The value of toxicological analysis in acute poisoning patients with uncertain exposure histories:a retrospective and descriptive study from an institute of poisoning

BACKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison exposure.The aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis perspective.METHODS:This was a retrospective and descriptive study from an institute of poisoning.Patient registration information and test reports spanning the period from April 1,2020 to March 31,2022,were obtained.Patients with uncertain exposure histories and who underwent toxicological analysis were included.Clinical manifestations and categories of toxics were analyzed.RESULTS:Among the 195 patients with positive toxicological analysis results,the main causes of uncertain exposure history was disturbance of consciousness(62.6%),unawareness(23.6%)and unwillingness or lack of cooperation(13.8%).The predominant clinical manifestations were disturbed consciousness(62.6%),followed by vomiting and nausea(14.4%)and liver function abnormalities(8.7%).A comparison of clinical manifestations between patients with positive and negative(n=99)toxicological analyses results revealed significantly different proportions of disturbances in consciousness(63%vs.21%),dizziness(1.5%vs.5.1%),multi-organ failure(1.5%vs.7.1%),and local pain(0 vs 4%).The main categories of substances involved were psychiatric medications(23.1%),sedatives(20.5%),insecticides(13.8%),and herbicides(12.8%).CONCLUSION:The clinical manifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific,and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.

ANALYSIS OF STRYCHNINE ALKALOIDS IN BIOLOGICAL SAMPLES BY THIN-LAYER CHROMATOGRAPHIC DENSITOMETRY AND DISTRIBUTION STUDY OF STRYCHNINE IN INTOXICATED RATS

A sensitive and rapid analytical procedure was established to detrmine strychnie alkaloids in diverse biological specimens. Samples were treated with hydrochloric acid to precipitate protein and scanned in thin-layer chromatograpic scanner in zig-zag dual-wavelength reflection mode.Detection sensitivity for strychniue was about 0. 05 μg. Quantification recoveries were between89. 2% and 99. 5% with RSD between 2. 92% and 13. 21 %. The method was applied to investigate thedistribution or strychnine in intoxicated rats. The results showed that there were remarkable difference in organs or tissues with the aigaest concentration 4. 56±1. 41μg/g in liver. Diversification experiment proves the method also could be used to analyze other alkaloids in biological samples if theconditions slightly modified.

Rapid Screening of Nine Illicit Drugs in Human Blood and Urine by Direct Analysis in Real‑Time Mass Spectrometry

We aimed to establish for the rapid detection of morphine,O6‑monoacetylmorphine,heroin,codeine,cocaine,methamphetamine,ketamine,methadone,and dolantin in human blood and urine by direct analysis in real‑time coupled with tandem mass spectrometry(DART‑MS/MS).These samples were extracted by acetonitrile‑methanol(V/V=4:1),using DART 12 Dip‑it automatic sampling system.They were injected at 400℃,and analyzed by positive ion and multiple reaction monitoring mode.The detection limits of morphine,O6‑Monoacetylmorphine,heroin,codeine,cocaine,methamphetamine,ketamine,methadone,and dolantin were 100,50,50,100,20,20,10,1,and 0.01 ng/mL,respectively.The practical cases contained methamphetamine,codeine,cocaine,and O6‑monoacetylmorphine were detected accurately and rapidly.The method has the advantages of high sensitivity and good accuracy.The sample processing is simple and can be analyzed in a short time.This method is suitable for the analysis of morphine,O6‑monoacetylmorphine,heroin,codeine,cocaine,methamphetamine,ketamine,methadone,and dolantin in some practical cases.

Molecularly imprinted polymers for highly sensitive detection of morphine using surface plasmon resonance spectroscopy

Molecular imprinting technology is applied in surface plasmon resonance spectroscopy for highly sensitive and selective detection of morphine（MO）.As SPR-based sensor of MO,the preparation of molecular imprinted polymer is as follows： methacryhc acids（MAA）,ethylene glycol dimethacrylate（EGDMA）,azodiisobutyronitrile（AIBN） were used as functional monomer,cross-linker and initiator,respectively.The experiment results showed that morphine imprinted polymer had the performance of high sensitivity and specificity,i.e.the relative signal of SPR response was proportional to the concentration of morphine in acetonitrile in the range of 10^（-9）mol/L to 10^（-6）mol/L（1 ppb-1 ppm） with LOD of 10^（-10）mol/L,and MO was distinguished from its analogs,such as codeine.

Advances in Toxins and Narcotics Determination Techniques in China During 2013

Recently,toxin and narcotics detection techniques have been developed in China.A number of new technologies have been applied.The pretreatment technologies such as solid‑phase extraction(SPE)techniques,solid‑phase microextraction(SPME)techniques,hollow‑fiber liquid‑phase microextraction(HF‑LPME)techniques,etc.,have matured,and thus have greatly improved both the accuracy and efficiency of the analysis of toxins and narcotics as well as the technical system of analysis.Based on analyses conducted using the traditional methods of gas chromatography(GC)as well as other conventional methods,various new methods of analysis have been gradually discovered and developed.For instance,ultra‑performance liquid chromatography(UPLC)‑mass spectrometry(MS)and other combination technologies have enriched the variety of detection methods that are available to researchers.These highly precise methods are developed on the basis of and as extensions of traditional applications and still draw the attention of researchers from a variety of disciplines.

Comparison of the Concentrations of Lidocaine in Different Body Fluids/Tissues after Subarachnoid Space and Intravenous Administration of a Lethal Dose of Lidocaine

The objective of the study was to compare the concentration of lidocaine in different body fluids/tissues after subarachnoid space and intravenous administrations of a lethal dose of lidocaine.Totally 18 dogs were used in the experiment.Six dogs were given subarachnoid anesthesia,another were given an intravenous injection of a dose of 75 mg/kg weight of lidocaine hydrochloride in 5 min and the last 6 dogs were used as the blank control dogs and given a subarachnoid space injection or a femoral artery injection of the same volume of sodium chloride.As soon as its vital signs disappeared,each dog was dissected and the specimen,such as brain,cerebrospinal fluid(CSF)in lateral ventricle,CSF in subarachnoid space,spinal cord(cervical spinal cord,thoracic spinal cord,lumbar spinal cord,and waist spinal cord),heart,lung,liver,spleen,kidney,bile,urine,heart blood,peripheral blood,muscle in injection location,and muscle in no injection location,were collected for analysis of lidocaine immediately.Analysis was performed with gas chromatography‑mass spectrometry(GC‑MS).From the maximum to the minimum,the order of lidocaine concentration detected in the subarachnoid space‑administered dogs was as follows:CSF in subarachnoid space,waist spinal cord,thoracic spinal cord,CSF in lateral ventricle,lumbar spinal cord,cervical spinal cord,lung,kidney,muscle in injection location,heart,brain,spleen,heart blood,liver,peripheral blood,bile,muscle in no injection location,and urine.The order of lidocaine concentration detected in the intravenously administered dogs was as followed:Kidney,heart,lung,spleen,brain,liver,peripheral blood,bile,heart blood,cervical spinal cord,thoracic spinal cord,muscle in injection location,lumbar spinal cord,muscle in no injection location,CSF in subarachnoid space,urine,and CSF in lateral ventricle.The maximum concentration of lidocaine was detected in the subarachnoid space CSF of subarachnoid space‑administered dead dogs,while in intravenously injected dead dogs,the maximum concentration of lidocaine was detected in the kidney.Our study provides some useful data for the forensic identification of epidural anesthesia accidents to decide the way the lidocaine enters the body.

Determination of Periplocymarin in Human Blood and Urine by High-Performance Liquid Chromatography-Mass Spectrometry

A simple,rapid and sensitive liquid chromatography with tandem mass spectrometry method for the determination of periplocymarin in human blood and urine was developed.The digoxin‑d3 was used as an internal standard.Periplocymarin and digoxin‑d3(IS)were processed with ethyl acetate by liquid–liquid extraction.The chromatographic separation was performed on a Shim‑pack XR‑ODSIII C18 column with a 7 min gradient elution using methanol‑ammonium formate(5 mmol/L)as mobile phase at a flow rate of 0.3 mL/min(65:35,v/v).The detection was performed on a triple quadrupole tandem mass spectrometer using positive‑ion mode electrospray ionization in selected reaction monitoring mode.The periplocymarin was well separated from the internal standard.Two calibration curves were linear within the concentration range 0.01–1µg/mL.The limit of detection and quantification of blood and urine samples were both estimated at 0.005 and 0.01µg/mL.The interday and intraday precisions,accuracy,and recovery were assessed to verify this method.The results showed that the method was suitable for the determination of periplocymarin in forensic toxicological analysis and clinical diagnosis.

Determination of Chlorpyrifos in Human Blood by Gas Chromatography-Mass Spectrometry

Gas chromatography-mass spectrometry method was developed for the qualitative and quantitative analyses of chlorpyrifos in human blood samples.The chlorpyrifos and parathion(internal standard)in human blood were extracted with a mixed solvent of hexane and acetonitrile.Chlorpyrifos was well separated from the internal standard.The linear range of chlorpyrifos was 0.01-2 μg/ml in blood.The limit of detection and limit of quantification were estimated at 0.002 and 0.01μg/ml,respectively.The inter-and intra-day precisions,accuracy,and recovery were assessed to verify this method.The results showed that the developed method is rapid,sensitive,and reliable.It is suitable for the determination of chlorpyrifos in forensic toxicological analysis and clinical diagnosis.