RESUMO
The pollution of surface waters by pharmaceuticals and personal care products (PPCPs) has aroused widespread concern. Constructed wetlands (CWs) have outstanding advantages in the removal of PPCPs; however, few studies have focused on the interaction of different types of PPCPs in CWs. In this study, two typical PPCPs[broad-spectrum antimicrobial agents triclosan (TCS) and non-steroidal anti-inflammatory drug diclofenac (DCF)] were selected as target pollutants and their removal behavior in subsurface flow CWs was analyzed. The effects of different seasons and influent conditions (i.e., single and combined addition of TCS and DCF) on removal efficiency was also examined. The main parameters of the CW system were as follows:the up-flow subsurface CW had a hydraulic load of 0.20 m·d-1 and a hydraulic residence time of 3 d with a continuous flow inlet. The initial influent concentration of PPCPs was 80 g·L-1 for TCS and 25 g·L-1 for DCF. The results showed that the average removal efficiencies for TCS and DCF in summer (91.72% and 85.86%, respectively) were significantly higher than in winter (52.88% and 32.47%, respectively). Independent sample t-tests confirmed that there was no significant difference in the removal efficiency of TCS and DCF under the different influent conditions (single and combined addition). The degradation products of TCS and DCF were also no different between the influent systems, and the representative degradation products of TCS were not detected in all systems. The main degradation products of DCF in the different systems were 3,5-dichlorobenzoic acid and m-dichlorobenzene. The two studied PPCPs showed no significant antagonism and competition effects at trace levels.
RESUMO
Background and Objective. Transcutaneous electric acupoint stimulation (TEAS) is recommended for its sedative and analgesic effects. We sought to evaluate the effect of TEAS on cough suppression during flexible bronchoscopy (FB) and explore the underlying mechanism. Methods. In this single-center, randomized, single-blind, parallel-controlled study, we randomized 100 patients scheduled for FB into two equal groups treated with or without TEAS (TEAS group and control group). Patients in the TEAS group received 30 min of stimulation at the Hegu (LI4), Neiguan (PC6), and Lieque (LU7) points before FB. The control group underwent the same procedure, but without stimulation. The primary outcome was the intraoperative cough score determined by the bronchoscopist. The secondary outcomes were patient-reported discomfort scores and other procedural parameters. Results. Compared with the controls, patients who received TEAS preconditioning had lower cough scores (P=0.0027) and requirement of lidocaine and fentanyl (P < 0.05) and significantly higher postprocedural plasma ß-endorphin levels (P=0.0367). There were no intergroup differences in discomfort scores, midazolam dosage, rate of premature termination, oxygen requirement, sedation level, airway assistance, oxygen saturation, lowest oxygen saturation level, heart rate, plasma substance-P levels, and rate of complications after 24 h. The total procedure duration, time for passage of the bronchoscope through the vocal cords, and systolic and diastolic blood pressure levels were less in the TEAS group than in the control group (P=0.033, 0.039 and <0.05, respectively). Conclusion. The combination of midazolam and TEAS was superior to midazolam alone for cough suppression during FB, probably due to increased plasma ß-endorphin levels. This trial is registered with ChiCTR1800016612 at chictr.org.cn/index.aspx.
