Network pharmacology-based analysis on the key mechanisms of Yiguanjian acting on chronic hepatitis

Chronic hepatitis (CH) encompasses a prevalent array of liver conditions that significantly contribute to global morbidity and mortality. Yiguanjian (YGJ) is a classical traditional Chinese medicine with a long history of medicinal as a treatment for CH. Although it has been reported that YGJ can reduce liver inflammation, the intricate mechanism requires further elucidation. We used network pharmacology approaches in this work, such as gene ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, and network-based analysis of protein-protein interactions (PPIs), to clarify the pharmacological constituents, potential therapeutic targets, and YGJ signaling pathways associated with CH. Employing the random walk restart (RWR) algorithm, we identified GNAS, GNB1, CYP2E1, SFTPC, F2, MAPK3, PLG, SRC, HDAC1, and STAT3 as pivotal targets within the PPI network of YGJ-CH. YGJ attenuated liver inflammation and inhibited GNAS/STAT3 signaling in vivo. In vitro, we overexpressed the GNAS gene further to verify the critical role of GNAS in YGJ treatment. Our findings highlight GNAS/STAT3 as a promising therapeutic target for CH, providing a basis and direction for future investigations.

Extracellular vesicles derived from bone marrow mesenchymal stem cells ameliorate chronic liver damage via microRNA-136-5p

Chronic liver damage (CLD) encompasses a spectrum of conditions and poses a significant global health challenge, affecting millions of individuals. Currently, there is a deficiency of clinically validated therapeutics with minimal side effects. Emerging evidence underscores the significant potential of extracellular vesicles derived from bone marrow mesenchymal stem cells (BMSC-EVs) as a promising therapeutic method for CLD. This study aimed to evaluate the influence of BMSC-EVs containing microRNA-136-5p (BMSC-EVs-miR-136-5p) on macrophage polarization during chronic liver injury and elucidate the mechanisms associated with the GNAS/PI3K/ERK/STAT3 axis. Surface markers of BMSCs were detected via Immunofluorescent Staining. Subsequently, EVs were harvested from the BMSC culture medium. In vivo fluorescence imaging was employed to locate the BMSC-EVs. Additionally, fluorescence microscopy was used to visualize the uptake of DIR-labeled BMSC-EVs by RAW264.7 cells. Various methods were employed to assess the impact of BMSC-EVs on the expression levels of inflammatory factors (IL-1β, IL-6, IL-10, and TNF-α), M1/M2 macrophage markers (iNOS and Arg-1), and members of inflammation-related signaling pathways (GNAS, PI3K, ERK, and STAT3) in RAW264.7 cells co-cultured with BMSC-EVs. Loss-of-function approaches targeting miR-136-5p in RAW264.7 cells were subsequently utilized to validate the role of BMSC-EVs-miR-136-5p. The Luciferase Reporter Assay indicates that GNAS was identified to be a target of miR-136-5p, and miR-136-5p demonstrating increased within BMSC-EVs compared to Raw264.7-EVs. BMSC-EVs-miR-136-5p mitigated CCl4-induced liver inflammation and improved liver function by Suppressing the GNAS/STAT3 Signaling. Notably, miR-136-5p suppressed lipopolysaccharide (LPS)-induced inflammation in RAW264.7 cells. BMSC-EVs-miR-136-5p alleviates CLD by activating M2 polarization through the GNAS-mediated PI3K/ERK/STAT3 axis. Accordingly, the members of this axis may serve as therapeutic targets.

Identification and verification of inflammatory biomarkers for primary Sjögren's syndrome

INTRODUCTION

Primary Sjögren's syndrome (pSS) is an autoimmune disease characterized by inflammatory infiltration, and dysfunction of the salivary and lacrimal glands. This research aimed to explore the disease pathogenesis and improve the diagnosis and treatment of pSS by mining inflammation-associated biomarkers.

METHODS

Five pSS-related datasets were retrieved from the Gene Expression Omnibus (GEO) database. Inflammation-associated biomarkers were determined by the least absolute shrinkage and selection operator (LASSO) and support vector machines recursive feature elimination (SVM-RFE). Single sample gene set enrichment analysis (ssGSEA) was implemented to profile the infiltration levels of immune cells. Real-time quantitative PCR (RT-qPCR) verified the expression of biomarkers in clinical samples.

RESULTS

Four genes (LY6E, EIF2AK2, IL15, and CXCL10) were screened as inflammation-associated biomarkers in pSS, the predictive performance of which were determined among three pSS-related datasets (AUC > 0.7). Functional enrichment results suggested that the biomarkers were involved in immune and inflammation-related pathways. Immune infiltration analysis revealed that biomarkers were notably connected with type 2 T helper cells, regulatory T cells which were significantly expressed between pSS and control. TESTOSTERONE and CYCLOSPORINE were predicted to take effect by targeting CXCL10 and IL15 in pSS, respectively.

CONCLUSION

Four inflammation-associated biomarkers (LY6E, EIF2AK2, IL15, and CXCL10) were explored, and the underlying regulatory mechanisms and targeted drugs associated with these biomarkers were preliminarily investigated according to a series of bioinformatics methods based on the online datasets of pSS, which provided a reference for understanding the pathogenesis of pSS. Key Points • Inflammation-associated biomarkers (LY6E, EIF2AK2, IL15, and CXCL10) were firstly identified in Sjögren's syndrome based on LASSO and SVM-RFE analyses. • CXCL10, EIF2AK2 and LY6E were prominently positively correlated with immature B cells, while IL15 were significantly negatively correlated with memory B cells in Sjögren's syndrome. • LY6E, EIF2AK2, IL15, and CXCL10 were significantly more highly expressed in clinical Sjögren's syndrome samples compared to healthy control samples, which was consistent with the analysis results of the GEO database. •LY6E, EIF2AK2, IL15, and CXCL10 might be used as the biomarkers for the treatment and diagnosis of Sjögren's syndrome.

OsEIN2-OsEIL1/2 pathway negatively regulates chilling tolerance by attenuating OsICE1 function in rice

Low temperature severely affects rice development and yield. Ethylene signal is essential for plant development and stress response. Here, we reported that the OsEIN2-OsEIL1/2 pathway reduced OsICE1-dependent chilling tolerance in rice. The overexpressing plants of OsEIN2, OsEIL1 and OsEIL2 exhibited severe stress symptoms with excessive reactive oxygen species (ROS) accumulation under chilling, while the mutants (osein2 and oseil1) and OsEIL2-RNA interference plants (OsEIL2-Ri) showed the enhanced chilling tolerance. We validated that OsEIL1 and OsEIL2 could form a heterxodimer and synergistically repressed OsICE1 expression by binding to its promoter. The expression of OsICE1 target genes, ROS scavenging- and photosynthesis-related genes were downregulated by OsEIN2 and OsEIL1/2, which were activated by OsICE1, suggesting that OsEIN2-OsEIL1/2 pathway might mediate ROS accumulation and photosynthetic capacity under chilling by attenuating OsICE1 function. Moreover, the association analysis of the seedling chilling tolerance with the haplotype showed that the lower expression of OsEIL1 and OsEIL2 caused by natural variation might confer chilling tolerance on rice seedlings. Finally, we generated OsEIL2-edited rice with an enhanced chilling tolerance. Taken together, our findings reveal a possible mechanism integrating OsEIN2-OsEIL1/2 pathway with OsICE1-dependent cascade in regulating chilling tolerance, providing a practical strategy for breeding chilling-tolerant rice.

A novel sandwich-type electrochemical immunosensor for sensitive detection of zearalenone using NG/PDDA/HNTs and Ti-MOF-KB composites for signal amplification

In this work, a novel sandwich-type electrochemical immunosensor based on signal amplification was developed for the ultrasensitive detection of zearalenone (ZEA). The composite consisting of poly(diallyldimethylammonium chloride) functionalized nitrogen doped graphene, halloysite nanotubes and toluidine blue (Tb/NG/PDDA/HNTs), was synthesized for the first time. Then it was modified with gold nanoparticles (AuNPs) to bind the secondary antibody (Ab2, 10 μg mL-1) and form the tracer label. In addition, ketjen black (KB) was doped into titanium-based metal-organic framework (Ti-MOF), which provided large specific surface area and employed as the sensing platform to increase the immobilization of the primary antibody (Ab1, 10 μg mL-1). This immunosensor showed a wide linear range for ZEA from 10 fg mL-1 to 100 ng mL-1 with a limit of detection (LOD) as low as 0.57 fg mL-1, which was below the maximum tolerable levels (50∼100 µg kg-1) set by the United Nations Food and Agriculture Organization (FAO).

Lactococcus garvieae exerts a critical role in inducing inflammation in dairy mastitis by triggering NLRP3 inflammasome-mediated pyroptosis in MAC-T cells

Lactococcus garvieae (L. garvieae) is a pathogenic bacterium that is Gram-positive and catalase-negative (GPCN), and it is capable of growing in a wide range of environmental conditions. This bacterium is associated with significant mortality and losses in fisheries, and there are concerns regarding its potential as a zoonotic pathogen, given its presence in cattle and dairy products. While we have identified and characterized virulent strains of L. garvieae through phenotyping and molecular typing studies, their impact on mammary tissue remains unknown. This study aims to investigate the pathogenicity of strong and weak virulent strains of L. garvieae using in vivo mouse models. We aim to establish MAC-T cell model to examine potential injury caused by the strong virulent strain LG41 through the TLR2/NLRP3/NF-kB pathway. Furthermore, we assess the involvement of NLRP3 inflammasome-mediated pyroptosis in dairy mastitis by silencing NLRP3. The outcomes of this study will yield crucial theoretical insights into the potential mechanisms involved in mastitis in cows caused by the L. garvieae-induced inflammatory response in MAC-T cells.

Efficacy of 2% Hydroxypropyl Methylcellulose and Bandage Contact Lens for the Management of Dry Eye Disease after Cataract Surgery

Objectives

To investigate the effect of 2% hydroxypropyl methylcellulose (HPMC) and bandage contact lens (BCL) on dry eye disease after cataract surgery.

Methods

This prospective randomized controlled trial included 63 eyes which were divided into the balanced salt solution (BSS), HPMC, BCL, and combined HPMC and BCL (H&B) groups. The Ocular Surface Disease Index (OSDI), tear meniscus height (TMH), and average tear break-up time were measured before cataract surgery and 30 days postoperatively. Differences in corneal nerve fiber (CNF) and dendritic cell (DC) density in various directions were evaluated and compared. The CNFs and DCs in central and infratemporal directions were observed using in vivo confocal microscopy. Data were evaluated using the Kruskal-Wallis rank-sum test and analysis of variance.

Results

The differences in variations in OSDI and TMH after cataract surgery between the four groups were statistically significant (P < 0.05). The postoperative OSDI of the HPMC group decreased compared with their preoperative OSDI. A statistically significant difference in the variations of OSDI score was observed between the HPMC and other groups (P < 0.05). The postoperative variations in TMH in the HPMC group were significantly higher than those observed preoperatively and significantly differed between HPMC and BCL groups and between BCL and H&B groups (P < 0.05). Postoperatively, the density of corneal DCs decreased in BSS and HPMC groups and increased in BCL and H&B groups (P < 0.001).

Conclusions

The application of 2% HPMC in cataract surgery has a certain effect on managing dry eye after cataract surgery. Although the use of BCLs after cataract surgery has some benefits, it may cause mild ocular surface inflammation. Nevertheless, using 2% HPMC with BCLs in the perioperative phase of cataract surgery can alleviate the subjective discomfort of patients and can safely and effectively replace eye patch after cataract surgery.

Analysis of cellular response to drugs with a microfluidic single-cell platform based on hyperspectral imaging

BACKGROUND

Cellular response to pharmacological action of drugs is significant for drug development. Traditional detection method for cellular response to drugs normally rely on cell proliferation assay and metabolomics examination. In principle, these analytical methods often required cell labeling, invasion analysis, and hours of co-culture with drugs, which are relatively complex and time-consuming. Moreover, these methods can only indicate the drug effectiveness on cell colony rather than single cells. Thus, to meet the requirements of personal precision medicine, the development of drug response analysis on the high resolution of single cell is demanded.

RESULTS

To provide precise result for drug response on single-cell level, a microfluidic platform coupled with the label-free hyperspectral imaging was developed. With the help of horizontal single-cell trapping sieves, hundreds of single cells were trapped independently in microfluidic channels for the purposes of real-time drug delivery and single-cell hyperspectral image recording. To significantly identify the cellular hyperspectral change after drug stimulation, the differenced single-cell spectrum was proposed. Compared with the deep learning classification method based on hyperspectral images, an optimal performance can be achieved by the classification strategy based on differenced spectra. And the cellular response to different reagents, for example, K+, Epidermal Growth Factor (EGF), and Gefitinib at different concentrations can be accurately characterized by the differenced single-cell spectra analysis.

SIGNIFICANCE AND NOVELTY

The high-throughput, rapid analysis of cellular response to drugs at the single-cell level can be accurately performed by our platform. After systematically analyzing the materials and the structures of the single-cell microfluidic chip, the optimal single-cell trapping method was proposed to contribute to the further application of hyperspectral imaging on microfluidic single-cell analysis. And the hyperspectral characterization of single-cell with cancer drug stimulation proved the application potential of our method in personal cancer medication.

Comparison of dynamic visual acuity after implantation of toric bifocal or trifocal intraocular lens in age-related cataract patients: a randomized controlled trial

Purpose

To investigate the dynamic visual acuity (DVA) after implantation of toric bifocal or trifocal intraocular lens in age-related cataract patients.

Methods

This was a prospective randomized controlled trial. Of one hundred and twenty-four patients enrolled and randomized to receive unilateral phacoemulsification and toric trifocal (939 M/MP, Carl Zeiss Meditec AG, Jena, Germany) or toric bifocal (909 M, Carl Zeiss Meditec AG, Jena, Germany) intraocular lenses (IOL) implantation, ninety-nine patients completed the follow-up and were included in final analysis. Postoperatively, uncorrected and corrected distance (UDVA and CDVA), intermediate (UIVA and DCIVA) and near (UNVA and DCNVA) static visual acuity, manifest refraction and uncorrected and corrected distance DVA (UDDVA and CDDVA) at 20, 40 and 80 degrees per second (dps) were evaluated at one week, one month and three months.

Results

Three months postoperatively, the UDVA were 0.13 ± 0.11 and 0.14 ± 0.13 in the toric trifocal and bifocal IOL group, respectively. Significant better UIVA (trifocal, 0.17 ± 0.13 vs. bifocal, 0.23 ± 0.13, p = 0.037) and DCIVA (trifocal, 0.16 ± 0.11 vs. bifocal, 0.20 ± 0.12, p = 0.048) were observed in patients implanting toric trifocal than bifocal IOL at three months postoperatively. Patients implanted with toric bifocal IOL obtained better CDDVA at 80 dps (0.5607 ± 0.2032) than the trifocal group (0.6573 ± 0.2450, p = 0.039) at three months. Postoperative UDDVA and CDDVA at 20, 40 and 80 dps were significantly associated with age (p < 0.05, respectively) and postoperative static visual acuity (p < 0.05, respectively).

Conclusion

Toric trifocal IOL provides better static intermediate visual acuity, and toric bifocal IOL implantation provides better distance dynamic visual acuity at high speed.

Allergen-specific IgE in the tear fluid of Chinese patients with common allergic conjunctivitis in autumn and winter

PURPOSE

In this study, we determined the positive rates of allergen-specific immunoglobulin E (IgE) in the tear fluid of Chinese patients with common allergic conjunctivitis (AC) in autumn and winter, compared systemic and ocular allergen tests, and explored the correlation between the numbers and categories of allergens and clinical AC features.

METHODS

This cross-sectional study recruited 44 patients with AC (86 eyes). Specific IgEs for allergens common in China (house dust mite, cat/dog dander, mugwort/ragweed pollen, cottonwood/willow/elm pollen, milk, egg whites, soybeans) were measured in collected tears using kits for allergen-specific IgE antibodies. AC signs and symptoms were graded according to severity.

RESULTS

Specific IgE in tears was positive in 87.2% of eyes. House dust mite was the most common allergen (86.0%), followed by cat (24.4%) and dog (7.0%) dander; tree and grass pollen accounted for only 4.7% and 2.3%, respectively. Food allergens were not detected. The positive rates of the systemic allergen tests were lower than in tear fluid tests in both eyes, especially for house dust mites (P = 0.000). In patients with more allergens, itching was more severe (P = 0.035), while conjunctival hyperemia was milder (P = 0.002).

CONCLUSION

In autumn and winter, the most common AC allergen in Chinese patients was house dust mites. Compared with systemic allergen tests, measuring specific IgE in tears may be a non-invasive method to diagnose and evaluate AC severity, which may be more suitable to reflect the local conditions of ocular surface inflammation due to its high positive rate and convenience.

Circuit-specific gene therapy reverses core symptoms in a primate Parkinson's disease model

Parkinson's disease (PD) is a debilitating neurodegenerative disorder. Its symptoms are typically treated with levodopa or dopamine receptor agonists, but its action lacks specificity due to the wide distribution of dopamine receptors in the central nervous system and periphery. Here, we report the development of a gene therapy strategy to selectively manipulate PD-affected circuitry. Targeting striatal D1 medium spiny neurons (MSNs), whose activity is chronically suppressed in PD, we engineered a therapeutic strategy comprised of a highly efficient retrograde adeno-associated virus (AAV), promoter elements with strong D1-MSN activity, and a chemogenetic effector to enable precise D1-MSN activation after systemic ligand administration. Application of this therapeutic approach rescues locomotion, tremor, and motor skill defects in both mouse and primate models of PD, supporting the feasibility of targeted circuit modulation tools for the treatment of PD in humans.

MCPIP-1 knockdown enhances endothelial colony-forming cell angiogenesis via the TFRC/AKT/mTOR signaling pathway in the ischemic penumbra of MCAO mice

Cerebral ischemia is a serious disease characterized by brain tissue ischemia and hypoxic necrosis caused by the blockage of blood vessels within the central nervous system. Although stem cell therapy is a promising approach for treating ischemic stroke, the inflammatory, oxidative, and hypoxic environment generated by cerebral ischemia greatly reduces the survival and therapeutic effects of transplanted stem cells. Endothelial colony-forming cells (ECFCs) are a class of precursor cells with strong proliferative potential that can migrate and differentiate directly into mature vascular endothelial cells. Consequently, ECFCs can exert significant therapeutic and reparative effects in diseases associated with vascular injury. Monocyte chemoattractant protein-induced protein 1 (MCPIP-1) exerts multiple biological effects; however, no studies have yet reported its role in the angiogenic function of ECFCs. In this study, we performed Proteome Profiler™ Human Angiogenesis Antibody arrays and tandem mass tag protein profiling to investigate the effect of MCPIP-1 on ECFCs. We demonstrated that MCPIP-1 knockdown enhanced the proliferation, migration, and in vivo and in vitro angiogenic capacity of ECFCs by upregulating the transferrin receptor-activated AKT/m-TOR signaling pathway to promote cellular trophic factor secretion. Furthermore, we found that the lateral ventricular transplantation of ECFCs with lentiviral MCPIP-1 knockdown into mice with middle cerebral artery occlusion increased serum vacular endothelial growth factor(VEGF), angiopoietin-1, and HIF-1a levels, enhanced neovascularization and neurogenesis in the ischemic penumbra, reduced the size of cerebral infarcts, and promoted neurological recovery. Together, these findings suggest new avenues for enhancing the therapeutic efficacy of ECFCs.

Lactococcus lactis, a bacterium with probiotic functions and pathogenicity

Lactococcus lactis (L. lactis) is the primary organism for lactic acid bacteria (LAB) and is a globally recognized safe microorganism for the regulation of the intestinal micro-ecological balance of animals and improving the immune performance of the host. L. lactis is known to play a commercially important role in feed fortification, milk fermentation, and vaccine production, but pathogenic L. lactis has been isolated from many clinical cases in recent years, such as the brain of silver carp with Lactococcosis, the liver and spleen of diseased waterfowl, milk samples and padding materials with cow mastitis, and blood and urine from human patients with endocarditis. In dairy farming, where L. lactis has been used as a probiotic in the past, however, some studies have found that L. lactis can cause mastitis in cows, but the lack of understanding of the pathogenesis of mastitis in cows caused by L. lactis has become a new problem. The main objective of this review is to analyze the increasingly serious clinical mastitis caused by L. lactis and combined with the wide application of L. lactis as probiotics, to comprehensively discuss the characteristics and diversity of L. lactis.

Coexistence of MRCS syndrome, extremely long axis and exfoliation syndrome: a case report and literature review

BACKGROUND

The coexistence of MRCS (microcornea, retinal dystrophy, cataract, and posterior staphyloma) syndrome and extremely long axis is rare since microcornea frequently accompanies with diminution of entire anterior segment and occasionally the whole globe. In the case presented here, combination of these two elements were identified, together with XFS (exfoliation syndrome).

CASE PRESENTATION

A 66-year-old Han Chinese woman presented for consultation due to impaired vision which accompanied throughout her entire life span and worsened during the last 2 years. Combination of MRCS syndrome and extremely long axial length was evidently diagnosed in both eyes, with XFS confirmed in her right eye, but mutation screening failed to identify disease-causing sequence variants in some specific genes reported previously, including BEST1 and ARL2. However, likely pathogenic mutations in FBN2 gene were identified. Bilateral cataract phacoemulsification without intraocular lens implantation was performed using scleral tunnel incision and under general anesthesia. At 3-month follow-up, ocular recovery of the patient was satisfactory.

CONCLUSIONS

The case presented here exhibited rare coexistence of MRCS syndrome, extremely long axis and XFS. The complexity of her ocular abnormalities brought challenges to surgical management, in which multidisciplinary collaboration is often required. Furthermore, the genetic analysis in this case yielded a possible novel candidate gene for MRCS syndrome and provided evidence in support of genetic heterogeneity in this phenotype.

Hydroxysafflor yellow a confers neuroprotection against acute traumatic brain injury by modulating neuronal autophagy to inhibit NLRP3 inflammasomes

ETHNOPHARMACOLOGICAL RELEVANCE

Hydroxysafflor yellow A (HSYA) is the principal bioactive compound isolated from the plant Carthamus tinctorius L. and has been reported to exert neuroprotective effects against various neurological diseases, including traumatic brain injury (TBI). However, the specific molecular and cellular mechanisms underlying HSYA-mediated neuroprotection against TBI are unclear.

AIM OF THE STUDY

This study explored the effects of HSYA on autophagy and the NLRP3 inflammasome in mice with TBI and the related mechanisms.

MATERIALS AND METHODS

Mice were subjected to TBI and treated with or without HSYA. Neurological severity scoring, LDH assays and apoptosis detection were first performed to assess the effects of HSYA in mice with TBI. RNA-seq was then conducted to explore the mechanisms that contributed to HSYA-mediated neuroprotection. ELISA, western blotting, and immunofluorescence were performed to further investigate the mechanisms of neuroinflammation and autophagy. Moreover, 3-methyladenine (3-MA), an autophagy inhibitor, was applied to determine the connection between autophagy and the NLRP3 inflammasome.

RESULTS

HSYA significantly decreased the neurological severity score, serum LDH levels and apoptosis in mice with TBI. A total of 921 differentially expressed genes were identified in the cortices of HSYA-treated mice with TBI and were significantly enriched in the inflammatory response and autophagy. Furthermore, HSYA treatment markedly reduced inflammatory cytokine levels and astrocyte activation. Importantly, HSYA suppressed neuronal NLRP3 inflammasome activation, as indicated by decreased levels of NLRP3, ASC and cleaved caspase-1 and a reduced NLRP3⁺ neuron number. It increased autophagy and ameliorated autophagic flux dysfunction, as evidenced by increased LC3 II/LC3 I levels and decreased P62 levels. The effects of HSYA on the NLRP3 inflammasome were abolished by 3-MA. Mechanistically, HSYA may enhance autophagy through AMPK/mTOR signalling.

CONCLUSION

HSYA enhanced neuronal autophagy by triggering the AMPK/mTOR signalling pathway, leading to inhibition of the NLRP3 inflammasome to improve neurological recovery after TBI.

Multi-Target Tracking Based on a Combined Attention Mechanism and Occlusion Sensing in a Behavior-Analysis System

Multi-object tracking (MOT) is a topic of great interest in the field of computer vision, which is essential in smart behavior-analysis systems for healthcare, such as human-flow monitoring, crime analysis, and behavior warnings. Most MOT methods achieve stability by combining object-detection and re-identification networks. However, MOT requires high efficiency and accuracy in complex environments with occlusions and interference. This often increases the algorithm's complexity, affects the speed of tracking calculations, and reduces real-time performance. In this paper, we present an improved MOT method combining an attention mechanism and occlusion sensing as a solution. A convolutional block attention module (CBAM) calculates the weights of space and channel attention from the feature map. The attention weights are used to fuse the feature maps to extract adaptively robust object representations. An occlusion-sensing module detects an object's occlusion, and the appearance characteristics of an occluded object are not updated. This can enhance the model's ability to extract object features and improve appearance feature pollution caused by the short-term occlusion of an object. Experiments on public datasets demonstrate the competitive performance of the proposed method compared with the state-of-the-art MOT methods. The experimental results show that our method has powerful data association capability, e.g., 73.2% MOTA and 73.9% IDF1 on the MOT17 dataset.

Fabrication and properties of multi-functional polydopamine coated Cu/F-codoped hydroxyapatite hollow microspheres as drug carriers

Due to its excellent bone conductivity and drug adsorption as well as pH-responsive drug release property, hydroxyapatite (HAp) is widely used as a drug carrier in bone repair field. Here, we report for the first time a novel multi-functional polydopamine (PDA) coated Cu/F-codoped HAp (Cu/F-HAp-PDA) hollow microspheres. Both Cu²⁺ and F^- were successfully doped into the lattice of HAp and uniformly distributed in the shell of hollow microspheres through a one-step hydrothermal synthesis. Then PDA was coated homogeneously on the outer layer of Cu/F-HAp hollow microspheres. Both Cu/F-HAp and Cu/F-HAp-PDA samples displayed high drug loading efficiency and pH responsive drug release behavior. Moreover, the obtained Cu/F-HAp-PDA hollow microspheres exhibited excellent photothermal conversion efficiency and photothermal stability. The molecular dynamics simulations showed that PDA and HAp can form mutual binding mainly through Ca-O bonding, while doxorubicin (DOX) is mainly bound to PDA molecules through hydrogen bonding and π-π stacking interaction.

Effect of Combining Sound Therapy with Pharmacotherapy on the Recovery of Hearing Abilities in the Case of Sudden Sensorineural Hearing Loss: A Prospective Study

INTRODUCTION

This study investigated the effect of sound therapy combined with drug therapy (SDT) on gap detection threshold and speech recognition scores in patients with sudden sensorineural hearing loss (SSNHL).

METHODS

Patients with SSNHL were grouped randomly into SDT and drug therapy (DT) groups. All patients received standard drug treatment and patients in the SDT group additionally received sound stimulation for the affected ears for 6 days. Pure tone audiogram, speech recognition scores at normal and time-compressed rates under quiet and noisy conditions, and the gap detection threshold of the SDT and DT groups before treatment and on day 6 and 30 after treatment were compared.

RESULTS

There were 20 patients in the SDT group and 24 in the DT group. The pure tone thresholds of affected ears were significantly lower in the SDT group on day 6 after treatment than those in the DT group at 125 and 250 Hz. Significantly lower gap detection thresholds and higher speech recognition scores under noisy conditions were observed at the normal and time-compressed rates in the SDT group than those in the DT group on day 6 and 30 after treatment. Significant correlations were observed between the gap thresholds and speech recognition scores in a noisy environment at normal and time-compressed rates on day 6 and 30.

CONCLUSIONS

SDT may improve the recovery of hearing abilities, such as the gap in noise thresholds and speech recognition in noise, in the case of SSNHL.

TRIAL REGISTRATION NUMBER

ChiCTR-IOR-17012262.

Metagenomic nanopore sequencing of ocular microbiome in patients with meibomian gland dysfunction

PURPOSE

To explore the composition of the ocular microbiome in patients with Meibomian gland dysfunction (MGD) using metagenomic nanopore sequencing.

METHODS

A total of 98 participants were recruited from September to December 2021, including 86 patients with MGD and 12 controls. Symptoms and signs of dry eye were assessed, and bacterial samples in the conjunctival sac (CS) and meibomian gland (MG) secretions were then identified by bacterial culture identification and metagenomic nanopore sequencing.

RESULTS

The positive rate of CS bacterial culture in the MGD group was significantly higher than that in the normal group. A more complex composition of bacterial genera was detected in the mild and moderate MGD groups than in the control. However, the severe MGD groups had the simplest composition of bacteria. Metagenomic nanopore sequencing detected more species of bacteria than traditional culture.

CONCLUSION

The CS and MG of MGD patients may have different degrees of bacterial microbiota imbalance. Metagenomic nanopore sequencing technology provides a new way for us to understand the composition of "real-world" ocular surface microorganisms.

Application of ANN to Nucleic Acid Analysis: Accurate Discrimination for Untypical Real-Time Fluorescence Curves with High Specificity and Sensitivity

As a division of polymerase chain reaction (PCR), convective PCR (CPCR) is able to achieve highly efficient thermal cycling based on free thermal convection with pseudo-isothermal heating, which could be beneficial to point-of-care (POC) nucleic acid analysis. Similar to traditional PCR or isothermal amplification, due to a couple of issues, e.g., reagent, primer design, reactor, reaction dynamics, amplification status, temperature and heating condition, and other reasons, in some cases of CPCR tests, untypical real-time fluorescence curves with positive or negative tests will show up. Especially, when parts of the characteristics between untypical low-positive and negative tests are mixed together, it is difficult to discriminate between them using traditional cycle threshold (Ct) value method. To handle this issue which may occur in CPCR, traditional PCR or isothermal amplification, as an example, instead of using complicated mathematical modeling and signal processing strategy, an artificial intelligence (AI) classification method with artificial neural network (ANN) modeling is developed to improve the accuracy of nucleic acid detection. It has been proven that both the detection specificity and sensitivity can be significantly improved even with a simple ANN model. It can be estimated that, the developed method based on AI modeling can be adopted to solve similar problem with PCR, or isothermal amplification methods.

Evidence of air pollution-related ocular signs and altered inflammatory cytokine profile of the ocular surface in Beijing

We evaluated how different degrees of air pollution affect the ocular surface of a cohort of human subjects in Beijing by correlating in-patient test outcomes with tear cytokines. A cross-sectional study involving 221 volunteers was carried out in different districts of Beijing. Air pollution indices were recorded for 7 d (including the visit day). The indices recorded were the air quality index (AQI), which is a dimensionless measure that quantitatively describes the state of air quality, concentrations of particulate matter smaller than 2.5 μm (PM2.5) and 10 μm (PM10), sulfur dioxide (SO₂), ozone (O₃), and nitrogen dioxide (NO₂). The Ocular Symptom Disease Index (OSDI) questionnaire provided. Subsequently, subjects underwent slit-lamp examination, which included meibomian gland examination, conjunctival congestion score, conjunctivochalasis grade, tear meniscus height (TMH), tear breakup time (TBUT), corneal fluorescein staining (CFS), Schirmer I test, and conjunctival impression cytology. The concentrations of vascular endothelial growth factor (VEGF), interleukins (IL)-1β, IL-6 and IL-8 in tears were measured by microsphere-based immunoassay analysis. According to the value of the AQI, participants are divided into a slightly polluted (SP) group (n = 103) which the AQI value is less than or equal to 100 and a heavily polluted (HP) group (n = 118) whose AQI value is more than 100. Air pollution is related to ocular discomfort based on tear cytokine concentrations. PM2.5, PM10 and NO₂ were positively correlated with OSDI, MG expressibility, meibum score, meiboscore, conjunctival congestion score, Schirmer I test value, TMH, goblet-cell density, concentrations of IL-6, and VEGF were negatively correlated with TBUT. PM2.5 and PM10 appear to be the major risk factors to the ocular surface, with NO₂ being another important risk factor based on this study. The symptoms and signs of eye discomfort in the SP group were significantly less severe than those in the HP group, and tear cytokine concentrations (IL-6 and VEGF) were lower. Air pollution degrees were significantly correlated with tear cytokine concentrations, indicating an alteration of cytokine balance at the ocular surface under different degrees of air pollution.

Change Patterns in Corneal Intrinsic Aberrations and Nerve Density after Cataract Surgery in Patients with Dry Eye Disease

This study aimed to evaluate the change patterns in corneal intrinsic aberrations and nerve density after cataract surgery in dry eye disease. The preoperative, 1- and 3-month postoperative dry eye-related parameters were obtained by the Oculus keratograph and the ocular surface disease index questionnaire. The corneal intrinsic aberrations were measured using the Pentacam HR system. In vivo confocal microscopy was performed to observe the vortical and peripheral corneal nerves. An artificial intelligence technique run by the deep learning model generated the corneal nerve parameters. Corneal aberrations on the anterior and total corneal surfaces were significantly increased at 1 month compared with the baseline (p < 0.05) but gradually returned to the baseline by 3 months (p > 0.05). However, the change in posterior corneal aberration lasted up to 3 months (p < 0.05). There was a significant decrease in the corneal vortical nerve maximum length and average density after the operation (p < 0.05), and this damage lasted approximately 3 months. The corneal vortical nerve maximum length and average density were negatively correlated with the anterior corneal surface aberrations before and 1 month after the operation (correlation coefficients, CC = −0.26, −0.25, −0.28; all p < 0.05). Corneal vortex provided a unique site to observe long-term corneal nerve injury related to eye dryness. The continuous damage to the corneal vortical nerve may be due to the continuous dry eye state.

miR-124- and let-7-Mediated Reprogram of Human Fibroblasts into SST Interneurons

Many neurological disorders stem from defects in or the loss of specific neurons. Dysfunction of γ-aminobutyric acid (GABA)ergic interneurons may cause a variety of neurological and psychiatric disorders such as epilepsy, autism, Alzheimer's disease, and depression. Unlike other types of neurons, which can be generated relatively easily by direct reprogramming, it is difficult to generate GABAergic neurons by traditional methods. Neuronal transdifferentiation of fibroblasts mediated by nongenomic-integrated adenovirus has many advantages, but the efficiency is low, and there is a lack of studies using human cells as the initial materials. In this study, we explored the feasibility of the conversion of human fibroblasts into neurons through adenovirus-mediated gene expression and found that by introducing two microRNAs, miR-124 and let-7, together with several small chemical compounds, they can effectively generate GABAergic neuron-like cells from human neonatal fibroblasts without reverting to a progenitor cell stage. Most of these cells expressed neuronal markers and were all somatostatin (SST)-positive cells. Therefore, our study provides a relatively safe and efficient method to generate SST interneurons.

Mesenchymal stem cells protect against TBI-induced pyroptosis in vivo and in vitro through TSG-6

Background

Pyroptosis, especially microglial pyroptosis, may play an important role in central nervous system pathologies, including traumatic brain injury (TBI). Transplantation of mesenchymal stem cells (MSCs), such as human umbilical cord MSCs (hUMSCs), has been a focus of brain injury treatment. Recently, MSCs have been found to play a role in many diseases by regulating the pyroptosis pathway. However, the effect of MSC transplantation on pyroptosis following TBI remains unknown. Tumor necrosis factor α stimulated gene 6/protein (TSG-6), a potent anti-inflammatory factor expressed in many cell types including MSCs, plays an anti-inflammatory role in many diseases; however, the effect of TSG-6 secreted by MSCs on pyroptosis remains unclear.

Methods

Mice were subjected to controlled cortical impact injury in vivo. To assess the time course of pyroptosis after TBI, brains of TBI mice were collected at different time points. To study the effect of TSG-6 secreted by hUMSCs in regulating pyroptosis, normal hUMSCs, sh-TSG-6 hUMSCs, or different concentrations of rmTSG-6 were injected intracerebroventricularly into mice 4 h after TBI. Neurological deficits, double immunofluorescence staining, presence of inflammatory factors, cell apoptosis, and pyroptosis were assessed. In vitro, we investigated the anti-pyroptosis effects of hUMSCs and TSG-6 in a lipopolysaccharide/ATP-induced BV2 microglial pyroptosis model.

Results

In TBI mice, the co-localization of Iba-1 (marking microglia/macrophages) with NLRP3/Caspase-1 p20/GSDMD was distinctly observed at 48 h. In vivo, hUMSC transplantation or treatment with rmTSG-6 in TBI mice significantly improved neurological deficits, reduced inflammatory cytokine expression, and inhibited both NLRP3/Caspase-1 p20/GSDMD expression and microglial pyroptosis in the cerebral cortices of TBI mice. However, the therapeutic effect of hUMSCs on TBI mice was reduced by the inhibition of TSG-6 expression in hUMSCs. In vitro, lipopolysaccharide/ATP-induced BV2 microglial pyroptosis was inhibited by co-culture with hUMSCs or with rmTSG-6. However, the inhibitory effect of hUMSCs on BV2 microglial pyroptosis was significantly reduced by TSG-6-shRNA transfection.

Conclusion

In TBI mice, microglial pyroptosis was observed. Both in vivo and in vitro, hUMSCs inhibited pyroptosis, particularly microglial pyroptosis, by regulating the NLRP3/Caspase-1/GSDMD signaling pathway via TSG-6.

The Efficacy and Safety of New-Generation Intense Pulsed Light in the Treatment of Meibomian Gland Dysfunction-Related Dry Eye: A Multicenter, Randomized, Patients-Blind, Parallel-Control, Non-Inferiority Clinical Trial

Introduction

This study aimed to evaluate the efficacy and safety of a new-generation intense pulsed light (IPL) device in improving the symptoms and signs of meibomian gland dysfunction (MGD)-related dry eye, and compare it with a traditional IPL device.

Methods

This multicenter randomized controlled trial enrolled 132 patients with MGD-related dry eye from two centers. Patients were randomly assigned into the new-generation IPL (Eyesis) group or traditional IPL (E-Eye) group, and then blinded to receive treatment on days 0 and 7. Ocular Surface Disease Index (OSDI), tear meniscus height (TMH), tear breakup time (TBUT), corneal fluorescein staining (CFS), Schirmer test, and meibomian gland signs were evaluated on days 0, 7, and 14. The primary outcome was defined as the effective rate of treating MGD at day 14. Any adverse events were recorded for safety assessment. Intergroup comparisons and non-inferiority analysis were performed. p values less than 0.05 were considered statistically significant.

Results

Basic information showed no significant difference between treatment groups. The intergroup difference of the effective rate was − 1.7% in the left eye and 1.6% in right eye, verifying the non-inferiority of the Eyesis device (p = 0.927). Significant improvements in OSDI, TBUT, Schirmer test, TMH, CFS, and meibomian gland signs were observed in Eyesis group on days 7 and 14 (all p < 0.05). Compared to the E-Eye group, the Eyesis group achieved more significant improvements in OSDI, TBUT, Schirmer test, TMH, and meibum quality (all p < 0.05). There was no significant difference in the incidences of adverse events between groups (p = 1.000).

Conclusions

The new-generation IPL was effective and safe in relieving the symptoms and signs of MGD-related dry eye, exhibiting a non-inferior effective rate compared to the traditional IPL. Additionally, Eyesis showed more clinical benefits over E-Eye in alleviating symptoms, increasing tear film stability and improving meibomian gland function.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40123-022-00556-1.

Incidence, Prophylaxis and Prognosis of Acute Postoperative Endophthalmitis After Cataract Surgery: A Multicenter Retrospective Analysis in Northern China from 2013 to 2019

Objective

To investigate the incidence of acute postoperative endophthalmitis (POE) after cataract surgery in Northern China from 2013 to 2019, evaluate the efficacy of prophylaxis and analyze the predictors of visual prognosis among POE patients.

Methods

The study was conducted as a retrospective multi-center research, with seven hospitals in Northern China enrolled. The diagnosis of acute-onset POE was made on the basis of clinical manifestations within six weeks after initial surgery. By reviewing electronic medical system, the number of cataract surgeries and acute POE cases were recorded to estimate the overall incidence and incidences by different years and hospitals. Perioperative measures for preventing infection in different hospitals were collected. The correlations between unfavorable final vision and potential factors including basic information and clinical characteristics were examined to determine the predictive factors for final visual prognosis.

Results

Of 72,255 cataract surgeries performed during seven years in the seven hospitals, 19 cases developed acute POE, yielding an overall incidence of 0.026%. The average incidence of acute POE among seven hospitals significantly declined annually during the past 7 years (p = 0.021). In Hospital-D, the incidence of acute POE significantly decreased after the application of 0.5% povidone-iodine (PVP-I) for conjunctival washing (p = 0.003). Two hospitals adopting tobramycin in the irrigation solution achieved a significant lower incidence of POE than the other hospitals (p = 0.044). The positive rate of pathogen culture was just 17.6% (3/19). Patients with presenting BCVA of CF or better were more likely to present with unfavorable final vision than those with worse presenting BCVA (p = 0.003).

Conclusion

The overall incidence of acute POE after cataract surgery from 2013 to 2019 in Northern China was 0.026%, and the incidence declined annually over the period. Presenting BCVA could be a significant prognosis factor for predicting the final visual outcomes of acute POE patients.

Ferulic Acid Combined With Bone Marrow Mesenchymal Stem Cells Attenuates the Activation of Hepatic Stellate Cells and Alleviates Liver Fibrosis

Bone marrow mesenchymal stem cells (BMSCs) can effectively alleviate liver fibrosis, but the efficacy of cell therapy alone is insufficient. In recent years, a combination of traditional Chinese medicine (TCM) and cell therapy has been increasingly used to treat diseases in clinical trials. Ferulic acid (FA) is highly effective in treating liver fibrosis, and a combination of cells and drugs is being tested in clinical trials. Therefore, we combined BMSCs and Ferulic acid to treat CCl₄-induced fibrosis and determine whether this combination was more effective than single treatment. We used BMSCs and FA to treat CCl₄-induced fibrosis in rat models, observed their therapeutic effects, and investigated the specific mechanism of this combination therapy in liver fibrosis. We created a BMSC/hepatic stellate cell (HSC) coculture system and used FA to treat activated HSCs to verify the specific mechanism. Then, we used cytochalasin D and angiotensin II to investigate whether BMSCs and FA inactivate HSCs through cytoskeletal rearrangement. MiR-19b-3p was enriched in BMSCs and targeted TGF-β receptor II (TGF-βR2). We separately transfected miR-19b-3p into HSCs and BMSCs and detected hepatic stellate cell activation. We found that the expression of the profibrotic markers α-SMA and COL1-A1 was significantly decreased in the combination group of rats. α-SMA and COL1-A1 levels were also significantly decreased in the HSCs with the combination treatment. Cytoskeletal rearrangement of HSCs was inhibited in the combination group, and RhoA/ROCK pathway gene expression was decreased. Following angiotensin II treatment, COL1-A1 and α-SMA expression increased, while with cytochalasin D treatment, profibrotic gene expression decreased in HSCs. The expression of COL1-A1, α-SMA and RhoA/ROCK pathway genes was decreased in the activated HSCs treated with a miR-19b-3p mimic, indicating that miR-19b-3p inactivated HSCs by suppressing RhoA/ROCK signalling. In contrast, profibrotic gene expression was significantly decreased in the BMSCs treated with the miR-19b-3p mimic and FA or a miR-19b-3p inhibitor and FA compared with the BMSCs treated with the miR-19b-3p mimic alone. In conclusion, the combination therapy had better effects than FA or BMSCs alone. BMSC and FA treatment attenuated HSC activation and liver fibrosis by inhibiting cytoskeletal rearrangement and delivering miR-19b-3p to activated HSCs, inactivating RhoA/ROCK signalling. FA-based combination therapy showed better inhibitory effects on HSC activation.

In vivo Confocal Microscopic Evaluation of Previously Neglected Oval Cells in Corneal Nerve Vortex: An Inflammatory Indicator of Dry Eye Disease

This study aimed to investigate the association of between previously neglected oval cells located in the corneal vortex and dry eye disease (DED). This was an observational, prospective study involving 168 patients with different degrees of DED. In vivo confocal microscopy was used to observe the corneal subbasal nerves and Langerhans cells (LCs) in the corneal vortex and periphery. Bright and oval cells were also observed in the corneal vortex. An artificial intelligence technique was used to generate subbasal nerve fiber parameters. The patients were divided into the three groups based on the presence of inflammatory cells. Group 2 patients showed a significant increase in the corneal peripheral nerve maximum length and average corneal peripheral nerve density. Patients in group 3 had more LCs than other patients. A bright and oval cell was identified in the corneal vortex, which might be a type of immature LC related to the disease severity of DED.

Impression Cytology and In Vivo Confocal Microscopy of Lip Mucosa Compared With Labial Gland Biopsy and Classification Criteria In Patients With Clinically Suspected Primary Sjögren's Syndrome

Purpose

The study assessed the validity of impression cytology (IC) and in vivo confocal microscopy (IVCM) of lip mucosa compared with labial gland biopsy, anti-Sjögren's syndrome A (SSA)/Ro antibody status, and classification criteria in suspected primary Sjögren's syndrome (pSS) patients.

Methods

Clinically suspected pSS patients (n = 201) were enrolled consecutively and were divided into pSS (n = 56) and control (n = 145, only with dryness) groups according to the American College of Rheumatology-European League Against Rheumatism (ACR-EULAR) criteria. All patients underwent lip mucosa IC (inflammatory cell density) and IVCM (epithelium/intrinsic layer thickness and labial gland density/diameter) analyses. The associations between IC/IVCM parameters and clinical/laboratory results were analyzed.

Results

The absolute agreement between positive lip mucosal IC (≥50 cells/4 mm2) and the ACR-EULAR criteria (94.5%)/labial gland biopsy (95.5%) was good, with sensitivities of 82.1 and 85.2%, respectively, and a specificity of 99.3%. Compared with controls, IVCM revealed significant lip mucosal atrophy and glandular decreases in the pSS group (all P = 0.000). The sensitivities for diagnosing pSS corresponding to a lamina propria thickness ≤128 μm and a gland diameter ≤114 μm were 85.7 and 89.3%; the specificities were 90.3 and 95.9%, respectively. A combination of positive IC/IVCM and anti-SSA/Ro antibody results showed a high predictive value for diagnosing pSS.

Conclusions

IC and IVCM could detect distinctive cellular and morphological changes in the lip mucosa of patients with pSS. These noninvasive and easy-to-perform examinations may be an alternative to labial gland biopsy for diagnosing pSS.

Influences of SMILE and FS-LASIK on Corneal Sub-basal Nerves: A Systematic Review and Network Meta-analysis

PURPOSE

To compare postoperative corneal sub-basal nerve density and number between small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK).

METHODS

A search was made in PubMed, EMBASE, and the Cochrane library for prospective comparative studies. The analysis was divided into two parts: network meta-analysis and traditional meta-analysis of the studies directly comparing two surgical groups. Stata 16 (Stata Corporation) and Rev-Man 5.4 (Cochrane) software were used to analyze the data.

RESULTS

Twelve studies (n = 775) were included. In the network meta-analysis, the SMILE group showed a significant increase compared with the FS-LASIK group in corneal nerve density at 1 month postoperatively (mean: 4.23; 95% CI: 0.06 to 8.39, P < .05), and in the number of corneal nerve trunks at 6 months postoperatively (mean: 13.25; 95% CI: 10.20 to 16.30, P < .05). In the traditional meta-analysis, the SMILE group showed significant improvement compared with the FS-LASIK group in corneal nerve density at 1 (weighted mean difference [WMD]: -2.05, 95% CI: -3.11 to -1.00, P < .05) and 3 (WMD: -0.90, 95% CI: -1.30 to -0.50, P < .05) months postoperatively, and in the number of corneal nerve trunks (WMD: -2.52, 95% CI: -4.91 to -0.14, P < .05) and corneal nerve branches (WMD: -2.80, 95% CI: -3.41 to -2.19, P < .05) at 1 month postoperatively.

CONCLUSIONS

The corneal nerve injury in the FS-LASIK group was worse than that in the SMILE group. The corneal nerve recovery in the SMILE group was better at 3 months postoperatively. However, there was no significant difference in corneal nerve density and number between the two groups at 6 months postoperatively. [J Refract Surg. 2022;38(4):277-284.].

Highly Sensitive and Stretchable MXene/CNTs/TPU Composite Strain Sensor with Bilayer Conductive Structure for Human Motion Detection

The universal application of wearable strain sensors in various situations for human-activity monitoring is considerably limited by the contradiction between high sensitivity and broad working range. There still remains a huge challenge to design sensors featuring simultaneous broad working range and high sensitivity. Herein, a typical bilayer-conductive structure Ti₃C₂T_x MXene/carbon nanotubes (CNTs)/thermoplastic polyurethane (TPU) composite film was developed by a simple and scalable vacuum filtration process utilizing a porous electrospun thermoplastic polyurethane (TPU) mat as a skeleton. The MXene/CNTs/TPU strain sensor is composed of two parts: a brittle densely stacked MXene upper lamella and a flexible MXene/CNT-decorated fibrous network lower layer. Benefiting from the synergetic effect of the two parts along with hydrogen-bonding interactions between the porous TPU fiber mat and MXene sheets, the MXene/CNTs/TPU strain sensor possesses both a broad working range (up to 330%) and high sensitivity (maximum gauge factor of 2911) as well as superb long-term durability (2600 cycles under the strain of 50%). Finally, the sensor can be successfully employed for human movement monitoring, from tiny facial expressions, respiration, and pulse beat to large-scale finger and elbow bending, demonstrating a promising and attractive application for wearable devices and human-machine interaction.

High expression of HHLA2 predicts poor prognosis in medullary thyroid carcinoma

Background

Human endogenous retrovirus-H long terminal repeat-associating protein 2 is a newly identified immune checkpoint molecule that was aberrantly expressed in many malignant tumors. However, its expression in medullary thyroid carcinoma is still unclear. This study aimed to investigate the human endogenous retrovirus-H long terminal repeat-associating protein 2 expression in medullary thyroid carcinoma tissues and to evaluate the relationships between its expression and clinicopathologic together with prognostic relevance.

Methods

Using 51 surgical specimens obtained from medullary thyroid carcinoma patients, the expression levels of the human endogenous retrovirus-H long terminal repeat-associating protein 2 protein in medullary thyroid carcinoma tumor tissues and adjacent noncancerous tissues were measured by immunohistochemistry, and its correlations with clinicopathologic and prognostic features were analyzed. Status of CD8+ tumor infiltrating lymphocytes was also investigated.

Results

The results showed that human endogenous retrovirus-H long terminal repeat-associating protein 2 was only detected in tumor tissues, and 31.4% of the medullary thyroid carcinoma patients had high expression of human endogenous retrovirus-H long terminal repeat-associating protein 2. High human endogenous retrovirus-H long terminal repeat-associating protein 2 expression was significantly associated with lymph node metastasis and advanced American Joint Committee on Cancer stages (P = 0.005). There existed an inverse trend between human endogenous retrovirus-H long terminal repeat-associating protein 2 expression and CD8+ tumor infiltrating lymphocytes infiltration in medullary thyroid carcinoma tumor samples (P = 0.042). The log-rank test showed a shorter disease-free survival in patients with high human endogenous retrovirus-H long terminal repeat-associating protein 2 expression (P = 0.002). The disease-free survival rates were also significantly low in cases of medullary thyroid carcinoma with lymph node metastasis, American Joint Committee on Cancer stages III–IV and multifocality. Multivariate Cox analysis confirmed that human endogenous retrovirus-H long terminal repeat-associating protein 2 acted as an independent predictive factor in the disease-free survival of medullary thyroid carcinoma patients (hazard ratio = 4.138, 95% confidence interval: 1.027–16.667, P = 0.046).

Conclusions

Taken together, human endogenous retrovirus-H long terminal repeat-associating protein 2 is highly expressed in medullary thyroid carcinoma patients and is a poor prognostic biomarker of disease-free survival of medullary thyroid carcinoma patients.

A microfluidic system for rapid nucleic acid analysis based on real-time convective PCR at point-of-care testing

A microfluidic system for rapid nucleic acid analysis based on real-time convective PCR is developed. To perform 'sample-in, answer-out' nucleic acid analysis, a microfluidic chip is developed to efficiently extract nucleic acid, and meanwhile convective PCR (CPCR) is applied for rapid nucleic acid amplification. With an integrated microfluidic chip consisting of reagent pre-storage chambers, a lysis & wash chamber, an elution chamber and a waste chamber, nucleic acid extraction based on magnetic beads can be automatically performed for a large size of test sample within a limited time. Based on an easy-to-operate strategy, different pre-stored reagents can be conveniently released for consecutive reaction at different steps. To achieve efficient mixing, a portable companion device is developed to introduce properly controlled 3-D actuation to magnetic beads in nucleic acid extraction. In CPCR amplification, PCR reagent can be spontaneously and repeatedly circulated between hot and cool zones of the reactor for space-domain thermal cycling based on pseudo-isothermal heating. A handheld real-time CPCR device is developed to perform nucleic acid amplification and in-situ detection. To extend the detection throughput, multiple handheld real-time CPCR devices can be grouped together by a common control system. It is demonstrated that influenza A (H1N1) viruses with the reasonable concentration down to 1.0 TCID₅₀/ml can be successfully detected with the microfluidic system.

The MicroRNA-106a/20b Strongly Enhances the Antitumour Immune Responses of Dendritic Cells Pulsed with Glioma Stem Cells by Targeting STAT3

BACKGROUND

Evaluate the effect of the miRNA-106a/20b on the efficacy of DCs pulsed with GSCs in activating GSC-specific T cell responses.

METHODS

We cultured GSCs and prepared GSC antigen lysates by apoptosis. Then, immature DCs were pulsed with GSC antigen lysates in vitro. STAT3 levels in DCs were assessed by Western blotting, and the expression of CD80, CD86, and MHC-II was tested by fluorescence-activated cell sorting. The production and secretion of the cytokines IL-6, IL-12, TNF-α, and IL-10 in DCs induced by GSCs were determined by enzyme-linked immunosorbent assay. Finally, the cytotoxic functions of T cells stimulated by GSC-DC fusion cells transfected with a miR-106a/20b mimic in vitro and the antitumour activity in vivo were detected.

RESULTS

We found that the levels of miR-106a/20b were downregulated, but the expression of STAT3 was significantly upregulated. Simultaneously, the inhibition of STAT3 in the fusion cells by STAT3-specific siRNA caused significant upregulation of the expression of CD80, CD86, and MHC-II, and the secretion of the cytokines IL-6 and IL-12 was substantially increased, IL-10 was markedly decreased. These findings revealed that STAT3 is an important regulator of DC maturation. Furthermore, the interactional binding sites between the 3'-untranslated region (3'-UTR) of STAT3 mRNA and miR-106a/20b were predicted by bioinformatics and verified by a dual-luciferase assay. Moreover, the reduction in STAT3 levels in GSC-DCs enhanced the generation of CD8+ T cells and reduced the generation of Foxp3+ regulatory T cells. Meanwhile, the secretion of the T cell cytokine IFN-γ was significantly increased. Further research showed that DCs after miR-106a/20b-mimics transfection could promote the inhibition of GSC proliferation by T cells in vitro and suppress tumour growth in vivo.

CONCLUSIONS

This study indicted that the miR-106a/20b activation could be one of the important molecular mechanisms leading to enhance antitumour immune responses of GSC-mediated DCs, which downregulated the expression of STAT3 to alleviate its the inhibitory effect.

Change patterns in the corneal sub-basal nerve and corneal aberrations in patients with dry eye disease: An artificial intelligence analysis

We aimed to investigate the change patterns in corneal sub-basal nerve morphology and corneal intrinsic aberrations in dry eye disease (DED). Our study included 229 eyes of 155 patients with DED and 40 eyes of 20 healthy control. We used the Oculus keratograph and the ocular surface disease index questionnaire to assess their signs and symptoms. In vivo confocal microscopy was used to observe the corneal sub-basal nerves, corneal endothelial cells, and Langerhans cells (LCs). An artificial intelligence (AI) technique run by the deep learning model generated the sub-basal nerve fibre parameters. Furthermore, we used the Pentacam HR system to measure the corneal intrinsic aberrations and corneal surface regularity indices. DED patients more frequently had increased anterior and total corneal aberrations than controls (P < 0.05). In addition, DED had decreased average density and maximum length of corneal nerve. (Both P < 0.01) The LC number was significantly correlated with maximum length (CC = -0.19, P = 0.01) of the sub-basal nerve fibre. Furthermore, the corneal nerve average density was negatively correlated with IHD, and anterior, posterior, and total corneal aberrations (All P < 0.05) especially the higher-order aberrations. Significant correlations were seen between corneal nerve morphology changes, analysed by AI and corneal intrinsic aberrations, particularly higher-order aberrations.

Nitrogen and phosphorus removal in simulated wastewater by two aquatic plants

Water pollution control is the focus of environmental pollution control. Ecological water treatment is widely used because of its low cost and landscape effect, and has no pollution. Aquatic plants have attracted wide attention because of their low cost and high level of resource utilization. In order to study the effects of emergent and submerged plants on the removal of different concentrations of wastewater, and the effect of pollutants on plant growth, two common aquatic plants found in Northeast China (Iris ensata Thunb. and Potamogeton malaianus Miq.) were selected. Under static conditions, the removal efficiency of nitrogen and phosphorus in wastewater with different concentrations by two kinds of plants was studied. The results showed that the removal rate of total nitrogen (TN) in medium- and high-pollutant concentration water samples and total phosphorus (TP) in medium- and low-pollutant concentration water with I. ensata reached more than 75%. The removal rate of TN in the medium-pollutant concentration water with P. malaianus reached 71.4%, while the removal efficiency of TN and TP in the low-pollutant concentration water was higher than 80%. In the Nanhu Park Lake samples, I. ensata had the highest removal rates of TN (80.38%) and TP (85.62%). This study shows that both I. ensata and P. malaianus can be used as aquatic plants to restore the water quality of urban lakes. This research provides an important basis for the phytoremediation and treatment of urban domestic wastewater and urban surface water bodies in Northern China.

Case Series: Ocular Trauma Secondary to Masks during the COVID-19 Pandemic

SIGNIFICANCE

Previously, people had only recognized the discomfort of masks, and no one had ever realized the risk of ocular trauma associated with masks. We classify the causes of injuries into two categories and emphasize the importance of using masks properly.

PURPOSE

This study aimed to characterize and classify ocular injuries caused by masks.

CASE REPORTS

With the increase in the number of masks used during the coronavirus disease 2019 pandemic, we have seen a rise in mask-related ocular injuries. This is a single-center retrospective case series of patients presenting to the Peking University Third Hospital Ophthalmology Department emergency department with ocular injuries secondary to masks from February to August 2020. Nine patients (six males, three females) were reviewed. All patients had a unilateral injury (four right eyes, five left eyes). The most frequently injured site was the cornea, which was seen in five patients. Some patients were injured in more than one area. Seven patients were injured by metal nose wires or other rigid, sharp parts of masks. The other two patients were injured by elastic mask straps.

CONCLUSIONS

Masks can cause two types of ocular injuries that may require surgical intervention. One kind is metal nose wires or other rigid, sharp parts of masks causing lacerations or abrasions. The other is recoiling elastic mask straps snapping into the eyes and causing contusions. Our report emphasizes the importance of using masks properly.

A Three-Dimensional-reconstruction-based study on the ocular volume of Chinese children with high myopia

BACKGROUND

Highly myopic eyes differ in morphology from emmetropic eyes, and the correct estimation of the vitreous volume is difficult. To explore an effective method to estimate ocular volume using refractive factors in children.

METHODS

This is a retrospective study of children with high myopia who visited the Shenzhen Shekou People's Hospital (July-December 2018) before undergoing posterior scleral reinforcement surgery. Data on refractive factors and ocular 3D reconstruction imaging based on high-end CT were collected for linear correlation and linear regression analyses.

RESULTS

Ten patients (20 eyes) were included. There are nine males and one female. They were 4 to 12 years of age. The spherical equivalent ranges from + 0.25 to -20.00 D. The cylindrical equivalent ranges from - 0.50 to -6.25 D. The AL(axial length, AL) ranges from 21.78 to 33.90 mm. The corneal curvature (mean) ranges from 42.44 to 46.75. The 3D reconstruction of the CT images shows that the ocular volume ranges from 4.591 to 10.988 ml. The ocular volume of the 20 eyes decreases with the increase of diopter and total curvature, both presenting a linear trend, with the Pearson correlation coefficients being - 0.776 (P < 0.001) and - 0.633 (P = 0.003), respectively. The ocular volume of the 20 eyes increases with the increasing AL, also presenting a linear trend, with the Pearson correlation coefficient being 0.939 (P < 0.001).

CONCLUSIONS

In children, the ocular volume is negatively and linearly correlated with the diopter and curvature, and positively and linearly correlated with the AL.

Design and evaluation of GLP-1 receptor G-protein biased agonist with prolonged efficacy on diabetes

AIM

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as potent drug development target for treating diabetes and obesity. Here, we designed and evaluated novel long-acting GLP-1R G protein biased agonist with potent clinical application.

MAIN METHODS

GLP-1R G-protein biased sequences were screened via a high-throughput autocrine-based strategy and then fused to Exendin (9-39). These fusion peptides were further performed with site-specific modification. Surface plasmon resonance (SPR) measurements, GLP-1R activation potencies and plasma stability tests were applied to screen optimal candidate. Acute and chronic hypoglycemic and insulinotropic activities of selected agent were evaluated in diabetic and obese rodent animals.

MAIN FINDINGS

AX09 exert highest binding affinities for GLP-1R extracellular domain (GLP-1R ECD). Further in vitro plasma stability and GLP-1R activation assays demonstrated better potency of AX18. Acute pharmacodynamic evaluation of AX18 demonstrated the promising insulinotropic and hypoglycemic activities which were exhibited in a dose-dependent manner. Prolonged hypoglycemic efficacies of AX18 were also observed in both hypoglycemic duration test and multiple oral glucose tolerance tests (OGTTs) in the diabetic mice. Further pharmacokinetic test in cynomolgus monkeys exhibited that the half-life of AX18 was more than 6 days. Once weekly treatment of AX18 in diabetic mice for 8-week achieved significantly improved %HbA1C, insulin resistance, glucose tolerance, β-cells and diabetic retinal injury. Chronic treatment of AX18 in diet-induced obese (DIO) mice also exhibited beneficial efficacies on %HbA1C, inflammation-related factors lowering, and weight gains.

CONCLUSION

AX18, as a novel GLP-1R G protein biased agonist, exhibited potency for treating diabetes mellitus and its complications.

An optical neural chip for implementing complex-valued neural network

Complex-valued neural networks have many advantages over their real-valued counterparts. Conventional digital electronic computing platforms are incapable of executing truly complex-valued representations and operations. In contrast, optical computing platforms that encode information in both phase and magnitude can execute complex arithmetic by optical interference, offering significantly enhanced computational speed and energy efficiency. However, to date, most demonstrations of optical neural networks still only utilize conventional real-valued frameworks that are designed for digital computers, forfeiting many of the advantages of optical computing such as efficient complex-valued operations. In this article, we highlight an optical neural chip (ONC) that implements truly complex-valued neural networks. We benchmark the performance of our complex-valued ONC in four settings: simple Boolean tasks, species classification of an Iris dataset, classifying nonlinear datasets (Circle and Spiral), and handwriting recognition. Strong learning capabilities (i.e., high accuracy, fast convergence and the capability to construct nonlinear decision boundaries) are achieved by our complex-valued ONC compared to its real-valued counterpart.

Correlation of NUF2 Over-expression with Poorer Patient Survival in Multiple Cancers

Purpose

NUF2 has been implicated in multiple cancers recently, suggesting NUF2 may play a role in the common tumorigenesis process. In this study, we aim to perform comprehensive meta-analysis of NUF2 expression in the cancer types included in the Cancer Genome Atlas (TCGA).

Materials and Methods

RNA-sequencing data in 31 cancer types in the TCGA data and 11 independent datasets were used to examine NUF2 expression. Silencing NUF2 using targeting shRNAs in hepatocellular carcinoma (HCC) cell lines was used to evaluate NUF2’s role in HCC in vitro and in vivo.

Results

NUF2 up-regulation is significantly observed in 23 out of the 31 cancer types in the TCGA datasets and validated in 13 major cancer types using 11 independent datasets. NUF2 overexpression was clinically important as high NUF2 was significantly associated with tumor stages in eight different cancers. High NUF2 was also associated with significantly poorer patient overall survival and disease-free survival in eight and six cancers, respectively. We proceeded to validate NUF2 overexpression and its negative association with overall survival at the protein level in an independent cohort of 40 HCC patients. Compared to the non-targeting controls, NUF2 knockdown cells showed significantly reduced ability to grow, migrate into a scratch wound and invade the 8 μm porous membrane in vitro. Moreover, NUF2 knockdown cells also formed significantly smaller tumors than control cells in mouse xenograft assays in vivo.

Conclusion

NUF2 up-regulation is a common feature of many cancers. The prognostic potential and functional impact of NUF2 up-regulation warrant further studies.

Analysis of lens epithelium telomere length in age-related cataract

We aimed to investigate the associations among lens epithelium telomere length (LETL), cataract types, and systemic pro-senescence factors in patients with age-related cataract. In this prospective study, the general demographic factors, body mass index, smoking history, depression, hypertension, diabetes, various psychological measures, and uncorrected distant visual acuity of patients with age-related cataract were recorded. Lens Opacities Classification System III (LOCS III) scores and lens density measured by Scheimpflug imaging were used to evaluate the cataracts. LETL was measured by real-time polymerase chain reaction. Correlations among these parameters were analyzed. The LOCS III nuclear opalescence (NO) score was associated with age (β = 0.053, P < 0.001) and Patient Health Questionnaire-9 score (β = -0.042, P = 0.004). Smoking was identified as a risk factor affecting LOCS III NO score (odds ratio = 1.546, 95% confidence interval, 1.128-2.119), but not the LOCS III cortical or posterior subcapsular scores. LETLs showed a weak association with systemic factors and LOCS III scores, and a significantly moderate correlation with the average objective lens densities of different regions measured by Scheimpflug imaging (r values ranged from -0.278 to -0.523, P < 0.05). However, there was no correlation between the LETLs and the maximum lens densities. The groups with a relatively low lens density had longer LETLs. In Conclusion, being an age-related disease, cortical cataract was also associated with "aging of the lens epithelium." Notably, lens epithelium activity rarely showed systemic effects. Thus, future studies should emphasize the importance of the telomeric system in cataractous process and aging.

Patient satisfaction with the ocular surface individualized medical program

PURPOSE

To improve the medical management system and the quality of medical treatment, this study aimed to assess patient satisfaction related to an ocular surface individualized medical program for dry eye, and identified patient needs that should be addressed in future.

METHODS

We enrolled 166 patients from the dry eye clinic at the Peking University Third Hospital from December 2017 to May 2019. An investigator followed up with all patients by telephone 2 months after the first assessment of overall patient satisfaction, expectations, and experiences. We determined patient satisfaction using a questionnaire and analyzed the results. Multivariate linear regression analysis was used to assess the predictors of overall patient satisfaction.

RESULTS

The overall patient satisfaction with the ocular surface individualized medical program skewed toward a positive assessment. Ten variables were significantly associated with overall patient satisfaction: two involving fulfilment of expectations, seven involving patient-reported experiences, and one involving socio-demographics. The most important predictor of overall patient satisfaction was patient-reported experiences with the treatment outcome (β = 0.281, p < 0.001), followed by experiences with medical staff services (β = 0.240, p = 0.002), examination services (β = 0.198, p = 0.002), and interpretation and professionalism (β = 0.168, p = 0.04), expectations fulfilment (β = 0.147, p = 0.025), as well as age (β = -0.13, p = 0.014). Free response-style negative patient feedback suggested that examination wait time and environment needed improvement.

CONCLUSION

Overall, the ocular surface individualized medical program is effective and is able to achieve satisfaction for most patients. The examination procedures and environment require improvements, and treatment must be made more patient-centric to improve satisfaction.

Desloratadine Ameliorates Olfactory Disorder and Suppresses AMPA Receptor GluA1 Expression in Allergic Rhinitis Rat

Allergic rhinitis (AR) is an IgE-mediated inflammation which causes olfactory dysfunction. Antihistamines have been widely used to treat AR while few studies have investigated the effect of antihistamines on improving the sense of smell. In addition, the underlying mechanisms are not well elucidated. We established the ovalbumin (OVA)-induced allergic rhinitis rat model and administrated desloratadine to AR rats. The AR symptoms, serum level of OVA-specific IgE and IL-17, and expression of IL-4, IL-5 and IL-13 in nasal mucosa were measured. The olfactory dysfunction was monitored by buried food test and the expression of GluR1 was measured. Desloratadine treatment alleviated AR symptoms, decreased serum level of OVA-specific IgE and IL-17 in AR rats. Desloratadine decreased IL-4, IL-5, and IL-13 expression in nasal mucosa of AR rats. Desloratadine ameliorated olfactory dysfunction in AR rats and decreased GluR1 expression in AR rats. Desloratadine treatment alleviated AR symptoms and ameliorated olfactory dysfunction in AR rats. The expression of AMPA receptor subunit GluR1 in olfactory bulb was associated with olfactory disorder.

Development of Transparent Acellular Dermal Matrix as Tissue-Engineered Stroma Substitute for Central Lamellar Keratoplasty

Purpose

To improve the transparency of the acellular dermal matrix (ADM) and investigate the optical, mechanical and histologic properties and biocompatibility of transparent ADM (TADM) in lamellar keratoplasty.

Methods

A stepwise sectioning strategy was applied to determine the transparency distribution of the ADM, and TADM was fabricated accordingly. Transmittance measurements, uniaxial tension testing, and histologic staining were applied to detect its properties. Lamellar keratoplasty was performed in rabbits with TADM, and postoperative evaluations were conducted including the transmittance of the transplant area and histologic staining.

Results

The transmittance of the ADM increased with increasing depth, and TADM was isolated mechanically at the deepest level. There was a significant improvement in the transmittance of the TADM compared with the ADM, and no significant difference in transmittance between dehydrated TADM and cornea was observed. The elastic modulus of TADM was significantly stronger than that of normal cornea (P = 0.004). TADM consisted of dense collagen fibrils, mainly collagen type I, and the collagen fibril diameter and interfibrillar spacing were determined to be larger than corneal stroma. After lamellar keratoplasty in rabbits, the TADM was well integrated with the host cornea, and transparent cornea without neovascularization was observed at 6 months. Re-epithelization was completed at 1 month, and keratocyte repopulation and collagen remodeling were observed in the graft 3 and 6 months after surgery.

Conclusions

This study presents the transparency distribution of the ADM and a method for obtaining TADM, which demonstrates ideal transparency, strong mechanical properties, and satisfactory biocompatibility when applied in lamellar keratoplasty.

TMIS: a new image-based software application for the measurement of tear meniscus height

PURPOSE

To present a new automated image recognition software for the measurement of tear meniscus height (TMH) and investigate its correlation and efficacy compared with an open-source software (NIH ImageJ) and manual evaluation.

METHODS

A total of 520 slit lamp photographs, among which 276 were in ×16 magnification and 244 were ×40 magnified, captured from 138 eyes of 69 healthy subjects were assessed for TMH by the new automated Tear Meniscus Identification Software (TMIS), ImageJ and human graders. Images processing of TMIS included filtration, recognition and measurement of slit lamp photographs under certain algorithm, which output two measurement patterns, TMIS_{M ax} and TMIS_{M ean} . TMH measured by ImageJ software, considered as the reference value, was conducted by a masked observer while four masked ophthalmologists performed the manual evaluation.

RESULTS

In both magnifications, TMH measured by TMIS_{M ean} showed similar values with ImageJ while manual evaluation demonstrated underestimated results, and a strong correlation was detected between TMIS and ImageJ. In ×16 magnified photographs, manually obtained TMH revealed a higher correlation with ImageJ, whereas a notably stronger correlation of TMIS with ImageJ was observed in ×40 photographs. Correspondingly, the accuracy for both TMIS_{M ax} and TMIS_{M ean} appeared to be lower than most doctors in ×16 slit lamp images, in contrast to a better precision of TMIS_{M ean} in ×40 ones.

CONCLUSION

The new software displayed high accuracy and efficacy in ×40 magnification and TMIS_{M ean} pattern, suggesting the possibility of this automated TMH measurement platform to be a valid tool in dry eye screening and follow-up practice.

Lysobacter oculi sp. nov., isolated from human Meibomian gland secretions

A Gram-stain negative, rod-shaped bacterial, catalase and oxidase positive strain (83-4^T) that formed yellow colonies was isolated from human Meibomian gland secretions. Strain 83-4^T belongs to the genus Lysobacter according to phylogenetic analysis based on 16S rRNA gene sequences. The DNA G+C content was 67.1 mol%. The circular genome was 2.6 Mb, which contained 2431 protein-coding sequences, 75 pseudogenes, 46 tRNAs, 3 rRNAs and 4 ncRNAs. A bacteriocin cluster and aryl polyene cluster were also found in the genome. The average nucleotide identity value was 79.6% between isolate 83-4^T and the closely related type strain Lysobacter tolerans UM1^T. The estimated DNA-DNA hybridization value between strain 83-4^T and L. tolerans UM1^T was 41.6%. Diphosphatidylglycerol, phosphatidylethanolamine and phosphatidylglycerol were the major polar lipids. Iso-C_15:0, iso-C_11:0 3-OH, iso-C_11:0 and summed feature 9 (iso-C_17:1ω9c) were the major fatty acids. Ubiquinone (Q-8) was the only respiratory quinone. Therefore, based on the data of phylogenetic analysis, chemotaxonomical and biochemical analyses, it is concluded that strain 83-4^T represents a novel species of the genus Lysobacter with the name of Lysobacter oculi sp. nov. The type strain is 83-4^T (= CGMCC 1.13464^T = NRBC 113451^T).

Osteopontin-Enhanced Autophagy Attenuates Early Brain Injury via FAK-ERK Pathway and Improves Long-Term Outcome after Subarachnoid Hemorrhage in Rats

Osteopontin (OPN) enhances autophagy, reduces apoptosis, and attenuates early brain injury (EBI) after a subarachnoid hemorrhage (SAH). A total of 87 Sprague–Dawley rats were subjected to sham or SAH operations to further investigate the signaling pathway involved in osteopontin-enhanced autophagy during EBI, and the potential effect of recombinant OPN (rOPN) administration to improve long-term outcomes after SAH. Rats were randomly divided into five groups: Sham, SAH + Vehicle (PBS, phosphate-buffered saline), SAH + rOPN (5 μg/rat recombinant OPN), SAH + rOPN + Fib-14 (30 mg/kg of focal adhesion kinase (FAK) inhibitor-14), and SAH + rOPN + DMSO (dimethyl sulfoxide). Short-term and long-term neurobehavior tests were performed, followed by a collection of brain samples for assessment of autophagy markers in neurons, pathway proteins expression, and delayed hippocampal injury. Western blot, double immunofluorescence staining, Nissl staining, and Fluoro-Jade C staining assay were used. Results showed that rOPN administration increased autophagy in neurons and improved neurobehavior in a rat model of SAH. With the administration of FAK inhibitor-14 (Fib-14), neurobehavioral improvement and autophagy enhancement induced by rOPN were abolished, and there were consistent changes in the phosphorylation level of ERK1/2. In addition, early administration of rOPN in rat SAH models improved long-term neurobehavior results, possibly by alleviating hippocampal injury. These results suggest that FAK–ERK signaling may be involved in OPN-enhanced autophagy in the EBI phase after SAH. Early administration of rOPN may be a preventive and therapeutic strategy against delayed brain injury after SAH.

Evaluation of ocular surface impairment in meibomian gland dysfunction of varying severity using a comprehensive grading scale

This study aimed to propose a comprehensive grading scale to evaluate different clinical manifestations in patients with varying severity of meibomian gland dysfunction (MGD) and analyze the correlations between the parameters of ocular surface impairment in MGD.A total of 63 patients with MGD were enrolled. Ten specific symptoms were evaluated each with a subjective score and total score was applied to grade the severity of MGD. Thirty-seven patients were diagnosed with mild, 19 with moderate, and 7 with severe MGD. Slit-lamp and keratography were used to assess the signs of ocular surface and meibomian gland (MG). In vivo confocal microscopy (IVCM) was performed to evaluate the corneal nerves and dendritic cells. The differences and correlations between symptoms, signs, and IVCM parameters were analyzed.Dryness, foreign body sensation, asthenopia, and photophobia were the most common and severe symptoms in our patients. The severe MGD group showed worse MG expressibility, Meibum score, Meiboscore, MG score, and higher nerve reflectivity (P < .05). The mild MGD group showed higher nerve density (P < .05). Total symptom score was negatively correlated with nerve density (r = -0.374, P < .05), while positively correlated with nerve reflectivity and dendritic cell density (r = 0.332 and 0.288, respectively, P < .05). MG score was correlated with nerve reflectivity (r = 0.265, P < .05).The comprehensive grading scale was suitable for evaluating clinical manifestations in MGD of varying severity. The relationship between the specific symptoms, signs, and IVCM results concerning whole ocular surface impairment could help elucidate MGD pathophysiology and benefit evaluation or treatment in the future.