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INTRODUCTION: Patients with clinically significant portal hypertension (CSPH) are recommended to be treated with non-selective beta-blockers (ie, carvedilol) to prevent the first hepatic decompensation event by the renewing Baveno VII consensus. CSPH is defined by hepatic venous pressure gradient (HVPG)≥10 mm Hg; however, the HVPG measurement is not widely adopted due to its invasiveness. Liver stiffness (LS)≥25 kPa can be used as a surrogate of HVPG≥10 mm Hg to rule in CSPH with 90% of the positive predicting value in majority aetiologies of patients. A compelling argument is existing for using LS≥25 kPa to diagnose CSPH and then to initiate carvedilol in patients with compensated cirrhosis, and about 5%-6% of patients under this diagnosis criteria may not be benefited from carvedilol and are at risk of lower heart rate and mean arterial pressure. Randomised controlled trial on the use of carvedilol to prevent liver decompensation in CSPH diagnosed by LS remains to elucidate. Therefore, we aimed to investigate if compensated cirrhosis patients with LS≥25 kPa may benefit from carvedilol therapy. METHODS AND ANALYSIS: This study is a randomised, double-blind, placebo-controlled, multicentre trial. We will randomly assign 446 adult compensated cirrhosis patients with LS≥25 kPa and without any previous decompensated event and without high-risk gastro-oesophageal varices. Patients are randomly divided into two groups, with 223 subjects in group A and 223 subjects in group B. Group A is a carvedilol intervention group, while group B is a placebo group. All patients in both groups will receive aetiology therapies and are followed up at an interval of 6 months. The 3-year incidences of decompensated events of cirrhosis-related and liver-related death are the primary outcome. The secondary outcomes include development of each complication of portal hypertension individually (ascites, variceal bleeding or overt hepatic encephalopathy), development of spontaneous bacterial peritonitis and other bacterial infections, development of new varices, growth of small varices to large varices, delta changes in LS and spleen stiffness, change in hepatic dysfunction assessed by Child-Pugh and model for end-stage liver disease score, change in platelet count, development of hepatocellular carcinoma, development of portal vein thrombosis and adverse events with a 3-year follow-up. A predefined interim analysis will be performed to ensure that the calculation is reasonable. ETHICS AND DISSEMINATION: The study protocol has been approved by the ethics committees of the Sixth People's Hospital of Shenyang (2023-05-003-01) and independent ethics committee for clinical research of Zhongda Hospital, affiliated to Southeast University (2023ZDSYLL433-P01). The results from this trial will be submitted for publication in peer-reviewed journals and will be presented at international conferences. TRIAL REGISTRATION NUMBER: ChiCTR2300073864.
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Carvedilol , Hipertensión Portal , Cirrosis Hepática , Carvedilol/uso terapéutico , Carvedilol/farmacología , Humanos , Hipertensión Portal/tratamiento farmacológico , Hipertensión Portal/etiología , Cirrosis Hepática/complicaciones , Método Doble Ciego , China/epidemiología , Estudios Multicéntricos como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Antagonistas Adrenérgicos beta/uso terapéutico , Femenino , Hígado/efectos de los fármacos , Hígado/fisiopatología , Presión Portal/efectos de los fármacos , Várices Esofágicas y Gástricas/etiología , Várices Esofágicas y Gástricas/prevención & control , Diagnóstico por Imagen de Elasticidad , Adulto , MasculinoRESUMEN
The productivity and efficiency of two-chamber microbial electrolysis cell and anaerobic digestion integrated system (MEC-AD) were promoted by a complex of anaerobic granular sludge and iron oxides (Fe-AnGS) as inoculum. Results showed that MEC-AD with Fe-AnGS achieved biogas upgrading with a 23%-29% increase in the energy recovery rate of external circuit current and a 26%-31% decrease in volatile fatty acids. The energy recovery rate of MEC-AD remained at 52%-57%, indicating a stable operation performance. The selectively enriched methanogens and electroactive bacteria resulted in dominant hydrogenotrophic and acetoclastic methanogenesis in the cathode and anode chambers. Mechanistic analysis revealed that MEC-AD with Fe-AnGS led to specifically upregulated enzymes related to energy metabolism and electron transfer. Fe-AnGS as inoculum could improve the long-term operation performance of MEC-AD. Consequently, this study provides an efficient strategy for biogas upgrading in MEC-AD.
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Biocombustibles , Electrólisis , Metano , Anaerobiosis , Metano/metabolismo , Ácidos Grasos Volátiles/metabolismo , Aguas del Alcantarillado/microbiología , Fuentes de Energía Bioeléctrica/microbiología , Reactores Biológicos , Electrodos , Bacterias/metabolismoRESUMEN
Microbial electrolysis cells (MECs) are increasingly recognized as a promising technology for converting CO2 to CH4, offering the dual benefits of energy recovery from organic wastewater and CO2 emission reduction. A critical aspect of this technology is the enhancement of the electron-accepting capacity of the methanogenic biocathode to improve CH4 production efficiency. This study demonstrates that adjusting the cathode resistivity is an effective way to control the electric field intensity, thereby enhancing the electron accepting capacity and CH4 production. By maintaining the electric field intensity within approximately 8.50-10.83 mV·cm-1, the CH4 yield was observed to increase by up to two-fold. The improvement in CH4 production under optimized electric field conditions was attributed to the enhancement of the direct accepting capacity of the biocathode. This enhancement was primarily due to an increase in the relative abundance of Methanosaeta by approximately 10 % and an up to 83.78 % rise in the electron-accepting capacity of the extracellular polymeric substance. These insights offer a new perspective on the operation of methanogenic biocathodes and propose a novel biocathode construction methodology based on these findings, thus contributing to the enhancement of MEC efficiency.
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Fuentes de Energía Bioeléctrica , Carbono , Dióxido de Carbono , Matriz Extracelular de Sustancias Poliméricas , Electrólisis , Electrodos , MetanoRESUMEN
The performance, system stability, and microbial community response in anaerobic co-digestion (AcoD) of corn stover (CS) and chicken manure (CM) were investigated by running completely stirred tank reactor (CSTR) under controlled organic loading rate (OLR). Prior to anaerobic digestion (AD), potassium hydroxide (KOH) or liquid fraction of digestate (LFD) was applied to pretreat CS, respectively. The results showed that the daily biogas production (DBP) in co-digestion showed a gradual increasing trend with an increase in the OLR from 65 g TS·L-1 to 100 g TS·L-1. The daily methane production per g volatile solids (DMP-VS) in co-digestion increased by 23.0%-27.1%, 18.7%-18.8%, and 17.5%-18.0% at the OLRs of 65, 80, and 100 g TS·L-1, respectively, upon pretreatment with KOH or LFD, as compared to that in co-digestion CSTR without any pretreatment. In addition, all co-digestion CSTRs were operated in stable state. Approximately half of the total carbon in the substrates was recovered in the form of a biogas product, with the carbon mass balance being impacted by the OLR as well as pretreatment. The diversity as well as function of the microbial community varied in response to different OLRs and pretreatment methods. The majority of bacterial genera were strongly correlated with operational parameters. The study indicates that management of OLR and selection of proper pretreatment method could enhance the efficiency and productivity of CS and CM co-digestion in CSTR.
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Estiércol , Zea mays , Anaerobiosis , Animales , Biocombustibles , Reactores Biológicos , Pollos , Digestión , MetanoRESUMEN
The effects of liquid fraction of digestate (LFD) pretreatment on anaerobic digestion (AD) performance and microbial community characteristics were estimated. Prior to AD, LFD (LFDSM, LFDFW, and LFDWS) collected separately from three continuously stirred tank reactors (CSTRs) using swine manure (SM), food waste (FW), and wheat straw (WS) as the mono-substrate was applied to pretreat WS. The results showed that AD with LFD pretreatment resulted in biomethane yields of 240.2-277.9 mL·gVS-1, a 33.57%-54.54% improvement over the yield of the control, and also produced a time saving of 32.26%-46.77%. The pretreatment parameters were optimized for LFD pretreatment. The enhancement effect was in the order of LFDFW > LFDSM > LFDWS. Simultaneously, the cellulose, hemicellulose and lignin contents in the WS and their characteristics (surface properties, crystallinity index, etc.) varied accordingly. The function of the microbial community was strengthened during the pretreatment stage, but the structure of the microbial community had a clear response to the LFD source substrates. Bacteroidetes was the most dominant phyla and was positively correlated with the hydrolysis rate. Consequently, the LFD from the different substrates used as pretreat agents could improve the AD performance of WS.
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Microbiota , Eliminación de Residuos , Anaerobiosis , Animales , Biocombustibles , Reactores Biológicos , Alimentos , Metano , Porcinos , TriticumRESUMEN
The performance and microbial community dynamics in anaerobic co-digestion (ACoD) of chicken manure and corn stover with different modification methods and trace element supplementation strategy were investigated in this study. KOH and liquid fraction of digestate (LFD) were applied for modification; Fe, Co, Mn, Mo, and Ni were used for supplement. Results showed that the selected trace element was insufficient in the partial or whole digestion process. When trace element supplement was combined with KOH or LFD modifications, the ACoD obtained biomethane yields of 245.3-258.0 and 254.0-261.8 mLN·gVS-1, 26.0%-32.5% and 30.5%-34.5% more than that of the control, respectively. Microbial community analyses indicated that the composition and diversity of archaea and bacteria varied at genus level. Main pathways involved in ACoD were affected accordingly, which in turn affected co-digestion performance. This study demonstrated that the combining modification and trace element supplement could improve the digestion performance and achieve higher biomethane yield.
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Microbiota , Oligoelementos , Anaerobiosis , Animales , Biocombustibles , Reactores Biológicos , Pollos , Suplementos Dietéticos , Digestión , Estiércol , Metano , Zea maysRESUMEN
Two probes based on tetrahydroxanthylium unit (probe 1a) and methyltetrahydroxanthylium unit (probe 1b) were designed and synthesized for the detection of hydrazine. Probes 1a-b exhibited turn-on red emission signal and high selectivity toward NH2NH2. The response time of probe 1a to NH2NH2 was more than 60 min, while that of probe 1b was less than 30 min. The detection limits of probes 1a-b were calculated as 210 nM and 110 nM respectively. What's more, the tolerance experiments showed that methyltetrahydroxanthylium unit possessed higher tolerance toward nucleophiles. Moreover, cells imaging experiments demonstrated that probe 1b could detect exogenous NH2NH2 in living HeLa cells.
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The effect of enhanced hydrolysis and acidification (EHA) strategy on co-digestion performance of pretreated corn stover (CS) with chicken manure (CM) was investigated. The EHA process was applied to the CS pretreated with KOH and liquid fraction of digestate (LFD), prior to anaerobic digestion. The results showed that the efficiencies of hydrolysis and acidification for the pretreated CS group were significantly higher than the CS group. The maximum cumulative biomethane yield of 240.5 mL·gVS-1 and 242.0 mL·gVS-1 were obtained for the KOH CS group and LFD CS group during the EHA process at 1 day, showing 26.6% and 27.4% improvement over that of the control, respectively. T90 was shortened by 38.2%-44.1% and 17.7%-38.2%, correspondingly. The synergistic effects and hydrolysis kinetics were also enhanced by the EHA process. The communities of bacteria (Firmicutes, Proteobacteria, and Bacteroidetes) and archaea (Methanosaeta, Methanobacterium, and Methanosarcina) were enriched by the EHA process, and their interactions contributed to the improved digestion performance. Therefore, the EHA process was recommended for efficient biomethane conversion in co-digestion of CS and CM.
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Estiércol , Microbiota , Anaerobiosis , Animales , Reactores Biológicos , Pollos , Concentración de Iones de Hidrógeno , Hidrólisis , Metano , Zea maysRESUMEN
A small molecule fluorescent probe (probe 1) based on adenine-coumarin derivative was designed and synthesized in this paper. Probe 1 exhibited a significant fluorescence-enhancing response to nucleic acids at 495 nm (for DNA) and 487 nm (for RNA). The fluorescence enhancement of probe 1 for DNA and RNA was 5.68 and 9.73 times respectively, the fluorescence quantum yield was changed from 2.5% to 11.7% and 22.5% accordingly. Meanwhile, an excellent linear relationship of fluorescence intensity at 495 nm or 487 nm versus the nucleic acid concentration (1 µM for probe 1, 0-350 µg/mL for DNA and 0-300 µg/mL for RNA) was obtained. Co-staining and nucleic acid digestion experiments showed that probe 1 could selectively image nucleic acids in mitochondria and nucleoli in HeLa cells.
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Adenina/química , ADN Mitocondrial , Colorantes Fluorescentes/química , Imagen Molecular , ADN Mitocondrial/química , ADN Mitocondrial/metabolismo , Células HeLa , HumanosRESUMEN
Liquid fraction of digestate (LFD) was used to pretreat corn stover to enhance the biomethane production of anaerobic co-digestion (AcoD) with cattle manure. The effects of LFD concentration and water content (WC) for pretreatment on co-digestion performance and microbial community structure were investigated in a batch system. Results showed that the cumulative biomethane yield (CBY) for co-digestion was improved by 16.85%-41.78% compared with the control. The highest biomethane yield of 238.25â¯mLâ¯gâ¯VS-1 was obtained at 85% WC for pretreatment and a 5â¯M LFD concentration, and this yield was 41.78% higher than that in the control. The LFD pretreatment enriched the dominant bacterial phyla (Firmicutes and Bacteroidetes), but had little influence on the prevalent archaeal genus (Euryarchaeota). This study demonstrated that LFD pretreatment can greatly enhance the biomethane yield of co-digestion of corn stover and cattle manure under optimal parameters.
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Estiércol , Microbiota , Anaerobiosis , Animales , Biocombustibles , Reactores Biológicos , Bovinos , Digestión , Metano , Zea maysRESUMEN
Type 2 diabetes mellitus (T2DM) is a common chronic disease, and the fragment data collected through separated vendors makes continuous management of DM patients difficult. The lack of standard of fragment data from those diabetic patients also makes the further potential phenotyping based on the diabetic data difficult. Traditional T2DM data repository only supports data collection from T2DM patients, lack of phenotyping ability and relied on standalone database design, limiting the secondary usage of these valuable data. To solve these issues, we proposed a novel T2DM data repository framework, which was based on standards. This repository can integrate data from various sources. It would be used as a standardized record for further data transfer as well as integration. Phenotyping was conducted based on clinical guidelines with KNIME workflow. To evaluate the phenotyping performance of the proposed system, data was collected from local community by healthcare providers and was then tested using algorithms. The results indicated that the proposed system could detect DR cases with an average accuracy of about 82.8%. Furthermore, these results had the promising potential of addressing fragmented data. The proposed system has integrating and phenotyping abilities, which could be used for diabetes research in future studies.
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Diabetes Mellitus Tipo 2/complicaciones , Retinopatía Diabética/diagnóstico , Programas Informáticos , Algoritmos , Australia , HumanosRESUMEN
Diabetes is one of the major burdens in health care, but could be controlled if the relevant data are well-managed. Referring to current successful cases, we designed a framework for the interoperability and integration of medical data in compliance with both archetype and reference information model specification. The clinical data model (CDM) was designed on the basis of OpenEHR archetypes and self-made patient generated health data (PGHD). Integrating healthcare enterprise (IHE) protocol was taken into integrating different modality data. After terminology mapping, the personal health record could be transferred and shared in different clinical information vendors complying with HL7 standards. Many fragment data such as blood glucose and gene data were also integrated to system. Those patients suspected of higher risk of diabetic retinopathy (DR) were grouped as case and other patients could be filtered as control cohort. Furthermore, the framework could be further developed for precision medicine.
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Diabetes Mellitus , Registros Electrónicos de Salud , Programas Informáticos , Atención a la Salud , Humanos , Integración de SistemasRESUMEN
Biological and chemical pretreatment methods using liquid fraction of digestate (LFD), ammonia solution (AS), and NaOH were compared in the process of mesophilic anaerobic co-digestion of cattle manure and corn stover. The results showed that LFD pretreatment could achieve the same effect as the chemical pretreatment (AS, NaOH) at the performance of anaerobic digestion (AD). Compared with the untreated corn stover, the cumulative biomethane production (CBP) and the volatile solid (VS) removal rate of three pretreatment methods were increased by 25.40-30.12% and 14.48-16.84%, respectively, in the co-digestion of cattle manure and corn stover. T80 was 20-37.14% shorter than that of the control test (35 ± 1 days). LFD pretreatment not only achieved the same effect as chemical pretreatment, but also reduced T80 and improved buffer capacity of anaerobic digestion system. Therefore, this study provides meaningful insight for exploring efficient pretreatment strategy to stabilize and enhance AD performance for practical application.
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Anaerobiosis/fisiología , Estiércol/microbiología , Zea mays/microbiología , Amoníaco/metabolismo , Animales , Bovinos , Metano/biosíntesisRESUMEN
OBJECTIVE: To observe the effect of electroacupuncture (EA) on plasma estrin (E) 2 and bone mineral density (BMD) in ovariectomized (OVX) rats for studying its underlying mechanism in treating osteoporosis. METHODS: Thirty-two female SD rats were randomized into normal control, model, EA, and medication groups with 8 rats in each group. Postmenopausal osteoporosis model was established by removing the uterus under anesthesia (2% Phenobarbital, 40 mg/kg). In EA group, bilateral "Zusanli" (ST 32) and "Sanyinjiao" (SP 6) were punctured and stimulated electrically for 20 minutes with 1-3 Hz in frequency, 1 ms in duration of waves, and 0.7-1.0 mA in strength, once daily and 8 weeks altogether. Rats of medication group were drenched with 5% Nilestriol, 5 mL/week and for 8 weeks. At the end of experiments, blood samples were collected after removing the rat eyeball, and the left femoral bone tissue was taken. Serum E2 was assayed by using enzyme linked immunosorbent assay (ELISA) and BMD was measured by using double functional X-ray digital bone density meter. RESULTS: Compared with normal group, the body weight of model group was significantly bigger (P < 0.05), and that of model group was also significantly bigger than that of EA and medication groups (P < 0.11). No significant differences were found among the 4 groups before experiments and among normal control and EA groups after treatment (P > 0.05). In comparison with normal group, BMD and serum E2 of model group decreased significantly (P < 0. 01), while compared with model group, BMD and E2 of EA and medication groups increased significantly (P < 0.01, < 0.05). No significant differences were found among normal, EA and medication groups (P > 0.05). CONCLUSION: Both EA and medication can increase BMD and serum E2 in OVX rats, which may be one of the mechanisms of acupuncture in treating osteoporosis.