[Efficacy of small incision lenticule extraction combined with femtosecond laser-assisted in situ keratomileusis for optimized monovision correction in myopia patients with presbyopia].

Objective: To evaluate the efficacy of optimized monovision correction using small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) in myopic patients with presbyopia and to assess the corneal epithelial remodeling following these procedures. Methods: A prospective study was conducted. Thirty-two patients (64 eyes) with myopia and presbyopia who underwent surgical correction at Chongqing Bai Ji Eye Clinic from August 2021 to April 2023 were continuously included. There were 9 males and 23 females, with an average age of (44.25±2.96) years. The dominant eyes (32 eyes) underwent SMILE, while the non-dominant eyes (32 eyes) underwent FS-LASIK with mild myopia and partial negative spherical aberration induction. Data on visual acuity and refraction were collected preoperatively and at 1 week, 1 month, 3 months, and 6 months postoperatively. Total ocular aberrations were measured using the iProfiler Plus, and the corneal epithelial thickness in different regions was assessed using anterior segment optical coherence tomography. Safety and efficacy indices were calculated based on visual acuity, the defocus and contrast sensitivity were measured using the Binoptometer 4P binocular vision tester, and a patient satisfaction survey was performed. Results: At 1 week postoperatively, the uncorrected distance visual acuity (UDVA) of dominant eyes significantly improved compared to preoperative values. At 3 months postoperatively, the uncorrected near visual acuity (UNVA) of non-dominant eyes showed significant improvement (P<0.05), 96.9% (31 eyes) of the dominant eyes achieved UDVA of 1.0 or better, and 93.8% (30 eyes) of the non-dominant eyes achieved UNVA of 0.8 or better. The safety index for distance vision was 1.15±0.09, and the efficacy index was 1.15±0.11. At 1 week, 1 month, 3 months, and 6 months postoperatively, the proportion of dominant eyes with a spherical equivalent (SE) deviation within ±0.50 D of the target was 90.6% (29 eyes), 90.6% (29 eyes), 93.8% (30 eyes), and 96.2% (31 eyes), respectively; for non-dominant eyes, the corresponding proportions were 81.3% (26 eyes), 87.5% (28 eyes), 93.8% (30 eyes), and 96.2% (31 eyes). The postoperative spherical aberration was (0.11±0.03) µm for dominant eyes and (-0.01±0.04) µm for non-dominant eyes, showing a statistically significant difference (P<0.05). At 1 week and 1 month postoperatively, the central corneal epithelial thickness of non-dominant eyes was significantly higher than that of dominant eyes [(71.34±21.69) µm vs. (51.97±6.33) µm at 1 week, and (61.34±15.85) µm vs. (52.72±6.32) µm at 1 month; P<0.05]. Patient satisfaction was high, with 96.9% (31 patients) rating their satisfaction as "satisfactory" or higher. Conclusions: The combined use of SMILE and FS-LASIK for optimized monovision correction in myopic patients with presbyopia is both safe and effective, achieving high postoperative satisfaction. The SMILE procedure reduces the extent of corneal epithelial remodeling compared to FS-LASIK.

[Comparative study of decentration, tilt and visual quality after implantation of aspherical intraocular lenses].

Objective: To compare the difference of decentration and tilt among 4 kinds of aspherical intraocular lenses (IOLs), and to analyze their objective visual quality. Methods: Prospective non-randomized controlled clinical trial. Age-related cataract patients who planned to undergo phacoemulsification and IOL implantation in the Affiliated Hospital of North Sichuan Medical College from April to June in 2020 were divided into ZCB00 group, SN60WF group, A1-UV group, and AO group according to IOL types. Thirty right eyes and thirty left eyes were selected in each group. Before operation and at 1 day, 1 week and 1 month postoperatively, decentration and tilt values were measured by a new swept-source anterior-segment optical coherence tomography device (CASIA2), and wavefront aberrations, objective scatter index (OSI), modulation transfer function cut off frequency (MTF cut off) and Strehl ratio (SR) were also examined. Values of decentration, tilt and visual quality compared among 4 groups were took from the right eye. One-way analysis of variance was used for inter-group comparison, and repeated measurement one-way analysis of variance was used for intra-group comparison. Data between right eyes and left eyes from all the individuals were compared by independent sample t-test. Results: A total of 181 patients (240 eyes) were enrolled, and 169 patients (224 eyes) completed the follow-up (114 right eyes and 110 left eyes). There were 77 males and 92 females, with an age of (69±9) years. There was no significant difference in gender, age, axial length, decentration and tilt of crystalline lens and IOL power among 4 groups (all P>0.05). At 1 day, 1 week and 1 month postoperatively, there was significant difference in decentration value among 4 groups (F=7.11, 6.12, 4.66; all P<0.05). For further pairwise comparison, the decentration value of SN60WF group was higher than that of the other 3 groups at 1 day and 1 week postoperatively, and the decentration value of SN60WF group was (0.259±0.101) mm at 1 month postoperatively, which was higher than that of ZCB00 group (0.177±0.099) mm and AO group (0.163±0.122) mm, and the differences were statistically significant (using SNK-q test, both P<0.05). The IOL tilt value in the ZCB00 group, SN60WF group, A1-UV group, and AO group at 1 month postoperatively were (4.806±1.129)°, (5.080±1.309)°, (4.586±1.338)°, (5.112±1.406)°, respectively. No significant difference in tilt value among 4 groups was found at any time after surgery (all P>0.05). In each group, there was no significant difference in decentration and tilt value at different postoperative time points (all P>0.05). At 1 month postoperatively, there was no significant difference in decentration and tilt at horizontal and vertical directions respectively among 4 groups (all P>0.05), and in each group, there was no significant difference in decentration and tilt value between right eyes and left eyes (all P>0.05), and IOLs tended to tilt towards the inferonasal or inferotemporal direction in both eyes. With 4-mm and 6-mm pupil diameter, there was significant difference in internal (F=131.32, 85.17) and ocular (F=46.64, 47.55) spherical aberration among 4 groups (all P<0.01). For further pairwise comparison, the spherical aberration of AO group was higher than that of the other 3 groups, and the difference was statistically significant (using SNK-q test, all P<0.05). There was no significant difference in OSI, MTF cut off and SR among 4 groups (all P>0.05). Conclusions: The four types of IOLs show decentration and tilt in varying degrees after implantation in the capsular bag, but this difference do not lead to clinical significance. Human eyes have tolerance to mild decentration and tilt of aspheric IOLs, showing good visual quality.

[Comparison of Toric intraocular lenses and corneal incisional procedures for correction of low and moderate astigmatism during cataract surgery: A meta-analysis].

Objective: To systematically compare the effects of Toric intraocular lens (IOL) implantation and corneal incisional procedures on the correction of astigmatism during cataract surgery. Methods: A peer-reviewed literature search was implemented in MEDLINE, EMBASE, EBSCO, ScienceDirect, Trip Database, Ovid, and the Chinese databases including CNKI and Wanfang Data. The inclusion criteria were randomized controlled trials (RCTs) that compared the Toric IOL implantation and the corneal incisional procedures to correct low and moderate astigmatism during cataract surgery. The mean difference (MD) and the relative risk were respectively used to describe the effect sizes of continuous data and nominal data with a confidence interval (CI) of 95%. The random effects model was applied to pool the data including postoperative uncorrected visual acuity, residual astigmatism and surgical complications by Review Manager 5.3. Results: A total of 12 RCTs were included in this study, including 330 eyes implanted with Toric IOLs and 336 eyes with non-Toric IOLs combined with corneal incisional procedures to correct astigmatism. According to the types of corneal incisions, the included RCTs were divided into three groups: limbal relaxing incision group, opposite clear corneal incision group, and astigmatic keratotomy group. Meta-analysis showed that postoperative logarithm of the minimum angle of resolution uncorrected visual acuity was significantly better in eyes implanted with Toric IOLs than those with corneal incisional procedures (MD, -0.05; 95% CI, -0.08 to -0.02; P<0.01), and the residual astigmatism was significantly lower in eyes implanted with Toric IOLs (MD, -0.33 D; 95% CI, -0.48 to -0.18 D; P<0.01). There was no significant difference in the risk of surgical complications between the Toric IOL implantation and the corneal incision correction for astigmatism (relative risk, 0.45; 95% CI, 0.07 to 2.95; P=0.40). Conclusions: The current evidence suggests that Toric IOL implantation is more effective in correcting astigmatism than corneal incisional procedures during cataract surgery and shows better postoperative visual acuity. However, they are similar in the risk of postoperative complications. (Chin J Ophthalmol, 2019, 55: 522-530).

[Comparison of Dengue viral nonstructural protein 1 antigen testing kits].

Objective: To investigate the sensitivity and specificity of commercial nonstructural protein 1 (NS1) testing kits for Dengue fever diagnose, and provide the evidence for diagnostic criteria revision. Methods: 300 PCR or virus isolation positive blood samples for dengue virus were collected from sentinel hospitals for dengue surveillance in Guangzhou, Dongguang and Zhongshang from May 2015 to Nov. 2016. At the same time, 308 PCR negative samples for Dengue virus were collected as control group. The information of the sample was collected using questionnaires. These samples were tested using imported and domestic ELISA and the colloidal gold-labeled kits that were widely used for detecting dengue NS1. Sensitivity, specificity and coincidence were calculated and analyzed, and Z hongshan's result was regarded as the reslut of the third part. Results: The positive group includes 133 males and 167 females, average ages are 47.2±13.3, 179, 110 and 11 of them is Dengue Ⅰ, Ⅱ and Ⅲ respectively. The negative group includes 154 males and 154 females, average ages are (40.1±11.6) years old. The sensitivity of domestic ELISA Kits (94.5%) is less than imported (99.5%), and the result has statistical significance (χ(2)=8.59, P=0.030), the specificity is 99.7% and 97.7% respectively; The sensitivity of imported and domestic the colloidal gold-labeled Kits is 97.5% and 96.5% respectively, both of specificities are 100%. The sensitivity and specificity of Dengue Ⅰ for NS1 test are more than 97.0%. The sensitivity of domestic ELISA and gold-labeled Kits is 90.0% and 95.0%, and the specificity is 96.8% and 100% respectively for Dengue Ⅱ test. The sensitivity of imported ELISA and gold-labeled Kits is 100% and 98.0%, and the specificity is 99.4% and 100% respectively for Dengue Ⅱ test. The result of the third party show the sensitivity and specificity of domestic ELISA and gold-labeled Kits are 90.0% and 98.0%, the differences has statistical significance (χ(2)=5.67, P=0.020). Conclusion: NS1 testing can be used as early dengue fever diagnose for higher sensitivity and specificity.

Absence of juvenile hormone signalling regulates the dynamic expression profiles of nutritional metabolism genes during diapause preparation in the cabbage beetle Colaphellus bowringi.

Temperate insects have evolved diapause, a period of programmed developmental arrest during specific life stages, to survive unfavourable conditions. During the diapause preparation phase (DPP), diapause-destined individuals generally store large amounts of fat by regulating nutrition distribution for the energy requirement during diapause maintenance and postdiapause development. Although nutritional patterns during the DPP have been investigated at physiological and biochemical levels in many insects, it remains largely unknown how nutritional metabolism is regulated during the DPP at molecular levels. We used RNA sequencing to compare gene expression profiles of adult female cabbage beetles Colaphellus bowringi during the preoviposition phase (POP) and the DPP. Most differentially expressed genes were involved in specific metabolic pathways during the DPP. Genes related to lipid and carbohydrate metabolic pathways were clearly highly expressed during the DPP, whereas genes related to protein metabolic pathways were highly expressed during the POP. Hormone challenge and RNA interference experiments revealed that juvenile hormone via its nuclear receptor methoprene-tolerant mediated the expression of genes associated with nutritional metabolism during the DPP. This work not only sheds light on the mechanisms of diapause preparation, but also provides new insights into the molecular basis of environmental plasticity in insects.

First Report of Pine Wilt Disease Caused by Bursaphelenchus xylophilus on Pinus thunbergii in the Inland City of Zibo, Shandong, China.

The pinewood nematode (PWN) Bursaphelenchus xylophilus (Steiner & Buhrer 1934) Nickle 1970 is the causal agent of pine wilt disease. It is especially damaging in East Asian countries, including Japan, China, and Korea. In China, the nematode has been found in Anhui, Guangdoung, Guizhou, Chongqing, and Zhejiang Provinces since its discovery in Jiangsu Province in 1982 (1). China is confronted with an enormous threat to its pine forests. B. xylophilus is transmitted by the insect vector pine sawyer beetle (Monochamus alternatus). The main host trees are Pinus massoniana, P. thunbergii, and P. densiflora, which are the most common pine trees in China. Shandong Province, located north of Jiangsu Province, is a high-risk area because it was thought to be the northernmost suitable area for the pine wood nematode. P. tabulaeformis, P. densiflora, and P. thunbergii are the principal hosts. In 2010, a pine tree with suspected wilt disease was found in Lushang Forest (36°16'31.11″ N, 118°03'59.79″ E) of P. thunbergii located in Zibo city of Shandong Province. Symptoms were systemic, with almost all leaves brown or yellowish; the tree was nearly dead. Wood samples were collected and nematodes were extracted using a modified Baermann's funnel method. After 12 h, the nematodes were collected from the wood chips, and their morphology was observed with an inverted light microscope (Nikon 90i, Japan). Nematodes had a typical Aphelenchoid-type esophagus and female vulva flap. Females had subcylindrical tails, usually with broadly rounded terminus, some with a short mucro, and flat vulva, whereas males had large paired arcuate spicules with a sharply pointed prominent rostrum, and typical disc-like expansions on distal ends. Standard measurements of these nematodes were as follows: 25 females: body length = 960.9 ± 117.4 (791.5 to 1,265.2) µm, a = 32.1 ± 5.1 (23.7 to 44.5), b = 13.6 ± 1.4 (11.4 to 16.1), c = 28.3 ± 4.6 (21.7 to 42.2), V = 77.8 ± 2.0 (74.2 to 83.9), stylet length = 13.7 ± 1.6 (11.4 to 17.6) µm; 21 males: body length = 785.6 ± 103.2 (609.6 to 1,004.5) µm, a = 33.3 ± 4.4 (26.0 to 40.8), b = 11.9 ± 1.3 (9.0 to 14.6), c = 31.0 ± 2.7 (25.5 to 37.1), stylet length = 13.5 ± 1.9 (11.0 to 17.5) µm, spicule length = 18.8 ± 2.5 (14.9 to 23.9) µm. The morphometrics of this population, apart from body length and "a" value, which are shorter than the Portugal isolate measured by Mota et al. (3), are very much in the same range reported for B. xylophilus. For a more accurate identification, DNA was extracted from individual nematodes using a liquid nitrogen method. The internal transcribed spacers (ITS-1, ITS-2, 5.8S) were amplified by using PCR (2). Nucleotide sequences were compared with the sequences of B. xylophilus in GenBank, accession nos. JN684828 (Portugal), JN684829 (Portugal), JF826219 (Madeira Island) and JQ288086 (Japan). The ITS DNA sequences of the nematode from P. thunbergii were 99% identical to those of B. xylophilus in GenBank. A sequence of this nematode was submitted to the GenBank database and assigned the number KC460340. We have thus confirmed that B. xylophilus is now present north of Changjiang River in Zibo city, Shandong Province. This range expansion, perhaps the result of global warming, will affect both domestic and international quarantine efforts to control the further spread of pinewood nematode. References: (1) X. Y. Cheng et al. Heredity 100:356, 2008. (2) K. Metge and W. Burgermeister. J. Plant Dis. Protect. 113:275, 2006. (3) M. Mota et al. Nematology 1:727, 1999.

[Advances in research of protein kinase A in parasites: a review].

Protein kinase A (PKA) is an important intracellular substance that regulates substance metabolism and biological functions, which exerts a wide range of biological effects through phosphorylation of specific serine/threonine residues in specific proteins. PKA plays an important role in the cAMP signaling pathway, and is involved in various life activities of parasites. Therefore, investigating the role of PKA in the life activities of parasites may provide insights into the development of novel anti-parasitic targets. The review mainly describes the structure and function of PKA and its role in life activities of parasites.