Salt-Assisted, In Situ Current Nanowelding of an Interfacial Au Nanoparticle Film for a High-Performance Electrocatalyst.

Interfacial self-assembly is a well-established method for the preparation of a two-dimensional (2D) metal nanofilm from nanoscale building blocks. However, the as-prepared nanofilm exhibits limited conductivity because of the large contact resistance at the junctions among its building blocks. Here, we report a salt-assisted, in situ current nanowelding strategy to weld an interfacial Au nanoparticle (NP) film for downstream applications, such as high-performance electrocatalysts. Particularly, we found that salt-assisted interfacial assembly can reduce the size of the nanogaps among neighboring Au NPs and, in turn, greatly improve the conductivity of the resultant Au NP film. Consequently, the Au NP film can be readily welded using current, and the welding extent can be monitored in real-time by looking at the passing current. The welding finally produces a nanoporous Au film (NPGF) with a network nanostructure, high conductivity, and abundant active sites so that it delivers a large current density of 86.96 µA·cm-2 (1.81 times higher than that from the pristine Au NP film) and shows improved cycling stability for methanol electrooxidation. Thus, these results offer a low-cost, solution-processable approach for the fabrication of a large-area, interconnected nanofilm from nanoscale building blocks beyond Au NPs, which may find diverse downstream applications.

Analysis of the Optic Nerve Head Microcirculation Using Optical Coherence Tomography Angiography and the Upstream Macrocirculation Using Color Doppler Imaging in Low-Tension and High-Tension Glaucoma Patients.

INTRODUCTION: The aim of the study was to analyze the optic nerve head (ONH) microcirculation using optical coherence tomography angiography (OCT-A) and the upstream macrocirculation using color Doppler imaging (CDI) in low-tension and high-tension glaucoma (LTG and HTG, respectively). METHODS: This cross-sectional study included 67 eyes of 67 HTG patients, 55 eyes of 55 LTG patients, and 42 eyes of 42 healthy controls. We recorded the complete ophthalmological examination, visual fields, retinal nerve fiber layer (RNFL) thickness, ONH vessel density (VD) measured using OCT-A, peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) measured using CDI. SPSS software was used for data analysis. Data are presented as mean ± standard deviation or median (interquartile range) and compared using t test or Mann-Whitney U test, as appropriate. Pearson χ2 test or Fisher's exact test was used for comparisons, as appropriate. Pearson correlation analysis was used to evaluate the correlations between variables. p < 0.05 was considered statistically significant. RESULTS: The ONH VD and RNFL thickness were considerably lower in glaucomatous eyes than in healthy eyes (both p < 0.001). Compared with the HTG group, the LTG group had lower VD in the peripapillary region (p = 0.027). Compared with the healthy group, the HTG group had lower PSV (p = 0.029 and = 0.023, respectively), lower EDV (p = 0.023 and <0.001, respectively), and higher RI (p = 0.019 and = 0.006, respectively) of the internal carotid artery (ICA) and central retinal artery (CRA). The LTG group had lower PSV (p = 0.015 and <0.001, respectively) and EDV (p = 0.047 and = 0.001, respectively) of the ophthalmic artery (OA) and CRA. The LTG group had lower PSV of CRA than the HTG group (p = 0.034). In glaucomatous eyes, peripapillary VD had a significant association with the mean defect (p < 0.001) and RNFL thickness (p < 0.001), but not with the other CDI indices (all p > 0.05). CONCLUSION: The ONH microcirculation and upstream macrocirculation of the large arteries exhibited differences in the blood flow characteristics between the LTG and HTG groups. These differences may improve our understanding of glaucoma. There was no correlation between the characteristics of the ONH microcirculation and the upstream macrocirculation of large vessels in the LTG and HTG groups.

A New Perspective on Dry Eye Classification: Proposal by the Asia Dry Eye Society.

The 2017 consensus report of the Asia Dry Eye Society (ADES) on the definition and diagnosis of dry eyes described dry eye disease as "Dry eye is a multifactorial disease characterized by unstable tear film causing a variety of symptoms and/or visual impairment, potentially accompanied by ocular surface damage." The report emphasized the instability of tear film and the importance of visual dysfunction in association with dry eyes, highlighting the importance of the evaluation of tear film stability. This report also discussed the concept of tear film-oriented therapy, which stemmed from the definition, and which is centered on provision of insufficient components in each tear film layer and ocular surface epithelium. The current ADES report proposes a simple classification of dry eyes based on the concept of tear film-oriented diagnosis and suggests that there are three types of dry eye: aqueous-deficient, decreased wettability, and increased evaporation. It is suggested that these three types respectively coincide with the problems of each layer: aqueous, membrane-associated mucins, and lipid/secretory mucin. Although each component cannot be quantitatively evaluated with the current technology, a practical diagnosis based on the patterns of fluorescein breakup is recommended. The Asia Dry Eye Society classification report suggests that for a practical use of the definition, diagnostic criteria and classification system should be integrated and be simple to use. The classification system proposed by ADES is a straightforward tool and simple to use, only through use of fluorescein, which is available even to non-dry eye specialists, and which is believed to contribute to an effective diagnosis and treatment of dry eyes.

A 8-year retrospective clinical analysis of 272 patients of epidemic Keratoconjunctivitis in Beijing, China.

BACKGROUND: Epidemic keratoconjunctivitis (EKC) is one of the most common eye infections worldwide. The analysis of clinical manifestations in different age groups help better know the disease. This study aims to provide more detailed analysis of 272 cases of EKC in 8 years, describe the differences of the clinical features among different age groups, and establish new clinical grading criteria. METHODS: 272 individuals were reviewed (2011-2019) in Beijing China. All the patients were classified into 3 grades according to the new grading criteria. The typical clinical signs of EKC and the photographs of the multiple subepithelial corneal infiltrates (MSI) were collected and analyzed. The number of 3 grades among and within different age groups were compared. The incidence of the typical signs among and within different age groups were compared. The proportion of each region of the cornea involved by MSI were compared. RESULTS: No significant differences were detected among the 4 groups in terms of the number of mild, moderate and severe cases, no matter in all-patients analysis (P = 0.271) nor in acute-phase-patients analysis (P = 0.203). The proportion of the severe cases was the highest among all patients (P = 0.000). Among the incidence of the typical signs, corneal involvement was the most common accounting for 69.8% (P<0.05). The probability of central region involvement was significantly higher than that of pericentral region involvement (P = 0.015) and peripheral region involvement (P = 0.000). CONCLUSIONS: Appropriate attention should be paid on EKC, because of the considerable proportion of severe cases, the high incidence of corneal lesion, and the high incidence of central region involvement of MSI.

Acanthamoeba keratitis related to contact lens use in a tertiary hospital in China.

BACKGROUND: To report the clinical and microbiological features of Acanthamoeba keratitis (AK) related to contact lens use in a tertiary hospital in China. METHODS: In this retrospective study, the medical results of 61 cases of AK related to contact lens use from January 2000 to December 2017 were reviewed. The data included patients' demographics, lens type, history, risk factors, disease stages, corneal scraping and culture reports, and treatments. Moreover, genotypic identification of some of the isolates was carried out with a PCR assay and sequence analysis of the 18S ribosomal DNA gene. RESULTS: There were 64 eyes included in the study. A total of 32.8% of the patients wore soft contact lenses, and 67.2% of patients used overnight orthokeratology. In the cases (20 eyes) in the early stage, 65% (13 eyes) had positive results according to Giemsa-stained smears, and 0.9% sodium chloride (NaCl) wet mounts revealed trophozoites in 7 eyes (35%). Six eyes (30%) were diagnosed by confocal microscopy combined with clinical signs. In the orthokeratology patients, 87.8% (36/41) rinsed their lenses and/or cases with tap water; 55% of soft-lens wearers wore their lenses while showering. The genotype of 9 isolates was determined, and all the strains belonged to genotype T4. In the orthokeratology group, the number of patients who required therapeutic penetrating keratoplasty after 2005 was less than that before 2005 (chi-square test, χ2 = 4.209, P = 0.04). CONCLUSIONS: More than two-thirds of the cases were associated with orthokeratology. Examinations with Giemsa-stained smears, 0.9% NaCl wet mounts and confocal microscopy should be performed for patients who are highly suspected of having early-stage AK to help with early diagnosis. In the orthokeratology group, the rate of therapeutic keratoplasty after 2005 was less than that before 2005.

Epithelial changes with corneal punctate epitheliopathy in type 2 diabetes mellitus and their correlation with time to healing.

BACKGROUND: To study basal epithelial cell (BEC), sub-basal nerve plexus (SBN) and Langerhans cell (LC) density in patients with type 2 diabetes mellitus (T2DM) with corneal punctate epitheliopathy (CPE) and to assess their association with time to healing of CPE. METHODS: Retrospective study of in vivo confocal microscopy (IVCM) in 160 eyes from 160 patients with T2DM diagnosed with CPE due to a single cause. Key exclusion criteria included multiple-causes for CPE or treatment with autologous serum. A total of 149 eyes from 149 gender- age- and aetiolgy-matched patients with CPE without T2DM comprised the control group. Electronic records were reviewed for demographic features, history of T2DM and aetiology of CPE. Density of BEC, SBN and LC were compared between the two groups. RESULTS: The healing time in days for CPE with different aetiologies in the T2DM and control groups were as follows: dry eye (21.56 ± 2.41; 7.00 ± 2.19; P = 0.001); meibomian gland dysfunction (26.42 ± 6.04; 9.21 ± 2.55; P = 0.001); cataract extraction (38.00 ± 19.62; 25.83 ± 11.49; P = 0.043); drug induced (53.19 ± 18.83; 41.86 ± 23.87; P = 0.018) and exposure (38.25 ± 14.13; 29.00 ± 13.67; P = 0.026). LC density was 38.70 ± 9.65 cells/mm2 in the T2DM group comparedwith 25.53 ± 3.54 cells/mm2 in the controls (P = 0.001). SBN density was 11.76 ± 1.69 mm/mm2 in the T2DM group compared with 20.92 ± 1.43 mm/mm2 in the controls (P = 0.001). BEC density in the T2DM group was 4982 ± 1178 cells/mm2 compared with 5739 ± 394 cells/mm2 in the control group (P = 0.018). Age and duration of T2DM had no relationship with healing time (multiple linear regression, P = 0.618; P = 0.787). The density of LC in the T2DM group showed a negative correlation with SBN density (r = 0.350; R2 = 0.1225; P = 0.034). The density of SBN in the T2DM group showed a positive correlation with BEC density (r = 0.427; R2 = 0.1823; P = 0.008). The density of BEC in the T2DM group showed a negative correlation with healing time (r = 0.931; R2 = 0.8668; P = 0.001). CONCLUSIONS: Utilising IVCM, we have demonstrated increased LC and decreased SBN in patients with T2DM and CPE. Both may be related to lower BEC density and nuclei enhanced reflection. Furthermore, decreased BEC density may lead to delay in cornea epithelium healing in the T2DM group comparedwith controls. An immune-mediated response may play a role in delayed wound closure in patients with T2DM.

Recent Progress in Technologies for Tactile Sensors.

Over the last two decades, considerable scientific and technological efforts have been devoted to developing tactile sensing based on a variety of transducing mechanisms, with prospective applications in many fields such as human-machine interaction, intelligent robot tactile control and feedback, and tactile sensorized minimally invasive surgery. This paper starts with an introduction of human tactile systems, followed by a presentation of the basic demands of tactile sensors. State-of-the-art tactile sensors are reviewed in terms of their diverse sensing mechanisms, design consideration, and material selection. Subsequently, typical performances of the sensors, along with their advantages and disadvantages, are compared and analyzed. Two major potential applications of tactile sensing systems are discussed in detail. Lastly, we propose prospective research directions and market trends of tactile sensing systems.

Mitochondrial pathways are involved in Eimeria tenella-induced apoptosis of chick embryo cecal epithelial cells.

Accumulating evidence suggests that Eimeria tenella severely damages the intestinal mucosa in infected poultry, resulting in deadly haemorrhagic typhlocolitis and major economic losses. Damage to host tissue is believed to arise mainly from apoptosis, which is, in general, intimately related to mitochondrial function. However, it is unclear whether mitochondria-dependent apoptotic pathways are specifically involved in parasite-induced apoptosis of chick embryo cecal epithelial cells. Because the mitochondrial permeability transition pore (MPTP) and caspase-9 are important elements in these pathways, we studied the effects of their respective inhibitors (i.e., cyclosporine A [CsA] and Z-LEHD-FMK, respectively) in primary cultures of chicken embryonic cecum epithelial cells using histopathological techniques, terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling (TUNEL) assays, flow cytometry (FCM) and ELISA. Results indicated that the inhibitors significantly decreased (p < 0.01) DNA injury, apoptosis and caspase-9 and caspase-3 activity of chick embryo cecal epithelial cells at 24, 48, 72, 96 and 120 h after E. tenella infection. Thus, our data supported that mitochondria-dependent apoptotic pathways were involved in apoptosis of parasitised chick embryo cecal epithelial cells.

[Pay attention to the corneal epithelial cell dysfunction after cataract surgery].

Corneal epithelial dysfunction ( CED ) is the abnormality of the regeneration, conjunction, adhesion and immigration of the corneal epithelium cells without the decompensation of the corneal limbal cells. Due to the affection resulting from the systemic problems of patients and the management in the preoperative period, some of the patients at one to two weeks after cataract surgery will present the edema and fluorescein staining of the corneal epithelium. Without correct therapy, the defect of the epithelium, or even persisting ulceration of the cornea will occur. The key points of the management for CED are the early diagnosis and reasonable therapy. We suggest paying special attention to CED in the patients with metabolism diseases, abnormality of the tear film and long-term blepharitis.

[Clinical analyses of 21 cases of Thygeson's superficial punctate keratitis].

OBJECTIVE: To study the clinical features, diagnosis and treatment of Thygeson's superficial punctate keratitis (TSPK). METHODS: Twenty-one cases diagnosed as TSPK between June 2010 and July 2013 were retrospectively analyzed, including clinical manifestation, characteristics of morphological changes imaged by laser confocal microscopy, treatment and therapeutic effects. RESULTS: All the 21 cases had the same presentation. Slit lamp examination showed several rough punctate intraepithelial opacities, which were usually slightly above the niveau of the surrounding epithelium. No cases had conjunctival congestions. Eight eyes of five patients with TSPK were imaged with a laser confocal biomicroscope. Clusters of highly reflective dots were revealed in the epithelium. The number of Langerhans cells was greatly increased in the basal cell layer of the focal corneal epithelium and the Bowman's layer in ten eyes affected by TSPK. The density of the subepithelial nerve plexus decreased. Some keratocytes had highly reflective cell bodies of irregular size, orientation, and shape in the anterior stroma in the affected eyes. After treatment with low concentration steroid eye drops and antiviral drugs, punctate opacities in all 21 cases were completely absorbed, leaving no scar, and the cure rate was 100%. But TSPK recurred in four cases. All recurrent cases were cured completely after treatment. CONCLUSIONS: Thygeson's superficial punctate keratitis is a kind of chronic recurrent superficial keratitis, without conjunctivitis. Confocal microscopic images have certain specificity, help diagnose and contribute to its pathogenesis research. Local use of low concentration steroid eye drops combined with antiviral drugs is effective for TSPK. Clinicians should pay attention to recurrence of TSPK.

Reis-Bücklers corneal dystrophy: a reappraisal using in vivo and ex vivo imaging techniques.

PURPOSE: To characterize the phenotype of Reis-Bücklers corneal dystrophy (RBCD) using in vivo and ex vivo imaging techniques. METHODS: Five RBCD patients with penetrating keratoplasty (PK) were enrolled. Before surgery, all patients underwent a complete ophthalmological examination including slitlamp biomicroscopy, in vivo confocal microscopy (IVCM) and anterior segment (AS) optical coherence tomography (OCT). After PK, corneal buttons were examined by light and transmission electron microscopy (TEM). Correlations between in vivo and ex vivo images were analyzed. RESULTS: In all cases, irregular geographic-like subepithelial gray-white opacities were observed in the central and mid-peripheral cornea. AS-OCT images of the cornea of all patients revealed hyperreflective homogeneous and continuous deposits concentrated at the level of Bowman's layer and anterior stroma. Using IVCM, a highly reflective irregular amorphous material was observed from intermediate epithelial cells to the anterior stroma. Sparse deposits of highly reflective material were also detected in the posterior stroma. TEM showed in all specimens basal epithelial cells containing small vesicles with rod-shaped dense material. CONCLUSIONS: IVCM and AS-OCT may be a useful adjunct to biomicroscopy for the diagnosis and management of RBCD. The correlations between the different in vivo and ex vivo imaging techniques emphasize the hypothesis of an epithelial origin for RBCD.

[Characteristics of filamentous fungal biofilms and their roles in ophthalmology].

A filamentous fungal biofilm is a collection of hyphae and spores encased in a matrix, which has distinct developmental phases governed by complex molecular events. Resistance to antifungal drugs and components of the innate immune system remain the greatest threats to patients with filamentous fungal biofilms. There is increasing evidence that filamentous fungal biofilms play a role in a variety of ocular infections. Filamentous fungal biofilms may participate in ocular infections by allowing filamentous fungi to persist on abiotic surfaces that come in contact with the eye, and by direct biofilm formation on biotic surfaces of the eye. This review discusses the current understanding of the basic biology and clinical implications associated with filamentous fungal biofilms in ophthalmology.

[Study on the clinical manifestation of 90 cases with scleritis and episcleritis].

OBJECTIVE: To evaluate the demographic characteristics, clinical features, ocular complications, and disease associations of patients who were diagnosed as scleritis and episcleritis in clinic. METHODS: A retrospective case series study.Ninety patients were diagnosed clinically as scleritis and episcleritis in Beijing Tongren Hospital from Jan 2010 to Jan 2013. Analyzed the general states of health, case history, the clinical manifestation, clinical features, ocular complications (decrease in vision, anterior uveitis, keratitis, ocular hypertension, cataract, and diseases of retina), and disease associations, to summarize the clinical characteristics of scleritis and episcleritis. RESULTS: Ninety patients were recorded, from 4 to 83 years old, and the average was (48 ± 15) years old. 30 cases (33.3%) were male, and 60 (66.7%) were female. There were no significant difference between male and female (χ² = 10.000, P < 0.01).In the 90 cases, 36 (40.0%) were episleritis and 54 cases (60.0%) were scleritis. Children group (0-16 years old) had 2 cases (2.2%), which all were episleritis.Young adult group (17-44 years old) had 39 cases (43.4%), including 13 were episleritis and 26 cases were scleritis. Middle adult group (45-59 years old) had 30 cases, including 9 cases episleritis and 21 cases scleritis. There were 19 cases (21.2%) in aged group ( ≥ 60 years), including 12 cases episleritis and 7 scleritis.Young adult group, Middle adult group and Aged group were significantly more than Children and aged group (χ² = 33.390, 24.500 and 13.762, P < 0.01).Young group was significantly more than Aged group Children group (χ² = 6.889, P < 0.01). Ocular complications were more frequent overall in patients with scleritis versus in those with episcleritis (χ² = 30.044, P < 0.01) , including decrease in vision, keratitis, and ocular hypertension (χ² = 130.200, 67.200, 54.444, P < 0.01) .Nineteen cases (21.1%) had different types of arthritis, and 10 cases (11.1%) had infection diseases in local. There were difference between episcleritis and scleritis (χ² = 145.644, P < 0.01) . CONCLUSIONS: Scleritis occurs in all ages, but mainly in adults.It is uncommon, and potentially life-threatening diseases. It is needed pay attention to diagnosis and treatment of the patients with systemic disease and ocular complications by Ophthalmologist.

[Evaluation of the diagnostic value for meibomian gland dysfunction examinations].

OBJECTIVE: To evaluate the sensitivity and specificity of clinical examinations in meibomian gland dysfunction (MGD). METHODS: A prospective case-controlled study. Fifty-two patients with MGD and 32 healthy age- and sex-matched control subjects were included from January to August 2013. All subjects were underwent the examinations sequentially as follows: evaluation of ocular surface disease symptoms using the Ocular Surface Disease Index (OSDI); lid margin and ocular surface examination by slit lamp microscrope; infrared meibomian photography; cornea sensation testing using the Cochet-Bonnet esthesiometer; tear film break-up time (BUT); corneal and conjunctival staining (Oxford scale); and Schirmer I test. One eye of each subject was included in the study. The parameters between MGD group and the control group were compared using the independent-samples T test. Spearman's correlation analysis was used to analyze the correlation of each parameter of MGD group. Receiver operating characteristic curve (ROC curve) and area under the curve (AUC) were used to describe the accuracy of each parameter to differentiate MGD from normal eyes. RESULTS: OSDI score, lid margin abnormality score, miss rate of meibomian glands and corneal and conjunctival staining score were obviously higher in MGD group (36.13 ± 14.71, 2.37 ± 0.937, (52.64 ± 17.23) %, 1.06 ± 1.75) than those in control group(5.22 ± 11.97, 0.94 ± 0.564, (23.97 ± 6.36) %, 0.03 ± 0.18) (t = 10.019, 7.808, 8.796, 3.293, respectively; P < 0.01). BUT, schirmer I value and corneal sensitivity score were significantly lower in MGD group (4.57 ± 2.13, 6.04 ± 7.09, 5.77 ± 0.38) than those in control group (13.31 ± 2.54, 12.56 ± 6.99, 5.98 ± 0.07) (t = -16.97, -4.119, -3.018, respectively; P < 0.01). AUC value of BUT was the largest (0.995), and the followings were the miss rate of meibomian (0.944), OSDI (0.925) and lid margin abnormalities (0.811). The sensitivity and the specificity of BUT were 90.4% and 100.0%; the miss rate of meibomian were 76.9% and 100.0%; OSDI were 97.4% and 87.1%; and lid margin abnormalities were 79.5% and 79.4%. The diagnostic value of these four parameters were better than the rest ones. CONCLUSION: BUT and the miss rate of meibomian have great value in diagnosis of MGD. Patients considered MGD can be performed these examinations to confirm the diagnosis.

Identification of Hub genes with prognostic values in colorectal cancer by integrated bioinformatics analysis.

BACKGROUND: Our study aimed to investigate the Hub genes and their prognostic value in colorectal cancer (CRC) via bioinformatics analysis. METHODS: The data set of colorectal cancer was downloaded from the GEO database (GSE21510, GSE110224 and GSE74602) for differential expression analysis using the GEO2R tool. Hub genes were screened by protein-protein interaction (PPI) comprehensive analysis. GEPIA was used to verify the expression of Hub genes and evaluate its prognostic value. The protein expression of Hub gene in CRC was analyzed using the Human Protein Atlas database. The cBioPortal was used to analyze the type and frequency of Hub gene mutations, and the effects of mutation on the patients' prognosis. The TIMER database was used to study the correlation between Hub genes and immune infiltration in CRC. Gene set enrichment analysis (GSEA) was used to explore the biological function and signal pathway of the Hub genes and corresponding co-expressed genes. RESULTS: We identified 346 differentially expressed genes (DEGs), including 117 upregulated and 229 downregulated. Four Hub genes (AURKA, CCNB1, EXO1 and CCNA2) were selected by survival analysis and differential expression validation. The protein and mRNA expression levels of AURKA, CCNB1, EXO1 and CCNA2 were higher in CRC tissues than in adjacent tissues. There were varying degrees of immune cell infiltration and gene mutation of Hub genes, especially B cells and CD8+ T cells. The results of GSEA showed that Hub genes and their co-expressed genes mainly participated in chromosome segregation, DNA replication, translational elongation and cell cycle. CONCLUSION: Overexpression of AURKA, CCNB1, CCNA2 and EXO1 had a better prognosis for CRC and this effect was correlation with gene mutation and infiltration of immune cells.

[The research progress of biofilm and biofilm in eye disease].

Bacteria adherent on the active or inactive surface can form biofilms in which they are encased in a hydrated matrix of extracellular polymeric substances, which is so called bacterial biofilm (BBF). BBF has greater virulence and drug resistance, they can also evade the host immune system and lead to immune injury compared with planktonic bacteria. Many common medical infections involving ophthalmic infection are biofilm-associated. In this paper, the concept and biological characteristics of BBF and BBF-related ophthalmic infection were reviewed.

[Analysis of etiology and in vitro drug resistance of ocular fungal infection in period of 2009 - 2010].

OBJECTIVE: To analyze the distribution and shifting trends of fungal culture specimens and assess the drug sensitivity in vitro. METHODS: Case series study. From January 2009 to December 2010, 1302 specimens were collected. These specimens were cultured on potato dextrose agar medium under 28°C and 40% humidity for 3 - 8 days. Drug sensitivity of positive cultures were evaluated by K-B method. Chi-square test was used for the analysis. RESULTS: In 1302 specimens, 292 samples (22.4%) were culture-positive, in which 69.9% were isolated from the cornea, 3.8% from the vitreous body, 1.0% from the anterior chamber, 0.7% from the conjunctiva, 0.7% from palpebral margin and 24.0% from other parts of the eye. Culture-positive rate of 2009 and 2010 were 21.2% (135/637) and 23.6% (157/665) respectively with no statistically significant difference (χ(2) = 1.092, P = 0.296). Two peaks of culture-positive outcome appeared in May and November. Culture results showed that Fusarium sp. was the commonest pathogen (59.6%, 174/292), Aspergrium sp. in 16.8% (49/292) and Alternaria sp.in 10.6% (31/292). Patients from 31 to 60 years old accounted for 82.2% (240/292) of positive cases. The sensitive rate in vitro to natamycin, terbinafine, fluconazole, amphotericin B and itraconazole was 94.0% (63/67), 63.4% (154/ 243), 6.0% (17/285), 39.7% (98/247) and 21.2% (65/306), respectively. CONCLUSIONS: The top three commonest fungus of Beijing Tong Ren hospital successively are Fusarium sp., Aspergrium sp. and Alternaria sp. Natamycin should be the first choice for fusarium infection and pathogen-unknown infection. All species with the exception of Fusarium sp. are sensitive to natamycin, terbinafine and amphotericin B but not itraconazole. Almost all fungal strains are resistant to fluconazole.

[Research progresses in treating infectious keratitis with photodynamic therapy].

Photodynamic therapy(PDT) as a new therapeutic method is increasing widely used in ocular surface disease. Along with intensive studies of microorganism inhibition and promoting function in tissue repairing of PDT have been developed, PDT been gradually applied to treating infectious keratitis in clinical. We review mechanism, sterilization and application in infectious keratitis of PDT.

[Role of in vivo confocal microscopy in the management of infectious keratitis].

Infectious keratitis remains a severe ocular condition that can lead to irreversible complications and even blindness. An early diagnosis of an infective microorganism leading to effective treatment may improve the outcome of infectious keratitis.However, the accurate and rapid identification of the infectious agent remains a challenge for the ophthalmologist.In vivo confocal microscopy (IVCM) is a noninvasive imaging technique that provides high-resolution images of ocular surface structures at a cellular level and infectious keratitis represents one of its most important clinical uses. The value of IVCM has been demonstrated in the diagnosis of acanthamoeba and filamentous fungal keratitis. The follow-up of such corneal infections may also be improved by this noninvasive imaging technique.However, the current resolution of IVCM limits its use in cases of bacterial and viral keratitis.

[Features and differentiation of smear cytology in ocular fungal infection].

OBJECTIVE: To investigate the cytological feature and differentiate diagnosis of ocular fungal infections by smear cytology. METHODS: Experimental study. One thousand two hundred and twenty-six specimens of smear cytology were collected retrospectively during January 2007- December 2010 from Microbial Laboratory of Beijing Institute of Ophthalmology. The 1226 specimens analyzed in this study were collected from patients who suffered from ocular fungal infections. The corneal scraping cells were observed by Giemsa staining, and the photographic record was saved. The morphological characteristics of fungal pathogens and the surrounding cells were analyzed by light microscopy. RESULTS: Nine hundred and ninety eight of 1226 (81.40%) specimens were positive with fungal pathogens, 228 of 1226 (18.60%) specimens were fungal negative by smear cytology. 976 of 998 (97.80%) fungal positive specimens were filamentous fungi positive, and 22 of 998 (2.20%) specimens were yeast positive. Among the 998 fungal positive specimens analyzed in this study, twenty-seven (2.71%) were collected from the vitreous, twelve (1.20%) were collected from aqueous humors, thirteen (1.30%) were collected from conjunctiva, seven (0.70%) were collected from eyelid margin, three (0.30%) were collected from lachrymal, and 8 were collected from other parts. The fungal pathogens should be differentiated from the deformed corneal epithelial cells, vacuoles, amebic cyst and other tissue cells during scraping. CONCLUSIONS: The smear cytology test for the diagnosis of ocular fungal infections has advantages of higher detection rate, less time-consuming and easier operation. The identification of fungal like ingredients is very important to improve the accuracy of diagnosis of ocular fungal infections.