[Cyclopexy on cyclodialysis cleft guided by anterior segment optic coherence tomography].

Objective: To analyze the accuracy of cyclopexy on traumatic cyclodialysis cleft guided by anterior segment optic coherence tomography (AS-OCT). Methods: Fifty-six eyes of 56 consecutive patients[41 males, 15 females, with a mean age of (43.14±13.85) years]who diagnosed with traumatic cyclodialysis cleft confirmed by ultrasound biomicroscopy (UBM) and underwent cyclopexy surgery at Shanxi Eye Hosiptal from July 2013 to February 2016 were included in the study. Patients were measured with the AS-OCT system before cyclopexy. AS-OCT findings of the cyclodialysis clefts were recorded. Localizing and suturing the clefts was guided by AS-OCT imaging. Preoperative and postoperative visual acuity (VA), intraocular pressure (IOP) and anterior chamber depth (ACD) were recorded and analyzed. Results: Imaging of preoperative AS-OCT of the 56 eyes showed an annular ciliary body detachment, a cyclodialysis cleft and shallow anterior chamber. The ciliary body detachment detected by AS-OCT showed an echo free zone between the annular ciliary body and the sclera. The cyclodialysis cleft showed a new pathway between the anterior chamber and the suprachoroidal space. AS-OCT imaging showed that the extent of cyclodialysis clefts ranged from 30 degrees to 240 degrees, which had a 0 degree to 20 degrees difference compared with UBM imaging. Localizing and suturing of the cyclodialysis clefts was guided by AS-OCT imaging. The best corrected visual acuity (BCVA) was 0.21±0.17 at baseline and 0.29±0.21 at five days postoperatively. The initial and final BCVA showed a remarkable difference after treatment (t=-4.98, P<0.01). The mean intra-ocular pressure (IOP) was (8.33±2.29) mmHg before surgery and (15.40±2.34) mmHg at five days postoperatively. There was a significant difference of IOP between preoperative and postoperative period (t=-16.590, P<0.01). The mean ACD was (1.94±0.45) mm preoperatively and (2.69±0.44) mm at five days postoperatively. There was also a significant difference of ACD between preoperative and postoperative period (t=-10.276, P<0.01). The postoperative reexamination found that ciliary body detachment or cyclodialysis clefts was not observed in the 56 eyes by AS-OCT. Conclusions: As a non-invasive method, AS-OCT is accurate, correlating well with UBM in the examination of cyclodialysis cleft, and can localize the extent of clefts before cyclopexy.

[Genotypes of rubella viruses circulating in Russia].

The phylogenetic analysis of rubella virus gene E1 in 6 strains isolated in Russia in 1967 - 1997 and in 36 isolates obtained from different countries during the period of 1963 - 1997 was carried out. Most of the genotypes were classified with genotype 1--these were strains from Europe, North America, Japan, China. Strains not included into genotype 1 were found to exhibit accelerated evolution in comparison with strains of genotype 1, but this was only seeming acceleration, as the strains of genotype "non-1" formed 3 sharply defined groups, standing quite apart, whose intragroup divergence was less or equal to that within genotype 1. The genetic distance between these 3 groups and genotype 1 was essentially higher than the intragroup divergence and equal to 6.20 - 8.21%. The data obtained in this study made it possible to regard these groups as separate genotypes. The suggestion was made that five strains isolated in Russia should be classified with genotypes IIB or III in contrast to strains of genotype II from India, China, South Korea, Italy.

Characterization of genotype II Rubella virus strains.

Two genotypes of Rubella virus have been described that differ by 8-9% at the nucleotide level in the E1 glycoprotein gene. Of these, genotype II (RGII) was only recently reported and in this study two RGII viruses, the BRDII vaccine strain and BR1 wild type strain, were characterized. Monoclonal antibodies against each of the virion proteins (capsid [C], glycoproteins E1 and E2) and polyclonal anti-rubella virus sera reacted similarly with purified virions from the RGII and reference RGI strains on Western gels, with the exception of one anti-E2 Mab, and thus the two genotypes are closely related antigenically. The genomic sequences of two genotype II (RGII) rubella virus strains were determined and compared with the six previously reported RGI sequences. The genomes of these viruses all contained 9762 nts and the lengths of the three untranslated regions (UTRs) and two open reading frames (ORF's) were identical. The overall difference between the RGI and RGII sequences at the nt level was approximately 8% and this difference was maintained across most of the genome. At the amino acid level, the RGI and RGII sequences differed overall by approximately 4%, however this difference was not uniform across the ORF's as the N-terminal third of P150 and the entirety of P90, both replicase proteins, were more conserved (<1% difference) while the C-terminal two thirds of P150 exhibited greater variation ( approximately 8% difference), including a hypervariable region between residues 771-801 within which divergence as great as 20-30% was detected. The parent wt virus of the BRDII vaccine was not available and its sequence was compared with the BR1 sequence to identify potential attenuating mutations. The BRDII and BR1 sequences varied at 252 residues (2.59%), including twelve in the UTRs and thirty coding differences in the ORF's. None of these differences in the BRDII sequence was vaccine-specific when compared with RGI wt and vaccine sequences and, therefore, there appeared to be no common pathway in the generation of live, attenuated rubella vaccines.

Molecular evolution of a type 1 wild-vaccine poliovirus recombinant during widespread circulation in China.

Type 1 wild-vaccine recombinant polioviruses were isolated from poliomyelitis patients in China from 1991 to 1993. We compared the sequences of 34 recombinant isolates over the 1,353-nucleotide (nt) genomic interval (nt 2480 to 3832) encoding the major capsid protein, VP1, and the protease, 2A. All recombinants had a 367-nt block of sequence (nt 3271 to 3637) derived from the Sabin 1 oral poliovirus vaccine strain spanning the 3'-terminal sequences of VP1 (115 nt) and the 5' half of 2A (252 nt). The remaining VP1 sequences were closely (up to 99.5%) related to those of a major genotype of wild type 1 poliovirus endemic to China up to 1994. In contrast, the non-vaccine-derived sequences at the 3' half of 2A were more distantly related (<90% nucleotide sequence match) to those of other contemporary wild polioviruses from China. The vaccine-derived sequences of the earliest (April 1991) isolates completely matched those of Sabin 1. Later isolates diverged from the early isolates primarily by accumulation of synonymous base substitutions (at a rate of approximately 3.7 x 10(-2) substitutions per synonymous site per year) over the entire VP1-2A interval. Distinct evolutionary lineages were found in different Chinese provinces. From the combined epidemiologic and evolutionary analyses, we propose that the recombinant virus arose during mixed infection of a single individual in northern China in early 1991 and that its progeny spread by multiple independent chains of transmission into some of the most populous areas of China within a year of the initiating infection.

Distribution of wild type 1 poliovirus genotypes in China.

Poliomyelitis remains an important public health problem in China. Most cases and outbreaks are associated with wild type 1 polioviruses. To obtain an overview of type 1 poliovirus transmission in China, partial genomic sequences were compared for 24 case isolates from 12 provinces. Because polioviruses evolve rapidly during infection of humans, the genetic relationships among isolates provide a measure of the extent of epidemiologic linkage among cases. The observed genetic relationships were complex: six different genotypes, apparently derived from five separate endemic origins, were found. One genotype was recombinant, having noncapsid sequences derived from the Sabin type 1 vaccine strain and capsid sequences derived from a genotype indigenous to several northern and eastern provinces. Some isolates from geographically separate provinces were closely related; other isolates were related to wild polioviruses found in neighboring countries. The combination of epidemiologic and virologic analyses may facilitate the development of more effective strategies for poliomyelitis eradication.