目的：调查八年制临床医学生对眼科学直播课堂的满意度及教学效果。方法：基于八年制临床医 学生的直播课堂教学体验视角，进行问卷调查、课堂测验及课程考试，问卷内容包括调查对象基 本情况、直播课堂教学评价及满意度3个部分。采用SPSS 20.0统计学软件进行数据分析。结果：共 92名学生完成了问卷调查，男37名，女55名，年龄为(22.9±0.71)岁。课堂内容、课堂资源、平台设 计、平台技术及学习交流5个纬度的得分为40.60±4.582、17.43±2.814、13.07±1.759、13.14±2.052、 20.82±2.685；其中，与线下课堂交流相似性、学习交流积极性2个子条目的得分最低，分别为 3.42±1.131、3.85±0.864，这二者具有相关性(r=0.276，P=0.008)。直播课堂满意度的总得分为 13.52±1.872，课堂内容对其有显著影响(P<0.001)，标准化回归系数为0.687。相较于课前测验，课 测验成绩(65.9±11.4分)的提升差异具有统计学意义(P=0.033)；但是与2013级相比，2015级学生的 课程考试成绩(72.6±7.0分)降低，差异有统计学意义(P=0.009)。结论：课堂内容对直播课堂教学满 意度具有重要影响，需要注意直播课堂与线下课堂交流方式的差异，改进学习交流的参与积极性， 以提升教学效果。

Objective: To investigate the satisfaction and teaching effect of 8-year program medical students in live-streamed classroom on ophthalmology. Methods Based on teaching experience of live-streamed classroofrom the perspective of the 8-year program medical students, a questionnaire survey, classroom tests and course examination were conducted. The content of the questionnaire includes 3 parts: the basic information of the respondents, evaluation of live-streamed classroom teaching and its satisfaction. The SPSS 20.0 statistical software was used for data analysis. Results: A total of 92 students completed the questionnaire survey, including 37 males and 55 females, aged (22.9±0.71) years. The sores of content, resource, platform design, platform technology and learning communication of live-streamed classroom were 40.60±4.582, 17.43±2.814, 13.07±1.759, 13.14±2.052 and 20.82±2.685, respectively. Among all items, the scores of the similarity of offline classroom communication styles and enthusiasm for communication were lowest, with the points of 3.42±1.131 and 3.85±0.864, respectively, and the correlation of the two items were statistically significant (correlation coefficient =0.276, P=0.008). The total score of the live-streamed classroom satisfaction was 13.52±1.872. The classroom content has a significant effect on the satisfaction of the live-streamed classroom (P<0.001), and the standardized regression coefficient is 0.687. Compared with the pre-class test, the post-class test score was 65.9±11.4, with a statistically significant improvement (P=0.033); however, compared with grade 2013, the course test score of the students of grade 2015 was 72.6±7.0, with a statistically significant reduction (P=0.009). Conclusion: The classroom content has an important impact on the satisfaction of live-streamed classroom teaching. It is necessary to pay attention to the communication difference between live -streamed classroom and offline classroom settings, and improve the enthusiasm for participation in the study communication, in order to improve the effectiveness of teaching. 

原发性获得性鼻泪管阻塞(primary acquired nasolacrimal duct obstruction，PANDO)是泪道阻塞性疾病中最常见的一类，好发于中老年女性，是眼科临床上的常见病、多发病，常继发急性或慢性泪囊炎的症状和体征，严重影响患者的日常工作和生活。本文对近年来PANDO可能的发病机制相关的研究进展、亟待解决的问题及未来研究的热点方向作一综述，旨在进一步加深对泪道阻塞性疾病发生发展的认识。

Primary acquired nasolacrimal duct obstruction (PANDO), which mainly occurs in the middle-aged and elderly women, is the most common type of obstructive diseases of the lacrimal duct, and it is also a common and frequently-occurring disease in ophthalmology. It constantly occurs secondary to various symptoms and signs of acute or chronic dacryocystitis, which seriously affects the daily work and life of patients. This article summarizes the research progress on the possible pathogenesis of PANDO in recent years, the urgent problems to be solved

and the hot research directions in the future, aiming to further deepen the understanding of the occurrence and development of lacrimal obstructive diseases.

目的：探讨眼科住院医师规范化培训中睑板腺囊肿诊疗的培训效果及存在的问题，以期改进培训方式。方法：以2020年4月在中山大学中山眼科中心培训的154名学员为对象，进行问卷调查，采用SPSS 20.0统计学软件进行数据分析。结果：共76名专业型硕士(专硕)、78名住院医师培训(住培)学员完成了问卷调查。专硕具有睑板腺囊肿诊断、保守治疗及手术主刀经验的比例分别为40.8%、11.8%、7.9%；住培则显著高于前者，分别为79.5%(P<0.001)、60.3%(P<0.001)和21.8%(P=0.016)。对于关键诊疗环节的判断，90.8%的专硕选择了临床诊断(P=0.007)，94.9%的住培则选择治疗方案(P<0.001)。去除囊壁、术中意外与破溃皮肤的处理是专硕难以掌握的手术步骤(P<0.001)；而住培仅为去除囊壁(P<0.001)。结论：睑板腺囊肿诊疗水平在眼科住院医师规范化培训中亟待提高，并根据各类型学员的临床能力和认知差异，进行分级分类培训。

Objective: To explore the teaching effect of diagnosis and treatment on chalazion in the standardized training of ophthalmology residents and its existing problems, in order to improve the quality of the training systems. Methods: A self-designed questionnaire survey was conducted with 154 ophthalmology residents in Zhongshan Ophthalmic Center in April 2020, and the investigative data was analyzed using SPSS 20.0. Results: Totally 76 medical postgraduates and 78 ophthalmology residents completed the questionnaire survey. The proportions of medical postgraduates who had individual experience on diagnosis, conservative and surgical treatment of chalazion were 40.8%, 11.8%, and 7.9%. Compared to the former, ophthalmology residents had significantly higher proportion, with 79.5% (P<0.001), 60.3% (P<0.001), and 21.8% (P=0.016), respectively. For judging the important aspect of diagnosis and treatment process, the medical postgraduates chose the clinical diagnosis (90.8%) (P=0.007), while the ophthalmology residents paid more attention on treatment options (94.9%) (P<0.001). In the surgical procedures, removal of cyst wall, management of intraoperative accidents and skin ulcers are all their difficult skills to master for medical postgraduates (P<0.001), while only removal of cyst wall for residents (P<0.001). Conclusion: The training level of diagnosis and treatment of chalazion still needs to be improved in the standardized training of ophthalmology residents. The training should be carried out according to the clinical competence and cognition differences of various types of students.

目的：观察黏膜瓣泪小点成形术用于治疗慢性泪小管炎的疗效。方法：回顾性病例系列研究。收集2018年1月至2020年12月中山眼科中心眼整形科就诊的44例慢性泪小管炎患者的临床资料，分析其性别、年龄、患病眼别、临床症状、泪道冲洗结果等临床特点。采用黏膜瓣泪小点成形术进行治疗，术后随访评估其疗效。结果：44例慢性泪小管炎患者以女性为主(男女比例1:3.9)，单侧发病，多累及下泪小管(上下泪小管比例1:3)，主要表现为分泌物增多、溢泪以及内眦部位红肿，结石阳性率为95.7%，病原微生物检查结果显示以放线菌感染为主(78.3%)。大部分患者术后1周内症状得到明显改善，其中1例上下泪小管炎患者于术后2个月出现上泪小管炎复发。总体治愈率为97.8%，随访时间为(20.7±10.9)个月。结论：黏膜瓣泪小点成形术治疗慢性泪小管炎的临床疗效确切，方法可靠。

Objective: To evaluate the efficacy of mucosal flap punctoplasty in patients with chronic canaliculitis. Methods: In this retrospective serial case study, the clinical data of 44 patients with chronic canaliculitis were collected from the Oculoplastic Department of Zhongshan Ophthalmic Center at Sun Yat-sen University between January 2018 and December 2020. Demographic data such as gender, age, affected eye, clinical presentations and lacrimal duct irrigation results were analyzed. The efficacy of the procedure, symptom resolution and complications were assessed. Results: Of the 44 patients, most (male:female 1:3.9) were female, and the disease most often (upper:lower 1:3) involved the lower lacrimal canaliculus of only one eye. Main symptoms included increased secretion, tearing, and swelling of the inner canthus. Stones were present in 95.7% of patients and Actinomyces israelli was found to be the most common pathogen (78.3%). Most patients’ symptoms improved significantly within 1 week after surgery. Only one patient, who had infections in both the upper and lower canaliculi, had recurrence of upper canaliculitis 2 months after the surgery. The overall cure rate was 97.8%, and the follow-up time was (20.7±10.9) months. Conclusion: Mucosal flap punctoplasty is an efficacious and reliable method in the treatment of chronic canaliculitis.

原发性获得性鼻泪管阻塞(primary acquired nasolacrimal duct obstruction，PANDO)是泪道阻塞性疾病中最常见的一类，好发于中老年女性，是眼科临床上的常见病、多发病，常继发急性或慢性泪囊炎的症状和体征，严重影响患者的日常工作和生活。本文对近年来PANDO可能的发病机制相关的研究进展、亟待解决的问题及未来研究的热点方向作一综述，旨在进一步加深对泪道阻塞性疾病发生发展的认识。

Primary acquired nasolacrimal duct obstruction (PANDO), which mainly occurs in the middle-aged and elderly women, is the most common type of obstructive diseases of the lacrimal duct, and it is also a common and frequently-occurring disease in ophthalmology. It constantly occurs secondary to various symptoms and signs of acute or chronic dacryocystitis, which seriously affects the daily work and life of patients. This article summarizes the research progress on the possible pathogenesis of PANDO in recent years, the urgent problems to be solved and the hot research directions in the future, aiming to further deepen the understanding of the occurrence and development of lacrimal obstructive diseases.

目的：探讨眼科住院医师规范化培训中睑板腺囊肿诊疗的培训效果及存在的问题，以期改进培训方式。方法：以2020年4月在中山大学中山眼科中心培训的154名学员为对象，进行问卷调查，采用SPSS 20.0统计学软件进行数据分析。结果：共76名专业型硕士(专硕)、78名住院医师培训(住培)学员完成了问卷调查。专硕具有睑板腺囊肿诊断、保守治疗及手术主刀经验的比例分别为40.8%、11.8%、7.9%；住培则显著高于前者，分别为79.5%(P<0.001)、60.3%(P<0.001)和21.8%(P=0.016)。对于关键诊疗环节的判断，90.8%的专硕选择了临床诊断(P=0.007)，94.9%的住培则选择治疗方案(P<0.001)。去除囊壁、术中意外与破溃皮肤的处理是专硕难以掌握的手术步骤(P<0.001)；而住培仅为去除囊壁(P<0.001)。结论：睑板腺囊肿诊疗水平在眼科住院医师规范化培训中亟待提高，并根据各类型学员的临床能力和认知差异，进行分级分类培训。

Objective: To explore the teaching effect of diagnosis and treatment on chalazion in the standardized training of ophthalmology residents and its existing problems, in order to improve the quality of the training systems. Methods: A self-designed questionnaire survey was conducted with 154 ophthalmology residents in Zhongshan Ophthalmic Center in April 2020, and the investigative data was analyzed using SPSS 20.0. Results: Totally 76 medical postgraduates and 78 ophthalmology residents completed the questionnaire survey. The proportions of medical postgraduates who had individual experience on diagnosis, conservative and surgical treatment of chalazion were 40.8%, 11.8%, and 7.9%. Compared to the former, ophthalmology residents had significantly higher proportion, with 79.5% (P<0.001), 60.3% (P<0.001), and 21.8% (P=0.016), respectively. For judging the important aspect of diagnosis and treatment process, the medical postgraduates chose the clinical diagnosis (90.8%) (P=0.007), while the ophthalmology residents paid more attention on treatment options (94.9%) (P<0.001). In the surgical procedures, removal of cyst wall, management of intraoperative accidents and skin ulcers are all their difficult skills to master for medical postgraduates (P<0.001), while only removal of cyst wall for residents (P<0.001). Conclusion: The training level of diagnosis and treatment of chalazion still needs to be improved in the standardized training of ophthalmology residents. The training should be carried out according to the clinical competence and cognition differences of various types of students.