1.Nursing preventive interventions of venous thromboembolism in ICU:a methodological systematic review
Jingjing ZHANG ; Zhixia JIANG ; Xia ZHANG ; Kaihan YANG ; Yanbin PAN ; Mingtao QUAN ; Fang CHEN ; Hui ZENG
Chinese Journal of Practical Nursing 2017;33(26):2069-2073
Objective To systematically review the nursing preventive interventions and their effects on venous thromboembolism (VTE) in ICU patients. Methods We searched PubMed, Cochrane Library, EMBASE, SCI, CINAHL, Science Direct, BM, CNKI, WanFang and VIP, to collect the randomized controlled trials of nursing prophylaxis on VTE in ICU patients. Results 57 studies were included, meta-analysis provided that: the incidence rates of VTE and bleeding between Intermittent Pneumatic Compression Devices(IPC) group and low molecular weightheparin group in severe trauma patients had no statistical significance (P=0.14); comparing with graduated compression stockings (GCS) only group, the incidence rates of deep vein thrombosis(DVT) were lower in combination with IPC and GCS group (P=0.003);comparing with routine nursing group, the incidence rates of VTE were lower in IPC group and GCS group (P<0.01), the blood flow velocity and the average velocity of venous flow in lower limbs were increased in IPC group (P<0.01). The results of descriptive analysis show that early comprehensive nursing interventions and corresponding nursing interventions after risk assessment can reduce the incidence of VTE in ICU. Conclusion According to the present projects, using IPC, GCS, adopting early comprehensive nursing interventions and giving corresponding nursing interventions after DVT risk assessment are the effective interventions on ICU VTE.
2.N-acetyl-D-glucosamine inhibits oxidative stress and promotes M2 macrophage polarization to alleviate acute pancreatitis in rats
Zuzhi XU ; Liang ZHANG ; Xin HUANG ; Lei YU ; Pengfei CHEN ; Xuewen XIE ; Zhifei CHEN ; Kaihan FANG ; Shuke FEI
Acta Laboratorium Animalis Scientia Sinica 2023;31(11):1389-1398
Objective To investigate the effects of N-acetyl-D-glucosamine(GlcNAc)on acute pancreatitis in rats.Methods Twenty male SD rats were randomly divided into a control group,AP group,low GlcNAc + AP group and high GlcNAc + AP group,with five rats in each group.Acute pancreatitis was induced in AP group,low GlcNAc + AP group and high GlcNAc + AP group by two intraperitoneal injections of 2.5 g/kg L-arginine with a 1 hour interval.Among them,low GlcNAc + AP group and high GlcNAc + AP group were administered 50 and 200 mg/kg GlcNAc,respectively,by intraperitoneal injection at 24 hours before the first intraperitoneal injection of L-arginine.Group control and AP were intraperitoneally injected with the same volume of normal saline.After 24 h,the rats were sacrificed,and serum and pancreatic tissues were collected.Pancreatic tissue morphology was observed by HE staining,and serum levels of amylase(AMY),lipase(LPS),interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),superoxide dismutase(SOD)and malondialdehyde(MDA)were measured by enzyme-linked immunosorbent assay.Protein expression of nuclear factor E2-related factor 2(NRF2),heme oxygenase-1(HO-1),and peroxisome proliferator-activated receptor-γ(PPAR-γ)in pancreatic tissue was detected by Western Blot.Cluster of differentiation(CD)86,CD206 and macrophage markers(F4/80)were detected by immunofluorescence.Expression of CD86 and CD206 in pancreatic tissue was detected by immunohistochemistry.Results(1)Compared with control group,AMY,LPS,IL-1β,IL-6,TNF-α,and MDA levels and pancreatic CD86 expression in AP group were significantly increased(P<0.05),while SOD activity,protein expression levels of NRF2,HO-1,and PPAR-γ,and pancreatic CD206 expression were significantly decreased(P<0.05).(2)Compared with AP group,serum IL-1β,IL-6,TNF-α,MDA,and LPS and the pancreatic CD86 expression in low GlcNAc + AP group were significantly decreased(P<0.05).The PPAR-γ protein level in the pancreas was significantly increased(P<0.05).(3)Compared with AP group,serum AMY,LPS,IL-1β,IL-6,TNF-α,and MDA and pancreatic CD86 expression in high GlcNAc + AP group were significantly decreased(P<0.05),while serum SOD,and NRF2,HO-1,PPAR-γ,and pancreatic CD206 expression were significantly increased(P<0.05).(4)Compared with low GlcNAc + AP group,serum LPS,IL-1β and IL-6 in high GlcNAc + AP group were significantly decreased(P<0.05).Pancreatic expression of HO-1,PPAR-γ,and pancreatic CD206 were significantly increased(P<0.05).Conclusion GlcNAc treatment attenuates acute pancreatitis injury in AP rats,possibly by activating the NRF2/HO-1 signaling pathway to inhibit oxidative stress and promoting M2 macrophage polarization to attenuate pancreatic injury in AP rats.