Nonlinear effects of humidex on risk of outpatient visit for allergic conjunctivitis among children and adolescents in Shanghai, China: A time series analysis.

Background: Various epidemiological studies have focused on the adverse health outcomes of meteorological factors. However, there has been little research on the impact of humidex on allergic conjunctivitis, especially in child and adolescent populations. We aimed to explore the impact of humidex, a comprehensive index of relative humidity and temperature, on child and adolescent allergic conjunctivitis admissions. Methods: Outpatient visit data for allergic conjunctivitis, meteorological factors and air pollutants in Shanghai for the 2017-2022 period were retrieved. For the purpose of analysing the nonlinear connection and lag impact between humidex and admissions for paediatric and adolescent allergic conjunctivitis, the distributed lag nonlinear model (DLNM) was fitted. Results: A total of 147 090 cases were included in our cohort. We found a significantly nonlinear effect on humidex and allergic conjunctivitis. In the single-day lag pattern, the relative risks (RR) of allergic conjunctivitis were significant at lag 0 (RR = 1.08, 95% confidence interval (CI) = 1.05-1.11) to lag 2 (RR = 1.01, 95% CI = 1.00-1.01), lag 5 (RR = 1.01, 95% CI = 1.00-1.01) to lag 9 (RR = 1.01, 95% CI = 1.00-1.01), and lag 14 (RR = 1.02, 95% CI: 1.01-1.03). In the cumulative-lag day pattern, the RR of allergic conjunctivitis were significant at lag 0-0 (RR = 1.08, 95% CI = 1.05-1.11) to lag 0-14 (RR = 1.21, 95% CI = 1.13-1.28). We found that boys, children aged 7-17 years, and children in the warm season were more vulnerable to humidex. In addition, the highest attributable fraction (AF) and attributable number (AN) of humidex are at lag 0-14 (AF = 0.17, AN = 25 026). Conclusions: Humidex exposure markedly increased the risk of allergic conjunctivitis, especially in highly high humidex. Appropriate public health management is needed for disease management and early intervention.

The effect of short-term air pollutants exposure on outpatient admission for blepharitis in Shanghai, China: a hospital-based study.

Blepharitis is a very common ophthalmologic disease, and few studies have examined if air pollutants contribute to the risk of blepharitis. We investigated the presence of any potential correlation between exposure to air pollution and outpatient admission for blepharitis in Shanghai, China. Data on daily outpatient admission for blepharitis were collected from January 2017 to July 2022. Air pollution and meteorological data were acquired from the Shanghai Environmental Protection Agency. Using the distributed lag non-linear model (DLNM) we investigated the relationship between air pollutants and blepharitis. Seasonal stratified analysis was carried out. In total, 10,681 blepharitis patients were recruited. In the single-pollutant model, a 10 µg/m3 increase in particulate matter with < 2.5 µm PM2.5 and 10 µm PM10 along with sulfur dioxide (SO2) and 100 µg/m3 increase in carbon monoxide (CO) was significantly associated with outpatient visits for blepharitis. In the multi-pollutant model, a 10 µg/m3 increase in ozone (O3) and nitrogen dioxide (NO2) and a 100 µg/m3 increase in carbon monoxide (CO) was significantly associated with outpatient visits for blepharitis. Moreover, there was an obvious relationship between blepharitis and PM2.5 and O3 in the summers and blepharitis and PM10, NO2, and SO2 during the winters. Exposure to short-term air pollution increases the risk of blepharitis outpatient visits in Shanghai, China.

Lidocaine Hydrochloride Gel for Ocular Surface Anesthesia: Pharmacokinetic Evaluation and Randomized Placebo-Controlled Trial in China.

Backgrounds: A new generic formulation of 3.5% lidocaine hydrochloride ophthalmic gel has been developed in China. This study aimed to evaluate the pharmacokinetics and effectiveness of this lidocaine hydrochloride gel for ocular surface anesthesia. Methods: In the pharmacokinetics study, the new form of 3.5% lidocaine hydrochloride gel or Akten™ 3.5% lidocaine hydrochloride gel was applied in eyes of 70 rabbits. The ocular tissues and plasma samples were collected after the application of 3.5% lidocaine hydrochloride gel or Akten lidocaine gel and analyzed using the liquid chromatography with tandem mass spectrometry (LC-MS/MS) method to determine the concentration of lidocaine. A multicenter, randomized, double-blind prospective clinical trial was conducted in Chinese adults. Two hundred twenty participants were 1:1 randomized into the sham gel group or the lidocaine hydrochloride group. The primary efficacy endpoint was defined as the percentage of subjects achieving anesthesia by 5 min. Results: The animal pharmacokinetics study showed the lidocaine level was significantly higher in the choroid at 15 min and the vitreous body at 15 and 30 min; it was lower in tears at 8 h for 3.5% lidocaine hydrochloride gel than Akten (P ≤ 0.05). Our clinical trial showed that the percentage of subjects achieving anesthesia within 5 min in the lidocaine hydrochloride gel group was significantly higher than the sham gel group (86.92%-18.18%, P < 0.0001). The incidence of adverse events was relatively low and favorable for both groups. Conclusion: This new formulation of lidocaine hydrochloride gel, with pharmacokinetics similar to Akten, may exert a sustained, effective, and safe anesthetic effect. The clinical trial for this new generic formulation of lidocaine hydrochloride has been registered with the Drug Clinical Trial Registration and Information Publicity Platform established by State Food and Drug Administration of China (Registration No. CTR20160593).