Application of Femtosecond Laser + Piggyback Multifocal Intraocular Lens Implantation in Patients with Super-High Myopia Complicated with Cataract.

OBJECTIVE: To observe the clinical effect of piggyback multifocal intraocular lens (IOL) implantation in treating patients with high myopia complicated with cataract. METHODS: This was a prospective controlled study. We compared 32 eyes of 32 patients who underwent femtosecond laser-assisted cataract surgery with piggyback IOL implantation (two IOLs were implanted into the capsule) with 32 eyes of 32 patients who also underwent the same surgery (one IOL implanted into the capsule) due to high myopia complicated with cataract at the Wuhan Aier Eye Expert Hospital between January 2019 and October 2020. All patients were followed up for three months after surgery. Uncorrected distance visual acuity (UCDVA), uncorrected intermediate visual acuity (UCIVA), uncorrected near visual acuity (UCNVA), best-corrected distance visual acuity, distance-corrected intermediate visual acuity (DCIVA), distance-corrected near visual acuity (DCNVA), postoperative spectacle independence, postoperative visual interference, equivalent spherical lens, defocus curve, and IOL tilt and eccentricity were evaluated. RESULTS: Three months after surgery, the patients' UCIVA, UCNVA, DCIVA, and DCNVA were 0.49 ± 0.07, 0.38 ± 0.15, 0.47 ± 0.09, and 0.36 ± 0.12, respectively, in the research group and 0.56 ± 0.18, 0.72 ± 0.22, 0.55 ± 0.13, and 0.69 ± 0.15, respectively, in the control group; the differences between the two groups were statistically significant (P < .05). The spectacle independence rate was higher in the research group (93%) than in the control group (13%). The overall satisfaction regarding postoperative visual quality was also higher in the research group than in the control group. The absolute mean value of the spherical equivalents was 0.48 ± 0.28 D in the research group and 0.62 ± 0.33 D in the control group; the difference between the two groups was statistically significant (P < .05). CONCLUSION: Piggyback multifocal IOL implantation can expand the multifocal IOL application range, and satisfy the desire of patients with high myopia complicated with cataract to see both near and far.

[Clinical effect of stem cell transplantation via hepatic artery in the treatment of type II hyperammonemia: a report on 6 cases].

This study aimed to investigate the clinical effect of transplantation of CD133⁺ peripheral blood stem cells or umbilical cord mesenchymal stem cells via the hepatic artery in children with type II hyperammonemia and its possible action mechanism. Umbilical cord mesenchymal stem cells were obtained by collecting cord blood (100-150 mL) from healthy fetuses and separating stem cell suspension (5 mL) from the cord blood by hydroxyethyl starch sedimentation. CD133⁺ peripheral blood stem cells were obtained by mobilizing peripheral blood from the fathers of sick children using recombinant human granulocyte colony-stimulating factor for 5 days, collecting mononuclear cells (120 mL), and separating out CD133⁺ cells by sorting. With catheterization and percutaneous puncture, the obtained stem cells were slowly injected into the liver of sick children via the hepatic artery. The changes in clinical symptoms and laboratory indices such as blood ammonia, liver function, and arginine and citrulline concentrations were observed. After stem cell transplantation via the hepatic artery, the 6 children showed significantly decreased blood ammonia levels, and their blood ammonia levels slowly increased 1 to 2 weeks later, but remained below 100 µmol/L, and changes in glutamic-pyruvic transaminase levels were similar to blood ammonia. Plasma citrulline and arginine concentrations increased significantly after transplantation and the increase in citrulline level exceeded the increase in arginine level. An 8 months follow-up visit for one typical patient showed that the weight and height increased after transplantation and sleep was improved without night crying. The child could actively gaze at interesting objects instead of responding indifferently and started to say simple words. With regard to fine motor skills, the child could pinch things with the thumb and middle finger instead of displaying a lack of hand-eye coordination and progress was also made in gross motor skills. Gesell test showed that the child made progress for an average of 3.82 months in all areas. It was concluded that after stem cell transplantation, children with type II hyperammonemia have decreased blood ammonia levels, stable and improved liver function and steadily increased plasma citrulline and arginine concentrations. They display a progressive trend in such aspects as movement, language and environmental adaptability. It is hypothesized that stem cell transplantation via the hepatic artery partially or totally activates, or provides supplementary ornithine carbamoyl transferase, so that plasma citrulline and arginine concentrations increase and urea cycle disorder can be corrected to some extent.

New Framework for Dynamic Water Environmental Capacity Estimation Integrating the Hydro-Environmental Model and Load-Duration Curve Method-A Case Study in Data-Scarce Luanhe River Basin.

A better understanding of river capacity for contaminants (i.e., water environmental capacity, WEC) is essential for the reasonable utilization of water resources, providing government's with guidance about sewage discharge management, and allocating investments for pollutant reduction. This paper applied a new framework integrating a modified hydro-environmental model, Soil and Water Assessment Tool (SWAT) model, and load-duration curve (LDC) method for the dynamic estimation of the NH3-N WEC of the data-scarce Luanhe River basin in China. The impact mechanisms of hydrological and temperature conditions on WEC are discussed. We found that 77% of the WEC was concentrated in 40% hydrological guarantee flow rates. While the increasing flow velocity promoted the pollutant decay rate, it shortened its traveling time in streams, eventually reducing the river WEC. The results suggest that the integrated framework combined the merits of the traditional LDC method and the mechanism model. Thus, the integrated framework dynamically presents the WEC's spatiotemporal distribution under different hydrological regimes with fewer data. It can also be applied in multi-segment rivers to help managers identify hot spots for fragile water environmental regions and periods at the basin scale.

Zero-impact emission limits of enterprise-scale air pollutants-a case study of a typical petrochemical enterprise in Shanghai Chemical Industry Park.

The implementation of pollutant emission control has made initial achievements in the plant power, iron, and steel industries in China. To further improve air quality, it is of great significance to carry out research on zero-impact emissions of the petrochemical industry. Based on the existing concept and practice of zero emissions, this study proposes the concept of zero-impact emissions, taking emission concentration as the constraint. A typical petrochemical enterprise (namely Enterprise A) in Shanghai Chemical Industry Park as the research object, and used the CALPUFF model to simulate the target pollutant emissions (i.e. sulfur dioxide (SO2), nitrogen oxide (NOx), particulate matter (PM), and volatile organic compounds (VOCs)). The current emission standard, spatial distributions, and emission heights of chimneys in Enterprise A was considered as the baseline emission scenario and taking the zero-impact emission as a target for simulation. The results show that the current emission standards of NOx and VOCs (benzene) exceeded the zero-impact emission limits, and needed to be reduced by 22% and 87.5%, respectively. Moreover, the areas that exceeded the zero-impact concentration limits were located northwest of the chimneys and Hangzhou Bay. In terms of seasonal effects, the wind conditions in spring were more adverse for the enterprise to achieve zero-impact emissions. Based on the simulation, the zero-impact emission limits of SO2, NOx, PM, and VOCs (benzene) for Enterprise A were 50 mg/m3, 78 mg/m3, 10 mg/m3, and 0.32 mg/m3, respectively.Implications: Through case study, this paper solves the environmental management issue which is of universal significance for chemical industry park. The concept of zero-impact emissions and the determination method of zero-impact concentration limits proposed in this study could be used as references for related research on cutting emissions. Although the conclusion of this study about the emission limits is not suitable for other enterprises to apply directly, the calculation method of zero-impact emission limit can be used by other enterprises. Furthermore, the zero-impact emission limits on park scale can be determined after comprehensive evaluation based on the calculation results of multiple enterprises.

Factors of Retinal Re-detachment and Visual Outcome after Intraocular Silicone Oil Removal in Silicone Oil-filled Eyes.

Background: This study aims to evaluate the risk factors of retinal re-detachment and visual outcome after silicone oil removal (SOR) in silicone oil-filled eyes.Methods: A total of 57 patients who underwent pars plana vitrectomy (PPV) and silicone oil injection for retinal detachment (RD), and subsequently underwent a silicone oil removal procedure. Pre-operative examinations were performed to determine the best-corrected visual acuity (BCVA) using the Snellen chart, while Icare was used to determine the intraocular pressure (IOP). In addition, slit-lamp examination of the anterior segment and lens, fundus pre-set lens examination for the posterior segment, color fundus photography, anterior segment photography and type B-ultrasonic scans were performed.Results: In five of 57 patients (8.77%), the retina re-detached following the removal of silicone oil. The factors for re-detachment were proliferative vitreoretinopathy (PVR) (two cases), the formation of new retinal breaks (two cases), and incomplete membrane peeling (one case). The rate of retinal re-detachment (reRD) was statistically independent of the duration of silicone oil endotamponade (P = .810). BCVA significantly improved following the removal of silicone oil (P = .001). The duration of the silicone oil tamponade was significant in the development of cataract (27 eyes, 47.3%; P = .0008), emulsified oil in the anterior chamber (13 eyes, 22.8%; P = .009), and glaucoma (seven eyes, 12.2%).Conclusion: The improvement of visual acuity was discovered following the removal of the intraocular silicone oil. Although the duration of the intraocular silicone oil endotamponade had no effect on the rate of retinal attachment, a longer duration of silicone oil endotamponade can lead to the development of complications, such as cataract, emulsified oil in the anterior chamber and glaucoma, suggesting that the earlier removal of oil should be performed.

Psychometric properties of the Chinese version of the 25-item National Eye Institute Visual Function Questionnaire.

PURPOSE: The goal of this study was to present the psychometric properties of the Chinese version of the short-form National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) in older adults with age-related ocular disorders. METHODS: The NEI-VFQ-25 was translated and adapted into the Chinese version and then was administered to a sample of 167 older adults with age-related visual problems. All participants were also administered with a Medical Outcomes study 12-item Short-Form Health Survey, and received a detailed eye examination by an ophthalmologist. The sample was divided into two groups--a group with mild visual problems, and a moderately or severely visually impaired group--based on visual acuity in the better eye. The psychometric properties of the questionnaire were examined by both traditional validation methods and Rasch analysis. RESULTS: Results of traditional validation analyses showed that the Chinese version of NEI-VFQ-25 obtained satisfactory validity and reliability, and was able to discriminate among older adults with different severities of visual impairment. Cronbach alpha coefficients for multi-item subscales were all above 0.70 for the whole sample. Results of Rasch analysis revealed significant misfits of some items to the Rasch model. CONCLUSIONS: These results suggest that both the conventional psychometric properties and potential weakness of the Chinese version of NEI-VFQ-25 are similar to those of the English version. The significant limitations of the questionnaire may limit the application of the whole questionnaire in the future.

Empirical study on clique-degree distribution of networks.

The community structure and motif-modular-network hierarchy are of great importance for understanding the relationship between structures and functions. We investigate the distribution of clique degrees, which are an extension of degree and can be used to measure the density of cliques in networks. Empirical studies indicate the extensive existence of power-law clique-degree distributions in various real networks, and the power-law exponent decreases with an increase of clique size.

[Treatment of an infant with severe neonatal hypoxic-ischemic encephalopathy sequelae with transplantation of human neural stem cells into cerebral ventricle].

OBJECTIVE: Severe newborn hypoxic-ischemic encephalopathy (HIE) has a very high rate of disability and no effective treatment is available. The present study aimed to preliminarily evaluate the effects of human neural stem cell transplantation in treatment of severe neonatal HIE. METHODS: The patient was a 75-day old male infant with sequelae of severe HIE who had highly delayed development of intelligence and movement and myotonia. MRI showed multiple cerebromalacia and encephalatrophy. Cells obtained from the forebrain of an 11-week old fetus were cultured and amplified for 15 days. And then the human fetal neural stem cells were injected into cerebral ventricle of this infant. RESULTS: Twenty eight days after transplantation, remarkable improvement occurred not only in his myotonia but also in his intelligence and movement, which became similar to those of the normal infants of the same age. Positron emission tomography (PET) showed significantly increased radioactivity at temporal and occipital lobes which suggested that the cellular metabolism had increased greatly. CONCLUSION: The short-term effect of NSCs transplantation on the infant with severe HIE sequelae was significant. PET suggested that the implanted NSCs survived. Many more studies are needed to evaluate long-term effects of NSC transplantation in treatment of HIE.