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.
目的:探讨急救护理技能规范化培训考核在眼科护士中的应用效果。方法:对暨南大学附属深圳眼科医院142名眼科护士实施急救护理技能的规范化培训考核,比较培训前后急救理论考核成绩及急救技能操作考核成绩的差异,并采用自制调查问卷进行培训评价的调查。结果:在实施急救护理技能规范化培训后,眼科护士的急救理论与技能操作考核成绩均高于培训前,差异有统计学意义(P<0.05);90%以上的眼科护士对急救培训持肯定意见。结论:急救护理技能规范化培训考核提高了眼科护士的临床急救护理水平,培养了良好的急救护理意识和团队协作精神,同时增加了护士的自我价值及职业认同感,获得了较好的培训效果。
Objective: To explore the application effect of standardized training and assessment of emergency nursing skills in ophthalmology nurses. Methods: We implemented standardized training and assessment of emergency nursing skills for 142 ophthalmology nurses in our hospital, compared the difference between the first aid theory and the first aid skill operation before and after the training, and used a self-made questionnaire to conduct training evaluation surveys. Results: After implementing the standardized training of emergency nursing skills, the assessment scores of first aid theory and skill operation of ophthalmology nurses were higher than those of the pre-training assessment. And the difference was statistically significant (P<0.05). More than 90% of ophthalmology nurses had a positive opinion on first aid training. Conclusion: Standardized training and assessment of emergency nursing skills have improved the clinical emergency nursing level of ophthalmology nurses and cultivated a good emergency nursing awareness and teamwork spirit. At the same time, they have strengthened nurses’ self-worth and professional identity, and achieved better training results.
干眼为最常见的眼表疾病之一,以泪膜稳态丢失及伴随眼部症状为特征。干眼的治疗以消除病因、缓解症状和保护视功能为目标,而其中的心理护理、眼睑物理治疗、健康宣教和院外管理尤为重要。优质的整体护理方案有助于干眼患者的治疗。本团队在参考干眼诊疗共识的基础上,结合自身护理经验,为干眼患者制定了个性化、涵盖全面的整体护理方案并运用。
Dry eye is one of the most common ocular surface diseases, characterized by a loss homeostasis of tear film,and accompanied by ocular symptoms. The treatment of dry eye aims to eliminate the cause of disease, relieve symptoms, and protect the visual function, among which psychological care, physical treatment of eyelid, health education and management outside the hospital are particularly important. High quality holistic nursing plan is helpful to the treatment of dry eye patients. Based on the consensus of the diagnosis and treatmen of dry eye,combined with our nursing experience, our team has developed and applied a personalized and comprehensive holistic nursing plan for dry eye patients.
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.
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.
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.
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.
目的:了解八年制医学生对全程导师的教学需求与满意度。方法:将中山大学八年制临床医学生分为低年级、高年级两组,均进行匿名线上问卷调查。分析问卷结果,并比较两组间的不同。结果:回收问卷352份。学生对导师个人“比较满意”占比高(低年级45.56% vs 高年级37.79%,P=0.087),对全程导师制度“比较满意”占比高(低年级 36.67% vs 高年级33.14%,P=0.806)。对全程导师制度“很了解”与“比较了解”的学生在低年级中明显低于高年级的占比(16.67% vs77.91%,P<0.001)。低年级学生期待全程导师在职业规划、临床思维、科研思维、心理健康发挥较大影响的占比均高于高年级的实际评估(构成比4个方面均P<0.001,选择“有很大影响”及“比较有影响”在低、高年级占比分别为83.33% vs 36.63%,92.22% vs 29.07%,91.67% vs 31.39%,62.78% vs 38.37%)。结论:学生对全程导师个人及制度均较满意,但存在低年级对该制度了解少、师生联系少、导师实际作用低于学生预期、科研训练机会不足等问题。亟需完善全程导师制,推动临床医学高水平人才的培养。
Objective: To evaluate the teaching needs and satisfaction of the eight-year program medical students to the whole-course tutors. Methods: An anonymous online questionnaire survey was conducted among the eight-year program medical students at Sun Yat-sen University. All students were divided the junior group and the senior group, and the differences between the two groups were compared. Results: A total of 352 valid questionnaires were collected. The proportion of students who were fairly satisfied with their whole-course tutors was 45.56% in the junior group and 37.79% in the senior group (P=0.087). The proportion of students who were fairly satisfied with the whole-course tutorial system was 36.67% in the junior group and 33.14% in the senior group (P=0.806). The proportion of students who “know well” and “know fairly well” about the whole-course tutorial system in the junior group was significantly lower than that in the senior group (16.67% vs 77.91%, P<0.001). The proportion of students in the junior group expecting their whole-course tutors “having a great impact” or “having some impact” on career planning, clinical thinking, scientific research thinking and mental health was significantly higher than that in the senior group (tests for proportions, all P<0.001, 83.33% vs 36.63%, 92.22% vs 29.07%, 91.67% vs 31.39%, 62.78% vs 38.37%). Conclusion: The eight-year program medical students are satisfied with their whole-course tutors and the whole-course tutorial system. However, some problems still exist, such as lower grade students lack of understanding of the whole-course tutorial system, insufficient contact between tutors and students, the actual influences of tutors failing to meet the students’ expectation, and insufficient opportunity of scientific research and training. It is urgent to improve the whole-course tutorial system and promote the cultivation of qualified medical talents.
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.