The Discovery and Anti-Colorectal Cancer Activities of Cembranolides from the South China Sea Soft Coral Sinularia pendunculata.

A new cembranolide, namely, sinupendunculide A (1), along with eight known related compounds (2-9), was isolated from the South China Sea Soft coral Sinularia pendunculata. The structure of sinupendunculide A (1) was established by extensive spectroscopic analysis and X-ray diffraction experiments. In a bioassay, anti-colorectal cancer (CRC) activity was performed, and the results showed that several compounds exhibited cytotoxicity against RKO cells, and a preliminary structure-activity relationship was analysed. Meanwhile, the most effective compound 7 was proven to increase reactive oxygen species levels, which promoted cell apoptosis and inhibited cell proliferation.

Virtual reality training improves accommodative facility and accommodative range.

AIM: To evaluate the effects of virtual reality (VR) training on different parameters of vision. METHODS: Sixty individuals ranged 18-60 years old with asthenopia were randomly divided into short-term (n=40) and long-term (n=20) treatment groups. They were given a specially designed VR training device only once for 15min or 3-4 times a day for 15min each time for 1mo. The visual acuity, spherical equivalent, accommodative range, accommodative facility, pupil size, and visual fatigue were evaluated before (control) and after VR training. RESULTS: The visual acuity, accommodative range, and accommodative facility increased in subjects of the short-term treatment group, whereas their pupil size contracted significantly. No significant changes in spherical equivalent and visual fatigue were observed. The changes in distant vision and corrected visual acuity were positively correlated with those in pupil size, but not with spherical equivalent. The accommodative range and accommodative facility improved significantly in subjects of the long-term treatment group. No significant changes in visual acuity, spherical equivalent, pupil size, and visual fatigue were noted. CONCLUSION: VR training can improve the accommodative range and accommodative facility of human eyes. Although short-term VR training can transiently improve vision, which probably due to bright light adaptation, there is no evidence that it can improve myopia.

Botulinum toxin A in the treatment of trigeminal neuralgia.

AIMS: The aims of this study were to investigate the clinical effects and safety of botulinum toxin A (BTX-A) in treating trigeminal neuralgia and its influences on accompanied depression, anxiety, sleep disorders, and quality of life. METHODS AND MATERIAL: Eighty-seven patients with one-branch classical trigeminal neuralgia were injected with BTX-A in the pain area. The visual analogic scale score, sleep interference score, Hamilton Anxiety Scale score, Hamilton Depression Scale score, and side effects were assessed at 1 week prior to and 8 weeks after treatment, respectively. RESULTS: The effective rates after 1, 2, 4, and 8 weeks of treatment were 48.28%, 66.67%, 78.16%, and 80.46%, respectively. The effective rates of anxiety and depression were 90.32% and 96.77%, respectively. When compared to that before treatment, the quality of life was significantly better in terms of role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health (all P < 0.01), while physical function was not significantly improved (P = 0.317). CONCLUSION: BTX-A treatment can significantly relieve the pain in trigeminal neuralgia patients; improve anxiety, depression, and sleep; and increase the quality of life. BTX-A treatment is a safe and effective method to treat classical trigeminal neuralgia.

MiR-27a-3p promotes esophageal cancer cell proliferation via F-box and WD repeat domain-containing 7 (FBXW7) suppression.

Emerging evidence has suggested that dysregulation of microRNA-27a-3p (miR-27a-3p) may contribute to tumor development and progression in various types of cancers. However, its role in esophageal cancer is still unknown. In the present study, miR-27a-3p was significantly increased in esophageal squamous cell carcinoma (ESCC) tissues and cell lines. In esophageal cancer Eca109 cells, ectopic overexpression of miR-27a-3p promoted cell proliferation, meanwhile, cell proliferation was reduced by miR-27a-3p inhibition. Further studies showed that down-regulated miR-27a-3p expression could induced cell cycle arrest at the G1/S transition. In exploring mechanisms underlying the promotive role, our results revealed that miR-27a-3p markedly inhibited the expression of F-box and WD repeat domain-containing 7 (FBXW7). FBXW7, a tumor suppressor, exhibited significantly inhibitory effect on Eca109 cell proliferation. Thus our observations suggested that miR-27a-3p functioned as a tumor suppressor by targeting FBXW7. These findings indicated that miR-27a-3p could be considered as a potential therapeutic strategy for ESCC therapy.

Efficacy of dexmedetomidine on postoperative shivering: a meta-analysis of clinical trials.

PURPOSE: Shivering is a frequent complication in the postoperative period. The aim of the current meta-analysis was to assess the efficacy of dexmedetomidine on postoperative shivering. METHODS: Two researchers independently searched PubMed, EMBASE and the Cochrane Central Register of Controlled Trials for controlled clinical trials. The meta-analysis was performed by Review Manager. RESULTS: Thirty-nine trials with 2,478 patients were included in this meta-analysis. Dexmedetomidine reduced postoperative shivering compared with placebo (risk ratio [RR] = 0.26; 95% confidence interval [CI]: 0.20 to 0.34), with a minimum effective dose of 0.5 µg·kg(-1) (RR = 0.36; 95% CI: 0.21 to 0.60). The anti-shivering effect can be achieved both intravenously and epidurally when administered within two hours prior to the end of surgery. The efficacy of dexmedetomidine was similar to widely used anti-shivering agents, such as fentanyl, meperidine, tramadol, clonidine and so on; however, dexmedetomidine may increase the incidence of sedation, hypotension, bradycardia and dry mouth. CONCLUSIONS: The present meta-analysis indicates that dexmedetomidine shows superiority over placebo, but not over other anti-shivering agents. Therefore, considering its high price and potential adverse events, dexmedetomidine may not be appropriate solely for the purpose of the prevention of postoperative shivering.

[Selection of the posterior chamber phakic intraocular lens length].

OBJECTIVE: To evaluate the efficacy, safety and clinical value of calculating the posterior chamber phakic intraocular lens (ICL) length according to the corneal horizontal diameter. METHODS: This was a retrospective study. A Staar Visian implantable contact lens (ICL) was implanted in 32 patients (64 eyes) with high myopia in the Department of Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University between November 15, 2005 and January 15, 2011. The lens length was calculated according to the corneal horizontal diameter measured by Orbscan II. Patients were followed up postoperatively at 1 day, 1 week, 1, 3, 6 and 12 months and every 6 months thereafter. The evaluations included visual acuity, manifest refraction, applanation tonometry, endothelial cell count, slit-lamp microscopy to detect cataract, and UBM to assess the degree of ICL tilt and distances between the corneal endothelium, the ICL, and the crystalline lens. All of the preoperative and 12-month follow-up observations were analyzed using SPSS 16.0 software. RESULTS: No anterior subcapsular cataracts were found in any of the eyes after surgery. Pigmentary dispersion was observed on the anterior and posterior surface of the ICL, but the difference was not statistically significant (χ(2) = 2.24, P = 0.13). The intraocular pressure changed from (15.67 ± 3.23) mm Hg (1 mm Hg = 0.133 kPa) to (15.78 ± 3.23) mm Hg, but the difference was not significant (t = 0.24, P = 0.38). The corneal endothelium-lens (central section) distance measured by UBM postoperatively was (2.97 ± 0.25) mm and the corneal endothelium-ICL (central section) distance was (2.24 ± 0.27) mm; the difference between them was statistically significant (t = 15.77, P < 0.01). The degree of ICL tilt measured by UBM was 1.20° ± 1.05 °. The percentage of eyes with a trabecular-iris angle (TIA) greater than 30°, between 21° and 30°, between 11°and 20°, and smaller than 10° were 29.1%, 50.0%, 11.6%, and 9.3%, respectively. The angle opening distance at 500 micron (AOD500) measured by UBM postoperatively was (0.32 ± 0.15) mm. The contact distance between the iris and the ICL measured by UBM postoperatively was (0.85 ± 0.46) mm and the ICL-lens central distance was (0.47 ± 0.25) mm. The Pearson's correlation coefficients between the ICL-lens central distance and the corneal horizontal diameter, sulcus diameter, anterior chamber depth(ACD) and ICL length were 0.11, 0.16, 0.04 and 0.19, respectively; none were statistically significant. The ICL-lens peripheral distance measured by UBM postoperatively was (0.25 ± 0.20) mm. CONCLUSION: Selecting the length of the ICL according to the corneal horizontal diameter is appropriate, and assures the safety, effectiveness and predictability of ICL implantation.

[Mid-long term follow-up results in correction of extreme myopia by posterior chamber phakic intraocular lens].

OBJECTIVE: To evaluate the mid-long term stability and safety of posterior chamber phakic intraocular lens (ICL) implantation for the correction of extreme myopia. METHODS: This retrospective study included 993 eyes of 498 patients received ICL implantation from June 1996 to December 2008. Multivariate analysis and variance analysis were used to evaluate the stability of the results and to identify risk factors of the complications. RESULTS: Successful implantation was achieved in all patients. Spherical equivalent (SE) was (16.23 ± 4.12, mean ± SD) D before the operation and (-0.92 ± 1.22) D at the last examination. Intraocular pressure was (13.58 ± 2.93) mm Hg (1 mm Hg = 0.133 kPa) preoperatively which was (13.90 ± 3.01) mm Hg at the last examination. There was no statistical significance in follow-up (t = 0.44 ∼ 1.30, P > 0.05). Endothelial cell density was (2858.21 ± 395.13)/mm(2) before the operation and (2567.19 ± 423.45)/mm(2) at last examination. Pupillary block glaucoma occurred in 2 eyes (0.2%) at two hours and 1 eye (0.1%) at one month after the operation. Three eyes developed anterior cataracts between 6 months to 1 year after ICL implantation and another 2 eyes subcapsular opacification at semi-peripheral regions occurred 4 years after the operation, and was not related with age, SE and vaults (F = 2.42, 1.98, 0.81, P > 0.05). Macular puckers were found in 5 eyes (0.5%) 1 year postoperatively, including 2 eyes developed choroidal neovascularization and received PDT, best corrected visual acuity lost more than 2 lines. Retinal detachment occurred in 2 eyes at 1.5 years after the operation. Acute iritis happened in 1 eye (0.1%) and chronic iritis in 1 eye (0.1%) which combined with slight pupil distortion and elevation of intraocular pressure. Iris stroma atrophy and pupil distortion were found in 2 eyes (0.2%). CONCLUSION: Correction of high myopia by ICL implantation is a safe procedure and the results are stable.

[Posterior chamber phakic intraocular lens for correction of extreme myopia].

OBJECTIVE: To evaluate the efficacy, safety and stability of posterior chamber phakic intraocular lens implantation for the correction of extreme myopia. METHODS: This study included 216 eyes of 113 patients with a mean age of 30 years (18 approximately 49) from January 1997 to December 2005. An implantable contact lens (ICL V2 and V4, Staar Surgical Inc.) was inserted. Patients were examined preoperatively and followed at 1 day, 1 week, 1, 3, 6, 12, 24, and 36 months postoperatively. The examination content included the uncorrected visual acuity, best corrected visual acuity (BCVA), slitlamp examination, refraction, intraocular pressure, endothelial cell morphometry, etc. Spherical equivalent was (17.78 +/- 3.88) diopters before the operation. Surgical implantation was performed through a 3.2 mm clear corneal sutureless incision using paraocular anesthesia. The mean follow-up period was 18.2 months (ranged 6 to 24 months) for refractive data and 24.3 months (ranged 6 to 36 months) for the complications. RESULTS: Successful implantation was achieved in all patients. Postoperatively, all eyes had a significant increase in uncorrected visual acuity. The mean spherical equivalent refraction at the last examination was (-1.00 +/- 1.40), within +/- 1.00 D of the targeted refraction in 191 eyes (88.4%) and within +/- 0.50 D in 165 eyes (76.4%). In eyes in which the preoperative myopia was less than 20.00 D (n = 151), the achieved refraction was within +/- 1.00 D of the intended refraction in 145 eyes (96.0%) and within +/- 0.50 D in 128 eyes (84.8%). The refraction remained stable with a statistically insignificant change (P > 0.05) at each interval during the follow-up. The best corrected visual acuity (BCVA) improved by 1 or more lines in 168 eyes (77.8%) at 1 year after the operation. Four eyes (1.85%) lost 1 line of BCVA. Pupillary block glaucoma requiring surgical intervention occurred in 4 eyes (1.85%). Three eyes (1.39%) developed cataract 1 year after ICL (V2) implantation, all ICLs in these eyes were removed, and the refractive errors were corrected by lensectomy and implantation of low-power posterior chamber IOLs. BCVA was mentioned in all of these eyes. CONCLUSION: Posterior chamber phakic intraocular lens implantation appears to be an effective, safe and reliable method for the correction of extreme myopia.