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Tuli A, Suresh G, Halder N, Velpandian T. Analysis and remediation of phthalates in aquatic matrices: current perspectives. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:23408-23434. [PMID: 38456985 DOI: 10.1007/s11356-024-32670-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 02/23/2024] [Indexed: 03/09/2024]
Abstract
Phthalic acid esters (PAEs) are high production volume chemicals used extensively as plasticizers, to increase the flexibility of the main polymer. They are reported to leach into their surroundings from plastic products and are now a ubiquitous environmental contaminant. Phthalate levels have been determined in several environmental matrices, especially in water. These levels serve as an indicator of plasticizer abuse and plastic pollution, and also serve as a route of exposure to different species including humans. Reports published on effects of different PAEs on experimental models demonstrate their carcinogenic, teratogenic, reproductive, and endocrine disruptive effects. Therefore, regular monitoring and remediation of environmental water samples is essential to ascertain their hazard quotient and daily exposure levels. This review summarises the extraction and detection techniques available for phthalate analysis in water samples such as chromatography, biosensors, immunoassays, and spectroscopy. Current remediation strategies for phthalate removal such as adsorption, advanced oxidation, and microbial degradation have also been highlighted.
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Affiliation(s)
- Anannya Tuli
- High Precision Bio-Analytical Facility (DST-FIST Sponsored), Ocular Pharmacology and Pharmacy, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Gayatri Suresh
- High Precision Bio-Analytical Facility (DST-FIST Sponsored), Ocular Pharmacology and Pharmacy, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Nabanita Halder
- High Precision Bio-Analytical Facility (DST-FIST Sponsored), Ocular Pharmacology and Pharmacy, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Thirumurthy Velpandian
- High Precision Bio-Analytical Facility (DST-FIST Sponsored), Ocular Pharmacology and Pharmacy, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Zhang X, Xu C, Li Y, Chen Z, Xu F, Zhang H, Ding L, Lin Y, Zhao N. Association between phthalate metabolite mixture in neonatal cord serum and birth outcomes. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 919:170614. [PMID: 38316308 DOI: 10.1016/j.scitotenv.2024.170614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/07/2024]
Abstract
Prenatal exposure to phthalates (PAEs) is ubiquitous among Chinese neonates. PAEs entering the body will be transformed to various hydrolyzed and oxidated PAE metabolites (mPAEs). PAEs and mPAEs exposure may lead to adverse birth outcomes through disruption of multiple hormone signaling pathways, induction of oxidative stress, and alterations in intracellular signaling processes. In this study, the concentrations of 11 mPAEs in 318 umbilical cord serum samples from neonates in Jinan were quantified with HPLC-ESI-MS. Multiple linear regression, Bayesian kernel machine regression, and quantile g-computation models were utilized to investigate the effects of both individual mPAE and mPAE mixture on birth outcomes. Stratified analysis was performed to explore whether these effects were gender-specific. mPAE mixture was negatively associated with birth length (BL) z-score, birth weight (BW) z-score, head circumference (HC) z-score, and ponderal index (PI). Mono(2-ethylhexyl) phthalate (MEHP) manifested negative associations with BL(z-score), BW(z-score), HC(z-score), and PI, whereas mono(2-carboxymethylhexyl) phthalate (MCMHP) was negatively associated with BW(z-score) and PI within the mPAE mixture. Stratified analysis revealed that the negative associations between mPAE mixture and four birth outcomes were attenuated in female infants, while the positive impact of mono(2-ethyl-5carboxypentyl) phthalate (MECPP) on BL(z-score) and BW(z-score) could be detected only in females. In summary, our findings suggest that prenatal exposure to phthalates may be associated with intrauterine growth restriction, and these effects vary according to the gender of the infant.
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Affiliation(s)
- Xiaozhen Zhang
- School of Environmental Science and Engineering, Shandong University, Qingdao 266237, China
| | - Caihong Xu
- School of Environmental Science and Engineering, Shandong University, Qingdao 266237, China
| | - Yahui Li
- Jinan Digital Application Center of Ecology and Environment (Jinan Grid Supervision Center of Ecological and Environmental Protection), Jinan 250102, China
| | - Zhongkai Chen
- Jinan Digital Application Center of Ecology and Environment (Jinan Grid Supervision Center of Ecological and Environmental Protection), Jinan 250102, China
| | - Fei Xu
- School of Environmental Research Institute, Shandong University, Qingdao 266237, China
| | - Haoyu Zhang
- School of Environmental Research Institute, Shandong University, Qingdao 266237, China
| | - Lei Ding
- School of Environmental Research Institute, Shandong University, Qingdao 266237, China
| | - Yongfeng Lin
- Department of Occupational Health and Environmental Health, School of Public Health, Qingdao University, Qingdao 266071, China
| | - Nan Zhao
- School of Environmental and Material Engineering, Yantai University, Yantai 264005, Shandong, China.
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Masinga P, Simbanegavi TT, Makuvara Z, Marumure J, Chaukura N, Gwenzi W. Emerging organic contaminants in the soil-plant-receptor continuum: transport, fate, health risks, and removal mechanisms. ENVIRONMENTAL MONITORING AND ASSESSMENT 2024; 196:367. [PMID: 38488937 DOI: 10.1007/s10661-023-12282-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/29/2023] [Indexed: 03/17/2024]
Abstract
There is a lack of comprehensive reviews tracking emerging organic contaminants (EOCs) within the soil-plant continuum using the source-pathway-receptor-impact-mitigation (SPRIM) framework. Therefore, this review examines existing literature to gain insights into the occurrence, behaviour, fate, health hazards, and strategies for mitigating EOCs within the soil-plant system. EOCs identified in the soil-plant system encompass endocrine-disrupting chemicals, surfactants, pharmaceuticals, personal care products, plasticizers, gasoline additives, flame retardants, and per- and poly-fluoroalkyl substances (PFAS). Sources of EOCs in the soil-plant system include the land application of biosolids, wastewater, and solid wastes rich in EOCs. However, less-studied sources encompass plastics and atmospheric deposition. EOCs are transported from their sources to the soil-plant system and other receptors through human activities, wind-driven processes, and hydrological pathways. The behaviour, persistence, and fate of EOCs within the soil-plant system are discussed, including sorption, degradation, phase partitioning, (bio)transformation, biouptake, translocation, and bioaccumulation in plants. Factors governing the behaviour, persistence, and fate of EOCs in the soil-plant system include pH, redox potential, texture, temperature, and soil organic matter content. The review also discusses the environmental receptors of EOCs, including their exchange with other environmental compartments (aquatic and atmospheric), and interactions with soil organisms. The ecological health risks, human exposure via inhalation of particulate matter and consumption of contaminated food, and hazards associated with various EOCs in the soil-plant system are discussed. Various mitigation measures including removal technologies of EOCs in the soil are discussed. Finally, future research directions are presented.
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Affiliation(s)
- Privilege Masinga
- Department of Soil Science and Environment, Faculty of Agriculture, Environment, and Food Systems, University of Zimbabwe, Mount Pleasant, P. O. Box MP 167, Harare, Zimbabwe
| | - Tinoziva T Simbanegavi
- Department of Soil Science and Environment, Faculty of Agriculture, Environment, and Food Systems, University of Zimbabwe, Mount Pleasant, P. O. Box MP 167, Harare, Zimbabwe
| | - Zakio Makuvara
- Department of Physics, Geography and Environmental Science, School of Natural Sciences, Great Zimbabwe University, Masvingo, Zimbabwe
- Department of Life and Consumer Sciences, School of Agriculture and Life Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Pretoria, South Africa
| | - Jerikias Marumure
- Department of Physics, Geography and Environmental Science, School of Natural Sciences, Great Zimbabwe University, Masvingo, Zimbabwe
- Department of Life and Consumer Sciences, School of Agriculture and Life Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Pretoria, South Africa
| | - Nhamo Chaukura
- Department of Physical and Earth Sciences, Sol Plaatje University, Kimberley, 8301, South Africa
| | - Willis Gwenzi
- Biosystems and Engineering Research Group, 380 New Adylin, Marlborough, Harare, Zimbabwe.
- Biosystems and Environmental Engineering Research Group, 380 New Adylin, Marlborough, Harare, Zimbabwe.
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Hu P, Zhang Y, Wei H, Zhang W, Song L, Zhang M, Meng X, Shang M, Wang C. Point-of-Use SERS Approach for Efficient Determination and Removal of Phthalic Acid Esters Based on a Metal-Organic Framework-Coated Melamine Sponge. ACS APPLIED MATERIALS & INTERFACES 2024; 16:11528-11536. [PMID: 38386864 DOI: 10.1021/acsami.3c17729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Phthalic acid esters (PAEs) are ubiquitous environmental contaminants, and their real-time monitoring and removal remain challenging. Herein, a point-of-use (POU) device integrating adsorption, surface-enhanced Raman spectroscopy (SERS), and removal strategy was developed and realized ultrafast on-site determination of PAEs and cleanup of them from water. A piece of flexible melamine sponge (MS) was coated with gold nanostars (AuNSs) and metal-organic frameworks (MOFs), thus obtaining SERS activity and adsorption capacity. Based on this multifunctional AuNSs@MOFs/MS composite, clear trends were observed between SERS signal intensity and concentration of di(2-ethylhexyl)phthalate (DEHP) and dibutyl phthalate (DBP). The method detection limits of DEHP and DBP were calculated to be 0.75 × 10-7 and 0.67 × 10-7 M in water, respectively, proving good sensitivity. Furthermore, this POU device exhibited satisfactory adsorption capacity (∼82.3 g/g for DBP and ∼90.0 g/g for DEHP), high adsorption efficiency (equilibrium in 100 s), and good regeneration capability (removal efficiency >70% after 5 cycles). The applicability of this device was verified by its good determination and removal performance in real environmental water matrices. The whole process could be completed within 5 min. This approach provides a new POU alternative for real-time monitoring and removal of PAEs in water.
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Affiliation(s)
- Peishan Hu
- Physical and Chemical Laboratory, Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250000, China
| | - Yuxuan Zhang
- The First Clinical Medical College, Nanjing Medical University, Nanjing 211166, China
| | - Haiyan Wei
- Physical and Chemical Laboratory, Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250000, China
| | - Wei Zhang
- Physical and Chemical Laboratory, Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250000, China
| | - Liqun Song
- Physical and Chemical Laboratory, Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250000, China
| | - Mengping Zhang
- Physical and Chemical Laboratory, Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250000, China
| | - Xiao Meng
- Physical and Chemical Laboratory, Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250000, China
| | - Ming Shang
- Shandong Provincial Key Laboratory of Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250000, China
| | - Cuijuan Wang
- Physical and Chemical Laboratory, Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250000, China
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Mi L, Xie Z, Xu W, Waniek JJ, Pohlmann T, Mi W. Air-Sea Exchange and Atmospheric Deposition of Phthalate Esters in the South China Sea. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:11195-11205. [PMID: 37459505 PMCID: PMC10399291 DOI: 10.1021/acs.est.2c09426] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Phthalate esters (PAEs) have been investigated in paired air and seawater samples collected onboard the research vessel SONNE in the South China Sea in the summer of 2019. The concentrations of ∑7PAEs ranged from 2.84 to 24.3 ng/m3 with a mean of 9.67 ± 5.86 ng/m3 in air and from 0.96 to 8.35 ng/L with a mean of 3.05 ng/L in seawater. Net air-to-seawater deposition dominated air-sea exchange fluxes of DiBP, DnBP, DMP, and DEP, while strong water-to-air volatilization was estimated for bis(2-ethylhexyl) phthalate (DEHP). The estimated net atmospheric depositions were 3740 t/y for the sum of DMP, DEP, DiBP, and DnBP, but DEHP volatilized from seawater to air with an average of 900 t/y. The seasonally changing monsoon circulation, currents, and cyclones occurring in the Pacific can significantly influence the concentration of PAEs, and alter the direction and magnitude of air-sea exchange and particle deposition fluxes. Consequently, the dynamic air-sea exchange process may drive the transport of PAEs from marginal seas and estuaries toward remote marine environments, which can play an important role in the environmental transport and cycling of PAEs in the global ocean.
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Affiliation(s)
- Lijie Mi
- Institute of Coastal Environmental Chemistry, Helmholtz-Zentrum Hereon, Geesthacht 21502, Germany
- Institute of Oceanography, University of Hamburg, Hamburg 20146, Germany
| | - Zhiyong Xie
- Institute of Coastal Environmental Chemistry, Helmholtz-Zentrum Hereon, Geesthacht 21502, Germany
| | - Weihai Xu
- Key Laboratory of Ocean and Marginal Sea Geology, South China Sea Institute of Oceanology, Chinese Academy of Sciences, Guangzhou 510301, China
| | - Joanna J Waniek
- Department of Marine Chemistry, Leibniz Institute for Baltic Sea Research Warnemünde, Rostock 18119, Germany
| | - Thomas Pohlmann
- Institute of Oceanography, University of Hamburg, Hamburg 20146, Germany
| | - Wenying Mi
- MINJIE Institute of Environmental Science and Health Research, Geesthacht 21502, Germany
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Li G, Huang Z, Li H, Zhang Z, Cui L. Synergistic removal of sulfamethoxazole and dimethyl phthalate by five constructed wetland substrates. CHEMOSPHERE 2023; 318:137936. [PMID: 36702409 DOI: 10.1016/j.chemosphere.2023.137936] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/09/2023] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
Frequent detection and joint toxicity of sulfonamides (SAs) and phthalate acid esters (PAEs) in water environment have caused serious health and safety problems that can be reduced by vertical flow constructed wetland (VFCW). However, it remains unclear what kind of substrate used in VFCW can synergistically remove SAs and PAEs. In this study, it was determined if biochar, zeolite, vermiculite, peat and sand synergistically removed sulfamethoxazole (SMX) and dimethyl phthalate (DMP) as representatives of SAs and PAEs by using batch and column experiments. The batch experiments showed that pseudo-second-order and intraparticle diffusion kinetics and Freundlich isotherm could better describe the synergistic adsorption of SMX and DMP on each substrate. SMX promoted hydrophobic interaction between DMP and each substrate so that low concentration DMP almost was adsorbed completely at neutral pH. Both neutral and alkaline pH conditions were favorable for synergistic adsorption of SMX and DMP on each substrate. The column experiments showed that removal of SMX or DMP in VFCW by substrate adsorption alone was limited with run time increasing, but SMX and DMP were effectively removed with run time increasing when loaded with simulated wastewater, SMX and DMP. The VFCW not only removed 94.7% SMX and 91.8% DMP after running 50 d, but also improved total nitrogen removal. In conclusion, these results strongly suggest that biochar, zeolite, vermiculite, peat and sand filled in VFCW can synergistically remove SMX and DMP.
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Affiliation(s)
- Guowan Li
- College of Natural Resources and Environment, South China Agricultural University, Guangzhou, 510642, PR China; Postdoctoral Workstation, Shenzhen BLY Landscape & Architecture Planning & Design Institute Ltd., Shenzhen, 518055, PR China
| | - Zhujian Huang
- College of Natural Resources and Environment, South China Agricultural University, Guangzhou, 510642, PR China
| | - Huashou Li
- College of Natural Resources and Environment, South China Agricultural University, Guangzhou, 510642, PR China
| | - Zhenyao Zhang
- Postdoctoral Workstation, Shenzhen BLY Landscape & Architecture Planning & Design Institute Ltd., Shenzhen, 518055, PR China
| | - Lihua Cui
- College of Natural Resources and Environment, South China Agricultural University, Guangzhou, 510642, PR China.
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Li X, Wang Q, Jiang N, Lv H, Liang C, Yang H, Yao X, Wang J. Occurrence, source, ecological risk, and mitigation of phthalates (PAEs) in agricultural soils and the environment: A review. ENVIRONMENTAL RESEARCH 2023; 220:115196. [PMID: 36592811 DOI: 10.1016/j.envres.2022.115196] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/30/2022] [Accepted: 12/29/2022] [Indexed: 06/17/2023]
Abstract
The widespread distribution of phthalates (PAEs) in agricultural soils is increasing drastically; however, the environmental occurrence and potential risk of PAEs in agricultural systems remain largely unreviewed. In this study, the occurrence, sources, ecotoxicity, exposure risks, and control measures of PAEs contaminants in agricultural soils are summarized, and it is concluded that PAEs have been widely detected and persist in the soil at concentrations ranging from a few μg/kg to tens of mg/kg, with spatial and vertical variations in China. Agrochemicals and atmospheric deposition have largely contributed to the elevated contamination status of PAEs in soils. In addition, PAEs cause multi-level hazards to soil organisms (survival, oxidative damage, genetic and molecular levels, etc.) and further disrupt the normal ecological functions of soil. The health hazards of PAEs to humans are mainly generated through dietary and non-dietary pathways, and children may be at a higher risk of exposure than adults. Improving the soil microenvironment and promoting biochemical reactions and metabolic processes of PAEs are the main mechanisms for mitigating contamination. Based on these reviews, this study provides a valuable framework for determining future study objectives to reveal environmental risks and reduce the resistance control of PAEs in agricultural soils.
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Affiliation(s)
- Xianxu Li
- College of Resources and Environment, Key Laboratory of Agricultural Environment, Shandong Agricultural University, Tai'an, 271S000, China
| | - Qian Wang
- College of Resources and Environment, Key Laboratory of Agricultural Environment, Shandong Agricultural University, Tai'an, 271S000, China
| | - Nan Jiang
- College of Resources and Environment, Key Laboratory of Agricultural Environment, Shandong Agricultural University, Tai'an, 271S000, China; College of Natural Resources and Environment, Northwest A&F University, Yangling, 712000, China
| | - Huijuan Lv
- College of Resources and Environment, Key Laboratory of Agricultural Environment, Shandong Agricultural University, Tai'an, 271S000, China
| | - Chunliu Liang
- College of Resources and Environment, Key Laboratory of Agricultural Environment, Shandong Agricultural University, Tai'an, 271S000, China
| | - Huiyan Yang
- College of Resources and Environment, Key Laboratory of Agricultural Environment, Shandong Agricultural University, Tai'an, 271S000, China
| | - Xiangfeng Yao
- College of Resources and Environment, Key Laboratory of Agricultural Environment, Shandong Agricultural University, Tai'an, 271S000, China
| | - Jun Wang
- College of Resources and Environment, Key Laboratory of Agricultural Environment, Shandong Agricultural University, Tai'an, 271S000, China.
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Zhang C, Ren W, Sun C, Liu L, Li M, Wang W, Fang Y, Liu L, Yang X, Zhang X, Li S. Associations between gastrointestinal infection and urinary phthalate metabolite concentrations in US children and adolescents from NHANES 2005-2016. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:4582-4591. [PMID: 35972658 DOI: 10.1007/s11356-022-22327-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
The purpose of this study was to evaluate at the link between gastrointestinal illness and urine phthalate metabolite concentrations in children and adolescents in the United States between 2005 and 2016. A total of 4008 National Health and Nutrition Examination Survey (NHANES) participants had urine samples obtained during the survey and self-reported their gastrointestinal functional status over the previous week. High performance liquid chromatography/tandem mass spectrometry (HPLC/MS-MS) was used to identify twelve phthalate metabolites in urine samples. The link between PAE concentrations and gastrointestinal illnesses was investigated using logistic regression, which was controlled for possible confounders. The combined and independent effects of PAEs on gastrointestinal illnesses were investigated using Bayesian Kernel Machine Regression (BKMR) and quantile-based g-computation (qgcomp). In children and adolescents, the prevalence of gastrointestinal infection was 9.0%. One log-unit increase in urinary concentrations was associated with an increased risk of gastrointestinal infection for monocarboxyoctyl phthalate (MCOP) (adjusted odd ratio (aOR) = 1.36, 95 percent confidence interval (95%ci): 1.08, 1.62), mono(2-ethylhexyl) phthalate (MEHP) (aOR = 1.18, 95 percent CI: 1.05, 1.32) and mono(2-eth The mixed exposure model findings revealed that the combined effect of PAEs was substantially linked with gastrointestinal infection; exposure to the combination of PAEs was positively associated with the risk of gastrointestinal infection. In the BKMR model, the exposure to the mixture of PAEs was positively associated with the risk of gastrointestinal infection. In qgcomp, a substantial positive correlation between PAEs and gastrointestinal illnesses was identified (OR = 1.16, 95 percent CI: 1.05, 1.28). MCOP and MEHP may be the major contributors after controlling for other PAE homologs. These associations were more pronounced in overweight and obese children and adolescents. Mixed exposure to phthalates (PAEs) in children and adolescents was significantly associated with gastrointestinal infections, with MCOP and MEHP accounting for the major proportions. These associations were more pronounced in overweight and obese children and adolescents.
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Affiliation(s)
- Chuang Zhang
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Weirui Ren
- Department of Gastroenterology, The Third Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Chi Sun
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Lin Liu
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Meng Li
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Wenbo Wang
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Yanbin Fang
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Lin Liu
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Xiaofeng Yang
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Xiangjian Zhang
- Hebei Key Laboratory of Vascular Homeostasis and Hebei Collaborative Innovation Center for Cardio-Cerebrovascular Disease, Shijiazhuang, 050000, China
| | - Suolin Li
- Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
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