Effect of vitamin E on retinal pigment epithelial cells injured by high dose blue light / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To study the effect of vitamin E on the injury of human retinal pigment epithelial(hRPE)cells induced by high-dose blue light, and provide experimental evidence for intercepting blue light damaged hRPE cells. <p>METHODS: The hRPE cell injury model was established with 3000±150Lx blue light. The apoptosis rate and reactive oxygen species(ROS)of the six groups of hRPE cells were detected by flow cytometry at 0, 3, 6, 9, 12 and 24h respectively. Apoptosis and ROS in hRPE cells were detected by cytometry in 0h-irradiation group, 6h-irradiation group, and vitamin E added groups(vitamin E concentration 10, 50, 100μmol/L)before or after 6h-irradiation. The fluorescence intensity of hRPE cells was observed under a fluorescence microscope using Hoechst 33258 staining reagent.<p>RESULTS: Compared with the 0h-irradiation group, the relative amount of reactive oxygen species increased significantly in 3, 6, 9, 12 and 24h groups(all <i>P</i><0.01), the apoptosis rate of hRPE cells increased significantly in 6, 9, 12 and 24h groups(all <i>P</i><0.01), the apoptosis rate of the 3h-irradiation group was not statistically significantly increased(<i>P</i>=0.46). Compared with the 6h-irradiation group, the relative amounts of ROS and apoptotic rate of the six groups of hRPE cells added vitamin E were significantly decreased, and the blue fluorescence of Hoechst 33258 released in the cells gradually decreased, which was concentration dependent(all <i>P</i><0.01),except for apoptosis rate of hRPE cells in the 10 μmol/L vitamin E group before irradiation(<i>P</i>=0.66). Compared with the 0h-irradiation group, the difference in the relative amount of ROS and apoptosis rate of hRPE cells in added groups were statistically significant(all <i>P</i><0.01). At the same concentration of vitamin E, the relative amount of ROS and apoptosis rate of hRPE cells added vitamin E after irradiation were significantly lower than those added vitamin E before irradiation(all <i>P</i><0.01), except for apoptosis rate of hRPE cells in the 10 μmol/L vitamin E group, which had no difference between added before and after irradiation(<i>P</i>=0.08).<p>CONCLUSION: After hRPE cells had been irradiated by blue light, the increase in the relative amount of intracellular ROS was earlier than that of apoptosis. Elimination of intracellular ROS is the idea of intercepting high doses of blue light induced hRPE cell injury. Vitamin E protects RPE cell against damage induced by high doses of blue light, and the effect becomes stronger as the concentration of vitamin E increases, which is better when added after irradiating. However, it doesn't take effect until the concentration reaches a certain level. And the damage can't be completely repaired.

Effect of Huanglian Wendantang on Inflammatory Response and Hepatocyte Burn Death in IGT Rats / 中国实验方剂学杂志

Objective:To investigate whether there is inflammatory reaction and cell pyroptosis in impaired glucose tolerance （IGT） rats induced by high-fat diet and the intervention effect of Huanglian Wendantang. Method:Healthy male SD rats were fed with 45% fat content diet for 20 weeks to replicate the IGT model. The rats in line with the model establish criteria were randomly divided into 3 groups， with 10 rats in each group， another 10 rats were selected as the blank control group. Huanglian Wendantang group was given 7.8 g·kg^-1·d^-1 compound decoction of Huanglian Wendantang， and the positive control group was given 0.05 g·kg^-1·d^-1 aqueous solution of metformin hydrochloride， with the dose volume of 10 mL·kg^-1·d^-1. The blank group and the model group were given the same volume of distilled water. After continuous intragastric administration for 4 weeks， the body weight， body length and abdominal circumferences were measured， the Lee's obesity index was calculated， and the levels of fasting plasma glucose （FPG） and 2-hour plasma glucose （2 h PG） were detected in each group. Serum interleukin-6 （IL-6） content was detected by enzyme-linked immunosorbent assay （ELISA）. The mRNA and protein expressions of nuclear factor kappa B （NF-<italic>κ</italic>B）， cysteinyl aspartate specific proteinase-1 （Caspase-1） and NOD-like receptor protein 3 （NLRP3） in liver tissues were detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot. Immunofluorescence was used to detect the expression of Caspase-1 and NLRP3 in rat liver. Hematoxylin and eosin （HE） staining was used to observe the morphology of liver tissue. Result:Compared with blank group， the body weight， abdominal circumference， body length and Lee's index in model group were significantly increased （<italic>P</italic><0.05， <italic>P</italic><0.01）， the levels of FPG and 2 h PG were significantly increased （<italic>P</italic><0.05， <italic>P</italic><0.01）， serum IL-6 content and NF-<italic>κ</italic>B， Caspase-1 and NLRP3 gene and protein expressions in liver tissue were significantly increased （<italic>P</italic><0.01）， immunofluorescence technique showed that Caspase-1 and NLRP3 expressions increased obviously in IGT rat model’s liver tissues， and inflammatory cells infiltration was observed obviously in HE stained rat liver tissue model. Compared with model group， Huanglian Wendantang and metformin hydrochloride groups could effectively reduce the body weight of IGT rats （<italic>P</italic><0.01） and abdominal obesity， and correct the levels of FPG and 2 h PG （<italic>P</italic><0.01）， while effectively reducing serum IL-6 content and gene and protein expressions of NF-<italic>κ</italic>B， Caspase-1 and NLRP3 in liver tissues of IGT rats， and alleviating inflammatory cell infiltration. Conclusion:Inflammatory response exists in IGT model rats induced by high-fat diet. Huanglian Wendantang can obviously reduce its inflammatory response and alleviate liver cell pyroptosis.

Effect of Huanglian Wendantang on Classical Pathway of Skeletal Muscle Pyroptosis in IGT Rats / 中国实验方剂学杂志

Objective:To explore the effects of Huanglian Wendantang （HLWDT） on pyroptosis of skeletal muscle in rats with impaired glucose tolerance （IGT） and to explain the mechanism based on NOD-like receptor protein 3 （NLRP3）/cysteine aspartate-specific protease-1 （Caspase-1）/gasdermin D （GSDMD）/interleukin-1<italic>β </italic>（IL-1<italic>β</italic>）/IL-18 signaling pathway. Method:The SD male rats were fed with 45% high-fat diet for 20 weeks to induce the IGT model. After modeling， the rats were randomly divided into a blank group， a model group， a positive control group （metformin hydrochloride， 0.05 g·kg^-1d^-1）， and an HLWDT （7.8 g·kg^-1d^-1） group based on the body weight of rats. The blank group and the model group were fed with the same volume of distilled water. The dose for each group was set as 10 mL·kg^-1d^-1. After four weeks of continuous gavage， blood was collected and serum was separated. The skeletal muscles of rats were stored in liquid nitrogen. Subsequently， serum IL-1<italic>β</italic> and IL-18 were detected by the enzyme-linked immunosorbent assay （ELISA）. The mRNA and protein expression levels of NLRP3， Caspase-1， and GSDMD were detected by real-time quantitative PCR （Real-time PCR） and Western blot， respectively. The expression of GSDMD， IL-1<italic>β</italic>， and IL-18 proteins in skeletal muscle tissues was detected by immunofluorescence. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of skeletal muscles. Result:Compared with the blank group， the model group showed increased IL-1<italic>β</italic> and IL-18 in serum， and NLRP3， Caspase-1， and GSDMD gene and protein expression in skeletal muscle tissues （<italic>P</italic><0.01）. Immunofluorescence assay showed that GSDMD， IL-18， and IL-1<italic>β </italic>protein expression in skeletal muscle tissues of the model group was significantly elevated （<italic>P</italic><0.01）. HE staining showed obvious pathological changes in skeletal muscles. Compared with the model group， the HLWDT group and the positive control group could decrease IL-1<italic>β</italic> and IL-18 in serum and NLRP3， Caspase-1， and GSDMD gene and protein expression in skeletal muscle tissues （<italic>P</italic><0.01）. In addition， immunofluorescence assay revealed that HLWDT could reduce protein expression levels of GSDMD， IL-1<italic>β</italic>， and IL-18 in skeletal muscles of IGT rats （<italic>P</italic><0.01）. The results of HE staining showed that HLWDT could improve the pathological changes of skeletal muscles in IGT rats<bold>.</bold> Conclusion:HLWDT can inhibit skeletal muscle pyroptosis of IGT rats， and the mechanism may be closely related to NLRP3/Caspase-1/GSDMD/IL-18/IL-1<italic>β</italic> signaling pathway.

Mechanism of Huanglian Wendan Decoction in improving impaired glucose tolerance based on skeletal muscle NLRP3/caspase-1/IL-1β, IL-18 pathway / 中国中药杂志

This study investigated the mechanism of improving impaired glucose tolerance(IGT) of rats by Huanglian Wendan Decoction from the perspective of the skeletal muscle Nod-like receptor protein 3(NLRP3)/cysteinyl aspartate specific proteinase-1(caspase-1)/interleukin-1β(IL-1β), interleukin-18(IL-18) pathway. Healthy male SD rats were fed with the diet containing 45% fat for 20 weeks, accompanied by a high-temperature and high-humidity environment and an inactive lifestyle, for the establishment of the IGT rat model. The rats were divided into the blank control group, model control group, metformin hydrochloride group(positive drug group, 0.05 g·kg~(-1)·d~(-1)) and Huanglian Wendan Decoction group(7.8 g·kg~(-1)·d~(-1)). After continuous intragastric administration for 4 weeks, the obesity and glycemic indexes of all the rats were measured. The fasting serum insulin(FINS) level was determined by ELISA, with the insulin sensitivity index(ISI) and insulin resistance index(IRI) calculated. The mRNA and protein expression le-vels of nuclear factor kappaB(NF-κB), NLRP3, caspase-1, IL-1β and IL-18 in skeletal muscle tissue were detected by real-time polymerase chain reaction(PCR), Western blot and immunofluorescence. Compared with the blank control group, the model control group witnessed significantly increased mRNA and protein expression of NF-κB, NLRP3, caspase-1, IL-1β and IL-18. As revealed by the comparison with the model control group, Huanglian Wendan Decoction could effectively regulate the obesity status, reduce body weight, correct the abnormal levels of 2-hour plasma glucose(2 hPG), insulin resistance index(IRI), insulin sensitivity index(ISI), and lower the mRNA and protein expression of NF-κB, NLRP3, caspase-1, IL-1β and IL-18 in the skeletal muscle tissue of IGT rats. Combined with previous studies, the above results showed that the occurrence and development of IGT was closely related to inflammatory response and the classic pyroptosis pathway in skeletal muscle, such as NLRP3/caspase-1/IL-1β, IL-18. It is inferred that the mechanism of Huanglian Wendan Decoction was to alleviate insulin resistance(IR) and then reverse the course of IGT lies in the regulation of the abnormal insulin receptor signaling pathway based on the NLRP3 inflammasome pathway.

Mechanism of Huanglian Wendan Decoction in intervening IGT IR based on liver cell pyroptosis / 中国中药杂志

To investigate the mechanism of Huanglian Wendan Decoction in intervening impaired glucose tolerance( IGT) rat insulin resistance( IR) based on the pyroptosis pathway of liver cells. The IGT rat model was established by high-fat diet( 20 weeks) combined with high temperature,humidity environment and inactive lifestyle. The experiment was divided into blank group,model group,metformin hydrochloride group( positive group)( 0. 05 g·kg~(-1)·d~(-1)) and Huanglian Wendan Decoction group( 7. 8 g·kg~(-1)·d~(-1)). After continuous intragastric administration for 4 weeks,the body weight,body length and abdominal circumferences of all the rats were measured,the Lee' s obesity indexes was calculated,and the levels of fasting plasma glucose( FPG) and 2-hour plasma glucose( 2 hPG) in each group were measured. Serum insulin levels( FINS) and tumour necrosis factor-α( TNF-α) levels were detected by ELISA,and insulin sensitivity index( ISI) and insulin resistance index( IRI) values were calculated. The expressions of cysteinyl aspartate specific proteinase-1( caspase-1),gasdermin D( GSDMD),interleukin-1β( IL-1β) and interleukin-18( IL-18) m RNA and proteins in liver tissues were detected by Real-time PCR and Western blot. Immunofluorescence was used to detect the expressions of caspase-1 and GSDMD protein in liver tissues. Huanglian Wendan Decoction could effectively reduce the weight of model rats,improve abdominal obesity,FINS,IRI and ISI indexes and correct 2 hPG levels. Compared with blank group,TNF-α levels in serum and caspase-1,GSDMD,IL-1β and IL-18 expressions in liver tissue of model control group were increased significantly. Huanglian Wendan Decoction could effectively reduce TNF-α level in serum,regulate the expressions of caspase-1,GSDMD,IL-1β and IL-18 genes and proteins in liver tissues of IGT rats. The above results showed that the occurrence and development of " obesity-IR-abnormal glucose metabolism-type 2 diabetes mellitus" was closely related to inflammatory response and the classical pyroptosis pathway mediated by caspase-1/GSDMD. The mechanism of Huanglian Wendan Decoction in improving IR may be correlated with reduction of the level of inflammatory factors and the alleviation of the state of pyroptosis,and thus reverse the course of IGT.

Comparison on dry eye symptoms and stability of tear film after correction of myopia by LASIK versus LASEK with the use of artificial tears / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the dry eye symptoms and the stability changes of tear film after correction of myopia by laser-assisted <i>in situ</i> keratomileusis(LASIK)and laser epithelial keratomileusis(LASEK)with the use of 0.1% sodium hyaluronate(HA).<p>METHODS:A total of 230 myopia patients(460 eyes)were divided into LASIK group and LASEK group from February 2017 to December 2017. Each operation group was randomly assigned to 0.1% HA treatment subgroup and HA-free subgroup. Both subgroups were instructed to apply gatifloxacin(0.3%)and loteprednol(0.5%)after the corneal refractive surgery. The changes of dry eye symptom score, corneal perceptual reaction, corneal fluorescein staining(FL), basic Schirmer Ⅰ test(SⅠt)and tear film break-up time(BUT)were observed in different time points.<p>RESULTS:There were significant differences in FL, dry eye symptom score and corneal perceptual response between the 0.1% HA treatment group and HA-free group at 1wk, 1, 3 and 6mo after operation both in LASIK and LASEK patients(<i>P</i><0.05). BUT after operation in each group was significantly deceased at 1wk compared with preoperative level. Other observation time points after surgery of BUT and each postoperative level of SⅠt were still within the normal range although lower than the preoperative levels. The subjective symptoms of dry eyes, tear film stability and corneal surface perception of LASEK patients were better than LASIK patients especially at 1wk, 1 and 3mo after surgery.<p>CONCLUSION:These two kinds of refractive surgery may cause different degrees of dry eye symptoms. These symptoms in the LASEK group were lighter than that in the LASIK group in the early postoperative period. The early adequate use of preservative-free 0.1% HA could effectively promote the corneal repair and be greatly helpful for postoperative dry eye symptoms.

Analysis of postoperative satisfaction, nocturnal visual symptoms and related factors after FS-LASIK / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To analyze satisfaction on night vision and its related factors after FS-LASIK in patients with high and low-to-moderate myopia.<p>METHODS:This was a retrospective study. Totally 75 patients(150 eyes)who underwent FS-LASIK in Xi'an No.1 Hospital from June 2018 to September 2019 were included. All subjects were divided into two groups based on spherical equivalent(SE): high myopia group(SE≥-6.00D)and low-to-moderate myopia group(<-6.00D). Six months after surgery, corneal topography and corneal higher-order aberrations(total HOAs, spherical aberrations, coma and trefoil)under 7mm pupil diameter was investigated by Sirius. Patients were required to complete a questionnaire to evaluate satisfaction and night vision symptoms.<p>RESULTS:For the high myopia group and low-to-moderate myopia group, preoperative SE was -7.85±1.27D and -4.57±1.01D respectively. There were significant differences in total HOAs, spherical aberrations and coma(all <i>P</i><0.001)except for the trefoil(<i>P</i>>0.05)between the two groups. Overall satisfaction was 95.3% and 100.0% in high and low-to-moderate myopia group. 18.8% and 9.3% experienced worsen night vision, 51.2% and 40.6% experienced halo, 41.9% and 43.8% experienced starburst, and 18.6% and 15.6% experienced double vision, respectively. Except that there was significant differences in night vision between the two groups(<i>P</i>=0.010), the occurrence of other night vision symptoms were similar and there were no significant differences in any of them(all <i>P</i>>0.05). For all patients, the satisfaction was correlated with preoperative astigmatism and ablation zone(all<i> P</i><0.05), night vision was correlated with preoperative SE, ablation depth, corneal curvature, total HOAs, spherical aberrations and coma postoperatively(all<i> P</i><0.05), star burst was correlated with preoperative total HOAs, coma and postoperative trefoil(all<i> P</i><0.05), double vision was correlated with preoperative astigmatism(<i>P</i><0.05).<p>CONCLUSION: High myopic patient experienced worsen night vision mainly because of increased total HOAs, spherical aberration and coma. However, symptoms such as halo, starburst and double vision were similar in both groups and did not affect overall satisfaction.

Comparative analysis on the effects of three surgical methods on postoperative visual quality and higher-order aberrations in patients with refractive errors / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the effects of femtosecond laser-assisted <i>in situ</i> keratomileusis(FS-LASIK), topography guided LASIK(TG-LASIK)and small incision lenticule extraction(SMILE)on postoperative visual quality and higher-order aberrations(HOA)in patients with refractive errors.<p>METHODS: A total of 296 patients(586 eyes)with simple myopia or myopic astigmatism who were admitted to refractive center of the hospital between December 2019 and February 2020 were enrolled. Under the premise of determining surgical indications, the patients chose to undergo FS-LASIK, TG-LASIK and SMILE voluntarily. Among them, there were 95 cases(189 eyes)in FS-LASIK group, 104 cases(205 eyes)in TG-LASIK group and 97 cases(192 eyes)in SMILE group. The data such as visual acuity, diopter, corneal topography, HOA and contrast sensitivity were collected before and at 6, 12mo after surgery.<p>RESULTS:The uncorrected visual acuity, best corrected visual acuity, spherical equivalent and spherical equivalent refraction at 6mo after surgery were better than those before surgery(<i>P</i><0.05), and there was no significant difference among different groups(<i>P</i>>0.05). At 6, 12mo after surgery, regularity index of corneal surface and surface asymmetry index in TG-LASIK group were significantly lower than those in SMILE group and FS-LASIK group(<i>P</i><0.05), and there was no significant difference between SMILE group and FS-LASIK group(<i>P</i>>0.05). At 6, 12mo after surgery, total HOA, clover aberration and coma at 6mo spherical aberration in FS-LASIK group were significantly higher than those in TG-LASIK group and SMILE group(<i>P</i><0.05), while the spherical aberration in the SMILE group was significantly lower than that of the other two groups(<i>P</i><0.05). At 6, 12mo after surgery, contrast sensitivities with or without glare in TG-LASIK group were significantly higher than those in SMILE group and FS-LASIK group at frequencies of 12.0c/d and 18.0c/d(<i>P</i><0.05).<p>CONCLUSION: The curative effect of FS-LASIK, TG-LASIK and SMILE are satisfactory. However, the aberration increase is less after TG-LASIK, the corneal topography is more regular, and the visual quality is higher.

Effects of SMILE and FS-LASIK on early postoperative corneal higher order aberrations in patients with high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To study the effects of small-incision lenticule extraction(SMILE)and femtosecond laser-assisted excimer laser <i>in situ</i> keratomileusis(FS-LASIK)on early postoperative corneal higher order aberrations(HOAs)and visual quality in patients with high myopia. <p>METHODS:Totally 102 patients(204 eyes)with high myopia who underwent corneal refractive surgery between August 2018 and August 2020 in the hospital were selected as study subjects for the prospective study, and they were randomly divided into SMILE group(51 cases, 102 eyes)and FS-LASIK group(51 cases, 102 eyes). The postoperative visual acuity, corneal HOAs and objective visual quality were compared between the two groups, and the correlation between corneal HOAs and objective visual quality was analyzed. <p>RESULTS: At 1mo after surgery, the spherical equivalent degrees in SMILE group and FS-LASIK group were significantly reduced(<i>P</i><0.05), and there was no statistically significant difference in the proportion of patients with postoperative uncorrected visual acuity≥preoperative best corrected visual acuity between the two groups(95.1% <i>vs</i> 92.2%, <i>P</i>>0.05). The corneal HOAs in the two groups were significantly increased(<i>P</i><0.05), and the overall spherical aberration(SA), trefoil and higher HOAs in SMILE group were lower than those in FS-LASIK group(all <i>P</i><0.05). The objective scattering index(OSI)was significantly increased in the two groups while the MTF cutoff frequency(MTF_cutoff), Strehl Ratio(SR)and contrast visual acuity(VA100%, VA20%, VA9%)were significantly decreased(all <i>P</i><0.05). The OSI of SMILE group was lower than that of FS-LASIK group while MTF_cutoff and VA9% were higher than those of FS-LASIK group(all <i>P</i><0.05). The corneal HOAs in patients with high myopia were negatively correlated with MTF_cutoff and were positively correlated with OSI(<i>P</i><0.05).<p>CONCLUSION:Both SMILE and FS-LASIK can effectively correct high myopia, and SMILE has a smaller increase in early postoperative corneal HOAs, and it is of great significance to relieve visual quality impairment.

Identify pathogenic mutations of <i>CYP4V2</i> gene in Bietti crystalline corneoretinal dystrophy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To identify pathogenic mutations of <i>CYP4V2</i> gene in two Chinese families with Bietti crystalline corneoretinal dystrophy(BCD)by Sanger sequencing. <p>METHODS: The relevant clinical examination of BCD patients were collected. Peripheral blood of patients and their family members was collected. Then DNA was extracted from peripheral blood, and Sanger sequencing was used to identify mutation sites.<p>RESULTS: Two probands of BCD from different families were collected. All the probands showed progressive decrease of visual acuity and typical crystal-like material deposition could be seen in the fundus. Sanger sequencing showed that proband 1 and her brother and sister all had homozygous mutation of c.802-8_810del17insGC in <i>CYP4V2</i> gene. On the other hand, proband 2 had a compound heterozygous mutation of c.219T>A(p.F73L)and c.802-8_810del17insGC in <i>CYP4V2</i> gene. <p>CONCLUSION: The most common mutation was c.802-8_810del17insGC in Chinese BCD patients. The homozygous c.802-8_810del17insGC mutation was the cause of BCD in the proband 1 family. On the other hand, proband 2 had c.802-8_810del17insGC heterozygous mutation and c. 219T>A(p.F73L)heterozygous missence mutation, all of which affected the normal coding of <i>CYP4V2</i> gene and led to disease.

Progress in the construction of inner blood retinal barrier model<i> in vitro</i> / 国际眼科杂志(Guoji Yanke Zazhi)

@#The blood-retinal barrier is an important structural basis for maintaining the homeostasis of the retinal environment, but there is still a lack of further research on its complete structure and function. The <i>in vitro</i> blood-retinal barrier model has the characteristics of controllable, efficient, fast and stable, and has become an effective tool to study the specific structure and function of the barrier. This paper mainly reviews the structure, function and <i>in vitro</i> model of blood-retinal barrier, which is helpful to promote the study of physiology, biochemistry, pathopharmacology and clinic of blood-retinal barrier. It also provides a common and key experimental basis for the study of fundus vascular diseases such as diabetic retinopathy.

Early changes of the corneal higher-order aberrations after femtosecond laser-assisted <i>in situ</i> keratomileusis for different degrees of myopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the early changes of corneal higher-order aberrations(HOAs)of the anterior surface, posterior surface, and total cornea after femtosecond laser-assisted <i>in situ</i> keratomileusis(FS-LASIK)in mild to moderate myopic and high myopic patients. <p>METHODS: This retrospective study included 129 patients(129 eyes)underwent FS-LASIK surgery from December 2018 to December 2019. Treated eyes were divided into two groups, according to the preoperative spherical equivalent(SE): mild to moderate myopic group(<-6.0D, 76 eyes)and high myopic group(≥-6.0D, 53 eyes). Corneal HOAs of the anterior surface, posterior surface, and total cornea were measured by Pentacam anterior segment analysis system preoperatively and 6mo postoperatively. <p>RESULTS: The tHOAs, spherical aberrations and horizontal coma of the anterior surface and total cornea, significantly increased in both groups 6mo postoperatively(all <i>P</i><0.01). And more tHOAs, spherical aberrations and horizontal coma of the anterior surface and total cornea were induced in high myopic group than mild to moderate myopic group postoperatively(all <i>P</i><0.01). The horizontal coma of the posterior surface, significantly increased in both groups 6mo after operation(all <i>P</i><0.01). And more horizontal coma of the posterior surface were induced in high myopic group than mild to moderate myopic group postoperatively(<i>P</i><0.01). Changes in anterior surface and total corneal tHOAs, spherical aberrations and horizontal coma were related to the SE(all <i>P</i><0.01).<p>CONCLUSION:Anterior and total corneal tHOAs, spherical aberrations and horizontal coma, significantly increased after FS-LASIK, and aberration changes were related to SE. Whereas posterior corneal HOAs remained stable except horizontal coma. The long-term effect should be investigated in the future.

Association between single nucleotide polymorphisms of <i>LSS</i> and <i>HMGCR</i> genes and age-related cataract / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the association between single nucleotide polymorphisms(SNPs)of Lanosterol synthase(LSS)and 3-Hydroxy-3-methylglutaryl coenzyme A reductase(HMGCR)genes and age-related cataract(ARC)risks. <p>METHODS: This was a case-control study. The SNPs of the genes were assayed with TaqMan RT-PCR genotyping. The qRT-PCR was used to detect the <i>LSS</i> mRNA levels of lens epithelial cells(LECs)in individuals. The Chi-square test was used to compare differences of each SNPs between ARCs and controls and to calculate the odds ratio. <p>RESULTS: We found that <i>LSS</i>-rs2968 of ARCs was different from controls(<i>P</i>=0.018), but the significance was lost after Bonferroni correction(<i>P</i>=0.072). We then further performed stratification analysis and found that <i>LSS</i>-rs2968 A allele was associated with nuclear type of ARC risk in Chinese population(<i>P</i>=0.003), and the significances still existed after Bonferroni correction(<i>P</i>=0.012). Consequently, we found that the <i>LSS</i> mRNA levels was lower in LECs of all subtypes of ARC group than that of control group(<i>P</i><0.05). <p>CONCLUSION: <i>LSS</i>-rs2968 A allele might plays a role in the formation and development of nuclear type of ARC risk in Jiangsu population.

Clinical analysis of minimal <i>in situ</i> conjunctival incision for segmental scleral buckling surgery in the treatment of rhegmatogenous retinal detachment / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the postoperative outcomes after segmental scleral buckling(SSB)surgery with minimal <i>in situ</i> conjunctival incision(MCI)and conventional limbal conjunctival incision(LCI). <p>METHODS: Prospective randomized controlled study. Eighty eyes of 80 patients with rhegmatogenous retinal detachment(RRD)who received SSB surgeries in our hospital from August 2016 to November 2018 were recruited. They were randomly divided into two groups. Patients in control group were performed with conventional LCI, while patients in observation group received MCI. The length of the surgery, the retinal reattachment rate and the visual analogue scale(VAS)for evaluating the pain on the first postoperative day, questionnaire scoring method for evaluating the postoperative comfort level(including foreign body sensation and tearing)on the first, seventh, fourteenth, and thirtieth days were recorded. <p>RESULTS: The difference of surgery time between the control group and the observation group was statistically significant(<i>t</i>=2.057, <i>P</i><0.05). There was no significance in retinal reattachment rate between two groups. At the first day after surgery, the postoperative pain of the observation group was significantly lower than the control group(<i>P</i><0.05). At the first and seventh day after surgery, the observation group had higher postoperative comfort questionnaire score than the control group(<i>P</i><0.01), however, at the fourteenth and thirtieth day after surgery, the score was similar between the two groups(<i>P</i>>0.05). <p>CONCLUSION: Using MCI in SSB operation could shorten the operation time and significantly reduced postoperative pain and discomfort level.

Comparison of refractive outcomes of femtosecond LASIK with two different flap thickness in the correction of myopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the refractive outcomes of femtosecond LASIK with two different flap thickness in the correction of myopia.<p>METHODS: A total of 236 eyes of 118 myopic patients received LASIK with Wave-Light exeimer laser system. In the non-high myopia group, 30 people(60 eyes)used 90 micron corneal flaps, the other(60 eyes)used 110 micron corneal flaps; in the high myopia group,29 people(58 eyes)used 90 micron corneal flaps,the other(58 eyes)used 110 micron corneal flaps. Uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), manifest refraction and intraocular pressure before operation, at 1mo, 3mo postoperatively were evaluated.<p>RESULTS: The percent of postoperative UDVA better than or equal to preoperative CDVA after 3mo: 57 eyes(95%). In the non-high myopia group no matter 90 micron corneal flaps or 110 micron corneal flaps. In the high myopia group, there are 53 eyes(91.4%)with 90 micron corneal flaps and 56 eyes(96.6%)with 110 micron corneal flaps(<i>P</i>=0.438); The percent of spherical equivalent refraction(SE)within ±0.50D of the target refraction change: 51 eyes(85%). In the non-high myopia group no matter 90 micron corneal flaps or 110 micron corneal flaps, 48 eyes(82.8%). In the high myopia group with 90 micron corneal flaps or 110 micron corneal flaps; The percent of change in SE within 0.50D between 1mo and 3mo postoperatively: there are 57 eyes(95%)with 90 micron corneal flaps and 55 eyes(91.7%)with 110 micron corneal flapsin the non-high myopia group(<i>P</i>=0.717). In the high myopia group, there are 44 eyes(75.9%)with 90 micron corneal flaps and 50 eyes(86.2%)with 110 micron corneal(<i>P</i>=0.464). <p>CONCLUSION: Both 90 micron corneal flaps and 110 micron corneal flaps show similar good efficacy, predictability and stability in the correction of myopia.

An <i>in vivo</i> confocal microscopy study: correlation between morphological changes of corneal subbasal nerve and clinical symptoms of Sjogren syndrome / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the morphological changes of corneal subbasal nerve(SBN)plexus in patients with Sjogren syndrome(SS)by <i>in vivo</i> confocal microscopy(IVCM)study and analyze its correlation with clinical symptoms.<p>METHODS: We collected 22 cases(44 eyes)patients with Sjogren's syndrome(observation group)and 22 cases(44 eyes)healthy people with the same age(control group)for observation of central corneal SBN fibers diameter, number of beads, and tortuosity, and recorded tear film break up time(BUT), Schirmer's Ⅰ test(SⅠt), tear meniscus height(TMH), dendritic cell(DC)density, the results were applied to perform statistical analysis.<p>RESULTS: Under IVCM observation, the diameter of corneal SBN fibers in the observation group became thinner, the number of beads and the degree of nerve fiber tortuosity were increased compared with the control group(<i>P</i><0.05). Pearson correlation analysis: the diameter of corneal SBN fibers in the observation group was significantly correlated with BUT(<i>r</i>=0.472, <i>P</i><0.01), SⅠt(<i>r</i>=0.562, <i>P</i><0.01), TMH(<i>r</i>=0.246, <i>P</i>=0.02)and DC density(<i>r</i>=-0.636, <i>P</i><0.01). The number of nerve fiber beads was correlated with BUT(<i>r</i>=-0.621, <i>P</i><0.01), SⅠt(<i>r</i>=-0.688, <i>P</i><0.01), TMH(<i>r</i>=-0.438, <i>P</i><0.01)and DC density(<i>r</i>=0.528, <i>P</i><0.01). There was a significant correlation between nerve fiber tortuosity and BUT(<i>r</i>=-0.634, <i>P</i><0.01), SⅠt(<i>r</i>=-0.713, <i>P</i><0.01), TMH(<i>r</i>=-0.384, <i>P</i>< 0.01)and DC density(<i>r</i>=0.604, <i>P</i><0.01).<p>CONCLUSION: IVCM can effectively observe the morphology of corneal nerve plexus. In SS patients, the diameter of corneal SBN fibers becomes thinner, the number of beads increases, and the tortuosity of nerve fiber increases. Moreover, the degree of nerve fiber lesions is correlated with the severity of dry eye clinical symptoms.

Analysis of short-term objective visual quality after two kinds of corneal refractive surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze changes in objective visual quality before and after femtosecond laser <i>in situ</i> keratomileusis(FS-LASIK)and smart pulse technology-assisted transepithelial photorefractive keratectomy(SMART).<p>METHODS: Prospective study. We collected 50 cases(100 eyes)treated with FS-LASIK(FS-LASIK group)and another 50 cases(100 eyes)treated with SMART(SMART group)from the Ophthalmology Department of our hospital between October 2018 and December 2018 using Optical Quality Analysis System(OQAS)to measure objective scatter index(OSI), modulation transfer function cut off frequency(MTF cut off), strehl ratio(SR)before and after surgery.<p>RESULTS: In the FS-LASIK and SMART groups, the OSI values were higher in the 1 and 3mo after surgery, whereas the MTF cut off and SR were lower in the 1 and 3mo after surgery(<i>P</i><0.05). There was no statistical difference between the two groups in the objective visual quality index before and after 1mo(<i>P</i>>0.05). However, after 3mo, the OSI value of the FS-LASIK group was higher than the SMART group(0.88±0.28 <i>vs</i> 0.70±0.27, <i>P</i><0.001), whereas the SR was lower than SMART group(0.21±0.05 <i>vs</i> 0.24±0.05, <i>P</i>=0.002).<p>CONCLUSION: Both FS-LASIK and SMART caused an increase in the intraocular scattering index and a decrease in objective visual quality. However, the visual quality of the SMART group was generally better than that of the FS-LASIK group, and long-term visual quality was more dominant.

Application and development of <i>in vivo</i> confocal microscopy in the diagnosis of microbial keratitis / 国际眼科杂志(Guoji Yanke Zazhi)

@#Microbial keratitis(MK)is a common corneal blind eye disease in the world. Severe keratitis can cause irreversible complications and even lead to blindness. Rapididentification of pathogen is the key for early and accurate MK treatment and a large of clinical data indicated that identifying the type of infected microorganisms accurately and quickly is still a challenge for ophthalmologists. The <i>in vivo</i> confocal microscopy(IVCM)is a non-invasive imaging technology that can provide high-resolution images of all corneal layers in a fast and real-time manner, has been used in the diagnosis and follow-up of corneal diseases. In recent years, with the intersection and integration of disciplines, artificial intelligence has been used to identify the characteristic structures in microbial keratitis IVCM images, which has brought important value for accurate and rapid diagnosis of microbial keratitis. Therefore, this article will review the characteristics of confocal microscopy in the diagnosis of microbial keratitis and the application of artificial intelligence in the diagnosis of microbial keratitis. It is of great significance to promote the diagnosis and treatment of keratitis in the future.

Theoretical Analysis of Prevention and Treatment of Around-adolescence Women with IGT Type PCOS by Wenshen Huatan Prescription Combined with Food Exchange / 浙江中医药大学学报

[Objective]The purpose of this study is to provide a new idea for the prevention and treatment of PCOS in around-adolescence period through the cooperation of Wenshen Huatan prescription and food exchange. [Methods]By referring to and sorting out the related literatures, combined with clinical practice, this paper discusses how to form a specific plan of prevention and treatment of around -adolescence PCOS complicated with IGT by Wenshen Huatan prescription and food exchange. [Results]Food exchange can scientifically control diet, combined with kidney-warming and phlegm-Tiaojing, spleen phlegm, which has a remarkable effect on the treatment of around-adolescence PCOS complicated with IGT, such as improving clinical symptoms, shortening the menstrual cycle, improving endocrine disorders and insulin resistance.[Conclusion]It is significant for patients with IGT-type PCOS around-adolescence by the exchange of food with Wenshen Huatan prescription combined with diet intervention, which provides a new train of thought for clinical research.

Determination of nonalcoholic fatty liver disease in patients with pre-impaired glucose tolerance

INTRODUCTION: Pre-impaired  glucose  tolerance  (pre-IGT) or  compensated  hyperinsulinemia,  is  defined  as  normal glucose,  and  elevated  insulin  two  hours  after  a  75-gram oral glucose load.  It is characteristic of the early stages of diabetes  mellitus  (DM),  where  beta  cells  compensate  for  insulin resistance by increasing insulin secretion to maintain normoglycemia. With  continuing  beta  cell  failure,  insulin  secretion  eventually  fails,  leading  to  the  progression  to diabetes.    Nonalcoholic  fatty  liver  disease  (NAFLD),  a common feature of insulin resistance, is found in 50-75% and 42-55% of DM and pre-diabetes patients. We determined if NAFLD was present in patients with pre-IGT.METHOD: A study on the determination of NAFLD - diagnosed by liver ultrasound in pre-IGT patients at a university hospital.Descriptive statistics, Chi square test of independence, 2x2 Fischer  Exact  test,  Z  test  of  difference  in  proportion, were used  for  statistical  analysis  with  a  p-value  set  at  0.05?.IBMSPSS ver 21 was used as software.RESULTS:The mean age of 22 patients was 29.95 years, with average BMI of 25.73 kg/m2;77.3% were female.  Average lipid  panels  were  within  optimal  limits;  kidney  and  liver functions were normal.  The mean insulin level was 58.36 uIU/mL. NAFLD was identified in eight of the subjects. CONCLUSION: Although  pre-IGT  is  a  subclinical  phase  in  the  diabetes  spectrum,  36%  already  have  NAFLD.This prevalence  was  lower  compared  to  diabetics  and  pre-diabetics, but higher compared to the general population.There was a noticeable trend of increasing insulin levels with increasing severity of fatty liver.