ABSTRACT
Non-alcoholic fatty liver disease (NAFLD) has a high prevalence worldwide, with a significant proportion of patients progressing into non-alcoholic steatohepatitis (NASH) and further into cirrhosis and hepatocellular carcinoma (HCC). Most of the current animal models of NASH have limitations, such as incompatibility with human pathogenesis characteristics or long induction periods, which severely limit the development of new drugs and preclinical studies for NASH. We investigated the progression of NASH and fibrosis, as well as metabolic indicators, at different time points in aged mice induced by the Gubra Amylin NASH (GAN) diet, a high-fat, high-sugar, high-cholesterol diet, and attempted to establish a rapid and useful mouse model of NASH. Young and aged C57BL/6 mice were induced on a normal chow or GAN diet for 12 and 21 weeks, respectively. After 12 weeks of induction, aged mice developed NASH, including hepatic steatosis, lobular inflammation and hepatic ballooning, and the phenotype was more severe compared with young mice. After 21 weeks of induction, aged mice developed hepatic fibrosis, which greatly shortened the induction time compared with young mice. Furthermore, analysis of immune cell infiltration in the liver by flow cytometry elucidated the changes of multiple immune cells during the pathogenesis of NASH. These findings suggest that aged mice may develop NASH and fibrosis more rapidly under GAN diet induction, which may significantly shorten the period for preclinical studies of NASH.
Subject(s)
Carcinoma, Hepatocellular , Liver Neoplasms , Non-alcoholic Fatty Liver Disease , Humans , Mice , Animals , Aged , Non-alcoholic Fatty Liver Disease/pathology , Carcinoma, Hepatocellular/pathology , Liver Neoplasms/pathology , Mice, Inbred C57BL , Liver/metabolism , Liver Cirrhosis/pathology , Disease Models, Animal , Diet, High-Fat/adverse effectsABSTRACT
BACKGROUND: Core competencies of intensive care unit (ICU) nurses were defined as the essential capability to influence patient safety and interdisciplinary collaboration; however, there has been no research conducted that relates to core competencies of ICU nurses at Chinese tertiary-A hospitals in Shanghai. AIMS AND OBJECTIVES: To investigate the current state of core competencies and the factors that influence this key capability in ICU nurses in Chinese tertiary-A hospitals. DESIGN: This was a multicentre, cross-sectional study. METHODS: A convenient sampling method was used to investigate 451 ICU nurses at five tertiary-A hospitals in Shanghai. Data were collected using self-administered questionnaires. RESULTS: The core competencies of ICU nurses were above average, and the scores of seven dimensions, ranked from first to last, were medical ethics, clinical practice, nurse-nurse co-operation, assessment and decision-making, personal and professional development, teaching and research and nurse-physician co-operation. Multivariate linear regression analysis showed that the factors exerting an influence on the core competencies of ICU nurses were title, role incumbent and ICU department. CONCLUSION: This study showed an above-average level of core competencies among ICU nurses in tertiary-A hospitals in Shanghai; however, competencies related to nurse-physician co-operation and the translation of research into practice were underdeveloped. RELEVANCE TO CLINICAL PRACTICE: Nursing managers should implement targeted interventions to improve nurse-physician co-operation and translate research into practice competencies, such as high-fidelity simulation, inter-professional education, scientific research training and innovative skills tutorials. Moreover, this study demonstrated the influencing factors that can be used to improve core competences of ICU nurses.
