Chapter 1 Conspectus of Disease

Concept of Disease

Etiology of Disease

Pathogenesis of Disease

Outcome of Disease

Chapter 2 Water and Electrolytes Balance and Imbalance

Water and Sodiun Balance and Imbalance

Water and Sodium Balance

Total Fluid Volume and Distribution

Body Fluid Composition

Osmolality of the Body Fluids

Water Balance

Mechanisms for Regulation of Body Fluid and Electrolyte Balance

Disorders of Sodium and Water Metabolism

Hyponatremia

Hypernatremia

Isotonic Dehydration

Edema

Disorder of Potassium Metabolism

Normal Potassium Metabolism

Internal Potassium Distribution

Regulation of Potassium Homeostasis

Physiological Function of Potassium

Disorders of Potassium Metabolism

Hypokalemia and Potassium Deficiency

Hyperkalemia

Disturbances of Magnesium Metabolism

Normal Metabolism and Function of Mag-nesium

Intake and Excretion

Regulation of Magnesium Balance

Distribution and Content of Magnesium

Function of Magnesium

Hypomagnesemia

Definition

Etiology and Pathogenesis

Alterations of Metabolism and Function

Pathophysiology Basis of Prevention and Treatment

Hypermagnesemia

Definition

Etiology and Pathogenesis

AIterations of Metabolism and Function

Pathophysiology Basis of Prevention and Treatment

Disorders of Calcium and Phosphorus Meta-bolism

Calcium and Phosphorus Homeostasis

Calcium and Phosphorus Intake and Excre-tion

Content and Distribution of Calcium and Phosphorus within the Body

Regulation of Internal Calcium and Pho-sphorus Balance

Regulation of Intracellular Calcium and Phosphorus Balance

Function of Calcium and Phosphorus

Hypocalcemia

Definition

Etiology and Pathogenesis

Alteration of Metabolism and Function

Pathophysiological Basis of Prevention and Treatment

Hypercalcemia

Definition

Etiology and Pathogenesis

Alteration of Metabolism and Function

Pathophysiological Basis of Prevention and Treatment

Hypophosphaternia

Definition

Etiology and Pathogenesis

Alteration of Metabolism and Function

Pathophysiological Basis of Prevention and Treatment

Hyperphosphatemia

Definition

Etiology and Pathogenesis

Alteration of Metabolism and Function

Pathophysiological Basis of Prevention and Treatment

Case Presentation

Chapter 3 Acid-Base Balance and Imba-lance

Normal Acid-Base Balance

Concepts of Acid and Base

Sources of Acids and Bases

Sources of Acids

Sources of Bases

Regulation of Acid-Base Balance

Buffer Systems

Respiratory Regulation of Acid-Base Bala-nce

Reral Regulation of Acid-Base Palance

Parameters of Acid-Base Balance

pH

PaCO2

Standard Bicarbonate and Actual Bicarbo-nate

Buffer Base

Base Excess

Anion Gap

Simple Acid-Base Disturbance

Metabolic Acidosis

Etiology

Classification

Compensation

Changes of Acid-Base Parameters and Electrolytes

Alterations of Metabolism and Function

Principles of Prevention and Treatment

Respiratory Acidosis

Etiology

Compensation

Changes of Acid-Base Parameters and Electrolytes

Alterations of Metabolism and Function

Principles of Prevention and Treatment

Metabolic Alkalsosis

Etiology

Classification

Compensation

Changes of Acid-Base Parameters and Electrolytes

A1terations of Metabolism and Function

Principles of Prevention and Treatment

Respiratory Alkalosis

Etiology

Classification and Compensation

Changes of Acid-Base Parameters

Alterations of Metabolism and Function

Principles of Prevention and Treatment

Mixed Acid-Base Disturbances

Double Acid-Base Disturbances

Respiratory Acidosis and Metabolic Aci-dosis

Respiratory Alkalosis and Metabolic Alka-losis

Respiratory Acidosis and Metabolic Alka-losis

Metabolic Acidosis and Respiratory Alka-losis

High AG Metabolic Acidosis and Meta-bolic Alkalosis

Triple Acid-Base Disturbances

Respiratory Acidosis and High AG Meta-bolic Acidosis and Metabolic Alkalosis

Respiratory Alkalosis and High AG Meta-bolic Acidosis and Metabolic Alkalosis

Guidelines for the Diagnosis of Acid-Base Disturbances

Diagnosis of Simple Acid-Base Disturbances

Diagnosis of Mixed Acid-Base Disturbances

Differentiate Between Simple and Mixed Acid-base Disturbance According to Compensatory Formulas

Changes of PaCO2 and HCO3￣in Opposite Directions

Calculation of AG value is important for the difierentiation of the classes of simple metabolic acidosis and the diagnosis of mixed acid-base disorders

Case Presentation

Chapter 4 Fever

Etiology

Exogenous Pyrogens

Non-microbial Pyretic Substances

Pathogenesis

Endogenous Pyrogens

EP and the Thermoregulatory Center

Central Mediators of Fever

Stages and Manifestations

The Fervescence Stage

The Persistent Febrile Stage

The Defervescence Stage

Alterations of Metabolism and Function

Metabolism

Central nervous System

Cardiovascular System

Respiratory System

Digestive System

Self-defense

Pathophysiological Bosis of Prevention and Treatment

Case Presentation

Chapter 5 Stress

Etiology and Pathogenesis

Stressor

The Stress Response

Alterations of Metabolism and Function

Stress and Disease

General Adaptation Syndrome(GAS)

Stress Ulcer

Cardiovascular Diseases

Immune Dysfunctions

Posttraumatic Stress Disorder

Basic Principle of Prevention and Treatment for Stress Disorders

Case Presentation

Chapter 6 Hypoxia

Parameters of Blood Oxygen

Partial Pressure of Oxygen

Oxygen Binding Capacity of Haemoglobin

Oxygen Content in Blood

Oxygen Saturation of Haemoglobin

Classification,Etiology and Mechanisms of Hypoxia

Hypotonic Hypoxia

Etiology and Mechanisms of Hypotonic Hypoxia

Characteristics of Blood O2

Hemic Hypoxia

Etiology and Mechanisms of Hemic Hypoxia

Characteristics of Blood O2

Circulatory Hypoxia

Etiology and Mechanisms of Circulatory Hypoxia

Characteristic of Blood Oxygen

Histogenous Hypoxia

Etiology and Mechanisms of Histogenous Hypoxia

Characteristics of Blood O2

Alterations of Metabolism and Function in the Body

Alterations of Respiratory System

Compensatory Response

Injury Manifestation

Alterations of Circulatory System

Compensatory Response

lnjury Manifestation

Alterations of Hematologic System

Compensatory Response

Injury Manifestation

Alterations of Central Nerve System

Alterations of Tissues and Cells

Compensatory Response

Injured Manifestation

Pathophysiological Basis of Prevention and Treatment

Case Presentation

Chapter 7 Shock

Etiology and Classification of Shock

Classification According to Causes

Classification According to the Pathogene-sis of Shock Development

Pathogenesis of Shock

Microcirculatory Mechanisms

Ischemic Hypoxia Stage(Compensatory Stage)

Stagnant Hypoxia Stage(Reversible Decompensated Stage)

Refractory Stage(Microcirculatory Fai-lure Stage)

Cellular and Molecular Mechanisms

Alterations of Cellular Metabolism

Cell Injury and Apoptosis

Humoral Factors

Inflammatory Mediator and Inappropriate Inflammatory Response

Alterations of Metabolism and Function

Metabolic Derangement

Water,Electrolytes and Acid-Base Distur-bance

Organ Dysfunction

Features of Several Common Types of Shock

Hypovolemic Shock

Septic Shock

Anaphylactic Shock

Neurogenic Shock

Cardiogenic Shock

Pathophysiologic Basis of Prevention and Treatment

Improve Microcirculation

Blockage of Humoral Factors

Cell Protection

Organ Protection

Case Presentation

Chapter 8 Disturbances of Hemostasis

Coagulation Cascade and its Regulation

Coagulation System and its Functions

Extrinsic Coagulation Pathway

Intrinsic Coagulation Pathway

Roles of Platelet in Coagulation

Adhesion and Conformational Change of Platelets

Release Reaction of Platelets

Platelet Aggregation Follows Adhesion and Secretion

Anticoagulant Systems

Actions of Serine Protease Inhibitors and Heparin

Thrombomodulin-protein C System

Tissue Factor Pathway Inhibitor

Fibrinolytic System and its Function

Endothelial Cells Modulate Several Aspects of Normal Hemostasis

Coagulation and Anti-coagulation Disorders

Bleeding Caused by Coagulation Factor Disorders

Hereditary Coagulation Factor Disorders

Acquired Coagulation Factor Disorders

Hypercoagulable Status

Hereditary Risk Factors For Thrombosis(Hereditary Thrombosis-Related Coagulation Factor Disorders)

Acquired Risk Factors for Thrombosis-Secondary Hypercoagulable Status

Atrophy

P1asma Fibrinolysis Abnormalities

Bleeding-related Fibrinolysis Abnorma-lities—α2-Antiplasmin Deficiency

Thrombosis-related Fibrinolysis Abnor-malities

Platelet Disorders

Thrombocytopenia

Thrombocytosis

Qualitative Platelet Disorders

Vessel Wall Disorders

Disseminated Intravascular Coagulation(DIC)

Etiologies and Mechanisms of DIC

Extensive Tissue Injuries

Damage of Vascular Endothelial Cells

Destruction of Blood Cells and Activa-tion of Platelets

Pro-coagulants Entering Circulation

Factors Influencing the Formation and Development of DIC

Inappropriately Conditioned Monocytes-Macrophages

Impairment of Liver and Spleen Functions

Hypercoagulable Status

Dysfunction of Microcirculation

Clinical Classifications

Classification According to The Clinical Course

Classification According to the Compensatory Level

Alterations of Metabolism and Function

Bleeding

Organ Dysfunctions

Shock

Microangiopathic Hemolytic Anemia

Pathophysiological Basis of Prevention and Treatment of DIC

Reversing the Underlying Disorders Initiating DIC

Improving the Microcirculation

Reconstructing the Balance Among Coagulation,Anti-coagulation and Fibrinolysis

Case Presentation

Chapter 9 Ischemia-Reperfusion Injury

Etiology

Duration of Ischemia

Collateral Circulation

Dependency on Oxygen Supply

Condition of Reperfusion

Pathogenesis

Free Radicals

Calcium Overload

Neutrophils Activation

Alterations of Metabolism and Function

Myocardial Ischemia-repeffusion Injury

Cerebral Ischemia-repeffusion Injury

Ischemia-reperfusion Injury in Other Organs

Pathophysiological Basis of Prevention and Treatment

Control the Reperfusion Conditions

Scavenge the Free Radicals

Relieve Calcium Overload

Improve the Metabolism

Case Presentation

Chapter 10 Signal Transduction and the Related Disorders

General Concept

Signal Transduction

Transmembrane Signal Transduction

Key Elements of Signal Transduction

Relationship Between Stimulants and Pa-thological Effects

Major Pathways for Cell Signaling

G-Protein-Mediated Cell Signaling

Tyrosine Protein Kinase Mediated Signa-ling

Intracellular Receptor Signaling

Dysfunction of Cell Signaling in Diseases

Aberrant Receptors in Diseases

Aberrant G-Proteins in Diseases

Aberrant Intracellular Signal Molecules in Diseases

Multiple Signaling Aberrations in Diseases

Pathophysiologic Basis of Prevention and Treatment of Diseases

To Regulate the Level of Extracellular Molecules

To Regulate the Structure and the Func-tion of Receptors

To Regulate the Level and Modifications of Intracellular Messenger Molecules and Transducers

To Regulate the Level of Nuclear Trans-cription Factors

Case Presentation

Chapter 11 Abnormal Cell Proliferation,Differenfiation and Related Diseases

Deregulated Cell Proliferation and Diseases

Concept and Phases of the Cell Cycle

Regulation of the Cell Cycle

Regulation of the Cell Cycle by Intracell-ular Signals

Regulation of the Cell Cycle by Extracell-ular Signals

Role of Abnormal Cell Cycle in the Path-ogenesis of Disease

Overexpression of Cyclins

Increased Activation of Cdks and Muta-tion of their Substrates

Deficient Expression and Mutation of Ckis

The Impairment of Checkpoint System

Deregulated Cell Differentiation and Diseases

Regulation of Cell Differentiation

The Regulation on the Genomic Level

Regulation on Transcription and Post-transcription Levels

Extracellular Factors that Control Diif-erentiation

The Role of Abnormal Cell Differentiationin the Pathogenesis of Diseases

Chapter 12 Apoptosis and Related Dis-eases

Introduction

Features of Apoptotic Cells

Phases of Apoptosis

Influence Factors of Apoptosis

Biochemical Mechanism of Apoptosis

A Central Role for Caspases in Apoptosis

Apoptosis Pathways

Regulated Mechanism of Apoptosis

Regulation of the Extrinsic Pathway

Bcl-2 Family Proteins and Regulation of Apoptosis

Regulation of Apoptosis by IAP Family Members

p53

Apoptosis and Diseases

Regulation of Apoptosis in Treatment of Disease

Chapter 13 Heart Failure

Fundamental Knowledge

Histology of Myocardium

Physiology of the Whole Heart

Cellular Physiology of Ventricular and Atrial Myocytes

Biochemical Metabolic Particularity of Myocardium

Etiology

Classification

Right-Side Versus left-side Heart Failure

Acute Versus Chronic Heart Failure

Low-output Versus High-Output Heart Failure

Compensatory Responses

Cardiac Compensation

Systemic Compensation

Pathogenesis

Decreased Myocardial Contractility

Diastolic Dvsfunction

Altered Signal Transduction

Excessive Cardiac Hypertrophy

Clinical Manifestations

Left Heart Failure

Right Ventricular Failure

Pathophysiologic Basis of Prevention and Treatment

Etiologic Therapy

Avoiding Precipitating Factors

Improving Cardiac Functions

Reducing Afterload and Preload

Controlling Edema

Case Presentation

Chapter 14 Respiratory Failure

Etiology and Classification

Etiology

Classification

Pathogenesis

Ventilation Disorder

Gas-exchanging Dysfunction

Alterations of Metabolism and Function

Acid-Base Imbalance and Electrolyte Dis-turbance

Changes of Respiratory System

Changes of Circulatory System

Changes of Central Nervous System

Changes of Urinary System

Changes of Digestive System

Pathophvsiological Basis of Prevention and Treatment

Prevent and Remove of Reasons

Raise PaO2

Degrade PaCO2

Improve Internal Environment and Function of Critical Organ

Case Presentation

Chapter 15 Hepatic Failure

Etiology

Hepatic Insufficiency

Metabolic Disorders

Metabolic Disorders of Water and Electro-lytes

Disorders in Production of Bile Salts and Elimination of Bilirubin

Impaired Kupffer Cells Function

Hepatic Encephalopathy

Etiology and Classification

Pathaogenesis

Precipitating Factors of Hepatic Encepha-lopathy

Principles of Treatment

Hepatorenal Syndrome

Principles of Treatment and Prevention

Case Presentation

Chapter 16 Renal Failure

Acute Renal Failure

Etiology and Classification

Prerenal Acute Renal Failure

Intrarenal Acute Renal Failure

Posuenal Acute Renal Failure

Pathogenesis

Alterations of Metabolism and Function

Urinary Abnormalities

Hyperkalemia

Other Abnormalities

Pathophysiological Basis of Prevention and Treatment

Chronic Renal Failure

Etiology

Clinical Course of Chronic Renal Failure

Stage of Decreased Renal Reserve

Stage of Renal Insufficiency

Stage of Renal Failure

Stage of Uremia

Pathogenesis

Intact Nephron Hypothesis

Trade-Off Hypothesis

Glomerular Hyperfiltration Hypothesis

Alterations of Metabolism and Function

Disorders of Urine

Disorders of Water and Sodium Balance

Disorders of Potassium Balance

Metabolic Acidosis

Renal Azotemia

Renal Hypertension

Calcium,Phosphate and Bone Metabolism

Renal Anemia and Bleeding Tendency

Uremia

Etiology and Pathogenesis

Urea and Other Small Molecular Weight Molecules

Middle Molecules

Polypeptide Hormones

Alterations of Metabolism and Function

Neuromuscular Abnormalities

Cardiovascular and Pulmonary Abnorma-lities

Hematological Abnormalities

Gastrointestinal Abnormalities

Endocrine and Metabolic Abnormalities

Dermatologic Abnormalities

Inmunologic Abnormalities

Pathophysiological Basis of Prevention and Treatment

Case Presentation

Chapter 17 Brain Dysfunction

Cell Biology of the Brain

Neurons

Astrocytes

Oligodendrocytes

Microglia

Basic Knowledge on Consciousness

Anatomy

Physiology

Pathophysiology of Selected Brain Disorders

Parkinson's Disease

Epilepsy

Alzheimer's Disease

Stroke

Case Presentation

Chapter 18 Multiple Organ Dysfunction Syndrome

Overview

Systemic Inflarmmatory Response Syndrome(SIRS)

Etiology

Diagnostic Criteria of SIRS

Stages of SIRS

Pathogenesis of SIRS

Multiple Organ Dysfunction

Types of MODS

Alterations of Metabolism and Function During MODS

Pathophysiological Basis of Prevention and Treatment

Case Presentation

Chapter 19 Metabolic Syndrome

Etiology and Pathogenesis

Obesity and Abnormal Body Fat Distri-bution

Insulin Resistance

Independent Factors that Mediate Specific Components of the Metabolic Syndrome

Other Contributing Factors

Alterations of Metabolism and Function

Hyperglycemia

Obesity

Hypertension

Hypertriglyceridemia

Principles of Prevention and Treatment

Life-style Modification

Pharmacological Therapy

Other Managements

Case Presentation

English-Chinese Comparison