Precise management of the activity dose is a core component of the(early mobilization,EM)plan for ICU patients.However,the lack of clinical practice guidelines related to EM dose of existing programs hinders the implementation and development of EM in ICU patients to some extent.Therefore,this review focuses on 4 aspects,covering the definition of activity dose,assessment tools,the current clinical implementation status,and implications for future nursing.The aim is to systematically review the assessment tools and intervention strategies for the activity dose of EM in ICU patients,providing a reference for optimization of EM programs.

Precise management of the activity dose is a core component of the(early mobilization,EM)plan for ICU patients.However,the lack of clinical practice guidelines related to EM dose of existing programs hinders the implementation and development of EM in ICU patients to some extent.Therefore,this review focuses on 4 aspects,covering the definition of activity dose,assessment tools,the current clinical implementation status,and implications for future nursing.The aim is to systematically review the assessment tools and intervention strategies for the activity dose of EM in ICU patients,providing a reference for optimization of EM programs.

White matter hyperintensities (WMHs) is a magnetic resonance imaging phenotype of cerebral small vessel disease,which is manifested as diffuse or confluent subcortical white matter.There is usually no clinical manifestation in the early stage of WMHs,and its pathophysiological mechanism has not been fully elucidated.Studies have shown that a variety of factors are associated with WMHs.The article reviews the risk factors for WMHs.

Objective To explore the effects of group guidance on the cognitive ability of empty nesters in a community.Methods Totally 179 empty nesters aged above 60 from a community in Xicheng District,Beijing between April 2014 and April 2015 were selected by convenience sampling,and divided into an intervention group (n=89) and a control group (n=90). Patients in the intervention group were treated by group guidance,once a week (60 min each time) for 12 months,while patients in the control group received no intervention. And the empty nesters' cognitive ability was evaluated with Mini-mental State Examination (MMSE) before and after the intervention.Results The differences found in comparing the orientation,memory, linguistic competence and cognitive ability of the empty nesters in the intervention group were statistically significant (P<0.05). And the differences found in comparing the memory and cognitive ability of the empty nesters in the control group were also statistically significant (P<0.05). Before the intervention,however,there was no significant difference between the empty nesters in the two groups in cognitive ability and other indicators (P>0.05). After the intervention,the empty nesters in the observation group scored higher in orientation, attention,numeracy,linguistic competence and cognitive ability than the empty nesters in the control group (P<0.05).Conclusions Empty nesters' cognitive ability comes to weaken and decline with age,and group guidance helps to improve their cognitive ability significantly.

Objective To analyze the characteristics of early cognitive impairment in leukoaraiosis (LA) patients and fractional anisotropy (FA) changes by diffusion tensor imaging (DTI) in various regions of interest (ROIs), and explore the relationship between FA values and cognitive impairment. Methods A total of 38 chronic ischemic LA patients, admitted to our hospital from August 2015 to August 2016, and 20 healthy elderly controls were chosen in our study. Comprehensive assessment of cognitive functions, and MRI and DTI examinations were performed in subjects from these two groups. The cognitive functions, and FA values in ROIs were compared between the two groups;the FA values in ROIs of mild, moderate, and severe ischemic LA patients were compared. The correlations between FA values in ROIs and cognitive functions in LA patients were analyzed. Results As compared with the healthy control group, the patient group had significantly lower Mimi Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores, statistically longer time of Stroop test C, lower scores of verbal fluency test (VFT), digit span (DS)-inverted sequence, word similarity test in Chinese Revision of Wechsler Intelligence Scale for Children (WISC-CR), auditory verbal learning test (AVLT), clock drawing test and block testing, and significantly longer time of Trail Marking Test A (TMTA) and Stroop test B (P<0.05), suggesting that the overall cognitive function, executive function, memory, visual-spatial ability, information processing capability of LA patients decreased greatly. Significantly decreased FA values in bilateral anterior horn of lateral ventricle, left superior frontal gyrus, left inferior frontal gyrus, bilateral frontal orbital gyrus, right deep temporal lobe, right cingulate gyrus, and genu of corpus callosum in the LA patient group were noted as compared with those in the control group (P<0.05). In mild, moderate and severe LA patients, the FA values of these ROIs decreased in turn, with statistically significant differences (P<0.05). In the LA patient group, correlation analysis showed that the scores of auditory verbal learning test were positively correlated with FA values in the brain regions of left anterior horn of lateral ventricle, bilateral frontal orbital gyrus, deep white of right temporal lobe, right cingulate gyrus, and genu of corpus callosum (P<0.05), and negatively correlated with FA values in left inferior frontal gyrus (P<0.05); the scores of trail making test A were negatively related with FA values in right anterior horn of lateral ventricle (P<0.05); the Stroop test B scores were negatively correlated with FA values in deep white matter of the right temporal lobe (P<0.05); the Stroop test C scores were negatively related with FA values in left orbital frontal cortex, deep white of right temporal lobe, right cingulate gyrus, and genu of corpus callosu (P<0.05); and the block testing scores were positively related with FA values in left frontal orbital gyrus, right temporal lobe deep, and genu of corpus callosu (P<0.05). Conclusions The early cognitive impairment and decreased FA values are noted in LA patients. FA values are related to cognitive impairment. DTI contributes to diagnose early cognitive impairment in LA patients.

Objective To study the risk factors and to provide preventive measures of pulmonary infection for patients with severe brain injury.Methods A total of 320 patients with severe brain injury were analyzed with hospital-based case-control study method.A total of 101 patients complicated with lung infection were set as the experimental group.Another 101 patients with no pulmonary infection according to the proportion of 1:1 choice over the same period were set as the control group.The related factors were analyzed with the univariate analysis and the multiple factors Logistic regression analysis.Results Univariate analysis showed that the occurrence of pulmonary infection of patients with severe brain injury was closely related to the old age,low GCS score,long time stay in the bed,long time hormone application,long time antibiotic application,the combined underlying disease,use of mechanic ventilation,long-term smoking history and indwelling gastric tube.Multivariable Logistic regression analysis showed that the application of mechanic ventilator,the combined underlying disease and long time stay in bed were the independent risk factors for pulmonary infection of patients with severe brain injury,but GCS score was a protective factor.Conclusions The occurrence of lung infection were related to the ventilator application,the combined underlying disease,long time stay in bed and low GCS score.Considering these risk factors,the medical staffs should take preventive measures early to control lung infection.

Objective To use the method of Meta-analysis to evaluate the effect of the evidencebased nursing in preventing the deep vein thrombosis after orthopaedic surgery,to provide the basis for clinical prevention of DVT.Methods The randomized controlled trials (RCT) on the evidence-based nursing in preventing the DVT were collected using the databases of China National Knowledge Infrastructure (CNKI),Wanfang Periodical Databases,Chinese Science Technology Periodical Databases (VIP) and PubMed and analyzed by RevMan 5.2 software.Results Nine RCTs were included in the study.The results of Meta-analysis revealed that the incidence of the DVT could be effectively prevented by evi-dencebased nursing.Conclusions The evidence-based nursing can reduce the incidence of the DVT after orthopaedic surgery.

BACKGROUND:With the development and improvement of liver transplantation technology, patients waiting for or undergoing liver transplantation have continued to increase in number. Due to their fears and concerns about post-transplantation rehabilitation, patients are under physical and mental stress, most of whom are shown to have a variety of mental disorders that affect rehabilitation. At present, mental problems of liver transplant patients are more concentrated in post-transplantation research, while patients waiting for liver transplantation do not get enough mental assessment and intervention.
OBJECTIVE:To investigate the suitable mode of cognitive-behavioral therapy for liver transplant recipients waiting for donor liver and to evaluate the effect to improve patient’s physical and mental state.
METHODS:Twelve liver transplant patients who underwent pre-transplantation assessment were randomly divided into experimental group and control group, each group with six cases. The control group received conventional treatment. The experimental group received cognitive-behavioral therapy in addition to conventional treatment. Self-rating anxiety scale (SAS) and vital signs were measured in the two groups on admission, 1 week and 3 weeks after admission.
RESULTS AND CONCLUSION:The SAS score of the experimental group was lower than that of the control group at 1 and 3 weeks after admission, and SAS score decreased as the intervention extended. The systolic blood pressure of the experimental group was lower than that of the control group at 3 weeks after admission, but there was no significant difference in diastolic blood pressure between two groups. The heart rate of the experimental group was lower than that of the control group at 1 and 3 weeks after admission. The respiratory rate of the experimental group was lower than that of the control group at 3 weeks after admission. Cognitive-behavioral therapy can reduce the level of anxiety and keep vital signs stable with good feasibility and effectiveness in patients waiting for liver transplantation.

Objective To discuss the application effect of evidence-based nursing in preventing the phlebitis using the method of Meta analysis,and provide basis for clinical prevention of phlebitis.Methods The randomized controlled trials (RCT) on the evidence-based nursing in preventing the phlebitis were collected using the databases of China National Knowledge Infrastructure(CNKI),Wanfang Periodical Databases,Chinese Science Technology Periodical Databases (VIP) and PubMed which were analyzed by RevMan 5.0 software.Results Seven RCTs were included in the study.The results of meta-analysis revealed that the incidence of the phlebitis was effectively prevented by evidence-based nursing.Conclusions The evidence-based nursing can reduce the incidence of the phlebitis.

Objective To evaluate the impact of programmed nursing intervention based on MEWS for potential accidents in critical patients.Methods The randomized controlled trials (RCT) on programmed nursing intervention based on MEWS for potential accidents in critical patients were collected using the databases of PubMed,Medline,FMJS,CNKI,Wanfang database,VIP.Data were analyzed with RevMan5.0 software.Results Four RCTs were included in the study.All were Chinese articles.The incidence of accidents in the intervention group was significandy lower than that of the control group,the difference was statistically significant.Conclusions Programmed nursing intervention based on MEWS can effectively reduce the potential accidents happened in critical patients.