Effectiveness of analgesia with hydromorphone hydrochloride for postoperative pain following surgical repair of structural congenital malformations in children: a randomized controlled trial.

BACKGROUND: Effective postoperative analgesia is needed to prevent the negative effects of postoperative pain on patient outcomes. To compare the effectiveness of hydromorphone hydrochloride and sufentanil, combined with flurbiprofen axetil, for postoperative analgesia in pediatric patients. METHODS: This prospective randomized controlled trial included 222 pediatric patients scheduled for repair of a structural congenital malformation under general anesthesia. Patients were randomized into 3 groups: hydromorphone hydrochloride 0.1 mg/kg (H1), hydromorphone hydrochloride 0.2 mg/kg; (H2) or sufentanil 1.5 µg/kg (S). Analgesics were diluted in 0.9% saline to 100 ml and infused continuously at a basic flow rate of 2 mL per h. The primary outcome measure was the Face, Legs, Activity, Cry, and Consolability (FLACC) pain score. Secondary outcomes included heart rate (HR), respiration rate (RR), SpO2, Ramsay sedation scores, scores on the Paediatric Anaesthesia Emergence Delirium (PAED) scale, adverse reactions, parent satisfaction with analgesia. RESULTS: The FLACC score was significantly lower in H1 and H2 groups compared to S. The Ramsay sedation score was significantly higher in H1 and H2 groups compared to S. Recovery time was shorter in H1 group compared to patients H2 group or S group. There were no significant differences in the PAED scale, HR, RR, SpO2, adverse reactions, satisfaction of parents with analgesia, or length and cost of hospital stay. CONCLUSIONS: Hydromorphone hydrochloride is a more effective analgesic than sufentanil for postoperative pain in pediatric patients following surgical repair of a structural congenital malformation, however, hydromorphone hydrochloride and sufentanil had similar safety profiles in this patient population. TRIAL REGISTRATION: Chinese Clinical Trial Register ChiCTR-INR-17013935). Clinical trial registry URL: Date of registration: December 14, 2017.

Phases and rates of iron and magnetism changes during paddy soil development on calcareous marine sediment and acid Quaternary red-clay.

Dynamic changes in Fe oxides and magnetic properties during natural pedogenesis are well documented, but variations and controls of Fe and magnetism changes during anthropedogenesis of paddy soils strongly affected by human activities remain poorly understood. We investigated temporal changes in different Fe pools and magnetic parameters in soil profiles from two contrasting paddy soil chronosequences developed on calcareous marine sediment and acid Quaternary red clay in Southern China to understand the directions, phases and rates of Fe and magnetism evolution in Anthrosols. Results showed that paddy soil evolution under the influence of artificial submergence and drainage caused changes in soil moisture regimes and redox conditions with both time and depth that controlled Fe transport and redistribution, leading to increasing profile differentiation of Fe oxides, rapid decrease of magnetic parameters, and formation of diagnostic horizons and features, irrespective of the different parent materials. However, the initial parent material characteristics (pH, Fe content and composition, weathering degree and landscape positions) exerted a strong influence on the rates and trajectories of Fe oxides evolution as well as the phases and rates of magnetism changes. This influence diminished with time as prolonged rice cultivation drove paddy soil evolving to common pedogenic features.

The reparative effects of Momordica Charantia Linn. extract on HIT-T15 pancreatic beta-cells.

The aim of this study is to investigate the cell reparative effects of Mormordical Charantia Linn. boiling water extract (MCE) on the HIT-T15 Hamster Pancreatic beta-cells. Furthermore, the superoxide dismutase (SOD) activity of MCE was determined. 0.02% MCE (w/v) achieved the highest cell proliferation rate of 45.6% (p<0.01) on alloxan damaged HIT-T15 cells while 0.2% MCE increased the proliferation of the normal cells by 35.4% (p<0.05). The high molecular weight fraction of MCE (MHMF, MW>3 kDa) showed the stronger effects in repairing alloxan damaged cells (cell proliferation rate=32.1%, p<0.05) than that of the low molecular weight fraction (MLMF, MW< or =3 kDa), while the latter showed the higher activity on increasing insulin secretion of normal or damaged cells. 2%MCE and MLMF showed the highest SOD activities, 19.74 NU/mL and 19.84 NU/mL, but they failed to improve the proliferation rate of alloxan damaged cells. These results indicated MCE has significant repairing effects on HIT-T15 cells against superoxide anion radicals, which did not correlate to MCEfs SOD activity. It was hypothesized that the different fractions of MCE may make different contributions to MCE's cell repairing activity and its ability of stimulating insulin secretion.