由损伤周围的同种细胞来修复Aprocessthatthenecrotic.PPTVIP

They are in the resting phase (G0) but can be stimulated to enter the cell cycle. They retain the capacity to multiply in response to stimuli. Chances of regeneration remain Including: parenchymal cells of organs like liver, pancreas，kidneys, adrenal and thyroid; mesenchymal cells like, fibroblasts and endothelium. They are non-dividing cells which have left the cell cycle and die after injury. Including: neurons, skeletal muscle and cardiac muscle cells The peripheral nerve has retained the capacity for regeneration with damage. Regeneration of Epithelial Tissues It may regenerate completely if the basement membran is intact. Regeneration of Connective tissue Proliferation of Blood Vessels --Angiogenesis Regeneration of muscular tissues 横纹肌的再生依肌膜是否存在及肌纤维是否完全断裂而有所不同 心肌再生能力极弱，破坏后一般都是瘢痕修复 平滑肌具有一定的分裂再生能力 Regeneration of nerve tissue 肉芽组织（Granulation tissue） 瘢痕组织（scar） Consequences of granulation tissue Function of granulation tissue anti-infection and protecting the surface of wound 抗感染保护创面 filling wound or tissue defect 填补创口及其它组织缺损 organization or encapsulation: granulation tissue replace necrotic tissue, blood clot, and foreign bodies 机化，包裹 Morphology and function of scar Morphology and function of scar The mechanism of granulation tissue and scar formation Fibrosis Tissue remodeling Matrix Metalloproteinase (MMPs) Clinical Stages in skin Wound Healing 表皮及其它组织再生 病例讨论 王××，男，12岁，因“车祸左小腿疼痛活动受限2小时“入院。患者2小时前被车撞倒在地，当时左小腿弯曲、疼痛，不能活动。入院检查：体温37o脉搏100次/分，血压90/60mmHg，左小腿肿胀，短缩，局部有压痛，可触及骨擦感，左小腿不能活动。 B超：腹内脏器未见异常。 实验室检查：血常规、尿常规均正常. X线检查： 临床处理：术后,X线报告对位、对线尚可。术后一周再次复查，结果同前。一月后复查，对位、对线良好，见少量骨痂形成。牵引一月后改为石膏固定二月。术后三月复查： 讨论： 1.该骨折愈合属于哪种类型的修复? 2.骨折愈合的基本过程如何？ 3.哪些因素可影响骨折的愈合？ Process of fracture repair（骨折愈合） HEALING OF A CLOSED FRACTURE (Histologic Features Hours After the Fracture) Features HEALING OF A CLOSED FRACTURE(Histologic Features Days After the Fracture) Features HEALING OF A CLOSED FRACTURE(Histologic Features Weeks After t