《诊断学》课程教学大纲(五年制英文班临床医学专业)

Outline of Diagnostics

课程名称：Diagnostics

授课专业：五年制英文班临床医学专业

学分与学时：理论课66学时，见习课68学时

一、理论课教学内容及基本要求

Introduction

【Objective and emphasis 目的要求】

1．To master the basic contents of Diagnostics 掌握诊断学的基本内容

2．To understand the ways of learning 理解诊断学学习方法

【Instruction contents教学内容】

1．Definition of Diagnostics诊断学的定义

2．The importance of learning Diagnostics学习诊断学的重要性

3．Basic contents of Diagnostics诊断学的基本内容

4．The ways of learning学习方法

【The times教学时数】0.5 hour ，0.5小时

【Teaching methods教学方法】instruction, multiple media presenting, 讲授,多媒体

History collection (Inquisition) 病史采集

【Objective and emphasis 目的要求】

1．To master the contents of inquistion掌握问诊的内容

2．To understand the inquisition skill理解问诊技巧

【Instruction contents教学内容】

①general data, ②chief complaint, ③history of the present illness, ④past history,⑤review of systems, ⑥personal history, ⑦Marital history, ⑧Menstrual and reproductive history ⑨ family history.

一般项目主诉现病史既往史系统回顾个人史婚姻史月经和生育史家族史

【The times教学时数】1.5 hour，1.5小时

【Teaching methods教学方法】

instruction, multiple media presenting, case-presenting 讲授，多媒体，临床实习

History record 病史记录

【Objective and emphasis 目的要求】

1. To master how to make a history record掌握怎样记录病史

2. To understand the basic requirement for the history record理解病史记录的基本要求

【Instruction contents 教学内容】

（一）Outline of case record 病史记录提纲

1. Biographical data 一般资料

2. chief complaint 主诉

3. History of present illness (HPI) 现病史

4. Past history (PH) 既往史

6. Personal history 个人史

7. Marital history 婚姻史

8. Menstrual history ( for female patients) 月经史

9. Childbearing (reproductive) history 生育史

10. Family history (FH) 家族史

11. Physical examination (PE) 体格检查

12. Laboratory tests and instrumental examination 实验室检查和仪器检查

13. Primary diagnosis 初步诊断

（二）Example of case record 病历示范

【The times 教学时数】 2 hours ，2小时

【Teaching methods 教学方法】instruction, power point showing, case-presenting 讲授,多媒体，临床实习

Common symptoms 常见症状

Fever发热

【Objective and emphasis 目的要求】

1．To master the type of fever and clinical classification掌握发热的类型和临床分类

2．To understand the mechanism of fever and etiology理解发热的机制和病因

【Instruction contents 教学内容】

1．Physiology 生理机制

2．Mechanism of fever发热的机制

3．Etiology 病因

4．Clinical classification:临床分类

5．Clinical manifestation临床症状

6．Type of fever热型

（1）Continuous(continued) fever 稽留热

（2）Remittent fever弛张热

（3）Intermittent (periodic) fever周期性发热

（4）Undulant fever波状热

（5）Relapsing (recurrent)fever间歇热

（6）Irregular fever不规则发热

7．Symptoms and signs of fever发热的症状和体征

【The times 教学时数】 2 hour 2小时

【Teaching methods教学方法】instruction, multiple media presenting, 讲授,多媒体

Abdominal pain腹痛

【Objective and emphasis目的要求】

1．To master the contents of abdominal pain掌握腹痛的内容

2．To understand the significance of abdominal pain了解腹痛的意义

【Instruction contents 教学内容】

1．Inquisition technique问诊技巧

2．Contents of inquisition for abdominal pain腹痛问诊的内容

（1）Where is the pain located? (Site)疼痛的部位?

（2）Where does the pain radiate to(referred pain), or does it originate elsewhere and move to the abdomen?疼痛放射到哪里?或疼痛原发于别的部位然后转移至腹部?

（3）whar kind of pain is it? (Character)疼痛的性质?

（4）How sever is it? (Severity)疼痛的程度?

（5）What other symptoms accompany the pain?疼痛伴随哪些症状?

（6）What factors bring it about? 什麽原因导致疼痛的发生?

（7）What factors cause relief of pain? (Aggravating and Relieving factors) 什麽原因可减轻疼痛?

（8）In chronic abdominal pain inquire about the patients’ day. 慢性腹痛的病人要问诊疼痛时间

（9）Again in chronic pain it is useful to inquire about the periodicity of the pain. 慢性腹痛的病人问诊疼痛的周期性

3．Clinical Significance临床意义

【The times 教学时数】 2 hours 2小时

【Teaching methods教学方法】instruction, multiple media presenting，讲授，多媒体

Cough ,sputum production and dyspnea咳嗽,咳痰和呼吸困难

【Objective and emphasis 目的要求】

1．To master the causes and mechanism of sputum production and dyspnea

掌握痰液产生和呼吸西困难的机制和原因

2．To understand the clinical significance of sputum and dyspnea

理解痰液产生和呼吸西困难的临床表现

【Instruction contents教学内容】

1．Definition of cough and dyspnea咳嗽和呼吸困难的定义

2．Causes and mechanism病因和机制

respiratory disorders呼吸疾病

pleural diseases胸膜疾病

cardiovascular disorders心血管疾病

central nervous system disorders中枢神经系统疾病

3．Sputum production痰液产生

Transudates漏出液

Exudates渗出液

Mucus黏液

Dusts aspirated吸入灰尘

Infracted tissues坏死组织

4．Causes and significance of dyspnea呼吸困难的病因和临床表现

【The times教学时数】2 hours教学时数2小时

【Teaching methods教学方法】instruction, power point showing, case-presenting

讲授,幻灯片,病例分析

CHAPTER 1. Basic methods for physical examination 体检的基本方法

【Objective and emphasis 目的要求】

1．To master the basic methods of physical examination掌握体格检查的基本方法

2．To understand the significance of these physical examination理解体格检查的意义

【Instruction contents 教学内容】

1．Inspection: the definition of inspection and give some examples视诊: 视诊的定义并举例

2．Palpation: the definition of palpation and the kinds of palpation, to master the maneuver of palpation

and their significance.触诊: 触诊的定义和分类,掌握触诊的方法和意义

3．Percussion: the definition of percussion and the kinds of percussion, to master the maneuver and the different sounds produced by percussion.

叩诊：叩诊的定义和分类,掌握叩诊的方法和意义

4．Auscultation: the definition and the significance of auscultation. Know how to use stethoscope.

听诊: 听诊的定义意义.掌握怎样使用听诊器

5．Olfactory examination: know some special odors that could provide valuable clues in clinic.

嗅诊：掌握一些在临床上提供有意义线索的特殊气味.

【The times 教学时数】2 hours 2小时

【Teaching methods教学方法】instruction, power point showing讲授,幻灯片

CHAPTER 2. General examination 一般检查

【Objective and emphasis 目的要求】

1．To master the basic methods and the contents of general examination

掌握一般检查的基本方法和内容

2．To master measurement of the temperature, blood pressure and examination of sequence and maneuver of lymph nodes

掌握体温测量,血压测量的方法和淋巴结检查的顺序和方法

3．To understand the significance of the physical examination and master the normal and abnormal signs and clinical significance

理解体格检查的意义,掌握正常和异常体征及临床意义

【Instruction contents教学内容】

Vital signs: the normal range and abnormal conditions of Temperature, Blood pressure, Pulse, Respiration. To master measurement of the temperature, blood pressure.

生命体征：正常范围,体温血压,脉搏,呼吸的异常情况.掌握体温血压的测量方法

Sex：know some sex-related disease such as hemophilia, systemic lupus erythematous.

性别：知道哪些性别相关性疾病,如血友病,系统猩红斑狼疮

Age年龄

Development and habitus: know the judgments about the normal development and three types of habitus.

发育和姿势:掌握正常发育和三种姿势

Nutrition: how to judge the state of nutrition.营养:怎样判定营养状态

State of consciousness: the definition of the Somnolence, Confusion, Stupor, Coma.

意识状态:嗜睡,昏睡,木僵和昏迷的定义

Position and posture: the three types of position including active position, passive position and compulsive position.

体位和体态:主动体位,被动体位,强迫体位

Gait步态

Facial (features) characteristics: know the abnormal sign and clinical significance about the facial

面容特征:掌握异常面容的体征和临床意义如急性面容,慢性面容,肝病面容,甲状腺功能减低面容,满月脸,二尖瓣面容

feature such as Acute facial feature, Chronic facial feature, Hepatic face, Hyperthyroidism face, Moon face, Mitral face.

Skin: to master the definition of spider angioma and its clinical significance.

皮肤:掌握蜘蛛痣的定义和临床意义

Edema: the definition and kinds of edema and its significance.

水肿:水肿的定义和意义

Subcutaneous nodules and hair 皮下结节和毛发

Lymphatic node: to master examination of sequence and maneuver of lymph node. Significance of lymphatic node if be palpated.

淋巴结:掌握淋巴结检查顺序和方法,可触到的淋巴结的意义

【The times教学时数】 2 hours 2小时

【Teaching methods教学方法】instruction, power point showing 讲授,幻灯片

CHAPTER 3. Head and neck 头颈

【Objective and emphasis 目的要求】

1．To master the methods and the contents of head and neck examination掌握头颈检查的方法和内容2．To master the significance of the physical examination: especially measurement of sequence and maneuver of carotid artery, jugular vein, thyroid and trachea掌握体格检查的意义:颈动脉,颈静脉甲状腺和气管检查的顺序和方法

3．To understand the examination of sequence and maneuver of head理解头部检查的顺序和方法【Instruction contents 教学内容】

1．Head: to master the contents of examination of the head and the maneuver of the detection of the cranium, to know certain deformities of the skull, such as

头部：掌握头部检查的内容和颅部检查的方法,知道头颅畸形,例如

Microcephalus头颅过小

Squared skull方型颅

Deforming skull畸形颅

Oxycephalia (tower skull, steeple skull)尖颅

Macrocephalus头颅过大

2．Eyes：to master the normal and abnormal signs and their significance in clinic

眼：掌握正常和异常体征及其临床意义

（1）Eyebrow:眉毛

（2）Eyelids眼睑

1）Disturbance of closure of the eyelids:眼睑关闭异常

2）Ectropion 睑外翻

3）Entropin睑内翻

4）Eyelid edema 眼睑水肿

5）Eyelid ptosis睑下垂

（3）Conjunctiva：结膜

（4）Eyeball:眼球

l）Exophthalmos：眼球突出

2）Enophthalmos：眼球内陷

3）Eyeball movements眼球运动

（5）Sclera：yellow sclera often was seen in jaundice巩膜:巩膜黄染常见于黄疸

（6）Cornea：角膜

（7）Iris and pupil：虹膜和瞳孔

l）Pupillary shape：瞳孔形状

2）Pupillary direct and consensual response to light: to master the contents of examination, the maneuver and significance

瞳孔光反射：掌握检查的内容,方法和意义

3）Convergence and accommodation集合反射

4）Functional ocular examinations, including vision (acuity), color sensation:.

眼功能检查，包括视力，色觉

3．Ears耳

4．Nose：to master the examination’s contents, the maneuver and significance of paranasal sinuses

鼻：掌握检查内容,方法和意义

5．Mouth (Oral cavity)口腔

1）Inspect the lips: to know the abnormal signs such as Pallor, Redness, Cyanosis and pigmentation

视诊口唇：异常的体征如苍白,紫绀和色素沉着

2）Inspect oral mucous membrane: to know the abnormal signs such as Pallor, Redness, Cyanosis and pigmentation

视诊口黏膜：掌握异常体征如苍白,红润,紫绀和色素沉着

3）Examine the teeth and gingiva (gum): Method for counting the teeth

检查牙齿和牙龈:牙齿的计数方法

4）The tongue: 舌

5）Pharynx and larynx: Method for examining the Pharynx and larynx. To master the Degree of the enlarged tonsil

咽喉：咽喉的检查方法.掌握扁桃体肿大的程度

6. Neck: to learn the anatomy of the neck and the contents of physical examinations.

颈部：掌握颈部的解剖和检查内容

1）Cervical vessels: to master the definition and significance of distended cervical vein

颈部血管：掌握颈静脉扩张的定义和意义

2）Thyroid gland: to master the palpation of the thyroid gland and the degree of thyroid gland enlargement. Know how to describe the thyroid gland when you palpate and auscultate the thyroid gland 甲状腺：掌握甲状腺的触诊方法和肿大程度.掌握甲状腺触诊和听诊的描述

3）Trachea: to master the contents of examination, the maneuver and significance

气管：掌握检查的内容,方法的意义

【The times教学时数】 2 hours 2小时

【Teaching methods教学方法】instruction, power point showing, case-presenting.

讲授，幻灯片，临床实习

CHAPTER 4. Abdominal examination 腹部检查

【Objective and emphasis 目的要求】

1．To master the markers and the lines of body surface, the areas and important viscera underlying these regions.

掌握体表线和体表标志，分区和这些区域的重要内脏器官

2．To master inspection, palpation, percussion, auscultation of abdomen. Especially palpation of liver and spleen.

掌握腹部的视,触,叩听方法,特别是肝脾触诊

3．To understand the symptoms and signs of common abdominal diseases

理解常见腹部疾病的症状和体征

【Instruction contents 教学内容】

1. the markers and the lines of body surface, the areas and inoportant viscera underlying these regions. 掌握体表线和体表标志,分区和这些区域的重要内脏器官

2.examination of abdomen腹部检查

(1)Inspection: symmetry, abdominal pulsation, shape, scars, sinuses, fistuas, engorged vein, flank haemorrhages, Visible peristalsis.

视诊:对称性,腹部搏动,形状,瘢痕,窦道,瘘管,扩张的静脉,胁腹出血，胃肠蠕动波

(2)Palpation: direct tenderness and resistance of muscle, rebound tenderness, palpation of liver, spleen, gallbladder, kidney, atrtributes of masse, fluid trills, succusion splash, tender spots of kidney and ureter.

触诊:直接压痛和腹壁紧张度,反跳痛,肝脏,脾脏,胆囊,肾脏,包块,液波震颤，振水音,肾脏和输尿管压痛点

(3)Percussion: Traube’s space, regions of liver, spleen, bladder and kidney.

叩诊:胃泡鼓音区，肝脾，膀胱和肾脏的区域

(4)Ascultation: bowel sound abdominal bruits, friction rubs.听诊:肠鸣音和摩擦音

3. The symptom and sings of common abdominal diseases: Peptic ulcer diseases and the complications, hepatic cirrhosis and portal hypertention, intestinal obstruction, acute peritonitis, appendicitis.常见腹部疾病的症状和体征:消化性溃疡和并发症,肝硬化和门脉高压,肠梗阻,急性腹膜炎,阑尾炎

【The times教学时数】14 hours (Instruction 6 hours, practice 8 hours) 14小时

【Teaching methods教学方法】instruction, power point showing ,case-presenting. 讲授,幻灯片,临床实习CHAPTER 5. Physical examination of the thorax 胸部体检

【Objective and emphasis 目的要求】

1．To master the methods and the contents of thorax examination 掌握胸部体检的方法和内容

2．To master the mechanism and clinical significance of tactile fremitus and abnormal percussion 掌握触觉语颤的机制和临床意义

3．To understand the physical examination and positive signs of some common pulmonary diseases 了解常见肺部疾病体格检查和阳性体征

【Instruction contents 教学内容】

1．the markers and the lines of body surface, the areas and imoportant viscera underlying these regions.

掌握体表线和体表标志，分区和这些区域的重要内脏器官

2．examination of thorax胸部检查

（1）Inspection of the lung and pleura肺和胸膜的视诊

（2）Palpation of the lung and pleura肺和胸膜的触诊

（3）Percussion of the lung and pleura肺和胸膜的叩诊

（4）Auscultation of the lung and pleura肺和胸膜的听诊

3．The symptom and sings of common respiratory diseases: pneumothorax,emphysema,Pleural effusion, pneumonia

常见胸部疾病的症状和体征

【The times教学时数】14hours（Instruction 6 hours, practice 8 hours）

14小时（讲授6小时,实习8小时）

【Teaching methods教学方法】instruction, power point showing,case-presenting. 讲授,幻灯片,临床实习CHAPTER 6. Cardiovascular system 心血管系统

【Objective and emphasis 目的要求】

1．To master the examining sequence and methods of heart，including inspection, palpation, percussion and auscultation.

掌握心脏的检查顺序和方法包括: 视,触,叩,听方法

2．To master the producing mechanism of heart murmurs and their clinical significance. Mastering the key points of auscultation of heart murmurs and differential diagnosis of physical and pathological heart murmurs.

掌握心脏杂音的产生机制和他们的临床意义.掌握杂音听诊的关键点和生理性杂音和病理性杂音的鉴别诊断

3．understand the symptoms and sings of common heart diseases .

理解常见心脏疾病的症状和体征

【Instruction contents 教学内容】

1．Heart 心脏

Inspection 视诊

1）Observing precordium

观察心前区

2）The location, intensity and scope of normal apical impulse and clinical value of its displacement.

正常心尖搏动的部位,强度和范围,异常的临床意义

3）Abnormal pulsations in the other areas and their clinical values其他区域的异常搏动和临床意义Palpation触诊

1）The location, intensity and scope of normal apical impulse and clinical value of its displacement.

正常心尖搏动的部位,强度和范围. 异常的临床意义

2）The precordial pulsation’s location and its amplitude, duration and intensity.

心前区搏动的部位,强度,持续时间和强度.

3）The producing mechanism of thrills and location, intensity and quality of thrills.

震颤的产生机制和部位强度和性质

4）Pericardial friction rub

心包摩擦感

Percussion 叩诊

1）The percussion method of the heart. 心脏的叩诊方法

2）The heart borders and their constituents. 心界大小

3）Normal relative dullness of the heart and changing cardiac dullness.心脏的相对浊音界和绝对浊音界Auscultation 听诊

It includes rate, rhythm, heart sound, murmur and pericardial friction sound.

包括心率,心律,心音,杂音和心包摩擦音

1）Auscultatory Valve Areas 听诊瓣膜区

2）The producing mechanism of heart sound and differential diagnosis of normal heart sounds（S1 and S2）. 心音产生的机制和正常心音的鉴别诊断

3）Heart rate and heart rhythm. 心率和节律

4）The producing mechanism and characteristics of heart murmurs (Location, timing, quality, radiation, and intensity).

心脏杂音的产生机制和性质(部位,时期,性质,放射和强度)

5）The producing mechanism and its clinical values of pericardial friction rub.

心包摩擦音的产生机制和临床意义

2．Blood Vessels 血压

1）The arterial pulse and its rate, rhythm, intensity and tension.

动脉脉搏和频率,节律,强度和张力

2）The producing mechanism and characteristics of wave forms (Water hammer pulse, Pulsus alternans, Dicrotic pulse, Paradoxical pulse)

波形的产生机制和性质(水冲脉,交替脉,重搏波,奇脉)

3）The measurement of arterial pressure and its significance.

血压测量的方法和意义

4）Pistol-shot sound and Duroziez's sign.

枪击音和Duroziez's征

3．Common symptoms and signs of cardiovascular diseases: mitral stenosis,mitral imcompetece,aortic incompetence,aortic stenosis,pericardical effusion.

心血管疾病的常见症状和体征:二尖瓣狭窄, 二尖瓣关闭不全,主动脉瓣狭窄, 主动脉瓣关闭不全【The times教学时数】

14 hours.（Instruction 6 hours, practice 8 hours）14小时（讲授6小时,实习8小时）

【Teaching methods教学方法】instruction, power point showing，case-presenting.讲授,幻灯片，临床实习CHAPTER 7. Physiological and pathological reflex生理和病理反射

【Objective and emphasis 目的要求】

1．To master the methods of physiological and pathological reflex掌握生理和病理反射的方法

2．To understand the significance of the physical examination理解体格检查的意义

【Instruction contents 教学内容】

1．Superficial reflex: 浅反射

（1）corneal reflex,角膜反射

（2）plantar reflex,跖反射

（3）abdominal reflex, 腹壁反射

（4）cremasterie reflex: 提睾反射

（5）Eanal reflex

2．Deep reflexes: 深反射

（1）biceps reflex, 肱二头肌反射

（2）triceps reflex, 肱三头肌反射

（3）brachioradialis reflex,桡骨膜反射

（4）ankle jerk. 跟腱反射

（5）knee jerk. 膝腱反射

3．Clonus:阵挛

（1）Ankle clonus: 踝阵挛

（2）Patellar clonus: 髌阵挛

4．Pathological reflex病理反射

（1）Babinski's sign:.巴氏征

（2）Oppenheim's sign: 奥本海姆征

（3）Hoffmann’s sign:.霍夫曼征

5. Signs of meningeal irritation脑膜刺激征

（1）Neck rigidity: 颈项强直

（2）Kernig's sign:克氏征

（3）Brudzinski's sign: 布氏征

【The times教学时数】 1.5 hour 1.5小时

【Teaching methods教学方法】instruction, power point showing，case-presenting. 讲授,幻灯片，实习

Laboratory Examination实验室检查

CHAPTER 1. Stool Routine Test 大便常规

【Objective and emphasis 目的要求】

1．To master the methods of stool routine test掌握大便常规的方法

2．To master the significance of the changes of stool property and the occult blood test

掌握大便性状改变的意义和隐血实验的意义

3．To understand the significance of microscopic examination理解显微镜检查的意义

【Instruction contents教学内容】

1．General property of stool大便的一般性状

（1）watery stool: 水样便

（2）mucus stool: 黏液便

（3）pyohemochezia stool:脓血便

（4）hematochezia stool: 血便

（5）melena or tarry stool: 黑便或柏油样便

2．Microscopic examination显微镜检查

（1）Cells: 细胞

（2）WBC 白细胞

（3）RBC红细胞

（4）macrophage:normal巨噬细胞

（5）tumor cell肿瘤细胞

（6）Food residue:食物残渣

（7）Ovum of parasite 寄生虫卵

3.Occoul blood test隐血实验

【The times教学时数】0.5 hour 0.5小时

【Teaching methods教学方法】Instruction, power point showing. 讲授,幻灯片

CHAPTER 2. Urine Routine Test 小便常规

【Objective and emphasis 目的要求】

1．Master the methods of urine routine test掌握尿常规的方法

2．Master the significance of the changes of urine property掌握尿液性状改变的意义

3．Understand the significance of microscopic examination理解显微镜检查的意义.

【Instruction contents 教学内容】

1．Sample’s collection and sending标本采集和送检

2．General property一般性状

（1）Urine volume尿量

（2）Color颜色

（3）Smell气味

（4）Urine Ph尿PH

（5）Urine Specific Gravity尿比重

3．Chemical tests化学实验

（1）protein test蛋白检测

（2）Glucose:糖

（3）Ketones酮体

（4）Bilirubin胆红素

（5）Urobilinogen尿胆原

（6）Blood血

（7）Urinary Nitrites尿硝酸盐

4. Microscopic examination显微镜检查

（1）Cells细胞

（2）Casts管形

（3）Pathogenic organism病原微生物

（4）Addis count爱迪计数

（5）Cell excretion per hour每小时细胞沉渣

【The times教学时数】 2 hours 2小时

【Teaching methods教学方法】Instruction and powerpoint showing. 讲授,幻灯片

CHAPTER 3. Examination of Blood 血液检查

【Objective and emphasis 目的要求】

1．To master the methods of red blood cell count (RBC)and hemoglobin(Hb) concentration determination.掌握红细胞计数和血红蛋白浓度测定的方法

2．To mater the the methods of white blood cell count(WBC) and differentiate count(DC).掌握白细胞计数和分类的方法

3．To master the reference values of RBC,Hb,WBC and DC.掌握RBC,Hb,WBC and DC.的参考值4．To master the singnificance of changes of RBC, Hb, WBC and DC.掌握RBC,Hb,WBC and DC.变化的意义

5．To understand the significance of RBC and WBC in some common hematological diseases.

理解常见血液疾病的意义

【Instruction contents教学内容】

1．Blood routine test (BRT)血常规检测

（1）Red blood cell count(RBC) and Hemoglobin(HB) concentration determination红细胞计数和血红蛋白浓度测定

1）The physiological functions of RBC and HB红细胞和血红蛋白的生理功能

2）The referential values of RBC and HB红细胞和血红蛋白的参考值

3）The clinical significance of RBC and HB红细胞和血红蛋白的临床意义

（2）.Total white blood cell count (WBC) and Leukocyte differential count (DC)

白细胞计数和分类计数

4）The morphology of WBC白细胞的形态

5）The referential values of WBC and DC白细胞计数和分类计数的参考值

6）The clinical significance of WBC and DC白细胞计数和分类计数临床意义

2．Special Investigations in hematological diseases血液病的特殊检查

（1）Reticulocyte count (RC)网帜红细胞计数

1）The referential values of RC网帜红细胞参考值

2）The clinical significance of RC网帜红细胞临床意义

（2）Hematocrit (Hct)红细胞比容

（3）Erythrocyte sedimentation rate (ESR)红细胞沉降率

1）The referential values of ESR红细胞沉降率参考值

2）The clinical significance of ESR红细胞沉降率临床意义

【The times 教学时数】4 hours 4小时

【Teaching methods教学方法】instruction, power point showing. 讲授,幻灯片

CHAPTER 4. Liver Function 肝功能

【Objective and emphasis目的要求】

1．To master the contents of liver function test掌握肝功能检测的内容

2．To master the significance of the liver function test 掌握肝功能检测的意义【Instruction contents教学内容】

1．Markers of hepatic synthetic capacity 肝脏合成能力的指标

（1）Serum proteins:Serum total protein A, G血清蛋白

（2）Electrophoresis of serum protein 血清蛋白电泳

（3）Prothrombin time(PT)凝血酶原时间

2．Tests of bilirubin metabolism 胆红素代谢的检测

3．Markers of cholestasis胆汁淤积的标志

（1）Alkaline phosphatase (ALP)碱性磷酸酶

（2）Gamma-glutamyl transpeptidase (GGT) 谷光酐酞转移酶

4．Markers of hepatocellular necrosis肝细胞坏死的

（1）Hepatic enzymes: ALT,AST, 肝细胞酶

5．Test for hepatic carcinoma肝癌检测

（1）Alpha-fetoprotein(AFP)

6．Detectiion of hepatic viruses肝病毒检测

（1）Hepatitis A:甲

（2）Hepatitis B:乙

（3）Hepatitis C:丙

7．Case analysis病例分析

【The times教学时数】 3.5 hours 3.5小时

【Teaching methods教学方法】instruction, power point showing, case-presenting. 讲授,幻灯片

CHAPTER 5. Renal function 肾功能

【Objective and emphasis 目的要求】

1．Master the contents of renal function掌握肾功能的内容

2．Master the significance of the renal function tests掌握肾功能检测的意义【Instruction contents 教学内容】

1．Review of the renal function肾功能

2．Endogenous creatinine clearance rate内源性肌酐清除率

3．plasma creatinine level血浆肌酐水平

4．β2-microglobulin β2微球蛋白

5．α1-microglobuliu.α1微球蛋白

6．The specific gravity特殊比重

【The times 教学时数】 2 hours 2小时

【Teaching methods 教学方法】Instruction and powerpoint showing 讲授,幻灯片

CHAPTER 6. Examination of Hemorrhagic Disorders 出血疾病的检测

【Objective and emphasis目的要求】

1．To master both the the reference values and the clinical significance of platelet count（PC）,coagulation time（CT）and prothrobin time（PT）.

掌握血小板计凝血时间和凝血酶原时间的参考值和临床意义

2．To understand both the mechanism and the significance of hemostasis,coagulation and anti-coagulation. 理解止血, 凝血和抗凝血的机制和意义

【Instruction contents 教学内容】

1．Mechanism of hemostasis凝血机制

（1）Blood vessel血管

（2）Platelet 血小板

（3）Coagulation factors凝血因子

2．Mechanism of coagulation凝血机制

3．Anti-coagulation system抗凝血系统

4．Tests for hemorrhagic diseases出血疾病

（1）Tests of the vascular and platelet phases:Bleeding time (BT),PC出血时间

（2）Tests of coagulation phase：CT，Activated partial thromboplastin time（APTT），PT，Thrombin time （TT）

（3）Tests for DIC:The Screening tests,the further tests初筛实验,确诊实验

【The times教学时数】2 hours 2小时

【Teaching methods教学方法】instruction, power point showing, case-presenting. 讲授,幻灯片，实习CHAPTER 7. Examination of bone marrow骨髓的检测

【Objective and emphasis 目的要求】

1．To master the regulation of blood cell development.掌握血细胞发育的规律

2．To master the significance of the plastic degree of marrow cell and the ratio of myeloid to erythroid(G/E).掌握骨髓细胞和粒红比值

3．To understand the clinical application of bone marrow examination.理解骨髓检测的临床运用

4．To understand the morphology of bone marrow cells.理解骨髓细胞的形态

5．To understand the contents and steps in marrow examination.理解骨髓检查的步骤和内容【Instruction contents 教学内容】

1．The clinical application of marrow examination骨髓检查的临床运用

2．The development of blood cells血细胞的发育

3．The regulation of blood cell development血细胞发育的临床意义

（1）The cytobody胞体

（2）The cytoplasma胞浆

（3）The nucleus核

（4）The ratio of nucleus to cytopasm核浆比率

4．The morphology of bone marrow cells骨髓细胞的形态

（1）The morphology of erthrocytic series红系系列的形态

（2）The morphology of granulocytic series粒系系列的形态

（3）The morphology of monocytic series单核系系列的形态

（4）The morphology of megakaryocytic series巨核细胞系列的形态

（5）The morphology of lymphocytic series淋巴细胞系列的形态

5．The contents and steps in marrow examination骨髓检查的内容和步骤

（1）Microscopy of myelogram骨髓细胞分类计数的显微镜检查

（2）Hemogram血细胞分类计数

6．Normal myelgram and hemogram正常骨髓细胞分类计数

（1）Myelogram骨髓细胞分类计数

（2）Hemogram血细胞分类计数

7．The common cytochemical stains in marrow examination.骨髓检查的细胞化学染色

8．The characters of common blood diseases in microscope常见血液病的特征

【The times 教学时数】 2 hours 2小时

【Teaching methods教学方法】instruction, power point showing, case-presenting.

讲授,幻灯片，实习

CHAPTER 8. Laboratory test in clinical infection 临床感染的实验室检查

【Objective and emphasis 目的要求】

1．To master the contents of laboratory test in clinical infection临床感染的实验室检查内容

2．To understand the clinical significance tests in clinical infection临床感染的临床意义

【Instruction contents 内容】

1．Introduction简介

2．Collection of specimens标本采集

3．Laboratory techniques in the diagnosis of infection感染诊断的实验室技术

1）Microscopic methods:显微镜

2）Culture methods培养方法

3）Serological methods:Precipitation test,Slide agglutination,Tube agglutination

血清学方法:沉降实验,玻片凝集,管凝集

ELISA（enzyme-linked immunosorbent assay），Western blot（immunoblotting）

酶联免疫试验，蛋白印迹试验

4．Molecular methods: Nucleic acid assay and PCR are main Molecular methods

分子生物学方法:核酸分析和PCR是主要的分子生物学方法

5．Antimicrobial susceptibility test (AST)抗微生物特异性实验

【The times教学时数】 2 hours 2小时

【Teaching methods教学方法】instruction, power point showing, case-presenting. 讲授,幻灯片CHAPTER 9. Immunodiagnostic tests of autoimmune disease 自身免疫疾病的免疫诊断

【Objective and emphasis 目的要求】

1．To understand serum immunoglobulins test, sellular immunity tests, hepatitis marker test , tumor marker test理解免疫蛋白实验,细胞免疫检测,肝炎病毒标志物实验,肿瘤标志物实验

2．To master the clinical significance of the three of serum immunoglobulins(IgG, IgM, IgA ); several hepatitis markers and tumor markers

掌握血清免疫球蛋白,肝炎标志物和肿瘤标志物的临床意义

【Instruction contents教学内容】

1．review two concept of immunology: antibody-mediated immunity and cell-mediated immunity综述免疫学的两个概念:抗体介导的免疫和细胞介导的免疫

2．main topic主题

（1）Serum immunoglobulins test: Serum immunoglobulins (Ig) :IgG, IgM, IgA IgD, IgE

血清免疫球蛋白实验: 血清免疫球蛋白

（2）Cellular immunity tests: T abd B lymphocyte enumeration, Lymphocyte subset analysis

细胞免疫实验: T ,B淋巴细胞计数,淋巴细胞亚群分析

（3）Hepatitis marker test: Anti-Hav, HbsAg, Anti-HBs, HbcAb, HbeAg, .HBV-DNA, Hepatitis C, HCV-RNA 肝炎标志物实验:

（4）Tumor marker test: AFP, CEA,HCG, PSA肿瘤标志物实验

【The times教学时数】 2 hours 2小时

【Teaching methods教学方法】instruction, power point showing, case-presenting. 讲授,幻灯片CHAPTER 10. Examination of clinical biochemictry 临床生化检测

【Objective and emphasis 目的要求】

1．To master the contents of examination of clinical biochemistry掌握临床生化检测的内容

2．To understand the significance of clinical biochemistry掌握临床生化检测的意义

【Instruction contents 教学内容】

1．Examination of glucose metabolism糖代谢的检测

（1）Determination of Fasting blood glucose快速血糖检测

（2）Oral glucose tolerance test (OGTT)口服糖耐量实验

（3）Glucose-insulin releasing test糖胰岛素释放实验

（4）Glycosylated Hemoglobin糖苷糖蛋白

2．Examination of blood lipids血脂的检测

（1）Measurement of total cholesterol总胆固醇的测量

（2）Measurement of triglyceride：甘油三酯的测量

（3）Measurement of high density lipoprotein; (HDL-C)高密度脂蛋白的测量

（4）Measurement of low density lipoprotein; (LDL-C)低密度脂蛋白的测量

（5）Determination of apolipoprotein A1脂蛋白A1

（6）Determination of Apolipoprotein B脂蛋白B

3．Examination electrolytes电解质的检测

（1）Determination of Potassium钾离子

（2）Determination of sodium钠离子

（3）Determination of chloride氯离子

4．Biochemical markers of myocardial injure肌损伤的生化指标

（1）Examination of creatine kinase肌酐酶的检测

（2）Examination of lactate dehydrogenase(LDH) 乳酸脱氢酶的检测

【The times 教学时数】2 hours 2小时

【Teaching methods教学方法】instruction, power point showing, case-presenting.

讲授,幻灯片

CHAPTER 11. Examination of cerebrospinal fluid and serous membrane fluid

脑脊液和浆膜积液的检测

【Objective and emphasis 目的要求】

1．To master the contents of examination of cerebrospinal fluid (CSF) and serous membrane fluid (SMF)掌握脑脊液和浆膜积液检测的内容

2．To master the significance of the changes of cerebrospinal fluid property, chemical and microscopic test 掌握脑脊液性状,化学和显微镜检查的意义

3．To master the significance of the changes of serous membrane fluid general property, microscopic test, chemical and bacteriologic examination掌握浆膜积液性状,化学和显微镜检查的意义

【Instruction contents教学内容】

◇Examination of cerebrospinal fluid (CSF) 脑脊液检测

General property: 一般性状

Normal CSF正常脑脊液

Abnormal status异常脑脊液

Chemical examination 化学检测

Protein蛋白

Glucose糖

Chloride氯

Microscopic test 显微镜检测

Total cell count总细胞计数

DC: lymphocyte , neutrophil granulocyte分类计数

◇Examination of serous membrane fluid(SMF) 浆膜积液检测

Definition of effusion渗出液的定义

General property一般性状

Chemical examination化学检测

Microscopic test 微生物检测

Bacteriology细菌学检测

◇The main differential points of transudate and exudate漏出液和渗出液的主要鉴别点

【The times教学时数】 2 hour 2小时

【Teaching methods教学方法】instruction, power point showing. 讲授,幻灯片

ELECTROCARDIOGRAM（ECG）心电图

【Objective and emphasis 目的要求】

1．Master the components of the ECG

掌握心电图的组成

2．Master the normal ECG (P waves, QRS complex, ST segment, T wave, U wave)

掌握正常心电图

3．Master how to measure every waves and complexes, P-R interval, Q-T interval, R-R interval.

掌握怎样测量每一个波

4．To be familiar with Chamber Hypertrophy, Myocardial Infarction.

熟悉房室肥大和心肌梗塞

5．To be familiar with the common arrhythmia

熟悉常见的心律失常

【Instruction contents教学内容】

1．Components of the ECG:（1）Electrodes and leads（2）Rate and rhythm（3）Electrical Axis

ECG的组成（1）电极和导联（2）心率和节律（3）电轴

2．Normal shapes of waves and complexes:（1）P waves（2）QRS complexes（3）ST segment

（4）T wave（5）U wave

正常波形（1）P波（2）QRS波群（3）ST段（4）T波（5）U波

3．Left Atrial Hypertrophy （LAH），Right Atrial Hypertrophy（RAH），Left Ventricular Hypertrophy （LVH），Right Ventricular Hypertrophy（RVH），Myocardial Infarction（MI）

左房肥大,右房肥大,左室肥大,右室肥大,心肌梗塞

4．Sinus Rhythm，Premature Atrial Contraction（PAC），Premature Ventricular Contraction （PVC）Tachycardia, E. Atrioventricular Block (A VB)

窦性节律,房性期前收缩,室性期前收缩,心动过速,房室传导阻滞

【The times教学时数】16 hour(instrution 8hours, practice of 8 hours) 16小时(讲授8小时,实习8小时) 【Teaching methods教学方法】instruction, power point showing,practicing.讲授,幻灯片，实习

Department of Diagnosics 1st Clinical Medical College