Objective To construct a diaphragm exercise program for patients with mechanical ventilation in intensive care unit（ICU），and to explore its clinical application effect. Methods Based on literature analysis and expert meeting，a diaphragm exercise program of ICU patients with mechanical ventilation was constructed. A total of 69 adult patients with mechanical ventilation in our comprehensive ICU from October 2020 to October 2021 were randomly divided into an experimental group（35 cases） and a control group（34 cases）. The control group was given ICU routine rehabilitation nursing care and early activities，and the experimental group was given the diaphragm exercise on the basis of the interventions in the control group. End-inspiratory diaphragm thickness （DTei），end-expiratory diaphragm thickness（DTee），diaphragm thickening fraction（DTF） and diaphragmatic excursion（DE） were evaluated by ultrasound before and 24，48，72 and 120 hours after intervention. The success rate of weaning and the incidence of adverse events were compared and analyzed between the 2 groups. Results Repeated measures ANOVA showed that the time effect and interaction effect of DTei between the 2 groups were statistically significant（P<0.05）；the time effect of DTee in the 2 groups was statistically significant（P<0.05）；the time effect and interaction effect of DTF in the 2 groups were statistically significant（P<0.05）；the time effect and interaction effect of DE in the 2 groups were statistically significant（P<0.05）. The DTei of the experimental group was higher than that of the control group at 120 h after intervention；the DTF of the experimental group was higher than that of the control group at 72 h and 120 h after intervention；the DE of the experimental group was higher than that of the control group at 120 h after intervention；the differences were statistically significant（P<0.05）. The weaning success rate of the experimental group was higher than that of the control group，and the difference was statistically significant（P<0.05）. There were no adverse events such as sudden drop of oxygen saturation，tachycardia or musculoskeletal injury occurred in the 2 groups. Conclusion The diaphragm exercise program is safe and feasible for ICU patients with mechanical ventilation，which can improve diaphragm function，increase the success rate of weaning，and promote the rehabilitation of patients.

Peer support refers to emotional,appraisal,informational support provided by social networking partners with empirical knowledge and similar personalities to address the health problems of a population. As a part of social support,peer support has been applied in adults with chronic diseases. This article reviews the research progress on peer support for parents of premature infants,focusing on its content,modalities,and the challenges and difficulties in program development and implementation. Based on the current status,we raised the recommendations of improving parents’ access to peer support and avoiding potential psychological harm to parents. The results of this review could provide a reference for further research and practice on peer support for parents of premature infants in China.

Objective To systematically evaluate the application effect of prone ventilation in patients with hypoxemia after cardiopulmonary bypass surgery，so as to provide a reference for further discussing the effective mechanical ventilation position of such patients. Methods Pubmed，Web of Science，Embase，Cochrane Library，CENTRAL，CBM，CNKI，Wanfang Data and VIP database were searched from the establishment of databases until September，2021. All the published randomized controlled trials（RCTs） about the effects of prone position ventilation on patients with hypoxemia after cardiac surgery were confirmed by the literature reference citation retrieval. Inclusion and exclusion criteria were used to review and rank the literature. After the evaluation of the quality of included studies，the data was extracted from RCTs and a meta-analysis was conducted by RevMen 5.4. Results 9 RCTs with 456 cases were included. The results of meta-analysis showed that in oxygenation index，the oxygenation index of prone ventilation was higher than that of supine ventilation when the ventilation time（T1） in prone position≥12 h，and the start time（T2） was 6 hours after surgery and the intermittent prone ventilation，and the difference was statistically significant [MD=57.31，95%CI（35.84，78.77），P<0.001]，[MD=71.98，95%CI（64.34，79.61），P<0.001]，[MD=37.97，95%CI（18.36，57.58），P=0.001]. In oxygen partial pressure，when the oxygen concentration（FiO₂） of prone ventilation was lower than that of supine ventilation，the oxygenation index of prone ventilation was higher than that of supine ventilation，and the difference was statistically significant[MD=5.70，95%CI（0.46，10.94），P=0.03]. In clinical outcome，the mechanical ventilation time[MD=-56.47，95%CI（-72.62，-40.33），P<0.001]，ICU stay time[MD=-60.82，95%CI（-76.82，-44.81），P<0.001] and hospital stay time[MD=-44.36，95%CI（-63.10，-25.62），P<0.001] in prone ventilation group were lower than those in supine ventilation group，and the differences were statistically significant. Conclusion The prone position ventilation is effective to improve PaO₂/FiO₂，duration of mechanical ventilation，duration of ICU care，and hospital stays in patients with hypoxemia after cardiac surgery，while it could not effectively improve PaO₂. Despite subgroup analysis of the main indicators，the optimal duration and initiation of prone ventilation remained unclear. Due to the limitations of the quality of included studies，randomized controlled trials with large sample size are needed in the future to evaluate the effects of prone position ventilation on neonatal respiratory distress syndrome.