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Objective To investigate the effect of acupuncture therapy in relieving the anxiety of patients undergoing glaucoma surgery. Methods Totally 95 glaucoma patients undergoing trabeculectomy were randomly divided into two groups: control group with 47 cases and observation group with 48 cases. The perioperative health education was carried in both two groups 1 day before surgery. In the observation group, patients received acupuncture therapy 1 day and 30 minutes before surgery respectively. In the control group, patients were administrated with intramuscular injection of phenobarbital sodium 30 minutes before surgery. The Visual Analogue Scale for Anxiety (VAS-A) was used to measure the anxiety status of patient 1 day before surgery, 30 minutes before surgery, intraoperative period and 30 minutes after surgery. The non-invasive blood pressure and heart rate were measured. Results There was no significant difference in systolic pressure between two groups(P＞0. 05). A significant difference in diastolic pressure at 1 day before surgery was found between two groups(P＜0. 05). There was a significant difference in heart rate between two groups at 1 day before surgery, 30 minutes before surgery and 30 minutes after surgery, respectively (P＜0. 05). A significant difference was found in VAS-A score between two groups during intraoperative period and 30 minutes after surgery(P＜0. 05). Conclusion Acupuncture therapy shows a similar sedative and anti-anxiety effect as intramuscular injection of phenobarbital sodium among patients undergoing glaucoma surgery, moreover, avoiding the drug-induced adverse reactions and potential risks. (目的 探讨运用针灸疗法缓解青光眼手术患者焦虑的效果。方法 选取行小梁切除手术的95例青光眼患者为研究对象, 采用随机数字表法分成2组: 对照组47例和观察组48例。2组均在术前1天开展围手术期健康教育。观察组在术前1 d进行第一次针灸, 在手术前30 min进行第二次针灸治疗; 对照组仅在手术前30 min肌肉注射苯巴比妥钠。术前1天使用视觉模拟量表(VAS)评出基线焦虑分数, 测量患者的基线血压与心率, 此后在手术前30 min、术中、术后30 min使用VAS评估2组患者的焦虑水平, 测量患者的无创血压、心率。结果 术前1 d、术前30min、术中、术后30 min收缩压差异无统计学意义(P＞0. 05); 舒张压在术前1 d差异有统计学意义(P＜0. 05), 在术前30 min、术中、术后30 min差异均无统计学意义(P＞0. 05); 术中心率差异无统计学意义(P＞0. 05), 在术前1 d、术前30 min、术后30 min差异有统计学意义(P＜0. 05); VAS得分在术前1 d、术前30min差异无统计学意义(P＞0. 05), 在术中、术后30 min差异有统计学意义(P＜0. 05)。结论 术前应用针灸疗法可以达到苯巴比妥的镇静抗焦虑效果, 还能够避免因使用药物所带来的不良反应和潜在风险, 保证患者安全。)

To investigate the plasma lipoprotein subclasses in patients with primary open-angle glaucoma (POAG), a total of 20 Chinese POAG patients on intraocular pressure (IOP)-lowering treatment and 20 age-matched control subjects were recruited. Based on the levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), the study subjects were divided into elevated- and normal-level subgroups. The plasma lipoprotein, lipoprotein subclasses, and oxidized LDL (oxLDL) levels were quantitatively measured. The discrimination potential of the lipoproteins was evaluated using the area under the receiver operating characteristic curve (AUC), and their correlation with clinical parameters was also evaluated. Compared to the control subjects with elevated TC and/or LDL-C levels, the levels of TC, LDL-C, non-high-density lipoprotein cholesterol (non-HDL), LDL subclass LDL3 and small dense LDL (sdLDL), and oxLDL were significantly higher in POAG patients with elevated TC and/or LDL-C levels. No differences in any lipoproteins or the subclasses were found between the POAG patients and control subjects with normal TC and LDL-C levels. Moderate-to-good performance of TC, LDL-C, non-HDL, LDL3, sdLDL, and oxLDL was found in discriminating between the POAG patients and control subjects with elevated TC and/or LDL-C levels (AUC: 0.710–0.950). Significant negative correlations between LDL3 and sdLDL with retinal nerve fiber layer (RNFL) thickness in the superior quadrant and between LDL3 and average RNFL thickness were observed in POAG patients with elevated TC and/or LDL-C levels. This study revealed a significant elevation of plasma lipoproteins, especially the LDL subclasses, in POAG patients with elevated TC and/or LDL-C levels, providing insights on monitoring specific lipoproteins in POAG patients with elevated TC and/or LDL-C. [ABSTRACT FROM AUTHOR]

Deep neural network-based programs can be applied to protein structure modeling by inputting amino acid sequences. Here, we aimed to evaluate the AlphaFold2-modeled myocilin wild-type and variant protein structures and compare to the experimentally determined protein structures. Molecular dynamic and ligand binding properties of the experimentally determined and AlphaFold2-modeled protein structures were also analyzed. AlphaFold2-modeled myocilin variant protein structures showed high similarities in overall structure to the experimentally determined mutant protein structures, but the orientations and geometries of amino acid side chains were slightly different. The olfactomedin-like domain of the modeled missense variant protein structures showed fewer folding changes than the nonsense variant when compared to the predicted wild-type protein structure. Differences were also observed in molecular dynamics and ligand binding sites between the AlphaFold2-modeled and experimentally determined structures as well as between the wild-type and variant structures. In summary, the folding of the AlphaFold2-modeled MYOC variant protein structures could be similar to that determined by the experiments but with differences in amino acid side chain orientations and geometries. Careful comparisons with experimentally determined structures are needed before the applications of the in silico modeled variant protein structures. [ABSTRACT FROM AUTHOR]

Purpose: To delineate the seasonality of acute primary angle‐closure (APAC) admission in a coastal city of southern China and its association with climatic factors. Methods: A total of 1155 Chinese subjects with principal diagnosis of APAC attack were recruited from 2012 to 2016, and their medical records were retrieved. Monthly climatic factors were obtained from the Meteorological Bureau of Shantou. Monthly and seasonal APAC admissions were compared, and its correlation with climatic factors was evaluated. Results: APAC admission was higher in female subjects (75.9%) with an overall mean age of 64.7 ± 9.3 years. APAC admission was highest in summer with the peak onset in June. The peak of APAC admission for female subjects aged ≤ 65 years was in June, and that for> 65 years was in July. The peak of APAC admission for male subjects aged > 65 years was in August. Precipitation was positively correlated with APAC admission rate for both aged ≤ 65 (β = 0.415, p = 0.001) and > 65 years old (β = 0.364, p = 0.004) female subjects. In contrast, surface temperature was positively correlated with APAC admission rate for male subjects aged > 65 years (β = 0.441, p < 0.001). No climatic factor was correlated with APAC admission rate for male subjects ≤ 65 years. Conclusions: This study revealed the peak season of APAC admission in summer, and surface temperature and precipitation are the associated factors. Close monitoring of climate changes could help to reduce the incidence of APAC attack. [ABSTRACT FROM AUTHOR]

Abstract Background To date, studies on the role played by cigarette smoking in primary open-angle glaucoma (POAG) remains controversial. The current study evaluated cigarette smoking as a risk factor of POAG and its relationships with vertical cup-to-disc ratio (VCDR), central corneal thickness (CCT) and intraocular pressure (IOP) in a Chinese cohort. Methods In a total of 248 unrelated individuals including 30 juvenile-onset POAG (JOAG), 92 adult-onset POAG (AOAG) and 126 sex-matched senile cataract controls, underwent comprehensive ophthalmic examination. Their smoking was obtained and documented by questionnaire. Association of cigarette smoking with POAG was performed using logistic regression controlled for age and sex. Effects of cigarette smoking on VCDR, IOP and CCT were analyzed with multiple linear regression. Results In either JOAG or AOAG, no association of cigarette smoking was found with disease onset (P = 0.692 and 0.925 respectively). In controls and JOAG, no significant effects of smoking were found on VCDR, IOP or CCT (all P > 0.05). Smoking was found to be correlated with decreased CCT in AOAG and combined POAG (JOAG + AOAG) (P = 0.009 and 0.003), but no association with VCDR or IOP was observed (P > 0.05). Conclusions Although cigarette smoking was not found to be risk factor for onset of POAG, it was correlated with CCT in AOAG, and thus might still play a role in the disease course, especially for AOAG.

Background: Primary chronic angle-closure glaucoma (PCACG) is one of the main types of glaucoma in China. Trabeculectomy is the most commonly used glaucoma filtration surgery for glaucoma in the world. Conventional trabeculectomy is prone to anesthesia-related complications intraoperative and operation-related complications postoperative in PCACG treatment. Modified minimally invasive trabeculectomy maybe can reduce the incidence of complications., Methods: We conducted a prospective case series study and performed modified fornix-based trabeculectomy in 27 patients (30 eyes) under topical anesthesia; we then observed intraoperative anesthesia and cooperation effect, intraoperative and postoperative complications, preoperative and postoperative visual acuity, intraocular pressure (IOP), visual field, and the use of ocular hypotensive drugs. The patients were followed up for at least 12 months., Results: All operations were completed successfully with no intraoperative complications. All 27 patients (30 eyes) were followed up for at least 12 months. No significant decrease in visual acuity was observed at days 1 or 7 and at months 1, 3, 6, and 12 after operation; however, a significant decrease in IOP was observed at days 1 and 7 and at months 1, 3, 6, and 12 after operation. Moreover, no significant progression in visual field mean defect was observed at month 12 after operation, and the number of ocular hypotensive drugs required was significantly reduced at months 6 and 12 after operation. By month 12 after operation, the overall success rate was 93.33% (28/30)., Conclusions: Modified minimally invasive trabeculectomy is safe and effective for the treatment of PCACG.

Purpose: To investigate the efficacy of a soft bandage contact lens in the management of early bleb leak following trabeculectomy., Methods: Between October 2011 and April 2013, 11 patients with early bleb leak following fornix-based trabeculectomy were instructed to wear a soft bandage contact lens 14 mm in diameter continuously for 1-2 weeks. The daily visual acuity, intraocular pressure (IOP), anterior chamber situation, and healing condition were measured at 1, 3, and 7 d, after con tact lens removal, and 3 months after trabeculectomy. The conditions of blebs, sensation of wearing contact lens, and adverse events were recorded., Results: Bleb leaks were observed at 2-8 d after surgery, (4.09 ± 1.10 d on average). The daily LogMAR visual acuity did not significantly differ before and after contact lens wear (P > 0.05). The IOP was significantly raised after at 1, 3, and 7 d after lens wear (all P < 0.05).The IOP at 3 months after lens wear did not significantly differ from that measured at lens removal (t = 1.191, P = 0.089). At 1 d after lens wear, 6 cases had deeper anterior chambers. All patients presented with a significantly deepened anterior chamber at 3 d after lens wear, and were restored to the preoperative conditions. The bleb leakage was successfully treated at 7 d after lens removal in 10 patients, while 1 patient had to wear the contact lens for another 7 d for full healing of the bleb leak. No ocular infection was noted throughout the management., Conclusion: A soft bandage contact lens of 14 mm diameter is a safe and efficacious therapy for an early bleb leak following fornix-based trabeculectomy.

Purpose: To examine whether adeno-associated virus (AAV) vector-mediated overexpression of growth-associated protein-43 (GAP-43) has protective or deleterious effects on retinal ganglion cell (RGC) survival in laser-induced chronic intraocular pressure (IOP) elevation injury., Methods: Adult Fischer 344 rats received unilateral intravitreal injection of either normal saline, AAV-green fluorescent protein (AAV-GFP), or a bicistronic AAV vector encoding GAP-43 and GFP (AAV-GAP-43). Two weeks later, experimental chronic glaucoma was induced in the injected eyes by scarring the trabecular meshwork with a diode laser. IOP was measured with an impact (rebound) tonometer. Survival of RGCs was estimated after 3 weeks of IOP elevation by quantifying β-III tubulin⁺ neurons in retinal whole mounts. The transfection efficiency of target genes was assessed with direct view of GFP and western blot analysis of GAP-43., Results: Quantification of β-III tubulin⁺ immunostaining revealed that, compared to uninjured eyes (1,172±80 cells/mm²), 3 weeks of laser-induced IOP elevation led to a 60% decline in RGC survival (496±136 cells/mm²). Transfection with control vector AAV-GFP by itself did not have a significant effect on RGC viability (468±124 cells/mm²). Overexpression of GAP-43 in RGC cell bodies and axons via bicistronic AAV-GAP-43 led to more severe RGC death (260±112 cells/mm²) in IOP elevated eyes, an 80% loss of the total RGC population., Conclusions: Overexpression of GAP-43 aggravated RGC death in experimental chronic IOP elevation injury. GAP-43 was upregulated in RGCs regenerating after optic nerve injury. Thus, the finding that this same protein is deleterious to RGC viability after chronic IOP elevation may aid in understanding the mechanisms involved in RGC loss in glaucoma and how best to treat this condition.

Purpose: Genome-wide association studies have shown association of the atonal homolog 7 (ATOH7) and raftlin lipid raft linker 1 (RFTN1) genes with glaucoma-related optic disc parameters. ATOH7 and RFTN1 sequence variations were investigated in patients with primary open-angle glaucoma (POAG) and their relationships with vertical cup-to-disc ratio (VCDR) and central corneal thickness (CCT) were determined., Methods: In 289 unrelated controls and 142 patients with adult-onset POAG, including 117 with high-tension glaucoma (HTG) and 25 with normal-tension glaucoma (NTG), the single exon of ATOH7 was sequenced by direct sequencing. Additional single-nucleotide polymorphisms (SNP) at upstream ATOH7 (rs1900004 and rs3858145) and an RFTN1 SNP (rs690037) were genotyped. Quantitative trait and disease associations were analyzed by linear and logistic regression respectively, controlling for sex and age., Results: ATOH7 rs61854782 was associated with VCDR (P = 0.004) in controls and RFTN1 rs690037 was associated with CCT in combined POAG (HTG+NTG; P = 0.026). No coding mutation was detected in POAG, and no SNP was associated with POAG (P between 0.441 and 0.996). However, ATOH7 rs3858145 showed significant interaction with RFTN1 rs690037 in NTG and combined POAG (P = 0.026 and 0.013 respectively). ATOH7 rs3858145 GG combined with RFTN1 rs690037 TT conferred risk for glaucoma in HTG, NTG, and combined POAG (odds ratio = 2.11, 8.44, and 2.69, respectively)., Conclusions: Coding mutations of ATOH7 were unlikely to be involved in POAG. But combination of ATOH7 and RFTN1 SNPs increased risk to POAG, indicating their diversified effects in the complex genetics of glaucoma.

Purpose: To identify a disease-causing paired box 6 (PAX6) gene mutation in a Chinese family affected by autosomal dominant congenital aniridia., Methods: All participants in the study, including the aniridia family and 100 unrelated senile cataract controls, received a comprehensive ophthalmic examination. Genomic DNA was extracted from their whole blood. Mutation screen in all exons and their adjacent splicing junctions of PAX6 was performed by direct sequencing of polymerase chain reaction (PCR) products. PCR products of heterozygous mutation were further cloned into T-vectors and confirmed by sequencing. Multiple alignments were performed using ClustalX to compare PAX6 protein sequences among vertebrates. MicroRNA binding sites were predicted by TargetScan., Results: A novel heterozygous PAX6 deletion c.1251&#95;1353del103 (p.Pro418Serfs*87) affecting exon 14 and the 3'-untranslated-region (3'-UTR) was identified in the congenital aniridia family. The mutation was exclusively observed in all affected family members but not in any unaffected family member or unrelated control. Bioinformatics analysis showed that the deletion led to remarkable changes of the PAX6 protein, including a frameshift, changes of protein sequence, and a COOH-terminal extension. Multiple alignments showed that the affected region of PAX6 shared high sequence identity (100%) among its vertebrate orthologs. The COOH-terminal extension might also affect microRNA binding sites in the 3'-UTR as predicted by TargetScan., Conclusions: In the current study we reported a novel PAX6 deletion resulting in an abnormal PAX6 COOH-terminal extension in the Chinese family affected by aniridia. Our findings thus add to the mutation spectrum of PAX6.