Video在线视频

我是Howard Takiff
I am Howard Takiff.

我在巴斯德研究院的分枝杆菌遗传学研究组工作
I work in the Mycobacterial Genetics Unit at the Institut Pasteur.

我还在中国深圳市
I also work at the Shenzhen

南山区慢性病防治院（Nanshan CCDC）
Nanshan Center for Chronic Disease Control (Nanshan CCDC), .China

和委内瑞拉加拉加斯的
and in the Laboratorio de Genética Molecular

IVIC分子遗传学实验室工作
in IVIC in Caracas, Venezuela.

本课程讲述的是结核病
This is a course on tuberculosis.

课程的目的是
It is intended to provide practical,

在理论背景下为诊断和治疗提供实用
useful knowledge on how to diagnose and treat the disease

有用的知识
within a theoretical background

使您有能力决断如何最好地管理病人
to enable you to make decisions about how best to manage patients.

您还将了解该疾病的流行病学
You will also learn about the epidemiology of the disease

以及增加结核病易感性的遗传
and the genetic and acquired conditions

和后天条件
that increase susceptibility to tuberculosis.

我们虚构了五个虚拟病人作为学习工具
As a learning tool, we have invented five fictional patients

这些病人案例诠释结核病的不同方面
whose cases illustrate different aspects of tuberculosis, its epidemiology,

其流行病学以及包含耐药菌株
and special situations such as drug-resistant strains

和儿童结核病等特殊情况
and tuberculosis in children.

这些虚构病例将在整个课程中
These fictional cases will be used throughout the course to illustrate

用来说明如何诊断结核病
how to diagnose tuberculosis,

检测耐药性并确定最佳治疗方案
test for drug resistance and decide on the best treatment options.

虚构病人的图片
The pictures of the illustrative patients

大部分来自结核病相关的网站
were mostly obtained from websites dedicated to tuberculosis,

但他们的姓名和临床病史完全是虚构的
but their names and clinical histories are purely fictional.

首例病人A
First case is patient A.

Leila是一名27岁的女性
Leila is a 27-year-old woman

来自非洲撒哈拉南部
from sub-Saharan Africa

主要症状有咳嗽
with cough,

体重减轻
she has lost weight,

发烧和盗汗
and she has fever and night sweats.

Leila也带来了她2岁的儿子Prince
Leila has brought Prince,her 2-year-old son

因为他也有咳嗽和发烧的症状
because he also has cough and fever.

她还带来了
She has also brought Junior,

5岁的儿子Junior
a 5-year-old son.

但是Junior很健康
But Junior is well.

病人B彭（音）
Patient B is Peng,

一位68岁的中国男子
a 68-year-old man in China

主要症状有咳嗽
with cough,

发烧
fever,

盗汗和体重减轻
night sweats and he has also been losing weight.

病人C是Luc
Patient C is Luc.

他是一名糖尿病患者
He is a diabetic patient in Lyon,

来自法国里昂
France,

他也有咳嗽和发烧的症状
who also has cough and fever.

他之前接受过两次结核病治疗
He was treated twice previously for tuberculosis

但依从性很差
but he was poorly compliant.

他没有服用全部药物
He did not take all of his medicines

结核病也没有治愈
and his tuberculosis was not cured.

病人D是Sylvia
Patient D is Sylvia.

她来自东欧
She is an HIV-positive woman

是一位HIV病毒感染者
in Eastern Europe.

主要症状有咳嗽
She has fever,

发烧
cough

体重减轻
and she has also been losing weight.

Sylvia有两个孩子
Sylvia has two children.

一个是8岁的Irina
Irina who is 8 years old.

她是HIV病毒感染者
She is also HIV-positive but she is well,

但是她没有生病
she is not sick.

另一个是19岁的Anton
Anton, age 19,

也是HIV病毒感染者
is HIV-positive.

他有发烧
He has fever,

咳嗽和盗汗的症状
cough and night sweats.

最后一位病人是Peter
Finally, there is Peter.

他是一名24岁的德国男子
He is a 24-year-old man in Germany.

Peter患有囊胞性纤维症
Peter has cystic fibrosis

咳嗽持续了数周
and he has had a cough for several weeks.

这些患者代表了不同的临床情况
These patients illustrate different clinical situations.

您如何诊断这些病人是否患有结核病
How would you evaluate these patients to diagnose whether they have tuberculosis?

如果他们患有结核病
If they have tuberculosis,

您会用什么药治疗呢
what drugs would you like to give to treat it?

您如何确定致病菌株
How would you determine if the strain of tuberculosis making them sick

是否有药物抵抗
is resistant to any of the drugs?

您如何治疗耐药菌株
How do you cure drug-resistant strains?

本课程将为您提供一个理论背景
This course will give you a theoretical background

包括决定应该做哪些检查
to decide which test to give,

了解他们如何进行检查
understand how they work,

为什么做这些检查以及如何解释检查结果
why you are giving them and how to interpret the results.

本课程无意为您提供用来根据体格检查
This course is not intended to give you a clinical background

或X光或X线断层图进行诊断的临床背景
to evaluate the patients based on physical exam or X-rays or tomograms.

但是本课程会让您知道
But they will allow you to know

如何使用当前的分子检测 分子生物学检测
how to evaluate a patient using molecular tests, molecular biology,

以及在不久的将来推出的检测手段
tests that are used today and that are being introduced

来评估病人
to be used in the near future.