Safety and efficacy of esketamine for postoperative analgesia in pediatric patients with hypospadias

ObjectiveTo explore the safety and efficacy of the combination of continuous intravenous infusion of esketamine with sacral block for postoperative analgesia in pediatric patients undergoing surgery for hypospadiasMethodsPediatric patients (n = 77) undergoing surgery for hypospadias were randomized into two groups: a hydromorphone group (H group, initial dose, 0.02 mg/kg; maintenance dose, 0.01 mg/kg/h) or an esketamine group (E group, initial dose, 0.3 mg/kg; maintenance dose 0.15 mg/kg/h). Caudal epidural block involved injection of 0.2% ropivacaine 1 ml/kg through the sacral hiatus. Age, weight, grade of hypospadias, intraoperative blood loss, operative time, and awaking time of patients were recorded. The Face, Legs, Activity, Cry and Consolability (FLACC) scale and Ramsay sedation scores were recorded when leaving the PACU (0 h) and at postoperative 2, 6, 12, 24, 36, and 48 h. The Pediatric Anesthesia Emergence Delirium Scale (PAED), incidence of hypotension, respiratory depression, nausea and vomiting and pruritus, and the time to first bowel movement after surgery were recorded.ResultsThere were no significant differences in demographic and clinical characteristics between the H group and the E group. There were no significant differences in FLACC scores at postoperative 0, 2, 6, 12, 24, 36, and 48 h in intra-group and inter-group comparisons. There were no significant differences in Ramsay sedation scores at postoperative 0, 2, 6, 12, 24, 36, and 48 h in the intra-group comparisons. Ramsay sedation scores were significantly lower at postoperative 2, 12, and 36 h in the H group compared to the E group. There were no significant differences in the PAED scale or incidence of nausea and vomiting or pruritus between the H group and the E group. The incidence of hypotension and respiratory depression was significantly lower, and the time to first bowel movement was significantly shorter in the E group compared to the H group. Urinary tryptophan, 5-hydroxytryptamine and substance P levels were significantly lower but arginine was significantly higher in the E group compared to the H group.ConclusionsThe combination of continuous intravenous infusion of esketamine with sacral block provided safe and effective postoperative analgesia for pediatric patients undergoing surgery for hypospadias.Trial registrationChinese Clinical Trial Register ChiCTR2200066967. Clinical trial registry URL: http://www.chictr.org.cn/edit.aspx?pid=185042&htm=

Flame-Retardant and Thermal Degradation Mechanism of Caged Phosphate Charring Agent with Melamine Pyrophosphate for Polypropylene

An efficient caged phosphate charring agent named PEPA was synthesized and combined with melamine pyrophosphate (MPP) to flame-retard polypropylene (PP). The effects of MPP/PEPA on the flame retardancy and thermal degradation of PP were investigated by limiting oxygen index (LOI), vertical burning test (UL-94), cone calorimetric test (CCT), and thermogravimetric analysis (TGA). It was found that PEPA showed an outstanding synergistic effect with MPP in flame retardant PP. When the content of PEPA was 13.3 wt% and MPP was 6.7 wt%, the LOI value of the flame retardant PP was 33.0% and the UL-94 test was classed as a V-0 rating. Meanwhile, the peak heat release rate (PHRR), average heat release rate (AV-HRR), and average mass loss rate (AV-MLR) of the mixture were significantly reduced. The flame-retardant and thermal degradation mechanism of MPP/PEPA was investigated by TGA, Fourier transform infrared spectroscopy (FTIR), TG-FTIR, and scanning electron microscopy-energy dispersive X-ray spectrometry (SEM-EDXS). It revealed that MPP/PEPA could generate the triazine oligomer and phosphorus-containing compound radicals which changed the thermal degradation behavior of PP. Meanwhile, a compact and thermostable intumescent char was formed and covered on the matrix surface to prevent PP from degrading and burning

Examination of interannual variability of sea surface temperature in the Indian Ocean using the physical decomposition dethod

The physical decomposition method suggested by Qian (2012) is used to examine the interannual variability of sea surface temperature (SST) and anomaly (SSTA) in the Indian Ocean (IO) for the period 1945.2003. The monthly mean SSTs taken from the global ocean reanalysis produced by the Simple Ocean Data Assimilation (SODA) are decomposed into four terms. The first term is the zonally averaged monthly climatological SST ([Tt(ϕ)]), which features relatively warm surface waters in the tropical IO and relatively colder surface waters over the southern IO. This term also has a relatively low SST pool between the Equator and 20°N. The SST at the center of the pool in summer is about 1-2°C lower than in spring and autumn. The second term is the spatially-varying monthly climatological SSTA (Tt*(λ,ϕ)), due mainly to the topographic effect and seasonal variation in wind forcing. The values of Tt*(λ,ϕ) are negative over the western coastal waters and positive over the eastern coastal and shelf waters in the tropical and northern IO. The third term is the zonally-averaged transient SSTA([T(ϕ,t)']Y). The largest values of [T(ϕ,t)']Y occur over the subtropical and mid-latitudes of the IO, which differs from the SSTA in the tropical waters of the Pacific Ocean. Time series of zonally and meridionally averaged T(ϕ,t)'Y in the tropical-subtropical IO is strongly correlated with the Indian Ocean basin-wide (IOBW) mode. The fourth term is the spatially-varying transient SSTA (T(λ,ϕ,t)*Y']. The REOF analysis of the fourth term demonstrates that the first REOF is correlated strongly with the South Indian Ocean Dipole (SIOD) mode. The second REOF is correlated strongly with the equatorial Indian Ocean dipole (IOD) mode. The third REOF is highly correlated with the tropical IOBW mode

Variations of surface marine heatwaves in the Northwest Pacific during 1993–2019

Parameters of surface marine heatwaves (MHWs) in the Northwest Pacific during 1993–2019 are derived from two sea surface temperature (SST) products: the Optimum Interpolation SST based on satellite remote sensing (OISST V2.1) and the Global Ocean Physics Reanalysis based on data-assimilative global ocean model (GLORYS12V1). Similarities and differences between the MHW parameters derived from the two datasets are identified. The spatial distributions of the mean annual MHW total days, frequency, duration, mean intensity and cumulative intensity, and interannual variations of these parameters are generally similar, while the MHW total days and duration from GLORYS12V1 are usually higher than that from OISST V2.1. Based on seasonal-mean values from GLORYS12V1, longer MHW total days (>7) have the largest spatial coverage in both the shelf and deep waters in summer, while the smallest coverage in spring. In selected representative regions, interannual variations of the MHW total days are positively correlated with the SST anomalies. In summer, the MHW total days have positive correlations with the Western Pacific Subtropical High intensity, and negative correlations with the East Asia Monsoon intensity, over nearly the whole South China Sea (SCS) and the low-latitude Pacific. In winter, positive correlations with both the Subtropical High and Monsoon intensities present over the western part of SCS. Strong El Niño is followed by longer MHW total days over the western half of SCS in winter, and over the whole SCS and low-latitude Pacific in summer of the next year. These correlation relationships are valuable for developing forecasts of MHWs in the region

Purification and Characterization of Bioactive Compounds from Styela clava

The immunomodulatory activity of extract from Styela clava was studied systematically based on activity tracking in vitro in order to find out novel-structured secondary metabolite. The proliferation rates of mouse splenic lymphocytes and peritoneal macrophages were used as screening index, as well as NO release promoting activities. The crude extract (CE) and its different polar fractions from S. clava all exhibited proliferative activity of splenolymphocytes and mouse macrophages, as well as NO release promoting activities, among which petroleum ether fraction (PE) showed the strongest effect. The antioxidant experiment in vitro showed that CE demonstrated antioxidant ability in 1,1-diphenyl-2-picrylhydrazyl (DPPH) system and the beta carotene-linoleic acid system; the activity of ethyl acetate fraction (ET) was much stronger than that of the others. Further isolated by silica gel column chromatography, ET was classified into seven sub-components (E1∼E7) listed in the order of activity as E5 > E6 > E4 > E3 > E7 > E2 > E1. Five compounds were separated as (1) cholesteric-7-en-3 -ol, (2) cholesteric-4-en-3 ,6 -diol, (3) cholesterol, (4) batilol, and (5) ceramide, among which (1), (2), and (4) were isolated for the first time from S. clava

Optimizing DUS testing for Chimonanthus praecox using feature selection based on a genetic algorithm

Chimonanthus praecox is a famous traditional flower in China with high ornamental value. It has numerous varieties, yet its classification is highly disorganized. The distinctness, uniformity, and stability (DUS) test enables the classification and nomenclature of various species; thus, it can be used to classify the Chimonanthus varieties. In this study, flower traits were quantified using an automatic system based on pattern recognition instead of traditional manual measurement to improve the efficiency of DUS testing. A total of 42 features were quantified, including 28 features in the DUS guidelines and 14 new features proposed in this study. Eight algorithms were used to classify wintersweet, and the random forest (RF) algorithm performed the best when all features were used. The classification accuracy of the outer perianth was the highest when the features of the different parts were used for classification. A genetic algorithm was used as the feature selection algorithm to select a set of 22 reduced core features and improve the accuracy and efficiency of the classification. Using the core feature set, the classification accuracy of the RF model improved to 99.13%. Finally, K-means was used to construct a pedigree cluster tree of 23 varieties of wintersweet; evidently, wintersweet was clustered into a single class, which can be the basis for further study of genetic relationships among varieties. This study provides a novel method for DUS detection, variety identification, and pedigree analysis

MicroRNA-197 Promotes Metastasis of Hepatocellular Carcinoma by Activating Wnt/β-Catenin Signaling

Background/Aims: MicroRNA-197 (miR-197) has been shown to play roles in epithelialmesenchymal transition (EMT) and metastasis. The Wnt/β-catenin pathway is associated with EMT, but whether miR-197 regulatesWnt/β-catenin remains unclear. This study was to demonstrate the role of miR-197 on the Wnt/β-catenin pathway in hepatocellular carcinoma (HCC). Methods: Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the expression of miR-197 in 105 HCC specimens and 15 HCC cell lines. We tested the predicted target gene of miR-197 using a genetic report system. The role of miR-197 in HCC cell invasion and migration (wound healingand cell invasion and migrationby Transwell assays) and in an HCC xenograft modelwas analyzed. Results: Using a miRNA microarray analysis of HCC specimens and compared with non-metastatic HCC, miR-197 was identified as one of the most upregulated miRNAs in metastatic HCC. miR-197 expression was positively associated with the invasiveness of HCC cell lines. Metastatic HCC cells with high miR-197 expression had Wnt/β-catenin signaling activation. High levels of miR-197 expression also promoted EMT and invasionHCC cells in vitro and in vivo. miR-197 directly targeted Axin-2, Naked cuticle 1 (NKD1), and Dickkopf-related protein 2 (DKK2), leading to inhibition of Wnt/β-catenin signaling. High miR-197 expression was found in HCC specimens from patients with portal vein metastasis;high miR-197 expression correlated to the expression of Axin2, NKD1, and DKK2. Conclusion: miR-197 promotes HCC invasion and metastasis by activating Wnt/β-catenin signaling. miR-197 could possibly be used as a prognostic marker and therapeutic target for HCC

Transcriptome and digital gene expression analysis reveal immune responses of mantle and visceral mass pearl culturing in Hyriopsis cumingii

Biomineralization is a widespread phenomenon in marine mollusks and is responsible for the production of shells and pearls. However, the regulatory mechanisms governing the adaptive immune responses in the mollusk mantle and visceral mass during mineralization remain unclear. In this work, we examined the mantle and visceral mass immune responses of Hyriopsis cumingii during pearl culture using high-throughput sequencing techniques. A mantle transcriptome database was established using transcriptome sequencing technology and reference to the major databases. Digital gene expression profiling was used to identify the differentially expressed genes of mantle and visceral mass at different insertion periods. Moreover, quantitative real-time PCR was used to verify the expression of five immune-related genes. Transcriptome sequencing results showed 257,457 unigenes were identified. Digital gene expression profiles showed 1389, 3572, 1888, and 2613 differentially expressed genes (DEGs) in the mantle and visceral mass at 5, 20, 50, and 90 d after insertion, respectively, with the highest number at 20 d and the lowest at 5 d after insertion (q < 0.05). A cluster analysis of the DEGs showed similar clustering and expression features in the mantle to the control group, and at 5, 50 and 90 d, after mantle insertion. The DEGs in the visceral mass showed similar clustering and expression features to the control group and at 5, 20 and 50 d after insertion. We also screened 22 immune-related DEGs in the mantle and visceral mass during the same pearl culture period, including serine/threonine-protein kinase NLK, C-type lectin, and galectin. The greatest number of DEGs was found 90 d after insertion. Compared with the mantle, more immune-related DEGs were down-regulated than up-regulated in the visceral mass during pearl culture, indicating that the immune regulatory mechanisms in the visceral mass and the mantle differ during pearl culture, and that the visceral mass is liable to higher infection and mortality rates. Quantitative real-time PCR results showed that the expression of five immune-related genes was consistent with DGE results. Our findings will further knowledge of the immune systems that are present in the mantle and visceral mass during pearl culture

The endowment effect in the genes: An exploratory study

The endowment effect is a well-documented decision phenomenon, referring to a tendency that people price a commodity higher when selling it than when buying it. This phenomenon can be interpreted as a sort of inertia, an unwillingness to make a change, or in other words an attachment to the status-quo. People with autism dislike social interaction, whereas buying and selling are social interaction. Therefore, autistic people may have stronger attachment to the status-quo and thus a stronger endowment effect. Previous research revealed that T-carriers of a single{}-nucleotide polymorphism (SNP) of the dopamine beta-hydroxylase (DBH) gene, rs1611115 (C-1021T), are associated with autism and difficulty in social interaction. Therefore, rs1611115 may modulate the endowment effect. In the current study, the subjects sold and bought lotteries with various probabilities of winning money and provided saliva for genotyping. We found that T-carriers (people of CT genotype in this study) exhibited greater endowment effects compared to people of CC genotype. We discuss another two possible explanations of our results: empathy and loss aversion. This is the first attempt to research the endowment effect from the perspective of genes. The result indicates that an SNP of genes (an innate factor) can exert an observable effect on human market activities