[Risk factors of cytomegalovirus infection in patients with failed corneal grafts].

Objective: To investigate the levels of cytomegalovirus (CMV) infection and associated risk factors in corneal transplant recipients who experienced transplant failure. Methods: This was a case-control study. Clinical data from 576 cases (576 eyes) of patients who underwent repeat corneal transplant surgery at the Department of Ophthalmology, Peking University Third Hospital, due to corneal transplant failure from January 2016 to May 2022 were collected. Of these, 305 were male and 271 were female, with a median age of 44.0 (0.7, 91.0) years. The CMV infection rate was analyzed based on the detection of CMV DNA in aqueous humor or corneal tissue during corneal transplant surgery. Patients were divided into the CMV group (CMV DNA positive) and the control group (herpes virus DNA negative). The main research indicators included the CMV infection rate, clinical characteristics, and risk factors in corneal transplant recipients. Chi-square tests and binary logistic analysis were used to compare differences between the two groups in general information, systemic diseases, ocular lesions, ocular surgical history, and local and systemic medications. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for each CMV infection risk factor. Results: The overall CMV infection rate was 21.9%(126/576), with annual rates ranging from 10.9% to 37.7% from 2016 to 2021. After applying inclusion and exclusion criteria, 378 patients were included in the control trial, with 126 in the CMV group and 252 in the control group. Statistically significant differences between the two groups were observed in systemic immune-related corneal lesions [CMV group: 38 (30.2%), control group: 26 (10.3%)], local immune and inflammatory corneal lesions [CMV group: 46 (36.5%), control group: 40 (15.9%)], congenital corneal opacity [CMV group: 46 (36.5%), control group: 48 (19.0%)] total number of corneal transplants (CMV group: 178 times, control group: 276 times), corneal deep neovascularization crossing the graft [CMV group: 104 (82.5%), control group: 68 (27.0%)] and severe opacity [CMV group: 44 (34.9%), control group: 30 (11.0%)]. Binary logistic regression analysis showed that systemic immune-related corneal lesions (OR=4.044, 95%CI 1.810-9.033, P<0.001), local immune and inflammatory corneal lesions (OR=3.554, 95%CI 1.569-8.052, P=0.002), congenital corneal opacity (OR=2.606, 95%CI 1.216-5.589, P=0.014), total number of corneal transplants (OR=3.206, 95%CI 1.753-5.864, P<0.001), corneal deep neovascularization crossing the graft (OR=8.347, 95%CI 3.967-17.559, P<0.001), and severe opacity (OR=3.063, 95%CI 1.221-7.682, P=0.017) were independent risk factors for CMV infection after corneal transplant. Conclusions: CMV infection was present in more than 1/5 of corneal transplant recipients who experienced transplant failure. CMV infection after corneal transplant may be related to immune rejection reactions and ocular inflammatory responses. Inflammatory corneal lesions associated with systemic or local immune abnormalities, congenital corneal opacity, and multiple corneal transplants may exacerbate the levels of inflammatory factors during the perioperative period of corneal transplant, increasing the risk of post-transplant CMV infection, leading to the infiltration of deep neovascularization and severe opacity in the cornea.

Contrasting water sources and water-use efficiency in coexisting desert plants in two saline-sodic soils in northwest China.

Soil degradation resulting from various types of salinity is a major environmental problem, especially in arid and semiarid regions. Exploring the water-related physiological traits of halophytes is useful for understanding the mechanisms of salt tolerance. This knowledge could be used to rehabilitate degraded arid lands. To investigate whether different types of salinity influence the water sources and water-use efficiency of desert plants (Karelinia caspia, Tamarix hohenackeri, Nitraria sibirica, Phragmites australis, Alhagi sparsifolia, Suaeda microphylla, Kalidium foliatum) in natural environments, we measured leaf gas exchange, leaf carbon and xylem oxygen isotope composition and soil oxygen isotope composition at neutral saline-sodic site (NSS) and alkaline saline-sodic site (ASS) in northwest China. The studied plants had different xylem water oxygen isotope compositions (δ18 O) and foliar carbon isotope compositions (δ13 C), indicating that desert plants coexist through differentiation in water use patterns. Compared to that at the NSS site, the stem water in K. caspia, A. sparsifolia and S. microphylla was depleted in 18 O at the ASS site, which indicates that plants can switch to obtain water from deeper soil layers when suffering environmental stress from both salinity and alkalinisation. Alhagi sparsifolia had higher δ13 C at the ASS site than at the NSS site, while K. caspia and S. microphylla had lower δ13 C, which may have resulted from interspecific differences in plant alkali and salt tolerance ability. Our results suggest that under severe salinity and alkalinity, plants may exploit deeper soil water to avoid ion toxicity resulting from high concentrations of soluble salts in the superficial soil layer. In managed lands, it is vital to select and cultivate different salt-tolerant or alkali-tolerant plant species in light of local conditions.