Synthesis of 13C-labeled parabens from isotopically enriched phenols using the Houben–Hoesch reaction

Parabens are antimicrobial additives found in a wide array of consumer products. However, the halogenated compounds formed from parabens during wastewater disinfection are a potential environmental concern. In order to identify these transformation products and investigate their mechanism of formation, a synthetic route to ethyl parabens labeled with the stable isotope carbon-13 at specific positions within the benzene ring was developed. This efficient two-step procedure starts from commercially available ¹³C-labeled phenols and involves (1) initial acylation of the phenol via a Houben–Hoesch reaction with trichloroacetonitrile followed by (2) a modified haloform reaction of the resulting trichloromethyl ketone to afford the corresponding ¹³C-labeled ethyl parabens in 65%–80% overall yield. The scope of the modified haloform reaction was also investigated, allowing for the synthesis of other parabens derived from primary or secondary alcohols, including ¹³C- and deuterium-labeled esters. In addition, 4-hydroxybenzoic acid can be formed directly from the common trichloromethyl ketone intermediate upon treatment with lithium hydroxide. This protocol complements existing methods for preparing ¹³C-labeled paraben derivatives and offers the specific advantages of exhibiting complete regioselectivity in the Houben–Hoesch reaction (to form the para-disubstituted product) and avoiding the need for protecting groups in the modified haloform reaction that forms the paraben esters.     

盘锦市防水卷材加工行业职业危害现状分析

目的　探讨根本原因分析法联合追踪法对消毒供应中心管理质量及控制医院感染的效果。 方法　抽检2018年10月8日—2019年1月20日我院消毒供应中心灭菌器械500件，统计不良事件发生情况及同期医院感染发生率。用根本原因法分析并找出不良事件发生的原因，落实质量管理，用追踪法追踪改进措施后的消毒灭菌质量情况。再于2019年1月21日—7月30日间抽检灭菌器械500件，统计不良事件发生情况及同时期医院感染发生率。比较分析根本原因分析法联合追踪法管理法（联合管理法）实施前后不良事件发生率及医院感染率。结果　联合管理法实施后无菌包标签日期错误发生率为0.20%，器械清洗不合格发生率为0.40%，外标签与包内器械不相符发生率为0.20%，与联合管理法实施前相比明显下降，且差异均有统计学意义（P均＜0.05）。联合管理法实施后医院感染率为1.20%，低于实施前的6.80%（P＜0.05）。结论　通过运用联合管理法改进消毒供应中心管理措施，可有效降低不良事件发生率，提高医院感染控制效果。     

微酸性次氯酸水用于口腔综合治疗台水路消毒的研究

目的　检测不同浓度微酸性次氯酸水（slightly acidic hypochlorite water，SAHW）应用于口腔综合治疗台水路（dental unit waterlines，DUWLs）的消毒效果。方法    选取32台口腔综合治疗台（dental chair unit，DCU），随机均分为4组（1个对照组和3个实验组，每组8台DCU）。首先，采集高速手机和三用枪基础水样行细菌培养、菌落计数；然后，实验组分别用有效氯含量8 ~ 12 mg/L（实验1组）、18 ~ 22 mg/L（实验2组）、28 ~ 32 mg/L（实验3组）的SAHW供水DUWLs，连续7 d采集高速手机和三用枪水样行细菌培养、菌落计数。第8 d始改用无菌蒸馏水（distilled water，DW）供水DUWLs后采集水样菌落培养计数；对照组用DW替代消毒水，同样程序流动冲洗DUWLs后收集高速手机和三用枪水样菌培养后菌落计数。数据采用SPSS 20.0软件进行统计分析。结果    与基础水样比较，SAHW消毒1 d，3个实验组的高速手机和三用枪水样菌落计数均显著下降（P < 0.05）；SAHW消毒2 d，实验3组高速手机和三用枪水样菌落计数均小于消毒合格水样上限值（100 CFU/mL）；SAHW消毒3 d开始，实验3组菌落计数为0 CFU/mL，实验1组和2组菌落计数均显著小于100 CFU/mL。更换为DW供水后1 ~ 2 d，3个实验组的高速手机和三用枪水样菌落计数维持小于100 CFU/mL，组间差异无统计学意义（P > 0.05）；3 ~ 7 d，3个实验组的高速手机和三用枪水样菌落计数持续增加（149 ~ 1014 CFU/mL），实验1、2、3组的组内不同时间点检测数据比较差异均有统计学意义（均P < 0.05），且均明显大于合格水样上限值（P < 0.05）。结论    高有效氯含量较低有效氯含量的SAHW消毒效果更稳定；低有效氯含量8 ~ 12 mg/L的SAHW持续作用于DUWLs内环境亦可有效控制菌落计数，消毒效果明显。     

Guidelines for standardizing cleansing and disinfection of gastrointestinal endoscopes

As part of the activities toward standardizing endoscopy procedures, the Japan Gastroenterological Endoscopy Society has prepared guidelines for cleansing and disinfection of gastrointestinal endoscopes. The environment of gastrointestinal endoscopy differs between Japan and advanced Western countries. In advanced Western countries, gastrointestinal endoscopy is performed almost exclusively at specialized facilities, where strict provisions are observed for cleansing and disinfecting endoscopes. In Japan, however, gastrointestinal endoscopy is performed even in small clinics, and the annual number of gastrointestinal endoscopy cases is enormous. In addition, the method for cleansing and disinfecting endoscopes differs among hospitals. Although there is a distinct lack of evidence for how gastrointestinal endoscopes are cleaned and disinfected, it is necessary to standardize the method for doing so to advance the field of endoscopic medicine.     

一体化护理管理在消毒供应室中的应用分析

目的探讨在消毒供应室中运用手术器械一体化护理管理的价值。方法将本院外科实施手术治疗的96例患者(2017年3月-2019年7月间)纳入研究,用计算机随机分组:常规组(n=48,手术器械常规管理)、一体化组(n=48,对手术器械实施消毒供应室一体化护理管理),分析总结手术室器械清洗消毒合格状况、主刀医师使用满意度状况、患者感染状况。结果一体化组手术室器械检查中回收、清洗及消毒、包装、灭菌、存储、发放合格率与常规组组间对比更高(P<0.05)。一体化组主刀医生对手术室器械的器械外形、器械性能、器械外观清洁、器械准备齐全满意度评分与常规组组间对比均更高,差异显著(P<0.05)。两组感染发生率无显著差异(P>0.05)。结论在消毒供应室中运用手术器械一体化护理管理可提升清洁消毒质量,提升医生使用满意度,降低患者感染风险。     

37所医院消化内镜超声探头清洗消毒现况调查

目的 了解目前国内消化内镜超声探头的清洗消毒现状及存在的问题。方法 采用问卷调查的方式对全国范围内37所医院的消化内镜超声探头清洗和消毒灭菌情况进行调查。结果 70.27%的医院内镜超声探头数量为1~3条，奥林巴斯品牌最多（72.97%），48.65%的医院内镜中心每日使用探头的患者例数为0~5例；83.78%的医院采用专人清洗消毒内镜超声探头，人员主要以护理员为主（51.35%）；清洗方法以"酶洗-擦洗-擦干"为主（89.19%），清洗时间以>1 min为主（62.16%）；83.78%的医院内镜超声探头消毒方式为化学消毒剂浸泡，其中以邻苯二甲醛（70.27%）和全浸泡消毒（48.65%）为主；消毒时间以≥ 5 min为主（56.76%）；27.03%的医院对内镜超声探头进行灭菌，其中以"一用一灭菌"（21.62%）和过氧乙酸浸泡10 min（10.81%）为主；消毒灭菌后的内镜超声探头主要放置在内镜储存柜（56.76%）；78.38%的医院对当日拟使用的内镜超声探头进行再次消毒；56.76%的医院从未对消毒后的内镜超声探头进行消毒效果监测。结论 37所医院对内镜超声探头清洗和消毒灭菌情况存在一定差异，建议尽快制定内镜超声探头清洗消毒相关国家标准，规范内镜超声探头的清洗消毒流程。     

可见光连续环境消毒系统对手术室消毒前后菌群生物气溶胶浓度的影响

目的探讨可见光连续环境消毒系统(CED)对手术室真菌和细菌气溶胶浓度的影响以及与环境因素的相关性。方法以焦作市第二人民医院5间手术室作为研究对象,分别对CED应用前后手术室内生物气溶胶浓度进行检测,并进行真菌和细菌培养,将检测结果进行比较,并与同期检测的消毒前后的室内温度和湿度相关性进行分析。结果消毒前和消毒后强化消毒模式下手术室内细菌、真菌浓度均较常规消毒模式降低,其次术后消毒完成后强化消毒模式下室内相对湿度相比常规消毒降低,差异均有统计学意义(P<0.05)。消毒过程中手术室的相对湿度标准值为(41.12±4.06)%,温度为(23.41±2.07)℃。经Spearman相关分析显示,消毒后真菌和细菌浓度与相对湿度标准值呈正相关(r=0.109,0.107;P=0.034,0.037),与温度无相关性(P>0.05)。结论常规消毒措施上加用可见光连续环境消毒系统能大大降低手术室的菌群生物气溶胶浓度,同时维持室内相对湿度减少细菌和真菌的繁殖。     

三种消毒剂对体检中心物体表面消毒效果与使用成本的比较研究

目的对3种消毒剂在体检中心物体表面消毒的消毒效果及使用成本进行比较,为体检中心优选合适的物体表面消毒方式提供依据。方法分别使用I型复合双链季铵盐卫生湿巾、500mg/L含氯消毒剂、75%乙醇擦拭消毒健康体检中心采血台、彩超机和乳腺红外线诊断仪的表面,在消毒前、消毒后即刻、消毒后30min及1h分别对各区域进行棉拭子涂抹采样及培养。结果受检物体表面细菌菌落数采血台为(78.4±6.2)cfu/cm2,彩超机为(36.2±2.1)cfu/cm2,乳腺红外线诊断仪为(45.9±3.0)cfu/cm2。3种消毒剂消毒后各时间点采样菌落数与消毒前比较,差异有统计学意义(均P0.01)。I型复合双链季铵盐卫生湿巾消毒效果在消毒后即刻、消毒后30min及1h优于500mg/L含氯消毒剂、75%乙醇(P0.05,P0.01);每次消毒成本I型复合双链季铵盐卫生湿巾最低。结论 3种消毒剂对各监测表面均有良好的消毒效果,但I型复合双链季铵盐卫生湿巾的消毒持续效果优于其他两种,且使用成本低,使用方便、侵蚀性小,适用于体检中心物表消毒。     

空管药物消毒根管对预防根管治疗术复诊间痛的临床观察

目的：通过暂封空管药物来消毒根管，达到预防根管治疗术复诊间痛的发生。方法：选择患急、慢性根尖周炎，牙髓坏死需接受根管治疗的362例患者共376个患牙为受试对象，随机分成实验组180例186个患牙和对照组182例190个患牙。两组均行两次法完成根管治疗术。实验组暂封空管药物，对照组暂封FC。比较两组患牙在根管治疗期间发生疼痛的比率。结果：暂封空管药物组发生疼痛的患牙为21个（11.29%），对照组发生疼痛的患牙为41个（21.58%），经统计学检验，两组有显著差异（P＜0.01）。结论：暂封空管药物可以有效预防根管治疗术复诊间痛的发生。     

Effect of Disinfection Treatments on the Hardness of Soft Denture Liner Materials

PURPOSE: To evaluate the effects of disinfection treatments with chemical solutions (2% glutaraldehyde, 5% sodium hypochlorite, and 5% chlorhexidine) and microwave energy on the hardness of four long-term soft denture liners. MATERIALS AND METHODS: Forty rectangular specimens of four soft lining materials (Molloplast-B, Ufi Gel P, Eversoft, and Mucopren soft) were made for each material. Ten samples of each material were immersed in different disinfectant solutions for 10 minutes or placed in a microwave oven for 3 minutes at 500 W. The hardness values were obtained with a Shore A durometer, before the first disinfection cycle (control), and also after two cycles of disinfection. Data were submitted to analysis of variance and Tukey's test (p < 0.01). RESULTS: The highest value of hardness was obtained for Molloplast-B, independent of the disinfection technique. Mucopren soft demonstrated intermediate values and Ufi Gel P and Eversoft the lowest values of Shore A hardness. For Molloplast-B, the disinfection using glutaraldehyde demonstrated the highest value of hardness. The number of disinfections had no effect on the hardness values for all the materials studied and disinfection techniques. CONCLUSIONS: The application of two disinfection cycles did not change the Shore A hardness values for all the materials. The glutaraldehyde solution demonstrated the highest values of Shore A hardness for the Molloplast-B, Mucopren soft, and Ufi Gel P materials, while Eversoft did not present any differences in hardness when submitted to different disinfection treatments.