在热带和亚热带国家，真菌性角膜炎是角膜盲的一个重要原因。随着现代医学的进展，早期真菌性角膜炎通过药物或者手术治疗后治愈率有了显著改善，但是很多真菌性角膜炎患者由于缺乏及时合理的治疗，病情变得迁延难治，预后较差。随着无数学者的努力，近年来在难治性真菌性角膜炎领域在抗真菌药物、给药方式及其他治疗方式上有了一些新的进展，目前可选的难治性真菌性角膜炎治疗方式各有特点及优劣之处。了解目前可用的抗真菌治疗方式、其适应证及不良反应等，是处理难治性真菌性角膜炎病例的必要条件。

Fungal keratitis is a significant cause of corneal blindness in tropical and subtropical countries. With the development of modern medicine, the cure rate of early fungal keratitis has been significantly improved after medical or surgical treatment. However, due to the lack of timely and reasonable treatment for many patients with fungal keratitis, the disease has become difficult to treat and the prognosis is poor. With the efforts of numerous scholars, some new advances have been made in the treatment of recalcitrant fungal keratitis in recent years, such as antifungal drugs and administration methods. At present, the treatment methods of recalcitrant fungal keratitis have their own characteristics, advantages and disadvantages. It is necessary to understand the available antifungal therapies, their indications and side effects for the treatment of recalcitrant fungal keratitis.

间充质干细胞由于其独特的自我更新和多向分化能力，成为了一种替代无效的常规治疗的新兴治疗方法。间充质干细胞通过免疫调节、促修复、抗新生血管机制和细胞替代作用在眼表疾病中发挥作用，而不同来源的间充质干细胞其作用机制也不完全相同。迄今为止，已有8项注册的间充质干细胞治疗的临床试验应用于干眼、角膜烧伤、圆锥角膜等眼表疾病。

Due to its unique self-renewal and multi-directional differentiation capabilities, mesenchymal stem cells (MSCs) have become an emerging therapy that replaces of ineffective conventional options in treating multiple diseases. It plays an important role in ocular surface illnesses through a variety of functions, including immunoregulation, promoting repairing, anti-angiogenesis mechanisms, and cell replacement. MSCs from different sources have different mechanisms. So far, 8 registered clinical trials of MSCs therapy have been applied to treat dry eye, ocular burn, keratoconus and other ocular surface diseases.

干眼是以泪膜稳态丢失及伴随眼部不适症状为特征的最常见眼表疾病，泪膜不稳定、泪液高渗透性、眼表炎症及感觉神经异常为其主要病因。地夸磷索钠是一种P2Y2受体激动剂，能刺激黏蛋白及泪液分泌，其独特的作用机制为干眼的治疗开辟了新的方向，本文就地夸磷索钠近年的临床及基础研究进展作一综述。

Dry eye is one of the most common ocular surface diseases. It is characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and tear hyperosmolarity, ocular surface inflammation, and neurosensory abnormalities play major etiological roles. Diquafosol tetrasodium is a purinergic P2Y2 receptor agonist that promotes mucin and aqueous tear secretion. The unique pharmacological mechanism of diquafosol tetrasodium opens up a new direction for the medical therapies of dry eye. This article reviews the clinical therapeutic effect and research progress of diquafosol tetrasodium for the past few years.

血源性滴眼液是治疗干眼的一种有效的治疗方法。来源可分为自体、供体，其中供体来源又可分为成人外周血及脐带血，并以血清、富血小板血浆、血小板来源生长因子以及血小板裂解产物的形式制成。由于各种血液制品的原理及适应症不同，本文将对不同血源性滴眼液制品的制备及面临的挑战的共识问题进行解读。

Blood-based eye drops can be used effectively in the treatment of dry eyes. The sources of blood-based eye drops can be divided into autologous and donor, and donor sources can be divided into adult peripheral blood and umbilical cord blood, which are prepared in the form of serum, platelet-rich plasma, platelet-derived growth facters and platelet lysate. Due to the different principles and indications of various blood products, the consensus issues on the preparation and challenges of different blood-based eye drop products are reviewed.

在大力发展精准医疗的时代背景下，北京大学第三医院眼科中心率先建立干眼精准医疗平台。通过规范和优化干眼诊疗流程，为患者提供个性化的治疗方案和预防指导意见，有效提高了干眼诊断的精确性与治疗的有效性，同时提升了干眼门诊接诊效能，改善了患者就诊体验。本文将从干眼精准医疗平台体系的建设内容、标准化的检查流程、个性化的诊疗方案等方面进行阐述，并结合实际临床案例，综合分析北京大学第三医院在干眼精准医疗方面进行的探索，展望干眼精准医疗平台的前景与未来。

In the era of developing precision medicine, the Ophthalmic Center of Peking University Third Hospital has taken the lead in establishing a dry eye precision medical platform. By standardizing and optimizing the diagnosis and treatment process of dry eye, this center provides personalized treatment plan and prevention guidance for patients, effectively improves the accuracy of dry eye diagnosis and the effectiveness of treatment, at the same time, improves the reception efficiency of dry eye clinic, and improves the patient’s clinic experience. In this paper, the construction content, standardized inspection process and personalized diagnosis and treatment scheme of dry eye precision medicine platform system will be described. Combined with the actual clinical cases, the exploration of the Peking University Third Hospital in dry eye precision medicine will be comprehensively analyzed, and the future of dry eye precision medical platform will be prospected.

目的：探讨以Base-out恢复点为目标手术量的急性共同性内斜视(acute acquired comitant esotropia，AACE)的治疗效果。方法：随诊以Base-out恢复点为目标手术量、且术后随访时间超过4个月的AACE患者，分析术前及末次随诊时斜视度、双眼视功能参数及术后立体视恢复的影响因素。结果：将43例患者纳入研究，其中男27例(63%)，女16例(37%)，手术年龄9~53(23.7±11.4)岁，术前斜视持续时间3个月~11年(24.8±24.5个月)，术后随访4~62(15.8±14.5)个月。术前Base-out恢复点比斜视度更大[远距差值(9.3±6.9) PD，P<0.001；近距差值(11.4±6.7) PD，P<0.001]；术前视远和视近斜视度分别为(38.4±13.2) PD和(37.6±13.7) PD，末次随诊时视远和视近斜视度分别为(0.74±2.4) PD和(0.70±2.4) PD(均P<0.001)，38例(88%)患者无眼位偏斜，5例(12%)有轻微内隐斜视。末次随诊时视远和视近立体视锐度显著改善(P<0.001)，末次立体视功能与术前近距立体视水平和术前斜视持续时间相关。结论：以Base-out恢复点为目标手术量的AACE手术能取得较好的矫正效果，未见眼位过矫者；术后立体视恢复与术前近距立体视和术前斜视持续时间相关，提示适当早期手术可能有助于术后立体视功能的恢复。

Objective: To evaluate the effect of using the amount of base-out (BO) recovery point as the surgical target for acute acquired comitant esotropia (AACE). Methods: Patients with AACE underwent surgery based on the target angle of the base-out recovery point and were followed up at least 4 months. The deviation, binocular functions before and after the surgery were analyzed and the factors related the post-operative stereopsis were evaluated. Results: Totally 43 patients were included in the study, including 27 males (63%) and 16 females (37%), aged from 9 to 53 years (23.7±11.4 years), duration of preoperative strabismus ranged from 3 months to 11 years (24.8±24.5 months), and postoperative follow-up ranged from 4 to 62 (15.8±14.5 months). Both distant and near pre-operative Base-out recovery point were larger than the angle of esotropia [(9.3±6.9) PD for distant; (11.4±6.7) PD for near, both P<0.001]. The pre-operative esotropia for distant and near viewing were (38.4±13.2) PD and (37.6±13.7) PD respectively and reduced to (0.74±2.4) PD and (0.70±2.4) PD at the last visit time (P<0.001). Thirty-eight cases were orthosia without any phoria and five cases still had some esophoria or minimal esotropia at the last visit. The stereoacuity improved significantly after the surgery. The post-operative stereopsis significantly correlated with the pre-operative stereopsis and the duration from onset of esotropia to the time of surgery. Conclusion: The acute acquired comitant esotropia can be corrected with strabismus surgery based on the target angle of base-out recovery point. The post-operative stereopsis correlated with the pre-operative stereo function and the time of esotropia lasting. It suggested the earlier esotropia was corrected the better the stereopsis recovered.

目的：探讨品管圈活动提升眼科带螺母器械清洗质量的效果。方法：中山大学中山眼科中心珠江新城院区自2020年8月1日到2020年9月30日消毒供应中心处理的眼科带螺母器械(以量规为例)共2 076件，8月31日前为对照组，按常规清洗流程处理；9月1日后为实验组，成立品管圈小组，针对器械结构制定相应清洗流程。结果：实验组的清洗合格率为98.7%，对照组的清洗合格率为93.4%，差异有统计学意义(P<0.01)。结论：实施品管圈活动可提升眼科带螺母器械的清洗质量。

Objective: To explore the effect of quality control circle activity on improving the cleaning quality of ophthalmic equipment with nuts. Methods: The object of the study was 2 076 pieces of ophthalmic equipment with nuts (taking gauge as an example) used from August 1, 2020 to September 30, 2020 in the central sterile supply department of the Zhongshan Ophthalmic Center of Sun Yat-sen University in Zhujiang New Town. The equipment used before August 31 was set as the control group and was dealt with common cleaning process. The equipment used after September 1 was set as experimental group and the quality control circle group was set up to develop corresponding cleaning procedures for the instrument structure. Results: The qualified rate of cleaning in the experimental group was 98.7%, and that in the control group was 93.4%. The difference was statistically significant (P<0.01). Conclusion: Quality control circle activity can improve the cleaning quality of ophthalmic equipment with nuts.

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 of general 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：探索基于眼底彩照和人工智能构建冠心病智能诊断系统的可行性。方法：于2013—2014年收集广东省人民医院530例患者共2 117张眼底彩照，其中冠心病217例共909张眼底彩照。根据患者有无冠心病的情况进行标记，使用Inception-V3深度卷积神经网络训练人工智能模型，随后使用验证数据判断模型的准确率。计算深度卷积网络模型的准确性、一致率、敏感性、特异性和受试者工作特性曲线下面积(area under the curve，AUC)。结果：在2 117张眼底彩照中，1 903张用于模型训练，214张用于模型的性能评估。在测试集中，该算法的准确性为98.1%，一致率为98.6%，敏感性为100.0%，特异性为96.7%，AUC为0.988(95%CI：0.974~1.000)。结论：眼底彩照联合人工智能技术可精准判定冠心病，该模型具备较高的敏感性和特异性，但须进一步增加样本量，使用大样本量数据验证该模型，排除过拟合的可能性。

Objective: To explore the feasibility of developing a deep learning algorithm for detecting coronary heart diseases based on fundus color photography and artificial intelligence (AI). Methods: A total of 2 117 fundus color photographs were taken from 530 patients in Guangdong Provincial People’s Hospital from 2013 to 2014, including 909 fundus color photographs from 217 patients with coronary heart disease (CHD). According to whether the patient had coronary heart disease or not, the Inception-V3 depth convolution neural network was used to train the deep learning model, and then the validation data were used to judge the accuracy of the model. The accuracy, consistency rate, sensitivity and specificity of the deep convolution network model and the area under the working characteristic curve (AUC) were calculated. Results: Among the 2 117 fundus color photographs, 1 903 were used for model training, and 214 were used to test the accuracy of the model. In the test dataset, the accuracy of the algorithm was 98.1%, the consistency rate was 98.6%, the sensitivity was 100.0%, and the specificity was 96.7%. The AUC was 0.988 (95% CI, 0.974–1.000). Conclusion: The combination of fundus color photography and artificial intelligence can achieve the accurate diagnosis of the coronary heart disease, and the model has high sensitivity and specificity. However, future studies are warranted to validate our model and exclude the possibility of over-fitting.

目的：分析不同程度2型糖尿病视网膜病变的血清生化全套指标，探讨各生化指标与糖尿病性视网膜病变(diabetic retinopathy，DR)程度的相关性。方法：回顾性收集2018年5月至2020年10月在福建医科大学附属第二医院就诊的2型糖尿病患者。根据眼底情况分为3组：糖尿病不伴视网膜病变(non-diabetic retinopathy，NDR)组(17例)、糖尿病伴非增殖性视网膜病变(non-proliferative diabetic retinopathy，NPDR)组(29例)、糖尿病伴增殖期视网膜病变(proliferative diabetic retinopathy，PDR)组(34例)。采用SPSS 24.0分析比较3组血清生化全套各指标水平，对差异指标与DR相关性采用Pearson相关分析与多重线性回归分析。结果：3组年龄差异无统计学意义(P>0.05)；3组的总蛋白、白蛋白、白球比、钙浓度差异均有统计学意义(均P<0.05)。组间比较发现NPDR和PDR组总蛋白、白蛋白、白球比、钙浓度低于NDR组，差异有统计学意义(P<0.05)。Pearson相关分析显示总蛋白(r=?0.290)、白蛋白(r=?0.304)，钙浓度(r=?0.252)与DR呈负相关(均P<0.05)，多重线性回归提示总蛋白、白蛋白及血钙浓度是DR保护因素(P<0.05)。结论：血清指标总蛋白、白蛋白及血钙浓度与DR成负相关，在生理范围内将这些指标维持相对较高的水平，或许可以为糖尿病视网膜病变的防治提供新思路。

Objective: To analyze the serum biochemical indexes of different degrees of type 2 diabetic retinopathy, and the correlation between biochemical indexes and the degree of diabetic retinopathy (DR). Methods: Patients with type 2 diabetes admitted to the Fujian Medical University 2nd Affiliate Hospital from May 2018 to October 2020 were retrospectively collected. The patients were divided into 3 groups according to fundus conditions: non-diabetic retinopathy (NDR) group (n=17), diabetes with non-proliferative diabetic retinopathy (NPDR) group (n=29), diabetes with proliferative diabetic retinopathy (PDR) group (n=34). SPSS 24.0 was used to compare the levels of a complete set of serum biochemical indexes in the three groups. Pearson correlation analysis and multiple linear regression analysis were used for the correlation between the different indexes and DR. Results: There was no statistically significant difference in age between the three groups. The differences in total protein, albumin, white sphere ratio, and calcium concentration of the three groups were statistically significant (P<0.05). The comparison between the groups showed that the total protein, albumin, white sphere ratio, and calcium concentration in the NPDR and PDR groups were lower than those in the NDR group. The difference was statistically significant (P<0.05). Pearson correlation analysis showed that total protein (r=?0.290), albumin (r=?0.304), and calcium concentration (r=?0.252) were negatively correlated with DR (all P<0.05). Multiple linear regression indicated total protein, albumin and blood calcium concentration were the protective factors of DR (P<0.05). Conclusion: This study found that serum levels of total protein, albumin, and blood calcium levels are negatively correlated with DR. Maintaining a relatively high level of these indexes within the physiological range may provide new ideas for the prevention and treatment of diabetic retinopathy.