This study explores the effectiveness of an integrated anaerobic membrane bioreactor (AnMBR) coupled with an anoxic/oxic membrane bioreactor (A/O MBR) for the treatment of natural rubber industry wastewater with high sulfate, ammonia, and complex organic contents. This study was conducted at the lab-scale over a duration of 225 days to thoroughly investigate the efficiency and sustainability of the proposed treatment method. With a hydraulic retention time of 6 days for the total system, COD reductions were over 98%, which reduced the influent from 22,158 ± 2859 mg/L to 118 ± 74 mg/L of the effluent. The system demonstrates average NH3-N, TN, and total phosphorus (TP) removal efficiencies of 72.9 ± 5.7, 72.8 ± 5.6, and 71.3 ± 9.9, respectively. Despite an average whole biological system removal of 50.6%, the anaerobic reactor eliminated 44.9% of the raw WW sulfate. Analyses of membrane fouling revealed that organic fouling was more pronounced in the anaerobic membrane, whereas aerobic membrane fouling displayed varied profiles due to differential microbial and oxidative activities. Key bacterial genera, such as Desulfobacterota in the anaerobic stage and nitrifiers in the aerobic stage, are identified as instrumental in the biological processes. The microbial profile reveals a shift from methanogenesis to sulfide-driven autotrophic denitrification and sulfammox, with evidence of an active denitrification pathway in anaerobic/anoxic conditions. The system showcases its potential for industrial application, underpinning environmental sustainability through improved wastewater management.

The dissolved organic matter (DOM) should be purified for safe drinking water due to disinfection by-products (DBPs) produced by disinfectants reaction with DOM. Current research on groundwater in the chronic kidney disease with unknown etiology (CKDu) zone of the North Central Province (NCP) in Sri Lanka has focused mainly on aquatic chemistry, with limited attention paid to the spatial distribution, compositional sources and factors of DOM. Therefore, the structure, composition, source and spatial distribution of the DOM of two kinds of groundwater samples collected from dug well and tube well in the NCP during the wet season were determined, compared and analyzed by analytical tools such as parallel factor analysis (PARAFAC). Results show that the average concentrations of TOC in these two groundwater samples are generally higher than 5.0 mg/L, and the concentration of TOC in the groundwater of the shallow weathered aquifer is higher than that of the deep hard rock aquifer, while its distribution of the two aquifers are on contrary. The DOM in the dug well has three types and four components, including humus-like component C1 (33.36%) and C2 (38.60%), protein-like component C3 (13.09%) and heterogeneous organic component C4 (14.95%). In the tube well, two types and two components of the DOM are determined, including humus-like component CⅠ (69.80%) widely existing in natural water and soluble microbial by-product CⅡ (30.20%) produced by microbial community activities. In the dug well, DOM is mainly exogenous input, the higher ion concentration in water affected the fluorescence intensity of humus and protein components. And in the tube well, DOM has obvious endogenous characteristics, and higher pH value may inhibit the production of protein like fluorescent substances to a certain extent.

全科医学临床技能是全科医师必备的基本技能,是全科医学教育教学中的难点和重点.虚拟仿真教学平台是将仿真技术、多媒体技术和计算机技术结合起来而产生的一种新型医学教育范式.在全科医学临床技能教学中,虚拟仿真教学与临床技能教学的结合可极大地提高其教学效率和质量,是全科医学教育教学改革的重要举措之一.

The health effect of antibiotic resistance genes (ARGs) remains to pose a major threat to the humans and environment, while little is known about the dynamic characteristics of different types of ARGs in the urban river systems, including intra- and extracellular ARGs (iARGs and eARGs). In this study, profiles of iARGs and eARGs and their associate MGEs were quantified using high-throughput quantitative PCR during dry and wet seasons in two typical reclaimed water replenishing urban rivers. Results showed that seasonal variations induced by rainfall significantly affect the absolute abundance and diversity of iARGs and eARGs (p < 0.01), in which absolute abundance of eDNA was approximately an order of magnitude greater than that of iDNA in the dry season. Conversely, rainfall demoted the diversity and absolute abundance of eARGs. Structural equation models (SEM) suggested MGEs, DOM, and pathogen were the predominant factor for eARG. Network analysis suggested tnp-04, tra-A, IS613, and tnpA-7 exhibited co-occurrence with eARGs in river and reservoir systems, regarded as molecular indicators to shape eARGs profiles. Given the findings that rainfall contributed the spread of eARGs, the risk triggered by DOM and pathogen in the river and reservoir system should be devoted more attention.

为实现猪粪中抗生素的有效削减及控制,迫切需要开发快速、同步兽用抗生素的检测分析方法,明确猪粪中多种类抗生素赋存特征.本研究建立并优化了猪粪中21种常见抗生素的同步分析方法.该方法采用甲醇和Na2EDTA-McIlvaine缓冲溶液(1 ∶ 1,V/V)提取,提取液经固相萃取净化后高效液相色谱串联质谱检测.猪粪样品中5种四环素类、2种 内酰胺类、6种大环内酯类、4种磺胺类和4种喹诺酮类抗生素的内标定量回收率29.53％-116.36％,检出限0.90-26 ug·kg-1 DS,定量限2.91-85.20 ug·kg-1 DS,相关系数R2均大于0.997.采用该方法对单个猪场不同畜舍样品加标回收率的单因素方差分析发现,除了四环素-D6(TC-D6)有显著性影响之外,其它内标回收率在不同样品中无显著性影响.分别采集不同地区2个猪场的猪粪样品进行验证分析,发现猪粪样品中单个抗生素含量范围在ND-99.37 mg·kg-1 DS.结果表明,该方法可用于猪粪中多种类抗生素的同步检测.

建制镇是新型城镇化与乡村振兴协调发展的重要载体.研究统计结果数据显示,我国10000～100000人口规模的建制镇数量占全国总建制镇数量的90.92％.建制镇污水产生量则呈现橄榄型分布,且具有较强的地域性:产生量<1000 m3/d的建制镇数量比例为13.12％,主要处在西部地区;产生量为1000～5000 m3/d的建制镇数量为71.03％,均匀分布在中东部地区;产生量>5000 m3/d的建制镇数量为15.85％,地处东部地区.直接套用城市污水处理的相关排放、设计与处理技术标准等"一刀切"方式,使得建制镇污水处理及长效运行面临严峻挑战.因此,以城乡融合发展为指导思想,明确不同区域建制镇污水的产生特征和规模界定范围,通过不同规模与不同排放去向建立建制镇污水分级分类的排放标准,因地制宜进行建制镇污水处理设施的技术路线选择,建立符合我国城乡融合发展进程的建制镇污水治理技术标准化体系对于加快推进新型城镇化与乡村振兴战略中的人居环境改善具有重要意义.

为促进反硝化除磷与厌氧氨氧化工艺的耦合,实现污水氮、磷的同步高效去除,构建序批式反应器(Sequencing batch reactor,SBR),优化了反硝化除磷工艺实现亚硝酸盐积累的工艺参数.SBR在厌氧-缺氧-微好氧运行条件下,缺氧段投加模拟硝酸盐工业废水逐步实现了反硝化除磷过程的亚硝酸盐积累.结果表明,经过142d的培养驯化,在进水C/P比为55时,缺氧段引入NO3-N浓度为23mg/L时,亚硝酸盐积累率为51.01％,NO3-N→NO2-N转化率为40.22％,硝酸盐去除率为72.14％,PO43--P去除率最高达88.17％.出水COD浓度低于25mg/L,COD去除率维持在90％以上.微生物群落结构分析表明,拟杆菌门(Bacteroidetes)、变形菌门(Proteobacteria)、绿弯菌门(Chloroflexi)、酸杆菌门(Acidobacteria)为系统内优势菌门.通过参数优化实现了聚磷菌的驯化,Candidatus Accumulibacter为代表的反硝化聚磷菌丰度增加(累积丰度由1.49％增加到5.08％),以Candidatus Competibacter为代表的反硝化聚糖菌丰度增加更为明显(累积丰度由1.02％增加到15.49％),聚磷菌与聚糖菌的共同作用有利于实现除磷过程的亚硝酸盐累积.

地下水是我国农村地区主要的饮用水来源.选择河南兰考、河北固安、内蒙古磴口和新疆叶城为对象,通过现场调研和采样分析,比较地下水的水化学类型及主要影响因素,分析地下水中溶解性有机物(DOM)组分,并采用水质指数(WQI)评价水质状况.结果表明,四地的地下水中TOC、硬度、Na+、SO24-、NO-3均存在不同程度的超标状况,不能满足《地下水质量标准》(GB/T 14848-2017)Ⅲ类标准要求;兰考地下水的水化学类型以Na·K-HCO3型为主,固安、磴口分别以HCO3·SO4-Na和Cl·SO4-Na型为主,叶城地区以HCO3·SO4-Ca·Na和SO4·Cl-Na·Ca型为主,并受岩石风化、蒸发结晶、阳离子交替吸附作用影响.DOM组分主要为短波类腐殖质组分C1(26.57％)和类蛋白组分C2(73.43％),其中兰考、固安和磴口地下水的DOM以自生源为主,叶城地区兼具外源和自生源特征.WQI评价结果表明,兰考、磴口和叶城的地下水分别有12.5％、80％和75％低于"良好",需进一步净化处理.

针对斯里兰卡CKDu病区饮用水安全保障的需求,分别在雨季和旱季调查了斯里兰卡CKDu病区北中省Anuradhapura地区的地下水水质.结果 表明,地下水中硬度和F-的平均质量浓度分别超过250.0 mg·L-1和1.49 mg·L-1,均高于斯里兰卡饮用水标准(SLS 614-2013),且溶解性有机物(DOC)平均质量浓度大于4.0 mg·L-1.在斯里兰卡Anuradhapura地区Sirimapura村援建以纳滤(NF)膜技术为核心的地下水源饮用水站,于2018年9月投入运行.运行结果表明,NF水站可有效去除地下水的硬度、F-和DOC,硬度、F-的平均截留率分别达80％和85％,DOC可完全去除,产水水质满足斯里兰卡国家饮用水水质标准(SLS 614-2013).NF水站具有易于操作、便于维护、产水水质优异等优点,产水呈弱碱性(pH=7.3),且可保留部分对人体有益的矿物质.

深度融合信息技术,推动医学教育改革的进一步发展已被医学教育者所广泛接受和认可,文中就多种现代信息技术在医学生临床技能教学中的应用进行了初步的探讨,并对现代信息技术深度融合背景下的医学生临床技能培养模式及发展前景做了展望.

Two types of full-scale reactors(SBR, 116.6 m3, activated sludge process; SBBR, 64.8 m3, activated sludge and biofilm process) were inoculated with activated sludge from a swine wastewater treatment plant. The effect of NO2--N concentration on ANAMMOX was investigated in the reactors during the start-up of the combined partial nitritation and ANAMMOX(CPNA) process by controlling the dissolved oxygen(DO), aeration mode, and NaNO2 dosing. The results showed that the SBBR was more suitable for rapid start-up of partial nitritation under the same operation conditions. Despite NO2--N inhibition(100-129 mg·L-1, 7 days), the ANAMMOX process was successfully started by the SBR on day 39, and the total nitrogen removal rate and efficiency(TNRR and TNRE) were 0.069 kg·(m3·d) -1 and 23.3%, respectively. However, 17 days of NO2--N inhibition(129-286 mg·L-1) had an unrecoverable effect on ANAMMOX activity in the SBBR. By adding NaNO2, the SBR successfully started the CPNA process on day 77. The TNRR, TNRE, and activity of ANAMMOX from day 51 to 77 increased rapidly from 0.070 to 0.336 kg·(m3·d) -1, 16.0% to 52.2%, and 0.012 to 0.307 kg·(kg·d) -1, respectively. The gene copy concentration of AOB and ANAMMOX bacteria in the SBR increased from the original 8.06×106 and 4.42×104 copies·mL-1 to 1.02×109 and 1.77×107 copies·mL-1, respectively, which indicated that the rapid enrichment of AOB and ANAMMOX bacteria in the SBR was achieved mainly by controlling DO, aeration mode, and NaNO2 dosing. Reasonable nitrite regulation is the key for the start of the CPNA process.

Antibiotics discharged into the environment cause increased environmental resistance. Four types of antibiotics (quinolones, tetracyclines, macrolides, and β-lactams) were selected for this study. In a comparison with the municipal wastewater plant, the concentration and removal of antibiotics in influent and effluent of domestic wastewater treatment facilities of different scales in villages and towns was investigated using high-performance liquid chromatography (HPLC) and tandem mass spectrometry (MS). The results showed that the highest amount of ofloxacin in rural wastewater treatment facilities reached 32663.5 ng·L-1. Due to the different situations of influent fluctuation, discharge requirements, and management between urban and rural wastewater plants, only 33% of the rural domestic wastewater facilities detected an antibiotics removal rate of more than 60%. The effective removal of some antibiotics can be achieved when the rural domestic wastewater treatment facilities maintain the standard discharge of conventional pollutants.

为考察氨氮浓度对中温厌氧消化处理马铃薯加工废水的影响,通过批式实验,探究该类废水厌氧消化处理的氨氮抑制阈值.结果 表明:氨氮浓度为3 000 mg·L-1 (TAN≈3 659 mg·L-1)时,累积产甲烷量降低至276.1 mL·g-1且出现产甲烷迟滞期;氨氮浓度为4 000 mg·L-1 (TAN≈4 468 mg·L-1)时,累积产甲烷量仅为对照组的39.2％,迟滞期明显延长了7.2 d;高浓度氨氮抑制造成了以丙酸为主的VFAs积累和有机物(蛋白质等)降解不完全,这是COD去除率下降的主要原因;VFAs作为氨氮抑制发生时COD的主要组分,其积累可作为马铃薯加工废水厌氧消化过程发生氨氮抑制的指示因子;马铃薯加工废水中温厌氧消化的氨氮阈值约为3 000 mg·L-1.该结果可为马铃薯加工废水的高效处理与资源化利用提供参考.

N6-甲基腺嘌呤(N6-methyladenosine,m6A)是腺嘌呤(A)第6位氮原子被甲基转移酶催化形成的一种RNA甲基化修饰,是真核生物信使RNA(mRNA)上最多的化学修饰形式.近年来研究发现m6A对RNA在脂肪组织生成、细胞分化和免疫/炎症反应等过程中发挥重要的调控作用.代谢性疾病是由体内蛋白质、葡萄糖和脂质代谢紊乱引起的一类慢性炎症疾病.在肥胖、2型糖尿病和心血管痰病等代谢性疾病的发生发展中,m6A甲基化修饰通过调控糖脂代谢和免疫/炎症发挥着重要角色.文章拟对m6A甲基化在代谢性疾病中的作用做一综述,并从表观转录组学的角度为代谢性疾病的防治提供新的思路.

不明原因肾病(CKDu)是斯里兰卡亟需解决的重要民生问题,其地下水源饮用水中的溶解性污染物可能是重要的致病原因.系统分析了北部中心省内高、低、非发病区及对照区(HR、LR、NR、CR)干湿季地下水的水化学特征和DOM特性,结果表明:地下水主要呈Ca-Mg-HCO3型,硬度和F-超标率较高,是地下水作为饮水安全保障最关键的指标;地下水中DOM主要为自生源,芳香性和腐熟化程度较低,主要为富里酸、腐殖酸和小分子蛋白质类物质;湿季DOM浓度较高,是Fe浓度增加的关键原因;而干季地下水中微生物活性较高,腐殖质和蛋白质发生分解,小分子络氨酸/赖氨酸的浓度增加.同时,发现不同区域地下水中DOM的生物利用性表现为HR＜LR＜NR＜CR.其中,HR区地下水中的DOM最稳定,SUVA为(3.29±0.44) L·(mg·m)-1,芳香性较高.有机无机的相互作用导致赋存形态、生物可利用性的变化可能是CKDu致病的重要原因.针对以上问题,提出“吸附-除F-软化-NF-消毒”的处理策略,通过有机物吸附处理、阴离子交换除F、软化除硬分离预处理及NF深度处理等技术有效解决地下水中DOM、F-、Ca2+和Mg2+超标的问题,实现饮用水的供给.本研究全面分析了CKDu病区地下水中的污染物组成,并提出解决策略,可为斯里兰卡饮用水安全保障提供支撑.

随着技术的不断发展,人工智能在医学诊疗方面的运用越来越广泛,文中阐述了目前人工智能发展的技术水平和特点,对人工智能在医学生临床技能教学中的应用进行了初步探讨,并对人工智能技术在医学教育中的发展前景作了展望.

卓越医生教育培养计划正在深入实施,其中将以学生为中心开展教学、形成学生自主学习能力作为难点着力推进.结合卓医班的改革试点,突出信息技术的应用,支持学生自主学习能力的培养,对临床技能学教学资源进行优化整合,为实现卓医计划项目的实施目标发挥促进作用.

临床技能教学是我国临床医学本科教育阶段的重要内容,是培养学生自主学习和提高学生职业素养的关键环节,更是每个医学生都必须掌握的基本技能.基于问题的学习(problem-based learning,PBL)是使学生在复杂的临床问题中牢固掌握临床基本技能的学习方法和教学模式之一,在国际上已受到广泛认同,因此在国内医学教育界也受到了提倡.由于PBL遵循"以学生为本"的观念,符合现代医学培养模式的思路,总结教师在PBL教学中的定位与职责并阐明教师的多元化作用,有利于推广PBL在卓越医生培养模式下临床技能教学中的应用.

Objective:To evaluate the association between rs2294008 C＞T polymorphism of prostate stem cell antigen (PSCA) gene and the risk of gastric cancer in East Asian by using Metaanalysis.Methods:A computer-based online search was performed in PubMed,Web of Science,Cochrane Library,Google Scholar,China National Knowledge Infrastructure,Chinese BioMedical Literature database,VlP database and Wanfang database.The case-control studies about the association between PSCA rs2294008C＞T polymorphism and gastric cancer in East Asian before June 6,2016 were collected.The literatures were screened according to the inclusion and exclusion criteria,and the data were extracted after the quality analysis.The Meta-analysis was performed by STATA 14.1 software,and the odds ratio (OR) and 95％ confidence interval (CI) were calculated.Furthermore,the subgroup analysis and Metaregression analysis were used to evaluate the confounding factors,and the sensitivity analysis and publication bias test were performed.Results:A total of 13 case-control studies contained 13 667 patients and 11 868 health controls were included.Meta-analysis showed that the carriers with PSCA rs2294008 CT and TT genotypes had significantly higher risk of gastric cancer as compared with other genotype (OR =1.68,95％ CI:1.43-1.96).The polymorphism distribution of PSCA rs2294008 was significantly different among Chinese,Japanese and Korean populations (P =0.001).Subgroup analyses showed that the risk of gastric cancer on the carriers with PSCA rs2294008CT and TT was significantly increased in Chinese (OR =1.36,95％ CI:1.23-1.49,P =0.004),Japanese (OR =2.61,95％ CI:2.22-3.07,P =0.001) and Korean populations (OR =2.04,95％ CI:1.28-3.27,P =0.012) compared with rs2294008 CC.The sub-group analyses also showed that there was no significant difference in the risk of gastric cancer between the controls from hospitals (OR =1.74,95％ CI:1.23-2.44) and ones from communities (OR =1.64,95％ CI:1.40-1.93).The Meta-regression found the differences in countries and control sources were not the major contribution to the heterogeneity in this analysis (P =0.163,P =0.381).The Begg's funnel plots showed no publication bias (corrected P =0.053),and the sensitivity analysis confirmed the data were steady (OR =1.54,95％ CI:1.45-1.64).Conclusion:The polymorphism of PSCA rs2294008 C＞T is closely associated with the risk of gastric cancer in East Asia.

Nanofiltration (NF) is considered to be a promising alternative process for the reuse of wastewater recently. However, membrane fouling is one of the major obstacles for the practical application of NF in the treatment of wastewater. The purpose of this paper is to summarize status of NF membrane fouling in the treatment of wastewater, to thoroughly review the analyze methods and control strategies of membrane fouling, and to propose the future research direction.