To investigate the current status of sleep quality among nurses in tertiary hospitals in China, analyze the correlations of work stress and perceived organizational support with the risk of sleep problems, and further examine the mediating effect of perceived organizational support between work stress and sleep problems in nurses.

Objective To summarize the best evidences of thirst management in the patients with tra-cheal intubation to provide the evidence-based evidence for clinical practice.Methods According to the"6S"evidence pyramid model,the literatures on thirst management of the patients with tracheal intubation were systematically retrieved from the relevant guide websites,evidence-based databases,association websites and original literature databases at home and abroad.The databases included BMJ Best Practice,Up To Date,JBI Evidence-Based Health Care Center Database,Guidelines International Network(GIN),National Institute for Health and Clinical Excellence,National Institute for Health and Clinical Excellence(NICE),Scottish Inter-collegiate Guidelines Network(SIGN),Registered Nurses'Association of Ontario,Canada(RNAO),National Guideline Clearing House(NGC),Cochrane Library,American Society of Critical Care Medicine(SCCM),A-merican Association of Critical Care(AACN),European Society of Intensive Medicine(ESIM),Chinese Socie-ty of Critical Care Medicine,PubMed,Embase,CNKI,Wanfang Medical Network,VIP Database and Chinese Biomedical Literature Database(SinoMed).The retrieval limit was from the database establishment to August 31,2023.Two researchers trained by evidence-based nursing independently completed the literature quality e-valuation,and the literatures meeting the quality standards conducted the evidence extracted and summary.Results A total of 23 literatures were included,including 1 clinical decision,1 evidence summary,12 random-ized controlled trials,3 quasi-experimental studies,and 6 cross-sectional studies.Eighteen pieces of best evi-dence were formed,including six aspects:definition of thirst,classification of thirst degree,risk factors,assess-ment methods,intervention strategies and quality management.Conclusion Nurses should conduct the clini-cal transform and application of the best evidences by combining the clinical situation and specific department policies to alleviate the thirst symptoms in the patients with tracheal intubation.

Objective To summarize the best evidence for diaphragm rehabilitation in mechanically ven-tilated ICU patients with ventilator-associated diaphragm dysfunction based on evidence-based methods.Meth-ods A systematic search was conducted across guideline websites,professional associations,and Chinese/English databases for evidence regarding diaphragm rehabilitation in mechanically ventilated ICU patients.The search timeframe spanned from database inception to December 31,2024.Two researchers independently per-formed quality assessment and synthesized the evidence.Results Twenty articles were included:2 clinical de-cisions,1 guideline,2 evidence summaries,3 systematic reviews,7 randomized controlled trials(RCT),and 5 expert consensuses/opinions.Twenty-seven pieces of evidence were formed across 6 themes:rehabilitation team,rehabilitation assessment,rehabilitation interventions,outcome evaluation,precautions,and education/training.Conclusion This study summarizes the best evidence for diaphragm rehabilitation in ICU mechani-cally ventilated patients.Healthcare professionals should implement diaphragm rehabilitation by integrating this evidence with specific clinical contexts to improve patient outcomes and enhance nursing quality.

Objective To explore the correlation between tongue features of type 2 diabetes patients with coronary heart disease and glycosylated hemoglobin,liver function,blood lipids,C-reactive protein,so as to provide reference for related research.Methods Using the TFDA-1 tongue imaging device to collect patients'tongue images,experts will interpret the tongue images and extract objective parameters of the tongue images through the intelligent auxiliary diagnosis system of traditional Chinese medicine tongue diagnosis;Record patient laboratory indicators and use SPSS statistical software to analyze the correlation between tongue image distribution characteristics,tongue image parameter characteristics,and laboratory indicators using Spearman method.Results 702 patients with type 2 diabetes and coronary heart disease were included.In terms of glycated hemoglobin indicators,bruising parameters are positively correlated with HbA1c,while tongue tip RGB values are negatively correlated with HbA1c.In terms of liver function indicators,tongue edge redness,tongue tip and tongue texture R value are positively correlated with ALT and AST;Red tongue tip,tooth marks on the tongue,etc.are positively correlated with ALT;Fat tongue is positively correlated with AST.In terms of blood lipid indicators,parameters such as tooth mark tongue and tooth mark are positively correlated with TG;The parameters of white coating and tongue coating area are positively correlated with LDL-C;Thin coating is positively correlated with HDL-C,while thick coating is negatively correlated with HDL-C;Red tongue is negatively correlated with TCHO.In terms of C-reactive protein,red tongue,tip red,and edge red are positively correlated with CRP;The GB value of tongue root and tongue substance is negatively correlated with CRP.Conclusion Type 2 diabetes patients with coronary heart disease have tongue picture distribution,tongue shape parameters,tongue color parameters,coating color parameters and HbA1c,ALT,AST,TCHO,TG,HDL-C,LDL-C,CRP indicators in varying degrees of correlation.The combination of patients'tongue picture and laboratory indicators is helpful to clarify the diagnosis and prognosis of type 2 diabetes with coronary heart disease.

Objective To systematically retrieve,evaluate and summarise the best available evidence on prevention and management of diagnostic blood loss in critically ill adult patients and to provide guidance for standardising diagnostic blood sampling in clinical practice.Methods A structured evidence question was created using the PIPOST framework(Population,Intervention,Professional,Outcome,Setting and Type of evidence).Guided by the"5S"levels-of-evidence pyramid,a top-down systematic search was conducted on databases of BMJ Best Practice,UpToDate,the Joanna Briggs Institute(JBI)EBP Database,GIN,SIGN,RNAO,NICE,Medlive Guideline,WHO,National Blood Authority(Australia),National Health Commission of China,Cochrane Library,PubMed,EMbase,CINAHL,Web of Science,Wanfang Data,CNKI,VIP,and SinoMed.Searched literature included clinical decision aids,guidelines,evidence summaries,systematic reviews Meta analysis,RCTs,quasi-experimental,cross-sectional,cohort studies and expert consensus/opinions.Search period covered between 1st January 2015 and 10th February 2025.Quality appraisal,evidence extraction,synthesis and grading were performed according to JBI and GRADE approaches.Results Nineteen articles were retrieved including five guidelines,five systematic reviews,one RCT,two quasi-experimental studies,two cross-sectional studies,one professional standard and three expert consensuses.A total of 26 recommendations were extracted and they were organised into five domains:education and training,blood-sampling assessment,frequency of sampling,strategies to minimise blood volume drawn,and quality control.Conclusion This evidence summary provides the best current guidance for preventing and managing iatrogenic blood loss caused by diagnostic testing in critically ill adults,providing evidence-based basis for standardizing blood tests by medical staff.

Diaphragmatic dysfunction often occurs in ICU patients with prolonged mechanical ventilation, which seriously affects patients′prognosis. This article reviewed the progress of rehabilitation treatment of diaphragmatic dysfunction in ICU patients with mechanical ventilation, focused on the concept and assessment of diaphragm rehabilitation, the current status, evaluation indexes, emphasized the importance of nurses, analyzed the dilemmas and countermeasures in the application, which aimed to provide a reference for the promotion of diaphragm rehabilitation in clinical practice.

Objective To systematically retrieve,evaluate and summarise the best available evidence on prevention and management of diagnostic blood loss in critically ill adult patients and to provide guidance for standardising diagnostic blood sampling in clinical practice.Methods A structured evidence question was created using the PIPOST framework(Population,Intervention,Professional,Outcome,Setting and Type of evidence).Guided by the"5S"levels-of-evidence pyramid,a top-down systematic search was conducted on databases of BMJ Best Practice,UpToDate,the Joanna Briggs Institute(JBI)EBP Database,GIN,SIGN,RNAO,NICE,Medlive Guideline,WHO,National Blood Authority(Australia),National Health Commission of China,Cochrane Library,PubMed,EMbase,CINAHL,Web of Science,Wanfang Data,CNKI,VIP,and SinoMed.Searched literature included clinical decision aids,guidelines,evidence summaries,systematic reviews Meta analysis,RCTs,quasi-experimental,cross-sectional,cohort studies and expert consensus/opinions.Search period covered between 1st January 2015 and 10th February 2025.Quality appraisal,evidence extraction,synthesis and grading were performed according to JBI and GRADE approaches.Results Nineteen articles were retrieved including five guidelines,five systematic reviews,one RCT,two quasi-experimental studies,two cross-sectional studies,one professional standard and three expert consensuses.A total of 26 recommendations were extracted and they were organised into five domains:education and training,blood-sampling assessment,frequency of sampling,strategies to minimise blood volume drawn,and quality control.Conclusion This evidence summary provides the best current guidance for preventing and managing iatrogenic blood loss caused by diagnostic testing in critically ill adults,providing evidence-based basis for standardizing blood tests by medical staff.

Objective To explore the value of carotid pulse wave combined with urinary transferrin(TRF)and β2-microglobulin(β2-MG)in the evaluation of renal injury in patients with hyperten-sive nephropathy.Methods A total of 30 patients with hypertensive nephropathy,30 patients with simple hypertension and 90 patients with non-hypertensive nephropathy who were admitted to our hospital between May 2021 and April 2024,and 30 healthy individuals(control group)who taking physical examination during same period were enrolled and assigned into corresponding groups,respectively.According to the severity of renal injury,the 120 patients from the hyperten-sive nephropathy group and non-hypertensive nephropathy group were divided into normal group(28 cases),mildly injured group(36 cases),moderately injured group(31 cases)and severely in-jured group(25 cases).The carotid pulse wave indicators[pulse wave velocity at beginning of the systole(PWV-BS),pulse wave velocity at ending of the systole(PWV-ES)],and urinary TRF and β2-MG levels were detected and compared in above groups.ROC curves were plotted to ana-lyze the diagnostic values of these indicators in hypertensive nephropathy.The relationship be-tween the above indicators and the severity of renal injury was analyzed with sequential multivari-ate logistics regression analysis.Results There were significant differences in PWV-BS,PWV-ES,and urinary TRF and β2-MG levels among the hypertensive nephropathy group,non-hyperten-sive nephropathy group,hypertension group and control group(P＜0.01).ROC curve analysis showed that the AUC value of the four indictors combined together in the diagnosis of hyperten-sive nephropathy was 0.907,which was statistically greater than that of single indicator alone(0.774,0.743,0.728,0.749,P＜0.01).Obvious differences were also observed in PWV-BS,PWV-ES,and urinary TRF and β2-MG levels among the severely,moderately and mildly injured groups and normal group(P＜0.01).Sequential multivariate logistics regression analysis indicated that PWV-BS(OR=1.824,95％CI:1.272-2.616,P=0.001),PWV-ES(OR=1.910,95％CI:1.268-2.877,P=0.002),and urinary TRF(OR=2.442,95％CI:1.485-4.018,P=0.001)and β2-MG levels(OR=2.807,95％CI:1.580-4.984,P=0.001)were influencing factors of renal injury severity in the renal injured patients.Conclusion Carotid pulse wave combined with urinary TRF and β2-MG can be applied in auxiliary diagnosis of hypertensive nephropathy,and they are correla-ted with the severity of renal injury.

Objective To explore the correlation between tongue features of type 2 diabetes patients with coronary heart disease and glycosylated hemoglobin,liver function,blood lipids,C-reactive protein,so as to provide reference for related research.Methods Using the TFDA-1 tongue imaging device to collect patients'tongue images,experts will interpret the tongue images and extract objective parameters of the tongue images through the intelligent auxiliary diagnosis system of traditional Chinese medicine tongue diagnosis;Record patient laboratory indicators and use SPSS statistical software to analyze the correlation between tongue image distribution characteristics,tongue image parameter characteristics,and laboratory indicators using Spearman method.Results 702 patients with type 2 diabetes and coronary heart disease were included.In terms of glycated hemoglobin indicators,bruising parameters are positively correlated with HbA1c,while tongue tip RGB values are negatively correlated with HbA1c.In terms of liver function indicators,tongue edge redness,tongue tip and tongue texture R value are positively correlated with ALT and AST;Red tongue tip,tooth marks on the tongue,etc.are positively correlated with ALT;Fat tongue is positively correlated with AST.In terms of blood lipid indicators,parameters such as tooth mark tongue and tooth mark are positively correlated with TG;The parameters of white coating and tongue coating area are positively correlated with LDL-C;Thin coating is positively correlated with HDL-C,while thick coating is negatively correlated with HDL-C;Red tongue is negatively correlated with TCHO.In terms of C-reactive protein,red tongue,tip red,and edge red are positively correlated with CRP;The GB value of tongue root and tongue substance is negatively correlated with CRP.Conclusion Type 2 diabetes patients with coronary heart disease have tongue picture distribution,tongue shape parameters,tongue color parameters,coating color parameters and HbA1c,ALT,AST,TCHO,TG,HDL-C,LDL-C,CRP indicators in varying degrees of correlation.The combination of patients'tongue picture and laboratory indicators is helpful to clarify the diagnosis and prognosis of type 2 diabetes with coronary heart disease.

Objective To explore the value of carotid pulse wave combined with urinary transferrin(TRF)and β2-microglobulin(β2-MG)in the evaluation of renal injury in patients with hyperten-sive nephropathy.Methods A total of 30 patients with hypertensive nephropathy,30 patients with simple hypertension and 90 patients with non-hypertensive nephropathy who were admitted to our hospital between May 2021 and April 2024,and 30 healthy individuals(control group)who taking physical examination during same period were enrolled and assigned into corresponding groups,respectively.According to the severity of renal injury,the 120 patients from the hyperten-sive nephropathy group and non-hypertensive nephropathy group were divided into normal group(28 cases),mildly injured group(36 cases),moderately injured group(31 cases)and severely in-jured group(25 cases).The carotid pulse wave indicators[pulse wave velocity at beginning of the systole(PWV-BS),pulse wave velocity at ending of the systole(PWV-ES)],and urinary TRF and β2-MG levels were detected and compared in above groups.ROC curves were plotted to ana-lyze the diagnostic values of these indicators in hypertensive nephropathy.The relationship be-tween the above indicators and the severity of renal injury was analyzed with sequential multivari-ate logistics regression analysis.Results There were significant differences in PWV-BS,PWV-ES,and urinary TRF and β2-MG levels among the hypertensive nephropathy group,non-hyperten-sive nephropathy group,hypertension group and control group(P＜0.01).ROC curve analysis showed that the AUC value of the four indictors combined together in the diagnosis of hyperten-sive nephropathy was 0.907,which was statistically greater than that of single indicator alone(0.774,0.743,0.728,0.749,P＜0.01).Obvious differences were also observed in PWV-BS,PWV-ES,and urinary TRF and β2-MG levels among the severely,moderately and mildly injured groups and normal group(P＜0.01).Sequential multivariate logistics regression analysis indicated that PWV-BS(OR=1.824,95％CI:1.272-2.616,P=0.001),PWV-ES(OR=1.910,95％CI:1.268-2.877,P=0.002),and urinary TRF(OR=2.442,95％CI:1.485-4.018,P=0.001)and β2-MG levels(OR=2.807,95％CI:1.580-4.984,P=0.001)were influencing factors of renal injury severity in the renal injured patients.Conclusion Carotid pulse wave combined with urinary TRF and β2-MG can be applied in auxiliary diagnosis of hypertensive nephropathy,and they are correla-ted with the severity of renal injury.