To summarize the successful care of a patient with acute liver failure who formed an obstructive fibrinous tracheal pseudomembrane during mechanical ventilation，and whose tracheal pseudomembrane annular abscised after extubation. Key points of nursing include early identification of pseudomembrane abscission，and team collaboration in emergency management；individualized airway care after re-intubation to prevent aggravation of airway injury；active infection control to reduce airway inflammation；strengthening anticoagulation care to promote the recovery of traumatic mucosa；goal-directed sedation and analgesia to assist mechanical ventilation；aspiration prevention during nasal feeding and swallowing function recovery after extubation. The patient was successfully extubated 3 days after re-intubation.

Fatigue is one of the most common complaints in patients with interstitial lung disease（ILD） and seriously affects their prognosis and quality of survival. The study introduces the hazards of fatigue in patients with interstitial lung disease，and describes the common measurement tools for fatigue symptoms in ILD. Management measures to improve their symptoms are summarized in order to provide a basis for the development of comprehensive，multidisciplinary and individualized ILD fatigue management programs in the clinical settings.

Objective To form an expert consensus of enteral feeding and nursing care for patients with severe neurological diseases,and to promote the standardized,safe and effective implementation of enteral feeding by neuro intensive nursing personnel,so as to provide effective nutritional support for patients. Methods The evidence in this field was searched,evaluated and summarized to extract the recommendations related to enteral feeding in patients with severe neurological diseases. The first draft of consensus was formed. Through 2 rounds of Delphi expert consultations and expert demonstration meetings,the expert suggestions were analyzed,modified and improved to form the final draft of consensus. Results The positive coefficient of inquiry experts was 100%;the coefficient of expert judgment was 0.93;the degree of familiarity was 0.88;the coefficient of authority was 0.91. The concordance coefficient of Kendall was 0.256~0.278,which was statistically significant（P<0.05）. The final consensus included the evaluation of enteral feeding care for patients with several neurological illness,selection of feeding methods,nutrient solution infusion,identification and care of complications,and indicators for terminating tube feeding. Conclusion This consensus provides guidance for clinical nursing practice and quality control of enteral feeding in critically ill patients.

To summarize the nursing experience of a case of Kabuki syndrome complicated with idiopathic pulmonary hemosiderosis caused by heterozygous mutation of H3 lysine 4 methylase. Key points of nursing include：to choose the appropriate respiratory support treatment to improve the symptoms of anoxia；to carry out the deoxygenation training in a timely manner after the improvement of anoxia to promote the recovery of respiratory function；to strengthen airway management to control pulmonary infection；to conduct blood transfusion and iron supplementation as soon as possible to correct anemia；to carry out hormone shock therapy to avoid adverse drug reactions；to select reasonable feeding methods to promote the recovery of the disease；to carry out family participatory nursing care to improve the quality of life of the child after discharge. After 42 days of related treatment and nursing，the lung condition of the child improved，and the child was discharged smoothly.

Objective To explore the effect of “Return-to-Family” intervention program on rehabilitation effects of breast cancer survivors. Methods A total of 70 breast cancer survivors were recruited by convenient sampling in Breast Surgery Department and Breast Nursing Clinic of a tertiary hospital in Beijing. They were divided into a control group and an intervention group,and each group has 35 patients. In the intervention group,the program of “Return-to-Family” intervention was carried out. In the control group,the routine care was provided. The effectiveness of the intervention program was assessed before and after intervention by the function of shoulder joint and arm at affected side,the Disabilities of the Arm,Shoulder and Hand questionnaire（Quick-DASH）,the Cancer Rehabilitation Evaluation System-Short Form（CARES-SF）,the Family Adaptability and Cohesion Evaluation Scales （FACES）. Results After intervention,the total scores of the function of shoulder joint and arm at affected side,the FACES in the intervention group were higher than those in the control group and those before intervention（P< 0.05）. The total scores of the Quick-DASH and the CARES-SF in the intervention group were lower than those in the control group and those before intervention（P<0.05）. Conclusion “Return-to-Family” intervention benefits the improvement of upper limb function,quality of life,family function for breast cancer patients,and help breast cancer survivors return to family smoothly.

Objective To observe the effects of Sizi powder wax therapy on the area of Three Yin Muscle Meridians of arm for upper limb motor function,spasticity and quality of life for upper limb motor dysfunction in stroke patients with hemiplegia. Methods The stroke patients with upper limb hemiplegia who were admitted to the Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine from May 2020 to January 2021 were selected. 141 patients were randomly divided into a Sizi powder wax therapy group,a wax therapy group and a control group with 47 cases in each group. All patients in the 3 groups received the routine treatment,nursing and rehabilitation training protocol. On this basis,the Sizi powder wax therapy group received Sizi powder wax therapy on the Three Yin Muscle Meridian of arm;the wax therapy group received wax therapy on the Three Yin Muscle Meridian of arm,once a day,20 minutes each time,5 times per week for 4 weeks. The upper limb motor function and degree of spasticity were evaluated before the intervention,2 weeks after the intervention and 4 weeks after the intervention,and the quality of life was evaluated before the intervention and after the intervention. Results A total of 130 cases completed the trial. In the Sizi powder wax therapy group,1 case was excluded,3 cases fell off and 1 case was discontinued. In the wax therapy group,1 case was excluded,2 cases fell off and 1 case was discontinued. In the control group,1 case was excluded and 1 case fell off. After 4 weeks of intervention,the improvement of Upper Limb Fugl-Meyer Assessment Scale（U-FMA） and Modified Ashworth Scale（MAS） in Sizi powder wax therapy group was higher than that in control group（P<0.05）;the Stroke Specific Quality of Life（SS-QOL） scores of Sizi powder wax therapy group and wax therapy group were better than those of the control group（P<0.05）. The results of Generalized Estimation Equation showed that the time effect and interaction effect of U-FMA score were statistically significant（P<0.05）,and the time effect of clinical efficiency of spasticity was statistically significant（P<0.05）. Conclusion Sizi powder wax therapy on the Three Yin Muscle Meridian of arm can improve upper limb motor function,spasticity and quality of life of patients with upper limb motor dysfunction after stroke.

Objective To construct a combined Chinese and Western medicine continuity of care platform based on artificial intelligence（AI） technology and to explore the effect of the platform in diabetic patients. Methods A convenience sampling method was used to select patients with type 2 diabetes mellitus admitted to the Department of Endocrinology of the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine in 2020 who met the inclusion and exclusion criteria as the study subjects. Among them which 97 patients admitted on odd days were allocated to an experimental group and they were given the combined Chinese and Western medicine continuous care intervention based on AI technology,while 96 patients admitted on even days were allocated into a control group. The control group was given the conventional health management plan for nursing intervention. After 6 months of intervention,the 2 groups were compared in terms of blood glucose index,type 2 diabetes self-management behavior scale score and quality of life scale score. Results After intervention,the FBG in the experimental group and the control group were（7.28±1.16） mmol/L and（8.22±1.95） mmol/L respectively,and the difference was statistically significant（P<0.05）. The 2HPG of the experimental group and the control group were（8.23±0.99） mmol/l and（9.94±1.75） mmol/L respectively,and the difference was significant（P<0.05）. After intervention,the self-management performance of the experimental group and the control group were 93.81% and 78.13% respectively,after intervention,the scores of self-management were 85.09±13.87 and 77.52±12.13 in the experimental group and the control group,respectively,with significant difference（P<0.05）. The total scores of quality of life in the experimental group and the control group were（118.1±37.8） and（104.1±40.4） respectively. The difference was statistically significant（P<0.01）. Conclusion The combined Chinese and Western medicine continuity of care platform for diabetic patients based on AI can effectively help patients control FBG and 2hPG levels,improve patients’ self-management,as well as quality of life,thus enhancing patients’ recovery beliefs and improving disease prognosis.

Objective To develop an instrument for measuring recurrence risk perception of stroke patients and to test its reliability and validity. Methods The research was completed under the guidance of Health Belief Model and Risk Perception Attitude Framework. The initial measurement was developed after literature review and qualitative interviews. The items were formed and adjusted after Delphi technique and cognitive reviews. 327 stroke patients were conveniently selected and investigated to test the reliability and validity of the scale. Results The stroke recurrence risk perception scale included 2 parts：the first part was consisted of 3 items,and the second part was consisted of 3 domains and 17 items with the accumulated variance contribution rate of 61.103%. The content validity index of the scale ranged from 0.926 to 0.954. The Cronbach’s α coefficient of the second part was 0.850;the split-half reliability was 0.656;the two-week test-retest reliability was 0.710,and the one-month test-retest reliability was 0.635. Conclusion The stroke recurrence risk perception scale has good reliability and validity,which is a suitable tool for the evaluation of recurrence risk perception of stroke patients.

Objective To construct a decision support system for pain management in hospitalized children and to evaluate its effects. Methods Based on the theory of pain management and clinical decision support technology,a new pain management information system was constructed,integrating all aspects of nursing procedure,order processing and nursing task list. The system was trial-run in a tertiary comprehensive pediatric hospital from September 2018 to November 2019. The application effect of the new system was evaluated and compared through the quality of nursing document writing,the timeliness of doctor’s order processing and the experience of nurses before and after the use of the new system. Results After the application of the decision support system for pain management of hospitalized children,the quality of nursing document writing was significantly improved（P<0.05）;the timeliness of medical order processing before and after the use was 100%,and the difference was not statistically significant（χ²=0.012,P=0.913）;in the using experience of clinical nurses,the dimensions of "information quality","service quality","user satisfaction" and "net income" were improved. The differences were statistically significant（P<0.05）. Conclusion The new pain management decision support system improves the homogeneity,continuity,integrity and timeliness of pain management for hospitalized children,and nurses have good overall experience of this system.

Objective To build a knowledge base of nursing procedures in pediatric hyperthermia based on Clinical Care Classification（CCC） 2.5 version. Methods With the common symptoms of pediatrics “axillary temperature≥37.5 ℃” as the research content,the research team summarized all the specific nursing measures related to "axillary temperature≥37.5 ℃" combined with clinical nursing routine and hospital management system based on CCC 2.5 version by evidence-based nursing method. Based on the definition of "axillary temperature≥37.5℃" related nursing diagnosis,core nursing interventions,modifiers of nursing activity types and modifiers of nursing outcomes in CCC 2.5,the first draft of knowledge base of "pediatric hyperthermia" nursing procedures was constructed.According to the coding rules of "code of specific nursing measures=code of core nursing interventions +code of modifiers of nursing activity type" and "code of nursing outcomes=code of nursing diagnosis+code of nursing outcome modifiers" in CCC 2.5,the first draft of the knowledge base was coded. After that,the expert consultation meeting was held to evaluate,discuss and revise the draft content and code of the knowledge base,and the final draft of the knowledge base was determined. Results The final draft of the knowledge base of pediatric "hyperthermia" nursing procedures includes 1 nursing diagnosis,19 specific nursing measures and 4 nursing outcomes. Conclusion The knowledge base of pediatric "hyperthermia" nursing procedures is professional,scientific and practical,which standardizes nursing language and facilitates information sharing.

Objective To evaluate the effects of Sizi Powder with salt hot-ironing on meridians for spastic hemiplegia in convalescent stroke patients.Methods Totally 86 patients were randomly divided into two groups,namely,the experimental group and the control group with 43 cases in each group. Patients in the experimental group received routine treatment,nursing,and rehabilitation,plus Sizi Powder with salt hot-ironing treatment,whereas the control group only received routine treatment. Hot-ironing treatment was applied for 30 minutes per day,5 days per week for 4 weeks. The spasticity and motor function were measured at pretest,2 weeks and 4 weeks after intervention by the Modified Ashworth Scale（MAS）,Compopsite Spasticity Scale（CSS）,and simplify Fugl-Meyer Assessment Scale（FMA）.Results Compared with pretest and 4 weeks after intervention,the scores of MAS,CSS and FMA in the experimental group were significantly improved（P<0.01）. The effective rate of spasticity improvement in upper limb and lower limb in the experimental group were significantly higher than that in the control group （P<0.05）. Repeated measurements analysis of variance showed that the main effect of time was statistically significant （P<0.01） in the score of CSS and scores for each dimension,the interaction effect of intervention and time were statistically significant（P<0.01） in the CSS score and tendon reflex. The main effect of time and the interaction effect of groups and time were statistically significant （P<0.01） in the score of FMA.Conclusion Sizi Powder with salt hot-ironing on meridians for spastic hemiplegia in stroke patients may have effects on spasticity to some extent,and improve patients’ motor function.

Objective To investigate the prevalence of physical restraint in neuro-ICU patients and to analyze the risk factors.Methods A total of 337 neuro-ICU patients from four tertiary hospitals in Beijing were selected by means of convenience sampling. Data were collected using a self-designed questionnaire of Physical Restraints Use in Neuro-ICU Patients.Results The prevalence of patients with body restraint was 62.3%. 43.8% of the nurses performed physical constraint based on experience. Body-constrained parts was documented in 29.5% of the nursing records,and 50.5% recorded the start and release time. Evaluation during restraint was documented in 60% records. The influencing factors of physical restraint use were decision makers,indwelling nasogastric tube,state of consciousness,risk of pressure ulcers,type of invasive devices,and delirium.Conclusion The rate of body restraint in neurology ICU patients was at a high level and body restraint was not standardized. The indications for the use and release of physical restraint need to be clarified. Influencing factors can provide a basis for clinical nurses and nursing managers to design physical restraint strategy for patients in neurology ICU.