摘要目的 探讨基于E-Coach健康管理模式的营养管理联合主动循环呼吸训练（ACBT）在非小细胞肺癌（NSCLC）化疗患者中的应用效果。方法 选取2023年6月至2025年8月我院收治的98例NSCLC化疗患者，采用随机数字表法将所有研究对象分为联合组和常规组，每组49例。常规组给予常规干预，联合组在常规组基础上予以E-Coach健康管理模式的营养管理联合ACBT干预。比较两组干预前后营养状况、肺功能、运动耐力、生活质量以及营养不良发生率。结果 干预12周后，两组BMI、ALB、PA、Hb均较干预前上升且联合组高于常规组（P<0.05）；联合组FVC、FEV1、MVV及6MWT均显著高于常规组（P＜0.05）；干预前两组6MWT组间对比差异无统计学意义（P>0.05），干预4周、6周、8周、12周后，两组6MWT均较干预前增加，且联合组远于常规组（P<0.05）；干预12周后，两组身体功能、社会或家庭功能、情感功能、功能性状况得分均较干预前上升，且联合组高于常规组（P<0.05）。结论基于E-Coach健康管理模式的营养管理联合ACBT能够有效改善NSCLC化疗患者的营养状况和肺功能，提高生活质量和运动耐力。

Abstract Objective To investigate the application effect of nutrition management based on the E-Coach health management model combined with active cycle of breathing technique (ACBT) in patients undergoing chemotherapy for non-small cell lung cancer (NSCLC). Methods A total of 98 NSCLC patients receiving chemotherapy in our hospital from June 2023 to August 2025 were selected and randomly divided into a combination group and a conventional group using a random number table method, with 49 cases in each group. The conventional group received routine intervention, while the combination group received nutrition management based on the E-Coach health management model combined with ACBT in addition to the routine intervention. The nutritional status, lung function, exercise endurance, quality of life, and incidence of malnutrition were compared between the two groups before and after the intervention. Results After 12 weeks of intervention, BMI, ALB, PA, and Hb in both groups increased compared with baseline, and the levels in the combination group were higher than those in the conventional group (P<0.05). The FVC, FEV1, MVV, and 6MWT in the combination group were significantly higher than those in the conventional group (P<0.05). There was no statistically significant difference in 6MWT between the two groups before intervention (P>0.05); after 4, 6, 8, and 12 weeks of intervention, the 6MWT in both groups increased compared with baseline, and the walking distance in the combination group was significantly longer than that in the conventional group (P<0.05). After 12 weeks of intervention, the scores of physical function, social/family function, emotional function, and functional well-being in both groups increased compared with baseline, and the scores in the combination group were higher than those in the conventional group (P<0.05). Conclusion Nutrition management based on the E-Coach health management model combined with ACBT can effectively improve the nutritional status and lung function of NSCLC patients undergoing chemotherapy, and enhance their quality of life and exercise endurance.

【摘要】目的：探讨多元化健康宣教在幽门螺旋杆菌（Hp）感染碳13（13C）呼气试验筛查中的应用效果。方法：将2024年5月~2026年4月至我院体检科进行无痛胃肠镜检查后，结果提示Hp阳性的300例患者作为研究对象，开展前瞻性临床试验。经数字表法将入组患者随机列为常规组和试验组，每组150例。两组患者均行13C呼气试验，常规组检查前实施常规健康宣教，试验组检查前实施多元化健康宣教，比较两组患者的心理状态，准备情况，检查情况及整体满意度。结果：试验组的疾病不确定感（MUIS）评分、广泛性焦虑量表-7（GAD-7）评分均低于常规组（t=7.644，10.923；P＜0.05）。试验组的药物停用依从率、饮食依从率、空腹依从率分别92.00%（138/150）、93.33%（140/150）、96.67%（145/150），均高于常规组[80.00%（120/150）、81.33%（122/150）、85.33%（128/150）]（x2=8.970，9.763，11.762；P＜0.05）。试验组的吹气一次成功率、肺泡气样本质量达标率、检查完成率、检查结果准确率分别为94.67%（142/150）、94.00%（141/150）、96.67%（145/150）、96.00%（144/150），均高于常规组[82.67%（124/150）、83.33%（125/150）、84.67%（127/150）、84.00%（126/150），]（x2=10.748，8.492，12.763，12.000；P＜0.05）。试验组的心理舒适、信息获取、检查流畅、结果可靠满意度评分均高于常规组（t=5.279，4.625，4.592，5.729；P＜0.05）。结论：多元化健康宣教可改善Hp感染患者的心理状态，并优化13C呼气试验的准备情况、检查情况，对提升检查结果准确性及患者满意度均有积极影响

[Abstract]Objective:Exploring the application effect of diversified health education in screening for Hp infection with 13C breath test.Methods:A prospective clinical trial will be conducted on 300 patients who were found to be Hp positive after undergoing painless gastroscopy in our hospital from May 2024 to April 2026. The enrolled patients were randomly divided into a control group and an experimental group using a numerical table method, with 150 cases in each group. Both groups of patients underwent 13C breath tests. The routine group received routine health education before the examination, while the experimental group received diversified health education before the examination. The psychological status, preparation, examination results, and overall satisfaction of the two groups of patients were compared.Results:Compare to the control group,the experimental group had lower MUIS scores and GAD-7 scores (t=7.644，10.923; P<0.05). The medication discontinuation compliance rate, dietary compliance rate, and fasting compliance rate of the experimental group were 92.00% (138/150), 93.33% (140/150), and 96.67% (145/150), respectively, all higher than those of the conventional group [80.00% (120/150), 81.33% (122/150), 85.33% (128/150)] (x2=8.970，9.763，11.762; P<0.05). The success rate of one-time blowing, the quality compliance rate of alveolar gas samples, the completion rate of examination, and the accuracy of examination results in the experimental group were 94.67% (142/150), 94.00% (141/150), 96.67% (145/150), and 96.00% (144/150), respectively, which were higher than those in the conventional group [82.67% (124/150), 83.33% (125/150), 84.67% (127/150), 84.00% (126/150)] (x2=10.748，8.492，12.763，12.000; P<0.05). Compare to the control group,the experimental group had higher satisfaction scores of psychological comfort, information acquisition, smooth examination, and reliable results (t=5.279，4.625，4.592，5.729; P<0.05).Conclusion:Diversified health education can improve the psychological state of Hp infected patients, optimize the preparation and examination of 13C breath tests, and have a positive impact on improving the accuracy of examination results and patient satisfaction.

目的 探讨3M复合树脂填充乳牙龋齿患儿治疗中的临床价值。方法 回顾性收集2023年4月至2025年4月我院口腔科128例乳牙龋齿患儿临床资料，根据治疗方法不同分为对照组（高强度玻璃离子填充，67例）、观察组（3M复合树脂填充，61例），采用倾向匹配评分法匹配，按照1:1配对选例，两组均纳入53例。比较两组疗效、治疗前后疼痛程度[Wong-Baker面部疼痛评分量表（Wong-Baker评分）]、牙髓活力、牙齿敏感性、龈沟液炎症因子[白细胞介素（IL）-6、IL-8、单核细胞趋化蛋白-1（MCP-1）]、儿童口腔健康影响量表（ECOHIS）评分及并发症。结果 观察组治疗总有效率94.34%高于对照组81.13%（P＜0.05）；治疗后1周观察组Wong-Baker评分、牙髓活力评分低于对照组，牙齿敏感性分级优于对照组（P＜0.05）；治疗后1周，观察组龈沟液IL-6、IL-8、MCP-1水平低于对照组（P＜0.05）；治疗后6个月，观察组口腔症状、口腔功能、心理状态评分低于对照组（P＜0.05）；两组并发症发生率比较，无显著差异（P＞0.05）。结论 3M复合树脂填充治疗乳牙龋齿患儿效果显著，能抑制龈沟液炎症，降低牙齿敏感性，提升牙髓活力，缓解患儿疼痛，改善口腔健康，且安全性较高。

       目的   了解育龄期乳腺癌患者对子代健康和遗传风险担忧现状及其对癌症诊断前后生育意愿改变的影响。方法   于2019年11月—2020年9月，采用中文版癌症后生育忧虑量表（RCAC）-子女健康亚量表对广州市某三甲医院的230例育龄期乳腺癌患者进行调查，应用SPSS 26.0及PSM插件对结果进行统计分析。在进行子女健康亚量表得分低分组和中高分组患者的生育意愿改变率的比较时，应用倾向性评分匹配法控制混杂因素。结果   育龄期乳腺癌患者对子代健康和遗传风险担忧得分为（11.40±2.99）分；匹配前后不同子女健康亚量表得分分组的患者在癌症诊断前后生育意愿改变率的差异均不具有统计学意义（P＞0.05）。结论   育龄期乳腺癌患者对子代健康和遗传风险的担忧虽然没有显著影响其生育意愿的改变，但其对子代健康和遗传风险担忧处于较高水平，临床医护人员应提高对这一现象的重视，可通过多渠道科普相关知识，开展遗传咨询服务以减轻患者的担忧。

      Objective  To explore the current status of childbearing age breast cancer patients’  concerns  about their children’s health and genetic risk and its influence on the change of fertility intention before and after cancer diagnosis．Methods  From November 2019 to September 2020，the Chinese version of the Reproductive Concern After Cancer Scale（RCAC）- Children’s Health Sub-scale was used to interview 230 patients with breast cancer of childbearing age in a tertiary hospital in Guangzhou，and SPSS 26.0 and PSM plug-in were used to analyze the results statistically．The  propensity  score matching method was used to control confounding factors when comparing the change  rate of fertility intention of patients with low scores and those with medium and high scores in the children health subscale．Results  The score of concern for the health and genetic risk of children in breast cancer patients of childbearing age was（11.40±2.99）．There was no statistically significant difference in the change  rate of fertility intention before and after cancer diagnosis among patients with different subscale scores of children’s health．Conclusions   Despite not significantly impacting fertility intentions，the notably high level of concern regarding children’s health and genetic risks among childbearing-age breast cancer patients necessitates increased clinical awareness．It is recommended that healthcare professionals address this through multi-channel education and genetically focused counseling within a collaborative model to mitigate patient distress．

       目的   识别经皮冠状动脉介入治疗（PCI）后恐动症患者抑郁、焦虑和压力的影响因素。方法   采用横断面研究，纳入780例行PCI术后恐动症患者。应用系列量表评估恐动症患者的不良心理健康状况、生活质量、自我感受负担、社会支持和运动自我效能，并通过问卷收集了患者的社会人口学数据。线性回归和Logistic回归用于识别抑郁、焦虑和压力等不良心理状态的影响因素，应用中介分析探索潜在的中介机制。结果  271例（34.7%）、304例（39.0%）和153例（19.6%）恐动症患者存在不同程度的抑郁、焦虑和压力。恐动症患者的抑郁、焦虑和压力水平呈正相关。线性回归和Logistic分析结果表明，较高的家庭月收入与较高的抑郁水平相关（线性回归：β为0.908和1.937；Logistic：OR为2.05和5.47），社会支持程度与抑郁水平呈负相关（线性回归：β=-0.079；Logistic：OR=0.93）。单身/离异/寡居患者的焦虑水平显著高于已婚患者（线性回归：β=1.613；Logistic：OR=2.28）。与家庭月收入低于5 000元者相比，家庭月收入为5 000~10 000元之间的患者的压力水平较高（线性回归：β=1.065；Logistic：OR=3.14）。此外，自我感受负担较重的患者具有更高的压力水平（线性回归：β=0.077；Logistic：OR=1.05）。中介分析结果表明，焦虑和压力是社会支持/自我感受负担与抑郁之间关联的潜在中介因子。结论  PCI术后恐动症患者广泛存在心理健康问题，其家庭月收入、年龄、婚姻状况、生活方式和病史等因素对患者的不良心理健康状态具有显著影响。医务人员应关注这些患者的心理健康状况及影响因素，制定综合管理策略以改善其预后。

       Objective  To identify the risk factors associated with depression，anxiety  and  stress in  patients with kinesiophobia after percutaneous coronary intervention（PCI）．Methods  In this cross-sectional study，780 patients who developed kinesiophobia after undergoing PCI were enrolled．A series of scales were used to assess the psychological health status，quality of life，self-perceived burden，social support，and exercise self-efficacy of patients with kinesiophobia，and socio-demographic data of the patients were collected through a questionnaire．Linear regression analyses and Logistic regression analyses were used to identify risk factors of adverse psychological outcomes，including depression，anxiety，and stress．Furthermore，mediation analysis was employed to explore the potential mediating mechanisms．Results  Among the 780 patients with kinesiophobia，271（34.7%），304（39.0%）and 153（19.6%）were found to have varying degrees of depression，anxiety，and stress，respectively．The levels of depression，anxiety and stress in patients with kinesiophobia were positively correlated with each other．The results of both linear regression and Logistic regression analyses indicated that higher levels of family monthly income were associated with higher levels of depression（linear：β=0.908 and 1.937；Logistic：OR=2.05 and 5.47），while the degree of social support was negatively correlated with depression levels（linear：β=-0.079；Logistic：OR=0.93）．For patients who were single，divorced or widowed，their levels of anxiety were significantly higher than those of married patients（linear：β=1.613；Logistic：OR=2.28）．Compared to patients with a monthly household income of less than 5 000 yuan，those with a monthly income between 5 000 and 10 000 yuan reported higher levels of stress（linear：β=1.065；Logistic：OR=3.14）．Additionally，patients who perceived a higher personal burden also experienced greater stress（linear：β=0.077；Logistic：OR=1.05）．Mediation analysis indicated that anxiety and stress were potential mediating factors in the relationship between social support/self-perceived burden and depression．Conclusions  This study  reported the widespread psychological health issues among patients with kinesiophobia after PCI and the interactions between these issues．Factors such as monthly household income，age，marital status，lifestyle and medical  history were found to  be significantly associated with these negative psychological outcomes．Clinicians and nurses should focus on the psychological health and influencing factors of these patients and develop comprehensive management strategies to improve their prognosis．

更好地保障医务人员的职业安全与健康是备受关注的议题。文章介绍了华南理工大学附属第二医院（广州市第一人民医院）基于国际医院评审认证标准促进医院职业安全与健康管理体系建设完善的经验做法, 为国内三甲医院的职业安全与健康管理体系建设提供参考。

How to better protect the occupational safety and health of medical personnel is a topic of great concern．This article introduces the empirical approach of Guangzhou First People’s Hospital, the Second Affiliated Hospital of South China University of Technology to establish and improve hospital occupational safety and health management system based on international hospital accreditation standard．It provides a reference for the construction of occupational safety and health management system in domestic 3A-grade hospital．

目的 探讨基于健康意识理论（HEC）的健康管理联合早期活动护理干预应用于急性胰腺炎（AP）患者的效果。方法 将南阳市第一人民医院2020年1月—2023年1月期间收治的80例AP患者作为研究对象,按照随机数字表法分为对照组（n=40）和观察组（n=40）。两组患者均按照AP护理常规进行护理,对照组予早期活动护理干预,观察组予早期活动护理和基于HEC的健康管理,观察两组健康行为能力、健康促进行为和并发症发生情况。结果 干预后,两组患者健康行为能力自评量表得分均高于干预前,且观察组得分高于对照组（P<0.05）;两组患者健康促进生活方式量表Ⅱ得分均高于干预前,且观察组得分高于对照组（P<0.05）;观察组并发症发生率（5.00%）低于对照组（20.00%）。结论 基于HEC的健康管理联合早期活动护理可以有效改善AP患者的健康行为能力、健康促进行为减少并发症的发生。

Objective To explore the effect of health management combined with early activity nursing intervention based on health as expanding consciousness（HEC）on patients with acute pancreatitis（AP）．Methods Eighty patients with AP admitted to the First People’s Hospital of Nanyang City from January 2020 to January 2023 were selected as the study subjects．They were randomly divided into a control group（n=40）and an observation group（n=40）using a random number table method．Both groups of patients received routine AP nursing care．The control group received early activity nursing intervention,while the observation group received early activity nursing and HEC based health management．The health behavior ability,health promotion behavior,and incidence of complications were observed in both groups．Results After the intervention,both groups of patients had higher scores on the Self Rating Health Behavioral Ability Scale than before the intervention,and the observation group had higher scores than the control group（P<0.05）．The scores of the Health Promotion Lifestyle Scale II for both groups of patients were higher than before intervention,and the scores of the observation group were higher than those of the control group（P<0.05）．The incidence of complications in the observation group（5.00%）was lower than that in the control group（20.00%）．Conclusions Health management based on HEC combined with early activity nursing can effectively improve the health behavior ability of AP patients,promote health behavior,and reduce the occurrence of complications．

目的 探讨大一护理系学生（护生）心理健康素养、心理健康与心理弹性的现状以及三者之间的关系。方法 采用方便抽样法选取大一护生202人作为研究对象,采用一般资料问卷、青少年心理健康素养评定量表（AMHLAQ）、心理健康量表（K10）,心理弹性量表（CD-RISC）进行调查。结果 （1）城市大一护生心理健康素养（t=-2.832,P<0.01）、心理健康水平（t=3.052,P<0.001）和心理弹性水平（t=-2.521,P<0.05）高于农村大一护生;独生子女的心理健康素养（t=2.098,P<0.05）和心理健康水平（t=-2.684,P<0.01）高于非独生;父亲学历为高中及以上的心理健康素养（t=-2.543,P<0.05）和心理健康水平（t=3.082,P<0.01）高于父亲学历为初中及以下;母亲学历为高中及以上的心理健康素养（t=-2.052,P<0.05）和心理健康水平（t=2.595,P<0.01）高于父亲学历为初中及以下;（2）心理健康得分越高,心理问题越严重,心理健康素养与心理弹性呈正相关（r=0.340,P<0.01）,心理健康得分与心理健康素养、心理弹性呈负相关（r=-0.651,-0.384,P<0.01）。（3）心理弹性在心理健康素养与心理健康中存在部分中介效应,中介效应值为-0.190,中介效应占比15.68%。结论 山西医科大学汾阳学院大一护生心理健康存在一定问题,要多注重农村地区、非独生子女以及父母学历较低的人群心理健康和心理健康素养的培养,大一护生心理健康素养越高,心理弹性水平越高,心理健康得分越低,心理健康水平越高。心理弹性在心理健康素养与心理健康中起中介作用,可以提升大一护生的心理弹性水平,培养其坚韧性、自强性和乐观性,从而降低心理健康得分,提高心理健康水平。

Objective To explore the current status of mental health literacy,mental health,and psychological resilience among first-year nursing students,as well as the relationship among the three．Methods A total of 202 freshmen were selected as the research subjects using convenience sampling method．The survey was conducted using a general information questionnaire,the Adolescent Mental Health Literacy Assessment Scale（AMHLAQ）,the Mental Health Scale（K10）,and the Psychological Resilience Scale（CD-RISC）．Results （1）The mental health literacy（t=-2.832,P<0.01）,mental health level（t=3.052,P<0.001）,and psychological resilience level（t=-2.521,P<0.05）of urban freshmen were significantly higher than those of rural freshmen．The mental health literacy（t=2.098,P<0.05）and mental health level（t=-2.684,P<0.01）of only-child were higher than those of non-only-child．The mental health literacy（t=-2.543,P<0.05）and mental health level（t=3.082,P<0.01）of the father with a high school education or above were higher than those of the father with a middle school education or below．The mental health literacy（t=-2.052,P<0.05）and mental health level（t=2.595,P<0.01）of the mother with a high school education or above were higher than those of the father with a middle school education or below．（2）The higher the mental health score,the more serious the psychological problem．There was a significant positive correlation between mental health literacy and psychological resilience（r=0.340,P<0.01）,while there was a significant negative correlation among mental health score and mental health literacy and psychological resilience（r=-0.651,-0.384,P<0.01）．（3）Psychological resilience had a partial mediating effect between mental health literacy and mental health,with a mediating effect value of -0.190,accounting for 15.68% of the total．Conclusions There are certain problems with the mental health of freshmen nursing students in Shanxi Medical University．It is necessary to pay more attention to the cultivation of mental health and mental health literacy in rural areas,non-only-child,and those whose parents with lower educational level．The higher the mental health literacy and resilience level of freshmen nursing students,the lower their mental health scores,and the higher their mental health level．Psychological resilience plays a mediating role in the relationship between mental health literacy and mental health．It can cultivate the level of psychological resilience,resilience,self-improvement and optimism of first-year nursing students,thereby reducing their mental health scores and improving their mental health level．

目的 分析共同照护模式联合回授法健康教育在2型糖尿病患者中的应用效果。方法 将2023年1月—2023年12月广州市第一人民医院收治 的114例2型糖尿病患者作为此次研究对象,分为研究组（n=57）和对照组（n=57）,对照组患者给予常规护理结合健康教育,研究组患者给予共同照护模式联合回授法健康教育,评估两组在培训前及培训后1、3个月的血糖控制情况及糖尿病患者自我管理行为量表（SDSCA）等指标。结果 培训1、3个月后,两组患者的空腹血糖、餐后2 h血糖、糖化血红蛋白均低于培训前,且研究组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于对照组（P<0.05）。培训1、3个月后,两组患者的糖尿病患者SDSCA评分高于培训前,且研究组各项评分高于对照组（P<0.05）。重复测量方差分析表明随着时间的推移,患者的血糖控制状况随着不同护理培训策略而得到改善。结论 使用共同照护模式联合回授法健康教育对2型糖尿病患者可以更显著改善血糖控制水平、提高自我管理效能。

Objective To analyze the effect of co-care mode and feedback health education on patients with type 2 diabetes．Methods From January 2023 to December 2023,114 patients with type 2 diabetes admitted to Guangzhou First People's Hospital were divided into two groups：experimental group（n=57）and control group（n=57）．Patients in control group were given routine nursing combined with health education．Patients in study group were given co-care and feedback health education． Before intervention and 1,3 months after intervention,patients' blood glucose control and diabetic self-management behavior scale（SDSCA）were evaluated．Results After 1 and 3 months of intervention,the fasting blood glucose,2-hour blood glucose and HbA1c of the two groups were significantly lower than those before intervention,and the fasting blood glucose,2-hour blood glucose and HbA1c of the experimental group were significantly lower than those of the control group（P<0.05）．After 1 month and 3 months of intervention,the SDSCA scores of diabetic patients in both groups were higher than those before intervention,and the scores of study group were higher than those of control group（P<0.05）．Repeated measures analysis of variance indicating that glycemic control improved significantly over time with different nursing training strategies．Conclusions Co-care mode and feedback health education can significantly improve blood glucose control and self-management efficiency in patients with type 2 diabetes．

目的 探讨情景模拟式健康教育对飞秒激光小切口角膜基质透镜取出手术（SMILE）患者的应用效果,提高手术患者术中的配合度。方法 随机选取2020年6月—12月于我院拟进行SMILE手术患者200例,随机分为观察组和对照组,各100例,其中对照组采用常规术前健康教育,观察组采用情景模拟宣教视频的方式实施术前健康教育。比较两组患者围术期依从性、焦虑自评量表（SAS）和SMILE手术知识知晓率。结果 观察组患者围术期依从性和SMILE手术围术期知识知晓率得分高于对照组、患者术前焦虑水平低于对照组,差异均有统计学意义（P<0.05）。结论 情景模拟式健康教育能有效提升SMILE手术患者围术期依从性,减轻患者手术紧张的情绪,提升患者SMILE手术围术期健康知识知晓率,提升就医体验及手术成功率。

Objective To explore the application effect of scenario simulation based health education on patients undergoing small incision lenticule extraction（SMILE）,in order to improve the cooperation of surgical patients．Methods From June to December in 2020,200 patients who were scheduled to undergo SMILE in the hospital were randomly selected and divided into an observation group and a control group,with 100 patients in each group．The control group received routine preoperative health education,while the observation group received preoperative health education through scenario simulation educational videos．The perioperative adherence of patients,Self Rating Anxiety Scale（SAS）,and SMILE surgical knowledge awareness rates were compared between patients of two groups．Results The observation group had higher scores in perioperative adherence of patients and perioperative knowledge awareness of SMILE surgery than the control group,and lower preoperative anxiety levels than the control group,with statistically significant differences（P<0.05）．Conclusions Scenario simulation based health education can effectively improve the adherence of SMILE patients,alleviate their surgical anxiety,enhance their awareness of perioperative health knowledge,improve their medical experience,and increase the success rate of the surgery．