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ISSN: 2957-5443
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Editor-in-Chief: Lize XIONG
Email: PPM@zentimecorp.com
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Perioperative Precision Medicine (PPM) is an open-access, peer-reviewed online journal dedicated to the rapid publication of research on medicine during perioperative period. With the aim to deepen the understanding of the pathogenesis and to promote the development of diagnosis and treatment, PPM provides a platform for clinicians to share their cutting-edge research results in perioperative medicine, hoping to provide a new impetus to the progression of scientific research in perioperative medicine. Articles from experts in this field will offer key insights in the areas of clinical practice, advocacy, education, administration, and research of perioperative precision medicine.


Please join us in this Open-Access endeavor by submitting your high-quality papers to PPM. 

Lastest Issue

Changes in brain functional connectivity of patients with postoperative delirium

Tuo Deng1, Changkuan Tan1, Guangkuo Ma1, Meiyan Zhou2, Liwei Wang1,2 

1Department of Anesthesia, Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China. 2Department of Anesthesiology, Xuzhou Central Hospital, Xuzhou 221000, Jiangsu Province, China.

Address correspondence to: Liwei Wang, Department of Anesthesia, Xuzhou Medical University, No. 199 Jiefang South Road, Quanshan District, Xuzhou 221000, Jiangsu Province, China. Tel: +86 18952170255. E-mail: 18952170255@163.com.

DOI: https://doi.org/10.61189/052994nhuqqb

Received July 25, 2024; Accepted October 16, 2024; Published December 31, 2024 

Highlights 

● Electroencephalography (EEG) and Functional Magnetic Resonance Imaging (fMRI) are compared for studying brain connectivity in POD. EEG provides high temporal resolution, while fMRI offers detailed spatial mapping. Combining these techniques can deliver a comprehensive view of brain function in POD. 

●The article highlights the role of the Default Mode Network (DMN) and posterior cingulate cortex in the cognitive deficits seen in POD, noting that weakened connectivity in these areas is a key contributing factor. 

●Graph theory is applied to study brain networks in POD, offering insights through metrics such as small-world structure and node degree, enhancing the understanding of POD-related connectivity changes. 

●This article explores how perioperative factors (such as anesthesia, inflammation, and physiological stress) affect brain functional connectivity and their association with postoperative delirium (POD), offering important new perspectives. And this article deeply analyzes the differences in brain functional connectivity patterns caused by different surgical types and their potential association with the development of POD. 

●The article advocates for combining EEG and fMRI to enable dynamic studies of brain connectivity and recommends larger, diverse samples to validate findings across various surgical types.

Pain biomarkers based on electroencephalogram: Current status and prospect

Hui Wu1,2,*, Kai Wang1,2,*, Meiyan Zhou2, Guangkuo Ma1,2, Ziwei Xia1,2, Liwei Wang1,2, Conghai Fan1,2 

1Graduate School, Xuzhou Medical University, Xuzhou 221004, Jiangsu Province, China. 2Department of Anesthe siology, Xuzhou Central Hospital, Xuzhou 221009, Jiangsu Province, China. 

 *The authors contribute equally.

Address correspondence to: Conghai Fan, Graduate School, Xuzhou Medical University, Jiangsu, China. No.209 Tongshan Road, Yunlong District, Xuzhou 221004, Jiangsu Province, China. Tel: +86 13013983238. E-mail: Fch120@126.com. Liwei Wang, Department of Anesthesiology, Xuzhou Central Hospital, No. 199 Jiefang South Road, Quanshan District, Xuzhou 221009, Jiangsu Province, China. Tel: +86-18952170255. E-mail: 18952170255@163.com.

Acknowledgement: This work was supported by Young Scientist Fund of National Natural Science Foundation of China (81700078) and Xuzhou Medical Key Talents program (XWRCHT20220051).

DOI: https://doi.org/10.61189/109077nkhkny

Received June 25, 2024; Accepted September 27, 2024; Published December 31, 2024 

Highlights 

● During the perioperative period, electroencephalography (EEG) has significant advantages as a tool for pain assessment. The applications of indicators such as the pain threshold index (PTI) and γ wave activity in preoperative, intraoperative, and postoperative pain assessment have been validated, contributing to the optimization of   perioperative analgesic strategies. 

● CEEG showed that pain intensity was negatively correlated with α wave activity and positively correlated with γ wave activity. 

● Analysis of the characteristics of EEG in pain state is helpful for the diagnosis and treatment of pain, and to prevent the transformation of chronic pain. 

● Comparing different EEG pain biomarkers can enhance the understanding of brain activity in pain state and improve the accuracy of data.

Research progress of digital therapy in pain management

Zhaoyang Yan1*, Chunhui Qin2*, Shuya Wang1*, Zhaohui Xie3, Liyun Kong4, Lili Zhong5, Hong Wang5, Yun Cai6, Guohua Jiao7, Zhenwei Wang8, Qiwen Zhu9*, Ruoyu Tang10* 

1Shanghai Reacool Medical Technology Co., Ltd., Shanghai 200041, China. 2Department of Anesthesiology, Yuey ang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China. 3Department of Pain Management, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China. 4Department of Pain Management, The First Affiliated Hospital of Gan nan Medical University, Ganzhou 341000, Jiangxi Province, China. 5Department of Anesthesiology and Pain Man agement, Wuhu Fifth People’s Hospital (Anhui Province Wannan Rehabilitation Hospital), Wuhu 241004, Anhui Province, China. 6School of Health and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing 210046, Jiangsu Province, China. 7Department of Pain Management, Tongxiang Hospital of Traditional Chinese Medicine, Tongxiang 314500, Zhejiang Province, China. 8Department of Respiratory Medicine, Yueyang Hospital of Integrat ed Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China. 9Department of Engineering and Computer Science, Syracuse University, New York State/Syra cuse 13210, the United States of America. 10Department of Psychology, University of British Columbia (UBC), Van couver V6T 1Z4, British Columbia, Canada. 

 *The authors contribute equally.

Address correspondence to: Lili Zhong, Department of Anesthesiology and Pain Management, No. 2, Zhe-Shan East Road, Jinghu District, Wuhu 241004, Anhui Province, China. Tel: +86-180-0963-7377. E-mail: williyia@wnmc.edu.cn. Zhenwei Wang, Department of Respiratory Medicine, No. 110, Ganhe Road, Hongkou District, Shanghai 200437, China. Tel: +86-189-1875-7762. E-mail: wangzhenwei@ shyueyanghospital.com.

Acknowledgement: This project was supported by the research on the application of digital therapy in the treat ment of neuropathic pain caused by herpes zoster (2023yf004) and the Gansu Province Intelligent Pain Diagnosis and Treatment Industry Technology Center. The authors would like to thank all the guest editors and anonymous reviewers for their constructive advice.

DOI: https://doi.org/10.61189/285507yclyaz

Received June 21, 2024; Accepted September 3, 2024; Published December 31, 2024 

Highlights 

 ● Analysis of collected data reveals that digital therapy offer new treatment methods and options in the field of pain management. After conducting research and analysis, it has been found that digital therapeutics offer new treatment methods and options, especially in the area of perioperative pain management. 

 ● Multiple clinical studies indicate that digital therapy has significant effects in the treatment and relief of pain caused by various conditions. 

 ● Domestic and international policies have positively influenced the development and progress of digital therapy. 

 ● Ethical considerations require continuous evaluation, decision-making, and regulation, warranting ongoing reflection. 

 ● Digital therapeutics, as an emerging intervention for pain, are propelling perioperative pain treatment towards a diversified and personalized comprehensive diagnostic and treatment model.

A review on Angelica sinensis alleviates acute lung tissue injury through TLR-4/MyD88 signal pathway

Ke Xu1,2, Yu Xiang1,2, Shangping Fang1,2 

1School of Anesthesiology, 2Anesthesia Laboratory and Training Center, Wannan Medical College, Wuhu 241002, Anhui, China. 

Address correspondence to: Shangping Fang, Anesthesia Laboratory and Training Center, School of Anesthesiology, Wannan Medical College, No. 22 Wenchang West Road, Lugang Street, Yijiang Dis trict, Wuhu 241002, Anhui Province, China. Tel: 0553-3932220. E-mail: 20180041@wnmc.edc.cn.

Acknowledgement: This work was supported by the Anhui Province College Student Innovation and Entrepreneur ship Project (S202310368027). 

DOI: https://doi.org/10.61189/368731zhrnsv

Received May 23, 2024; Accepted August 6, 2024; Published December 31, 2024

Highlights 

 ● This review describes the main components of Angelica sinensis and their efficacy. 

 ● Current status and basic mechanisms of the classical inflammatory signal pathways in lipopolysaccharide-induced acute lung injury (ALI) are discussed. 

 ● Angelica sinensis contributes to the anti-inflammation in lipopolysaccharide-induced ALI and is expected to expand the application of traditional Chinese medicine in the treatment of ALI. 

The effectiveness of a novel modified retracting arm for transaxillary endoscopic thyroid surgery to minimize complications: A randomized controlled study

Mingling Wang1*, Gaolei Jia2*, Kai Wang3, Haifeng Zhuang4, Li Ma2, Ping Wang4 

1Department of Operating Room, Xuzhou Central Hospital, Xuzhou 221009, China. 2Department of Thyroid, Xuzhou Central Hospital, Xuzhou 221009, China. 3Department of Anesthesiology, Xuzhou Central Hospital, Xuzhou 221009, China. 4Department of Nursing, Xuzhou Central Hospital, Xuzhou 221009, China. 

*The authors contribute equally.

Address correspondence to: Ping Wang, Department of Nursing, Xuzhou Central Hospital, No. 199 Jiefang South Road, Xuzhou 221009, China. Tel: +86-18952172176; Fax: 0086-0516-83956203;  E-mail: wangkaistream99@xzhmu.edu.cn. Li Ma, Department of Thyroid, Xuzhou Central Hospital, No. 199 Jiefang South Road, Xuzhou 221009, China. Tel: +86-18112023690; E-mail: 675694863@ qq.com.

Acknowledgement: This study was financially supported by a grant from the Xuzhou City Science and Technology Project (KC22156). We thank International Science Editing (http://www.internationalscienceediting.com) for editing this manuscript.

DOI: https://doi.org/10.61189/031494xruanc

Received May 17, 2024; Accepted August 9, 2024; Published September 30, 2024

Highlights

● A novel modified retracting arm for transaxillary endoscopic thyroid surgery was designed. 

● The modified hook better exposed and protected the recurrent laryngeal nerve and parathyroid glands.

● The modified retracting arm achieved better visual analog scale and cosmetic scores.

Artificial intelligence in perioperative pain management: A review

Yan Liao1*, Zhanheng Chen1*,Wangzheqi Zhang1*, Lindong Cheng2 , Yanchen Lin2 , Ping Li3 , Miao Zhou4 ,  Mi Li1 , ChunHua Liao

1School of Anesthesiology, Naval Medical University, Shanghai 200433, China. 2Graduate School, Hebei North University, Zhangjiakou 075000, China. 3Graduate School, Wannan Medical College, Wuhu 241000, China. 4Department of Anesthesiology, the Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University, Nanjing 210009, China. 

* The authors contribute equally.

Address correspondence to: Miao Zhou, The Affiliated Cancer Hospital of Nanjing Medical University, Department of Anesthesiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University, Nanjing 210009, China. E-mail: zhoumiao2613@163.com; Tel: +86  18217567295. Mi Li, School of Anesthesiology, Naval Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, China. E-mail: limi@smmu.edu.cn; Tel: +86-21-81872033. Chunhua Liao, School of Anesthesiology, Naval Medical University, 800 Xiangyin Road, Yangpu District. Shanghai  200433, China. E-mail: Liaochh7@smmu.edu.cn; Tel: +86 21 81872025.

Acknowledgement: This work was supported by the National Natural Science Foundation of China under Grants 62002297, 62073225, and 61836005, the Science and Technology Commission of Shanghai Municipality under Grant 20XD1434400, talent Development Fund of Shanghai under Grant 2020075, Medical-Engineering Cross Fund of Shanghai Jiao Tong University under Grant YG2022QN043, and the Guangxi Science and Technology Base and Talent Special Project under Grant 2021AC19394. The authors would like to thank all the guest editors and anonymous reviewers for their constructive advice.

DOI: https://doi.org/10.61189/275419wdddvs

Received February 21, 2024; Accepted March 25, 2024; Published September 30, 2024

Highlights

● Artificial intelligence (AI) is lauded for its capacity to resolve intricate problems with unwavering efficiency, devoid of fatigue. To elucidate the potential of AI in perioperative pain management, we have meticulously surveyed a vast array of scholarly works to discern the landscape of research in this multifaceted domain. 

● Conventional perioperative pain studies have primarily confined their scope to clinical aspects. However, this review delves into the amalgamation of AI and perioperative pain, heralding a diverse methodology for pain control. 

● AI's applicability in medical domains, particularly anesthesia, has spawned numerous inquiries into its synergy  with perioperative pain. Yet, a dearth of comprehensive reviews encapsulating the current research milieu, pin  pointing hurdles, and envisioning future directions in this sphere necessitated the present discourse. 

● We herein offer horizontal and vertical assessments of diverse models and algorithms employed in periopera  tive pain management, encapsulated in diagrammatic form for reader accessibility. The compilation of this review draws from a spectrum of online scholarly repositories, thus ensuring a thorough and relevant assembly of insights.

Ultrasound-guided forearm selective nerve block: A bright future on the horizon

Ziwei Xia1,2, Guangkuo Ma1,2, Huanjia Xue1,2, Hui Wu1,2, Liwei Wang1,2, Kai Wang1,2

1Graduate School, Xuzhou Medical University, Xuzhou 221009, Jiangsu Province, China. 2Department of Anesthesiology, Xuzhou Central Hospital, Xuzhou 221009, Jiangsu Province, China.

Address correspondence to: Kai Wang, Department of Anesthesiology, Xuzhou Central Hospital, No. 199 Jiefang South Road, Quanshan District, Xuzhou 221009, Jiangsu Province, China. Tel: +86-18112012729; E-mail: wangkaistream99@sina.com or 760020230115@xzhmu.edu.cn.

Acknowledgement: This work was supported by the Department of Anesthesiology of Xuzhou Central Hospital. The authors would like to thank all the guest editors and anonymous reviewers for their constructive comments.

DOI: https://doi.org/10.61189/768941essmpc

Received January 25, 2024; Accepted April 2, 2024; Published September 30, 2024

Highlights

● In the realm of forearm, wrist, and hand surgeries, ultrasound-guided forearm selective nerve block techniques offer distinct advantages over alternative methods such as Bier's block, brachial plexus block, and wrist block. These advantages include reduced anesthesia-related time, prolonged duration of analgesia, and minimal inter-ference with upper extremity motor function. 

● Ultrasound-guided forearm selective nerve block stands as a straightforward and conducive anesthesia method ideally suited for distal upper limb surgeries. This approach harmonizes seamlessly with the principles of fast surgical recovery and enhances patient comfort during both diagnostic and therapeutic procedures. 

● Supplementation of dexmedetomidine or dexamethasone in ultrasound-guided selective nerve blocks of the forearm has been shown to significantly prolong the duration of analgesia.

Progress in heatstroke-induced multiple organ damage

Ruilong Li1,2*, Dezhi Guo1,2*, Tianying Li1,2, Panpan Hu1,3, Tianying Xu1

1Department of Anesthetic Pharmacology, School of Anesthesiology, Second Military Medical University/Naval Medical University, Shanghai 200433, China. 2College of Basic Medicine, Second Military Medical University/Naval Medical University, Shanghai 200433, China. 3National Key Laboratory of Immunity & Inflammation, Second Military Medical University/Naval Medical University, Shanghai 200433, China. 

* The authors contribute equally.

Address correspondence to: Tianying Xu, Department of Anesthetic Pharmacology, School of Anesthesiology, Second Military Medical University/Naval Medical University, 800 Xiangyin Road, Shanghai 200433, China. Tel: +86 021 81872029, E-mail: xutianying@smmu.edu.cn; Panpan Hu, Department of Anesthetic Pharmacology, School of Anesthesiology, National Key Laboratory of Immunity & Inflammation, Second Military Medical University/Naval Medical University, 800 Xiangyin Road, Shanghai  200433, China. Tel: +86 021 81872029, E-mail: hpp510@smmu.edu.cn.

Acknowledgement: This work was supported by the Basic Medical Research Fund of Naval Medical University (2023QN034). The authors would like to thank all the guest editors and anonymous reviewers for their constructive comments.

DOI: https://doi.org/10.61189/313377zqjuff

Received January 23, 2024; Accepted April 29, 2024; Published September 30, 2024

Highlights

● Patients with heatstroke often suffer from multiple organ dysfunction and have a high fatality rate. 

● The molecular mechanisms underlying multiple organ damage in heatstroke are complex. 

● This review outlines the manifestations of multiple organ dysfunction caused by heatstroke and explores the possible molecular mechanisms involved.

Research advances in understanding the role and mechanism of pyroptosis in myocardial ischemia-reperfusion injury

Ziyue Li1, Bailong Hu2, Xiaohua Zou2

1College of Anesthesiology, Guizhou Medical University, Guizhou 550004, China. 2Department of Anesthesiology, the Affiliated Hospital of Guizhou Medical University, Guizhou 550004, China. 

Address correspondence to: Bailong Hu, Department of Anesthesiology, the Affiliated Hospital of Guizhou Medical University, NO. 28 Guiyi Street, Guiyang 550004, Guizhou, China. Phone number: +86-15185184309; E-mail: hubailong@gmc.edu.cn. Xiaohua Zou, Department of Anesthesiology, the Affiliated Hospital of Guizhou Medical University, NO. 28 Guiyi Street, Guiyang 550004, Guizhou, China. Tel: +86-13809416036; Fax: +86-851-86771013; E-mail: zouxiaohuazxh@gmc.edu.cn.

Acknowledgement: This work was supported by the National Natural Science Foundation of China (No. 82160951, 82160224), the project of Guiyang Science and Technology Plan (zhukehe[2024]-2-27), the Cultivate project 2021 for National Natural Science Foundation of China, the Affiliated Hospital of Guizhou Medical University (gyfynsfc-2021-35, gyfynsfc-2021-49).

DOI: https://doi.org/10.61189/434706ysltap

Received December 5, 2023; Accepted February 4, 2024; Published June 30, 2024

Highlights 

Currently, ischemic heart disease ranks as the most prevalent form of primary heart disease. The risk of myocardial ischemia-reperfusion injury, along with its associated mortality, is notably rising among perioperative patients. Recognizing the underlying mechanisms of myocardial ischemia-reperfusion injury and identifying suitable treatments are crucial. Inhibitors targeting the key molecules involved in pyroptosis hold promise as potential therapeutic options for managing myocardial ischemia-reperfusion injury

Difficult airway management in patients with laryngeal tumor: Case series and systematic review

Chenglong Zhu1,3*, Miao Zhou1,4*, Yongchu Hu2, Wenyun Xu2, Zui Zou1,2

1School of Anesthesiology, Naval Medical University, Shanghai 200433, China. 2Department of Anesthesiology, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China. 3Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China. 4Department of Anesthesiology, the Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University, Nanjing 210009, Jiangsu, China. 

*The authors have contributed equally to this work. 

Address correspondence to: Zui Zou, School of Anesthesiology, Naval Medical University, 168 Changhai Road, Yangpu District, Shanghai 200433, China. Email: zouzui@smmu.edu.cn. Wenyun Xu, Second Affiliated Hospital of Naval Medical University, 415 Fengyang Road, Huangpu District, Shanghai 200003, China. Email: xuwenyun@ smmu.edu.cn.

Acknowledgement: This study was funded by the National Natural Science Foundation of China (81670072), the Shanghai Municipal Committee of Science and Technology (20XD1434400) and Special Project on Incubation of Civil-Military Integration Achievements of the Naval Medical University (2022-RH10). Declaration of conflict of interest: None. 

Ethics approval and consent to participate: Chinese Clinical Trial Registry approved this study (ChiCTR2200060783). All procedures and research activities performed in the study were in accordance with the ethical standards of the institutional research committee. Consent was obtained from a legally authorized representative. 

DOI: https://doi.org/10.61189/109678mkmeds

Received November 29, 2023; Accepted January 16, 2024; Published June 30, 2024

Highlights 

● SEEKflex (Safe Easy Endotracheal Kit-flexible) is a modified introducer, which provides a simple and rapid way for intubating patients with laryngeal tumors. 

● With its non-invasive and gentle approach, SEEKflex minimizes patient discomfort, enhancing the overall patient experience. 

● Flexible fiberoptic bronchoscope remains the most frequently used tool for managing difficult airways.

Most Read

The effectiveness of a novel modified retracting arm for transaxillary endoscopic thyroid surgery to minimize complications: A randomized controlled study

Mingling Wang1*, Gaolei Jia2*, Kai Wang3, Haifeng Zhuang4, Li Ma2, Ping Wang4 

1Department of Operating Room, Xuzhou Central Hospital, Xuzhou 221009, China. 2Department of Thyroid, Xuzhou Central Hospital, Xuzhou 221009, China. 3Department of Anesthesiology, Xuzhou Central Hospital, Xuzhou 221009, China. 4Department of Nursing, Xuzhou Central Hospital, Xuzhou 221009, China. 

*The authors contribute equally.

Address correspondence to: Ping Wang, Department of Nursing, Xuzhou Central Hospital, No. 199 Jiefang South Road, Xuzhou 221009, China. Tel: +86-18952172176; Fax: 0086-0516-83956203;  E-mail: wangkaistream99@xzhmu.edu.cn. Li Ma, Department of Thyroid, Xuzhou Central Hospital, No. 199 Jiefang South Road, Xuzhou 221009, China. Tel: +86-18112023690; E-mail: 675694863@ qq.com.

Acknowledgement: This study was financially supported by a grant from the Xuzhou City Science and Technology Project (KC22156). We thank International Science Editing (http://www.internationalscienceediting.com) for editing this manuscript.

DOI: https://doi.org/10.61189/031494xruanc

Received May 17, 2024; Accepted August 9, 2024; Published September 30, 2024

Highlights

● A novel modified retracting arm for transaxillary endoscopic thyroid surgery was designed. 

● The modified hook better exposed and protected the recurrent laryngeal nerve and parathyroid glands.

● The modified retracting arm achieved better visual analog scale and cosmetic scores.

Ultrasound-guided forearm selective nerve block: A bright future on the horizon

Ziwei Xia1,2, Guangkuo Ma1,2, Huanjia Xue1,2, Hui Wu1,2, Liwei Wang1,2, Kai Wang1,2

1Graduate School, Xuzhou Medical University, Xuzhou 221009, Jiangsu Province, China. 2Department of Anesthesiology, Xuzhou Central Hospital, Xuzhou 221009, Jiangsu Province, China.

Address correspondence to: Kai Wang, Department of Anesthesiology, Xuzhou Central Hospital, No. 199 Jiefang South Road, Quanshan District, Xuzhou 221009, Jiangsu Province, China. Tel: +86-18112012729; E-mail: wangkaistream99@sina.com or 760020230115@xzhmu.edu.cn.

Acknowledgement: This work was supported by the Department of Anesthesiology of Xuzhou Central Hospital. The authors would like to thank all the guest editors and anonymous reviewers for their constructive comments.

DOI: https://doi.org/10.61189/768941essmpc

Received January 25, 2024; Accepted April 2, 2024; Published September 30, 2024

Highlights

● In the realm of forearm, wrist, and hand surgeries, ultrasound-guided forearm selective nerve block techniques offer distinct advantages over alternative methods such as Bier's block, brachial plexus block, and wrist block. These advantages include reduced anesthesia-related time, prolonged duration of analgesia, and minimal inter-ference with upper extremity motor function. 

● Ultrasound-guided forearm selective nerve block stands as a straightforward and conducive anesthesia method ideally suited for distal upper limb surgeries. This approach harmonizes seamlessly with the principles of fast surgical recovery and enhances patient comfort during both diagnostic and therapeutic procedures. 

● Supplementation of dexmedetomidine or dexamethasone in ultrasound-guided selective nerve blocks of the forearm has been shown to significantly prolong the duration of analgesia.

Progress in heatstroke-induced multiple organ damage

Ruilong Li1,2*, Dezhi Guo1,2*, Tianying Li1,2, Panpan Hu1,3, Tianying Xu1

1Department of Anesthetic Pharmacology, School of Anesthesiology, Second Military Medical University/Naval Medical University, Shanghai 200433, China. 2College of Basic Medicine, Second Military Medical University/Naval Medical University, Shanghai 200433, China. 3National Key Laboratory of Immunity & Inflammation, Second Military Medical University/Naval Medical University, Shanghai 200433, China. 

* The authors contribute equally.

Address correspondence to: Tianying Xu, Department of Anesthetic Pharmacology, School of Anesthesiology, Second Military Medical University/Naval Medical University, 800 Xiangyin Road, Shanghai 200433, China. Tel: +86 021 81872029, E-mail: xutianying@smmu.edu.cn; Panpan Hu, Department of Anesthetic Pharmacology, School of Anesthesiology, National Key Laboratory of Immunity & Inflammation, Second Military Medical University/Naval Medical University, 800 Xiangyin Road, Shanghai  200433, China. Tel: +86 021 81872029, E-mail: hpp510@smmu.edu.cn.

Acknowledgement: This work was supported by the Basic Medical Research Fund of Naval Medical University (2023QN034). The authors would like to thank all the guest editors and anonymous reviewers for their constructive comments.

DOI: https://doi.org/10.61189/313377zqjuff

Received January 23, 2024; Accepted April 29, 2024; Published September 30, 2024

Highlights

● Patients with heatstroke often suffer from multiple organ dysfunction and have a high fatality rate. 

● The molecular mechanisms underlying multiple organ damage in heatstroke are complex. 

● This review outlines the manifestations of multiple organ dysfunction caused by heatstroke and explores the possible molecular mechanisms involved.

Artificial intelligence in perioperative pain management: A review

Yan Liao1*, Zhanheng Chen1*,Wangzheqi Zhang1*, Lindong Cheng2 , Yanchen Lin2 , Ping Li3 , Miao Zhou4 ,  Mi Li1 , ChunHua Liao

1School of Anesthesiology, Naval Medical University, Shanghai 200433, China. 2Graduate School, Hebei North University, Zhangjiakou 075000, China. 3Graduate School, Wannan Medical College, Wuhu 241000, China. 4Department of Anesthesiology, the Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University, Nanjing 210009, China. 

* The authors contribute equally.

Address correspondence to: Miao Zhou, The Affiliated Cancer Hospital of Nanjing Medical University, Department of Anesthesiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University, Nanjing 210009, China. E-mail: zhoumiao2613@163.com; Tel: +86  18217567295. Mi Li, School of Anesthesiology, Naval Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, China. E-mail: limi@smmu.edu.cn; Tel: +86-21-81872033. Chunhua Liao, School of Anesthesiology, Naval Medical University, 800 Xiangyin Road, Yangpu District. Shanghai  200433, China. E-mail: Liaochh7@smmu.edu.cn; Tel: +86 21 81872025.

Acknowledgement: This work was supported by the National Natural Science Foundation of China under Grants 62002297, 62073225, and 61836005, the Science and Technology Commission of Shanghai Municipality under Grant 20XD1434400, talent Development Fund of Shanghai under Grant 2020075, Medical-Engineering Cross Fund of Shanghai Jiao Tong University under Grant YG2022QN043, and the Guangxi Science and Technology Base and Talent Special Project under Grant 2021AC19394. The authors would like to thank all the guest editors and anonymous reviewers for their constructive advice.

DOI: https://doi.org/10.61189/275419wdddvs

Received February 21, 2024; Accepted March 25, 2024; Published September 30, 2024

Highlights

● Artificial intelligence (AI) is lauded for its capacity to resolve intricate problems with unwavering efficiency, devoid of fatigue. To elucidate the potential of AI in perioperative pain management, we have meticulously surveyed a vast array of scholarly works to discern the landscape of research in this multifaceted domain. 

● Conventional perioperative pain studies have primarily confined their scope to clinical aspects. However, this review delves into the amalgamation of AI and perioperative pain, heralding a diverse methodology for pain control. 

● AI's applicability in medical domains, particularly anesthesia, has spawned numerous inquiries into its synergy  with perioperative pain. Yet, a dearth of comprehensive reviews encapsulating the current research milieu, pin  pointing hurdles, and envisioning future directions in this sphere necessitated the present discourse. 

● We herein offer horizontal and vertical assessments of diverse models and algorithms employed in periopera  tive pain management, encapsulated in diagrammatic form for reader accessibility. The compilation of this review draws from a spectrum of online scholarly repositories, thus ensuring a thorough and relevant assembly of insights.

Difficult airway management in patients with laryngeal tumor: Case series and systematic review

Chenglong Zhu1,3*, Miao Zhou1,4*, Yongchu Hu2, Wenyun Xu2, Zui Zou1,2

1School of Anesthesiology, Naval Medical University, Shanghai 200433, China. 2Department of Anesthesiology, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China. 3Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China. 4Department of Anesthesiology, the Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University, Nanjing 210009, Jiangsu, China. 

*The authors have contributed equally to this work. 

Address correspondence to: Zui Zou, School of Anesthesiology, Naval Medical University, 168 Changhai Road, Yangpu District, Shanghai 200433, China. Email: zouzui@smmu.edu.cn. Wenyun Xu, Second Affiliated Hospital of Naval Medical University, 415 Fengyang Road, Huangpu District, Shanghai 200003, China. Email: xuwenyun@ smmu.edu.cn.

Acknowledgement: This study was funded by the National Natural Science Foundation of China (81670072), the Shanghai Municipal Committee of Science and Technology (20XD1434400) and Special Project on Incubation of Civil-Military Integration Achievements of the Naval Medical University (2022-RH10). Declaration of conflict of interest: None. 

Ethics approval and consent to participate: Chinese Clinical Trial Registry approved this study (ChiCTR2200060783). All procedures and research activities performed in the study were in accordance with the ethical standards of the institutional research committee. Consent was obtained from a legally authorized representative. 

DOI: https://doi.org/10.61189/109678mkmeds

Received November 29, 2023; Accepted January 16, 2024; Published June 30, 2024

Highlights 

● SEEKflex (Safe Easy Endotracheal Kit-flexible) is a modified introducer, which provides a simple and rapid way for intubating patients with laryngeal tumors. 

● With its non-invasive and gentle approach, SEEKflex minimizes patient discomfort, enhancing the overall patient experience. 

● Flexible fiberoptic bronchoscope remains the most frequently used tool for managing difficult airways.

Research progress of sphingosine 1-phosphate receptor 3 in the cardiovascular system

Yangmengna Gao1,2, Ran Yuan1,2, Kecheng Zhai1,2, Hui Su1,2, Renke Sun1,2, Shangping Fang1,2 

1School of Anesthesiology, 2Anesthesia Laboratory and Training Center, Wannan Medical College, Wuhu 241002, Anhui, China. 

Address correspondence to: Shangping Fang, Anaesthesiology Experimental Training Center, College of Anesthesiology, Wannan Medical College, No.22 Wenchang West Road, Yijiang District, Wuhu 241002, Anhui, China. Tel:+86-19855362767. E-mail: 20180041@wnmc.edu.cn.

Acknowledgement: Key Project Research Fund of Wannan Medical College (WK2022Z10); National College Student Innovation and Entrepreneurship Project (202310368016); Anhui Province College Student Innovation and Entrepreneurship Project (S202210368107, S202210368108); Student Research Funding Project of Wannan Medical College (WK2023XS10).

DOI: https://doi.org/10.61189/076009mwdtns

Received January 25, 2024; Accepted March 19, 2024; Published Jane 30, 2024

Highlights 

● Sphingosine 1-phosphate receptor 3 (S1PR3) promotes the proliferation of vascular endothelial cells and enhances barrier function. 

● S1PR3 is a promising target for clinical treatment of cardiac ischemia-reperfusion, cardiac fibrosis and atherosclerosis. 

● Fingolimod and other modulators of S1PR3 have shown therapeutic efficacy in phase I and II clinical trials for cardiovascular diseases. 

● S1PR3 play crucial roles in the perioperative evaluation and treatment of the cardiovascular system, as well as in sepsis.

Research advances in understanding the role and mechanism of pyroptosis in myocardial ischemia-reperfusion injury

Ziyue Li1, Bailong Hu2, Xiaohua Zou2

1College of Anesthesiology, Guizhou Medical University, Guizhou 550004, China. 2Department of Anesthesiology, the Affiliated Hospital of Guizhou Medical University, Guizhou 550004, China. 

Address correspondence to: Bailong Hu, Department of Anesthesiology, the Affiliated Hospital of Guizhou Medical University, NO. 28 Guiyi Street, Guiyang 550004, Guizhou, China. Phone number: +86-15185184309; E-mail: hubailong@gmc.edu.cn. Xiaohua Zou, Department of Anesthesiology, the Affiliated Hospital of Guizhou Medical University, NO. 28 Guiyi Street, Guiyang 550004, Guizhou, China. Tel: +86-13809416036; Fax: +86-851-86771013; E-mail: zouxiaohuazxh@gmc.edu.cn.

Acknowledgement: This work was supported by the National Natural Science Foundation of China (No. 82160951, 82160224), the project of Guiyang Science and Technology Plan (zhukehe[2024]-2-27), the Cultivate project 2021 for National Natural Science Foundation of China, the Affiliated Hospital of Guizhou Medical University (gyfynsfc-2021-35, gyfynsfc-2021-49).

DOI: https://doi.org/10.61189/434706ysltap

Received December 5, 2023; Accepted February 4, 2024; Published June 30, 2024

Highlights 

Currently, ischemic heart disease ranks as the most prevalent form of primary heart disease. The risk of myocardial ischemia-reperfusion injury, along with its associated mortality, is notably rising among perioperative patients. Recognizing the underlying mechanisms of myocardial ischemia-reperfusion injury and identifying suitable treatments are crucial. Inhibitors targeting the key molecules involved in pyroptosis hold promise as potential therapeutic options for managing myocardial ischemia-reperfusion injury

Progress of ultrasound-guided nerve block in foot and ankle arthroscopy

Huanjia Xue1,3, Shengze Yang2,3, Guangkuo Ma1,3, Ziwei Xia1,3, Liwei Wang1,3, Kai Wang 1,3

1Xuzhou Clinical College, 2School of Anesthesiology, Xuzhou Medical University, Xuzhou 221009, China. 3Department of Anesthesiology, Xuzhou Central Hospital, Xuzhou 221009, China.

Address correspondence to: Kai Wang, Department of Anesthesiology, Xuzhou Central Hospital, No.199 Jiefang South Road, Quanshan District, Xuzhou 221009, Jiangsu, China. Tel: 18112012729. E-mail: wangkaistream99@ xzhmu.edu.cn.

Acknowledgement: This work was supported by Young Scientist Fund of National Natural Science Foundation of China (81700078) and Xuzhou Medical Key Talents program (XWRCHT20220051).

DOI: https://doi.org/10.61189/601268tfpowt

Received November 5, 2023; Accepted January 30, 2024; Published June 30, 2024

Highlights

● Foot and ankle arthroscopic techniques are vital for diagnosing and treating foot and ankle disorders.

● Ultrasound-guided nerve blocks in the foot and ankle provide precise nerve selection.

Progress of artificial intelligence in anesthesia and perioperative medicine

Wen-Hui Guo1,*, Qing-Lai Zang2,*, Bing Xu1, Tian-Ying Xu1, Zhan-Heng Chen1, Miao Zhou3

1School of Anesthesiology, Second Military Medical University/Naval Medical University, Shanghai 200433, China. 2Department of Anesthesiology, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China. 3Department of Anesthesiology, the Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University, Nanjing 210009, Jiangsu, China.

*The authors contribute equally.

Address correspondence to: Zhan-Heng Chen, School of Anesthesiology, Second Military Medical University/Naval Medical University, 800 Xiangyin Road, Shanghai 200433, China. Tel: +86 21 81872034. E-mail: chenzhanheng17@mails.ucas.ac.cn; Miao Zhou, Department of Anesthesiology, the Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University, Nanjing 210009, Jiangsu, China. Tel: +86 18217567295. E-mail: zhoumiao@jszlyy.com.cn.

Acknowledgment: This work was supported by the National Natural Science Foundation of China (62002297, 62073225, and 61836005), the Science and Technology Commission of Shanghai Municipality (20XD1434400), the Talent Development Fund of Shanghai (2020075), the Medical-Engineering Cross Fund of Shanghai Jiao Tong University (YG2022QN043), and the Guangxi Science and Technology Base and Talent Special Project (2021AC19394). The authors would like to thank all the guest editors and anonymous reviewers for their constructive advice.

DOI: https://doi.org/10.61189/536468bkwzzn

Received July 21, 2023; Accepted November 15, 2023; Published March 31, 2024

Highlights

● This review introduces the core concepts of artificial intelligence (AI) and describes the most commonly encountered computerized functioning of AI in anesthesiology.

● This survey systematically presents the main clinical applications of AI in anesthesia and perioperative medicine according to the perioperative phases.

● The advantages and disadvantages of introducing AI into the medical field are also discussed to explore the career development direction of anesthesiologists in the future.

Research progress of oxidative stress in sepsis-associated liver injury

Hui Su1,2,Tianying Xu3, Renke Sun1,2, Yu Xiang1,2, Yangmengna Gao1,2, Kecheng Zai1,2, Shangping Fang1,2 

1School of Anesthesiology, 2Anesthesia Laboratory and Training Center, Wannan Medical College, Wuhu 241002, China. 3School of Anesthesiology, Department of Anesthetic Pharmacology, Second Military Medical University/Naval Medical University, Shanghai 200433, China. 

Address correspondence to: Shangping Fang, Anesthesia Laboratory and Training Center, School of Anesthesiology, Wannan Medical College, No. 22, Wenchang West Road, Lugang Street, Yijiang District, Wuhu 241002, Anhui, China. Tel: 19855362767; E-mail: 20180041@wnmc.edc.cn.

Acknowledgements: This work was supported by Key Project Research Fund of Wannan Medical College (WK2022Z10) and Research Grant for College Students of Wannan Medical College (WK2022XS26). 

DOI: https://doi.org/10.61189/270899wnwlnz 

Received September 17, 2023; Accepted November 28, 2023; Published March 31, 2024

Highlights 

● The approaches of antioxidant therapy to alleviate sepsis-associated liver injury are summarized from the per spective of oxidative stress in different cells of the liver. 

● Reactive oxygen species, one of the main substances that induce oxidative stress, affects the molecular mecha nism of the relevant signaling pathways. 

 ● Antioxidant therapy is helpful for the recovery of various liver cells in sepsis-associated liver injury and is expect- ed to advance basic and clinical research.