CHAPTER Ⅱ Tissue repair CHAPTER Ⅱ Tissue repair. §1. Regeneration Complete regeneration:...

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一. Cell cycle and proliferative potential 1. Cell cycle Interphase G1 (presynthetic) S (DNA synthesis) G2 (premitotic) Mitotic phase (M) Go : quiescent cells in a physiologic state

Transcript of CHAPTER Ⅱ Tissue repair CHAPTER Ⅱ Tissue repair. §1. Regeneration Complete regeneration:...

CHAPTER Tissue repair CHAPTER Tissue repair 1. Regeneration Complete regeneration: Incomplete regeneration: fibrous repair scar Physiologic: cell renewing Pathologic: cell injury regeneration . Cell cycle and proliferative potential 1. Cell cycle Interphase G1 (presynthetic) S (DNA synthesis) G2 (premitotic) Mitotic phase (M) Go : quiescent cells in a physiologic state 2.Types (1) Labile cells (continuously dividing C) Definition: continue to proliferate replacing destroyed cells aged cells Cell groups: Stratified squamous cell : epidermis, oral cavity, vagina and cervix The lining mucosa of respiratory gastrointestinal tract Epithelium of the male and female tract Transitional epithelial of urinary tract Hematopoietic and lymphoid cells (2) Stable (quiescent) cells: Definition: These cells not divide or at a very slow rate and undergo rapid division in response to injury. Cell groups: Parenchymal cells of glandular organ: liver, kidneys tubuel epithelial. Mesenchymal cells: fibroblast, SMC (3) Permanent (nondividing) cells: Definition: no capacity of regeneration Cell groups: Nerve cells: Neurons destroyed are permanent lost replaced by the proliferation of glial C. Skeletal muscle cells Cardiac muscle cells Regeneration process of various tissues ( ) Epithelial tissue 1. Surface epithelium: Squamous cell basal layer cell proliferation Columnar cell adjacent gland recess cellsproliferation 2. Glandular epithelium: Base membrane intact restored cell Base membrane destroyed difficult Liver: Resected partly liver cell proliferation Necrosis of liver C, reticular framework intact : hepatocyte proliferation restore the structure Necrosis widely, framework collapsed hepatocyte nodular regeneration, FT ( ) Fibrous tissue Fibroblast proliferation synthesis collagen derived from quiescent fibrocyte undifferentiated mesenchymal C ( ) BV regeneration 1. Capillary: EC budding proteolytic degradation of BM EC budding maturation of EC secrete collagen IV, laminin, fibronectin BM 2. Large BV EC proliferation SMC CT proliferation Regeneration of capillary ( ) Cartilage and bone tissue 1. Cartilage: proliferation capacity (chondroblast) 2. Bone: proliferation capacity (osteoblast) ( ) muscle regeneration Muscle tissue: lower regenerative capacity Muscle fiber spilt completely FTscar ( ) Nervous tissue NC cant regeneration replaced by glial cell glial scar (4) --- --- 3. Fibrous repair Form and Functions of Granulation Tissue ( ) Composition 1.Granulation tissue: composed of numerous newly formed capillaries and fibroblast, accompanied with inflammatory cell infiltration 2.Morphology: (1) Gross: red, soft, granular appearance (2) LM: cap + fibroblast + inflammatory cells Granulation tissue ( ) Functions and results 1. Functions: (1)Anti-infection and protect wound surface from further injury. (2) Filling wound and the detect area (3) Replacing or encapsule necrosis thrombus, foreign bodies 2. Results: GTcap, cell, fFT scar Scar Concept granulation tissue CT Morphology Gross contract, pallor, semitransparent tough less elasticity. LM composed of collagen parallel fasciculi(hyaline change), less fibrous cells, and BV Scar effect and harm of scar 1 benefits filling the wound and ulcer, make tissue, organ intact; stronger resist pull if lack of elasticity hernia. 2 disbenefit and harm: contract obstruction. conglutination. excess hyperplasia hypertrophic scar (keloid). wound healing: 1.early change: an acute inflammatory process by the initial injury 2.contraction of wound 3. proliferation of granulation tissue and formation of scar 4. migration and regeneration of epithelium and other tissues 2. types of wound healing 1) Healing by first intention (wounds with opposed edges) a clean, uninfected surgical incision 2) Healing by second intention (wounds with separated edges) more extensive loss of cells and tissue, as occurs in infarction, inflammatory ulceration, abscess formation, and surface wounds that create large defects ( ) bone fracture healing 1. basic process hematoma formation 1-2days fibrous bone scab formation 2-3days, granulation tissue form osteal bone scab: osblast osloid tissue calcium deposition woven bone osteal bone scab. rebuild or remodel: woven bone ply bone normal relationship normal struture. ( ) bone fracture healing 1. basic process hematoma formation 1-2days fibrous bone scab formation 2-3days, granulation tissue form osteal bone scab: osblast osloid tissue calcium deposition woven bone osteal bone scab. rebuild or remodel: woven bone ply bone normal relationship normal struture. 2. factors of affect fracture healing correct reposition timely firmly fixation timely take exercise early, keep local blood supply well. CPC 3 12 2 2 37 C 100 / 90/60mmHg B X 1/3 1/3 X Masson masson 1. 2. 3. 1. 2. (1) (2) (3) 3. (1) (2) (3)