Volume 3, Issue 1

Thoracic drainage plays a crucial role in both peacetime and wartime clinical medicine, serving as an indispensable method for treating thoracic diseases and managing trauma patients. Whether in routine medical care or in the complex situations of war or military operations, thoracic drainage is essential. This expert consensus aims to clarify the primary uses and appropriate patient populations for different types of thoracic drainage tubes, providing healthcare professionals with a systematic guide for the correct selection and application of drainage tubes in various scenarios, thereby optimizing treatment outcomes. We emphasize the need to establish specific rapid response mechanisms to meet the urgent medical demands of wartime, ensuring timely and effective thoracic drainage even in resource-limited situations. Furthermore, innovation in new technologies and materials is also key to advancing thoracic drainage techniques.

Objective: The multi-objective teaching model is an educational strategy that aims to promote the holistic development of students through diverse teaching methods and activities. This study explores the application method of multi-objective teaching model in the standardized training of anesthesiology residents in China, aiming to enhance teaching outcomes and cultivate skilled anesthesiologists. Methods: A total of 60 anesthesiology residents undergoing standardized training at our center were included in this clinical observation. Participants (n=30/group) were randomly assigned to either the observation group (multi-objective teaching model) or the control  group (conventional teaching model). All the participants received training on ultrasound-guided short-axis inplane and short-axis out-of-plane axillary brachial plexus nerve block. In the control group, the teaching of the two kinds of punctures were carried out separately without comparison of the two or inclusion of additional puncture techniques. In the observation group, the teaching of the two kinds of puncture were integrated, and the experience was summarized and extended to the vascular and nerve puncture requiring similar technology. After the  teaching of two different models, the difference of success rates in supraclavicular vein and internal jugular vein punctures were evaluated. Results: The observation group demonstrated a significantly shorter puncture and catheter placement time compared to the control group during supraclavicular vein and internal jugular vein puncture procedures (5.19±2.20 minutes vs. 8.35±2.40 minutes, P<0.01), with a higher success rate (76% vs. 64%, P=0.08). The number of mistaken arterial punctures was significantly reduced (4 cases vs. 8 cases, P=0.26). Additionally, both student and mentor evaluations of the multi-objective teaching model were significantly higher than those of the conventional model (student evaluation: 82±11 points vs. 71±9 points, P<0.01; mentor evaluation: 85±9 points vs. 76±7 points, P<0.01). Conclusion: The multi-objective teaching model significantly improves perioperative skills and teaching satisfaction among anesthesiology residents. It is an effective educational approach for enhancing anesthesiology training.

Sepsis is a systemic inflammatory response syndrome caused by infection, leading to acute lung injury and acute respiratory distress syndrome, which are common life-threatening complications in intensive care units. Mitochondrial autophagy, a process that selectively removes damaged mitochondria, is essential for maintaining the stability of the intracellular environment and cellular function. In recent years, the role of mitochondrial autophagy in sepsis-associated acute lung injury and acute respiratory distress syndrome has garnered significant attention. This review summarizes the research progress of mitochondrial autophagy in sepsis-associated acute lung injury and acute respiratory distress syndrome, focusing on its mechanism, influencing factors, and potential therapeutic agents.

Obstructive jaundice can lead to systemic multi-organ complications, with the heart being one of the most critically affected organs. This review summarizes recent insights into the mechanisms of cardiac injury induced by obstructive jaundice, including bile acid toxicity, inflammatory responses, oxidative stress, nitric oxide dysregulation, endotoxemia, apoptosis, and autophagy. Currently, no specific treatment protocol exists for this condition. However, appropriate anesthetic choices, traditional Chinese herbal medicine, and optimized perioperative management have shown potential in mitigating myocardial damage. This review provides a detailed discussion of these aspects.