Use of cataract surgery in urban Beijing: a post screening follow-up of the elderly with visual impairment due to age-related cataract.

OBJECTIVE: To understand the perception for the use of cataract surgical services in a population of acceptors and non-acceptors of cataract surgery in urban Beijing. METHODS: From a community-based screening program a total of 158 patients with presenting visual acuity of less than 6/18 on either eye due to age-related cataract were informed about the possibility of surgical treatment. These patients were interviewed and re-examined 36 to 46 months after initial screening. The main reasons for not accepting surgery were obtained using a questionnaire. Vision function and vision-related quality of life scores were assessed in those who received and did not receive surgery. RESULTS: At the follow-up examination 116 of the 158 patients were available and 36 (31.0%) had undergone cataract surgery. Cases who chose surgery had higher education level than those who did not seek surgery (OR=2.64, 95% CI: 1.08-6.63, P=0.02). There were no significant differences in vision function (P=0.11) or quality of life scores (P=0.16) between the surgery group and the non-surgery group. Main reasons for not having surgery included no perceived need (50.0%), feeling of being "too old" (19.2%), and worry about the quality of surgery (9.6%). Cost was cited by 1 (1.9%) subject as the main reason for not seeking surgery. CONCLUSIONS: The data suggest that in China's capital urban center for patients with moderate visual impairment there is a relative low acceptance rate of cataract surgery, mainly due to people's perception of marginal benefits of surgery. Cost is not a determining factor as barrier to undergo surgery and patients with poorer education are less likely to undertake surgery.

Gonioscopy and ultrasound biomicroscopy in the detection of angle closure in patients with shallow anterior chamber.

OBJECTIVE: To assess the agreement between gonioscopy and ultrasound biomicroscopy (UBM) in detecting angle closure in Chinese patients with shallow anterior chamber. METHODS: An observational comparative study of the two different examination methods was conducted. Patients with normal intraocular pressure and temporal peripheral anterior chamber depth less than a quarter of corneal thickness based on slit lamp examination were included in this study from December 2007 to May 2009 in the outpatient clinic of First Hospital of Tsinghua University. Gonioscopy was performed with a Goldman goniolens in dark room first and followed by full beam light and indentation. If the filtering trabecular meshwork was invisible or any peripheral anterior synechia was found, that quadrant of the angle was considered closed. UBM was first undertaken in a darkened room then repeated with normal room lighting. If iridotrabecular apposition was showed, that quadrant of the angle was considered closed. The status of angle closure of each quadrant with different methods was recorded. RESULTS: 85 eyes of 46 patients were included in this study. The agreement between gonioscopy and UBM was poor (Κ<0.4) with Kappa analysis in both dark and light conditions in each quadrant. The accordance of agreement between gonioscopy and UBM was hardly affected by age or sex, while in dark condition, eyes with deeper anterior chamber (P=0.005) or plateau iris configuration tended to produce different results (P=0.075) in the 2 methods. CONCLUSION: Gonioscopy and UBM are both indispensable methods for detecting angle closure, neither can completely replace the other.

Self-assembly of TiO2/ZIF-8 nanocomposites for varied photocatalytic CO2 reduction with H2O vapor induced by different synthetic methods.

Photoreduction of carbon dioxide (CO2) provides an effective perspective for solving the energy crisis and environmental problems. Herein, two types of composite photocatalysts (TiO2/ZIF-8) based on ZIF-8 and TiO2 have been designed and synthesized with the help of the grinding method and the solid-synthesis method. Both composite photocatalysts are employed for the photocatalytic reduction of CO2. In composite photocatalysts prepared by the grinding method, ZIF-8 particles are distributed on the surface of TiO2, and provide extra available spaces for storing CO2, which is beneficial for improving their photoreduction performances. As a result, an enhanced CO formation rate of 21.74 µmol g-1 h-1 with a high selectivity of 99% is obtained for this family of composite photocatalysts via the solid-gas mode without photosensitizers and sacrificial agents. For comparison, the other family of composite photocatalysts synthesized via the solid-synthesis method possesses structures similar to ZIF-8, where TiO2 is encapsulated inside the framework of ZIF-8. This structural feature obstructs the contact between the active sites of TiO2 and CO2, and leads to lower activities. The best CO formation rate of this family is only 10.67 µmol g-1 h-1 with 90% selectivity. Both the structural features of the two families of photocatalysts are described to explain their differences in photoreduction performances. The experimental finding reveals that different synthetic approaches indeed result in diversified structures and varied photocatalytic performances. This work affords a new scalable and efficient approach for the rational design of efficient photocatalysts in the area of artificial photosynthesis.

Integration of zirconium-based metal-organic framework with CdS for enhanced photocatalytic conversion of CO2 to CO.

It is a promising strategy to prepare composite photocatalysts based on MOFs and semiconductors for enhancing photocatalytic reduction of carbon dioxide (CO2). A family of binary composite photocatalysts (CdS@UiO-66-NH2) with different CdS contents have been designed and synthesized, which have been explored for photocatalytic reduction of CO2. CdS@UiO-66-NH2 can efficiently convert CO2 into CO under visible light irradiation via the solid-gas mode in the absence of sacrificial agents and photosensitizers. The generation rate of CO can reach up to 280.5 µmol g-1 h-1, which is 2.13-fold and 2.9-fold improvements over the pristine CdS and UiO-66-NH2, respectively, and the selectivity for CO is very high. Furthermore, this kind of photocatalysts can still maintain great photocatalytic activity in CO2/N2 mixed atmosphere with different CO2 concentrations. The outstanding performances of CdS@UiO-66-NH2 may be attributed to the existence of the direct Z-scheme heterojunction, which possesses the enhanced separation and migration of photo-generated charge carriers between UiO-66-NH2 and CdS, available specific surface areas and improved visible light absorption ability as well as abundant reaction active sites. This case reveals that MOF-based composite photocatalysts exhibit promising potential applications in the field of CO2 conversion.

Comparison between ophthalmologists and community health workers in screening of shallow anterior chamber with oblique flashlight test.

OBJECTIVE: To study the agreement between ophthalmologists and community health workers in detecting shallow anterior chamber with oblique flashlight test. METHODS: Totally 425 subjects were given an eye examination in a community health center. The anterior chamber depth of each subject was examined by one ophthalmologist and two trained community health workers (one nurse and one non-professional health worker) using oblique flashlight test. Inter-observer agreement was determined using the weighted kappa statistic. RESULTS: Among the enrolled subjects, 148 (35%) were male and 277 (65%) were female. Good agreement was noted in all the three observers. The comparison between the ophthalmologist and the nurse showed a kappa statistic of 0.42 for both eyes (P < 0.001). The kappa statistic was 0.54 and 0.52 for right and left eyes respectively between the ophthalmologist and the non-professional health worker (P<0.001). As for agreement between the nurse and the non-professional health, worker, the kappa statistic was 0.49 and 0.38 for right and left eyes, respectively (P < 0.001). CONCLUSION: The oblique flashlight test may be used as an applicable tool by trained community health workers for screening of shallow anterior chamber and play a role in blindness prevention in community.

[Expression of interleukin-6 in rat model of doxorubicin-induced nephropathy].

OBJECTIVE: The pathogenesis of minimal change nephrotic syndrome (MCNS) remains unclear. This study aimed to investigate the expression of interleukin-6 (IL-6) in rats with doxorubicin-induced nephropathy and its possible roles in the pathogenesis of MCNS. METHODS: Eighty-three male Wistar rats were randomly assigned into a control group (n=32) and a nephropathy group (n=51). Nephropathy was induced by a single tail vein injection of doxorubicin (5 mg/kg). The control group was injected with normal saline. Twenty-four-hour urinary protein excretion was measured 7, 14, 28 and 42 days after doxorubicin injection. IL-6 expression in urine and renal tissues was determined using ELISA 7, 14, 28 and 42 days after doxorubicin injection. RESULTS: The urinary protein excretion increased significantly in the nephropathy group 7, 14, 28 and 42 days after doxorubicin injection compared with that in the control group (P<0.01). IL-6 expression in urine and renal tissues increased significantly 7, 14, 28 and 42 days after doxorubicin injection compared with that in the control group (P<0.01). IL-6 expression in urine and renal tissues was positively correlated with 24-hour urinary protein excretion in the nephropathy group (r=0.794, P<0.01; r= 0.870, P<0.01). IL-6 expression in urine was positively correlated with that in renal tissues (r=0.739, P<0.01). CONCLUSIONS: IL-6 expression in the urine and renal tissues is increased in MCNS rats. IL-6 might play an important role in the pathogenesis of MCNS.

Polyoxometalate-based metallogels as anode materials for lithium ion batteries.

A series of polyoxometalate (POM)-based metallogels have been synthesized, which combine both the advantages of POMs and metallogels. Notably, POM-based metallogels are employed as anode materials for the first time, and the optimized sample exhibits high reversible capacity (658 mA h g-1), high rate capability, and good cycling stability.

Predictors for attending annual eye screening for diabetic retinopathy amongst patients with diabetes in an urban community of Beijing.

AIM: To gain a better understanding of possible factors that may influence the decision of diabetes persons to participate in annual eye screening in an urban community setting of China. METHODS: A structured interview including questions on attendance of eye screening, knowledge and awareness of diabetic retinopathy was conducted. The presence and degree of retinopathy were assessed using two field non-mydriatic retinal photography. RESULTS: Totally 720 diabetes persons were recruited and 519 were enrolled in this cross-sectional study. In this urban setting of Beijing, among diabetes patients of average of 10y duration, 77% confirmed having undergone at least one eye examination and 61% reported having at least one eye examination with dilated pupil. As for the last 12mo, the number decreased to 210 (47%) and 131 (30%) separately. Most of the participants (95%) were aware that diabetes could affect their vision and that regular eye examination was necessary. Very few of them (12%) however were aware that the early stages of diabetic retinopathy presented without symptoms of vision loss. Having attended patient education on diabetes was effective in building awareness about diabetic eye disease and was a significant positive predictor for attending eye screening [education in a year, Adj. OR=0.47 (0.29-0.74), P<0.001, education years ago, Adj. OR=0.56 (0.33-0.96), P=0.036]. The duration of disease also increased the likelihood of having undergone eye screening (Adj. OR=0.96, P<0.05). CONCLUSION: Being exposed to education about the complications of diabetes increases the probability of attending diabetic eye screening. An appropriate patient knowledge building strategy should be made available to patients from the time of diagnosis.

[Visual fields changes in chronic angle closure glaucoma patients after their intraocular pressures were well controlled].

OBJECTIVE: To investigate the progression of visual field loss and to explore the prognosis of glaucomatous optic neuropathy in patients with chronic angle-closure glaucoma (CACG) after their intraocular pressures were well controlled under 21 mmHg. METHODS: Forty-seven eyes of 29 patients in the Department of Ophthalmology in PUMC Hospital were included. All the patients had at least two separate tests of visual fields using the 24-2 program of the Humphery Visual Field Analyzer after their intraocular pressure were well controlled under 21 mmHg after sugery. The visual fields of patients were followed routinely for at least 1 year. In addition, all patients were divided into 2 groups according to follow-up period: 1-2 years group and over 2 years group. Visual field scores were calculated with the Advanced Glaucoma Intervention Study (AGIS) method. The visual fields were divided 5 sections and the sensitivity and defect depth of each section were calculated. RESULT: No statistically significant differences were found in terms of AGIS scores, localized sensitivities and localized defects within the time interval of the observation. CONCLUSION: Glaucomatous optic neuropathy is not likely to progressively deteriorate in CACG cases once their intraocular pressure are well controlled under 21 mmHg.

[An epidemiological study of visual disability and visual rehabilitation in Beijing].

OBJECTIVE: To investigate the status of visual disability and the demands for visual rehabilitation services in Beijing. METHODS: Five hundred and fifty-five persons with visual disability in Beijing from the Second National Survey on Disability of China were involved in this study. Their visual disability and demands for rehabilitation were evaluated. RESULTS: About three fourth of the visual disabled persons were over 60 years of age. Cataract, retinal and choroidal diseases, and glaucoma were the three leading causes of the visual impairment. Medical service was the number one (82.0%) demand for the persons with visual disability, although 89.4% of them had previously received some kinds of medial services. People who had received visual aid devices or rehabilitation training were 26.7% and 5.8%, respectively, while more people showed their demand for these service (36.6% and 11.9%, respectively). The demand for visual rehabilitation varied in different groups of age and severity of disability. CONCLUSION: Accessibility of high quality medical services for preventable blindness diseases should be further promoted. Public health education on visual rehabilitation is also needed.