目的：探索翻转课堂联合改良的迷你临床演练评估(mini-clinical evaluation exercise，Mini-CEX)在眼科住院医师规范化培训中的应用可行性及效果。方法：回顾性分析上海交通大学医学院附属第九人民医院眼科在2018—2021年所有参加规范化培训结业考核的住院医师，共计39人。比较翻转课堂教学方法实施前后，包括改良Mini-CEX在内的综合能力考核、毕业合格率、课程出勤率及学员对教学模式的满意度。结果：实验组20人(2020及2021年毕业)，对照组19人(2018及2019年毕业)。两组间的性别比例、学历或学制构成差异无统计学意义(P>0.05)。实验组的毕业合格率明显高于对照组(100.00% vs 68.42%，P=0.008)；改良Mini-CEX(P=0.011)及放射诊断(P=0.025)平均成绩也显著高于对照组。两组的理论考核及心电图诊断的平均成绩无统计学差异。4年间的比较发现，学员的改良Mini-CEX平均成绩(P=0.006)及线下课出勤率(P=0.025)出现显著提升。实验组对教学模式的满意度显著高于对照组。结论：翻转课堂联合改良Mini-CEX应用于眼科住院医师规范化培训教学可获得良好效果，提示了积极的深入研究及拓展应用前景。
Objective: To evaluate the application of flipped classroom combined with revised mini-clinical evaluation exercise (Mini-CEX) in standardized training for ophthalmology residents. Methods: A retrospective analysis was performed on 39 residents who participated in the standardized training graduation examination during 2018 to 2021 in ophthalmology department of Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. The comprehensive ability assessment including the improved Mini-CEX, pass rate of program completion, course attendance rate, and students’ satisfaction with the teaching mode were compared before and after the implementation of the flipped classroom teaching method. Results: There are no significant difference of sex or educational level was found between the experimental group (20 people graduated in year 2020 and 2021) and the control group (19 people graduated in year 2018 and 2019). Compared with the controls, the pass rate (100.00% vs 68.42%, P=0.008) and the average scores of revised Mini-CEX (P=0.011) and radiology (P=0.025) were significantly higher in the experimental group, while the average scores of basics and electrocardiograph were almost the same. Among the 4 years, the average revised Mini-CEX scores (P=0.006) and attendance rate of off-line courses (P=0.025) significantly progressed. Surveys of satisfaction degree suggested that the experimental group were significantly more satisfied with the education they accepted during their residency training program. Conclusion: It is effective to apply flipped classroom combined with revised Mini-CEX in residency training program of ophthalmology. Further study and development on this teaching pattern is encouraged.
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.
研究生导师的能力和水平是影响研究生教育质量的最关键因素之一。针对眼科学研究生专业基础 知识薄弱、动手实践机会缺乏、创新能力不足，导师队伍教学主动性不强、活力欠佳等问题，中 山眼科中心逐步建立了“行政+专家”的双重教学管理架构，引导激励教师积极主动参与、推动研 究生课程改革、科研创新能力培训、教学信息化建设、教学质控与学生管理等各项教学改革与决 策，通过不断完善教师参与教学改革共同治理的长效机制，打造高素质的教师队伍，实现高质量 的眼科学研究生培养。
The ability and level of postgraduate tutor is one of the key factors affecting the quality of graduate education. In view of the weak basic ophthalmic knowledge, lack of practical opportunities and the inefficiency in innovation ability among ophthalmology graduates, as well as the lack of initiative and vitality in teaching team, Zhongshan Ophthalmic Center, Sun Yat-Sen University has been gradually established the dual management structure of “administration and experts”. By guiding and encouraging the teachers participate in the curriculum reform of graduates, scientific research ability training, management informatization, the teaching quality control, student administration and so on. Through improving the long-term mechanism of teachers’ participation in teaching reform governance, the quality of teachers has been improved, which promote the high-quality development of ophthalmology graduate education.
目的：建立眼科专科护理门诊及探讨其实施效果。方法：调查2020年7月开展眼科护理门诊以来至2022年3月就诊的206例患者满意度和健康知识知晓率，并由医生、护士对眼科专科护理门诊的实践效果进行评价。结果：206例患者满意度较好，总分在90以上；眼科专科护理门诊针对患者问题提供个体化护理服务，进行眼部检查206人次，健康教育206人次，滴眼药水、涂眼药膏操作示范184人次，术后特殊体位指导38人次，滤过泡按摩26人次，为患者提供了多元化护理服务；同行评价显示眼科护理门诊体现了护士的专业价值；患者就诊后的健康知识知晓率明显高于就诊前，差异有统计学意义(P<0.001)。结论：眼科专科护理门诊的开设满足了患者多元化护理服务需求，提高了患者满意度和健康知识知晓率，提升了护士的自我价值感，为专科护士提供了职业发展平台，促进了眼科专科护理的发展。
Objective: To explore the establishment and effect of ophthalmology specialist nursing clinic. Methods: To Investigate the satisfaction and the awareness rate of health knowledge of 206 patients who visited ophthalmology specialist nursing clinic from July 2020 to March 2022. Doctors and nurses were investigated for evaluation of the clinic. Results: A total of 206 patients were satisfied with a total score of 90 points or more; the ophthalmology specialist nursing clinic provided individualized nursing services for patients’ problems, conducted 206 eye examinations and 206 health education, and demonstrated the operation of eye drops and eye ointment 184 times. 38 patients received post-operative special posture guidance and 26 patients received filter bubble massages. The clinic provided patients with diversified nursing services. Peer reviews showed that the ophthalmological care clinic reflects the professional value of nurses; the awareness rate of health knowledge after the patient’s visit was significantly higher than that before the visit, and the difference was statistically significant (P<0.001). Conclusion: The establishment of ophthalmology specialist nursing clinic meets patients for diversified nursing services, improves patients’ satisfaction and health knowledge awareness rate, and improves nurses’ sense of self-worth. Furthermore, it provides a career development platform for specialist nurses and promotes the development of ophthalmic specialist nursing.
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.
近年来，眼科手术后的疼痛受到关注，部分患者术后表现出疼痛区域扩大，神经性畏光。术后这种 对伤害性刺激性信号反常性增加的现象称之为痛觉过敏。痛觉过敏的发展会导致患者延迟术后恢 复等问题。此外，痛觉过敏还会引起患者不适，诱使患者使用更多的止痛药而产生相关的不良反 应。而TRPV1/TRPA1是一种伤害性感受器，能够被伤害性刺激特异性激活而诱发痛觉过敏。尽管 如此，目前关于眼科术后的痛觉过敏发病机制未完全阐明，TRPV1如何增敏导致痛觉过敏的分子生 物学过程尚未明确。
The postoperative pain of ophthalmic surgery has been widely concerned in recent years. Some patients show enlarged painful areas and neurophotophobia postoperatively. This abnormal increase in noxious irritant signals after surgery is called hyperalgesia. The development of hyperalgesia can result in delayed postoperative recovery for patients. In addition, hyperalgesia can also cause discomfort for patients, and induce patients to use more analgesics, which can have related side effects. TRPV1/TRPA1 is a nociceptor, which can be specifically activated by nociceptive stimuli to induce hyperalgesia. Nevertheless, the pathogenesis of hyperalgesia after ophthalmology surgery has not been fully elucidated, and the molecular signal pathway of how TRPV1 sensitizes and causes hyperalgesia is not yet clear.
目的：了解思政元素融入临床医学八年制眼科学整合课程的学生满意度与教学效果。方法：对中山大学临床医学八年制的五年级医学生进行匿名纸质版问卷调查，评估学生对思政教育的满意度与教育效果。对问卷结果进行描述性统计分析，计数资料以频率与百分比的形式表示。结果：共回收有效问卷90份，91%的学生认同在课程中融入思政元素，93%的学生认为思政与课程的融合度为好或者非常好，82%的学生认为思政课程对激发眼科学兴趣有帮助。思政题目的总体正确率高达92.9%，正确率从高到低依次为：医患沟通(100%)、眼科历史(98.9%)、政策要点(83.3%)、研究前沿(82.2%)。结论：临床医学八年制学生对眼科学整合课程的思政元素融合的满意度高。思政教育获得良好效果，学生对思政知识的掌握度高。后续课程在保持学生对医患沟通以及学科历史兴趣的同时，还应加强对于研究前沿和政策要点的教育。
Objective: To investigate the student satisfaction and educational effect of integrating ideological and political elements into the eight-year clinical medicine ophthalmology integrated curriculum. Methods: An anonymous paper questionnaire survey was administered to fifth-grade clinical medicine students ofthe eight-year clinical medicine program of Sun Yat-sen University to assess students’ satisfaction with ideological and political education as well as the educational effectiveness. Descriptive statistical analysis was performed on thequestionnaire results, and the qualitative data were represented by frequency and percentage. Results: Ninety valid surveys were collected. 91% of the students agreed with the incorporation of ideological and political elements into the curriculum, 93% of the students thought the incorporation of ideological and political elements into the curriculum was good or very good, and 82% of the students believed that the ideological and political curricula helped arouse their interest in ophthalmology. The overall correct rate for ideological and political questions reached 92.9%, with the following correct rates from most accurate to least accurate: doctor-patient communication (100%), history of ophthalmology (98.9%), policy (83.3%), and research frontier (82.2%). Conclusion: Eight-year clinical medicine students are highly satisfied with the integration of intellectual and political components into the ophthalmology integration curriculum. Ideological and political education has yielded favorable results, with students demonstrating a thorough grasp of ideological and political facts. Future curricula should expand students’ awareness of research frontiers and policy issues while maintaining their interest in doctor-patient communication and the history of ophthalmology.
随着亚太眼科学会(Asia-Pacific Academy of Ophthalmology，APAO)永久会址和秘书处落户在中山大学中山眼科中心珠江新城院区眼科学国家重点实验室大楼(中国广州)，在大数据时代背景下，建设先进的亚太级眼科学科学数据中心已成为亚太眼科创新战略发展的需要。通过建设科学数据中心，一方面缓解眼科学国家重点实验室项目科研数据增长压力，一方面为眼科大数据与人工智能等新兴科研项目开展提供保障平台，为亚太眼科学科建设打下坚实的数据基础。科学数据中心设计建设遵照国家《科学数据管理办法》实施，以加强和规范科学数据管理，保障科学数据安全，提高开放共享水平，更好支撑国家科技创新、经济社会发展和符合国家信息安全建设方针。
As the Asia-Pacific Academy of Ophthalmology (APAO) secretariat permanently located in the building of State Key Laboratory of Ophthalmology (Guangzhou, China). In big data time, it’s a problem for the development of the Asia-pacific ophthalmology innovation strategy to construct the Asia-pacific science data center of ophthalmology. Through the construction of science data center, alleviate the pressure of the state key laboratory of ophthalmology data growth, for big data and new research fields such as artificial intelligence to provide guarantee, provided a basis for the Asia-pacific eye subject construction. Science data center construction in accordance with national “scientific data management method”, to strengthen and standardize the scientific data management, to ensure the safety of scientific data, improve the level of open sharing, better support scientific and technological innovation, economic and social development and national security as a policy.
