Objective:To evaluate the clinical effect of comfort nursing intervention in preventing incontinent-associated dermatitis(IAD)and related complications in critically ill patients.Methods:This study enrolled critically...Objective:To evaluate the clinical effect of comfort nursing intervention in preventing incontinent-associated dermatitis(IAD)and related complications in critically ill patients.Methods:This study enrolled critically ill patients from the Intensive Care Unit at Ningxiang People’s Hospital between June 2020 and June 2024.Patients were randomly assigned to a comfort nursing group(n=51)and a routine nursing group(n=53).The comfort nursing group received comprehensive comfort nursing,while the routine nursing group received standard care.The incidence,classification and area of IAD as well as the incidence of complications and patient/family satisfaction with nursing care,were assessed.Results:The incidence of IAD was significantly lower in the comfort nursing group(8 patients)compared to the routine nursing group(21 patients)(P<0.05).Additionally,the incidences of wound infection and muscle soreness were notably lower in the comfort nursing group(both P<0.05).Patient and family satisfaction in the comfort nursing group was significantly higher than in the routine nursing group(both P<0.05).Conclusion:Comfort nursing intervention is effective in preventing IAD and reducing associated complications in critically ill patients,thereby improving patient and family satisfaction with treatment.展开更多
Chemerin is present in various inflammatory sites and is closely involved in tissue inflammation. Recent studies have demonstrated that chemerin treatment can cause either anti-inflammatory or pro-inflammatory effects...Chemerin is present in various inflammatory sites and is closely involved in tissue inflammation. Recent studies have demonstrated that chemerin treatment can cause either anti-inflammatory or pro-inflammatory effects according to the disease model being investigated. Elevated circulating chemerin was recently found in patients with inflammatory bowel disease （IBD）; however, the role of chemerin in intestinal inflammation remains unknown. In this study, we demonstrated that the administration of exogenous chemerin （aa 17-156） aggravated the severity of dextran sulfate sodium （DSS）-induced colitis, which was characterized by higher clinical scores, extensive mucosal damage and significantly increased local and systemic production of pro-inflammatory cytokines, including IL-6, TNF-a and interferon （IFN-7）. Interestingly, chemerin did not appear to influence the magnitudes of inflammatory infiltrates in the colons, but did result in significantly decreased colonic expression of M2 macrophage-associated genes, including Arginase 1 （Arg-1）, Yml, FIZZ1 and IL-IO, following DSS exposure, suggesting an impaired M2 macrophage skewing in vivo. Furthermore, an in vitro experiment showed that the addition of chemerin directly suppressed M2 macrophage-associated gene expression and STAT6 phosphorylation in IL-4-stimulated macrophages. Significantly elevated chemerin levels were found in colons from DSS-exposed mice and from ulcerative colitis （UC） patients and appeared to positively correlate with disease severity. Moreover, the in vivo administration of neutralizing anti-chemerin antibody significantly improved intestinal inflammation following DSS exposure. Taken together, our findings reveal a pro-inflammatory role for chemerin in DSS-induced colitis and the ability of chemerin to suppress the anti-inflammatory M2 macrophage response. Our study also suggests that upregulated chemerin in inflamed colons may contribute to the pathogenesis of IBD.展开更多
文摘Objective:To evaluate the clinical effect of comfort nursing intervention in preventing incontinent-associated dermatitis(IAD)and related complications in critically ill patients.Methods:This study enrolled critically ill patients from the Intensive Care Unit at Ningxiang People’s Hospital between June 2020 and June 2024.Patients were randomly assigned to a comfort nursing group(n=51)and a routine nursing group(n=53).The comfort nursing group received comprehensive comfort nursing,while the routine nursing group received standard care.The incidence,classification and area of IAD as well as the incidence of complications and patient/family satisfaction with nursing care,were assessed.Results:The incidence of IAD was significantly lower in the comfort nursing group(8 patients)compared to the routine nursing group(21 patients)(P<0.05).Additionally,the incidences of wound infection and muscle soreness were notably lower in the comfort nursing group(both P<0.05).Patient and family satisfaction in the comfort nursing group was significantly higher than in the routine nursing group(both P<0.05).Conclusion:Comfort nursing intervention is effective in preventing IAD and reducing associated complications in critically ill patients,thereby improving patient and family satisfaction with treatment.
基金ACKNOWLEDGEMENTS We thank Dr Hongguang Zhu from the Department of Pathology, Fudan University for his useful advice on the histological analysis. This work was supported by the National Natural Science Foundation of China Grant 81172797 （to RH） and the Program of Shanghai Pujiang Talent 11PJ1400400 （to RH）.
文摘Chemerin is present in various inflammatory sites and is closely involved in tissue inflammation. Recent studies have demonstrated that chemerin treatment can cause either anti-inflammatory or pro-inflammatory effects according to the disease model being investigated. Elevated circulating chemerin was recently found in patients with inflammatory bowel disease （IBD）; however, the role of chemerin in intestinal inflammation remains unknown. In this study, we demonstrated that the administration of exogenous chemerin （aa 17-156） aggravated the severity of dextran sulfate sodium （DSS）-induced colitis, which was characterized by higher clinical scores, extensive mucosal damage and significantly increased local and systemic production of pro-inflammatory cytokines, including IL-6, TNF-a and interferon （IFN-7）. Interestingly, chemerin did not appear to influence the magnitudes of inflammatory infiltrates in the colons, but did result in significantly decreased colonic expression of M2 macrophage-associated genes, including Arginase 1 （Arg-1）, Yml, FIZZ1 and IL-IO, following DSS exposure, suggesting an impaired M2 macrophage skewing in vivo. Furthermore, an in vitro experiment showed that the addition of chemerin directly suppressed M2 macrophage-associated gene expression and STAT6 phosphorylation in IL-4-stimulated macrophages. Significantly elevated chemerin levels were found in colons from DSS-exposed mice and from ulcerative colitis （UC） patients and appeared to positively correlate with disease severity. Moreover, the in vivo administration of neutralizing anti-chemerin antibody significantly improved intestinal inflammation following DSS exposure. Taken together, our findings reveal a pro-inflammatory role for chemerin in DSS-induced colitis and the ability of chemerin to suppress the anti-inflammatory M2 macrophage response. Our study also suggests that upregulated chemerin in inflamed colons may contribute to the pathogenesis of IBD.
