背景：目前已有研究报道了一种MATLAB的定制算法，用于Triton光学相干断层扫描血管成像(optical coherence tomography angiography，OCTA)图像的中心凹无血管区(fovea avascular zone，FAZ)的自动测量。由于这种算法非开源，且难以获取，因而大大限制了其在临床实践和科学研究中的应用。本研究提出一种用于Triton OCTA图像的FAZ自动分割的开源算法，即Smooth Level Sets macro(SLSM)算法，并将其测量结果与MATL AB和人工方法相比较，评估该算法分割的准确性和可靠性。方法：纳入35位健康受试者的35只健眼，选用Triton OCTA机器中的3 mm×3 mm扫描模式，对其黄斑区进行连续4次扫描。分别用人工和自动方法(包括MATL AB和SLSM)，测量浅层毛细血管图像中FAZ的面积、周长和圆度。分析各种自动算法的准确性、重复性，以及与人工方法结果的一致性。结果：SLSM算法的准确性仅低于人工方法，而高于MATLAB算法(Dice系数：人工方法，0.9568；SLSM，0.9506；MATL AB，0.9483)。SLSM和MATL AB测量FAZ面积的重复性均很高[组内相关系数(intraclass correlation coefficient，ICC)：SLSM，0.987；MATLAB，0.983]。SLSM、MATLAB测量FAZ面积的结果均与人工方法呈很高的一致性(ICC：SLSM，0.973；MATL AB，0.968)。结论：SLSM在Triton OCTA图像的FAZ自动分割中的准确性高于MATL AB，其测量结果与人工测量结果很相近。作为免费和开源的资源，SLSM有望成为Triton OCTA图像中有效可靠的FAZ自动分割和测量方法。

Background: Previous studies have proposed an automated customized program named MATLAB used in the foveal avascular zone (FAZ) measurements in Triton optical coherence tomography angiography (OCTA) images. But it is not open-source and not easy to obtain, which will largely restrict its application in clinical practice and medical research. In this study, we aimed to investigate the feasibility of the Smooth Level Sets macro (SLSM), a free and open-source program, and compared with the manual measurements and MATLAB in the FAZ quantification in Triton OCTA. Methods: Thirty-five eyes of 35 healthy subjects were scanned four times continuously using Triton OCTA. Manual and automated methods including the SLSM and MATLAB were used in the FAZ metrics (area, perimeter, and circularity) of the superficial capillary plexus. The accuracy, repeatability of all methods, and agreement between automated and manual methods were analyzed. Results: The SLSM presented higher accuracy with a higher average Dice coefficient (0.9506) than MATLAB (0.9483), which was just second to the manual method (0.9568). Both the SLSM [intraclass correlation coefficient (ICC) =0.987; coefficient of variation (CoV) =3.935%] and MATLAB (ICC =0.983; CoV =4.165%) showed excellent repeatability for the FAZ area. They also had excellent agreement with manual measurement (SLSM, ICC =0.973; MATLAB, ICC =0.968). Conclusion: The SLSM exhibits better accuracy than MATLAB in the automated FAZ measurement in Triton OCTA, the results of which were comparable to those obtained by manual measurement. This free and open-source program may be an accessible and feasible option for automated FAZ segmentation on Triton OCTA images.

视神经属于中枢神经的一部分，损伤后难以再生。视神经损伤通常伴随视网膜神经节细胞(retinal ganglion cells，RGCs)的持续性凋亡及视神经变性坏死，引起视力损害甚至完全失明。目前针对视神经再生的基础研究主要集中于保护和维持视神经损伤后RGCs的存活、促进RGCs轴突再生及重建视神经功能。本文以RGCs保护、轴突再生及视神经功能重建等为关键词，查询国内外最新视神经再生研究类文献，并分析整理，从抗氧化应激、提供外源性细胞因子、炎症刺激、抗胶质瘢痕、基因调控等方面阐述近年的视神经再生研究进展，以期对后续的基础研究开展及临床转化有所帮助。

Optic nerves are a part of the central nervous system, which is difficult to regenerate after injury. Optic nerve injury is usually accompanied by continuous apoptosis of retinal ganglion cells (RGCs) and degeneration or necrosis of optic nerves, resulting in visual impairment or even complete blindness. At present, the basic research on optic nerve regeneration mainly focuses on protecting and maintaining the survival of RGCs after optic nerve injury, promoting RGCs axon regeneration, and reconstructing optic nerve function. In this paper, RGCs protection,axon regeneration, and optic nerve function reconstruction are used as key words to collect the latest domestic and foreign literatures on optic nerve regeneration. The research progress of optic nerve regeneration in recent years was reviewed from the aspects of antioxidant stress, provision of exogenous cytokines, inflammatory stimulation, anti-glial scar, gene regulation and so on, in order to help the follow-up basic research and clinical translation.

目的：利用生物信息学方法分析与葡萄膜恶性黑色素瘤转移相关的非编码RNA，以及它们作为竞争性内源RNA的作用机制。方法：从癌症基因组图谱(The Cancer Genome Atlas，TCGA)数据库下载80例葡萄膜恶性黑色素瘤患者的RNA测序数据和临床资料，采用edgeR算法分析转移与非转移患者组织中差异表达(differentially expressed，DE)的长链非编码RNA(lncRNA)、微小RNA(miR)和mRNA，并构建lncRNA-miR-mRNA的竞争性内源RNA(competing endogenous RNA，ceRNA)调控网络，基因富集分析和通路分析研究网络中mRNA的生物学功能。Kaplan-Meier生存曲线分析ceRNA网络中核心RNA与生存率的关系。结果：从发生远处转移的葡萄膜恶性黑色素瘤样本中，共鉴定出346个上调的mRNA，118个下调的miR和45个上调的lncRNA。其中67个mRNA，7个miR和30个lncRNA相互组合形成616个ceRNA单元，并形成了一个具有181条边线ceRNA网络。基因富集分析表明：网络中的mRNA富集在肿瘤生成和转移相关的几个基因本体(Gene Ontology)和信号通路。拓扑分析确定了6个核心lncRNA(LINC00861、LINC02421、BHLHE40-AS1、LINC01252、LINC00513和LINC02389)和3个核心mRNA(UNC5D、BCL11B和MTDH)。 所有核心lncRNA、核心mRNA的表达水平和5个miR(miR-221、miR-222、miR-506、miR-507、miR-876)的表达水平均与总体生存率显着相关(均P<0.05)。结论：本研究揭示了几种lncRNA及其相关的ceRNA网络在葡萄膜恶性黑色素瘤转移中的作用，为进一步研究葡萄膜恶性黑色素瘤的发生和/或转移提供了新的方向。

Objective: To elucidate the expression of long non-coding RNAs (lncRNAs) and their roles as competing endogenous RNAs (ceRNAs) in uveal melanoma (UM) metastasis. Methods: RNA sequencing data and clinical information of 80 patients with UM were obtained from The Cancer Genome Atlas (TCGA) database. Differentially expressed (DE) mRNAs, microRNAs (miR), and lncRNAs between metastatic and non-metastatic individuals with UM were screened using the edgeR algorithm. Gene enrichment analysis was conducted for the DE mRNAs. LncRNA-miR-mRNA regulatory triples and a ceRNA network were constructed. Betweenness centrality was used to screen hub genes and lncRNAs for subnetwork analysis. Kaplan-Meier survival analysis was conducted to explore correlations between the expression of hub RNAs and overall survival in the TCGA UM cohort. Results: A total of 346 upregulated mRNAs, 118 downregulated miRs, and 45 upregulated lncRNAs were identified in samples with systemic metastasis. Among them, 67 mRNAs, 7 miRs, and 30 lncRNAs mapped to 616 ceRNA triples, thus forming an interconnected ceRNA network with 181 edges. Gene enrichment analysis revealed that mRNAs in the network were enriched in multiple gene ontology terms and pathways associated with carcinogenesis and metastasis. Topological analysis identified 6 hub lncRNAs (LINC00861, LINC02421, BHLHE40-AS1, LINC01252, LINC00513, and LINC02389) and 3 hub mRNAs (UNC5D, BCL11B, and MTDH). The expression levels of all hub genes and 5 DEmiRs (miR-221, miR-222, miR-506, miR-507, miR-876) were significantly associated with the overall survival probability. Conclusion: This bioinformatic study revealed the functions of several lncRNAs and their associated ceRNA network in UM metastasis. It provides a novel in silicon evidence for future experimental study on the pathogenesis of systemic metastasis in uveal melanoma, especially from the perspective of non-coding RNA.

目的：比较不同预设光学区组的飞秒激光小切口基质透镜取出术(small incision lenticule extraction，SMILE)和飞秒激光制瓣联合准分子激光原位角膜磨镶术(femtosecond laser-assisted in situ keratomileuses，FS-LASIK)术后有效光学区(effective optical zone，EOZ)大小与角膜高阶像差(high order aberrations，HOAs)变化以及有效光学区大小对角膜高阶像差的影响。方法：收集2019年2月 至2020年5月来佛山市第二人民医院行激光手术的患者80例，均取右眼入组，SMILE组43例，FSLASIK组37例，按预设光学区大小分为6.5 mm和6.0 mm组，分别于术前和术后1个月应用Pentacam三维眼前节分析系统测量有效光学区及总角膜高阶像差、彗差、球差，分析不同预设光学区下SMILE组和FS-LASIK组有效光学大小及与角膜高阶像差的关系。结果：在相同预设光学区下，术后1个月SMILE组的有效光学区均大于FS-LASIK组，差异均有统计学意义(均P<0.05)，且SMILE组的角膜总高阶像差、球差、彗差均较FS-LASIK组低，差异均有统计学意义(均P<0.05)；对于相同手术方式，预设光学区6.0 mm较6.5 mm组，术后1个月角膜总高阶像差、球差、彗差均升高，差异均有统计学意义(均P<0.05)。结论：SMILE组和FS-LASIK组术后1个月的有效光学区均小于预设光学区，SMILE组大于FS-LASIK组；术后1个月有效光学区越大，角膜高阶像差越小；在相同预设光学区下，SMILE组术后1个月角膜高阶像差小于FS-LASIK组。

Objective: To compare the effective optical zone (EOZ) and the changes in corneal high order aberrations (HOAs) after small incision lenticule extraction (SMILE) with those after femtosecond laser-assisted in situ keratomileuses (FS-LASIK). Methods: This study included 80 subjects who underwent laser refractive surgery at the Second People’s Hospital of Foshan between February 2019 and May 2020. Only data from the right eye of each subject were analyzed. A total of 43 eyes underwent SMILE while 37 eyes received FS-LASIK. The eyes were further stratified into subgroups based on different programmed optical zones: the 6.5 mm group and the 6.0 mm group. EOZ, coma, and spherical aberration were measured with Pentacam 3D anterior segment analysis system preoperatively and one month postoperatively. In addition, the relationship between EOZ and corneal HOAs was analyzed and compared between different optical-zone groups after SMILE and FS-LASIK. Results: For the same programmed optical zone, the SMILE group achieved a significantly greater EOZ than the FS-LASIK group who was measured 1-month postoperatively did (P<0.05). Meanwhile, corneal HOAs, spherical aberration, and coma in the SMILE group are significantly lower than those in the FS-LASIK group (P<0.05). For the same procedure (SMILE or FS-LASIK), the 6.0 mm group demonstrated significantly higher corneal total HOAs, spherical aberration, and coma than the 6.5 mm group did 1-month after the surgery (P<0.05). Conclusion: In both the SMILE and the FS-LASIK groups, 1-month postoperative EOZ was smaller than the programmed optical zone. EOZ in the SMILE group was larger than that in the FS-LASIK group. The larger the 1-month postoperative EOZ was, the lower corneal HOAs were. For the same programmed optical zone, 1-month postoperative corneal HOAs in the SMILE group is lower than that in the FS-LASIK group.

目的：调查干眼在郑州市机关工作者中的患病情况，分析相关危险因素，为有效防治干眼提供科学依据。方法：选取2019年9月到2020年9月在郑州大学第一附属医院体检的郑州市机关工作者873例。采用自行设计的一般资料问卷和OCULUS Jenvis-OSDI干眼问卷进行调查，记录评分结果，同时检查记录裂隙灯、角膜荧光素染色评分(corneal fluorescein staining score，FL)、基础泪液分泌实验(Schimier I test，SIT)、泪膜破裂时间(tear break-up time，BUT)测定结果。统计分析机关工作者干眼患病率与危险因素。结果：体检的873例郑州市机关工作者中360例诊断为干眼，干眼总患病率为41.24%，女性患病率(44.62%)明显高于男性(36.26%)，差异有统计学意义(P=0.014)。干眼问卷OSDI评分与FL评分呈正相关，BUT与SIT呈正相关，OSDI(和FL评分)与BUT(和SIT)呈负相关。Logistics多因素分析表明：干眼家族史、绝经、曾行眼部手术、滴眼液使用情况、长时间佩戴角膜接触镜、长时间操作视频终端、睡眠不足、糖尿病史是机关工作者干眼患病的危险因素(均P<0.05)，而饮酒是保护因素(P=0.001)。结论：机关工作者干眼患病率较高，危险因素囊括家族患干眼史、绝经、曾行眼部手术、滴眼液使用情况、长时间佩戴角膜接触镜、长时间操作视频终端、睡眠不足、糖尿病病史。加强干眼防治的宣传教育，针对不同危险因素提供眼健康指导并进行防控治疗，保护机关工作者的眼健康。

Objective: To investigate and analyze the prevalence of dry eyes in Zhengzhou office workers, and identify the related risk factors in order to provide evidence for effective prevention and treatment. Methods: We selected 873 cases of Zhengzhou office workers who had checkup in our hospital from September 2019 to September 2020 as the research subjects. They were investigated with self-designed general information questionnaire and OCULUS Jenvis-OSDI dry eye questionnaire and scores of the questionnaires will be assessed. At the same time,they underwent dry-eye-related inspections such as slit lamp examination, corneal fluorescein staining score (FL), Schimier I test (SIT) and tear break-up time (BUT) assessment. The prevalence and risk factors of dry eyes in these office workers were statistically analyzed. Results: Among 873 Zhengzhou office workers, 360 cases were diagnosed as dry eyes, and the total prevalence of dry eye was 41.24%. The female prevalence rate was 44.62%, which was significantly higher than that of male (36.26%, P=0.014). OSDI scores and FL scores were positively correlation as well as BUT and SIT, while OSDI (and FL) and BUT (and SIT) were negatively correlation. Logistic multivariate analysis showed that dry eyes family history, menopause, ocular surgery history, eye drops using, long time corneal contact lenses wearing, long time video terminal operating, lack of sleep and diabetes history were independent risk factors in office workers’ dry eye disease (all P<0.05), while drinking was protective factor (P=0.001). Conclusion: The dry eyes prevalence is high among office workers. The risk factors include dry eye family history, menopause, ocular surgery history, eye drops using, long time corneal contact lenses wearing, long time video terminal operating, lack of sleep and diabetes history. We should strengthen the publicity and education of the dry eye prevention and treatment, provide eye health guidance, prevention and treatment according to different risk factors, and protect the office workers’ eye health.

目的：了解重度视力损伤和盲患者居家的主要护理问题及护理需求的内容，为医护人员制订居家照护支持计划提供依据。方法：采用描述性质性研究方法，于2020年4至9月对在广州市某三甲眼科专科医院的20例重度视力损伤和盲的住院患者进行面对面的半结构式访谈，采用归纳式内容分析法对访谈资料进行分析。结果：重度视力损伤和盲患者居家的主要护理问题有日常生活自理的能力缺失、外出社交活动受限和难以适应家庭角色的改变；护理需求包括希望医院提供多维度的疾病相关知识和提供多渠道的医疗咨询服务。结论：重度视力损伤和盲患者居家照护存在诸多的护理问题及需求，患者希望得到多维度相关知识和多渠道医疗咨询，医院、社区应该高度重视此类患者，同时给予相应的指导和帮助，从而提高患者的居家生活质量。

Objective: To explore the main nursing problems and demands of patients with severe visual impairment or blindness, so as to provide the basis for health staff to formulate home care support plans of high quality. Methods: By using a descriptive qualitative method, face-to-face semi-structured interviews were conducted among 20 patients with severe visual impairment or blindness who were hospitalized in the top-grade ophthalmic hospital in Guangzhou from April to September 2020. The inductive content analysis method was used to analyze the data. Results: The main nursing problems of these patients were the lack of self-care ability, limited social activities, and difficulty in adapting to changes in family roles. Nursing needs include the hope that hospitals can provide multidimensional disease-related knowledge and multi-channel medical consulting services. Conclusion: Patients with severe visual impairment or blindness have many problems and needs in home care. They would like to obtain multi-dimensional knowledge and receive multi-channel medical consultation. Health staff from hospitals and communities should attach great importance to these patients, as well as provide appropriate guidance and assistance, so as to improve their activities of daily living.

随着科学技术的提高、手术方式的改进，角膜屈光手术成为治疗近视的主要方式。角膜屈光手术后角膜形态及生物力学的变化对于尽早发现术后相关并发症及术后长期稳定性具有重要意义，不同的术式及术后不同的恢复阶段角膜表面非球面参数及生物力学指标的变化存在一定差异，明确其变化的原因及机制可对临床研究提供一定的参考。

With the improvement of science and technology and the improvement of surgical methods, corneal refractive surgery has become the main way to treat myopia. The changes of corneal morphology and biomechanics after corneal refractive surgery are of great significance for early detection of postoperative complications and also affect the long-term stability after corneal refractive surgery. There are some differences in the changes of aspheric parameters and biomechanical properties in different surgical procedures and different postoperative recovery stages. Clarifying the reasons and mechanisms of these changes can provide some reference for clinical research.

晚期糖尿病(diabetes mellitus，DM)患者常出现的糖尿病性视网膜病变能够被发现，而糖尿病性角膜病变(diabetic keratopathy，DK)却时常被人们忽略。近年来的许多研究表明，DK对角膜的结构、代谢、生理功能等多个方面均有重要影响。目前临床上尚无根治DK的有效疗法，现主流疗法多集中于对症治疗以维持光滑湿润的眼表，最大限度地减少视觉损失以及提高舒适度，如局部滴用人工泪液、使用角膜绷带镜及局部使用抗炎药物等，但这些现有的治疗方法对于角膜组织损伤的修复能力有限。近年来出现神经生长因子、胰岛素疗法等新兴的治疗方法，有望未来应用于临床。

The diabetic retinopathy which often occurs in patients with advanced diabetes mellitus (DM) can usually be realized, but diabetic keratopathy (DK) could sometimes be ignored. In recent years, many studies have found out that DK can cause significant abnormal changes in many ways, including structure, metabolism and physiological functions of the cornea. At present, there is no effective therapy to cure DK. The current mainstream therapy mostly focuses on symptomatic treatment to maintain a smooth and moist ocular surface, minimize visual loss and improve comfort, such as local drip of artificial tears, use of corneal bandage lens and local use of anti-inflammatory drugs. However, these existing treatment methods have limited repair ability for corneal tissue damage. In recent years, a number of new treatment methods have emerged, which are expected to be clinically used in the future, such as nerve growth factors and insulin therapy.

临床上儿童外眦部肿物合并眼睑畸形及结膜肿物少见，需在切除眼睑、结膜肿物的同时，灵活处置眼睑整复。本文回顾2例就诊于北京儿童医院的先天性外眦肿物合并眼睑缺损的病例。术后病理示皮赘伴结膜皮样脂肪瘤。患儿眼睑肿物切除彻底，眼睑整复后外观满意。

Lateral canthus mass with eyelid deformity and conjunctival mass is rare in children. The eyelid reduction should be handled flexibly while the mass is removed. Two cases of congenital lateral canthus with eyelid coloboma were reviewed in Beijing Children’s Hospital. Postoperative pathology showed fibroepithelial polyp and conjunctival dermolipoma. The eyelid masses of the child were completely excised, and the appearance was satisfactory after eyelid reduction.

八年制医学教育的目的是培养适合我国国情的高素质医学人才。本文回顾了我国八年制医学教育的产生与发展；介绍了八年制医学教育改革中各个方面积极的探索，包括教师改革、教学理念改革、教学方法改革、教学手段变化和特色课程设置等；总结了我国目前八年制医学教育的现状；并探讨了进一步完善这一教育体系，提高八年制医学生素质的策略与方案。

The purpose of the eight-year medical education is to train students for well-qualified medical talents that are in line with our national conditions. This article introduces the establishment and development of the eight-year medical education in China, and various aspects of exploration in its reform which includes the reform of the tutoring system, teaching philosophy, teaching approach, means of teaching, special courses and so on. It also summarizes the current situation of the eight-year medical education and discusses potential strategies to improve the education system and the quality of eight-year medical students.

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.