Prophylactic control of post‐operative nausea and vomiting using ondansetron and ramosetron after cardiac surgery

Background: The aim of this study was to evaluate the efficacy of ondansetron and ramosetron in the reduction of post‐operative nausea and vomiting (PONV) associated with patient‐controlled analgesia (PCA) after cardiac surgery. Methods: A total of 320 patients scheduled for elective cardiac surgery were enrolled. Patients were randomly assigned to one of four treatment regimens (n=80 in each group): no prophylactic antiemetics (group P); intravenous (i.v.) ondansetron 4 mg at the end of surgery and 12 mg added to PCA (group O); i.v. ramosetron 0.3 mg at the end of surgery and no antiemetics added to PCA (group R1); and i.v. ramosetron 0.3 mg at the end of surgery and 0.6 mg added to PCA (group R2). Results: The incidence of PONV during the 48‐h post‐operative period was lower in groups O (46%), R1 (54%), and R2 (35%) compared with group P (71%, P<0.001). The incidence and severity of nausea were lower in groups O, R1, and R2 than in group P during the 24‐h post‐operative period, whereas the incidence and severity of nausea during 24–48 h after surgery were lower in groups O and R2, but not in group R1, than in group P. Compared with group P (53%), the frequency of rescue antiemetic usage was significantly lower in groups O (34%) and R2 (29%), but not in group R1 (43%). Conclusion: The addition of either ondansetron or ramosetron to PCA can reduce the incidence of PONV during 48 h after cardiac surgery.     

Prevalence of motor‐skill impairment in preterm children who do not develop cerebral palsy: a systematic review

Aim Motor skill impairment is a common negative outcome in children born preterm who do not develop cerebral palsy (CP). This study aimed to conduct a systematic review of current data to provide an accurate estimate of the prevalence of non‐CP motor impairment in preterm children at school age. Method We searched the Medline, PubMed, and PsycInfo databases and relevant journals to identify all studies published post‐1990 that reported the prevalence of motor impairment in school‐aged children born preterm (<37wks’ gestation) using standardised motor assessment batteries. We applied a range of exclusionary criteria, with 11 studies included in the final analyses. We identified two levels of motor impairment commonly reported – mild–moderate and moderate – and conducted a random effects meta‐analysis to produce a prevalence estimate for each. Results The pooled estimate for mild–moderate impairment in preterm children was 40.5/100. and for moderate motor impairment the estimate was 19.0/100. There was also a trend for lower motor impairment levels in samples born before 1990 compared with those born after 1990. Interpretation Children born preterm are at increased risk of motor impairment, with prevalence three to four times greater than in the general population. This highlights the need for improved surveillance and intervention strategies in this group of children.     

Pharmacogenetics of response to simvastatin in Chinese patients with hyperlipidaemia

Objective To examine the relationship of single-nucleotide polymorphisms(SNPs)in candidate genes with the lipid responses to simvastatin.Methods Chinese patients were treated with simvastatin 40 mg daily for at least 6 weeks.20 SNPs in 11 genes were genotyped.Results 95 patients age(mean±SD)57.5±10.6 years completed the treatment.The Adiponectin 45T>G polymorphism was significantly related to absolute reductions in total cholesterol(TC)and LDL-cholesterol with a trend(P=0.053)for percentage reductions in TC(TT∶TG∶GG=-38.4%∶-35.6%∶-32.6%).Similar findings were seen with LDL-Receptor(LDLR)SNPs(2052T>C and 1866C>T)with absolute reductions in TC and LDL-cholesterol significantly associated.The Breast Cancer Resistance Protein(ABCG2)421C>A polymorphism was related(P<0.05)to HDL-cholesterol response(CC∶CA∶AA=+0.50%∶-5.73%∶-11.41%).Conclusions Adiponectin,LDLR and ABCG2 SNPs had some influence on the lipid responses to simvastatin.     

0.5%心居康杀白蚁饵剂防治台湾乳白蚁药效试验研究

目的研究0.5%心居康杀白蚁饵剂对台湾乳白蚁(Coptotermes formosanusShiraki)的防治效果。方法2001年在无锡和杭州进行了试验研究,试验分实验室和建筑物现场试验两个部分进行。结果无论是地上(AG)投药,还是地下(IG)投药,不论是室外投药还是室内投药,消灭一个族群需要35~69 d,平均(54.75±12.25)d。消灭一个族群只需要0.5%心居康杀白蚁饵剂48~150 g,平均(103.05±28.9)g,折合有效成分(0.52±0.146)g。结论0.5%心居康杀白蚁饵剂均可以达到消灭台湾乳白蚁的整个族群。     

Cost-analysis of neonatal intensive and special care

Abstract In the present economic climate and with increasing expenditure on neonatal intensive care, there has been a demand for economic evaluation and justification of neonatal intensive care programmes. This study assesses the inhospital costs of neonatal intensive care. Fixed and variable costs were calculated for services and uses of an Intensive/Special Care Nursery for the year 1985 and corrected to 1987 Australian dollar equivalents. Establishing a new neonatal intensive care unit of 43 cots in an existing hospital with available floor space including operating costs for a year were estimated in Australian dollars for 1987 at $6 408 000. Daily costs per baby for each level of care were $1282 ventilator, $481 intensive, $293 transitional and $287 recovery, respectively. The cost per survivor managed in the Intensive/Special Care Nursery in 1985 showed the expected inverse relationship to birthweight being $2400 for > 2500 g, $4050 for 2000–2500 g, $9200 for 1500–1999 g, $23 900 for 1000–1499 g and $63 450 for < 1000 g. Further analysis for extremely low birthweight infants managed in 1986 and 1987 demonstrated costs per survivor of $128 400 for infants < 800 g birthweight and $43 950 for those 800–999 g. This methodology might serve as a basis for further accounting and cost-evaluation exercises.     

Post-orchidectomy radiation therapy for patients with stage I seminoma of the testis

The outcome of radiotherapy in patients with stage I testicular seminoma was evaluated. During the period 1960–89 (inclusive) 270 patients with stage I seminoma of the testis received radiotherapy to the para-aortic nodes and ipsilateral hemipelvis following radical orchidectomy. Two hundred and fifty seven patients (95.2%) received a minimum tumour dose of 30Gy in 20 daily fractions using 4–6 MV photons. The 5 year overall and recurrence-free survival rates were 97 and 95%, respectively. Only eight of the 270 patients relapsed and three were cured with ‘salvage’therapies. Of the 11 patients who died, four deaths (36%) were the result of uncontrolled testicular cancer, six (55%) intercurrent illness and one (9%) the result of attempted salvage. Patients staged and treated prior to 1979 had a significantly worse disease-free survival compared to patients treated during and after 1979. As side effects were negligible, it was concluded that radiotherapy for stage I seminoma provides excellent cure rates. The difficulties arranging a ‘surveillance’programme in so large a State as Queensland are discussed.     

Screening for congenital hypothyroidism in Hong Kong

A pilot cord blood TSH screening program for congenital hypothyroidism was commenced in Hong Kong in April 1982. By April 1984, 14 411 neonates born in two hospitals were screened for this disorder. Five cases of primary hypothyroidism and two cases of transient hypothyroidism were detected. The detection of cases of congenital hypothyroidism with only moderately elevated cord blood TSH values means that the recall rate will remain high.     

贴报-P2临床毒理学、药理学和疗效研究

5-Flourouracil（5-FU） is one of well known anti-cancer drugs, but its toxicity in normal lymphocytes remains a major problem in chemotherapy. The eastern traditional drug, Bupleuri radix（BR）, has been used for the treatment of liver diseases and contains series of triterpene saponins.     

氟-18去氧葡萄糖正子断层造影于孤立肺结节的诊断效力——中山医学大学附设医院的经验

目的孤立肺结节（solitary pulmonary nodules）时常在胸部X光片与电脑断层（CT）上被发现，往往是诊断上的挑战。时常要靠切片检查方能进一步评估。非侵袭性的检查或许能够避免侵袭性的组织切片的风险舆成本。本研究意在评估氟-18去氧葡萄糖正子断层造影用于电脑断层无法判断的孤立肺结节的诊断效力。方法在2000年8月与2005年3月间，共有48位病患因为电脑断层无法判断的孤立肺结节（直径不大于3公分）被转介至本院做氟-18去氧葡萄糖正子断层造影检查。所有病患在接受静脉注射10毫居里的氟-18去氧葡萄糖後约60分钟开始接受正子断层造影检查。本院使用之正子断层扫瞄仪的机型为CTI，ECAT，HR＋。所有病患的正子断层影像均由两位已知其电脑断层结果的资深核普科普师共同判读。当正子断层影像上在封应于电脑断层上的孤立肺结节的氟-18去氧葡萄糖摄取强度超过肝脏的摄取强度时判读为阳性，若不然则判读为阴性。最终诊断则是根据病理报告或追踪病人的情况至少一年的结果。结果在总共48个孤立肺结节中，其中有21个为恶性，27个为良性病灶。藉正子断层影像之助，所有21个恶性病灶及27个良性病灶中的20个被正确的归类（灵敏度100％，专一度74％，阳性预测值75％，阴性预测值100％）。结论本研究显示氟-18去氧葡萄糖正子放射断层造影能有效的区别良性舆恶性的孤立肺结节。氟-18去氧葡萄糖正子放射断层造影实乃提供了一种非侵袭性的评估电脑断层无法判断良恶性的孤立肺结节的方法，其高度的阴性预测值或得以减少侵袭性的组织切片的需要。