On March 27, 2022, Shanghai is facing a new round of COVID-19 epidemic. In order to cut off the spread of the virus, the city gradually "silenced" and the whole city is ready. At this moment, a battle to defend life started in Shanghai Ruijin Hospital : On the same day, the operating room received an emergency notice to prepare for a heart transplant. The patient's heart function was already extremely poor, and he was in the auxiliary state of ECMO, and it combined with liver, kidney, lung and other multiple organ dysfunctions.
surgical treatment team gathered as soon as possible. Everyone knows that at this moment, a team is indispensable - that is, the anesthesia team. For any high-difficulty surgery, the anesthesia team determines whether the surgery can be opened, whether it can be opened safely, and whether it can be completed safely. Understanding this responsibility deeply, Ruijin Hospital's anesthesia team, who received the notice, quickly assembled elite troops to formulate accurate surgical guarantee plans, and spared no effort to ensure the safety of patients' lives. On this day, when the heartbeat recovered again, Ruijin anesthesia once again completed his mission.
Ruijin Anesthesiology Department is a department with a glorious history of more than 70 years. Currently, the department has more than 100 members and an annual operation volume of more than 150,000 cases. As the chairman unit of the Anesthesiology Branch of the Chinese Medical Association and the president unit of the Anesthesiology Branch of the Chinese Medical Association, Ruijin Anesthesiology Department has always ranked first in the national hospital rankings since 2012, and is in a leading position in the domestic and internationally advanced disciplines. Adhering to the concept of "ideal anesthesia, safety cornerstone, and comfortable medical care", Ruijin Anesthesia has always taken inheritance and innovation as its mission, and has always taken serving the people as its mission, and has broadened the depth and width of modern anesthesia and even modern medicine through the repeated "challenging the impossible" of patients.
Seventy years of hardships: Development is courage, inheritance is mission, and innovation is challenge
"Anesthesia", as the name suggests, "naesthesia" is numbness and paralysis, and "drunk" is drunk and coma. In short, anesthesia is the use of drugs to temporarily lose consciousness in the whole or local area, so as to achieve painless purpose for surgical treatment. It should be said that the establishment and development of modern anesthesia have bid farewell to the "rabbited era" of modern medicine. For many years, surgical operations have been performed after binding patients, stunning, drunken, and causing bleeding to cause shock to . It was not until the emergence of anesthesia that all this ended.
In China, the creation of modern anesthesia was almost the same as that of New China. In the 1950s, the Department of Anesthesiology of Guangci Hospital (now Ruijin Hospital) was officially established. At the beginning of the founding of New China, medicine was in ruins. Under the leadership of Professor Li Xingfang and Professor Shi Jixiang and Professor , Shi Jixiang and , the Department of Anesthesiology at Ruijin Hospital opened up its territory, especially setting a precedent for cardiac anesthesia in my country.
In 1986, Professor Li Xingfang received
At that time, due to the limited time of blocking the heart at low temperature, many complex heart surgeries could not be performed. In 1958, Professor Li Xingfang took the lead in developing and using the domestic artificial heart and lung machine . Under the protection of extracorporeal circulation , he successfully performed anesthesia for atrial and ventricular septal defect repair surgery.
Development is courage, innovation is a challenge, and Ruijin Anesthesia continues to try to make breakthroughs. In 1958, Ruijin anesthesia was first anesthetized with muscle relaxant and artificial hibernation technology, ensuring that Qiu Caikang was successfully rescued by the first international patient with severe severe burns on a large scale. In 1977 and 1978, Professor Li Xingfang led the anesthesia team to protect him and cooperated perfectly. Ruijin Hospital successfully carried out the first liver transplant in China and the first heart transplant in China.
Professor Shi Jixiang (first from right) Anesthesia treatment for critically ill patients in skin grafting surgery
. Anesthesiologists are like "running on the edge of a cliff". The terrain here is very dangerous and the scenery here is infinitely beautiful. The Ruijin anesthesia team challenged such "runs" again and again. The confidence comes from the careful study of medical skills, and the courage comes from the concern for life.
996, Yu Bu, a famous professor of anesthesiology in my country, embarked on a new journey of the development of the science of anaesthesiology in Ruijin.Professor Yu Buwei was the first in China to establish the "philosophical thinking of clinical anesthesia" and proposed the concepts of "ideal anesthesia state" and "precise anesthesia management" for the first time. Through comprehensive quantitative evaluation of anesthesia, analgesia, muscle relaxation and anti-nociceptive feelings, clinical anesthesia becomes a science that can be reproduced repeatedly, achieving a safe, unconscious, painless, and memory-free clinical anesthesia satisfactory state. Under the guidance of advanced anesthesia concept, Ruijin anesthesia team has accumulated rich clinical experience and proposed a breakthrough initiative of "no contraindications to anesthesia" - expanding the surgical population, ensuring the perioperative safety of critically ill patients, and helping the development of surgical operations!
Perioperative volume management has been the focus of debate among anesthesiologists in terms of clinical technology. Under the leadership of Professor Yu Buwei, Ruijin Anesthesiology Department actively explored circulating capacity management, formed an advanced capacity management strategy, and established and improved the "high capacity filling during the anesthesia induction period" and "effective blood volume assessment technology". At the same time, Ruijin Anesthesia has explored and practiced the "sandwich method" anesthesia technology, relying entirely on inhalation anesthesia technology, deep anesthesia and extubation technology, deep electroencephalopathy anesthesia deep monitoring technology, perioperative brain function evaluation and cognitive dysfunction risk prevention strategies, and difficult airway management optimization technology, forming distinctive core clinical anesthesia technology.
It is under the guidance of advanced concepts and technology that Ruijin anesthesia completed countless critically ill patients and major surgical anesthesia: in 2002, the first liver and kidney combined transplant surgery was completed in China; in 2004, the first total abdominal organ transplant surgery was completed in China; in 2005, the first cesarean section and liver transplant surgery was successfully performed in one week for patients with pregnancy and acute liver failure; in 2005, the surgical anesthesia of pheochromocytoma patients with more than 10,000 blood methoxynorepinephrine (NMN) and methoxyadrepinephrine (MN) were completed; in 2008, the successful treatment of severe bleeding for women with Rh-negative placenta previa... The successful treatment of these patients reflects the clinical advantages of Ruijin Anesthesiology Department and the comprehensive strength of Ruijin Hospital.
is also in the process of such major rescues, which makes people more deeply realize that anesthesia is not as simple as an auxiliary department in a hospital. Anesthesiology is a comprehensive discipline that studies anesthesia, analgesia, emergency resuscitation and critical care medicine. At the same time, anesthesia is also an emerging discipline. Many new theories, new technologies, new drugs and new instruments have been applied in the clinical and research of anesthesia, and many new problems need to be further studied and explored.
In 2010, Ruijin Anesthesiology Department won the first batch of national clinical key construction specialties and national clinical drug trial bases. At the same time, it is also the six clinical technical training centers of the Anesthesiology Branch of the Chinese Medical Association (i.e., the elderly anesthesia, intravenous target-controlled infusion technology, inhalation anesthesia technology, peripheral nerve block technology, deep anesthesia technology for EEG monitoring, and training for the director of the Department of Anesthesiology at the grassroots hospital). In 2015, Ruijin Anesthesiology Department won the first batch of important weak disciplines in Shanghai. In 2018, it won the Shanghai Clinical Key Clinical College.
In 2018, Professor Luo Yan took over the baton of the department director. Under the guidance of the tutor's philosophy, he inherited and innovated, vigorously developed the treatment of critical and comfortable medical diagnosis and treatment, and continued to write a new chapter in the development of Ruijin anesthesia in all aspects of medicine, education, and research. At the most severe moment of the COVID-19 epidemic in 2022, Professor Luo Yan led Ruijin anesthesia to stay at his post, overcome all difficulties, successfully implemented heart transplant surgery anesthesia and lung transplant surgery anesthesia, and successfully treated patients with severe bleeding from liver cancer and 15-year-old children with severe infection with esophageal tracheal fistula... The extraordinary rescue in extraordinary times, from years of accumulation, Ruijin anesthesia always has a tenacity that is about to emerge. Those who have taken different ways and broke the rules, those who dare to think and act, and have hills and valleys in their chests, gradually converged into a magnificent river.
Anesthesia Responsibility: "Anesthesia Teaching" Gold Signature, Standardized Training Adds a Guarantee to Life
Ruijin Anesthesiology Department As a standardized training base for resident and specialist anaesthesia in Shanghai, it has absorbed batches of intern doctors, resident doctors, specialist , and advanced practitioners in Ruijin Anesthesiology Department to improve their skills.
Under the leadership of Professor Luo Yan, the teaching group conducted a series of explorations and formulated a "standardized training plan for anesthesia" based on the training modes of different doctors, and implemented a multi-mode, multi-level, advanced training plan for "theoretical foundation, skill training, simulation drills, and clinical practice".
Department regularly holds basic theoretical training on online classes in the anesthesiology department, teaching rounds , small lectures, difficult case discussions, and business learning within the department. Combined with the high-quality platform of Ruijin Medical Simulation Center, a special training project for advanced anaesthesia skills "Ma Shen Forging Camp" was opened, and a special simulation drill was designed - to advance the clinical anesthesia quality control nodes and improve the safety of clinical practice.
combined with the new field of core clinical anesthesia technology, Ruijin anesthesia has set up a series of unique training courses:
visual technology greatly reduces the risks of "blind injection" and "blind injection" in the past, and also changes the identification and processing of difficult airways. Combined with visual tracheal intubation tools, targeted training of difficult airway plans and treatment methods. Ultrasound technology gives anesthesiologists a "fluoroscopic eye". The training content covers many fields. In diagnosis, focus on core function monitoring, blood volume assessment, deep venous thrombosis diagnosis, difficult airway assessment, gastric content assessment, lung function assessment, etc.; in treatment, focus on peripheral nerve block, deep venous puncture, etc. In the training class for transesophageal heart ultrasound, the students observed the heart structure through real pig heart anatomy, and were extremely involved, saying "too intuitive!" The deep anesthesia technology of electroencephalopathy has completely changed the experience of "hair estimation" in the past, and advanced to the field of precise anesthesia to ensure the development of special surgeries such as cardiovascular surgery, intraoperative awakening, and spinal nerve electrophysiological monitoring. As an in-depth technical training center for the Asian EEG monitoring and anesthesia, Ruijin Anesthesiology Department focuses on improving meticulous monitoring, trains anesthesiologists to comprehensively interpret important organ monitoring indicators, and establish individualized and accurate anesthesia plans.
In 2020, Ruijin's standardized anesthesia training was included in the anesthesia nursing team, starting with basic knowledge and basic skills of anesthesia, allowing anesthesia nurses to be familiar with the work content in an easy-to-understand manner and quickly adapt to clinical work. At present, anesthesia nurses are active in various positions in the clinical and logistics work of the Department of Anesthesiology, becoming another line of defense for the safety of clinical anesthesia.
After years of exploration and practice, Ruijin Anesthesiology Department has formed a unique "ansthesis teaching brand". Over the years, it has organized and undertaken the standardized training of Shanghai resident physicians and the examination training, served as a question assessment expert, participated in the national-level Shanghai resident training policy research, standard plan formulation, etc.; held national and college-level teacher training; demonstrated teaching rounds and scenario simulation results nationwide. So far, Ruijin Anesthesia has compiled and published a number of special textbooks, including "Demonstration Cases of Standardized Training for Residents", "Handbook of Clinical Anesthesia", "Sub-volume of Standardized Tutorial on Physician Assessment Training for Anesthesia", etc., and has written "China's Shortcut Guide for Anesthesia in 2014/2017" and "Anesthesia Technical Operations of Industry Technical Standards of the People's Republic of China", which are promoted nationwide as anesthesia operation specifications.
teaching helps clinical practice, and standards improve the bottom line! Turn risks into plans, write them efficiently into processes, integrate safety and quality development, and the advanced concepts and technical effects of Ruijin anesthesia are constantly amplifying, fundamentally benefiting more patients.
3 From the past to the future: Face opportunities and challenges, realize the five major visions of anesthesia discipline
After more than 70 years of development, the talent echelon of the Department of Anaesthesiology has been steadily moving forward, and its comprehensive academic influence has been increasing year by year. At present, Ruijin Anesthesiology Department undertakes many research projects such as the National Natural Science Foundation of China, the Ministry of Health and the Shanghai Municipal Science and Technology Commission, and is committed to the fields of sepsis and organ protection, general anesthesia mechanism, anesthesia and cognition. It has published more than 200 SCI papers, and many achievements have provided an important theoretical basis for clinical anesthesia. During this period, Ruijin anesthesia has never stopped the exploration and practice of modern anesthesia medicine.
In 2018, Professor Yu Buwei established the world's first anesthesia treatment department, carried out clinical practice of anesthesia treatment, and performed anesthetic treatment for patients suffering from refractory psoriasis, tetanus , rabies , stubborn insomnia , amyotrophic lumbar disease and other diseases. By reducing sympathetic nerve tone and blocking excessive activation of the immune system, all achieved effective clinical remission effects.
In 2022, Yu Bu published innovative research results for targeting sensory nerve treatment of psoriasis, and achieved excellent industry reputation and social reputation.
Anesthesia therapy is a new way to use the concept of anesthesia to treat primary, stubborn and difficult diseases. It is expected to bring breakthroughs to more medical problems and bring hope for survival to more patients. Of course, the road that few people are interested in may intertwin, and moving forward to the unknown seems to be a tradition of genes engraved with Ruijin anesthesia.
With the development of medical science, patients have also put forward higher requirements for the discipline of anesthesia. Patients are no longer satisfied with safe and smooth passage of perioperative period, but seek a comprehensive range of comfortable and painless medical services and experiences. As the public service platform department of Ruijin Hospital, Ruijin Anesthesiology Department coordinates and cooperates with the sister departments. From the patient's admission to rehabilitation and discharge, it plays a leading role in the rapid rehabilitation system - preoperative evaluation of anesthesia, painless diagnosis and treatment, precise intraoperative management, individualized postoperative analgesia, etc. Comfortable medical care has always been throughout it to protect the entire perioperative period.
Looking back at the road of the past, walking the path of the footsteps, and looking at the future, Ruijin anesthesia discipline team remembers the scientific training of "noble medical ethics, excellent medical skills, honest medical style, and elegant medical style", and put forward new development goals - to realize the five major visions of the discipline of anesthesia: becoming the dominant discipline to promote the development of "comfortable medical care", becoming a key discipline to ensure medical safety, becoming a hub discipline to improve hospital work efficiency, becoming a central discipline to coordinate the relationship between various disciplines, and becoming a key discipline that is well-known and recognized by the society.
From Guangci to Ruijin , over the past 100 years, the brilliant Guangci University internal medicine and major surgery have developed forward, gradually forming various advantageous specialties today, and under the guidance of the spirit of "broad, loving, and pursuing excellence", they have continuously climbed new peaks in medicine. On the occasion of the 115th anniversary of the founding of the hospital, the column "Ruijin Famous Science" was launched, allowing us to get closer to these advantageous disciplines of Ruijin Hospital and understand how they shoulder the important tasks of the "national team".
Written by: Lv Zhuochen, Xu Yiqiong, Tang Wenjia,
Edited by: Zhang Ziqing,
