Demographic and lifestyle factors associated with dry eye disease in China: A cross-sectional multi-center study.

PURPOSE: Associations were assessed between demographic/lifestyle factors and tear film breakup time (TBUT) defined dry eye disease (DED) in China. METHODS: The cross-sectional study involved 50,280 subjects (54 ± 17 y) in 217 clinics (25 provinces). Data included sleep disorders; digital screen exposure; and use of cosmetics, contact lenses, and eye drops (for asthenopia). Clinical examinations included TBUT; Schirmer I test; meibomian gland plug status. TBUT-defined DED was TBUT <10 seconds, with TBUT ≤5 seconds also considered (i.e., short TBUT-type DED), either unilateral or bilateral. RESULTS: TBUT-defined DED was present in 81.6% overall. The highest rates were in those 71 years or older, living in the north, with chronic daily sleep disorder, or daily cosmetic application; or daily digital screen exposure for 5 years, contact lenses 4 hours, or 3 months eye drops. Compared with those without TBUT-defined DED, those with TBUT-defined DED showed lower Schirmer I results and more severe meibomian gland plug status (each, P <0.001). Independent risk factors of DED were: aging; living in the southwest; daily digital screen exposure ≥3 hours; and occasional cosmetic use. Risk factors of DED TBUT ≤ 5 s were: living in the southwest; wearing contact lenses (>3 y); and using eye drops. Rates of unilateral and bilateral DED were comparable. CONCLUSIONS: DED in China is more likely in the aged and those in the north/southwest. DED rates increase with digital screen exposure, and use of cosmetics, contact lenses, or eye drops for asthenopia. Unilateral DED should be treated as promptly as bilateral.

San-Huang-Yi-Shen Capsule Ameliorates Diabetic Nephropathy in Rats Through Modulating the Gut Microbiota and Overall Metabolism.

San-Huang-Yi-Shen capsule (SHYS) has been used in the treatment of diabetic nephropathy (DN) in clinic. However, the mechanisms of SHYS on DN remain unknown. In this study, we used a high-fat diet (HFD) combined with streptozotocin (STZ) injection to establish a DN rat model. Next, we used 16S rRNA sequencing and untargeted metabolomics to study the potential mechanisms of SHYS on DN. Our results showed that SHYS treatment alleviated the body weight loss, hyperglycemia, proteinuria, pathological changes in kidney in DN rats. SHYS could also inhibite the oxidative stress and inflammatory response in kidney. 16S rRNA sequencing analysis showed that SHYS affected the beta diversity of gut microbiota community in DN model rats. SHYX could also decrease the Firmicutes to Bacteroidetes (F to B) ratio in phylum level. In genus level, SHYX treatment affected the relative abundances of Lactobacillus, Ruminococcaceae UCG-005, Allobaculum, Anaerovibrio, Bacteroides and Candidatus_Saccharimonas. Untargeted metabolomics analysis showed that SHYX treatment altered the serum metabolic profile in DN model rats through affecting the levels of guanidineacetic acid, L-kynurenine, prostaglandin F1α, threonine, creatine, acetylcholine and other 21 kind of metabolites. These metabolites are mainly involved in glycerophospholipid metabolism, tryptophan metabolism, alanine, aspartate and glutamate metabolism, arginine biosynthesis, tricarboxylic acid (TCA) cycle, tyrosine metabolism, arginine and proline metabolism, arginine and proline metabolism, phenylalanine, tyrosine and tryptophan biosynthesis, phenylalanine metabolism, and D-glutamine and D-glutamate metabolism pathways. Spearman correlation analysis showed that Lactobacillus, Candidatus_Saccharimonas, Ruminococcaceae UCG-005, Anaerovibrio, Bacteroides, and Christensenellaceae_R-7_group were closely correlated with most of physiological data and the differential metabolites following SHYS treatment. In conclusion, our study revealed multiple ameliorative effects of SHYS on DN including the alleviation of hyperglycemia and the improvement of renal function, pathological changes in kidney, oxidative stress, and the inflammatory response. The mechanism of SHYS on DN may be related to the improvement of gut microbiota which regulates arginine biosynthesis, TCA cycle, tyrosine metabolism, and arginine and proline metabolism.

Analysis of Clinical and Regional Distribution Characteristics of Obstructive Meibomian Gland Dysfunction in China: A Multicenter Study.

Purpose: To analyze the clinical and regional distribution characteristics of obstructive meibomian gland dysfunction (OMGD) in China. Methods: A total of 2900 patients (2900 eyes) diagnosed with OMGD were enrolled in this multicenter, cross-sectional, observational study. The Ocular Surface Disease Index (OSDI), tear film breakup time (FBUT), Schirmer test (SI), lipid layer thickness (LLT), OMGD grade, meibomian gland loss score (Meiboscore), meibum expressibility score (MES), meibum quality score (MQS), Lid margin abnormality score(LMS) and other tear film stability markers were evaluated. Results: The prevalence of dry eye in OMGD patients was 89%. There were gender differences among OMGD patients in the 30-39 and 50-59 years age groups (p < .05), and FBUT, Meiboscore, MES and MQS were significantly different among different OMGD grades (p < .05). There were significant differences in the detection indexes of OMGD patients in the six regions (p < .05), except LLT (p = .329). According to the Qinling-Huaihe River in China, OMGD patients were divided into the North Group (Shenyang and Beijing) and South Group (Wuhan, Changsha, Chongqing, and Chengdu). There was a significant difference in the detection indexes, except LLT (p = .600), between the two groups (p < .05). FBUT was significantly correlated with the OSDI (r = -0.131; p < .000). Meiboscore and LLT were significantly correlated with the OMGD grade (r = 0.299 and r = 0.106; p < .001). Age, LMS and MQS were significantly correlated with Meiboscore (r = 0.415, r = 0.256 and r = 0.328; p < .001). Conclusions: The prevalence of dry eye was high among OMGD patients. OMGD patients in different age groups may show different gender distributions. The symptoms of patients showed variation among subgroups with different OMGD grades and among different regions.

Establishment of a non-integrate iPS cell line CSUASOi002-A, from urine-derived cells of a female patient with macular corneal dystrophy carrying compound heterozygous CHST6 mutations.

We report the human induced pluripotent stem cell line (iPSC) CSUASOi002-A, generated from urine-derived cells (UCs) from a 51-year-old female patient carrying compound heterozygous mutations (c.62_63delTinsGA and c.C892T) in the carbohydrate sulfotransferase 6 gene (CHST6). This patient was from a Chinese family of three siblings with macular corneal dystrophy (MCD). Patient UCs were reprogrammed by electroporation using the episomal plasmids (OCT4, SOX2, KLF4, l-MYC, LIN28 and shP53). The human MCD-UiPS cell line CSUASOi002-A retained the disease-associated genotype, while expressed pluripotent stem cell markers and could be differentiated into cells of all three germ layers.