The distribution characteristics of strabismus surgery types in a tertiary hospital in the Central Plains region during the COVID-19 epidemic.

OBJECTIVE: This study aimed to analyze the distribution of different types of strabismus surgery in a tertiary hospital in Central China during the three-year period of the COVID-19 pandemic. METHODS: A retrospective analysis was conducted on the clinical data of strabismus patients who underwent surgery and were admitted to the Department of Strabismus and Pediatric Ophthalmology at the First Affiliated Hospital of Zhengzhou University between January 2020 and December 2022. RESULTS: A total of 3939 strabismus surgery patients were collected, including 1357 in 2020, 1451 in 2021, and 1131 in 2022. The number of surgeries decreased significantly in February 2020, August 2021, and November and December 2022. Patients aged 0-6 years accounted for 37% of the total number of strabismus surgery patientsr. The majority (60%) of all strabismus surgery patients were diagnosed with exotropia, with intermittent exotropia accounting for the highest proportion (53%). There was no statistically significant difference in the proportion of intermittent exotropia and constant exotropia during the three-year period (χ2 = 2.642, P = 0.267 and χ2 = 3.012, P = 0.221, respectively). Among patients with intermittent exotropia, insufficient convergence type was the most common form of strabismus (accounting for over 70%). Non-accommodative esotropia accounted for more than 50% of all internal strabismus cases. CONCLUSION: During the period from 2020 to 2022, the total number of strabismus surgeries in our hospital did not show significant fluctuations, but there was a noticeable decrease in the number of surgeries during months affected by the pandemic. Exotropia accounted for the highest proportion among strabismus surgery patients. Intermittent exotropia was the most common type among patients undergoing surgery for exotropia, and the most prevalent subtype was the insufficient convergence type. The age distribution of patients varied in different months, with a concentration of surgeries for strabismus patients in the 7-12 years old age group during the months of July and August each year.

Crystal structure of phloridzin and its distribution changes in flowering and fruiting stage of Malus rockii.

The exact structure of phloridzin was further confirmed as phloretin 6'-O-glucopyranoside by a single-crystal X-ray diffraction experiment. The distribution changes of phloridzin in flowering, fruitlet, and fruit ripening phases of Malus rockii were quantified by an HPLC with an external standard. The concentrations of phloridzin in leaves, twigs, and bark and xylem of twigs increased at first and then decreased, and reached the highest value in the fruitlet period. The highest concentration of phloridzin was found in leaves, with the percentage contents of 10.92-14.43 %. What is more, the decreased value of the concentration of phloridzin in leaves from fruit ripening period was almost equivalent to the increased value of the concentration of phloretin. This interesting physiological phenomenon should be able to provide the readers, especially plant physiologists, with a new perspective for the development and utilization of phloridzin.

Four new phenolic glycosides from Dobinea delavayi.

Three new benzophenone glycosides, 2-O-ß-D-glucopyranosyl-6,3',4'-trihydroxy-4-methoxybenzophenone (1), 4'-O-ß-D-glucopyranosyl-2,4,6,3'-tetramethoxybenzophenone (2) and 2-O-ß-D-glucopyranosyl-4'-hydroxy-6-methylbenzophenone (3), and a new flavonoid glycoside 5'-hydroxyombuoside (6), along with three known phenolic glycosides 4-O-ß-D-glucopyranosyl-2,6,4'-trihydroxybenzophenone (4), mangiferin (5), and ombuoside (7), were isolated from the 80% ethanol extract of roots of Dobinea delavayi. Their structures were determined by the comprehensive analyses of the physicochemical properties and spectroscopic data (1D NMR, 2D NMR, and HR-ESI-MS). Cytotoxicity and in vitro antimalarial activity of compounds 1, 3, 4, 6, and 7 were evaluated by MTT colorimetric assay and ß-hematin formation inhibition assay, respectively.

Dibenzofurans from Crataegus oresbia and their lipid-lowering activity.

Three new dibenzofurans, 2-hydroxy-3,4-dimethoxydibenzofuran (1), 2,8-dihydroxy-3,4,9-trimethoxydibenzofuran (5) and 2-hydroxy-3,4,6,8-tetramethoxydibenzofuran (6), together with three known dibenzofurans 1-hydroxy-2,3,4-trimethoxydibenzofuran (2), 2-hydroxy-3,4,6-trimethoxydibenzofuran (3) and 1,6-dihydroxy-2,3,4-trimethoxydibenzofuran (4), were isolated from the twigs and leaves of Crataegus oresbia. Their structures were identified by the comprehensive analyses of the physicochemical properties and spectroscopic data (NMR and HR-ESI-MS). Compounds 1-3 showed significant in vitro lipid-lowering activities, especially compound 3 was stronger than simvastatin.

Phloridzin Highly Accumulated in Malus rockii Rehder and Its Structure Revision and Hypolipidemic Activity.

Phloridzin is a lead compound of the prestigious antidiabetic gliflozins. The present study found that phloridzin highly accumulated in Malus rockii Rehder. The content of phloridzin in M. rockii was the highest among wild plants, with the percentage of 15.54% in the dry leaves. The structure of phloridzin was revised by proton exchange experiments and extensive 2D NMR spectra. Phloridzin exhibited significant hypolipidemic activity in golden Syrian hamsters maybe by increasing the expression of CYP7A1, at the doses of 50 mg/kg and 200 mg/kg. The total performance of anti-hyperlipidemic effect of phloridzin may be superior to that of lovastatin, though lovastatin was more active than phloridzin. In addition, phloridzin exhibited moderate antimalarial activity with inhibition ratio of 31.3 ± 10.9% at a dose of 25 mg/kg/day, and showed moderate analgesic activity with 28.0% inhibition at a dose of 50 mg/kg.

Effect of regulation of the NRG1/ErbB4 signaling pathway on the visual cortex synaptic plasticity of amblyopic adult rats.

This study aimed to investigate the effect of the neuregulin-1/epidermal growth factor 4 (NRG1/ErbB4) signaling pathway on visual cortex synaptic plasticity in adult amblyopic rats with monocular deprivation (MD). Compared with the control group, the P wave latency and amplitude of the MD group were prolonged and low, respectively, with reduced synaptic plasticity-related protein expression, lower number of visual cortex neurons, and increased apoptosis of visual cortex neurons. Recombinant neuregulin-1 (rNRG1) administration activated the NRG1/ErbB4 signaling pathway and improved the visual cortex synaptic plasticity in MD amblyopic rats. However, the effects of rNRG1 were reversed by AG1478 (ErbB4 receptor blockers). The NRG1/ErbB4 signaling pathway in the parvalbumin neurons from MD rats was also inactivated. Amblyopic rats had significantly low cell activity and downregulated expression of synaptic plasticity-related proteins. Thus, exogenous administration of NRG1 can activate ErbB4 signal transduction and improve the damaged synaptic plasticity of the visual cortex among amblyopic rats. Further studies are warranted to explore the potential for clinical management of amblyopia.

Successful treatment of a patient with recurrent infection of Chromobacterium violaceum.

BACKGROUND: Chromobacterium violaceum (C. violaceum) is a Gram-negative saprophytic bacterium that is widespread in tropical and subtropical environments, and belongs to conditional pathogenic bacteria. Human infection with C. violaceum is rare, and this can be fatal when the diagnosis and treatment are delayed, especially recurrent infection patients. Since clinicians lack the knowledge for C. violaceum, rapid diagnosis and early appropriate antimicrobial treatment remains challenging. CASE PRESENTATION: A 15-year-old male student was hospitalized for dark abscess, pustules, severe pain in both legs, and fever for 11 days. There were pustules with gray-white pus and red infiltrating plaques on the back, and the subcutaneous nodules could be touched in front of both tibias, with scab, rupture and necrotic tissue of the lower limb. The patient's condition rapidly progressed. Therefore, next-generation sequencing (NGS), pustular secretion and blood culture were concurrently performed. The final diagnosis for this patient was C. violaceum infection by NGS. However, no bacterial or fungal growth was observed in the pustular secretion and blood culture. After 4 weeks of treatment, the patient was discharged from the hospital without any complications associated with C. violaceum infection. CONCLUSION: Rapid diagnosis and early appropriate antimicrobial treatment is the key to the successful treatment of C. violaceum infection, especially in patients with sepsis symptoms. This case highlights that NGS is a promising tool for the rapid diagnosis of C. violaceum infection, preventing the delayed diagnosis and misdiagnosis of C. violaceum infection in patients who tested negative for pustular secretion and blood culture.

microRNA-362-3p targets USP22 to retard retinoblastoma growth via reducing deubiquitination of LSD1.

Accumulating evidence has reported the role of microRNA (miR) in retinoblastoma (RB). Therefore, the objective was to discuss how miR-362-3p exerted its function in RB cell progression via regulating ubiquitin-specific protease 2 (USP22) and lysine-specific histone demethylase 1 (LSD1). MiR-362-3p, USP22 and LSD1 expression in RB cells and tissues were tested. The biological functions of RB cells were detected via over-expressing miR-362-3p and down-regulating USP22. The target relationship of USP22 and miR-362-3p as well as the interaction of USP22 and LSD1 in RB was verified. Down-regulated miR-362-3p and up-regulated USP22 and LSD1 were demonstrated in RB tissues and cells. Restoring miR-362-3p and depleting USP22 attenuated invasion, proliferation and migration, and facilitated apoptosis of RB cells. USP22 was a target gene of miR-362-3p. USP22 deubiquitinated LSD1 in RB. It is revealed that miR-362-3p targets USP22 and then restrains invasion, proliferation and migration while promotes apoptosis of RB via reducing LSD1 modified by deubiquitination.

ALA-PDT combined with cystoscopy: A method to eliminate refractory HPV infection in a patient with condyloma acuminata.

BACKGROUND: Condyloma acuminata is a common sexually transmitted disease for which an underlying chronic human papillomavirus (HPV) infection is an important cause of recurrence. 5-aminolaevulinic acid-mediated photodynamic therapy (ALA-PDT) has become an effective method to treat condyloma acuminata. Urinary tract condyloma acuminata are not considered common, but warts in the bladder can be detected by cystoscopy. OBJECTIVE: To treat a urinary tract HPV infection in a 35 years old woman diagnosed with condyloma acuminata and to eliminate HPV infection. METHOD: A total of six sessions of ALA-PDT to the cervix and seven sessions of ALA-PDT to the vagina were executed, and the patient subsequently had a cystoscope examination. The wart in the bladder was found by cystoscopy and cauterized with radiofrequency. RESULT: Internal urethra, urethral orifice, cervical, vaginal, and vulvar HPV-DNA detection eventually all returned negative results, and there was no recurrence with two years of follow-up.

Comparison of botulinum toxin with surgery for the treatment of acute acquired comitant esotropia and its clinical characteristics.

We compared the therapeutic effects between botulinum toxin and surgery for acute acquired comitant esotropia (AACE) and analyze its clinical characteristics. The data of the 29 cases, who received treatment for AACE in the Ophthalmic Center of the First Affiliated Hospital of Zhengzhou University and Henan Provincial Ophthalmology Hospital between January 2016 and January 2017, were collected. The 29 cases with AACE were followed for 6 months or more, and received either botulinum toxin injection (group A with 13 cases) or squint correction (group B with 16 cases). The distant and near deviation angles were compared between the two groups before and after treatment. The success rate (total horizontal deviation of 10 prism diopters or less) and stereopsis were compared between the two groups at post-treatment 6 months. At the same time, the relations between distant and near deviation angles were analyzed among different myopia levels and different AACE types. Results indicated that he success rate was not significantly different at post-treatment 6 months (84.6% vs 81.3%, P = 1.00). The distant and near deviation angles were all significantly different one day and one month after treatment (all P < 0.05); but at post-treatment 6 months, they were not significantly different (all P > 0.05) between the two groups. There were no significant differences in the distant and near stereoacuity between the two groups at post-treatment 6 months (all P > 0.05). Among the 25 cases with myopia, the pre-treatment distant deviation angle was significantly higher than pre-treatment near deviation angle in the cases with myopia level >-2.5 D (P < 0.05), and the pre-treatment distant and near deviation angles were all significantly higher in the cases with type-IIAACE than in the cases with type-IIIAACE (all P < 0.05). This study suggests that Botulinum toxin is as effective as surgery in the treatment of AACE at post-treatment 6 months. For the cases with myopia level >-2.5 D, the pre-treatment distant deviation angle is significantly higher than pre-treatment near deviation angle; and both pre-treatment distant and near deviation angles are greater in the cases with type-IIAACE than in the cases with type-IIIAACE.

Assessment of cortical dysfunction in infantile esotropia using fMRI.

PURPOSE: Functional magnetic resonance imaging (fMRI) is popular in the field of neuroimaging. The aim of this study was to explore the neural basis of infantile esotropia and locate the cortical region of fusion function defects using blood oxygen level-dependent fMRI (BOLD-fMRI). METHODS: Subjects (5 with infantile esotropia and 8 normal) were presented with a visual stimulus (letter E). The BOLD-fMRI was used to measure the visual cortex response as the distance between the E and the eyes changing from 20 to 100 cm using a block experimental design. Data were processed offline using statistical parametric mapping and compared between the 2 groups. RESULTS: Areas activated in the visual cortex of normal subjects were located in the bilateral frontal gyrus and left lingual visual cortex (p<0.001). The BOLD signal in the left cingulate gyrus, bilateral precuneus, and left angular gyrus was higher in the infantile esotropia group than in the controls (p<0.001). None of the visual cortical areas showed higher signal in the control individuals than in those with infantile esotropia (p<0.001). CONCLUSIONS: The bilateral frontal gyrus and left lingual visual cortex regulate normal fusion function in human eyes. In infantile esotropia, the left cingulate gyrus, bilateral precuneus, and left angular gyrus visual cortex may compensate for the fusion dysfunction. These insights may help improve the diagnosis and treatment of strabismus.