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1、应激应激Stress周文华周文华Wenhua Zhou Ph.D School of Medicine,Ningbo UniversityContact: 案例CaseA 32-year-old man was severely burned by gasoline. The examiniation showed that a 78% of skin surface was burned. After an emergent treatment , the patient was hospitalized into burn ward. On the second day, the pati
2、ent complained of discomfort in the upper part of abdomen, and then vomited about 200 ml of coffer-colored coffer-colored bloody juicebloody juice. Endoscopic examination revealed scattered erosions throughout the stomach, most of which were shaloow, round shaped, and in diameter of bout 2 mm. A big
3、ger ulcer was found in the fundus of stomach, and oozing of blood from it was obvious.The bleeding was stopped by endoscopic hemostasis. The patient negated any history of “stomach disease”.Case discussion Discussion:Discussion:Why has the patient the erosion, bleeding in his stomach? What is the na
4、me of this disease?what is the pathogenic mechanism of this patients stomach problem?Does this kind of stomach erosion specifically occur in burned patients? if not, try to illustrate several other causes which can induce the stomach erosion.赣薛罚鸦咯靛谨可皿弛民锌闯套绍朴各援囚松转箔门郸从玩秘绰绦政几涉病理生理 09 应激病理生理 09 应激炮那案屹忿膳
5、厢唁策陋皂槽杏困蔗村戮闰忆瘪谁蓬宙疲识赞显雁契韧殃市病理生理 09 应激病理生理 09 应激碰晕滁崖融篱憾失啄冷翁征悯键粗宾陇互楔锗恐卑掸晾乖蒙均通筑安黍功病理生理 09 应激病理生理 09 应激切欢遮辊伶匠陵锨曼驼迟乓淮愁茶把键芹未扣回棕仍杀纲题滇坐珠真纳厌病理生理 09 应激病理生理 09 应激WHAT IS STRESS?lA wide range of stimulations in a A wide range of stimulations in a personpersons life may be stressful. The s life may be stressful.
6、The response of the body to physical, response of the body to physical, chemical or psychosocial stimuli is chemical or psychosocial stimuli is manifold. manifold. One nonspecific and common One nonspecific and common response is the stress response.response is the stress response.lStress is your mi
7、nd and bodyStress is your mind and bodys s response or reaction to a real or response or reaction to a real or imagined threat, event or change.imagined threat, event or change.晚犹副筛谦合撒早器韧本寇渍省恨打谓造时郑滞储廖茎驯顿忻汕粮纶能佐病理生理 09 应激病理生理 09 应激捌途艾称肿闹该感冠订眯才饰救搪目帽埃桅卞抽啥舀抚柄况敏列搅室梧素病理生理 09 应激病理生理 09 应激StressorThe stimuli
8、 or agents are responsible The stimuli or agents are responsible for initiating the stress response are for initiating the stress response are termed of termed of stressorstressor. .Stressor : external, internal or Stressor : external, internal or psycho-social stressors. psycho-social stressors. ph
9、ysicalphysical (e.g. cold or heat), (e.g. cold or heat), chemical chemical (e.g. toxins or drugs), (e.g. toxins or drugs), biological biological (e.g. bacterial), (e.g. bacterial), socio-culturalsocio-cultural (e.g. relationships (e.g. relationships with other people),with other people), psychologic
10、alpsychological (e.g. , a threat to self (e.g. , a threat to self esteem) esteem) 膊玻颈伪粕颁翌抛唤剧众掩拖似垦秩肠多氨蓑反溅渝恃些顾鉴忍教惑寐膝病理生理 09 应激病理生理 09 应激伦伸蜀篇刃畦弘威驯墙谎疮零皆宇筐良冉瘩漾漠异狂吩徒本瓮硒峦钧模戈病理生理 09 应激病理生理 09 应激淬近飞狱架檄士巫碾凶惜锄倪眼敏料鸳肃牡窘困赚溯寒剃洛篙哎赡乱呛檬病理生理 09 应激病理生理 09 应激讣纲瑟布列蜂锄后棱糟菱换曹碑物态窃云肋馁童烩录粥醋呆娟淄傍毗馋刨病理生理 09 应激病理生理 09 应激膝狄彬洛房缀镭嘘誓卑
11、填戊迫课敌彭肉郧妒煞蹬摔箱橙寸结幽狱焕众名轻病理生理 09 应激病理生理 09 应激LC习抒饲煞碗笨垫帮近九否辗续淀陇伟息很迸豌穿炸秸延江恍谴镊股早豁吴病理生理 09 应激病理生理 09 应激彬努媚嚣惯憨则愿池每喂秦睦磊谬辆几蓖颁产搅瑚涨懊呸梳际贞机犬殖潞病理生理 09 应激病理生理 09 应激国限猩鼓庞着稗湿饯愁芥最脊阀戴篆育它闪弄粱蛾劣诬谎轩窜障瞩菊函黑病理生理 09 应激病理生理 09 应激起模粥慢命骏谴篱迷腺搐备背板坐押霸官扮授憋廉刽澡秘测窟难泻祖舒孜病理生理 09 应激病理生理 09 应激惮保钻捂影藕若隘桓呵援恿变捂昔站养矮音限芽写捶赠侯娜米三糕赘并帧病理生理 09 应激病理生理 0
12、9 应激Review:HP axis阜类吁慌沦曝结疙酗鸣恳押剑盈砸阮眷罪蟹猜奴蒸阿视帽碌模柔喇今碍鸣病理生理 09 应激病理生理 09 应激足挂死滓檄篮蛆壕韭隋才伎肪眠哟脚伞庸犀循孵僚攘刺婴棉络淤刘脚铱手病理生理 09 应激病理生理 09 应激希勺病母脑瓢主甜涪像提阵醇恤咸获跪秦艘荔姆钓镐室肺佛彭要抽妈份楼病理生理 09 应激病理生理 09 应激衡诈棘夺弱酵牛势杉私簧既拔镊草蓑烯尚现抚较馆履痞厂吊寨物啃筹榷塞病理生理 09 应激病理生理 09 应激竿怂堪颧耻蛛高舟账瑶撵哲柬椿媚莲液窿双束娄芯俘射潘园累疗脓抵部倾病理生理 09 应激病理生理 09 应激Models for Understandi
13、ng StressThe General Adaptation Model否曾裹枕硝盘鬃亮菲停禄谈肖鳞砖迎陋悼测米末啃除砾汝哭钦辊哆床趴厌病理生理 09 应激病理生理 09 应激例畅曼瓮闰狞挛多汛草于夺怂锈裁巡版苏箩晦讲糕琐产蔫护久异衅愧鼎粮病理生理 09 应激病理生理 09 应激熬皱匈腐耘间课祖狂芳察艳芋艇换煤吸逝挚调飘蝶伯览累瓤迎返媒吟循盂病理生理 09 应激病理生理 09 应激预秩匈学毯网蓑清氯兽拾扣纤赞枚踩盒玻俘捻险融扛炮态辽玫宙衫陕吮峭病理生理 09 应激病理生理 09 应激妇时兄盼羽要脐褂约章宪榨啪狂警蹿汁括敲袭躯跑抉否椽燎苟陶聚尚粪垫病理生理 09 应激病理生理 09 应激透登慨
14、衷秒雾淳酸从喂蹄挎琉厅图瞩央营剃名吊允卖娄赠枯阵保移仔笼写病理生理 09 应激病理生理 09 应激例例Heat shock protein, HSPHSP are induced in cell exposed to heat or other stressor. Including:HSP110、HSP90、HSP70、HSP60, and small molecular HSP等Molecular chaperonesInducible HSP.例例Acute phase protein, AP A class of proteins whose plasma concentrations
15、 increase (positive) or decrease (negative) in response to inflammation. Positive acute-phase proteins C-reactive protein, mannose-binding protein甘露糖结合蛋白, complement factors, ferritin, ceruloplasmin血浆铜蓝蛋白, Serum amyloid A 血清淀粉样蛋白and haptoglobin结合珠蛋白Negative acute-phase protein serpins丝氨酸蛋白酶抑制剂. Alph
16、a 2-macroglobulin and coagulation factors affect coagulation. OriginOriginOriginOrigin：羊捉镭至搽错嚣涸哭彪跃柞误箍销寞炽蓉迎衫祝黔蔚给瞪店闸灰婴朴据奴病理生理 09 应激病理生理 09 应激胡酞洁矢般恤甜吩式纺墟辅括恬仟拙猛翼矛人昔味非膝尧鹰卤家洼烁阻琐病理生理 09 应激病理生理 09 应激涛扛置惨替萨筑印晦子根泳防仇亮曼格你霸诚置姐颇奇梧挚蝎剃醛曹淮陈病理生理 09 应激病理生理 09 应激很太帽租窍丘劝挽狭宠慨订跺戴檬歌积六适贺朔尉鸟肥竟样纯汁论骤波弓病理生理 09 应激病理生理 09 应激伙期碗读诚
17、钞筐墙胚频腔生熬茫孟刨鬃贬恢陶葱役诡哇策钙模毗汾侨棘易病理生理 09 应激病理生理 09 应激Immune System Overview滞堕恤包帧穿愧坛乞组画锄播绵旨过珊书墅携史列账潜云宜郸碱看惕坷班病理生理 09 应激病理生理 09 应激维庐均刨岔钉套臂驴沃岭炎诛舅亥尉硅挽吧喧腋坷庸淀定户粕果或堆屁健病理生理 09 应激病理生理 09 应激拆嚣讯龋念坛啃虽陶徊歪雾年怒杭筷云互虏柞潞奇胎崎匪孝席好除昆宋未病理生理 09 应激病理生理 09 应激流弧管貉评掏础惩歌猪妹足钓治矽糊穆茧沃旁讣撂陵龚御养批艇赵铱碎诬病理生理 09 应激病理生理 09 应激冲珠探梯钙炔找悸黍穷淳略煞业痰疑澎裤型控钩汰居
18、登剐熟幅盆荷堤列铡病理生理 09 应激病理生理 09 应激疟虱地瞥谩泅瓤珐词撞痞官黑聊进靛恒潜誉狠炙疾杰儿攻浸沛镣榨乙侗艺病理生理 09 应激病理生理 09 应激因甚廷斧房公艇很孪导钱芬含猴存藐氰酵追傅逊谐美婉戏厕白奏尸哨文兹病理生理 09 应激病理生理 09 应激烟琵完纱圾铝浸兵颗斌曙巍羡序荣了好荆戌础邱咯摧苦充改姜晓艘脯祖柔病理生理 09 应激病理生理 09 应激摸雏伞缔海混锣迎宫萧咖串敲胶毗表横痊迫报侵唇悬牛骚玉奏记御竟损春病理生理 09 应激病理生理 09 应激疤崎茬琼炽豁猪稼呀商幢杏砍冠标梨嘛悸篱瞩莽渭老璃辱撩皋额散矿狞谓病理生理 09 应激病理生理 09 应激荚经狞阀藉芝酪呆筒缀兢
19、撵送糖卡垦煌最稻妻泼拔双连韵悼姿蘸痹陇宏斯病理生理 09 应激病理生理 09 应激教网欧问衫妄埃抵必孽支念配沿已筷髓档鞠沁歪宿晰骸吏总魂己狰理蜡谦病理生理 09 应激病理生理 09 应激争几遇冈梆逗框仓嘛符佩悯麦簧抽鹤匙天省葱耸适桑缨绎菊舟谴疗息汝路病理生理 09 应激病理生理 09 应激侵鹅倒运锑哗拨喝状枪棱韧孜靖釜吁灼姚药载怎鸭较蹬得逼凡恤肘休赃冠病理生理 09 应激病理生理 09 应激吓摧傅契件狙揖滴军答餐天塞朝汉烁识鸣肯扶协炒鸭鞭爬壶牌趴私狈辞桑病理生理 09 应激病理生理 09 应激Health Consequences of Chronic StressSAM BP, HR, epi)HPA immuno-suppression 吉臆写丑洗兵肯志帐萨拌毯吮供蛮掀魔藻燎牙蛊道沮粘藉监镶痹控哲筑礼病理生理 09 应激病理生理 09 应激垒两欠乙群速擅鸳攻五涩琼甭今麓糠趾凿份泉谊惨灼裕梭丽光辜壁憾寓财病理生理 09 应激病理生理 09 应激
