物伦理学 ) is a field of study which concerns the relationship between biology, science,

medicine and ethics, philosophy and theology. Biomedical Engineering (生物医学工程 ) is a field dealing with the application of engineering principles to

medical practice. Clinical pharmacology (临床药理学 ) is concerned with how systems of therapeutics interact with patients. Conservation medicine ( 保护医学 ) studies the relationship between human and animal health, and

environmental conditions. Also known as ecological medicine, environmental medicine, or medical geology. Disaster medicine ( 灾难医学 ) deals with medical aspects of emergency preparedness, disaster mitigation

and management. Diving medicine ( 潜水医学 ) (or hyperbaric medicine) is the prevention and treatment of diving-related

problems. Evolutionary medicine ( 进化医学 ) is a perspective on medicine derived through applying evolutionary

theory. Forensic medicine (法医学 ) deals with medical questions in legal context, such as determination of the

time and cause of death. Gender-based medicine ( 性别医学 ) studies the biological and physiological differences between the human

sexes and how that affects differences in disease. Hospital medicine (医院医学 ) is the general medical care of hospitalized patients. Physicians whose primary

professional focus is hospital medicine are called hospitalists in the USA. Medical humanities (医学人文学 ) includes the humanities (literature, philosophy, ethics, history and

religion), social science (anthropology, cultural studies, psychology, sociology), and the arts (literature, theater, film, and visual arts) and their application to medical education and practice.

Medical informatics (医学信息学 ), medical computer science, medical information and eHealth are relatively recent fields that deal with the application of computers and information technology to medicine.

Nosology ( 疾病分类学 ) is the classification of diseases for various purposes. Preventive medicine ( 预防医学 ) is the branch of medicine concerned with preventing disease.

Community health (社区卫生 ) or public health is an aspect of health services concerned with threats to the overall health of a community based on population health analysis.

Occupational medicine ( 职业医学 ) 's principal role is the provision of health advice to organizations and individuals to ensure that the highest standards of health and safety at work can be achieved and maintained.

Aerospace medicine ( 航空航天医学 ) deals with medical problems related to flying and space travel. Osteopathic medicine (骨病医学 ), a branch of the U.S. medical profession. Pharmacogenomics (药理基因学 ) is a form of individualized medicine. Sports medicine (运动医学 ) deals with the treatment and preventive care of athletes, amateur and

professional. The team includes specialty physicians and surgeons, athletic trainers, physical therapists, coaches, other personnel, and, of course, the athlete.

Therapeutics (治疗学 ) is the field, more commonly referenced in earlier periods of history, of the various remedies that can be used to treat disease and promote health [1].

Travel medicine ( 旅行医学 ) or emporiatrics deals with health problems of international travelers or travelers across highly different environments.

Professions complementing physicians Nursing specialties (护理专业 ): specialties performed by Nurses. Mid-level practitioners (中级专业医师 ): performance of medical sciences by other certified people than physicians or nurses; Nurse

practitioners, practitioners of medical psychology, midwives and physician assistants, treat patients and prescribe medication in many jurisdictions.

Allied health professions ( 健康相关职业 ): a diverse set of clinical healthcare professions distinct from medicine and nursing. Urgent care (急救护理 ) focuses on delivery of unscheduled, walk-in care outside of the hospital

emergency department for injuries and illnesses that are not severe enough to require care in an emergency department. In some jurisdictions this function is combined with the emergency room.

Veterinary medicine ( 兽医学 ); veterinarians apply similar techniques as physicians to the care of animals.

基础医学： 人体解剖学、组织学和胚胎学、生理学、生物化学、微生物学、寄生虫学、免疫学、病理学、病理生理学、分子生物学、医学遗传学、药理学

公共卫生与预防医学临床医学 口腔医学中医学法医学护理学药学

Morphological courses: 人体解剖学、组织学和胚胎学、病理学

Functional courses: 生理学、病理生理学、药理学、生物化学、分

子生物学、免疫学Mixed courses:

医学遗传学、微生物学、寄生虫学

Morphological courses: Anatomy (解剖学 ) Histology and Embryology (组织学与胚胎

学 ) Pathology (病理学 )

Functional courses: Physiology (生理学 ) Pathophysiology (病理生理学 ) Pharmacology (药理学 )

Include the theoretical contents and corresponding laboratory contents of following courses: Anatomy (解剖学 ) Histology and Embryology (组织学与胚胎学 ) Pathology (病理学 ) Physiology (生理学 ) Pathophysiology (病理生理学 ) Pharmacology (药理学 )

Theoretical contents: 整合课程，解剖学、组织学与胚胎学、病理学、生理学、病理生理学、药理学的理论部分 Introduction to BMS (基础医学导论 ) BMS 1 (基础医学各论 1) BMS 2 (基础医学各论 2) BMS 3 (基础医学各论 3)

Laboratory contents: Morphological Practicals (整合实验课，人体形态学实验基础、

比较人体形态学 )(解剖学、组织学与胚胎学、病理学的实验部分。独立开课 )

Experiments of Physiological Sciences (整合实验课，生理科学实验 )(生理学、病理生理学、药理学的实验部分。独立开课 )

Systematic anatomy (系统解剖学 ) 是按人体的器官功能系统阐述正常人体器官的形态结构的科学

Regional anatomy ( 局部解剖学 ) 是按人体的某一局部或器官，重点描述人体器官的配布位置关系及结构层次等的学科

系统解剖学和局部解剖学主要通过肉眼观察来描述人体的形态结构，又称巨视解剖学 (Macroanatomy)

人体的分部：从外形上可分 10 个局部 头部 ( 包括颅、面部 ) 颈部 ( 包括颈、项部 ) 背部 胸部 腹部 盆会阴部 左、右上肢 左、右下肢

躯干部

Leonardo da Vinci (1452-1519) (Italian)

构成人体的基本单位是细胞（ cell）细胞与细胞间质共同构成组织（ tissue） 几种组织相互结合，组成器官（ organ） 两个或两个以上的器官及相关结构组合形成系统（ system）

多个系统组成整体的个体——人体（ human body）

人体的 9 大系统： 运动系统 (locomotor system ) 消化系统 (alimentary system) 呼吸系统 (respiratory system) 泌尿系统 (urinary system) 生殖系统 (reproductive system) 脉管系统 (vascular system) 感觉器 (sensory organ) 神经系统 (nervous system) 内分泌系统 (endocrine system)

组织学（ histology）： 是研究机体微细结构及其相关功能的科学 与解剖学的区别：组织学是在解剖学的基础上发展起来的▪ 解剖学：主要在系统和器官水平上研究机体的结构▪ 组织学：主要在组织、细胞、亚细胞和分子水平研究机体的结构

组织学的内容： 四大基本组织：上皮组织，结缔组织，肌组织，神经组织 各系统的组织学

胚胎学（ embryology）： 是研究从受精卵发育为新生个体的过程及其机制的科学，

包括生殖细胞的发生、受精、胚胎发育、胚胎与母体关系、先天性畸形等

胚胎学的内容： 人体胚胎发生：配子发生、受精和胚前期（受精后的前 2

周）发育，胚期（受精后 15-56 天）的发育，胎期（受精后第 9 周 -胎儿出生）的发育

各器官系统的发生

生理学（ physiology）： 是研究生物体及其各组成部分正常功能活动规律的一门科学

人体生理学 (human physiology)：是研究正常人体功能活动规律的科学（功能、机制）

生理学的内容： 细胞的基本功能 各系统的生理学

病理生理学（ pathophysiology）： 是一门研究疾病发生、发展、转归的规律和机制的科学（疾病中功能和代谢的变化）

病理生理学的内容： 疾病概论 细胞与分子病理生理学（细胞增殖分化凋亡异常、细胞信

号转导异常、基因异常） 基本病理过程的病理生理学（水电解质与酸碱平衡紊乱、应激、发热、缺氧、缺血 - 再灌注损伤、休克、肿瘤）

各器官系统的病理生理学

病理学（ pathology）： 是研究疾病的病因、发病机制、病理变化、结局和转归的科学（疾病的本质与发生发展规律）

病理学的内容： 普通病理学（细胞和组织的适应与损伤、损伤的修复、局部血液循环障碍、炎症、肿瘤）

各系统的病理学

药理学（ pharmacology）： 是研究药物与机体（包括病原体）相互作用及作用规律的科学▪ 药物效应动力学 (pharmacodynamics，简称药效学 )：主要研

究药物对机体的作用和作用原理▪ 药物代谢动力学 (pharmacokinetics，简称药动学 )：主要研究机体如何对药物的处理，包括药物的吸收、分布、生物转化和排泄

药理学的内容： 药理学总论（药物效应动力学、药物代谢动力学、影响药物作用的因素）

各系统的药理学

形态学学科 /课程： 解剖学，组织学与胚胎学，病理学

形态学的主要研究方法： 肉眼观察：包括进行尸体解剖和对标本进行观察 光学显微镜、荧光显微镜和电子显微镜观察：有

时需要制作相应的切片进行观察，免疫显微术等 X 线、计算机辅助 X 线断层扫描（ CT）、正电

子断层扫描（ PET）及磁共振（MRI）等

研究方法： 光学显微镜技术

HE染色，垂体远侧部 镀银染色，小脑皮质神经元

电子显微镜技术▪ 透射电镜术（ transmission electron microscopy）：用于观察组织细胞的超微结构▪ 扫描电镜术（ scanning electron microscopy）：用于观察组织细胞表面结构

透射电镜图，浆细胞 扫描电镜图，血细胞

显微切割术（microdissection ） :▪ 能从组织切片或细胞涂片上的任一区域内切割下几百

个、几十个同类细胞，甚至单个细胞，再进行如 PCR及比较基因组杂交等有关的分子水平的研究

组织化学术（ histochemistry）：为应用化学、物理、生物化学、免疫学或分子生物学的原理和技术，与组织学技术结合而产生，在组织切片显示某种物质的存在和分布状态▪ 一般组织化学术：组织中的某种结构成分与所加试剂发生化学反应、并呈现某种颜色，在显微镜下可观察到

▪ 免疫组织化学术（ immunohistochemistry）：根据抗原、抗体特异性结合原理，检测组织切片中的肽和蛋白质

▪ 原位杂交术（ in situ hybridization）：即核酸分子杂交组织化学术，检测基因（ DNA 片段）的有无、基因的表达活性（ mRNA）

PAS反应（过碘酸希夫反应，显示多糖和糖蛋白，呈紫红色），小肠上皮杯状细胞的黏原颗粒

免疫组织化学（荧光素标记），毛细血管内皮细胞呈 vWF阳性

免疫组织化学（辣根过氧化物酶标记），胰岛B细胞呈胰岛素阳性

原位杂交，主动脉平滑肌细胞呈弹性蛋白mRNA阳性

放射自显影术（ autoradiography）：通过活细胞对某种放射性物质的特异性摄入，以显示该物质在组织和细胞内的分布、含量和代谢过程，以反映细胞的功能状态

放射自显影，示幽门部胃小凹底的干细胞 （ 3H标记的胸腺嘧啶核苷标记）

原位多聚合酶链式反应技术（ in situ polymerase chain reaction, in situ PCR）：▪ 是将 PCR的高效扩增与原位杂交的细胞及组织学定

位相结合，在冷冻切片或石蜡包埋组织切片、细胞涂片或培养细胞爬片上检测和定位核酸的技术

比较基因组杂交技术（ comparative genomic hybridization）：▪ 是通过单一的一次杂交可对某一肿瘤全基因组的染色体拷贝数量的变化进行检查的一种分子细胞学技术

生物芯片技术（ biochip technique）：▪ 基因芯片（ gene chip）：又称 DNA芯片，是指在固相载体上的高密度的 DNA微点阵

▪ 蛋白质芯片（ protein chip）：又称蛋白质微阵列（ protein microarray），是在一个载体上高密度地点布不同种类的蛋白质，再用荧光标记的已知抗体或配体与待测样品中的抗体或配体一起与芯片上的蛋白质竞争结合，利用荧光扫描仪测定芯片上各点阵的荧光强度，再经计算机分析计算出待测样本结果

▪ 组织芯片（ tissue chip）：又称组织微阵列（ tissue microarray），是将数十个至数百个小的组织片排列在某一载体上而成的微缩组织切片

Fully Automatic DNA Testing System

Example of a DNA Chip for Infectious Disease Diagnosis

Detection of proteins using the magneto-nano protein chip

Tissue Microarray

形态学研究的定量术：▪ 形态计量术（morphometry）：运用数学和统计学

原理，对组织和细胞进行二维和三维的形态学测量研究。其中三维立体结构的研究又称体视学（ stereology）

▪ 显微分光光度术（microspectrophotometry）：是应用显微分光光度计测定标本中微细结构的吸收光度和荧光光度，以进行化学成分定量的技术

▪ 图像分析术（ image analysis）：应用图像分析仪进行形态计量和显微光度测量

▪ 流式细胞术（ flow cytometry）：应用流式细胞仪对单个细胞进行生物化学和生物物理特性的快速定量测定

流式细胞术

计算机三维重建，示肝小叶血管显微分光光度计

Granulocyte flow cytometry. Granulocytes are electronically selected (upper left plot: red R1 region), and analysed for expression of CD16, CD55 and CD66 cell-membrane proteins (lower dot-plots). Two cell populations are visible, a residual normal and the GPI-deficient PNH clone.

活体组织和活细胞研究方法：▪ 细胞培养术（ cell culture）： 把从机体取得的细胞在体外模拟体内的条件下进行培养▪ 组织工程（ tissue engineering）：用细胞培养术

在体外模拟构建机体组织或器官的技术

实验中的组织工程耳

活体组织和活细胞研究方法：▪ 活体染色（ vital staining）：是将无毒、无菌的燃料注入动物体内，组织或细胞选择性地摄取染料后，通过显微镜观察、鉴定组织细胞类型，研究其分布和功能等

▪ 细胞分离术（ cell isolation）：利用细胞的黏附性、大小、密度和特殊的表面标志等分离细胞▪ 差速离心法▪ 密度梯度离心法

台盼蓝染色

人体病理学的诊断和研究方法： 尸体剖检（ autopsy）：简称尸检，是对死者的遗体进行病理解剖和后续的病理学观察

活体组织检查（ biopsy）：简称活检，是用局部切取、钳取、细针穿刺和搔刮等手术方法，从活体内获取病变组织进行病理诊断

细胞学检查（ cytology）：通过采集病变处的细胞，涂片染色后进行诊断

机能学学科 /课程： 生理学，病理生理学，药理学

研究方法： 动物实验（ animal experiment）：采用正常动物或人类疾病的动物模型▪ 急性动物实验（ acute animal experiment）：▪ 离体实验▪ 在体实验

▪ 慢性动物实验（ chronic animal experiment ） :

慢性实验

急性离体实验

急性在体实验

人类疾病的动物模型（ animal model of human diseases）：是指生物医学科学研究中所建立的具有人类疾病模拟性表现的动物实验对象和材料。分为：▪ 自发性动物模型（ spontaneous animal model）：是指实

验动物未经任何有意识的人工处置，在自然情况下所发生的疾病。如自发性高血压大鼠（ spontaneous hypertensive rat, SHR）

▪ 诱发性或实验性动物模型（ experimental animal model）：是指研究者通过物理性、化学性和生物性致病因素作用于动物，造成动物组织、器官或全身一定的损害，出现某些类似于人类疾病时的功能、代谢或形态结构方面的病变，以供研究使用

Obese Rat and Normal Rat

Coronary heart disease

人体实验、临床观察或临床试验：▪ 正常人体数据采集和实验▪ 病人的临床观察、检查和实验研究▪ 临床药理学：研究药物与人体（健康志愿者和病人）

相互作用的规律

器官和系统水平细胞和分子水平整体水平

四川省北川县， 26岁的男子陈坚在废墟下等待援救，已经被埋了60 多个小时。 2008年 5 月 15日晚上 8 时，经过 7 个钟头的营救他被救出，但由于伤势严重没能活下来。

地震“挤压伤综合症”并发高血钾症

患者男，现年 52岁，在一家企业谋职。 7 月 18日上午，患者因感觉身体不适，并伴有低热（体温： 37.5），自带头孢拉定，来到某医院一社区门诊就诊，因为是常来看病的病人，门诊医生并未对病人做进一步询问和检查，而且病人一再声称，此类药物以往经常使用，门诊有一药剂师接过病人自带的药物，配置好药物之后就给患者进行静脉滴注，滴注不过十分钟，患者突然感觉口中发苦，随之而来的伴随呼吸困难，并出现一系列药物过敏体征，此时门诊方对病人做了紧急处理之后，随之急送上级医院，最终抢救无效死亡。

你的看法是什么？

基础医学导论 学分： 5.0 学时： 80 课程成绩：▪ 形成性评价：多次作业和测验，文献阅读和报告。 50-60%▪ 终结性评价：期末考试（至少四种题型）。 40-50%

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