[The role of peripheral retinal defocus in myopia progression].

The increasing incidence of myopia has become a global public health concern. Exploring the mechanisms underlying the onset and progression of myopia is crucial for prevention and control. This paper reviews the role of peripheral retinal defocus mechanisms in the development of myopia, with particular emphasis on the interaction between accommodation lag and peripheral retinal defocus, as well as the impact of optical intervention on myopia control effectiveness. In recent years, researchers have developed various optical tools for myopia prevention and control based on the peripheral retinal defocus theory, such as peripheral defocus spectacle lenses, orthokeratology lenses, and peripheral defocus soft contact lenses. This paper aims to provide clinicians with the latest research findings to deepen their understanding of the mechanisms involved in myopia development and to guide the future development and clinical application of myopia prevention and control products.

FABP4 inhibitor attenuates inflammation and endoplasmic reticulum stress of islet in leptin receptor knockout rats.

OBJECTIVE: Metabolic syndrome is characterized by abdominal obesity, hypertriglyceridemia and hyperglycemia. Fatty acid binding protein 4 (FABP4), as a member of intracellular lipid chaperones, is not only engaged in lipid transport but involved in inflammation and insulin resistance. The present study was to investigate the effects of BMS309403, a specific FABP4 inhibitor, on metabolic syndrome and its possible molecular mechanisms in islets. MATERIALS AND METHODS: Leptin receptor knockout (Lepr-/-) rat, a novel and representative animal model of metabolic syndrome, was adopted in this study. Lepr-/- male rats and their wild littermates were grouped and intragastrically administered with BMS309403. Glucose Tolerance Test (GTT) and Insulin Tolerance Test (ITT) were performed on all rats. Serum insulin was detected by ELISA. The metabolic characters, as well as liver and kidney functions, were evaluated by serum biochemical assay. Immunohistochemistry and Western blot were adopted to detect the expression levels of FABP4, CD68, GRP78, ATF6, p-IRE1a, and Cleaved caspase-3. RESULTS: Lepr-/- rats showed prominent characteristics of metabolic syndrome with increased FABP4, inflammatory infiltration, ER stress and apoptosis in islets. BMS309403 administration attenuated inflammation, ER stress and apoptosis in Lepr-/- rat islets while stimulating insulin secretion as well as improving manifestation of metabolic syndrome without hepatic and renal toxicity. CONCLUSIONS: FABP4 increased in Lepr-/- rat islets and might be involved in the regulation of islet inflammation and apoptosis via ER stress. FABP4 inhibitor BMS309403 could ameliorate islet inflammation and apoptosis in metabolic syndrome through suppressing ER stress.

Factors associated with delay in undescended testis referral.

INTRODUCTION: Undescended testis (UDT) is one of the most common congenital disorders and is associated with infertility and testicular cancer. Multiple guidelines internationally have recommended orchiopexy by 18 months. Multiple large retrospective studies published in the last decade have found persistent delay in timing of orchiopexy. OBJECTIVE: The aim of the study was to determine timing at which UDTs are referred at the tertiary pediatric hospital and assess factors that are associated with delay in UDT referral. STUDY DESIGN: Based on clinical observations and previous data, a series of clinical and socio-economic variables were constructed to design a prospective database. All patients who underwent orchiopexy for UDT from March 1, 2017, to August 31, 2018, were reviewed for demographic and clinical data. Referral appointments after 18 months were considered delayed. Factors associated with delay in UDT referral were analyzed using univariate and multivariate analysis with logistic regression. RESULTS: One hundred seventy-eight patients underwent orchiopexy for UDT. The median age was 44 months, and 64% of them had delay in referral. On univariate analysis, normal birth testicular examination, diagnosis of 'retractile testicle,' long gap without seeing pediatrician, diagnosis by a new physician, and primary language non-English were associated with delayed UDT referral. On multivariate analysis, delayed referral was associated with normal testicular examination at birth, history of 'retractile testis,' diagnosis not by the regular primary care provider, and other health or social issues that may have led to delay. DISCUSSION: This is the first prospective study analyzing timing of referral for boys with cryptorchidism. It was found that timing of treatment of UDT with orchiopexy has not improved over the last decade. Major causes in delay in referral may be due to poor of education of families and lack of routine testicular examinations by referring providers. Secondary ascent may account a significant number of delayed orchiopexy cases. CONCLUSION: Most patients at Doernbecher had delayed referral of cryptorchidism. Factors associated with delay were determined. To improve treatment of cryptorchidism, quality-based interventions and the importance of education and routine testicular examinations need to be focused on.

[The analysis of pattern visual evoked potential in obstructive sleep apnea syndrome].

OBJECTIVE: To objectively evaluate visual function by pattern visual evoked potential (PVEP) and its related factors in patients with obstructive sleep apnea syndrome (OSAS)without any ocular symptoms. METHODS: Eighty-three newly diagnosed OSAS and 18 normal subjects were enrolled in the study. The OSAS patients were divided into mild (n=11), moderate(n=17) and severe (n=55) groups based on the apnea-hypopnea index(AHI). Before the polysomnography(PSG) test, all participants underwent a PVEP examination measuring the latency and amplitude of P100. RESULTS: Compared to healthy controls, the latency of P100 was significantly increased in OSAS patients [controls group: 97(95-100) ms, mild OSAS group: 101(98-103) ms, moderate OSAS group: 101(98-105) ms, severe OSAS group: 105(101-108) ms, all P<0.05], and the amplitude of P100 was significantly reduced [controls group: 9(8-10) µV, mild OSAS group: 7(5-8) µV, moderate OSAS group: 6(5-7) µV, severe OSAS group: 6(4-7) µV, all P<0.05]. The severe group showed significantly longer latency of P100 when compared with mild and moderate groups(P<0.05). In the OSAS patients, univariate analysis showed that, the latency of P100 was correlated with ODI, T90, AHI, sleep efficiency, minimum SaO2, and mean SaO2, and the amplitude of P100 was statistically associated with sleep efficiency .But the stepwise multiple linear regression analysis revealed that only AHI was significantly correlated with the latency of P100 (r=0.275, P<0.01). CONCLUSION: Abnormal PVEP was found in patients with OSAS without any clinical manifestations of the optic neuropathy. The dysfunction of optic nerve was significantly associated with AHI and sleep efficiency.

[The expression of serum endoplasmic reticulum stress protein-78 in obstructive sleep apnea patients].

OBJECTIVE: This study aimed to detect serum level of glucose regulated protein 78(GRP78) in patients with obstructive sleep apnea(OSA) and explore the relationship between endoplasmic reticulum stress and the pathophysiology of OSA. METHODS: A total of 91 patients with OSA were enrolled in this study, including 30 mild, 28 moderate and 33 severe. The other 27 obese subjects were of age, gender and BMI matched group. Eleven moderate or severe OSA patients were administrated with continuous positive airway pressure (CPAP) treatment for 24 hours. Polysomnography, apnea hypopnea index (AHI), lowest arterial oxygen saturation(SaO2) and percentage of time spent at SaO2 below 90% (SIT90) were measured before and after sleep. Serum GRP78 was measured by ELISA. RESULTS: The expression of GRP78 in mild(3.42±0.97)µg/L, moderate(2.67±1.14)µg/L and severe(2.62±1.11)µg/L OSA groups was significantly higher than in control group(1.75±0.41)µg/L (P<0.05). The GRP78 level in mild OSA group was significantly higher than either moderate or severe OSA group (P<0.05). After 24 h treatment of CPAP, serum GRP78 level decreased significantly [(1.77±0.39)µg/L vs(2.84±0.39)µg/L; P<0.05]. CONCLUSIONS: Endoplasmic reticulum stress involves in the pathophysiology of patients with OSA. Higher GRP78 level in mild OSA patients suggests that endoplasmic reticulum related protein GRP 78 might rise then fall during exacerbation of OSA.

Gastroenteritis in a Taipei emergency department: aetiology and risk factors.

A matched case-control study was used to determine pathogens and risk factors associated with gastroenteritis in a Taipei Emergency Department. Viruses (40.0%) were the leading cause of gastroenteritis, with noroviruses the most prevalent (33.2%). Bacteria were found in 26.0% of all cases, mostly suspected diarrheagenic E. coli (22.2%), followed by Salmonella spp. (5.4%) and Vibrio parahaemolyticus (4.2%). Giardia lamblia was identified in 16.4% of all cases. Statistical significance was noted for seven risk factors: taking antacids before gastroenteritis (OR = 3.91; 95% CI, 2.13, 7.15), other household members with gastroenteritis (OR = 5.18; 95% CI, 2.09, 12.85), attending a banquet (OR = 1.93; 95% CI, 1.25, 2.98), eating out (OR = 2.35; 95% CI, 1.30, 4.23), drinking bottled water (OR = 1.72; 95% CI, 1.07, 2.75), eating honey peaches (OR = 3.26; 95% CI, 1.24, 8.58), and eating raw oysters (OR = 3.24; 95% CI, 1.02, 10.28). Eating out was identified as the highest risk behavior, as measured by population attributable risk fraction (PAR) (50.9%). Respective PAR values for drinking bottled water, attending a banquet and taking antacids before illness were 19.7%, 19.6% and 17.6%. Of these, additional research on bottled water appears to be the highest priority, because this is the first time it has been identified as a risk factor for gastroenteritis.

hMan2c1 transgene promotes tumor progress in mice.

In order to study the biological significance of alpha-mannosidase Man2c1, hMan2c1 transgenic mice were developed. In 113 F0 mice, eight were found to be genomic PCR positive for hMan2c1; 9/20 (45%) F1 mice, 16/21 (76.2%) F2 mice, and 12/14 (85.7%) F3 mice were genomic PCR positive for hMan2c1. RT-PCR demonstrated hMan2c1 mRNA transcription in four of eight transgenic lines. Enzymatic activity on p-nitrophenyl-alpha-D: -mannopyranoside was enhanced in 35# and 54# transgenic mice and real-time RT-PCR showed hMan2c1 mRNA expression in these mice. Reduced Con A binding to splenocytes implied N-glycosylation modification of host proteins by hMan2c1 transgene. hMan2c1 transgene promoted growth, invasion, and metastasis to lung of implanted hepatoma H22 and sarcoma S180. The average weights of H22 and S180 tumors were 3.98 +/- 1.62, 3.29 +/- 0.76, 1.69 +/- 1.09, and 3.19 +/- 0.44, 2.72 +/- 1.38, 0.97 +/- 0.41 g for 35#, 54# transgenic mice and wild type mice (W), respectively, (35# or 54# versus W, paired t-test, P < 0.05). In 35# and 54# mice 5/10 and 3/10 showed lung metastasis of H22 tumor in contrast with 1/10 in W mice. In 35# and 54# mice 1/6 and 2/6 showed lung metastasis of S180 tumor in contrast with 0/6 in W mice. The possible mechanism of the promotion was explored on both humoral and cellular immunity. Reduced antibody response to BSA was observed in transgenic mice, suggesting that specific antibody response to tumor antigens might be suppressed by hMan2c1 transgene. However, NK cytotoxicity in splenocytes was not affected by the transgene.

Risk factors for cumulative mortality in broiler chicken flocks in the first week of life in Taiwan.

(1) Factors influencing the survival of chickens in the first week of life in Taiwan were identified by modelling data from 63% of the annual national broiler production database (4769 broiler flocks). (2) Broiler chicks raised in rooms with open-curtain ventilation had the lowest mean first week cumulative mortality (CM), 1.30%, relative to those raised in rooms with negative pressure ventilation (1.42%) and water-cooled ventilation (1.37%). Increasing flock size reduced the CM. Broiler chicks shipped distances within 50 km had the lowest CM (1.22%), while broiler chicks raised in mountain areas showed the highest CM (1.65%). (3) Multiple regression analysis results indicate that ventilation type, flock size, shipping distance and delivery route influence CM in broiler chickens. Broiler chicks kept in rooms with negative pressure ventilation have an 11.22% greater CM compared to those in rooms with open-curtain ventilation. For each 1000-chicken increase in flock size, CM is reduced by 0.12%. For each kilometre increase in shipping distance, CM increases by 0.05%. Broiler chicks delivered via mountain routes show a 9.48% increase in CM compared to delivery via flat terrain. (4) Negative pressure ventilation and delivery via mountain routes are the most critical factors affecting the survival of chicks up to one week old.

Risk factors for ICU mortality in critically ill patients.

BACKGROUND AND PURPOSE: Advances in critical care medicine have increased the chances of survival for patients with severe illness or trauma. However, such patients consume a large proportion of medical resources. This study sought risk factors for mortality that have potential to be modified among patients treated in medical or surgical intensive care units (ICUs). METHODS: This 6-month prospective observational study was conducted in the medical and surgical ICUs of an 1,800-bed university hospital. All adult patients with an expected ICU stay of 48 hours or more were followed up regularly until discharge from the ICUs, or for 10 weeks during their stay in ICUs. RESULTS: Of 342 patients enrolled, 77 (22.5%) died during a median follow-up period of 5 days (range, 2-70 days). Among a range of variables at the time of ICU entry or developing during stay in ICUs, 17 were associated with higher mortality rate. Multivariate analysis using a logistic regression model demonstrated that the presence of systemic inflammatory response syndrome (SIRS) at the time of ICU entry (adjusted relative risk, ARR, 2.85; 95% confidence interval, CI, 1.16-7.05), Acute Physiological and Chronic Health Evaluation (APACHE) II score on ICU Day 4 (ARR 1.12 with increment of one score; 95% CI 1.01-1.24), Therapeutic Intervention Scoring System (TISS) score on Day 4 (ARR 1.13 with increment of one score; 95% CI 1.05-1.23), parenteral nutrition (ARR 4.97, 95% CI 1.73-14.26), and nosocomial Candida infection (ARR 3.39, 95% CI 1.12-10.23) were independently associated with ICU mortality. CONCLUSIONS: In addition to SIRS and the APACHE II and TISS scores, this study found that nosocomial Candida infection and parenteral nutrition were independently associated with mortality after control for admission conditions, severity of illness scores, and interventions.