Relationship between indwelling site and peripheral venous catheter-related complications in adult hospitalized patients: A systematic review and meta-analysis

AIMS AND OBJECTIVES

This systematic review and meta-analysis aimed to compare the incidence of PVC-related complications between catheterisation in the forearm and back of the hand in adult patients.

BACKGROUND

A peripheral intravenous catheter (PVC) is often inserted as part of care during patients' hospitalisation. The catheter is typically inserted in the forearm or at the back of the hand in usual practice. Studies have not yet reached a consensus on the optimal insertion site in any clinical setting.

DESIGN

We performed a systematic review and meta-analysis based on PRISMA guidelines.

METHODS

We searched the following electronic databases: PubMed, Cochrane Library, Embase, and CINAHL. Randomised controlled trials, cohort studies, case-control studies and cross-sectional studies from inception to July 2021 reporting the incidence of PVC-related complications at the forearm and back of the hand were included. Fixed-effects models and random-effects models were used to derive the pooled risk ratios.

RESULTS

Twenty-four studies involving 16562 PVCs met our inclusion criteria. The meta-analysis showed that compared with PVC placement in the back of the hand, placement in the forearm was associated with a higher incidence of total complications and infiltration/extravasation. However, the differences between the PVC indwelling sites were not significant (total complications: P = 0.43; phlebitis: P = 0.35; infiltration/extravasation: P = 0.51). Both incidence of total complications and infiltration/extravasation analyses showed high heterogeneity (total complications: I2  = 60%; infiltration/extravasation: I2  = 58%).

CONCLUSION

Available evidence suggests that there is no significant difference between PVC placement in the forearm and at the back of the hand in terms of the incidence of complications, thus making both approaches suitable.

RELEVANCE TO CLINICAL PRACTICE

For patients who need indwelling PVC, medical staff can choose the best indwelling site, and both forearm and back of the hand are suitable.

Generation of a long-acting fusion inhibitor against HIV-1

AIDS has evolved from a fatal infectious disease to a manageable chronic disease under the treatment of anti-AIDS medications. HIV fusion inhibitors with high activity, low side effects and strong selectivity are promising drugs against HIV. Only one fusion inhibitor is currently approved, thereby highly active long-acting fusion inhibitors need to be developed for long-term AIDS treatment. Here, we synthesised MT-SC22EK (a small HIV fusion inhibitor) derivatives containing 1-2 staples to improve its stability. Antiviral activity studies showed that MT-SC22EK-2 with two staples exhibited potent inhibitory activity against HIV-1 standard strains and Chinese epidemic strains, and at the same time, MT-SC22EK-2 presented strong anti-T20 resistance. Surprisingly, MT-SC22EK-2 possessed excellent protease stability with a half-life of 3665 min. MT-SC22EK-2 is a potential HIV fusion inhibitor considered as a long-acting anti-HIV drug candidate.

Effect of atorvastatin on plasma NT-proBNP and inflammatory cytokine expression in patients with heart failure

The aim of this study was to explore the effect of atorvastatin intervention on plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) and inflammatory cytokine levels in patients with heart failure (HF). One hundred and twenty-three HF patients were selected from our hospital and randomly divided into control (N = 61) and observation (N = 62) groups; the former received conventional treatment, while the latter were given conventional treatment combined with atorvastatin. Plasma NT-proBNP, inflammatory cytokines [high-sensitive C-reactive protein (hs-CRP), interleukin (IL)-6, IL-10] and cardiac function [left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF), end-diastolic maximum flow rate ratio (E/A)] were compared among groups. The effective rate of treating HF significantly increased after atorvastatin treatment. The plasma NT-proBNP, IL-6, IL-10, hs-CRP, and LVEDD levels significantly decreased (P < 0.05), while the LVEF and E/A levels significantly increased (P < 0.05) in the observation group compared to the control group and before intervention. The NT-proBNP and cytokine levels significantly differed among patients with different classes of heart function (P < 0.05); the NT-proBNP and cytokine levels increased with the severity of heart function. Pearson's correlation analysis revealed a negative correlation between the NT-proBNP and inflammatory cytokine levels and LVEF and E/A values, and a positive correlation between these factors and LVEDD (P < 0.05). In conclusion, atorvastatin significantly improves cardiac function; the mechanism atorvastatin action was related to the decrease in plasma NT-proBNP and inflammatory cytokine levels.

Risk factors for damaged liver function after chemotherapy in hepatitis B virus carriers with non-Hodgkin lymphoma

The goal of this study was to investigate damaged liver function after chemotherapy in hepatitis B virus (HBV) carriers with non-Hodgkin lymphoma (NHL) and to evaluate risk factors associated with a high risk of damaged liver function. Clinical histories of 134 HBV carriers with NHL who were treated with chemotherapy were obtained and analyzed for the occurrence of damaged liver function and other related high-risk factors. Analysis showed that 76 patients (56.7%) had damaged liver function after chemotherapy: 6 patients (7.9%) had I degree, 17 patients (22.4%) had II degree, 20 patients (26.3%) had III degree, and 33 patients (43.4%) had IV degree damage. After treatment, 18 patients (23.7%) continued to receive chemotherapy according to their original schedule, 39 patients (51.3%) delayed chemotherapy, 16 patients (21.1%) stopped chemotherapy, and 3 patients (3.9%) died. Analysis of a binary multivariate logistic regression model showed that administration of steroids was a high-risk factor for damaged liver function after chemotherapy in NHL patients. The incidence of damaged liver function after chemotherapy is high among HBV carriers with NHL; therefore, administration of steroid chemotherapy is a high-risk factor.

Optical properties of ZnMgO nanowalls grown by plasma-assisted molecular beam epitaxy

ZnMgO nanowalls were prepared by plasma-assisted molecular beam epitaxy without a catalyst on c-Al2O3 substrate. The obtained nanowalls have preferred orientation along c axis. The nanowalls are about 10 to 20 nm in thickness and about 50 nm in height. Only Zn, Mg, O and Al signals are detected in the nanowalls from the energy dispersive spectroscopy (EDS). The Mg content is about 3% in ZnMgO nanowalls. The room temperature photoluminescence (PL) spectra shows the emission peak of the ZnMgO nanowalls at 3.346 eV. The origin of the ultraviolet emission is discussed with the help of temperature-dependent PL spectra. The ultraviolet emission band is free exiton recombination observed in the low temperature PL spectra (at 81 K). We also observe the free-to-acceptor (FA) emission of the ZnMgO nanowalls. The acceptor binding energy obtained from photoluminescence studies is about 123 meV. The results show that Mg doping leads to an increase of the acceptor binding energy. The possible growth mechanism of the ZnMgO nanowall networks was discussed.

Mimicking mussel adhesion to improve interfacial properties in composites

The macroscale properties of polymer-matrix composites depend immensely on the quality of the interaction between the reinforcement phase and the bulk polymer. This work presents a method to improve the interfacial adhesion between metal-oxides and a polymer matrix by performing surface-initiated polymerization (SIP) by way of a biomimetic initiator. The initiator was modeled after 3,4-dihydroxy-L-phenylalanine (dopa), an amino acid that is highly concentrated in mussel foot adhesive proteins. Mechanical pull out tests of NiTi and Ti-6Al-4V wires from poly (methyl methacrylate) (PMMA) were performed to directly test the interfacial adhesion. These tests demonstrated improvements in maximum interfacial shear stress of 116% for SIP-modified NiTi wires and 60% for SIP-modified Ti-6Al-4V wires over unmodified specimens. Polymer chain growth from the metal oxides was validated using x-ray photoemission spectroscopy (XPS), ellipsometry, scanning electron microscopy (SEM), and contact angle analysis.

Photoluminescence of ZnO nanocrystals embedded in BaF2 matrices by magnetron sputtering

This paper describes ZnO nanocrystals embedded in BaF2 matrices by the magnetron sputtering method in an attempt to use fluoride as a shell layer to embed ZnO nanocrystals core. BaF2 is a wide-band gap material, and can confine carriers in the ZnO films. As a result, the exciton emission intensity should be enhanced. The sample was annealed at 773 K, and X-ray diffraction (XRD) results showed that ZnO nanocrystals with wurtzite structure were embedded in BaF2 matrices. Raman-scattering spectra also confirmed the formation of ZnO nanoparticles. Abnormal longitudinal-optical (LO) phonon-dominant multiphonon Raman scattering was observed in the sample. Room-temperature photoluminescence (PL) spectra showed an ultraviolet emission peak at 374 nm. The origin of the ultraviolet emission is discussed here with the help of temperature-dependent PL spectra. The ultraviolet emission band was a mixture of free exciton and bound exciton recombination observed in the low temperature PL spectra (at 77 K). Abnormal temperature dependence of ultraviolet near-band-edge emission-integrated intensity of the sample was observed. The band tail state was observed in the absorption spectra, illustrating that the impurity-related defects were caused by the shell of the BaF2 grain layer. For comparison, ZnO films on BaF2 substrates were also fabricated by the magnetron sputtering method, and the same measurement methods were used.

Preparation of ZnO colloids by aggregation of the nanocrystal subunits

Colloidal ZnO particles with narrow size distribution were prepared via a sol-gel process by base-catalyzed hydrolysis of zinc acetate. The morphology of ordered arrays of the particles was recorded by SEM. SEM also reveals that these uniform particles were composed of tiny ZnO subunits (singlets) sized of several nanometers. The size of the singlets, which is confirmed by X-ray diffraction and UV-vis absorption spectra, increases as the aging time is prolonged. The size-selective formation of colloids by aggregation of nanosized subunits is proposed to consist of two-stage growth by nucleation of nanosized crystalline primary particles and their subsequent aggregation into polycrystalline secondary colloids. The aggregates are all spherical because the internal rearrangement processes are fast enough. The ZnO colloids, i.e., the aggregates, tend to self-assemble into well-ordered hexagonal close-packed structures. Room-temperature photoluminescence was characterized for green and aged ZnO.

Optical properties of ZnO and ZnO:In nanorods assembled by sol-gel method

Self-assembled zinc oxide (ZnO) and indium-doping zinc oxide (ZnO:In) nanorod thin films were synthesized on quartz substrates without catalyst in aqueous solution by sol-gel method. The samples were characterized by x-ray diffraction (XRD), scanning electron microscope (SEM), Raman-scattering spectroscopy, room-temperature photoluminescence (PL) spectra, and temperature-dependent PL spectra measurements. XRD and Raman spectra illustrated that there were no single In2O3 phase in ZnO lattice after indium doping. The PL spectra of ZnO showed a strong UV emission band located at 394 nm and a very weak visible emission associated with deep-level defects. Indium incorporation induced the shift of optical band gap, quenching of the near-band-edge photoluminescence and enhanced LO mode multiphonon resonant Raman scattering in ZnO crystals at different temperatures. Abnormal temperature dependence of UV emission integrated intensity of ZnO and ZnO:In samples is observed. The local state emission peak of ZnO:In samples at 3.37 eV is observed in low-temperature PL spectra. The near-band-edge emission peak at room temperature was a mixture of excitons and impurity-related transitions for both of two samples.

The optical properties of ZnO hexagonal prisms grown from poly (vinylpyrrolidone)-assisted electrochemical assembly onto Si (111) substrate

ZnO hexagonal prisms have been grown from poly (vinylpyrrolidone)-assisted electrochemical assembly onto p-type Si (111) substrate. These ZnO prisms arrays are highly (0002) orientated. The (0001) end facets and {1010} side facets of the hexagonal prisms are well defined. The photoluminescence (PL) spectrum of these ZnO prisms shows an intense ultraviolet near band-gap emission with a full width at half maximum of 86 meV at room temperature. The low-temperature PL spectrum is split into well-resolved free and bound exciton emission lines. The temperature dependence of the exciton emission intensities shows a nonmonotonic decaying behavior, which can be explained by the existence of interfacial states.

Effects of thermal annealing on the structural and optical properties of MgxZn1−xO nanocrystals

Mg(x)Zn(1-x)O ternary alloy nanocrystals with hexagonal wurtzite structures were fabricated by using the sol-gel method. X-ray diffraction patterns, UV-vis absorption spectra, and photoluminescence spectra were used to characterize the structural and optical properties of the nanocrystals. For as-prepared nanocrystals, the band gap increases with increasing Mg content. Weak excitonic emission with strong deep-level emission related to oxygen vacancy and interface defects is observed in the photoluminescence spectra at room temperature. Thermal annealing in oxygen was used to decrease the number of defects and to improve the quality of the nanocrystals. In terms of XRD results, the grain sizes of nanocrystals increase with increasing annealing temperature and the lattice constants of alloy are smaller than those of pure ZnO. The band gap becomes narrower with increasing annealing temperature. For Mg(x)Zn(1-x)O nanocrystals (x=0.03-0.15) annealed at temperatures ranging from 500 to 1000 degrees C, intense near-band-edge (NBE) emissions and weak deep-level (DL) emissions are observed. Consequently, the quality of Mg(x)Zn(1-x)O nanocrystals can be improved by thermal annealing.

The effect of surface properties on visible luminescence of nanosized colloidal ZnO membranes

Luminescence properties of nanosized zinc oxide (ZnO) colloids depend greatly on their surface properties, which are in turn largely determined by the method of preparation. ZnO nanoparticles in the size range from 3 to 9 nm were prepared by addition of tetramethylammonium hydroxide ((CH3)4NOH) to an ethanolic zinc acetate solution. X-ray diffraction (XRD) indicates nanocrystalline ZnO membranes with polycrystalline hexagonal wurtzite structure. The ZnO membranes have a strong visible-emission intensity and the intensity depends upon hydrolysis time. The infrared spectra imply a variety of forms of zinc acetate complexes present on the surface of ZnO particles. The effect of the ZnO membrane surface properties on photoluminescence is discussed.