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  • Author: Hong-Xia Li x
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Management of early mobilization in intensive care units: a multicenter cross-sectional study

Abstract

Objective

The aim of this study was to assess the management of early mobilization (EM) in Chinese intensive care units (ICUs).

Methods

This survey used a cross-sectional, observational design. A total of 65 tertiary and secondary hospitals were enrolled by convenience sampling and investigated using self-designed questionnaires.

Results

We identified 69 ICUs in Jiangsu, China (response rate: 94.2%). 74.2% (1,004/1,353) of the nurses and nursing managers from 65 ICUs reported mobility practice. For the mobility level, 98.1% (1,327) reported use of in-bed exercise, 5.7% (77) sitting on a side of bed, 21.7% (294) transfer to chair, and 2.4% (33) walking. The most frequently reported barriers to early mobility were unplanned extubation, nursing resource, and absence of physical therapist. Nurses’ educational backgrounds, nursing experience, the lack of nursing resources, absence of physician, and the weakness of patient were the factors that influenced ICU early rehabilitation (P<0.01).

Conclusions

Although implementation rates for EM in critically ill patients are high, the activity level is generally poor in most of the involved ICUs.

Open access
NPS2390, a selective calcium-sensing receptor antagonist controls the phenotypic modulation of hypoxic human pulmonary arterial smooth muscle cells by regulating autophagy

Abstract

Background and Objectives

Calcium-sensing receptor (CaSR) is known to regulate hypoxia-induced pulmonary hypertension (HPH) and vascular remodeling via the phenotypic modulation of pulmonary arterial smooth muscle cells (PASMCs) in small pulmonary arteries. Moreover, autophagy is an essential modulator of VSMC phenotype. But it is not clear whether CaSR can regulate autophagy involving the phenotypic modulation under hypoxia.

Methods

The viability of human PASMCs was detected by cell cycle and BrdU. The expressions of proliferation protein, phenotypic marker protein, and autophagy protein in human PASMCs were determined by western blot.

Results

Our results showed that hypoxia-induced autophagy was considerable at 24 h. The addition of NPS2390 decreased the expression of autophagy protein and synthetic phenotype marker protein osteopontin and increased the expression of contractile phenotype marker protein SMA-ɑ and calponin via suppressing downstream PI3K/Akt/mTOR signal pathways.

Conclusions

Our study demonstrates that treatment of NPS2390 was conducive to inhibit the proliferation and reverse phenotypic modulation of PASMCs by regulating autophagy levels.

Open access
Investigation of Hepatitis C Virus Infection Rate of Patients in a General Hospital

Abstract

Objective To investigate the infection rate of hepatitis C virus among the ambulatory patients and in-patients of a tertiary teaching hospital, and study the demographic factors related to the prevalence of hepatitis C virus infection.

Methods All patients tested for hepatitis C virus antibody from July 2008 to July 2009 in Peking Union Medical College Hospital were enrolled in this cross-sectional analysis. The prevalence of hepatitis C virus infection was compared according to age, gender, and departments, respectively. Among patients with positive serology hepatitis C virus marker, the positivity of hepatitis C virus RNA was analysed.

Results Among 29 896 subjects included, the hepatitis C virus antibody of 494 patients were positive (1.7%). When patients were divided into 9 age groups, the age specific prevalence of hepatitis C virus antibody were 0.2%, 1.7%, 1.2%, 1.1%, 1.5%, 1.9%,2.6%, 2.4% and 2%, respectively. The prevalence of hepatitis C virus antibody in non-surgical department and surgical department was 3% and 1%, respectively. The prevalence of hepatitis C virus antibody of males was higher than that of the females. Total of 194 patients with positive hepatitis C virus antibody were tested for hepatitis C virus RNA, the RNA level of 113 patients (58.2%) were higher than the low detection limit.

Conclusions The prevalence of hepatitis C virus antibody was relatively high among patients of general tertiary hospital. Age group of 60-69, males and patients in non-surgical departments were factors associated with high rate of hepatitis C virus infection.

Open access