Nonspecific orbital inflammation(NSOI)is an orbital inflammation that is not associated with an infection. Even though it's often considered the most common diagnosis in orbital biopsies, it's still an exclusionary diagnosis that means systemic illnesses and other possible causes have to be ruled out. Though it is always an excluded clinical diagnosis, acute orbital symptoms such discomfort, exophthalmos, periorbital edema, chemosis, diplopia, and vision impairment are commonly associated with NSOI. Clinical diagnosis and management of NSOI provide a substantial difficulty. There are presently no recognized diagnostic criteria or standard treatment strategy for NSOI, and the clinical symptoms and histological features show significant variation. This guide was formulated under the auspices of the Ocular Oncology Committee of the Opthalmology Branch of the Chinese Medical Doctor Association, Opthalmology Committee of International Association of Intelligent Medicine, Opthalmology Committee of International Association of Translational Medicine making a detailed summary of the definition, classification, diagnosis and treatment of the NSOI, with a view to aiding clinicians to improve diagnostic efficiency and formulate a better treatment plan for patients.

Objective:To evaluate the optimization effect of ultrasound-guided erector spinae plane block (ESPB)combined with general anesthesia on Nuss procedure in pediatric patients with pectus excavatum undergoing Nuss procedure.Methods:One hundred and eight pediatric patients of either sex, aged 7-18 yr, with body mass index within the normal range, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing elective Nuss procedure, were randomized into 3 groups ( n=36 each) using a random number table method: ultrasound-guided ESPB combined with general anesthesia group (group E), thoracic epidural anesthesia plus general analgesia group (group T), and general analgesia group (group G). Pediatric patients received ultrasound-guided bilateral ESPB (0.3% ropivacaine was injected, 0.5 ml/kg bilateral total volume [maximum 20 ml]) or thoracic epidural anesthesia (0.3% ropivacaine 0.5 ml/kg [maximum 20 ml/side]) after induction of anesthesia in group E and group T, respectively. All the three groups underwent general anesthesia, anesthesia was induced with propofol 2-3 mg/kg, sufentanil 0.3-0.5 μg/kg and cis-atracurium 0.1-0.2 mg/kg and maintained with propofol 6-10 mg·kg -1·h -1 and remifentanil 0.1-0.3 μg·kg -1·min -1. The patients were endotracheally intubated and mechanically ventilated after anesthesia induction. The parent-controlled intravenous analgesia (PCIA) was used for patients in all the three groups postoperatively. The consumption of intraoperative remifentanil and postoperative consumption of sufentanil for PCIA in each period after surgery were recorded. The time to the first rescue analgesia, consumption of ibuprofen and postoperative complications were also recorded. Results:Compared with group G, the intraoperative consumption of remifentanil and postoperative consumption of sufentanil for PCIA in each period were significantly decreased, the time to the first rescue analgesia was prolonged, and the consumption of ibuprofen was decreased in group E ( P<0.05). There was no significant difference among the three groups ( P>0.05). Conclusions:ESPB combined with general analgesia is helpful in reducing postoperative hyperalgesia in pediatric patients undergoing the Nuss procedure.

Objective:To observe the clinical features, treatment and prognosis of ciliary body tumors.Methods:A retrospective clinical study. From November 2011 to March 2023, 8 cases (8 eyes) with ciliary body tumours confirmed by pathohistological examination at the Department of Ocular Oncology, Beijing Tongren Hospital were included in the study. Patients' age, gender, involved eyes, symptoms, best corrected visual acuity (BCVA), intraocular pressure, cataract, lens subluxation, and imaging manifestations were collected in detail. All affected eyes were treated surgically. The follow-up time after surgery ranged from 1 to 10 years. The patients' clinical presentation as well as imaging, pathohistological features and treatment and prognosis were analysed retrospectively.Results:Among 8 cases (8 eyes), there were 3 males (3 eyes) and 5 females (5 eyes), 3 and 5 eyes in the right and left eyes, respectively. The median age was 44 years. Ciliary body medulloepitheliomas, melanoma, squamous cell carcinoma, leiomyoma, schwannoma, and adenoma of the nonpigmcnted ciliary epithelium were in 2, 2, 1, 1, 1, and 1 eyes, respectively. All reported decreased or loss of vision. Cataract, vitreous opacity, red eye and or (ocular pain), retinal detachment, lens subluxation, and secondary glaucoma were 6, 4, 4, 2, 1, and 1 eyes, respectively. Diagnostic imaging was consistent with pathological findings in 3 eyes. The first surgery was performed for enucleation and orbital implantation in 2 eyes, the patients were 9 and 10 years old with medullary epithelioma; the follow-up time after surgery was 1 and 5 years, respectively. Local tumour resection was performed in 6 eyes. Among them, 3 eyes with benign tumours were followed up for 1 to 9 years after surgery; 2 eyes showed significant improvement in visual acuity, 1 eye with adenoma of the nonpigmcnted ciliary epithelium had a preoperative BCVA of finger count/1 m, and a postoperative BCVA of 0.5, and 1 eye with leiomyoma had a preoperative BCVA of 0.06, and a postoperative BCVA of 0.5; and 1 eye was lost to follow-up. Malignant tumour in 3 eyes, of which 2 eyes recurred after surgery. Re-operation for enucleation and local tumour excision combined with local cryotherapy in 2 eyes of recurrence were 1 eye each, respectively. The follow-up period after surgery was 2 and 4 years, respectively. No recurrence after surgery in 1 eye, but there was no significant improvement in visual acuity during follow-up. No recurrence or metastasis was observed in any of the eyes during the follow-up period or at the final follow-up.Conclusions:Ciliary body tumour types and clinical presentations are complex and varied; imaging can detect tumours but is poor at determining the nature of the lesion. Benign tumours do well with local excision surgery; malignant tumours do well with enucleation.

Forsythiae fructus,a traditional Chinese medicine for heat clearing and detoxifying,is commonly used in clinic.It mainly contains phenylethanol glycosides,lignans,terpenoids,volatile oils,flavonoids and other chemical components.Numerous studies have confirmed that forsythiae fructus has anti-inflammatory,antibacterial,antiviral,anti-cancer and other pharmacological effects.Moreover,it has high safety.In this paper,the chemical composition,pharmacological action and safety of forsythiae fructus were reviewed.The aim of this study is to collect the relevant research achievements of forsythiae fructus,and to provide ideas and references for its further research and clinical application.

Orbital lymphomas (OLs) are the common types of ocular lymphomas.The disease is an extranodal malignant tumor, which can be either primary orbital or secondary to orbital involvement of systemic lymphoma.OLs are more common in women and usually present with unilateral eyeball protrusion and periorbital swelling.The symptoms of indolent lesions last longer, while the rapid development of invasive lesions is often accompanied by pain and inflammation.Symptoms such as ptosis, diplopia and visual impairment can also occur when the tumor involves different tissues in the orbit.The clinical features and imaging findings of OLs are not specific, so OLs need to be identified with a variety of orbital diseases.Therefore, when patients have certain non-specific orbital symptoms, orbital CT, MRI and other imaging examinations are required to check the orbital situation.Further surgical biopsy should be performed to confirm the diagnosis at an early stage.The current gold standard for the diagnosis of OLs is histopathological examination, and its classification and staging depend on immunohistochemical analysis and PET-CT, respectively.The clinical staging of the disease directly affects the development of the treatment plan and the prognostic outcomes, so once the diagnosis is confirmed and the staging of OLs is completed, the appropriate treatment plan can be formulated as soon as possible.This article reviews the clinical manifestations and diagnosis of OLs in recent years to further understand the disease and provide a reference for clinical work.

Thyroid-associated ophthalmopathy (TAO) is one of the common orbital diseases in adults, which is closely related to autoimmune thyroid diseases.TAO can cause disfigurement.In severe cases, TAO can impair patients' visual function and even result in blindness.TAO greatly damages patients' physical and mental health and causes social barriers.Early prediction and diagnosis, and timely intervention and treatment can improve the clinical manifestations of patients and enhance their quality of life.There are many risk factors for TAO, which are influenced by heredity, immunity, environment, general state and other factors.Among them, environmental factors and general conditions can slow down the progress of the disease through early intervention and benefit patients.This article analyzes the risk factors related to TAO to provide references for early prediction and diagnosis of TAO and provide ideas for prevention of high-risk populations.

Orbital lymphomas (OLs) are the common orbital malignancies in adults.To date, many studies have reported the treatment of OLs, including radiotherapy, chemotherapy, immunotherapy, antibiotic therapy, surgical resection, or combination therapy.However, the selection of the best treatment is still a multidisciplinary task.Different treatment schemes were adopted for different subtypes and clinical stages of OLs.Radiotherapy is usually the first choice for the treatment of primary low-grade OLs, especially MALT lymphomas.Other non-MALT lymphomas can also be treated with radiotherapy, but the efficacy is not as good as MALT lymphomas.Chemotherapy is the most common choice for high-grade and other recurrent or refractory OLs.At present, rituximab combined with CHOP can significantly improve the prognosis of high-grade OLs.And antibiotics may be effective against a small portion of MALT lymphomas associated with Chlamydia psittaci infection.Also, studies have shown that histopathological subtypes and clinical stages are the most important factors affecting the prognosis of OLs.High-grade lymphomas have a poor prognosis, while the prognosis of low-grade lymphomas is better.Age, sex, the primary site of the disease and the use of various treatments are also related to prognostic outcomes of OLs.This article reviews the research on the treatment and prognostic factors of OLs at home and abroad to provide a reference for the formulation of clinical treatment plans and evaluate the prognosis.

Pleomorphic adenoma of the lacrimal gland (LGPA) is the most common epithelial lacrimal gland tumor, mainly occurring in the orbital lacrimal gland.The specific mechanism of its occurrence is unknown.The average onset age of LGPA is 39.5 years, and its clinical manifestations are usually lachrymal mass and exophthalmos, which are painless.If patients feel pain, malignant lesions should be considered.Imaging studies are of great value in the diagnosis of LGPA and can also be an important reference for the formulation of the surgical plan.To avoid capsule damage and tumor spillage, incisional biopsy isn't performed before surgery in LGPA.The treatment of LGPA is intact capsule excision.The risk of recurrence and malignant transformation is closely related to whether the tumor can be completely removed.This article reviews the clinical manifestation, histopathological changes, medical imaging changes, molecular mechanisms of tumor occurrence and development, malignant transformation mechanism, treatment and prognosis of LGPA in recent years from domestic and foreign research results, expecting to provide some references for the diagnosis and treatment of LGPA.

Adenoid cystic carcinoma (ACC) is a common malignant tumor in the head and neck, with a high rate of neuroinvasion, local recurrence, and distant metastasis, and a poor prognosis. Animal models are ideal models for studying the pathogenesis of tumors and effective drugs. This article summarizes the methods and advantages and disadvantages of establishing animal models for head and neck salivary and lacrimal gland ACC in recent years, laying a foundation for the rational selection and optimization of animal models.

IgG4-associated disease (gG4-RD) is a systemic immune-mediated fibroinflammatory disease that can involve almost all organs and systems, and the main clinical manifestations are enlargement or mass of the affected organs. The typical pathological features of the disease are a large number of lymphocytoplasmic infiltration in the pathological tissue, accompanied by mat fibrosis and obliterated phlebitis, and most patients may have elevated serum IgG4 levels. At present, the specific pathogenesis of the disease is not clear. In recent years, the mechanism of intestinal microbiome dysregulation in the occurrence and development of autoimmune diseases has been gradually clarified. However, the association between the gut microbiome and IgG4-RD is still poorly understood. Therefore, this article will review the progress of intestinal microbiome research of IgG4-RD.