Increased risk of heavy metal accumulation in mangrove seedlings in coastal wetland environments due to microplastic inflow.

The recovery phase of mangrove seedlings in coastal wetland ecosystems can be negatively affected by exposure to external pollutants. This study aimed to investigate the impact of microplastics (MPs) influx, specifically polystyrene (PS) and polymethyl methacrylate (PMMA), on the growth of Aegiceras corniculatum seedlings and their accumulation of heavy metals (HMs). PS and PMMA significantly increased HMs accumulation (up to 21.0-548%), particularly in the roots of seedlings, compared to the control treatment (CK). Additionally, elevated activities of malondialdehyde and catalase enzymes were observed in the leaves of seedlings, while peroxidase enzyme activity decreased. Topological analysis of the root sediment microbiota coexistence network revealed that the modularization data increased from 0.69 (CK treatment) to 1.07 (PS treatment) and 5.11 (PMMA treatment) under the combined stress of MPs and HMs. This suggests that the introduction of MPs intensifies microbial modularization. The primary cause of increased HMs accumulation in plants is the MPs input, which influences the secretion of organic acids by plants and facilitates the shift of HMs in sediment to bioavailable states. Furthermore, changes in microbial clustering may also contribute to the elevated HMs accumulation in plants. This study provides valuable insights into the effects of external pollutants on mangrove seedlings and offers new perspectives for the preservation and restoration of mangrove coastal wetlands.

Microbial mechanisms in nitrogen fertilization: Modulating the re-mobilization of clay mineral-bound cadmium in agricultural soils.

Soil cadmium (Cd) can affect crop growth and food safety, and through the enrichment in the food chain, it ultimately poses a risk to human health. Reducing the re-mobilization of Cd caused by the release of protons and acids by crops and microorganisms after stabilization is one of the significant technical challenges in agricultural activities. This study aimed to investigate the re-mobilization of stabilized Cd within the clay mineral-bound fraction of soil and its subsequent accumulation in crops utilizing nitrogen ammonium nitrogen (NH4+-N) and nitrate nitrogen (NO3--N), at 60 and 120 mg kg-1. Furthermore, the study harvested root exudates at various growth stages to assess their direct influence on the re-mobilization of stabilized Cd and to evaluate the indirect effects mediated by soil microorganisms. The results revealed that, in contrast to the NO3--N treatment, the NH4+-N treatment significantly enhanced the conversion of clay mineral-bound Cd in the soil to NH4NO3-extractable Cd. It also amplified the accumulation of Cd in edible amaranth, with concentrations in roots and shoots rising from 1.7-6.0 mg kg-1 to 4.3-9.8 mg kg-1. The introduction of NH4+-N caused a decrease in the pH value of the rhizosphere soil and stimulated the production and secretion organic and amino acids, such as oxalic acid, lactic acid, stearic acid, succinic acid, and l-serine, from the crop roots. Furthermore, compared to NO3--N, the combined interaction of root exudates with NH4+-N has a more pronounced impact on the abundance of microbial genes associated with glycolysis pathway and tricarboxylic acid cycle, such as pkfA, pfkB, sucB, sucC, and sucD. The effects of NH4+-N on crops and microorganisms ultimately result in a significant increase in the re-mobilization of stabilized Cd. However, the simulated experiments showed that microorganisms only contribute to 3.8-6.6 % of the re-mobilization of clay mineral-bound Cd in soil. Therefore, the fundamental strategy to inhibit the re-mobilization of stabilized Cd in vegetable cultivation involves the regulation of proton and organic acid secretion by crops.

Differential Nitrous oxide emission and microbiota succession in constructed wetlands induced by nitrogen forms.

Nitrous oxide (N2O) emission during the sewage treatment process is a serious environmental issue that requires attention. However, the N2O emission in constructed wetlands (CWs) as affected by different nitrogen forms in influents remain largely unknown. This study investigated the N2O emission profiles driven by microorganisms in CWs when exposed to two typical nitrogen sources (NH4+-N or NO3--N) along with different carbon source supply (COD/N ratios: 3, 6, and 9). The results showed that CWs receiving NO3--N caused a slight increase in total nitrogen removal (by up to 11.8 %). This increase was accomplished by an enrichment of key bacteria groups, including denitrifiers, dissimilatory nitrate reducers, and assimilatory nitrate reducers, which enhanced the stability of microbial interaction. Additionally, it led to a greater abundance of denitrification genes (e.g., nirK, norB, norC, and nosZ) as inferred from the database. Consequently, this led to a gradual increase in N2O emission from 66.51 to 486.77 ug-N/(m2·h) as the COD/N ratio increased in CWs. Conversely, in CWs receiving NH4+-N, an increasing influent COD/N ratio had a negative impact on nitrogen biotransformation. This resulted in fluctuating trend of N2O emissions, which decreased initially, followed by an increase at later stage (with values of 122.87, 44.00, and 148.59 ug-N/(m2·h)). Furthermore, NH4+-N in the aquatic improved the nitrogen uptake by plants and promoted the production of more root exudates. As a result, it adjusted the nitrogen-transforming function, ultimately reducing N2O emissions in CWs. This study highlights the divergence in microbiota succession and nitrogen transformation in CWs induced by nitrogen form and COD/N ratio, contributing to a better understanding of the microbial mechanisms of N2O emission in CWs with NH4+-N or NO3--N at different COD/N ratios.

Microbiota and genetic potential for reducing nitrous oxide emissions by biochar in constructed wetlands.

The denitrification process in constructed wetlands (CWs) is responsible for most of the nitrous oxide (N2O) emissions, which is an undesired impact on the ecology of sewage treatment systems. This study compared three types of CWs filled with gravel (CW-B), gravel mixed with natural pyrite (CW-BF), or biochar (CW-BC) to investigate their impact on microbiota and genetic potential for N2O generation during denitrification under varying chemical oxygen demand (COD) to nitrate (NO3--N) ratios. The results showed that natural pyrite and biochar were superior in enhancing COD (90.6-91.2 %) and NO3--N removal (90.0-93.5 %) in CWs with a COD/NO3--N ratio of 9. The accumulation of NO2--N during the denitrification process was the primary cause of N2O emission, with the fluxes ranging from 95.6-472.0 µg/(m2·h) in CW-B, 92.9-400 µg/(m2·h) in CW-BF, and 54.0-293.3 µg/(m2·h) in CW-BC. The addition of biochar significantly reduced N2O emissions during denitrification, while natural pyrite had a lesser inhibitory effect on N2O emissions. The three types of substrates also influenced the structure of microbiota in the biofilm, with natural pyrite enriched nitrogen transformation microorganisms, especially for denitrifiers. Notably, biochar significantly enhanced the abundance of nosZ and the ratio of nosZ/(norB + norC), which are critical factors in reducing N2O emissions from CWs. Overall, the results suggest that the biochar-induced changes in microbiota and genetic potential during denitrification play a significant role in preventing N2O production in CWs, especially when treating sewage with a relatively high COD/NO3--N ratio.

Pancreatitis and Pancreatic Cancer Risk.

Purpose: The present retrospective study aimed to explore the relationship between pancreatitis and pancreatic cancer in the population cohort of the UK Biobank (UKB) (https://www.ukbiobank.ac.uk). Methods: From the 500 thousand population cohort of UKB, according to the age and gender of patients with pancreatic cancer 1:10, matching the control without pancreatic cancer, the binary Logistic regression model was used to analyze the relationship between pancreatitis and pancreatic cancer, and subgroup analyses were used to identify potential effect modifiers. Results: A total of 1538 patients with pancreatic cancer were compared with 15 380 controls. In the fully adjusted model, patients with pancreatitis had a significantly increased risk of pancreatic cancer compared with no pancreatitis. The risk of pancreatitis and pancreatic cancer increased with the age of pancreatitis, and the risk of pancreatic cancer was highest in the 61 to 70 age group. In addition, in the first 3 years of acute pancreatitis, the risk of pancreatic cancer increased significantly with the increase in the duration of the disease (odds ratio [OR] 29.13, 95% confidence interval [CI]: 16.34-51.93), after 3 years, the trend of increase decreased. After more than 10 years, there was no significant correlation between the risk of acute pancreatitis and pancreatic cancer. However, patients with chronic pancreatitis were significantly associated with an increased risk of pancreatic cancer only in the first 3 years (OR 28.14, 95% CI: 14.86-53.31). Conclusion: Pancreatitis may associate with an increased risk of pancreatic cancer. The older the age of pancreatitis, the higher the risk of pancreatic cancer. The risk of pancreatic cancer increases significantly in the first 3 years of the course of pancreatitis. This may provide an alternative strategy for the early identification of individuals at high risk of pancreatic cancer.

Ocular Perfusion Pressure in 7- and 12-Year-Old Chinese Children: The Anyang Childhood Eye Study.

Purpose: The purpose of this study was to report the distribution of mean ocular perfusion pressure (MOPP) and its associated factors in Chinese children. Methods: We enrolled 3048 grade 1 students and 2258 grade 7 students of the Anyang Childhood Eye Study in central China. Systolic and diastolic blood pressure (SBP and DBP) were recorded with a digital automatic sphygmomanometer. Intraocular pressure (IOP) was assessed by a non-contact tonometer. MOPP was calculated as 2/3 × (DBP + 1/3[SBP - DBP]) - IOP. Risk factors for myopia were obtained through a questionnaire survey. Results: The MOPP was 33.83 ± 6.37 mm Hg (mean ± SD) in grade 1, which was lower than 36.99 ± 6.80 mm Hg in grade 7 (P < 0.001). Compared with myopic eyes, non-myopic eyes had higher MOPP in grade 7 (37.72 ± 6.72 mm Hg versus 36.58 ± 6.57 mm Hg, P < 0.001) and in grade 1 (33.88 ± 6.29 mm Hg versus 33.12 ± 7.03 mm Hg, P = 0.12). Multivariable analysis showed that higher MOPP was associated with less myopia (P < 0.001), higher body mass index (BMI; P < 0.001), thinner central corneal thickness (P < 0.001), less time on near work (P < 0.001), and more time on sleeping (P = 0.04). Conclusions: MOPP was higher in children of older age, with higher BMI, less time on near work, and more time on sleeping, and was higher in eyes with less myopia. Translational Relevance: We found that MOPP might be an indicator for the detection of myopia development.

Sleep Duration, Bedtime, and Myopia Progression in a 4-Year Follow-up of Chinese Children: The Anyang Childhood Eye Study.

Purpose: To investigate the relationship between sleep duration and bedtime with myopia progression and axial elongation during a 4-year follow-up in primary school children. Methods: This study included 1887 children (aged 7.09 ± 0.41 years) who had cycloplegic refractions data at baseline and a fourth visit and 2209 children (aged 7.10 ± 0.41 years) for axial length. All children underwent comprehensive ophthalmologic examinations, including cycloplegic refraction and ocular biometry, and standardized questionnaires, including average night-time sleep duration (h/d) and bedtime (time to bed). Myopia was defined as spherical equivalent < -0.5 diopters. Results: At the last follow-up, the mean myopia progression and axial elongation for all children were -1.89 ± 1.28 diopters and 1.22 ± 0.57 mm. After stratifying the sleep duration into tertile groups, myopia progression and axial elongation were slower in children with highest sleep duration tertile (P = 0.04 and P =0.014) in girls but not in boys, compared with the middle sleep duration tertile. However, after adjusting for potential confounders, no significant association was found for sleep duration with myopia progression and axial elongation for the children (P = 0.255 and P = 0.068), and the association with axial elongation was only of borderline significance in girls (P = 0.045). The bedtime was not associated with myopia progression and axial elongation in the regression analyses (P = 0.538; P = 0.801). Conclusions: These results show that there was no significant association between sleep duration and bedtime with myopia progression and axial elongation among children. The findings in girls might be related to the earlier onset of puberty.

Cycloplegic refraction by 1% cyclopentolate in young adults: is it the gold standard? The Anyang University Students Eye Study (AUSES).

AIMS: To document the difference between non-cycloplegic and cycloplegic refraction and explore its associated factors in Chinese young adults. METHODS: A school-based study including 7971 undergraduates was conducted in Anyang, Henan Province, China. Cycloplegia was achieved with two drops of 1% cyclopentolate and 1 drop of Mydrin P (Tropicamide 0.5%, phenylephrine HCl 0.5%) with a 5 min interval. Non-cycloplegic and cycloplegic refractions were measured by an autorefractor. A paired-sample t-test and Spearman correlation analysis were used for analysis with data from only the right eyes included.  RESULTS: Of the 7971 students examined, 7793 (97.8%) with complete data were included, aging 20.2±1.5 years. Male students accounted for 36.8%. Overall, there was a significant difference between non-cycloplegic and cycloplegic SE (spherical equivalent) of 0.83±0.81D (p<0.01). The difference was 1.80±1.11D, 1.26±0.93D and 0.69±0.69D for those with cycloplegic hyperopia, emmetropia and myopia, respectively (p<0.01 for all). Those with a hyperopic shift less than 0.25D and 0.5D accounted for 11.1% and 34.1%, respectively. A significant relationship was found between difference in SE and cycloplegic refraction (r=0.33, b=0.11, p<0.01). Without cycloplegia, prevalence of hyperopia and emmetropia would be underestimated by 6.2% (1.0% vs 7.2%) and 5.7% (3.8% vs 9.5%), respectively, with prevalence of myopia and high myopia overestimated by 12.1% (95.3% vs 83.2%) and 6.1% (17.2% vs 11.1%).  CONCLUSION: Lack of cycloplegia will lead to significant misclassification of myopia, emmetropia and hyperopia in Chinese young adults. Cycloplegia is therefore essential for this age-group in epidemiological studies.

Effect of uncorrection versus full correction on myopia progression in 12-year-old children.

PURPOSE: To investigate the effects of no correction versus full correction on myopia progression in Chinese children over a period of 2 years. METHODS: Myopia was defined as cycloplegic spherical equivalent (SE) of ≤ -0.50 D. Uncorrection was defined as no spectacles worn, and full correction was defined as when the value of SE subtracted from the dioptric power of the child's current spectacles was less than 0.5 D. Ocular examinations included visual acuity, cycloplegic autorefraction, axial length and vertometer measurements. Questionnaires were completed by parents on behalf of the children. RESULTS: A total of 121 myopic children, with a median age of 12.7 years, were screened from the Anyang Childhood Eye Study, with 65 in the uncorrected group and 56 in the full correction group. At 2-year follow-up, children with no correction had slower myopia progression (-0.75 ± 0.49 D vs. -1.04 ± 0.49 D, P < 0.01) and less axial elongation (0.45 ± 0.18 mm vs. 0.53 ± 0.17 mm, P = 0.02) than children with full correction. In multivariate modeling, adjusting for baseline SE or axial length, age, gender, height, number of myopic parents, age at myopia onset, and time spent in near work and outdoors, children with no correction still had slower myopia progression (-0.76 ± 0.07 vs. -1.03 ± 0.08 D, P < 0.01) and less axial elongation (0.47 ± 0.03 mm vs. 0.51 ± 0.03 mm, P < 0.01). Myopia progression decreased significantly with an increasing amount of undercorrection in all children (r = 0.22, b = 0.16, P = 0.01). CONCLUSION: Our findings suggest that myopic defocus slows the progression of myopia in already myopic children, supporting previous findings from animal studies.

Studies using concentric ring bifocal and peripheral add multifocal contact lenses to slow myopia progression in school-aged children: a meta-analysis.

PURPOSE: To evaluate the effect of soft contact lens with concentric ring bifocal and peripheral add multifocal designs on controlling myopia progression in school-aged children. METHODS: We systematically searched MEDLINE, EMBASE, Cochrane Library and reference lists of included trials. Methodological quality of included trials was assessed using Jadad Scale and Newcastle-Ottawa Quality Assessment Scale items. RESULTS: We identified five randomised controlled trials (RCTs) and three cohort studies with a total of 587 myopic children. Compared with the control group, concentric ring bifocal soft contact lenses showed less myopia progression with a weighted mean difference (WMD) of 0.31 D (95% CI, 0.05~0.57 D, p = 0.02) and less axial elongation with a WMD of -0.12 mm (95% CI, approximately -0.18 to -0.07 mm, p < 0.0001) at 12 months. Relative to the control group, peripheral add multifocal soft contact lenses showed less myopia progression with a WMD of 0.22 D (95% CI 0.14~0.31 D, p < 0.0001) and less axial elongation of -0.10 mm (95% CI -0.13~0.07 mm, p < 0.0001) at 12 months, respectively. The soft contact lenses with concentric ring bifocal and peripheral add multifocal designs produced additional myopia control rates of 30~38% for slowing myopia progression and 31~51% for lessening axial elongation within 24 months. CONCLUSIONS: Both concentric ring bifocal and peripheral add multifocal soft contact lenses are clinically effective for controlling myopia in school-aged children, with an overall myopia control rates of 30~50% over 2 years. Concentric ring bifocal soft contact lenses seem to have greater effect than peripheral add multifocal soft contact lenses.

Peripapillary retinal nerve fibre layer thickness and its association with refractive error in Chinese children: the Anyang Childhood Eye Study.

BACKGROUND: To report the thickness of the peripapillary retinal nerve fibre layer (pRNFL) in Chinese children and examine its association with refractive error, axial length (AL) and optic disc parameters. DESIGN: Population-based cross-sectional study. PARTICIPANTS: A total of 2893 seven-year-old children from 11 randomly selected primary schools in Anyang, central China. METHODS: Participants underwent ophthalmic examinations including optical biometry, cycloplegic autorefraction and spectral-domain ocular coherence tomography. MAIN OUTCOME MEASURES: Retinal nerve fibre layer thickness in 16 radial sections, cycloplegic spherical equivalent, AL. RESULTS: The mean (SD) average RNFL thickness was 102.01(8.02) µm. The average RNFL thickness decreased with smaller disc area (r = 0.18, R2 = 0.03, P < 0.0001), bigger cup area (r = -0.11, R2 = 0.01, P < 0.0001), smaller rim area (r = 0.28, R2 = 0.08, P < 0.0001), smaller nerve head volume (r = 0.27, R2 = 0.07, P < 0.0001), longer AL (r = -0.15, R2 = 0.02, P < 0.0001) and a negative spherical equivalent (r = 0.11, R2 = 0.01, P < 0.0001). Hyperopic children had a thicker RNFL than emmetropic children [102.45(8.13) µm vs. 100.81 (7.18) µm, P < 0.001]. Myopic children had thinner RNFL than emmetropic children [99.17 (7.69) µm vs. 100.81 (7.18) µm, P < 0.05]. CONCLUSION: Retinal nerve fibre layer thickness decreased with increasing AL, higher myopia, bigger cup area, smaller disc and rim area, and a smaller nerve head volume, but the coefficient of determination for all these associations was small. The RNFL in myopes was significantly thinner than emmetropes or hyperopes, but with small absolute differences. The study provides RNFL values for healthy 7-year-old Chinese children. Follow up of this cohort to observe the change of RNFL thickness with myopia and possible change in detected associations with age is planned.

Case report: successful resection of a leiomyoma causing pseudoachalasia at the esophagogastric junction by tunnel endoscopy.

BACKGROUND: Pseudoachalasia is a rare disorder whose presentation strongly resembles idiopathic achalasia. CASE PRESENTATION: Here, we present a case of a 42-year-old female patient with esophageal leiomyoma who was initially diagnosed with achalasia. On endoscopical investigation, however, it became apparent that she had pseudoachalasia as consequence of a leiomyoma at the esophagogastric junction (EGJ). The condition was successfully treated through submucosal tunneling endoscopic resection. CONCLUSION: This case suggests that submucosal tunneling endoscopic resection is a therapeutic u option for the treatment of pseudoachalasia caused by leiomyoma of EGJ.

Corneal Power, Anterior Segment Length and Lens Power in 14-year-old Chinese Children: the Anyang Childhood Eye Study.

To analyze the components of young Chinese eyes with special attention to differences in corneal power, anterior segment length and lens power. Cycloplegic refractions and ocular biometry with LENSTAR were used to calculate lens power with Bennett's method. Mean refraction and mean values for the ocular components of five different refractive groups were studied with ANOVA and post-hoc Scheffé tests. There were 1889 subjects included with full data of refraction and ocular components. As expected, mean axial length was significantly longer in myopic eyes compared to emmetropes. Girls had steeper corneas, more powerful lenses and shorter eyes than boys. Lens power was lower in boys and also lower in myopic eyes. Lens thickness was the same for both genders but was lower in myopic eyes. Although cornea was steeper in myopic eyes in the whole sample, this was a gender effect (more girls in the myopic group) as this difference disappeared when the analysis was split by gender. Anterior segment length was longer in myopic eyes. In conclusion, myopic eyes have lower lens power and longer anterior segment length, that partially compensate their longer axial length. When analyzed by gender, the corneal power is not greater in low and moderate myopic eyes.

Relative Peripheral Hyperopia Does Not Predict Development and Progression of Myopia in Children.

PURPOSE: To test the hypothesis that relative peripheral hyperopia predicts development and progression of myopia. METHODS: Refraction along the horizontal visual field was measured under cycloplegia at visual field angles of 0°, ±15°, and ±30° at baseline, 1 and 2 years in over 1700 initially 7-year-old Chinese children, and at baseline and 1 year in over 1000 initially 14-year olds. One refraction classification for central refraction was "nonmyopia, myopia" (nM, M), consisting of nM greater than -0.50 diopters (D; spherical equivalent) and M less than or equal to -0.50 D. A second classification was "hyperopia, emmetropia, low myopia, and moderate/high myopia" (H, E, LM, MM) with H greater than or equal to +1.00 D, E, -0.49 to +0.99 D, LM, -2.99 to -0.50 D, and MM less than or equal to -3.00 D. Subclassifications were made on the basis of development and progression of myopia over the 2 years. Changes in central refraction over time were determined for different groups, and relative peripheral refraction over time was compared between different subgroups. RESULTS: Simple linear regression of central refraction as a function of relative peripheral refraction did not predict myopia progression as relative peripheral refraction became more hyperopic: relative peripheral hyperopia and relative peripheral myopia predicted significant myopia progression for 0% and 35% of group/visual field angle combinations, respectively. Subgroups who developed myopia did not have more initial relative peripheral hyperopia than subgroups who did not develop myopia. CONCLUSIONS: Relative peripheral hyperopia does not predict development nor progression of myopia in children. This calls into question the efficacy of treatments that aim to slow progression of myopia in children by "treating" relative peripheral hyperopia.

Paraxial Schematic Eye Models for 7- and 14-Year-Old Chinese Children.

PURPOSE: To develop three-surface paraxial schematic eyes with different ages and sexes based on data for 7- and 14-year-old Chinese children from the Anyang Childhood Eye Study. METHODS: Six sets of paraxial schematic eyes, including 7-year-old eyes, 7-year-old male eyes, 7-year-old female eyes, 14-year-old eyes, 14-year-old male eyes, and 14-year-old female eyes, were developed. Both refraction-dependent and emmetropic eye models were developed, with the former using linear dependence of ocular parameters on refraction. RESULTS: A total of 2059 grade 1 children (boys 58%) and 1536 grade 8 children (boys 49%) were included, with mean age of 7.1 ± 0.4 and 13.7 ± 0.5 years, respectively. Changes in these schematic eyes with aging are increased anterior chamber depth, decreased lens thickness, increased vitreous chamber depth, increased axial length, and decreased lens equivalent power. Male schematic eyes have deeper anterior chamber depth, longer vitreous chamber depth, longer axial length, and lower lens equivalent power than female schematic eyes. Changes in the schematic eyes with positive increase in refraction are decreased anterior chamber depth, increased lens thickness, decreased vitreous chamber depth, decreased axial length, increased corneal radius of curvature, and increased lens power. In general, the emmetropic schematic eyes have biometric parameters similar to those arising from regression fits for the refraction-dependent schematic eyes. CONCLUSIONS: The paraxial schematic eyes of Chinese children may be useful for myopia research and for facilitating comparison with other children with the same or different racial backgrounds and living in different places.

Efficacy of Chinese eye exercises on reducing accommodative lag in school-aged children: a randomized controlled trial.

PURPOSE: To evaluate the efficacy of Chinese eye exercises on reducing accommodative lag in children by a randomized, double-blinded controlled trial. METHODS: A total of 190 children aged 10 to 14 years with emmetropia to moderate myopia were included. They were randomly allocated to three groups: standard Chinese eye exercises group (trained for eye exercises by doctors of traditional Chinese medicine); sham point eye exercises group (instructed to massage on non-acupoints); and eyes closed group (asked to close their eyes without massage). Primary outcome was change in accommodative lag immediately after intervention. Secondary outcomes included changes in corrected near and distant visual acuity, and visual discomfort score. RESULTS: Children in the standard Chinese eye exercises group had significantly greater alleviation of accommodative lag (-0.10 D) than those in sham point eye exercises group (-0.03 D) and eyes closed group (0.07 D) (P = 0.04). The proportion of children with alleviation of accommodative lag was significantly higher in the standard Chinese eye exercises group (54.0%) than in the sham point eye exercises group (32.8%) and the eyes closed group (34.9%) (P = 0.03). No significant differences were found in secondary outcomes. CONCLUSION: Chinese eye exercises as performed daily in primary and middle schools in China have statistically but probably clinically insignificant effect in reducing accommodative lag of school-aged children in the short-term. Considering the higher amounts of near work load of Chinese children, the efficacy of eye exercises may be insufficient in preventing myopia progression in the long-term. TRIAL REGISTRATION: ClinicalTrials.gov NCT01756287.

The association of TGFB1 genetic polymorphisms with high myopia: a systematic review and meta-analysis.

OBJECTIVE: The TGFB1 gene is among the most studied genes in high myopia due to its role in scleral remodeling. But reported findings of association on TGFB1 and high myopia are inconsistent. This present study is to evaluate the association of TGFB1 polymorphisms and high myopia. METHODS: A comprehensive literature search was conducted on studies published up to April 5, 2015. Summary odds ratios (ORs) and 95% confidence intervals were analyzed. Heterogeneity across studies was evaluated by Cochran Q statistic test and the I(2) index. Sensitivity analyses were conducted by the approach of one-study remove to assess the influence of single study on the combined effect. RESULTS: Eight studies were included in this study for meta-analysis. Rs1982073 was associated with high myopia in dominant model (OR=1.64; 95% CI=1.04~2.58; P<0.05), heterozygous model (OR=1.54; 95% CI=1.02~2.33; P<0.05), homozygous model (OR=1.90; 95% CI=1.01~3.55; P=0.05) and allelic model (OR=1.36; 95% CI=1.01~1.84; P=0.05). However, there was no statistical significance when Bonferroni correction was considered. Rs4803455 was associated with high myopia in recessive model (OR=0.40; 95% CI=0.25~0.64; P<0.01) and homozygous model (OR=0.42; 95% CI=0.26~0.68; P<0.01). Rs1800469 was associated with high myopia in allelic model (OR=0.78; 95% CI=0.64~0.96; P<0.05). And the associations can withstand Bonferroni correction in models mentioned above when referring to rs4803455 (P<0.01) and rs1800469 (P<0.05). CONCLUSIONS: Meta-analysis of existing data revealed a suggestive association of TGFB1 rs1982073 and rs4803455 with high myopia.

Atropine slows myopia progression more in Asian than white children by meta-analysis.

PURPOSE: To conduct a meta-analysis on the effects of atropine in slowing myopia progression and to compare Asian and white children and randomized controlled trials (RCTs) and observational studies. METHODS: Randomized controlled trials and observational studies that assessed the effects of all concentrations of atropine in slowing myopia progression in children were searched from MEDLINE, EMBASE, and the Cochrane Library up to April 2013. Jadad scoring was used to evaluate the quality of RCTs, and the Newcastle-Ottawa Scale was used for observational studies. RESULTS: Four RCTs and seven cohort studies (a kind of observational study) with 1815 children aged 5 to 15 years were included. The children had a baseline refraction of -0.50 to -9.75 diopters (D) and were followed up for 22.0 months (range, 12.0 to 36.5 months). The weighted mean differences in myopia progression in RCTs and cohort studies of Asian children were 0.55 D per year (p < 0.01) and 0.54 D per year (p < 0.001), respectively, and 0.35 D per year (p = 0.01) in cohort studies of white children. Compared with placebo, the risk of fast myopia progression (>1.0 D per year) using atropine was significantly decreased in both RCTs (odds ratio [OR], 0.14; p < 0.01) and cohort studies (OR, 0.08; p < 0.01), and the benefit of slow myopia progression (<0.50 D per year) using atropine was significantly increased in both RCTs (OR, 6.73; p < 0.01) and cohort studies (OR, 22.10; p < 0.01). CONCLUSIONS: Atropine could significantly slow myopia progression in children, with greater effects in Asian than in white children. Randomized controlled trials and cohort studies provided comparable effects.

[Detection of serum coxsackievirus B-specific antibody and nucleic acid in aged patients with cardiopathy].

OBJECTIVE: To understand the status of coxsackievirus B (CVB) infection in senior subjects and explore the association of the infection with cardiovascular diseases. METHOD: By means of ELISA and RT-PCR, CVB IgG antibody and nucleic acid were detected in 172 patients with cardiopathy and 58 control subjects. RESULTS: The positivity rate of CVB IgG antibody was 43.61% (75/172) in the patient group and 15.52% (9/58) in the control group, showing obvious difference between the two groups. CVB RNA tests revealed a CVB RNA-positivity rate of 20.93% (36/172) in the former group and 3.45% (2/58) in the latter, with also a significant difference (P<0.01). CONCLUSION: CVB infection is prevalent in aged patients with heart disease, which should be given due attention to.