[Considering about the timing of cataract surgery with high myopia].

With the rapid increase in the myopic population, cataract surgery in individuals with high myopia has become increasingly prevalent. For patients, the benefits of cataract surgery in highly myopic individuals are more pronounced compared to conventional cataract surgery. However, For cataract surgeons, performing cataract surgery in highly myopic individuals presents a more complex surgical procedure with elevated surgical risks and less favorable postoperative outcomes. As a result, the decision regarding the timing of cataract surgery in highly myopic individuals exhibits a clear polarization. some patients with mild cataracts strongly advocate for early surgery, while others with severe cataracts hesitate due to concerns about surgical risks. When making surgical decisions, both medical professionals and patients should thoroughly consider the benefits and risks of the surgery, allowing for an objective selection of the most appropriate timing for the procedure.

[Safety and efficacy of toric intraocular lens implantation for more than 5 years].

Objective: To evaluate the clinical safety and efficacy of toric intraocular lens (IOL) implantation for more than 5 years. Methods: This study was a prospective cohort study in which subjects were continuously observed over a two-year period (May 2014 to May 2016) in nine hospitals. The study randomly assigned subjects to two groups using a central dynamic randomization system: the study group, which received Proming® IQ toric IOL implants, and the control group, which received AcrySof® IQ toric IOL implants. The subjects completed a one-year follow-up, during which various measures were taken and evaluated, including visual acuity, IOL rotation, postoperative complications, intraocular pressure, and subjective evaluation (preoperatively and at 1 day, 6 months, 1 year, and 5 years post-surgery). The main statistical analysis methods include the Mann-Whitney U test, independent sample t-test, Wilcoxon signed rank test, paired sample t-test, chi-square test, and Fisher's exact test. Results: A total of 45 eyes (26 in the study group and 19 in the control group) completed the five-year continuous observation period. The mean age of the subjects was (72.07±10.67) years and the mean interval from surgery to the last visit was (5.39±0.47) years. After five years, there were no significant differences in uncorrected distance visual acuity (0.20±0.26 vs. 0.16±0.13, t=0.17,P=0.752), best corrected distance visual acuity[0.00(0.00, 0.20) vs. 0.05±0.10, U=188.00, P=0.880], uncorrected near visual acuity[0.50 (0.20, 0.60) vs. 0.42±0.20, t=0.35, P=0.857], and best corrected near visual acuity (0.13±0.16 vs. 0.17±0.23, U=161.00, P=0.884) between the two groups. However, all measures improved significantly from baseline levels in both groups (all P<0.05). Five years after surgery, no matter objective refraction [(-0.67±0.85) D vs. (-0.73±1.08)D] or subjective refraction[-0.50 (-1.00, 0.00)D vs. (0.69±0.87)D], the degree of cylindrical degree is significantly lower than preoperative corneal astigmatism [(1.27±0.49) D vs. (1.34±0.82) D, all P<0.001]. In addition, there were no significant differences in intraocular pressure, subjective evaluation of visual adverse symptoms, distance vision spectacle independence, or overall satisfaction evaluation between the two groups (all P>0.05). The IOL rotation was 3.0°(1.0°, 6.0°) in the study group and 4.0°(2.0°, 6.0°)in the control group (U=185.50,P=0.574), indicating no significant difference between the groups in terms of rotational stability. Five years after surgery, there were 7 cases of posterior capsular opacification in the study group and 4 cases in the control group. There were no cases of IOL glistening in the study group, but 5 cases (26.32%) were observed in the control group. Conclusions: The long-term effects of Proming® toric IOL implantation in correcting cataracts with regular corneal astigmatism are clear after five years, with few complications and stable results.

[Correlation between corneal refractive power and anterior chamber morphology in age-related cataract patients with shallow anterior chambers].

Objective: To investigate the relationship between corneal refractive power and anterior chamber parameters in age-related cataract patients with normal axial lengths and shallow anterior chambers. Methods: Retrospective case series study. Clinical data of 627 age-related cataract patients (627 eyes) with axial lengths between 22 mm and 24 mm and anterior chamber depths less than 2.20 mm treated in the Department of Ophthalmology of Peking University International Hospital from June 2018 to October 2021 were selected. There were 215 male patients and 412 female patients, with an average age of (75±10) years. According to the average corneal refractive power, eyes were divided into groups of keratometry (K)<42 diopters (D) (50 eyes), 42 D ≤K<45 D (398 eyes) and K ≥45 D (179 eyes). Axial length, anterior chamber depth, corneal diameter, anterior chamber volume and anterior chamber angle of 3 groups were recorded, and Spearman correlation analysis was used to analyze the correlation between parameters. The differences of parameters among different groups were compared by one-way analysis of variance or Kruskal-Wallis test, and multiple or pairwise comparisons using LSD-t test or Mann-Whitney U test. Results: There was a negative correlation between axial length and corneal refractive power in 627 eyes (r=-0.62, P<0.001). Corneal refractive power was positively correlated with anterior chamber depth (r=0.26, P=0.006), while in the K≥45 D group, corneal refractive power was also positively correlated with anterior chamber depth (r=0.23, P=0.025). Anterior chamber depth [M (Q1,Q3)] was 1.77 (1.64, 1.90) mm in the K<42 D group, 1.85 (1.70, 2.14) mm in the 42 D≤K<45 D group and 2.02 (1.81, 2.18) mm in the K≥45 D group. Multiple comparisons showed that there were significant differences in anterior chamber depth between the K<42 D group and the K≥45 D group, between the 42 D≤K<45 D group and the K≥45 D group (U=14 372.00, 18 226.00; both P<0.05). There was a negative correlation between corneal refractive power and corneal diameter in 627 eyes (r=-0.52,P<0.001), while in the 42 D≤K<45 D group and the K≥45 D group, corneal refractive power were also negatively correlated with corneal diameter (r=-0.20, -0.28; both P<0.05). Corneal diameter was (11.77±0.43) mm in the K<42 D group, (11.24±0.35) mm in the 42 D≤K<45 D group and (10.90±0.33) mm in the K≥45 D group, while there were significant differences in multiple comparisons (t=1.92, 2.96, 2.01; all P<0.05). There was no correlation between corneal refractive power and anterior chamber volume, or between corneal refractive power and anterior chamber angle in 627 eyes (all P>0.05). There was no significant difference both in anterior chamber volume and in anterior chamber angle among 3 groups (all P>0.05). Conclusion: For age-related cataract patients with normal axial lengths and shallow anterior chambers, the anterior chamber depth increase and the corneal diameter decrease with the increase of corneal refractive power, but there is no significant change in anterior chamber volume and anterior chamber angle.

[Posterior chamber implantation of iris-claw intraocular lenses in a child with bilateral dislocated spherophakia].

A 6-year-old boy with blurred vision for 18 months was diagnosed as bilateral spherophakia and ectopia lentis. He received lensectomy and implantation of an iris-claw intraocular lens in the posterior chamber in both eyes. Good visual results were achieved, and there were no complications during the two-year follow-up.

Glycyrrhizin improves bone metabolism in ovariectomized mice via inactivating NF-κB signaling.

OBJECTIVES: Postmenopausal osteoporosis (PMO) is a prevalent metabolic bone disease with high morbidity and serious complications. Here, we studied the effect of glycyrrhizin on bone metabolism using the ovariectomized (OVX) mouse model. METHODS: Osteoclast-related gene expression and osteoclastic function were evaluated in RAW264.7 cells and bone marrow-derived monocytes (BMMs) by real-time polymerase chain reaction and bone resorption assay. For animal studies, female C57BL/6J mice were randomly divided into sham operated, OVX and OVX with glycyrrhizin groups. Bone mass and trabecular microarchitecture were analyzed by micro-computed tomography, dual X-ray absorptiometry, and histomorphometric analysis. Receptor activator of nuclear factor-κB (NF-κB) ligand-induced osteoclastogenesis and the NF-κB signaling pathway were studied by tartrate-resistant acid phosphatase staining and western blotting, respectively. RESULTS: Glycyrrhizin inhibits RANKL-induced expression of Nfatc-1, c-Fos, Trap, Ds-stamp, and Ctsk in RAW264.7 cells. Also, fewer bone resorption pits form when BMMs are incubated in the presence of glycyrrhizin. Glycyrrhizin ameliorates bone loss and improves trabecular bone parameters in OVX mice. BMMs isolated from OVX mice show higher ability of RANKL-induced osteoclastogenesis, which is tremendously reversed by glycyrrhizin. There is significantly higher phosphorylation of IκB-α at Ser32 and NF-κB p65 at Ser536, as well as increased protein levels of c-FOS and NFATc-1 in BMMs of OVX mice, which are all greatly suppressed by glycyrrhizin. CONCLUSIONS: Our findings imply that glycyrrhizin is a potential efficient adjuvant therapeutic for PMO.

[Association between ocular dominance and refraction in myopic subjects].

Objective: To determine the association between ocular dominance and myopic-astigmatic characteristics in myopic subjects. Methods: Cross-sectional study. A total of 1 503 myopic subjects visiting from the myopiac clinic from December 2011 to December 2012 were included. The spheres and cylinders were recorded. The ocular dominance was determined by the hole-in-the-card test. The average spherical equivalent (SE) and the cylinder between the dominant eyes and the non-dominant eyes were compared with the paired t test. The associations between ocular dominance laterality and refractive characters were analyzed with the crosstab Chi-square test. Results: There were 527 males and 976 females in this study. The median (min, max) of age was 24 (17, 49) years old. Among the subjects, 66.00% (992/1 503) of subjects were right-eye dominant, while 34.00% (511/1 503) of subjects were left-eye dominant. The dominant eyes had significantly lower average sphere powers ï¼»(-5.01±1.91) D vs. (-5.10±1.99) Dï¼½ and lower average cylinder powers ï¼»(-0.70±0.68) D vs. (-0.76±0.73) Dï¼½ than the non-dominant eyes (t=2.976, 4.319; both P<0.01). In the subgroups of |ΔSE|≤0.50 D, 0.50 D<|ΔSE|≤1.00 D, 1.00 D<|ΔSE|≤2.00 D and |ΔSE|>2.00 D, respectively, the dominant eyes were lower myopic in 49.37% (355/719), 51.10% (163/319), 58.48% (100/171) and 65.56% (59/90) of the subjects. The inter-group difference was statistically significant (χ²=11.588, P=0.009). In the subgroups of |ΔCyl|≤0.25 D, 0.25 D<|ΔCyl|≤0.50 D and |ΔCyl|>0.50 D, the dominant eyes had lower astigmatism in 53.94% (89/165), 65.66% (65/99) and 69.70% (46/66) of the subjects, respectively. The inter-group difference was statistically significant (χ²=6.414, P=0.040). Conclusion: The ocular dominance laterality is significantly associated with lower myopia and lower astigmatism in the myopic subjects. (Chin J Ophthalmol, 2020, 56: 693-698).

[Is emmetropization after cataract surgery the best option].

Since the advent of intraocular lenses (IOL), the accuracy of IOL measurements has been paid much attention. With the continuous development of eye biometric equipment and the diversification of IOL power calculation formulas, the precision of IOL power calculation has increased, the function of IOL has improved, and refractive cataract surgery has become popular. However, there is an excessive pursuit of the emmetropization of postoperative refraction after cataract surgery in order to demonstrate the accuracy of IOL measurements, and postoperative emmetropization may cause visual discomfort in some patients with preoperative myopia. This phenomenon is worthy of concern. (Chin J Ophthalmol, 2020, 56: 333-336).

[Characteristics and analysis of corneal astigmatism in age-related cataract patients over 50 years old].

Objective: To investigate the relationship between corneal astigmatism and age, axial length (AL) in age-related cataract patients over 50 years old. Methods: In this retrospective study, 1 906 eyes of 953 patients with age-related cataract were diagnosed from February 2016 to August 2016 atPeking University People's Hospital, and their demographics, preoperative AL, magnitude and meridian of the corneal astigmatism measured by IOL Master were collected. Restricted cubic splines and Spearman rank correlation coefficients were used to investigate the relationship of the magnitude of cornea astigmatism to age. Chi-square test was used to assess the relationship of the meridian of astigmatism to age, AL and the magnitude of cornea astigmatism. Results: The patients were 410 men and 543 women. The corneal astigmatism was with-the-rule (WTR) in 570 eyes (29.91%), against-the-rule (ATR) in 1 005 eyes (52.73%) and oblique in 331 eyes (17.37%). The mean age was (72±9) years old. The medians (min, max) of AL and corneal astigmatism magnitude were 23.49 mm (19.83 mm to 33.89 mm) and 0.97 D (0.06 D to 4.65 D) in right eyes and 23.41 mm (17.54 mm to 32.09 mm) and 0.92 D (0.11 D to 4.88 D) in left eyes, respectively. The corneal astigmatism was ≥0.75 D in 64.95% (619/953) of the right eyes and 61.59% (587/953) of the left eyes. Among the elderly patients over 65 years old, when the AL was between 22.00-25.99 mm (r=0.186-0.279), the value of corneal astigmatism was positively correlated with age (all P<0.01) in both eyes. The value of ATR corneal astigmatism was positively correlated with age (right eyes, r=0.278, P<0.01; left eyes, r=0.225, P<0.01), while the value of WTR corneal astigmatism had no statistically significant correlation with age (right eyes, P=0.335; left eyes, P=0.633). The prevalence of WTR astigmatism decreased with age from 43.81% (46/105) to 20.73% (51/246) in right eyes and from 40.00% (42/105) to 24.80% (61/246) in left eyes, while the prevalence of ATR astigmatism increased with age from 38.10% (40/105) to 61.38% (151/246) in right eyes and from 33.33% (35/105) to 58.94% (145/246) in left eyes. The prevalence of oblique astigmatism was not significantly changed with age (right eyes, χ(2)=31.986, P<0.01; left eyes, χ(2)=27.686, P<0.01). There was no statistically significant difference in the distribution of corneal astigmatism meridians between different AL groups (right eyes, P=0.497; left eyes, P=0.897). With the increase of the magnitude of corneal astigmatism, the prevalence of oblique astigmatism significantly decreased from 25.45% (85/334) to 0 in right eyes and from 29.78% (109/366) to 1.35% (1/74) in left eyes, while the prevalence of ATR astigmatism significantly increased from 39.82% (133/334) to 79.27% (65/82) in right eyes and from 41.80% (153/366) to 59.46% (44/74) in left eyes (right eyes, χ(2)=72.229, P<0.01; left eyes, χ(2)=72.166, P<0.01). Conclusions: A majority of age-related cataract patients over 50 years old have astigmatism ≥0.75 D before cataract surgery. When the AL is between 22.00 mm and 25.99 mm, the magnitude of corneal astigmatism increases with age among people over 65 years old, especially the magnitude of ATR corneal astigmatism, while the magnitude of WTR corneal astigmatism has no obvious increase with age. The percentage of ATR astigmatism increases while the percentage of WTR astigmatism decreases with age. (Chin J Ophthalmol, 2020, 56: 349-355).

[Long-term outcome of bilateral surgery in infant with congenital cataract using different approaches].

Objective: To explore the best surgical approach for infant with congenital cataract by comparing long-term follow-up results of bilateral congenital cataract surgery by different approaches conducted during infant age at last time of visit. Methods: This retrospective case control study includes 108 eyes of 54 infants with bilateral congenital cataract who received bilateral cataract triple procedure (vitrector lensectomy, posterior capsulotomy and anterior vitrectomy) performed by a single surgeon, by either anterior or posterior approach, followed by refractive correction by aphakic glasses or intraocular lens (if suitable)during the follow-up periods (at least for 3 years), between January 2002 and February 2013 in Department of Ophthalmology, Peking University People's Hospital. The unilateral and bilateral best corrected visual acuity (BCVA), intraocular pressure, anterior segment and fundus exam of each visit and post-operative complications were evaluated, and data collected at patients' last visit were compared between two approaches (Student's t test for continuous variables, chi-squeare test for constitutional variables). Results: A total of 44 cases (33 males) were included in anterior approach group, median age of primary surgery was 3.0 (0.5-10.0) months. The rest 10 cases (7 males) were included in the posterior approach group, median age of primary surgery was 4.0 (1.0-11.0) months. At last visit, longest follow up period of anterior and posterior group were 3.5 (3.0-8.5) years and 4.0 (3.0-7.0) years, respectively. Neither unilateral nor bilateral BCVA (logarithm of minimum angle of resolution) of both anterior and posterior approach groups at last visit showed any difference(both P>0.05).Long-term post-operation complications of anterior and posterior group include strabismus (8 cases and 2 cases), nystagmus(8 cases and 6 cases), optical opaque (4 cases and 2 cases), and ocular hypertension(2 cases and 1 case). Nystagmus (P<0.001) and optical opaque (P=0.041) was more prevalent in posterior approach group. Conclusion: For bilateral congenital cataract surgery during infant age, anterior approach would produce less post-operation complications as compared to posterior approach, and is recommended for infants without other abnormalities of posterior segment of the eye. (Chin J Ophthalmol, 2019, 55:46-50).

[A multicenter study of the effectiveness and safety of Toric intraocular lens implantation].

Objective: To evaluate the effectiveness and safety of Proming(®)Toric intraocular lens (IOL) in adults with cataract combined with corneal regular astigmatism. Methods: Multicentre, randomized, open and positive parallel controlled clinical study. A total of 121 patients (121 eyes) who had cataract combined with corneal regular astigmatism and met the inclusion criteria were enrolled in 9 hospitals from May 2014 to May 2016. There were 45 males and 76 females and the median age was 71 (42-88) years old. A total of 121 patients (121 eyes) were randomly assigned to the study group and the control group through the Central Randomization System. Sixty patients (60 eyes) of the study group were implanted with Proming(®)Toric IOL (Model: AT1BH-AT6BH) from Eyebright Medical Technology (Beijing) Co., Ltd., and 61 patients (61 eyes) of the control group were implanted with AcrySof (®)IQ Toric IOL (Model: SN6AT2-SN6AT7) from Alcon Laboratories, Inc. The visual acuity, IOL axial position, slit lamp examination, residual astigmatism and contrast sensitivity were recorded at 1 day, 1 week, 1 month, 3 months, 6 months and 1 year postoperatively. Statistical analysis was performed using χ(2) test, independent sample t test, Mann-Whitney U test, Friedman repeated measured ANOVA on ranks and non-parametric 2-factor variance analysis. Results: A total of 118 patients completed 6 months of follow-up, including 59 from the study group and 59 from the control group. The difference between the two groups in terms of the percentage of best corrected distance visual acuity (BCDVA) reaching 20/40 was 1.69% [100% (59/59) vs. 98.31% (58/59) ], and the lower limit of the 95% CI (-1.60%) was greater than -10.00%. A total of 90 patients were followed up for 1 year, including 43 patients from study group and 47 patients from control group. At 1 year after operation, the percentages of the BCDVA up to 20/40 were 97.67%(42/43) in the study group and 97.87% (46/47) in the control group, and there was no significant difference between the two groups (χ(2)=0.00, P=0.95);the percentages of the uncorrected distance visual acuity (UCDVA) up to 20/40 were 81.40%(35/43) in the study group and 82.98%(39/47) in the control group, and there was no significant difference between the two groups (χ(2)=0.04, P=0.84). At 1 year follow-up, the difference of contrast sensitivity at 18.0 c/d under the bright light, dark light, bright glare and dark glare between the two groups was not statistically significant (U=468.50, P=0.17;U=528.00, P=0.28;U=465.50, P=0.19;U=629.00, P=0.39);the difference of residual astigmatism between the two groups was not statistically significant (U=798.50, P=0.08);the difference of IOL rotation degree between the two groups was not statistically significant (U=869.00, P=0.25). There were no severe inflammatory responses nor other complications associated with IOL in both groups at each follow-up point. Conclusion: The visual quality, astigmatism correction effect, rotation stability and safety of Proming(®)Toric IOL for the treatment of cataract combined with corneal regular astigmatism is equivalent to AcrySof(®) IQ Toric IOL. (Chin J Ophthalmol, 2018, 54: 349-356).

[Pay attention to the complexity of cataract surgery of no vitreous eyes].

With wide-spread performance of pars plana vitrectomy, cataract surgeries with no vitreous are getting more and more. This kind of surgery has great difference between individuals and it lacks randomized large sample clinical trial. Surgical strategy decision was basically relied on the surgeon's personal experience. We should fully aware the individual and common characteristics of no vitreous cataract surgery. Surgical time should be carefully decided. Complete ocular examination, evaluation, design of cataract surgical procedure and appropriate intra-ocular lens selection are needed. We must pay highly attention on the cataract surgery of no vitreous eyes. (Chin J Ophthalmol, 2017, 53: 241-243).

[Correlation between axial length and corneal curvature and spherical aberration].

Objective: To discuss the correlation between axial length and corneal curvature and corneal spherical aberration in a group of cataract patients with axial length greater than 24 mm. Methods: Retrospective case series. This study comprised 117 (234 eyes) age-related cataract patients. There were 51 men (43.59%) and 66 women (56.41%) with mean age of (69.0±8.7) years (range from 52.0 to 85.0 years). The average axial length was 27.6±1.8 (range from 24.2 to 31.9 mm). We devided them into four groups according to the axial length. A-scan was used to measure the axial length and Pentacam was used to get the corneal curvature and corneal spherical aberration of both anterior and posterior surface. kolmogorov-smirnov test was used to check the normal distribution. ANOVA test was used to compare eachcorneal parameter among different groups. Pearson correlation analysis was used to obtain the correlation of corneal parameters in groups. Results: There were correlations between the axial length and the anterior and posterior corneal curvature (r=-0.213, r=0.174, respectively, P<0.05). No correlation was found between the axial length and anterior or posterior corneal spherical aberration (r=-0.114, 0.055, respectively, P>0.05). Mean values of corneal anterior surface curvature were (45.26±1.60) D (group 1), (44.17±1.45) D (group 2), (44.40±1.99)D (group 3), and (44.53±1.69) D (group 4) respectively. Mean values of corneal posterior surface curvature were(-6.57±0.26)D (group 1), (-6.40±0.24)D (group 2), (-6.41±0.38)D (group 3), and (-6.43±0.26)D (group 4) respectively. There were significant difference of corneal anterior and posterior surface curvature among 4 groups (P=0.004, P=0.001). There was significant difference of corneal curvature of anterior surface in group 1 compared to group 2 and group 3(P<0.01, P=0.01). There was significant difference of curvature of posterior surface in group 1 compared to group 2 and group 3, respectively (P<0.01). Mean values of anterior surface corneal spherical aberration were (2.09±0.53) µm (group 1), (1.90±0.44) µm (group 2), (2.00±0.74) µm (group 3), and (1.78±0.52) µm (group 4) respectively. Mean values of posterior surface corneal spherical aberration were (2.69±1.15) µm (group 1), (2.46±1.16) µm (group 2), (2.92±2.51) µm (group 3), and (2.69±1.13) µm (group 4) respectively. No correlation was found in anterior and posterior surface corneal spherical aberration(P>0.05) among different groups. Conclusions: The eye with a longer axial length have a flatter cornea. Cornea fails to compensate for axial length elongation when the axial length is longer than 28mm. The corneal spherical aberration varies among individuals, which suggests us to do the customized measurement before cataract surgery to make a decision on choosing the aspherical intraocular lens. (Chin J Ophthalmol, 2017, 53: 255-259).

Non-extracorporeal circulation for coronary artery bypass graft surgery is more beneficial than extracorporeal circulation.

OBJECTIVE: The objective of this study was to compare coronary artery bypass graft (CABG) surgery with non-extracorporeal vs. extracorporeal circulation. The study outcomes included operative time, number of graft vessels, pulmonary infection rates, and systemic inflammatory markers. PATIENTS AND METHODS: 96 patients received selective CABG, either with non-extracorporeal (study group; n = 48) or extracorporeal circulation (control group; n = 48). Operative time, pulmonary infection rates, and blood levels of inflammatory markers TNF-α, IL-6, and IL-8 before and 4, 24, and 48 hours after the surgery were quantified. Graft vessels were quantified using computed tomography. RESULTS: Operative time was significantly shorter in study group (4.58 ± 0.91 vs. 5.36 ± 1.12 hours in control group; p < 0.05). The number of graft vessels and pulmonary infection rates were comparable between both techniques. However, systemic inflammatory markers were significantly (p < 0.05) lower in study group at 4 and, partly, 24 hours after the surgery. CONCLUSIONS: Extracorporeal circulation prolongs operation and can aggravate systemic inflammatory response. Therefore, CABG with non-extracorporeal circulation offers more beneficial outcomes.

MKL1-184C>T gene polymorphism is associated with coronary artery disease in the Chinese Han population.

We investigated genetic susceptibility to coronary artery disease (CAD) by studying the association of MKL1 gene polymorphisms with CAD in the Chinese Han population. We performed a case-control study with 476 unrelated CAD patients and 325 non-CAD controls. All SNPs were genotyped with a TaqMan SNP genotyping assay. The distribution of MKL1-184C>T gene polymorphism in each group was in Hardy-Weinberg equilibrium. The frequency of the MKL1 T allele in the CAD group was significantly higher than in the control group (38.6 vs 30.8%). After logistic regression models adjusted for CAD risk factors, the risk of CAD among CT genotypes was 1.765 times higher than among the CC genotypes [odds ration (OR) = 1.765, 95% confidence interval (CI) = 1.246-2.5], and for TT genotypes it was 1.806 times higher than for the CC genotypes (OR = 1.806, 95%CI = 1.203-2.71). In summary, genotypes with at least one T allele (CT or TT genotypes) had a significantly increased CAD risk than the CC genotypes, with a ratio of 1.78 to 1 (OR = 1.780, 95%CI = 1.311-2.418). There was a close association between -184 T allele and 3VD (OR = 1.614, 95%CI = 1.259-2.07, P < 0.05). We conclude that the -184C>T of MKL1 is an important susceptibility factor for CAD in the Han Chinese in Henan Province. Homozygosity for the T allele is not only associated with an increased risk for CAD, it is also correlated with severity of stenosis in the Chinese Han population.

[A report of the quantitative determination of relative afferent pupillary defect in central retinal vein occlusion].

Relative afferent pupillary defect (RAPD) indicates injury to the afferent pupillary nerve fibers anterior to the optic chiasma. The light attenuator composed of 2 optical polarizers was utilized to determine the RAPD quantitatively in 32 cases of central retinal vein occlusion (CRVO). In 13 cases with ischemic CRVO, 77% manifested an RAPD of 0.9 log unit or over and none less than 0.75 log unit. In contrast, among 19 cases with non-ischemic CRVO, 84% showed an RAPD of 0.65 log unit or less and none over 0.75 log unit, suggesting that RAPD was a sensitive index for differentiating ischemic from non-ischemic CRVO.