Case report: A toxoplasmic encephalitis in an immunocompromised child detected through metagenomic next-generation sequencing.

There exist numerous pathogens that are capable of causing infections within the central nervous system (CNS); however, conventional detection and analysis methods prove to be challenging. Clinical diagnosis of CNS infections often depends on clinical characteristics, cerebrospinal fluid (CSF) analysis, imaging, and molecular detection assays. Unfortunately, these methods can be both insensitive and time consuming, which can lead to missed diagnoses and catastrophic outcomes, especially in the case of infrequent diseases. Despite the application of appropriate prophylactic regimens and evidence-based antimicrobial agents, CNS infections continue to result in significant morbidity and mortality in hospital settings. Metagenomic next-generation sequencing (mNGS) is a novel tool that enables the identification of thousands of pathogens in a target-independent manner in a single run. The role of this innovative detection method in clinical pathogen diagnostics has matured over time. In this particular research, clinicians employed mNGS to investigate a suspected CNS infection in a child with leukemia, and unexpectedly detected Toxoplasma gondii. Case: A 3-year-old child diagnosed with T-cell lymphoblastic lymphoma was admitted to our hospital due to a 2-day history of fever and headache, along with 1 day of altered consciousness. Upon admission, the patient's Glasgow Coma Scale score was 14. Brain magnetic resonance imaging revealed multiple abnormal signals. Due to the patient's atypical clinical symptoms and laboratory test results, determining the etiology and treatment plan was difficulty.Subsequently, the patient underwent next-generation sequencing examination of cerebrospinal fluid. The following day, the results indicated the presence of Toxoplasma gondii. The patient received treatment with a combination of sulfamethoxazole (SMZ) and azithromycin. After approximately 7 days, the patient's symptoms significantly improved, and they were discharged from the hospital with oral medication to continue at home. A follow-up polymerase chain reaction (PCR) testing after about 6 weeks revealed the absence of Toxoplasma. Conclusion: This case highlights the potential of mNGS as an effective method for detecting toxoplasmic encephalitis (TE). Since mNGS can identify thousands of pathogens in a single run, it may be a promising detection method for investigating the causative pathogens of central nervous system infections with atypical features.

The correlation between non-arteritic anterior ischemic optic neuropathy and cerebral infarction.

Background: The aim of this study was to explore the correlation between non-arteritic anterior ischemic optic neuropathy (NAION) and cerebral infarction (CI). Moreover, the ocular and systemic parameters are also compared between NAION patients with or without CI. Methods: Retrospective analysis is performed for NAION patients and the controls. The controls were collected at the eye outpatient with cranial computed tomography (CT), and data of blood triglyceride, cholesterol, low-density lipoprotein, high-density lipoprotein, and apolipoprotein B were drawn. The diagnosed NAION patients with cranial CT are included, and data of clinical history and routine clinical examination were drawn from the medical record. Visual acuity, intraocular pressure (IOP), visual field, and visual evoked potential were also drawn. Results: Eighty-two unilateral and 6 bilateral patients, totally 94 eyes for 88 NAION patients and 69 controls are included. NAION and control patients have matched age, gender, and weight. There is no difference in triglyceride, cholesterol, low-density lipoprotein, high-density lipoprotein, and apolipoprotein B between these two groups. NAION patients (43.18%, 38/88) have a higher ratio of CI than the controls (14.49%, 10/69) (p = 0.000). For NAION, the odds ratio (OR) of CI is 2.691 (p = 0.011). Body mass index, height, and IOP show no significant difference between NAION patients with or without CI. NAION patients with CI have a significant higher ratio of hypertension than those without CI, and the OR of HBP is 2.623 (p = 0.008). Conclusions: The correlation between NAION and CI is possible as NAION patients have a significant higher ratio with CI. In NAION patients, hypertension is a risk factor for those with CI.

Analysis of macular structure in age-related cataract patients with different antibody levels of severe acute respiratory syndrome coronavirus-2 vaccine.

Objective: To analyze the macular structure of age-related cataract (ARC) patients with different antibody levels after COVID-19 vaccine injection, in order to obtain the effect of COVID-19 vaccine on the macular structure, and speculate whether the COVID-19 vaccine has adverse effects on the macular structure. Methods: This retrospective study is conducted to analysis on the status of COVID-19 vaccine and the thickness of different layers at different positions in the macular area of ARC patients. In the age, sex and eye axial length matched population, in the un-injection, no-antibody, IgM and IgG positive groups after vaccination, the choroid, ganglion cell complex, nerve fiber layer and retinal thickness at different positions of ETDRS zoning in the macular area were discussed. Results: A total of 164 patients (164 eyes) were included in the analysis. There were 63 males and 101 females. The average age was 65.99 ± 8.43 years. There was no significant difference in age and sex among the groups (p>0.05). The average axial length of 164 eyes was 23.56 ± 1.46mm, and no significant difference between the groups (p>0.05). Non parametric test and ANOVA test for the thickness of choroid, retina, ganglion cell complex and retinal nerve fiber layer in each division of ETDRS showed no significant difference in the four groups of un-injection, no-antibody, IgM and IgG (p>0.05). There was no correlation between the antibody concentration and the thickness of macular structure (p>0.05). Conclusion: There was no significant difference in the thickness of choroid, retina, ganglion cell complex and retinal fiber layer in different macular areas after COVID-19 vaccine injection. There was no linear correlation between the thickness of choroid, retina, ganglion cell complex and retinal fiber layer and the antibody concentration produced after COVID-19 vaccine injection. It suggests that the injection of COVID-19 vaccine might have no significant effect on the macular structure of eye.

The diagnostic value of next-generation sequencing technology in sepsis.

Objective: This study aims to assess the clinical utility of next-generation sequencing (NGS) in sepsis diagnosis. Methods: A prospective study was conducted on patients with a high suspicion of sepsis by unknown pathogens from January 2017 to December 2021. Blood samples were taken from patients to perform NGS, blood culture (BC), leucocyte (WBC), procalcitonin (PCT), creatinine (CREA), Albumin (ALB) and C-reactive protein (CRP) tests. Results: The feedback time for BC was 3~5 days for bacteria and 5~7 days for fungi, while the turnover time for NGS was only 24 h. The clinical diagnosis was considered the "gold standard". 83 patients passed our inclusion criteria and were separated into two groups by clinical diagnosis. 62 met the clinical diagnosis criteria for sepsis and 21 were non-sepsis. The data from the two groups were retrospectively compared and analyzed. Of 62 sepsis in 83 patients, 8(9.64%) were diagnosed by both BC and NGS, 51 (61.45%) by NGS only, 1(1.20%) by BC and 2 (2.41%) by conventional testing only; PCT, CREA, CRP levels and the detection rate of NGS and BC were higher in the sepsis group than in the non-sepsis group, while ALB levels were lower (p<0.05). The logistic regression results in our study revealed that NGS and ALB were independent prediction factors for sepsis (p<0.05), the area under the receiver operating characteristic curve (AUC), sensitivity and specificity of NGS for diagnosing sepsis was 0.857, 95.16% and 76.19%, while ALB was 0.728, 58.06%, 80.95%, respectively. The combination's sensitivity, specificity and AUC of NGS and ALB were 93.55%, 85.71% and 0.935, greater than that of Albumin or NGS only (both p<0.05). Conclusion: NGS can effectively and quickly identify pathogens, thereby emerges as a promising technology for sepsis diagnosis. Combination of NGS and ALB can be used for early screening and is more powerful than NGS or ALB only.

Effect of cataract incision type on corneal spherical aberration.

Corneal spherical aberration (CSA) plays an important role in the ocular refractive system. However, ophthalmologists have not considered the effect of difference cataract incisions on it. The purpose of this study is to investigate the effect of transparent corneal incision (TCI) and scleral tunnel incision (STI) on CSA after the cataract phacoemulsification with foldable IOLs. One hundred ninety-three eyes (61 males and 79 females) for 1-month observation and 114 eyes (29 males and 51 females) for 3-month observation with age-related cataracts (ARC) were included in this study. CSA was measured with dilated pupil by Pentacam Scheimpflug system at 1 day preoperative and 1, 3-month postoperative. Preoperative CSA >1.00 µm was excluded. Both TCI and STI are 3 mm incisions with Infiniti system and Ozil handpiece. No significant difference of age or gender was found between TCI and STI groups in 1 or 3-month observation. In 1-month observation, preoperative CSA for TCI and STI are 0.31 ± 0.29 and 0.41 ± 0.19 µm, which of postoperative are 0.42 ± 0.17 and 0.44 ± 0.35 µm, respectively. The change of CSA is 0.11 ± 0.32 and 0.04 ± 0.33 µm (P = .233). For 3-month observation, preoperative CSA for TCI and STI are 0.32 ± 0.28 and 0.36 ± 0.23 µm, which of postoperative are 0.43 ± 0.16 and 0.39 ± 0.26 µm, respectively. The change of CSA is 0.10 ± 0.34 and 0.03 ± 0.21 µm (P = .312). For the phacoemulsification combined with foldable IOL implantation, STI has minimal effect on CSA, but TCI might increase postoperative CSA.

Poldip2 knockdown protects against lipopolysaccharide-induced acute lung injury via Nox4/Nrf2/NF-κB signaling pathway.

Polymerase δ-interacting protein 2 (Poldip2) has been reported to mediate acute lung injury (ALI); however, the underlying mechanism is not fully explored. Male C57BL/6 mice and A549 cells were used to establish the lipopolysaccharide (LPS)-induced ALI model, then the expression of Poldip2 and its effect on oxidative stress and the resulting inflammation were detected. Adeno-associated virus serotype 6 (AAV6) mediated Poldip2 knockdown was transfected into mice via intratracheal atomization. And A549 cells stimulated with LPS was used to further confirm our hypothesis in vitro. ML385, specifically inhibited the activation of the Nrf2 signaling pathway. Our data suggested that LPS stimulation remarkably increased protein levels of Nox4 and p-P65, activities of NADPH and MPO, and generation of ROS, TNF-α, and IL-1ß while decreased protein levels of Nrf2 and HO-1 compared with those in NC shRNA + Saline group, which were obviously reversed by Poldip2 knockdown. Concomitantly, Poldip2 knockdown dramatically reduced contents of MDA and enhanced activities of SOD and GSH-Px compared to NC shRNA + LPS group. In vitro, we found that knockdown of Poldip2 significantly reversed LPS-induced increase protein levels of Nox4 and p-P65, activity of NADPH, and generation of ROS, TNF-α, and IL-1ß, and decrease protein levels of Nrf2 and HO-1, ML385 pretreatment reversed the effects of Poldip2 knockdown mentioned above. Our study indicated that Poldip2 knockdown alleviates LPS-induced ALI via inhibiting Nox4/Nrf2/NF-κB signaling pathway.

The different structure-function correlation as measured by OCT and octopus perimetry cluster analysis in intracranial tumor and glaucoma patients.

Background: To explore the correlation between visual field (VF) defect values and retinal nerve fiber layer (RNFL) thickness for intracranial tumor and glaucoma patients. Methods: Retrospective analysis is performed for the intracranial and glaucoma patients, whose VF defect values were measured with Octopus perimeter cluster analysis, RNFL thickness, ganglion cell layer (GCL) thickness, and optic disk parameters measured with swept-source OCT. The differences between VF and RNFL (including the data of optic disc) are calculated. The correlation between VF defect values and RNFL and GCL thickness are explored. Results: In total 43 eyes of 29 patients with intracranial tumor and 31 eyes of 19 patients with glaucoma were enrolled. The thickness of RNFL not only for the whole (360°), but also for the four quadrants was thinner in the glaucoma group than those of the intracranial tumor group (p<0.05), and similar to the thickness of GCL without significance (p>). There is no significant difference in VF for those two groups except glaucoma having lower sLV (p<0.05). A stronger correlation for mean deviations (MD)s of VF ten clusters and RNFL thickness of OCT twelve sectors is found in the glaucoma patients, but few in the intracranial tumor patients. Logistic regression also shows the loss of RNFL or increasing of vertical CDR and cup volume tending to the diagnosis of glaucoma and the irregular VF damage is inclined to the diagnosis of intracranial tumor. Conclusions: Intracranial tumor has a weak correlation between the RNFL thickness and Octopus VF MD, compared with that of glaucoma. OCT and Octopus VF might provide more helpful information for the differential diagnosis of intracranial tumor and glaucoma.

Comparison of Total Corneal Astigmatism between IOLMaster and Pentacam.

Purpose: To compare the total corneal astigmatism (TCA) measured by IOLMaster 700 and Pentacam and to investigate the consistency of corneal keratometry (CK) measured by IOLMaster and Pentacam. Methods: Cataract patients were retrospectively enrolled in March and April, 2021. Retrospective analysis was performed on those patients with binocular and monocular CK measured by IOLMaster and Pentacam. Results: A total of 102 patients (204 eyes) were included, 64 of whom were female (62.75%). The flat (K1) and steep (K2) CK of anterior corneal surface (ACS) and flat (TK1) and steep (TK2) of total cornea measured with IOLMaster 700 were 44.16 ± 1.60 D, 45.09 ± 1.68 D, 44.12 ± 1.62 D, and 45.14 ± 1.69 D, respectively. Those measured with Pentacam were 44.31 ± 1.57 D, 45.22 ± 1.65 D, 44.15 ± 1.67 D, and 45.19 ± 1.82 D, respectively. The astigmatism of ACS and TCA were -0.94 ± 0.63 D and -1.02 ± 0.69 D (p < 0.01) in the IOLMaster group and -0.90 ± 0.59 D and -1.05 ± 0.81 D in the Pentacam group, respectively (p < 0.01). TCA measurement results of IOLMaster and Pentacam were consistent (Pearson = 0.710, p < 0.01), and there was no significant difference (p = 0.591). Conclusions: Total corneal astigmatism measured by IOLMaster was consistent with that measured by Pentacam. The difference between the astigmatism of anterior corneal surface and total cornea was detected in the measurement of IOLMaster and Pentacam, respectively.

The Changes of Irisin and Inflammatory Cytokines in the Age-Related Macular Degeneration and Retinal Vein Occlusion.

Purpose: Age-related macular degeneration (AMD) and retinal vein occlusion (RVO) are irreversible chorioretinal diseases, which might induce severe damage in visual function. The metabolic factor and inflammatory factors might play important roles in the pathogenesis of AMD and RVO. The levels of irisin and 14 cytokines were analyzed in aqueous humor of AMD and RVO eyes to evaluate the roles of irisin and inflammatory factors. Methods: We collected aqueous humor samples from patients with AMD (n = 27), RVO (n = 30), and cataract (as control, n = 23) eyes. Samples were assayed using ELISA kit for irisin and a multiplex immunoassay kit for 14 cytokines. The macular thickness (MT) was measured with OCT in all included eyes. Results: MT in the RVO group is significantly higher than that in the AMD or control group. Irisin levels in the aqueous samples of AMD and RVO eyes were both significantly lower than that in the control. Furthermore, a positive correlation was found between irisin and MT in the RVO. Compared with the controls, AMD eyes had significantly higher levels of BDNF, VEGF-A, VEGF-R1, VEGF-R2, IL-10, TNF-α, VCAM-1, IP-10, and MCP-1. Similarly, RVO eyes had significantly higher levels of BDNF, VEGF-A, VEGF-R1, VEGF-R2, IL-6, IL-8, IL-10, TNF-α, ICAM-1, VCAM-1, IP-10, and MCP-1. However, there was no significant difference between the levels of PDGF-BB or TNF-ß in these three groups. A negative correlation was found between VEGF-A and MT in AMD, as well as in control. Furthermore, a positive correlation was found between IL-6 and MT in the 80 included eyes, as well as in RVO. A positive correlation was found between ICAM-1 and MT in the 80 included eyes, as well as in RVO. Conclusions: The metabolic factor, irisin levels in the aqueous humor are decreased in AMD and RVO eyes and show a positive correlation between irisin and MT in RVO eyes, prompting researchers to explore the relationship between irisin and macular edema. We also identified the higher expression of vascular growth factors (VEGF-A, VEGF-R1, and PDGF-BB), inflammatory cytokines (IL-6, IL-8, IL-10, and TNF-α), and chemokines (ICAM-1, VCAM-1, IP-10, and MCP-1) in AMD and RVO eyes.

Correlation of Sunlight Exposure and Different Morphological Types of Age-Related Cataract.

PURPOSE: The previous lab and clinical studies of the correlation between the ultraviolet B and age-related cataract (ARC) did not reach in the universal agreement, especially in different morphological types of ARC. It is important to systemically summarize those previous data of epidemiological studies, which might penetrate the relevance between three morphological types of ARC, cortical, nuclear, and posterior capsular (PSC), with sunlight exposure. METHODS: PubMed, Web of Science, CNKI, Embase, and Cochrane were searched online. Data were extracted and recalculated, and quality check was performed by hand. Review Manager was used to perform the fixed effects meta-analysis on ARC and its morphological types. The highest exposed dose group was defined as the exposed group, and the lowest dose group as the control group as possible. RESULTS: Finally, the number of analyzed studies was 31: 20 for ARC and twelve, eleven, and nine for the morphological types cortical, nuclear, and PSC, respectively. The pooled OR for ARC was 1.15 (range 1.00~43.78, 95% CI 1.09 to 1.21). The cortical cataract revealed a slightly higher risk, and pooled OR was 1.03 (range 0.67~2.91, 95% CI 1.02 to 1.03). But the pooled OR for nuclear and PSC were 1.00 (range 0.50~5.35, 95% CI 1.00 to 1.00) and 0.99 (range 0.57~1.87, 95% CI 0.95 to 1.01), respectively. CONCLUSIONS: The systemic analysis of epidemiological articles reported till now reveals a significantly increased risk of ARC for those exposed with more sunlight, especially the morphological type of cortical cataract.

Case Report: A Candida Meningitis in an Immunocompetent Patient Detected Through the Next-Generation Sequencing.

Background: Fungal infections of the central nervous system (CNS) are not commonly seen clinically. Clinical diagnosis of fungal infections often depend on the pathogen culture and the clinical features. This method is time-consuming and insensitive, which can lead to misdiagnosis. The authors introduce an adult patient with fungal infections diagnosed by next-generation sequencing (NGS). Case: The patient was a 60-year-old male Chinese who had both hypermyotonia of the lower extremities and fever. The auxiliary examinations such as MRI, CT, and cerebrospinal fluid (CSF) analysis showed obvious abnormalities. Because of the difficulties in diagnosis, it was hard to determine the treatment plan. The NGS detected specific sequences of Candida albicans in 3 days. The patient was then treated with liposomal amphotericin B and fluconazole. About 3 weeks later, the symptoms of the patient improved significantly and he was discharged from the hospital. Conclusion: Compared with the routine cultural method, NGS has made a huge advancement in infection diagnosis and targeting antimicrobial therapy for CNS infection.

An Updated Understanding of the Current Emerging Respiratory Infection: COVID-19.

According to the World Health Organization (WHO), the COVID-19 pandemic has been declared as a priority disease. Some patients with COVID-19 had symptoms of multiple organ failure and death. The published articles on COVID-19 infection were reviewed. The origin of SARS-CoV-2 is still not completely established. Person-to-person transmission via droplets, probable aerosols, or close contact is considered as the main mode of transmission. With increased mortality due to SARS-CoV-2, valuable clinical indicators or treatments should be further identified and summarized. CT scanning plays an important role in the diagnosis and evaluation of COVID-19 in asymptomatic patients or those with initially negative RT-PCR results. No specific antiviral therapy is recommended, except the main supportive treatments, and effective measures should be taken into consideration to protect important organs and prevent the development of acute respiratory distress syndrome (ARDS) in patients with severe infection.

Partial thickness sclerectomy and intravitreal anti-VEGF therapy for intractable uveal effusion syndrome.

PURPOSE: To report a case series of three patients with intractable uveal effusion syndrome (UES), treated with partial thickness sclerectomy and intravitreal anti-VEGF therapy. METHODS: Three patients with intractable UES were included. All patients underwent intravitreal anti-VEGF therapy to facilitate resolution of uveal effusion. The concentrations of IL-1ß, IL-6, IL-8, IL-10, IL-12p70, TNF and VEGF in aqueous humor were measured. RESULTS: After the last intravitreal injection, all three eyes had total resolution of the chorioretinal detachment or subretinal fluid. One eye experienced improvement in visual acuity. All patients were free from recurrence during the follow-up period. Aqueous IL-6, IL-8 and VEGF concentrations were elevated in all cases. CONCLUSIONS: Our current data provided the evidence that VEGF was increased in eyes with intractable UES and anti-VEGF therapy was effective, suggesting that partial thickness sclerectomy and intravitreal anti-VEGF therapy could be a new choice for intractable UES.

Region Based CNN for Foreign Object Debris Detection on Airfield Pavement.

In this paper, a novel algorithm based on convolutional neural network (CNN) is proposed to detect foreign object debris (FOD) based on optical imaging sensors. It contains two modules, the improved region proposal network (RPN) and spatial transformer network (STN) based CNN classifier. In the improved RPN, some extra select rules are designed and deployed to generate high quality candidates with fewer numbers. Moreover, the efficiency of CNN detector is significantly improved by introducing STN layer. Compared to faster R-CNN and single shot multiBox detector (SSD), the proposed algorithm achieves better result for FOD detection on airfield pavement in the experiment.

Video stabilization in atmosphere turbulent conditions based on the Laplacian-Riesz pyramid.

Video stabilization in atmosphere turbulent conditions is aimed at removing spatiotemporally varying distortions from video recordings. Conventional shaky video stabilization approaches do not perform effectively under turbulent circumstances due to the erratic motion common to those conditions. Using complex-valued image pyramids, we propose a method to mitigate this erratic motion in videos. First, each frame of a video is decomposed into different spatial frequencies using the Laplacian pyramid. Second, a Riesz transform is adopted to extract the local amplitude and the local phase of each sub-band. Next, low-pass filters are designed to attenuate the local amplitude and phase variations to remove turbulence-induced distortions. Experimental results show that the proposed approach is efficient and provides stabilizing video in atmosphere turbulent conditions.

C3a Increases VEGF and Decreases PEDF mRNA Levels in Human Retinal Pigment Epithelial Cells.

Complement activation, specifically complement 3 (C3) activation and C3a generation, contributes to an imbalance between angiogenic stimulation by vascular endothelial growth factor (VEGF) and angiogenic inhibition by pigment epithelial derived factor (PEDF), leading to pathological angiogenesis. This study aimed to investigate the effects of C3a and small interfering RNA (siRNA) targeting C3 on the levels of VEGF and PEDF mRNAs in human retinal pigment epithelial (RPE) cells. ARPE-19 cells were cultured in the presence of exogenous C3a at 0.1 µM and 0.3 µM C3a for 24, 48, and 72 hours. 0.1 pmol/µL duplexes of siRNA targeting C3 were applied for C3a inhibition by transfecting ARPE-19 cells for 48 hours. RT-PCR was performed to examine the level of VEGF and PEDF mRNA. A random siRNA duplex was set for control siRNA. Results demonstrated that exogenous C3a significantly upregulated VEGF and downregulated PEDF mRNA levels in cultured ARPE-19 cells, and siRNA targeting C3 transfection reversed the above changes, significantly reducing VEGF and enhancing PEDF mRNAs level in ARPE-19 cells compared to the control. The present data provided evidence that reducing C3 activation can decreases VEGF and increase PEDF mRNA level in RPE and may serve as a potential therapy in pathological angiogenesis.

The Correlation of Age and Postoperative Visual Acuity for Age-Related Cataract.

PURPOSE: Clinically, what is the best time for age-related cataract (ARC) patients to receive surgeries and get the most benefits is important. We explored the relationship between age and presenting postoperative visual acuity (POVA) in patients from rural China. METHODS: Three Lifeline Express Hospital Eye-Train missions of Peking University People's Hospital were chosen. At the first day after surgery, 3452 ARC eyes with the presenting POVA ≥ 6/60 were enrolled. The relationship between age and POVA was analyzed statistically. RESULTS: In these three missions, there were more female patients than males; the ratio of females to males was 1.71. The average age of females was older than males. Overall, the percentages of patients with good visual outcomes (≥6/18) were significantly decreased with aging. Different regions had variations, but the trends were the same. There was weak linear correlation between age and POVA. The correlations of females were stronger than males in Yuncheng and Sanmenxia and weaker than males in Zhoukou. CONCLUSION: The good visual outcomes of presenting POVA were significantly decreased with aging and there were weak linear correlations between age and POVA in rural China. The linear correlation might be influenced by the difference of gender and region.

Angiotensin converting enzyme (I/D) gene polymorphism contributes to ischemic stroke risk in Caucasian individuals: a meta-analysis based on 22 case-control studies.

BACKGROUND: Stroke is a multifactorial disease in which genetic factors play an important role. Previous studies associated angiotensin converting enzyme (ACE) (insertion/deletion, I/D) gene polymorphism with ischemic stroke risk in Caucasian individuals reported conflicting results. The purpose of this study was to evaluate the association between ACE (I/D) gene polymorphism and ischemic stroke risk by a meta-analysis. METHODS: The related studies were searched in MEDLINE, EMBASE and HuGEnet databases. The odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for ischemic stroke risk associated with this polymorphism were estimated using fixed-effect or random-effects model. Twenty-two studies (5528/5081 cases/controls) were eligible in our meta-analysis. RESULTS: Overall, statistical associations of the ACE (I/D) polymorphism with ischemic stroke risk were found in dominant model (DD + ID versus II) : OR = 1.21, 95% CI = (1.06,1.38), P = 0.006, recessive model (DD versus ID + II): OR = 1.28, 95% CI = (1.05,1.55), P = 0.01, and homozygote comparison (DD versus II): OR = 1.37, 95% CI = (1.14,1.65), P = 0.001 for Caucasians. When stratifying according to stroke subtypes, there were similarly significant differences for small vessel disease in dominant model (DD + ID versus II) : OR = 1.44, 95% CI = (1.01,2.05), P = 0.04, recessive model (DD versus ID + II): OR = 1.30,95% CI = (1.09,1.55), P = 0.004, and homozygote comparison (DD versus II): OR = 1.44, 95% CI = (1.15,1.80), P = 0.001. CONCLUSION: This analysis suggests that the ACE (I/D) polymorphism may be a risk factor for ischemic stroke, genotype DD of ACE could increase the risk of ischemic stroke in Caucasians. Subgroup analyses indicate that stroke subtypes may be a genetic risk factor of ischemic stroke, and there might be a greater genetic liability with small vessel disease.

The Ocular Biometry of Adult Cataract Patients on Lifeline Express Hospital Eye-Train in Rural China.

Aims. To describe and explore the distribution of ocular biometric parameters of adult cataract patients in rural China. Methods. Three Lifeline Express Hospital Eye-Train missions of Peking University People's Hospital in China were chosen. 3828 adult cataract patients aged 29 to 88 years with axial length (AL) less than 27.0 mm were enrolled. The ocular biometry including visual acuity (VA), intraocular pressure, AL, corneal power (K1 and K2), and corneal endothelial counting (CEC) were collected and analysis. Corneal radius (CR) was calculated from the corneal power. Results. The participants in Zhoukou of these three missions had the worse preoperative VA (p < 0.001), the lowest K1 (p < 0.001), K2 (p < 0.001), and K (p < 0.001) and the highest |K1 - K2| (p < 0.001), moreover AL/CR more closely to 3.0. The AL, |K1 - K2|, and AL/CR were normally distributed. But the K1, K2, K, and CEC were not normal distributions. Except K1, all parameters were positively skewed and peaked. Conclusion. Our study provides normative ocular biometry in a large, representative rural Chinese population. The AL is normally distributed with a positive skew and big kurtosis. The corneal powers are not normal distribution. The corneal astigmatism might have a significant effect on the visual acuity.

Angle of arrival fluctuations considering turbulence outer scale for optical waves' propagation through moderate-to-strong non-Kolmogorov turbulence.

Based on the generalized von Kármán spectrum and the extended Rytov theory, new analytic expressions for the variance of angle of arrival (AOA) fluctuations are derived for optical plane and spherical waves propagating through moderate-to-strong non-Kolmogorov turbulence with horizontal path. They consider finite turbulence outer scale and general spectral power law value, and cover a wide range of non-Kolmogorov turbulence strength. When the turbulence outer scale is set to infinite, the new expressions can reduce correctly to previously published analytic expressions [J. Opt. Soc. Am. A, 302188 (2013]. The final results show that the increased turbulence outer scale value enlarges the variance of AOA fluctuations greatly under moderate-to-strong (or strong) non-Kolmogorov turbulence.