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Objectives: This study aimed to assess the effectiveness and safety of intense pulsed light (IPL) therapy plus topical 0.05% cyclosporine A (CsA) eye drops to treat Sjögren's Syndrome-related dry eyes (SS-DE). Research design and methods: In this prospective, randomized trial included, 60 individuals with SS-DE symptoms were randomized to receive topical eye drops containing either 0.1% sodium hyaluronate (Group S) or 0.05% CsA (Group C) plus IPL therapy. Before the first treatment (baseline), and at 12, 16, and 20 weeks after treatment commencement, we assessed the best corrected visual acuity (BCVA), the Ocular Surface Disease Index (OSDI) score, the Schirmer I test (SIT), noninvasive tear breakup time (NBUT), corneal fluorescein staining (CFS), meibomian gland (MG) dropout, lid margin abnormality, MG expressibility, and meibum quality. Results: Both groups showed significant improvements in the OSDI, NBUT, CFS, MG expressibility, and meibum quality (all p < 0.05). Group C showed a greater increase in OSDI, NBUT, MG expressibility, and meibum quality (all p < 0.05). Moreover, SIT and lid margin abnormalities significantly improved in Group C (both p < 0.05), but not in Group S. Conclusion: Treatment with 0.05% CsA eyedrops plus IPL therapy could significantly reduce the issues and physical discomfort of patients with SS-DE. Clinical Trial: Registered on 20 July 2021, with the registration number ChiCTR2100049059. [ABSTRACT FROM AUTHOR]

Medical education is primarily based on practical schooling and the accumulation of experience and skills, which is important for the growth and development of young ophthalmic surgeons. However, present learning and refresher methods are constrained by several factors. Nevertheless, virtual reality (VR) technology has considerably contributed to medical training worldwide, providing convenient and practical auxiliary value for the selection of students' sub-majors. Moreover, it offers previously inaccessible surgical step training, scenario simulations, and immersive evaluation exams. This paper outlines the current applications of VR immersive teaching methods for ophthalmic surgery interns. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether glucocorticoids affect the prognosis of fungal keratitis by inhibiting the formation of neutrophil extracellular traps (NETs). Methods: A mouse model of Candida albicans (C.albicans) keratitis was established. Animals were randomly assigned to treatment with 0.1% dexamethasone (DXM) eye drops and normal saline (3 times each day for 3 days). The effects of DXM on fungal keratitis were assessed using clinical scores, immunofluorescence staining, histopathological examination, scanning electron microscopy (SEM), and pathogen burden assay. All the analyses were performed using SPSS software version 17.0 (Chicago, IL). Results: NETs formation was noteworthy in the cornea lesions of fungal keratitis. The clinical score of the DXM-treated group was significantly higher than that of the control group (P <.05). During the measured period, corneas from DXM-treated group contained more C.albicans than those from the control group by histology and pathogen burden assay. Compared with the control group, the DXM treatment group had a higher depth of infiltration of C.albicans. Histological and immunofluorescence staining showed that there were fewer neutrophils in the cornea focus of DXM-treated group (P <.05）, and the number of NETs formed in scrapings from control group was higher than that in the DXM treatment group on day 3 (P <.05, Z = −3.56)) and day 5 (P <.05, Z = −3.69). In a similar amount of cell scraping, the NETs of neutrophils formation from the DXM-treated group were also less than that from the control group. Conclusion: Our results indicated that NETs were involved in the immune response in C.albicans keratitis. Glucocorticoids may exacerbate fungal keratitis not only by increasing fungal aggressivity and reducing the infiltration of neutrophils but also by inhibiting the formation of NETs. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the analgesic and sedative effectiveness of dezocine and midazolam in vitrectomy. Methods: One hundred and sixty patients undergoing vitrectomy were randomized into four groups. The control group was given local anesthetic in retrobulbar nerve block only, while the other three groups received a single dose of 0.1 mg/kg dezocine or/and 0.05 mg/kg midazolam (groups D, M, DM), respectively, at 10 min before retrobulbar block. Mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO2) were recorded prior to local anesthesia (Tp), at the start of surgery (T0), 5, 15, 30 min during (T1–T3), and at the end of surgery (T4). Pain at T2 and T4 was assessed by Numeric Rating Scale (NRS). Level of sedation at T2 was assessed using the Ramsay scale. Postoperative nausea and vomiting (PONV) events were recorded for 24 h. Results: Group DM showed a decrease in HR during T0–T4 compared to Tp (p < 0.001). The MAP of all groups decreased significantly at T0 compared to Tp (p < 0.05), but remained unchanged at T1–T4. At T2, all groups have lower pain level than control (p < 0.001), while group DM showed the lowest pain level. At T4, groups D and DM showed a lower pain level than control (p < 0.01). Groups M and DM showed a higher Ramsay score than group C (p < 0.01). Compared with control, group D had a higher PONV rate (p < 0.1). Groups M and DM showed a lower PONV rate than group D (p < 0.0001), and group M had a lower PONV rate than group C (p < 0.01). Conclusion: Combinatory use of dezocine and midazolam in addition to local anesthetic in retrobulbar nerve block can help relief pain and anxiety during vitrectomy and reduce PONV. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the relationship between meibomian gland dysfunction (MGD) and incomplete blinking caused by cranial nerve seven (CN VII) palsy. Methods: A prospective case series of 60 consecutive patients with unilateral CN VII palsy was evaluated for MGD. According to the House–Brackmann scale, patients were divided into complete or incomplete blinking group, with the incomplete group further subdivided to early, middle or late stage according to the paralysis duration. Schirmer’s I test, tear break-up time (BUT), superficial punctate keratopathy, eyelid abnormality, ability and quality of meibum expression were evaluated. Unaffected contralateral eyes were used as control for comparison. Results: A paired samplet-test between affected and unaffected eyes demonstrated a significant difference for BUT, superficial punctate keratopathy, eyelid abnormality, ability and quality of meibum expression in the incomplete blinking group. However, only BUT showed significant difference between affected and unaffected eyes in complete blinking group. Furthermore, we showed that paralysis duration was related to the incidence of MGD. Significant difference was demonstrated between the affected and unaffected eyes for superficial punctate keratopathy, eyelid abnormality, ability and quality of meibum expression in the middle and late stage, but not early stage. Conclusions: These findings suggest that the inability to blink completely induced by CN VII palsy for more than one week might contribute to the development of MGD. Clinical optimization of blinking may ameliorate MGD symptom and benefit CN VII palsy patients. [ABSTRACT FROM AUTHOR]

Feminist geographers and leisure scholars have long argued that one critical way to understand gendered norms and expectations is through examining women's access to and experiences of leisure activities. Set in the context of the rapid economic, political, and social changes that have taken place in Beijing over the past half century, this article draws on in-depth interviews and extensive participant observation to explore the role of newly available public leisure spaces in the lives and leisure of young women in Beijing, in particular by examining the way that these spaces provide an opportunity for the negotiation of new gender norms and identities. Through an analysis of the interaction of gender norms and practices with women's use of and behavior in public leisure spaces, we argue that women's behavior in public leisure spaces in contemporary Beijing remains strongly circumscribed by gendered norms. Rather than their presence itself constituting a challenge to gender expectations, in many cases their leisure behavior and experiences serve to reinforce the social norms that masculinize public leisure spaces. In spite of this, however, the findings of this research suggest that public leisure spaces may, in some cases, provide women with a place from which to challenge gender norms. [ABSTRACT FROM PUBLISHER]

Purpose: To evaluate the effect of glucocorticoids on the innate immunity of corneal epithelial cells. Methods: Human corneal epithelial cell lines (HCEC) were co-cultured with LPS and hydrocortisone to determine whether hydrocortisone modulates the expression and function of TLR2, 4. The release of IL-6, 8 from cultured HCEC was measured in the presence and absence of specific blocking antibodies to TLR2, 4. The proteins of TLR2, 4 were also compared by Western blot. Results: Incubation of HCEC with LPS upregulated the expression of TLR2, 4 and increased the release of IL-6, 8. This upregulation was enhanced by low-concentration hydrocortisone, but inhibited by high-concentration hydrocortisone. The concentration of IL-6, 8 was also enhanced by low-concentration hydrocortisone and inhibited by high-concentration hydrocortisone. Conclusions: Low-concentration hydrocortisone enhances the expression and function of TLRs in HCEC and provides evidence for a novel function of glucocorticoids in innate immunity. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate hydrocortisone's potential in inhibiting the expression of VEGF in cultured human cornea fibroblasts (HCF) and to determine whether the role of hydrocortisone in the expression of VEGF may relate to toll-like receptors 2 and 4 (TLR2 and TLR4). Methods: Three different concentrations of hydrocortisone were used to stimulate the cultured HCF. The cellular abundance of the mRNAs for VEGF and TLR2, 4 were determined by real-time polymerase chain reaction analysis. The release of IL-6, IL-8, and VEGF from cultured HCF was measured using enzyme-linked immunosorbent assays (ELISA) in the presence and absence of specific blocking antibodies to TLR2, 4. The proteins of TLR2, 4 were also compared by Western blot. Results: Following incubation of HCF with hydrocortisone, we found the mRNA expression of TLR2, 4 and VEGF were markedly inhibited. ELISA and Western blot analysis confirmed that protein expression of TLR2, 4 and VEGF was down-regulated in response to hydrocortisone. The result of ELISA also showed the release of IL-6 and IL-8 can be inhibited by hydrocortisone. But all these inhibitions were partly counteracted after pretreatment with anti-TLR2 and/or anti-TLR4 monoclonal antibody. Conclusions: Hydrocortisone may decrease the expression of VEGF through inhibiting TLR2, 4 activity in cultured human corneal fibroblasts. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the expression of toll-like receptors (TLRs) in the human cornea with Fusarium solani (F. solani) keratitis. Methods: Five human corneas with F. solani keratitis and 5 healthy human corneas were evaluated for TLR1-10 mRNA by reverse transcribed polymerase chain reaction (RT-PCR) and relative real-time PCR. The proteins of TLR2, 4, and 9 were also compared by Western blot. The mean times between these corneas were collected, and the onset of treatment to surgery was 34.4 ± 12.4 days, ranging from 15 to 47 days. The data were analyzed with SPSS15.0. Results: TLR1-10 mRNA was expressed in both healthy and F. solani infected human corneas. The expression of TLR2, 4, 6, and 9 mRNA in the F. solani infected human corneas were upregulated. The Western blot showed the protein expression of TLR2, 4, and 9 was also upregulated in the corneas with F. solani keratitis than that of the healthy corneas. Conclusions: TLRs are expressed diversely in the F. solani infected human cornea, and TLR2, 4, and 9 may be implicated in the pathogenesis of F. solani infection in the cornea. [ABSTRACT FROM AUTHOR]