观察聚乙二醇化重组人粒细胞刺激因子(Pegylated Recombinant Human Granulocyte Colony Stimulating Factor，PEG-rhG-CSF)与重组人粒细胞刺激因子(Recombinant Human Granulocyte Colony Stimulating Factor，rhG-CSF)在造血干细胞移植后促进造血恢复的疗效对比。方法 回顾分析2016年1月—2020年12月以来在深圳市第二人民医院血液科进行造血干细胞移植的恶性血液疾病患者共 100例，以1：1比例随机分为2组，分别在造血干细胞回输后给与聚乙二醇化重组人粒细胞刺激因子与重组人粒细胞刺激因子。结果 PEG-rhG-CSF组与rhG-CSF组中性粒细胞植入时间分别为（18.7±3.4）天、（18.0±3.1）天，P=0.281，无统计学差异。粒细胞缺乏伴发热在PEG-rhG-CSF组与rhG-CSF组分别发生26例、29例，发生率分别为53.06%、56.86%，P=0.89，无统计学差异。用药次数分别为2.6次（2次-5次）、18.1次（11次-31次），P<0.05，具有明显统计学差异。不良反应主要为骨痛、肌肉疼痛。结论 PEG-rhG-CSF组与rhG-CSF组结果相似，PEG-rhG-CSF具有用药次数少的优势。

The efficacy of pegylated recombinant human granulocyte stimulating factor (PEG-rhG-CSF) and recombinant human granulocyte stimulating factor(rhG-CSF) in promoting hematopoiesis recovery after hematopoietic stem cell transplantation. Methods The data of 100 patients with malignant blood diseases who underwent hematopoietic stem cell transplantation in the Hematology Department of Shenzhen Second People's Hospital from January 2016 to December 2020 were retrospectively analyzed. They were randomly assigned to two groups with 1:1, which were accepted PEG-rhG-CSF and rhG-CSF after hematopoietic stem cell transfusion. 根据中文摘要重新翻译Results The time of neutrophil implantation in PEG-rhG-CSF group and rhG-CSF group was (18.7±3.4) days and (18.0±3.1) days respectively, P=0.281, showing no statistical difference. There were 26 cases of neutropenia with fever in PEG-rhG-CSF group and 29 cases in rhG-CSF group, with incidence of 53.06% and 56.86% (P=0.89), showing no statistical difference. The times of medication were 2.6 times (2-5 times) and 18.1 times (11-31 times), P<0.05, with significant statistical difference. The main adverse reactions were bone pain and muscle pain. Conclusion The outcomes of PEG-rhG-CSF group and rhG-CSF group were similar, PEG-rhG-CSF had the advantage of fewer times of medication.

剥脱性青光眼是剥脱综合征继发的一类青光眼，临床上少见。本文报告2例患者，患眼瞳孔缘可见灰白色碎屑样物质沉积，散大瞳孔后可见晶状体前囊周边部混浊带，房角镜下可见Sampaolesi线。认识其临床特征，将有助于提高其诊治率。

Exfoliation glaucoma is a category of glaucoma secondary to exfoliation syndrome, which is rarely encountered in clinical practice. We reported 2 cases with deposits of white material on the pupillary border of the iris. Opacity band could be observed surrounding the anterior lens capsule after pupil dilation, and the Sampaolesi line was seen under gonioscope. Understanding the clinical characteristics contribute to improving the diagnosis and treatment of exfoliation glaucoma.

目的：了解重度视力损伤和盲患者居家的主要护理问题及护理需求的内容，为医护人员制订居家照护支持计划提供依据。方法：采用描述性质性研究方法，于2020年4至9月对在广州市某三甲眼科专科医院的20例重度视力损伤和盲的住院患者进行面对面的半结构式访谈，采用归纳式内容分析法对访谈资料进行分析。结果：重度视力损伤和盲患者居家的主要护理问题有日常生活自理的能力缺失、外出社交活动受限和难以适应家庭角色的改变；护理需求包括希望医院提供多维度的疾病相关知识和提供多渠道的医疗咨询服务。结论：重度视力损伤和盲患者居家照护存在诸多的护理问题及需求，患者希望得到多维度相关知识和多渠道医疗咨询，医院、社区应该高度重视此类患者，同时给予相应的指导和帮助，从而提高患者的居家生活质量。

Objective: To explore the main nursing problems and demands of patients with severe visual impairment or blindness, so as to provide the basis for health staff to formulate home care support plans of high quality. Methods: By using a descriptive qualitative method, face-to-face semi-structured interviews were conducted among 20 patients with severe visual impairment or blindness who were hospitalized in the top-grade ophthalmic hospital in Guangzhou from April to September 2020. The inductive content analysis method was used to analyze the data. Results: The main nursing problems of these patients were the lack of self-care ability, limited social activities, and difficulty in adapting to changes in family roles. Nursing needs include the hope that hospitals can provide multidimensional disease-related knowledge and multi-channel medical consulting services. Conclusion: Patients with severe visual impairment or blindness have many problems and needs in home care. They would like to obtain multi-dimensional knowledge and receive multi-channel medical consultation. Health staff from hospitals and communities should attach great importance to these patients, as well as provide appropriate guidance and assistance, so as to improve their activities of daily living.

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.

目的：探索白内障术眼低视力的原因。方法：对2011年10月至2013年3月在汕头国际眼科中心行白内障手术，术前无法窥清眼底，术后1周最佳矫正视力<0.3的患者进行视力、最佳矫正视力、眼压测量、裂隙灯检查、眼底镜检查、眼底照相及光学相干断层扫描(optical coherence tomography，OCT)，若未发现任何视网膜器质性病变，再进行视觉诱发电位检查及视野检查。由2位医生对检查结果进行分析，对不同的眼底病变做出诊断，统计分析白内障术眼低视力的原因。结果：共纳入行白内障手术患者5 608例，术后1周最佳矫正视力<0.3的患者共49例(共49眼)，其中男20例，女29例，右眼31只，左眼18只，年龄(69.11±12.05)岁。白内障术后低视力比例为0.87%。其中高度近视性脉络膜视网膜病变12例(24.5%)，椭圆体带连续性破坏10例(20.4%)，糖尿病性视网膜病变8例(16.3%)，黄斑孔5例(10.2%)，老年性黄斑变性4例(8.1%)，黄斑前膜3例(6.1%)，黄斑区视网膜厚度变薄1例(2.0%)，视网膜色素变性1例(2.0%)，视网膜劈裂症1例(2.0%)，视网膜分支动脉阻塞1例(2.0%)，白塞氏病1例(2.0%)，缺血性视神经病变1例(2.0%)，视网膜前膜1例(2.0%)。结论：在本组白内障术眼低视力的患者中，高度近视性脉络膜视网膜病变占主要部分，为24.5%，其次分别为椭圆体带连续性破坏、糖尿病性视网膜病变、黄斑孔、老年性黄斑变性和黄斑前膜。利用OCT可发现影响白内障术后视力的细微视网膜结构变化，对于白内障术前眼底可见的患者常规行OCT有利于判断手术预后，便于医患沟通，提高手术满意度。

Objective: To explore the causes of low vision after cataract surgery. Methods: Patients who underwent cataract surgery at Joint Shantou International Eye Center of Shantou University and the Chinese university of Hong Kong ( JSIEC) from October 2011 to March 2013, whose fundus status could not be seen before surgery, and the best corrected visual acuity <0.3 in the first week after surgery, underwent a series of detailed ocular examinations, including visual acuity, best corrected visual acuity, intraocular pressure, slit-lamp examination, fundus examination, fundus photography and optical coherence tomography. If no organic lesions of the retina were found, then visual evoked potential examination and visual field examination were performed. Two doctors analyzed the examination results of the examination, made the diagnosis of different fundus diseases, and statistically analyzed the causes of low vision after cataract surgery. Results: A total of 5 608 cataract surgeries were performed in our hospital from October 2011 to March 2013. A total of 49 patients (49 eyes) with best corrected visual acuity worse than 0.3 within postoperative 1 week 20 male and 29 female, 31 right eyes and 18 left eyes, aged (69.11±12.05) years on average. The proportion of low vision after cataract surgery was 0.87%. 12 cases (24.5%) of high myopic chorioretinopathy, 10 cases (20.4%) of ellipsoidal band defect, 8 cases (16.3%) of diabetic retinopathy, 5 cases (10.2%) of macular holes, 4 cases (8.1%) of age-related macular degeneration, 3 cases (6.1%) of macular epiretinal membrane, 1 case (2.0%) of thinning macular retinal thickness, 1 case (2.0%) of retinitis pigmentosa, 1 case of retinoschisis (2.0%), 1 case of branch retinal artery occlusion (2.0%), 1 case of Behcet’s disease (2.0%), and 1 case of ischemic optic neuropathy (2.0%), 1 case of epiretinal membrane (2.0%). Conclusion: Among patients with low vision after cataract surgery, high myopic chorioretinopathy accounts for 24.5%, followed by ellipsoidal band defect, diabetic retinopathy, macular hole, age-related macular degeneration, and macular epiretinal membrane. The use of optical coherence tomography can detect subtle microscopic retinal structural changes that affect vision after cataract surgery. For patients with visible fundus before cataract surgery, routine optical coherence tomography contributes to evaluating the prognosis of the operation, facilitating doctorpatient communication, and improving the degree of surgical satisfaction.

全科医生对个人及其家庭所提供的基本、连续性、综合性及整体性的医疗服务。全科医生要求具备更为“广博”的知识结构。那么如何在有限的培训期内更好地完成亚专科的培训并获得社区卫生服务中切实需要的临床技能及知识储备，是目前亟待解决的问题。基于社区卫生服务的基本特点，全科医生规范化培训中培训眼科学的相关内容，强调重视眼与全身疾病、眼科急症及全身药物的眼部损害等，有助于全科医生迅速、准确地发现和判断在社区医疗机构就诊的各类眼部急危重症患者，及时向专业眼科机构转诊，避免延误诊治，为后续专业的眼科治疗赢得宝贵时间，从而使全科医生更好地胜任社区居民健康“守门人”的工作。

General practitioners provide basic, continuous, comprehensive and holistic medical services to individuals and their families, which requires them to have a more “extensive” knowledge structure. However, within the limited training period, how to successfully complete subspecialty training and acquire the clinical skills and knowledge needed in community health services is an urgent problem which need to be explored. Based on the basic characteristics of community health service, the ophthalmology training of the standardized training of general practitioners, focus on the eye and systemic diseases, ophthalmic emergency and side-effect of systemic drug on eye would help general practitioners rapidly and accurately find and diagnose all kinds of serious emergent ophthalmologic diseases, and then refer to professional eye institutions in time, which avoid delay in diagnosis and treatment and save more valuable time for subsequent professional treatment. It would make the general practitioners become good healthy gatekeepers for the local community residents.

[摘　要] 目的：减轻行角膜移植术的患儿及家属的心理负担，提高患儿对手术的耐受性，减少术后并发症。方法：对45例将进行角膜移植的患儿进行围手术期护理。结果：所有患儿经过精心的治疗和护理后均恢复良好，视力均有提高。结论：术前做好充足的准备、术前心理护理，术后严密观察生命体征和眼部敷料的情况，做好相关的生活和饮食指导，遵医嘱及时有效用药，注意患儿异常的反应及眼部的情况，及时发现并处理并发症，给予细致的出院指导，有利于患儿早日康复。

Abstract Objective: To reduce the psychological burden of the children and families who are scheduled to the corneal transplantation, and to improve the patients’ tolerance and reduce postoperative complications. Methods: The perioperative care was given to 45 patients with corneal transplantation. Results: All children were treated well by careful treatment and care. Conclusion: Before operation, comprehensive preparation and psychological nursing care should be delivered. After operation, the physicians and nurses should guide the patients to live a healthy lifestyle, remind them to take the drugs timely, identify the abnormal symptoms and postoperative complications in children with abnormal responses, implement effective treatment timely to accelerate postoperative recovery

[摘　要] 目的：研究准分子激光原位角膜磨镶术(laser in situkeratomileusis，LASIK)前后角膜滞后量(corneal hysteresis，CH)和角膜阻力因子(corneal resistance factor，CRF)变化量，对其相关因素进行多元线性回归分析。方法：前瞻性研究。纳入行LASIK手术的近视眼及近视散光患者70眼(38例)，术前与术后6个月各项参数分别由眼反应分析仪(ocular response analyzer，ORA)、非接触眼压仪、超声角膜测厚仪及Pentacam眼前节分析仪测量。分析LASIK手术前后△CH，△CRF与术前、手术设计等参数的相关性，并对相关参数进行多元线性回归分析。结果：手术前后CH分别为(10.05±1.36)，(8.15±0.90) mmHg(1 mmHg=0.133 kPa)，CRF分别为(9.91±1.38)，(6.92±0.88) mmHg，差异均有统计学意义(P<0.01)；△CH与△CRF分别为(1.90±1.15)，(2.99±1.23) mmHg。△CH与术前CH，CRF，眼压(intraocular pressure，IOP)，预计切削深度(ablative depth，AD)以及AD/CCT呈正相关；△CRF与术前CH，CRF，IOP，AD，AD/CCT，术前等值球镜(spherical equivalent，SE)以及预计 基质床厚度(residual stromal bed’s thickness，RSBT)有相关性。采用多元线性回归对LASIK手术前后△CH，△CRF与术前、手术设计等各相关参数进行分析，回归方程为：△CH=?6.182+0.658CH术前+8.421AD/CCT (R2=0.639，P<0.01)，△CRF=?0.007+0.725CRF术前?0.014RSBT (R2=0.689，P<0.01)。结论：LASIK术前后CH与预计AD和角膜厚度比值密切相关，CRF变化量与预计角膜RSBT密切相关，在设计手术时应慎重考虑预计AD与预计RSBT。

Abstract Objective: To discuss the change of corneal hysteresis and corneal resistance factor before and after laser in situkeratomileusis (LASIK), and to analyze their related factors by multivariate linear regression. Methods: In this prospective study, 70 eyes (38 patients) with myopia and myopic astigmatism undergoing LASIK were included. Related factors were measured preoperatively and at 6 months postoperatively by ocular response analyzer, noncontact tonometer (NCT), ultrasonic pachymeter, and Pentacam system. The correlation was analyzed between △CH, △CRF and preoperative and operative design’s parameters, and correlative factors analyze. △CH and △CRF were analyzed by the multiple linear regression. Results: CH before and after LASIK were (10.05±1.36) and (8.15±0.90) mmHg, and CRF before andafter LASIK were (9.91±1.38) and (6.92±0.88) mmHg. There was significant difference between preoperative and postoperative CH and CRF (P<0.01). △CH and △CRF were (1.90±1.15) and (2.99±1.23) mmHg. Preoperative CH, CRF, intraocular pressure (IOP), ablative depth (AD) and AD/CCT were positive correlated with △CH. Preoperative CH, CRF, IOP, AD, AD/CCT, preoperative spherical equivalent (SE) and predicted residual stromal bed’s thickness (RSBT) were correlated with △CRF. The regression equation of △CH and △CRF and influencing factors were △CH =?6.182 + 0.658CHpreoperative + 8.421AD/CCT (R2=0.639, P<0.01), △CRF =?0.007 + 0.725CRFpreoperative ? 0.014RSBT (R2=0.689, P<0.01). Conclusion: The change of CH before and after LASIK is correlative with AD/CCT. The change of CRF before and after LASIK is correlative with predicted residual stromal bed’s thickness. Ablative depth and predicted residual stromal bed’s thickness should be considered carefully during the surgical design.

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.

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.