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.

Homogeneous management of multi-campus medical care is an effective way to promote the expansion of high-quality medical resources, improve medical quality, and ensure medical safety. The Second Affiliated Hospital Zhejiang University School of Medicine actively explored an integrated and high-quality management mode to effectively improve medical service capacity, ensure medical technology and quality, and enhance hospital influence and social benefits from three dimensions: unified establishment, implementation of core elements, and unified quality and safety evaluation and monitoring. These practices had achieved good results and could provide reference for the multi-campus construction of other large public hospitals.

Objective:To establish a method for the rapid determination of the three metabolites of xylene, 2-methylmarmaluronic acid, 3-methylmarmaluronic acid and 4-methylmarmaluronic acid, in urine of occupationally exposed workers by ultra-performance liquid chromatography-high resolution mass spectrometry (UPLC-HRMS) .Methods:In July 2022, urine samples were diluted and extracted with pH=6.86 phosphate cache solution, cleaned up by a MAX solid-phase extraction (SPE) column and separated by an Accucore Ph/Hexyl column (100 mm×2.1 mm, 2.6 μm) with a gradient of 5 mmol/L ammonium formate-0.1% formic acid aqueous solution and methanol as mobile phases. The analysis was carried out in electrospray ionization mode and full mass-data dependent secondary mass spectrometry mode, and quantified by external standard method. The characteristics of each index of this method were analyzed.Results:A good linearity was obtained in the concentration range of 1.0-200.0 μg/L for 2-methylmuramic acid, 3-methylmuramic acid and 4-methylmuramic acid with the correlation coefficients of 0.9979-0.9993. The limits of detection of the method were 0.18-0.24 μg/L. While the spiked recoveries at the three concentrations (1.0 μg/L, 100.0 μg/L, and 180.0 μg/L) were in the range of 83.0%-93.7%, with the relative standard deviations of 2.2%-7.9%.Conclusion:The UPLC-HRMS method is simple, rapid, sensitive and accurate, and is suitable for the simultaneous determination of the three metabolites of xylene in the urine of occupationally exposed workers.

Objective:To establish a method for the rapid determination of the three metabolites of xylene, 2-methylmarmaluronic acid, 3-methylmarmaluronic acid and 4-methylmarmaluronic acid, in urine of occupationally exposed workers by ultra-performance liquid chromatography-high resolution mass spectrometry (UPLC-HRMS) .Methods:In July 2022, urine samples were diluted and extracted with pH=6.86 phosphate cache solution, cleaned up by a MAX solid-phase extraction (SPE) column and separated by an Accucore Ph/Hexyl column (100 mm×2.1 mm, 2.6 μm) with a gradient of 5 mmol/L ammonium formate-0.1% formic acid aqueous solution and methanol as mobile phases. The analysis was carried out in electrospray ionization mode and full mass-data dependent secondary mass spectrometry mode, and quantified by external standard method. The characteristics of each index of this method were analyzed.Results:A good linearity was obtained in the concentration range of 1.0-200.0 μg/L for 2-methylmuramic acid, 3-methylmuramic acid and 4-methylmuramic acid with the correlation coefficients of 0.9979-0.9993. The limits of detection of the method were 0.18-0.24 μg/L. While the spiked recoveries at the three concentrations (1.0 μg/L, 100.0 μg/L, and 180.0 μg/L) were in the range of 83.0%-93.7%, with the relative standard deviations of 2.2%-7.9%.Conclusion:The UPLC-HRMS method is simple, rapid, sensitive and accurate, and is suitable for the simultaneous determination of the three metabolites of xylene in the urine of occupationally exposed workers.

Objective:To explore the curative effect of the "domino" sequential method with prosthesis preservation in the treatment of infection around the prosthesis after limb salvage surgery for bone tumors.Methods:A retrospective analysis of 11 patients with peripheral prosthetic infections after limb salvage surgery with prosthesis preserving "domino" from January 2016 to January 2020 was retrospectively analyzed, including 8 males and 3 females; age 21-74 years old, with an average of 51.8 years old. There were 6 cases of knee prosthesis for distal femoral tumor, 2 cases of proximal tibia knee prosthesis, 2 cases of pelvic prosthesis infection, and 1 case of middle femoral prosthesis. Before the operation, 8 cases had fever, and 2 cases had sinus. Sequential treatment failure is defined as: recurrence of infection. The treatment method is the debridement and lavage of the prosthesis and the systemic combined local application of drug-sensitive antibiotics to evaluate the patient's blood routine, C-reflective protein, erythrocyte sedimentation rate and other indicators, X-ray and CT of the surgical site, and the Musculoskeletal Tumor Society (MSTS) score.Results:The positive rate of microorganism culture was 72.7% (8/11), including 2 cases of Staphylococcus aureus, 1 case of Staphylococcus epidermidis, 1 case of methicillin-resistant Staphylococcus epidermidis, 1 case of methicillin-resistant Staphylococcus aureus, abalone There were 2 cases of Acinetobacter mannifolia and 1 case of Streptococcus degalactiae. The MSTS score before treatment and at the last follow-up after treatment increased from 10.91±2.31 points to 20.73±3.52 points, the difference was statistically significant ( t=7.162, P<0.05). A total of 3 cases of sequential treatment failed to control infection, and the operation success rate was 72.7% (8/11). One case was amputation, one case was long-term replacement of wound dressing, and one case was switched to antibiotic bone cement combined with intramedullary nail reverse double insertion technique to control infection. Conclusion:For bone tumors with clinical infection symptoms less than one month after limb salvage surgery, the use of prosthesis-preserving "domino" sequential method for treatment of prosthetic infections is desirable for early and mid-term clinical efficacy.

The process of ambulatory surgery in China is faced with such challenges as the conflict between convention medical record writing requirements and time sensitiveness of ambulatory surgery, difficulty to fully take care of key points of ambulatory surgery and sufficient doctor-patient communication, difficulty to adapt to medical insurance requirements and absence of medical record writing norms for special circumstances. In this consideration, the practices of Zhejiang province were cited for a discussion on related issues, for reference of medical institutions in their standardization of ambulatory surgery.

Objective To observe the contents of homocysteine (Hcy),C-reactive protein (hsCRP) and D-dimer(DD) in patients with cerebral infarction and the effects of hyperbaric oxygen (HBO) on them.Methods One hundred and twenty cases of cerebral infarction were voluntarily divided into 2 groups,the control group and the therapy group,each consisting of 60 cases.The patients of the control group received drug treatment,while the therapy group received HBO treatment in addition to routine drug treatment.The levels of Hcy,hsCRP and DD in the patients of the 2 groups were measured both before and after therapy,and changes in neurological functional defect (NFD) were also evaluated both before and after treatment.Results For both groups,the levels of Hcy,hsCRP and DD before therapy were higher than the normal reference value,and they all significantly decreased following therapy (P ＜ 0.01).When compared with those of the control group,the levels of Hcy,hsCRP and DD all decreased significantly (P ＜ 0.05 or P ＜ 0.01).The NFD in the patients of both group were decreased after therapy(P ＜ 0.01),with the NFD decreased more significantly in the patients of the therapy group (P ＜ 0.01).Conclusions HBO therapy could obviously reduced the levels of Hcy,hsCRP and DD in patients with cerebral infarction,which might be beneficial to the recovery of patients with cerebral infarction.

Objective To observe the contents of homocysteine (Hcy),C-reactive protein (hsCRP) and D-dimer(DD) in patients with cerebral infarction and the effects of hyperbaric oxygen (HBO) on them.Methods One hundred and twenty cases of cerebral infarction were voluntarily divided into 2 groups,the control group and the therapy group,each consisting of 60 cases.The patients of the control group received drug treatment,while the therapy group received HBO treatment in addition to routine drug treatment.The levels of Hcy,hsCRP and DD in the patients of the 2 groups were measured both before and after therapy,and changes in neurological functional defect (NFD) were also evaluated both before and after treatment.Results For both groups,the levels of Hcy,hsCRP and DD before therapy were higher than the normal reference value,and they all significantly decreased following therapy (P ＜ 0.01).When compared with those of the control group,the levels of Hcy,hsCRP and DD all decreased significantly (P ＜ 0.05 or P ＜ 0.01).The NFD in the patients of both group were decreased after therapy(P ＜ 0.01),with the NFD decreased more significantly in the patients of the therapy group (P ＜ 0.01).Conclusions HBO therapy could obviously reduced the levels of Hcy,hsCRP and DD in patients with cerebral infarction,which might be beneficial to the recovery of patients with cerebral infarction.

The paper described the specific measures and results of postoperative complications reporting system, including reporting coverage, methods, deadline, data management, supervision and feedback. In addition, it introduced results of the practice and the positive impact on quality of care and safety management. Based on these, the authors proposed further improvements of the system for the purposes of constant improvement of care and higher medical safety.