Actively extracting kidney stones combined dusting technique can improve SFR of moderate-complexity kidney stones in fURL.

PURPOSE: To evaluate the necessity and effectiveness of actively extracting kidney stones with different complexity that have been visually dusted in flexible ureteroscopic lithotripsy (fURL). METHODS: We retrospectively reviewed the medical records of patients who underwent fURL with dusting technique in established hospitals. A total of 535 cases were divided into the dusting group or the dusting plus basketing group according to the use of stone basket. Their characteristics and operative parameters were collected and analyzed. We used the R.I.R.S. scoring system to classify the complexity of kidney stones and divided these kidney stones into three subgroups, namely, mild-, moderate-, and severe-complexity group. And then, the effectiveness of stone basket in these subgroups was analyzed. RESULTS: Although using a stone basket significantly reduced re-operation rate (17.8% in dusting group versus 10.2% in dusting plus basketing group, p = 0.013), no significant difference on stone-free rate (SFR) and overall incidence of complications were noticed between groups. After we classified the complexity of kidney stones using the R.I.R.S. scoring system, we found a stone basket was helpful to improve SFR in kidney stones with moderate-complexity that had been visually dusted in fURL (73.5% in dusting group versus 87.3% in dusting plus basketing group, p = 0.002) but had limited influence on SFR in mild (93.8% in dusting group versus 92.6% in dusting plus basketing group, p = 0.783) or severe (28.5% in dusting group versus 34.0% in dusting plus basketing group, p = 0.598)-complexity kidney stones. CONCLUSION: The use of stone basket should be encouraged in moderate-complexity kidney stones which can be visually dusted in fURL.

Removal of ofloxacin from wastewater by chloride electrolyte electro-oxidation: Analysis of the role of active chlorine and operating costs.

Electro-oxidation (EO) has received increasing attention as an efficient and green method for removing pollutants from wastewater. Chloride anions (Cl-), which commonly exist in wastewater, can act as an electrolyte for the EO process. However, the role of reactive chlorine species (RCS) generated near electrodes is often underestimated. In this study, we generated hydroxyl radicals (OH) and RCS in a boron-doped diamond (BDD) electrode system and investigated its degradation mechanism for ofloxacin (OFX) removal. The findings suggested that OFX degradation was dominated by OH existing near the anode in solution, with RCS playing a supporting role. Based on the produced intermediates, we proposed an OFX decomposition pathway. The biological toxicities of the intermediates were evaluated through the ECOSAR and T.E.S.T. procedure. Nearly half of the intermediates are less toxic than the parent compound. After optimizing the operating parameters by the response surface methodology, 20 mg/L OFX was almost completely degraded after 10 min of reaction in 1.45 g/L NaCl with a current density (j) of 18 mA/cm2, and the total organic carbon was decreased by 30.55 %. The energy consumption and current efficiency were 0.648 kW·h/gTOC and 8.65 %, respectively. Comparing the operating costs of the proposed and other EO methods, our method emerged as a viable new treatment scheme for similar polluted wastewaters. This study aims to comprehensively understand the potential application value of BDD electrodes in the treatment of Cl- containing organic wastewater.