Performance of a completely autotrophic nitrogen removal over nitrite process for treating wastewater with different substrates at ambient temperature

The stability and parameters of a bio-ceramic filter for completely autotrophic nitrogen removal were investigated. The completely autotrophic nitrogen removal over nitrite （CANON） reactor was fed with different concentrations of ammonia （400, 300, and 200 mg N/L） but constant influent ammonia load. The results showed that the CANON system can achieve good treatment performance at ambient temperature （15-23℃）. The average removal rate and removal loading of NH4＋-N and TN was 83.90%, 1.26 kg N/（m3.day）, and 70.14%, 1.09 kg N/（m3.day）, respectively. Among the influencing factors like pH, dissolved oxygen and alkalinity, it was indicated that the pH was the key parameter of the performance of the CANON system. Observing the variation of pH would contribute to better control of the CANON system in an intuitive and fast way. Denaturing gradient gel electrophoresis analysis of microorganisms further revealed that there were some significant changes in the community structure of ammonium oxidizing bacteria, which had low diversity in different stages, while the species of anaerobic ammonium oxidizing （anammox） bacteria were fewer and the community composition was relatively stable. These observations showed that anaerobic ammonia oxidation was more stable than the aerobic ammonia oxidation, which could explain that why the CANON system maintained a good removal efficiency under the changing substrate conditions.

Value of contrast-enhanced ultrasound combined with percutaneous ultrasound-guided fine-needle aspiration in the diagnosis of solid pancreatic lesions

Background:Contrast-enhanced ultrasound(CEUS)can detect lesions hidden in inflammatory regions and find necrosis or areas of severe fibrosis within the lesion.This retrospective study aimed to compare the diagnostic accuracy of solid pancreatic lesions using percutaneous ultrasound(US)-guided fine-needle aspiration(FNA)with or without CEUS assessment.Methods:Clinical,imaging,and pathologic data of 181 patients from January 2014 to December 2018 in Pecking Union Medical College Hospital,with solid pancreatic masses who underwent percutaneous US-FNA and ThinPrep cytologic test were retrospectively evaluated.Patients were divided into CEUS and US groups according to whether CEUS was performed before the biopsy.According to FNA cytology diagnoses,we combined non-diagnostic,neoplastic,and negative cases into a negative category.The positive category included malignant,suspicious,and atypical cases.The final diagnosis was confirmed by pathology or clinical and radiological follow-up for at least 12 months.The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and accuracy of US-FNA were evaluated between the two groups.Results:This study enrolled 107 male and 74 female patients(average age:60 years).There were 58 cases in the US group and 123 cases in the CEUS group.No statistically significant differences in age,gender,or lesion size were found between the two groups.The diagnostic accuracy of the CEUS group was 95.1%(117/123),which was higher than the 86.2%(50/58)observed in the US group(P=0.036).The sensitivity,specificity,PPV,and NPV of the CEUS group were increased by 7.5%,16.7%,3.4%,and 18.8%,respectively,compared with the US group.However,the differences of the two groups were not statistically significant.Conclusions:Compared with the conventional US,the use of CEUS could improve the biopsy accuracy and avoid the need for a repeat biopsy,especially for some complicated FNA cases.

Laparoscopic radical distal pancreatectomy with portal venous tumor thrombectomy for the treatment of pancreatic acinar cell carcinoma after neoadjuvant chemotherapy

We have read the article“Current status and future prospect of surgical treatment for pancreatic cancer”,published in HepatoBiliary Surgery and Nutrition in 2020(1).This article mentions that in the past two decades,there has been significant development and progress in the surgical treatment of pancreatic cancer,significantly improving the tumor resection rate and reducing perioperative mortality and the incidence of severe complications.

Pancreatic carcinoma disguised as type 1 autoimmune pancreatitis with a mass-forming appearance: a clinical dilemma

In December 2022,a 69-year-old male was presented to the local hospital due to upper abdominal discomfort,gradually developing jaundice with itching,dark urine,and pale-colored stools,with symptoms first appearing ten months prior.Laboratory examinations revealed alanine aminotransferase(ALT)at 507 U/L,aspartate aminotransferase(AST)at 528 U/L,total bilirubin(TBIL)at 226.5μmol/L,and direct bilirubin(DBIL)at 135.2μmol/L.