Effect of COVID-19 home confinement on the efficacy of orthokeratology, 0.01% atropine and combined treatment

PURPOSE

To investigate the effect of COVID-19 home confinement on the efficacy of the interventions for controlling myopia, and to select effective therapies to control myopia during COVID-19 confinement.

METHOD

Children (n = 164) aged 8-12 years with spherical equivalent refraction of -1.00 to -6.00 diopters were stratified into two age subgroups and randomly allocated into the control, 0.01% atropine, orthokeratology (ortho-k) and atropine combined ortho-k (ACO) groups. Axial length (AL) was measured at baseline, 6-, 12-, 18- and 24-month visits. The follow-up spanned the period before the COVID-19 outbreak, the period of the home confinement, and the period of the school reopening. Hence, the AL change in different periods was collected and compared. Data analysis was performed following the criteria of intention to treat (ITT).

RESULTS

All 164 children were involved in the ITT analysis. Compared to control, all interventions can still reduce the AL elongation during the COVID-19 home confinement period (all p < 0.05). However, the efficacy was compromised: individuals experienced more AL elongation during the COVID-19 home confinement period in the control, 0.01% atropine and ACO groups (all p < 0.05). Interestingly, in the ortho-k group, the difference was insignificant (p = 0.178), and the interaction between the intervention type (control vs. ortho-k) and the confinement severity was significant (p for interaction = 0.041), which is different from the atropine (p for interaction = 0.248) or ACO group (p for interaction = 0.988). These results were stable after being adjusted by other variables based on the multivariable regression model.

CONCLUSION

Ortho-k was less affected by the COVID-19 home confinement, which is potentially a better therapy for children in this high-risk environment. Further investigations are warranted to validate this issue.

The Role of OCTA in Evaluating Diabetic Retinopathy Progression: A Meta-Analysis

Background

Diabetic retinopathy (DR) substantially threatens ocular health, necessitating the accurate and prompt assessment of its onset and progression. Optical coherence tomography angiography (OCTA) is a valuable tool for evaluating periocular microvascular indicators, offering insights crucial for diagnosing and treating DR.

Objective

This meta-analysis aims to evaluate the progression of diabetic retinopathy (DR) by examining periocular microvascular indicators using optical coherence tomography angiography (OCTA). The objective is to provide substantive evidence for the future diagnosis and treatment of DR.

Methods

We analyzed the relevant research retrieved from PubMed and Web of Science until January 2023. The inclusion and exclusion criteria were carefully applied to select eligible studies. Quality assessment was performed using the Newcastle-Ottawa Scale, with studies scoring 4 or less excluded. Meta-analysis was conducted using Revman 5.3 software and focused on key indicators, including peripapillary vascular length density (pVLD) and peripapillary vascular density (pVD). Heterogeneity was assessed using I2 and P values, with effect sizes determined via fixed-effect or random-effects models based on heterogeneity levels.

Results

Six studies involving 839 DR-afflicted eyes and 3209 non-DR eyes were included after screening. All selected articles exhibited high reference value, with quality scores ranging from 5 to 8 points. The meta-analysis demonstrated that DR patients displayed significantly lower pVD and pVLD in the superficial (SCP) and deep capillary plexus (DCP) compared to non-DR patients (P < .05). These findings remained consistent across different effect models, reaffirming their validity.

Conclusions

Patients with DR exhibit reduced levels of pVD and pVLD in the SCP and DCP compared to non-DR individuals. OCTA examination of periocular microvascular indicators emerges as an effective tool for assessing the onset and progression of DR.

The molecular genetics of anterior segment dysgenesis

Anterior segment dysgenesis is a severe developmental eye disorder that leads to blindness in children. The exact mechanisms underlying this condition remain elusive. Recently, an increasing amount of studies have focused on genes and signal transduction pathways that affect anterior segment dysgenesis;these factors include transcription factors, developmental regulators, extracellular matrix genes, membrane-related proteins, cytoskeleton proteins and other associated genes. To date, dozens of gene variants have been found to cause anterior segment dysgenesis. However, there is still a lack of effective treatments. With a broader and deeper understanding of the molecular mechanisms underlying anterior segment development in the future, gene editing technology and stem cell technology may be new treatments for anterior segment dysgenesis. Further studies on the mechanisms of how different genes influence the onset and progression of anterior segment dysgenesis are still needed.

Association between prediabetes/hyperglycemia and retinal diseases: A meta-analysis

PURPOSE

To explore the effect of prediabetes/hyperglycemia on the incidence of retinopathy.

METHODS

PubMed and EMBASE databases were retrieved to screen case-control studies or prospective cohort studies of retinopathy in prediabetic patients from January, 2004 to December, 2019. After quality evaluation by two evaluators according to inclusion and exclusion criteria, RevMan 5.3 software was used for meta-analysis.

RESULTS

A total of 18 articles were included. Meta-analysis showed that there have been more incidents of retinal diseases in patients with prediabetes/hyperglycemia [MD (mean difference) = 2.50, 95% CI (1.74 to 3.6)] than those in normal controls (p < 0.05). The incidence of macular diseases [MD = 1.36, 95% CI (1.05 to 1.76)] was significantly higher in prediabetic patients than that of the control group (p < 0.05). No significant differences in DR-like retinopathy were found between both groups [MD = 2.02, 95% CI (0.84 to 4.85)] (p > 0.05). In neonates, hyperglycemia was associated with an increased risk of ROP [MD = 3.6, 95% CI (1.89 to 6.86)] (p < 0.001).

CONCLUSIONS

Prediabetes/hyperglycemia is associated with an increased risk of retinal diseases. Retinal diseases screening such as macular diseases among people with prediabetes should be warranted. But no significant differences in DR-like retinopathy were found. However, more further studies are needed to clarify the details between prediabetes/hyperglycemia and different kinds of retinal diseases.

Latest progress in the study of nanoparticle-based delivery of the CRISPR/Cas9 system

The CRISPR/Cas9 system has been harnessed to cleave a targeted DNA fragment via its Cas nuclease activity under the direction of guide RNA for rendering gene insertions, deletions, and point mutations in basic research and clinical applications. There are a number of vehicles, including lipofectamine, viruses, and nanoparticles, that can deliver the CRISPR/Cas9 system, but all these methods face numerous challenges during their application in life science contexts. Here, we focus on the delivery of CRISPR/Cas9 via nanoparticles because this method has shown great advantages in terms of safety, simplicity and flexibility.

New compound heterozygous CYP4V2 mutations in bietti crystalline corneoretinal dystrophy

Bietti crystalline corneoretinal dystrophy (BCD) is an autosomal recessive retinal dystrophy which is caused by the mutations of CYP4V2, usually progressing to legal blindness by the 5th or 6th decade of life. Here we identified CYP4V2 compound heterozygous mutations in two female siblings with BCD without subjective symptoms. After 381 pathogenic genes related to retinal diseases were screened by targeted sequence capture array techniques and confirmed by Sanger sequencing, two compound heterozygous mutations in CYP4V2 were found. One was missense mutation c.1198C>T (p.R400C) and the other was frameshift mutation c.802-8_810delinsGC (p.V268_E329del). Optical coherence tomography (OCT) showed that the ellipsoid zone was absent in the macular regions and electroretinogram (ERG) revealed poor cone and rod responses. Compound heterozygous mutations in CYP4V2 are related to the BCD. Our study expands our knowledge of heterogenic phenotypes and genotypes through genetic diagnosis of the BCD patients.

Nosocomial infection by Klebsiella pneumoniae among neonates: a molecular epidemiological study

BACKGROUND

Nosocomial infection by Klebsiella pneumoniae (Kp) and drug resistance of Kp among neonates is a major concern. Hypervirulent K. pneumoniae (hvKp) infections are gradually increasing worldwide. Carbapenem-resistant hvKp infection has brought challenges to clinical treatment.

AIM

To evaluate the changes in drug resistance trends of Kp strains in neonatal intensive care unit (NICU) nosocomial infections, to analyse drug resistance genes and virulence genes of carbapenem-resistant K. pneumoniae (CRKP) and to identify whether these CRKP strains are hvKp.

METHODS

A total of 80 neonates with Kp nosocomial infections from 2013 to 2018 were retrospectively studied. Drug susceptibility testing was performed on 80 Kp strains, among which the 12 CRKP strains were further studied.

FINDINGS

Kp accounted for 26.9% of nosocomial infections in the NICU. CRKP strains accounted for 15.0%. Among the 80 nosocomial infection Kp strains, CRKP strains accounted for 33.3% and 53.3% in 2017 and 2018 respectively. One of the 12 CRKP strains was positive in the drawing test. The 12 CRKP strains were divided into four complete genome sequence types: cgST1 (N = 2), cgST2 (N = 1), cgST3 (N = 1), and cgST4 (N = 8). Among genes that mediated carbapenem resistance, strains of cgST4 carried NDM-5, strains of cgST2 and cgST3 carried NDM-1, and strains of cgST1 carried IMP-4. None of the 12 CRKP strains carried rmpA/rmpA2 (highly related with hvKp).

CONCLUSION

Nosocomial infections of CRKP among neonates are becoming common, but no hvKp was found among the CRKP strains in this study.

Identification of prognostic risk factors of acute lymphoblastic leukemia based on mRNA expression profiling

We aim to identify prognosis risk factors in acute lymphoblastic leukemia (ALL). mRNA microarray data of adult ALL patients were downloaded from TCGA database, whose mRNAs were isolated from bone marrow aspirate fluid mononuclear cells. Then the differentially expressed genes (DEGs) between good and poor prognosis samples were screened. Following that, the sample dependency network was constructed based on the Pearson connection coefficients of DEGs in the samples. The prognosis-related genes were collected using logistic regression analysis. A classifier for predict the prognosis of ALL patients was established, which was validated in another independent dataset GSE13280 including 173 ALL samples. A total of 578 down-regulated and 637 up-regulated DEGs for worse prognosis were identified. A sample dependency network was established, comprising 100 samples combined by 246 lines. 13 prognosis-related genes were selected to constructed the prognosis classification model, which had an overall precision of 82.7% on distinguishing prognosis status of ALL patients. Total 4 genes were found as the prognosis risk factors in predicting the prognosis of ALL samples, including ALPK1, ACTN4, CALR, and ZNF695. ALPK1, ACTN4, CALR, and ZNF695 were identified as the potential prognosis risk factors in adult ALL.

A novel FGFR1-binding peptide attenuates the degeneration of articular cartilage in adult mice

OBJECTIVE

We previously reported that genetic ablation of (Fibroblast Growth Factors Receptors) FGFR1 in knee cartilage attenuates the degeneration of articular cartilage in adult mice, which suggests that FGFR1 is a potential targeting molecule for osteoarthritis (OA). Here, we identified R1-P1, an inhibitory peptide for FGFR1 and investigated its effect on the pathogenesis of OA in mice induced by destabilization of medial meniscus (DMM).

DESIGN

Binding ability between R1-P1 and FGFR1 protein was evaluated by enzyme-linked immuno sorbent assay (ELISA) and molecular docking. Alterations in cartilage were evaluated histologically. The expression levels of molecules associated with articular cartilage homeostasis and FGFR1 signaling were analyzed by quantitative real-time polymerase chain reaction (qRT-PCR), Western blotting and immunohistochemistry (IHC). The chondrocyte apoptosis was detected by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) assay.

RESULTS

R1-P1 had highly binding affinities to human FGFR1 protein, and efficiently inhibited extracellular signal-regulated kinase (ERK)1/2 pathway in mouse primary chondrocytes. In addition, R1-P1 attenuated the IL-1β induced significant loss of proteoglycan in full-thickness cartilage tissue from human femur head. Moreover, this peptide can significantly restore the IL-1β mediated loss of proteoglycan and type II collagen (Col II) and attenuate the expression of matrix metalloproteinase-13 (MMP13) in mouse primary chondrocytes. Finally, intra-articular injection of R1-P1 remarkably attenuated the loss of proteoglycan and the destruction of articular cartilage and decreased the expressions of extracellular matrix (ECM) degrading enzymes and apoptosis in articular chondrocytes of mice underwent DMM surgery.

CONCLUSIONS

R1-P1, a novel inhibitory peptide for FGFR1, attenuates the degeneration of articular cartilage in adult mice, which is a potential leading molecule for the treatment of OA.

Cartilage-specific deletion of Alk5 gene results in a progressive osteoarthritis-like phenotype in mice

OBJECTIVE

Previous studies have shown that Transforming growth factor-β (TGF-β)/TGFβRII-Smad3 signaling is involved in articular cartilage homeostasis. However, the role of TGF-β/ALK5 signaling in articular cartilage homeostasis has not been fully defined. In this study, a combination of in vitro and in vivo approaches was used to elucidate the role of ALK5 signaling in articular cartilage homeostasis and the development of osteoarthritis (OA).

DESIGN

Mice with inducible cartilage-specific deletion of Alk5 were generated to assess the role of ALK5 in OA development. Alterations in cartilage structure were evaluated histologically. The expressions of genes associated with articular cartilage homeostasis and TGF-β signaling were analyzed by qRT-PCR, western blotting and immunohistochemistry. The chondrocyte apoptosis was detected by TUNEL staining and immunohistochemistry. In addition, the molecular mechanism underlying the effects of TGF-β/ALK5 signaling on articular cartilage homeostasis was explored by analyzing the TGF-β/ALK5 signaling-induced expression of proteoglycan 4 (PRG4) using specific inhibitors.

RESULTS

Postnatal cartilage-specific deletion of Alk5 induced an OA-like phenotype with degradation of articular cartilage, synovial hyperplasia, osteophyte formation, subchondral sclerosis, as well as enhanced chondrocyte apoptosis, overproduction of catabolic factors, and decreased expressions of anabolic factors in chondrocytes. In addition, the expressions of PRG4 mRNA and protein were decreased in Alk5 conditional knockout mice. Furthermore, our results showed, for the first time, that TGF-β/ALK5 signaling regulated PRG4 expression partially through the protein kinase A (PKA)-CREB signaling pathway.

CONCLUSIONS

TGF-β/ALK5 signaling maintains articular cartilage homeostasis, in part, by upregulating PRG4 expression through the PKA-CREB signaling pathway in articular chondrocytes.

eNOS/iNOS and endoplasmic reticulum stress-induced apoptosis in the placentas of patients with preeclampsia

Disruption of nitric oxide pathway and endoplasmic reticulum (ER) stress had been observed in preeclampsia (PE). However, the correlation and overall detailed expression profiles of ER stress-related markers and endothelial nitric oxide synthase/inducible nitric oxide synthase (eNOS/iNOS) in patients with PE were poorly understood. In this study, placental protein expression of ER stress-related markers as well as eNOS/iNOS in normotensive control (n=32) and PE pregnancies (n=32) was examined by western blot. In addition, apoptosis was detected by terminal deoxynucleotidyl transferase-mediated nick-end labelling (TUNEL) staining in placentas. Compared with control, we found elevated ER stress response was agreeable with iNOS upregulation in placenta tissue of PE patients. Placental protein expression of ER stress-related markers, including GRP78, GRP94, p-PERK, eIF2a, p-eIF2a, XBP1, CHOP, Ire1, p-Ire1 and iNOS, was higher, and eNOS expression was lower in PE (P<0.05 for all); however, the expression of ATF6 and PERK was similar in the PE and control groups. Upregulation of CHOP and iNOS was consistent of apoptosis increasing indicated by TUNEL staining and caspase 4 expression upregulation in PE placenta. Our datas suggest that the exaggerated ER stress response and upregulated iNOS are probably associated with increased apoptosis in placenta of PE patients and may contribute to the pathophysiology of PE.

The proliferative and migratory effects of physical injury and stromal cell-derived factor-1α on rat cardiomyocytes and fibroblasts

OBJECTIVE

This study aims to explore the effects of physical injury and stromal cell-derived factor-1α (SDF-1α) on the proliferation of cardiomyocytes and chemotactic effects of cardiomyocytes on the migration of cardiac fibroblasts.

MATERIALS AND METHODS

Isolation and primary culture of rat cardiomyocytes and cardiac fibroblasts were performed; scratching was employed to induce physical injury on cells which were cultured with SDF-1α at different concentrations; proliferation ability of cardiomyocytes was checked with CCK-8 assay and migratory ability of cardiac fibroblasts under the chemotaxis of cardiomyocytes was detected with Transwell assay.

RESULTS

SDF-1α enhanced the proliferation ability of cardiomyocytes with physical injury, especially at the concentration of 80 µg/L when the proliferation rate of cardiomyocytes increased most markedly. Moreover, physically injured cardiomyocyte that was cultured with SDF-1α significantly elevated migratory ability of cardiac fibroblasts, which tended to be more obvious along with the chemotactic culture time.

CONCLUSIONS

SDF-1α enhanced the proliferation ability of cardiomyocytes with physical injury, and physically injured cardiomyocyte that was cultured with SDF-1α promoted the migration of cardiac fibroblasts.

Thrombin generation and fibrin formation under flow on biomimetic tissue factor-rich surfaces

BACKGROUND

Blood flow regulates coagulation and fibrin assembly by controlling the rate of transport of zymogens, enzymes and plasma proteins to and from the site of an injury.

OBJECTIVE

The objective of this work was to define the hemodynamic conditions under which fibrin can form under flow on tissue factor (TF)-rich substrates.

METHODS

TF-coated silica beads (~ 800 nm) were patterned into 18-85-μm spots. Normal pooled plasma and factors VIII, IX and XI deficient plasmas were perfused over the beads coated with 0.08, 0.8 and 8 molecules-TF μm(-2) at shear rates of 50-1000 s(-1) . Fibrin deposition and thrombin generation were measured by fluorescence microscopy in a hydrodynamic focusing microfluidic device.

RESULTS AND CONCLUSIONS

Fibrin deposition was supported on patterned bead spots, but not planar TF substrates at the same surface TF concentration. There was a threshold spot size and a shear rate dependent TF concentration that was necessary to support fibrin polymerization. FVIII and FIX had minor effects on fibrin dynamics at 8 molecules-TF μm(-2) , but were essential at 0.8 molecules-TF μm(-2) . The absence of FXI influenced thrombin generation and fibrin deposition at both 0.8 and 8 molecules-TF μm(-2) . These results show that fibrin deposition requires perturbations in the flow field that protect reactions from dilution by flow under venous and arterial conditions. FVIII and FIX have a modest effect on fibrin deposition at high TF concentrations, but are necessary for fibrin deposition at low TF concentrations. FXI amplifies thrombin generation under flow at both low and high TF concentrations.

Assessment of resistance to paclitaxel of murine tumors by (99m)Tc-MIBI/(201)Tl dual-radionuclide imaging

This study investigated P-glycoprotein (Pgp) expression by murine tumors with and without resistance to paclitaxel and the role of (99m)Tc-2-methoxyisobutylisonitrile (MIBI)/(201)Tl imaging in predicting the effect of paclitaxel. Antitumor effect of paclitaxel and biodistribution of the radiopharmaceuticals were evaluated in mice bearing four tumor types. Pgp expression did not correlate with the antitumor efficacy of paclitaxel. Although the absolute uptake of (99m)Tc-MIBI did not correlate with Pgp expression, (99m)Tc-MIBI could predict paclitaxel sensitivity by its higher uptake.

[Study on bacterial strains in conjunctival sac before and after intraocular surgery]

PURPOSE

To investigate the changes of bacterial strains in the conjunctival sac before and after intraocular surgery, as well as clinical effects of preoperative antibiotic agents.

METHODS

One hundred and thirty-three eyes with intraocular surgery included 68 eyes with cataract surgery, 39 eyes with glaucoma surgery, 20 eyes with retinal detachment surgery and 6 eyes with vitretomy. Bacterial culture and pharmacologic sensitivity test were performed on the conjunctival smear from the 133 eyes with intraocular surgery before and after the operation and the anterior chamber aspirate from the 68 eyes with cataract surgery after the operation.

RESULTS

At the time of admission, 61 eyes(45.8%) of 133 eyes with intraocular surgery were culture-positive conjunctival smears with the following identified: Staphlococcus aureus: 23 eyes; Staphlococcus epidermidis: 25 eyes; Gram-positive rods: 13 eyes. 8 eyes(6%) had culture-positive conjunctival smears before disinfection, (Staphlococcus aureus: 3 eyes; Staphlococcus epidermidis: 5 eyes). One eye(1.5%) had culture-positive Staphylococcus epidermidis in anterior chamber aspirate of 68 eyes with cataract surgery at conclusion of surgery. Also, 4 eyes(3%) were culture-positive conjunctival smears after surgery. All the bacterial strains of the group were sensitive to Tobramycin, Gentamycin, Cephradinum(Velosel), Vancomycinum and Rifampin, but they were resistance to Tetracyclinum, Chloromycetin, Erythromycin and Ofloxacin. Eye Science 1999; 15: 267-269.

CONCLUSION

In order to prevent bacterial endophthalmitis after intraocular surgery, installation of an useful antibiotic eye drop before the surgery is important.

[Quality control for huoxiang-zhengqi liquid]

The Rhizoma Atractylodis, Cortex Magnoliae Officinalis and Pericarpium Citri Reticulatae in Huoxiang-zhengqi Liquid were identified by TLC. The total contents of magnolol and honokiol were determined by HPLC to be no less than 1.9 mg/ml, with an average recovery of 104.4% and 103.3%, RSD 1.23% and 0.91% respectively.

Percutaneous intratumoral injection of cisplatin microspheres in tumor-bearing rats to diminish acute nephrotoxicity

Poly(D,L-lactide) microspheres loaded with cisplatin (PLA-CDDP MS) were prepared by a solvent evaporation technique for direct intratumoral injection. The microspheres, 50-100 microns, containing 40.04% of cisplatin produce sustained release in vitro. PLA-CDDP MS (6 mg/kg body weight of cisplatin) suspensions were injected intratumorally into mammary tumors in rats. Cisplatin solution (6 mg/kg body weight) was injected either intratumorally or intraperitoneally in two groups. After treatments, the tumor size decreased in each of the groups as a function of time. Sixteen days post-injection, the tumors had either disappeared or significantly shrunk. PLA-CDDP MS had a similar antitumor effect compared with cisplatin aqueous solution. Blood urea nitrogen, serum creatinine and histopathology examinations revealed that the renal toxicity in the PLA-CDDP MS group was significantly less than in the control groups. These results indicate that intratumoral injection of PLA-CDDP MS maintains anticancer potency and reduces acute renal toxicity.