神经病学绪论英文PPT课件

.,1,Introductionofneurology,Jia,Jianping,.,2,Whatisnew?The6theditionThenewboard,.,3,Whatisnew?,CopingwiththeclinicalpracticeAccordtotheclinicalsequenceReinforcenewconceptRefertonewcriteriaRunbyconcise,.,4,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,.,5,我国脑血管病发病率逐年递增,中国-MONICA25-74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),.,6,2002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,.,7,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;24:2a1-22NEnglJMed2010;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,.,8,WhatisNeurology?,.,9,NeurologyisamemberinNeurosciencefamily,.,10,Position,Neuroscience,Clinical,Basic,NeurologyNeurosurgeryNeuropediatriesSenileNeurology,NeuroanatornyNeurophysiologyNeuropathologyNeuropharmacologyNeurobiologyNeuropharmacology,.,11,1.TheTaskofNeurology,TodeveloptheNeurologicaltheorywithnewconceptparalleltoadvancedcountriesToelevatethelevelofdiagnosisandtreatmentofneurologicaldiseasessoastocultureeligibledoctorinNeurologyToreduceincidenceandprevelenceofneurologicaldisease,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,.,12,2.TheCharacteristicsofNeurology,1-ThecomplexityofthediseaseNervoussystemandmusclestructureisverycomplicated,ifseveralpartsofbothofthemdamaged,thesymptomswilloverlapThisiswhyweusuallymakedirection,localization,qualitationdiagnosis,.,13,2.TheCharacteristicsofNeurology,2-TheextensivenessofsymptomsOnediseasecanhavedifferentsymptomsExample:EncephalitiscanincludeheadacheandepilepsySamesymptomcanoriginfromdifferentdiseaseExample:Headachecanbecausedbyencephalitis,alsobytumors,.,14,2.TheCharacteristicsofNeurology,3-TheDependenceofdiagnosisScientificdevelopmentmakestheNeurologistmoreandmoredependentonauxiliaryexamination:CT:CerebralhemorrhageMRI:MultiplesclerosisSerology:Syphilis,.,15,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,.,16,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）,.,17,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）,.,18,脑MRI提示脑干梗死（箭头）呈长T2信号,.,19,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）,.,20,脑CT扫描提示左侧基底节区出血呈均匀高密度病灶（箭头）,.,21,脑CT扫描提示脑干出血（箭头）呈高密度病灶,.,22,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,.,23,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）,.,24,2.TheCharacteristicsofNeurology,4-TheseverityofthediseaseMoreacuteandsevereneurologicalemergency,suchascerebralhemorrhage,cerebralinfarctionNeedtodevelopabilitytohandleemergency,.,25,2.TheCharacteristicsofNeurology,5-TheRefractorinessofthediseaseSomediseasecurable:mostInflammationSomediseasetreatable:epilepsy,ParkinsonsdiseaseandcerebrovasculardiseaseSomediseaseuntreatable:malignanttumor,.,26,3.ThePracticeofNeurology,Theprocedureofdiagnosis:,Carefulaskingcasehistoryandmakingthroughphysicalexamination,Usageofknowledgeofanatomyandphysiology,tofindthelesionparts,Usageofauxiliaryexamination,toconfirm,andmakeafinaldianosis,.,27,3.ThePracticeofNeurology,Theabilityofinterpretationofauxiliary:CT,digitalsubtractionangiography,MRI,evokedpotentials,EMG,EEG,TCD,carotidarteryultrasound,PET,MEG,nerveandmuscletissuebiopsy,cerebrospinalfluidcellsandbiochemicaltests,blood-specificantigenandantibodytests,genetictestingpositioningofqualitativeHowever,anyadditionaltestsarenotasubstituteformedicalexaminationandclinicalanalysis,.,28,28,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.TheFutureofNeurology,LancetNeurol,2007.,1-Changesindiseasespectrum,.,29,29,4.TheFutureofNeurology,2-Changesindiagnosisinstruments,ComputedTomography(CT)equipment,.,30,PatientsinexaminationwithCTscan,.,31,Sampleimage:Aneurysm(arrows)arisingfromthebasilarartery.,.,32,TheiMotion1.5TeslaMagnet,2)Magneticresonanceimaging(MRI),.,33,MRIequipment,.,34,Tumorshowninthepicture.,.,35,3)PETscanner,.,36,PETscansofthebrain,.,37,37,4.TheFutureofNeurology,2-Changesinther