Objective To observe the intervention effects of humanistic care nursing based on the peak-end rule on clinical outcomes，psychological status，and family satisfaction in ICU patients. Methods One hundred patients admitted to the ICU ward of a tertiary hospital in Beijing from July 2024 to July 2025 were selected and randomly divided into an experimental group（n=50） and a control group（n=50） using a random number table. The experimental group received humanistic care nursing based on the peak-end rule，while the control group received routine ICU care. Primary outcome measures included clinical outcomes（length of ICU stay，incidence of delirium） and patient satisfaction. Secondary outcome measures included patient psychological status and family experience. Results The average length of ICU stay in the experimental group was shorter than that in the control group[（9.12±1.89） days vs. （10.45±2.10） days，t=3.329，P=0.001]. The incidence of delirium in the experimental group was lower than that in the control group（14.00% vs. 34.00%，χ²=5.482，P=0.019）. The experimental group scored higher than the control group in the dimensions of understanding needs，communication and decision-making，respect and privacy protection，comfort care，caring and support，and transfer and follow-up（all P<0.001）. Scores for Hospital Anxiety and Depression Scale-Anxiety（HADS-A） and Hospital Anxiety and Depression Scale-Depression（HADS-D），and Impact of Event Scale-Revised（IES-R） in the experimental group were all lower than those in the control group（all P<0.05）. The Chinese version of the Critical Care Family Satisfaction Survey（C-CCFSS） score in the experimental group[（97.35±10.26） points] was higher than that in the control group[（84.31±11.54） points]，and this difference was statistically significant（t=5.971，P<0.001）. Conclusion Humanistic care nursing based on the peak-end rule can improve patient satisfaction and family experience，reduce the risk of psychological stress in patients，and enhance the quality of nursing care.

Objective To explore fear of progression profiles and related factors at discharge in lung cancer day surgery patients，and guide individualized hierarchical psychological interventions. Methods Convenience sampling was used to select 225 patients undergoing day surgery for lung cancer，who were admitted to a tertiary-level A hospital in Zhejiang Province from October 2023 to February 2024. The survey adopted the general information questionnaire，the Postoperative Symptom Scale for lung cancer patients，and the Fear of Progression Questionnaire-Short Form. Latent profile analysis was used to identify categories，and multivariate Logistic regression was used to examine the associations between different profile groups，baseline characteristics and symptoms. Results There were three categories：“high fear-personal feelings group”（7.56%，n=17），“moderate fear-disease distress group”（43.55%，n=98），“low fear-disease adaptation group”（48.89%，n=110）. Influencing factors included dizziness，pain，nausea and vomiting，insomnia，and subcutaneous emphysema（P<0.05）. Conclusion Day surgery lung cancer patients show varying levels of concern about disease progression at discharge. Nursing staff should focus on individual characteristics，dynamically identify and manage related factors，strengthen discharge guidance and health management to improve the medical experience.

Objective To develop and validate a risk warning model for autologous arteriovenous fistula（AVF） occlusion using multiple machine learning algorithms，aiming to provide a precise and efficient decision-support tool for early clinical identification of high-risk patients and guidance for nursing interventions. Methods A retrospective analysis was conducted using convenience sampling，including 403 patients undergoing hemodialysis at a tertiary Grade-A hospital in Jiangsu Province from August 2021 to January 2024. Patients were divided into an occlusion group（n=97） and a non-occlusion group（n=306） based on the occurrence of AVF occlusion during follow-up. Independent risk factors for AVF occlusion were first identified using univariable and binary logistic regression analyses. Subsequently，seven machine learning algorithms，including Random Forest，Support Vector Machine （SVM），and AdaBoost，were employed to construct prediction models. Model performance was evaluated and optimized using 10-fold cross-validation，and the best-performing model was interpreted using the SHAP（SHapley Additive exPlanations） algorithm. Results Logistic regression analysis revealed that AVF usage time（AVF time），a history of coronary artery disease（CAG），and AVF location were independent risk factors for occlusion（P<0.05）. Among the seven machine learning models，the AdaBoost and Random Forest models demonstrated the best overall predictive performance，with areas under the receiver operating characteristic（ROC） curve（AUC） of 0.882 and 0.876 on the test set，respectively. SHAP interpretability analysis indicated that AVF usage time，serum calcium level，history of diabetes mellitus（DM），and AVF location were the four most influential features for the model’s predictions. Conclusion The AVF occlusion risk warning models developed based on AdaBoost and Random Forest algorithms exhibit excellent discrimination and accuracy. They can effectively predict the risk of fistula occlusion in hemodialysis patients，providing a reliable basis for personalized nursing interventions.

Objective To construct and validate a prediction model for hypoglycemia risk in emergency brain injury patients，providing a basis for early clinical intervention. Methods A total of 362 brain injury patients admitted to the emergency department of a tertiary hospital from January 2022 to December 2024 were retrospectively recruited as the modeling group，and hypoglycemia in patients was recorded. The screen for risk factors for hypoglycemia was analyzed by univariable analysis and multivariable logistic regression，and nomogram was constructed based on R language. The model’s discrimination，and the Hosmer-Lemeshow test were evaluated by receiver operating characteristic（ROC） curve. A prospective collection of 90 cases of patients admitted to the same center were conducted for external validation from January to May 2025. Results The rate of hypothermia among 362 brain injury patients was 21.55%（78/362）. The model included 7 predictive factors：Glasgow Coma Scale （GCS），coefficient of variation of blood glucose，Injury Severity Score（ISS），history of diabetes，elevated intracial pressure，use of insulin，and nutritional support. The ROC area under the curve（AUC） for the validation group was 0.852（95%CI：0.802-0.868），with sensitivity of 0.832 and specificity of 0.783 at the optimal cutoff value of 0.403. The AUC for the validation group was 0.847（95%CI：0.796-0.899），with a sensitivity of 0.815 and specificity of 0.769 at a cutoff value of 0.418. Conclusion The nomogram model constructed in this study can effectively identify high-risk groups for hypoglycemia in emergency brain injury patients，providing clinical guidance for optimizing blood glucose strategies and reducing the risk of secondary brain injury.

Objective To investigate the effect of analgesic dose on enteral feeding intolerance（EFI） in patients undergoing prone position ventilation（PPV），to determine the dose-response relationship，with aiming to provide evidence for balancing analgesia and nutrition management in critically ill patients. Methods We retrospectively collected clinical data from 630 patients receiving enteral nutrition（EN） support and PPV in the intensive care unit of a tertiary hospital in Nanjing between January 2020 and December 2024. Patients were divided into a tolerance group and an intolerance group based on the occurrence of EFI. Demographic data，disease and treatment-related information，and EN support data were collected. Logistic regression was used to explore the independent relationship between analgesic dose and EFI. Restricted Cubic Splines（RCS） were used to analyze the dose-response relationship between the daily cumulative dose of analgesic and EFI. A forest plot was used to visualize this relationship across subgroups. Results Among the 630 patients，366 tolerated EN and 264 did not，resulting in an EFI incidence of 41.90%. Among the 264 patients with EFI，70 presented with ≥2 symptoms of feeding intolerance，with a total of 336 episodes of EFI symptoms recorded. The most frequently reported symptom was gastric retention，occurring in 137 instances（40.8%，137/336）. The incidence of EFI was relatively higher within the first three days of initiating feeding，with rates of 19.0%，20.8%，and 19.6%，respectively. Multivariable regression analysis showed that the daily cumulative dose of remifentanil（OR=1.032，95%CI：1.005~1.061），use of ≥2 analgesics（OR=2.963，95%CI：1.557~5.640），extracorporeal membrane oxygenation（ECMO） therapy（OR=3.352，95%CI：1.819~6.175），higher number of antibiotic types used（OR=1.605，95%CI：1.329~1.939），and post-pyloric feeding（OR=1.564，95%CI：1.114~2.196） were independent risk factors for EFI. The model demonstrated good calibration （Hos-mer-Lemeshow test，P=0.259）. RCS analysis revealed a positive linear dose-response relationship between the daily cumulative dose of remifentanil and the risk of EFI（overall P=0.026；nonlinear P=0.379）. A daily cumulative dose exceeding 10.77 mg significantly increased EFI risk（OR>1.0）. Subgroup analysis showed that the effect of the remifentanil dose on EFI was consistent across patients of different ages，gender，APACHE Ⅱ scores，modified Nutrition Risk in the Critically Ill（mNUTRIC） scores，feeding routes，and types of analgesic agents（all interaction effects P>0.05）. However，the association was not statistically significant in the post-pyloric feeding，female，or ≥2 analgesics subgroups. Conclusion The dose of remifentanil is an independent risk factor for EFI in PPV patients，showing a dose-dependent effect. These findings provide a dose-threshold reference to support the balance between analgesia and nutrition management. Clinical practice should follow the principle of the lowest effective analgesic dose，and intensify EFI monitoring and prevention for the patients requiring high-dose analgesics to improve nutrition support outcomes.

Objective To understand the current situation of early postoperative pain within 24 hours in patients undergoing thoracoscopic lung cancer radical resection and analyze the influencing factors，in order to provide a reference for implementing individualized and precise pain management strategies. Methods A prospective cohort study design was adopted. 210 patients who underwent thoracoscopic lung cancer radical resection in a tertiary grade A hospital in Zhejiang Province from July to August 2025 were selected as the research subjects. General information questionnaires，Numerical Rating Scales，and the Chinese version of the functional activity assessment method were used for investigation. Univariable and logistic regression analysis were used to screen the influencing factors of early postoperative pain after thoracoscopic surgery. Results A total of 201 patients was finally included. The incidence of early postoperative pain was 100%. Among them，the incidence of moderate pain was 49.7% （100/201），and the incidence of severe pain was 0%. The results of functional activity assessment showed that 87.7%（176/201） of the patients had a level Ⅱ degree of activity limitation during pain，11.4%（23/201） had a level Ⅲ degree，and 0.9%（2/201） had a level Ⅳ degree. The postoperative pain degree was significantly weakly positively correlated with functional activity limitation（r=0.252，P<0.001），but it could only explain about 6.4% of the variation in functional activity limitation. The results of logistic regression analysis showed that patients with age <65 years（OR=0.970） and pain existing when leaving the anesthesia recovery room（OR=2.344） had a higher risk of moderate pain（P<0.001）. Compared with thoracoscopic lung wedge resection，patients undergoing lung segment or resection had a significantly lower risk of moderate pain（OR=0.097）. Conclusion The incidence of moderate pain after thoracoscopic lung cancer radical resection is relatively high. It is influenced by age，surgical method，and the presence of pain when leaving the anesthesia recovery room. For patients under 65 years old，undergoing wedge surgery，and having pain when leaving the anesthesia recovery room，pain monitoring should be strengthened and the analgesic strategy should be adjusted in time to promote early postoperative rehabilitation.

Objective To develop a questionnaire on knowledge，attitude，and practice（KAP） regarding procedural pain management among ICU nurses and examine its reliability and validity，so as to provide a reliable tool for assessing the KAP levels in this area. Methods Based on the KAP theoretical framework，the initial questionnaire was developed through literature review and Delphi expert consultation. A convenience sampling method was used to select 800 clinical nurses from five tertiary hospitals in Zhejiang Province for a survey conducted from July to August 2025，and reliability and validity tests were performed. Results A total of 800 questionnaires were distributed，yielding 787 valid responses，for an effective response rate of 98.38%. The final questionnaire included 36 items across knowledge，attitude，and practice dimensions. The expert authority coefficients for the two Delphi rounds were 0.88 and 0.90，with Kendall’s W of 0.280 and 0.450，and positive coefficients of 100% for both rounds. The content validity index ranged from 0.875 to 1.000，with an average of 0.901. Factor analysis indicated good structural validity，with a cumulative variance contribution rate of 72.56% and a good model fit in the confirmatory factor analysis. The Cronbach’s α of the questionnaire was 0.972 for the overall scale，split-half reliability was 0.843，and test-retest reliability was 0.915. Conclusion The KAP Questionnaire about procedural pain management exhibits good reliability and validity，and can serve as a reliable instrument for evaluating ICU nurses’ knowledge，attitudes，and practices in procedural pain management.

Objective To systematically describe and evaluate the current situation and relevant evidence of non-pharmaceutical intervention for pain in critically ill patients，to provide evidence-based support for the application of non-pharmaceutical analgesia in clinical practice. Methods PubMed，Embase，Cochrane Library，Web of Science，CINAHL，CNKI，VIP，and Wanfang databases were retrieved to obtain systematic reviews or meta-analyses of pain in critically ill patients with non-pharmaceutical interventions in the past 10 years. Literature was screened strictly in accordance with the inclusion and exclusion criteria，and the methodological quality of the included literature was evaluated using A Measurement Tool to Assess Systematic Reviews 2（AMSTAR 2）. The relevant information of the included literature was comprehensively presented by using the evidence map. Results A total of 15 articles were included in this study，including 7 non-pharmaceutical analgesic measures：virtual reality technology，acupuncture therapy，massage，music intervention，guided imagery，spiritual care，and aromatherapy. The included literature suggested that non-pharmacological interventions had a certain effect in relieving pain in critically ill patients. The quality evaluation results showed that the overall methodological quality of the papers was low，with 2 papers rated as high，4 as intermediate，6 as low，and 3 as very low. The results of the evidence map showed that the conclusions of 4 studies were beneficial，9 were possibly beneficial，1 had no differential effect，and 1 was uncertain. Conclusion The current evidence shows that non-pharmacological interventions can relieve pain in critically ill patients，but the methodological quality of relevant studies needs to be improved. It is suggested that standardized and high-quality research should be carried out in the future to provide more scientific and reliable evidence to support non-pharmacological interventions for pain in critically ill patients.

Functional near-infrared spectroscopy（fNIRS） is a non-invasive，portable functional brain imaging technique that indirectly reflects neural activity by monitoring cortical blood oxygenation changes. This review summarizes the application progress of fNIRS in critical care nursing，including sensory stimulation and pain assessment in critically ill neonates，covert consciousness detection and risk warning in patients with disorders of consciousness，rehabilitation monitoring and training program optimization in stroke patients，as well as delirium and fall risk warning for special populations. fNIRS provides an objective tool for nursing assessment and an accurate basis for nursing interventions，facilitating the transformation of critical care from experience-based to data-driven practice. However，its clinical application still faces challenges such as complex data interpretation，insufficient equipment standardization，and insufficient training for nurses. Future efforts should focus on developing nursing-specific devices，establishing standardized operating procedures，strengthening multidisciplinary collaboration，and exploring the optimal practice models of fNIRS in critical care nursing.

This study retrospectively analyzed the clinical data of six pediatric patients with acute lymphoblastic leukemia（ALL） who underwent blinatumomab therapy under the multi-departmental collaborative management model，and systematically evaluated its impact on treatment efficacy and safety. The integrated nursing protocol comprised three core components，including structured training for caregivers，optimized medication administration workflows in the Emergency Department（ED），and remote home-based medication support. Among the six patients，three achieved successfully completed the treatment. Adverse events included one case of central venous catheter occlusion（occurring at the end of treatment） and two allergic reaction；both were successfully managed with timely thrombolysis and anti-allergy therapy，allowing treatment completion. Notably，no severe adverse reactions—such as tumor lysis syndrome，neurological symptoms，severe infections，or critical organ dysfunction—were observed. The findings demonstrated that the multi-departmental collaborative model significantly enhance treatment adherence in pediatric patients and caregiver satisfaction while maintaining standardized therapeutic quality.

Objective To summarize the rapid identification and nursing experience of 109 patients with botulinum toxin type A injection-related poisoning，and to provide clinical reference. Methods Clinical data of 109 patients with botulinum toxin type A injection-related poisoning admitted to a tertiary occupational disease hospital from July 2024 to September 2025 were retrospectively analyzed. Centered around the core of rapid identification， nursing interventions were implemented along the timeline of disease progression，including rapid identification process based on symptom checklists during hospitalization and safety monitoring of antitoxin administration during the admission phase，respiratory graded monitoring based on warning thresholds and airway clearance during the acute phase，early active and passive rehabilitation training for patients receiving mechanical ventilation during the respiratory failure phase，stepwise swallowing rehabilitation and comprehensive assisted nursing during the recovery phase，and layered narrative psychological support throughout the whole course. Results All 18 patients on mechanical ventilation were successfully weaned，and 84 patients with dysphagia resumed oral feeding. No complications occurred in any patient，and the median hospital stay was 5 days. Conclusion Rapid identification and stratified，dynamic，and individualized nursing interventions for patients with injection-related botulinum toxin type A poisoning can improve rehabilitation compliance，promote functional recovery，and shorten hospital stay.

This article summarized the nursing experience of a patient with congenital allied disorders of Hirschsprung’s disease（ADHD） who developed ultra-short bowel syndrome（USBS） with multiple stomas after surgery. In response to clinical challenges including a high risk of anastomotic leakage，severe malnutrition，high-output stoma，and transition to home care，the following nursing interventions were implemented，including tube-stoma linkage for dynamic monitoring，stepwise and sequential nutritional support，individualized management of high stoma output，coordinated care of multiple stomas，and a tripartite guidance model for home transition. After 49 days of tailored interventions，the patient was discharged successfully. During the one-year follow-up，the patient showed favorable recovery with weight gain and partial restoration of intestinal autonomous absorption function.

To summarize the nursing experience of a patient with oral multiple primary tumors who developed flap vascular crisis，wound bleeding，pulmonary embolism，and tracheal softening collapse following free flap transplantation. The nursing challenges in this case included the superimposed multiple complications，contradiction between anticoagulation and bleeding，pulmonary embolism and pulmonary infection lead to decreased ventilation function，increased airway pressure，and induced tracheomalacia. We implemented multi-dimensional precise monitoring and early warning for vascular crisis of skin flaps，dynamic balance management of anticoagulation and hemostasis to break the chain reaction of complications，stepwise intervention for tracheal softening collapse to establish an airway safety protection system，and precision control of multi-drug resistant infections to break the vicious cycle. The patient was discharged with T-shaped silicone tube after 66 days of hospitalization and followed up for 2 month with good recovery.

Objective Based on the social context theory，this study explored the influence and mechanism of the multiple leadership styles of head nurses on the safety behaviors of ICU nurses，providing a scientific basis for nursing safety management. Methods A convergent mixed-methods design was adopted. Using convenience sampling，446 ICU nurses from 14 tertiary hospitals in Zhejiang Province were surveyed with the general data questionnaire，Multifactor Leadership Questionnaire，Error Management Climate Scale，Error Strain Orientation Questionnaire and Nurse Safety Behavior Questionnaire. Multiple linear regression and structural equation modeling were conducted to analyze the pathways of influence. In addition，purposive sampling was used to conduct qualitative interviews with 15 ICU nurses，and data were analyzed using content analysis. Results Quantitative findings indicated that nurse managers’ multiple leadership style was a significant predictor of ICU nurses’ safety behaviors，with error management climate and error strain orientation playing a chain mediating role. Qualitative analysis identified four themes，including roles of leadership style，influence of organizational atmosphere，responses to unsafe events，and individual intrinsic drivers. The mixed-methods integration further revealed the roles of perceived workload，team collaboration，and error-benefit cognition in shaping safety behaviors. Conclusion Head nurses’ multiple leadership styles directly influence ICU nurses’ safety behaviors and exert an indirect influence through the serial mediating effect of error management climate and error strain orientation. In management practice，head nurses should take into account the construction of multiple leadership styles，the creation of an error management climate，and the intervention of error stress to promote nurses’ proactive safety behaviors.

Objective To explore the role experiences during training among advanced practice nurses（APNs） in critical care，ascertain their expectations regarding competence transformation and professional development，and provide a reference basis for promoting the role transition and professional development of critical care APNs. Methods Using a descriptive phenomenological qualitative research methodology，purposive sampling was conducted to select 15 participants from various provinces and cities across China who had completed a critical care advanced practice nurses training program. Semi-structured interviews were conducted with these individuals from November 15 to 29，2024. Colaizzi’s phenomenological data analysis method was applied to organize the interview data and extract core themes. Results Five core themes were summarized as follows：Expectations regarding role cognition and transition；Expectations for core competency enhancement；Practical experiences and reflections on individualized training；Effectiveness of training in career development and its practical challenges；Support demands for professional development. Conclusion The study academically reveals the pressures，dilemmas and expectations for development encountered by critical care APNs during training and reflects their urgent needs for improvement in role cognition，competence enhancement and personal professional qualifications. It provides a reference basis for optimizing training system，role positioning，and professional development pathways，and serves as a reference for clinical training，job position design，and policy improvement.

Objective To extract and synthesize the best evidence on family participation in the rehabilitation care of ICU patients，aiming to provide an evidence-based foundation for standardized practice of family-involved care model in ICU rehabilitation nursing. Methods According to the “6S” model of evidence resources，relevant literature on the application of family involvement model in ICU patient rehabilitation nursing was systematically searched in relevant websites and domestic and international databases，including guidelines，expert consensus，systematic reviews，reviews，and original research. The search period was from database inception to November 20，2025. Literature screening，quality assessment，evidence grading，and synthesis were independently conducted by two researchers. Results A total of 18 articles were included，comprising four guidelines，an expert consensus，seven systematic reviews，three general reviews，two quasi-experimental studies and one randomized control study. Nineteen pieces of evidence were summarized across six domains，including preparation，team support，pre-intervention assessment，intervention protocol，withdrawal criteria，and outcome evaluation. Conclusion Standardizing family participation in ICU rehabilitation nursing helps improve patient outcomes and family satisfaction. Based on multidisciplinary cooperation and scientific support，the summarized evidence offers evidence-based reference for the clinical application and standardized practice of family participation model in ICU rehabilitation nursing.

Objective To summarize the best evidence on hematopoietic stem cell infusion management. Methods According to the “5S” model of the evidence pyramid，clinical decisions，evidence summaries，best practices，guidelines，expert consensus，and systematic reviews and original studies on adult hematopoietic stem cell infusion management in domestic and foreign databases and relevant professional websites were systematically searched. The time limit for literature retrieval was from establishment of databases to September 30 2025. Two researchers independently conducted quality assessment，evidence extraction，and integration of the literature. Results A total of 13 literature were included，including a clinical decision，two guidelines，five expert consensuses，two group standard，a evidence summary，and two quasi-experimental studies. 35 best evidences were summarized from 6 aspects，including institutional and personnel qualification management requirements，pre-infusion assessment，infusion quality control，monitoring and documentation，management of infusion-related adverse reactions，and health education. Conclusion This study systematically and comprehensively summarizes the best evidence for adult hematopoietic stem cell infusion management. It is recommended that clinical healthcare providers select and apply the best evidence based on the type of stem cells，combined with the patient’s age and comorbidities，to improve the safety and standardization of adult hematopoietic stem cell infusion.

Objective To conduct a scoping review on intervention strategies for elderly trauma patients，providing references for improving clinical management practices. Methods PubMed，Embase，CINAHL，Cochrane Library，Web of Science，CNKI，CBM，Wanfang Data，and VIP databases were searched to collect studies on intervention strategies for elderly trauma patients，covering the period from database inception to July 2025. Two researcher screened the literature and extracted the data independently. Results A total of 21 studies were included. The geriatric-centered interventions for elderly trauma patients structurally included geriatric consultation，multidisciplinary collaborative management，and the establishment of specialized geriatric trauma units/wards. Contents of interventions encompassed comprehensive geriatric assessment，medication adjustment，and interdisciplinary ward rounds. Outcome measures included in-hospital mortality，complication rates，length of stay. Post-discharge and patient-reported outcomes were rarely included. Conclusion The structural framework of geriatric-centered interventions for elderly trauma patients is generally consistent，though implementation processes vary. Outcome measurement remains limited，highlighting the need for more evidence to clarify strategy components and standardize processes，as well as to investigate post-discharge outcomes and patient-reported outcomes.

Ventilator-associated pneumonia（VAP） is one of the most severe complications in ICU patients undergoing orotracheal intubation mechanical ventilation，significantly prolonging hospital stay，increasing medical costs，and elevating mortality rates. Standardized oral care can effectively reduce the incidence of VAP，current clinical practice still faces three core challenges：the inadequate applicability of traditional assessment tools for ICU patients，the controversy regarding the efficacy and safety of chlorhexidine solution concentration selection，and the generally low clinical implementation rate of oral care. To address these issues，this article systematically integrates evidence from the past decade literature，reviews the research progress in four dimensions of oral care for mechanical ventilation patients—“assessment，tool，solution，frequency”，and summarizes a three-step progressive clinical decision-making pathway termed “assessment-matching-adjustment.” This pathway integrates artificial intelligence visual recognition system and Intensive Care Oral Care Frequency Assessment Scale（ICOCFAS） to achieve precise assessment，matches nursing tools and solutions based on risk stratification and resource conditions，and dynamically adjusts the frequency of care via ICOCFAS scores. It aims to provide a structured，individualized practical strategy for clinical practice，promoting the transition of oral care toward standardization and precision. However，the overall efficacy of this decision-making pathway and its adaptability across different healthcare resource environments still require further validation and optimization through large-sample，multicenter real-world clinical studies.