An iron-biochar composite from co-pyrolysis of incinerated sewage sludge ash and peanut shell for arsenic removal: Role of silica.

Modification of biochar by low-cost iron sources has gained increasing attention to improve pollutants removal performance and reduce production costs compared to conventional chemical modifications. While such iron sources generally have complex compositions, their effects on properties of the iron-biochar composite are not well investigated. This study produced an iron-biochar (RBC) composite from co-pyrolysis of incinerated sewage sludge ash (ISSA) and peanut shell, and examined the role of silica with widespread existence in ISSA and other low-cost iron sources on properties of the iron-biochar composite relevant to As(III)/As(V) removal. Silica was found to react with iron during the pyrolysis process at 850 °C and formed iron silicon at the expense of producing zero valent iron and Fe3O4 which resulted in a poorer removal efficacy for As(III) and As(V) compared to the iron-biochar (FBC) made from pure Fe2O3 and peanut shell. Moreover, a high leaching of reactive silica from RBC was observed which affected the formation of corrosion products of ZVI and competed with arsenic for active adsorption sites. Despite this, RBC still exhibited a maximum adsorption capacity of 17.44 and 57.56 mg/g towards As(III) and As(V) respectively at pH 3.0. Overall, this study provides an interesting insight into upcycling ISSA into useful media for sorptive removal of arsenic from aqueous solutions.

Immobilization and recycling of contaminated marine sediments in cement-based materials incorporating iron-biochar composites.

Sustainable stabilization/solidification (S/S) incorporating biochar for hazardous wastes has attracted increasing attention. In this study, contaminated marine sediments were remediated and recycled as useful materials via cement-based S/S process incorporating iron-biochar composites derived from incinerated sewage sludge ash (ISSA) and peanut shell. Results showed that incorporation of 20% iron-biochar composites notably increased the Cr immobilization (52.8% vs 92.1-99.7%), while attained similar As (70%) and Cu (95%) immobilization efficiencies compared to the control group (CK) prepared with plain cement as the binder based on the Toxicity Characteristic Leaching Procedure. S/S products with the addition of ISSA derived iron-biochar composite had a mechanical strength of 5.0 MPa, which was significantly higher than its counterparts derived from pure iron oxide or pristine biochar (< 4.5 MPa). Microstructural and spectroscopic characterizations and chemical leaching experiments demonstrated that reduction of Cr(VI) to Cr(III) followed by formation of Cr-Fe precipitates by zero valent iron in iron-biochar composites contributed to the enhanced immobilization efficacy of Cr(VI) compared to CK. Overall, these results demonstrated the potential of applying ISSA and peanut shell derived iron-biochar composites as additives in the cement-based S/S treatment for contaminated sediments.

Serum creatinine/cystatin C ratio as a screening tool for sarcopenia and prognostic indicator for patients with esophageal cancer.

BACKGROUND & AIMS: Sarcopenia is associated with poor clinical outcomes of patients who underwent esophagectomy. The current diagnostic criteria for sarcopenia are complex and laborious. We aimed to employ the simple and economic indicator sarcopenia index (SI = creatinine/cystatin C ×100) to screen for sarcopenia and to evaluate its prognostic value in patients with esophageal cancer (EC). METHODS: Older participants in the National health and nutrition examination survey (NHANES) database (1999-2002) were divided into three groups according to tertiles of the SI value to explore the feasibility of SI in the diagnosis of sarcopenia. Restricted cubic spline (RCS) was utilized to show the non-linear relationship between all-cause mortality and SI. Patients with EC admitted to Jinling Hospital were enrolled to validate the efficacy and prognostic value of SI. Cut-off values of SI were determined using receiver operating characteristic curves. Multivariable logistic analyses and Cox analyses were used to identify the independent factors of postoperative complications and long-term survival, respectively. RESULTS: A total of 989 participants were identified from the NHANES database. SI showed the diagnostic value of sarcopenia (tertile 1 vs. tertile 3: odds ratio [OR]=3.67, 95% confidence interval [CI]: 1.52-8.87, p=0.004; tertile 2 vs. tertile 3: OR=1.79, 95% CI: 0.75-4.28, p=0.191) adjusted for race, gender, and body mass index (BMI). Individuals with SI ≤ 68 had a poorer overall survival (OS) (hazard ratio [HR]=2.14, 95% CI: 1.71-2.68, p<0.001), and the RCS plot showed that the all-cause mortality risk gradually decreased with the increase in SI. Then, 203 patients with EC were enrolled, of which 76 patients were diagnosed with sarcopenia. There was a linear correlation between SI and skeletal muscle index and prealbumin, indicating that SI was reliable for diagnosing sarcopenia. Patients in the high sarcopenia risk group (Male: SI < 62; Female: SI < 55) showed a higher incidence of complications (OR=3.50, 95% CI: 1.85-6.61, p<0.001) and poorer long-term survival (HR=2.62, 95% CI: 1.02-6.77, p=0.046). CONCLUSION: SI could be used to identify sarcopenia in patients with EC, and it is a useful prognostic factor of postoperative complications and long-term survival.

Surgical Apgar score could predict complications after esophagectomy: a systematic review and meta-analysis.

OBJECTIVES: Esophagectomy is the most effective treatment for oesophageal cancer, although the incidence of postoperative complications remains high. Severe major complications, such as intrathoracic anastomotic leakage, are costly and life-threatening to patients. Therefore, early identification of postoperative complications is essential. The surgical Apgar score (SAS) was introduced by Gawande and colleagues to predict major complications after oesophagectomy. Several studies were carried out with inconsistent results. METHODS: PubMed, Embase, Web of Science, ClinicalTrials.gov and the Cochrane Library were searched for studies regarding SAS and oesophagectomy. Forest plots were generated using a random-effects model to investigate the actual predictive value of SAS in identifying major complications after oesophagectomy. RESULTS: Nine retrospective cohort studies were finally identified from selected electronic databases. The meta-analysis demonstrated that SAS could forecast the incidence of postoperative complications (odds ratio = 1.82, 95% confidence interval: 1.43-2.33, P < 0.001). Subgroup analysis validated the predictive value of SAS whether as continuous or discrete variables. In addition, a meta-analysis of 4 studies demonstrated that SAS could predict the incidence of pulmonary complications (odds ratio = 2.32, 95% confidence interval: 1.61-3.36, P < 0.001). Significant heterogeneity but no publication bias was found. CONCLUSIONS: Lower SAS scores could predict the incidence of major morbidities and pulmonary complications after oesophagectomy. Significant heterogeneity limits the reliability of the results, even if publication bias is not observed. More high-quality prospective research should be conducted to verify the findings. PROSPERO registration ID: CRD42020209004.

Clinical value of multi-slice 3-dimensional computed tomographic angiography in the preoperative assessment of meningioma.

The aim of this study was to evaluate the clinical value of multislice 3-dimensional computed tomographic angiography (3D-CTA) in the preoperative assessment of meningiomas. A total of 331 cases with meningiomas confirmed by CT and MRI were examined using 3D-CTA. The locations of the tumors were observed to be as follows: parasagittal and falcine in 125 cases, sphenoidal in 39 cases, in the olfactory groove in 19 cases, tentorial in 21 cases, parasellar in 33 cases, petroclival in 29 cases, intraventricular in 7 cases and on the convexity of the brain in 58 cases. The reconstructed images were processed by shaded volume rendering, maximum intensity projection and color-shaded surface display. The 3D-CTA images were used to imitate the surgical approach. Surgery was performed according to the information provided in the 3D-CTA images. 3D-CTA provided clear 3D images of the meningioma and the relationship with the adjacent vessels and the skull base, and demonstrated the optimal surgical approach for removing the neoplasm. The results of 3D-CTA corresponded extremely well with the surgical observations. 3D-CTA is able to provide 3D images of the meningioma, adjacent vessels and the bones in the skull base. Furthermore, 3D-CTA supplies information vital in the selection of the optimal surgical approach and information that aids the management of the sinus during the surgery. 3D-CTA is of great value in the preoperative evaluation of meningiomas.

Neuron discharge and c-Fos expression in the nucleus of the solitary tract following electroacupuncture at acupoints of the Yangming Stomach Meridian of Foot.

The nucleus of the solitary tract (nucleus tractus solitarii; NTS) is a primary center for both visceral afferents and somatic afferents. Previous experiments have demonstrated that the NTS is closely connected to the stomach and acupoints in the Yangming Stomach Meridian of Foot (ST Meridian). In this study, extracellular recording and immunochemistry methods were used to analyze the discharge of neurons and c-Fos protein expression in the NTS following acupuncture at different acupoints and a nonacupoint. A total of 104 discharging neurons were detected in the NTS of 52 rats, of which 86 provided complete data. After acupuncture at Sibai (ST 2), Zusanli (ST 36), Neiting (ST 44), Quanliao (SI 18), and the nonacupoint, the neuron response rate in the NTS was 65.12%, 51.16%, 46.51%, 34.88% and 31.40% respectively. For neuron response rate, there was a significant difference among Sibai (ST 2), Zusanli (ST 36), Neiting (ST 44), Quanliao (SI 18), and the nonacupoint (p < 0.01 or p < 0.05). In the other 48 rats, the number of c-Fos immunoreactive neurons in the NTS by electroacupuncture (EA) at Sibai (ST 2) group was significantly higher than that EA at other acupoints and the nonacupoint (p < 0.05 or p < 0.01). EA at both Zusanli (ST 36) and Neiting (ST 44) increased c-Fos immunoreactive neurons significantly over EA at Quanliao (SI 18) and the nonacupoint (p < 0.05 or p < 0.01), while there was no difference between EA at Quanliao (SI 18) and the nonacupoint group (p > 0.05). The experiments demonstrated that the afferent convergence in NTS are different by body surface points stimulus, which suggests that the NTS might be a primary center in the central nervous system receiving acupoints stimulus from the ST Meridian.

[Effects of electroacupuncture on c-fos expression in nucleus of the solitary tract and electrocardiogram ST(II) in myocardial ischemia rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) of "Neiguan" (PC 6) and "Zusanli" (ST 36) on c-fos expression in the nucleus of the solitary tract (NTS)and ischemic electrocardiogram (ECG) in acute myocardial ischemia (AMI) rats, so as to study the role of NTS in EA-induced improvement of AMI. METHODS: Thirty-six male SD rats were randomly divided into control, model, ST 36, PC 6, "Pianli" (LI 6), and "Heyang" (BL 55) groups, with 6 cases in each. AMI model was established by intraperitoneal injection of Isoproterenol (5 mg/kg). EA (4 Hz/20 Hz, 1 mA) was applied to PC 6, ST 36, LI 6 and BL 55 for 20 min separately. c-fos expression in the NTS was detected by immunohistochemistry and ECG-ST(II) was recorded before and after AMI and EA. RESULTS: (1) Compared to control group, ECG-ST(II) of model group elevated significantly, while in comparison with model group, ECG-ST(II) values of ST 36 and PC 6 groups decreased significantly (P < 0.01), suggesting an improvement of AMI after EA. No significant changes of ECG-ST(II) were found in LI 6 and BL 55 groups (P > 0.05). (2) The number of fos-immunoreaction (fos-IR) positive neurons in the NTS in ST 36 and PC 6 groups was significantly lower than that in model, LI 6 and BL 55 groups (P < 0.01). CONCLUSION: EA of PC 6 and ST 36 can improve ischemic ECG in AMI rats and NTS is one of the centers for integrating cardiac functional activity and information from EA of PC 6 and ST 36.

Minimally invasive ventriculo-atrial shunt for hydrocephalus.

OBJECTIVE: To study the therapeutic effect of mini-traumatic ventriculo-atrial shunt on hydrocephalus. METHODS: Seventeen patients were treated with right internal jugular venepuncture intubation to finish minimally invasive ventriculo-atrial shunt for hydrocephalus. The patients were evaluated by CT/MRI. The catheters were deployed at the proper position in the right atrium under X-ray fluoroscopy. RESULTS: The hydrocephalus in all the 17 patients eliminated with this surgical procedure with a 100% success rate technically. The operational duration ranged from 0.75 to 1.5 h (average: 1 h). Mistaken puncture into the internal carotid artery as a complication occurred on 1 case. CONCLUSIONS: The mini-traumatic ventriculo-atrial shunt, as a novel minimal invasion technique, has the advantages of small trauma, no influence on local blood circulation, short time and simplicity at operation, rapid healing, and good short-term effect. Moreover, it is suitable for those patients with organic dysfunction.