Objective To investigate the effect of restriction decision wheel and grade ICU patients with critical consciousness disorder. Methods Two hundred and fifty four patients in ICU with critical consciousness disorder from July to December 2012, who were intubated and constrained with their limbs due to the risk of unexpected extubation, were divided into the control group (n=125) and the experiment group (n=129), according to registration sequence. The former were constrained to their limbs after evaluation referring to the constraint nursing form and the latter was constrained by using the constraint decision-making wheel and grade. The two groups were compared in terms of restraint rate, unplanned extubation rate, and incidence of skin abnormality. Results The restraint rate of the observation group was significantly lower than that of the control group (P<0.01). There was no incidence of abnormal skin in the two groups. There was no significance in the rate of unplanned extubation between the two groups (P>0.05). Conclusion Constraints decision making wheel and grade is effective in ensuring patients'safety and improving the quality of nursing safety management by reducing unnecessary constraints or the incidence of delayed constraints.

To fill the urgent need of researches on the structure and function of proteins to obtain conformation information, we combined targeted molecular dynamics ( TMD) simulation with protein network methods to analyze conformation variations in the activation process of β2 adrenergic receptor. First, targeted MD was used to obtain the conformation resembles in the activation process, and then the protein network method was applied to identify the key residues and pathways in the activation process. The results indicate that the activa-tion process of β2 adrenergic receptor involves in the cooperation of all regions and the connector region of transmembrane helices is signaling hubs. In addition, the helix ends, including intracellular and extracellular loops, are the core areas. The pathway analysis reveals that there is more than one signaling pathway. All the pathways start from Ser204 of the ligand pocket and finally transmit to NPxxY or ICL2 region, which are depended on the different pathways. While the helix TMIII, TMV, TMVI are the important areas in all the pathways. The observations from the work provide valuable information at molecular level for unraveling the signal transduction mechanism associated with the activation process.

Objective To investigate the application effects of the new restraint tools in the critical patient care. Methods A total of 354 critical patients were averagely divided into observation group and control group according to the order number with random number table. The patients in the control group were routinely used ordinary restraint belt with restraint upper limbs or limbs, while the patients underwent the new restraint tools and implemented personalized restraint that emphasize personalized and humanized on restraint of method, site, time and tools selecting. Results In the observation group, binding site skin abnormalities ( swelling, bruising or injury), unplanned extubation rates were lower than these of the control group (P <0. 05). Conclusions Personalized application of the new restraint tool can reduce restraint adverse events, ensure patient safety and improve effectiveness of care and safety management.