[Application progress of on-line sample preparation techniques coupled with liquid chromatography-mass spectrometry system in the detection of food hazards].

Food safety has received increased attention, and food detection is of great significance. The food matrix is complex, and diverse food hazards have been identified. Thus, the detection methods and sample preparation techniques for food matrices must be continuously optimized and updated. Several steps are usually required when a chromatographic system is used to determine food hazards: sample preparation, that is, the separation of targets from different substrates using a suitable preprocessing method and target-substance separation and purification, which is usually achieved using chromatographic separation. The selection of an appropriate detector for qualitative and quantitative analyses is usually based on the properties of the target compound. The sample preparation procedure is considered the most time-consuming aspect of the entire food-analysis process. It is also prone to analytical errors. Therefore, optimization of the sample preparation process is a key issue in the field of chemical analysis. Researchers have developed a series of new, efficient, and accurate sample preprocessing methods, and an on-line sample-preparation system has been found to be a feasible approach. On-line sample preparation coupled with liquid chromatography-mass spectrometry (LC-MS) presents many advantages. First, manual operation could reduce analytical errors to ensure good accuracy and repeatability. It could also reduce the consumption of chemical reagents and avoid cross-contamination between samples. Furthermore, an on-line sample-preparation system could shorten the sample-preparation time and improve the detection efficiency. On-line sample preparation coupled with LC-MS has been widely applied in the fields of environment, biology, and food. On-line sample preparation systems coupled with LC-MS are divided into two modules: the first modules involves sample preparation and the second module involves the LC system. The first module remove impurities and isolates the target compounds in preparation for their qualitative and quantitative detection. The coupling of these two modules depends mainly on valve switching. In this paper, we introduce the most frequently used on-line sample-preparation techniques, including on-line solid phase extraction (on-line SPE), in-tube solid phase microextraction (in-tube SPME), and turbulent chromatography (TFC). We then describe the basic principles and coupling equipment of these three on-line analytical technologies in detail. The coupling equipment establishes a physical connection between the two modules. Next, we discuss the properties of different purification fillers in an on-line sample-preparation column. The applications and research progress of on-line systems for pesticide residues, veterinary drug residues, and biotoxins are also discussed. Compared with offline sample preparation, on-line analytical systems present several advantages. On-line analytical systems can not only greatly reduce the analysis time and solvent consumption but also improve the detection sensitivity and accuracy. Such systems can be used to determine food hazards to ensure food safety. Finally, the existing problems and development trends of on-line analytical systems are discussed and prospected. To promote the applications of on-line analytical technology in food-safety detection, we suggest that the following three aspects be considered. First, more on-line purification columns with novel fillers, in addition to C18 or polymer fillers, should be developed. Second, compared with ordinary detectors, high-resolution MS detectors have better precision and accuracy. Coupling on-line analytical technologies with a high-resolution mass spectrometer may be beneficial for the further development of on-line analyses. Third, different food matrices should be compared and evaluated to continuously optimize the detection process and improve the efficiency of on-line analytical systems. As concerns regarding food safety issues have increased, the applications of on-line analytical technologies for food detection can be expected to become increasingly important.

Targeted delivery of food functional ingredients in precise nutrition: design strategy and application of nutritional intervention.

With the high incidence of chronic diseases, precise nutrition is a safe and efficient nutritional intervention method to improve human health. Food functional ingredients are an important material base for precision nutrition, which have been researched for their application in preventing diseases and improving health. However, their poor solubility, stability, and bad absorption largely limit their effect on nutritional intervention. The establishment of a stable targeted delivery system is helpful to enhance their bioavailability, realize the controlled release of functional ingredients at the targeted action sites in vivo, and provide nutritional intervention approaches and methods for precise nutrition. In this review, we summarized recent studies about the types of targeted delivery systems for the delivery of functional ingredients and their digestion fate in the gastrointestinal tract, including emulsion-based delivery systems and polymer-based delivery systems. The building materials, structure, size and charge of the particles in these delivery systems were manipulated to fabricate targeted carriers. Finally, the targeted delivery systems for food functional ingredients have gained some achievements in nutritional intervention for inflammatory bowel disease (IBD), liver disease, obesity, and cancer. These findings will help in designing fine targeted delivery systems, and achieving precise nutritional intervention for food functional ingredients on human health.

Determination of L-Ergothioneine in Cosmetics Based on Ultraperformance Liquid Chromatography-Tandem Mass Spectrometry.

A new method was developed for the identification and determination of L-ergothioneine in cosmetics based on ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The pretreatment method, chromatographic column, chromatographic conditions, and mass spectrometric conditions of cosmetic samples were optimized. Methanol was chosen as the extraction solvent, 85% acetonitrile with 0.1% FA was selected as the mobile phase, and the Waters CORTECS UPLC hydrophilic interaction liquid chromatography (HILIC) column was chosen for the separation. The sample was extracted with methanol and filtered, then separated by HILIC and detected by triple-quadrupole mass spectrometry. The quantitation was done under the matrix calibration curve using the external standard method. The results showed good linear relationships in the range of 5-200 ng/mL, and the correlation coefficient was greater than 0.999 in cosmetic samples. The limit of detection was in the range of 25-50 µg/kg and the limit of quantitation was in the range of 50-100 µg/kg. The recoveries of the method spiked ranged from 85.3% to 96.2% and the relative standard deviation (RSD) was in the range of 0.84%-2.08% (n = 6). The method is simple, quick, and accurate for the determination of L-ergothioneine in cosmetics, and has great practical value.

Rapid determination of 103 common veterinary drug residues in milk and dairy products by ultra performance liquid chromatography tandem mass spectrometry.

A multi-residue method has been developed for the identification and quantification of 103 common veterinary drug residues in milk and dairy Products. This method was based on QuEChERS with dispersive solid-phase where C18 sorbent and anhydrous sodium sulfate were used to sample purification. After evaporation and reconstitution, the samples were analyzed by ultra-performance liquid chromatography-tandem mass spectrometry. The mean recovery results were all higher than 60% except ampicillin, pipemidic acid, enoxacin, and estriol, and the relative standard deviation was <20.0%. The limit of quantification ranged between 0.1 and 5 µg/kg for milk and between 0.5 and 25 µg/kg for milk powder. It was successfully used to detect residues of veterinary drug in real samples. This study proposes a simple and fast analytical method for monitoring multi-class veterinary drug residues to ensure food safety.

Stretchable and fatigue resistant hydrogels constructed by natural galactomannan for flexible sensing application.

Exploration of sustainable and functional materials from biomolecules has received much interest, while the limited mechanical property and possible bacterial contamination were proved to be their major shortages. Here, we proposed novel double network (DN) hydrogels based on galactomannan (GM) polysaccharide as backbone. Folic acid (FA) and polyacrylamide (PAM) were introduced to form hydrogen bond linkages and covalent bond networks respectively. The three-dimensional hydrogel networks showed greatly improved mechanical strength. Impressive compressive fatigue resistance was present for 100 cycles' compression forming only 0.7 % shape deformation. The phenomenon was mainly attributed to promoted stress-bearing and energy dissipation from the DN cross-linking. The GM hydrogels also exhibited good electronic conductivity and excellent anti-bacterial capabilities with inhibition against more than 80 % of E. coli., attributing to the tunable attachments of FA. Thus, we provided multi-functional hydrogels of high potential serving as anti-fatigue/bacterial and conductive strain sensors on the fields of wearable devices.

Isoflurane and Sevoflurane Induce Cognitive Impairment in Neonatal Rats by Inhibiting Neural Stem Cell Development Through Microglial Activation, Neuroinflammation, and Suppression of VEGFR2 Signaling Pathway.

Inhaled anesthetics are known to induce neurotoxicity in the developing brains of rodents, although the mechanisms are not well understood. The aim of this study was to elucidate the molecular mechanisms underlying anesthetics-induced neurodevelopmental toxicity by VEGF receptor 2 (VEGFR2) through the interaction between microglia and neural stem cells (NSCs) in postnatal day 7 (P7) rats. Cognitive function of P7 rats exposed to isoflurane and sevoflurane were assessed using Morris Water Maze and T maze tests. We also evaluated the expression levels of NSC biomarkers (Nestin and Sox2), microglia biomarker (CD11b or or IBA1), pro-inflammatory cytokines (IL-6 and TNF-α), and VEGFR2 using western blotting and immunohistochemistry in the brains of control and anesthesia-treated rats. We found spatial learning and working memory was impaired 2 weeks after anesthetics exposure in rats. Isoflurane induced stronger and more prolonged neurotoxicity than sevoflurane. However, cognitive functions were recovered 6 weeks after anesthesia. Isoflurane and sevoflurane decreased the levels of Nestin, Sox2, and p-VEGFR2, activated microglia, decreased the number of NSCs and reduced neurogenesis and the proliferation of NSCs, and increased the levels of IL-6, TNF-α, and CD11b. Our results suggested that isoflurane and sevoflurane induced cognitive impairment in rats by inhibiting NSC development and neurogenesis via microglial activation, neuroinflammation, and suppression of VEGFR2 signaling pathway.

Antrodia cinnamomea exerts an anti-hepatoma effect by targeting PI3K/AKT-mediated cell cycle progression in vitro and in vivo.

Antrodia cinnamomea is extensively used as a traditional medicine to prevention and treatment of liver cancer. However, its comprehensive chemical fingerprint is uncertain, and the mechanisms, especially the potential therapeutic target for anti-hepatocellular carcinoma (HCC) are still unclear. Using UPLC‒Q-TOF/MS, 139 chemical components were identified in A. cinnamomea dropping pills (ACDPs). Based on these chemical components, network pharmacology demonstrated that the targets of active components were significantly enriched in the pathways in cancer, which were closely related with cell proliferation regulation. Next, HCC data was downloaded from Gene Expression Omnibus database (GEO). The Cancer Genome Atlas (TCGA) and DisGeNET were analyzed by bioinformatics, and 79 biomarkers were obtained. Furtherly, nine targets of ACDP active components were revealed, and they were significantly enriched in PI3K/AKT and cell cycle signaling pathways. The affinity between these targets and their corresponding active ingredients was predicted by molecular docking. Finally, in vivo and in vitro experiments showed that ACDPs could reduce the activity of PI3K/AKT signaling pathway and downregulate the expression of cell cycle-related proteins, contributing to the decreased growth of liver cancer. Altogether, PI3K/AKT-cell cycle appears as the significant central node in anti-liver cancer of A. Cinnamomea.

Rheological properties of Sesbania cannabina galactomannan as a new source of thickening agent.

The present study evaluated the rheological properties of galactomannan from Sesbania cannabina. The intrinsic viscosity of galactomannan was determined to be 8.63 ± 0.06 dl/g. Moreover, the onset of galactomannan coil overlap occurred at 5.12 ± 0.13 g/L. With increasing concentration, galactomannan showed a more distinct shear-thinning behavior, which was well characterized by the Cross model. Notably, the viscosity of polysaccharide showed a negative relationship with the temperature, while the activation energy decreased with increasing polysaccharide concentration. Furthermore, at high concentrations, the galactomannan solution showed stability after heating or freezing, as well as over the wide pH range of 5.0-9.0. Dynamic viscoelasticity measurements reveal a gradual transition from viscous to elastic behavior of galactomannans with an increasing frequency. It is anticipated that S. cannabina galactomannan will find interesting applications as a natural thickener due to the comprehensive description of its rheological properties presented herein. PRACTICAL APPLICATION: The investigated S. cannabina galactomannan has shown a higher viscosity and heat stability at high concentration, as well as a good stability at the pH range of 5-9. The S. cannabina galactomannan may be employed as stabilizers in the food field.

Determination of Tropomyosin in Shrimp and Crab by Liquid Chromatography-Tandem Mass Spectrometry Based on Immunoaffinity Purification.

A UPLC-MS/MS method was developed for the detection of tropomyosin (TM) in shrimp and crab. After simple extraction, the samples were purified by immunoaffinity column and then digested by trypsin. The obtained sample was separated by Easy-nLC 1000-Q Exactive. The obtained spectrums were analyzed by Thermo Proteome Discoverer 1.4 software and then ANIQLVEK with high sensitivity was selected as the quantitative signature peptide. Isotope-labeled internal standard was used in the quantitative analysis. The method showed good linearity in the range of 5-5,000 µg/L with a limit of quantification (LOQ) of 0.1 mg/kg. The average recoveries were 77.22-95.66% with RSDs ≤ 9.97%, and the matrix effects were between 88.53 and 112.60%. This method could be used for rapid screening and quantitative analysis of TM in shrimp and crab. Thus, it could provide technical support for self-testing of TM by food manufacturers and promote further improvement of allergen labeling in China.

The immunomodulatory activity of degradation products of Sesbania cannabina galactomannan with different molecular weights.

Galactomannan (GM) is widely recognized as an immune enhancer; however, the underlying molecular mechanism is still unknown. Herein, four products with molecular weights in descending order, namely GM40, GM50, GM65, and GMOS, were separated from incomplete degradation products of Sesbania cannabina GM by ethanol precipitation, followed by their immunomodulatory activity. Through FTIR and XPS spectra, the amount of free hydroxyl groups was shown to decrease in the following order: GM > GM50 > GMOS > GM40 > GM65. Moreover, the immunomodulatory activity of different products decreased in abovementioned order. The TNF-α, IL-6 and TLR4 content in RAW 264.7 cells treated with different GM products in the presence or absence of TAK-242 (TLR4 inhibitor) suggested that the immunomodulatory activity of GM and its degradation products is TLR4-dependent. Overall, the preliminary relationship indicated here between the hydroxyl groups or the possible deeper structural changes of GM and the immunomodulatory activity need to be further investigated.

Facile adjustment on cellulose nanocrystals composite films with glycerol and benzyl acrylate copolymer for enhanced UV shielding property.

In the present work, cellulose nanocrystals (CNCs) composite films with suitable applicable capabilities were prepared by facilely incorporating glycerol (Gly) and poly(benzyl acrylate) (PBA). Chemical and morphological variations during the fabrication of the films were systematically characterized. The properties of modified CNCs composite films including UV blocking ability, mechanical strength and thermal properties were characterized to assess their applicable potentials. As a result, the composite films have good UV shielding property in UVC (220-280 nm) region and UVB (280-320 nm) region. The shielding performance of the modified film in the ultraviolet absorption region reached 92.77% to 95.49% respectively, without damaging the original chiral nematic structure of the films. Along with the modification, BACNC film improved the mechanical properties, presenting the tensile strength 16 times higher compared to pure CNCs film. The nanocomposite films proposed in this work showed promising potentials in broad fields, such as food preservation, medical protection, and surface coating applications.

A rare case of fetus in fetu in the sacrococcygeal region: CT and MRI findings.

BACKGROUND: Fetus in fetu is a rare condition in which a malformed fetus is found in the body of a living twin. The retroperitoneum is the most common location of this condition. However, the sacrococcygeal region is a rare site of the disease. The presence of vertebral bodies and limbs differentiates FIF from teratoma. Imaging modalities are important for diagnosing FIF. CASE PRESENTATION: A 12-months old boy was hospitalized because of a mass in the sacrococcygeal region. CT showed a large, complex mass with bony structure resembling sacrococcygeal bone, hip bone and the femur in the sacrococcygeal region of the boy. The blood supply of the mass was from the aorta of the host. MRI revealed the mass was connected with the dilated sacral canal of the host, which resulted in tethered cord. A preoperative diagnosis of FIF was made and surgery was performed to remove the mass. Surgical removal and subsequent pathological examination revealed the anencephalic fetus had limb buds and a sacrum but no axial skeleton, which supported the diagnosis of FIF. Conclusions CT and MRI played important roles in diagnosing FIF based on the location of the lesion.

Determination of 35 Free Amino Acids in Tea Using Ultra-Performance Liquid Chromatography Coupled With Quadrupole Time-of-Flight Mass Spectrometry.

The purpose of this research was to develop a simple, sensitive, and accurate method for simultaneous determination of 35 free amino acids using ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS). Tea samples were extracted with boiling water bath, and then separated by XBridge BEH Amide column by gradient elution. The exact mass and MS/MS spectra of the target compound was detected under the TOF-MS and Information dependent acquisition (IDA)-MS/MS mode. The results demonstrated good linearity (R 2 > 0.9980) in the range of 0.5-1,000 ng/mL. The limits of detection (LODs) were 0.13-25.00 mg/kg and the limits of quantitation (LOQs) were 0.25-50.00 mg/kg. The recovery rate ranged from 70.1 to 105.1% with relative standard deviations (RSDs) <11% (n = 6). This research provides a targeted strategy for developing an analysis method for amino acids in tea.

Effects of the Hofmeister anion series salts on the rheological properties of Sesbania cannabina galactomannan.

Sesbania cannabina galactomannan (2%) solutions added with strongly hydrated ions (Na2CO3, NaH2PO4, NaCl) and weakly hydrated ions (NaNO3) at different ionic strengths were rheologically characterized. The four selected salts dramatically decreased the intrinsic viscosity of galactomannan solution in the following order of effectiveness: Na2CO3 < NaH2PO4 < NaCl < NaNO3. This conforms effectively to the Hofmeister anion series. Moreover, salt addition increased the viscosity of galactomannan solution when the ionic strength was 1 mmol/kg, which related to an increased occurrence of intermolecular interactions. As increasing ionic strength, galactomannan chains may tend to contract or expand due to the presence of strongly or weakly hydrated ions, thereby decreasing the viscosity. These phenomena were demonstrated by zeta potential measurement and again observed in dynamic viscoelasticity measurement. Overall, this property can be used to manipulate the rheological properties of galactomannan in food gums to obtain gums of high quality for enhancing consumer goods.

Surface plasmon resonance biosensor for the detection of phenylethanolamine A in swine urine.

In the present study, an antibody against phenylethanolamine A (PEA) was produced, confirmed, and used in a surface plasmon resonance (SPR)-based measurement. Bovine serum albumin (BSA)-conjugated PEA was linked to nano-gold particles bound to l-cysteine modified on the surface of a Au-NP sensor chip. The concentrations of antigen and antibody were optimized, and the designed biosensor chip was investigated to examine the stability and accuracy of the proposed method. The recovery of PEA ranged from 80.4-93.4% in swine urine samples with spike levels of 5, 10 and 20 ng mL-1, and the relative standard deviations of PEA were less than 2%. PEA analogues, such as clenbuterol, ractopamine, and salbutamol, did not influence the PEA measurement. The developed method could be used to measure PEA in swine urine samples.

Colloid preloading versus crystalloid preloading to prevent hypotension after spinal anesthesia for cesarean delivery: A protocol for systematic review and meta-analysis.

BACKGROUND: Maternal hypotension is the most frequent complication of spinal anesthesia for cesarean delivery, and intravenous fluid preloading is a preventive measure. We aimed to assess the efficacy of colloids versus crystalloids for preloading to reduce the incidence of spinal anesthesia-induced hypotension and vasopressor requirement in healthy parturients during elective cesarean delivery. METHODS: We searched the Cochrane Library, MEDLINE and EMBASE to identify all studies published to June, 2019, through OVID and PubMed. We included randomized controlled trials, comparing colloid preloading with crystalloid preloading in women having spinal anesthesia for cesarean delivery. Primary outcomes were the incidence of hypotension and vasopressor requirement. Secondary outcomes included nausea and/or vomiting, neonatal Apgar score, neonatal umbilical blood pH. We used standardized mean differences for expressing continuous outcomes and risk ratios for dichotomous outcomes. Random-effect model was performed to estimate the pooled risk ratios and standardized mean differences. RESULTS: Thirty-three randomized controlled trials contributed data for this meta-analysis. Fewer women experienced hypotension in the colloid group compared with the crystalloid group (risk ratio: 0.72, 95% confidence interval: 0.63-0.82; 2566 women, 32 studies; P < .00001). The total ephedrine dose required was significantly lower with colloid preloading (standardized mean difference: -0.37, 95% CI: -0.64 to -0.09; 1472 women, 19 studies; P = .009). Colloid preloading was also associated with fewer phenylephrine requirement compared with crystalloid preloading (standardized mean difference: -0.54, 95% CI: -0.82 to -0.25; 169 women; P = .0002). The incidence of nausea and/or vomiting was significantly reduced with colloid preloading (risk ratio: 0.72, 95% CI: 0.55-0.95; 1601 women, 20 studies; P = .02). However, the incidence of 1-minute Apgar score < 7, umbilical artery pH < 7.2 and umbilical vein pH < 7.2 were not statistically different between groups. CONCLUSIONS: Colloid preloading is superior to crystalloid preloading in reducing the incidence of hypotension induced by spinal anesthesia and vasopressor requirement in the healthy parturients undergoing elective cesarean delivery.The PROSPERO registration number: CRD42018096402.

Determination of Deoxynivalenol and Its Derivative in Corn Flour and Wheat Flour Using Automated On-line Solid-Phase Extraction Combined with LC-MS/MS.

An automated on-line solid-phase extraction (SPE) combined with LC-MS/MS method was developed for determination of deoxynivalenol (DON), 3-acetyl-DON and 15-acetyl-DON in corn flour and wheat flour samples. The extraction solvent of the samples was injected into the automated on-line SPE system to remove matrix interference. After washing step, the targets were eluted from the SPE cartridge into liquid chromatography (LC) column. Several SPE parameters including injection volume, elution volume and eluting flow rate were assessed and optimized. Method validation was evaluated and good linearity was obtained (R2 > 99%) with the limit of detection of 0.1-0.2 µg/kg. Recoveries were evaluated in spiked corn flour and wheat flour samples at three concentrations and the values ranged from 86.5% to 99.7%. The benefit of the present method with automated on-line SPE system is the ability to inject directly pure extracts into LC-MS/MS, offering faster analyses and improving analysis efficiency.

Determination of 4 psychoactive substances in tea using ultra high performance liquid chromatography combined with the quadrupole time-of-flight mass spectrometry.

In this study, a method for the qualification and quantification of 4 psychoactive substances in tea using ultra high performance liquid chromatography coupled with the quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS) has been developed. Tea samples were extracted by a 50% (v/v) methanol-water solution, and then separated by an ACQUITY UPLC BEH Shield RP18 column using a binary solvent system by gradient elution. The analytes were determined by Q-TOF/MS in TOFMS and information-dependent acquisition (IDA)-MS/MS mode. The results showed that the mass accuracy error of the 4 psychoactive substances were lower than 5.0 × 10-6, and a good linear relationship was observed in the range of 0.5-500 µg L-1 and correlation coefficient was higher than 0.9990. The LOD was in the range of 0.005-0.020 mg kg-1 and the LOQ was in the range of 0.010-0.040 mg kg-1. The recovery of the method was in range of 80.14-93.25% with spike levels of 0.010-0.400 mg kg-1, and relative standard deviations were lower than 10%. The method was simple, specific and reliable. It has been successfully used for the detection of 4 psychoactive substances in tea samples.

Minimally invasive surgery for appendiceal intussusception caused by mucocele of the appendix: case report and review of the literature.

Appendiceal intussusception caused by mucocele of the appendix is extremely rare. In the current study, a 32-year-old woman was admitted to the department of general surgery of our hospital, complaining of persistent right, lower quadrant pain without an obvious cause for 17 hours. Physical examination indicated significant pain and tenderness in the right, lower abdominal quadrant. Blood analysis indicated that leukocyte count, the percentage of neutrophils and the serum C-reactive protein were increased. Abdominal and pelvic computed tomography revealed a well-encapsulated cystic mass surrounded by the caecum and intussusception. The appendiceal intussusception caused by mucocele of the appendix was revealed during the laparoscopic exploration. Appendectomy and partial cecectomy were conducted using the laparoscopic approach. Postoperative pathological examinations showed ileocecal intussusception and chronic inflammation, appendiceal mucocele and acute suppurative appendicitis. The patient showed satisfactory recovery that was observed during 15-months of follow-ups. This case highlights that laparoscopic appendectomy and partial cecectomy may be a beneficial, minimally invasive approach for appendiceal intussusception caused by mucocele of the appendix.

Bronchoscopy-guided intervention therapy with extracorporeal membrane oxygenation support for advanced cancer metastasis to the central airway: A case report.

INTRODUCTION: Dyspnea due to tracheal invasion by malignant tumors is a common oncological emergency that is difficult to manage, and a common cause of death among patients with advanced cancer. Bronchoscopy-guided intervention therapy under conventional ventilation is very risky for patients with severe central airway stenosis. Extracorporeal membrane oxygenation (ECMO) provides strong cardiopulmonary support, but is rarely used in bronchoscopy-guided interventional therapy. PATIENT CONCERNS: The patient had advanced esophageal cancer with metastases to the trachea and left and right main bronchi. Despite several sessions of radiotherapy, chemotherapy, and bronchoscopy-guided intervention therapy, the tumor in the airway became enlarged, the lumen was severely narrow, and the patient experienced respiratory distress. DIAGNOSIS: A thoracic computed tomography scan performed at our hospital revealed invasion of the trachea and opening of the left and right main bronchi by the esophageal cancer, blockage of the stent by the tumor, and severe luminal narrowing. An emergency bronchoscopy showed slit-like stenosis of the middle and lower part of the trachea and the left and right main bronchi, and the tumor was highly vascular. INTERVENTIONS: To reduce the risk of major airway bleeding and asphyxia during bronchoscopy under conventional ventilation, we finally performed argon plasma coagulation with a high frequency electric knife and cryotherapy with ECMO support. OUTCOMES: We successfully cleared the tumor tissue in the airway under ECMO support. The trachea and left and right main bronchi recovered smoothly, and the patient was soon discharged. CONCLUSION: ECMO can meet the oxygenation needs during bronchoscopy-guided intervention therapy. For patients with severe central airway obstruction due to malignant tumors, ECMO should be considered if conventional respiratory support cannot guarantee the safety of surgery.