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PURPOSE: To report three cases with Acanthamoeba keratitis after laser vision correction and their treatment course and outcomes, and to compare these with the existing literature. METHODS: Case series and literature review. RESULTS: Three eyes of three patients presented with Acanthamoeba keratitis after laser vision correction and were treated with a high concentration of anti-amoebic medication after a timely diagnosis. In the first case, which occurred after laser in situ keratomileusis, there was an excellent recovery 1 month after treatment. In the second case, the uncorrected distance visual acuity (UDVA) after laser-assisted subepithelial keratectomy (LASEK) returned to 8/20 after similar anti-amoebic treatment, but for a period of 4 months. Despite using the same treatment regimen, the third case of Acanthamoeba keratitis after LASEK required a penetrating keratoplasty. This was deemed necessary because the cornea was completely infiltrated. There was no recurrence of the infection and the UDVA achieved 6 months postoperatively was 4/20. CONCLUSIONS: Early diagnosis and standardized postoperative management is the top priority in Acanthamoeba keratitis after laser vision correction. Glucocorticoids should stop when the infection is suspected and Acanthamoeba keratitis should always be considered, particularly when pain is severe and standard antibiotics fail. Intensive anti-amoebic treatment in the early period and judicious use of penetrating keratoplasty in Acanthamoeba keratitis after laser vision correction may benefit prognosis. [ Journal of Refractive Surgery Case Reports. 2022;2(2):e32–e37.]

Photocatalytic degradation is an advanced technique towards remediation of wastewater laden with organic contaminants. In the present study, in order to improve the photocatalytic activity and recycling times of TiO2 under visible light, TiO2 was facilely in situ immobilized on activated carbon fiber (ACF) surface by coating and hydrothermal treatment, called ACF-TiO2. XRD indicated that TiO2 on ACF-TiO2 was nano anatase type with a grain size of 3.72 nm. SEM, XPS and FT-IR analysis showed that TiO2 was uniformly dispersed on the surface of ACF, and the C element of ACF entered the lattice of TiO2, forming Ti–O–C bond. According to the analysis of UV-Vis DRS, the response of ACF-TiO2 to light exhibited a significant red shift, and the bandgap energy value decreased to 3.03 eV; In the process of eliminating MB, the presence of ACF improved the photocatalytic performance of TiO2 and the loaded TiO2 continuously degraded the MB molecules adsorbed by ACF. The whole process of adsorption-photocatalytic degradation was dynamically completed, and the synergistic effect between ACF and nano TiO2 was beneficial to the in situ regeneration and sustainable use of ACF-TiO2. This study may provide a facile reference to prepare ACF supported TiO2 without the sacrifice of the pores and adsorption capacity of substrates of ACF, and the desirable performance can be highly applied in the treatment of wastewater contaminated with organic dyes.

The bacterial infection that involves antimicrobial resistance is a rising global threat to public health. Chlorine-based water disinfection processes can inactivate antibiotic resistant bacteria. However, at the same time, these processes may cause the release of antibiotic resistance genes into the water as free DNA, and consequently increase the risk to disseminate antibiotic resistance via natural transformation. Presently, little is known about the contribution of residual chlorine affecting the transformation of extracellular antibiotic resistance genes (ARGs). This study investigates whether chloramine and free chlorine promote the transformation of ARGs and how this may occur. We reveal that both chloramine and free chlorine, at practically relevant concentrations, significantly stimulated the transformation of plasmid-encoded ARGs by the recipient Acinetobacter baylyi ADP1, by up to a 10-fold increase. The underlying mechanisms underpinning the increased transformations were revealed. Disinfectant exposure induced a series of cell responses, including increased levels of reactive oxygen species (ROS), bacterial membrane damage, ROS-mediated DNA damage, and increased stress response. These effects thus culminated in the enhanced transformation of ARGs. This promoted transformation was observed when exposing disinfectant-pretreated A. baylyi to free plasmid. In contrast, after pretreating free plasmid with disinfectants, the transformation of ARGs decreased due to the damage of plasmid integrity. These findings provide important insight on the roles of disinfectants affecting the horizontal transfer of ARGs, which could be crucial in the management of antibiotic resistance in our water systems.

Purpose: To investigate the effect of mitomycin-C (MMC) intraoperative application on postoperative corneal epithelial remodeling, haze incidence, and refractive correction in transepithelial photorefractive keratectomy (transPRK). Setting: Eye Hospital of Wenzhou Medical University, Wenzhou, China. Design: Prospective randomized controlled study. Methods: Eyes that completed all follow-ups were included. Epithelial thickness (ET) map measurement was conducted preoperatively and at 1 week, and at 1 month, 3 months, and 6 months postoperatively, generating ET in central, paracentral, and midperipheral zones. The difference between postoperative and preoperative ET (Delta ET) was computed for each zone. During follow-up, haze incidence and visual acuity were assessed and compared between groups. Results: A total of 100 eyes completed all follow-up, including 40 eyes treated with MMC in MMC group and 60 eyes in control group without MMC treatment. For Delta ET, between-group difference was found in midperipheral (P = .011) zone at 1 week postoperatively and in central (P = .036) and paracentral zones (P = .039) at 1 month postoperatively. Haze incidence was lower in MMC group at 1 week and 1 month postoperatively (P = .035 and .018, respectively). Safety index (postoperative uncorrected distance visual acuity/preoperative corrected distance visual acuity [CDVA]) and efficacy index (postoperative CDVA/preoperative CDVA) were higher in MMC group (P = .012 and P = .036, respectively) at 1 month postoperatively. No difference was found after 3 months postoperatively. Conclusions: With a temporary impact on corneal epithelial regeneration and refractive correction, intraoperative MMC application in transPRK decreased the haze incidence but had no effect on epithelial remodeling. Copyright (C) 2021 Published by Wolters Kluwer on behalf of ASCRS and ESCRS

Pelvic malignant solitary fibrous tumor (SFT) is a relatively rare disease, and literature on radical resection with transcatheter arterial embolization of pelvic SFT is lacking. In this work, we report on a 55-year-old man with a presacral mass who was hospitalized at our department. Computed tomography and magnetic resonance imaging indicated pelvic space-occupying lesions that were 12 cm × 10 cm in size and pelvic lesions that were not clearly demarcated from the right posterior wall of the bladder and the right ureter. This result suggested severe secondary hydronephrosis of the right renal pelvis. The patient underwent transcatheter iliac arterial embolization. Radical tumor resection was performed, and the results of pathological examination confirmed the diagnosis of malignant pelvic SFT. There was no SFT recurrence in this patient at 1-year follow-up. Herein, we report on the treatment of a patient with malignant pelvic SFT, a rare condition, who underwent successful radical resection after transcatheter arterial embolization. Transcatheter arterial embolization can block the blood supply of the SFT as much as possible and improve the possibility of tumor resection. In the future, pelvic SFTs can be considered improving the resection rate by transcatheter arterial embolization before surgery.

Antibiotic resistance is a global concern threatening public health. Horizontal gene transfer (HGT) between bacterial species contributes greatly to the dissemination of antibiotic resistance. Conjugation is one of the major HGT pathways responsible for the spread of antibiotic resistance genes (ARGs). Antidepressant drugs are commonly prescribed antipsychotics for major depressive disorders and are frequently detected in aquatic environments. However, little is known about how antidepressants stress bacteria and whether such effect can promote conjugation. Here, we report that commonly prescribed antidepressants, sertraline, duloxetine, fluoxetine, and bupropion, can promote the conjugative transfer of plasmid-borne multidrug resistance genes carried by environmentally and clinically relevant plasmids. Noteworthy, the transfer of plasmids across bacterial genera is significantly enhanced by antidepressants at clinically relevant concentrations. We also reveal the underlying mechanisms of enhanced conjugative transfer by employing flow cytometric analysis, genome-wide RNA sequencing and proteomic analysis. Antidepressants induce the production of reactive oxygen species and the SOS response, increase cell membrane permeability, and upregulate the expression of conjugation relevant genes. Given the contribution of HGT in the dissemination of ARGs, our findings highlight the importance of prudent prescription of antidepressants and to the potential connection between antidepressants and increasing antibiotic resistance.

BACKGROUND Breast cancer is one of the most common malignant tumors in women, severely threatening the health of women worldwide. Designing an effective data management and processing system to help collect, manage, and use variables for breast cancer diagnosis and treatment has become an urgent need. As an important part of artificial intelligence, a knowledge graph provides an ideal means to solve this problem. OBJECTIVE Our study intends to utilize the natural language processing (NLP) technique on Chinese breast cancer mammography reports to effectively identify and extract the features related to breast cancer and construct a knowledge graph for breast cancer diagnosis. METHODS This paper focuses on the knowledge graph frame structure and feature extraction that were the main challenges for constructing a Chinese breast cancer diagnosis knowledge graph. Based on mammography examination guidelines and specifications, as well as clinical experiences and recommendations of experts in the hospital, we define entities, entity attributes, and entity relationships for constructing the concept layer of a knowledge graph. From mammography examination reports, we extract mammographic features using deep learning models, with which we build a knowledge graph for breast cancer diagnosis. RESULTS When annotating mammography examination reports in NLP tasks, we have identified 15 important types of mammographic features. To improve the versatility of the constructed knowledge graph, we have added additional 7 types of mammographic features. Mammographic features are extracted from a total of 1171 mammography examination reports. For the overall results of the model, the recognition accuracy rate is 98.97%, the accuracy rate is 97.16%, the recall rate is 98.06%, and F1 is 97.61. Based on the structure of the concept layer of the knowledge graph, we import the demographic risk factors and mammographic features extracted from the text reports into the Neo4j graph database to complete the construction of the knowledge graph. CONCLUSIONS We constructed a Breast Cancer Diagnosis Knowledge Graph Based on Chinese Electronic Medical Records. Through the evaluation of the design of the concept layer, the construction of the data layer, and the functions of the application layer, the rationality, effectiveness, and practicability of the knowledge graph are demonstrated. This study provides a reference for the rapid design and construction of knowledge graph for other disease diagnosis and treatment.

Visible light-promoted dearomative [2 + 2] cycloaddition of indole derivatives tethered with olefins at the N1 position has been considered thermodynamically unfeasible due to the high triplet exci...

Purpose: To evaluate whether repeated application of riboflavin during corneal cross-linking (CXL) has an impact on the corneal biomechanical strength in ex-vivo porcine corneas. Design: Laboratory investigation.Methods: Sixty-six porcine corneas with intact epithelium were divided into three groups and analyzed. All corneas were pre-soaked with an iso-osmolar solution of 0.1% riboflavin in a phosphate-buffered saline (PBS) solution ("riboflavin solution"). Then, the corneas in Groups 1 and 2 were irradiated with a standard epi-off CXL (S-CXL) UV-A irradiation protocol (3 mW/cm2 for 30 min); while the corneas in Group 3 were not irradiated and served as control. During irradiation, Group 1 (CXL-PBS-Ribo) received repeated riboflavin solution application while corneas in Group 2 (CXL-PBS) received only repeated iso-osmolar PBS solution. Immediately after the procedure, 5-mm wide corneal strips were prepared, and elastic modulus was calculated to characterize biomechanical properties. Results: Significant differences in stress-strain extensiometry were found between two cross-linked groups with control group (P = 0.005 and 0.002, respectively). No significant difference was observed in the normalized stiffening effect between Groups 1 and 2 (P = 0.715).Conclusions: The repeated application of riboflavin solution during UV-A irradiation does not affect the corneal biomechanical properties achieved with standard epi-off CXL. Riboflavin application during CXL may be omitted without altering the biomechanical stiffening induced by the procedure.

Purpose: To assess the repeatability of several corneal biomechanical parameters with a Scheimpflug tonometer (Corvis ST) in myopic eyes and eyes that underwent transepithelial photorefractive keratectomy (transPRK), small-incision lenticule extraction (SMILE), or femtosecond laser-assisted in situ keratomileusis (FS-LASIK) surgery. Setting: Eye Hospital of Wenzhou Medical University, Wenzhou, China. Design: Prospective randomized controlled study. Methods: 315 eyes from 315 patients (135 myopes, 58 post-transPRK, 52 post-SMILE, and 70 post-FS-LASIK) were included. 3 consecutive scans were performed to evaluate the repeatability of the 40 parameters examined. Results: 315 eyes were included. In all eyes, the coefficient of variation (CoV) for intraocular pressure (IOP) and biomechanical-corrected IOP (bIOP) ranged from 7.29% to 9.47% and 6.11% to 7.75%, respectively; the CoV of pachymetry was

Additional file 1: Figure S1. Metformin did not affect the expression of SOCS3 in either SH-SY5Y cells or C8-DA cells. (a) SH-SY5Y cells were subjected to metformin (2.5 mM) for 12 h. (b) c8-DA cells were treated with metformin (2.5 mM) for 12 h. The protein level of SOCS3 was tested by western blot (n = 3). Data were analyzed by Student���s t-test. Figure S2. Metformin did not affect the level of miRNA-30a-5p in either SH-SY5Y cells or C8-DA cells. (a) SH-SY5Y cells were treated with metformin (2.5 mM) for 12 h. (b) c8-DA cells were treated with metformin (2.5 mM) for 12 h. The level of miRNA-30a-5p was calculated by real time PCR (n = 3). Data were analyzed by Student���s t-test.

Inflammation is one of the major adverse effects of fine particulate matter (PM

BACKGROUND: Robotic-assisted thoracic surgery (RATS) has been widely used in the treatment of lung cancer. The perioperative outcomes of right upper lobectomy (RUL) using RATS and video-assisted thoracic surgery (VATS) were retrospectively investigated and compared. We aimed to summarize a single-center experience of RATS and 4-port unidirectional VATS in RUL, and to discuss the safety and the essentials of the surgery. METHODS: We retrospectively analyzed the 685 with non-small cell lung cancer (NSCLC) patients who underwent minimally invasive RUL in our center by the same surgical group from January 2015 to December 2019. Both RATS and VATS were performed with three ports with utility incision. The 685 participants were divided into RATS (335 cases) and VATS (350 cases) groups according to surgical method. Baseline characteristics and perioperative outcomes including dissected lymph nodes, postoperative duration of drainage, postoperative hospital stay, and incidence of postoperative complications were compared between the groups. RESULTS: In the 685 patients enrolled, the baseline characteristics were comparable, and no postoperative 30-day mortality or intraoperative blood transfusion were observed. Compared with VATS, RATS had less surgical duration (90.22±12.16 vs. 92.68±12.26 min, P