Background and objectivesPrevious reports on the outbreak of coronavirus disease 2019 were on the basis of data from the general population. Our study aimed to investigate the clinical features of patients on maintenance hemodialysis.Design, setting, participants, & measurements In this retrospective, single-center study, we included 49 hospitalized patients on maintenance hemodialysis and 52 hospitalized patients without kidney failure (controls) with confirmed coronavirus disease 2019 at Tongren Hospital of Wuhan University from January 30, 2020 to March 10, 2020. Demographic, clinical, laboratory, and radiologic characteristics and treatment and outcomes data were analyzed. The final date of follow-up was March 19, 2020.ResultsThe median age of 101 patients was 62 years (interquartile range, 49–72). All patients were local residents of Wuhan. In terms of common symptoms, there were differences between patients on hemodialysis and controls (fatigue [59% versus 83%], dry cough [49% versus 71%], and fever [47% versus 90%]). Lymphocyte counts were decreased (0.8×109/L [patients on hemodialysis] versus 0.9×109/L [controls], P=0.02). Comparing patients on hemodialysis with controls, creatine kinase–muscle and brain type, myoglobin, hypersensitive troponin I, B-type natriuretic peptide, and procalcitonin were increased, and the percentage of abnormalities in bilateral lung was higher in computed tomographic scan (82% versus 69%, P=0.15) and unilateral lung was lower (10% versus 27%, P=0.03). Common complications including shock, acute respiratory distress syndrome, arrhythmia, and acute cardiac injury in patients on hemodialysis were significantly higher. Compared with controls, more patients on hemodialysis received noninvasive ventilation (25% versus 6%, P=0.008). As of March 19, 2020, three patients on hemodialysis (6%) were transferred to the intensive care unit and received invasive ventilation. Seven patients on hemodialysis (14%) had died.ConclusionsThe main symptoms of coronavirus disease 2019 pneumonia, including fever and cough, were less common in patients on hemodialysis. Patients on hemodialysis with coronavirus disease 2019 were at higher risk of death.

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Neutrophils infiltration in liver is one of the typical histological characteristics of nonalcoholic steatohepatitis (NASH) in both animal models and human subjects. This study was aimed to investigate the role of neutrophils in the process of NASH and its underling mechanisms. C57BL/6J mice were fed with either standard chow (SC) or methionine/choline-deficient (MCD) diet for 1, 2, 4, 8 weeks, respectively. C57BL/6J APOE(-/-) mice were fed with SC or high-fat high-cholesterol (HFHC) diet. Anti-Ly6G antibody was employed to deplete neutrophils and sivelestat was used to inhibit neutrophil elastase (NE). MCD-diet-receiving mice with neutrophil depletion had much lower serum ALT activity, liver inflammation, and mRNA levels of proinflammatory genes in the early stage of NASH (1 and 2 weeks) when compared to non-neutrophil-depleted mice. NE inhibitor sivelestat could recapitulate the effects of neutrophil depletion in APOE(-/-) mice fed with HFHC diet. As the disease progressed (4 and 8 weeks), neutrophil depletion did not lower serum ALT levels and liver lesions due to activation of Kupffer cells. Finally, we found neutrophils also affected anti-inflammation cytokine interleukin-1 receptor antagonist mRNA expression. Neutrophils play a crucial role in the early stage of NASH via NE.

We compare multifocal intraocular lenses (MFIOLs) to monofocal IOLs for visual acuity (VA), contrast sensitivity, and adverse events using data from 21 randomized controlled trials with 2951 subjects. There was no statistical difference between uncorrected distance VA and corrected distance VA. Compared with monofocal IOLs, MFIOLs showed a better performance on uncorrected intermediate VA measured at 60 cm and uncorrected near VA; the mean differences were-0.06 (95% confidence interval [

BackgroundTo compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted.MethodsA comprehensive literature retrieval of PubMed, Science Direct and EMBASE was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction.ResultsThere were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no significance [MD = 0.02, 95%CI: (− 0.03,0.06)]. There was no significant difference in the distant-corrected near VA (DCNVA) with MD of 0.04 [95%CI (− 0.02, 0.10)]. Compared with trifocal group, the uncorrected intermediate visual acuity (UIVA) [MD = 0.09,95%CI:(0.01,0.17)] was significantly worse in the bifocal group. No difference was found in distance-corrected intermediate VA (DCIVA) [MD = 0.09, 95%CI: (− 0.04, 0.23)] between two groups. Analysis on AT LISA subgroup indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839 M) [MD = 0.18, 95%CI: (0.12, 0.24) for UIVA and MD = 0.19, 95%CI: (0.13, 0.25) for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA (UDVA) and corrected distance visual acuity (CDVA) [MD = 0.01, 95%CI: (− 0.01,0.04) for UDVA; MD = 0.00, 95%CI: (− 0.01,0.01) for CDVA].The postoperative refraction of bifocal group was similar to that of trifocal group [MD = -0.08, 95% CI: (− 0.19, 0.03) for spherical equivalent; MD = -0.09, 95%CI: (− 0.21, 0.03) for cylinder; MD = -0.09, 95% CI: (− 0.27, 0.08) for sphere]. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR = 0.89, 95% CI: (0.71, 1.12) for spectacle independence; RR = 1.81, 95% CI: (0.50, 6.54) for PCO incidence; RR = 0.98, 5% CI: (0.86, 1.12) for patient satisfaction].ConclusionPatients receiving trifocal IOLs, especially AT LISA tri 839 M, have a better intermediate VA than those receiving bifocal IOLs. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs.Electronic supplementary materialThe online version of this article (10.1186/s12886-019-1078-1) contains supplementary material, which is available to authorized users.

Purpose To explore the effectiveness and safety of vitrectomy for congenital cataract surgery. Methods We searched PubMed, Science Direct, The Cochrane Library, China National Knowledge Infrastructure and the Wanfang Database. Two researchers extracted data and assessed paper quality independently. Posterior capsule opacification (PCO) or visual axis opacification (VAO), reoperation rate, visual acuity, intraocular lenses (IOL) deposit, synechias, uveitis, secondary glaucoma, low‐contrast sensitivity and IOL decentration were compared. Results We included 11 randomized controlled trials (RCTs) with 634 congenital cataract eyes. Cases of posterior capsule opacification in vitrectomy group were significantly less than that of control group, with risk ratio (RR) of 0.15 [95% confidence interval (CI): 0.09, 0.26], and there was no heterogeneity (I2 = 0%, p = 0.94). Reoperation rate in vitrectomy group was lower than that of control group either (RR = 0.40, 95%CI: 0.17, 0.94), and there was no heterogeneity (I2 = 0%, p = 0.85). Best‐corrected visual acuity (BCVA) measured in LogMAR unit of vitrectomy group was smaller, with a mean difference (MD) of −0.17 (95%CI: −0.28, −0.05), and I2 was only 22%, indicating of a small heterogeneity. No statistical difference was found between two groups on IOL deposit (RR = 1.23, 95%CI: 0.70, 2.17), and the heterogeneity was small (I2 = 16%, p = 0.31). No statistical difference was found between two groups on synechias (RR = 1.08, 95%CI: 0.60, 1.94), with a quite small heterogeneity (I2 = 3%, p = 0.38). No statistical difference was found between two groups on uveitis (RR = 0.55, 95%CI: 0.15, 2.01), and there was no heterogeneity (I2 = 0%, p = 0.94). There was no statistical difference on IOP either, with a MD of 0.25 (95%CI: −1.56, 2.07), and there was no heterogeneity (I2 = 0%). Egger's test showed that there was no publication bias for all assessed outcomes. Low‐contrast sensitivity was better in the vitrectomy group. And no evidence indicated vitrectomy could lead to a higher risk on secondary glaucoma or IOL decentration. Conclusion Vitrectomy helps lower the PCO risk and reoperation risk after congenital cataract surgery, and also, vitrectomy helps patients gain a better BCVA and achieve a better low‐contrast sensitivity, with no trade‐off on IOP control, IOL deposit, synechias, uveitis and secondary glaucoma. We recommend performing vitrectomy during congenital cataract surgery.

Objective. The spectrum of UDP-glucuronyl transferase A1 (UGT1A1) variants in hereditary unconjugated hyperbilirubinemia varies markedly between different ethnic populations. This study evaluated the UGT1A1 genotypes in hyperbilirubinemia patients from southeastern China. Methods. We enrolled 60 patients from southeastern China (44 men and 16 women; age range: 3–76 years) with unconjugated hyperbilirubinemia and performed genetic analysis of the UGT1A1 gene by direct sequencing. Results. For patients with Gilbert syndrome, 85% (47/55) harbored pathogenic variants of UGT1A1⁎60. Both UGT1A1⁎28 and UGT1A1⁎81 were detected in the promoter region of UGT1A1. Additionally, 83% (20/24) of patients with Gilbert syndrome heterozygous for UGT1A1⁎60 had an association with heterozygous variation of UGT1A1⁎28 or UGT1A1⁎81, while 91% (21/23) of Gilbert syndrome patients homozygous for UGT1A1⁎60 had biallelic variations of UGT1A1⁎28 and UGT1A1⁎81. We detected 213 UGT1A1 allelic variants, including six novel variations, with the most frequent allele being the UGT1A1⁎60, followed by UGT1A1⁎28 and UGT1A1⁎6. All of the patients showed multiple sites of variants in UGT1A1; however, variation number was not associated with bilirubin levels (P>0.05). Conclusions. The spectrum of UGT1A1 variants in southeastern Chinese patients was distinct from other ethnic populations. Our findings broaden the knowledge concerning traits associated with UGT1A1 variants and help profile genotype–phenotype correlations in hyperbilirubinemia patients.

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