Mitomycin C and capecitabine: An additional option as an advanced line therapy in patients with metastatic colorectal cancer

BACKGROUND In recent years survival of patients with metastatic colorectal cancer(mCRC),though still limited,has improved significantly;clearly,when the disease becomes refractory to standard regimens,additional treatment options are needed.Studies have shown that mitomycin C(MMC),an antitumor antibiotic,and capecitabine,a precursor of 5-fluorouracil,may act synergistically in combination.The efficacy of MMC/capecitabine has been demonstrated in the first-line setting,but only a few small studies have tested it in the advanced-line setting,with contradictory results.received a median of 2 MMC/capecitabine cycles(range 0.5-9.0).Thirty-four patients(28.6%)experienced grade≥3 toxicity,including 2(1.7%)with grade 4;there was no drug-related mortality.The objective response rate was 0.8%,and the disease control rate,24.4%.Median progression-free survival(PFS)was 2.1 mo(range 0.2-20.3),and median overall survival,4.8 mo(range 0.2-27.5).The 6-month overall survival rate was 44%;8.7%of patients remained progression-free.Factors associated with longer PFS were lower gamma-glutamyl transferase level(P=0.030)and primary tumor location in the left colon(P=0.017).Factors associated with longer overall survival were lower gamma-glutamyl transferase level(P=0.022),left-colon tumor location(P=0.044),low-to-moderate histological grade(P=0.012),Eastern Cooperative Oncology Group performance status 0-1(P=0.036),and normal bilirubin level(P=0.047).CONCLUSION MMC/capecitabine is an active,available,and relatively safe regimen for use beyond standard lines of therapy in mCRC.Several clinical and laboratory parameters can identify patients more likely to benefit.

Anaerobic ammonium oxidation for advanced municipal wastewater treatment: is it feasible?

Anaerobic ammonium oxidation（ANAMMOX） is a recently developed process to treat ammonia-rich wastewater. There were numerous articles about the new technology with focus on the ammonium-rich wastewater treatment, but few on advanced municipal wastewater treatment. The paper studied the anaerobic ammonium oxidation （ANAMMOX） process with a down flow anoxic biofilter for nitrogen removal from secondary clarifier effluent of municipal wastewater with low COD/N ratio. The results showed that ANAMMOX process is applicable to advanced wastewater treatment with normal temperature as well as ammonia-rich high temperature wastewater treatment. The results indicated that ammonia removal rate was improved by raising the nitrite concentration, and the reaction rate reached a climax at 118.4 mgN/L of the nitrite nitrogen concentration. If the concentration exceeds 118.4 mgN/L, the ANAMMOX process was significantly inhibited although the ANAMMOX bacteria still showed a relatively high reactivity. The data also indicated that the ratio of NO2^- -N：NH4 ＊ -N = 1.3：1 in the influent was appropriate for excellent nitrogen removal. The pH increased gradually along the ANAMMOX biofilter reactor. When the ANAMMOX reaction was ended, the pH was tend to calm. The data suggested that the pH could be used as an indicator to describe the course of ANAMMOX reaction.

Advanced treatment of biologically pretreated coking wastewater by intensified zero-valent iron process(IZVI) combined with anaerobic filter and biological aerated filter(AF/BAF)

Experiments were conducted to investigate the behavior of the sequential system of intensified zero-valent iron process(IZVI) and anaerobic filter and biological aerated filter(AF/BAF) reactors for advanced treatment of biologically pretreated coking wastewater. Particular attention was paid to the performance of the integrated system for the removal of chemical oxygen demand(COD), ammonia nitrogen(NH3-N) and total nitrogen(TN). The average removal efficiencies of COD, NH3-N and TN were 76.28%, 96.76% and 59.97%, with the average effluent mass concentrations of 56, 0.53 and 18.83 mg/L, respectively, reaching the first grade of the national discharge standard. Moreover, the results of gas chromatography/mass spectrum(GC/MS) and gel permeation chromatography(GPC) analysis demonstrated that the refractory organic compounds with high relative molecular mass were partly removed in IZVI process by the function of oxidation-reduction, flocculation and adsorption which could also enhance the biodegradability of the system effluent. The removal efficiencies of NH3-N and TN were achieved mainly in the subsequent AF/BAF reactors by nitrification and denitrification. Overall, the results obtained show that the application of IZVI in combination with AF/BAF is a promising technology for advanced treatment of biologically pretreated coking wastewater.

Contemporary management of locally advanced rectal cancer:Resolving issues, controversies and shifting paradigms

Advancements in rectal cancer treatment have resulted in improvement only in locoregional control and have failed to address distant relapse, which is the predominant mode of treatment failure in rectal cancer. As the efficacy of conventional chemoradiotherapy（CRT） followed by total mesorectal excision（TME） reaches a plateau, the need for alternative strategies in locally advanced rectal cancer（LARC） has grown in relevance. Several novel strategies have been conceptualized to address this issue, including： 1） neoadjuvant induction and consolidation chemotherapy before CRT; 2） neoadjuvant chemotherapy alone to avoid the sequelae of radiation; and 3） nonoperative management for patients who achieved pathological or clinical complete response after CRT. This article explores the issues, recent advances and paradigm shifts in the management of LARC and emphasizes the need for a personalized treatment plan for each patient based on tumor stage, location, gene expression and quality of life.

Immobilization biological activated carbon used in advanced drinking water treatment

Bacteria separated from a mature filter bed of groundwater treatment plants were incubated in a culture media containing iron and manganese. A consortium of 5 strains of bacteria removing iron and manganese were obtained by repeated enrichment culturing. It was shown from the experiments of effect factors that ironmanganese removal bacteria in the euhure media containing both Fe and Mn grew better than in that containing only Fe, however, they were unable to grow in the culture media containing only Mn. When comparing the bacteria biomass in the case ofp （DO） ：2.8 mg/L andp （DO） ：9. 0 mg/L, no significant difference was found. The engineering bacteria removing the organic and the bacteria removing iron and manganese were simuhaneously inoculated into activated carbon reactor to treat the effluent of distribution network. The experimental results showed that by using IBAC （ Immobilization Biological Activated Carbon） treatment, the removal efficiency of iron, manganese and permanganate index was more than 98% , 96% and 55% , respectively. After the influent with turbidity of 1.5 NTU, color of 25 degree and oflbnsive odor was treated, the turbidity and color of effluence were less than 0.5 NTU and 15 degree, respectively, and it was odorless. It is determined that the cooperation function of engineering bacteria and activated carbon achieved advanced drinking water treatment.

Sonication for advanced drinking water treatment

This paper investigated the feasibility of sonication as an advanced treatment method for drinking water production and used comprehensive indexes of water quality to examine its efficiency. Results show that sonication significantly reduces the toxicity of water. Sonication with 5 W/L at 90 kHz lasting for 30 rain decreases the water SUVA and the disinfection byproduct formation potential （DBPFP） by 38.7% and 27. 2% respectively. Sonication also decreases the UV254 by more than 50% through destroying unsaturated chemical bonds. Higher sound intensity and higher frequency benefit the reduction of TOC and UV254. Besides, sonication significantly increases the affinity of organics with granular activated carbon （ GAC ） , and thus the hybrid sonication-GAC method reduces the water TOC, COD, UV254, and DBPFP by 78.3%, 69.4%, 75.7%, and 70.0% respectively. Therefore, sonication and the hybrid sonication-GAC metbod are proposed as advanced treatment methods for drinking water.

Enriched Oxygen BAC Method in Advanced Treatment of Textile Dyeing-printing & Alkali-peeling Wastewater

A novel Pressurized Enriched Oxygen Biological Activated Carbon （PRBAC） method in treating secondary effluent of textile dying-printing ＆ alkali peeling wastewater was configured. The PRBAC reactor simply increased reactor pressure to create an eurtched dissolved oxygen （DO） environment to stimulate the bioactivities of microbes on GAC surface for removing refractory organic matter. Rapid Small- Scaled Colunm Test （RSSCT） was carried out to evaluate the adsorption characteristics of target stream constituents, and over 80% COD components were poorly adsorbable while about 82.5% color inducing matter and 85% UV254 surrogated matter were readily adsorbable. Compared with performances of normal BAC reactor under conventional DO condition, PRBAC achieved 20%, 10% and 50% more removal in COD, color and NH3-N abatement.

Improving AOC degradation rate by intensified biological process in advanced water treatment

The object of is to evaluate assimilable organic carbon（AOC） degradation rate by intensified biological technique in advanced water treatment. By artificially acclimating and cultivating strains attached onto carbon surface, the selected strains can be intensified for their degradation to organic matters. The research indicates that ozonation process increases AOC concentration considerably, however, it is beneficial to microdegradation. Temperature and empty bed contact time （ TEBC ） are two important factors affecting microbiology. From 14 to 27 ℃, intensified biological carbon can remove AOC better compared with granular activated carbon （GAC）. Under identical TERC, intensified technique increases more than 10% AOC reduction.

Pilot Study on Drinking Water Advanced Treatment by GAC-MF System

The pilot performance of the combined GAC-MF membrane process for drinking water advanced treatment was described. In the process of GAC adsorption, under the conditions of 20 min HRT and 6 m/h filtration rate, the removal efficiencies of UV_(254) and trichloromethane could reach 40% and 50% respectively and the UV_(254) and trichloromethane in system effluent was less than 0.015 cm^(-1) and 5μg/L respectively. In the post MF membrane process, MF membrane effectively retained the particles and bacteria in raw water. The effluent turbidity was less than 0.2 NTU and no bacteria were detected at all in permeate. A computer-controlled system was employed to control this system. The membrane operating parameters of backwash interval, duration and flux were studied. The backwash interval of 10-min, 20-min and 60-min was researched respectively, and the variation of trans-membrane pressure was also analyzed. Consequently short backwash interval was recommended under the same water consume.

TEGAFUR PLUS MMC OR ACNU IN THE TREATMENT OF ADVANCED GASTRIC CANCER-A PILOT STUDY

Twenty four cases of advanced gastric cancer were divided into two groups according to the general condition of the patients (PS 0-2 and 3-4), further subdivided into localized abdominal form, liver metastatic form, ascitic form and distant metastatic form. These patients were allocated randomly into Regimen A or B. Regimen A: Tegafur 600 mg daily and Mitomycin C (MMC) 5 mg/m2/1-2 weeks. Regimen B: Tegafur 600 mg daily and ACNU (Nimustine, water-soluble Nitrosourea) 60 mg/week for 2 weeks. After a course of ACNU, it was with drawn for 4 weeks and then resumed again. The response rate of Regimen A was 3/11 (27%), that of Regimen B was 3/13 (23%).

Advanced Treatment of Biologically Treated Chemical Comprehensive Wastewater by Nano-TiO2 Photocatalytic Oxidation

Nano-TiO2 photocatalytic oxidation was used to perform the advanced treatment of biologically treated chemical comprehensive wastewater. The effects of reaction time,nano-TiO2 dosage and initial p H of the wastewater on the removal rate of COD were tested. The GC/MS and EEM techniques were used to qualitatively analyze organic compounds in the wastewater before and after treatment. The result showed that after the biologically treated chemical comprehensive wastewater was treated by nano-TiO2 photocatalytic oxidation under the conditions of reaction time 3 h,nano-TiO2 dosage 8 g/L,and pH 8. 0,the effluent COD was 61. 9 mg/L and its removal rate was 63. 8%. Additionally,the species of organic pollutants reduced from 12 to 6. Meanwhile,the content of humic-like and fulvic-like substances dropped dramatically.

Clinical efficacy and tolerance of sunitinib in the treatment of advanced renal cell carcinoma

Objective To evaluate the clinical efficacy and side effects of sunitinib in treatment of advanced renal cell carcinoma. Methods Forty-five patients with advanced renal cell carcinorna and an average age of 48. 6 yrs were treated with sunitinib. of the study group。

Occurrences of Glucocorticoids in Aquatic Environment and Their Removal during Wastewater Treatment

Glucocorticoids(GCs) are a group of endocrine-disrupting compounds(EDCs) frequently prescribed against various medical conditions.Recently,GCs have been shown to be effective in managing septic shock in patients infected with the 2019 novel coronavirus(COVID-19).Due to colossal consumption and potential risks to aquatic organisms,GCs have immensely attracted the focus of the scientific research community as a water pollutant.Therefore,the aim of this paper is to review the current knowledge on the occurrence of various GCs in the aquatic environment and their removal during wastewater treatment.A variety of GCs are ubiquitous in surface water,hospital wastewater,and sewage water worldwide.And the minimum concentration in volume is below 0.01 ng/L,and the maximum one is 10 000 ng/L,and enter the environment through hospital and urban wastewater discharging.Compared with natural GCs,higher risks to aquatic environments could be induced by synthetic GCs.The current activated sludge processes used in wastewater treatment plants(WWTPs) are not fully effective in eliminating GCs,some of which may further increase the risk of GC in the environment.In comparison with the aerobic process in WWTPs,the anaerobic and anoxic processes were found to be more efficient for GC degradation.Of the studied GCs,fluticasone propionate,clobetasol propionate,fluocinolone acetonide,and triamcinolone acetonide need more attention due to their low removal efficiencies and strong toxicity.Among the advanced treatment processes,reverse osmosis,ultraviolet irradiation,CaO_(2),and plasma could achieve significant GC activity removal while micro/ultra-filtration,chlorination,and ozonation were less efficient.

Advanced wastewater treatment with microalgae-indigenous bacterial interactions

Microalgal-indigenous bacterial wastewater treatment(MBWT)emerges as a promising approach for the concurrent removal of nitrogen(N)and phosphorus(P).Despite its potential,the prevalent use of MBWT in batch systems limits its broader application.Furthermore,the success of MBWT critically depends on the stable self-adaptation and synergistic interactions between microalgae and indigenous bacteria,yet the underlying biological mechanisms are not fully understood.Here we explore the viability and microbial dynamics of a continuous flow microalgae-indigenous bacteria advanced wastewater treatment system(CFMBAWTS)in processing actual secondary effluent,with a focus on varying hydraulic retention times(HRTs).The research highlights a stable,mutually beneficial relationship between indigenous bacteria and microalgae.Microalgae and indigenous bacteria can create an optimal environment for each other by providing essential cofactors(like iron,vitamins,and indole-3-acetic acid),oxygen,dissolved organic matter,and tryptophan.This collaboration leads to effective microbial growth,enhanced N and P removal,and energy generation.The study also uncovers crucial metabolic pathways,functional genes,and patterns of microbial succession.Significantly,the effluent NH4 t-N and P levels complied with the Chinese national Class-II,Class-V,Class-IA,and Class-IB wastewater discharge standards when the HRT was reduced from 15 to 6 h.Optimal results,including the highest rates of CO_(2) fixation(1.23 g L^(-1)),total energy yield(32.35 kJ L^(-1)),and the maximal lipid(33.91%)and carbohydrate(41.91%)content,were observed at an HRT of 15 h.Overall,this study not only confirms the feasibility of CFMBAWTS but also lays a crucial foundation for enhancing our understanding of this technology and propelling its practical application in wastewater treatment plants.

New advances in targeted gastric cancer treatment

Despite a decrease in incidence over past decades,gastric cancer remains a major global health problem. In the more recent period, survival has shown only minor improvement, despite significant advances in diagnostic techniques, surgical and chemotherapeutic approaches, the development of novel therapeutic agents and treatment by multidisciplinary teams. Because multiple genetic mutations, epigenetic alterations, and aberrant molecular signalling pathways are involved in the development of gastric cancers, recent research has attempted to determine the molecular heterogeneity responsible for the processes of carcinogenesis, spread and metastasis. Currently, some novel agents targeting a part of these dysfunctional molecular signalling pathways have already been integrated into the standard treatment of gastric cancer, whereas others remain in phases of investigation within clinical trials. It is essential to identify the unique molecular patterns of tumours and specific biomarkers to develop treatments targeted to the individual tumour behaviour. This review analyses the global impact of gastric cancer, as well as the role of Helicobacter pylori infection and the efficacy of bacterial eradication in preventing gastric cancer development. Furthermore, the paper discusses the currently available targeted treatments and future directions of research using promising novel classes of molecular agents for advanced tumours.

Wastewater Treatment for Removal of Recalcitrant Compounds：A Hybrid Process for Decolorization and Biodegradation of Dyes

While conventional wastewater treatments for urban effluents are fairly routine and have proved highly effective,industrial wastewater requires more complex and specific treatments.This paper provides a technological strategy for removal of recalcitrant contaminants based on a hybrid treatment system.The model effluent containing a binary mixture of synthetic dyes is treated by a combination of a preliminary physicochemical stage followed by a biological stage based on ligninolytic enzymes produced by Phanerochaete chrysosporium.This proposal includes biosorption onto peat as pretreatment,which decreases the volume and concentration to be treated in the biological reactor,thereby obtaining a completely decolorized effluent.The treated wastewater can therefore be reused in the dyeing baths with the consequent saving of water resources.

Pancreatic cancer: Advances in treatment

Pancreatic cancer is a leading cause of cancer mortality and the incidence of this disease is expected to continue increasing.While patients with pancreatic cancer have traditionally faced a dismal prognosis,over the past several years various advances in diagnosis and treatment have begun to positively impact this disease.Identification of effective combinations of existing chemotherapeutic agents,such as the FOLFIRINOX and the gemcitabine+nab-paclitaxel regimen,has improved survival for selected patients although concerns regarding their toxicity profiles remain.A better understanding of pancreatic carcinogenesis has identified several pre-malignant precursor lesions,such as pancreatic intraepithelial neoplasias,intraductal papillary mucinous neoplasms,and cystic neoplasms.Imaging technology has also evolved dramatically so as to allow early detection of these lesions and thereby facilitate earlier management.Surgery remains a cornerstone of treatment for patients with resectable pancreatic tumors,and advances in surgical technique have allowed patients to undergo resection with decreasing perioperative morbidity and mortality.Surgery has also become feasible in selected patients with borderline resectable tumors as a result of neoadjuvant therapy.Furthermore,pancreatectomy involving vascular reconstruction and pancreatectomy with minimally invasive techniques have demonstrated safety without significantly compromising oncologic outcomes.Lastly,a deeper understanding of molecular aberrations contributing to the development of pancreatic cancer shows promise for future development of more targeted and safe therapeutic agents.

Treatment of pharmaceutical wastewater containing recalcitrant compounds in a Fenton-coagulation process

The advanced treatment using integrated Fenton＇s reaction and coagulation process was investigated in this study. Before the advancement, the pharmaceutical wastewater containing lincomycin hydrochloride was pretreated by UASB （upflow anaerobic sludge bed） and a SBR （sequencing batch reactor） process. The residual recalcitrant compounds, measured by gas chromatographymass spectrometry （GC-MS）, mainly consisted of alcohols, phenols, and nitrogenous and sulfur compounds. The experimental results indicated that when the Fenton＇s reaction was conducted at pH=3.0, H2O2CODOcr=0.27, H2O2/Fe^2＋=3：1 and 30 min of reaction time, and the coagulation process operated at a sulfate aluminum concentration of 800 mg/L and pH value of 5.0, the color and COD in the wastewater decreased by 94% and 73%, respectively; with a finale COD concentration of 267 mg/L and color level of 40 units, meeting the secondary standard of GB8978-1996 for industrial wastewater.

Removal of TOC and Color in Bleaching Effluents from Straw Pulp and Paper Mill by Fe^0-H_2O_2 Process

TOC and color in the bleaching effluent from straw pulp paper process could not reach draining standard after its treatment by a biochemical process. In this study, advanced treatment by integrated micro-electrolysis （Fe^0） method and Fenton-like process was investigated under various conditions, i.e. pH, Fe/C ratio, initial I-I2O2 concentration and carrier gas. Results showed that Fe/C ratio（V/V = 1.5）, larger H2O2 dosage around 50 rag/L, lower pH（pH= 3） turned out to be particularly efficient. Temperature was a key parameter, remarkably increasing reaction rates. Carrier air not only improved reaction efficiency, but also saved H2O2 dosage. Chlorinated organic compounds could be reductive dechlorinated by Fe^0 reaction and oxidated by OH produced from Fenton process. The combination of Fe^0 and H2O2 reactions had been proved to be highly effective for the advanced treatment of such a type of wastewaters, and important advantages concerning the application in the study.

Advances in minimally invasive treatment of hemorrhagic and ischemic stroke

Cerebrovascular diseases,including ischemic and hemorrhagic strokes,affect more than 6 million US adults annually.Strokes cause high rates of morbidity and mortality due to the central nervous system’s sensitivity to disruptions in blood flow,and are refractory to traditional surgical interventions.A variety of minimally invasive surgical and endovascular approaches have recently been developed to improve patient outcomes following stroke.