Ocular surface squamous neoplasia(OSSN)is a series of pathological solid tumors formed by dysplasia of keratoconjunctival epithelium, which is one of the most common ocular surface tumors in adults. In the past two decades, the treatment of OSSN has gradually changed from surgical resection to topical chemotherapy. Interferons, 5-fluorouracil and mitomycin are the most commonly used topical agents for the clinical treatment of this disease. This paper summarizes the diagnosis of OSSN and various local chemotherapy treatment options, highlights the potential role of high-resolution optical coherence tomography(HR-OCT)technology in the diagnosis and treatment of this disease.

Limbal niche cells (LNCs) in the limbal niche, a type of mesenchymal stem cells closely associated with limbal epithelial stem/progenitor cells (LESCs), heterogeneously express both mesenchymal and putative embryonic stem cell markers and play a critical role in regulating the quiescence, self-renewal, and differentiation of LESCs.Previous studies have shown that LNCs can be isolated by collagenase, dispase, dispase-collagenase and explant culture.Transwell and 3D Matrigel coculture are widely used in ex vivo studies of LNCs and LESCs, and the interactive mechanism may include SDF-1/CXCR4, Notch, BMP, Wnt, Sonic Hedgehog, and KIT/AKT signaling pathways, and various cytokines such as nerve growth factor, keratinocyte growth factor, and insulin-like growth factor.LNCs have become a hot topic in corneal epithelial tissue engineering, ocular surface reconstruction, and corneal regeneration.This review provides an overview of the research background, isolation and culture methods, interaction mechanism of LNCs with LESCs, and its application prospects.

Abstract According to the Healthy China Action Plan, Wuhan gives full play to the role of preventing and controlling student myopia by promoting student health. The primary focus is placed on education in schools, and Wuhan has integrated educational resources to develop a multi-level myopia prevention and control system and service network for school students. The network contains educational adminstrative, schools, families, and professional technical service organizations. By integrating multiple disciplines, Wuhan has built a comprehensive vision health management service system for all students. The Internet and cloud intelligent monitoring facilitated the establishment of a smart vision health management platform for students, which thoroughly and efficiently implemented myopia prevention and control to safeguard students visual health by engaging in education, monitoring, and supervision. The prevention and control of student myopia is a breakthrough for comprehensive healthy development of students. A comparison of the standard myopia rate in Wuhan in 2019 and 2018 revealed that the standard myopia rate at different learning stages of primary school, junior high school, and high school dropped by 3.31, 2.50, and 2.26 percentage points, respectively, and the rate of myopia in primary school was significantly lower than the national level. Post-epidemic surveys showed that the compliance rate and the awareness rate of the visual environment and visual behaviors of primary and secondary school students in Wuhan reached more than 80%, and prevalence of newly onset myopia or decreased vision was 30%, which was lower than the national average. The "Wuhan Model" provides an important referential framework for public health services for school students.

An expert consensus about the clinical diagnosis and treatment of dry eye was documented in 2013 by a corneal expert group of Chinese Ophthalmological Society.However, due to the rapid development of diagnostic and therapeutic devices of dry eye, researoh on dry eye has made significont progress in China since then.Consequently, the existing expert consensus cannot meet the needs of clinical practice.It is therefore urgent to develop a series of standardized diagnosis and treatment protocols, and publish a new consensus of experts and an operating guideline.At the same time, basic, clinical, and translational research on dry eye should be promoted to provide better services to the patients with dry eyes.On January 12, 2019 many experts in the field of dry eye in China held a panel discussion of dry eye study in Guangzhou to analyze the current development status and trends in the field of dry eye in China and abroad.In that meeting, opinions and recommendations were put forward based on a new understanding of the definition of dry eye, new concepts of dysfunctional dry eye, advances its diagnosis and classification, refinement and standardization of dry eye treatment, and the future development of dry eye research.

Objective:To explore the application value of artificial intelligence-assisted diagnosis model based on convolutional neural network (CNN) in the differential diagnosis of benign and malignant breast masses.Methods:A total of 10 490 images of 2 098 patients with breast lumps (including 1 132 cases of benign tumor, 779 cases of malignant tumor, 32 cases of inflammation, 155 cases of adenosis) were collected from January 2016 to January 2018 in Beijing Tiantan Hospital Affiliated to the Capital University of Medical Sciences. They were divided into training set and test set and the auxiliary artificial intelligence diagnosis model was used for training and testing. Two sets of data training models were compared by two-dimensional imaging (2D) and two-dimensional and color Doppler flow imaging (2D-CDFI). The ROC curves of benign breast tumors, malignant tumors, inflammation and adenopathy were analyzed, and the area under the ROC curve (AUC) were calculated.Results:The accuracies of 2D-CDFI ultrasonic model for training group and testing group were significantly improved. ①For benign tumors, the result from training set with 2D image was: sensitivity 92%, specificity 95%, AUC 0.93; the result from training set with 2D-CDFI images was: sensitivity 93%, specificity 95%, AUC 0.93; the result for test set with 2D images was: sensitivity 91%, specificity 96%, AUC 0.94; the result for test set with 2D-CDFI images was: sensitivity 93%, specificity: 94%, AUC 0.94. ② For malignancies, the result for training set with 2D images was: sensitivity 93%, specificity 97%, AUC 0.94; the result for training set with 2D-CDFI images was: sensitivity 93%, specificity 96%, AUC 0.94; the result for test set with 2D images was: sensitivity 93%, specificity 96%, AUC 0.94; the result for test set with 2D-CDFI images was: sensitivity 93%, specificity 96%, AUC 0.94. ③For inflammation, the result for training set with 2D images was: sensitivity 81%, specificity 99%, AUC 0.91; the result for training set with 2D-CDFI images was: sensitivity 86%, specificity 99%, AUC 0.89; the result for test set with 2D images was: sensitivity 100%, specificity 98%, AUC 0.98; the result for test set with 2D-CDFI images was: sensitivity 100%, specificity 99%, AUC 0.96. ④For adenopathy, the result for training set with 2D images was: sensitivity 88%, specificity 97%, AUC 0.94; the result for training set with 2D-CDFI images was: sensitivity 93%, specificity 98%, AUC 0.94; the result for test set with 2D images was: sensitivity 94%, specificity 98%, AUC 0.93; the result for test set with 2D-CDFI images was: sensitivity 88%, specificity 99%, AUC 0.90. Its diastolic accuracy was not affected even if the maximum diameter of the tumor was less than 1 cm.Conclusions:Through the deep learning of artificial intelligence based on CNN for breast masses, it can be more finely classified and the diagnosis rate can be improved. It has potential guiding value for the treatment of breast cancer patients.

Objective Because of statistical noise in Monte Carlo dose calculations,the effective point doses may not be accurately calculated.A user-defined sphere volume was adopted to substitute the effective point to take sphere sampling around the effective point,which minimize the random errors and improve the accuracy of statistical dose.Methods Direct dose measurements were performed at 0°and 90° using a 0.125 cm3 Semiflex ionization chamber (IC) 31010 isocentrically placed in the center of a homogeneous Cylindric sliced RW3 phantom (PTW,Germany).In the scanned CT phantom series,the sensitive volume length of the IC (6.5 mm) was delineated and the isocenter was defined as the simulated effective point.All beams were simulated in the treatment planning system (TPS) in accordance to the measured model.The grid spacing was calculated by 2 mm voxels and the relative standard deviation should be ≤ 0.5％.The statistical and measured doses were statistically compared among three IC models with different electron densities (ED;esophageal lumen ED =0.210 g/cm3 for model A,air ED =0.001 g/cm3 for model B and the default CT scanned ED for model C) at different sampling sphere radius (2.5,2.0,1.5 and 1.0 mm) to evaluate the effect of Monte Carlo.calculation uncertainty upon the dose accuracy.Results In the Monaco TPS,the statistical value was in the highest accordance with the measured value with an absolute average deviation of 0.49％ when the IC was set as esophageal lumen ED =0.210 g/cm3 and the sampling sphere radius was 1.5 mm.When the IC was set as air ED=0.001 g/cm3 and default CT scanned ED,and,the recommended statistical sampling sphere radius was 2.5 mm,the absolute average deviations were 0.61％ and 0.70％.Conclusion In the Monaco TPS,the calculation model with an ED of 0.210 g/cm3 and a sampling radius of 1.5 mm is recommended for the ionization chamber 31010 to substitute the effective point dose measurement to decrease the random stochastic errors of Monte Carlo.

Objective T o explore the occurrence and the differences of clinical m anifestations of organic personality disorder w ith varying degrees of craniocerebral traum a. Methods A ccording to the Interna-tional C lassification of D iseases-10, 396 subjects w ith craniocerebral traum a caused by traffic accidents w ere diagnosed, and the degrees of craniocerebral traum a w ere graded. T he personality characteristics of all patients w ere evaluated using the sim plified N euroticism E xtraversion O penness Five-Factor Inventory (N E O-FFI). Results T he occurrence rate of organic personality disorder w as 34.6% w hile it w as 34.9%and 49.5% in the patients w ith m oderate and severe craniocerebral traum a, respectively, w hich signifi-cantly higher than that in the patients (18.7% ) of m ild craniocerebral traum a (P<0.05). C om pared w ith the patients w ithout personality disorder, the neuroticism , extraversion and agreeableness scores all show ed significantly differences (P<0.05) in the patients of m ild craniocerebral traum a w ith personality disorder; the neuroticism , extraversion, agreeableness and conscientiousness scores show ed significantly differences (P<0.05) in the patients of m oderate and severe craniocerebral traum a w ith personality disor-der. T he agreeableness and conscientiousness scores in the patients of m oderate and severe craniocerebral traum a w ith personality disorder w ere significantly low er than that of m ild craniocerebral traum a, and the patients of severe craniocerebral traum a had a low er score in extraversion than in the patients of m ild craniocerebral traum a. Conclusion T he severity of craniocerebral traum a is closely related to the in-cidence of organic personality disorder, and it also affects the clinical features of the latter, w hich pro-vides a certain significance and help for forensic psychiatric assessm ent.

Objective To figure out the optimal parameters of a volumetric modulated arc therapy ( VMAT) plan for cervical and upper esophageal cancer by quality evaluation of VMAT plans with different parameters, and to provide a reference for the design of clinical VMAT treatment plan. Methods Ten patients with cervical esophageal cancer and ten patients with upper esophageal cancer were enrolled as subjects. The Nucletron Oncentra 4. 3 treatment planning system was used to generate plans for Elekta Synergy VMAT accelerator. Six VMAT plans were made with variation in the gantry angle ( 2°, 3°, and 4°), the maximum delivery time (80 s, 110 s, and 150 s), and the collimator angle (0° and 45°). The doses to the planning target volume and organs at risk were analyzed by paired t test. Results For cervical and upper esophageal cancer, the quality of VMAT plans with a collimator angle of 45° was better than those with a collimator angle of 0°(P=0. 003?0. 007). For cervical esophageal cancer, there was no significant difference in quality between VMAT plans with a maximum delivery time of 110 s or 150 s and those with a maximum delivery time of 80 s ( P>0. 05 );for upper esophageal cancer, there was also no significant difference in quality between VMAT plans with three different maximum delivery times ( P>0. 05 ) . For cervical esophageal cancer, the VMAT plans with a gantry angle of 3° had a better quality than those with a gantry angle of 2° or 4°(P=0. 010?0. 048). For upper esophageal cancer, the VMAT plans with a gantry angle of 3° had a better quality than those with a gantry angle of 4° ( P=0. 010?0. 048) . Compared with those with a gantry angle of 2° , the VMAT plans with a gantry angle of 3° had a slightly better dose distribution in the target volume ( P=0. 046 ) , but a slightly higher dose to lung tissue ( V25 and V30 , P=0. 007 and 0. 026) . Conclusions The optimal initial parameters of a VMAT plan for cervical and upper esophageal cancer are a collimator angle of 45°, a maximum delivery time of 80 s, and a gantry angle of 3°.

OBJECTIVETo investigate the disease-causing mutation in a Chinese family affected with Usher syndrome type II.

METHODSAll of the 11 members from the family underwent comprehensive ophthalmologic examination and hearing test, and their genomic DNA were isolated from venous leukocytes. PCR and direct sequencing of USH2A gene were performed for the proband. Wild type and mutant type minigene vectors containing exon 42, intron 42 and exon 43 of the USH2A gene were constructed and transfected into Hela cells by lipofectamine reagent. Reverse transcription (RT)-PCR was carried out to verify the splicing of the minigenes.

RESULTSPedigree analysis and clinical diagnosis indicated that the patients have suffered from autosomal recessive Usher syndrome type II. DNA sequencing has detected a homozygous c.8559-2A>G mutation of the USH2A gene in the proband, which has co-segregated with the disease in the family. The mutation has affected a conserved splice site in intron 42, which has led to inactivation of the splice site. Minigene experiment has confirmed the retaining of intron 42 in mature mRNA.

CONCLUSIONThe c.8559-2A>G mutation in the USH2A gene probably underlies the Usher syndrome type II in this family. The splice site mutation has resulted in abnormal splicing of USH2A pre-mRNA.

Adolescent ; Adult ; Aged ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child ; China ; Extracellular Matrix Proteins ; genetics ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Pedigree ; Usher Syndromes ; genetics ; metabolism ; Young Adult

BACKGROUNDLowering intraocular pressure (IOP) is currently the only therapeutic approach in primary open-angle glaucoma. and the fixed-combination medications are needed to achieve sufficiently low target IOP. A multicenter prospective study in the Chinese population was needed to confirm the safety and efficacy of Bimatoprost/Timolol Fixed Combination Eye Drop in China. In this study, we evaluated the safety and efficacy of Bimatoprost/Timolol Fixed Combination with concurrent administration of its components in Chinese patients with open-angle glaucoma or ocular hypertension.

METHODSIn this multicenter, randomized, double-masked, parallel controlled study, patients with open-angle glaucoma or ocular hypertension who were insufficiently responsive to monotherapy with either topical β-blockers or prostaglandin analogues were randomized to one of two active treatment groups in a 1:1 ratio at 11 Chinese ophthalmic departments. Bimatoprost/timolol fixed combination treatment was a fixed combination of 0.03% bimatoprost and 0.5% timolol (followed by vehicle for masking) once daily at 19:00 P.M. and concurrent treatment was 0.03% bimatoprost followed by 0.5% timolol once daily at 19:00 P.M. The primary efficacy variable was change from baseline in mean diurnal intraocular pressure (IOP) at week 4 visit in the intent-to-treat (ITT) population. Primary analysis evaluated the non-inferiority of bimatoprost/ timolol fixed combination to concurrent with respect to the primary variable using a confidence interval (CI) approach. Bimatoprost/timolol fixed combination was to be considered non-inferior to concurrent if the upper limit of the 95% CI for the between-treatment (bimatoprost/timolol fixed combination minus concurrent) difference was ≤ 1.5 mmHg. Adverse events were collected and slit-lamp examinations were performed to assess safety. Between-group comparisons of the incidence of adverse events were performed using the Pearson chi-square test or Fisher's exact test.

RESULTSOf the enrolled 235 patients, 121 patients were randomized to receive bimatoprost/timolol fixed combination and, 114 patients were randomized to receive concurrent treatment. At baseline the mean value of mean diurnal IOP was (25.20 ± 3.06) mmHg in the bimatoprost/timolol fixed combination group and (24.87 ± 3.88) mmHg in the concurrent group. The difference between the treatment groups was not statistically significant. The mean change from baseline in mean diurnal IOP (± standard deviation) in the bimatoprost/timolol fixed combination group was (-9.38 ± 4.66) mmHg and it was (-8.93 ± 4.25) mmHg in the concurrent group (P < 0.01). The difference between the two treatment groups (bimatoprost/timolol fixed combination minus concurrent) in the change from baseline of mean diurnal IOP was -0.556 mmHg (95% CI: -1.68, 0.57, P = 0.330). The upper limit of the 95% CI was less than 1.5 mmHg, the predefined margin of non-inferiority. Adverse events occurred in 26.4% (32/121) of the bimatoprost/timolol fixed combination patients and 30.7% (35/114) of the concurrent patients. The most frequent adverse event was conjunctival hyperemia, which was reported as treatment related in 16.5% (20/121) in the bimatoprost/timolol fixed combination group and 18.4% (21/114) in the concurrent group (P > 0.05).

CONCLUSIONSBimatoprost/Timolol Fixed Combination administered in Chinese patients with open-angle glaucoma or ocular hypertension was not inferior to concurrent dosing with the individual components. Safety profiles were similar between the treatment groups.

Adolescent ; Adult ; Aged ; Amides ; administration & dosage ; adverse effects ; therapeutic use ; Bimatoprost ; Cloprostenol ; administration & dosage ; adverse effects ; analogs & derivatives ; therapeutic use ; Female ; Glaucoma, Open-Angle ; drug therapy ; Humans ; Male ; Middle Aged ; Ocular Hypertension ; drug therapy ; Timolol ; administration & dosage ; adverse effects ; therapeutic use ; Young Adult