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A two-way referral system for eye diseases management was developed between the Weifang community health service centers and Shanghai eye hospital in May 2014.With the “peer-to-peer” two-way referral model, the physicians in community health service center and ophthalmologists in eye hospital were directly responsible for screening , diagnosis and treatment of patients.The specialists of eye hospital also regularly provided clinic service in the center for longitudinal management of the patients .The “peer-to-peer” two-way referral model played a positive role in enhancing the cooperation between community health service center and superior hospital , upgrading skills of general practitioners, and improving the residents′satisfaction.
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Background Epidemic keratoconjunctivitis is a common eye disease,and adenovirus is one of the common pathogens.The hexon protein,one main capsid protein of the virus,is an important target of antibody binding.Thus,sequencing the coding region of the hexon protein is an important way for adenovirus fast typing.Objective This study was to complete a molecular epidemiology survey of epidemic keratoconjunctivitis and investigate its association with adenovirus in Shanghai area by sequencing the coding region of hexon protein.Methods Two hundred and fourteen sacconjunctival swab specimens were collected from 214 patients with suspicious epidemic keratoconjunctivitis who visited Shanghai Eye Disease Prevention and Treatment Center and the clinical sites supervised by the Shanghai Prevention and Monitoring Office of Acute Hemerragic Conjunctivitis under the informed consent from January 2010 to December 2012.DNA was extracted from the specimens and then the 140 bp conserved sequence in hexon protein coding region was amplified by PCR initially to determine an adenovirus pathogen.Furtherly,956 bp conserved sequence of the hexon codind district was sequencied to clarify the serotype of adenovirus in the adenovirus-positive specimens.Results 50.93％ patients (109/214) were detected to be adenovirus-positive by generic PCR,in which AdV1 + was in 4 patiens,AdV2+ was in 33 patients,AdV3+ was in 15 patients,AdV4+ was in 12 patients,AdV8+ was in 19 patiens,AdV19+ was in 15 patients,AdV37+ was in 8 patients.The subgenus D adenoviruses,including AdV8+,AdV19+ and AdV37+ often resulted in corneal inflammation,pseudomembranous conjunctivitis and preauricular lymph nodes;while subgenus B adenovirus induced much frequent tract infection and less corneal response.Conclusions PCR-sequence of conserved region of hexon protein coding district is applicable for the detection and serotyping of adenovirus in epidemic keratoconjunctivitis.
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Background The commonly used method of typing the adenovirus (AdV) for epidemic keratoconjunctivitis is direct DNA sequence.However,heteroduplex mobility assay (HMA) is found to be a faster method to identify the subtypes of adenovirus and is more conforming to the principle of cost and economic benefit.There are few studies to illustrate the application of HMA in epidemic keratoconjunctivitis.Objective This study analyzed the conserved region of hexon coding sequence and compared the outcomes between direct DNA sequence and HMA for classification of adenovirus in epidemic keratoconjunctivitis patients.The validity of HMA is evaluated by comparing the result of both studies Methods Two hundreds and fourteen patients with suspicious epidemic keratoconjunctivitis were included in Shanghai Eye Disease Prevention and Treatment Center or the clinical sites supervised by the Shanghai Prevention and Monitoring Office of Acute Hemerragic Conjunctivitis from January 2010 to December 2012.Sacconjunctival swab samples were collected from each patient under the informed consent.DNA of pathogens was extracted from the samples using QIA-amp minikit,and the conserved sequence with 366 bp at hexon protein coding region was amplified by PCR and sequenced subsequently to determine the infected adenovirus and their subtypes.These samples were simultaneously assayed by HMA,and the outcomes between DNA sequence and HMA were compared.Results Extracted DNA presented a yellow fluorescence band with the fragment size 35 kb and absorbance ratio at the wavelength 260 nm and 280 nm (A260/A280) was I.7.In the 214 samples,AdV type 1 (AdV1) was found in 4 samples,AdV2 in 33 samples,AdV3 in 15 samples,AdV4 in 12 samples,AdV8 in 19 samples,AdV19 in 15 samples and AdV37 in 8 samples.HMA showed the same outcome for the identification of AdV1,AdV2,AdV3,AdV8,AdV19 and AdV37 with direct DNA sequence.AdV4 was not feasible to HMA owing to 59.6％ (over 10％) mutation sites.Conclusions Direct DNA sequencing for conserved regions in coding sequence of hexon is an important way to identify causing-disease adenovirus subtypes in the patients with epidemic keratoconjunctivitis.HMA can offer a consistent result with the DNA sequencing,and it might be used as a suitable tool for large-scale molecular epidemiology researches.
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Objective To explore the histopathological changes of the radial optic neurotomy (RON) in human eyes, and to establish the theoretical foundation for the effective RON. Methods Ten patients with unaffected eyeball or optic disc who had undergone ophthalmectomy (7 patients) or orbital exenteration (3 patients) because of intraocular or orbital tumor were gathered. A double-incision in pars plana was performed. One was inserted into illuminating fiber, and another was inserted into a standard microvitreoretinal (MVR) blade (unbent MVR blade in 4 patients and bent ones in 6; radial incision on nasal side of the optic disc in 4 patients and on both nasal and temporal side in 6). The histopathological examination was performed to observe the location and depth of the incision. Results Eleven incisions were found in 8 out of 10 patients, of which surgical spaces can be observed clearly. Three incisions were obliquely inserted into the optic nerves, 5 sieve plate lateral incisions had the surgical intervals connected with the subarachnoid spaces, and 3 incisions caused obvious damage of retinal ganglion cell axons due to the position close to the center. Nine incisions approached to the retrolaminal level, and the other 2 reached the laminal and prelaminal level respectively. Injured retina beside the optic disc in 1 incision was found. Central retinal vessels were not damaged. Conclusions An optimal incision may be in the edge of the lamina cribrosa, whose depth should be in the level of lamina cribrosa and retrolamina, with surgical intervals connected with the subarachnoid spaces.