新型冠状病毒核酸检测在眼科医院疫情防控中的实践与有效性研究

目的:探索以系统化、标准化的新型冠状病毒核酸检测为核心和重要组成部分,建立适合于眼科医院新冠疫情精准防控切实可行的防控体系。方法:系列病例研究。自2020年2月24日至3月2日期间,以标准化病毒核酸检测联合血常规、C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)等检测作为所有眼科手术患者术前筛查常规检测项目,同时也为返岗员工提供病毒核酸检测。设计调查问卷了解受检者对鼻咽拭子采样的接受度以及核酸检测结果对其心理状态的影响。结果:99例患者血液学检测结果有一定的异常比例,其中SAA检测结果增高13例,淋巴细胞计数减低12例、增高5例,白细胞计数增高11例、减低1例,CRP增高2例,新型冠状病毒核酸检测均阴性。33例本院职工新型冠状病毒核酸检测均阴性。12%的受访者对鼻咽拭子采样接受度评分较低。受检者在核酸检测前后思想压力评分较高的比例分别为46.7%和6.7%。结论:该项举措一方面为术前新冠病毒肺炎筛查及鉴别诊断提供了客观依据,很大程度上排除了隐性无症状感染者传播的可能,有利于减少二次传播的风险,降低院内交叉感染的概率;另一方面,核酸检测阴性结果有利于调整患者术前的心理状态并缓解医护人员在疫情防控期间的心理压力。     

“健康快车”特殊条件下眼科手术器械漂洗方法的研究

 目的 探索在"健康快车"无流动水清洗设备的特殊条件下,复用眼科手术器械有效的漂洗方法。方法 研究分两个阶段进行,分别探索不同漂洗方法对手术器械多酶清洗剂清除效果和清洗质量的影响。分别选择无污染和模拟临床手术污染的白内障显微手术器械。A、B、C、D、F、G组为试验组,模拟"健康快车"条件下使用非流动水漂洗手术器械,A、B、C 3组的漂洗方法分别为"2、4、6 L水结合刷洗"、D组"不漂洗"、F组漂洗方法同B组、G组在B组的基础上增加"0.5 L水结合涮洗"的步骤。E、H组为对照组,遵守指南使用流动水漂洗手术器械。清洗效果评价：采用蛋白残留检测仪间接检测多酶清洗剂残留量;采用ATP生物荧光检测仪检测手术器械的清洗质量。结果 B组多酶清洗剂残留量为（1.90±0.23）μg/20把,B组与对照组［（3.45±0.46）μg/20把］的多酶清洗剂残留结果比较,差异无统计学意义（P=0.053）。G组ATP生物荧光检测结果为（9.46±1.50）RLU/把,G组ATP生物荧光检测结果与对照组［（11.60±1.44）RLU/把］比较,差异无统计学意义（P=0.339）。结论 结合两阶段试验结果,在"健康快车"无流动水清洗设备的特殊条件下漂洗眼科手术器械,推荐选用G组漂洗方法。     

Targeting NF-κB c-Rel in regulatory T cells to treat corneal transplantation rejection

The relevance of Tregs in the induction of tolerance against corneal allografts has been well established. Although it is well known that the conversion of Tregs into effector-like cells contributes to the loss of corneal immune privilege, the underlying mechanism is still not fully understood. Using heterologous penetrating keratoplasty model, we found that Tregs from corneal allograft rejected mice (inflam-Tregs) exhibit impaired function and characteristics of effector T cells. Further study showed that the expression of NF-κB c-Rel, a key mediator of effector T cell function, was significantly increased in inflam-Tregs. Mechanistic study revealed that elevated NF-κB c-Rel level in inflam-Tregs impaired Treg function through the promotion of inflammatory cytokine production and glycolysis. More importantly, we demonstrated that targeting NF-κB c-Rel was able to improve the immune suppressive function of inflam-Tregs in vitro and enhance the potential of them to suppress corneal transplantation rejection. Therefore, our current study identified NF-κB c-Rel as a key mediator of the conversion of Tregs into effector-like cells when under inflammatory environment.     

HOW TO TREAT OPTIC ATROPHY WITH ACUPUNCTURE ?

Opticatrophyresultsfromretrogradede-generationofopticnerve,causingtheopticdisctobecomepaleandappearshallowconcave.Itissimilarto"qingmang(opticatrophy)","shizhanhunmiao(blurredvirsion)"describedintraditionalChinesemedicine,manifestingmainlyasthatthediseasedeyeisnormalinappearance,butthepatientfeelsdiminutionofvirsion,blur-ringofvirsion,etc..Thesesituationsbecomeworseandworsedaybyday.Fundusexamina-tionshQWsthattheopticpapillalightensincolourorevengetspale,andbloodvesselsofretinaarenormalorbecom…     

Miraculous ophthalmological therapies in Byzantium

A series of cures for ophthalmological diseases practised by saints are described, particularly the Saints Cosmas and Damian and the Saints Cyrus and John, the famous Anargyroi. In the xenones of the Byzantine churches and in the hospitals connected to these, therapeutic regimes, cures and surgical interventions took place at night during incubation, following the example of the ancient Asclepieia. This conclusion stands in spite of the fact that the authors describing the lives of the saints were often clergy who frequently cloak the true therapeutical cures by presenting them in a supernatural manner in order to stress the divine intervention of the saints. From the operations mentioned, it is clear that cataract surgery was among the operations most frequently practised.     

3D打印在眼科血管性疾病的应用进展

近年3D打印技术在各个领域广泛应用,在医学领域的应用也日趋增多,为医学研究的发展提供了新的方向。作为一种数字化制造技术,3D打印在对眼科疾病的评估、研究和治疗中发挥了重要作用。目前,3D打印的生物材料、细胞、组织和器官在眼科逐渐投入应用并引起重视,同时展现出巨大的潜力。随着医学成像技术的发展和打印技术的进步,3D打印与各种医学成像技术结合使眼部血管可视化,有助于眼科血管性疾病的研究和诊断。本文主要对3D打印在眼科血管性疾病的应用进展进行简要综述。     

Posterior amorphous corneal dystrophy caused by a de novo deletion

We present a newborn diagnosed with posterior amorphous corneal dystrophy (PACD). PACD is a rare disorder with partial or complete posterior lamellar corneal opacification. Genetic screening showed a deletion of chromosome 12q21.33-q22 containing the identified four small leucine-rich proteoglycans (SLRP’s) associated with this particular dystrophy. Neither parents were carrier of the deletion. To our knowledge, this is the first report of a de novo mutation causing PACD.     

Clinical Practice Guidelines on the Internet

Abstract

Access to quality information on the Internet for health care situations can be problematic. Currently there is a tremendous wealth of practice guidelines available over the Internet. The Institute of Medicine defines practice guidelines as systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. This article discusses the role of practice guidelines in health care decision making, and highlights some of the practice guidelines that are available over the Internet.