Objective To analyze and evaluate the implementation effect of tuberculosis prevention and control program in Wuhan, and to provide reference for scientific formulation of tuberculosis prevention and control measures. Methods Using the National Tuberculosis Information Management System, descriptive statistical analysis was carried out on the medical record information of pulmonary tuberculosis patients registered in Wuhan , 2016 - 2021. Results A total of 34 937 cases of pulmonary tuberculosis were registered in Wuhan , with an average annual incidence rate of 49.85/100 000. The incidence rate showed a downward trend year by year, with a statistically significant difference in 2016—2021 (χ²_trend = 708.387, P<0.001). The patients mainly came from referrals, accounting for 71.86%, and the proportion of referrals varied significantly among different years (χ²=355.541, P<0.001). The diagnosis type was mainly pathogenic negative, accounting for 49.12%. The proportion of pathogenic negative had statistically significant difference among different years (χ²=1 354.830, P<0.001). The proportion of patients cured and completed the course of treatment reached 93.98%, with statistically significant differences in the proportions among different years (cured, χ²=1 080.252, P<0.001; completed the treatment course, χ²= 933.655, P<0.001). The sputum examination rate of newly diagnosed patients in each year reached over 90%, and the overall completion rate reached over 95%. The proportion of positive pathogens showed an increasing trend year by year. Conclusion The overall epidemic situation of tuberculosis in Wuhan is declining year by year, and tuberculosis prevention and control work has achieved remarkable results. Active screening in key areas and populations should be strengthened, and prevention and control strategies should be formulated by emphasizing the key and difficult points.

Qi and blood are the two cornerstones of the theoretical system of traditional Chinese medicine.Luobing theory con-structs an academic system with the prominent characteristics of"Qi-blood correlation"to guide the prevention and treatment of compli-cated diseases of internal injury and severe external diseases.Qi is the leader of blood,blood is the mother of Qi,qiluo runs meridian qi,mailuo runs blood,and the relationship between qiluo and mailuo is essentially a dialectical relationship between Qi and blood.Qi and blood play a role in the regulation of collaterals,warming and nourishing,blood supply and Qi supply,and the exchange of Jin and blood.The normal structure and function of collateral vessel is the key factor to maintain the normal structure and function of the viscer-a.The collateral vessel entering the viscera is the collateral of the viscera,and entering the heart is divided into the mailuo of the heart and the qiluo of the heart.Cardiac mailuo infiltration can nourish the heart tissue and provide material basis for maintaining the struc-ture and function of the heart,which is identical with the modern medical coronary system and cardiac microvessels;qiluo regulates cardiac function,maintains cardiac systolic pulsation,and has the same identity with cardiac conduction system and regulatory mecha-nism.The interaction of mailuo disease and qiluo disease can lead to arrhythmias,such as coronary heart disease arrhythmias and pri-mary arrhythmias.According to the therapeutic principle that collateral vessels work by circulation,the key to the treatment of arrhyth-mia is to unobstruct the collateral veins and harmonize Qi and blood,which has important guiding value for the treatment of arrhythmia.The treatment of arrhythmias should not only remove pathogenic factors and improve cardiac conduction function,but also protect cardiac microcirculation,especially for arrhythmias without clear organic disease,which provides a new idea for the prevention and treatment of arrhythmias by combining traditional Chinese and Western medicine.

Objective:To conduct scoping review of researches on application of traditional Chinese medicine exercises in exercise rehabilitation of patients with heart failure, so as to provide reference for effective clinical intervention of traditional Chinese medicine exercises.Methods:Chinese and English literature published in PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP, Wanfang Database and China Biology Medicine disc were searched by computer, and the search deadline was from database establishment to May 28, 2023. The Joanna Briggs Institute Scoping Review Guide was used as a methodological framework to summarize and analyze the included literature.Results:A total of 19 literatures were included, including 17 randomized controlled trials and 2 quasi-randomized controlled trials. The subjects of the intervention were heart failure patients with New York Heart Association heart function gradeⅠ toⅢ. The types of exercises mainly included Eight Pieces of Brocade and Tai Chi. The intervention duration was mostly 30 min each time, and the frequency was mostly 3 to 5 times a week. The intervention intensity was mostly based on The Borg Rating of Perceived Exertion (RPE), and the intervention duration was mostly 3 months. Most of the implementation scenarios were "hospital-home" or home. Traditional Chinese medicine exercises had a positive effect on the clinical symptoms, psychological state and quality of life of patients with heart failure, and were safe and feasible.Conclusions:Traditional Chinese medicine exercises have a positive effect on the exercise rehabilitation of patients with heart failure, and are safe and feasible.

Talaromycosis marneffei has been increasing in recent years. Our understanding of this disease has gradually deepened through extensive basic and clinical research, but there are still many limitations. In this article, by incorporating the latest research advancements, we discuss important issues in managing Talaromycosis marneffei trends, aiming to guide effective prevention and control of the disease, improving public health, and reducing the healthcare burden.

Gastric cancer is a common malignant tumor of digestive tract, and its prognosis varies greatly with different stages of the tumor. In recent years, more and more evidence shows that artificial intelligence (AI) technology has excellent performance in imaging diagnostic applications, with remarkable diagnostic effects and broad prospects. AI not only improves the accuracy of diagnosis and staging of gastric cancer, but also has great application value in pathological assessment, adjuvant therapy and prognosis prediction. This article systematically reviews domestic and foreign literature to explore the application progress of AI in gastric cancer imaging.

Gastric cancer is a common malignant tumor of digestive tract, and its prognosis varies greatly with different stages of the tumor. In recent years, more and more evidence shows that artificial intelligence (AI) technology has excellent performance in imaging diagnostic applications, with remarkable diagnostic effects and broad prospects. AI not only improves the accuracy of diagnosis and staging of gastric cancer, but also has great application value in pathological assessment, adjuvant therapy and prognosis prediction. This article systematically reviews domestic and foreign literature to explore the application progress of AI in gastric cancer imaging.

Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis among students in Wuhan from 2011 to 2020, and to provide a basis for the scientific development of interventions and strategies. Methods: Epidemiological distribution, time of onset and treatment, as well as treatment outcomes of student tuberculosis in Wuhan from 2011 to 2020 registered in the national tuberculosis information management system were described. Results: During 2011-2020, 4 337 student tuberculosis patients in Wuhan were registered. The average annual incidence rate was 22.44/10 million, and the annual decreasing rate of 7.86% The incidence of male and female patients was 1.76:1, and the incidence rate of male was higher than that of female( χ 2=184.18, P <0.01). Most of patients aged 19-22 years old, accounting for 47.89%; Tuberculosis reports were highest during March to May, and September to November, and lowest during January to February, and July to August. Student patients were mainly concentrated in Hongshan District, Jiangxia District and Wuchang District, where schools were more distributed in Hongshan District, Dongxihu District, Wuchang District and Xinzhou District. The median duration from tuberculosis onset to treatment was 9(3, 21) days, which varied significantly by region, age, nationality, and patient residence ( Z =-9.25, 47.14, 9.88,43.96, P <0.01). The treatment and outcome of student tuberculosis patients were varied significantly by year and nationality( P <0.05). Conclusion The incidence of student tuberculosis in Wuhan City showed a slow downward trend. Most of student tuberculosis are college and high school students. Time and place of case detection are relatively fixed. The time of treatment and the outcome of treatment vary significantly. Tuberculosis prevention and control strategies should be formulated according to the local conditions according to the tuberculosis distribution characteristics, as well as enhancing surveillance, health promotion, active discovery and supervision management of tuberculosis in school settings.

Objective To determine the genotype and clustering characteristics of multidrug-resistant (MDR) mycobacterium tuberculosis in Wuhan City. Methods A total of 149 mycobacterium tuberculosis strains from MDR tuberculosis (MDR-TB) patients were genotyped by DTM-PCR, mycobacterial interspersed repetitive unit–variable number tandem repeat typing (MIRU-VNTR) and sequencing of drug-resistant associated genes. The Hunter-Gaston discriminatory index (HGDI), clustering rate and recent minimum estimated infection rate were calculated. Results The cumulative HGDI of all MIRU loci was 0.9944. Gene locus with the highest HGDI（0.6467）was QUB11b. Combing MIRU-VNTR and DTM-PCR, 111 unique genotypes and 11 clustered genotypes（38 strains）from 149 isolates were identified. The clustering rate was 25.50%, and the recent minimum infection rate was estimated to be 18.12%. After further genotyping by sequencing of drug-resistant associated genes, the results showed that 17 (44.74%) strains in each cluster shared the same mutation sites, while the other strains had different mutation sites. Conclusion The combination of DTM-PCR, 24 locus MIRU-VNTR typing and drug resistance gene sequencing demonstrates a relatively high discriminatory power, which is suitable for the genotyping of multi drug resistant mycobacterium tuberculosis in Wuhan. The epidemic of MDR-TB in Wuhan is mainly caused by reactivation, and the recent transmission rate is not high.

Objective:To observe the application effect of respiratory stepwise management in patients with septic shock combined with acute lung injury (ALI).Methods:100 patients with septic shock combined with ALI were selected as the research objects in Haikou Hospital Affiliated to Xiangya Medical College of Central South University from January 2018 to June 2020. Fifty patients were given endotracheal intubation or invasive ventilation on the basis of conventional treatment (conventional treatment group). According to the respiratory situation and blood gas, 50 patients were given systematic respiratory support step-by-step treatment according to the principle of simple to complex, and appropriate and scientific respiratory support was given according to the sequence from unarmed to mechanical (respiratory stepwise management group). The differences of cardiac index (CI), central venous pressure (CVP), mean arterial pressure (MAP), extravascular lung water index (EVLWI), arterial partial pressure of carbon dioxide (PaCO 2), arterial partial pressure of oxygen (PaO 2), oxygenation index (PaO 2/FiO 2) before and after treatment were compared between the two groups, the therapeutic effects of the two groups were evaluated, and the resuscitation effect, postoperative complications rate, tracheotomy rate, utilization rate of invasive ventilator of the two groups were recorded. Results:After treatment, CI, CVP, EVLWI, PaO 2, PaO 2/FiO 2 levels of the two groups were significantly higher than before treatment, MAP and PaCO 2 levels were significantly lower than before treatment; MAP and PaCO 2 levels after treatment of the respiratory stepwise management group were significantly lower than those of the conventional treatment group [MAP (mmHg, 1 mmHg = 0.133 kPa): 68.2±7.0 vs. 74.4±6.8, PaCO 2 (mmHg): 37.82±4.05 vs. 41.76±4.59], the levels of EVLWI, PaO 2 and PaO 2/FiO 2 in the respiratory stepwise management group were significantly higher than those in the conventional treatment group [EVLWI (mL/kg): 15.34±3.03 vs. 13.64±3.32, PaO 2 (mmHg): 84.44±4.83 vs. 79.03±5.54, PaO 2/FiO 2 (mmHg): 452.42±51.32 vs. 431.73±50.03, all P < 0.05]. There was no significant difference in CI or CVP after treatment between respiratory stepwise management group and conventional treatment group [CI (mL·s -1·m -2): 70.01±21.67 vs. 66.68±18.34, CVP (mmHg): 11.1±3.2 vs. 12.3±3.2, both P > 0.05]. Compared with the conventional treatment group, the average recovery time of the respiratory stepwise management group was earlier (hours: 2.04±0.54 vs. 4.29±0.20, P < 0.05), the stable breathing time was shorter (hours: 3.07±0.22 vs. 5.36±0.35, P < 0.05), the total effective rate and the success rate of recovery were significantly improved [86.0% (43/50) vs. 60.0% (30/50), 94.0% (47/50) vs. 74.0% (37/50), both P < 0.05], the incidence of ventilator associated pneumonia (VAP) and airway complications were significantly reduced [14.0% (7/50) vs. 32.0% (16/50), 12.0% (6/50) vs. 40.0% (20/50), both P < 0.05], and the tracheotomy rate and the utilization rate of invasive ventilator were significantly reduced [8.0% (4/50) vs. 28.0% (14/50), 30.0% (15/50) vs. 60.0% (30/50), both P < 0.05]. Conclusion:Respiratory stepwise management can effectively improve the resuscitation effect of septic shock patients with ALI, improve cardiopulmonary function, blood gas index and the treatment efficiency, effectively reduce the incidence of iatrogenic trauma and complications.

Objective:To compare the effects between improved catheter extubation method and the traditional one on urination pain, urinary retention, first urination time and first urination volume, and to evaluate the advantage of the improved method.Methods:144 patients with indwelling catheters after operation in our department were randomly divided into observation group and control group, with 72 cases in each group. The control group returned to the ward after surgery and began to clamp the urinary tube to train the bladder function, the catheter was removed by traditional method. Observation group: urination reflex was evaluated before extubation, according to more than 250 ml urine in the urine bag. Pumping the saline of the gas bag and injecting back 0.5ml to keep the wall of the bag smooth, eventually the catheter was excreted when urinating. Urethral pain, urinary retention, first micturition time and first micturition volume of two groups were analyzed.Results:Urethral pain, urinary retention, first micturition time in observation group and control group were 1.47±1.48, (20.44±12.98) min, 95.8% (69/72) and 3.11±1.98, (28.03±27.00) min, 83.3% (60/72), respectively, and the difference between the two groups was statistically significant ( t value was -5.644, -2.148, χ2 value was 6.628, all P<0.05). The first micturition volume in observation group and control group were (258.6±41.57) ml and (248.14±48.82) ml, respectively, and there was no significant difference between the two groups ( t value was 1.377, P>0.05). Conclusion:The improved catheter extubation method could significantly reduce the urethral pain, shorten the time of the first urination, and improve the success rate of self-urination, which of clinical promotion.