Globally, over 300 million surgeries are performed each year, and more than 50% of surgeries involve patients aged 65 and older. Aging poses significant challenges to perioperative brain health, as the deterioration of brain structure and function increases susceptibility to postoperative neurological complications. Protecting perioperative brain health remains a worldwide clinical challenge. With senescence, the brain undergoes a progressive decline in homeostasis across various molecular, cellular, and regional functions. Anesthetics and surgical stimuli may accelerate the disruption of brain homeostasis and exacerbate age-related neurodegeneration. This review provides a framework for understanding how anesthesia and surgery can affect brain health in the aging population and contribute to postoperative neurological complications, with a particular focus on perioperative neurocognitive disorder.

In the trends of large-scale brain research projects around the world, the China Brain Project aims to promote the understanding of the basic principles of the brain, and use the basic research of neuroscience to serve some urgent social and economic needs at the same time.As we approach the launch of this effort aimed at revolutionizing our understanding of cognitive principles of the brain, early diagnoses of brain diseases and brain-like intelligence technologies, it is timely to review the new progress in recent international brain research projects, and the deployment and future trajectory of neuroscience research in China.

Acute renal injury (AKI) is one of the serious complications after cardiac surgery.The incidence of AKI after cardiac surgery was 5%-42%.It is independently associated with an increase in costs of treatment, prolongation of hospital stay, and increase in short- and long-term mortality rates.Currently, there is no effective treatment for AKI after cardiac surgery.Early identification of high-risk patients, early prevention and early treatment can reduce the incidence and severity of AKI after cardiac surgery.Risk prediction models of AKI after cardiac surgery can help clinicians identify high-risk patients and thus carry out corresponding measures.This paper aimed to provide a reference for the use of the model and to indicate the direction for further research though analyzing the literature information about the establishment of risk prediction model of AKI after cardiac surgery in recent years.

In the medical treatment activities to fight against the coronavirus disease 2019 epidemic, many anesthesia practioners in the country, especially the intensive care unit (ICU) medical staff, are on the front line and perform the therapeutic procedures with high risk of infection such as tracheal intubation, sputum suction, bronchoscopy and so on in ICU with most high risk of infection. What should the anesthesia practioners pay attention to? In the fight against the SARS epidemic in 2003, the author served as ICU director of SARS designated hospital, the Beijing Xiaotangshan hospital, for nearly 2 months and had some experience. Combining the situation of this epidemic, the author puts forward some personal suggestions: 1. Improving the success rate of critically ill patients is an important basis to avoid social panic. 2. For confirmed and suspected patients, non-emergency surgery should not be performed if possible; 3. For confirmed and suspected patients who must undergo surgery, the highest level of protection must be taken; 4. Before the outbreak is resolved, unconventional treatment must be taken even if anesthesia is performed for routine surgery. 5. Ensuring self-protection is the greatest contribution to the control of the epidemic.

The identification and diagnosis of coronavirus disease 2019 (COVID-19) is of great significance in the treatment of COVID-19. Based on Diagnosis and Treatment Protocol for COVID-19 (Trial Version 5) issued on February 8, 2020 by the National Health Commission, there is no fungal pneumonia among the disease listed in the identification and diagnosis item. Thus, we reported a case of patient with AIDS associated with pneumocystis carinii severe pneumonia admitted to Shanghai Fourth People′s Hospital affiliated to Tongji University School of Medicine in January, 2020, which was helpful in improving the identification and diagnosis of COVID-19.

During the epidemic of coronavirus disease 2019 (COVID-19), the infection of the elderly population will bring great challenges to clinical diagnosis and treatment, outcome and management.Combined with the characteristics of anesthesia and the pathophysiological characteristics of COVID-19 on lung function impairment in elderly patients, Chinese Society of Anesthesiology formulated the " Recommendations for anesthesia management and infection control in elderly patients with COVID-19″. This recommendation expounds preoperative visit and infection control, anesthesia management protocol, anesthesia monitoring, anesthesia induction/endotracheal intubation, anesthesia maintenance and infection control, intraoperative lung protection strategy, anti-stress and anti-inflammatory management, hemodynamic optimization, infection control during emergence from anesthesia, and postoperative analgesia in elderly patients with COVID-19, and provides the reference for the safe and effective implementation of anesthesia management in elderly patients during the prevention and control of COVID-19 epidemic.

Objective To evaluate the effectiveness and accuracy of a domestic continuous non-invasive blood pressure (NIBP) device in monitoring intraoperative blood pressure.Methods Sixty patients of both sexes,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective surgery under general anesthesia,were included in the study.The invasive blood pressure (IBP) and NIBP were simultaneously measured in the radial artery.Systolic and diastolic blood pressure (SBP,DBP) was continuously recorded,and the paired data and data of waveform were collected.For paired data,the agreement was evaluated using Bland-Altman analyses between the two monitoring methods.For waveform data,Pearson linear correlate analysis was performed between the two monitoring methods.Results For paired data,the bias of NIBP value from IBP value were (-2.1±5.4) mmHg (95％ CI-3.5-0.7 mmHg) and (2.6±6.4) mmHg (95％ CI 1.0-4.3 mmHg) for SBP and DBP,respectively.The 95％ limit of agreement of bias between the two methods was-12.6-8.5 mmHg for SBP and-10.0-15.3 mmHg for DBP.For waveform data,the bias of NIBP value from IBP value were (-2.1±6.5) mmHg (95％ CI-3.7-0.4 mmHg) and (3.1±6.8) mmHg (95％ CI 1.3-4.8 mmHg) for SBP and DBP,respectively.The correlation coefficient between the two methods was O.82 for SBP and 0.88 for DBP,P＜0.01.Conclusion The effectiveness and accuracy of this domestic continuous NIBP monitoring device in monitoring intraoperative blood pressure is clinically acceptable.