Changes of dysfunctional lens index before and after implantable collamer lens V4c implantation in patients with moderate-to-high myopia.

BACKGROUND: Dysfunctional lens index (DLI) changing is rarely reported after implantable collamer lens (ICL) implantation. In the current research, we hope to investigate the changes of DLI by ray-tracing aberrometry before and after implantation of the posterior chamber phakic implantable collamer lens with a central artificial hole for patients with moderate-to-high myopia. METHODS: This retrospective, observational case series included 206 eyes of 104 patients with moderate-to-high myopia who underwent ICL V4c implantation. Data were collected on ocular indicators preoperatively and at 1 day, 1, 3, and 6 months postoperatively. The i-Trace Visual Functional Analyzer was used to assess the DLI measurement. RESULTS: The overall values of safety index and efficacy index were both more than 1. Preoperatively, the mean spherical equivalent (SE) of included 206 eyes was - 10.77 ± 3.46 diopter (D). Then at 1-day postoperation, the mean SE was - 0.22 ± 0.55 D, and barely changed from 1 day to 6 months postoperatively. Although the endothelial parameters had no significant differences between preoperation and postoperation, the mean loss of endothelial cells was 0.74 ± 0.98% at 6 months. Regarding the vault, there was a significant difference between each time of follow-up (P < 0.001). The mean of the vault decreased 109.6 ± 13.5 µm from 1-day post-op to 6 months post-op. The DLI values were 3.70, 9.26, 10.00, and 9.68 at baseline, 1, 3, and 6 months, respectively (P < 0.001), but no significant differences were found between 1, 3, and 6 months postoperatively (P > 0.05). The preoperative lnDLI showed a significant positive linear correlation (r = 0.621, P < 0.001) with the preoperative spherical equivalent (SE). The lnDLI was negatively correlated with the axial length (r = - 0.462, P < 0.001), corneal thickness (r = - 0.207, P = 0.003), preoperative LogMAR UDVA (r = - 0.189, P = 0.006), and preoperative LogMAR CDVA (r = - 0.306, P < 0.001). CONCLUSIONS: The postoperative refractive parameters were confirmed excellent in efficacy, predictability, and stability in half a year. The DLI was significantly improved after the ICL V4c implantation in patients with moderate-to-high myopia and showed good stability during the follow-up periods. The DLI deserves a more comprehensive understanding and application in clinical services.

Pheochromocytoma crisis with refractory Acute Respiratory Distress Syndrome (ARDS), Takotsubo syndrome, emergency adrenalectomy, and need for Extracorporeal Membrane Oxygenation (ECMO) in a previously undiagnosed and asymptomatic patient, due to the use of metoclopramide.

BACKGROUND: Pheochromocytoma (PCC) crisis is a rare life-threatening endocrine emergency. The diagnosis and treatment of PCC crisis, with acute respiratory distress syndrome (ARDS) as the first manifestation, is highly challenging, and traditional PCC management strategies are no longer suitable for these patients. CASE PRESENTATION: A 46-year-old female patient was admitted to the Intensive Care Unit (ICU) following sudden-onset acute respiratory distress and subsequent initiation of mechanical ventilation via endotracheal intubation. She was initially suspected of having a PCC crisis through the bedside critical care ultrasonic examination protocol. The computed tomography examination revealed a left adrenal neoplasm of 6.5cm × 5.9cm. The plasma-free metanephrine level was 100 times higher than the reference value. These findings were compatible with her PCC diagnosis. Alpha-blockers and fluid intake were started immediately. The endotracheal intubation was removed on the 11th day after admission to the ICU. The patient progressed to severe ARDS again, and invasive ventilation and continuous renal replacement therapy were needed. Despite aggressive therapy, her condition deteriorated. Therefore, she underwent veno-arterial extracorporeal membrane oxygenation (VA-ECMO)-assisted emergency adrenalectomy after multidisciplinary discussion. Postoperatively, the patient was supported by VA-ECMO for 7days. She was discharged from the hospital on day 30 after tumor resection. CONCLUSIONS: This case highlighted the challenges in diagnosing and managing ARDS associated with PCC crisis. The traditional preoperative preparation protocol and optimal operation timing for patients with PCC are not suitable for patients with PCC crisis. Patients with life-threatening PCC crisis may benefit from early tumor removal, and VA-ECMO could maintain hemodynamic stability during and after surgery.

Salidroside attenuates LPS-induced inflammatory activation in young rats with acute lung injury via PI3K/Akt signaling pathway.

This experiment aimed to analyze the salidroside effect on lipopolysaccharide (LPS)-induced inflammatory activation in young rats with acute lung injury (ALI) via PI3K/Akt signaling pathway. In this study, sixty SD young rats were divided into 5 groups (control, model, salidroside low-dose, salidroside medium-dose and salidroside high-dose), with 12 rats in each group. ALI rat model was established. In the control and model group, rats were intraperitoneally injected with normal saline, while the salidroside low-, medium-, and high-dose groups were intraperitoneally injected with 5, 20, and 40 mg/kg salidroside, then the pathological changes of lung tissue, lung injury score, wet/dry lung weight ratio, neutrophils and TNF-α, MPO, MDA, NO, p-PI3K and p-AKT were detached and compared between these groups. Results showed that the ALI rat model was successfully established. The lung injury score, wet/dry lung weight ratio, neutrophils and TNF-α in alveolar lavage fluid, MPO, MDA, NO, p-PI3K and p-AKT in the lung tissue of the model group were increased than the control group. With the increase of salidroside dose, lung injury score, wet lung weight/dry lung weight ratio, neutrophils and TNF-α in alveolar lavage fluid, and the levels of MPO, MDA, NO, p-PI3K and p-AKT in lung tissues of the salidroside group were decreased then model group (P < 0.05). In conclusion, salidroside may reduce the activation of inflammatory cells in the lung tissue of young rats with LPS-induced ALI by activating PI3K/AKT signaling pathway, thereby exerting a certain protective effect on the lung tissue with LPS-induced ALI.

Mitogenome evidence shows two radiation events and dispersals of matrilineal ancestry from northern coastal China to the Americas and Japan.

Although it is widely recognized that the ancestors of Native Americans (NAs) primarily came from Siberia, the link between mitochondrial DNA (mtDNA) lineage D4h3a (typical of NAs) and D4h3b (found so far only in East China and Thailand) raises the possibility that the ancestral sources for early NAs were more variegated than hypothesized. Here, we analyze 216 contemporary (including 106 newly sequenced) D4h mitogenomes and 39 previously reported ancient D4h data. The results reveal two radiation events of D4h in northern coastal China, one during the Last Glacial Maximum and the other within the last deglaciation, which facilitated the dispersals of D4h sub-branches to different areas including the Americas and the Japanese archipelago. The coastal distributions of the NA (D4h3a) and Japanese lineages (D4h1a and D4h2), in combination with the Paleolithic archaeological similarities among Northern China, the Americas, and Japan, lend support to the coastal dispersal scenario of early NAs.

Effects of intraocular lens anterior edge design on anterior capsule morphology changes following femtosecond laser-assisted capsulotomy.

PURPOSE: To compare morphological changes in the anterior capsule of two intraocular lenses (IOLs) with different anterior edge designs 6 months after femtosecond laser-assisted capsulotomy surgery (FLACs). METHODS: This study included 168 eyes from168 patients undergoing FLACs. Group A included 74 eyes from 74 patients who had an Acrysof IQ Restor SN6AD3 IOL implantation with a flat anterior edge and Group B included 94 eyes of 94 patients with a TECNIS Multifocal ZMB00 IOL implantation and a "peak-like" anterior edge. All patients were followed up for 6 months. We assessed anterior capsule morphological changes including variation of anterior opening diameters and lens epithelial cell (LEC) proliferation in four directions, variation of anterior opening area, and the level of anterior capsule opacification (ACO). RESULTS: Variation of anterior opening diameters in 4 directions were significantly lower in Group B (P < 0.05). Obvious shrinkage ratio of anterior opening diameters and contraction of anterior opening area (P < 0.05) appeared in Group A. LEC proliferation was along the "peak" in Group B, while it spread to the edge of anterior capsule in Group A. ACO grades 6 months after operation in Groups A and B were as follows: grade I in 28.38% and 82.98% of eyes, grade II in 51.35% and 17.02% of eyes, and grade III in 20.27% and 0% of eyes, respectively. CONCLUSIONS: These findings suggest that a "peak-like" IOL anterior edge design played an important role in maintaining the morphology of anterior capsule in the early postoperative stage.

Effectiveness of reducing corneal astigmatism after combined high-frequency LDV Z8 femtosecond laser-assisted phacoemulsification and arcuate keratotomy.

Purpose: In this retrospective study, the efficacy of the FEMTO LDV Z8 Femtosecond Laser-Assisted Cataract Surgery (Femto Z8 FLACS) and the Femtosecond laser Arcuate Keratotomy (FSAK) in decreasing the corneal astigmatism was investigated. Methods: During FLACS, FSAK was positioned with the help of the FEMTO LDV Z8 laser at a diameter of 8.5 mm and an 80% depth. Before and 3 months after surgery, the astigmatism of the cornea was measured with the aid of Pentacam. The variables influencing the efficacy of FSAK were assessed using the multiple regression analysis technique. Vector analyses were carried out. To determine the net corneal alterations, the with-the-wound and against-the-wound variations were computed along the FSAKs' meridian. Results: This study investigated 80 eyes from 62 participants. The average keratometric astigmatism value was 0.92 ± 0.44 diopters (D). The average keratometric astigmatism decreased to 0.61 ± 0.45 D 3 months following FSAK compared to preoperative corneal astigmatism (p < 0.05). Additionally, there was a considerable decline in the percentage of eyes with ±0.5 D and ±1.0 D astigmatism, which reduced 3 months after surgery by 58% and 85%, respectively (p < 0.05). Conclusion: The FEMTO LDV Z8 laser can create an effective and precise arcuate keratotomy with an excellent safety profile, rapid recovery, and vision stability.

Prediction of corneal astigmatism based on corneal tomography after femtosecond laser arcuate keratotomy using a pix2pix conditional generative adversarial network.

Purpose: This study aimed to develop a deep learning model to generate a postoperative corneal axial curvature map of femtosecond laser arcuate keratotomy (FLAK) based on corneal tomography using a pix2pix conditional generative adversarial network (pix2pix cGAN) for surgical planning. Methods: A total of 451 eyes of 318 nonconsecutive patients were subjected to FLAK for corneal astigmatism correction during cataract surgery. Paired or single anterior penetrating FLAKs were performed at an 8.0-mm optical zone with a depth of 90% using a femtosecond laser (LenSx laser, Alcon Laboratories, Inc.). Corneal tomography images were acquired from Oculus Pentacam HR (Optikgeräte GmbH, Wetzlar, Germany) before and 3 months after the surgery. The raw data required for analysis consisted of the anterior corneal curvature for a range of ± 3.5 mm around the corneal apex in 0.1-mm steps, which the pseudo-color corneal curvature map synthesized was based on. The deep learning model used was a pix2pix conditional generative adversarial network. The prediction accuracy of synthetic postoperative corneal astigmatism in zones of different diameters centered on the corneal apex was assessed using vector analysis. The synthetic postoperative corneal axial curvature maps were compared with the real postoperative corneal axial curvature maps using the structural similarity index measure (SSIM) and peak signal-to-noise ratio (PSNR). Results: A total of 386 pairs of preoperative and postoperative corneal tomography data were included in the training set, whereas 65 preoperative data were retrospectively included in the test set. The correlation coefficient between synthetic and real postoperative astigmatism (difference vector) in the 3-mm zone was 0.89, and that between surgically induced astigmatism (SIA) was 0.93. The mean absolute errors of SIA for real and synthetic postoperative corneal axial curvature maps in the 1-, 3-, and 5-mm zone were 0.20 ± 0.25, 0.12 ± 0.17, and 0.09 ± 0.13 diopters, respectively. The average SSIM and PSNR of the 3-mm zone were 0.86 ± 0.04 and 18.24 ± 5.78, respectively. Conclusion: Our results showed that the application of pix2pix cGAN can synthesize plausible postoperative corneal tomography for FLAK, showing the possibility of using GAN to predict corneal tomography, with the potential of applying artificial intelligence to construct surgical planning models.

Inclisiran inhibits oxidized low-density lipoprotein-induced foam cell formation in Raw264.7 macrophages via activating the PPARγ pathway.

Proprotein convertase subtilisin kexin type 9 (PCSK9) is a well-known proprotein convertase that influences foam cell formation and modulates atherosclerosis. Inclisiran is a novel chemosynthetic small interfering RNA that inhibits PCSK9 synthesis. This study aimed to explore the effect of inclisiran on oxidized low-density lipoprotein (ox-LDL)-induced foam cell formation in Raw264.7 macrophages and to investigate the underlying mechanisms. Raw264.7 cells were treated with ox-LDL to induce the formation of macrophage-derived foam cells. Oil Red O staining and high-performance liquid chromatography were performed to detect lipid accumulation and cholesterol levels. Dil-ox-LDL uptake assay, CCK-8, RT-qPCR, and Western blotting analysis were performed to examine ox-LDL uptake, cell viability, and expression of scavenger receptor-related factors. Inclisiran reduced lipid accumulation in ox-LDL-treated macrophages in a dose-dependent manner. Inclisiran significantly inhibited the levels of total cholesterol, free cholesterol, and cholesterol ester in the supernatant of Raw264.7 cells. Inclisiran reduced ox-LDL uptake and increased Raw264.7 cell viability. Meanwhile, inclisiran downregulated the expression of SR-A, LOX-1, and CD36 and upregulated SR-BI, ApoE, and ABCA1. Furthermore, inclisiran increased PPARγ activity and decreased NF-κB activity. An inhibitor of PPARγ (T0070907) reversed the beneficial effects of inclisiran on ox-LDL uptake, NF-κB inactivation, and cytokine expression. In conclusion, these data suggested that inclisiran inhibited the formation of macrophage-derived foam cells by activating the PPARγ pathway.HighlightsInclisiran reduces lipid accumulation in Raw264.7 cells;Inclisiran reduces ox-LDL uptake and increases Raw264.7 cell viability;Inclisiran inhibits foam cell formation by activating the PPARγ pathway.

Opportunity of Next-Generation Sequencing-Based Short Tandem Repeat System for Tumor Source Identification.

Personal identification using the tumor DNA not only plays an important role in postoperative tissue management but also might be the only accessible source of biological material in forensic identification. Short tandem repeat (STR) is the worldwide accepted forensic marker; however, widespread loss of heterozygosity (L) in tumor tissues challenges the personal identification using the conventional capillary electrophoresis (CE)-based STR typing system (CE-STR). Because the tumors are mixtures of tumor cells and basal cells, we inferred that every germline-originated allele should be detected if the detection method was sensitive enough. Next-generation sequencing (NGS) is known as a highly sensitive application, which might be a promising tool for tumor source identification. In the study, we genotyped and compared the STR results between the platforms, and we found that the concordance was only 91.43%. Higher sensitivity did help identify more germline-originated alleles as expected, and 93.89% of them could be captured by using an NGS-based STR system (NGS-STR). The identity-by-state (IBS) scoring system was applied to generate a new tumor source identification method based on NGS-STR, and the number of loci with 2 identical alleles (A2) proved to be an ideal criterion for the larger area under the receiver operating characteristic (ROC) curve (AUC). Both the sensitivity and specificity were above 98% in the cutoff of A2 to distinguish the paired carcinoma (PC) sample group from the unrelated individual (UI) group, the simulated full sibling (FS) group, and the simulated parent-offspring (PO) group.

Melatonin protected against myocardial infarction injury in rats through a Sirt6-dependent antioxidant pathway.

BACKGROUND: The Sirt6, one of the members of the sirtuin family, has been regarded as a key factor in the pathogenesis of myocardial infarction (MI) through its antioxidant defense mechanisms. A previous study reported that melatonin is an antioxidant drug that can act as an agent for cardioprotection in cardiac ischemia-reperfusion (I/R) injury. However, whether melatonin could protect against cardiac remodeling after myocardial injury via the Sirt6-dependent antioxidant pathway remains unknown. OBJECTIVES: To explore the protective effects and the potential mechanisms of melatonin on MI-induced injury in rats. MATERIAL AND METHODS: A cardiac remodeling model was established through left coronary artery ligation surgery. The dose of melatonin was 10 mg/kg body weight. Four weeks after the treatment for 7 successive days, the infarct size and hemodynamic parameters were evaluated. The relative mRNA level and protein level of Sirt6 were also determined. Finally, the levels of oxidative stress, including reactive oxygen species (ROS) and superoxide dismutase (SOD), were measured, and the expression of nitric oxide (NO), inducible nitric oxide synthase (iNOS), endothelial nitric oxide synthase (eNOS) and their corresponding phosphorylation were evaluated. RESULTS: After the treatment with melatonin, infarct size, the left ventricular end-diastolic diameter (LVEDd), and left ventricular end-systolic diameter (LVEDd) and minimum first derivative of developed pressure (min dP/dt) decreased, while left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS) and maximum first derivative of developed pressure (max dP/dt) increased in the melatonin-MI (MM) group compared to the placebo-MI (PM) group. Furthermore, the expressions of Sirt6, both in mRNA and protein level, were significantly increased in the MM group treated with melatonin, as compared to the melatonin-control (MC) group treated with melatonin. In addition, melatonin enhanced SOD activity and reduced ROS levels. At the same time, we observed that the eNOS/NO signaling pathways were activated. CONCLUSIONS: Melatonin improved cardiac function through the Sirt6-dependent antioxidant pathway in MI rats.

Investigation on the genetic-inconsistent paternity cases using the MiSeq FGx system.

Mutations might challenge the paternity index calculation in forensic identification. While many studies have focussed on the autosomal short tandem repeats (A-STR), the mutation status of sex chromosomes and single nucleotide polymorphism (SNP) remain blank. Next generation sequencing (NGS), known as high throughput and large sequence polymorphism, is a promising tool for forensic genetics. To describe the mutation landscapes in the paternity cases with genetic inconsistencies, a total of 63 parentage confirmed paternity cases contained at least one mismatched locus have been collected. The mutations were subsequently evaluated using Verogen's MPS ForenSeqTM DNA Signature Kit and a microsatellite instability (MSI) detection kit. The result showed 98.41% (62/63) of the cases had no additional autosomal mutations even when the number of A-STRs increased to 27. As for the sex chromosomes, about 11.11% (7/63) of the cases exhibited either X-STR or Y-STR mutations. D2S1338, FGA and Penta E were the most frequent altered STRs, which suggested they might be the mutation hotspots. In addition, a male with sex chromosome abnormality was observed accidently, whose genotype might be 47, XXY, rather than MSI. Nearly 56.90% of the STR loci possessed isoalleles, which might result in higher STR polymorphisms. No Mendelian incompatibility was detected among the SNP markers, which indicated that SNP was a more reliable genetic marker in the genetic-inconsistent paternity cases. Supplemental data for this article is available online at https://doi.org/10.1080/20961790.2021.2009631 .

Modulation of STIM1 by a risk insertion/deletion polymorphism underlying genetics susceptibility to sudden cardiac death originated from coronary artery disease.

Stromal interaction molecule 1 (STIM1), as a dynamic calcium signal transducer and key regulator of cardiomyocyte Ca2+ homeostasis, has been implicated in various pathological processes related to sudden cardiac death originated from coronary artery disease (SCD-CAD). In this study, we performed a systematic variant screening on promoter region of STIM1 to filter potential functional genetic variations. Based on the screening results, a 5-bp insertion/deletion (indel) polymorphism (rs3061890) in promoter region of STIM1 was selected as the candidate variant. We investigated the association of rs3061890 with SCD-CAD susceptibility in Chinese Han populations. The homozygote del/del genotype significantly increased risk for SCD-CAD as compared with the ins/ins genotype (odds ratio, 2.86 [95% confidence interval, 1.69-4.29]; P = 2.3 × 10-5). Compared with the common allele, the 5-bp deletion risk allele exhibited lower transcriptional capacity in luciferase assays. Intriguingly, genotype-phenotype correlation studies using human myocardium tissue samples revealed that the expression of STIM1 was associated with the genotype of rs3061890. Computational prediction combined with electrophoretic mobility shift (EMSA) and chromatin immunoprecipitation (ChIP) assays provided convincing evidence for stronger binding affinity of ELF1 (E74 like ETS transcription factor 1) with the deletion allele promoter. Taken together, our findings implied an allele-specific mechanism of regulating the transcription of STIM1 via ELF1, which contribute to SCD-CAD susceptibility. rs3061890 may thus considered as a candidate genetic marker for SCD-CAD prediction and prevention.

Circ-Sirt1 inhibits proliferation, induces apoptosis, and ameliorates inflammation in human rheumatoid arthritis fibroblast-like synoviocytes.

Rheumatoid arthritis (RA) is a chronic inflammatory disease related to abnormal activation of fibroblast-like synovium cells (FLS) with apoptosis, inflammation, and oxidative damage. Circular RNA Sirt1 (circ-Sirt1) is an abundant circRNA, exerts the function in inhibiting inflammation. However, little is known about the roles of circ-Sirt1, if any, in RA. The present study aimed to investigate the biological roles and mechanism of circ-Sirt1 on cell inflammation in RA-FLS MH7A cell line. This study showed circ-Sirt1 inhibited the proliferation and induced apoptosis of MH7A cells. Overexpression of circ-Sirt1 decreased of the levels of interleukin (IL)-1ß and IL-6, tumour necrosis factor (TNF)-α, and matrix matalloproteinases (MMP)-1 and MMP-3 in MH7A cells. In addition, overexpression of circ-Sirt1 increased the expression of Sirt1, Nrf2, HO-1, IκBα, GCLC and GCLM, and decreased the ratio of acetylated NF-κB to normal NF-κB, and the expression of AP-1, COX-2 and HMGB1. Moreover, the expression of Keap1 and the ratio of acetylated NF-κB to normal NF-κB were partially increased and the Nrf2 and Sirt1 were partially reduced by siSirt1. Additionally, circ-Sirt1 overexpression promoted the activation of Sirt1 signal pathways by upregulating miR-132. In conclusion, the protective effect of Circ-Sirt1 on MH7A depends on inhibiting cell proliferation, promoting apoptosis and miR-132-mediated Sirt1 pathway to reduce inflammation.

Investigation of an Alternative Marker for Hypermutability Evaluation in Different Tumors.

A growing number of studies have shown immunotherapy to be a promising treatment strategy for several types of cancer. Short tandem repeats (STRs) have been proven to be alternative markers for the evaluation of hypermutability in gastrointestinal (GI) cancers. However, the status of STRs and microsatellite instability (MSI) in other tumors have not yet been investigated. To further compare STR and MSI alterations in different tumors, a total of 407 paired DNAs were analyzed from the following eight tumor types: breast cancer (BC), hepatocellular cancer (HCC), pancreatic cancer (PC), colorectal cancer (CRC), gastric cancer (GC), lung cancer (LC), esophageal cancer (EC), and renal cell cancer (RCC). The STR alteration frequencies varied in different tumors as expected. Interestingly, none of the patients possessed MSI-low (MSI-L) or MSI-high (MSI-H), except for the GI patients. The highest STR alteration was detected in EC (77.78%), followed by CRC (69.77%), HCC (63.33%), GC (54.55%), LC (48.00%), RCC (40.91%), BC (36.11%), and PC (25.71%). The potential cutoff for hypermutability was predicted using the published objective response rate (ORR), and the cutoff of LC and HCC was the same as that of GI cancers (26.32%). The cutoffs of 31.58% and 10.53% should be selected for BC and RCC, respectively. In summary, we compared MSI and STR status in eight tumor types, and predicted the potential threshold for hypermutability of BC, HCC, CRC, GC, LC, EC, and RCC.

Research progress of STC2 in breast cancer.

Breast cancer ranks second in the list of most common cancers among women and brings the double burden of economy and health to women. Therefore, it is an urgent and necessary task to study the pathogenic mechanism and the treatment of breast cancer. Glycoprotein hormone is a kind of hormones to promote the growth and the development of cell and stanniocalcin 2 (STC2) is one of them. Research has shown us a various expression of SCT2 in organs and tissues and it can regulate many different pathological and physiological processes. In addition, there are a lot of previous studies that indicated a close correlation between STC2 and the development and metastasis of many cancers, which infers STC2 can serve as biomarker of certain cancers. Until now, the effects of STC2 on breast cancer have been studied widely, but research findings demonstrated two different views, one view is that STC2 plays an oncogenic role and the other is the opposite. In this paper, it will summarize and evaluate the research data and results about mammalian STC2 on breast cancer.

Clinical evaluation of toric intraocular lens implantation based on iTrace wavefront keratometric astigmatism.

BACKGROUND: Currently, there is no standard technique for determining corneal astigmatism. The iTrace wavefront aberrometry of cornea calculated steep power and axis based on the best Zernike mathematical fit from all topo data within 4 mm circle. It was supposed to be more accurate than iTrace simulated keratometry which was calculated based on only 4 points on the circle of 3 mm. This aim of this study was to evaluate visual outcomes and rotational stability after toric intraocular lens (IOL) implantation using the wavefront aberrometry of the cornea with iTrace. SETTING: Single site in China, Shanxi Eye Hospital, Shanxi, China. DESIGN: Prospective case series. METHODS: The study included 85 eyes of 63 patients undergoing phacoemulsification and toric IOL implantation. The IOL power and cylinders were chosen with the help of the iTrace toric planning program using wavefront keratometric astigmatism. Astigmatic changes were assessed using Alpins vector method over a 3-month follow-up period. RESULTS: Preoperative mean corneal topographic astigmatism was 1.91 diopters (D) ± 0.69 (standard deviation). Postoperative mean refractive astigmatism decreased significantly to 0.48 D ± 0.34. Surgical induced astigmatism was 1.73 D ± 0.77 and the mean correction index was 0.89 ± 0.22, showing a slight undercorrection. The proportion of astigmatism ≤0.50 D increased from 0 to 71.8% postoperatively. CONCLUSIONS: This is the first study on evaluation of clinical outcomes of toric IOL implantation in corneal astigmatism patients using iTrace wavefront keratometric readings. The findings show that use of iTrace built-in toric calculator is safe and effective for planning toric IOL surgery for wavefront keratometric astigmatism. TRIAL REGISTRATION: Current Controlled Trials ISRCTN94956424 , Retrospectively registered (Date of registration: 05 February 2020).

Visual quality observation of clear lens extraction by ultrasonic phacoemulsification and intraocular lens implantation in a child with microspherophakia: A case report.

RATIONALE: Microspherophakia is characterized by a small, spherical crystalline lens with increased sagittal diameter. Because of the uncertainty about the outcome, as well as the complexity of the operation and development of complications, the management and timing of surgical intervention for microspherophakia are still debated. Lens extraction is effective for avoiding the risk of pupillary blockage, but the outcome after operation is controversial. The iTrace (Tracey, USA) report shows the influence of low-order aberrations (LOA) and high-order aberrations (HOA), which may be valuable in predicting postoperative outcome. Our report concerns a child with microspherophakia who underwent lens extraction via the analysis of visual quality by iTrace. PATIENT CONCERNS: Our report is on the case of a 7-year-old girl whose parents observed she had to bring her papers and books extremely close to her face to read. On examination, the girl was bilaterally diagnosed microspherophakia with a small tremble lens. The objective refraction was -15.0 diopter of spherical power (DS)/-1.00 diopter of cylindrical power (DC) × 180 right eye (OD) and -12.5 DS/-1.50 DC × 20 left eye (OS). The HOA of OD and OS were high up to 0.926 and 0.659, respectively by iTrace. The visual quality remained terrible after correcting LOA (high myopia and astigmatism). According to iTrace report, the patient would get a good visual quality by extracting the clear lens with HOA from cornea after correcting LOA. The girl's parent opted for surgery on the left eye. DIAGNOSIS: Due to the patient's symptoms, examination results, she was diagnosed with microspherophakia. INTERVENTIONS: The patient underwent clear lens extraction by ultrasonic phacoemulsification and intraocular lens implantation. OUTCOMES: The first day after operation, total HOA was decreased to 0.077. Total LOA was 0.713. Corrected distance visual acuity (CDVA) is 20/20. One week after surgery, HOA was 0.110 and LOA was 0.328. CDVA was 20/25. CDVA was still 20/25 one month after surgery. The total HOA was 0.110 and the LOA was 0.334 by iTrace. LESSONS: ITrace not only plays an important role in analyzing potential reasons of undesirable preoperative visual quality but also can predict postoperative outcomes. All these functions are helpful for determining surgical intervention of microspherophakia cases.

Detecting genetic hypermutability of gastrointestinal tumor by using a forensic STR kit.

Growing evidence suggests that somatic hypermutational status and programmed cell death-1 overexpression are potential predictive biomarkers indicating treatment benefits from immunotherapy using immune checkpoint inhibitors. However, biomarker-matched trials are still limited, and many of the genomic alterations remain difficult to target. To isolate the potential somatic hypermutational tumor from microsatellite instability low/microsatellite stability (MSI-L/MSS) cases, we employed two commercial kits to determine MSI and forensic short tandem repeat (STR) alternations in 250 gastrointestinal (GI) tumors. Three types of forensic STR alternations, namely, allelic loss, Aadd, and Anew, were identified. 62.4% (156/250) of the patients with GI exhibited STR alternation, including 100% (15/15) and 60% (141/235) of the microsatellite high instability and MSI-L/MSS cases, respectively. 30% (75/250) of the patients exhibited STR instability with more than 26.32% (26.32%-84.21%) STR alternation. The cutoff with 26.32% of the STR alternations covered all 15 MSI cases and suggested that it might be a potential threshold. Given the similar mechanism of the mutations of MSI and forensic STR, the widely used forensic identifier STR kit might provide potential usage for identifying hypermutational status in GI cancers.

Comparison of Corneal Power and Corneal Astigmatism of Different Diameter Zones Centered on the Pupil and Corneal Apex Using Scheimpflug Tomography.

PURPOSE: Using Scheimpflug tomography to investigate the difference in corneal power and corneal astigmatism between 3- and 4-mm diameter zones centered on the pupil and corneal apex. METHODS: A total of 90 eyes were included in this study. Axial keratometry, total refractive power, and true net power centered on the pupil and corneal apex in 3- and 4-mm diameter zones were assessed. The paired sample t test and independent sample t test were used for data comparison. RESULTS: For corneal power and corneal astigmatism for the 3- and 4-mm diameter zones, the flat K values of axial keratometry, total refractive power, and true net power centered on the pupil (3-mm: 43.99 ± 1.69 D, 43.12 ± 1.71 D, 42.53 ± 1.67 D; 4-mm: 44.04 ± 1.67 D, 43.38 ± 1.71 D, 42.61 ± 1.65 D) were significantly higher than those centered on the apex (3-mm: 43.93 ± 1.69 D, 43.05 ± 1.71 D, 42.46 ± 1.67 D; 4-mm: 44.01 ± 1.67 D, 43.34 ± 1.69 D, 42.58 ± 1.65 D; all P < 0.02). However, the steep K and astigmatism magnitude values centered on the pupil (3-mm: 45.71 ± 1.73 D, 45.01 ± 1.73 D, 44.38 ± 1.69 D; 1.72 ± 0.83 D, 1.89 ± 0.86 D, 1.85 ± 0.84 D; 4-mm: 45.78 ± 1.73 D, 45.28 ± 1.74 D, 44.45 ± 1.68 D; 1.73 ± 0.84 D, 1.90 ± 0.85 D, 1.84 ± 0.85 D) were lower than those centered on the apex (3-mm: 45.81 ± 1.74 D, 45.10 ± 1.72 D, 44.50 ± 1.70 D; 1.88 ± 0.90 D, 2.05 ± 0.90 D, 2.04 ± 0.90 D; 4-mm: 45.85 ± 1.73 D, 45.34 ± 1.73 D, 44.51 ± 1.69 D; 1.83 ± 0.88 D, 2.00 ± 0.90 D, 1.93 ± 0.86 D; all P < 0.01). Compared with the 3-mm diameter zone, the corresponding 4-mm diameter zone showed higher corneal power centered on both pupil and corneal apex. CONCLUSIONS: The difference in corneal power and corneal astigmatism, measured at 3 and 4 mm, centered on the pupil and the corneal apex should be noted in corneal refractive surgery and toric intraocular lens calculation.

Identification of Key Metabolites for Acute Lung Injury in Patients with Sepsis.

BACKGROUND: The study aimed to detect critical metabolites in acute lung injury (ALI). METHODS: A comparative analysis of microarray profile of patients with sepsis-induced ALI compared with sepsis patients with was conducted using bioinformatic tools through constructing multi-omics network. Multi-omics composite networks (gene network, metabolite network, phenotype network, gene-metabolite association network, phenotype-gene association network, and phenotype-metabolite association network) were constructed, following by integration of these composite networks to establish a heterogeneous network. Next, seed genes, and ALI phenotype were mapped into the heterogeneous network to further obtain a weighted composite network. Random walk with restart (RWR) was used for the weighted composite network to extract and prioritize the metabolites. On the basis of the distance proximity among metabolites, the top 50 metabolites with the highest proximity were identified, and the top 100 co-expressed genes interacted with the top 50 metabolites were also screened out. RESULTS: Totally, there were 9363 nodes and 10,226,148 edges in the integrated composite network. There were 4 metabolites with the scores > 0.009, including CHITIN, Tretinoin, sodium ion, and Celebrex. Adenosine 5'-diphosphate, triphosadenine, and tretinoin had higher degrees in the composite network and the co-expressed network. CONCLUSION: Adenosine 5'-diphosphate, triphosadenine, and tretinoin may be potential biomarkers for diagnosis and treatment of ALI.