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.

Hip arthrograghy is a valuable procedure for visualization of the intrinsic obstructive factors impeding closed reduction and for critical assessment of quality of reduction in developmental dislocation of the hip. The authors have analyzed 25 cases of developmentally dislocated hips in 24 patients who have been followed up for more than 1 year postoperatively by roentgenographies and arthrographies. Among them 16 cases in 16 patients who had been treated by closed reduction according to acceptable quality of initial reduction were studied to estimate a value of arthrography and to evaluate an outcome of closed rediction performed on the base of an arthrographic finding. The following results were obtained. 1. The frequency of the common arthrographic observations were assessed. Medial dye columns identifying the depth of reduction were observed 25 cases(100%), configuration of osteocartilaginous structures in 24 cases(96.0%), limbus in 24 cases(96.0%), and ligamentum teres in 18cases(75.0%). 2. Good closed reduction classified according to Race and Herring on initial arthrography was associated with rapid improvement of acetabular angle and the CE angle and low incidence of avascular necrosis, compared with adequate or poor reduction. 3. In cases of initial good and adequate reductions, initial AP arthrograms showed some dye filling shadows owing to folding or redundancy of lax joint capsule of the dislocated hip after reduction just lateral to the limbus, of which finding decreased markedly on the second arthrograms. 4. The widths of medial dye column decreased with time during the first postoperative 7 weeks by an average of 0.5mm in cases with initial good quality of reduction, 3.5mm in adequate reductions and 0.5mm in poor reductions. 5. In cases with adequate closed reduction on initial arthrogram, but without substantial decrease in width of medial dye column on the second arthogram the outcome was poor. In those cases with decrease in width of medial dye column on the second arthrogram compared with initial arthogram, the shorter the period of immobilization in a plaster cast was, the worse eventual result was. 6. We think that hip arthography is a helpful procedure for visualization of obstacle obstructing closed reduction and for determination of treatment modality in developmental dislocation of the hip.
Acetabulum ; Arthrography ; Casts, Surgical ; Continental Population Groups ; Dislocations ; Hip ; Humans ; Immobilization ; Incidence ; Joint Capsule ; Necrosis ; Round Ligaments

· AlM:To analyze the association between the macular thickness and emmetropic, low myopic, moderate myopic and highly myopic eyes.
·METHODS:The 276 teenagers (276 eyes) between 18~28 years treated in our hospital from January, 2013 to May, 2014 were selected, whose corrective visual acuity was≥1.0 and intraocular preasure was ≤21mmHg and who were willing to participate in this research.Forty-nine emmetropic, 72 low myopic, 104 moderate myopic and 51 highly myopic eyes were measured by optical coherence tomography ( OCT ) to detect the central subfield thickness, bitamporal, superior, lateral and inferior region thickness of inner and outer region, average thickness of retinal macula, foveal thickness and retinal volume.The thickness of different parts of macula lutea was measured and statistically compared among emmetropic, low myopic, moderate myopic and highly myopic eyes.
· RESULTS: The central subfield thickness of emmetropic, low myopic, moderate myopic and highly myopic eyes were (225.38±20.97), (230.97±19.15), (227.01±16.92), (231.91 ±18.97 )μm. The average thickness of retinal macula, of emmetropic, low myopic, moderate myopic and highly myopic eyes were (280.92±12.71), (278.15± 11.90), (270.05±12.07), (267.93±11.08) μm.There were no significant differences of center thickness (F=1.253, P=0.291) and central subfield thickness ( F=1.034, P=0.378) between emmetropic, low myopic, moderate myopic and highly myopic eyes.The macular thickness of inner and outer region in moderate myopic eyes was significantly less than that in emmetropic eyes, and there was significant difference (P<0.05).Comparison between low myopic, moderate myopic and highly myopic eyes was carried out and macular thickness of all regions of inner and outer region in moderate myopic group was significantly increased, and there was significant difference (P<0.05).There was no significant difference when compared with the macular thickness of inner and outer region of the highly myopic group (P>0.05).
· CONCLUSlON: ln low myopic eyes of teenagers, the center macular thickness do not become thinner. However, the macular thickness of inner and outer region is thinner than that of emmetropic eyes.Furthermore, with the increase of the degree of the myopia, the amount of macular thinner gradually decreases from outer region to inner region.

The Ilizarov technique has been used successfully in the treatment of nonunion of long bone accompanied by infection, severe bone and soft tissue defects, and deformity. We report the results of treatment of 21 cases of nonunion using the Ilizarov technique. There were 20 males and 1 female with an average age of 34.2 years (range, 8-72 years). The average follow up period was 45 months (range, 12-74months). Infected nonunion(15/21 cases) was the most common cause of nonunion. The treatment methods include simple compression method(4 cases) and internal and external bone transport method(17 cases). Bony union was achieved in 20 cases out of 21 cases. One case is still having difficulty in achieving union. The mean time to union was 7.3 months in femurs and 6.3 months in tibias. The amount of bone defect that developed after the removal of infected bone fragments and soft tissue averaged 3.8cm (range, 2.3-9cm). The healing index, in cases of bone transport, was an average of 45 days per cm (range, 30-62 days per cm). Complications developed in 17 cases out of 21 cases. Pin site infection occurred in 5 cases, premature consolidation in ~1 case, angulation deformity in 2 cases, LOM of the knee in 2 cases, equinus deformity in 2 cases, ankle stiffness in 3 cases, and nonunion in 1 case. The Ilizarov technique is thought to be effective in the treatment of complicated nonunion combined with shortening, deformity, bone defect and infection. However, in order to reduce complications caused by the Ilizarov method, accurate surgical techniques and postoperative care are necessary.
Ankle ; Congenital Abnormalities ; Equinus Deformity ; External Fixators* ; Female ; Femur ; Follow-Up Studies ; Humans ; Ilizarov Technique ; Knee ; Male ; Postoperative Care ; Tibia

In the treatment of DDH, generally we have used the acetabular index (AI) and the center-edge (CE) angle as diagnostic factors for hip dysplasia. However, it is sometimes difficult to mark the exact lateral edge of the acetabulum to measure these factors due to indistinct bony shadows on the image of the dysplastic hip. The purpose of this study was to evaluate the lateral edge of the acetabulum to determine the location of the most accurate marking point on the plain radiograph. Using plain radiograph, we studied 53 patients with DDH which were treated with closed reduction. 26 patients were studied using plain radiograph and another method: 16 patients with 3- DCT, 4 patients with MRI, and 6 patients with arthrograph. According to this study, the most lateral bony margin of the acetabular roof on the plain radiograph indicates the antero-lateral portion of the acetabulum. The lateral edge of the sourcil indicates the lateral margin of the centro-lateral (mid-superior) portion of the acetabulum. The marking point on the lateral end of the sourcil reflects a dysplastic condition of the acetabulum, especially in the mid-superior portion of the acetabulum.
Acetabulum* ; Hip ; Hip Dislocation ; Humans ; Magnetic Resonance Imaging