中药熏蒸联合人工泪液治疗干眼症的临床观察及对患者视觉相关生命质量的影响

目的:探究中药熏蒸联合人工泪液治疗干眼症的临床疗效,分析其对患者视觉相关生命质量的影响。方法:选取2014年11月至2016年12月北京市健宫医院收治的干眼症患者72例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组36例(72只患眼),对照组给予人工泪液治疗,观察组在对照组的基础上联合中药熏蒸治疗,2周为1个疗程,2组均连续治疗2个疗程。统计2组临床疗效;比较2组患者治疗前后主要中医症状积分、泪液分泌量、泪膜破裂时间;采用美国国家眼科研究所视觉相关生命质量量表(NEI-VFQ-25)评价并比较2组患者治疗前后视觉相关生命质量。结果:治疗后观察组总有效率为90. 28%,较对照组的63. 89%显著升高(P 0. 01);与治疗前比较,治疗后2组患者患眼疲劳感、干涩感、异物感及烧灼感等症状积分均显著降低,且观察组显著低于对照组(P 0. 01);与治疗前比较,治疗2周后至治疗4周后2组泪液分泌量呈逐渐升高趋势(P 0. 01),泪膜破裂时间呈逐渐延长趋势(P 0. 05),且治疗后2组间差异有统计学意义(P 0. 05或P 0. 01);与治疗前比较,治疗后2组患眼一般健康状况、活动障碍及视力障碍评分均显著升高(P 0. 01),且观察组显著高于对照组(P 0. 01)。结论:中药熏蒸联合人工泪液治疗干眼症可有效缓解患眼临床症状,促进患眼泪液分泌并增强泪膜稳定性,同时还可显著改善患眼视觉相关生命质量,疗效显著优于人工泪液单用。     

Atmospheric input of 137Cs and 239,240Pu isotopes in Korea after the Fukushima nuclear power plant accident

Caesium isotopes (¹³⁴Cs and ¹³⁷Cs) and ^239,240Pu in rainwater and dry deposition have been analyzed by Korea Research Institute of Standards and Science (KRISS) since the Fukushima nuclear power plant (NPP) accident in March 2011. The concentrations of ^239,240Pu and ¹³⁷Cs in the rainwater are 2.6±1.0 to 15±3 µBq/kg and 0.01 to 0.36 mBq/kg, respectively. The concentrations are concordant to those observed before the Fukushima NPP accident, on the other hand, the monthly depositional flux of ^239,240Pu and ¹³⁷Cs are much lower than the amounts observed after Fukushima NPP accident and in Monaco in 1998–2001. This confirms that the Fukushima NPP accident caused no significant impact in Korea.     

Spray freeze drying for dry powder inhalation of nanoparticles

Formulating nanoparticles for delivery to the deep lung is complex and many techniques fail in terms of nanoparticle stability. Spray freeze drying (SFD) is suggested here for the production of inhalable nanocomposite microcarriers (NCM). Different nanostructures were prepared and characterized including polymeric and lipid nanoparticles. Nanoparticle suspensions were co-sprayed with a suitable cryoprotectant into a cooled, stainless steel spray tower, followed by freeze drying to form a dry powder while equivalent compositions were spray dried (SD) as controls. SFD-NCM possess larger specific surface areas (67–77 m²/g) and lower densities (0.02 g/cm³) than their corresponding SD-NCM. With the exception of NCM of lipid based nanocarriers, SFD produced NCM with a mass median aerodynamic diameter (MMAD) of 3.0 ± 0.5 μm and fine particle fraction (FPF ⩽ 5.2 μm) of 45 ± 1.6% with aerodynamic performances similar to SD-NCM. However, SFD was superior to SD in terms of maintaining the particle size of all the investigated polymeric and lipid nanocarriers following reconstitution (S_f/S_i ratio for SFD ≈ 1 versus >1.5 for SD). The SFD into cooled air proved to be an efficient technique to prepare NCM for pulmonary delivery while maintaining the stability of the nanoparticles.     

Dry eyes in patients with diabetes mellitus

Dry eyes may be caused by impairment in the tear production or excessive tear evaporation and are associated with photophobia, red eyes, vision impairment, local pain and pruritus. It has been described that patients with Diabetes Mellitus (DM) may have a higher prevalence of dry eyes than normal population.This is a case control study of 120 patients with Diabetes Mellitus (DM) and 120 paired controls aiming to compare their prevalence of dry eyes (by the Schirmer test) and its severity (measured by OSDI or Ocular Surface Disease Index) as well as their association with diseases’ clinical variables.We found that 38.3% of DM patients had dry eyes, a prevalence that was higher than controls (p = 0.02). At univariate analysis, they were found to be more common in older individuals (p = 0.001) with type 2 diabetes (p = 0.001) and in those using metformin (p = 0.001). A multivariate linear regression showed that metformin use was the only independent variable associated with dry eyes. When patients with dry eyes with and without DM were compared, no differences in the symptom’s intensity were found.     

Relationship between unhealthy sleep status and dry eye symptoms in a Japanese population: The JPHC-NEXT study

PurposeTo investigate whether and how unhealthy sleep habits (i.e., the frequency of difficulty falling or staying asleep, and the frequency of waking up tired) and the duration of sleep are related to the prevalence of dry eye disease (DED) in a general population.MethodsThis study included a total of 106,282 subjects aged 40–74 years who participated in a baseline survey of the Japan Public Health Center-based Prospective Study for the Next Generation. DED was defined as the presence of clinically diagnosed DED or severe symptoms. Multivariable-adjusted logistic regression models were used to assess the relationships of various components of sleep status with DED.ResultsHigher frequencies of having difficulty falling or staying asleep, and waking up tired were significantly related to increased DED in both sexes (P_trend<0.001). Compared with those with 8 h/day of sleep, shorter sleepers had an increased prevalence of DED in both sexes, although DED was increased among men who slept ≥10 h/day. By comparing participants with the greatest vs. the least difficulty of falling asleep, the multivariable-adjusted odds ratios (95% confidence interval [CI]) were 2.23 (95% CI, 1.99–2.49) for men and 1.91 (95% CI, 1.76–2.07) for women. When analyzed separately, the magnitude of each relationship was stronger with severe DED symptoms than with clinically diagnosed DED.ConclusionsSleep deprivation and poor sleep quality were significantly related to DED in a Japanese population.     

Therapeutic efficacy of intense pulsed light in patients with refractory meibomian gland dysfunction

Purpose

To evaluate the efficacy and safety of intense pulsed light (IPL) combined with meibomian gland expression (MGX) for treatment of refractory meibomian gland dysfunction (MGD).

Visual pathways in the brain of the jumping spider Marpissa muscosa

Some animals have evolved task differentiation among their eyes. A particular example is spiders, where most species have eight eyes, of which two (the principal eyes) are used for object discrimination, whereas the other three pairs (secondary eyes) detect movement. In the ctenid spider Cupiennius salei, these two eye types correspond to two visual pathways in the brain. Each eye is associated with its own first- and second-order visual neuropil. The second-order neuropils of the principal eyes are connected to the arcuate body, whereas the second-order neuropils of the secondary eyes are linked to the mushroom body. We explored the principal- and secondary eye visual pathways of the jumping spider Marpissa muscosa, in which size and visual fields of the two eye types are considerably different. We found that the connectivity of the principal eye pathway is the same as in C. salei, while there are differences in the secondary eye pathways. In M. muscosa, all secondary eyes are connected to their own first-order visual neuropils. The first-order visual neuropils of the anterior lateral and posterior lateral eyes are connected with a second-order visual neuropil each and an additional shared one (L2). In the posterior median eyes, the axons of their first-order visual neuropils project directly to the arcuate body, suggesting that the posterior median eyes do not detect movement. The L2 might function as an upstream integration center enabling faster movement decisions.     

Impact of physical therapists’ instructions on function and the perception of post-dry needling soreness in mechanical cervical pain; a randomized clinical trial

BackgroundTo investigate the impact of physical therapists’ instructions on the perception of post dry needling (DN) soreness and function in patients with mechanical neck pain.MethodsSeventy-five patients with neck pain were randomly assigned to three groups: “positive” group (n = 25) received positive verbal input; “negative” group (n = 25) received negative verbal input, and control group (n = 25) did not receive any input about post-needling soreness. All three groups received DN of a trigger point in the upper trapezius muscle. The subjective pain experience, pressure pain threshold (PPT), and neck disability Index (NDI) were assessed before and after DN.ResultsPatients in all groups showed improvement in pain, PPT and NDI. There were no significant differences in pain (P = 0.41) and PPT (P = 0.68) in the positive and negative groups compared with the control group. Significant difference in function was seen with the NDI after DN of patients in the positive and negative groups compared with the control group (P = 0.011, standard error: 1.08–1.5).ConclusionConsidering that the power of our study may be too low to draw more definitive conclusions, DN appears to be an effective technique to improve pain and mechanical hyperalgesia. The experience of post-needling soreness does not appear to influence the outcome of DN on pain, PPT, and NDI. Post-needling soreness does not seem to be a limiting factor in achieving acceptable outcomes, especially when clinicians offer DN within a therapeutic emphasizing a positive patient response. This study questions whether any treatments need to be offered to patients receiving DN.