A Chinese scoring system for predicting successful retrograde collateral traverse in patients with chronic total coronary occlusion.

BACKGROUND: Retrograde approach technique has been challenging in percutaneous coronary interventional treatment of chronic total occlusion (CTO) coronary disease. The present study endeavors to determine a novel Chinese scoring system for predicting successful collateral channels traverse via retrograde approach. METHODS: The demographic characteristics and angiographic characteristics of 309 CTO patient were analyzed by univariable and multivariable analysis for selecting potential predictors. And the nomogram was used to establish the scoring system. Then it was evaluated by the internal and external validation. RESULTS: The predictors of Age, Connections between collateral channels and recipient vessels, and Channel Tortuosity (ACT) were identified with univariable and multivariable analysis and employed to the ACT score system. With acceptable calibrations, the area under curve of the scoring system and the external validation were 0.826 and 0.816 respectively. Based on score, the predictors were divided into three risk categories and it showed a consistent prediction power in the validation cohort. CONCLUSIONS: The novel Chinese ACT score is a reliable tool for predicting successful retrograde collateral traverse.

The Therapeutic Efficacy of Pulsed Radiofrequency Alone Versus a Dexamethasone and Pulsed Radiofrequency Combination in Patients With Trigeminal Postherpetic Neuralgia: A Double-blind, Randomized Controlled Trial.

BACKGROUND: Pulsed radiofrequency (PRF) of the Gasserian ganglion is a common surgical intervention used to treat trigeminal postherpetic neuralgia (PHN). Dexamethasone has been reported to possess anti-inflammatory effects and potential analgesic benefits. OBJECTIVES: The primary objective of our study was to compare the therapeutic efficacies of PRF alone versus a combination of PRF and dexamethasone for trigeminal PHN. STUDY DESIGN: A prospective, double-blind, randomized controlled trial. SETTING: Department of Pain Management, Wuhan First Hospital. METHODS: A total of 103 patients diagnosed with trigeminal PHN were randomly assigned into 2 groups (the PRF group and PRF plus dexamethasone [PRF+D] group). Digital subtraction angiography-guided puncture of the Gasserian ganglion was performed. All patients received PRF of the Gasserian ganglion first, and then a local injection was administered into the Gasserian ganglion. Patients in the PRF+D group received PRF therapy and one mL of 5 mg dexamethasone in the Gasserian ganglion, while patients in the PRF group received PRF therapy and one mL of normal saline in the Gasserian ganglion. The primary outcome was pain intensity, measured by the visual analog scale (VAS). The secondary outcome was quality of life, assessed by the Short Form-36 questionnaire (SF-36). The dosage of pregabalin administered was recorded to assess treatment effectiveness. RESULTS: Compared with the PRF group in this study, the PRF+D group showed more promising outcome results in pain relief as measured by the VAS; quality of life enhancement, as measured by the SF-36; and a reduced requirement for antiepileptic drugs (P < 0.01). LIMITATIONS: Single center study, relatively small number of patients. CONCLUSIONS: The therapeutic efficacy of PRF combined with a dexamethasone injection into the Gasserian ganglion was superior to that of PRF{and saline injection} alone of the Gasserian ganglion for trigeminal PHN.

[6-Gingerol ameliorates adipose tissue insulin resistance in aging rats].

This study investigated the effects and mechanisms of 6-gingerol on adipose tissue insulin resistance in naturally aging rats with glycolipid metabolism disorders. Twenty-seven aging male SD rats were randomly divided into a model group(aged, n=9) and two groups treated with 6-gingerol at 0.05 mg·kg~(-1)(G-L, n=9) and 0.2 mg·kg~(-1)(G-H, n=9). Six young rats were randomly assigned to a normal control group(NC). Rats were treated for seven weeks by gavage. Non-esterified fatty acid(NEFA) and insulin content was determined by enzyme-linked immunosorbent assay(ELISA), and adipose tissue insulin resistance index(Adipo-IR) was calculated. HE staining was used to observe the size of adipocytes in epididymal white adipose tissue(eWAT). The gene and protein expression levels of adiponectin receptor 1(AdipoR1), AMP-activated protein kinase α(AMPKα), phosphorylated AMPK(p-AMPKα~(Thr172)), peroxisome proliferator-activated receptor-γ coactivator-1α(PGC-1α), phosphatidylinositol 3-kinase(PI3 K), protein kinase B(Akt), phosphorylated Akt(p-Akt~(Ser473)), tumor necrosis factor-α(TNF-α), c-Jun N-terminal kinase 1/2(JNK1/2), phosphorylated JNK1/2(p-JNK~(Thr183/Tyr185)), interleukin-1ß(IL-1ß), and interleukin-6(IL-6) in adiponectin(APN), insulin, and inflammatory factor signaling pathways were detected by Western blot and real-time RCR, respectively. The results showed that 6-gingerol at a high dose could significantly decrease the fasting plasma content of NEFA and insulin and reduce Adipo-IR. Additionally, 6-gingerol at a high dose significantly increased the protein and mRNA expression of APN, AdipoR1, PGC-1α, and PI3 K in eWAT, elevated the relative expression of p-AMPK~(Thr172) and p-Akt~(Ser 473), reduced the protein and mRNA expression of TNF-α, IL-1, and IL-6 in eWAT, and decreased the relative expression of p-JNK1 and p-JNK2. This study reveals that 6-gingerol can improve insulin sensitivity of adipose tissues in aging rats with glycolipid metabolism disorders, and this effect is presumedly achieved by enhancing the PI3 K/Akt signaling pathway, inhibiting adipose tissue inflammation, increasing APN synthesis, enhancing AdipoR1 expression, and activating its downstream AMPK/PGC-1α signaling pathway.

[Levels, Characteristics, and Potential Source of Micro(meso)plastic Pollution of Soil in Liaohe River Basin].

With the Liaohe River basin as the research object, the morphology, abundance, and distribution characteristics of micro(meso) plastics of soil in Liaohe River basin were studied based on the density flotation principle and the technique of stereo microscope and micro-FTIR and the significant factors affecting the distribution of the micro(meso)plastics and their potential sources were reasonably speculated. The results indicated that the average abundance of the soil micro(meso)plastic is (145.83±211.46) n·kg-1. The most abundant types of micro(meso)plastics are debris (46.00%), <1000 µm (39.57%), PP (41.71%), and white (46.86%). Among them, Rayon, PES, and PET micro(meso)plastics are primarily in the shape of fibrous (>85%), PE is mostly in the shape of film and fragments (96.91%), PP is mainly in the shape of fragments (85.62%), and PS is primarily in the shape of foam. Industrial activities (express delivery companies, plastic factories, and clothing factories), agricultural activities (plastic mulch, sewage irrigation, and sludge composting), population density, and sewage treatment plants, etc, may lead to higher levels of micro(meso)plastic abundance in the soil of the study area. Plastic products (pesticide bottles, chemical fertilizer packaging bags, woven bags, and plastic agricultural films), sewage discharge and irrigation, and foam materials used for packaging and decoration are the potential sources of soil micro(meso)plastic in the region.

Predictors for New Native-Vessel Occlusion in Patients with Prior Coronary Bypass Surgery: A Single-Center Retrospective Research.

OBJECTIVES: Chronic total occlusion (CTO) is prevalent in patients with prior coronary artery bypass grafting (CABG). However, data available concerning the prevalence of new-onset CTO of native vessels in patients with prior CABG is limited. Therefore, the objective of the study is to determine predictors for new native-vessel occlusion in patients with prior coronary bypass surgery. METHODS: 354 patients with prior CABG receiving follow-up angiography are selected and analyzed in the present study, with clinical and angiographic variables being analyzed by logistic regression to determine the predictors of new native-vessel occlusion. RESULTS: The overall new occlusion rate was 35.59%, with multiple CTOs (42.06%) being the most prevalent (LAD 24.60% and RCA 18.25%, respectively). Additionally, current smoking (OR: 2.67; 95% CI: 2.60 to 2.74; p=0.01), reduced ejection fraction (OR: 1.76; 95% CI: 1.04 to 2.97; p=0.04), severe stenosis (OR: 3.65; 95% CI: 2.55 to 5.24; p=0.01), and diabetes mellitus (OR: 1.86; 95% CI: 1.34 to 2.97; p=0.04) serve as the independent predictors for new native-vessel occlusion. CONCLUSION: As to high incidence of postoperative CTO, appropriate revascularization strategies and postoperative management should be taken into careful consideration.

Myocardial bridge-related coronary heart disease: Independent influencing factors and their predicting value.

BACKGROUND: Myocardial bridge (MB) will compress the mural coronary artery (MCA) during the systole and cause myocardial ischemia. In the diagnosis of coronary heart disease (CHD), because the structure of MB is difficult to be observed by coronary angiography (CAG), the clinical study of the influence of MB on CHD is lacking. With the advancement of computed tomography coronary angiography technology, detailed observations of the MB anatomy have realized. AIM: To explore the main influencing factors of MB-related CHD and to find potential indicators for predicting MB-related CHD. METHODS: A total of 1718 patients with suspected CHD due to the symptoms of myocardial ischemia were enrolled as subjects. Patients diagnosed with CHD were included in a CHD group, and patients with no significant abnormalities were included in a control group. In the CHD group, patients were divided into an MB-CHD subgroup if MB-related CHD was found. In the control group, patients were divided into a simple MB subgroup if MB was found. The patient's clinical data and MB-related indicators, including the branch of MB, MB type (superficial/deep type), MB length, MB thickness, systolic and diastolic compression of the MCA, and MCA systolic stenosis rate were recorded and compared. Logistic regression analysis was used to explore the independent influencing factors of MD-related CHD. ROC curve was used to analyze the diagnostic efficacy of potential indicators for MB-related CHD. RESULTS: There were 1060 cases in the CHD group and 658 cases in the control group, and there were 236 cases in the MB-CHD subgroup and 52 cases in the simple MB subgroup. Multivariate logistic regression analysis showed that the combined MB had a significant effect on the occurrence of CHD (P < 0.05). MB thickness, systolic compression, diastolic compression, and MCA systolic stenosis rate had significant effects on the occurrence of MB-related CHD (P < 0.05). The area under the curve (AUC) of the combination of these influencing factors for the diagnosis of MB-related CHD was 0.959, which was significantly higher than the AUCs of the four indicators separately (P < 0.05). The sensitivity was 97.06% and the specificity was 87.63%. CONCLUSION: MB thickness, systolic compression, diastolic compression, and MCA systolic stenosis are independent influencing factors for MB-related CHD. The combination of these factors has potential diagnostic value for MB-related CHD.

[Effect of electroacupuncture stimulation of "Fenglong" (ST 40) on expression of inflammatory cytokines of celiac macrophages in hyperlipidemia rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) stimulation of "Fenglong" (ST 40) on celiac inflammatory factors in rats with hyperlipemia (HLP), so as to reveal its mechanism underlying improvement of HLP. METHODS: A total of 40 SD rats were randomized into normal control, high fat forage, high fat + common forage, high fat + EA, and high fat + common forage+ EA groups, with 8 rats in each group. The HLP model was established by feeding the animals with high fat forage for 28 days. EA (2 mA, 2 Hz/100 Hz) was applied to bilateral ST 40 for 30 min, once daily for 28 days. Contents of plasma total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) were detected by using an automatic biochemistry analyzer. Intercellular adhesion molecule-1 (ICAM-1), monocyte chemoattractant protein 1 (MCP-1), and interleukin-1 gamma (IL-1gamma) in macrophages of the abdominal cavity were detected using flow cytometry (FCM). RESULTS: Compared with the normal control group, the contents of plasma TC and LDL-C, and celiac macrophages' MCP-1, ICAM-1 and IL-1gamma contents were significantly increased in the high fat forage group and high fat + common forage group (P < 0.01). In comparison with the high fat forage group, contents of plasma TC and LDL-C, and macrophages' MCP-1, ICAM-1 and IL-1gamma were considerably down-regulated in the high fat + EA group (P < 0.01). Similarly, the levels of plasma TC and LDL-C, and macrophages' MCP-1, ICAM-1 and IL-1gamma were obviously lower in the high fat+ common forage+ EA group than in the high fat + common forage group (P < 0.01). No significant differences were found in plasma TG and HDL-C levels among the five groups (P > 0.05). CONCLUSION: EA stimulation of "Fenglong" (ST 40) has a role in down-regulating contents of plasma TC and LDL-C and celiac macrophages' MCP-1, ICAM-1 and IL-1gamma in the abdominal cavity in hyperlipemia rats, which may contribute to its effect in improving hyperlipemia.

[Effects of electroacupuncture at "Fenglong" (ST 40) on formation of macrophage-derived foam cell and efflux of cholesterol in hyperlipidemia rats].

OBJECTIVE: To explore action mechanism of electroacupuncture (EA) at "Fenglong" (ST 40) for treatment of hyperlipidemia. METHODS: Forty SPF-grade SD rats were randomly divided into a normal group (group A), a model group (group B), a model diet-control group (group C), a model + EA group (group D) and model diet-control + EA group (group E), 8 cases in each one. The rats in group A were fed with normal diet continuously while those in the rest 4 groups were fed with high-fat diet to establish hyperlipidemia model. Afterwards, the rats in group C and group E were fed with normal diet, while EA at "Fenglong" (ST 40) was applied in group D and group E, 30 min per time, once a day. After 28 days of treatment, macrophage was collected in each group. Oil red O-staining was applied to detect the formation of foam cells, and enzyme-linked immunosorbent assay (ELISE) was adopted to measure the contents of total cholesterol (TC) in macrophage and analyze the rate of cholesterol efflux. RESULTS: The counts of positive cells of oil red O-staining and the contents of TC in the group B, group C and group D were significantly increased compared with those in the group A (all P < 0.01). The counts of positive cells and contents of TC in the group C, group D and group E were significantly clecreased compared with those in the group B (all P < 0.01), and the decline in group D was more obvious than that in the group C (all P < 0.01). Compared with group C and group D, the counts of positive cells and contents of TC in the group E was obviously decreased (all P < 0.01), which was not statistically different from group A (P > 0.05). In the meantime, compared with group C, the rate of cholesterol efflux in group D and group E was significantly increased (both P < 0.01), and the rise in group E was more obvious than that in the group D. CONCLUSION: The electroacupuncture at "Fenglong" (ST 40) could significantly prohibit the transformation of macrophage into foam cell and increase rate of cholesterol efflux in macrophage, which could prevent and reverse the formation of foam cell and play an essential role in treating hyperlipidemia and stopping it from developing into a further level.

Hospital-based integrated diabetes care management: an overview.

To provide continuous, accessible, and quality care, a diabetes share-care program has been in place in Taiwan for several years. Lukang Christian Hospital, a member of the diabetes share-care network, endeavors to provide "patient-centered" care aimed at increasing care quality and reducing diabetic complications. Information technology has been employed by the hospital for monitoring care quality and analyzing cost-effectiveness. Structured health-care programs have also been developed to ensure the completeness of diabetes care and to encourage self-management of individuals at high risk for diabetes. The implementation of these strategies has led to progressive improvement in quality measures and spawned novel and creative ways to deliver care services.

Measuring the activity of heterotrophic microorganism in membrane bioreactor for drinking water treatment.

In order to quantify the activity of heterotrophic microorganism in membrane bioreactor (MBR) for drinking water treatment, biomass respiration potential (BRP) test and 2,3,5-triphenyl tetrazolium chloride-dehydrogenase activity (TTC-DHA) test were introduced and modified. A sludge concentration ratio of 5:1, incubation time of 2h, an incubation temperature that was close to the real operational temperature, and using a mixture of main AOC components as the substrate were adopted as the optimum parameters for determination of DHA in drinking water MBR. A remarkable consistency among BDOC removal, BRP and DHA for assessing biological performance in different MBRs was achieved. Moreover, a significant correlation between the BRP and DHA results of different MBRs was obtained. However, the TTC-DHA test was expected to be inaccurate for quantifying the biomass activity in membrane adsorption bioreactor (MABR), while the BRP test turned out to be still feasible in that case.

Correlations of relevant membrane foulants with UF membrane fouling in different waters.

Correlations between potential fouling-relevant substances and membrane fouling during ultrafiltration (UF) of different waters were investigated, including water samples from Lake Tegel, from a Berlin canal (Landwehrkanal) and from a wastewater treatment plant (WWTP) secondary effluent. The biopolymers quantified with liquid chromatography-organic carbon detection (LC-OCD) showed a remarkable correlation with UF membrane fouling for all the three water sources at different seasons. This finding suggests that the biopolymer content in water can be employed as a universal indicator for predicting membrane fouling potential in UF processes. The particulate matter in the two surface waters Lake Tegel and Berlin canal, as characterized by suspended solids and turbidity, also exhibited a distinct correlation with UF membrane fouling, although its correlation was slightly weaker than that of biopolymers. However, the humic substances, which are generally believed to be major membrane foulants, did not show any reliable correlation with the UF membrane fouling of the different waters. This work may provide useful information for the development of optimized fouling control strategies for sustainable UF operation.

[Effect of electroacupuncture at fenglong (ST40) on expressions of inflammatory factors in macrophages of hyperlipidemia model rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) at Fenglong (ST40) on inflammatory factors in macrophages of hyperlipemia (HLP) rats, and to explore the role of EA in treating HLP. METHODS: Totally 50 adult male SD rats were selected. After one-week adaptative feeding, they were randomly divided into 5 groups, i.e., the blank control group (Group A), the model group (Group B), the diet control group (Group C), the EA group (Group D), the diet control + EA group (Group E), 10 in each group. By the end of treatment, all rats were sacrificed to get blood from the carotid artery. The contents of serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were determined. Peritoneal macrophages were isolated. Contents of intercellular adhesion molecule-1 (ICAM-1), monocyte chemoattractant protein 1 (MCP-1), tumor necrosis factor-alpha (TNF-alpha), and interleukin 6 (IL-6) were detected using flow cytometry (FCM) after adding the fluorescein-labeled molecule antibodies of inflammatory factors. RESULTS: Compared with Group A, the serum contents of TC and LDL-C obviously increased and HDL-C significantly decreased in Group B (all P < 0.01). There was no obvious change in the content of TG between Group A and Group B (P > 0.05). Compared with Group B, the contents of TC and LDL-C significantly decreased in Group C, D, and E (P < 0.01). Compared with Group C, serum contents of TC and LDL-C obviously decreased in Group D and E (P < 0.01). Compared with Group B, the content of macrophages significantly increased in Group A (P < 0.01). Compared with Group B, the content of macrophages significantly decreased in Group D and E (P < 0.01), more obviously in Group E (P < 0.01). Compared with Group C, the content of macrophages significantly decreased in Group E (P < 0.05). Compared with Group A, levels of ICAM-1, MCP-1, TNF-alpha, and IL-6 in the peritoneal macrophages significantly increased in Group B (P < 0.01). Compared with Group B, levels of ICAM-1, MCP-1, TNF-alpha, and IL-6 significantly decreased in Group C, D, and E, but more obviously in Group E (P < 0.01). Compared with Group C, levels of ICAM-1, MCP-1, TNF-alpha (P < 0.05, P < 0.01), and IL-6 (P < 0.05) significantly decreased in Group E. CONCLUSION: EA at Fenglong (ST40) could obviously downregulate the serum levels of TC and LDL-C in HLP rats, reduce the contents of macrophages, ICAM-1, MCP-1, TNF-alpha, and IL-6, thus arriving at the therapeutic effect in treating HLP.

[Effect of electroacupuncture of "Fenglong" (ST 40) on levels of blood lipid and macrophage TNF-alpha and IL-6 in hyperlipidemic rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) stimulation of "Fenglong" (ST 40) on blood lipid contents and inflammatory factor levels in hyperlipemia rats so as to elucidate its mechanism underlying improvement of hyperlipemia. METHODS: Fifty male SD rats were randomized into 5 groups: normal, model, diet -control, EA intervention (EA), diet-control + EA groups, with 10 rats in each group. Hyperlipemia model was established by feeding the animals with high-fat diet for 30 days. After modeling, rats in the diet-control group were fed with routine fodder. EA was applied to bilateral "Fenglong" (ST 40) for 30 min, once daily for 30 days. Following intraperitoneal injection of 1640 culture fluid, the peritoneal fluid was collected and centrifuged for extracting macrophages. Flow cytometry (FCM) was employed to determine the levels of tumor necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6) after adding fluoresce-labeled antibodies. RESULTS: The contents of serum TC and LDL-C were remarkably higher and HDL-C level was significantly lower in the model group than in the normal group (P < 0.01). After EA intervention, serum TC and LDL-C showed an apparent decrease (P < 0.01). Compared with the normal group, percentages of CD11 b, TNF-alpha and IL-6 were significantly increased in the model group (P < 0.01), while in comparison with the model group, percentages of CD11 b in both EA and diet-control + EA groups, TNF-alpha and IL-6 percentages of macrophages in the diet-control, EA and diet-control + EA groups were notably decreased (P < 0.05, P < 0.01). The effects of the diet-control + EA group were considerably superior to those of the diet-control group in lowering CD11 b, TNF-alpha and IL-6 percentages (P < 0.05, P < 0.01). No significant differences were found between the diet-control and EA groups in the aforementioned indexes (P > 0.05). CD11 b level indicates changes of macrophage level due to its specific marker character. CONCLUSION: EA stimulation of "Fenglong" (ST 40) is effective in lowering serum TC, LDL-C, and macrophage TNF-alpha and IL-6 levels in hyperlipemia rats.

Characteristics of adsorbents made from biological, chemical and hybrid sludges and their effect on organics removal in wastewater treatment.

Meso-macropore adsorbents were prepared from biological sludge, chemical sludge and hybrid sludge of biological and chemical sludges, by chemically activating with 18.0 M H(2)SO(4) in the mass ratio of 1:3, and then pyrolyzing at 550 °C for 1 h in anoxic atmosphere. The physical and chemical characteristics of the sludge-based adsorbents were examined in terms of surface physical morphology, specific surface area and pore size distribution, aluminum and iron contents, surface functional groups and crystal structure. Furthermore, the adsorption effect of these adsorbents on the organic substances in wastewater was also investigated. The results indicated that the adsorption capacities of the sludge-based adsorbents for UV(254) were lower than that of commercial activated carbon (AC), whereas the adsorption capacities of the adsorbents prepared from hybrid sludge (HA) and chemical sludge (CA) for soluble COD(Cr) (SCOD(Cr)) were comparable or even higher than that of the commercial AC. The reasons might be that the HA and CA possessed well-developed mesopore and macropore structure, as well as abundant acidic surface functional groups. However, the lowest adsorption efficiency was observed for the biological sludge-based adsorbent, which might be due to the lowest metal content and overabundance of surface acidic functional groups in this adsorbent.

Consecutive chemical cleaning of fouled PVC membrane using NaOH and ethanol during ultrafiltration of river water.

Chemical cleaning of fouled hollow-fiber polyvinyl chloride (PVC) membrane with the consecutive use of NaOH and ethanol during ultrafiltration of river water was investigated in the study. Results showed that through the chemical cleaning with 1% NaOH for 30min, a negative cleaning efficiency of -14.6% was observed for the PVC membrane. This might be due to the increase of membrane hydrophobicity, which was reflected by the increase of contact angle from 69.7 degrees to 87.6 degrees . On the other hand, the cleaning efficiency of 85.1% was obtained by the consecutive cleaning with 30min of 1% NaOH and 30min of ethanol. Individual ethanol cleaning could remove 48.5% of the irreversible resistance, indicating that NaOH cleaning also made its contribution (36.6%) to the removal of membrane foulants. Scanning electronic microscopy (SEM) and atomic force microscopy (AFM) analyses demonstrated that both NaOH and ethanol were not only able to eliminate the foulants on membrane surface, but also able to remove the in-pore fouling of the PVC membrane. The synergetic effects for removing membrane foulants were observed between the NaOH and ethanol. Furthermore, ethanol could also restore the hydrophilicity of the membrane by decreasing the contact angle from 87.6 degrees to 71.4 degrees . Considering that ethanol is easy to be used and reclaimed, the consecutive chemical cleaning by alkali and ethanol is recommended for PVC membrane in filtration of surface water.

Hybrid process of BAC and sMBR for treating polluted raw water.

The hybrid process of biological activated carbon (BAC) and submerged membrane bioreactor (sMBR) was evaluated for the drinking water treatment from polluted raw water, with the respective hydraulic retention time of 0.5 h. The results confirmed the synergetic effects between the BAC and the subsequent sMBR. A moderate amount of ammonium (54.5%) was decreased in the BAC; while the total removal efficiency was increased to 89.8% after the further treatment by the sMBR. In the hybrid process, adsorption of granular activated carbon (in BAC), two stages of biodegradation (in BAC and sMBR), and separation by the membrane (in sMBR) jointly contributed to the removal of organic matter. As a result, the hybrid process managed to eliminate influent DOC, UV(254), COD(Mn), TOC, BDOC and AOC by 26.3%, 29.9%, 22.8%, 27.8%, 57.2% and 49.3%, respectively. Due to the pre-treatment effect of BAC, the membrane fouling in the downstream sMBR was substantially mitigated.

Membrane coagulation bioreactor (MCBR) for drinking water treatment.

In this paper, a novel submerged ultrafiltration (UF) membrane coagulation bioreactor (MCBR) process was evaluated for drinking water treatment at a hydraulic retention time (HRT) as short as 0.5h. The MCBR performed well not only in the elimination of particulates and microorganisms, but also in almost complete nitrification and phosphate removal. As compared to membrane bioreactor (MBR), MCBR achieved much higher removal efficiencies of organic matter in terms of total organic carbon (TOC), permanganate index (COD(Mn)), dissolved organic carbon (DOC) and UV absorbance at 254nm (UV(254)), as well as corresponding trihalomethanes formation potential (THMFP) and haloacetic acids formation potential (HAAFP), due to polyaluminium chloride (PACl) coagulation in the bioreactor. However, the reduction of biodegradable dissolved organic carbon (BDOC) and assimilable organic carbon (AOC) by MCBR was only 8.2% and 10.1% higher than that by MBR, indicating that biodegradable organic matter (BOM) was mainly removed through biodegradation. On the other hand, the trans-membrane pressure (TMP) of MCBR developed much lower than that of MBR, which implies that coagulation in the bioreactor could mitigate membrane fouling. It was also identified that the removal of organic matter was accomplished through the combination of three unit effects: rejection by UF, biodegradation by microorganism and coagulation by PACl. During filtration operation, a fouling layer was formed on the membranes surface of both MCBR and MBR, which functioned as a second membrane for further separating organic matter.