Abstract:Objective To investigate the impact of cardiopulmonary bypass(CPB)surgery for congenital heart disease(CHD)on intestinal microbiota and evaluate the therapeutic potential of probiotics in modulating dysbiosis for preventing postoperative complications after CHD surgery.Methods Eighteen male specific pathogen free(SPF)SD rats,aged 2 weeks,weighing(80±20 g)were randomly divided into the control group(n=6),the CPB group(n=6),and the probiotic groups(n=6)according to random number table method.Intestinal microbiota was analyzed by 16S rRNA sequencing.Mucosal injury was assessed by HE staining and cognitive function was evaluated using Morris water maze(MWM)testing.Results CPB induced severe intestinal dysbiosis in juvenile rats,manifested as decreased α-diversity,enrichment of opportunistic pathogens(e.g.,Clostridium,Spirochaetes)and a reduction in beneficial bacteria(e.g.,Muribaculaceae,Prevotella).Probiotic intervention effectively restored microbial diversity and inhibited the proliferation of pathogens.β-diversity analysis revealed significant microbial structural differences between the control group and the CPB group(P＜0.001),with probiotics shifting the structure toward controls.LEfSe analysis indicated that the CPB group was enriched with pro-inflammatory bacteria(e.g.,Spirochaetaceae,Lachnospiraceae),while probiotics promoted the proliferation of anti-inflammatory genera(e.g.,Oscillospiraceae,Lactobacillus).Probiotics significantly alleviated mucosal injury(lower Chiu scores,downregulated CLDN2,inhibited MAPK pathway,decreased apoptosis;P＜0.05)and improved spatial memory deficits(longer target quadrant time;P＜0.05).Conclusion CPB can disrupt intestinal microbiota,induce intestinal mucosal injury and cause spatial memory impairment.Probiotics intervention can restore microbial homeostasis and mitigate CPB-associated intestinal mucosal injury and spatial memory impairment.

Abstract:Obstetric surgery involves the management of maternal and neonatal complications during pregnancy,childbirth,and the puerperium.Its anesthetic management needs to simultaneously address multiple goals,such as ensuring maternal and infant safety,achieving effective analgesia,maintaining hemodynamic stability,promoting postoperative recovery,and safeguarding neonatal health.Traditional anesthetic drugs have limited clinical application due to numerous risks,including respiratory depression,strong penetrability through the placental barrier,and neurotoxicity to neonates.Dexmedetomidine,a highly selective α2-adrenergic receptor agonist,has offered significant potential for the development of obstetric anesthesia by virtue of its unique pharmacokinetic properties.This article aims to review the progress of clinical research on dexmedetomidine in obstetric anesthesia in recent years,so as to provide references for optimizing obstetric anesthesia regimens and improving the quality of perioperative management.

Abstract:Objective To investigate the effect of driving pressure-guided individualized positive end-expiratory pressure(PEEP)ventilation on postoperative atelectasis in elderly patients undergoing laparoscopic hernia repair.Methods A total of 80 elderly patients of both sexes,aged≥60 years,of American Society of Anesthesiologists(ASA)physical status Ⅰ-Ⅲ,with body mass index(BMI)of 18.5-29.9 kg/m2 undergoing laparoscopic hernia repair at Hulun Buir People's Hospital,from January to December 2023 were selected.The final research data were divided into the conventional PEEP group(group C,n=40)and the driving pressure-guided individualized PEEP group(group P,n=40)according to the random number table method.After the establishment of pneumoperitoneum at the beginning of the operation,PEEP was set at 5 cmH2O in Group C,while in Group P,individualized PEEP was titrated based on driving pressure.The titration method was as follows:PEEP was increased from 4 cmH2O to 12 cmH2O in 2 cmH2O increments,and each PEEP level was maintained for 10 respiratory cycles.The airway plateau pressure(Pplat)at the last respiratory cycle was recorded,and the driving pressure was calculated.The PEEP value corresponding to the minimum driving pressure was determined as the optimal individualized PEEP for the patient and maintained until the end of the operation.The lung ultrasound score(LUS)was recorded at three time points:before anesthesia(T0),before leaving the recovery room(T4),and 24 h after extubation(T5).The driving pressure was recorded at two time points:5 min after pneumoperitoneum establishment(T1),30 min after pneumoperitoneum establishment(T2),and at the end of the operation when the pneumoperitoneum was released(T3).The operation time,intraoperative blood loss,urine output,fluid infusion volume,intraoperative peak airway pressure(Ppeak),Pplat,and dynamic lung compliance(Cdyn)were recorded for both groups.The PEEP values,intraoperative pulse oxygen saturation(SpO2),postoperative visual analog scale(VAS)pain score,and hospital stay were also recorded.The primary outcome was the LUS score 24 h after extubation;The secondary outcomes included intraoperative driving pressure,Cdyn,and postoperative complications.Results The LUS score at T5 was lower in group P than that in group C(1.65±1.05 vs 3.40±1.55,P＜0.001);the intraoperative driving pressure was lower in group P at T1(13 vs 17 cm H2O,P＜0.001),T2(13 vs 17 cmH2O,P＜0.001),and T3(8 vs 10 cmH2O,P＜0.001).The Ppeak and Pplat in group C were significantly higher than those in group P at T2(P＜0.05);the intraoperative Cdyn was higher in group C at T1(32.18±4.15 vs 26.49±4.99 mL/cmH2O,P＜0.001),T2(30.95±3.90 vs 24.83±4.53 mL/cmH2O,P＜0.001),and T3(56.88±10.89 vs 41.24±7.83 mL/cmH2O,P＜0.001).The median individualized PEEP value determined by driving pressure-guided titration was 8(6-8)cmH2O,while the conventional PEEP was 5 cmH2O,with a statistically significant difference(P＜0.05).There was no statistically significant difference in the postoperative VAS score(P＞0.05)or hospital stay(P＞0.05)between the two groups.Conclusion Intraoperative individualized PEEP settings guided by driving pressure can reduce the driving pressure during surgery and the postoperative lung ultrasound score in elderly patients undergoing hernia repair,decrease the severity of atelectasis.This leads to a reduction in the incidence of postoperative pulmonary complications and a shorter postoperative convalescence.

Abstract:Against the backdrop of global population aging,the clinical necessity for risk assessment in elderly surgical patients is increasingly prominent.Frailty syndrome,a prevalent pathological condition among the geriatric population,is not adequately integrated into the evaluation of its effect on postoperative recovery within current anesthesia grading assessment systems,despite their ability to reflect patients'systemic status and surgical risks.This results in limitations in preoperative risk assessment for elderly patients.This study analyzes the role of combined frailty and anesthesia grading assessment in elderly surgical patients and explores its impact on postoperative prognosis,thereby aiming to optimize preoperative assessment for this population and reduce the occurrence of postoperative adverse events.

Abstract:Although traditional opioids remain first-line agents,they frequently cause opioid-related adverse events such as respiratory depression and postoperative nausea and vomiting.Oliceridine,a novel biased μ-opioid receptor agonist,preferentially activates the G-protein signaling pathway while down-regulating β-arrestin recruitment;theoretically,this mechanism preserves analgesic efficacy and lowers the incidence of opioid-related adverse events.A growing body of domestic and international studies has demonstrated that oliceridine is safe and effective during general anesthesia induction,patient-controlled postoperative analgesia,and anesthesia outside the operating room.It can partially replace conventional opioids,reduce their consumption,and provide a safer and more effective anesthetic regimen for surgical patients.

Abstract:Objective To analyze the association between anesthesia quality control and perioperative adverse events,and to compare differences in quality control practices among hospitals of different levels,for providing references for optimizing anesthesia safety management strategies,based on anesthesia quality control data from 200 hospitals in Jiangsu Province.Methods Data from the Jiangsu Provincial Anesthesia Medical Quality Control Management Platform between April 2023 and March 2024 were extracted.Key indicators,including the intraoperative active warming rate,ultrasound-guided puncture coverage rate,and the incidence of adverse events,were analyzed.Random forest algorithm and generalized linear mixed models(GLMM)were employed to explore the intrinsic relationships between these indicators and the occurrence of adverse events.Results Significant heterogeneity in anesthesia quality control levels was observed among hospitals of different grades,with tertiary grade A hospitals excelling in multiple indicators.Both the intraoperative active warming rate(β=-0.186,p＜0.01)and the ultrasound-guided puncture coverage rate(β=-0.182,p＜0.01)were negatively correlated with the incidence of adverse events,suggesting a protective effect.Conversely,the total number of anesthetic cases(β=0.342,p＜0.001),the average monthly number of anesthetic cases per anesthesiologist(β=0.159,p＜0.01),and the invasive monitoring rate for critically ill patients(β=0.177,p＜0.01)showed positive correlations,reflecting the risks associated with workload and patient acuity.Regarding the composition of adverse events,unplanned transfer to the ICU accounted for the highest proportion(42.65%),highlighting the variability of perioperative conditions and the necessity for continuous postoperative monitoring.Conclusion This study demonstrates that the application of intraoperative active warming and ultrasound-guided puncture techniques is associated with a reduction in perioperative risks.Hospitals at all levels should optimize quality control strategies based on their resources and workload,while strengthening information systems and data-driven decision-making to enhance perioperative safety and healthcare quality.

Abstract:Objective To explore the anesthesia quality control management experience and operational outcomes from the first 1,000 cardiac surgeries performed during the initial operation period of the Department of Anesthesiology of Beijing Anzhen Hospital(Tongzhou),providing a replicable and scalable anesthesia quality management model for newly established hospitals and medical institutions at various levels.Methods A retrospective study was conducted on 1,000 patients who underwent cardiac surgery at Beijing Anzhen Hospital(Tongzhou)from October 14th to December 18th,2024.Among them,40.9%were aged over 65 years,85.7%were classified as American Society of Anesthesiologists(ASA)physical status≥Ⅲ,and 93.1%underwent surgeries with a classification≥Ⅲ.Perioperative data were collected through an anesthesia information platform,and key quality control indicators were statistically analyzed and compared with domestic and international benchmarks.Results The perioperative mortality rate of these patients was 0.10%,significantly lower than the international average of 3.29%.Rates of reoperation for bleeding(1.50%),unplanned intubation(0.90%),and new-onset postoperative stroke(1.40%)were all better than those reported in the literature.The incidence of major intraoperative and perioperative complications,such as severe allergic reactions and postoperative hoarseness due to extubation,was 0.00%.Despite limited human resources,the center efficiently handled high-intensity surgical workloads,with anesthesiologists working an average of 9.94 h per day and anesthesia assistants 8.55 h per day.Conclusion The anaesthesia quality control system established by the Department of Anesthesiology of Beijing Anzhen Hospital encompasses preoperative risk assessment,standardized intraoperative monitoring,postoperative enhanced recovery,and continuous quality improvement.During the initial operation phase,this system ensured the high-quality and steady advancement of medical quality control management,with mortality and the incidence of major complications far below the international averages.

Abstract:Objective To investigate the effects of ultrasound-guided fascia iliaca compartment block(FICB)combined with patient-controlled intravenous analgesia(PCIA)on postoperative analgesia and the incidence of complications in elderly patients undergoing hip arthroplasty.Methods A total of 117 elderly patients,aged≥60 years,of American Society of Anesthesiologists(ASA)physical statusⅠ-Ⅲ,who underwent hip arthroplasty in Yantian District People's Hospital of Shenzhen from November 2021 to November 2024 were enrolled.The patients were assigned to group A(n=39,FICB was performed 30 min before surgery),group B(n=39,PCIA was administered postoperatively),and group C(n=39,FICB 30 min before surgery+PCIA postoperatively),according to the random drawing method.All patients were followed up for 30 d after surgery.The three groups were compared in terms of recovery status[quality of recovery-40(QoR-40)scores],inflammatory cytokine levels[interleukin-6/interleukin-10(IL-6/IL-10)and tumor necrosis factor-alpha(TNF-α)],incidence of delirium and other complications,and quality of life[short form-36 health survey(SF-36)scores]and pain intensity[numeric rating scale(NRS)].Results Compared with the pre-anesthesia baseline,QoR-40 scores at 24 h and 72 h after surgery in all three groups decreased initially and then increased.At both 24 h and 72 h postoperatively,QoR-40 scores were highest in group C,followed by group A,and lowest in group B,with statistically significant differences among the three groups(P＜0.05).Compared with pre-anesthesia,IL-6 and TNF-α levels at 24 h and 72 h postoperatively were lower in all three groups,with the lowest levels in group C,while IL-10 levels were higher,with the highest levels in group C(all P＜0.05).However,there were no statistically significant differences in IL-6,IL-10,or TNF-α levels between group A and group B(P＞0.05).Within 7 days after surgery,there were no significant differences among the three groups in the incidence of delirium or in the incidence of complications(nausea,vomiting,respiratory depression,somnolence)(P＞0.05).Compared with preoperative values in each group,SF-36 scores at 30 d postoperatively were higher in all three groups;the intergroup comparisons showed that group C＞group A＞group B,with statistically significant differences(P＜0.05).Conclusion FICB combined with PCIA can promote postoperative recovery in elderly patients undergoing hip arthroplasty,reduce inflammatory cytokine levels and the risk of adverse events,as well as improve quality of life.

Abstract:Objective To investigate the application of the artificial intelligence(AI)based image recognition system in ultrasound-guided nerve block training for residents undergoing standardized residency training in the Department of Anesthesiology.Methods Forty residents who received standardized anesthesia training at the Sixth Medical Center of PLA General Hospital from September 2023 to September 2025 were enrolled.Using a random-number table method,they were allocated into the control group(group C,n=20)and the experimental group(group E,n=20).The group E was trained with an AI-assisted image recognition system,whereas group C followed the conventional teacher-led instruction.After the course,the training quality and teaching effect were evaluated and statistically analyzed.Results No significant inter-group differences were found in mean scores of multiple-choice questions,short-answer questions,or total theory marks(P＞0.05).In structural-identification assessment,the average score of group E(4.12±0.25),was significantly higher than that of group C(3.27±0.19)(P＜0.05).In puncture-module assessment,the average score of group E(4.06±0.21)was significantly higher than that of group C(3.11±0.14)(P＜0.05).Questionnaire results showed that group E outperformed group C in enhancing learning interest,increasing teaching affinity,improving practical skills,and endorsing the teaching model(P＜0.05).Conclusion The AI-assisted image recognition system improves the training effectiveness of ultrasound-guided nerve block for the residents undergoing standardized residency training in the Department of Anesthesiology and offers notable advantages in teaching of ultrasound-guided nerve block.

Abstract:Objective To investigate the correlation between 24-h ambulatory blood pressure patterns and perioperative complications.Methods A retrospective analysis was conducted on 130 patients,39 males and 91 females,aged 18-88 years,with a mean age of(49.92±15.88)years,who underwent surgery at the First Affiliated Hospital of Hainan Medical University from 2013 to 2022 and had completed preoperative 24-h ambulatory blood pressure monitoring.All the patients were classified into four groups based on the nocturnal systolic blood pressure decline rate:dipper pattern(10%-20%fall,n=28),non-dipper pattern(＜10%fall,n=61),extreme-dipper pattern(＞20%fall,n=8),and reverse-dipper pattern(nocturnal mean higher than diurnal mean,n=33).Perioperative hypertension,hypotension,sinus arrhythmia,postoperative disorientation,ICU admission rate,and length of stay were compared among the four groups.Results The incidence of perioperative hypertension was significantly higher in reverse-dipper group(39.4%)than those in the non-dipper(14.8%)and extreme-dipper(25.0%)groups(P＜0.05).No statistically significant differences were observed in hypotension,postoperative disorientation,sinus arrhythmia,ICU admission rate(P＞0.05).Conclusion Patients with preoperative dipper or reverse-dipper ambulatory blood pressure patterns are at higher risk of perioperative hypertension.Enhanced perioperative blood pressure monitoring and cerebral function evaluation are warranted for patients with abnormal circadian blood pressure rhythms to prevent related complications.

Abstract:Driven by evolving medical concepts,the demand for comfort-oriented diagnosis and treatment has surged,exposing the core contradiction between imbalanced resource allocation and lagging systematic construction.The safety and quality of current services are constrained by a chronic shortage of anesthesiologists,a one-sided underestimation of their professional value(often oversimplified by the"painless"label),fragmented operational layouts,and disrupted postoperative safety management chains.Furthermore,regulatory loopholes in pharmaceutical supervision and the absence of a full-process quality control system remain critical challenges.To address these issues,this paper proposes a systematic pathway for establishing comfort-oriented diagnosis and treatment centers.By affirming the leading role of anesthesiologists and implementing multidisciplinary collaborative mechanisms,including dynamic resource scheduling,tiered postoperative management,pre-procedural assessment,stratified human resource allocation,and closed-loop quality control,resource intensification and process standardization can be achieved.This analysis demonstrates that promoting the standardized and systematic development of comfort-oriented diagnosis and treatment centers is an imperative strategy to meet public demand and drive the comprehensive upgrading of healthcare quality.

Abstract:Medical errors rank as the third leading cause of patient death worldwide.Standardized whole-process management of patient safety incidents in surgical anesthesia is of great importance for patient safety during the perioperative period.Currently,there is an urgent need to strengthen the reporting mechanisms for patient safety incidents in clinical anesthesia and perioperative care.Meanwhile,a practical and feasible patient safety incidents management system grounded in actual clinical needs to be established.Reporting patient safety incidents and learning from errors can help healthcare institutions fully leverage the valuable resources derived from such incidents,enabling continuous improvement in clinical quality and safety management.In practice,the Department of Anesthesiology of Peking Union Medical College Hospital has explored and established a targeted grid-based management system for perioperative anesthesia patient safety incidents.This system encompasses a closed-loop,whole-process management approach,including reporting,handling,follow-up,discussion and analysis,feedback,data collection,and database development.This model has effectively ensured the reporting rate and timely feedback of patient safety incidents.It has significantly enhanced patient safety management and been beneficial to foster a positive department safety culture.

Abstract:Objective To investigate the status of labor analgesia in secondary and lower-level medical institutions in Shaanxi Province and the impact of the Shaanxi Provincial Health Commission's Delivery-Friendly Service Initiative on labor analgesia,thereby providing a basis for further promoting labor analgesia.Methods A self-designed questionnaire was distributed in September 2025 to anesthesiology medical staff in 228 secondary and lower-level medical institutions in Shaanxi Province to survey their knowledge and application of labor analgesia.The results were compared with historical data from November 2023(before and after the implementation of the Delivery-Friendly Service Initiative).Results Among the 228 secondary and lower-level medical institutions,196 routinely provided labor analgesia,with a coverage rate of 85.9%.The labor analgesia rate in September 2025 was 40.2%,significantly higher than the 25.1%recorded in November 2023.Additionally,the survey results showed that after the implementation of the Delivery-Friendly Service Initiative,the training rate(89.3%)and awareness of labor analgesia-related tasks among medical staff in secondary and lower-level institutions significantly improved.The top three current issues with labor analgesia were insufficient manpower,inadequate hospital support,and charging problems.Conclusion The Delivery-Friendly Service Initiative has significantly promoted the coverage and awareness of labor analgesia in secondary and lower-level medical institutions in Shaanxi Province.

Abstract:Objective To systematically evaluate the influencing factors for hypoxemia during anesthesia recovery in postoperative patients undergoing general anesthesia.Methods A comprehensive search was conducted in databases including PubMed,Web of Science,Cochrane Library,Embase,CNKI,VIP,Wanfang,and CBM from inception to July 4th,2025,to identify studies investigating influencing factors for hypoxemia during anesthesia recovery in patients after general anesthesia.Two researchers independently screened the literature,extracted data,and assessed the quality of the included studies using Agency for Healthcare Research and Quality(AHRQ)and Newcastle-Ottawa scale(NOS).Meta-analysis was performed using Stata 17.0 software for each identified influencing factor.Results A total of 21 studies were included,involving a surveyed population of 22,184 cases,with 2,204 hypoxemia cases,from which 13 influencing factors were extracted.The Meta-analysis results indicated that the following were risk factors for hypoxemia during anesthesia recovery:age≥60 years(OR=2.36,95%CI:1.74-3.19),BMI≥24 kg/m2(OR=4.63,95%CI:2.71-7.91),BMI≥28 kg/m2(OR=2.84,95%CI:1.14-7.04),smoking(OR=3.28,95%CI:2.29-4.71),hypertension(OR=2.56,95%CI:2.18-2.99),diabetes(OR=2.75,95%CI:1.59-4.74),preoperative SpO₂＜95%(OR=4.25,95%CI:2.17-8.30),ASA classification(OR=2.30,95%CI:1.92-2.75),anesthesia duration(OR=1.01,95%CI:1.00-1.01),surgery duration(OR=1.05,95%CI:1.03-1.07),body temperature＜36℃upon PACU admission(OR=6.46,95%CI:3.22-12.97),and Riker sedation-agitation scale score≥5(OR=4.19,95%CI:1.96-8.96).FEV₁/FVC ratio(OR=0.95,95%CI:0.91-1.00)was identified as a protective factor against hypoxemia during anesthesia recovery.Conclusion Hypoxemia during anesthesia recovery is influenced by multiple factors.Healthcare professionals can utilize these factors to identify high-risk patients and implement interventions to reduce the incidence of hypoxemia during this period.

Abstract:Objective To investigate the effect of auricular point pressing bean therapy combined with pentazocine on analgesia and sedation in patients after craniotomy.Methods A total of 100 patients after craniotomy who were hospitalized in the Second Affiliated Hospital of Guangxi Medical University from October 2023 to June 2024 were selected as the research objects.The patients were divided into the control group(n=50)and the observation group(n=50)by random number table method.The patients were treated with the same treatment plan before and during the operation.The control group was treated with pentazocine for analgesia after surgery,and the observation group was additionally treated with auricular point pressing with beans on the basis of the control group.The Ramsay score,visual analogue scale(VAS)score,mean arterial pressure,heart rate,pulse oxygen saturation,blood pressure and other vital signs were compared between the two groups at different time points(2,6,12,24 h),and the incidence of adverse reactions in patients undergoing craniotomy during treatment was recorded.Results At 2,6,12 and 24 h after administration,the Ramsay score and VAS score of the two groups were significantly improved,and the observation group was better than the control group(P＜0.05).At 12 and 24 h after administration,the hemodynamics of the two groups were improved compared with those before administration,and the improvement effect of the observation group was more significant(P＜0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(8.00%vs 24.00%,P＜0.05).Conclusion Auricular point pressing bean therapy combined with pentazocine has obvious advantages in analgesia and sedation of patients after craniotomy.This therapy can not only effectively reduce the pain of patients,enhance the sedative effect,improve vital signs,but also reduce the incidence of adverse reactions,and open up a new path for postoperative pain management.

Abstract:In response to the urgent demand for high-level medical professionals under the"Healthy China"strategy,the standardized training of anesthesiology residents assumes a core mission.However,the prevalent disconnect between basic knowledge and clinical practice in standardized training,coupled with the retrospective characteristic of anesthesia quality control,collectively forms a core bottleneck that constrains the cultivation of high-quality anesthesiologists and the assurance of patient safety.To address this dilemma,this paper,based on the concept of competency-based medical education and deeply synthesizing various pedagogical methods such as Kolb's experiential learning cycle and problem/case-based learning,constructs and practices a teaching model that integrates basic anesthesiology education into standardized residency training,driven by clinical case quality control.This model uses authentic quality control cases as an anchor,and through five-step basic root-tracing method,it guides residents to start from actual clinical problems and trace back to fundamental theoretical knowledge,thereby reconstructing fragmented knowledge into systematic core competencies.This model is not merely an innovation in teaching methodology but also a reshaping of the educational paradigm,which shifts the quality control checkpoint forward and transforms retrospective reviews into proactive interventions.It is committed to embedding the principles of medical quality control into the residents'cognitive instincts and represents an effective pathway for exploring a new"quality control-as-teaching"integration,thereby safeguarding the frontline of anesthesia safety in the new era.

Abstract:Objective To compare the effects of different combinations of desflurane,sevoflurane,and propofol on postoperative cognitive function of school-age children.Methods A total of 150 children,aged 5-12 years old,of American Society of Anesthesiologists(ASA)physical status Ⅰ or Ⅱ,who underwent elective tonsil and/or adenoidectomy,from June 2018 to January 2020,in the Second Affiliated Hospital of University of South China and the First Affiliated Hospital of University of South China,were selected as the subjects.According to different combinations of induction and maintenance drugs,they were randomly divided into five groups:sevoflurane-induced and sevoflurane-maintenance group(SS group),sevoflurane-induced and propofol-maintenance group(SP group),sevoflurane-induced and desflurane-maintenance group(SD group),propofol-induced and propofol-maintenance group(PP group),propofol-induced and desflurane-maintenance group(PD group),with 30 cases in each group,according to random number table method.Peabody picture vocabulary test(PPVT)scores were assessed on the day before surgery(T0)and the day after surgery(T1),and combined Raven's test(CRT)scores were assessed at 3 d,1 month,and 3 months after surgery.Serum concentrations of S100β protein and neuron-specific enolase(NSE)were measured at T0 and T1.Recovery time,extubating time,and PACU stay time were recorded.Results There were no statistically significant differences among the five groups in PPVT scores and serum S100β protein concentrations at T0 and T1(P＞0.05),and no statistically significant differences were observed among the groups(P＞0.05).The CRT scores of the five groups showed no statistically significant differences at 3 d,1 month,and 3 months postoperatively(P＞0.05),and no statistically significant differences were found among the groups(P＞0.05).The NSE concentration of the five groups in serum at T1 was higher than that at T0,and this difference was statistically significant(P＞0.05),while there were no statistically significant differences among the groups(P＞0.05).The SD group and PD group had shorter recovery time and extubation time than other groups,with the SD group having the shortest time,showing statistically significant differences(P＜0.05).Conclusion Different combinations of induction and maintenance agents(desflurane,sevoflurane,and propofol)don't result in cognitive impairment in school-aged children without prior exposure to anesthesia.Additionally,maintenance with desflurane offers the advantages of rapid awakening and early extubation,making it suitable for short pediatric surgeries.

Abstract:Objective To explore the application effect of personal goal orientation combined with goal-oriented teaching in clinical teaching of oral anesthesia.Methods A total of 70 standardized training residents who rotated in the Department of Surgical Anesthesiology,Affiliated Stomatological Hospital of Guangxi Medical University from January 2022 to October 2024 were selected as research objects.Those residents were randomly divided into the control group(n=35)and the observation group(n=35)according to random number table method.The control group adopted the conventional teaching mode,while the observation group used the teaching mode of personal goal orientation combined with goal-oriented teaching.When the residents completed the rotation,both groups received theoretical assessments,skill assessments,comprehensive quality assessments,and the number of clinical procedures performed was recorded.Meanwhile,the residents'satisfaction with the teaching mode was surveyed.Results The scores of theoretical assessments(93.00 ± 4.81)points,skill assessments(92.66 ± 1.83)points and comprehensive quality assessments(91.34 ± 4.12)points in the observation group were higher than those in the control group[(89.46 ± 4.35)points,(89.40 ± 4.98)points,(88.66 ± 3.81)points],and all differences were statistically significant(P＜0.05).Among these findings,the observation group performed more clinical procedures and reported higher satisfaction with the teaching method,with statistically significant differences(P＜0.05).Conclusion Combining personal goal orientation with goal-oriented teaching can effectively enhance the quality of clinical teaching in oral anesthesia and improve teaching satisfaction.

Abstract:Remimazolam is an ultra-short-acting benzodiazepine sedative,primarily used for general anesthesia induction,intraoperative maintenance and sedation for outpatient painless operations.The new sedative remimazolam has the advantages of fast onset,long-term infusion without accumulation,and minimal hemodynamic impact.Its application in the special population of pediatric patients is still in the exploration stage.The physiological characteristics of children are obviously different from adults,with the characteristics of large drug distribution volume and immature organ systmes and relevant protease systems.The unique metabolic properties of remimazolam make it more suitable for pediatric anesthesia.This review aims to illustrate the pharmacological characteristics of remimazolam and its application progress in pediatric clinical practice in recent years,and to provide a reference for its safe medication in pediatric clinical application.

Abstract:Brain science is a highly interdisciplinary and emerging frontier discipline,which is closely related to anesthesiology.In order to promote the deep integration of brain science and anesthesiology and cultivate innovative talents,we explored the innovative training model of interdisciplinary talents in anesthesia and brain science through curriculum system optimization,teaching model reform and quality improvement of education.The curriculum system covers two modules of basic knowledge and clinical practice,three levels of undergraduate education,postgraduate education and professional education,and three combinations of theory and ability,foundation and application,tradition and frontier.A teaching model has been established to break disciplinary barriers,empower with digital intelligence,innovate teaching concepts,renew teaching content and innovate teaching methods.Furthermore,we established a cross-disciplinary collaborative innovation mechanism to promote the development of teaching staff.A new education model of interdisciplinary integration between anesthesia and brain science has been formed and this new model will provide support for cultivating high-level composite innovative talents.