A bidirectional Mendelian randomisation study of the association between rheumatoid arthritis and frailty.

OBJECTIVES: Observational studies have linked rheumatoid arthritis and frailty, but confounding factors and reverse causality make it unclear if there is a causal relationship. The current study used bidirectional two-sample Mendelian randomisation (MR) to assess the bidirectional causation between rheumatoid arthritis and frailty. METHODS: The primary analysis used the latest GWAS data for rheumatoid arthritis and frailty index in pure Europeans from large genome-wide association studies. Validation analysis was done to verify the accuracy of the results. The appropriate instrumental variables (IVs) were selected based on the three MR assumptions. The MR methods used were MR-Egger, weighted median (WM), and inverse variance weighted (IVW). The effects of horizontal pleiotropy were examined using the MR-Egger intercept and the MR-PRESSO method. To avoid single SNP bias, a leave-one-out analysis was performed. RESULTS: Genetic predictions suggested that there is a significant association between rheumatoid arthritis and the increased prevalence of frailty (IVW OR=1.01; 95% CI=[1.01-1.02], p=2.47 E-06). It has been verified in validation analysis that rheumatoid arthritis is also associated with frailty (IVW OR=1.03, 95% CI=[1.02-1.04], p=3.30E-17). Notably, genetic predictions suggested that frailty may be associated with the onset or development of rheumatoid arthritis (IVW ß=1.25, SE=0.44, 95% CI=[0.39-2.12], p=4.58E-03). CONCLUSIONS: The present study provides evidence supporting the fact that rheumatoid arthritis can increase the prevalence of frailty. Frailty may be a risk factor for rheumatoid arthritis, and whether frailty is involved in triggering the onset or progression of rheumatoid arthritis needs further study.

Electrical aligned polyurethane nerve guidance conduit modulates macrophage polarization and facilitates immunoregulatory peripheral nerve regeneration.

Biomaterials can modulate the local immune microenvironments to promote peripheral nerve regeneration. Inspired by the spatial orderly distribution and endogenous electric field of nerve fibers, we aimed to investigate the synergistic effects of electrical and topological cues on immune microenvironments of peripheral nerve regeneration. Nerve guidance conduits (NGCs) with aligned electrospun nanofibers were fabricated using a polyurethane copolymer containing a conductive aniline trimer and degradable L-lysine (PUAT). In vitro experiments showed that the aligned PUAT (A-PUAT) membranes promoted the recruitment of macrophages and induced their polarization towards the pro-healing M2 phenotype, which subsequently facilitated the migration and myelination of Schwann cells. Furthermore, NGCs fabricated from A-PUAT increased the proportion of pro-healing macrophages and improved peripheral nerve regeneration in a rat model of sciatic nerve injury. In conclusion, this study demonstrated the potential application of NGCs in peripheral nerve regeneration from an immunomodulatory perspective and revealed A-PUAT as a clinically-actionable strategy for peripheral nerve injury.

Dilute Povidone-Iodine Solution Soaking Is Ineffective in Improving Outcomes of Necrotizing Fasciitis Caused by Diabetic Foot.

ABSTRACT: Wound soaking is a physical debridement method that helps reduce bacterial colonization and consequently promotes wound healing. Although soaking in povidone-iodine solution was ineffective in reducing bacterial colonization in acute trauma wounds, there is still a lack of evidence supporting the efficacy of this method in treating severe soft tissue infection. This study aimed to explore the effects of wound soaking in 1% dilute povidone-iodine solution on necrotizing fasciitis caused by diabetic foot ulcers. We retrospectively reviewed and finally included 153 patients who were admitted because of diabetic foot ulcers after undergoing fasciotomy for necrotizing infection from January 2018 to December 2021. Results showed no statistical difference in the outcomes between patients in the soaking and nonsoaking groups. End-stage renal disease (P = 0.029) and high serum C-reactive protein level (P = 0.007) were the only independent factors for below-knee amputation in the univariate and multivariate logistic regression analyses. Therefore, soaking diabetic wounds with severe infection in 1% dilute povidone-iodine solution may not reduce the hospital length of stay, risk of below-knee amputation, and readmission rate.

Accurate calculation of tunneling splittings in water clusters using path-integral based methods.

Tunneling splittings observed in molecular rovibrational spectra are significant evidence for tunneling motion of hydrogen nuclei in water clusters. Accurate calculations of the splitting sizes from first principles require a combination of high-quality inter-atomic interactions and rigorous methods to treat the nuclei with quantum mechanics. Many theoretical efforts have been made in recent decades. This Perspective focuses on two path-integral based tunneling splitting methods whose computational cost scales well with the system size, namely, the ring-polymer instanton method and the path-integral molecular dynamics (PIMD) method. From a simple derivation, we show that the former is a semiclassical approximation to the latter, despite that the two methods are derived very differently. Currently, the PIMD method is considered to be an ideal route to rigorously compute the ground-state tunneling splitting, while the instanton method sacrifices some accuracy for a significantly smaller computational cost. An application scenario of such a quantitatively rigorous calculation is to test and calibrate the potential energy surfaces of molecular systems by spectroscopic accuracy. Recent progress in water clusters is reviewed, and the current challenges are discussed.

The clinical characteristics of neuronal intranuclear inclusion disease and its relation with inflammation.

BACKGROUND: Neuronal intranuclear inclusion disease (NIID) is a great imitator with a broad spectrum of clinical manifestations that include dementia, parkinsonism, paroxysmal symptoms, peripheral neuropathy, and autonomic dysfunction. Hence, it may also masquerade as other diseases such as Alzheimer's disease, Parkinson's disease, and Charcot-Marie-Tooth disease. Recent breakthroughs on neuroimaging, skin biopsy, and genetic testing have facilitated the diagnosis. However, early identification and effective treatment are still difficult in cases of NIID. OBJECTIVE: To further study the clinical characteristics of NIID and investigate the relationship between NIID and inflammation. METHODS: We systematically evaluated the clinical symptoms, signs, MRI and electromyographical findings, and pathological characteristics of 20 NIID patients with abnormal GGC repeats in the NOTCH2NLC gene. Some inflammatory factors in the patients were also studied. RESULTS: Paroxysmal symptoms such as paroxysmal encephalopathy, stroke-like episodes, and mitochondrial encephalomyopathy lactic acidosis and stroke (MELAS)-like episode were the most common phenotypes. Other symptoms such as cognitive dysfunction, neurogenic bladder, tremor, and vision disorders were also suggestive of NIID. Interestingly, not all patients showed apparent diffusion-weighted imaging (DWI) abnormality or intranuclear inclusions, while abnormal GGC repeats of NOTCH2NLC were seen in all patients. And fevers were noticed in some patients during encephalitic episodes, usually with increasing leukocyte counts and neutrophil ratios. Both IL-6 (p = 0.019) and TNF-α (p = 0.027) levels were significantly higher in the NIID group than in normal controls. CONCLUSION: Genetic testing of NOTCH2NLC may be the best choice in the diagnosis of NIID. Inflammation might be involved in the pathogenesis of NIID.

Piezosurgery versus conventional osteotomy: a randomized clinical trial on pain and anxiety in children with unerupted mandibular third molars.

OBJECTIVE: Dental anxiety for unerupted mandibular third molars extraction in children under local anesthesia is a tricky problem. The purpose of this study was to compare psychological and physiologic findings of extractions of unerupted mandibular third molars in children by piezosurgery and conventional osteotomy. MATERIALS AND METHODS: This prospective, single-center, double-blind study included children who required extraction of mandibular third molars under local anesthesia. All subjects were randomly divided into two groups: piezosurgery and conventional osteotomy (control). The primary outcome variables were dental anxiety assessed by the Modified Child Fear Survey Schedule Dental Subscale (CFSS-DS) and postoperative pain qualified by the visual analog scale (VAS). Secondary outcome variables included blood pressure, heart rate, saturation, and operation duration. The data were analyzed by t-test and chi-square test (P ≤ 0.05). RESULTS: All 40 study patients (37.5% males and 62.5% females with an average age of 14.43 ± 1.32 years) completed the entire trial. There were no statistically significant differences observed between the two groups in terms of gender allocation, age, side of extraction, and Winter's Classification (P > 0.05). The operation duration of the piezosurgery group was significantly longer than the conventional osteotomy group (P < 0.01). The VAS scores showed that pain levels of children in the piezosurgery group were significantly less than the conventional osteotomy group on the first and third days postoperatively (P < 0.05 and P < 0.01, respectively). The CFSS-DS score in the piezosurgery group significantly decreased compared to the conventional osteotomy group (P < 0.05). Compared with the conventional osteotomy group, a significant decrease in heart rate, and lower systolic and diastolic blood pressures were observed after extraction in the piezosurgery group (P < 0.05 and P < 0.01, respectively). CONCLUSION: Compared with conventional osteotomy, piezosurgery can effectively reduce postoperative pain and have some effect in relieving dental anxiety for the extraction of unerupted mandibular third molars in children. CLINICAL RELEVANCE: Piezosurgery may be a viable technique for the extraction of unerupted mandibular third molars in children under local anesthesia.

Coking-Resistant Polyethylene Upcycling Modulated by Zeolite Micropore Diffusion.

Although the mass production of synthetic plastics has transformed human lives, it has resulted in waste accumulation on the earth. Here, we report a low-temperature conversion of polyethylene into olefins. By mixing the polyethylene feed with rationally designed ZSM-5 zeolite nanosheets at 280 °C in flowing hydrogen as a carrier gas, light hydrocarbons (C1-C7) were produced with a yield of up to 74.6%, where 83.9% of these products were C3-C6 olefins with almost undetectable coke formation. The reaction proceeds in multiple steps, including polyethylene melting, flowing to access the zeolite surface, cracking on the zeolite surface, formation of intermediates to diffuse into the zeolite micropores, and cracking into small molecules in the zeolite micropores. The ZSM-5 zeolite nanosheets kinetically matched the cascade cracking steps on the zeolite external surface and within micropores by boosting the intermediate diffusion. This feature efficiently suppressed the intermediate accumulation on the zeolite surface to minimize coke formation. In addition, we found that hydrogen participation in the cracking process could hinder the formation of polycyclic species within zeolite micropores, which also contributes to the rapid molecule diffusion. The coking-resistant polyethylene upcycling process at a low temperature not only overturns the general viewpoint for facile coke formation in the catalytic cracking over the zeolites but also demonstrates how the polyethylene-based plastics can be upcycled to valuable chemicals. In addition to the model polyethylene, the reaction system worked efficiently for the depolymerization of multiple practically used polyethylene-rich plastics, enabling an industrially and economically viable path for dealing with plastic wastes.

Piezosurgery Versus Conventional Osteotomy: A Comparison of Techniques in the Extraction of Unerupted Mandibular Third Molars in Children.

PURPOSE: Piezoelectric bone surgery is a precise and effective osteotomy technique used in maxillofacial surgery. The purpose of this study was to compare postoperative sequelae and efficacy of extractions of unerupted mandibular third molars in children by piezosurgery and conventional osteotomy. METHODS: Healthy subjects, aged 10 to 14 years, needing removal of their bilateral lower third molars were included in this study. The right or left unerupted mandibular third molars were randomly extracted by either piezosurgery or conventional osteotomy. Pain (qualified by the visual analog scale), facial swelling, trismus, and operation duration were evaluated. RESULTS: All 32 study patients (40.6% males and 59.4% females with an average age of 11.91 ± 1.40 years) completed the entire trial. Swelling and trismus experienced by the conventional osteotomy were more severe than the piezosurgery group on the third (10.34 ± 2.36 mm vs 4.9 ± 1.95 mm and 6.09 ± 2.08 mm vs 2.34 ± 1.79 mm, respectively) and seventh (2.03 ± 1.26 mm vs 0.25 ± 0.57 mm and 0.91 ± 1.00 mm vs 0.09 ± 0.30 mm, respectively) days postoperatively (P < .01). Visual analog scale showed that pain levels of children in the piezosurgery group were significantly less than the conventional osteotomy group on third day postoperatively (2.06 ± 1.41 vs 4.81 ± 1.94; P < .01). The operation duration of the piezosurgery group was significantly longer than the conventional osteotomy group (27.16 ± 5.75 minutes vs 16.69 ± 3.22 minutes; P < .01). CONCLUSION: Compared with conventional osteotomy, piezosurgery can effectively reduce the severity of postoperative sequelae for the extraction of unerupted lower third molars in children.

The Regrowth of Mandibular Coronoid Process After Coronoidectomy: A Retrospective Analysis of 57 Cases.

PURPOSE: Coronoidectomy is carried out frequently as a part of the cranial-maxillofacial surgery procedure. There are few articles on the fate of coronoid process after coronoidectomy, except that several case reports mentioned that coronoid process had regenerated. This study aimed to radiographically access the anatomic outcomes of coronoid process and investigate which factors were associated with the outcomes after coronoidectomy. MATERIALS AND METHODS: A retrospective cohort study included patients undergoing coronoidectomy over a 7-year period. The primary outcome variable was the new coronoid process occurrence (yes/no). Secondary outcome variable was the type of the new coronoid process by evaluating its size, shape and position. Radiograph at 1-year postoperative visit was used to determine the outcomes. The predictor variables included age, sex, surgical purpose, surgical side, surgical approach and the maximal interincisal opening. Appropriate statistics were analyzed by SPSS version 22. χ2 test and binary logistic regression were used to assess the association between predictor factors and anatomic outcomes (P <.05). RESULTS: The study sample included 57 patients. In total, 96 coronoidectomies were performed. Seventy-four coronoid processes (77.1%) showed complete (n = 44, 45.8%), nonunion (n = 19, 19.8%) or partial (n = 11, 11.5%) regrowth, whereas no evidence of regeneration in 22 sites was observed radiographically at 1-year postoperative visit. Binary logistic regression showed that a young age (odds ratio 0.704; 95% confidence interval 0.562-0.882; P = .002) was significantly associated with regeneration of coronoid process. CONCLUSIONS: Coronoid process can mostly regenerate after coronoidectomy. A young age may contribute to regrowth of coronoid process.

Standard orthodontic treatment after condylectomy for patients with active unilateral condylar hyperplasia.

INTRODUCTION: Unilateral condylar hyperplasia (UCH) is a progressive, nonneoplastic overgrowth of the condyle of the temporomandibular joint. For treating active UCH, a popular method combines orthognathic surgery with high condylectomy and orthodontic treatment. The goal of this study was to introduce a new method to correct asymmetry for active UCH. METHODS: Retrospectively, 47 patients with active UCH were divided into horizontal-type, vertical-type, and combined-type. All patients were treated with condylectomy plus postsurgery standard orthodontics (CPSO) with applied miniscrews implanted in infrazygomatic crest and hard palate to intrude affected side of maxillary molars and apply intermaxillary traction for contralateral molars. Cone-beam computed tomography was taken at presurgery, postsurgery, and the end of orthodontics (T3). RESULTS: In the vertical (n = 10) and combined (n = 28) types, deviation of the chin and the canting of the mandible and maxillary occlusal plane were significantly reduced at T3. A difference in the torque of bilateral maxillary first molar (U6) and bilateral mandibular first molar (L6) was significantly reduced at T3. The anterior, superior, and posterior joint spaces in the vertical-type and combined-type were significantly decreased at T3 compared with postsurgery. In contrast, in the horizontal-type group (n = 9), the deviation of the chin was corrected; however, the canting of the mandible and maxillary occlusal plane was significantly increased at T3 compared with presurgery. CONCLUSIONS: CPSO restored facial and occlusal symmetry for vertical-type and combined-type active UCH and returned affected-side condyle to the glenoid fossa. However, CPSO was not suitable for treating the horizontal-type UCH.

Porous Electroactive and Biodegradable Polyurethane Membrane through Self-Doping Organogel.

In order to improve the processability of conductive polyurethane (CPU) containing aniline oligomers, a new CPU containing aniline trimer (AT) and l-lysine (PUAT) are designed and synthesized. Further, the 3D porous PUAT membranes have been prepared by a simple gel cooperated with freeze-drying method. Chemical testings and conductive properties testify a self- doping model of PUAT based on the rich electronic l-lysine and electroaffinity AT moities. The self-doping behavior further endows the PUAT copolymers specific characteristics such as high electrical conductivity and the formation of the polaron lattice like-structure in good solvent dimethyl sulfoxide. The combination of organogel and freeze-drying could prevent the collapse of pore structure when the copolymers are molded as membranes. The synergistic effect of l-lysine and AT components has a strong influence on the dissolution, degradation, thermal stability, and mechanical properties of PUAT. The excellent properties of PUAT would broad the application of conductive polymers in biomedicine field.

Comparison of performances of different fungal laccases in delignification and detoxification of alkali-pretreated corncob for bioethanol production.

The performance of the alkaline fungal laccase PIE5 (pH 8.5) in the delignification and detoxification of alkali-pretreated corncob to produce bioethanol was evaluated and compared with that of the neutral counterpart (rLcc9, 6.5), with the acidic laccase rLacA (4.0) was used as an independent control. Treatment with the three laccases facilitated bioethanol production compared with their respective controls. The lignin contents of alkali-pretreated corncob reduced from 4.06%, 5.06%, and 7.80% to 3.44%, 3.95%, and 5.03%, after PIE5, rLcc9, and rLacA treatment, respectively. However, the performances of the laccases were in the order rLacA > rLcc9 > PIE5 in terms of decreasing total phenol concentration (0.18, 0.36, and 0.67 g/l), boosting ethanol concentration (8.02, 7.51, and 7.31 g/l), and volumetric ethanol productivity (1.34, 0.94, and 0.91 g/l hr), and shortening overall fermentation time. Our results would inform future attempts to improve laccases for ethanol production. Furthermore, based on our data and the fact that additional procedures, such as pH adjustment, are needed during neutral/alkaline fungal laccase treatment, we suggest acidic fungal laccases may be a better choice than neutral/alkaline fungal laccases in bioethanol production.

Light induced expression of ß-glucosidase in Escherichia coli with autolysis of cell.

BACKGROUND: ß-Glucosidase has attracted substantial attention in the scientific community because of its pivotal role in cellulose degradation, glycoside transformation and many other industrial processes. However, the tedious and costly expression and purification procedures have severely thwarted the industrial applications of ß-glucosidase. Thus development of new strategies to express ß-glucosidases with cost-effective and simple procedure to meet the increasing demands on enzymes for biocatalysis is of paramount importance. RESULTS: Light activated cassette YF1/FixJ and the SRRz lysis system were successfully constructed to produce Bgl1A(A24S/F297Y), a mutant ß-glucosidase tolerant to both glucose and ethanol. By optimizing the parameters for light induction, Bgl1A(A24S/F297Y) activity reached 33.22 ± 2.0 U/mL and 249.92 ± 12.25 U/mL in 250-mL flask and 3-L fermentation tank, respectively, comparable to the controls of 34.02 ± 1.96 U/mL and 322.21 ± 10.16 U/mL under similar culture conditions with IPTG induction. To further simplify the production of our target protein, the SRRz lysis gene cassette from bacteriophage Lambda was introduced to trigger cell autolysis. As high as 84.53 ± 6.79% and 77.21 ± 4.79% of the total ß-glucosidase were released into the lysate after cell autolysis in 250 mL flasks and 3-L scale fermentation with lactose as inducer of SRRz. In order to reduce the cost of protein purification, a cellulose-binding module (CBM) from Clostridium thermocellum was fused into the C-terminal of Bgl1A(A24S/F297Y) and cellulose was used as an economic material to adsorb the fusion enzyme from the lysate. The yield of the fusion protein could reach 92.20 ± 2.27% after one-hour adsorption at 25 °C. CONCLUSIONS: We have developed an efficient and inexpensive way to produce ß-glucosidase for potential industrial applications by using the combination of light induction, cell autolysis, and CBM purification strategy.

A novel Enterovirus 96 circulating in China causes hand, foot, and mouth disease.

Enterovirus 96 (EV-96) is a recently described member of the species Enterovirus C and is associated with paralysis and myelitis. In this study, using metagenomic sequencing, we identified a new enterovirus 96 strain (EV-96-SZ/GD/CHN/2014) as the sole pathogen causing hand, foot, and mouth disease (HFMD). A genomic comparison showed that EV-96-SZ/GD/CHN/2014 is most similar to the EV-96-05517 strain (85% identity), which has also been detected in Guangdong Province. This is the first time that metagenomic sequencing has been used to identify an EV-96 strain shown to be associated with HFMD.

First identification of Gordonia sputi in a post-traumatic endophthalmitis patient - a case report and literatures review.

BACKGROUND: We present a case of post-traumatic endophthalmitis with relatively good prognosis caused by Gordonia sputi, which, to our knowledge is the first case in the literature. CASE PRESENTATION: A 24 year old man, who underwent an intraocular foreign body extraction half a month before presentation in the left eye, was referred to us complaining of blurred vision and slight pain for 5 days. His first presentation showed moderate intracameral and intravitreous purulent inflammation with a best corrected vision of counting fingers. After gram staining of the intravitreous samples revealed a gram-positive bacilli infection, a combination of amikacin and vancomycin was initially injected intravitreously. The left eye kept stable for three days but deteriorated on the 4th day. On the 5th day after presentation conventional culture characterized the bacterium as an Actinomyces sp. while 16S ribosomal RNA gene sequencing confirmed it as Gordonia sputi. Thereby a complete pars plana vitrectomy combined with lensectomy and silicone oil tamponade was performed. During the surgery an intraocular irrigation with penicillin G was adopted, followed by administration of intravenous penicillin G twice one day for a week. A relatively normal fundus with slight intracameral inflammation was observed a week after the operation, and the best corrected vision recovered to 0.15. One year later his vision remained 0.1. CONCLUSION: Gordonia sputi should be taken into consideration in patients with post-traumatic endophthalmitis especially due to foreign body penetration. Compared to conventional laboratories, molecular methods are recommended for an accurate diagnosis. A comprehensive strategy of antimicrobial agents and vitrectomy may render a satisfactory result.

IL-1ß mediating high mobility group box protein-1 expression in condylar chondrocyte during temporomandibular joint inflammation.

BACKGROUND: Temporomandibular joint (TMJ) osteoarthritis(OA)characterized with cartilage degen-eration is associated with inflammation. High mobility group box chromosomal protein-1(HMGB-1)is a potent mediator of inflammation and the trigger of OA. The expression of HMGB-1 in TMJ OA was uncovered, but the role of HMGB-1 in TMJ cartilage degeneration is not fully understood. In this study, the regulation of HMGB-1 in TMJ condylar cartilage was revealed. METHODS: A complete Freund's adjuvant (CFA)-induced TMJ inflammation animal model was employed and the expression of HMGB-1 was detected at 1st, 2nd, and 6th weeks by immunohistochemistry. TMJ condylar chondrocytes were incubated with IL-1ß (10 and 40 ng/ml) at 24, 48, and 72 h, and the translocation and protein level of HMGB-1 were evaluated by immunofluorescence and Western blot. RESULT: Nuclear HMGB-1 staining was predominantly located in chondrocytes of both the fibrosis and proliferative zones in healthy TMJ. 1st week and 2nd week after CFA injection, immunoreaction could be detected in the cytoplasms of HMGB-1-positive cells and cartilage matrix especially in hypertrophic zone. At 6th week after CFA injection, cartilage matrix expression was disappeared and the cytoplasm expression of HMGB-1 was very weak in hypertrophic zone. HMGB-1 was translocated from the nucleus to the cytoplasm at 48 h after incubated with IL-1ß (10 ng/ml and 40 ng/ml). The protein level of HMGB-1 was increased after stimulation and had a peak at 48 h. CONCLUSION: HMGB-1 might be associated with TMJ inflammation and OA. Insight into the role of HMGB-1 in TMJ inflammation is helpful to add the new knowledge into the pathogenesis of TMJ OA.

Refractive shift of silicone oil tamponade in pseudophakic eye.

BACKGROUND: Refraction change of silicone oil (SO) tamponade in phakic and aphakic eye has been studied thoroughly; however, it is rarely studied in pseudophakic eye. In this paper we aimed to deduce a theoretical formula predicting refractive shift of silicone oil tamponade in pseudophakic eye and compared it with clinical findings. METHOD: A theoretical formula was deduced through strict geometric optical principles under the Helmholtz Schematic eye model. Pre/postoperative refractive status of patients who previously underwent phacoemulsification, intraocular lens (IOL) implant, vitrectomy, SO tamponade and required SO extraction was studied. RESULTS: Twenty-six patients (27 eyes, 13 males and 13 females) were studied. Refractive error of SO-off was -1.88 ± 2.73D, and of SO-in was 2.02 ± 3.90. Refractive shift of SO tamponade was -3.90 ± 1.74D. Refractive shift was significantly associated with refractive power of IOL (r = -0.7903, p < 0.0001, Pearson correlation test) and anterior chamber distance (ACD, r = 0.3840, p = 0.0480, Pearson correlation test). Theoretical refractive shift was -4.10 ± 1.51D, and there was no significant difference between the theoretical and the clinical refractive shift (p = 0.3329, Paired T test). CONCLUSIONS: Refractive shift of SO tamponade in pseudophakic eye correlates with refractive power of implanted IOL and ACD, and strong correlation between theoretical formula and clinical findings was detected.

In situ fabrication of a tunable microlens.

We demonstrate an optofluidic variable-focus microlens formed by a solid polydimethylsiloxane (PDMS) meniscus channel wall and a tunable liquid lens body. A novel method for in situ fabrication of the meniscus channel wall is developed by introducing liquid PDMS prepolymer into a microchannel followed by curing. Three-light manipulation techniques including tunable optical focusing, collimating, and diverging are realized by varying the refractive index (RI) of liquid lens body. Also, we present an absorption measurement of methylene blue (MB) with a collimated probing light, achieving a detection limit of 0.25 µM by using a 5-mm-long detection cell.

Transurethral cystolitholapaxy with the AH-1 stone removal system for the treatment of bladder stones of variable size.

BACKGROUND: The treatment of large volume bladder stones by current equipments continues to be a management problem in both developing and developed countries. AH-1 Stone Removal System (SRS) invented by us is primarily used to crush and retrieve bladder stones. This study evaluated the safety and efficiency of transurethral cystolitholapaxy with SRS for the treatment of bladder stones of variable size. METHODS: SRS, which was invented by Aihua Li in 2007, composed by endoscope, continuous-flow component, a jaw for stone handling and retrieving, lithotripsy tube, handle, inner sheath and outer sheath. 112 patients with bladder stones were performed by transurethral cystolitholapaxy with SRS since 2008. We compare the surgical outcome to bladder stones of variable size, and evaluate the surgical efficiency and safety. RESULTS: Characteristics of patients and stone removal time in variable size were evaluated. To patients with single stone, stone size was 1.35 ± 0.37 cm and the operating time was 5.50 ± 3.92 min in Group A. Stone size was 2.38 ± 0.32 cm and the operating time was 11.90 ± 9.91 min in Group B. Stone size was 3.30 ± 0.29 cm and the operating time was 21.92 ± 9.44 min in Group C. Stone size was 4.69 ± 0.86 cm and the operating time was 49.29 ± 30.47 min in Group D. The difference was statistically significant between the four groups. Among them, 74 (66.07%) patients accompanied with benign prostatic hyperplasia (BPH) were treated by transurethral resection of the prostate (TURP) simultaneously. Compared between the four groups, the difference of the TURP time was not statistically significant, P >0.05. No significant complication was found in the surgical procedure. CONCLUSIONS: Transurethral cystolitholapaxy with SRS appears to be increased rapidity of the procedure with decreased morbidity. It is a safe and efficient surgical management to bladder stones. This endoscopic surgery best fits the ethics principle of no injury; meanwhile, the accompanied BPH could be effectively treated by TURP simultaneously.

[Preretinal hemorrhage and prognosis following vitrectomy and silicone oil tamponade for severe proliferative diabetic retinopathy].

OBJECTIVE: To examine the prognosis of preretinal hemorrhage following vitrectomy and silicone oil tamponade for severe proliferative diabetic retinopathy. METHODS: Clinical data of 76 cases of proliferative diabetic retinopathy treated with vitrectomy and silicone oil infusion tamponade in Sir Run Run Shaw Hospital from October 2006 to September 2013 were retrospectively reviewed. Intraoperative bleeding,postoperative preretinal bleeding,blood reabsorption time, and preretinal fibrosis were assessed. RESULTS: All preretinal hemorrhage developed within 1 week after surgery, blood was distributed in thin and scattered patterns (32 cases), thick and localized patterns (25 cases) or thick and scattered patterns (19 cases). The preretinal hemorrhage was ceased in 1 day after operation in 35 cases, in 2 days after operation in 18 cases, in two weeks after operation in 23 case. Recurrent hemorrhage occurred within 1 week after operation in 15 cases. Thin blood was largely reabsorbed in about two weeks, and thick blood was largely reabsorbed in about five weeks. Fibrosis tissue was resulted in 15 cases(34.1%) with thick blood. CONCLUSION: Most of preretinal hemorrhage occurs within 1 week after surgery and is reabsorpted with 5 weeks in patients with proliferative diabetic retinopathy undergoing vitrectomy and silicone oil tamponade. The major complication of preretinal bleeding is the formation of preretinal fibrosis.