Patients in the intensive care unit (ICU) often need to have various catheters placed on their bodies due to their severe condition. In order to prevent the occurrence of unplanned extubation, patients' hands should be restrained appropriately. The current restraint gloves used in clinical practice have problems such as improper restraint, easy falling off of oxygen saturation monitoring probes, and pressure injury of hands. Therefore, department of critical care medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine designed a wrist restraint glove suitable for restless patients, and obtained the national utility model patent (ZL 2020 2 1612453.7). The device is composed of restraint gloves and restraint rings, which can not only restrain patients, but also continuously monitor the changes of blood oxygen saturation in patients with restfulness. This device is convenient to use, low cost, comfortable to wear, and can prevent the occurrence of device-related pressure injuries, which is suitable for clinical application.
Humans ; Wrist ; Intensive Care Units ; Critical Care ; Hand ; Upper Extremity ; Restraint, Physical

As a traditional animal drug, Hirudo is slightly toxic and has the effects of breaking blood stasis, dredging meridians, expelling stasis, and resolving mass. It has a long history of processing, and the early boiling records can be traced back to the Han Dynasty. More than ten processing methods such as frying, roasting, and lime processing appeared later. After processing, Hirudo is deodorized and modified in taste and becomes crispy, which is conducive to crushing and clinical application. At present, the reported components in Hirudo mainly include protein polypeptides, pteridines, and lipids, which have anti-coagulant, anti-thrombotic, anti-atherosclerotic, anti-tumor, and other pharmacological effects. This study reviewed the processing history evolution, chemical consti-tuents, and pharmacological effects of Hirudo to provide a reference for the related research on Hirudo.
Animals ; Drugs, Chinese Herbal/pharmacology* ; Evolution, Chemical ; Leeches ; Thrombosis ; Restraint, Physical

Quality evaluation of Chinese medicinal decoction pieces is vital for the development of the downstream industries, and is an important channel for implementing the strategy of "higher quality, higher price, and priority for the high quality" for traditional Chinese medicine. At the moment, the quality of Chinese medicinal decoction pieces is mainly evaluated based on chemical component examination. Considering the weak preliminary research foundation and poor research conditions, traditional experience-based evaluation is undervalued in the quality rating of Chinese medicinal decoction pieces. However, traditional experience is a summary of the quality of Chinese medicinal materials based on clinical experience, which thus can be a potential basis for the quality evaluation of the decoction pieces. It is a challenge in the evaluation of Chinese medicinal decoction pieces to objectify the traditional experience-based evaluation from multiple aspects such as chemistry, effect, and characterization via modern techniques. Therefore, this study developed the "experience-ingredients-activity-electronic sensing" evaluation system for Chinese medicinal decoction pieces on the basis of experience-based assessment, chemical ingredients that can truly reflect the traditional experience, biological effect assessment, and electronic sensory evaluation, which is expected to quantify the traditional experience of quality evaluation of Chinese medicinal decoction pieces via chemistry, biology, and sensory simulation. The evaluation system can serve as a reference for clinical experience-based quality evaluation of Chinese medicinal decoction pieces.
China ; Drugs, Chinese Herbal ; Electronics ; Medicine, Chinese Traditional ; Restraint, Physical

Animals ; Cognitive Dysfunction/therapy* ; Maze Learning ; Mice ; Protein Phosphatase 2 ; Restraint, Physical ; Stress, Psychological/therapy*

Background: Physical restraint is any measure or technique that prohibits an individual’s body movement. Although physical restraint is one of the most common methods used to ensure patient safety in the intensive care units, its usage is an arguable practice. Involuntary immobilisation of a patient challenges patient’s rights while over usage of physical restraints can lead to possible harm to the patients. Critical care nurses especially should make accurate decisions regarding the use of physical restrains if they are to ensure patient safety. Objective: The objective of this study was to determine the knowledge, attitude, and practices of critical care nurses on usage of physical restrainer in a private hospital in Klang Valley. Methods: This was a cross-sectional, quantitative descriptive study using the Physical Restraint Questionnaire (PRQ) to collect data from 103 registered nurses through simple random sampling in the Critical Care Unit of a private hospital. Results: A total of 103 critical care nurses participated in this study. The nurses had moderate level of knowledge of physical restraint usage, 43.96 ± 4.05 (36 to 53), positive attitude towards the use of physical restraint, 30.47 ± 2.96 (24 to 39) and good practices on usage of physical restrainers, 38.88 ± 2.73 (29 to 43). Conclusion Findings revealed that majority of critical nurses have moderate knowledge, positive attitude and satisfactory practices on usage of physical restraint. However, continuous updates on usage of physical restraint and its legal implications are highly recommended to ensure critical care nurses are better informed before deciding to use physical restraint on their patients.
Knowledge ; Attitude ; Restraint, Physical

Humans with chronic psychological stress are prone to develop multiple disorders of body function including impairment of immune system. Chronic psychological stress has been reported to have negative effects on body immune system. However, the underlying mechanisms have not been clearly demonstrated. All immune cells are derived from hematopoietic stem cells (HSC) in the bone marrow, including myeloid cells which comprise the innate immunity as a pivotal component. In this study, to explore the effects of chronic psychological stress on HSC and myeloid cells, different repeated restraint sessions were applied, including long-term mild restraint in which mice were individually subjected to a 2 h restraint session twice daily (morning and afternoon/between 9:00 and 17:00) for 4 weeks, and short-term vigorous restraint in which mice were individually subjected to a 16 h restraint session (from 17:00 to 9:00 next day) for 5 days. At the end of restraint, mice were sacrificed and the total cell numbers in the bone marrow and peripheral blood were measured by cell counting. The proportions and absolute numbers of HSC (LinCD117Sca1CD150CD48) and myeloid cells (CD11bLy6C) were detected by fluorescence activated cell sorting (FACS) analysis. Proliferation of HSC was measured by BrdU incorporation assay. The results indicated that the absolute number of HSC was increased upon long-term mild restraint, but was decreased upon short-term vigorous restraint with impaired proliferation. Both long-term mild restraint and short-term vigorous restraint led to the accumulation of CD11bLy6C cells in the bone marrow as well as in the peripheral blood, as indicated by the absolute cell numbers. Taken together, long-term chronic stress led to increased ratio and absolute number of HSC in mice, while short-term stress had opposite effects, which suggests that stress-induced accumulation of CD11bLy6C myeloid cells might not result from increased number of HSC.
Animals ; Antigens, Ly ; metabolism ; Bone Marrow Cells ; cytology ; CD11b Antigen ; metabolism ; Cell Proliferation ; Hematopoietic Stem Cells ; cytology ; Mice ; Mice, Inbred C57BL ; Restraint, Physical ; Stress, Psychological

OBJECTIVE: To explore the pathogenic role of changes of Wnt/β-catenin signaling pathway in the hippocampus in depression- and anxiety-like behaviors caused by prenatal stress (PS) in offspring rats. METHODS: Twelve female SpragueDawley rats weighing 240-260 g were randomly divided into control and restraint stress groups. The rats in the control group received no interventions, and those in restraint stress group were subjected to restraint stress (three times a day, 45 min each time) at the gestational age of 14-20 days. The 1-month-old offspring rats underwent open field test and forced swimming test to assess the anxiety- and depression-like behaviors, and the expressions of Wnt1, Gsk-3β and β-catenin in the hippocampus were detected using Western blotting. RESULTS: In open field test, the offspring rats with PS showed significantly decreased crossings of the center ( < 0.01) with reduced time spent in the center ( < 0.05) compared with control offspring rats. In forced swimming test, the offspring rats in PS group exhibited a significantly longer immobility time than in the control rats, and showed obvious depression- and anxiety-like behaviors. Compared with those in the control offspring rats, Gsk-3β expression increased significantly while the expressions of β-catenin and Wnt1 were significantly lowered in the hippocampus of the offspring rats in PS group ( < 0.01). CONCLUSIONS PS causes changes in Wnt/β-catenin signaling pathway in the hippocampus to contribute to the occurrence of depression-and anxiety-like behaviors in rats.
Animals ; Anxiety ; etiology ; metabolism ; Behavior, Animal ; Depression ; etiology ; metabolism ; Female ; Glycogen Synthase Kinase 3 beta ; Hippocampus ; metabolism ; Pregnancy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Restraint, Physical ; psychology ; Stress, Psychological ; complications ; Swimming ; psychology ; Wnt Signaling Pathway

PURPOSE: This study aimed to investigate incidence of delirium in the pediatric intensive care unit (PICU) and to analyze associated risk factors. METHODS: The participants were 95 patients, newborn to 18 years, who were admitted to the PICU. The instruments used were the Richmond Agitation Sedation Scale (RASS), and the Cornell Assessment of Pediatric Delirium. Data analysis was performed using the descriptive, χ² test, t-test, and logistic regression analyses. RESULTS: The incidence of delirium in children admitted to the PICU was 42.1%. There were significant differences according to age (χ²=14.10, p=.007), admission type (χ²=7.40, p=.007), use of physical restraints (χ²=26.11, p<.001), RASS score (χ²=14.80, p=.001), need for oxygen (χ²=5.31, p=.021), use of a mechanical device (χ²=9.97, p=.041), feeding (χ²=7.85, p=.005), and the presence of familiar objects (χ²=29.21, p<.001). Factors associated with the diagnosis of delirium were the use of physical restraint (odds ratio [OR]=13.82, 95% confidence interval [CI]=4.16~45.95, p<.001) and the presence of familiar objects (OR=0.09, 95% CI=0.03~0.30, p=.002). CONCLUSION: Periodic delirium assessments and intervention should be actively performed. The use of restraints should be minimized if possible. The caregiver should surround the child with familiar objects and ensure a friendly hospital environment that is appropriate for the child.
Caregivers ; Child ; Critical Care ; Delirium ; Diagnosis ; Dihydroergotamine ; Humans ; Incidence ; Infant, Newborn ; Intensive Care Units ; Logistic Models ; Oxygen ; Pediatrics ; Restraint, Physical ; Risk Factors ; Statistics as Topic

PURPOSE: This study estimated the incidence of delirium and associated risk factors and outcomes in ICU patients with acute poisoning. METHODS: Data were collected from ICU patients over 18 years of age that were admitted via the emergency center after presenting with poisoning from 2010 to 2015. Delirium was assessed retrospectively using the Intensive Care Delirium Screening Checklist (ICDSC). Risk factors were evaluated by univariate and multivariate analysis. RESULTS: A total of 199 patients participated in this study and 68 (34.2%) were diagnosed with delirium based on the ICDSC score. The delirium group showed a significantly higher association with prolonged length of stay in the hospital and ICU in comparison with the non-delirium group. The delirium group was associated with greater use of physical restraint. A statistically greater number of patients with pharmaceutical substance poisoning developed delirium over a short period of time than those with non-pharmaceutical substance poisoning. There was no significant difference between the two groups with respect to age, sex, past history, GCS score, vital signs, application of ventilator care and renal replacement therapy. CONCLUSION: The finding that the delirium group had a greater length of stay in both the hospital and the ICU is consistent with the results of previous worldwide studies of the effects of delirium on the prognosis of patients who were admitted to the ICU, suggesting the possibility for domestic application. Additionally, use of physical restraint was positively related to the incidence of delirium. Thus, interventions for minimizing the use of physical restraints and considering alternatives are needed.
Checklist ; Critical Care ; Delirium ; Emergencies ; Humans ; Incidence ; Intensive Care Units ; Length of Stay ; Mass Screening ; Multivariate Analysis ; Poisoning ; Prognosis ; Renal Replacement Therapy ; Restraint, Physical ; Retrospective Studies ; Risk Factors ; Ventilators, Mechanical ; Vital Signs

OBJECTIVES: Although delirium is a common complication among patients hospitalized in intensive care units(ICUs), little is known about the roles that diagnostic and therapeutic procedures play in its development. This study investigates the procedure-related risk factors of delirium in ICU patients. METHODS: All the consecutive patients admitted to the ICU between June 2016 and May 2017 were routinely evaluated for delirium by psychiatrists. In total, 1156 patients met the inclusion criteria and were retrospectively analyzed. A multiple logistic regression analysis was conducted to investigate independent risk factors of delirium development while adjusting for other characteristics. RESULTS: The age, Acute Physiology and Chronic Health Evaluation (APACHE II) score, proportion of patients who had undergone an operation, and proportion of patients who were foley catheterized, mechanically ventilated, and physically restrained were higher in the delirium group. The multiple logistic regression analysis confirmed that the use of restraint was an independent risk factor of delirium (odds ratio : 10.006 ; 95% confidence interval : 6.120–16.360 ; p<0.001). The patient factors independently associated with delirium were an advanced age and a higher APACHE II score. The incidence of delirium was 15.3%. CONCLUSIONS: There is a high prevalence of delirium influenced by potentially harmful procedures in patients in ICU settings. The use of physical restraint had the strongest association with the development of delirium. These findings advocate the need to target procedure-related risk factors such as the use of restraints as preventive intervention measures for ICU delirium.
APACHE ; Catheters ; Critical Care ; Delirium ; Humans ; Incidence ; Intensive Care Units ; Logistic Models ; Prevalence ; Psychiatry ; Restraint, Physical ; Retrospective Studies ; Risk Factors