Initiation and maintenance of acquired immunity in dry eye / 国际眼科杂志(Guoji Yanke Zazhi)

Dry eye(DE)is a multifactorial ocular surface disorder arising from numerous pathologies. The pathogenesis of DE includes immune inflammation, oxidative stress, changes in tear film composition, corneal nerve abnormalities, and meibomian gland dysfunction. Among them, the immune inflammatory response is the most crucial in the pathogenesis of DE, which is regulated by both innate and acquired immune responses on the ocular surface. Multiple environmental stresses trigger the ocular surface innate immune response leading to corneal epithelial cell damage and inflammation and activate acquired immunity to participate in the ocular surface immune inflammatory response. Currently, multiple immune cells and inflammatory factors have been shown to be involved in the occurrence and development of DE. This article reviewed the immune progress and focused on the initiation and maintenance of acquired immunity in DE. Through the analysis of the latest viewpoints and research hot spots, we systematically introduced the immunomodulating mechanism underlying the mechanisms of the pathogenesis of DE and provided references for the prevention and treatment of DE.

Sleep deprivation disrupts the lacrimal system and induces dry eye disease

Sleep deficiency is a common public health problem associated with many diseases, such as obesity and cardiovascular disease. In this study, we established a sleep deprivation (SD) mouse model using a ‘stick over water’ method and observed the effect of sleep deficiency on ocular surface health. We found that SD decreased aqueous tear secretion; increased corneal epithelial cell defects, corneal sensitivity, and apoptosis; and induced squamous metaplasia of the corneal epithelium. These pathological changes mimic the typical features of dry eye. However, there was no obvious corneal inflammation and conjunctival goblet cell change after SD for 10 days. Meanwhile, lacrimal gland hypertrophy along with abnormal lipid metabolites, secretory proteins and free amino-acid profiles became apparent as the SD duration increased. Furthermore, the ocular surface changes induced by SD for 10 days were largely reversed after 14 days of rest. We conclude that SD compromises lacrimal system function and induces dry eye. These findings will benefit the clinical diagnosis and treatment of sleep-disorder-related ocular surface diseases.

Minimal incision surgery for total hip replacement / 中国矫形外科杂志

[Objective]To explore the advantages and disadvantages of minimal incision surgery(MIS) for total hip replacement.[Methods]Thirty-two patients(37 hips) who had undergone a MIS were compared with 32 patients(37hips) who had undergone conventional incision surgery with similar condictions.The length of incision,operation time,intraoperative blood loss,postoperative drainage,hospitalized days and complications were observed.[Results]The average incision length was 7.7 cm for MIS group and 11.5 cm for conventional incision group(P0.05).In MIS group,greater trochanter fracture occured in 1 patient during operation.Dislocation occurred in another patient with anterolateral approach 3 days postoperatively because of malposition of the cup,the cup was then adjusted to proper position by re-operation with extended incision length.In conventional incision group,no complication occured during or after operations.[Conclusion]Total hip replacement with the incision length of 6～8.5 cm is a very demanding technique.There were no much advantages of MIS for total hip replacement concerning surgical time,blood loss or trauma compare with a conventional incision surgery.The incision length for total hip replacement should not be stressed.The most important thing for total hip replacement is not the length of the incision and the length of incision should not be reduced at the price of more soft tissue injury.