佝偻病手足抽搐症.pptxVIP

BackgroundWhat happened to these children ?First thorough account of ricketsFrancis Glisson(1650)Martins e Silva J. Acta Reumatol Port,2007. 32:205.Isolation of the antiricketic factor from liver oil Mellanby Edward(1918)Mellanby E. Br Med J, 1924 , 24: 895 Synthetically prepare vitamin D3Adolf windaus (1922) In the 1970s“ no more campaign on rickets”Veena Bahl. Nutrition Food Science, 1993, 81 :2 In the 2000sThe Lancet: “re-emergence of rickets”“I think this is a major unrecognized epidemic in the United States. It affects children and adults of all ages, all races, and both sexes. It’s very significant. ”“Vitamin D deficiency symptoms in children have long been overlooked.” Rowe PM. Lancet,2001,357:1100 Rickets of vitamin D deficiency 营养性维生素D缺乏性佝偻病Teaching aimsTo be familiar with its pathology, diagnosis and differential diagnosisTo master its etiology,clinical manifestations, treatment and prevention of RicketsDefinition Rickets is the term signifying a failure in mineralization of growing bone or osteoid tissue due to deficiency of vitamin D What is Rickets?Mineralization:矿化Osteoid:骨样组织 Osteomalacia:骨软化症The source and conversion of Vitamin DResource of VitD Calciferol(vitD2)Cholecalciferol(vitD3)Materno-fetus 296~310nmDietary and therapeutic source 7-dehydrocholesterol in skinActivation of VitDHydrooxylated in the renalBiologically active form1,25(OH)2D3Hydrooxylated in the LiverCirculating form25(OH)D3DBPVitD2 VitD3 Function of 1,25(OH)2D3Receptors（intestins, renal, bone）Facilitation of intestinal absorption of calcium and phosphorusReabsorption of phosphorus in the kidneysDirect effect on mineral metabolism of boneAccommodation of cell proliferation and immune system Function of 1,25(OH)2D Quiz What is the major circulating form of vitamin D ? 25(OH) D3What is the biologically active form of vitamin D? 1,25(OH)2D3Tell us the function of 1,25(OH)2D3.Antiricketic function：intestines, renal, boneOthers：anticancer，immunomodulationEtiologychildrenetiology