自闭症谱系障碍（ASD）是一类神经发育障碍性疾病，其核心临床表现为社交行为障碍、语言沟通困难以及重复刻板行为。早期诊断并进行早期行为干预，是目前能改善患者临床症状且减少终身残疾的主要措施。但早期诊断困难，因为目前所采用的行为量表，比如ABC（异常行为检查表）等，在儿童生命早期阶段，如2岁左右，很难准确地反应出被试者的社交行为或者语言交流能力；而且，其判断也非常依赖于医生的经验，具有一定的主观性。近年来，随着脑影像技术，比如核磁共振（MRI），特别是功能性核磁共振（fMRI），以及人工智能技术（AI）的飞速发展，为ASD的早期诊断，从无创、客观、以及神经活动异常-行为异常偶联的角度，展示了一种新的机遇。本文比较系统地介绍了ASD的临床基础与诊断挑战，并详细阐述了AI在ASD早期诊断中的数据来源、核心算法和典型研究案例。通过分析当前技术面临的挑战与局限性，提出未来研究方向与临床转化路径，以期进一步加强AI在ASD早期诊断中的临床使用研究，使之最终能高效的服务于临床。

   Autism spectrum disorder（ASD）is a group of neurodevelopmental disorders clinically characterized by deficits in social interaction and verbal communication，along with repetitive behaviors．Early diagnoses，followed by early behavioral interventions，are currently effective strategies to attenuate clinical symptoms and improve patient outcomes in ASD; however，early diagnosis remains challenging at present．Current diagnostic tools，such as the Aberrant Behavior Checklist（ABC），have difficulty in accurately evaluating social engagement and verbal communication in early childhood（e.g. ，at 2 years of age）．Furthermore，such evaluations may be somewhat subjective，as they rely，at least partially，on clinicians’ experience．Recently，with the rapid development of brain imaging techniques（e.g. ，MRI，especially fMRI）and artificial intelligence（AI），a significant opportunity has emerged to develop novel early-diagnostic tools for ASD．These tools exhibit clear advantages，including being non-invasive，more objective，and focusing on the coupling of abnormalities in both neuronal activity and behavioral responses．Here，we systematically introduce the clinical features of ASD，discuss the challenges in early diagnosis，and review the current status of AI-driven diagnostic tool development in detail，including data acquisition methods，computational architectures，and typical clinical applications．Through a detailed analysis of the technical challenges，advantages，and limitations of these tools，we propose future research directions，aiming to eventually establish highly valuable AI-based diagnostic approaches for clinical use in ASD care．

       癫痫是一种由多种病因引起的慢性脑部疾病，其患者死亡风险为一般人群的2~3倍。我国农村地区，受多种因素的影响，约2/3的癫痫患者未得到合理的治疗，给患者及其家庭和社会带来沉重负担。顺德区积极响应“中国农村地区癫痫防治管理项目”，成立癫痫专科医联体，构建三级诊疗体系，开展了一系列实践探索。本文旨在总结顺德区专科医联体管理模式下的癫痫综合管理实践，分析管理现状，并提出改进路径，以期为癫痫患者提供更优质的服务，改善患者生活质量。

      Epilepsy is a chronic brain disorder caused by various etiologies，the mortality risk of epilepsy patients is 2 to 3 times higher than that of the general population．In rural areas of China，due to multiple influencing factors，approximately two-thirds of epilepsy patients receive inadequate or no proper treatment，imposing a heavy burden on patients，their families，and the society．Shunde District has actively responded to the “China Rural Epilepsy Prevention and Management Project” by establishing an epilepsy specialty medical consortium and building a three-tiered diagnostic and treatment system，conducting a series of practical explorations．This article aims to summarize the comprehensive epilepsy management practices under the specialty medical consortium model in Shunde District，analyze the current management status，and propose improvement strategies to provide better services for epilepsy patients and enhance their quality of life．

在按病种分值付费（DIP）模式深化实施的背景下，医用耗材管理作为医院成本控制与医疗质量保障的核心环节，其监督效能直接影响医院运营效益。本文基于供应链溢出视角，以某医院医用耗材信息化管理实践为案例，从技术溢出、管理溢出、风险溢出三个维度，探讨信息技术对医院内部医用耗材监督管理的优化路径。研究表明，通过构建医疗器械唯一标识（UDI）系统、收拾耗占比动态监控、专项议价管控等措施，可实现监督技术跨环节渗透、管理标准全链条协同、风险防控全周期覆盖。实践表明，该模式有效控制了医院耗材的整体运营成本，并显著提升了高值耗材的用后结算管理水平，为公立医院构建精准、高效的内部监管机制提供了有价值的实践路径。

Under the deepening implementation of the diagnosis-intervention packet（DIP） payment model，the management of medical consumables serves as a core aspect of hospital cost control and medical quality assurance，with its supervision efficiency directly impacting hospital operational benefits．Based on the perspective of supply chain spillover，this paper takes the informatization management practices of medical consumables in a hospital as a case study，exploring the optimization paths of information technology in the internal supervision and management of medical consumables from three dimensions：technological spillover，managerial spillover，and risk spillover．The research shows that by establishing a unique device identification（UDI） system，implementing dynamic monitoring of the consumption ratio of medical consumables，and conducting special negotiation controls，cross-process penetration of supervision technology，full-chain coordination of management standards，and comprehensive risk prevention and control throughout the entire cycle can be achieved．Practice demonstrates that this model has reduced the hospital’s overall cost of medical consumables by 2.75%，increased the post-use settlement rate of high-value consumables to 80%，and provided practical references for public hospitals to establish a precise and efficient internal supervision system．

       目的 深入分析实时动态血糖监测系统（CGMS）在2型糖尿病患者接受胰岛素泵强化治疗过程中的实际应用意义。方法 本研究采用前瞻性随机对照试验设计，收集2025年1月至2026年3月间收治的80名2型糖尿病患者，运用随机数字表法将其随机分配为两组，每组40名患者。对照组患者接受常规指尖血糖检测与胰岛素泵治疗，研究组采用深圳硅基传感公司生产的GS1型动态血糖监测系统辅助胰岛素泵治疗，两组患者的治疗周期均延长至14天。主要观测指标：目标血糖范围内时间占比（TIR，3.9~10.0 mmol/L）；次要观测指标：糖化血红蛋白（HbAlc）、空腹血糖（FBG）、餐后2 h血糖（2hPBG）等代谢指标，低血糖发生频率、日内血糖波动幅度（MAGE）、日间血糖平均绝对差（MODD）、血糖高于目标范围时间占比（TAR，＞10.0 mmol/L）、血糖低于目标范围时间占比（TBR，＜3.9 mmol/L）。结果 治疗14天后，两组患者的血糖指标均较治疗前改善，研究组主要指标TIR（78.65%±8.23%）高于对照组（62.34%±9.56%）（P＜0.001）；次要指标中，研究组HbAlc、FBG和2hPBG的改善幅度及MAGE、MODD的降低幅度均优于对照组（P＜0.05）；研究组低血糖发生率（2.5%）、TBR（1.82%±0.95%）低于对照组（20%、5.68%±1.32%），TAR（19.53%±7.81%）低于对照组（31.98%±8.64%）（P＜0.05）。研究组动态血糖图谱（AGP）显示血糖波动更平稳，峰值与谷值差异缩小，TIR分布更集中。结论 实时动态血糖监测技术通过提供连续、完整的血糖数据，精准捕捉血糖波动规律，为胰岛素泵参数调整提供科学依据，显著提升目标血糖达标时间占比，优化整体血糖控制效果，同时有效降低低血糖事件及血糖偏离目标范围的风险，是2型糖尿病患者胰岛素泵强化治疗的重要辅助手段。

      Objective To analyze the practical significance of real-time continuous glucose monitoring system（CGMS） in patients with type 2 diabetes mellitus（T2DM） receiving intensive insulin pump therapy．Methods A prospective randomized controlled trial design was used to collect 80 patients with T2DM from January 2025 to March 2026．The patients were randomly divided into two groups by random number table method，with 40 patients in each group．The patients in the control group received routine fingertip blood glucose detection and insulin pump therapy，while the patients in the study group received insulin pump therapy assisted by GS1 type CGMS produced by Shenzhen Sili-based Sensor company．The treatment period of the two groups was extended to 14 days．Primary outcome measures：time in range（TIR，3.9-10.0 mmol/L）；secondary outcomes：hemoglobin A1c（HbAlc），fasting blood glucose（FBG），2-hour postprandial blood glucose（2hPBG），frequency of hypoglycemia，mean amplitude of glycemic excursion（MAGE），mean of daily differences（MODD），time above range（TAR，＞10.0 mmol/L） and time below the target range（TBR，＜3.9 mmol/L），and other metabolic indicators．Results After 14 days of treatment，the blood glucose indexes of the two groups were significantly improved compared with those before treatment．The main index TIR in the study group（78.65%±8.23%） was significantly higher than that in the control group（62.34%±9.56%）（P＜0.001）．Among the secondary indexes，the improvement of HbAlc，FBG and 2hPBG and the reduction of MAGE and MODD in the study group were significantly better than those in the control group（P＜0.05）．The incidence of hypoglycemia（2.5%），TBR（1.82%±0.95%） and TAR（19.53%±7.81%） in the study group were significantly lower than those in the control group（20%，5.68%±1.32%，31.98%±8.64%）（P＜0.05）．The ambulatory glucose profile（AGP） of the study group showed that blood glucose fluctuation was more stable，the difference between peak and trough was reduced，and TIR distribution was more concentrated．Conclusions Real-time CGMS can accurately capture blood glucose fluctuation by providing continuous and complete blood glucose data，provide scientific basis for insulin pump parameter adjustment，significantly improve the proportion of time to reach the target blood glucose，optimize the overall blood glucose control effect，and effectively reduce the risk of hypoglycemia events and blood glucose deviation from the target range．It is an important auxiliary method for intensive insulin pump therapy in patients with type 2 diabetes．

       目的 分析舒肝解郁胶囊联合体外反搏治疗冠心病介入术后焦虑抑郁患者的效果。方法 选择2023年1月—2025年1月平顶山市第一人民医院收治的86例冠心病介入术后患者，随机分为对照组（43例）、舒肝解郁胶囊组（43例），均进行常规治疗及体外反搏治疗，舒肝解郁胶囊组加用舒肝解郁胶囊，测量并比较两组患者治疗前后心肺功能，评估患者焦虑和抑郁情绪、临床疗效及生活质量。结果 治疗后舒肝解郁胶囊组左心室射血分数（LVEF）和最大摄氧量（VO2max）均显著高于对照组（P＜0.05）；治疗后舒肝解郁胶囊组汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评分均低于对照组（P＜0.05）；舒肝解郁胶囊组总有效率高于对照组（P＜0.05）；治疗后舒肝解郁胶囊组生活质量综合评定问卷（GQOLI-74）各维度评分均显著高于对照组（P＜0.05）。结论 舒肝解郁胶囊联合体外反搏治疗冠心病介入术后焦虑抑郁效果显著，可减轻患者负面情绪，改善其心肺功能及生活质量。

     Objective To analyze the effect of Shugan Jieyu Capsule combined with external counterpulsation in the treatment of anxiety and depression in patients with coronary artery disease after percutaneous coronary intervention（PCI）．Methods From January 2023 to January 2025，86 patients with coronary heart disease who had undergone PCI in our hospital were enrolled and randomly divided into a control group（43 cases） and a Shugan Jieyu Capsule group（43 cases）．All patients received conventional treatment and external counterpulsation．The Shugan Jieyu Capsule group was given Shugan Jieyu Capsule in addition．Cardiopulmonary function was measured and compared before and after treatment between the two groups，and anxiety and depression，clinical efficacy，and quality of life were evaluated．Results After treatment，the left ventricular ejection fraction（LVEF） and maximum oxygen uptake（VO2max） in the Shugan Jieyu Capsule group were significantly higher than those in the control group（P＜0.05）．The Hamilton Anxiety Rating Scale（HAMA） and Hamilton Depression Rating Scale（HAMD） scores in the Shugan Jieyu Capsule group were significantly lower than those in the control group（P＜0.05）．The total effective rate in the Shugan Jieyu Capsule group was significantly higher than that in the control group（P＜0.05）．After treatment，the scores on all dimensions of the General Quality of Life Assessment Questionnaire-74（GQOLI-74） in the Shugan Jieyu Capsule group were significantly higher than those in the control group（P＜0.05）．Conclusions Shugan Jieyu Capsule combined with external counterpulsation is effective in treating anxiety and depression after PCI，alleviating negative emotions and improving cardiopulmonary function and quality of life．

       目的 探讨基于德尔菲法构建专科护士能力分层管理模式。方法 通过查阅文献，并结合半结构式访谈，初步梳理出评价指标的条目集合。随机抽取20名权威护理临床实践专家，运用德尔菲专家函询法，依据专家反馈，确定评价指标体系。结果 共进行2轮专家函询，积极系数均为100%。专家权威系数分别为 0.83、 0.85。专家意见肯德尔系数分别为0.350、0.340。最终构建专科护士临床实践能力的分层级评价管理模式包括3项一级指标，8项二级指标，23项三级指标。结论 基于德尔菲法构建的专科护士能力分层管理模式，对于提升护理服务质量、推动护理学科发展具有积极的指导意义。

      Objective To explore the construction of a hierarchical management model for the clinical practice ability of specialist nurses based on the Delphi method．Methods By reviewing literature and conducting semi-structured interviews，we initially sorted out a collection of evaluation indicator items．Twenty authoritative nursing clinical practice experts were randomly selected．The Delphi expert consultation method was employed，and based on the experts’ feedback，the evaluation indicator system was determined．Results A total of two rounds of expert consultations were conducted，with a 100% positive response rate in both rounds．The expert authority coefficients were 0.83 and 0.85，respectively．The Kendall’s coefficient of concordance for expert opinions was 0.350 and 0.340，respectively．The final hierarchical evaluation and management model for the clinical practice ability of specialist nurses included 3 first-level indicators，8 second-level indicators，and 23 third-level indicators．Conclusions The hierarchical management model for the ability of specialist nurses constructed based on the Delphi method has positive guiding significance for improving nursing service quality and promoting the development of the nursing discipline．

       目的 探讨自回归求和时间序列模型（ARIMA）在耐碳青霉烯类肺炎克雷伯菌（CRKP）医院感染预测中的应用，为CRKP感染的科学防控提供策略。方法 选取贾汪区人民医院住院患者2018年1月—2024年12月共7年每月CRKP医院感染率，应用SPSS 19.0建立ARIMA模型，利用该模型对2024年1—12月每月CRKP医院感染数据进行验证，以评价模型的预测性能。结果 用2018—2024年住院患者每月CRKP医院感染率建模、拟合，建立最优模型ARIMA（1，1，1），模型拟合值与实际值较吻合，模型对CRKP医院感染率实际值与预测值吻合度较高，平均相对误差为5.40%。结论 用ARIMA模型可有效拟合、预测CRKP医院感染情况，为CRKP防控提供科学指导。

     Objective To explore the value of auto regressive integrated moving average（ARIMA）model in predicting theinfection rate of carbapenem-resistant Klebsiella pneumoniae（CRKP）．Methods The monthly incidence of nosocomial infection of CRKP in Jiawang District People’s Hospital from 2018 to 2024 was selected，and the ARIMA model was established by19.0 SPSS to analyze the fitting and prediction value of the model．Results The ARIMA was established based on the monthly CRKP infection rate from January 2018 to December 2024．The fitted value of the ARIMA（1，1，1）model was in good agreement with the actual value．The incidence of CRKP infection were in good agreement with the predicted value．The average relative errors were 5.40%．Conclusions The ARIMA model can effectively fit and predict the CRKP infection rate，providing scientific guidance for the prevention and control of CRKP infection．

      目的 探讨多模态深度学习融合心脏超声与心电图特征对冠心病患者心源性猝死的预测价值。方法 选取2024年1月—2025年6月收治的60例冠心病患者，所有患者均接受心脏超声、心电图检查及多模态深度学习模型预测，随访6个月记录心源性猝死事件。根据随访结果分为事件组（n=15）和非事件组（n=45），比较两组临床资料及各项指标差异。结果 多模态深度学习模型预测敏感度为86.67%，特异度为91.11%，准确率为90.00%，AUC为0.923，显著优于单独心脏超声（AUC=0.761）和单独心电图（AUC=0.788）。结论 多模态深度学习融合心脏超声与心电图特征能够有效预测冠心病患者心源性猝死风险，预测性能优于传统单一模态评估方法。

      Objective To investigate the predictive value of multimodal deep learning integrating echocardiography and electrocardiogram features for sudden cardiac death in patients with coronary heart disease．Methods A total of 60 patients with coronary heart disease admitted from January 2024 to June 2025 were enrolled．All patients underwent echocardiography，electrocardiogram examination，and multimodal deep learning model prediction，with a 6-month follow-up to record sudden cardiac death events．According to the follow-up results，patients were divided into the event group（n=15） and non-event group（n=45），and clinical data and various indicators were compared between the two groups．Results The multimodal deep learning model achieved a sensitivity of 86.67%，specificity of 91.11%，accuracy of 90.00%，and AUC of 0.923，which were significantly superior to echocardiography alone（AUC=0.761） and electrocardiogram alone（AUC=0.788）．Conclusions Multimodal deep learning integrating echocardiography and electrocardiogram features can effectively predict the risk of sudden cardiac death in patients with coronary heart disease，with predictive performance superior to traditional single-modality assessment methods．

       目的 探究1990—2023年中国人群下背痛（LBP）疾病负担，并预测2024—2040年LBP疾病负担发展趋势，为公共卫生政策制定提供数据支撑。方法 基于GBD2023数据库，采用Joinpoint模型、分解分析（decomposition analysis）量化我国LBP负担变化趋势，最后通过ARIMA（autoregressive integrated moving average model）模型预测未来趋势。结果 2023年我国LBP患病人数达9 532.40万人，发病人数为4 138.36万人，伤残调整生命年（DALYs），虽然患病人数、发病人数及DALYs绝对数较1990年显著增长，但年龄标准化率（ASR）均呈显著下降趋势（AAPC依次为-0.90%、-0.84%、-0.89%）。分解分析表明，人口年龄结构是我国LBP疾病负担增长的主要正向驱动因素，流行病学趋势变化对患病率和DALYs起关键抑制作用，且存在明显性别差异。ARIMA模型预测显示，2024—2040年男性和女性LBP相关ASR将持续下降，但我国女性LBP负担仍高于男性。结论 我国LBP负担沉重，受人口结构、性别差异、行为与职业等多方面因素影响，未来需通过分人群、分职业精准干预及多部门协同，持续降低疾病负担。

     Objective To explore the characteristics of disease burden of low back pain（LBP） in the Chinese population from 1990 to 2023，and predict its development trend from 2024 to 2040，so as to provide data support for the formulation of public health policies．Methods Based on the Global Burden of Disease Study 2023（GBD 2023） database，the Joinpoint model and decomposition analysis were adopted to quantify the changing trend of LBP burden in China．The autoregressive integrated moving average（ARIMA） model was used to predict the future trend，with the data for prediction stratified by gender and age group．Results In 2023，the number of LBP patients in China reached 95.3240 million，the number of incident cases was 41.3836 million，and the disability-adjusted life years（DALYs） were 10.6359 million person-years．Although the absolute numbers of prevalent cases，incident cases，and DALYs increased significantly compared with 1990，the age-standardized rates（ASRs） all showed a significant downward trend（average annual percentage changes were -0.90%，-0.84%，and -0.89%，respectively）．Decomposition analysis revealed that population age structure was the primary positive driving factor for the growth of LBP disease burden in China，while changes in epidemiological trends played a key inhibitory role in prevalence and DALYs，with significant gender differences．ARIMA model prediction indicated that the LBP-related ASRs would continue to decrease in both males and females from 2024 to 2040，but the LBP burden in females would remain higher than that in males in China．Conclusions The baseline burden of LBP in China is heavy，affected by multiple factors such as population structure，gender differences，behavioral and occupational factors．In the future，targeted interventions for specific populations and occupations，as well as multi-sectoral collaboration，are needed to continuously reduce the disease burden．

       目的 探究单髁膝关节置换（UKA）联合注射布比卡因脂质体治疗老年孤立性内侧间室骨关节炎（OA）的效果，并分析其对患者术后长效镇痛的作用。方法 前瞻性选取2023年11月—2025年11月期间收治的80例老年孤立性内侧间室OA患者，分为对照组与研究组，各40例。两组患者均接受UKA手术治疗，研究组在术中于相同部位注射布比卡因脂质体，对照组于术中关节周围注射等体积的生理盐水混合物。比较两组术后疼痛强度，镇痛药物消耗与需求，早期膝关节功能恢复情况、早期膝关节功能，以及两组不良反应发生率。结果 研究组术后6 h、12 h、24 h及48 h VAS评分均低于对照组，术后48 h内，研究组中重度疼痛发生率较对照组低（P＜0.05）；研究组术后首次请求镇痛的时间晚于对照组，48 h内曲马多总消耗量及补救镇痛需求率均较对照组低（P＜0.05）；研究组在术后24 h、48 h、72 h的膝关节主动活动度较对照组大，研究组首次直腿抬高时间、术后下地行走时间及住院时间均较对照组短（P＜0.05）；术前两组膝关节协会评分（KSS）和牛津膝关节评分（OKS）评分无差异（P＞0.05）。术后1周，两组评分均改善，且研究组优于对照组（P＜0.05）；两组不良反应发生率无差异（P＞0.05）。结论 UKA术中联合应用布比卡因脂质体，能安全、有效地为老年孤立性内侧间室OA患者提供长效术后镇痛。且该方案不仅能显著减轻患者早期疼痛、减少阿片类药物依赖，更能有效促进膝关节早期功能恢复、缩短住院时间，并为患者获得更优的早膝关节功能奠定基础。

    Objective To investigate the efficacy of unicompartmental knee arthroplasty（UKA） combined with injection of bupivacaine liposomes in the treatment of elderly isolated medial compartment osteoarthritis（OA），and analyze its long-term analgesic effect on patients after surgery．Methods A prospective study was conducted on 80 elderly patients with isolated medial compartment OA admitted between November 2023 and November 2025．They were divided into a control group and a study group，with 40 patients in each group．Both groups of patients received UKA treatment．The study group received injection of bupivacaine liposomes at the same site during surgery，while the control group received injection of an equal volume of physiological saline mixture around the joints during surgery．Postoperative pain intensity，analgesic drug consumption and demand，early knee joint function recovery，early knee joint function were compared between two groups，and the incidence of adverse reactions was compared between the two groups．Results The study group had lower VAS scores at 6 h，12 h，24 h，and 48 h postoperatively compared to the control group．Within 48 hours after surgery，the incidence of moderate to severe pain in the study group was lower than that in the control group（P＜0.05）．The time to first postoperative analgesic request in the study group was later than that in the control group，and the total tramadol consumption and the need for analgesia within 48 hours were lower（P＜0.05）．The active range of motion of the knee at 24 h，48 h，and 72 h postoperatively was greater in the study group compared to the control group．Additionally，the time to first straight leg raise，time to ambulation，and length of hospital stay were all shorter in the study group（P＜0.05）．Preoperatively，there were no differences between the two groups in the Knee Society Score（KSS） and the Oxford Knee Score（OKS）（P＞0.05）．One week postoperatively，both groups showed improved scores，with the study group showing greater improvement than the control group（P＜0.05）．There was no significant difference in the incidence of adverse reactions between the two groups（P＞0.05）．Conclusions The combined use of bupivacaine liposomes during UKA can provide safe and effective long-term postoperative analgesia for elderly patients with isolated medial compartment OA．And this plan not only reduces early pain and opioid dependence in patients，but also effectively promotes early knee joint function recovery，shortens hospitalization time，and lays a solid foundation for patients to achieve better early knee joint function．