Search

Abstract Objective To investigate indications and surgical procedures of keratoplasty in a tertiary comprehensive hospital in northern part of China over a 20-year period. Methods All patients undergoing keratoplasty between January 1, 2002 to December 31, 2021 in a tertiary comprehensive hospital in northern part of China were retrospectively reviewed. The annual proportion of keratoplasty indications and surgical procedures was recorded and analyzed. Results A total of 8266 keratoplasty procedures were included. Leading indications were keratoleukoma (n = 2108, 25.50%), followed by regraft (n = 1453 ,17.58%), corneal endothelial dysfunction (n = 1085, 13.13%), and keratoconus (n = 922,11.15%). A decreasing trend was observed for keratoleukoma (P

Abstract To report the correlation between corneal biomechanical parameters and age in healthy Chinese individuals. This cross-sectional study was conducted on 864 eyes of 543 healthy participants. A comprehensive ophthalmic examination and corneal biomechanics examination using Corneal Visualization Scheimpflug Technology (Corvis ST) were conducted. Based on age, all participants were further divided into five age groups (n) as follows: group A, 11–20 years (105); group B, 21–30 years (112); group C, 31–40 years (113); group D, 41–50 years (100); and group E, > 50 years (113). Using Corvis ST, we examined 35 corneal biomechanical parameters and compared them across the different age groups. Spearman’s correlation coefficients and stepwise multivariate linear regression models were used to investigate whether the corneal biomechanical parameters were related to demographic and ocular characteristics. A correlation analysis between the left and right eyes revealed that 13 parameters were significantly associated with eye differences. Among the 35 corneal biomechanical parameters, 28 exhibited significant differences across the age groups, with stiffness parameter at applanation 1(SPA1) showing an upward trend after the age of 30 and stress–strain index (SSI) demonstrates a statistically significant upward trend when comparing the five age groups in the study. Additionally, Spearman’s correlation analysis and stepwise multivariate linear regression analysis revealed that 11 corneal biomechanical parameters were positively correlated with age and 10 were negatively correlated with age. Corvis biomechanical index (CBI) was significantly negatively correlated with intraocular pressure (IOP) and central corneal thickness (CCT), SSI was significantly positively correlated with age and IOP, and SPA1 were positively correlated with IOP and CCT. In conclusion, most corneal biomechanical parameters showed a significant correlation with age, with corneal stiffness progressively increasing alongside advancing age, IOP, or CCT.

Abstract Aiming at the problem that an Interior Permanent Magnet Synchronous Motor (IPMSM) cannot be smoothly started in zero-low speed range and smoothly transitioned to medium-high speed range by a single observer. This paper proposes a full-speed range control algorithm based on the fusion of pulsating high-frequency injection and back electromotive force (EMF) position error information. In the low-speed range or at start-up, a square-wave high-frequency signal is injected, and the obtained high-frequency current signal is processed to obtain the rotor position error information. The phase shift due to the introduction of a filter is reduced, which improves the control bandwidth and reduces the noise. To ensure smooth switching of the observer, the observer uses a dual second-order generalized integrator module to output the angular frequency in the low-speed range. A higher-order sliding mode observer based on an inverse EMF model obtains rotor position error information at high speeds. During switching, the rotor position information is processed by a fusion strategy, and the obtained hybrid information is fed into the system to improve the stability of the motor operation. A 0.2 kW IPMSM position sensorless vector control system verifies the algorithm’s accuracy.

AIM: To investigate the clinical features of the ocular surface in patients with different degrees of myopia. METHODS: A cross-sectional study was conducted involving 122 participants with myopia in Beijing Tongren Hospital from February to June, 2023. After completing the Ocular Surface Disease Index (OSDI) score scale, measurements were taken for refraction, biometric parameters and ocular surface parameters. The prevalence, severity and related parameters of the dry eye among different groups based on axial length (AL) were compared. Correlation analysis was performed between ocular surface parameters and refraction/biometric measurement parameters. RESULTS: Statistically significant differences were observed in refractive error, corneal thickness, anterior chamber depth, and subfoveal choroidal thickness among the groups (all P

In the era of transcriptomics, the role of epigenetics in the study of cancers in females has gained increasing recognition. This article explores the impact of epigenetic modifications, such as DNA methylation, histone modification, and non-coding RNA, on cancers in females, including breast, cervical, and ovarian cancers (1). Our findings suggest that these epigenetic markers not only influence tumor onset, progression, and metastasis but also present novel targets for therapeutic intervention. Detailed analyses of DNA methylation patterns have revealed aberrant events in cancer cells, particularly promoter region hypermethylation, which may lead to silencing of tumor suppressor genes. Furthermore, we examined the complex roles of histone modifications and long non-coding RNAs in regulating the expression of cancer-related genes, thereby providing a scientific basis for developing targeted epigenetic therapies. Our research emphasizes the importance of understanding the functions and mechanisms of epigenetics in cancers in females to develop effective treatment strategies. Future therapeutic approaches may include drugs targeting specific epigenetic markers, which could not only improve therapeutic outcomes but also enhance patient survival and quality of life. Through these efforts, we aim to offer new perspectives and hope for the prevention, diagnosis, and treatment of cancers in females.

AIM: To evaluate dry eye disease (DED) symptomatology and mental health status in different COVID-19 patients. METHODS: A cross-sectional observational design was used. Totally 123 eligible adults (46.34% of men, age range, 18-59y) with COVID-19 included in the study from August to November, 2022. Ocular Surface Disease Index (OSDI), Five-item Dry Eye Questionnaire (DEQ-5), Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index (PSQI) were used in this study. RESULTS: OSDI scores were 6.82 (1.25, 15.91) in asymptomatic carriers, 7.35 (2.50, 18.38) in mild cases, and 16.67 (4.43, 28.04) in recurrent cases, with 30.00%, 35.56%, and 57.89%, respectively evaluated as having DED symptoms (χ2=7.049, P=0.029). DEQ-5 score varied from 2.00 (0, 6.00) in asymptomatic carriers, 3.00 (0, 8.00) in mild cases, and 8.00 (5.00, 10.00) in recurrent cases, with 27.50%, 33.33%, and 55.26%, respectively assessed as having DED symptoms (χ2=8.532, P=0.014). The prevalence of clinical anxiety (50.00%) and depression (47.37%) symptoms were also significantly higher in patients with recurrent infection (χ2=24.541, P

Abstract Objective The purpose of this article is to systematically review the association between dry eye and sleep quality. Methods PubMed, EMBASE, Cochrane, Web of Science, and grey literature databases were searched for observational studies published before April 2023. Meta-analysis was performed using STAT15 software. Results A total of 21 studies with 419,218 participants were included. The results showed that the dry eye subjects had a worse sleep quality than the healthy population, with poorer subjective sleep quality, longer sleep latency, and a higher risk of unhealthy sleep duration such as insufficient sleep or excessive sleep. The Pittsburgh Sleep Quality Index (PSQI) scores of the dry eye subjects were significantly higher than those of the control subjects (WMD = 1.78, 95%CI: 1.06, 2.50, P

This paper explores the significant role of epigenetics in women’s reproductive health, focusing on the impact of environmental factors. It highlights the crucial link between epigenetic modifications—such as DNA methylation and histones post-translational modifications—and reproductive health issues, including infertility and pregnancy complications. The paper reviews the influence of pollutants like PM2.5, heavy metals, and endocrine disruptors on gene expression through epigenetic mechanisms, emphasizing the need for understanding how dietary, lifestyle choices, and exposure to chemicals affect gene expression and reproductive health. Future research directions include deeper investigation into epigenetics in female reproductive health and leveraging gene editing to mitigate epigenetic changes for improving IVF success rates and managing reproductive disorders.

Purpose: To analyze the influence of dextran solution and corneal collagen crosslinking (CXL) on corneal biomechanical parameters in vitro, evaluated by Corneal Visualization Scheimpflug Technology (Corvis ST). Materials and Methods: Forty porcine eyes were included in this study. Twenty porcine eyes were instilled with dextran solution for 30 min (10 eyes in 2% dextran solution and 10 eyes in 20% dextran solution). CXL treatment was performed in 10 porcine eyes; the other 10 porcine eyes were regarded as the control group. Each eye was fixed on an experimental inflation platform to carry out Corvis measurements at different IOPs. Corneal biomechanical parameters were calculated based on Corvis measurement. Statistical analysis was used to analyze the influence of dextran solution and CXL on corneal biomechanical parameters based on Corvis parameters. Results: The corneal energy-absorbed area (Aabsorbed) decreased after being instilled with dextran solution under IOP of 15 mmHg (p < 0.001); the elastic modulus (E) of the cornea instilled with 20% dextran solution was significantly higher than that instilled with 2% dextran solution (p < 0.001), since it decreased after being instilled with 20% dextran solution (p = 0.030); the stiffness parameter at the first applanation (SP-A1) increased after CXL (p < 0.001). Conclusions: Both dextran solution and CXL can change corneal biomechanical properties; the concentration of dextran solution can influence the corneal biomechanical properties, which may, in turn, affect the effectiveness of CXL. SP-A1 may be used as an effective parameter for the evaluation of CXL.

Aims Non-Suicidal Self-Injury (NSSI) occurs when direct, deliberate harm is caused to one's physical body without intention of suicide. Approximately 22.1% of youth worldwide would engage in NSSI in their lifetimes. Due to the increased risk of harm and future suicide attempts, NSSI is a behaviour that warrants attention and has been identified as a condition in need of further study. While some studies have examined the prevalence and experiences of NSSI in Singapore, there is a lack of detailed studies on the presentation and overall phenomenology of NSSI in the local context. This study aims to assess the characteristics of NSSI using the Non-Suicidal Self-Injury – Assessment Tool (NSSI-AT) in a cross-sectional design. We investigated the functions, characteristics, and personal experiences of local youths who engage in NSSI for the development and improvement of patient-centred care. Methods 121 youths between 12 and 25 years old were recruited from the National University Health System. The study included patients seeking treatment for mood disorders and have self-reported NSSI behaviours such as cutting, hitting, and scratching prior to or at the time of visit. Outcomes for the NSSI–AT, including the actions, functions, frequency, age of onset, initial motivations, severity, practice patterns, disclosure, and treatment experiences of self-harm, were reported using descriptive analysis. Personal reflections were analysed using thematic analysis. Results Participants were mostly female (n = 86, 71.1%) with a mean age of 16.2 years (SD = 2.33). Many participants engaged in NSSI actions such as cutting, scratching, and banging on objects, to manage high-pressure agitating and low-pressure depressive emotional states. Most participants started engaging in NSSI in early adolescence (mean = 13.0 years old, SD = 2.37, range = 7–23) and have hurt themselves more severely than intended (n = 79, 65.3%). When reflecting on overall NSSI experiences, participants had similar levels of ambivalence toward NSSI and growth due to NSSI. Participants also gave encouragement to others going through similar experiences and reported the negative aspects of self-harm. Conclusion Findings support emotional regulation as a function of NSSI in the local population, where self-harm was not generally used for social communication purposes. Findings also suggest that youths may be more vulnerable to NSSI during early adolescence, corresponding to a time of substantial life changes. This study also demonstrated the individuality of NSSI experiences among the local youth, highlighting the importance of having a person-centred approach in NSSI treatment. Taken together, this highlights the need to develop interventions that can effectively serve this age group and their specific challenges.

Abstract Introduction This study explored the behaviours of people living with HIV in Singapore and Hong Kong in terms of achieving and maintaining their physical and psychological wellbeing in relation to HIV, to identify the challenges and support needed in HIV care. Methods This qualitative study involved 90‐minute interviews among Singapore and Hong Kong people living with HIV aged ≥18 years to explore health‐related quality of life perceptions and gaps in patient empowerment in HIV care during February–May 2022. The COM‐B (C: Capability; O: Opportunity; M: Motivation; B: Behaviour) framework was used during data analysis to identify behaviour facilitators and barriers for people living with HIV to achieve and maintain their wellbeing. Detailed accounts of respondents’ experience of living with and managing HIV, that is what worked well, unmet needs and perceived significance of wellbeing indicators, were analysed qualitatively via a combination of inductive content and deductive frameworks. Results A total of 30 and 28 respondents were recruited from Singapore (SG) and Hong Kong (HK), respectively. Most respondents were aged 20−49 years (SG: 83.3%; HK: 64.3%), males (SG: 96.7%; HK: 92.9%), men who have sex with men (SG: 93.3%; HK: 71.4%), had university or higher education (SG: 73.3%; HK: 50.0%) and were fully employed (SG: 73.3%; HK: 57.1%). In both Singapore and Hong Kong, physical health was considered a key focus of overall wellbeing, albeit attention to long‐term health associated with cardiovascular and renal health was less salient. The impact of symptoms, side effects of treatment, mood and sleep were among the top wellbeing indicators of importance. Respondents felt that insufficient information was provided by physicians, citing consultation time and resource constraints impeding further expression of concerns to their physicians during consultation. Respondents prioritized functional wellness and delegated psychosocial health to supportive care professionals, patient groups, families and/or friends. Conclusions There is a need in Singapore and Hong Kong to empower people living with HIV to establish better communications with their physicians and be more involved in their treatment journey and equally prioritize their psychosocial wellbeing.

Among the post-transcriptional modifications, m6A RNA methylation has gained significant research interest due to its critical role in regulating transcriptional expression. This modification affects RNA metabolism in several ways, including processing, nuclear export, translation, and decay, making it one of the most abundant transcriptional modifications and a crucial regulator of gene expression. The dysregulation of m6A RNA methylation-related proteins in many tumors has been shown to lead to the upregulation of oncoprotein expression, tumor initiation, proliferation, cancer cell progression, and metastasis.Although the impact of m6A RNA methylation on cancer cell growth and proliferation has been extensively studied, its role in DNA repair processes, which are crucial to the pathogenesis of various diseases, including cancer, remains unclear. However, recent studies have shown accumulating evidence that m6A RNA methylation significantly affects DNA repair processes and may play a role in cancer drug resistance. Therefore, a comprehensive literature review is necessary to explore the potential biological role of m6A-modified DNA repair processes in human cancer and cancer drug resistance.In conclusion, m6A RNA methylation is a crucial regulator of gene expression and a potential player in cancer development and drug resistance. Its dysregulation in many tumors leads to the upregulation of oncoprotein expression and tumor progression. Furthermore, the impact of m6A RNA methylation on DNA repair processes, although unclear, may play a crucial role in cancer drug resistance. Therefore, further studies are warranted to better understand the potential biological role of m6A-modified DNA repair processes in human cancer and cancer drug resistance.

Abstract Meibomian gland dysfunction (MGD)‐related dry eye disease (DED) is a significant subtype of DED. In this research, we investigate the effectiveness of far infrared (FIR) functional glasses in the treatment of MGD‐related DED. According to the TFO DEWS II diagnostic criteria, 61 eyes with MGD‐related DED were included. All participants wore functional FIR glasses throughout the day for a period of 4 weeks and were followed up three times during the treatment. All subjects were followed up thoroughly in accordance with the DED clinical examination procedure. Ultimately, the treatment's impact was assessed. We found the Visual Analogue Scale and Ocular Surface Disease Index scores after FIR treatment were significantly lower than the baseline values (p

Summary: Background: Dry eye disease has a high prevalence and exerts a significant negative effect on quality of life. In China, there are currently no available nasal sprays to promote natural tear production in patients with dry eye disease. We therefore evaluated the efficacy and safety of OC-01 (varenicline solution) nasal spray versus vehicle in Chinese patients with dry eye disease. Methods: This was a randomized, multicenter, double-masked, vehicle-controlled, phase 3 clinical trial conducted at ophthalmology departments in 20 hospitals across China (NCT05378945). Eligible patients had a diagnosis of dry eye disease based on patient symptoms, Eye Dryness Score (EDS), Schirmer's Test (with topical anesthesia) Score (STS), and corneal fluorescein staining (CFS) score. Participants were randomly assigned 1:1 using an Interactive Web Response System (IWRS) to receive OC-01 0.6 mg/mL twice daily (BID) or vehicle nasal spray. Participants, investigators, and sponsor were all masked to treatment assignment. The primary endpoint was the percentage of subjects in the intention-to-treat population achieving ≥10 mm improvement in STS from baseline at week 4. Findings: In total, 340 patients were randomized from 21 July 2022 to 04 April 2023, 78.8% were female. Patients in the OC-01 group (n = 176) had significantly higher achievement of ≥10 mm improvement in STS (35.8% [n = 63] versus 17.7% [n = 29], stratified odds ratio: 2.67, 95% CI: 1.570–4.533, p = 0.0002) and a significantly greater increase from baseline STS (least-squares mean difference [SE]: 3.87 [0.794], p

Abstract Background To investigate the validation of phenol red thread (PRT) test in a Chinese population by evaluating the intraobserver repeatability and interobserver reproducibility, determining correlations between the PRT test and other dry eye disease (DED) parameters including tear meniscus height (TMH) and Schirmer I test, and testing the accuracy of diagnosing DED when using the PRT test alone. Methods A total of 108 eyes were involved in this prospective and diagnostic study, and were divided into two groups (with and without DED). Each subject underwent a series of ocular surface examinations, including Ocular Surface Disease Index (OSDI) questionnaire, non-invasive tear breakup time (NIBUT), tear meniscus height (TMH) assessment, PRT test, fluorescein tear breakup time (FBUT), corneal fluorescein staining and Schirmer I test. Results In the experimental group and the control group, the intra-class correlation coefficients (ICCs) of the repeatability were 0.747 and 0.723, respectively (all P

AIM: To investigate the relationship between dynamic tear meniscus parameters and dry eye using an automated tear meniscus segmentation method. METHODS: The analysis of tear meniscus videos captured within 5s after a complete blink includes data from 38 participates. By processing video data, several key parameters including the average height of the tear meniscus at different lengths, the curvature of the tear meniscus's upper boundary, and the total area of the tear meniscus in each frame were calculated. The effective values of these dynamic parameters were then linearly fitted to explore the relationship between their changing trends and dry eye disease. RESULTS: In 94.74% of the samples, the average height of central tear meniscus increased over time. Moreover, 97.37% of the samples exhibited an increase in the overall tear meniscus height (TMH) and area from the nasal to temporal side. Notably, the central TMH increased at a faster rate compared to the nasal side with the temporal side showing the slowest ascent. Statistical analysis indicates that the upper boundary curvature of the whole tear meniscus as well as the tear meniscus of the nasal side (2, 3, and 4 mm) aid in identifying the presence of dry eye and assessing its severity. CONCLUSION: This study contributes to the understanding of tear meniscus dynamics as potential markers for dry eye, utilizing an automated and non-invasive approach that has implications for clinical assessment.

Abstract Background Mesenchymal stem cells (MSCs) have shown promising potential in allograft survival. However, few reports have focused on comparing the immunosuppressive capacity of MSCs from different sources and administered via different routes in inhibiting transplant rejection. Moreover, virtually nothing is known about the role of MSCs in the regulation of graft neovascularization and lymphangiogenesis. In this study, we compared the efficacy of human adipose MSCs (hAD-MSCs) and human umbilical cord MSCs (hUC-MSCs) in vitro and in corneal transplantation models to explore the underlying molecular mechanisms and provide a powerful strategy for future clinical applications. Methods hAD-MSCs and hUC-MSCs were generated, and their self-renewal and multi-differentiation abilities were evaluated. The inhibitory effect of human MSCs (hMSCs) was examined by T-cell proliferation assays with or without transwell in vitro. Two MSCs from different sources were separately adoptively transferred in mice corneal transplantation (5 × 105 or 1 × 106/mouse) via topical subconjunctival or intravenous (IV) routes. Allograft survival was evaluated every other day, and angiogenesis and lymphomagenesis were quantitatively analyzed by immunofluorescence staining. The RNA expression profiles of hMSCs were revealed by RNA sequencing (RNA-seq) and verified by quantitative real-time PCR (qRT‒PCR), western blotting or ELISA. The function of the differentially expressed gene FAS was verified by a T-cell apoptosis assay. Results hAD-MSCs induced stronger immunosuppression in vitro than hUC-MSCs. The inhibitory effect of hUC-MSCs but not hAD-MSCs was mediated by cell–cell contact-dependent mechanisms. Systemic administration of a lower dose of hAD-MSCs showed better performance in prolonging corneal allograft survival than hUC-MSCs, while subconjunctival administration of hMSCs was safer and further prolonged corneal allograft survival. Both types of hMSCs could inhibit corneal neovascularization, while hAD-MSCs showed greater superiority in suppressing graft lymphangiogenesis. RNA-seq analysis and confirmation experiments revealed the superior performance of hAD-MSCs in allografts based on the lower expression of vascular endothelial growth factor C (VEGF-C) and higher expression of FAS. Conclusions The remarkable inhibitory effects on angiogenesis/lymphangiogenesis and immunological transplantation effects support the development of hAD-MSCs as a cell therapy against corneal transplant rejection. Topical administration of hMSCs was a safer and more effective route for application than systemic administration.

Abstract Background Dilated cardiomyopathy (DCM) is a severe, non-ischemic heart disease which ultimately results in heart failure (HF). Decades of research on DCM have revealed diverse aetiologies. Among them, familial DCM is the major form of DCM, with pathogenic variants in LMNA being the second most common form of autosomal dominant DCM. LMNA DCM is a multifactorial and complex disease with no specific treatment thus far. Many studies have demonstrated that perturbing candidates related to various dysregulated pathways ameliorate LMNA DCM. However, it is unknown whether these candidates could serve as potential therapeutic targets especially in long term efficacy. Methods We evaluated 14 potential candidates including Lmna gene products (Lamin A and Lamin C), key signaling pathways (Tgfβ/Smad, mTor and Fgf/Mapk), calcium handling, proliferation regulators and modifiers of LINC complex function in a cardiac specific Lmna DCM model. Positive candidates for improved cardiac function were further assessed by survival analysis. Suppressive roles and mechanisms of these candidates in ameliorating Lmna DCM were dissected by comparing marker gene expression, Tgfβ signaling pathway activation, fibrosis, inflammation, proliferation and DNA damage. Furthermore, transcriptome profiling compared the differences between Lamin A and Lamin C treatment. Results Cardiac function was restored by several positive candidates (Smad3, Yy1, Bmp7, Ctgf, aYAP1, Sun1, Lamin A, and Lamin C), which significantly correlated with suppression of HF/fibrosis marker expression and cardiac fibrosis in Lmna DCM. Lamin C or Sun1 shRNA administration achieved consistent, prolonged survival which highly correlated with reduced heart inflammation and DNA damage. Importantly, Lamin A treatment improved but could not reproduce long term survival, and Lamin A administration to healthy hearts itself induced DCM. Mechanistically, we identified this lapse as caused by a dose-dependent toxicity of Lamin A, which was independent from its maturation. Conclusions In vivo candidate evaluation revealed that supplementation of Lamin C or knockdown of Sun1 significantly suppressed Lmna DCM and achieve prolonged survival. Conversely, Lamin A supplementation did not rescue long term survival and may impart detrimental cardiotoxicity risk. This study highlights a potential of advancing Lamin C and Sun1 as therapeutic targets for the treatment of LMNA DCM. Graphical Abstract

Circadian rhythms are a ubiquitous feature throughout the organism. Accumulating evidence suggests that the dysfunction of circadian rhythms due to genetic mutations or environmental factors contributes to the genesis and progress of multiple diseases. The physiological homeostasis of the ocular surface, like any other tissue or organ, is also orchestrated by circadian rhythms. In this review, we summarize the molecular clocks and the expression of clock-controlled genes in the mammalian ocular surface. Based on the circadian expression of these genes, we conclude the diurnal oscillations of cellular biological activities in the mammalian ocular surface. Moreover, we evaluate the factors entraining circadian oscillators in the ocular surface. Finally, we further discuss the latest development of the close correlation between circadian rhythms and ocular health. Briefly, this review aimed to synthesize the previous studies to aid in understanding the importance of circadian rhythms in the ocular surface and the possible opportunities for circadian rhythm-based interventional strategies to restore the homeostasis of the ocular surface.

The landscape of ophthalmology has observed monumental shifts with the advent of artificial intelligence (AI) technologies. This article is devoted to elaborating on the nuanced application of AI in the diagnostic realm of anterior segment eye diseases, an area ripe with potential yet complex in its imaging characteristics. Historically, AI's entrenchment in ophthalmology was predominantly rooted in the posterior segment. However, the evolution of machine learning paradigms, particularly with the advent of deep learning methodologies, has reframed the focus. When combined with the exponential surge in available electronic image data pertaining to the anterior segment, AI's role in diagnosing corneal, conjunctival, lens, and eyelid pathologies has been solidified and has emerged from the realm of theoretical to practical. In light of this transformative potential, collaborations between the Ophthalmic Imaging and Intelligent Medicine Subcommittee of the China Medical Education Association and the Ophthalmology Committee of the International Translational Medicine Association have been instrumental. These eminent bodies mobilized a consortium of experts to dissect and assimilate advancements from both national and international quarters. Their mandate was not limited to AI's application in anterior segment pathologies like the cornea, conjunctiva, lens, and eyelids, but also ventured into deciphering the existing impediments and envisioning future trajectories. After iterative deliberations, the consensus synthesized herein serves as a touchstone, assisting ophthalmologists in optimally integrating AI into their diagnostic decisions and bolstering clinical research. Through this guideline, we aspire to offer a comprehensive framework, ensuring that clinical decisions are not merely informed but transformed by AI. By building upon existing literature yet maintaining the highest standards of originality, this document stands as a testament to both innovation and academic integrity, in line with the ethos of renowned journals such as Ophthalmology.

This paper aims to delve deeply into the practical guidelines for the application of artificial intelligence(AI)in the diagnosis of anterior ocular diseases in ophthalmology. Given the complexities and variability inherent in the images associated with the research of anterior segment diseases, AI has traditionally found its principal application in the sphere of posterior segment diseases within ophthalmology. However, with the evolution and advancement of AI technologies, notably machine learning and deep learning, alongside an exponential surge in anterior segment electronic image data, the implementation of AI in the domain of corneal, conjunctival, lens, and eyelid disease is not only feasible but has become a reality. The Ophthalmic Imaging and Intelligent Medicine Branch of the Chinese Medical Education Association, in tandem with the Ophthalmology Professional Committee of the International Translational Medicine Association, have orchestrated a consortium of experts. These specialists have synthesized the most recent progressions, both nationally and internationally, in the application of AI in the diagnosis of anterior ocular diseases. This includes its use in corneal, conjunctival, lens, and eyelid diseases, and provides an analysis of the current challenges faced as well as the future directions of development. This guideline has been formulated through several iterations of thoughtful discussion and revisions. Its purpose is to empower clinical ophthalmologists with a reliable framework to facilitate the enhanced application of AI in diagnostic decision-making and clinical research for anterior ocular diseases.

Purpose: The assessment of tear film and ocular surface conditions in patients with acquired immunodeficiency syndrome (AIDS) has been poorly studied thus far. We aim to assess tear film parameters, ocular surface characteristics, and dry eye disease (DED) symptoms of patients with AIDS who did not undergo highly active antiretroviral treatment (HAART). Methods: This case–control study included 154 age-, sex-, and ethnicity-matched healthy controls and patients with AIDS. All participants underwent comprehensive ocular surface assessment and subjective DED symptomology evaluation. Data were collected between March 2022 and July 2022. Results: HAART-naïve patients with AIDS had a shorter noninvasive tear film breakup time (median 3.76 vs. 8.54 s), thinner tear film lipid layer thickness (median 73.00 vs. 91.00 nm), and lower Schirmer I test values (median 5.00 mm/5 min vs. 12.00 mm/5 min) (all P < 0.001). Moreover, higher corneal fluorescein staining scores (median 1.00 vs. 0.00) and higher upper, lower, and total meibomian gland grades were observed in AIDS patients (all P < 0.05). Negative correlations between the blood viral load and the Ocular Surface Disease Index score (r = -3.50, P = 0.027) and the Schirmer I test score (r = -0.374, P = 0.017) were detected in patients with AIDS. Conclusion: Altered tear film status was observed in individuals with HAART-naïve AIDS, even when there were no other ocular symptoms present. Therefore, patients with AIDS should be encouraged to undergo comprehensive ocular surface examinations to detect any subclinical tear film alterations occurring.

Energy conservation is one of the most important and economical ways to achieve the targets of Carbon Emissions Peak and Carbon Neutrality in our country. Waste heat is largely discharged into the environment during the engine operation resulting in the low engine working efficiency. The technology of semiconductor thermoelectric generation based on the Seebeck effect has great advantages in waste heat utilization from engines, which has been attracting extensive and intensive researches. This study introduces the working principle of thermoelectric generation, the device structure, and the components of the thermoelectric generation system. A review of thermoelectric generation research at home and abroad is also presented, in which the R&D status, application potential, evaluation metrics, and current challenges of thermoelectric materials and systems are analyzed. Several key scientific problems that affect the performance of the waste heat thermoelectric generation system, including thermoelectric efficiency and overall power generation efficiency, are proposed, and the corresponding preliminary solutions are given. The non-uniformity of the hot-end temperature distribution is one of the essential problems to design a high-performance waste heat thermoelectric generation system. In addition, the inherent contradictory between heat collection efficiency of the heat collector and pressure drop should be balanced to achieve the maximum fuel saving rate. Besides, new issues and data in application demonstration project of engine waste heat utilization have been presented to provide a useful guidance for future studies.

Abstract Introduction This study compares the clinical characteristics of dry eye secondary to primary biliary cholangitis (PBC), drug-induced liver injury (DILI), and viral hepatitis B(HBV) to evaluate the ocular surface damage caused by different types of liver diseases. Methods Thirty healthy people were included as control group. Sixty patients with dry eye secondary to different types of liver disease were included, including 19 cases of PBC, 18 cases of DILI, and 23 cases of HBV. All patients were evaluated by the SPEED questionnaire, corneal fluorescein staining (CFS), noninvasive tear breakup time (NIBUT), Schirmer I test (SIt), tear meniscus height test (TMH), the area of meibomian glands dropout (MG dropout), partial blinking rate (PBR), lipid layer thickness (LLT), meibum expressibility, and meibum quality. Results There are statistical differences in ophthalmic examination results between different types of liver diseases and normal people (P 0.05).The Meibum quality score in the DILI group was significantly higher than the HBV group (P

AIM: To investigate the effectiveness and safety of subconjunctival injection of conbercept in the treatment of corneal neovascularization (CNV). METHODS: The data on 10 consecutively recruited patients with CNV who received a subconjunctival conbercept (1 mg) once, and measured the area, length, and diameter of neovascularization before and after (1d, 1, 2wk, and 1mo) treatment as well as the occurrence of systemic and ocular complications after treatment were analyzed. RESULTS: There was a statistically significant reduction in the area of CNV one day after treatment (mean±SD: 38.46±11.36 mm2), compared with before treatment (42.46±12.80 mm2, P

Cardiovascular disease (CVD) and kidney disease are the main causes of morbidity and mortality in type 2 diabetes mellitus (T2DM). Globally, the incidence of T2DM continues to rise. A substantial increase in the burden of CVD and renal disease, alongside the socioeconomic implications, would be anticipated. Adopting a purely glucose-centric approach focusing only on glycemic targets is no longer adequate to mitigate the cardiovascular risks in T2DM. In the past decade, significant advancement has been achieved in expanding the pharmaceutical options for T2DM, with novel agents such as the sodium-glucose cotransporter type 2 (SGLT2) inhibitors and glucagon-like peptide receptor agonists (GLP-1 RAs) demonstrating robust evidence in cardiorenal protection. Combinatorial approaches comprising multiple pharmacotherapies combined in a single agent are an emerging and promising way to not only enhance patient adherence and improve glycemic control but also to achieve the potential synergistic effects for greater cardiorenal protection. In this review, we provide an update on the novel antidiabetic agents in the past decade, with an appraisal of the mechanisms contributing to cardiorenal protection. Additionally, we offer a glimpse into the landscape of T2DM management in the near future by providing a comprehensive summary of upcoming agents in early-phase trials.

Introduction: Small artery disease caused by neutrophils and immune-mediated is known as leucocytoclastic vasculitis (LCV). Clinically, it manifests as palpable, asymptomatic purpuric papules on the limbs. Ocular manifestation is rare. Here, we describe a case of peripheral ulcerative keratitis (PUK) associated with LCV. Case presentation: A 59-year-old man was referred to the hospital with blurred vision due to corneal perforation in his left eye. He complained of itchy nodules on his hands and lower legs for 15 years and the skin biopsy of the back of his hand revealed LCV 6 years ago, which suggested erythema elevatum diutinum. The patient was under treatment with anti-inflammatory and immunosuppressive drugs and physical features of LCV seen in him included erythema on his hands and legs. After receiving conjunctival flap covering surgery, the corneal perforation was resolved. Conjunctival flaps covered cornea that limited his vision to hand motion. Six months later, he was referred to our clinic again because of pain, redness, photophobia, and tearing in the right eye, presenting with PUK. Necrotic tissue was removed during surgery, which also included a conjunctival flap covering procedure. Following surgery, the symptoms were reduced, and the postoperative eye condition remained stable. Conclusion: To our knowledge, it is the first case of PUK secondary to LCV which was diagnosed 6 years ago. This case demonstrates that PUK associated with LCV can be successfully treated by surgical interventions.

Background: Increasing the interval between the first and second SARS-CoV-2 vaccine doses enhances vaccine immunogenicity, however the optimal timing of the third vaccine is unknown. In this study, we investigated how the time interval between the first and second (V1–V2), or second and third (V2–V3) doses affects immunogenicity after three doses of the BNT162b2 (Comirnaty, Pfizer-BioNTech) vaccine. Methods: This is an observational cohort consisting of 360 participants enrolled in the COVID-19 Occupational Risks, Seroprevalence, and Immunity among Paramedics in Canada (CORSIP) study. Immune responses to BA.1 and other variants were measured from serum using an ACE2 competitive binding assay for surrogate SARS-CoV-2 neutralization. We fit a multiple linear regression model to estimate the independent association between both the V1–V2 and V2–V3 intervals and serum SARS-CoV-2 neutralization, while adjusting for age, sex, and the V3-to-blood collection interval. We examined vaccine dosing intervals as continuous variables and categorized them into quartiles. Results: The mean age was 40 years, 45% were female sex (at birth), and the median BA.1 surrogate neutralization was 61% (IQR 38–77%). The multivariate analysis indicated that longer V1–V2 (β = 0.1292, 95% CI: 0.04807–0.2104) and V2–V3 (β = 0.2653, 95% CI: 0.2291–0.3015) intervals were associated with increased surrogate neutralization of BA.1. These results were consistent when examining responses against Spike from other SARS-CoV-2 strains. When categorized into V2–V3 quartiles, the first (56–231 days), and second (231–266 days) quartiles demonstrated decreased BA.1 surrogate neutralization compared to the longest V2–V3 quartile (282–329 days). There was no significant difference in surrogate neutralization between the long (266–282 days) and longest (282–329 days) V2–V3 intervals. Conclusion: Longer intervals between first, second and third doses are independently associated with increased immunogenicity for all tested SARS-CoV-2 strains. Increasing the intervals between the second and third vaccine doses up to 8.9 months provided additive benefits increasing the immunogenicity of BNT162b2 vaccine schedules.

Introduction: Pterygium is a common multifactorial external eye disease, which causes various ocular symptoms and negatively affects appearance. The aim of this study was to analyze the epidemiological characteristics and the change of surgical methods of pterygium and pseudopterygium in China from 2013 to 2019. Materials and methods: This study was a hospital-based nationwide retrospective study to estimate the epidemiologic characteristics and the change of surgical methods of pterygium and pseudopteygium in China from 2013 to 2019. The data was extracted from the Hospital Quality Monitoring System (HQMS) database. The diagnosis was based on the tenth revision of the International Classification of Diseases (ICD-10) code. Results: Our study included 1,007,800 pterygium and 2,681 pseudopteygium inpatients. From 2013 to 2019, the proportion of pterygium and pseudopterygium patients who underwent surgery, among all ophthalmology inpatients, increased from 3.3% in 2013 to 7.84% in 2019. The male-female ratio of surgically treated pterygium and pseudopterygium is 1:1.8 and 1.6:1 respectively. Among all age groups, the hospitalized pterygium patients who received surgery were mainly 60–69 years old, accounting for 36.53%. The pseudopterygium patients who received surgery were mostly 50–59 years old, accounting for 24.02%. Among the 31 provinces of mainland China, Yunnan Province has the highest proportion of pterygium patients treated surgically (6.40%), while Shanghai has the highest proportion of pseudopterygium patients treated surgically (12.98%). The most common occupation of participants in the study was farmer, accounting for 47.62% and 28.53%, respectively. During the study period, the application of autologous stem cell transplantation increased year by year, and became the first choice for pterygium and pseudopterygium surgery. Discussion: This study was the first to describe the epidemiological characteristics and surgical methods of hospitalized pterygium and pseudopterygium patients in China. This study provides important information for better diagnosis, treatment and prevention of pterygium and pseudopterygium.

Background: Corneal fluorescein staining is a key biomarker in evaluating dry eye disease. However, subjective scales of corneal fluorescein staining are lacking in consistency and increase the difficulties of an accurate diagnosis for clinicians. This study aimed to propose an automatic machine learning-based method for corneal fluorescein staining evaluation by utilizing prior information about the spatial connection and distribution of the staining region. Methods: We proposed an end-to-end automatic machine learning-based classification model that consists of staining region identification, feature signature construction, and machine learning-based classification, which fully scrutinizes the multiscale topological features together with conventional texture and morphological features. The proposed model was evaluated using retrospective data from Beijing Tongren Hospital. Two masked ophthalmologists scored images independently using the Sjögren’s International Collaborative Clinical Alliance Ocular Staining Score scale. Results: A total of 382 images were enrolled in the study. A signature with six topological features, two textural features, and two morphological features was constructed after feature extraction and selection. Support vector machines showed the best classification performance (accuracy: 82.67%, area under the curve: 96.59%) with the designed signature. Meanwhile, topological features contributed more to the classification, compared with other features. According to the distribution and correlation with features and scores, topological features performed better than others. Conclusions: An automatic machine learning-based method was advanced for corneal fluorescein staining evaluation. The topological features in presenting the spatial connectivity and distribution of staining regions are essential for an efficient corneal fluorescein staining evaluation. This result implies the clinical application of topological features in dry-eye diagnosis and therapeutic effect evaluation.

Abstract Background To compare the dynamic corneal response (DCR) and tomographic parameters of thin normal cornea (TNC) with thinnest corneal thickness (TCT) (≤ 500 µm), forme fruste keratoconus (FFKC) and mild keratoconus (MKC) had their central corneal thickness (CCT) matched by Scheimpflug imaging (Pentacam) and corneal visualization Scheimpflug technology (Corvis ST). Methods CCT were matched in 50 eyes with FFKC, 50 eyes with MKC, and 53 TNC eyes with TCT ≤ 500 µm. The differences in DCR and tomographic parameters among the three groups were compared. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic significance of these parameters. Back propagation (BP) neural network was used to establish the keratoconus diagnosis model. Results Fifty CCT-matched FFKC eyes, 50 MKC eyes and 50 TNC eyes were included. The age and biomechanically corrected intraocular pressure (bIOP) did not differ significantly among the three groups (all P > 0.05). The index of height asymmetry (IHA) and height decentration (IHD) differed significantly among the three groups (all P 0.80) to differentiate FFKC and MKC from TNC eyes. Partial DCR parameters showed significant differences between the MKC and TNC groups, and the deflection amplitude of the first applanation (A1DA) showed a good potential to differentiate (AUC > 0.70) FFKC and MKC from TNC eyes. Diagnosis model by BP neural network showed an accurate diagnostic efficiency of about 91%. Conclusions The majority of the tomographic and DCR parameters differed among the three groups. The IHD and partial DCR parameters assessed by Corvis ST distinguished FFKC and MKC from TNC when controlled for CCT.

Meibomian gland dysfunction (MGD) is caused by abnormalities of the meibomian glands (MG) and is one of the causes of evaporative dry eye (DED). Precise MG segmentation is crucial for MGD-related DED diagnosis because the morphological parameters of MG are of importance. Deep learning has achieved state-of-the-art performance in medical image segmentation tasks, especially when training and test data come from the same distribution. But in practice, MG images can be acquired from different devices or hospitals. When testing image data from different distributions, deep learning models that have been trained on a specific distribution are prone to poor performance. Histogram specification (HS) has been reported as an effective method for contrast enhancement and improving model performance on images of different modalities. Additionally, contrast limited adaptive histogram equalization (CLAHE) will be used as a preprocessing method to enhance the contrast of MG images. In this study, we developed and evaluated the automatic segmentation method of the eyelid area and the MG area based on CNN and automatically calculated MG loss rate. This method is evaluated in the internal and external testing sets from two meibography devices. In addition, to assess whether HS and CLAHE improve segmentation results, we trained the network model using images from one device (internal testing set) and tested on images from another device (external testing set). High DSC (0.84 for MG region, 0.92 for eyelid region) for the internal test set was obtained, while for the external testing set, lower DSC (0.69–0.71 for MG region, 0.89–0.91 for eyelid region) was obtained. Also, HS and CLAHE were reported to have no statistical improvement in the segmentation results of MG in this experiment.

Mutations in the LaminA gene are the second most common inherited cause of Dilated Cardiomyopathy, a major form of heart failure. Here the authors show that disruption of the nuclear protein SUN1 in cardiomyocytes, by AAV mediated transduction of a SUN1 inhibitor, significantly suppress cardiomyopathy progression, providing a potential therapeutic route to treat this disease.

Abstract Objective To report the clinical outcomes of a novel surgical technique, namely simple limbal epithelial transplantation (SLET), for the treatment of limbal stem cell deficiency (LSCD). Methods Thirteen patients (13 eyes) with LSCD who underwent autologous (10 eyes) or allogeneic (3 eyes) modified SLET between 2018 and 2021 were enrolled in this study. Grades of symblepharon, corneal conjunctivalization, vascularization, opacification, and visual acuity (VA) were evaluated preoperatively and postoperatively. In 2 cases, in vivo confocal microscopy (IVCM) and impression cytology (IC) were performed to assess the proliferation and degeneration of limbal tissue. Results At a postoperative follow-up of 6.5±5.3 (range, 2–20) months, 10 (10/13, 76.92%) eyes maintained a successful outcome. The grades of symblepharon, corneal conjunctivalization, vascularization, and opacification were significantly improved after SLET (P

Background: To compare the corneal biomechanics of thin normal cornea (TNC) with thinnest corneal thickness (TCT) (≤500 µm), forme-fruste keratoconus (FFKC) and cornea after small incision lenticule extraction (Post-SMILE) had their central corneal thickness (CCT) matched by Corneal Visualization Scheimpflug Technology (Corvis ST).Methods: CCT were matched in 23 eyes with FFKC, 23 eyes by SMILE in 3 months post-operatively, and 23 TNC eyes. The differences in corneal biomechanics by Corvis ST among the three groups were compared.Results: There was no significant difference in CCT among the three groups, and the biomechanically corrected intraocular pressure (bIOP) did not differ significantly among the three groups (all p > 0.05). There were significant differences in most DCR parameters between pre- and post-operatively (all p < 0.05). Compared with TNC, the values of corneal deflection amplitude during the first applanation (A1DA), length at the first applanation (A1L), corneal deflection amplitude during the second applanation (A2DA), and maximum deformation amplitude (DA) decreased in 3 months after SMILE (all p < 0.05), these values increased in the FFKC (all p < 0.05).Conclusion: The majority of the DCR parameters were different among the three groups. The parameters A1DA, A1L, A2DA, and DA may be different between TNC and Post-SMILE, TNC and FFKC, and Post-SMILE and FFKC.

Purpose: To evaluate the repeatability and reproducibility of recalculated dynamic corneal response (DCR) parameters and the biomechanical-compensated intraocular pressure (bIOP) derived from the Corneal Visualization Scheimpflug Technology (Corvis ST), as well as to study the variations of DCR parameters and their relationship with demographic, and ocular characteristics.Methods: A total of 544 healthy subjects were recruited in this study and a series of ophthalmological examinations were performed on their right eyes. Three repeated measurements were obtained at 3-min intervals for 291 of the participants to ensure repeatability. A sum of 100 participants was examined twice within 2-h intervals using two different Corvis ST in the reproducibility study. The repeatability and reproducibility of 37 parameters, including 36 DCR parameters and bIOP, were assessed by the coefficient of repeatability (CR), coefficient of variation (CV), intraclass correlation coefficient (ICC), and within-subject standard deviation (sw). Pearson’s correlation coefficients and stepwise multivariate linear regression models were performed to investigate whether the DCR parameters were related to demographic and ocular characteristics.Results: Of all the 37 parameters, 34 showed excellent (ICC ≥0.90) or good (ICC ≥0.75) repeatability while 27 of the 37 parameters showed excellent (ICC ≥0.90) or good (ICC ≥0.75) reproducibility. In particular, a CV of less than 20% was found for all DCR parameters and bIOP. A fraction of 14 out of 36 DCR parameters was selected for correlation analysis, based on measurement reliability and clinical relevance in referring to previous literature. Age was negatively associated with the Highest concavity delta arc length (HCdArcL) and peak distance (PD) but it positively correlated with the Whole Eye Movement Max Length (WEMML). Intraocular pressure (IOP) and central corneal thickness (CCT) were negatively associated with the deformation amplitude ratio (DARM) [1 mm], A1 Velocity (A1V), and PD, while positively related to the stiffness parameter at applanation 1 (SP-A1). The bIOP was negatively associated with A1V but positively associated with A2 Velocity (A2V). The anterior chamber volume (ACV) was negatively associated with the pachy slope (PS), WEMML, and SP-A1.Conclusion. The Corvis ST showed good precision for the repeatability and reproducibility of 36 DCR parameters and bIOP parameters in healthy eyes. The IOP, CCT, bIOP, Km, and ACV significantly influenced the DCR parameters of the eyes.

Purpose: The Ocular Response Analyzer (ORA) is one of the most commonly used devices to measure corneal biomechanics in vivo. Until now, the relationship between the output parameters and corneal typical biomechanical parameters was not clear. Hence, we defined the output parameters of ORA as ORA output parameters. This study aims to propose a method to determine corneal biomechanical parameters based on ORA measurements by finite element simulation and parametric analysis.Methods: Finite element analysis was used to simulate the mechanics process of ORA measurements with different intraocular pressure (IOP), corneal geometrical parameters and corneal biomechanical parameters. A simplified geometrical optics model was built to simulate the optical process of the measurements to extract ORA output parameters. After that, 70% of the simulated data was used to establish the quantitative relationship between corneal biomechanical parameters and ORA output parameters by parametric analysis and 30% of the simulated data was used to validate the established model. Besides, ten normal subjects were included to evaluate the normal range of corneal biomechanical parameters calculated from ORA.Results: The quantitative relationship between corneal biomechanical parameters and ORA output parameters is established by combining parametric analysis with finite element simulation. The elastic modulus (E) and relaxation limit (G∞) of the ten normal subjects were 0.65 ± 0.07 MPa and 0.26 ± 0.15, respectively.Conclusions: A method was proposed to determine corneal biomechanical parameters based on the results of ORA measurements. The magnitude of the corneal biomechanical parameters calculated according to our method was reasonable.

Abstract Coronavirus disease 2019 (COVID‐19) is a global pandemic that is caused by a novel coronavirus, severe acute respiratory syndrome coronavirus‐2. Data from several countries have shown higher morbidity and mortality among individuals with chronic metabolic diseases, such as diabetes mellitus. In this review, we explore the contributing factors for poorer prognosis in these individuals. As a significant proportion of patients with COVID‐19 also have diabetes mellitus, this adds another layer of complexity to their management. We explore potential interactions between antidiabetic medications and renin–angiotensin–aldosterone system inhibitors with COVID‐19. Suggested recommendations for the use of antidiabetic medications for COVID‐19 patients with diabetes mellitus are provided. We also review pertinent clinical considerations in the management of diabetic ketoacidosis in COVID‐19 patients. In addition, we aim to increase clinicians’ awareness of the metabolic effects of promising drug therapies for COVID‐19. Finally, we highlight the importance of timely vaccinations for patients with diabetes mellitus.

Objective To explore the correlation between lymphocyte subtypes and CT pulmonary inflammatory index in patients with coronavirus disease 2019 (COVID-19). Methods Clinical data of 80 COVID-19 patients identified by nucleic acid test and clinical symptoms admitted in our hospital from January to February 2020 were collected in this study. They were 45 males and 35 females, and at an average age of 51.2 years. According to the severity of the disease, they were divided into the non-severe group (ordinary type, n=68) and the severe group (serious and critical type, n=12). The clinical data, chest CT findings and pneumonia index of the patients were observed and analyzed. Spearman analysis was employed to analyze the correlation between pneumonia index and lymphocyte subtypes count. Results The results showed that the T lymphocyte subsets of patients with COVID-19 were normal or decreased, and the levels of C-reactive protein and IL-6 were increased or normal. During the following courses of disease, within 1 week, weeks 1~2 and 2 weeks later, counts of CD3+ and CD4+ T cells in the severe group were decreased significantly at above 3 periods (P < 0.05), CT pulmonary inflammatory index was obviously elevated at the 3 periods (P < 0.05), and CD8+ T cells count was decreased during the former 2 periods (P < 0.05), when compared with the non-severe group. It was found that the peak time of CT pulmonary inflammation was mainly within 2 weeks after onset, and the beginning time of pneumonia absorption was mainly within 1~3 weeks. The pneumonia index was negatively correlated with CD3+, CD4+, CD8+ T cells and Lym counts (P < 0.05). Conclusion The lower counts of lymphocyte subsets are, the severer the CT pulmonary inflammation is, and the more serious the condition is in COVID-19 patients.

The lymph node (LN) is a vital organ of the lymphatic and immune system that enables timely detection, response, and clearance of harmful substances from the body. Each LN comprises of distinct substructures, which host a plethora of immune cell types working in tandem to coordinate complex innate and adaptive immune responses. An improved understanding of LN biology could facilitate treatment in LN-associated pathologies and immunotherapeutic interventions, yet at present, animal models, which often have poor physiological relevance, are the most popular experimental platforms. Emerging biomaterial engineering offers powerful alternatives, with the potential to circumvent limitations of animal models, for in-depth characterization and engineering of the lymphatic and adaptive immune system. In addition, mathematical and computational approaches, particularly in the current age of big data research, are reliable tools to verify and complement biomaterial works. In this review, we first discuss the importance of lymph node in immunity protection followed by recent advances using biomaterials to create in vitro/vivo LN-mimicking models to recreate the lymphoid tissue microstructure and microenvironment, as well as to describe the related immuno-functionality for biological investigation. We also explore the great potential of mathematical and computational models to serve as in silico supports. Furthermore, we suggest how both in vitro/vivo and in silico approaches can be integrated to strengthen basic patho-biological research, translational drug screening and clinical personalized therapies. We hope that this review will promote synergistic collaborations to accelerate progress of LN-mimicking systems to enhance understanding of immuno-complexity.

Abstract Background Although immunoglobulin E (IgE) increases significantly in tears and serum during seasonal allergic conjunctivitis (SAC), it is unclear whether tear total IgE can reflect the severity and prognosis of SAC more accurately than serum total IgE. We aimed to investigate the usefulness of measuring the total IgE in tears to evaluate the severity and determine the treatment of SAC. Methods This prospective, nonrandomized study involved 55 patients with SAC and 10 age‐ and sex‐matched healthy controls. Serum and tears were collected before and after treatment to analyze the total IgE. SAC patients received the same topical anti‐allergy treatment and were followed‐up every 2 weeks for 1 month. The relationship of tear and serum total IgE concentrations with pollen concentrations and symptom severity before and after treatment was assessed. Results The total IgE concentration in tears was higher in SAC patients than in healthy participants with significant correlations between tear and serum total IgE concentrations. The total IgE concentration in tears, but not in serum, correlated with the pollen concentration and severity of ocular symptoms and reactions in SAC. Treatment‐associated improvements in symptoms and reactions in SAC correlated with decreased concentrations of the tear total IgE. Patients with disease recurrence following treatment demonstrated significantly higher tear total IgE concentrations than patients with no recurrence. Conclusion The total tear IgE level can indicate the severity and predict the prognosis of SAC more accurately than the serum total IgE.

ObjectiveTo assess a novel eyelid pressure measurement device and study the relationship between eyelid pressure and ocular surface parameters of moderate-to-severe dry eye disease (DED).MethodsThe present study included 70 eyes of 35 moderate-to-severe DED patients. All subjects were subjected to the following examinations for DED assessment: Ocular Surface Disease Index (OSDI) questionnaire, tear meniscus height (TMH), lipid layer thickness (LLT), number of partial blink (PB), total blink (TB) and partial blink rate (PBR), fluorescein tear breakup time (FBUT), corneal fluorescein staining (CFS), lid margin abnormality, meibum expression assessment (meibum score), meibomian gland dropout (MGd) and Schirmer I test. Pressure of the upper eyelid was measured thrice with the novel pressure measurement device. Repeatability of the device was evaluated by intraclass correlation coefficient (ICC). Safety of the device was evaluated by observing ocular adverse reactions of each subject prior to measurement, at day 1 and day 7 following measurement. Correlations between eyelid pressure and ocular surface parameters of moderate-to-severe DED were analyzed by using Pearson correlation coefficient and Kendall's tau-b correlation coefficient.ResultsICC of the measurement results in our study was 0.86. There was no abnormality presenting in all subjects recorded prior to measurement, 1 and 7 days following measurement. The eyelid pressure was significantly correlated with PBR (r = 0.286, P = 0.016), FBUT (r = −0.331, P = 0.005), CFS (r = 0.528, P = 0.000), lid margin abnormality (r = 0.408, P = 0.011) and MGd (r = 0.226, P = 0.016) in moderate-to-severe DED patients, but not significantly correlated with OSDI score (r = 0.016, P = 0.912), TMH (r = −0.002, P = 0.988), meibum score (r = −0.196, P = 0.317), LLT (r = 0.114, P = 0.346), PB (r = 0.116, P = 0.338), TB (r = 0.074, P = 0.544), meibum score (r = −0.196, P = 0.317) and Schirmer I test (r = 0.028, P = 0.821).ConclusionThe novel pressure measurement device exhibited good repeatability and safety in measuring eyelid pressure. Significant correlations were noted between the eyelid pressure and PBR, FBUT, CFS, lid margin abnormality and MGd in moderate-to-severe DED. The measurement of eyelid pressure combined with ocular surface parameters may be valuable for the assessment of DED.