亚甲蓝在感染性心内膜炎患者行心脏瓣膜置换术中的应用效果

目的观察亚甲蓝在感染性心内膜炎患者行心脏瓣膜置换手术中的应用效果。方法选择2016年10月至2018年11月拟行心脏瓣膜置换术的感染性心内膜炎患者30例,男21例,女9例,年龄38~67岁,ASAⅡ-Ⅳ级,采用随机数字表法分为两组:亚甲蓝组(MB组)和对照组(C组),每组15例。MB组于CPB停机前10 min开始泵注亚甲蓝2.0 mg/kg持续20 min,C组于相同时点注入等剂量生理盐水。记录术中总输液量、术后机械通气时间、ICU停留时间;分别于给肝素前(T1)、CPB停机后10 min(T2)以及静注完亚甲蓝后1 h(T3)、3 h(T4)、6 h(T5)和12 h(T6)时记录HR、MAP、CVP、HR与SBP的乘积(RPP)、正性肌力药物评分(IS)和血管活性药物评分(VIS)以及血糖和乳酸浓度。结果与T1时比较,T2-T6时两组IS、VIS、血糖和乳酸浓度明显升高(P<0.05);与C组比较,T3-T6时MB组IS、VIS、RPP和乳酸浓度明显降低(P<0.05),术中总输液量明显减少(P<0.05),术后机械通气时间和ICU停留时间明显缩短(P<0.05)。结论亚甲蓝在感染性心内膜炎患者行心脏瓣膜置换手术中早期预防应用,可减少术中液体输注量和术后血管活性药物应用,降低心肌氧耗,缩短术后机械通气时间和ICU停留时间。

Hand dysfunction after transradial artery catheterization for coronary procedures

AIM To sythesize the available literature on hand dysfunction after transradial catheterization.METHODS We searched MEDLINE and EMBASE. The search results were reviewed by two independent judicators for studies that met the inclusion criteria and relevant reviews. We included studies that evaluated any transradial procedure and evaluated hand function outcomes post transradial procedure. There were no restrictions based on sample size. There was no restriction on method of assessing hand function which included disability, nerve damage, motor or sensory loss. There was no restriction based on language of study. Data was extracted, these results were narratively synthesized.RESULTS Out of 555 total studies 13 studies were finally included in review. A total of 3815 participants with mean age of 62.5 years were included in this review. A variety of methods were used to assess sensory and motor dysfunction of hand. Out of 13 studies included, only 3 studies reported nerve damage with a combined incidence of 0.16%, 5 studies reported sensory loss, tingling and numbness with a pooled incidence of 1.52%. Pain after transradial access was the most common form of hand dysfunction(6.67%) reported in 3 studies. The incidence of hand dysfunction defined as disability, grip strength change, power loss or any other hand complication was incredibly low at 0.26%. Although radial artery occlusion was not our primary end point for this review, it was observed in 2.41% of the participants in total of five studies included.CONCLUSION Hand dysfunction may occur post transradial catheterisation and majority of symptoms resolve without any clinical sequel.

冠状动脉CT血流储备分数应用临床路径中国专家共识

目前血流储备分数(FFR)被认为是心外膜冠状动脉狭窄功能性评价的“金标准”,但由于各种原因在实际临床中FFR的应用受到一定限制。基于冠状动脉CT血管造影(CCTA)影像数据应用高级计算流体力学及深度学习等方法获得的冠状动脉CT血流储备分数(CT-FFR)能同时提供冠状动脉的解剖和生理学信息,成为临床研究和应用的新热点。CT-FFR在国内临床实践中的使用仍处于探索阶段。本专家共识介绍了CT-FFR的基本原理及诊断效能、工作流程、临床证据、应用临床路径及局限性。专家组希望本临床路径共识的制订与发布能够对未来CT-FFR技术的临床规范化使用起到积极推动作用。

Anti-angiogenesis and anti-inflammatory effects of Moringa oleifera leaf extract in the early stages of streptozotocin-induced diabetic nephropathy in rats

Objective:To investigate the effect of Moringa oleifera leaf extract on angiogenesis and inflammatory process in a rat model of streptozotocin-induced diabetic nephropathy.Methods:Four weeks after a single injection of 50 mg/kg streptozotocin,rats were treated with 100 or 200 mg/kg/day Moringa oleifera leaf extract,1 mg/kg/day dapagliflozin,or a combination of Moringa oleifera leaf extract and dapagliflozin for further eight weeks.Renal function,kidney histology,and gene expression were evaluated at the end of the experiment.Results:Renal function of diabetic rats was significantly impaired as evidenced by increased blood urea nitrogen,albuminuria,24-h proteinuria,and high creatinine clearance which indicated glomerular hyperfiltration.In addition,diabetic rats showed an increase in gene expressions of vascular endothelial growth factor-A(VEGF-A),angiopoietin-2(Ang2),the Ang2/Ang1 ratio,tumor necrosis factor-α,interleukin-1βand monocyte chemoattractant protein-1.Immunohistochemical staining demonstrated a significant increase in the density of glycoprotein CD34.Moringa oleifera leaf extract markedly improved all renal dysfunction markers and modulated the upregulated expression of angiogenic factors and inflammatory genes.Conclusions:Moringa oleifera leaf extract could suppress abnormal angiogenesis and inflammatory processes possibly by downregulating gene expression of angiogenesis factors and proinflammatory cytokines.

Diffuse coronary artery vasospasm in a patient with subarachnoid hemorrhage: A case report

BACKGROUND Coronary artery vasospasm(CAV)is a reversible,transient form of vasoconstriction with clinical manifestations ranging from stable angina to acute coronary syndromes(ACS).Vasospasm of epicardial coronary arteries or associated micro-vasculature can lead to total or subtotal occlusion and has been demonstrated in nearly 50%of patients undergoing angiography for suspected ACS.The mechanism for CAV has been described in literature,but in a subgroup of patients presenting with intracranial hemorrhage,it appears to be multifactorial.These patients tend to have electrocardiographic changes,elevation of cardiac biomarkers of injury and neurogenic stress cardiomyopathy.CASE SUMMARY A 44-year-old woman presented with severe headaches and tonic-clonic seizures.She was found to have diffuse subarachnoid hemorrhage(SAH)requiring ventricular drain placement,coil embolization and induced hypertension.She subsequently developed chest pain with ST elevations in anterior precordial leads,elevated cardiac enzymes and apical ballooning with left ventricular ejection fraction of 35%on transthoracic echocardiogram.Coronary angiogram revealed severe diffuse triple vessel stenoses secondary to CAV seen distally.Subsequent cardiac MRI notable for apical non-viability and scar formation.CONCLUSION This case highlights a unique etiology of acute myocardial infarction in a patient with SAH leading to ST elevations,diffuse triple vessel CAV and apical scar.

Antihypertensive efficacy of extract of Hedera helix in high salt-induced hypertensive Sprague-Dawley rats

Objective: To explore the antihypertensive effect of extracts from the leaves of Hedera helix(H. helix) on normotensive and hypertensive rats in-vivo followed by vasodilatory studies in-vitro.Methods: The crude methanolic extract was prepared and the activity directed fractionation was carried out. Spectrophotometric analysis of total phenolic and flavonoid content was also done. HPLC analysis was performed for the detection of hederacoside C. In-vivo blood pressure study was carried out in normotensive and high salt-induced hypertensive SpragueDawley rats. Isolated aortic tissues from rat and rabbit were used for in-vitro studies. The effects were recorded and analyzed through PowerL ab data acquisition system. Results: Crude extract of H. helix(1-30 mg/kg) decreased blood pressure to greater extent in high salt-induced hypertensive rats in-vivo compared to the normotensive [Max. fall(58.59±0.02) mm Hg vs.(67.53±3.07) mmH g]. The n-hexane, chloroform, ethyl acetate and aqueous fractions were also checked. These fractions were more effective in hypertensive rats. Aqueous fraction was more potent and n-hexane the least. In isolated rat aortic rings precontracted with phenylephrine, crude extract induced endothelium-dependent effect. The endothelium-dependent component of vasodilatory effect was ablated with L-NAME, and denudation of endothelium. The aqueous fraction was most potent vasodilator. In aortic rings from hypertensive rats, extract and fractions produced partial endothelium-independent effect which was not affected by pretreatment with L-NAME, indicating endothelium dysfunction in the hypertensive rats and suggesting additional vasodilatory mechanisms. In rabbit aorta, the extract and fractions also inhibited phenylephrine and high K^+-induced precontractions, and shifted Ca^(++) concentration–response curves. Conclusions: Our findings indicate that extract and fractions of H. helix are antihypertensive remedies, which is the outcome of vasodilatory effect. This vasodilatory effect is mediated through nitric oxide and Ca^(++) antagonism.

Plasma membrane calcium ATPase proteins as novel regulators of signal transduction pathways

Emerging evidence suggests that plasma membrane calcium ATPases (PMCAs) play a key role as regulators of calcium-triggered signal transduction pathways via interaction with partner proteins. PMCAs regulate these pathways by targeting specific proteins to cellular sub-domains where the levels of intracellular freecalcium are kept low by the calcium ejection properties of PMCAs. According to this model, PMCAs have been shown to interact functionally with the calcium-sensitive proteins neuronal nitric oxide synthase, calmodulindependent serine protein kinase, calcineurin and endothelial nitric oxidase synthase. Transgenic animals with altered expression of PMCAs are being used to evaluate the physiological significance of these interactions. To date, PMCA interactions with calcium-dependent partner proteins have been demonstrated to play a crucial role in the pathophysiology of the cardiovascular system via regulation of the nitric oxide and calcineurin/nuclear factor of activated T cells pathways. This new evidence suggests that PMCAs play a more sophisticated role than the mere ejection of calcium from the cells, by acting as modulators of signaling transduction pathways.

Gene regulatory networks in atrial fibrillation

Atrial fibrillation(AF)is the most frequent arrhythmogenic syndrome in humans.With an estimate incidence of1%-2%in the general population,AF raises up to almost10%-12%in 80+years.Thus,AF represents nowadays a highly prevalent medical problem generating a large economic burden.At the electrophysiological level,distinct mechanisms have been elucidated.Yet,despite its prevalence,the genetic and molecular culprits of this pandemic cardiac electrophysiological abnormality have remained largely obscure.Molecular genetics of AF familiar cases have demonstrated that single nucleotide mutations in distinct genes encoding for ion channels underlie the onset of AF,albeit such alterations only explain a minor subset of patients with AF.In recent years,analyses by means of genome-wide association studies have unraveled a more complex picture of the etiology of AF,pointing out to distinct cardiac-enriched transcription factors,as well as to other regulatory genes.Furthermore a new layer of regulatory mechanisms have emerged,i.e.,post-transcriptional regulation mediated by non-coding RNA,which have been demonstrated to exert pivotal roles in cardiac electrophysiology.In this manuscript,we aim to provide a comprehensive review of the genetic regulatory networks that if impaired exert electrophysiological abnormalities that contribute to the onset,and subsequently,on self-perpetuation of AF.

Hyperbaric Oxygen Treatment in a Diabetic Rat Model Is Associated with a Decrease in Blood Glucose, Regression of Organ Damage and Improvement in Wound Healing

Diabetes leads to widespread complications including pancreatic β-cell damage, nephropathy and impaired wound healing. Hyperbaric oxygen therapy (HBOT) has been shown to improve wound healing through induction of stem cell recruitment and the potential to inhibit progression of diabetic complications. We aimed to determine the efficacy of HBOT in wound healing and organ preservation in a diabetic rat model. Diabetes was induced in male Wistar rats (n = 10/group) using streptozotocin (20 mg/kg sc) daily for 3 days. A wound was inflicted on the skin over the back and the rats were given HBOT (2.3 ATA for 1 h/day) for 1, 3, 5, 7 or 10 days or were not treated. Blood glucose, pancreatic β-cell damage, diabetic nephropathy and wound healing progression were assessed. Diabetic rats not treated with HBOT had significantly higher blood glucose levels compared to controls (26.7 ± 3.3 mmol/L vs. 5.8 ± 0.4 mmol/L;P ≤ 0.05). This was associated with significant increase in the percentage of β-cell damage (72% ± 9% vs. 10% ± 2%;P ≤ 0.05) and diabetic nephropathy. HBOT for 3 days and longer in diabetic rats reduced hyperglycemia to control levels. Pancreatic β-cell damage was negligible in rats treated with HBOT for 5 days and longer while diabetic nephropathy was diminished in animals treated for 10 days. Similarly HBOT induced wound healing and accelerated epithelial closure from 5 days of HBOT. In summary, our findings show the efficacy of HBOT in this diabetic rat model. There was significant reduction of hyperglycemia and inhibition of diabetic complications in the form of preservation of pancreatic and kidney structure and accelerated wound healing.

A Patient with Atezolizumab-Induced Autoimmune Diabetes Mellitus Presenting with Diabetic Ketoacidosis

Background:Atezolizumab,an immune checkpoint inhibitor,is a humanized monoclonal,anti-programmed death ligand 1(PD-L1)antibody used for the treatment of metastatic urothelial carcinoma that has progressed after chemo-therapy.Case Presentation:We describe a patient with a known history of urothelial carcinoma who presented with dia-betic ketoacidosis 6 weeks following his second cycle of atezolizumab.His serum lactate level was slightly elevated(2 mM)and hisβ-hydroxybutyrate level was elevated(3.9 mM).High anion gap metabolic acidosis secondary to dia-betic ketoacidosis was diagnosed.Subsequent testing demonstrated hemoglobin A 1c level of 9.9%,positivity for anti-glutamic acid decarboxylase antibody(0.03 nM,reference range<0.02 nM),and suppressed C-peptide level(0.1μg/L,reference range 0.9-7.1μg/L)in the absence of detectable anti-islet antigen 2(IA-2)or anti-insulin antibodies.His initial management included cessation of atezolizumab treatment,intravenous sodium chloride administration,and insulin pump infusion,after which metabolic acidosis gradually resolved.The insulin pump was subsequently switched to Protaphane at 18 units before breakfast and 8 units before dinner,together with metformin at 1000 mg twice daily.Four weeks later his medication was changed to human isophane insulin plus neutral insulin(70%/30%;Mixtard 30 HM;26 units/4 units).Linagliptin at 5 mg was added 1 month later.His hemoglobin A 1c level declined to 8.1%1 year later.Conclusions:PD-L1 inhibitors can induce type 1 diabetes,and patients can present with diabetic ketoacidosis.Blood glucose levels should be regularly monitored in patients who are prescribed these medications.

充血性心力衰竭预后及治疗效果的种族差异

Background: In congestive heart failure(CHF), it is unknown whether race affects mortality and whether the effect of treatments differs by race. Methods: This study was a post hoc analysis of data from the DIG study that evaluated the effect of digoxin on morbidity and mortality in CHF. Results: Investigators followed 897 black and 6660 white participants for a mean of 37 months. Compared with whites, blacks were younger(60± 13 vs 65± 11 years). Total mortality was 34.2% in blacks and 33.6% in whites; hospitalization for worsening CHF occurred in 39% of blacks and 28% of whites. Cox regressions with race as the only covariate showed no effect of race on risk for death(relative risk=1.04, 95% CI 0.93- 1.18, P=.49)but an increase in CHF hospitalization in blacks(relative risk=1.52, 95% CI 1.35- 1.70, P=.0001). Multivariate Cox regression showed no difference by race in risk for death or death/hospitalization for CHF and no difference in the effect of digoxin on either end point. Conclusion: Race is not an independent predictor of mortality in CHF. The effect of digoxin on morbidity and mortality in CHF does not differ in blacks and whites.

Protective effects of rice bran hydrolysates on heart rate variability,cardiac oxidative stress,and cardiac remodeling in high fat and high fructose diet-fed rats

Objective:To examine the ameliorative effect of rice bran hydrolysates(RBH)on metabolic disorders,cardiac oxidative stress,heart rate variability(HRV),and cardiac structural changes in high fat and high fructose(HFHF)-fed rats.Methods:Male Sprague-Dawley rats were daily fed either standard chow diet with tap water or an HFHF diet with 10%fructose in drinking water over 16 weeks.RBH(500 and 1000 mg/kg/day)was orally administered to the HFHF-diet-fed rats during the last 6 weeks of the study period.At the end of the treatment,metabolic parameters,oxidative stress,HRV,and cardiac structural changes were examined.Results:RBH administration significantly ameliorated metabolic disorders by improving lipid profiles,insulin sensitivity,and hemodynamic parameters.Moreover,RBH restored HRV,as evidenced by decreasing the ratio of low-frequency to highfrequency power of HRV,a marker of autonomic imbalance.Cardiac oxidative stress was also mitigated after RBH supplementation by decreasing cardiac malondialdehyde and protein carbonyl,upregulating eNOS expression,and increasing catalase activity in the heart.Furthermore,RBH mitigated cardiac structural changes by reducing cardiac hypertrophy and myocardial fibrosis in HFHFdiet-fed rats.Conclusions:The present findings suggest that consumption of RBH may exert cardioprotective effects against autonomic imbalances,cardiac oxidative stress,and structural changes in metabolic syndrome.

ST-Segment Depression in Leads I and aVL: Artifactual or Pathophysiological Findings ?

The 12-lead electrocardiogram(ECG)is a routinely performed test but is susceptible to misinterpretation even by experienced physicians.We report a case of a 72-year-old lady with no prior cardiac history presented to our hospital with atypical chest pain.Her initial electrocardiogram shows an initial ST depression followed by positive defl ections leads I and aVL.Non-physiological ST segment and T-wave changes are also observed in the precordial leads V2 to V6.By contrast,these abnormalities are notably absent in lead II.A repeat of the ECG taken 30 minutes later reveals the resolution of most abnormalities seen in the initial ECG on a background of high-frequency noise in the limb leads.She was referred to the cardiology department for further management.An urgent echocardiogram revealed no regional wall motion abnormalities with preserved ejection fraction,and her coronary angiogram revealed no signifi cant coro-nary stenosis.This case illustrates the importance of understanding different factors that can cause ST segment abnor-malities,notably artifactual changes that can mimic ST segment myocardial infarction.

Prognostic value of cardiovascular magnetic resonance in immune checkpoint inhibitor-associated myocarditis:A systematic review and meta-analysis

Background:The role of surgery in metastatic breast cancer(MBC)is currently controversial.Several novel statistical and deep learning(DL)methods promise to infer the suitability of surgery at the individual level.Objective:The objective of this study was to identify the most applicable DL model for determining patients with MBC who could benefit from surgery and the type of surgery required.Methods:We introduced the deep survival regression with mixture effects(DSME),a semi-parametric DL model integrating three causal inference methods.Six models were trained to make individualized treatment recommendations.Patients who received treatments in line with the DL models'recommendations were compared with those who underwent treatments divergent from the recommendations.Inverse probability weighting(IPW)was used to minimize bias.The effects of various features on surgery selection were visualized and quantified using multivariate linear regression and causal inference.Results:In total,5269 female patients with MBC were included.DSME was an independent protective factor,outperforming other models in recommend-ing surgery(IPW-adjusted hazard ratio[HR]=0.39,95%confidence interval[CI]:0.19–0.78)and type of surgery(IPW-adjusted HR=0.66,95%CI:0.48–0.93).DSME was superior to other models and traditional guidelines,suggesting a higher proportion of patients benefiting from surgery,especially breast-conserving surgery.The debiased effect of patient characteristics,including age,tumor size,metastatic sites,lymph node status,and breast cancer subtypes,on surgery decision was also quantified.Conclusions:Our findings suggested that DSME could effectively identify patients with MBC likely to benefit from surgery and the specific type of surgery needed.This method can facilitate the development of efficient,reliable treatment recommendation systems and provide quantifiable evidence for decision-making.

Efficacy of vasopressin, steroid, and epinephrine protocol for in-hospital cardiac arrest resuscitation: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis

OBJECTIVES To assess the effect of vasopressin,steroid and epinephrine(VSE)combination therapy on return of spontan-eous circulation(ROSC)after in-hospital cardiac arrest(IHCA),and test the conclusiveness of evidence using trial sequential ana-lysis(TSA).METHODS The systematic search included PubMed,EMBASE,Scopus,and Cochrane Central Register of Controlled Trials.Randomized controlled trials(RCTs)that included adult patients with IHCA,with at least one group receiving combined VSE therapy were selected.Data was extracted independently by two reviewers.The main outcome of interest was ROSC.Other out-comes included survival to hospital discharge or survival to 30 and 90 days,with good neurological outcomes.RESULTS We included a total of three RCTs(n=869).Results showed that VSE combination therapy increased ROSC(risk ra-tio=1.41;95%CI:1.25-1.59)as compared to placebo.TSA demonstrated that the existing evidence is conclusive.This was also validated by the alpha-spending adjusted relative risk(1.32[1.16,1.49],P<0.0001).Other outcomes could not be meta-analysed due to differences in timeframe in the included studies.CONCLUSIONS VSE combination therapy administered in cardiopulmonary resuscitation led to improved rates of ROSC.Fu-ture trials of VSE therapy should evaluate survival to hospital discharge,neurological function and long-term survival.

The impact of post-operative atrial fibrillation on outcomes in coronary artery bypass graft and combined procedures

BACKGROUND Postoperative atrial fibrillation(POAF)is a common yet understudied clinical issue after coronary artery bypass graft(CABG)leading to higher mortality rates and stroke.This systematic review and metaanalysis evaluated the rates of adverse outcomes between patients with and without POAF in patients treated with CABG or combined procedures.METHODS The search period was from the beginning of PubMed and Embase to May 18th,2020 with no language restrictions.The inclusion criteria were:(1)studies comparing new onset atrial fibrillation before or after revascularization vs.no new onset AF before or after revascularization.The outcomes assessed included allcause mortality,cardiac death,cerebral vascular accident(CVA),myocardial infarction(MI),repeated revascularization,major adverse cardiac event(MACE),and major adverse cardiac and cerebrovascular events(MACCEs).RESULTS Of the 7,279 entries screened,11 studies comprising of 57,384 patients were included.Compared to nonPOAF,POAF was significantly associated with higher risk of allcause mortality(Risk Ratio(RR)=1.58;95%Confidence Interval(CI):1.42−1.76,P<0.00001)with accompanying high level of heterogeneity(I^(2)=62%).Conclusions Patients with POAF after CABG or combined procedures are at an increased risk of allcause mortality or CVAs.Therefore,POAF after such procedures should be closely monitored and treated judiciously to minimize risk of further complications.While there are studies on POAF versus no POAF on outcomes,the heterogeneity suggests that further studies are needed.

Association of electrocardiographic markers with myocardial fibrosis as assessed by cardiac magnetic resonance in different clinical settings

BACKGROUND Cardiac magnetic resonance(CMR)is a unique tool for non-invasive tissue characterization,especially for identifying fibrosis.AIM To present the existing data regarding the association of electrocardiographic(ECG)markers with myocardial fibrosis identified by CMR-late gadolinium enhancement(LGE).METHODS A systematic search was performed for identifying the relevant studies in Medline and Cochrane databases through February 2021.In addition,we conducted a relevant search by Reference Citation Analysis(RCA)(https://www.referencecitationanalysis.com).RESULTS A total of 32 studies were included.In hypertrophic cardiomyopathy(HCM),fragmented QRS(fQRS)is related to the presence and extent of myocardial fibrosis.fQRS and abnormal Q waves are associated with LGE in ischemic cardiomyopathy patients,while fQRS has also been related to fibrosis in myocarditis.Selvester score,abnormal Q waves,and notched QRS have also been associated with LGE.Repolarization abnormalities as reflected by increased Tp-Te,negative Twaves,and higher QT dispersion are related to myocardial fibrosis in HCM patients.In patients with Duchenne muscular dystrophy,a significant correlation between fQRS and the amount of myocardial fibrosis as assessed by LGE-CMR was observed.In atrial fibrillation patients,advanced inter-atrial block is defined as P-wave duration≥120 ms,and biphasic morphology in inferior leads is related to left atrial fibrosis.CONCLUSION Myocardial fibrosis,a reliable marker of prognosis in a broad spectrum of cardiovascular diseases,can be easily understood with an easily applicable ECG.However,more data is needed on a specific disease basis to study the association of ECG markers and myocardial fibrosis as depicted by CMR.

老年人体外反搏临床应用中国专家共识(2019)

增强型体外反搏作为一项无创辅助循环技术,在心绞痛、心力衰竭、缺血性脑血管病、神经系统变性疾病、睡眠障碍、糖尿病及其并发症、眼部缺血性疾病、突发性耳聋、男性勃起功能障碍、心理精神疾病等老年人多系统疾病防治中积累了丰富的循证医学证据。老年患者行体外反搏治疗,需进行安全评估并注意风险把控,根据病情制定个体化治疗方案,并注重指标监测和疗效评价。

新型冠状病毒肺炎肺部超声检查及远程诊断实施方案(第一版)

2019年12月以来,湖北省武汉市发生的新型冠状病毒肺炎已成为全国突发公共卫生事件。目前确认该疾病诊断的影像学主要依据为高分辨率CT的影像学征象。肺部超声在肺渗出性病变的鉴别诊断、胸腔积液的评估、气胸识别、呼吸困难与急性呼吸衰竭患者的评价以及在治疗中监测、疗效评估和指导治疗等方面已应用于临床,并已形成多个国内外专家共识。

新型冠状病毒肺炎床旁超声心动图检查及远程诊断实施建议(第一版)

2019年12月湖北省武汉市发生的新型冠状病毒肺炎(corona virus disease 2019,COVID-19)已成为全国突发公共卫生事件。已知2019新型冠状病毒(2019 novel coronavirus,2019-nCoV)与我国2003年导致严重急性呼吸综合征暴发的病毒均属于同一类冠状病毒,主要导致肺组织炎症,可快速进展为急性呼吸窘迫综合征和肺功能衰竭[1]。