口内反光镜专用清洗篮筐的制作及应用

目的 针对口内反光镜清洗消毒存在的不足,自行研发口内反光镜专用清洗篮筐,探讨其应用后的清洗消毒效果。方法 选取全新大号口内反光镜480件,随机分成2组,每组各240件,临床上依次使用后统一送消毒供应中心进行机械热力清洗消毒,实验组采用自制的口内反光镜专用清洗篮筐装载清洗消毒,对照组采用普通清洗篮筐装载清洗消毒,比较两组目测清洗合格率、三磷酸腺苷生物荧光阳性率、划痕率、装载量等指标。结果 实验组目测清洗合格率为97.91%,对照组为80.41%,两组比较,差异有统计学意义（χ ²=38.045,P<0.001）。实验组三磷酸腺苷生物荧光测试阳性率为0.84%,对照组为18.75%,两组比较,差异有统计学意义（χ ²=43.611,P<0.001）。第1次清洗消毒后,实验组划痕率为0.42%,对照组为15.00%,两组比较,差异有统计学意义（χ ²=35.813,P<0.001）。第2次清洗消毒后,实验组划痕率仍为0.42%,对照组为26.67%,两组比较,差异有统计学意义（χ ²=70.625,P<0.001）。实验组一次最多可装载120件口内反光镜,对照组一次只能装载9件口内反光镜。结论 在机械热力清洗消毒口内反光镜时采用口内反光镜专用清洗装载篮筐,可以明显提高清洗消毒质量及装载量,同时有效减少划痕。     

5种灭菌器对牙科手机性能的影响

目的 了解5种灭菌器对牙科手机机械性能的影响情况。方法 用5种灭菌器分别对4把牙科手机进行灭菌200次，每完成10次灭菌全过程检测一遍牙科手机的夹持力和转速。结果 经200次灭菌后20支牙科手机中，1支停转，另有8支转速下降，低于30万转／分钟，但高于16万转／分钟．可满足基本使用要求。灭菌时间最短的灭菌器只明显影响一支牙科手机的转速，其他灭菌器均明显影响两支牙科手机的转速。结论 灭菌时间短对牙科手机机械性能影响小，灭菌前应做好牙科手机的清洁和润滑，以减少机械性能损耗。     

Denture disinfection by microwave irradiation: A randomized clinical study

Objective

This study evaluated the clinical effectiveness of two exposure times of microwave irradiation on the disinfection of complete dentures.

Methods

Biofilm samples were collected from dentures of 30 patients, who were randomly divided into two experimental groups of 15 subjects each: Group 1—patients had their maxillary denture microwaved for 3 min (650 W); Group 2—patients had their maxillary denture microwaved for 2 min (650 W). Denture biofilm samples were taken with swabs, before (left side surfaces) and after (right side surfaces) microwave irradiation. All microbial material was plated on selective media for Candida spp., Staphylococcus spp., mutans streptococci and a non-selective media. After incubation (48 h/37 °C), the number of colony-forming units (cfu/mL) was counted. Microorganisms which grew on selective media were identified using biochemical methods. The data were statistically analyzed by Kruskal–Wallis test, followed by Dunn's post-test (α = 0.05).

Results

Microwave irradiation for 3 min (Group 1) resulted in sterilization of all dentures evaluated. After microwave irradiation for 2 min (Group 2), a significant decrease in Candida spp. (P = 0.0062), Staphylococcus spp. (P = 0.0178), mutans streptococci (P = 0.0047) and non-identified species (P < 0.0001) was achieved in comparison with the cfu/mL obtained before irradiation. The colonies grown after 2 min of microwave irradiation were identified as Candida albicans, non-aureus Staphylococci and Streptococcus mutans.

Conclusion

Microwave irradiation for 3 min may be a potential treatment to prevent cross-contamination.     

全院消毒灭菌物品一体化管理的探讨

目的探讨将全院消毒灭菌物品集中处理的管理措施，以降低管理成本，使全院设备物资资源达到共享。方法我院中心供应室自2002年12月起，应用先进的网络技术，对全院所有消毒灭菌物品进行集中处理，同时进行细致准确的成本核算，并与各科分散的处理进行比较。结果供应室经一体化管理后，消毒灭菌物品的质量及成本效益均取得明显成效。结论实施一体化的管理不仅加强了各环节的工作质量，更充分发挥了中心供应室的职能，有利于提高医院的管理效益。     

两种消毒液对口腔印模的消毒效果及尺寸稳定性影响的研究

目的探讨两种消毒液对口腔科印模灭菌的效果及尺寸稳定性的影响。方法分别采用2%戊二醛消毒液和含氯消毒液对实验室污染了细菌悬液的不可逆水胶体印模和硅橡胶印模试件进行浸泡消毒处理,蒸馏水浸泡作为阳性对照,每组12个样本。对处理后的口腔印模进行消毒效果检测。采用上述两种消毒液对不可逆水胶体印模和硅橡胶印模进行浸泡消毒处理,印模不浸泡作为对照,灌制超硬石膏模型,测量模型的尺寸稳定性,每组8个样本。结果2%戊二醛消毒液和含氯消毒液浸泡消毒20min,对不可逆性水胶体印模及硅橡胶印模均可起到有效的灭菌作用。与对照组相比,2%戊二醛消毒液浸泡消毒20min对不可逆性水胶体印模和硅橡胶印模的尺寸稳定性均无显著影响(P>0.05),而含氯消毒液浸泡消毒20min对不可逆性水胶体印模的左上中切牙-左上尖牙(B1-B3)宽度及B3颈部唇舌径均有影响(P<0.01),对硅橡胶印模的B1-B3宽度有影响(P<0.01),对B3颈部唇舌径无显著影响(P>0.05)。结论2%戊二醛消毒液浸泡消毒20min可用于临床口腔印模的消毒处理。     

牙科手机消毒灭菌效果评价及损耗研究

目的 探讨清洗、消毒、灭菌环节对清除牙科手机外表面和内腔细菌、乙肝表面抗原(hepatitis B surface antigen,HBsAg)的效果,及对其损耗的影响.方法 随机抽取手机40支,分别在其使用后的清洗前、清洗后、消毒后和灭菌后,检测其外表面和内腔细菌、HBsAg;调查其使用第1、2、3个月后的损耗情况.结果 手机使用后外表面和内腔均有细菌检出;清洗、消毒均不能完全清除外表面和内腔细菌,两者检出率差异均有统计学意义(均有P＜0.05);灭菌能完全清除外表面和内腔细菌,差异无统计学意义(x2=0.48,P=0.489).使用后手机表面和内腔HBsAg检出率达1 1.8％;清洗、消毒均不能完全清除外表面和内腔HBsAg,两者检出率差异均有统计学意义(均有P＜0.05);灭菌能完全清除外表面和内腔HBsAg.3个月中,每支手机均使用了90支次,第2个月有2支次手机维修,第3个月有1支次手机更换部件.结论 当前处理流程能给牙科手机有效灭菌但造成损耗,建议在清洗、消毒、灭菌时间等环节加以优化.     

输卵管绝育术后再次妊娠2例并文献复习

输卵管绝育术是国际上常用的女性长效避孕手段之一,主要包括输卵管切除术、输卵管阻塞术和输卵管结扎术,这些术式各有特点,可以不同地在腹腔镜手术、宫腔镜手术或者开腹手术中实现。其中输卵管切除术具有输卵管重塑不可逆性,因而避孕效果显著;而输卵管阻塞术和输卵管结扎术两种术式虽然具有输卵管重塑的可逆性,但是存在一定的避孕失败率,其原因目前并不完全清楚,但具有多方面性。现回顾本院2例输卵管绝育术后再次妊娠的病例,并对输卵管绝育术进行简要文献复习,以期引起妇产科医生的重视,准确处置。     

Autoclave sterilization of dental handpieces: A literature review

PurposeThe present review aimed to investigate autoclave sterilization of dental handpieces based on available studies.Study selectionThe sterilizing efficiency of dental handpieces with autoclave is mainly affected by the types of apparatus (N, B, and S), the packaging with sterilizing pouch, cleaning, and lubrication. These subjects were reviewed based on the in vitro experimental studies.ResultsDental handpieces can be sterilized, including inactivation of heat-resistant bacterial spores, with type B or type S sterilizers, regardless of the use of a sterilization pouch. In contrast, although type N autoclaves are capable of sterilization of general bacteria such as Streptococcus salivarius even in a sterilization pouch if instruments are washed beforehand, complete sterilization of the wrapped handpiece is not always achieved. Therefore, to achieve sterilization efficiency with type N autoclaves, processing without any packaging is recommended. As regards cleaning of handpiece, although contamination decreases with irrigation and wiping of handpieces, all reports concluded that these treatments alone do not achieve complete decontamination of reusable handpieces.ConclusionAlthough type B and type S autoclaves allow us to sterilize the dental handpieces, it is important to realize that complete sterilization of the handpiece is not always achieved by type N autoclave. Understanding autoclave processing of handpieces is essential for dental practice to deliver the safe dental care.     

Toward electron-beam sterilization of a pre-assembled Boston keratoprosthesis

PurposeTo evaluate the effects of electron-beam (E-beam) irradiation on the human cornea and the potential for E-beam sterilization of Boston keratoprosthesis (BK) devices when pre-assembled with a donor cornea prior to sterilization.MethodsHuman donor corneas and corneas pre-assembled in BK devices were immersed in recombinant human serum albumin (rHSA) media and E-beam irradiated at 25 kGy. Mechanical (tensile strength and modulus, and compression modulus), chemical, optical, structural, and degradation properties of the corneal tissue after irradiation and after 6 months of preservation were evaluated.ResultsThe mechanical evaluation showed that E-beam irradiation enhanced the tensile and compression moduli of human donor corneas, with no impact on their tensile strength. By chemical and mechanical analysis, E-beam irradiation caused a minor degree of crosslinking between collagen fibrils. No ultrastructural changes due to E-beam irradiation were observed. E-beam irradiation slightly increased the stability of the cornea against collagenase-induced degradation and had no impact on glucose diffusion. The optical evaluation showed transparency of the cornea was maintained. E-beam irradiated corneal tissues and BK-cornea pre-assembled devices were stable for 6 months after room-temperature preservation.ConclusionsE-beam irradiation generated no detrimental effects on the corneal tissues or BK-cornea pre-assembled devices and improved native properties of the corneal tissue, enabling prolonged preservation at room temperature. The pre-assembly of BK in a donor cornea, followed by E-beam irradiation, offers the potential for an off-the-shelf, ready to implant keratoprosthesis device.