Objective To summarize the best evidence of exercise guidance programs for patients with ankylosing spondylitis based on the evidence，and to provide the basis for exercise therapy for patients with ankylosing spondylitis. Methods The computer system retrieved UpToDate，BMJ，OVID，CINAHL，Cochrane，Embase，Pubmed，Scopus，CNKI，Wanfang Database，Chongqing VIP，China Biomedical Database，Yimaitong and other guidelines on exercise programs for patients with ankylosing spondylitis，systematic reviews，Meta-analysis，expert consensuses，evidence summaries，randomized controlled trials，etc. The retrieval time was from January 1，2021 to January 1，2022. There were 2 nurses who independently screened the literature，evaluated the quality，and extracted the best literature，evidence and grading，and then summarized the best evidence for exercise guidance programs. Results A total of 16 articles，involving 1 guideline，6 systematic reviews，4 meta-analyses，and 5 expert consensus articles，were included. The best evidence for exercise guidance programs was summarized. There are 38 pieces of evidence in a total of 7 aspects，including pre-exercise evaluation，scope of exercise，exercise in different stages，sports content （project，exercise intensity，frequency，period），sports monitoring indicators，sports risk assessment and related precautions. Conclusion Based on the best evidence of ankylosing spondylitis exercise guidance programs summarized by evidence-based nursing，this study standardizes the theory and practice of rehabilitation exercise for patients with ankylosing spondylitis，and forms a scientific，standardized exercise guidance program with the best evidence.

Objective To investigate the current status of grip strength level in elderly patients with mechanical ventilation in ICU,and to explore its influencing factors. Methods The convenient sampling method was adopted to select 218 elderly mechanical ventilation patients in ICU of a tertiary hospital in Zhejiang Province as the research subjects from January 2020 to December,and researchers completed the cross-sectional study by using a general information questionnaire,an electronic grip strength device,and the Nutrition Risk Scaling 2002. Multivariate linear regression was used to analyse the factors influencing the grip strength level of elderly patients with mechanical ventilation. Results The average grip strength level of elderly patients with mechanical ventilation in ICU was（13.8±4.7） kg. Multivariate linear regression analysis showed that gender,age,exercise mode,time of sedative drugs,and score of Nutrition Risk Scaling 2002 were the main factors influencing their grip strength level（P<0.05）. Conclusion Grip strength levels were relatively low in elderly patients with mechanical ventilation in ICU. Grip strength levels were lower in patients with mechanical ventilation who were female,elderly,previously unexercised,the time of using sedation medication for >5 d,and the score of Nutrition Risk Scaling 2002≥3. Nursing staff should strengthen the dynamic evaluation of grip strength in patients with mechanical ventilation and control the related influencing factors.

Objective To investigate nurses practice environment in tertiary hospitals in Shandong Province,which can provide a basis for the improvement and construction of a healthy nurse practice environment. Methods The convenience sampling method was used to investigate 56 776 nurses from 59 tertiary hospitals in Shandong Province by the Nursing Work Index-Revised（NWIR） from March to December 2018. Results The mean score of NWIR was 79.20±19.15. The items of “the hospital has a systematic training program for newly recruited nurses”,“nurses in the work team are qualified for nursing work” received the highest scores. The items of “the system of salary allotment is reasonable in hospital”,“the level of salary of nurses is reasonable in all sectors of the society”,“nurses have opportunities to participate in hospital internal management”,“nurses have opportunities to become members in the hospital management committee” and “nurses have opportunities to participate in hospital management decisions making” got the lowest scores. Multiple linear regression analysis showed that gender,age,education,professional title,years of work,whether being recruited by government agencies had an impact on the nursing practice environment scores（P<0.05）. Conclusion Nurses practice environment in tertiary hospitals in Shandong Province is generally optimistic,but it still requires continuous improvement. The nursing managers and experts should focus on the establishment and improvement of the authorization management mechanism,encourage nurses to actively engage in hospital affairs,and give much attention to the career development of male nurses and medium seniority nurses,so as to continuously improve and optimize the nursing practice environment.