Objective:To investigate the anesthesiology and perioperative management status of elderly patients in Beijing tertiary hospitals in 2024.Methods:Using the cluster sampling, a questionnaire was distributed to hospitals affiliated with members of the Geriatric Anesthesiology Group under the Beijing Society of Anesthesiology. The survey primarily included: ① the current status of anesthesia for elderly patients in 2024; ② the continuing education landscape related to anesthesia for elderly patients; and ③ the current practices in anesthesia management of elderly patients. The questionnaires were completed by anesthesiologists responsible for quality control data at each hospital.Results:The survey data were collected from 34 hospitals in Beijing. In 2024, the total number of anesthesia procedures performed across these hospitals was 1, 285, 620, of which 264, 257 were performed on elderly patients (age ≥ 65 yr), representing 20.55% of the total. General anesthesia remained the dominant method of anesthesia for elderly patients 77.00%(203, 478/264, 257), and sedation and anesthesia for diagnostic and therapeutic procedures accounted for 58.00% (153, 269/264, 257). Fewer than 20% of hospitals routinely conducted preoperative cognitive function assessment and frailty assessment. Intraoperative monitoring of anesthesia depth was routinely implemented in 82% (28/34) of the hospitals, and routine monitoring of muscle relaxation only accounted for 9% (3/34 hospitals). The use of dexmedetomidine during the perioperative period to prevent postoperative delirium accounted for 38% (13/34), the use of target-oriented fluid management combined with vasoconstrictors to maintain circulatory stability strategy accounted for 53% (15/34), and the use of lung-protective ventilation strategy accounted for 68% (23/34). After surgery, 90% of elderly patients returned to postanesthesia care unit, and the proportion of patients returning to intensive care unit/anesthesia unit intensive care was about 10.00% (26, 426/264, 257). In 85% of hospitals, extubation of endotracheal tubes and removal of laryngeal mask airways were performed in the operating room. Additionally, 68% of hospitals reported having an acute pain management team, with an average incidence of moderate-to-severe postoperative pain of 20%.Conclusions:In 2024, the proportion of elderly patients receiving anesthesia in Beijing tertiary hospitals is high. Preoperative assessment of cognitive function and frailty is insufficient, but routine monitoring for geriatric anesthesia and perioperative management strategies are good, and postoperative pain management is acceptable. The overall status of perioperative anesthesia management of elderly patients is good but still needs improvement.

Semaglutide is a long-acting glucagon-like peptide-1 receptor agonist (GLP-1RA), which is commonly used in the treatment of type 2 diabetes mellitus and weight loss. Its weight loss effect was exerted mainly by suppressing appetite, delaying gastric emptying, promoting energy metabolism, and accelerating lipolysis. However, delayed gastric emptying can lead to residual gastric content, increasing the risk of pulmonary aspiration during anesthesia. This article reviews the effects and mechanisms of semaglutide on gastric emptying, and proposes preventive measures for perioperative pulmonary aspiration in patients treated with semaglutide by reviewing case reports and clinical studies on semaglutide-related delayed gastric emptying. This provides a reference for the safety of semaglutide treatment during the perio- perative period.

Objective:To investigate the anesthesiology and perioperative management status of elderly patients in Beijing tertiary hospitals in 2024.Methods:Using the cluster sampling, a questionnaire was distributed to hospitals affiliated with members of the Geriatric Anesthesiology Group under the Beijing Society of Anesthesiology. The survey primarily included: ① the current status of anesthesia for elderly patients in 2024; ② the continuing education landscape related to anesthesia for elderly patients; and ③ the current practices in anesthesia management of elderly patients. The questionnaires were completed by anesthesiologists responsible for quality control data at each hospital.Results:The survey data were collected from 34 hospitals in Beijing. In 2024, the total number of anesthesia procedures performed across these hospitals was 1, 285, 620, of which 264, 257 were performed on elderly patients (age ≥ 65 yr), representing 20.55% of the total. General anesthesia remained the dominant method of anesthesia for elderly patients 77.00%(203, 478/264, 257), and sedation and anesthesia for diagnostic and therapeutic procedures accounted for 58.00% (153, 269/264, 257). Fewer than 20% of hospitals routinely conducted preoperative cognitive function assessment and frailty assessment. Intraoperative monitoring of anesthesia depth was routinely implemented in 82% (28/34) of the hospitals, and routine monitoring of muscle relaxation only accounted for 9% (3/34 hospitals). The use of dexmedetomidine during the perioperative period to prevent postoperative delirium accounted for 38% (13/34), the use of target-oriented fluid management combined with vasoconstrictors to maintain circulatory stability strategy accounted for 53% (15/34), and the use of lung-protective ventilation strategy accounted for 68% (23/34). After surgery, 90% of elderly patients returned to postanesthesia care unit, and the proportion of patients returning to intensive care unit/anesthesia unit intensive care was about 10.00% (26, 426/264, 257). In 85% of hospitals, extubation of endotracheal tubes and removal of laryngeal mask airways were performed in the operating room. Additionally, 68% of hospitals reported having an acute pain management team, with an average incidence of moderate-to-severe postoperative pain of 20%.Conclusions:In 2024, the proportion of elderly patients receiving anesthesia in Beijing tertiary hospitals is high. Preoperative assessment of cognitive function and frailty is insufficient, but routine monitoring for geriatric anesthesia and perioperative management strategies are good, and postoperative pain management is acceptable. The overall status of perioperative anesthesia management of elderly patients is good but still needs improvement.

Semaglutide is a long-acting glucagon-like peptide-1 receptor agonist (GLP-1RA), which is commonly used in the treatment of type 2 diabetes mellitus and weight loss. Its weight loss effect was exerted mainly by suppressing appetite, delaying gastric emptying, promoting energy metabolism, and accelerating lipolysis. However, delayed gastric emptying can lead to residual gastric content, increasing the risk of pulmonary aspiration during anesthesia. This article reviews the effects and mechanisms of semaglutide on gastric emptying, and proposes preventive measures for perioperative pulmonary aspiration in patients treated with semaglutide by reviewing case reports and clinical studies on semaglutide-related delayed gastric emptying. This provides a reference for the safety of semaglutide treatment during the perio- perative period.

Background: and Purpose To examine the clinical and safety outcomes after endovascular treatment (EVT) for acute basilar artery occlusion (BAO) with different anesthetic modalities. Methods: This was a retrospective analysis using data from the Endovascular Treatment for Acute Basilar Artery Occlusion (ATTENTION) registry. Patients were divided into two groups defined by anesthetic modality performed during EVT: general anesthesia (GA) or non-general anesthesia (non-GA). The association between anesthetic management and clinical outcomes was evaluated in a propensity score matched (PSM) cohort and an inverse probability of treatment weighting (IPTW) cohort to adjust for imbalances between the two groups. Results: Our analytic sample included 1,672 patients from 48 centers. The anesthetic modality was GA in 769 (46.0%) and non-GA in 903 (54.0%) patients. In our primary analysis with the PSM-based cohort, non-GA was comparable to GA concerning the primary outcome (adjusted common odds ratio [acOR], 1.01; 95% confidence interval [CI], 0.82 to 1.25; P=0.91). Mortality at 90 days was 38.4% in the GA group and 35.8% in the non-GA group (adjusted risk ratio, 0.95; 95% CI, 0.83 to 1.08; P=0.44). In our secondary analysis with the IPTW-based cohort, the anesthetic modality was significantly associated with the distribution of modified Rankin Scale at 90 days (acOR: 1.45 [95% CI: 1.20 to 1.75]). Conclusion In this nationally-representative observational study, acute ischemic stroke patients due to BAO undergoing EVT without GA had similar clinical and safety outcomes compared with patients treated with GA. These findings provide the basis for large-scale randomized controlled trials to test whether anesthetic management provides meaningful clinical effects for patients undergoing EVT.

ObjectiveTo study the relationship between tumor siza,aource intensita,arescription dose and source dwell time in the after-loading treatment plaa,and to establish a method that can be used for rapid quality control of after-loading plans.Methods The all of gynecological cancer patients treated in this hospital were selected:84 cases of all three tubes of Fletcher applicator,58 cases of uterine alone and 39 cases of vaginal applicator.Each patient was scanned with CT before treatment.Contouring the target and organs at risa,ahe treatment plan was optimized using IPSA.Record the source strengta,arescription dosa,aource dwell tima,and tumor volume of the prescribed dose for each case.Calculate CI values and Rv.The kvalue analyzes the CI distribution characteristics and the correlation with the Rv value.In addition,46 cases of gynecologic tumor patients were used to verify the method.Results The fitting index of the after-loading scheme of the three applicators showed a normal distribution.The mean value of the Fletcher applicator CI was 0.720±0.067,the k value was 1 394,Rvalue was 0.894.The mean value of the uterine alone CI was 0.697±0.076,the k value was 1 428,R=0.940,the mean value of the vaginal applicator CI was 0.742± 0.067,the k value was 1 362,and R=0.909.Conclusions Using this methoa,at can quickly assess whether the planned target voluma,aadiation source intensita,arescription dose and treatment time matca,and find the cause of deviation based on the feedback results to ensure that the after-loading treatment plan can be quickla,accuratela,and efficiently implemented according to clinical requirements.

Cholangiocarcinoma is a malignant tumor originating from bile duct epithelial cells, among which hilar cholangiocarcinoma is the most common, accounting for about 58％-70％ of cholangiocarcinoma. Due to its atypical clinical features, special anatomical site, low radical resection rate, high recurrence rate and poor prognosis, the 5-year survival rate of hilar cholangiocarcinoma was only 14.7％-33.8％. Hence, the most effective method of hilar cholangiocarcinoma lies in early diagnosis and radical resection. Good perioperative management can improve the rate of radical resection of hilar cholangiocarcinoma and contribute a lot to prognosis of the patients. The perioperative management of hilar cholangiocarcinoma is described as follows.