1
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Komaki Y, Ono S, Okuya T, Ibuki Y. Glucose starvation impairs NER and γ-H2AX after UVB irradiation. Toxicol In Vitro 2023; 86:105503. [DOI: 10.1016/j.tiv.2022.105503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/12/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022]
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2
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Shukal DK, Malaviya PB, Sharma T. Role of the AMPK signalling pathway in the aetiopathogenesis of ocular diseases. Hum Exp Toxicol 2022; 41:9603271211063165. [PMID: 35196887 DOI: 10.1177/09603271211063165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AMP-activated protein kinase (AMPK) plays a precise role as a master regulator of cellular energy homeostasis. AMPK is activated in response to the signalling cues that exhaust cellular ATP levels such as hypoxia, ischaemia, glucose depletion and heat shock. As a central regulator of both lipid and glucose metabolism, AMPK is considered to be a potential therapeutic target for the treatment of various diseases, including eye disorders. OBJECTIVE To review all the shreds of evidence concerning the role of the AMPK signalling pathway in the pathogenesis of ocular diseases. METHOD Scientific data search and review of available information evaluating the influence of AMPK signalling on ocular diseases. RESULTS Review highlights the significance of AMPK signalling in the aetiopathogenesis of ocular diseases, including cataract, glaucoma, diabetic retinopathy, retinoblastoma, age-related macular degeneration, corneal diseases, etc. The review also provides the information on the AMPK-associated pathways with reference to ocular disease, which includes mitochondrial biogenesis, autophagy and regulation of inflammatory response. CONCLUSION The study concludes the role of AMPK in ocular diseases. There is growing interest in the therapeutic utilization of the AMPK pathway for ocular disease treatment. Furthermore, inhibition of AMPK signalling might represent more pertinent strategy than AMPK activation for ocular disease treatment. Such information will guide the development of more effective AMPK modulators for ocular diseases.[Formula: see text].
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Affiliation(s)
- Dhaval K Shukal
- 534329Iladevi Cataract and IOL Research Centre, Memnagar, Ahmedabad, Gujarat, India.,76793Manipal Academy of Higher Education, Mangalore, Karnataka, India
| | - Pooja B Malaviya
- 534329Iladevi Cataract and IOL Research Centre, Memnagar, Ahmedabad, Gujarat, India.,76793Manipal Academy of Higher Education, Mangalore, Karnataka, India
| | - Tusha Sharma
- 534329Iladevi Cataract and IOL Research Centre, Memnagar, Ahmedabad, Gujarat, India
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3
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Dang KR, Wu T, Hui YN, Du HJ. Newly-found functions of metformin for the prevention and treatment of age-related macular degeneration. Int J Ophthalmol 2021; 14:1274-1280. [PMID: 34414094 PMCID: PMC8342286 DOI: 10.18240/ijo.2021.08.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 05/11/2021] [Indexed: 12/18/2022] Open
Abstract
Metformin (MET), a first-line oral agent used to treat diabetes, exerts its function mainly by activating adenosine monophosphate-activated protein. The accumulation of oxidized phospholipids in the outer layer of the retina plays a key role in retinal pigment epithelium (RPE) cells death and the formation of choroidal neovascularization (CNV), which mean the development of age-related macular degeneration (AMD). Recent studies have shown that MET can regulate lipid metabolism, inhibit inflammation, and prohibit retinal cell death and CNV formation due to various pathological factors. Here, newly discovered functions of MET that may be used for the prevention and treatment of AMD were reviewed.
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Affiliation(s)
- Kuan-Rong Dang
- Department of Ophthalmology, Xijing Hospital, Eye Institute of Chinese PLA, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Tong Wu
- Department of Ophthalmology, Xijing Hospital, Eye Institute of Chinese PLA, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Yan-Nian Hui
- Department of Ophthalmology, Xijing Hospital, Eye Institute of Chinese PLA, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Hong-Jun Du
- Department of Ophthalmology, Xijing Hospital, Eye Institute of Chinese PLA, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
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4
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Behl T, Gupta A, Sehgal A, Sharma S, Singh S, Sharma N, Diaconu CC, Rahdar A, Hafeez A, Bhatia S, Al-Harrasi A, Bungau S. A spotlight on underlying the mechanism of AMPK in diabetes complications. Inflamm Res 2021; 70:939-957. [PMID: 34319417 DOI: 10.1007/s00011-021-01488-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/29/2021] [Accepted: 06/08/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Type 2 diabetes (T2D) is one of the centenarian metabolic disorders and is considered as a stellar and leading health issue worldwide. According to the International Diabetes Federation (IDF) Diabetes Atlas and National Diabetes Statistics, the number of diabetic patients will increase at an exponential rate from 463 to 700 million by the year 2045. Thus, there is a great need for therapies targeting functions that can help in maintaining the homeostasis of glucose levels and improving insulin sensitivity. 5' adenosine monophosphate-activated protein kinase (AMPK) activation, by various direct and indirect factors, might help to overcome the hurdles (like insulin resistance) associated with the conventional approach. MATERIALS AND RESULTS A thorough review and analysis was conducted using various database including MEDLINE and EMBASE databases, with Google scholar using various keywords. This extensive review concluded that various drugs (plant-based, synthetic indirect/direct activators) are available, showing tremendous potential in maintaining the homeostasis of glucose and lipid metabolism, without causing insulin resistance, and improving insulin sensitivity. Moreover, these drugs have an effect against diabetes and are therapeutically beneficial in the treatment of diabetes-associated complications (neuropathy and nephropathy) via mechanism involving inhibition of nuclear translocation of SMAD4 (SMAD family member) expression and association with peripheral nociceptive neurons mediated by AMPK. CONCLUSION From the available information, it may be concluded that various indirect/direct activators show tremendous potential in maintaining the homeostasis of glucose and lipid metabolism, without resulting in insulin resistance, and may improve insulin sensitivity, as well. Therefore, in a nut shell, it may be concluded that the regulation of APMK functions by various direct/indirect activators may bring promising results. These activators may emerge as a novel therapy in diabetes and its associated complications.
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Affiliation(s)
- Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, Punjab, India.
| | - Amit Gupta
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Aayush Sehgal
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Sanchay Sharma
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Sukhbir Singh
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Neelam Sharma
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Camelia Cristina Diaconu
- Internal Medicine Department, Clinical Emergency Hospital of Bucharest, Bucharest, Romania.,Department 5, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| | - Abbas Rahdar
- Department of Physics, University of Zabol, Zabol, Iran
| | - Abdul Hafeez
- Glocal School of Pharmacy, Glocal University, Mirzapur, Uttar Pradesh, India
| | - Saurabh Bhatia
- Amity Institute of Pharmacy, Amity University, Haryana, India.,Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, Oman
| | - Ahmed Al-Harrasi
- Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, Oman
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
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5
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Huang DR, Dai CM, Li SY, Li XF. Obacunone protects retinal pigment epithelium cells from ultra-violet radiation-induced oxidative injury. Aging (Albany NY) 2021; 13:11010-11025. [PMID: 33535179 PMCID: PMC8109142 DOI: 10.18632/aging.202437] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 08/08/2020] [Indexed: 12/22/2022]
Abstract
Ultra-violet (UV) radiation (UVR) causes significant oxidative injury to retinal pigment epithelium (RPE) cells. Obacunone is a highly oxygenated triterpenoid limonoid compound with various pharmacological properties. Its potential effect in RPE cells has not been studied thus far. Here in ARPE-19 cells and primary murine RPE cells, obacunone potently inhibited UVR-induced reactive oxygen species accumulation, mitochondrial depolarization, lipid peroxidation and single strand DNA accumulation. UVR-induced RPE cell death and apoptosis were largely alleviated by obacunone. Obacunone activated Nrf2 signaling cascade in RPE cells, causing Keap1-Nrf2 disassociation, Nrf2 protein stabilization and nuclear translocation. It promoted transcription and expression of antioxidant responsive element-dependent genes. Nrf2 silencing or CRISPR/Cas9-induced Nrf2 knockout almost reversed obacunone-induced RPE cytoprotection against UVR. Forced activation of Nrf2 cascade, by Keap1 knockout, similarly protected RPE cells from UVR. Importantly, obacunone failed to offer further RPE cytoprotection against UVR in Keap1-knockout cells. In vivo, intravitreal injection of obacunone largely inhibited light-induced retinal damage. Collectively, obacunone protects RPE cells from UVR-induced oxidative injury through activation of Nrf2 signaling cascade.
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Affiliation(s)
- Da-Rui Huang
- Department of Ophthalmology, The Affiliated Huaian NO.1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Chang-Ming Dai
- Department of Ophthalmology, The Affiliated Huaian NO.1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Shu-Yan Li
- Department of Ophthalmology, The Affiliated Huaian NO.1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Xiao-Feng Li
- Department of Ophthalmology, The Affiliated Huaian NO.1 People's Hospital of Nanjing Medical University, Huaian, China
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6
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Kaarniranta K, Uusitalo H, Blasiak J, Felszeghy S, Kannan R, Kauppinen A, Salminen A, Sinha D, Ferrington D. Mechanisms of mitochondrial dysfunction and their impact on age-related macular degeneration. Prog Retin Eye Res 2020; 79:100858. [PMID: 32298788 PMCID: PMC7650008 DOI: 10.1016/j.preteyeres.2020.100858] [Citation(s) in RCA: 246] [Impact Index Per Article: 61.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 12/21/2022]
Abstract
Oxidative stress-induced damage to the retinal pigment epithelium (RPE) is considered to be a key factor in age-related macular degeneration (AMD) pathology. RPE cells are constantly exposed to oxidative stress that may lead to the accumulation of damaged cellular proteins, lipids, nucleic acids, and cellular organelles, including mitochondria. The ubiquitin-proteasome and the lysosomal/autophagy pathways are the two major proteolytic systems to remove damaged proteins and organelles. There is increasing evidence that proteostasis is disturbed in RPE as evidenced by lysosomal lipofuscin and extracellular drusen accumulation in AMD. Nuclear factor-erythroid 2-related factor-2 (NFE2L2) and peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α) are master transcription factors in the regulation of antioxidant enzymes, clearance systems, and biogenesis of mitochondria. The precise cause of RPE degeneration and the onset and progression of AMD are not fully understood. However, mitochondria dysfunction, increased reactive oxygen species (ROS) production, and mitochondrial DNA (mtDNA) damage are observed together with increased protein aggregation and inflammation in AMD. In contrast, functional mitochondria prevent RPE cells damage and suppress inflammation. Here, we will discuss the role of mitochondria in RPE degeneration and AMD pathology focused on mtDNA damage and repair, autophagy/mitophagy signaling, and regulation of inflammation. Mitochondria are putative therapeutic targets to prevent or treat AMD.
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Affiliation(s)
- Kai Kaarniranta
- Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland and Kuopio University Hospital, P.O. Box 1627, FI-70211, Kuopio, Finland.
| | - Hannu Uusitalo
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland and Tays Eye Centre, Tampere University Hospital, P.O.Box 2000, 33521 Tampere, Finland
| | - Janusz Blasiak
- Department of Molecular Genetics, Faculty of Biology and Environmental Protection, University of Lodz, 90-236, Lodz, Poland
| | - Szabolcs Felszeghy
- Department of Biomedicine, Faculty of Health Sciences, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Ram Kannan
- The Stephen J. Ryan Initiative for Macular Research (RIMR), Doheny Eye Institute, 1355 San Pablo St, Los Angeles, CA, 90033, USA
| | - Anu Kauppinen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Antero Salminen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211, Kuopio, Finland
| | - Debasish Sinha
- Glia Research Laboratory, Department of Ophthalmology, University of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA, PA 15224, USA; Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Room M035 Robert and Clarice Smith Bldg, 400 N Broadway, Baltimore, MD, 21287, USA
| | - Deborah Ferrington
- Department of Ophthalmology and Visual Neurosciences, 2001 6th St SE, University of Minnesota, Minneapolis, MN 55455, USA
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7
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Mo Y, Zhu JL, Jiang A, Zhao J, Ye L, Han B. Compound 13 activates AMPK-Nrf2 signaling to protect neuronal cells from oxygen glucose deprivation-reoxygenation. Aging (Albany NY) 2019; 11:12032-12042. [PMID: 31852839 PMCID: PMC6949105 DOI: 10.18632/aging.102534] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 11/18/2019] [Indexed: 12/25/2022]
Abstract
Oxygen glucose deprivation-reoxygenation (OGD-R) causes the production of reactive oxygen species (ROS) and oxidative injury in neuronal cells. We tested the potential neuroprotective function of compound 13 (C13), a novel AMP-activated protein kinase (AMPK) activator, against OGD-R. We show that C13 pretreatment protected SH-SY5Y neuronal cells and primary hippocampal neurons from OGD-R. C13 activated AMPK signaling in SH-SY5Y cells and primary neurons. It significantly inhibited OGD-R-induced apoptosis activation in neuronal cells. Conversely, AMPKα1 shRNA or knockout reversed C13-mediated neuroprotection against OGD-R. C13 potently inhibited OGD-R-induced ROS production and oxidative stress in SH-SY5Y cells and primary neurons. Furthermore, C13 induced Keap1 downregulation and Nrf2 activation, causing Nrf2 stabilization, nuclear accumulation, and expression of Nrf2-dependent genes. Nrf2 silencing or knockout in SH-SY5Y cells abolished C13-mediated neuroprotection against OGD-R. In conclusion, C13 activates AMPK-Nrf2 signaling to protect neuronal cells from OGD-R.
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Affiliation(s)
- Yanqing Mo
- Minhang Hospital, Fudan University, Minhang District, Shanghai, China
| | - Jian-Liang Zhu
- Department of Emergency and Intensive Care Unit, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Aihua Jiang
- Minhang Hospital, Fudan University, Minhang District, Shanghai, China
| | - Jing Zhao
- Minhang Hospital, Fudan University, Minhang District, Shanghai, China
| | - Liping Ye
- Minhang Hospital, Fudan University, Minhang District, Shanghai, China
| | - Bin Han
- Minhang Hospital, Fudan University, Minhang District, Shanghai, China
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8
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GSK621 attenuates oxygen glucose deprivation/re-oxygenation-induced myocardial cell injury via AMPK-dependent signaling. Biochem Biophys Res Commun 2019; 514:826-834. [DOI: 10.1016/j.bbrc.2019.04.196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 04/29/2019] [Indexed: 12/25/2022]
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9
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Hao R, Su G, Sun X, Kong X, Zhu C, Su G. Adiponectin attenuates lipopolysaccharide-induced cell injury of H9c2 cells by regulating AMPK pathway. Acta Biochim Biophys Sin (Shanghai) 2019; 51:168-177. [PMID: 30668810 DOI: 10.1093/abbs/gmy162] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 11/21/2018] [Indexed: 12/15/2022] Open
Abstract
Adiponectin, an adipokine synthesized and secreted majorly by adipose tissue, is reported to exert cardioprotective properties via anti-inflammation and antiapoptosis. Lipopolysaccharide (LPS) is a common inflammation and apoptosis inducer of cardiomyocytes. However, few studies have reported the roles of adiponectin on LPS-induced inflammation as well as apoptosis of H9c2 cells, and the possible mechanisms of these effects. In the present study, we found that adiponectin significantly relieved LPS-induced cytotoxicity including decreased viability and elevated LDH release, inhibited LPS-triggered inflammation, which is evidenced by increases in release of TNF-α, IL-1β as well as IL-6, and attenuated the enhanced rates of apoptotic cells as well as increased caspase-3 activity caused by LPS in H9c2 cells. In addition, our data demonstrated that adiponectin upregulated AMP-activated protein kinase (AMPK) activation of H9c2 cells with or without LPS administration. Moreover, we found that blocking AMPK pathway by compound c attenuated the protective effects of adiponectin against the cytotoxicity, inflammatory response, and apoptosis of H9c2 cells resulted from LPS. Our observations bring novel insights for understanding the mediatory role of AMPK pathway implicated in the protective effects of adiponectin against LPS-induced cardiotoxicity.
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Affiliation(s)
- Rui Hao
- Department of Cardiovascular Medicine, Jinan Central Hospital Affiliated to Shandong University, Ji’nan, China
- College of Medicine and Life Sciences, Shandong Academy of Medical Sciences, Jinan University, Ji’nan, China
| | - Guoying Su
- Department of Cardiovascular Medicine, Jinan Central Hospital Affiliated to Shandong University, Ji’nan, China
| | - Xiaolin Sun
- College of Medicine and Life Sciences, Shandong Academy of Medical Sciences, Jinan University, Ji’nan, China
- The Fourth People’s Hospital of Ji’nan City, Ji’nan, China
| | - Xiangran Kong
- College of Medicine and Life Sciences, Shandong Academy of Medical Sciences, Jinan University, Ji’nan, China
| | - Cuiying Zhu
- College of Medicine and Life Sciences, Shandong Academy of Medical Sciences, Jinan University, Ji’nan, China
| | - Guohai Su
- Department of Cardiovascular Medicine, Jinan Central Hospital Affiliated to Shandong University, Ji’nan, China
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10
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An Optical Fiber Sensor Based on La₂O₂S:Eu Scintillator for Detecting Ultraviolet Radiation in Real-Time. SENSORS 2018; 18:s18113754. [PMID: 30400264 PMCID: PMC6263712 DOI: 10.3390/s18113754] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/26/2018] [Accepted: 10/28/2018] [Indexed: 02/06/2023]
Abstract
A novel ultraviolet (UV) optical fiber sensor (UVOFS) based on the scintillating material La2O2S:Eu has been designed, tested, and its performance compared with other scintillating materials and other conventional UV detectors. The UVOFS is based on PMMA (polymethyl methacrylate) optical fiber which includes a scintillating material. Scintillating materials provide a unique opportunity to measure UV light intensity even in the presence of strong electromagnetic interference. Five scintillating materials were compared in order to select the most appropriate one for the UVOFS. The characteristics of the sensor are reported, including a highly linear response to radiation intensity, reproducibility, temperature response, and response time (to pulsed light) based on emission from a UV source (UV fluorescence tube) centered on a wavelength of 308 nm. A direct comparison with the commercially available semiconductor-based UV sensor proves the UVOFS of this investigation shows superior performance in terms of accuracy, long-term reliability, response time and linearity.
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11
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Li XF, Li SY, Dai CM, Li JC, Huang DR, Wang JY. PP2A inhibition by LB-100 protects retinal pigment epithelium cells from UV radiation via activation of AMPK signaling. Biochem Biophys Res Commun 2018; 506:73-80. [PMID: 30340831 DOI: 10.1016/j.bbrc.2018.10.077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 10/13/2018] [Indexed: 12/21/2022]
Abstract
AMP-activated protein kinase (AMPK) signaling activation can inhibit Ultra-violet (UV) radiation (UVR)-induced retinal pigment epithelium (RPE) cell injuries. LB-100 is a novel inhibitor of protein phosphatase 2A (PP2A), the AMPKα1 phosphatase. Here, our results demonstrated that LB-100 significantly inhibited UVR-induced viability reduction, cell death and apoptosis in established ARPE-19 cells and primary murine RPE cells. LB-100 activated AMPK, nicotinamide adenine dinucleotide phosphate (NADPH) and Nrf2 (NF-E2-related factor 2) signalings, inhibiting UVR-induced oxidative injuries and DNA damage in RPE cells. Conversely, AMPK inhibition, by AMPKα1-shRNA, -CRISPR/Cas9 knockout or -T172A mutation, almost blocked LB-100-induced RPE cytoprotection against UVR. Importantly, CRISPR/Cas9-mediated PP2A knockout mimicked and nullified LB-100-induced anti-UVR activity in RPE cells. Collectively, these results show that PP2A inhibition by LB-100 protects RPE cells from UVR via activation of AMPK signaling.
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Affiliation(s)
- Xiao-Feng Li
- Department of Ophthalmology, The Affiliated Huai'an NO.1 People's Hospital of Nanjing Medical University, Huai'an, China
| | - Shu-Yan Li
- Department of Ophthalmology, The Affiliated Huai'an NO.1 People's Hospital of Nanjing Medical University, Huai'an, China
| | - Chang-Ming Dai
- Department of Ophthalmology, The Affiliated Huai'an NO.1 People's Hospital of Nanjing Medical University, Huai'an, China
| | - Jian-Chang Li
- Department of Ophthalmology, The Affiliated Huai'an NO.1 People's Hospital of Nanjing Medical University, Huai'an, China
| | - Da-Rui Huang
- Department of Ophthalmology, The Affiliated Huai'an NO.1 People's Hospital of Nanjing Medical University, Huai'an, China
| | - Jun-Ying Wang
- Department of ENT, The Affiliated Huai'an NO.1 People's Hospital of Nanjing Medical University, Huai'an, China.
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