The triglyceride-glucose index is associated with atherosclerosis in patients with symptomatic coronary artery disease, regardless of diabetes mellitus and hyperlipidaemia.

BACKGROUND: Diabetes and hyperlipidaemia are both risk factors for coronary artery disease, and both are associated with a high triglyceride-glucose index (TyG index). The TyG index has been presented as a marker of insulin resistance (IR). Its utility in predicting and detecting cardiovascular disease has been reported. However, few studies have found it to be a helpful marker of atherosclerosis in patients with symptomatic coronary artery disease (CAD). The purpose of this study was to demonstrate that the TyG index can serve as a valuable marker for predicting coronary and carotid atherosclerosis in symptomatic CAD patients, regardless of diabetes mellitus and hyperlipidaemia. METHODS: This study included 1516 patients with symptomatic CAD who underwent both coronary artery angiography and carotid Doppler ultrasound in the Department of Cardiology at Tianjin Union Medical Center from January 2016 to December 2022. The TyG index was determined using the Ln formula. The population was further grouped and analysed according to the presence or absence of diabetes and hyperlipidaemia. The Gensini score and carotid intima-media thickness were calculated or measured, and the patients were divided into four groups according to TyG index quartile to examine the relationship between the TyG index and coronary or carotid artery lesions in symptomatic CAD patients. RESULTS: In symptomatic CAD patients, the TyG index showed a significant positive correlation with both coronary lesions and carotid plaques. After adjusting for sex, age, smoking, BMI, hypertension, diabetes, and the use of antilipemic and antidiabetic agents, the risk of developing coronary lesions and carotid plaques increased across the baseline TyG index. Compared with the lowest quartile of the TyG index, the highest quartile (quartile 4) was associated with a greater incidence of coronary heart disease [OR = 2.55 (95% CI 1.61, 4.03)] and carotid atherosclerotic plaque [OR = 2.31 (95% CI 1.27, 4.20)] (P < 0.05). Furthermore, when compared to the fasting blood glucose (FBG) or triglyceride (TG) level, the TyG index had a greater area under the ROC curve for predicting coronary lesions and carotid plaques. The subgroup analysis demonstrated the TyG index to be an equally effective predictor of coronary and carotid artery disease, regardless of diabetes and hyperlipidaemia. CONCLUSION: The TyG index is a useful marker for predicting coronary and carotid atherosclerosis in patients with symptomatic CAD, regardless of diabetes mellitus and hyperlipidaemia. The TyG index is of higher value for the identification of both coronary and carotid atherosclerotic plaques than the FBG or TG level alone.

Multi-Ionic Hydrogel with Outstanding Heat-to-Electrical Performance for Low-Grade Heat Harvesting.

Ionic thermoelectric (i-TE) materials have attracted much attention due to their ability to generate ionic Seebeck coefficient of tens of millivolts per Kelvin. In this work, we demonstrate that the ionic thermopower can be enhanced by the introduction of multiple ions. The multi-ionic hydrogel possesses a record thermal-to-electrical energy conversion factor (TtoE factor) of 89.6 mV K-1 and an ionic conductivity of 6.8 mS cm-1 , which are both better than single salt control hydrogel. Subsequently we build a model to explain thermal diffusion of the ions in multi-ionic hydrogels. Finally, the possibility of large-scale integrated applications of multi-ionic hydrogels is demonstrated. By connecting 7 i-TEs hydrogels, we obtained an open-circuit voltage of 1.86 V at ΔT=3 K. Our work provides a new pathway for the design of i-TEs and low-grade heat harvesting.

Effectiveness of multiple therapeutic strategies in neovascular glaucoma patients: A PRISMA-compliant network meta-analysis.

PURPOSE: Neovascular glaucoma (NVG) is a severe secondary glaucoma with uncontrolled intraocular pressure that leads to serious eye pain and vision loss. Presently, the therapeutic strategies for NVG are diverse, but the therapeutic effects are still not ideal. We performed a network analysis to assess the effect of multiple therapeutic strategies on the treatment of NVG patients. METHODS: We searched public electronic databases through April 2017 using the following keywords "neovascular glaucoma," "iris neovascularization," "hemorrhagic glaucoma," and "random" without language restrictions. The outcome considered in the present analysis was treatment success rate. A network meta-analysis and multilevel mixed-effects logistic regression were used to compare regimens. RESULTS: We included 27 articles assessing a total of 1884 NVG patients in our analysis. According to the network analysis, interferon and mitomycin plus trabeculectomy (94.9%), glaucoma valve implantation (86.9%), and iris photocoagulation plus trabeculectomy (81.9%) were the most likely to improve treatment success rate in NVG patients. The multilevel logistic regression analysis showed that glaucoma valve, bevacizumab, interferon, cyclophotocoagulation, trabeculectomy, iris photocoagulation, ranibizumab, and mitomycin had advantages in terms of improving treatment success rate in NVG patients. However, the application of retinal photocoagulation and vitrectomy reduced patient treatment success rate. CONCLUSION: The regimen including mitomycin, interferon, and trabeculectomy was the most likely to improve the treatment success rate in NVG patients. The application of glaucoma valve and bevacizumab were more beneficial for improving patient treatment success rate as a surgery and as an agent, respectively.

Small incision lenticule extraction (SMILE) and femtosecond laser LASIK: comparison of corneal wound healing and inflammation.

AIM: To evaluate and compare early corneal wound healing and inflammatory responses after small incision lenticule extraction (SMILE) versus femtosecond laser laser in situ keratomileusis (LASIK). METHODS: Thirty-six eyes of 36 rabbits underwent SMILE, while another 36 eyes of 36 rabbits were treated with femtosecond laser LASIK. All the eyes were subjected to the same refractive correction of -6.00 DS/-1.00 DC. Twelve eyes that had no surgery were included for control. After euthanisation, corneal tissue sections were evaluated with terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick-end labelling (TUNEL) assay to detect apoptosis at postoperative 4 and 24 h, immunocytochemistry for Ki67 to detect keratocyte proliferation at postoperative day 3, week 1 and month 1, and immunocytochemistry for CD11b to detect inflammation at postoperative day 1, day 3 and week 1, respectively. RESULTS: No adverse effects were noted after SMILE or LASIK. Corneal healing postoperatively was uneventful in all cases. There were significantly fewer TUNEL-positive corneal stromal cells after the SMILE procedure at 4 and 24 h postoperatively (p<0.01) compared with the LASIK procedure. In addition, immunocytochemistry showed significantly fewer Ki67-positive cells in the SMILE group than those in the femtosecond laser LASIK group at day 3 and week 1 postoperatively (p<0.05), but there was little expression of Ki67 at month 1 postoperatively in both groups. The CD11b-positive cells were significantly fewer in the SMILE group at day 1, day 3 and week 1 postoperatively (p<0.01). CONCLUSIONS: SMILE induces less keratocyte apoptosis, proliferation and inflammation compared with femtosecond laser LASIK.

Microdistortions in Bowman's layer following femtosecond laser small incision lenticule extraction observed by Fourier-Domain OCT.

PURPOSE: To study microdistortions in Bowman's layer after femtosecond laser small incision lenticule extraction (SMILE) using Fourier-domain optical coherence tomography (OCT) and to investigate possible sources and potential visual impacts. METHODS: A nonrandomized controlled prospective study enrolled 52 eyes of 29 consecutive patients undergoing SMILE, with spherical equivalent of -6.33 ± 1.88 diopters and 4.2 mm superior incision. The microdistortions in Bowman's layer were counted at 1 day, 1 week, and 1 month postoperatively and at long-term follow-up. Another 38 eyes of 20 patients undergoing femtosecond laser-assisted LASIK (FS-LASIK) were examined at 1 day and long-term postoperatively as the control group. RESULTS: Microdistortions in Bowman's layer were observed by OCT, with no clinically significant corneal striae under slit-lamp microscopy, in 46 eyes (88.5%) on day 1 after SMILE and in 16 eyes (42.1%) after FS-LASIK, with more in SMILE eyes than in FS-LASIK eyes. The amount decreased at 1 week and then remained stable. There were more microdistortions in the center area than in the periphery in both groups. Microdistortions were more in the inferior than the superior quadrant on the first day after SMILE but there was no difference at long-term follow-up. Microdistortions after SMILE were associated with the refractive lenticule thickness and surgery order but had no significant impact on long-term visual outcomes or wavefront aberrations. CONCLUSIONS: Microdistortions in Bowman's layer after SMILE were associated with the refractive lenticule thickness and surgery order. The microdistortions remained stable after 1 week and had no impact on long-term visual performance.

Irregular astigmatism after femtosecond laser refractive lenticule extraction.

UNLABELLED: We report a case of irregular corneal astigmatism after refractive lenticule extraction. A refractive lenticule was created using a femtosecond laser and then extracted through a small arcuate incision. One day postoperatively, the corneal findings by slitlamp biomicroscopy indicated mild corneal edema. Corneal topography demonstrated an area of steepened corneal surface inferiorly, and corneal thickness was relatively thicker in this area than in others. At 5 months, the corneal findings were normal by slitlamp biomicroscopy but corneal topography results remained unchanged. Fourier-domain optical coherence tomography examination showed remnant intrastromal lenticule tissue in this affected area. To our knowledge, this is the first case of residue intrastromal lenticule after refractive lenticule extraction. To prevent this complication, we believe it is important to completely dissect the lenticule and carefully examine the intactness of the lenticule during the surgery. FINANCIAL DISCLOSURE: Neither author has a financial or proprietary interest in any material or method mentioned.

[Advances in biomechanical effects of laser corneal refractive surgery].

Corneal biomechanical properties will change after laser refractive surgery, which can be evaluated by several biomechanical parameters. The biomechanical stress will decrease remarkably after LASIK, but thin flap is helpful to maintain its stress. Excimer laser surface ablation has biomechanical advantages over LASIK procedure. The femtosecond laser technology can achieve smooth and regular incision and make the angle design. Flap adhesion is stronger when completed by a femtosecond laser. Laser refractive surgery will become safer and achieve more stable outcomes with the emphasis on biomechanical effects.

[The clinical study of femtosecond lenticule extraction for myopia].

OBJECTIVE: To evaluate the clinical efficacy, safety and predictability of femtosecond lenticule extraction (FLEx) for myopia. METHODS: This is a prospective Clinical trial involved 10 cases (10 eyes). The patients aged from 18 years old to 53 years old, an average of (34 ± 11) years old. Femtosecond lenticule extraction (FLEx) was used to treat myopia from -4.88 DS to -9.25 DS, an average of (-6.94 ± 1.50) DS with cylinder from 0.50 DC to 3.0 µm DC an average of (1.28 ± 0.73)DC. Their corneal thickness were (527.10 ± 29.05) µm in an average. The patients were followed up for 6 to 10 months with visual acuity, manifest refraction, intraocular pressure, wavefront aberration, corneal topography and optical coherence tomography (OCT). SPSS software was used to analysis. RESULTS: FLEx procedure was done well in every patients without any scanning problem. No infection happened to in the trial. The patients' UCVA improved to 0.6 - 1.2 while BCVA improved 0.7 - 1.2 postoperatively. BCVA improved more than 2 lines in 2 eyes whereas 1 line in 2 eyes. No eye lost BCVA. The difference between pre-and postoperative refraction was within ± 0.75 DS, an average of SE (-0.25 ± 0.33) DS. No epicenter showed in topography. Spherical aberration increased slightly in 8 eyes but decreased in 2 eyes. OCT showed that stroma bed fit to each other very well. CONCLUSION: Femtosecond lenticule extraction appears to be efficiency, safety and predictable for myopia. Femtosecond lenticule extraction could have a good stroma fit. Its wavefront aberration changes need to further investigation.

Collagen cross-linking with riboflavin in a femtosecond laser-created pocket in rabbit corneas: 6-month results.

PURPOSE: To evaluate the initial changes of normal rabbit corneas after collagen cross-linking (CXL) with a femtosecond laser. DESIGN: Experimental study in animal eyes. METHODS: The right eyes of 10 male New Zealand white rabbits were treated with CXL with a femtosecond laser. A femtosecond laser was used to create an intrastromal pocket with 80-µm depth and 7-mm diameter. Intrastromal administration of 0.1% riboflavin solution was made into the femtosecond laser-created pocket and the cornea was irradiated with 3 mW/cm(2) ultraviolet A (UVA) light of mean 370 nm wavelength for 10 minutes. The corneal topography and pachymetry were evaluated by the Pentacam. All observations were performed preoperatively and at postoperative day 1, week 1, week 2, and months 1, 3, and 6. Light microscopy was applied to observe changes in the cornea at postoperative month 6. RESULTS: Cornea healing postoperatively was uneventful in all cases. The central corneal thickness (CCT) in the treated rabbit cornea reached the peak value at postoperative day 1, which descended gradually to the minimum at month 1 and returned to a high level at postoperative months 3 and 6. The CCT data postoperatively was significantly thicker than that preoperatively, except at postoperative month 1 (P > .05). Steepening of the operative area was found at the corneal front at postoperative day 1, which recovered dramatically after only 1 week. Then the treated area gradually flattened over the course of follow-up. In 8 of 10 rabbits, a demarcation line-like change in the stroma was visible in the Scheimpflug image at slightly increased contrast as early as 1 month after CXL treatment. The micromorphologic examination also confirmed the existence of the demarcation line. Crystalline lens transparency remained unchanged all the time. CONCLUSIONS: CXL with a femtosecond laser appears to be safe. The cornea can realize a faster, uneventful recovery. The stromal demarcation line may be a direct clinical sign to detect an effective corneal cross-linking during the early phase postoperatively.