Constructing Hollow Multishelled Microreactors with a Nanoconfined Microenvironment for Ofloxacin Degradation through Peroxymonosulfate Activation: Evolution of High-Valence Cobalt-Oxo Species.

This study constructed hollow multishelled microreactors with a nanoconfined microenvironment for degrading ofloxacin (OFX) through peroxymonosulfate (PMS) activation in Fenton-like advanced oxidation processes (AOPs), resulting in adequate contaminant mineralization. Among the microreactors, a triple-shelled Co-based hollow microsphere (TS-Co/HM) exhibited optimal performance; its OFX degradation rate was 0.598 min-1, which was higher than that of Co3O4 nanoparticles by 8.97-fold. The structural tuning of Co/HM promoted the formation of oxygen vacancies (VO), which then facilitated the evolution of high-valence cobalt-oxo (Co(IV)═O) and shifted the entire t2g orbital of the Co atom upward, promoting catalytic reactions. Co(IV)═O was identified using a phenylmethyl sulfoxide (PMSO) probe and in situ Raman spectroscopy, and theoretical calculations were conducted to identify the lower energy barrier for Co(IV)═O formation on the defect-rich catalyst. Furthermore, the TS-Co/HM catalyst exhibited remarkable stability in inorganic (Cl-, H2PO4-, and NO3-), organic (humic acid), real water samples (tap water, river water, and hospital water), and in a continuous flow system in a microreactor. The nanoconfined microenvironment could enrich reactants in the catalyst cavities, prolong the residence time of molecules, and increase the utilization efficiency of Co(IV)═O. This work describes an activation process involving Co(IV)═O for organic contaminants elimination. Our results may encourage the use of multishelled structures and inform the design of nanoconfined catalysts in AOPs.

Modulating the electron structure of Co-3d in Co3O4-x/WO2.72 for boosting peroxymonosulfate activation and degradation of sulfamerazine: Roles of high-valence W and rich oxygen vacancies.

Sulfate radical (SO4•-)-based heterogonous advanced oxidation processes (AOPs) show promising potential to degrade emerging contaminants, however, regulating the electron structure of a catalyst to promote its catalytic activity is challenging. Herein, a hybrid that consists of Co3O4-x nanocrystals decorated on urchin-like WO2.72 (Co3O4-x/WO2.72) with high-valence W and rich oxygen vacancies (OVs) used to modulate the electronic structure of Co-3d was prepared. The Co3O4-x/WO2.72 that developed exhibited high catalytic activity, activating peroxymonosulfate (PMS), and degrading sulfamerazine (SMR). With the use of Co3O4-x/WO2.72, 100 % degradation of SMR was achieved within 2 min, at a pH of 7, with the reaction rate constant k1 = 3.09 min-1. Both characterizations and density functional theory (DFT) calculations confirmed the formation of OVs and the promotion of catalytic activity. The introduction of WO2.72 greatly regulated the electronic structure of Co3O4-x. Specifically, the introduction of high-valence W enabled the Co-3d band centre to be closer to the Fermi level and enhanced electrons (e-) transfer ability, while the introduction of OVs-Co in Co3O4-x promoted the activity of electrons in the Co-3d orbital and the subsequent catalytic reaction. The reactive oxygen species (ROS) were identified as •OH, SO4•-, and singlet oxygen (1O2) by quenching experiments and electron spin resonance (EPR) analysis. The DFT calculation using the Fukui index indicated the reactive sites in SMR were available for an electrophilic attack, and three degradation pathways were proposed.

Parecoxib sodium pretreatment reduces myoclonus after etomidate: A prospective, double-blind, randomized clinical trial
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OBJECTIVE: Myoclonus induced by etomidate during induction of general anesthesia is a common phenomenon. This prospective, randomized, saline-controlled clinical study was performed to evaluate the effect of parecoxib sodium pretreatment on the incidence and severity of etomidate-induced myoclonus. METHODS: 60 patients, American Society of Anesthesiologists (ASA) physical status I or II, aged 20 to 60 years, who were scheduled to undergo elective laparoscopic cholecystectomy under general anesthesia, were allocated randomly into one of two groups to receive parecoxib sodium 40 mg intravenous (group P, n = 30) or the same volume of saline (group S, n = 30) 30 minutes before administration of etomidate (0.3 mg/kg). Myoclonus was assessed on a scale of 0 - 3. Postoperative side effects were recorded. RESULTS: The two groups were comparable with regard to baseline characteristics. The incidence of myoclonus was significantly lower in the parecoxib sodium group (11/30; 37%) than in the saline group (21/30; 70%) (p < 0.05). The severity of myoclonic movements was also significantly reduced by parecoxib sodium (p < 0.05). There were no significant differences between the two groups with respect to postoperative side effects. CONCLUSIONS: Pretreatment with intravenous injection of parecoxib sodium 40 mg significantly reduced the incidence and severity of etomidate-induced myoclonus without significant side effects.
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Parecoxib sodium reduces the need for opioids after tonsillectomy in children: a double-blind placebo-controlled randomized clinical trial.

OBJECTIVE: Postoperative pain is a common phenomenon after pediatric tonsillectomy. This prospective randomized double-blind placebo-controlled clinical trial was performed to evaluate the analgesic efficacy of intravenous parecoxib sodium in children undergoing tonsillectomy. METHODS: Sixty children (American Society of Anesthesiologists physical status I-III, aged three to seven years, and scheduled to undergo elective tonsillectomy under general anesthesia) were randomly allocated into one of two groups to receive intravenous parecoxib sodium 1 mg·kg(-1) (Group P, n = 30) or the same volume of saline (Group S, n = 30) just after induction of general anesthesia. Between-group comparisons were made for the number of patients requiring rescue morphine, total number of doses of postoperative rescue morphine, time to first rescue analgesic, postoperative pain and sedation scores, and adverse effects. RESULTS: Rescue morphine was given to more children in Group S (25/30, 83%) than in Group P (17/30, 57%) [relative risk (RR), 1.5; 95% confidence interval (CI), 1.0 to 2.1; P = 0.024]. The mean (SD) time to first rescue analgesic was shorter in Group S than in Group P [132 (54) min vs 193 (78) min, respectively; mean difference, 61; 95% CI, 26.6 to 96.1; P = 0.001]. The median (interquartile range [IQR]) Children's Hospital of Eastern Ontario Pain Scale scores in the postanesthesia care unit were lower in Group P than in Group S (7 [5-8] vs 9 [8-11], respectively; P = 0.001). The incidence of postoperative nausea and vomiting (PONV) was higher in Group S than in Group P [11/30 (37%) vs 4/30 (13%), respectively; RR, 2.8; 95% CI, 1.0 to 7.7; P = 0.037]. CONCLUSIONS: A single intravenous injection of parecoxib sodium 1 mg·kg(-1) after anesthesia induction is an effective method for the control of postoperative pain. It provides a morphine-sparing effect, prolongs the time to first rescue analgesic, and reduces PONV in children undergoing tonsillectomy.

Comparison of the effects of dezocine, fentanyl, and placebo on emergence agitation after sevoflurane anesthesia in children.

OBJECTIVES: The purpose of the study was to compare the efficacy and adverse events of dezocine with that of fentanyl or placebo for the control of emergence agitation. METHODS: 114 children scheduled for adenotonsillectomy under sevoflurane anesthesia were allocated randomly into 1 of the 3 groups to receive dezocine 0.1 mgxkg(-1) (group D, n=38), fentanyl 1 µg×kg(-1) (group F, n=38), or saline (group S, n=38) just before the end of anesthesia. Emergence agitation scores were assessed. Postoperative pain scores, awakening and extubation times, and the incidence of adverse effects were recorded. RESULTS: Emergence agitation scores, the incidence of emergence agitation and severe emergence agitation were significantly lower in groups D and F than in group S (p=0.021, p=0.018, and p=0.028, respectively). The postoperative pain scores were lower in groups D and F as compared to group S (p=0.01). Awakening and extubation times in groups D and F were longer than that of group S (p=0.001 and p=0.000, respectively). The overall incidence of postoperative complications was higher in group F compared to that in groups D and S (p=0.01). CONCLUSIONS: In children undergoing adenotonsillectomy under sevoflurane anesthesia, a single IV injection of dezocine 0.1 mgxkg(-1) and fentanyl 1 µg×kg(-1) were comparable in decreasing the incidence and severity of emergence agitation. However, the use of dezocine was associated with a lower incidence of postoperative side effects.

Effect of parecoxib sodium on postoperative shivering: a randomised, double-blind clinical trial.

BACKGROUND: Postoperative shivering is one of the most common complications in patients recovering from general anaesthesia. Although a variety of pharmacological therapies have been used to control postoperative shivering, no ideal drug has been found to date. OBJECTIVES: The aim of this study was to compare the efficacy and accompanying side-effects of prophylactic parecoxib sodium with that of tramadol or placebo for the prevention of postoperative shivering. DESIGN: A randomised, double-blind clinical study. SETTING: Mianyang Central Hospital, Sichuan, China, from December 2011 to November 2012. PATIENTS: One hundred and twenty adult patients, ASA 1 or 2, aged 20 to 60 years and scheduled for elective abdominal surgery under general anaesthesia. Reasons for noninclusion included allergy to any of the medications used; severe cardiovascular disease; kidney or liver dysfunction; peptic ulcer; muscle disease; intraoperative blood or blood products transfusion; or a history of convulsions or fever. INTERVENTIONS: The patients were allocated randomly to receive parecoxib sodium 40 mg (Group P, n = 40), tramadol 2 mg kg (Group T, n = 40) or isotonic saline (Group S, n = 40) 30 min before the end of surgery. MAIN OUTCOME MEASURES: The primary outcome measure was the incidence of postoperative shivering. Secondary outcomes were scores for postoperative pain and sedation, and the incidence of postoperative nausea and vomiting. RESULTS: The incidence and severity of postoperative shivering were significantly lower in Groups P and T than in Group S (P < 0.001). The sedation scores were higher in Group T than in Groups P and S (P < 0.05). The incidence of postoperative nausea and vomiting was also significantly higher in Group T than in Groups P and S (P = 0.016). CONCLUSION: Intravenous injection of parecoxib sodium 40 mg before the end of surgery effectively reduces the occurrence and severity of postoperative shivering after general anaesthesia without significant side effects. TRIAL REGISTRATION: ChiCTR-TRC-12002870.

The effect of small dose sufentanil on emergence agitation in preschool children following sevoflurane anesthesia for elective repair of unilateral inguinal hernia.

OBJECTIVE: To conduct a comparative study of sufentanil and fentanyl on emergence agitation in pediatric patients. METHODS: We conducted a prospective, randomized, and double-blind study in 80 preschool children admitted at the Pediatric Surgery, Mianyang Central Hospital, Sichuan, China between March 2011 and April 2012. They underwent sevoflurane anesthesia for elective repair of unilateral inguinal hernia. Children received a single intravenous dose of sufentanil 0.15 ug/kg or fentanyl 1.5 ug/kg just before skin incision. The emergence agitation scale and the frequency of severe emergence agitation were measured. Patients who required additional fentanyl during surgery and postoperative rescue fentanyl were recorded. Recovery time and the incidence of adverse effects were assessed. RESULTS: The mean emergence agitation scores were significantly lower in the sufentanil group compared with the fentanyl group (9.1+/-3.5 versus 12+/-3.8; 95% confidence interval [1.27+/-0.53]; p=0.001). The frequency of severe emergence agitation was 27.5% in the sufentanil group and 50% in the fentanyl group (p=0.039). Significantly fewer children in the sufentanil group received additional fentanyl during surgery compared to the fentanyl group (5% versus 20%; p=0.043) and significantly fewer children in the sufentanil group received one dose of postoperative rescue fentanyl compared to the fentanyl group (17.5% versus 42.5%; p=0.015). The incidence of vomiting was significantly higher in the fentanyl group than in the sufentanil group (p=0.023). CONCLUSION: In preschool children undergoing repair of unilateral inguinal hernia with sevoflurane anesthesia, compared with a single dose of 1.5 ug/kg fentanyl, 0.15 ug/kg sufentanil before skin incision can significantly decrease the incidence of emergence agitation without delaying the recovery time.