Synthesis, characterization and photocatalytic properties of In2.77S4/Ti3C2 composites.

Recently, the problem of water pollution, caused by antibiotics, is becoming more and more serious. Photocatalysis is one of the promising technologies for removing antibiotics from water. Herein, the In2.77S4/Ti3C2 composites were prepared by an in-situ hydrothermal growth method for photocatalytic degradation of tetracycline (TC). The as-developed composites were characterized by various methods. The UV-Vis DRS spectra reveals that the introduction of Ti3C2 makes the bandgap of the as-prepared composites smaller and the visible light absorption ability improved. The photocatalytic degradation efficiency of the as-prepared composite is enhanced under visible light illumination. It is shown as first increasing and then decreasing with increasing the content of Ti3C2 in the composite and reaches to the maximum of 89.3% in 90 min, which is higher than 75.1% of In2.77S4 and 6.7% of Ti3C2. The reason of improvement is the interface between In2.77S4 and Ti3C2 is tightly combined to form a heterojunction. Moreover, the photocurrent intensity of the as-obtained composite is improved, while its Nyquist arc radius is decreased. In addition, holes are the main active species and ·OH and ·O2 - play an auxiliary role during the degradation of TC.

Long noncoding RNA KCNQ1OT1 promotes apoptosis in neuroblastoma cells by regulating miR-296-5p/Bax axis.

Long noncoding RNAs (lncRNAs) are emerging as important regulators of multiple cellular processes such as cell invasion, growth, apoptosis and differentiation. LncRNAs can function as competing endogenous RNAs (ceRNAs) which sponge and sequester microRNA (miRNA) to regulate specific targets. Previously, we found that the target genes of several miRNAs, including FADD, Fas, Casp and Bax, are related to neuronal apoptosis and form a regulatory network. Among several factors, microRNA-296-5p expression was found to be negatively correlated with caspase activity and apoptosis. Here, we aimed to investigate the role of miR-296-5p in neuroblastoma (NB) cells. By performing quantitative real-time PCR (qRT-PCR), western blot and flow cytometry assays we analysed the expression of apoptotic markers in NB cells transfected with miR-296-5p mimics or inhibitor. Pathway-specific PCR array allowed us to identify the target genes of miR-296-5p. Using LncBase online tool, we predicted lncRNA KCNQ1 opposite strand/antisense transcript 1 (KCNQ1OT1) as an upstream regulator of miR-296-5p. The binding of KCNQ1OT1 and miR-296-5p was validated via RNA immunoprecipitation and Biotin pull-down assays. We also demonstrate that miR-296-5p suppresses apoptosis of NB cells in vitro and in vivo. Mechanistically, miR-296-5p directly bound the 3'UTR of Bax mRNA, thus repressing Bax at the mRNA and protein level. Moreover, through bioinformatic analysis and molecular experiments, we showed that KCNQ1OT1 sponged miR-296-5p and impaired its effect on NB cell apoptosis. In summary, KCNQ1OT1 is a potent promoting factor of cell apoptosis, which acts by sponging miR-296-5p and upregulating Bax. Our findings identify a regulatory axis of cell fate in NB cells.

Homocysteine is Associated with Exaggerated Morning Blood Pressure Surge in Patients with Acute Ischemic Stroke.

BACKGROUND: Considerable researches suggest that high level of homocysteine (Hcy) is associated with the risk of ischemic stroke. Ambulatory blood pressure monitoring (ABPM) parameters have also been confirmed associated with cardio-cerebrovascular events. However, the relationship between Hcy and ABPM parameters remains unclear in patients with acute ischemic stroke. In this study, we aim to investigate the association between Hcy level and ABPM parameters in patients with acute ischemic stroke. METHODS: We enrolled 60 patients with acute ischemic stroke who received ABPM. We calculated ABPM parameters like morning blood pressure surge (MBPS), ambulatory arterial stiffness index, blood pressure variability, and night dipping patterns. RESULTS: Multivariate logistic regression analysis indicated that patients in the top quartile of Hcy level tended to have a higher level of prewaking and sleep-trough MBPS compared with patients in the lower 3 quartiles after adjusted for age and gender (P = .028 and P = .030, respectively). When treating Hcy as a continuous variable, the linear regression showed the association between Hcy level and both MBPS parameters remained significant (prewaking MBPS, r = .356, P = .022; sleep-trough MBPS, r = .365, P = .017, respectively). However, there is no association between Hcy level and ambulatory arterial stiffness index, blood pressure variability or night dipping patterns (P = .635, P = .348 and P = .127 respectively). CONCLUSIONS: There is a relationship between the 2 major cerebrovascular risk factors: MBPS and Hcy.

Hypoxia increases amyloid-ß level in exosomes by enhancing the interaction between CD147 and Hook1.

Hypoxia promotes the accumulation of amyloid-ß (Aß), which is related to the pathogenesis of Alzheimer's disease (AD). CD147 is considered as an additional subunit of γ-secretase regulated by hypoxia, and has been identified in exosomes. Aß is also found in exosomes that participate in the intercellular communication and amyloids propagation. This study was to investigate the role of CD147 in hypoxia-induced accumulation of Aß in exosomes. Our results showed that hypoxia increased the levels of Aß40 and Aß42 in exosomes and enhanced the interaction between CD147 and Hook1 in SH-SY5YAPP695 cells. Moreover, hypoxia increased the interaction between amyloid precursor protein (APP) and CD147 as well as the expression of CD147 in isolated membrane. After we interfered the interaction between CD147 and Hook1 by decreasing Rab22a expression, the hypoxia induced Aß accumulation in exosomes was significantly suppressed. In addition, the increased interaction between CD147 and Hook1 was further confirmed in hypoxia exposed C57BL/6 mice. Our findings reveal that hypoxia may increase exosome Aß level by enhancing the interaction between CD147 and Hook1.

Observation of Corneal Langerhans Cells by In Vivo Confocal Microscopy in Thyroid-Associated Ophthalmopathy.

PURPOSE: To examine the density and morphology of Langerhans cells (LCs) in the cornea of patients with thyroid-associated ophthalmopathy (TAO). METHODS: Forty patients with TAO and 20 healthy volunteers were studied. All subjects underwent a thorough ophthalmic examination of both eyes. The ocular surface status was assessed by Ocular Surface Disease Index (OSDI) symptom questionnaires, tear break-up time (BUT), fluorescein staining and the Schirmer test. Laser scanning in vivo confocal microscopy was applied to evaluate the LC density and morphology in both central and peripheral cornea. The correlations between confocal microscopy data and clinical data were also analyzed. RESULTS: The OSDI and fluorescein staining values were significantly higher, while BUT and Schirmer test scores were lower in both active and inactive TAO patients compared to the controls. Central LC densities of patients with active TAO (76.38 ± 67.77 cell/mm(2)) and inactive TAO (47.49 ± 38.58 cell/mm(2)) were both significantly higher than those of the controls (21.46 ± 21.74 cell/mm(2)). The number of LCs in the peripheral cornea was also significantly increased in the active TAO group (131.53 ± 74.18 cell/mm(2)) compared to the control group (70.21 ± 37.76 cell/mm(2)). Central LC morphology (LCM) values were significantly higher in both active (1.77 ± 0.63) and inactive (1.51 ± 0.63) TAO groups compared to the control group (1.01 ± 0.80), whereas peripheral LCM scores of the two TAO groups were increased without statistical significance. There were significant correlations between both central LC density and central LCM scores and clinical data, including clinical activity score, OSDI and Schirmer test scores, and between peripheral LC density and OSDI and Schirmer test scores. No significant correlations were found between peripheral LCM scores and clinical data. CONCLUSIONS: The increase of corneal LCs in density and maturation in patients with TAO reflects an activated state of the local immune system, which indicates an inflammatory process in the cornea of TAO.

CD40 ligand induces expression of vascular cell adhesion molecule 1 and E-selectin in orbital fibroblasts from patients with Graves' orbitopathy.

PURPOSE: The aim of this study was to detect the effect of the CD40 ligand (CD40L) on the expression of vascular cell adhesion molecule 1 (VCAM-1) and E-Selectin in orbital fibroblasts (OFs) from patients with Graves' orbitopathy (GO), as well as the signaling pathways involved in this effect. METHODS: OFs were isolated from orbital tissues obtained from patients with severe GO who were undergoing orbital decompression surgery. VCAM-1 and E-selectin RNA and protein expression levels were quantified in OFs stimulated with soluble CD40L (sCD40L). RNA and protein quantification was performed with real-time polymerase chain reaction (PCR) and western blot analysis. Cytoplasmic and nuclear fractions were isolated in order to detect the nuclear translocation of nuclear factor-κB (NF-κB). Signaling pathway inhibitors were applied to determine the pathways involved. RESULTS: Compared to unstimulated OFs, the mRNA and protein levels of VCAM-1 and E-selectin in OFs incubated with sCD40L were significantly increased. This was observed in dose- and time-course experiments, and the inductive effects of sCD40L were much weaker in OFs from healthy donors. At the same time, we observed that CD40L induced nuclear translocation of NF-κB, also in a dose- and time-dependent manner. The up-regulation of VCAM-1 and E-selectin, as well as the NF-κB nuclear translocation induced by CD40L, was significantly attenuated by inhibitors targeting mitogen-activated protein kinases (MAPKs), phosphatidylinositol 3-kinase (PI3K), and NF-κB. CONCLUSIONS: CD40L demonstrated the ability to up-regulate the expression of VCAM-1 and E-selectin at the pre-translational level in OFs from patients with GO. The MAPK and PI3K pathways and NF-κB may play important roles in CD40L-induced VCAM-1 and E-selectin expression.

Meta-analysis of association between the +49A/G polymorphism of cytotoxic T-lymphocyte antigen-4 and thyroid associated ophthalmopathy.

PURPOSE OF THE STUDY: Cytotoxic-T lymphocyte antigen-4 (CTLA-4) has been shown to play an important role in the development and progression of thyroid associated ophthalmopathy (TAO). A number of case-control studies focused on the association between CTLA-4 +49A/G polymorphism and risk for TAO. But the results were not always consistent. So we performed a meta-analysis to evaluate the precise association between this polymorphism and risk for TAO. MATERIALS AND METHODS: All publications on the association between CTLA-4 +49A/G polymorphism and TAO were searched in the following electronic databases: PubMed, Embase, the Cochrane library and Chinese Biomedical Literature Database, with the last report up to May 2014. This meta-analysis was assessed by Review Manager 5.1. RESULTS: A total of 14 studies were involved in this meta-analysis, including 1128 cases and 2539 controls. Overall, we found a significant association between CTLA-4 +49A/G polymorphism and TAO (G versus A: OR = 1.64, 95% CI = 1.40-1.92, p < 0.00001; GG versus AG + AA: OR = 2.02, 95% CI = 1.59-2.57, p < 0.00001; GG + AG versus AA: OR = 2.01, 95% CI = 1.66-2.43, p < 0.00001; GG versus AA: OR = 2.74, 95% CI = 1.83-4.10, p < 0.00001; AG versus AA: OR = 1.75, 95% CI = 1.42-2.15, p < 0.00001). The results were not materially altered after the studies which did not fulfill Hardy-Weinberg equilibrium were excluded. Significant association was also detected in both Caucasian and Asian populations in subgroup analysis divided by different ethnicity. CONCLUSION: Our meta-analysis supports the association between the CTLA-4 +49A/G polymorphism and TAO.

Meta-analysis of association between the -2578C/A polymorphism of the vascular endothelial growth factor and retinopathy in type 2 diabetes in Asians and Caucasians.

BACKGROUND AND OBJECTIVES: Vascular endothelial growth factor (VEGF) has been shown to play an important role in the development and progress of diabetic retinopathy (DR). A number of case-control studies focused on the association between VEGF -2578C/A and risk for DR. But the results were not always consistent, so we performed a meta-analysis to evaluate the precise association between this variant and risk for DR. METHODS: All publications on the association between VEGF -2578C/A polymorphism and DR were searched in the following electronic databases: PubMed, Embase, the Cochrane Library and Chinese Biomedical Literature Database, with the last report up to January 2013. This meta-analysis was assessed by Review Manager 5.1. RESULTS: A total of 6 studies were involved in this meta-analysis, including 835 cases and 867 controls. Overall, we found a significant association between this polymorphism and DR (A vs. C: OR=1.49, 95% CI=1.26-1.77, p<0.00001; AA vs. CA+CC: OR=1.26, 95% CI=0.94-1.68, p=0.12; AA+CA vs. CC: OR=1.56, 95% CI=1.27-1.91, p<0.00001; AA vs. CC: OR=1.67, 95% CI=1.20-2.32, p=0.003; CA vs. CC: OR=1.51, 95% CI=1.21-1.87, p=0.0002), but we did not find any significant association in Caucasians in subgroup analysis. The results were not materially altered after the studies which did not fulfill the Hardy-Weinberg equilibrium were excluded. CONCLUSION: Our meta-analysis supports the association between the VEGF -2578C/A polymorphism and DR, but not in the Caucasian population.

Meta-analysis of selective laser trabeculoplasty with argon laser trabeculoplasty in the treatment of open-angle glaucoma.

OBJECTIVE: To evaluate the efficacy and tolerability of selective laser trabeculoplasty (SLT) and argon laser trabeculoplasty (ALT) in the treatment of open-angle glaucoma. DESIGN: Systematic review and meta-analysis. PARTICIPANTS: Six clinic studies, all of which were random controlled trials. METHODS: Pertinent studies were selected through extensive searches of PubMed, Cochrane Library, Embase, and meeting abstracts. Efficacy measures were weighted by mean differences for intraocular pressure (IOP), as well as change of number of glaucoma medications and relative risks (RRs) for therapeutic IOP responses. Tolerability measures were RRs for adverse events. Pooled estimates were carried out in RevMan software 5.1. RESULTS: SLT was associated with a numerically larger reduction compared with ALT, with a weighted mean difference (WMD) of 0.60 (95% CI, 0.06-1.14). There was no significant difference in therapeutic IOP responses between SLT and ALT, with a pooled RR of 0.84 (95% CI, 0.51-1.38). Patients who received SLT took fewer glaucoma medications after operations than those who received ALT, with a WMD of 0.29 (95% CI, 0.01-0.56). When compared in patients with previous failed laser treatment (ALT or SLT), SLT was more effective in IOP reduction than ALT with a WMD of 1.48 (95% CI, 0.75-2.21). The frequencies of anterior chamber flare and IOP peak after operation were similar comparing SLT and ALT, with pooled RRs of 0.90 (95% CI, 0.74-1.11) and 0.90 (95% CI, 0.45-1.82), respectively. CONCLUSIONS: SLT was associated with relatively higher efficacy of IOP lowering compared with ALT. SLT results in a larger reduction of number of glaucoma medications versus ALT, and it appeared to be more effective for patients who did not respond adequately to previous laser treatment. The difference in tolerability of the 2 lasers was not significant.

Sustained release of 5-fluorouracil from chitosan nanoparticles surface modified intra ocular lens to prevent posterior capsule opacification: an in vitro and in vivo study.

PURPOSE: The study aimed to prepare a new type intra ocular lens (IOL), in which 5-Fu, as an antimetabolite drug, could be sustained released to prevent posterior capsule opacification (PCO), and evaluate its efficacy and safety in vitro and in vivo. METHODS: 5-fluorouracil chitosan nanoparticles (5-Fu-CSNP) were prepared by template polymerization and selected by a cell counting kit (CCK-8). The 5-Fu-CSNPs that inhibit Human Lens Epithelial Cells (HLECs) proliferation most efficiently were chosen for further analysis. We then investigated cell death type in vitro by flow cytometry and fluorescent probe. IOLs were surface modified by 5-Fu-CSNP after being activated by a low energy fluorine ion beam, and then were implanted into rabbits' eyes after transparent lens enucleation to evaluate the efficacy of preventing PCO and safety in anterior chamber. Transparency and haze of the 5-Fu-CSNP-surface-modified intraocular lens (Nano-5-Fu-IOL) were detected by a haze meter. Drug release of the Nano-5-Fu-IOL was measured by UV spectrophotometry. RESULTS: The CCK results showed that the half inhibition dose (ID50) of the HLECs in 5-Fu-CSNP group and in 5-Fu solution group was 0.2 µg/mL and 1 µg/mL, respectively. The transparency of the 5-Fu-CSNP modified IOL was observed to have no significant difference with the blank control. The IOLs can continuously release 5-Fu in 4 days in vitro. In vivo, 5-Fu-CSNP IOL group had little aqueous flare 3 days after the surgery, and lighter PCO 4 weeks after the surgery than the blank control group. The results of the light microscope and electron microscope further confirmed the above results in vivo. CONCLUSIONS: The new IOL modified by 5-Fu-CSNP could be prepared and have a sustained release of 5-Fu to prevent PCO by promoting HLEC apoptosis. The drug-loaded CSNP could reduce the anterior chamber toxicity of 5-Fu markedly, which was probably due to the occurrence of endoplasmic reticulum stress and induction of apoptosis.

The prevalence of primary glaucoma in mainland China: a systematic review and meta-analysis.

OBJECTIVE: To estimate the prevalence of primary glaucoma in mainland China and to quantify its association with age, sex, and region. METHODS: Population-based studies that reported the prevalence of primary open-angle glaucoma (POAG) or/and primary angle-closure glaucoma (PACG) among adult populations in mainland China were identified through systematic searches. Fourteen articles providing 12 population-based studies were included. The overall pooled prevalence estimates were calculated using a random-effects model. A logistic metaregression was used to model the associations between the odds ratio (OR) and 95% confidence interval of primary glaucoma and age, sex, and region. RESULTS: The overall pooled prevalence of POAG was 0.7% (95% confidence interval, 0.4-1.2), and PACG was found in 1.4% (1.0%, 1.7%). The OR per decade increase in age was 1.68 (1.12, 2.52) for POAG, and 2.11 (1.72, 2.60) for PACG. The OR of POAG prevalence was 0.65 (0.26, 1.62) between men and women. Chinese women were 1.75 (1.20, 2.56) times more likely than men to have PACG. The OR between western China and east China were 0.37 (0.10, 1.35) for POAG, and 1.06 (0.63, 1.76) for PACG. The OR between urban China and rural China were 3.92 (1.55, 9.92) for POAG, and 1.07 (0.55, 2.10) for PACG. CONCLUSIONS: The prevalence of PACG was approximately double that of POAG in adult Chinese. The rate of change of PACG prevalence with age increased more rapidly than that of POAG. The prevalence of POAG in urban was higher than that in rural. PACG was more common in women than in men.

Myocilin polymorphisms and primary open-angle glaucoma: a systematic review and meta-analysis.

BACKGROUND: Glaucoma is the leading cause of irreversible blindness in the world. Recent evidence indicates a role for genetic susceptibility to primary open-angle glaucoma (POAG). The relation between myocilin polymorphisms and POAG susceptibility has been studied in different populations. METHODS: A meta-analysis of 32 published genetic association case-control studies, which examined the relation between POAG and the R46X, R76K, Y347Y, T353I, and Q368X polymorphisms of the myocilin gene, was carried out. RESULTS: In meta-analysis, significant associations were observed between POAG risk and two myocilin polymorphisms with summarized odds ratio of 4.68 (95%CI, 2.02-10.85) for Q368X and 2.17 (95% CI, 1.32-3.57) for T353I. Both Q368X and T353I were significantly associated with high-tension glaucoma, with summarized odds ratio of 4.26 (1.69, 10.73) and 2.26 (1.37-3.72). In Westerners, significant association was observed for Q368X mutation (odds ratio, 5.17; 95% CI, 2.16-12.40). However, in Asians it was for T353I (odds ratio, 2.17; 95% CI, 1.32-3.57). CONCLUSIONS: There is strong evidence that myocilin polymorphisms are associated with POAG susceptibility, and the prevalence of myocilin mutations might be ethnicity-dependent in Caucasians for Q368X and in Asians for T353I.

Impact of weight gain following smoking cessation on one-year outcome after drug-eluting stent implantation.

BACKGROUND: Weight gain following smoking cessation increases cardiovascular risk, but its effects on prognosis after percutaneous coronary intervention (PCI) remain unclear. This study aimed to investigate the relationship between weight gain post smoking cessation and one-year clinical outcome in patients who underwent PCI with drug-eluting stent (DES). METHODS: A total of 895 consecutive male smoking patients were divided into quitters (n = 437) and continuers (n = 458) according to their smoking status after PCI. Weight gain, major adverse cardiac events (MACE, including cardiac deaths, myocardial infarction and revascularization), and recurrent angina were recorded during follow-up for one year. RESULTS: Average weight gain in quitters was more than that in continuers (1.5 kg vs. -0.03 kg, P < 0.001). Weight was unchanged or increased by more than 1.5 kg in 78.17% of continuers, while 50.57% of quitters had a weight gain of less than 1.5 kg. Compared with continuers, MACE in quitters was significantly reduced after PCI (6.12% vs. 4.81%, P = 0.049), especially recurrent angina (13.97% in continuers vs. 9.84% in quitters, P = 0.027). After adjusting for weight gain and other factors, smoking cessation was independently associated with a lower risk of MACE and recurrent angina (OR = 0.73, P = 0.035). However, weight gain > 1.5 kg (OR = 1.55, P = 0.026) could curtail the benefits from smoking cessation. CONCLUSIONS: Weight gain may reduce the benefits of smoking cessation after PCI with DES implantation. Thus, although smoking cessation is recommended after PCI, weight control should also be highly encouraged for these patients.

Lack of association of conjunctival MALT lymphoma with Chlamydiae or Helicobacter pylori in a cohort of Chinese patients.

BACKGROUND: This study was conducted to detect microbial pathogens in conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma specimens in an attempt to determine possible associations between conjunctival MALT lymphoma and microbial infections. MATERIAL/METHODS: Using PCR technique, freshly obtained tumor specimens from 16 cases of conjunctival MALT lymphoma, as confirmed by postoperative pathology, were analyzed for DNA of Chlamydia psittaci (C. psittaci), Chlamydia trachomatis (C. trachomatis), Chlamydia pneumoniae (C. pneumoniae) and Helicobacter pylori (H. pylori). Synthetic C. psittaci, C. trachomatis, C. pneumoniae and H. pylori DNA were used as positive control, and blank plasmid DNA as negative control. RESULTS: Electrophoresis showed that no bands corresponding to the positive control were observed in the specimens, indicating that no DNA of the 4 microorganisms was detected in the specimens of the 16 cases of conjunctival MALT lymphoma. CONCLUSIONS: The PCR technique was able to detect the positive control quickly and accurately, but the results of PCR in analyzing the 16 specimens were negative, indicating that there is no association between conjunctival MALT lymphoma and the 4 microorganisms in Chinese patients.

[The relationship between amount of cigarette smoked and insulin resistance in male patients with coronary artery disease].

OBJECTIVE: To investigate the relationship between smoking and insulin resistance in non-obese male patients with CAD. METHODS: 414 consecutive non-obese male patients with angiographically-documented CAD (luminal diameter narrowing > 50%) were recruited, including 113 nonsmokers and 301 smokers. With 99 mild smokers (< 400 packs/year), 95 medium smokers (400 - 799 packs/year) and 107 heavy smokers (≥ 800 packs/year). Insulin resistance index (IRI) was expressed by homeostasis model assessment for insulin resistance (HOMA-IR) calculated by the formula of [fasting serum glucose (mmol/L) × fasting plasma insulin (mU/L)]/22.5. IRI ≥ 2.69 was defined as insulin resistance, while IRI < 2.69 was insulin sensitive. Fasting glucose, fasting insulin and IRI were recorded and odds ratio for the incidence of insulin resistance was calculated. RESULTS: Fasting glucose was higher in heavy smokers (5.86 mmol/L) than that in nonsmokers (5.51 mmol/L, P = 0.037) and mild smokers (5.33 mmol/L, P = 0.014). Fasting insulin and IRI were also significantly higher in heavy smokers (10.25 mU/L) than those in non-smokers (8.72 mU/L, P = 0.0231, respectively) and mild smokers (8.67 mU/L, P = 0.0231). Compared with nonsmokers, the odds ratio for the incidence of insulin resistance was 1.53 (95%CI 0.55 - 2.94; P = 0.027) in medium smokers and 1.89 (95%CI 0.49 - 3.14; P = 0.018) in heavy smokers. CONCLUSIONS: The relationship between smoking and insulin resistance is highly dose dependent in non-obese male patients with CAD.

Meta-analysis: clinical outcomes of laser-assisted subepithelial keratectomy and photorefractive keratectomy in myopia.

PURPOSE: To examine possible differences in clinical outcomes between laser-assisted subepithelial keratectomy (LASEK) and photorefractive keratectomy (PRK) for myopia. DESIGN: Systematic review and meta-analysis. PARTICIPANTS: Patients from previously reported randomized controlled trials (RCTs) and comparative studies of LASEK and PRK with clinical outcomes. METHODS: A comprehensive literature search was performed using the Cochrane Collaboration methodology to identify RCTs and comparative studies comparing LASEK and PRK for myopia. MAIN OUTCOME MEASURES: Primary outcome parameters included uncorrected visual acuity (UCVA) of 20/20 or better, manifest refractive spherical equivalent (SE) within ± 0.50 diopters (D), final refractive SE, and final UCVA of 20/40 or worse. Secondary outcome parameters included healing time of corneal epithelium, postoperative pain, and corneal haze. RESULTS: Twelve studies were identified and used for comparing PRK (499 eyes) with LASEK (512 eyes) for myopia. There were no significant differences in odds ratio (OR), weighted mean difference (WMD), and standardized mean difference (SMD) in the primary and secondary outcome measures. The final mean refractive SE (WMD, 0.00; 95% confidence interval [CI], -0.08 to 0.07; P = 0.95), manifest refractive SE within ± 0.50 D of the target (OR, 0.90; 95% CI, 0.63-1.29; P = 0.56), patients achieving UCVA of 20/20 or better (OR, 0.86; 95% CI, 0.61-1.20; P = 0.37), final UCVA of 20/40 or worse (OR, 1.26; 95% CI, 0.63-2.51; P = 0.52), re-epithelialization time (WMD, 0.08; 95% CI, -0.44 to 0.59; P = 0.77), and postoperative pain (SMD, 0.26; 95% CI, -0.20 to 0.72; P = 0.27) were analyzed. However, LASEK-treated eyes showed less corneal haze at 1 month after surgery (WMD, 0.25; 95% CI, 0.10-0.39; P = 0.0007) and 3 months after surgery (WMD, 0.14; 95% CI, 0.01-0.26; P = 0.03) compared with PRK. No statistically significant difference was observed between the 2 groups at 6 months after surgery (WMD, 0.14; 95% CI, -0.02 to 0.30; P = 0.08). CONCLUSIONS: In this meta-analysis, LASEK-treated eyes had no significant benefits over PRK-treated ones with regard to clinical outcomes. Less corneal haze was observed in LASEK-treated eyes at 1 to 3 months after surgery.

Influence of insulin resistance on long-term outcomes in patients.

BACKGROUND: Insulin resistance (IR) is significantly associated with coronary artery disease and cardiovascular events in patients with or without type 2 diabetes mellitus. This study aimed to evaluate the influence of IR on long-term outcomes of patients undergoing percutaneous coronary intervention (PCI) with sirolimus-eluting stent (SES) implantation. METHODS: A total of 467 consecutive patients undergoing SES-based PCI were divided into IR group (n = 104) and non-IR group (n = 363). The patients were followed up for one year. The rate of major adverse cardiac events (MACEs) including death, non-fatal myocardial infarction and recurrent angina pectoris was compared by the log-rank test, and the independent risk factors were identified by the Cox regression analysis. RESULTS: MACEs occurred more frequently, and cumulative survival rate was lower in the IR group than in the non-IR group during the follow-up (all P < 0.05). IR was an independent risk factor for the occurrence of cardiac death and non-fatal myocardial infarction (OR = 2.76, 95%CI = 1.35 - 5.47, P = 0.034). Old age, diabetes, and multi-vessel disease were determinants for recurrent angina pectoris after PCI (P < 0.05). Subgroup analysis revealed that IR (OR = 3.35, 95%CI = 1.07 - 13.59, P = 0.013) and multi-vessel disease (OR = 2.19, 95%CI = 1.01 - 5.14, P = 0.044) were independent risk predictors for recurrent angina pectoris in patients with diabetes after PCI. CONCLUSIONS: IR is associated with reduced MACE-free survival and remains an independent predictor for recurrent angina pectoris after PCI with SES implantation.

Krypton yellow laser for the treatment of macular hole in high myopia without retinal detachment.

PURPOSE: To evaluate the prophylactic effect of krypton yellow laser for the treatment of macular holes in high myopic eyes in order to reduce the risk of retinal detachment. METHODS: Twenty-seven eyes of 27 patients with high myopia and macular holes were randomly assigned to two groups. Fifteen patients (group A, 15 eyes) were subject to laser photocoagulation around the hole margin along with an oral placebo (vitamin B1), while 12 patients (group B, 12 eyes) were only given the oral placebo (vitamin B1). The incident rate of retinal detachment due to macular hole and the mean best-corrected visual acuity of the two groups before and after treatment were measured. The data were statistically tested by X2 test and Student's t test. RESULTS: The incident rates of retina1 detachment in group A and group B were 20%(3/15) and 58.3%(7/12), respectively (X2=4.201, P0.05). The mean BCVA of group B on the initial examination was 24/200, while the mean BCVA at the final follow-up was 30/200 (P>0.05). No significant difference in initial visual acuity (P>0.05) or final visual acuity (P>0.05) was found between the two groups. CONCLUSION: Krypton yellow laser photocoagulation could reduce the incidence of retinal detachment due to a macular hole in high myopia with acceptable functional results in this study.

Effect of intraoperative mitomycin-C on healthy corneal endothelium after laser-assisted subepithelial keratectomy.

PURPOSE: To evaluate the effect of mitomycin-C (MMC) on corneal endothelial cells after laser-assisted subepithelial keratectomy (LASEK). SETTING: Department of Ophthalmology, Changzheng Hospital, Shanghai, China. METHODS: One hundred seventy-four eyes of 89 patients who did not previously wear contact lenses were treated with LASEK with intraoperative use of topical MMC 0.02% (15 seconds). Noncontact corneal specular microscopy was performed in all eyes preoperatively and 1, 3, and 6 months after surgery. Preoperative pachymetry and ablation depth were measured in all eyes. Repeated-measures analysis of variance was used to compare the changes in the endothelial central cell density (CCD), coefficient of variation in cell size (CV), and percentage of hexagram cells (HEX) over time. Linear regression analysis was conducted to analyze the correlation between the change in the 3 corneal endothelium indices over time and the ablation depth and residual stroma bed (RSB) thickness. RESULTS: Preoperatively, the mean CCD was 2755 cells/mm(2)+/-373 (SD), the mean CV was 31.45+/-8.26, and the mean HEX was 66.03%+/-25.83%. After LASEK, there were no statistically significant changes in CCD, CV, or HEX (P>.05). Multiple linear regression did not identify ablation depth or RSB thickness as being predictive of a change in CCD, CV, or HEX (P>.05). CONCLUSION: The use of intraoperative topical MMC 0.02% for 15 seconds after LASEK did not affect the corneal endothelium.

Prophylactic use of timolol maleate to prevent intraocular pressure elevation after Nd-YAG laser posterior capsulotomy.

PURPOSE: To evaluate the effective prophylaxis of topical 0.5% timolol maleate for the intraocular pressure rise following Nd-YAG laser posterior capsulotomy. METHODS: A total of 190 eyes of 184 patients who underwent Nd-YAG laser posterior capsulotomy were randomly assigned to pre-treatment with either topical application of 0.5% timolol maleate (treatment group) or nothing (control group). RESULTS: The mean intraocular pressure (IOP) of the treatment group was 14.8+/-3.0 mmHg before capsulotomy and 15.7+/-3.4 mmHg after capsulotomy (P>0.05), whereas IOP was 15.1+/-3.3 mmHg and 17. 2+/-4.3 mmHg (P<0.05) for the control group. There was no statistically significant difference between the two groups with regard to mean IOP before capsulotomy (P>0.05), but a statistically significant difference was seen between the two groups after capsulotomy (P<0.05). Six of 91 eyes (6.6%, two with aphakia) in the treatment group had an IOP elevation greater than 6 mmHg compared with 14 of 99 eyes (14.1%, eight with aphakia) in the control group (P<0.01). CONCLUSION: Pre-treatment with a topical application of 0.5% timolol maleate is effective in preventing IOP elevation after Nd-YAG laser posterior capsulotomy.