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．

       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．

       目的  探讨胸部肿瘤患者手术后早期排痰的效果，降低肺部并发症的发生率。方法  选择2024年6月—2025年7月在本院进行胸部肿瘤切除的60例术后患者作为研究对象。采用非同期回顾对照设计，以不同时间段病例分组，分为对照组（n＝30）和观察组（n＝30）。两组胸部手术后患者均给予常规围术期护理，观察组胸部手术后患者增加早期排痰护理。统计两组排痰效果［咳痰难度、血氧饱和度（SPO₂）］变化、疼痛评分，并统计两组肺部相关并发症及住院时间进行比较。结果  观察组患者术后的SPO₂水平高于对照组（P＜0.05），咳痰难度评分低于对照组患者（P＜0.05）。干预后第B、C时间点观察组患者的疼痛评分均低于对照组（P＜0.05）。观察组住院时间短于对照组（P＜0.05），胸部并发症总发生率低于对照组（P＜0.05），满意度高于对照组（P＜0.05）。结论  胸部肿瘤术后早期排痰有助于促进术后患者排痰，减少肺部相关发症，缩短住院时间。

       Objective  To investigate the efficacy of early expectoration management in reducing pulmonary complications for patients following thoracic tumor surgery．Methods  Sixty patients undergoing thoracic tumor  resection at our hospital between 2024 and 2025 were enrolled．A non-concurrent retrospective control design was adopted．Cases were grouped according to different time periods，divided into a control group（n=30）and an observation group（n=30）．The control group  received  standard perioperative care，while the observation group received additional early expectoration nursing interventions．Outcome measures included expectoration efficacy（assessed by cough difficulty score and oxygen saturation［SpO₂］），pain scores，incidence of pulmonary complications，and hospital stay duration．Results  Postoperative SpO₂ levels were higher in the observation group than in the control group （P＜0.05），while cough difficulty scores were significantly lower（P＜0.05）．At time points B and C after the intervention，the pain scores of patients in the observation group were lower than those in the control group（P＜0.05）．The observation group demonstrated a significantly shorter hospital stay（P＜0.05），a lower overall incidence of thoracic complications（P＜0.05），and higher patient satisfaction  than the control group（P＜0.05）．Conclusions  Implementing early expectoration protocols after thoracic tumor surgery facilitates sputum clearance can reduce pulmonary complications，and shorten hospitalization time．

       脑卒中后认知障碍（PSCI）是脑卒中患者常见的并发症，严重影响患者的生活质量和社会功能。近年来，随着认知储备理论的发展和早期干预理念的普及，PSCI的早期干预模式逐渐成为研究热点。文章综述了PSCI早期干预模式的研究现状与进展，包括干预的理论基础、具体措施及未来发展方向，以期为临床实践和科研提供参考。

       Post-stroke cognitive impairment（PSCI）is a common complication among stroke patients．It seriously affects the patients’ quality of life and social functions．In recent years，with the development of the cognitive  reserve theory and the popularization of the concept of early intervention，the early intervention model for PSCI has gradually become a research hotspot．This article reviews the current research status and progress of the early intervention model for PSCI，including the theoretical basis of the intervention，specific measures，and future development directions，aiming to provide  references for clinical practice and scientific research．

       目的   探讨基于手术风险模型（RoSCo）评分系统的早期下床活动时机在肾肿瘤患者术后的应用效果。方法   选取2021年6月—2024年6月天津市人民医院收治的80例肾肿瘤患者，应用随机数字表法将其分为观察组与对照组，各40例。80例患者均实施腹腔镜肾部分切除术，对照组实施常规干预与术后早期下床活动干预，观察组实施常规干预与基于RoSCo评分系统的早期下床活动时机干预。对比两组术后康复水平，疼痛程度与睡眠质量，并发症发生率及生活质量。结果   观察组首次下床活动（19.30±4.17）h、排气（22.03±4.15）h、排便时间（29.93±5.58）h及术后住院时间（5.35±1.33）h短于对照组［（25.08±5.11）、（29.38±5.75）（34.20±5.98）（7.35±2.38）］h，对比差异有统计学意义（t=-5.540、-6.557、-3.308、-4.637，P＜0.05）；手术后，观察组视觉模拟量表（VAS）评分（3.93±0.92）分、PSQI评分（9.13±1.64）分高于对照组［（5.38±1.25）、（12.23±2.40）］分，对比差异有统计学意义（t=-5.902、-6.747，P＜0.05）；观察组并发症发生率7.50%低于对照组27.50%（χ ² =5.541，P=0.019）；手术后观察组SF-36评分相关维度［生理职能（84.45±9.74）、总体健康（60.75±10.65）、躯体疼痛（65.65±8.60）、生理功能（72.98±9.22）、活力（71.95±6.93）、社会功能（75.38±8.33）、精神健康（75.63±8.02）、情感职能（65.43±9.70）］分值高于对照组［生理职能（69.98±10.09）、总体健康（53.58±7.96）、躯体疼痛（58.83±9.35）、生理功能（65.68±7.58）、活力（62.83±12.80）、社会功能（68.98±10.99）、精神健康（71.58±9.69）、情感职能（57.90±6.86）］分值，对比差异有统计学意义（t=6.530、3.414、3.398、3.870、3.966、2.936、2.037、4.004，P＜0.05）。结论   针对肾肿瘤患者术后应用基于RoSCo评分系统的早期下床活动时机干预可促进其术后康复，辅助减轻术后疼痛程度，提升睡眠质量，降低并发症发生率，进一步提升患者生活质量。

      Objective  To explore the application effect of early mobilization timing  based on the Risk of  Surgical Complication（RoSCo）scoring system in renal tumor patients after surgery．Methods  From June 2021 to June 2024，80 patients with renal tumors admitted to the hospital were selected as the research subjects．They were  randomly divided into an observation group and a control group using a random number table method，with 40 patients in each group．All patients underwent laparoscopic partial nephrectomy．The control group received routine care and early postoperative mobilization intervention，while the observation group received routine care and early mobilization intervention based on the RoSCo scoring system．The postoperative rehabilitation level，pain level and sleep quality，incidence of complications，and quality of life between two groups were compared．Results  The first time getting out of bed，exhaust，defecation and postoperative hospitalization time in observation group（［19.30±4.17］h，［22.03±4.15］h，［29.93±5.58］h，［5.35±1.33］h） were shorter than those in control group（［25.08±5.11］h，［29.38±5.75］h，［34.20±5.98］h，［7.35±2.38］h），the  differences  were  statistically significant（t=-5.540，-6.557，-3.308，-4.637，all P＜0.05）．After operation，VAS score（3.93±0.92）and PSQI score（9.13±1.64）in the observation group were higher than those in the control group（［5.38±1.25］and［12.23±2.40］），and the differences were statistically significant（t=-5.902，-6.747，both P＜0.05）．The complication  rate of the observation group （7.50%） was lower than that of the control group（χ ² =5.541，P=0.019）．After operation，SF-36 scores in the observation group were physiological function（84.45±9.74），general health（60.75±10.65），physical pain（65.65±8.60），physiological function（72.98±9.22），vitality（71.95±6.93），social function（75.38±8.33），spiritual health（75.63±8.02）and emotional function（65.43±9.70），which were higher than those of the control group（physiological function［69.98±10.09］，general health［53.58±7.96］，physical pain［58.83±9.35］，physiological function［65.68±7.58］and vitality［62.83±12.80］，social function［68.98±10.99］，mental health［71.58±9.69］，emotional function［57.90±6.86］），and the differences were statistically significant（t=6.530，3.414，3.398，3.870，3.966，2.936，2.037，4.004，all P＜0.05）．Conclusions  Early mobilization intervention based on the RoSCo scoring system can promote postoperative recovery，assist in reducing postoperative pain，improve sleep quality，reduce the incidence of complications，and further enhance the quality of life of patients with renal tumors．

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 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 研究基于儿童早期预警评分（PEWS）的分级干预模式促进重症肺炎患儿康复进程及对呼吸功能的影响。方法 回顾性分析2021年4月—2023年4月我院收治的100例重症肺炎患儿临床资料。将其按照干预方式的差异分为研究组（n=50）及对照组（n=50）。对照组选用常规干预,研究组则于对照组基础上增加基于PEWS的分级干预。对比两组康复进程（相关指标涵盖症状持续时长及住院天数）、呼吸功能（涵盖通气流速、每分钟最大通气量、肺活量、用力肺活量及深吸气量）、并发症发生情况（涵盖呼吸机相关性肺炎、肺大疱及胸膜炎）、患儿家属满意度。结果 研究组各项症状持续时长及住院天数均短于对照组（均P<0.05）。研究组各项呼吸功能指标水平均高于对照组（均P<0.05）。两组各项并发症发生率对比差异无统计学意义（P>0.05）。研究组患儿家属满意度高于对照组（96.00% vs 82.00%,P<0.05）。结论 基于PEWS的分级干预模式促进重症肺炎患儿康复进程的效果较佳,且能改善呼吸功能,提高患儿家属满意度。

Objective To study the effect of graded intervention mode based on Pediatric Early Warning Score（PEWS）on the recovery process and respiratory function of children with severe pneumonia．Methods The clinical data of 100 children with severe pneumonia treated in our hospital from April 2021 to April 2023 were retrospectively analyzed．Those children were divided into study group（n=50）and control group（n=50）according to the difference of intervention methods．Conventional intervention was used in the two groups,and PEWS-based graded intervention was added to the study group．The two groups were compared with each other in terms of recovery process（including duration of symptoms and length of stay）,respiratory function（including ventilation velocity,maximum volume per minute,vital capacity,forced vital capacity and deep inspiratory capacity）,complications（including ventilators associated pneumonia,bullosa and pleurisy）,and family member satisfaction．Results The duration of symptoms and hospitalization days in the study group were shorter than those in the control group（all P<0.05）．The levels of respiratory function indexes in study group were higher than those in control group（all P<0.05）．There was no significant difference in the incidence of complications between the two groups（P>0.05）．The satisfaction of family member in the study group was higher than that in the control group（96.00% vs 82.00%）（P<0.05）．Conclusions The PEWS based graded intervention model has a good effect on promoting the rehabilitation process of children with severe pneumonia,and can improve respiratory function,and increase the satisfaction of family member of children with severe pneumonia．

目的 探讨血清胱抑素C（SCys-C）、同型半胱氨酸（Hcy）及尿微量白蛋白（UmAlb）在高血压患者肾损害早期评估中的应用价值。方法 选择2022年9月—2023年9月期间福建中医药大学附属第三人民医院接收的150例高血压患者作为观察组,另选择健康体检者150例为对照组,测定肾小球滤过率（GFR）、SCys-C、Hcy、UmAlb,比较不同血压程度及对照组的各指标水平,比较观察组各指标检测阳性率及诊断符合率,依据GFR值评估肾损害程度,比较不同肾损害程度患者的SCys-C、Hcy、UmAlb水平。结果 高血压2级、高血压3级患者SCys-C、Hcy、UmAlb水平高于高血压1级患者（t=5.255、10.976、21.578,P<0.05;t=7.378、18.012、23.708,P<0.05）及对照组患者（t=8.308、19.675、31.891,P<0.05;t=10.661、31.511、21.578,P<0.05）,高血压3级患者高于高血压2级患者（t=2.776、12.725、7.779,P<0.05）。观察组肾损害患者SCys-C、Hcy、UmAlb的阳性率79.41%、73.53%、83.82%高于无肾损害患者的阳性率6.10%、4.88%、6.10%（χ²=83.733、76.040、92.613,P<0.05）。观察组中重度肾损害、轻度肾损害患者的SCys-C、Hcy、UmAlb水平高于无损害患者（t=7.567、24.214、30.836,P<0.05;t=5.783、16.054、25.164,P<0.05）,中重度肾损害高于轻度肾损害患者（t=2.685、7.179、9.561,P<0.05）。结论 高血压分级越高患者的SCys-C、Hcy、UmAlb水平越高,各指标联合检测的阳性率高,而且SCys-C、Hcy、UmAlb水平越高,肾损害程度越严重。

Objective To explore the application value of serum cystatin C（SCys-C）,homocysteine（Hcy） and urinary microalbumin（UmAlb）in early assessment of renal damage in hypertensive patients．Methods A total of 150 hypertensive patients admitted to the Third People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from September 2022 to September 2023 were selected as the observation group,and 150 healthy individuals were selected as the control group．Glomerular filtration rate（GFR）,serum cystatin C（SCys-C）,homocysteine（Hcy）,and UmAlb were measured,and the levels of various indicators in different blood pressure levels and the control group were compared．The positive rate and diagnostic accuracy of each indicator in the observation group were compared,and the degree of renal damage was evaluated based on GFR values．The levels of SCys-C,Hcy and UmAlb in patients with different degrees of renal damage were compared．Results The levels of SCys-C,Hcy and UmAlb in patients with grade 2 and grade 3 hypertension were significantly higher than those in patients with grade 1 hypertension（t=5.255,10.976,21.578,P<0.05;t=7.378,18.012,23.708,P<0.05）,as well as in the control group（t=8.308,19.675,31.891,P<0.05;t=10.661,31.511,21.578,P<0.05）,patients with grade 3 hypertension were significantly higher than those with grade 2 hypertension（t=2.776,12.725,7.779,P<0.05）．The positive rates of SCys-C,Hcy and UmAlb in patients with renal injury in the observation group were 79.41%,73.53% and 83.82%,which were significantly higher than the positive rates of 6.10%,4.88% and 6.10% in patients without renal injury（χ²=83.733,76.040,92.613,P<0.05）．The levels of SCys-C,Hcy and UmAlb in patients with severe and mild kidney damage in the observation group were significantly higher than those in patients without damage（t=7.567,24.214,30.836,P<0.05;t=5.783,16.054,25.164,P<0.05）,patients with moderate to severe kidney damage were significantly higher than those with mild kidney damage（t=2.685,7.179,9.561,P<0.05）．Conclusions The higher the grading of hypertension,the higher the levels of SCys-C,Hcy and UmAlb in patients,and the higher the positive rate of combined detection of various indicators．Moreover,the higher the levels of SCys-C,Hcy and UmAlb,the more severe the renal damage．

通过筛查和早期发现,可以降低结直肠癌（CRC）的发病率,有效切除肿瘤病变可以降低CRC的病死率。虽然对CRC的危险因素、发病机制和前体病变的了解已经取得进展,但最近年轻人群CRC发病率升高,原因尚不清楚。在过去十年中,出现了多种侵入性、半侵入性和非侵入性筛查方式。目前对结肠镜检查质量的重视提高了筛查的有效性,人工智能等影像新技术在肿瘤检测中的作用正在迅速显现。而且,CRC有效干预措施,如保肛治疗新术式、靶向治疗及免疫治疗领域的新进展,被证明可以提高CRC患者的生存率。该文旨在总结目前国内外CRC筛查方式和指南的证据,并综述CRC治疗领域的进展。

The incidence of colorectal cancer（CRC）can be reduced through screening and early detection．Effective resection of tumor lesions reduces mortality from CRC．Although progress has been made in understanding the risk factors,pathogenesis and precursor lesions of CRC,the reasons for the recent increase in the incidence of CRC in young adults are largely unknown．A variety of invasive,semi-invasive and non-invasive screening modalities have emerged in the last decade．The current emphasis on the quality of colonoscopy has improved the effectiveness of screening,and the role of new imaging technologies such as artificial intelligence in tumor detection is rapidly emerging．Moreover,there are effective interventions for CRC,such as new surgical modalities for anal preservation therapy,and new advances in the field of targeted therapy and immunotherapy,which have been shown to improve the survival rate of CRC．The aim of this article is to summarize the current evidence on CRC screening modalities and guidelines both nationally and internationally,and to provide an overview of advances in the field of CRC treatment．