1.Guidelines on diagnosis and treatment of nonspecific orbital inflammation(2024)
Yi SHAO ; Jianmin MA ; Huasheng YANG ; Huasheng YANG ; Huasheng YANG ; Huasheng YANG ; Huasheng YANG
International Eye Science 2025;25(2):171-178
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.
2.Impact of excessive pregnancy weight gain on pregnancy outcomes and neonatal conditions in pre-pregnancy overweight and obese women
Xia CHEN ; Yunlan YUAN ; Yan ZHANG ; Ziwen MA ; Jianmin ZHANG
Shanghai Journal of Preventive Medicine 2024;36(3):255-261
ObjectiveTo explore the influence of excessive weight gain during pregnancy in pre-pregnancy overweight and obese women on pregnancy outcomes and neonatal conditions, and to provide scientific evidence for formulating weight management strategies before and during pregnancy and prevent adverse pregnancy outcomes. MethodsClinical data of 2 172 parturients collected from a community in Huangpu District from 2017 to 2021 were retrospectively analyzed, and they were divided into pre-pregnancy overweight and obesity group (n=530), normal pre-pregnancy weight group(n=937), and underweight pre-pregnancy group(n=705) according to maternal precursor body mass index (BMI). Based on their weight gain during pregnancy,the parturient were divided into moderate gestational weight gain (MGWG) group and excessive gestational weight gain (EGWG) group. Meanwhile, the pregnancy and neonatal outcomes such as postpartum hemorrhage, puerperal infection, placental abruption, premature rupture of membranes, mode of delivery, premature birth, stillbirth, fetal distress, admission to the intensive care unit (ICU), macrosomia, and Apgar score, were recorded. Then the differences in pregnancy and neonatal outcomes between groups were compared. The effects of pre-pregnancy BMI and gestational weight gain on pregnancy outcomes and neonatal conditions was retrospectively analyzed. ResultsThe pre-pregnancy overweight and obese group had higher proportions of placental abruption, premature rupture of membranes, cesarean section, premature birth, fetal distress, and macrosomia compared to the normal pre-pregnancy weight group and the underweight pre-pregnancy group, with Apgar scores lower than the normal pre-pregnancy weight group and the underweight pre-pregnancy group (all P<0.05). The EGWG group had higher proportions of postpartum hemorrhage, placental abruption, premature rupture of membranes, cesarean section, premature birth, fetal distress, admission to the ICU, and macrosomia than the MGWG group (all P<0.05). In the pre-pregnancy overweight and obese group, the EGWG group had higher proportions of placental abruption, premature rupture of membranes, premature birth, fetal distress, admission to the ICU, and macrosomia than the MGWG group, with lower Apgar scores than the MGWG group (all P<0.05). In the normal pre-pregnancy weight group, the EGWG group had higher proportions of placental abruption, premature rupture of membranes, premature birth, fetal distress, admission to the ICU, and macrosomia than the MGWG group (all P<0.05). In the pre-pregnancy overweight and obese group, the EGWG group had higher proportions of premature rupture of membranes, cesarean section, premature birth, fetal distress, and macrosomia than the EGWG group in the normal pre-pregnancy weight group(all P<0.05). Logistic regression analysis showed that EGWG in pre-pregnancy overweight and obese women was a risk factor for placental abruption (OR=2.971, 95%CI: 1.098‒8.042), premature rupture of membranes (OR=4.662, 95%CI: 2.798‒7.770), cesarean delivery (OR=1.375,95%CI: 1.260‒2.541), premature birth (OR=4.249, 95%CI: 2.384‒7.573), fetal distress (OR=3.238, 95%CI: 1.589‒6.598), admission to the ICU (OR=3.010, 95%CI: 1.265‒7.164), and macrosomia (OR=5.437, 95%CI: 3.392‒8.716) (all P<0.05). ConclusionExcessive gestational weight gain in pre-pregnancy overweight and obese women is a risk factors for placental abruption, premature rupture of membranes, cesarean section, premature birth, fetal distress, admission to the ICU, and macrosomia.
3.Retrospective analysis of infectious endophthalmitis secondary to ophthalmic surgery
Yin ZHANG ; Qingmin MA ; Jialin NIU ; Jianmin WANG
International Eye Science 2024;24(12):2016-2019
AIM: To investigate the pathogenic bacteria, drug resistance, therapy and prognosis of infectious endophthalmitis secondary to different ophthalmic surgeries.METHODS:A retrospective analysis was conducted on the clinical data of 37 patients(37 eyes)with infectious endophthalmitis secondary to different ophthalmic surgeries. All these patients were treated in the Ophthalmology Department of Hebei General Hospital between January 2009 and June 2023. The pathogenic bacteria, drug resistance and therapeutic effects of early intravitreal injection of antibiotics or vitrectomy combined with silicone oil filling were analyzed.RESULTS:There were 24 eyes following cataract phacoemulsification combined with intraocular lens implantation, 4 eyes following vitrectomy, 2 eyes following combination surgery for glaucoma and cataract, 2 eyes following anti-glaucoma surgery, 2 eyes following corneal transplantation, 2 eyes following anterior chamber puncture, and 1 eye following intravitreal injection among the 37 eyes with infectious endophthalmitis. Totally 37 samples of intraocular fluid were submitted for bacterial and fungal culture, and 20 strains of pathogenic bacteria were identified, including 17 Gram-positive bacteria, 2 Gram-negative bacteria, 1 fusarium, and 12 cases were staphylococcus epidermidis. According to the final therapy, 7 eyes only treated by intravitreal injection, 11 eyes treated by intravitreal injection and vitrectomy, and 19 eyes only treated by vitrectomy. At the last follow-up, the best corrected visual acuity(BCVA)was ≤0.05 in 15 eyes, 0.06-0.3 in 15 eyes, and 0.4-1.0 in 7 eyes. Compared to before treatment(no light perception - hand movement in 31 eyes, counting fingers -0.05 in 3 eyes, 0.06-0.3 in 3 eyes), the difference was statistically significant(P<0.001).CONCLUSION: For infectious endophthalmitis patients with relatively mild ocular manifestation and good initial visual acuity, intravitreal injection of antibiotics remains an economically viable and effective therapy option. Early vitrectomy may effectively prevent the progression of infectious endophthalmitis, reduce the number of surgeries, and significantly improve the vision outcomes.
4.Guidelines for the operation of imaging equipment in orbital diseases(2024)
Yi SHAO ; Jianmin MA ; Xiaoming HUANG ; Xiaoming HUANG ; Xiaoming HUANG ; Xiaoming HUANG ; Xiaoming HUANG ; Xiaoming HUANG
International Eye Science 2024;24(2):171-181
Orbital disorders include conditions originating from the orbital bones, surrounding tissues, and post-orbital septum. They also include systemic ailments affecting the orbit. Different clinical symptoms make up the complex range of orbital disorders. Because these disorders mostly impact the orbital area instead of the intraocular compartment, there is little diagnostic usefulness for typical ophthalmic visual tests. As such, the primary instruments for diagnosing and evaluating orbital illnesses have become ophthalmic imaging modalities, including ocular ultrasonography(B-scan), computed tomography(CT), and magnetic resonance imaging(MRI). One way to improve the precision and promptness of diagnosing orbital diseases is to standardize the functioning of widely used imaging equipment and define the radiological features of orbital abnormalities. Such programs are crucial for the care of patients with orbital disorders since they considerably reduce the number of misdiagnoses and missed diagnoses in these individuals. The underlying concepts, operational techniques, and normal and pathological imaging findings associated with common diagnostic tools for orbital illnesses are all thoroughly reviewed in this guideline. The objective is to improve primary healthcare settings' diagnostic competence in the field of orbital pathology and to standardize procedures for diagnosing orbital disorders.
5.Efficacy and safety of ozone therapy for lumbar disc herniation:a meta-analysis based on a randomized control and systematic review
Feihong MA ; Zhouli FENG ; Tianying JI ; Zhijing SONG ; Yang LI ; Rui CHANG ; Jianguo WANG ; Jianmin WU
Journal of Interventional Radiology 2024;33(7):745-752
Objective To evaluate the efficacy and safety of ozone injection therapy for lumbar disc hemiation(LDH).Methods A computerized retrieval of academic papers concerning the randomized controlled trial(RCT)on ozone injection therapy for LDH from the databases of Embase,PubMed,Cochrane library and Web of science was conducted.The retrieval time period was from the establishment of the database to February 2023.The literature retrieval,screening,and data extraction were independently performed by two researchers.Cochrane bias risk assessment tool was used to assess the quality of the included literature.Stata 17.0 software was used to make meta-analysis.Results A total of 9 RCTs including 702 patients were finally included in this study.The results of meta-analysis showed that compared with radiofrequency thermocoagulation,percutaneous rotation and other treatments for LDH,the combination use of ozone injection could signifiicantly improve the effective rate based on Macnab efficacy evaluation criteria(RR=1.097,95%CI:1.038~1.159,P=0.001)and the excellent rate(RR=1.185~95%CI:1.074~1.309,P=0.001),and decrease the visual analog scale(VAS)pain score(WMD=-0.810~95%CI:-1.205~-0.414,P=0.000),and the differences in the above indexes were statistically significant.Conclusion Compared with the simple use of radiofrequency thermocoagulation,percutaneous rotation,and other treatment for LDH,the combination use of ozone injection therapy can significantly improve the effective rate and excellent rate based on Macnab efficacy evaluation criteria,decrease VAS score,with a high clinical safety.Limited by the quantity and quality of the original studies included in this study,the above conclusions need to be further verified by multi-center,large-sample and high-quality studies.
6.Clinical features and diagnostic progress of orbital lymphoma
Chinese Journal of Experimental Ophthalmology 2024;42(8):774-779
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.
7.Research progress on risk factors of thyroid-associated ophthalmopathy
Chinese Journal of Experimental Ophthalmology 2024;42(9):871-875
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.
8.Research progress on the treatment and prognosis of orbital lymphomas
Chinese Journal of Experimental Ophthalmology 2024;42(10):963-969
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.
9.Clinical features and research status of the pleomorphic adenoma of the lacrimal gland
Chinese Journal of Experimental Ophthalmology 2024;42(11):1036-1042
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.
10.Research progress on animal models of adenoid cystic carcinoma
Journal of Chinese Physician 2024;26(5):786-788
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.

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