Outcomes of surgery for different types of chronic pulmonary aspergillosis: results from a single-center, retrospective cohort study.

BACKGROUND: The reported experience of surgical treatment for chronic pulmonary aspergillosis (CPA) mainly focused on simple aspergilloma (SA), few about other types of CPA. The present study aims to evaluate the outcomes of surgical treatment for different types of CPA. METHODS: We performed a retrospective analysis of 85 patients with CPA who underwent surgery from 2014 to 2020 at Shandong Provincial Chest Hospital. The patients were divided into four types, including SA, chronic cavitary pulmonary aspergillosis (CCPA), chronic fibrosing pulmonary aspergillosis (CFPA), aspergillus nodule (AN). We collected and analyzed the preoperative, perioperative, and postoperative data to evaluate the outcomes of surgical treatment of different types of CPA. RESULTS: The four groups had similar age (p = 0.22), symptoms (p = 0.36), lesion location (p = 0.09), VATS rate (p = 0.08), recurrence rate (p = 0.95), and had significant difference in surgical procedures (p < 0.01), time of surgery (p < 0.01), intraoperative blood loss (p < 0.01), postoperative complication (p = 0.01). CFPA (P = 0.01), longer surgical time (P = 0.001), and more intraoperative blood loss (P = 0.004) were risk factors of postoperative complication, more intraoperative blood loss (> 400 ml) was the independent risk factor (OR 13.5, 95% CI 1.6-112.1, P = 0.02). 6 patients relapsed after surgery with a recurrence rate of 7.1%. The mean time to relapse was 14.8 months (2-30 months) after surgery. Relapse occurred in 2 SA patients, 3 CCPA, and 1 CFPA, respectively, while none of the AN patients relapsed. No risk factor for recurrence was found. CONCLUSIONS: Surgical resection seems safe and effective in the treatment of SA, AN, CCPA with a low complication and recurrence rate, while surgery for CFPA should be limited to selected patients because of its higher complication rate.

Comparison of anaerobic phosphorus release from activated sludge with three carbon sources.

Three carbon sources, namely sodium acetate, sewage and effluent, were used to simulate the process of phosphorus release in an actual sewage treatment plant, in order to explore the phosphorus release performance of the sludge, the relationship between phosphorus release and chemical oxygen demand (COD) in sewage, and the stability of phosphorus-rich sludge. The results showed that the type and concentration of carbon sources had significant effects on the rate of phosphorus release, reaction equilibrium time and phosphorus release amount. When sodium acetate was used as the carbon source, the phosphorus release rate reached 12.54 mg P (g VSS·h)-1, and tended to be stable at 4.0 hours. The phosphorus release amount in the first 2.5 hours accounted for 36.88% of the total phosphorus in the sludge. When sewage was used as the carbon source, the phosphorus release rate did not reach equilibrium even at 5.0 hours, and the phosphorus release amount increased by 1.0 mg L-1 for every 10.5 mg L-1 increase sewage COD within a certain range. When effluent was used as the carbon source, the visual phosphorus release amount was only 0.83 mg L-1 after standing for 24 hours and the actual phosphorus release amount was 17.98 mg L-1. These conclusions can provide technical support for the optimization of phosphorus removal in sewage treatment plants.

Alkaline fermentation of waste activated sludge stimulated by saponin: volatile fatty acid production, mechanisms and pilot-scale application.

Volatile fatty acid (VFA) production stimulated by saponin (SP), an environmentally friendly bio-surfactant, was investigated during sludge alkaline fermentation in laboratory studies and pilot applications. The combined use of SP and pH 9 condition significantly enhanced VFA production to approximately 425 mg COD/g VSS, which was 4.7-fold of raw sludge and 1.5-fold of sole pH 10 adjustment (the optimum pH for alkaline fermentation). Further results indicated that SP & pH 9 condition provided sufficient substrates for acidification and decreased the consumption of VFAs through methanogenesis. Moreover, SP accompanied by moderate alkaline condition (i.e. pH 9) showed weaker inhibitory effects on key enzyme activities and metabolic potential of acidification microorganisms than sole pH 10 adjustment. On this basis, a pilot-scale system involving anaerobic fermentation and anaerobic-anoxic-aerobic step-feed bioreaction tanks was established to study the potential of VFAs as supplementary carbon sources for wastewater treatment. The influent of the pilot system was sanitary wastewater characterized by low C/N ratios from a scenic rural area. After flocculation and nutrient precipitation, the fermentation supernatant was mixed with the influent at a volume ratio of 1:30. With this approach, nitrogen and phosphorus concentrations in effluent fulfilled the first-A wastewater discharge standard in China.

Effects of Sensitized Sorafenib with a Paeoniflorin and Geniposide Mixture on Liver Cancer via the NF-κB-HIF-2α-SerpinB3 Pathway.

Purpose: This study focused on determining the anticancer effect of paeoniflorin and geniposide mixture (PFGS) combined with sorafenib (Sor) in hepatocellular carcinoma (HCC) and, in particular, whether PFGS increases the antitumor effect of Sor by modulating the NF-κB/HIF-2α/SerpinB3 pathway. Methods: The H22 hepatoma tumor-bearing mouse model was treated with PFGS, Sor, and a combination of the two drugs for 12 days. The effects of PFGS combined with Sor on tumor growth and apoptosis and the expression of NF-κB, HIF-2α, and SerpinB3 in tumor tissue were assessed. In addition, Sor-resistant hepatoma cells were treated with PFGS, Sor, and the combination of the two drugs in vitro. The effects of PFGS combined with Sor on cell proliferation and invasion and the protein expression of NF-κB p65, HIF-2α, and SerpinB3 were investigated. Results: PFGS combined with Sor treatment synergistically inhibited tumor growth in HCC tumor-bearing mice. Immunostaining showed that PFGS combined with Sor treatment significantly decreased the expression of Ki-67 and obviously induced apoptosis in the tumor compared with a single treatment. Similarly, PFGS combined with Sor treatment significantly downregulated the expression of NF-κB, HIF-2α, and SerpinB3 in the tumor compared with a single treatment. Additionally, PFGS combined with Sor markedly inhibited cell proliferation and invasion and activation of the NF-κB/HIF-2α/SerpinB3 pathway in Sor-resistant hepatoma cells compared with a single treatment. Conclusion: Our study demonstrated that PFGS synergistically increased the antiliver cancer effects of Sor by lowering activation of the NF-κB/HIF-2α/SerpinB3 pathway. These findings provided a scientific foundation for clinical studies using PFGS and Sor to treat liver cancer.

A new operation mode solving clogging problems of horizontal subsurface constructed wetlands.

Horizontal subsurface constructed wetland (SSFCW) has been widely used to treat wastewater, however the capacity of SSFCW is severely confined by clogging problems which are very common during the lifespan of a SSFCW. Therefore it is of great practical significance to improve the performance of SSFCW. In this study, a new operation mode by changing the flow direction periodically was executed and the performance on the pollutants removal was studied. Three years' experimental results showed that the SSFCW with new operation mode achieved better pollutant removal efficiency compared with the performance obtained under traditional operation mode. The microorganism test showed that the reciprocating SSFCW had larger quantity microorganism which effectively prevented organic compounds accumulation. The readings of gauge glass in the traditional SSFCW rose gradually, while the water level kept stable in reciprocating one, which also reflected the severity of the clogging problem in the two wetlands. During the whole operation period, the SSFCW with reciprocating operation mode didn't have any infiltration problem, while SSFCW with traditional operation mode had visible clogging problems as a result of pollutants accumulation in the inlet zone.

An Electrochemical Sandwich Immunosensor Based on Signal Amplification Technique for the Determination of Alpha-Fetoprotein.

The synthesis of Au nanocubes is used to label alpha-fetoprotein antibody (anti-AFP) and horseradish peroxidase (HRP) to form an immune complex for antibody detection. Graphene oxide-methylene blue-gold nanoparticles (GO-MB-AuNPs) nanocomposites were used as the immunosensing platform. This proposed sandwich-type immunoassay shows good performance. This method establishes a feasible amperometric immunoassay method for sensitive analysis of AFP in serum samples. Under the optimal experimental conditions, the DPV current response of the immunosensor is proportional to the logarithmic value of the AFP concentration. The linear detection range can achieve to 0.005-20 ng/mL with a detection limit of 1.5 pg/mL. The proposed immunosensor has good precision, selectivity and stability, and can be used for AFP determination in clinical tests.

Polyaluminum chloride-functionalized colloidal gas aphrons for flotation separation of nanoparticles from water.

The present work used the coagulative colloidal gas aphron (CCGA)-involved flotation as a robust technology to efficiently remove the typical engineered nanoparticles - silica nanoparticles (SNPs) from water. The inorganic polymer coagulant - polyaluminum chloride (PACl) was used to surface-functionalize the zwitterionic surfactant (C15B)-based CGAs. Results denote that the physicochemical conditions of PACl/C15B mixed solution markedly influenced the flotation behaviors by changing the properties of CCGAs. The C15B molecules showed different dissociated states and interaction behaviors with Al species with the variation of pH. The addition of salt into the PACl/C15B mixed solution decreased the foamability of solution, and the bubbles collapsed before they could efficiently capture SNPs in their rising trajectory. The optimum SNP removal (87.2%) was obtained when the pH and the additional ionic strength of PACl/C15B mixed solution were ∼4.7 and ≤ 1.0 g NaCl/L, individually, and the pH of SNP suspension was ∼9.4. Importantly, modifying PACl on microbubbles took greater advantages than directly using it as coagulant in terms of SNP removal and PACl utlization. The CCGAs were robust since their colloidal attraction and collision efficiency with SNPs were simultaneously enhanced. The PACl was more efficiently utilized during flotation whilst the regular chemical-dosing unit was omitted.

Hepatic Resection is Safe for Metachronous Hepatic Metastases from Ovarian Cancer.

OBJECTIVE: To explore the efficacy of hepatic resection (HR) in a relatively unselected group of patients with ovarian cancer liver metastases (OCLM). METHODS: A study was conducted between September 2000 and September 2011 on 60 ovarian cancer patients with hepatic metastases (24 solitary and 36 multiple), 40 of whom had extrahepatic metastases. HR was done in all patients provided that curative hepatic resection was feasible, and extrahepatic disease was controlled with medical and/or surgical therapy. RESULTS: Most patients (n=54; 90.0%) had a negative hepatic margin (R0), whereas 6 patients (10.0%) had microscopic disease at the margin (R1). The prognostic value of each study variable was assessed using log rank tests for univariate analysis and Cox proportional hazard models for multivariate analysis. The result was a median survival of 39 months and 5-year overall survival rate of 30%. Univariate analysis showed that surgery result (P=0.001), disease free interval (P=0.018) and the number of hepatic lesions (P=0.018) were significantly related to survival. Furthermore, the surgery result (P=0.004) remained significant for prognosis in multivariate analysis. CONCLUSIONS: For patients with OCLM, HR is safe and may provide a significant survival benefit compared with medical therapy alone. A long interval time, the number of hepatic lesions, and surgery results are key prognostic factors. Favorable outcomes can be achieved even in patients with medically controlled or surgically resectable extrahepatic disease, indicating that surgery should be considered more frequently in the multidisciplinary care of patients with OCLM.