2022年4月 第37卷 第4期

主管:中华人民共和国教育部
主办:中山大学
承办:中山大学中山眼科中心
主编:葛坚 刘奕志
“筑梦·铸人”专题

视网膜神经节细胞特异的报告基因干细胞系构建及其应用

Establishment and application of a retinal ganglion cell-specific reporter stem cell line

:245-254
 
目的:建立能驱动GFP在视网膜神经节细胞(retinal ganglion cell,RGC)中特异性表达的小鼠胚胎干细胞系。方法:通过同源重组的方式建立Brn3b-GFP敲入的小鼠胚胎干细胞系(Brn3b-GFP ESC),利用3D培养将其诱导成视网膜类器官检测GFP表达的细胞特异性,再用流式细胞分选富集GFP阳性RGC,采用玻璃体腔注射的方式将GFP阳性RGC移植到健康小鼠和NMDA损伤模型小鼠眼中探索该细胞的应用价值。结果:Brn3b-GFP ESC经3D视网膜诱导培养后在RGC中特异性表达GFP,将这些GFP阳性RGC移植到两种小鼠中2周后能在所有视网膜内观察到GFP阳性细胞存活,且均能观察到有供体RGC整合到宿主视网膜RGC层。结论:本研究建立了RGC特异的报告基因干细胞系Brn3b-GFP ESC,通过将该细胞系诱导成视网膜类器官进而获得的GFP阳性RGC移植后能够整合进宿主视网膜。该细胞系的建立将为青光眼及相关疾病提供重要的研究手段和工具。
Objective: This study was designed to establish a mouse embryonic stem cell line that can drive GFP expression specifically in retinal ganglion cells (RGCs). Methods: In this study, we established a Brn3b-GFP knock-in embryonic stem cell line (Brn3b-GFP ESC) by homologous recombination. By 3D culture, we induced these cells into retinal organoids to investigate the cell-specificity of GFP expression. GFP-positive RGCs were then enriched by flow cytometry and transplanted by intravitreal injection into the eyes of healthy mice and NMDA injury model mice to explore the feasibility of a potential clinical application. Results: GFP was specifically expressed in RGCs following induction of Brn3b-GFP ESCs into 3D retinal organoids. Two weeks after these GFP-positive RGCs were transplanted into the control and injured mice, GFP-positive cells were observed in all transplanted retinas, and donor RGCs were seen to integrate into the RGC layer of the host retina. Conclusion: This study has established a retinal ganglion cell-specific reporter stem cell line Brn3b-GFP ESC. The GFP-positive RGCs obtained by inducing the cell line into retinal organoids can be integrated into the host retina after transplantation. The establishment of such a cell line will provide an important research tool for glaucoma and related diseases.

视网膜类器官衍生物的研究应用

An overview on applications of retinal organoid derivatives

:255-270
 
视网膜退行性疾病的种类繁多、患病人口基数大,该病特征为终末期严重的视网膜细胞丢失。视网膜类器官(retinal organoid,RO)可通过3D干细胞体外分化培养技术大量获取,并拥有完整的各亚型视网膜细胞和经典的视网膜分层结构。因此,RO可作为最佳的视网膜退行性疾病建模方法之一,以便于发现潜在致病机制。目前,RO衍生物已被广泛用于视网膜细胞替代治疗的动物实验和临床研究,具体的成效参差不齐,可能的影响因素包括移植细胞数量、移植时间窗、移植工具等。随着RO相关研究的快速发展,视网膜退行性疾病在分子和个体上的诊断和治疗将进一步完善。
Retinal degenerative diseases, characterized by severe retinal cell loss at the end stage, are of various kinds and haunt vast amounts of patients. Retinal organoid (RO) with complete retinal cell subtypes and classic retinal stratification structures can be obtained in large quantities through stem cells in vitro 3D differentiation and culture method. Therefore, RO can serve as one of the best ways for retinal degenerative disease modeling to facilitate the decipherment of underlying pathogenic mechanisms. At present, RO derivatives have been widely used in animal experiments and clinical studies of retinal cell replacement therapy with varying results possibly affected by cell quantity, time window, or tools in terms of transplantation. With the booming progress of RO-related research, the diagnosis and treatment on molecular and individual level for retinal degenerative diseases will be further improved.
“眼科再生医学”专题

生物工程角膜应用于感染性角膜炎的临床观察

Clinical observation of bioengineered cornea in infectious keratitis

:271-280
 
目的:观察生物工程角膜应用于感染性角膜炎的治疗效果。方法:对成都爱迪眼科医院19例采用生物工程角膜治疗的感染性角膜病角膜植片存活状况、术后视力变化及并发症进行回顾性分析。与同期22例人来源供体角膜移植行术后排异对比。结果:在19例患者中,女9例(47.37%),平均年龄53.32岁;病因中细菌性角膜炎7例(36.84%),真菌性角膜炎8例(42.11%),病毒性角膜炎4例(21.05%)。术前裸眼视力检查:光感3例(光定位准),手动5例,眼前指数4例,3.0~3.9者7例。随访1~14个月未发生原发感染复发;植片成活18例(94.74%),1例1月内植片溶解再手术(5.26%)。裸眼视力4.0~4.5者15例(78.95%),3.0~4.0者3例(15.79%),数指1例(5.26%)。远期(6~12个月以上)生物工程角膜移植术后角膜缘新生血管更易侵入,以植片缘环形浑浊为主。两组间排异差异无统计学意义(Mann-Whitney检验,P=0.736)。结论:生物工程角膜具有较好的人角膜结构替代功能,对未累及全层的感染性角膜疾病起到较好的结构和功能重建作用,恢复有用视力,缓解角膜供体来源不足,有一定推广意义。
Objective: To observe the outcomes of bioengineered cornea for lamellar keratoplasty in the infectious keratitis.Methods: A total of 19 cases with infectious keratitis treated by bioengineered cornea in Chengdu Aidi Eye Hospital were analyzed retrospectively. The results of graft survival, visual acuity and complications were collected.Rejection reaction was compared with 22 cases of human donor corneal lamellar keratoplasty during the same period. Results: In the 19 cases patients, 9 cases were women (47.37%) with the average age of 53.32 years. Among the pathogenic factors, 7 cases were bacterial keratitis (36.84%), 8 cases were fungal keratitis (42.11%) and 4 cases were viral (21.05%). The results of preoperative uncorrected visual acuity (UCVA) showed that 3 cases were light perception (accurate light positioning), 5 cases were hand moving, 4 cases were counting finger, and 7 cases were in the range of 3.0–3.9. In the follow-up, no case of primary infection recurrence occurred; 18 grafts survived except one case dissolved end with re-transplant by human donor. The postoperative UCVA of 15 cases (78.95%) were in the range of 4.0–4.5, 3 cases were in the range of 3.0–4.0 (15.79%), and 1 case of counting finger (5.26%). There was no significant difference in rejection action (P=0.736). In the follow-up more than 6–12 months, the limbal neovascularization of the biological engineering cornea is more likely to invade with the result of ring shape opacity at the graft edge. Conclusion: The biological engineering cornea can play a good role in the reconstruction for the cases with infectious keratitis. It provides another way to solve the shortage of corneal grafts.

晶状体发育过程中细胞器降解及其机制的研究现状

Research progress of organelle degradation and its mechanisms during lens development

:281-290
 
在晶状体纤维细胞分化的终末阶段,细胞核、线粒体、内质网及高尔基体等膜性细胞器会发生程序性的降解,这对晶状体透明性的维持至关重要。然而,晶状体细胞器降解过程的机制尚不明确。研究晶状体细胞器的降解过程可为阐明白内障的发病机制提供理论依据,也有望为晶状体再生提供新的干预靶点。本文就晶状体细胞器降解过程及其机制进行综述。
During terminal differentiation of lens fiber cells, nuclei and other organelles experience programmed elimination.This process is essential for the maintenance of lens transparency. However, the mechanisms underlying lens organelle degradation remain unclear. Identification of the mechanisms can provide a theoretical basis for elucidating the pathogenesis of cataract and is expected to reveal new intervention targets for lens regeneration. In this review, we discuss potential mechanisms and the process of lens organelle degradation.
论著

高效液相色谱法同时测定盐酸丁卡因滴眼液中盐酸丁卡因和羟苯乙酯的含量

Determination of tetracaine hydrochloride and ethyl hydrobenzoate in tetracaine hydrochloride eye drops by HPLC

:291-297
 
目的:建立高效液相色谱法(high-performance liquid chromatography,HPLC)测定盐酸丁卡因滴眼液中盐酸丁卡因和羟苯乙酯的含量。方法:采用Agilent Eclipse PLUS C18色谱柱(250 mm ×4.6 mm,5 μm);以1%三乙胺溶液(三乙胺10 mL,加水990 mL,用冰醋酸调节pH值至5.0±0.5)-乙腈(65 : 35)为流动相,流速为1.0 mL/min;柱温为30 ℃;检测波长为256 nm;进样体积20 μL。结果:盐酸丁卡因在0.05~0.36 mg/mL范围内线性关系良好( r =1.000),平均回收率为99.2%,相对标准偏差(relative standard deviation,RSD)为0.3%(n=9),羟苯乙酯在3.02~24.14 μg/mL范围内线性关系良好(r=1.000),平均回收率为98.2%,RSD为0.4%(n=9),该方法重现性好。对照品溶液和供试品溶液在室温放置24 h基本稳定;结论:本方法简便、快速、准确。适用于检测盐酸丁卡因滴眼液中盐酸丁卡因和羟苯乙酯的含量。
Objective: To establish a high-performance liquid chromatography (HPLC) method for the determination of tetracaine hydrochloride and ethyl hydrobenzoate in tetracaine hydrochloride eye drops. Methods: The analytic column was Agilent Eclipse Plus C18 (4.6 mm ×250 mm, 5 μm) and the mobile phase was 1% triethylamine solution (10 mL triethylamine and 990 mL water, pH adjusted to 5.0±0.5 with glacial acetic acid) - acetonitrile (65:35) at a flow rate of 1.0 mL/min. The detection wavelength was 256 nm and the column temperature was 30 ℃. The injection volume was 20 μL. Results: The linear range of tetracaine hydrochloride was well shown within 0.05–0.36 mg/mL (r=1.000). The average recovery rate of tetracaine hydrochloride was 99.2% with relative standard deviation (RSD) 0.3% (n=9). The linear range of ethyl hydrobenzoate was well shown within 3.02–24.14 μg/mL (r=1.000). The average recovery rate of tetracaine hydrochloride was 98.2% with RSD 0.4%(n=9). The method had high reproducibility. The reference solution and testing solution were stable for 24 h in room. Conclusion: The method is simple, quick and accurate, which is suitable for the determination of tetracaine hydrochloride and ethyl hydrobenzoate in tetracaine hydrochloride eye drops.

二甲双胍治疗与2型糖尿病患者糖尿病性视网膜病变的相关性研究

Relationship between metformin treatment and diabetic retinopathy in patients with type 2 diabetes mellitus

:298-306
 
目的:探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者二甲双胍治疗与糖尿病性视网膜病变(diabetic retinopathy,DR)的相关性。方法:回顾2015年9月至2020年8月在中日友好医院眼科就诊的1 891例T2DM患者的临床资料,对病程≥10年的324例T2DM患者的一般资料、内科疾病史、糖尿病治疗史、眼科检查和实验室血生化指标进行回顾性病例研究。根据是否接受二甲双胍治疗分为二甲双胍治疗组与非二甲双胍治疗组,根据眼底检查结果同时结合DR临床诊断标准,将DR分为无明显DR、非增生性DR及增生性DR。采用logistic多因素回归分析判断年龄、性别、糖尿病发病年龄、糖尿病病程、高血压病程、高血脂病程、吸烟年数、体重指数、胰岛素治疗及空腹血糖、糖化血红蛋白、总胆固醇、三酰甘油、尿酸和血肌酐水平对结局变量的影响。结果:在DR的发病风险方面,二甲双胍治疗组与非二甲双胍治疗组的差异无统计学意义(P>0.05)。对T2DM患者DR发生及不同分期的相关变量行单因素及多因素分析,结果显示吸烟年数、空腹血糖及肌酐均与DR发病呈正相关(均P<0.05),而年龄与DR发病呈负相关(P<0.01),糖尿病发病年龄与DR发生呈显著负相关(OR=0.95,95%CI:0.92~0.98,P=0.0003)。在二甲双胍治疗的T2DM患者中,二甲双胍的疗程(OR=1.02,95%CI:0.96~1.08,P>0.05)及平均剂量(OR=1.50,95%CI:0.79~2.84,P>0.05)与DR的发生与进展均无显著相关性;女性DR发生与进展的风险较男性低(P<0.05);合并胰岛素治疗与DR发生呈明显正相关(OR=3.11,95%CI:1.59~6.07,P<0.01);吸烟年数长、糖化血红蛋白及尿酸水平高于正常范围均与DR的发生与进展呈正相关(P<0.05)。在口服二甲双胍患者中,未使用胰岛素治疗组和联合使用胰岛素组的DR发病风险有显著差异(P<0.01);而未口服二甲双胍患者中,胰岛素治疗与DR发生呈正相关(OR=12.43,95%CI:3.75~41.19,P<0.0001)。结论:病程10年以上T2DM患者中,二甲双胍治疗与DR发生与进展均无显著相关性。
Objective: To investigate the correlation between metformin therapy and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). Methods: The clinical data of 1 891 patients with type 2 diabetes mellitus attending the ophthalmology department of China-Japan Friendship Hospital from September 2015 to August 2020 were reviewed. A retrospective study was performed on 324 cases of these T2DM patients with disease duration ≥10 years. Medical records of all patients including general information, history of medical disease, diabetes treatment, ophthalmologic examination and blood biochemical indices were collected. According to whether metformin treatment was received or not, the patients were divided into a metformin-treated and a non-metformin-treated groups. DR is classified into non-obvious DR, non-proliferative DR and proliferative DR according to the fundus examination and the clinical diagnostic criteria of DR. Logistic multiple regression analysis was used to determine the effects of age, sex, age of DM onset, duration of DM, duration of hypertension,
duration of hyperlipidemia, years of smoking, body mass index, insulin treatment and fasting glucose, glycated hemoglobin, total cholesterol, triglycerides, uric acid and blood creatinine levels on DR. Results: There was no statistically significant difference in the risk of developing DR between the metformin-treated and non-metformin-treated groups (P>0.05). Univariate and multifactorial analyses of variables related to the occurrence and different stages of DR in patients with T2DM showed that years of smoking, fasting glucose and creatinine were positively associated with DR (P<0.05), while age was negatively associated with DR (P<0.01), and age of DM onset was significantly negatively associated with DR (OR=0.95, 95%CI: 0.92 to 0.98, P=0.0003). In T2DM patients treated with metformin, neither the duration of metformin (OR=1.02, 95%CI: 0.96 to 1.08, P>0.05) nor the mean dose(OR=1.50, 95%CI: 0.79 to 2.84, P>0.05) was significantly associated with developing DR. The risk of developing DR was lower in women than in men (P<0.05); combined insulin therapy was significantly positively correlated with the risk of DR (OR=3.11, 95%CI: 1.59 to 6.07, P<0.01); long-term smoking, glycosylated hemoglobin and uric acid levels higher than normal were positively associated with DR (P<0.05). In metformin users, there was a significant difference in the risk of developing DR between the no-insulin treatment group and the combined insulin group (P<0.01); and among patients not using metformin, insulin therapy was positively associated with the occurrence of DR (OR=12.43, 95%CI: 3.75 to 41.19, P<0.0001). Conclusion: There was no significant association between metformin treatment and DR among patients with T2DM for >10 years.

医联体糖尿病患者眼科随访的健康信念及其影响因素

Health belief and influencing factors of ophthalmic follow-up in patients with diabetes in medical alliance

:307-316
 
目的:测量医联体糖尿病患者眼科随访依从性及相关的健康信念,分析其影响因素。方法:采用便利抽样的方法,使用中文版糖尿病眼科随访依从性问卷对在广州医科大学附属第二医院所辖医联体内的334例糖尿病患者进行调查。结果:仅24.3%的受访者在过去的1年中接受过眼科散瞳检查,受访者眼科随访健康信念的总体评分为3.09±0.64,其中感知的益处和威胁维度评分最高,行为线索维度评分最低。糖尿病类型、就医倾向、合并其他糖尿病并发症、医联体相关知识和家庭类型是糖尿病患者眼科随访健康信念的主要影响因素。结论:医联体糖尿病患者眼科随访健康信念处于一般水平,缺乏行为线索支持,提示在糖尿病眼部并发症筛查和防治过程中,医联体应发挥下筛上转的功能,通过对障碍因素的干预,提高辖区糖尿病患者接受眼科随访的依从性。
Objective: To measure the adherence to ophthalmology follow-up and the related health belief of patients with diabetes in medical alliance, and analyze the influencing factors. Methods: Totally 334 community-dwelling patients with diabetes mellitus were recruited in a medical alliance in Guangzhou by convenient sampling method. They were investigated by the Chinese version of the Compliance with Annual Diabetic Eye Exams Survey (CADEES-C). Results: Dilated fundus examination within the last year were only reported by 24.3% of respondents. The mean score of the CADEES-C was 3.09±0.64, with the highest score in perceived benefit and threat dimensions and the lowest score in behavioral cue dimension. The factors that mainly influence the adherence to ophthalmology follow-up and their related health beliefs of patients with diabetes are types of diabetes, propensity to seek treatment, other complications of diabetes, knowledge of medical alliance and family pattern. Conclusion: The adherence to ophthalmology follow-up and the related health belief of patients with diabetes are at low level with the deficiency of behavioral cues. It is suggested that medical alliance should play a critical role to improve the status quo by developing more screening and referrals.

多元化宣教在提高眼科日间手术患者眼部用药正确率及满意度的应用

Application of diversified education in improving the accuracy and satisfaction of eye medication in patients undergoing day ophthalmic surgery

:317-322
 
目的:探讨多元化宣教在提高眼科日间手术患者眼部用药正确率及满意度的应用效果。方法:用便利抽样的方法,选取中山大学中山眼科中心2020年10至12月收治的200例眼科日间手术患者眼部用药的执行者为对象,将10至11月收治的100例日间手术患者眼部用药的执行者纳入对照组,将12月收治的100例日间手术患者眼部用药的执行者纳入试验组。对照组采取传统宣教方式,试验组应用多元化宣教模式进行健康教育。采用自制的健康教育需求调查表调查眼部用药执行者的健康教育需求,采用眼部用药执行评价表、健康宣教满意度调查表评价干预效果。结果:采用多元化宣教方式干预后,试验组患者眼部用药正确率(94%)高于对照组(35%),差异具有统计学意义(P<0.05)。试验组对多元化宣教满意度得分明显高于对照组,差异具有统计学意义(P<0.05)。结论:多元化宣教模式可提高眼科日间手术患者眼部用药正确率,提高患者及家属的满意度,值得临床推广应用。
Objective: To explore the effect of diversified education on improving the accuracy and satisfaction of eye medication in patients undergoing ophthalmic ambulatory surgery. Methods: A total of 200 practitioners of administering eye medication after undergoing ambulatory surgery in Zhongshan Ophthalmic Center, Sun Yat-sen University from October to December 2020 were investigated by convenience sampling, 100 practitioners admitted from October to November were included in the control group, and 100 practitioners were included in the experimental group. The control group adopted the traditional method of education, while the experimental group applied diversified education mode to carry out health education. The health education needs of the patients were investigated by the self-made health education needs questionnaire, and the effect of intervention wasevaluated by the eye medication implementation evaluation form and health education satisfaction questionnaire. Results: After the intervention, the correct rate of eye medication in experimental group (94%) was higher than the control group (35%) with a statistical difference (P<0.05). The satisfaction score about diversified education in experimental group was significantly higher than the control group with a statistical difference (P<0.05).Conclusion: Diversified education model can improve the accuracy of administering eye medication in patientsundergoing ophthalmic ambulatory surgery, and the satisfaction in patients and their families is significantly improved. It is worthy of clinical application.

2016—2020年世界干眼研究的文献计量学和可视化分析

Bibliometric and visualized analysis of global dry eye research from 2016 to 2020

:323-334
 
目的:了解近5年世界干眼研究的文献分布特征,并分析这一领域的研究趋势及研究热点。方法:以Web of Science核心数据库(WoSCC)为基础,采用文献计量学方法对干眼相关的全球研究趋势进行评估。通过VOSviewer v.1.6.16构建知识图谱,可视化了该领域的出版物、国家/地区分布、国际合作、作者、来源期刊和研究热点。另外,用CiteSpace IV来捕获爆发的关键词,探索热点的兴起和没落时间,以发现研究前沿。结果:在2016—2020年间共检索到2 567篇同行评议文章,其中美国是发表文献数量最多的国家,文献产量最高的机构是日本的庆应义塾大学。Kazuo Tsubota是该领域发表论文最多的作者,MA Lemp是被引次数最多的作者。Ocular Surface是干眼研究中发表文章最多的杂志。被引用最多的文献主要是TFOS Dr y Eye Workshop II发表的干眼系列报道。关键词聚类分析得出6大类:1)致病机制和病理生理;2)定义和分类;3)流行病学研究;4)治疗;5)继发性干眼;6)诊断。目前的研究前沿是眼痛、瑞巴派特、小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)手术和泪膜动力学。结论:本研究通过对国际干眼领域近5年的文献进行文献计量学分析,可视化呈现了最近这一领域的研究现状、热点及前沿。干眼研究的前沿主题是眼痛、瑞巴派特、SMILE手术和泪液动力学。
Objective: To understand the literature distribution characteristics of dry eye research in the world in the last 5 years, and to analyze the research trend and hotspots in this field. Methods: Based on the Web of Science Core Collection (WoSCC) database, a bibliometric analysis was conducted to evaluate the global research trends related to dry eye. Knowledge mappings were constructed by VOSviewer v.1.6.16 to visualize the publications, the distribution of countries, international collaborations, author productivity, source journals, and research hotspots in this fifield. In addition, CiteSpace IV was used to capture the keywords of outbreaks and to explore the rise and fall of hotspots. Research frontiers could be discovered by this analysis. Results: In total, 2 567 peer-reviewed articles were retrieved on dry eye research from 2016 to 2020. The United States ranked the highest among countries withthe most publications. The most productive institution was the Keio University. Kazuo Tsubota contributed the largest number of publications in this field, and MA Lemp was the most cited author. Ocular Surface was the most prolific journal in dry eye research. The top-cited references were mainly about the reports of the International Workshop on Meibomian Gland Dysfunction (MGD). The most cited literature was mainly dry eye series reports by TFOS Dry Eye Workshop II. Six categories were obtained by cluster analysis: 1) pathogenic mechanism and pathophysiology; 2) definition and classification; 3) epidemiological study; 4) treatment; 5) secondary dry eye; 6) diagnosis. Current research foreword is ocular pain, rebamipide, small incision lenticule extraction (SMILE) surgery, and tear film dynamics. Conclusion: Through the bibliometrics analysis of the international literature in the field of dry eye in the past five years, this study visualized the current research status, hotspots, and frontier in this field. Leading topics in dry eye research are eye pain, rebamipide, SMILE surgery, and tear dynamics.
综述

睑板腺功能障碍发病机制的研究进展

Research progress in the pathogenesis of meibomian gland dysfunction

:335-341
 
睑板腺功能障碍(meibomian gland dysfunction,MGD)是一种慢性、弥漫性的睑板腺病变,通常以睑板腺终末导管的阻塞或分泌的睑脂数量或质量发生改变为特征,临床上可以引起泪膜异常、角膜上皮损害、眼部刺激等干眼表现。MGD病因复杂且受多种因素影响,因此MGD发病机制的研究对于指导临床工作至关重要。本文对研究MGD的动物模型进行了介绍,并根据一些基础研究对MGD相关的细胞及分子机制等方面进行综述。
Meibomian gland dysfunction (MGD) is a chronic and diffuse disease of the eyelid gland. It is usually characterized by obstruction of the terminal duct of the eyelid gland or changes in the quantity/quality of the eyelid fat secreted. It can clinically cause dry eye symptoms such as abnormal tear film, corneal epithelial damage and eye irritation. The etiology of MGD is complex and affected by a variety of factors. Therefore, the study on the pathogenesis of MGD is of great importance to guide clinical work. This article introduces the animal research model of MGD, and reviews the cellular and molecular mechanisms related to MGD based on some basic research.

过敏性结膜炎发病机制的研究进展

Research progress in the pathogenesis of allergic conjunctivitis

:342-347
 
过敏性结膜炎经典的发病机制包括了IgE介导的I型超敏反应以及T淋巴细胞介导的IV型超敏反应,其中肥大细胞、肥大细胞脱颗粒释放的组胺、嗜酸性粒细胞等在过敏性结膜炎病理发展中发挥了重要作用。然而,临床发现针对上述机制的治疗药物临床疗效欠佳,有相当数量的过敏性结膜炎患者无法获得较好的生存质量,因此研究和阐明过敏性结膜炎的新机制,寻找新的治疗手段和药物靶点具有重要的临床意义。目前研究发现Th17细胞等多种炎性细胞和IL-17等细胞因子、过敏原介导神经调节机制、菌群失调机制、脂质介质作用方面可能与过敏性结膜炎发病相关,这对过敏性结膜炎新机制的研究有着重大的临床意义。本文将对过敏性结膜炎发病机制的新进展进行综述,以期为过敏性结膜炎的治疗提供新思路。
The classic pathogeneses of allergic conjunctivitis include type I hypersensitivity and type IV hypersensitivity, in which mast cells, eosinophils and some active substances such as histamine play important role. However, sincethe therapeutic drugs have not achieved satisfactory efficacy in clinical practices, a significant number of patients fail to achieve a good quality of life. The pathogenesis of allergic conjunctivitis remains to be further studied.Current studies have identified a variety of inflammatory cells such as Th17 cell and cytokines such as IL-17, the mechanisms of neuromodulation, flora dysregulation mechanisms, and lipid mediators that may be involved in the pathogenesis of allergic conjunctivitis, which has significant clinical implications for the study of mechanisms of allergic conjunctivitis. In this article, we will review the recent research progress of the pathogenesis of allergic conjunctivitis in order to provide new ideas for the treatment of allergic conjunctivitis.
技术交流

影响角膜异物剔除术预后的因素分析

Analysis of influencing factors of prognosis of corneal foreign body removal

:348-352
 
角膜异物是眼科急诊中常见病之一,不及时处置或处置不当会导致角膜不同程度的损伤,严重者可引起角膜感染、角膜穿孔等并发症,严重损害视功能。因此安全、高效地剔除角膜异物至关重要。本文从角膜异物的特点、伤后首诊时间、角膜合并感染以及角膜异物的剔除方法等方面对角膜异物剔除术预后的影响进行回顾总结,旨在为医护人员行角膜异物剔除时提供有用参考。
Corneal foreign body is one of common diseases in ophthalmic emergency. Improper handling can cause different degree of corneal injuries, even corneal infection, perforation and endophthalmitis. Therefore, it is essential to eliminate corneal foreign bodies safely and effectively. This article mainly summarizes the influence of the characteristics of the corneal foreign bodies, the first diagnosis time after injury, corneal co-infection and the methods of weeding out the corneal foreign bodies upon the clinical prognosis of corneal foreign body removal, aiming to provide useful reference for medical practitioners in removing corneal foreign bodies.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
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