Diagnosis (6th Edition)

Author: Chen Wenbin et al. (Editor-in-Chief)
Publisher:
Publish Date: 2004-03-01
Features: Diagnostics is a discipline that applies fundamental medical theories, knowledge, and skills to diagnose diseases. It serves as a mandatory course for medical students to transition from studying basic medical sciences, including anatomy, physiology, biochemistry, microbiology, histology and embryology, pathophysiology, and pathology, to learning clinical medical sciences. Its main content includes collecting medical histories through interviews, systematically and comprehensively mastering patients' symptoms. Through methods such as inspection, palpation, percussion, and auscultation, it carefully investigates patients' signs and symptoms, and conducts necessary laboratory tests, such as hematological, biochemical, and etiological examinations, as well as instrumental examinations like electrocardiography, X-rays, and ultrasound, to reveal or discover the entire clinical manifestations of patients. Learning how to obtain these clinical signs and mastering the basic skills of collecting this clinical data are essential. By applying acquired basic medical theories, students can elucidate the pathophysiological basis of clinical manifestations and propose possible diagnoses, laying a foundation for learning clinical medical sciences, clinical observation, and internships. The sixth edition of the textbook "Diagnostics" was compiled not only according to the unified requirements of the Ministry of Health's Clinical Professional Textbook Review Committee but also incorporated many suggestions from teachers and students, undergoing comprehensive revisions to further enhance the scientific and practical value of the book. The main revision opinions are as follows.
Physical Examination Section:
Enhanced training in interview techniques, with special emphasis on how doctors interact with patients and establish a good doctor-patient relationship to improve the accuracy of history-taking. In the practice of interview techniques, emphasis was placed on how to guide the interview, progressing in a step-by-step manner according to the time, nature, and related symptoms of each symptom. To ensure students first master the methods and techniques of interviewing, the chapter "Common Symptoms" was placed after the chapter "Content of Interviewing," making the sequence more logical and easier for students to grasp. To make the content of interviewing more accurate and comprehensive, the chapter "Methods of Interviewing" was supplemented with "Interviewing Techniques for Special Cases." Previously, physical examinations were mostly taught and practiced by body region or system, lacking an overall examination concept, leaving students helpless when facing patients and unsure where to start. Therefore, a new chapter titled "Comprehensive Physical Examination" was added after each system examination to establish the concept and methods of holistic examination. Regarding medical record writing, this book dedicates a separate chapter to it, closely linking it with interviewing and physical examination, making it more systematic and logical. This chapter not only describes the types, formats, and content of medical records but also adds examples of inpatient and outpatient medical records, as well as requirements for common medical documents, for students to refer to when writing medical records. Some content that has been rarely used in clinical practice for many years or is highly specialized and not required for this course was removed, such as heart vector electrography, esophageal pacing, bronchoalveolar lavage, and the coin percussion sign for diagnosing pneumothorax. The chapter on "Ultrasound Examination" was merged into the textbook "Imaging Diagnostics," and this book no longer covers this content. Additionally, considering that "Clinical Common Diagnostic Techniques" are not taught in the diagnostics course, this content is mainly for reference during clinical internships and has been included in the appendix.
Clinical Diagnostic Thinking Methods and Steps:
The thinking methods and steps of clinical diagnosis are designed to help medical students learn diagnostics and transition to diagnosing diseases in internal medicine and other clinical disciplines. The final chapter of this book provides a detailed introduction, briefly summarizing the various relationships to be addressed during the diagnostic process, as well as the basic principles and steps for establishing a diagnosis.
Laboratory Diagnosis Section:
In the sixth edition of "Diagnostics," the chapter on "Laboratory Diagnosis" is still organized based on different types of specimens for testing, but it emphasizes the integration of the complete medical testing system, categorizing related testing items into nine chapters. A new chapter titled "Applications of Molecular Biology in Clinical Practice" was added, ensuring both clear logic and alignment with the progressive arrangement of teaching courses. The introduction focuses on the concept, main content, progress in clinical laboratory testing, and the objectives and requirements of learning laboratory diagnosis. This book also specially adds important content suitable for the current trends and status of laboratory diagnosis in the introduction, such as "Evidence-Based Medicine and Laboratory Diagnosis," "Laboratory Quality Systems," "Personalized Diagnosis," and "Point-of-Care Testing," laying a foundation for further mastering various laboratory diagnostic techniques. Additionally, the introduction emphasizes that students should master the principles of selecting testing items, specimen collection and submission, and evaluating test results to ensure that laboratory diagnosis content can be practically applied in clinical settings.
In the chapter "Applications of Molecular Biology in Clinical Practice," the basic concepts and common techniques of molecular biology, as well as the fundamental concepts and detection methods of gene and chromosome testing, are introduced. This aligns with the current widespread use of molecular biology techniques in clinical disease diagnosis and treatment, providing foundational theories and knowledge in this field to further develop gene diagnosis and treatment. Additionally, this book adds content on "Testing for Organ and Bone Marrow Transplantation" in the chapter "Clinical Common Immunological Tests," allowing students to gain some understanding of transplant immunology monitoring, given the increasing prevalence of organ transplantation in clinical practice today.