Efficacy of indirect intense pulsed light irradiation on meibomian gland dysfunction: a randomized controlled study

AIM:To investigate the efficacy and mechanisms of indirect intense pulsed light(IPL)irradiation on meibomian gland dysfunction(MGD).METHODS:A total of 60 MGD patients was included in this prospective randomized controlled trial.Patients were randomly assigned 1:1 into two groups(3-mm group and 10-mm group)in which IPL was applied at distances from the lower eyelid margin of 3 and 10 mm,respectively.Both groups received three times treatment with 3-week interval.Meibomian gland yield secretion score(MGYSS),standard patient evaluation of eye dryness(SPEED)questionnaire,tear break-up time(TBUT),corneal fluorescein staining(CFS),and in vivo confocal microscopy were performed at baseline and after every treatment.RESULTS:After three IPL treatments,both groups had significant improvement in MGYSS(both P<0.05).The noninferiority test showed that improvement in 10-mm group was not inferior to that in 3-mm group(P<0.001).In both groups,temporal regions of both upper and lower eyelids showed significant improvement in MGYSS.Scores of SPEED questionnaire in both groups declined significantly(both P<0.001)and changes of SPEED had no difference between two groups(P=0.57).Density of central corneal subepithelial nerves and TBUTs showed no statistically significant changes.The 3-mm group had improvement on corneal fluorescein staining(P=0.048)and meibomian gland morphology(acini wall thickness P=0.003,hyperreflective points P=0.024)while the 10-mm group had not.CONCLUSION:The efficacy of IPL indirect irradiation in improving meibomian gland secretion and alleviating dry eye symptoms remains unchanged with increase in treatment distance.IPL may primarily act on the functional improvement of the meibomian glands and corneal nerves.

A study of medial and lateral temporal lobe epilepsy based on stereoelectroencephalography

Background:Patients with temporal lobe epilepsy(TLE)originating from different seizure onset zones had distinct electrophysiological characteristics and surgical outcomes.In this study,we aimed to investigate the relationship between the origin and prognosis of TLE,and the stereoelectroencephalography(SEEG)features.Methods:Thirty patients with TLE,who underwent surgical treatment in our functional neurosurgery department from January 2016 to December 2017,were enrolled in this study.All patients underwent anterior temporal lobectomy after an invasive preoperative evaluation with SEEG.Depending on the epileptic focus location,patients were divided into those with medial temporal lobe seizures(MTLS)and those with lateral temporal lobe seizures(LTLS).The Engel classification was used to evaluate operation effectiveness,and the Kaplan-Meier analysis was used to detect seizure-free duration.Results:The mean follow-up time was 25.7±4.8 months.Effectiveness was 63.3%for Engel I(n=19),13.3%for Engel II,3.3%for Engel III,and 20.0%for Engel IV.According to the SEEG,60.0%(n=18)had MTLS,and 40.0%(n=12)had LTLS.Compared with the MTLS group,the operation age of those with LTLS was significantly greater(26.9±6.9 vs.29.9±12.5 years,t=-0.840,P=0.009)with longer epilepsy duration(11.9±6.0 vs.17.9±12.1 years,t=-1.801,P=0.038).Patients with MTLS had a longer time interval between ictal onset to seizure(67.3±59.1 s vs.29.3±24.4 s,t=2.017,P=0.008).The most common SEEG ictal pattern was a sharp/spike-wave rhythm in the MTLS group(55.6%)and low-voltage fast activity in the LTLS group(58.3%).Compared with the LTLS group,patients with MTLS had a more favorable prognosis(41.7%vs.77.8%,P=0.049).Post-operative recurrence was more likely to occur within three months after the operation for both groups,and there appeared to be a stable longterm outcome.Conclusion:Patients with MTLS,who accounted for three-fifths of patients with TLE,showed a more favorable surgical outcome.

Benzimidazolium Functionalized Polysulfone-based Anion Exchange Membranes with Improved Alkaline Stability

The stability of anion exchange membranes(AEMs)is an important feature of alkaline exchange membrane fuel cells(AEMFCs),which has been extensively studied.However it remains a real challenge due to the harsh working condition.Herein,we developed a novel type of polysulfone-based AEMs with three modified 1,2-dimethylbenzimidazoliums containing different substitutes at C4-and C7-position.The results showed that the introduction of the substitutes could obviously improve the dimensional and alkaline stabilities of the corresponding membranes.The swelling ratios of resultant AEMs were all lower than 10%after water immersion.The membrane with 4,7-dimethoxy-1,2-dimethylbenzimidazolium group exhibited the highest alkaline stability.Only 9.2%loss of hydroxide conductivity was observed after treating the membrane in 1 mol·L^(-1)KOH solution at 80°C for 336 h.Furthermore,the density functional theory(DFT)study on the three functional group models showed that the substitutes at C4-and C7-position affected the lowest unoccupied molecular orbital(LUMO)energies of the different 1,2-dimethylbenzimidazolium groups.

Optimal Policies for Inventory Systems with Discretionary Sales,Random Yield and Lost Sales

We determine replenishment and sales decisions jointly for an inventory system with random demand, lost sales and random yield. Demands in consecutive periods are independent random variables and their distributions are known. We incorporate discretionary sales, when inventory may be set aside to satisfy future demand even if some present demand may be lost. Our objective is to minimize the total discounted cost over the problem horizon by choosing an optimal replenishment and discretionary sales policy. We obtain the structure of the optimal replenishment and discretionary sales policy and show that the optimal policy for finite horizon problem converges to that of the infinite horizon problem. Moreover, we compare the optimal policy under random yield with that under certain yield, and show that the optimal order quantity （sales quantity） under random yield is more （less） than that under certain yield.