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AIM: To evaluate the efficacy of 0.01% hypochlorous acid as a conjunctival sac disinfectant before cataract phacoemulsification and its impact on the ocular surface.METHODS: Randomized controlled clinical trial. A total of 285 patients who were scheduled for cataract phacoemulsification surgery were randomly divided into the hypochlorous acid group and the povidone iodine group. Before and after disinfection, conjunctival sac swabs were taken, and bacterial culture and colony-forming units(CFUs)testing were performed using blood agar and chocolate agar media, respectively. All patients were evaluated for ocular symptom scores and pain severity scores 2 h, 1 d, and 1 wk after disinfection, and underwent corneal fluorescein staining, eye redness index, tear meniscus height, and noninvasive breakup time(NIBUT)examination. The incidence of endophthalmitis after surgery was recorded.RESULTS: Conjunctival sac disinfection with 0.01% hypochlorous acid significantly reduced the rate of positive bacterial cultures and colony-forming ability of the conjunctival sac, with statistically significant differences compared with the pre-disinfection period(both P<0.01), and the disinfecting ability of hypochlorous acid was comparable to that of povidone-iodine(χ2=0.811, P=0.368). The scores of ocular symptoms and pain severity in the hypochlorous acid group were significantly lower than those in the povidone-iodine group(both P<0.01). The corneal fluorescein staining and eye redness index in the hypochlorous acid group were significantly lower than those in the povidone-iodine group(all P<0.01). No endophthalmitis occurred in either group of patients. CONCLUSION: As a conjunctival sac disinfectant, 0.01% hypochlorous acid is safe and effective, with minimal discomfort and damage to the ocular surface in patients.
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AIM:To establish a model of meibomian gland dysfunction in rats induced by eyeliner tattoo and investigate its potential mechanisms.METHODS:A total of 40 SD rats were selected, with 30 randomly chosen to have eyeliner tattoo applied their right eyes and designated as the eyeliner group. The remaining 10 rats were not given any treatment and served as the normal group. The corneal morphology of both groups was observed using a slit lamp at 1, 2, and 4 wk after establishment, and the tear film break-up time(BUT), Schirmer I test(SIt), corneal fluorescein staining score, and corneal irregularity score were calculated. The corneal Placido rings were examined using an ocular surface analyzer, and the corneal tissue structures of both groups were observed under a confocal microscope. After 4 wk and completion of clinical indicator recording, the eyeballs and upper and lower eyelid tissues were taken for pathological examination. The meibomian gland structures were observed through HE staining, the conjunctival goblet cells were observed using PAS staining, and the lipid droplets were observed with ORO staining.RESULTS:The slit lamp examination results showed that the eyeliner group rats exhibited in situ black pigmentation in the eyelids, with no eyelid deformation or scarring. The corneal epithelium was rough, with positive fluorescein staining, presenting as spotty staining that worsened over time. Compared with the normal group, the BUT was significantly shortened, tear secretion volume was significantly decreased, and the corneal fluorescein staining score and corneal irregularity score were significantly increased at 1, 2, and 4 wk after modeling in the eyeliner group(all P<0.01). The corneal confocal microscopy results showed a decrease in corneal epithelial cells in the eyeliner group, with the appearance of abnormally bright cells, and inflammatory cell infiltration visible in the stromal layer. The ORO staining results revealed a decrease in lipid droplets in the eyeliner group, showing a downward trend with increasing observation time. The HE staining results showed that pigment blocked the meibomian gland openings in the eyeliner group, and the density of meibomian gland acini showed a downward trend over time. The PAS staining results showed a decreasing trend in the number of PAS-positive cells in the eyeliner group.CONCLUSION:Eyeliner tattoo can induce meibomian gland dysfunction, and the blockage of meibomian gland openings caused by the pigment particles used may be an important cause of meibomian gland dysfunction.
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Due to the cultural lack in second documents'analysis of medical tangle,and the clinical teachers'three bases weakening,the facts that medical students fail to devote to communication between hospitals and patients,and the disjunction between the practice outline and clinical practice,trigger the reflection on the teaching professional level and the educational quality.First,we carry out the systematic construction of chnical practice teaching which includes aim orientation,curriculum design,resource integration,quality management and effectiveness evaluation.Second,we inelusively develop clinical professional skiUs and humanist accomplishment.Above all,we take the initiative to conform the teaching,including knowledge,technology,methods,and implement,to the incubation containing virtue,group,labor and pleasing,all of which promote a variety of needs of study and teaching
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Faced with the rate’s drop of the Chinese clinical graduates’physician qualification examination and the experimental evaluation feedbacks from global medical education standard, we set up a research in clinical teaching bases’educational guarantee mechanism of medical colleges and universities. With the action research method and the descriptive studies in the definition of guarantee mechanism, the demand of graduates, the system of clinical lectures and the revolution of teaching mode, the standard of education, the system of basic condition datadetection, and the planning and the policy of clinical teachers’growth, we constructed the technical route of the leader’s supporting responsibilities, the teachers’professional roles and the students’ clinical teaching bases’ quality. We applied an empirical study in affiliated and non-affiliated hospitals of western and Chinesetraditional medicine and achieved predicted effort.
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International services trade in the light of the principles of WTO makes a dif-ference in medical domain when confronting the direction of the global educational services. The Ministry of Education Project,"The Research of medical distance education and practice pattern in rural areas in west China",establishes an educational platform of modern service in central China, invests nursing human resources of west China and outputs vocational standard patients in east China,which provides school of medicine,especially English class of Chinese system,with abundant social teaching resources and has been adopted as Shanghai Human Resources Training Project.
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It is necessary to integrate students, teachers and content with learning-centralization so that time and space will no longer be parted in modern distance-education system. Guided by KAQ pattern, we suggest that we should integrate subjects in teaching activity, form support system and normalize information management process. All these are essential for the project of modern distance education.