Objective:To translate Myasthenia Gravis-Activities of Daily Living Scale (MG-ADL) into Chinese and test its reliability and validity in patients with myasthenia gravis (MG) .Methods:According to the cross-cultural adaptation guidelines of the self-report scale, the Chinese version of the MG-ADL was completed through cross-cultural adaptation steps such as pre-translation, integration, back-translation, expert committee evaluation and pre-survey. A total of 150 MG patients hospitalized in Department of Neurology and Thoracic Surgery of Beijing Tongren Hospital Affiliated to Capital Medical University from November 2021 to August 2022 were selected as research objects by the convenient sampling method to test the reliability and validity of the Chinese version of MG-ADL. A total of 150 questionnaires were sent out in this study and 135 were effectively received, with the effective recovery of 90.00%.Results:The content validity index at the level of each item of the Chinese MG-ADL was 0.857-1.000, and the average content validity index at the level of the scale was 0.982. MG quantitative score scale was used as the criterion, and the criterion validity was 0.807 ( P<0.01) . The Cronbach's α coefficient of MG-ADL was 0.645. The retest reliability coefficient was 0.959. The evaluation time of MG-ADL was (4.69±1.79) min, and the minimum clinically significant difference was 1.82. Conclusions:The Chinese version of MG-ADL has good validity, reliability and operability, and it can be used as a specific assessment tool to evaluate the activity of daily living of MG patients.

Objective To observe the preventive effect of ceftriaxone sodium(CRO)combined with bundle management(BM)on early ventilator-associated pneumonia(VAP)in the intensive care unit(ICU)patients with mechanical ventilation(MV).Methods A total of 138 ICU patients treated with MV at Beijing Tongren Hospital affiliated to Capital Medical University were selected from May 2022 to April 2023.According to whether CRO was used,they were divided into CRO group and non-CRO(NCRO)group,and BM was performed during hospitalization in both groups.The incidence of early VAP,mortality,duration of mechanical ventilation,ICU stay,and total hospital stay were observed and compared between the two groups.In addition,the changes in inflammatory indicators[C-reactive protein(CRP),procalcitonin(PCT),and white blood cell count(WBC)]were compared before and after the intervention(on day 7).Results The incidence of early VAP was lower in the CRO group than in the NCRO group(P＜0.05).The mortality rate of patients in the CRO group was lower than that in the NCRO group,but the difference was not statistically significant(P＞0.05).The duration of mechanical ventilation,length of ICU stay and total hospital stay in the CRO group were shorter than those in the NCRO group(P＜0.05).Before treatment,the CRP levels,serum PCT levels,and WBC were not significantly different between the two groups(P＞0.05).Compared with before treatment,serum CRP levels,PCT levels and WBC were significantly decreased in the CRO and NCRO groups(P＜0.05).In addition,serum CRP,PCT and WBC of the CRO group were lower than the NCRO group on the seventh day,with a statistically significant difference(P＜0.05).Conclusion CRO combined with BM can reduce the incidence of early VAP in ICU patients undergoing MV,shorten MV time,ICU stay and total hospital stay,and reduce the level of inflammatory response.

Objective To explore the construction of modular intervention for patients dependent on mechanical ventilation in ICU,and to conduct the clinical empirical study.Methods A total of 100 mechanical ventilation-dependent patients in ICU were enrolled and divided into two groups according to the admission order,with 50 patients in each group.Control group received routine intervention,while observation group was treated with modular intervention in addition to the treatment given to control group.The weaning success rate,weaning time,complications,rehabilitation index,blood gas analysis index,psychological state,and nutritional status were compared between two groups.Results Compared with control group,observation group had higher weaning success rate,shorter weaning time,ICU stay and general ward admission,and lower incidence of complications(P<0.05).After intervention,observation group had lower PaCO2,and higher PaO2 and PaO2/FiO2 than control group(P<0.05);the scores of SAS,SDS and APACHEⅡwere lower in observation group than in control group(P<0.05);and the serum levels of ALB,PA,TRF and TP in observation group were higher than those in control group(P<0.05).Conclusion Modular intervention for mechanical ventilation-dependent patients in ICU can increase weaning success rate,improve blood gas analysis index and nutritional status,alleviate negative emotions,reduce complications and speed recovery.

Objective To retrieve and integrate relevant evidence on best sleep position nursing in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) so as to provide scientific and effective references for clinical departments.Methods Firstly, we put forward questions aiming at sleep position of OSAHS patients with the Johns Hopkins nursing evidence-based practice model. And then, we retrieved related studies by computers in the round and carried out assessment of literature quality and level of evidence for various researches. Finally, we integrated the evidence and made recommendations.Results Combining the judgment of specialized persons, a total of 7 evidences on sleep position nursing of OSAHS patients were integrated, such as adapt-to-the-crowd and effects of position nursing, the best sleep position and method to maintain position.Conclusions The sleep position nursing is very important for OSAHS patients. In further clinical transformation and application, clinical departments should well judge on selection of patients, conditions of evidence application to make sensible decisions so as to improve the quality of nursing by improving patients' sleep hypopnea with the scientific nursing methods through applying the best evidence.

Objective:To evaluate the effect of aerosol inhalation and airway dripping for airway humidification of patients with tracheotomy, and explore airway humidification methods suitable for China's national conditions.Methods:The documents published from January 2010 to October 2020 in The Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI) , Wanfang Data and VIP were searched by computer, including randomized controlled trials (RCTs) on the application of aerosol inhalation and airway dripping as a method of airway humidification in patients with tracheotomy. Two researchers used the quality evaluation method of Cochrane Handbook (5.1.0.) to rigorously evaluate the quality of the documents and extract data, and conducted a meta-analysis of the documents that met the quality standards.Results:A total of12 RCTs were included, with a total of 1 010 patients. The results of meta-analysis showed that the sputum viscosity in the aerosol inhalation group was lower than that in the airway dripping group [ RR=0.29, 95% CI (0.21, 0.40) , P<0.01], the incidences of airway mucosal injury, irritating dry cough and lung infection also decreased [ RR=0.34, 95% CI (0.23, 0.51) , P<0.01; RR=0.24, 95% CI (0.16, 0.38) , P<0.01; RR=0.48, 95% CI (0.38, 0.61) , P<0.01], the airway humidification effect was better than that of the airway dripping group [ RR=0.1.34, 95% CI (1.23, 1.45) , P<0.01]. Conclusions:The application of aerosol inhalation to humidify the airway in patients with tracheotomy can significantly reduce the sputum viscosity, airway mucosal injury, irritating dry cough, and the lung infection, and achieve a good airway humidification effect.

Objective:To explore the mental workload status of nurses in the Intensive Care Unit (ICU) and analyze its influencing factors.Methods:The convenience sampling was used to select 240 ICU nurses from 4 ClassⅢ Grade A hospitals in Beijing from February to April 2020 as the research object. The survey was conducted using the General Information Questionnaire, the Chinese version of National Aeronautics and Space Administration Task Load Index (NASA-TLX) , and the Chinese version of the Caring Assessment Tool-administration (CAT-admin) . Multiple linear regression analysis was used to analyze the influencing factors.Results:Among 240 ICU nurses, the total scores of the Chinese version of NASA-TLX and the Chinese version of CAT-admin were (82.26±14.82) and (131.16±21.96) , respectively. Multiple linear regression analysis showed that nurses' perceived care of managers, children's condition and working years were the influencing factors of ICU nurses' mental workload and the difference was statistically significant ( P<0.01) , which could explain 40.9% of the total variation. Conclusions:The mental workload of ICU nurses is at the upper-middle level. Nursing managers should take targeted measures according to the influencing factors to reduce the mental workload of ICU nurses.