This study summarized the nursing experience of a patient with right-sided aortic arch and kommerell's diverticulum and thoracic aortic aneurysm complicated with acute coronary syndrome after thoracic endovascular aortic repair.The nursing points are as follows:optimizing emergency procedures to improve the quality of rescue;monitoring the condition of the patient dynamically to prevent postoperative complications;developing personalized rehabilitation training to promote postoperative recovery;implementing"Internet+"follow-up management to improve treatment compliance.After the comprehensive management of a multidisciplinary team and careful nursing care,the patient was discharged 12 days after operation.During 18-month follow-up,the patient was in good condition.

Objective:To establish a rapid method for the determination of glyphosate and glufosinate residues in plasma samples by solid-phase extraction-liquid chromatography-tandem mass spectrometry (SPE-LC-MS/MS) .Methods:In March 2024, plasma samples were extracted and protein precipitated with methanol and purified using a weak cation exchange (WCX) SPE cartridge. Then the samples were separated on a Dikma Polyamino HILIC column (150 mm×2.0 mm, 5 μm) with a gradient elution of 1.0 mmol/L ammonium fluoride aqueous solution (pH=11) and acetonitrile as mobile phases. Analysis was performed using an electrospray ionization source (ESI) in multiple reaction monitoring (MRM) mode with internal standard quantification. The method's linearity, detection limits, spiked recovery and precision were then evaluated.Results:Glyphosate and glufosinate exhibited good linearity in the concentration range of 1.0-200.0 μg/L, with correlation coefficients of 0.9986-0.9992. The limits of detection (LODs) of glyphosate and glufosinate were 0.5 and 1.0 μg/L, respectively. At low, medium and high spiked concentrations, the spiked recovery rates and precision for glyphosate and glufosinate in plasma ranged from 92.5% to 113.2% and 3.01% to 11.23%, respectively.Conclusion:The SPE-LC-MS/MS method is simple, rapid, sensitive and accurate, and is suitable for the qualitative and quantitative analysis of glyphosate and glufosinate in plasma from poisoned patients.

Objective:To establish a rapid method for the determination of glyphosate and glufosinate residues in plasma samples by solid-phase extraction-liquid chromatography-tandem mass spectrometry (SPE-LC-MS/MS) .Methods:In March 2024, plasma samples were extracted and protein precipitated with methanol and purified using a weak cation exchange (WCX) SPE cartridge. Then the samples were separated on a Dikma Polyamino HILIC column (150 mm×2.0 mm, 5 μm) with a gradient elution of 1.0 mmol/L ammonium fluoride aqueous solution (pH=11) and acetonitrile as mobile phases. Analysis was performed using an electrospray ionization source (ESI) in multiple reaction monitoring (MRM) mode with internal standard quantification. The method's linearity, detection limits, spiked recovery and precision were then evaluated.Results:Glyphosate and glufosinate exhibited good linearity in the concentration range of 1.0-200.0 μg/L, with correlation coefficients of 0.9986-0.9992. The limits of detection (LODs) of glyphosate and glufosinate were 0.5 and 1.0 μg/L, respectively. At low, medium and high spiked concentrations, the spiked recovery rates and precision for glyphosate and glufosinate in plasma ranged from 92.5% to 113.2% and 3.01% to 11.23%, respectively.Conclusion:The SPE-LC-MS/MS method is simple, rapid, sensitive and accurate, and is suitable for the qualitative and quantitative analysis of glyphosate and glufosinate in plasma from poisoned patients.

This study summarized the nursing experience of a patient with right-sided aortic arch and kommerell's diverticulum and thoracic aortic aneurysm complicated with acute coronary syndrome after thoracic endovascular aortic repair.The nursing points are as follows:optimizing emergency procedures to improve the quality of rescue;monitoring the condition of the patient dynamically to prevent postoperative complications;developing personalized rehabilitation training to promote postoperative recovery;implementing"Internet+"follow-up management to improve treatment compliance.After the comprehensive management of a multidisciplinary team and careful nursing care,the patient was discharged 12 days after operation.During 18-month follow-up,the patient was in good condition.

Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.

Objective:To establish a method for the determination of triclocarban (TCC) and triclosan (TCS) in urine by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) after purification by QuEChERS.Methods:In May 2022, urine samples were extracted by acetonitrile, purified by QuEChERS, separated by Waters Acquity UPLC BEH C18 column (100 mm×2.1 mm, 1.7 μm), and eluated with water-acetonitrile as mobile phase gradient at a flow rate of 0.3 ml/min. The detection was conducted in negative ion mode (ESI -) and multiple reaction monitoring (MRM) scanning, it was quantified with a internal standard method, and the methodology was verified. Results:The linear ranges of TCC and TCS were 0.5-100.0 μg/L and 1.0-100.0 μg/L, and the correlation coefficients were 0.9997 and 0.9991, respectively. The limits of detection and quantitation of TCC and TCS were 0.17 and 0.33 μg/L, and 0.5 and 1.0 μg/L, respectively. The recoveries of TCC and TCS were 100.1%-102.8% and 96.7%-108.6%, and the relative standard deviations were 4.9%-6.7% and 4.1%-8.3%, respectively, at 2.0, 10.0 and 80.0 μg/L.Conclusion:QuEChERS-UPLC-MS/MS method is simple, rapid, sensitive and reproducible, and can be used for rapid and accurate simultaneous detection of TCC and TCS exposure levels in occupational population.

Objective:To establish a method for the determination of two perfluorinated compounds in urine by liquid chromatography-tandem mass spectrometry.Methods:In November 2022, urine samples were extracted by acidic methanol, purified by WAX solid phase extraction column, and eluted with methanol water, then Waters ACQUITY UPLC BEH C18 column (100 mm×2.1 mm, 1.7 μm) was used with 1.0 mmol/L ammonium acetate solution and methanol as mobile phase. The gradient elution was carried out, the detection was carried out by electrospray negative ion multiple response monitoring (MRM) mode, and the quantitative method was internal standard method.Results:Perfluorooctanoic acid and perfluorooctane sulfonic acid had a good linear relationship in the concentration range of 0.5-50.0 μg/L, and the correlation coefficient was >0.999. The limit of detection was 0.017 μg/L, and the limit of quantitation was 0.005 μg/L. The average recoveries were 96.3% and 101.8%, respectively. Days of precision were 3.5%-6.2% and 3.1%-7.4%, respectively, daytime precision were 4.3%-6.8% and 4.7%-8.1%, respectively.Conclusion:The established method of liquid chromatography-tandem mass spectrometry is high sensitivity and accuracy, and is suitable for the determination of perfluorooctanoic acid and perfluorooctane sulfonic acid in human urine.

Objective:To establish a method for the determination of triclocarban (TCC) and triclosan (TCS) in urine by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) after purification by QuEChERS.Methods:In May 2022, urine samples were extracted by acetonitrile, purified by QuEChERS, separated by Waters Acquity UPLC BEH C18 column (100 mm×2.1 mm, 1.7 μm), and eluated with water-acetonitrile as mobile phase gradient at a flow rate of 0.3 ml/min. The detection was conducted in negative ion mode (ESI -) and multiple reaction monitoring (MRM) scanning, it was quantified with a internal standard method, and the methodology was verified. Results:The linear ranges of TCC and TCS were 0.5-100.0 μg/L and 1.0-100.0 μg/L, and the correlation coefficients were 0.9997 and 0.9991, respectively. The limits of detection and quantitation of TCC and TCS were 0.17 and 0.33 μg/L, and 0.5 and 1.0 μg/L, respectively. The recoveries of TCC and TCS were 100.1%-102.8% and 96.7%-108.6%, and the relative standard deviations were 4.9%-6.7% and 4.1%-8.3%, respectively, at 2.0, 10.0 and 80.0 μg/L.Conclusion:QuEChERS-UPLC-MS/MS method is simple, rapid, sensitive and reproducible, and can be used for rapid and accurate simultaneous detection of TCC and TCS exposure levels in occupational population.

Objective:To establish a method for the determination of two perfluorinated compounds in urine by liquid chromatography-tandem mass spectrometry.Methods:In November 2022, urine samples were extracted by acidic methanol, purified by WAX solid phase extraction column, and eluted with methanol water, then Waters ACQUITY UPLC BEH C18 column (100 mm×2.1 mm, 1.7 μm) was used with 1.0 mmol/L ammonium acetate solution and methanol as mobile phase. The gradient elution was carried out, the detection was carried out by electrospray negative ion multiple response monitoring (MRM) mode, and the quantitative method was internal standard method.Results:Perfluorooctanoic acid and perfluorooctane sulfonic acid had a good linear relationship in the concentration range of 0.5-50.0 μg/L, and the correlation coefficient was >0.999. The limit of detection was 0.017 μg/L, and the limit of quantitation was 0.005 μg/L. The average recoveries were 96.3% and 101.8%, respectively. Days of precision were 3.5%-6.2% and 3.1%-7.4%, respectively, daytime precision were 4.3%-6.8% and 4.7%-8.1%, respectively.Conclusion:The established method of liquid chromatography-tandem mass spectrometry is high sensitivity and accuracy, and is suitable for the determination of perfluorooctanoic acid and perfluorooctane sulfonic acid in human urine.

Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.