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OBJECTIVES@#To investigate the clinical application of metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) in the etiological diagnosis and treatment of refractory pneumonia (RTP) in children.@*METHODS@#A retrospective analysis was performed on 160 children with RTP who were admitted to the Department of Pediatric Internal Medicine, Maternal and Child Health Hospital of Inner Mongolia Autonomous Region, from January 2020 to March 2023. According to whether mNGS was performed, they were divided into two groups: mNGS (n=80) and traditional testing (n=80). All children received the tests of inflammatory markers and pathogen tests after admission. Traditional pathogenicity tests included microbial culture (sputum specimen collected by suction tube), nucleic acid detection of respiratory pathogens, and serological test (mycoplasma, tuberculosis, and fungi). For the mNGS group, BALF specimens were collected after bronchoscopy and were sent to the laboratory for mNGS and microbial culture. The two groups were analyzed and compared in terms of the detection of pathogens and treatment.@*RESULTS@#Compared with the traditional testing group, the mNGS group had a significantly higher detection rate of pathogens (92% vs 58%, P<0.05), with more types of pathogens and a higher diagnostic rate of mixed infections. Compared with the traditional testing group, the mNGS group had a significantly higher treatment response rate and a significantly lower incidence rate of complications during hospitalization (P<0.05). Treatment was adjusted for 68 children in the mNGS group according to the results of mNGS, with a treatment response rate of 96% (65/68) after adjustment.@*CONCLUSIONS@#Compared with traditional pathogen tests, BALF mNGS can significantly improve the detection rate of pathogens and find some rare pathogens. In clinical practice, when encountering bottlenecks during the diagnosis and treatment of children with RTP, it is advisable to promptly perform the mNGS to identify the pathogens.
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Humanos , Criança , Líquido da Lavagem Broncoalveolar , Estudos Retrospectivos , Pneumonia/terapia , Sequenciamento de Nucleotídeos em Larga Escala , Broncoscopia , Sensibilidade e EspecificidadeRESUMO
Objective: To analyze the concentrations of glyphosate and its metabolites in occupational exposed workers and their possible effects on human health, so as to provide a reference for improving the safe use of glyphosate and toxicity research. Methods: From April to December 2020, 247 workers directly exposed to glyphosate in 5 enterprises were selected as the contact group, and 237 workers who were not exposed to glyphosate and other pesticides in the same enterprise were selected as the control group. Questionnaire survey and occupational health examination were conducted on objects, and the concentrations of glyphosate and its metabolites in the air of workplaces and biological samples were detected. The correlation between the concentrations and the difference of health examination between the two groups were analyzed. Results: The urine glyphosate concentration (0.022-47.668 mg/L), the rate of exceeding the standard (60.32%, 149/247) and the urine aminomethyl phosphonic acid concentration (<0.010-1.624 mg/L) in the contact group were higher than those in the control group [urine glyphosate concentration (<0.020-4.482 mg/L), the rate of exceeding the standard (2.53%, 6/237) and the urine aminomethyl phosphonic acid concentration (<0.010-0.524 mg/L) ], respectively (P<0.001). The exceeding standard rate of glyphosate concentration in the workplace was 33.67% (33/98). The concentration of glyphosate in the workplace was positively correlated with the concentrations of glyphosate and aminomethylphosphonic acid in urine (r(s)=0.804, 0.238, P<0.001), and the concentration of glyphosate in urine was positively correlated with the concentration of aminomethylphosphonic acid in urine (r(s)=0.549, P<0.001). The alanine aminotransferase (ALT), white cell ratio, creatinine, uric acid, the abnormal rates of ALT and total protein (TP) in the contact group were higher than those in the control group, and TP was lower than that in the control group, the differences were statistically different (P<0.05). The abnormal rates of overall liver function, overall renal function, blood routine test, urine routine test, electrocardiogram, liver B ultrasound and blood lipid in the contact group were significantly higher than those in the control group (P<0.05) . Conclusion: The concentration of glyphosate in the workplace is related to the concentrations of glyphosate and aminomethyl phosphonic acid in the urine of workers, and exposure to glyphosate may have some harmful effects on human health.
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Humanos , Exposição Ocupacional/efeitos adversos , Nível de SaúdeRESUMO
AIM: To investigate the effects of antitumor drug paclitaxel(PTX)on the proliferation, apoptosis, cell cycle, cell morphology, and related protein expression of Müller cells, and to evaluate its potential toxicity to the retina.METHODS:Müller cells were cultured in vitro and divided into two groups: control group(normal medium)and PTX group. Retinal Müller cells were treated with different concentrations of PTX(0.005, 0.05, 0.5 and 5mg/L)for varying durations(12, 24, 36, 48 and 72h). The CCK8 method was used to assess the effects of different concentrations of PTX and treatment duration on the proliferation Müller cells. Flow cytometry was employed to investigate the impact of different concentrations of PTX on Müller cells apoptosis and cell cycle arrest. Immunofluorescence was used to observe morphological changes in Müller cells. The effects of PTX on the expression of apoptosis-related proteins and aquaporins were analyzed by Western blot and qRT-PCR.RESULTS: PTX exhibits the ability to inhibit the proliferation of Müller cells when cultured in vitro. The efficacy of this inhibition was found to be dependent on both the concentration of the drug and the duration of the stimulation. Higher concentrations of the drug and longer stimulation times resulted in a weaker ability of the cells to proliferate. Additionally, PTX also induces apoptosis in Müller cells, with increased drug concentrations and longer stimulation times leading to higher apoptosis rates. Flow cytometry analysis demonstrates that PTX arrests Müller cells in the G2-M phase of the cell cycle. Moreover, there is a distinct change in cell morphology, with a shift from the typical appearance characterized by clear and slender fibrous structures to a rounder morphology, accompanied by a significant decrease in cell numbers. Further, our findings reveal that there is a transient increase in the expression of cytoinflammatory factors following drug treatment compared to the control group. However, discontinuation of drug stimulation can alleviate this heightened expression. In treated cells, the expression of the CA XIV protein is upregulated compared to the control group, while the expression of vascular endothelial growth factor(VEGF)is downregulated(P&#x003C;0.05). Additionally, the levels of inflammatory factors in the PTX group are significantly higher than those in the control group(P&#x003C;0.05), suggesting that PTX has the potential to disrupt the retinal barrier function.CONCLUSION: PTX affects the proliferation and apoptosis of Müller cells, with the effects dependent on stimulation duration and drug concentration. In addition, PTX blocks the Müller cell cycle at the G2-M phase and alters cell morphology, leading to a transient upregulation of inflammatory factors and affecting the integrity of the retinal barrier. These findings indicate the potential toxicity of the antitumor drug PTX to the retina.
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Objective: A method for the determination of acetochlor and its metabolites in urine by liquid chromatography-tandem mass spectrometry (LC-MS/MS) was established. Methods: After cleaned-up by a HLB extraction cartridges, the urine was eluted with 1% acetic acid acetonitrile solution. The target compounds were separated by ACQUITY UPLC®HSS T3 Column (2.1 mm×100 mm×1.8 μm) by using 1% formic acid solution and acetonitrile as mobile phase with gradient elution program, and analyzed in positive electrospray ionization mode by liquid chromatography tandem mass spectrometry. Results: All the target compounds showed good linear relationships in the range of 1-50 μg/L, and the correlation coefficients (r) were higher than 0.997. The recoveries rates at three different spiked levels for all target compounds in blank matrices were 107.6%-129.1%, and the relative standard deviations (RSD) were 1.5%-9.9% (n=6) . The limits of detection and quantitation of the method were 0.04-0.11 μg/L and 0.15-0.42 μg/L, respectively, and target substances were detected in all urine samples from occupational exposure workers to acetochlor. Conclusion: This method is suitable for rapid screening and analysis of acetochlor and metabolites in urine with the advantages of accuracy, rapidity, simplicity, high sensitivity and good specificity.
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Humanos , Acetonitrilas , Cromatografia Líquida de Alta Pressão , Cromatografia Líquida , Extração em Fase Sólida , Espectrometria de Massas em Tandem , ToluidinasRESUMO
AIM: To compare the consistency and feasibility of objective ocular torsion measured with GMPE module-based optical coherence tomography(OCT)and fundus color photography(FCP).METHODS: Patients were enrolled in our strabismus clinic from December 2020 to March 2021, and the objective ocular torsion of the eyes was measured by both GMPE module-based OCT and FCP on the same day. FCP was used to measure the fovea-disc angle(FDA)manually by using the Adobe Photoshop software, while the GMPE module-based OCT software positioned automatically the macula and the center of the optic disc to measure the FDA.RESULTS: Fifty-five patients were included, the FDA measured by OCT was -6.6°±4.5° in the right eye and -8.8°±4.7° in the left eye, respectively; The FDA measured by FCP was -6.6°±4.7° in the right eye and -8.4°±4.1° in the left eye, respectively, with no statistically significant difference between the results of the two methods(Pright eye=0.90, Pleft eye=0.08). In patients with exotropia, the FDA measured by OCT was -5.8°±4.9° in the right eye and -9.1°±4.5° in the left eye, respectively, the FDA measured by FCP was -5.7°±5.0° in the right eye and -8.6°±4.3° in the left eye, respectively,(Pright eye=0.75, Pleft eye=0.15). Similarly, the patients with esotropia, the FDA measured by OCT was -9.0°±7.3° in the right eye and -11.3°±3.5° in the left eye, respectively, while the FDA measured by FCP was -10.0°±7.0° in the right and -10.1°±2.8° in the left eye(Pright eye=0.21, Pleft eye=0.10), respectively. There were no significant differences between the two methods in patients with esotropia or exotropia(P>0.05). The results of both Pearson test and Bland-Altman analysis were highly correlated(rright eye=0.93, rleft eye=0.94, P<0.01). CONCLUSION: GMPE module-based OCT can be used for objective ocular torsion measurement with high reliability and reproducibility, and is a promising clinical alternative to the fundus color photographic method.
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Objective:To investigate the relationship of HRAS gene mutation and lymph node metastasis and ultrasonographic characteristics in differentiated thyroid carcinoma (DTC).Methods:The clinical data of 162 patients with DTCs who underwent thyroidectomy and confirmed by postoperative pathological examination in Beijing Friendship Hospital from January 2014 to February 2019 were retrospectively analyzed. There were 139 patients with papillary thyroid carcinoma (PTC group) and 23 patients with follicular thyroid carcinoma (FTC group); the PTC were further classified as classic variant of papillary thyroid carcinoma (CVPTC, n=34), follicular variant of papillary thyroid carcinoma (FVPTC, n=36) and tall cell variant (TCV, n=69). Tissue HRAS mutation frequency was detected in 162 DTC patients and 19 patients with follicular adenoma (FA); blood HRAS mutation frequency was detected in 195 healthy subjects. The correlation between HRAS mutation (IVS1-82del gctgggcctggg) and cervical lymph node metastasis was analyzed, and the ultrasonographic characteristics of DTC patients were also analyzed. Results:The frequency of HRAS mutation in DTC patients was higher than that in healthy controls[37.0%(60/162) vs. 26.2%(51/195), χ2=4.538, P=0.03], while there was no significant difference between FTC and FA [39.1%(9/23) vs. 5/19, χ2=0.769, P=0.38]. In DTC patients there was no significant difference in cervical lymph node metastasis between HRAS mutation group and wild type group [57.3% (43/75) vs. 42.6% (32/75), χ2=1.898, P=0.16]. Among CVPTC, FVPTC and TCV patients, the rates of cervical lymph node metastasis were 7/12, 8/14 and 48.0% (12/25) in HRAS mutation group, while those were 50.0% (11/22), 40.9% (9/22) and 43.1% (19/44) in wild-type group, respectively (χ2=1.009, P=0.98).There were 9 patients with HRAS mutation in FTC group, and the cervical lymph node metastasis in mutation group and wild-type group was 5/9 and 4/14, respectively ( P=0.38). The ultrasonographic characteristics of PTC patients with HRAS mutation were more likely to have clear boundaries [66.7%(34/51) vs. 42.0%(37/88); χ 2=7.833, P<0.01] and not close to the membrane[84.3%(43/51) vs. 65.9%(58/88);χ2=5.506, P=0.02]. Conclusion:DTC patients are more likely to have HRAS (IVS1-82del gctgggcctggg) mutation, and the ultrasonic characteristics of DTC patients with HRAS mutation are likely to have clear boundaries and be not close to the membrane.
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Objective To investigate the correlation of BRAF mutation frequency with cervical lymph node metastasis ,and to compare the ultrasonic characteristics in patients with BRAF mutation in papillary thyroid carcinoma ( PTC) different subtypes . Methods The tumor samples were collected from 139 PTC patients who underwent thyroidectomy . And they were classified by histological subtype into 3 groups:classic variant of papillary thyroid carcinoma (CVPTC) group( 34 cases) ,follicular variant of papillary thyroidcarcinoma (FVPTC) group(36 cases) ,tall cell variant (TCV) group(69 cases) . The BRAF mutation frequency and the correlation with cervical lymph node metastasis among 3 groups were analyzed , then the ultrasonic characteristics with BRAF mutation in PTC different subtypes were compared . Results①The frequency of BRAF mutation was statistically significant different in different subtypes( χ2 =6 .390 , P =0 .041) ,and the frequency in TCV was 86 .9% . There was also a statistical difference between BRAF mutation frequency and cervical lymph node metastasis among three subtypes ( χ2 = 13 .106 , P =0 .041) .②There was no statistically significant difference among the three groups in nodule number ,echo level , internal structure ,boundary ,crossbar ,morphology and acoustic halo of patients with BRAF mutation ( P >0 .05) . ③ A single factor analysis was performed for the ultrasonographic characteristics of patients with BRAF mutation ,and there were significant statistical differences among the 3 groups in calcification type (χ2 = 21 .7 , P = 0 .001 ) and close to the envelope (χ2 = 7 .726 , P = 0 .021 ) . ④ Multivariate logistic regression showed that BRAF mutation was an independent influence factor affecting the calcification type of different histological subtypes in PTC patients.Conclusions ①BRAF mutation is correlated with cervical lymph node metastasis in different PTC subtypes . ② BRAF mutation is an independent influence factor affecting the morphology type of different calcification subtypes in PTC . The CVPTC group is mainly microcalcification ,and the TCV group is mainly macrocalcification .
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Objective To explore the role of integrin αvβ3 in the promotion of the development of choroidal neovascularization (CNV) by SDF-1/CXCR4.Methods This study was divided into two parts in vitro and in vivo.As for the in vivo study,a CNV model was induced by laser on C57BL/6J mice,and then assigned into 4 groups:mice with solely CNV modeling as control group,with intravitreal injection of SDF-1 after immediate CNV modeling as SDF-1 group,with intravitreal injection of SDF-1 + CXCR4 inhibitor (AMD3100) after CNV modeling as SDF-1 + AMD3100 group,and mice with intravitreal injection of SDF-1 + αvβ3 inhibitor (SB273005) after modeling as SDF-1 + SB273005 group.CXCR4 and αvβ3 expression levels in laser-induced eyes were quantified by qRT-PCR at time points of day 1,3,5,7,10 and 14 after modeling,and immunofluorescence staining was applied to detect αvβ3 expression in regional CNV and its endothelial cells in the four groups.Finally,OCT was used to observe the height of retinal pigment epithelial (RPE) layers in CNV after treatment in the four groups.Moreover,in the experiment in vitro,Western blot was used to measure the expression of CXCR4 protein of RF/6A cells in normal control group,Si-CXCR4 knockdown group and Si-NC knockdown model group.Meanwhile,the expression of integrin subunit β3 protein was determined in the normal control group,SDF-1 group,SDF-1 + AMD3100group,SDF-1 + Si-NC group and SDF-1 + Si-CXCR4 group.Transwell assay was conducted to detect the migration ability of RF/6A cells in the normal control group,SDF-1group,SDF-1 +AMD3100 group,SDF-1 + SB273005 group.Results On the one hand,the study in vivo,qRT-PCR showed that the expression of CXCR4 and integrin subunit β3 mRNA was up-regulated at first,and then down-regulated with time passed after CNV induction,with the highest expression level of CXCR4 mRNA (4.263 ± 0.464) on day 3,and the peak expression of β3 mRNA (3.678 ±0.364) on day 7 after CNV modeling.The results of immunofluorescence staining showed that the β3 fluorescence intensity of SDF-1 group was significantly enhanced,and the ratio of β3/CD31 was also significantly increased,which both were significantly higher than those of the control group (P < 0.01).However,the β3 fluorescence intensity and β3/CD31 ratio of SDF-1 +AMD3100 group and SDF-1 + SB273005 group were significantly weakened and decreased,respectively (P <0.05).OCT showed that the elevation level of RPE layer inSDF-1 group was significantly higher than that in the control group [(135.503 ± 10.301) μm vs.(94.443 ± 12.156) μm](P<0.05).The height of RPE uplift in SDF-1 + AMD3100 group [(95.283 ±20.062) μm] and SDF-1 + SB273005 group [(99.807 ± 10.403) μm] was significantly decreased (P < 0.05).On the other hand,in experiment in vitro,Western blot showed that the expression levels of integrin β3 in SDF-1 group and SDF-1 + Si-NC group were significantly higher than those in the control group [(1.301 ± 0.043) and (1.273 ± 0.077) vs.(0.244 ± 0.069)] (P < 0.01).The levels of integrin subunit β3 protein in SDF-1 + si-CXCR4 group (0.322 ± 0.042) and SDF-1 + AMD3100 group (0.336 ± 0.077) were significantly down-regulated (P < 0.01).Transwell assay showed that the amount of migrating cells in SDF-1 group increased,which was significantly higher than that of the control group (P < 0.01),while the number of migrating cells in SDF-1 +AMD3100 group and SDF-1 + SB273005 group was significantly decreased.Conclusion Integrin αvβ3 can promote the development of CNV by mediating SDF-1/CXCR4 signaling in endothelial cells.
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Objective To investigate the correlations between corneal biomechanical properties and corneal high-order aberrations (HOAs) in myopic eyes.Methods In this retrospective study,263 right eyes with myopia or myopic astigmatism were enrolled from January to October 2015 in Tianjin Eye Hospital.The values of first applanation time (A1T),first applanation length (A1L),first applanation velocity (A1V),second applanation time (A2T),second applanation length (A2L),second applanation velocity (A2V),highest concavity time (HCT),highest concavity deformation amplitude (HCDA),highest concavity peak distance (HCPD),highest concavity radius (HCR) and non-contact intraocular pressure (IOPnct) were measured using the corneal visualization Scheimpflug technology (Corvis ST).The central corneal thickness (CCT) and wavefront aberrations of the anterior,posterior surface,and the total cornea were measured with Pentacam.Pearson correlation and stepwise multivariate linear regression analysis were applied to analyze the correlations between biomechanical properties and corneal HOAs.This study follows the Helsinki declaration.The experiment was approved by the Ethic Committee of Tianjin Eye Hospital.Informed consent was signed from each patient.Results There was a correlation between biomechanical properties and corneal HOAs.Negative correlations were found between A1L and the spherical aberration,HOAs RMS of anterior surface,total RMS and HOAs RMS of the posterior surface and HOAs RMS of the total cornea (P<0.05).HCRs were negatively correlated with total RMS of the total cornea and the anterior surface (P<0.05).The A2V was correlated with various aberrations.Multiple stepwise linear regression model analysis showed that,the correlation between the aberrations of anterior surface and biomechanical parameters,and the correlations between the total corneal aberration and biomechanical parameters were weak,the correlations between the aberrations of posterior surface and biomechanical parameters were strong.Conclusions There is a correlation between the biomechanical properties and corneal HOAs.The changes of the corneal biomechanical properties are mainly associated with the posterior corneal aberrations,which may contribute to the early diagnosis of subclinical keratoconus or dilated corneal disease.
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Background Small incision lenticule extraction (SMILE) is increasingly applied in the correction of myopia and astigmatism.However,the early clinical outcomes of SMILE for different refractive myopia and astigmatism is seldom reported.Objective This study was to investigate the safety,efficacy,predictability and early stability after SMILE in low,moderate and high myopia.Methods A series of cases-observational study was carried out.A total of 195 eyes of 108 myopic patients were enrolled in Tianjin Eye Hospital from May to December 2012 under the informed consent.The patients were divided into the low (≤-3.00 D),moderate (>-3.00 to-6.00 D) and high myopia (>-6.00 D) groups according to different diopters,with 57 eyes,76 eyes and 62 eyes,respectively.SMILE was performed on all the eyes.The uncorrected visual acuity (UCVA)(LogMAR),best corrected visual acuity (BCVA) (LogMAR),equivalent sphere (SE),intraocular pressure,anterior segment and corneal topography were examined before operation and 1 day,1 week,1 month and 3 months after operation to evaluate the effective index (postoperative UCVA/preoperative BCVA),safety index (postoperative BCVA/preoperative BCVA),predictability and early stability of SMILE.The linear regression analysis was used to analyze the relationships between the attempted refraction and the achieved refraction postoperative 3 months in three groups.Results The percentage of UCVA (LogMAR)<0.1 was 100%,97.1% and 92.8% in the low,moderate and high myopia group,respectively in 3 months after SMILE.The postoperative BCVA of all the operated eyes reached preoperative one.The residual SE was (-0.07±0.16),(-0.05 ±0.20) and (-0.08±0.27)D in the low,moderate and high myopia group,respectively in 3 months after SMILE.The percentage of residual SE±0.5 D was 100%,98.7% and 93.6% in the low,moderate and high group,and that of SE±1.0 D was 100% in all of the groups.The postoperative corrected SE was gradually increased with the raise of predicted SE in the low,moderate and high myopia groups (r=0.942,0.959,0.957,all at P<0.001).Conclusions SMILE is safe,effective,predictable and stable for the correction of low,moderate and high myopia.The corneal wound healing was slightly slower in the low myopia group than that in the moderate and high group.A slight regression of myopic power appears in high myopia eyes 3 months after SMILE.
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Background The current evaluation of corneal optical quality after small incision lenticule extraction (SMILE) is based on the single factor,such as scattering,diffraction or aberration,and all of them are not comprehensive and objective methods.Modulation transfer function (MTF) and Strehl ratio (ST) are novel parameters of corneal optical quality,which can be used to assess the optical quality comprehensively.Objective This study was to evaluate the change of MTF and SR under the photopic and scotopic environment (3 mm and 6 mm pupil size,respectively) after SMILE procedure.Methods The study protocol was approved by Ethic Committee of Tianjin Eye Hospital,and written informed consent was obtained from each patient before any medical procedure.A series cases-observational study with self-control design was carried out.Sixty-three eyes of 32 myopia or myopic astigmatism patients who underwent SMILE surgery in Tianjin Eye Hospital were included from December 2013 to March 2014.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA) (LogMAR),the effective index (postoperative UCVA/preoperative BCVA) and refractive diopter were examined,and the MTF,SR and root mean square (RMS) on the anterior corneal surface were measured under the 3 mm and 6 mm pupil size at different spatial frequencies (10,20,30,40,50 and 60 c/d) by Sirius anterior analyzer before surgery and 1 week,1 month and 3 months after surgery,respectively.Results UCVA was ≥0.8 in 59,62 and 63 eyes in 1 week,1 month and 3 months after SMILE,with the percentage of 93.65%,98.41% and 100%,and the effective index was 1.104± 0.128,1.126±0.145 and 1.158±0.208,respectively.The refractive diopter was normal in the eyes at postoperative 3 months.The MTFs of various spatial frequencies on the vertical and horizontal meridian under the 3 mm pupil size after SMILE were significantly higher than those before SMILE,while under the 6 mm pupil size,the MTFs were higher only on vertical meridian and 10,20,30 and 40 e/d,and there were not significant differences on the horizontal meridian (all at P<0.05).The SRs under the 3 mm and 6 mm pupil size showed increasing softly after surgery in comparison with before surgery,and the SRs were higher under the 3 mm pupil size than those under the 6 mm pupil size at various time points (all at P<0.05).There were not significant differences in RMS among different time points under both 3 mm pupil size and 6 mm pupil size (3 mm pupil size:F =1.348,P =0.184;6 mm pupil size:F=1.990,P=0.137).Conclusions SMILE provides a great improvement in corneal optical quality for myopia or myopic astigmatism patients,which is more distinct in photopic condition than that in scotopic condition.
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Background The relationship between corneal central thickness (CCT) and corneal biomechanical property does not reflect the effective amount of ablated tissue because CCT measures only the change in a single point.Corneal volume (CV) is a representative parameter of corneal morphology,and it can fully reflect corneal thickness and tissue distribution.Objective This study was to investigate the correlation between volumetric corneal changes and corneal biomechanical properties after small incision lenticule extraction (SMILE).Methods A prospective series cases-observational study was carried out.This study protocol was approved by Ethic Committee of Tianjin Eye Hospital,and written informed consent was obtained from each patient prior to entering the cohort.Sixty-seven right eyes of 67 myopia or myopic astigmatism patients who received SMILE in Tianjin Eye Hospital from June 2014 to July 2015 were included in this study.Before and 3 months after surgery,the CV at 3,3-5,5-7 and 7-10 mm (CV3,CV3-5,CV5-7,CV7-10) was measured by Pentacam anterior segment analysis system,and corneal hysteresis (CH) and corneal resistance factor (CRF) were obtained by ocular response analyzer (ORA).The changes of CV (ACV),CH (ACH) and CRF (ACRF) were calculated,and the correlations between ACV and ACH or ACRF were analyzed.Results CV3,CV3-5 and CV5-7 values after SMILE were significantly lower than those before SMILE (t =36.24,20.38,16.17,all at P< 0.001).The CH values before and after SMILE were (10.06± 1.11) mmHg and (8.10± 1.05) mmHg (1 mmHg =0.133 kPa),and the CRF values before and after SMILE were (10.40 ± 1.38) mmHg and (6.91 ± 1.19) mmHg,respectively,showing significant reduces after SMILE than before SMILE (t =16.71,27.41,both at P<0.001).Positive correlations were seen between the CV values at different corneal areas and CH value or CRF value.Moderate positive correlations were found between CV3 and CH or CRF (r =0.571,0.569;both at P<0.001) before surgery,and 3 months after surgery,a weak positive correlation was seen between ACV3 and ACH (r =0.394,P < 0.001) or a moderate positive correlation between ACV3 and ACRF (r=0.501,P<0.001).Conclusions The CV value is gradually increased from the central cornea to periphery cornea.The CV change is associated with CH and CRF changes after SMILE,and CV3 probably is a useful parameter for the evaluation of corneal biomechanics after refractive surgery.
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Background Small incision lenticule extraction (SMILE) is lack of eye-tracking system and there is controversy in the treatment of astigmatism.It is very important to understand its correction effctiveness for myopic astigmatism.Objective This study was to evaluate the clinical outcomes in the correction of myopic astigmatism between SMILE and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK).Methods In this retrospective study,95 eyes of 51 patients and 69 eyes of 40 patients with myopic astigmatism underwent the SMILE surgery and FS-LASIK surgery respectively in Tianjin Eye Hospital from December 2013 to July 2014 under the informed consent.No significant differences were found in spherical power,astigmatic power and spherical equivalent (SE) between the SMILE group and FS-LASIK group before surgery (all at P>0.05).The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),manifest refraction,slit-lamp microscopy,intraocular pressure and corneal topography were measured before surgery and 1 day,1 week,1 month,3 months after surgery.Vector analysis was used to calculate the components of astigmatism before and after surgery.Correction index (CI),index of success (IOS),angle of error (AofE) and flattening index (FI) were used to evaluate the correction effectiveness of astigmatism.Safety index and efficacy index were used to evaluate the recovery status of visual acuity.The corrected effectiveness was compared between the two groups,and the correlations of kappa angle with measured parameter were assessed by Spearman rank correlation analysis.Results The mean spherical power,astigmatic power and SE were (0.003±0.106),(-0.063 ± 0.126) and (-0.029 ± 0.101) D in the SMILE group,which were significantly lower than (0.112 ± 0.212),(-0.091 ± 0.142) and (0.067 ± 0.198)D in the FS-LASIK group (Z =-4.328,-3.197,both at P<0.05).Vector analysis showed the postoperative with-the-rule astigmatism in the SMILE group and oblique astigmatism in the FS-LASIK group respectively,and the CI and F1 in the SMILE group were significantly lower than those in the FS-LASIK group (Z =-3.051,-3.126,both at P < 0.05).The insignificant reduce in IOS and AofE were seen in the SMILE group compared with the FS-LASIK group (Z=-1.557,P=0.119;Z =-1.923,P =0.054).In addition,the safety index and efficacy index were not significantly different between the two groups (both at P > 0.05).Negative correlations were found between safety index or efficacy index and preoperative kappa angle in the SMILE group (r =-0.258,-0.257,both at P<0.05).Conclusions Both SMILE and FS-LASIK surgeries are effective and safe in correcting myopic astigmatism with good postoperative visual acuity.SMILE surgery shows less axis rotation and higher accuracy than FS-LASIK because of small incision and flapless procedure.The correction of cylinder can adjust based on experience of surgeon.
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Background The visual quality and corneal biomechanical change are two major sides for evaluating the outcomes of cornea refractive surgery.It was determined that small incision lenticule extraction (SMILE) can improve the visual outcomes,but its long-term effects on corneal biomechanical are not known clearly.Objective This study was to investigate the change of corneal biomechanics and influence factors following SMILE.Methods A serial cases-observional study was performed.One hundred eyes of 58 patients with a mean spherical diopter (-5.00 ± 1.55) D and cylindrical diopter (-0.98 ± 0.87) D were included in Tianjin Eye Hospital from August 2011 to July 2013 under the informed consent.Corneal biomechanical parameters,including corneal resistance factor (CRF) and cornea hysteresis (CH) were measured using the ocular response analyzer (ORA) in preoperation and postoperative 1,3,6 and 12 months,respectively.The patients were grouped based on different lenticule thickness ratio (LTR),preoperative CRF values and residual stromal thickness (RST) separately,and the correlations of LTR,preoperative CRF and RST with ΔCRF and ΔCH were assessed.In addition,the associations between ΔCRF or ΔCH and related preoperation parameters were evaluated.Results The CRF and CH values at postoperative 1 month were (7.12 ± 1.20) mmHg and (7.90 ± 0.97) mmHg,which were significantly lower than preoperative (10.17±1.46) mmHg and (10.00±1.16) mmHg,respectively (t=15.552,P=0.000;t =13.411,P=0.000).The CRF values at postoperative 3,6 and 12 months were (7.06±0.90),(6.98 ± 1.11) and (6.87 ± 1.07) mmHg,and those of CH were (8.12 ±0.84),(8.12 ±0.97) and (8.14 ±0.86) mmHg,and no significant differences were found in CRF and CH between the adjacent time points (CRF:P =0.848,0.992,0.270;CH:P =0.370,0.791,0.777).Positive correlations were seen between the ΔCRF or ΔCH and LT/preoperative central corneal thickness (CCT) (LTR),preoperative CRF or preoperative CH values,respectively (LTR:r =0.468,P =0.000;r =0.299,P =0.004;preoperative CRF:r =0.696,P =0.000;r =0.590,P =0.000;preoperative CH:r =0.576,P =0.000;r =0.690,P =0.000).ΔCRF and ΔCH were negatively correlated with preoperative spherical equivalent diopter (r =-0.496,P =0.000;r =-0.292,P =0.010),the sum of preoperative spherical diopter and cylindrical diopter (r =-0.484,P =0.000;r =-0.293,P =0.005) or RST/preoperative CCT (r =-0.362,P =0.000;r =-0.243,P =0.019) and were positively correlated with lenticule (r =0.495,P =0.000;r =0.325,P =0.002).No significant association was found between ΔCRF or ΔCH and age,preoperative CCT and preoperative mean keratometry (all at P>0.05).Conclusions Corneal biomechanical strength is decreased at the early stage after SMILE.However,biomechanical strength gradually enhances 1 month after surgery and tends to stability.The large RST/preoperative CCT can improve postoperative CRF and CH.The another main factor affecting the corneal biomechanics after SMILE is corrected-diopter.
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Background The novel dynamic biomechanical device Corvis ST can measure a variety of corneal deformation parameters and record the dynamic process of cornea deformation.Understanding various corneal deformation parameters is of important clinical significance for morphological and functional prediction for myopic eyes in corneal refractive surgery.However,the range and meaning of corneal deformation parameters in myopic eyes are still unknown.Objective This study was to establish the range of corneal defamation parameters by Corvis ST and explore its clinical significance in myopic eyes.Methods A descriptive study was designed under the approval of Ethic Committee of Tianjin Eye Hospital and informed consent of patients.This study protocol complied with Helsinki Declaration.Four hundred and seventy-seven eyes of 257 myopic patients who were going to receive corneal refractive surgery were included in Tianjin Eye Hospital from June 2014 to January 2015.The corneal deformation parameters including the first applanation time (1st A-time),first applanation lengh (1 st A-length),first applanation velocity (1 st A-velocity),second applanation time (2nd A-time),second applanation length (2nd A-length),second applanation velocity (2nd A-velocity),highest concavity time (HC-time),highest concavity deformation amplitude (HC-DA),highest concavity peak distance (HC-PD),highest concavity radius (HC-R),non-contact intraocular pressure (IOPnct) and the central corneal thickness (CCTst) were measured by Corvis ST.Corneal structural parameters including CCT and corneal curvature were measured by 3-D anterior segment analysis system (Pentacam),and corneal biomechanical parameters including corneal resistance factor (CRF),corneal hysteresis (CH),intraocular pressure mimic Goldmann (IOPg) and intraocular pressure of corneal compensation (IOPcc) were measured by Ocular Response Analyzer (ORA).The distributions of the data were tested with the Shapiro-Wilk test and 95% confidence intervals (CI) were calculated.The correlations of the variables were evaluated by Pearson correlation coefficient and Spearman rank correlation coefficient.Multiple linear regression was used to analyze the changes of 1st A-time,2nd A-time and HC-DA with corneal morphology and biomechanical parameters.Resnlts Only 1st A-time,2ndA-time,HC-time,HC-DA,CCTst and IOPnct showed the normality distribution in corneal deformation parameters.The positive correlations were found between 1st A-time,1st A-length,2nd A-length,2nd A-velocity,HC-R with CCT (r=0.338,rs=0.129,rs=0.282,rs =0.374,r=0.306,all at P<0.01),while 1st A-velocity,2nd A-time,HC-D and HC-PD showed the negative correlations with CCT (rs =-0.235,r=-0.130,r=-0.259,r=-0.226,all at P<0.01).CRF and CH showed positive correlations with 1st A-time,2nd A-length,2nd A-velocity,HC-time,HC-R and negative correlations with HC-PD,△A-length (all at P<0.05).1st A-time,2nd A-time and HC-DA changed with CRF and IOPcc with the regression formations of 1st A-time =6.185+0.066CRF+0.034IOPec (F=300.123,P =0.000),2nd A-time=23.397-0.074IOPec-0.044CRF (F=227.979,P=0.000) and HC-DA =1.523-0.017IOPcc-0.017CRF (F=152.662,P=0.000).The CCTst,IOPst and IOPnct values by Corvis ST were significantly lower than CCT by Pentacam ([548.23±26.31] μm,IOPg ([15.02±2.72]mmHg and ([16.02-±2.56]mmHg) by ORA respectively (t =11.00,2.919,6.815,all at P < 0.01).Conclusions The corneal deformation parameters by Corvis ST can quantitatively describe corneal biomechanical properties in myopic eyes.Both IOP and the corneal steep curvature of the 3 mm center area (K2) affect the deformation response of cornea.The reliability of Corvis ST in the measurement of CCT and IOP remains to be further studied.
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BACKGROUND:Ultrasound has been widely used in developmental hip dysplasia screening in infants and young children, but there are significant differences among different inspection findings, even in the reexamination by the same examiner. Therefore, the accuracy of ultrasound imaging in the diagnosis is of insufficient evidence. OBJECTIVE:Through virtual reality three-dimensional reconstruction images showing the structure of acetabulum and femoral head space, to obtain a new parameter in order to enrich measurement standards of Graf ultrasonic diagnosis technology and to further improve the credibility of the diagnosis of developmental dysplasia of the hip. METHODS:Ten fresh cadaver specimens of Chinese infants were selected, including five males and five females. Two-dimensional ultrasonic method was employed for hip screening, and at the same time, multi-slice spiral CT was used for three-dimensional reconstruction fol owed by volume reconstruction and fitting of surface reconstruction to display the anatomic structure around the hip and to simulate Graf’s two-dimensional ultrasound method to measure a andβangles on three-dimensional virtual reality images. RESULTS AND CONCLUSION:As confirmed by three-dimensional reconstruction, Graf’s two-dimensional ultrasound could be used to measure a and angles, truly reflecting the development of bony and cartilaginous acetabulum. Graf’s two-dimensional ultrasound contributed to the proper evaluation of beonatal hip dysplasia, which can be used as a routine examination for developmental dysplasia of the hip. These indicate that to master Graf’s ultrasound technology and strictly grasp the evaluation standards for developmental dysplasia of the hip is the important guarantee for diagnosis of developmental dysplasia of the hip.
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<p><b>OBJECTIVE</b>To establish a method for determining glyphosate in the air of workplaces by ion chromatography.</p><p><b>METHODS</b>Ultra-fine glass fiber filter paper was used to collect glyphosate from the workplace air. After being ultrasonically eluted with deionized water, samples were determined by ion chromatography using a conductivity detector.</p><p><b>RESULTS</b>Within the range of 0.05-1.00 mg/L, a linear relationship was found with a limit of detection of 0.003 mg/m(3). The minimum detectable concentration was 0.000 41 mg/m(3) (calculated by sampling 75 L of air). For three different concentrations of glyphosate, the intra-batch relative standard deviations (RSDs) were 1.8%, 1.6%, and 0.8%, respectively, and the inter-batch RSDs were 1.9%, 2.1%, and 2.2%, respectively. The recovery rate ranged from 94.8% to 97.4%. The elution efficiency ranged from 94.5% to 96.7%. The sampling efficiency was 100%. Samples could be stored at room temperature for at least 7 days.</p><p><b>CONCLUSION</b>This presented method meets the requirements of Guide for establishing occupational health standards-Part 4: Determination methods of air chemicals in workplace and is feasible for determination of glyphosate in the air of workplaces.</p>
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Poluentes Ocupacionais do Ar , Cromatografia Gasosa , Glicina , Local de TrabalhoRESUMO
Objective To investigate the role of overexpression of Smad7,the inhibitory factor of TGF-?/Smads signaling,in epithelial-mesenchymal transition (EMT) of peritoneal mesothelial cells.Methods Peritoneal fibrosis rat model was built by daily intraperitoneal injection with 4.25% Dineal (100 ml/kg) and lipopolysaccharide(LPS) (0.6 mg/kg) at day 8,10,12,22,24,26. Smad7 or control empty vectors was transferred at day 0,14 and was induced by doxycline in the daily drinking water (200 mg/L).Rats were sacrificed on day 28 and the expression of TGF-beta/ Smads,?-SMA and E-cadherin was examined.Results Compared with normal rats,empty vector rats showed higher expression of phosphorylated Smad2/3.?-SMA expression was elevated but E-cadherin was reduced.Under electron microscope,the mesothelial cells removed to submesothelial zone and showed large bundles of actin microfilaments and dense bodies within the cytoplasm. Basement membrane was broken.After induction of Smad7 in peritoneal fibrosis rats,the morphology of mesothelial ceils normalized partly,phosphorylated Smad2/3 was reduced.Moreover,expression of E-cadherin was increased,expression of?-SMA was dramatically reduced.Conclusion Inhibition of TGF-?/Smad signaling by Smad7 overexpression may inhibit the epithelial-mesenchymal transition of mesothelial cell,which may provide a new therapeutic method for peritoneal fibrosis by overexpression of Smad7.