Background With the progression of industrialization, an increasing number of emerging contaminants are entering aquatic environments, posing significant threats to the safety of drinking water. Therefore, establishing a system for identifying unknown hazardous factors and implementing safety warning mechanisms for drinking water is of paramount importance. Among these efforts, non-target screening plays a critical role, but its effectiveness is largely constrained by the scope of coverage of sample pre-treatment methods. Objective To integrate modern chromatography/mass spectrometry techniques with advanced data mining methods to develop a non-discriminatory sample pre-treatment method for comprehensive enrichment of unknown contaminants in drinking water, laying a technical foundation for the discovery and identification of unknown organic hazardous factors in drinking water. Methods A non-discriminatory pre-treatment method based on supramolecular and solid-phase extraction was developed. The final target compounds including 333 pesticides, 194 pharmaceuticals and personal care products (PPCPs), and 59 per- and polyfluoroalkyl substances (PFASs) were used for optimizing the pre-treatment method, confirming its coverage. The impacts of different eluents on the absolute recovery rates of target compounds were compared to select the conditions with the highest recovery for sample pre-treatment. The effects of different supramolecular solvents and salt concentrations on target compound recovery were also evaluated to determine the most suitable solvent and salt concentration. Results The solid-phase extraction elution solvents, supramolecular extraction solvents, and salt concentrations were optimized based on the target compound recovery rates. The optimal recovery conditions were achieved using 2 mL methanol, 2 mL methanol (containing 1% formic acid), 2 mL ethyl acetate, 2 mL dichloromethane, hexanediol supramolecular solvent, and 426 mg salt. The detection method developed based on these conditions showed a good linear relationship for all target compounds in the range of 0.1-100.0 ng·mL⁻¹, with R² > 0.99. The method’s limit of detection ranged from 0.01 ng⁻¹ to 0.95 ng⁻¹, and 95% of target compounds were recovered in the range of 20%-120%, with relative standard deviation (RSD) less than 30%, indicating good precision. Conclusion The combined pre-treatment method of solid-phase extraction and supramolecular solvent extraction can effectively enrich contaminants in drinking water across low, medium, and high polarities, enabling broad-spectrum enrichment of diverse trace contaminants in drinking water. It provides technical support for broad-spectrum, high-throughput screening and identification of organic pollutants in drinking water, and also serves as a reference for establishing urban drinking water public safety warning systems.

Background Per- and polyfluoroalkyl substances (PFAS) are a class of persistent organic pollutants that possess potential toxicity to the human body. The production and utilization of diverse emerging PFAS have resulted in widespread human exposure. Therefore, it is imperative to establish a quantitative methodology encompassing a wide range of PFAS for a comprehensive assessment of human exposure to these compounds. Objective To establish a high-throughput quantitative method for the simultaneous determination of 53 PFAS in human serum based on ultra-high-performance liquid chromatography-Q Exactive high resolution mass spectrometry (UPLC-Q Exactive HRMS). Methods The extraction recoveries of hydrophilic-lipophilic balance (HLB) column, weak anionexchange (WAX) column, and 96-well WAX μElution plate were compared to select the SPE column with the highest recovery. The retention time and peak shape of the target compounds were compared between ACQUITY UPLC BEH C₁₈ column and Accucore aQ column, and the more cost-effective column was chosen. The effects of adding different levels of ammonium formate (0, 2, 5 and 10 mmol·L⁻¹) in mobile phase on peak shape and target response were compared to determine the optimal buffer salt concentration. The optimal spray voltage was obtained by comparing −2 kV and −4 kV. The proposed method was validated from the aspects of selectivity, standard curve, limits of detection, precision, accuracy, and matrix effect. The method was applied to 142 umbilical serum samples. Results The best recovery rate (64%-118%) was achieved by using 96-well WAX μElution plate. The optimal separation and peak shape were obtained by utilizing Accucore aQ column with H₂O-methanol (containing 5 mmol·L⁻¹ ammonium formate) as the mobile phase. Less in-source collision and better target response were observed when the spray voltage was set to −2 kV. All target analytes had a good linearity, with R² > 0.99. The limits of detection ranged from 0.01 to 0.50 μg·L⁻¹, and the recovery ranged from 69% to 127% with the precision less than 26%. A total of 31 PFAS were detected in the 142 actual samples, among which 14 PFAS had a detection frequency over 50%. Perfluorooctanoic acid showed the highest median concentration of 4.16 μg·L⁻¹, followed by 6:2 chlorinated polyfluorinated ether sulfonate and perfluorooctane sulfonates (3.50 μg·L⁻¹ and 1.59 μg·L⁻¹, respectively). Conclusion In this study, we establish a UPLC-Q Excative HRMS method for simutanious determination of 53 PFAS concentrations in serum. This method has the advantages of wide coverage of PFAS, good selectivity, and easy operation, and is suitable for biological detection with a large sample size.

OBJECTIVE To establish an HPLC method for investigating the stability of mandelonitrile in commonly used solvents and quantitation determination of mandelonitrile in Jian’er Qingjie mixture. METHODS The assay was performed on an Agilent TC-C18(250 mm×4.6 mm, 5 μm) column with a mobile phase consisting of acetonitrile-0.1% phosphoric acid(23∶27) pumped at a flow rate of 1.0 mL·min–1. The column temperature was 30 ℃ and the detection wavelength was set at 207 nm. The stability of the mandelonitrile solution prepared with solvents such as methanol, 95% ethanol, acetonitrile, water, phosphoric acid solution with pH 2.0−6.0, and acetonitrile solution containing 1.0% glacial acetic acid was investigated using the peak reduction rate as the indicator. RESULTS Mandelonitrile was labile in methanol, 95% ethanol or water and relatively stable in acetonitrile. The standard solutions of mandelonitrile prepared with phosphoric acid solutions at pH 2.0−3.5 or acetonitrile containing 1.0% glacial acetic acid were stable in 12 h. The linear range of mandelonitrile was 1.033−294.987 µg·mL–1(r=0.999 9) and the average recovery was 97.4% with RSD of 0.6%(n=9). The content range of mandelonitrile in 16 batches of Jian’er Qingjie mixture produced by 5 manufactures was 3.854−154.578 µg·mL–1. CONCLUSION The established method is simple and accurate. It can be used for the quality control of Jian’er Qingjie mixture. For almond aromatic water and its preparations, the influence of solvent on stability of mandelonitrile should be noticed.

Objective:To understand the clinical characteristics of stenotrophomonas maltophilia（SMA）infections in pediatric patients.Methods:This was a retrospective observational study.The children diagnosed with SMA infections between January 2018 and June 2023 at Shanghai Children's Medical Center were selected as the study population.The clinical characteristics of patients were analyzed.According to the outcome,the patients were categorized into survival and death groups to compare the clinical characteristics.Results:A total of 70 patients were included in the study,including 23 females and 47 males,with an onset age of 9.0 (3.0,12.6) years old.Sixty-five (92.9%) patients had underlying malignancies，primarily hematologic and solid tumors,of which 24(34.3%) cases underwent bone marrow hematopoietic stem cell transplantation,and 18(25.7%) cases underwent chimeric antigen receptor T cell immunotherapy (CAR-T).Forty (57.1%) cases of SMA infection sites were respiratory infections,19 (27.1%) cases were bloodstream infections,and 11 (15.7%) cases were soft tissue infections.Prior to infection，33（47.14%）patients were treated with glucocorticoids and 63（90.0%）patients with carbapenems.Eventually，39（55.7%）patients were discharged,while 31 patients died,with a mortality rate of 44.3%.Minocycline（100.0%），levofloxacin（98.1%），co-trimoxazole（96.2%），and cefoperazone/sulbactam（94.0%）showed high sensitivity rates to SMA.Compared with the survival group,the death group had a younger age [11.9 (8.4,13.8) years vs.6.3 (2.1,10.0) years],longer hospitalization before infection and duration after stem cell transplantation [28 (23,46) d vs.25 (16,34) d,140 (93，221) d vs.24 (12,49) d],and a higher proportion of pre-infection ICU admission,pre-infection glucocorticoids usage,receiving CAR-T treatment and lymphoma as the underlying disease [26 (83.9%) cases vs.15 (38.46%) cases,22 (71.0%) cases vs.11 (28.2%) cases,13 (41.9%) cases vs.5(12.8%) cases,11（35.5%）cases vs.3（7.7%）cases],and the differences were all statistically significant ( P<0.05). Conclusion:SMA infection pose a serious risk to pediatric patients with malignancies,compromised immune systems and exposured to broad-spectrum antibiotics.SMA maintains excellent sensitivity to compound sulfamethoxazole，minocycline，levofloxacin，and cefoperazone/sulbactam in pediatric patients.The mortality rate of SMA infection is very high，with longer pre-infection hospitalization，pre-infection ICU admission，pre-infection glucocorticoids usage，older onset age，longer duration after stem cell transplantation,receiving CAR-T treatment and lymphoma as the underlying disease possibly associated with post infection mortality

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To explore the clinical efficacy of retzius-sparing robot-assisted laparoscopic radical prostatectomy with retrograde release of the neurovascular bundle.Methods:From January 2021 to January 2022, the clinical data of 113 patients with retzius-sparing robot-assisted laparoscopic radical prostatectomy (RS-RARP) was retrospectively analyzed. The ages of the optimized group and the standard group were (67.5±6.4) years and (67.7±6.1) years, and the body mass index (BMI) was (25.0±3.2) kg/m 2 and (24.9±3.1) kg/m 2, respectively. The prostate volume was (42.8±15.4) ml and (41.0±17.9) ml, the preoperative PSA was (13.5±13.1) ng/ml and (11.9±16.0) ng/ml, and the preoperative IIEF-5 score was (15.0±4.0) and (14.8±4.2) points, respectively. Gleason scores were (7.2±0.8) points and (7.1±0.9) points, respectively, with no statistical significance ( P>0.05). The clinical stages of cT 2 and cT 3 were 35 and 40 cases in the optimized group and 16 and 22 cases in the standard group, respectively. There were 5 and 11 cases of preoperative neoadjuvant therapy, respectively, with no statistical significance ( P>0.05). The optimized RS-RARP is the blunt dissection of the denonvilliers fascia and forward to the apex of prostate, and retrograde release of the NVB. The operation time, intraoperative blood loss, drainage tube retention time, days of hospital stay, positive rate of pathological margin and incidence of complications were compared. The recovery of urinary continence was evaluated at 2 weeks after the catheter was removed, and the postoperative IIEF-5 score and PSA were followed up at 1 month after the surgery. Immediate urinary continence was defined as the use of 1 pad on the day of radical prostatectomy. Follow-up intervals were no more than 3 months. The log-rank test compared urinary incontinence rates between the two modalities. Results:All 113 cases of surgery were completed, and median follow-up was 16 months. The operation time was (79.7±26.6) min and (149.8±40.1) min, and the intraoperative blood loss was (54.9±24.7) ml and (110.0±83.2) ml, respectively, and the difference was statistically significant ( P<0.01). The retention time of postoperative drainage tube was (5.3±2.1) d and (5.5±2.1) d in the optimal group and the standard group, and the days of hospital stay was (7.6±2.1) d and (8.5±2.3) d, respectively. The positive rate of postoperative pathological margin was 19.6% (10/51) and 24.2% (15/62), respectively. There was no significant difference ( P>0.05). immediate urinary continence was 86.3% (44/51) and 69.4% (43/62) in the optimized group and the standard group, respectively, and the difference was statistically significant ( P=0.033). Postoperative IIEF-5 scores were (13.2±3.3) and (11.0±4.3), respectively, and the difference was statistically significant ( P=0.012). Kaplan-Meier analysis showed that the risk of urinary incontinence was lower in the optimized group ( P=0.02). Conclusions:The optimized RS-RARP might shorten the operation time, reduce intraoperative bleeding, and help the recovery of urinary continence and sexual function to a great extent.

Oxidative stress, due to the disruption of the balance between reactive oxygen species (ROS) generation and the antioxidant defense system, plays an important role in the pathogenesis of rheumatoid arthritis (RA). Excessive ROS leads to the loss of biological molecules and cellular functions, release of many inflammatory mediators, stimulate the polarization of macrophages, and aggravate the inflammatory response, thus promoting osteoclasts and bone damage. Therefore, foreign antioxidants would effectively treat RA. Herein, ultrasmall iron-quercetin natural coordination nanoparticles (Fe-Qur NCNs) with excellent anti-inflammatory and antioxidant properties were constructed to effectively treat RA. Fe-Qur NCNs obtained by simple mixing retain the inherent ability to remove ROS of quercetin and have a better water-solubility and biocompatibility. In vitro experiments showed that Fe-Qur NCNs could effectively remove excess ROS, avoid cell apoptosis, and inhibit the polarization of inflammatory macrophages by reducing the activation of the nuclear factor-κ-gene binding (NF-κB) pathways. In vivo experiments showed that the swollen joints of mice with rheumatoid arthritis treated with Fe-Qur NCNs significantly improved, with Fe-Qur NCNs largely reducing inflammatory cell infiltration, increasing anti-inflammatory macrophage phenotypes, and thus inhibiting osteoclasts, which led to bone erosion. This study demonstrated that the new metal-natural coordination nanoparticles could be an effective therapeutic agent for the prevention of RA and other diseases associated with oxidative stress.

Objective:To investigate the clinical characteristics of SARS-CoV-2 Omicron variant BA.2.2 infection in children with different basic diseases.Methods:A total of 76 children with different basic diseases admitted to Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine from March 2 to June 10, 2022 were retrospectively analyzed in terms of clinical manifestations, supplementary examination, treatment and prognosis.These children were divided into hematologic tumor group and non-hematologic tumor group which included cardiopulmonary disease group, neurological disease group and congenital malformation group.The clinical characteristics and prognosis of SARS-CoV-2 Omicron variant infection in children with basic diseases were analyzed.Results:Among 76 children with basic diseases, 61 patients were newly diagnosed with fever and 15 patients were asymptomatic.There were 26, 22, 20, and 8 cases with hematologic tumor diseases, cardiopulmonary diseases, neurological diseases and congenital malformation, respectively.The average fever time was 3-7 days.There was no significant difference in the clinical manifestations among each group ( P>0.05). However, children with hematological tumors were more prone to single organ or multiple organ dysfunction.The level of C-reactive protein was higher than that in the non-hematologic tumor group, while the white blood cell count, neutrophil count, lymphocyte count and hemoglobin were lower than those in the non-hematologic tumor group.The time of virus negative transformation and the duration of fever were higher than those in the non-hematologic tumor group, with statistical significance ( P<0.05). Among the children in the hematologic tumor group, the blood routine and inflammation indexes of children infected with SARS-CoV-2 after chemotherapy within 2 weeks were worse than those in the non-chemotherapy group, and the duration of fever and the time of virus negative transformation were significantly longer ( P<0.05). Three children with hematologic tumor showed virus positive recovery after chemotherapy and surgical treatment after virus negative transformation. Conclusion:Omicron variant BA.2.2 of SARS-CoV-2 has no serious impact on children with cardiopulmonary diseases, nervous system diseases and congenital malformations.However, the duration of fever and virus positive time in hematologic tumor group extended, especially after chemotherapy.It has an important impact on the formulation of epidemic prevention and timing selection of chemotherapy for children with hematological tumors.

Objective:To investigate the pathogens and drug resistance of bacterial enteritis in children, analyze the clinical characteristics of bacterial enteritis in children, and provide basis for clinical diagnosis and treatment.Methods:The fecal culture strain and drug sensitivity of patients with bacterial enteritis admitted to our hospital from January 2016 to December 2020 were analyzed and summarized, and the clinical characteristics of patients who were infected by Salmonella and Escherichia coli were compared.Results:There were a total of 173 patients, aged from 21 days to 15 years, with a median age of 2.00(1.10, 3.54)years.Bacterial enteritis was most likely to occur in summer and autumn, and the incidence rate was 40.5% and 29.5%, respectively.One hundreds and seventy-three strains of bacteria were cultured in feces, including 148 strains of Salmonella(85.5%), 18 strains of Escherichia coli(10.4%), five strains of Staphylococcus aureus and two strains of Shigella.One hundreds and one of 141 patients who were infected with Salmonella were detected for leukocytes of in feces(71.6%), and four of 16 patients with Escherichia coli were detected for leukocytes(25.0%). The difference was significant( χ2=14.1, P<0.001). Eighty-eight of 113 patients(77.9%) who were infected by Salmonella with increased CRP(CRP>8 mg/L)and the proportion in Escherichia coli infection cases was 6/13(46.2%). There was significant difference( χ2=4.63, P=0.03). The drug sensitivity of Salmonella and Escherichia coli was summarized.There was no carbapenem resistant strain cultured; The sensitivity to piperacillin/tazobactam and cefoperazone/sulbactam was higher than 85%; The sensitivity to cefepime, ceftazidimeand ceftriaxone was higher than 75%; The sensitivity to ampicillin was lower than 30%, and the sensitivity to quinolones was between 20%-40%. Conclusion:Children aged 1-3 years are prone to bacterial enteritis in summer and autumn.The most common pathogens causing bacterial enteritis are Salmonella and Escherichia coli.White blood cells are more easily detected in feces of patients with Salmonella infection, and the increase rate of C-reactive protein in peripheral blood is higher.Patients with bacterial enteritis are recommended to use the third-generation cephalosporins and aforementioned antibiotics and piperacillin/tazobactam for empirical treatment.The sensitivity to quinolones is reduced, and may not be suitable for clinical application.

Objective To investigate the effects of particle size, wind speed and dumping velocity on aerosol concentration distribution during powder dumping in a reprocessing plant. Methods CeO₂ powder was selected as the substitute material of PuO₂. FLUENT software was used to calculate the pouring process of CeO₂ powder under different operation conditions. Then the aerosol concentration distribution under different dumping speeds was measured by particle size spectrometer to verify the accuracy of simulation results. Results The particles with small particle size are more likely to be separated from the mainstream area by the drag force of the surrounding gas, and the radius of the diffusion range also increases with the decrease of the particle size. 2) When the ventilation speed is less than 1 m/s, the dust lifting can be reduced and the concentration of dust particles in the chamber can be reduced to a certain extent. 3) In the process of powder dumping, the spoon is rotated anticlockwise at a speed of 100° in 2～3 s, and less dust aerosol is produced on the right side of the tray. Conclusion When operating the powder particles with smaller particle size, more attention should be paid to the monitoring of aerosol at different positions; the change of air inlet velocity makes the flow field in glove box more complex, and the volume fraction of dust particles is related to the size and location of vortex formed by airflow. The greater the wind speed, the greater the impact on the powder dumping process. The experimental results are basically consistent with the simulation results, and the results show that the lower the dumping speed, the smaller the aerosol concentration near the tray.