Positive role and ethical problems of artificial intelligence in ophthalmology / 国际眼科杂志(Guoji Yanke Zazhi)

@#Artificial intelligence is described as the“fourth industrial revolution”. Driven by the development of the Internet and big data, ophthalmology has become a frontier discipline in this wave, showing a good prospect of vigorous development. Artificial intelligence has been applied to the auxiliary screening, diagnosis and treatment of a variety of eye diseases, and assisted in the completion of corneal, refractive, cataract and other related operations; Help realize graded diagnosis and treatment, telemedicine and improve the training mode of ophthalmic talents, and participate in eye health management and ophthalmic education. While artificial intelligence brings benefits to mankind, it also brings a number of ethical problems, among which the contradictions related to medical ethics, such as the division of responsibility for diagnosis and treatment errors, the protection of patient information privacy, humanistic care and its fairness, the contradiction between the growing artificial intelligence and imperfect ethics and laws are particularly prominent. Artificial intelligence must be guided by the correct value and abide by the corresponding ethical norms to continue to mature and improve in clinical practice. This paper summarizes the development status and ethical dilemma of ophthalmology under the background of artificial intelligence to provide reference for promoting its healthy development in the field of ophthalmology.

Curative effect of pterygium resection and autologous limbal stem cell transplantation combined with amniotic membrane transplantation in the treatment of pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the curative effect of pterygium resection and autologous limbal stem cell transplantation(LSCT)combined with amniotic membrane transplantation(AMT)in the treatment of pterygium.<p>METHODS: Totally 177 patients(187 eyes)with pterygium treated in ophthalmology clinic of the hospital between January 2017 and January 2020 were selected and randomly divided into group A(59 cases, 64 eyes), group B(59 cases, 60 eyes), and group C(59 cases, 63 eyes). All were treated with pterygium resection. On this basis, patients in the three groups were treated with autologous LSCT, AMT, and autologous LSCT combined with AMT, respectively. All subjects were followed up for 12mo after surgery. Visual acuity, corneal epithelial repair, and neovascularization of the three groups were comparatively analyzed. Postoperative recurrence rate, ocular symptoms, complications, and survival of grafts were statistically analyzed.<p>RESULTS: Visual acuity changes and repair time of corneal epithelial defect showed no statistically significant difference among the three groups(<i>P</i>>0.05). 1mo after surgery, the corneal fluorescein staining(FL)value of group C was significantly lower than that of group A or group B(all <i>P</i><0.05). No angiogenesis or recurrent true pterygium was observed. 6mo and 12mo after surgery, the grades of conjunctival fibroplasia in group A and group C were significantly different from that in group B(<i>P</i><0.05). There was no statistically significant difference in the wet length of the filter paper in Schirmer I test in terms of time, inter-group and interaction effects(<i>P</i>>0.05). 1mo after surgery, the tear film breakup time(BUT)of group C was significantly longer than that of group A or group B(all <i>P</i><0.05). There were different degrees of conjunctival edema in the three groups after surgery, which disappeared within 2wk after suture removal. Grafts all survived, vascularization of amniotic membrane grafts ended.<p>CONCLUSION:Autologous LSCT, AMT and autologous LSCT combined with AMT all are effective in the treatment of pterygium. However, autologous LSCT combined with AMT can achieve better short-term effect, with milder conjunctival fibroplasia and dry eye symptoms.

Outcome of 126 adolescent and adult T-cell acute leukemia/lymphoma patients and the prognostic significance of early T-cell precursor leukemia subtype / 中华血液学杂志

Objective: To evaluate the clinical characteristics of T-cell acute leukemia/lymphoma (T-ALL) and explore the prognosis significance of early T-cell precursor leukemia/lymphoma. Methods: A cohort of 126 patients diagnosed with T-ALL from 2008 to 2014 in West China Hospital, Sichuan University were enrolled in this study. They were further categorized by immunophenotype according to the expression of T-cell lineage markers CD1a, CD8, CD5 and one or more stem cell or myeloid markers. The laboratory indicators and prognosis factors were also statistically analyzed. Results: Of all patients, the ratio of male to female was 2.5∶1, with the median age of 25 years old (range 14 to 77) . The percentage of ETP-ALL was up to 47.6%. T-ALL patients showed higher ratio in first clinical remission rate (CR(1)) than T-LBL ones (64.4% vs 30.8%, P=0.032) . Group with WBC count higher than 50×10(9)/L at presentation showed higher ration of achieving CR(1) than those lower than 50×10(9)/L (78.4% vs 50.9%, P=0.010) . In comparison with the non-ETP-ALL, ETP-ALL patients had older age of onset (P<0.001) , lower WBC count (P<0.001) , lower risk of CNS involvement (10.0% vs 30.2%, P=0.009) and slightly inferior overall survival (P=0.073) . T-cell lineage markers CD1a(-), CD8(-) and CD4(-) positive patients had higher CR(1) than their corresponding negative ones (P=0.002, P=0.000, P=0.001) , while CD33(-) and CD56(-) positive patients had lower ratio of achieving CR(1) than their negative ones, respectively (P=0.035, P=0.035) . Conclusion: Flow cytometry and associated markers for immunophenotyping was of significance in the diagnosis and prognosis monitoring of T-ALL/LBL. The percentage of ETP-ALL/LBL subtype was high in Chinese adolescent and adult T-ALL patients. ETP-ALL/LBL was a high risk subtype, which needs more precise standard for diagnosis and advanced therapies for better outcome.

Effects of estradiol on naphthalene-induced telomerase activity and apoptosis of LEC in ovariectomized female rats / 眼科新进展

Objective To explore the effects of estradiol on the telomerase activity and apoptosis of lens epithelial cells and its mechanisms.Methods Fifty adult female Sprague-Dawley rats were randomly divided into five groups (n =10):ovariectomized group,estradiol group 1,estradiol group 2,estradiol group 3 and sham group.All rats were prepared for ovariectomized models except that of the sham group.After 2 weeks of the operation,rats in the 5 groups were given naphthalene solution through a stomach tube,and meanwhile,estradiol group 1,estradiol group 2,estradiol group 3 received estradiol valerate with the dose of 0.21 mg · kg-1 · d-1,0.42 mg · kg-1 · d-1 and 0.84 mg · kg-1 · d-1,accordingly,while rats in the ovariectomized group and sham group were given 9 g · L-1 Nacl by stomach perfusion with a dose of 0.42 mg · kg-1 ·d-1.Then,the opacity of the lens in each group was examined by a slit lamp microscope every week.After 12 weeks of naphthalene solution administration,all rats were sacririced and the serum estradiol concentration was determined by radioimmunoassay.Next,the lenses were taken out,and TERT mRNA expression of lens epithelial cells (LEC) was measured by RT-qPCR,and finally,the apoptotic rate was detected by TUNEL method.Results The opacity of lens in the ovariectomized group was different from that in the estradiol group 1,estradiol group 2,estradiol group 3 and sham group,with statistical significances (all P ＜ 0.05),and the opacity of lens in the estradiol group 1,2,3 and sham group were mild and occurred later.The serum estradiol concentration in the ovariectomized group (8.19 ± 1.45)ng · L-1 was significantly lower than that of estradiol groupl,2,3 and sham group,and there were significant differences (all P ＜ 0.05).Thc relative expression of TERT mRNA in LEC in the ovariectomized group (0.371 2-±0.056 4) was significantly lower than that in estradiol group 1,2,3,but the apoptotic rate of LEC (0.602 1 ±0.010 8) was obviously higher than that of estradiol group 1,2,3 in a dose-dependent manner,and there were significant differences (all P ＜ 0.05).Pearson correlation analysis showed the relative expression of LEC TERT mRNA in rats was negatively correlated with the apoptosis rate(r =-0.859,P ＜ 0.05).Conclusion Estradiol can up-regulate TERT mRNA expression and enhance telomerase activity of LEC in naphthalene-induced ovariectomized female rats in a dose-dependent manner.Estradiol can inhibit the LEC apoptosis in naphthalene-induced ovariectomized female rats,and the mechanism may be related to the increase of telomerase activity in the LEC.