IMPORTANCE While the outbreak of coronavirus disease 2019 has resulted in more than 100 000 infected individuals in China and worldwide, there are few reports on the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with ocular abnormalities. Understanding ocular manifestations of patients with COVID-19 by ophthalmologists and others may facilitate the diagnosis and prevention of transmission of the disease. OBJECTIVE To investigate ocular manifestations and viral prevalence in the conjunctiva of patients with COVID-19. DESIGN, SETTING, AND PARTICIPANTS In this case series, patients with COVID-19 treated from February 9 to 15, 2020, at a hospital center in Hubei province, China, were retrospectively reviewed for ocular manifestations. During the period of treatment, the ocular signs and symptoms as well as results of blood tests and reverse transcriptase-polymerase chain reaction (RT-PCR) from nasopharyngeal and conjunctival swabs for SARS-CoV-2 were noted and analyzed.MAIN OUTCOMES AND MEASURES Ocular signs and symptoms as well as results of blood tests and RT-PCR for SARS-CoV-2. RESULTSOf the 38 included patients with clinically confirmed COVID-19, 25 (65.8%) were male, and the mean (SD) age was 65.8 (16.6) years. Among them, 28 patients (73.7%) had positive findings for COVID-19 on RT-PCR from nasopharyngeal swabs, and of these, 2 patients (5.2%) yielded positive findings for SARS-CoV-2 in their conjunctival as well as nasopharyngeal specimens. A total of 12 of 38 patients (31.6%; 95% CI, 17.5-48.7) had ocular manifestations consistent with conjunctivitis, including conjunctival hyperemia, chemosis, epiphora, or increased secretions. By univariate analysis, patients with ocular symptoms were more likely to have higher white blood cell and neutrophil counts and higher levels of procalcitonin, C-reactive protein, and lactate dehydrogenase than patients without ocular symptoms. In addition, 11 of 12 patients with ocular abnormalities (91.7%; 95% CI, 61.5-99.8) had positive results for SARS-CoV-2 on RT-PCR from nasopharyngeal swabs. Of these, 2 (16.7%) had positive results for SARS-CoV-2 on RT-PCR from both conjunctival and nasopharyngeal swabs. CONCLUSIONS AND RELEVANCEIn this study, one-third of patients with COVID-19 had ocular abnormalities, which frequently occurred in patients with more severe COVID-19. Although there is a low prevalence of SARS-CoV-2 in tears, it is possible to transmit via the eyes.
Matrix metalloproteinases (MMPs) are known to play important roles in extracellular matrix remodeling during the process of tumor invasion and metastasis. However, little is known about their role in esophageal squamous cell carcinoma (ESCC). Expression of MMP-2 and MMP-9 in ESCC was detected in our research. Tissue microarray chip was prepared, consisting of 58 cases of ESCC and corresponding esophageal epithelium tissues. MMP-2 and MMP-9 were examined by immunohistochemistry. Overexpression of MMP-2 and MMP-9 was found in ESCC (42.1 and 60.3%, respectively), compared with paired distal normal esophageal tissues (22.9 and 8.9%, respectively). Expression of MMP-2 in ESCC was significantly associated with the tumor invasion depth, tumor-node-metastasis stages, and lymph node metastasis. MMP-2 and MMP-9 may play important roles in carcinogenesis, and MMP-2 may act as a biological marker of invasion and lymph node metastasis in ESCC.
Purpose: To analyze the genus profile of isolated pathogens and antibiotic susceptibility trends of microbial keratitis over nine years at a large referral eye center in southern China. Methods: Data of corneal specimens from January 2010 to August 2018 of patients clinically diagnosed with infectious keratitis were obtained from the center’s microbiology database. Results with positive cultures along with antibiotic susceptibility were reviewed and analyzed. Results: We collected and reviewed 7,229 specimens, including 3,092 with positive cultures. Among them, 1,630 (52.72%) were bacterial, 1781 (57.60%) were fungal, and 319 (10.32%) were coinfected. A significant decreasing trend was observed in the isolates of Gram-positive cocci (r =−0.711, P =0.032), among which the proportion of coagulase-negative staphylococcus (CNS) was also reduced (r =−0.883, P =0.002). In contrast, an increasing trend in the proportion of Gram-negative bacilli was observed (r=0.661, P =0.053). The susceptibility rates of Gram-positive cocci to cephalosporins were near 90%, which was relatively high compared to fluoroquinolones. Fluoroquinolones represented the antibiotics to which Gram-negative bacilli were the most susceptible. Their susceptibility to moxifloxacin was 78.79%. The overall performance of aminoglycosides and vancomycin was both around 70%. The susceptibility of Gram-positive cocci to several antibiotics including levofloxacin (r=−0.717, P =0.03), tobramycin (r= −0.933, P <0.001), cefazolin (r= −0.964, P <0.001), ceftazidime (r=−0.929, P =0.003), chloramphenicol (r=−0.929, P =0.003), and cefuroxime (r=−0.829, P =0.042) decreased over time. The susceptibility of Gram-negative bacilli to ofloxacin increased over time (r=0.854, P =0.004), whereas that to cefazolin (r=−0.833, P =0.005) and chloramphenicol (r=−0.886, P =0.019) decreased over time. Conclusion: From 2010 to 2018 in Zhongshan Ophthalmic Center, most isolates from infectious keratitis were Gram-positive cocci (mainly CNS), which decreased over time, with an increase in Gram-positive bacilli. More than half of the antibiotics showed reducing trend of susceptibilities, and the antibiotic resistance situation in southern China was not encouraging.
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