Prevalence of dry eye in people over 50 years old in Beichen district, Tianjin city: a cross-sectional population-based survey.

BACKGROUND: A cross-sectional population-based survey in the Beichen district of Tianjin was conducted to estimate the prevalence of dry eye disease (DED) among the population over 50 years old with Dry Eye Workshop (DEWS) II and Chinese expert consensus (CEC) criteria. METHODS: A total of 5791 subjects over 50 years old were enrolled. Ocular surface disease index (OSDI) questionnaire, lipid layer thickness (LLT), partial blink ratio (PBR), fluorescein tear film breakup time (FBUT), Schirmer I test (SIT), fluorescein staining, meibomian gland dropout, meibomian gland expression scores (MES) and quantity scores (MQS) was assessed. Additionally, basic information, weight, disease history, living habits, anxiety, and depression condition were collected. RESULTS: According to the CEC, the prevalence of DED was 39.0%, whereas 44.0% based on DEWS II. The prevalence of DED increased with age and was substantially greater among women (41.1%, 95% CI, 39.5-42.6%) than males (35.1%, 95% CI, 33.1 -37.2%) (p < 0.001). Furthermore, the severity of DED was more severe in women (p = 0.006). The associated risk factors were age, female, depression, smoking, insomnia, and glaucoma. On the other hand, 53.6% of these populations were diagnosed as asymptomatic DED, and the morbidity was higher in males (p = 0.007). CONCLUSIONS: The prevalence of DED in China was relatively high, which was associated with aging, female(sex), depression, smoking and sleep problems. Hence, it is crucial for clinicians and caregivers to be aware of the existence of asymptomatic DED within the susceptible population.

Effect of PPARγ on oxidative stress in diabetes-related dry eye.

Oxidative stress is closely associated with diabetes and can cause free radical accumulation and eventually lead to ocular surface tissue damage. The purpose of this study was to investigate peroxisome proliferator-activated receptor-γ (PPARγ) expression in the lacrimal gland (LG), meibomian gland, and cornea of diabetes-related dry eye mice and whether the PPARγ agonist rosiglitazone can alleviate the oxidative stress of the ocular surface, thereby improving the condition of diabetes-related dry eye. Quantitative RT-PCR (Q-PCR) showed that the PPARγ, catalase, glutathione peroxidase 3, and heme oxygenase-1 (HO-1) mRNA expression levels in the LG of diabetes-related dry eye mice decreased at 8 and 12 weeks. In addition, the increased levels of oxidative stress were confirmed by western blot. Although the mRNA expression levels of antioxidant enzymes in the cornea and meibomian gland decreased at 8 weeks, some of them recovered by 12 weeks. Rosiglitazone alleviated ocular surface damage and increased corneal sensitivity and tear production in diabetes-related dry eye mice. Moreover, the reactive oxygen species accumulation was reduced and the PPARγ, HO-1, and glutathione peroxidase 3 mRNA expression levels were increased in the LG. The PPARγ, HO-1, translocase of the outer membrane 20, and mitochondrial transcription factor A protein levels were also significantly increased. These results demonstrated that rosiglitazone reduced oxidative stress in the LG of diabetes-related dry eye mice, at least in part, by activating PPARγ to up-regulate antioxidant enzyme expression.

Safety and Efficacy of the Phototherapeutic Keratectomy for Treatment of Recurrent Corneal Erosions: A Systematic Review and Meta-Analysis.

BACKGROUND: Phototherapeutic keratectomy (PTK) has been increasingly used to treat severe recurrent corneal erosion syndrome (RCES) patients who do not respond to other treatments. However, the efficacy and complication of each study are currently uncertain due to varying rates. OBJECTIVES: The objective of this study was to investigate the safety and efficacy of the PTK for recurrent corneal erosions. METHODS: This article performed a systematic literature research in Cochrane, Embase, PubMed, Scopus, and the Web of Science for the literature on PTK treatment of RCES until December 20, 2022. The extracted data including recurrence rate and the adverse event rate were used for meta-analysis. RESULTS: The recurrence rate was 18% (95% CI, 13%-24%) (129/700 eyes). Subgroup analysis showed that the RCE recurrence was 17% (95% CI, 9%-24%) after trauma and 22% (95% CI, 11%-32%) in the corneal dystrophy group. Treatment-related adverse events included subepithelial haze, hyperopic shift, and decrease of the best spectacle-corrected visual acuity. In this study, the incidence of these events was 13% (95% CI, 6%-21%), 20% (95% CI, 11%-28%), and 11% (95% CI, 5%-16%), respectively. CONCLUSIONS: PTK represented a valuable treatment option for patients with recurrent corneal erosions, especially those with traumatic injuries, which had minimal side effects.

Efficacy and Safety evaluation of a single thermal pulsation system treatment (Lipiflow®) on meibomian gland dysfunction: a randomized controlled clinical trial.

PURPOSE: Evaluate the efficacy and safety of LipiFlow® thermal pulsation treatment system compared with lid massage combined warm compress in Chinese patients with meibomian gland dysfunction (MGD). METHODS: Patients (n = 100 eyes, 50 subjects) diagnosed with MGD were recruited for this prospective, randomized, 3-month clinical trial. In Lipiflow group, patients (n = 50 eyes) received a single LipiFlow® thermal pulsation system treatment. In warm compress group, patients (n = 50 eyes) underwent warm compress daily for two weeks after an initial manual lid massage. Patients' symptoms were evaluated using Standard Patient Evaluation for Eye Dryness (SPEED) questionnaire. Safety parameters included best-corrected visual acuity (BCVA), intraocular pressure (IOP) and objective parameters including meibomian glands yielding lipid secretion (MGYLS) number, meibomian glands secretion (MGS) score, lipid layer thickness (LLT), tear-film breakup time (TBUT), corneal fluorescein staining (CFS) were measured and presented from baseline and to 3 months post-treatment. RESULTS: Baseline parameters in both groups were comparable (p > 0.05). SPEED score and TBUT improved in two groups from baseline to 3 months. MGYLS number, MGS score, LLT improved in LipiFlow group and these improvements were maintained with no significant regression at 3 months. CFS showed significant improvement in warm compress group at 1 month compared with LipiFlow group. Moreover, the correlation analysis indicated LLT was positively correlated with TBUT, MGS score, and MGYLS number. CONCLUSION: A single 12-min LipiFlow treatment is an effective therapy for MGD patients and can achieve improvements in symptoms alleviation and meibomian gland lipid secretion function lasting for at least 3 months.

NIR Photothermal-Responsive Shape Memory Polyurethane with Protein-Inspired Aggregated Chymotrypsin-Sensitive Degradable Domains.

Biodegradable shape memory polymers are promising biomaterials for stents used in minimally invasive surgical procedures such as intestinal stents. Herein, a series of biodegradable shape memory polyurethanes (SMPUs) containing a novel phenylalanine-derived chain extender (PHP) are synthesized. Inspired by the fact that the function of biomacromolecules such as proteins is rich and varied because of the multiple combinations of the amino acid in highly evolved biosystems, this study finds that the sequence distribution of PHP in SMPU will also have a great influence on the phase structure and degradation behavior, especially the difference of surface morphology caused by degradation. Considering that the transition temperature (Ttrans ) of SMPU obtained is higher than physiological temperature, oxidized carbon black (OCB) with the ability of photothermal conversion is introduced into SMPU, which can not only endow SMPU with near-infrared response shape recovery characteristics, but also enhance phase separation degree and mechanical properties of them. SMPU/OCB composites show excellent shape memory effect and rapid photothermal response, and they can be degraded by chymotrypsin with an adjustable degradation rate. These SMPU/OCB composites show broad potential for application as intestinal stents.

Clinical observations of EVO-ICL implantation and changes in corneal astigmatism using a modified technique.

BACKGROUND: Implantable collamer lens (ICL) surgery techniques are constantly progressing. The purpose of this study was to investigate the application effect of the modified technique and its impact on the change in corneal astigmatism in EVO-ICL surgery. METHODS: The analysis of retrospective cohort data included 153 eyes of 81 patients with myopia from July 2018 to May 2020. An EVO-ICL was inserted by modified surgical skills, including a single 3.0 mm corneal incision and no ophthalmic viscosurgical device (OVD) before the insertion of the ICL (modified technique group: 41 cases, 80 eyes) and standard procedure (standard technique group: 40 cases, 73 eyes). Early postoperative intraocular pressure (IOP) was monitored at 2 and 24 h. IOP, corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), vault, and anterior chamber depth (ACD) were measured 1, 6, and 12 months following the initial examination. The corneal endothelial cell density (ECD) was monitored at 6 and 12 months after the operation. Surgically induced astigmatism (SIA) in the total, anterior, and posterior corneal surfaces was analysed 1 month after the operation. RESULTS: No serious complications were detected. The two groups had no difference in visual outcomes, ICL vaults, or ACD at any time point (P > 0.05). Two hours postoperatively, IOP was significantly lower in the modified technique group (16.22 ± 2.22 vs. 18.37 ± 1.92 mmHg, P < 0.05) than in the standard technique group. IOP decreased gradually after 24 h to preoperative levels. The postoperative IOP remained stable over a 12-month period. The ECD at 6 and 12 months was not significantly different between the groups (P > 0.05). SIA in the total, anterior, and posterior corneal surfaces were assumed to have no clinically meaningful differences between groups at one month after operation (P > 0.05). CONCLUSIONS: The modified technique is efficient and safe, producing comparable visual and structural outcomes without adversely affecting ECD, and reduces fluctuations in IOP at the early postoperative stages. The auxiliary incision in the standard technique does not increase corneal SIA, which is also a factor to consider for inexperienced surgeons.

Melatonin and its metabolite N(1)-acetyl-N(1)-formyl-5-methoxykynuramine improve learning and memory impairment related to Alzheimer's disease in rats.

The aim of this study was to investigate the effect of melatonin (MT) and its metabolite N(1)-acetyl-N(2)-formyl-5-methoxykynuramine (AFMK) on Alzheimer-like learning and memory impairment in rats intracerebroventricularly injected with streptozotocin (STZ). The results showed that the escape latency of the STZ group was longer than that of the control (CON), MT, and AFMK groups. Increased levels of hyperphosphorylated tau, neurofilament proteins, and malondialdehyde and decreased superoxide dismutase levels were observed in the brains of the rats from the STZ group compared with the brains of the rats from the CON, MT, AFMK high and low group. These results suggest that exogenous MT and AFMK can improve memory impairment and downregulate AD-like hyperphosphorylation induced by STZ, most likely through their antioxidation function. Meanwhile, we found that an equal dose of AFMK had a stronger effect than that of MT. Our results indicate that MT and its metabolite AFMK represent novel treatment strategies for Alzheimer's disease.

Adsorption and Morphology Analysis of Bovine Serum Albumin on a Micropillar-Enhanced Quartz Crystal Microbalance.

The adsorption of bovine serum albumin (BSA), a widely used blood plasma protein, onto poly(methyl methacrylate) (PMMA) surface is a fundamental phenomenon attracting increasing interests in molecular biology, cell culture, immunology, diagnostics, and vaccinology. The nanostructured PMMA surfaces have shown a considerable effect on the BSA adsorption process. However, the effect of microstructures (e.g., micropillars) on BSA adsorption has seldom been studied. This research reports on the development of an acoustic resonance based method to explore the adsorption of BSA proteins on PMMA micropillars in terms of surface coverage, apparent binding constants, and pH-induced morphology variation. A theoretical model is developed to understand the frequency changes of QCM induced by BSA adsorption by taking into consideration the effects of the hydrodynamic force and an equivalent BSA/liquid layer formed on the micropillar surface. In addition, it was found that the resonance of micropillars with a quartz crystal microbalance (QCM) substrate significantly influenced BSA adsorption on micropillar surfaces.

Exploration of efficacy and mechanism of 0.05% cyclosporine eye drops (II) monotherapy in allergic conjunctivitis-associated dry eye.

PURPOSE: To explore the efficacy and relevant mechanism of 0.05% cyclosporine A (CsA) eye drops (II) monotherapy in patients with allergic conjunctivitis-associated dry eye (ACDE). METHODS: Prospective, randomized, controlled study. Fifty-three patients with mild-to-moderate ACDE were randomly assigned to two groups. The CsA group received 0.05% CsA eye drops (II) monotherapy four times daily. The control group received 0.1% olopatadine twice daily combined with 0.1% preservative-free artificial tears four times daily. Clinical symptoms and signs, tear total IgE, and lymphotoxin-α (LT-α) concentrations were assessed at pre- and post-treatment days 7, 30, and 60. And we further measured six tear cytokines levels using a microsphere-based immunoassay. RESULTS: The CsA group showed significant improvement in symptoms (Ocular Surface Disease Index and itching scores) and signs (conjunctival hyperaemia, conjunctival oedema, conjunctival papillae, tear break-up time (TBUT), corneal fluorescein staining, and goblet cell density) at each follow-up period compared to pre-treatment (all P < 0.050). And its improvement in itching scores (P7th < 0.001, P30th = 0.039, and P60th = 0.031) and TBUT (P7th = 0.009, P30th = 0.003, and P60th = 0.005) was more significant than the control group at all follow-up periods. The tear total IgE, interleukin (IL)-5, IL-6, periostin, eotaxin-3, and MMP-9 levels significantly decreased in the CsA group at day 60 after treatment (all P < 0.050). And the changed values in tear total IgE were positively correlated with the change in itching scores. CONCLUSIONS: 0.05% CsA eye drops (II) monotherapy can rapidly improve the symptoms and signs, especially in ocular itching and TBUT, in patients with ACDE. And its efficacy is superior to 0.1% olopatadine combined with artificial tears. Moreover, CsA downregulates the expression levels of tear inflammatory cytokines, including tear total IgE, IL-5, IL-6, periostin, eotaxin-3, and MMP-9. Among that, the reduction in tear total IgE levels may reflect the improvement of ocular itching.

Study on detonation characteristics of pulverized coal and evolution law of detonation residue.

This study explores the detonation characteristics and compositional changes of pulverized coal, focusing on its use in Rotary Detonation Wave (RDW) technologies. While pulverized coal has shown high fuel efficiency in RDW settings, transitioning from theory to practical detonation engineering presents substantial scientific and technical hurdles. A key issue is the reprocessing of detonation byproducts for in-situ coal mine gob filling, a topic that has received little attention. Utilizing advanced methods like X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR), this paper investigates the micro-morphology, composition, and aromatic structures of gas-solid products pre and post-detonation at the Tashan Coal Mine's 2305 working face. Results indicate that coal dust from the underground mining face has enhanced detonation characteristics, with the addition of coal powder fuel extending the gas detonation limits. This benefits economic aspects by reducing reliance on gas fuel and lowering detonation fuel costs. The highest recorded detonation wave velocity was 2450 m/s, 14.8% greater than that of coal dust from external sources, suggesting more effective energy release and pressure gain. Furthermore, the study links detonation combustion intensity to coal's aromatic properties, noting a post-detonation aromaticity index (I) of 0.4941. This indicates an improvement in the aromatic structure under high-temperature conditions, vital for coal's reactivity and energy efficiency in RDW applications. This research not only deepens the understanding of coal dust combustion mechanisms but also advances clean coal utilization and deep coal fluidization mining, addressing significant RDW technological challenges.

Effects of climate factors and Demodex infestation on meibomian gland dysfunction-associated dry eye diseases.

We examined the effects of climatic factors and Demodex infestations on meibomian gland dysfunction (MGD)-associated dry eye disease (DED) in a cross-sectional study. This study included 123 patients from Tianjin and Chengdu regions, and climate factors and the Air Quality Index (AQI) were recorded for one year. Ocular surface parameters and Demodex infestations were evaluated using various tests. Significant differences in all climatic factors and AQI were observed between Tianjin and Chengdu (P < 0.01), and ocular surface parameters also differed significantly between the two regions (P < 0.05). Temperature, relative humidity, and precipitation positively correlated with tear break-up time (BUT), meibum gland expressibility, and lid margin irregularity but negatively correlated with lissamine green staining scores (P < 0.05). Wind speed and atmospheric pressure positively correlated with corneal fluorescein staining and lissamine green staining but negatively correlated with BUT and lid margin irregularity (P < 0.05). AQI positively correlated with DED symptoms and corneal findings but negatively correlated with tear film stability and meibomian gland characteristics (P < 0.05). Demodex infestation was only positively correlated with meibum quality scores (P < 0.05). Our findings suggest that geographic climates influence ocular surface characteristics in MGD-associated DED, with daily precipitation potentially playing a significant role, and Demodex infestation contributes to meibum gland degeneration.

Pressure Characteristics and Secondary Ignition Effects of Gas Produced in RDE Using Lignite and Anthracite/CH4 Fuel.

This study aims to address the energy efficiency release and environmental impact of coal dust in rotating detonation engines (RDEs) by monitoring the detonation characteristics of lignite and anthracite in methane gas-solid mixtures using high-precision sensor technology. Experimental results indicate that the peak detonation pressure of anthracite is 1.4% higher than that of lignite, and its detonation wave propagation speed is at least 5.5% faster, suggesting that anthracite exhibits more stable and efficient fuel energy release characteristics during detonation. Additionally, the sensor technology enabled detailed recording of pressure fluctuations and gas composition changes during the detonation process, providing accurate data for assessing and controlling emissions of harmful gases such as carbon monoxide and carbon dioxide. These data are crucial for designing more efficient and environmentally friendly coal dust detonation systems, enhancing mine safety and environmental protection. The outcomes of this research not only advance technological progress in the field of energy science but also address efficiency and environmental issues in industrial applications, offering significant support for achieving safer and more sustainable energy production methods.

Experimental Study and Application Prospects of Coal Dust/Methane/Oxygen Pulse Detonation Performance: Coal Dust Equivalence Ratio and Types.

In order to achieve reliable application of coal in pulse detonation combustion chambers, this study explored the influence mechanism of equivalence ratio and coal type (lignite, anthracite) on the detonation characteristics of coal/methane/oxygen methane-solid two-phase fuel. A high-energy ignition device was used to ignite the preblast methane fuel, and the high-temperature and high-pressure energy generated directly initiated the detonation of coal/methane/oxygen methane-solid two-phase fuel. The experimental results are as follows: (1) The maximum detonation pressure of coal/methane/air fuel is positively correlated with the initial pressure. With the increase of the φglobal, the maximum detonation pressure of the two types of coal gradually increases. To be specific, when the φglobal rises from 0.5 to 1.6, the sensitivity of lignite and anthracite to the maximum detonation pressure with respect to the initial pressure increases from 4.56 to 6.11 and 5.48, respectively; (2) In terms of detonation flame and maximum pressure wave velocity, anthracite shows better dynamic performance than lignite. The maximum velocity of detonation flame and pressure wave is achieved when the φglobal is 1.4. (3) In terms of detonation thrust performance, as the φglobal increases from 0.5 to 1.6, the rate of increase in average thrust of the two types of coal first increases and then decreases. Compared with lignite, anthracite has a wider time domain and higher peak value in the average thrust curve and the generated detonation wave displays a greater impulse. The experimental data and conclusions obtained in this study are of practical significance for realizing the engineering application of pulverized coal detonator power generation.

Clinical ocular surface characteristics and expression of MUC5AC in diabetics: a population-based study.

OBJECTIVES: To investigate the clinical characteristics and the expression of mucin 5AC (MUC5AC) in in diabetic and non-diabetic subjects with or without dry eye disease. METHODS: A total of 399 participants (796 eyes) aged 50-80 years were enrolled in this study. Participants were divided into 4 groups: non-diabetic without dry eye group (normal group), non-diabetic with dry eye group, diabetic without dry eye group and diabetic with dry eye group. Demographic information, fasting plasma glucose (FBG), and glycated haemoglobin A1C (HbA1C) data were collected. Additionally, ocular surface disease index (OSDI) questionnaire, signs of dry eye, tear osmolarity, and meibomian glands were evaluated. Tear MUC5AC expression and conjunctival goblet cells density (GCD) were tested. RESULTS: Compared with non-diabetic with dry eye group, diabetic with dry eye group showed significantly lower tear film osmolarity (TFO), but higher corneal fluorescein and conjunctival lissamine green staining scores. In comparison with diabetic without dry eye group, diabetic with dry eye group showed significantly higher TFO, corneal fluorescein and conjunctival lissamine green staining scorers. The MUC5AC concentration and GCD of diabetic with dry eye group was significantly lower than those of the non-diabetic with dry eye group. Diabetic subjects with higher HbA1c levels (≥7.8%) showed higher TFO and shorter fluorescein tear break time. CONCLUSION: Diabetics with dry eye exhibited notably higher corneal fluorescein and conjunctival lissamine green staining scores. Conjunctival goblet cells and MUC5AC were significantly reduced in diabetics. Higher TFO was associated with the duration of diabetes and HbA1c levels.

Breaking Down the Barriers of Drug Resistance and Corneal Permeability with Chitosan-Poly(ethylene glycol)-LK13 Peptide Conjugate to Combat Fungal Keratitis.

Fungal keratitis (FK) is a leading cause of preventable blindness and eye loss. The poor antifungal activity, increased drug resistance, limited corneal permeability, and unsatisfactory biosafety of conventional antifungal eye drops are among the majority of the challenges that need to be addressed for currently available antifungal drugs. Herein, this study proposes an effective strategy that employs chitosan-poly(ethylene glycol)-LK13 peptide conjugate (CPL) in the treatment of FK. Nanoassembly CPL can permeate the lipophilic corneal epithelium in the transcellular route, and its hydrophilicity surface is a feature to drive its permeability through hydrophilic stroma. When encountering fungal cell membrane, CPL dissembles and exposes the antimicrobial peptide (LK13) to destroy fungal cell membranes, the minimum inhibitory concentration values of CPL against Fusarium solani (F. solani) are always not to exceed 8 µg peptide/mL before and after drug resistance induction. In a rat model of Fusarium keratitis, CPL demonstrates superior therapeutic efficacy than commercially available natamycin ophthalmic suspension. This study provides more theoretical and experimental supports for the application of CPL in the treatment of FK.

ICL Postimplantation Decentration and Tilt in Myopic Patients with Primary Iridociliary Cysts.

Purpose: To observe the decentration and tilt of implantable collamer lens (ICL) as well as possible visual effects postimplantation in primary iridociliary cysts. Methods: The present investigation was a retrospective cohort study. All 48 patients (91 eyes) who underwent ICL surgery at the Center of Refraction Surgery of Tianjin Medical University Eye Hospital between July 2018 and May 2020 were split into two groups based on the absence or presence of primary iridociliary cysts established by ultrasonic biological microscopy (UBM) examination. Intraocular pressure (IOP), corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), anterior chamber angle (ACA), anterior chamber volume (ACV), and anterior chamber depth (ACD) were recorded preoperatively and postoperatively at 1, 6, and 12 months. Additionally, we performed an analysis of the ICL vault, decentration, and tilt using a rotating Scheimpflug Oculus Pentacam camera system at 1, 6, and 12 months after surgery. Results: No serious complications were observed. Significant postoperative improvement (P < 0.05) of UDVA was established in the two studied groups; however, we did not observe statistically significant intergroup differences (P > 0.05) throughout the entire research period. In each group, the preoperative ACA, ACV, and ACD were statistically significantly reduced (P < 0.05), but no such decrease was established between their postoperative values (P > 0.05). We observed no statistical differences between both groups with regard to their values of IOP, ACA, ACV, ACD, ICL vault, ICL decentration, and tilt at 1, 6, and 12 months after surgery. Similarly, no statistically significant within-group correlation (P > 0.05) of the decentration of ICL and the tilt and the CDVA values was established. Conclusion: No postimplantation effect of ICL with a central hole on vision was established in myopia patients with primary iridociliary cysts, within certain limits of ICL decentration and tilt values.

Characteristics and factors associated with the position of the haptic after ICL V4C implantation.

PURPOSE: To assess the position of implantable collamer lens (ICL) haptic after ICL V4C implantation using standardized panoramic ultrasound bimicroscopy (UBM), to analyze its characteristics, associated factors, and the relationship with the clinical vault quantitatively. SETTING: Hankou Aier Eye Hospital, Wuhan, Hubei, China. DESIGN: Cross-sectional study. METHODS: 167 subjects (323 eyes) implanted with ICL V4C who had a 3-month follow-up with UBM examination were included in this study. The relative position of ICL to the adjacent structure and ICL haptic-related parameters (the final tip point of ICL haptic [ftICL haptic], measured from the scleral spur to the final tip of the ICL haptic, the posterior of the ICL to ICL haptic [ICL arc], measured from the posterior surface of the ICL to the ICL haptic plane, and the height of the crystalline lens from the ICL haptic (lens arc), measured from the anterior surface of the crystalline lens to the ICL haptic plane and other parameters), were estimated on the UBM image. Eyes were divided into 3 subgroups according to the ftICL haptic (Group 1: ≤0.5 mm; Group 2: 0.5 to 1.0 mm; and Group 3:≥1.0 mm, respectively), and the factors associated with the ICL haptic-related parameters and their impact on the clinical vault were evaluated. RESULTS: The haptics could be imaged in the ciliary sulcus, on the ciliary body, and under the ciliary body in 629 (48.7%), 525 (40.6%), and 138 (10.7%) eyes, respectively. The ftICL haptic and the summation of ICL arc and lens arc showed a correlation with the clinical vault ( r = -0.34, P = .00; r = 0.87, P = .00). When the ftICL haptic results were divided into 3 groups, the percentage of eyes that exhibited clinical vault >750 µm were lowest in Group 3. Multivariate regression analysis showed spherical equivalent, white-to-white (WTW), anterior chamber volume (ACV) and iris-ciliary angle (ICA); the difference between the implanted ICL size and horizontal sulcus-to-sulcus (ICL size-STS) were associated with the ftICL haptic. The IOP, WTW, ACV, and the ICL size-STS were significantly associated with ICL arc, while the ICA and lens rise were associated with lens arc. CONCLUSIONS: The position of ICL haptic was associated with the clinical vault. Its quantitative evaluation may provide valuable information to help clinicians to select the best ICL size before surgery and understand the formation of clinical vault after surgery.

Overcoming the Stromal Barrier of the Cornea with a Peptide Conjugate Nano-Assembly to Combat Fungal Keratitis.

Fungal hyphae deeply invade the cornea in fungal keratitis. The corneal stroma hinders the infiltration of antifungal drugs and reduces their bioavailability. Here, this work reports a peptide conjugate nano-assembly that permeates the stroma and kills the pathogen without irritating the ocular cornea. The hydrophilic surface of the nano-assembly ensures deep permeation into the stroma. When encountering a fungal hyphal cell, the nano-assembly disassembles and exposes the α-helical peptide to destroy the fungal membrane, thus inactivating the pathogen. In a rabbit model of fungal keratitis, the nano-assembly exhibits a better therapeutic effect than commercially available natamycin ophthalmic suspension. Peptide conjugates with a nano-assembled structure and assembly-disassembly behavior could serve as the foundation of a new therapy for fungal keratitis.

Identification of featured necroptosis-related genes and imbalanced immune infiltration in sepsis via machine learning.

Background: The precise diagnostic and prognostic biological markers were needed in immunotherapy for sepsis. Considering the role of necroptosis and immune cell infiltration in sepsis, differentially expressed necroptosis-related genes (DE-NRGs) were identified, and the relationship between DE-NRGs and the immune microenvironment in sepsis was analyzed. Methods: Machine learning algorithms were applied for screening hub genes related to necroptosis in the training cohort. CIBERSORT algorithms were employed for immune infiltration landscape analysis. Then, the diagnostic value of these hub genes was verified by the receiver operating characteristic (ROC) curve and nomogram. In addition, consensus clustering was applied to divide the septic patients into different subgroups, and quantitative real-time PCR was used to detect the mRNA levels of the hub genes between septic patients (SP) (n = 30) and healthy controls (HC) (n = 15). Finally, a multivariate prediction model based on heart rate, temperature, white blood count and 4 hub genes was established. Results: A total of 47 DE-NRGs were identified between SP and HC and 4 hub genes (BACH2, GATA3, LEF1, and BCL2) relevant to necroptosis were screened out via multiple machine learning algorithms. The high diagnostic value of these hub genes was validated by the ROC curve and Nomogram model. Besides, the immune scores, correlation analysis and immune cell infiltrations suggested an immunosuppressive microenvironment in sepsis. Septic patients were divided into 2 clusters based on the expressions of hub genes using consensus clustering, and the immune microenvironment landscapes and immune function between the 2 clusters were significantly different. The mRNA levels of the 4 hub genes significantly decreased in SP as compared with HC. The area under the curve (AUC) was better in the multivariate prediction model than in other indicators. Conclusion: This study indicated that these necroptosis hub genes might have great potential in prognosis prediction and personalized immunotherapy for sepsis.

[Clinical research of the phakic foldable angle-supported intraocular lens for the correction of high myopia].

OBJECTIVE: To assess the safety, efficacy, predictability and stability of the phakic foldable angle-supported intraocular lens (IOL) (CACHET IOL, Alcon Inc., USA.) for correction of high-to-extremely high myopia in adults. METHODS: In this prospective study, 29 eyes of 15 patients were implanted with CACHET phakic angle-supported IOL and followed for 1 year postoperatively. Preoperative manifest refractive sphere was -12.08 ± 2.44 diopters (D). Visual acuity(uncorrected visual acuity, UCVA; best spectacle-corrected visual acuity, BSCVA), predictability and stability of manifest refraction spherical equivalent (MRSE), adverse events, and endothelial cell density were analyzed primarily during 1-year of follow-up. RESULTS: After 1 year of follow-up, a BSCVA of 0.6 or better was achieved by 100% of eyes; 9.7% (26/29) had a BSCVA of 1.0 or better; no eyes lost ≥ 1 line BSCVA, 62.1%(18/29) had no change in lines of BSCVA, 31.0% (9/29) gained 1 line of BSCVA, 3.4% (1/29) gained 2 line of BSCVA, and 3.4% (1/29) gained more than 2 line of BSCVA; the safety index was 1.13 (1.08/0.96); UCVA of 1.0 or better was achieved by 58.6% (17/29), 100% had an UCVA of 0.5 or better, 86.2% (25/29) of eyes achieved a UCVA of 0.8 or better, and 93.1% (27/29) of eyes achieved a UCVA of 0.6 or better; the efficacy index was 1.03(0.99/0.96). The overall mean percentage change in endothelial cell density 1 year after surgery was -0.23% ± 4.80%. Five eyes (17.2%) had increased intraocular pressure (IOP) on the day of surgery. No pupil ovalization, pupillary block, or retinal detachment events were observed. Glare (6.9%, 2/29) and halo (13.8%, 4/29) mainly appeared in the first month after surgery, and had no influence on driving in night. CONCLUSIONS: After 1 year of follow-up, the implantation of phakic foldable angle-supported IOL was proved to be safe, effective and predictable with minimal complications in patients with high myopia. Due to the limitation of visiting time, long-term of clinical investigation is necessary to verify the safety and efficacy of this IOL.