目的：探讨个性化护理在眼科患儿全身麻醉手术中的应用效果。方法：选取于2015年7月至2016年8月中山大学附属第一医院收治的50例眼科全身麻醉手术患儿，按手术例数单、双号顺序分组，单 数为对照组，采用传统常规护理，双数为观察组，采用个性化护理。比较两组麻醉配合度与家属对护理满意度。结果：50例患儿手术顺利。对照组在麻醉及复苏过程出现烦躁与躁动情况的患儿18例，观察组为3例,对照组明显高于观察组；观察组麻醉配合度与家属对护理满意度明显高于对照组，差异均有统计学意义(P<0.05)。结论：眼科全身麻醉手术患儿运用个性化护理，可改善患儿心理状态，提高配合度，增加患儿家属的满意度。

Objective: To detect the effect of individualized nursing on ophthalmic children under general anesthesia operation. Methods: Ophthalmic children under general anesthesia operation in First Afifliated Hospital of Sun Yat-sen University were included from July 2015 to August 2016. All of children were divided into odd and even groups by the operation sequence number. The children with odd numbers were in control group and accepted traditional nursing. The children with even numbers were in experimental group and accepted individualized nursing. Anesthesia cooperation degree and family members’ satisfaction on nursing were compared between the two groups. Results: Fifty operations were proceeded successfully. 18 children appeared irritability and restlessness during anesthesia and recovery process in the control group. Irritability and restlessness were only showed in 3 children in the experimental group. The satisfaction in experimental group was much higher than  the control group, the differences were statistically signiffcant (P<0.05). Conclusion: Individualized nursing can improve the mental state and the degree of cooperation. It can also improve family members’ satisfaction.  

目的：了解中国华南地区眼科患者近年术前四项指标的感染状况及阳性患者在不同眼病中的分布。方法：回顾性分析2017年1月~2023年12月在中山大学中山眼科中心进行乙型肝炎表面抗原(HBsAg)、丙肝肝炎病毒抗体(抗-HCV)、梅毒螺旋体抗体(抗-TP)、人类免疫缺陷病毒抗体(抗-HIV)指标筛查的门诊、手术和(或)住院患者资料，并记录和分析患者各项指标的阳性情况。结果：共纳入253 246例患者，HBsAg、抗-HCV、抗-TP和抗-HIV阳性率分别是9.00%、0.45%、1.55%、0.13%。两种或两种以上感染指标阳性的患者共有686例， HBsAg和抗HCV同时阳性的例数最高(57.29%)，其次为抗-HIV和抗-TP(15.74%)。2017~2023年HBsAg阳性率逐年递减，而抗-HCV、抗-HIV、抗-TP阳性率变化不明显。男性的HBsAg、抗-HCV、抗-TP、抗-HIV阳性率均高于女性，差异均有统计学意义(P <0.001)。HBsAg、抗-HCV、抗-TP、抗-HIV阳性率在不同年龄段比较差异均有统计学意义(P <0.001)。在HBsAg、抗-HCV、抗-TP阳性患者中，晶状体病的病例数占比最高，分别为36.72%、39.12%、46.97%。其次是玻璃体/视网膜疾病，占比分别为22.52%、19.65%、19.69%。在抗-HIV阳性患者中，玻璃体/视网膜疾病的病例数占比最高，为42.99%，其次是晶状体病，占26.17%，葡萄膜炎占8.72%。结论：本研究揭示了眼科患者术前四项指标的感染情况及感染患者在不同眼病中的分布，这对于评估眼科手术风险、制定感染控制措施具有重要意义。

Objective: To understand the infection status of four blood-borne pathogens among ophthalmology patients in South China and the distribution of positive patients across different eye diseases. Methods: A retrospective analysis of data from outpatient and inpatient or surgical ophthalmic patients who underwent screening for hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (anti-HCV), treponema pallidum antibody (anti-TP) and human immunodeficiency virus antibody (anti-HIV) at Zhongshan Ophthalmic Center of Sun Yat-sen University from January 2017 to December 2023. The positivity rates of these markers were recorded and analyzed. Results: A total of 253246 patients were included in the study, with positivity rates for HBsAg, anti-HCV, anti-TP, and anti-HIV at 9.00%, 0.45%, 1.55% and 0.13%, respectively. Among these, 686 patients tested positive for two or more markers, with the highest co-positivity observed for HBsAg and anti-HCV (57.29%), followed by anti-HIV and anti-TP (15.74%). The positivity rate of HBsAg showed a yearly decline, while the rates for anti-HCV, anti-HIV, and anti-TP remained relatively stable from 2017 to 2023. Males had significantly higher positivity rates for HBsAg, anti-HCV, anti-TP, and anti-HIV compared to females (P < 0.001). Significant differences in positivity rates for these markers were also observed across different age groups (P < 0.001). In patients with positive HBsAg, anti-HCV, and anti-TP, the proportion of cases with lens diseases were the highest, at 36.72%, 39.12%, and 46.97%, respectively. Vitreoretinal diseases followed, with proportions of 22.52%, 19.65%, and 19.69%, respectively. Among patients with positive anti-HIV, the proportion of cases with vitreoretinal diseases was the highest, at 42.99%, followed by lens diseases at 26.17%, and uveitis at 8.72%. Conclusions: This study reveals the infection status of four blood-borne pathogens in ophthalmology patients and the distribution of infected patients across different eye diseases, which is significant for assessing the risks of ophthalmic surgery and formulating infection control measures.

原发性干燥综合征 (primary Sjogren' s syndrome，SS) 是一种主要累及外分泌腺体的自身免疫性疾病，患者通常因为严重的干眼症状首先就诊于眼科，大多数临床医师对原发性干燥综合征相关性干眼 (Sjogren' s syndrome dry eye disease，SS-DED) 认识不足，可能导致漏诊和误诊。侵入性极小的客观检查及生物标志物的发展，将有助于发现 SS-DED 的真面目，并可能从新的角度阐释其发病机制，为其诊断、分类及治疗提供新的思路。SS-DED 的治疗没有特效的药物，大多数患者需接受多种方法的治疗，以了解哪些方法最有效。

Primary Sjogren' s syndrome is an autoimmune disease that mainly affects exocrine glands. Patients usually refer to ophthalmologists because of severe dry eye symptoms. Most clinicians have insufficient knowledge with dry eye disease associated with primary Sjogren' s syndrome probably leading to misdiagnosis or missing the diagnosis. The diagnosis of Sjogren' s syndrome dry eye disease (SS-DED) is difficult, but the extremely invasive objective examination and the development of biomarkers will help to understand this disease and explain its pathogenesis from a new perspective. There is no specific treatment for the SS-DED, and most patients should receive multiple treatments to select the optimal treatment. 

10% 水合氯醛是最常用的小儿镇静药之一，广泛应用于眼科小儿检查和治疗前。对于年龄小、不配合的患儿，如何合理、安全使用水合氯醛，提高其镇静效果，减少其并发症发生，笔者总结护理心得如下：使用前对小儿进行全身的评估和家长的准备，使用时要掌握口服或灌肠的操作技巧，使用后要注意观察小儿的全身反应、用药效果和做好家长的宣教。

10% chloral hydrate is one of the most commonly used pediatric sedatives, which is widely used before ophthalmic pediatric examination and treatment. For young uncooperative children, how to use chloral hydrate reasonably and safely to improve their sedative effect and reduce the occurrence of complications, we summarized the nursing experiences, including evaluating child’s whole body and the preparation of parents before its use; mastering operative techniques of oral or enema route of admission in its use; paying attention to observe the child's systemic response and efficacy of drug, and patient education

目的：住院医师委托培养是我国医学教育标准化和国际化的重要举措。本研究采用客观考核和主观问卷两种方法评估我国眼科住院医师委托培养效果。方法：本研究对象为广东省深圳市政府于

2012年8月至2015年7月期间委托中山大学中山眼科中心进行眼科住院医师规范化培训的9名学员。本研究对所有学员的基本信息、临床培训情况、以及考核成绩等客观指标进行统计分析，同时设 计了一份包含13个问题的调查问卷，对每位学员的培训情况进行主观评估。结果：本研究纳入9名研究对象，包括2名男性和7名女性，平均年龄为(26±3)岁，学历水平情况为学士7名和硕士2名，其中有7名毕业于国家重点医学院校。3年内人均轮转眼科亚专科超过10科，平均主管病人数及参加手术例数分别为736和1 219例，门诊工作总量人均6 274人次，所有学员均按规定至少完成综 述1篇。8名(88.89%)学员认为可以独立诊断并治疗大部分常见眼科疾病，而且能独立完成大部分眼科基本临床操作，5名(55.56%)学员可以单独完成翼状胬肉切除术、霰粒肿刮除术、前房穿刺术等。6名(66.67%)学员认为培训时间安排合理。8名(88.89%)学员对这次委托培养总体比较满意。 所有9名培训学员中，最终有7名(77.8%)顺利通过中山大学第一阶段住院医师规范化培训考核。结论：培训学员对现行的眼科住院医师规范化培训方案的接受程度较高，基本达到预期的培训效果，对常见眼病能独立进行诊治。委托培养学员的学历和学习能力的差异在一定程度上影响了最终的培训考核通过率。

Objective: The entrusted standardized training for residents is an important measure to gear the medical education in China to the international conventions. In this study, the effectiveness of standardized training for entrusted ophthalmic residents in China was evaluated both objectively and subjectively. Methods: Nine ophthalmic residents, commissioned by Shenzhen government of Guangdong Province, studied at Zhongshan Ophthalmic Center, Sun Yat-sen University during August 2012 to July 2015 were included in this study. The objective indicators of all participants were analyzed, including the basic information, clinical training, the score of examination, etc. The subjective self-assessment was also implemented thought a questionnaire including 13 designed questions.Results: All 9 participants included 2 males and 7 females, 2 medical masters and 7 bachelors, and the mean age was 26±3 years. Seven of them graduated from the national key medical universities. The mean number of rotated sub-clinical departments was 10.3, the mean number of managed inpatients and the participated operations were 736 and 1,219, respectively. The total number of managed outpatients was 6,274 in average. All participants completed at least one review article. Eight (88.89%) participants could independently diagnose and treat the most common ophthalmic diseases, they also could complete the basic clinical ophthalmic operation independently. Five (55.56%) participants could independently manage the pterygium excision, curettage of chalazion, anterior chamber penetration, etc. And 6 (66.67%) of the participants believed that the training length was reasonable. Eight (88.89%) of them were satisfied with the standardized training for residents on the whole. Finally, 7 participants successfully passed the first stage of standardized training program in Sun Yat-sen University. Conclusion: There was a high level acceptance rate of the standardized training programs for entrusted ophthalmic residents. The participants achieved the expected training effects, and could managed the diagnosis and treatment of common ophthalmic diseases independently. But the training effects and passing rate of examination were partly affected by the learning ability of the training students.

眼科日间手术显著提高了医疗效率、节约了医疗资源，眼科麻醉复苏体系的建立则是眼科日间全身麻醉手术的重要安全保障，也是提高眼科手术室效率的重要举措。在眼科手术结束后，全身麻醉患者被即刻转运至麻醉恢复室(post-anesthesia care unit, PACU)，此时患者仍处于麻醉状态，密切的监测和呼吸机辅助通气是必不可少的，从而保障患者从麻醉状态逐渐恢复至清醒状态。当患者清醒后，拔除喉罩，各项监测指标达到PACU的转出标准，可进入到Ⅱ期复苏并日间手术离院。然而，在PACU复苏期间，患者易出现喉罩移位、呛咳等引起急性缺氧等呼吸道不良事件的发生，小儿患者则由于术后眼罩遮盖等原因，出现苏醒期躁动的概率高，从而影响到患者顺利转出PACU，间接影响到手术患者的周转。因此，如何预防这些并发症的发生，对提高眼科麻醉复苏质量显得十分重要。

眼科日间手术显著提高了医疗效率、节约了医疗资源，眼科麻醉复苏体系的建立则是眼科日间全身麻醉手术的重要安全保障，也是提高眼科手术室效率的重要举措。在眼科手术结束后，全身麻醉患者被即刻转运至麻醉恢复室(post-anesthesia care unit, PACU)，此时患者仍处于麻醉状态，密切的监测和呼吸机辅助通气是必不可少的，从而保障患者从麻醉状态逐渐恢复至清醒状态。当患者清醒后，拔除喉罩，各项监测指标达到PACU的转出标准，可进入到Ⅱ期复苏并日间手术离院。然而，在PACU复苏期间，患者易出现喉罩移位、呛咳等引起急性缺氧等呼吸道不良事件的发生，小儿患者则由于术后眼罩遮盖等原因，出现苏醒期躁动的概率高，从而影响到患者顺利转出PACU，间接影响到手术患者的周转。因此，如何预防这些并发症的发生，对提高眼科麻醉复苏质量显得十分重要。

大部分眼科手术/操作具有创伤小、疼痛刺激轻等特点，因此，选择眼表面麻醉即可满足手术的镇痛的需要，促进了眼科日间手术的广泛开展。其中，盐酸奥布卡因滴眼液是常用的眼科表面麻醉剂，具有麻醉起效迅速、镇痛作用强、持续时间久(约13 min)等特点，已经广泛应用在眼内手术中，在使用过程中，盐酸奥布卡因滴眼液对瞳孔及血管无影响，保证了眼内手术的安全。盐酸奥布卡因滴眼液能提供良好的眼表环境，对角膜厚度及角膜上皮厚度影响轻微，从而满足屈光手术的需要。此外，盐酸奥布卡因滴眼液能提供良好的术后镇痛，减少术后镇痛药物的使用，降低斜视术后患儿的躁动发生率。不含防腐剂的表面麻醉剂不影响麻醉剂的起效时间及镇痛效果，对眼表的影响轻微，从而创造良好的手术操作环境，提高手术效果，降低并发症和手术风险，是眼科手术中较为理想的表面麻醉药物。文章就盐酸奥布卡因滴眼液的作用机制及麻醉效果、药代动力学、临床疗效、安全性等进行综述。

Most ophthalmic surgeries are characterized by small incisions and mild pain, therein, the choice of topical anesthesia can meet the needs of surgeries and accelerate ophthalmic surgeries to be conducted in day surgery model. 0.4% oxybuprocaine hydrochloride eye drops is one of commonly used topical anesthetics for ophthalmic surgery, which has the characteristics of rapid onset and sufficient analgesia with long duration (about 13 minutes). Oxybuprocaine hydrochloride eye drops has been widely and safely used in intraocular surgery without affecting the pupil and blood vessels. Meanwhile, oxybuprocaine hydrochloride eye drops has negligible effects on corneal thickness and corneal epithelial thickness to meet the needs of refractive surgery. In addition, oxybuprocaine hydrochloride eye drops can provide sufficient postoperative analgesia, reduce the use of postoperative analgesics and the incidence of emergence agitation in children after strabismus surgery. The preservative-free topical anesthetic would be one of ideal topical anesthetics as it can provide a good surgical condition and reduce complications and risks of post-operative infections without changing the onset time and analgesia effects. This article provides a review of the mechanism, analgesia, pharmacokinetics, clinical efficacy, and safety profiles of 0.4% oxybuprocaine hydrochloride eye drops.

谷氨酸是哺乳动物中枢神经系统中的主要兴奋性神经递质，谷氨酸酶系统的持续激活会导致神经元的兴奋性毒性，进而引起神经元损伤和细胞死亡。兴奋性氨基酸转运体家族成员是一种多次跨膜蛋白，位于突触前膜、突触囊泡和神经胶质细胞膜上，也是一种高亲和力的钠钾依赖性载体，能够不断清除细胞外残留的谷氨酸，维持正常的突触内外谷氨酸水平和细胞内氧化还原稳态，对于保护细胞免受兴奋性毒性以及氧化应激损伤至关重要，兴奋性氨基酸转运体家族成员表水平达的失调与多种中枢神经系统疾病神经退行性变的发生和发展密切相关。在视网膜组织中，兴奋性氨基酸转运体家族成员广泛表达。目前大量研究表明，兴奋性氨基酸转运体家族成员广泛参与了青光眼、视网膜缺血再灌注损伤、年龄相关性黄斑变性等眼部疾病的发病，但具体机制有待进一步阐明。为此，文章综述了兴奋性氨基酸转运体家族成员的生理功能及其在相关眼科疾病发生和发展中作用的研究进展，为进一步阐明相关眼病发病的分子机制及新的防治靶点的发现提供新的视角。

SGlutamate is the primary excitatory neurotransmitter in the mammalian central nervous system. Persistent activation of the glutamatergic system can lead to excitotoxicity, resulting in neuronal damage and cell death. Members of the excitatory amino acid transporter (EAAT) family are multi-transmembrane proteins located on the presynaptic membrane, synaptic vesicles, and glial cell membranes. They function as high-affinity, sodium-potassium-dependent transporters, continuously clearing extracellular residual glutamate to maintain normal intra- and extracellular glutamate levels and intracellular redox homeostasis. This process is crucial for protecting cells from excitotoxicity and oxidative stress-induced damage. Dysregulation of EAATs is closely associated with the onset and progression of neurodegenerative diseases in the central nervous system. EAAT family members are widely expressed in retina. Numerous studies have demonstrated that these transporters are extensively involved in the pathogenesis of ocular diseases, including glaucoma, retinal ischemia-reperfusion injury, and age-related macular degeneration, although the specific mechanisms remain to be elucidated. Therefore, this article reviews the physiological functions of EAAT family members and their role in the development and progression of related ophthalmic diseases, providing new perspectives for further understanding the molecular mechanisms underlying these conditions and identifying novel therapeutic targets.

目的：以提升进行住院医师规范化培训(住培)的眼科医生临床诊疗思维能力为导向，建立LRC渐进协作教学体系(LRC Stepwise Collaborative Learning Model)。方法：2023年7月—2023年12月，以26名进行眼科住培的医生为试验组的研究对象，采用小讲课(Lecture)、教学查房(Rounds)及病例讨论(Case discussion)的LRC渐进协作教学体系，通过定量分析方法评估教学效果。结果：实施LRC渐进协作教学模式后，住培医生平均成绩由培训前的50.00 (40, 50)分提高至培训后的90.00 (80, 100)分，差异具有统计学意义(P＜0.001)。问卷调查满分5分，小讲课、教学查房和病例讨论三种教学形式的满意度满分比例分别为92.3%(24/26)，84.6%(22/26)、76.9%(20/26)，三种教学形式的满意评分分别为5.00 (5.00, 5.00)、5.00 (5.00, 5.00)、5.00 (4.75, 5.00)分。结论：LRC渐进协作教学体系作为住培教学新体系，得到眼科住培医生的认可，促进临床诊疗思维的整体提升，有助于岗位胜任力的培养，为未来教学模式的设计与实施提供了重要参考。

Objective: To introduce the LRC Stepwise Collaborative Learning Model, a novel teaching approach designed to improve clinical thinking skills in ophthalmology training. Methods: From July 2023 to December 2024, 26 ophthalmology residents were included in the experimental group, underwent training using LRC Stepwise Collaborative Learning Model of Lectures, Rounds and Case Discussions. Their educational outcomes were quantitatively analyzed. Results: The LRC Stepwise Collaborative Learning Model improved average resident scores from pre-training [50(40, 50) points] to post-training [90(80,100) points], with a statistical significance (P < 0.001). The questionnaire survey had a maximum score of 5 points, and the rates of full marks for the three teaching forms of lectures, rounds, and case discussions were 92.3% (24/26), 84.6% (22/26), and 76.9% (20/26), respectively. The satisfaction scores for the three teaching forms were 5.00 (5.00, 5.00), 5.00 (5.00, 5.00), and 5.00 (4.75, 5.00) points, respectively. Conclusions: The LRC Stepwise Collaborative Learning Model, as a new training system for residency education, has been recognized by ophthalmology residents. It facilitates the overall improvement of clinical thinking, contributes to competency development, and provides valuable insights for future teaching model designs.

哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin,mTOR)是一种蛋白激酶，在体内主要参与营养水平、生长代谢的调节。mTOR是癌症、衰老和其他代谢相关病理性疾病的重要靶点，参与了增殖、转分化、自噬等多种生物学过程。眼被认为是具有免疫特权的区域，由于血管系统会影响视力，眼的血管系统位于中心光路以外。眼的许多区域都有将免疫细胞运输至发育不良、受损或衰老有关的病变部位的机制。尽管免疫应答主要是为了修复或保护自身，但是免疫细胞可能会分泌一些细胞因子，导致炎症或纤维化，进而损害视力。研究证实，mTOR与翼状胬肉、年龄相关性黄斑变性(age-related macular degeneration,AMD)、青光眼、白内障、糖尿病视网膜病变(diabetic retinopathy,DR)、眼部肿瘤等多种眼病密切相关。目前，mTOR抑制剂通常被用作免疫抑制剂，用于癌症的治疗，但mTOR抑制剂用于眼部疾病的报道尚少。因此，该文就mTOR信号通路在相关眼科疾病中的作用、调控机制、药物治疗等方面进行简要综述，为相关眼科疾病的病理机制与治疗提供思路，以便后续开展更深入的研究。

Mammalian target protein of rapamycin (mTOR) is a protein kinase that primarily involves in the regulation of nutrient levels andgrowth metabolism in vivo. mTOR serves as a crucial target for cancer, aging, and other metabolic related pathological diseases, participating in various biological processes such as proliferation, transdifferentiation, and autophagy. Te eye is considered an area with immune privilege, as the vascular system afects vision and is located outside the central light path. Many areas of the eye have mechanisms for transporting immune cells to the afected areas related to developmental, damaged, or aging. Although the immune response is primarily aimed at reparing or protecting itself, immune cells may secrete some cytokines, leading to infammation or fbrosis, which in turn can damage vision. Results from studies have confirmed that mTOR is closely related to pterygium, age-related macular degeneration (AMD), glaucoma, cataract, diabetic retinopathy (DR), eye tumors and other eye diseases. Currently, mTOR inhibitors are widely used as immunosuppressants and approved for cancer treatment; however, there are few reports on the use of mTOR inhibitors for eye diseases. Therefore, in the article it provides a brief overview of the role, regulatory mechanisms, and drug treatment of the mTOR signaling pathway in related ophthalmic diseases, providing ideas for the pathological mechanisms and treatment of related ophthalmic diseases, in order to carry out more in-depth research in the future.