Objective To establish a method for determination of new abused drugs in plasma by using ultra-high performance liquid chromatography tandem mass spectrometry ( UPLC-MS/MS ) combined with in-tube solid-phase microextraction. Methods 2 mL of borax buffer was added to 1 mL of plasma with drugs. Then,the mixture was withdrawn into a syringe connected to a stainless steel needle welded with DB-1701 capillary column. 50 μL acetonitrile was used as elution solvent at the flow rate of 300 μL·min-1 for 2 min. Subsequently,the drugs on elute were determined by using UPLC-MS/MS in positive mode with multiple reaction monitoring( MRM) to determine drug concentration in human plasma samples. ResultsThe recoveries rates of the five abused drugs ( codeine hydrochloride, tramadol, diphenoxylate hydrochloride, diazepam, and triazolam) in plasma were between 69. 2% -81. 7% with the RSDs less than 10%. LODs of the drugs were less than 25 ng·mL-1 . Seven out of the 26 plasma samples were determined positive. Conclusion The in-tube SPME method coupled to UPLC-MS/MS is simple, rapid, and environmental friendly, which is suitable for the the rapid screening of the new abused drugs.

Objective To retrospective analyze the use of inpatients taking sacubitril/valsartan in Nanjing Drum Tower Hospital,and to provide references for rational clinical application.Methods The relevant data of inpatients taking sacubitril/valsartan in our hospital were systematically collected from July 2019 to September 2021,and the rationality of drug use was eval-uated.Results A total of 2 682 cases were collected,and 868 cases(32.36%)of them involved 918 times of irrational drug use.The specific situations of irrational drug use included off-label use(182 times),irrational usage and dosage(389 times),irrational conversation of drugs(251 times),and irrational drug use for special populations(96 times).Conclusion The use of sacubitril/valsartan exists in unreasonable situations in our hospital.Clinical pharmacists should participate in medication man-agement to a certain extent,strengthen the pharmaceutical care of patients,and improve the rational rate of drug use.

Objective To observe the regulatory effect of roxadustat on lipid metabolism while correcting anemia in hemodialysis patients.Methods Sixty patients with chronic kidney disease(CKD)receiving hemodialysis treatment at Nanjing Drum Tower Hospital and combined with concurrent renal anemia were selected.These included 30 patients receiving erythropoietin(EPO)therapy at a dose of 10 000 U per week,and 30 patients receiving roxadustat treatment at a dose based on body weight.The patients'hemoglobin levels were measured,and data on lipid and iron metabolism-related indicators were collected for statistical analysis.Results After 6 months of treatment,the mean hemoglobin levels of both groups of patients were significantly higher than the baseline levels.The mean hemoglobin level in the roxadustat group was higher than that in the EPO group(114.1±7.88 vs.122.23±10.33,P<0.05),but there was no significant difference in the achievement rate between the two groups(77%vs.93%,P>0.05).The total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and triglycerides(TG)in the roxadustat group decreased significantly(P<0.05),while there was no significant change in the EPO group.Compared with the EPO group,roxadustat showed an improvement in iron metabolism indicators.Conclusion Roxadustat has been shown to improve lipid metabolism while correcting anemia.

Objective:To establish a new strategy for rapid correction of the interference of chyle blood on hemoglobin (HGB) and related indexes by reticulocyte (RET) channel research parameters (HGB-O, MCHC-O) from automatic hematological analyzer.Methods:With the diagnostic experimental design, a total of 90 impatient samples were sequential picked from Fuwai Hospital, which had routine blood testing from June 1 to July 31, 2021. The selected samples were free of hemolysis, jaundice, chylo. The age of the patients was (49.2±5.7) years, with 47 males and 43 females. Three different contents(25, 50, 75 μl) of fat emulsion injection were used to replace plasma in equal amounts to prepare chyle blood samples with mild, medium and heavy degrees of average red blood cell hemoglobin concentration (MCHC). The research parameters (HGB-O, MCHC-O) obtained by the RET channel detection of the automatic blood analyzer were used as the corrected HGB and its related index values (RET method), and the original values (the detection values before adding fat emulsion) and the formula correction values were paired with t-test or Wilcoxon signed rank test, single factor analysis of variance or Kruskal-Wallis rank-sum test, Bland-Altman and correlation analysis to evaluate the correction effect of RET method.Results:There was no significant difference ( H=0.035, P=0.983; H=0.097, P=0.953; H=0.112, P=0.945) between the RET correction values of HGB (g/L) [104.0(83.8, 132.8), 109.0(87.78, 128.25), 104.0(87.8, 131.8)] and the original values [104.0(83.0, 133.0), 107.5(86.75, 129.25), 103.5(85.8, 131.3)] and the formula correction values [104.0(84.0, 133.8), 106.0(86.75, 131.25), 102.5(86.8, 131.3)] in the samples of chythemia with varying degrees of MCHC (g/L) elevation; meanwhile, the RET correction values [366.5(325.8, 341.5), 333.5(323.8, 340.0), 333.5(327.0, 341.25)] and the original values [336.0(324.8, 342.0), 333.0(323.5, 342.3), 332.0(326.75, 340.5)] and the formula correction values [333.5(323.5, 343.3), 331.0(321.0, 338.3), 329.5(325.25, 337.25)] were also not statistically significant ( H=0.049, P=0.976; H=3.149, P=0.207; H=0.883, P=0.643). The detection values of HGB and related indexes corrected by RET method were in good agreement with the original values [96.7% (29/30) of the points were within the 95% consistency limit], and the two were positively correlated (the correlation coefficients were all higher than 0.919, P<0.01). Conclusion:The RET method based on the research parameters of RET channel of automatic hematological analyzer can serve as a new strategy to correct the interference of chyle blood on the detection of HGB and related indexes.