Ammonium-derived nitrous oxide is a global source in streams.

Global riverine nitrous oxide (N2O) emissions have increased more than 4-fold in the last century. It has been estimated that the hyporheic zones in small streams alone may contribute approximately 85% of these N2O emissions. However, the mechanisms and pathways controlling hyporheic N2O production in stream ecosystems remain unknown. Here, we report that ammonia-derived pathways, rather than the nitrate-derived pathways, are the dominant hyporheic N2O sources (69.6 ± 2.1%) in agricultural streams around the world. The N2O fluxes are mainly in positive correlation with ammonia. The potential N2O metabolic pathways of metagenome-assembled genomes (MAGs) provides evidence that nitrifying bacteria contain greater abundances of N2O production-related genes than denitrifying bacteria. Taken together, this study highlights the importance of mitigating agriculturally derived ammonium in low-order agricultural streams in controlling N2O emissions. Global models of riverine ecosystems need to better represent ammonia-derived pathways for accurately estimating and predicting riverine N2O emissions.

Altered Effective Connectivity of Children and Young Adults With Unilateral Amblyopia: A Resting-State Functional Magnetic Resonance Imaging Study.

The altered functional connectivity (FC) in amblyopia has been investigated by many studies, but the specific causality of brain connectivity needs to be explored further to understand the brain activity of amblyopia. We investigated whether the effective connectivity (EC) of children and young adults with amblyopia was altered. The subjects included 16 children and young adults with left eye amblyopia and 17 healthy controls (HCs). The abnormalities between the left/right primary visual cortex (PVC) and the other brain regions were investigated in a voxel-wise manner using the Granger causality analysis (GCA). According to the EC results in the HCs and the distribution of visual pathways, 12 regions of interest (ROIs) were selected to construct an EC network. The alteration of the EC network of the children and young adults with amblyopia was analyzed. In the voxel-wise manner analysis, amblyopia showed significantly decreased EC between the left/right of the PVC and the left middle frontal gyrus/left inferior frontal gyrus compared with the HCs. In the EC network analysis, compared with the HCs, amblyopia showed significantly decreased EC from the left calcarine fissure, posterior cingulate gyrus, left lingual gyrus, right lingual gyrus, and right fusiform gyrus to the right calcarine fissure. Amblyopia also showed significantly decreased EC from the right inferior frontal gyrus and right lingual gyrus to the left superior temporal gyrus compared with the HCs in the EC network analysis. The results may indicate that amblyopia altered the visual feedforward and feedback pathway, and amblyopia may have a greater relevance with the feedback pathway than the feedforward pathway. Amblyopia may also correlate with the feedforward of the third visual pathway.

Altered Spontaneous Brain Activity of Children with Unilateral Amblyopia: A Resting State fMRI Study.

Objective: This study is aimed at investigating differences in local brain activity and functional connectivity (FC) between children with unilateral amblyopia and healthy controls (HCs) by using resting state functional magnetic resonance imaging (rs-fMRI). Methods: Local activity and FC analysis methods were used to explore the altered spontaneous brain activity of children with unilateral amblyopia. Local brain function analysis methods included the amplitude of low-frequency fluctuation (ALFF). FC analysis methods consisted of the FC between the primary visual cortex (PVC-FC) and other brain regions and the FC network between regions of interest (ROIs-FC) selected by independent component analysis. Results: The ALFF in the bilateral frontal, temporal, and occipital lobes in the amblyopia group was lower than that in the HCs. The weakened PVC-FC was mainly concentrated in the frontal lobe and the angular gyrus. The ROIs-FC between the default mode network, salience network, and primary visual cortex network (PVCN) were significantly reduced, whereas the ROIs-FC between the PVCN and the high-level visual cortex network were significantly increased in amblyopia. Conclusions: Unilateral amblyopia may reduce local brain activity and FC in the dorsal and ventral visual pathways and affect the top-down attentional control. Amblyopia may also alter FC between brain functional networks. These findings may help understand the pathological mechanisms of children with amblyopia.

A novel splicing mutation of PTCH1 in a Chinese family with nevoid basal cell carcinoma syndrome.

Nevoid basal cell carcinoma syndrome (NBCCS) is a rare autosomal dominant disease characterized by the development of multiple jaw keratocysts and basal cell carcinomas (BCC) and accompanied by diverse phenotypes. The establishment of diagnosis lies on the identification of a heterozygous germline pathogenic variant in the patched homolog 1 gene (PTCH1). PTCH1 has alternative splicing and selective initial coding exon, leading to three types of encoding proteins (PTCHL, PTCHM and PTCHS). The expression of each protein in NBCCS remains ambiguous, especially the importance of the first two exons in translation. Here, we report a Chinese NBCCS family of a novel PTCH1 heterozygous mutation (IVS 2, c.394+1G>T, g.10652G>T) identified by genomic sequencing and reverse-transcription-PCR as aberrant splicing. To the best of our knowledge, this is the first report of NBCCS with a splicing site mutation in intron 2 resulting in exon 2 skipping. Our finding suggests that exon 2 plays an important role in the development of NBCCS and further speculates that the role of longer isoforms PTCHL and PTCHM is crucial in NBCCS, while that of short isoform PTCHS might be dispensable.

Orbital decompression surgery and horse chestnut seed extract improved superior orbital vein blood flow in patients with thyroid-associated ophthalmopathy.

AIM: To evaluate the efficacy and safety of orbital decomposition (OD) surgery in combination with horse chestnut seed extract (HCSE), as compared to OD alone, in patients with thyroid-associated ophthalmopathy (TAO). METHODS: Sixty-two orbits from 62 TAO patients were randomly assigned to OD or OD+HCSE at 1:1 ratio (31 received OD alone, 31 received OD+HCSE). Forty-two orbits from 21 healthy subjects were used as controls. Complete ophthalmic examination and color Doppler flow imaging (CDFI) were performed before surgery and 3mo post-surgery on all 62 orbits from the TAO patients. CDFI were also performed on the 42 control orbits. The effect of OD+HCSE and OD alone on TAO orbits was compared on several endpoints, including superior ophthalmic vein blood flow (SOVBF) parameters, subjective assessment, soft tissue involvement, lid retraction, diplopia, eye movement restriction, degree of exophthalmos, and intraocular pressure. The control orbits were used as reference for the SOVBF parameters. RESULTS: OD surgery with or without HCSE improved SOVBF, symptoms and soft tissue involvement, decreased degree of exophthalmos and intraocular pressure in orbits of TAO patients. The OD+HCSE combination led to significantly better improvement of SOVBF than OD alone. The differences between the reductions of SOVBF in the two groups are 1.26 cm/s in max-volecity and 0.52 cm/s in min-volecity (P<0.0001). CONCLUSION: SOVBF is significantly reduced in the orbits affected with TAO, indicating that congestion may be an important factor contributing to TAO pathogenesis. OD surgery improves the SOVBF, and combination of HCSE medication and OD surgery further improved venous return than OD surgery alone.

Effectiveness of strabismus surgery on the health-related quality of life assessment of children with intermittent exotropia and their parents: a randomized clinical trial.

PURPOSE: To evaluate the ability of strabismus surgery to improve the health-related quality of life (HRQOL) assessment scores of children with intermittent exotropia and their parents. METHODS: For this prospective, randomized, parallel group study, 130 children (8-17 year of age) with intermittent exotropia were recruited and randomized to undergo either corrective strabismus surgery or active monitoring without surgery. Each child was accompanied by a parent. HRQOL was assessed with 3 intermittent exotropia questionnaires (IXTQ)--the child self-report, parental proxy report, and parental self-report--administered at enrollment and 3 months after intervention. The primary outcome was change in IXTQ score after 3 months for both groups. RESULTS: At enrollment the scores of the surgery group (n = 63) and monitoring group (n = 57) did not differ significantly (P > 0.05). The sex of the reporting parent had no significant influence on the proxy or parental scores at enrollment or at 3 months (P > 0.05, multivariate analysis). Strabismus surgery significantly improved all parts of the IXTQ scores (P < 0.0001, repeated measures analysis of variance). No significant changes were found for the child scores at 3 months in the monitoring group (P = 0.33). However, the parental and proxy scores were significantly decreased (P < 0.0001). CONCLUSIONS: Corrective strabismus surgery significantly improved the HRQOL scores of the children with intermittent exotropia and their parents.

MiRNA-21 promotes fibrosis in orbital fibroblasts from thyroid-associated ophthalmopathy.

PURPOSE: This study aimed to determine the role of miR-21 in orbital fibroblasts obtained from donors with thyroid-associated ophthalmopathy (TAO) and to elucidate the regulation of fibrosis by miR-21 in the pathological process of TAO. METHODS: The expression of miR-21 was investigated in orbital tissues from 26 donors with TAO and 10 donors without TAO. Human orbital fibroblasts were cultivated from TAO donors, and the role of miR-21 in orbital fibroblast proliferation, apoptosis, and differentiation was analyzed. Moreover, the effect of transforming growth factor-beta1 (TGF-ß1) on miR-21 expression was also analyzed. In addition, the regulation of miR-21 in TGF-ß1-induced collagen production was determined. RESULTS: The expression of miR-21 in orbital fibroblasts from TAO was higher than in donors without TAO. Additional experiments demonstrated that miR-21 enhanced proliferation, decreased apoptosis, and promoted differentiation in TAO orbital fibroblasts. Moreover, this study also showed that TGF-ß1 induced miR-21 expression in a time- and dose-dependent manner and miR-21 promoted collagen I mRNA expression and total collagen production induced by TGF-ß1. Additionally, miR-21 activated the TGF-ß1/Smad signaling pathway by enhancing Smad3 phosphorylation. CONCLUSIONS: The present study shows that miR-21 regulates cell proliferation, apoptosis, and differentiation in orbital fibroblasts from TAO, and acts as a mediator in TGF-ß1-induced collagen production. These data predict a close association between miR-21 and orbital muscle fibrosis, and provide a novel therapeutic target for TAO.

[Application of Icare rebound tonometer in children after congenital cataract surgery].

OBJECTIVE: To compare the difference in intraocular pressure (IOP) readings as well as the tolerability between Icare rebound tonometer (Icare RBT) and Goldmann applanation tonometer (GAT), and to evaluate the application of Icare RBT in monitoring the intraocular pressure in children after congenital cataract surgery. METHODS: The IOP was measured with the Icare RBT and GAT respectively in 150 children (262 eyes) after congenital cataract surgery by two experienced ophthalmologists. Correlation and Bland-Altman analysis were used to assess the agreement in IOP readings between the two instruments. The influence of the central corneal thickness (CCT) adjusted for age on IOP readings was analyzed by linear regression analysis. The tolerance of the patients to Icare RBT and GAT measurement were surveyed. RESULTS: The mean age was (44.82 ± 11.56) months in 150 children, including 81 boys and 69 girls. The mean IOP readings by the Icare RBT and GAT were (16.08 ± 5.72) mmHg and (14.17 ± 5.05) mmHg, respectively. The mean difference between the Icare RBT and GAT was (1.91 ± 2.04) mmHg, which was significantly correlated with CCT (r=0.409, P<0.001). The IOP readings by Icare RBT was significantly correlated with that measured by GAT(r= 0.936, P<0.001). The 95% confidence interval of the difference between the two instruments was ?2.10 to 5.91 mmHg. The Icare RBT examination was well tolerated by the children compared to the GAT examination. CONCLUSION: The Icare RBT is easy to use and well tolerated by the children after congenital cataract surgery. Compared to GAT, the value measured by the IOPs trends to be overestimated. The difference in readings between the 2 tonometers will magnify with the increase in CCT.

[Pattern visual evoked potentials in normal-vision eyes of post-therapy amblyopia].

OBJECTIVE: To evaluate the clinical significance of pattern visual evoked potential (P-VEP) parameters on amblyopic patients with normal-vision after pleoptic therapy. METHODS: We investigated 60 amblyopic children (8-12 years old) who gained normal-vision after pleoptic therapy. These patients were assigned to a unilateral amblyopia group (40 patients) and a bilateral amblyopia group (20 patients). Another 20 healthy children served as a control group. All patients underwent a full initial ophthalmologic and orthoptic evaluation. P-VEP test was performed in all. Amplitude and latencies were analyzed and compared among groups. The latencies of P100 waves in the amblyopic eyes were used to generate a multiple linear regression formula from sex, first treatment age, baseline visual acuity, and cycloplegic refraction. RESULTS: There was no significant difference in the mean levels of best-corrected visual acuity among groups (P>0.05). A significant prolongation of the latency and a decrease of amplitude of P100 waves were observed in the unilateral amblyopia group and the bilateral amblyopia group compared with the healthy control group (P<0.05). Amplitude and latencies of the fellow eyes in the unilateral amblyopia group were abnormal compared with the healthy control group (P<0.05). Multiple linear regression analysis revealed that the latencies of P100 waves were significantly correlated with the first treatment age, baseline visual acuity, and cycloplegic refraction (R(2)= 0.52, P<0.05). CONCLUSION: Deficits exist in the fellow eyes and in normal-vision eyes after pleoptic therapy. The delayed P100 latency is affected by the first treatment age, baseline visual acuity, and cycloplegic refraction. Traditional amblyopic therapy may be not enough for vision function recovery.

Comparison of the Icare tonometer and the hand-held goldmann applanation tonometer in pediatric aphakia.

PURPOSE: To compare the intraocular pressure (IOP) measurements obtained by the Icare and the hand-held Goldmann applanation tonometer (also called Perkins) in aphakic children after congenital cataract surgery. METHODS: We investigated 125 children with aphakia after congenital cataract surgery in this study. A younger group (3 to 30 mo) and an elder group (31 to 72 mo) were divided in those patients by their age. In the younger group, all measurements were performed under sedation using chloral hydrate. Axial length of the eye and central corneal thickness (CCT) were also measured from all patients. RESULTS: Significant correlation was found on IOP readings obtained by the Icare and the Perkins tonometers (r=0.943, P<0.001). After establishing a Bland-Altman plot, we found that 95% limit of the agreement between the 2 methods distributed between -1.6 to 5.6 mm Hg. The IOPs recorded from the Icare increased faster than that from the Perkins tonometer with the increase of the CCT thickness; a significant association relationship was found on the IOP difference between the 2 measurements (r=0.408, P<0.001). However, no statistical correlation was identified between the axial length and the IOPs recorded by either tonometer. CONCLUSIONS: Most of the young patients accepted the Icare tonometer under unsedated conditions. This significant advantage indicated that the Icare tonometer will be overall better tolerated in pediatric aphakia population, although it could overestimate the IOPs compared with the measurements obtained from the Perkins tonometer. Differences in readings between the 2 tonometers become bigger as the CCT increase.

[Thickness of the retinal nerve fiber layer in unilateral amblyopic patients with high myopia in children].

OBJECTIVE: To investigate the retina nerve fiber layer (RNFL) thickness in unilateral amblyopic patients with high myopia. METHODS: Twenty-three cases (23 eyes) with unilateral high myopia amblyopia were tested by GD(X) ECC with laser polarized light scans in the posterior pole of retina, to measure the relative RNFL thickness according to papilla optical as a center, 3.2 mm as the diameter of outer ring, 2.4 mm as the diameter of inner ring. The relative RNFL thickness of high myopia amblyopia was compared with fellow eyes, normal eyes and high myopia respectively and statistics analysis. RESULTS: TSNIT average, superior average and inferior average of RNFL in high myopia amblyopia became thinning (56.39 +/- 5.69, 68.30 +/- 10.16, 67.34 +/- 5.83), it showed statistically differences when compared with fellow eyes (t = 2.090, 2.243, 4.236) and normal eyes (t = 3.087, 1.025, 3.481) (P < 0.05). RNFL parameters were no statistically significant differences between high myopia amblyopia and simple high myopia (t = 0.872, 0.297, 0.658; P > 0.05). TSNIT average decreases with axial length in high myopia amblyopia and high myopia, there was inverse linear correlation between RNFL thickness and axial length (r = -0.462, -0.395; P < 0.05). CONCLUSIONS: The RNFL thickness of unilateral high myopia amblyopia of children was thinner than normal, but there wasn't obvious compared with simple high myopia. The reasons for decreased best corrected vision of unilateral high myopia amblyopia in children still need further research.

[Diagnosis and management of lipogranuloma of the eyelids from nasal endoscopic surgery].

OBJECTIVE: To enhance the safety of nasal endoscopic surgery and decrease its complications of eyes. METHOD: Three patients of chronic rhinosinusitis and nasal polyposis with lipogranulomas of the eyelids after nasal endoscopic surgery and nasal packing of petrolatum gauze were reported and analyzed, and their treatment results were presented during the last 2 years. RESULT: The medial orbital wall injury occurred in all three patients during endoscopic sinus surgery. The patients developed an ipsilateral periocular swelling, eyelid hematoma and palpebral conjunctival edema during 2 to 3 hours after surgery. Nasal packs petrolatum gauze were removed 10-24 hours after surgery. The patients were discharged from hospital when periorbital swelling and eyelid ecchymoma disappeared, and nasal cavity obstruction was improved 6 to 8 days after surgery. The swelling and nodular mass of ipsilateral eyelids (one in left upper eyelid and two in right lower eyelid) were found 12-15 days after surgery, and their eye movement and eyesight were normal. Antibiotic and corticosteroid were administered for 3 4 weeks with only improvement in eyelid swelling. These masses of eyelids were completely excised through palpebral margin 1-6 months after surgery. The histopathological examination of the surgical specimens showed lipogranuloma. No recurrence and symptom of the eyes had been observed during 4-18 months follow up. CONCLUSION: The lipogranuloma of the eyelid is a rare and late complication after nasal endoscopic surgery and nasal packing with vaspetrolatum gauze. The medial orbital wall injury and bleeding during surgery, and vaseline of nasal packing permeated into the eyelid are the direct causes of this complication. The application of petrolatum gauze should be avoided when the medial orbital wall trauma is identified. The complete excision of granulomas is a best effective therapy.

[Clinical features and surgical treatment of congenital ocular muscle palsy characterized with double elevator dysfunction].

OBJECTIVE: To investigate the clinical features of congenital ocular elevator muscle palsy and to evaluate the efficacy of surgical treatment. METHODS: Pre- and post-operative eye position, superior rectus muscle and inferior oblique muscle function, clinical features were examined and analyzed in 11 patients with congenital double elevator palsy of ocular muscles. RESULTS: When fixated with the nonparetic eye, ten of 11 patients showed hypotropia and pseudoblepharoptosis in the primary position; One of 11 patients fixated with the paretic eye and showed hypotropia in the primary position. All cases were a monocular elevation deficiency in abduction and adduction, and showed pseudoblepharoptosis. In ten patients fixated with the nonparetic eye, two of 10 were undergone inferior rectus recession on paretic eyes; six of 10 were undergone inferior rectus recession and superior oblique tenectomy on paretic eyes; two of 10 were applied inferior rectus recession and superior oblique tenectomy on paretic eyes, superior rectus recession was performed on healthy eyes in six months postoperation. The patient fixated with the paretic -eye were undergone superior rectus recession and inferior oblique tenectomy on healthy eyes. Seven patients with exotropia had lateral rectus muscle surgery performed at the time of their vertical operation. Strabismus were complete corrected in 81.8% (9/11) of patients in our study and 18.2% (2/11) of patients were partial corrected. The functions of superior rectus muscle and inferior oblique muscle were not corrected. Nine patients showed complete correction of the psuedoptosis, one patient showed partial correction of the psuedoptosis, one patient did not showed any improvement of the pseudoptosis. CONCLUSIONS: We conclude that superior rectus muscle and inferior oblique muscle insufficiency are the primary factors in the etiology of congenital double ocular elevator palsy. Vertical rectus recession and superior oblique tenectomy on paretic eyes is an effective way of surgical treatment the disease.

[Lacrimal duct stent for nasolacrimal duct obstruction].

OBJECTIVE: To introduce a new interventional procedure using lacrimal duct stent for the treatment of nasolacrimal duct obstruction, evaluate the short-term and long-term efficacy and observed its intra- and post-operative complications and management. METHODS: 102 cases (136 eyes) of nasolacrimal duct obstruction underwent the lacrimal duct stent placement, the nasolacrimal duct was dilated and the stent was placed retrograde. Digital subtraction dacryocystography was performed before and after the stent placement. RESULTS: Stent placement was technically successful in 132 eyes, and the technical success rate was 97.1%. Good flow of contrast medium was obtained in all patients after stenting. Three months postoperatively, the success rate was 99.2%. After twelve months of follow-up, the success rate was 91.4%. The intra-and post-operative complications included stenting failure, transient hemorrhage and obstruction of the stent. CONCLUSION: Interventional procedure using lacrimal duct stent is a safe, simple and effective method for nasolacrimal duct obstruction without disturbing the normal anatomy.

[A new probe for congenital nasolacrimal duct obstruction].

OBJECTIVE: To investigate the therapeutic effect of a new probe for congenital nasolacrimal duct obstruction. METHODS: The probe was designed and manufactured by ourselves. We observed 158 cases (172 eyes) with congenital nasolacrimal duct obstruction and treated them with the probe 1-3 times. RESULTS: The mean period of postoperative follow-up was 17.8 (range 12-24 months) months. The success rate was 98.2%. Common complications included a slight blood-stained nasal discharge. CONCLUSION: Our newly designed and manufactured probe provides a new probe for congenital nasolacrimal duct obstruction. The probe is a safe, simple and effective treatment method for congenital nasolacrimal duct obstruction.