Occurrence of micropollutants in rural domestic wastewater in Zhejiang Province, China and corresponding wastewater-based epidemiology analysis.

By 2021, rural regions in China were occupied by over 500 million residents, generating an annual volume of 19.5 billion m3 of rural domestic wastewater (RDW). This study aimed to investigate the occurrence and removal of micropollutants (MPs) in RDW treatment facilities and to perform a corresponding wastewater-based epidemiology analysis (WBE). Our findings indicated the significantly high levels of influent MPs, particularly pharmaceuticals, such as ofloxacin and diclofenac being most prevalent (ranging from several to tens of µg/L) across different facilities. After various treatments, regular water indexes in the effluent, like NH3 -N and COD, have basically satisfied the local discharge standard. However, the concentration of certain dominant MPs in effluent remained notably high, ranging from hundreds of ng/L to several µg/L. The risk quotients of MPs like diclofenac, ciprofloxacin, ofloxacin, sulfamethoxazole, diuron, and isoproturon were all above 1 in the effluent, signifying significant hazards to aquatic organisms. The quantitative meta-analysis revealed higher average standardized removal efficiency for membrane bioreactor (MBR) treatment (-11 %) compared to anaerobic/anoxic/aerobic (A2O) treatment (11 %), indicating the higher efficiency of MBR treatment in outperforming the A2O as a secondary treatment. Additionally, employing biofilter as a tertiary treatment proved to be more effective as compared to flocculation-air flotation and artificial wetlands. Moreover, the results of WBE analysis showed that diclofenac and ofloxacin emerged as the most commonly used pharmaceuticals (of seven), with consumption levels recorded at 1222 and 517 mg/(d·103 capita), with daily defined doses per day per 103 capita of 12.2/1000 and 1.29/1000, respectively. This study addresses the existing knowledge gaps regarding the occurrence and removal of MPs in RDW and offers valuable insights into pharmaceutical consumption patterns in rural regions, thereby improving our understanding of public health.

Pros and cons for transitional ICU care after major hepatectomy / 中华普通外科杂志

Objective:To explore the necessity of transitional ICU care for patients with liver cancer after major hepatectomy.Methods:The clinical data of 548 liver cancer patients with major hepatectomy were retrospectively analyzed. According to whether by way of transitional ICU care was used or not, patients were divided into ICU group(92 cases) and none-ICU group(456 cases). The clinical data, postoperative complications and mortality were compared.Results:There were no difference in the incidence of major complications(ascites, liver failure, bile leakage, infection and bleeding), mortality and length of hospital stay between the two groups( P>0.05). But the total hospitalization costs of patients in the ICU group were significantly higher than those in the non-ICU group [(72 019±24 516) yuan vs. (67 002±21 374) yuan, t=2.004, P=0.046]. Multivariate analysis showed that intraoperative blood loss and transfusion were independent risk factors for patients undergoing transitional ICU care. Conclusion:Transitional ICU care does not reduce the incidence of postoperative complications and mortality for major hepatectomy patients, only increase the hospitalization costs.

Clinical analysis on 32 cases of benign biliary-enteric anastomotic stricture treated by quadrate lobectomy combined with large-caliber cholangio-jejunostomy / 中华普通外科杂志

Objective:To evaluate liver quadrate lobectomy combined with large-bore cholangio-jejunostomy for the treatment of benign biliary-enteric anastomotic stricture.Methods:The clinical data of 32 patients undergoing liver quadrate lobectomy combined with large-caliber cholangio-jejunostomy were retrospectively analyzed. The bile drainage effect and postoperative complications were analyzed. And the clinical effects of different size of biliary-enteric anastomosis were compared.Results:The most common short-term complications were cholangitis (9.4%) and bile leakage (9.4%), and the most common long-term complications were reflux cholangitis (15.6%). No anastomotic restenosis, stone formation or canceration were found. During the follow-up period, the total bilirubin ( t=19.455, P=0.000), direct bilirubin ( t=18.479, P=0.000), alkaline phosphatase ( t=3.229, P=0.002) and γ-glutamyltranspeptidase ( t=3.057, P=0.003) level were significantly improved. The effect of bile drainage in patients with 2-3 cm diameter of biliary-enteric anastomosis was similar to that in patients with >3 cm diameter ( t=0.284, P=0.778). The incidences of cholangitis (χ 2=0.121, P=0.728), bile leakage (χ 2=0.121, P=0.728) and reflux cholangitis (χ 2=0.205, P=0.652) were no statistical difference in both groups. Conclusion:Liver quadrate lobectomy combined with large-caliber cholangio-jejunostomy is effective in the treatment of benign biliary-enteric anastomotic stricture. More than 2cm in diameter of the biliary-enteric anastomosis is enough.

The protective effects of ulinastatin on liver function in patients with liver cancer after major hepatectomy / 中华普通外科杂志

Objective:To investigate the effects of ulinastatin on liver function in patients with liver cancer after major hepatectomy.Methods:The clinical data of 232 patients with major liver resection due to liver cancer were retrospectively analyzed. According to whether ulinastatin was applied after operation, patients were divided into treatment group (105 cases) and control group (127 cases). The postoperative inflammatory factors, liver function, postoperative complications and hospital stay were compared.Results:The levels of CRP、IL-6 and TBIL、ALT、AST were significantly lower than the control group 3 days after surgery (CRP: t=4.520, P=0.000; IL-6: t=17.982, P=0.000; TBIL: t=9.843, P=0.000; ALT: t=11.913, P=0.000; AST: t=4.520, P=0.000). The incidence of massive ascites in the treatment group (χ 2=4.212, P=0.040) and the average postoperative hospital stay ( t=9.994, P=0.000) were significantly lower than that in the control group. Conclusion:Early application of ulinastatin effectively inhibits the inflammatory process, protects liver function, reduces the incidence of massive ascites, and shortens the postoperative hospital stay.

The Key Problems and Technology Strategies of KY3H Health Care Service Model / 世界科学技术-中医药现代化

KY3H is a traditional Chinese medicine health care service mode based on the existing problem,focusing on an interconnected and continuous integration of four key technological innovation,which promotes the service model transformation from passive "doctor-searching" to "asking yourself ".There are four features on KY3H mode.First,based on traditional Chinese medicine meridian and viscera theory,it can accurately identify the health status and take risk assessment of individuals through digital quantitative model.Then,the mode realizes the personalized health status recognition and precisious intervention through integrated technology products of dynamic monitoring and identification,assessment and intervention with independent intellectual property rights.The third is to improve the intelligence,realtime and accessibility of KY3H health care services through developing the Chinese-western medicine informationalized software system about health status identification,assessment and intervention.The last one is formulating traditional Chinese medicine health care standards,industry standards and service package design,which drive KY3H health service model spreading effectively and practical applying,achieving remarkable social and economic benefits.

Combined therapy of silkworm eroded dissolving with micro-needle for small facial hyperplastic scar in early stage / 中华医学美学美容杂志

Objective To analyze the clinical efficacy and safety of the silkworm eroded dissolving method induced by micro-needle (the combined therapy of traditional Chinese and Western medicines including micro-needle guiding,external application of herbal membrane and anti-scar cream) for treatment of facial small area scar in early stage,and to explore a simple and effective therapy for facial scar.Methods Total 100 patients with facial small hyperplastic scar within 6 months after acute trauma healing were divided randomly into two groups with 50 cases each.The cases in treatment group were micro-needle acpunctured densely into scar,and then herbal membrane and anti-scar cream were applied.The cases in control group were treated similar to the treatment group except acpuncture.All cases in the two groups were treated for 3 months and followed-up for 6 months.Short-term efficacy,long-term efficacy,complications,safety and patient satisfaction were analyzed.Results There was no significant difference between treatment group and control group after treatment for one month,and significant difference was found after treatment for 2,3 months (P＜0.05).The earlier treatment after wound healing,the better efficacy.After treatment for three months most of scar showed no longer hyperplasia,and became soft gradully.Conclusions The combined therapy of micro-needle guiding,external application of herbal membrane and anti-scar cream for treatment of early facial small area scar demonstrates stable effects and high satisfactory rate of patients,the scar softens rapidly,and no obvious side effect occurs.

Epicanthus correction by subciliary incision epicanthoplasty / 中华医学美学美容杂志

Objective To explore an operative method which can adequately enlarge the inner canthus with inconspicuous scar and perfect shape based on the transverse incision for epicanthus correction,and to evaluate the short-term results and long-term effects comprehensively.Methods The surface projection of tears port medial point was designed as a new inner canthal point,the full thickness skin from new inner canthal point was cut to the free edge of epicanthus,and an outward prolonged incision was made along the lower eyelid edge,separating the subcutanous dissociation or cutting off part of displaced orbicularis,so to relieve the skin tension of inner canthal and reset skin,suturing the new inner canthal point and lower eyelid edge.Results 120 cases were followed up for more than one year,the complication rate at different postoperative time points and patient satisfactory rate one year after operation were compared.12 cases had mild scar formation,from six months to one year after operation,the scar gradually became softened and then inconspicuous.22 cases had a little skin fold at the inner canthal in postoperational one month.2 cases were unsatisfied with the shape of inner canthal,Others were satisfied with therapeutic efficacy,the correction was sufficient with inconspicuous scar and 1ess recrudescence.Conclusions Epicanthus correction by subciliary incision epicanthoplasty is a simple and effective method and suitable for all types of epicanthic fold,and it has the advantages of sufficient enlarged inner canthus,inconspicuous scar and 1ess recrudescence.

Diagnosis and treatment of gastric carcinoma combined with severe pulmonary dysfunction in 20 cases / 国际外科学杂志

Objective To summarize the experience of operation on gastric carcinoma combined with severe pulmonary dysfunction and reduce the incidence of postoperative fatality and complications.Methods According to FVC,MVV,FEV1 from high to low grouping,and interfere with ambroxol hydrochloride,doxofylline,budesonide,terbutaline,ipratropium bromide,tiotropium bromide to 20 patients who suffered gastric carcinoma combined with severe pulmonary dysfunction before and after operation,and interfere with different anesthesia methods.Results Postoperative complications occurred in 20 patients within one month,Hydrothorax in 2 cases,pulmonary infection in 2 cases,respiratory failure in 2 cases,acute pulmonary edema in 1 cases,acute pulmonary embolism in 1 case.After active treatment,19 patients cured,1 case died due to acute pulmonary edema.Conclusion The complications rate and risks are high in the gastric carcinoma patients combined with severe pulmonary dysfunction,and strict preoperative and postoperative managements are key to the operation.

Application of dolabriform flap in repairing periorbital skin and soft tissue defects / 中华医学美学美容杂志

Objective To discuss the efficacy and advantage of dolabriform flap in repairing periorbital skin and soft tissue defects.Methods 21 patients with periorbital skin disease were treated by radical resection,and then the adjacent or distant dolabriform flaps were designed for the one stage repair of skin and soft tissue defects in these cases according to the defect location,size,shape and neighborous skin conditions.The largest defect size was 3.5 cm × 4.5 cm,The smallest defect size was 1.2 cm × 1.5 cm.The largest ratio of hatchet pedicle width to axe handle length reached 1 ∶ 5,and the largest ratio of hatchet pedicle width to hatchet edge length was 1 ∶ 4.Results All of these dolabriform flaps in 21 patients survived well with primary incision healing.18 cases had been followed up for 3 to 12 months,showing that there was no deformation found on eyelids,eyebrow and nose,the colour of these flaps were similiar to that of the normal skin,without being fat and clumsy,all scars were almost invisible,and the cosmetic results were satisfactory.Conclusions Larger diameter of skin and soft tissue defect in different periorbital parts could be repaired individually with dolabriform flap according to the characters of natural lines,and it is a simple and flexible method for repairing periorbital skin defects,and can achieve satisfactory functional and cosmetic results.

Effect of α-melanocyte stimulating hormone on human dermal fibroblasts: preliminary identification of protein expression / 中华医学美学美容杂志

Objective To evaluate the effect of this neuroendocrine hormone on protein expression by treating the human dermal fibroblasts with a-melanocyte stimulating hormone (α-MSH ).Methods Thehuman dermal fibroblasts was cultured, and the total protein of the fibroblasts were separated with immobilized pH gradient-based two-dimensional gel electrophoresis (2-DE). After Coomassie bright blue staining, gel images were acquired by Image-scanner and then analyzed with the PDQuest software. 2-DE maps of fibroblasts were established. Partial differently expressed protein spots were incised from gels and digested by trypsin in-gel. Matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) and MSDB database searching by Mascot? software were used for protein identification. Results Well-resolved, reproducible 2-DE patterns of dermal fibroblasts treated with and without crMSH were obtained. 8 differently expressed protein spots were detected, among which 8 obtained peptide mass fingerprints (PMF) by MALDI-TOF-MS analysis. Among these proteins, of particular interest were five proteins annexin I, HSP27 and lamin A, etc. Conclusions Proteins expressed by human dermal fibroblasts treated with or without crMSH are different, and some of the differently expressed proteins involve apoptosis, intracellular signal transduction and framework construction and so on, which may be associated with anti-fibrosis effects of (a)-MSH on human dermal fibroblasts.

Conjugated therapy of traditional Chinese and Western medicine for pigmentation on face: a micro-explosion technique / 中华医学美学美容杂志

Objective To analyze the clinical efficacy and safety of combined therapy of traditional Chinese and Western medicine (heparin sodium cream massage, induced treatment by micro-needle, and external application of herbal membrane) and micro-explosion method for facial pigmentation after trauma, and to explore an effective and safety therapy for skin-whitening and anti-freckle. Methods A total of 100 cases with pigmentation on face were divided randomly into two groups with 50 cases each: the cases in treatment group were massaged with heparin sodium cream, needled skin pigmentation spot densely by micro-needle and applied with herbal membrane; the cases in control group only were massaged with heparin sodium cream, and applied with herbal membrane, without needling on skin. Short-term efficacy, long-term efficacy, safety and satisfaction of patients were observed. Results These cases were followed-up for 3-6 months. There was no significant difference between treatment group and control group after treatment for 15 days, and then significant difference was found after 1, 2 and 3 months (P<0. 05). There was no side effect after treatment for 6 months, and all cases were satisfactory. Conclusions There is rapid regression of pigmentation, with stable effect and without recurrence and obvious side effect, and the satisfactory rate of patients is high after treated by combined therapy of herbal membrane external application, heparin sodium cream massage and induced treatment by micro-needle.

Combined therapy of super-pulsed CO2 laser and traditional Chinese medicine for prevention and treatment of post-traumatic hypertrophic scar / 中华医学美学美容杂志

Objective To analyse the clinical efficacy of combined therapy of super-pulsed CO2 laser and traditional Chinese medicine on the prevention and treatment of post-traumatic hypertrophic scar, and to discuss effective comprehensive therapy for hypertrophic scars. Methods 108 cases of early post-traumatic hypertrophic scar were divided randomly into three groups with 36 cases each: combined treatment group of super-pulsed CO2 laser and traditional Chinese medicine (combined group), Chinese medicine treatment group (Chinese medicine group) and simple laser-treated group (laser group). They were regularly treated for 6 months and followed up for longer than 1 year. Clinical effects were evaluated according to scar property and subjective symptoms in patients. Results The total effective rate was 97.2 % and 86.1% in combined group and Chinese medicine group that were higher than 61.1 % in laser group. Obviously effective rate of the three methods were 55. 6 %, 27.8 % and 11. 1 %, respectively, and the difference of obviously effective rate between combined group and other two groups was significally different. Conclusion The method combined with super-pulsed CO2 laser and traditional Chinese medicine for prevention and treatment of post-traumatic hypertrophic scar has advantages of high obviously effective rate, long-term and stable effects, less complication, and it can achieve satisfactory cosmetic effects.

Modified round block technique in removal of huge breast tumor and mammoplasty / 中华医学美学美容杂志

Objective To explore a surgical method which can not only remove the enormous breast tumor entirely, but also maintain the breast function and obtain satisfactory shape.Methods On the basis of traditional round block technique, we designed different form's outer ring and breast lateral Sshaped incision line according to the size of breast tumor and the degree of the papillae ptosis, trimmed away the epidermis between the two circles, a S-shape skin incision along lateral border of breast was made; after reaching to the capsule of tumor, we stripped off the tumor entirely along capsule surface, a large breast cavus subdermalis remained, and then made full use of the dermal-fat flap or dermal-fat breast flap to fill the cavity after tumor removal so that the shape of breast was reconstructed. Results All of the 5 cases maintained the breast function and satisfactory shape after surgery, no sensory obstacle and necrosis occurred in the papillae and areola, and the wound reached good healing. Up to 2 years of follow-up there was no recurrence of tumor was found. Conclusions The modified round block' technique is an i-deal method for removal of a huge breast tumor. The design is nimble and simple, and postoperative breast shape is satisfactory with light scar formation.

Correction of epicanthus by transverse-one's procedure / 中华医学美学美容杂志

Objective To explore a simple and effective epicanthoplasty.Methods A total of 65 cases were corrected by incising the epicanthus levelly,extending the incision along the lower palpebral margin,separating the skin about 1 cm×1 cm scope below incision,cutting off part of the orbicularis and epicanthus ligament,fixing epicanthus angle to nasal aponeurosis,and suturing the incision without tension.Results All the cases corrected by the transverse-one's procedure were followup one month to one year,and satisfactory results obtained.Conclusion This method is a simple and effective epicanthoplasty with less tissue damage and good appearance.