Comparison of Botulinum toxin type A with surgery for the treatment of intermittent exotropia in children.

BACKGROUND: The aim of this study was to observe the effectiveness of botulinum toxin type A (BTA) in the treatment of intermittent exotropia (IXT) in children compared with strabismus surgery. METHODS: One hundred forty-four children with a clear diagnosis of IXT and an indication for surgery were eligible for inclusion. Subjects were divided into two groups based on parental decision: the BTA injection group (injection group) or the conventional surgery group (surgery group). All cases were followed up for 6 months. The primary outcome was a comparison of the success rate (deviation between - 10 and + 10 PD) between the two groups at 6 months after the initial treatment. Secondary outcomes included change in deviation, visual function, and post-surgical complications. RESULTS: Seventy-two patients were enrolled in each group. At 6-month follow-up, there was no significant difference in the success rate between the injection and surgery groups (52.8% vs 66.7%, P = 0.13; postoperative deviation - 12.22 ± 10.80 PD vs - 9.17 ± 10.30 PD, P = 0.09). The binocular Visual function, except for near stereoacuity, improved after treatment in both groups, while the fusion recovery rate was higher in the surgical group (68.1% vs 95.8%, P < 0.001). Transient complications in the injection group included diplopia, ptosis, and subconjunctival hemorrhage, whereas subconjunctival hemorrhage, conjunctival edema, foreign body sensation, pain, and diplopia were seen in the surgical group. The complications of BTA were relatively mild. CONCLUSIONS: BTA is as effective as surgery in the treatment of IXT in children, but the recovery of the fusion is lower than surgery. TRIAL REGISTRATION: The study has completed the clinical registration on ( ChiCTR-INR-17013777 ).

Pinhole does not increase screening accuracy of detecting decreased best corrected visual acuity in schoolchildren.

BACKGROUND: Decreased best corrected visual acuity among children should be treated early in life, and vision screening in schoolchildren is an efficient and feasible selection for developing countries. Thus, the screening accuracy of different visual acuity tests is the key point for making vision screening strategies. The present study aims to explore the screening accuracy of uncorrected visual acuity (UCVA) and pin-hole corrected visual acuity (PCVA) using different vision chart in the detection of decreased best-corrected visual acuity (BCVA) among schoolchildren. METHODS: Grade one primary schoolchildren in urban Lhasa with data of UCVA using tumbling E chart (UCVAE), PCVA using tumbling E chart (PCVAE), UCVA using Lea Symbols chart (UCVAL), PCVA using Lea Symbols chart (PCVAL) and BCVA using Lea Symbols chart were reviewed. Decreased BCVA was defined as BCVA≤20/32(≥0.2 logMAR). Difference, reliability, and diagnostic parameters in the detection of decreased BCVA of different visual acuity results were analyzed. RESULTS: Overall, 1672 children aged 6.58 ± 0.44 years fulfilling the criteria. The prevalence of decreased BCVA was 6.8%. Although no significant differences were found between UCVAE vs UCVAL (p = .84, paired t-test) as well as PCVAE vs PCVAL (p = .24), the ICC between them was low (0.68 and 0.57, respectively). The average difference between BCVA and UCVAE, UCVAL, PCVAE, PCVAL was logMAR -0.08 (- 0.37, 0.21), - 0.08 (- 0.29, 0.17), - 0.05 (- 0.30, 0.19), - 0.06 (- 0.23, 0.12) using Bland-Altman method. The area under the receiver operating characteristic curve of UCVAE, PCVAE, UCVAL, PCVAL for the detection of decreased BCVA was 0.78 (0.73, 0.84), 0.76 (0.71, 0.82), 0.95 (0.94, 0.96), 0.93 (0.91, 0.95), respectively. CONCLUSION: Pinhole does not increase the screening accuracy of detecting decreased BCVA in grade one primary schoolchildren. Visual acuity test using Lea Symbols is more efficient than Tumbling E in the screening of that age. TRIAL REGISTRATION: Data were maily from the Lhasa Childhood Eye Study which has finished the clinical registration on ( ChiCTR1900026693 ).

Recent advances of green pretreatment techniques for quality control of natural products.

A few advancing technologies for natural product analysis have been widely proposed, which focus on decreasing energy consumption and developing an environmentally sustainable manner. These green sample pretreatment and analysis methods following the green Analytical Chemistry (GAC) criteria have the advantage of improving the strategy of chemical analyses, promoting sustainable development to analytical laboratories, and reducing the negative effects of analysis experiments on the environment. A few minimized extraction methodologies have been proposed for replacing the traditional methods in the quality evaluation of natural products, mainly including solid-phase microextraction (SPME) and liquid phase microextraction (LPME). These procedures not only have no need for large numbers of samples and toxic reagent, but also spend a small amount of extraction and analytical time. This overview aims to list out the main green strategies on the application of quality evaluation and control for natural products in the past 3 years.

Paediatric vision screening in Urban Lhasa from the Tibetan Plateau of Southwest China.

PURPOSE: Few studies of vision screening in school-aged children were reported in Tibetan Plateau. We herein summarize the results of a mandatory vision screening conducted in young children in the Tibetan Plateau of Southwest China. METHODS: The Lhasa Childhood vision Screening (LCVS) performed uncorrected distant visual acuity (UCVA) test on primary school students in urban Lhasa from July to September 2019. Pin-hole corrected VA (PCVA) was obtained for individuals with the UCVA less than 20/25. Decreased VA was defined for UCVA based on the American Academy of Pediatrics guidelines 2016 (UCVA < 20/32 for over 60 months). Visual impairment (VI), Mild VI, and moderate VI to blindness, defined as a PCVA less than 20/40, less than 20/40 to 20/63 and less than 20/63 in the better eye, respectively. RESULTS: Overall, 34,848 children aged 9.03 ± 1.87 years fulfilled the screening with a response rate of 98.5%. 18,412 (52.8%) of the participants were males, and 30,531(87.6%) were Tibetan. The prevalence of decreased VA, VI, Mild VI, and moderate VI to blindness was 35.6%, 4.4%, 3.5%, and 1.0%, respectively. The prevalence of decreased VA in grade 1-6 students was 28.8%, 20.8%, 26.9%, 40.7%, 50.8%, 59.5%, respectively. The prevalence of VI in grade 1 to 6 students was 1.5%, 1.4%, 2.4%, 5.6%, 7.7% and 9.9%, respectively. CONCLUSION: This study documented a relatively low prevalence of decreased VA and VI in Tibetan primary school students than other urban populations in China. An increasing trend of poor vision with grades was found.

A Rapid High Throughput Vibration and Vortex-Assisted Matrix Solid Phase Dispersion for Simultaneous Extraction of Four Isoflavones for Quality Evaluation of Semen Sojae Praeparatum.

Isoflavones (daidzein, daidzin, genistein and genistin) were main chemical components and usually selected as markers for quality control of Traditional Chinese Medicine semen sojae praeparatum (SSP). High throughput vibration and vortex-assisted matrix solid phase dispersion and high performance liquid chromatography with diode array detection were developed to simultaneously extract and quantify four isoflavones in SSP. Some parameters influencing extraction efficiency of isoflavones by vortex-assisted matrix solid phase dispersion such as sorbent type, ratio of sample to sorbent, crushing time, vibration frequency, methanol concentration, eluting solvent volume and vortex time were optimized. It was found that the best extraction yields of four isoflavones were obtained when the sample (20 mg) and SBA-3 (40 mg) was crushed by ball mill machine for 2 min at vibration frequency of 800 times per minute. Methanol/water (1.5 ml, 8:2, v/v) solution was dropped into the treated sample and vortexed for 3 min. The recoveries of the four isoflavones ranged from 86.1 to 94.8% and all relative standard deviations were less than 5%. A good linearity (r > 0.9994) was achieved within the range 0.5-125 µg/ml. It was concluded that the high throughput vibration and vortex-assisted matrix solid-phase dispersion coupled with high performance liquid chromatography was user-friendly extraction and quantification method of multiple isoflavones for quality evaluation of SSP.