Characteristics and source apportionment of water-soluble inorganic ions in atmospheric particles in Lvliang, China.

Seasonal atmospheric particulate matter samples with different particle sizes (< 2.5 µm [PM2.5], 2.5-5 µm [PM2.5-5], 5-10 µm [PM5-10], and 10-100 µm [PM10-100]) were collected to analyze the mass concentration and distribution characteristics of nine water-soluble ions (WSIs; F-, Cl-, NO3-, SO42-, Na+, NH4+, K+, Mg2+, and Ca2+) in Lvliang in China. The results of chemical composition analysis indicated that the average concentration of total WSIs was 29.08 µg·m-3 and accounted for 40.45% of PM2.5, 80.99% of which was attributable to SO42-, NH4+, and NO3-; the concentration demonstrated obvious distribution characteristics. NO3- and NH4+ primarily exist as NH4NO3 and (NH4)2SO4, respectively, in fine particles but as NaNO3 and NH4Cl, respectively, in coarse particles. The PM2.5 was alkaline overall, and K+ and NH4+ caused the highest RC/A values in autumn. Stationary sources contribute more to WSIs in particulates than mobile sources. The secondary transformation degree of SO2 was higher than that of NOx, especially in fine particles. The positive matrix factorization (PMF) and potential source contribution function (PSCF) models were combined to determine the sources of WSIs in PM2.5. Through use of the PMF model, five source factors were categorized: secondary aerosols (43.0%), biomass combustion (21.7%), coal combustion (17.6%), dust (10.9%), and vehicular traffic (6.8%). The results of the PSCF model suggested that the transport of pollutants from Shanxi, northwestern Shaanxi, Gansu, Inner Mongolia and Henan, had the greatest effect on air quality in Lvliang.

A Case of Bilateral Aortoiliac Aneurysm with Persistent Aneurysmal Sciatic Artery Treated by Endovascular Aneurysm Repair.

The femoral artery is the conventional access for endovascular abdominal aortic aneurysm repair (EVAR). Patients with an anomalous persistent sciatic artery (PSA) is usually at the expense of an atrophied femoral artery. Therefore, EVAR for patients with PSA anomalies is exceptionally challenging. We report the case of a 69-year-old man with an aortoiliac aneurysm and right PSA. Preoperative computed tomography angiography (CTA) revealed a tortuous infrarenal abdominal aortic aneurysm, bilateral common-internal iliac aneurysms, and a right aneurysmal PSA with an ipsilateral atrophic femoral and superficial femoral artery. The aortoiliac aneurysm was successfully repaired through an endovascular approach with access through the right persistent sciatic artery, bilateral femoral artery, and left brachial artery. One-month postoperation, CTA revealed a type 1 endoleak originating from the proximal end of the aorta graft. The second and third operations were performed to close the endoleak through extended proximal cuff with chimney bilateral renal stents and sac embolization with coils and fibrin glue at 1 and 14 months, respectively, after the first operation. CTA performed three months after the third operation did not show any endoleaks. A persistent sciatic artery can be used as an access for endovascular repair of a complicated infrarenal aortoiliac aneurysm combined with an anomalous persistent sciatic artery and an atrophied femoral artery.

Comparative Effectiveness of Endovascular Treatment Modalities for De Novo Femoropopliteal Lesions: A Network Meta-analysis of Randomized Controlled Trials.

Purpose: To report the results of a network meta-analysis of randomized controlled trials (RCTs) comparing multiple endovascular treatments for de novo femoropopliteal lesions. Materials and Methods: The MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases were systematically searched on June 1, 2019, for prospective RCTs comparing 14 treatments [ie, atherectomy, brachytherapy, cryoplasty, cutting balloons, drug-coated balloons, bare nitinol stents, drug-eluting stents (DES), covered stents (CS), and combinations] in the treatment of de novo femoropopliteal lesions. Outcomes were technical success; binary restenosis and target lesion revascularization (TLR) at 6, 12, and/or 24 months; and all-cause mortality at 12 months. Ultimately, 53 articles reporting on 45 studies (91 study arms; 5565 patients) were selected. For the technical success outcome, all types of stents, all balloons, and all atherectomy devices were aggregated in stent, balloon, and atherectomy technology groups, respectively. Results: In terms of technical success for aggregated treatment types, stent technology was the most effective treatment and was better than balloon and atherectomy technologies. In terms of binary restenosis, DES was the most effective single treatment at the 6- and 12-month follow-up and CS at the 24-month follow-up. Both DES and CS were better than the majority of other single treatments, including balloon angioplasty, cutting balloon, cryoplasty, directional atherectomy, and bare nitinol stent during all follow-up periods. In terms of TLR, DES was the second most effective single treatment and the most effective single treatment at the 6- and 12-month follow-up intervals; CS was the most effective single treatment at the 24-month follow-up. Both DES and CS were better than the majority of other single treatments. The 12-month all-cause mortality of both DES and CS were similar to other treatments, whereas cryoplasty seemed to be the least effective treatment with regard to binary restenosis and TLR. Conclusion: Both DES and CS had substantial advantages in terms of restenosis and TLR in femoropopliteal lesions and were similar to aggregate stent technology in terms of technical success. DES performed better within 12 months after operation and CS at ~24 months, but neither had much advantage in terms of mortality. In contrast, cryoplasty seemed to be a less effective treatment.

A Network Meta-analysis of Randomized Controlled Trials Comparing Treatment Modalities for Infrapopliteal Lesions in Critical Limb Ischemia.

BACKGROUND: We aimed to conduct a network meta-analysis of randomized controlled trials comparing treatment modalities for infrapopliteal lesions in critical limb ischemia. METHODS: Five treatments for infrapopliteal lesions in critical limb ischemia were recognized. We compared primary patency, target lesion revascularization (TLR), major amputation at the 12-month follow-up, and technical success rate of the treatment modalities. RESULTS: Altogether, 11 studies (22 study arms; 1,330 patients) were considered eligible. The drug-eluting balloon (DEB) significantly increased primary patency compared with balloon angioplasty (BA; odds ratio [OR] 9.02, 95% confidence interval [CI] 3.18-25.55), the bare metal stent (BMS; OR 14.39, 95% CI 4.33-47.87), and the drug-eluting stent (DES; OR 3.70, 95% CI 1.20-11.11). The DES significantly increased primary patency compared with BA (OR 2.42, 95% CI 1.57-3.74) and BMS (OR 3.86, 95% CI 2.24-6.65). DES significantly increased the technical success rate compared with BA (OR 11.78, 95% CI 1.42-97.59). According to the value of the surface under the cumulative ranking curve (SUCRA), DEB was considered the best treatment in terms of primary patency (SUCRA = 99.7) and TLR (SUCRA = 70.7), and DES was considered the best treatment in terms of technical success rate (SUCRA = 90.6) and major amputation (SUCRA = 85.9). CONCLUSIONS: DEB has shown encouraging results in terms of primary patency for infrapopliteal lesions in critical limb ischemia; furthermore, DEB may be better than other treatments in terms of TLR. DES may be better than other treatments in terms of technical success and major amputation. In contrast, BA and BMS seem to be less effective treatment options.

Emission factors and source profiles of VOCs emitted from coke production in Shanxi, China.

Coking plants in China generate a substantial amount of volatile organic compounds (VOCs). The emission factors (EFs) of VOCs from coking plants are not well known, and thus, this study characterized the VOCs in the emissions from four coking plants in Shanxi, China. The EFs of VOCs from different stages of the coking process were calculated, and coal charging exhibited the highest EFs of VOCs, followed by the flue gases from combustion of coke oven gas, wastewater treatment, coke pushing and chemical byproduct recycling. The VOCs in emissions differed by coking process. Alkanes, aromatics and alkenes were the main VOCs emitted during the coking, wastewater treatment and chemical byproduct recycling processes, respectively. To effectively control the contribution of VOCs from coking processes to secondary organic aerosols and ozone formation, attention should be given to wastewater treatment and coal loading processes. The mean annual weight of VOCs emitted from coking plants in China from 2019 to 2021 was estimated to be 32.91 Gg with coking, chemical byproduct recycling, and wastewater treatment processes accounting for 91.34%, 7.85%, and 0.80% of total VOCs, respectively. An uneven spatial distribution of VOCs emissions in China was identified, with Shanxi, Shaanxi, Hebei, Inner Mongolia and Shandong being the largest contributors.

[Source Analysis and Health Risk Assessment of PAHs in PM2.5, Lüliang City].

To investigate the seasonal variation, health risks, and potential sources of polycyclic aromatic hydrocarbons(PAHs) in PM2.5 in the Lüliang area, PM2.5 samples were collected in Lishi District(downtown area) and Xiaoyi City(suburban area) from October 23, 2018 to July 1, 2019, and the concentrations of 14 PAHs were determined using gas chromatography-mass spectrometry(GC-MS). The annual average concentration of PAHs was 95.50 ng·m-3, and the concentration of 5-6 ring PAHs was mainly(49.7%), with 3 ring PAHs accounting for a relatively low proportion(8.3%).The concentration of PAHs in Lüliang City showed a seasonal pattern of winter>autumn>spring>summer. The results of the ILCRs model and Monte Carlo simulation showed that the toxicity of PAHs in Lüliang City followed the rule of adults>youth>children. Except in summer, the ILCRs values in the Lishi area were between 10-6 and 10-4, much higher than those in Xiaoyi City, indicating that there was a high potential risk of polycyclic aromatic hydrocarbons in the urban area. Through the characteristic ratio method and positive matrix factorization(PMF), it was shown that the PAHs in Lüliang City were mainly from the combustion of coal and biomass(61.9%) and vehicle exhaust emissions(38.1%). Based on the backward trajectory and potential source factor contribution analysis model, it was determined that the potential sources of PAHs in Lüliang City were mainly distributed in southern Shanxi, northern Shaanxi, and western Inner Mongolia.

Characterization and emission factors of carbonaceous aerosols originating from coke production in China.

Coking is a substantial source of carbonaceous aerosols in China, but the emission characteristics and pollution levels of coking-produced organic carbon (OC) and elemental carbon (EC) remain unknown, causing considerable uncertainty in emission estimates. In this study, the emission factors of OC (EFOC) and EC (EFEC) of typical coking plants in Shanxi, China, were measured. The measured EFEC and EFOC from fugitive emissions (7.43 and 9.54 g/t) were significantly higher than those from flue gas (1.67 and 3.71 g/t). The technological conditions of coke production affect the emissions of OC and EC. For example, the total emissions from coke plants that use 3.2-m-high coke ovens were greater than those from plants that use 4.3- and 6-m-high ovens. The EFOC and EFEC for plants conducting stamp charging were considerably higher than those for plants using top charging. The stable carbon isotopes of total carbon (δ13CTC), OC (δ13COC), and EC (δ13CEC) for fly ash during coking were -23.74‰ to -24.17‰, -23.32‰ to -23.87‰, and -23.84‰ to -24.14‰, respectively, and no clear isotopic fractionation was found during coke production. Different EC/OC ratios from different emission pathways and the carbon isotope signature of coke production should be considered when investigating the sources of carbonaceous aerosols. The total estimated EC and OC emissions from coke production in China were 3.93 and 5.72 Gg in 2017, and Shanxi, Hebei, and Shaanxi made the largest contributions.

[Characteristics, Sources, and Health Risks of Elements in PM2.5 in Shanxi University Town].

In order to investigate the pollution characteristics and sources of elements in PM2.5 in the Shanxi University Town in 2017, an energy dispersive X-ray fluorescence spectrometer (ED-XRF) was used to analyze 21 kinds of elements in PM2.5 samples. A health risk assessment was conducted for Mn, Zn, Cu, Sb, Pb, Cr, Co, and Ni. The main sources of elements were identified by the principal component analysis (PCA) and positive matrix factorization (PMF). The results found that, among the 21 kinds of elements in PM2.5 in Shanxi University Town, the mass concentration of Ca was the highest, followed by Si, Fe, Al, S, K, and Cl. These seven elements accounted for 95.71% of the total element concentrations. The concentration of Cr exceeded the annual average concentration limit of ambient air quality standards in China by 104 times. The concentration of Ca in PM2.5 was the highest in spring, summer, and winter, while in autumn the concentration of S was the highest. Mn was the element that had non-carcinogenic risks to the three population types, and the level of risks were in the order of children > adult men > adult women. Cr and Co had tolerable carcinogenic risks, and the risk levels were in the order of adult men > adult women > children. The main sources of elements in PM2.5 in Shanxi University Town in 2017 were natural mineral dust, urban dust, coal combustion, and traffic.

Comparative Efficacy and Safety of Endovascular Treatment Modalities for Femoropopliteal Artery Lesions: A Network Meta-analysis of Randomized Controlled Trials.

PURPOSE: We conducted a network meta-analysis of randomized controlled trials comparing the efficacy and safety of multiple endovascular treatments for femoropopliteal lesions. METHODS: Nine treatments for femoropopliteal lesions were identified. We compared major amputation and all-cause mortality at 12-month follow-ups and primary patency at 6-, 12- and 24-month follow-ups of the treatments. RESULTS: Altogether, 26 studies (52 study arms; 4102 patients) were considered eligible. In terms of primary patency, drug-eluting stent (DES) placement was the most effective treatment at 6- and 12-month follow-ups and covered stent (CS) placement at 24-month follow-ups, whereas directional atherectomy (DA) was the least effective treatment during all follow-up periods; both DES and CS placements were better than the majority of other single treatments, including balloon angioplasty, DA, nitinol stent (NS) placement and drug-coated balloon use, during all follow-up periods. In terms of 12-month major amputation and all-cause mortality, DA was the most safe treatment, whereas NS placement was the least safe single treatment. CONCLUSIONS: DES and CS placements have shown encouraging results in terms of primary patency for femoropopliteal lesions, DES placement performs better within 12 months after operation and CS placement at approximately 24 months, while DA seems to be less effective. DA may be better than other treatments in terms of major amputation and all-cause mortality, while NS seems to be less safe.