目的：探讨角膜绷带镜对独眼白内障患者焦虑情绪及生活质量的影响。方法：选取中山大学中山眼科中心白内障科2020年12月至2021年7月收治的120例独眼白内障患者作为试验对象，采用便利抽样法分为实验组(佩戴角膜绷带镜)与对照组(未佩戴角膜绷带镜)。运用焦虑自评量表、视功能的生存质量量表来评估比较2组患者的焦虑程度、术后生存质量。结果：入院前2组患者的焦虑评分、生存质量评分差异无统计学意义(P>0.05)，术后第1天实验组患者的焦虑评分明显低于对照组、生存质量评分明显高于对照组，差异有统计学意义(P<0.05)。实验组患者的焦虑评分由入院前的55.35±7.09降低至43.77±5.56，焦虑程度比入院前减轻20%；对照组患者焦虑评分由入院前的54.27±5.93降低至47.92±7.02，焦虑程度较入院前减轻12%；实验组患者生存质量评分由入院前的55.32±25.57增至术后第1天的81.01±13.74，增长了46%；对照组患者生存质量评分由入院前的56.38±14.43降低至术后第1天的36.15±17.97，降低了35%。结论：角膜绷带镜可以减轻独眼白内障患者的焦虑情绪，提高术后生活质量。
Objective: To investigate the effect of corneal bandage lens on anxiety and quality of life in patients with monocular cataract. Methods: A total of 120 patients with monocular cataract treated in our department from December 2020 to July 2021 were selected as the subjects. They were divided into an experimental group (wearing corneal bandage lens) and a control group (without corneal bandage lens) by convenient sampling method. Self-rating Anxiety Scale and Visual Function Quality of Life Scale were used to evaluate and compare the degree of anxiety and postoperative quality of life between the 2 groups. Results: There was no significant difference in anxiety score and quality of life score between the 2 groups before admission (P>0.05). On the first day after operation, the anxiety score of the experimental group was significantly lower than that of the control group, and the quality of life score was significantly higher than that of the control group (P<0.05). The anxiety score of patients in the experimental group decreased from 55.35±7.09 to 43.77±5.56, and the degree of anxiety decreased by 20% compared with that before admission. The anxiety score of patients in the control group decreased from 54.27±5.93 to 47.92±7.02, and the degree of anxiety decreased by 12% compared with that before admission. The score of quality of life in the experimental group increased from 55.32±25.57 before admission to 81.01±13.74 on the first day after operation, an increase of 46%. The quality of life score of patients in the control group decreased from 56.38±14.43 before admission to 36.15±17.97 on the first day after operation, a decrease of 35%.Conclusion: Corneal bandage lens can reduce the anxiety of patients with monocular cataract and improve the quality of life after operation.
目的：构建、实施并评价眼科日间手术健康教育模式的有效性。方法：依托信息化手段和Teach-back法，构建眼科日间手术健康教育模式。选取2020年1月至2021年5月中山大学中山眼科中心日间手术患者177例为研究对象，采用历史对照研究法，对照组97例，观察组80例。对照组予常规健康宣教，观察组予基于信息化和Teach-back法的健康教育模式，比较2组患者健康教育知识掌握情况和围手术期护理满意度。结果：观察组健康教育知识自评得分和实际掌握程度得分均显著高于对照组(P<0.05)；2组患者体位护理知识得分和护理工作满意度得分之间的差异无统计学意义(P>0.05)。结论：构建基于信息化和Teach-back法的健康教育模式可以提高眼科日间手术患者健康教育知识掌握度，但对于患者体位护理知识掌握程度和护理工作满意度方面的影响还需要进一步研究。
Objective: To construct, implement and evaluate the effectiveness of the health education model for ophthalmic day surgery. Methods: The health education model for ophthalmic day surgery was constructed relying on information-oriented means and Teach-back method. A total of 177 patients with day surgery in Zhongshan Ophthalmic Center from January 2020 to May 2021 were selected as the research subjects and divided into a control group (n=97) and an intervention group (n=80) by historical comparative study. The intervention group was carried out with the health education model based on information-oriented means and Teach-back method, while the control group received the routine health education. The health education knowledge and perioperative nursing satisfaction were compared between the 2 groups. Results: The scores of self-evaluation and nurse evaluation for health education knowledge in the intervention group were significantly higher than those in the control group (P<0.05). There was no significant difference in body position nursing knowledge score and nursing satisfaction score between the 2 groups (P>0.05). Conclusion: The health education model based on information oriented means and Teach-back method can improve the health education knowledge level of patients with ophthalmic day care surgery. In the meanwhile, further studies will be needed to explore the effects on patients in body position nursing knowledge and nursing satisfaction.
外伤、感染、先天性疾病等均可能破坏角膜的组织结构和细胞稳态，同时造成角膜干细胞缺损，进而导致组织无法正常愈合，引起角膜盲，是世界范围内致盲的重要原因之一。目前已有多种干细胞相关的技术方法应用于重建功能性角膜组织，取得了瞩目的治疗效果。本综述以角膜缘干细胞缺乏症为主，旨在介绍多种来源的干细胞在角膜重建中的研究现状和最新进展，同时对不同干细胞的特异性标志物的研究进展进行阐述。
Trauma, infection and congenital diseases may disrupt the tissue structure and cellular homeostasis of the cornea, while causing impaired function of corneal stem cell defects, which in turn may even lead to corneal blindness caused by the inability of the tissue to heal properly. Corneal blindness is one of the major causes of blindness worldwide. Several stem cell-related techniques have been applied to reconstruct functional corneal tissue with impressive therapeutic results. This review focuses on corneal limbal stem cell deficiency and aims to present the current status and recent progress of research on stem cells from multiple sources in corneal reconstruction, as well as to describe specific markers of corneal stem cells.
目的：调查抗VEGF药物治疗湿性年龄相关性黄斑变性(wet age-related macular degeneration, wAMD)5年的疗效。方法：2011年至2021年于北京医院眼科诊断为wAMD的患者共84人103只眼进行回顾性分析。抗VEGF治疗采用3+PRN方案。观察5年来的最佳矫正视力(best-corrected visual acuity，BCVA)、玻璃体腔注射次数、随访次数和病灶的解剖学变化。结果：治疗5年后平均BCVA为38.1个字母，与基线相比下降9.4个字母，差异有统计学意义(P<0.001)。23.3%的患眼5年后可维持初始视力。5年内平均注射次数为13.8次，第1年注射次数最多，平均为4.3次。5年内平均随访次数为24.3次，仅有34.0%的患眼可遵循每次随访间隔≤3个月。5年后有68.0%的患眼出现纤维瘢痕，27.2%的患眼出现地图样萎缩，69.0%(71/103)的患眼存在持续的色素上皮脱离(pigment epithelial detachment，PED)。年龄、基线BCVA、是否初始治疗、随访年限、注射次数、中心视网膜厚度 (central retina thickness，CRT)、地图样萎缩等对BCVA有显著影响。结论：多数患者在抗VEGF治疗1年内可维持视力，但5年以上维持效果不佳。早期诊治、提高注射频率，可能是未来改善预后的研究方向。
Objective:To investigate the efficacy of anti-VEGF injection in the treatment of wet age-related macular degeneration (wAMD) for 5 years. Methods: A total of 84 patients (103 eyes) wAMD diagnosed in Department of Ophthalmology in Beijing Hospital from 2011 to 2021 were analyzed retrospectively. 3 + PRN regimen was applied for anti-VEGF treatment. The changes of best corrected visual acuity (BCVA), the number of intravitreal injections and the number of follow-up visits, and the anatomical changes of the lesions in the past 5 years were collected. Results: The average BCVA after 5 years was 38.1 letters, indicating a decrease of 9.4 letters comparing to baseline, which was statistically significant (P<0.001). 23.3% of the eyes could maintain the baseline BCVA after 5 years. The average injection times within 5 years was 13.8, and the injection was concentrated in the first year, with an average of 4.3. The average number of follow-up visits within 5 years was 24.3, and only 34.0% of the affected eyes could keep the follow-up interval ≤3 months. After 5 years, 68.0% of the eyes developed fibrous scar, 27.2% developed geographic atrophy, and 69.0% (71/103) had consistent pigment epithelial detachment. Factors significantly affect BCVA include: age, baseline BCVA, initial treatment, follow-up time, injection times, central retinal thickness, geographic atrophy and so on. Conclusion: Most patients can maintain vision within the first year after anti-VEGF treatment, but the efficacy is poor for more than 5 years. Early diagnosis and treatment, and increased injection frequency may be the research direction for improving prognosis in the future.
将课程思政理念融入专业课程是落实立德树人根本任务和全面推进课程育人的重要途径。本文根据课程思政的内涵要求和发展实际，结合实验室技能培训课程特点，从知识点、人与社会、故事、案例辨析、实验操作5个方面进行思政探索和实践。通过优化教学设计、创新教学方法和丰富教学内容，切实将社会主义核心价值观教育贯穿专业课教育全过程，为眼科学及分子医学专业课相关课程的思政教学和高质量人才培养提供了有价值的参考。
Integrating ideological and political concepts of the curriculum into the professional curricula is an important way to implement the fundamental task of cultivating people with morality and comprehensively promote the education of people through the curriculum. Based on the connotation requirements and actual development of the integration of ideological and political education throughout curriculum, considering the features of laboratory skills training courses, this paper explores ideological and political education in 5 aspects. The 5 aspects include knowledge points, humans and society, stories, case analysis, and experimental operation. By optimizing teaching design, innovating teaching methods, and enriching teaching contents, the education of socialist core values should be effectively carried out throughout the whole process of professional course education, which provides a valuable reference for the ideological and political teaching in ophthalmology and molecular medicine related courses and for the cultivation of high-quality talents.
目的：探讨无糖尿病性视网膜病变(diabetic retinopathy，DR)的糖尿病人群中，糖尿病与近视对黄斑区节细胞-内丛状层(ganglion cell layer and inner plexiform layer，GCIPL)厚度纵向变化的影响。方法：纳入广州糖尿病眼病研究中1 165名基线无视网膜病变的糖尿病和正常对照者，纵向随访2年。根据是否存在近视[等效球镜(spherical equivalent，SE)≤-3 屈光度(diopter，D)]和糖尿病分为健康组(n =508)、糖尿病组(n =525)及糖尿病合并近视组(n =132)。扫频光学相干断层成像(swept source-optical coherence tomography，SS-OCT)技术测量并比较三组间GCIPL厚度的变化，以确定糖尿病和近视的影响，三组间差异使用协方差分析，采用线性混合模型分析评估GCIPL厚度与相关因素的关系。结果：对照组的SE为(1.07±1.06) D，糖尿病组为(1.02±1.00) D，糖尿病合并近视组为(-5.36±2.30D)，组间差异有统计学意义(P<0.001)。对照组基线GCIPL厚度为(71.1±0.3) μm，糖尿病组为(74.4±0.2) μm，糖尿病合并近视组为(71.7±0.5) μm。在2年随访过程中，对照组GCIPL厚度下降-0.10(95%CI：0.05~-2.03) μm/年，糖尿病组GCIPL厚度下降的速度为对照组的12倍[-1.21(95%CI：0.05~?24.04) μm/年，P<0.001]，糖尿病合并近视组GCIPL厚度下降的速度为对照组的22倍[-2.17(95%CI：0.10~-21.63) μm/年，P<0.001]。结论：近视是无DR的糖尿病患者中GCIPL加速变薄的危险因素，糖尿病和近视GCIPL损伤中可能存在协同作用。
Objective: To investigate the association between myopia and ganglion cell layer and inner plexiform layer(GCIPL) in diabetic population without diabetic retinopathy (DR). Methods: In this Guangzhou Diabetic Eyestudy, a total of 1165 patients aged 30–80 years were recruited followed up longitudinally for 2 years. According tothe presence or absence of myopia [spherical equivalence (SE)≤-3 diopter (D)] and diabetics, the patients weredivided into a healthy group (n=508), a diabetes mellitus group (n=525), and a diabetes mellitus + myopia group(n=132). GCIPL was measured via swept-source optical coherence tomography. Univariable and multivariablemixed models were used to show the association of GCIPL change and baseline parameters. Results: SE was(1.07±1.06) D in the healthy group, (1.02±1.00) D in the diabetes mellitus group and (-5.36±2.30) D in thediabetes mellitus + myopia group (P<0.001). The baseline GCIPL thickness were (71.1±0.3), (74.4±0.2), and(71.7±0.5) μm, respectively. The slope of GCIPL thickness was ?0.10 (95% CI: 0.05 to -2.03) μm/year in the healthy group, which was 12 folds faster than those in the diabetes mellitus group [-1.21(95% CI: 0.05 to-24.04) μm/year, P<0.001] and 22 folds higher among those in diabetes mellitus + myopia group [-2.17 (95%CI: 0.10 to ?21.63) μm/year, P=0.009]. Conclusion: Both myopia and diabetes status accelerate macular ganglioncell layer and inner plexiform layer thinning in diabetic patients without diabetic retinopathy.
Abstract: To report a palliative and alternative surgical procedure, allogeneic sclera graft combined with autologous conjunctival flap (ASGACF), employing to repair the large emergent corneal perforation. The detail protocol of the surgical procedure was characterized and four representative cases were reviewed. An allogeneic sclera graft and recipient bed were prepared as the traditional penetrating keratoplasty (PK). And then sutured the sclera graft to the bed with 10-0 nylon suture and covered with a pedicled autologous conjunctival flap in half size. In the follow-up, the ASGACF repaired all of the corneal perforations and restored the integral walls of eyeballs, in spite of one who underwent a second surgery. This surgical procedure provided a palliative method to repair the large emergent corneal perforation while there is the lack of a corneal graft.
Abstract: To report a palliative and alternative surgical procedure, allogeneic sclera graft combined with autologous conjunctival flap (ASGACF), employing to repair the large emergent corneal perforation. The detail protocol of the surgical procedure was characterized and four representative cases were reviewed. An allogeneic sclera graft and recipient bed were prepared as the traditional penetrating keratoplasty (PK). And then sutured the sclera graft to the bed with 10-0 nylon suture and covered with a pedicled autologous conjunctival flap in half size. In the follow-up, the ASGACF repaired all of the corneal perforations and restored the integral walls of eyeballs, in spite of one who underwent a second surgery. This surgical procedure provided a palliative method to repair the large emergent corneal perforation while there is the lack of a corneal graft.
