Objective To establish the rehabilitation program of external diaphragm pacer and to explore its preventive effect on ventilator-induced diaphragmatic dysfunction（VIDD） in patients with ICU non-invasive mechanical ventilation. Methods Through the literature review,group meeting and pre-experiment,a program was formulated to prevent VIDD in patients with non-invasive ventilation in ICU. Patients with non-invasive ventilation were conveniently selected from September 2020 to June 2021 in a respiratory intensive care unit of a tertiary hospital in Henan province. They were divided into 2 groups by random number table method. On the basis of routine nursing care,the experimental group was given the external diaphragm pacer training program,and the control group was given routine nursing program. The incidence of VIDD,diaphragm thickness score,diaphragm displacement and blood gas analysis were compared between 2 groups after the intervention. Results A total of 74 patients were included with 10 cases fallen off,and finally 64 cases were included with 32 cases in the experimental group and 32 cases in the control group. After the intervention,the incidence of VIDD was 6.25% in the experimental group,while that was 43.75% in the control group. The difference between 2 groups was statistically significant（P=0.001）. Conclusion The external diaphragm pacer rehabilitation program can reduce the incidence of VIDD and improve diaphragm and respiratory function in patients with ICU non-invasive mechanical ventilation.

Objective To extract and summarize the best evidence related to constipation management in peritoneal dialysis patients，so as to provide bases for clinical medical staff to formulate peritoneal dialysis constipation assessment process and management plan. Methods We searched relevant guideline networks，UpToDate，BMJ，JBI，Cochrane Library，Web of Science，PubMed，Embase，CNKI，Wanfang databases to collect relevant guidelines，expert consensuses，best practices，recommended practices and systematic evaluations related to constipation management in peritoneal dialysis from the establishment of the database to March 18，2022. There were 2 researchers who independently evaluated the literature quality and extracted data. Results A total of 14 pieces of literature were included，including 4 guidelines，3 expert consensuses，2 best practices，2 systematic evaluations and 3 evidence summaries. Finally，22 pieces of best evidence including 4 dimensions were summarized，namely evaluation，health guidance，medication management and other treatments. Conclusion This study summarized the best evidence of constipation management in peritoneal dialysis patients，which can provide evidence-based bases for formulating constipation evaluation process，management plan and practice standard of peritoneal dialysis patients.

The nursing experience of an acute leukemia patient complicated with left lower extremity aeromonas pyogenic osteomyelitis was summarized. The nursing points include:taking targeted measures to prevent the outbreak of hospital infection;actively preventing and dealing with complications such as septic shock,anemia and bleeding,deep vein thrombosis and limb dysfunction;maintaining a balance between meeting nutritional needs and controlling blood sugar;strengthening discharge education,improving patients’ treatment and follow-up compliance. After 30 days of intensive treatment and nursing care,the patient was discharged from the hospital after osteomyelitis under control. After 2 months of follow-up,the patient had no recurrence of osteomyelitis,and the wound healed well. The patient received allogeneic hematopoietic stem cell transplantation successfully.

Objective To establish sensitive indicators of nursing care quality in post anesthesia care unit（PACU）,and to provide standard and professional quantitative basis for treatment,monitoring and management of patients in PACU. Methods The first draft was formed based on the structure-process-result theory,National Database of Nursing Quality Indicators（NDNQI） and existing research results from domestic and international anesthesia nursing experts. Delphi Method was adopted to conduct 3 rounds of expert consultations,combining with Pareto’s principle to finalize the content of the indicators and scientific measuring methods. Results A PACU nursing care quality sensitive indicators system was built up,including 11 indicators,such as the median recovery time,the proportions of patients from different departments,the effectiveness of hypothermia intervention and the effectiveness of postoperative pain intervention,etc. After 3 rounds of expert consultations,the effective response rates were all 100% with authority coefficients of 0.86,0.84 and 0.90,coefficients of concordance of 0.245,0.256 and 0.356 respectively（P<0.01）. Conclusion The sensitive indicators of nursing care quality in PACU covered the key contents of post anesthesia monitoring,which was highly operable,scientific,practical and distinctive in specialty,and can provide references for data-based continuous quality improvement and improvement of nursing quality in PACU.