Objective To study the effects of early progressive exercise training on muscle strength and quality of life in ICU patients.Methods A total of 80 ICU patients who were treated in the First Affiliated Hospital of Zhengzhou University from May 2014 to May 2016 were selected as the research subjects.All the subjects were randomly divided into observation group and control group,with 40 patients in each.The two groups received routine care.In addition,the observation group were given early progressive exercise training.Patient outcome of ICU treatment were compared between the two groups,by Medical Research Council Score(MRC-Score),Barthel Index Score,36-Item Short Form Healthy Survey(SF-36).Results The rate of adverse event of the observation group was 7.5％,and it was 20.0％in the control group.The difference was statistically significant(χ2=4.021,P<0.05).The muscle strength of the 39 patients in the observation group recovered toⅣ-Ⅴ level at discharge.It was 31 in the control group,and the difference was statistically significant(Z=-2.093,P < 0.05).The Barthel Index of the observation group at discharge was(60.25±6.18),and the score fo the general health dimension of SF-36 was(58.49±7.12),which were both higher than those of the control group,with statistical significance(t=4.400,4.036;P<0.05).Conclusions The early progressive exercise training can help the recovery of muscle strength and self-care ability in ICU patients,and reduce the incidence of adverse events,which are great significance to improve the quality of life.

Objective? To explore the effect of hierarchical management mode in family rehabilitation in out-of-hospital nursing of elderly patients with chronic obstructive pulmonary disease (COPD). Methods? The elderly patients with COPD at stable stage in two communities were divided into the observation group (n=33) and the control group (n=31) based on the unit of community. The observation group was managed by family oxygen therapy and rehabilitation training guided by hierarchical management mode, while the control group received routine community care for chronic diseases. Exercise of Self-Care Agency Scale(ESCA) and Health Promoting Lifestyle Profile(HPLP) were used to compare the intervention effect of the two groups and count the acute episodes of COPD during the intervention period of the two groups. Results? Before intervention, there were no statistical differences in both of the dimensional scores of ESCA and HPLP scales between the two groups (P＞0.05). After 12 months of intervention, the dimensional scores of "health knowledge" (41.76±6.20), "self-responsibility"(22.94±8.22), and "self-nursing skills" (25.85±6.46) in ESCA of the observation group were higher than those of the control group with statistical significance(t=2.894, 4.138, 6.096;P＜ 0.05); in the observation group, the dimensional score of "health responsibility" was(23.79±7.44),"mental growth" was (16.70±3.73), "stress management" was (17.09±5.44), "interpersonal relationship" was (17.97±4.54), "sports activity" was (15.70±4.57), "nutrition" was (16.70±4.10), all higher than the control group with statistical significance (t=3.184,3.365,3.212,5.277,5.131,4.589;P＜ 0.05). Within the 12 months of intervention, there were 11 cases in the observation group and 4 cases in the control group without acute episodes of COPD, and the difference was statistically significan(t Z=2.166,P＜ 0.05). Conclusions? Hierarchical management mode infamily rehabilitation can effectively improve the elderly COPD patients' compliance of family oxygen therapy and rehabilitation training,hence improve their prognosis.