四川大学病理学课件20communica

1、发病数居前五位的病种为：肺结核、乙肝、痢疾、麻疹和梅毒，占报告发病总数的86.25%。死亡数居前五位的病种为：狂犬病、肺结核、艾滋病、乙肝和新生儿破伤风，占报告死亡总数的89.83%。 伤寒杆菌（伤寒杆菌（G）菌体菌体“O”抗原抗原（抗原性强）（抗原性强） 血清凝集试验肥达反应血清凝集试验肥达反应鞭毛鞭毛“H”抗原抗原 （临床诊断依据）（临床诊断依据）（抗原性强）（抗原性强）表面表面“V”抗原抗原Typhoid cellTyphoid granulomaLeptospiraClassification of important STDs Gonorrhea Purulent urethral

2、dischargeNeisseria gonorrheae from Purulent urethral dischargeAbscess of epididymitisPurulent infection of eyeGonorrhea Ophthalmia neonatorumBlindness Neonatal gonorrheaBacterial cultureHistological feature1. Diffuse plasmacytic infiltration 2. Endothelial proliferationPrimary stageChancre painless

3、lesion with serous exudate and loads of spirochete in the lesion. 3 weeks after infection, 26weeks healingSyphilid all over, including palms and soles. Rashes are also loaded with spirochete and highly infectious.Lymphode enlargement Secondary stage810 weeks after infectionGumma formation810 weeks a

4、fter infectionTertiary stageGumma Antibody tests are strongly positive in secondary stage! Early deathBone deformitiesSaddle noseMalformation of the teethSexal intercourseIndirect contactCondylomata acuminata-venereal wartsNumerous condylomas of the vulva. Condylomata acuminataKoliocytosis Gold crit

5、eria for diagnosisIn situ hybridization (ISH)Electron microscopy 卡氏肺囊虫性肺炎(Pneumocystis carinii pneumonia,PCP)肺广泛实变，似肝脏肺广泛实变，似肝脏PCPPCP（GMS）Mycosis鹅口疮鹅口疮Pulmonary AspergillosisPASCryptococcosisCryptococcosis amoebiasis阿米巴脓液阿米巴脓液AmoebiasisBacillary dysenteryPathogenesis尾蚴所致的损害尾蚴所致的损害童虫所致的损害童虫所致的损害成虫所致的

6、损害成虫所致的损害虫卵所致的损害（最大）虫卵所致的损害（最大）循环抗原引起的免疫损害循环抗原引起的免疫损害T T细胞产生细胞因子细胞产生细胞因子B B细胞产生抗体细胞产生抗体嗜酸性粒细胞等聚集嗜酸性粒细胞等聚集 抗原抗体复合物形成抗原抗体复合物形成嗜酸性脓肿嗜酸性脓肿（肉芽肿）（肉芽肿）虫卵周放射状火焰虫卵周放射状火焰样物质样物质 Clonorchiasis sinensis好发部位：人体肝内胆道系统好发部位：人体肝内胆道系统Pulmonary paragonimiasis病变特点：病变特点：形成窦道形成窦道, , Charcot-Leyden结晶结晶, ,嗜酸性粒细胞嗜酸性粒细胞 多房性小囊肿多房性小囊肿Pulmonary paragonimiasisPulmonary HydatidosisFilariasis班氏丝虫（库蚊传播）班氏丝虫（库蚊传播） 马来丝虫（中华按蚊传播）马来丝虫（中华按蚊传播）Basic pathologic changes淋巴管炎和淋巴结炎淋巴管炎和淋巴结炎淋巴系统回流障碍的继发改变淋巴系统回流障碍的继发改变 淋巴窦及淋巴管扩