Calcium hydroxide recycled from waste eggshell resources for the effective recovery of fluoride from wastewater.

In the hunt of waste recovery pathways, eggshells emerged as a potential adsorbent for fluoride because they contain plenty of calcium. However, as the main component, calcite has weak interaction with fluoride. In this study, calcium hydroxide was derived from waste eggshells successfully by an aging treatment with moisture for fluoride recovery from water. The X-ray diffraction (XRD) and infrared spectroscopy (FT-IR) analyses indicate that CaO in calcined egg shells (AEG900) is completely converted to calcium hydroxide. The adsorption experiments showed that the adsorption capacity of AEG900 for fluoride was improved by nearly 29.21% compared with the calcined eggshells without the aging treatment. In the batch experiment, the temperature effect is the most significant for the adsorption process, and nearly a half increment of removal rate is achieved by increasing the temperature by 30 °C. Further research revealed that the adsorption process fitted well with the pseudo-second order model and the Langmuir-Freundlich isotherm model, with a maximum adsorption capacity of 370.15 mg g-1. Moreover, precipitation was regarded as the main step for fluoride removal mechanism based on the calculated results of the surface complexation model. X-ray photoelectron spectroscopy (XPS) results showed that the stable fluorite formed in situ of AEG900 avoids calcium loss in water. Finally, AEG900 was applied in fluoride removal with real-life groundwater and industrial wastewater, and the results showed that the final fluoride concentration could meet the WHO requirement and industrial wastewater discharge standard.

Relatively Early and Late-Onset Neuromyelitis Optica Spectrum Disorder in Central China: Clinical Characteristics and Prognostic Features.

Background: We aimed to analyze the clinical characteristics and prognostic features of Chinese patients with relatively late-onset neuromyelitis optica spectrum disorder (RLO-NMOSD>40 years of age at disease onset), compared with patients with relatively early onset NMOSD (REO-NMOSD, ≤ 40 years of age at disease onset). Methods: We retrospectively reviewed the medical records of patients with NMOSD in central China (with disease courses longer than 3 years) between January 2012 and January 2021. We further analyzed the clinical and prognostic differences between patients with REO-NMOSD and RLO-NMOSD. Results: A total of 71 patients were included in this study. The results showed that 39 (54.9%) of the patients had RLO-NMOSD. The patients with RLO-NMOSD had higher expanded disability status scale (EDSS) scores than patients with REO-NMOSD at the initial (5.0 vs. 3.0, p = 0.01), 3-month (4.0 vs. 2.5, p = 0.001), 1-year (4.0 vs. 2.5, p = 0.003), 3rd-year (3.5 vs. 3.0, p = 0.0017), and final follow-up (4.0 vs. 2.5, P = 0.002) time points. The EDSS scores of visual function were 2.0 (1.0-3.0) in REO-NMOSD and 3.0 (2.0-3.0) in RLO-NMOSD (p = 0.038) at the final follow-up time point. The locations of spinal cord lesions at transverse myelitis (TM) onset were prone to cervical cord in patients with REO-NMOSD. There were no between-group treatment differences. The risk of requiring a cane to walk (EDSS score of 6.0) increased as the age of disease onset increased: for every 10-year increase in the age of disease onset, the risk of needing a cane to walk increased by 65% [hazard ratio (HR) = 1.65, 95% CI 1.15-2.38, p = 0.007]. Another significant predictor identified in the multivariate analysis was annualized relapse rate (ARR) (HR = 2.01, 95% CI 1.09-3.71, p = 0.025). In addition, we observed a positive correlation between age at onset and EDSS scores at the final follow-up (Spearman's r = 0.426, p < 0.0001) time point. EDSS scores at different periods were significantly different between patients with RLO-NMOSD and REO-NMOSD with anti-aquaporin-4 (AQP4) IgG positive. Conclusion: The patients with RLO-NMOSD developed more severe disabilities than patients with REO-NMOSD at a variety of time periods. All of the patients may experience recurrent aggravated symptoms after their first year, with only patients with REO-NMOSD partly recovering from the 3rd year. The age at onset and ARR were the main predictors of outcomes.

Laparoscopic hepatectomy assisted by a flexible 915 MHz microwave antenna: A safe and innovative device for hepatectomy.

BACKGROUND: The objective of the present study was to elaborate a flexible 915 MHz microwave antenna (F915 MMA) and to evaluate the safety and feasibility in laparoscopic hepatecyomy (LH). METHODS: The F915 MMA was redesigned based on the experiences in clinical practice. Ten porcine LHs were divided into a 'flexible' group and a control group, with 5 porcine LHs in each group. The F915 MMA was used in the flexible group. The data for 48 patients who underwent LH were analyzed; 12 patients underwent F915 MMA-assisted LH and were regarded as the flexible group, and the others were considered as controls. RESULTS: The F915 MMA bends freely and rotates flexibly. In the porcine LH in vivo, the flexible group had less intraoperative blood loss (54.00 ±â€¯27.02 ml vs 230.00 ±â€¯83.67 ml, P = 0.002), and the mean duration of hepatic parenchyma transection in the flexible group was significantly shorter than that in the control group (17.3 ±â€¯7.8min vs 37.9 ±â€¯6.4min). Among th patients, compared to the control group, the flexible group had less intraoperative blood loss (154.17 ±â€¯68.95 ml vs 284.86 ±â€¯294.68 ml, P = 0.018), less frequency and duration of the first porta hepatic occlusion (1.50 ±â€¯0.52times vs 2.35 ±â€¯1.14times, P = 0.021 and 22.50 ±â€¯7.83min vs 35.95 ±â€¯17.23min, P = 0.017, respectively) and lower accumulative complications (33.3% vs 80.5%, P = 0.008). CONCLUSIONS: Laparoscopic F915 MMA is an innovative device that can assist LH in a safe, feasible and flexible manner.

Strategy for discriminating cholesterol and premalignancy in polypoid lesions of the gallbladder: a single-centre, retrospective cohort study.

BACKGROUND: The present study aimed to assess the risk factors of cholesterol and premalignancy in polypoid lesions of the gallbladder (PLGs) and to establish an appropriate treatment strategy. METHODS: Data from patients who underwent cholecystectomy at the First Affiliated Hospital, School of Medicine, Zhejiang University, between January 2011 and July 2017, were collected retrospectively. RESULTS: A total of 1561 patients were included in the present study. The cohort comprised of 636 (40.7%) males and 925 (59.3%) females, with a mean age of 49.5 (range 16-88) years; 65.6% (1024/1561) demonstrated cholesterol lesions in this cohort, among which cholesterol polyps accounted for 81.0%. Age younger than 50 years and multiple number of polyps were found to be independent predictive variables for cholesterol lesions (odds ratio (OR) 3.461, 95% confidence interval (CI) 2.058-5.820, P < 0.001 and OR 3.321, 95% CI 1.988-5.547, P < 0.001, respectively). The presence of polyp growth was associated with premalignancy (OR 5.366, 95% CI 1.466-19.637, P = 0.011), and the presence of clinical symptoms indicated benign non-cholesterol lesions (OR 0.368, 95% CI 0.153-0.885, P = 0.026). CONCLUSION: In the case of patients ≥50 years old with single asymptomatic polyp, cholecystectomy was recommended if the polyp presented growth at a rate above 3-4 mm within 6 months. If not, trimonthly ultrasound follow up was recommended, and clinicians should carefully assess the risk factors for premalignancy in PLGs.

Natural product pectolinarigenin inhibits proliferation, induces apoptosis, and causes G2/M phase arrest of HCC via PI3K/AKT/mTOR/ERK signaling pathway.

BACKGROUND: Hepatocellular carcinoma (HCC) is characterized by considerable phenotypic and molecular heterogeneity, but the overall survival of HCC patients remains extremely poor. Thus, novel and efficient alternatives to antitumor agents are urgently needed. Pectolinarigenin, a flavonoid compound extract, has been previously reported for the treatment of nasopharyngeal cancer. However, the potential antitumor roles of pectolinarigenin in HCC have not been clearly elaborated. In the present study, we investigated its role in HCC treatment and explored the potential molecular mechanism(s). MATERIALS AND METHODS: HCC cell lines SMMC7721 and PLC5 were cultured and treated with indicated concentrations of pectolinarigenin. For the HCC cell proliferation, after HCC cells were stimulated with indicated concentrations of pectolinarigenin, the cell viability was detected in CCK-8 and colony-forming assays. HCC cell invasion/migration assay was performed by Transwell and wound scratch methods. Additionally, cellular apoptosis and cell cycle arrest analysis was performed with flow cytometric analysis. Finally, the involved underlying signaling pathway, the PI3K/AKT/mTOR/ERK signaling-related molecular markers were detected through Western blot methods with indicated antibodies. Meanwhile, antitumor activity of pectolinarigenin was also assessed in tumor-bearing mice. RESULTS: The results indicated that the treatment with pectolinarigenin significantly inhibited cell proliferation and migratory and invasive abilities of SMMC7721 and PLC5 cells in concentration- and time-dependent manner. Meanwhile, pectolinarigenin markedly induced cell apoptosis and G2/M phase arrest in SMMC7721 and PLC5 cells, which was associated with apoptosis- and cell cycle-related protein levels, respectively. Furthermore, pectolinarigenin inhibited PI3K/AKT/mTOR/ERK signaling pathway. It also significantly suppressed HCC tumor growth in vivo. CONCLUSION: Pectolinarigenin could suppress the viability and motility and cause apoptosis and G2/M phase arrest in HCC cell lines by inhibiting the PI3K/AKT/mTOR/ERK signaling pathway. This might be an appealing potential therapeutic agent for HCC treatment.

Current status of epilepsy treatment and efficacy of standard phenobarbital therapy in rural areas of Northern China.

PURPOSE: To investigate the current status of epilepsy treatment and the efficacy and adverse effects of phenobarbital therapy in rural areas of Northern China. METHODS: A total of 2192 patients diagnosed with convulsive epilepsy were recruited from seven different rural regions in Jilin Province, China to investigate the current status of epilepsy treatment, and 1379 of them were enrolled in a standard phenobarbital therapy trial. Patients were selected according to strict inclusion and exclusion criteria, and medical records for all patients were collected and analyzed before the standard treatment was started. Patients were followed up monthly, and efficacy in 1218 patients was analyzed at 1, 3, 6 and 12 months of treatment. RESULTS: More patients had the initial seizure in juveniles than in adults, and 40.72% of the 2192 patients were not receiving any treatment before the treatment trial. The efficacy of phenobarbital increased and adverse effects decreased within the treatment period. Among the 349 patients who were followed up for 12 months from the beginning of the phenobarbital treatment, seizures were decreased by more than 75% in 71.3% of patients using a low-to-medium dose of phenobarbital. Major adverse effects of phenobarbital included mild exhaustion, drowsiness, dizziness and headache. CONCLUSIONS: Standardized long-term and regular administration of phenobarbital at a low-to-medium dose can be used as an effective, economic and safe treatment against epilepsy in rural areas.

Reversible posterior leukoencephalopathy associated with chronic graft-versus-host disease: A case report.

The present study describes the clinical manifestations, magnetic resonance imaging (MRI) features and treatments of a 22-year-old male patient diagnosed with reversible posterior leukoencephalopathy syndrome (RPLS) associated with graft-versus-host disease (GVHD) 7 months after a haploid hematopoietic stem cell transplantation. The patient was admitted to hospital after falling unconscious. Head MRI demonstrated abnormal signals in the bilateral, frontal, parietal, temporal and occipital lobes, consistent with reversible posterior leukoencephalopathy syndrome (RPLS). Based on a detailed diagnosis, the response to treatment and follow-up, it was concluded that RPLS was closely associated with chronic graft-versus-host disease in the patient. The present case report is described in order to increase the awareness of RPLS.

The Treatment and Follow-Up of Anti-LGI1 Limbic Encephalitis.

OBJECTIVE: This study aims to retrospectively study clinical characteristics, diagnosis, treatment and follow-up visits in patients with anti-leucine-rich glioma inactivated-1 (LGI1) limbic encephalitis (LE) for prompting the early diagnosis and efficacious treatment of this disease. METHODS: Four anti-LGI1 LE patients were hospitalized in the Department of Neurology at the First Hospital of Jilin University. Data from their clinical manifestations, diagnoses, treatments and follow-up visits were analyzed. RESULTS: Four patients with anti-LGI1 LE were characterized by hypomnesia, mental and behavior disorder, faciobrachial dystonic seizures (FBDS), seizures accompanied by pathological changes in the limbic system, obstinate hyponatremia and positive detection of anti-LGI1 antibody. In this study, we found that 1 patient initially presented with an abnormal sensation and had a subsequent FBDS, inconsistent with normal cases of anti-LGI1 LE. This patient had abnormalities in the basal ganglia region identified with head MRI, unlike most cases, which report abnormalities in the limbic system by positron emission tomography/CT scan. Finally, 3 of our patients with FBDS were treated with antiepileptic drugs as well as immune modulatory treatment, and they responded well. CONCLUSIONS: We identified new characteristics in clinical manifestation, diagnosis and treatment of anti-LGI1 LE, which contribute to a better understanding of this disease and help improve its early diagnosis and efficacious treatment.