Culture ; Drugs, Chinese Herbal ; standards ; Evidence-Based Medicine ; Humans ; Medicine, Chinese Traditional ; Singapore

Objective To establish a diagnostic scoring system for diabetic patients with smear-negative pulmonary tuberculosis , and then to improve the rapidity and accuracy of clinical diagnosis and save medical expenses. Methods A case-control study was applied. 150 diabetic patients with smear-positive pulmonary tuberculosis who on initial treatment were assigned to a study group; 150 patients with lung infection were recruited as a study group. The data on general status, symptoms, chest X-ray manifestation, and laboratory examinations was collected. Univariate logistic regression analysis was used to gain significant indexes for multiple logistic regression analysis. β-coefficients derived from the independent predictors in our logistic regression model was applied to develop a scoring system. Results Toxic symptoms of tuberculosis, cough, upper lung, cavity, multiple lung field , and PPD positive entered into the final multipie logistic regression model , and the scoring system was accordingly established. The patient with a score of more than 11 had higher probability of TB , while those with a score of smaller than 11 were not likely to have TB. Conclusion The scoring system can be used as a predictive tool in diagnosis of diabetes mellitus complicated by smear-negative pulmonary tuberculosis , helping diagnose active tuberculosis rapidly.

The onset of stroke is related to the deficiency of kidney water, internal stirring of liver wind, disorder of brain marrow, and blood. They are in evolutionary relationship. The disorder of kidney-liver-brain axis is the core pathogenesis of stroke. In the aspect of meridian and function, the Du meridian is closely related to the kidney, liver and brain. Acupuncture on the Du meridian to regulate the kidney-liver-brain axis is an effective method in the treatment of stroke. The clinical practice and research have proved that DU20-Baihui and DU14-Dazhu are im-portant acupoints in the treatment of stroke.

Ultrasound, as a mechanical wave with frequencies > 20 kHz, needs an elastic medium to transmit energy, and it can safely penetrate into the tissues without significant attenuation. Sonodynamic therapy is a new noninvasive therapy based on ultrasound, and it mainly uses low-intensity ultrasound to activate sonosensitizers to produce cytotoxic reactive oxygen species to kill cells. Compared with photodynamic therapy, sonodynamic therapy overcomes the limitation of low penetration depth of light for deep tumors. In addition, sonodynamic therapy can be combined with photothermal therapy, chemotherapy, immunotherapy and gas therapy for synergistic therapy of tumors. This review aims to discuss the latest development of sonodynamic therapy in the field of tumor treatment.

Objective To find the way of predicting invasive blood pressure.Methods 47 subjects were enrolled into the study.Non-invasive blood pressure (NBP) measurements were performed by the oscillometric device.The corresponding invasive blood pressure (IBP) reading was obtained from a radial intra-arterial catheter on the same arm.The index of the blood vessel structure was measured by two-dimensional ultrasound,homodynamic parameters of carotid and radial artery were measured by using the color Doppler ultrasound.Linear relation between IBP and NBP,as well as IBP and indices measured by non-invasive methods Was analyzed by regression method. Canonical correlation analysis was also conducted to find out the potential predictive factors of invasive blood pressure. Results The regression equation was:Y=17.21-64.357X1+2.802X2+1.324X3(Yrepresents ISBP,Xl represents RRI,X2 represents RPI,X3 represents NSBP).The first canonical correlation coefficients can be explained the correlation between index measured by non-invasive methods and invasive blood pressure.Conclusion Invasive blood pressure can be predicted from non-invasive blood pressure and hemodynamic parameters.In addition to noninvasive systolic hlood pressure and radial artery resistance index.the potential predictive factors of invasive blood pressure includes explmned by non-invasive diastolic blood pressure,radial pulsating index,carotid shear rate and carotid peak systolic velocity.

Objective To study the clinical features of juvenile primary fibromyalgia syndrome (FMS). Methods Six patients with juvenile primary FMS were registered in the department. Their clinical data were assessed and compared with 36 patients with adults FMS. Results Abdominal pain was the first symptom in five of six juvenile primary FMS, diffuse aching and left knee pain were the first symptoms in one of six patients. All were misdiagnosed prior to their rheumatological evaluation. Diffuse aching, fatigue, sleep disturbances, illness changes with weather and feeling worse with exercise were existed in six juvenile FMS patients (100%), the mean pain score was 8.8 and the mean initial tender point (TP) was 13.7. Arthrodynia, subjective joint swelling, abdominal pain, irritable bowel symptoms and urinary urgency were existed in five of six patients (83%). Dysmenorrhea was present in 4(67%), depression in 3 (50%), morning stiffness in 2 (33%), paresthesias in 2 (33%) and anxiety in 2 (33%) respectively. There was no difference compared with adults FMS. Conclusion Juvenile primary FMS is a common disease and clinicians should pay more attention to it to avoid misdiagnosis.

Child ; Cranial Nerves ; pathology ; Eyelids ; Female ; Humans ; Male ; Ophthalmoplegia ; etiology ; Polyradiculopathy ; complications

Given the stressful demands of their work, primary care physicians are susceptible to experiencing burnout. Evidence-based strategies to effectively manage emotions at work are essential to preventing physician burnout. This article details the role of emotional regulation in a physician’s workplace, a model for understanding the processes underlying emotion regulation, and the theorised pathways to emotion dysregulation. Finally, this article provides strategies to assist the physician in practicing regular adaptive emotion regulation so as to reduce burnout.

Adolescent ; Adult ; Apgar Score ; Birth Weight ; Breast Feeding ; Congenital Abnormalities ; epidemiology ; Delivery, Obstetric ; Female ; Humans ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases ; epidemiology ; Male ; Mass Screening ; Middle Aged ; Singapore

Objective To explore the effect of glutamine on immune function of rat with obstructive jaundice and its possible mechanism. Methods Fifty male Wistar rats were randomly divided into three groups: Control group (n=10), obstructive jaundice group (n=20) and glutamine treatment group (n=20). The serum concentration of TNF-?, IL-10 was detected by using radioimmune method. Liver function was measured through automated biochemistry analyzer. The animal model of obstructive jaundice was established by ligating the rat's common bile duct. Bacteria cultures were performed with the rat's tissues of lung, spleen, liver and kidney respectively. Resu- lts Compared with control group, obstructive jaundice group showed statistically lower serum level of TNF-?, and statistically higher serum level of IL-10, TBIL, ALT and AST during the first and the second week after ligation of common bile duct. During the first and second week after administration of glutamine, the serum TNF-? of glutamine treatment group was statistically higher than that in control group and obstructive jaundice group. Meanwhile, glutamine treatment group showed statistically lower serum level of IL-10, TBIL, ALT and AST than obstructive jaundice group. There were statistically less bacteria translocations in glutamine treatment group than those in obstructive jaundice group. Conclusion Glutamine can increase the immune function by changing serum concentration of TNF-?, IL-10 and decrease the bacteria translocation.