Comparison of Repeated Video Display vs Combined Video Display and Live Demonstration as Training Methods to Healthcare Providers for Donning and Doffing Personal Protective Equipment: A Randomized Controlled Trial.

PURPOSE: The lack of training in personal protective equipment (PPE) donning and doffing is hindering the current fight against the COVID-19 worldwide. In order to enable medical staff to learn how to don and doff PPE faster and more effectively, we compared two training methods of PPE donning and doffing. METHODS: Participants in this study were 48 health care workers randomly divided into two groups. Group A watched a 10-minute demonstration (demo) video four times, while Group B watched the same 10-minute demo video twice and then watched a 10-minute live demo twice. The 40-minute learning time was the same for both groups. A 29-step examination was held after the training was completed. The examination scores of Groups A and B were recorded according to a checklist containing PPE donning and doffing steps . The time spent by the participants on PPE donning and doffing, their satisfaction with the training, and their confidence in donning and doffing PPE accurately were analyzed. RESULTS: The average score of Group B was higher than that Group A, with a mean (SD) of 94.92 (1.72) vs 86.63 (6.34), respectively (P<0.001). The average time spent by Group B was shorter than that spent by Group A, with a mean (SD) of 17.67 (1.01) vs 21.75 (1.82), respectively (P<0.001). The satisfaction and confidence of Group B were higher than those of Group A (P<0.001). CONCLUSION: Compared with repeated video display, combined video display and live demonstration are more suitable training methods for donning and doffing PPE.

Tetramethyl Pyrazine Protects Hippocampal Neurons Against Anoxia/Reoxygenation Injury Through Inhibiting Apoptosis Mediated by JNK/MARK Signal Pathway.

BACKGROUND Tetramethyl pyrazine (TMP) is a typical biologically active alkaloid isolated from the Chinese herb Ligusticum walliichi. It has been reported that TMP shows neuroprotective and stroke injury reductive properties in cerebral ischemia/reperfusion (I/R) animal models. In the present study we sought to investigate the effect and potential intervention mechanism of TMP in anoxia/reoxygenation (A/R) rat hippocampal neurons. MATERIAL AND METHODS After being cultured for 7 days, primary hippocampal neurons were randomly assigned into a normal control group (N), a TMP group (C: 0 ug/ml, L: 60 ug/ml, M: 200ug/ml and H: 800 ug/ml), and a JNK inhibitor group (S: SP600125, 10 µmol/L). A hypoxia/reoxygenation model were prepared 1 h after incubation. Hippocampal neurons were incubated in 90% N2 and 10% CO2 for 2 h, and then reoxygenated for 24 h in an incubator with 5%CO2 at the temperature of 37°C. The apoptosis rate, MKK4 and MKK7 mRNA and JNK kinase protein levels (C-fos, c-jun, and P-JNK) of hippocampal neurons were detected. RESULTS The apoptosis rates of hippocampal neurons induced by A/R showed significant reduction after being pre-treated with JNK inhibitor, TMP 60 µg/ml, 200 µg/ml, and 800 µg/ml. The JNK kinase MKK4mRNA and MKK7mRNA levels, as well as the expressions of C-fos, C-jun, and P-JNK protein levels, were also be reduced. CONCLUSIONS TMP may produce a protective effect in anoxia/reoxygenation-induced primary hippocampal neuronal injury by inhibiting the apoptosis of the hippocampal neurons; the possible mechanism may be inhibition of the JNK signal pathway.

[Effects of electroacupuncture assistant general anesthesia on postoperative cognitive dysfunction of aged patients].

OBJECTIVE: To observe the effects of electroacupuncture (EA) assistant general anesthesia on postoperative cognitive dysfunction (POCD) of aged patients. METHODS: One hundred and twenty senile American Society of Anesthesiology (ASA) grade I - III patients (more than 65 years old) with non-cardiac surgery were randomly assigned to two groups, Group A and Group B, 60 cases in each group. Patients in Group A received general anesthesia, while those in Group B received EA assistant general anesthesia. Patients in Group B received EA at Baihui (DU20), Hegu (LI4), Neiguan (PC6), Zusanli (ST36) 30 min before anesthesia induction to the end of operation. Anesthesia was induced by etomidate 0.2 - 0.3 mg/kg, fentanyl 3-5 microg/kg, cisatracurium 0.15 mg/kg in the two groups. Anesthesia maintenance was provided by sevoflurane and continuous pumping of remifentanil. Tramadol 50 mg was given 30 min before ending the operation. The scores of mini-mental state examination (MMSE), nausea and vomiting were recorded in the two groups one day before anesthesia, the 2nd, 4th, and 6th day after operation. The occurrence of postoperative cognitive dysfunction (POCD) on day 2, 4, and 6 was compared. RESULTS: The occurrence of POCD on day 2 and 4 was obviously lower in Group B than in Group A at the same time period (40.0% vs 66.7%, 13.3% vs 43.3%), showing statistical difference (P < 0.05). There was no significant difference in the pre-anesthesia scores of MMSE between the two groups. The scores of MMSE on the 2nd and the 4th day were higher in Group B than in Group A (21.3 +/- 3.9 vs 18.3 +/- 3.8, 26.4 +/- 2.9 vs 22.9 +/- 3.9, P < 0.05). Compared with one day before anesthesia in the same group, the scores of MMSE were significantly different on the 2nd and the 4th day (Group A: 18.3 +/- 3.8, 22.9 +/- 3.9 vs 27.9 +/- 2.1; Group B: 21.3 +/- 3.9 vs 27.5 +/- 2.5; P < 0.05). The occurrence of post-aesthesia nausea and vomiting was lower in Group B (23.3%, 14/60) than in Group A (46.7%, 28/60) with statistical difference (P < 0.05). CONCLUSION: EA assistant general anesthesia could reduce the occurrence of POCD in aged patients.

[Effects of electroacupuncture anesthesia of different frequencies on stress reaction in thyroid surgery].

OBJECTIVE: To probe into the optimal frequency of electroacupuncture for the access to the best anesthesia. METHODS: Sixty cases of optional thyroid surgery were randomly divided into group A, group B and group C, 20 cases in each group. In group A, 2 Hz/100 Hz disperse-dense wave was selected in stimulation. In group B, 2 Hz/15 Hz disperse-dense wave was selected. Group C was the control group without electric stimulation applied. Hegu (LI 4) and Neiguan (PC 6) were stimulated bilaterally. Cervical plexus block was produced after 15 min acupuncture. The concentration changes in plasma cortisone (COR) and beta-endorphin (beta-EP) were compared among 4 time-points, named before anesthesia (T1), before skin incision after induction (T2), thyroid traction in surgery (T3) and the end of surgery (T4). RESULTS: Group B achieved the highest significant rate of analgesia (50.0%, 10/20) and that in group C was the lowest (10.0%, 2/20). COR content was the highest at T2 in group A and that was the lowest at T3 in group B. At the end of surgery, COR content was up the maximum in 3 groups, but still COR content was the lowest in group B in comparison. The plasma beta-EP content decreased apparently at T3 and T4 in group B as compared with the value before (both P < 0.05). CONCLUSION: In electroacupuncture-assisted anesthesia, 2 Hz/15 Hz disperse-dense wave achieves the optimal anesthesia compared with 2 Hz/100 Hz disperse-dense wave, and moreover inhibits stress reaction induced by anesthesia surgery.