内科学 内分泌总论-高鑫

1高鑫GaoXinDepartmentofEndocrinologyZhongshanHospital,[e-mail]ogy2Threestagesofendocrinologydevelopment内分泌学发展三阶段腺体内分泌学OrganicEndocrinology组织内分泌学HistologicalEndocrinology分子内分泌学MoleculerEndocrinology3PrinciplesofEndocrinologyBasicofendocrinology______StructureandfunctionofEndocrinologySystem1.Endocrineglandsandcells2.Hormonesecretioncell3.Definitionofhormone:classificationSynthesisandEliminationDiurnalrhythmsVariation4.Correlationwithneuralandimmunesystem5.RegulationofendocrinesystemsAxisragulationRegulationbetweenhormones6.MechanismsofHormoneActionHormoneswithCellSurfaceReceptors:4typesHormoneswithIntracellularReceptorsDownstreamSignalingPathways7.NutrimentmetabolismClinicalendocrinologyCharacteristicofendocrinesystems:PrinciplesofDiagnosis:Function,Localization,PathologicaldiagnosisPrinciplesofpreventionandtreatment5PrinciplesofEndocrinologyBasicofendocrinology______StructureandfunctionofEndocrinologySystem1.Endocrineglandsandcells2.Hormonesecretioncell3.Definitionofhormone:classificationSynthesisandEliminationDiurnalrhythmsVariation4.Correlationwithneuralandimmunesystem5.RegulationofendocrinesystemsAxisragulationRegulationbetweenhormones6.MechanismsofHormoneActionHormoneswithCellSurfaceReceptors:4typesHormoneswithIntracellularReceptorsDownstreamSignalingPathways7.NutrimentmetabolismClinicalendocrinologyCharacteristicofendocrinesystems:PrinciplesofDiagnosis:Function,Localization,PathologicaldiagnosisPrinciplesofpreventionandtreatment6EndocrineSystemEndocrineglandsHormonesandtheirregulationsystemMetabolicProcess代谢过程OrgansFunction器官功能Growthanddevelopment生长发育Reproductionandaging生殖衰老DiffusednerveandendocrineCellsinothertissueNervousSystem7EndocrineSystemEndocrineglandsHormonesandtheirregulationsystemMetabolicProcess代谢过程OrgansFunction器官功能Growthanddevelopment生长发育Reproductionandaging生殖衰老DiffusednerveandendocrineCellsinothertissueNervousSystem8PrinciplesofEndocrinologyEndocrineglands9EndocrineSystemEndocrineglandsHormonesandtheirregulationsystemMetabolicProcess代谢过程OrgansFunction器官功能Growthanddevelopment生长发育Reproductionandaging生殖衰老DiffusednerveandendocrineCellsinothertissueNervousSystem10DiffusednerveandendocrineCellsinothertissuePrinciplesofEndocrinology11PrinciplesofEndocrinologyBasicofEndocrinologyisthestudyof:(1)hormones(2)theirreceptors(3)andtheintracellularsignallingpathwaysClinicalendocrinologyisthestudyofendocrinediseases(1)hormoneoverproduction;(2)hormoneunderproduction;(3)alteredtissueresponsestohormones;(4)tumorsofendocrineglands.12PrinciplesofEndocrinologyDefinitionofhormoneHormonesarechemicalmessengerssecretedintobloodorextracellularfluidbyonecellthataffectthefunctioningofothercells.Whatexactlyarehormones?131415PrinciplesofEndocrinology16PrinciplesofEndocrinology17PrinciplesofEndocrinology18PrinciplesofEndocrinologyHormone’sclassificationMostcommonly,hormonesarecategorizedintofourstructuralgroups:•Peptidesandproteins:ACTH,LH,FSH,PHT,TSH,Insulin,Glucagon,IGFsSteroids:cortisone,aldosterone,1,25(OH)2D3,androgen,estrogen•Aminoacidderivatives:catecholamine,noradrenalin,adrenalin•Fattyacidderivatives:prostaglandings,Retinol19Regulationofendocrinesystems20Regulationofendocrinesystems2122AnteriorPituitaryHormones23MechanismsofHormonesActionandintracellularsignallingpathways与膜受体结合G蛋白偶联发挥生物效应（肽类激素、生物胺、前列腺素）与膜受体结合受体自身磷酸化发挥生物学效应（酪氨酸激酶）（生长因子家族、Insulin,IGFs)与核受体结合与DNA特异序列结合功能蛋白转录（甾体类激素）24MechanismsofHormonesActionandintracellularsignallingpathways25G-proteincoupled7membranespanningreceptor26G-proteincoupled7membranespanningreceptor27MechanismsofInsulinActionandintracellularsignallingpathways28MechanismsofNuclearReceptorAction30Threestagesofendocrinologydevelopment内分泌学发展三阶段腺体内分泌学OrganicEndocrinology组织内分泌学HistologicalEndocrinology分子内分泌学MoleculerEndocrinology31PrinciplesofEndocrinologyTedRyder---oneofthefirstpatientsoftype1diabetestreatedbyinsulinin192232PrinciplesofEndocrinologyJ.J.R.Macleod(1876-1935)FrederickG.Banting(1891-1941)JamesB.Collip(1892-1965)CharlesHBest(1899-1978)TheNobelprizein1923toBantingFGforhiscontributiontodiscoveryofinsulin33Coris:发现了磷酸化酶的可逆磷酸化（无活性的磷酸化酶b/有活性的磷酸化酶a之间的互变）获得1951年诺贝尔奖。Sutherland:成功分离和确定的腺苷酸环化酶和磷酸二酯酶（cAMP合成与分解的两个关键酶）提出了激素作用的第二信使学说获得1971年诺贝尔生理医学奖。Krebs&Fisher:于60年代末发现蛋白激酶A(PKA)（依赖cAMP,刺激多种底物蛋白磷酸化)阐明了PKA启动的磷酸化和去磷酸化途径。获得1992年诺贝尔生理医学奖。MechanismsofHormonesActionandintracellularsignallingpathways34PrinciplesofEndocrinologyBasicofendocrinology______StructureandfunctionofEndocrinologySystem1.Endocrineglandsandcells2.Hormonesecretioncell3.Definitionofhormone:classificationSynthesisandEliminationDiurnalrhythmsVariation4.Correlationwithneuralandimmunesystem5.RegulationofendocrinesystemsAxisragulationRegulationbetweenhormones6.MechanismsofHormoneActionHormoneswithCellSurfaceReceptors:4typesHormoneswithIntracellularReceptorsDownstreamSignalingPathways7.NutrimentmetabolismClinicalendocrinologyCharacteristicofendocrinediseases:PrinciplesofDiagnosis:Function,Localization,PathologicaldiagnosisPrinciplesofpreventionandtreatmentExpectation35Character