Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Annexin A3（ANXA3）is a member of the membrane associated protein family. It has two subtypes of 36 kDa and 33 kDa. Its gene is located on the fourth chromosome of human. ANXA3, widely expressed in human bone marrow, lung, placenta, prostate and thyroid, is closely related to several biological processes such as exoplasmosis, vascular production, fat cell maturity, and white blood cell migration. Studies have found that ANXA3 is abnormally expressed in various diseases including cancer, cardiovascular disease and inflammation. It can regulate multiple signaling pathways such as JNK, NF-κB, PI3K/AKT, and may become a potential drug target for treatment of related diseases. The structure, functions, the link with diseases and related mechanisms of ANXA3 were summarized in this paper, which could provide reference for ANXA3 related research.

Objective To investigate the effect of glycerin enema in preoperative intestinal preparation for anorectal benign diseases.Methods A total of 74 patients with benign anorectal diseases admitted to the anorectal department of our hospital from September 2023 to December 2023 were selected as the study ob-jects.According to different preoperative intestinal preparation methods,they were divided into glycerol group(n=30)and compound polyethylene glycol electrolyte powder(PEG-EP)group(n=44).The glycerol group was treated with glycerol enema to clean the intestine,and the PEG-EP group was treated with PEG-EP ene-ma before operation.Adverse reactions,defecation frequency,intestinal cleanliness,intestinal preparation tol-erance,first postoperative defecation time and bowel quality were observed and compared between the two groups.Results Propensity score was used for 1∶1 matching,and 25 patients were included in the two groups after PSM.The main adverse reactions were abdominal pain in the glycerol group and nausea,abdomi-nal distension and diarrhea in the PEG-EP group.There was no significant difference in the incidence of ad-verse reactions between the two groups(P＞0.05).Compared with the PEG-EP group,the number of bowel movements after bowel preparation in the glycerol group was less,the intestinal preparation tolerance rate was higher,and the time of first postoperative bowel movement was earlier,with statistical significance(P＜0.05).Conclusion Glycerin enema has more advantages than oral PEG-EP in preoperative intestinal prepara-tion for anorectal benign diseases.

Biometric recognition technology has developed rapidly and highly integrated with clinical diagnostics,phenotypic genomics,genomics,and big data analytics,facilitating not only precise personal identification but also demonstrating significant potential in health maintenance,particularly for military personnel.Global research has increasingly focused on uncovering the complex associations between biometric traits and key health determinants,such as disease susceptibility,psychological states,and physiological functions,to further harness biometrics in proactive health management.This paper provided a comprehensive overview of the latest progress and emerging applications of biometric technology in healthcare and military medicine,aiming to offer a scientific reference supporting the strategic development of biometrics research,its application promotion,and population-wide health management enhancement.

ObjectiveTo study the effect and efficacy of Nirmatrelvir tablet/Ritonavir tablet in the treatment of patients with COVID‑19 infection aged ≥90 years, to inform pharmacological treatment of patients aged ≥90 years with COVID‑19 infection. MethodsMild to moderate COVID-19 patients who were hospitalized in the Department of Geriatrics of the First Affiliated Hospital of the Naval Medical University from March 2022 to June 2024, aged ≥90 years, and who had not been vaccinated against novel coronavirus were selected as the research subjects. A total of 112 patients who received Nirmatrelvir tablet/Ritonavir tablet antiviral treatment within 5 days after the diagnosis of COVID‑19 infection were referred to the drug group, and 80 patients who were not treated with antiviral drugs were referred to as the control group. A retrospective research method was employed to gather and compare patitents’ clinical laboratory data before and after antiviral treatment, such as blood routine tests, inflammatory markers, coagulation function tests, liver and renal function tests, electrolyte levels, and blood gas analysis, between the drug group and the control group. Additionally, the time duration to negative conversion and 28-day all-cause mortality rates were compared between the two groups. Logistic regression analysis was conducted on factors associated with mortality, such as the oxyhemoglobin saturation after treatment, time duration to negative conversion, and the use of Nirmatrelvir tablet/Ritonavir tablet or not, while correlation analysis was performed to evaluate the efficacy of Nirmatrelvir tablet/Ritonavir tablet based on the level of oxyhemoglobin saturation, time duration to negative conversion, and all-cause mortality rates within 28 days. ResultsAfter treatment, oxyhemoglobin saturation increased in the drug group (t=-2.726, P=0.011), and the differences between the indicators in the control group compared to the pre-treatment period were not statistically significant (all P>0.05). The time to negative conversion and 28-day all-cause mortality of control group were higher than those in the drug group (all P<0.05). Logistic regression analysis revealed that the lower the post-treatment oxyhemoglobin saturation, the lower the use of Nirmatrelvir tablet/Ritonavir tablet, the longer the time to conversion, and the higher the mortality rate of the patients (all P<0.05). Correlation analysis showed that treatment with Nirmatrelvir tablet/Ritonavir tablet resulted in higher oxyhemoglobin saturation (r=0.425, P=0.008), shorter time to negative conversion (r=-0.398, P=0.013), and lower all-cause mortality rates within 28 days (r=-0.370, P=0.022). ConclusionNirmatrelvir tablet/Ritonavir tablet is effective in mild and moderate infection patients aged ≥90 years who have not been vaccinated against COVID‑19 infection, and can increase patients’ oxyhemoglobin saturation, shorten the time to negative conversion, and reduce 28-day all-cause mortality rate.

Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Objective:To evaluate the efficacy of oliceridine for patient-controlled intravenous analgesia (PCIA) after lung surgery.Methods:In this single-center, retrospective cohort study, patients of either sex, aged 18-80 yr, with American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, with a body mass index of 18-28 kg/m 2, who underwent elective lung surgery with PCIA at Shanghai Chest Hospital from January 1, 2023 to August 15, 2024, were enrolled. Based on the drug components used in PCIA, patients were divided into traditional opioid group (sufentanil or hydromorphone, etc.) and oliceridine group. Patients′ demographics, surgery- and anesthesia-related data, and visual analogue scale scores for pain, and opioid-related adverse reactions at 24 h postoperatively were obtained from the anesthesia specialty database. The primary outcome was the incidence of moderate to severe pain (visual analogue scale score≥ 4) at rest assessed within 24 h postoperatively. Secondary outcomes were the occurrence of opioid-related adverse reactions within 24 h postoperatively. Data were analyzed after adjusting for baseline imbalances using propensity score matching. Results:After matching, 3 053 patients were ultimately included in each group. Compared to traditional opioid group, the incidence of moderate to severe pain was significantly decreased within 24 h after surgery ( RR: 1.298, 95% confidence interval: 1.120-1.503, P<0.001), and the incidence of moderate to severe PONV was decreased in oliceridine group ( RR: 1.432, 95% confidence interval: 1.096-1.871, P=0.008). There was no significant difference in the incidence of dizziness and hypoxemia between the two groups ( P>0.05). Conclusions:Oliceridine provides better efficacy for PCIA than traditional opioids in patients undergoing lung surgery.

Objective:To evaluate the efficacy of oliceridine for patient-controlled intravenous analgesia (PCIA) after lung surgery.Methods:In this single-center, retrospective cohort study, patients of either sex, aged 18-80 yr, with American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, with a body mass index of 18-28 kg/m 2, who underwent elective lung surgery with PCIA at Shanghai Chest Hospital from January 1, 2023 to August 15, 2024, were enrolled. Based on the drug components used in PCIA, patients were divided into traditional opioid group (sufentanil or hydromorphone, etc.) and oliceridine group. Patients′ demographics, surgery- and anesthesia-related data, and visual analogue scale scores for pain, and opioid-related adverse reactions at 24 h postoperatively were obtained from the anesthesia specialty database. The primary outcome was the incidence of moderate to severe pain (visual analogue scale score≥ 4) at rest assessed within 24 h postoperatively. Secondary outcomes were the occurrence of opioid-related adverse reactions within 24 h postoperatively. Data were analyzed after adjusting for baseline imbalances using propensity score matching. Results:After matching, 3 053 patients were ultimately included in each group. Compared to traditional opioid group, the incidence of moderate to severe pain was significantly decreased within 24 h after surgery ( RR: 1.298, 95% confidence interval: 1.120-1.503, P<0.001), and the incidence of moderate to severe PONV was decreased in oliceridine group ( RR: 1.432, 95% confidence interval: 1.096-1.871, P=0.008). There was no significant difference in the incidence of dizziness and hypoxemia between the two groups ( P>0.05). Conclusions:Oliceridine provides better efficacy for PCIA than traditional opioids in patients undergoing lung surgery.

Objective     To investigate the effect of intravenous analgesia with a wireless or traditional analgesia pump system in thoracoscopic lung resection. Methods     Patients who used the patient-controlled intravenous analgesia after thoracoscopic lung resection between June 2016 and June 2021 were enrolled in the study. They were allocated into a wireless pump group (a ZigBee-based wireless analgesia pump system collecting data automatically) and a traditional analgesia pump group. Perioperative analgesia management followed the routine standard operation protocol of Shanghai Chest Hospital. The patients’ numeric rating scale (NRS) for pain and postoperative nausea and vomiting (PONV) scores were collected for analysis from the Anesthesia Information Record System. The incidence of postoperative analgesia insufficiency (defined as NRS≥4 points) within 48 h, the incidence of PONV within 24 h, and the 48 h completion rate of analgesia pump infusion were compared. Results    A total of 59 431 patients were collected, including 24 855 males and 34 576 females, 17 209 patients in the wireless pump group, and 42 222 patients in the traditional analgesia pump group. The incidence of analgesia insufficiency within 48 h after operation (3.75% vs. 4.98%, P=0.007), the incidence of PONV within 24 h after operation (13.60% vs. 16.70%, P=0.030) in the wireless pump group were lower than those in the traditional analgesia pump group. The 48 h completion rate of analgesia pump infusion in the wireless pump group was higher than that in the traditional analgesia pump group (83.40% vs. 71.90%, P<0.001). The wireless pump group could monitor the pressing times and use of the analgesia pump, while the traditional analgesia pump group could not record the relevant data. Conclusion    Compared with the traditional analgesia pump, the wireless analgesia management system may be convenient for timely, accurate and individualized management, and has good analgesic effect and low incidence of adverse reactions, and may be more suitable for perioperative analgesia management.

Objective:To investigate the correlation between cognitive function and living ability of older adult patients living in a mining community.Methods:A total of 180 older adult patients living in a mining community who received treatment during July-October 2019 were included in this study. They were randomly divided into the low-age group (< 68 years old, n = 94) and the high-age group (≥ 68 years old, n = 86). Cognitive function and living ability were evaluated using the Mini-Mental State Examination (MMSE), The Montreal Cognitive Assessment (MoCA), and the Activity of Daily Living Scale (ADL). The relationship between cognitive function and living ability was investigated using hierarchical analysis and Pearson correlation analysis. Results:The proportions of older adult patients with abnormal cognitive function identified by the MMSE and MoCA were 39.4% and 66.0%, respectively in the low-age group, and they were 32.6% and 61.6%, respectively in the high-age group. The MoCA had a greater performance in identifying abnormal cognitive function in each group than the MMSE ( χ2 = 26.69, 10.18, both P < 0.001). There were no significant differences in proportions of older adult patients with abnormal cognitive function identified by the MMSE and MoCA between low-age and high-age groups ( χ2 = 0.90, 0.36, both P > 0.05). The proportion of older adult patients with abnormal living ability was not significantly different between low-age and high-age groups (4.3% vs. 10.5%, χ2 = 2.58, P > 0.05). Compared with patients negative for MMSE items, living ability and instrumental activity of daily living increased by 7.0% and 9.4% in low-age patients positive for MMSE items (both P < 0.05). Compared with patients negative for MoCA items, living ability increased by 3.5% in low-age patients positive for MoCA items ( P < 0.05). Correlation analysis revealed that total scores of MMSE and MoCA were significantly negatively correlated with ADL score ( r = -0.26, -0.27, both P < 0.001) and instrumental activity of daily living score ( r = -0.27, -0.27, P < 0.001). Conclusion:Cognitive function and living ability are correlated in older adult patients living in a mining community. We should pay attention to the screening results of cognitive disorder in older adult patients and improve their living ability by improving their cognitive function.