Venous thromboembolism in patients with severe lung cancer: a narrative review.

OBJECTIVE: At present, there are several guidelines for cancer complicated with VTE, but there is no specific recommendation for the treatment of lung cancer complicated with VTE. Whether is necessary to explore treatment and prevention of VTE in lung cancer. BACKGROUND: Venous thromboembolism (VTE) is a common complication of severe lung cancer that can entail many adverse effects for patients. The incidence of VTE is higher in patients with lung cancer than in those with other kinds of solid tumors, and it is especially high among patients with lung adenocarcinoma, at advanced tumor-node-metastasis (TNM) stages, or with a history of central venous catheter (CVC) or chemotherapy. However, the clinical symptoms of VTE in patients with lung cancer are not typical and cannot be detected easily, and the clinical prevention rate is low. In the acute phase of VTE in lung cancer, the Eastern Cooperative Oncology Group (ECOG) performance status score of patients typically ranges from 2 to 4 points, leaving end-stage maintenance therapy as the only treatment option. METHODS: Here, we analyze the existing literature and discuss the current status (including epidemiology, clinical manifestations, and risk factors), risk assessment tools, and the treatment and prevention of VTE in severe lung cancer. We focus particularly on the use of low-molecular-weight heparin and new oral anticoagulants (including in the management of thrombocytopenia after antitumor therapy) in lung cancer patients with VTE. CONCLUSIONS: Large-scale prospective multicenter studies on the treatment and prevention of VTE in lung cancer are necessary.

Light opens a new window for N-heterocyclic carbene catalysis.

N-Heterocyclic carbenes (NHCs) are efficient Lewis basic catalysts for the umpolung of various polarized unsaturated compounds usually including aldehydes, imines, acyl chlorides and activated esters. NHC catalysis involving electron pair transfer steps has been extensively studied; however, NHC catalysis through single-electron transfer (SET) processes, despite having the potential to achieve chemical transformations of inert chemical bonds and using green reagents, has long been a challenging task in organic synthesis. In parallel, visible-light-induced photocatalysis and photoexcitation have been established as powerful tools to facilitate sustainable organic synthesis, as they enable the generation of various reactive radical intermediates under extremely mild conditions. Recently, a number of elegant visible-light-induced, NHC-catalyzed transformations were developed for accessing valuable organic compounds. As a result, this minireview will highlight the recent advances in this field.

Posterior corneal surface differences between non-laser in situ keratomileusis (LASIK) and 10-year post-LASIK myopic eyes.

PURPOSE: To evaluate the posterior corneal surface differences between non-laser in situ keratomileusis (LASIK) and 10-year post-LASIK myopic eyes. METHODS: The study included 130 eyes from 65 patients, who were treated with myopic LASIK 10 years ago. In addition, 130 eyes from 65 unoperated myopic patients of matching present age and preoperative refraction were divided into control group. Data on the posterior corneal surface and anterior chamber were obtained from Pentacam software and compared between the groups. Postoperative visual acuity (VA) and refractive error were also analysed. RESULTS: The mean preoperative spherical equivalent (SE) was -6.99 ± 1.78 dioptre (D) in the LASIK group. Ten years after surgery, the mean SE was -0.45 ± 1.22 D, the efficacy index was 0.98, and the safety index was 1.01. The posterior corneal elevations of the LASIK group at 2 mm corneal diameter were significantly lower than those of the control group. However, posterior corneal elevations at 6 mm corneal diameter were higher in the LASIK group than the controls (p < 0.01 for all). The mean Q-values of posterior corneal surface demonstrated significant positive direction compared to that of control eyes at 6 and 7 mm corneal diameters (p < 0.05 for both). At the thinnest point of the cornea, the anterior chamber depths were shallower in the LASIK group than in controls. Meanwhile, the anterior chamber volumes (ACV) were smaller in the LASIK group than in the control group. CONCLUSION: Our results demonstrated that the posterior corneal surface tends to show signs of central flattening and peripheral steepening 10 years after myopic LASIK surgery compared to that of non-operated myopic eyes.

Age-Related Changes in Corneal Astigmatism.

PURPOSE: To analyze the changes in corneal astigmatism as a function of age and develop a novel model to estimate corneal astigmatic change according to age. METHODS: This was a cross-sectional study of right eyes of 3,769 individuals. Total corneal astigmatism, keratometric astigmatism, anterior corneal astigmatism, and posterior corneal astigmatism were measured by a Scheimpflug tomographer. Smoothing fitting curves of polar values of corneal astigmatism as a function of age were drawn and average changes in corneal astigmatism at different ages were calculated. RESULTS: Two turning points of age on total corneal astigmatism were 36 and 69 years. The average change of total corneal astigmatism toward against-the-rule astigmatism was 0.13 diopters (D)/10 years from 18 to 35 years, 0.45 D/10 years from 36 to 68 years, and decreased after 69 years, mainly caused by anterior corneal astigmatism. The mean magnitude of posterior corneal astigmatism was -0.33 D and exceeded 0.50 D in 14.27% of eyes. The vectorial difference between total corneal astigmatism and keratometric astigmatism was correlated with posterior corneal astigmatism, polar value of anterior corneal astigmatism, age, and corneal higher order aberrations (r = 0.636; standard partial regression coefficients were 0.479, -0.466, 0.282, and 0.196, respectively; all P < .001). Based on the non-linear model to estimate corneal astigmatic change with age, a formula was developed to calculate recommended correction of astigmatism according to age and astigmatic type. CONCLUSIONS: The rate of change of total corneal astigmatism showed a non-linear trend toward against-the-rule astigmatism, which was low at young and old age, high at middle age, and should be taken into account when performing surgery to correct astigmatism. [J Refract Surg. 2017;33(10):696-703.].

Toxic effects of seu are different from those of other staphylococcal enterotoxins.

BACKGROUND/PURPOSE: Staphylococcal enterotoxins (SEs) are soluble extracellular proteins excreted by Staphylococcal bacterial strains, sharing similar structures and virulence. More than 20 genotypes of SEs have been identified, but the toxicity of some new SEs is still unclear. METHODS: In this study, we assessed the toxicity effects of six recombinant SEs (rSEA, rSEO, rSEG, rSEK, rSEU and rSEQ) on Balb/c mice by reverse transcription-polymerase chain reaction (RT-PCR)-based methods and enzyme activity detection. RESULTS: Except rSEU, the other five SEs resulted in systemic inflammatory responses with a significant increase of spleen and liver index and decrease of thymus index. SEs enhanced the enzyme activities of liver POD, T-SOD, LDH but reduced the activity of liver GSH-PX. The transcription levels of five cytokines were all down-regulated by rSEA, rSEG and rSEQ at a dose of 20 ng/g, which was coincided with the results of Caspase 3 level. The transcription and expression of IFN-γ, IL-4, IL-6, and TNF-α involved in inflammatory response were significantly up-regulated by rSEs at a low dose (20 ng/mL) except rSEU in vitro and in vivo. CONCLUSION: Our results reveals that the rSEA, rSEO, rSEG, rSEK, and rSEQ have cytotoxicity and superantigenicity for Balb/c mice except the rSEU enterotoxin.

Assessment of Tear Film Optical Quality Dynamics.

PURPOSE: To investigate tear film optical quality dynamics by analyzing the postblink temporal changes of objective scatter index (OSI). METHODS: A total of 109 myopic subjects without symptoms of dry eye and 32 myopic subjects diagnosed with dry eye disease were recruited in this cross-sectional study. The right eye for each subject was analyzed. Serial measurements of OSI were performed for 20 seconds in the interval of 0.5 second using a double-pass instrument, and 10 successive seconds of nonblinking immediately after a blink was selected to analyze the tear film optical quality dynamics. The tear breakup time (TBUT) was also measured. The mean OSI in 10 successive seconds and the correlation coefficient between OSI and time were analyzed. RESULTS: For subjects without symptoms of dry eye, 109 eyes were divided into two categories based on the correlation coefficient between OSI and time: category A (without positive correlation) and category B (with positive correlation). Categories A and B were further divided into four categories based on the mean OSI for 10 seconds: category A1 (36.7%, lower than 1.00); category A2 (33.0%, equal to or greater than 1.00); category B1 (13.8%, lower than 1.00), and category B2 (16.5%, equal to or greater than 1.00). Dry eye subjects were set as category C for comparison. There was no significant difference in the TBUT among the five categories (A1, A2, B1, B2, C) except between category C and category A1 (P < 0.01) and category C and category A2 (P < 0.05). CONCLUSIONS: Dynamic changes of OSI after blinking showed variations even in clinically asymptomatic subjects, and four categories of tear film were proposed based on the optical quality dynamics. The procedure using serial measurements of OSI as a noninvasive and objective method may have potential applications for detecting preclinical phase of dry eye disease in asymptomatic subjects.

Retinal Nerve Fiber Layer Thickness Changes in Migraine: A Meta-Analysis of Case-Control Studies.

BACKGROUND: The neurovascular dysfunction appears to be related to the development of migraines and it could be possible that hypoperfusion might also involve other areas besides brain, including the retina. Numerous studies have analyzed the ability of optical coherence tomography (OCT) to detect retinal nerve fiber layer (RNFL) thickness abnormalities and changes in migraine, but the results have not always been consistent. Therefore, we carried out a meta-analysis to evaluate the RNFL thickness measured with OCT in migraine. METHODS: Case-control studies were selected through an electronic search of the Cochrane Controlled Trials Register, PUBMED and EMBASE. For the continuous outcomes, we calculated the weighted mean difference (WMD) and 95% confidence interval (CI). The statistical analysis was performed by RevMan 5.0 software. RESULTS: Six case-control studies were included in the present meta-analysis, containing a total of 432 eyes in migraine patients and 288 eyes in healthy controls. The results of our study showed that there was a significant reduction in average RNFL thickness in patients with migraine compared to healthy controls (WMD = -3.67, 95% CI: -6.84 to -0.49, p = 0.02). Additionally, differences of RNFL thickness in superior quadrant (WMD = -9.23, 95% CI: -15.63 to -2.82, p = 0.005), inferior quadrant (WMD = -3.47, 95% CI: -6.73 to -0.22, p = 0.04), nasal quadrant (WMD = -3.86, 95% CI: -7.10 to -0.61, p = 0.02) and temporal quadrant (WMD = -3.10, 95% CI: -5.05 to -1.15, p = 0.002) were all significant between the two groups. CONCLUSIONS: Our meta-analysis found that RNFL thickness in the migraine patients was thinner than that in the healthy control group. Given the limited sample size, further investigations are needed to validate these findings.

Effect of translation and rotation fitting on analysis of corneal topography.

The purpose was to assess the suitability of quadratic equations for the accurate representation of corneal topography and consider the effect of translation and rotation fitting on the quality of fit and the curvature results. Topography images were recorded for the anterior and posterior surfaces of 490 corneas of 490 myopic patients using Pentacam. Elevation data were fitted to four shape models, three of which considered translational and/or rotational fitting. Differences between the models in the estimates of radii of curvature (R) and asphericity coefficients (Q) and in the quality of fit (as measured by the root mean square (RMS) error and the structural similarity index (SSIM)) were statistically analysed. The general shape model that considered both translational and rotational misalignments provided the best fit for the anterior (RMS = 1.18 ± 0.56 µm, SSIM = 0.99 ± 0.01) and posterior (RMS 3.64 ± 1.23 µm, SSIM = 0.99 ± 0.01) corneal surfaces in all subjects. The quality of fit degraded significantly (with p < 0.01 in all cases) when misalignments were not considered, increasing RMS to 5.20 ± 2.27 µm (anterior) and 17.10 ± 6.08 µm (posterior) and decreasing SSIM to 0.84 ± 0.18 (anterior) and 0.68 ± 0.22 (posterior) when both translational and rotational misalignments were ignored. The estimates of Rx, Ry, Qx and Qy as obtained when both forms of misalignment were considered varied, respectively, by as much as 0.18 mm, 0.23 mm, 0.27 and 0.54 for the anterior surface, and 0.25 mm, 0.39 mm, 0.32 and 0.37 for the posterior surface when misalignments were ignored. The variations were statistically significant, with p remaining below 0.01 in all cases. In conclusion, consideration of geometric misalignments helps improve the accuracy of describing corneal topography. The effects of misalignments on the estimates of corneal radius and asphericity are statistically significant and may in some cases be clinically significant.

Repeatability and reproducibility of a double-pass optical quality analysis device.

PURPOSE: To evaluate the repeatability and reproducibility of a double-pass instrument (OQASII, Visiomereics SL, Spain), which objectively measures overall optical quality of the human eyes. METHODS: The right eye of 119 healthy subjects with best corrected visual acuity of 20/25 or better was included in this prospective, comparative, observational study. Two separate tests with OQASII were conducted sequentially on the same day by two different examiners. A week later, the first examiner conducted the third measurement. All subjects underwent three consecutive tests during each session. The repeatability and reproducibility of the modulation transfer function cut off frequency (MTF cutoff), the Strehl ratio, the OQAS values (OVs) at contrasts of 100%, 20% and 9%, and the objective scatter index (OSI) were analyzed. RESULTS: For MTF cutoff, Strehl ratio, OV100%, OV20%, OV9%, and OSI, the mean values were 39.32±9.75cpd, 0.22±0.06, 1.31±0.33, 1.33±0.39, 1.33±0.41, 0.60±0.42, respectively. Repeatability and reproducibility were good with a very low coefficient of variation and high interclass correlation coefficients (>0.88) for all parameters. Bland-Altman plots showed good correlation with 95% limits of agreement ranged from -6.04 to 6.78cpd, -0.05 to 0.05, -0.20 to 0.23, -0.29 to 0.32, -0.40 to 0.42, -0.23 to 0.21 in inter-observer, and -6.56 to 7.42cpd, -0.06 to 0.06, -0.22 to 0.24, -0.30 to 0.32, -0.35 to 0.34, -0.24 to 0.23 in inter-visit, respectively. CONCLUSION: The OQASII system yields excellent repeatability and good reproducibility for objective measurements of overall optical quality in clinic.

Correlation among lens opacities classification system III grading, visual function index-14, pentacam nucleus staging, and objective scatter index for cataract assessment.

PURPOSE: To investigate the relationship among Lens Opacities Classification System III (LOCS III) grading score, Visual Function Index-14 (VF-14) score, average lens density by the Pentacam Nucleus Staging system, and the objective scatter index measured by the Optical Quality Analysis System in age-related cataract patients. DESIGN: Prospective, single-center, cross-sectional study. METHODS: Thirty-six subjects (60 eyes) with age-related cataract were recruited. Subjects with any corneal anomaly potentially affecting intraocular scatter were excluded. The best-corrected visual acuity (BCVA), LOCS III nuclear opalescence score and cortical cataract score, VF-14 score, average lens density, and objective scatter index were obtained. Correlations among these parameters were analyzed. RESULTS: The LOCS III nuclear opalescence score was correlated with the BCVA (r = 0.438; P = .001), objective scatter index (r = 0.543; P < .001), and average lens density (r = 0.621; P < .001). The objective scatter index was also correlated with the BCVA (r = 0.779; P < .001) and the average lens density (r = 0.320; P = .013). The VF-14 score had the strongest correlation with the objective scatter index (r = -0.712; P < .001). The difference between groups with objective scatter index<3.0 and ≥3.0 was significant with regard to BCVA, average lens density, LOCS III nuclear opalescence score, and VF-14 score. CONCLUSIONS: LOCS III grading remains an economical and effective method to assess lens opacities, especially in the formation of early cortex cataracts. The objective scatter index can be a useful parameter to objectively analyze the correlation between ocular examination findings and patient concerns. Furthermore, the objective scatter index scores ≥3.0 can be a possible objective cut-off for preoperative decision making.

Retinal nerve fiber layer thickness changes in Parkinson disease: a meta-analysis.

BACKGROUND: Parkinson disease (PD) is a neurodegenerative process that leads to a selective loss of dopaminergic neurons, mainly in the basal ganglia of the brain. Numerous studies have analyzed the ability of optical coherence tomography (OCT) to detect retinal nerve fiber layer (RNFL) thickness abnormalities and changes in PD, but the results have not always been consistent. Therefore, we carried out a meta-analysis to evaluate the RNFL thickness measured with OCT in PD. METHODS AND FINDINGS: Case-control studies were selected through an electronic search of the Cochrane Controlled Trials Register, PUBMED and EMBASE. For the continuous outcomes, we calculated the weighted mean difference (WMD) and 95% confidence interval (CI). The statistical analysis was performed by RevMan 5.0 software. Thirteen case-control studies were included in the present meta-analysis, containing a total of 644 eyes in PD patients and 604 eyes in healthy controls. The results of our study showed that there was a significant reduction in average RNFL thickness in patients with PD compared to healthy controls (WMD = -5.76, 95% CI: -8.99 to -2.53, P = 0.0005). Additionally, differences of RNFL thickness in superior quadrant (WMD = -4.44, 95% CI: -6.93 to -1.94, P = 0.0005), inferior quadrant (WMD = -7.56, 95% CI: -11.33 to -3.78, P<0.0001), nasal quadrant (WMD = -3.12, 95% CI: -5.63 to -0.61, P = 0.01) and temporal quadrant (WMD = -4.63, 95% CI: -7.20 to -2.06, P = 0.0004) were all significant between the two groups. CONCLUSION: In view of these results and the noninvasive nature of OCT technology, we surmise that OCT could be a useful tool for evaluating the progression of the Parkinson disease. TRIAL REGISTRATION: ClinicalTrials.gov NCT01928212.

Association of Lumican gene polymorphism with high myopia: a meta-analysis.

PURPOSE: Numerous studies have evaluated the association between the single-nucleotide polymorphism (SNP) (rs3759223, C→T) in Lumican gene and high myopia risk in the Chinese population. However, the results have been inconsistent. We therefore here examined whether the rs3759223 polymorphism confers high myopia risk by conducting a meta-analysis. METHODS: PubMed, EMBASE, Science Citation Index, and Chinese National Knowledge Infrastructure (up to November 30, 2012) were searched by two investigators independently. Pooled relative ratios (RRs) and 95% confidence interval (CI) were used to assess the strength of the associations between SNP rs3759223 and myopia. Statistical analysis was undertaken using the program STATA 11.0 software (Stata Corporation, College Station, TX). RESULTS: Five case-control studies involving 923 patients with high myopia and 622 controls were included in this meta-analysis. A significant relationship between SNP rs3759223 and high myopia in the Chinese population was found under the homozygote (RR = 1.47, 95% CI 1.01-2.12, p = 0.04) and recessive (RR = 1.69, 95% CI 1.09-2.62, p = 0.02) genetic models. However, no significant association was found under the heterozygote (RR = 1.01, 95% CI 0.76-1.35, p = 0.93) and dominant (RR = 1.06, 95%CI 0.90-1.26, p = 0.48) genetic models. CONCLUSIONS: This meta-analysis showed the evidence that SNP rs3759223 may affect individual susceptibility to high myopia in the Chinese population. Given the limited sample size, further investigations are needed to validate the association.

Surgical management of malignant glaucoma with white cataract in nanophthalmos.

We present a 49-year-old woman with nanophthalmos, white cataract, and malignant glaucoma in her left eye. The corrected distance visual acuity (CDVA) in that eye was hand motion, and the intraocular pressure (IOP) fluctuated between 28 mm Hg and 45 mm Hg with antiglaucoma medications. An unsutured sclerectomy combined with zonulectomy, hyaloidectomy, and anterior vitrectomy was performed. At 6 months postoperatively, the IOP was maintained at 12 mm Hg, the anterior chamber was deep, and the Snellen CDVA was 20/80. No intraoperative or postoperative complications were observed. The outcome in this case suggests that sclerectomy combined with phacoemulsification, zonulectomy, hyaloidectomy, and anterior vitrectomy is effective for the management of nanophthalmic patients with white cataract and malignant glaucoma.

[Repeatability and agreement of corneal thickness measurement with Pentacam Scheimpflug photography and Visante optical coherence tomography].

OBJECTIVE: To evaluate the repeatability and agreement of central and peripheral corneal thickness (CT) measurements by high resolution Pentacam rotating Scheimpflug photography and Visante optical coherence tomography (OCT) in unoperated myopic eyes and eyes after Laser In Situ Keratomileusis (LASIK). METHODS: CT at central, thinnest, 1.0 mm and 2.5 mm superior, inferior, nasal and temporal periphery locations, and the location of the corneal thinnest thickness were measured using Pentacam and Visante OCT in 60 myopia patients (60 eyes) and 60 patients (60 eyes) after LASIK. The results were analyzed by paired-t test, Pearson correlation analysis and Bland-Altman method. RESULTS: Both Pentacam and Visante OCT demonstrated high intraobserver repeatability, with all intraclass correlation coefficients and Cronbach's alphas were more than 0.9, and coefficient of variation were less than 0.9%. Significantly higher CoV was measured with Pentacam than by Visante OCT in at central (0.46 ± 0.30), thinnest (0.43 ± 0.28) and 1.0 mm locations in both groups (t = 2.465, 2.226, P < 0.05), but no statistically significant difference were found at 2.5 mm locations in healthy subjects and all locations in post-LASIK eyes (t = -0.518, 1.542, -0.876, 0.756, P > 0.05). The thickness of central corneal with Pentacam was (543.01 ± 22.89) µm, the thinnest point was (540.61 ± 22.84) µm, they were greater than the value of Visante OCT (t = 17.946, 23.071, P < 0.05). The Pearson correlation coefficients were all more than 0.9 (all r > 0.9, P < 0.01). The Bland-Altman plots showed the 95% LoA between both devices were lower than 22 µm at central, thinnest and 1.0 mm locations. However, the 95% LoA were 24 µm to 44 µm at 2.5 mm locations. CONCLUSIONS: Pentacam and Visante OCT demonstrate high repeatability for central and peripheral CT measurements in young myopia and post-LASIK eyes. However, both devices can't be used interchangeably for measurements of peripheral CT.

Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis.

BACKGROUND: A number of published comparative studies have been conducted to evaluate the efficacy and safety of intraoperative mitomycin C (MMC) in endoscopic dacryocystorhinostomy (EN-DCR). However, results have not always been consistent. Therefore, we carried out a meta-analysis to compare the clinical results of EN-DCR with and without MMC. METHODS AND FINDINGS: A comprehensive literature search of Cochrane Library, PubMed and EMBASE to identify relevant trials comparing EN-DCR with and without MMC. Eleven studies including 574 eyes were included in this meta-analysis. The success was defined as patency of the nasolacrimal canal and symptomatic improvement. There was significantly higher success rate in the MMC group in comparison with control group [RR = 1.12, 95% CI (1.04, 1.20), P = 0.004]. A sensitivity analysis after the non-randomized controlled trials were excluded from the meta-analysis demonstrated no differences compared with the overall results. Subgroup analyses showed that MMC group had a significantly higher success rate than control group in primary and revision EN-DCR, and EN-DCR without silicone intubation, but no difference in the subgroup of with silicone intubation. The size of the osteotomy site was bigger in the MMC group compared to the control group at 3 months [WMD = 7.65, 95% CI (0.33, 14.98), P = 0.041] and 6 months [WMD = 9.28, 95% CI (2.45, 16.11), P = 0.008] after surgery. However, there was statistically significant difference in the osteotomy surface area between the two groups at 12 months after surgery [WMD = 11.63, 95% CI (-1.04, 24.29), P = 0.072]. CONCLUSION: Intraoperative MMC application seems to be a safe adjuvant that could reduce the closure rate of the osteotomy and enhance the success rate after both primary and revision EN-DCR. TRIAL REGISTRATION: ClinicalTrials.gov NCT01772277.

The effect of hinge location on corneal sensation and dry eye after LASIK: a systematic review and meta-analysis.

BACKGROUND: The aim of this meta-analysis is to investigate the possible effect of hinge location on corneal sensation and dry eye syndrome after laser-assisted in situ keratomileusis (LASIK). METHODS: A comprehensive literature search was conducted in the PubMed, EMBASE, and Cochrane Controlled Trials Register to identify potentially relevant randomized controlled trials (RCTs) of comparing the effects of horizontal-hinge flaps and vertical-hinge flaps on corneal sensation and dry eye after LASIK. Meta-analyses were performed for corneal sensation, tear break-up time (TBUT), Schirmer's I test and corneal fluorescein staining (CFS) at 1 week, 1, 3, and 6 months postoperatively. RESULTS: Eight RCTs (657 eyes) investigating the effects of hinge location on the corneal sensation and dry eye syndrome after LASIK were identified. The results showed that the horizontal-hinge group causes less loss of sensation than the vertical-hinge group, and the difference was significant at 3-month postoperative (p = 0.01). The TBUT value was significantly larger and a lower percentage of patients with CFS in the horizontal-hinge group than in the vertical-hinge group at 1-month postoperative (p = 0.007 and p = 0.01, respectively) and 3-month (p = 0.03 and p = 0.009, respectively); Schirmer's I test values were also higher in the horizontal-hinge group, but the difference did not reach statistically significance at each postoperative period. CONCLUSIONS: According to the available data, we suggest that hinge location may have some effect on corneal sensation and dry eye syndrome after LASIK at the early postoperative period. However, there was no significant difference between the groups at 6 months after surgery. Further well-organized, prospective, randomized studies involving more patients are warranted.

A meta-analysis of primary external dacryocystorhinostomy with and without mitomycin C.

OBJECTIVE: To assess the efficacy and safety of local application of intraoperative mitomycin C (MMC) at the osteotomy site in primary external dacryocystorhinostomy (EX-DCR). METHODS: A comprehensive literature search of the Cochrane Library, PubMed and Embase was undertaken to identify relevant trials comparing EX-DCR with MMC (MMC group, from 0.2-1.0 mg/mL) and without MMC (control group). A total of nine randomized controlled trials (RCTs) were selected and a meta-analysis performed on the results of success rates, which were defined as patency of the nasolacrimal canal and symptomatic improvement. Statistical analysis was performed using RevMan 5.0 software. RESULTS: Nine RCTs reporting on a total of 562 DCRs including patients in the age range 30-57 years were included in the meta-analysis. However, the total number of males and females could not be determined as only four RCTs reported on this aspect. There was a significantly higher success rate in the MMC group in comparison with the control group (odds ratio, OR, 2.11; 95% confidence interval, CI, 1.19-3.74, P = 0. 01). In two RCTs, the mean osteotomy size 6 months postoperatively was significantly larger in the MMC group than in the control group (about 27mm(2) in the MMC group versus about 12mm(2) in the control group in the first study, and about 22mm(2) in the MMC group versus about 18mm(2) in the control group in the second study, P < 0.005). No intraoperative or postoperative complications except two cases with delayed healing of the external skin wound were recorded in the MMC group. CONCLUSION: Intraoperative MMC application seems to be a safe adjuvant that could reduce the closure rate of the osteotomy site after primary EX-DCR. Further well-organized, prospective, randomized studies involving larger patient numbers divided into subgroups for different concentrations of locally applied MMC are warranted.

[Assessments of total corneal power and intraocular lens power in post-LASIK eyes].

OBJECTIVE: To compare the different evaluations of corneal power in post-laser-assisted in situ keratomileusis (LASIK) eyes and assess the accuracy and differences of intraocular lens (IOL) power prediction with corneal powers through different calculation methods. METHODS: For this prospective study, 71 eyes of 39 candidates undergoing LASIK and 3 months later returning for reexamination were included. All subjects were divided into 2 groups according to the axial length: Group A (23.46 - 25.97 mm) 44 eyes, Group B (26.00 - 28.52 mm) 27 eyes. The ranges of spherical equivalents were -1.75 - -9.50 D with an average of (-4.82 ± 1.98) D. Subjective refraction and Pentacam Scheimpflug analyzer were performed at pre-operation and subjective refraction, IOLMaster and Galilei II dual Scheimpflug analyzer at over 3 months post-operation. The following values were obtained: SimK by Galilei II dual Scheimpflug analyzer, Kn calculated with Gaussion thick lens formula, Kray with ray tracing method, Kchm calculated with clinical history method and Km by IOLMaster. Repeated measures analysis of variance analyze the differences between SimK, Kn, Kray, Km and Kchm. Repeated measurement analysis of variance was employed to analyze the differences between SimK, Kn, Kray, Km combining intraocular lens power formula and Kchm combining intraocular lens power formula. Pearson's analysis was performed to analyze the correlations between SimK, Kn, Kray, Km and Kchm. Those combining with formulas for IOL power calculations were also analyzed. P < 0.05 indicated statistical significance. RESULTS: The values of SimK, Kn, Kray, Km and Kchm were (39.02 ± 1.8), (37.8 ± 1.51), (36.8 ± 1.84), (39.18 ± 1.75) and (38.55 ± 1.83) D respectively. The differences between SimK, Kn, Kray, Km and Kchm had statistical significances (P < 0.01). High correlations existed between SimK, Kn, Kray, Km and Kchm (r > 0.9, P < 0.01). In the same IOL formula, Kray had the highest IOL power value, Kn followed, Kchm the third, SimK and Km the smallest. Among the IOL formulas, Haigis-L and Haigis predicted the highest IOL power, HofferQ followed, Holladay the third and SRK/T the smallest. CONCLUSION: Kn/Kray combining with Haigis formula may be a new and effective method for predicting the IOL power in post-LASIK eyes.

[Comparison of Lenstar and IOLMaster for intraocular lens power calculation].

OBJECTIVE: To evaluate the precision of Intraocular Lens (IOL) power calculation using a new optical low-coherence reflectometry biometer (Lenstar) and compare the results with those obtained with IOLMaster. METHODS: It was a prospective controlled study. Biometry measurements in 157 eyes of 98 cataract patients were performed by the same examiner with Lenstar and IOLMaster. Axial length (AL), corneal keratometry readings (Km), and anterior chamber depth (ACD) were obtained. Correlation and differences of biometry measurements obtained with two biometers were made. Intraocular Lens power were calculated using 4 formulas and the corresponding IOL constants, the target was emmetropia. Then statistical analysis was proceeded. RESULTS: Axial length were (23.65 ± 1.17) mm and (23.65 ± 1.16) mm respectively, Km (44.15 ± 1.58) D and (44.17 ± 1.58) D respectively by Lenstar and IOLMaster and no statistical differences were found (P > 0.05). ACD were (3.09 ± 0.41) mm and (3.05 ± 0.41) mm respectively by Lenstar and IOLMaster and there was statistical difference between them (P = 0.001). All biometry measurements showed good linear correlation (r > 0.9, P < 0.001). IOL power calculations with biometry values between Lenstar and IOLMaster using the 4 formulas showed good agreement. The least difference was obtained with formula SRK/T and the most with formula Haigis. CONCLUSIONS: Lenstar can provide precise and noncontact biometry measurements easily and safely, which are welcome by patients. Providing precise and reliable biometry measurements of cataract patients for Intraocular Lens power calculation, it shows good agreement with IOLMaster and the two biometers can be interchanged.

[Purification and structural analysis of the nucleocapsid of PRRS virus expressed from Escherichia coli].

The DNA fragment encoding the nucleocapsid protein (N) of PRRSV BJ4 strain were cloned into the BamH I / EcoR I sites of pET28a vector to construct the expression plasmid pET28-N by designing special primers. The soluble protein (P28-N) were obtained by introducing the expression plasmid into E. coli BL21 (DE3) host cell, and the amount of recombinant protein reached to 28% of the total mass of bacterial protein. PET28-N were purified by nickel-affinity column of Proband resin. The circular dichroism (CD) analysis showed that the purified PET28-N shared a significant (26%) alpha-helical structure, beta-sheet (23.7%), beta-turn (19.8%), and random coil (30.3%), respectively. Finally,the secondary structure of N protein of PRRSV was deduced.