三组内分泌课件完整版

,Made By 3th group 2013.11.11,Made By 3th group 2013.11.11,New words,New words,Background of the Endocrine System,The endocrine system is one of the most important accommodation system of the body .It consists of the endocrine glands and the endocrine tissues from different parts of the body .For a long time ,it has been recognized that this system of ductless（无导管的）glands exerts profound influence on the body .It including growth and development , breeding activities and metabolic processes .The function or power of this system is expressed by the substance-The Hormone.,Gland,release their secretions into a duct that carries them to the outside the body,The endocrine system of vertebrate（脊椎动物）,Hypophysis 垂体Thyroid 甲状腺Parathyroid 甲状旁腺Adrenal gland 肾上腺Pancreas 胰岛Sexual gland/gonad 性腺,Endocrine organ,Endocrine organ,Endocrine organ,epiphysis松果体,About Hormones,These endocrine organs or tissues can secrete somesubstances called hormones , which get into the blood circulation and regulate the activities of the organs in the body.,Hypophysis 垂体,1.Hormones secreted by neurohypophysis 神经垂体释放的激素 Vasopressin ，VP 血管加压素 oxytocin ， OT 催产素2.Hormones secreted by adenohypophysis 腺垂体释放的激素 adrenocorticotropic hormone , ATCH 促肾上腺皮质激素； thyroid-stimulation hormone , TSH 促甲状腺素； follicle-stimulation hormone ，FSH 卵泡刺激素 Luteinizing hormone , LH 黄体生成素 Prolactin , PRL 催乳素 growth hormone ，GH 生长素 melanocyte-stimulating hormone , MSH 黑素细胞刺激素,Thyroid 甲状腺,regulates basal metabolism 调节基础代谢 stimulates the catabolism of glucoseand lipid. 促进葡萄糖和脂类的分解代谢stimulates growth and development 促进生长发育,Parathyroid 甲状旁腺,parathyroid hormone, PTH 甲状旁腺激素The function of PTH : effect on the bones , kidney and intestine 影响骨、肾和小肠的作用,Adrenal gland 肾上腺,Adrenal cortical hormone肾上腺皮质激素Mineralocorticoid 盐皮质激素 Glucocorticoid 糖皮质激素 Adrenal medulla 肾上腺髓质,Pancreas 胰岛,胰腺,Insulin 胰岛素-B cell secretion It is the pancreatic hormone that stimulate the anabolism and store nutrient contents 为促进合成代谢，储存营养物质的激素。,Sexual gland 性 腺,The function of sexual gland：Produces gamete产生配子Endocrine function内分泌机能：three kinds of hormones secreted androgen雄激素 promote the growth and maturity of sperm 促进精子的生成与成熟； stimulate the appearance of accessory sexual characteristics and maintain them 刺激男性副性征的出现与维持； promote the synthesis of protein 促进蛋白质的合成.,Sexual gland 性 腺, Estrogen 雌激素 stimulate the growth and development of female sexual organs 促进雌性性器官的发育与生长； stimulate the appearance of female accessory（副的；配件，附件） sexual characteristics 促进雌性副性征的出现； promote the constriction of oviduct and uterine smooth muscle增强输卵管和子宫平滑肌的收缩。,Sexual gland 性 腺,progestogen 孕激素mainly effect on endometrium and uterus muscle 主要作用于子宫内膜与子宫肌maintain gravidity and protects embryo 维持妊娠与保胎,Pathology,Hyperfunction of glands endocrine tumorsectopic(异位、移位) endocrine syndrome(异位内分泌综合征) autoimmunity（自身免疫）Hypofunction of glands Endocrine gland disrupting（内分泌腺破坏） endocrine gland hormone synthesis defect（内分泌腺激素合成缺陷）The receptor is lack of sensitivity to hormones.,缺乏激素敏感性,Hyper-高于、超过、上Hypo-低于、次于,Diagnosis,1.Functional diagnosis Clinical Manifestation (临床表现) Laboratory tests（实验室检查）2.Pathological diagnosis A.Evidence of metabolic disturbance:（新陈代谢障碍） Evidence of inappropriate hormone: （荷尔蒙分泌不当） Endocrine function test:（内分泌功能检测） Immunology（免疫学检测） B.Imageology（影像学） X ray , CT , B ultrasound, （B超） Isotope.（同位素检测） Histology and cytology.（组织细胞学检测）,Common diseases of endocrine system,Diabetes Mellitus hyperthyroidism（甲亢）hypothyroidism（甲减） thyroiditis（甲状腺炎）cushings syndrome（库欣综合征）diabetes insipidus（尿崩症）primary aldosteronism（原发性醛固酮增多症）chronic adrenocortical hypofunction(Addison)慢性肾上腺皮质功能减退症dyslipidemia（血脂异常症）obesity（肥胖症) Gigantism（巨人症）osteoporosis（骨质疏松症） acromegaly（肢端肥大症）,Typical feature in endocrine,Acromegaly肢端肥大症,cretinism呆小症,Gigantism,hyperthyroidism,Exophthalmos突眼症,沈殿霞肥姐,包大人仪铭,83版射雕郭靖他妈苏杏璇,What is the most commom disease in endocrine systerm?,What is the most commom disease in endocrine system ？,Diabetes Mellitus,DM is a group characterized by hyperglycemia and metabolic diseases.It is a disease in which a person has high blood sugar,either because the pancreas does not produce enough insulin ,or because cells do not respond to the insulin that is produced .there are 2 main types of DM,Classification of diabetes(ADA-1997),Type 1 (beta-cell destruction, usually leading to absolute insulin deficiency) Autoimmune Idiopathic （先天的；自发的，特发的） Type 2 (predominantly insulin resistance with relative insulin deficiency ， predominantly secretory defect（缺陷） Some specific types of DM：secondary pancreas disease 、 endocrinopathies（内分泌病）、genetic diabetes. Gestational diabetes (妊娠糖尿病),The most common form of diabetes-Type 2 DM,Nearly 95% belongs to type 2 DM,it often associated with older age, obesity, family history of diabetes e.t.c. In type 2 diabetes, the pancreas is usually producing enough insulin, but for unknown reasons the body cannot use the insulin effectively, which called insulin resistance. After several years, insulin production decreases. So thus glucose builds up in the blood and the body can not make efficient use of its main source of fuel.,producing insulin,not ineffective use of the produced insulin,But,Risk factors for diabetes,Obesity/overweightFamily history of diabetes Having high blood pressure Lack of physical activityToo much sweet food intakeOverstressInfectionHyperlipidemia（血脂过高）,Typical Symptoms,Polyuria（多尿）Polydipsia（多饮）Polyphagia（多食）Lose weight（体重下降）,Complications of Diabetes,视网膜病,冠状动脉,截肢，切断术,Standard of Diagnosis,FPG Random plasma glucose OGTT 2hPG mmol/L mmol/L mmol/LDM 7.0 OR 11.1 OR 11.1 IFG 6.1FPG7.0 OR 7.8 IGT 7.0 OR 7.82hPG11.1Nor 3.9 FPG 5.6 7.8FPG（Fasting Plasma Glucose） OGTT (Oral Glucose Tolerance Test) IFG (Impaired Fasting glucose ) （空腹血糖受损）IGT (Impaired Glucose Tolerance )（糖耐量降低） IFG+ IGT= IGR (Impaired Glucose Regulation )(葡萄糖调节受损),（空腹血糖）,（随机血糖）,（餐后两小时血糖）,Treatment principles-Five Carriages,Early synthesis（综合） individual life-long,Health Education,Exercise,Nutrition Therapy,Disease Surveillance监督，监视,Oral Anti-diabetic Agent,Nutrition Therapy,Reasonable control total quantity of heat(合理控制总热量）Many meals and less food（少食多餐）regularly and quantitatively（定时定量）Diversity and blance (多样平衡),Diabetes Health Education,Health education is considered the key to the success of treatment .,Exercise,Before diabetic patients engage in exercise program, they should consult with their healthcare provider（保健服务人员）because they need to have a complete history（历史记录） and physical examination .Exercise includes anything that keeps them move.Exercise (total of about 30 minutes a day, at least 5 days a week) lowers blood sugar levels by improving cell uptake（摄取，举起） of glucose, causing the body to process glucose faster.,Exercise,Regular monitoring,Regular monitoring of blood glucose is recommended to use a portable blood glucose meter（便携式血糖测量仪）,Drug therapy,Biguanides-Metformin (Glucophage)双胍类decreasing liver glucose（肝糖原） release and cellular insulin resistance.Alpha-Glucose Inhibitors: -糖苷酶抑制剂Slows digestion and absorption（吸收） of carbohydrates（糖类，碳水化合物） to maintain normal blood glucose levels.Sulfonylureas and Meglitinides: (Prandin)磺脲类和格列奈类Stimulates pancreas to secrete insulin.Thiazolidinediones: (Avandia, Actos)噻唑烷二酮类Increases insulin sensitivity at receptor sites on liver, muscle, and fat cells. The medication works by helping make your cells more sensitive to insulin.The insulin can then move glucose from your blood into your cells for energy.,Indications of insulin,Type 2 DMAcute complicationsSevere chronic complications of diabetesEmergency Severe dysfunction of liver or kidneyGestation and bleeding womenWithout tolerance OHA ( Oral Hypoglycemic Agents口服降糖药)，OHA 、SU（磺脲类）invalidationDistinct（明显的；独特的；清楚的；有区别的） lean（依赖）With diseases treated by glucocorticoid（糖皮质激素）,TCM pathogenesis,Diabetes Mellitus in western medcine is “xiao ke ” areas in TCM.According to the theory of TCM, the basic pathogenesis of “xiao ke ”（consumptive thirst）is yin scorching（灼热）on the root while fire preponderance(优势，多数) on the branch, Besides, it could involve different organs and parts, and could also cause the disordering of qi, blood, jin, yin and yang. Xiaoke is usually classified into four types of syndrome：1.Type of the yin deficiency: the yi