Objective: To assess the drinking water quality and its related factors in rural schools in Anhui Province from 2023 to 2025, so as to provide a basis for drinking water management of school. Methods: From July 2023 to December 2025, a total of 920 drinking water samples from rural schools were collected and tested in all 59 counties in Anhui Province by using stratified random sampling. The results were evaluated based on the Standards for Drinking Water Quality. Chi-square test, Chi-square trend test, and Logistic regression analysis were used for statistical analysis. Results: From 2023 to 2025,the compliance rates of drinking water quality in rural schools were 79.06%,84.10%,87.15% respectively,with an overall compliance rate of 84.24%. The water quality compliance rate showed an upward trend over the three years ( χ 2 trend =5.99, P <0.05). Conventional treatment was the predominant water supply mode (74.57%), and rural centralized projects accounted for most water supply facilities (83.70%). Univariate analysis indicated that water samples from surface water sources, large scale water plants, municipal water supply, rural centralized water supply projects, conventional treatment processes and plants with sanitary licenses had significantly higher compliance rates ( χ 2=94.52, 74.39, 253.69, 218.34, 113.34，all P <0.05). Multivariate Logistic regression analysis showed that after adjustment for survey year, water supply mode( OR =4.98, 95% CI =2.55-9.75), sanitary license( OR =2.36, 95% CI =1.29-4.31), and water plant type( OR =3.78, 95% CI =2.04-7.03) were factors associated with the compliance rate of drinking water (all P <0.05). Conclusions Drinking water quality in rural schools across Anhui Province has improved, but the compliance rates of water samples from supplies with unconventional treatment, self supplied facilities, and supplies without health permits are relatively low. The water treatment of water plants should be improved, sanitation management should be strengthened, so as to ensure the safety of drinking water in schools.

Objective:To evaluate the effectiveness of integrated pediatric training course of extracorporeal membrane oxygenation(ECMO)based on simulation teaching.Methods:The instructors of ECMO team of Children′s Hospital of Fudan University developed the teaching curriculum.Team members as a unit were recruited to study simulation-based courses, whose theoretical knowledge, skills and teamwork were assessed, and feedback from the trainees were gathered.Results:Since May 2018, 22 teams of pediatric specialized hospitals or general hospitals have taken part in our ECMO simulation, with totally 132 participants, including 45 ICU doctors(34.1%), 60 ICU nurses(45.5%), 23 thoracic surgeons(17.4%) and four anesthesiologists(3.0%). Twelve of them(9.1%)had a little ECMO experience.After training, the trainees had a high evaluation on each part of the course, with average score more than four, of which the theoretical score was lowest.Their self-evaluation on the theory, skills, teamwork and confidence in the implementation of ECMO had been significantly improved.Most(80.3%)of the trainees were confident to carry out ECMO in their local hospitals.The trainees′ baseline score of theoretical knowledge was 55.2±7.6, and increased to 67.1±7.3 after training( P<0.001). The average teamwork score of the 22 teams was 70.2±8.2, and the qualified rate was up to 86.4%.The most prominent skill problems in operation assessment were no albumin and blood priming(90.9%), non-skill problems were extremely anxious during the overall assessment(84.8%)of the participants, poor team work(74.2%), poor leadership(68.2%). For the feedback of the whole course, 97.0% and 94.7% of the trainees thought that integrated training and simulation teaching were the highlights of the course.At present, 13(59.1%)units have successfully developed ECMO technology after the course, and the number of children treated has been up to 83, with a survival rate of discharge of 54.2%.However, it was found that the skill level of some participants decreased about 2 weeks after the course. Conclusion:As a new attempt of ECMO teaching, this curriculum has achieved certain efficiency in both teaching and clinical practice.At the same time, our study also plays a role in promoting the development of ECMO in pediatrics.

Objective Radiological grade of splenic injury was seldomly used in China trauma center now,though it had been established in 1994 by American Association for Surgery of Trauma (AAST) and widely used.The present study is aimed to analyze the imaging grade and clinical characteristics of traumatic splenic rupture in children,discuss the feasibility of conservative treatment,and the role of radiographic grading during clinical treatment.Methods Information (including age,gender,severity based on radiological findings,treatment strategies,and clinical outcome) regarding 59 hospitalized splenic injury patients whose injuries occurred between 2008 and 2014 was retrospectively analyzed.Results Between 2008 and 2014,59 pediatric patients with splenic injury were treated in our institution.Median age was 9.5 years (range,3 months to 16 years).Of all patients,41 (69.5%) were male.The injuries were primarily caused by traffic crash (45.7%),stumbling/falling from a height (38.9%).According to AAST,5 cases were grade Ⅰ,26 patients grade Ⅱ (44.1%),and 21 cases grade Ⅲ (35.6%),6 over grade Ⅳ,and only one was unclear.Of all patients,25 cases were with the other organs complications.All patients underwent fasting,bed rest,and antibiotics.Only 1 case was transferred to operation during the conservative treatment.Forty-nine patients underwent with CT scan over 2 times.Conclusion Imaging classification helps guide clinical treatment.Conservative treatment is feasible for traumatic splenic injury in children.Early imaging classification of splenic injury may be helpful in clinical judgment,and reduce children radiation exposure.

Objective To summarize the experience in applying a technique of inserting a cannula through right internal jugular vein and common carotid artery to build extracorporeal membrane oxygenation (ECMO) for critically ill children.Method The data of critically ill patients received ECMO support through right internal jugular vein and common carotid artery between December 2011 and December 2015 from Children's Hospital of Fudan University were analyzed retrospectively.The data included diagnosis,age,body weight,time of cannula and ECMO running,complication and prognosis.Result In total 28 patients received ECMO support,3 patients of post-cardiac surgery with transthoracic cannula were excluded.Twenty-five patients inserted cannula through neck vessels were enrolled,15 boys and 10 girls,the median age was 1.8 years (range,1 d-13 years),the median weight was 12.0 (2.8-50.0) kg.All the cannula sites were right internal jugular vein and right common carotid artery,before cannula use 5 patients had been inserted central vein tube and 3 patients with blood filter tube in right internal jugular vein,in one case cannula was applied during cardiopulmonary resuscitation.V-A ECMO had been built for all the cases successfully,the median operation time was (45 ± 26) min.The pump flow was 80-150 ml/(kg · min),the median duration of ECMO support was 153 (14-567) h.Sixteen (64％) patients weaned off ECMO successfully,15 (60％) survived to hospital discharge.About the complication of cannula,six patients developed cannula site bleeding,and two patients required re-fixation of cannula,one patient's external jugular vein had been hurt and sutured for bleeding.Conclusion Application of right jugular vessels to build ECMO is easy and safe for treating the sick children.The skill should be proficient to assure ECMO run and reduce the complications.

Objective To investigate the effect of di-2-ethylhexyl phthalate (DEHP) on the proliferation of SK-N-SH human neuroblastoma cells and its underlying mechanism. Methods Cells were cultured in estrogen-free improved Dulbecco's Modified Eagle's Medium and then divided into 5 groups: no treatment (control group); treated with 17β-estradiol (E_2 group); treated with DEHP (DEHP group); treated with both E_2 and phosphatidylinositol-3-kinases (PI3K) inhibitor LY294002 (E_2 + LY294002 group); treated with both DEHP and LY294002 (DEHP + LY294002 group). The absorbance value (AV) was measured on day 0, 2, and 5. DNA proliferation index (PI) and apoptotic index (AI) were determined by flow cytometry on day 5. Caspase-3 protein, protein-serine-threonine kinase (Akt) and phosphor-Akt (Ser473) protein expression were analyzed by Western blot on day 5. Results The AV of All groups increased on day 2, and 5. The AV of E_2 and DEHP groups were higher than that of the control group (P<0. 001), but the AV of E_2 + LY294002 and DEHP + LY294002 groups were lower than those of E_2 and DEHP groups (P<0.01) on day 2 and 5. On day 5, PI of E_2 and DEHP groups were also higher than that of control (P<0.01). However, PI of E_2 + LY294002 and DEHP + LY294002 groups were lower than those of E_2 and DEHP group (P<0.01) on day 5. There was no significant difference in AI and caspase-3 protein expression among the groups. At the same time, phosphor-Akt (Ser473) protein expression of E_2 and DEHP groups increased obviously, compared with the control group. Compared with E_2 and DEHP groups, E_2 + LY294002 and DEHP + LY294002 groups decreased significantly. However, Akt protein expression was equal among those groups. Conclusions DEHP can promote the growth of SK-N-SH cells to a level similar to that of E_2, with activation of the PI3K/Akt signaling pathway.