Repeated Low-Level Red Light Therapy for Myopia Control in High Myopia Children and Adolescents: A Randomized Clinical Trial.

PURPOSE: To assess the effectiveness and safety of repeated low-level red light (RLRL), which is a newly available treatment for myopia control in children and adolescents with high myopia. DESIGN: Multicenter, randomized, parallel-group, single-blind clinical trial (randomized controlled trial; NCT05184621). PARTICIPANTS: Between February 2021 and April 2022, 192 children aged 6 to 16 years were enrolled. Each child had at least 1 eye with myopia of cycloplegic spherical equivalent refraction (SER) at least -4.0 diopters (D), astigmatism of ≤2.0 D, anisometropia of ≤3.0 D, and best-corrected visual acuity (BCVA) of 0.2 logarithm of the minimum angle of resolution or better. Follow-up was completed by April 2023. METHODS: Participants were randomly assigned at a 1:1 ratio to intervention (RLRL treatment plus single-vision spectacles) or control (single-vision spectacles) groups. The RLRL treatment was administered for 3 minutes per session, twice daily with a minimum interval of 4 hours, 7 days per week. MEAN OUTCOME MEASURES: The primary outcome and key secondary outcome were changes in axial length (AL) and cycloplegic SER measured at baseline and the 12-month follow-up visit. Participants who had at least 1 postrandomization follow-up visit were analyzed for treatment efficacy. RESULTS: Among 192 randomized participants, 188 (97.91%) were included in the analyses (96 in the RLRL group and 92 in the control group). After 12 months, the adjusted mean change in AL was -0.06 mm (95% confidence interval [CI], -0.10 to -0.02 mm) and 0.34 mm (95% CI, 0.30 to 0.39 mm) in the intervention and control groups, respectively. A total of 48 participants (53.3%) in the intervention group were still experiencing axial shortening >0.05 mm at the 12-month follow-up. The mean SER change after 12 months was 0.11 D (95% CI, 0.02to 0.19 D) and -0.75 D (95% CI, -0.88 to -0.62 D) in the intervention and control groups, respectively. CONCLUSIONS: Repeated low-level red light demonstrates stronger treatment efficacy among those with high myopia, with 53.3% experiencing substantial axial shortening. Repeated low-level red light provides an excellent solution for the management of high myopia progression, a significant challenge in ophthalmology practice. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Mesenchymal stem cell secretome-loaded fibrin glue improves the healing of intestinal anastomosis.

Anastomotic leakage is a serious complication following gastrointestinal surgery and one of the leading causes of patient mortality. Despite the significant clinical and economic burden, there are currently no reliable treatment options to improve the healing of intestinal anastomosis and subsequently prevent anastomotic leakage. Recently, the development of regenerative medicine has shown promise for improving anastomotic healing. Recent studies have illustrated that stem cell-derived secretome can enhance tissue regeneration without the safety and ethical limitations of stem cell transplantation. Herein, we developed a fibrin glue topical delivery system loaded with mesenchymal stem cells (MSCs)-derived secretome for controlled delivery of bioactive factors, and evaluated its application potential in improving the healing of intestinal anastomosis. Under in vitro conditions, the MSCs secretome significantly promoted cell proliferation viability in a dose-dependent manner and resulted in the controlled release of growth factors via fibrin glue delivery. We established a rat surgical anastomotic model and experimentally found that MSCs secretome-loaded fibrin glue enhanced anastomotic bursting pressure, increased granulation tissue formation and collagen deposition, and significantly promoted anastomotic healing. Mechanistically, fibrin glue accelerated cell proliferation, angiogenesis, and macrophage M2 polarization at the surgical anastomotic site by releasing bioactive factors in the secretome, and it also alleviated the inflammatory response and cell apoptosis at the anastomotic site. Our results demonstrated for the first time that MSCs-derived secretome could promote the healing of intestinal anastomosis. Considering the accessibility and safety of the cell-free secretome, we believed that secretome-loaded fibrin glue would be a cell-free therapy to accelerate the healing of intestinal anastomosis with great potential for clinical translation.

Incidence, Management, and Outcome of Pulled-in-Two Syndrome Associated With Strabismus Surgery.

PURPOSE: To report the incidence and outcomes of pulled-in-two syndrome during strabismus surgery and investigate the clinical features and management of the disease. METHODS: The medical records of patients who underwent strabismus surgery and developed pulled-in-two syndrome between July 2013 and October 2020 were reviewed retrospectively. The demographic characteristics, intraoperative details (including surgery type and management), and subsequent and final outcomes were extracted from the records. RESULTS: Of the 11,824 strabismus surgeries during the study period, 4 cases of pulled-in-two syndrome were documented, accounting for an overall incidence of 0.034%. The average age of the patients with pulled-in-two syndrome was 61.75 ± 8.99 years. All 4 patients were women; 2 had abducens nerve palsy and the other 2 had myopic strabismus fixus. The inferior rectus muscle was involved in 1 patient and the medial rectus muscle was involved in 3 patients. All of the involved extraocular muscle was lost. One patient achieved orthotropia, and the others were undercorrected after the surgery. CONCLUSIONS: Pulled-in-two syndrome is one of the rarest and most severe complications of strabismus surgery. Cranial nerve palsy, advanced age, prior surgery, thyroid-associated ophthalmopathy, and degenerative conditions of the extraocular muscle are risk factors for pulled-in-two syndrome. Therefore, the prevention of pulled-in-two syndrome in patients with these risk factors should be investigated further. [J Pediatr Ophthalmol Strabismus. 2023;60(4):263-267.].

Epidemiological characteristics and pathological changes of primary glomerular diseases.

OBJECTIVE: By analyzing the pathological characteristics and clinical data of renal biopsy in our hospital in the past 20 years, to further understand the epidemic characteristics and pathological changes of primary glomerular disease, and to provide regional data for the big data of kidney disease in my country. METHODS: A retrospective analysis of 9448 patients with primary glomerular disease who were hospitalized in our hospital from January 1, 2000 to December 31, 2019, aged 18 years or older, and undergoing renal biopsy. Divided every 5 years into a group, a total of 4 groups (first group 2000.1.1-2004.12.31, second groups 2005.1.1-2009.12.31; third groups 2010.1.1-2014.12.31, fourth groups 2015.1.1-2019.12.31). RESULTS: ① There were more males than females, and male: female vs 1.53:1. The proportion of men in the past five years has increased compared with the previous 15 years. ② Mostly middle-aged, with a median age of 41.39 years old. The age is increasing over time. There are differences between the four groups, P <0.001; ③ The most common clinical manifestations are nephrotic syndrome, followed by chronic glomerulonephritis. Occult glomerulonephritis, the proportion of patients with nephrotic syndrome increases over time, first to fourth group (40.08%< 42.64% < 47.08%< 53.69%); ④ The most common pathology type from 2000 to 2009 was mesangial proliferative glomerulonephritis. IgA nephropathy was the most common type from 2010 to 2014, but the proportion of membranous nephropathy increased year by year, and it became the most common pathological type from 2015 to 2019; ⑤ The clinical and pathological manifestations of different genders are different, but there is no statistical difference. CONCLUSION: In the past 20 years, the primary glomerular disease is mainly middle-aged. There are more men than women. The most common type of clinical manifestation is nephrotic syndrome. The pathological type is mesangial proliferative glomerulonephritis. Over time, the average age is increasing, and the proportion of patients with renal syndrome is increasing. IgA nephropathy is the most common pathological type from 2010 to 2014, and membranous nephropathy has become the main pathological type in the past 5 years.

Prismatic treatment of acute acquired concomitant esotropia of 25 prism diopters or less.

BACKGROUND: This study aimed to assess the efficacy of prismatic treatment in a step-by-step manner to reduce prismatic strength in acute acquired concomitant esotropia (AACE) of 25 prism diopters (PD) or less. METHODS: In this retrospective comparative study, 36 patients with AACE with deviation angle ≤ 25 PD were treated with Fresnel prism in a step-by-step manner to reduce prismatic strength. The patients were divided into two groups according to whether they regained orthophoria and were weaned off the press-on prisms within 1 year: (1) the treatment-success group, which consisted of patients who had their esotropia eliminated and were weaned off the press-on prisms within 1 year after prism correction, and (2) the treatment-continuing group, which comprised patients who needed to continue wearing a Fresnel prism at 1 year after the beginning of prismatic correction because diplopia and esotropia still existed. Clinical characteristics and cooperation were analyzed and compared between groups. RESULTS: Fourteen of 36 patients (38.9%) were weaned off the prism and regained orthophoria and binocular single vision within 1 year after prismatic treatment. Compared with the treatment-continuing group, the treatment-success group showed smaller deviation at near and distant fixations (P = 0.024 and P = 0.006, respectively) measured at the beginning of prismatic correction, a shorter time from onset to prismatic treatment (P = 0.02), and a greater percentage of patients exhibiting good cooperation (P < 0.001). CONCLUSIONS: Prismatic treatment in a step-by-step manner to reduce prismatic strength can lead to good outcomes of motor alignment and binocular function in patients with AACE of 25 PD or less. Patients showing good cooperation, smaller angle of esotropia, and shorter duration from onset to treatment tend to eliminate esotropia and be weaned off press-on prisms within 1 year after prismatic correction.

Renal amyloidosis complicated by light chain deposition nephropathy: a case report.

Light chain amyloidosis (AL) and light chain deposition disease (LCDD) are systemic diseases caused by an abnormal production of monoclonal immunoglobulin light chains and their deposition in systemic tissue. We herein present a rare case of renal amyloidosis complicated with light chain deposition nephropathy. The patient presented with nephrotic syndrome and an increased serum creatinine. Laboratory studies showed the serum k light chain was decreased and the urine free λ light chain was positive. On a lighted microscopy examination of the renal cortical tissue, λ and κ light chain protein deposits were in the glomerular and renal tubular basement membranes and Congo red staining was positive. It was determined using electron microscopy that amyloid fibrils and continuous electron-dense granules were deposited in the glomerular basement membrane. Due to differences in the protein polymerization mechanisms, it is almost impossible for AL and LCDD to coexist. This rare case can help provide ideas for clinical diagnosis and for exploring new therapeutic targets.

Fabrication and characterization of antistatic epoxy composite with multi-walled carbon nanotube-functionalized melamine foam.

A novel strategy for synthesizing an antistatic epoxy composite was carried out. Pre-embedded antistatic melamine foam was first synthesized and then used to prepare an antistatic epoxy composite. Azidized polyacrylic acid (APAA) was grafted onto multiwalled carbon nanotubes (APAA-MWCNTs) by direct functional modification of the MWCNT sidewalls. Melamine was then covalently bonded to MWCNTs (MA-APAA-MWCNTs). The chemical structure of MA-APAA-MWCNTs was characterized by FT-IR spectroscopy, EDS, TGA, Raman spectroscopy, and TEM. As an antistatic agent, MA-APAA-MWCNTs utilized the functional groups of the surface to participate in the formation of melamine foam by reaction with paraformaldehyde. The surface resistivity was decreased to 3.6 × 108 Ω sq-1 when the loading of MWCNTs was 2.4 kg m-3. The prepared antistatic foam at different compression ratios was immersed in epoxy resin, which was then cured. When the compression ratio reached 40%, the surface resistivity and volume resistivity, respectively, reached 1.05 × 108 Ω sq-1 and 3.5 × 108 Ω cm, thereby achieving an antistatic effect.

CropWatch agroclimatic indicators (CWAIs) for weather impact assessment on global agriculture.

CropWatch agroclimatic indicators (CWAIs) are a monitoring tool developed by the CropWatch global crop monitoring system in the Chinese Academy of Sciences (CAS; www.cropwatch.com.cn , Wu et al Int J Digital Earth 7(2):113-137, 2014, Wu et al Remote Sens 7:3907-3933, 2015). Contrary to most other environmental and agroclimatic indicators, they are "agronomic value-added", i.e. they are spatial values averaged over agricultural areas only and they include a weighting that enhances the contribution of the areas with the largest production potential. CWAIs can be computed for any time interval (starting from dekads) and yield one synthetic value per variable over a specific area and time interval, for instance a national annual value. Therefore, they are very compatible with socio-economic and other variables that are usually reported at regular time intervals over administrative units, such as national environmental or agricultural statistics. Two of the CWAIs are satellite-based (RAIN and Photosynthetically Active radiation, PAR) while the third is ground based (TEMP, air temperature); capitals are used when specifically referring to CWAIs rather than the climate variables in general. The paper first provides an overview of some common agroclimatic indicators, describing their procedural, systemic and normative features in subsequent sections, following the terminology of Binder et al Environ Impact Assess Rev 30:71-81 (2010). The discussion focuses on the systemic and normative aspects: the CWAIs are assessed in terms of their coherent description of the agroclimatic crop environment, at different spatial scales (systemic). The final section shows that the CWAIs retain key statistical properties of the underlying climate variables and that they can be compared to a reference value and used as monitoring and early warning variables (normative).

Improvement in fusion and stereopsis following surgery for intermittent exotropia.

PURPOSE: To evaluate fusion stereopsis in patients with intermittent exotropia before and after strabismus surgery. METHODS: Fifty-three patients (mean age: 11.8 years, range: 5 to 25 years) with intermittent exotropia were enrolled. Fusion was measured with the Worth 4-dot test. Near stereopsis was examined with Titmus and stereoscopic test charts (created in China by Shao-Ming Yan). Distance stereopsis was tested with random-dot stereograms produced by Tianjin Eye Hospital. All patients completed the tests preoperatively and 2 and 6 weeks postoperatively. RESULTS: There were no statistically significant differences in stereoscopic test charts among groups preoperatively (P > .05) and postoperatively (P > .05) or on Titmus tests preoperatively (P > .05) and postoperatively (P > .05). Among 53 patients, the percentage of distance stereoscopic improvement was 49% after 2 weeks and 77% after 6 weeks compared to 13% preoperatively. Six weeks postoperatively, random-dot stereograms were significantly different in those younger than 7 years and older than 13 years (P < .05), as well as those 7 to 13 years and older than 13 years (P < .05). Fifty (94%) demonstrated peripheral fusion and only 21 (40%) demonstrated central fusion preoperatively. Six weeks postoperatively, all patients exhibited peripheral fusion and 52 (98%) demonstrated central fusion. Central fusion in patients with intermittent exotropia significantly increased after 6 weeks (chi-square = 42.29, P < .01). CONCLUSIONS: Patients with intermittent exotropia have good near stereoacuity preoperatively and postoperatively. Even if surgery is postponed until adolescence, distance stereopsis can still be recovered. Surgical intervention can restore central fusion and stereoacuity in patients with intermittent exotropia.

[Recurrent N1173K mutation in FBN1 gene in a Chinese family with ectopia lentis].

OBJECTIVE: To study the disease-causing gene mutation in a Chinese family with ectopia lentis. METHODS: The phenotype of each family member in a Chinese family with ectopia lentis was identified by detailed clinical examination. The inheritance mode in this family was ascertained by the pedigree analysis. Linkage analysis was performed by microsatellite markers on chromosome 15 and LOD Score was calculated by Mlink program. Gene mutations were detected by sequence analysis to the whole coding region and exon-intron boundaries of the candidate gene. RESULTS: A significant LOD score of 3.01 was obtained at D15S978 on chromosome 15q21.1, where FBN1 gene was located. A C3519G change in exon 29 of FBN1 gene, resulting in asparagine change to lysine at codon 1173, was detected by direct sequence analysis. This mutation was absent in the normal family members and 100 normal controls. CONCLUSIONS: Our results indicate that c.C3519G (p.N1173K) mutation in FBN1 gene is the underlying molecular pathogenesis of this family with ectopia lentis.