Incidence, risk factors and medical cost of peripheral intravenous catheter-related complications in hospitalised adult patients.

BACKGROUND: Peripheral intravenous catheters (PVCs) are widely used vascular access devices for infusion therapy; however, they are associated with relatively high failure rates. This study aimed to identify the incidence, risk factors and medical costs of PVC-induced complications in adult hospitalised adult patients in China. METHODS: An observational, prospective study on 1069 patients lasting 5 months was conducted at a tertiary teaching hospital. RESULTS: Infiltration ranked first among PVC complications with an incidence of 17.8%, followed by occlusion (10.8%) and phlebitis (10.5%). Most complications in phlebitis (88.4%) and infiltration (93.7%) were Grade 1. Catheters left in for over 96 h did not show a higher incidence of complications. Patients from the surgical department were more susceptible to infiltration, phlebitis and occlusion. The 26 gauge (Ga) catheters decreased the risk of phlebitis and occlusion, whereas 24Ga catheters increased infiltration rates. Infusing irritant drugs increased phlebitis and infiltration rates. The presence of comorbidities and non-use of needleless connectors were associated with occlusion. Compared with forearm insertion, the risk of occlusion nearly doubled with the dorsum of the hand insertion and the risk of infiltration tripled with antecubital fossa insertion. Medical treatment costs for PVC complications ranged from 0.3 to 140.0 CNY. CONCLUSIONS: Infiltration is the most common PVC-related adverse event. Clinically-indicated instead of routine replacement of catheters is safe. More efforts are warranted to improve nurses' adherence to recent guidelines in terms of insertion site selection and needleless connector utilisation to reduce medical costs associated with catheter replacement.

[Effects of Apelin-13 on barrier injury of human umbilical vein endothelial cells induced by LPS].

Objective: To investigate the effects of Apelin-13 on barrier function injury of human umbilical vein endothelial cells (HUVECs) induced by LPS. Methods: The HUVECs cultured in vitro were divided into 4 groups: Control group, LPS group, Apelin-13+LPS group, Apelin-13 group. HUVECs were treated by 5 µg/ml LPS for 24 h to replicate the model with endothelial barrier impaired. Apelin-13 at the concentration of 1 µmol/L was given 30 min before LPS treatment. The cell viabillity of HUVECs was measured by CCK-8 assay. Protein expressions of VE-cadherin and F-actin were measured by Western blot and immunofluorescence. Nuclear factor κB p65(NF-κB p65) was detected by immunofluorescence. Results: Compared with the control group, the cell viabillity of HUVECs and protein expression of VE-cadherin were decreased by LPS, but the protein expression of F-actin and activation of NF-κB p65 were increased by LPS. These effects were attenuated by Apelin-13 administration. Conclusion: Apelin-13 ameliorates LPS-induced barrier function injury of HUVECs, which may be related to the inhibition of inflammation.

[The effects of optical genetic techniques on new neurons through the Wnt/ß-Catenin pathway].

OBJECTIVE: To investigate the effects of optical genetic techniques on new neurons through the Wnt/ß-Catenin pathway. METHODS: Neural stem cells (ESCs)were extracted from the cerebral cortex of fetal rat and transfected by lentivirus carrying DCX-ChR2-EGFP gene and the expression of DCX of newborn neurons differentiated from neural stem cells were observed. All cells were divided into 3 groups(n=9): control group, NSCs+EGFP and NSCs+ChR2 groups. The control group was normal cultured NSCs (NSCs group); the neural stem cells in NSCs+EGFP group were transfected with lentivirus carrying EGFP gene. The neural stem cells in NSCs+ChR2 group were infected with lentivirus carrying DCX-ChR2-EGFP gene. After 48 hours of lentivirus infection, 470 nm blue laser irradiation was performed for 3 consecutive days. NeuN+ positive cell density(the maturation of neural stem cells)and the ratio of NeuN+/Hoechst in each group were observed. Western blot was used to detect the expression levels of MAP2, NeuN, Neurog2, NeuroD1 and GluR2. Western blot was used to detect the expressions of ß-catenin and TCF4 associated with Wnt/ß-catenin signaling channel. Verapamil (100 µmol/L, L-type calcium channel blockers) and Dkk1 (50 µg/ml, ß-catenin inhibitor) were used to treat stem cells of the NSCs+ChR2 group and then the expressions of MAP2, NeuN, Neurog2, NeuroD1 and GluR were detected by Western blot. RESULTS: After 3 days of 470 nm blue laser irradiation, NeuN+ positive cell density(the maturation of neural stem cells)and the ratio of NeuN+/Hoechst, the expression levels of the protein MAP2, NeuN, Neurog2, NeuroD1, GluR and the protein ß-catenin and TCF4 associated with Wnt/ß-catenin signaling channel detected by Western blot were significantly increased in the group of NSCs+ChR2, compared with NSCs and NSCs+EGFP groups. The expressions of MAP2, NeuN, Neurog2, NeuroD1 and GluR were remarkably decreased after treated by verapamil and Dkk1 in the group of NSCs+ChR2. It was proved that the opening of ChR2 channel producing cationic influx promoted the maturation of neural stem cells and induced by the Wnt/ß-catenin signaling pathway. CONCLUSION: Optical genetic promoted the maturation of newborn neurons through the Wnt/ß-catenin signaling pathway.