BACKGROUND Gastric cancer(GC)is a prevalent malignancy with a substantial health burden and high mortality rate,despite advances in prevention,early detection,and treatment.Compared with the global average,Asia,notabl...BACKGROUND Gastric cancer(GC)is a prevalent malignancy with a substantial health burden and high mortality rate,despite advances in prevention,early detection,and treatment.Compared with the global average,Asia,notably China,reports disproportionately high GC incidences.The disease often progresses asymptoma-tically in the early stages,leading to delayed diagnosis and compromised out-comes.Thus,it is crucial to identify early diagnostic biomarkers and enhance treatment strategies to improve patient outcomes and reduce mortality.METHODS Retrospectively analyzed the clinical data of 148 patients with GC treated at the Civil Aviation Shanghai Hospital between December 2022 and December 2023.The associations of coagulation indices-partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen,fibrinogen degradation products(FDP),fasting blood glucose,and D-dimer(D-D)with TNM stage and distant metastasis were examined.RESULTS Prolongation of APTT,PT,and TT was significantly correlated with the GC TNM stage.Hence,abnormal coagulation system activation was closely related to disease progression.Elevated FDP and D-D were significantly associated with distant metastasis in GC(P<0.05),suggesting that increased fibrinolytic activity contributes to increased metastatic risk.CONCLUSION Our Results reveal coagulation indices,FDPs as GC biomarkers,reflecting abnormal coagulation/fibrinolysis,aiding disease progression,metastasis prediction,and helping clinicians assess thrombotic risk for early intervention and personalized treatment plans.展开更多
BACKGROUND:This study aimed to explore the importance of routine coagulation tests for the early detection of sepsis and to quickly identify patients at a high risk of mortality.METHODS:This retrospective single-cente...BACKGROUND:This study aimed to explore the importance of routine coagulation tests for the early detection of sepsis and to quickly identify patients at a high risk of mortality.METHODS:This retrospective single-center study collected data from patients meeting the clinical criteria for systemic inflammatory response syndrome(SIRS) with a confirmed infection source.Patients with coagulation disorders or on medications affecting coagulation were excluded.Patients were divided into sepsis and non-sepsis groups based on a Sequential Organ Failure Assessment(SOFA) score of ≥2.Univariate and multivariate logistic regression identified indicators from routine coagulation tests that predict sepsis.Prognostic roles of coagulation indicators were analyzed within the sepsis group.RESULTS:A total of 512 patients were included,with 396 in the sepsis group and 116 in the non-sepsis group.The predictive factors in the sepsis prediction model encompass fibrin degradation products(FDP),D-dimer,lactate,procalcitonin(PCT) levels and the utilization of mechanical ventilation.Early elevation of FDP and D-dimer levels predicted sepsis onset.The model exhibited an area under the curve(AUC) of 0.943(95% CI:0.923–0.963).In the sepsis group,Cox regression analysis revealed an association between prothrombin time(PT) and in-hospital mortality.CONCLUSION:Abnormal high FDP and D-dimer levels in the early stages of sepsis provide a supplementary method for predicting sepsis.As the disease progresses,prolonged PT in the early stages of sepsis suggests a poor prognosis.展开更多
As part of sewage treatment,coagulation could remove phosphorus from the effluent of the Anaerobic-Anoxic-Oxic-Anoxic(A^(2)OA)biological process.The importance in investigating the influence of coagulation on Anaerobi...As part of sewage treatment,coagulation could remove phosphorus from the effluent of the Anaerobic-Anoxic-Oxic-Anoxic(A^(2)OA)biological process.The importance in investigating the influence of coagulation on Anaerobic-Anoxic-Oxic-Anoxic Membrane Bioreactor(A^(2)OA-MBR)should be emphasized.In this study,systematic optimization of coagulation parameters for greater pollutant removal was conducted in terms of coagulant dosage,coagulation residence time and stirring hydraulic conditions.Coagulation process could remarkably remove turbidity,phosphorus,chemical oxygen demand,humic-like,protein-like and polysaccharide-like substances from secondary effluent and A^(2)OA sludge-liquid mixture.Furthermore,the influence of coagulation on membrane fouling development during the ultrafiltration of secondary effluent and A^(2)OA sludge-liquid mixture was investigated based on optimum coagulation parameters.Coagulation simultaneously reduced reversible membrane fouling and the irreversible one by 86%and 16%,respectively.According to excitation-emission matrix and attenuated total reflection-fourier transform infrared spectra,membrane fouling was primarily influenced by the cake layer,although pore fouling might be aggravated by A^(2)OA processes.Besides,the feasibility of coagulation-assisted A^(2)OA-MBRwas also assessed using hollowfibermembranes.It exhibited excellent potential in alleviatingmembrane fouling,while regular cleaning twice a day was not enough to suppress transmembrane pressure increase during direct domestic wastewater ultrafiltration.Additionally,both polysaccharide-like and protein-like foulants were vital components for membrane fouling during wastewater treatment.展开更多
BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally adva...BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally advanced gastric cancer(LAGC)undergoing new treatments remains to be determined.AIM To determine whether hypercoagulation is an effective prognostic indicator in patients with LAGC who underwent radical resection after NICT.METHODS A retrospective analysis of clinical data from 104 patients with LAGC,who underwent radical resection after NICT between 2020 and 2023,was performed.Ddimer and fibrinogen concentrations were measured one week before NICT,and again one week before surgery,to analyze the association between these two indicators and their combined indices[non-hypercoagulation(D-dimer and fibrinogen concentrations within the upper limit of normal)vs hypercoagulation(D-dimer or fibrinogen concentrations above the upper limit of normal)]with prognosis.After radical resection,patients were followed-up periodically.The median follow-up duration was 21 months.RESULTS Data collected after NICT revealed that the three-year overall survival(OS)and disease-free survival(DFS)rates the non-hypercoagulation group were significantly better than those in the hypercoagulation group[94.4%vs 78.0%(P=0.019)and 87.0%vs 68.0%(P=0.027),respectively].Multivariate analysis indicated that hypercoagulation after NICT was an independent factor for poor postoperative OS[hazard ratio(HR)4.436,P=0.023]and DFS(HR 2.551,P=0.039).Pre-NICT data demonstrated no statistically significant difference in three-year OS between the non-hypercoagulation and hypercoagulation groups(88.3%vs 84.1%,respectively;P=0.443).CONCLUSION Hypercoagulation after NICT is an effective prognostic indicator in patients with LAGC undergoing radical gastrectomy.展开更多
BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma...BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma(HCC),underscoring the urgent need for higher-level research in this area.AIM To investigate the association of multidisciplinary treatment strategies with the immunological,coagulation,and tumor biomarker responses after post-TACE in HCC.METHODS This retrospective analysis included 100 patients with HCC who were categorized based on the treatment approach into the control(patients treated with TACE alone)and experimental groups(patients receiving multidisciplinary treatment strategies post-TACE).Participant characteristics,short-term efficacy,and safety assessment as well as immunological,coagulation,and tumor biomarker res-ponses between the two groups were collected and compared.RESULTS Compared with the control group,the experimental group demonstrated a superior overall response rate,along with an increased fibrinogen,markedly improved immunological biomarker,lower prothrombin time,thrombin time,alpha-fetoprotein,carcinoembryonic antigen,and carbohydrate antigen 199 levels,as well as a decreased abnormal prothrombin incidence,and a lower overall rate of adverse reactions.Notably,no significant difference in the activated partial thromboplastin time and D-dimer levels was observed between the two groups.CONCLUSION Multidisciplinary treatment strategies post-TACE have improved the treatment outcome,the immunological response,and the coagulation function,lowered the tumor biomarker response levels,and reduced the risk of adverse reactions in patients with HCC.展开更多
Gastric cancer(GC)has remained one of the leading causes of cancer-related deaths globally.The development of noninvasive biomarkers in cancer diagnosis and treatment has gained substantial traction in recent years.Re...Gastric cancer(GC)has remained one of the leading causes of cancer-related deaths globally.The development of noninvasive biomarkers in cancer diagnosis and treatment has gained substantial traction in recent years.Recent evidence highlights hypercoagulation as a promising prognostic biomarker,particularly in locally advanced GC(LAGC)who underwent radical resection after neoadjuvant immunochemotherapy(NICT).A recent study by Li et al showed that hypercoagulation is a valuable prognostic indicator for patients with LAGC who have undergone radical resection following NICT.While the study addresses an important clinical issue and provides insightful findings,the present study offered valuable insights;the applicability of these findings was constrained by the retrospective design,the focus on a single center,and the small sample size of the existing studies.Additionally,vital confounders,such as preoperative comorbidities and systemic inflammation,are inadequately addressed.Future studies should focus on prospective multicenter trials,incorporating advanced predictive models such as machine learning algorithms to integrate coagulation markers with other clinical variables for personalized risk stratification.In addition,we are required to validate findings to examine the biological mechanisms correlating hypercoagulation to tumor progression.Integrating machine learning,comprehensive biomarker panels,and real-world data would allow the researchers to have personalized risk stratification,improve predictive accuracy,and optimize clinical decision-making.Finally,A multidisciplinary approach,including lifestyle interventions and imaging modalities,is essential to improve outcomes among patients with GC.展开更多
This letter to the editor involves the article published in the World Journal of Gastrointestinal Oncology.Bone metastasis(BM)in gastric cancer(GC)is uncommon but can be prevalent in autopsy studies.BM significantly i...This letter to the editor involves the article published in the World Journal of Gastrointestinal Oncology.Bone metastasis(BM)in gastric cancer(GC)is uncommon but can be prevalent in autopsy studies.BM significantly impairs quality of life and is frequently underdiagnosed,as sensitive diagnostic tests are only performed after symptoms occur.Imaging is crucial for the diagnosis of BM but is not routinely used for screening and is expensive.Examining laboratory risk factors for BM in GC patients using multivariate analysis could be a more effective approach.展开更多
The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine.Despite their reliability,traditional laboratories often lag in terms of rapid diagnosis.Point...The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine.Despite their reliability,traditional laboratories often lag in terms of rapid diagnosis.Point-of-care testing(POCT)has emerged as a promising alternative,which is awaiting rigorous validation.We assessed 226 samples from patients at the First Affiliated Hospital of Guangzhou Medical University using a Beckman Coulter AU5821 and a PUSHKANG POCT Biochemistry Analyzer MS100.Furthermore,350 samples were evaluated with a Stago coagulation analyzer STAR MAX and a PUSHKANG POCT Coagulation Analyzer MC100.Metrics included thirteen biochemical indexes,such as albumin,and five coagulation indices,such as prothrombin time.Comparisons were drawn against the PUSHKANG POCT analyzer.Bland-Altman plots(MS100:0.8206-0.9995;MC100:0.8318-0.9911)evinced significant consistency between methodologies.Spearman correlation pinpointed a potent linear association between conventional devices and the PUSHKANG POCT analyzer,further underscored by a robust correlation coefficient(MS100:0.713-0.949;MC100:0.593-0.950).The PUSHKANG POCT was validated as a dependable tool for serum and whole blood biochemical and coagulation diagnostics.This emphasizes its prospective clinical efficacy,offering clinicians a swift diagnostic tool and heralding a new era of enhanced patient care outcomes.展开更多
[Objective] The aim was to treat acidic wastewater containing thallium by enhanced coagulation oxidation process. [Method] Enhanced coagulation oxidation process was made use of to remove thallium in the acidic wastew...[Objective] The aim was to treat acidic wastewater containing thallium by enhanced coagulation oxidation process. [Method] Enhanced coagulation oxidation process was made use of to remove thallium in the acidic wastewater in the experiment under the condition of 0.05 kg/L of potassium permanganate, 30% hydrogen peroxide and 0.05 kg/L calcium hypochlorite as oxidant, together with 0.092 kg/L CaO as coagulation. [Result] The results showed that thallium removal efficiencies achieved 99.98%, 99.1% and 99.95% when dosages of KMnO4, H2O2and Ca（ClO）2were added at 20, 2.2 and 37 ml, respectively, under the condition of 30 ml 0.092kg/L CaO being dosed and 99.93%, 99.69% and 99.98% were achieved when different dosages of CaO were added at 25, 35 and 25 ml, under the condition of 20ml KMnO4, 2.2 ml H2O2and 37 ml Ca（ClO）2respectively. [Conclusion] The experiment demonstrates that good removal effects of removal thallium from the acidic wastewater would be achieved by enhanced coagulation oxidation process.展开更多
Snake venoms,especially those from the two subfamilies,Crotalinae and Viperinae,contained a lot of serine proteases. They were responsible for the hemorrhage,shock,or disorder of blood coagulation after envenomation. ...Snake venoms,especially those from the two subfamilies,Crotalinae and Viperinae,contained a lot of serine proteases. They were responsible for the hemorrhage,shock,or disorder of blood coagulation after envenomation. They acted,by activating,inactivating,or other converting effects,on almost all the components of hemostatic and fibrinolytic systems. Their sequences were homologous to trypsin-kallikrein serine proteases. Variation of primary sequences out of active center results in the difference of substrate specificities and the further difference of biological and pharmacological activities. Because of their common and unique properties compared to their physiological corresponding factors,snake venom proteases are proved to be an excellent model for the study of protease substrate discriminating mechanism. Furthermore,they have found an important position both in basic research and application of hemostasis and thrombosis in clinic.展开更多
Objective: To evaluate the efficacy and safety of percutaneous microwave coagulation therapy (PMCT) for patients with primary and metastatic hepatic tumors.Methods: The enrolled 100 patients with 186 tumor nodules who...Objective: To evaluate the efficacy and safety of percutaneous microwave coagulation therapy (PMCT) for patients with primary and metastatic hepatic tumors.Methods: The enrolled 100 patients with 186 tumor nodules who underwent PMCT included 79 cases of primary or recurrent liver cancers and 21 cases of metastatic liver cancer. The tumors were divided into two groups according to the tumor size in diameter: group A, 0.5 cm?<3 cm; group B, ≥3 cm?<5 cm. Under local and/or epidural anesthesia, a single percutaneous microwave antenna (or two antennas array applicator) was inserted directly into the tumor in the liver for thermo-coagulation with the aid of ultrasound guidance.Results: Among the 186 lesions in 100 patients with primary and metastatic liver cancers, in group A, 123 (66%) were coagulated once. A Follow-up of 6–12 months demonstrated that 112 lesions (91%) showed no local recurrence by CT or MRI; In group B, of the 63 lesions (33.87%) coagulated twice, 31 (49%) showed no local recurrence by CT or MRI during a follow-up of 6 months. There were no serious clinical side effects or complications in all the PMCT patients.Conclusion: PMCT gives satisfactory curative effect on tumors with <3 cm in size. It is partly effective on lesions ≥3 cm?<5 cm in size. It is a minimally invasive and effective therapy, can be used safely in the field of percutaneous hepatis surgery, and carried out even in patients with poor liver function. Key words hepatocellular carcinoma - microwave - coagulation - therapy展开更多
Cyclovirobuxine D （CVB-D） is a compound extracted from Chinese traditional plant Buxus microphylla, which has been used for treating arrhythmia and myocardial ischemia in China. In this study, we investigated its ef...Cyclovirobuxine D （CVB-D） is a compound extracted from Chinese traditional plant Buxus microphylla, which has been used for treating arrhythmia and myocardial ischemia in China. In this study, we investigated its effect on blood coagulation and thrombotic formation in mouse and rat models. The doses of CVB-D used in this study （5-20 mg/kg） prolonged clotting time （CT） in a dose-dependent manner （P〈0.01）. It also significantly prolonged thrombin time （TT）, prothrombin time （PT） and activated partial thromboplast time （aPTT） （P〈0.05 or P〈0.01） at the doses of 10-20 mg/kg. CVB-D did not affect the bleeding time （BT） compared with the control group, while warfarin significantly prolonged the bleeding time. CVB-D at the doses of 5-20 mg/kg reduced wet weight of thrombosis （P〈0.01）. This study demonstrated the anti-coagulation effect and anti-thrombosis effect of orally administered CVB-D without substantially increasing bleeding. These findings suggest that CVB-D probably can be used as an oral anti-coagulant in addition to its current applications.展开更多
A composite control scheme consisting of modepredictive control （MPC） and disturbance observer （DOB） iproposed to solve the control performance degradationproblem of the turbidity of the treated water in the prese...A composite control scheme consisting of modepredictive control （MPC） and disturbance observer （DOB） iproposed to solve the control performance degradationproblem of the turbidity of the treated water in the presence osignificant changes in raw water quality, water flow rate andinternal model mismatch disturbances. The MPC is employedas a feedback controller for the coagulation process with alarge time delay. The DOB is adopted to estimate the severedisturbances in the turbidity control, such as large changes inraw water quality and water flow rate. The estimated valuesare applied for feed-forward compensation to rejecdisturbances. Finally, the disturbance rejection performancesfor step disturbances and time-varying disturbances in thenominal case and model mismatch case are tested. Thesimulation results illustrate that, compared with the MPCmethod, the proposed method can significantly improve thedisturbance rejection performance in the turbidity control othe treated water, no matter if in the presence of externadisturbances or internal model mismatch disturbances.展开更多
The purpose of this study is to understand the effect and mechanism of preventing membrane fouling, by coagulation pretreatment, in terms of fractional component and molecular weight of natural organic matter （NOM）....The purpose of this study is to understand the effect and mechanism of preventing membrane fouling, by coagulation pretreatment, in terms of fractional component and molecular weight of natural organic matter （NOM）. A relatively higher molecular weight （MW） of hydrophobic compounds was responsible for a rapid decline in the ultrafiltration flux. Coagulation could effectively remove the hydrophobic organics, resulting in the increase of flux. It was found that a lower MW of neutral hydrophilic compounds, which could remove inadequately by coagulation, was responsible for the slow declining flux. The fluxes in the filtration of coagulated water and supernatant water were compared and the results showed that a lower MW of neutral hydrophilic compounds remained in the supernatant water after coagulation could be rejected by a membrane, resulting in fouling. It was also found that the coagulated flocs could absorb neutral hydrophilic compounds effectively. Therefore, with the coagulated flocs formed on the membrane surface, the flux decline could be improved.展开更多
There is wide variation in the management of coagulation and blood transfusion practice in liver transplantation. The use of blood products intraoperatively is declining and transfusion free transplantations take plac...There is wide variation in the management of coagulation and blood transfusion practice in liver transplantation. The use of blood products intraoperatively is declining and transfusion free transplantations take place ever more frequently. Allogenic blood products have been shown to increase morbidity and mortality. Primary haemostasis, coagulation and fibrinolysis are altered by liver disease. This, combined with intraoperative disturbances of coagulation, increases the risk of bleeding. Meanwhile, the rebalancing of coagulation homeostasis can put patients at risk of hypercoagulability and thrombosis. The application of the principles of patient blood management to transplantation can reduce the risk of transfusion. This includes: preoperative recognition and treatment of anaemia, reduction of perioperative blood loss and the use of restrictive haemoglobin based transfusion triggers. The use of point of care coagulation monitoring using whole blood viscoelastic testing provides a picture of the complete coagulation process by which to guide and direct coagulation management. Pharmacological methods to reduce blood loss include the use of anti-fibrinolytic drugs to reduce fibrinolysis, and rarely, the use of recombinant factor VIIa. Factor concentrates are increasingly used; fibrinogen concentrates to improve clot strength and stability, and prothrombin complex concentrates to improve thrombin generation. Non-pharmacological methods to reduce blood loss include surgical utilisation of the piggyback technique and maintenance of a low central venous pressure. The use of intraoperative cell salvage and normovolaemic haemodilution reduces allogenic blood transfusion. Further research into methods of decreasing blood loss and alternatives to blood transfusion remains necessary to continue to improve outcomes after transplantation.展开更多
The aim of the present work was to produce a polyaluminium ferric silicate chloride （PAFSiC） coagulant from acidic and alkaline wastewater of purifying graphite by roasting, and subsequently to evaluate coagulation ...The aim of the present work was to produce a polyaluminium ferric silicate chloride （PAFSiC） coagulant from acidic and alkaline wastewater of purifying graphite by roasting, and subsequently to evaluate coagulation efficiency of the reagent by treating surface water from the Yellow River as well as municipal wastewater in comparison with the conventional coagulant polyaluminium chloride （PAC）. The PAFSiC coagulant was prepared by co-polymerization. The effects of （Al＋Fe）/Si molar ratio, OH/（Al＋Fe） molar ratio （i.e., γ value）, coagulant dosage and pH value of test suspension on the coagulation behavior of FAFSiC and the stability of the PAFSiC were also examined. Results showed that PAFSiC performed more efficiently than PAC in removing turbidity, chemical oxygen demand （COD）, and total phosphate （TP）. The PAFSiC with a γ value of 2.0 and （Al＋Fe）/Si ratio of 5 （PAFSiC 2.0/5） showed excellent coagulation effect for both turbidity and COD, while PAFSiC 1.0/5 was the best for TP. The optimum coagulation pH range of PAFSiC 2.0/5 was 5.0–9.0, slightly wider than that of PAC （6.0–8.0）. The process can be easily incorporated into high-purity graphite production plants, thereby reducing wastewater pollution and producing a valuable coagulant.展开更多
Coagulation and growth of nanoparticles subject to large coherent structures in a planar jet has been explored by using large eddy simulation. The particle field is obtained by employing a moment method to approximate...Coagulation and growth of nanoparticles subject to large coherent structures in a planar jet has been explored by using large eddy simulation. The particle field is obtained by employing a moment method to approximate the nanoparticle general dynamic equa- tion. An incompressible fluid containing particles of 1 nm in diameter is projected into a particle-free ambient. The results show that the coherent structures dominate the evolution of the nanoparticle number intensity, diameter and polydispersity distributions as the jet develops. In addition, the coherent structures act to increase the diffusion of particles, and the vortex rolling-up makes the particles distributing more irregularly while the vortex pairing causes particle distributions to become uniform. As the jet travels downstream, the time-averaged particle number concentration becomes lower in the jet core and higher in the outskirts, whereas the time- averaged particle mass over the entire flow field maintains unaltered, and the time-averaged particle diameter and geometric standard deviations grow and reach their maximum on the interface of the jet region and the ambient.展开更多
In order to evaluate the influence of particle size and particle concentration on the coagulation process, two kinds of particle suspensions, nanoparticles and microparticles,were employed to investigate the effect of...In order to evaluate the influence of particle size and particle concentration on the coagulation process, two kinds of particle suspensions, nanoparticles and microparticles,were employed to investigate the effect of particle size on coagulation mechanisms with varying coagulation parameters. Results showed that it is easier for nanoparticles to cause self-aggregation because of Brownian motion, while interception and sedimentation are the mainly physical processes affecting particle transport for microparticles, so they are more stable and disperse more easily. The particle size distribution and particle concentration had distinct influence on the coagulation mechanisms. Under neutral conditions, as the amount of coagulant increased, the coagulation mechanism for nanoparticles changed from charge neutralization to sweep flocculation and the nanoparticles became destabilized, re-stabilized and again destabilized. For microparticles, although the coagulation mechanism was the same as that of nanoparticles, the increased rate of aluminum hydroxide precipitation exceeded the adsorption of incipiently formed soluble alum species, resulting in the disappearance of the re-stabilization zone. Under acidic conditions, Brownian motion dominates for nanoparticles at low particle concentrations, while sweep flocculation is predominant at high particle concentrations. As for microparticles, charge neutralization and sweep flocculation are the mechanisms for low and high particle concentrations respectively.Under alkaline condition, although the mechanisms for both nano-and microparticles are the same, the morphology of flocs and the kinetics of floc formation are different. At low particle concentrations, nanoparticles have larger growth rate and final size of flocs, while at high particle concentrations, nanoparticles have higher fractal dimension and recovery factors.展开更多
Water supply and sanitation demands are foreseen to face enormous challenges over the coming decades to meet the fast growing needs in a global perspective. Significant growth in the industry is predicted and membrane...Water supply and sanitation demands are foreseen to face enormous challenges over the coming decades to meet the fast growing needs in a global perspective. Significant growth in the industry is predicted and membrane separation technologies have been identified as one of the possible solutions to meet future demands. Application and implementation of membrane technology is expected both in production of potable water as well as in treatment of wastewater. In potable water production membranes are substituting conventional separation technologies due to the superior performance, potential for less chemical use and sludge production, as well as the potential to fulfill hygienic barrier requirements. Membrane bio-reactor （MBR） technology is probably the membrane process which has had most success and has the best prospects for the future in wastewater treatment. Trends and developments indicate that this technology is becoming accepted and is rapidly becoming the best available technology for many wastewater treatment applications. A major drawback of MBR systems is membrane fouling. Studies have shown that fouling mitigation in MBR systems can potentially be done by coupling coagulation and flocculation to the process.展开更多
文摘BACKGROUND Gastric cancer(GC)is a prevalent malignancy with a substantial health burden and high mortality rate,despite advances in prevention,early detection,and treatment.Compared with the global average,Asia,notably China,reports disproportionately high GC incidences.The disease often progresses asymptoma-tically in the early stages,leading to delayed diagnosis and compromised out-comes.Thus,it is crucial to identify early diagnostic biomarkers and enhance treatment strategies to improve patient outcomes and reduce mortality.METHODS Retrospectively analyzed the clinical data of 148 patients with GC treated at the Civil Aviation Shanghai Hospital between December 2022 and December 2023.The associations of coagulation indices-partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen,fibrinogen degradation products(FDP),fasting blood glucose,and D-dimer(D-D)with TNM stage and distant metastasis were examined.RESULTS Prolongation of APTT,PT,and TT was significantly correlated with the GC TNM stage.Hence,abnormal coagulation system activation was closely related to disease progression.Elevated FDP and D-D were significantly associated with distant metastasis in GC(P<0.05),suggesting that increased fibrinolytic activity contributes to increased metastatic risk.CONCLUSION Our Results reveal coagulation indices,FDPs as GC biomarkers,reflecting abnormal coagulation/fibrinolysis,aiding disease progression,metastasis prediction,and helping clinicians assess thrombotic risk for early intervention and personalized treatment plans.
基金supported by the Science and Technology Commission of Shanghai Municipality (grant no.22Y11900300)China Primary Health Care Foundation (grant no.MTP2022A0132)Project of Shanghai Administration of Traditional Chinese Medicine (ZXXT-202213)to EQM and LM。
文摘BACKGROUND:This study aimed to explore the importance of routine coagulation tests for the early detection of sepsis and to quickly identify patients at a high risk of mortality.METHODS:This retrospective single-center study collected data from patients meeting the clinical criteria for systemic inflammatory response syndrome(SIRS) with a confirmed infection source.Patients with coagulation disorders or on medications affecting coagulation were excluded.Patients were divided into sepsis and non-sepsis groups based on a Sequential Organ Failure Assessment(SOFA) score of ≥2.Univariate and multivariate logistic regression identified indicators from routine coagulation tests that predict sepsis.Prognostic roles of coagulation indicators were analyzed within the sepsis group.RESULTS:A total of 512 patients were included,with 396 in the sepsis group and 116 in the non-sepsis group.The predictive factors in the sepsis prediction model encompass fibrin degradation products(FDP),D-dimer,lactate,procalcitonin(PCT) levels and the utilization of mechanical ventilation.Early elevation of FDP and D-dimer levels predicted sepsis onset.The model exhibited an area under the curve(AUC) of 0.943(95% CI:0.923–0.963).In the sepsis group,Cox regression analysis revealed an association between prothrombin time(PT) and in-hospital mortality.CONCLUSION:Abnormal high FDP and D-dimer levels in the early stages of sepsis provide a supplementary method for predicting sepsis.As the disease progresses,prolonged PT in the early stages of sepsis suggests a poor prognosis.
基金supported by the National Natural Science Foundation of China(Nos.52170070,52400022 and 52200088)the Youth S&T Talent Support Programme of Guangdong Provincial Association for Science and Technology(GDSTA)(No.SKXRC202406)+1 种基金China Postdoctoral Science Foundation(No.2023M740754)“One hundred Youth”Science and Technology Plan,Guangdong University of Technology,China(No.263113906).
文摘As part of sewage treatment,coagulation could remove phosphorus from the effluent of the Anaerobic-Anoxic-Oxic-Anoxic(A^(2)OA)biological process.The importance in investigating the influence of coagulation on Anaerobic-Anoxic-Oxic-Anoxic Membrane Bioreactor(A^(2)OA-MBR)should be emphasized.In this study,systematic optimization of coagulation parameters for greater pollutant removal was conducted in terms of coagulant dosage,coagulation residence time and stirring hydraulic conditions.Coagulation process could remarkably remove turbidity,phosphorus,chemical oxygen demand,humic-like,protein-like and polysaccharide-like substances from secondary effluent and A^(2)OA sludge-liquid mixture.Furthermore,the influence of coagulation on membrane fouling development during the ultrafiltration of secondary effluent and A^(2)OA sludge-liquid mixture was investigated based on optimum coagulation parameters.Coagulation simultaneously reduced reversible membrane fouling and the irreversible one by 86%and 16%,respectively.According to excitation-emission matrix and attenuated total reflection-fourier transform infrared spectra,membrane fouling was primarily influenced by the cake layer,although pore fouling might be aggravated by A^(2)OA processes.Besides,the feasibility of coagulation-assisted A^(2)OA-MBRwas also assessed using hollowfibermembranes.It exhibited excellent potential in alleviatingmembrane fouling,while regular cleaning twice a day was not enough to suppress transmembrane pressure increase during direct domestic wastewater ultrafiltration.Additionally,both polysaccharide-like and protein-like foulants were vital components for membrane fouling during wastewater treatment.
基金Natural Science Foundation of Hubei Province of China,No.2024AFB655Key Research and Development Program of Hubei Province of China,No.2021BCA116National Natural Science Foundation of China,No.82072736,No.82003205,No.
文摘BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally advanced gastric cancer(LAGC)undergoing new treatments remains to be determined.AIM To determine whether hypercoagulation is an effective prognostic indicator in patients with LAGC who underwent radical resection after NICT.METHODS A retrospective analysis of clinical data from 104 patients with LAGC,who underwent radical resection after NICT between 2020 and 2023,was performed.Ddimer and fibrinogen concentrations were measured one week before NICT,and again one week before surgery,to analyze the association between these two indicators and their combined indices[non-hypercoagulation(D-dimer and fibrinogen concentrations within the upper limit of normal)vs hypercoagulation(D-dimer or fibrinogen concentrations above the upper limit of normal)]with prognosis.After radical resection,patients were followed-up periodically.The median follow-up duration was 21 months.RESULTS Data collected after NICT revealed that the three-year overall survival(OS)and disease-free survival(DFS)rates the non-hypercoagulation group were significantly better than those in the hypercoagulation group[94.4%vs 78.0%(P=0.019)and 87.0%vs 68.0%(P=0.027),respectively].Multivariate analysis indicated that hypercoagulation after NICT was an independent factor for poor postoperative OS[hazard ratio(HR)4.436,P=0.023]and DFS(HR 2.551,P=0.039).Pre-NICT data demonstrated no statistically significant difference in three-year OS between the non-hypercoagulation and hypercoagulation groups(88.3%vs 84.1%,respectively;P=0.443).CONCLUSION Hypercoagulation after NICT is an effective prognostic indicator in patients with LAGC undergoing radical gastrectomy.
文摘BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma(HCC),underscoring the urgent need for higher-level research in this area.AIM To investigate the association of multidisciplinary treatment strategies with the immunological,coagulation,and tumor biomarker responses after post-TACE in HCC.METHODS This retrospective analysis included 100 patients with HCC who were categorized based on the treatment approach into the control(patients treated with TACE alone)and experimental groups(patients receiving multidisciplinary treatment strategies post-TACE).Participant characteristics,short-term efficacy,and safety assessment as well as immunological,coagulation,and tumor biomarker res-ponses between the two groups were collected and compared.RESULTS Compared with the control group,the experimental group demonstrated a superior overall response rate,along with an increased fibrinogen,markedly improved immunological biomarker,lower prothrombin time,thrombin time,alpha-fetoprotein,carcinoembryonic antigen,and carbohydrate antigen 199 levels,as well as a decreased abnormal prothrombin incidence,and a lower overall rate of adverse reactions.Notably,no significant difference in the activated partial thromboplastin time and D-dimer levels was observed between the two groups.CONCLUSION Multidisciplinary treatment strategies post-TACE have improved the treatment outcome,the immunological response,and the coagulation function,lowered the tumor biomarker response levels,and reduced the risk of adverse reactions in patients with HCC.
文摘Gastric cancer(GC)has remained one of the leading causes of cancer-related deaths globally.The development of noninvasive biomarkers in cancer diagnosis and treatment has gained substantial traction in recent years.Recent evidence highlights hypercoagulation as a promising prognostic biomarker,particularly in locally advanced GC(LAGC)who underwent radical resection after neoadjuvant immunochemotherapy(NICT).A recent study by Li et al showed that hypercoagulation is a valuable prognostic indicator for patients with LAGC who have undergone radical resection following NICT.While the study addresses an important clinical issue and provides insightful findings,the present study offered valuable insights;the applicability of these findings was constrained by the retrospective design,the focus on a single center,and the small sample size of the existing studies.Additionally,vital confounders,such as preoperative comorbidities and systemic inflammation,are inadequately addressed.Future studies should focus on prospective multicenter trials,incorporating advanced predictive models such as machine learning algorithms to integrate coagulation markers with other clinical variables for personalized risk stratification.In addition,we are required to validate findings to examine the biological mechanisms correlating hypercoagulation to tumor progression.Integrating machine learning,comprehensive biomarker panels,and real-world data would allow the researchers to have personalized risk stratification,improve predictive accuracy,and optimize clinical decision-making.Finally,A multidisciplinary approach,including lifestyle interventions and imaging modalities,is essential to improve outcomes among patients with GC.
文摘This letter to the editor involves the article published in the World Journal of Gastrointestinal Oncology.Bone metastasis(BM)in gastric cancer(GC)is uncommon but can be prevalent in autopsy studies.BM significantly impairs quality of life and is frequently underdiagnosed,as sensitive diagnostic tests are only performed after symptoms occur.Imaging is crucial for the diagnosis of BM but is not routinely used for screening and is expensive.Examining laboratory risk factors for BM in GC patients using multivariate analysis could be a more effective approach.
基金supported by the National Natural Science Foundation of China(No.82302607)the Guangdong Basic and Applied Basic Research Foundation(Nos.2022A1515110555 and 2023A1515010932)+3 种基金the State Key Laboratory of Respiratory Disease(No.SKLRD-Z-202410)the Precision Medicine Joint Foundation of Basic and Applied Basic Research Foundation of Guangdong Province(No.2021B1515230008)the Independent Project of Guangdong-Hong Kong-Macao Joint Laboratory for Respiratory Infectious Diseases(No.GHMJLRID-Z-202102)the Guangdong Zhong Nanshan Medical Foundation(No.ZNSXS-20220015).
文摘The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine.Despite their reliability,traditional laboratories often lag in terms of rapid diagnosis.Point-of-care testing(POCT)has emerged as a promising alternative,which is awaiting rigorous validation.We assessed 226 samples from patients at the First Affiliated Hospital of Guangzhou Medical University using a Beckman Coulter AU5821 and a PUSHKANG POCT Biochemistry Analyzer MS100.Furthermore,350 samples were evaluated with a Stago coagulation analyzer STAR MAX and a PUSHKANG POCT Coagulation Analyzer MC100.Metrics included thirteen biochemical indexes,such as albumin,and five coagulation indices,such as prothrombin time.Comparisons were drawn against the PUSHKANG POCT analyzer.Bland-Altman plots(MS100:0.8206-0.9995;MC100:0.8318-0.9911)evinced significant consistency between methodologies.Spearman correlation pinpointed a potent linear association between conventional devices and the PUSHKANG POCT analyzer,further underscored by a robust correlation coefficient(MS100:0.713-0.949;MC100:0.593-0.950).The PUSHKANG POCT was validated as a dependable tool for serum and whole blood biochemical and coagulation diagnostics.This emphasizes its prospective clinical efficacy,offering clinicians a swift diagnostic tool and heralding a new era of enhanced patient care outcomes.
基金National Natural Science Foundation(51208122)Department of Science and Technology of Guangdong Province(2010B030900008)New Special Science and Technology Project of Pearl River and College Students’Innovative Entrepreneurial Training Plan Project in Guangdong Province~~
文摘[Objective] The aim was to treat acidic wastewater containing thallium by enhanced coagulation oxidation process. [Method] Enhanced coagulation oxidation process was made use of to remove thallium in the acidic wastewater in the experiment under the condition of 0.05 kg/L of potassium permanganate, 30% hydrogen peroxide and 0.05 kg/L calcium hypochlorite as oxidant, together with 0.092 kg/L CaO as coagulation. [Result] The results showed that thallium removal efficiencies achieved 99.98%, 99.1% and 99.95% when dosages of KMnO4, H2O2and Ca（ClO）2were added at 20, 2.2 and 37 ml, respectively, under the condition of 30 ml 0.092kg/L CaO being dosed and 99.93%, 99.69% and 99.98% were achieved when different dosages of CaO were added at 25, 35 and 25 ml, under the condition of 20ml KMnO4, 2.2 ml H2O2and 37 ml Ca（ClO）2respectively. [Conclusion] The experiment demonstrates that good removal effects of removal thallium from the acidic wastewater would be achieved by enhanced coagulation oxidation process.
文摘Snake venoms,especially those from the two subfamilies,Crotalinae and Viperinae,contained a lot of serine proteases. They were responsible for the hemorrhage,shock,or disorder of blood coagulation after envenomation. They acted,by activating,inactivating,or other converting effects,on almost all the components of hemostatic and fibrinolytic systems. Their sequences were homologous to trypsin-kallikrein serine proteases. Variation of primary sequences out of active center results in the difference of substrate specificities and the further difference of biological and pharmacological activities. Because of their common and unique properties compared to their physiological corresponding factors,snake venom proteases are proved to be an excellent model for the study of protease substrate discriminating mechanism. Furthermore,they have found an important position both in basic research and application of hemostasis and thrombosis in clinic.
文摘Objective: To evaluate the efficacy and safety of percutaneous microwave coagulation therapy (PMCT) for patients with primary and metastatic hepatic tumors.Methods: The enrolled 100 patients with 186 tumor nodules who underwent PMCT included 79 cases of primary or recurrent liver cancers and 21 cases of metastatic liver cancer. The tumors were divided into two groups according to the tumor size in diameter: group A, 0.5 cm?<3 cm; group B, ≥3 cm?<5 cm. Under local and/or epidural anesthesia, a single percutaneous microwave antenna (or two antennas array applicator) was inserted directly into the tumor in the liver for thermo-coagulation with the aid of ultrasound guidance.Results: Among the 186 lesions in 100 patients with primary and metastatic liver cancers, in group A, 123 (66%) were coagulated once. A Follow-up of 6–12 months demonstrated that 112 lesions (91%) showed no local recurrence by CT or MRI; In group B, of the 63 lesions (33.87%) coagulated twice, 31 (49%) showed no local recurrence by CT or MRI during a follow-up of 6 months. There were no serious clinical side effects or complications in all the PMCT patients.Conclusion: PMCT gives satisfactory curative effect on tumors with <3 cm in size. It is partly effective on lesions ≥3 cm?<5 cm in size. It is a minimally invasive and effective therapy, can be used safely in the field of percutaneous hepatis surgery, and carried out even in patients with poor liver function. Key words hepatocellular carcinoma - microwave - coagulation - therapy
文摘Cyclovirobuxine D （CVB-D） is a compound extracted from Chinese traditional plant Buxus microphylla, which has been used for treating arrhythmia and myocardial ischemia in China. In this study, we investigated its effect on blood coagulation and thrombotic formation in mouse and rat models. The doses of CVB-D used in this study （5-20 mg/kg） prolonged clotting time （CT） in a dose-dependent manner （P〈0.01）. It also significantly prolonged thrombin time （TT）, prothrombin time （PT） and activated partial thromboplast time （aPTT） （P〈0.05 or P〈0.01） at the doses of 10-20 mg/kg. CVB-D did not affect the bleeding time （BT） compared with the control group, while warfarin significantly prolonged the bleeding time. CVB-D at the doses of 5-20 mg/kg reduced wet weight of thrombosis （P〈0.01）. This study demonstrated the anti-coagulation effect and anti-thrombosis effect of orally administered CVB-D without substantially increasing bleeding. These findings suggest that CVB-D probably can be used as an oral anti-coagulant in addition to its current applications.
基金The National Natural Science Foundation of China(No.61504027)the Natural Science Foundation of Jiangsu Province(No.BK20140647)the Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘A composite control scheme consisting of modepredictive control （MPC） and disturbance observer （DOB） iproposed to solve the control performance degradationproblem of the turbidity of the treated water in the presence osignificant changes in raw water quality, water flow rate andinternal model mismatch disturbances. The MPC is employedas a feedback controller for the coagulation process with alarge time delay. The DOB is adopted to estimate the severedisturbances in the turbidity control, such as large changes inraw water quality and water flow rate. The estimated valuesare applied for feed-forward compensation to rejecdisturbances. Finally, the disturbance rejection performancesfor step disturbances and time-varying disturbances in thenominal case and model mismatch case are tested. Thesimulation results illustrate that, compared with the MPCmethod, the proposed method can significantly improve thedisturbance rejection performance in the turbidity control othe treated water, no matter if in the presence of externadisturbances or internal model mismatch disturbances.
基金Project supported by the Hi-Tech Research and Development Project(863) of China (No. 2002AA601130)the National Science and Technology Research Project (No, 2003BA808A17)
文摘The purpose of this study is to understand the effect and mechanism of preventing membrane fouling, by coagulation pretreatment, in terms of fractional component and molecular weight of natural organic matter （NOM）. A relatively higher molecular weight （MW） of hydrophobic compounds was responsible for a rapid decline in the ultrafiltration flux. Coagulation could effectively remove the hydrophobic organics, resulting in the increase of flux. It was found that a lower MW of neutral hydrophilic compounds, which could remove inadequately by coagulation, was responsible for the slow declining flux. The fluxes in the filtration of coagulated water and supernatant water were compared and the results showed that a lower MW of neutral hydrophilic compounds remained in the supernatant water after coagulation could be rejected by a membrane, resulting in fouling. It was also found that the coagulated flocs could absorb neutral hydrophilic compounds effectively. Therefore, with the coagulated flocs formed on the membrane surface, the flux decline could be improved.
文摘There is wide variation in the management of coagulation and blood transfusion practice in liver transplantation. The use of blood products intraoperatively is declining and transfusion free transplantations take place ever more frequently. Allogenic blood products have been shown to increase morbidity and mortality. Primary haemostasis, coagulation and fibrinolysis are altered by liver disease. This, combined with intraoperative disturbances of coagulation, increases the risk of bleeding. Meanwhile, the rebalancing of coagulation homeostasis can put patients at risk of hypercoagulability and thrombosis. The application of the principles of patient blood management to transplantation can reduce the risk of transfusion. This includes: preoperative recognition and treatment of anaemia, reduction of perioperative blood loss and the use of restrictive haemoglobin based transfusion triggers. The use of point of care coagulation monitoring using whole blood viscoelastic testing provides a picture of the complete coagulation process by which to guide and direct coagulation management. Pharmacological methods to reduce blood loss include the use of anti-fibrinolytic drugs to reduce fibrinolysis, and rarely, the use of recombinant factor VIIa. Factor concentrates are increasingly used; fibrinogen concentrates to improve clot strength and stability, and prothrombin complex concentrates to improve thrombin generation. Non-pharmacological methods to reduce blood loss include surgical utilisation of the piggyback technique and maintenance of a low central venous pressure. The use of intraoperative cell salvage and normovolaemic haemodilution reduces allogenic blood transfusion. Further research into methods of decreasing blood loss and alternatives to blood transfusion remains necessary to continue to improve outcomes after transplantation.
基金supported by the National Natural Science Foundation of China (No. 20971112)the Major Public Service Project of Henan Province (No. 101100910300)+1 种基金the Natural Science Research Pro- gram of Education Department in Henan Province (No. 2011A610012)the Science and Technology Program of Zhengzhou City (No. 10PTGG339-4)
文摘The aim of the present work was to produce a polyaluminium ferric silicate chloride （PAFSiC） coagulant from acidic and alkaline wastewater of purifying graphite by roasting, and subsequently to evaluate coagulation efficiency of the reagent by treating surface water from the Yellow River as well as municipal wastewater in comparison with the conventional coagulant polyaluminium chloride （PAC）. The PAFSiC coagulant was prepared by co-polymerization. The effects of （Al＋Fe）/Si molar ratio, OH/（Al＋Fe） molar ratio （i.e., γ value）, coagulant dosage and pH value of test suspension on the coagulation behavior of FAFSiC and the stability of the PAFSiC were also examined. Results showed that PAFSiC performed more efficiently than PAC in removing turbidity, chemical oxygen demand （COD）, and total phosphate （TP）. The PAFSiC with a γ value of 2.0 and （Al＋Fe）/Si ratio of 5 （PAFSiC 2.0/5） showed excellent coagulation effect for both turbidity and COD, while PAFSiC 1.0/5 was the best for TP. The optimum coagulation pH range of PAFSiC 2.0/5 was 5.0–9.0, slightly wider than that of PAC （6.0–8.0）. The process can be easily incorporated into high-purity graphite production plants, thereby reducing wastewater pollution and producing a valuable coagulant.
基金The project was supported by the National Natural Science Foundation of China (10372090)the Doctoral Program of Higher Education of China (20030335001)
文摘Coagulation and growth of nanoparticles subject to large coherent structures in a planar jet has been explored by using large eddy simulation. The particle field is obtained by employing a moment method to approximate the nanoparticle general dynamic equa- tion. An incompressible fluid containing particles of 1 nm in diameter is projected into a particle-free ambient. The results show that the coherent structures dominate the evolution of the nanoparticle number intensity, diameter and polydispersity distributions as the jet develops. In addition, the coherent structures act to increase the diffusion of particles, and the vortex rolling-up makes the particles distributing more irregularly while the vortex pairing causes particle distributions to become uniform. As the jet travels downstream, the time-averaged particle number concentration becomes lower in the jet core and higher in the outskirts, whereas the time- averaged particle mass over the entire flow field maintains unaltered, and the time-averaged particle diameter and geometric standard deviations grow and reach their maximum on the interface of the jet region and the ambient.
基金supported by the National Natural Science Foundation of China(No.51808530)
文摘In order to evaluate the influence of particle size and particle concentration on the coagulation process, two kinds of particle suspensions, nanoparticles and microparticles,were employed to investigate the effect of particle size on coagulation mechanisms with varying coagulation parameters. Results showed that it is easier for nanoparticles to cause self-aggregation because of Brownian motion, while interception and sedimentation are the mainly physical processes affecting particle transport for microparticles, so they are more stable and disperse more easily. The particle size distribution and particle concentration had distinct influence on the coagulation mechanisms. Under neutral conditions, as the amount of coagulant increased, the coagulation mechanism for nanoparticles changed from charge neutralization to sweep flocculation and the nanoparticles became destabilized, re-stabilized and again destabilized. For microparticles, although the coagulation mechanism was the same as that of nanoparticles, the increased rate of aluminum hydroxide precipitation exceeded the adsorption of incipiently formed soluble alum species, resulting in the disappearance of the re-stabilization zone. Under acidic conditions, Brownian motion dominates for nanoparticles at low particle concentrations, while sweep flocculation is predominant at high particle concentrations. As for microparticles, charge neutralization and sweep flocculation are the mechanisms for low and high particle concentrations respectively.Under alkaline condition, although the mechanisms for both nano-and microparticles are the same, the morphology of flocs and the kinetics of floc formation are different. At low particle concentrations, nanoparticles have larger growth rate and final size of flocs, while at high particle concentrations, nanoparticles have higher fractal dimension and recovery factors.
文摘Water supply and sanitation demands are foreseen to face enormous challenges over the coming decades to meet the fast growing needs in a global perspective. Significant growth in the industry is predicted and membrane separation technologies have been identified as one of the possible solutions to meet future demands. Application and implementation of membrane technology is expected both in production of potable water as well as in treatment of wastewater. In potable water production membranes are substituting conventional separation technologies due to the superior performance, potential for less chemical use and sludge production, as well as the potential to fulfill hygienic barrier requirements. Membrane bio-reactor （MBR） technology is probably the membrane process which has had most success and has the best prospects for the future in wastewater treatment. Trends and developments indicate that this technology is becoming accepted and is rapidly becoming the best available technology for many wastewater treatment applications. A major drawback of MBR systems is membrane fouling. Studies have shown that fouling mitigation in MBR systems can potentially be done by coupling coagulation and flocculation to the process.
