风湿总论0.ppt

大数据和云时代的临床医学 检测手段的进步，单个病人所提供的医学信息越来越庞大，不是每个医生都能看得懂新的影像学和分子生物学的检测结果 同类病人信息集合越来越大，如何挖掘其中有用和有指导意义的的信息越来越困难 虽然循证医学可以提供理想的证据，信息量的增加使得每个病人都各有不同，个体化和精准化医疗难于循证 大数据和云时代的风湿病学 根据遗传学特点、分子生物学特点、临床特征、影像学特征等的分型呼之欲出 评价问题，解决问题 需要更加精准化的治疗 目前的状态 未来的趋势 潜在的风险 证据正在积累中 避免过与不及 over diagnosis 过度诊断、过度治疗：专科医生容易犯 low diagnosis 诊断不及时、治疗不充分：对非自己专业疾病容易忽视 心不近佛者不可为医 技不如仙者不可为医 做好人 看好病 交叉学科，与兄弟科室协作 相关专业了解风湿病是高手的共同特征 风湿医师宽广的知识面才能成就真大师 慢性疾病，与病人的协作 上下级医生与医院的合作 学会会诊，把握各学科最新 中国人要讲团结风湿医生更应该讲团结 谢谢大家 下次预告 与高冠民医生一起看风湿系列 1，糖皮质激素在风湿病中的应用 2，如何选择非甾体抗炎药 3，不同免疫抑制剂的特点及选择策略 4，生物制剂的治疗现状和未来 5，风湿病各论 幻灯片同步到百度文库 可自由下载 /view/bffcf424b4daa58da0114aef.html (CTD) is so called because diseases of this commonly attack the connective tissues. Connective Tissue is defined as the tissue which binds together and is the support of the various structures of the body A more recent term used to describe CTDs is Collagen Vascular Disease as these illnesses specifically target the collagen matrix that supports much of the bodies systems and especially the walls of the blood vessels. Many of these illnesses are also called Rheumatic, Autoimmune, Arthritis-like. You get the picture. CTDs actually wreak havoc on virtually every part of the body and the major source of their weaponry is the human immune system. Immune cells produce many components that ideally, work to protect the body from invasion of foreign cells and viruses, heal wounds. The immune system begins to see native molecules (nuclear proteins, DNA, collagen, etc.) as invaders. Depending on where exactly these cells wage war defines to some extent what your doctor calls your illness and the severity of that illness. Some Autoimmune diseases are Rheumatoid Arthritis (RA), Systemic Lupus Erythematosus (SLE), Discoid Lupus Erythematosus (DLE), and Psoriatic Arthritis. Many affect women much more than men. A few are actually more often seen in men but are generally more rare (Bechets Syndrome, Ankylosing Spondylitis). Many seemingly unrelated conditi