Bicanalicular-nasal silicone stent for deep canalicular laceration management.

We evaluated the efficacy and clinical outcomes of bicanalicular-nasal silicone stents for deep canalicular lacerations and their anatomical restoration advantages. This retrospective case series study included patients with deep canalicular lacerations who underwent bicanalicular-nasal silicone stent intubation between January 2010 and June 2021 at a Chinese tertiary hospital and two primary hospitals. Intra- and post-operative complications were recorded. Anatomical, functional, and cosmetic outcomes were evaluated as anatomical restoration assessments at the last follow-up. We defined anatomical success as a free passage with no reflux during irrigation. Functional success was evaluated using the Munk epiphora scale and fluorescein dye disappearance test. Cosmetic outcomes were evaluated by examining the eyelid, lacrimal punctum, and medial canthus for any structural abnormalities and recorded objectively using a grading scale. We evaluated 92 eyes of 92 patients (63 men and 29 women); the mean distance from the lateral lacerated end to the punctum was 7.74 mm (range 7-10 mm). Bicanalicular-nasal silicone stents were successfully used in all 92 eyes with no severe intra- or post-operative complications noted. The stent placement duration ranged from 12 to 16 weeks (mean, 13.18 weeks). The follow-up period after stent removal ranged from 3 to 12 months (mean, 6.04 months). The anatomical and functional restoration success rates were 96.74% (89/92) and 100% (92/92), respectively. Satisfactory eyelid position realignment was achieved in all patients. Bicanalicular-nasal silicone stent placement sufficiently relieved orbicularis muscle tension during deep canalicular laceration repair, providing good functional results and excellent cosmetic realignment and anatomical restoration of the eyelid.

Outcomes and Complications of Sutured Scleral-Fixated Foldable Intraocular Lens Implantation: A Retrospective Study of 5-Year Follow-Up.

PURPOSE: To evaluate long-term outcomes and complications of sutured scleral-fixated foldable intraocular lens (IOL) implantation. DESIGN: Retrospective study. METHODS: Patients who underwent sutured scleral-fixated foldable IOL implantation using 10-0 polypropylene suture were followed up for at least 5 years at one Chinese tertiary hospital and two primary hospitals. RESULTS: 52 eyes among 48 patients (35 male and 13 female) were evaluated. The mean age (years) was 50.27 ± 20.08 (range: 6 to 81). The mean postoperative follow-up time (months) was 79.70 ± 18.84 (range: 60 to 121). The mean best-corrected visual acuity (BCVA) improved from 0.83 ± 0.69 logarithm of the minimum angle of resolution (logMAR) at baseline to 0.50 ± 0.45 logMAR at the last follow-up visit. There was improved or unchanged BCVA in 44 eyes (84.62%) and reduced BCVA in 8 eyes (15.38%). Mild intraoperative intravitreal hemorrhage was observed in 3 eyes (5.77%). Early postoperative complications included transient elevated intraocular pressure (IOP) in 5 eyes (9.62%) and hypotony in 1 eye (1.92%). Secondary epimacular membrane occurred in 5 eyes (9.62%) and retinal detachment (RD; 3 years postsurgery), subconjunctival suture knot exposure (5 years postsurgery), and persistent elevated IOP (in a GRAVES patient) occurred in 1 eye (1.92%) each. No suture erosion or breakage nor IOL dislocation was observed. No visually threatening IOL tilt or decentration was reported in any patient. CONCLUSION: Sutured scleral-fixated foldable IOL implantation demonstrated satisfactory long-term outcomes and rare suture-related complications. This technology was safe and did not require complicated equipment and is of considerable interest in the setting of aphakia without adequate capsule support.

The Urinary Microbiome in Postmenopausal Women with Recurrent Urinary Tract Infections.

PURPOSE: The etiology of postmenopausal recurrent urinary tract infection (UTI) is not completely known, but the urinary microbiome is thought to be implicated. We compared the urinary microbiome in menopausal women with recurrent UTIs to age-matched controls, both in the absence of acute infection. MATERIALS AND METHODS: This is a cross-sectional analysis of baseline data from 64 women enrolled in a longitudinal cohort study. All women were using topically applied vaginal estrogen. Women >55 years of age from the following groups were enrolled: 1) recurrent UTIs on daily antibiotic prophylaxis, 2) recurrent UTIs not on antibiotic prophylaxis and 3) age-matched controls without recurrent UTIs. Catheterized urine samples were collected at least 4 weeks after last treatment for UTI and at least 6 weeks after initiation of vaginal estrogen. Samples were evaluated using expanded quantitative urine culture (EQUC) and 16S rRNA gene sequencing. RESULTS: With EQUC, there were no significant differences in median numbers of microbial species isolated among groups (p=0.96), even when considering Lactobacilli (p=0.72). However, there were trends toward different Lactobacillus species between groups. With 16S rRNA sequencing, the majority of urine samples contained Lactobacillaceae, with nonsignificant trends in relative abundance among groups. Using a Bayesian analysis, we identified significant differences in anaerobic taxa associated with phenotypic groups. Most of these differences centered on Bacteroidales and the family Prevotellaceae, although differences were also noted in Actinobacteria and certain genera of Clostridiales. CONCLUSIONS: Associations between anaerobes within the urinary microbiome and postmenopausal recurrent UTI warrants further investigation.

Simvastatin inhibits inflammatory response in lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages through the microRNA-22/Cyr61 axis.

Simvastatin, a 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, has been shown to improve atherosclerosis (AS) via its anti-inflammatory activity. Recently, several studies have reported the involvement of macrophages in chronic inflammation associated with AS. However, it is unknown whether macrophages participate in the anti-inflammatory activity of simvastatin in AS. This study was designed to investigate the roles and underlying mechanisms of simvastatin in LPS-stimulated RAW264.7 macrophages. First, we examined the anti-inflammatory effects of simvastatin on LPS-treated macrophage RAW264.7 cells using an enzyme-linked immunosorbent assay (ELISA) and a quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). Then, a microarray assay was used to analyze the microRNA (miRNA) expression profile in RAW264.7 cells incubated with or without simvastatin in the presence of LPS. MicroRNA-22 (miR-22) with the highest change was validated independently by qRT-PCR. Luciferase reporter assays were conducted to determine the association between miR-22 and the cysteine-rich protein 61 (Cyr61). Subsequently, we investigated the molecular mechanism by which miR-22 functions in the anti-inflammation of simvastatin in LPS-stimulated macrophages. We found that simvastatin treatment could significantly inhibit inflammation by modulating the expression of mediators, such as IL-1ß, TNF-α and IL-6, whose expression were increased remarkably in the activated RAW264.7 cells. miR-22 was found to be one of the most significantly upregulated miRNAs in LPS-stimulated RAW264.7 macrophages after treatment with simvastatin. Pre-treatment of simvastatin in LPS-stimulated RAW264.7 macrophages enhanced miR-22 expression in a dose dependent manner. Interestingly, Cyr61, a novel pro-inflammatory factor involved in the pathogenesis of atherosclerosis (AS), was identified as a direct target of miR-22. Overexpression of miR-22 enhanced the anti-inflammatory effects of simvastatin, whereas inhibition of miR-22 had an opposite effect. More importantly, further study demonstrated that the knockdown of Cyr61 by siRNA could attenuate the inhibitory effects of miR-22 inhibition on anti-inflammatory activities of simvastatin. The results clearly show that simvastatin inhibits the inflammation response in LPS-stimulated RAW264.7 macrophages through the miR-22/Cyr61 axis and suggests that targeting the miR-22/Cyr61 axis may be a promising molecular target for AS therapy.

The effect of bone marrow-derived cells on diastolic function and exercise capacity in patients after acute myocardial infarction.

BACKGROUND: The early- to mid-term impact of bone-marrow-derived stem cells (BMC) on diastolic function and exercise capacity after acute myocardial infarction (AMI) remains controversial. We performed a systematic analysis to assess whether BMC transfer is related to an early improvement in diastolic function and exercise capacity after AMI. METHODS: Randomized controlled trials (RCTs) of BMC therapy after AMI were extracted from MEDLINE, EMBASE and CENTRAL and analyzed for a change in tissue Doppler annular early (Ea) and late diastolic (Aa) velocities, mitral inflow E velocity to tissue Doppler Ea (E/Ea) ratio, exercise time and exercise capacity. RESULTS: A total of 365 patients were included from 6 trials. A greater improvement was observed in the E/Ea ratio after 1 year in the BMC group compared to the control group. Additionally, the BMC-treated patients had a larger improvement in exercise time, ventilation/CO2 production (VE/VCO2 slope) and respiratory exchange ratio (RER) after 1 year. CONCLUSION: The results indicate that intracoronary BMC treatment in AMI patients leads to a mid-term improvement in diastolic function and exercise capacity.