目的：探讨眼科住院医师规范化培训中睑板腺囊肿诊疗的培训效果及存在的问题，以期改进培训方式。方法：以2020年4月在中山大学中山眼科中心培训的154名学员为对象，进行问卷调查，采用SPSS 20.0统计学软件进行数据分析。结果：共76名专业型硕士(专硕)、78名住院医师培训(住培)学员完成了问卷调查。专硕具有睑板腺囊肿诊断、保守治疗及手术主刀经验的比例分别为40.8%、11.8%、7.9%；住培则显著高于前者，分别为79.5%(P<0.001)、60.3%(P<0.001)和21.8%(P=0.016)。对于关键诊疗环节的判断，90.8%的专硕选择了临床诊断(P=0.007)，94.9%的住培则选择治疗方案(P<0.001)。去除囊壁、术中意外与破溃皮肤的处理是专硕难以掌握的手术步骤(P<0.001)；而住培仅为去除囊壁(P<0.001)。结论：睑板腺囊肿诊疗水平在眼科住院医师规范化培训中亟待提高，并根据各类型学员的临床能力和认知差异，进行分级分类培训。
Objective: To explore the teaching effect of diagnosis and treatment on chalazion in the standardized training of ophthalmology residents and its existing problems, in order to improve the quality of the training systems. Methods: A self-designed questionnaire survey was conducted with 154 ophthalmology residents in Zhongshan Ophthalmic Center in April 2020, and the investigative data was analyzed using SPSS 20.0. Results: Totally 76 medical postgraduates and 78 ophthalmology residents completed the questionnaire survey. The proportions of medical postgraduates who had individual experience on diagnosis, conservative and surgical treatment of chalazion were 40.8%, 11.8%, and 7.9%. Compared to the former, ophthalmology residents had significantly higher proportion, with 79.5% (P<0.001), 60.3% (P<0.001), and 21.8% (P=0.016), respectively. For judging the important aspect of diagnosis and treatment process, the medical postgraduates chose the clinical diagnosis (90.8%) (P=0.007), while the ophthalmology residents paid more attention on treatment options (94.9%) (P<0.001). In the surgical procedures, removal of cyst wall, management of intraoperative accidents and skin ulcers are all their difficult skills to master for medical postgraduates (P<0.001), while only removal of cyst wall for residents (P<0.001). Conclusion: The training level of diagnosis and treatment of chalazion still needs to be improved in the standardized training of ophthalmology residents. The training should be carried out according to the clinical competence and cognition differences of various types of students.
为使眼科手术铺巾方法更安全、便捷、利于操作，本研究团队在原有眼科手术铺巾基础上，增加不同规格尺寸、标识定位、背胶等功能，发明了一种眼科手术铺巾[专利号：国家实用新型专利(ZL 201921410018.3)]。该种眼科手术铺巾采用一次性防水无纺布为主要制作材料，具有规格多样、结构简单、便于操作、无菌屏障功能更强等特点，能更好地满足眼科手术术前消毒铺巾的使用要求。
In order to make ophthalmic surgical draping safer, more convenient and easier to operate, this research team invented an ophthalmic surgical drape [patent number: National Utility Model Patent (ZL 201921410018.3)] based on the original ophthalmic surgical drape, adding functions such as various sizes, marking and positioning,and glutinosity. This kind of ophthalmic surgical drape is made of disposable waterproof non-woven fabric, which has the characteristics of various specifications, simple structure, easy operation and strong function of aseptic barrier, which can better meet the requirements of disinfection drape before ophthalmic surgery than the original drape.
为在眼科日间手术模式下既能满足玻璃体视网膜术后体位需求，又能合理利用有限空间，本研究团队在原有的眼科日间病房座椅的基础上，增加玻璃体手术后体位护理等功能，发明了一种护理座椅[专利号：国家实用新型专利(ZL 2017 2 0942404. 1)]。该座椅采用钢喷塑(或不锈钢)、木板、海绵和人造革皮等材料，其结构主要包括座椅的主体部分、俯卧台、杂物篮、收纳架、输液杆套筒等部分。其制作材料简单，操作方便，安全使用，既能保证临床体位护理需求，又能节省空间，便于病房环境管理。
To meet the needs of the postoperative position nursing after pars plana vitrectomy in the day surgery mode,this research team has designed a nursing chair [patent number: National Uutility Model Patent (ZL 201720942404. 1)] based on the original chair of ophthalmic day ward, adding the functions of postvitreous nursing and so on. The seat is made from steel spray plastic (or stainless steel), wood, sponge and artificial leather, and the structure mainly consists of the main body, the countertop for prone position, the junk basket, the storage rack, and the infusion rod sleeve. The seat can be made by simple materials. The seat is easy to operate and safe to use, which can not only meet the needs of clinical body position nursing care, but also save the ward’ space and facilitate the environmental management of the ward.
目前Wetlab眼科手术教学采用猪眼球作为教学模型，与实际手术差别较大，且无法满足外眼手术教学的需求。通过使用带有眼球、眼外肌、眶组织、眶骨及眼睑结构的全眼模型，可高度模拟真实手术场景，覆盖更多眼科手术教学需求。基于全眼模型构建多个眼科手术教学平台，依照培养阶段设计手术课程，创建新的评价体系，改变传统将“内眼”“外眼”分开的教学理念，可使年轻医师从一开始就建立眼科“分科而不分割”的整体思维，从而使眼科手术培训更加规范和完善。
Porcine eyes have been used as animal model in ophthalmic surgery training. However, it differs greatly from real surgery and cannot meet the needs of external eye surgery teaching. Porcine orbit model with eyeball, extraocular muscles, orbital tissue, bones and eyelids can be more realistic simulation of real surgeries and cover more needs for ophthalmic surgery teaching. By setting up ophthalmic surgery teaching platforms, designing staged course and creating new assessment methods based on porcine orbit model, the traditional concept about separation of internal and external eye is changed. This helps young doctors to establish a holistic view from the very beginning,that ophthalmic surgeries should not be split because of subspeciality. In this way, ophthalmic surgery training will become more standardized and perfected.
近些年来，眼科疾病的临床诊断治疗及其病理发展的研究对医学影像学技术的要求日益增高，磁共振技术已广泛应用于研究眼科疾病的发病机制、治疗和分析预后。基于体素的形态学分析(voxel-based morphometry，VBM)作为一种新型的磁共振图像的分析方式，VBM可以对活体脑进行无创的形态学研究，定量分析磁共振图像中每一个单独体素内的白质、灰质的密度和体积的变化，从而反映对应区域的解剖学结构差异，能发现常规MRI不能检测到的灰质和白质结构的细微改变。不同于那些只作用于预设的感兴趣区域的分析方法，VBM完全没有偏向性，它探测全脑的异常变化，无需对感兴趣区的先验性假设，不会被研究人员的主观思维影响。这提供了一种全新的方法来探索眼科疾病中的神经病理变化，尤其在青光眼和弱视的研究中应用最多。
With the increasing requirements for medical imaging technologies in clinical diagnosis, treatment and pathological basis research of ophthalmic diseases, magnetic resonance imaging (MRI) has been broadly used in the diagnosis and prognostic evaluation of ophthalmic diseases. As a novel analytic method of MR images, voxel-based morphometry (VBM) quantitatively analyzes the changes in brain gray, white matter density and volume in each individual voxel in MR images to reflect the differences of anatomical structures in the corresponding areas, and it provides a novel way to reveal the neuronal pathological changes in ophthalmic diseases.
眼科病理学是系统组织病理学的重要分支，作为基础医学与临床医学之间的桥梁和纽带，对于深入认识和揭示眼部疾病的发病特点发挥着重要作用。眼科病理学在老一辈专家们的努力下奠定了坚实的基础。目前眼科病理学学科的发展随着眼科临床技术以及系统病理学的发展在不断的前进，细胞生物学及分子生物学的全方位结合和纵深应用带动并拓展了眼科病理学的研究领域，临床病理学及实验病理学的研究不断更新，新形势下眼科病理学的发展充满着机遇和挑战。
Ophthalmic pathology is an important branch of histopathology. As a bridge and link between basic medicine and clinical medicine, ophthalmic pathology plays an important role in understanding and revealing the characteristics of ocular diseases. The previous generations have laid a solid foundation for ophthalmic pathology with their hard work. Moreover, the advancement of ophthalmic clinical technology and systematic pathology in recent years have further facilitated the development of ophthalmic pathology. The comprehensive combination and in-depth application of cell biology and molecular biology have promoted and expanded the research field of ophthalmic pathology. In addition, new progress has been witnessed in the field of clinical pathology and experimentalpathology constantly. Under the new situation, the development of ophthalmic pathology is faced with both opportunities and challenges.
目的：构建具有较强科学性和实用性的眼科专科护士培训体系，为眼科专科护士的准入、培养、考核提供理论基础。方法：通过查阅文献、焦点小组和专家会议法，拟定眼科专科护士培训体系的课程、带教、评价体系。结果：构建的眼科专科护士培训体系内容包括课程体系、培训过程、临床实践指标、考核评价方法4个部分。其中，课程体系部分包含一级指标5项，二级指标11项，三级指标55项；培训过程包括一级指标4项、二级指标12项；临床实践指标包括一级指标6项、二级指标23项；考核评价方法包括一级指标5项、二级指标10项。结论：眼科专科护士培训体系构建过程科学，内容设置合理，对开展专科护士培训具有较好的指导意义。
Objective: To develop a scientific and practical training system for ophthalmic specialist nurses and provide theoratical basis for the the admission, training and assessment of ophthalmic specialist nurses. Methods: Through extensive review of domestic and foreign literatures, a focus group interview and an expert meeting, the curriculum, teaching and evaluation system of the ophthalmic specialist nurses training system was developed.Results: The training system for ophthalmic specialist nurses consists of four parts: training content, training process, clinical practice, assessment and evaluation. Among them, the training content includes 5 first-level indicators, 11 second-level indicators and 55 third-level indicators. The training process of ophthalmic specialist nurses includes 4 indicators of the first level and 12 indicators of the second level. The clinical practice indexes of ophthalmic specialist nurses include 6 indexes of the first grade and 23 indexes of the second grade. The methods of assessment and evaluation of ophthalmic specialist nurses include 5 indicators of the first level and 10 indicators of the second level. Conclusion: The scientific process and reasonable content of the training system for ophthalmic specialist nurses have a good guiding significance for the training of ophthalmic specialist nurses.
CRISPR(clustered regularly interspaced short palindromic repeats)基因编辑技术通过精准改变细胞DNA序列，控制细胞命运及表型，是有望从根本上改变疾病治疗的新技术。由于眼球独特的生理构造，基因编辑疗法在治疗眼科疾病方面的应用具有明显的优势。目前，CRISPR基因编辑疗法治疗10型Leber先天性黑矇(Leber congenital amaurosis 10，LCA10)的临床试验已经展开，治疗其他多种眼科疾病的临床试验也即将开始。随着新一代CRISPR基因编辑技术的发展，基因编辑疗法有望为眼科疾病的治疗提供新的手段。
Clustered regularly interspaced short palindromic repeats (CRISPR) genome editing is a newly developed technology to precisely modify cellular DNA sequence, which could control cell fate and phenotype and fundamentally reform disease treatment. The structure of the eye offers unique advantages as a genome editing target. Recently, a CRISPR genome editing therapy has begun to be tested in Leber congenital amaurosis 10 (LCA10) patients, and the clinical trials for more ocular diseases are about to start. The development of CRISPR/Cas genome editing tools will drive major advances in the application of gene therapies in the treatment of ophthalmic disease.
目的：探讨以岗位需求为导向的培训模式在眼科手术室护士上岗前消毒供应专科专项培训中的应用效果。方法：手术室上岗前护士共44名，按随机分配原则，其中23名为实验组，另外21名为对照组。实验组以医院消毒供应中心三大行业标准和医院消毒技术规范为理论依据，以手术室护理岗位需求为目标，制定针对性培训内容，采用多方式培训方法，在消毒供应中心培训3个月考核合格后调入手术室。对照组直接调入手术室工作。采用手术室带教老师对新上岗护士满意度调查作为评价指标。结果：23名学员的理论知识考核、技术操作考核全部合格，小讲课顺利完成。手术室带教老师对实验组的满意度明显高于对照组。结论：建立以岗位需求为导向的眼科手术室护士消毒供应专科培训模式，有助于提高新上岗的手术室护士工作适应性，并提升手术室护士对专科器械的管理能力。
Objective: To explore the application effect of job demand-oriented training model in specialized training of sterile supplying for nurses in the ophthalmic operation room. Methods: A total of 44 nurses who would work in the operating room were randomly divided into the experimental group (n=23) and control group (n=21). Based on the three industrial standards of Central Sterile Supply Department (CSSD) and the technical specifications of disinfection in hospital, and targeting the job requirements of operating room nursing, the experimental group formulates specific training contents and adopts various training methods. The experimental group was transferred to the operating room after being trained in CSSD for 3 months and passing the examination. The control group was transferred directly to the operating room. The degree of satisfaction from the teachers of operating room to new nurses was used as the evaluation index. Results: All the 23 students passed the examination of theoretical knowledge and technical operation, and the small lectures were completed successfully. The degree of satisfaction from teachers in operating room to trainees was obviously higher than that of untrained nurses. Conclusion: The establishment of job demand-oriented training model in specialized training of sterile supplying for nurses in ophthalmic operation room is helpful to improve the work adaptability of the newly-hired nurses in the operation room. It also helps the nurses in the operation room to enhance the management ability on the specialized instruments.
为较好地满足眼科诊疗的使用要求，提升医护人员的工作效率以及患者的治疗效果，笔者设计了一种眼科多功能尺。该眼科多功能尺主要采用PVC材料，其结构主要包括圆盘、主尺、第一副尺、第二副尺以及第三副尺；功能主要包括测量长度、视力检查、照明、患者体位角度测量等。该眼科多功能尺设计巧妙，功能较齐全，能够较好地满足眼科医疗和诊断过程的使用要求。
To meet the demands of ophthalmic medical diagnosis, and to improve the efficiency of medical staff and patients’ treatment, the authors designed an ophthalmological multifunctional ruler. Its main material is PVC, and mainly includes a circular disk and 4 rules (the main ruler, the first ruler, the second ruler and the third ruler). Its functions mainly contain the measurement of length, visual test, illumination, the angle measurement for patients position and so on. The ruler is ingenious in design and has complete functions, which can meet the requirements of ophthalmic medical treatment and diagnosis.
