Analysis of vibration response characteristics of subway station and superstructure with hard combination

The vibration response and noise caused by subway trains can affect the safety and comfort of superstructures.To study the dynamic response characteristics of subway stations and superstructures under train loads with a hard combination,a numerical model is developed in this study.The indoor model test verified the accuracy of the numerical model.The influence laws of different hard combinations,train operating speeds and modes were studied and evaluated accordingly.The results show that the frequency corresponding to the peak vibration acceleration level of each floor of the superstructure property is concentrated at 10–20 Hz.The vibration response decreases in the high-frequency parts and increases in the lowfrequency parts with increasing distance from the source.Furthermore,the factors,such as train operating speed,operating mode,and hard combination type,will affect the vibration of the superstructure.The vibration response under the reversible operation of the train is greater than that of the unidirectional operation.The operating speed of the train is proportional to its vibration response.The vibration amplification area appears between the middle and the top of the superstructure at a higher train speed.Its vibration acceleration level will exceed the limit value of relevant regulations,and vibration-damping measures are required.Within the scope of application,this study provides some suggestions for constructing subway stations and superstructures.

Evaluating the predictive value of endoscopic findings for residual colorectal cancer following neoadjuvant combination immunotherapy

BACKGROUND Endoscopy allows for the direct observation of primary tumor characteristics and responses after neoadjuvant treatment.However,reports on endoscopic evaluation following neoadjuvant immunotherapy remain limited.AIM To examine the predictive value of endoscopic findings of primary tumors for responses to neoadjuvant immunotherapy.METHODS This retrospective study,conducted at a tertiary center in China,evaluated 74 patients with colorectal cancer,including 17 with deficient mismatch repair(dMMR)and 15 with proficient mismatch repair(pMMR)tumors.Patients underwent neoadjuvant immunotherapy followed by surgery.Endoscopic findings before and after neoadjuvant immunotherapy were reviewed and compared with the pathology of the resected specimens.RESULTS In the pMMR group(n=57 evaluable patients),endoscopy identified 11/17 patients who achieved a complete response(CR),while misidentifying 1/40 patients with residual disease as CR(64.7%vs 2.5%,P<0.01).Conversely,22/40 patients with residual disease were accurately identified as achieving a partial response(PR),with 1/17 patients who achieved CR misclassified as PR(55.0%vs 5.9%,P<0.01).The sensitivity,specificity,and accuracy of endoscopic diagnosis for pathological CR were 64.7%,97.5%,and 87.7%,respectively.In the dMMR cohort,endoscopy classified 9/17 patients as CR and 2 of the remaining patients with residual tumors as PR(64.3%vs 66.7%,P=0.73).The method demonstrated 100%sensitivity and 82.4%accuracy in diagnosing pathological CR.CONCLUSION Endoscopic evidence of CR or PR was well correlated with postoperative pathological outcomes in the pMMR cohort.Despite endoscopic indications of tumor residue,a complete pathological response post-surgery was possible in the dMMR cohort.

New perspectives and prospects for the next generation of combination therapy in inflammatory bowel disease

This article comments on the letter by Lowell et al,which addresses the next generation of combination therapy for inflammatory bowel disease(IBD).As the understanding of the pathogenesis of IBD continues to improve,treatment strategies are evolving rapidly.The letter examines the current status and future directions of combination therapy for IBD,focusing on approaches that combine biologics with immunomodulators and the emerging dual-biologic therapy(DBT).The traditional combination of biologics and immunomodulators has demonstra-ted preliminary efficacy by enhancing the effects of biologics through immunomo-dulation.However,concerns regarding long-term safety warrant careful evalua-tion.Recent trials,including DUET-Crohn's disease and DUET-ulcerative colitis,have shown promising potential for the broader adoption of DBT.Nevertheless,comprehensive data on efficacy and safety,as well as the effective integration of supportive treatments,remain essential to establish new paradigms for the next generation of IBD care.

Variation Analysis of Seed and Seedling Traits of Cross Combination Progenies in Populus

Twenty-five species and hybrids in Populus were used as parents, and 26 cross combinations, including more than 5000 seedlings, were obtained by artificial cross breeding. The length of infructescence, number of seeds per infructescence, thousand-seed weight, germination rate of seeds among these cross combinations were tested. The results indicated that the cross combinational effects were significant for these traits, and demonstrated that the length of infructescence, thousand-seed weight were positively affected by female parent. In addition, seedling height, diameter above ground, diameter at breast height （DBH） of 17 cross combination progenies were investigated. The analysis of mean and standard deviation of these three traits showed that seedling height, diameter above ground, DBH had extensive variation among combinations and individuals within combination. Variance analysis and estimate of heritability indicated that the three traits had wide variation and were controlled by heredity. It was feasible to select superior cross combinations and seedlings. Further more, the result of multiple comparison showed that P.deltoides ‘Lux＇× P.deltoides ‘D324＇, P.ussuriensis cl. ‘U4＇× P deltoides ‘T66＇, P.ussuriensis cl. ‘U4＇× P. deltoides ‘T26＇, P.deltoides ‘Lux＇× P.ussuriensis cl. ‘U3＇, （P.tomentosa×P.bolleana）×（P.alba×P.glandulosa）, （P.alba×P.tomentosa）×（P.alba×P.glandulosa）, and （P.alba×P.glandulosa‘No.2＇）× P. tomentosa ‘Lumao 50＇ were superior cross combinations with higher growth rate. Finally, 123 elite seedlings were selected for further test.

State-of-the-Art Technology in the Construction of Sea-Crossing Fixed Links with a Bridge, Island, and Tunnel Combination

In general, two kinds of structures are used to provide a way across a river, canal, sea, or other obstacle: bridge structures that pass over the obstacle, and tunnel structures that pass below the obstacle. Although the construction of both bridges and tunnels can be traced back over thousands of years, bridge–tunnel combinations that use an island as a sea-crossing fixed link (SCFL) have only been built over the past 82 years. The first such combination was probably the 6.4 km long San Francisco–Oakland Bay Bridge in the United States, which was completed in 1936. The most recently constructed SCFL combining a bridge, tunnel, and island is the Hong Kong–Zhuhai–Macao (HZM) Bridge, which opened for traffic on October 24, 2018 with the longest SCFL combination in the world, at a total length of 29.6 km.

Growth Performance of Different Cross Combinations of Quality Lean Type Pig

Ten healthy weaning piglets of Landrace x Yorkshire （LY） in good body condition with body weight of （24 ± 1.27） kg were selected, and ten weaning piglets of Berkshire × LY （BLY） and Duroc × LY （DLY） with similar situation were also selected respectively to study the growth performance of different cross combinations. Three groups of experimental pigs were bred with conventional diet. The results showed that the average dry matter intakes of combinations of BLY and DLY were slightly decreased by 4.97% and 5.47% compared with the combination of LY, while average daily gain was significantly increased by 3.13% and 1.14%, and feed-weight ratio was decreased by 7.94% and 6.35%, respectively; economic benefit per pig was increased by 0.61 and 0.41 yuan, respectively. The combinations of BLY and DLY have better growth performance, which can be promoted in the production.

基于Cross熵与改进麻雀搜索算法的图像分割模型

传统基于熵标准的图像分割法采用穷尽法搜索分割阈值,存在计算代价高、分割效率低的不足。针对这一问题,设计基于Cross熵与改进麻雀搜索算法的图像分割方法。为了提升标准麻雀搜索算法的寻优精度和寻优速率,利用反向学习机制进行种群初始化,改善初始种群结构,提升种群多样性和初始解质量。设计正余弦优化和惯性权重的发现者更新机制,提升发现者全局搜索能力。提出柯西混沌变异的追随者更新机制,结合混沌映射和柯西变异,避免算法产生局部最优。以Cross熵最小为标准评估个体适应度,利用改进麻雀搜索算法寻找图像分割最佳阈值,并实现图像分割。实验结果表明,改进算法在分割指标上表现优异,可以有效提升图像分割精度和分割效率。

基于遗传算法与Hardy-Cross方法的矿井通风机控制

针对矿井通风机系统控制的复杂问题,提出了一种遗传算法与Hardy-Cross方法相结合的矿井通风控制,强化了其在处理离散变量和非凸搜索空间中寻找全局最优解的能力。通过数学形式化定义问题并结合基尔霍夫定律,确立了通风机网络的优化模型。根据实际用风情况智能调节通风机的供风量,以实现能源节约和安全生产的目标。通过对某煤矿的通风案例深入研究和验证,风扇的配置在优化气流方面表现出了卓越性能。该研究不仅为矿山工程领域提供了新的优化思路和方法,也为通风机系统的管理提供了重要参考。

Back to the drawing board:Overview of the next generation of combination therapy for inflammatory bowel disease

Inflammatory bowel disease(IBD)is entering a potentially new era of combined therapeutics.Triantafillidis et al provide an insightful review of the current state of combination therapy,with a focus on the use of a combined biologic and immunomodulator,as well as emerging data on the future potential of dual-biologic therapy(DBT).While current evidence for DBT is limited,encouraging safety profiles and ongoing trials suggest a brighter future for this approach.The importance of controlled trials should be stressed in establishing new treatment paradigms.Ongoing prospective randomized trials of DBT and perhaps future combinations of biologics and small molecule therapies will hopefully guide the next generation of IBD care.

Analysis of Combining Ability for Resistance of Sugarcane Parents and Cross Combinations to Brown Stripe Disease

[Objectives] The paper was to screen resistant sugarcane varieties against brown stripe disease,and to breed disease-resistant germplasm resource.[Methods]The combining ability for resistance to sugarcane brown stripe disease was analyzed based on 23 female parents,21 male parents and 29 cross combinations. [Results]The average heritability of resistance to sugarcane brown stripe disease successively were female parents（ 95. 3%）,cross combinations（ 93. 0%）and male parents（ 79. 1%）. The general combining ability of 12 female parents showed negative effect,including Pma 98-40,Yacheng 93-26,Yunrui 05-283,Yuetang 91-976,Chuanzhe 19,ROC10,Yunzhe 06-80,ROC26,Zhanzhe 74-141,K86-110,Yunzhe 03-194 and ROC25. The general combining ability of 10 male parents showed negative effect,including Q 199,Yunrui 06-649,Yunrui 05-733,CP 84-1198,CP 88-1762,Yacheng 84-125,Yunrui 05-784,Yuetang 00-236,CP72-3591 and CP 94-110. The special combining ability of 16 cross combinations showed negative effect,including Pma 98-40 × Yunrui 05-649,Yacheng 93-26 ×Yunrui 05-733,Yunrui 05-283 × Q199,Yuetang 91-976 × CP 84-1198,Chuanzhe 19 × CP 88-1762 and ROC10 × Yuenong 73-204. [Conclusions] There were significant differences in combining ability among female parents,male parents and cross combinations,which were mainly controlled by additive and non-additive gene.

Calculation of Photo-Ionisation Cross Sections and Radiative Recombination Rate Coefficients for CO and CO^+ Molecules

A method based upon the weighted total cross section （WTCS） theory is proposed to calculate the photo-ionisation cross sections and the radiative recombination rate coefficients between the fundamental level of CO and the main electronic states of its corresponding ion. Total photo-ionisation cross sections and radiative recombination rate coefficients are determined from the calculation of elementary vibrational photo-ionisation cross sections. Transitions be- tween CO＋（X, A and B） and CO（X） are considered. Total photo-ionisation cross sections and recombination coefficients are computed in the temperature interval 500-15000 K.

Meat Production Performances of Geese in Different Crossbred Combinations

[ Objective] To study the meat production performance of geese in different crossbred combination, and provide a reference for cultivating new multiplication strains of meat geese. [Method] A total of five goose breeds including Taihu goose （T）, Wulong goose （WL）, Wanxi white goose （WX）, Sichuan white goose （SC） and Sanhua goose （SH） were used as research objects, and eight crossbred combinations were designed. The body measurements, slaughter performance, conventional meat quality and muscle composition of 90-day-old geese in eight crossbred combinations were determined and comparatively analyzed. [ Result] All the body measurement indexes except thud width of WXSC combination were the biggest in the eight crossbred combinations. Contrarily, the body measurement indexes of SHSC combination, including average body weight, body slope length, breast depth, breast width, shank length, neck length and half-diving depth were the lowest in the eight crossbred combinations. The live weight, slaughter weight and abdomen fat weight of WXSC combinations ware 3 291.36, 2 956.46 and 77.84 g, respectively, which were the biggest in eight crossbred combinations. The slaughter rate of SHWL combinations was 92.96%, and more than other crossbred combinations. The shear force of SHT and WXWL combinations were the lowest （3.09 kg） and the highest （3.78 kg）, respectively. The water holding capacities of SCWL and WXSC combinations were the highest （66.46%） and the lowest （61.48%）, respectively. The percentage of moisture content of SHWL and SCT combinations were the highest （73.05%） and the lowest （66.77%）, respectively. The crude protein content of SHT and SHWL combinations were the highest （23.32%） and the lowest （21.94%）, respectively. The percentage of crude fat content of SHT and SCWL combinations were the highest （3.06%） and the lowest （1.67%）, respectively. [ Concusion] The growth rate of WXSC combination is the fastest, and the meat performance of SHT combination is the best.

Combination treatment of inflammatory bowel disease:Present status and future perspectives

The treatment of patients with inflammatory bowel disease(IBD),especially those with severe or refractory disease,represents an important challenge for the clinical gastroenterologist.It seems to be no exaggeration to say that in these patients,not only the scientific background of the gastroenterologist is tested,but also the abundance of“gifts”that he should possess(insight,intuition,determ-ination,ability to take initiative,etc.)for the successful outcome of the treatment.In daily clinical practice,depending on the severity of the attack,IBD is treated with one or a combination of two or more pharmaceutical agents.These combin-ations include not only the first-line drugs(e.g.,mesalazine,corticosteroids,antibiotics,etc)but also second-and third-line drugs(immunosuppressants and biologic agents).It is a fact that despite the significant therapeutic advances there is still a significant percentage of patients who do not satisfactorily respond to the treatment applied.Therefore,a part of these patients are going to surgery.In recent years,several small-size clinical studies,reviews,and case reports have been published combining not only biological agents with other drugs(e.g.,immunosuppressants or corticosteroids)but also the combination of two biologi-cal agents simultaneously,especially in severe cases.In our opinion,it is at least a strange(and largely unexplained)fact that we often use combinations of drugs in a given patient although studies comparing the simultaneous administration of two or more drugs with monotherapy are very few.As mentioned above,there is a timid tendency in the literature to combine two biological agents in severe cases unresponsive to the applied treatment or patients with severe extraintestinal manifestations.The appropriate dosage,the duration of the administration,the suitable timing for checking the clinical and laboratory outcome,as well as the treatment side-effects,should be the subject of intense clinical research shortly.In this editorial,we attempt to summarize the existing data regarding the already applied combination therapies and to humbly formulate thoughts and suggestions for the future application of the combination treatment of biological agents in a well-defined category of patients.We suggest that the application of biomarkers and artificial intelligence could help in establishing new forms of treatment using the available modern drugs in patients with IBD resistant to treatment.

Erlotinib combination with a mitochondria-targeted ubiquinone effectively suppresses pancreatic cancer cell survival

BACKGROUND Pancreatic cancer is a leading cause of cancer-related deaths.Increased activity of the epidermal growth factor receptor(EGFR)is often observed in pancreatic cancer,and the small molecule EGFR inhibitor erlotinib has been approved for pancreatic cancer therapy by the food and drug administration.Nevertheless,erlotinib alone is ineffective and should be combined with other drugs to improve therapeutic outcomes.We previously showed that certain receptor tyrosine kinase inhibitors can increase mitochondrial membrane potential(Δψm),facilitate tumor cell uptake ofΔψm-sensitive agents,disrupt mitochondrial homeostasis,and subsequently trigger tumor cell death.Erlotinib has not been tested for this effect.AIM To determine whether erlotinib can elevateΔψm and increase tumor cell uptake ofΔψm-sensitive agents,subsequently triggering tumor cell death.METHODSΔψm-sensitive fluorescent dye was used to determine how erlotinib affectsΔψm in pancreatic adenocarcinoma(PDAC)cell lines.The viability of conventional and patient-derived primary PDAC cell lines in 2D-and 3D cultures was measured after treating cells sequentially with erlotinib and mitochondria-targeted ubiquinone(MitoQ),aΔψm-sensitive MitoQ.The synergy between erlotinib and MitoQ was then analyzed using SynergyFinder 2.0.The preclinical efficacy of the twodrug combination was determined using immune-compromised nude mice bearing PDAC cell line xenografts.RESULTS Erlotinib elevatedΔψm in PDAC cells,facilitating tumor cell uptake and mitochondrial enrichment ofΔψm-sensitive agents.MitoQ triggered caspase-dependent apoptosis in PDAC cells in culture if used at high doses,while erlotinib pretreatment potentiated low doses of MitoQ.SynergyFinder suggested that these drugs synergistically induced tumor cell lethality.Consistent with in vitro data,erlotinib and MitoQ combination suppressed human PDAC cell line xenografts in mice more effectively than single treatments of each agent.CONCLUSION Our findings suggest that a combination of erlotinib and MitoQ has the potential to suppress pancreatic tumor cell viability effectively.

Circulating proteomic biomarkers for diagnosing sporadic amyotrophic lateral sclerosis:a cross-sectional study

Biomarke rs are required for the early detection,prognosis prediction,and monitoring of amyotrophic lateral sclerosis,a progressive disease.Proteomics is an unbiased and quantitative method that can be used to detect neurochemical signatures to aid in the identification of candidate biomarke rs.In this study,we used a label-free quantitative proteomics approach to screen for substantially differentially regulated proteins in ten patients with sporadic amyotrophic lateral scle rosis compared with five healthy controls.Su bstantial upregulation of serum proteins related to multiple functional clusters was observed in patients with spo radic amyotrophic lateral sclerosis.Potential biomarke rs were selected based on functionality and expression specificity.To validate the proteomics profiles,blood samples from an additional cohort comprising 100 patients with sporadic amyotrophic lateral sclerosis and 100 healthy controls were subjected to enzyme-linked immunosorbent assay.Eight substantially upregulated serum proteins in patients with spora dic amyotrophic lateral sclerosis were selected,of which the cathelicidin-related antimicrobial peptide demonstrated the best discriminative ability between patients with sporadic amyotrophic lateral sclerosis and healthy controls(area under the curve[AUC]=0.713,P<0.0001).To further enhance diagnostic accuracy,a multi-protein combined discriminant algorithm was developed incorporating five proteins(hemoglobin beta,cathelicidin-related antimicrobial peptide,talin-1,zyxin,and translationally-controlled tumor protein).The algo rithm achieved an AUC of 0.811 and a P-value of<0.0001,resulting in 79%sensitivity and 71%specificity for the diagnosis of sporadic amyotrophic lateral scle rosis.Subsequently,the ability of candidate biomarkers to discriminate between early-stage amyotrophic lateral sclerosis patients and controls,as well as patients with different disease severities,was examined.A two-protein panel comprising talin-1 and translationally-controlled tumor protein effectively distinguished early-stage amyotrophic lateral sclerosis patients from controls(AUC=0.766,P<0.0001).Moreove r,the expression of three proteins(FK506 binding protein 1A,cathelicidin-related antimicrobial peptide,and hemoglobin beta-1)was found to increase with disease progression.The proteomic signatures developed in this study may help facilitate early diagnosis and monitor the progression of sporadic amyotrophic lateral sclerosis when used in co mbination with curre nt clinical-based parameters.

Corneal collagen cross-linking in patients with keratoconus from the Dresden protocol to customized solutions:theoretical basis

Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced stages.In keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe procedure.CXL consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks formation.The aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment protocols.Finally,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.

Advances in extracellular vesicle-based combination therapies for spinal cord injury

Spinal cord injury is a severe insult to the central nervous system that causes persisting neurological deficits.The currently available treatments involve surgical,medical,and rehabilitative strategies.However,none of these techniques can markedly reverse neurological deficits.Recently,extracellular vesicles from various cell sources have been applied to different models of spinal cord injury,thereby generating new cell-free therapies for the treatment of spinal cord injury.However,the use of extracellular vesicles alone is still associated with some notable shortcomings,such as their uncertainty in targeting damaged spinal cord tissues and inability to provide structural support to damaged axons.Therefore,this paper reviews the latest combined strategies for the use of extracellular vesicle-based technology for spinal cord injury,including the combination of extracellular vesicles with nanoparticles,exogenous drugs and/or biological scaffold materials,which facilitate the targeting ability of extracellular vesicles and the combinatorial effects with extracellular vesicles.We also highlight issues relating to the clinical transformation of these extracellular vesicle-based combination strategies for the treatment of spinal cord injury.

Rationale of Cross-Sectional Descriptive Study on Clinical Effectiveness of Oral Combination Therapy Based on Secnidazole, Azithromycin and Fluconazole in Syndromic Treatment of Abnormal Vaginal Discharge in Kinshasa/DR Congo

Background: Vaginal discharge is one of the most common troubles faced by childbearing age women. About 20% - 25% of women who visit service of gynecology complain of vaginal discharge and leucorrhoea. Management of vaginal discharge in low-income countries generally depends on syndromic approach, which limits the understanding of specific responsible agents. Thus targeted management is based on the identification of causal organism and targeting of therapy against it, while syndromic management is based on presence of high risk factors. Thus the oral combination kit (Azimyn FS Kit®) offers convenience of a one-day treatment compared to other multidose treatments, which will also ensure high patient adherence to treatment, thus increasing chances of desired results. Due to its widespread use, it is proposed to evaluate the effectiveness of this oral association kit therapy in management of vaginal discharge in the population of our milieu in the Democratic Republic of Congo (DRC) particularly those received in outpatient consultation in some medical facilities in city of Kinshasa. Expensive laboratory tests and the associated waiting period for result mean that patient remains without treatment while waiting for test results. Therefore, by adopting a syndromic management approach, patient’s eligibility for treatment will be decided based on abnormal vaginal discharge, their characteristics, severity and other presentations symptomatic. This approach will also avoid losing sight of patients during follow-up and will help to reduce financial burden for patients. Objectives: To determine the efficacy and safety of oral combination kit therapy containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit®) in syndromic treatment of abnormal vaginal discharge in patients received in outpatient consultation in some medical facilities in the city of Kinshasa;to measure rate of recurrence of abnormal vaginal discharge in these patients. And to identify the adverse effects observed in these patients who received treatment with the combined oral kit containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit®) in outpatient consultation in some medical facilities in the city of Kinshasa. Methods: It will be a cross-sectional descriptive study. Sample size will be 319 women of childbearing age who consult the gynecology department with complaint of abnormal vaginal discharge and suspicion of vaginal infection, who agree to abstain from sex during treatment and who have given their written consent to use their personal and/or health data in the study. Conclusion: A study on clinical efficacy of oral combination therapy based on secnidazole, azithromycin and fluconazole is beneficial.

The Combination of Moberg Flap with V-Y Advancement and Reverse Adipofascial Cross Finger Flap for Coverage of Degloving Injury of the Thumb-Case Report

We report a case of 22 years old male patient who is a worker in a factory and sustained degloving injury of his left thumb in a machine while working. There was loss of the pulp of the thumb extending circumferentially to the dorsal aspect with loss of the skin of the terminal phalanx and part of the proximal phalanx. The nail and germinal matrix were lost with exposure of the bone and extensor pollicis longus tendon insertion. The thumb was totally covered with a combination of two flaps: Moberg flap with V-Y advancement was used to cover most of the volar surface of the thumb and reverse adipofascial cross finger flap from the adjacent index finger was used to cover the dorsal surface and the tip of the thumb. The reverse adipofascial cross finger flap was covered with split thickness skin graft. Three weeks later this flap was divided and the thumb was mobilized freely. The patient had a full range of movement of the thumb and index finger with few settings of physiotherapy postoperatively. We recommend combining both of these flaps to reconstruct degloving injury of the thumb as they provide near adjacent tissue of similar texture, preserve sensation at the volar aspect of the thumb and also avoid the complications of the distant flaps.

Corneal collagen cross-linking and liposomal amphotericin B combination therapy for fungal keratitis in rabbits

AIM： To observe the therapeutic effect of corneal collagen cross-linking（CXL） in combination with liposomal amphotericin B in fungal corneal ulcers.METHODS： New Zealand rabbits were induced fungal corneal ulcers by scratching and randomly divided into 3groups, i.e. control, treated with CXL, and combined therapy of CXL with 0.25% liposomal amphotericin B（n =5 each）. The corneal lesions were documented with slit-lamp and confocal microscopy on 3, 7, 14, 21 and 28 d after treatment. The corneas were examined with transmission electron microscopy（TEM） at 4wk.RESULTS： A rabbit corneal ulcer model of Fusarium was successfully established. The corneal epithelium defect areas in the two treatment groups were smaller than that in the control group on 3, 7, 14 and 21d（P 〈0.05）. The corneal epithelium defect areas of the combined group was smaller than that of the CXL group（P 〈0.05） on 7 and 14 d, but there were no statistical differences on 3, 21 and 28 d. The corneal epithelium defects of the two treatment groups have been healed by day 21. The corneal epithelium defects of the control group were healed on 28 d. The diameters of the corneal collagen fiber bundles（42.960 ±7.383 nm in the CXL group and 37.040±4.160 nm in the combined group） were thicker than that of the control group（24.900±1.868 nm）,but there was no difference between the two treatment groups. Some corneal collagen fiber bundles were distorted and with irregular arrangement, a large number of fibroblasts could be seen among them but no inflammatory cells in both treatment groups. CONCLUSION： CXL combined with liposomal amphotericin B have beneficial effects on fungal corneal ulcers. The combined therapy could alleviate corneal inflammattions, accelerate corneal repair, and shorten the course of disease.