Electroacupuncture for mild-to-moderate dry eye: study protocol for a multicentre, randomised, single-blind, sham-controlled trial.

INTRODUCTION: Dry eye (DE) is a multifactorial ocular surface disease causing considerable medical, social and financial implications. Currently, there is no recognised long-term, effective treatment to alleviate DE. Clinical evidence shows that electroacupuncture (EA) can improve DE symptoms, tear secretion and tear film stability, but it remains controversial whether it is just a placebo effect. We aim to provide solid clinical evidence for the EA treatment of DE. METHODS AND ANALYSIS: This is a multicentre, randomised, sham-controlled trial. A total of 168 patients with DE will be enrolled and randomly assigned to EA or sham EA groups to receive 4-week consecutive treatments and follow-up for 24 weeks. The primary outcome is the change in the non-invasive tear break-up time (NIBUT) from baseline to week 4. The secondary outcomes include tear meniscus height, the Schirmer I test, corneal and conjunctival sensation, the ocular surface disease index, corneal fluorescein staining, the numerical rating scale and the Chinese DE-related quality of life scale. ETHICS AND DISSEMINATION: The trial protocol and informed consent were approved by the Ethics Committee of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine (identifier: 2021-119), Shanghai Eye Disease Prevention and Treatment Center (identifier: 2022SQ003) and Eye and ENT Hospital of Fudan University (identifier: 2022014). TRIAL REGISTRATION NUMBER: NCT05552820.

Efficacy Comparison Between Toric Posterior Chamber Phakic IOL and Posterior Chamber Phakic IOL Plus Modified Steep Meridian Corneal Relaxing Incision for Moderate to High Astigmatism Corrections.

PURPOSE: To compare posterior chamber phakic intraocular lens (Implantable Collamer Lens [STAAR Surgical]) (ICL) plus modified steep meridian corneal relaxing incision (MS-CRI) to toric posterior chamber phakic intraocular lens (Toric Implantable Collamer Lens [STAAR Surgical]) (TICL) implantation for the correction of moderate to high astigmatism. METHODS: In this prospective, randomized clinical trial, patients with myopia who had moderate to high astigmatism (200 eyes) were enrolled and divided into TICL (n = 100) and MSCRI (n = 100) groups. All patients underwent examinations for uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and subjective refraction before surgery and at the 1- and 6-month follow-up visits. Vector astigmatism analysis was evaluated using the Alpins method. RESULTS: The mean UDVA and CDVA demonstrated significant improvement after surgery in both groups. During the 6-month follow-up, the MS-CRI group showed a slight regression tendency (P < .001) and the TICL group was stable for the astigmatism correction (P = .510). At 6 months postoperatively, the mean magnitudes of the surgically induced astigmatism were 1.46 ± 0.53 and 1.10 ± 0.48 diopters (P < .001). The correction index of the TICL group was closer to 1 compared to that of the MS-CRI group (0.95 vs 0.76). Approximately 99% of eyes in the TICL group had angle of error within ±15°, whereas 89% eyes in the MS-CRI group were within that range. A significant relationship between the magnitudes of target induced astigmatism and correction index was noted in the MS-CRI group (P < .001), but not in the TICL group (P = .592). CONCLUSIONS: TICL implantation could achieve better visual outcomes for correcting moderate to high astigmatism compared to ICL implantation plus MS-CRI. [J Refract Surg. 2023;39(8):539-545.].

Addition of Auricular Acupoint Stimulation to 0.01% Atropine for Myopia: 12-Month Results from a Randomized Trial.

Introduction: A previous 6-month report showed that adjunctive auricular acupoint stimulation (AAS) slowed myopia progression compared with 0.01% atropine (0.01% A) alone. This 12-month report was to determine whether the antimyopic effect of AAS, when added to 0.01% A, continued beyond treatment cessation, and explore the mode of action of AAS from the accommodative response. Design and Interventions: One hundred four children were randomly assigned to either a 0.01% A group or a 0.01% A + AAS group. Participants in the 0.01% A + AAS group received AAS in addition to 0.01% A for 6 months, and then kept using 0.01% A for the following 6 months. Participants in the 0.01% A group only used 0.01% A. The primary outcome was the difference in the mean cycloplegic spherical equivalent refraction (SER) from the baseline to the 12-month visit. Secondary outcomes included axial length (AL) and accommodative lag assessments. Results: The adjusted mean change from baseline to month 12 in the SER was -0.62 D for 0.01% A and -0.46 D for 0.01% A + AAS (difference, 0.16 D; p = 0.01), with a respective mean increase of 0.37 and 0.31 mm in AL (difference, -0.05 mm; p = 0.05). For the 5D near target, there was a reduction in the accommodative lag in children receiving add-on AAS relative to 0.01% A alone at 1 and 6 months (both p = 0.002). Conclusions: AAS treatment produced additional benefits >0.01% A in slowing myopia progression over the 12-month period, where the efficacy was sustained after the cessation of AAS. An effect of add-on AAS on reducing accommodative lag in response to 5D stimulus was found, but its role in mediating therapeutic response remained unclear. Chinese Clinical Trial Registry number: ChiCTR1900021316.

Immediate effect in retina and choroid after 650 nm low-level red light therapy in children.

INTRODUCTION: To investigate the changes in the retina and choroid of children after 650 nm low-level red light therapy (LLRLT). METHODS: In this prospective study, 25 subjects in the Shanghai Eye and ENT Hospital of Fudan University were included from August 2021 to September 2021. One eye was randomly selected to receive LLRLT for 3 minutes. Swept-source optical coherence tomography (OCT) and OCT angiography (OCTA) were used to measure retinal fovea perfusion density (RFPD), retinal fovea thickness (RFT), choroidal fovea blood flow (CFBF), and choroidal fovea thickness (CFT) before LLRLT, 5 minutes and 1 hour after LLRLT. Baseline characteristics between LLRLT and non-LLRLT eyes were compared. Changes in the retinal and choroidal parameters were analyzed by ANCOVA models. SAS software was used for data analysis. The difference was considered statistically significant if p < 0.05. RESULTS: There was no difference in baseline characteristics between LLRLT eyes and non-LLRLT eyes. The RFPD in LLRLT eyes significantly increased 5 minutes after LLRLT and the increment was 1.70±0.83 % (p = 0.0389). The RFPD significantly decreased from 5 minutes to 1 hour after LLRLT with a mean of -2.62±0.86 % decrement (p = 0.0031). The RFPD levels returned to baseline at 1 hour after LLRLT (p = 0.8646). However, compared with insignificant RFPD changes in non-LLRLT eyes, there was no significant difference in RFPD changes at any sampling point. No significant changes in RFT, CFBF, and CFT were found in LLRLT eyes at each sampling point. CONCLUSION: Although LLRLT has no effect on the choroid, it may cause a short-term transient increase in RFPD. It will provide theoretical support for the role of LLRLT in myopia control.

Lysosome-mediated mitochondrial apoptosis induced by tea polysaccharides promotes colon cancer cell death.

The release of lysosomal hydrolase into the cytoplasm is accompanied by several systems of apoptosis signal transduction, and the imbalance between cell viability and apoptosis induces tumorigenesis. Tea polysaccharides (TPs) are the main bioactive components in green tea with hopeful anti-tumor efficacy, while their mechanism is still unclear. Here, TPs significantly promoted the death of colon cancer cell line CT26. RNA-seq results showed that the signal pathways up-regulated by TPs included lysosome pathways, apoptosis, the release of mitochondrial pigment c and programmed cell death. Among them, the results of AO-EB and annexin V-FITC/PI double staining indicated that TPs significantly up-regulated apoptosis. In addition, TPs significantly disrupted the function of lysosomes, which would cause mitochondrial damage. Intriguingly, TPs treatment increased the expression of Bak1, cleaved caspase-9 and cleaved caspase-3, but decreased the level of Bcl-2 and mitochondrial membrane potential, which indicated that TPs induced mitochondrial-mediated apoptosis. Moreover, TPs ameliorated the reduced lysosomal numbers by Baf A1 (lysosomal inhibitor). Therefore, our data indicated that TPs targeted lysosomes and induced apoptosis by a lysosomal-mitochondrial pathway mediated caspase cascade, thereby inhibiting the proliferation of CT26 cells. In short, the data would help the development of TPs as potential cancer drug therapeutics.

Glucomannan from Aloe vera Gel Promotes Intestinal Stem Cell-Mediated Epithelial Regeneration via the Wnt/ß-Catenin Pathway.

Intestinal stem cells (ISCs) are essential to maintain intestinal epithelial regeneration and barrier function. Our previous work showed that glucomannan from Aloe vera gel (AGP) alleviated epithelial damage, but the mechanism was still elusive. Herein, RNA-sequencing analysis showed that proliferation and differentiation of intestinal epithelial cells as well as the canonical Wnt pathway were involved in this process. Further experiments exhibited that AGP promoted nuclear translocation of ß-catenin and expression of transcription factor 7, increased the number of Lgr5+ ISCs, and differentiated epithelial cells in mice colon. Intriguingly, AGP reversed the inhibition of IEC-6 cells proliferation induced by an inhibitor of the canonical Wnt pathway. Hence, this study implied that AGP promoted proliferation and differentiation of colon stem cells via Wnt/ß-catenin signaling, which subsequently facilitated the regeneration of epithelial cells and alleviated colitis in mice. It may provide new insights into the role of polysaccharides in regulating intestinal homeostasis and relieving intestinal injury.

Auricular acupressure for myopia prevention and control in children and its effect on choroid and retina: a randomized controlled trial protocol.

BACKGROUND: Nowadays, because of the increasing incidence, the prevention and control of myopia has become an urgent issue. In China, auricular acupressure has been commonly used in the clinical treatment of myopia in children, but the exact effectiveness remains unproven. The purpose of this trial is to observe the efficacy of auricular acupressure in myopia prevention and control, as well as its effect on the choroidal and retinal thickness. METHOD/DESIGN: A total of 480 subjects at 8-9 years old will be randomized in a 1:1 ratio to an intervention group versus a control group. The intervention group will receive auricular acupressure for 12 months, while the control group will be taken as a blank control. The primary and secondary outcomes will be measured at baseline, and again at 3, 6, 9, and 12 months after recruitment. The myopia incidence (spherical equivalent ≤ - 0.50 D) and the mean change of spherical equivalent will be taken as the primary variables; the secondary outcome measures include axial length, uncorrected visual acuity, and choroidal and retinal thickness. DISCUSSION: This trial aims to evaluate the effectiveness of auricular acupressure for myopia prevention and control with objective evidence and to preliminarily explore the plausible mechanism and provide reference for adopting this approach to retard the onset and control the progression of myopia. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000038456 . Registered on September 23, 2020.

Lysosome-Mediated Cytotoxic Autophagy Contributes to Tea Polysaccharide-Induced Colon Cancer Cell Death via mTOR-TFEB Signaling.

Targeting autophagy and lysosome may serve as a promising strategy for cancer therapy. Tea polysaccharide (TP) has shown promising antitumor effects. However, its mechanism remains elusive. Here, TP was found to have a significant inhibitory effect on the proliferation of colon cancer line HCT116 cells. RNA-seq analysis showed that TP upregulated autophagy and lysosome signal pathways, which was further confirmed through experiments. Immunofluorescence experiments indicated that TP activated transcription factor EB (TFEB), a key nuclear transcription factor modulating autophagy and lysosome biogenesis. In addition, TP inhibited the activity of mTOR, while it increased the expression of Lamp1. Furthermore, TP ameliorated the lysosomal damage and autophagy flux barrier caused by Baf A1 (lysosome inhibitor). Hence, our data suggested that TP repressed the proliferation of HCT116 cells by targeting lysosome to induce cytotoxic autophagy, which might be achieved through mTOR-TFEB signaling. In summary, TP may be used as a potential drug to overcome colon cancer.