Clinical analysis of secondary glaucoma in Central China.

To describe the epidemiology, clinical and social characteristics, management, and outcomes of patients with secondary glaucoma in Central China, a total of 1,129 cases (1,158 eyes) among 710 males (62.89%) and 419 females (37.11%) were analyzed. The mean age was 53.75 ± 17.11 years. The New Rural Cooperative Medical System (NCMS) played the most important role in reimbursement (60.32%) for secondary glaucoma-related medical expenses. The predominant occupation was "farmer" (53.41%). Neovascularization and trauma were the leading causes of secondary glaucoma. Cases of trauma-induced glaucoma decreased substantially during the coronavirus disease 2019 (COVID-19) pandemic. An education level of senior high school or above was uncommon. Ahmed glaucoma valve implantation was the most commonly performed surgery. At the final follow-up, the overall intraocular pressure (IOP) in patients with vascular disease- and trauma-related secondary glaucoma was 19.53 ± 10.20 mmHg, 20.26 ± 11.75 mmHg, and 16.90 ± 6.72 mmHg, while the mean visual acuity (VA) was 0.33 ± 0.32, 0.34 ± 0.36, and 0.43 ± 0.36. In 814 (70.29%) eyes, the VA was < 0.01. Effective preventive measures for at-risk populations, increased NCMS coverage and the promotion of higher education are necessary. These findings will help ophthalmologists detect secondary glaucoma early and manage it in a timely manner.

Improved Cloud Auditing Protocol and Its Application for Pandemic Data Management

Data integrity verification mechanisms play an important role in cloud environments. Recently, a lightweight identity-based cloud storage audit scheme has been proposed;this paper points out security vulnerabilities of their OffTagGen algorithm. That is, the attackers such as malicious cloud servers can forge the tags, which can destroy data integrity. By improving the construction of OffTagGen algorithm, an improved security cloud auditing protocol is proposed in this work to better protect user’s privacy. The analysis shows that the new protocol is effective and resistant to attacks.

SARS-Cov-2 Spike Protein Causes Human Lung Endothelial Inflammation

Patients with COVID-19 often present with pulmonary inflammation and blood coagulopathy, with severe cases advancing to acute respiratory distress syndrome (ARDS) and multiple organ failure. Although the pathogenesis is not completely understood, endothelial inflammation is suspected to be a major causative factor for the systemic manifestations of COVID-19. In this study, we investigated the direct effects of SARS-Cov-2 spike protein on pulmonary microvascular endothelial cells (ECs) isolated from the small airway region of viable human lungs. We verified the expression of angiotensin-converting enzyme 2 (Ace-2), the receptor for SARS-Cov-2 spike protein, in pulmonary ECs using flow cytometry analysis and immunofluorescence labeling. Treating ECs with recombinant spike protein caused increased F-actin stress fibers, enhanced phosphorylation of myosin light chain 2, and disruption of adherens junction continuity. In addition to the junction and cytoskeletal changes, spike protein-treated ECs showed increased expression of intercellular adhesion molecule 1 and enhanced adherence for monocytic cells. Interestingly, there was a significant accumulation of von Willebrand factor long strands on the cell surface in ECs isolated from COVID-19 positive human lungs, as well as on ECs from normal human lungs following spike protein treatment. In conclusion, we demonstrate that the SARS-Cov-2 spike protein is capable of directly activating human lung ECs and promoting inflammation/coagulopathy.

Extracellular vesicles: new players in regulating vascular barrier function.

Extracellular vesicles (EVs) have attracted rising interests in the cardiovascular field not only because they serve as serological markers for circulatory disorders but also because they participate in important physiological responses to stress and inflammation. In the circulation, these membranous vesicles are mainly derived from blood or vascular cells, and they carry cargos with distinct molecular signatures reflecting the origin and activation state of parent cells that produce them, thus providing a powerful tool for diagnosis and prognosis of pathological conditions. Functionally, circulating EVs mediate tissue-tissue communication by transporting bioactive cargos to local and distant sites, where they directly interact with target cells to alter their function. Recent evidence points to the critical contributions of EVs to the pathogenesis of vascular endothelial barrier dysfunction during inflammatory response to injury or infection. In this review, we provide a brief summary of the current knowledge on EV biology and advanced techniques in EV isolation and characterization. This is followed by a discussion focusing on the role and mechanisms of EVs in regulating blood-endothelium interactions and vascular permeability during inflammation. We conclude with a translational perspective on the diagnostic and therapeutic potential of EVs in vascular injury or infectious diseases, such as COVID-19.