The Combination of Coagulation-Flocculation Method and the SCWO in the Waste Water Treatment Problems

The influence of the degree of wastewater coagulation-flocculation and supercritical water oxidation (SCWO) methodsisconsidered. The regularities of changes in the composition of the purity of the reagents used and the parameters of SCWO are established. Based on the results of chromatographic analysis of the effluent after washing the mass rape, it is found that the achievement of the required parameters is achieved by treatment with a combination of coagulation-flocculation method and supercritical water oxidation (SCWO). The necessity of combining techniques is insufficient oxidation in SCWO lignin conducted at T = 400oC and P = 25 MPa, T = 500oC and P = 30 MPa. Effluent treatment of process of styrene and propylene oxide“Nizhnekamskneftekhim”conducted by the SCWO, using an oxidant (H2O2), and without an oxidant showed the possibility of cleaning without the use of an oxidizing agent in the process parameters T = 500oC, P = 30 MPa.

PVDF/PVA共混膜的制备及其在去除污水COD中的应用

以聚乙烯醇(PVA)、聚偏氟乙烯(PVDF)为原料,聚乙烯吡咯烷酮为溶剂,制备了PVDF/PVA共混膜。将该膜应用于膜生物反应器处理污水,测试化学需氧量(COD)去除率和膜的使用性能。结果表明:膜的水通量随PVA加入量的增加而逐渐增加,在牵伸比为1.7时,膜的水通量达到最大值;平板膜用清水清洗后,膜的水通量恢复率较高,膜的运行周期经第一次清洗后下降了18 h,经第二次和第三次清洗后,膜的运行周期基本稳定在6~8 h,COD去除率高于90%,表明该膜具有良好的使用性能。

基层全科医生常见病诊疗能力现状与能力提升需求调查

背景建立基层卫生“守门人”制度,实现基层首诊、有序分流是落实分级诊疗制度的关键,而实施基层首诊的关键在于基层医疗卫生队伍能力建设。目的了解湖南省基层全科医生的常见病诊疗能力、转诊和循证实践能力现状,并了解其能力提升培训的需求,为开展以需求为导向的培训提供依据。方法2023年4—5月采用便利抽样的方法,选取近5年在中南大学湘雅医院参加过住院医师规范化培训或全科医师转岗培训的基层全科医生为调查对象,采用自行设计的调查问卷,包括基本信息、常见病诊疗能力的自我评价、循证实践能力的自我评价、能力提升的需求四个部分,利用“问卷星”平台进行数据收集,采用描述性分析方法对结果进行呈现和描述。结果共收集到来自湖南省各个地级市、自治州的337份有效问卷,其中128份来自社区卫生服务中心,209份来自乡镇卫生机构。乡镇卫生机构与社区卫生服务中心全科医生的性别、年龄、职称、基层工作年限、编制情况比较,差异均有统计学意义(P<0.05)。调查结果显示,75.1%(253/337)的基层全科医生认为自己具备基层常见病的诊疗能力;16.6%(56/337)的医生表示对某些疾病能力欠缺,这些疾病的前六位为抑郁[89.3%(50/56)]、压力性尿失禁[69.6%(39/56)]、痴呆[66.1%(37/56)]、脑卒中[53.6%(30/56)]、共病[51.8%(29/56)]、结核[46.4%(26/56)],结果在社区全科医生和乡镇全科医生中相似。71.8%(242/337)的基层全科医生表示对转诊规范和流程不够熟悉。73.0%(246/337)的医生表示对循证医学不够了解,85.8%(247/288)的基层全科医生表示循证医学在日常诊疗中的应用有限。77.2%(260/337)的医生对基层常见病的诊疗指南不够了解;90.8%(306/337)的医生在决策困难时一般不会选择查找指南,其原因主要是认为指南不能解决复杂的病情[50.0%(153/306)]、不清楚获取指南的操作[43.1%(132/306)]和来源[34.3%(105/306)]等;目前获取诊疗指南的渠道主要是微信公众号平台[72.5%(237/327)]、知网等数据库[50.2%(164/327)]。97.0%(327/337)的基层全科医生对能力提升的培训有需求,并提出应根据基层需求个性化开展培训[60.8%(205/337)];期望的途径主要是上级医院进修[71.3%(233/327)]和高诊疗能力的基层医疗卫生机构培训[56.3%(184/327)];期望的培训项目主要是常见疾病[78.0%(263/337)]和多病共存[69.4%(234/337)]的规范诊疗和转诊。结论湖南省基层全科医生中大多数认为自己具备基层常见病的诊疗能力,但对抑郁、压力性尿失禁、痴呆、脑卒中、共病、结核等疾病的诊疗能力相对欠缺;大多数医生规范转诊、循证医学实践、指南检索和应用等能力有待提高,提示这些可作为能力提升培训的侧重项目。基层全科医生对培训的需求较高,主要希望通过去高诊疗能力的卫生机构进修学习,对基层常见疾病和多病共存的规范诊疗、转诊培训有较高需求,具体的培训方式和内容可在广泛了解基层需求后根据实际情况制定。

臭氧催化氧化系统在膜法有机浓水深度处理中的应用

洱源县某污水厂处理规模为1.0×10^(4)m^(3)/d,主体工艺为“膜生物反应器(MBR)-纳滤”双膜工艺,其中纳滤系统产生的浓水经臭氧催化氧化处理系统处理后与纳滤产水混合,混合出水主要指标达到国家《地表水环境质量标准》(GB 3838—2002)中Ⅲ类(湖、库)标准,实现污水零排放。臭氧催化氧化处理系统采用两段式设计,处理规模为1000 m^(3)/d。臭氧催化氧化系统通水运行一年后的性能测试显示,系统总体处理效果稳定,臭氧催化氧化处理后化学需氧量(CODCr)平均质量浓度由148.39 mg/L降低到75.45 mg/L,耗电量约为1.85 kW·h/m^(3)。结果表明,臭氧催化氧化工艺是膜法有机浓水深度处理的有效工艺。

电絮凝-三维电极深度处理油田采出水工艺研究

鉴于电化学工艺具有反应时间短、不添加化学药剂的特点,利用室内实验装置,采用电絮凝+三维电极的组合工艺实现对油田采出水的深度处理。文章通过控制变量法,考察了电极材料、电流密度、初始pH值和极板间距等因素对电絮凝工艺的影响,以及活性炭吸附率、电流和初始pH值等因素对三维电极工艺的影响,并监测两种工艺联合的处理效果。结果表明,以铁板为阳极,在电流密度50 mA/cm、初始pH值为8、极板间距40 mm、电解时间40 min的条件下,电絮凝工艺的处理效果最佳;在活性炭填充率90%、初始pH值为8、反应时间40 min的条件下,三维电极工艺的处理效果最佳。5次重复实验结果表明,两种工艺联合处理后的各项指标满足SY/T 5329—2022的注水水质要求。

需求风险下污水处理PPP项目调价方式研究

污水处理PPP项目所惯用的保底机制常常被认为会给政府造成隐性债务,审计时要求整改,当实际污水处理需求量低于基本水量时,政府如何合理支付相应费用有待深入研究。以调整污水处理单价的形式取代传统的直接以基本水量乘以原单价进行结算,基于演化博弈理论构建政府和社会资本之间的博弈模型,分析双方决策的动态演化规律,求出社会资本接受和不接受调整后的污水处理单价的阈值,根据运维绩效考核系数确定最终单价,并通过案例分析验证了模型的有效性。研究表明:该调价方式能够在保证污水处理企业可持续发展的前提下使政府的财政支出更为合理,提高后续项目入库的概率,推动PPP模式高质量发展。

以患者需求为导向的阶段性干预结合知信行健康教育对慢性肾病行CRRT患者疾病健康行为及代谢情况的影响

目的 探讨以患者需求为导向的阶段性干预结合知信行健康教育对慢性肾病行连续性肾脏替代治疗(CRRT)患者疾病健康行为及代谢情况的影响。方法 选择2021年1月至2022年1月收治的100例慢性肾病患者为研究对象,以随机数字表法将其分为对照组与观察组,各50例。对照组接受常规护理干预,观察组在对照组基础上实施以患者需求为导向的阶段性干预结合知信行健康教育。比较两组的干预效果。结果 干预后,观察组的饮食及服药管理、病情自我监测、积极配合治疗及规律作息评分均高于对照组(P<0.05)。干预后,观察组的血磷、总胆固醇(TC)水平低于对照组,血钙水平高于对照组(P<0.05)。干预后,观察组的中文版恐惧疾病进展简化量表(FoP-Q-SF)评分低于对照组,肾脏疾病特异性调查表(KDQ)评分高于对照组(P<0.05)。结论 以患者需求为导向的阶段性干预结合知信行健康教育能改善慢性肾病行CRRT患者疾病健康行为及代谢情况,提高其生活质量,减轻疾病恐惧程度。

焦化废水系统生化处理后深度除氰降氮的研究

在实际的运行过程中,焦化废水处理系统存在生化处理后出水总氰化物、化学需氧量、氨氮难以稳定达标排放的问题,为了解决这一问题,需要进一步的除氰降氮。目前采用最有效的办法为絮凝沉淀法,但传统的聚合硫酸铁联合阳离子聚丙烯酰胺的处理方案达不到现场处理需求。针对上述情况研发出AK873,应用到系统后效果显著,出水总氰化物稳定在0.2 mg·L^(-1)以下、化学需氧量低于20 mg·L^(-1)、氨氮小于10 mg·L^(-1),色度也得以降低。

海拔对生活污水处理厂生化池曝气量影响探讨

我国地域广阔,平均海拔跨度大,海拔越高氧气越稀薄、气压越低,对污水处理厂标准传氧速率和曝气量具有明显影响。本文结合相关工程实例,对0、500、1000、1500、2000、2500、3000、3500、4000、4500、5000 m海拔下生化池实际需氧量、标准传氧速率和曝气量相关参数进行计算和校核。结果表明,考虑氧分压修正工况下曝气量与未考虑修正工况下差值随着海拔增加逐渐增大;实际需氧量不受海拔影响;标准传氧速率、供气量与海拔呈现一定指数关系,高海拔地区标准传氧速率和曝气量成倍增长,与平原地区差距显著。该研究结果也可为相关高原地区生化池曝气量的计算和设备选型提供参考。

基于Kano模型的三级癫痫中心护理服务需求调查

目的 分析三级癫痫中心护理服务建设的应用需求,为优化中心建设提供参考。方法 采用便利抽样的方法选取2022年6月至2023年6月在宜春市人民医院综合癫痫中心接受治疗的100例患者为研究对象,采用基于Kano模型及德尔菲专家咨询法设计的问卷进行调查。通过Kano模型需求属性分类、Better-Worse系数分析和二维矩阵分析,确定三级癫痫中心护理服务建设的需求属性,通过需求要素筛选确定最敏感和需要改进的要素。结果 根据Kano模型需求属性分类结果,根据指标分类的20项需求中包含期望需求9项(45%)、魅力需求3项(15%)、必备需求7项(35%)、无差异需求1项(5%),其中“护士服务态度”和“远程服务快速响应”两个需求指标的敏感度最高。结论 医疗机构及三级癫痫中心管理者应重视护士服务态度提升,确保每位患者都能得到尊重和关怀,同时优化远程服务流程,提高响应速度和服务质量,以满足患者对即时性和便捷性的需求。同时,三级癫痫中心服务建设需要提高互联网端远程指导能力及信息安保能力,针对住院或居家癫痫患者及时优化调整护理策略,改善患者康复效果。

Performance of a water hyacinth(Eichhornia crassipes)system in the treatment of wastewater from a duck farm and the effects of using water hyacinth as duck feed

Nowadays, intensive breeding of poultry and livestock of large scale has made the treatment of its waste and wastewater an urgent environmental issue, which motivated this study. A wetland of 688 mz was constructed on an egg duck farm, and water hyacinth （Eichhornia crassipes） was chosen as an aquatic plant for the wetland and used as food for duck production. The objectives of this study were to test the role of water hyacinth in purifying nutrient-rich wastewater and its effects on the ducks＇ feed intake, egg laying performance and egg quality. This paper shows that the constructed wetland removed as much as 64.44% of chemical oxygen demand （COD）, 21.78% of total nitrogen （TN） and 23.02% of total phosphorus （TP）. Both dissolved oxygen （DO） and the transparency of the wastewater were remarkably improved, with its transparency 2.5 times higher than that of the untreated wastewater. After the ducks were fed with water hyacinth, the average daily feed intake and the egg-laying ratio in the test group were 5.86% and 9.79% higher, respectively, than in the control group; the differences were both significant at the 0.01 probability level. The egg weight in the test group was 2.36% higher than in the control group （P 〈 0.05）, but the feed conversion ratios were almost the same. The eggshell thickness and strength were among the egg qualities significantly increased in ducks fed with water hyacinth. We concluded that a water hyacinth system was effective for purifying wastewater from an intensive duck farm during the water hyacinth growing season, as harvested water hyacinth had an excellent performance as duck feed. We also discussed the limitations of the experiment.

Large-Scale Membrane Bioreactors for Industrial Wastewater Treatment in China:Technical and Economic Features,Driving Forces,and Perspectives

Membrane bioreactors(MBRs)have been and will continue playing an important role in industrial wastewater treatment and reuse in China.The sustainable development of MBR technology in its mature-application stage requires reciprocal interactions between engineering and research participants.Thus,in this study,a total of 182 large-scale MBR projects treating industrial wastewater(with individual treatment capacities5000 m3d1)commissioned and under construction from 2003 to 2019 were analyzed comprehensively.Fast growth of the cumulative treatment capacity was observed,with extension to diverse industries,and the super large-scale was enhanced recently.The treatment processes,pollutant removal efficiencies,and actual operational parameters were summarized regarding the particularity of industrial wastewater compared to municipal wastewater.Economic features including the total investment costs of the projects,their total footprint,and their operational energy consumption were analyzed as well.A vigorous MBR market has formed in China with the fast development of membrane elements and engineering suppliers,continuously increasing official oriented projects,and responsive and innovative business modes.MBR technology has been mostly applied in specific economic zones and water-deficient areas,but its widespread use all over China is foreseeable considering the vast future market for industrial wastewater treatment and recycling.The policy–economy and market–technology driving forces revealed that MBR is consistent with the national development demand.According to the survey and analysis,prospective development in both engineering and research aspects of MBR is proposed to maintain its competitive edge.

Soft Computing of Biochemical Oxygen Demand Using an Improved T–S Fuzzy Neural Network

It is difficult to measure the online values of biochemical oxygen demand(BOD) due to the characteristics of nonlinear dynamics, large lag and uncertainty in wastewater treatment process. In this paper, based on the knowledge representation ability and learning capability, an improved T–S fuzzy neural network(TSFNN) is introduced to predict BOD values by the soft computing method. In this improved TSFNN, a K-means clustering is used to initialize the structure of TSFNN, including the number of fuzzy rules and parameters of membership function. For training TSFNN, a gradient descent method with the momentum item is used to adjust antecedent parameters and consequent parameters. This improved TSFNN is applied to predict the BOD values in effluent of the wastewater treatment process. The simulation results show that the TSFNN with K-means clustering algorithm can measure the BOD values accurately. The algorithm presents better approximation performance than some other methods.

Process optimization for treatment of methyltin mercaptide effluents using modified semi-coke

The central composite process optimization was performed by response surface methodology technique using a design for the treatment of methyltin mercaptide with modified semi-coke. The semi-coke from the coal industry was suitably modified by treating it with phosphoric acid, with a thermal activation process. The objective of the process optimization is to reduce the chemical oxygen demand （COD） and NH4＋-N in the methyltin mercaptide industrial effluent. The process variables considered for process optimization are the semi-coke dosage, adsorption time and effluent pH. The optimized process conditions are identified to be a semi-coke dosage of 80 g/L, adsorption time of 90 min and a pH value of 8.34. The ANOVA results indicate that the adsorbent dosage and pH are the significant parameters, while the adsorption time is insignificant, possibly owing to the large range of adsorption time chosen. The textural characteristics of modified semi-coke were analyzed using scanning electron microscopy and nitrogen adsorption isotherm. The average BET surface area of modified semi-coke is estimated to be 915 mE/g, with the average pore volume of 0.71 cm3/g and a average pore diameter of 3.09 nm, with micropore volume contributing to 52.36%.

Characterisation of Raw Sewage and Performance Evaluation of Al-Diwaniyah Sewage Treatment Work, Iraq

These days, water and wastewater treatment are one of the most important issues regarding to the human health. Wastewaters are one of the most environmental pollutants and a wide range of adverse effects linked to the effect of untreated wastewaters or wastewaters that treat improperly. The aim of this present study was to evaluate performance of the wastewater treatment plant at Al-Diwaniyah City according to the national standards. Therefore, data of the most common parameters (PH, BOD5, COD, TSS, PO4, NO3, Cl, and Oil and Grease) were collected from the wastewater treatment plant. The study revealed that the wastewater treatment plant was receiving medium to strong influent with a BOD5/COD ratio of between (0.4 - 0.7). Regression analysis was achieved to approximate the influent of BOD5 and TSS. While the effluent quality was exceeded the Iraq standards for disposing treated wastewater to the water bodies with a fluctuation in the ratio of BOD5to COD as a consequence of the operational problems. Therefore, these results would be of help to planners and policy makers in the City to combat such this problem and to take the necessary actions to reduce the impact of these pollutants.

Continuous Biological Treatment of Ozone Pre-treated Membrane Concentrates of Deinking Wastewater Streams from Pulp and Paper Industry

The implementation of the European WFD （water framework directive） requires IWRM （integrated water resource management）, an important tool in managing available water resources in the presence of emerging constraints. Pressures caused by variability in water supply cycles, droughts, pollution, industrialization, increasing domestic and commercial demand, inadequate infrastructure, intense urbanization and population growth, and decrepit distribution networks have led to the increasing exploitation of industrial wastewater. Most industrial process has some negative impacts on the environment especially on a catchment scale i.e. water, air and soil quality. In the context of water resources and environmental protection measures, the term ＂sustainable development＂, a development that is compatible with the future gains and environmental protection, is regulated more and more by law. To comply with these emission-based limit values, so-called ＂end-of-pipe-techniques＂ are used. Experimental results show CBT （continuous biological treatment） processes present secondary measures to purify highly contaminated industrial wastewater.

Prescription of Cancer Treatment Modalities in Developing Countries:Results from a Multi-Centre Observational Study

Background: Treatment is an important component of a comprehensive cancer control approach and its outcomes strongly depend on infrastructure, equipment, human and financial resources available. Therefore it is imperative to generate evidence-based tools to assist health policy makers from low resourced countries in planning efficient and equitable treatment services for a defined population based on what it is feasible to these settings. Methods: The intended cancer spe-cific treatment planned and written in the patients’ medical record (treatment prescription) of untreated adult cancer cases (≥18 years of age), excluding non-melanoma skin cancer, was recorded in a chronological way from 1 January 2012 onwards in a group of eight comprehensive cancer centres located in middle income countries and offering the main modalities of cancer treatment (surgery, medical oncology and radiotherapy). Results: A total of 17,713 medical records were reviewed, of which 7106 (54.2%) met the eligibility criteria. Prescription of main cancer treatment modalities were distributed as follows: 57.6% for chemotherapy (n = 4093), 56.8% for surgery (n = 4038), and 46.8% for radiotherapy (n = 3327). There was a predominance of plans consisting of combined treatment modalities over monotherapy (55.2% versus 44.8%). At the time of diagnosis 54.3% of the cancer cases had disease that had spread beyond the primary site, 41.2% were considered as having local disease and in 4.5% of the cases the information on disease extension was unknown. Conclusions: The results obtained should be seen as an approximation of cancer treatment service demand based on what it is currently practiced and therefore feasible in developing countries, particularly in middle income countries.

南宁市产妇对产后康复治疗的认知与需求调查

目的了解南宁市产妇对产后康复治疗的认知和需求情况。方法自行设计问卷对南宁市494例产妇进行线上+线下调查,了解其对产后康复治疗的认知和需求情况。分析不同特征产妇对产后康复治疗的知晓率及对产后康复治疗的需求。采用Logistic回归模型分析产妇知晓产后康复治疗的影响因素。结果494例产妇中,有95.7%(473/494)的产妇产后6个月出现产后相关症状,54.7%(270/494)的产妇知晓产后康复治疗,96.6%的产妇(477/494)表示对产后康复治疗有需求。不同年龄、学历、家庭月收入、职业的产妇对产后康复治疗的知晓率差异均具有统计学意义(均P<0.05),不同人口学和分娩特征产妇对产后康复治疗的需求差异均无统计学意义(均P>0.05)。Logistic回归分析结果显示,与年龄>40岁的产妇相比,年龄在19~28岁的产妇对产后康复治疗知晓率较高,与家庭月收入水平>20000元的产妇相比,家庭月收入≤10000元的产妇对产后康复治疗知晓率较低。结论南宁市产妇对产后康复治疗的知晓率较低,而对产后康复需求率较高。年龄和家庭月收入是影响产妇知晓产后康复治疗的因素。

江西省农村老年人中医药治疗服务需求意愿及影响因素分析

目的:研究江西省农村老年人对中医药治疗服务的需求意愿及其影响因素,为推进农村地区中医药服务改革提供参考。方法:采用多阶段抽样方法,在江西省农村地区选取720名老年人进行问卷调查,用卡方检验、Logistic回归对影响因素进行分析。结果:共回收609份有效问卷,其中有39.9%的老年人愿意接受中医药治疗服务。Logistic回归结果显示,是否患慢性病、中医药服务信任程度、自感健康状况、中医药宣传栏设置情况、中医药服务支出对老年人中医药治疗服务需求意愿有显著影响。结论:江西省农村老年人的中医药治疗服务整体需求意愿较低。建议拓宽中医药健康知识的传播广度,创新基层地区中医特色健康服务模式,加强中医药人才队伍建设,完善中医药价格和医保政策,使中医药健康服务能够在农村地区发挥关键作用。

供需匹配视角下社区医疗卫生机构医养结合服务模式优化研究

[目的]分析成都市现有基层医疗机构医养服务供需匹配现状,细化基层医养资源调配方向,为缩小医养服务供需匹配差距提供建议。[方法]采取方便抽样,在成都市4个行政区分别选取开展医养结合服务具有代表性的社区卫生服务中心进行调研,构建供需匹配模型对不同维度医养结合服务进行供需匹配分析。[结果]匹配模型能较好地反映医养结合服务的供需水平,基层医养结合总体匹配度为0.8829,处于较低水平;在不同维度中供需匹配差异明显,整体呈现护理服务>健康管理服务>医疗服务>心理关怀服务>智慧化服务。[结论]基层医养结合服务存在供需错位,供给总量不足、服务发展偏离群众、服务需要难以转化为需求等问题。应建立以医疗护理为主,多元化养老服务并举的社区医养结合养老格局,构建综合性社区医疗卫生机构医养结合服务模式,提供更加多元、更高质量的养老服务。