Aging and mitigation of microplastics during sewage sludge treatments: An overview.

Wastewater treatment plants (WWTPs) receive large quantities of microplastics (MPs) from raw wastewater, but many MPs are trapped in the sludge. Land application of sludge is a significant source of MP pollution. Existing reviews have summarized the analysis methods of MPs in sludge and the effect of MPs on sludge treatments. However, MP aging and mitigation during sludge treatment processes are not fully reviewed. Treatment processes used to remove water, pathogenic microorganisms, and other pollutants in sewage sludge also cause surface changes and degradation in the sludge MPs, affecting the potential risk of MPs. This study integrates MP abundance and distribution in sludge and their aging and mitigation characteristics during sludge treatment processes. The abundance, composition, and distribution of sludge MPs vary significantly with WWTPs. Furthermore, MPs exhibit variable degrees of aging, including rough surfaces, enhanced adsorption potentials for pollutants, and increased leaching behavior. Various sludge treatment processes further intensify these aging characteristics. Some sludge treatments, such as hydrothermal treatment, have efficiently removed MPs from sewage sludge. It is crucial to understand the potential risk of MP aging in sludge and the degradation properties of the MP-derived products from MP degradation in-depth and develop novel MP mitigation strategies in sludge, such as combining hydrothermal treatment and biological processes.

Activationless Electron Transfer of Redox-DNA in Electrochemical Nanogaps.

Our recent discovery of decreased reorganization energy in electrode-tethered redox-DNA systems prompts inquiries into the origin of this phenomenon and suggests its potential use to lower the activation energy of electrochemical reactions. Here, we show that the confinement of the DNA chain in a nanogap amplifies this effect to an extent to which it nearly abolishes the intrinsic activation energy of electron transfer. Employing electrochemical atomic force microscopy (AFM-SECM), we create sub-10 nm nanogaps between a planar electrode surface bearing end-anchored ferrocenylated DNA chains and an incoming microelectrode tip. The redox cycling of the DNA's ferrocenyl (Fc) moiety between the surface and the tip generates a measurable current at the scale of ∼10 molecules. Our experimental findings are rigorously interpreted through theoretical modeling and original molecular dynamics simulations (Q-Biol code). Several intriguing findings emerge from our investigation: (i) The electron transport resulting from DNA dynamics is many times faster than predicted by simple diffusion considerations. (ii) The current in the nanogap is solely governed by the electron transfer rate at the electrodes. (iii) This rate rapidly saturates as overpotentials applied to the nanogap electrodes increase, implying near-complete suppression of the reorganization energy for the oxidation/reduction of the Fc heads within confined DNA. Furthermore, evidence is presented that this may constitute a general, previously unforeseen, behavior of redox polymer chains in electrochemical nanogaps.

Ballistic Brownian Motion of Nanoconfined DNA.

Theoretical treatments of polymer dynamics in liquid generally start with the basic assumption that motion at the smallest scale is heavily overdamped; therefore, inertia can be neglected. We report on the Brownian motion of tethered DNA under nanoconfinement, which was analyzed by molecular dynamics simulation and nanoelectrochemistry-based single-electron shuttle experiments. Our results show a transition into the ballistic Brownian motion regime for short DNA in sub-5 nm gaps, with quality coefficients as high as 2 for double-stranded DNA, an effect mainly attributed to a drastic increase in stiffness. The possibility for DNA to enter the underdamped regime could have profound implications on our understanding of the energetics of biomolecular engines such as the replication machinery, which operates in nanocavities that are a few nanometers wide.

Clinicopathologic features and long-term prognosis of hepatitis B virus-associated glomerulonephritis: a retrospective cohort study.

BACKGROUND: Hepatitis B virus-associated glomerulonephritis is a common form of secondary glomerulonephritis in China. However, the clinicopathological features and long-term prognosis of Hepatitis B virus-associated Glomerulonephritis remain only partially known. METHODS: Biopsy-proven Hepatitis B virus-associated Glomerulonephritis patients were enrolled between November 1994 and December 2013 at our center. The composite endpoints were doubling serum creatinine, end-stage renal disease, or death from renal disease during follow-up. The clinicopathological features and predictors of the long-term prognosis of Hepatitis B virus-associated Glomerulonephritis patients were explored. RESULTS: The median age of the 259 Hepatitis B virus-associated Glomerulonephritis patients was 31.0 years (IQR 24.0-40.0), and 71.0% were males. Among the patients, 45.2% presented with nephrotic syndrome, and 45.9% presented with proteinuria combined with hematuria. The two most prevalent pathological patterns were IgA nephropathy (27.0%) and membranous nephropathy (27.0%). The mean follow-up period was 68.8 ± 46.9 months. The 3-, 5-, and 10-year clinical event-free survival rates were 93.4%, 85.2%, and 70.3%, respectively. Multivariable Cox regression analysis showed that hypertension (HR 2.580, 95% CI 1.351-4.927, P = 0.004), hyperuricemia (HR 2.101, 95% CI 1.116-3.954, P = 0.021), glomerulosclerosis (P = 0.001), and intrarenal arterial lesions (P = 0.041) were independent predictors of composite clinical event endpoint. Patients in the antiviral therapy group exhibited a significantly better prognosis compared to those who received no antiviral therapy (log-rank χ2 = 5.772, P = 0.016). CONCLUSION: Hepatitis B virus-associated Glomerulonephritis has specific clinicopathologic features and should not be considered a benign disease in adults. Hypertension, hyperuricemia, glomerulosclerosis, and intrarenal arterial lesions were independent predictors of the long-term prognosis in Hepatitis B virus-associated Glomerulonephritis patients. Antiviral therapy could be effective in improving the long-term prognosis of Hepatitis B virus-associated Glomerulonephritis patients.

Electrochemical response of surface-attached redox DNA governed by low activation energy electron transfer kinetics.

The mechanism responsible for electron transport within layers of redox DNA anchored to electrodes has been extensively studied over the last twenty years, but remains controversial. Herein, we thoroughly study the electrochemical behavior of a series of short, model, ferrocene (Fc) end-labeled dT oligonucleotides, terminally attached to gold electrodes, using high scan rate cyclic voltammetry complemented by molecular dynamics simulations. We evidence that the electrochemical response of both single-stranded and duplexed oligonucleotides is controlled by the electron transfer kinetics at the electrode, obeying Marcus theory, but with reorganization energies considerably lowered by the attachment of the ferrocene to the electrode via the DNA chain. This so far unreported effect, that we attribute to a slower relaxation of water around Fc, uniquely shapes the electrochemical response of Fc-DNA strands and, being markedly dissimilar for single-stranded and duplexed DNA, contributes to the signaling mechanism of E-DNA sensors.

Acute toxicity and genotoxicity studies on new melatonergic antidepressant GW117.

GW117, a novel derivate compound of agomelatine that acts as both a 5-HT2C receptor antagonist and a MT1/MT2 receptor agonist, likely underlines the potent antidepressant action with less hepatotoxicity than agomelatine. We evaluated the acute toxicity of GW117, and the genotoxicity of GW117 using bacterial reverse mutation test, mammalian chromosomal aberration test in Chinese hamster lung cells (CHL) and mouse bone marrow micronucleus test. The acute toxicity test results showed that maximum tolerated dose (MTD) of GW117 was 2000 mg/kg, under which mean Cmax and AUC0→t was 10,782 ng/mL and 81,046 ng/mL × h, respectively. The result of bacterial reverse mutation test showed that the number of bacterial colonies in each dose group of GW117 did not increase significantly compared with that in the solvent control group with or without S9 metabolic activation system. In vitro chromosome aberration test of CHL cells, the chromosome aberration rate of each dose group of GW117 did not increase with or without S9 metabolic activation system. In mouse micronucleus test, the highest dose was 2000 mg/kg, the micronucleus rate did not increase significantly. Under the conditions of this study, the MTD of a single GW117 administration was 2000 mg/kg, there was no genotoxicity effect of GW117.

Assessing stock market contagion and complex dynamic risk spillovers during COVID-19 pandemic.

A very important area where COVID-19 has seriously disrupted is the global financial markets, where stock markets have experienced great turmoil. To shed light on the nature of this turmoil and to characterize nonlinear dynamics in inter-market risk transmission, we formally test the existence of inter-stock market contagion, identify the main channel once the presence of contagion has been established, and assess the upside and downside risk spillovers dynamically focusing on complexity during pre-COVID-19 and post-COVID-19 periods. Applying multiple measures including time-varying conditional value-at-risk based on copula theory, and sample entropy methods, considering a sample covering seven countries (USA, UK, France, Germany, Japan, Brazil, China) during the period from 4 January 2019 to 30 December 2020, we show that contagion is widely present among analysed stock markets with only a few exceptions and that "portfolio rebalancing" as opposed to "wealth constraint" occurs more as the main channel of transmission. All market pairings exhibit significant bilateral upside and downside spillovers after the outbreak of COVID-19. A significant shift in complexity of risk spillover dynamics is evident for most recipient countries following the shock of COVID-19, among which all but China display a downward shift. The findings of this paper could help regulators, politicians, and portfolio risk managers amid the uncertainty created by the COVID-19 pandemic.

CBL-Interacting Protein Kinases 18 (CIPK18) Gene Positively Regulates Drought Resistance in Potato.

Sensor-responder complexes comprising calcineurin B-like (CBL) proteins and CBL-interacting protein kinases (CIPKs) are plant-specific Ca2+ receptors, and the CBL-CIPK module is widely involved in plant growth and development and a large number of abiotic stress response signaling pathways. In this study, the potato cv. "Atlantic" was subjected to a water deficiency treatment and the expression of StCIPK18 gene was detected by qRT-PCR. The subcellular localization of StCIPK18 protein was observed by a confocal laser scanning microscope. The StCIPK18 interacting protein was identified and verified by yeast two-hybrid (Y2H) and bimolecular fluorescence complementation (BiFC). StCIPK18 overexpression and StCIPK18 knockout plants were constructed. The phenotypic changes under drought stress were indicated by water loss rate, relative water content, MDA and proline contents, and CAT, SOD and POD activities. The results showed that StCIPK18 expression was upregulated under drought stress. StCIPK18 is localized in the cell membrane and cytoplasm. Y2H shows the interaction between StCIPK18 and StCBL1, StCBL4, StCBL6 and StCBL8. BiFC further verifies the reliability of the interaction between StCIPK18 and StCBL4. Under drought stress, StCIPK18 overexpression decreased the water loss rate and MDA, and increased RWC, proline contents and CAT, SOD and POD activities; however, StCIPK18 knockout showed opposite results, compared with the wild type, in response to drought stress. The results can provide information for the molecular mechanism of the StCIPK18 regulating potato response to drought stress.

EGR1 is crucial for the chlorogenic acid-provided promotion on liver regeneration and repair after APAP-induced liver injury.

Improper use of acetaminophen (APAP) will induce acute liver failure. This study is designed to investigate whether early growth response-1 (EGR1) participated in the promotion on liver repair and regeneration after APAP-induced hepatotoxicity provided by natural compound chlorogenic acid (CGA). APAP induced the nuclear accumulation of EGR1 in hepatocytes regulated by extracellular-regulated protein kinase (ERK)1/2. In Egr1 knockout (KO) mice, the liver damage caused by APAP (300 mg/kg) was more severe than in wild-type (WT) mice. Results of chromatin immunoprecipitation and sequencing (ChIP-Seq) manifested that EGR1 could bind to the promoter region in Becn1, Ccnd1, and Sqstm1 (p62) or the catalytic/modify subunit of glutamate-cysteine ligase (Gclc/Gclm). Autophagy formation and APAP-cysteine adduct (APAP-CYS) clearance were decreased in Egr1 KO mice administered with APAP. The EGR1 deletion reduced hepatic cyclin D1 expression at 6, 12, or 18 h post APAP administration. Meanwhile, the EGR1 deletion also decreased hepatic p62, Gclc and Gclm expression, GCL enzymatic activity, and glutathione (GSH) content and decreased nuclear factor erythroid 2-related factor 2 (Nrf2) activation and thus aggravated oxidative liver injury induced by APAP. CGA increased EGR1 nuclear accumulation; enhanced hepatic Ccnd1, p62, Gclc, and Gclm expression; and accelerated the liver regeneration and repair in APAP-intoxicated mice. In conclusion, EGR1 deficiency aggravated liver injury and obviously delayed liver regeneration post APAP-induced hepatotoxicity through inhibiting autophagy, enhancing liver oxidative injury, and retarding cell cycle progression, but CGA promoted the liver regeneration and repair in APAP-intoxicated mice via inducing EGR1 transcriptional activation.

Potato Stu-miR398b-3p Negatively Regulates Cu/Zn-SOD Response to Drought Tolerance.

One of the main impacts of drought stress on plants is an excessive buildup of reactive oxygen species (ROS). A large number of ·OH, highly toxic to cells, will be produced if too much ROS is not quickly cleared. At the heart of antioxidant enzymes is superoxide dismutase (SOD), which is the first antioxidant enzyme to function in the active oxygen scavenging system. To shield cells from oxidative injury, SOD dismutation superoxide anion free radicals generate hydrogen peroxide and molecule oxygen. Cu/Zn SOD is a kind of SOD antioxidant enzyme that is mostly found in higher plants' cytoplasm and chloroplasts. Other studies have demonstrated the significance of the miR398s family of miRNAs in the response of plants to environmental stress. The cleavage location of potato stu-miR398b-3p on Cu/Zn SOD mRNA was verified using RLM-5'RACE. Using the potato variety 'Desiree', the stu-miR398b-3p overexpression mutant was created, and transgenic lines were raised. SOD activity in transgenic lines was discovered to be decreased during drought stress, although other antioxidant enzyme activities were mostly unaltered. Transgenic plants will wilt more quickly than wild-type plants without irrigation. Additionally, this demonstrates that the response of Cu/Zn SOD to drought stress is adversely regulated by potato stu-miR398b-3p.

Highly Robust Vehicle Lateral Localization Using Multilevel Robust Network.

Vision-based vehicle lateral localization has been extensively studied in the literature. However, it faces great challenges when dealing with occlusion situations where the road is frequently occluded by moving/static objects. To address the occlusion problem, we propose a highly robust lateral localization framework called multilevel robust network (MLRN) in this article. MLRN utilizes three deep neural networks (DNNs) to reduce the impact of occluding objects on localization performance from the object, feature, and decision levels, respectively, which shows strong robustness to varying degrees of road occlusion. At the object level, an attention-guided network (AGNet) is designed to achieve accurate road detection by paying more attention to the interested road area. Then, at the feature level, a lateral-connection fully convolutional denoising autoencoder (LC-FCDAE) is proposed to learn robust location features from the road area. Finally, at the decision level, a long short-term memory (LSTM) network is used to enhance the prediction accuracy of lateral position by establishing the temporal correlations of positioning decisions. Experimental results validate the effectiveness of the proposed framework in improving the reliability and accuracy of vehicle lateral localization.

Enhanced elemental mercury removal in coal-fired flue gas by modified algal waste-derived biochar: Performance and mechanism.

A novel biochar involving pyrolysis of dewatered algal waste combined with KOH and residual FeCl3 co-activation was synthesized as an efficient sorbent specifically for Hg0 removal from coal-fired flue gas. It was found that the SBET of biochar co-activated by KOH and FeCl3 (BCFK) was 195.82 m2 g-1, much higher than that of single FeCl3 activated biochar (BCF) of 133.38 m2 g-1 and un-activated biochar (UBC) of 20.36 m2 g-1. Furthermore, BCFK exhibited higher magnetization characteristics as well as elemental Fe and Cl contents of 2.71% and 10.33%, respectively, based on the combined characterization of XPS and VSM, etc., which is a jump of about 10-fold compared to BCF. This allows BCFK to show the best Hg0 removal capability of 689.66 µg g-1 under the inlet Hg0 concentration of 100 µg m-3 and 150 °C, according to pseudo-second-order kinetic model. Further analysis by XPS and Hg-TPD (Temperature Programmed Desorption) revealed that oxidation by Cl∗ radicals and C-Cl as well as weak chemisorption contributed to the removal of Hg0. Eventually, this efficient, simply prepared, low-cost and easily separable biochar distinguished itself in comparison to other materials. This will undoubtedly promote the valorization of algae and provide a reliable alternative material for the treatment of coal-fired flue gas.

Synthesis and Biological Evaluation of Substituted Pyrazole-Fused Oleanolic Acid Derivatives as Novel Selective α-Glucosidase Inhibitors.

A series of novel substituted pyrazole-fused oleanolic acid derivative were synthesized and evaluated as selective α-glucosidase inhibitors. Among these analogs, compounds 4a-4f exhibited more potent inhibitory activities compared with their methyl ester derivatives, and standard drugs acarbose and miglitol as well. Besides, all these analogs exhibited good selectivity towards α-glucosidase over α-amylase. Analog 4d showed potent inhibitory activity against α-glucosidase (IC50 =2.64±0.13 µM), and greater selectivity towards α-glucosidase than α-amylase by ∼33-fold. Inhibition kinetics showed that compound 4d was a non-competitive α-glucosidase inhibitor, which was consistent with the result of its simulation molecular docking. Moreover, the in vitro cytotoxicity of compounds 4a-4f towards hepatic LO2 and HepG2 cells was tested.

Effective mitigation of ammonia in sewage-sludge-derived fermentation liquid using flow-electrode capacitive deionization.

Due to the high toxicity of ammonia to organisms and its contribution to eutrophication in surface water, the risk of emission of ammonia and other nitrogenous ions to the environment and ecosystems has aroused wide concerns. Therefore, the discharge criterion on nitrogen in effluent from conventional wastewater treatment plants (WWTP) is very stringent. Furthermore, during the conventional denitrification processes, the relatively costly external carbon source is usually required. Nowadays production of volatile fatty acids (VFAs) from sewage sludge by alkaline anaerobic fermentation has regarded as an attractive carbon source. However, usually ammonia is quite abundant in the fermentation liquid and thus effective mitigation of ammonia in the fermentation liquid is also a significant step for its further utilization. In the present study, the flow electrode capacitive deionization (FCDI) was applied to remove ammonia in the fermentation liquid of sewage sludge. Firstly, response surface method (RSM) was employed to optimize parameters and then the performance of the FCDI in ammonia removal were examined. Results showed that optimal flow rates, carbon content and ammonia concentration were 8.0 mL min-1, 4.0 wt% and 110 mg N·L-1 and the ammonia removal efficiency (ARE) reached 42.7%, while treating the alkaline fermentation liquid. Seemingly the presence of Na+ and polypeptides in the liquid with their average RE of 53.3% and 11.1% substantially compromised ammonia removal probably due to the competition of adsorption sites. This present study serves as a proven concept for the feasibility of the application of the FCDI system in ammonia separation from the VFAs, which could realize economic and ecological benefits.

Pathological characteristics of liver injury induced by N,N-dimethylformamide: From humans to animal models.

N,N-Dimethylformamide (DMF) is widely used in chemical industries because of its excellent solvent properties. Poisoning accidents caused by DMF have been frequently reported, particularly hepatotoxicity; however, the hepatic pathological changes have rarely been described. This study aimed to summarise the pathological characteristics of the hepatotoxicity associated with DMF in clinical cases and to verify in animal models. Liver pathologies of two patients with liver failure due to DMF were retrospectively analysed. Thirty-six rats were categorised into the DMF group (intraperitoneally injected with 4 g/kg DMF once a week), carbon tetrachloride (CCl4) group (intraperitoneally injected with 0.5 g/kg CCl4 twice a week) and control group (intraperitoneally injected with normal saline once a week). The general condition and changes in hepatic pathology at 48 h and 8 weeks were observed. Liver tissues of patients exhibited multiple unevenly distributed inflammatory and fibrotic lesions. The DMF-induced liver injury animal model was successfully established. Inflammation and fibrosis were heterogeneously observed throughout the liver in the DMF group, contrast to entirely homogeneous lesions in the CCl4 group. Specific hepatic pathological findings (heterogeneous lesions) caused by DMF detected for the first time in humans and animal model, may be significant in the clinical diagnosis of DMF poisoning.

FexN produced in pharmaceutical sludge biochar by endogenous Fe and exogenous N doping to enhance peroxymonosulfate activation for levofloxacin degradation.

For preparing high performance biochar to be applicated in persulfate-based oxidation treatment of wastewater, the feasibility of deriving Fe-N biochar from pharmaceutical sludge by endogenous Fe and exogenous N doping was investigated. With exogenous urea doping, FexN contained biochar (PZBC800U) was successfully derived from endogenous Fe(OH)3 contained pharmaceutical sludge. PZBC800U effectively activated peroxymonosulfate (PMS) to remove 80 mg·L-1 levofloxacin (LEV) within 90 min. The main mechanism of PMS activation by PZBC800U for LEV degradation was revealed as non-radical pathways dominated by 1O2 generation and direct electron transfer. The formation of FexN combined with the increase of pyridinic-N in the biochar changed the electronic structure, improved the electron transfer ability, and thus achieved the excellent PMS activation capacity of the biochar. The vital function of endogenous Fe(OH)3 was verified by comparing PZBC800U to Fe leached and extra Fe added controls. A total of 18 intermediates in the degradation of LEV were identified, and degradation pathways were proposed. Combined with the average local ionization energy calculation, the priority of piperazine breakage during LEV degradation was experimentally proved and mechanistically elucidated. This study provides a new insight into FexN biochar preparation from pharmaceutical sludge and the mechanisms of its excellent PMS activation performance for LEV degradation.

Pseudo-capacitive and kinetic enhancement of metal oxides and pillared graphite composite for stabilizing battery anodes.

Nanostructured TiO2 and SnO2 possess reciprocal energy storage properties, but challenges remain in fully exploiting their complementary merits. Here, this study reports a strategy of chemically suturing metal oxides in a cushioning graphite network (SnO2[O]rTiO2-PGN) in order to construct an advanced and reliable energy storage material with a unique configuration for energy storage processes. The suggested SnO2[O]rTiO2-PGN configuration provides sturdy interconnections between phases and chemically wraps the SnO2 nanoparticles around disordered TiO2 (SnO2[O]rTiO2) into a cushioning plier-linked graphite network (PGN) system with nanometer interlayer distance (~ 1.2 nm). Subsequently, the SnO2[O]rTiO2-PGN reveals superior lithium-ion storage performance compared to all 16 of the control group samples and commercial graphite anode (keeps around 600 mAh g-1 at 100 mA g-1 after 250 cycles). This work clarifies the enhanced pseudo-capacitive contribution and the major diffusion-controlled energy storage kinetics. The validity of preventing volume expansion is demonstrated through the visualized image evidence of electrode integrity.

Synthesis and Structure of a Two-Dimensional Palladium Oxide Network on Reduced Graphene Oxide.

New nanostructures often reflect new and exciting properties. Here, we present an two-dimensional, hitherto unreported PdO square network with lateral dimensions up to hundreds of nanometers growing on reduced graphene oxide (rGO), forming a hybrid nanofilm. An intermediate state of dissolved Pd(0) in the bacterium S. oneidensis MR-1 is pivotal in the biosynthesis and inspires an abiotic synthesis. The PdO network shows a lattice spacing of 0.5 nm and a thickness of 1.8 nm on both sides of an rGO layer and is proposed to be cubic or tetragonal crystal, as confirmed by structural simulations. A 2D silver oxide analog with a similar structure is also obtained using an analogous abiotic synthesis. Our study thus opens a simple route to a whole new class of 2D metal oxides on rGO as promising candidates for graphene superlattices with unexplored properties and potential applications for example in electronics, sensing, and energy conversion.

Circadian regulation of protein cargo in extracellular vesicles.

The circadian clock controls many aspects of physiology, but it remains undescribed whether extracellular vesicles (EVs), including exosomes, involved in cell-cell communications between tissues are regulated in a circadian pattern. We demonstrate a 24-hour rhythmic abundance of individual proteins in small EVs using liquid chromatography-mass spectrometry in circadian-synchronized tendon fibroblasts. Furthermore, the release of small EVs enriched in RNA binding proteins was temporally separated from those enriched in cytoskeletal and matrix proteins, which peaked during the end of the light phase. Last, we targeted the protein sorting mechanism in the exosome biogenesis pathway and established (by knockdown of circadian-regulated flotillin-1) that matrix metalloproteinase 14 abundance in tendon fibroblast small EVs is under flotillin-1 regulation. In conclusion, we have identified proteomic time signatures for small EVs released by tendon fibroblasts, which supports the view that the circadian clock regulates protein cargo in EVs involved in cell-cell cross-talk.

Comparison of concurrent chemoradiotherapy with radiotherapy alone for locally advanced esophageal squamous cell cancer in elderly patients: A randomized, multicenter, phase II clinical trial.

This randomized, multicenter, phase II clinical trial was performed to compare the safety and efficacy of concurrent chemoradiotherapy using S-1 (CCRT) with radiotherapy alone (RT) for elderly patients with locally advanced esophageal squamous cell carcinoma (ESCC). All eligible patients were randomly assigned to the CCRT group or the RT group at a 1:1 ratio. The CCRT group received 50.4 Gy radiotherapy concurrent with S-1 and the RT group received 59.4 Gy radiotherapy alone. The primary endpoints were toxicity and the overall response rate (ORR), and the secondary endpoints were overall survival (OS) and progression-free survival (PFS). In total, 157 elderly patients with ESCC were recruited from December 2016 to March 2020. By June 2021, the median follow-up duration had reached 38 months. No grade 5 toxicities occurred in either group and the overall rate of severe toxicities (≥grade 3) was higher in the CCRT group (19.2% vs 7.6%; P = .037), particularly neutropenia (7.7% vs 1.3%; P = .06). The CCRT group presented a significantly higher ORR (83.3% vs 68.4%; P = .009) and prolonged PFS (25.7 vs 13.9 months; P = .026) than the RT group. The median OS was 27.3 months in the CCRT group and 19.1 months in the RT group (P = .59). For patients older than 70 years with locally advanced ESCC, concurrent chemoradiotherapy with S-1 had tolerable adverse effects and improved ORR and PFS compared to radiotherapy alone.