Objective To explore the value of cardiopulmonary and additional ultrasound(CLAUS)protocol and point-of-care ultrasound rapid management(POCURM)protocol in etiological diagnosis of acute respiratory distress in critically ill patients in the emergency room.Methods A total of 242 patients with acute respiratory distress admitted to Jinhua City Central Hospital from January 2022 to January 2024 were selected as the research subjects.According to the final diagnosis after discharge,they were divided into cardiogenic group(n=144)and pulmonary group(n=98).Compare the CLAUS findings of two groups and accuracy of two protocols in diagnosing etiology of acute respiratory distress.Results The history of heart disease in cardiogenic group was higher than that in pulmonary group,and difference was statistically significant(P＜0.05).The lung disease history of patients in cardiogenic group was lower than that in pulmonary group,and difference was statistically significant(P＜0.05).The proportion of pleural smoothness/slight thickening,sliding presence/slight weakening,left heart dysfunction,right heart dysfunction,and B-line pulmonary ultrasound scores in cardiogenic group were higher than those in pulmonary group,and differences were statistically significant(P＜0.05).The sensitivity,specificity of POCURM protocol for diagnosing acute respiratory distress were 90.28％,91.84％.The sensitivity,specificity of CLAUS protocol for diagnosing acute respiratory distress were 96.53％,97.96％.Conclusion CLAUS regimen can effectively diagnose specific causes of acute respiratory distress in patients,with higher accuracy than POCURM regimen.

Objective Exploring the clinical value of pulmonary ultrasound B-line score,left ventricular ejection fraction(LVEF),insulin-like growth factor binding protein-7(IGFBP7),and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels in diagnosing cardiogenic acute dyspnea.Methods A retrospective analysis was conducted on the clinical data of 80 patients with acute dyspnea diagnosed and treated at Jinhua Municipal Central Hospital from February 2021 to February 2024.According to the discharge diagnosis of patients,they were divided into cardiogenic group(cardiogenic acute dyspnea,50 cases)and non-cardiogenic group(non-cardiogenic acute dyspnea,30 cases).The pulmonary ultrasound B-line score,LVEF,IGFBP7 and NT-proBNP levels of two groups of patients were compared,their correlations were analyzed,and the receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of each index for cardiogenic acute dyspnea.Results There were no statistically significant differences in the clinical baseline data such as age,gender,body mass index,proportion of atrial fibrillation,urea nitrogen,serum creatinine,systolic blood pressure,arterial partial pressure of oxygen,heart rate and blood oxygen saturation between two groups of patients(P＞0.05).The pulmonary ultrasound B-line score,the levels of IGFBP7 and NT-proBNP in cardiogenic group were significantly higher than those in non-cardiogenic group,and the LVEF was significantly lower than that in non-cardiogenic group(P＜0.05).Pearson correlation analysis showed that the pulmonary ultrasound B-line score was positively correlated with both IGFBP7 and NT-proBNP(P＜0.05),with no significant correlation with LVEF(P＞0.05).The results of ROC curve showed that the pulmonary ultrasound B-line score,LVEF,IGFBP7 and NT-proBNP all had high diagnostic value for cardiogenic acute dyspnea,and the area under the curve were 0.917,0.855,0.946 and 0.925,respectively.Conclusion The pulmonary ultrasound B-line score,LVEF,IGFBP7,and NT-proBNP levels have high diagnostic value for cardiogenic acute dyspnea and are worthy of clinical promotion and application.

Objective To explore the value of cardiopulmonary and additional ultrasound(CLAUS)protocol and point-of-care ultrasound rapid management(POCURM)protocol in etiological diagnosis of acute respiratory distress in critically ill patients in the emergency room.Methods A total of 242 patients with acute respiratory distress admitted to Jinhua City Central Hospital from January 2022 to January 2024 were selected as the research subjects.According to the final diagnosis after discharge,they were divided into cardiogenic group(n=144)and pulmonary group(n=98).Compare the CLAUS findings of two groups and accuracy of two protocols in diagnosing etiology of acute respiratory distress.Results The history of heart disease in cardiogenic group was higher than that in pulmonary group,and difference was statistically significant(P＜0.05).The lung disease history of patients in cardiogenic group was lower than that in pulmonary group,and difference was statistically significant(P＜0.05).The proportion of pleural smoothness/slight thickening,sliding presence/slight weakening,left heart dysfunction,right heart dysfunction,and B-line pulmonary ultrasound scores in cardiogenic group were higher than those in pulmonary group,and differences were statistically significant(P＜0.05).The sensitivity,specificity of POCURM protocol for diagnosing acute respiratory distress were 90.28％,91.84％.The sensitivity,specificity of CLAUS protocol for diagnosing acute respiratory distress were 96.53％,97.96％.Conclusion CLAUS regimen can effectively diagnose specific causes of acute respiratory distress in patients,with higher accuracy than POCURM regimen.

Objective Exploring the clinical value of pulmonary ultrasound B-line score,left ventricular ejection fraction(LVEF),insulin-like growth factor binding protein-7(IGFBP7),and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels in diagnosing cardiogenic acute dyspnea.Methods A retrospective analysis was conducted on the clinical data of 80 patients with acute dyspnea diagnosed and treated at Jinhua Municipal Central Hospital from February 2021 to February 2024.According to the discharge diagnosis of patients,they were divided into cardiogenic group(cardiogenic acute dyspnea,50 cases)and non-cardiogenic group(non-cardiogenic acute dyspnea,30 cases).The pulmonary ultrasound B-line score,LVEF,IGFBP7 and NT-proBNP levels of two groups of patients were compared,their correlations were analyzed,and the receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of each index for cardiogenic acute dyspnea.Results There were no statistically significant differences in the clinical baseline data such as age,gender,body mass index,proportion of atrial fibrillation,urea nitrogen,serum creatinine,systolic blood pressure,arterial partial pressure of oxygen,heart rate and blood oxygen saturation between two groups of patients(P＞0.05).The pulmonary ultrasound B-line score,the levels of IGFBP7 and NT-proBNP in cardiogenic group were significantly higher than those in non-cardiogenic group,and the LVEF was significantly lower than that in non-cardiogenic group(P＜0.05).Pearson correlation analysis showed that the pulmonary ultrasound B-line score was positively correlated with both IGFBP7 and NT-proBNP(P＜0.05),with no significant correlation with LVEF(P＞0.05).The results of ROC curve showed that the pulmonary ultrasound B-line score,LVEF,IGFBP7 and NT-proBNP all had high diagnostic value for cardiogenic acute dyspnea,and the area under the curve were 0.917,0.855,0.946 and 0.925,respectively.Conclusion The pulmonary ultrasound B-line score,LVEF,IGFBP7,and NT-proBNP levels have high diagnostic value for cardiogenic acute dyspnea and are worthy of clinical promotion and application.

Objective To investigate the efficacy and safety of endoscopic hematoma evacuation in treatment of non-isodense chronic subdural hematoma and subacute subdural hematoma.Method From June 2019 to June 2022,endoscopic surgery was performed on 18 cases of non-isodense chronic subdural hematoma and subacute subdural hematoma.Then analyze the indicators such as hematoma clearance rate,postoperative midline deviation reduction,surgical time,intraoperative blood loss,postoperative recurrence rate,Glasgow coma score (GCS) and modified Rankin scale (mRS) at different times.Result The average surgical time was (147.89±10.29) min,the intraoperative blood loss was (130.52±18.42) mL.The average preoperative hematoma volume of 18 patients was (111.91±34.25) mL,on the first day after surgery,CT scan showed that all the 16 hematoma cases were cleared,and the majority of 2 hematoma cases were cleared,the average hematoma clearance rate was 88.89％.Craniocerebral CT showed an average midline displacement of (11.49±3.23) mm before surgery,which returned to (6.19±2.61) mm on the first day after surgery,the difference was statistically significant (P<0.01);At 1 month after surgery,16 patients had a median midline displacement,while 2 patients had a median midline displacement of 1.21 and 2.23 mm,the median line regression rate was 88.89％ at 1 month after surgery;6 months after surgery,all the 18 patients had a median midline displacement,and the median line regression rate was 100.00％.All the 18 patients did not experience any further bleeding after surgery,one patient developed subdural effusion after surgery,which was absorbed after taking medication.After a follow-up of six months,all the 18 patients did not recur.The GCS on admission was (14.06±2.46),which improved to (15.00±0.00) at discharge,with a statistically significant difference (P<0.05);mRS on admission was (3.17±1.26),and decreased to (0.56±0.02) at discharge,with statistical significance (P<0.05).Conclusion Endoscopic removal of chronic and subacute subdural hematomas with non-isodense is a safe and effective method of hematoma removal.While achieving the effect of large bone flap craniotomy,it can significantly reduce the surgical complications and postoperative recurrence,have a less invasive.It is worthy clinical application.

Objective To investigate the efficacy and safety of endoscopic hematoma evacuation in treatment of non-isodense chronic subdural hematoma and subacute subdural hematoma.Method From June 2019 to June 2022,endoscopic surgery was performed on 18 cases of non-isodense chronic subdural hematoma and subacute subdural hematoma.Then analyze the indicators such as hematoma clearance rate,postoperative midline deviation reduction,surgical time,intraoperative blood loss,postoperative recurrence rate,Glasgow coma score (GCS) and modified Rankin scale (mRS) at different times.Result The average surgical time was (147.89±10.29) min,the intraoperative blood loss was (130.52±18.42) mL.The average preoperative hematoma volume of 18 patients was (111.91±34.25) mL,on the first day after surgery,CT scan showed that all the 16 hematoma cases were cleared,and the majority of 2 hematoma cases were cleared,the average hematoma clearance rate was 88.89％.Craniocerebral CT showed an average midline displacement of (11.49±3.23) mm before surgery,which returned to (6.19±2.61) mm on the first day after surgery,the difference was statistically significant (P<0.01);At 1 month after surgery,16 patients had a median midline displacement,while 2 patients had a median midline displacement of 1.21 and 2.23 mm,the median line regression rate was 88.89％ at 1 month after surgery;6 months after surgery,all the 18 patients had a median midline displacement,and the median line regression rate was 100.00％.All the 18 patients did not experience any further bleeding after surgery,one patient developed subdural effusion after surgery,which was absorbed after taking medication.After a follow-up of six months,all the 18 patients did not recur.The GCS on admission was (14.06±2.46),which improved to (15.00±0.00) at discharge,with a statistically significant difference (P<0.05);mRS on admission was (3.17±1.26),and decreased to (0.56±0.02) at discharge,with statistical significance (P<0.05).Conclusion Endoscopic removal of chronic and subacute subdural hematomas with non-isodense is a safe and effective method of hematoma removal.While achieving the effect of large bone flap craniotomy,it can significantly reduce the surgical complications and postoperative recurrence,have a less invasive.It is worthy clinical application.

Objective To sort out the development history of disease control informatization in Hubei, and provide reference for the establishment of the ^"Hubei model^" of disease control informatization. Methods To understand the development process through data access and site investigation. Result Hubei CDC has built a provincial and municipal two-level data center; built a full-coverage security network; built a full traceable immune planning system; built a provincial, city, and county three-level video conference system; established a professional disease Control the information team. Conclusion The ^"Hubei model^" of disease control informationization has a solid foundation. It will adhere to the development concept of people as the core, business as the problem-oriented, big data as the means, multi-point trigger as the benchmark, and network security as the foundation. Play the role of technical support and information leadership in the control business.

Objective To evaluate the pathological stage,the presence of detrusor muscle and the clinical significance for standardized examination of specimens for en bloc transurethral resection technique with Hybrid Knife to treat NMIBC (ERBT) compared with conventional TURBT.Methods This was prospective randomized controlled study.This study was approved by the Ethics Committee of Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology (TJ-IRB20180604),and patients all signed informed consent.The clinical study registration number of this study:NCT03221062.The margin of the tumor was recognized and marked by with Hybrid Knife (0.5 cm away from the normal mucosa).Then water was injected into the submucosa and form a water pad,with a circular cutting layer by layer (0.5 cm away from the marked position),reaching the detrusor muscle in depth.After complete resection,the tumor was removed by specimen bag.Specimens for ERBT cohort were given standard handling.Resected specimen of ERBT stretched with pins on foam and its margin was stained.The basement of specimen was also stained.Total specimen sectioned into appropriate pieces for histological assessment in the department of pathology.TURBT cohort performed traditional surgical methods and pathological examination.All patients received postoperative intravesical instillation according to their pathology.Imaging and cystoscopy were performed every 3 months.The primary study end-point was the quality of resection,including the pathological stage and the presence of DM.Secondary outcomes were:short-term tumour recurrence rate (18 month),feasibility,and safety.Results From January 2017 to October 2017,109 patients were enrolled.51 patients underwent ERBT,and 58 patients underwent TURBT.The clinical characteristics of the patients in each cohort,such as average age,gender,average BMI,smoking history,the mean number of lesions and tumour size had no significant differences (P ＞ 0.05).The operation of 109 cases was completed successfully.There was no statistical difference between the operative time and the postoperative bladder irrigation time.Major intraoperative or postoperative complications (Clavien ≥ Ⅱ) did not occur in all of the patients.The percentage of T1 staging was higher in the ERBT cohort vs.TURBT cohort [21/51 (41.2％) vs.13/58 (22.4％),P =0.035],of which ERBT cohort accurately detected 9 cases (42.8％) of T1b patients,significantly higher than TURBT cohort (2 cases,15.4％) (P =0.096).All the ERBT samples showed the presence of DM (100.0％),while there was only 77.4％ in TURBT cohort (P ＜ 0.05).Mean follow-up (20.3 ± 3.1) months (ranged from 18 to 24 months).Recurrence rate were 8.9％ (4/45) in ERBT cohort vs.22.2％ (12/54) in TURBT cohort (P=0.059).Conclusions ERBT with Hybrid Knife for treatment NMIBC is a safe,effective,and provides high-quality specimens compared to TURBT.More high-risk NMIBC patients,especially T1 b patients,can be detected obviously by pathologist with the standardized treatment of specimens.