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BACKGROUND: Colorectal cancer (CRC) is a common malignant tumor, and liver metastasis is one of the main recurrence and metastasis modes that seriously affect patients' survival rate and quality of life. Indicators such as albumin bilirubin (ALBI) score, liver function index, and carcinoembryonic antigen (CEA) have shown some potential in the prediction of liver metastasis but have not been fully explored. AIM: To evaluate its predictive value for liver metastasis of CRC by conducting the combined analysis of ALBI, liver function index, and CEA, and to provide a more accurate liver metastasis risk assessment tool for clinical treatment guidance. METHODS: This study retrospectively analyzed the clinical data of patients with CRC who received surgical treatment in our hospital from January 2018 to July 2023 and were followed up for 24 months. According to the follow-up results, the enrolled patients were divided into a liver metastasis group and a nonliver metastasis group and randomly divided into a modeling group and a verification group at a ratio of 2:1. The risk factors for liver metastasis in patients with CRC were analyzed, a prediction model was constructed by least absolute shrinkage and selection operator (LASSO) logistic regression, internal validation was performed by the bootstrap method, the reliability of the prediction model was evaluated by subject-work characteristic curves, calibration curves, and clinical decision curves, and a column graph was drawn to show the prediction results. RESULTS: Of 130 patients were enrolled in the modeling group and 65 patients were enrolled in the verification group out of the 195 patients with CRC who fulfilled the inclusion and exclusion criteria. Through LASSO regression variable screening and logistic regression analysis. The ALBI score, alanine aminotransferase (ALT), and CEA were found to be independent predictors of liver metastases in CRC patients [odds ratio (OR) = 8.062, 95% confidence interval (CI): 2.545-25.540], (OR = 1.037, 95%CI: 1.004-1.071) and (OR = 1.025, 95%CI: 1.008-1.043). The area under the receiver operating characteristic curve (AUC) for the combined prediction of CRLM in the modeling group was 0.921, with a sensitivity of 78.0% and a specificity of 95.0%. The H-index was 0.921, and the H-L fit curve had χ2 = 0.851, a P value of 0.654, and a slope of the calibration curve approaching 1. This indicates that the model is extremely accurate, and the clinical decision curve demonstrates that it can be applied effectively in the real world. We conducted internal verification of one thousand resamplings of the modeling group data using the bootstrap method. The AUC was 0.913, while the accuracy was 0.869 and the kappa consistency was 0.709. The combination prediction of liver metastasis in patients with CRC in the verification group had an AUC of 0.918, sensitivity of 85.0%, specificity of 95.6%, C-index of 0.918, and an H-L fitting curve with χ 2 = 0.586, P = 0.746. CONCLUSION: The ALBI score, ALT level, and CEA level have a certain value in predicting liver metastasis in patients with CRC. These three criteria exhibit a high level of efficacy in forecasting liver metastases in patients diagnosed with CRC. The risk prediction model developed in this work shows great potential for practical application.
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This study focused on the syngenetic control of polychlorinated-ρ-dibenzodioxins and dibenzofurans (PCDD/Fs) and heavy metals by field stabilization/solidification (S/S) treatment for municipal solid waste incineration fly ash (MSWIFA) and multi-step leachate treatment. Modified European Community Bureau of Reference (BCR) speciation analysis and risk assessment code (RAC) revealed the medium environment risk of Cd and Mn, indicating the necessity of S/S treatment for MSWIFA. S/S treatment significantly declined the mass/toxic concentrations of PCDD/Fs (i.e., from 7.21 to 4.25 µg/kg; from 0.32 to 0.20 µg I-TEQ/kg) and heavy metals in MSWIFA due to chemical fixation and dilution effect. The S/S mechanism of sodium dimethyldithiocarbamate (SDD) and cement was decreasing heavy metals in the mild acid-soluble fraction to reduce their mobility and bioavailability. Oxidation treatment of leachate reduced the PCDD/F concentration from 49.10 to 28.71 pg/L (i.e., from 1.60 to 0.98 pg I-TEQ/L) by suspension absorption or NaClO oxidation decomposition, whereas a so-called "memory effect" phenomena in the subsequent procedures (adsorption, press filtration, flocculating settling, slurry separation, and carbon filtration) increased it back to 38.60 pg/L (1.66 pg I-TEQ/L). Moreover, the multi-step leachate treatment also effectively reduced the concentrations of heavy metals to 1-4 orders of magnitude lower than the national emission standards. Furthermore, the PCDD/Fs and heavy metals in other multiple media (soil, landfill leachate, groundwater, and river water) and their spatial distribution characteristics site were also investigated. No evidence showed any influence of the landfill on the surrounding liquid media. The slightly higher concentration of PCDD/Fs in the soil samples was ascribed to other waste management processes (transportation and unloading) or other local source (hazardous incineration plant). Therefore, proper management of landfills and leachate has a negligible effect on the surrounding environment.
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Contaminantes Ambientales , Metales Pesados , Dibenzodioxinas Policloradas , Contaminantes Químicos del Agua , Cadmio/análisis , Carbono , Ceniza del Carbón/análisis , Dibenzofuranos/análisis , Dibenzofuranos Policlorados/análisis , Dimetilditiocarbamato/análisis , Contaminantes Ambientales/análisis , Incineración , Metales Pesados/análisis , Dibenzodioxinas Policloradas/análisis , Sodio/análisis , Suelo , Residuos Sólidos/análisis , Instalaciones de Eliminación de Residuos , Agua/análisis , Contaminantes Químicos del Agua/análisisRESUMEN
Fruit and vegetable waste (FVW) contains rich resources that can be recovered by methods such as incineration, anaerobic digestion to generate heat energy, biogas, and preservation by ensiling. However, a horizontal comparison of the resource potential and environmental impact of different recycling methods employed for FVW has not been conducted. This study quantifies and computes the recycling potential and global warming potential (GWP) of anaerobic digestion, ensiling, and incineration of the FVW generated during primary production in China. First, a gray model was employed to estimate the FVW output in 2030, based on the FVW produced between 2002 and 2017. Next, the resource potential and GWP of anaerobic digestion, incineration, and ensiling were evaluated. Finally, an optimization method was utilized to analyze possible strategies of FVW recycling in 2030. Results indicate that FVW output in China is expected to increase to 170 Mt by 2030, highlighting the need for efficient treatment options. Further, the resource potential and GWP of different waste treatment strategies were notably different. The recycling potential of ensiling was the highest at 1950 MJ/t; while the GWP of anaerobic digestion was the lowest at -31 kg CO2eq. An optimization analysis suggested that the optimal target of 100% would be attained if all FVW is ensiled in 2030. The study provides a basis for informed technical decision-making related to FVW recycling options in the future.
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Eliminación de Residuos , Verduras , Anaerobiosis , Reactores Biológicos , Frutas , Calentamiento GlobalRESUMEN
Cement kiln dust is commonly recycled back into the production process. This results in elevated concentrations of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in the flue gases of cement plants. The present study investigated the effects the reaction temperature, oxygen content, and origin of kiln dust had on the thermal reaction characteristics of PCDD/Fs. The concentration of 2,3,7,8-PCDD/Fs that were desorbed from the kiln dust decreased as the reaction temperature was increased and the higher temperature facilitated the degradation of PCDD/Fs. However, the oxygen content, which ranged from 6-21%, had only a minor impact on the thermal reaction characteristics of PCDD/Fs. Finally, the thermal reaction characteristics of PCDD/Fs were largely affected by the origin of the kiln dust; 1.2 pg I-TEQ g-1 was desorbed from kiln dust originating from a cement plant that co-processed refuse-derived fuel (RDF) and 47.5 pg I-TEQ g-1 was desorbed from kiln dust originating from a cement plant that co-processed hazardous waste. The study also found that PCDD/F formation pathways were dependent on the origin of the kiln dust; precursor synthesis dominated PCDD/F formation on the kiln dust collected from a cement plant that co-processed RDF, while de novo synthesis dominated the formation of PCDD/Fs on the remaining samples of kiln dust.