Let-7c-3p suppresses lens epithelial-mesenchymal transition by inhibiting cadherin-11 expression in fibrotic cataract.

Fibrotic cataract, including anterior subcapsular cataract (ASC) and posterior capsule opacification, always lead to visual impairment. Epithelial-mesenchymal transition (EMT) is a well-known event that causes phenotypic alterations in lens epithelial cells (LECs) during lens fibrosis. Accumulating studies have demonstrated that microRNAs are important regulators of EMT and fibrosis. However, the evidence explaining how microRNAs modulate the behavior and alter the cellular phenotypes of the lens epithelium in fibrotic cataract is insufficient. In this study, we found that hsa-let-7c-3p is downregulated in LECs in human ASC in vivo as well as in TGFß2-induced EMT in vitro, indicating that hsa-let-7c-3p may participate in modulating the profibrotic processes in the lens. We then demonstrated that overexpression of hsa-let-7c-3p markedly suppressed human LEC proliferation and migration and attenuated TGFß2-induced EMT and injury-induced ASC in a mouse model. In addition, hsa-let-7c-3p mediated lens fibrosis by directly targeting the CDH11 gene, which encodes cadherin-11 protein, an important mediator in the EMT signaling pathway. It decreased cadherin-11 protein expression at the posttranscriptional level but not at the transcriptional level by binding to a specific site in the 3-untranslated region (3'-UTR) of CDH11 mRNA. Moreover, blockade of cadherin-11 expression with a specific short hairpin RNA reversed TGFß2-induced EMT in LECs in vitro. Collectively, these data demonstrated that hsa-let-7c-3p plays a clear role in attenuating ASC development and may be a novel candidate therapeutic for halting fibrosis and maintaining vision.

Association of refractive outcome with postoperative anterior chamber depth measured with 3 optical biometers.

PURPOSE: This study evaluated the relationship between refractive outcomes and postoperative anterior chamber depth (ACD, measured from corneal epithelium to lens) measured by swept-source optical coherence tomography (SS-OCT), optical low-coherence reflectometry (OLCR), and Scheimpflug devices under the undilated pupil. METHODS: Patients undergoing cataract phacoemulsification with intraocular lens (IOL) implantation in a hospital setting were enrolled. Postoperative ACD (postACD) was performed with an SS-OCT device, an OLCR device, and a Scheimpflug device at least 1 month after cataract surgery. After adjusting the mean predicted error to 0, differences in refractive outcomes were calculated with the Olsen formula using actual postACD measured from 3 devices and predicted value. RESULTS: Overall, this comparative case study included 69 eyes of 69 patients, and postACD measurements were successfully taken using all 3 devices. The postACD measured with the SS-OCT, OLCR, and Scheimpflug devices was 4.59 ± 0.30, 4.50 ± 0.30, and 4.54 ± 0.32 mm, respectively. Statistically significant differences in postACD were found among 3 devices (P < 0.001), with intraclass correlation coefficients (ICCs) and Bland-Altman showing good agreement. No significant difference in median absolute error was found with the Olsen formula using actual postACD obtained with 3 devices. Percentage prediction errors were within ± 0.50 D in 65% (OLCR), 70% (Scheimpflug), and 67% (SS-OCT) calculated by actual postACD versus 64% by predicted value. CONCLUSION: Substantial agreement was found in postACD measurements obtained from the SS-OCT, OLCR, and Scheimpflug devices, with a trend toward comparable refractive outcomes in the Olsen formula. Meanwhile, postACD measurements may be potentially superior for the additional enhancement of refractive outcomes.

Pyridine-Based Covalent Organic Frameworks with Pyridyl-Imine Structures for Boosting Photocatalytic H2O2 Production via One-Step 2e- Oxygen Reduction.

Bipyridine-based covalent organic frameworks (COFs) have emerged as promising contenders for the photocatalytic generation of hydrogen peroxide (H2O2). However, the presence of imine nitrogen alters the mode of H2O2 generation from an efficient one-step two-electron (2e-) route to a two-step 2e- oxygen reduction pathway. In this work, we introduce 3,3'-bipyridine units into imine-based COF skeletons, creating a pyridyl-imine structure with two adjacent nitrogen atoms between the pyridine ring and imine linkage. This unique bipyridine-like architecture can effectively suppress the two-step 2e- ORR process at the single imine-nitrogen site, facilitating a more efficient one-step 2e- pathway. Consequently, the optimized pyridyl-imine COF (PyIm-COF) exhibits a remarkable H2O2 production rate of up to 5850 µmol h-1 g-1, nearly double that of pristine bipyridine COFs. This work provides valuable insight into the rational design of functionalized COFs for enhanced H2O2 production in photocatalysis.

Construction of Covalent Organic Framework Nanofiber Membranes for Efficient Adsorption of Antibiotics.

Techniques beyond crystal engineering are critical for manufacturing covalent organic frameworks (COFs) and to explore them for advanced applications. However, COFs are normally obtained as insoluble, unmeltable, and thus nonprocessible microcrystalline powders. Therefore, it is a significant challenge to implement COFs into larger architectures and structural control on different length scales. Herein, a facile strategy is presented to prepare flexible COF nanofiber membranes by in-situ growth of COFs on polyacrylonitrile (PAN) nanofiber substrates via a reversible polycondensation-termination approach. The obtained PAN@COF nanofiber membranes with vertically aligned COF nanoplates combine a large functional surface with efficient mass transport, thus making it a promising adsorbent, for example, for water purification. The antibiotic pollutant ofloxacin (OFX) is removed from water with a superior absorption capacity of ≈236 mg g-1 and removal efficiency as high as 98%. The here presented in-situ growth of COFs on nanofiber membranes can be extended to various Schiff base-derived COF materials with different compositions, providing a highly efficient way to construct flexible COF-based membranes for several applications.

A case report of interstitial keratitis and secondary glaucoma after cataract surgery that may be related to late congenital syphilis.

BACKGROUND: The destruction of blood eye barrier and the administration of corticosteroid eyedrops after phacoemulsification surgery can lead to the replication of the local potential pathogens. With the rapid increase and popularization of cataract surgery, all kinds of rare postoperative complications have appeared. Here, we report a case of interstitial keratitis and secondary glaucoma after cataract surgery, which may be related to late congenital syphilis, which eventually led to blindness in the right eye. We hope that the timely report of this case will enable doctors to pay more attention to the possibility of potential pathogen replication after cataract surgery, and enable more patients to receive reasonable and effective treatment. CASE PRESENTATION: A 63-year-old female was referred to our clinic for investigation with a 1-week history of moderate pain in the right eye and ipsilateral headache in January 2020. She had cataract surgery on her right eye two years ago and on her left eye one year ago. The intraocular pressure (IOP) in the right eye was 43.2 mmHg and that in the left eye was 28.5 mmHg. Her right eye underwent medication, trabeculectomy and finally was subjected to ciliary body photocoagulation to control the IOP. The IOP of the left eye was well controlled by regular use of eye drops. In addition to the elevated IOP, the inflammation of the anterior segment and corneal stroma was found. Before cataract surgery, bilateral corneal opacities was revealed, but after cataract surgery, interstitial keratitis in both eyes was gradually aggravated, during the follow-up period from 2019 to 2021. She informed us that she had suffered from decreased vision in both eyes and was diagnosed with bilateral keratitis and congenital syphilis at the age of 20. In 2018, the serologic test for syphilis was positive in blood (Chemiluminescence analysis (CLIA): + ; Toluidine red unheated serum test (TRUST): + , titer was 1:1). However, four tests for TRUST were negative in 2019 and 2020, so she was not treated for syphilis. CONCLUSION: This case of glaucoma and interstitial keratitis might be secondary to ocular inflammation caused by late congenital syphilis. The ocular inflammation and the activation of syphilis may be related to cataract surgery.

Bioinformatics Analysis of Competing Endogenous RNA Network and Immune Infiltration in Atrial Fibrillation.

Background: There is still no clear understanding of the pathogenesis of atrial fibrillation (AF). For this purpose, we used integrated analysis to uncover immune infiltration characteristics and investigated their relationship with competing endogenous RNA (ceRNA) network in AF. Methods: Three AF mRNA data sets (GSE14975, GSE79768, and GSE41177) were integrated using the SVA method from Gene Expression Omnibus (GEO). Together with AF circRNA data set (GSE129409) and miRNA data set (GSE70887) from GEO database, we built a ceRNA network. Then hub genes were screened by the Cytoscape plug-in cytoHubba from a protein-protein interaction (PPI) network. As well, CIBERSORT was employed to investigate immune infiltration, followed by Pearson correlation coefficients to unravel the correlation between AF-related infiltrating immune cells and hub genes. Ulteriorly, circRNA-miRNA-mRNA regulatory axises that could be immunologically related to AF were obtained. Results: Ten hub genes were identified from the constructing PPI network. The immune infiltration analysis revealed that the number of monocytes and neutrophils was higher, as well as the number of dendritic cells activated and T cells regulatory (Tregs) was lower in AF. Seven hub genes (C5AR1, CXCR4, HCK, LAPTM5, MPEG1, TLR8, and TNFSF13B) were associated with those 4 immune cells (P < 0.05). We found that the circ_0005299-miR-1246-C5AR1 and circRNA_0079284-miR-623-HCK/CXCR4 regulatory axises may be associated with the immune mechanism of AF. Conclusion: The findings of our study provide insights into immuno-related ceRNA networks as potential molecular regulators of AF progression.

Rationale and Design of the ADIDAS Study: Association Between Dapagliflozin-Induced Improvement and Anemia in Heart Failure Patients.

BACKGROUND: Heart failure (HF) is one of the most serious health concerns worldwide. Anemia is a highly prevalent comorbidity and outcome predictor in HF patients. Sodium glucose co-transport 2 (SGLT2) inhibitors have been demonstrated to reduce the risk of cardiovascular death and HF hospitalization in HF patients. PURPOSE: This investigator-initiated, interventional, prospective, double-blind, multicenter study is designed to investigate whether anemia correction is one of the prerequisites and determinants related to the beneficial effects of dapagliflozin in HF patients. METHODS AND RESULTS: Up to 2030 HF participants receiving standard care will be randomly assigned to either oral dapagliflozin 10 mg once daily or placebo 10 mg once daily for 12 months. The primary outcome is the composite incidence of hospital admission for HF and all-cause death. Secondary outcomes include change in the Kansas City Cardiomyopathy Questionnaire (KCCQ) score and change in 6-min walk distance and hemoglobin level. Patients will be followed for 12 months after randomization. CONCLUSIONS: The ADIDAS trial offers an opportunity to assess the hemoglobin change and association between hemoglobin change and readmissions due to heart failure and all-cause death in patients with heart failure treated with dapagliflozin or placebo. This study could highlight if dynamic hemoglobin change is related to the outcome for HF patients. TRIAL REGISTRATION: ClinicalTrials.gov ; NCT04707261. Registration date, 2020/12/01, "retrospectively registered".

Protective effects of 4-octyl itaconate against inflammatory response in angiotensin II-induced oxidative stress in human primary retinal pigment epithelium.

4-octyl itaconate (OI) is one kind of cell-permeable derivative of itaconate to regulate inflammation and oxidative stress. However, its effects on the angiotensin II (Ang II)-induced inflammatory response and oxidative stress in human primary retinal pigment epithelium (hRPE) cells as well as its underlying mechanisms were unclear. In this study, we found that OI suppressed changes in pro-inflammatory cytokines (MCP-1, IL-8, and IL-6) and reactive oxygen species (ROS), malondialdehyde (MDA), and superoxide dismutase (SOD) via activation of Nrf2 signaling in Ang II-treated hRPE cells. A total of 645 differentially expressed long non-coding RNAs (lncRNAs) and 455 mRNAs were identified by microarray analysis. Ten lncRNAs were analyzed using the Coding-non-coding gene co-expression (CNC) network and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, revealing that many differentially expressed lncRNAs were enriched in immune response-related pathways, such as IL-17, TNF, and NOD-like receptor signaling. This finding suggested that OI inhibits Ang II-induced inflammatory response and oxidative stress by activating Nrf2 signaling in hRPE cells. We also provided a novel perspective on the role of lncRNAs in the protective effects of OI.

rs10490924 surrounding HTRA1/ARMS2 regulates the susceptibility of age-related macular degeneration.

Multiple studies have assessed the contribution of rs10490924 on chromosome 10q26 surrounding HTRA1/ARMS2 gene to age-related macular degeneration (AMD) risk. However, the causal allele at this locus is still inconclusive. In this meta-analysis, we systematically characterized the potential association between rs10490924 polymorphism and AMD risk. Data available from 12 case-control studies, including a total of 5244 cases and 2755 controls in three different ethnic populations, were used to evaluate the correlation between rs10490924 G/T polymorphism (Ala69Ser) and AMD risk. In overall populations, the results indicated the Ala69Ser polymorphism was significantly associated with AMD under allelic (OR = 0.35, 95% CI = 0.30-0.40), homozygous (OR = 0.12, 95%CI = 0.09-0.17), dominant (OR = 0.18, 95%CI = 0.14-0.24), recessive (OR = 0.33, 95%CI = 0.28-0.39), and heterozygous genetic models (OR = 0.26, 95% CI = 0.21-0.33). Similar results were observed in subgroup analysis. This meta-analysis suggests that rs10490924 (Ala69Ser) polymorphism was significantly associated with the susceptibility of AMD in all ethnicities, Ala69 carriers are resistant to AMD risk.

Accuracy of intraocular lens power calculation in primary angle-closure disease: comparison of 7 formulas.

PURPOSE: To assess the accuracy of intraocular lens power calculation formulas Barrett Universal II (BUII), Hill-Radial Basis Function (RBF) 3.0, Kane, Ladas Super Formula (LSF), Haigis, Hoffer Q, and SRK/T in primary angle-closure disease (PACD). METHODS: A total of 129 PACD eyes were enrolled. Prediction refraction was calculated for each formula and compared with actual refraction. Accuracy was determined by formula performance index (FPI), median absolute error (MedAE) and percentage of eyes with a prediction error (PE) within ± 0.50D. Subgroup analysis was performed according to axial length (AL). RESULTS: Overall, FPI was ranked as follows: Kane (0.067), RBF 3.0 (0.064), Haigis (0.062), SRK/T (0.060), BUII (0.058), Hoffer Q (0.055), and LSF (0.049). Kane got the highest (71.3%) percentage of eyes with PE within ± 0.50 D. In medium AL eyes (22 mm < AL ≤ 25 mm), FPI ranked the same as in total group. MedAEs were equal across all formulas (P = 0.121). In short eyes (AL ≤ 22 mm), FPI was Kane (0.055), RBF 3.0 (0.050), SRK/T (0.050), Haigis (0.049), BUII (0.047), Hoffer Q (0.045), and LSF (0.033). MedAEs were significantly different across all formulas (P = 0.033). Haigis showed the lowest MedAE (0.35 D), Haigis and Kane got the highest percentage (63.6%) of eyes with PE within ± 0.50 D. CONCLUSION: Kane outperformed in total PACD eyes; RBF 3.0, Haigis, and SRK/T achieved satisfying performance. When dealing with PACD eyes shorter than 22 mm, Kane achieved the best accuracy. RBF 3.0, SRK/T, Haigis, and BUII achieved comparable outcomes. No formula showed superiority over others for medium AL PACD eyes.

Refractive outcomes of second-eye adjustment methods on intraocular lens power calculation in second eye.

BACKGROUND: To investigate the refractive outcomes of second-eye adjustment (SEA) methods in different intraocular lens (IOL) power calculation formulas for second eye following bilateral sequential cataract surgery. METHODS: This retrospective consecutive case-series study included 234 eyes from 234 patients who underwent bilateral sequential phacoemulsification and implantation of enVista MX60 in a hospital setting. Postoperative refraction outcomes calculated by standard formulas (SRK/T and Barrett Universal II, BUII) with SEA method were compared with those calculated by an artificial intelligence-based IOL power calculation formula (PEARL DGS) under second eye enhancement (SEE) method. The median absolute error (MedAE), mean absolute error (MAE) and percentage prediction errors (PE) of eyes within ±0.25 diopters (D), ±0.50 D, ±0.75 D and ± 1.00 D were determined. RESULTS: Overall, the improvement in MedAE after SEA was significant for PEARL DGS (p < 0.01), SRK/T (p < 0.001) and BUII (p = 0.031), which increased from 74.36, 71.37, and 77.78% to 83.33, 80.34, and 79.49% of eyes within a PE of ±0.50 D, respectively. For first eyes with a medium axial length (22-26 mm), PEARL DGS with SEE had the lowest MedAE (0.21 D). For a first-eye MAE over 0.50 D, SEA method led to significant improvement in the second eye (p < 0.01). Interocular axis length differences exceeding 0.3 mm were associated with weaker effects using SEA in the studied formulas (p > 0.05). CONCLUSIONS: Either SEA method with SRK/T and BUII formulas or second-eye enhancement method based on the PEARL DGS formula can improve postoperative refractive outcomes in second eye.

Retinitis pigmentosa-associated anterior subcapsular cataract: morphological features and visual performance.

PURPOSE: To investigate the morphological features and surgical outcomes of retinitis pigmentosa (RP)-associated anterior subcapsular cataract (ASC). METHODS: Consecutive RP-associated ASC cases were reviewed, and one hundred patients (171 eyes) were included. Anterior segment photographed images by slit-lamp microscope were reviewed. Best-corrected visual acuity (BCVA) was recorded. The cases were classified according to preoperative best BCVA, the area (central, midperipheral and peripheral) and the density (Grade 1, vacuolar/bubble-like; Grade 2, plaque-like/translucent; and Grade 3, fibrotic/opaque) of ASC; subgroup analysis of surgical outcomes was then performed. RESULTS: The mean age was 52.1 ± 13.7 years, and the 41-50-year group had the best BCVA. 13.5% of eyes had BCVA better than 20/63, 30.4% were between 20/400 and 20/63, and 56.1% were worse than 20/400. The percentage of ASCs in the central, midperipheral and peripheral areas was 55.0%, 37.4% and 7.6%, respectively. Postoperative BCVA was improved in the central and midperipheral groups (P < 0.001) but was not in the peripheral group (P = 0.07). The percentage of ASCs in density of Grade 1, 2 and 3 was 11.1%, 38.6% and 50.3%, respectively. Grade 2 and 3 achieved improved postoperative BCVA (P < 0.001), but Grade 1 did not (P = 0.693). CONCLUSIONS: Mostly, ASC is located at the center of the pupillary area and affected the residual vision of RP patients. The patients benefited from cataract removal except for those with ASC extended to peripheral area. Surgery was also recommended for RP with ASC developed to be plaque-like and even fibrotic.

Accuracy evaluation of objective refraction using the wavefront aberrometer in pseudophakic eyes.

PURPOSE: To evaluate the accuracy of wavefront-derived objective refraction in pseudophakic eyes. METHODS: Retrospective case series. A total of 356 eyes (356 patients) that underwent phacoemulsification and posterior chamber intraocular lens implantation were included. Noncycloplegic subjective manifest refraction (MR) and objective refraction results from the wavefront aberrometer were obtained and compared. Subgroup analysis of objective refraction at 2.6-mm zone was performed based on axial length (AL) and average keratometry. RESULTS: The biases (at the 2.6-mm, 3-mm, and 4-mm zones) were - 0.29 ± 0.37 D, - 0.53 ± 0.41 D, and - 0.51 ± 0.60 D for sphere; - 0.27 ± 0.36 D, - 0.52 ± 0.38 D, and - 0.53 ± 0.51 D for spherical equivalent (SE); 0.03 ± 0.20 D, 0.03 ± 0.22 D, and 0.04 ± 0.27 D for J0; and 0.01 ± 0.16 D, 0.03 ± 0.22 D, and 0.01 ± 0.22 D for J45, respectively. Objective refraction for sphere, SE, and J0 (at 2.6 mm, 3 mm, and 4 mm) was significantly different from MR (P < 0.05), while J45 values were equal. The objective refraction at 2.6 mm was the most accurate in short eyes (≤ 22.5 mm) with a minimum bias for SE (- 0.15 ± 0.28 D) and highest percentage of SE within ± 0.25 to ± 0.75 D of MR. However, there was no difference between the keratometry subgroups. CONCLUSIONS: The wavefront aberrometer achieved the best accuracy at 2.6 mm in pseudophakic eyes with short AL. It still needs modification to be used as a substitute for MR in such patients.

Accuracy of intraocular lens power calculations in paediatric eyes.

IMPORTANCE: There is no clear consensus on which intraocular lens (IOL) power calculation formula provides the best refractive prediction in the paediatric population. BACKGROUND: To evaluate the predictability of desired postoperative refractive outcomes by using six IOL formulas in paediatric cataract cases. DESIGN: Retrospective case series. PARTICIPANTS: A total of 377 eyes in 377 paediatric patients (<13 years of age) who received primary IOL implants in the capsular bag. METHODS: This study utilized formulas, namely, SRK II, SRK/T, Hoffer Q, Holladay 1, T2 and Super formula. Prediction errors were calculated based on the difference between the postoperative refraction and the refraction predicted by each formula. MAIN OUTCOME MEASURES: The mean prediction error, mean absolute error, median absolute error, percentages of eyes within the prediction errors of ±0.50 D, ±1.00 D and ± 2.00 D. RESULTS: The mean axial length was 22.48 ± 1.91 mm (<22.0 mm for 161 eyes). The average age at surgery was 55.21 ± 28.01 months (<24 months for 37 eyes). The mean prediction error was positive (hyperopic error) with all formulas. Compared to the other IOL power formulas, SRK II showed significantly higher absolute errors (P < .001). Hoffer Q and Holladay 1 generated the least absolute error, followed closely by Super formula. Multiple logistic analyses indicated that age at time of surgery was an independent factor significantly contributing to the refractive surprise using all formulas. CONCLUSIONS AND RELEVANCE: SRK II was the least predictable formula in this study. HofferQ and Holladay 1 yielded the best predictive values.

Hydrocephalus due to aqueductal stenosis presenting with acute bilateral ptosis: case report.

Hydrocephalus may cause Parinaud's syndrome which consists of vertical gaze palsy, convergence palsy, lid retraction and pupil light-near dissociation. We are aware of only two prior reports of hydrocephalus presenting with bilateral ptosis. Both were cured by ventriculoperitoneal shunts. We report a 28-month-old girl who presented acute bilateral ptosis but full eye movements both sides. Neuroimages revealed chronic hydrocephalus and aqueductal stenosis. The bilateral ptosis resolved quickly after endoscopic third ventriculostomy (ETV).

Refractive predictability using two optical biometers and refraction types for intraocular lens power calculation in cataract surgery.

PURPOSE: To evaluate the accuracy of intraocular lens (IOL) power calculation in relation to optical biometry devices and refraction types. METHODS: Patients undergoing cataract phacoemulsification and insertion of the MX60 IOL were enrolled. Optical biometric measurements were performed with both IOLMaster 700 and Lenstar 900. Biometry measurements were compared between devices. A subsample of 133 eyes (81.1%) had examination for both autorefraction and subjective refraction postoperatively. The differences between the postoperative refraction and the refraction predicted by eight formulas (Kane, Hill-RBF 2.0, Barrett Universal II, Olsen, Haigis, SRK/T, Holladay 1 and Hoffer Q) were calculated. RESULTS: Overall, this study comprised 164 eyes of 164 patients. High agreement between the two biometers for axial length, average keratometry readings, anterior chamber depth, lens thickness and central corneal thickness was found (interclass correlation confidents: 0.999, 0.988, 0.965, 0.865 and 0.972, respectively, all P < 0.001). The absolute prediction error calculated with IOLMaster 700 measurements was significantly lower than that calculated with Lenstar 900 measurements for Olsen (P = 0.003), Haigis (P < 0.001) and Hoffer Q (P = 0.028). OPD-Scan III gave slightly more negative readings than subjective refraction (mean difference - 0.107 ± 0.553, P = 0.003 for spherical equivalent). However, no significant difference in absolute prediction error was found between the two refraction types per each formula. CONCLUSION: IOLMaster 700 and Lenstar 900 showed good agreement in biometric measurements with a trend toward better refractive outcome using IOLMaster 700. The accuracy of IOL calculation assessed with OPD autorefraction was equivalent to that assessed with subjective refraction.

An investigation on the current patterns of using consumables and sterilizing accessories in phacoemulsification in China.

PURPOSE: To survey the routine application of consumables and sterilized accessories of phacoemulsification in mainland China. METHODS: This was a cross-sectional questionnaire-based study. A questionnaire link was sent to Chinese ophthalmologists via the most widely used social communication tool (WeChat platform). RESULTS: A total of 815 questionnaires were determined to be valid and were included in the final analysis. The majority of respondents were from Guangdong, Shandong, Zhejiang, Hebei, and Henan provinces. A number of hospitals (48.22%) reused the fluidics management system (FMS) after sterilization. Among the hospitals using disposable FMS, 38.03% reused tubing after sterilization. Most respondents' hospitals (70.43%) sterilized the handpiece for each operation. Only 38.77% of the respondents' hospitals adopted irrigation fluid antibiotics and/or intracameral antibiotics intraoperatively. Greater single usage of FMS was significantly associated with higher provincial gross domestic product (GDP), government hospitals, provincial hospitals, and disposable tubing (P < 0.05). The adoption of irrigation fluid/intracameral antibiotics was correlated with the financial type of the hospital, the daily volume of phacoemulsification, and the usage of silicone tubing (P < 0.05). CONCLUSIONS: The results show a wide variation in the application of consumables and the sterilization of accessories in phacoemulsification in mainland China. Only half of the hospitals adopted interfusion/intracameral antibiotic prophylaxis, despite its efficacy having been confirmed. These data revealed potential safety issues of the sterilization of phacoemulsification instruments and the risk of intraocular infection.

Analysis of genetic polymorphisms for age-related macular degeneration (AMD) in Chinese Tujia ethnic minority group.

BACKGROUND: Age-related macular degeneration (AMD) can cause vision loss or blindness in elderly. The associations between single nucleotide polymorphism (SNP) and AMD in Chinese Tujia ethnic minority group are still unclear. METHODS: A total of 2122 Tujia volunteers were recruited and 197 of them were diagnosed with AMD (either dry or wet type).Then the blood specimens of these 197 AMD patients and 404 controls from the remaining 1925 normal Tujia volunteers were collected to detect the frequencies of 39 chosen SNPs. The Bonferroni method was used to correct the P values from the Fisher's exact test. RESULTS: The mean age of the 197 AMD patients(113 males and 84 females) was 68.4197 years old. No significant differences in allelic and genotypic frequencies were found for all the 39 SNPs between the patients and controls. However, weak correlations between 10 SNPs (CFH rs1329428 TT genotype, CFH rs3753394 CC genotype and T allele, CFH rs1410996 AA genotype, CFH rs800292 AA genotype, CFH rs800292 A allele, VEGF rs833061 TT genotype and C allele, VEGF rs2010963 CG genotype, VEGFR2 rs1531289 TT genotype, ARMS2 rs10490924 TT genotype, KCTD10 rs238104 GC genotype, rs1531289 T allele and ARMS2 rs10490924 T allele) and AMD were shown. CONCLUSIONS: The effects of 39 SNPs have found no associations with the morbidity of AMD in Chinese Tujia ethnic minority group.

Chitosan inhibits inflammation and adipogenesis of orbital fibroblasts in Graves ophthalmopathy.

Purpose: The aim of this study was to investigate the roles of chitosan in inflammation and adipogenesis of primary cultured orbital fibroblasts in Graves ophthalmopathy (GO). Methods: Cell viability, apoptosis, and cell cycle were determined with the Cell Counting Kit-8 (CCK-8), the Annexin V-FITC/PI kit, and flow cytometry, respectively. Inflammation of orbital fibroblasts was stimulated by interleukin-1 beta (IL-1ß). The levels of IL-6 and prostaglandin E-2 (PGE-2) were measured using an enzyme-linked immunosorbent assay (ELISA). The expression of cyclooxygenase-2 (COX-2) was measured with real-time PCR and western blot assay. Phosphorylation of c-Jun N-terminal kinase (JNK) was evaluated with western blot assay. An inhibitor of JNK was used to investigate the signal transduction pathway of cytokine production. Orbital fibroblasts differentiated to adipose cells in differentiation medium. Adipose cells were dyed with Oil Red O. FABP4, adiponectin, C/EBPα, PPAR-γ, and phosphorylation of AKT were evaluated with western blot assay. Results: The results showed that IL-1ß statistically significantly increased the expression of IL-6, PGE-2, and COX-2 in orbital fibroblasts. Phosphorylation of JNK was promoted by IL-1ß. IL-6 and PGE-2 were modulated by the JNK signaling pathway as determined with the inhibition experiments. Chitosan downregulated expression of IL-1ß-stimulated IL-6, COX-2, and PGE-2 and downregulated phosphorylation of JNK. Chitosan inhibited the production of adipose cells dyed by Oil Red O. Chitosan statistically significantly decreased the protein levels of FABP4, adiponectin, C/EBPα, and PPAR-γ with downregulation of AKT phosphorylation during adipocyte differentiation. Conclusions: Chitosan statistically significantly inhibits inflammation and adipogenesis, as well as related signaling pathways, of orbital fibroblasts in GO. This indicates a possible therapeutic effect of chitosan on Graves ophthalmopathy.

Shunt surgery for early-onset severe hydrocephalus in methylmalonic acidemia: report on two cases and review of the literature.

OBJECT: Methylmalonic acidemia (MMA) with early-onset severe hydrocephalus is rare. In this paper, we described two cases of MMA with hydrocephalus and review the literature to elucidate the clinical features of the disease, treatment options, and follow-up results. METHODS: The PubMed and Embase databases were searched for clinical reports on MMA with severe hydrocephalus, and two unreported cases were presented to illustrate the clinical spectrum. RESULTS: Six cases of MMA with severe hydrocephalus were observed in the previous literature. Our two patients with severe hydrocephalus but not bulging fontanelle received a ventriculo-peritoneal shunt, and intracranial hypertension was confirmed in both cases during the operation. These patients' clinical symptoms significantly improved after the operation. CONCLUSIONS: Intracranial hypertension can exist in early-onset severe hydrocephalus in MMA, even if the bulging anterior fontanelle is not apparent. These patients could benefit from a ventriculo-peritoneal shunt.