目的:研究佛山市禅城区五年级、六年级近视儿童的心理健康及其影响因素,为解决其因近视产生的心理问题及近视防治工作提供依据。方法:选择佛山市禅城区3所小学,在其五年级、六年级选择2个班作为调查对象开展近视筛查、并使用儿童社交焦虑量表、孤独量表以及儿童自尊量表进行心理健康测量。结果:佛山市禅城区近视患病率52.0%,女性(57.5%)较男性(47.4%)有较高患病率,六年级患病率(57.6%)高于五年级(46.3%)。近视儿童均比正常视力儿童存在明显的社交焦虑、孤独感以及低自尊度(得分分别为5.53±4.04 vs 4.66±3.59,30.15±11.72 vs 27.29±10.40,97.97±12.73 vs 100.87±12.21),差异均具有统计学意义(均P<0.05)。进一步分析显示,初发近视社会焦虑、孤独以及自尊方面比中度近视明显。性别、年龄等社会因素对于近视儿童心理健康影响不明显。根据矫正的不同方式分类,近视儿童中,戴角膜塑形镜者社交焦虑感较低(F=4.21,P=0.01),戴框架眼镜者则较容易产生较低的自尊度(F=5.67,P=0.02)。结论:小学生近视问题是全社会普遍关心的问题,近视与其心理健康关系密切,这需要全社会密切配合,采取综合措施,且近视矫正方式的选择影响近视儿童的心理。
Objective: By studying the mental health and its influencing factors of myopia children in grade 5 and grade 6 in Chancheng District, Foshan City, this paper provided the basis for solving the psychological problems caused by myopia and the prevention and treatment of myopia. Methods: Three primary schools in Chancheng District,Foshan City were chosen. Two classes in grade 5 and grade 6 were selected to carry out myopia screening followed by evaluation of their mental health with children’s social anxiety scale, loneliness scale and children’s self-esteem scale. Results: The prevalence of myopia was 52.0% in Chancheng District, Foshan City. Females (57.5%) had a higher prevalence than males (47.4%). The prevalence in grade 6 (57.6%) was higher than that in grade 5 (46.3%).Children with myopia had obvious social anxiety, loneliness, and low self-esteem (scores of 5.53±4.04 vs 4.66±3.59,30.15±11.72 vs 27.29±10.40, 97.97±12.73 vs 100.87±12.21, respectively) than those with normal vision, whose difference was statistically significant (all P<0.05). Further analysis showed that social anxiety, loneliness, and self-esteem in children with primary myopia were more obvious than those with moderate myopia. Social factors such as gender and age had little effect on the mental health of myopic children. According to different correction methods, among myopic children, those who wore orthokeratology lenses had lower social anxiety (F=4.21, P=0.01), and those who wore spectacles were more likely to have lower self-esteem (F=5.67, P=0.02).Conclusion: The problem of myopia in primary school students, which is closely related to mental health, is ofgeneral concern to the whole society. This requires the whole society to cooperate closely and take comprehensive measures. The choice of myopia correction methods affects the psychology of myopic children.
目的:了解眼科住院医师在规范化培训期间的科研培训现状及需求,为今后开展住院医师科研能力相关课程提供科学依据。方法:采用横断面调查的方式,在2021年7月间对北京大学第三医院眼科中心42名住院医师进行问卷调查,对结果进行数据分析。从科研现状、科研能力及科研需求3个方面来进行分析,其中科研能力通过常规科研技能掌握程度和软件的使用情况来评分,最后将各项得分汇总得到的分数为科研能力得分。对科研现状及可能能力得分进行了相关分析,其他数据按数据类型选择对应的分析方法。结果:共42名北京大学第三医院住院医师参与了问卷调查,其中男20名,女22名,平均年龄25岁。有90.5%的住院医师参与过科研工作,而科研内容主要来自及导师布置(90.5%)。只有14.3%的住院医师具备良好的科研能力(科研能力得分在18分及以上)。此外,有92.9%的住院医师认为临床研究有助于临床技能的理解,97.6%的参与者认为非常有必要进行临床研究方法的继续教育培训。结论:眼科住院医师科研能力普遍偏低,目前的规范化培训不能满足住院医师科研能力培养的需求,在课程设计及内容安排上需要更广泛更具实际意义的拓展。
Objective: To understand the current situation and needs of scientific research training for ophthalmologists in general hospitals during standardized training, and to provide scientific basis for the future development of courses to improve the scientific research capabilities of residents. Methods: A cross-sectional survey was used to conduct a questionnaire survey among 42 residents in the Eye Center of Peking University Third Hospital in July 2021, and the results were analyzed. We conduct research from three aspects: scientific research status, scientific research ability and scientific research needs. The scientific research ability is scored by the mastery of conventional scientific research skills and the use of software. Finally, the score obtained by summarizing the various scores is the scientific research ability score. Correlation analysis is carried out on the status of scientific research and possible ability scores, and the corresponding analysis methods are selected according to the data type for other data. Results: A total of 42 residents of Peking University Third Hospital participated in the questionnaire survey, including 20 males and 22 females, with an average age of 25 years. 90.5% of residents have participated in scientific research, and the content of scientific research mainly comes from the arrangement of supervisors (90.5%). Only 14.3% of residents have good scientific research capabilities (research ability scores of18 points and above). In addition, 92.9% of residents believe that clinical research is helpful to the understanding of clinical skills, and 97.6% of participants believe that it is necessary to conduct continuing education and training on clinical research methods. Conclusion: The scientific research ability of ophthalmology residents is generally low. The current standardized training cannot meet the needs of the residents’ scientific research ability training. The curriculum design and content arrangement need more extensive and practical expansion.
目的:探究角膜移植日间手术患者的延续护理需求现状及其影响因素。方法:采用便利抽样法抽取行角膜移植日间手术的173例患者,采用课题组自行设计的一般资料调查表、角膜移植日间手术患者延续护理需求调查问卷进行调查。采用独立样本t检验、单因素方差分析、多元线性回归进行统计分析。结果:角膜移植日间术后患者延续护理需求得分为88.13±15.55,其中,对疾病相关知识的需求得分最高,为4.39±0.66,对心理护理的需求得分最低,为2.72±1.18;在延续护理实施方式方面,74.6%患者倾向于电话随访,只有5.8%倾向于上门服务;在影响因素方面,婚姻状况、视力、家庭月收入、文化程度是延续护理需求的影响因素。结论:角膜移植日间术后患者的延续护理需求较高,应根据患者延续护理需求及影响因素进行个性化指导,以提高角膜移植手术的成功率和减少并发症的发生。
Objective: To explore transition care needs among patients with keratoplasty in day ward and analyze the influencing factors. Methods: Using convenience sampling method, 173 patients undergoing keratoplasty in day ward were selected, and they were investigated by using a self-designed general information questionnaire and a questionnaire of transitional care needs of patients with keratoplasty in day ward. T-test, one-way analysis of variance (ANOVA), multiple linear regression were used to analyze the data. Results: The total score of transitional care needs among patients with keratoplasty in day ward was 88.13±15.55. The demand for disease related knowledge was the highest (4.39±0.66), the demand for mental nursing was the lowest (2.72±1.18). In terms of the way of implementation, 74.6% patients preferred telephone follow-up and only 5.8% preferred door-to-door service. Single-factor analysis showed that marital status, vision, monthly income, educational level were the factors influencing the demand for transitional care (P<0.05). Conclusion: Patients with keratoplasty in day ward have a high demand for transitional care. In order to improve the success rate of keratoplasty and reduce the incidence of complications, personalized guidance should be given according to patients’ transitional care needs and influencing factors.
目的:分析眼科超说明书用药使用情况,为眼科临床合理用药提供有效、安全的循证参考依据。方法:考察并收集21家爱尔眼科医院集团眼科中心城市及省会级医院备案的超说明书用药情况,同时抽查处方、医嘱用药,对超说明书用药情况进行充分论证评估,参考广东省、山东省等超说明书用药共识、文献,进行统计、分析和归纳,并征求相关眼科临床专家意见。结果:梳理指南、共识及期刊论文等循证医学证据,得出超说明书用药推荐级别1级8项、2级29项、3级24项,并编写了供集团内使用的《眼科医院眼科超药品说明书用药参考目录(2021年版)》,便于临床参考使用。在眼科常用有32种超说明书药品,61项超说明书用药,其中超给药途径32项(52.5%)、超适应证用药13项(21.3%)、超适应证合并超给药途径14项(23.0%)。超说明书品种及超说明用药项目数均以抗菌药物最多,分别为13个(40.6%)品种,26项(42.6%)。结论:眼科因特殊的给药途径,超说明书用药比较普遍,而如抗菌药物注射剂使用眼内注射或滴眼等超说明书用药方式对某些急性眼内感染性疾病起到了很好的治疗效果。规范眼科超说明书用药,是防范医疗风险的必要措施。
Objective: To investigate off-label ophthalmic medications, and provide an effective and safe evidence-based reference for the rational use of ophthalmic drugs. Methods: On the basis of collecting the off-label drug use recorded in 21 Aier Eye Hospital Group which including ophthalmic central cities and provincial capital level hospitals, and spot checking the prescription and doctor’s order drug use, this article conducted full demonstration and evaluation of off-label drug use which referred to the off-label drug used consensus of Guangdong and Shandong, and other literature on the off-label drug use in ophthalmology. The paper conducted statistics, analysis and induction, and solicited the opinions of relevant ophthalmology clinical experts. Results: Sorting out the evidence of the guides,consensus, journal papers and other evidence-based medicine in ophthalmic medication, recommending 8 items of level 1, 29 items of level 2, and 24 items of level 3, we compiled the “Reference catalogue for the off-label drug use in ophthalmic hospital (2021 edition)” within the group which can providing reference for clinical use. There were 61 off-label drugs commonly used in ophthalmology, involving 32 drugs. Among them, 32 items (52.5%) were used by over administration route, 13 items (21.3%) were used by over indication, and 14 items (23.0%) were used by over indication and administration route. Antibacterial drugs were the most frequently used in the varieties and items of off-label drug use, accounting for 13 (40.6%) and 26 (42.6%) respectively. Conclusion: Ophthalmic off-label medications are common owing to the special route of administration. Such as intraocular injection or eye drop have played a good role in the treatment of some ocular infectious diseases. Standardizing the off-label drug use of ophthalmology is an effective measure to reducing medical risks.
目的:调查中山大学中山眼科中心参加分子医学实验技能培训课程的研究生学员上课前的实验基础,为研究生实验技术课程的备课提供参考。方法:对2020年及2021年参加分子医学实验技能培训课程的博士和硕士研究生进行课前问卷调查。从理论知识和操作经验两方面对15个专题课程进行分析。结果:共155名学生完成问卷调查。在全部专业研究生中,25%以上学生对理论知识不了解的专题有14个,而仅有10%以下学生熟练操作的专题有6个;分子医学专业的优于前者,不了解和熟练掌握的专题个数分别是9和12。理论掌握程度最低的4个专题是细胞增殖、流式细胞、图像采集和组学分析。15个小专题整合成7个大专题,操作熟练程度由低到高依次是:眼科实验数据收集、组学技术、数据分析、细胞技术、蛋白技术、组织分析、分子技术。结论:新入学研究生存在分子医学实验技能基础理论知识薄弱以及科研训练不足等问题,迫切需要改善实验技能培训制度,深化课程体系建设。
Objective: To conduct a pre-course survey on the graduate students who participated in the Molecular Medicine Laboratory Skills Training Course in the Zhongshan Ophthalmic Center of Sun Yat-sen University to provide a reference for the preparation of the course. Methods: We asked the doctoral and master’s students who participated in the training courses of molecular medical experimental skills in 2020 and 2021 to take a pre-course questionnaire survey and analyzed the results by the students’ pre-course command of theoretical knowledge and pre-training operational experience in 15 lessons of special topics or techniques. Results: A total of 155 students completed the pre-course questionnaire survey. Our results showed that there were 14 lessons in which more than 25% of the students were not familiar with the theoretical knowledge, whereas there were 6 lessons in which less than 10% of the students had high operational proficiency. The students majoring in the molecular medicine had better prior knowledge of the techniques: there were only 9 lessons in which more than 25% of the students were not familiar with the theoretical knowledge, whereas there were 12 lessons in which less than 10% of the students had high operational proficiency. The four lessons with worst prior knowledge were cell proliferation, flow cytometry, image acquisition, and omics analyses. We grouped the 15 lessons into 7 categories: the ophthalmic experimental data collection, the omics technology, the data analyses, the cell technology, the protein technology, the tissue analyses, and the molecular technology, presenting by the level of the students’ pre-training proficiency from low to high. Conclusion: The first-year graduate students were very weak in basic knowledge and had little experience in techniques before joining the molecular medicine training courses. It is urgent to improve the laboratory skills training system and strengthen the construction of the curriculum system.
目的:调查干眼在郑州市机关工作者中的患病情况,分析相关危险因素,为有效防治干眼提供科学依据。方法:选取2019年9月到2020年9月在郑州大学第一附属医院体检的郑州市机关工作者873例。采用自行设计的一般资料问卷和OCULUS Jenvis-OSDI干眼问卷进行调查,记录评分结果,同时检查记录裂隙灯、角膜荧光素染色评分(corneal fluorescein staining score,FL)、基础泪液分泌实验(Schimier I test,SIT)、泪膜破裂时间(tear break-up time,BUT)测定结果。统计分析机关工作者干眼患病率与危险因素。结果:体检的873例郑州市机关工作者中360例诊断为干眼,干眼总患病率为41.24%,女性患病率(44.62%)明显高于男性(36.26%),差异有统计学意义(P=0.014)。干眼问卷OSDI评分与FL评分呈正相关,BUT与SIT呈正相关,OSDI(和FL评分)与BUT(和SIT)呈负相关。Logistics多因素分析表明:干眼家族史、绝经、曾行眼部手术、滴眼液使用情况、长时间佩戴角膜接触镜、长时间操作视频终端、睡眠不足、糖尿病史是机关工作者干眼患病的危险因素(均P<0.05),而饮酒是保护因素(P=0.001)。结论:机关工作者干眼患病率较高,危险因素囊括家族患干眼史、绝经、曾行眼部手术、滴眼液使用情况、长时间佩戴角膜接触镜、长时间操作视频终端、睡眠不足、糖尿病病史。加强干眼防治的宣传教育,针对不同危险因素提供眼健康指导并进行防控治疗,保护机关工作者的眼健康。
Objective: To investigate and analyze the prevalence of dry eyes in Zhengzhou office workers, and identify the related risk factors in order to provide evidence for effective prevention and treatment. Methods: We selected 873 cases of Zhengzhou office workers who had checkup in our hospital from September 2019 to September 2020 as the research subjects. They were investigated with self-designed general information questionnaire and OCULUS Jenvis-OSDI dry eye questionnaire and scores of the questionnaires will be assessed. At the same time,they underwent dry-eye-related inspections such as slit lamp examination, corneal fluorescein staining score (FL), Schimier I test (SIT) and tear break-up time (BUT) assessment. The prevalence and risk factors of dry eyes in these office workers were statistically analyzed. Results: Among 873 Zhengzhou office workers, 360 cases were diagnosed as dry eyes, and the total prevalence of dry eye was 41.24%. The female prevalence rate was 44.62%, which was significantly higher than that of male (36.26%, P=0.014). OSDI scores and FL scores were positively correlation as well as BUT and SIT, while OSDI (and FL) and BUT (and SIT) were negatively correlation. Logistic multivariate analysis showed that dry eyes family history, menopause, ocular surgery history, eye drops using, long time corneal contact lenses wearing, long time video terminal operating, lack of sleep and diabetes history were independent risk factors in office workers’ dry eye disease (all P<0.05), while drinking was protective factor (P=0.001). Conclusion: The dry eyes prevalence is high among office workers. The risk factors include dry eye family history, menopause, ocular surgery history, eye drops using, long time corneal contact lenses wearing, long time video terminal operating, lack of sleep and diabetes history. We should strengthen the publicity and education of the dry eye prevention and treatment, provide eye health guidance, prevention and treatment according to different risk factors, and protect the office workers’ eye health.
纳入126名中山大学临床医学五年制4年级学生,对其接受为期1周的直接检眼镜见习教学后,进行问卷调查,了解学生对直接检眼镜学教学的看法以及学习过程中的操作难点。结果显示大部分学生认为直接检眼镜对临床工作有重要作用。但学生普遍反映学习过程难度大,师生视野无法共享,进而阻碍了师生直接的教学沟通。多数学生愿意接受更进一步的直接检眼镜教学。
A total of 126 senior of 5-year clinical medicine students in Sun Yat-sen University were recruited. After 1-week internship and direct ophthalmoscope training, a questionnaire survey was conducted to scrutinize students’ feedback about the training methods and learning difficulties during the internship. The results showed that most students thought that the direct ophthalmoscope played an important role in clinical work. However, students generally felt complicated and hard during the learning process due to the communication obstacle between teachers and students caused by the unavailability of vision sharing. In spite of this, most students are still willing to accept further direct ophthalmoscopy training.