Objective To establish a qualitative detection method for tulobuterol in dried urine spots(DUS)as derivatives produced after administration of the non-prohibited substance bupropion can inter-fere with the detection of the doping tulobuterol in urine,and further explore the interference in blood samples and find a method for its detection in dried blood spots(DBS).Methods Ten volunteers(5 males and 5 females)were chosen for method validation,and another 2 volunteers(1 male and 1 fe-male)were recruited for the bupropion study.Totally 20 μL samples of DUS and DBS were collected separately.After pretreatment steps such as liquid-liquid extraction with mixed organic solvents and ni-trogen blowing for re-dissolution,the detection and analysis were carried out using liquid chromatogra-phy-high resolution mass spectrometry(LC-HRMS).Results The limits of detection(LOD)for tulobuter-ol in both DUS and DBS samples were 0.13 ng/mL,respectively,while the limit of identification(LOI)were 0.16 ng/mL and 0.90 ng/mL,respectively.Meanwhile,the repeatability and reproducibility relative standard deviation(RSD%)were<20%for different concentrations,with recovery rate of 38.65%～70.01%and the matrix effect of 37.98%～142.13%,and the stability of the samples could reach 30 days in different storage conditions.As to the bupropion study,its derivatives could be effectively sepa-rated from tulobuterol in DUS samples,but were not detected in DBS samples,which directly ex-cludes their interference.Conclusion Detection of tulobuterol in DUS and DBS using LC-HRMS can eliminate interference from bupropion derivatives in the detection of the doping tulobuterol.

Objective To establish a qualitative detection method for tulobuterol in dried urine spots(DUS)as derivatives produced after administration of the non-prohibited substance bupropion can inter-fere with the detection of the doping tulobuterol in urine,and further explore the interference in blood samples and find a method for its detection in dried blood spots(DBS).Methods Ten volunteers(5 males and 5 females)were chosen for method validation,and another 2 volunteers(1 male and 1 fe-male)were recruited for the bupropion study.Totally 20 μL samples of DUS and DBS were collected separately.After pretreatment steps such as liquid-liquid extraction with mixed organic solvents and ni-trogen blowing for re-dissolution,the detection and analysis were carried out using liquid chromatogra-phy-high resolution mass spectrometry(LC-HRMS).Results The limits of detection(LOD)for tulobuter-ol in both DUS and DBS samples were 0.13 ng/mL,respectively,while the limit of identification(LOI)were 0.16 ng/mL and 0.90 ng/mL,respectively.Meanwhile,the repeatability and reproducibility relative standard deviation(RSD%)were<20%for different concentrations,with recovery rate of 38.65%～70.01%and the matrix effect of 37.98%～142.13%,and the stability of the samples could reach 30 days in different storage conditions.As to the bupropion study,its derivatives could be effectively sepa-rated from tulobuterol in DUS samples,but were not detected in DBS samples,which directly ex-cludes their interference.Conclusion Detection of tulobuterol in DUS and DBS using LC-HRMS can eliminate interference from bupropion derivatives in the detection of the doping tulobuterol.

Objective:To analyze and summarize the basic characteristics and clinical features of botulism patients caused by cosmetic injection of botulinum toxin.Methods:Retrospective investigation and analysis method were used to analyze the data of botulism patients caused by cosmetic injection of botulinum toxin admitted to the Poisoning Treatment Center of the PLA from March 2016 to June 2019.Results:Total of 380 cases were included in this study, including 114 hospitalized cases and 266 emergency cases. The majority patients (97.4%) were female, and most of them (39.5%) were among 30-39 years old. Most of the cases occurred in beauty salons or beauty studios, and most of the botulinum toxin injected was fake and inferior products. Onset latency were mainly distributed in 3 to 6 days. Common clinical symptoms included dizziness, blurred vision, eyes open weakness, dysphagia, chest tightness of breath, fatigue, diplopia, nausea, bilateral eyelid drooping, and dysarthria. The "4D" sign of cranial nerve injury occurred less frequently, mainly with mild and moderate poisoning; The occurrence rates of dysarthria, dysphagia, eyes open weakness, blurred vision, choking in drinking water, chewing weakness, bilateral eyelid drooping, decreased limb muscle strength, and chest tightness of breath in the hospitalized case were significantly higher than those in the emergency cases (all P < 0.05). Three hundred and nine patients received botulinum antitoxin therapy. The dose of botulinum antitoxin was 20 000 (20 000-30 000) U, with a total treatment duration of 4 (3-7) days in the emergence cases, and 30 000 (30 000-50 000) U with a total treatment time of 8 (5-11) days in the hospitalized cases, and there were significant differences between the two groups ( P < 0.05). All cases were followed up with good prognosis. Conclusions:Cosmetic injection of botulinum toxin has certain risk. If symptoms of poisoning occur such as dizziness, blurred vision, eyes open weakness and dysphagia, patients should be treated promptly, and early treatment with botulinum antitoxin can improve the prognosis.