Yan Yun Lv

Outdoor Activity and Myopia among Primary Students in Rural and Urban Regions of Beijing.

OBJECTIVE To assess associations among outdoor activity, ocular biometric parameters, and myopia among grade 1 and grade 4 primary students in Beijing. DESIGN School-based, cross-sectional study. PARTICIPANTS A total of 382 grade 1 and 299 grade 4 children participated in the study. METHODS The children underwent a comprehensive eye examination, including ocular biometry by optical low-coherence reflectometry and noncycloplegic refractometry. Parents and children participated in a detailed interview, including questions on time spent indoors and outdoors. MAIN OUTCOME MEASURES Factors associated with myopia. RESULTS The study included 681 children, with 382 (56.1%) students from grade 1 (mean age, 6.3 ± 0.5 years; range, 5-8 years) and 299 students from grade 4 (mean age, 9.4 ± 0.7 years; range, 8-13 years); 370 students (54.3%) lived in the urban region. The mean daily time spent outdoors was 1.6 ± 0.8 hours (range, 0.5-5.1 hours). In multivariate analysis, axial length was significantly associated with older age (P<0.001; standardized β coefficient, 0.28), taller body height (P = 0.001; β, 0.18), maternal myopia (P = 0.03; β, 0.09), and urban region of habitation (P<0.001; β, -0.21), or alternatively to the region of habitation, with less time spent outdoors (P = 0.001; β, -0.16) and more time spent indoors studying (P = 0.02; β, 0.10). The axial length-to-corneal curvature radius ratio was associated with older age, urban region of habitation, maternal and paternal myopia, and paternal level of education. Presence of myopia (defined as refractive error ≤-1 diopters in the right eye) was associated with older age (P<0.001; odds ratio [OR], 1.45; 95% confidence interval [CI], 1.24-1.69), maternal myopia (P<0.001; OR, 2.99; 95% CI, 1.94-5.35), and urban region of habitation (P<0.001; OR, 0.17; 95% CI, 0.11-0.26), or alternatively to the region of habitation, with less time spent outdoors (P<0.001; OR, 0.32; 95% CI, 0.21-0.48) and more time spent indoors studying (P<0.001; OR, 1.38; 95% CI, 1.09-1.75). CONCLUSIONS Less outdoor activity, more indoor studying, older age, maternal myopia, and urban region of habitation were associated with longer ocular axial length and myopia in grade 1 and grade 4 primary school children in Greater Beijing. Remaining outdoors more (e.g., during school) may reduce the high prevalence of myopia in the young generation in Beijing.

Myopic shift and outdoor activity among primary school children: one-year follow-up study in Beijing.

Purpose To assess whether a change in myopia related oculometric parameters of primary school children in Beijing was associated with indoors and outdoors activity. Methods The longitudinal school-based study included school children who were examined in 2011 and who were re-examined in 2012. The children underwent a comprehensive eye examination including ocular biometry by optical low-coherence reflectometry and non-cycloplegic refractometry. Parents and children had a detailed interview including questions on time spent indoors and outdoors. Results Out of 681 students examined at baseline, 643 (94.4%) returned for follow-up examination. Within the one-year period, mean time spent daily outdoors increased by 0.4±0.9 hours, mean axial length by 0.26±0.49 mm, the ratio of axial length divided by anterior corneal curvature (AL/CC) by 0.03±0.06, and myopic refractive error by −0.06±0.89 diopters. In multivariate analysis, elongation of axial length was significantly associated with less total time spent outdoors (P = 0.02; standardized coefficient beta −0.12) and more time spent indoors with studying (P = 0.007; beta: 0.14) after adjustment for maternal myopia (P = 0.02; beta: 0.12). An increase in AL/CC was significantly associated with less time spent outdoors (P = 0.01; beta:−0.12) after adjustment for paternal myopia (P = 0.003; beta: 0.15) and if region of habitation was excludedors for leisure (P = 0.006; beta:−0.13), with less total time spent outdoors (P = 0.04; beta:−0.10), or with more time spent i. An increase in myopic refractive error, after adjustment for age, was significantly associated with less time spent outdo ndoors with studying (P = 0.005; beta: 0.13). Conclusions A change in oculometric parameters indicating an increase in myopia was significantly associated with less time spent outdoors and more time spent indoors in school children in Greater Beijing within a study period of one year. Our study provides additional information on the potentially helpful role of outdoors activity in the prevention of myopia. Public health care measures such as school agendas may potentially take it into account.

Genomic Characterizations of Six Pigeon Paramyxovirus Type 1 Viruses Isolated from Live Bird Markets in China during 2011 to 2013

The genomes of six pigeon paramyxovirus type 1 (PPMV-1) isolated from symptomless pigeons in live poultry markets during the national active surveillance from 2011 to 2013 were sequenced and analyzed in this study. The complete genome lengths of all isolates were 15,192 nucleotides with the gene order of 3’-NP-P-M-F-HN-L-5’. All isolates had the same motif of 112RRQKRF117 at the cleavage site of the fusion protein, which was typical of velogenic Newcastle disease virus (NDV). Several mutations were identified in the functional domains of F and HN proteins, including fusion peptide, heptad repeat region, transmembrane domains and neutralizing epitopes. Phylogenetic analysis based on sequences of complete genomes and six genes revealed that all isolates belonged to genotype VI in class II, but at least 2 sub-genotypes were identified. Most isolates were placed into sub-genotype VIb with the exception of pi/GX/1015/13, which was classified in sub-genotype VIa. The obvious antigenic difference between PPMV-1 isolates and La Sota strain was found based on the R-value calculated by cross hemagglutination inhibition (HI) assay. These results provided the evidence that PPMV-1 could be detected from healthy pigeons, and our study may be useful in designing vaccines used in pigeon, and developing molecular diagnostic tools to monitor and prevent future PPMV-1 outbreaks.

Outdoor activity and myopia progression in 4-year follow-up of Chinese primary school children: The Beijing Children Eye Study.

Purpose To investigate factors associated with ocular axial elongation and myopia progression during a 4-year follow-up in primary school children in Beijing. Methods This school-based study included 382 grade-1 children at baseline in 2011 (age:6.3±0.4 years) with 305 (79.8%) returning for the follow-up examination in 2015. At baseline and in yearly follow-up examinations, the children underwent a comprehensive eye examination including auto-refractometry, ocular biometry with measurement of axial length, and fundus photography. The parents underwent a standardized interview. Results During the study period, the mean axial length elongated by 1.15±0.56mm in boys and 1.10±0.63mm in girls. At baseline and at the end of follow-up, axial length was significantly (P<0.001) longer in boys, with no difference (P = 0.50) between genders in axial elongation. In multivariate analysis, greater axial elongation was associated (regression coefficient r2:0.15) with less time spent outdoors (P = 0.004; standardized coefficient beta: -0.22), more time spent indoors with studying (P = 0.02; beta: 0.18) and paternal myopia (P = 0.03; beta: 0.16). Larger increases in the axial length/anterior corneal curvature (AL/CC) ratio were associated (r2:0.09) with less time spent outdoors (PP = 0.003; beta: -0.22) and maternal myopia (PP = 0.02; beta: 0.18). Conclusions Myopic axial elongation during a 4-year follow-up was associated with shorter time spent outdoors and longer time spent indoors studying and with parental myopia. Other factors such as level of paternal education, family income, gender and region of habitation were significantly associated with axial elongation and with myopia progression only in univariate analysis.

Retinal oxygen saturation in Chinese adolescents

To study the retinal oxygen saturation in normal eyes of Chinese adolescents.

Parapapillary Beta Zone in Primary School Children in Beijing: Associations With Outdoor Activity

PURPOSE To investigate prevalence and size of parapapillary alpha zone and beta zone and associations with myopia-related factors in primary school children in Beijing. METHODS The school-based study included 382 grade-1 children and 299 grade-4 children. The children underwent a comprehensive eye examination and the parents, an interview. The examination was repeated after 1 year. RESULTS Beta zone (prevalence: 44.5% ± 2.1%; mean area: 0.17 ± 0.29 mm(2)) was significantly associated with more time spent indoors with studying (P = 0.004; standardized correlation coefficient β: 0.14; regression coefficient B: 0.05; 95% confidence interval [CI]: 0.02, 0.09) after adjusting for longer axial length (P < 0.001; β: 0.22; B: 0.07; 95% CI: 0.04, 0.10), more myopic refractive error (P < 0.001; β: -0.29; B: -0.07; 95% CI: -0.09, -0.04), region of habitation (P = 0.03; β: 0.11; B: 0.07; 95% CI: 0.01, 0.14), and vertical disc diameter (P = 0.03; β: 0.10; B: 0.16; 95% CI: 0.02, 0.30). As a corollary, indoors studying time was associated with larger area of beta zone (P = 0.01; β: 0.11; B: 0.30; 95% CI: 0.07, 0.54) after adjusting for higher axial length/corneal curvature radius ratio (AL/CC; P = 0.006; β: 0.12; B: 0.94; 95% CI: 0.27, 1.62) and urban region of habitation (P < 0.001; β: -0.44; B: -0.75; 95% CI: -0.89, -0.61). An increase in AL/CC ratio at 1-year follow-up was associated with more indoors studying time (P = 0.04; β: 0.10; B: 0.01; 95% CI: 0.00, 0.01) and larger beta zone area (P < 0.001; β: 0.19; B: 0.04; 95% CI: 0.02, 0.05) after adjusting for axial length (P < 0.001; β: -0.21; B: -0.01; 95% CI: -0.02, -0.01). CONCLUSIONS Larger parapapillary beta zone area was associated with more indoors studying time after adjustment for axial length, refractive error, and region of habitation, and reversely, more indoors studying time was associated with larger beta zone in multivariate analysis. The results could indicate that parapapillary beta zone is associated with external factors-dependent development of myopia.

Visual impairment and spectacle use in schoolchildren in rural and urban regions in Beijing.

Purpose: To determine prevalence and associations of visual impairment and frequency of spectacle use among grade 1 and grade 4 students in Beijing. Methods: This school-based, cross-sectional study included 382 grade 1 children (age 6.3 ± 0.5 years) and 299 grade 4 children (age 9.4 ± 0.7 years) who underwent a comprehensive eye examination including visual acuity, noncycloplegic refractometry, and ocular biometry. Results: Presenting visual acuity (mean 0.04 ± 0.17 logMAR) was associated with younger age (p = 0.002), hyperopic refractive error (p<0.001), and male sex (p = 0.03). Presenting visual impairment (presenting visual acuity ≤20/40 in the better eye) was found in 44 children (prevalence 6.64 ± 1.0% [95% confidence interval (CI) 4.74, 8.54]). Mean best-corrected visual acuity (right eyes –0.02 ± 0.04 logMAR) was associated with more hyperopic refractive error (p = 0.03) and rural region of habitation (p<0.001). The prevalence of best-corrected visual impairment (best-corrected visual acuity ≤20/40 in the better eye) was 2/652 (0.30 ± 0.21% [95% CI 0.00, 0.72]). Undercorrection of refractive error was present in 53 children (7.99 ± 1.05%) and was associated with older age (p = 0.003; B 0.53; OR 1.71 [95% CI 1.20, 2.42]), myopic refractive error (p = 0.001; B –0.72; OR 0.49 [95% CI 0.35, 0.68]), and longer axial length (p = 0.002; B 0.74; OR 2.10 [95% CI 1.32, 3.32]). Spectacle use was reported for 54 children (8.14 ± 1.06%). Mean refractive error of the worse eyes of these children was –2.09 ± 2.88 D (range –7.38 to +7.25 D). Conclusions: Factors associated with presenting visual impairment were older age, myopic refractive error, and higher maternal education level. Despite a prevalence of myopia of 33% in young schoolchildren in Greater Beijing, prevalence of best-corrected visual impairment (0.30% ± 0.21%), presenting visual impairment (6.64% ± 1.0%), and undercorrection of refractive error (7.99% ± 1.05%) were relatively low.

Optic Disc Ovality in Primary School Children in Beijing

PURPOSE The purpose of this study was to assess the ovality of the optic disc and its associations with myopia-related factors in primary school children in Beijing. METHODS This longitudinal school-based study included 382 grade 1 children and 299 grade 4 children who were followed for 2 years. Study participants underwent a comprehensive eye examination including autorefractometry, ocular biometry, and fundus photography. RESULTS Fundus photographs were available for 562 children (82.5%). The mean optic disc ovality (maximal-to-minimal disc diameter) was 1.17 ± 0.29 (range, 1.00-1.50). Oval discs defined by an ovality of ≥ 1.33 were detected in 37 children (prevalence: 6.6%; 95% confidence interval: 4.5-8.6). In multivariate linear regression analysis, higher optic disc ovality index was significantly associated with older age (P = 0.001), female sex (P = 0.005), larger parapapillary beta zone (P < 0.001), and shorter time spent indoors with studying (P = 0.003) and was marginally significant (P = 0.057), with greater increase in myopic refractive error from 2011 to 2013. From 2011 to 2013, myopic refractive error increased in the oval optic disc group by 1.03 ± 0.99 diopters compared to 0.67 ± 1.31 diopters in the nonoval disc group. CONCLUSIONS The prevalence of oval optic discs in Beijing school children was markedly higher than in the elderly Beijing Eye Study population (6.6% vs. 0.36%), paralleling the higher prevalence of myopia in school children. The association between oval optic discs and less time spent indoors with studying after adjusting for longitudinal change in myopic refractive error, age, sex and parapapillary beta zone may warrant further exploration of external factors associated with oval optic discs.

Magnetic resonance imaging characteristics and treatment aspects of ventricular tuberculosis in adult patients.

Background Ventricular involvement in neurotuberculosis is rare. The literature regarding the characteristics of magnetic resonance imaging (MRI) in ventricular tuberculosis is very limited. Purpose To describe MRI characteristics of ventricular tuberculosis and discuss the medical treatment along with the clinical outcome. Material and Methods Ten patients (6 men, 4 women; average age, 39 years) were diagnosed with ventricular tuberculosis during a period of 3 years. Four patients had the history of pulmonary/pleural tuberculosis. The clinical and MRI features of these patients were reviewed retrospectively. Results On a brain MRI, three patients showed ependymitis associated with contrast enhancement of the ependymal lining of the ventricular walls. One patient had choroid plexitis associated with prominent swollen and marked enhancement of the choroid plexus. One patient had intraventricular tuberculoma associated with an intraventricular nodule. Two patients had both ependymitis and choroid plexitis. Three patients had both intraventricular tuberculoma and choroid plexitis. Four patients had hydrocephalus. All patients underwent intrathecal injection of isoniazid and dexamethasone combined with multidrug anti-tuberculosis treatment. All patients had a good clinical recovery, except for one who developed hemi-paralysis due to cerebral infarction. On the repeated MRI of eight patients after therapy, all lesions disappeared or decreased in size, apart from in one patient who showed ventricular separation. Conclusion MRI characteristics of ventricular tuberculosis included ependymal enhancement, swelling, and enhancement of the choroid plexus and intraventricular tuberculomas. Intrathecal injection of isoniazid and dexamethasone along with multidrug chemotherapy showed good efficacy in ventricular tuberculosis.

Genomic Characterizations of a Newcastle Disease Virus Isolated from Ducks in Live Bird Markets in China.

One class I Newcastle disease virus (NDV), designated as duck/Guangxi/1261/2015 (GX1261), was isolated from asymptomatic ducks in live bird markets (LBM) from southern China during the national active surveillance for NDVs in 2015. The complete genome length of GX1261 isolate was 15,198 nucleotides with the gene order of 3’-NP-P-M-F-HN-L-5’. The motif at the cleavage site of F protein was 112ERQER/L117, which was typical of low virulence NDV. Several mutations were identified in the functional domains of F and HN proteins, including fusion peptide, heptad repeat region, transmembrane domains and neutralizing epitopes. Phylogenetic analysis based on the complete F gene revealed that the isolate was clustered into sub-genotype 1c in class I, and showed a high level of similarity with the strains isolated from waterfowl in the United States of America. This is the first report of this kind of virus in the mainland of China. These results demonstrated that GX1261-like viruses might exist in asymptomatic waterfowl, and remain undetected or unidentified. Thus, more investigation needs to be done in order to identify the source of the virus. This study revealed the genetic and phylogenetic characteristics of GX1261 isolate and could help us to better understand the epidemiological context of class I NDV in China.