晋秀明，男，医学博士，副主任医师、硕士研究生导师，浙江大学附属第二医院眼科中心角膜和眼表疾病专科主任，中华医学会眼科学分会角膜病学组全国委员，浙江省医学会眼科青年委员会副主任委员，从事眼科临床工作20年，主攻角膜和眼表疾病。主持国家自然科学基金面上项目2项；浙江省自然科学基金2项，浙江省卫生厅课题一项。发表SCI收录论文20篇。

《黏蛋白和眼表疾病》

正常眼表是由一层泪膜覆盖，这层泪膜主要提供角膜上皮营养，防止病原体入侵，保持角膜表面光滑和稳定的视力。泪膜分为三层：脂质层，水液层和黏蛋白层。泪液的粘蛋白层具有重要的屏障功能，提供了角膜和结膜上皮表面的水润滑。结膜杯状细胞分泌的粘蛋白受副交感神经和交感神经调节; 特别是副交感神经的神经递质乙酰胆碱和血管活性肠肽（VIP）能刺激杯状细胞分泌。临床研究发现在干眼症患者泪液粘蛋白浓度比正常人低，而且杯状细胞密度是在严重的干眼症疾病如眼瘢痕性类天疱疮（OCP），Stevens-Johnson综合征，和碱烧伤表达更低。黏蛋白和干眼发病间的密切关系越来越得到了临床的重视，临床对干眼的治疗往往重视水液缺乏和脂质层缺乏，现在已经逐渐重视黏蛋白层在干眼治疗中的作用，在国外也有了相关治疗的促进黏蛋白分泌的药物如地夸磷索和瑞巴派特滴眼液，均表现出较强的干眼改善和治疗效果。本讲座分析了黏蛋白在眼表的分布及其在眼表微环境中的作用，阐述黏蛋白缺失和眼表疾病、干眼等相互间的关系，并探讨眼表黏蛋白缺乏的检测方法和黏蛋白相关干眼人工泪液的选择。

  Mucin deficiency and Ocular diseaseXiuming JinEye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road; Hangzhou 310009, ChinaThe ocular surface is covered by a tear film for lubrication, playing the role of a nutritional route for corneal epithelium, protecting against pathogens, and maintaining the smooth refractive surface of the eye for vision. The tear Film contains many substances secreted by different glands and tissues around the ocular surface, and is composed of multiple layers. The outer layer of the tear film consists of lipids secreted from the meibomian glands to slow evaporation of aqueous components in tears. The intermediate aqueous layer includes electrolytes and water from the lacrimal glands, as well as gel-forming mucin secreted by the goblet cells of the conjunctiva. Tear mucin has an important barrier function, providing hydration and lubrication of the corneal and conjunctival epithelial surfaces. Mucin secretion from conjunctival goblet cells is regulated by parasympathetic and sympathetic nerves; the parasympathetic neurotransmitters acetyl- choline and vasoactive intestinal peptide (VIP), in particular, stimulate goblet cell secretion.  The mucin concentration in tears of dry eye patients is lower than that in normal subjects. Goblet cell density is also lower in severe dry eye diseases, including ocular cicatricial pemphigoid (OCP), Stevens−Johnson syndrome, and alkali burn. Hence, it has been thought that the concentration of mucin in tears may depend on the number of goblet cells and/or their physiological condition. However, it remains unclear whether the secreted MUC5AC concentration in tear is significantly correlated with goblet cell density in the human conjunctiva.The relationship between mucin and dry eye has been got more clinical attention. The eye drops such as Rebamipide and Diquafosol （Mucin secretion promoting drug） have shown strong improvement and treatment of dry eye. This lecture analyzed the distribution of the ocular surface mucin and its role in ocular microenvironment and explain the relationship between mucin loss and ocular surface disease, dry eye. We also explain the method to detect the ocular surface mucin deficiency and the choice of artificial tears to treat mucin-related dry eye.