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AIM: To analyze a series of antimicrobial peptides (AMPs) in corneal tissue from individuals with fungal keratitis (FK) during the active phase of the fungus infection and after healing. METHODS: Patients undergone lamellar keratoplasty for the treatment of severe FK or corneal scar had their corneal buttons sampled. Quantitative real-time polymerase chain reaction (PCR) was used to ascertain the gene expression of human beta-defensin (HBD)-1, -2, -3, -9, S100A7, 8, 9, and LL-37. RESULTS: All AMPs' messenger ribonucleic acid (mRNA) expression was considerably elevated in all samples (n=12). In contrast to controls, where HBD-2, -3, and S100A7 mRNAs were expressed at very low levels, it was discovered that HBD-1, -9, S100A8, S100A9, and LL-37 were constitutively expressed in all healed samples (n=4). HBD-1, -2 -3, S100A7, and LL-37 mRNAs were significantly increased in all active FK samples (n=8). The levels of HBD-9, S100A8, and S100A9 mRNAs were moderately upregulated in all active FK samples. Subgroup comparison showed that HBD-2 was significantly increased in Fusarium keratitis samples (n=5), and LL-37 mRNAs were significantly enhanced in Aspergillus keratitis samples (n=3). Whereas there was not significantly increased of HBD-1, -3, -9, S100A7, 8, 9 mRNA in Aspergillus keratitis samples compared with Fusarium keratitis samples. CONCLUSION: AMPs expression is increased in active FK, but not all AMPs are equally expressed. HBD-2 and LL-37 expression levels are the highest, showing some specificity of AMP expression related to FK. Human AMPs, particularly HBD-2 may play a significant role in Fusarium keratitis and LL-37 might be the key player in Aspergillus keratitis.

AIM: To investigate whether the two-step strategy [conjunctival flap covering surgery (CFCS) combined with secondary deep anterior lamellar keratoplasty (DALK)] is effective for patients with high-risk fungal keratitis (FK). METHODS: In this noncomparative, retrospective case series, 10 subjects (6 males, 4 females) with a mean age of 56.5±7.1 (range 47-72)y with high-risk FK undergone the two-step strategy were included. Reported outcome measures were healing of the corneal ulcer, recurrence of FK, reject reaction, improvement in best corrected visual acuity (BCVA) and relevant complications. RESULTS: The average diameter of corneal infiltrates was 7.50±0.39 mm, ranging from 6.94 to 8.13 mm. The mean depth of corneal infiltrates was 422.4±77.1 μm, ranging from 350 to 535 μm. The mean corneal thickness was 597.4±117.3 μm, ranging from 458 to 851 μm. Hypopyon and endothelial plaques were presented in all patients. The period between the two steps was 3.65±0.9 (ranging from 3 to 5)mo. The graft diameter was 7.75±0.39 mm. At the last follow-up (average 9.25±3.39, ranging from 5.5 to 17mo), no fungal recurrence or graft rejection appeared, and all patients showed improvement of BCVA. One patient suffered from liver function impairment due to oral voriconazole for 4wk and recovered spontaneously after 1wk of drug withdrawal. CONCLUSION: The two-step strategy is safe and effective in the treatment of high-risk FK by transforming intentional therapeutic penetrating keratoplasty during acute infection to later optical DALK. It is a practical strategy, especially in areas lacking fresh donor corneas and eye bank services.

Purpose: To investigate the efficiency of amniotic membrane transplantation (AMT) combined with conjunctival flap covering surgery (CFCS) for patients with corneal perforations in fungal keratitis (FK). Methods: In this non-comparative, retrospective case series, 16 participants of corneal perforation in FK were successfully treated by a combination of multilayer AMT and bipedicle conjunctival flap with partial tenon's capsule. Corneal healing, recurrence of FK, visual acuity, and relevant complications were reported as outcome measures. Results: Sixteen patients (13 male, 3 female) had a mean age of 58.8 ± 10.3 (range 29–72) years. The mean diameter of corneal perforation was 1.9 ± 0.7 (range 0.5–2.8) mm. Corneal perforations healed and all the patients preserved their eyeballs. During the 11.0 ± 4.4 (range 6–18) months of follow-up, there was no recurrence of FK in any of these cases. Visual acuity improved in 15 eyes (93.8 %) and remained unchanged in 1 patient (6.3 %) who had no light perception when first admitted. All 6 patients who accepted secondary keratoplasty showed improved best corrected visual acuity of more than 4 lines. The most frequently found fungi were Aspergillus species (6 of 16, 37.5 %) and Fusarium species (4 of 16, 25.0 %), followed by 1 Scedosporium apiospermum (1 of 16, 6.3 %). Conclusions: Combination AMT with CFCS is a safe and effective surgery for patients with corneal perforations in FK, particularly where eye banks and fresh corneas are not available. This surgery could preserve the integrity of the eyeball and avoid the recurrence of FK. Besides, it provides a greater opportunity for further optical keratoplasty.

Meibomian gland dysfunction (MGD) is a functional and morphological disorder of the meibomian glands which results in qualitative or quantitative alteration in meibum secretion and is the major cause of evaporative dry eye (EDE). EDE is often characterized by tear film instability, increased evaporation, hyperosmolarity, inflammation, and ocular surface disorder. The precise pathogenesis of MGD remains elusive. It has been widely considered that MGD develops as a result of ductal epithelial hyperkeratinization, which obstructs the meibomian orifice, halts meibum secretion, and causes secondary acinar atrophy and gland dropout. Abnormal self-renewal and differentiation of the acinar cells also play a significant role in MGD. This review summarizes the latest research findings regarding the possible pathogenesis of MGD and provides further treatment strategies for MGD-EDE patients.

Purpose: To investigate the characteristics of in vitro culture and in vivo confocal microscopy (IVCM) in patients with fungal keratitis (FK) presented in a tertiary referral hospital in central China. Methods: In this noncomparative retrospective study, patients with the diagnosis of FK between October 2021 and November 2022 were reviewed. An IVCM and fungal culture (corneal scraping specimens) were performed, and the characteristics were analyzed. Results: During October 2021 and November 2022, 85 patients were diagnosed with FK. From 63 culture-positive cases, 8 species of fungus were identified. The proportions of isolated fungal species were Fusarium and Aspergillus equally accounting for 33.3% (21 of 63), Alternaria 9.5% (6 of 63), Curvularia 6.3% (4 of 63), Scedosporium apiospermum 6.3% (4 of 63), Paecilomyces lilacinus 3.2% (2 of 63), Exserohilum 3.2% (2 of 63), and Candida 4.8% (3 of 63), respectively. In positive culture cases, IVCM was found to be positive for hyphae or spores in 61 of 63 patients (96.8%). Different fungal species had a variety of cultural characteristics and IVCM manifestations. Conclusions: In a tertiary referral hospital in central China, Fusarium species, Aspergillus species, and Alternaria species were the 3 most common isolated fungal pathogens, and the proportion of Aspergillus species was significantly higher than that in other regions of China. Careful lesion depth examination by IVCM and OCT should be taken before lamellar keratoplasty to avoid postoperative recurrence. Identifying the IVCM image and culture characteristics will facilitate rapid diagnosis and proper treatment, but IVCM cannot yet replace fungal cultures to distinguish between different fungal species.

Aluminum alloys are lightweight materials widely used in the automobile industry because of their high specific strength. As the aluminum alloy with the highest strength at room temperature, 7075 aluminum alloy has great potential for usage in the manufacturing of structural parts. However, its formability at room temperature is poor and its springback is large. Although both good formability and high strength in aluminum alloys can be realized by hot forming, 7075 aluminum alloy has high susceptibility to adhesive wear, which means its tribological properties are poor during hot forming. Exploration of the influence of process parameters on the friction behavior and wear mechanism of 7075 aluminum alloy has great significance for the numerical simulation of the hot-stamping process and lubrication engineering. The high-temperature friction process of 7075 aluminum alloy during the actual hot forming–quenching integrated process was simulated by a self-made high-temperature strip friction tester. The upper and lower friction components were cooled and heated, respectively, to simulate the cooling and heating of the die (blank holder) in the actual hot-stamping process. The effects of the preheating temperature of the lower die, normal load, and sliding speed on the friction behavior and wear mechanism of 7075 aluminum alloy were analyzed. The results show that the friction coefficient of aluminum alloy increases with increase in the preheating temperature, and the wear mechanism changes from adhesive wear at 300 °C to adhesive, abrasive, and oxidative wear at 500 °C. The larger the normal load applied, the larger is the friction coefficient. The wear mechanism under different loads was determined to be adhesive wear with slight abrasive wear, with the degree of adhesive wear increasing with the increase in load. A high sliding speed leads to the formation of local oxides on the surface, which makes the friction coefficient decrease with an increase in the sliding speed. The main wear mechanisms are oxidative, abrasive, and adhesive wear when the sliding speed is 30 mm·s−1.

AIM: To evaluate the retinal nerve fiber layer (RNFL) thickness changes in patients with obstructive sleep apnoea syndrome (OSAS), and detect possible prevalence of glaucoma in this population. METHODS: Comprehensive studies were conducted on the Cochrane Library, PubMed and Embase through March, 2015. Only studies that fit the selection criteria about RNFL and OSAS would be included. For the measures, we calculated the 95% confidence interval (CI) and weighted mean differences (WMD). The systematic review and Meta-analysis was performed by RevMan 5.2 software. RESULTS: Nine case-control studies were analyzed containing a total of 1086 cases and 580 controls. Average RNFL thickness in OSAS was reduced significantly compared with healthy controls in random effects model (WMD=-2.56, 95% CI: -4.82 to -0.31, P =0.003, I² =57%). A significant RNFL thickness reduction were found between the two groups in inferior quadrant (WMD=-3.11, 95% CI: -5.53 to -0.69, P=0.01), superior quadrant (WMD=-2.37, 95%CI: -4.7 to 0.04, P =0.05). In nasal quadrant (WMD=-2.54, 95% CI: -6.53 to 1.45, P =0.21) and temporal quadrant (WMD=-1.26, 95% CI: -2.19 to 0.47, P =0.15) there was no difference of RNFL thickness between the two groups. CONCLUSION: The results show that RNFL thickness is lower in patients with moderate or severe OSAS than in normal subjects or patients with mild OSAS according to the nine homogeneity studies.

To evaluate the outcome of amniotic membrane transplantation (AMT) after tumor excision followed by topical interferon alfa-2b (IFNα2b) drops for primary ocular surface squamous neoplasia (OSSN). Twelve eyes of 12 patients with a mean age of 66±10y were included. The average follow-up was 23±10mo. All 12 patients had limbal involvement. Smooth ocular surface and transparent cornea were achieved in all cases. No sign of inflammation, neovascularization, symblepharon or recurrence was noted at the last follow-up. We conclude that AMT with topical IFNα2b drops restores a healthy ocular surface in OSSN without recurrence.

Purpose. To ex vivo expand oral mucosal epithelium cells (OMECs) on acellular porcine corneal stroma (APCS) without using feeder cells and serum and to compare the morphologic and phenotypic characteristics of cultured oral cells on APCS to those of cells on deluded human amniotic membrane (HAM). Methods. SD rat oral mucosal biopsies were cultured on APCS and HAM. Reverse-transcription polymerase chain reaction (RT-PCR) and immunohistochemistry were used to analyze the characterization of stem cells and epithelial differentiation of the outgrowth products. Results. Stratified and optimal transplantable OMECs were obtained after being cultured three to four weeks. Both RT-PCR and immunohistochemistry showed that cultured OMECs expressed markers of epithelial differentiation cytokeratin K3 and epithelial stem cell markers of p63 and ABCG2. Conclusions. OMECs can be successfully cultured on APCS without using xenobiotic feeder cells and serum. Characterization showed that these sheets retain the morphologic and phenotypic characteristics of OMECs within differentiated cells and stem cells. The optimal transplantable sheets can prove to be particularly beneficial to both bilateral limbal stem cell deficiency and deep corneal lesions.

Objective: To grasp the endemic situation of schistosomiasis in Jingzhou City in 2017, so as to provide the evidence for formulating prevention strategies., Methods: According to the requirements of National Schistosomiasis Surveillance Program ( 2014 ), Hubei Schistosomiasis Surveillance Program ( 2015 ) and Jingzhou Schistosomiasis Surveillance Program , the local population infection monitoring, mobile population infection monitoring, livestock disease monitoring, snail monitoring, and wild manure monitoring were carried out at 71 monitoring sites throughout the city., Results: Among the 71 surveillance sites, 44 118 local residents received the indirect hemagglutination test (IHA) for schistosomiasis and 1 925 persons were positive, with the positive rate of 4.36%, However, no stool examination positive cases were found. Totally 2 175 mobile people received the IHA for schistosomiasis and 93 persons were positive, with the positive rate of 4.28%, but no stool examination positive cases were found. A total of 1 937 head of cattle received the stool examination for schistosome infection, but no positives were found. Totally 1 302 Oncomelania hupensis habitats were found in 69 surveillance sites, with 1 923.64 hm 2 area with snails. Totally 348 756 frames were surveyed, and the occurrence rate of snails was 17.19%. A total of 142 494 living snails were captured, with the average density of 0.41 snail/0.1 m 2 . No schistosome-infected snails were found. Totally 596 cases of wild manure were picked up in 41 environments with snails among 23 surveillance sites, but schistosome infested wild manure was not found., Conclusions: In 2017, the level of schistosomiasis epidemic was very low in Jingzhou City. However, the risk of epidemic rebound still exists, and therefore, it is necessary to strengthen the monitoring work to further consolidate the achievements of schistosomiasis control.

Objective: To investigate the effects and cost of four formulations of niclosamide ethanolamine salt in Oncomelania hupensis snail control in the field in marshland and lake regions, so as to provide the evidence for drawing up the plan of molluscicide using in schistosomiasis endemic areas., Methods: One drainage channel and one channel without water in the same area with snails in Jiangling County, Jingzhou City were selected as the research fields. The drainage channel was divided into 9 sections, except one section as a blank control group where the natural death rate of snails was observed only, and the remaining 8 sections were taken as the observation groups, where different dosages of 4% niclosamide ethanolamine salt powder, 5% niclosamide ethanolamine salt granules, 25% niclosamide ethanolamine salt suspending agent, 26% metaldehyde and niclosamide ethanolamine salt suspending agent, and 50% niclosamide ethanolamine salt wettable powder were used respectively. The channel without water were divided into 4 sections, except one section as a blank control group, the other 3 segments were taken as the observation groups, where 4% niclosamide ethanolamine salt powder, 5% niclosamide ethanolamine salt granules, and 50% niclosamide ethanolamine salt wettable powder were used respectively. Before and after spraying molluscicide for 7 days and 15 days, the system sampling method was used to observe the effects of snail control. Meanwhile, the unit cost method was used to calculate the costs of the different mulluscicide formulations abovementioned in unit area (1 m 2 )., Results: In the field at the drainage channel, the snail mortality rates of the groups spraying 4% niclosamide ethanolamine salt powder (50 g/m 2 ), 5% niclosamide ethanolamine salt granules (40 g/m 2 ), 25% niclosamide ethanolamine suspending agent, 26% metaldehyde and niclosamide ethanolamine salt suspending agent, and 50% niclosamide ethanolamine salt wettable powder (2 g/m 2 and 4 g/m 2 ) for 7 days were 79.52%97.87%, while the rates after spraying for 15 days were 71.00%-96.30%, and compared with those before spraying, the differences were statistically significant (all P < 0.01). For the groups spraying with 2 g/m 2 or 4 g/m 2 suspending agent as well as wettable powder for 7 days, the snail mortality rates were significantly different (both P < 0.05). In the field at the channel without water, the snail mortality rates of the 3 observation groups after spraying molluscicide for 7 days were 97.14%-100%, while for 15 days were 94.32 %-100%, and compared with the rates before spraying, all the differences were statistically significant (all P < 0.01). The unit costs per 1 m 2 of the molluscicide abovementioned were ranged from 0.280 Yuan to 0.416 Yuan., Conclusions: In marshland area inside embankment, the molluscicide formulations of the powder and granule are suitable for the environments without water or with instability water level, while the molluscicide formulations of the suspended agents and wettable powder are suitable for the water environment. Though the unit cost of powder is the lowest, the molluscicide in this formulation flies away seriously.

Objective: To observe the Oncomelania hupensis snail control effects of molluscicides with different formulations in the ditch with unstable water level in field of marshland and lake areas, so as to provide the evidence for formulating the prevention strategies., Methods: A drainage channel with O. hupensis snails in Jiangling County, Jingzhou City were selected as the study field, then it was divided into 6 segments, except 1 segment was treated as the blank control group for observing the natural mortality rate of the snails, the other 5 segments were treated as observation groups, where 4% niclosamide ethanolamine salt powder, 5% niclosamide ethanolamine salt granule, 25% suspension concentrate of niclosamide ethanolamine salt, 26% suspension concentrate of metaldehyde and niclosamide ethanolamine salt, 50% niclosamide ethanolamine salt wettable powder were applied respectively. Before and after the mollusciciding, the snail surveys were carried out through the systematic sampling method, and the short- and long-term effects of snail control were observed, and the mortality rates of the snails on the slope above the water level and those below the water level were compared., Results: When 7 d and 15 d after mullusciciding, the mortality rates of snails on the slope above the water level in each observation group were 79.52%-97.87% and 90.43%-96.30%, respectively, when compared with those before mollusciciding, all the differences were statistically significant (all P < 0.01). When 7 d after mullusciciding, the mortality rates of snails below the water level in each observation group were 17.11%-50.00%, which were all lower than those of the snails on the slope above the water level in the corresponding groups (all P ＜ 0.05); when 15 d after mullusciciding, the rates were 9.43%-95.24%, and those in 25% suspension concentrate of niclosamide ethanolamine salt, 26% suspension concentrate of metaldehyde and niclosamide ethanolamine salt, 50% niclosamide ethanolamine salt wettable powder groups were all lower than those of the snails on the slope above the water level in the corresponding groups (all P ＜ 0.01). Compared with the densities of living snails before mollusciciding, those 6 months after mollusciciding in each observation group decreased by 70.21%-78.98%., Conclusions: The molluscicides in the formulation of powders and granule are suitable for both the snail environment with or without water, while those in the formulation of suspension agents and wettable powders are suitable only for environments with water.

Objective: To evaluate the effect of the clinical nursing path integrated with the holistic nursing on advanced schistosomiasis patients with ascites., Methods: A total of 226 advanced schistosomiasis patients with ascites were randomly divided into a control group and an experimental group (113 cases each group). The subjects in the experimental group were nursed by the clinical nursing path integrated with the holistic nursing, while those in the control group were nursed only by the holistic nursing. Then the clinical relevant indexes of the two groups were observed, and the quality of life of the patients before and after hospital discharge was assessed., Results: The improvement rate, satisfaction degree, and awareness rate of health knowledge of the patients in the experiment group were 93.8%, 100% and 97.4%, respectively, which were significantly higher than those of the control group (all P < 0.05). The mortality rate and the complication rate of the patients in the experimental group were 0 and 2.7%, respectively, which were significantly lower than those of the control group (both P < 0.05). In addition, the average hospitalization days and the hospitalization cost of the experiment group were (12.2 ± 0.7) d and (4 725.0 ± 310.1) Yuan respectively, which were less than those of the control group (both P < 0.01). When 6 months after the discharge from hospital, the quality of life of the patients in the experimental group in various fields was significantly better than that of the control group (all P < 0.05)., Conclusions: The clinical nursing pathway integrated with holistic nursing can effectively improve the improvement rate and decrease the mortality of the advanced schistosomiasis patients with ascites; meanwhile, it can shorten the hospitalization time and save the hospitalization cost. Therefore, this nursing model is suitable for popularization and application in the treatment and nursing work of the advanced schistosomiasis assistance.

Objective: To analyze the change of endemic situation of schistosomiasis in Jingzhou City of Hubei Province, so as to provide evidence for the development of future control strategy., Methods: The data of endemic situation of schistosomiasis and the implementation of integrated control measures were collected and analyzed in the 9 counties (districts, cities) of Jing-zhou City from 2004 to 2014., Results: The endemic situation of schistosomiasis appeared a decline year by year since 2004. The prevalence of human Schistosoma japonicum infection was 0.40% in 2014, which was reduced by 95.72% as compared to that in 2004, and the fitting exponential equation was y = 11.067e -0.240 x . The incidence of acute schistosomiasis reduced to less than 0.5 per 100 000 in 2007. No acute infection was found since 2010, and no emergency epidemics occurred for successive 9 years. It was estimated that there were currently 22 547 people infected with S. japonicum , which reduced by 85.87% in relative to 2004. The prevalence of cattle S. japonicum infection reduced to 0 in 2014, with a 100% reduction as compared to that in 2004, and the fitting exponential equation was y = 15.69e -0.339 8 x . The actual Oncomelania hupensis snail area was 31 084.00 hm 2 , which reduced of 1931.21 hm 2 as compared to that in 2004, with a 5.91% reduction, and no schistosome-infected snails were found since 2012. Both human and animal schistosome infections reduced to less than 1% in all administrative villages in 2013., Conclusions: The implementation of the key schistosomiasis program and whole-county promotion and province-ministry joint integrated control program results in effective control of schistosomiasis in Jingzhou City. However, further control programs are required to consolidate the achievements, interrupt and eliminate schistosomiasis.

Objective: To evaluate the schistosomiasis control effect of county promotion and comprehensive control interventions in Jingzhou City., Methods: The data of schistosomiasis endemic situation of 9 counties (cities, districts) in Jingzhou City from 2006 to 2010 were collected by a retrospective survey method, and the schistosome infection situation of residents and cattle were selectively examined in November, 2010., Results: The endemic situation in Jingzhou City from 2006 to 2010 presented a decline tendency. Compared to the infection rate of residents in 2006 (5.15%), that in 2010(2.22%) decreased by 56.89%, and no acute schistosomiasis cases were found. No sudden epidemic happened in the consecutive 5 years. The infection rate of cattle dropped from 8.04% in 2006 to 1.87% in 2010, with a reduction rate of 81.72%. The snail area and area with infected snails in 2010 were 31 070.61 hm2 and 321.70 hm2, respectively, with reduction rates of 3.68% and 71.20%, respectively, compared to those in 2006. Compared to 2006, the snail density and infection rate of snails in 2010 decreased by 63.76% and 64.74%, respectively., Conclusions: After the implementation of the project with county promotion and comprehensive control interventions in Jingzhou City, the schistosomiasis control work has obtained obvious achievement, and the endemic situation has been controlled effectively.