本文概述了传统日间腹腔镜胆囊切除术患者术后早期康复质量存在的问题，IMB模型通过向患者提供科学的疾病知识，改变其疾病认知与态度，最终促使其采纳并维持健康行为。本文还介绍了IMB模型在日间腹腔镜胆囊切除术后患者早期康复质量中应用涉及的相关概念、研究背景和国内外的研究现状以及未来发展趋势与挑战。研究结果显示，IMB模型可显著降低患者术后疼痛发生率，并提高患者参与治疗决策的程度，为后期关于IMB模型在日间腹腔镜胆囊切除术患者术后早期康复质量的相关研究提供借鉴与参考，以便后期实施相关个性化干预措施，并提供相关理论依据。

       This paper summarizes the problems existing in the early postoperative rehabilitation quality of patients undergoing traditional ambulatory laparoscopic cholecystectomy．The IMB model changes patients’ disease cognition and attitude by providing them with scientific disease knowledge，and ultimately promotes their adoption and maintenance of healthy behaviors．It also introduces the relevant concepts involved in the application of the IMB model in the early postoperative rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy，the research background of this study，the current research status at home and abroad，as well as the future development trends and challenges．The research results show that the IMB model can significantly reduce the incidence of postoperative severe pain in patients and the degree of patient participation in treatment decision-making．This provides reference and guidance for subsequent studies on the early rehabilitation quality of patients undergoing ambulatory laparoscopic cholecystectomy using the IMB model，so as to implement relevant personalized intervention measures in the future and provide relevant theoretical basis．

       目的 构建首发脑出血患者并发卒中相关性肺炎的风险预测模型并验证模型的预测性能。方法 回顾性分析2012年1月—2022年12月广州市第一人民医院治的419例首发脑出血患者的临床资料，按照7︰3比例随机化分为训练列（293例）和验证队列（126例）。统计基于开发队列数据，采用Logistic回归模型分析首发脑出血患者并发卒中相关性肺炎的影响因素，并构建风险预测模型。基于开发队列和验证队列数据，采用校准曲线、受试者操作特征（ROC）曲线下面积和决策曲线分析模型的预测性能。结果 419例首发脑出血患者中有113例发生卒中相关性肺炎，发生率为26.97%。美国国立卫生研究院卒中量表（NIHSS）评分、吞咽困难、初始血肿体积、中性粒细胞百分比与白蛋白比值（NPAR）、中性粒细胞计数与淋巴细胞计数比值（NLR）、手术治疗、气管插管、留置胃管均是首发脑出血患者并发卒中相关性肺炎的影响因素（P＜0.05）。基于上述影响因素构建了首发脑出血患者并发卒中相关性肺炎的风险预警模型，校准曲线显示模型在开发队列和验证队列中预测卒中相关性肺炎发生率均与实际发生率相近；ROC曲线显示此模型在开发队列、验证队列中预测的曲线下面积分别为0.906（95%CI：0.867~0.937）、0.884（95%CI：0.815~0.934）；决策曲线分析显示当开发队列阈概率在3%~80%内、验证队列阈概率在2%~76%内使用此模型干预比全/无干预更有临床价值。结论 基于NIHSS评分、吞咽困难、初始血肿体积、NPAR、NLR、手术治疗、气管插管、留置胃管构建的首发脑出血患者并发卒中相关性肺炎的风险预测模型具有良好预测性能和临床应用价值。

      Objective To construct a risk prediction model for stroke associated pneumonia in patients with initial cerebral hemorrhage（ICH）and validate the predictive performance of the model．Methods A retrospective analysis was conducted on the clinical data of 419 patients with ICH admitted to our hospital from January 2012 to December 2022．They were randomly divided into a development cohort（293 cases）and a validation cohort（126 cases）according to a 7∶3 ratio．The Logistic regression model was used to analyze the influencing factors of stroke related pneumonia in patients with ICH based on the development cohort data，and a risk prediction model was constructed．Based on the development cohort data and validation cohort data，the predictive performance of the model was analyzed using calibration curves，receiver operating characteristic（ROC）curve，and decision curve analysis．Results Among 419 patients，113 developed stroke associated pneumonia，with a rate of 26.97%．The National Institutes of Health Stroke Scale（NIHSS）score，swallowing difficulties，initial hematoma volume，neutrophil percentage to albumin ratio（NPAR），neutrophil count to lymphocyte count ratio（NLR），surgical treatment，endotracheal intubation，and indwelling gastric tube were all independent influencing factors for stroke associated pneumonia in patients with ICH（P＜0.05）．Based on the above influencing factors，a risk prediction model for stroke associated pneumonia in patients with ICH was constructed．The calibration curve showed that the predicted incidence of stroke associated pneumonia by the model in both the development and validation cohorts was close to the actual incidence．The ROC curve showed that the predicted area under the curve for this model in the development cohort and validation cohort was 0.906（95%CI：0.867-0.937）and 0.884（95%CI：0.815-0.934），respectively．The decision curve analysis showed that when the threshold probability of the development cohort was between 3%-80%，and the threshold probability of the validation cohort was between 2%-76%，the intervention using this model was more clinically valuable than all/no intervention．

Conclusions The risk prediction model for stroke associated pneumonia in patients with ICH based on NIHSS score，swallowing difficulties，initial hematoma volume，NPAR，NLR，surgical treatment，tracheal intubation，and indwelling gastric tube has good predictive performance and clinical application value．

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.

目的：分析急性有机磷农药中毒（AOPP）引发缺血缺氧性脑病预后相关因素，建立相关的预后预测模型。方法：回顾性分析90例（33例预后不良、57例预后良好）AOPP致HIE患者（2022年3月～2025年8月）的临床资料、中毒指标和血清学指标，独立危险因素用Logistic回顾分析筛选，并构建预后不良预测模型，采用ROC工具对模型效能进行验证。结果：Logistic 回归分析显示，年龄≥60岁、重度中毒、中毒至就诊时间、LAC水平、CHE水平、CRP水平及NSE水平均为患者预后不良的独立危险因素（P＜0.05）；AUC、灵敏度、特异度为0.943、90.91%、87.72%。结论：高龄、中毒程度高及中毒至就诊时间长等因素可导致AOPP致HIE患者出现不良结局，据此构建风险预测模型可有效预测预后不良的发生风险。

To determine the key impacting factors for hypoxic ischemic encephalopathy (HIE) caused by acute organophosphorus pesticide poisoning (AOPP) and build a prediction model. Methods: The clinical data, poisoning indicators and serological indicators of 90 patients (33 cases with poor prognosis and 57 cases with good prognosis) with HIE caused by AOPP (from March 2022 to Aug 2025) were analyzed. Independent risk factors were screened using logistic retrospective analysis, and a poor prognosis prediction model was constructed. The model efficiency was verified by the receiver operating curve (ROC). Results: Logistic regression analysis showed that age ≥ 60 years, severe poisoning, time from poisoning to treatment, LAC level, CHE level, CRP level, and NSE level were all risk factors for the prognosis in patients (P < 0.05). The AUC, sensitivity, and specificity were 0.943, 90.91%, and 87.72%.Conclusion: Factors such as advanced age, high degree of poisoning, and long time from poisoning to treatment can lead to adverse outcomes in patients with HIE caused by AOPP. Based on this, building a risk prediction model can effectively predict the risk of poor prognosis.

【摘要】目的：探讨HEART五步沟通模式对突发性耳聋（SSHL）患者心理状态及恢复情况的影响。方法：将2024年3月~2025年9月就诊于本院的110例SSHL患者作为研究对象，经抛币法将入组患者随机列为常规组、试验组，55例为一组。常规组实施常规临床护理，试验组在常规组的护理基础上联合实施HEART五步沟通模式，比较两组患者的心理状态，治疗依从性，护理结束后开展为期3个月短期随访，比较两组患者的听力改善情况及生活质量。结果：护理后，试验组的医院焦虑抑郁量表（HADS）、疾病不确定感（MUIS）评分分别为（8.25±1.39）分、（20.34±5.49）分，均低于常规组[（10.28±2.46）分、（25.52±6.67）分]（t=5.328，4.447；P＜0.05）。护理后，试验组的用药依从性、康复依从性、随访依从性均高于常规组（x2=9.429，11.733，11.282；P＜0.05）。试验组随访1个月、随访3个月时气导1kHz下平均听阈（PTA）及2kHz下PTA分别为（25.62±5.41）dB HL、（18.35±3.69）dB HL、（28.52±5.44）dB HL、（20.18±5.24）dB HL，均低于常规组[（30.67±6.35）dB HL、（21.33±4.25）dB HL、（33.69±6.37）dB HL、（25.49±6.33）dB HL]（t=4.490，3.927，4.577，4.792；P＜0.05）。截至随访结束时，试验组的成人听力障碍量表（HHIA）中社交维度、情绪维度、躯体维度评分均低于常规组（t=3.787，5.562，12.132；P＜0.05）。结论：HEART五步沟通模式可改善SSHL患者的不良心理状态并提升治疗依从性，对促进患者听力水平恢复及生活质量提升均有积极影响

[Abstract]Objective:To explore the impact of the HEART five step communication model on the psychological state and recovery of patients with sudden sensorineural hearing loss (SSHL).Methods:110 patients with SSHL who visited our hospital from March 2024 to September 2025 were selected as the research subjects. The enrolled patients were randomly divided into a control group and an experimental group using a coin toss method, with 55 patients in each group. The routine group received routine clinical nursing care, while the experimental group received the HEART five step communication model in addition to the routine nursing care. The psychological status and treatment compliance of the two groups of patients were compared. After the nursing was completed, a 3-month short-term follow-up was conducted to compare the hearing improvement and quality of life of the two groups of patients.Results:After nursing, the HADS and MUIS scores of the experimental group were (8.25 ± 1.39) points and (20.34 ± 5.49) points, respectively, which were lower than those of the control group [(10.28 ± 2.46) points and (25.52 ± 6.67) points] (t=5.328，4.447; P<0.05). After nursing, the medication compliance, rehabilitation compliance, and follow-up compliance of the experimental group were higher than those of the conventional group (x2=9.429，11.733，11.282; P<0.05). The PTA of the experimental group at 1kHz and 2kHz were (25.62 ± 5.41) dB HL, (18.35 ± 3.69) dB HL, (28.52 ± 5.44) dB HL, and (20.18 ± 5.24) dB HL, respectively, during a 1-month and 3-month follow-up, which were lower than those of the control group [(30.67 ± 6.35) dB HL, (21.33 ± 4.25) dB HL, (33.69 ± 6.37) dB HL, and (25.49 ± 6.33) dB HL] (t=4.490，3.927，4.577，4.792; P<0.05). As of the end of the follow-up, the scores of social, emotional, and physical dimensions in the HHIA of the experimental group were lower than those of the control group (t=3.787，5.562，12.132; P<0.05).Conclusion:The HEART five step communication model can improve the adverse psychological state of SSHL patients and enhance treatment compliance, which has a positive impact on promoting the recovery of patients' hearing level and improving their quality of life.

随着公立医院免陪照护试点推进，家属由床旁陪伴转为院外等待，信息不对称、分离焦虑及信任弱化等问题日益凸显。本文围绕国际免陪照护实践，梳理家属数字化参与从虚拟探视、信息共享到共同决策的演进路径，并总结住院门户、电子日记、代理访问等工具在维系家庭支持、提升照护透明度中的作用。在此基础上，提出我国应依托智慧病房构建医护患属闭环沟通机制，完善授权分级、隐私保护、数字公平与人文支持制度，推动免陪照护兼具效率与温度。

With the advancement of pilot programs for accompaniment-free care in public hospitals, family members have shifted from bedside companionship to waiting outside the ward, giving rise to increasingly prominent problems such as information asymmetry, separation anxiety and weakened trust. Focusing on international practices of accompaniment-free care, this paper reviews the evolutionary path of digital family participation from virtual visits and information sharing to shared decision-making, and summarizes the role of tools such as inpatient portals, electronic diaries and proxy access in maintaining family support and improving care transparency. On this basis, it proposes that hospitals in China should rely on smart ward construction to establish a closed-loop communication mechanism integrating healthcare professionals, patients and family members, and improve institutional arrangements for hierarchical authorization, privacy protection, digital equity and humanistic support, so as to promote accompaniment-free care that combines efficiency with warmth.

【摘要】目的：基于潜类别增长模型（LCGM）探讨脑出血患者神经功能恢复轨迹及不同轨迹对预后的影响。方法：回顾性采集360例自发性脑出血患者（2023年6月～2025年6月）的临床资料及神经功能评分[美国国立卫生研究院卒中量表（NIHSS）]，并采用LCGM识别神经功能恢复轨迹的潜在类别，分析影响恢复不良型轨迹的危险因素，对比不同轨迹的预后情况[改良Rankin量表（mRS）、格拉斯哥预后评分（GOS）]。结果：LCGM模型拟合结果显示，3类轨迹为最优拟合模型，可将360例自发性脑出血患者分为快速恢复型139例（38.61%）、稳定恢复型154例（42.78%）、恢复不良型67例（18.61%）；入院格拉斯哥昏迷量表（GCS）评分、初始NIHSS评分、机械通气、血管活性药物使用及血肿体积是神经功能恢复不良的独立影响因素（P＜0.05）；预后方面，三组患者mRS、GOS评分存在显著差异（P＜0.05）。结论：基于LCGM可有效识别脑出血患者神经功能恢复的异质性轨迹，同时还能明确影响患者神经功能修复的独立危险因素及不同神经功能恢复轨迹与预后的关联。

Abstract Objective: To explore the trajectory of neurological recovery in patients with cerebral hemorrhage and the impact of different trajectories on prognosis based on latent class growth model (LCGM). Methods: The clinical data and neurological function scores [National Institutes of Health Stroke Scale (NIHSS)] of 360 patients with spontaneous cerebral hemorrhage (June 2023 to June 2025) were retrospectively collected, and LCGM was used to identify potential categories of neurological recovery trajectories, analyze risk factors affecting poor recovery trajectories, and compare the prognosis of different trajectories [modified Rankin Scale (mRS), Glasgow Outcome Score (GOS)]. Results: The LCGM model fitting results showed that the three types of trajectories were the optimal fitting model, and 360 patients with spontaneous cerebral hemorrhage could be divided into 139 cases (38.61%) of rapid recovery type, 154 cases (42.78%) of stable recovery type, and 67 cases (18.61%) of poor recovery type; admission to Glasgow Coma Scale (GCS) score, initial NIHSS score, mechanical ventilation, use of vasoactive drugs and hematoma volume are independent influencing factors of poor neurological recovery (P＜0.05); in terms of prognosis, there were significant differences in mRS and GOS scores among the three groups of patients (P＜0.05).Conclusion: Based on LCGM, it is possible to effectively identify the heterogeneous trajectories of neurological function recovery in patients with intracerebral hemorrhage (ICH), while also identifying independent risk factors influencing neurological function repair and establishing associations between different recovery trajectories and prognosis.

目的 基于生物—心理—社会模式分析精神专科住院患者负荷现状及其关联因素。 方法 选取某三级精神专科医院住院患者为研究对象，构建涵盖住院天数、费用、护理风险、联合用药、危机干预及出院准备难度的住院负荷综合评分，采用多元线性回归和Logistic回归分析影响因素。 结果 患者住院负荷评分为57.16±15.36分，高负荷患者约占三分之一；生物、心理、社会因素联合模型可解释68.4%的负荷变异；明显睡眠问题、既往住院次数≥3次、治疗依从性差、家庭支持低、社会功能重度受损及缺乏社区衔接资源等为高住院负荷危险因素。 结论 精神专科住院负荷具有复合性和多因素累积特征，应建立多维评估与分层干预机制，以优化资源配置和连续照护。

Objective To analyze the current status of inpatient burden and its associated factors among psychiatric inpatients based on the biopsychosocial model. Methods Inpatients from a tertiary psychiatric hospital were selected as study subjects. A comprehensive inpatient burden score was developed, incorporating length of stay, cost, nursing risk, polypharmacy, crisis intervention, and difficulty in discharge preparation. Multivariate linear regression and logistic regression analyses were used to identify influencing factors. Results The mean inpatient burden score was 57.16 ± 15.36 points, with approximately one-third of patients experiencing high burden. The combined model of biological, psychological, and social factors explained 68.4% of the variance in burden. Significant sleep problems, prior hospitalizations ≥3 times, poor treatment adherence, low family support, severe impairment in social functioning, and lack of community follow-up resources were identified as risk factors for high inpatient burden. Conclusion Psychiatric inpatient burden is complex and characterized by cumulative multifactorial influences; therefore, a multidimensional assessment and tiered intervention system should be established to optimize resource allocation and ensure continuous care.

扩张型心肌病（DCM）以左心室或双心室扩大并伴心肌收缩功能下降为主要特征，左心室逆重构（LVRR）可反映治疗后心室结构和功能恢复，并与患者预后改善相关。近年来，中医药联合常规西医治疗DCM的研究逐渐增多，部分研究显示其可改善左心室射血分数、左心室内径或容积、BNP或NT-proBNP、6min步行距离及生活质量等LVRR相关指标。现有证据提示，中医药可能通过改善心肌细胞损伤与能量代谢、减轻心肌纤维化与细胞外基质重塑、调节神经内分泌激活与心室负荷等环节参与DCM患者左心室结构重塑改善和收缩功能恢复，从而促进LVRR。然而，现有研究对LVRR的判定标准尚未统一，相关临床证据仍需进一步规范和验证。鉴于此，本文旨在围绕DCM-LVRR的概念、评价指标、中医药临床证据及可能机制进行叙述性综述，以期为DCM的中西医结合治疗及后续临床研究设计提供参考。

Dilated cardiomyopathy (DCM) is mainly characterized by left ventricular or biventricular dilatation accompanied by impaired myocardial systolic function. Left ventricular reverse remodeling (LVRR) reflects the recovery of ventricular structure and function after treatment and is associated with improved prognosis. In recent years, studies on traditional Chinese medicine (TCM) combined with conventional Western medical therapy for DCM have gradually increased. Some studies have shown that such combined treatment may improve LVRR-related indicators, including left ventricular ejection fraction, left ventricular diameter or volume, BNP or NT-proBNP, 6-minute walking distance, and quality of life. Current evidence suggests that TCM may contribute to left ventricular structural remodeling and systolic functional recovery in patients with DCM by alleviating myocardial cell injury, improving energy metabolism, attenuating myocardial fibrosis and extracellular matrix remodeling, and modulating neuroendocrine activation and ventricular load, thereby promoting LVRR. However, the criteria for defining LVRR remain inconsistent across existing studies, and the relevant clinical evidence requires further standardization and validation. Therefore, this narrative review aims to summarize the concept, evaluation indicators, clinical evidence of TCM, and potential mechanisms related to DCM-LVRR, with the aim of providing a reference for integrated Chinese and Western medical treatment of DCM and the design of future clinical studies.

扩张型心肌病（DCM）以左心室或双心室扩大并伴心肌收缩功能下降为主要特征，左心室逆重构（LVRR）可反映治疗后心室结构和功能恢复，并与患者预后改善相关。近年来，中医药联合常规西医治疗DCM的研究逐渐增多，部分研究显示其可改善左心室射血分数、左心室内径或容积、BNP或NT-proBNP、6min步行距离及生活质量等LVRR相关指标。现有证据提示，中医药可能通过改善心肌细胞损伤与能量代谢、减轻心肌纤维化与细胞外基质重塑、调节神经内分泌激活与心室负荷等环节参与DCM患者左心室结构重塑改善和收缩功能恢复，从而促进LVRR。然而，现有研究对LVRR的判定标准尚未统一，相关临床证据仍需进一步规范和验证。鉴于此，本文旨在围绕DCM-LVRR的概念、评价指标、中医药临床证据及可能机制进行叙述性综述，以期为DCM的中西医结合治疗及后续临床研究设计提供参考。

Dilated cardiomyopathy (DCM) is mainly characterized by left ventricular or biventricular dilatation accompanied by impaired myocardial systolic function. Left ventricular reverse remodeling (LVRR) reflects the recovery of ventricular structure and function after treatment and is associated with improved prognosis. In recent years, studies on traditional Chinese medicine (TCM) combined with conventional Western medical therapy for DCM have gradually increased. Some studies have shown that such combined treatment may improve LVRR-related indicators, including left ventricular ejection fraction, left ventricular diameter or volume, BNP or NT-proBNP, 6-minute walking distance, and quality of life. Current evidence suggests that TCM may contribute to left ventricular structural remodeling and systolic functional recovery in patients with DCM by alleviating myocardial cell injury, improving energy metabolism, attenuating myocardial fibrosis and extracellular matrix remodeling, and modulating neuroendocrine activation and ventricular load, thereby promoting LVRR. However, the criteria for defining LVRR remain inconsistent across existing studies, and the relevant clinical evidence requires further standardization and validation. Therefore, this narrative review aims to summarize the concept, evaluation indicators, clinical evidence of TCM, and potential mechanisms related to DCM-LVRR, with the aim of providing a reference for integrated Chinese and Western medical treatment of DCM and the design of future clinical studies.