[The relationship between classroom environment and myopia]

Objective: Based on a cohort and intervention study of the Eastern Chinese Student Surveillance, Cohort and Intervention Study (ES-SCI), this research aims to explore the correlation between monitor of the school environment and longitudinal data on myopia and provide evidence for the government myopia intervention strategy. Methods: This survey adopts the stratified cluster sampling method with the school as the unit. Students from grade 1 to grade 3 were selected according to the whole class to monitor the school environment in the classroom. Students will use the full-automatic computer optometer (TOPCON RM800) to conduct optometry from 2019 to 2021 under the condition of mydriasis to perform refractive eye examinations. Meantime eye axis length monitoring was also conducted. Cox proportional risk regression model was used to explore the relationship between school environmental monitoring and the occurrence and development of students' myopia. Results: From 2019 to 2021, 2 670 students from 77 classrooms participated in the observation study. The students' diopter after right/left eye mydriasis decreased in varying degrees (P<0.001), and the axial length of the right/left eye increased in various degrees (P<0.001). The weighted qualified rate of per capita area of primary school classrooms increased from 18.0% in 2019 to 26.0% in 2021, the weighted average illuminance pass rate of blackboard surface increased from 23.8% in 2019 to 26.4% in 2021, and the weighted average illuminance pass rate of classroom table decreased from 86.7% in 2019 to 77.5% in 2021. The trend chi-square test was significant (P<0.05). Cox proportional risk regression showed that after correcting for the grade, gender, parental myopia, diet, sleep, near work (sitting posture, working time, electronic mobile equipment, eye exercises), and outdoor activities, the per capita area of 1.36- m² was the protective factor of eye axis length (HR=0.778, 95%CI: 0.659-0.918, P=0.003); The average reflection ratio of blackboard 0.15-0.19 was the protective factor of eye axis length (HR=0.685, 95%CI: 0.592-0.793, P<0.001); The average illumination of the blackboard 150-, 300-, 500- lx was the protective factor of the eye axis length (HR=0.456, 95%CI: 0.534-0.761, P<0.001; HR=0.794, 95%CI: 0.705-0.895, P<0.001; HR=0.690, 95%CI: 0.619-0.768, P<0.001). The blackboard evenness 0.40-0.59 was the risk factor of eye axis length (HR=1.528, 95%CI: 1.018-2.293, P=0.041), and the blackboard evenness 0.80- was the protection factor of eye axis length (HR=0.542, 95%CI: 0.404-0.726, P<0.001). The evenness of the desktop 0.40-0.59 was the protective factor of eye axis length (HR=0.820, 95%CI: 0.698-0.965, P=0.017). The average illuminance of 150-, 300-, 500- lx was the protective factor of a diopter (HR=0.638, 95%CI: 0.534-0.761, P<0.001; HR=0.911, 95%CI: 0.848-0.978, P=0.011; HR=0.750, 95%CI: 0.702-0.801, P<0.001). The average illumination of desktop 500- lx was a protective factor of a diopter (HR=0.855, 95%CI: 0.763-0.958, P=0.007). Conclusion: School environmental monitoring indicators, such as meeting per capita area standards, passing blackboard, and desk top-related indicators, all play protective effects on myopia development in students.

[Epidemiology and the risk factors of myopia among children and youths in Yunnan province]

Objective: The purpose of the study was to describe the prevalence of myopia and to explore the associated factors of myopia among Han and Yi students aged 5-16 years in Yunnan province, China. Methods: A total of 5 971 Han and Yi students were included in the data analysis from the Yunnan eye study which was conducted from March to August, 2014. Information regarding demographic factors, socioeconomic status and lifestyle-related exposures were collected by per-designed questionnaires. The ophthalmic examinations including distance visual acuity, anterior segment examination, cycloplegic auto-refraction, and ocular motility examination were conducted. Logistic regression models were fitted to estimate the risk factors for myopia. Results: The age of 5 971 subjects was (10.68±2.24)years old, and the total prevalence of myopia and high myopia was 48.05% and 0.59%. Myopia prevalence was found to be higher in Han students compared with Yi ethnicity (50.20% vs. 47.10%,P=0.029). In multivariate analysis, the occurrence of myopia was associated with age (OR=1.28, 95%CI: 1.25-1.31), girls (OR=1.32, 95%CI: 1.18-1.48), increasing reading and writing time per day (OR=1.13, 95%CI: 1.07-1.20), having self-reported myopia among friend(s) (OR=1.15, 95%CI: 1.02-1.29), having myopic father (OR=1.38, 95%CI: 1.06-1.79), having myopic mother (OR=1.43, 95%CI: 1.12-1.83) and higher educated mother (OR=1.24, 95%CI: 1.03-1.51). Conclusions: We observed a high prevalence of myopia among Mangshi students. The presence of myopia was associated with increasing age, girls, increasing reading and writing time per day, having self-reported myopia among friend(s), having myopic father, having myopic and high educated mother.

Artificial Intelligence in the Management of Intracranial Aneurysms: Current Status and Future Perspectives

Intracranial aneurysms with subarachnoid hemorrhage lead to high morbidity and mortality. It is of critical importance to detect aneurysms, identify risk factors of rupture, and predict treatment response of aneurysms to guide clinical interventions. Artificial intelligence has received worldwide attention for its impressive performance in image-based tasks. Artificial intelligence serves as an adjunct to physicians in a series of clinical settings, which substantially improves diagnostic accuracy while reducing physicians' workload. Computer-assisted diagnosis systems of aneurysms based on MRA and CTA using deep learning have been evaluated, and excellent performances have been reported. Artificial intelligence has also been used in automated morphologic calculation, rupture risk stratification, and outcomes prediction with the implementation of machine learning methods, which have exhibited incremental value. This review summarizes current advances of artificial intelligence in the management of aneurysms, including detection and prediction. The challenges and future directions of clinical implementations of artificial intelligence are briefly discussed.

Numerical research on the biomechanical behaviour of braided stents with different end shapes and stent-oesophagus interaction

Quasi-static and dynamic numerical analyses are carried out by referring to computational models of commercial self-expandable braided stents with 3 commonly used end shapes, to evaluate the influence of different end shapes of stent on the biomechanical interaction between stent and oesophagus. The end shape has no influence on the equivalent stress, but has a great influence on the contact stress in the narrowest zone of the oesophagus-neoplasm system. However, the end shapes have significant effect on the equivalent stress and the contact stress in the healthy area of the oesophagus in contact with the stent ends. The results show that the maximum equivalent stress of the oesophagus occurs in the zone contact with the cup-shaped end and the maximum contact stress occurs in the zone contact with the edge of the trumpet-shaped stent end. Moreover, the stent apposition is almost not affected by the end shapes. Although small zones with an incomplete stent apposition appear in the transition zones of spherical-cup-shaped stent, such occurrence might not contribute to stent malapposition or stent migration. Therefore, these stents with 3 types of end shapes all have good stent apposition. Finally, the numerical simulation results can be used to assess the mechanical performance of stents with different end shapes, the effectiveness of stent expansion therapy, and the possibility of complications after stent implantation.

Development-specific differences in the proteomics of Angiostrongylus cantonensis

Angiostrongyliasis is an emerging communicable disease. Several different hosts are required to complete the life cycle of Angiostrongylus cantonensis. However, we lack a complete understanding of variability of proteins across different developmental stages and their contribution to parasite survival and progression. In this study, we extracted soluble proteins from various stages of the A. cantonensis life cycle [female adults, male adults, the fifth-stage female larvae (FL5), the fifth-stage male larvae (ML5) and third-stage larvae (L3)], separated those proteins using two-dimensional difference gel electrophoresis (2D-DIGE) at pH 4-7, and analyzed the gel images using DeCyder 7.0 software. This proteomic analysis produced a total of 183 different dominant protein spots. Thirty-seven protein spots were found to have high confidence scores (>95%) by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Comparative proteomic analyses revealed that 29 spots represented cytoskeleton-associated proteins and functional proteins. Eight spots were unnamed proteins. Twelve protein spots that were matched to the EST of different-stage larvae of A. cantonensis were identified. Two genes and the internal control 18s were chosen for quantitative real-time PCR (qPCR) and the qPCR results were consistent with those of the DIGE studies. These findings will provide a new basis for understanding the characteristics of growth and development of A. cantonensis and the host-parasite relationship. They may also assist searches for candidate proteins suitable for use in diagnostic assays and as drug targets for the control of eosinophilic meningitis caused by A. cantonensis.

In vitro study of the effects of Angiostrongylus cantonensis larvae extracts on apoptosis and dysfunction in the blood-brain barrier (BBB)

It has been hypothesized that blood-brain barrier (BBB) dysfunction in Angiostrongylus cantonensis infection might be due to the apoptosis of the hosts' BBB cells. Here, we evaluated this hypothesis through several methods, all based on an in vitro mouse BBB model consisting of primary culture brain microvascular endothelial cells (BMECs) and brain astrocytic cells (BACs). In the present study, a four-hour percolation and HRP permeability experiment showed that A. cantonensis larvae extracts can increase the permeability of the BBB. Apoptosis among BMECs and BACs after exposure to larvae extracts was monitored by TUNEL and annexin-V-FITC/PI double staining. A. cantonensis larvae extracts were found to induce apoptosis in both BMECs and BACs. For this reason, we concluded that the induction of apoptosis might participate in the BBB dysfunction observed during angiostrongyliasis. Improved fundamental understanding of how A. cantonensis induces apoptosis may lead to new approaches to the treatment or prevention of this parasitic disease.

[Application of double antibody sandwich ELISA for detection of nucleoside triphosphate hydrolase-II protein of Toxoplasma gondii]

OBJECTIVE

To establish a double antibody sandwich ELISA method for detection of nucleoside triphosphate hydrolase-II (NTPase-II) protein of Toxoplasma gondii.

METHODS

BALB/c mice were immunized with recombinant NTPase-II (rTgNTPase-II) protein of T. gondii. The hybridomas that secreted high titer of monoclonal antibodies (mAbs) with high specificity were screened and used to establish the double antibody sandwich ELISA for the detection of rTgNTPase-II. In order to evaluate the sensitivity of the method, the concentration of whole-tachyzoite lysate and rTgNTPase-II was detected, respectively. Serum samples from patients with malaria (7 cases), schistosomiasis (12 cases), paragonimiasis (14 cases) and cysticercosis (10 cases) were examined by the same method.

RESULTS

Two hybridoma cell lines, MNTI and MNT2, were developed for secreting mAbs against rTgNTPase-II. Western blotting analysis showed that the two mAbs specifically recognized rTgNTPase-II and whole-tachyzoite lysate. The MNT1 was used as coating antibody, and HRP-labeled MNT2 as secondary antibody. The double antibody sandwich ELISA detecting rTgNTPase-II was developed with a minimum concentration of 6 microg/ml for whole-tachyzoite lysate and 1.5 microg/ml for rTgNTPase-II. An overall specificity of 100% was determined.

CONCLUSION

The double antibody sandwich ELISA based on MNT1 as coating antibody and MNT2 as secondary antibody has a high specificity.

[Expression and antigenicity analysis of NTPase gene of Toxoplasma gondii]

OBJECTIVE

To clone and express prokaryotic recombinant plasmid of nucleoside triphosphate hydrolase (NTPase) gene of Toxoplasma gondii, and analyze its antigenicity.

METHOD

NTPase gene was amplified by PCR from RH strain of T. gondii and cloned into pGEM-T Easy vector. Positive clones were screened and identified by BglII, HindIII digestion and sequenced. The target gene was then subcloned into prokaryotic expression vector pBAD-HisB and transformed into E. coli BL21 (DE3). The expressed recombinant protein was purified with Ni-NTA agarose and further analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting.

RESULTS

NTPase-II gene was specifically amplified, and the homology of DNA sequence was 100% to that in the GenBank. SDS-PAGE showed that the recombinant NTPase protein with correct molecular weight was expressed highly in E.coli BL21 (DE3). Western blotting testified that the purified recombinant protein could be specifically recognized by mouse serum immunized with T. gondii and mouse anti-recombinant protein serum.

CONCLUSION

The NTPase-II gene has been cloned and expressed in E.coli BL21 (DE3), and the purified protein of NTPase-II gene displays a specific antigenicity.

[Study on the infectivity of Angiostronglus cantonensis in the epidemic foci]

OBJECTIVE

To analyze the degrees on the epidemic foci of Angiostronglus cantonensis and to explore the measurement methods.

METHODS

Snails (Pila gigas) were collected from the spots of Wenzhou, Cangnan, Yongjia, Yueqing in Zhejiang province and Minhou, Changle, Ningde in Fujian province. The snails were examined microscopically in order to calculate their infection rates and the average worm number in the positive snails, then taking the product of multiplication of both values as infestation index.

RESULTS

The infection rates of the epidemic foci were 10.59% (9/85), 60.74% (181/298), 34.96% (79/226), 32.90% (76/231), 57.50% (184/320), 40.00% (82/205), 17.65% (12/68) and the rates of infectivity were 6.57, 183.54, 121.73, 93.45, 276.36, 76.08, 12.65, respectively.

CONCLUSION

The epidemic foci were divided into five ranks (super, high, mid-range, low and non-epidemic foci) according to the value of infestation index which ranked from > 75, 30-75, 5-29, < 5 to 0.

[Preparation of monoclonal antibodies against the adhesion protein 33 of Trichomonas vaginalis]

OBJECTIVE

To prepare and characterize the monoclonal antibodies (McAbs) against recombinant adhesion protein 33 (AP33) of Trichomonas vaginalis.

METHODS

The purified recombinant fusion protein AP33 was used as antigen to immunize BALB/c mice. Sp2/0 myeloma cells were fused with the splenocytes from immunized BALB/c mice. After ELISA screening and 4 times of limited dilution, 5 positive hybridoma cell lines were obtained, and the biological properties of the McAbs were identified by Western blotting. Indirect immunofluorescent antibody test (IFAT) was performed and the inhibition effect of McAbs on the cytoadherence of Trichomonas vaginalis to HeLa cell was assayed.

RESULTS

Western blotting demonstrated that 5 McAbs, designated as 4A2, 4F11, 4F8, 4E7 and 4H11, specifically combined with the recombinant AP33 of T. vaginalis. The McAbs were IgG1 isotypes. Four of them (4F11, 4F8, 4E7 and 4H11) showed parasite recognition by IFAT. Parasite cytoadherence to a monolayer of HeLa cells was inhibited in vitro with a inhibition rate of 50.08%, 65.03%, 50.70% and 49.08% by the 4 McAbs under a concentration of 200, 200, 400 and 200 microg/ml, respectively.

CONCLUSIONS

The prepared McAbs against the recombinant AP33 show a protective inhibition on cytoadherence of Trichomonas vaginalis in vitro.

[Epidemiological investigation on an outbreak of angiostrongyliasis cantonensis in Wenzhou]

OBJECTIVE

To find out the cause and transmission factors of an outbreak of eosinophilic meningoradiculitis in Wenzhou City during October to November in 1997.

METHODS

In addition to a retrospective cohort study on 182 persons who had dined at a same restaurant of the city, etiological and immunoserological investigations were conducted.

RESULTS

Among 105 cases who had eaten the undercooked Ampullaria gigas in that restaurant, 47 cases were infected, the incidence rate was 44.8%; whereas none of the persons who did not eat the under-cooked Ampullaria gigas in that restaurant got the infection, the difference between the two groups being significant(P < 0.001). The incidence rate of the cases who had eaten 4 and more pieces of the undercooked Ampullaria gigas was 86.2%(25/29), while that of those who had eaten less than 4 pieces was 28.9%(22/76), the difference between the two being very significant (chi 2 = 27.83, P < 0.001, RR = 2.98). The third stage larvae of the Angiostrongylus cantonensis were found out from Ampullaria gigas living in the same locality, and the adult worms of Angiostrongylus contonensis were found out from the rats living in the locality else. The positive rate of serum anti-Angiostrongylus cantonensis antibody in the patients was 84.0%.

CONCLUSION

On the basis of the clinical, epidemiological, immunoserological and etiological investigations, an outbreak of the angiostrongyliasis cantonensis caused by eating undercooked Ampullaria gigas was confirmed.

Prenatal diagnosis of de novo distal 11q deletion associated with sonographic findings of unilateral duplex renal system, pyelectasis and orofacial clefts

In utero diagnosis of de novo distal 11q deletion associated with renal and orofacial malformations has not been previously described. We present a 35-year-old pregnant woman with prenatal sonographic findings of a unilateral duplex renal system, pyelectasis and orofacial clefts at 20 weeks' gestation. Both genetic amniocentesis and postnatal cytogenetic analysis revealed de novo 46,XX,del(11)(q23). After birth, the fetus manifested a dysmorphic phenotype correlated with del(11q) syndrome. Genetic marker analysis showed a paternally derived distal deletion of chromosome 11q and a breakpoint centromeric to D11S1341. The present case represents the earliest prenatal diagnosis of a duplex renal system, pyelectasis and an additional feature of orofacial clefts associated with distal 11q deletion. Prenatal sonographic detection of a duplex renal system, pyelectasis and orofacial clefts should warrant a careful assessment of fetal anatomy and prompt cytogenetic analysis looking for chromosomal aberrations.

Partial trisomy 8q and partial monosomy 15q associated with congenital hydrocephalus, diaphragmatic hernia, urinary tract anomalies, congenital heart defect and kyphoscoliosis

We describe perinatal findings in a female fetus with partial trisomy 8q(8q24.1-->8qter) and partial monosomy 15q(15q26.1-->15qter) resulting from a paternal t(8;15) reciprocal translocation. Prenatal sonographic examination showed intra-uterine growth retardation, bilateral ventriculomegaly, cardiomegaly with arrhythmia, anhydramnios, and absent kidney and urinary bladder images. The pregnancy was terminated at 28 weeks of gestation. At birth, the infant manifested typical dysmorphic features of partial trisomy 8q. Necropsy further revealed hydrocephalus, congenital diaphragmatic hernia, ventricular septal defect, a horseshoe kidney with renal hypoplasia, and kyphoscoliosis. Our case shows that the coexistence of partial trisomy 8q24.1-->8qter and partial monosomy 15q26.1-->15qter are more detrimental than either defect alone and can result in a complex of major malformations. Prenatal ultrasound examination and cytogenetic assessment should be offered in subsequent pregnancies.

Echocardiographic study of cardiac abnormalities in families of patients with Marfan's syndrome

Twelve patients (5 male and 7 female; mean age 17.7 +/- 12.3 years, range 5 to 42) with Marfan's syndrome and 48 of their first degree relatives (16 male and 22 female; mean age 29.8 +/- 17.3 years, range 4 to 60) were evaluated for cardiac abnormalities by echocardiography. Of the patients with Marfan's syndrome, aortic valve prolapse was present in 1, tricuspid valve prolapse in 4, mitral valve prolapse in 12 and aortic root dilation in 10. Of the 48 first degree relatives of these 12 patients, tricuspid valve prolapse was diagnosed in 3, mitral valve prolapse in 15 and aortic root dilation in 12; aortic valve prolapse was not observed in any of these subjects. Of the 60 persons studied in these 12 kindreds, 28 (47%) had cardiac involvement. Among the 28 with cardiac involvement, aortic valve prolapse was observed in 1 (3.5%), tricuspid valve prolapse in 7 (25%), mitral valve prolapse in 27 (96%) and aortic root dilation in 22 (79%). Mitral valve prolapse was also present in the seven subjects with tricuspid valve prolapse and one with aortic valve prolapse. In 32 of the 60 persons studied in the 12 families, at least one abnormality of the cardiac, skeletal or ophthalmologic system was observed. Nineteen subjects were younger than 18 years of age; all had cardiac involvement associated with Marfan's syndrome. The notably earlier presentation of cardiac involvement in young persons may be responsible for a shorter life span in this group.(ABSTRACT TRUNCATED AT 250 WORDS)