ABSTRACT
Background Lattice corneal dystrophy (LCD) is a progressive disease,whose clinical features are varied in different stages.It is rarely be reported that clinical findings of different stages and factors of promoting the occurrence and development on LCD in a family.Objective The aim of this study was to identify the characteristics of the pedigree and clinical features of different stages in a LCD family,and further to discuss its influence factors.Methods A cross-sectional study was performed in this study.A Chinese family with LCD was enrolled in Shenzhen Eye Hospital from 2015 to 2016.Questionnaires for disease-related history,visual acuity measurement,ocular anterior segment examination and color photography were carried out for all the members of the family.In addition,anterior segment OCT (AS-OCT),laser scanning confocal microscope and corneal endothelium microscope were used to observe the morphology of corneal stroma and changes of corneal endothelial cells.The pedigree chart was drawn by Cyrillic2.1 software and analyzed based on Mendel law.Results This family included 5 generations of 73 members.Patients with LCD were found in each generation with similar morbidity in different gender,which followed the law of autosomal dominant inheritance.Eleven patients were found in 49 members related with Ⅲ1 of this family with the prevalence rate of 22.45％ and onset age at 21-50 years old,and the course of disease was 3-34 years.All of the members had no systemic disease except for two patients (Ⅲ 1 and Ⅲ 5) with hypertension.In the early stage of LCD,some bifurcate striolae appeared in the patients' corneal stroma without symptoms for many years.In the progressive stage,there was corneal irritation symptom accompanying with vision's decrease in the eyes with LCD.The bifurcate striolae were increased,widened and interwoven into lattice lines that the boundaries gradually became fuzzy,then corneal macula was formed because of recurrent corneal infiltration,and eventually resulted in corneal leucoma.High reflection corresponding to the pathologic region was showed by laser scanning confocal microscope and AS-OCT.No significant differences were found in corneal endothelial cell density and the percentage of hexagonal cells between LCD patients and normal phenotype families (t =1.887,P=0.075;t=-0.719,P =0.481).Penetrating keratoplasty was performed in a patient with corneal opacity and serious corneal opacity occurred near the surgical incision one year after the surgery.One patient was diagnosed as LCD 2 years after laser assisted in-situ keratomileusis.One patient was a welder.Conclusions LCD is autosomal dominant inheritance in the family.The clinical manifestations of LCD in the early,progressive and late stage can be seen in the pedigree,which offers a reference for ophthahnologists.Corneal surgery and lesion may induce the onset or aggravation of LCD.
ABSTRACT
Background Posner-Schlossman syndrome (PSS) is often recurrent and is a cause of blindness.The etiology of PSS remains to be elucidated.It is reported that there is a certain association between pathogenic microorganisms and PSS in rather small samples.Objective This study was to analyze the related serum antibody levels of cytornegalovirus (CMV),herpes simplex virus (HSV),rubella virus (RV),helicobacter pylori (HP) and anti-streptolysin O (ASO) and provide a clue for the study on pathogenesis and therapy of PSS.Methods A prospective cases-controlled study was carried out in Shenzhen Eye Hospital from December,2014 to December,2016 under the approval of Ethic Committee of this hospital and informed consent of each subject prior to initial of any medical examination.Peripheral blood samples were collected from 82 PSS patients as the PSS group and 100 age-and gender-matched healthy blood donors as the normal control group.The positive rates of serum CMV IgG,CMV IgM,HSV IgG,HSV IgM,RV IgG,RV IgM,HP IgG and HP IgM in the subjects were detected by indirect ELISA,and the positive rate of serum ASO antibody was determined by immuno-scatter turbidmetry.Results The positive rates of serum CMV-IgG,CMV-IgM,HP-IgG,HP-IgM and ASO antibody were 22.0％,17.1％,22.0％,17.1％ and 17.1％ in the PSS group,which were significantly higher than 5.0％,0.0％,10.0％,2.0％ and 7.0％ in the normal control group (x2 =11.726,18.496,4.943,12.766,4.479,all at P＜0.05).The positive rates of serum HSV-IgG,HSV-IgM,RV-IgG and RV-IgM in the PSS group were not significantly different from those in the normal control group (x2 =3.305,0.986,0.898,0.503,all at P ＞ 0.05).Conclusions CMV,HP and hemolytic streptococcal infection may participate in the occurrence and development of PSS.
ABSTRACT
Background Activation of serum complement system is involved in the pathological process of uveitis and open angle glaucoma.Pathogenesis and pathological characteristics of Posner-Schlossman syndrome (PSS) are similar to uveitis and open angle glaucoma.However,etiology of PSS remains unelucidated.The activation complement in PSS patients' serum is rarely reported.Objective The aim of this study was to investigate the activation of serum complement in PSS patients for PSS pathogenesis.Methods A prospective case-controlled study was designed.The peripheral blood simples of 79 PSS patients were collected from Shenzhen Eye Hospital during December 2013 to December 2015,and the peripheral blood simples were obtained from 83 unrelated healthy blood donors as healthy control group.Immuno-scatter turbidmetry was adopted to detect the common activated components in complement pathway in each group including complement C3 (a vital intersection molecule in the three pathways),C4 (the vital molecule both the complement classical and lectin pathways),split products C3a,soluble membrane attack complex (sC5b-9),C 1q (complement classical pathway),L-ficolin (complement lectin pathway),complement factor Bb (complement alternative pathway),IgG,IgA and IgM.The correlation between serum C3a content and sC5b-9 content in PSS group was analyzed.The serum contents of fabric binding protein 2 (FCN2) (a marker of serum classical pathway),factor Bb (a marker of complement alternative pathway),C3a (the common activation products of three complement activation pathways),and sC5b-9 were assayed by ELISA.This research protocal was approved by Shenzhen Eye Hospital and written informed consent was obtained from each PSS patient prior to any medical examination.Results Compared with normal control group,the serum levels of C3,C4,C3a,sC5b-9,C1q,FCN2,IgG,IgA and IgM were significantly higher in PSS group (Z =-4.743,-2.913,-1.985,-2.620,-2.062,-2.500,-7.010,-6.327,-3.652,all at P ＜ 0.05).The serum complement factor Bb level was 13.87 (9.24,32.00) μg/ml in PSS group,which was significantly lower than 20.51 (12.90,33.50) μg/ml in normal control group (Z =-2.515,P =0.012).Serum C3a content was positively correlated with the serum sC5b-9 content in PSS group (rs =0.832,P＜0.001).Conclusions The serum complement system is activated in PSS patients.Complement alternative pathway,classical pathway and lectin pathway might all be involved in the activative process of complement system.
ABSTRACT
Objective To assess the safety and the curative effect of the combination of minipercutaneous nephrolithotomy (mini-PCNL) and ureteroscopic lithotripsy (URL) in the treatment of nonhydronephrotic staghorn calculi. Methods The clinical data of 53 eases with non-hydronephrotic staghom calculi treated by mini-PCNL combined with URL were retrospectively analyzed. Results Fifty-three cases (64 renal units) were performed first-stsge operation, 9 renal units were stone free in first-stage operation, 33 renal units were stone free in second-stage operation, other 13 renal units were stone free in third-stage operation. A complete stone clearance rate of 85.9%(55/64) was achieved, and after one to three sessions of mini-PCNL and extracorpereal shock wave lithotripsy afterwards that increased to 95.3% (61/64). Blood transfusion was performed in 3 cases, no major complication was noted in the patients. Conclusions The combination of mini-PCNL and URL has more advantages, less invasions, easier recovery and less complications. It provides a new minimally invasive way for non-hydronephrotic staghorn calculi.
ABSTRACT
Objective To explore emergency treatment methods for acute renal failure caused by negative imaging ureterolith. Methods There were 36 cases of acute renal failure caused by negative imaging ureterolith, which were finally diagnosed by ureteroscope examination. The negative imaging ureterolith were broken by air pressure ballistic curve shock wave,and taken out of ureter by ureteroscope. All cases were put double-J in ureter. Results Thirty-six cases were got success relieves of ureter obstruction in 24 hours. The urine volume of them were increased, symptoms of urinemia were disappeared, BUN and creatinine were normal after operations. Conclusions The treatment and diagnosis methods by ureteroscope for acute renal failure caused by negative imaging ureterolith are quick and safety, which can treat both side ureterolith at the same time and get reliable and safe effect with less trauma. It should be the first choice to treat acute renal failure caused by negative imaging ureterolith.