神经病学绪论英文.ppt

Introduction of neurology,Jia, Jianping,What is new? The 6th edition The new board,What is new?,Coping with the clinical practice Accord to the clinical sequence Reinforce new concept Refer to new criteria Run by concise,人口老龄化问题日益突出，脑老化与认知功能障碍患者增加迅速。,全国和北京市65岁以上老年人口比例（%）,我国认知障碍疾病的患病率（%）,研究背景,我国脑血管病发病率逐年递增,中国-MONICA 25-74岁人群脑卒中发病率,年龄标化发病率(1/100000),我国现有脑血管病患者1300余万人，每年有150万-200万新发脑卒中患者，年发病率（116-219）/10万人口,中华神经科杂志. 2010;43(2):1-7. 中国心血管病报告(2008-2009),2002年我国成人高血压患者1.6 亿，患病率达18.8,中国高血压防治指南 (2005年修订版) 中国高血压防治指南(2009年基层版),我国历次全国调查高血压患病率(%),20.00%,16.00%,12.00%,8.00%,4.00%,0.00%,1959,1980,1991,2002,我国高血压患病率持续增长,2006年中国高血压人数2亿，每年新增高血压患者1000万,中华医学会糖尿病分会 2007.6-2008.5 中华医学会糖尿病学分会. 中华内分泌代谢杂志,2008;24:2a1-22 N Engl J Med 2010; 362:1090-1101.,9.7%,患病率（%）,中华医学会糖尿病学分会最新流调数据显示： 年龄标化的总糖尿病（既往诊断的和既往未诊断的糖尿病）患病率为9.7%； 糖尿病前期（空腹血糖受损或糖耐量受损）患病率为15.5%。,中国成年人 9240万有糖尿病!,中国糖尿病患病率逐年上升,What is Neurology?,Neurology is a member in Neuroscience family,Position,Neuroscience,Clinical,Basic,Neurology Neurosurgery Neuropediatries Senile Neurology,Neuroanatorny Neurophysiology Neuropathology Neuropharmacology Neurobiology Neuropharmacology,1.The Task of Neurology,To develop the Neurological theory with new concept parallel to advanced countries To elevate the level of diagnosis and treatment of neurological diseases so as to culture eligible doctor in Neurology To reduce incidence and prevelence of neurological disease,发展神经病学理论水平，与世界接轨 培养合格的神经科医师 减少神经科疾病的发生率和患病率,2.The Characteristics of Neurology,1- The complexity of the disease Nervous system and muscle structure is very complicated, if several parts of both of them damaged, the symptoms will overlap This is why we usually make direction, localization, qualitation diagnosis,2.The Characteristics of Neurology,2- The extensiveness of symptoms One disease can have different symptoms Example: Encephalitis can include headache and epilepsy Same symptom can origin from different disease Example: Headache can be caused by encephalitis, also by tumors,2.The Characteristics of Neurology,3- The Dependence of diagnosis Scientific development makes the Neurologist more and more dependent on auxiliary examination: CT: Cerebral hemorrhage MRI: Multiple sclerosis Serology: Syphilis,脑CT扫描提示颈内动脉血栓形成致左侧大脑半球低密度梗死（箭头），同侧脑室受压变小,脑CT扫描提示右侧大脑半球出血性梗死，即低密度的梗死灶（星号）周围伴有点片状高密度出血灶（箭头）,脑CT扫描提示溶栓后发生的右侧大脑半球出血性梗死，即在低密度梗死灶（星号）内伴发大片高密度出血灶（箭头）,脑MRI提示脑干梗死（箭头）呈长T2信号,脑CT扫描提示多发性脑栓塞致双侧大脑半球多发性脑梗死（箭头）,脑CT扫描提示左侧基底节区出血呈均匀高密度病灶（箭头）,脑CT扫描提示脑干出血（箭头）呈高密度病灶,脑CT扫描提示左侧大脑半球的脑叶出血（箭头）并破入脑室（星号），均呈均匀性高密度病灶,脑CT扫描提示蛛网膜下腔出血，脑干周围的环池为高密度病灶（箭头）,2.The Characteristics of Neurology,4- The severity of the disease More acute and severe neurological emergency, such as cerebral hemorrhage, cerebral infarction Need to develop ability to handle emergency,2.The Characteristics of Neurology,5- The Refractoriness of the disease Some disease curable: most Inflammation Some disease treatable: epilepsy, Parkinsons disease and cerebrovascular disease Some disease untreatable: malignant tumor,3.The Practice of Neurology,The procedure of diagnosis:,Careful asking case history and making through physical examination,Usage of knowledge of anatomy and physiology, to find the lesion parts,Usage of auxiliary examination, to confirm, and make a final dianosis,3.The Practice of Neurology,The ability of interpretation of auxiliary: CT, digital subtraction angiography, MRI, evoked potentials, EMG, EEG, TCD, carotid artery ultrasound, PET, MEG, nerve and muscle tissue biopsy, cerebrospinal fluid cells and biochemical tests, blood-specific antigen and antibody tests, genetic testing positioning of qualitative However, any additional tests are not a substitute for medical examination and clinical analysis,28,我国城乡脑卒中 发病率约为200/10万 患病率约为400/10万 死亡率为冠心病的3倍,4.The Future of Neurology,Lancet Neurol, 2007.,1-Changes in disease spectrum,29,4.The Future of Neurology,2-Changes in diagnosis instruments,Computed Tomography (CT) equipment,Patients in examination with CT scan,Sample image: Aneurysm (arrows) arising from the basilar artery.,The iMotion 1.5 Tesla Magnet,2) Magnetic resonance imaging (MRI),MRI equipment,Tumor shown in the picture.,3) PET scanner,PET scans of the brain,37,4.The Future of Neurology,2-Changes in therapy,S