Background: Day surgery has become the main mode of surgery in American and European countries, but it is still in the early stage in developing countries due to the limitation of medical technology and the backward management concept. At present, day surgery accounts for more than 60% of elective surgery in many countries in Europe and North America and more than 85% in countries such as the United Kingdom and the United States. There are 8469 ambulatory surgery centers in the United States in 2023. In China, the first ambulatory surgery center was established in 2001. In 2018, more than half of the tertiary hospitals (high‐level hospitals) in China carried out day surgery, of which 639 hospitals set up ambulatory surgery centers; the proportion of day surgery in elective surgery increased to 12.8%. The annual number of day surgeries exceeded 1.25 million. In 2022, our hospital established an ambulatory surgery center managed by anesthesiologists. Day surgery requires anesthesiologists to participate in the whole process of patient management from preoperative preparation to postoperative recovery. The establishment of ambulatory surgery centers managed by anesthesiologists is of great significance to China, developing countries, and the whole world.Objectives: So this study aimed to review the development of day surgery in China, combine Chinese government policy evolution, summarize the management model of Chinese ambulatory surgery centers, guide the establishment of ambulatory surgery centers in low‐ and middle‐income countries, and highlight and analyze the advantages of anesthesiologist‐managed ambulatory surgery centers as distinct from other physician‐managed ones.Discussion: We call on anesthesiologists, other physicians, surgeons, nurses, and health system managers around the world to promote efficient, low‐cost day surgery in developing countries and thereby increase access to surgical treatment for the world's poor.

Background: Neuroprotection strategies after cardiac arrest (CA)/cardiopulmonary resuscitation (CPR) remain key areas of basic and clinical research. This study was designed to investigate the neuroprotective effects of dexmedetomidine following resuscitation and potential mechanisms. Methods: Anesthetized rats underwent 6-min asphyxia-based cardiac arrest and resuscitation, after which the experimental group received a single intravenous dose of dexmedetomidine (25 μg/kg). Neurological outcomes and ataxia were assessed after the return of spontaneous circulation. The serum levels and brain expression of inflammation markers was examined, and apoptotic cells were quantified by TUNEL staining. Results: Neuroprotection was enhanced by dexmedetomidine post-conditioning after the return of spontaneous circulation. This enhancement was characterized by the promotion of neurological function scores and coordination. In addition, dexmedetomidine post-conditioning attenuated the serum levels of the pro-inflammatory cytokine tumor necrosis factor (TNF)-α at 2 h, as well as interleukin IL-1β at 2, 24, and 48 h. TUNEL staining showed that the number of apoptotic cells in the dexmedetomidine post-conditioning group was significantly reduced compared with the control group. Further western blot analysis indicated that dexmedetomidine markedly reduced the levels of caspase-3 and nuclear factor-kappa B (NF-κB) in the brain. Conclusions: Dexmedetomidine post-conditioning had a neuroprotective effect against cerebral injury following asphyxia-induced cardiac arrest. The mechanism was associated with the downregulation of apoptosis and neuroinflammation.

Oral squamous cell carcinoma (OSCC) is a prevalent type of cancer in the head and neck region, significantly impacting patient survival rates and quality of life. Lymph node (LN) metastasis is a lead contributor to the poor prognosis associated with OSCC. SOAT1 plays a critical role in cholesterol metabolism and has been implicated in various cancers, although its specific mechanisms in OSCC are poorly understood. Additionally, NLRP3 inflammasome has been identified as a factor that promotes cancer progression by influencing various processes involved in tumor development, with its activation linked to cancer metastasis. Lymphangiogenesis enhancing cancer metastasis has been identified in OSCC, while the molecule networks of regulating it remains unclear. In our study, we found that SOAT1 is overexpressed in OSCC and promotes proliferation, migration, and invasion of OSCC cells. Knockdown SOAT1 expression impaired OSCC progression both in vitro and in vivo, and reduced the rate of LN metastasis. RNA sequencing analysis revealed that NLRP3 is a downstream regulated by SOAT1, with NLRP3 inflammasome reactivation having recovered cancer malignancy inhibited by SOAT1 knockdown. Furthermore, we revealed that IL‐1β, released by NLRP3 inflammasome activation, could directly bind to IL‐1R‐1 in lymphatic endothelial cells (LECs), and enhance tube formation capacity of LECs, indicating the potential role of NLRP3 inflammasome in promoting lymphangiogenesis and metastasis in OSCC. In conclusion, SOAT1 could promote OSCC malignancy and regulate the activation of NLRP3 inflammasome to increase the rate of lymphangiogenesis and cancer metastasis via IL‐1β/IL‐1R‐1 axis in OSCC.

Postoperative cognitive dysfunction (POCD) is a prevalent complication that significantly affects the quality of life. Notably, patients who have experienced ischemic stroke are at an increased risk of developing POCD. Exploring the underlying mechanisms of POCD is crucial for its management. Numerous studies have established neuroinflammation as an independent risk factor in POCD pathogenesis, with TREM2 emerging as a key neuroprotective factor that modulates neuroinflammatory responses through the PI3K/Akt signaling pathway. In this study, we aimed to investigate the effect of TREM2 on POCD in a mouse model of ischemic stroke, with a focus on the mechanisms involving TREM2 and the PI3K/Akt signaling pathway. Our findings indicated that mice with ischemic stroke exhibited severe cognitive impairment after surgical trauma. However, we observed that an enriched environment (EE) could ameliorate this cognitive impairment by upregulating microglia TREM2 expression in the hippocampus and suppressing neuroinflammation. Additionally, the PI3K/AKT signaling pathway was activated in the hippocampal tissue of the mice housed in EE. Importantly, the beneficial neuroprotective and anti-inflammatory effects of EE were abolished when TREM2 was knocked down, underscoring the essential role of TREM2 in mediating the effects of EE on neuroinflammation and cognitive function after ischemic stroke and surgical trauma. In general, our study has confirmed a potential molecular mechanism that led to the occurrence of POCD in individuals with ischemic stroke and provided new strategies to treat POCD.

Objective The purpose of the study is to construct a postoperative nausea and vomiting (PONV) risk prediction model for day-case laparoscopic cholecystectomy (LC) using a machine learning combination algorithm and evaluate its performance. Design A retrospective cohort study. Setting The Hospital Information System (HIS) and the Surgical Anaesthesia Information Management System (SAIMS). Participants Patient data are collected from the day surgery ward of Sichuan Provincial People’s Hospital from February 2023 to April 2024. The research subjects are adult patients (18–75) who underwent day-case LC, excluding patients with unexpected termination of the day surgery plan, such as the patient who was transferred to hepatobiliary surgery due to intraoperative conversion to laparotomy. Main outcomes/measures The study employed two data filling methods, two data sampling methods, two variable screening methods and six machine learning algorithms to construct 48 predictive models. Area under curve (AUC), accuracy, precision, recall rate and F1 value were used to evaluate the predictive performance of the model. The AUC of the test set is mainly used to evaluate the prediction performance, and the Shapley weighted explanatory value is used to determine the weight of the variable’s prediction contribution. We will collect patient data from this unit in July 2025 to evaluate the model’s performance. Results A total of 2709 patients were selected for model construction in the study. 20 input variables were retained for developing the predictive model. The combined model of KNN, BSMOTE, RFEL and GBM shows the best AUC performance (0.9600). The five most important variables in the prediction model were postoperative pain, LESS method, citraturia dosage, gender and sufentanil dosage. An additional 211 patients were collected to validate the model performance with an AUC of 0.79. Conclusion The study finds that postoperative pain, LESS method and cisatracurium dosage are closely related to the occurrence of PONV in day-case LC. However, these three variables have rarely been reported in the previous literature and worth further research. The prediction model obtained in this study provides a meaningful reference for the perioperative prevention and treatment of PONV in day surgery.