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摘要:目的 探讨病理学教材插图的作用与插图的教学方法。 方法 对国内外几本病理学教材插图进行对比和进行相关的统计分析。 结果 从第四版到第六版，国内的病理学教材插图在质量上明显提高了。与国内的教科书插图相比，国外教材各类插图数量均更多，而且其中线条图和模式图所占的比例也明显高于国内教科书。 结论 有必要提高教材插图的质量并增加其在病理学教学中的应用。
关键词:病理学;插图;教学
Discussion on the illustrated teaching in pathology textbook.CHEN Gang，LUO Dian-zhong，LIULiang，et al.（Division of Pathology of Guangxi Medical University，Nanning530021，Guangxi，P.R.China）
Abstract:Objective To investigate the role and teaching methods of illustration in pathology textbooks. Methods Some comparison and statistical analysis research for illustration had been done on several domestic and international pathology textbooks. Results The quality of the illustration in the domestic textbooks had obviously been enhanced from the4 th to6 th edition.Compared with the domestic textbooks，there was more illustration in the international ones.Among the illustration，the proportion of the pattern and line-drawing pictures were significantly higher than those in domestic ones. Conclusion It delicates that it is necessary to improve the quality of illustration and strengthen its application in pathology teaching.
Key words:Pathology;Illustration;Teaching
Pathology is a basic medical subject，which plays a bridge role in basic medicine with clinical medicine con-cerned.It is also a useful tool for medical scientific re-searches and clinical works.A textbook is an indispensable tool for teaching.Since pathology is a morphological sub-ject，the illustration has an important position in pathology teaching.And illustration is not merely the accessory of a textbook，but has already become one of the indispensablecontents in teaching.
The illustration in pathology textbooks can be classified into macroscopic photos，microscopic photos，pattern pic-tures and line-drawing pictures.Among them，macroscop-ic photos show pathological changes observed by naked eyes.Microscopic photos show the structure under the mi-croscope，including HE staining，immunohistochemical staining and a small amount of electron microscope photos.The pattern and line-drawing pictures display the relation-ship of different pathologic changes，the process of patholog-ical changes，the differentiation various pathological changes and different pathogenesis.All kinds of illustration are com-bined closely with the paragraghs described in the chapterthat complements each other.
By the comparison of several domestic and international textbooks，the function of illustration in pathology textbooksand pathology teaching was discussed in this paper.
1 Illustration composition of different pathology textbooks
There is a large quantity of illustration in pathology textbooks with complex and vivid contents.Some statistical analysis research for illustration has been done on the fol-lowing several domestic and international pathology textbooks
（Figure1.）.
As shown by the figure1，from the4 th edition to the6 th edition，domestic pathology textbooks make every effort to reflect new development of discipline in pathology，while inheriting and keeping traditional system.Though the quan-tity of illustration changes a little，its quality obviously reaches a new lever.For example，all illustration in the lat-ter edition becomes clearer，more colorful and accuracy.All illustration in the4 th and5 th edition is black-and-white，which could not show the characteristic of diseases accurate-ly.One hundred and eight of colorized pictures have been joined in the textbook of the7-year program in the acces-sory pages，which enriches the content and make a great step forward in research of the illustration.But it is not very convenient for students to read the illustration that attached at the end of the book.Similar to international textbooks，all illustration is colorized and appears closely to the paragraphs described in the chapter.It produces brand-newpositive impact on pathology teaching.
Figure1 The Composition of Illustration in Several Kinds of Pathology Textbooks(canceled)
Compared with the domestic textbook，there is more il-lustration in the international ones.Among the illustration，the proportion of the pattern and line-drawing pictures are significantly higher than those in domestic ones，which indi-cate that the illustration is more widely used in pathology teaching，especially the pattern ones.And this point alsoneeds further study.
2 The Role of the illustration in the textbook and the func-tion in teaching
2.1 Organic component of the textbook As a morphologi-cal subject，pathology textbook should have a large amount of illustration on the basis of texts.The illustration of pathology mainly shows the macroscopic samples，micro-scopic photos and mechanism and course of pathology changes.The consummate unification of description and the illustration could enhance the quality of the textbook.In the textbook，the illustration explains the content vividly.It is not only the supplementary of the content，but also contains pathology knowledge and abundant teaching resources.
2.2 Improving the vitality of teaching Using vivid pic-tures to replace various words expressions in the course of teaching can diagrammatize and demonstrate abstract and microcosmic contents intuitively.So it can let students un-derstand the knowledge clearly and get effect instantly.At the same time，its simple，clear and highlighted character-istic accords with students'cognitive law.Therefore，it is easy to solve teaching puzzles，reduce the degree of difficul-ty of acquiring knowledge，open up student's thinking，promote the combination of concrete and abstract thinking and raise the efficiency and quality of teaching.For exam-ple，when mentioned the knowledge about the responses to injury of the microvasculature in the chapter of inflamma-tion，pattern pictures represent four mechanisms of the responses thoroughly and clearly to let students understand it visually.
2.3 Producing the curiosity of study When the pathology textbook is opened，what firstly brings students'attention is often the colorful illustration，then the strong curiosity and desire to learn relative diseases in the pathology textbook will be produced by students.Meanwhile，illustration is convenient for teachers to explain vividly the macroscopic and microscopic pathological changes.This vivid teaching method will bring out and maintain students'attentions in the course of study in order to help themselves study better.
2.4 Strengthening the effect of study Since pictures in human brain are much more direct and simple than letters in it，and they can help students rebuild new imagination，the application of illustration can strengthen students'imagina-tion for pathological changes，promote students'understand-ing of basic conception and principle of pathology，and con-solidate students'memory.Using illustration to replace a lot of words in teaching can improve students'learning efficien-cy and strengthen the effect of study.When reviewing，it is very difficult for students to recollect theory in textbook only by words memory.Illustration can make complicated theory become simple，so it gets easier to achieve the desire when combining with the illustration.For instance，in the chapter of the parasitic diseases in the6th edition，it can be clearly and easily understood the extraintestJnal amebiasis，such as amebic anal fistula，amebic lung abscess，amebic liver ab-scess，etc.only through a simple photograph.
2.5 Causing students'sympathetic responses Illustration not only demonstrates scientificity，but also gives us a feel-ing like looking at a beautiful picture.Its medical knowl-edge and inspiring meaning will cause sympathetic responses in students'mind and make them provoke strong interest in studying on the basis of obtaining certain art-building，thus impel them to gain the abundant knowledge of patholo-gy conscientiously.
2.6 Enhancing the cultivation of general ability The menus displayed by the illustration are static，but a continu-ous course and the content of disease outside the menu will be supplemented by students'legend and imagination.This kind of students'vision can be developed by regular prac-tice.Illustration can enhance students'practical ability of pathological knowledge.In practice，students can macro-scopically and microscopically observe samples by them-selves by the helping of illustration.Illustration can also help students to analyze and understand microstructure of diseases more accurately，and to train themselves certain clinical thinking ability tentatively.
3 How to make ideal illustration in textbook
Illustration in textbook needs to be in line with interna-tional standard actively and accept newmethods and ideas of international medical education while according with domes-tic conditions.The pictures of macroscopic samples should be clear and the pathological changes should be obviously observed at first，for the fuzzy pictures are unfavorable to students'study;what's more，they can influence the accu-racy of study.The color of the pathological changes is the characteristic，so black-and-white pictures cannot meet the requirements.In this way，it had better that the col-orized macroscopic photos are used in textbook，which show the pathological changes objectively ［1，2］ .The histological pictures need to be clear and pathological changes should be typical.The ideal illustration is that both a part of the pathological changes and normal histology images are shown in the same picture，thus it helps students to strengthen their memory.It should be noted that illustration in textbook is prepared for medical students，but not for pathologist，therefore the depth and scope of illustration in textbook should be adjusted according to the goal of training.The same shortcoming of both macroscopic and microscopic pho-tos is that it only displays the static pathological changes，but cannot demonstrate dynamic course，so the help of the pattern pictures is needed.Making mode pictures should first design figure according to teaching purpose，that is to say，it would be short and refined to get the main point.Though mode pictures have certain aesthetic feeling and har-monious sense in color and layout，it is not a pure artistic work at all.So it is not necessary to use too many miscella-neous and beautiful colors and make the simple outline com-plicated either!Different kinds of pictures have differentfunctions.Sometimes the best way to describe the pathologi- cal is to combine macroscopic photos，microscopic photos and mode pictures together ［3］ .For instance，in the chapter of hemodynamic disorders in the6 th edition，the mode pic-ture of the formation of the mixed thrombus is combined with the microscopic photo，which makes it easier for students to understand the process of the thrombosis.And in the chap-ter of Respirator system，the macroscopic photo of the lobar pneumonia in the stage of gray hepatization is combined with the microscopic picture，which makes students master thecharacteristic of lobar pneumonia better.
4 Methods of the illustration application in teaching
4.1 In theory lessons Since the illustration in textbook is level and static，students need to rebuild the new image in the mind.And some illustration in pathology textbook is de-scribed too abstractly;sometimes it is difficult ibr students to understand.So teachers should choose other teaching me-dias such as projections，samples，videos and networks，etc.in theory lessons，taking different'ways such as from multifarious angles，multi-forms，and many kinds of sens-es to combine together and complement advantages in order to extend the study functions of eyes，ears and brains.In this way it would let students form the image of the figure and relevant knowledge systems elementarily in order to strengthen students'perceptual knowledge，make the sense systematized in an all-round way，form students'imagina-tion effectively，impel perceptual knowledge to become ra-tional knowledge and lead students to analyze and grasp relevant pathology knowledge.
4.2 In practice The illustration in textbook can help stu-dents know how to observe the samples in practice.Through contrasting the photos in the book，students are easy to find the corresponding position of the pathological changes in samples and master the characteristic of them.In the situa-tion mentioned above，if teachers do proper guidance and answer questions，they could get the anticipated result in practice.How to use microscope to observe sections is a very important training in pathology.By only studying the theory in the class，most students have not mastered the pathologic changes in sections.After the guidance and ex-planations of the teachers，students could find corresponding pathological changes in sections by themselves by combining the microscopic photos in the textbook.In this case students could understand well microstructure of pathological changes in the state of human disease.
4.3 Self-study after class Teachers should emphasize the importance of the illustration in class in order to let stu-dents raise the consciousness to utilize the illustration.Stu-dents will use the illustration in full way when reviewing and doing self-study after class.When students review the knowledge that is related with illustration，they can observe and review its illustration at first to compare and sum up the illustration，and then read contents.In this way，students can form the systematic knowledge structure in the brain to strengthen memory.Students can learn knowledge which is not explained in the theory classes by themselves after class through studying the illustration.Through this method，stu-dents can also form a good habit of using the illustration.It plays a very good role for training the ability of self-study.Therefore illustration can not only let students acquire new knowledge voluntarily，but also help students reviewing after class.
4.4 Tying up the clinic Since most of students will be medical doctors in the future，the training for students'clinical thinking ability should be paid attention to in pathology teaching.While learning the illustration，students should realize the inner link of multiplicate knowledge，a connecting link between the preceding and following of knowledge points and the cross and infiltration of relevant knowledge，such as pathology connecting with internal medicine，surgery，the gynecology and obstetrics，etc.Through some pictures，students can be leaded to thinking of relevant clinical symptom.For example，in the illustra-tion of the macroscopic sample of the stomach carcinoma，besides grasping relevant pathology knowledge，students can also be brought to think associated questions，like what kindof clinical symptoms that stomach carcinoma patients willhave，how to make a definite final diagnosis，and think this symptom appears.In this way，students not only will have grasped pathology theory，but also will have done somepreparations for the future clinical work.
In a word，illustration plays an important role in pathology teaching.To enhance the illustration teaching will be helpful in strengthening the cognition of visual informa-tion，solving the difficulty in teaching，holding the focal point of knowledge，opening up scientific thinking，thus promoting the students'understanding and remembering of basic conception，principle，and training students'clinical thinking tentatively.So it will help to whip up students'study interest，develop intelligence and train thinking abili-ty.In this way，it can effectively improve the pathology teaching quality.Hence，in order to let illustration to be able to perform an important function in practice of modern medical education，it must be precise，practical and scien-tific when making and choosing illustration;multi-teaching methods should be chosen according to the content of the il-lustration and students'reality in teaching;and the teach-ing reform and innovation of the illustration in textbookshould be emphasized.
Reference:
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作者单位:
1.广西医科大学病理教研室，广西南宁 530021;
2.广西医科大学研究生学院，广西南宁 530021.