Extraction of phosphorus from sewage sludge ash by electrodialysis combined with wet-chemical extraction.

Phosphorus (P) recovery from sewage sludge ash (SSA) is considered to be an effective method for P recovery. In this work, P extraction and the removal of heavy metals were realized by electrodialysis. Low-cost, easily available, and environmentally friendly plant extracts were applied as suspension to reduce the inevitable secondary pollution. And the feasibility of using plant extracts was analysed by comparing with using deionized water (DI) and oxalic acid (OA) solution. When SSA was suspended in different solutions (DI, OA, and three plant extracts - Hovenia acerba (HA), Saponin (SA) and Portulaca oleracea (PO)), the effects of reaction time and plant extract concentration on P extraction and heavy metal separation of SSA under ED treatment were compared. After the process of electrodialysis, compared to other experimental groups, electrodialysis with plant extracts obtained more P released from SSA, but less P migrated to the anode chamber. However, when SSA was suspended in PO at a concentration of 80 g/L, the proportion of P transferred from SSA to the anode chamber can still reached 37.86%. In addition, the use of plant extracts as suspension had a positive effect on the removal of heavy metals, but its effect was lower than that of the oxalic acid-treated experimental group. The results indicated that the use of plant extracts for wet-chemical extraction combined with electrodialysis promoted the removal of heavy metals and the extraction of P from SSA, which is a feasible option.

N2O emission factors in bubbling fluidized bed incineration of municipal sewage sludge: The China case.

The N2O emissions resulting from sludge incineration are estimated using the default values published by the Intergovernmental Panel on Climate Change (IPCC), which may differ significantly from the actual emissions. In this investigation, N2O emissions from four sludge incineration lines in two plants were monitored for varying durations. The variation in N2O emission factors (EFs) between incineration lines of the same plant was much smaller than the difference between different plants. Data on N2O EFs obtained from brief monitoring may contain variabilities of up to 30%. N2O EFs were more sensitive to temperature changes at low temperatures, necessitating extended monitoring periods to improve the reliability of N2O monitoring outcomes in cases of low furnace temperatures. Excessive use of the SNCR system to reduce NOx emissions resulted in concentrations of N2O and NH3 in the exhaust gases exceeding NOx levels. In the case of furnace temperature control and advanced reburning technology, it is advisable to utilize actual monitoring data or the smaller default values provided by the IPCC in China. Otherwise, the estimated N2O emissions may exceed the actual emissions.

Preparation of phosphorus containing products by co-incineration of sludge ash and calcium-based additives: Focusing one-step and multi-step method.

Due to the irreplaceable nature of phosphorus (P) in biological growth and the shortage of P rock, it is necessary to recover P from waste, such as sludge ash. P-containing products were prepared using sludge ash and calcium-based additives (CaCO3 and eggshell). In addition, the effects of different incineration methods (one-step method (OSM) and multi-step method (MSM)), additive doses, and incineration temperature on the P content and species in the products were investigated. The results indicated that as the dose of calcium-based additives increased, total P (TP) content in P-containing products reduced, apatite P (AP) content increased, non-apatite P (NAIP) content declined, and P solubility in citric acid content decreased. The amount of AP increased, NAIP reduced, and P solubility in citric acid decreased as the incineration temperature climbed. Although P in P-containing products prepared by OSM and MSM changed in a similar way at different additive doses and temperatures, P-containing products prepared by MSM had at least a 6.1% increase in P solubility in citric acid. Compared with OSM, MSM could save 10% of calcium-based additives when reaching the maximum AP value. Additionally, pure materials were employed to investigate how P species changed during the incineration procedure. The advantage of the MSM-prepared product over the OSM-prepared product may be explained by the high concentration of Ca3(PO4)2 and low concentration of amorphous calcium bound P (Ca-P). Overall, MSM is an effective method to reduce the dose of calcium-based additives and increase the bioavailability of P in P-containing products.

Association Between Peritoneal Carcinomatosis Index (PCI) Assessed by CT and Pathological Parameters and Short-Term Prognosis of Rectal Cancer.

Objective: The study aimed at explore the correlation between the CT-based Peritoneal Carcinomatosis Index (PCI) and pathological parameters of rectal cancer, as well as the correlation with short-term postoperative prognosis. Methods: A retrospective analysis was performed on 198 rectal cancer patients treated in our institution from January 2017 to December 2022. Based on preoperative CT-PCI, patients were classified into a normal and low CT-PCI groups. Baseline characteristics and short-term postoperative outcomes were compared between the two groups. Univariate and Multivariable logistic regression analyses were conducted to ascertain the independent risk factors for postoperative complications (Clavien-Dindo classification ≥ Grade II) following neoadjuvant treatment and radical rectal cancer surgery. Results: There were significant statistical differences between the two groups regarding age, ASA score, and surgical method (P < .05). Variations in overall postoperative complications and complications of Grade II or higher among patients with differing preoperative CT-PCI were statistically significant (P < .05). No significant statistical difference was found in the time to first liquid intake post-surgery between the preoperative low CT-PCI group and the normal CT-PCI group (P > .05); however, differences in the time to first flatus, duration of postoperative hospital stay, and total hospital expenditure were statistically meaningful (P < .05). Multivariate logistic regression revealed that CT-PCI (OR=2.254) was an influential factor for postoperative complications (Clavien-Dindo classification ≥ Grade II) (P < .05). The ROC curve demonstrated an AUC of 0.854 for CT-PCI in predicting postoperative complications (Clavien-Dindo classification ≥ Grade II). Conclusion: Preoperative CT-PCI may be utilized to evaluate the short-term prognosis of patients who undergo radical surgery for rectal cancer after neoadjuvant therapy. This evaluation assists in guiding clinical diagnostic and therapeutic decision-making, allowing for prompt interventions and enhancing short-term patient outcomes.

Lateral lymph node dissection can increase overall survival and 5­year survival rate of rectal cancer patients: A meta­analysis.

Rectal cancer is one of the most malignant tumors, and postoperative recurrence and metastasis are the main reasons for treatment failure. Lymph node metastasis is the main metastatic pathway of rectal cancer. The present study aimed to investigate the role of lateral lymph node dissection (LLND) in patients with rectal cancer using a meta-analysis. Articles in Chinese and English related to the application of LLND in patients with rectal cancer were retrieved and eligible studies were selected for data analysis. Evaluation indicators included the 5-year survival rate, recurrence rate, urinary system function and operation time. The random-effects model was utilized for the analysis. A total of 10 studies that met the eligibility criteria were selected, comprising 2,272 patients, including 1,101 cases in the LLND group and 1,171 cases in the non-LLND group. No significant difference was found between the two groups in terms of local recurrence rate, 5-year disease-free survival (DFS) rate, and DFS rate at the follow-up. It is noteworthy that cases in the LLND group had no significantly longer overall survival, but had a higher 5-year survival rate. However, cases in the LLND group had a longer operation time and worse urinary dysfunction. The results remained consistent throughout separate analyses for different research quality sources. The present meta-analysis showed that LLND provided a specific advantage in prolonging survival time. However, it was associated with prolonged operation time and an increased incidence of urinary dysfunction.

Phosphorus recovery from incinerated sewage sludge ash using electrodialysis coupled with plant extractant enhancement technology.

Phosphorus (P) is an integral mineral nutrient for the growth of plants and animals. As the increasing population worldwide, the demand for P resources keeps increasing. Therefore, it is necessary to recover P from secondary resources. Unlike conventional P recovery processes, this work focused on the recovery of P from incinerated sewage sludge ash (ISSA) using electrodialysis as the main technology coupled with plant extractants. In this study, Amaranthus and hydrolyzed polymaleic anhydride (HPMA) were used as P extractants, investigating the effects of HPMA concentration and pH of the compound agent on the migration of P and heavy metals from ISSA. The results showed that the concentration of HPMA and pH of the compound agent had a significant influence on the mobility of P and heavy metals. Meanwhile, the impacts of eggshell additions and voltage on the recovery efficiency of P was also studied by using waste eggshells as calcium sources. We found that when eggshells were added at 10 g/L and the voltage was 10 V, the recovery efficiency of P reached 96.05%. Moreover, XRD patterns revealed that the mineral phase of recovered P-containing products was predominantly hydroxyapatite, which had good environmental benefits. Generally, the favorable results have been achieved in the recovery efficiency of P and has practical implications for P recovery from ISSA.

Prediction of intraoperative bleeding and blood transfusion in patients with recurrent retroperitoneal liposarcoma: a retrospective study.

Background: Surgery is the main treatment for recurrent retroperitoneal liposarcoma (RPLS). The aim of the present study was to explore the factors associated with blood loss during surgery for recurrent RPLS. Methods: This retrospective study included patients with first recurrence of RPLS who were treated at our hospital between January 2015 and December 2019. Factors associated with intraoperative blood loss were identified by univariate and multivariate logistic regression analyses. Receiver-operating characteristic (ROC) curve analyses were conducted to evaluate whether tumor size and number of tumor-containing abdominal/pelvic zones were predictive of the need for blood transfusion. Results: The study included 67 cases. The number of zones containing tumors was 1 in 4 cases (6%), 2 in 36 cases (53.7%), 3 in 14 cases (20.9%), and 4 in 13 cases (19.4%). Tumor size was associated with blood loss >500 mL [odds ratio (OR): 1.153, 95% confidence interval (CI): 1.051-1.266, P=0.003]. The number of tumor-containing zones was associated with blood loss >1,000 mL (OR: 3.161, 95% CI: 1.248-8.003, P=0.015) and >1,500 mL (OR: 2.674, 95% CI: 1.061-6.739, P=0.037). Multiple tumors were associated with blood loss >2,000 mL (OR: 3.161, 95% CI: 1.092-13.133, P=0.036) and >2,500 mL (OR: 2.674, 95% CI: 1.243-16.299, P=0.022). Tumor dedifferentiation was associated with blood loss >1,000 mL (OR: 4.802, 95% CI: 1.287-17.916, P=0.019) and >1,500 mL (OR: 9.249, 95% CI: 1.927-44.39, P=0.005). ROC curve analysis showed that tumor size >15.25 cm [area under the ROC curve (AUC): 0.772, P<0.001] and the number of tumor-containing zones >2.5 (AUC: 0.670; P=0.023) were predictive of the need for blood transfusion. Conclusions: The main finding of the present study was that a larger tumor size, a larger number of tumor-containing zones, multiple tumors, and dedifferentiation were independently associated with a larger volume of intraoperative blood loss in patients with recurrent RPLS. The tumor size >15.25 cm and the tumor area >2.5 areas predicted the need for blood transfusion. Formulating the intraoperative blood transfusion plan for recurrent RPLS, it is necessary to pay attention to two spatial factors, tumor size and affected area, rather than one of them.

Analysis of benign retroperitoneal schwannomas: a single-center experience.

Background： Retroperitoneal schwannomas are rare. The purpose of this study was to present our experience with the diagnosis and treatment of 67 such tumors. Methods： Retrospective analysis of 67 patients with retroperitoneal schwannoma admitted to Peking University International Hospital from 2015 to 2021. Results： 67 patients presented with retroperitoneal schwannomas, 37 cases had no obvious clinical symptoms. 62 cases were completely excised, 5 cases were subtotal resection, 7 cases were combined with organ resection. The intraoperative blood loss was 300ml (20-9000ml), the tumor maximum size was 9cm (2.5-26cm), post-complication occurred in 6 cases (9.0%). Compared with abdominal retroperitoneal tumors, pelvic retroperitoneal tumors had larger tumor volume, more bleeding, higher proportion of block resection, and longer postoperative hospitalization time (P<0.05). The residual mass progressed slowly in 5 patients with subtotal resection, and no obvious malignant transformation occurred. Conclusion：Complete resection of schwannoma can achieve a good long-term prognosis. Patients with residual tumor after surgery progress slowly and rarely become malignant. We recommend early resection after the discovery of a pelvic retroperitoneal schwannoma. Keywords： Schwannoma; Retroperitoneal neoplasms; Postoperative complications.

Treatment Effect of Tuftsin and Antigen Peptide Combined with Immune Cells on Colorectal Cancer.

BACKGROUND The aim of this study was to investigate the effect of antigenic peptides on dendritic cell maturation and activation as well as the role of dendritic cell induced cell function. The tumor-specific cytotoxic T lymphocytes induced by activation of the dendritic cells were also evaluated. MATERIAL AND METHODS SW-480 cell lysate and peptide antigens were selected as adjuvants in dendritic cell sensitization, and tuftsin was used to induce the phagocytosis of dendritic cells. Immature dendritic cells were stimulated with the antigen and adjuvant as follows: group A was negative control; group B was SW-480 (20 µg/mL); group C was SW-480 (20 µg/mL)+tumor necrosis factor (TNF)-alpha (10 µg/mL); group D was SW-480 (20 µg/mL)+tuftsin (20 µg/mL); group E was antigen peptide (2 µg/mL); group F was antigen peptide (2 µg/mL)+TNF-alpha (10 µg/mL); group G was antigen peptide (2 µg/mL)+tuftsin (20 µg/mL). Cytotoxic T lymphocytes activation and in vitro anti-tumor effects were examined by detecting the maturation marks of dendritic cells as well as interleukin (IL)-10 and IL-12 levels secreted by dendritic cells. Cells with the strongest immunizing effects were injected into nude mice and tumor suppression status was evaluated. RESULTS Group D (SW-480+tuftsin), group E (antigen peptides), group F (antigen peptide+TNF-alpha), and group G (antigen peptides+tuftsin) displayed significant differences compared to the control group (P<0.05). Group G (antigen peptides+tuftsin) could also promote the secretion of cytokines IL-12, as well as inhibit cytokine IL-10 secretion, compared to the other experimental groups (P<0.05). In the in vivo experiments of tumor inhibitions, antigenic polypeptide+tuftsin was the most effective (P<0.05). CONCLUSIONS Combination of cytotoxic T lymphocytes and T peptide therapy in treating human colorectal cancer might be used as a new treatment strategy based on adoptive cellular immunotherapy.