Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.
High-entropy alloys (HEAs) have been attracting extensive research interests in designing advanced nanomaterials, while their precise control is still in the infancy stage. Herein, we have reported a well-defined PtBiPbNiCo hexagonal nanoplates (HEA HPs) as high-performance electrocatalysts. Structure analysis decodes that the HEA HP is constructed with PtBiPb medium-entropy core and PtBiNiCo high-entropy shell. Significantly, the HEA HPs can reach the specific and mass activities of 27.2 mA cm À 2 and 7.1 A mg Pt À 1 for formic acid oxidation reaction (FAOR), being the record catalyst ever achieved in Pt-based catalysts, and can realize the membrane electrode assembly (MEA) power density (321.2 mW cm À 2 ) in fuel cell. Further experimental and theoretical analyses collectively evidence that the hexagonal intermetallic core/atomic layer shell structure and multi-element synergy greatly promote the direct dehydrogenation pathway of formic acid molecule and suppress the formation of CO*.
Study objectiveTo evaluate effect of parecoxib sodium pretreatment combined with dexmedetomidine on early postoperative cognitive dysfunction in elderly patients after shoulder arthroscopy.DesignRandomized, double-blind study.SettingUniversity-affiliated teaching hospital.PatientsOne hundred and fifty-two elderly patients scheduled for shoulder arthroscopy.InterventionsAt 15 min before the induction of anesthesia, 152 patients received intravenously parecoxib sodium 40 mg and dexmedetomidine at a dose of 0.5 μg/kg over 15 min, followed by a continuous infusion at a rate of 0.5 μg/kg/h until the end of surgery. Then all patients who received postoperative patient-controlled intravenous analgesia were divided 2 groups: sufentanil(0.04μg/kg/h, S group), sufentanil (0.04μg/kg/h) plus dexmedetomidine(0.06μg/kg/h) (SD group).MeasurementsThe mini–mental status examination score in SD group was significantly higher than S group at 1, 2 and 7 days after surgery. The incidence of postoperative cognitive dysfunction during 7 days after surgery in S and SD groups was respectively 17.1% and 6.7%. Compared with the S group, the visual analogue scale scores at rest and upon movement were significantly lower at 6, 14, 24, 36 and 48 h after surgery in SD group; analgesia pump liquid amount during 24 h after surgery and number of rescue analgesia during 48 h after surgery were significantly lower in SD group. Jugular venous oxygen partial pressure and jugular venous oxygen saturation values in SD group were significantly higher than S group at postoperative 24 h. The occurrence of nausea and vomiting within 48 h after surgery in SD group were significantly lower than S group. We found no complications including respiratory depression and sinus bradycardia within 48 h after surgery in all patients.ConclusionsParecoxib sodium pretreatment combined with dexmedetomidine could reduce the incidence of early postoperative cognitive dysfunction in elderly patients. This might be related to the improvement of postoperative analgesia effect and cerebral oxygen metabolism in patients.
Although supertetrahedralT n sulfide clusters (n = 2-6) have been extensively explored, the synthesis of Tn selenide clusters with n > 4h as not been achieved thus far.R eported here are ionic-liquid (IL)-assisted precursor route syntheses, characterizations, and the photocatalytic properties of six new M-In-Q (M = Cu or Cd;Q= Se or Se/S) chalcogenide compounds,n amely [Bmmim] 12 MIm = 1-methylimidazole), and [Bmmim] 9 Cd 6 In 28 Se 8 S 44 Cl(MIm) 3 (T5-6). The cluster compounds T5-1 and T5-3 represent the largest molecular supertetrahedralT n selenide clusters to date. Under visiblelight illumination,t he Cu-In-Q compounds showed photoca-talytic activity towards the decompositiono fc rystal violet, whereas the Cd-In-Q compounds exhibited good photocatalytic H 2 evolution activity.I nterestingly,t he experimental results show that the photocatalytic performances of the selenide/sulfide solid solutions weres ignificantly bettert han those of their selenide analogues, for example, the degradation time of the organic dye with T5-2 wasm uch shorter than that with T5-1,w hereas the photocatalytic H 2 evolution efficiencies with T5-3-T5-6 improved significantly with increasings ulfur content.T his work highlightst he significance of IL-assisted precursor route synthesis and the tuning of photocatalytic properties through the formation of solids olutions.Scheme1.Typical crystallization processes of the cluster compounds T5-1-T5-6 in the IL [Bmmim]Cl. The amounts of reactantsare given in mmoles.
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