Ultrasound-enhanced coagulation for Microcystis aeruginosa removal and disinfection by-product control during subsequent chlorination.

Ultrasound techniques have gained increased interest in environmental remediation because of their promising performance and reagent-free nature. This study investigated the effects of ultrasound-coagulation on Microcystis aeruginosa removal, disinfection by-product (DBP) formation during subsequent chlorination, and acute toxicity and DBP-associated toxicity variations in chlorinated effluents. Compared with coagulation using polymeric aluminum chloride (5 mg-Al/L) alone, ultrasound-coagulation showed significantly enhanced turbidity removal, with the removal ratio increasing from 51% to 87%-96%. Although the addition of ultrasound may not substantially improve and even deteriorate the coagulation removal of DOC following the leakage of intracellular organic matter, the significantly improved DBP control was achieved as the cells dominated DBP formation. With the addition of ultrasound, the chlorine demand, aggregate DBP concentration and total organic halogen concentration reductions in the chlorinated M. aeruginosa solution increased from 15%, 47% and 52% (coagulation alone), respectively, to 56%-78%, 56%-80% and 68%-89%. The enhanced DBP mitigation was mainly attributed to the enhanced algal removal. Similarly, the acute toxicity and DBP-associated toxicity of chlorinated effluents further decreased from 100% and 0.0092 (coagulation alone) to 30%-88% and 0.0029-0.0060. Therefore, ultrasound-enhanced coagulation is a promising strategy for urgent algal removal, DBP mitigation and toxicity abatement.

Kushenin Combined with Adefovir Dipivoxil or Entecavir for Chronic Hepatitis B: A Systematic Review and Meta-Analysis.

Kushenin (KS) has become a traditional Chinese medicine preparation that plays an important role in treating chronic hepatitis B (CHB). Many clinical studies have discussed its curative effect and safety in combination with adefovir dipivoxil (ADV) or entecavir (ETV) for treating CHB, but there is still a lack of a systematic analysis. Therefore, this study evaluated the efficacy and safety of KS through a meta-analysis to better guide clinical treatment. Seven databases were searched to identify randomized controlled trials (RCTs) concerning KS combined with ADV or ETV for treating CHB. The primary outcomes included serum viral indices and adverse events, and the secondary outcomes were liver function indices. The risk of bias of the included RCTs was appraised by Cochrane software. STATA 15.1 and Review Manager 5.3 software were used for the meta-analysis. Thirty-two RCTs recruiting 3343 patients with CHB were collected for this meta-analysis. KS combined with ETV or ADV led to an amelioration of the CHB index to various degrees. In short, the meta-analysis indicated that the combination group, compared to the single group, showed great improvement in HBeAg seroconversion, frequency of undetectable HBV-DNA levels, loss of serum HBeAg, and loss of serum HBsAg. The combination treatment also decreased serum HBV-DNA levels when compared to the levels after the single treatment. However, KS combined with ADV or ETV displayed no remarkable difference in the incidence of adverse events or in serum ALT levels. Current evidence showed that, compared with the use of either drug alone, KS combined with ADV or ETV can improve the clinical efficacy of CHB treatment.