Challenging behavior is the most common abnormal behavioral symptom in patients with Alzheimer’s disease. It is also a manifestation of poor health of patients，which brings great burden to patients and their caregivers. This article introduces the main content，reliability and validity，characteristics，application status and applicability of common assessment tools for challenging behavior in patients with Alzheimer’s disease，in order to provide references for the development of challenging behavior assessment tools for patients with Alzheimer’s disease in China and provide references for medical staff to scientifically select appropriate assessment tools.

Extracorporeal cardiopulmonary resuscitation provides cardiopulmonary support for patients with cardiac arrest，ensures tissue perfusion of brain，heart and important organs，reduces ischemia and hypoxia of patients，provides support for follow-up treatment，and improves survival rate of patients. With the wide application of extracorporeal cardiopulmonary resuscitation，the incidence of neurological complications has increased，which has brought great burden to patients，their families and society. This article summarized the influencing factors and nursing measures of neurological complications in patients undergoing extracorporeal cardiopulmonary resuscitation，providing references for effective nursing intervention in patients undergoing extracorporeal cardiopulmonary resuscitation.

Objective To construct a diet and nutrition rehabilitation program for patients after weight loss and metabolism,and to provide references for clinical nursing work. Methods The first draft of diet and nutrition rehabilitation program after weight-loss metabolism was prepared by retrieving domestic and foreign literature. From July to September 2021,15 experts were consulted by Delphi method for 2 rounds of correspondence to seek their opinions,and the final draft was formed. Results The recovery rate of the 2 rounds of expert inquiries was 100%（15/15） and the expert authority factor was 0.854. Kendall’s Coordination Coefficient was 0.227 and 0.578（P<0.01）,and the final program consisted of 5 primary indicators,18 secondary indicators and 37 tertiary indicators. Conclusion The diet and nutrition rehabilitation program after metabolic and bariatric surgery developed in this study is scientific and reliable,which can provide references for postoperative nursing practice in the future.

Percutaneous coronary intervention has become the main treatment of cardiovascular diseases. Returning to work marks the transformation from disease to positive social status and is an important indicator of disease recovery. This paper reviews the concept,current situation,influencing factors,and interventions of patients returning to work after percutaneous coronary intervention,in order to provide references for the definition of returning to work,the formulation of comprehensive intervention measures and the research of nursing practice.

Objective To understand the current situation of aspiration in ICU patients with different feeding patterns and to compare its characteristics,so as to provide a basis for targeted prevention of aspiration. Methods The study was a prospective study. The convenience sampling method was used to select patients who were admitted to the ICU of a tertiary hospital in Suzhou from January 2020 to April 2021 as the survey subjects. According to the different feeding patterns,patients were divided into an oral feeding group,a gastric tube feeding group and a post-pyloric feeding group. The occurrence and characteristics of dominant aspiration and micro-aspiration of patients with different feeding patterns were observed and compared. Results A total of 721 patients were enrolled. The incidences of dominant aspiration in the oral feeding group,the gastric tube feeding group and the post-pyloric feeding group were 8.10%,15.26%,and 11.26%. The incidences of micro-aspiration were 76.95%,77.11%,and 58.28%,respectively. The characteristics of the occurrence of dominant aspiration in 3 groups were compared. The time of first aspiration in the gastric feeding group earlier than that in the post-pyloric feeding group;the oral feeding group had the most frequent aspirations. The proportions of patients with impaired consciousness,gastric retention,intra-abdominal hypertension,dysphagia,and mechanical ventilation in the gastric feeding group and the post-pyloric feeding group were higher than that in the oral feeding group（Bonferroni method,all P<0.017）. The characteristics of micro-aspiration among 3 groups were compared;the proportion of patients with vomiting in the oral feeding group was higher than that in the post-pyloric feeding group;the acute physiology and chronic health scores and ICU stay time of the patients in the post-pyloric feeding group were higher than those in the oral feeding group;the proportions of patients with impaired consciousness and mechanical ventilation in the gastric tube feeding group and the post-pyloric feeding group were higher than that in the oral feeding group. The above differences are statistically significant（Bonferroni method,all P<0.017）. Conclusion The incidence of dominant aspiration and micro-aspiration in ICU patients fed by gastric tube was higher, and the characteristics of aspiration in ICU patients with different feeding patterns were significantly different. Clinically,individualized preventive measures should be taken as early as possible according to the characteristics of the patient and the way of eating.

Objective To systematically evaluate the disease experience and psychological feeling of pregnant women with hypertensive disorders of pregnancy，and to provide the evidence for disease management measures for pregnant women with hypertensive disorders of pregnancy. Methods Chinese and English databases，including SinoMed，CNKI，Wanfang，VIP，PubMed，Cochrane Library，Web of Science，Embase，PsycINFO，Proquest，CINAHL，were searched for qualitative studies on real experience of hypertensive disorders of pregnancy in pregnant women from the inception of databases to November 10th 2021. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia. The results were integrated by integrating methods. Results 16 studies were included in the final review. Totally 60 findings were extracted;12 new categories were generated;4 integrated results were synthesized as following，complex and lasting emotional response，breaking the pregnancy norm，seeking understanding and support，finding the benefits from experience. Conclusion Nurses should strengthen the dynamic assessment of the mental health of pregnant women with hypertensive disorders of pregnancy，promote the establishment of a multi-coping system of medical care-family-self through coordinated and continuous maternal health care services，enhance the sense of pregnancy control of such pregnant women，reduce the adverse effects of disease factors on pregnancy outcomes and mental health，and ensure the safety of mothers and infants.

Objective To explore the change of transition readiness from perspective of adolescents with chronic diseases and their caregivers，and to identify its long-term effect on their quality of life，and to clarify the regulating role of family management adjustment. Methods A prospective study was conducted among 201 pairs of adolescents with chronic diseases and their caregivers hospitalized in the wards of nephrology，rheumatology，and endocrinology of 2 children’s hospitals in Shanghai from March to September 2019. Data were collected at hospitalization（T1），1 year after discharge（T2） and 2 years after discharge（T3） using a demographic questionnaire，Chinese version of Family Management Measure，Chinese version of Self-Management and Transition to Adulthood with Rx=Treatment Questionnaire，Pediatric Quality of Life Inventory 4.0 and Pediatric Quality of Life Inventory Family Impact Model. The longitudinal actor-partner interdependence model was used to analyze the impact of transition readiness on quality of life. Results The results of ANOVA showed that transition readiness from perspective of adolescents and their caregivers increased year by year（P<0.001）. The results of correlation analysis showed that there was a significant positive correlation between transition readiness and quality of life at T3（P<0.001）. The analysis results of actor-partner interdependence model showed that adolescents’ perspective of transition readiness had a positive actor effect on their own quality of life（P<0.05）;caregivers’ perspective of transition readiness had positive actor and partner effects on their own quality of life and adolescents’ quality of life（P<0.05）;family management adjustment had significant positive impacts on transition readiness. Conclusion In the context of family management，transition readiness could positively predict quality of life of adolescents with chronic diseases and their caregivers. Medical staff should carry out targeted family interventions at different stages，improve self-management level of adolescents，and thus enhance quality of life of the whole family.

Objective To synthesize the findings of qualitative research exploring men’s experiences of partner perinatal loss,and to provide a basis for constructing psychological interventions. Methods Literature retrieval of qualitative research on men’s experiences of partner perinatal loss was conducted in 8 databases,including SinoMed,CNKI,Web of Science,Pubmed,CINAHL,psychINFO,embase,Cochrane library,from the establishment of the databases to April 30,2021. The JBI Critical Appraisal Tool for qualitative studies from Australia was used to evaluate the methodology quality of the included research,and the meta-aggregation was used to conduct the synthesis. Results 12 qualified studies were included and integrated into 59 valuable findings. These findings were then classified into 11 categories under 5 groups,namely men’s complex emotional experience after perinatal loss,the negative changes in life,the different coping strategies,difficulties and needs,and the discovery of benefits. Conclusion Nurses should break up the stereotypes about males,pay more attention to their emotional experience in perinatal loss,and cooperate with their families to provide them with information,environment and humanistic support under the guidance of hospitals. In this way,it will be easier to reduce the males’ care burden and the negative impact of partner perinatal loss on their life,so as to promote their personal growth.

Objective To investigate the effects of the starting time of drinking water on peripheral dose equivalent rate in patients undergoing bone scan,in order to further reduce the impact of bone imaging on the public. Methods Sixty hospitalized patients with bone imaging were randomly divided into an experimental group and a control group. The experimental group began to drink water for 1 000 ml at 1 h before injection,and the control group drank water for 1 000 ml at 2 h after injection,both within 1 h to finish. The dose equivalent rates at 0.5 h,1 h,2 h,3 h,6 h,12 h,and 24 h after injection were measured by a radiation dosimeter at 0.5 m,1 m,2 m,and 3 m in front of the subjects. The distance and time were compared between the two groups when the peripheral dose equivalent rate was reduced to 2.5μSv/h. Results There were statistically significant differences in the peripheral dose equivalent rates between the two groups at 5 time points（0.5 h,1 h,2 h,3 h,and 6 h） and different distances（0.5 m,1 m,2 m,and 3 m） after injection（P<0.05）. Also,the peripheral dose equivalent rate in the experimental group was lower than that in the control group. The distance and time of the experimental group were less compared to those in the control group when the peripheral dose equivalent rate was reduced to 2.5μSv/h. The image quality of both groups was satisfactory and met the diagnostic criteria. Conclusion The bone imaging subjects can drink 1 000 ml of water at 1 hour before the injection,in order to accelerate the excretion of the imaging agent while ensuring image quality,and reduce the surrounding dose equivalent rate in 6 hours after the injection. Nurses can use the results of measurement to guide radiation protection for patients,family members and the public.

Objective To analyze the risks in a temporarily renovated ICU at Tongji Hospital in Wuhan using the Hazard Vulnerability Analysis based on the Kaiser Model,and to propose strategies to respond and manage the risks. Methods The risk management index evaluation system for nursing management was developed based on the Kaiser Model and the status of the temporarily renovated ICU at Tongji Hospital. It was surveyed via web questionnaires during Feb 21st to 25th,2020 among the medical teams in the ICU,and the index risk value and matrix distribution were analyzed. Results The top 13 risk events perceived by the medical team were listed as following.C8 nurses needle stick injury（0.447 6）,B1 patients need to be rescued （0.413 0）,C10 nurses being infected （0.411 0）,B2 patients’ psychological problems（0.407 4）,C9 doctors being infected（0.359 8）,E3 insufficient or interrupted oxygen supply（0.329 1）,D9 drug shortage（0.324 2）,E2 insufficient protective equipment（0.317 9）;C12 doctors and nurses’ absence from work due to emergency illness（0.309 1）,C7 doctors needle stick injury（0.298 2）,E1 insufficient supporting staff in the hospital（0.293 5）,B6 adverse drug reactions in patients（0.292 4）,C6 nurses’ psychological maladjustment（0.289 1）. Conclusion Managers should pay attention to the risk assessment on the status of the temporarily renovated ICU at Tongji Hospital,and then guide the problem solving; at the same time,they should attach great importance to the occupational protection and physical and mental health of medical staff.

Objective To explore a novel triage management mode during the coronavirus disease 2019（COVID-19）epidemic,so as to reduce missed cases,in-hospital cross-infection,and improve satisfaction of patients and their family members. Methods During the COVID-19 epidemic,we moved the triage points to the entries of departments of outpatient,emergency and inpatient by setting up tents. The precise management of triage staff and facilities was enhanced,and the precise triage procedures and information was developed. Results From January 25 to February 20,2020,we triaged a total of 37,698 patients and visitors,among which 301 cases were triaged to the COVID-19 fever clinic,639 cases to the general fever clinic,and 160 cases were suspected as COVID-19 and quarantined,and 3 cases were confirmed as COVID-19 and referred to the designated treatment hospital. Even though the total volume of triage was large,we achieved zero missed detection of suspected patients with COVID-19,zero occurrence of in-hospital cross-infection,and zero complaint from patients and their family members in our hospital. Conclusion The triage management of One-Move and Two-Precise is an effective way and is worth applying to the prevention and control during COVID-19 epidemic or potential infectious disease outbreaks in the future.

Objective To investigate the effect of different exercise modes （handgrip exercise,grip functional exercise,finger exercise） on preventing catheter related thrombosis（CRT） after the PICC placement in cancer patients.Methods The cancer patients with PICC in our tumor ward from November 2015 to December 2016 were divided into three groups-the handgrip exercise group,the grip functional exercise group,the finger exercise group. The incidence and severity of CRT were observed and compared among the three groups within three months after catheterization.Results Within three months after catheterization,the incidence of CRT in the three groups was 31.44%,21.28%,12.05%,respectively. The total incidence and the incidence in first week after PICC catheterization of CRT in three groups were statistically significant（ χ ²=15.357,P<0.001; χ ²=7.700,P=0.021）. The incidence and severity of CRT in finger exercise group was lower than the other two groups.Conclusion Finger exercise in cancer patients with PICC catheterization can reduce the incidence and ease the severity of CRT. The finger exercise method is simple and easy to implement without increasing costs,and patients are willing to accept it.

Objective To construct a predictive model to assess the risk of intraoperative hypothermia during laparoscopic surgery,and to provide technical support for screening patients with high risk of intraoperative hypothermia during laparoscopic surgery.Methods A total of 264 patients were enrolled from January 2016 to December 2017,and risk factors between hypothermia group（116 cases） and non-hypothermia group（148 cases） were compared using logistic regression for model construction. The goodness of fit of the model was verified by Hosmer-Lemeshow test. The predictive validity of the model was evaluated by the area under the ROC curve（AUC）. From January to December 2018,132 patients were recruited for application of the model.Results The incidence of hypothermia in this study was 43.93%（116/264）,and 41.66%（55/132）. The factors that ultimately entered the predictive model were basal body temperature（OR=0.296）,type of surgery（OR=1.457）,room temperature（OR=0.521）,and anesthesia time（OR=1.009）. H-L test P=0.123,the area under the ROC curve（AUC） was 0.791,while the Youden index was 0.867,with sensitivity as 0.60 and specificity as 0.867. The accuracy of the model was 79.54%,indicating the fit and predictive validity of the model were good.Conclusion The predictive model constructed in this study can predict the risk of intraoperative hypothermia in patients undergoing laparoscopic surgery,and thus can provide a reference for clinical screening of high-risk patients.

Objective To identify the Geatures o￡ catch-up growth o￡ weight, length and head circumGerence in very low birth weight (VLBW) preterm infants in 12 months of corrected age and to explore the influencing factors. Methods We conducted a retrospective review o￡ medical records o￡ the VLBW preterm in￡ants who were in compliance with inclusion and exclusion criteria and admitted to neonatal intensive care unit (NICU) from January 2014 to March 2016 in one maternity and infant hospital in Shanghai. Infants’ growth chat from Fenton (2003) and Centers for Disease Control and Prevention (CDC) were used for development outcome comparison. We also analyzed the influencing factors of physical growth outcome at 6 and 12 months corrected age. Results A total of 113 VLBW preterm infants were included in this study!of which 106 cases were followed up to 3 months. The outcomes of physical growth in VLBW preterm infants showed significant difference (P<0.05), comparing with other preterm and term infants. For male VLBW preterm infants at 6 months corrected age!longer length of stay, initiating oral feeding later!achieving full oral feeding later and initiating oral feeding with breast milk later were associated with non-optimal length growth & non-optimal weight growth was associated with prolonged length of stay and initiation of oral feeding later (P<0.05). For female VLBW preterm infants at 12 months corrected age!older maternal age and feeding with preterm formulas had negative association with the growth of head circumference (P<0.05 )& older maternal age in NICU was factors influencing weight growth (P<0.05). For male VLBW preterm infants at 12 months corrected age! initiating oral feeding and achieving full oral feeding later negatively impacted on the growth of head circumference (P<0.05) while exclusively feeding with breast milk in NICU was negatively related to length growth (P<0.05). Conclusion Transition to full oral feeding earlier and providing mixed feeding both in-hospital and post-discharge period played important role in VLBW infants’ physical growth. The results suggested feeding counselling in NICU and during follow-up periods is essential for successful catch-up growth in VLBW preterm infants.