论著
目的:制备抗水通道蛋白4(aquaporin 4,AQP4)单克隆抗体,鉴定其免疫学性能为后期临床应用奠定基础。方法:合成AQP4优势抗原表位多肽,经过免疫小鼠、细胞融合及亚克隆筛选,制备可分泌高效价高亲和力的单克隆抗体细胞株,后期获取大量单克隆抗体通过酶联免疫吸附和免疫组织化学实验进行初步实验应用。结果:获得4株杂交瘤细胞株,均能稳定分泌高亲和力抗体,经酶联免疫吸附测定实验和免疫组织化学实验证实均能特异性识别人的AQP4蛋白。结论:成功制备了亲和力高、特异性强的抗人AQP4优势抗原表位的单克隆抗体,为小分子抗体以及抗体人源化制备奠定了基础,进而为治疗视神经脊髓炎相关疾病提供理论依据和技术支持。
Objective: To lay the foundation for clinical applications in the future, we prepare and identify the immunological properties of aquaporin 4 (AQP4) monoclonal antibodies. Methods: The dominant epitope polypeptides of AQP4 were synthesized and used to obtain the cell lines which secrete high tiler and high affinity monoclonal antibodies by immunizing BALB/c mouse cell fusion and screening of subclone. The large amount of monoclonal antibodies were obtained and used for practice via immunohistochemical staining and Enzyme-linked immunosorbent assay (ELISA). Results: Four hybridomas that can stably secret anti-AQP4 antibodies were obtained. ELISA, Western blot and Immunohistochemistry results suggested that the monoclonal antibodies specifically recognized human AQP4 protein. Conclusion: The anti-human AQP4 monoclonal antibody with high affinity and specificity was successfully generated, which thereby provides the foundation for the preparation of small molecule antibodies or humanized antibodies, and then lays a theoretical and technical basis for the treatment of neuromyelitis optica (NMO).
综述
白内障是世界范围内失明的主要原因。正常晶状体是富有弹性的形似双凸透镜的透明体,是机体内蛋白质含量最高的组织,由晶状体囊膜、晶状体上皮细胞、晶状体纤维和悬韧带构成。白内障为晶状体透明度下降,表现为晶状体混浊。近年来随着分子生物学、表观遗传学、免疫学、有机化学等学科快速发展,国内外学者对白内障也进行了大量分子水平的研究,探讨了白内障发生发展相关分子机制,为未来基因治疗和靶向药物等治疗白内障提供了理论基础。对白内障分子病理改变的了解,是白内障精准诊治的基础。
Cataract is the main cause of blindness worldwide. The normal crystalline lens is a transparent biconvex disc, with highest protein content in all human tissues. The lens is composed of capsule, lens epithelial cells, lens fiber and zonular ligment. Cataract is a decrease in the transparency of the lens, which is characterized by opacity. In recent years, with the rapid development of molecular biology, epigenetics, immunology and organic chemistry, researchers have conducted a large number of studies on the molecular basis of genetic or targeted therapy of cataract. It is important to know the molecular pathology of cataract, which is the basis of precise diagnosis and treatment of cataract.
病例报告
线状皮脂腺痣综合征(linear nevus sebaceous syndrome,LNSS)是一种以皮脂腺痣(nevus sebaceous,NS)为特征性改变,同时合并癫痫、智力迟钝、神经缺陷或骨骼畸形等病变的疾病。本文报道1例经病理组织学检查确诊的LNSS患者,同时伴有双眼脉络膜骨瘤和脑部先天发育异常。由于线状皮脂腺综合征伴双眼多发异常较为少见,本文将总结该例患者的临床和病理表现,旨在为临床诊疗提供一定参考资料。
Linear nevus sebaceous syndrome (LNSS) is a disease characterized by nevus sebaceous (NS) and accompanied by epilepsy, mental retardation, nerve defect or skeletal deformity. We report a case of linear sebaceous nevus syndrome diagnosed by histopathological examination with bilateral choroidal osteoma and congenital developmental abnormalities of the brain. Since linear sebaceous gland syndrome with binocular abnormalities is relatively rare, this paper will summarize the clinical and pathological manifestations of this patient, aiming to provide certain reference for clinical diagnosis and treatment.
病例报告
眼眶部副神经节瘤极为罕见,多属非功能性肿瘤。本病例为1位中年女性,以右眼眼睑抬举无力为主诉就诊,眼眶计算机断层扫描(computed tomography,CT)和磁共振成像(magnetic resonance imaging,MRI)检查发现右眼眼眶内肿物,手术完整切除,结合HE染色和免疫组织化学检查,病理组织学诊断为眼眶副神经节瘤,随访3年,肿瘤无复发。
Orbital paraganglioma is a rare disease and mostly belongs to non-functional tumors. In this report, we described a middle-aged female admitted to our hospital with the chief complaint of weak lifting of her right eyelid. Orbital computed tomography (CT) and magnetic resonance imaging (MRI) examination detected an intra-orbital mass in the right eye. Complete excision was conducted, and post-operative histopathological and immunohistochemical examination revealed the mass to be orbital paraganglioma. Within the 3-year follow-up, the patient showed no recurrence.
病例报告
上皮内生是眼外伤或眼前节手术后罕见的严重并发症,可导致角膜内皮失代偿、继发性青光眼或其他不良结果。其中难治性青光眼是上皮内生后眼球摘除的主要原因,因此提高对本病的认识并严加防范至关重要。本文回顾分析1例上皮内生性青光眼患者的临床资料和病理切片,结合文献讨论本病的危险因素、发病机制及防范措施。
Epithelial downgrowth is a rare yet serious complication after ocular trauma or anteriorsegmental surgery. It can lead to decompensation of corneal endothelium, secondary glaucoma or other serious complications, among which refractory glaucoma is the main cause of enucleation. It is vital to raise the awareness of this disease and take strict precautions against it. We present a case of epithelial downgrowth and discuss the risk factors, pathogenesis and preventive measures of the disease through analyzing clinical data and pathological sections.
专家述评
眼球表面鳞状细胞性肿瘤是比较常见的眼表肿瘤,包括鳞状细胞乳头状瘤、日光性角化病、结膜上皮内瘤变和鳞状细胞癌。深入了解这些病变的临床和病理学特点,有利于提高临床诊断的正确性。本文对眼球表面鳞状细胞性肿瘤的类型、临床表现和病理学特点进行阐述,以期对临床诊治提供参考。
Ocular surface squamous neoplasia (OSSN) is the most common tumor of the ocular surface, including squamous cell papilloma, actinic keratosis, conjunctival intraepithelial neoplasia and squamous cell carcinoma. The extended understanding of clinicopathological features could help improve clinical accurate diagnosis of these lesions. This article reviews the classification, clinical features and pathological characteristics of OSSN to provide the reference for clinical diagnosis and treatment.
专家述评
眼科病理学是系统组织病理学的重要分支,作为基础医学与临床医学之间的桥梁和纽带,对于深入认识和揭示眼部疾病的发病特点发挥着重要作用。眼科病理学在老一辈专家们的努力下奠定了坚实的基础。目前眼科病理学学科的发展随着眼科临床技术以及系统病理学的发展在不断的前进,细胞生物学及分子生物学的全方位结合和纵深应用带动并拓展了眼科病理学的研究领域,临床病理学及实验病理学的研究不断更新,新形势下眼科病理学的发展充满着机遇和挑战。
Ophthalmic pathology is an important branch of histopathology. As a bridge and link between basic medicine and clinical medicine, ophthalmic pathology plays an important role in understanding and revealing the characteristics of ocular diseases. The previous generations have laid a solid foundation for ophthalmic pathology with their hard work. Moreover, the advancement of ophthalmic clinical technology and systematic pathology in recent years have further facilitated the development of ophthalmic pathology. The comprehensive combination and in-depth application of cell biology and molecular biology have promoted and expanded the research field of ophthalmic pathology. In addition, new progress has been witnessed in the field of clinical pathology and experimental pathology constantly. Under the new situation, the development of ophthalmic pathology is faced with both opportunities and challenges.
论著
目的:探讨赋能教育模式在干眼患者健康教育中的应用价值。方法:选取2017年6月至12月期间首诊于南方医科大学珠江医院眼科的干眼患者,按照完全随机分配法分为试验组(n=73)及对照组(n=73),试验组采用赋能教育模式,对照组采用传统健康教育方式。经治疗1周、1个月、2个月及6个月后,分别随访并记录每组患者的眼表疾病指数(ocular surface disease index,OSDI)、泪膜破裂时间值(tear film break up time,BUT),同时记录患者家庭护理(清洁睑缘、热敷、睑板腺按摩)频率以及复诊频率。结果:赋能教育组家庭护理频率及复诊频率均优于传统教育组(P<0.05)。治疗前两组OSDI和BUT差异均无统计学意义(P>0.05),但试验组OSDI随时间的推移呈下降趋势,BUT值呈上升趋势;而对照组OSDI以及BUT值的变化均不明显。结论:运用赋能教育模式有助于提高干眼患者治疗的依从性,提高患者的家庭护理频率和复诊频率,显著改善患者的眼表情况,进而提高长期治疗效果。
Objective: To evaluate the application value of empowerment education mode in health education for patients with dry eye syndrome. Methods: Patients with dry eye syndrome were recruited from Department of Ophthalmology, Zhujiang Hospital, Southern Medical University from June 2017 to December 2017. All patients were randomly divided into the experimental group (n=73), educated with empowerment education mode, and control group (n=73), treated with traditional health education. Patients were followed up after 1 week, 1 month, 2 months and 6 months, respectively. Data were collected in each follow-up visit including ocular surface disease index (OSDI), tear film break up time (BUT), the frequency of home care (cleaning eyelid margin, hot compress, palpebral gland massage) and re-visit frequency. Results: The OSDI and BUT were similar between two groups before corresponding treatment (P>0.05). After the treatment, patients in the experimental group showed a downtrend in the OSDI and uptrend in the BUT. No significant changes were found in the control group during the follow-up. The frequency of family nursing and re-visit in the experimental group was statistically higher than that in the control group. Conclusion: The application of empowering education mode can improve the compliance of dry eye patients, improve the frequency of home care and follow-up visit, and mitigate the ocular surface of patients, thereby enhancing the long-term efficacy.
论著
目的:评估硅油填充术后眼压对角膜内皮细胞的影响及变化特点。方法:选取2019年1月1日至9月30日在佛山市第二人民医院眼科中心行玻璃体切除联合硅油注射的患者共131名,分为高眼压组(n=80)和正常眼压组(n=51)。高眼压组术后任意一次测眼压>21 mmHg,正常眼压组术后眼压均≤21 mmHg。比较填充硅油前与取硅油时的角膜内皮细胞参数测量值。结果:高眼压组的平均眼压为20.79 mmHg,正常眼压组的平均眼压为14.70 mmHg(P<0.001)。取硅油时,两组角膜内皮细胞密度(corneal endothelial cell density,ECD)均明显减少,平均内皮细胞面积均明显增大(P<0.05),高眼压组内皮细胞大小变异系数(coefficient of variation of endothelial cell size,CV)明显变大(P<0.05)。高眼压组ECD丢失率(6.3%)高于正常眼压组(3.5%);其中,高眼压组中术后1~6周内的眼压升高(7.1%)、眼压≥40 mmHg(7.3%)对角膜内皮细胞影响最大。ECD丢失与眼压变化有显著相关性(r=0.176,P=0.044)。结论:硅油填充后高眼压是角膜内皮细胞丢失的重要危险因素。
Objective: To evaluate the effect of intraocular pressure (IOP) on corneal endothelial cells after silicone oil tamponade. Methods: Patients (n=131) received vitrectomy with silicone oil injection in Ophthalmology Center in Second People’s Hospital of Foshan City from January 1st to September 30th 2019 were divided into the high IOP group (n=80) and normal IOP group (n=51). IOP was >21 mmHg at any time in the high IOP group and was ≤21mmHg in the normal IOP group after surgery. The values of corneal endothelial cells before filling with silicone oil and before removing silicone oil were compared. Results: The average IOP was 20.79 mmHg in the high IOP group, and 14.70 mmHg in the normal IOP group (P<0.001). The number of endothelial cells (ECD) was reduced, but the average endothelial cell area was increased (P<0.05) in both groups. The coefficient of variation of endothelial cell size in high IOP group was increased (P<0.05). ECD loss rate was 6.3% in the high IOP group and 3.5% in normal IOP group. Increased IOP within 1–6 weeks after surgery (7.1%) and IOP ≥40 mmHg (7.3%) had the greatest impact on ECD. ECD loss was correlated with IOP (r=0.176, P=0.044). Conclusion: High intraocular pressure after silicone oil filling is an important risk factor for the loss of corneal endothelial cells.
论著
目的:了解玻璃体切除硅油填充术后患者(face-down positioning,FDP)依从性的相关影响因素。方法:采用随机抽样研究的方法,选取2018年1月至2019年12月于无锡市人民医院眼科行玻璃体切除硅油填充术后的患者100例,采用问卷调查对一般资料、FDP可能发生的反应和依从性进行调查。采用SPSS 19.0进行统计分析。结果:患者性别、对疾病的重视程度与FDP的依从性有显著差异(P<0.05),但家庭支持系统与FDP的依从性差异无统计学意义(P>0.05)。患者术后第1天对FDP依从性的主要影响因素依次为呼吸不畅(84%)、睡眠不佳(78%)、肩颈部不适(10%);术后第3天的主要影响因素依次为呼吸不畅(66%)、腰酸背痛(50%)、睡眠不佳(39%);术后第5天的主要影响因素依次为肢体麻木(70%)、腰酸背痛(87%)、睡眠不佳(30%)、肩颈部不适(18%)以及肘关节疼痛(10%)。结论:影响患者依从性的主要因素主要有性别、对疾病的自我重视程度以及FDP引起的不适症状。需加强对高危因素的识别,不同病情时段给予征对性的宣教和指导,以提高患者对FDP的依从性。
Objective: To investigate the influencing factors of compliance of patients with silicone oil tamponade after vitrectomy. Methods: A total of 100 patients with silicone oil tamponade after vitrectomy in Wuxi People’s Hospital of Jiangsu Province from January 2018 to December 2019 were selected by random sampling method. The general information, possible reaction, and compliance of face-down positioning (FDP) were investigated by questionnaire. SPSS 19.0 was used for statistical analysis. Results: There were significant differences in patients’ gender, attention to disease and FDP compliance (P<0.05), but there was no significant difference between family support system and FDP (P>0.05). The main influencing factors of FDP compliance were dyspnea (84%), poor sleep (78%), the discomfort of shoulder and neck (10%); on the third day after operation, the main influencing factors were dyspnea (66%), low back pain (50%) and poor sleep (39%); on the fifth day, the main influencing factors were numbness of the limbs (70%), low back pain (87%) and poor sleep (30%), the discomfort of shoulder and neck (18%) and elbow pain (10%). Conclusion: The main factors that affect the compliance of patients are gender, self-awareness of the disease and discomfort caused by FDP. It is necessary to strengthen the identification of high-risk factors, and give symptomatic education and guidance at different stages of illness, to improve the compliance of patients to FDP.