Objective To explore the effects of ultrasound-guided intercostal nerve block(INB)and thoracic paravertebral nerve block(TPVB)on the dosage of anesthetics and the efficacy of analgesia in video-assisted thoracoscopic lobectomy.Methods From October 2019 to October 2023,90 patients undergoing video-assisted thoracoscopic lobectomy at the People's Hospital of Tongling City,Anhui,were selected.They were divided into the INB group(42 cases)and the TPVB group(48 cases).The INB group received ultrasound-guided intercostal nerve block,while the TPVB group was administered ultrasound-guided thoracic paravertebral nerve block.The two groups were compared before anesthesia induction(T0),15 minutes of anesthesia(T1),30 minutes of anesthesia(T2),45 minutes of anesthesia(T3),and after extubation(T4),vita4 signs,anesthetic dosage,analgesic effect,pain stress index and adverse reactions.Results In the TPVB group,systolic blood pressure(SBP)of T1,T2,T3 and T4 were(115.88±9.29)mmHg,(113.58±9.72)mmHg,(117.33±9.17)mmHg and(121.15±10.51)mmHg,respectively;diastolic blood pressure(DBP)were(86.74±7.35)mmHg,(90.83±8.82)mmHg,(90.83±8.82)mmHg and(91.05±8.73)mmHg,respectively;Heart rate(HR)were(79.94±7.46)times/min,(81.97±7.28)times/min,(82.36±7.41)times/min and(85.83±8.32)times/min,respectively.Which were all higher than the INB group[(103.53±8.28)mmHg,(105.40±8.66)mmHg,(109.03±8.13)mmHg,(114.64±9.65)mmHg.(77.68±6.57)mmHg,(79.27±6.69)mmHg,(83.21±7.37)mmHg,(85.83±8.21)mmHg,(71.17±6.21)times/min,(75.18±6.47)times/min,(74.82±6.12)times/min and(79.35±7.12)times/min,respectively],there were statistical significance between the two groups(P＜0.05).Postoperatively,the TPVB group had lower 24-hour sufentanil consumption[(27.68±2.64)μg]and fewer presses of the analgesia pump[(5.16±0.38)times]compared to the INB group[(36.22±3.36)μg and(6.87±0.42)times,(P＜0.05)].Visual analogue scale(VAS)scores for pain at rest and during coughing at 2,24,and 48 hours in group TPVB were 2.44±0.27,3.55±0.42,2.81±0.34 and 3.36±0.23,4.13±0.33,3.80±0.25,respectively,which were also lower than the INB group(2.83±0.44,3.98±0.55,3.33±0.46 and 3.87±0.30,4.59±0.47,4.17±0.29,respectively)(P＜0.05).Levels of prostaglandin E2(PGE2)(1.53±0.28 μg/L),norepinephrine(NE)(362.25±33.85 ng/L),and cortisol(Cor)(278.72±25.13 ng/L)in the TPVB group were lower than those in the INB group(2.71±0.32 μg/L,425.67±38.37 ng/L,315.68±29.21 ng/L)(P＜0.05).Adverse reactions such as nausea and vomiting,and dizziness were less frequent in the TPVB group[1(2.1％),1(2.1％)]compared to the INB group[6(12.5％),5(10.4％)](P＜0.05).Conclusion Ultrasound-guided thoracic paravertebral nerve block is superior to intercostal nerve block in terms of anesthetic dosage and analgesic efficacy in video-assisted thoracoscopic lobectomy.

Objective To explore the effects of ultrasound-guided intercostal nerve block(INB)and thoracic paravertebral nerve block(TPVB)on the dosage of anesthetics and the efficacy of analgesia in video-assisted thoracoscopic lobectomy.Methods From October 2019 to October 2023,90 patients undergoing video-assisted thoracoscopic lobectomy at the People's Hospital of Tongling City,Anhui,were selected.They were divided into the INB group(42 cases)and the TPVB group(48 cases).The INB group received ultrasound-guided intercostal nerve block,while the TPVB group was administered ultrasound-guided thoracic paravertebral nerve block.The two groups were compared before anesthesia induction(T0),15 minutes of anesthesia(T1),30 minutes of anesthesia(T2),45 minutes of anesthesia(T3),and after extubation(T4),vita4 signs,anesthetic dosage,analgesic effect,pain stress index and adverse reactions.Results In the TPVB group,systolic blood pressure(SBP)of T1,T2,T3 and T4 were(115.88±9.29)mmHg,(113.58±9.72)mmHg,(117.33±9.17)mmHg and(121.15±10.51)mmHg,respectively;diastolic blood pressure(DBP)were(86.74±7.35)mmHg,(90.83±8.82)mmHg,(90.83±8.82)mmHg and(91.05±8.73)mmHg,respectively;Heart rate(HR)were(79.94±7.46)times/min,(81.97±7.28)times/min,(82.36±7.41)times/min and(85.83±8.32)times/min,respectively.Which were all higher than the INB group[(103.53±8.28)mmHg,(105.40±8.66)mmHg,(109.03±8.13)mmHg,(114.64±9.65)mmHg.(77.68±6.57)mmHg,(79.27±6.69)mmHg,(83.21±7.37)mmHg,(85.83±8.21)mmHg,(71.17±6.21)times/min,(75.18±6.47)times/min,(74.82±6.12)times/min and(79.35±7.12)times/min,respectively],there were statistical significance between the two groups(P＜0.05).Postoperatively,the TPVB group had lower 24-hour sufentanil consumption[(27.68±2.64)μg]and fewer presses of the analgesia pump[(5.16±0.38)times]compared to the INB group[(36.22±3.36)μg and(6.87±0.42)times,(P＜0.05)].Visual analogue scale(VAS)scores for pain at rest and during coughing at 2,24,and 48 hours in group TPVB were 2.44±0.27,3.55±0.42,2.81±0.34 and 3.36±0.23,4.13±0.33,3.80±0.25,respectively,which were also lower than the INB group(2.83±0.44,3.98±0.55,3.33±0.46 and 3.87±0.30,4.59±0.47,4.17±0.29,respectively)(P＜0.05).Levels of prostaglandin E2(PGE2)(1.53±0.28 μg/L),norepinephrine(NE)(362.25±33.85 ng/L),and cortisol(Cor)(278.72±25.13 ng/L)in the TPVB group were lower than those in the INB group(2.71±0.32 μg/L,425.67±38.37 ng/L,315.68±29.21 ng/L)(P＜0.05).Adverse reactions such as nausea and vomiting,and dizziness were less frequent in the TPVB group[1(2.1％),1(2.1％)]compared to the INB group[6(12.5％),5(10.4％)](P＜0.05).Conclusion Ultrasound-guided thoracic paravertebral nerve block is superior to intercostal nerve block in terms of anesthetic dosage and analgesic efficacy in video-assisted thoracoscopic lobectomy.

Objective:To analyze the current status of internet-based patient education materials related to labor analgesia in China.Methods:Labor analgesia-related materials were retrieved and screened according to the search habits of Chinese search engine users. The coverage and accuracy of the content were evaluated by 3 anesthesiologists. The Chinese version of the Patient Education Materials Assessment Tool for Print Materials was used to subjectively assess comprehensibility and operability from a medical text perspective. The consistency of the evaluation results of the three anesthesiologists was analyzed using the intraclass correlation coefficient method. A machine learning method combined with ChatGPT-4.0 was employed to establish a Chinese readability classification model to objectively evaluate the readability difficulty of the included materials from a Chinese text perspective.Results:A total of 97 web pages were retrieved, with 21 valid materials included in the study. The coverage rate of contraindications for labor analgesia was only 62% (13/21), and the accuracy rate of materials exceeding 90% was 71% (15/21). Internet-based materials that were easy to understand accounted for 81% (17/21), while the constituent ratio of internet-based materials with instructional significance were only 5% (1/21). The intraclass correlation coefficient values of consistency evaluation for coverage rate, accuracy rate, and comprehensibility and operability were 0.975, 0.833, 0.758, and 0.773, respectively ( P<0.001). Internet-based materials suitable for compulsory education level were only 5% (1/21), while those suitable for high school and above education level accounted for 43% (9/21). Conclusions:There are numerous internet-based patient education materials related to labor analgesia in China, but the quality needs improvement. In the future, a collaborative model of " anesthesiology+ linguistics" should be developed to provide patients with more comprehensive, accurate, and pregnant-friendly patient education materials.

Interarterial subtype of coronary artery with anomalous aortic origin is a rare and congenital cardiovascular malformation,manifested by chest pain and syncope after exertion or activity,which can lead to decreased cardiac contractility,myocardial infarction,and even sudden death.Here we report a case of an adolescent patient,who presented with chest pain during activity accompanied by syncope and lost consciousness.Initially diagnosed with acute myocardial infarction,the patient was subsequently diagnosed as interarterial subtype of a coronary artery originating from anomalous aorta after echocardiography,coronary angiography,coronary CT angiography examinations.After anomalous coronary artery correction and coronary angioplasty,the paitent recovered well.

The exploration of anesthesia and consciousness has always been an important subject in neuroscience,but the underlying neural mechanisms of consciousness are still unclear,which limits the de-velopment of anesthesia monitoring and consciousness evaluation systems.The neural correlates of conscious-ness(NCC)cannot be determined by a single brain region or mechanism,suggesting that consciousness may arise from complex interactions of brain functions on space and time scales.In order to characterize these interactions,network science has been introduced in exploring the mechanisms of consciousness.In this paper,the basic concepts and common indicators of brain network research are introduced,and the lat-est progress of brain network research in anesthesia is reviewed,so as to provide new ideas for the applica-tion of brain network indicators in clinical monitoring and provide directions for the exploration of NCC.

Objective To evaluate the association between 5-factor modified frailty index(mFI-5)with prognosis in elderly patients undergoing off-pump coronary artery bypass grafting(OPCABG).Methods Retrospective data were collected from elderly patients who underwent OPCABG between January 2019 and May 2022.The patients were divided into three groups based on preoperative mFI-5:non frailty group(mFI-5=0),pre-frailty group(mFI-5=1),and frailty group(mFI-5 ≥2).Baseline,intraopera-tive,and prognostic indicators of the three groups were collected and compared.Multivariate(logistic re-gression and linear regression)analyses were used to evaluate the association between mFI-5 with prognosis in elderly patients undergoing OPCABG.Results A total of 244 patients were included in the analysis,in-cluding 35 patients(14.3％)in the non-frailty group,82 patients(33.6％)in the pre-frailty group,and 127 patients(52.1％)in the frailty group.Compared with the non-frailty group,the pre-frailty group had higher incidence of acute kidney injury(P＜0.05);the frailty group had lower preoperative LVEF and in-traoperative urine volume,and higher incidence of acute kidney injury and mortality(P＜0.05).Compared with the pre-frailty group,the frailty group had lower intraoperative urine volume,prolonged ICU stay,and higher incidence of mortality(P＜0.05).Multivariate logistic regression analysis showed that for every point increase in mFI-5,the length of stay in ICU was extended by 3.189 days(95％CI 1.457-4.920 days,P＜0.001),and the total length of stay was extended by 2.890 days(95％CI 1.070-4.709 days,P=0.002).Linear regression analysis showed that elevated mFI-5 was associated with complications during hospitalization,including acute kidney injury(OR=1.519,95％CI 1.076-2.145,P=0.017),pulmonary complications(OR=1.453,95％CI 1.075-1.965,P=0.015)and death(OR=3.730,95％CI 1.980-7.027,P＜0.001).Conclusion mFI-5 is a simple and practical screening tool for frail-ty,and using the mFI-5 scale for frailty assessment in elderly patients undergoing OPCABG can screen high-risk patients with poor prognosis during hospitalization.

By using hyperpolarized 13C labeling technology,the magnetic resonance signals of 13C-labeled metabolic substrates are enhanced,which enables the in vivo monitoring of their metabolic states through magnetic resonance spectroscopy.Compared with traditional non-invasive metabolic diagnostic technologies,hyperpolarized 13C technology exhibits a number of strengths,including real-time monitoring,high precision,non-invasiveness,the absence of radiation,and the ability to assess a broader range of metabolic pathways,showing great potential for application in the treatment of glioma,stroke,Alzheimer disease,and cerebral injury.Following the approval of[1-13C]-pyruvate for clinical trials by U.S.Food and Drug Administration(FDA),there has been growing academic interest in this technology.Currently,the primary challenge lies in creating more probes and promoting their clinical applications.Herein,we outlined the principles of hyperpolarized 13C labeling technology,examined its current role in neurological metabolic diagnostics,and explored the future directions,including conducting hyperpolarized 13C magnetic resonance spectroscopy(MRS)technology at higher magnetic field strengths(such as 7T),designing additional magnetic resonance sequences specific to hyperpolarized 13C MRS,and its integration with other neuro-metabolic diagnostic methods.

Objective To investigate the risk factors for postoperative pulmonary infection in pa-tients undergoing liver transplantation.Methods Clinical data of 1 358 patients who underwent liver trans-plantation for the first time from June 2005 to June 2013 at three clinical medical centers were retrospectively analyzed.Patients were divided into two groups according to whether or not they developed lung infection within 30 days after surgery:the infection group and the non-infection group.General,intrao-perative and postoperative data were collected,and risk factors for pulmonary infection after liver transplan-tation were analyzed using univariate analysis and binary logistic regression.Results Lung infections after liver transplantation occurred in 316 patients(23.3%),of whom 21 patients(6.7%)died.Compared with the non-infection group,the proportion of preoperative diagnosis of chronic severe hepatitis,hepatocellular carcinoma,hepatitis C cirrhosis,congenital liver disease and liver failure,preoperative combined hepatore-nal syndrome,hepatic coma and diabetes mellitus,preoperative creatinine concentration were significantly increased in the infection group(P＜0.05),preoperative total protein and albumin concentrations were significantly decreased(P＜0.05),and the duration of the hepatic-free period,the duration of postoperative awakening,and the duration of postoperative extubation were significantly prolonged(P＜0.05),intraoperative blood loss was significantly increased(P＜0.05),intraoperative urine output was significantly decreased(P＜0.05),the proportion of intraoperative phenylephrine,atropine,lidocaine,and furosemide drugs were significantly decreased(P＜0.05),and postoperative mortality rate was signifi-cantly increased in the infection group(P＜0.05).The results of binary logistic regression analysis showed that chronic severe hepatitis,hepatitis C cirrhosis,liver failure,preoperative diabetes mellitus,intraopera-tive blood loss＞1 900 ml,and postoperative awakening time＞7.3 hours were the risk factors for postoper-ative pulmonary infections in liver transplant patients,and the surgical method(classical non-transfusion in situ liver transplantation),the use of lidocaine during surgery,preoperative total protein＞64.6 g/L,and intraoperative urine volume＞1 800 ml were protective factors for postoperative pulmonary infections in liver transplantation patients.Conclusion Preoperative diagnosis of chronic severe hepatitis,hepatitis C cirrho-sis,liver failure,preoperative combined diabetes mellitus,intraoperative blood loss＞1 900 ml,and post-operative awakening time＞7.3 hours are risk factors for pulmonary infection after liver transplantation.

The effective analysis of electroencephalography(EEG)data to objectively reflect the changes of nociception has been a hot topic of research in recent years.The incidence of moderate to severe postoperative acute pain remains high.Postoperative acute pain seriously affects patients'physical and psy-chological health,yet there is no objective gold standard for measuring perioperative nociception to guide perioperative analgesia.The results of current studies on the characteristics of EEG changes during nociception are contradictory.This paper presents the EEG characteristics of nociception in order to provide a reference for future research design.

Perioperative neurocognitive disorders(PND)are common perioperative diseases,which bring heavy burden to patients and society.Due to complex pathogenesis of PND and the lack of relia-ble diagnosis and intervention means,and electroencephalography(EEG)and magnetic resonance imaging(MRI)have the advantage of providing objective indicators,so their application in the study of PND has gradually become a hot topic.In this review,the intraoperative processed EEG indices,EEG spectral analy-sis,EEG functional connectivity analysis,EEG nonlinear dynamics analysis,and perioperative MRI analysis in patients with PND are reviewed,aiming to explore the clinical value of EEG and MRI in predic-ting and diagnosing PND.