If the validity of this questionnaire is supported in other ICU samples, RCSQ-C could be used as a routine evaluation instrument to distinguish good and poor sleepers and then direct nurses to form corresponding treatment plans to promote sleep.
Podophyllotoxin (PPT) and its derivatives exert significant anti-cancer activities, and one derivative etoposide is often utilized to treat various cancers in the clinic. The aim of the present study is to investigate the inhibitory effects of PPT on major cytochrome P450 (CYP) isoforms in human livers. Inhibition of CYP3A4, CYP2C9, CYP2C8, CYP2D6, CYP2E1 and CYP2A6 by PPT was investigated in the human liver microsomal system. Time-dependent inhibition of CYP3A4 by PPT was also evaluated. The results showed that PPT strongly exhibited inhibitory effects on CYP3A4 and CYP2C9 in a concentration-dependent manner. Half inhibition concentration (IC50) was 1.1 +/- 0.3 and 4.6 +/- 0.3 meu M for CYP3A4 and CYP2C9, respectively. Inhibition kinetic analysis showed that PPT exhibited competitive inhibition towards CYP3A4 and CYP2C9 with Ki of 1.6 and 2.0 meu M, respectively. Additionally, PPT exerted time-dependent inhibition towards CYP3A4 and the kinetic parameters were 4.4+/- 2.1 meu M and 0.06 +/- 0.01 min-1 for KI and kinact, respectively. Our experimental data indicate that potential drug-drug interaction (DDI) might exist when PPT is co-administered with the substrates which mainly undergo CYP3A4- or CYP2C9-mediated metabolism.
The method of ultrasonic Doppler setting lower extremity tourniquet pressure during the operation could not only ensure the hemostatic effect, but it could also provide the optimum individual pneumatic tourniquet pressure value for patients. In the meanwhile, it could reduce the incidence of adverse reaction using tourniquets effectively as well as improve the safety of the tourniquet. This method played an important role in the recovery of patients.
BackgroundMusic listening can be easily implemented as a safe, low‐cost, and non‐invasive intervention.AimsWe assessed the effectiveness of music listening on sleep quality, psychological outcomes, and physiological outcomes for critically ill patients in intensive care units (ICUs).Study designIt is a systematic review and meta‐analysis. Twelve electronic databases were searched from inception to February 2022. Inclusion criteria were randomized and quasi‐experimental trials that assessed the effect of music listening during ICUs, excluding those receiving music therapy. The outcome indicators were sleep quality, anxiety, depression, and physiological outcomes. We assessed the quality of the included studies using the Cochrane risk of bias tool, and performed a meta‐analysis using RevMan 5.3 software. Standardized mean difference (SMD) or mean difference (MD) were used as measures of effect and the results were presented as SMD or MD with 95% confidence intervals (CIs).ResultsA total of 1585 titles and abstracts were identified, in which 29 studies were included in the systematic review, which evaluated 2198 subjects, including 1106 in control groups and 1092 in intervention groups. Compared with control groups, music listening improved sleep quality (SMD: 0.93 [95% CI: 0.49–1.38]), anxiety (SMD: −1.12 [−1.55 to −0.69]), depression (SMD: −1.08 [−1.62 to −0.55]), and physiological parameters. Subgroup analysis revealed that music listening produced better results in improving sleep quality in studies of non‐surgical patients, in studies in which researchers selected the type of music, in studies with longer intervention duration (>45 to ≤60 min), and in studies that used the Richards‐Campbell sleep questionnaire. Bias risk was moderate in all of the included studies.ConclusionsMusic listening can improve sleep quality, anxiety, and depression in critically ill patients. However, high‐quality trials are still needed to determine the role of music listening in critical care in more depth.Relevance to clinical practiceMusic listening is an inexpensive and easy‐to‐administer intervention that is unlikely to have adverse effects, in contrast to many sedative and analgestic drugs. It deserves widespread use in critically ill patients.RegistrationThe present study is registered with PROSPERO, number CRD42019147202.
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