Objective To study the effect of positive pressure ventilation extubation on arterial blood gas indexes of patients undergoing cardiac surgery. Methods 50 patients with orotracheal intubation after intracardiac opening operation under direct vision were randomly divided into the control group and the experimental group with 25 cases in each group. We used traditional method to pull out tracheal intubation in the control group. And positive pressure ventilation at 5 ～15 cm H2O during inspiration and pulling out tracheal intubation during expiration in the experimental group. The change of arterial blood PaO2, PaCO2, SaO2, pH and respiratory rate before and 1min、5min、10min after extubation was observed,and also the incidence rate of air tube obstruction was recorded. Results The change amplitude of arterial blood gas indexes of patients in the experimental group was obviously lower,and the length of change time reduced more than 50%. There were 4 air tube obstructions in the control group and there was no obstruction in the experimental group. The difference was statistically significant. Conclusions Positive pressure ventilation extubation can raise lung's compliance and improve oxygenation. And arterial blood gas indexes are more stable. It can decrease the incidence rate of hypoxemia and is a much more safe method.

Objective To study the clinical features of senile salivary gland neoplasms. Methods A total of 104 cases of senile (beyond 60 years old) salivary gland tumors treated in the past 15 years were analysed. Results Among the 104 cases of senile salivary gland tumors, benigns(85.6%) was more than malignants; males(76.0%) was more than females, the ratio of M∶F was about 1.5∶1. Seventy-two cases(69.2%) were from the parotid gland, 19 (18.3%) from the submandibular gland, 6 (5.8%) from the sublingual gland, 7 cases(6.7%) from the minor salivary gland. Warthin tumor (34 cases) accounted for 32.7%(34/104) of all senile salivary gland tumors, and 47.2%(34/72) of senile parotid gland tumors, 54.8%(34/62) of benign parotid gland tumors. Conclusions The senile salivary gland tumor were mainly benign tumor; Warthim tumor is the most commonly seen and the parotid gland is the most frequently targeted organ. The incidence in males is higher than in females, patients at 60-70 years old (76.0%) are the main victims. Regional excision of parotid gland (resection of tumor together with its surrounding glands) was efficient for surgical treatment in the elderly.

Sudden unexpected death in epilepsy (SUDEP) refers to sudden, unpredictable and unexplained death of seemingly healthy individuals with epilepsy, which is an important reason for the higher risk of death in patients with epilepsy than in the general population. The risk factors of SUDEP include poor seizure control, nocturnal seizures, prone position, antiepileptic drugs and comorbidities. SUDEP has become a major public health problem. The latest progress in the definition, incidence, risk factors, mechanism and preventive methods of SUDEP were reviewed in this article.

OBJECTIVETo analyze mutations of IDUA gene in two pedigrees affected with mucopolysaccharidosis type I and provide prenatal diagnosis for them.

METHODSThe 14 exons of the IDUA gene were subjected to PCR amplification and Sanger sequencing.

RESULTSFor pedigree 1, the proband was found to harbor compound heterozygous mutations c.46-57delTCGCTCCTGGCC (p.Ser16_Ala19del) of exon 1 and c.1147delC (p.Arg383Alafs*57) of exon 8 of the IDUA gene, which were inherited from his father and mother, respectively. The latter was unreported previously. Prenatal diagnosis suggested that the fetus has carried a heterozygous c.46-57delTCGCTCCTGGCC mutation. For family 2, the proband was also found to carry compound mutations of the IDUA gene, namely c.721T to C (p.Cys241Arg) of exon 6 and c.1491delG (p.Thr497fs27) of exon 8, which were inherited from her mother and father, respectively. Neither mutation was reported previously. Prenatal diagnosis suggested that the fetus has carried a heterozygous c.721T to C mutation.

CONCLUSIONMutations of the IDUA gene probably underlie the MPS-I in both pedigrees. Above results have enriched the spectrum of IDUA gene mutations and facilitated prenatal diagnosis for both families.

Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child ; Child, Preschool ; China ; DNA Mutational Analysis ; Female ; Fetal Diseases ; diagnosis ; genetics ; Heterozygote ; Humans ; Iduronidase ; genetics ; Male ; Molecular Sequence Data ; Mucopolysaccharidosis I ; diagnosis ; embryology ; genetics ; Pedigree ; Pregnancy ; Prenatal Diagnosis ; Sequence Deletion

INTRODUCTIONVancomycin-resistant enterococci (VRE) have emerged as one of the major nosocomial antimicrobial-resistant pathogens globally. In this article, we describe the epidemiology of VRE in Singaporean public hospitals in the 5 years following the major local VRE outbreak in 2005.

MATERIALS AND METHODSA passive laboratory surveillance programme identified non-duplicate VRE isolates from 7 hospitals from 2006 to 2010. Descriptive statistics and time-series analysis was performed on all clinical VRE isolates for each individual hospital as well as for the combined dataset.

RESULTSThere were a total of 418 VRE isolates over 5 years, of which 102 isolates (24.4%) were from clinical cultures. Between 0.4% and 0.7% of all clinical enterococcal isolates were resistant to vancomycin. The overall incidence-density of VRE did not change over time in Singapore despite 2 separate outbreaks in tertiary hospitals in 2009 and 2010. Incidence-density of clinical VRE cases fell in 2 secondary hospitals, while another 2 hospitals experienced no significant VRE infections after 2008.

CONCLUSIONThe prevalence of VRE clinical isolates remains low in Singaporean public sector hospitals. However, the presence of at least 2 outbreaks in separate hospitals over the past 5 years indicates the need for continued vigilance in order to prevent any further increase in VRE prevalence locally.

Anti-Bacterial Agents ; pharmacology ; Cross Infection ; epidemiology ; Enterococcus ; drug effects ; isolation & purification ; Gram-Positive Bacterial Infections ; drug therapy ; Hospitals, Public ; Humans ; Population Surveillance ; Singapore ; epidemiology ; Vancomycin ; therapeutic use ; Vancomycin Resistance ; drug effects

Objective To explore the approach to establish a temporal lobe epilepsy model via intraperitoneal pilocarpine injection in C57BL/6J mice,and to summarize behavioral indicators predicting successful modeling during the acute phase of epileptic seizures after pilocarpine administration,aiming to offer a practical mice model for future epilepsy research.Methods Thirty C57BL/6J substrain mice(primary subjects)and forty C57BL/6N substrain mice(control subjects)were selected to establish a temporal lobe epilepsy model by inducing seizures through a single intraperitoneal injection of pilocarpine.The mice from the two substrains were each divided into 3 groups,and were injected intraperitoneally with 300 mg/kg,330 mg/kg,or 360 mg/kg of pilocarpine,respectively.Motor seizure behaviors were observed and compared between the two substrains of C57BL/6 mice post pilocarpine injection,and the spontaneous recurrent seizures(SRS)were continuously monitored from the 7th day after injection.On the 28th day post-injection,the mice were euthanized and the histopathological changes in their hippocampi were examined.Results After pilocarpine administration,C57BL/6N mice displayed characteristic motor seizures followed by the onset of status epilepticus(SE).Conversely,C57BL/6J mice showed fewer instances of typical motor seizure behavior and the subsequent SE.Instead,they more often exhibited systemic tremors lasting several seconds to tens of seconds following limb twitching.This behavior is classified as"severe seizure(SS)"in current study.Following intraperitoneal injection of 330 mg/kg and 360 mg/kg pilocarpine,C57BL/6J mice displaying SS during the acute phase of seizure might exhibit SRS after a latency period.The percentage of spontaneous seizures observed in C57BL/6J mice post-modeling(70% )was comparable to that seen in C57BL/6N mice(75% )which developed SRS subsequent to SE.C57BL/6J mice displayed characteristic pathological alterations associated with temporal lobe epilepsy in the hippocampi after 28 d following pilocarpine injection,including increased mossy fiber sprouting and neuronal death.Conclusions When inducing an epilepsy model via intraperitoneal pilocarpine injection in C57BL/6J mice,the behavioral criteria to predict the successful establishment of the model could be either the occurrence of SE or the manifestation of SS.