1、The Diseases ofThe Diseases ofFemale Reproductive SystemFemale Reproductive System-Brief Introduction-Brief Introduction王世宣王世宣 Shixuan Wang MD,PhDDepartment of Obstetrics and Gynecology,Tongji Hospital,Tongji Medical College,HUST2History Founder of Department Of Obstetrics and Gynecology,Tongji Hosp
2、italu金问淇教授（金问淇教授（1899-1968）u国家一级教授，清末举人国家一级教授，清末举人u中国妇产科先驱之一中国妇产科先驱之一u同济医院妇产科创始人同济医院妇产科创始人u1946年年1955年，任同济大学医学院妇产科，年，任同济大学医学院妇产科，主任，教授主任，教授u1955年年随同济医院迁至武汉随同济医院迁至武汉u1968年，受迫害含冤而死年，受迫害含冤而死蔡桂茹蔡桂茹马庭元马庭元罗丽兰罗丽兰漆秀梅漆秀梅顾美皎顾美皎3History Former chairmen of the Department百年磨砺宝剑锋百年磨砺宝剑锋闻良珍闻良珍4厚积薄发创辉煌厚积薄发创辉煌Chairm
3、an and vice chairmen of the Dept.at present马马 丁丁乔福元乔福元王世宣王世宣章汉旺章汉旺l 2003年，首批国家重点学科年，首批国家重点学科l 2008年，再次荣获国家重点学科年，再次荣获国家重点学科l 2014年，年，国家妇产疾病临床中心国家妇产疾病临床中心 马丁教授：马丁教授：973首席科学家，国家杰出青年基金获得者首席科学家，国家杰出青年基金获得者 王世宣教授：楚天学者特聘教授王世宣教授：楚天学者特聘教授5 妇产科学系妇产科学系学科建设学科建设6妇产科学系妇产科学系临床（临床（Clinic）u规模：综合医院前列规模：综合医院前列妇科：首批妇科：
4、首批荣获荣获国家临床国家临床重点重点专科专科国家首批住院医师培训基地国家首批住院医师培训基地国家首批四级内镜手术培训基地国家首批四级内镜手术培训基地湖北省妇科和产科质量控制中心湖北省妇科和产科质量控制中心7u2009年年，国家级国家级精品课程精品课程u2010年，年，国家国家双语示范课程双语示范课程参与编写卫生部规划教材配套教材参与编写卫生部规划教材配套教材4本，本，编著共编著共10本，主本，主编编6本本，副主编，副主编6本本妇产科学系妇产科学系教学教学(Teaching)788 妇产科学系妇产科学系科研科研（Research）科研项目：数量、质量数量、质量领先领先科研论文：数量数量、质量领先
5、、质量领先科研获奖：国家科技进步二等奖等国家科技进步二等奖等科研特色：肿瘤转移；妇科肿瘤（如肿瘤转移；妇科肿瘤（如宫颈癌）发生宫颈癌）发生发展机制、防治策略的基础与临床研究；卵巢衰老基础发展机制、防治策略的基础与临床研究；卵巢衰老基础、预警体系；围产期感染；、预警体系；围产期感染；IVF-ETIVF-ET新技术：冷冻胚胎新技术：冷冻胚胎A womans life9 产科学（产科学（Obstetrics）:pregnancy-related 妇科学（妇科学（Gynecology）:Non-pregnant changes10妇产科学（妇产科学（Obstetrics and Gynecology）
6、专门研究专门研究女性特有女性特有的生理、病理变化及的生理、病理变化及生育调控的临床医学学科生育调控的临床医学学科产科学（产科学（Obstetrics）研究研究对象对象：孕产妇、胚胎及胎儿：孕产妇、胚胎及胎儿阶段阶段：妊娠期、分娩期、产褥期：妊娠期、分娩期、产褥期内容内容：生理及病理变化，对病理改变的：生理及病理变化，对病理改变的预防、诊断、处理预防、诊断、处理性质性质：协助：协助新生命诞生新生命诞生的临床医学学科的临床医学学科包括包括：产科学基础，生理：产科学基础，生理产科学产科学，病理病理产科学，产科学，胎儿医学胎儿医学 1112Pregnancy32 weeks36 weeks12 wee
7、ks16 weeks20 weeks24 weeks28 weeks8 weeks4 weeks13Problems during pregnancy14n Abortionn Ectopic pregnancyn Placenta previan Placenta abruptionn Hypertentive disorders complicating pregnancyn Pregnancy with internal diseases 15Abortion 流产流产 Termination of a pregnancy 28 weeksFetus weighing 28 weeks
8、The placenta is inserted in lower uterine segment Vaginal bleedingPlacental abruption 胎盘早剥胎盘早剥19 20 weeks The placenta separates from the uterus ahead of time Persistent abdominal painOne of the leading causes for maternal and peri-neonatal deathIncidence 5%12%Maternal mortality：49.6/100,000Peri-neo
9、natal mortality：16.6%20Hypertentive disorders complicating pregnancy妊娠期高血压疾病妊娠期高血压疾病Gestational hypertension 妊娠期高血压妊娠期高血压Preeclampsia子痫前期子痫前期Eclampsia 子痫子痫Preeclampsia superimposed on chronic hypertension 慢性高血压并发子痫前期慢性高血压并发子痫前期Chronic hypertension complicating pregnancy 慢性高血压合并妊娠慢性高血压合并妊娠Classificat
10、ion Angiocardial system diseases Viral hepatitis Endocrine system diseases Hematologic diseases Acute appendicitis 21Pregnancy with internal diseases and surgical diseasesNormal labor 正常分娩正常分娩22FetusBaby!How?Normal顺产顺产23vaginal delivery Abnormalities of the power(delivery forces)e.g.uterine inertia
11、子宫收缩乏力子宫收缩乏力 Abnormalities of the passage(delivery canal)e.g.contracted pelvis 狭窄骨盆狭窄骨盆 Abnormalities of the passenger(fetus)e.g.abnormal fetal position 胎位异常胎位异常24 Abnormal labor 异常分娩异常分娩Management of abnormal labor in ancient time 25产钳术产钳术胎头吸引术胎头吸引术26Cesarean section 剖宫产术剖宫产术 27 A blood loss of mor
12、e than 500 ml after the baby delivery in the first 24 h postpartum A blood loss of more than 1000 ml during cesarean section Causes:Uterine atony;Placental factors;Genital tract trauma;Coagulopathy 28Postpartum hemorrhage 产后出血产后出血 29 Non-pregnant changes Physiological and pathological Strategies:phy
13、siology;endocrine disorders;inflammatory diseases;gynecologic cancers;endometriosis;genetic and congenital abnormalities;breast diseases;Gynecology 妇科学妇科学BenignHydatidiform mole/molar pregnancy 葡萄胎葡萄胎Malignant(GTT)Invasive mole 侵蚀性葡萄胎侵蚀性葡萄胎 Choriocarcinoma 绒癌绒癌Placental site trophoblastic tumor(PSTT
14、)30Gestational Trophoblastic Disease(GTD)妊娠滋养细胞疾病妊娠滋养细胞疾病妊娠滋养细胞疾病妊娠滋养细胞疾病GTD3132Normal Menstrual Cycle 正常月经周期正常月经周期 most remarkable symbol of a woman regulated by HPO axisGynecological disease33Gynecological diseaseReproductive endocrine diseaseInflammatory diseasesEndometriosis&AdenomyosisPelvic fl
15、oor dysfunctionTumor&Gestational Trophoblastic Disease Defined as abnormal uterine bleeding caused by a hormonal mechanism.No serious medical cause Dysfunctional uterine bleeding is abnormal uterine bleeding occurring in the absence of any obvious pathology.34Dysfunctional uterine bleeding功能失调性子宫出血功
16、能失调性子宫出血35Inflammatory diseases 炎症性疾病炎症性疾病 外阴及阴道炎症外阴及阴道炎症细菌、真菌、滴虫细菌、真菌、滴虫宫颈炎宫颈炎性传播疾病病原体、内源性病原体性传播疾病病原体、内源性病原体输卵管炎输卵管炎输卵管卵巢脓肿输卵管卵巢脓肿子宫内膜炎子宫内膜炎盆腔腹膜炎盆腔腹膜炎盆腔炎性盆腔炎性疾病疾病(PID)Pelvic pain Infertility Abnormal menses36Endometriosis子宫内膜异位症子宫内膜异位症 Endometria appear outside the uterine cavity卵巢内膜异位灶卵巢内膜异位灶小肠内膜异
17、位灶小肠内膜异位灶宫颈内膜异位灶宫颈内膜异位灶腹膜内膜异位灶腹膜内膜异位灶陶氏腔内膜异位灶陶氏腔内膜异位灶37 阴道前壁膨出：膀胱膨出阴道前壁膨出：膀胱膨出(cystocelecystocele)、尿道膨出尿道膨出(urethroceleurethrocele)阴道后壁膨出：直肠膨出阴道后壁膨出：直肠膨出(rectocelerectocele)子宫脱垂子宫脱垂(uterine(uterine prolapseprolapse)压力性尿失禁压力性尿失禁(stress urinary incontinence(stress urinary incontinence，SUI)SUI)生殖道瘘：尿瘘生
18、殖道瘘：尿瘘(urinary fistula)(urinary fistula)粪瘘粪瘘(fecal fistula)(fecal fistula)38Pelvic floor dysfunction盆底功能障碍性疾病盆底功能障碍性疾病39Uterine prolapse 子宫脱垂子宫脱垂40膀胱膨出膀胱膨出 直肠膨出直肠膨出 Myoma of uterus 子宫肌子宫肌瘤瘤41-most common tumor in the female reproductive systemSubserousSubmucous(/intracavitary)Submucous+intramuralSub
19、mucous+Intramural+SubserousMyoma of uterus42Ovarian tumor 卵巢肿瘤卵巢肿瘤43宫颈癌（宫颈癌（cervical cancer）4445Endometrial cancer子宫内膜癌子宫内膜癌Generally defined as the inability of a couple to conceive after 12 months of frequent coitus.Primary infertility applies to those who have never conceived.Secondary infertilit
20、y designates those who have conceived at some time in the past.46Infertility 不孕症不孕症47Any part of the process with a dysfunction or disease,will lead to failure of fertilization Assisted Reproductive Techniques辅助生殖技术辅助生殖技术48Artificial insemination(AI)人工授精In vitro fertilization and embryo transfer(IVF
21、-ET)体外授精与胚胎移植Intracytoplasmic sperm injection(ICSI)卵细胞质内单精子注射Preimplantation genetic diagnosis(PGD)胚胎植入前遗传学诊断 Prenatal diagnosis(3D/4D ultrasonography;genetic diseases;abnormalities)Intrauterine endoscopy Eugenics 优生学优生学49Hot areas for basic and clinical research-Obstetrics PCOS Ovarian aging/POI(PO
22、F)Endometriosis Endoscopic surgery Urogynecology50Hot areas for basic and clinical research Gynecology Chemoresistance in ovarian cancer Early diagnosis of ovarian cancer Biological prevention and treatment of cervical cancer Reversal of the metastasis of gynecologic malignancies Survivorship(生存者权益）
23、生存者权益）51Hot areas for basic and clinical research Gynecologic Oncology Cryo-preservation of oocytes,follicles,or even ovary Pre-transfer genetic analysis Improvement of IVF-ET tech52Hot areas for basic and clinical research InfertilityPelvic SurgeryInternal medicine(Endocrinology,Pharmacology,Oncology)Anatomy,Physiology,Pathology,Ultrosonography,Radiology,molecular biochemistry,.Operation,Chemotherapy,Radiotherapy,Biotherapy(gene therapy)53As a curriculum specialty involved内外兼修，文武双全内外兼修，文武双全做一个医学科学家做一个医学科学家热爱热爱勤奋勤奋思考思考坚持坚持手术刀手术刀分子刀分子刀55
