ObjectiveTo investigate the encountered life events in patients with tuberculosis within 1 year before the attack.MethodsThe encountered life events within 1 year before the attack were investigated in 85 patients with tuberculosis, the life event frequency (LEF) and life event intensity (LEI) were calculated respectively, and the life events were compared with those within 1 year in 55 healthy subjects.Results71 cases (83.5%) of the 85 patients with tuberculosis had encountered different life events within 1 year before the attack, which was significantly different from that in the control group (9 cases, 16.4%) (χ2=12.351,P<0.01 ). The LEF, negative LEF, average LEI, average negative LEI in the tuberculosis group before the attack were obviously higher than those in the control group (P<0.05～0.01), but there were no significant differences in the positive LEF and average positive LEI between the two groups (P>0.05).ConclusionThe encountered life events are closely correlated with primary tuberculosis, so more mental cares should be paid to the patients.

Bacteremia ; microbiology ; Female ; Humans ; Infant ; Pseudomonas Infections ; pathology ; Pseudomonas aeruginosa

South East Asia has 8% of world population, but only has 2% of the total number of neurologists in the world. Seven of the 11 countries in South East Asia have training programmes in Neurology. Brunei, Laos, Malaysia, Myanmar and Singapore require prior training and certification in Internal Medicine before admission to training to Neurology. Most training programmes are 3 years in duration, inclusive of mandatory rotation to clinical neurophysiology. Assessment and certification processes are vigorous in most countries. Mature age, lack of funding, inadequate direct clinical responsibilities, and poor literacy in English are other issues in some of the countries. There is need to improve the quality as well as quantity in the training of neurologists in the region.
Training ; Certification ; Asia, Southeastern ; Clinical ; Training Programs

The case report describes the presentation of a 19-year old female with tuberous sclerosis who presented with progressive dyspnoea over 2 days. Chest radiograph revealed bilateral pneumothorax. Computed tomography showed features of pulmonary lymphangioleiomyomatosis and bilateral renal angiomyolipomas. The coexistence of both conditions may cause devastating morbidity and mortality.

The family physician has the monumental task of deciding if a pediatric patient can be treated as an outpatient or needs to be referred to the hospital for further acute care. Some common conditions that may be discharged without referral include the stable child with a minor head injury and balanitis. Others may be complicated by decompensated gastroenteritis or serious bacterial infections such as unstable pneumonia and urinary tract infection in the very young. The younger the child, the more subtle the signs and symptoms are. There is also a higher incidence of congenital conditions like pyloric stenosis in the very young that are unique in this population group. This article summarises such conditions with helpful hints on recognition of abnormal vital signs, and seeks to act as a guide to assist the family physician who may face these patients in his daily practice.

The family physician has the monumental task of deciding if a pediatric patient can be treated as an outpatient or needs to be referred to the hospital for further acute care. Some common conditions that may be discharged without referral include the stable child with a minor head injury and balanitis. Others may be complicated by decompensated gastroenteritis or serious bacterial infections such as unstable pneumonia and urinary tract infection in the very young. The younger the child, the more subtle the signs and symptoms are. There is also a higher incidence of congenital conditions like pyloric stenosis in the very young that are unique in this population group. This article summarises such conditions with helpful hints on recognition of abnormal vital signs, and seeks to act as a guide to assist the family physician who may face these patients in his daily practice.

Objective To observe the efficacy and safety of the etomidate target controlled in-fusion (TCI)in the total thoracoscopic mitral valve replacement surgery.Methods One hundred and ten patients,aged 29-55 years,48 males and 62 females with ASA grade Ⅱ or Ⅲ rheumatic mitral valve disease planned to be corrected with total thoracoscopic mitral valve replacement surgery were randomly divided into group E and group P,55 cases in each group.In group E,etomidate-sufentanil target controlled infusion was used for induction (the initiate plasma concentration of etomidate was 0.2 ng/ml and increased 0.1 ng/ml per minute according to the bispectral index and the effect-site concentration of sufentanil was maintained at 1.0 ng/ml)and maintenance.In group P,using propo-fol-sufentanil target controlled infusion for induction (the initiate plasma concentration of propofol was 1.0 ng/ml and increased 0.3 ng/ml per minute according to the bispectral index and the effect-site concentration of sufentanil was maintained at 1.0 ng/ml)and maintenance.We documented the incidence of hypotension during the induction phase, recorded the basic clinical parameters of patients,the dosage of vasopressors during induction and sufentanil during anesthesia,time of eyelash reflex absence,operation time,CPB time,clamping time,APACHE Ⅱ score when enter CCU,pos-itive inotropic score 24 h postoperatively,wakening time,mechanical ventilation time,CCU stay,in-hospital stay,blood glucose and lactic acid preoperatively,2,6,24 h postoperatively,cortisol,aldo-sterone and adrenocorticotropin preoperatively and 24 h postoperatively and postoperative complications in both groups.Results The incidence of hypotension during induction in group E was much lower than that in group P (P<0.05).The dosage of norepinephrine during the induction in group E were much less than group P (P <0.05).The wakening time,mechanical ventilation time,CCU stay and in-hospital stay in group E were significantly shorter than group P (P <0.05).The blood glucose and lactic acid at postoperative 2,6,24 h were much higher than the preoperative value within each group (P <0.05).They reached the maxim at 6 h postoperatively and began to decline at 24 h postoperatively. Blood glucose and lactic acid at all the time points between two groups were similar.Cortisol at 24 h postoperatively was much higher than the preoperative value in group P (P <0.05).The dosage of cortisol and aldosterone 24 h postoperatively in group E were much less than that in group P (P <0.05).The incidence of postoperative lung infection in hospital in group E was remarkably lower than that in group P (P <0.05).Conclusion Etomidate target controlled infusion can maintain stable he-modynamics during the induction period, shorten postoperative recovery time and reduce postoperative lung infection obviously,which can be safely used in total thoracoscopic mitral valve re-placement surgery.

ObjectiveTheaimofthisstudywastoprovideabetterpositivecontrolforallergictestbycomparing the allergic effect of two kinds of positive materials , human albumin and ovalbumin , on active systemic anaphylaxis in guinea pig.Methods Guinea pigs were randomly divided into 14 groups, and were given human albumin , ovalbumin (2, 10, 100 mg/animal), or 0.9%sodium chloride injection as test substances , to assess the symptoms and incidence of systemic allergic responses induced by different sensitizing substances in different challenge doses and different challenge intervals.Results In the range of 2 to 100 mg/animal, the guinea pigs showed a 100%incidence rate of positive allergic reaction to human albumin and ovalbumin , the severity of anaphylactic symptoms was increasing along with the increase of sensitizing doses and challenge doses , and the allergic reaction was more strong induced by the same dose of ovalbumin than human albumin .Conclusions Our findings indicate that in the active systemic anaphylaxis test in guinea pigs , we recommend ovalbumin as the positive control in a dose of 2 mg/animal.

Objective To observe the efficacy of pregabalin in the treatment of painful diabeticperipheral neuropathy.Methods In a 8-week study,50 patients were randomly assigned into two groups:the therapy group and the control group.The patients in the therapy group were treated with pregabalin 150 mg/d,and the patients in the control group were treated with carbamazepine 200 mg/d.The dose of pregabalin was increased to 300 mg/d till pain was alleviated in the therapy group,and the dose of carbamazepine was increased to 600 mg/d till pain was alleviated in the control group.The therapeutic effect and VAS score in the two groups were observed and evaluated.Results After 1 and 8 weeks' treatment,the therapeutic effect of therapy group were significantly superior to the control group ( At 1 week:U =2.028,P =0.046 ; At 8 week:U =3.540,P ＜0.001 ).After 1 and 8 weeks' treatment,the VAS scores of therapy group were significantly lower than the control group ( At 1 week:5.13 ± 1.76 vs.6.74 ± 1.52,P ＜ 0.05 ; At 8 week:1.13 ± 0.45 vs 3.27 ± 1.04,P ＜ 0.05).There were 5 patients (20％) and 10 patients (40％) had adverse reaction in the therapy and the control groups respectively.Conclusion Pregabalin is effective and safe for the treatment of painful diabetic peripheral neuropathy.

Intrauterine growth retardation (IUGR) is one of the most commonly encountered developmental toxicity, which could lead to perinatal morbidity and mortality, be also extended from the fetus to adulthood, and seriously affect the quality of the population. Caffeine widely exists in a variety of daily beverages and some drugs. Its consumption is increasing year by year. Caffeine intake during pregnancy is one of the risk factors for IUGR. However, its mechanism of adverse outcome based on embryonic research is still unclear. In this paper, the possible mechanisms of caffeine-induced IUGR focusing on 3 important factors-the mother, placenta and fetus were explored. Caffeine's impact on the mother is the chronic activation of renin-angiotensin system; on the placenta, caffeine induces cell damage or the failure of the cell proliferation/apoptosis balance, leading to blockage of blood supply to the placenta; caffeine is also capable of directly affecting fetal development through interfering its neuroendocrine.