How does environmental legislation guide urban green transition development? Evidence from China.

Based on the unique perspective of local environmental regulations promulgated in Chinese prefecture-level cities from 2000 to 2018, this paper examines the impact of urban environmental legislation on green total factor energy efficiency (GTFEE). The results show that implementing environmental legislation significantly improves local GTFEE, with comprehensive protection regulations contributing to local energy efficiency improvements, while the impact of pollution prevention regulations is insignificant. This conclusion remains robust to multiple scenarios. Potential mechanisms through which environmental legislation can guide urban green transition include the industrial upgrading effect represented by "clean industry development" and "polluting industry exit", as well as the technical innovation effect achieved through "new technology generation" and "old technology upgrading". Furthermore, environmental legislation with a higher degree of regulatory effectiveness has a greater potential for energy saving. Environmental legislation has a more significant impact on improving GTFEE in cities in non-old industrial bases, with less frequent turnover of officials, and in central and western regions in China. This study evaluates the positive impact of urban environmental legislation on GTFEE, aiming to advancing the rule of law in local environmental pollution governance and thereby promote urban green transition.

The clinical significance of complete process management for the quality control of horizontal rotational resection of a breast mass.

Objective: To explore the clinical outcomes of the complete process management of horizontal rotational resection of a breast mass. Methods: A retrospective study was conducted involving 638 patients who underwent horizontal rotational resection of breast tissue in the Department of Thyroid and Breast Surgery of the People's Hospital of China Medical University from August 2018 to August 2020 using the ultrasound Breast Imaging-Reporting and Data System (BI-RADS) classification of 4A and below. These patients were divided into the experimental group and the control group based on whether the surgery had been performed following the order of the complete process management. The time cutoff point for the two groups was June 2019. The propensity score matching method was used to implement 1:1 ratio matching according to age, mass size, location, ultrasound BI-RADS classification, and breast size (measured by basal diameter), and the patients in the two groups were compared for the duration of surgery (the time needed to performed the three-step 3D positioning), postoperative skin hematoma and ecchymosis, postoperative pathological malignancy rate, residual rate of the mass, and satisfaction rate. Results: After 278 pairs were matched, no statistically significant differences were found between the two groups in terms of demographics (P > 0.05). The duration of surgery in the experimental group was significantly shorter compared with the control group (7.90 ± 2.18 min vs. 10.20 ± 5.99 min, respectively; P < 0.05); the satisfaction score in the experimental group (8.33 ± 1.36) was higher compared with the control group (6.48 ± 1.22) (P < 0.05); the malignant and residual rates of mass in the experimental group were lower than those in the control group, i.e., 6 vs. 21 cases (P < 0.05), and 4 vs. 16 cases, respectively (P < 0.05); the incidence of skin hematoma and ecchymosis was lower in the experimental group, i.e., 3 vs. 21 cases (P < 0.05). Conclusion: Complete process management for horizontal rotational resection of a breast mass can shorten the duration of surgery, reduce the residual mass, postoperative bleeding, and postoperative malignancy rates, and improve the breast preservation rate and patient satisfaction. Accordingly, its popularization represents research value.

Autochthonous bioaugmentation accelerates phenanthrene degradation in acclimated soil.

Bioaugmentation helps to obtain a microbiome capable of remediating polycyclic aromatic hydrocarbons (PAHs). In this study, acclimation of microorganisms to soil supplemented with phenanthrene (PHE) led to enrichment with PAH-degraders, including those in Actinobacteriota and in the genera Streptomyces, Rhodococcus, Nocardioides, Sphingomonas, and Mycobacterium. Aqueous (28 °C, pH 6.5) and soil cultures inoculated with PHE-acclimated soil showed a high PHE (ca. 50 mg L-1) degradation efficiency. The PHE degradation kinetics in aqueous and soil incubations fitted to the Gompertz equation and the first-order kinetic equation, respectively. Indigenous microorganisms adapted to PHE in their environment, and this increased their capacity to degrade PHE. The effect of co-contaminants and pathway intermediates on PHE degradation showed that the degradation of PHE improved in the presence of diesel while being hindered by lubricant oil, catechol, salicylic and phthalic acid. Our findings provide theoretical and practical support for bioremediationof PAHs in the environment.

The clinical value of three-dimensional measurement in the diagnosis of thoracic myelopathy caused by ossification of the ligamentum flavum.

BACKGROUND: Thoracic ossification of the ligamentum flavum (OLF) is a major cause of thoracic myelopathy, which is often accompanied by multiple segmental stenosis or other degenerative spinal diseases. However, in the above situations, it is difficult to determine the exact segment responsible. The objective of this study was to analyze three-dimensional (3D) radiological parameters in order to establish a novel diagnostic method for discriminating the responsible segment in OLF-induced thoracic myelopathy, and to evaluate its superiority compared to the conventional diagnostic methods. METHODS: Eighty-one patients who underwent surgery for thoracic myelopathy caused by OLF from 2016 to 2020 were enrolled in this study as the myelopathy group, and 79 patients who had thoracic OLF but displayed no definite neurological signs from 2018 to 2020 were enrolled as the non-myelopathy group. We measured the one-dimensional (1D), two-dimensional (2D), and 3D radiological parameters, calculated their optimal cutoff values, and compared their diagnostic values. RESULTS: Significant differences were observed in the 1D, 2D, and 3D radiological parameters between the myelopathy and non-myelopathy groups (P<0.01). As a 3D radiological parameter, the OLF volume (OLFV) ratio (OLFV ratio = OLFV/normal canal volume × 100%) was the most accurate parameter for diagnosing OLF-induced thoracic myelopathy, with a diagnostic coincidence rate of 88.1%. We also found that an OLFV ratio of 26.3% could be used as the optimal cutoff value, with a sensitivity of 87.7% and a specificity of 88.6%. Moreover, the OLFV ratio [area under the curve (AUC): 0.92, 95% confidence interval (CI): 0.86-0.95] showed a statistically higher diagnostic value than the 1D and 2D parameters (AUC: 0.75, 95% CI: 0.67-0.81; AUC: 0.84, 95% CI: 0.77-0.89, respectively) (P<0.05). Pearson correlation analysis illustrated that the OLFV ratio was significantly negatively correlated with preoperative modified Japanese Orthopedic Association (mJOA) score (r=-0.73, 95% CI: -0.81 to -0.60, P<0.01). CONCLUSIONS: Our results demonstrate the superiority of the OLFV ratio over the conventional 1D and 2D computed tomography (CT)-based radiological parameters for the diagnosis of OLF-induced thoracic myelopathy. The novel diagnostic method based on the OLFV ratio will help to determine the responsible segment in multi-segmental thoracic OLF or when thoracic OLF coexists with other degenerative spinal diseases. The OLFV ratio also accurately reflects the clinical state of symptomatic patients with thoracic OLF.

Horizontal Rotary Cutting Technique for Skin Injury Avoidance in Superficial Benign Breast Masses.

OBJECTIVE: This study aims to investigate the feasibility of the horizontal rotary-cut technique in the removal of superficial benign breast tumors with a ≤1.0 cm distance between the upper margin of the tumor and the skin. PATIENTS AND METHODS: A total of 69 patients with superficial benign breast tumors received horizontal rotary-cut surgery between July 2018 and June 2019 (horizontal group). The rotary cutter groove was in the true lateral position of the tumor and the ultrasonic probe was vertical to the rotary cutter groove. The patients were compared with 33 patients who underwent the traditional vertical rotary-cut surgery between July 2017 and June 2018 (traditional group) regarding the aspects of operation time, intraoperative bleeding volume, postoperative skin ecchymosis, skin damage, and tumor residue. The rotary cutter groove was directly below the tumor and the ultrasonic probe was parallel to the rotary cutter groove in the traditional vertical rotary-cut surgery. RESULTS: The operation time in the horizontal group was significantly shorter than in the traditional group (7.7 ± 1.1 minutes vs 9.5 ± 1.3 minutes, with t = -7.458 and p = 0.000) and there was significantly less skin damage in the horizontal group than in the traditional group (0 cases vs 3 cases, with p = 0.032). The differences in intraoperative bleeding and postoperative skin ecchymosis between the two groups were not statistically significant (6.0 ± 1.3 mL vs 6.5 ± 1.5 mL, with t = -1.853 and p = 0.067; 4 cases vs 2 cases, with χ 2 = 0.003 and p = 0.958). Ninety-seven patients attended follow-ups for 6-30 (16.5 ± 4.5) months. No residues or recurrences were observed under ultrasound reviews in either group. CONCLUSION: In superficial benign breast tumor removal, the horizontal rotary-cut breast technique can help avoid skin injury, shorten the operation time, and reduce tumor residue more effectively compared with the traditional vertical rotary-cut technique. It has certain popularization and application values.

How much space of the spinal canal should be restored by hoisting the vertebrae-OPLL complex for sufficient decompression in anterior controllable antedisplacement and fusion? A multicenter clinical radiological study.

BACKGROUND CONTEXT: Anterior controllable antedisplacement and fusion (ACAF) is a novel surgical technique for the treatment of ossification of the posterior longitudinal ligament (OPLL). Its prognostic factors for decompression have not been well studied. Additionally, no detailed radiological standard has been set for hoisting the vertebrae-OPLL complex (VOC) in ACAF. PURPOSE: To identify the possible prognostic factors for decompression outcomes after ACAF for cervical OPLL, to determine the critical value of radiological parameters for predicting good outcomes, and to establish a radiological standard for hoisting the VOC in ACAF. STUDY DESIGN: This was a retrospective multicenter study. PATIENT SAMPLE: A total of 121 consecutive patients with OPLL who underwent ACAF at a point between January 2017 and June 2018 at any one of seven facilities and were monitored for at least 1 year afterward were enrolled in a multicenter study. OUTCOME MEASURES: Japanese Orthopedic Association (JOA) scores, recovery rate (RR) of neurologic function, and surgical complications were used to determine the effectiveness of ACAF. METHODS: Patients were divided into two groups according to their RR for neurologic function. Patients with an RR of ≥50% and an RR of <50% were designated as having good and poor decompression outcomes, respectively. The relationship between various possible prognostic factors and decompression outcomes was assessed by univariate and multivariate analysis. The receiver operating characteristic curve was used to determine the optimal cutoff value of the radiological parameters for prediction of good decompression outcomes. Next, the patients were redivided into three groups according to the cutoff value of the selected radiological parameter (postoperative anteroposterior canal diameter [APD] ratio). Patients with postoperative APD ratios of ≤80.7%, 80.7%-100%, and ≥100% were defined as members of the incomplete, optimal, and excessive antedisplacement groups, respectively. Differences in decompression outcomes among the three groups were compared to verify the reliability of the postoperative APD ratio and assess the necessity of excessive antedisplacement. RESULTS: Multivariate logistic regression analysis showed that patients' age at surgery (odds ratio [OR]=1.18; 95% confidence interval [CI]=1.08-1.29; p<.01) and postoperative APD ratio (OR=0.83; 95% CI=0.77-0.90; p<.01) were independently associated with decompression outcomes. The optimal cutoff point of the postoperative APD ratio was calculated at 80.7%, with 86.2% sensitivity and 73.5% specificity. There were no significant differences in the postoperative JOA scores and RRs between the excessive antedisplacement group and optimal antedisplacement group (p>.05). However, a lower incidence of cerebrospinal fluid leakage and screw slippage was observed in the optimal antedisplacement group (p<.05). CONCLUSIONS: Patients' age at surgery and their postoperative APD ratio are the two prognostic factors of decompression outcomes after ACAF. The postoperative APD ratio is also the most accurate radiological parameter for predicting good outcomes. Our findings suggest that it is essential for neurologic recovery to restore the spinal canal to more than 80.7% of its original size (postoperative APD ratio >80.7%), and restoration to less than its original size (postoperative APD ratio <100%) will help reduce the incidence of surgical complications. This may serve as a valuable reference for establishment of a radiological standard for hoisting the VOC in ACAF.

Optimization of a Capacitated Vehicle Routing Problem for Sustainable Municipal Solid Waste Collection Management Using the PSO-TS Algorithm.

Sustainable management of municipal solid waste (MSW) collection has been of increasing concern in terms of its economic, environmental, and social impacts in recent years. Current literature frequently studies economic and environmental dimensions, but rarely focuses on social aspects, let alone an analysis of the combination of the three abovementioned aspects. This paper considers the three benefits simultaneously, aiming at facilitating decision-making for a comprehensive solution to the capacitated vehicle routing problem in the MSW collection system, where the number and location of vehicles, depots, and disposal facilities are predetermined beforehand. Besides the traditional concerns of economic costs, this paper considers environmental issues correlated to the carbon emissions generated from burning fossil fuels, and evaluates social benefits by penalty costs which are derived from imbalanced trip assignments for disposal facilities. Then, the optimization model is proposed to minimize system costs composed of fixed costs of vehicles, fuel consumption costs, carbon emissions costs, and penalty costs. Two meta-heuristic algorithms, particle swarm optimization (PSO) and tabu search (TS), are adopted for a two-phase algorithm to obtain an efficient solution for the proposed model. A balanced solution is acquired and the results suggest a compromise between economic, environmental, and social benefits.

Treatment strategy for chylous leakage after dissection of central lymph nodes in thyroid cancer.

OBJECTIVE: To explore the treatment strategies of chylous leakage after dissection of central lymph nodes in thyroid cancer. METHODS: Patients with chylous leakage after dissection of central lymph nodes in thyroid cancer were recruited in this study. All participants adopted a conservative treatment method of external fixation of neck brace + cotton ball packing and compression bandage + adequate negative pressure drainage and assisted low-fat diet. RESULTS: A total of two patients were included in this study. The results showed that the drainage rate of these two patients was reduced to less than 10 ml after 1-2 days of drainage. The maintenance treatment was continued for 10 days. The drainage volume of the patient did not increase during the three days after returning to normal diet. There was no recurrence of posterior lymphatic leakage. CONCLUSION: External fixation of neck brace + cotton ball packing and compression bandage + adequate negative pressure drainage is important for the treatment of mild to moderate chylotrhea after thyroid cancer surgery which was worthy of clinical application. KEY WORDS: Chylous leakage; Dissection of lymph nodes; Thyroid cancer; External fixation of neck brace; Postoperative complication.

Anion exchange strategy to synthesis of porous NiS hexagonal nanoplates for supercapacitors.

A facile anion exchange strategy was applied to the synthesis of porous NiS hexagonal nanoplates (NiS HNPs) as an electrode material for supercapacitors. It was found that Na2S concentration is a key factor to achieve porous NiS hexagonal nanoplates with well-defined architecture. Porous NiS hexagonal nanoplates exhibited a specific capacitance of 1897 F g-1 at a current density of 1 A g-1. NiS HNPs//activated carbon (AC) asymmetric supercapacitor (ASC) shows a long cycle lifespan (about 100% capacity retention after 4000 cycles at a current density of 3 A g-1) with a maximum energy density of 11.6 Wh kg-1 at a large loading mass of about 30 mg. Impressively, two NiS HNPs//AC ASCs in series could light up a red LED for about 30 min. The remarkable electrochemical performance of NiS HNPs is ascribed to their unique hierarchical porous architectures. The anion exchange method is a facile and versatile strategy for the synthesis of metal sulfides with high performance for energy storage.

[Expression and immunological activity of an anti-CD3×VEGFR2 bispecific single-chain antibody].

AIM: To construct and express an anti-VEGFR2/anti-CD3 bispecific single-chain antibody (bscVEGFR2×CD3)and to identify its binding specificities to CD3 and VEGFR2. METHODS: The gene encoding anti-VEGFR2/anti-CD3 bispecific single-chain antibody was designed and synthesized. Bispecific single-chain antibody (bsc-Ab) DNA was subcloned into a eukaryotic expression vector pcDNA3.1(+), then transfected into Chinese hamster ovary (CHO) cells and stable expression cell lines were selected. Expressed Bsc-Ab was purified by His-tag affinity chromatography and confirmed by 120 g/L SDS-PAGE and Western blotting. Antigen binding activity of the bsc-Ab was analyzed by FACS. RESULTS: The plasmid DNA containing bispecific single-chain fragments were confirmed. BscVEGFR2×CD3 was secreted by CHO into the supernatant. Six stable expression cell lines were established. The molecular weight of bsc-Ab was correct indicated by SDS-PAGE and Western blotting. The bsc-Ab could specifically bind to CD3(+); jurkat cells and VEGFR2(+); A375 cells. CONCLUSION: An anti-VEGFR2/anti-CD3 bispecific single-chain antibody is successfully constructed and expressed, and the antibody has specific binding capacity to CD3 and VEGFR2.