Objective To explore the expressions of Dectin-1 and Toll-like receptor 4 (TLR4)and the secretory charateristics of inflammatory factors of the Aspergillus fumigatus infected cornea of the rats,and to clarify theirs role in the pathogenesis of rat keratitis.Methods 40 SD rats were separated into control group (n = 10)and aspergillus keratitis group (n=30).The rats in aspergillus keratitis group were infected by Aspergillus fumigatus in two eyes for 12,24 and 48 h,and the cornea tissue was took and ELISA kit was used to detect the level of inflammatory cytokines IL-1,TNF-a,IL- 6,IL-10,and NF-κB;immunohistochemistry,Western blotting and RT-PCR methods were used to determine the Dectin-1 and TLR4 protein and mRNA expressions.Results The rat models were successfully established.The eyes of the rats in control group were limpid tested by corneal slit lamp, however,there existed a clear boundary film on the surface of eyes of the rats in aspergillus keratitis group infected for 12 h,white infiltrates and bloodshot in the eyes in 24 h group and the white infiltrates were further strengthened and almost covered the entire eyes in 48 h group. The order of inflammatory cytokines IL-1,TNF-α,IL-6,IL-10, NF-κB was:48 h group> 24 h group> 12 h group> control group (P < 0.05),so did the expression levels of Dectin-1 and TLR4 protein and mRNA in various groups tested by Western blotting and RT-PCR methods.The expression levels of Dectin-1 and TLR4 were increased with the prolongation of time investigated by immunohistochemical staining.Conclusion Dectin-1 and TLR4 are secreted in excess after the eyes are infected with fumigatus,which promotes the expressions of related inflammatory cytokines and results in the occurrence of keratitis.

Keratoconus is a progressive and bilateral corneal disease with the characteristics of the protrusion of the dilated and central thinning cornea.Keratoconus often causes myopia and irregular astigmatism, and corneal edema and scarring in the late stage, leads to significant vision loss, and brings patients psychological pressure and economic burden.Eye rubbing is an important risk factor of keratoconus.Many studies suggest that eye rubbing is related to the occurrence and development of keratoconus.Different frequency and intensity of eye rubbing have different effects on the cornea.In susceptible population, eye rubbing causes severer damage to the cornea and more serious consequences.Eye rubbing damages the cornea by direct mechanical action, raising corneal temperature and intraocular pressure and releasing inflammatory factors resulting in cell apoptosis.Avoiding eye rubbing is of great significance in delaying the development of keratoconus.Reducing the rubbing time and frequency of patients with keratoconus by treating the primary disease causing eye rubbing and distracting them can reduce the occurrence and slow down the progression of keratoconus, and the life quality of patients can be improved.In this review, the role of eye rubbing in the etiology of keratoconus was elucidated to provide reference for the treatment and prevention of keratoconus.

Corneal densitometry is a biological property of corneal tissue, which is related to the transparency of cornea, and can be used to describe the degree of corneal transparency.At present, corneal densitometry has been used in the auxiliary diagnosis and severity evaluation of corneal diseases, as well as in the evaluation of the surgical outcome and the postoperative follow-up, even some systemic diseases affecting the cornea.The measurement of corneal densitometry is an objective, non-invasive and repeatable method to evaluate corneal transparency, which has important reference values for the monitoring of corneal and systemic health.In this article, the application of corneal densitometry in clinical practices was reviewed.

Objective To explore the correlation of fatigue with health-promoting lifestyle in the udnergraduate students, so as to provide scientific evidence for the intervention. Methods A cross-section trial was carried out in the undergraduate students from a medical university in Guangzhou. By a self-designed questionnaire, the incidence of fatigue in the undergraduate students was figured out after data processing and statistical analysis. Results A total of 6 100 questionnaires were released, and 5 843 were responded, with a respondent rate being 95.79%. The number of effective questionnaires arrived 5 676. The results showed that the prevalence of fatigue among undergraduate students was 49.6%. The female had a higher risk than the male ( 51.6% vs 45.8%, P<0.01). The prevalence of fatigue in grade 1-3 students was 49.4%, 48.1% and 52.1% , respectively, the difference being insignificant among the three grades (P>0.05). The students with poor level of health-promoting lifestyle had a higher risk of suffering from fatigue (OR=6.647, 95%CI: 4.913-8.993). Conclusion Fatigue is prevalent among the undergraduate students. The incidence of fatigue can be reduced by increasing the level of self-actualization, physical exercise and pressure management.

Objective To investigate the changes of traditional Chinese medical constitution types with menstrual cycle of sub-health state women, thus to explore the affectability of diseases during menstrual cycle. Methods Sub-health State Questionnaire and Menstruation State Questionnaire established in our previous study were used for the epidemiological survey of 330 women outpatients aged 20-45 years admitted by the disease-preventive department of Tianhe District Hospital of Traditional Chinese Medicine. Results In 330 cases, the cases of sub-health state accounted for 64.5%, in which 21.5%had pure sub-health state without any chronic diseases, and 43.0% had sub-health state together with some diseases. The diseases of hyperplasia of mammary glands, vaginitis, cervical spondylosis, hyperlipemia, chronic appendagitis, and uterus myoma had higher morbidity rate in order. At premenstrual phase, constitution types of Qi stagnation, damp heat, and blood stasis had the higher incidences; at menstruation phase, Qi stagnation, blood stasis, and damp heat had the higher incidences; at postmenstrual phase, yang deficiency, Qi deficiency, and damp heat had the higher incidences. Most of the sub-health state women had the complex constitution types, accounting for 93%. Conclusion Traditional Chinese medical constitution types are correlated with menstral cycle of sub-health state women, and show some effects on the affectability and progress of diseases. The investigation results of dynamic changes and the distribution of traditional Chinese medical constitution types during menstrual cycle will supply some evidence for the prevention and treatment of irregular menstruation and sub-health state of the women with Chinese medine.

Background Researches showed that femtosecond laser corneal small incision lenticule extraction (SMILE) was used in the correction of myopia and myopic astigmatism due to its fast recovery,good shortterm efficacy and few complications.However,few research focused on its long-term efficacy.Objective Thisstudy was to evaluate the effectiveness,safety,predictability,stability and complications of SMILE.Methods A serial cases-observational study was carried out under the approval of Ethic Committee of Henan Eye Institute and informed consent of patients.Sixty-seven eyes of 34 patients with myopia and myopic astigmatism were included in Henan Eye Institute from January to June 2013.All the patients received SMILE and followed-up for 2-year duration.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),automatic optometry,intraocular pressure and corneal topography were examined before surgery and 1 day,1 week,1 month,3 months,1 year and 2 years after surgery and calculated the spherical equivalent (SE).The long-term efficacy of SMILE included effective index (preoperative BCVA/postoperative UCVA),safety index (postoperative BCVA/ preoperative BCVA),predictability (linear regression analysis between actual SE and attempted SE) and refractive stability (SE changes at postoperative time points).Results The preoperative BCVA was ≥ 20/20 in 60 eyes with the percentage of 89.55％.UCVA≥ 20/20 were found in 61 eyes and 60 eyes in postoperative 3 months and 2 years respectively (91.04％ and 89.55％).The effective index was 1.038±0.182 and 1.029±0.231 in postoperative 3 months and 2 years respectively,showing an insignificant difference between them (t =0.400,P ＞ 0.05).Compared with the preoperative BCVA,8.96％ (6/67) and 10.45％ (7/67) eyes lost 1 line at 3 months and 2 years after surgery,respectively.The safety indexes were 1.141±0.193 and 1.312±0.242 at 3 months and 2 years after surgery,with no significant difference between them (t =0.414,P＞0.05).A linear correlation was found between actual SE and attempted SE both at postoperative 3 months and 2 years,with the linear regression equations of Y=0.897 1X-0.440 8 (R2 =0.914 2,P＜0.05) and Y =0.893 7X-0.382 3 (R2 =0.915 7,P＜0.05),respectively.The SE was (0.013±0.578),(-0.033±0.489),(-0.106±0.508),(-0.103±0.375),(-0.154±0.518) and (-0.147±0.366)D 1 day,1 week,1 month,3 months,1 year and 2 years after surgery,respectively,and there were no significant difference among different time points (F =0.185,P =0.176).Eighteen in the 67 eyes occurred opaque bubble layer after surgery.Diffuse lamellar keratitis appeared in 6 eyes and punctate keratitis was in 2 eyes.These complications were cured 1 month after administration of drugs.Conclusions SMILE is good in effectiveness,safety,predictability and refreactive stability and has fewer complications during 2-year following-up.

China ; Humans ; Streptococcus pneumoniae

Objective: To evaluate the repeatability of corneal biomechanics parameters measured by Corneal Visualization Scheimpflug Technology (Corvis ST) and explore the factors that influence the repeatability. Methods: A diagnostic test study was performed.A total of 190 eyes in 95 myopia patients (34 males and 61 females) were enrolled from September to October 2017 in Henan Eye Hospital.All the subjects underwent 5 repeated examinations with the Corvis ST.The intraclass correlation coefficient (ICC), Cronbach α coefficients and repeatability coefficient (RC) were computed to evaluate repeatability of Corvis ST parameters.The multiple linear regression analysis was used to study the factors that affect the magnitude of the test-retest variability (within subject SD) of new Corvis ST parameters.This study was approved by the Ethics Committee of Henan Eye Hospital (HNEECKY-2019[5]), and written informed consent was obtained from each subject. Results: Among the 39 biomechanics parameters, The ICC and Cronbach α were greater than 0.75 for 26 parameters, within 0.60-0.75 for 4 parameters, and lower than 0.60 for deflection amplitude max time (DLAMT). The ICC and Cronbach α of DA ratio max[1 mm], DA ratio max [2 mm], max inverse radius, Ambrósio's relational thickness horizontal (ARTh), biomechanical intraocular pressure (bIOP), integrated radius, stiffness parameter applanation 1 (SPA1) and Corvis biomechanical index (CBI)were all above 0.920.The multivariate regression results indicated that the within subject SD of bIOP increased with the increase of IOP (β=0.210, P=0.010). The within subjects SD of DA Ratio Max [1 mm]decreased with the increase of central corneal thickness (CCT) (β=-0.218, P=0.008). The within subjects SD of DA Ratio Max [2 mm]decreased with the increase of CCT(β=-0.295, P<0.001). The within subject SD of CBI decreased with the increase of astigmatism, axial lengths and CCT (β=-0.190、-0.148、-0.428, all P<0.05). Conclusion The Corvis ST parameters showed favorable measurement repeatability in myopia patients, especially for the new parameters.Astigmatism, axial lengths and CCT significantly affected the repeatability of CBI.

Objective To study the sensitivity and specificity of parameter Corvis biomechanical index (CBI)— a new biomechanical index of Corvis ST in the diagnosis of keratoconus and evaluate the role of CBI in the diagnosis of keratoconus and the change of biomechanic.Methods A diagnostic trial study was adopted,and 66 eyes from 49 keratoconic patients (keratoconus group) and 91 right eyes from 91 myopic patients (control group) from April in 2018 to August in 2018 in Henan Eye Hospital were enrolled.Pentacam and Corvis ST examinations were performed by the same operator after the basic eye examinations.Using the evaluation of diagnostic test,consistency test,and receiver operating characteristic (ROC) curve analysis,gain the outcome of the sensitivity,specificity,consistency,Youden index,and area under the ROC curve of the parameter CBI.This study protocol was approved by Ethic Committee of Henan Eye Hospital and followed the Declaration of Helsinki.Written informed consent was obtained from each patient prior to any medical examination.Results Sixty eyes were diagnosed as keratoconus by the parameter CBI of Corvis ST.Evaluation of diagnosis test:the sensitivity was 97.0％,and the specificity was 97.8％;consistency check:Kappa =0.948,P＜0.05.ROC curve analysis:the sensitivity was 98.5％,the specificity was 96.8％,Youden index was 96.3％,P＜0.000 1 and AUC was 0.996.Conclusions CBI can separate healthy eyes from keratoconic eyes with highly sensitivity and specificity,which was highly consistency with results of Rabinowitz keratoconus diagnostic criteria.CBI could be used as a new biomechanical indicator for the diagnosis of keratoconus.

OBJECTIVETo explore the relationship between the occurrence of sub-health and health promotion lifestyle in Guangdong province to provide epidemiological evidences for prevention of sub-health.

METHODSA 1:1 nested case-control study was carried out involving 133 cases from the cohort study paired with 133 control case matched for gender and age.

RESULTSThe univariate conditional logistic regression model showed no significant association of marital status, education level, or body mass index with the occurrence of sub-health, but a significant correlation was found between lifestyle and sub-health with an odd ratio of 5.90 (95% CI: 3.12-11.16, P=0.000). Analysis of the multivariate conditional logistic regression model on the 6 subscales of health promotion lifestyle showed that stress management was significantly correlated with the occurrence of sub-health with an odd ratio of 4.00 (95% CI: 1.54-10.40, P=0.004).

CONCLUSIONA unhealthy lifestyle, especially in terms of stress management, is the major risk factor contributing to the occurrence of sub-health.