High-efficient stabilization and solidification of municipal solid waste incineration fly ash by synergy of alkali treatment and supersulfated cement.

Municipal solid waste incineration fly ash (IFA) designated as hazardous waste poses risks to environment and human health. This study introduces a novel approach for the stabilization and solidification (S/S) of IFA: a combined approach involving alkali treatment and immobilization in low-carbon supersulfated cement (SSC). The impact of varying temperatures of alkali solution on the chemical and mineralogical compositions, as well as the pozzolanic reactivity of IFA, and the removal efficiency of heavy metals and metallic aluminum (Al) were examined. The physical characteristics, hydration kinetics and effectiveness of SSC in immobilizing IFA were also analyzed. Results showed that alkali treatment at 25 °C effectively eliminated heavy metals like manganese (Mn), barium (Ba), nickel (Ni), and chromium (Cr) to safe levels and totally removed the metallic Al, while enhancing the pozzolanic reactivity of IFA. By incorporating the alkali-treated IFA and filtrate, the density, compressive strength and hydration reaction of SSC were improved, resulting in higher hydration degree, finer pore structure, and denser microstructure compared to untreated IFA. The rich presence of calcium-aluminosilicate-hydrate (C-(A)-S-H) and ettringite (AFt) in SSC facilitated the efficient stabilization and solidification of heavy metals, leading to a significant decrease in their leaching potential. The use of SSC for treating Ca(OH)2- and 25°C-treated IFA could achieve high strength and high-efficient immobilization.

Efficacy and safety of tibial nerve stimulation using a wearable device for overactive bladder.

OBJECTIVE: To evaluate the efficacy and safety of a wearable, smartphone-controlled, rechargeable transcutaneous tibial nerve stimulation (TTNS) device in patients with overactive bladder (OAB). PATIENTS AND METHODS: This multicentre, prospective, single-blind, randomised clinical trial included eligible patients with OAB symptoms who were randomly assigned to the stimulation group or sham group. The primary efficacy outcome was change from baseline in voiding frequency/24 h after 4 weeks of treatment. The secondary efficacy outcomes included changes in bladder diary outcomes (urgency score/void, nocturia episodes/day, micturition volume/void, and incontinence episodes/day), questionnaires on Overactive Bladder Symptom Score (OABSS), Patient Perception of Bladder Condition (PPBC), and American Urological Association Symptom Index Quality of Life Score (AUA-SI-QoL) at baseline and after 4 weeks of treatment. Device-related adverse events (AEs) were also evaluated. RESULTS: In the full analysis set (FAS), the mean (sd) change of voiding frequency/24 h in the stimulation group and sham group at 4 weeks were -3.5 (2.9) and -0.6 (2.4), respectively (P < 0.01). Similar results were obtained in the per-protocol set (PPS): -3.5 (2.9) vs -0.4 (2.3) (P < 0.01). In the FAS and PPS, micturition volume/void significantly improved at 4 weeks (P = 0.01 and P = 0.02). PPBC improvement almost reached significance in the FAS (P = 0.05), while it was significant in the PPS (P = 0.02). In the FAS and PPS, AUA-SI-QoL significantly improved at 4 weeks in the two groups (P < 0.01 and P < 0.01), whereas there were no significant differences in urgency score/void, nocturia episodes/day or OABSS between the groups. Also, no device-related serious AEs were reported. CONCLUSIONS: The non-invasive neuromodulation technique using the novel ambulatory TTNS device is effective and safe for treating OAB. Its convenience and easy maintenance make it a new potential home-based treatment modality. Future studies are warranted to confirm its longer-term efficacy.

Recycling of waste glass and incinerated sewage sludge ash in glass-ceramics.

Disposal of waste glass and incinerated sewage sludge ash (ISSA) in landfills is a waste of resources and poses significant environmental risks. This work aims to recycle waste glass and ISSA together to form value-added glass-ceramics. The physical and mechanical properties, leaching behaviour, and microstructure of the glass-ceramics produced with different proportions of waste glass powder (WGP) and ISSA were investigated. Thermodynamic calculations were performed to predict the formation of crystalline phases and the phase transformation involved. The results showed the potential of WGP and ISSA as raw materials in glass-ceramics production. WGP effectively densified the microstructure of the glass-ceramics by forming a viscous phase. As WGP content increased, the total porosity of glass-ceramics decreased whereas the density increased, accompanied by the formed anorthite transforming into wollastonite. The incorporation of WGP densified and refined the pore structure of the glass-ceramics, thereby improving the mechanical properties and reducing the water absorption. The glass-ceramics produced with a 50:50 blend of WGP and ISSA exhibited the highest compressive strength of 43.7 MPa and the lowest water absorption of 0.3 %. All fabricated glass-ceramics exhibited innocuous heavy metal leaching. The co-sintering of ISSA and WGP can produce additive-free glass-ceramics, characterized by reduced energy consumption and notable heavy metal immobilization capacity. These materials hold promise for utilization in construction as building materials.

Clinical Features and Predictive Nomogram of Acute Kidney Injury in Aging Population Infected with SARS-CoV-2 Omicron Variant.

Background: Since little is known about the acute kidney injury (AKI) in aging population infected with SARS-CoV-2 Omicron variant, we investigated the incidence, clinical features, risk factors and mid-term outcomes of AKI in hospitalized geriatric patients with and without COVID-19 and established a prediction model for mortality. Methods: A real-time data from the Shanghai Ninth People's Hospital information system of inpatients with COVID-19 from 1 April 2022 to 30 June 2022 were extracted. Clinical spectrum, laboratory results, and clinical prognosis were included for the risk analyses. Moreover, Cox and Lasso regression analyses were applied to predict the 90-day death and a nomogram was established. Results: A total of 1607 SARS-CoV-2 infected patients were enrolled; hypertension was the most common comorbidity, followed by chronic cardiovascular disease, diabetes mellitus, and lung disease. Most of the participants were non-vaccinated and the mean age of patients was 82.6 years old (range, 60-103 years). The AKI incidence was higher in relatively older patients (16.29% vs 3.63% in patients older than 80 years and 60 to 80 years, respectively). Linear regression models identified some variables associated with the incidence of AKI, such as older age, clinical spectrum, D-dimer level, number of comorbidities, baseline eGFR, and antibiotic or corticosteroid treatment. In this cohort, 11 patients died in-hospital and 21 patients died at 90-day follow-up. The predictive nomogram of 90-day death achieved a good C-index of 0.823 by using 5 predictor variables: ICU admission, D-dimer, peak of serum creatinine, rate of serum creatinine decline and white blood cell count (WBC). Conclusion: Older age, clinical spectrum, D-dimer level, number of comorbidities, baseline eGFR, and antibiotic or corticosteroid treatment are clinical risk factors for the incidence of AKI in geriatric COVID-19 patients. The prediction nomogram achieved an excellent performance at the prediction of 90-day mortality.

Ang-(1-7) attenuates podocyte injury induced by high glucose in vitro.

Objective: The incidence of diabetic nephropathy (DN) is gradually increasing worldwide. Podocyte injury, such as podocyte apoptosis and loss of the slit diaphragm (SD)-specific markers are early pathogenic features of DN. Materials and methods: The cultured mouse podocytes were separated into a high glucose-treated (HG, 30mM) group to mimic DN in vitro, a low glucose-treated (LG, 5mM) group as a control and HG+ angiotensin-(1-7)(Ang-(1-7)) and HG+Ang-(1-7) + D-Ala7-Ang-(1-7) (A779, Ang-(1-7)/Mas receptor antagonist) experimental groups. The Cell Counting Kit-8 (CCK-8) method and flow cytometry was used to detect podocyte activity and podocyte apoptosis respectively. The expression of angiotensin type 1 receptor (AT1R), Mas receptor (MasR) and podocyte-specific markers were examined by q-PCR and Western blot, respectively. Results: The results showed that the decrease in podocyte activity; the increase in podocyte apoptosis; the decreased mRNA and protein expression of nephrin, podocin, WT-1 and MasR; and the upregulated expression of AT1R induced by HG could be reversed by Ang-(1-7). However, these effects were blocked by A779. The possible mechanisms of the Ang-(1-7)-mediated effect depended on MasR. In addition, the protective effect of Ang-(1-7) on podocyte activity was dose-dependent and most obvious at 10 µM. A779 had the greatest antagonistic action against Ang-(1-7) at a concentration of 10 µM. Conclusion: This study reveals that binding of Ang-(1-7) to its specific receptor MasR may counteract the effects of Ang II mediated by AT1R to significantly attenuate podocyte injury induced by high glucose. Ang-(1-7)/MasR targeting in podocytes may be a therapeutic approach to attenuate renal injury in DN.

Effect of air pollution-controlled residue of a sewage sludge incinerator on the drying shrinkage and the pore structure of alkali-activated materials.

Recycling air pollution-controlled residues (APCR) generated from sewage sludge incinerators can be used for waste management, but the leaching of potentially toxic heavy metals from APCR poses environmental and human health issues. The present paper describes a procedure using APCR to produce alkali-activated materials and thereby realize their disposal. The effect of APCR on the compressive strength and drying shrinkage of the alkali-activated slag/glass powder was investigated. The pore structure characteristics were analyzed for clarifying its relationship with drying shrinkage. The results indicated that the drying shrinkage of the alkali-activated material was related to the mesopore volume. The drying shrinkage was slightly increased after the incorporation of the 10 % APCR, which was likely attributed to the high volume of mesopores compared to the 20 % APCR that lowered the drying shrinkage and compressive strength. This decrease in drying shrinkage was due to the recrystallization of sodium sulfate in the pore solution that can act as expansive agents and aggregates. The growth stress of the crystalline sodium sulfate within the matrix can offset the tension stress caused by the water loss. In addition, leaching studies using the SW-846 Method 1311 showed that recycling APCR into the alkali-activated system did not present a toxicity leaching risk or release unacceptable concentrations of heavy metals. The incorporation of waste APCR and waste glass can make AAMs a very promising and safe environmental technology.

Physicochemical and pozzolanic properties of municipal solid waste incineration fly ash with different pretreatments.

Swelling caused by gas generated from municipal solid waste incineration fly ash (MSWIFA) when it is mixed with alkali limits its uses. Besides, the leaching of anion salts and heavy metals contained in MSWIFA poses a high risk to environment. This study presents the feasibility of a one-step alkaline washing, one-step thermal quenching and two-step combination of alkaline washing and thermal quenching pretreatment methods in altering the key properties of MSWIFA for promoting its reusability. It was found that apart from H2(gas), NH3(gas) was also generated during the alkaline washing of the MSWIFA. Besides, pretreatments led to the reduction in particle size, the increase in pore volume and specific surface area of the MSWIFA, as well as the removal of chloride and sulfate anions. All the pretreatment methods were effective in reducing leaching of heavy metals to below levels of nonhazardous waste except Cd and Pb with alkaline washing. Furthermore, both the chemical Frattini test and the mechanical activity index test showed improvement in pozzolanic activities of the MSWIFA after the pretreatments. Overall, the combined pretreatment method was most effective in eliminating gas emission, and reducing leaching of metal ions and anions from the ash, while enhancing the pozzolanic activity of the ash.

Common susceptibility variants of KDR and IGF-1R are associated with poststroke depression in the Chinese population.

Background: Depression, one of the most frequent complications after stroke, increases the disease's burden and physical disability. Poststroke depression (PSD) is a multifactorial disease with genetic, environmental and biological factors involved in its occurrence. Genetic studies on PSD to date have mainly focused on the monoamine system and brain-derived neurotrophic factors. However, understanding is still limited about the influence of the single nucleotide polymorphism (SNP) of other neurotrophic factors on PSD. Aims: The present study aimed to investigate the relationship between seven vascular endothelial growth factor (VEGF) family gene variants that occur with PSD. Methods: A multicentre candidate gene study from five hospitals in Jiangsu Province from June 2013 to December 2014 involved 121 patients with PSD and 131 patients with non-PSD. Demographic characteristics and neuropsychological assessments were collected. The χ2 test was used to evaluate categorical variables, while the independent t-test was applied to continuous variables. SNPs in seven genes (VEGFA, VEGFB, KDR, FLT-1, IGF-1, IGF-1R and PlGF) were genotyped. Single-marker association for PSD was analysed by χ2 tests and logistic regression using SPSS and PLINK software. Results: Patients with PSD included more women and those with lower education levels, lower body mass indexes, lower Mini-Mental State Examination scores, and higher scores on the 17-item Hamilton Depression Rating Scale than non-PSD patients. Ninety-two SNPs with seven genes were genotyped and passed quality control. The rs7692791 CC genotypes, the C allele of KDR and the rs9282715 T allele of IGF-1R increased the risk for PSD (χ2=7.881, p=0.019; χ2=4.259, p=0.039; χ2=4.222, p=0.040, respectively). In addition, the SNP rs7692791 of KDR was significantly associated with PSD by the logistic regression of an additive model (p=0.015, OR=9.584, 95% CI: 1.549 to 59.31). Conclusions: Patients with rs7692791 C allele carriers or the CC genotype of KDR and the rs9282715 T allele of IGF-1R may have PSD susceptibility. Findings such as these may help clinicians to identify the high-risk population for PSD earlier and, thus, enable them to provide more timely interventions. Trial registration number: ChiCTR-OCH-13003133.

Development and validation of a diagnostic nomogram for sarcopenia in Chinese hemodialysis patients.

BACKGROUND: Sarcopenia is a clinical condition that is common in patients with chronic kidney disease (CKD), especially in those on dialysis. However, the relatively complicated diagnostic procedure limits its use in clinical situations. In this study we aimed to establish a simplified tool for the diagnosis of sarcopenia in patients on hemodialysis (HD). METHODS: Overall, 757 eligible patients from seven HD centers in Shanghai and Suzhou, China, were recruited from 2020 to 2021. The cross-sectional data were analyzed. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 criteria. Among them, 511 consecutive patients (77 with and 434 without sarcopenia) from five centers were included in the training set for the establishment of a diagnostic nomogram. Ten investigative parameters including clinical characteristics, body measurements and physical performance were used to derive the diagnostic nomogram. A total of 246 consecutive patients (47 with and 199 without sarcopenia) were included for validation of the diagnostic model. RESULTS: The average age of the enrolled patients was 60.4 ± 12.1 years, 59.8% were males and 90.5% received dialysis using an arteriovenous fistula. Overall, the sarcopenia rate was 16.4%. The training and validation sets showed no significant differences in sarcopenia rate (15.1% and 19.1%, respectively; P = .160). The nomogram derived from the training set for sarcopenia, which was based on only four features-age, sex, body weight and grip strength-achieved high C-indexes of 0.929 [95% confidence interval (CI) 0.904-0.953] and 0.955 (95% CI 0.931-0.979) in the training and external sets, respectively, and had a well-fitted calibration curve. The cut-off value was 0.725, with a sensitivity of 0.909 and a specificity of 0.816. The nomogram accurately diagnosed sarcopenia with fewer variables and more simplified diagnostic procedures. CONCLUSIONS: The nomogram had a good diagnostic capability for sarcopenia in patients on HD and may be a convenient tool for clinical use.

Gut microbiota dysbiosis and protein energy wasting in patients on hemodialysis: an observational longitudinal study.

Background: Protein energy wasting (PEW) is common in patients on hemodialysis, and its development may involve gut microbial dysbiosis. However, the exact relationship between the composition of different flora and the development of PEW remains unclear. Methods: This is an observational longitudinal study on 115 patients undergoing hemodialysis who were followed up for 1 year. All the patients were evaluated at baseline, and different microbiota compositions were determined. After a 1 year follow-up period, the correlations between clinical parameter variations and the relative abundance of different gut flora were assessed using Spearman correlation. Moreover, the associations of the abundance of different gut microbiota with decrease in lean tissue mass and the development of PEW were analyzed using ROC curve and logistical regression analyses. Results: We found that the relative abundances of Actinobacteria and Bifidobacteriaceae were significantly lower in patients with PEW than in those who did not develop PEW (p < 0.05). The abundance of Actinobacteria and Bifidobacteriaceae correlated positively with variations in serum albumin levels (r = 0.213, p = 0.035 and r = 0.214, p = 0.034, respectively), lean tissue mass (r = 0.296, p = 0.007 and r = 0.238, p = 0.002, respectively), and lean tissue index (r = 0.377, p < 0.001 and r = 0.419, p < 0.001, respectively). The area under the ROC curve or AUC values of Actinobacteria and Bifidobacteriaceae for the prediction of lean tissue mass decrease ranged from 0.676 to 0.708 (p < 0.05). Thus, decrease in the abundance of Actinobacteria and Bifidobacteriaceae may be associated with decrease in lean tissue mass and the occurrence of PEW. Conclusion: The present findings imply Actinobacteria and Bifidobacteriaceae may be potential markers for predicting skeletal muscle mass decrease and PEW development in patients on hemodialysis.

Ang-(1-7) attenuates podocyte injury induced by high glucose in vitro

ABSTRACT Objective: The incidence of diabetic nephropathy (DN) is gradually increasing worldwide. Podocyte injury, such as podocyte apoptosis and loss of the slit diaphragm (SD)-specific markers are early pathogenic features of DN. Materials and methods: The cultured mouse podocytes were separated into a high glucose-treated (HG, 30mM) group to mimic DN in vitro, a low glucose-treated (LG, 5mM) group as a control and HG+ angiotensin-(1-7)(Ang-(1-7)) and HG+Ang-(1-7) + D-Ala7-Ang-(1-7) (A779, Ang-(1-7)/Mas receptor antagonist) experimental groups. The Cell Counting Kit-8 (CCK-8) method and flow cytometry was used to detect podocyte activity and podocyte apoptosis respectively. The expression of angiotensin type 1 receptor (AT1R), Mas receptor (MasR) and podocyte-specific markers were examined by q-PCR and Western blot, respectively. Results: The results showed that the decrease in podocyte activity; the increase in podocyte apoptosis; the decreased mRNA and protein expression of nephrin, podocin, WT-1 and MasR; and the upregulated expression of AT1R induced by HG could be reversed by Ang-(1-7). However, these effects were blocked by A779. The possible mechanisms of the Ang-(1-7)-mediated effect depended on MasR. In addition, the protective effect of Ang-(1-7) on podocyte activity was dose-dependent and most obvious at 10 µM. A779 had the greatest antagonistic action against Ang-(1-7) at a concentration of 10 μM. Conclusion: This study reveals that binding of Ang-(1-7) to its specific receptor MasR may counteract the effects of Ang II mediated by AT1R to significantly attenuate podocyte injury induced by high glucose. Ang-(1-7)/MasR targeting in podocytes may be a therapeutic approach to attenuate renal injury in DN.

Automated regional citrate anticoagulation based on online monitoring of ionized calcium concentration: Proof of concept.

BACKGROUND: Regional citrate anticoagulation (RCA), a complex and effective technique, is recommended as the anticoagulation of choice for continuous renal replacement therapy. One of its key objectives is to keep the ionized calcium in the targeted range. In this study, we aimed to develop an automated RCA based on online monitoring of the ionized calcium concentration and closed-loop feedback. METHODS: We constructed calcium-selective electrodes with liquid inner contact, which measured a potentiometric signal as the output. We tested the responses, stability, and selectivity of the electrodes in flowing fluid containing calcium chloride. We compared the measurement accuracy between the electrodes and an i-STAT system in vivo. Moreover, we established closed-loop feedback using a proportional-integral-derivative controller model. We performed simulated automated RCA both in vivo and in vitro. RESULTS: The electrode gave a Nernstian response to the variation of ionized calcium concentration. It showed high stability and a relatively short response time. Changes in the fluid flow rate, solution PH, and addition of metal ions including Mg2+ and K+ did not interfere with the measurements of ionized calcium. These measurements in whole blood by the electrode were very close to those assessed by the i-STAT system. The feedback control system responded quickly to an abnormal ionized calcium concentration and regulated the infusion rates of calcium or citrate to maintain the concentration of ionized calcium within the targeted range. CONCLUSIONS: We successfully trialed automated RCA, which may help simplify the complexities of RCA in the future.

Accelerated Curing for Glass-Based Mortars Using Water at 80 °C.

The substitution of river sand with glass aggregate (GA) and cement with glass powder (GP) is a mainstream method to recycle waste glass. Traditionally, standard curing was widely used for glass-based mortars. However, it is time-consuming and cannot address low mechanical strengths of the early-age mortars. Therefore, the effect of water curing at 80 °C on the properties of GA mortars is investigated. Furthermore, the effect of the GP size is also considered. Results show that compared with the expansion of alkali-silica reaction (ASR), water curing at 80 °C has a negligible effect on the volume change. Moreover, the compressive strength of GA mortars under 1-day water curing at 80 °C is comparable with that under 28-day water curing at 20 °C. Therefore, the 1-day water curing at 80 °C is proposed as an accelerated curing method for GA mortars. On the other hand, the addition of GP with the mean size of 28.3 and 47.9 µm can effectively mitigate the ASR expansion of GA mortars. Compared with the size of 28.3 µm, GA mortars containing GP (47.9 µm) always obtain higher compressive strength. In particular, when applying the 1-day water curing at 80 °C, GA mortars containing GP (47.9 µm) can even gain higher strength than those containing fly ash.

Leonurine attenuates cisplatin nephrotoxicity by suppressing the NLRP3 inflammasome, mitochondrial dysfunction, and endoplasmic reticulum stress.

PURPOSE: Cisplatin has been widely accepted as an effective chemotherapy drug with various side effects, including nephrotoxicity. The mechanisms of cisplatin-induced acute kidney injury (AKI) are complex, and there are limited renoprotective approaches. Leonurine is the main active compound of a Chinese herb and has recently been reported to have a protective effect on the kidneys. This study aimed to verify the renoprotective effect of leonurine in attenuating cisplatin-induced AKI and explore the potential associated mechanisms. METHODS: C57BL/6 mice were divided into four groups (Sham, Cisplatin, Leonurine, and Cisplatin + Leonurine). Mice in the leonurine-treated groups were pretreated with a daily intraperitoneal injection of 25 mg/kg leonurine. AKI was induced by injecting cisplatin once intraperitoneally at 20 mg/kg body weight. Mice were killed on day 5. Kidney injury was assessed using a serum biochemical and histological assay. Apoptosis was evaluated using a terminal deoxyribonucleotide transferase-mediated dUTP nick-end labeling (TUNEL) staining assay and Western blot. Antioxidant enzymes were detected using commercial kits. The improvement in inflammasome activation, mitochondrial dysfunction, and endoplasmic reticulum stress (ERS) were assessed by polymerase chain reaction (PCR) and Western blot, respectively. RESULTS: Leonurine treatment improved kidney function by preventing renal tubular injury and apoptosis. Expression of nucleotide-binding leucine-rich repeat and pyrin domain containing protein 3 (NLRP3) inflammasome components and inflammatory cytokines, mitochondrial dysfunction, and ERS were all alleviated by leonurine. CONCLUSION: The results indicate that leonurine plays a protective role in cisplatin-induced AKI and may represent an effective multi-targeted intervention strategy.

Analysis of the molecular mechanism and pedigree investigation of para-Bombay phenotype caused by combined mutations at position h649 and h768 of FUT1 gene.

BACKGROUND: The para-Bombay phenotype is a rare red blood cell phenotype characterised by the lack of ABH antigens on red blood cells, but ABH substances can be found in saliva. The aim of this research was to study the mechanism of mutation of FUT1 and FUT2 genes and the pedigree of a family with the para-Bombay phenotype. MATERIAL AND METHODS: The blood group was detected by a conventional serological method, H antigen adsorption-elution test, and testing saliva for A, B, and H antigens. We amplified and sequenced the ABO, FUT1, and FUT2 genes of the proband and her family using a polymerase chain reaction method, and performed TA cloning and sequencing on the amplified products of the FUT1 gene to determine its genotype. RESULTS: With the conventional serological method, it was found that the red blood cell phenotype of the proband and her sister lacked H antigen, while the adsorption-elution test of H antigen could detect weak H antigen. Through FUT1 cloning and sequencing, it was found that the proband had a compound heterozygous mutation of c.649G>T and c.768delC, and the genotype was FUT1*01W.24/FUT1*01N.20; the proband's father and mother had heterozygous mutations of c.768delC and c.649G>T, and their genotypes were FUT1*01N.20/FUT1*01 and FUT1*01W.24/FUT1*01. The sister's FUT1 mutation site and genotype were the same as the those of the proband. FUT2 gene sequencing revealed that the proband and sister had a synonymous mutation of c.357C>T, while their parents both had a synonymous mutation of c.357C>T and a missense mutation of c.385A>T. The Lewis blood types of the four samples all showed Le (a-b+), all of which were secretory. CONCLUSION: Blood group serology and molecular diagnostic techniques showed that the compound heterozygous mutations of the proband and her sister were inherited from their father and mother.

Measuring the Level of Urban-Rural Integration Development and Analyzing the Spatial Pattern Based on the New Development Concept: Evidence from Cities in the Yellow River Basin.

Urban-rural integration development (URID) is the solution to the excessive urban-rural gap, unequal and insufficient development in urban-rural areas, along with the process of dynamic and balanced urban-rural growth. The promotion of high-quality development and sustainable development in the Yellow River Basin (YRB) depends heavily on the scientific development of an evaluation index for urban-rural integration (URI), the quantitative measurement of the level of URI, and the accurate identification of the spatial layout of URI. The URI indicator system is built using the new development philosophy, and 94 cities in the YRB are used as samples. The spatial and temporal evolution characteristics of the URID in the YRB were studied from 2010 to 2020 using the entropy value method and coupled coordination model. The study shows that from 2010 to 2020, along the YRB, both urban and rural development (URD) levels generally increased. However, regional differences increased and development levels varied, showing a trend of uneven development between provinces. Overall, the degree of URID was increasing and still low, but there are three main types of urban-rural coupling and coordination (URCC) that are relatively stable: barely coordinated, primary coordination, and on the verge of disorder. Primary coordination replaced barely coordinated as the dominant type over time. Finally, it is suggested that urban and rural regions should not be "managed separately" but rather should be viewed as a cohesive organic whole; to drive urban cluster construction and spur rural development, to further close the urban-rural divide, reliance on the city centre is necessary. Concurrently, this encourages the transfer of farm labour and supports the coordinated growth of urban-rural industries; investment in advantageous industries is strengthened; the construction of URIs should be promoted at a more microscopic city and county level; and strong support is provided to achieve high-quality sustainable development of the YRB. It is important to put into practice the new development philosophy, investigate the fundamental causes of the growing urban-rural divide, change the development strategy, and optimize this new development path.

Circulating serum exosomal miR-92a-3p as a novel biomarker for early diagnosis of gastric cancer.

Gastric cancer (GC) is one of the common malignant tumors with high mortality. The abundance of miRNAs in serum exosomes has proved to have a high application value as a new noninvasive diagnostic method. The purpose of this study was to investigate whether serum exosomal miR-92a-3p could be used as a new biomarker for early diagnosis of GC and evaluate its clinical application value by detecting the expression of serum exosomal miR-92a-3p in 131 patients with primary GC and 122 healthy controls by real-time quantitative (qRT)-PCR. The results showed that the expression level of serum exosomal miR-92a-3p in GC patients was significantly lower than that in normal controls (p < 0.0001). In addition, the level was closely correlated with lymph node metastasis and tumor node metastasis stage of GC patients. The area under the curve for serum exosomal miR-92a-3p was 0.829, significantly higher than for other indicators. Furthermore, combined detection of serum exosomal miR-92a-3p, CEA and CA19-9 was more sensitive than any of the three alone or any pair. These results showed that serum exosomal miR-92a-3p could be used as a novel new tumor biomarker to improve diagnostic efficiency in GC.

Apatinib Monotherapy for Chemotherapy-Refractory Metastatic Colorectal Cancer: A Multi-centre, Single-Arm, Prospective Study.

Angiogenesis inhibitors are of considerable interest for treating metastatic colorectal cancer (mCRC). This trial evaluated the efficacy and safety of apatinib in chemotherapy-refractory mCRC. Apatinib 500 mg was administered daily to patients who had progressed after two or more lines of standard fluorouracil-based chemotherapy. Primary endpoint was progression-free survival (PFS). Secondary endpoints were objective response rate (ORR), disease control rate (DCR), overall survival (OS), and toxicity. Overall, 48 patients were enrolled. ORR and DCR were 8.3% (4/48) and 68.8% (33/48), respectively. Median PFS and OS were 4.8 (95% confidence interval [CI], 3.653-5.887) and 9.1 months (95% CI, 5.155-13.045), respectively, and did not differ between subgroups stratified by previous anti-angiogenic therapies. The most prevalent grade 3-4 adverse events were hypertension (12.5%), hand-foot syndrome (HFS, 10.4%), thrombocytopenia (10.4%), and proteinuria (8.3%). Low baseline neutrophil/lymphocyte ratio (NLR, hazard ratios [HR], 0.619; P = 0.027), early carbohydrate antigen 19-9 (CA19-9) decrease (HR, 1.654; P = 0.016), and HFS (HR, 2.087; P = 0.007) were associated with improved PFS. In conclusion, apatinib monotherapy demonstrated encouraging efficacy with manageable toxicities in chemotherapy-refractory mCRC. Previous anti-angiogenic therapies did not influence outcomes. Baseline NLR, early CA19-9 decrease, and HFS could predict the efficacy of apatinib.

Bisphenol A analogs in patients with chronic kidney disease and dialysis therapy.

Bisphenol A (BPA) accumulates in patients with chronic kidney disease (CKD), and hemodialysis filters may contribute to bisphenol burden in patients on hemodialysis (HD). The serum levels of BPA and three BPA analogs, namely, bisphenol B (BPB), bisphenol S (BPS), and bisphenol F (BPF), in 58 patients with CKD, 66 patients on dialysis therapy and 30 healthy control were investigated. The content of four bisphenols (BPs) was also examined in three types of dialysis filters, followed by an in vitro elution experiment to test the release of BPs from the dialysis filters. The serum levels of BPA (r = -0.746, p < 0.05) and BPS (r = -0.433, p < 0.05) in 58 CKD patients and 30 healthy control were correlated with the decrease in estimated glomerular filtration rate. The serum levels of BPs in the HD patients were higher than those in the peritoneal dialysis patients (p < 0.05). In the in vitro study on the BP contents in dialysis filters, BPA was the main form of the BPs in the polysulfone membrane (20.86 ±â€¯1.18 ng/mg) and in the polyamide membrane (18.70 ±â€¯2.88 ng/mg), and a modicum of BPS (0.01 ±â€¯0.01 ng/mg) was detected in the polyethersulfone membrane. The results of the elution experiment were in accordance with the results of BPs content in the dialysis filters. Insufficient renal function may lead to BPs accumulation in patients with CKD, and BPs in dialysis products may cause BPs burden in patients on HD.