Exploring anesthesiology nurse' presenteeism in China: cross-sectional study.

BACKGROUND: The department of anesthesiology is the main battlefield for the treatment of acute and critical patients, with high work risk and high work pressure. Due to the particularity of the working environment and nature of work, medical staff have become a group with a high incidence of occupational exhaustion and presenteeism. OBJECTIVE: To investigate the current status of presenteeism among anesthesiology nurses in China and to analyze the related influencing factors. METHODS: Three hundred twelve anesthesiology nurses in Sichuan Province were surveyed by means of general data questionnaire, presenteeism scale, work-family conflict scale, perceived social support scale, occupational commitment scale and stress resistance scale from September to November 2023 by convenience sampling method. RESULTS: The total score of presenteeism was (14.67 ± 3.92), the score of work-family conflict was (45.44 ± 15.90), the score of professional commitment was (87.28 ± 14.30), and the score of perceived social support was (66.04 ± 12.78). The evaluation score of stress resistance was (73.35 ± 11.54). The results of multivariate analysis showed that age, education, mode of employment, position, overtime hours per week, work-family conflict, perceived social support and stress resistance were the factors that affected the presenteeism of anesthesiology nurses, which could explain 44.1% of the total variation. The position ( ß = 0.296, P < 0.001), overtime hours per week (h) ( ß = 0.271, P < 0.001), perceived social support ( ß = -0.279, P < 0.001) turned out as the stronger predictors of presenteeism. CONCLUSION: The presenteeism of anesthesiology nurses is at a high level and needs to be further improved. Clinical nursing managers should pay attention to the physical and mental health and special needs of anesthesiology nurses. Interventions are made according to the main influencing factors, so as to reduce the incidence of presenteeism and improve the quality and safety of surgery.

Effect of esketamine on the EC50 of remifentanil for blunting cardiovascular responses to endotracheal intubation in female patients under general anesthesia: a sequential allocation dose-finding study.

BACKGROUND: This study aimed to investigate the effect of esketamine on the dose-effect relationship between remifentanil and the cardiovascular response to endotracheal intubation during target-controlled infusion (TCI) of propofol. METHODS: Patients underwent elective gynecological laparoscopic surgery under general anesthesia with endotracheal intubation, aged 18-65 years, American Society of Anesthesiologists class I or II, 18 kg/m2 ≤ body mass index ≤ 30 kg/m2, were randomly divided into the control (group C) and esketamine groups (group E). Before anesthesia induction, group E received an intravenous injection of 0.3 mg/kg of esketamine, while group C received an equal dose of physiological saline. TCI of propofol to the effect-site concentration (EC) of 3.0 µg/mL, and then TCI of remifentanil to the effect room and intravenous injection of rocuronium 0.6 mg/kg after MOAA/S was 0. Endotracheal intubation was performed after 2 min. Dixon's modified sequential method was used, and the initial EC of remifentanil was 3.0 ng/mL. The EC of remifentanil was determined according to the intubation response of the previous patient, with an adjacent concentration gradient of 0.3 ng/mL. The EC50 and EC95 values and their 95% confidence intervals (CIs) were determined using probit regression analysis. RESULTS: The EC50 for cardiovascular response inhibition to endotracheal intubation using remifentanil was 3.91 ng/mL (95% CI: 3.59-4.33 ng/mL) and EC95 was 4.66 ng/mL (95% CI: 4.27-6.23 ng/mL) with TCI of propofol 3.0 µg/mL. After intravenous administration of 0.3 mg/kg of esketamine, the EC50 of remifentanil was 3.56 ng/mL (95% CI: 3.22-3.99 ng/mL) and EC95 was 4.31 ng/mL (95% CI: 3.91-5.88 ng/mL). CONCLUSIONS: Combined with TCI of propofol 3.0 µg/mL for anesthesia induction, esketamine significantly reduced the EC50 and EC95 of remifentanil to inhibit the cardiovascular response to endotracheal intubation. TRIAL REGISTRATION: The trial was registered in the Chinese Clinical Trials Registry ( www.chictr.org.cn ; registration number: ChiCTR2200064932; date of registration:24/10/2022).

Influence of endothelin A receptor antagonist pretreatment on renal function after cardiopulmonary bypass in beagles / 重庆医学

Objective To observe the influence of endothelin A receptor antagonist pretreatment on renal function after cardiopulmonary bypass (CPB) in beagles.Methods A total of 18 male beagles were selected and allocated to 3 groups (n =6) by adopting the random number table method:sham operation group (Sham group),CPB group and endothelin A receptor antagonist (ETA) group.Sitaxsentan 0.7 mg/kg in the ETA group was infused by continuous pumping for 30 min at 1 h prior to CPB.The body temperature,mean arterial pressure (MAP) and arterial gas were collected.The concentrations of serum creatinine (Scr) and blood urea nitrogen (BUN) were detected.The renal tubular necrosis score was evaluated,and the expression levels of phosphorylated Akt (p-Akt),phosphorylated eNOS (p-eNOS) were also detected.Results Serum SCr and BUN levels at 2 h after CPB in the CPB and ETA group were significantly higher than those before operation (P＜0.05),and the ETA group was obviously lower than the CPB group (P＜0.05);the renal tubular necrosis score in the ETA group was obviously lower than that in the CPB group (P＜0.05).Expressions of p-Akt,p-eNOS in the ETA group were significantly higher than those in the CPB group(P＜0.05).Conclusion CPB might contribute to acute kidney injury,the endothelin A receptor antagonist pretreatment might alleviate acute kidney injury after CPB.

Effect of sitaxsentan on renal microcirculation in beagle dogs undergoing cardiopulmonary bypass:mornitoring using ultrasound microbubble angiography / 中华麻醉学杂志

Objective To evaluate the effect of sitaxsentan on renal microcirculation in beagle dogs undergoing cardiopulmonary bypass(CPB)when ultrasound microbubble angiography was used to monitor renal microcirculation.Methods Eighteen male Beagle dogs,weighing 10-15kg,aged 2-4 yr,were allocated into 3 groups(n=6 each)using a random number table:sham operation group(Sham group),CPB group and sitaxsentan group(S group).Sitaxsentan 0.7 mg/kg was infused over 30min starting from 1 h before CPB in group S.Before CPB(T1),at 1 h of CPB(T2),at the end of CPB(T3)and at 2h after the end of CPB(T4),the time-intensity curve of renal parenchyma perfusion was obtained using ultrasound microbubble angiography,and quantitative parameters including the slope rate of ascending curve(A),area under curve(AUC),derived peak intensity(DPI)and time to peak(TTP)were fitted.Results Compared with Sham group,the value of A was significantly decreased at T2-4,AUC and TTP were increased at T3,4,DPI was decreased at T4 in renal cortex and medulla in CPB group,and the value of A was significantly decreased and TTP was increased at T2-4,AUC was increased at T3,4(P0.05).Compared with CPB group,the value of A was significantly increased and AUC and TTP were decreased at T3,4 in renal cortex and medulla(P0.05).Conclusion Sitaxsentan can improve renal microcirculation in beagle dogs undergoing CPB.

Experimental Study on Immunomodulatory Effect of Ethanol Sediments of the seeds of Descurainia sophia(L.) Webb.ex Prantl / 世界科学技术-中医药现代化

This article was aimed to study the immunomodulatory effect of ethanol sediments of the seeds of Descurainia sophia(L.) Webb. ex Prantl. both in vitro and in vivo. The lymphocyte proliferation test in vitro was carried out to explore the effect of the ethanol sediments on the proliferation of T cell and B cell in the spleen of normal mice. And, the carbon clearance test, serum hemolysin test, and delayed-type hypersensitivity test were used to investigate the influence of fraction on non-specific immunity, humoral immunity and cellular immunity in the immunosuppressive mice induced by cyclophosphamide. Besides, the immunosuppressive model was used to evaluate the effect of fraction on immune organs and content of cellular factors in blood serum. The results showed that the ethanol sediments promoted Concanavalin A (Con A) induced T cell and Lipopolysaccharides (LPS) induced B cell (P < 0.01). It increased the carbon clearance index K, phagocytic index α, half value hemolysis (HC50), and swelling degree of auricula (P < 0.05 or P < 0.01). It reduced the body weight and atrophy of thymus and spleen index (P < 0.05 or P < 0.01). It increased the contents of IL-2, IFN-γ and IL-4 in serum in immunosuppressive mice (P < 0.05 or P < 0.01). It was concluded that ethanol sediments of the seeds of D. sophia(L.) Webb. ex Prantl. can boost the lymphocyte proliferation, protect the immune organs, and enhance the non-specific and specific immunity in immunosuppressive mice, which indicated that it had immune-promotion effect.

Study on Immunomodulatory Effect of Chemical Split Fractions ofMori Cortex / 世界科学技术-中医药现代化

This article was aimed to study immunomodulatory effect of chemical split fractions ofMori Cortex, in order to initially explain effective parts that played a role in immunomodulatory effect ofMori Cortex. The carbon clearance test, serum hemolysin test, E-rosette test, and lymphocyte transformation test were carried out to explore influence of these chemical split fractions ofMori Cortex on immune organs, nonspecific immunity, humoral immunity and cellular immunity. The results showed that in the carbon clearance test, 50% ethanol fraction markedly reduced the thymus index (P<0.01) and the correction indexα (P<0.05). In hemolysin test, the half value hemolysis (HC50) was improved by 30% ethanol fraction and fatty oil fraction (P<0.05). Besides, in the E-rosette test, the E-rosette ration was increased in the 30% ethanol fraction group (P<0.05). In the lymphocyte transformation test, the 30% ethanol fraction can promote the thymus and spleen lymphocytes proliferation (P<0.05 orP<0.01), while the 50% ethanol fraction inhibited the proliferation (P<0.05 orP<0.01). It was concluded that the 30% ethanol fraction can boost both the humoral immunity and cellular immunity; the 50% ethanol fraction can induce the growth of thymus with a suppressive effect on nonspecific immunity and cellular immunity; the fatty oil fraction can improve humoral immunity.