Analysis of surgically induced astigmatism of the anterior, posterior, and total cornea after implantable collamer lens implantation: a comparative study between temporal and superior clear corneal incisions.

BACKGROUND: To comparatively analyze the surgically induced astigmatism (SIA) of the anterior, posterior, and total corneas of eyes undertaking implantable collamer lens (ICL) implantation with temporal or superior corneal incisions. METHODS: One hundred and nine eyes of 109 patients who received ICL implantation were recruited: 40 eyes had temporal incisions and 69 eyes had superior incisions. Total corneal refractive power (TCRP); simulated keratometry of the anterior (Sim-KAnt) and posterior (Sim-KPost) corneal curvature; and astigmatism of the anterior (CAAnt), posterior (CAPost), and total (CATCRP) cornea were recorded through a Pentacam preoperatively and 3 months postoperatively. The SIA of the anterior, posterior, and total cornea were also compared between the two groups. RESULTS: There were no significant intergroup differences for TCRP, Sim-KAnt, Sim-KPost, CAAnt, CAPost, or CATCRP, preoperatively. However, values of CAAnt, CAPost, and CATCRP with temporal incision were significantly higher than those parameters with superior incision postoperatively. All of the SIA of the anterior, posterior, and total cornea were significantly lower for temporal incision than those with a superior incision (p < 0.001, p = 0.006 and p = 0.001 respectively). Meanwhile, the superior incisions created against-the-rule (ATR) astigmatism, and temporal incisions always induce with-the-rule (WTR) astigmatism in total cornea. CONCLUSIONS: A superior incision may be suitable for correcting WTR astigmatism, while a temporal incision for correcting ATR astigmatism when using a non-toric ICL. Meanwhile, temporal incision could be a better choice with little preoperative astigmatism or that preoperative astigmatism would be corrected with toric ICLs. TRIAL REGISTRATION: Registration number: ChiCTR2100051739. Prospectively registered: 01 October 2021.

Nomograms for Predicting Risk and Survival of Esophageal Cancer Lung Metastases: a SEER Analysis.

Background: The overall survival rate is notably low for esophageal cancer patients with lung metastases (LM), presenting significant challenges in their treatment. Methods: Through the Surveillance, Epidemiology, and End Results (SEER) program, individuals diagnosed with esophageal cancer between 2010 and 2015 were enrolled. Based on whether esophageal cancer metastasized to the lungs, we used propensity score matching (PSM) to balance correlated variables. Propensity score matching was a critical step in our study that helped to minimize the impact of possible confounders on the study results. We balanced variables related to lung metastases using the PSM method to ensure more accurate comparisons between the study and control groups. Specifically, we performed PSM in the following steps. First, we performed a univariate logistic regression analysis to screen for variables associated with lung metastasis. For each patient, we calculated their propensity scores using a logistic regression model, taking into account several factors, including gender, T-stage, N-stage, surgical history, radiotherapy history, chemotherapy history, and bone/brain/liver metastases. We used a 1:1 matching ratio based on the propensity score to ensure more balanced baseline characteristics between the study and control groups after matching. After matching, we validated the balance of baseline characteristics to ensure that the effect of confounders was minimized. We used logistic regression to identify risk variables for LM, while Cox regression was used to find independent prognostic factors. We then created nomograms and assessed their accuracy using the calibration curve, receiver operating curves (ROC), and C index. Results: In the post-PSM cohort, individuals diagnosed with LM experienced a median overall survival (OS) of 5.0 months (95% confidence interval [CI] 4.3-5.7), which was significantly lower than those without LM (P<0.001). LM has been associated to sex, T stage, N stage, surgery, radiation, chemotherapy, and bone/brain/liver metastases. LM survival was affected by radiation, chemotherapy, and bone/liver metastases. The nomograms' predictive power was proved using the ROC curve, C-index, and validation curve. Conclusion: Patients with LM have a worse chance of surviving esophageal cancer. The nomograms can effectively predict the risk and prognosis of lung metastases from esophageal cancer.

Case Report: Bilateral Corneal Ectasia Developed during Pregnancy after Small-incision Lenticule Extraction.

SIGNIFICANCE: This case highlights that hormonal changes during pregnancy could affect the biomechanical stability of the cornea and lead to corneal ectasia during pregnancy after corneal refractive surgery. PURPOSE: We report an unusual case of bilateral corneal ectasia after small-incision lenticule extraction that developed during pregnancy. CASE REPORT: A 27-year-old woman experienced post-small-incision lenticule extraction corneal ectasia. Her pre-operative corneal topography was normal, with a minimum central corneal thickness of 538 µm in the right eye and 530 µm in the left eye. The manifest refraction was -7.75 -0.25 × 180 and -7.50 -0.75 × 10, and the lenticule thickness was 140 and 139 µm in the right and left eyes, respectively. After 11 months, in her first trimester, the patient began to experience gradually deteriorating blurred vision. Two years post-operatively, corneal ectasia was diagnosed based on topographic data. The automatic optometer examination was -7.25 -2.50 × 42 in the right eye and -11.00 -5.00 × 140 in the left eye. Later, the patient underwent corneal collagen cross-linking to control further progression and was recommended to wear rigid gas-permeable contact lenses. CONCLUSIONS: Surgeons should be alert for cornea ectasia after refractive surgery in pregnant patients, as hormonal changes during pregnancy may affect corneal biomechanical stability.

Association between outpatient visits for pterygium and air pollution in Hangzhou, China.

Air pollution could be a risk factor for the development of pterygium. This study aimed to investigate the potential associations between outpatient visits for pterygium and air pollutants. Using a time-stratified case-crossover design, the data of 3017 outpatients with pterygium visiting an eye center in Hangzhou, China, and the air pollution data of the Environmental Protection Department of Zhejiang Province between July 1, 2014, and November 30, 2019, were examined. The relationships between the air pollutants nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone, and fine particulate matter (PM) with median aerometric diameter <2.5 µm (PM2.5) and <10 µm (PM10) and outpatient visits for primary pterygium were assessed using single- and multiple-pollutant models. Significant associations between outpatient visits for pterygium and air pollutants (PM2.5, PM10, SO2, and NO2) were observed. Younger patients were found to be more sensitive to air pollution. Interestingly, the younger female patients with pterygium were more vulnerable to PM2.5 exposure during the warm season, while the younger male patients with pterygium were more sensitive to NO2 during the cold season. Significant effects were also observed between the pterygium outpatients and PM2.5 (odds ratio [OR] = 1.06, P = 0.02), PM10 (OR = 1.04, P = 0.01), and SO2 (OR = 1.26, P = 0.01) during the warm season, as well as NO2 (OR = 1.06, P = 0.01) during the cold season. Our study provides evidence that outpatient visits for pterygium are positively associated with increases in the air pollutants PM2.5, PM10, SO2, and NO2, revealing the important role of air pollution in the occurrence and development of pterygium.

Risk factors and incidence of suction loss during small incision lenticule extraction (SMILE) in 8493 eyes.

BACKGROUND: To report the incidence and risk factors of suction loss during small incision lenticule extraction (SMILE). METHODS: This retrospective comparative case control study included 8493 eyes of 4261 patients. Patients underwent SMILE surgery between January 2014 and September 2019 were included. Videos of suction loss were reviewed, and the direct causes of suction loss were noted. An independent samples t-test was used for comparisons between the suction loss group and the control group. A binary logistic regression model was used to determine the possible significant risk factors that might increase the likelihood of suction loss during SMILE surgery. RESULTS: Suction loss occurred in 31 (0.37%) eyes of 30 patients; 23 (74.2%) cases occurred in the right eye (the first operative eye) and 8 (25.8%) cases occurred in the left eye. Among the 30 patients, 23 (76.7%) were male and 7 (23.3%) were female. The incidence in the six consecutive years were 0, 2.13, 0.34, 0.24, 0.22, and 0.25%. Head and eye movements during surgery caused suction loss in 16 (51.6%) and 15 (48.4%) eyes, respectively. Comparison between the suction loss group and the control group showed that the first operative eye and male sex are at a significantly high risk for suction loss (p < 0.05). CONCLUSIONS: The risk factors of suction loss were first operative eye and male sex. Head and eye movements due to patient anxiety are the most common direct causes of suction loss. Surgeon's experience may help to reduce the incidence of suction loss. Preoperative education and better communication during surgery needs to be emphasized. TRIAL REGISTRATION: Retrospectively registered. ChiCTR-ORC-17011040 . Registered 1 April 2017. Name of registry: The observation of clinical results after corneal refractive surgery. Data of enrolment of the first participant to the trial: 1 January 2014.

Corneal higher-order aberrations of the anterior surface, posterior surface, and total cornea after small incision lenticule extraction (SMILE): high myopia versus mild to moderate myopia.

BACKGROUND: To investigate corneal higher-order aberrations (HOAs) of the anterior surface, posterior surface, and total cornea after small incision lenticule extraction (SMILE) in high myopic and mild to moderate myopic patients. METHODS: This retrospective study included 197 eyes (101 patients) undergoing SMILE surgery. According to the preoperative spherical equivalent (SE), treated eyes were divided into two groups: a high myopic group (more than - 6.0 D, Group H) and a mild to moderate myopic group (less than - 6.0 D, Group M). Corneal HOAs of the anterior surface, posterior surface, and total cornea were measured using a Scheimpflug camera preoperatively and 3 months postoperatively. Pearson's correlation analysis was conducted to determine relationships between corneal aberrations and the SE. RESULTS: There were no significant differences in third-order to eight-order aberrations (RMS HOAs) of the anterior surface, posterior surface, and total corneal between the two groups before SMILE surgery. However, after SMILE, anterior and total corneal HOAs, especially vertical coma and spherical aberrations, significantly increased in both groups (p < 0.0167), whereas posterior corneal HOAs remained relatively stable (p > 0.0167). The induction of HOAs was significantly greater in Group H than Group M postoperatively (p < 0.0167). Changes in anterior surface and total corneal HOAs, especially vertical coma and spherical aberrations, were related to the SE (p < 0.05). CONCLUSIONS: Anterior and total corneal HOAs, particularly vertical coma and spherical aberrations, significantly increased after SMILE in both groups, whereas posterior corneal HOAs remained stable. Aberration changes were related to SE. TRIAL REGISTRATION: Retrospectively registered. ChiCTR-ORC-17011040 . Registered 1 April 2017. Name of registry: The observation of clinical results after corneal refractive surgery. Data of enrolment of the first participant to the trial: 15 December 2016.

Comparison of visual results and higher-order aberrations after small incision lenticule extraction (SMILE): high myopia vs. mild to moderate myopia.

BACKGROUND: To compare the refractive results and higher-order aberrations (HOAs) after small incision lenticule extraction (SMILE) in high myopia and mild to moderate myopia patients. METHODS: This prospective study included 165 eyes (86 patients) undergoing SMILE. According to the preoperative spherical equivalent (SE), treated eyes were divided into two groups: the high myopia group (more than -6.0 D, group-H) and the mild to moderate group (less than -6.0 D, group-M). Follow-up intervals were at 1 day, 10 days, 1 month and 3 months postoperatively. We obtained the following parameters: uncorrected (UDVA) and corrected distance visual acuity (CDVA), SE, efficacy and safety index, and HOAs. RESULTS: Preoperative SE was -7.16 ± 0.93 D in group-H and -4.34 ± 0.97 D in group-M. At 3 months postoperatively, the SE in group-H and group-M was -0.20 ± 0.37 D and 0.01 ± 0.19 D (t = - 4.11, P<0.05), respectively. It was found that 77% and 98% had an UDVA of 20/20, 98% and 99% had a CDVA of 20/20 in group-H and group-M, respectively, while 87% and 95% had a SE within ±0.5 D and ±1.0 D in group-H, and 98% and 100% in group-M. The efficacy indexes were 0.98 ± 0.18 in group-H and 1.05 ± 0.10 in group-M (t = - 3.084, p < 0.05). The safety indexes were 1.06 ± 0.09 and 1.06 ± 0.09 (t = 0.153, p > 0.05), respectively. There were significant increases in total HOAs, 3rd-order coma, and 4th-order spherical aberrations. CONCLUSIONS: SMILE is an effective and safe surgery for correcting myopia. But the target correction amount in high myopia patients should be adjusted to avoid undercorrection and acquired more satisfaction. SMILE induced increases of HOAs. TRIAL REGISTRATION: ChiTrial registration number: ChiCTR-OON-16009164 . Retrospectively registered: 06.September.2016.

Metal-linked Immunosorbent Assay (MeLISA): the Enzyme-Free Alternative to ELISA for Biomarker Detection in Serum.

Determination of disease biomarkers in clinical samples is of crucial significance for disease monitoring and public health. The dominating format is enzyme-linked immunosorbent assay (ELISA), which subtly exploits both the antigen-antibody reaction and biocatalytic property of enzymes. Although enzymes play an important role in this platform, they generally suffer from inferior stability and less tolerant of temperature, pH condition compared with general chemical product. Here, we demonstrate a metal-linked immunosorbent assay (MeLISA) based on a robust signal amplification mechanism that faithfully replaces the essential element of the enzyme. As an enzyme-free alternative to ELISA, this methodology works by the detection of α-fetoprotein (AFP), prostatic specific antigen (PSA) and C-reactive protein (CRP) at concentrations of 0.1 ng mL(-1), 0.1 ng mL(-1) and 1 ng mL(-1) respectively. It exhibits approximately two magnitudes higher sensitivity and is 4 times faster for chromogenic reaction than ELISA. The detection of AFP and PSA was further confirmed by over a hundred serum samples from hepatocellular carcinoma (HCC) and prostate cancer patients respectively.

Quick serological detection of a cancer biomarker with an agglutinated supramolecular glycoprobe.

While serology represents the forefront technique for cancer diagnosis, current clinical methods for the detection of serum biomarkers have flaws in terms of the need of complicated manipulations, long analytical time, and high cost. Here, we develop a supramolecular glycoprobe for the quick serological detection of a cancer biomarker. The probe formed by agglutination between self-assembled glyco-gold nanoparticles and a lectin shows subtle optical variations upon the competitive recognition of a glycoprotein biomarker secreted by cancer cells, tumor-bearing mice, as well as clinical cancer patients, with no response to a series of controls including the serum of hepatitis patients. This research provides an insight into the development of effective tools for serological diagnosis of cancer.

Analyzing Carbohydrate-Protein Interaction Based on Single Plasmonic Nanoparticle by Conventional Dark Field Microscopy.

We demonstrated a practical method to analyze carbohydrate-protein interaction based on single plasmonic nanoparticles by conventional dark field microscopy (DFM). Protein concanavalin A (ConA) was modified on large sized gold nanoparticles (AuNPs), and dextran was conjugated on small sized AuNPs. As the interaction between ConA and dextran resulted in two kinds of gold nanoparticles coupled together, which caused coupling of plasmonic oscillations, apparent color changes (from green to yellow) of the single AuNPs were observed through DFM. Then, the color information was instantly transformed into a statistic peak wavelength distribution in less than 1 min by a self-developed statistical program (nanoparticleAnalysis). In addition, the interaction between ConA and dextran was proved with biospecific recognition. This approach is high-throughput and real-time, and is a convenient method to analyze carbohydrate-protein interaction at the single nanoparticle level efficiently.

Colorimetric and plasmonic detection of lectins using core-shell gold glyconanoparticles prepared by copper-free click chemistry.

This study describes the simple preparation of core-shell glycosyl gold nanoparticles (AuNPs) using stepwise, copper-free click chemistry-promoted self-assembly. The as-formed glyco-AuNPs can be used for the selective detection of sugar-lectin interactions, which are vital to many important physiological and pathological processes. The approach uses AuNPs as bioprobes since they produce, sensitively, changes in both color visible to the naked eye and surface plasmon resonance (SPR), on aggregation. Strain-promoted click reaction of an azido galactoside with a lipid cyclooctyne affords a galactolipid that can be embedded into polyethylene glycol (PEG)-coated AuNP via self-assembly. Subsequently, using naked-eye and plasmon resonance scattering spectroscopy, we were able to observe the colorimetric and plasmonic variations of the glyco-AuNPs, respectively, in the presence of a selective lectin over other proteins.

Using estimative reaction free energy to predict splice sites and their flanking competitors.

A crucial part in the gene structure prediction is to identify the accurate splice sites, not only constitutive but also alternative ones. Here, we use the maximum information principle (MIP) to analyze the conservative segments around splice sites. According to the MIP, a reaction free energy (RFE) expression is deduced, which can be employed to estimate the free energy change during splicing reaction involving a donor or acceptor site. The expression contains not only the background probability factors, but also all kinds of dependencies among both adjacent and non-adjacent bases. We apply the RFE expression to recognize splice sites and their flanking competitors in human genes, the results show high sensitivity and specificity, so the RFE expression accords well with the splicing reaction process. Moreover, the RFE expression is better than previous methods for predicting competitors of splice sites, and it outperforms the reaction free energy subtraction (RFES), that implies RFE competition between a given splice site and its flanking competitor may not be an only primary factor for alternative splice site selection. The work is helpful to not only the understanding of splicing reaction from its relation to MIP, but also the research on computational recognition of splicing sites and alternative splice events.

Proteomic analysis of human lens epithelial cells exposed to microwaves.

PURPOSE: To study proteomic changes in human lens epithelial cells (HLECs) exposed to 1800-MHz Global System for Mobile Communication (GSM)-like microwaves. METHODS: In three separate experiments, HLECs were exposed and sham-exposed (six dishes each) to 1800-MHz GSM-like radiation for 2 h. The specific absorption rates were 1.0, 2.0, or 3.5 W/kg. Immediately after radiation, the proteome was extracted from the HLECs. Immobilized pH gradient two-dimensional polyacrylamide gel electrophoresis(2-DE; silver staining) and PDQuest 2-DE analysis software were used to separate and analyze the proteome of exposed and sham-exposed HLECs. Four differentially expressed protein spots were selected and identified by using electrospray ionization tandem mass spectrometry (ESI-MS-MS). RESULTS: When the protein profiles of exposed cells were compared with those of sham-exposed cells, four proteins were detected as upregulated. After analysis by ESI-MS-MS and through a database search, heat-shock protein (HSP) 70 and heterogeneous nuclear ribonucleoprotein K (hnRNP K) were determined to be upregulated in the exposed cells. CONCLUSIONS: Two-dimensional polyacrylamide gel electrophoresis combined with mass spectrometry may be a powerful tool for screening potential electromagnetic-reaction protein markers. HSP70 and hnRNP K are involved in the stress reaction of HLECs exposed to microwaves. These cell responses are nonthermal effects of the electromagnetic field.

[Experimental study on the effects of hydrogen peroxide on caveolin in human lens epithelial cells].

OBJECTIVE: To observe the expression and distribution of caveolin and phosphorylated caveolin-1 in human lens epithelial cells (HLECs) under H(2)O(2) treatment. METHODS: HLECs (SRA01/04) were exposed to different concentrations of H(2)O(2) for different periods of time. The distribution of caveolin and phosphorylated caveolin-1 in H(2)O(2) treated cells was observed by laser scanning confocal microscopy and fluorescence microscopy. Western blot was conducted to analyze the protein expression alterations of caveolin and caveolin-1 phosphorylation. RESULTS: HLECs contained abundant caveolin. Immunofluorescence image of caveolin in cytoplasm increased significantly in H(2)O(2) treated cells. One hour after H(2)O(2) treatment, the cells membranes began to break, whereas the immunofluorescence image of caveolin could still be observed. Caveolin-1 was phosphorylated on tyrosine 14 in HLECs after stimulation with H(2)O(2). Western blot analysis revealed that caveolin protein level was down regulated under H(2)O(2) stress. CONCLUSIONS: The caveolin is redistributed and the caveolae is destroyed in HLECs when stimulated by H(2)O(2). And the caveolin expression also down regulated by H(2)O(2) stimulation. Caveolae and caveolin are likely to play an important role in the HLECs.

[Influence of corneal refractive surgery on wavefront aberrations of human eye].

OBJECTIVE: To analyze the aberration of human eyes after LASIK by using wavefront analyzer, to evaluate the eye aberrations by using the large spot in refractive surgery, and to compare the aberrations in different pupil zones. METHODS: This is a prospective clinical study. Preoperatively and postoperatively, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalent (SE) and aberrations were evaluated on each patient. The patients were divided into three different groups according to the SE diopter before the surgery. We used the SAS and SPSS10.0 statistic software to analyze the data. RESULTS: Preoperatively, BCVA was 4.98 +/- 0.07. Ten days after surgery, UCVA and BCVA were 4.92 +/- 0.10 and 4.95 +/- 0.09, respectively. One month after surgery, UCVA and BCVA were 4.96 +/- 0.09 and 4.99 +/- 0.09, respectively. Over time, visual acuity improved with Postoperatively, parts of the eye's BCVA were better than preoperatively. Ten days after LASIK, the SE of three groups were hyperopic. But with time, SE changes to myopia. In the Allegretto exam, high order aberrations increased immediately after surgery in each group (P < 0.05), but decreased with time (P > 0.05) and did not return to preoperative values at one month. Preoperatively, the total aberrations (RMSg) were larger than postoperatively. The aberrations especially spherical are larger in the 6.5 mm pupil zone than in the 4 mm pupil zone. Preoperatively, there were no significant differences of high order aberrations between the three groups (P > 0.05). But after surgery, there were significant differences (P < 0.05). CONCLUSIONS: Initially, high order aberrations increased after LASIK, but decreased over time. Preoperatively, there were no significant differences of aberrations between the three groups, but after surgery, significant differences existed. The aberrations especially spherical were larger in the 6.5 mm pupil zone than in the 4 mm pupil zone. Allegretto wave-front analyzer can be used for low to middle myopia.