目的 基于Donabedian环节模型构建急诊脑出血患者护理质量评价体系, 并应用于临床,为急诊脑出血患者护理质量管理、监测与评价提供客观、科学的参考依据。方法 通过文献查阅、筛查与评价, 提取可行性资料, 基于Donabedian环节模型构建急诊脑出血患者护理质量评价体系的框架, 并采用德尔菲法完成两轮专家函询,确定最终的指标体系。选择2021年1月—2024年1月本院收治的230例急诊脑出血患者为研究对象, 将2021年1月—2022年6月作为干预前监测节点,该阶段的165例患者为传统组, 实施常规的护理质量管理;将2022年7月—2024年1月作为干预后监测节点,该阶段的165例患者为观察组, 实施以急诊脑出血患者护理质量评价指标进行护理质量监测管理。结果 两轮函询中专家积极系数分别为95%和100%, 意见提出率分别为56.25%和35.54%; 两轮函询专家权威系数为0.945、0.893; 第1轮函询中各项指标变异系数（CV）均值为0~0.136, Kendall’s W协调系数为0.065; 第2轮函询中变异系数（CV）均值为0~0.110, Kendall’s W协调系数为0.186。最终形成的急诊脑出血患者护理质量评价体系共涵盖一级指标3个、二级指标11个、三级指标55个。观察组入院-用药时间合格率、吞咽障碍患者动态评估率、气道管理合格率、早期被动/主动活动落实率高于传统组,差异具有统计学意义（χ²=14.850、12.261、8.183、37.420, P<0.05）, 观察组患者满意度明显高于传统组（χ²=14.049, P<0.001）。结论 本研究构建的急诊脑出血患者护理质量评价体系具有一定的科学性、可靠性和实用性, 可作为临床实现护理质量持续改进的重要评价工具。

Objective Based on the Donabedian model,the nursing quality evaluation system of emergency cerebral hemorrhage patients was constructed, and applied to clinical practice, providing an objective and scientific reference basis for realizing the nursing quality management, monitoring and evaluation of emergency cerebral hemorrhage patients．Methods Through literature review, screening and evaluation, the feasibility data was extracted, and the framework of the nursing quality evaluation system for patients with emergency cerebral hemorrhage was constructed based on the Donabedian model, and the Delphi method was adopted to complete two rounds of expert letter inquiry to determine the final index system．The study selected 230 patients with acute cerebral hemorrhage admitted to our hospital from January 2021 to January 2024 as the research subjects．The period from January 2021 to June 2022 was used as the pre-intervention monitoring period, during which 165 patients were in the traditional group, receiving routine nursing quality management．The period from July 2022 to January 2024 was used as the post-intervention monitoring period, during which 165 patients were in the observation group,implementing nursing quality monitoring and management based on evaluation indicators for the care of patients with acute cerebral hemorrhage．Results In the two rounds of letter inquiry, the positive coefficient of experts was 95% and 100%, respectively, and the rate of suggestions was 56.25% and 35.54%, respectively; the authority coefficient of experts in the two rounds of letter inquiry was 0.945 and 0.893．In the first round the mean value of coefficient of variation（CV）of each index was 0~0.136, and the coordination coefficient of Kendall’s W was 0.065; in the second round the mean value of variation coefficient（CV）was 0-0.110, and the coordination coefficient of Kendall's W was 0.186．The final nursing quality evaluation system for emergency cerebral hemorrhage patients covers 11 first-level indicators, 11 second-level indicators and 55 third-level indicators．The results showed that the pass rate of admission-medication time, dynamic assessment rate of dysphagia patients, airway management rate, and early passive / active activity implementation rate of the observation group were statistically significant different from those in the traditional group（χ²=14.850,12.261, 8.183, 37.420, P<0.05）, and the patient satisfaction in the observation group was significantly higher than that in the traditional group（χ²=14.049, P<0.001）．Conclusions The nursing quality evaluation system for emergency cerebral hemorrhage patients constructed in this study is scientific,reliable and practical, and can be used as an important evaluation tool to achieve continuous improvement of nursing quality in clinical practice．

背景 虚拟标准化患者作为医学教育中的新型教学工具, 已广泛用于提升学生的临床问诊能力。随着生成式人工智能的快速发展, 基于大语言模型（LLMs）构建的VSP系统成为研究热点。然而, 目前尚缺乏对不同LLM在模拟患者角色方面表现的系统比较。目的 比较ChatGPT-4o与DeepSeek两种主流LLM在VSP模拟中的适用性, 评估其在病史采集、语言自然度、线索引导能力及教学辅助效果等方面的表现差异。方法 采用类实验研究,参与者为某医学院校临床医学专业本科四年级学生, 所有参与者均已修完《诊断学》课程, 具备基础问诊技能, 研究对象共60人, 按学号尾数单双分为两组, 分别与ChatGPT-4o或DeepSeek驱动的VSP系统进行交互。进行模拟急性阑尾炎问诊, 并在完成病史采集后提交诊断判断与体验问卷。结果 ChatGPT-4o在结构化信息整合、线索引导及技术稳定性方面更为优越, 而DeepSeek则在语言亲和力与情感回应方面表现更具人文关怀色彩。结论 不同LLM在VSP中的优势方向不同, 可根据教学目标进行有针对性地系统选择与设计。未来研究可进一步拓展至不同病种、交互方式及评估维度,以全面评估LLM驱动VSP在医学教育场景下的适应性与教学成效。

Background Virtual standardized patients（VSPs）have emerged as a novel tool in medical education, widely adopted to enhance students’ clinical interview skills．With the rapid development of generative artificial intelligence, VSP systems powered by large language models（LLMs）have become a new focus of research．However, few studies have systematically compared the performance of different LLMs in simulating patient roles．Objective This study aims to compare the applicability of two mainstream LLMs, ChatGPT-4o and DeepSeek, in VSP-based medical interview simulations, focusing on their differences in history-taking performance,linguistic naturalness, clue guidance,and educational support．Methods A quasi-experimental study was conducted involving 60 fourth-year clinical medicine undergraduates from a medical school．All participants had completed a diagnostics course and possessed basic interviewing skills．Students were assigned to either the ChatGPT-4o or DeepSeek group based on the parity of their student ID numbers．Each participant conducted a text-based simulated interview with a VSP presenting with acute appendicitis, then submitted both a preliminary diagnosis and a structured satisfaction questionnaire．Results ChatGPT-4o demonstrated superior performance in structured information integration, clue-based prompting, and system stability．In contrast, DeepSeek showed more natural language affinity and emotional responsiveness,reflecting stronger humanistic communication traits．The two models displayed divergent strengths within the VSP framework, suggesting that system selection and integration should be tailored to specific teaching objectives．Conclusions Future research should expand the scope to include diverse disease scenarios, interaction modalities, and evaluation dimensions, to comprehensively assess the educational utility and adaptability of LLM-driven VSP systems in medical training．

脓毒症当前仍然是全球范围内重要的医疗卫生问题,其对世界公共卫生及患者安全带来重大威胁。脓毒症是指宿主对感染反应失调引起的危及生命的器官功能障碍, 其发病率和病死率均极高,是临床重症医学中的重大挑战。在脓毒症病情的进展过程中, 可出现组织灌注不足、血流动力学不稳定等变化, 从而导致多器官功能受损,而心脏是常见的被累及的重要靶器官之一, 这种由脓毒症所导致的不同程度的心肌损伤, 被称为“脓毒性心肌病”, 其发生和发展机制复杂多样, 涉及循环心肌抑制因素、心肌自身因素及自主神经失调等多个方面。文章综述了脓毒症患者发生心肌损伤的高危因素, 以期为临床治疗和预防提供参考。

Sepsis currently remains an important global healthcare issue, and a major threat to world public health and patient safety．Sepsis is a life-threatening organ dysfunction caused by dysregulation of the host response to infection, with extremely high morbidity and mortality,which is a major challenge in clinical critical care medicine．During the progression of sepsis, changes such as inadequate tissue perfusion and haemodynamic instability may occur, leading to impairment of multiple organ functions, while the heart is one of the commonly involved vital target organs, and the varying degree of myocardial damage caused by sepsis is known as “septic cardiomyopathy”．The mechanisms of its occurrence and development are complex and diverse, involving circulating myocardial inhibitory factors, myocardial auto-factors, and autonomic dysregulation．In this paper, we review the high-risk factors for myocardial injury in septic patients, providing a reference for clinical treatment and prevention.

近年来, 药物递送系统在肿瘤靶向治疗领域取得了显著进展, 已有多种递药系统获批临床应用。其中, 纳米药物因其能够减少传统小分子化疗药物的毒副作用、提高药物生物利用度,并通过增强通透性与滞留效应（EPR效应）实现肿瘤的被动靶向, 从而显著提升治疗效果, 受到广泛关注。尤其是具备尺寸可调、肿瘤特异性聚集、刺激响应性崩解及形貌转变等多功能的智能可变形纳米载体, 已成为当前纳米递药载体研究的热点。这类载体能够感应肿瘤微环境中的特定刺激信号（如酸性pH值、过氧化还原状态、酶活性或过表达细胞因子）, 实现包括尺寸调控、聚集组装、结构崩解与形态重构等在内的多种动态变形行为, 从而提升药物在肿瘤部位的滞留时间、渗透深度及控释能力, 最终获得更优的抗肿瘤疗效。例如在肿瘤组织中实现纳米载体尺寸缩小可增强药物的组织穿透力; 纳米粒子聚集变大会延长药物在病灶处的滞留时间; 而快速响应性崩解则有助于药物在肿瘤局部实现高效释放。这些智能变形策略为纳米药物递送系统提供了更高的治疗可控性与精准性。基于其多样化的响应特性和结构可塑性, 智能变形纳米载体在推动抗肿瘤药物的个体化治疗及联合疗法应用方面展现出巨大潜力。本文综述了近年来基于智能变形纳米载体增强抗肿瘤效果的研究进展,系统梳理了其设计策略, 并深入探讨了其在肿瘤精准治疗中的应用前景。

In recent years, drug delivery systems have made remarkable progress in the field of tumor-targeted therapy, with several platforms already approved for clinical use．Among them, nanomedicines have attracted considerable attention due to their ability to mitigate the side effects of conventional small-molecule chemotherapeutics, improve bioavailability, and passively accumulate at tumor sites via the enhanced permeability and retention（EPR）effect, thereby enhancing therapeutic efficacy．Of particular interest are stimuli-responsive, shape-transformable nanocarriers, which exhibit unique properties such as tunable size, tumor-specific accumulation, and structural adaptability in response to tumor-associated cues．These intelligent deformable nanocarriers are capable of undergoing various dynamic transformations—including aggregation, disassembly, size modulation, and morphological transitions—triggered by specific stimuli in the tumor microenvironment（TME）, such as pH, redox potential,enzymes,or cytokines．Such transformations enhance drug retention at tumor sites, improve intratumoral penetration, and enable spatiotemporally controlled drug release, ultimately resulting in superior antitumor efficacy．For instance, nanosystems that shrink in size at tumor sites can promote deeper tissue penetration, while those that aggregate into larger assemblies can prolong local drug retention．Conversely, carriers that disassemble rapidly under tumor-specific stimuli allow for burst release of the encapsulated payload precisely at the disease site．These adaptive features hold great promise for improving the therapeutic performance of nanomedicines. Furthermore, the multifunctionality of intelligent deformable nanocarriers supports the development of personalized treatment regimens and combination therapies, offering novel strategies for cancer management．This review highlights recent advances in the design and application of shape-transformable nanocarriers for enhanced anticancer drug delivery, summarizing design principles and exploring their emerging potential in precision oncology.

医联体是分级诊疗制度建设的重要抓手,对“健康中国”战略目标的实现具有重要作用。在当前医疗改革背景下,探究医联体建设模式具有重要意义。文章介绍了广州市属A医院和区属B医院探索的非托管紧密型医联体实践举措、成效、创新与不足,总结了该模式对我国医联体建设的启示：一是政府层面要做好顶层设计,给与政策支持;二是网顶医院要下沉优质资源,因地制宜帮扶;三是成员单位要主动参与建设,抓住发展机遇。

The establishment of medical unions is a crucial step in the development of a hierarchical diagnosis and treatment system and plays a significant role in achieving the strategic goal of “Healthy China．”Given the current context of healthcare reform,it is highly important to explore effective models for constructing medical unions．This paper introduces the practical measures taken by Guangzhou Hospital A and Hospital B to establish a non-trustee-close medical commonwealth．It discusses the effects achieved as well as innovations made through this approach while also highlighting its limitations．Furthermore,this study summarizes key insights that can be drawn from this model for building medical commonwealths in China：firstly,governments should focus on top-level design and provide policy support;secondly,leading hospitals should allocate high-quality resources based on local conditions;thirdly,member units should actively participate in construction efforts and seize development opportunities．

目的 分析“侧俯卧位”MRI引导腰脊神经后根神经节脉冲射频治疗腰椎间盘突出症的手术体位护理效果。方法 对2018年9月—2020年12月在广州市荔湾中心医院住院接受经MRI引导腰脊神经后根神经节脉冲射频的腰椎间盘突出症患者62例随机分为两组：侧俯卧位组和俯卧位组,每组各31例。侧俯卧位组采用患侧抬高约30 °的侧俯卧位手术,俯卧位组采用标准俯卧位手术。记录两组手术时间、手术并发症、手术体位相关并发症及术者对术野显露的满意度评价。结果 所有患者均顺利完成手术,未见出血、感染、下肢麻痹加重神经损伤、脏器损伤等手术并发症,无患者发生眼压增高、臂丛损伤、压疮等体位相关并发症。侧俯卧位组手术时间（60.65±12.45）min,俯卧位组手术时间（70.58±10.25） min,组间比较差异有统计学意义（t=3.429,P=0.001）。术者对侧俯卧位组和俯卧位组术野侧显露总满意度分别为93.55%和77.42%,组间比较差异有统计学意义（χ²=4.292,P=0.038）。结论 侧俯卧位MRI引导腰脊神经后根神经节脉冲射频治疗腰椎间盘突出症安全、有效,做好手术体位护理可有效防止并发症。

Objective To analyze the effect of surgical position nursing for radiofrequency ablation in posterior root ganglion in lumbar spinal nerve guided by MRI in lateral prone position．Methods Sixty-two patients with lumbar disc herniation hospitalized in Liwan Central Hospital of Guangzhou from September 2018 to December 2020 were randomly divided into two groups（the lateral prone position group and the prone position group,31 patients in each group）．The lateral prone position group used the lateral prone position with about 30 degrees elevation of the affected side,and the prone position group used the standard prone position for operation．Operating time,surgical complications,surgical position related complications,and operator satisfaction evaluation of surgical field exposure were recorded in both groups．Results All patients completed the operation successfully．No surgical complications such as bleeding,infection,lower limb paralysis,aggravated nerve injury or organ injury were found in the two groups．No surgical position related complications such as intraocular pressure raising,brachial plexus injury or pressure ulcers in both the groups either．The operation time was（60.65±12.45）min in the lateral prone position group and（70.58±10.25）min in the standard prone position group,respectively,and the difference was statistically significant（t=3.429,P=0.001）．The surgeon’s satisfaction evaluation of the surgical field exposure was much higher in the lateral prone position group（93.55%）compared with the standard prone position group（77.42%）,and the difference was statistically significant（χ²=4.29,P=0.038）．Conclusions Radiofrequency ablation in posterior root ganglion of lumbar spinal nerve guided by MRI in lateral prone position is safe and effective．Good surgical position nursing can effectively prevent complications．

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 探讨与分析全面护理联合细节干预在创伤骨科手术质量及康复中应用价值。方法 选择2022年1月—2023年1月在福建省立医院骨科进行创伤骨科手术患者120例为研究对象,用随机数字表法分组,分为常规组、联合组,各纳入60例患者。前者进行常规护理,后者在前者基础上开展全面护理联合细节干预,对两组患者术后恢复情况进行观察比较。结果 在围术期指标方面,联合组手术时间、术中出血量、术后首次下床活动时间、术后住院时间与常规组相比减少（P<0.05）。联合组术后1 d、术后3 d、术后7 d、术后14 d的疼痛VAS评分与常规组相比减少（P<0.05）。联合组术后14 d的护理总满意度为100.00%,常规组为83.33%,联合组与常规组相比明显提高（P<0.05）。联合组术后14 d的社会关系、心理关系、生理关系等生活质量评分均高于常规组（P<0.05）。结论 全面护理联合细节干预在创伤骨科手术患者的应用促进患者康复,能持续缓解患者的疼痛状况,提高患者的护理满意度与生活质量。

Objective To explore and analyze the application value of comprehensive nursing combined with detailed intervention in the quality and rehabilitation of orthopedic trauma surgery．Methods From January 2022 to January 2023,120 cases of patients who underwent trauma orthopedic surgery in the Department of Orthopedic Surgery of Fujian Provincial Hospital were selected as the research subjects．And the randomized numerical table method was taken to operate in groups,which were divided into the conventional group and the combined group,and 60 patients were included in each group．The former group recieved conventional nursing care,and the latter group recieved comprehensive nursing care combined with detail intervention on its basis to observe and compare the postoperative recovery of patients in the two groups．Results In terms of perioperative indicators,the operation time,intraoperative bleeding,time to first postoperative bed movement and postoperative hospitalization time were significantly reduced in the combined group compared with the conventional group（P<0.05）．The pain VAS scores of the combination group were significantly reduced compared to the conventional group at 1 day,3 days,7 days and 14 days after surgery（P<0.05）．The total satisfaction rate of postoperative care in the combination group at 14 days was 100.00%,while in the conventional group it was 83.33%．The combination group showed there were significant improvements compared to the conventional group（P<0.05）．The social,psychological and physiological quality of life scores of the combination group were significantly higher than those of the conventional group 14 days after surgery（P<0.05）．Conclusions The application of comprehensive nursing combined with detailed intervention in orthopedic trauma surgery patients can promote their recovery,continuously alleviate their pain status and improve their nursing satisfaction and quality of life．

目的 分析超早期阶梯式协同营养管理在改善重症急性胰腺炎患者喂养中的应用效果。方法 抽取2020年1月—2022年1月南阳市中心医院收治的80例重症急性胰腺炎患者为研究对象,随机数字表法分为观察组和参照组,各40例,两组患者均给予常规营养干预措施,其中观察组患者在以上基础上给予超早期阶梯式协同营养管理,对比两组患者的临床症状消退时间、营养状况、喂养相关并发症、喂养不耐受发生率。结果 与参照组相比,观察组患者的临床症状消退时间更短（P<0.05）,观察组患者的体质量指数、上臂肌围、肱三头肌皮褶厚度及血清清蛋白水平更高（P<0.05）;两组患者的喂养相关并发症主要包括恶心呕吐、误吸、腹泻、感染,观察组患者的喂养相关并发症发生率为7.50%,参照组患者的喂养相关并发症发生率为25.00%,观察组患者的喂养相关并发症发生率低于参照组（P<0.05）;观察组患者喂养不耐受发生2例（5.00%）,参照组患者喂养不耐受发生9例（22.50%）,观察组患者喂养不耐受发生率低于参照组（P<0.05）。结论 重症急性胰腺炎患者实施超早期阶梯式协同营养管理可降低喂养不耐受发生率及喂养相关并发症发生率,改善患者营养水平。

Objective To analyze the application effect of ultra early stepped collaborative nutrition management on improving feeding in patients with severe acute pancreatitis．Methods Eighty patients with severe acute pancreatitis admitted to our hospital from January 2020 to January 2022 were selected as research subjects and randomly divided into observation group and reference group,with 40 cases in each group．Patients in both groups were given conventional nutritional intervention measures,among which patients in the observation group were given super-early stepped collaborative nutritional management on the basis of the above．Clinical symptom resolution time,nutritional status,feeding related complications and feeding intolerance rate were compared between the two groups．Results Compared with the reference group,the time of clinical symptoms resolution in the observation group was shorter（P<0.05）,and the body mass index,upper arm muscle circumference,triceps skin fold thickness and serum albumin level in the observation group were higher（P<0.05）．The feeding-related complications of the two groups mainly included nausea and vomiting,aspiration,diarrhea and infection．The incidence of feeding-related complications in the observation group was 7.50%,and that in the reference group was 25.00%．The incidence of feeding-related complications in the observation group was lower（P<0.05）．There were 2 cases of feeding intolerance in the observation group,the feeding intolerance rate was 5.00%,and 9 cases of feeding intolerance in the reference group,the feeding intolerance rate was 22.50%,the feeding intolerance rate in the observation group was lower（P<0.05）．Conclusions Implementing ultra early stepped collaborative nutritional management in patients with severe acute pancreatitis can reduce the incidence of feeding intolerance and feeding related complications,and improve nutritional levels．

目的 探讨作业疗法结合经皮神经电刺激对脑卒中后肩痛的疗效。方法 选取2020年6月—2023年6月在肇庆市第一人民医院治疗的60例脑卒中后肩痛患者为研究对象,随机分为观察组和对照组各30例。其中,观察组进行作业疗法结合经皮神经电刺激;对照组单纯进行作业疗法。记录患者治疗前及治疗4周后的视觉模拟疼痛评分（VAS）,改良Barthel指数（MBI）和汉密顿抑郁量表评分（HAMD）,并对记录进行检验和t检验。结果 观察组和对照组的治疗效果比较差异有统计学意义（P=0.019）,观察组治疗有效率（93.33%）高于对照组（63.33%）;治疗前两组患者的VAS（P=0.536）和HAMD（P=0.558）分值比较差异无统计学意义,治疗后其VAS（P=0.049）及HAMD（P=0.023）分值均较治疗前下降,且观察组下降幅度分别为（2.23±1.14）分和（4.47±3.06）分,均高于对照组的（1.27±0.98）和（1.33±1.35）,组间比较差异有统计学意义;治疗前两组患者的MBI分值比较差异无统计学意义（P=0.216）,治疗后其MBI分值均较治疗前提高,且观察组提高幅度（21.87±10.25）较对照组（12.00±13.58）更显著,组间比较差异有统计学意义（P=0.003）。结论 作业疗法结合经皮神经电刺激可缓解脑卒中肩痛,改善患者日常生活能力和心理精神状态,减少抑郁的发生。

Objective To explore the therapeutic effect of occupational therapy combined with transcutaneous electrical nerve stimulation（TENS） on shoulder pain after stroke．Methods Sixty patients with post-stroke shoulder pain who were treated in the First People’s Hospital of Zhaoqing from June 2020 to June 2023 were selected as the study subjects and randomly divided into an observation group and a control group,with 30 cases in each group．Among them,the observation group received occupational therapy combined with TENS,while the control group received occupational therapy alone．This study recorded the Visual Analogue Scale（VAS）,modified Barthel Index（MBI）,and Hamilton Depression Rating Scale（HAMD）of patients before and after 4 weeks of treatment,and conducted the and t-test analysis．Results The test analysis showed a significant difference in treatment effectiveness between the observation group and the control group（P=0.019）,with the observation group having a significantly higher treatment effectiveness rate（93.33%）than the control group（63.33%）;t-test analysis showed that there was no statistically significant difference in VAS（P=0.536）and HAMD（P=0.558）indicators between the two groups of patients before treatment．However,after treatment,the VAS（P=0.049）and HAMD（P=0.023）indicators decreased compared to before treatment．The observation group had decreased（2.23±1.14）and（4.47±3.06）,respectively,which were significantly higher than the control group’s（1.27±0.98）and（1.33±1.35）,and the inter group differences were statistically significant;before treatment,there was no statistically significant difference in MBI indicators between the two groups of patients（P=0.216）．After treatment,their MBI indicators increased compared to before treatment,and the observation group（21.87±10.25）showed a more significant improvement compared to the control group（12.00±13.58）．The difference between the groups was statistically significant（P=0.003）．Conclusions Occupational therapy combined with TENS can significantly alleviate shoulder pain after stroke,improve daily living ability and psychological state of patients,and reduce the occurrence of depression．