Objective:To analyze clinical factors related to nosocomial infection in children with extracorporeal membrane oxygenation(ECMO)support.Methods:General data, infection data and relevant factors in children with ECMO support in Bayi Children′s Hospital, the 7 th Medical Center of People′s Liberation Army General Hospital and Henan Provincial People′s Hospital from September 2012 to February 2020 were reviewed.Relevant factors of nosocomial infection in them were analyzed. Results:Among 163 cases, 36(22.1%) children supported with ECMO had infections during the period of ECMO, and 72 pathogenic microorganisms were detected, including 67 bacteria (33 Acinetobacter baumannii, 21 Klebsiella pneumoniae, and 6 Pseudomonas aeruginosa) and 5 fungi.Pathogens from the respiratory system, blood system, urinary tract and abdominal cavity were detected in 45 cases(62.5%), 25 cases (34.7%), 1 case (1.4%), and 1 case (1.4%), respectively.Drug sensitivity analysis of the Acinetobacter baumannii showed that it was the extensively resistant strain.Compared with uninfected children supported with ECMO, ECMO support time[(10.0±6.7) d], hospitalization[(34.0±25.3) d], hospitalization cost[(234 368±113 234) yuan], preoperative oxygenation index(52.8±23.0) and lactate value[(9.6±5.9) mmol/L]were significantly higher in nosocomial infection ones[(4.6±3.2) d, (24.3±19.8) d, (161 416±65 847) yuan, 35.6±10.4, (5.6±5.4) mmol/L] supported with ECMO (all P<0.05). There was no significant difference in the mortality between 2 groups ( P>0.05). In addition, lactate level (9.8 mmol/L) and oxygenation index (36.0±12.7) were significantly higher in died children(2.7 mmol/L, 22.1±10.4) with nosocomial infection during the period of ECMO support than those of survivors (all P<0.05). Multivariate Logistic regression analysis showed that ECMO support time( OR=7.054, 95% CI: 2.206-25.525) and preoperative lactate value( OR=2.250, 95% CI: 1.378-4.611) were independent risk factors of nosocomial infection. Conclusions:Correcting underlying diseases of ECMO supporting and shortening the duration of ECMO can reduce the incidence and mortality of nosocomial infection in children who are supported with ECMO.

ObjectiveTo establish a GC-MS method for the detection of 9 halogenated alkanes in toothpastes. MethodsVarious brands of toothpastes on the market were collected as the samples. Methanol was used as the extraction solution. After shaking， vortex and centrifugation， the supernatant was filtered by 0.45 μm microporous filter membrane. The content of 9 halogenated alkanes including chloromethane， dichloromethane， chloroform， 1，1，1-trichloroethane， carbon tetrachloride， 1，2-dichloroethane， 1，1，2-trichloroethane， 1，2-dibromoethane， 1，2，3-trichloropropane in the filtrate were determined by GC-MS. ResultsThe 9 halogenated alkanes showed a good linear relationship in the concentration range of 0.03‒1.00 μg·mL^-1. The correlation coefficient was ≥0.998 7 with the detection limits of 0.015‒0.056 mg·kg^-1. The spiked recoveries were 83.2%‒108.9% with the RSD of 2.0%‒9.8%. In the actual sample analysis， 1，1，2-trichloroethane and 1，2，3-trichloropropane were respectively detected in 6 toothpaste samples from 5 brands. ConclusionThe method is simple， sensitive， accurate， and has good spiked recoveries. It can be used for the determination of halogenated alkanes in toothpastes.

ObjectiveTo establish a non-targeted screening method for emerging contaminants in drinking water based on high-resolution mass spectrometry and apply it to actual water samples. MethodsA total of 9 drinking water samples collected from 3 reservoirs in Shanghai were purified and concentrated by HLB solid phase extraction column， then separated and analyzed by liquid chromatography high-resolution mass spectrometer and gas chromatography high⁃resolution mass spectrometer. The acquired data were analyzed by Thermo Tracefinder， Excel and other software combined with mzCloud and NIST databases. The methodology was verified with representative compound standards. Pesticide and perfluorinated compounds were taken as examples to analyze their pollution status. ResultsA non-targeted analysis strategy based on liquid chromatography and gas chromatography tandem high-resolution mass spectrometry was established. The pollution level of 20 kinds of pesticides and 4 kinds of perfluorinated compounds identified in 9 drinking water samples were higher in the Huangpu River than in the Yangtze River estuary. ConclusionThe established non-targeted screening method by high-resolution mass spectrometry can detect potential emerging contaminants in drinking water without relying on the standards， which provides a powerful technical means for water quality monitoring and risk assessment.

Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.

ObjectiveTo study the relationship between the exposure to two kinds of phthalate esters （PAEs） ［Di-N-butyl phthalate，（DBP） and Di-（2-ethylhexyl）phthalate （DEHP）］ and estrogen homeostasis in pregnant women. MethodsIn 2021， we classified the Jiading District of Shanghai into five geographical areas， east， west， south， north and central. A total of 151 pregnant women from each area were selected for questionnaire survey， with random urine samples during first， second， and third trimesters collected. A DBP metabolite ［Mono-N-butyl phthalate （MBP）］ and two DEHP metabolites ［Mono（2-ethylhexyl） phthalate （MEHP）， Mono（2-ethyl5-oxohexyl） phthalate， （MEOHP）］ and three estrogens ［estrone （E₁）， 17β -estradiol （E₂）， and estriol （E₃）］ in urine were determined by ultra-performance liquid chromatography tandem quadrupole time-of-flight mass spectrometry. After a natural logarithmic transformation of PAEs metabolite levels and estrogen concentration， multivariable linear regression was used to control potential confounders and determine the relationship between PAEs metabolite levels and estrogen concentration. ResultsThe detection rates of three PAEs metabolites in urine of pregnant women were more than 98%. The median corrected concentrations of MBP， MEHP and MEOHP were 5.18， 0.59 and 4.23 mg·kg^-1， respectively. During the whole pregnancy， MEOHP was positively correlated with E₁ （β=0.450， 95%CI： 0.057‒0.844）， and MBP was positively correlated with E₃ （β=0.250， 95%CI： 0.034‒0.465）. Stratified by trimesters， MBP was positively correlated with E₃ in the first trimester （β=0.428， 95%CI： 0.103‒0.752）. MEOHP was positively correlated with E₁ in the second trimester （β=0.734， 95%CI： 0.130‒0.752）， and had a possitive trend with E₁ in the third trimester （β=0.744， 95%CI： -0.140‒1.629）. In addition， MEHP had a negative correlation with E₁ in the second trimester （β=-0.498， 95%CI： -1.063‒0.066）. MEOHP had a positive correlation trend with E₂ （β=0.628， 95%CI： -0.101‒1.356） in the third trimester. ConclusionPAEs exposure may interfere with estrogen homeostasis during pregnancy and differs by trimesters. Given the cross-sectional nature of this study， it warrants further study to validate the findings.

Objective To investigate the association of common polymorphism loci of the cystic fibrosis transmembrane conductance regulator (CFTR) gene with the onset of primary intrahepatic lithiasis (PIL) in the Chinese Han population. Methods A total of 104 patients with PIL who attended The 900th Hospital of PLA Joint Logistics Support Force from June to November 2018 were enrolled as PIL group, and 120 healthy controls who underwent physical examination during the same period of time were enrolled as control group. Sanger sequencing was used to detect the alleles and genotypes at the M470V, TG-repeats, and Poly-T loci of the CFTR gene. The two groups were compared in terms of age, sex ratio, age of onset, and allele and genotype frequencies, and the association of the above three polymorphism loci of the CFTR gene with the risk of PIL was analyzed. The K-S test was used to determine the normality of continuous variables. The independent samples t -test was used for comparison of normally distributed continuous data between two groups, and the chi-square test was used to compare categorical data and allele/genotype frequencies and analyze Hardy-Weinberg equilibrium. A binary logistic regression analysis was used to investigate the association of genotypes and alleles with the risk of the disease. The association of the loci deviating from Hardy-Weinberg equilibrium with the risk of PIL was expressed as adjusted odds ratio ( OR ). Results There were significant differences between the PIL group and the control group in the distribution of alleles ( χ 2 =15.139, P < 0.01) and genotypes ( χ 2 =22.889, P < 0.01) at the M470V locus, while there were no significant differences between the two groups in the distribution of alleles and genotypes at the TG-repeats and Poly-T loci (all P > 0.05). The PIL group had a significantly higher frequency of G allele at the M470V locus than the control group (60.1% vs 41.67%, P < 0.01). Compared with the individuals with AA genotype, the individuals with GG and AG genotypes had a significant increase in the risk of PIL ( OR =4.680 and 2.500, both P < 0.01). As for the TG-repeats locus, the individuals with 12TG/13TG genotype had a significantly higher risk of PIL than those with 11TG/12TG genotype ( OR =11.002, P =0.042), and as for the Poly-T locus, the individuals with 7T/5T genotype had a significantly lower risk of PIL than those with 7T/7T genotype ( OR =0.079, P =0.047). Conclusion The M470V polymorphism of the CFTR gene is independently associated with the risk of PIL in the Chinese Han population, and G allele is a high-risk mutation for the onset of PIL.