Issue 4-Perioperative Precision Medicine-ZENTIME PUBLISHING CORPORATION LIMITED

A unified framework of cell death: Energy interdependence and multimodal interactions in disease pathogenesis

Qilu Yan^1,*, Haoling Zhang^2,*, Ting Hu^3,4,#, Wangzheqi Zhang^4,#

¹Cancer Center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan 430060, Hubei, China. ²Department of Biomedical Sciences, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang 13200, Malaysia. ³940th Hospital of PLA Joint Logistic Support Force, 333 Nanbinhe Road, Lanzhou 730050, Gansu, China. ⁴Naval Medical University, 800 Xiangyin Road, Shanghai 200433, China.

^*The authors contribute equally.

^#Co-corresponding authors.

Address correspondence to: Ting Hu, 940th Hospital of PLA Joint Logistic Support Force, 333 Nanbinhe Road, Lanzhou 730050, Gansu, China. E-mail: huting@smmu.edu.cn. Wangzheqi Zhang, Naval Medical University, 800 Xiangyin Road, Shanghai 200433, China. E-mail: zwzq001031@smmu.edu.cn.

DOI: https://doi.org/10.61189/159279rpqbrp

Received November 19, 2025; Accepted November 24, 2025; Published December 3, 2025

Perspective |Published on: 03 December 2025

[Perioperative Precision Medicine] 2025; 3 (4): 116-121

DOI: https://doi.org/10.61189/159279rpqbrp

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Research progress on the mechanisms of traditional Chinese medicine extracts in improving acute lung injury in sepsis

Sixu Chen^1,2,5,*, Jiayin Wang^3,5,*, Weiqi Lin^4,5,*, Xinyi Xie^3,5, Yutong Sun^4,5, Haiyi Qian^3,5, Yichen He^1,2,5, Cuifeng Zhang^1,2,5

¹School of Anesthesiology, Wannan Medical College, Wuhu, Anhui Province, China. ²Anesthesia Laboratory and Training Center, Wannan Medical College, Wuhu, Anhui Province, China. ³School of Pharmacology, Wannan Medi-cal College, Wuhu, Anhui Province, China. ⁴School of Clinical Medicine, Wannan Medical College, Wuhu, Anhui Province, China. ⁵Wuhu Perioperative Monitoring and Prognostic Technology Research and Development Center, Wannan Medical College, Wuhu, Anhui Province, China.

* The authors contribute equally and co-first authors.

Address correspondence to: Cuifeng Zhang, School of Anesthesiology, Wannan Medical College, Wuhu, Anhui Province, China, No. 22 Wenchang West Road, Yijiang District, Wuhu 241002, Anhui Province, China. Tel: +86-15551257181. E-mail: zhangcuifeng@wnmc.edu.cn.

DOI: https://doi.org/10.61189/579841iexakc

Received March 5, 2025; Accepted May 12, 2025; Published December 31, 2025

Highlights

● The pathogenesis of sepsis-induced acute lung injury is outlined.

● A comprehensive overview of the role of TCM extracts in sepsis-induced acute lung injury is provided.

● The clinical application of classical TCM extracts is summarized in detail.

Review Article |Published on: 31 December 2025

[Perioperative Precision Medicine] 2025; 3 (4): 122-133

DOI: https://doi.org/10.61189/579841iexakc

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Limb nerve block localization using deep learning-driven segmentation: A review

Jiaxun Jiang¹, Miao Zhou², Liangqing Lin³, Haipo Cui¹, Long Liu¹, Jiaen Wu¹, Zhaopeng Zhou¹

¹School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China. ²Jiangsu Cancer Hospital, Nanjing 213164, Jiangsu Province, China. ³Anesthesiology, The First Hospital of Putian, Putian 351100, Fujian Province, China.

Address correspondence to: Haipo Cui, School of Health Science and Engineering, University of Shanghai for Science and Technology, No. 516 Jungong Road, Yangpu District, Shanghai 200093, China. E-mail: h_b_cui@163.com.

DOI: https://doi.org/10.61189/295165xbmhth

Received April 1, 2025; Accepted May 12, 2025; Published December 31, 2025

Highlights

● Deep learning-powered nerve block segmentation significantly contributes to optimized perioperative pain management by enhancing the precision and safety of regional anesthesia.

● Advanced architectures, particularly U-Net variants, dominate peripheral nerve block segmentation, offering high precision and adaptability to medical imaging challenges.

● Deep learning enhances clinical workflows by improving segmentation accuracy and efficiency in upper and lower limb nerve blocks, thereby supporting procedural success.

● Future efforts will focus on improving model robustness and generalizability to address limitations such as data variability and limited adaptability, facilitating broader clinical adoption.

Review Article |Published on: 31 December 2025

[Perioperative Precision Medicine] 2025; 3 (4): 134-151

DOI: https://doi.org/10.61189/295165xbmhth

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A review of multimodal medical image fusion: Developments in traditional, model-based and learning-based approaches

Zhaopeng Zhou¹, Jiaen Wu¹, Jiaxun Jiang¹, Miao Zhou², Wenhui Guo³, Yongchu Hu⁴

¹School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China. ²Jiangsu Cancer Hospital, Nanjing 213164, Jiangsu Province, China. ³The Department of Anesthesiology, Naval Medical University, Shanghai 200433, China. ⁴The Department of Anesthesiology, Second Affiliated Hospital of Navy Medical University, Shanghai 200003, China.

Address correspondence to: Yongchu Hu, The Department of Anesthesiology, Second Affiliated Hospital of Navy Medical University, No. 415 Fengyang Road, Shanghai 200003, China. E-mail: liuyang1268@smmu.edu.cn.

DOI: https://doi.org/10.61189/617079irudnn

Received April 10, 2025; Accepted July 11, 2025; Published December 31, 2025

Highlights

● Significant Advantages of Multimodal Fusion: Multimodal medical image fusion enhances diagnostic accuracy and medical value by integrating multi-source data such as CT, MRI, and PET images, outperforming singlemodality technologies.

● Benefits of Deep Learning: Deep learning technologies significantly advance multimodal medical image fusion, enabling more efficient and accurate fusion results.

● Perioperative clinical significance: Multimodal image fusion can provide important support for perioperative preoperative planning, intraoperative guidance, and postoperative evaluation, thereby improving surgical accuracy and patient safety.

● Future Research Directions: Future research should focus on improving model interpretability, enhancing modality alignment, and achieving breakthroughs in practicality, applicability, and efficiency.

Review Article |Published on: 31 December 2025

[Perioperative Precision Medicine] 2025; 3 (4): 152-167

DOI: https://doi.org/10.61189/617079irudnn

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Research progress of bone marrow mesenchymal stem cells in the treatment of acute liver failure

Huan Li^1,2, Xiaoyu Tang^1,2, Jiameng Liu^1,2, Wanning Li^1,2, Xin Niu^1,2, Xingchen Yue^1,2, Shangping Fang^1,2

¹School of Anesthesiology, Wannan Medical College, Wuhu 241002, Anhui Province, China. ²Anesthesia Laboratory and Training Center, Wannan Medical College, Wuhu 241002, Anhui Province, 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 Province, China. Tel: +86-19855362767. E-mail: fangshangping0@163.com.

Acknowledgement: This work was supported by Key Project Research Fund of Wannan Medical College (WK2022Z10); Anhui Province College Student Innovation and Entrepreneurship Training Program Project (S202410368031); Anhui Province College Student Innovation Training Program Project (S202510368032).

DOI: https://doi.org/10.61189/167468gjipte

Received April 15, 2025; Accepted July 25, 2025; Published December 31, 2025

Highlights

● This review focuses on the research of bone marrow mesenchymal stem cells (BM-MSCs) in treating acute liver failure (ALF).

● BM-MSCs are a heterogeneous subset of stromal stem cells that can be isolated from various adult tissues.

● BM-MSCs have the ability to migrate toward damaged tissues and differentiate into hepatocytes. They effectively suppress pro-inflammatory cytokine release and promote hepatocyte proliferation.

● BM-MSCs are a promising target for clinical treatment of acute liver failure.

● BM-MSCs provide a new therapeutic direction for patients with acute liver failure during the perioperative period.

Review Article |Published on: 31 December 2025

[Perioperative Precision Medicine] 2025; 3 (4): 168-175

DOI: https://doi.org/10.61189/167468gjipte

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The role and research progress of ferroptosis in myocardial injury in sepsis

Jiayin Wang^1,4,5,*, Sixu Chen^2,5,*, Weiqi Lin^3,^4,*, Xinyi Xie^1,5, Yutong Sun^3,5, Qin Zhang^3,5, Qixiang Xu^1,4,5, Cuifeng Zhang^2,5

¹School of Pharmacology, Wannan Medical College, Wuhu, Anhui, China. ²School of Anesthesiology, Wannan Medical College, Wuhu, Anhui, China. ³School of Clinical Medicine, Wannan Medical College, Wuhu, Anhui, China. ⁴Anesthesia Laboratory and Training Center, Wannan Medical College, Wuhu, Anhui, China. ⁵Wuhu Perioperative Monitoring and Prognostic Technology Research and Development Center, Wannan Medical College, Wuhu, Anhui, China.

^*The authors contribute equally and co-first authors.

Address correspondence to: Qixiang Xu, School of Pharmacology, Wannan Medical College, No. 22 Wenchang West Road, Yijiang District, Wuhu 241002, Anhui, China. Tel: +86-18355305112. E-mail: xuqixiang@wnmc.edu.cn. Cuifeng Zhang, School of Anesthesiology, Wannan Medical College, No. 22 Wenchang West Road, Yijiang District, Wuhu 241002, Anhui, China. Tel: +86-15551257181. E-mail: zhangcuifeng@wnmc.edu.cn.

Acknowledgement: This work was supported by The Foundation of Wannan Medical College (WK2023ZQNZ08), National university innovation and entrepreneurship training program (202310368014, 202310368049, 202410368014), Anhui Province university innovation and entrepreneurship training program (S202310368095, S202310368087, S202410368004, S202410368009).

DOI: https://doi.org/10.61189/691939hefazb

Received March 2, 2025; Accepted June 4, 2025; Published December 31, 2025

Highlights

● A comprehensive review of the role of ferroptosis in sepsis-induced myocardial injury is presented.

● The mechanisms of ferroptosis and recent advancements in its involvement in sepsis-induced myocardial injury are discussed.

● Perioperative whole-process risks may induce sepsis, activate ferroptosis and raise myocardial injury risk, while integrating ferroptosis into management can reduce this risk.

Review Article |Published on: 31 December 2025

[Perioperative Precision Medicine] 2025; 3 (4): 176-185

DOI: https://doi.org/10.61189/691939hefazb

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Diagnostic performance of deep learning for brachial plexus ultrasound: A systematic review

Jiaen Wu¹, Jiaxun Jiang¹, Zhaopeng Zhou¹, Miao Zhou², Liangqing Lin³, Jinjing Wu¹, Haipo Cui¹

¹School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China. ²Jiangsu Cancer Hospital, Changzhou 213164, Jiangsu Province, China. ³Department of Anesthesiology, The First Hospital of Putian, Putian 351100, Fujian, China.

Address correspondence to: Haipo Cui, School of Health Science and Engineering, University of Shanghai for Science and Technology, No. 516 Jungong Road, Yangpu District, Shanghai 200093, China. E-mail: h_b_cui@163.com.

DOI: https://doi.org/10.61189/251934gxqfic

Received April 9, 2025; Accepted August 13, 2025; Published December 31, 2025

Highlights

● This study compares deep learning methods for brachial plexus ultrasound segmentation, demonstrating improved segmentation efficiency and reduced learning difficulty, which may enhance perioperative regional anesthesia planning and safety.

● U-Net is favored for brachial plexus segmentation due to its enhanced ability to capture contextual features through increased channel utilization.

● Available public brachial plexus datasets are summarized, offering valuable resources for future research and perioperative ultrasound applications.

Review Article |Published on: 31 December 2025

[Perioperative Precision Medicine] 2025; 3 (4): 186-199

DOI: https://doi.org/10.61189/251934gxqfic

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Application of 0.15% ropivacaine in labor analgesia for primiparous women with severe pain

Sen Lu, Xiangbing Shui, Jianxin Zhang

Department of Anesthesiology, Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou 215010, Jiangsu Province, China.

Address correspondence to: Sen Lu, Department of Anesthesiology, Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, No. 181 Zhuyuan Road, Suzhou 215010, Jiangsu Province, China. E-mail: Sen.Lu@benqmedicalcenter.com.

Acknowledgement: This work was supported by the Suzhou BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University (SZMJ2209). The authors would like to thank all the guest editors and anonymous reviewers for their constructive comments.

DOI: https://doi.org/10.61189/924159jtzdps

Received July 7, 2025; Accepted December 4, 2025; Published December 31, 2025

Highlights

● Explored the delivery analgesia mode for the special population of first-time mothers with severe pain.

● Explored the effectiveness and safety of high-concentration ropivacaine in epidural labor analgesia.

● Focused on providing humanistic care for the emotional well-being of postpartum women, extending beyond mere pain relief.

Research Article |Published on: 31 December 2025

[Perioperative Precision Medicine] 2025; 3 (4): 200-206

DOI: https://doi.org/10.61189/924159jtzdps

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Research progress on pharmacological effects and mechanisms of cycloastragenol

Weiqi Lin^1,^2,3*, Qin Zhang^1,3* , Sixu Chen^2,4*, Xinyi Xie^3,5 , Jiayin Wang^3,5, Yutong Sun^1,3, Qixiang Xu^3,⁵, Cuifeng Zhang^2,3,4

¹School of Clinical Medicine, Wannan Medical College, Wuhu 241002, Anhui, China. ²Anesthesia Laboratory and Training Center, Wannan Medical College, Wuhu 241002, Anhui, China. ³Wuhu Perioperative Monitoring and Prognostic Technology Research and Development Center, Wannan Medical College, Wuhu 241002, Anhui, China. ⁴School of Anesthesiology, Wannan Medical College, Wuhu 241002, Anhui, China. ⁵School of Pharmacology, Wannan Medical College, Wuhu 241002, Anhui, China.

^*The authors contribute equally.

Address correspondence to: Qixiang Xu, School of Pharmacology, Wannan Medical College, No.22 Wenchang West Road, Yijiang District, Wuhu 241002, Anhui Province, China. Tel: +86-18355305112. E-mail: xuqixiang@wnmc.edu.cn. Cuifeng Zhang, School of Anesthesiology, Wannan Medical College, No.22 Wenchang West Road, Yijiang District, Wuhu 241002, Anhui Province, China. Tel: +86-15551257181. E-mail: zhangcuifeng@wnmc.edu.cn.

Acknowledgement: This work was supported by the Natural Science Foundation Of The Higher Education Insti tutions Of Anhui Province (2024AH051958), the Foundation Of Wannan Medical College (WK2023ZQNZ08), the National University Innovation And Entrepreneurship Training Program (202310368014, 202310368049, 202410368014), the Anhui Province University Innovation And Entrepreneurship Training Program (S202310368087, S202410368004, S202410368009), the Wannan Medical College Undergraduate Research Fund Project (WK2024XS01).

DOI: https://doi.org/10.61189/313450skrqzv

Received January 21, 2025; Accepted April 24, 2025; Published December 31, 2025

Highlights

● Cycloastragenol exhibits anti-aging, anti-cancer, and anti-fibrosis effects.

● Although cycloastragenol shows innovative therapeutic potential, further clinical trials are essential to confirm its clinical applicability.

● Cycloastragenol offers innovative therapeutic avenues for enhancing surgical recovery.

Review Article |Published on: 31 December 2025

[Perioperative Precision Medicine] 2025; 3 (4): 207-215

DOI: https://doi.org/10.61189/313450skrqzv

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Tailoring perioperative analgesia: Selecting ketamine or dexmedetomidine based on patient-specific factors

Edward Sun¹, Meikun Wang², Zongda He³, Mingyue Li⁴, Jingping Wang⁵

¹University of British Columbia, Vancouver, Canada BC V6T 1Z4. ²Department of Anesthesia, First Hospital, Jilin University, Changchun 130021, Jilin Province, China.³King' s College, London, UK WC2R 2LS. ⁴Department of Anesthesia, Second Hospital, Jilin University, Changchun 130021, Jilin Province, China. ⁵Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114, MA, USA.

Address correspondence to: Jingping Wang, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston 02114, MA, USA. Tel: +86-617-643- 2729. E-mail: jwang23@MGH.Harvard.edu.

DOI: https://doi.org/10.61189/577707zkzsmw

Received July 5, 2025; Accepted September 5, 2025; Published December 31, 2025

Highlights

● Ketamine and dexmedetomidine offer effective non-opioid perioperative analgesia, each with distinct cardiovas-cular, hepatic, and neurological profiles.

● Dexmedetomidine provides stable sedation and potential neuroprotection, making it particularly suitable for pa-tients with hepatic dysfunction and those undergoing neurosurgery.

● Ketamine helps maintain hemodynamic stability and possesses anti-inflammatory and anti-depressant proper-ties, making it beneficial for high-risk or unstable patients.

● Agent selection should be tailored to individual comorbidities, with combination therapy offering potential syner-gistic advantages.

Review Article |Published on: 31 December 2025

[Perioperative Precision Medicine] 2025; 3 (4): 216-225.

DOI: https://doi.org/10.61189/577707zkzsmw

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