Correlation between spherical equivalent and biometry parameters in adult Cynomolgus macaque.

PURPOSE: To characterize the distribution of refractive and ocular biometry parameters and analyze the effect factors of the refractive status in cynomolgus monkey colonies. METHODS: A Population-based cross-sectional study was conducted in adult cynomolgus macaque colonies. Animals were anesthetized with Zoletil 50. Intraocular pressure was measured using the Icare tonometer. Cycloplegic refraction (three drops of 1% tropicamide) and corneal radius of curvature (CRC) were measured using an autorefractor. The spherical equivalent (SE) was calculated. Biometric measurements, including the anterior chamber depth (ACD), lens thickness (LT), and axial length (AL), were obtained by A-scan ultrasonography. The AL-to-CR ratio (AL/CRC) was calculated. Central corneal thickness (CCT) and choroidal thickness (ChT) were measured using the Heidelberg Spectralis HRA OCT. Multiple regression analysis was performed to explore the association between refraction and ocular biometry. RESULTS: Among 263 cynomolgus monkeys (aged 5-26 years), which consisted of 520 eyes, 29.42% had hyperopia, 27.12% had emmetropia, 33.27% had mild-to-moderate myopia and 10.19% had high myopia. The mean SE was -1.27 ± 3.44 Diopters (D). The mean CRC, CCT, AL, and ChT was 5.70 ± 0.22 mm, 454.30 ± 32.40 µm, 18.76 ± 0.89 mm and 188.96 ± 38.19 µm, respectively. The LT was the thickest in the hyperopic eyes. CRC was the lowest, and CCT was the thickest in high myopic eyes. AL increased, while ChT decreased as SE decreased. For the SE variance, AL alone explained 40.5%; age, AL, and CRC together explained 57.5%. CONCLUSIONS: The refractive characteristics and biometry parameters of cynomolgus monkeys are highly comparable to those of humans. AL, CRC, and ChT showed the similar variation tendency in cynomolguses when compared to humans. Cynomolgus monkeys with naturally-occurring refractive errors may be a good animal model for refractive studies.

Cardiovascular outcomes of ß-blocker-calcium channel blocker initial dual therapy vs. other initial dual therapies in Chinese patients with hypertension: A real-world retrospective study.

This retrospective study compared cardiovascular (CV) outcomes between initial ß-blocker (BB) + calcium channel blocker (CCB) dual therapy ("B + C") and other initial dual therapies in Chinese newly diagnosed hypertensive patients. In this study, all patients in a regional electronic database with newly diagnosed hypertension from January 01, 2012 to December 31, 2016 who received any initial optimal dual therapy recommended by the Chinese hypertension guideline were included. 1:2 propensity score matching (PSM) was used to balance baseline characteristics between patients receiving B + C and patients receiving other initial dual therapies ("Others"). The primary outcome was major adverse cardiovascular events (MACE) that occurred from January 01, 2012 to December 31, 2017, consisting of non-fatal stroke, non-fatal myocardial infarction (MI), non-fatal chronic heart failure (CHF), and all-cause death. Cox proportional hazard models were used to compare these CV outcomes in the 2 matched cohorts. After the PSM, 6227 patients receiving B + C and 12 454 patients receiving Others were included. Compared to patients receiving Others, patients receiving B + C had a significantly lower risk of MACE (hazard ratio [HR] 0.85; 95% confidential interval [CI] 0.78-0.92; p < .001), non-fatal stroke (HR 0.89; 95% CI 0.81-0.98; p = .018) and non-fatal CHF (HR 0.74; 95% CI 0.63-0.86; p < .0001). Additionally, differences in risks of non-fatal MI and all-cause death between the 2 treatment cohorts were not statistically significant. In conclusion, BB + CCB initial dual therapy was associated with a lower risk of MACE, stroke, and CHF than other optimal initial dual therapies recommended by the Chinese hypertension guideline in Chinese newly diagnosed hypertensive patients.

Development and validation of the 40-item Glaucoma Visual Functioning Questionnaire.

AIMS: To evaluate the psychometric properties of a newly designed questionnaire, the 40-item Glaucoma Visual Functioning Questionnaire (GVFQ-40), in a Chinese sample to capture the visual ability of patients with glaucomatous vision impairment in five domains. METHODS: Eighty-four glaucoma suspects (controls) and 270 glaucoma patients were recruited from the Glaucoma Clinic at Zhongshan Ophthalmic Centre in this cross-sectional, observational study. All subjects completed two questionnaires during routine clinical visits: the GVFQ-40 and the validated National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25). The discriminant, criterion-related and construct validity of the GVFQ-40 were assessed. A subset of subjects completed the GVFQ-40 twice, with an interval of 7-21 days, to determine test-retest reliability. RESULTS: Domain-specific and total GVFQ-40 scores were significantly higher (worse visual ability) in glaucoma patients than in controls (all p<0.001). All pairwise subgroup comparisons were statistically significant except for the 'mobility' domain comparison between the mild visual field loss and control groups (p=0.189). Significant differences between these two groups were observed in only 2 of the 12 dimensions on the NEI VFQ-25. The GVFQ-40 results demonstrated strong correlations with better-eye mean deviation and Visual Field Index (glaucoma severity measures). Exploratory factor analysis tended to confirm a three-domain structure. Test-retest intraclass correlation coefficients were higher than 0.927 for domain-specific and total GVFQ-40 scores. CONCLUSIONS: The GVFQ-40 possesses good validity and reliability. It can be used to evaluate the impact of glaucomatous damage on visual ability and has potential in the evaluation of intervention efficacy. TRIAL REGISTRATION NUMBER: NCT04722861.

Recent Advances in Environmentally Friendly and Green Degumming Processes of Silk for Textile and Non-Textile Applications.

Silk has been widely used not only in the textile field but also in non-textile applications, which is composed of inner fibrous protein, named fibroin, and outer global protein, named sericin. Due to big differences, such as appearance, solubility, amino acid composition and amount of reactive groups, silk fibroin and sericin usually need to be separated before further process. The residual sericin may influence the molecular weight, structure, morphology and properties of silk fibroin, so that degumming of silk is important and necessary, not only in textile field but also in non-textile applications. Traditional textile degumming processes, including soap, alkali or both, could bring such problems as environmental damage, heavy use of water and energy, and damage to silk fibroin. Therefore, this review aims to present a systematic work on environmentally friendly and green degumming processes of raw silk, including art of green degumming process, quantitative and qualitative evaluation, influence of degumming on molecular weight, structure, morphology and properties of silk. It is anticipated that rational selection and design of environmentally friendly and green degumming process is quite important and meaningful, not only for textile application but also for non-textile application.

Characteristics and Risk Factors for Pupillary Capture of Intraocular Lens in Congenital Ectopia Lentis.

Importance: To analyze the characteristics and risk factors for pupillary capture (PC) of the intraocular lens (IOL) in congenital ectopia lentis (CEL) patients.Methods: Data of CEL patients who underwent lens extraction and intraocular implantation from 2013 to 2016 at Zhongshan Ophthalmic Center in China were collected. Best-corrected visual acuity (BCVA), axial length (AL), refractive status, corneal curvature, intraocular pressure (IOP), degree of lens dislocation, presence of strabismus, and methods of IOL fixation were recorded. Postoperative data were collected from the routine one-month postoperative follow-up. Patients with PC of IOL were characterized and risk factors for PC of IOL were analyzed using age-sex adjusted multiple logistic regression analysis.Results: Of the 89 included CEL subjects, 43.8% (39/89) of them suffered from PC after IOL implantation. There was no statistically significant difference in BCVA, AL, refractive status and IOP between the eyes which developed PC versus those which did not. Age-sex multiple logistic regression analysis shows that PC of IOL was associated with a more severe degree of lens dislocation and eyes with strabismus before surgery.Conclusions: Eyes with strabismus and more severe degrees of lens dislocation before surgery are risk factors for PC of IOL. When treating patients that present these risk factors, preoperative communication, and postoperative follow-up should be strengthened. Considering that PC of IOL has little effect on visual acuity, patients with slight PC of IOL can be exempt from surgical intervention.

Expression of transforming growth factor ß and matrix metalloproteinases in the aqueous humor of patients with congenital ectopia lentis.

It is well known that transforming growth factor ß (TGFß), which is able to stimulate multiple intracellular signaling pathways, exerts an important role in Marfan syndrome, although the effects of TGFß on congenital ectopia lentis (CEL) have yet to be fully elucidated. In the present study, the expression levels of TGFß and matrix metalloproteinases (MMPs) were investigated in the aqueous humor of patients with ectopic lentis who differed in terms of the severity of the disease. A total of 17 CEL patients with 21 eyes (aged 12.76±9.37 years) and 12 congenital cataract (CC) patients with 17 eyes (aged 6.82±9.18 years) were randomized in the present study. The levels of active TGFß and MMPs in the aqueous humor were analyzed with Luminex xMAP® technology by using commercially available Bio­Plex Pro™ Human MMP and TGFß assays. The distance from the lens edge to the pupil edge and the white to white corneal diameter (i.e. the horizontal distance between the borders of the corneal limbus) were measured, and the ratio was calculated as the degree of lens dislocation. The association between TGFß and MMP levels and the degree of lens dislocation was analyzed using Spearman's correlation test. Compared with the patients with CC, the level of TGFß2 in the patients with CEL was increased significantly. Specifically, the level of TGFß2 in the CEL patients was 855.19 pg/ml (744.33, 1,009.24), whereas it was 557.08 (438.24, 692.71) pg/ml in the CC patients (P<0.001). In addition, it was noted that the levels of MMP­2 and ­10 in the aqueous humor of the patients with CEL were higher compared with those in the CC patients, although this increase did not reach the level of statistical significance. Notably, the levels of MMP­8 and ­9 in the aqueous humor of patients with CEL were significantly lower compared with those in the CC patients (P=0.014 and P=0.002, respectively). Furthermore, a marginal correlation was identified between the severity of ectopic lentis and the levels of TGFß2 in the aqueous humor (r2=0.379; P=0.003) of the patients with CEL. Taken together, these results demonstrated that a significant correlation existed between high levels of aqueous humor TGFß2 and the severity of ectopia lentis in patients with CEL. In addition, aqueous humor TGFß2 levels in the CEL patients were significantly higher compared with those in CC patients.

Trends and characteristics of congenital ectopia lentis in China.

AIM: To elucidate the trends and characteristics of congenital ectopia lentis (CEL) in southern China. METHODS: CEL patients from China admitted to Zhongshan Ophthalmic Center (ZOC) from January 2006 to December 2015 were recruited in our study. Residence, gender, hospitalization time, age at surgery, and the presence of other ocular abnormalities and system disease were statistically analyzed in different subgroups. RESULTS: Four hundred and thirty-seven hospitalizations (306 in-patients) diagnosed with CEL from a total of 283 308 hospitalizations were identified, which accounted for 0.15% of the total in-patients. Of the identified CEL in-patients, the total ratio of boys to girls was 2.22:1. Based on a subgroup analysis according to age, patients aged 12-18 years old constituted the highest proportion (31.70%) of all hospitalized CEL patients, and those 0-3 year old constituted the lowest proportion (8.82%) of the total number. The number of CEL increased from 18 to 72 and the hospital based prevalence increased from 8.60% to 18.10% from 2006 to 2015, and the average age at surgery decreased from 9 years old in 2006 to 7.6 years old in 2015. CONCLUSION: The results reveal upward trends in both the number of CEL hospitalizations and hospital based prevalence of CEL in this 10-year study period, but a reduction in the age at surgery, which may reflect the increase of public awareness of children's eye care in China.

Analysis of Corneal Astigmatism before Surgery in Chinese Congenital Ectopia Lentis Patients.

PURPOSE: This study aims to describe the characteristics of corneal astigmatism before surgery in congenital ectopia lentis (CEL) patients. METHODS: This retrospective study reviewed 306 CEL patients from 1st January 2006 to 31st December 2015. One eye was randomly selected from each patient when the patient had bilateral EL. The influence of sex, laterality, and Marfan syndrome on corneal astigmatism in different age subgroups was evaluated and compared. The correlation between age and corneal astigmatism was evaluated. RESULTS: Two hundred fifty-two eyes were included in this study. The mean corneal astigmatism of CEL patients was 2.00 ± 1.28 D. There was a statistical difference in corneal astigmatism between CEL eyes with and without Marfan syndrome. However, no statistical difference was found between male and female patients, or between the EL-affected eye and the unaffected eye in monocular EL patients. There was a positive correlation between age and corneal astigmatism in CEL eyes. CONCLUSIONS: This study suggests that CEL patients' corneal astigmatism is higher in patients with Marfan syndrome, and corneal astigmatism of the CEL eye increases with age. Our results are useful for surgeons to make appropriate incision and intraocular lens (IOL) choices for patients, as well as a useful reference for designs of new IOLs.

Distribution of axial length in Chinese congenital ectopia lentis patients: a retrospective study.

BACKGROUND: Congenital ectopia lentis (CEL) usually leads to refractive error and may influence the axial length development. But few investigations have reported patient demographics and the distribution of axial length (AL) before surgery in Chinese pediatric patients with CEL. To describe the distribution of AL before surgery in CEL patients and its relationship with patients' demographics, such as age, Marfan syndrome, sex, and laterality. METHODS: This retrospective study reviewed 306 CEL patients from January 1, 2006 to December 31, 2015. One eye was randomly selected from each patient if both eyes were EL. The influences of Marfan syndrome, sex, and laterality to AL in different age subgroups were evaluated and compared. The differences of the AL between groups were assessed using the student t test or paired t-test. P-values less than 0.05 were considered statistically significant. RESULTS: Two hundred forty-seven eyes were enrolled. 58.3% of all the patients had binoculus EL, 70% of all the patients were male and 36% of all the patients were diagnosed with Marfan syndrome. The mean AL of EL patients was 25.1 ± 2.5 mm. There was no statistical difference in the AL between patients with and without Marfan syndrome, and in the AL between male and female patients. There was statistical difference in AL between the EL-affected eye and the unaffected eye in monocular EL patients younger than 12 years old. CONCLUSIONS: This study suggests that AL can be influenced by CEL, but the influence of CEL may be reduced after the age of 12 years old, which will likely provide a useful reference when considering the most appropriate time of surgery.

Removal of heavy metal Cu(II) in simulated aquaculture wastewater by modified palygorskite.

Palygorskite (PAL) is a good heavy metal adsorbent due to its high surface area, low cost, and environmentally compatibility. But the natural PAL has limited its adsorption capacity and selectivity. In this study, a cost-effective and readily-generated absorbent, l-threonine-modified palygorskite (L-PAL), was used and its performance for Cu(II) removal in simulated aquaculture wastewater was evaluated. After preparation, L-PAL was characterized by using Fourier transform infrared spectroscopy, scanning electron microscope, energy dispersive X-ray spectroscopy, X-ray diffractometer, X-ray photoelectron spectroscopy, transmission electron microscopy and thermogravimetric analysis. The impacts of pH, adsorbent dosage, contact time, and initial Cu(II) concentration on the adsorption capacity of L-PAL were examined. The Cu(II) adsorption capacity on L-PAL was enhanced almost 10 times than that of raw PAL. The adsorption isotherms of Cu(II) fit the Langmuir isotherms, and the adsorption kinetics was dominated by the pseudo-second-order model. The thermodynamic parameters at four temperatures were calculated, which indicated that the adsorption was spontaneous and endothermic. The adsorption mechanism involves complexation, chelation, electrostatic attraction, and micro-precipitation. Furthermore, L-PAL is shown to have a high regeneration capacity. These results indicate that L-PAL is a cheap and promising absorbent for Cu(II) removal and hold potential to be used for aquaculture wastewater treatment.

A new absorbent by modifying walnut shell for the removal of anionic dye: kinetic and thermodynamic studies.

A novel, low cost and easy regeneration biosorbent, chem-modified walnut shell (MWNS), was studied to investigate its potential for removal of an anionic dye, reactive brilliant red K-2BP. The MWNS was synthesized with epichlorohydrin and diethylenetriamine as etherifying agent and crosslinking agent, respectively, and its characteristics were performed with Fourier transform infrared spectroscopy, scanning electron microscope, electron dispersive spectroscopy and thermogravimetric analysis. The influences of pH (0.5-11) and adsorbent dosage (0.1-6g/L) on adsorption capacity of MWNS were evaluated. The maximum K-2BP adsorption capacities (Qm) calculated by best fitting model (Langmuir) were 568.18 mg/g at 313 K, which was almost 10 times than that of raw material. The adsorption kinetic was well confirmed with pseudo-second-order equation. Thermodynamic studies demonstrated adsorption process by MWNS was spontaneous and endothermic. Furthermore, the regeneration capability of MWNS implied MWNS was a cheap, excellent and promising biosorbent for K-2BP removal in azo dye wastewater treatment.