RESUMO
Since December 2019, more than 79,000 people have been diagnosed with infection of the Corona Virus Disease 2019 (COVID-19). A large number of medical staff were dispersed for Wuhan city and Hubei province to aid COVID-19 control. Psychological stress, especially vicarious traumatization (VT) caused by the COVID-19 pandemic, should not be ignored. To address this concern, the study employed a total of 214 general public (GP) and 526 nurses to evaluate VT scores via a mobile app-based questionnaire. Results showed that the VT scores slightly increased across periods of aiding COVID-19 control, although no statistical difference was noted (P = 0.083). However, the study found lower scores for VT in nurses [median = 69; interquartile range (IQR) = 56-85] than those of the GP (median = 75.5; IQR = 62-88.3) (P = 0.017). In addition, the VT scores for front-line nurses (FLNs; median = 64; IQR = 52-75), including scores for physiological and psychological responses, were significantly lower than those of non-front-line nurses (nFLNs; median = 75.5; IQR = 63-92) (P < 0.001). Interestingly, the VT scores of the GP were significantly higher than those of the FLNs (P < 0.001). However, no statistical difference was observed compared with those of nFLNs (P > 0.05). Importantly, nFLNs are more likely to suffer from VT, which might be related to two factors, namely, gender [odds ratio (OR) = 3.1717; 95% confidence interval (CI) = 4.247-18.808; P = 0.002] and fertility [OR = 2.072; 95%CI = 0.626-24.533; P = 0.039]. Therefore, increased attention should be paid to the psychological problems of the medical staff, especially nFLNs, and GP under the situation of the spread and control of COVID-19. Early strategies that aim to prevent and treat VT in medical staff and GP are extremely necessary.
RESUMO
Objective To investigate the impact of thoracic epidural anesthesia on stress hyper-glycemia in patients undergoing major abdominal operations.Methods Forty patients were divided in-to two groups:general anesthesia (group I)and thoracic epidural and general anesthesia (group E). The venous samples were collected for the measurements of blood glucose (Glu),nitric oxide (NO), malonadialdehyde (MDA),glutathione (GSH)and the activities of aldose reductase (AR),glucose-6-phasphate dehydrogenase (G-6PD), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD),catalase(CAT)in red blood cells at 30 min before induction (T0 ),90 min after incision (T1 ),60 min after surgery (T2 )and on the 1st,2nd postoperative day (T3 and T4 ).Results The lev-el of Glu was increased from T1 to T3 in two groups compared with T0 .The activities of AR,G-6PD and CAT in RBC and plasma MDA were increased markedly at T3 while plasma levels of GSH and NO were decreased significantly in group I (P<0.05).Above parameters,except Glu,changed slightly and did not reach significance in group E.Compared to group I,the level of Glu and the activities of AR,G-6PD,CAT in group E were decreased and NO level was increased significantly at T3 (P <0.05).SOD and GSH-Px activity changed slightly within and between two groups.Conclusion Tho-racic epidural anesthesia can effectively attenuate stress hyperglycemia in patients undergoing major abdominal surgery.
RESUMO
Objective To investigate the effects of mannitol on the activity of erythrncyte aldose reduclase (AR),plasma nitric oxide(NO)and malondialdehyde(MDA)concentrations in patients undergoing hepatolobectomy.Methods Forty ASA Ⅰ or Ⅱ patients(aged 24-63 yr and weighing 50-68 kg),receiving combined general and epidural anesthesia and undergoing selective hepatolobectomy,were randomly assigned into a mannitol group (group M)and a normal saline group(group C).During hepatic portal occlusion,normal saline 1.5 ml/kg and 20％ mannitol 1.5 ml/kg were intravenously infused in groups C and M respectively for 30 min.Venous blood samples were collected to measure the erythrocyte AR activity and plasma NO and MDA concentrations at the following time points:before anesthesia induction(T0),at the end of hepatic portal occlusion(T1),at the end of operation(T2),one day after operation(T3)and three days after operation(T4),respectively.Results Compared with group C at T1,2,the erythrocyte AR and plasma MDA concentration decreased while plasma NO concentration increased in group M(P ＜ 0.05).Conclusion Mannitol can reduce hepatic ischemia and reperfusion injury in patients undergoing hepatolobectomy,which may be related to the mechanism of mannitol removing oxygenderived free radicals and inhibiting lipid peroxidation.
