Exploration of Protective Factors Affecting Postoperative Natural Pregnancy in Patients with Endometriosis.

Objective: This study aimed to analyze the factors affecting natural pregnancy in patients with endometriosis (EMs) and to identify corresponding nursing measures. Understanding these factors is crucial as it may offer insights into improving fertility outcomes and enhancing the overall well-being of individuals with EMs. By identifying effective nursing measures, we hope to contribute to the development of targeted interventions that can positively impact the reproductive health of these patients. Methods: The clinical data of 147 patients with EMs who were admitted to our hospital from April 2018 to April 2020 were retrospectively analyzed. The analysis included a comprehensive examination of various key factors and parameters, such as demographic information, disease severity, surgical outcomes, and postoperative complications. All patients underwent laparoscopic conservative surgery in our hospital, and the analysis was conducted over a follow-up period of 2 years after discharge. Results: The two groups exhibited significant differences in the following factors: (1) Factors with significant differences (P < .05): Age, dysmenorrhea, duration of menstrual cramps, history of uterine cavity operation, combined gynecological inflammation, r-AFS stage, postoperative GnRH-a treatment, and EFI score. (2) Factors with no significant differences (P > .05): Uterine fibroids, endometrial polyps, affected side of the lesion, and postoperative ovulation-inducing drugs. (3) Protective Factors for Postoperative Natural Pregnancy in EMs Patients (P < .05): No history of dysmenorrhea, postoperative GnRH-a treatment, and high EFI score. (4) Risk factors affecting natural pregnancy after EMs patients (P < .05): Age ≥ 35 years, duration of menstrual cramps < 3 days, history of uterine cavity operations ≥ 2 times, gynecological inflammation, and r-AFS stage III-IV. Conclusions: Regarding nursing measures based on patient information, clinical nursing intervention can be carried out by strengthening the education of related knowledge such as reproductive health, maintaining the patient's menstrual cycle, guiding patients to apply GnRH-a treatment, and designing individualized nursing care for patients with high-risk factors. Among there, continuous monitoring and follow-up care, particularly for patients with risk factors, can contribute to ongoing assessment and timely intervention. Regular check-ins with high-risk patients can facilitate early identification of potential challenges and enable the adjustment of care plans as needed. Furthermore, nurses should establish a schedule for regular check-ins with high-risk patients, facilitating ongoing communication and rapport-building. These interventions can help patients improve the probability of natural pregnancy after surgery.

Curative Effect of IKAP Nursing in Perioperative Nursing of Endometriosis Treated by Laparoscopic Surgery.

Objective: To evaluate the effectiveness of Information, Knowledge, Attitude, and Practice (IKAP) nursing in the perioperative care of endometriosis patients treated with laparoscopic surgery. Methods: A total of 100 patients with endometriosis who underwent laparoscopic surgery in our hospital from June 2020 to December 2021 were recruited and assigned to receive either routine care (control group) or IKAP care (observation group), with 50 cases in each group. Outcome measures included operative time, time-lapse before postoperative passing gas, length of hospital stay, self-rating anxiety scale (SAS), self-rating depression scale (SDS), Generic Quality of Life Inventory-74 (GQOLI-74) scores, and nursing outcomes. Results: Before nursing, the SAS, SDS, and GQOLI-74 scores of the two groups were comparable (P > .05). IKAP care resulted in significantly lower SAS and SDS scores, and higher GQOLI-74 scores than routine care (P < .05). IKAP care was associated with significantly shorter operative time, time-lapse before postoperative passing gas, and length of hospital stay compared to routine care (P < .05). Patients receiving IKAP care showed higher compliance, lower incidence of postoperative complications, and higher nursing satisfaction than those with routine care (P > .05). Conclusion: IKAP nursing shortens the length of hospital stay after laparoscopic surgery for endometriosis, mitigates patients' adverse emotions, reduces postoperative complications, and effectively improves patients' medication adherence and quality of life.

Effects of riboflavin/ultraviolet-A(UVA) scleral crosslinking on the mechanical behavior of the scleral fibroblasts of lens-induced myopia Guinea pigs.

Myopia is becoming increasingly severe, and studies have shown that the cellular mechanics of scleral fibroblasts are altered following myopia. Scleral UVA-Riboflavin Collagen Crosslinking（sCXL） is a promising treatment for myopia prevention and control of axial growth. Understanding the mechanical properties of scleral fibroblasts is crucial, as it influences the cellular response and limits the extent of molecular deformation triggered. Thus, our study aimed to investigate the effect of mechanical properties of scleral fibroblasts in a lens-induced myopic guinea pig model following sCXL. For this purpose, we performed the 0.1% riboflavin/UVA scleral crosslinking (365 nm,3 mW/cm2,30 min) in the right eyes of guinea pigs in Group CXL. In Group LIM, the right eyes were only administrated negative lens for 6 weeks. No treatment was performed in both eyes of the guinea pigs in group Control. The scleral fibroblasts were isolated and cultured from the scleral tissue at the cross-linking area in Group CXL and the corresponding area in Group LIM and control. The curve of the length of microtubules inhaled by cells under negative pressure was measured by a microaspiration-based isolation technique, and the equilibrium Young's modulus and apparent viscosity of scleral fibroblasts were calculated by formula fitting. The equilibrium Young's modulus of scleral fibroblasts in group CXL was significantly lower than that in the LIM group (P < 0.01, two-sample t-test between pairs）, and there was no significant difference between groups CXL and control. The results show that sCXL can effectively moderate the phenomenon that scleral fibroblasts are not easy to deform after myopia. The apparent viscosity modulus in the CXL group was higher than the groups' control and LIM. Taken together, our data demonstrate the biomechanics of the scleral fibroblasts altered after Riboflavin/UVA scleral collagen cross-linking in a lens-induced myopia model.

Corneal metabolic biomarkers for moderate and high myopia in human.

This study aimed to identify the corneal metabolic biomarkers for moderate and high myopia in human. We enrolled 221 eyes from 221 subjects with myopia to perform the femtosecond laser small incision lenticule extraction (SMILE) surgery. Among these, 71 eyes of 71 subjects were enrolled in the low myopic group, 75 eyes of 75 subjects in the moderate myopic group and 75 eyes of 75 subjects in the high myopic group. The untargeted metabolomics analysis was performed to analyze the corneal tissues extracted during the SMILE surgery using an ultra-high-performance liquid chromatography (UHPLC) coupled to a quadrupole time-of-flight (Q-TOF) mass spectrometry (MS). The one-way analysis of variance (ANOVA) was used to identify the different metabolites among the three myopic groups, the orthogonal partial least-squares discriminant analysis (OPLS-DA) model was used to reveal the different metabolites between moderate myopia and low myopia, and between high myopia and low myopia. The Venn gram was used to find the overlapped metabolites of the three datasets of the different metabolites. The stepwise multiple linear regression analysis was used to determine the metabolic molecules associated with manifest refractive spherical equivalents (MRSE). The Receiver Operating Characteristics (ROC) analysis was performed to reveal the corneal biomarkers for moderate and high myopia. The hub biomarker was further selected by the networks among different metabolites created by the Cytoscape software. A total of 1594 metabolites were identified in myopic corneas. 321 metabolites were different among the three myopic groups, 106 metabolites were different between high myopic corneas and low myopic corneas, 104 metabolites were different between moderate myopic corneas and low myopic corneas, and 30 metabolic molecules overlapped among the three datasets. The multivariate linear regression analysis revealed the myopic degree was significantly influenced by the corneal levels of azelaic acid, arginine-proline (Arg-Pro), 1-stearoyl-2-myristoyl-sn-glycero-3-phosphocholine, and hypoxanthine. The ROC curve analysis showed that azelaic acid, Arg-Pro and hypoxanthine were effective in discriminating low myopia from moderate to high myopia with the area under the curve (AUC) values as 0.982, 0.991 and 0.982 for azelaic acid, Arg-Pro and hypoxanthine respectively. The network analysis suggested that Arg-Pro had the maximum connections among these three biomarkers. Thus, this study identified azelaic acid, Arg-Pro and hypoxanthine as corneal biomarkers to discriminate low myopia from moderate to high myopia, with Arg-Pro serving as the hub biomarker for moderate and high myopia.

Comparisons of the protein expressions between high myopia and moderate myopia on the anterior corneal stroma in human.

PURPOSE: To investigate the differentially expressed proteins (DEP) between high myopia and moderate myopia on the anterior corneal stroma. METHODS: Tandem mass tag (TMT) quantitative proteomics was utilized to reveal proteins. DEPs were screened by the multiple change of more than 1.2 times or less than 0.83 and the P value < 0.05. The DEPs were functional annotated by Gene Ontology (GO) terms. Proteins and protein interaction (PPI) networks were conducted with String online tool. Parallel reaction monitoring (PRM) data processing was used to verify the TMT proteomics results. RESULTS: There are 36 DEPs between high myopia and moderate myopia on the anterior corneal stroma, of which 11 proteins are upregulated, 25 proteins are downregulated. The GO analysis demonstrated keratinocyte migration and structural constituent of cytoskeleton that are significantly changed with most of the proteins decreased in high myopic corneas. Keratin 16 (KRT16) and erythrocyte membrane protein band 4.1-like protein 4B are the only two proteins involved in both functions. The PPI analysis showed keratin type II cytoskeletal 6A (KRT6A) and KRT16 that have strong connections. Immunoglobulin lambda variable 8-61(IGLV8-61) and nicotinamide phosphoribosyl transferase (NAMPT) have consistent results with the TMT. CONCLUSIONS: The high myopic corneas have 36 DEPs compared to the moderate myopic corneas on the anterior corneal stroma. Keratinocyte migrations and structural constituent of cytoskeleton are weakened in high myopic corneas, which may partly account for the lower corneal biomechanics in high myopic eyes. The lower expressed KRT16 plays important roles in high myopic corneas.

Corneal biomechanical characteristics following small incision lenticule extraction for myopia and astigmatism with 3 different cap thicknesses.

BACKGROUND: The design of cap thickness for small incision lenticule extraction (SMILE) plays a role in post-laser vision correction (post-LVC) corneal biomechanics. This study aimed to compare the corneal biomechanical characteristics following SMILE with different cap thicknesses of 110 µm, 120 µm, and 130 µm for myopia and myopic astigmatism correction. METHODS: Seventy-five patients (146 eyes) who underwent SMILE with designed cap thickness of 110 µm, 120 µm, and 130 µm were recruited at the Eye Center of Beijing Tongren Hospital between August 2020 and November 2021. Visual acuity, refraction, and corneal biomechanical parameters were measured preoperatively, 1 week and 1, 3, 6 months postoperatively. One-way analysis of variances (ANOVA) with Bonferroni correction or Kruskal-Wallis test was performed to compare the parameters among different groups. Repeated-measures analysis of variance with Bonferroni correction or Friedman test was applied for comparing the parameters within different follow-up times. RESULTS: Uncorrected distance visual acuity of 110-µm group was better only at 1-week and 1-month postoperatively (P = 0.012, 0.037). There were no significant differences in spherical equivalent, nor in Corvis biomechanical index-laser vision correction (CBI-LVC). All the parameters reached stability at 3-month postoperatively. Integrated radius (IR) and deformation amplitude ratio 2 mm (DA ratio 2 mm) in 120-µm and 130-µm groups were higher than 110-µm group at 1-month postoperatively (P = 0.019, 0.002). So was Ambrósio relational thickness (ARTh) at 6-month postoperatively (P = 0.011). Stiffness parameter at applanation A1 (SP-A1), stress-strain index (SSI), biomechanically corrected intraocular pressure (bIOP) and central corneal thickness (CCT) were highest in 130-µm group, followed by 120-µm group, then 110-µm group at 3-month (P<0.001, P = 0.030, P = 0.027, P = 0.008) and 6-month (P<0.001, P = 0.002, P = 0.0023, P = 0.001) postoperatively. CONCLUSIONS: The corneal stiffness following SMILE was greatest with 130-µm cap, followed by 120-µm cap, then 110-µm cap. 130-µm cap might have advantages in terms of corneal biomechanics and retreatment option. The SMILE-designed protocol should be customized in practice.

Effect of 3% Diquafosol Sodium on Dry Eye After Femtosecond Laser-Assisted In Situ Keratomileusis and Small Incision Lenticule Extraction Surgery in High-Myopic Eyes.

PURPOSE: To evaluate the effect of 3% diquafosol sodium eye drop on dry eye after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) in high-myopic eyes. METHODS: Eighty-one cases with high myopia (162 eyes) who received FS-LASIK or SMILE were divided into four groups by surgical design and tear film stability: D-FS-LASIK (5s

Predictive factors for postoperative visual acuity improvement with ICL-V4c for ultrahigh myopia above - 10 D.

PURPOSE: The purpose of this study is to evaluate the predictive factors for postoperative visual acuity improvement (PVAI) in subjects who underwent phakic intraocular lens implantation with a central hole (ICL-V4c) for ultrahigh myopia above - 10 D. METHODS: This was a retrospective study. Eyes with ultrahigh myopia above - 10 D undergoing ICL-V4c implantation were studied. Univariable linear regression models were used to assess the association between PVAI and preoperative parameters. Myopic maculopathy was classified into 5 categories by fundus photography. After the 1-month follow-up, the PVAI was compared within different age and preoperative spherical degree groups. RESULTS: This study included 726 eyes from 419 patients (111 men and 308 women), and the mean age, spherical refraction, and axial length were 28.67 ± 7.93 years, - 13.61 ± 3.44 D, and 28.59 ± 1.50 mm, respectively. At baseline, myopic maculopathy was classified (grades C0-C4) as follows: C0 was observed in 200 eyes (27.5%), C1 in 297 eyes (40.9%), C2 in 147 eyes (20.2%), C3 in 22 eyes (3.0%), and C4 in 60 eyes (8.3%). The PVAI was significantly negatively associated with age and positively associated with SD-pre(-Sph), but no significant association between myopic maculopathy classification and axial length was found. After 1 month, 417 eyes (57.4%) gained more than 1 line at BCVA, 250 eyes (34.4%) remained the same, and 59 eyes (8.13%) lost 1 line. The postoperative visual acuity of 52 eyes was improved by more than 3 lines, and 42.3% were grade C4. CONCLUSIONS: The ICL performed well for the correction of ultrahigh myopia above - 10 D. Younger patients and those with a higher preoperative spherical degree had greater postoperative satisfaction. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2000036335). Date of registration: 2020/8/22.

Factors associated with faster axial elongation after orthokeratology treatment.

BACKGROUND: To study the baseline factors that related to faster axial elongation after orthokeratology (OK) treatment and the characteristics of cases with axial length decrease in a group of myopia children. METHODS: This is a retrospective study. The records of 73 children who had wear OK lens for at least one year were reviewed. Only the data of right eyes were included. Baseline data included: age, gender, parental myopia, refractive error, corneal power, central corneal thickness, axial length and anterior chamber depth. Corneal power, central corneal thickness, anterior chamber depth and axial length after one-year of OK lens wear were also collected. The related factors affecting axial length change were analyzed. A comparison was made on the cases of axial length increase and axial length decrease. RESULTS: Of the 73 eyes, axial length increased by 0.18 ± 0.17 mm (P < 0.001) after one year of OK lens wear. Correlation analysis showed that one-year axial length change was negatively correlated with age and positively correlated with the parental myopia and baseline myopia. Stepwise multiple linear regression analysis showed that the factors associated with faster axial elongation were lower baseline myopic spherical equivalent (P = 0.018), higher parental myopia degree (P = 0.026), and younger age at the onset of lens wear. (P = 0.039). Nine eyes showed negative axial growth (-0.06 ± 0.04 mm), and had older initial age of lens wear, higher baseline myopic spherical equivalent, and lager baseline corneal power, when compared with cases of axial length increase. CONCLUSIONS: Myopia children with lower baseline myopic spherical equivalent, younger initial age and higher parental myopia had faster axial elongation after orthokeratology treatment. More aggressive treatment should be considered. In children with slow axial elongation, OK lens wear may lead to negative axial growth. Whether there are reasons other than central corneal thinning and choroidal thickening needs further study.

Changes in intraocular pressure and ocular pulse amplitude of rhesus macaques after blue light scleral cross-linking.

BACKGROUND: Scleral cross-linking can enhance the biomechanical strength of the sclera and is expected to be a new operative method for the prevention of myopia. However, studies investigating the changes in intraocular pressure (IOP) and ocular pulse amplitude (OPA) after blue light-riboflavin induced scleral collagen cross-linking (SXL) in rhesus monkeys are limited. This study aimed to investigate the changes in IOP and OPA in three-year-old rhesus macaques 1 week, 1 month, and 3 months after blue light-riboflavin SXL. METHODS: Seven three-year-old rhesus macaques (14 eyes) were randomly divided into two groups, with 4 monkeys in group A (8 eyes) and 3 monkeys in group B (6 eyes). The right eye of each rhesus macaque was used as the experimental eye, whereas the left eye was used as the control. In group A, one quadrant of each right eye was irradiated. In group B, two quadrants of each right eye and one quadrant of each left eye were irradiated. The IOP and OPA of both eyes were measured in all seven rhesus macaques before SXL and 1 week, 1 month, and 3 months postoperatively, and differences in the IOP and OPA between the experimental and control eyes were evaluated via the paired t test. RESULTS: In groups A and B, there were no significant differences between the experimental and control eyes in the IOP or OPA before SXL or 1 week, 1 month, or 3 months postoperatively (P > 0.05). CONCLUSIONS: The IOP and OPA are not significantly affected in 1 vs 0 or in 1 vs 2 quadrants of blue light SXL.

Vector analysis of high astigmatism (≥ 2.0 diopters) correction after small-incision lenticule extraction with stringent head positioning and femtosecond laser-assisted laser in situ keratomileusis with compensation of cyclotorsion.

BACKGROUND: The purpose of this study was to compare the astigmatic correction by vector analysis in patients with high myopic astigmatism after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) with cyclotorsion compensation or small-incision lenticule extraction (SMILE) with stringent head positioning. SETTING: Beijing Aier-Intech Eye Hospital, Beijing, China. DESIGN: A retrospective case series. METHODS: Patients who had correction of myopic astigmatism of 2 diopters (D) or more treated with either FS-LASIK with cyclotorsion compensation or SMILE with stringent head positioning were included. The results of vision and refraction were analyzed and compared between groups with the right eye. RESULTS: The study enrolled 94 patients (41eyes in an FS-LASIK with compensation of cyclotorsion group and 53 eyes in a SMILE with stringent head positioning control group. The mean preoperative manifest cylinder was -2.65 ± 0.77D in the FS-LASIK group and 2.51 ± 0.56D in the SMILE group (P = 0.302). At 12 months, there was no significant between-group difference in uncorrected distance visual acuity (UDVA, P = 0.274) and postoperative spherical equivalent (SEQ) (P = 0.107). 46.3% and 24.5% of eyes in the FS-LASIK and SMILE groups were within 0.25 D were within 0.25D postoperative cylinder, respectively, and 78% and 66% of eyes in these two groups were within 0.5 D postoperative cylinder (P = 0.027, P = 0.202). The vector analysis showed comparable between-group target-induced astigmatism (TIA) (P = 0.114), surgically induced astigmatism (SIA) (P = 0.057), difference vector (DV, P = 0.069), and the angle of error (AE) (P = 0 .213) values. The index of success (IOS) was 0.18 in the FS-LASIK group and 0.24 in the SMILE group (P = 0.024), with a significant difference between the two groups. CONCLUSION: FS-LASIK with compensation of cyclotorsion showed a favorable correction of high myopic astigmatism (≥ 2.0 D) compared to SMILE with stringent head positioning at 12 months.

Ocular safety evaluation of blue light scleral cross-linking in vivo in rhesus macaques.

PURPOSE: To investigate the safety of blue light scleral cross-linking (SXL) by evaluating changes in biological parameters in the retina and choroid in the eyes of rhesus macaques (Macaca mulatta). METHODS: Fifteen 3-year-old macaques (30 eyes) were randomly divided into three groups (n = 5). SXL was performed via riboflavin (0.5%) and blue light (460 nm) at the location of the equatorial sclera. Right eyes served as experimental eyes, and left eyes as control eyes. One quadrant of each right eye was irradiated in group A, two quadrants of each right eye and one quadrant of each left eye were irradiated in group B, and two quadrants of each right eye were irradiated in group C. Optical coherence tomography, optical coherence tomography angiography, and flash electroretinography (f-ERG) examinations were performed at baseline and 1 week, 1 month, 3 months, and 6 months after SXL. Additionally, retinal tissue alterations were detected via transmission electron microscopy at 1 week postoperatively. RESULTS: There were no significant differences between experimental eyes and control eyes in retinal thickness, vessel density of retinal superficial capillary plexus, and choroid thickness in any of the groups at any of the time points investigated (p > 0.05). Significant reductions in f-ERG parameters were detected 1 week postoperatively in the experimental eyes of groups A and C (p < 0.05), but they gradually recovered, and there was no significant difference 1 month postoperatively (p > 0.05). Ultrastructural changes were evident in the retinal layers of SXL eyes. In group B, there were no significant differences between the right and left eyes at any of the follow-up time points investigated. CONCLUSIONS: Blue light SXL can cause transient retina damage. The f-ERG parameters reductions and retinal ultrastructural changes were found at early stage, even though there were not significant changes in retinal thickness, vessel density of retinal superficial capillary plexus, and choroid thickness after blue light SXL. The long-term intraocular safety of the blue light SXL technique should be investigated further.

The Arabidopsis UDP-glycosyltransferases UGT79B2 and UGT79B3, contribute to cold, salt and drought stress tolerance via modulating anthocyanin accumulation.

The plant family 1 UDP-glycosyltransferases (UGTs) are the biggest GT family in plants, which are responsible for transferring sugar moieties onto a variety of small molecules, and control many metabolic processes; however, their physiological significance in planta is largely unknown. Here, we revealed that two Arabidopsis glycosyltransferase genes, UGT79B2 and UGT79B3, could be strongly induced by various abiotic stresses, including cold, salt and drought stresses. Overexpression of UGT79B2/B3 significantly enhanced plant tolerance to low temperatures as well as drought and salt stresses, whereas the ugt79b2/b3 double mutants generated by RNAi (RNA interference) and CRISPR-Cas9 strategies were more susceptible to adverse conditions. Interestingly, the expression of UGT79B2 and UGT79B3 is directly controlled by CBF1 (CRT/DRE-binding factor 1, also named DREB1B) in response to low temperatures. Furthermore, we identified the enzyme activities of UGT79B2/B3 in adding UDP-rhamnose to cyanidin and cyanidin 3-O-glucoside. Ectopic expression of UGT79B2/B3 significantly increased the anthocyanin accumulation, and enhanced the antioxidant activity in coping with abiotic stresses, whereas the ugt79b2/b3 double mutants showed reduced anthocyanin levels. When overexpressing UGT79B2/B3 in tt18 (transparent testa 18), a mutant that cannot synthesize anthocyanins, both genes fail to improve plant adaptation to stress. Taken together, we demonstrate that UGT79B2 and UGT79B3, identified as anthocyanin rhamnosyltransferases, are regulated by CBF1 and confer abiotic stress tolerance via modulating anthocyanin accumulation.

The maize secondary metabolism glycosyltransferase UFGT2 modifies flavonols and contributes to plant acclimation to abiotic stresses.

Background and Aims: Nowadays, the plant family 1 glycosyltransferases (UGTs) are attracting more and more attention since members of this family can improve the properties of secondary metabolites and have significantly enriched the chemical species in plants. Over the past decade, most studies on UGTs have been conducted in Arabidopsis thaliana and they were proved to play diverse roles during the plant life cycle. The Zea mays (maize) GT1 family comprises a large number of UDP-glycosyltransferase (UGT) members. However, their enzyme activities and the biological functions are rarely revealed. In this study, a maize flavonol glycosyltransferase, UFGT2, is identified and its biological role is characterized in detail. Methods: The UFGT2 enzyme activity, the flavonol and glycoside levels in planta were examined by high- performance liquid chromatography (HPLC) and liquid chromatography-mass spectrometry (LC-MS). The functions of UFGT2 in modifying flavonols, mediating flavonol accumulation and improving stress tolerance were analysed using two ufgt2 mutants and transgenic arabidopsis plants. Key Results: By in vitro enzyme assay, the maize UFGT2 was found to show strong activity towards two flavonols: kaemferol and quercetin. Two ufgt2 knockout mutants, Mu689 and Mu943, exhibited obvious sensitivity to salt and drought stresses. The endogenous quercetin and kaempferol glycosides, as well as the total flavonol levels were found to be substantially decreased in the two ufgt2 mutants, with declined H2O2-scavenging capacity. In contrast, ectopic expression of UFGT2 in arabidopsis led to increased flavonol contents and enhanced oxidative tolerance. Moreover, expression of typical stress-related genes in arabidopsis and maize were affected in UFGT2 overexpression plants or knockout mutants in response to abiotic stresses. UFGT2 was also transferred into the arabidopsis ugt78d2 mutant and it was found to recover the deficient flavonol glycoside pattern in the ugt78d2 mutant, which confirmed its catalysing activity in planta. Conclusion: It is demonstrated in our study that a maize glycosyltransferase, UFGT2, involved in modifying flavonols, contributes to improving plant tolerance to abiotic stresses.

A Nomogram to Improve Predictability of Small-Incision Lenticule Extraction Surgery.

BACKGROUND This study aimed to determine and validate that use of a nomogram could enhance the predictability of small-incision lenticule extraction (SMILE) surgery. MATERIAL AND METHODS 195 eyes from 98 patients were enrolled in group 1, and 46 eyes from 26 patients in group 2. Uncorrected and corrected distance visual acuity (UDVA and CDVA), manifest refraction spherical equivalent (SE) preoperatively and 1 day, 1 week, 1 month, and 3 months postoperatively were measured. A nomogram based on the error in SE correction was generated by using multifactor regression method in group 1. After applying this nomogram to redesign the refraction target, the predictability, safety, and efficacy of the SMILE procedure were determined. RESULTS A linear regression formula (SE error=0.259+0.113×SEpreoperative) was derived as a nomogram to adjust the SE target. In group 2, the predictability of error was 86.21% within 0.50 D and 97.83% within 1.00 D, compared with 70.25% and 95.90%, respectively, in group 1. The use of the nomogram significantly reduced the variance in postoperative SE. The efficacy and safety of SMILE did not differ significantly in the 2 groups 3 months postoperatively. CONCLUSIONS The nomogram can optimize the target refractive prediction of the SMILE procedure without compromising safety and efficiency.

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.

[Advance of femtosecond small incision lenticule extraction (SMILE) in clinic application].

Femtosecond small incision lenticule extraction (SMILE) had been performed in clinic more than 5 years in China. With the gradual development of the technology, SMILE has caused more and more attention because of the remarkable clinical effect, micro incision, minimally invasive and refractive stability. The reuse of the refractive lenticule (RL) from SMILE has recently become extensive focus, which brings potential method to corneal refractive surgery from subtraction to addition. This review has clarified the technology of SMILE on the aspects of corneal refractive correct, the clinical effect of reuse the materials (RL), the basis of related research and the possible improvement in the future.

MT1-MMP cleaves Dll1 to negatively regulate Notch signalling to maintain normal B-cell development.

Notch signalling controls the differentiation of haematopoietic progenitor cells (HPCs). Here, we show that loss of membrane-type 1 matrix metalloproteinase (MT1-MMP, MMP14), a cell surface protease expressed in bone marrow stromal cells (BMSCs), increases Notch signalling in HPCs and specifically impairs B-lymphocyte development. When co-cultured with BMSCs in vitro, HPCs differentiation towards B lymphocytes is significantly compromised on MT1-MMP-deficient BMSCs and this defect could be completely rescued by DAPT, a specific Notch signalling inhibitor. The defective B-lymphocyte development could also be largely rescued by DAPT in vivo. MT1-MMP interacts with Notch ligand Delta-like 1 (Dll1) and promotes its cleavage on cell surface in BMSCs. Ectopic MT1-MMP cleaves Dll1 and results in diminished Notch signalling in co-cultured cells. In addition, recombinant MT1-MMP cleaves a synthetic Dll1 peptide at the same site where MT1-MMP cleaves Dll1 on the cell surface. Our data suggest that MT1-MMP directly cleaves Dll1 on BMSCs to negatively regulate Notch signalling to specifically maintain normal B-cell development in bone marrow.

Efficacy of Blue-Light Cross-linking on Human Scleral Reinforcement.

PURPOSE: To evaluate the biomechanical effects of collagen cross-linking by riboflavin/blue light (460 nm) on human sclera. METHODS: Forty-two sclera samples from donated human eyes were treated with riboflavin at 0.5% on the equatorial sclera for 20 minutes and then randomly divided into seven groups and irradiated, respectively, with blue light at different intensities (14.6, 19.5, 22.5, 26, 32.5, and 40.6 mW/cm) for 20 minutes using a light-emitting diode source with an exposure area of 10 mm in diameter. The untreated samples constituted the control group. During irradiation, continuous riboflavin solution infiltration was carried out for 20 minutes. Stress-strain measurements of scleral strips were performed with a biomaterial tester. Stress data and Young modulus values in different groups were compared by one-way analysis of variance. RESULTS: Blue-light (460 nm) cross-linking was efficient in stiffening human sclera strips. Interestingly, eyes treated with 22.5 mW/cm exhibited higher Young modulus values (19.12 [±4.88] MPa) at 8% strain compared with other groups, representing a 307.68% increase over control eye values (4.69 [±1.26] MPa). Stress and Young modulus increased gradually with irradiation intensity from 19.5 to 22.5 mW/cm before decreasing for higher intensities. CONCLUSIONS: The biomechanical strength of human sclera may be enhanced by collagen cross-linking with riboflavin/460 nm blue-light irradiation; the dose of 22.5 mW/cm might be used for blue-light (460 nm) scleral cross-linking to achieve a higher efficacy.