Randomized comparative trial between percutaneous longlines and peripheral cannulae in the delivery of neonatal parenteral nutrition

Percutaneously inserted central venous catheters (CVCs) are frequently used for parenteral nutrition (PN) in neonates. Catheter-related sepsis (CRS) is the most commonly reported complication. The aim of this study was to compare sepsis rates between neonates receiving PN by CVC and by peripheral cannula. Neonates were randomized to receive PN either by CVC or by peripheral cannula. Primary outcomes were sepsis rates and efficacy of PN delivery. Interim analysis (49 neonates) revealed no difference in sepsis rates (CVC group 46%, cannula group 40%, p = 0.57). There was a significant discrepancy in PN delivered (median deficit 3.2% in the CVC group, 10.3% in the cannula group, p = 0.0014). After consideration of these findings the study was terminated.     

ENT Disabilities in Candidates for Recruitment

Background

Recruitment in the Army is subject to medical fitness as per laid down standards. A study of the frequency of referral and rejection gives us an understanding as to where to lay stress in the Ear Nose Throat Examination during recruitment medical. Method: A three year analysis of candidates reporting for review of ENT disabilities was carried out from January 1999 to December 2001.

Results

Of the 1156 candidates, 888(76.8%) were found to be fit. The commonest cause for rejection was Wax in ears in 496 cases (43%). 428(86.3%) were found to be fit on review. Chronic suppurative otitis media (21.9%) and tympanosclerosis (21.3%) were the other causes for rejection.

Conclusion

The desirable situation is wherein the evaluation by the specialist is in minimal variation with that of the initial recruitment medical examination. Awareness to have ears cleaned for wax before appearing for the examination, provision of better examination ambiance and equipment and a short training capsule will be beneficial to reduce the number of review cases to referral hospitals.Key Words: Hearing assessment, recruitment, tympanic membrane     

抗三尖杉酯碱HL-60细胞的抗程序性细胞死亡及其克服

三尖杉酯碱(harringtonin,HT)是中国产植物海南粗榧(Cephalotaxus hainanensis Li)中提取的一种抗肿瘤药物,对急性粒细胞白血病、急性单核细胞白血病有较好疗效⁽¹⁾。三尖杉酯碱可非常有效地诱导敏感HL-60细胞程序性死亡(apoptosis,Apo)^(2,3)。但超过半致死剂量(IC₅₀)近百倍的HT却不能诱导抗三尖杉酯碱细胞HT12程序性死亡。如用维拉帕米(verapamil,Vp)10μg·mL^-1逆转多药抗性后,HT虽可诱导HT12细胞程序性死亡,但与敏感细胞相比,出现程序性细胞死亡的时间大大推迟,用药浓度也提高约10倍。这些结果提示:程序性细胞死亡可能作为肿瘤细胞是否已形成抗药性的标志之一,同时也说明程序性细胞死亡相关因子可能参与肿瘤细胞抗药性的形成。