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AIM: To elucidate the effects of sleep parameters and renal function on the risk of developing new-onset severe metabolic dysfunction-associated steatotic liver disease (MASLD). MATERIALS AND METHODS: The primary analysis involved a cohort of 305 257 participants. Multivariable Cox models were employed to calculate hazard ratios and 95% confidence intervals. Traditional mediation and two-step Mendelian randomization (MR) analyses were conducted to assess the associations and mediating roles of renal function indicators between sleep and new-onset severe MASLD. RESULTS: Poor sleep score and renal function biomarker score (RFS) were associated with an increased risk of new-onset severe MASLD (all ptrend <0.001). Participants with poor sleep patterns and the highest RFS had a 5.45-fold higher risk of new-onset severe MASLD, compared to those with healthy sleep patterns and the lowest RFS (p < 0.001). The RFS could explain 10.08% of the correlations between poor sleep score and risk of new-onset severe MASLD. Additionally, MR analyses supported a causal link between insomnia and new-onset severe MASLD and revealed a mediating role of chronic kidney disease in the connection between insomnia and new-onset severe MASLD risk. CONCLUSIONS: This study highlights the independent and combined associations of sleep parameters and renal function indicators with new-onset severe MASLD, underscoring the bidirectional communication of the liver-kidney axis and providing modifiable strategies for preventing MASLD.
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Fígado Gorduroso , Transtornos do Sono-Vigília , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/fisiopatologia , Fígado Gorduroso/epidemiologia , Fígado Gorduroso/complicações , Fígado Gorduroso/fisiopatologia , Fatores de Risco , Adulto , Incidência , Estudos de Coortes , Análise da Randomização Mendeliana , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/etiologia , Insuficiência Renal Crônica/fisiopatologia , Índice de Gravidade de Doença , Doenças Metabólicas/epidemiologia , Doenças Metabólicas/complicações , Idoso , Modelos de Riscos ProporcionaisRESUMO
BACKGROUND: In patients with hilar cholangiocarcinoma (HCCA), radical resection can be achieved by resection and reconstruction of the vasculature. However, whether vascular reconstruction (VR) improves long-term and short-term prognosis has not been demonstrated comprehensively. METHODS: This was a retrospective multicenter study of patients who received surgery for HCCA with or without VR. Variables associated with overall survival (OS) and recurrence-free survival (RFS) were identified based on Cox regression. Kaplan-Meier curves were used to explore the impact of VR. Restricted mean survival time (RMST) was used for comparisons of short-term survival between the groups. Patients' intraoperative and postoperative characteristics were compared. RESULTS: Totally 447 patients were enrolled. We divided these patients into 3 groups: VR with radical resections (n = 84); non-VR radical resections (n = 309) and non-radical resection (we pooled VR-nonradical and non-VR nonradical together, n = 54). Cox regression revealed that carbohydrate antigen 242 (CA242), vascular invasion, lymph node metastasis and poor differentiation were independent risk factors for OS and RFS. There was no significant difference of RMST between the VR and non-VR radical groups within 12 months after surgery (10.18 vs. 10.76 mon, P = 0.179), although the 5-year OS (P < 0.001) and RFS (P < 0.001) were worse in the VR radical group. The incidences of most complications were not significantly different, but those of bile leakage (P < 0.001) and postoperative infection (P = 0.009) were higher in the VR radical group than in the non-VR radical group. Additionally, the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) up to 7 days after surgery tended to decrease in all groups. There was no significant difference in the incidence of postoperative liver failure between the VR and non-VR radical groups. CONCLUSIONS: Radical resection can be achieved with VR to improve the survival rate without worsening short-term survival compared with resection with non-VR. After adequate assessment of the patient's general condition, VR can be considered in the resection.
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BACKGROUND: The hepatic artery is the only blood source nourishing the biliary duct and associated with biliary complication after liver transplantation (LT). Gastroduodenal artery (GDA) disconnection increased proper hepatic artery flow. Whether this procedure attenuates biliary non-anastomotic stricture (NAS) is not clear. METHODS: A total of 241 patients with LT were retrospectively analyzed. The patients were divided into the GDA disconnection (GDA-) and GDA preservation (GDA+) groups. Propensity score matching (PSM) was administrated to reduce bias. Logistic regression was conducted to analyze risk factors for biliary NAS before and after PSM. Postoperative complications were compared. Kaplan-Meier survival analysis and log-rank tests were performed to compare overall survival. RESULTS: In all, 99 patients (41.1%) underwent GDA disconnection, and 49 (20.3%) developed NAS. Multivariate logistic regression revealed that GDA preservation (OR = 2.24, 95% CI: 1.11-4.53; P = 0.025) and model for end-stage liver disease (MELD) score > 15 (OR = 2.14, 95% CI: 1.12-4.11; P = 0.022) were risk factors for biliary NAS. PSM provided 66 pairs using 1:2 matching method, including 66 GDA disconnection and 99 GDA preservation patients. Multivariate logistic regression after PSM also showed that GDA preservation (OR = 3.15, 95% CI: 1.26-7.89; P = 0.014) and MELD score > 15 (OR = 2.41, 95% CI: 1.08-5.36; P = 0.031) were risk factors for NAS. When comparing complications between the two groups, GDA preservation was associated with a higher incidence of biliary NAS before and after PSM (P = 0.031 and 0.017, respectively). In contrast, other complications including early allograft dysfunction (P = 0.620), small-for-size graft syndrome (P = 0.441), abdominal hemorrhage (P = 1.000), major complications (Clavien-Dindo grade ≥ 3, P = 0.318), and overall survival (P = 0.088) were not significantly different between the two groups. CONCLUSIONS: GDA disconnection during LT ameliorates biliary NAS incidence and may be recommended for application in clinical practice.
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Constrição Patológica , Artéria Hepática , Transplante de Fígado , Humanos , Constrição Patológica/epidemiologia , Constrição Patológica/prevenção & controle , Doença Hepática Terminal/cirurgia , Artéria Hepática/cirurgia , Incidência , Transplante de Fígado/efeitos adversos , Transplante de Fígado/métodos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Retrospectivos , Fatores de RiscoRESUMO
Wastewater treatment sludge from a primary lead-zinc smelter is characterized as hazardous waste and requires treatment prior to disposal due to its significant arsenic and heavy metals contents. This study presents a method for the stabilization of arsenic sludge that uses a slag based curing agent composed of smelting slag, cement clinker and limestone. The Unconfined Compressive Strength (UCS) test, the China Standard Leaching Test (CSLT), and the Toxicity Characteristic Leaching Procedures (TCLP) were used to physically and chemically characterize the solidified sludge. The binder ratio was determined according to the UCS and optimal experiments, and the optimal mass ratio of m (smelting slag): m (cement clinker): m (gypsum sludge): m (limestone) was 70:13:12:5. When the binder was mixed with arsenic sludge using a mass ratio of 1:1 and then maintained at 25 °C for 28 d, the UCS reached 9.30 MPa. The results indicated that the leached arsenic content was always less than 5 mg/L, which is a safe level, and does not contribute to recontamination of the environment. The arsenic sludge from the Zn/Pb metallurgy plant can be blended with cement clinker and smelting slag materials for manufacturing bricks and can be recycled as construction materials.
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Arsênio/química , Recuperação e Remediação Ambiental/métodos , Resíduos Perigosos , Metalurgia , Metais Pesados/química , Esgotos/química , Águas Residuárias/química , Poluentes Químicos da Água/química , Arsênio/análise , China , Materiais de Construção , Resíduos Industriais/análise , Chumbo/química , Reciclagem , Poluentes Químicos da Água/análise , Zinco/químicaRESUMO
BACKGROUND: This study was prospectively designed to determine the risk factors of deep vein thrombosis (DVT) in patients who underwent different surgeries, and to evaluate the efficacy and accuracy of plasma D-dimer level as a screening test. METHODS: From June 2013 to June 2014, 360 consecutive patients undergoing orthopedic surgery were evaluated. All patients underwent ultrasonography preoperatively and on postoperative day 7. Plasma D-dimer levels were estimated by latex immunoturbidimetry on the day of surgery and on postoperative days 1, 3, and 7. RESULTS: Of the 360 patients in this study, 339 patients completed the analysis. Among them, DVT was confirmed in 28 (8.26%) patients based on ultrasonographic findings. Multivariate logistic analysis revealed that body mass index was an independent risk factor for developing DVT (P = 0.018) and D-dimer levels on postoperative days 1 and 7 were independently correlated with the development of DVT (P = 0.019 and P < 0.001, respectively). The receiver operating characteristic curve analysis determined that the area under the curve was largest (0.752) when using D-dimer level on postoperative day 7 as diagnostic index, and the sensitivity and specificity were 71.4% and 81.7% at the cut-off value of 6.17 µg/mL, respectively. The elevated D-dimer levels followed the same tendency toward a double-peaked distribution with peaks at days 1 and 7 postoperatively. CONCLUSION: D-dimer level was a useful screening test to exclude DVT, and the cut-off values of D-dimer determined in this study will provide a reference for the absence of DVT to a certain extent.
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Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Procedimentos Ortopédicos/efeitos adversos , Trombose Venosa/sangue , Trombose Venosa/diagnóstico , Idoso , Área Sob a Curva , Biomarcadores/sangue , Índice de Massa Corporal , China , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Nefelometria e Turbidimetria , Valor Preditivo dos Testes , Estudos Prospectivos , Curva ROC , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Doppler em Cores , Trombose Venosa/etiologiaRESUMO
This work demonstrates an electrically tunable silicon nitride (SiN) micro-ring resonator with polymer-stabilized blue phase liquid crystals (PSBPLCs) cladding. An external vertical electric field is applied to modulate the refractive index of the PSBPLCs by exploiting its fast-response Kerr effect-induced birefringence. The consequent change in the refractive index of the cladding can vary the effective refractive index of the micro-ring resonator and shift the resonant wavelength. Crystalline structures of PSBPLCs with a scale of the order of hundreds of nanometers ensure that the resonator has a very low optical loss. The measured tuning range is 0.45 nm for TM polarized light under an applied voltage of 150V and the corresponding response time is in the sub-millisecond range with a Q-factor of greater than 20,000.
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This investigation reports observations of optical bistability in a silicon nitride (SiN) micro-ring resonator with azo dye-doped liquid crystal cladding. The refractive index of the cladding can be changed by switching the liquid crystal between nematic (NLC) and photo-induced isotropic (PHI) states by. Both the NLC and the PHI states can be maintained for many hours, and can be rapidly switched from one state to the other by photo-induced isomerization using 532 nm and 408 nm addressing light, respectively. The proposed device exhibits optical bistable switching of the resonance wavelength without sustained use of a power source. It has a 1.9 nm maximum spectral shift with a Q-factor of over 10000. The hybrid SiN- LC micro-ring resonator possesses easy switching, long memory, and low power consumption. It therefore has the potential to be used in signal processing elements and switching elements in optically integrated circuits.
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Compostos Azo/química , Corantes/química , Refratometria/instrumentação , Compostos de Silício/química , Ressonância de Plasmônio de Superfície/instrumentação , Transdutores , Desenho de Equipamento , Análise de Falha de Equipamento , MiniaturizaçãoRESUMO
Arsenic is a kind of element widely distributed in the environment that may pose a threat to the ecological environment and human health, while effective remediation and sustainable utilization of arsenic-containing sludge is a challenge. Based on stabilization/solidification blast furnace slag-based cementitious materials (BCMs), this study innovatively proposes to improve the arsenic (As) solidification efficiency and long-term stability by using the activation mode of CaO and NaCl. The effects of different factors on the properties of the BCM were measured by unconfined compressive strength (UCS) tests, X-ray diffraction, Fourier transform infrared spectroscopy, and scanning electron microscopy. The long-term stability and safety of the BCM were verified by leaching toxicity and improved three stage continuous extraction method (BCR) tests. Experimental results show that the addition of CaO provides conditions for the formation of ettringite (AFt), thus promoting the crystal growth of AFt. The addition of NaCl can promote the formation of Cl-AFt and play a good long-term stabilizing role. When the content of the alkali activator is 10% and the modulus is 1.0, the contents of CaO and NaCl are 10 and 1%, respectively. The BCM has the best efficiency in terms of UCS and As solidification. The UCS at 28 days was 5.4 MPa, and the leaching concentration of As was 0.309 mg/L, and the As solidification efficiency was up to 99.9%. In the improved BCR test, the proportions of residual and oxidizable states of arsenic increased by 19.6 and 13.5%, respectively, and the stability of heavy metals improved. These findings show that the BCM has good long-term stability and safety. Overall, this study shows that CaO and NaCl significantly increase the output of AFt and achieve the purpose of efficient and stable solidification of As by the BCM.
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BACKGROUND: Kinase suppressor of Ras 2 (KSR2) is a regulator of MAPK signaling that is overactivated in most hepatocellular carcinoma (HCC). We sought to determine the role of KSR2 in HCC pathogenesis. METHODS: We tested the level of KSR2 in HCC tissues and cell lines by tissue microarray, qPCR, and western blotting. Functionally, we determined the effects of KSR2 on the proliferation, migration, and invasion of HCC cells through colony formation assays, scratch assays, transwell migration assays, and xenograft tumor models. Co-immunoprecipitation (co-IP) experiments were used to assess the interaction of phospho-serine binding protein 14-3-3ζ and KSR2, and the effects of this interaction on growth and proliferation of human HCC cells were tested by co-overexpression and knockdown experiments. Additionally, we used flow cytometry to examine whether the KSR2 and 14-3-3ζ interaction conveys HCC resistance to sorafenib. RESULTS: KSR2 was significantly upregulated in HCC tissues and cell lines, and high KSR2 expression associated with poor prognosis in HCC patients. KSR2 knockdown significantly suppressed HCC cell proliferation, migration, and invasion in vitro and in vivo. Mechanistically, co-IP experiments identified that 14-3-3ζ complexed with KSR2, and elevated 14-3-3ζ increased KSR2 protein levels in HCC cells. Importantly, Kaplan-Meier survival analysis showed that patients with both high KSR2 and high 14-3-3ζ expression levels had the shortest survival times and poorest prognoses. Interestingly, HCC cells overexpressing both KSR2 and 14-3-3ζ, rather than either protein alone, showed hyperactivated MAPK signaling and resistance to sorafenib. CONCLUSIONS: Our results provide new insights into the pro-tumorigenic role of KSR2 and its regulation of the MAPK pathway in HCC. The KSR2-14-3-3ζ interaction may be a therapeutic target to enhance the sorafenib sensitivity of HCC.
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RATIONALE: CD13 is a new marker for liver cancer stem cells (CSCs) that contributes to sorafenib resistance in hepatocellular carcinoma (HCC). However, the underlying mechanism of CD13 in HCC sorafenib resistance remains enigmatic. METHODS: The expression of CD13 in HCC cell lines and tissues was assayed by RT-PCR, western-blot, and immunohistochemistry staining. Athymic BALB/c nu/nu mice model was used to study the in vivo functions of CD13. Clinical significance of CD13 was evaluated by Kaplan-Meier methods. Cellular proliferation rate was evaluated by cell counting kit-8 cell proliferation assay and colony formation assay. Tunel assay was used to detect cell death ratio. Transwell assay was used to evaluate the motility of cells. Immunoprecipitation (IP), liquid chromatography-mass spectrometry (LC-MS)/MS, and co-IP were applied to investigate potential protein interactions of CD13. RESULTS: In this research, we found that CD13 expression was higher in metastatic HCC samples, and its overexpression was predicted worse prognosis for patients after surgical resection. Functionally, CD13 promoted HCC proliferation, invasion, cell cycle progression as well as sorafenib resistance. Mechanistically, CD13 interacted with histone deacetylase5 (HDAC5) to promote its protein stability, thus resulting in HDAC5-mediated lysine-specific demethylase 1 (LSD1) deacetylation and protein stabilization. Consequently, LSD1 decreased the NF-κB catalytic unit p65 methylation that led to p65 protein stability. A CD13 inhibitor ubenimex in combination with sorafenib, suppressed the tumor growth and attenuated the resistance of HCC cells toward sorafenib in patient-derived xenograft models. CONCLUSIONS: CD13 promotes HCC progression and induces sorafenib resistance, mainly via interacting with HDAC5 to prevent the degradation of p65 and activate NF-kB signaling pathway. CD13 is a prognostic indicator for HCC patients underwent curative resection as well as a predictor of response to treatment with sorafenib. Our study establishes the new therapeutic potential of targeting CD13-HDAC5-LSD1-NF-κB in HCC.
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Municipal solid waste incineration fly ash (MSWI FA) and granulated lead smelting slag (GLSS) are toxic industrial wastes. In the present study, granulated lead smelting slag (GLSS) was pretreated as a geopolymer precursor through the high-energy ball milling activation process, which could be used as a geopolymeric solidification/stabilization (S/S) reagent for MSWI FA. The S/S process has been estimated through the physical properties and heavy metals leachability of the S/S matrices. The results show that the compressive strength of the geopolymer matrix reaches 15.32 MPa after curing for 28 days under the best parameters, and the physical properties meet the requirement of MU10 grade fly ash brick. In addition, the toxicity characteristic leaching procedure (TCLP) test results show that arsenic and heavy metals are immobilized effectively in the geopolymer matrix, and their concentrations in the leachate are far below the US EPA TCLP limits. The hydration products of the geopolymer binder are characterized by X-ray diffraction and Fourier transform infrared methods. The results show that the geopolymer gel and Friedel's salt are the main hydration products. The S/S mechanism of the arsenic and heavy metals in the geopolymer matrix mainly involves physical encapsulation of the geopolymer gel, geopolymer adsorption and ion exchange of Friedel's salt.
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Cinza de Carvão/química , Chumbo/química , Polímeros/química , Eliminação de Resíduos/métodos , Poluentes Químicos da Água/química , Arsênio/química , Incineração , Resíduos Industriais , Metais Pesados/químicaRESUMO
BACKGROUND: Portal vein tumor thrombus (PVTT) is a common complication in hepatocellular carcinoma (HCC), signaling dismal outcomes. This study was conducted to evaluate the survival benefit of postoperative portal vein perfusion chemotherapy (PVC) in patients with HCC and PVTT. METHODS: A retrospective review was conducted in 401 consecutive patients with HCC and PVTT who underwent hepatic resection between January 2009 and December 2015 and 67 patients received adjuvant postoperative PVC. A propensity score matching (PSM) was used to match patients with and without PVC at a ratio of 1:1. RESULTS: After PSM, the median time to recurrence (TTR) and overall survival (OS) were significantly longer in PVC group compared with control group (12.3 vs 5.8 months, P = .001; 19.0 vs 13.4 months, P = .037; respectively). At 1, 2, 3, and 5 years, the cumulative recurrence rates in PVC group were 48.1%, 86.5%, 92.3% ,96.2%, respectively, with OS rates of 63.8%, 37.9%, 24.4%, 18.3%, respectively; whereas cumulative recurrence rates of 76.6%, 91.5%, 94.3%, and 97.2%, respectively and OS rates of 55.4%, 23.0%, 12.4%, and 12.4%, respectively were recorded for the control group. In multivariate analysis, postoperative PVC emerged as a significant predictor for TTR (hazard ratio [HR], 0.523; P = .001) and OS (HR, 0.591; P = .010). PVC could reduce early recurrence (≤1 year) rate after surgical resection (40.3% vs 64.2%, P = .006) and clinical outcomes were further enhanced by adding sorafenib to postoperative PVC. CONCLUSIONS: Compared with surgical resection alone, postoperative adjuvant PVC treatment boosts survival and reduces early tumor recurrences in patients surgically treated for HCC and PVTT.
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Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/cirurgia , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/cirurgia , Trombose Venosa/tratamento farmacológico , Trombose Venosa/cirurgia , Carcinoma Hepatocelular/mortalidade , Feminino , Hepatectomia , Humanos , Estimativa de Kaplan-Meier , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/prevenção & controle , Perfusão , Veia Porta , Pontuação de Propensão , TrombectomiaRESUMO
A new method in which Pb/Zn smelter waste containing arsenic and heavy metals (arsenic sludge), red mud and lime are utilized to prepare red mud-based cementitious material (RCM) is proposed in this study. XRD, SEM, FTIR and unconfined compressive strength (UCS) tests were employed to assess the physicochemical properties of RCM. In addition, ettringite and iron oxide-containing ettringite were used to study the hydration mechanism of RCM. The results show that the UCS of the RCM (red mud+arsenic sludge+lime) was higher than that of the binder (red mud+arsenic sludge). When the mass ratio of m (binder): m (lime) was 94:6 and then maintained 28days at ambient temperature, the UCS reached 12.05MPa. The red mud has potential cementitious characteristics, and the major source of those characteristics was the aluminium oxide. In the red mud-arsenic sludge-lime system, aluminium oxide was effectively activated by lime and gypsum to form complex hydration products. Some of the aluminium in ettringite was replaced by iron to form calcium sulfoferrite hydrate. The BCR and leaching toxicity results show that the leaching concentration was strongly dependent on the chemical speciation of arsenic and the hydration products. Therefore, the investigated red mud and arsenic sludge can be successfully utilized in cement composites to create a red mud-based cementitious material.
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Flotation waste of copper slag (FWCS), neutralization sludge (NS), and arsenic-containing gypsum sludge (GS), both of which are difficult to dispose of, are major solid wastes produced by the copper smelting. This study focused on the co-treatment of FWCS, NS, and GS for solidification/stabilization of arsenic and heavy metals with minimal cement clinker. Firstly, the preparation parameters of binder composed of FWCS, NS, and cement clinker were optimized to be FWCS dosage of 40%, NS dosage of 10%, cement clinker dosage of 50%, mill time of 1.5 h, and water-to-binder ratio of 0.25. On these conditions, the unconfined compressive strength (UCS) of the binder reached 43.24 MPa after hydration of 28 days. Then, the binder was used to solidify/stabilize the As-containing GS. When the mass ratio of binder-to-GS was 5:5, the UCS of matrix can reach 11.06 MPa after hydration of 28 days, meeting the required UCS level of MU10 brick in China. Moreover, arsenic and other heavy metals in FWCS, NS, and GS were effectively solidified or stabilized. The heavy metal concentrations in leachate were much lower than those in the limits of China standard leaching test (CSLT). Therefore, the matrices were potential to be used as bricks in some constructions. XRD analysis shows that the main hydration products of the matrix were portlandite and calcium silicate hydrate. These hydration products may play a significant role in the stabilization/solidification of arsenic and heavy metals.
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Arsênio/química , Compostos de Cálcio/química , Sulfato de Cálcio/química , Materiais de Construção/análise , Cobre/química , Metais Pesados/análise , Esgotos/análise , Silicatos/química , Arsênio/análise , Sulfato de Cálcio/análise , China , Cobre/análise , Metais Pesados/químicaRESUMO
INTRODUCTION: Intraoperative technical complications are occasionally encountered while implanting INTERTAN™ nails for intertrochanteric fractures. Surgeons need to pay attention to the difficulties they may encounter during the implantation of an INTERTAN™ nail. CASE PRESENTATION: We report four cases with intraoperative difficulties during the implantation of INTERTAN™ nails among Han Chinese patients from mainland China. In Case 1, during the operation on a 75-year-old woman, an anatomical specificity of excessive femoral shaft curvation at the coronal and sagittal planes was observed; a relatively smooth implantation was achieved by adjusting the entry point. In Case 2, due to fat obstruction, an INTERTAN™ nail was implanted at an oblique angle in 64-year-old obese woman, which resulted in an iatrogenic fracture of the proximal femur. In Case 3, an iatrogenic fracture of the distal femur developed in an 83-year-old woman because of violent hammering and underestimating of bone fragility. In Case 4, an iatrogenic fracture occurred in a 40-year-old woman around the distal locking slot during the drilling process. CONCLUSIONS: Preoperative evaluation should be considered as an important preparation for the implantation of an INTERTAN™ nail. Full-length anteroposterior and lateral radiographs of the injured femur are necessary to confirm the anatomical specificity. The vertical trajectory as well as sufficient reaming is important in reducing the possibility of iatrogenic fractures, particularly for obese patients. In older patients, violent hammering should be avoided and full reaming is recommended even if the canal seems to be wide enough. For cases where hard fracture reduction is predicted, the strategy of open reduction and fixation with a dynamic hip screw seems to be more rational and should be considered as an alternative method.
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Pinos Ortopédicos/efeitos adversos , Fixação Interna de Fraturas/efeitos adversos , Fraturas Cominutivas/etiologia , Fraturas do Quadril/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Fraturas do Fêmur/etiologia , Cabeça do Fêmur/lesões , Fixação Interna de Fraturas/instrumentação , Fraturas do Quadril/complicações , Humanos , Complicações Intraoperatórias/etiologia , Pessoa de Meia-IdadeRESUMO
A comprehensive investigation was conducted to the urban soil in the megacity Shanghai in order to assess the levels of PAHs and potential risks to human health, to identify and quantitatively assess source contributions to the soil PAHs. A total of 57 soil samples collected in main urban areas of Shanghai, China were analyzed for 26 PAHs including highly carcinogenic dibenzopyrene isomers. The total concentrations ranged from 133 to 8,650 ng g for ΣPAHs and 83.3 to 7,220 ng g for ΣPAHs, with mean values of 2420 and 1,970 ng g, respectively. DBalP and DBaeP may serve as markers for diesel vehicle emission, while DBahP is a probable marker of coke tar as distinct from diesel emissions. Six sources in Shanghai urban area were identified by PMF model; their relative contributions to the total soil PAH burden were 6% for petrogenic sources, 21% for coal combustion, 13% for biomass burning, 16% for creosote, 23% for coke tar related sources and 21% for vehicular emissions, respectively. The benzo[a]pyrene equivalent (BaP) concentrations ranged from 48.9-2,580 ng g for ΣPAHs, 7.02-869 ng g for ΣPAHs and 35.7-1,990 ng g for ΣDBPs. The BaP concentrations of ΣDBPs made up 72% of ΣPAHs. Nearly half of the soil samples showed concentrations above the safe BaP value of 600 ng g. Exposure to these soils through direct contact probably poses a significant risk to human health from carcinogenic effects of soil PAHs. The index of additive cancer risk (IACR) values in almost one third of urban soil samples were more than the safe value of 1.0, indicating these urban soil PAHs in the study area may pose a potential threat to potable groundwater water quality from leaching of carcinogenic PAH mixtures from soil.
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Hidrocarbonetos Policíclicos Aromáticos/análise , Poluentes do Solo/análise , Benzo(a)pireno , Carcinógenos/análise , China , Cidades , Carvão Mineral , Monitoramento Ambiental , Água Subterrânea , Humanos , Modelos Teóricos , Neoplasias/etiologia , Saúde Pública , Fatores de Risco , Emissões de Veículos , Poluentes Químicos da Água/análiseRESUMO
Short-chain chlorinated paraffins (SCCPs) are extremely complex technical mixtures of polychlorinated n-alkanes with carbon chain lengths from C10 to C13 and chlorine content between 49 and 70%. SCCPs are under consideration for inclusion in the Stockholm Convention on persistent organic pollutants. SCCPs have been used extensively in industrial production, but little is known about the pollution level in soil environment in China. In this study, levels and distribution of SCCPs in soil samples from Chongming Island were analyzed. Concentrations of total SCCPs in soil samples ranged from 0.42 to 420 ng g(-1), with a median of 9.6 ng g(-1). The ubiquitous occurrence of SCCPs in Chongming Island implied that long-range atmospheric transport and soil-air exchange may be the most important pathways for SCCP contamination in the background area. The localized SCCP contamination could be derived from an unidentified source. Hierarchical cluster analysis indicated that C13- and C11-congeners were predominant in most soils and C10- and C12-congeners dominated in the remaining soils. Cl7- and Cl8-congeners were on the average the most dominant chlorine congeners in nearly all soils. Principal component analysis suggested that the separation of even and odd carbon chain congeners occurred during long-range atmospheric transport and aging in soil in the study area.
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Parafina/análise , Parafina/química , Poluentes do Solo/análise , Solo/química , Alcanos/análise , Alcanos/química , Carbono/análise , Carbono/química , China , Monitoramento Ambiental/métodos , Hidrocarbonetos Clorados/análise , Análise de Componente Principal , Poluentes do Solo/químicaRESUMO
The concentration of 46 polychlorinated naphthalenes (PCNs) in the agricultural soils from Luqiao was analyzed by GC-NCI-MS. The objectives of this study were to investigate the contents, spatial distribution and sources of PCNs. The total concentrations of PCNs (sigma PCNs) in soil samples were in the range of 0.062 to 2.92 ng x g(-1), with a mean of 0.630 ng x g(-1). Tetra-CNs and penta-CNs were the predominant homologues in most of the samples, accounting for 18.4% - 88.8% and 8.40% - 53.1%, with average values of 46.7% and 30.7%, respectively, followed by tri-CNs, accounting for 0 - 47.3%, with a mean of 10.6%. Cluster analysis and combustion marker analysis showed that the sampling sites were mainly polluted by Halowax 1014 and Halowax 1013, also possibly polluted by PCBs mixtures and e-waste combustion process. Compared to other studies, the PCNs concentration in this study was at a medium level.
Assuntos
Resíduo Eletrônico/efeitos adversos , Hidrocarbonetos Clorados/análise , Naftalenos/análise , Reciclagem , Poluentes do Solo/análise , Solo/análise , China , Produtos Agrícolas/crescimento & desenvolvimento , Monitoramento AmbientalRESUMO
The concentrations of 144 polychlorinated biphenyls (PCBs) in the soils from Luqiao were analyzed by GC-microECD. The objectives of this study were to understand the contents, spatial distribution and sources. The sigma PCBs concentrations in soils samples were in the range of 0.779 ng x g(-1) to 937 ng x g(-1), with a mean of 75.7 ng x g(-1), and the relatively high level of PCBs were mainly distributed in the south central area. Penta-CBs, hexa-CBs and tetra-CBs were the primary homologues in 38 samples, with the range of 13.0% - 61.1%, 4.59% - 48.8% and 10.1% - 31.5%, respectively. Di-CBs was the most predominant homologues in other samples, with the range of 47.1% - 75.2%. The hierarchical cluster analysis (HCA) showed that most of samples were mainly polluted by Ar1254, few samples were polluted by Ar1221. Significant correlations were observed between sigma PCBs and TOC, which suggested PCBs were affected by TOC in soils. The correlation analysis also showed significant correlation among the PCBs homologues (except di-CBs and nona-CBs), which suggested PCBs might have the similar sources. Compared to other studies from different countries and regions, the PCBs concentrations in the present study were at an upper-middle level.
Assuntos
Resíduo Eletrônico/análise , Éteres Difenil Halogenados/análise , Resíduos Industriais/análise , Poluentes do Solo/análise , Solo/análise , China , Produtos Agrícolas/crescimento & desenvolvimento , Monitoramento Ambiental/métodos , Éteres Difenil Halogenados/classificaçãoRESUMO
The concentrations of 144 polychlorinated biphenyls (PCBs) in the river sediments from Luqiao were analyzed by GC-muECD. The objectives of this study were to understand the contents, spatial distribution and possible sources of PCBs. The Sigma PCBs concentrations detected in the river sediments were in the range of 1.66 to 5 930 ng x g(-1), with a mean of 763 ng x g(-1). Tri-CBs, tetra-CBs and penta-CBs were the primary PCB congeners in all samples, accounting for 2.63%-57.6%, 10.4%-54.6% and 7.82%-46.1%, respectively. Octa-CBs and deca-CBs were the minor PCB congeners in all samples, with the percentages of 0-8.57% and 0-11.0%, respectively. The hierarchical cluster analysis (HCA) showed that 22 samples were mainly polluted by Ar1248, 9 samples were polluted by Ar1254, and 6 samples were contaminated by Ar1016, Ar1232 and Ar1242. The PCBs concentrations found in the present study were at an upper-middle level compared with those in other studies in the world. The PCBs pollution in the present area had a high ecological risk.