雄安新区记录到一例白变白骨顶

2023年3月28日在雄安新区小白洋淀淀区(38.840°N,115.966°E;海拔7 m)调查时记录到1只羽色畸变(colour aberration)的白骨顶(Fulica atra)个体,该个体与正常白骨顶混群,体型相似,头部亦具白色额甲,但颈部以下及背部大部分羽毛变白,呈黑白斑状分布,鉴定为白骨顶白变(leucism)个体(图1)。

The HIF-1α/PLOD2 axis integrates extracellular matrix organization and cell metabolism leading to aberrant musculoskeletal repair

While hypoxic signaling has been shown to play a role in many cellular processes,its role in metabolism-linked extracellular matrix(ECM)organization and downstream processes of cell fate after musculoskeletal injury remains to be determined.Heterotopicossification(HO)is a debilitating condition where abnormal bone formation occurs within extra-skeletal tissues.Hypoxia andhypoxia-inducible factor 1α(HIF-1α)activation have been shown to promote HO.However,the underlying molecular mechanisms bywhich the HIF-1αpathway in mesenchymal progenitor cells(MPCs)contributes to pathologic bone formation remain to beelucidated.Here,we used a proven mouse injury-induced HO model to investigate the role of HIF-1αon aberrant cell fate.Usingsingle-cell RNA sequencing(scRNA-seq)and spatial transcriptomics analyses of the HO site,we found that collagen ECM organizationis the most highly up-regulated biological process in MPCs.Zeugopod mesenchymal cell-specific deletion of Hif1α(Hoxa11-CreER^(T2);Hif1a^(fl/fl))significantly mitigated HO in vivo.ScRNA-seq analysis of these Hoxa11-CreER^(T2);Hif1a^(fl/fl)mice identified the PLOD2/LOXpathway for collagen cross-linking as downstream of the HIF-1αregulation of HO.Importantly,our scRNA-seq data and mechanisticstudies further uncovered that glucose metabolism in MPCs is most highly impacted by HIF-1αdeletion.From a translational aspect,a pan-LOX inhibitor significantly decreased HO.A newly screened compound revealed that the inhibition of PLOD2 activity in MPCssignificantly decreased osteogenic differentiation and glycolytic metabolism.This suggests that the HIF-1α/PLOD2/LOX axis linked tometabolism regulates HO-forming MPC fate.These results suggest that the HIF-1α/PLOD2/LOX pathway represents a promisingstrategy to mitigate HO formation.

Changes in visual performance after implantation of different intraocular lenses

AIM:To evaluate the trending visual performance of different intraocular lenses(IOLs)over time after implantation.METHODS:Ninety-one patients received cataract surgery with implantations of monofocal(Mon)IOLs,segmental refractive(SegRef)IOLs,diffractive(Dif)IOLs,and extendeddepth-of-focus(EDoF)IOLs were included.The aberrations and optical quality collected with iTrace and OQAS within postoperative 6mo were followed and compared.RESULTS:Most of the visual parameters improved over the postoperative 6mo.The postoperative visual acuity(POVA)of the Mon IOL,SegRef IOL,and EDoF IOL groups achieved relative stability in earlier states compared with the Dif IOL group.Nevertheless,the overall visual performance of the 3 IOLs continued to upturn in small extents within the postoperative 6mo.The optical quality initially improved in the EDoF IOL group,then in the Mon IOL,SegRef IOL,and Dif IOL groups.POVA and objective visual performance of the Mon IOL and EDoF IOL groups,as well as POVA and visual quality of the Dif IOL group,improved in the postoperative 1mo and stabilized.Within the postoperative 6mo,gradual improvements were observed in the visual acuity and objective visual performance of the SegRef IOL group,as well as in the postoperative optical quality of the Dif IOL group.CONCLUSION:The visual performance is different among eyes implanted with different IOLs.The findings of the current study provide a potential reference for ophthalmologists to choose suitable IOLs for cataract patients in a personalized solution.

Integrated Test System for Large-aperture Telescopes Based on Astrophotonics Interconnections

This study aims to improve the integrated testing of large-aperture telescopes to clarify the fundamental principles of an integrated testing system based on astrophotonics.Our demonstration and analyses focused on element-position sensing and modulation based on spatial near-geometric beams,high-throughput step-difference measurements based on channel spectroscopy,distributed broadband-transmittance testing,and standard spectral tests based on near-field energy regulation.Comprehensive analyses and experiments were conducted to confirm the feasibility of the proposed system in the integrated testing process of large-aperture telescopes.The results demonstrated that the angular resolution of the light rays exceeded 5arcsec,which satisfies the requirements for component-position detection in future large-aperture telescopes.The measurement resolution of the wavefront tilt was better than 0.45μrad.Based on the channel spectral method—which combined a high signal-to-noise ratio and high sensitivity,along with continuous-spectral digital segmentation and narrowband-spectral physical segmentation—a resolution of 0.050μm and a range of 50μm were obtained.After calibration,the measurement resolution of the pupil deviation improved to exceed 4%accuracy,and the transmission measurements achieved a consistency of over 2%accuracy.Regarding fringe-broadband interferometry measurements,the system maintained high stability,ensuring its operation within the coherence length,and robustly detected the energy without unwrapping the phase.The use of a projector for calibrating broadband-spectrum measurements led to a reduction in contrast from 0.8142 to 0.6038,which further validates the system's applicability in the integrated testing process of large-aperture telescopes.This study greatly enhanced the observational capabilities of large-aperture telescopes while reducing the integrated system's volume,weight,and power consumption.

Orthokeratology with increased compression factor in adolescent myopia control:a 2-year prospective randomized clinical trial

AIM:To explore the long-term efficacy,safety,and optical mechanism of orthokeratology with increased compression factor in adolescent myopia control.METHODS:A prospective,double-masked,and randomized clinical trial was performed from May 2016 to June 2020.Subjects aged between 8 and 16y,with myopia(-5.00 to-1.00 D),low astigmatism(≥-1.50 D)and anisometropia(≤1.00 D),were stratified into low(-2.75 to-1.00 D)and moderate(-5.00 to-3.00 D)myopia groups.Then they were randomly assigned to wear either increased compression factor(ICF;1.75 D)orthokeratology or conventional compression factor(CCF;0.75 D)orthokeratology.The data were recorded including axial length(AL),spherical equivalent(SE),best corrected visual acuity(BCVA),near visual acuity(NVA),corneal staining(using Efron grading scales),corneal hysteresis(CH),corneal resistance factor(CRF),higher-order aberrations(HOAs,expressed as root mean square,RMS_(h)),and subfoveal choroidal thickness(SFCh T)in the 2-year followup period.Pearson's correlation coefficient was conducted to analyze the association between the changes in AL and RMS_(h),SFCh T.RESULTS:At the 2-year visit,there were no statistical differences in all the parameters between the ICF group and the CCF group in low myopia subjects(P>0.05).For the moderate myopia subjects,the ICF group had shorter AL elongation(0.23±0.08 vs 0.30±0.11 mm,P=0.015),higher RMS_(h)(1.94±0.50 vs 1.65±0.51μm,P=0.041),and higher SFCh T(279.04±35.72 vs 254.08±29.60μm,P=0.008)than those in CCF group.The change in AL was negatively correlated with RMS_(h)(r=-0.687,P<0.001)and SFCh T(r=-0.464,P=0.013).CONCLUSION:ICF orthokeratology can control the progression of moderate myopia more effectively,which might be related to greater RMS_(h) and SFCh T.

Symmetrical femtosecond laser arc incision in correcting corneal astigmatism in cataract patients

AIM:To evaluate the effect of symmetrical arc incision correcting corneal astigmatism in femtosecond laserassisted phacoemulsification(FLACS).METHODS:This study enrolled patients with cataract combined with regular corneal astigmatism of>0.75 D,who underwent FLACS.Symmetrical arc incision was set at 8 mm diameter and 85%depth.The follow-up time was 3-24mo(4.92±3.49mo).Pentacam recorded the corneal astigmatism and higher-order aberration at pre-operation and post-operation.The changes in corneal astigmatism were analyzed by Alpins method.The correlation of astigmatism type,age,corneal horizontal diameter,corneal thickness,arc incision length,and correction index(CI)was analyzed,and the residual corneal astigmatism was compared with the residual whole eye astigmatism.RESULTS:Totally 79 patients(102 eyes)were enrolled,10 patients had corneal epithelial injury,1 patient occurred corneal epithelial hyperplasia.The corneal astigmatism was 1.23±0.38 D pre-operation,and decreased to 0.76±0.39 D post-operation(t=10.146,P=0.000).Corneal high-order aberration was 0.17±0.08μm pre-operation and 0.24±0.11μm post-operation(t=-5.186,P=0.000).The residual corneal astigmatism and residual whole eye astigmatism were no significant difference(t=-0.347,P=0.729).Using Alpin’s method,the following were determined:target-induced astigmatism(TIA)=1.23±0.38 D,surgeryinduced astigmatism(SIA)=0.77±0.45 D,difference vector(DV)=0.77±0.39 D,and CI=0.54±0.28.Age,astigmatism size,corneal horizontal diameter,corneal thickness,and arc incision length were not correlated with CI.The CI for against the rule astigmatism(ATR)was better than that for with the rule astigmatism(WTR;P=0.001).CONCLUSION:Femtosecond laser-assisted astigmatic keratotomy has better CI of ATR,but increase higher-order corneal aberration.CI is not ideal,it’s not a perfect choice if we pursue ideal correction effect.

Comparative study of functional optical zone:small incision lenticule extraction versus femtosecond laser assisted excimer laser keratomileusis

AIM:To investigate the size of functional optical zone(FOZ)after small incision lenticule extraction(SMILE)versus femtosecond laser assisted excimer laser keratomileusis(FS-LASIK)for myopia correction and potential associated factors for FOZ.METHODS:A total of 133 patients who received corneal refractive surgery in our hospital between November 2018 and July 2021 were retrospectively enrolled.There were 63 patients(123 eyes)in SMILE group and 70patients(139 eyes)in FS-LASIK group.The size of FOZ was measured using Pentacam 3-dementional anterior segment analyzer before and 3mo after surgery,so as to analyze postoperative achieved functional optical zone(AFOZ)and its contributing parameters.RESULTS:When planned functional optical zone(PFOZ)was 6.5 mm for both groups,AFOZ was 1.45±0.27 and 1.67±0.25 mm smaller than preoperative FOZ in SMILE group and FS-LASIK group 3mo after surgery.AFOZ in SMILE group was significantly larger than that in FS-LASIK group(P<0.001).Variation of FOZ was negatively correlated with preoperative spherical equivalent(SE)and positively correlated with variation of mean keratometry value(△Km),variation of spherical aberration(△SA),and variation of Q-value(△Q,all P<0.001)in both groups.Multiple variable linear regression equations were△FOZ=1.354-0.1×pre-SE+0.336×△Q+1.462×△SA in SMILE group and△FOZ=1.512+0.137×△Q+0.468×△SA in FS-LASIK group.CONCLUSION:AFOZ is significantly smaller than preoperative FOZ in both SMILE and FS-LASIK groups.With the same PFOZ,larger AFOZ is achieved in SMILE group than in FS-LASIK group.

Efficacy of custom-made soft keratoconus lenses on corneal aberrations and photic phenomena in patients with keratoconus:a corneal topography imaging based study

AIM:To evaluate the efficacy of custom-made soft keratoconus(KC)lenses on corneal aberrations and photic phenomena in two different optical zones in patients with KC.METHODS:Sixty eyes of 42 patients with KC were examined at baseline and after fitting HydroCone(Toris K)soft silicone hydrogel lenses.Best spectacle-corrected visual acuity(BSCVA)and contact lens-corrected visual acuity(CLCVA)were recorded.Lower-and higher-order corneal aberrations(LOAs and HOAs)were measured with and without Toris K lenses and compared in central 4.5 mm and 7 mm zones.Mesopic pupil diameter and subjective photic phenomena were also assessed.RESULTS:Mean CLCVA was significantly improved compared to BSCVA(P<0.0001).Corneal curvature and refractive measurements were found to be significantly reduced by the use of Toris K lenses,except for posterior corneal curvature values.In the 4.5 mm central optical zone,all wavefront aberrations decreased significantly after lens fitting(P<0.0001).In contrast,in the 7 mm(peripheral)optical zone,values for HOAs,spherical and residual aberrations,and optical path differences were increased,while LOAs,trefoil,and quadrifoil coefficients were decreased.The rate of photic phenomena was significantly higher in participants with a pupil size>6.00 mm(85.7%).CONCLUSION:Toris K lenses provide good visual results and a significant reduction in central corneal aberrations in patients with KC but could cause an increase in peripheral aberrations.This practical and nonsurgical approach appears to be an effective method for the visual management of KC.

Design of 50 MeV proton microbeam based on cyclotron accelerator

High-energy proton microbeam facilities are powerful tools in space science,biology and cancer therapy studies.The primary limitations of the 50 MeV proton microbeam system are the poor beam quality provided by the cyclotron and the problem of intense scattering in the slit position.Here,we present an optical design for a cyclotron-based 50 MeV high-energy proton microbeam system with a micron-sized resolution.The microbeam system,which has an Oxford triplet lens configuration,has relatively small spherical aberrations and is insensitive to changes in the beam divergence angle and momentum spread.In addition,the energy filtration included in the system can reduce the beam momentum spread from 1 to 0.02%.The effects of lens parasitic aberrations and the lens fringe field on the beam spot resolution are also discussed.In addition,owing to the severe scattering of 50 MeV protons in slit materials,a slit system model based on the Geant4 toolkit enables the quantitative analysis of scattered protons and secondary particles.For the slit system settings under a 10-micron final beam spot,very few scattered protons can enter the quadrupole lens system and affect the focusing performance of the microbeam system,but the secondary radiation of neutrons and gamma rays generated at the collimation system should be considered for the 50 MeV proton microbeam.These data demonstrate that a 50 MeV proton microbeam system with a micron-sized beam spot based on a cyclotron is feasible.

One-year clinical efficacy evaluation of selective corneal wavefront aberration-guided FS-LASIK correction in patients with high myopia

AIM:To evaluate the effectiveness,safety,predictability,precision and changes of higher-order aberrations(HOAs)on corneal front surface of selective corneal wavefront aberration-guided femtosecond laser-assisted in situ keratomileusis(CW-FS-LASIK)in patients with high myopia 1-year postoperatively.METHODS:Totally 74 eyes of 37 patients with high myopia or myopic astigmatism in both the eyes who underwent the CW-FS-LASIK procedure in Xi’an Gaoxin Hospital from January 2021 to June 2021 were included.The changes of uncorrected distance visual acuity(UDVA),best corrected visual acuity(BCVA),spherical equivalent refraction(SER),astigmatism,HOAs and Strehl ratio(SR)on the anterior surface of the cornea after 1y of the surgery were analyzed.RESULTS:At postoperative 1y,the UDVA(logMAR)of 74 eyes(100%)reached 0 or better,including 0 in 8 eyes(10.81%),-0.1 in 45 eyes(60.81%),and-0.2 in 21 eyes(28.38%).The effectiveness index was 1.29±0.134.There was no decrease in postoperative BCVA compared with preoperative BCVA in all patients.Postoperative BCVA was the same in 44 eyes(59.46%)as preoperative BCVA,increased by 1 line in 23 eyes(31.08%)and increased by 2 lines in 7 eyes(9.46%)compared with preoperative BCVA.The safety index was 1.11±0.159.The estimated corrected SER before surgery was(-7.76±1.21)D,and the actual corrected SER was(-7.83±1.25)D(Y=0.9811X+0.2156,R2=0.9084).There was a high correlation between the estimated corrected SER and the actual corrected SER.The postoperative SER in 74 eyes(100%)was within±0.75 D.The postoperative astigmatism of all was within-0.75 D to 0.Root mean square(RMS)HOAs of spherical aberration and SR within 5 mm of the corneal front surface were all increased compared with those before operation(P<0.01).The total coma,horizontal coma and vertical coma were all decreased compared with those before operation(P<0.01).There was no statistically significant difference in horizontal trefoil and vertical trefoil compared with preoperative ones(P>0.05).CONCLUSION:Selective CW-FS-LASIK for correction of high myopia is effective,safe,predictive,and accurate.For patients with preoperative RMS HOAs over 0.25 defocus equivalent,postoperative coma aberration can be significantly reduced,and SR value can be increased,thus corneal imaging quality can be improved.

Study of strip-shaped chromatic aberration defects on the surface of an electro-galvanized fingerprint-resistant sheet

Strip-shaped chromatic aberration defects on the surface of an electro-galvanized fingerprint-resistant sheet were systematically studied using Thermo-Calc thermodynamic calculations,scanning electron microscope and X-ray diffractometer analyses,and rapid heat treatment simulation technology.The formation mechanism of these defects was also analyzed.The results show a strong correlation between the defects and the uneven distribution of the Fe(001)component on the surface of the steel substrate.The relatively high proportion of Fe(001)components on the surface of the steel substrate affects the distribution density of the Zn crystal cells in different orientations during the electrodeposition process,which causes the reflection intensity of the light of the galvanized layer to differ from various visual perspectives,and macroscopic strip-shaped chromatic aberration defects are finally formed.The high proportion of the Fe(001)component on the surface of the steel substrate is mainly related to the following two factors.First,when the strip steel is hot-rolled,the finishing hot-rolling temperature is close to theγ→αphase transition temperature.When the local temperature on the upper surface of the strip steel is low,γ+αtwo-phase rolling easily occurs,and this results in an uneven stress distribution between theγandαphases after the hot-rolling process.This uneven distribution of hot-rolling stress results in the formation of a coarse grain structure in the local area on the surface of the hot-rolled sheet,which strongly affects the subsequent cold rolling and annealing process,and the annealed steel sheet substrate ultimately contains a greater proportion of the Fe(001)component.And second,a fast cooling rate(>10 K/s)during the slow cooling stage in the continuous annealing process inhibits the transformation of the Fe(001)to the Fe(111)component on the surface of the cold-rolled steel sheet,and it is then not possible to effectively eliminate the influence of the unevenly distributed Fe(001)component on the surface of the annealed steel sheet(originating from the uneven hot-rolled microstructure).This uneven distribution of the Fe(001)component on the surface of the annealed steel sheet following the continuous annealing heat treatment has a strong effect on the electrodeposition behavior of the Zn crystal cell in the subsequent electroplating process and the formation of macroscopic strip-shaped chromatic aberration defects on the surface of electro-galvanized fingerprint-resistant sheet.

Carotid-subclavian bypass and endovascular aortic repair of Kommerell’s diverticulum with aberrant left subclavian artery:A case report

BACKGROUND Kommerell’s diverticulum(KD)with aberrant left subclavian artery is a rare congenital deformity and also has very little research literature about it(35%of case study).There are three types of aortic arch diverticulum.Even literature concerning the treatment options are limited.CASE SUMMARY We present a case report of a 50-year-old male with KD in the right aortic arch with aberrant left subclavian artery.We conducted a total endovascular repair procedure,which is innovative and will spread more light in the medical world.Our patient has no past medical history and is a non-smoker and non-alcoholic.Patient presented with shortness of breath,chest pain and dizziness for six months.Blood tests were done and computerized tomography(CT)angiogram of the chest confirmed the diagnosis,illustrating showed a 3.9 cm KD.On Day 1,the CT angiogram showed mild dilatation of the thoracic aorta,adjacent esophagus,trachea was compressed and displaced.Surgery was planned as the treatment modality.Carotid-Subclavian artery bypass and endovascular aortic repair was conducted.We used prolene 5-0 C1 sutures to precisely anastomose a 6-mm Dacron graft to the left subclavian artery.Haemostasis was secured and wounds were closed.Protamine was administered and patient was shifted to intensive care unit.Post-operative,patient responded favorably and was discharged.Regular follow-up is done.CONCLUSION The procedure we performed is novel.This will help the cardio-thoracic surgeons a better insight about the full procedures we conducted,thereby bringing more light and better treatment options in managing KD with aberrant subclavian artery.

深度学习与边缘增强相结合的断裂综合检测技术——顺北地区超深走滑断裂检测应用实例

塔里木盆地顺北地区超深断控缝洞型储集体发育,近年来不断有高产井涌现;同时,大量研究证实高角度走滑断裂对油气藏的运移和聚集起决定性作用。受“断控储集体”埋藏深,且走滑断裂断距小、难闭合等因素的影响,顺北地区地震资料信噪比低、断面特征不清晰,导致走滑断裂检测及空间解释难度较大。针对上述超深走滑断裂检测研究面临的难点,文中提出深度学习与边缘增强相结合的多尺度断裂综合检测技术:首先将走滑断裂按规模划分为主干断裂、伴生次级断裂、小尺度裂缝;通过正演主干断裂、次级断裂、裂缝等不同断裂模式的地震响应特征并进行方法实验,认为可应用U-Net卷积神经网络深度学习技术识别主干断裂、振幅梯度矢量凌乱性检测技术识别伴生次级断裂、Aberrance增强属性识别小尺度裂缝。将该套技术应用于顺北地区走滑断裂实际检测中,取得了显著效果。

APC and K-ras gene mutation in aberrant crypt foci of human colon

AIM To study the genetic alteration in ACF andto define the possibility that ACF may be a veryearly morphological lesion with molecularchanges, and to explore the relationshipbetween ACF and colorectal adenoma evencarcinoma.METHODS DNA from 35 CRC, 15 adenomas, 34ACF and 10 normal mucus was isolated by meansof microdissection. Direct gene sequencing of K-ras gene including codon 12, 13 and 61 as well asthe mutation cluster region (MCR) of APC genewas performed.RESULTS K-ras gene mutation frequency inACF, adenoma and carcinoma was 17.6% (6/34), 13.3% (2/ 15), and 14.3% (5/ 35)respectively, showing no difference ( P > 0.05)in K-fas gene mutation among three pathologicprocedures. The K-ras gene mutation inadenoma, carcinoma and 4 ACF restricted incodon 12 (GGT→GAT), but the other 2 mutationsfrom ACF located in codon 13 (GGC→GAC). K-res gene mutation was found more frequently inolder patients and patients with polypoidcancer. No mutation in codon 61 was found in thethree tissue types. Mutation rate of APO gene inadenoma and carcinoma was 22.9% (8/35) and26.7% (4/ 15), which was higher than ACF(2.9%) (P < 0.05). APC gene mutation incarcinoma was not correlated with age ofpatients, location, size and differentiation oftumor.CONCLUSION ACF might be a very earlymorphological lesion in the tumorogenesis ofcolorectal tumor. The morphological feature andgene mutation status was different in ACF andadenoma. ACF is possibly putative'microadenoma' that might be the precursor ofadenoma. In addition, the development of asubgroup of colorectal carcinomas mightundergo a way of 'normal epithelium→ ACF→carcinomas'.

MicroRNA aberrations:An emerging field for gallbladdercancer management

Gallbladder cancer(GBC) is infrequent but most lethal biliary tract malignancy characterized by an advanced stage diagnosis and poor survival rates attributed to absence of specific symptoms and effective treatment options. These necessitate development of early prognostic/predictive markers and novel therapeutic interventions. Micro RNAs(mi RNAs) are small, noncoding RNA molecules that play a key role in tumor biology by functioning like tumor suppressor- or oncogenes and their aberrant expression are associated with the pathogenesis of several neoplasms with overwhelming clinical implications. Since mi RNA signature is tissue specific, here, we focused on current data concerning the mi RNAs abberations in GBC pathogenesis. In GBC, mi RNAs with tumor suppressor activity(mi R-135-5p, mi R-335, mi R-34 a, mi R-26 a, mi R-146b-5p, Mir-218-5p, mi R-1, mi R-145, mir-130a) were found downregulated, while those with oncogenic property(mi R-20 a, mi R-182, mir-155) were upregulated. The expression profile of mi RNAs was significantly associated with GBC prognosis and prediction, and forced over-expression/ inhibition of these mi RNAs was shown to affect tumor growth and development. Further, differential expression of mi RNAs in the blood samples of GBC patients suggest mi RNAs as promising noninvasive biomarker. Thus, mi RNAs represent potential candidate for GBC management, though many hurdles need to be overcome before mi RNAs therapy can be clinically applied to GBC prevention and treatment.

Effects of higher-order aberrations on contrast sensitivity in normal eyes of a large myopic population

AIM：To study the relation between higher-order aberrations（HOAs）and contrast sensitivity（CS）in normal eyes among a population of laser in situ keratomileusis（LASIK）candidates.METHODS：In 6629 eyes of 3315 LASIK candidates,CS were measured under dark environment at the spatial frequencies of 1.5,3,6,12 and 18 cycles per degree（c/d）,respectively,using an Optec 6500 visual function tester.Meanwhile,ocular HOAs were measured for a 6.0 mm pupil with a Hartmann-Shack wavefront analyzer.RESULTS：In the study,the subjects with an average spherical equivalent of-4.86±2.07 D were included.HOAs decreased from the third to the sixth order aberrations with predominant aberrations of third-order coma,trefoil and fourth-order spherical aberration.At low and moderate spatial frequencies,CS was negatively correlated with the third-order coma and trefoil aberrations,and decreased with increasing Z31,but increased with increasing Z3-3and Z5-1.At high spatial frequencies,CS decreased with increasing Z3-3and increased with increasing Z5-1.CONCLUSION：At a large pupil size of 6.0 mm,the thirdorder aberrations,but not the total aberrations,are the main factors affecting CS.Vertical coma is negatively correlated with CS.

Accuracy of routine multidetector computed tomography to identify arterial variants in patients scheduled for pancreaticoduodenectomy

AIM:To assess the efficacy of cross-sectional multidetector computed tomography(MDCT) imaging without arterialreconstruction to identify aberrant right hepatic artery(RHA) and celiac artery stenosis(CAS) in patients scheduled for pancreaticoduodenectomy.METHODS:Patients with peri-ampullary and pancreatic head tumors who underwent routine preoperative MDCT and subsequent computed tomography(CT) angiography(CTA),conventional angiography or pancreaticoduodenectomy between September 2007 and August 2013 were identified.Retrospective analysis of imaging data was undertaken using CTA,conventional angiographic and surgical findings as the reference standards.The accuracy,sensitivity,specificity,positive predictive value(PPV) and negative predictive value(NPV) of MDCT in evaluation of aberrant RHA and CAS were calculated.RESULTS:A group of 458 patients met the inclusion criteria of this study to detect aberrant RHA,and 181 cases were included to identify CAS.Fifty-four(11.8%) patients were confirmed to have aberrant RHA,while 12(6.6%) patients with CAS were demonstrated.MDCT yielded an accuracy of 98.5%,sensitivity of 96.3% and specificity of 98.8% in the detection of aberrant RHA.The sensitivity,specificity,PPV and NPV of MDCT for detecting CAS were 58.3%,98.2%,70% and 97.1%,respectively.CONCLUSION:Routine MDCT is recommended such that surgeons and radiologists be alerted to the importance of arterial variants on preoperative CT scans in patients scheduled for pancreaticoduodenectomy.

Comparison of high order aberration after conventional and customized ablation in myopic LASIK in different eyes of the same patient

Purpose: To verify whether there exists any difference in higher order aberrations after undergoing myopic LASIK (laser in situ keratomileusis) with conventional ablation and customized ablation in different eyes of the same patient. Methods: This was a prospective randomized study of 54 myopic eyes (27 patients) that underwent LASIK using the Nidek EC-5000 ex-cimer laser system (Nidek, Gamagori, Japan). Topography-guided customized aspheric treatment zone (CATz) was used in the first eye of the patient (study group) and the other eye of the same patient was operated on with conventional ablation (control group). Higher order aberrations [root-mean-square (RMS) in the 5-mm zone] of both groups were observed with the Nidek OPD-Scan aberrometer before and 3 months after LASIK. Preoperative mean refractive error was similar between two eyes of the same patient (t=?0.577, P>0.05). Results: Preoperatively, higher order aberrations (RMS in the 5-mm zone) in the CATz ablation and conventional groups were (0.3600±0.0341) μm and (0.2680±0.1421) μm, respectively. This difference was not statistically significant (t=1.292, P>0.05). Three months after LASIK, higher order aberrations (RMS in 5-mm zone) in the CATz ablation and conventional groups were (0.3627±0.1510) μm and (0.3991±0.1582) μm, respectively. No statistically significant difference was noted between pre- and postoperative higher order aberrations in the CATz group (t=?0.047, P>0.05). However, a statistically significant increase in higher order aberrations was observed after conventional ablation (t=?5.261, P<0.05). A statistically sig-nificant difference was noted in the increase of higher order aberrations after LASIK between groups (t=?2.050, P=0.045). Con-clusion: LASIK with conventional ablation and topography-guided CATz ablation resulted in the same BSCVA (best specta-cle-corrected visual acuity) 3 month after LASIK. Higher order aberrations were increased, but the increase of higher order ab-errations after customized ablation treatment was less than that after conventional ablation.

CDX2 as a marker for intestinal differentiation: Its utility and limitations

CDX2 is a nuclear homeobox transcription factor that belongs to the caudalrelated family of CDX homeobox genes. The gene encoding CDX2 is a nonclustered hexapeptide located on chromosome 13q12-13. Homeobox genes play an essential role in the control of normal embryonic development. CDX2 is crucial for axial patterning of the alimentary tract during embryonic development and is involved in the processes of intestinal cell proliferation, differentiation, adhesion, and apoptosis. It is considered specif ic for enterocytes and has been used for the diagnosis of primary and metastatic colorectal adenocarcinoma. CDX2 expression has been reported to be organ specif ic and is normally expressed throughout embryonic and postnatal life within the nuclei of epithelial cells of the alimentary tract from the proximal duodenum to the distal rectum. In this review, the authors elaborate on the diagnostic utility of CDX2 in gastrointestinal tumors and other neoplasms with intestinal differentiation. Limitations with its use as the sole predictor of a gastrointestinal origin of metastatic carcinomas are also discussed.

High order aberration and straylight evaluation after cataract surgery with implantation of an aspheric,aberration correcting monofocal intraocular lens

·AIM: To evaluate the quality of vision in respect to high order aberrations and straylight perception after implantation of an aspheric, aberration correcting,monofocal intraocular lens(IOL).·METHODS: Twenty-one patients(34 eyes) aged 50 to83 y underwent cataract surgery with implantation of an aspheric, aberration correcting IOL(Tecnis ZCB00,Abbott Medical Optics). Three months after surgery they were examined for uncorrected(UDVA) and corrected distance visual acuity(CDVA), contrast sensitivity(CS)under photopic and mesopic conditions with and without glare source, ocular high order aberrations(HOA, Zywave II) and retinal straylight(C-Quant).· RESULTS: Postoperatively, patients achieved a postoperative CDVA of 0.0 log MAR or better in 97.1% of eyes. Mean values of high order abberations were +0.02±0.27(primary coma components) and-0.04 ±0.16(spherical aberration term). Straylight values of the C-Quant were 1.35±0.44 log which is within normal range of age matched phakic patients. The CS measurements under mesopic and photopic conditions in combination with and without glare did not show any statistical significance in the patient group observed(P ≥0.28).· CONCLUSION: The implantation of an aspherical aberration correcting monofocal IOL after cataractsurgery resulted in very low residual higher order aberration(HOA) and normal straylight.