Evaluating the Potential of Multi-Walled Carbon Nanotube-Modified Clay as a Landfill Liner Material.

In this paper, the feasibility of multi-walled carbon nanotube (MWCNT)-modified clay as a landfill liner material is investigated. Experiments were conducted on the modified clay with 0.5%, 1%, and 2% MWCNTs. The effects of the MWCNTs on the compaction characteristics, permeability coefficient, stress-strain curve, peak deviation stress, shear strength parameters (internal friction angle and cohesion), microstructures, and adsorption performance of the clay were analyzed. The results showed that the optimum moisture content (OMC) increased from 16.15% to 18.89%, and the maximum dry density (MDD) decreased from 1.79 g/cm3 to 1.72 g/cm3 with the increase in MWCNTs. The permeability coefficients firstly fell and then gradually rose as the MWCNTs increased; the minimum permeability coefficient was 8.62 × 10-9 cm/s. The MWCNTs can also effectively increase the peak deviation stress of the clay, and at the maximum level, the peak deviation stress was increased by 286%. SEM images were processed using the Pore and Crack Analysis System (PCAS), and the results showed that the appropriate amount of MWCNTs could fill the pores and strengthen the clay structure. The effect of the MWCNT-modified clay on the adsorption performance of common heavy metal ions Cd2+, Mn2+ and Cu2+ in landfill leachate was analyzed by batch adsorption tests. The maximum adsorption capacities (Qmax) of Cu2+, Cd2+ and Mn2+ in the 2% MWCNT-modified clay were, respectively, 41.67 mg/g, 18.69 mg/g, and 4.97 mg/g. Compared with the clay samples without MWCNTs, the adsorption properties of Cu2+, Cd2+, and Mn2+ were increased by 228%, 124%, and 202%, respectively. Overall, the results suggest that MWCNT-modified clays have the potential to be suitable barrier materials for the construction of landfills.

CO2 laser combined with low-temperature plasma radiofrequency ablation promotes recovery of swallowing function in elderly patients with early glottic carcinoma.

OBJECTIVE: This study was designed to determine the effect of CO2 laser combined with low-temperature plasma radiofrequency ablation (LPRA) on swallowing function and prognosis in elderly patients with early glottic laryngeal cancer (GLC). METHODS: The clinical data of 115 elderly patients with early GLC treated in General Hospital of Daqing Oil Field from May 2013 to September 2015 were retrospectively analyzed. These patients were assigned to a research group or control group according to different therapeutic regimen. Totally 56 cases treated with CO2 laser resection were assigned to the control group, and 59 cases treated with CO2 laser combined with LPRA were assigned to the research group. The hospital stay, postoperative pain, mucosal recovery score, postoperative complications, swallowing function, vocal function, and 5-year recurrence rate were compared between the two groups. Independent risk factors for 5-year recurrence in patients were analyzed by multivariate logistic regression. RESULTS: The research group was significantly superior to the control group in terms of hospital stay, postoperative pain, and mucosal recovery score (P<0.05), and the postoperative complication rate was not significantly different between the two groups (P>0.05). After treatment, the research group showed better swallowing function and vocal function than the control group, and the 5-year recurrence rate of the two groups was similar (P=0.288). Multivariate logistic regression analysis identified higher age, lower differentiation, and presence of a cumulative anterior commissure as independent risk factors for recurrence. CONCLUSION: CO2 laser combined with LPRA can provide relatively high clinical efficacy for early GLC in the elderly, after which patients' swallowing function and vocal function recover quickly, but the long-term benefit of adding LPRA is not evident.

Lymph node metastases outside tumor-bearing lobes and/or segments in non-small cell lung cancer.

Objective: Hilar and lung lymph node metastases (N1) are defined as ipsilateral bronchial and intrapulmonary lymph nodes. However, the cleaning standards for ipsilateral bronchial lymph nodes in different lobes and segments within the same lobe in segmentectomy are not clearly defined. Materials and methods: Sixty-six patients undergoing pulmonary resection for the treatment of lung cancer were evaluated. Intraoperatively visible non-tumor-bearing lobe (NTBL) and post-operatively non-tumor-bearing segment (NTBS) lymph nodes were removed and analyzed. The associations between the NTBL LNs and clinicopathological characteristics were analyzed. Results: Non-tumor-bearing lobe LNs metastases were found in 8 (12.1%) of the 66 patients, NTBS LNs metastasis were not found (0/13). The presence of NTBL metastases was significantly associated with age (<60 years vs. ≥60 years, P = 0.037), differentiation (Grade 1 well differentiated vs. Grade 2 moderately differentiated vs. Grade 3 poorly differentiated, P = 0.012), CAT-scan-findings of Mediastinal and hilar lymph nodes metastasis (node-positive vs. node-negative, P = 0.022), pN stage (N0 vs. N1 vs. N2, P = 0.003) and p stage (I vs. II vs. III, P = 0.009). Multivariate logistic analysis showed that tumor differentiation (P = 0.048, HR 6.229; 95% CI 1.016-38.181) and pN (P = 0.024, HR 5.099; 95% CI 1.245-20.878) were statistically significant predictors. Conclusions: Lobar lymph node metastasis of NTBL occurs frequently in patients with NSCLC, but lymph node metastases in NTBS LNs are rare. Advanced age, poorly differentiated and N1 and N2 status of CAT-scan-findings were independent risk factors for the involvement of the NTBL lobar lymph nodes. Although lymph node metastases in NTBS are rare, further investigation of the need to dissect is required.

High-Performance Supercapacitors Based on ɛ-MnO2/RGO Fiber Electrodes for Wearable Energy Storage.

Hybrid fibers based on MnO2/reduced graphene oxide have been fabricated for flexible energy storage devices. Graphene oxide nanoflakes were reduced in a polytetrafluoroethylene (PTFE) pipeline under the appropriate condition to develop a fiber current collector, which also provides the possibility of weaving. The RGO fiber with the radius of about 35 µm has a resistance of 150 Ω · cm. MnO2 nanoflakes directly grow on the RGO fiber surface acting as the electrode material of the device. The MnO2/RGO hybrid fibers provide excellent energy storage performances. The as-fabricated SC exhibits a high areal capacitance of 1.37 F·cm-2 at the scan rate of 1 mV·s-1, and outstanding long-term cycling stability of 93.75% retention after 5000 cycles. This work demonstrates a cost-effective and versatile strategy for wearable energy storage devices.

Magnetic resonance imaging evaluation of treatment efficacy and prognosis for brain metastases in lung cancer patients after radiotherapy: A preliminary study.

BACKGROUND: This study used magnetic resonance imaging (MRI) to monitor changes to brain metastases and investigate the imaging signs used to evaluate treatment efficacy and determine prognosis following radiotherapy for brain metastases from lung cancer. METHODS: A total of 60 non-small cell lung cancer patients with brain oligometastases were selected. MRI scans were conducted before and 3, 6, 9, 12, 18, 24, and 30 months after radiotherapy. The tumor and peritumoral edema diameters, Cho/Cr values, elevation of the Lip peak value, and whether the island (yu-yuan) sign or high-signal ring were present on T2 fluid-attenuated inversion recovery (FLAIR) imaging were recorded for each metastasis. RESULTS: The mortality risk was higher the earlier the maximum value of peritumoral edema diameter was reached, when there were fewer island signs, and when brain metastases did not present as tumor progression on imaging. There were significant differences in the average peritumoral edema diameter, apparent diffusion coefficient value, the number of elevated Lip peak values, and the number of T2 FLAIR imaging high-signal rings in a year after radiotherapy in 14 patients with a survival period < 1 year compared to patients with a survival period > 2 years. CONCLUSION: After radiotherapy for brain metastases, patients with the island sign had longer survival periods, high-signal rings in T2 FLAIR, elevated Lip peaks, and reduced apparent diffusion coefficient values, indicating tumor necrosis. Increased diameter of metastases and Cho/Cr > 2 cannot serve as reliable indicators of brain metastasis progression.

Atlas of the thoracic lymph nodal delineation and recommendations for lymph nodal CTV of esophageal squamous cell cancer in radiation therapy from China.

PURPOSE: To construct an anatomical atlas of thoracic lymph node regions of esophageal cancer (EC) based on definitions from The Japan Esophageal Society (JES) and generate a consensus to delineate the nodal clinical target volume (CTVn) for elective nodal radiation (ENI) of esophageal squamous cell carcinoma (ESCC). METHODS AND MATERIALS: An interdisciplinary group including two dedicated radiation oncologists, an experienced radiologist, a pathologist and two thoracic surgeons were gathered to generate a three-dimensional radiological description for the mediastinal lymph node regions of EC on axial CT scans. Then the radiological boundaries of lymph node regions were validated by a relatively large number of physicians in multiple institutions. RESULTS: An atlas of detailed anatomic boundaries of lymph node station No. 105-114 was defined on axial CT, along with illustrations. From the previous work, the study provided a guide of CTVn contouring for ENI of thoracic ESCC from a single center. CONCLUSION: It is feasible to use such an atlas of thoracic lymph node stations for radiotherapy planning. A phase III study based on the atlas is ongoing in China to measure quantitatively the ENI received by patients with ESCC.

Concurrent involved-field radiotherapy and XELOX versus XELOX chemotherapy alone in gastric cancer patients with postoperative locoregional recurrence.

PURPOSE: To compare the treatment outcomes of concurrent involved-field radiotherapy and XELOX (oxaliplatin and capecitabine) versus XELOX chemotherapy alone in gastric adenocarcinoma patients with locoregional recurrence. MATERIALS AND METHODS: From 2004 to 2008, 79 patients with recurrent locoregional gastric cancer after curative resection of gastric tumor were enrolled. Among them, 41 patients received involved-field radiotherapy (median dose 50 Gy) by a 3-dimensional conformal radiotherapy technique and concurrent XELOX chemotherapy, and 38 patients were treated with XELOX chemotherapy alone (oxaliplatin 130 mg/m, capecitabine 1000 mg/m, twice daily, 3 wk each cycle). RESULTS: The concurrent radiochemotherapy group showed better overall response (including complete response and partial response) when compared with the chemotherapy group (87.8% vs. 63.0%, P=0.01). The control rates for pain, bleeding, and dysphagia/obstruction were 89.5% (17/19), 81.8% (9/11), and 80% (8/10), respectively, in the radiochemotherapy group and 58.8% (10/17), 50% (5/10), and 57.1% (4/7), respectively, in the chemotherapy group. The concurrent radiochemotherapy group showed better overall symptom-control rate when compared with the chemotherapy group (55.9% vs. 85%, P=0.006). Patients receiving concurrent radiochemotherapy trended toward a better median overall survival when compared with those receiving chemotherapy alone (13.4 vs. 5.4 mo, P=0.06). In addition, there were no significant differences in the rates of toxicity or adverse reactions between the 2 groups. CONCLUSIONS: Concurrent involved-field radiotherapy and XELOX showed better responses and overall symptom-control rates compared with XELOX chemotherapy alone in gastric cancer patients with postoperative locoregional recurrence. A trend of survival benefit from radiochemotherapy was also observed but needs to be further explored.

Prophylactic cranial irradiation improved the overall survival of patients with surgically resected small cell lung cancer, but not for stage I disease.

OBJECTIVES: We conducted a retrospective study to evaluate the role of prophylactic cranial irradiation (PCI) on patients with surgically resected small cell lung cancer (SCLC). PATIENTS AND METHODS: Between January 2003 and December 2009, the records of completely resected patients who were diagnosed with SCLC and definitive pTNM stage on the basis of histological proof were reviewed. According to the therapy modality, patients were allocated to PCI group and non-PCI group. RESULTS: A total of 193 patients were finally included, 67 patients in PCI group and 126 in non-PCI group. The OS rates at 2-year and 5-year in PCI group were 92.5%, and 54.9%, respectively, and those of non-PCI were 63.2% and 47.8%, respectively (p=0.005). The BMFS rate at 2-year and 5-year in PCI group was significantly better than those of non-PCI group (96.8%, 76.6% and 79.4%, 75.5%, respectively, p = 0.014). But PCI could not confer survival benefit in the patients with p-stage I. Multivariate analysis revealed that PCI (HR = 2.339; p = 0.001) was an independent prognostic factor of the overall survival. CONCLUSIONS: PCI could improve the OS of patients with surgically resected SCLC, but not for p-stage I patients.

[Treatment of leg, foot, and ankle wounds with saphenous neurocutaneous vascular flaps combined with assembly external frisket for fixation in parallel-leg position].

OBJECTIVE: To explore the effectiveness of a new method to repair severe soft tissue defects of the leg, foot, and ankle with contralateral saphenous neurocutaneous vascular flaps combined with assembly external frisket for fixation in parallel-leg position. METHODS: Between August 2009 and August 2013, 29 cases with leg, foot, or ankle wound were treated. There were 18 males and 11 females, with an average age of 37.6 years (range, 11-65 years). The interval of injury and operation was 14-36 days (mean, 22.3 days). The locations were the planta pedis and heel in 5 cases, the dorsal foot in 2 cases, the ankle in 4 cases, middle and lower leg in 14 cases, and upper leg in 4 cases. The area of trauma ranged from 5 cm x 3 cm to 19 cm x 9 cm. The assembly external frisket was used for fixation in parallel-leg position; a bridge flap was transplanted to repair defects, and the area of flap ranged from 6 cm x 4 cm to 22 cm x 11 cm. The donor sites were directly sutured or repaired with skin graft. The pedicle of the bridge flap was cut off and the assembly external frisket was removed after 3-4 weeks. RESULTS: The flaps in all patients survived completely; primary healing of wound and incision at donor site was obtained. The patients were followed up 6-18 months (mean, 13.2 months). The appearance of flaps was satisfactory, and the sensation of the heel recovered. Moreover, the patients had a comfortable feeling, and the ankle and knee joints can move freely, and had good function. CONCLUSION: The assembly external frisket in parallel-leg position instead of cross-leg can make patients comfortable position, and achieve reliable fixation. The saphenous neurocutaneous vascular flap has the advantages of no need for anastomosis vein and for sacrifice of the main vein. Contralateral saphenous neurocutaneous vascular flap combined with assembly external frisket for fixation in parallel-leg position is a favorite method to repair severe soft tissue defects of the leg, foot, and ankle.

[Impact of the pattern of lymph node metastasis on the clinical target volume in radiotherapy for thoracic esophageal squamous cell carcinoma].

OBJECTIVE: To study the pattern of lymph node metastasis of thoracic esophageal squamous cell carcinoma (ESCC) after esophagectomy and its impact on the clinical target volume (CTV) delineation in radiotherapy fpr thoracic ESCC. METHODS: The pattern of lymph node metastasis was retrospectively analyzed in 1077 patients with primary thoracic ESCC. All patients received esophagectomy with two- or three-field lymphadenectomy. The clinicopathologic factors related to lymph node metastasis were then analyzed using logistic regression analysis. RESULTS: The rates of cervical, upper mediastinal, middle mediastinal, lower mediastinal and abdominal cavity lymph node metastasis were 16.7%, 33.3%, 11.1%, 5.6% and 5.6%, respectively. The rates of those node metastasis in the middle thoracic ESCC were 4.0%, 3.8%, 28.5%, 7.1% and 17.1%, respectively, and the rates of those node metastasis in the lower thoracic ESCC were 1.5%, 3.0%, 22.7%, 37.0% and 33.2%, respectively. The depth of tumor invasion, histologic differentiation and the length of tumor were showed to be statistically most significant risk factors of lymph node metastasis of ESCC (P < 0.001). CONCLUSION: The depth of tumor invasion, histologic differentiation, and length of tumor were closely correlated with lymph node metastasis of ESCC. All these factors and tumor location should be considered comprehensively when designing the target volume for radiotherapy.

Pattern of lymph node metastases and its implication in radiotherapeutic clinical target volume in patients with thoracic esophageal squamous cell carcinoma: A report of 1077 cases.

PURPOSE: To study the pattern of lymph node metastases after esophagectomy and clarify the clinical target volume (CTV) delineation of thoracic esophageal squamous cell carcinoma (ESCC). METHODS AND MATERIALS: Total 1077 thoracic ESCC patients who had undergone esophagectomy and lymphadenectomy were retrospectively examined. The clinicopathologic factors related to lymph node metastasis were analyzed using logistic regression analysis. RESULTS: The rates of lymph node metastases in patients with upper thoracic tumors were 16.7% (9/54) cervical, 38.9% (18/54) upper mediastinal, 11.1% (6/54) middle mediastinal, 5.6% (3/54) lower mediastinal, and 5.6% (3/54) abdominal, respectively. The rates of lymph node metastases in patients with middle thoracic tumors were 4.0% (27/680), 3.8% (26/680), 32.9% (224/680), 7.1% (48/680), and 17.1% (116/680), respectively. The rates of lymph node metastases in patients with lower thoracic tumors were 1.0% (5/343), 3.0% (10/343), 22.7% (78/343), 37.0% (127/343), and 33.2% (114/343), respectively. T stage, the length of tumor and the histological differentiation emerged as statistically significant risk factors of lymph node metastases of thoracic ESCC (P < 0.001). CONCLUSIONS: T stage, the length of tumor and the histologic differentiation influence the pattern of lymph node metastases in thoracic ESCC. These factors should be considered comprehensively to design the CTV for radiotherapy (RT) of thoracic ESCC. Selective regional irradiation including the correlated lymphatic drainage regions should be performed as well.

Biochemical relevance between oxidative/carbonyl stress and elevated viscosity of erythrocyte suspensions.

The effects of various aldehydes such as secondary products of peroxidized lipids and other aldehydes on rheological parameters and their relation with aging process were studied. Malondialdehyde (MDA) in different concentrations can increase significantly viscosity and plastic viscosity of erythrocytes suspended in plasma and HEPES buffer solution. Simultaneously, oxidation induced by Fe2+ can also enhance the viscosity of erythrocyte suspensions. All of these data suggest that MDA as one of the most studied unsaturated carbonyl products of lipid peroxidation leading to protein crosslinking may carry important information in understanding carbonyl stress-related rheological change in acute as well as chronic diseases and aging.

[Bronchial and pulmonary arterial sleeve resection and reconstruction in the treatment of central NSCLC].

OBJECTIVE: To evaluate the indications and surgical procedure of bronchial and pulmonary artery sleeve resection for patients with centrally located non-small cell lung cancer, and how to prevent complications. METHODS: From July 1989 to Aug 2000, 32 cases of central NSCLC were treated with bronchial and pulmonary arterial sleeve resection and reconstruction. The results were retrospectively analyzed. RESULTS: The complication rate was 25.0% (8/32), the mortality rate in 30-day postoperation was 6.3% (2/32), the overall 1-, 3- and 5-year survival rate was 82.8% (24/29), 50.0% (11/22) and 33.3% (4/12), respectively. CONCLUSION: Bronchial and pulmonary arterial sleeve resection and reconstruction in the treatment of patients with central NSCLC can not only maximize preservation of functional pulmonary parenchyma and improve patients, quality of life, but also provide an opportunity for those patients with poor pulmonary function to receive surgical resection of the tumor.