Clinical efficacy of Qi Di laxative decoction in the treatment of functional constipation: A protocol for systematic review and meta-analysis.

BACKGROUND: Functional constipation (FC) is a common gastrointestinal disorder characterized by slow bowel movement and defecation difficulties, significantly impacting patients' quality of life and exerting heavy financial burden to whole society. However, more than 50% FC patients are not completely satisfied with current therapies and alternative therapies are urgently required. Increasing evidences have demonstrated that traditional Chinese medicine has a good therapeutic effect on FC, which is well known for its multitarget and multimode effects on diverse diseases as well as less side effects. Furthermore, studies proved that Qi Di Laxative Decoction was an effective treatment for FC. Its safety and effectiveness should be verified by further studies. METHODS: We will search the following electronic databases for randomized controlled trials to evaluate the clinical efficacy of Qi Di Laxative Decoction in treating FC: Wanfang and Pubmed Database, China National Knowledge Infrastructure Database, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature, and Excerpta Medica database. Each database will be searched from inception to November 2020. The entire process will include study selection, data extraction, risk of bias assessment, and meta-analyses. RESULTS: This proposed study will evaluate the clinical efficacy of Qi Di Laxative Decoction for patients with FC. The outcomes will include changes in FC relief and adverse effect. CONCLUSION: This proposed systematic review will evaluate the existing evidence on the clinical efficacy of Qi Di Laxative Decoction in treating FC. DISSEMINATION AND ETHICS: The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/M2ESR.

[Non-filamentous sludge bulking caused by low concentration of dissolved oxygen and phosphorus deficiency and its control].

Non-filamentous sludge bulking occurred during sludge acclimation in lab-scale bio-reactors and the characteristics, properties and degrading pollutants capability of non-filamentous sludge were analyzed. Both low DO concentration (0 - 0.7 mg/L) and low ratio of P/BOD5 (0.78/100) resulted in excessive proliferation of viscous zoogloea and sludge bulking. SVI was directly proportional to extracellular polysaccharides and was inversely proportional to hydrophobicity of sludge. The sludge bulking could be effectively controlled by increasing DO concentration and P/BOD5 ratio. Besides, adding some porous padding into viscous bulking sludge was a useful method which might avoid the deterioration of sludge settlement and maintain good performance in the system. The viscous bulking sludge could not be controlled by addition of NaC1O.

[Performance of treating wastewater and anti-shockloading in oxic-settling-anaerobic (OSA) process for minimization of excess sludge].

Efficiency of pollution degradation, performance of activated sludge, effect of temperature fluctuation and recalcitrant organic compounds on system stability were investigated in OSA process for minimization of excess sludge. CAS process and OSA process were run with synthetic wastewater for 240 d. The results indicate that the OSA process excels the CAS process as a whole. COD removal efficiency in OSA process was slightly more than that in CAS. Removal efficiency of nitrogen and phosphorus could be enhanced to 42.58% and 53.84% respectively. Biological phosphorus accumulation in aerobic sludge from OSA and CAS were 2.69 g and 1.11 g per 100 g dry sludge, which further approved biological phosphorus removal in OSA process. Because of alternative aerobic and anaerobic environment in OSA process, sludge settleability and activity are improved. SVI in OSA process was 97 averagely. SOUR and dehydrogenase activity of sludge in OSA were higher appreciably than those in CAS. Protein concentration was higher above 1.69 mg x g(-1) and polysaccharide concentration was lower 6.7 mg x g(-1) in OSA sludge than those in CAS, which confirms the effect of anaerobic tank on sludge performance and microorganism diversity. Lower polysaccharide concentration in OSA sludge improves the settleability. Contrasting to CAS process, OSA process is more sensitive to impact of p-nitrophenol(PNP) and more inactive to temperature fluctuation. Temperature fluctuation led to an increase of the concentration of COD, NH4(+) -N, SS in effluent while sludge production Y(MLSS/COD) was reduced to 0.403 mg x mg(-1) and 0.227 mg x mg(-1) in CAS and OSA. When concentration of PNP was increased abruptly to 10 mg x L(-1), biological nutrient removal was ceased in OSA process. Once OSA system is impacted, it is difficult to restore.

[Phosphorus removal and recovery from human urine with MAP crystallization].

To realize the simultaneous removal and recovery of phosphate and partial nitrogen from stale human urine, a series of lab-scale jar tests, adopting MgCl2 x 6H2O as precipitant, were conducted to study the influence of the molar ratio of Mg/PO4(3-)-P, pH, mixing speed, reaction time and precipitation time on MAP precipitation. The experiment results showed that the molar ratio of Mg/PO4(3-)-P was found to be a very important operating parameter to affect phosphorus recovery efficiency. When the molar ratio of Mg/PO4(3-)-P was above 1.3:1, the phosphorus recovery efficiency was above 95% and the residual phosphorous was less than 10 mg/L in the solution. Increasing pH with 10 mol/L NaOH solution could not increase the recovery phosphorus efficiency obviously. Without pH control, the optimal parameters of reaction time, precipitation time and mixing speed could be set at 20 min, 2.0 h and 120 r/min, respectively. To reveal the chemical characteristics of MAP products from human urine, three MAP product samples, with no pH adjustment and under the above optimal operation condition, were obtained at different Mg/PO4(3-)-P molar ratios of 1:1, 1.3:1 and 1.5:1, respectively, and analyzed with SEM, XRD and ICP instrumentation. These precipitates were identified as nearly pure struvite (12.62% of P, 5.71% of N and 9.91% of Mg) with the presence of trace calcium, potassium and sodium. The contents of phosphorus, nitrogen and magnesium in the precipitates were 13.54%, 5.34% and 9.01% (Mg/PO4(3-)-P = 1:1), 13.78%, 5.23% and 9.36% (Mg/PO4(3-)-P = 1.3:1), as well as 13.34%, 5.12% and 9.15% (Mg/PO4(3-)-P = 1.5:1), respectively.