Asploro Open Access Publications (2025)

14/11/2025

Peripheral Nociceptor Input and Central Sensitization in Fibromyalgia: A Systematic Review and Meta-Analysis

Meisam Ahmadi Nejad1iD*, Arnold Desman Das1iD, Alexandra Ivanenko1iD, Hanh Nguyen-Clark1, Sabina Dhillon1iD

1 Medical Student, , School of Medicine, USA

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Review Article
DOI: https://doi.org/10.36502/2025/ASJBCCR.6423
Asp Biomed Clin Case Rep. 2025 Sept 10;8(3):256-62

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Abstract
Fibromyalgia (FM) is a prevalent nociplastic pain disorder characterized by widespread musculoskeletal pain, fatigue, sleep disturbance, and cognitive impairment. Central sensitization (CS), amplified pain processing within the central nervous system, is widely accepted as a core mechanism in FM pathophysiology. Whether ongoing peripheral nociceptor input is required to initiate and sustain CS in established FM remains controversial, despite evidence of subtle inflammation, muscle or metabolic abnormalities, and small-fiber pathology. This systematic review and meta-analysis integrate mechanistic and observational evidence from quantitative sensory testing, local anesthetic blocks, small-fiber neuropathy (SFN) studies, muscle and microcirculatory assessments, and markers of low-grade inflammation to reappraise the peripheral contribution to CS. Findings from local anesthetic block studies show that tonic peripheral input can dynamically modulate and maintain CS in some individuals, whereas the frequent observation of SFN (approximately 50%) and emerging metabolic or inflammatory data suggest clinically relevant peripheral drivers may define distinct FM phenotypes. Debate persists over the relative importance of peripheral versus central mechanisms, the clinical relevance of SFN, and the impact of minor peripheral changes when overt pathology is absent. Clarifying these issues has important implications for patient stratification and personalized treatment. The review underscores the need for high-quality longitudinal trials that simultaneously track peripheral and central sensitization dynamics, to illuminate the dynamic interplay between peripheral pathology and central pain amplification in FM.
This review was retrospectively registered with PROSPERO (CRD420251077548).

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Fibromyalgia review on central sensitization, nociplastic pain, peripheral nociceptive input, and small-fiber neuropathy mechanisms.

14/11/2025

Oliceridine: Progress in Clinical Research on a New Analgesic Drug

Ruixue Li1,2*

1 Department of Anesthesiology, West China Hospital, , Chengdu, Sichuan Province, China
2 The Research Units of West China (2018RU012), Chinese Academy of Medical Sciences, Chengdu, Sichuan Province, China

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Review Article
DOI: https://doi.org/10.36502/2025/ASJBCCR.6422
Asp Biomed Clin Case Rep. 2025 Aug 28;8(3):250-55

PDF:https://asploro.com/wp-content/uploads/2025/08/Oliceridine-Progress-in-Clinical-Research-on-a-New-Analgesic-Drug.pdf

HTML: https://asploro.com/asjbccr/oliceridine-progress-in-clinical-research-on-a-new-analgesic-drug/

Abstract
Oliceridine is a new class of μ-opioid receptor agonists, which is relatively selective to μ-opioid receptors and exerts analgesic effects by interacting with μ-opioid receptors (MORS). Compared with morphine, it has the characteristics of fast onset, strong analgesic effect, low incidence of respiratory depression and gastrointestinal adverse reactions, and less neurological complications. It is a safe and effective intravenous analgesic, providing a better choice for the treatment of patients with moderate to severe acute pain. In this paper, the mechanism of action, pharmacodynamics and pharmacokinetics, clinical application and development trend of oliceridine were reviewed, so as to provide theoretical basis for clinical application.

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Review of Oliceridine, a novel μ-opioid analgesic drug with rapid onset, strong effect, fewer side effects, and promising clinical applications.

14/11/2025

Awake Fiberoptic Double-Lumen Intubation in Traumatic Diaphragmatic Hernia: A Case Report

Qin Hou1*

1 Department of Anesthesiology, West China Hospital, , Sichuan, P. R. China

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Case Report
DOI: https://doi.org/10.36502/2025/ASJBCCR.6420
Asp Biomed Clin Case Rep. 2025 Aug 22;8(3):243-47

PDF:https://asploro.com/wp-content/uploads/2025/08/Awake-Fiberoptic-Double-Lumen-Intubation-in-Traumatic-Diaphragmatic-Hernia-A-Case-Report.pdf

HTML: https://asploro.com/asjbccr/awake-fiberoptic-double-lumen-intubation-in-traumatic-diaphragmatic-hernia-a-case-report/

Abstract
Traumatic diaphragmatic hernia (TDH) poses significant airway management challenges due to risks of visceral herniation and respiratory compromise during positive-pressure ventilation. We present detailed use of awake fiberoptic double-lumen intubation in a 58-year-old male with left-sided TDH following a car accident. Preoperative CT imaging demonstrated a 12 cm diaphragmatic defect with gastric herniation and rightward tracheal deviation (> 15 mm displacement). Given the possible difficult airway and high aspiration risk, we implemented awake fiberoptic double-lumen intubation with topical lidocaine analgesia, maintaining spontaneous breathing without neuromuscular blockade until the hernia sac was controlled. The patient kept oxygen saturation > 95% with stable hemodynamics (BP 135–145/75–88 mmHg, HR 70–85 bpm, RR 16–20 bpm).

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Awake fiberoptic double-lumen intubation for Traumatic Diaphragmatic Hernia. Case highlights airway management strategy with safe outcomes.

27/10/2025

Anesthesia Induction and Reflections for a Giant Floor of Mouth Mass in an Infant: A Case Report

Xiao Bai1*

1 Department of Anesthesiology, West China Hospital, , Chengdu, Sichuan, China

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Case Report
DOI: https://doi.org/10.36502/2025/ASJBCCR.6421
Asp Biomed Clin Case Rep. 2025 Aug 20;8(3):248-49

PDF:https://asploro.com/wp-content/uploads/2025/08/Anesthesia-Induction-and-Reflections-for-a-Giant-Floor-of-Mouth-Mass-in-an-Infant-A-Case-Report.pdf

HTML: https://asploro.com/asjbccr/anesthesia-induction-and-reflections-for-a-giant-floor-of-mouth-mass-in-an-infant-a-case-report/

Abstract
Infants possess unique anatomical and physiological characteristics that increase the risk of severe hypoxemia during airway management. A floor of mouth mass causing tongue displacement may directly induce airway obstruction, further elevating anesthetic risks. This report details the anesthesia induction strategy for a 3-month-old infant with a giant floor of mouth mass, discussing safe airway establishment in pediatric difficult airways.

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Anesthesia induction in a 3-month-old with Giant Floor of Mouth Mass. Highlights Pediatric Difficult Airway, Kaposi Sarcoma, and airway management strategy.

27/10/2025

Anesthetic Induction Strategy for a Patient with a Giant Aortic Arch Aneurysm Compressing the Main Airway: A Case Report

Xiao Bai1*

1 Department of Anesthesiology, West China Hospital, , Chengdu, Sichuan, China

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Case Report
DOI: https://doi.org/10.36502/2025/ASJBCCR.6419
Asp Biomed Clin Case Rep. 2025 Aug 20;8(3):240-42

PDF:https://asploro.com/wp-content/uploads/2025/08/Anesthetic-Induction-Strategy-for-a-Patient-with-a-Giant-Aortic-Arch-Aneurysm-Compressing-the-Main-Airway-A-Case-Report.pdf

HTML: https://asploro.com/asjbccr/anesthetic-induction-strategy-for-a-patient-with-a-giant-aortic-arch-aneurysm-compressing-the-main-airway-a-case-report/

Abstract
Isolated aortic arch aneurysms are relatively rare, accounting for 21.3% of thoracic aortic aneurysms. However, with an aging population and advancements in imaging technology, the detection rate of aortic arch aneurysms has gradually increased. Key risk factors include age, gender, hypertension, atherosclerosis, hereditary connective tissue disorders, and infections. A giant aortic arch aneurysm is not only a “ticking time bomb” within the patient but also poses significant challenges for anesthesiologists when associated with airway compression, which can lead to airway and circulatory collapse during induction. We report a case of a 52-year-old male who presented with chest pain; imaging revealed a giant aortic arch aneurysm compressing the main airway. The patient underwent total aortic arch replacement under general anesthesia, with a successful surgery. We share this case to discuss the anesthetic induction process and insights for managing aortic arch aneurysms with airway compression.

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Case of Giant Aortic Arch Aneurysm with Airway Compression managed under Anesthetic Induction using Remimazolam and Succinylcholine.

15/10/2025

A Female Case with Alcohol-Associated Liver Disease (ALD) and Medical and Psychological Problems

Hiroshi Bando1,2iD*, Hisako Yamash*ta1, Yoshinobu Kato1, Katsunori Ogura1, Yoshikane Kato1

1 Kanaiso Hospital, Komatsushima, Tokushima, Japan
2 Medical Research/ , Tokushima, Japan

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Case Report
DOI: https://doi.org/10.36502/2025/ASJBCCR.6418
Asp Biomed Clin Case Rep. 2025 Aug 20;8(3):234-39

PDF:https://asploro.com/wp-content/uploads/2025/08/A-Female-Case-with-Alcohol-Associated-Liver-Disease-ALD-and-Medical-and-Psychological-Problems.pdf

HTML: https://asploro.com/asjbccr/a-female-case-with-alcohol-associated-liver-disease-ald-and-medical-and-psychological-problems/

Abstract
Current case is a 54-year-old female with alcohol-associated liver disease (ALD). She suffered from depression, panic disorder, and self-harm in her 30’s, and has recently drunk more. The blood chemistry in 2023 showed AST 144 U/L, ALT 22 U/L, gamma-glutamyl transpeptidase (GGT) 1117 U/L, uric acid (UA) 12.2 mg/dL, and mean corpuscular volume (MCV) 115 fL, and then she was hospitalized and treated. Furthermore, she was diagnosed with psoriasis, probably related to alcoholism. She recently showed improvement in blood tests, and fatty liver, gallstones, and a pancreatic cyst by abdominal CT scan. Elevated AST/ALT ratio may indicate the advance of liver fibrosis.

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Case of Alcohol-Associated Liver Disease with elevated Gamma Glutamyl Transpeptidase, high Mean Corpuscular Volume, Psoriasis, and AST/ALT Ratio.

15/10/2025

Breakthrough of False Negative: A Case of Protracted H1N1 Influenza with Chest Pain Onset Implications for The Diagnosis and Treatment of Encapsulated Empyema

Binrong Cai1,2, Xian Yu1,2, Yiqin Xia1,2iD*

1 Department of Emergency Medicine, West China Tianfu Hospital, , Chengdu, 610023, Sichuan, China
2 Department of Emergency Medicine, West China Hospital, , Chengdu, 610041, Sichuan, China

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Case Report
DOI: https://doi.org/10.36502/2025/ASJBCCR.6416
Asp Biomed Clin Case Rep. 2025 Aug 18;8(3):219-27

PDF:https://asploro.com/wp-content/uploads/2025/08/Breakthrough-of-False-Negative-A-Case-of-Protracted-H1N1-Influenza-with-Chest-Pain-Onset-Implications-for-The-Diagnosis.pdf

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Abstract
Background: Influenza A (H1N1) infection usually has a self-limiting course (5–7 days), but some patients may progress to severe pneumonia or complications, resulting in a significantly prolonged course of the disease. This case reports a special case of protracted H1N1 infection lasting more than one month. The patient presented with persistent chest pain (>1 month) as the initial symptom. The preliminary diagnosis was “encapsulated empyema.” The results of multiple PCR tests on respiratory samples (swabs from the throat and sputum) in the early stage of fever were negative, masking the existence of the disease, and secondary bacterial mixed infections occurred. Through targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid (BALF), it was finally confirmed as H1N1 virus infection. This highlights the crucial diagnostic value of lower respiratory tract sample testing in overcoming false negatives in upper respiratory tract testing. Further analysis revealed that the patient’s weakened immunity might be a new risk factor for protracted influenza, providing clinical implications for the delayed initiation of antiviral treatment and the management of encapsulated empyema.
Case Presentation: This article reports a 49-year-old male patient who had a history of gastric perforation surgery and appendicitis surgery. He was admitted to the hospital with chest pain for more than 1 month and fever for 2 days. The final diagnosis was influenza A (H1N1) combined with purulent pleural effusion caused by Fusobacterium nucleatum and Klebsiella pneumoniae infection. The patient initially presented with a large amount of encapsulated pleural effusion on the right side. Empirical use of “ceftriaxone” for 5 days of anti-infection treatment was ineffective. The pleural fluid tNGS indicated “Fusobacterium nucleatum sequence number 9, relative abundance 49.9%.” Subsequently, the treatment was adjusted to “piperacillin-tazobactam” for 3 days. The patient no longer had fever, but on the 18th day of treatment, the patient had a fever again. The re-examination of nasopharyngeal swabs for influenza A and B antigens was all “negative.” The treatment continued with “piperacillin-tazobactam.” On the 21st day, the patient still had a fever. Bronchoalveolar lavage fluid tNGS indicated “influenza A virus H1N1 sequence number 1344, relative abundance 76.2%, Klebsiella pneumoniae sequence number 50, relative abundance 0.3%.” On the 22nd day, oseltamivir was added for antiviral treatment for 1 day. The fever was controlled, and the patient’s condition improved and was discharged. On the 29th day of follow-up after discharge, the patient’s pulmonary infection and pleural effusion had significantly absorbed.
Conclusion: This case suggests that for patients with refractory pleural effusion and repeated fever, the possibility of mixed viral and bacterial infection should be considered. When traditional respiratory tract tests are negative, molecular techniques such as BALF tNGS should be actively adopted to clarify the etiological diagnosis and guide precise treatment.

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Breakthrough of False Negative: A Case of Protracted Influenza A H1N1 Virus with Coinfection and Empyema diagnosed by tNGS of BALF.

07/10/2025

Anesthesia Strategy in Giant Thyroid Tumor Causing Critical Tracheal Compression: Case Report

Jingxuan Qiu1*

1 Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, , Chengdu, Sichuan, China

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Case Report
DOI: https://doi.org/10.36502/2025/ASJBCCR.6417
Asp Biomed Clin Case Rep. 2025 Aug 18;8(3):228-33

PDF:https://asploro.com/wp-content/uploads/2025/08/Anesthesia-Strategy-in-Giant-Thyroid-Tumor-Causing-Critical-Tracheal-Compression-Case-Report.pdf

HTML: https://asploro.com/asjbccr/anesthesia-strategy-in-giant-thyroid-tumor-causing-critical-tracheal-compression-case-report/

Abstract
This case report presented the anesthetic management of a 53-year-old male (173 cm, 59 kg) with a giant left thyroid carcinoma causing severe tracheal compression (narrowest diameter ~4 mm) and left vocal cord paralysis, scheduled for resection. Preoperative assessment highlighted a high risk for difficult airway and major hemorrhage.
Anesthesia was induced with incremental sevoflurane to preserve spontaneous ventilation and to confirm unimpeded mask ventilation, followed by rapid sequence induction and successful video laryngoscopy-guided intubation using a 6.5-mm internal diameter nerve monitoring endotracheal tube advanced to 25.5 cm to bypass the stenotic segment. Total intravenous anesthesia (TIVA) with propofol and remifentanil was maintained under BIS guidance.
The 9.5-hour procedure involved significant blood loss (2800 ml), managed with invasive hemodynamic monitoring, vasopressor support (norepinephrine), transfusion of 9 units PRBCs and 800 ml FFP, and TEG-guided coagulation therapy (additional FFP and tranexamic acid) for coagulation factor deficiency and hyperfibrinolysis. Lung-protective ventilation and active thermoregulation were employed.
Despite these measures, prolonged intubation contributed to postoperative pneumonia. The patient was extubated on postoperative day 3, transferred to the ward on day 5, and discharged home on day 18. This case underscores the critical importance of meticulous preoperative planning, advanced airway techniques, goal-directed hemostatic and hemodynamic management, and proactive complication prevention in complex head and neck oncologic surgery with critical airway compromise.

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Anesthetic management of a giant thyroid tumor with airway compression, difficult airway approach, and TEG-guided coagulation therapy.

07/10/2025

Meaningful Correlation among Well-Being, Mindfulness, Socioemotional Competencies (SEC), and Social Media Engagement (SME)

Hiroshi Bando1,2iD*, Yu Nishikiori1, Masahiro Bando1,2, Akiyo Yoshioka1

1 New Elderly Association (NEA) Tokushima, Tokushima, Japan
2 and Medical Research, Tokushima, Japan

Journal of Health Care and Research
ISSN: 2582-8967
Article Type: Commentary
DOI: https://doi.org/10.36502/2025/hcr.6247
J Health Care and Research. 2025 Jul 24;6(2):48-51

PDF:https://asploro.com/wp-content/uploads/2025/08/Meaningful-Correlation-among-Well-Being-Mindfulness-Socioemotional-Competencies-SEC-and-Social-Media-Engagement-SME.pdf

HTML: https://asploro.com/jhcr/meaningful-correlation-among-well-being-mindfulness-socioemotional-competencies-sec-and-social-media-engagement-sme/

Abstract
The authors have been involved in the Japanese Society of Psychosomatic Medicine (JSPM), and their recent activities include multifaceted approaches such as mindfulness, subjective happiness, well-being, socioemotional competencies (SEC), social media engagement (SME), education, and culture. Findings from several studies indicate that the four elements—mindfulness/meditation, happiness/well-being, SEC, and SME—are interrelated through one-way or mutual influences. As SME increases, happiness tends to decrease, suggesting that frequent SME has an inhibitory effect on happiness. Cultural orientation emerged as a moderator influencing the relationship between SEC and happiness. The link between culture and happiness varies depending on cultural alignment and the context-dependence of self-esteem.

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Psychosomatic Medicine study links mindfulness, subjective happiness, cultural orientation, socioemotional competencies, and social media engagement impacts.

27/09/2025

Association between Weight-adjusted Waist Index and Pulmonary Function: A Population-Based Study from the NHANES (2007–2012)

Jingxuan Qiu1*

1 Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, , Chengdu, Sichuan, China

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Original Research
DOI: https://doi.org/10.36502/2025/ASJBCCR.6415
Asp Biomed Clin Case Rep. 2025 Aug 08;8(2):210-18

PDF:https://asploro.com/wp-content/uploads/2025/08/Association-between-Weight-adjusted-Waist-Index-and-Pulmonary-Function-A-Population-Based-Study-from-the-NHANES-2007%E2%80%932012.pdf

HTML: https://asploro.com/asjbccr/association-between-weight-adjusted-waist-index-and-pulmonary-function-a-population-based-study-from-the-nhanes-2007-2012/

Abstract
Background: The relationship between central obesity and pulmonary function remains a critical area of investigation. The Weight-Adjusted Waist Index (WWI) has emerged as a novel marker for assessing central obesity. This study aimed to investigate the association between WWI and various pulmonary function indices.
Methods: Data were extracted from the National Health and Nutrition Examination Survey (NHANES) 2007–2012, involving 8,361 participants. Participants were categorized into tertiles based on their WWI values. Pulmonary function measures included Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), FEV1/FVC ratio, and Peak Expiratory Flow rate at 25–75% of forced vital capacity (PEF25–75%). Multivariate linear regression models were used to assess associations, adjusting for covariates such as gender, age, race, education level, hypertension, diabetes, smoking status, and poverty index ratio.
Results: Higher WWI was significantly associated with lower FVC, FEV1, and PEF25–75%, but not with FEV1/FVC ratio. Specifically, each unit increase in WWI corresponded to reductions in FVC (-603.9 ml, 95% CI: -628.7, -579.2), FEV1 (-527.7 ml, 95% CI: -547.7, -507.7), and PEF25–75% (-550.5 ml/s, 95% CI: -581.7, -519.3). Sensitivity analyses confirmed these findings after adjusting for multiple covariates. Subgroup analyses indicated similar trends across different genders and age groups.
Conclusion: The Weight-Adjusted Waist Index (WWI) is negatively associated with lung volumes and mid-expiratory flow rates, suggesting its potential role in respiratory impairment. These results underscore the importance of considering central adiposity in clinical evaluations of pulmonary health. Future longitudinal studies are warranted to further elucidate the mechanisms underlying these associations and to validate these findings in diverse populations.

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Weight-Adjusted Waist Index is linked to reduced pulmonary function in NHANES data, highlighting obesity’s impact on lung health.

27/09/2025

Anesthetic Management of Intestinal Ischemic Necrosis Complicated by Septic Shock: A Case Report

Jingxuan Qiu1*

1 Department of Anesthesiology, West China Hospital, , Chengdu, Sichuan, China

Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Case Report
DOI: https://doi.org/10.36502/2025/ASJBCCR.6413
Asp Biomed Clin Case Rep. 2025 Aug 04;8(2):198-202

PDF:https://asploro.com/wp-content/uploads/2025/08/Anesthetic-Management-of-Intestinal-Ischemic-Necrosis-Complicated-by-Septic-Shock-A-Case-Report.pdf

HTML: https://asploro.com/asjbccr/anesthetic-management-of-intestinal-ischemic-necrosis-complicated-by-septic-shock-a-case-report/

Abstract
Intestinal ischemic necrosis is a life-threatening condition caused by compromised intestinal blood flow due to arterial/venous occlusion or vasoconstriction, with acute mesenteric ischemia (60–70% of cases, mortality >60%) and colonic ischemia as primary subtypes. This case report describes the anesthetic management of a 56-year-old male with acute intestinal ischemic necrosis complicated by septic shock, requiring emergent laparotomy. Preoperative assessment revealed hemodynamic instability (HR 130 bpm, BP 85/43 mmHg, SpO₂ 89%) and peritoneal signs.
Anesthesia involved rapid-sequence induction with etomidate/rocuronium and maintenance with sevoflurane–remifentanil under BIS guidance. Hemodynamic stabilization included:

1. Fluid resuscitation (1500 mL crystalloid, 1000 mL colloid, 500 mL fresh frozen plasma) guided by pulse pressure variation (PPV) / transthoracic echocardiography (TTE)
2. Vasopressors (norepinephrine 0.1–0.3 μg/kg/min + vasopressin 0.01–0.02 U/min)
3. Metabolic correction (sodium bicarbonate for pH 7.246, calcium gluconate for Ca²⁺ 0.87 mmol/L)
4. Epinephrine infusion (0.02–0.1 μg/kg/min) improved left ventricular ejection fraction (35% → 45–50%) and right ventricular function
The patient underwent successful small bowel resection (300 cm) with primary anastomosis (operative time: 108 minutes, EBL: 100 mL), was extubated on postoperative day (POD) 3, and discharged on POD 22.
Key anesthetic principles emphasized:

1. Early hemodynamic optimization (MAP ≥65–70 mmHg, urine output >0.5 mL/kg/h)
2. Multimodal monitoring (PPV, TTE, etc.)
3. Balanced fluid/vasopressor therapy
4. Metabolic and temperature control
This case highlights the critical role of tailored anesthetic strategies in managing this high-mortality condition.

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Anesthesia for intestinal ischemic necrosis with septic shock managed via hemodynamic stabilization, emergency laparotomy, and multimodal monitoring.

Asploro Open Access Publications

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