Aim To observe the protective effects of SITS and DIDS,two kinds of chloride channel blockers,on hippocampal neuronal damage induced by NO in culture.Methods The cultures were divided into three groups:control group,NO treatment group,NO treatment plus chloride channel blocker group. The cultures were detected with the methods of morphological stain (Hoechst 33258),and the apoptotic neurons and neuronal viabilities were observed through MTT quantitative analysis. The activated caspase-3 was analyzed with western blot.Results There were significant protective effects of SITS and DIDS on neuronal damage with dose-dependence.Conclusions Chloride channel blockers have some protective effects against neuronal injury induced by NO.

Iridoid glycosides (mainly geniposide) and crocetin derivatives (crocins) are the two major active constituents in Gardenia jasminoides Ellis. In the present study, geniposide, crocins, crocin-1 and crocetin were separated from gardenia chromatographically. Then, mice were orally administrated with geniposide (400 mg/kg b.w.), crocins (400 mg/kg b.w.), crocin-1 (400 mg/kg b.w.) and crocetin (140 mg/kg b.w.) once daily for 7 days with CCl4. Hepatoprotective properties were evaluated by biochemical parameters: Administration of geniposide, crocins, crocin-1and crocetin significantly lowered serum alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase (ALP) levels in CCl4-treated mice. The reduced glutathione (GSH) levels and antioxidant enzymes (SOD and CAT) activities were also increased by geniposide, crocins, crocin-1 and crocetin. Histopathological examination of livers showed that these components reduced deformability, irregular arrangement and rupture of hepatocyte in CCl4-treated mice. These biochemical results and liver histopathological assessment demonstrated that geniposide, crocetin derivatives and crocetin show comparative beneficial effects on CCl4-induced liver damage via induction of antioxidant defense. Therefore, contents of geniposide and crocetin derivatives should be both considered for hepatoprotective efficacy of Gardenia jasminoides Ellis.
Alanine Transaminase ; Alkaline Phosphatase ; Animals ; Aspartate Aminotransferases ; Gardenia ; Glutathione ; Hepatocytes ; Iridoid Glycosides ; Liver* ; Mice* ; Rupture

Objective To analyze the influences of catheter related bloodstream infection(CRBSI) for ICU patients with PICC. Methods Information and documents of 164 PICC patients were collected from October 2014 to December 2016, general information, intravenous drugs and skin conditions were analyzed if they have any impacts on CRBSI. Results Sixteeen patients with CRBSI and 148 patients with non-CRBSI.The acute physiology and chronic health evaluation(APACHEⅡ) score,hospitalization time,PICC catheterization time was(22.25 ± 4.95)points,(99.44 ± 57.34)d, (67.44 ± 48.30)d in CRBSI patients, and (14.64 ± 6.86) points, 21.00(22.00) d, 12.00 (14.00) d in non-CRBSI patients. There were significant differences (U=439.00, 299.00, 383.00, all P<0.01). The incidence of injection of vasoactive drugs and skin edema were accounted for 8/16,10/16 in CRBSI patients,and 25.00%(37/148),31.08%(46/148) in non-CRBSI patients, the difference was statistically significant (χ2=4.53, 6.34, P<0.05). The APACHE II score was an independent risk factor for PICC catheter-related infections(OR=1.21,P<0.01). Conclusions The environment in ICU is quite complicated and patients often have the characteristic of instability, which drives us to evaluate the influence factors of CRBSI and offer guidance for PICC maintenance.These can help reduce the incidence of CRBSI in ICU and improve the quality of patients.

Objective:To investigate sedation level for postoperative patients with mechanical ventilation in ICU, and to explore the related factors and patient outcomes with different sedation level.Methods:Totally 163 postoperative ICU patients from 11th June to 30th October 2018 were prospectively analyzed. Medical information and all the RASS (Richmond Agitation Sedation Scale) scores was recorded by nurses.Results:The 163 enrolled patients received 11 261.62 hours mechanical ventilation therapy, and 2 815 RASS scores were assessed and recorded by nurses. Among these scores, 80.3% (2 261/2 815) were at light sedation level, while 17.4% (490/2 815) and 2.3% (64/2 815) were at excessive or insufficient sedation level, respectively. All patients were divided into satisfactory sedation group and unsatisfactory sedation group according to the recommendations of guidelines, and used both univariate analysis and multivariate analysis. Compared to males, female patients tend to be in a satisfactory sedation level ( OR value was 0.39, P<0.05); use of midazolam may increase the risk of unsatisfactory sedation level ( OR value was 5.60, P<0.05); the longer sedation assessment interval ( OR value was 1.70, P<0.05), the more likely the patient′s sedation level is unsatisfactory ( OR value was 1.70, P<0.05) . Patients in sedation unsatisfactory group have higher rate of tracheostomy ( χ 2 value was 9.70, P<0.01), longer ICU stay ( U value was -2.33, P<0.05) and more medical expense ( t value was -4.26, P<0.01). Conclusion:The current sedation management in our ICU is satisfactory, but there is still a small part of patients in a state of insufficient sedation or excessive sedation. Sedation level is closely related to sedatives, RASS assessments interval performed by the nurses. This study provides a reference and basis for clinical sedation management and the sedation assessment strategies in the ICU.

Objective To understand the whole level of head nurses ’ servant leadership behavior in Shanghai hospitals , so as to provide theoretical basis for optimal management .Methods A total of 2 000 nurses were chosen from two first-level hospitals , two second-level hospitals and two third-level hospitals from February to March 2012 , by the methods combined with step sampling and cluster sampling .Scale for head nurses ’ servant leadership behavior was used to investigate the whole level .SPSS 19.0 was used to analyze the data , descriptive analysis was used to analyze the scores , one-way anova or t test was used to compare perception of leadership behavior between different clusters , and LSD-t was used for pairwise comparison .P<0.05 indicated statistical significance .Results A total of 2 000 questionnaires were handed out and 1 511 effective questionnaires were recovered ,with the rate of 75 .6%.The average score of head nurses ’ servant leadership behavior in Shanghai hospitals was (84.54 ±17.98), which was higher than the median of the scale which was 60.The recognition degree about easy-going was the highest while the recognition degree about authorization was the lowest.The scores of head nurses from first-level hospitals, second-level hospitals and third-level hospitals were(91.62 ±9.40),(90.53 ±11.49),(80.53 ±17.98), respectively, and the difference was statistically significant (F=61.88,P <0.01).There was statistically significant difference in perception toward head nurses’ servant leadership behavior from nurses of different ages , degrees, titles and genders (P<0.05).And there was no statistically significant difference in perception toward head nurses ’ servant leadership behavior from nurses of different working years and marriage status (P >0.05).Conclusions The level of head nurses’ servant leadership behavior in Shanghai hospitals is comparatively good , but there is still room for improvement , especially for head nurses in third-level hospitals .Evaluation of head nurses ’ servant leadership behavior should consider and control the initialization of nurses , in order to prevent differences of perception from affecting the accuracy .

Objective To investigate the current status of nursing work environment and nurses′perceived stress, and to explore the influences of work environment on perceived stress in nursing staff. Methods The study used questionnaire survey to investigate 302 nurses of a second-class hospital in Shanghai from February to April in 2014. The scores of nursing work environment and perceived stress would be collected and the results would be evaluated and correlation analyzed. Results The average score of nursing work environment was (218. 92 ± 33. 54). The scores of workload and acceptance were lowest, and the scores of system maintain and transform were highest. The average score of the perceived stress scale was ( 26. 58 ± 6. 10);however, 103 (34. 1%) nurses were still in unhealthy status. Furthermore, the work environment had negative correlation to the perceived stress (r= -0. 422). Multivariate analysis demonstrated that workload and system maintain and transform were impact factors of perceived stress. Conclusions Nursing work environment is closely related to nurses′ perceived stress. Thus, the perceived stress can be relieved by reducing nurses′workload and improving system maintain and transform in order to develop their health and the quality of nursing.

Objective To explore and get insight into the demands and perplex of development in nurses, and provide evidence of nurse′s training and occupational planning for hospital administrators. Methods This study utilized live recording and noting to deeply interview 17 clinical nurses in a hospital of Shanghai, and analyzed the sound recordings by Colaizzi way. Results Clinical nurses had different orientation on their future career, and the inside and outside influencing factors included external recognition degree and opinion of family;they were eager to getting supports and opportunities, and looking forward to effective training mode and rich information resources. Conclusions Hospital administrators should pay more attention to the thoughts and needs of nurses about the career development, help them build occupational confidence, create more study opportunities, offer high-quality training courses, so as to improve the career development of clinical nurses.

Intensive care unit ( ICU) is a specialty department to centrally monitor and cure critically ill patients in hospital. With the increasing of patients with complex and severe operations, the high demands for ICU nurses are put forward in professional knowledge and nursing skills. That makes training and development of specialization in ICU nurses become an inevitable trend. This paper summarized the appearance and development of ICU nurse specialists via three aspects including roles, effects and usage patterns of ICU nurse specialists and raised the existing problems on usage patterns of ICU nurse specialists so as to provide references for further development.

Objective To construct a nomogram model to predict the risk of pressure injuries(PI)in mechanically ventilated patients in the intensive care unit(ICU).Methods Clinical data of mechanically ventilated patients in the ICU of Zhongshan Hospital,Fudan University from January 1,2020 to March 15,2023 were retrospectively collected as the training set,and data from ICU of the same hospital from October 1,2023 to December 11,2023 were collected as the external validation set.Risk variables for PI were selected using LASSO regression and Cox proportional hazards model,and a nomogram model was constructed.Receiver operating characteristic(ROC)curve was plotted,and the area under the curve(AUC)was calculated to evaluate the model.Calibration curve and decision curve analysis(DCA)were used to assess the model's calibration and clinical applicability.The external validation was performed using the validation set data.Results A total of 580 mechanically ventilated patients were included in the training set,with 84 cases(14.5％)of PI.LASSO regression and Cox proportional hazards model selected 10 variables to construct the nomogram model.The ROC curve showed an AUC of 0.830 for predicting PI in mechanically ventilated patients.Calibration curve and DCA indicated good calibration and predictive performance of the model.The external validation set included 100 patients,with 12 cases of PI,and the AUC was 0.870.Calibration curve and DCA showed good model performance.Conclusions The nomogram model based on LASSO-Cox regression has good predictive performance and can be used to screen high-risk population for PI in mechanically ventilated patients.