To reduce metal pipe corrosion, improve product quality, and meet zero liquid discharge (ZLD) criteria, managing chloride ion concentrations in industrial wastewaters from metallurgical and chemical sectors has become increasingly important. This review provides detailed information on the sources, concentration levels, and deleterious effects of chloride ions in representative industrial wastewaters, and also summarizes and discusses various chloride ion removal techniques, including precipitation, ion exchange, physical separation, and advanced oxidation (AOPs). Among these, AOPs are particularly promising due to their ability to couple with other technologies and the diversity of their auxiliary technologies. The development of dechlorination electrode materials by electro-adsorption (CDI) can be inspired by the electrode materials used in chloride ion battery (CIB). This review also provides insights into exploring the effective combination of multiple chloride removal mechanisms, as well as the development of environmentally friendly composite materials. This review provides a theoretical basis and development direction for the effective treatment and secondary utilization of chlorine-containing industrial wastewater in the future.

The 3-Monochloropropane-1, 2-diol ester (3-MCPDE) and glycidyl ester (GE) are formed at high processing temperatures with the presence of respective precursors. Both are potentially harmful to humans, causing adverse health impacts including kidney damage, reproductive problems, and increased risk of cancer. The presence of 3-MCPDE and GE in palm oil is of particular concern because of its widespread use by the food industry. There are a variety of methods for reducing 3-MCPDE and GE. For example, water washing eliminates mostly inorganic chlorides that, in turn, reduce the formation of 3-MCPDE. 3-MCPDE has also been reduced by up to 99% using combinations of methods and replacing stripping steam with alcohol-based media. Activated carbon, clay, antioxidants, potassium-based salts, and other post-refining steps have positively lowered GE, ranging from 10 to 99%. Several approaches have been successful in reducing these process contaminants without affecting other quality metrics.

Ordinary Portland cement (OPC) is known for its significant contribution to carbon dioxide emissions. Geopolymer has a lower footprint in terms of CO2 emissions and has been considered as an alternative for OPC. A well-developed understanding of the use of fly-ash-based and slag-based geopolymers as separate systems has been reached in the literature, specifically regarding their mechanical properties. However, the microstructural and durability of the combined system after slag addition introduces more interactive gels and complex microstructural formations. The microstructural changes of complex blended systems contribute to significant advances in the durability of fly ash/slag geopolymers. In the present review, the setting time, microstructural properties (gel phase development, permeability properties, shrinkage behavior), and durability (chloride resistance, sulfate attack, and carbonatation), as discussed literature, are studied and summarized to simplify and draw conclusions.

Digestive system malignant tumors are common tumors, and the traditional treatment methods for these tumors include surgical resection, radiotherapy, chemotherapy, and molecularly targeted drugs. However, diagnosis remains challenging, and the early detection of postoperative recurrence is complicated. Therefore, it is necessary to explore novel biomarkers to facilitate clinical diagnosis and treatment. Accumulating evidence supports the crucial role of chloride channels in the development of multiple types of cancers. Given that chloride channels are widely expressed and involved in cell proliferation, apoptosis and cell cycle, among other processes, they may serve as a promising diagnostic and therapeutic target. Chloride intracellular channels (CLICs) are a class of chloride channels that are upregulated or downregulated in certain types of cancer. Furthermore, in certain cases, during cell cycle progression, the localization and function of the cytosolic form of the transmembrane proteins of CLICs are also altered, which may provide a key target for cancer therapy. The aim of the present review was to focus on CLICs as biomarkers for digestive system tumors.

Cl‑/HCO3‑ anion exchangers (AEs), which are members of the solute carrier 4 family, contribute to the exchange of one intracellular HCO3‑ for one extracellular Cl‑. AE2, a vital subtype of the Cl‑/HCO3‑ exchangers, is expressed widely in various cells and tissues in mammals and serves essential roles in the pathophysiological processes of the cardiovascular system and renal tubular reabsorption. Recently, research on the function of AE2 in the digestive system shed new light on its roles in the regulation of cellular and organ physiology. AE2 not only participates in gastric acid secretion, but also mediates bile secretion and digestive cancer development. The aim of the present review was to describe the role of AE2 in the physiology and pathophysiology of the digestive system, with the aim of guiding clinical diagnosis and treatment.

Clinical guidelines include diuretics for the treatment of heart failure (HF), not to decrease mortality but to decrease symptoms and hospitalizations. More attention has been paid to the worse outcomes, including mortality, associated with continual diuretic therapy due to hypochloremia. Studies have revealed a pivotal role for serum chloride in the pathophysiology of HF and is now a target of treatment to decrease mortality. The prognostic value of serum chloride in HF has been the subject of much attention. Mechanistically, the macula densa, a region in the renal juxtaglomerular apparatus, relies on chloride levels to sense salt and volume status. The recent discovery of with-no-lysine (K) (WNK) protein kinase as an intracellular chloride sensor sheds light on the possible reason of diuretic resistance in HF. The action of chloride on WNKs results in the upregulation of the sodium-potassium-chloride cotransporter and sodium-chloride cotransporter receptors, which could lead to increased electrolyte and fluid reabsorption. Genetic studies have revealed that a variant of a voltage-sensitive chloride channel (CLCNKA) gene leads to almost a 50% decrease in current amplitude and function of the renal chloride channel. This variant increases the risk of HF. Several trials exploring the prognostic value of chloride in both acute and chronic HF have shown mostly positive results, some even suggesting a stronger role than sodium. However, so far, interventional trials exploring serum chloride as a therapeutic target have been largely inconclusive. This study is a review of the pathophysiologic effects of hypochloremia in HF, the genetics of chloride channels, and clinical trials that are underway to investigate novel approaches to HF management.

BACKGROUND: This systematic review discusses a clinical physiology aspect of chloride in fluid therapy. Crystalloid solutions are one of the most widely used remedies. While generally used in medicine for almost 190 years, studies focused largely on their safety have only been published since the new millennium. The most widely used solution, normal saline, is most often referred to in this context. Its excessive administration results in hyperchloremic metabolic acidosis with other consequences, including higher mortality rates.
METHODS: Original papers and review articles eligible for developing the present paper were identified by searching online in the electronic MEDLINE database. The keywords searched for included hyperchloremia, hypochloremia, and compound words containing the word \"chloride,\" infusion therapy, metabolic acidosis, renal failure, and review.
RESULTS: A total of 21,758 papers published before 31 May 2020 were identified; of this number, 630 duplicates were removed from the list. Upon excluding articles based on their title or abstract, 1850 papers were screened, of which 63 full-text articles were assessed.
CONCLUSIONS: According to the latest medical concepts, dyschloremia (both hyperchloremia and hypochloremia) represents a factor indisputably having a negative effect on selected variables of clinical outcome. As infusion therapy can significantly impact chloride homeostasis of the body, the choice of infusion solutions should always take into account the potentially adverse impact of chloride content on chloremia and organ function.

Metabolic alkalosis may develop as a consequence of urinary chloride (and sodium) wasting, excessive loss of salt in the sweat, or intestinal chloride wasting, among other causes. There is also a likely underrecognized association between poor salt intake and the mentioned electrolyte and acid-base abnormality. In patients with excessive loss of salt in the sweat or poor salt intake, the maintenance of metabolic alkalosis is crucially modulated by the chloride-bicarbonate exchanger pendrin located on the renal tubular membrane of type B intercalated cells. In the late 1970s, recommendations were made to decrease the salt content of foods as part of an effort to minimize the tendency towards systemic hypertension. Hence, the baby food industry decided to remove added salt from formula milk. Some weeks later, approximately 200 infants (fed exclusively with formula milks with a chloride content of only 2-4 mmol/L), were admitted with failure to thrive, constipation, food refusal, muscular weakness, and delayed psychomotor development. The laboratory work-up disclosed metabolic alkalosis, hypokalemia, hypochloremia, and a reduced urinary chloride excretion. In all cases, both the clinical and the laboratory features remitted in ≤7 days when the infants were fed on formula milk with a normal chloride content. Since 1982, 13 further publications reported additional cases of dietary chloride depletion. It is therefore concluded that the dietary intake of chloride, which was previously considered a \"mendicant\" ion, plays a crucial role in acid-base and salt balance.

The chloride concentration in the plant determines yield and quality formation for two reasons. First, chlorine is a mineral nutrient and deficiencies thereof induce metabolic problems that interfere with growth. However, due to low requirement of most crops, deficiency of chloride hardly appears in the field. Second, excess of chloride, an event that occurs under chloride-salinity, results in severe physiological dysfunctions impairing both quality and yield formation. The chloride ion can effect quality of plant-based products by conferring a salty taste that decreases market appeal of e.g. fruit juices and beverages. However, most of the quality impairments are based on physiological dysfunctions that arise under conditions of chloride-toxicity: Shelf life of persimmon is shortened due to an autocatalytic ethylene production in fruit tissues. High concentrations of chloride in the soil can increase phyto-availability of the heavy metal cadmium, accumulating in wheat grains above dietary intake thresholds. When crops are cultivated on soils that are moderately salinized by chloride, nitrate fertilization might be a strategy to suppress uptake of chloride by means of an antagonistic anion-anion uptake competition. Overall, knowledge about proteins that catalyse chloride-efflux out of the roots or that restrict xylem loading is needed to engineer more resistant crops.

BACKGROUND: Fluid resuscitation is the cornerstone in treatment of shock, and intravenous fluid administration is the most frequent intervention in operation rooms and intensive care units (ICUs). The composition of fluids used for fluid resuscitation gained interest over the past decade, with recent focus on whether balanced solutions should be preferred over isotonic saline.
METHODS: Systematic review and meta-analysis of randomized controlled trials (RCTs) comparing fluid resuscitation with a balanced solution versus isotonic saline in adult patients in operation room or ICUs. Primary outcome was in-hospital mortality, secondary outcomes included occurrence of acute kidney injury (AKI) and need for renal replacement therapy (RRT).
RESULTS: The search identified 11 RCTs involving 2,703 patients; 8 trials were conducted in operation room and 3 in ICU. In-hospital mortality, as well as the occurrence of AKI and need for RRT was not different between resuscitation with balanced solutions versus isotonic saline, neither in operation room nor in ICU patients. Serum chloride levels, but not arterial pH, were significantly lower in patients resuscitated with balanced solutions.
CONCLUSIONS: Currently evidence insufficiently supports the use of balanced over isotonic saline for fluid resuscitation to improve outcome of operation room and ICU patients.