Objective To search and obtain relevant evidence of exercise management in patients with nonalcoholic fatty liver disease（NAFLD） and to provide a reference for clinical practice. Methods UpToDate，BMJ Best Practice，International Guidelines Collaboration（GIN），Scottish College Guidelines Network（SIGN），National Institute for Healthcare Excellence（NICE） website，Cochrane Library，U.S. Agency for Healthcare Research and Quality（AHRQ） website，Canadian Association of Registered Nurses of Ontario（RNAO） website，American Association for the Study of Liver Diseases（AASLD） website，PubMed，Web of Science，CINAHL，DynaMed，Embase，CNKI，Chinese Medical journal full-text database，Wanfang Data Knowledge Service Platform，Sinomed and other databases were systematically searched for all evidence on exercise management of the NAFLD. It includes guidelines，evidence summaries，expert consensuses，best practice information booklets，clinical decisions，recommended practice，and systematic reviews. The retrieval period is from the database inception to November 2022. The quality of the literature was evaluated independently by 2 researchers. Results A total of 18 pieces of literature，including systematic evaluations，expert consensuses，and clinical practice guidelines，were included. 24 pieces of best evidence were collected from 6 aspects，including exercise principle，exercise supervision，exercise type，exercise selection，exercise time and frequency，and exercise intensity. Conclusion This study summarized the best evidence for exercise management of patients with NAFLD，which is comprehensive and scientific. Medical staff can use the best evidence to guide patients with NAFLD to exercise reasonably and improve the scientific nature of the intervention.

Objective To investigate the effect of specialty nurse-led discharge preparation in the perioperative period of lung transplantation patients. Methods Based on the transition theory，literature analysis and expert meetings，the hospital discharge preparation service plan for lung transplant patients was established. We selected 33 lung transplant patients in a tertiary hospital in Zhejiang Province for this study based on convenience sampling，and they were divided into an experimental group and a control group by random number method. The experimental group received the discharge preparation service program led by specialty nurses，and the control group received routine perioperative management of lung transplantation. Data from admission to 3 months after discharge were collected. Between the 2 groups，they were compared on readiness for hospital discharge，reintubation，readmission，and part 2 of Partners at Care Transitions Measure（PACT-M2）. Results A statistically significant difference was found in the scores for readiness for hospital discharge，reintubation rate，and Chinese version PACT-M2（P<0.05）. There was no significant difference in the number of readmissions 1 month and 3 months after discharge between the 2 groups（P>0.05）. Conclusion Specialized nurse-led discharge preparation services for lung transplant patients can improve their readiness for discharge and enhance the quality of self-care at home.

Objective To explore the application effect of the information system for prevention and treatment of hospital-acquired venous thromboembolism（HA-VTE） in HA-VTE management. Methods A team of HA-VTE management was set up and the information system for prevention and treatment of HA-VTE was established，which mainly included 4 content modules，namely assessment，early warning，decision-making，and monitoring，in order to achieve functions such as time points risk assessment，early warning assessment，prevention taboo assessment，auxiliary decision support，scoring supervision，and achieve coordinated prevention and control throughout the hospital. The system was officially clinically applied in October 2022. The hospital HA-VTE risk assessment rate，prevention rate among medium to high-risk patients，awareness rate of HA-VTE prevention knowledge among medium to high-risk patients，implementation rate of basic prevention measures among medium to high-risk patients，and incidence rate of HA-VTE were compared before（from April to September 2022） and after （from October 2022 to March 2023） the use of the system. Results After the application of the information system for prevention and treatment of HA-VTE，the risk assessment rate of HA-VTE has increased from 96.96% to 100%. The prevention rate of medium to high-risk patients increased from 37.93% to 46.86%（including the increase of drug prevention rate from 26.99% to 37.12%，and the increase of combined prevention rate from 2.16% to 4.66%）. The awareness rate of HA-VTE prevention knowledge for medium to high-risk patients has increased from 87.76% to 96.84%，and the implementation rate of basic preventive measures has increased from 83.67% to 94.74%，with statistically significant differences（P<0.05）. The incidence of HA-VTE has decreased from 0.066% to 0.046%. The difference was not statistically significant（P>0.05）. Conclusion The information system for prevention and treatment of HA-VTE can enhance the compliance of nursing staff in risk assessment，provide accurate and effective decision-making basis for medical staff，and improve the current situation of HA-VTE management in hospitalized patients.

This article summarizes a series of organization and contingency management strategies of convertible ICU in severe rescue of COVID-19. Based on the 4S management model，focusing on the 4 core issues of space，staff，system，and supplies，the convertible ICU was quickly established through rapid transformation and expansion，overall sharing of equipment，and visual management of material placement. Personnel management includes establishing 3 reservoirs and 4 echelons，carrying out severe illness training，and carrying out classification authorization and combined shift scheduling. At the system level，a multidisciplinary collaboration mechanism was established and the ventilation gateway was moved forward in the prone position to improve the success rate of critical care. At the supply level，the key configuration of the intelligent monitoring system enabled efficient care，and psychological counseling support was provided to maintain employee’s mental health. During the period of the convertible ICU of rapid establishment and operation，through the implementation of these strategies，the timely，orderly，safe and efficient treatment of critically ill patients was ensured. The experience and theoretical basis were provided for the establishment and transformation of convertible ICU for other institutions in emergency situations.

To summarize the nursing experience of 2 cases of lung transplantation in patients with versus host disease after allogeneic hematopoietic stem cell transplantation. Nursing points include observation and prevention of rejection reaction;strictly implementing prevention and control measures to reduce the risk of infection;through various rehabilitation training,promoting the recovery of respiratory function;conducting nutritional screening and developing nutritional support programmes;timely assessment of psychological state,individual psychological counseling. With aggressive treatment and care,2 patients recovered well and were transferred out of the intensive care unit.

To summarize the first aid and nursing experience of an ICU patient with stress cardiomyopathy after kidney transplantation. Nursing points：focus on changes in the condition and implement efficient first aid measures; rapid and accurate assessment,safe and stable transport;strict hemodynamic measurement,goal-oriented fluid management;precise drug administration,observation of drug effects and adverse reactions; emphasis on psychological counseling and rehabilitation training and doing a good job of continuous nursing are keys to the smooth transfer of patients. After careful treatment and care,the patient was transferred to the kidney transplant ward for continuous specialist treatment on the 16th day after the operation. On the 38th day after the operation,he recovered and was discharged from the hospital.

Objective To develop and evaluate the reliability and validity of Perception of Risk of Chronic Kidney Disease Scale（PRCKDS） for patients with type 2 diabetes mellitus. Methods The item pool was determined by literature review,interview,expert consultation,and pre-investigation,and the formal scale was formed. The newly developed PRCKDS was tested on 420 patients with type 2 diabetes through an online survey. The reliability and validity of the scale were evaluated by Spearman correlation analysis,factor analysis,and Cronbach’s α respectively. Results There were 36 items in the formal scale,with 5 dimensions including susceptibility,severity,beneficence,hindrance and precipitating factors. Spearman correlation analysis indicated that the content validity was good. Confirmatory factor analysis indicated that the model fit was good. The factor loads of 36 items were all greater than 0.45 and within the preset 5 dimensions,indicating that the structure validity was good. The Cronbach’s α of homogeneity is 0.875,and the split reliability is 0.865. Conclusion The PRCKDS established in this study has good reliability and validity,and it can be used as an effective and reliable measurement tool to assess the risk perception of chronic kidney disease in patients with type 2 diabetes mellitus. Different risk perception groups should be differentiated,and individualized strategies should be adopted in the prevention education of chronic kidney disease.

Objective To explore the current status and influencing factors of health education literacy of clinical pediatric nurses in China,so as to help clinical managers to formulate targeted training programs and provide references for the improvement of health education literacy of clinical nurses. Methods Pediatric nurses from 31 provinces and cities at all levels in the country were selected as survey subjects by the method of general survey,and a self-made “Pediatric Nurse Health Education Literacy Questionnaire” was distributed to investigate the knowledge,attitude and practice of health education literacy of nurses. The influencing factors of health education literacy were analyzed by multiple linear regression method. Results A total of 15,800 questionnaires were collected,of which 15,765 were valid with an effective recovery rate of 99.78%. 31 provinces,autonomous regions and municipalities nationwide participated in this survey. The knowledge of health education literacy of nationwide pediatric nurses scored（37.80±4.46）;the score of attitude was（31.74±3.60）;the practice scored（77.03±7.76）. Multiple linear regression analysis showed that professional titles,related publications,and the attendance of related trainings were main influencing factors of health education literacy of pediatric nurses（P<0.05）. Conclusion The health education literacy of pediatric clinical nurses in China was at a medium level,which needs to be further improved. Active participation in various forms of training could help nurses form a complete framework of health education and improve the holistic level of health education literacy. Nursing managers should provide effective trainings for nurses based on clinical needs and make joint efforts to improve the health education literacy of pediatric clinical nurses.

Objective To implement evidence-based practice of breast milk expression behaviors among postpartum women with neonatal-maternal separation and explore its influences on lactation. Methods Evidence-based nursing was used to obtain best evidence. The model of evidence-based continuous quality improvement was adopted as the theoretical framework. From May to December 2018,the best evidence was applied to separated mothers according to four stages：evidence acquisition,current situation review,evidence introduction and effect evaluation. The changes of breast milk expression compliance and lactation volume were observed before and after the application of evidence. Results A total of 12 items of evidence were applied. Breast milk expression compliance was improved after evidence implementation. The number of women who transported breast milk to neonatology department increased. The initial time of breast milk transportation after delivery was brought forward. The total estimated lactation volume per woman in the first seven days after delivery was increased. Conclusion Evidence-based nursing is useful to manage breast milk expression behaviors among postpartum women with neonatal-maternal separation,optimize lactation success and increase the amount of milk,which can provide references for breastfeeding management for women with neonatal-maternal separation.

Objective To establish and implement a neonatal care clinic for meeting the needs of neonatal continuing nursing service. Methods Regulations were set up,nurses were selected,and the neonatal care clinic was established for screening of neonatal jaundice and parenting guidance. Nurses,doctors and parents were investigated for evaluation of the clinic. Results A total of 16 nurses were selected for the clinic. From March to August 2017,there were 2,543 cases for neonatal care visits,and the number of cases for neonatal jaundice was the highest which was 2038（80.14%）. All nurses believed that the clinic improved parents’ satisfaction with hospital and nursing work,and they agreed that specialist nursing capacity was improved;66.67% of the doctors considered that specialist nursing clinic was helpful to the diagnosis and treatment of patients;80% of the parents had a total score of 90 to 100 on evaluation of the neonatal care clinic. Conclusion The neonatal care clinic can effectively identify pathological jaundice and solve parenting problems from parents,improve professional and social status of neonatal specialist nurses and their confidence to be clinical nursing specialists,and received recognition from doctors and parents.

Objective To investigate the effect of sequential sputum excretion scheme on pulmonary tuberculosis patients treated with mechanical ventilation. Methods Forty-five pulmonary tuberculosis patients with mechanical ventilation were selected as the experimental group from January to December 2018,and received sequential sputum excretion scheme;while 44 patients were recruited as the control group from January to December 2017 receiving routine sputum management. Breathing rate,mean arterial pressure,blood oxygen saturation,arterial oxygen partial pressure,artery oxygenation index,CO ₂ partial pressure,airway peak pressure value,the amount of sputum drainage,effect of sputum excretion,incidence of ventilator-associated pneumonia,length of mechanical ventilation,length of ICU stay,and success rate of ventilator weaning were compared between two groups. Results After 24 hours of intervention,there was significant difference in breathing rate and no significant difference in mean arterial pressure fluctuation before intervention in two groups,but blood oxygen saturation,arterial oxygen partial pressure and oxygenation index in the experimental group were higher than those in the control group and before intervention（ P<0.05）. After intervention,the peak airway pressure and arterial CO ₂ partial pressure in the experimental group were significantly lower than those in the control group and before intervention（ P<0.05）. After 24 hours of intervention,the daily sputum excretion in the experimental group（29.48±4.54） ml was significantly higher than the control group（12.56±2.287） ml（ P<0.001）. After 7 days of intervention,the effect of sputum excretion in the experimental group was better than the control group（ P<0.05）. Compared with the control group,the incidence of ventilator-associated pneumonia,the length of mechanical ventilation and the length of ICU stay in the experimental group were lower and shorter,and the success rate of ventilator weaning was higher（ P<0.05）. Conclusion Sequential sputum excretion scheme can promote the discharge of sputum in pulmonary tuberculosis patients with mechanical ventilation,improve pulmonary function and quality of life,shorten length of stay in ICU and reduce medical burden.