近视性黄斑病变(myopic maculopathy,MM)是近视最常见的并发症,也是影响病理性近视视功能下降的主要原因。目前,MM的分类系统尚不能完全解释患者黄斑部发生的多种变化,迫切需要一个全面、统一的分类系统来协助沟通和比较临床试验以及国际多中心研究的结果。随着眼底成像技术的发展与应用,最新的近视性黄斑病变分类,即ATN分类系统[萎缩(A)、牵拉(T)、和新生血管(N)]结合眼底照片与光学相干断层扫描(optical coherence tomography,OCT)图片,把黄斑病变分为3类,每一类又根据其严重程度进行分级,这对MM的诊断和治疗提供了较大的临床价值。
Myopic maculopathy (MM) is the most common complication of myopia, which is also the main cause of poor visual function in pathologic myopia. Presently, the classification system of MM cannot properly explain the numerous changes that occur in the patient’s macula. Therefore, a comprehensive and unified classification system is urgently needed to facilitate in communicating and comparing the results of clinical trials and international multicenter studies. With the development and application of fundus imaging technology, the latest classification of MM, namely ATN (atrophy, A; traction, T; neovascularization, N) classificationsystem, which combines fundus photographs and optical coherence tomography (OCT) images, classifies macular lesions into 3 categories according to its severity, generating greater clinical value for the diagnosis and treatment of MM.
八年制医学教育的目的是培养适合我国国情的高素质医学人才。本文回顾了我国八年制医学教育的产生与发展;介绍了八年制医学教育改革中各个方面积极的探索,包括教师改革、教学理念改革、教学方法改革、教学手段变化和特色课程设置等;总结了我国目前八年制医学教育的现状;并探讨了进一步完善这一教育体系,提高八年制医学生素质的策略与方案。
The purpose of the eight-year medical education is to train students for well-qualified medical talents that are in line with our national conditions. This article introduces the establishment and development of the eight-year medical education in China, and various aspects of exploration in its reform which includes the reform of the tutoring system, teaching philosophy, teaching approach, means of teaching, special courses and so on. It also summarizes the current situation of the eight-year medical education and discusses potential strategies to improve the education system and the quality of eight-year medical students.
在晶状体纤维细胞分化的终末阶段,细胞核、线粒体、内质网及高尔基体等膜性细胞器会发生程序性的降解,这对晶状体透明性的维持至关重要。然而,晶状体细胞器降解过程的机制尚不明确。研究晶状体细胞器的降解过程可为阐明白内障的发病机制提供理论依据,也有望为晶状体再生提供新的干预靶点。本文就晶状体细胞器降解过程及其机制进行综述。
During terminal differentiation of lens fiber cells, nuclei and other organelles experience programmed elimination.This process is essential for the maintenance of lens transparency. However, the mechanisms underlying lens organelle degradation remain unclear. Identification of the mechanisms can provide a theoretical basis for elucidating the pathogenesis of cataract and is expected to reveal new intervention targets for lens regeneration. In this review, we discuss potential mechanisms and the process of lens organelle degradation.
鼻内镜外科技术延伸到鼻眼相关疾病的诊断和治疗已经有二十余年的历史。随着鼻眼相关解剖研究、影像诊断技术和手术器械的进步和手术临床经验的积累,大量临床和基础研究不断涌现,逐渐形成了相对成熟的内镜鼻眼相关外科理论与实践体系。本文概述了内镜鼻眼相关外科的发展现状,对几种主要手术提供经验总结并提出展望。
Nasal endoscopic surgery technology has gradually developed and involved into the diagnosis and treatment of nose-eye related disease for more than 20 years. With the improvement of anatomical studies on nose-eye, imaging diagnostic technology and surgical instruments, the accumulation of surgical clinical experience, as well as the increasing emergence of a large number of clinical and basic studies on endoscopic rhino-orbital related surgery, a well-established theoretical and practical system of endoscopic nose-eye surgery has gradually been formed. This article summarized the development of endoscopic rhino-orbital surgery, and the advantages and limitations of several major surgical methods. Also, the further research was prospected.
干眼是一种临床常见慢性眼表疾病。它不仅能引发患者眼部不适及损害,还易导致患者出现心理障碍。目前最常见的干眼相关心理障碍主要为焦虑、抑郁和睡眠障碍。干眼病情的缓解,不仅需要针对干眼本身的积极治疗,还需要患者保持健康的心理状态。因此,应该关注干眼相关焦虑、抑郁等心理障碍的发病机制及预防、治疗措施。
Dry eye disease (DED) is a common chronic ocular surface disease. It can not only cause discomfort and damage to the eyes but also easily lead to psychological disorders in patients. The most common psychological disorders related to DED are anxiety, depression and sleep disorder. To alleviate the condition of DED, in addition to active treatment for DED itself, it is also necessary for the patients to maintain a healthy psychological state. Therefore, attention should be paid to the pathogenesis, prevention and treatment measures of DED-related anxiety, depression and other psychological disorders.
目的:了解眼科住院医师规范化培训学员(规培生)的沟通技能态度和人际沟通能力现状。方法:对中山大学中山眼科中心三个年级规培生的沟通态度和人际沟通能力进行问卷调查,并进一步分析其沟通态度与沟通能力的相关性。结果:共纳入196名规培生,沟通积极态度量表总分为51.38±6.52,消极态度为36.80±5.70,人际沟通能力为2.41±0.40,辅导与咨询维度得分为2.50±0.64,提供有效的负面反馈维度得分为2.61±0.50,支持性沟通维度得分为2.29±0.44。沟通技能的积极态度与人际沟通能力和三维度之间显著相关(P<0.01)。人际沟通技能得分与性别、规培年级、喜欢眼科专业的程度、得到家庭的关爱程度、得到朋友的关爱程度等因素显著相关(P<0.05)。结论:眼科规培生对沟通技能的积极态度优秀,但是总体沟通能力较弱,并受到多种因素影响。应充分重视规培生人际沟通能力的培养,开展医患沟通的专业化培训。
Objective: To evaluate the current status and correlations between attitudes and competency for interpersonal communication in ophthalmology standardized training trainee. Methods: A questionnaire survey was conducted on the communication attitudes and interpersonal communication ability of standardized training trainees from three grades in Zhongshan Ophthalmic Center, affiliated to Sun Yat-sen University, and the correlation between communication attitude and communication ability was further analyzed. Results: A total of 196 trainees were included. The scores of positive attitude, negative attitude, and interpersonal communication skills were 51.38±6.52, 36.80±5.70, and 2.41±0.40, respectively. In addition, the dimension of coaching and counseling scores were 2.50±0.64, the dimension of providing effective and negative feedback scores were 2.61±0.50, and the dimension of supportive communication scores were 2.29±0.44. The positive attitudes of communication skills were significantly related to the interpersonal communication skills and three-dimensionality (P<0.01). The interpersonal communication skills were significantly associated with sex, grades, interest in ophthalmology, social support from the family and friends (P<0.05). Conclusion: Ophthalmology trainees have excellent positive attitudes toward communication skills, but the overall communication skills are weak and influenced by a variety of factors. More attention should be paid to the development of interpersonal communication skills of the trainees, and specialized training in doctor-patient communication is warranted.
随着科学技术的提高、手术方式的改进,角膜屈光手术成为治疗近视的主要方式。角膜屈光手术后角膜形态及生物力学的变化对于尽早发现术后相关并发症及术后长期稳定性具有重要意义,不同的术式及术后不同的恢复阶段角膜表面非球面参数及生物力学指标的变化存在一定差异,明确其变化的原因及机制可对临床研究提供一定的参考。
With the improvement of science and technology and the improvement of surgical methods, corneal refractive surgery has become the main way to treat myopia. The changes of corneal morphology and biomechanics after corneal refractive surgery are of great significance for early detection of postoperative complications and also affect the long-term stability after corneal refractive surgery. There are some differences in the changes of aspheric parameters and biomechanical properties in different surgical procedures and different postoperative recovery stages. Clarifying the reasons and mechanisms of these changes can provide some reference for clinical research.