ABSTRACT
This study collected data on waste generation and management in China between 1979 and 2020 from government statistics and literature and reviewed the development of municipal solid waste (MSW) management in China. The extended stochastic impact by regression on population, affluence and technology (STIRPAT) model was employed to identify the driving forces of MSW generation, and the cointegration analysis showed that economy (0.35, t = -3.47), industrial structure (3.34, t = -20.77) and urbanization (-1.5, t = 5.678) were the significant socioeconomic driving forces in the long run. By employing the framework of evolutionary economics, this study then investigated the internal rules of long-term interaction between socioeconomic factors and MSW management. The results indicate that, in the long run, MSW management development can be viewed as an evolutionary process that includes a continuous adaptation to external socioeconomic factors and the co-evolution of internal institutions and technologies. Adaptation and diversity of institutions and technologies play an important role in achieving sustainable waste management and circular economy (CE). This study offers a novel evolutionary perspective for explaining dynamic changes of MSW management in China, as well as recommendations for emerging economies to achieve sustainable waste management and CE goals.
ABSTRACT
Relapsed/refractory (rel/ref) acute myeloid leukemia (AML) has a very high mortality rate. At present, hematopoietic stem cell transplantation (HSCT) is the most effective treatment for rel/ref AML. The remission of the primary disease before HSCT is crucial for the transplantation to be effective. Therefore, it is critical to choose a suitable type of chemotherapy before HSCT. Here, we recorded the outcomes of high-throughput drug sensitivity screening (HDS) in children with rel/ref AML. Thirty-seven pediatric rel/ref AML patients who received HDS from September 2017 until July 2021 were analyzed retrospectively. Most of the patients (24 patients, 64.9%) had adverse cytogenetics. Two patients had rel/ref AML with central nervous system leukemia. The complete remission (CR) rate was 67.6%. Eight patients developed IV grade bone marrow suppression. Twenty-three patients (62.2%) underwent HSCT. The 3-year overall survival (OS) and EFS rates were 45.9% and 43.2%, respectively. Infection in the myelosuppression stage was the main cause of death. The outcome of HDS was superior to the commonly reported rates. These results suggest that HDS may be a novel treatment option for pediatric patients with rel/ref AML, and it is a promising transitional regimen prior to HSCT.
ABSTRACT
Hematopoietic stem cell transplantation (HSCT) is generally considered as the only effective treatment for children with relapsed/refractory (R/R) acute myeloid leukemia (AML). Achieving remission prior to HSCT affects the efficacy of the procedure and patient survival; therefore, induction therapy in children with R/R AML prior to HSCT is very important. The aim of the present study was to evaluate the clinical efficacy, prognosis and safety of 5-aza-2-deoxycytidine (DAC) combined with homoharringtonine + cytarabine + aclarubicin (HAA regimen) in the treatment of pediatric R/R AML. A total of 53 pediatric patients with R/R AML, aged 1-14 years, were treated with DAC-HAA. The overall response rate was 83.1%, with a complete remission rate of 77.4% and a partial remission rate of 5.7%. In conclusion, DAC-HAA therapy for children with R/R AML was found to be associated with a high remission rate, a short period of bone marrow suppression and a good safety profile. Therefore, DAC-HAA may be of value as a transitional regimen prior to HSCT and is worthy of clinical consideration.
ABSTRACT
OBJECTIVE: To study the alteration of thymus matrix lymphocyte generator (TSLP) and change of the Th factor in the course of disease development, and to analyze the curative effect of inhalation of Vitamin A (VA) with corticosteroid for the treatment of asthmatic pneumonia. METHODS: Asthmatic pneumonia models were prepared by challenging rats with inhalation of ovalbumin for 4 weeks, and rested for 1 week. The treatment with VA and corticosteroid inhalation for 1 week was followed. The rat thymus and lung specimen were examen by histochemical and immunofluorescence staining. RESULTS: After 4 - 5 weeks of stimulation, there were more TSLP-positive cells and alveolar macrophages (AM) found in thymus and lung tissue of asthmatic group, the cell proliferation in spleen and thymus was obvious, and blood Th factors elevated. The inflammation within the lung tissue aggravated gradually. In VA group, the expression of TSLP and Th2 factors were all lowered at the 4th week. The TSLP expression slightly increased at the 5th week, and the cell proliferation within T-cell zone of spleen and thymus was strong at first and weakened later. Alveolar microphages (AM) increased significantly and the inflammation in the lung subsided gradually at the 5th week. In the hormone group, TSLP and Th2 factors expression in both thymus and lung were decreased at the 5th week, while the cell proliferation in thymus and lung was gradually increased. The quantity of AM was decreased, whereas the inflammation of the lung was increased gradually at the 5th week. CONCLUSION: During asthmatic period elevated TSLP expression was accompanied by Th2 type responses while VA and corticosteroid both suppressed TSLP and Th2 factors expression. VA alone promoted T lymphocyte proliferation as well as the antigen elimination function by AM, after ceasing the usage, the lung inflammation abated gradually. In contrast, after ceasing the use of corticosteroid, inflammation aggravated.
