Opinion on the development and research status of intelligent ophthalmology in China / 国际眼科杂志(Guoji Yanke Zazhi)

This paper provides a comprehensive analysis of the current state of intelligent ophthalmology in China, including technological advancements, academic exchange platforms, policy support, future challenges, and potential solutions. Technologically, remarkable progress have been made in various areas of intelligent ophthalmology in China, including diabetic retinopathy, fundus image analysis, and crucial aspects such as quality assessment of medical artificial intelligence products, clinical research methods, technological evaluation, and industrial standards. Researchers are constantly improving the safety and standardization of intelligent ophthalmology technology by formulating clinical application guidelines and standards. Academic exchange platforms have been established to provide extensive collaboration opportunities for professionals across diverse fields, and various academic journals serve as publication platforms for intelligent ophthalmology research. Regarding public policy, the Chinese government has not only established a supportive policy environment for the advancement of intelligent ophthalmology through various documents and regulations, but provided a legal basis and management framework. However, there are still challenges to overcome, such as technological innovation, data privacy and security, outdated regulations, and talent shortages. To tackle these issues, there is a requirement for increased technological research and development, the establishment of regulatory frameworks, talent cultivation, and greater awareness and acceptance of new technologies among patients. By comprehensively addressing these challenges, intelligent ophthalmology in China is expected to continue leading the industry's global development, bringing more innovation and convenience to the field of ophthalmic healthcare.

Effects and mechanism of Chinese medicine Jiawei Yupingfeng in a mouse model of allergic rhinitis / 中西医结合学报

OBJECTIVE@#Chinese medicine has the potential to modulate allergic rhinitis (AR). There have been studies investigating the treatment efficacy of Yupingfeng San, alone or in combination with other ingredients, in AR, though few have studied the potential mechanisms of these drugs. In the present study, we measured the effects of Jiawei Yupingfeng (JWYPF), a traditional Chinese medicine formula, on mice with ovalbumin-induced AR and explored its underlying mechanism of action.@*METHODS@#Forty BALB/c mice were randomly divided into normal control, allergy control and two treatment groups of ten mice each. In the normal control group, mice were sensitized and challenged with saline. The mice in the allergy control and treatment groups were sensitized and challenged with ovalbumin and aluminum hydroxide gel. The treatments of JWYPF and Nasonex were administered intranasally in the AR mice for one week. Several signs of allergic inflammation, such as nasal eosinophils and inflammatory cytokines, were measured to determine the underlying mechanisms.@*RESULTS@#Mice in the JWYPF and Nasonex groups had significantly lower AR symptom scores than those in the allergy control group (the mean differences between JWYPF and the allergy control, and Nasonex and the allergy control were -2.00 ± 0.35 and -2.40 ± 0.32). After treatment with JWYPF and Nasonex, the levels of ovalbumin-specific IgE and histamine were significantly reduced, as were the levels of interlukin-4 and transforming growth factor-β, while interferon-γ levels were increased (all P < 0.0001, vs. allergy control). These two treatments also significantly inhibited eosinophil and mast cell infiltration into the nasal cavity but were not statistically different from one-another.@*CONCLUSION@#JWYPF has a potential therapeutic effect on AR via adjusting the rebalance of T helper 1 and T helper 2.

Application of Single-breath Counting in Assessment of Pulmonary Function after Spinal Cord Injury / 中国康复理论与实践

Objective:To investigate the correlation between single-breath counting (SBC) and standard measures of pulmonary function in patients with spinal cord injury, to evaluate the value for predicting pulmonary function. Methods:Forty-two patients (24 with cervical injury and 18 with thoracic injury) were selected from October, 2018 to February, 2019 in outpatients and inpatients. SBC and standard laboratory spirometer tests were performed separately. The correlation of the outcome of SBC and lung function indicators including forced vital capacity (FVC), forced respiratory capacity in the first second (FEV1), FEV1/FVC, slow expiratory vital capacity (EVC) and all the predicted values on the percentage (%pred) were analyzed. A receiver operating characteristic (ROC) curve was constructed according to the lung function classification criteria. Results:The outcome of SBS was correlated with FVC, EVC as well as the percentage of predicted values (r = 0.723 to 0.760, P < 0.01 for the whole patients; r = 0.549 to 0.657, P < 0.01 for cervical ones; r = 0.623 to 0.847, P < 0.01 for thoracic ones), and was also correlated with FEV1 as well as the percentage of predicted values (r = 0.622 to 0.760, P < 0.01 for whole patients and cervical ones). The area under the ROC curve was 0.864 to 0.941. Conclusion:There is a good correlation between SBC and standard lung function for patients with spinal cord injury, suggesting an assistive diagnostic value for patients with reduced lung function.

Investigate the value of CEACAM1 in diagnosis and monitoring of ONFH / 医学研究生学报

ObjectiveThere are few studies on the correlation between the concentration of oncoembryonic antigen associated cell adhesion molecule 1(CEACAM1) and osteonecrosis of the femoral head (ONFH). The purpose of this study was to investigate the value of CEACAM1 in the early diagnosis of ONFH and the monitoring of the disease by detecting the CEACAM1 concentration in the serum of patients with ONFH and healthy subjects respectively.Methods95 patients, who were hospitalized and diagnosed as ONFH in the Department of No.3 Orthopaedic Ward, the First Affiliated Hospital of Guangzhou University of Chinese Medicine from May 2016 to November 2016, were selected as the experimental group. In addition, 56 genders and age-matched healthy subjects in our hospital were selected as the control group. The peripheral venous blood was taken and separated by a centrifuge. Their CEACAM1 concentrations were measured by enzyme linked immunosorbent assay (ELISA). The differences in CEACAM1 concentrations were analyzed between the two groups, and between patients with ONFH before (ARCO stage I or II) and after (ARCO stage III or IV) collapse as well.Results①The concentration of CEACAM1 in the experimental group was significantly lower than that in the control group [(6.11±2.07)ng/mL vs (7.21±3.76)ng/mL, P=0.022]. ②The concentration of CEACAM1 in Arco stage II[(7.33±1.90) ng/mL] was significantly higher than that in stage III [(6.08±2.26) ng/mL], P=0.037.③The difference of CEACAM1 concentration between before(stage II) and after collapse (stage III or stage IV) was statistically different [(7.33±1.90)ng/mL vs (5.86±2.02)ng/mL, P=0.007].④ROC curve analysis showed that the area under the curve was 0.710 (0.608-0.798), the sensitivity was 71.79%, the specificity was 58.82%, and the cut off value was ≤ 6.757ng/mL in the diagnosis of collapse of ONFH.ConclusionThe concentration of serum CEACAM1 can be used as a biochemical marker to assist in the diagnosis and monitoring of ONFH, which can provide reference for early diagnosis and monitoring of ONFH.

Activation of Multifidus and Erector Spinae Muscles during Upper Limb Flexion and Abduction in Patients with Nonspecific Low Back Pain / 中国康复理论与实践

Objective:To compare the difference in the onset time of the trunk muscles activity in individuals with and without nonspecific low back pain (NLBP) during upper limb flexion and abduction. Methods:From September to December, 2017, 21 patients with NLBP (NLBP group) and 21 volunteers (control group) participated in this study. Surface electromyography (sEMG) signals were recorded from the anterior deltoid, middle deltoid, multifidus and erector spinae muscles during upper limb flexion and abduction in standing position. Relative differences in the onset times between each muscle and the prime mover were calculated. Results:During upper limb flexion, the right multifidus muscle, bilateral erector spinae were activated in advance of the agonist muscle (anterior deltoid), while the left multifidus muscle was delayed relative to the agonist muscle in both groups. The onset time of the right erector spinae was significantly delayed in NLBP group than in the control group (t = -2.393, P = 0.019). During upper limb abduction, bilateral multifidus muscle and bilateral erector spinae were activated in advance of the agonist muscle (middle deltoid) in the control group. Additionally, in NLBP group, the left erector spinae was activated in advance of the agonist muscle, bilateral multifidus and right erector spinae were delayed relative to the agonist muscle. There was no significant difference in the relative onset time between both groups (t < 1.393, P > 0.05). Conclusion:During upper limb flexion and abduction, the trunk muscles of the lower back are activated in advance for healthy individuals, while individuals with NLBP have a possibly delayed activation of trunk muscles.

Test-retest Reliability of Lumbar Spine Position Sense for Aging People / 中国康复理论与实践

Objective:To determine the test-retest reliability of lumbar passive reposition accuracy for older people. Methods:A total of 58 healthy older people stood on an isokinetic dynamometer, and passively moved their trunk forward and backward to the target positions as accurately as possible. The targeted positions were set as flexion forward 15°, 30° and 60°, and flexion backward 15°. The absolute error (AE) was recorded. They were tested again a week latter. The intraclass correlation coefficient (ICC) and standard errors of measurement (SEM and SEM%) were calculated. Results:The ICC of AE was 0.699 to 0.833 for all the subjects, SEM was 1.18 to 3.26, and SEM% was 26.84% to 37.13%. For the men, the ICC was 0.462 to 0.818, SEM was 1.60 to 3.68, and SEM% was 36.37% to 48.78%. For the women, the ICC was 0.782 to 0.891, SEM was 1.48 to 2.71, and SEM% was 28.48% to 33.34%. Conclusions:Lumbar passive reposition accuracy is some reliable to assess the position sense for older people. However, there are too large errors for clinical measurement, which need further improvment.

Analysis of factors on early hemorrhage after vitrectomy with silicon oil tamponade for proliferative diabetic retinopathy / 中华眼底病杂志

Objective To evaluate the factors that may influence the possibility of early hemorrhage after vitrectomy with silicon oil tamponade for proliferative diabetic retinopathy (PDR).Methods Sixty-seven eyes of 60 patients of PDR who received vitrectomy and silicon oil filled in Department of Ophthalmology,China-Japan Friendship Hospital during January 2014 and May 2017 were included in this study.There were 34 males and 26 females,with the mean age of 51.3 ± 12.5 years.Groups were divided depending on the degree of postoperative hemorrhage in 3 days:non-hemorrhage group (NH group) and hemorrhage Group (H group) composed of two sub-group that were called slight hemorrhage (SH) and massive hemorrhage (MH) group.The treatment was conventional 25G or 27G pars plana vitrectomy combined with silicon oil tamponade.Forty eyes received phacoemulsification.The follow-up ranged from 8 to 16 months,with the mean follow-up of 11.2± 5.6 months.The possible related factors of early hemorrhage after vitrectomy with silicon oil tamponade were analyzed.Independent t test,x2 test and Fisher test were used in this study.Results 55 eyes of 48 patients were in the NH group,while 12 eyes of 12 patients were in the H Group.There were statistical significances on the difference of age (t=-3.552,P=0.001),gender (P=0.052),hypertension (P=0.021),HbA1c (t=2.187,P=0.033)and presence of neovascularization of iris (x2=6.414,P=0.011),but there was no difference on diabetes duration (t=-0.451,P=0.654).Of the 12 patients in the H group,7 were in the SH group and 5 were in the MH group.The MH group had a significantly higher HbA1c level (7.8± 1.1)％ compared with the SH Group (9.7±0.7)％,the difference was statistical significant (t=-3.256,P=0.009).Higher systolic blood pressure of MH group 186± 7 mmHg (1 mmHg=0.133 kPa) acquired during operation was observed compared with S H Group 153± 18 mmHg,the difference was statistical significant (t=-3.894,P=0.003).There was no statistical significances on the difference of age (t=1.954),gender,hypertension duration (t=-1.787),diabetes duration (t=-1.079),fasting blood-glucose (t=-0.361),diastolic blood pressure during operation (t=-0.811) between the two groups (P＞0.05).Conclusions Younger age,history of hypertension,presence of neovascularization of iris,higher level of HbA 1 c may predict greater possibility to cause early hemorrhage after vitrectomy with silicon oil tamponade for PDR.The patients with high level of HbA1c and high systolic pressure during the operation are more likely to undergo massive hemorrhage and secondary glaucoma.

Effects of Age and Gender on Lumbar Proprioception / 中国康复理论与实践

@# Objective To explore the difference in lumbar proprioception between the youth and the elderly, and the male and the female. Methods From September to November, 2017, 58 elderly aged 65 to 80 years and 56 youth aged 20 to 30 years were randomly picked up from the community. Their lumbar proprioceptions were measured by Con-Trex isokinetic dynamometer. The absolute error angles of lumbar flexion and extension in passive replication test was used to assess lumbar proprioceptive function. Results The absolute error angles of passive replication test were less on youth proprioception than on elderly ones (t > 4.218, P < 0.001), either in men or women (t > 2.844, P < 0.001), and was not different between men and women neither in the elderly group nor in the youth group (t < 1.473, P > 0.05). Conclusion The lumbar proprioception in the elderly was obviously inferior to that of the youth, both men and women. There was no gender difference between men and women in lumbar proprioception, both elderly and youth.

HepG2 cell IR:Establishment of model and improvement by berberine / 中国药理学通报

Aim To establish insulin resistance cell model on HepG2 cells (human embryonic liver tumor cells )and investigate the effect of berberine hydro-chloride on insulin-resistant HepG2 (IR-HepG2 ) cells.Methods ① IR model was induced by respec-tively using 10 -9 ,10 -8 ,10 -7 ,10 -6 ,10 -5 ,10 -4 mol ·L-1 insulin with 25 mmol · L-1 glucose in HepG2 cells.② HepG2 cells were incubated with 2-NBDG (fluorescent labeled glucose)in a series of concentra-tion:50,100,200,400,600,800 μmol·L-1 and a series of incubation time:20,40,60,80,100 min, to select the optimum concentration of insulin and the optimum incubation concentration and time of 2-NBDG in HepG2 cells.The success of the model was deter-mined by detecting the consumption of glucose in the cell supernatant and the uptake of glucose in HepG2 cells.③To study the effect of berberine hydrochloride on improving insulin resistance on the cell level,met-formin and berberine hydrochloride were used in the IR cells.Results Six concentrations of insulin induced the IR model in different degrees.Although 10 -4, 10 -5 mol·L-1 insulin was significant,a large amount of cells died.10 -6 mol·L-1 insulin was effective and had high survival rate of HepG2 cells,which had sta-tistical significance compared with the normal group. When the incubation concentration of 2-NBDG was more than 100 mol·L-1 ,the fluorescence intensity of the cells was significantly different from the normal group.When the incubation time of 2-NBDG was more than 20 min,fluorescence intensity was significantly different from the normal group.When the incubation time of 2-NBDG was more than 100 min,the fluores-cence quenching phenomenon was obvious in the cells. Berberine hydrochloride and metformin significantly in-creased the glucose consumption and glucose uptake in cell supernatant, which had statistical significance compared with the model group.Conclusions Using 10 -6 mol · L-1 insulin induced IR model in HepG2 cells,the optimum incubation concentration and incu-bation time of 2-NBDG is 200 μmol·L-1 and 80 min, respectively.Berberine hydrochloride and metformin have obvious effect on improving IR in HepG2 cells.

Effects of Xuanzhi Analgesic Tablet on Plasma Levels of 6-K-PGFlαand TXB2 in Rats with Acute Blood Stasis / 医药导报

Objective To investigate the effects of xuanzhi analgesic tablets on plasma levels of 6-keto-prostaglandin Flα(6-K-PGFlα) and thromboxane B2(TXB2) in rats with acute blood stasis. Methods Sixty SD rats were divided into six groups randomly, namely normal control, model control, positive control, xuanzhi analgesic tablets at 1. 36, 2. 72, and 5. 44 g·kg-1 groups. The rat model of blood stasis syndrome was caused by subcutaneous injection of adrenaline incorporated with ice-bathing. The effects of xuanzhi analgesic tablet on 6-K-PGFlαand TXB2 were observed. Results Compared with the normal control,plasma level of 6-K-PGFlα was significantly reduced(P<0. 01) and that of TXB2 in the model control was evidently increased(P<0. 01). Three dosages of xuanzhi analgesic tablets significantly raised 6-K-PGFlαlevel(P<0. 05)and lowered TXB2 level (P<0. 05). Conclusion Xuanzhi analgesic tablets significantly adjust plasma levels of 6-K-PGFlαand TXB2in rats with acute blood stasis. Xuanzhi analgesic tablets can coreect the imbalance between PGI2 and TXA2 through increasing 6-K-PGFlαand desearing TXB2 levels.

Effects of AG1478 on the expression of FOXM1 gene via FOXO3a in non-small cell lung cancer cells / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the effects of EGFR-TKI AG1478 on the expression of FoxMl and FOXO3a genes in non-small cell cancer (NSCLC) cell lines, and explore the effect on cell proliferation and drug sensitivity to AG1478 after down-regulation of FOXMl and FOXO3a expression by RNAi technique.</p><p><b>METHODS</b>Human lung cancer cells were treated with AG1478 at different concentrations. RT-PCR and Western blot were used to examine the expression of P-EGFR, FOXM1, FOXO3a mRNA and protein. After transient transfection of FOXM1 and FOXO3a siRNA, RT-PCR and Western blot were employed to determine the transfection efficiency and expression of the related proteins. CCK-8 assay, colony formation assay and flow cytometry were performed to evaluate the cell proliferation, colony formation ability and the changes in cell cycle distribution.</p><p><b>RESULTS</b>The expressions of FOXM1 mRNA and protein were inhibited by AG1478 in a dose-dependent manner (both P < 0.05). After transfection with FOXM1 siRNA, the expressions of FOXM1 mRNA and protein, and proteins of cyclin B1, c-Myc, and Bcl-2 were significantly down-regulated, and the expressions of p21 and cleaved-PARP proteins were significantly up-regulated (all P < 0.05). The colony number of FOXM1siRNA transfection group was 37.3 ± 8.6, significantly lower than that of the blank control (135.3 ± 7.0) and negative control group (125.3 ± 7.5, P < 0.05). The colony formation inhibition rate was (7.40 ± 0.94)% in the negative control group and (72.4 ± 6.09)% in the FOXM1 siRNA transfection group. FOXM1siRNA transfection induced cell cycle arrest at G2/M phase with a percentage of (55.6 ± 4.83)%, significantly higher than that of the blank control [(24.30 ± 1.95)%] and negative control group [(21.3 ± 2.06)%, P < 0.05]. Additionally, the FOXM1siRNA transfection significantly increased the chemosensitivity of A549 cells to AG1478 (P < 0.05). Besides, AG1478 induced expression and nuclear relocation of FOXO3a. After the FOXO3a siRNA transfection, the expression of FOXM1 protein was significantly up-regulated, and resulted in a reduction of AG1478-induced inhibition of FOXM1.</p><p><b>CONCLUSIONS</b>The expression of FOXM1 is down-regulated by AG1478 via FOXO3a in the NSCLC cell lines, and then increases the chemosensitivity of A549 cells to AG1478. It suggests that FOXM1 could be a potential target for the therapy and drug exploitation for NSCLC.</p>

Effects of bushen tongmai recipe on expression of phosphatidylinositol-3-kinase in PCOS rats accompanying with insulin resistance / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the effects of bushen tongmai recipe (BSTMR) on mRNA and protein expressions of phosphatidylinositol-3-kinase (PI-3K) p85alpha in hepatic, adipose, muscular and ovarian tissues in PCOS rats with insulin resistance (IR).</p><p><b>METHOD</b>Twenty-three-day-old female SD rats were injected subcutaneously with sodium prasterone sulfate (90 mg x kg(-1) x d(-1)) for 20 days, and fed with high-fat forage for 80 days to induce PCOS rats with IR Then the rats were randomly divided into the model group and the treated group. Meanwhile, a group of fifteen rats of the same age was considered as the normal control group. The treated group were administered with BSTMR. The ovulation condition was examined by hematoxylin-eosin (HE) staining. Fasting blood glucose (FBG) was determined using glucose oxidase method. Serum fasting insulin (Fins) was determined by radioimmunoassay (RIA). The mRNA level of PI-3K p85alpha was measured by reverse transcription polymerase chain reaction(RT-PCR). Immunohistochemistry staining was wtilised to detect protein expression of PI-3K p85alpha in ovary.</p><p><b>RESULT</b>Compared with the model group, the mean number of corpus luteum and the rate of ovulation in the treated group increased significantly (P <0. 01). The level of Fins in the treated group was much lower than that in the model group (P < 0.01). Both mRNA and protein expressions of PI-3K p85alpha in target tissues were up-regulated significantly in the treated group (P < 0.01 or P < 0.05).</p><p><b>CONCLUSION</b>BSTMR could improve IR and ovulation dysfunction in PCOS rats accompanying with IR and its molecular mechanisms might be closely related with the elevation of mRNA and protein levels of PI-3K p85alpha in target tissues of the model rats.</p>

Effects of Bushen Tongmai Recipe on protein kinase Balpha expression in polycystic ovary rats with insulin resistance / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the effects of Bushen Tongmai Recipe (, BSTMR) on mRNA and protein expressions of protein kinase B alpha (PKB alpha) in hepatic, adipose, muscular, and ovarian tissues of polycystic ovary (PCO) rats with insulin resistance (IR) and to explore the possible molecular mechanism of BSTMR in treating IR and ovulation dysfunction.</p><p><b>METHODS</b>Female 22-day-old SD rats were injected subcutaneously with sodium prasterone sulfate (9 mg.100g(-1).d(-1)) for 20 days and fed with high-fat diet for 80 days to induce PCO rats with IR. Then, the PCO rats were randomly divided into the model group (n=23) and the treated group (n=21). The treated group was administered with BSTMR for 2 weeks. Meanwhile, a group with 15 rats of the same age was used as the control group. The histological changes in the ovaries were examined. Fasting blood glucose (FBG) was determined by the glucose oxidase method. Serum fasting insulin (Fins) was determined by radioimmunoassay (RIA). The mRNA level of PKBalpha was measured by reverse transcription polymerase chain reaction (RT-PCR). Immunohistochemistry staining and Western blot analysis were employed to detect the protein expression in target tissues.</p><p><b>RESULTS</b>Compared with the control group, the ovaries in the model group showed multiple follicular cysts, levels of FBG and Fins in the model group increased markedly (P<0.05 or P<0.01, respectively), and the insulin sensitive index (ISI) decreased obviously (P<0.01). The mRNA and protein expressions of PKBalpha in target tissues in the model group were dramatically lower than those in the control group (P<0.05 or P<0.01). Compared with the model group, the stratum granulosum of the ovarian follicle in the treated group increased markedly, the level of Fins in the treated group decreased obviously (P<0.01), ISI in the treated group improved markedly (P<0.01), and the mRNA and protein expressions of PKBalpha in target tissues of the treated rats were elevated significantly (P<0.05 or P<0.01).</p><p><b>CONCLUSION</b>BSTMR could improve IR and ovulation dysfunction in PCO rats with IR, and its molecular mechanisms might be closely related with the elevation of mRNA and protein expressions of PKBalpha in target tissues of PCO rats with IR.</p>

Histological and ultrastructural study on the medial canthal ligament of blepharophimosis, ptosis and epicanthus inversus syndrome / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Blepharophimosis ptosis epicanthus inversus syndrome (BPES) is a rare congenital ophthalmic disorder, characterized by congenital eyelid malformation including bilateral ptosis, shortening of the horizontal eyelid fissure, epicanthus inversus, and increased distance between the inner canthi. In this research, we studied the histological structure and ultrastructure of medial canthal ligament of patients with BPES.</p><p><b>METHODS</b>Thirty patients with BPES who received plastic surgery at the Zhongshan Ophthalmic Center from March 2006 to January 2008 were studied. There were 17 males and 13 females with an average age of (8.73 +/- 3.37) years (3 - 31 years). The medial canthal ligaments of patients were collected during the plastic surgery to analyze the histological structure by hematoxylin and eosin (HE), Congo red, van Gieson's (VG), Masson trichrome and aldehyde-fuchsin staining. The ultrastructures of the medial canthal ligaments were also analyzed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Fifteen samples of medial canthal ligament from healthy persons with an average age of (9.02 +/- 3.12) years (6 - 30 years) were collected as a control group.</p><p><b>RESULTS</b>Morphological and histological study showed that the medial canthal ligaments of BPES patients were composed of collagen fibers, a few elastic fibers and striated muscles. The collagen fibers assemblies were disorganized and the fibrous connective tissues were undergoing hyaline degeneration. The karyopycnosis of fibroblasts was located among the collagen fibrils and the numbers of fibroblasts were decreased. Ultrastructural study with SEM showed that the collagen fibers were larger than normal, irregular and loose. Parts of the collagen fibers were broken and had a coarse surface. Ultrastructural study with TEM showed that the fibroblasts had less cytoplasm, fewer organelles and the nucleus displayed pyknosis.</p><p><b>CONCLUSIONS</b>The medial canthal ligament in BPES patients is composed chiefly of collagen fibers. The collagen fibers of medial canthal ligaments in BPES patients are disorganized and hyaline degeneration is present. The study revealed that the medial canthal ligament of BPES patients might have congenital dysplasia.</p>