Dioxins from medical waste incineration: Normal operation and transient conditions.

Polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) are key pollutants in waste incineration. At present, incinerator managers and official supervisors focus only on emissions evolving during steady-state operation. Yet, these emissions may considerably be raised during periods of poor combustion, plant shutdown, and especially when starting-up from cold. Until now there were no data on transient emissions from medical (or hospital) waste incineration (MWI). However, MWI is reputed to engender higher emissions than those from municipal solid waste incineration (MSWI). The emission levels in this study recorded for shutdown and start-up, however, were significantly higher: 483 ± 184 ng Nm(-3) (1.47 ± 0.17 ng I-TEQ Nm(-3)) for shutdown and 735 ng Nm(-3) (7.73 ng I-TEQ Nm(-3)) for start-up conditions, respectively. Thus, the average (I-TEQ) concentration during shutdown is 2.6 (3.8) times higher than the average concentration during normal operation, and the average (I-TEQ) concentration during start-up is 4.0 (almost 20) times higher. So monitoring should cover the entire incineration cycle, including start-up, operation and shutdown, rather than optimised operation only. This suggestion is important for medical waste incinerators, as these facilities frequently start up and shut down, because of their small size, or of lacking waste supply. Forthcoming operation should shift towards much longer operating cycles, i.e., a single weekly start-up and shutdown.

Dioxin emission and distribution from cement kiln co-processing of hazardous solid waste.

Cement kiln collaborative disposal technology can not only dispose of hazardous waste but also provide energy for the cement industry. However, the addition of hazardous waste may promote the formation of dioxins in cement kilns. In this study, typical hazardous solid wastes, such as solidified fly ash, electroplating sludge, and industrial residue, were co-processed in a cement kiln with different feeding positions and different feeding amounts. The concentrations of dioxins in the flue gas, clinker, and precalciner furnace slag were investigated. The effect of adding mixed hazardous solid waste on the formation of dioxin was also studied. The results showed that the concentration of dioxin in the flue gas without added hazardous waste was 1.57 ng/m3, and the concentration varied from 1.03 to 6.49 ng/m3 after the addition of hazardous waste. In addition, the concentration of dioxin in the flue gas and solid samples increased substantially when the co-processing ratio doubled. The large amount of Cu in solidified fly ash promoted the formation of dioxins, while the higher S content in the electroplating sludge suppressed the formation of dioxins. Compared with the addition of single hazardous waste, the concentration of dioxin in precalciner furnace slag increases by about 300%. Furthermore, the distributions of isomers in the clinker and precalciner furnace slag were similar. 1,2,3,4,6,7,8-HpCDD and OCDD accounted for a large proportion of the mass concentration, and the contribution rate ranged from 48.7 to 82.0%. Most importantly, correlation analysis showed that the concentration of dioxin was closely related to the copper content, hazardous waste types and additive proportion, with correlation coefficients of 0.79, 0.83, and 0.89, respectively. This study provides a basis for exploring the high environmental benefits of disposing of hazardous solid waste by co-processing in cement kilns.

Clinical observation on the combined use of acupuncture and herbal medicine for treatment of chloasma.

OBJECTIVE: To observe the clinical effects of the combined use of acupuncture and herbal medicine for treatment of chloasma. METHODS: Totally 60 patients were randomly divided into a treatment group of 30 cases, treated by acupuncture and herbal medicine, and a control group of 30 cases, administered Vitamin C and Vitamin E. The clinical effects were observed. RESULTS: The total effective rate of the treatment group is 93.3% better than that of the control group (76.7%), the difference was significant (P < 0.01). CONCLUSION: Combined use of acupuncture and herbal medicine may yield definite therapeutic effects in treating chloasma patients.

Comparative analyses of catalytic degradation of PCDD/Fs in the laboratory vs. industrial conditions.

This study investigates the efficiencies and mechanisms of the catalytic degradation of polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs) first, in simulated laboratory conditions and then, in a commercial municipal solid waste incineration (MSWI) plant. Five commercially available V2O5-WO3/TiO2 (VWTi) catalysts were tested. The degradation efficiency of PCDD/Fs in the simulated flue gas ranged 22.8-91.7% and was generally higher than that in the MSWI flue gas of 8.0-85.4%. The degradation efficiency of PCDD/Fs in the real flue gas of the MSWI plant was largely hindered by the complex composition of the flue gas, which could not be completely reproduced in the simulated laboratory conditions. Furthermore, the degradation of the higher chlorinated PCDD/Fs was easier compared to the lower chlorinated ones in the presence of the VWTi catalysts, which was primarily driven by the tendency of the higher chlorinated PCDD/Fs to be adsorbed on the surface of the catalyst and further destructed due to their lower vapor pressure. In addition, powdered catalysts should be preferred over the honeycomb shaped ones as they exposed higher PCDD/Fs degradation efficiencies under equal reaction conditions. The chemical composition and a range of the relevant to the study properties of the catalysts, such as surface area, crystallinity, oxidation ability, and surface acidity, were analyzed. The study ultimately supports the identification of the preferred characteristics of the VWTi catalysts for the most efficient degradation of toxic PCDD/Fs and elucidates the corresponding deactivation reasons of the catalysts.

Comparisons of three different doses of alirocumab application in patients with hypercholesterolemia: a meta-analysis.

INTRODUCTION: Low high-density lipoprotein cholesterol (HDL-C) and high low-density lipoprotein cholesterol (LDL-C) levels are associated with incidence of cardiovascular disease (CVD). Alirocumab has been considered as an efficacious, safe and promising therapeutic modality for hypercholesterolemia. The purpose of this study is to compare the differences of the three different doses of alirocumab in patients with hypercholesterolemia. EVIDENCE ACQUISITION: Randomized controlled trials were identified from PubMed, EMBASE, PMC and Cochrane-library databases. The inter-comparison of different doses were performed by subgroups analysis. Meta-analyses were performed by the Review Manager 5.3 and STATA 13.0 software. EVIDENCE SYNTHESIS: A total of nine studies involving 3870 patients were included in this meta-analysis. Alirocumab administered at 75-150 mg every 2 weeks (Q2W) resulted in a greater percent change from baseline in LDL-C concentrations (MD, -55.17; 95% CI: -64.35 to -45.99; P<0.05), and HDL-C levels (MD, 7.70; 95% CI 5.94 to 9.46; P<0.05) than other two doses (300 mg every 4 weeks [Q4W], 150 mg every 2 weeks [Q2W]). There was no difference in achieving the treatment goal of LDL-C (≤1.8 mmol/L), in other serum lipid parameters (total cholesterol [TC], triglyceride [TG]), and in the incidence of adverse events. CONCLUSIONS: The results demonstrate that alirocumab at a dose of 75-150 mg Q2W should be preferred in patients with hypercholesterolemia.

High temperature suppression of dioxins.

Combined Sulphur-Nitrogen inhibitors, such as sewage sludge decomposition gases (SDG), thiourea and amidosulphonic acid have been observed to suppress the de novo synthesis of dioxins effectively. In this study, the inhibition of PCDD/Fs formation from model fly ash was investigated at unusually high temperatures (650 °C and 850 °C), well above the usual range of de novo tests (250-400 °C). At 650 °C it was found that SDG evolving from dried sewage sludge could suppress the formation of 2,3,7,8-substituted PCDD/Fs with high efficiency (90%), both in weight units and in I-TEQ units. Additionally, at 850 °C, three kinds of sulphur-amine or sulphur-ammonium compounds were tested to inhibit dioxins formation during laboratory-scale tests, simulating municipal solid waste incineration. The suppression efficiencies of PCDD/Fs formed through homogeneous gas phase reactions were all above 85% when 3 wt. % of thiourea (98.7%), aminosulphonic acid (96.0%) or ammonium thiosulphate (87.3%) was added. Differences in the ratio of PCDFs/PCDDs, in weight average chlorination level and in the congener distribution of the 17 toxic PCDD/Fs indicated that the three inhibitors tested followed distinct suppression pathways, possibly in relation to their different functional groups of nitrogen. Furthermore, thiourea reduced the (weight) average chlorinated level. In addition, the thermal decomposition of TUA was studied by means of thermogravimetry-fourier transform infrared spectroscopy (TG-FTIR) and the presence of SO2, SO3, NH3 and nitriles (N≡C bonds) was shown in the decomposition gases; these gaseous inhibitors might be the primary dioxins suppressants.

Recycling ash into the first stage of cyclone pre-heater of cement kiln.

Fly ash collected from the bag filter could be recycled into the first stage of the cyclone pre-heater of the cement kiln, resulting in the possible enrichment of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs). In this study, soxhlet fly ash (SFA) and raw meal (RM) were selected as the basis for the PCDD/F formation experiments. The levels of 2,3,7,8-PCDD/Fs formed on the SFA and RM were observed to be 2550pg/g (157pg I-TEQ/g) and 1142pg/g (55pg I-TEQ/g), respectively. While less 2,3,7,8-PCDD/Fs was detected when SFA was mixed with RM, suggesting that recycling cement kiln ash would not largely increase the concentration of PCDD/Fs in flue gas. Furthermore, the possible influencing factors on the PCDD/F formation were also investigated. The formation of 2,3,7,8-PCDD/Fs was up to 10,871pg/g (380pg I-TEQ/g) with the adding of CuCl2, which was much higher than the results of CuO and activated carbon. Most importantly, the homologue, congener and gas/particle distribution of PCDD/Fs indicated that de novo synthesis was the dominant PCDD/F formation pathway for SFA. Lastly, principal component analysis (PCA) was also conducted to identify the relationship between the compositions of reactant and the properties of PCDD/Fs produced.

Suppression of dioxins by S-N inhibitors in pilot-scale experiments.

S-N inhibitors like thiourea and sewage sludge decomposition gases (SDG) are relatively novel dioxins suppressants and their efficiencies are proven in numerous lab-scale experiments. In this study, the suppression effects of both thiourea and SDG on the formation of dioxins are systematically tested in a pilot-scale system, situated at the bypass of a hazardous waste incinerator (HWI). Moreover, a flue gas recirculation system is used to get high dioxin suppression efficiencies. Operating experience shows that this system is capable of stable operation and to keep gaseous suppressant compounds at a high and desirable molar ratio (S + N)/Cl level in the flue gas. The suppression efficiencies of dioxins are investigated in flue gas both without and with addition of S-N inhibitors. A dioxin reduction of more than 80 % is already achieved when the (S + N)/Cl molar ratio is increased to ca. 2.20. When this (S + N)/Cl molar ratio has augmented to 4.18 by applying suppressant recirculation, the residual PCDD/Fs concentration in the flue gas shrank from 1.22 to 0.08 ng I-TEQ/Nm(3). Furthermore, the congener distribution of dioxins is analysed to find some possible explanation or suppression mechanism. In addition, a correlation analysis between (S + N)/Cl molar ratios and PCDD/Fs is also conducted to investigate the chief functional compounds for dioxin suppression.

Antiosteoporotic Effects of Huangqi Sanxian Decoction in Cultured Rat Osteoblasts by Proteomic Characterization of the Target and Mechanism.

Huangqi Sanxian decoction (HQSXD) is routinely used for the treatment of osteoporosis in the Chinese traditional healthcare system. However, the targets and mechanism underlying the effect of HQSXD on osteoporosis have not been documented. In the present study, seropharmacology and proteomic approaches (two-dimensional gel electrophoresis combined with mass spectrometry) were used to investigate the effects and possible target proteins of HQSXD on osteoblast. We found that HQSXD-treated rat serum significantly enhanced osteoblast proliferation, differentiation, and mineralization. In HQSXD-S-treated osteoblasts, there were increases in the expression of N-formyl peptide receptor 2 and heparan sulfate (glucosamine) 3-O-sulfotransferase 3A1 and reduction in the expression of alpha-spectrin, prohibitin, and transcription elongation factor B (SIII), polypeptide 1. The identified proteins are associated with cell proliferation, differentiation, signal transcription, and cell growth. These findings might provide valuable insights into the mechanism of antiosteoporotic effect affected by HQSXD treatment in osteoblasts.

Distribution of PCDD/Fs in the fly ash and atmospheric air of two typical hazardous waste incinerators in eastern China.

Distribution of polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs) in the fly ash and atmospheric air of one medical waste incinerator (MWI) and one industrial hazardous waste incinerator (IHWI) plants were characterized. The PCDD/F concentrations of the stack gas (fly ash) produced from MWI and IHWI were 17.7 and 0.7 ng international toxic equivalent (I-TEQ)/Nm(3) (4.1 and 2.5 ng I-TEQ/g), respectively. For workplace air, the total concentrations of PCDD/Fs were 11.32 and 0.28 pg I-TEQ/Nm(3) (819.5 and 15.3 pg/Nm(3)). We assumed that the large differences of PCDD/F concentrations in workplace air were due to the differences in chlorine content of the waste, combustion conditions, and other contamination sources. With respect to the homologue profiles, the concentrations of PCDFs decreased with the increase of the substituted chlorine number for each site. Among all of the PCDD/F congeners, 2,3,4,7,8-PeCDF was the most important contributor to the I-TEQ value accounting for ca. 43 % of two sites. The gas/particle partition of PCDD/Fs in the atmosphere of the workplace in the MWI was also investigated, indicating that PCDD/Fs were more associated in the particle phase, especially for the higher chlorinated ones. Moreover, the ratio of the I-TEQ values in particle and gas phase of workplace air was 11.0. At last, the relationship between the distribution of PCDD/Fs in the workplace air and that from stack gas and fly ash was also analyzed and discussed. The high correlation coefficient might be a sign for diffuse gas emissions at transient periods of fumes escaping from the incinerator.

PCDD/Fs' suppression by sulfur-amine/ammonium compounds.

Three distinct -S and -NH2 or NH4(+) containing compounds, including ammonium thiosulfate, aminosulfonic acid and thiourea, were studied as polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) inhibitors. All these three -S and -N containing compounds tested show strong suppression of PCDD/Fs formation, especially for thiourea which has not been studied before. With a (S+N)/Cl molar ratio of only 0.47, thiourea could inhibit 97.3% of PCDD/Fs and even 99.8% of I-TEQ. At an unusually high de novo test temperature (650 °C), the PCDD/Fs' formation was still very low but also the inhibition capacity of thiourea was weak, with an efficiency of 59% for PCDD/Fs when with a (S+N)/Cl molar ratio of 1.40. The results also revealed that the inhibition capability of the combined -S/-NH2 or -S/NH4(+) suppressant was strongly influenced by both the nature of the functional group of nitrogen and the value of the molar ratio (S+N)/Cl. The amine functional group -NH2 tends to be more efficient than ammonium NH4(+) and within a certain range a higher (S+N)/Cl value leads to a higher inhibition efficiency. Moreover, the emission of gases was continuously monitored: the Gasmet results revealed that SO2, HCN and NH3 were the most important decomposition products of thiourea. Thiourea is non-toxic, environment-friendly and can be sprayed into the post-combustion zone in form of powder or aqueous solution. The cost of thiourea at least can be partially compensated by its high inhibition efficiency. Therefore, the application of thiourea in a full-scale incinerator system is promising and encouraging.

[Polymorphism of Helicobacter pylori vacA, isolated in China].

OBJECTIVE: To understand the polymorphism of Helicobacter pylori (H. pylori) vacA alleles in China. METHODS: A total of 119 H. pylori strains were isolated from different gastro-duodenal diseases in 7 different geographic regions in China. vacA and its alleles were identified according to the length of PCR products with DNA electrophoresis. The distributions of vacA alleles were statistically analyzed. The core fragment of vacA was sequentially analyzed by software MEGA4.0. RESULTS: The alleles in vacA dominantly belonged to s1a, m2 and i1 in the tested strains. The distribution appeared to be 97.5% (116/119), 68.9% (82/119) and 91.6% (109/119), respectively. The m1b allele appeared to be 26.1% (31/119). s1b and m1a were not found. The major vacA recombination was between s1a/m2/i1 and 62.2%, followed by s1a/m1b/i1 (25.2%, 30/119). No association was found between the distribution of s1a allele and the clinical outcome, as well as the geographical regions (P > 0.05). However, the distribution of m alleles showed significant difference both among the types of disease and the geographic regions (P < 0.01). The present of i alleles did not show significant differences among disease patterns, but had significant differences between different geographic groups (P < 0.01). Three clusters were identified among these 119 isolates according to the DNA sequence of vacA. CONCLUSION: s1a/m2/i1 appeared to be the main allele in H. pylori vacA isolates from China in this study. The distribution of m alleles in vacA was correlated both to the regions and the disease patterns. The presence of i allele was associated to the regions but not the disease patterns.