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Clinical Diagnostics: Ran Zhi Hua (冉志华)
Clinical Diagnostics: Ran Zhi Hua (冉志华)
Department of gastroenterology
Ren-Ji hospital
Shanghai Jiao Tong University, School of
Medicine
Diagnosis
Identificatio Analysis
n
Diagnosis
(诊断)
☆ Derived from Greek words
distinguish or discern
识别 / 鉴别 认识
☆ English term
Diagnostic
学)
通过疾病的表现来识别疾病内在本质或属性
☆ In modern usage:
☆ Medical terminology:
Analysis: ( 分
析 ) Basic knowledge of medicine
Overall analysis
Scientific way of clinical thinking
Importance of Diagnostics
Essential ( 基础)
Basic courses
Bridge (桥梁)
Tools (工具)
Clinical medicine
Content of Clinical Diagnostics
Symptomatic diagnosis ( 症状诊断 )
Medical record
Inspection ( 望)
Palpation (触)
Percussion (叩)
Auscultation (听)
Laboratory test or ancillary tests
• Serum, Urine, Stool tests
• X-ray film
• EKG
• Endoscopy
• Ultrasonic imaging
• CT
• MRI
• PET (Positron Emission Tomography)
Medical record
• Look for current best evidence: the perfect study may not yet have
been published, written up or even commenced. We may have to
settle for something less rigorous, but be on the look out for new
research that will supersede older studies.
Important aspects---
interrogation
• To get the history in detail of a patient’s illness
Hippocrates
• c.130-c.200
• His work in
anatomy/physiology is notable
• Identified artery and vein
• Added greatly to knowledge of the
brain, spinal cord and pulse
Contribution of ancient doctors---Western
Auenbrugger
Laennec RTH
•A French physician
•Invented Auscultation and stethoscope
Contribution of ancient doctors---Western
Laennec RTH
1816
Contribution of Western Physician
17th~19th century
Leenwenhock Microscopy (end of 17th century)
Fahrenheit Thermometer (1724)( 体温计 )
Ludwig Hematomanometer (1847)( 血压
计)
Welcher Hematinometer (1854)
( 血细胞计数仪 )
20th century
X-ray film EKG
Endoscopy CT PET
Ultrasonic imaging
CT imaging
MRI
PET
Traditional Chinese Medicine
Wood
Wood
Fire
Fire
Earth
Earth
Metal
Metal
Water
Water
Contribution of ancient doctors---Chinese
Inspection
Interrogation
Smell
Pulse palpation
《内经》
Pay attention to: