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.
接触镜在全球的应用日益广泛，配适方法的不断进步是目前接触镜安全性、舒适性不断提高的原因之一。在接触镜适配过程中，越来越多的先进影像技术被运用于指导接触镜的配适，这些技术的出现简化了接触镜适配的过程，为临床医生进行简便、准确、个性化的接触镜适配提供了帮助，也为接触镜的个性化设计提供了参考数据。
Contact lens has been widely applied worldwide, and the advancement of fitting strategy is one of the reasons which improve the safety and comfort of contact lens fitting. During the contact lens fitting procedure, more and more ophthalmic imaging modalities have been applied to guide the contact lens fitting. These techniques simplify the contact lens fitting procedure, help optometrists accurately perform the customize contact lens fitting, and assist the personalized contact lens design technique.
碳点是一种新型荧光碳纳米材料，直径一般小于10 nm，具有自发荧光、高生物组织相容性、易于修饰、成本低廉等优点，在生物医学领域拥有广阔的应用前景。眼球因其独特的屏障结构，常规药物停留时间短、穿透性差，通过局部滴眼到达病灶的药物浓度有限，需要增加给药频次以保持药效。另外，糖尿病性黄斑水肿(diabetic macular edema,DME)、脉络膜新生血管(diabetic macular edema,CNV)等疾病的治疗给药则需依赖于玻璃体腔注射，该方法属于有创操作，有引起潜在并发症的可能，且需多次注射，给患者造成了沉重的心理和经济负担。优化眼部给药方法一直是眼科学领域的研究热点。基于碳点的优异特性，碳点在眼部药物递送、眼部成像、眼疾病诊疗中已展现出优秀的应用潜力。本综述将综合介绍碳点的特点及近十年来碳点在眼科疾病诊疗中的研究进展，旨在提供关于碳点在眼科应用现状的系统性认识，为未来研究提供方向。
Carbon dots is a new type of fluorescent carbon nanomaterial, which the diameter is generally less than 10 nm, has the advantages of self-fluorescence, remarkable biocompatibility, easy modification, low cost and so on, has a broad application prospect in the biomedical field. Due to the unique barrier of the eye, conventional drugs have a short residence time and poor penetration, so the concentration of drugs that can reach the lesions through local eye drops is limited, and for what to increase the frequency of administration to maintain efficacy. Up to now, the treatment of posterior eye diseases, such as diabetic macular edema (DME), choroidal neovascularization (CNV) and other diseases still rely on repeated vitreous injection, which is an invasive procedure with potential complications, and need multiple injections, causing a heavy psychological and economic burden on patients. Optimizing the method of ocular drug delivery has always been a hot topic in the field of ophthalmology. Carbon dots have shown excellent application potential in the ocular drug delivery, ocular imaging, and diagnosis and treatment of ocular disease based on its excellent characteristics. This review will systematically introduce the characteristics of carbon dots and the application of carbon dots in the diagnosis and treatment of eye diseases, aiming to provide a comprehensive understanding of the current situation of the application of carbon dots in ophthalmology and provide directions for future research.
数字眼科技术的蓬勃发展已经渗透于眼科各领域，并为眼科前沿技术研究带来了重大变革。文章对眼科前沿技术研究和发展进行综述，重点关注各项技术的突破和成果，聚焦国内的同时也放眼全球，阐明近年来全球数字眼科前沿技术现状和成果。如人工智能可运用于诸多疾病的精准监测、高发疾病的高效评估、远程医疗的技术支持等，提高了筛查、诊断、治疗等各环节的精确度和效率，减轻了医生的负担，展现了极大的应用潜能。其余各类技术方面，如数字成像技术也取得了飞跃式进展，在手术导航和影像诊断方面实现突破；3D建模技术和机器学习技术在手术设计和提高手术成功率方面立下汗马功劳，为世界各地的眼科疾病患者提供了更为高效、便捷的服务。此外，数字眼科技术还呈现出多元化发展的态势，与多学科协同交流，交叉运用。虽然诸多眼科前沿技术还处在发展初期，距离全覆盖实施仍有一定距离，在算法的准确性和可解释性、医疗伦理、民众接受度、医疗纠纷、临床技术挑战等问题上还存在很多不确定性。但毫无疑问的是，随着医学水平的日益提升，上述技术必会得到不断完善和普及。
The rapid evolution of digital ophthalmology technology has profoundly transformed various fields within ophthalmology. This article provides a comprehensive overview of the research and advancements in cutting-edge ophthalmology technologies, emphasizing both domestic and global breakthroughs and achievements. For instance, artificial intelligence has demonstrated remarkable potential in precise monitoring of various diseases, efficient assessment of high-prevalence conditions, and the technological support for telemedicine, thereby enhancing the accuracy and efficiency of screening, diagnosis, treatment processes, while alleviating the workload of medical professionals. Additionally, digital imaging technology has made significant strides in surgical navigation and diagnostic imaging, while 3D modeling and novel machine learning techniques have contributed to surgical planning and enhanced surgical success rates, ultimately delivering more efficient and convenient services to patients with eye diseases worldwide. Despite the diversified development trends and interdisciplinary collaborations that digital ophthalmology technology exhibits, many of these cutting-edge technology are still in their infancy, facing challenges in achieving high coverage, algorithm accuracy and interpretability, medical ethics, public acceptance, medical disputes, and clinical technical hurdles. Nonetheless, while the continuous advancement of medical standards, it is anticipated that these technologies will undergo further refinement and widespread adoption.
外泌体(exosome)是直径30 nm~150 nm的纳米级囊泡，由脂质双分子层、蛋白质和遗传物质组成。人体内几乎所有类型的细胞都能分泌外泌体。它们在细胞通信、免疫调节、炎症反应和新生血管形成中起着关键作用。目前，外泌体已在肿瘤、心血管及泌尿系统中得到广泛研究。近年来，外泌体在眼科疾病中的作用受到越来越多的关注。外泌体在角膜病变、年龄相关性黄斑病变、糖尿病视网膜病变、青光眼等常见眼科疾病的发生、发展中发挥重要作用。不同间充质干细胞来源的外泌体在眼科疾病中的治疗潜力是当下的热点。间充质干细胞来源的外泌体具有与间充质干细胞相似的抗炎、抗凋亡、神经保护和组织修复的作用，因此外泌体可能是多种眼科疾病无细胞疗法治疗研究的新方向。进一步了解外泌体的生物学特性以及外泌体在眼科疾病的最新研究进展，将为相关眼病的发生机制和防治策略提供参考依据。
Exosomes are nanoscale vesicles with a diameter of 30 nm to 150 nm, which are composed of lipid bilayers, proteins, and genetic material. Almost all types of cells in the human body can secrete exosomes. Tey play key roles in cellular communication, immune regulation, infammatory responses and neovascularization. At present, exosomes have been widely studied in tumors, cardiovascular and urinary systems. In recent years, the role of exosomes in eye diseases has attracted more and more attention. The exosomes play an important role in the occurrence and development of common eye diseases such as keratopathy, age-related macular disease, diabetic retinopathy, glaucoma, etc. Currently it is a hot topic that the therapeutic potential of extracellular vesicles derived from diferent mesenchymal stem cells in eye diseases. Te exosomes derived from mesenchymal stem cells have anti-infammatory, anti apoptotic, neuroprotective and tissue repairing effects, which are similar to those of mesenchymal stem cells. Thus, exosomes may be a novel direction of research in the treatment of many eye diseases without cell therapy. Further understanding of the biological characteristics of exosomes and the latest research progress of exosomes in common eye diseases will provide reference for the pathogenesis and prevention strategies of related eye diseases.
目的：了解医学专业学位硕士(专硕)研究生培养并轨住院医师规范化培训制度下的眼科专硕科研能 力现状，并提出提升科研能力的对策。方法：对哈尔滨医科大学三所附属医院眼科学76名不同年级 专硕研究生的科研能力现状、阻碍科研学习的因素、科研训练意愿等进行问卷调查。结果：在目前 的培养模式下，专硕科研和临床知识基础相对薄弱及临床学习任务繁重是科研学习的主要障碍。 结论：提出教学基地可以因需施教、提供多模式科研训练；强化临床诊疗培训为科研思维培养助 力；导师可以结合新时代发展背景优化科研选题策略、拓宽学生科研视野等措施。
Objective: To understand the current situation of scientific research ability of postgraduates with professional degrees in ophthalmology and put forward improvement measures. Methods: A questionnaire survey was conducted on the current situation of scientific research ability, scientific research obstacles and scientific research training willingness, 76 postgraduate students of different grades majoring in ophthalmology of three affiliated hospitals of Harbin Medical University were involved. Results: Under the merging residency training system, the foundation of scientific research and clinical knowledge of postgraduates is relatively weak, and the heavy clinical learning task were the main obstacles to scientific research of postgraduates. Conclusion: It is proposed that the teaching bases could provide multi-mode scientific research training to cater to students' individual needs. Not only clinical diagnosis and treatment training could be strengthened to cultivate students’ scientific research thinking, but scientific research topic selection strategy could be optimized by to meet the demand for development of times and broaden students’ scientific research vision.
患者，男性，1岁9个月。以“发现右眼上、下眼睑肿物25 d”首诊于眼科，要求切除，但经影像学及病理学检查，诊断为多发性朗格汉斯细胞组织细胞增生症，且全身骨骼多处出现溶骨性改变，不符合切除指征。给予多次全身化学治疗后眼部肿物明显变小。该例诊治提醒眼科医生，眼部肿物可由全身系统性疾病引起，不可盲目切除，必要时做进一步检查。术中切除物均建议行病理活组织检查，以免延误治疗。
patient, male, 1year and 9months old, was first diagnosed as “eye tumor” in the ophthalmology department and requested for excision. But it was diagnosed as multiple Langerhans cell histiocytosis (LCH) through imaging and pathological examination ultimately.Bone lytic changes appeared in many parts of the whole body, which did not meet the indication of excision.The tumor was smaller after systemic chemotherapy. The diagnosis and treatment of this case suggests ophthalmologists that eye tumors can be caused by caused by systemic diseases, systemic diseases. During operation, it is recommended to perform pathological biopsy to avoid treatment delay.
目的：评价并汇总眼科成人日间手术患者病区护理管理的最佳证据，提高临床护理质量。方法：检索国内外数据库建库至2022年6月的日间手术患者病区护理管理的相关证据，包括系统评价、临床决策、证据总结、指南及专家共识。由2名研究人员独立对文献进行质量评价后，根据主题对证据进行提取和汇总。结果：根据纳入标准，共筛选出13篇文献，包括5篇专家共识、3篇证据总结、1篇循证实践、2篇系统评价、1篇指南。通过文献阅读、证据提取和归类，从日间手术护士准入资质、制定临床护理路径、院前管理、病历标准化、手术当日术前管理、术后管理、出院评估、康复及随访指导8个方面形成17条最佳证据。结论：该项目总结了眼科成人日间手术患者病区护理管理的最佳证据，可为护理管理者制定眼科日间手术病区流程方案、实践标准提供循证依据。
Objective: To evaluate and summarize the evidences of nursing management of ophthalmic postoperative adult patients intra-day ward, and improve the quality of clinical nursing. Methods: The related databases were searched from the establishment to June 2022. The searching contents include systematic review, clinical decision-making, evidence summary, guidelines and expert consensus on nursing management in postoperative patients intra-day wards at home and aboard. Based on the theme, the evidences were extracted and summarized after independent literature quality evaluation was conducted by 2 researchers. Results: Base on the inclusion criteria, a total of 13 pieces of literature were selected, including 5 expert consensus, 3 evidence summaries, 1 evidence-based practice, 2 systematic reviews and 1 guideline. Through literature review, evidence extraction and classification, a total of 17 pieces of evidence on 8 aspects were summarized, including admission qualifications for daytime surgical nurses, development of clinical nursing path, pre-hospital management, medical record standardization, preoperative management on the day of surgery, postoperative management, discharge assessment, rehabilitation and follow-up guidance. Conclusion: This article summarized the best evidence of nursing management for ophthalmic adult day surgery patients in intra-day ward,to provide scientific evidences for nursing managers to develop ophthalmic intra-day ward guidelines and practical standards.
眼睛由屈光系统和视觉神经系统两大部分构成，是人体最重要的感觉器官之一。眼部各组织的发育或功能异常都可能造成不同程度的视力损害。目前主要通过动物实验或体外细胞培养的方法探究眼病的病理生理机制和治疗手段，但上述两种方法都存在一定的局限性。体外细胞培养不能完全反映器官的形态、结构和生化特征，而动物模型的物种和遗传背景具有异质性。近年来，随着原代组织、胚胎干细胞、诱导多能干细胞衍生的体外三维结构类器官和器官微流控芯片技术的不断发展，构建出了与在体器官的结构、功能更为相似的器官克隆模型，能够提供更敏感、定量、规模化的表型分析，更好地应用于眼的发育、生理结构、疾病机制、个性化医学诊断和治疗方法等方面的研究。目前，眼科的微流控器官芯片与类器官技术在角膜、晶状体、泪腺、视网膜结构发育和疾病模型均展现出巨大的应用潜力。
The eye is composed of refractive system and visual nervous system. It is one of the most important sensory organs of the human body. The abnormal development or function of eye tissues may cause various degrees of visual impairment. At present, the pathophysiological mechanism and treatment of eye diseases are mainly explored through animal experiments and in-vitro cell culture. However, they are of certain limitations. The in-vitro cell culture cannot fully reflect the morphological, structural and biochemical characteristics of organs, whereas the animal models are heterogeneous of species and genetic background. In recent years, with the continuous development of in-vitro three-dimensional structure organoids and organ microfluidic organ-on-a-chip technology derived from primary tissues, embryonic stem cells and induced pluripotent stem cells, organ cloning models more similar to in vivo organs in terms of the structure and function have been constructed. These models can provide more sensitive, quantitative and large-scale phenotypic analysis, and can be better applied to the research of eye development, physiological structure, disease mechanism, personalized medical diagnosis and treatment. At present, microfluidic organ-on-a-chip and organoids technologies have shown great application potential in the structural development and disease models’ construction of cornea, lens, lacrimal gland and retina.
目的：探讨督导式教学门诊在眼科住院医师规范化培训中的具体实践和教学效果。方法：通过合理排班、限制号源等措施设立每周固定的督导式教学门诊时间，安排老师和学员出诊；在教学门诊开展4个月后，通过问卷调查和临床技能考核的形式采集反馈意见并评估教学效果。 结果：共有16名老师和8名学员参加了督导式教学门诊，调查问卷结果显示100%的带教老师和学员认可该教学模式，参加过教学门诊的学员临床技能考核得分显著高于对照组(t =3.631， P<0.05)。结论：督导式教学门诊应用于眼科住院医师规范化培训具有实际可行性，并可以提高学员的临床技能水平。
Objective: To explore the application and effects of supervised teaching clinic in standardized training of ophthalmology residents. Methods: A weekly supervised teaching clinic was set through reasonable scheduling and limiting the registration numbers. After 4 months of application, feedbacks were collected through questionnaire survey from both the teachers and residents. Clinical skills assessments were also taken to evaluate the teaching effect. Results: A total of 16 teachers and 8 residents participated in the supervised teaching clinic. The results of the questionnaire showed that 100% of the teachers and residents agreed with the teaching mode. The clinical skill assessment scores of the residents who participated in the teaching clinic were significantly higher than those of the control group (t=3.631, P<0.05). Conclusion: The application of supervised teaching clinic in standardized training of ophthalmology residents is feasible and can improve the clinical skills of the residents.
