封面简介

Schlemm's canal 结构和功能调控的研究进展及其在青光眼治疗中的应用

Research progress on the structure and functional regulation of Schlemm's canal and its application in glaucoma treatment

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Schlemm管(Schlemm’ s canal, SC)作为房水流出的主要通道,通过调节房水外排来维持眼内压的平衡,其结构和功能的异常与高眼压及青光眼的发生发展密切相关。对SC的研究有助于阐明房水外排阻滞的发生机制、探索促进房水外排新的途径,从而为降低眼压和青光眼治疗的新药物开发提供理论基础。目前,对SC发育和功能的调节机制的认识仍然有限,缺乏针对SC的特异性治疗策略。近年来,关于SC细胞命运决定及其结构发育的细胞学机制逐渐被揭示,功能调控的关键分子靶标也相继被发现,这促进了对SC结构和功能调控的深入理解。此外,作为降眼压药物靶点和针对性手术的创新应用也在不断拓展。文章系统回顾SC的结构与功能研究,总结关键的分子和细胞学调控机制,归纳SC相关药物和手术疗法的最新进展,为青光眼的临床诊治提供了新的思路。
Schlemm管(Schlemm’ s canal, SC)作为房水流出的主要通道,通过调节房水外排来维持眼内压的平衡,其结构和功能的异常与高眼压及青光眼的发生发展密切相关。对SC的研究有助于阐明房水外排阻滞的发生机制、探索促进房水外排新的途径,从而为降低眼压和青光眼治疗的新药物开发提供理论基础。目前,对SC发育和功能的调节机制的认识仍然有限,缺乏针对SC的特异性治疗策略。近年来,关于SC细胞命运决定及其结构发育的细胞学机制逐渐被揭示,功能调控的关键分子靶标也相继被发现,这促进了对SC结构和功能调控的深入理解。此外,作为降眼压药物靶点和针对性手术的创新应用也在不断拓展。文章系统回顾SC的结构与功能研究,总结关键的分子和细胞学调控机制,归纳SC相关药物和手术疗法的最新进展,为青光眼的临床诊治提供了新的思路。
论著

像差和对比敏感度数据提取处理软件的开发和应用

Development and application of aberration and contrast sensitivity data extraction software

:95-99
 
目的:像差和对比敏感度检查结果数据繁多复杂。为了高效准确地完成检查数据提取工作,自主开发一款像差和对比敏感度数据提取处理软件(Aberrations and Contrast Sensitivity Helper,ACSH)。方法:参考其他同类软件的设计模式,结合我院科研实际,采用开发工具VB6.0编程实现。结果:ACSH在Windows的运行环境下,能够准确地在局域网环境下实现对iTrace,Zywave像差仪和Optec_6500对比敏感度测试仪的检查数据进行提取。像差仪信息包括病人基本信息、屈光度、眼别、瞳孔直径,各项像差Zernike系数,高阶像差和总高阶像差均方根RMS(Root Mean Square)。对比敏感度仪数据包括:病人基本信息、检查时间、检查时的模拟光照度和眩光强度、 各空间频率的对比敏感度数值。同时软件支持对已提取的数据进行浏览、查询及导出EXCEL等功能,并开放数据接口供电子病历等其他系统对接。结论:ACSH是一款能够有效辅助视光专科科研和临床工作的应用软件。
Objective: Aberration and contrast sensitivity test results data is various and complex. In order to complete efficiently and accurately the data extraction work, we developed an aberration and contrast sensitivity data extraction software Aberrations and Contrast Sensitivity Helper (ACSH). Methods: VB6.0 was used as a development tool after we referred to other similar software design pattern and combined the reality of our scientific research. Results: The ACSH under the Windows environment can accurately extract the results’ data of iTrace and Zywave aberration meter and Optec 6500 contrast sensitivity tester in local area network. Aberration instrument information include patients’ basic information, refraction, which eye, pupil diameter, the aberration  Zernike coefficients, the high-order aberration and total aberration Root Mean Square (RMS). Contrast sensitivity tester data included: patients’ basic information, time, the intensity of analog light and the glare ,the contrast sensitivity values of every spatial frequency. ACSH is able to browse and query extracted data and export to EXCEL, and open data interface for electronic medical records and other system. Conclusion: ACSH is an effective software which assists optical specialized scientific research and clinical work.
论著

爱先蓝和细胞角蛋白双重染色技术在泪腺腺样囊性癌 诊断中的应用

Application of Alcian Blue and cytokeratin double staining technique in adenoid cystic carcinoma

:64-67
 
目的:探讨爱先蓝(Alcian Blue,AB)和细胞角蛋白(cytokeratin,CK)双重染色技术在泪腺腺样囊性癌组织中的应用, 提高泪腺腺样囊性癌染色效率。方法:选取中山大学中山眼科中心临床病理科2015年1月至2017年1月期间诊断为泪腺腺样囊性癌病例标本23例,在同一张切片上先进行AB染色,再进行CK染色,观察染色效果。结果:23例泪腺腺样囊性癌标本组织中黏液物质全部呈蓝色;癌细胞胞质CK阳性,呈棕黄色。结论:AB和CK双重染色方法稳定,颜色对比鲜明,能够良好显示癌细胞及黏液的关系,并且比分开的两次单种染色省时、经济。
Objective: To investigate the application of Alcian Blue (AB) and cytokeratin (CK) double staining technique in adenoid cystic carcinoma to improve the staining efficiency. Methods: Twenty-three specimens of adenoid cystic carcinoma from January 2015 to January 2017 in the Clinical Pathology Department of Zhongshan Ophthalmic Center, Sun Yat-sen University were stained with AB first and CK then on the same slide. Results: Mucinous substance showed blue. And the cytoplasm of the cancer cells presented with brown yellow in all the specimens.Conclusion: The method of double staining with AB and CK is stable and displays bright color contrast. It can effectively reveal the relationship between the mucus and cancer cells. It proves to be more time-saving and economical than the individual staining of AB and CK respectively.
论著

联合教学模式在留学生眼科临床教学的应用

Application of combined teaching mode in the ophthalmology clinical teaching of foreign students

:91-94
 
目的:探讨基于问题式教学法(problem-based learning,PBL)联合基于案例教学法(case-based learning,CBL)的模式在留学生眼科学教学中的效果。方法:将教学对象分为两组,其中传统教学组30人,联合教学组35人。传统教学组采用传统授课方法,联合教学组采用PBL联合CBL的教学方法。对其效果进行评估,评估指标包括发言次数、临床思维能力、学习兴趣、教学质量评分、教学满意度、理论分数、病例分析分数等。结果:与传统教学组相比,联合教学组学生在各项评估 指标上均明显优于传统教学组,且各项指标之间的差异均具有统计学意义。结论:PBL与CBL相结合的教学模式能有效提高眼科学教学质量,值得在临床教学中进一步推广应用。
Objective: To investigate the effect of problem-based learning (PBL) and case-based learning teaching (CBL) teaching approaches in the ophthalmology teaching of foreign students. Methods: The subjects were divided into a control group (30 students) and an experimental group (35 students). In the control group, the students were taught via traditional teaching methods. The PBL and CBL teaching approaches were applied in the experimental group. Then, the number of statements, clinical thinking ability, learning interest, teaching quality scores, teaching satisfaction, theoretical scores, and case analysis scores were assessed in these two groups. Results: Compared with the control group, the assessments in the experimental group were significantly better (P<0.05). Conclusion: The PBL and CBL teaching approaches can effectively improve the teaching quality of ophthalmology of foreign students. It is worth to popularize this method in clinical teaching.
综述

叶黄素类物质对视觉功能的保护作用及其在青少年视力维护中的应用

Protective effect of xanthophylls on visual function and its application in adolescent vision maintenance

:171-175
 
      叶黄素类物质为膳食类胡萝卜素,主要存在于视网膜组织中,为黄斑色素发挥抗氧化活性和蓝光滤过作用。近年来,有研究证实,叶黄素类物质可降低色差,提高视力及对比敏感度等功能,并对于年龄相关性黄斑变性、视网膜光损伤等疾病具有防治作用。
Xanthophylls is a kind of dietary carotenoid, which is mainly located in retina, and plays an important role in antioxidant and blue light ffltration. Lutein, zeaxanthin and meso-zeaxanthin can enhance visual performance by decreasing chromatic aberration and enhancing contrast sensitivity, and they can also prevent age-related macular degeneration and retinal light-induced injury. 

标准操作程序在玻璃体腔内注药术护理中的应用

Application of standard operation procedure in the intravitreal injection

:181-184
 

目的:探讨标准操作程序在玻璃体腔内注药术护理中的应用效果。方法:选择 2018 年 至 12 月中山大学中山眼科中心眼底专科门诊 504 例玻璃体腔内注药术患者作为研究对象,对护理人力资源的整合、患者等待手术时间、患者和家属的满意度、医护人员满意度进行评价。结果:标准操作程序后明确护士岗位职责,护士操作水平和综合能力有效提升,患者手术等待时间由原来的预约 周缩短为 2 d。患者和家属的满意度分别由 92.0% 和 91.0% 提高到 98.5% 和 97.0%。医护人员满意度的评价由 95% 提到至 98.4%结论:玻璃体腔内注药术标准操作程序不仅提升了工作效率,更提升了患者和家属、医务人员的满意度,规范化的标准操作程序是玻璃体腔内注药的安全保障。

Objective: To investigate the effect of standard operation procedure in the intravitreal injection. Methods: A total of 504 patients visiting the fundus clinics of our hospital from September to December 2018 were selected in this study. The integration of nursing human resources, patient waiting time, patient and family satisfaction, and medical staff satisfaction were evaluated. Results: The nursesjob responsibilities were clarified, and the Nursesoperation level and comprehensive ability were improved. The patientswaiting time for surgery was shortened from 2 weeks to 2 days. Patient and family satisfaction increased from 92.0% and 91.0% to 98.5% and 97.0%, respectively. The evaluation of the satisfaction of medical staff was elevated from 95% to 98.4%. Conclusion: The standard operation procedure of intravitreal injection not only improves the work efficiency, but also significantly increases the satisfaction of patients and their families and medical staffs. Therefore, the standard operation procedure can guarantee the safety of intravitreal injection.

论著

表格式护理记录单在眼底病中心日间病房精细化管理的应用

Application of eye nursing record sheets in the fine management of ophthalmic fundus center

:156-160
 
目的:自行设计并应用眼科表格式护理记录单,探讨眼科日间病房精细化护理管理工作的方法。方法:于中山大学中山眼科中心眼底病中心,根据日间手术流程,设计和运用眼底病中心24 h出入院护理记录单、眼底病中心日间病房交班记录单和眼底病中心日间病房手术记录单,书写方法基本以打勾、数字或简单文字记录为主。结果:新的表格式护理记录单大大节省护理记录和交班时间,提高护理工作效率,得到临床护理人员的广泛认可,提高医护对护理工作的满意度。结论:突出专科特色的表格式护理记录单能统一规范临床护理工作,提高护理工作效率和护理质量,保障护患安全,落实精细化护理管理。
Objective: To explore ffne management method of day ward in ocular department, through applying self-designed table format of eye nursing records. Methods: According to the day surgery process, the tables of 24-h nursing records and shifting records and surgery records were designed and applied to day ward of the ophthalmic fundus center. The basic writing methods included ticking, number and filling in the blanks. Results: The new nursing records tables decreased the time consumed in recording and shifting, improving the work efficiency, accepted widely by clinical staffs. Conclusion: The new table format with highlight of special features of the nursing records can unify and standard the clinical nursing work, improve the nursing work efficiency and nursing quality, ensure patients’ safety, and implement fine management. 
论著

医护一体化管理模式在眼底病中心日间病房的应用

Application of the medical integration mode in the day ward of ophthalmic fundus center

:148-151
 
目的:探讨医护一体化管理模式在眼底病中心日间病房中的应用与成效。方法:2015年6月至2016年6月于眼底病中心实行医护一体化管理模式,通过问卷调查比较实施前后医生和患者对护理工作的满意度。结果:医护一体化管理模式实行后,医生满意度显著提高,差异有统计学意义(t=?4.412,P<0.01),患者满意度有所提高,差异有统计学意义(t=2.592,P=0.01)。结论:采用医护一体化管理模式对眼底病日间手术住院患者进行管理,加强医护沟通,可有效提高护理质量,保障患者医疗、护理的安全性。
Objective: To explore the effect of the medical integration mode applying in the day ward of ophthalmic clinical key specialty. Methods: The ophthalmic fundus center started to carry out the medical integration mode from June 2015 to June 2016. Doctors’ and patients’ satisfaction towards nurses were surveyed before and after the implementation. Results: The doctors’ satisfaction towards nurses was statistically higher than before (t=?4.412, P<0.01). TTe patients’ satisfaction also improved, and the difference was statistically signiffcant (t=2.592, P=0.01). Conclusion: The medical integration mode strengthens the communication with doctors and patients, improves the nursing quality, and ensures the medical safety.

液相芯片技术及其在泪液细胞因子检测中的应用

Liquichip Technology and Its Application in Tear Cytokine Analysis

:4-10
 

      液相芯片技术是一种利用混悬在液相中的分类编码微球作为反应及信号检测载体,集合流式细胞技术、激光技术、数字信号处理技术及传统化学技术为一体的新型生物分子检测技术。它充分利用发展成熟的流式细胞术检测原理,对目标分子(如核酸、蛋白质等)进行高通量分析。目前已在生物医学研究中得到了广泛的应用。现就其技术原理、特点及其在泪液细胞因子检测中的应用作简要介绍。

Liquichip (Multiplexed microsphere-based flow cytometric assays) is a new biomolecular detection technology using encoded microspheres suspended in liquid as reaction and detection carrier, which is an integration of flow cytometry, laser technology, digital signal processing and traditional chemical technology. It is a high-throughput analyzer for the target molecular (e.g. nucleic acid and protein) based on the principles of flow cytometry. Liquichip is now widely used in biomedical analyses. This article briefly reviews the principle and characteristic of liquichip and its application in tear cytokine analysis.

论著

全视网膜光凝及术后应用羟苯磺酸钙治疗糖尿病视网膜病变的疗效观察

Curative effect observation of full retinal laser photocoagulation and postoperative application of calcium dobesilate in the treatment of diabetic retinopathy

:246-250
 
目的:探讨全视网膜光凝及术后应用羟苯磺酸钙治疗糖尿病视网膜病变的疗效。方法:选取96例患者,共175只眼,随机分为对照组(48例,86只眼)和研究组(48例,89只眼)。两组均予全视网膜激光光凝治疗,其中研究组术后再予羟苯磺酸钙继续12周治疗。12周后,观察两组患者治疗前后视力、血液流变学的变化。结果:治疗后研究组在视力>1.0范围的患者明显多于对照组(χ2=6.779,P=0.009), 而2组在视力≤0.4,0.4~0.6,0.7~1.0范围患者视力差异比较分别为( χ2=0.003,P=0.955),(χ2=1.640,P=0.200),(χ2=2.148,P=0.143)。治疗后研究组患者的血浆粘度、红细胞压积、红细胞变形指数、纤维蛋白原改善均优于对照组(P<0.05)。研究组总有效率89.9%,对照组75.6%,两组差异比较(χ2 =6.302,P=0.012)。结论:全视网膜激光光凝及术后应用羟苯磺酸钙治疗糖尿病性视网膜病,能有效提高视力及临床疗效,可能与改善患者血液流变相关。
Objective: To investigate the curative effect of the postoperative retinal laser photocoagulation and calcium dobesilate in the treatment of diabetic retinopathy. Methods: Selected 96 patients, 175 eyes, randomly divided into control group (48 cases, 86 eyes) and study group (48 cases, 89 eyes). Two groups were all given retinal laser photocoagulation treatment, while the study group continued to receive calcium dobesilate for 12 weeks after treatment. After 12 weeks, observed the eyesight, change of blood rheology of the two groups. Results: After the treatment, the patients with vision >1.0 in the study group were significantly more than the control group (χ2 =6.779, P=0.009), in the vision range of ≤0.4, 0.4~0.6, 0.7~1.0, the difference between the two groups was (χ2 =0.003, P=0.955), (χ2 =1.640, P=0.200), (χ2=2.148, P=0.143), respectively. After treatment, plasma viscosity, erythrocyte deposited, erythrocyte deformation index, fibrinogen in the study group were better than those in the control group (P<0.05). The total effectiveness in the study group was 89.9%, in the control group was 75.6%, the difference was statistically significant (χ2=6.302, P=0.012). Conclusion: The whole retinal laser photocoagulation and postoperative application of calcium dobesilate in treating the diabetic retinopathy can effectively improve eyesight and clinical curative effect, which may be associated with improving blood rheology.
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
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  • 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
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