Measures and Effects of Pain Management for Wound Dressing Change in Outpatient Children in Western China.

PURPOSE: The present study investigated the pain management of wound dressing change in outpatient children in western China, and the results may provide a reference to improve the pain management of wound dressing change. METHODS: A cross-sectional survey was performed to investigate the pain management of wound dressing change in outpatient children in western China. A total of 47 hospitals were selected via convenience sampling, and the pain management organization systems, concrete measures and barriers to adequate pain management of these hospitals were investigated. RESULTS: More than 70% of these hospitals had established pain management systems, analgesic drug management norms and wound care teams. Nurses were the primary providers for wound dressing change in 48.94% of the hospitals. The assessment, documentation or health education of the pain was not standard in 46.81% of the hospitals. Drug and non-drug analgesia measures were used in most hospitals, however, children did not receive adequate analgesia in 70% of the hospitals. Ibuprofen (30.49%) and lidocaine (29.27%) were commonly used analgesic drugs, and distraction (43.01%) was commonly used as a non-drug analgesia measure. The top three barriers to adequate pain management were medical staff lacking analgesic knowledge (82.98%), family members refusing to use analgesics (61.70%) and low compliance of children (55.32%). CONCLUSION: The concrete measures for the management of wound dressing pain in children are not standardized, and the analgesic effect is poor. In order to improve the pain management of children, Standardized procedures for pain management (pain assessment, analgesia measures, pain documentation and health education) should be strictly followed during wound dressing change, and the identified barriers should be addressed.

High-Throughput and Rapid Screening of Novel ACE Inhibitory Peptides from Sericin Source and Inhibition Mechanism by Using in Silico and in Vitro Prescriptions.

Several novel peptides with high ACE-I inhibitory activity were successfully screened from sericin hydrolysate (SH) by coupling in silico and in vitro approaches for the first time. Most screening processes for ACE-I inhibitory peptides were achieved through high-throughput in silico simulation followed by in vitro verification. QSAR model based predicted results indicated that the ACE-I inhibitory activity of these SH peptides and six chosen peptides exhibited moderate high ACE-I inhibitory activities (log IC50 values: 1.63-2.34). Moreover, two tripeptides among the chosen six peptides were selected for ACE-I inhibition mechanism analysis which based on Lineweaver-Burk plots indicated that they behave as competitive ACE-I inhibitors. The C-terminal residues of short-chain peptides that contain more H-bond acceptor groups could easily form hydrogen bonds with ACE-I and have higher ACE-I inhibitory activity. Overall, sericin protein as a strong ACE-I inhibition source could be deemed a promising agent for antihypertension applications.