Safety assessment of cenobamate: real-world adverse event analysis from the FAERS database.

Objective: This study aims to analyze adverse drug events (ADEs) associated with cenobamate from the FAERS database, covering the third quarter of 2020 to the second quarter of 2023. Methods: Data related to cenobamate-associated ADEs from the third quarter of 2020 to the second quarter of 2023 were collected. After standardizing the data, various signal quantification techniques, including ROR, MHRA, BCPNN, and MGPS, were employed for analysis. Results: Among 2535 ADE reports where cenobamate was the primary suspected drug, 94 adverse reactions involving 11 different System Organ Class (SOC) categories were identified through the application of four signal quantification techniques. More specifically, neurological disorders and injuries resultant from complications are frequent adverse reactions associated with cenobamate. Conclusion: Our research findings align with established results, affirming the favorable safety profile of cenobamate. Effective prevention of adverse reactions induced by cenobamate can be achieved through the establishment of efficient blood concentration monitoring and dose adjustments.

Interictal interleukin-6 and tumor necrosis factor α levels are associated with seizure recurrence in adults with epilepsy.

BACKGROUND: Although there are models predicting epilepsy recurrence under different clinical conditions, few studies have examined blood biomarkers. Inflammation plays a crucial role in the occurrence and development of epilepsy. We analyzed inflammatory mediators in a regional hospital-based epilepsy cohort and investigated their relationship with subsequent epilepsy recurrence. METHODS: Interictal inflammatory mediators were measured in 128 patients diagnosed with epilepsy participating in a prospective study. Inflammatory mediators were compared during the follow-up period between patients who experienced epilepsy recurrence and those who did not. We also assessed the correlation between inflammatory mediators and the time interval until the next recurrence. RESULTS: Over a median 4-month follow-up period, 41 patients experienced seizure recurrence. Differences in interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) levels were observed between seizure recurrence and non-recurrence groups. After adjusting for covariates through multivariate Cox regression analysis, the patients in the third IL-6 tertile (>2.31 pg/mL; HR: 2.49; 95 % CI: 1.00-6.16; P = 0.049) and in the third TNF-α tertile (>0.74 pg/mL; HR: 2.80; 95 % CI: 1.13-6.92; P = 0.026) had higher risk of seizure recurrence. The time until the next recurrence was negatively correlated with IL-6 level (ρ =  - 0.392, P = 0.011). CONCLUSION: High levels of IL-6 and TNF-α are associated with a higher possibility of seizure recurrence. Future predictive models should also include inflammatory mediators in addition to clinical variables.

Transesterification Induced Multifunctional Additives Enable High-Performance Lithium Metal Batteries.

The electrolyte chemistry is crucially important for promoting the practical application of lithium metal batteries (LMBs). Here, we demonstrate for the first time that 1,3-dimethylimidazolium dimethyl phosphate (DIDP) and trimethylsilyl trifluoroacetate (TMSF) can undergo in situ transesterification in carbonate electrolyte to generate dimethyl trimethylsilyl phosphate (DTMSP) and 1,3-dimethylimidazolium trifluoroacetate (DITFA) as multifunctional additives for LMBs. H2O and HF can be removed by the Si-O group in DTMSP to improve the moisture resistance of electrolyte and the stability of cathode. Furthermore, the dissolution of lithium nitrate (LiNO3) in carbonate electrolyte can be promoted by the trifluoroacetate anion (TFA-) in DITFA, thereby optimizing the solvation structure and transport kinetics of Li+. More importantly, both DTMSP and DITFA tend to preferential redox decomposition due to the low lowest unoccupied molecular orbital (LUMO) and high highest occupied molecular orbital (HOMO). Consequently, a thin and robust layer rich in P/N/Si on the cathode and an inorganic-rich layer (e.g. Li3N/Li3P) on the anode can be constructed and superior electrochemical performances are achieved. This artificial transesterification strategy to introduce favorable additives paves an efficient and ingenious route to high-performance electrolyte for LMBs.

Dual-Salt Electrolyte Additive Enables High Moisture Tolerance and Favorable Electric Double Layer for Lithium Metal Battery.

The carbonate electrolyte chemistry is a primary determinant for the development of high-voltage lithium metal batteries (LMBs). Unfortunately, their implementation is greatly plagued by sluggish electrode interfacial dynamics and insufficient electrolyte thermodynamic stability. Herein, lithium trifluoroacetate-lithium nitrate (LiTFA-LiNO3 ) dual-salt additive-reinforced carbonate electrolyte (LTFAN) is proposed for stabilizing high-voltage LMBs. We reveal that 1) the in situ generated inorganic-rich electrode-electrolyte interphase (EEI) enables rapid interfacial dynamics, 2) TFA- preferentially interacts with moisture over PF6 - to strengthen the moisture tolerance of designed electrolyte, and 3) NO3 - is found to be noticeably enriched at the cathode interface on charging, thus constructing Li+ -enriched, solvent-coordinated, thermodynamically favorable electric double layer (EDL). The superior moisture tolerance of LTFAN and the thermodynamically stable EDL constructed at cathode interface play a decisive role in upgrading the compatibility of carbonate electrolyte with high-voltage cathode. The LMBs with LTFAN realize 4.3 V-NCM523/4.4 V-NCM622 superior cycling reversibility and excellent rate capability, which is the leading level of documented records for carbonate electrode.

Progress and evolution of hotspots in butterfly diversity research in green spaces.

Ecosystems depend on biodiversity; therefore, protecting biodiversity is beneficial for the development of ecosystems. Butterflies are indicator species that respond quickly to environmental changes and reflect environmental conditions. Butterfly diversity is a crucial evaluation indicator of habitat quality in green spaces. We used CiteSpace and Bibliometrix to conduct a bibliometric analysis of research relating to butterfly diversity in green spaces. Based on 538 papers published from 2002-2022, we systematically reviewed the status, frontiers, and hotspots for research on butterfly diversity in green spaces. Our results showed that: (1) Research on butterfly diversity in green spaces has consistently demonstrated an upward trend between 2002-2022. Studies on this subject have garnered attention from researchers worldwide, with notable interest and contributions from scholars in the United States. (2) Early studies focused on butterfly habitat preferences and extinction concerns, and later articles appeared on the influence of external environmental factors (land use, climate change, plants, etc.). (3) Three main research topics received much attention between 2002 and 2022: biodiversity conservation, butterfly habitats, and the relationship between butterfly diversity and its influencing factors. (4) The relationship between green spaces and butterfly diversity (landscape features, vegetation features, and human activities) was discussed; these factors on butterfly communities should be considered in the planning and constructing of future green spaces. (5) Two significant future directions have been identified: more research on the impact of external factors and a need for more technical integration with the big data field. Future research on butterfly diversity in green spaces should adopt a more multi-scale, multi-disciplinary approach and aim to enhance the practicality and guidance of research findings.

Triple-function eutectic solvent additive for high performance lithium metal batteries.

Rational carbonate electrolyte chemistry is critical for the development of high-voltage lithium metal batteries (LMBs). However, the implementation of traditional carbonate electrolyte is greatly hindered by the generation of an unstable electrode interphase and corrosive by-product (HF). Herein, we propose a triple-function eutectic solvent additive of N-methylacetamide (NmAc) with LiNO3 to enhance the stability and compatibility of carbonate electrolyte. Firstly, the addition of NmAc significantly improves the solubility of LiNO3 in carbonate electrolyte by forming an eutectic pair, which regulates the Li+ solvation structure and leads to dense and homogenous Li plating. Secondly, the hydrolysis of acidic PF5 is effectively alleviated due to the strong complexation of NmAc with PF5, thus reducing the generation of corrosive HF. In addition, the optimized cathode electrolyte interphase layer decreases the structural degradation and transition metal dissolution. Consequently, Li||LiNi0.6Co0.2Mn0.2O2 (NCM622) cells with the designed electrolyte deliver superior long-term cycle reversibility and excellent rate capability. This study unveils the rationale for incorporating eutectic solvent additives within carbonate electrolytes, which significantly contribute to the advancement of their practical application for high-voltage LMBs.

The microclimate impact of treetop walk based on plant community simulation.

The treetop walk is an innovative urban greenway that harmoniously integrates with the natural topography, meandering through the tree canopy. It serves as a vital element in elevating the urban mountain landscape while also significantly impacting the recreational experiences of the public through its microclimate effects. Moreover, the distinctive plant community characteristics of the treetop walk significantly enhance the microclimate. Examining the plant community attributes that potentially influence the microclimate conditions of the treetop walk is of utmost importance. We chose the Fu Forest Trail in Fuzhou as the sample site for this research. By implementing an orthogonal experimental design and using ENVI-met software, we simulated data to explore the impacts of various plant community characteristics on the microclimate of the treetop walk in autumn. The findings revealed the following results: (1) The presence of tree height, leaf area index, crown type, and planting density significantly influenced the microclimate of the treetop walk green spaces, with some factors having primary effects while others having secondary effects. (2) No significant variations were observed in the microclimate effects of diverse plant community characteristics in the treetop walk during morning, noon, and evening hours. (3) Scheme 13 emerged as the optimal choice for cooling and humidifying ventilating, characterized by a tree height of 20 m, leaf area index of 4.4, spherical crown shape, and planting spacing of 2 m. The tree species available in the Fuzhou area include Ligustrum quihoui Carr., Buxus sinica, Laurus nobilis, Myrica rubra, and Osmanthus fragrans. (4) Compared to traditional understory trails, tree height and planting spacing notably influence the microclimate environment of the treetop walk.

The Impact of Urbanization on Taxonomic Diversity and Functional Similarity among Butterfly Communities in Waterfront Green Spaces.

Urbanization has been shown to cause biodiversity loss. However, its effects on butterfly taxonomic and functional diversity still need to be studied, especially in urban waterfront green spaces where mechanisms of impact still need to be explored. We used butterflies as indicators to study how urbanization affects their taxonomic and functional diversity and identify indicator species in different urban ecological gradient areas. From July to September 2022, we surveyed 10 urban waterfront green spaces in Fuzhou City, China. We recorded 1163 butterflies of 28 species from 6 families. First, we explored the effects of urbanization on butterfly communities and made pairwise comparisons of different urban ecological gradients (α-diversity); secondly, we looked for differences between butterfly communities across urban ecological gradients (ß-diversity); finally, we investigated differences in the response of butterfly functional groups to different urban ecological gradient areas and identified ecological indicative species. This study found the following: (1) Urbanization has led to the simplification of butterfly community structure, but there are also favorable factors that support the survival of individual butterflies; (2) Urbanization has led to significant differences in butterfly communities and plant-feeding polyphagous butterfly groups; (3) Urbanization has led to differences in the functional diversity of butterfly diet and activity space groups; (4) We identified five eco-indicator species in different urban ecological gradients.

Butterfly Communities Vary under Different Urbanization Types in City Parks.

Butterflies are key indicators of urban biodiversity and one of the most vulnerable organism groups to environmental changes. Studying how butterflies are distributed and what factors might influence them in urban green spaces is crucial. In this study, from July 2022 to September 2022, we examined and analyzed the butterfly diversity in nine parks in Fuzhou, China, along three different levels of urbanization (urban, peri-urban, and suburban). We investigated how butterfly communities respond to increasing urbanization. The findings revealed that: (1) A total of 427 butterfly individuals from 4 families and 13 species were observed; (2) Shannon diversity, richness, and abundance of the overall butterfly community were lower in the more urbanized parks. Urbanization had significant effects on Shannon diversity (p = 0.003) and abundance (p = 0.007) but no significant effects on the whole butterfly community richness (p = 0.241); (3) non-metric multidimensional scaling revealed that there were differences in the overall number of butterfly species in urban parks among different geographic regions.

Body Armor-Inspired Double-Wrapped Binder with High Energy Dispersion for a Stable SiOx Anode.

The high specific capacity and relatively low volume expansion of silicon suboxide (SiOx) highlight its potential as one of the most promising anode materials for lithium-ion batteries. Nevertheless, the traditional binder of polyacrylic acid (PAA) still cannot adapt to enormous stress during the repeated volume expansion/contraction owing to its intrinsic rigid backbone. Inspired by the "soft and hard composite body armor", we herein design a double-wrapped binder consisting of PAA with a high internal Young's modulus (hard part) and polyurethane (DOU) with a low external Young's modulus (soft part). When the SiOx particle expands during lithiation, the rigid PAA firstly accommodates the volume change to dissipate most of the inner stress, and the elastic DOU with triple dynamic bonds serves as a buffer layer to absorb the residual stress via the breakage/formation of dynamic bonds. By optimizing the PAA/DOU ratio, the SiOx anode can maintain the integrity during long-term cycling and deliver a relatively high reversible capacity of 1064.1 mAh g-1 with a preeminent capacity retention of 83.7% at 0.5C after 300 cycles. Such a double-wrapped binder can provide a novel design strategy for multicomponent functional polymer binders toward high-performance SiOx anodes.

Changes in seizure frequency and anti-seizure medication therapy during pregnancy and one year postpregnancy.

Seizure control in women with epilepsy (WWE) during pregnancy is a vital concern. The aim of this study was to compare changes in seizure frequency and anti-seizure medication (ASM ) therapy in WWE in a real-world setting over three epochs (prepregnancy, pregnancy, and postpregnancy). We screened WWE who were pregnant between 1 January 2010 and 31 December 2020 from the epilepsy follow-up registry database of a tertiary hospital in China. We reviewed and collected follow-up data for the following time periods: 12 months before pregnancy (epoch 1), throughout pregnancy and the first 6 weeks postpartum (epoch 2), and from 6 weeks to 12 months postpartum (epoch 3). Seizures were classified into two categories: tonic‒clonic/focal to bilateral tonic‒clonic seizures and non-tonic‒clonic seizures. The main indicator was the seizure-free rate over the three epochs. Using epoch 1 as a reference, we also compared the percentage of women with an increased seizure frequency, as well as changes in ASM treatment, in epochs 2 and 3. Ultimately, 271 eligible pregnancies in 249 women were included. The seizure-free rates in epoch 1, epoch 2, and epoch 3 were 38.4%, 34.7%, and 43.9%, respectively (P = 0.09). The top three ASMs used in the three epochs were lamotrigine, levetiracetam, and oxcarbazepine. Using epoch 1 as a reference, the percentages of women with increased frequencies of tonic‒clonic/focal to bilateral tonic‒clonic seizures in epoch 2 and epoch 3 were 17.0% and 14.8%, respectively, while the percentages of women with an increased frequency of non-tonic‒clonic seizures in epoch 2 and epoch 3 were 31.0% and 21.8% (P = 0.02). The percentage of women whose ASM dosages were increased in epoch 2 was higher than that in epoch 3 (35.8% vs. 27.3%, P = 0.03). The seizure frequency during pregnancy may not differ significantly from that during prepregnancy and postpregnancy if WWE are treated according to the guidelines.

Synthesis of hierarchical porous zirconium dioxide and its application in the detection of sulfonamides in animal-derived food.

In order to effectively remove grease for the detection of sulfonamides, a non-toxic and low-cost hierarchical porous zirconia material was synthesized using the dual template method. The lipid impurities in an animal-derived food matrix can be absorbed by hierarchical zirconia. A ZrO2 prepolymer was synthesized by mixing amphiphilic triblock copolymer poly(ethylene glycol)-block-poly(propylene glycol)-block-poly(ethylene glycol) (P123) with tannin extract as the double template and Zr(SO4)2 as the metal source. After aging, drying and calcination at high temperature, the prepolymer transforms into a hierarchical porous structure. The synthesized materials were characterized using SEM, XRD, FT-IR, and BET. The results show that the material has an abundant pore structure and hierarchical pore structure. The adsorption conditions were optimized. The hierarchical porous ZrO2 synthesized by this method is relatively uniform, and is characterized by large specific surface area as well as high lipid impurity adsorption capacity. Through the optimization experiment of adsorption conditions, we found that hierarchical porous ZrO2 can reach the maximum adsorption capacity in 60 min under weak acidic conditions. The samples are used for actual sample testing such as HPLC of sulfadiazine (SD), sulfamethazine (SM2), sulfamethoxydiazine (SMD), sulfamethoxazole (SIZ) and sulfadimethoxine (SDM), and the recovery experiment of sulfonamides in chicken was carried out. The recoveries were 80.9-97.6% and the detection limit was 3.8-17.6 µg L-1. This work provides a new strategy for oil removal using hierarchical porous materials.

Attitudes toward COVID-19 Vaccination: A Survey of Chinese Patients with Rheumatic Diseases.

The coronavirus disease 2019 (COVID-19) pandemic has imposed enormous morbidity and mortality burdens. Patients with rheumatic diseases (RDs) are vulnerable to the COVID-19 infection, given their immunocompromised status. Ensuring acceptance of the COVID-19 vaccine is important and has attracted attention by health professionals. In this study, we designed an online cross-sectional survey that used an online questionnaire from 8 May 2021 to 4 October 2021. Attitudes toward the COVID-19 vaccination, personal information, current disease activity status, adverse events (AEs), and knowledge sources of vaccines were collected. Descriptive statistics, nonparametric tests, and ordinal logistic regression were used to analyze the data. A total of 1022 questionnaires were received, among which 70.2% (720/1022) of patients with RDs agreed to vaccination, while only 31.6% of patients were actually vaccinated. Male, employed, high-income patients and those with inactive disease showed a more positive attitude. Concerns of AEs and disease flare were the main factors affecting vaccination willingness. Only 29.6% (304/1022) of patients thought they had received enough information about the COVID-19 vaccine from their doctors. In conclusion, most patients with RDs in China intended to get vaccinated, although the vaccination rate in this particular population was low. Rheumatologists should take more responsibility in COVID-19 vaccination education of patients with RDs.

Sawtooth patterns in flexural force curves of structural biological materials are not signatures of toughness enhancement: Part II.

Stiff biological materials (SBMs), such as nacre and bone, are composites that display remarkable toughness enhancements over their primary constituents, which are brittle minerals. These enhancements are thought to be a consequence of different mechanisms made possible by the SBMs' internal lamellar architecture. One such mechanism is the Cook-Gordon (crack-arrest-and-reinitiation) mechanism, whose operation manifests in flexural tests as a sawtooth pattern in the force-displacement curves. The curves from flexural tests carried out on marine sponge spicules, which also possess a lamellar architecture, also display a sawtooth-pattern, suggesting the presence of the Cook-Gordon mechanism. Intriguingly, the spicules were recently found not to display any significant toughness enhancement. To resolve this apparent contradiction, in the preceding paper (Kochiyama et al., 2021), we put forward the hypothesis that the sawtooth pattern was due to the spicules slipping at the tests' supports. In this paper, we present a model for the spicule's flexural tests in which we allow for the possibility for the specimen to slip at the test's supports. We model contact between the specimen and the test's supports using the Coulomb's friction law. By choosing experimentally reasonable values for the friction coefficient, we were able to get the model's predictions to match experimental measurements remarkably well. Additionally, on incorporating the spicules' surface roughness into the model, which we did by varying the friction coefficient along the spicule's length, its predictions can also be made to match the measured sawtooth patterns. We find that the sawtooth patterns in the model are due to slip type instabilities, which further reinforces the hypothesis put forward in our preceding paper.

Sawtooth patterns in flexural force curves of structural biological materials are not signatures of toughness enhancement: Part I.

Layered architectures are prevalent in tough biological composites, such as nacre and bone. Another example of a biological composite with layered architecture is the skeletal elements-called spicules-from the sponge Euplectella aspergillum. Based on the similarities between the architectures, it has been speculated that the spicules are also tough. Such speculation is in part supported by a sequence of sudden force drops (sawtooth patterns) that are observed in the spicules' force-displacement curves from flexural tests, which are thought to reflect the operation of fracture toughness enhancing mechanisms. In this study, we performed three-point bending tests on the spicules, which also yielded the aforementioned sawtooth patterns. However, based on the analysis of the micrographs obtained during the tests, we found that the sawtooth patterns were in fact a consequence of slip events in the flexural tests. This is put into perspective by our recent study, in which we showed that the spicules' layered architecture contributes minimally to their toughness, and that the toughness enhancement in them is meager in comparison to what is observed in bone and nacre [Monn MA, Vijaykumar K, Kochiyama S, Kesari H (2020): Nat Commun 11:373]. Our past and current results underline the importance of inferring a material's fracture toughness through direct measurements, rather than relying on visual similarities in architectures or force-displacement curve patterns. Our results also suggest that since the spicules do not possess remarkable toughness, re-examining the mechanical function of the spicule's intricate architecture could lead to the discovery of new engineering design principles.

Force sensors for measuring microenvironmental forces during mesenchymal condensation.

Mechanical forces are an essential element to early tissue formation. However, few techniques exist that can quantify the mechanical microenvironment present within cell-dense neotissues and organoid structures. Here is a versatile approach to measure microscale, cellular forces during mesenchymal condensation using specially tailored, hyper-compliant microparticles (HCMPs). Through monitoring of HCMP deformation over both space and time, measurements of the mechanical forces that cells exert, and have exerted on them, during tissue formation are acquired. The current study uses this technology to track changes in the mechanical microenvironment as mesenchymal stem cells self-assemble into spheroids and condense into cohesive units. An array analysis approach, using a high-content imaging system, shows that cells exert a wide range of tensile and compressive forces during the first few hours of self-assembly, followed by a period of relative equilibrium. Cellular interactions with HCMPs are further examined by applying collagen coating, which allows for increased tensile forces to be exerted compared to non-coated HCMPs. Importantly, the hyper-compliant nature of our force sensors allows for increased precision over less compliant versions of the same particle. This sensitivity resolves small changes in the microenvironment even at the earliest stages of development and morphogenesis. The overall experimental platform provides a versatile means for measuring direct and indirect spatiotemporal forces in cell-dense biological systems.

Diagnosing Thyrotropin-Secreting Pituitary Adenomas by Short-Term Somatostatin Analogue Test.

Background: Diagnosis of thyrotropin (TSH)-secreting pituitary adenomas (TSHoma) before surgery remains a challenge, especially for microadenomas. We aimed to establish a short-term somatostatin analogue (SSA) test to differentiate TSHomas from other causes of syndromes of inappropriate secretion of TSH (IST), mainly resistance to thyroid hormone ß (RTHß). Materials and Methods: We first evaluated the sensitivity and specificity of SSA test in a training cohort (TSHoma, n = 32; RTHß, n = 20). The test was then validated in an independent cohort (TSHoma, n = 9; RTHß, n = 2). We finally applied the SSA test in 12 perceptively enrolled IST cases with negative imaging findings and absent thyroid hormone receptor beta (THRB) mutations or mixed hormone imbalances. Results: Both TSHoma and RTHß patients showed a decrease of TSH at the start of the SSA test, but the velocity of the TSH suppression slowly decreased in RTHß patients after 2 hours. The suppression ratio of TSH at 24 hours versus 2 and 0 hours was significantly greater in TSHoma patients compared with RTHß patients (70.58% ± 18.6% vs. 6.01% ± 25.41%, p < 0.0001, 79.83% ± 12.79% vs. 51.16% ± 13.62%, p < 0.0001, respectively). The 24- versus 2-hour suppression ratio showed the best diagnostic accuracy at a cut point of 44.46% in the training cohort, with a sensitivity of 95.00%, a specificity of 93.75%, and a positive predictive value (PPV) of 88.89%. The accuracy was confirmed in the validation cohort. Three out of 12 patients in the prospective cohort showed a TSH suppression ratio greater than 44.46% and all developed microadenomas during follow-up. Conclusions: A short-term SSA test provides an alternative diagnostic approach for TSHomas. A positive SSA test result is suggestive for a TSHoma even before positive findings become apparent on pituitary imaging. However, studies including larger number of patients, especially those with RTHß, are needed to confirm our findings.

Effects of geometric nonlinearity in an adhered microbeam for measuring the work of adhesion.

Design against adhesion in microelectromechanical devices is predicated on the ability to quantify this phenomenon in microsystems. Previous research related the work of adhesion for an adhered microbeam to the beam's unadhered length, and as such, interferometric techniques were developed to measure that length. We propose a new vibration-based technique that can be easily implemented with existing atomic force microscopy tools or similar metrology systems. To make such a technique feasible, we analysed a model of the adhered microbeam using the nonlinear beam theory put forth by Woinowsky-Krieger. We found a new relation between the work of adhesion and the unadhered length; this relation is more accurate than the one by Mastrangelo & Hsu (Mastrangelo & Hsu 1993 J. Microelectromech. S., 2, 44-55. (doi:10.1109/84.232594)) which is commonly used. Then, we derived a closed-form approximate relationship between the microbeam's natural frequency and its unadhered length. Results obtained from this analytical formulation are in good agreement with numerical results from three-dimensional nonlinear finite-element analysis.

[Endoscopic orbital decompression for thyroid-associated ophthalmopathy].

OBJECTIVE: To evaluate the therapeutic results of endoscopic orbital decompression for thyroid-associated ophthalmopathy. METHOD: The records of nine patients (twelve orbits) received endoscopic orbital decompression for thyroid-associated ophthalmopathy were analyzed for changes in visual acuity, intraocular pressure, proptosis, corneal ulceration and movement. The follow-ups ranged from two months to thirty-six months. RESULT: Twelve orbits (100%) had improvement in visual acuity (range 0.1-0.7). Ten orbits (83.3%) decreased in intraocular pressure (range 0.2-21.4 mm Hg). Eight orbits (66.70%) decreased in proptosis (one-five mm). The orbit with corneal ulcer was healed after decompression. Diplopia was cured in one of four patients. CONCLUSION: Endoscopic orbital decompression is a safe and effective procedure for the treatment of thyroid-associated ophthalmopathy.