Objectives: The key to an ultrasound-guided system is to accurately determine the spatial position of the surgical instrument. The size and shape of the optical positioning target in the optical positioning device can restrict the doctor's hand movements. Additionally, the use of a binocular camera occupies valuable operating room space. To reduce both the space occupation and the impact on surgical procedures, this paper presents a device designed to provide enhanced navigation information to assist the surgeon. Methods: The proposed device is equipped with an angle sensor and a button. The angle sensor measures the relative angle between the puncture device and the ultrasound probe in real time. The button assists the surgeon in measuring the depth of the surgical target before performing the puncture. Furthermore, we propose a filtering algorithm to reduce noise in the angle sensor's output signal. The device's performance was evaluated using an ultrasound instrument and an experimental setup for data collection and testing. Results: The filtering algorithm effectively reduced noise in the angular data. After filtering, the Signal Smoothness decreased from 0.036989 to 0.0010376, the Coefficient of Variation decreased from 0.00046682 to 0.0004323, and the Count of Local Extrema decreased from 251 to 135. Additionally, we collected and compared the coordinates of the guide line endpoints at the tip of the puncture needle and found an average point-to-point error of 3.53 pixel. Conclusions: The developed guidance device and filtering algorithm provide valuable navigation data, supporting the surgeon's operations.

Electro-conductive hydrogel is a new composite hydrogel with high electrical conductivity, extraordinary mechanical properties, and controllability. It can be equipped with specific materials to obtain specific properties, which has attracted considerable research attention due to its wide range of application as a biomaterial in the biomedical engineering field. It can be used as a patch to promote healing and as a dressing for burns and pressure wounds. In pharmaceutical science, it is widely studied as a carrier of targeted and quantitative drug release. In surgery, it can serve as a cell scaffold for implantable therapy. Currently, increasing research is focusing on the development of sensors as simulated skin for robots, as well as in health monitors for human activity and well-being. In this review, we summarize the classification and selection of conductive mediums, natural polymer hydrogel matrices, and the application of electro-conductive hydrogels in the fields of bioengineering and biomedicine. We delve into the properties of different conductive mediums and the principle of combining different hydrogel matrices and discuss the advantages and disadvantages of emerging composite hydrogels. Our focus extends to the forefront of conductive hydrogel research in various fields, while also elucidating the current problems and challenges in terms of performance integration, preparation process and practical applications.

Objective: To evaluate the effectiveness of a simulation-based practice model for training anesthesiology residents in ultrasound-guided transversus abdominis plane (TAP) block. Methods: A total of 40 anesthesiology residents from the Department of Anesthesiology, Jiangsu Cancer Hospital, who participated in standardized anesthesiology residency training from June 2025 to December 2025, were enrolled and randomly assigned into a simulation group and a control group, with 20 residents in each group. TAP block training was provided through demonstration in both groups, while the simulation-based practice model was additionally applied to the simulation group. Outcome measures included total procedure duration, success rate of TAP block, skill operation scores, theoretical test scores, trainee satisfaction, training vividness, and willingness to recommend the training mode. Results: Compared with the control group, residents in the simulation group completed the TAP block procedure faster (10.54±3.42 min vs. 15.53±4.56 min, P<0.05), and achieved significantly higher scores in skill operations (25.81±1.13 vs. 22.91±1.25, P<0.05) and theoretical tests (92.51±2.93 vs. 85.67±1.01, P<0.05). Additionally, the simulation group reported significantly higher scores in trainee satisfaction (8.93±0.57 vs. 7.58±1.18, P<0.05), training vividness (8.98±0.67 vs. 7.33±0.82, P<0.05), and willingness to recommend the training mode (8.86±0.83 vs. 7.63±1.25, P<0.05). The success rate of TAP block performed by residents was significantly higher in the simulation group than in the control group (85% vs. 70%, P<0.05). Conclusion: The simulation-based practice model substantially improves the quality and effectiveness of TAP block training. By enabling repeated practice of both ultrasound techniques and TAP block procedures on simulators and real patients, anesthesiology residents can achieve proficiency in the relevant theoretical knowledge and technical skills before clinical application.

With advancements in surgical techniques and increasing complexity of patients' underlying conditions, the management of perioperative bleeding and coagulation disorders has intensified. Clinical practice faces issues such as non-standardized monitoring, inconsistent management protocols for specific patient populations, and unclear thresholds for blood transfusion and hemostatic agent administration. Based on evidence-based principles and integrating the latest evidence since 2020, the task force developed this consensus, titled "Expert Opinion on Perioperative Management of Bleeding and Coagulation in Anesthesiology (2026 Edition)". Focusing on the entire perioperative process, it covered coagulation assessment and monitoring, indications for blood product transfusion, rational use of hemostatic agents, and individualized strategies for special populations, including patients on antithrombotic therapy and those undergoing cardiac, neurosurgical, orthopedic or obstetric surgery. It emphasized preoperative risk screening, intraoperative dynamic monitoring, and post-operative balance between hemostasis and thrombosis prevention. Clinical decision-making should integrate the patient's baseline condition, surgical type, and real-time monitoring results. This opinion aims to provide standardized, multi-disciplinary guidance, optimize management protocols, reduce transfusion-related risks and thrombotic complications, and ultimately enhance perioperative patient safety and improve outcomes.

Medical education is moving beyond a model dominated by classroom teaching and opportunistic bedside exposure toward one characterized by contextualization, interactivity, continuity, and competency-based learning, driven by the rapid development of extended reality, artificial intelligence, digital humans, virtual patients, digital twins, and the Internet of Medical Things. Metaverse medicine should not be understood as a single device or software platform; rather, it represents an integrated educational and clinical ecosystem built on immersive interaction, virtual-real fusion, real-time connectivity, and data-driven learning. Respiratory education is particularly well suited to this transformation because it involves complex knowledge structures, dynamic monitoring, procedure-intensive training, and strong reliance on teamwork and workflow coordination. Current evidence suggests that XR/VR/AR, virtual patients, simulation-based education, and large language model-assisted teaching can improve knowledge acquisition, procedural performance, learner engagement, and clinical reasoning, although stronger evidence is still needed regarding long-term transfer, real-world clinical outcomes, and cost-effectiveness. In respiratory education, digital human teachers, virtual cases, virtual wards, bronchoscopy and EBUS simulation, immersive training for respiratory failure recognition, and mechanical ventilation education appear to be the most practice-relevant and immediately actionable scenarios. In parallel, concepts proposed by Professor Chunxue Bai’s team—including metaverse medicine, medical GPT, and BAIMGPT—provide an important localized theoretical foundation and implementation pathway for the intelligent upgrading of respiratory education in China. This review summarizes the theoretical basis, major application scenarios, educational value, practical challenges, and implementation strategies of metaverse medicine in respiratory education, with the aim of informing future educational reform and talent development in respiratory medicine.

Key Words: metaverse medicine; respiratory education; digital human teacher; virtual case; virtual ward; immersive clinical training; BAIMGPT

Objective: This study utilizes finite element modeling to investigate the coupled electric-thermal field distributions for three novel electrode designs, assessing their ability to induce electric breakdown in saline for plasma generation. Furthermore, the ablation effects of various electrode shapes were validated through ex vivo tissue ablation experiments, ensuring both the safety and feasibility of the electrodes. Methods: Three electrode structures were designed: the ring-needle electrode, the needle electrode, and the cylinder electrode. A COMSOL Multiphysics finite element model simulated their behavior in saline. This modeling approach enabled a detailed analysis of the spatial variations in both the electric and temperature fields. Furthermore, the electrodes were tested at four voltages (180 V, 220 V, 260 V, and 300 V) and a frequency of 100 kHz on porcine liver tissue to evaluate ablation performance. Results: Simulations showed temperatures of 25-70 °C at 0.3 mm above the three electrodes, with electric field strength exceeding 1 *10^6 V/m, which are sufficient to trigger electric breakdown and plasma formation. Ex vivo experiments confirmed ablation efficacy, with the ring-needle electrode exhibited the best performance at a voltage of 300 V, achieving a 2.3 mm ablation depth and 0.72 mm² thermal damage area. Conclusion: Finite element simulation and ex vivo experiments demonstrate the feasibility of the proposed electrodes, highlighting their potential as an innovative solution for plasma-based ablation technologies.

The consequences induced by the use of general anesthetics and better options of the drugs in children and infants have been topics of controversy due to the concerns about their potential impact on cognitive function. To address these concerns and ensure the safety of pediatric general anesthesia, this paper reviews existing basic and clinical studies that have investigated the mechanisms of general anesthetics on pediatric cognitive function. In this paper, the basic research on neurotoxicity of general anesthetics and the clinical research on the effects of general anesthesia drugs on cognitive function in children in recent years were analyzed and summarized. Although some of the clinical studies have suggested that general anesthesia in children or infants may cause neurocognitive damage and a series of behavioral complications, the results of the retrospective studies need to be viewed with caution as they may lack effective control for relevant factors that could have impacts in the perioperative period. It remains uncertain whether general anesthetics affect the cognitive function of pediatric patients. Further research is needed to establish clear evidence-based recommendations for clinical prevention and treatment measures to minimize the potential risks associated with the use of general anesthetics.

With the advancement of metaverse technology and the successful commercialization of head-mounted displays, the application prospects of the metaverse in medical education are increasingly prominent. This article systematically reviews the latest advancements in the application of the metaverse in otolaryngology and head and neck surgery, and proposes ideas for specialty construction. VR surgical simulators, 3D printing combined with VR technology, can significantly improve trainee assessment scores and operational confidence, optimizing hand-eye coordination and spatial perception abilities. AR microscope systems enable contactless interaction through gesture recognition, enhancing surgical efficiency. AR navigation platforms demonstrate real-time 3D visualization advantages in craniofacial surgery, and VR and 360° video training effectively improve the anterior nares packing skills of junior doctors. VR-assisted teaching for peritonsillar abscess drainage significantly enhances medical students' structured clinical examination scores, operational confidence, and engagement. Integrating 3D virtual models and image overlay technology in transoral robotic surgery provides practical value for image-guided surgery. VR technology can effectively alleviate pain and anxiety in patients undergoing otolaryngological surgery, improve satisfaction, and serve as a non-pharmacological intervention to reduce opioid use. VR combined with wearable devices can reduce postoperative opioid consumption, and VR vestibular rehabilitation training can enhance treatment compliance and quality of life for patients with otolith disorders. VR has become an innovative component of ENT digital teaching, demonstrating equivalent or even superior effects compared to traditional methods in anatomy, physiology, and pathology teaching. Based on these advancements, this article proposes the idea of relying on the "Fudan Zhongshan Huisheng Zhiyu" metaverse platform to build a specialized teaching system for otolaryngology: constructing high-fidelity 3D digital twin models and a structured case resource library, forming a tiered training path covering institutional education, post-graduation education, and continuing medical education, promoting the dissemination and sharing of high-quality teaching resources, and driving the innovative development of otolaryngology medical education in China.

Key Words: full-cycle medical education; training and management; Fudan Zhongshan Huisheng Zhiyu; metaverse platform; virtual reality