目的：建立眼科专科护理门诊及探讨其实施效果。方法：调查2020年7月开展眼科护理门诊以来至2022年3月就诊的206例患者满意度和健康知识知晓率，并由医生、护士对眼科专科护理门诊的实践效果进行评价。结果：206例患者满意度较好，总分在90以上；眼科专科护理门诊针对患者问题提供个体化护理服务，进行眼部检查206人次，健康教育206人次，滴眼药水、涂眼药膏操作示范184人次，术后特殊体位指导38人次，滤过泡按摩26人次，为患者提供了多元化护理服务；同行评价显示眼科护理门诊体现了护士的专业价值；患者就诊后的健康知识知晓率明显高于就诊前，差异有统计学意义(P<0.001)。结论：眼科专科护理门诊的开设满足了患者多元化护理服务需求，提高了患者满意度和健康知识知晓率，提升了护士的自我价值感，为专科护士提供了职业发展平台，促进了眼科专科护理的发展。
Objective: To explore the establishment and effect of ophthalmology specialist nursing clinic. Methods: To Investigate the satisfaction and the awareness rate of health knowledge of 206 patients who visited ophthalmology specialist nursing clinic from July 2020 to March 2022. Doctors and nurses were investigated for evaluation of the clinic. Results: A total of 206 patients were satisfied with a total score of 90 points or more; the ophthalmology specialist nursing clinic provided individualized nursing services for patients’ problems, conducted 206 eye examinations and 206 health education, and demonstrated the operation of eye drops and eye ointment 184 times. 38 patients received post-operative special posture guidance and 26 patients received filter bubble massages. The clinic provided patients with diversified nursing services. Peer reviews showed that the ophthalmological care clinic reflects the professional value of nurses; the awareness rate of health knowledge after the patient’s visit was significantly higher than that before the visit, and the difference was statistically significant (P<0.001). Conclusion: The establishment of ophthalmology specialist nursing clinic meets patients for diversified nursing services, improves patients’ satisfaction and health knowledge awareness rate, and improves nurses’ sense of self-worth. Furthermore, it provides a career development platform for specialist nurses and promotes the development of ophthalmic specialist nursing.
近年来随着人类生活方式的改变、用眼频率的增加，眼科药物的市场需求持续增长，但是目前眼病治疗仍面临“缺医少药”的困境。由于新药研发面临成本高、周期长、成功率低的风险，眼科药物创新迭代的进程日趋缓慢。人工智能(artificial intelligence，AI)作为一种全新的技术手段，有望赋能眼科药物研发的全过程，包括药物靶点发现、化合物筛选、药物动力学模型创新与临床试验开展等，以期为眼科药物研发“降本增效”。且随着大数据体系的完善、硬件计算力的提升以及生命科学与智能科学的深度融合，AI在眼科药物研发中的作用将进一步得到提升，助力眼科药物研发实现从精准化到智能化的跨越。
With the change of human lifestyle and overuse of eyes in recent years, the market demand for ophthalmic drugs continues to grow. However, the ocular therapy is still facing the shortage of doctors and drugs. Due to the risk of high cost, long lead time and low success rate, the process of novel ophthalmic drug innovation and iteration is getting slower. As an emerging technology, artificial intelligence is expected to enable the whole process of ophthalmic drug discovery and development, including drug target discovery, compound screening, pharmacokinetic model innovation and clinical trials, thus reducing R&D costs and increase efficiency for ophthalmic drug discovery and development. In addition, with the improvement of big data, hardware calculation and the deep integration of life science and intelligent science, the role of artificial intelligence in ophthalmic drug discovery and development will be significant improved , contributing to achieve the leap from precision to intelligence.
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.
手术前常规检查在临床诊疗中被广泛应用，但在一些低风险择期手术前对患者进行常规检查，对提高医疗质量并无帮助，反而降低了医疗效率，增加了医疗费用。为提高效率，一些地区、机构和专家学者陆续通过宣传教育、发表共识、制定指南等方式控制无指征术前常规检查，但效果仍依赖于执业者的重视程度和专业水平。大数据机器学习方法以其标准化、自动化的特点为解决这一问题提供了新的思路。在回顾已有研究的基础上，我们抽取2017至2019年在中山大学中山眼科中心进行眼科手术的3.4万名患者的病史和体格检查资料大数据，涵盖年龄、性别等口学信息，诊断、既往疾病等病史信息，视功能、入院时身体质量指数(BMI)等体格检查信息。并以此为基础使用机器学习方法预测术前胸部X线检查是否存在异常，受试者操作特性曲线(receiver operating characteristic curve，ROC)曲线下面积达到0.864，预测准确率可达到81.2%，对大数据机器学习精简术前常规检查的新方式进行了先期探索。
Preoperative routine tests are widely prescribed in clinical settings. However, these tests do not help improving the quality of medical care in low-risk elective surgery. Instead, they are associated with lower efficiency and increasing fees. To improve the efficiency, many regions, institutions, and scholars have attempted to reduce preoperative routine tests without indications through propaganda, education, consensus, and guidelines. Nevertheless, the effects are still highly dependent on the expertise and emphasis of practitioners. Machine learning based on big data provide a new solution with its standardization and automation. Through literature review, we extracted the big data, including demographic features such as sex and age, histories including diagnosis and chronic diseases, and physical examination features such as visual function and body mass index. A total of 34 000 patients undergone ocular surgeries in Zhongshan Ophthalmic Center, Sun Yat-sen university from 2017 to 2019. Machine learning was adopted to predict the risk of finding abnormalities in chest X-ray examination, with an accuracy of 81.2%. Area under the Receiver Operating Characteristic curve was 0.864. The study could be an early exploration into the field of simplifying preoperative tests by machine learning.
建立标准化的数据中心有利于收集高质量数据资源与促进医学人工智能的发展，在医疗大数据的基础上建立不同应用场景的医疗人工智能系统，整合、搭建可满足多种疾病诊疗需求的智能服务云平台，全面提升智能医疗管理的效率。本文以眼科为研究基础，对眼科数据中心和智能服务云平台的建设经验进行总结分析，为眼科及其他专科开展人工智能研究、建立数据中心、搭建智能服务云平台等方面提供参考。
The establishment of standardized data center can promote the accumulation of high-quality data resources and the development of medical artificial intelligence. On the basis of medical big data, medical artificial intelligence systems in different application scenarios can be established and integrated into an intelligent service cloud platform, which improves the management efficiency of intelligent medical systems. This article takes ophthalmology as a prototype to summarize the experience of the establishment of ophthalmic data center and intelligent service cloud platform, aiming to provide reference and guidance for ophthalmology and other specialties to carry out artificial intelligence research, establish data center and build an intelligent service cloud platform.
目的：评价StarEyes 900(万灵帮桥，中国)与IOLMaster 500(蔡司，德国)2种眼科光学生物测量仪测量健康受试者眼部参数的差异性、相关性及一致性。方法：前瞻性观察2021年6月至7月于中山大学中山眼科中心进行眼部检查的62例健康受试者共124只眼，分别通过StarEyes 900与IOLMaster 500完成眼轴长度(axial length，AL)、最小角膜屈光力径线上角膜曲率(keratometry for the flattest meridian，Kf)、最大角膜屈光力径线上角膜曲率(keratometry for the steepest meridian，Ks)、平均角膜曲率(mean keratometry，Km)、角膜白到白直径(white-to-white corneal diameter，WTW)等参数的测量，采用配对t检验、Pearson相关分析和Bland-Altman法对其测量结果的差异进行评价。结果：StarEyes 900与IOLMaster 500测量的AL分别为(24.18±1.08) mm和(24.16±1.08) mm；Kf分别为(42.84±1.65) D和(43.04±1.57) D；Ks分别为(44.34±1.90) D和(44.17±1.80) D；Km分别为(43.59±1.73) D和(43.61±1.64) D；WTW分别为(11.64±0.29) mm和(11.64±0.30) mm。StarEyes 900与IOLMaster 500在测量Km、WTW时，其差异无统计学意义(P>0.05)，而在AL、Kf、Ks的测量上差异有统计学意义(P<0.01)。其中StarEyes 900所测的AL和Ks值大于IOLMaster 500，而Kf、Km和WTW值则小于IOLMaster 500。经Pearson相关分析，2种仪器的测量结果均表现出较高的相关性；经Bland-Altman法评价，2种仪器的测量结果均表现出较高的一致性。结论：StarEyes 900与IOLMaster 500测量的Km、WTW均表现出较高的一致性，2种方法可互为参考；测量的AL、Kf、Ks存在的差异具有统计学意义；各项参数的测量均具有较好的相关性和一致性。
Objective: To evaluate the difference, correlation and agreement of eye parameters measured by StarEyes 900 visual function analyzer (Wan Ling Bang Qiao, China) and IOLMaster 500 (Carl Zeiss, Germany) swept-source optical coherence tomography biometer. Methods: A prospective study was designed involving 62 healthy subjects (124 eyes) undergoing ophthalmic examinations in Zhongshan Ophthalmic Center from June 2021 to July 2021. Data from their both eyes were selected for analysis in all patients. Axial length (AL), keratometry for the steepest meridian (Ks), keratometry for the flattest meridian (Kf), mean keratometry (Km) and corneal diameter (WTW) were measured by the StarEyes 900 visual function analyzer and IOLMaster 500 swept-source optical coherence tomography biometer. A paired t-test was used to analyze the differences in measurement results. The Pearson correlation coefficient was used to analyze the correlation. Bland-Airman method was used to assess the agreement of the instruments. Results: The AL, Kf, Ks, Km and WTW obtained by StarEyes 900 and IOLMaster 500 were (24.18±1.08) mm and (24.16±1.08) mm, (42.84±1.65) D and (43.04±1.57) D, (44.34±1.90) D and (44.17±1.80) D, (43.59±1.73) D and (43.61±1.64) D, and (11.64±0.29) mm and (11.64±0.30) mm, respectively. The Km and WTW of the two devices showed no significant difference (P>0.05), while the AL, Ks and Kf showed significant differences (all P<0.01). The AL and Ks obtained by StarEyes 900 were higher than by IOLMaster 500, while the Kf, Km and WTW were lower. The measurements of five aforementioned biometric parameters by both devices showed good correlation by Pearson correlation coefficient and good agreement by Bland-Airman. Conclusion: The Km and WTW measured by the two devices showed no significant difference, and provided references to one another. The difference in AL, Kf and Ks between the two devices showed significant differences. All of the measurements showed good correlation by Pearson correlation coefficient and good agreement by Bland-Airman.
克服现有婴幼儿眼科手术病号服存在的穿脱不便、容易着凉、无法避免患儿抓挠术眼等问题，提供一种便于穿脱、保护胸腹部和术眼的婴幼儿眼科手术病号服*。
Abstract Present patient clothing for infants and children with ophthalmic surgery have several limitations, which is inconvenient to wear, hard to keep warm and difficult in preventing patients from scratching eyes underwent surgery. A modified patient clothing for infants and children is designed to overcome these existing problems.
目的：调查中山大学中山眼科中心参加分子医学实验技能培训课程的研究生学员上课前的实验基础，为研究生实验技术课程的备课提供参考。方法：对2020年及2021年参加分子医学实验技能培训课程的博士和硕士研究生进行课前问卷调查。从理论知识和操作经验两方面对15个专题课程进行分析。结果：共155名学生完成问卷调查。在全部专业研究生中，25%以上学生对理论知识不了解的专题有14个，而仅有10%以下学生熟练操作的专题有6个；分子医学专业的优于前者，不了解和熟练掌握的专题个数分别是9和12。理论掌握程度最低的4个专题是细胞增殖、流式细胞、图像采集和组学分析。15个小专题整合成7个大专题，操作熟练程度由低到高依次是：眼科实验数据收集、组学技术、数据分析、细胞技术、蛋白技术、组织分析、分子技术。结论：新入学研究生存在分子医学实验技能基础理论知识薄弱以及科研训练不足等问题，迫切需要改善实验技能培训制度，深化课程体系建设。
Objective: To conduct a pre-course survey on the graduate students who participated in the Molecular Medicine Laboratory Skills Training Course in the Zhongshan Ophthalmic Center of Sun Yat-sen University to provide a reference for the preparation of the course. Methods: We asked the doctoral and master’s students who participated in the training courses of molecular medical experimental skills in 2020 and 2021 to take a pre-course questionnaire survey and analyzed the results by the students’ pre-course command of theoretical knowledge and pre-training operational experience in 15 lessons of special topics or techniques. Results: A total of 155 students completed the pre-course questionnaire survey. Our results showed that there were 14 lessons in which more than 25% of the students were not familiar with the theoretical knowledge, whereas there were 6 lessons in which less than 10% of the students had high operational proficiency. The students majoring in the molecular medicine had better prior knowledge of the techniques: there were only 9 lessons in which more than 25% of the students were not familiar with the theoretical knowledge, whereas there were 12 lessons in which less than 10% of the students had high operational proficiency. The four lessons with worst prior knowledge were cell proliferation, flow cytometry, image acquisition, and omics analyses. We grouped the 15 lessons into 7 categories: the ophthalmic experimental data collection, the omics technology, the data analyses, the cell technology, the protein technology, the tissue analyses, and the molecular technology, presenting by the level of the students’ pre-training proficiency from low to high. Conclusion: The first-year graduate students were very weak in basic knowledge and had little experience in techniques before joining the molecular medicine training courses. It is urgent to improve the laboratory skills training system and strengthen the construction of the curriculum system.
目的：了解眼科住院医师规范化培训学员(规培生)的沟通技能态度和人际沟通能力现状。方法：对中山大学中山眼科中心三个年级规培生的沟通态度和人际沟通能力进行问卷调查，并进一步分析其沟通态度与沟通能力的相关性。结果：共纳入196名规培生，沟通积极态度量表总分为51.38±6.52，消极态度为36.80±5.70，人际沟通能力为2.41±0.40，辅导与咨询维度得分为2.50±0.64，提供有效的负面反馈维度得分为2.61±0.50，支持性沟通维度得分为2.29±0.44。沟通技能的积极态度与人际沟通能力和三维度之间显著相关(P<0.01)。人际沟通技能得分与性别、规培年级、喜欢眼科专业的程度、得到家庭的关爱程度、得到朋友的关爱程度等因素显著相关(P<0.05)。结论：眼科规培生对沟通技能的积极态度优秀，但是总体沟通能力较弱，并受到多种因素影响。应充分重视规培生人际沟通能力的培养，开展医患沟通的专业化培训。
Objective: To evaluate the current status and correlations between attitudes and competency for interpersonal communication in ophthalmology standardized training trainee. Methods: A questionnaire survey was conducted on the communication attitudes and interpersonal communication ability of standardized training trainees from three grades in Zhongshan Ophthalmic Center, affiliated to Sun Yat-sen University, and the correlation between communication attitude and communication ability was further analyzed. Results: A total of 196 trainees were included. The scores of positive attitude, negative attitude, and interpersonal communication skills were 51.38±6.52, 36.80±5.70, and 2.41±0.40, respectively. In addition, the dimension of coaching and counseling scores were 2.50±0.64, the dimension of providing effective and negative feedback scores were 2.61±0.50, and the dimension of supportive communication scores were 2.29±0.44. The positive attitudes of communication skills were significantly related to the interpersonal communication skills and three-dimensionality (P<0.01). The interpersonal communication skills were significantly associated with sex, grades, interest in ophthalmology, social support from the family and friends (P<0.05). Conclusion: Ophthalmology trainees have excellent positive attitudes toward communication skills, but the overall communication skills are weak and influenced by a variety of factors. More attention should be paid to the development of interpersonal communication skills of the trainees, and specialized training in doctor-patient communication is warranted.
近年来，眼科手术后的疼痛受到关注，部分患者术后表现出疼痛区域扩大，神经性畏光。术后这种 对伤害性刺激性信号反常性增加的现象称之为痛觉过敏。痛觉过敏的发展会导致患者延迟术后恢 复等问题。此外，痛觉过敏还会引起患者不适，诱使患者使用更多的止痛药而产生相关的不良反 应。而TRPV1/TRPA1是一种伤害性感受器，能够被伤害性刺激特异性激活而诱发痛觉过敏。尽管 如此，目前关于眼科术后的痛觉过敏发病机制未完全阐明，TRPV1如何增敏导致痛觉过敏的分子生 物学过程尚未明确。
The postoperative pain of ophthalmic surgery has been widely concerned in recent years. Some patients show enlarged painful areas and neurophotophobia postoperatively. This abnormal increase in noxious irritant signals after surgery is called hyperalgesia. The development of hyperalgesia can result in delayed postoperative recovery for patients. In addition, hyperalgesia can also cause discomfort for patients, and induce patients to use more analgesics, which can have related side effects. TRPV1/TRPA1 is a nociceptor, which can be specifically activated by nociceptive stimuli to induce hyperalgesia. Nevertheless, the pathogenesis of hyperalgesia after ophthalmology surgery has not been fully elucidated, and the molecular signal pathway of how TRPV1 sensitizes and causes hyperalgesia is not yet clear.
