A Review of Transition Metal Boride, Carbide, Pnictide, and Chalcogenide Water Oxidation Electrocatalysts.

Transition metal borides, carbides, pnictides, and chalcogenides (X-ides) have emerged as a class of materials for the oxygen evolution reaction (OER). Because of their high earth abundance, electrical conductivity, and OER performance, these electrocatalysts have the potential to enable the practical application of green energy conversion and storage. Under OER potentials, X-ide electrocatalysts demonstrate various degrees of oxidation resistance due to their differences in chemical composition, crystal structure, and morphology. Depending on their resistance to oxidation, these catalysts will fall into one of three post-OER electrocatalyst categories: fully oxidized oxide/(oxy)hydroxide material, partially oxidized core@shell structure, and unoxidized material. In the past ten years (from 2013 to 2022), over 890 peer-reviewed research papers have focused on X-ide OER electrocatalysts. Previous review papers have provided limited conclusions and have omitted the significance of "catalytically active sites/species/phases" in X-ide OER electrocatalysts. In this review, a comprehensive summary of (i) experimental parameters (e.g., substrates, electrocatalyst loading amounts, geometric overpotentials, Tafel slopes, etc.) and (ii) electrochemical stability tests and post-analyses in X-ide OER electrocatalyst publications from 2013 to 2022 is provided. Both mono and polyanion X-ides are discussed and classified with respect to their material transformation during the OER. Special analytical techniques employed to study X-ide reconstruction are also evaluated. Additionally, future challenges and questions yet to be answered are provided in each section. This review aims to provide researchers with a toolkit to approach X-ide OER electrocatalyst research and to showcase necessary avenues for future investigation.

Synthesis of Silica Particles with Controlled Microstructure via the Choline Hydroxide Cocatalyzed Stöber Method.

This study investigates the utilization of choline hydroxide as a cocatalyst in the Stöber method to synthesize silica particles with controlled microstructure. Under low ammonia concentration, we add a robust organic base choline hydroxide and systematically explore the influence of choline hydroxide concentration on the hydrolysis and condensation equilibrium of tetraethyl orthosilicate (TEOS). Through the rational control of the water content, we significantly enhance both the size range and polydispersity of the resulting silica particles. Taking advantage of the regulated microstructure induced by controlled hydrolysis and condensation catalyzed by choline hydroxide, we achieved silica particles with hollow structures through hot water etching, exhibiting significantly enhanced surface area. These findings demonstrate the versatility of choline hydroxide as a cocatalyst in tailoring the microstructure of silica particles. In addition, due to its reducing ability and biocompatibility, which are not shared by other reported catalysts, the use of choline hydroxide opens up opportunities for applications in catalysis, sensing, and drug delivery.

Clinical validation of a ctDNA-Based Assay for Multi-Cancer Detection: An Interim Report from a Vietnamese Longitudinal Prospective Cohort Study of 2795 Participants.

The SPOT-MAS assay "Screening for the Presence Of Tumor by Methylation And Size" detects the five most common cancers in Vietnam by evaluating circulating tumor DNA in the blood. Here, we validated its performance in a prospective multi-center clinical trial, K-DETEK. Our analysis of 2795 participants from 14 sites across Vietnam demonstrates its ability to detect cancers in asymptomatic individuals with a positive predictive value of 60%, with 83.3% accuracy in detecting tumor location. We present a case report to support further using SPOT-MAS as a complementary method to achieve early cancer detection and provide the opportunity for early treatment.

Computed tomography-guided cryoablation for functional adrenal aldosteronoma.

PURPOSE: To assess the safety and clinical effectiveness of computed tomography (CT)-guided cryoablation for functional adrenal aldosteronoma. MATERIAL AND METHODS: From June 2012 to December 2018, 11 patients with functional adrenal aldosteronoma underwent CT-guided cryoablation in our center. Data comprising complete ablation rate, clinical success rate, procedure-related complications and long-term outcome were collected and analyzed. RESULTS: A total of 11 aldosteronoma in 11 patients were treated. Complete ablation was achieved in all patients after a single ablation session. No procedure-related complications occurred. Clinical success rate was 100%. Mean aldosterone levels, and systolic and diastolic pressure decreased from 858.6 ± 93.2 pmol/L, 156.4 ± 7.8 mmHg and 90.0 ± 10.5 mmHg prior to treatment, respectively, to 321.8 ± 41.2 pmol/L (p < .001), 129.1 ± 9.4 mmHg (p < .001) and 76.4 ± 5.5 mmHg (p = .005) after treatment, respectively. Mean renin and potassium improved from 0.2 ± 0.1 µg/L/h and 2.9 ± 0.2 mmol/L before treatment, respectively to 4.6 ± 0.4 µg/L/h (p < .001) and 4.2 ± 0.2 mmol/L (p < .001) following treatment, respectively. No tumor or clinical symptom recurrence occurred during the follow-up. CONCLUSIONS: CT-guided cryoablation is a safe and effective method for the treatment of functional adrenal aldosteronoma.

Endovascular treatment for hepatic vein-type Budd-Chiari syndrome: effectiveness and long-term outcome.

PURPOSE: To determine the clinical effectiveness and long-term outcomes of endovascular treatment for hepatic vein (HV)-type Budd-Chiari syndrome (BCS). MATERIALS AND METHODS: From June 2011 to August 2016, 68 consecutive patients with symptomatic HV-type BCS underwent endovascular treatment in our center. Data on the baseline characteristics, technical success, clinical success, and long-term outcomes were collected and analyzed retrospectively. RESULTS: The technical success rate of endovascular treatment was 100%. Fifty patients underwent HV recanalization, and 18 underwent accessory HV (AHV) recanalization. The clinical success rate was 95.6% (65/68). During a mean follow-up period of 29.4 ± 13.6 months, 19 patients experienced re-obstruction of either the HV (n = 18) or the AHV (n = 1). The cumulative 1-, 2-, and 5-year primary patency rates were 80.0, 72.8, and 67.9%, respectively. The cumulative 1-, 2-, and 5-year secondary patency rates were 93.8, 90.3, and 82.9%, respectively. Univariate and multivariate analyses revealed that the independent predictor of a prolonged primary patency duration was recanalization of the AHV. Five patients died 1-28 months (median, 15 months) after treatment. The cumulative 1-, 2-, and 5-year survival rates were 96.9, 93.4, and 91.2%, respectively. There was no significant difference in survival between the HV and AHV recanalization groups. CONCLUSION: Endovascular treatment is effective for patients with HV-type BCS. It can result in excellent long-term patency and survival rates. If it is applicable, AHV recanalization should be considered prior to treatment in order to achieve a longer patency.

Stent insertion for malignant superior vena cava syndrome: effectiveness and long-term outcome.

PURPOSE: To determine the clinical effectiveness and long-term outcome of stent insertion for malignant superior vena cava (SVC) syndrome. MATERIALS AND METHODS: From June 2010 to April 2016, 47 patients with malignant SVC syndrome were treated with stent insertion in our center. Data regarding the technical success, clinical success, and long-term outcome were collected and analyzed retrospectively. RESULTS: SVC stent insertion was successfully performed in all patients. A total of 65 stents were used. No procedure-related complication occurred in these patients. The mean SVC pressure gradient decreased from 17.8 mmHg before stent insertion to 7.6 mmHg after stent insertion (P < 0.001). Clinical success was 100%. During a mean follow-up period of 6 months (range 10 days-13 months), 25 patients underwent subsequent anti-cancer treatment. Six patients (12.8%) experienced re-obstruction of stent 1 to 189 days (median 76 days) after stent insertion. All patients died during the follow-up. The median stent patency time and survival were 339 and 167 days, respectively. The cumulative 3-, 6-, and 12-month stent patency rates were 93.4, 87.4, and 81.2%, respectively. The cumulative 3-, 6-, and 12-month survival rates were 83, 38.3, and 2.1%, respectively. The independent predictors of prolonging survival after stent insertion were lower tumor stage (P = 0.018) and subsequent anti-cancer treatment after stent insertion (P = 0.009). CONCLUSION: Stent insertion is a simple, safe, and effective method for patients with malignant SVC syndrome. Subsequent anti-cancer treatment after stent insertion may increase the survival.

Placement of integrated self-expanding Y-shaped airway stent in management of carinal stenosis.

PURPOSE: To investigate the feasibility and effectiveness of integrated self-expanding Y-shaped airway stent placement for patients with carinal stenosis. MATERIALS AND METHODS: From May 2010 to March 2015, 12 consecutive patients with carinal stenosis, treated by placement of integrated self-expanding Y-shaped airway stent, were included this retrospective study. Data on technical success, clinical success, and follow-up were analyzed. RESULTS: Technical success was 100 %. Eleven uncovered stents and one covered stent placed in 12 patients. Eleven patients underwent stent insertion under local pharyngeal anesthesia, and one patient underwent stent insertion under general anesthesia. Clinical success was 100 %. The respiratory difficulty improved instantly after treatment. The average Hugh-Jones classification grade and arterial oxygen saturation improved from 4.3 ± 0.6 and 83.0 ± 2.6 % before treatment to 1.4 ± 0.5 (p < 0.001) and 95.4 ± 1.2 % (p < 0.001) after treatment, respectively. During 3-15 months (mean 6.5 ± 3.3 months) of follow-up, two patients experienced the re-stenosis of the stent 75 and 78 days after treatment. All patients died during the follow-up. Survival after stent insertion ranged from 96 to 432 days (median 165 days). The cumulative 6- and 12-month survival rates were 41.7 and 8.3 %, respectively. CONCLUSIONS: Placement of integrated self-expanding Y-shaped airway stent is a simple, safe, and effective method for patients with carinal stenosis.

Sn(II)-doped one-dimensional hybrid metal halide [C5H14NO]CdCl3 single crystals with broadband greenish-yellow light emission.

Low-dimensional organic-inorganic hybrid halides, as an important branch of metal halide materials, have attracted much attention due to their excellent photoelectric properties. Herein, we designed one new hybrid cadmium chloride [C5H14NO]CdCl3 based on combinations of the d10 metal cation (Cd2+) and choline chloride molecules. [C5H14NO]CdCl3 single crystals belong to the orthorhombic Pna21 space group and show a one-dimensional (1D) structure with distorted [CdCl5O]5- octahedra. The second harmonic generation (SHG) response of [C5H14NO]CdCl3 exhibits an intensity of approximately 0.4 × KDP. Moreover, the photoluminescence properties of the [C5H14NO]CdCl3 crystal are activated by doping with Sn2+ ions having stereochemically active lone pair 5s2 electrons. Under UV excitation conditions, bright greenish-yellow light emission can be observed, and the quantum efficiency (PLQY) is as high as 91.27%. The luminescence mechanism is revealed by combining the results of temperature dependent luminescence and density functional theory (DFT) calculation. This work can serve as a guide for the design and synthesis of emerging optical materials.

Radioactive stent insertion for inoperable hilar cholangiocarcinoma: a prospective randomized controlled trial.

Introduction: Hilar cholangiocarcinoma (HC) is the leading cause of hilar biliary obstruction. Radioactive stent insertion has been utilized extensively for inoperable HC patients. Aim: To assess the relative clinical outcomes of inoperable HC patients who underwent either normal or radioactive stent insertion. Material and methods: This single-center, prospective, randomized, open-label study enrolled 90 inoperable HC patients from April 2021 to March 2022 and randomly assigned them to normal or radioactive stent groups (n = 45/group), with clinical data then being compared between these groups. Results: Technical success rates in the normal and radioactive stent insertion groups were 93.3% and 97.9%, respectively (p = 1.000), and clinical success rates were similarly consistent in both groups (95.3% vs. 97.7%, p = 0.983). Individuals in the radioactive stent group exhibited significantly longer median stent patency as compared to the normal stent group (195 days vs. 115 days, p < 0.001), and median overall survival (OS) was also significantly increased in the normal stent group (242 days vs. 125 days, p = 0.002). In the normal stent insertion group, 6 (14.3%) and 5 (11.9%) patients experienced early and late postoperative complications, respectively. Additionally, early and late postoperative complications impacted 7 (16.3%) and 8 (18.6%) patients in the radioactive stent insertion group, respectively. Complication rates were comparable in these 2 patient groups. Conclusions: Radioactive stent insertion represents a safe and effective strategy for patients with inoperable HC, potentially contributing to prolonged stent patency and OS relative to normal stent insertion.

Activation of α7nAChR by PNU282987 improves cognitive impairment through inhibiting oxidative stress and neuroinflammation in D-galactose induced aging via regulating α7nAChR/Nrf2/HO-1 signaling pathway.

Aging is an important risk factor for neurodegenerative diseases. The activation of α7 nicotinic acetylcholine receptor (α7nAChR) is involved in inflammation and cognition, but the specific role it plays in aging remains unknown. This study aimed to investigate the anti-aging effect of the activation of α7nAChR on aging rats and BV2 cells induced by D-galactose, as well as its potential mechanism. D-galactose induced an increase in the SA-ß-Gal positive cells, expression of p16 and p21 in vivo and in vitro. α7nAChR selective agonist PNU282987 decreased levels of pro-inflammatory factors, MDA, and Aß, enhanced SOD activity and levels of anti-inflammatory factor (IL10) in vivo. PNU282987 enhanced the expression of Arg1, decreased the expression of iNOS, IL1ß and TNFα in vitro. PNU282987 upregulated the levels of α7nAChR, Nrf2 and HO-1 in vivo and in vitro. The results of Morris water maze and novel object recognition tests showed that PNU282987 improved cognitive impairment in aging rats. Furthermore, α7nAChR selective inhibitor methyllycaconitine (MLA) results were opposite with PNU282987. PNU282987 improves cognitive impairment through inhibiting oxidative stress and neuroinflammation in D-galactose induced aging via regulating the α7nAChR/Nrf2/HO-1 signaling pathway. Therefore, targeting the α7nAChR may be a viable therapeutic approach for anti-inflammaging and neurodegenerative diseases.

S-adenosylmethionine improves cognitive impairment in D-galactose-induced brain aging by inhibiting oxidative stress and neuroinflammation.

Oxidative stress and neuroinflammation play crucial roles in aging. S-adenosylmethionine (SAM), a popular supplement, is a potential antioxidant and candidate therapy for depression. This study aimed to evaluate the neuroprotective effects of SAM on D-galactose-induced brain aging and explore its underlying mechanisms. Brain aging model was established with D-galactose (180 mg/kg/day) for 8 weeks. During the last 4 weeks, SAM (16 mg/kg) was co-administrated with D-galactose. Behavior tests were used to assess cognitive function and depression-like behaviors of rats. Results showed that cognitive impairment and depression-like behaviors were reversed by SAM. SAM reduced neuronal cell loss, increased brain-derived neurotrophic factor level in the hippocampus, inhibited amyloid-ß level and microglia activation, as well as pro-inflammatory factors levels in the hippocampus and serum. Further, SAM enhanced antioxidant capacity and attenuated cholinergic damage by reducing malondialdehyde levels, increasing acetylcholine levels, expression levels of α7 nicotinic acetylcholine receptor (α7nAChR), nuclear factor erythrocyte 2-related factor 2 (Nrf2) and heme oxygenase 1 (HO-1) in the hippocampus. Above all, SAM has a potential neuroprotective effect on ameliorating cognitive impairment in brain aging, which is related to inhibition of oxidative stress and neuroinflammation, as well as α7nAChR signals. DATA AVAILABILITY: Data will be made available on request.

2D Perovskite Mn2+ -Doped Cs2 CdBr2 Cl2 Scintillator for Low-Dose High-Resolution X-ray Imaging.

High-performance X-ray scintillators with low detection limits and high light yield are of great importance and are a challenge for low-dose X-ray imaging in medical diagnosis and industrial detection. In this work, the synthesis of a new 2D perovskite, Cs2 CdBr2 Cl2 , via hydrothermal reaction is reported. By doping Mn2+ into the perovskite, a yellow emission located at 593 nm is obtained, and the photoluminescence quantum yield (PLQY) of Cs2 CdBr2 Cl2 :5%Mn2+ perovskite reaches the highest value of 98.52%. The near-unity PLQY and negligible self-absorption of Cs2 CdBr2 Cl2 :5%Mn2+ enable excellent X-ray scintillation performance with a high light yield of 64 950 photons MeV-1 and low detection limit of 17.82 nGyair s-1 . Moreover, combining Cs2 CdBr2 Cl2 :5%Mn2+ with poly(dimethylsiloxane) to fabricate a flexible scintillator screen achieves low-dose X-ray imaging with a high resolution of 12.3 line pairs (lp) mm-1 . The results suggest that Cs2 CdBr2 Cl2 :5%Mn2+ is a promising candidate for low-dose and high-resolution X-ray imaging. The study presents a new approach to designing high-performance scintillators through metal-ion doping.

Enhanced light harvesting and charge separation of carbon and oxygen co-doped carbon nitride as excellent photocatalyst for hydrogen evolution reaction.

Solar-driven water splitting has been regarded as a promising strategy for renewable hydrogen production. Among many semiconductor photocatalysts, graphitic carbon nitride (g-C3N4) has received tremendous attention due to its two-dimensional structure, appropriate band gap and decent photocatalytic activity. However, it suffers severe charge recombination problems, affecting its practical performance. In this work, we demonstrated that dual heteroatoms (C and O) doped g-C3N4 can exhibit about 3 times higher catalytic performance for hydrogen evolution than that of the normal g-C3N4 with a hydrogen evolution rate reaching 2595.4 umol g-1h-1 and an apparent quantum efficiency at 420 nm of 16.6%. The heteroatoms (C and O) doped g-C3N4 photocatalyst also exhibited superior removal performance when removing Rhodamine B (RhB) . X-ray photoelectron spectroscopy (XPS), solid-state nuclear magnetic resonance (ssNMR) and X-ray absorption near-edge structure (XANES) spectroscopy reveal that the carbon and oxygen dopants replace the sp2 nitrogen and bridging N atom, respectively. DFT calculations demonstrate the codoping of carbon and oxygen- induced the generation of mid-gap state, leading to the improvement of light harvesting and charge separation.

Small RNA Analyses of a Ceratobasidium Isolate Infected with Three Endornaviruses.

Isolates of three endornavirus species were identified co-infecting an unidentified species of Ceratobasidium, itself identified as a symbiont from within the roots of a wild plant of the terrestrial orchid Pterostylis vittata in Western Australia. Isogenic lines of the fungal isolate lacking all three mycoviruses were derived from the virus-infected isolate. To observe how presence of endornaviruses influenced gene expression in the fungal host, we sequenced fungus-derived small RNA species from the virus-infected and virus-free isogenic lines and compared them. The presence of mycoviruses influenced expression of small RNAs. Of the 3272 fungus-derived small RNA species identified, the expression of 9.1% (300 of 3272) of them were up-regulated, and 0.6% (18 of 3272) were down-regulated in the presence of the viruses. Fourteen novel micro-RNA-like RNAs (Cer-milRNAs) were predicted. Gene target prediction of the differentially expressed Cer-milRNAs was quite ambiguous; however, fungal genes involved in transcriptional regulation, catalysis, molecular binding, and metabolic activities such as gene expression, DNA metabolic processes and regulation activities were differentially expressed in the presence of the mycoviruses.

Efficacy and safety of camrelizumab plus transarterial chemoembolization in intermediate to advanced hepatocellular carcinoma patients: A prospective, multi-center, real-world study.

Objective: Camrelizumab is a newly developed program-death receptor one inhibitor; the real-world evidence about its application in hepatocellular carcinoma (HCC) treatment is lacking. Therefore, this prospective, multi-center, real-world study evaluated the efficacy and safety of camrelizumab plus transarterial chemoembolization (TACE) in treating intermediate-to-advanced HCC patients. Methods: This study consecutively enrolled 101 intermediate to advanced HCC patients. All patients received camrelizumab-based treatment within 30 days of the perioperative period of the TACE operation. The primary outcome was progression-free survival (PFS), and the secondary effects were overall survival (OS), objective response rate (ORR), disease control rate (DCR), and AEs. Results: Specifically, the median PFS was 9.7 (95% confidence interval: 7.4-12.0) months, with a 1-year PFS rate of 30.6%. Meanwhile, the median OS was not reached (NR) yet, with a 1-year OS rate of 61.9%. Besides, the CR, PR, SD, and PD rates were 12.8%, 44.9%, 29.5%, and 12.8%, respectively. The ORR and DCR were 57.7% and 87.2%, respectively. More cycles of camrelizumab were independently correlated with prolonged PFS (hazard ratio (HR): 0.415, P = 0.002), whereas longer intervals between camrelizumab administration and TACE were independently associated with unfavorable PFS (HR: 1.873, P = 0.032). The incidence of total AEs was 90.1%; most AEs were grade 1 (20.8%), grade 2 (28.7%) and grade 3 (37.6%), while only 3 (3.0%) patients had grade 4 AEs. Conclusion: The camrelizumab plus TACE regimen is effective and safe, indicating its potential to serve as a promising treatment choice for intermediate to advanced HCC patients.

Costs and Cost-Effectiveness of mCME Version 2.0: An SMS-Based Continuing Medical Education Program for HIV Clinicians in Vietnam.

BACKGROUND: The Mobile Continuing Medical Education (mCME) 2.0 project was a randomized controlled trial that found that a 6-month text message-based CME intervention improved both the use of online medical training resources and medical knowledge among a cadre of HIV clinicians in Vietnam. This companion study analyzed intervention costs and cost-effectiveness. METHODS: We conducted (1) a financial analysis based on costs incurred during the trial's planning and implementation; (2) an economic analysis to consider resource utilization; and (3) cost-effectiveness analyses to estimate cost inputs relative to impact: increase in self-study (measured by visits to online courses) and increase in knowledge (measured by exam score improvement) (in 2016 US$). Finally, we estimated the economic cost of a 9-month national program and a 10-year scaled-up model (in 2021 US$). RESULTS: The total financial cost of the intervention was US$49,552; the main cost drivers were personnel time (71.4%) and technology inputs (14.9%). The total economic cost was estimated at US$92,212, with the same key cost inputs (representing 77.7% and 8.0%, respectively, of total costs). The financial cost per 10% increase in accessing online courses was US$923, while the cost of improving knowledge, measured by a 10% improvement in mean exam score across the study population, was US$32,057 (US$605 per intervention clinician). The comparable total economic cost of each improvement, respectively, was US$1,770 and US$61,452 (US$1,159 per intervention clinician). A future 9-month national program was estimated to cost US$37,403, while the full 10-year scaled-up program was estimated at US$196,446. CONCLUSIONS: This analysis indicates that leveraging mobile technology could be a feasible way to provide distance learning to health professions across Vietnam at a relatively low cost. Given the need for practical ways to expand CME in resource-constrained regions of the world, this approach warrants further study and possible adoption.

[Response of Microbial Community to Natural Organic Matter Input in Lake Sediments].

Increased loads of biogenic and terrestrial natural organic matter into freshwater lakes are projected to be a major consequence of global climate change and cyanobacterial blooms. In this study, the effects of phytoplankton-derived organic matter (POM) and terrestrial humic acid (HA) on the activity, composition, and function of the microbial community in Lake Taihu sediments were investigated. Fluorescent spectra demonstrated that POM with high chemodiversity was composed of labile protein-like components (50%) and recalcitrant humic-like components (50%), while humic-like substances accounted for 97% of HA. Over two-month periods, the organic carbon mineralization in sediments was enhanced owing to increasing NOM concentrations; however, the carbon consumption in POM-amended sediments was significantly higher than that in sediments amended with the same concentrations of HA. Analysis of extracellular polymeric substances indicated that NOM input improved the microbial secretion of proteins and polysaccharides, increasing the aggregation and stability of the microbial community. The amendment of POM also stimulated the activity of organic matter metabolic enzymes, promoting microbial activity. Moreover, 16S rRNA gene sequencing suggested that the mineralization of NOM (especially POM) increased the diversity of the microbial community, favored the survival of Proteobacteria and Bacteroidetes, and upregulated the function genes of organic matter metabolism. These results suggest that the composition and function of microbial community in sediments were associated with the origin, composition, and concentration of NOM input.

Stent Insertion With High Intensity-Focused Ultrasound Ablation for Biliary Obstruction Caused by Pancreatic Carcinoma: A Randomized Controlled Trial.

PURPOSE: This study was designed to assess the clinical efficacy of stent insertion with high intensity-focused ultrasound ablation (HIFUA) in patients with malignant biliary obstruction (MBO) as a consequence of pancreatic carcinoma (PC). MATERIALS AND METHODS: This was a single-center, open-label, prospective, randomized controlled trial. Consecutive patients with MBO caused by PC were randomly assigned to undergo stent insertion with or without HIFUA from June 2019 to February 2020. This study was registered at ClinicalTrials.gov (NCT03962478). RESULTS: In total, 92 patients were enrolled in this study and assigned to the stent-only (n=46) or combined (stent+HIFUA; n=46) treatment groups. Stent insertion was associated with a 100% technical success rate. For patients in the combination treatment group, 26, 18, and 2 patients underwent 2, 3, and 4 cycles of HIFUA, respectively. A positive clinical response to HIFUA treatment was noted in 38 patients (82.6%). Stent dysfunction was detected in 9 and 15 patients in the combination and stent-only groups, respectively (P=0.154), while median stent patency in these 2 groups was 188 and 120 days, respectively (P<0.001). All patients died over the course of the follow-up, with median survival periods of 218 and 140 days in the combination and stent-only treatment groups, respectively (P=0.001). The only detected predictor of prolonged survival was HIFUA treatment (P=0.004), and there were no significant differences in complication rates between these 2 treatment groups. CONCLUSION: A combination of stent insertion and HIFUA can improve stent patency and overall survival in patients suffering from MBO because of PC relative to stent insertion alone.

Percutaneous metal stenting for malignant hilar biliary obstruction: a systematic review and meta-analysis of unilateral versus bilateral stenting.

The purpose of this study is to assess the relative clinical efficacy of treating malignant hilar biliary obstruction (MHBO) via percutaneous unilateral or bilateral metal stenting. Relevant articles up to December 2019 were identified within the Web of science, Pubmed, Embase, and Cochrane Library databases. Stent dysfunction served as the primary endpoint, while we assessed technical success, clinical success, early and late complication incidence, and overall survival as secondary outcomes. Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated for dichotomous variables. Hazard ratio (HR) with 95% CI were determined for overall survival. This meta-analysis included seven studies. Six studies were non-randomized controlled trials (RCTs) and one study was a RCT. A total of 888 MHBO patients underwent either percutaneous unilateral (n = 376) or bilateral (n = 512) metal stenting in these seven studies. We detected no significant differences in stent dysfunction rates (OR 0.97; 95% CI 0.67, 1.41, P = 0.89), technical success rates (OR 1.10; 95% CI 0.53, 2.29, P = 0.81), clinical success rates (OR 0.72; 95% CI 0.43, 1.22, P = 0.22), early complication rates (OR 0.82; 95% CI 0.34, 1.98, P = 0.66), late complication rates (OR 0.87; 95% CI 0.29, 2.63, P = 0.81), or overall survival (HR: 0.99; 95% CI 0.83, 1.17, P = 0.88) between unilateral and bilateral groups. Funnel plots demonstrated no obvious publication bias of these primary and secondary endpoints. From a clinical perspective, percutaneous unilateral and bilateral metal stenting are similarly effective for treatment of patients with MHBO.

Nitrogen oxide gas purification using carbon in water as reducing reagent with the aid of microbial fuel cell.

Microbial Fuel Cell (MFC) can degrade the organic matter (OM) in wastewater at the anode and transfer electrons to the cathode. In this work, the harmful NOX gas was used as electron acceptor in MFC and converted to harmless N2. The OM in water was indirectly used as a zero-cost reducing agent for NOx removal. More than 80% of NOX was removed continuously by MFC at room temperature. The NOX was directly reduced to N2 at MFC cathode and the cathode activity played a key role on enhancing the NOX removal. The NOX removal efficiency by the cathode of high potential was 1.37 times that by the cathode of low potential. When O2 coexisting with NO as the electron acceptor, not only the NOX removal but also the power output of MFC was improved greatly. The presence of NOX did not decrease the power generation of MFC under the same O2 concentration. The MFCs showed good stability for NOX treatment and power output. Moreover, the possible pathways and advantages of NOX removal by MFC were discussed in detail. These results indicated that the MFC system has the potential to treat wastewater, purify flue gas and recover energy simultaneously.