Establishment and application of cricothyrotomy in vivo.

BACKGROUND: Cricothyrotomy is a procedure performed to establish an airway in critical airway events. It is performed only rarely and anesthesiologists are often unprepared when called upon to perform it. This study aimed to simulate cricothyrotomy using pig larynx and trachea models to help anesthesiologists master cricothyrotomy and improve the ability to establish cricothyrotomy quickly. METHODS: The porcine larynx and trachea were dissected and covered with pigskin to simulate the structure of the anterior neck of a human patient. An animal model of cricothyrotomy was established. Forty anesthesiologists were randomly divided into four groups. Each physician performed three rounds of cricothyrotomy, and recorded the time to accomplish each successful operation. After training the cricothyrotomy procedure, a questionnaire survey was conducted for the participating residents using a Likert scale. The participants were asked to score the utility of the training course on a scale of 1 ((minimum) to 5 ((maximum). RESULTS: Through repeated practice, compared with the time spent in the first round of the operation (67 ± 29 s), the time spent in the second round of the operation (47 ± 21 s) and the time spent in the third round of the operation (36 ± 11 s) were significantly shortened (P < 0.05). Results of the survey after training were quite satisfied, reflecting increased the ability of proficiency in locating the cricothyroid membrane and performing a surgical cricothyrotomy. CONCLUSION: The porcine larynx and trachea model is an excellent animal model for simulating and practicing cricothyrotomy, helping anesthesiologists to master cricothyrotomy and to perform it proficiently when required.

Occupational stress, burnout, and coping styles among medical staff from a tertiary first-class hospital in Hubei Province / 预防医学

Objective @#To investigate the status of occupational stress, burnout, and coping styles, and to explore the moderating effects of coping styles on the relationship between occupational stress and burnout among medical staff from one tertiary first-class hospital in Hubei Province, in order to provide the basis for mental health promotion of medical staff. @*Methods@#From June to October in 2020, using stratified cluster sampling, doctors, nurses, and medical or pharmaceutical technicians on the ratio of 2∶2∶1 were selected from the tertiary first-class hospital. Chinese version of Burnout Questionnaire, Core Occupational Stress Scale (COSS) and Trait Coping Style Questionnaire were used to investigate the levels of burnout, occupational stress and coping styles. A linear stratified regression model was used to analyze the moderating effect of coping styles on the relationship between occupational stress and burnout. @*Results@#Among 735 questionnaires issued, 679 valid ones were collected, with the response rate of 92.38%. The age of the respondents was ( 34.29±8.20 ) years old. There were 165 ( 24.30% ) males and 514 ( 75.70% ) females, including 241 ( 35.49% ) doctors, 358 ( 52.72% ) nurses and 80 (11.78%) medical or pharmaceutical technicians. The burnout score was 2.29±1.11 , and the positive rate of burnout was 44.33%; the COSS score was 47.32±8.31; the positive and negative coping style scores were 30.64±6.06 and 26.81±6.26, respectively. The linear stratified regression analysis suggested that the interactions between social support ( β=0.590, P<0.05 ), organization and reward ( β=0.523, P<0.05 ), and positive coping style were positively associated with burnout, and the interaction between organization and reward (β=-0.666, P<0.05) and negative coping style was negatively associated with burnout. @*Conclusions@#About 44.33% of medical staff investigated have burnout. Coping styles have a moderating effect on the relationship between occupational stress and burnout. Positive coping style helps to perceive social support and organizational support, to alleviate the adverse effects of occupational stress, and to reduce the risk of burnout.

Induction of Mitochondrial Dysfunction and Oxidative Damage by Antibiotic Drug Doxycycline Enhances the Responsiveness of Glioblastoma to Chemotherapy.

BACKGROUND Inducing mitochondrial dysfunction has been recently demonstrated to be an alternative therapeutic strategy for cancer treatment. Doxycycline is an antibiotic that has been shown to have anti-cancer activities in various cancers by way of targeting mitochondria. In this work, we examined whether doxycycline can be repurposed for glioblastoma treatment. MATERIAL AND METHODS The effects of doxycycline on the growth, survival, and mitochondrial metabolisms of glioblastoma were investigated. The efficacy of a combination of doxycycline with temozolomide was examined using xenograft mouse model in total number of 40 mice. RESULTS Doxycycline targeted glioblastoma cell lines, regardless of their origin, through inhibiting growth and inducing cell death, accompanied by a significant decrease in proliferating cell nuclear antigen (PCNA) and increase in cleaved caspase-3. In addition, doxycycline significantly sensitized glioblastoma cell response to temozolomide in vitro and in vivo. Mechanistically, doxycycline disrupted mitochondrial functions through decreasing mitochondrial membrane potential and mitochondrial respiration. Inducing mitochondrial dysfunctions by using doxycycline led to energy crisis, oxidative stress, and damage as shown by the decreased levels of ATP and the elevated levels of mitochondrial superoxide, intracellular ROS, 8-OHdG, protein carbonylation, and lipid peroxidation. An antioxidant N-acetyl-L-cysteine (NAC) significantly abolished the anti-proliferative and pro-apoptotic effects of doxycycline, demonstrating that doxycycline acts on glioblastoma via inducing oxidative stress. CONCLUSIONS In our study, we show that the antibiotic doxycycline is effective in targeting glioblastoma through inducing mitochondrial dysfunctions and oxidative stress. Our work also demonstrated the importance of mitochondrial metabolism in glioblastoma.